A monkeypox (MPX) outbreak has expanded worldwide since May 2022. We tested 147 clinical samples collected at different time points from 12 patients by real-time PCR. MPX DNA was detected in saliva from all cases, sometimes with high viral loads. Other samples were frequently positive: rectal swab (11/12 cases), nasopharyngeal swab (10/12 cases), semen (7/9 cases), urine (9/12 cases) and faeces (8/12 cases). These results improve knowledge on virus shedding and the possible role of bodily fluids in disease transmission.
Background Since May 2022, a new outbreak of monkeypox has been reported in several countries, including Spain. The clinical and epidemiological characteristics of the cases in this outbreak may differ from those in earlier reports. Objectives To document the clinical and epidemiological characteristics of cases of monkeypox in the current outbreak. Methods We conducted a prospective cross‐sectional study in multiple medical facilities in Spain to describe the cases of monkeypox in the 2022 outbreak. Results In total, 185 patients were included. Most cases started with primarily localized homogeneous papules, not pustules, in the probable area of inoculation, which could be cutaneous or mucous, including single lesions. Generalized small pustules appeared later in some of them. Heterogeneous lesions occurred during this generalized phase. All patients had systemic symptoms. Less common lesions included mucosal ulcers (including pharyngeal ulcers and proctitis) and monkeypox whitlows. Four patients were hospitalized, none died. Smallpox vaccination and well‐controlled HIV disease were not associated with markers of severity. Contact during sex is the most likely mechanism of transmission. In this outbreak, cases have been described in men who have sex with men and are strongly associated with high‐risk sexual behaviours. Seventy‐six per cent of the patients had other sexually transmitted diseases upon screening. Conclusions The clinical findings in this outbreak differ from previous findings and highly suggest contact transmission and initiation at the entry site. The characterization of the epidemiology of this outbreak has implications for control. What is already known about this topic? Monkeypox eruption is described as consisting of pustules. The roles of HIV and previous smallpox vaccination in the prognosis are unknown. The transmission route was initially described as respiratory droplets and was later suggested to be via sexual contact. What does this study add? Initial lesions at the probable inoculation area were homogeneous and papular (pseudopustules). Generalized small pustules appeared later in some of them. Heterogeneous lesions occurred during this generalized phase. All patients had systemic symptoms. Less common signs included mucosal ulcers (including pharyngeal ulcers and proctitis) and monkeypox whitlows. Well‐controlled HIV and previous smallpox vaccination were not associated with severity. No patient died. The data support the hypothesis of transmission via contact during sex. Although this might change, the outbreak is currently limited mostly to men who have sex with men, with high‐risk factors for sexually transmitted diseases.
Some symmetrical Ar3C and unsymmetrical (C6C15)3-xAr,C radicals with different chlorine substitution patterns (x = 1, 2; Ar: 2H-C6HC14, 3H,5H-C6H2C14, 4H-C6HC14, C6H5) are prepared. X-ray crystal structures for most of them have been obtained at room temperature. The general conformations are conditioned by the great volume of the chlorine atoms in the ortho positions resulting in unsymmetrical, propellerlike conformations. Experimental evidence of the steric shielding of the trivalent carbon atom, as well as the practical nonexistence of the so-called buttressing effect, is given. The steric shielding is in correlation with the observed stabilities. The magnetic susceptibilities of the radicals are discussed and related to molecular packing and spin densities in terms of McConnell's theory, when antiferromagnetism is observed. The g-factors, hyperfine coupling constants (hcc) of IH and I3C nuclei, and line widths of the radicals are determined at several temperatures by ESR experiments in solid-state and isotropic solutions. Different conformational dynamic behaviors are traced to the number of chlorine atoms in ortho positions. Temperature-dependent line widths are explained by the relative contribution of the modulation of the dipolar hyperfine interaction through molecular tumbling and chlorine nuclear quadrupolar relaxation mechanism. The hcc values have been calculated according to the INDO method with the experimental X-ray geometries and compared with the experimental values; a g o d agreement is obtained. The assignment of the I3C satellites to bridgehead and ortho positions is confirmed IntroductionIn the course of our studies on derivatives of perchlorotri-
Background: In the context of the COVID-19 pandemic the risk of misdiagnosis of other causes of respiratory infection is likely. In this work we aim to describe the clinical characteristics, treatment and outcome of pneumococcal infection in COVID-19 patients. Patients and methods: Every COVID-19 patient presenting with concomitant pneumococcal pneumonia during March 2020 in a tertiary teaching Hospital In Barcelona, Spain. Results: Five patients with PCR confirmed COVID19 or clinical and radiological suspicion were diagnosed of pneumococcal infection. In all cases chest X-ray were abnormal, with unilateral or bilateral infiltrates. Procalcitonin showed to be not sensitive enough to detect pneumococcal infection. Antibiotherapy was promptly started in all five cases with subsequent satisfactory evolution. Conclusion: International guidelines do not include the universal screening for bacterial co-infection. Radiological pattern of COVID-19 can be indistinguishable from that of pneumococcus pneumonia and frequency of co-infection is not well stablished, therefore clinicians should be aware of the possible SARS-CoV-2-pneumococcus association to avoid misdiagnosis and delay antibiotic therapy.
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