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Chronic kidney disease-associated pruritus (CKD-aP), a persistent itching sensation, is prevalent among hemodialysis patients. This study aims to understand its prevalence, its possible association with selected solutes, and impact on quality of life (QoL) in hemodialysis patients. Involving 434 hemodialysis patients in Spain, this observational study employed a survey based on validated pruritus assessment tools, alongside demographic, clinical, and biochemical data collection. The study used statistical analyses to examine the correlation between CKD-aP and various QoL dimensions. CKD-aP affected 46,4% (202) of the participants, with no significant variation across gender and age (p = 0.222 and p = 0.379, respectively). There were no significant associations between CKD-aP and biochemical markers like calcium, phosphate, and C-reactive protein (p > 0.05, in all cases). Each reporting period (morning, midday, evening, and night) revealed distinct patterns in pruritus prevalence and severity (p < 0.05). The nighttime report exhibited the most significant differences, as more than half of the patients with moderate to severe pruritus reported constant and frequent itching (23.0% and 27.9%, respectively). Concerning other variables and symptoms associated with QoL, pruritus group exhibited higher rates of anxiety, depression, decreased sexual desire and sexual function, and sometimes to most of the time reported sleep onset problems, sleeping pill use, and drowsiness on waking (p < 0.001 in all cases). When stratifying by pruritus intensity differences persisted across anxiety (p < 0.001) and sleep onset problems (p = 0.018). The findings underscore the high prevalence and severe impact of CKD-aP in QoL among hemodialysis patients, indicating a need for standardized screening and treatment approaches in clinical practice. The lack of correlation with common biochemical markers suggests an intricate pathophysiology, warranting further investigation. These insights emphasize the necessity of holistic management strategies and more research to understand CKD-aP complex nature for better patient outcomes., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

The ongoing monkeypox (mpox) disease outbreak has spread to multiple countries in Central Africa and evidence indicates it is driven by a more virulent clade I monkeypox virus (MPXV) strain than the clade II strain associated with the 2022 global mpox outbreak, which led the WHO to declare this mpox outbreak a public health emergency of international concern. The FDA-approved small molecule antiviral tecovirimat (TPOXX) is recommended to treat mpox cases with severe symptoms, but the limited efficacy of TPOXX and the emergence of TPOXX resistant MPXV variants has challenged this medical practice of care and highlighted the urgent need for alternative therapeutic strategies. In this study we have used vaccinia virus (VACV) as a surrogate of MPXV to assess the antiviral efficacy of combination therapy of TPOXX together with mycophenolate mofetil (MMF), an FDA-approved immunosuppressive agent that we have shown to inhibit VACV and MPXV, or the N-myristoyltransferase (NMT) inhibitor IMP-1088. Both MMF and IMP-1088 drugs exhibited strong dose-dependent antiviral activity against VACV and mpox, and potent synergistic effects in conjunction with TPOXX. Our findings support combination therapy of direct-acting (TPOXX) and host-targeted (MMF and IMP-1088) antivirals as a promising approach to treat mpox and prevent the emergence and spread of TPOXX-resistant MPXV variants.

Introduction: Severe or complicated atheromatosis of the aortic arch represents an important and often underdiagnosed embolic source in patients with ischemic stroke. The presence of a floating thrombus has significant clinical relevance, as it is associated with a high risk of early recurrence. The aim of this study was to analyze the potential of echocardiographic examination through the suprasternal window in both the detection of embolic sources and the monitoring of the response to anticoagulant treatment in patients with mobile thrombi., Methods: This case series study included ten consecutive patients with a mobile floating aortic arch thrombus associated with an atheromatous plaque, detected by focused echocardiography and confirmed by Computed Tomography Angiography (CTA). Epidemiological, clinical, radiological, and ultrasound characteristics were analyzed. Clinical and ultrasound follow-up was performed after initiation of anticoagulation as secondary prevention to assess the efficacy and safety of this treatment., Results: Ten patients (seven female) with a mean age of 76 years were identified. After anticoagulation, a complete resolution of the mobile thrombus was observed in eight of them during ultrasound follow-up. One patient suffered an ischemic recurrence. Two patients receiving associated antiplatelet therapy presented severe hemorrhagic complications, one of which was fatal. Once the disappearance of the mobile thrombus was detected, anticoagulation was discontinued, and no further ischemic recurrences were observed., Discussion: Floating thrombus of the aortic arch is an underdiagnosed but clinically relevant condition. The study of the aortic arch with echocardiography through the suprasternal window is a highly available and harmless technique, that may be highly useful for the detection and monitoring of response to treatment of this pathology. Furthermore, early anticoagulation could be an effective and safe treatment in these patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Esnaola Barriola, Escriche Gorospe, Miguel Navas, Martínez Campos, Molina Goicoechea, Capell Pascual, Jiménez Delgado and Muñoz Arrondo.)