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The resurgence of Mpox, predominantly among men who have sex with men (MSM), has prompted an analysis of its clinical manifestations and epidemiological patterns, particularly in individuals living with human immunodeficiency virus (HIV). This retrospective study aims to delineate and compare the clinical presentations and epidemiological characteristics of Mpox among HIV-positive and HIV-negative individuals. A total of 58 confirmed Mpox cases from a dermatology department in Lisbon were analyzed, focusing on mucocutaneous manifestations, systemic symptoms, and laboratory parameters. Our findings indicate no significant difference in disease severity and presentation between HIV-positive and HIV-negative groups, suggesting that HIV status may not be a determinant of Mpox severity, but rather an indicator of increased sexual risk behaviors, a recognized risk factor for Mpox transmission.

Competing Interests: Conflicts of interest None disclosed.

Competing Interests: Conflicts of interest the authors declare they have no conflicts of interest.

A monkeypox outbreak has been reported in several countries since early May 2022. Human monkeypox (MPX) diagnosis is based on a clinical suspicion supported by typical skin and mucosal lesions, confirmed with molecular testing. We present the results of all MPX confirmed patients presenting to our department until July 15 of 2022, describing the characteristics of the lesions at diagnosis. In total, 47 patients were included, all men and 44.7% ( n = 21) were HIV-positive. Skin lesions were noted in all patients. The most commonly affected area was the genital region (63.8%), followed by the anorectal region (46.8%). Extra anogenital mucosal (oral or conjunctival mucosa) involvement was reported in three patients. Typical skin findings included erythematous papules, whitish, umbilicated papules, some with a necrotic center and an elevated whitish border. Most patients had lesions in multiple phases presenting simultaneously. Correct identification of MPX skin and mucosal lesions is crucial to avoid late diagnosis and prevent further spreading, ensuring less worldwide morbidity.

Human monkeypox (MPX) is a zoonotic endemic disease in regions of Africa caused by the monkeypox virus, with a recent outbreak in several non-African countries. We report a case of a 24-year-old male patient with a concurrent diagnosis of MPX and acute HIV infection who presented to our Emergency Care Dermatology Clinic with disseminated papules throughout the trunk, face and genital area. On the perianal area, several grouped umbilicated whitish papules in a kissing lesion configuration could be seen. Laboratory workups were consistent with recent HIV infection, and swab samples from the lesion surfaces were positive for monkeypox virus. We provide novel information on the clinical presentation of MPX, expanding the data pool of the clinical manifestations of which health workers should be aware.

Competitive anxiety (CA) is an emotional reaction manifested at a somatic and/or cognitive level that regularly appears before or during sports competitions and can significantly impact an athlete's performance. Given the scarcity of validated instruments available for evaluating the competitive-anxiety trait in the Brazilian context, this study aimed to investigate the psychometric properties of the Sport Anxiety Scale-2 (SAS-2). The study sample was composed of 238 professional and amateur athletes aged 13 years or older who practice different sports modalities. The results of confirmatory factor analysis (CFA) revealed adequate fit indices of the original three-factor theoretical model of the SAS-2 after including a correlation between the errors for items 6 and 12 of the somatic anxiety subscale (CFI = 0.97, TLI = 0.96, RMSEA = 0.08, WRMR = 1.04). For convergent and divergent validity, the SAS-2 subscales exhibited a positive and strong correlations with the Competitive State Anxiety Inventory-2R (CSAI-2R; r = 0.52-0.82), weak to moderate correlations with the State-Trait Anxiety Inventory - only the trait scale (STAI-T; r = 0.49-0.59), weak correlations with the Social Phobia Inventory (SPIN; r = 0.29-0.41) and weak to moderate correlations with the Patient Health Questionnaire (PHQ-9; r = 0.49-0.56). The SAS-2 was also able to discriminate among participants with and without social anxiety, general trait anxiety and depressive symptoms, thus confirming its discriminant validity. According to ROC curve analysis, the cutoff point at a score of 29 indicated the optimal balance of sensitivity (0.74) and specificity (0.82). The internal consistency (α = 0.73-0.86) and the test-retest reliability (ICC = 0.73-0.80) were satisfactory. These results indicated that the Brazilian version of the SAS-2 exhibited satisfactory psychometric performance and could be used in the Brazilian context.