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© 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/), Human monkeypox (MPX) is an endemic zoonotic disease in regions of Africa caused by the monkeypox virus, with recent outbreaks in several non-African countries. In this study, we present two cases of patients with MPX infection complicated by a deep skin infection. Both patients presented to our dermatology clinic with a clinical syndrome characteristic of MPX. The diagnosis was confirmed based on swabs of skin lesions. Both patients later returned to our clinic with erythema, pain, and edema at the site of previous papules and were diagnosed with deep skin bacterial infection. In this study we provide information on what we believe was an underreported MPX infection complication and give some advice on preventing cases of cellulitis in these patients.

Publisher Copyright: © The Author(s) 2022. 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. publishersversion published

© 2022 European Academy of Dermatology and Venereology., An outbreak of monkeypox has emerged, with more than 2000 cases confirmed across the globe. While this condition, caused by the Monkeypox virus, a member of the Orthopoxvirus genus, is usually considered a zoonosis, we may be facing a sexually transmissible infection (STI), with yet uncertain consequences. In Portugal, we are seeing many suspected cases a day, most of which have been confirmed. At our department, we have had more than 20 confirmed cases, most of which in individuals with concomitant human immunodeficiency virus infection. The typical presentation we are observing is illustrated by the case of a 43-year-old man, with a 3-day history of painful umbilicated vesicles and ulcers localized to the perianal and genital areas (Fig. 1), with no prodromal symptoms. Centimetric elastic inguinal adenopathies were found, but no extrapelvic skin lesions or adenomegalies were present. He had engaged in unprotected receptive and insertive anal intercourse over the past 2 weeks, but the history was otherwise unremarkable. We collected samples from the vesicles, which identified Monkeypox virus in polymerase chain reaction.

A conduta do prelado deve superar em qualidade aquela do povo, na mesma medida em que o modo de viver do pastor se distingue daquele do rebanho. É necessário, portanto, que considere com atenção o dever que tem de viver uma vida honesta, visto que, justamente, em referência à sua pessoa, o povo é chamado rebanho.Gregório Magno. Regra Pastoral O ofício pastoral Na Península Ibérica do século XV e limiar do XVI, não faltavam obras em línguas vernáculas que visavam definir a ação pastoral dos bi...

As constituições sinodais de D. Diogo de Sousa de Braga, sentenciadas em um sínodo celebrado no ano de 1505, são um testemunho da política da Igreja que visava reformar as práticas de clérigos, religiosos e leigos. Compilada com base nas constituições sinodais que esse mesmo prelado havia promulgado na diocese do Porto em 1496, a obra cuja edição é agora publicada na coleçãoe-Spania Books alimentou a esperança cristã de formar clérigos mais atuantes em suas igrejas e também fiéis atentos às recomendações recorrentes em manuais de confessores da época. Com base em um original localizado na Biblioteca Pública Municipal do Porto, o presente livro procura apresentar não apenas uma leitura mais profunda das constituições de D. Diogo de Sousa, mas também um panorama acerca da ação pastoral atribuída ao prelado diocesano entre o final da Idade Média e começo dos tempos modernos. Tratando-se de uma edição modernizada, o presente trabalho oferece uma nova transcrição de uma das obras-chave da produção edificante em língua portuguesa do limiar do século XVI. No final do livro, o leitor também poderá consultar a versão fac-símile do documento. Les constitutions synodales de D. Diogo de Sousa, promulguées à Braga lors du synode célébré en 1505, témoignent de la politique de l'Église visant à réformer les pratiques du clergé, des religieux et des laïcs. Compilé à partir des constitutions synodales que ce même prélat avait promulguées dans le diocèse de Porto en 1496, l’ouvrage dont l’édition est maintenant publiée dans la collection e-Spania Books nourrissait l'espoir chrétien de former des clercs plus actifs dans leurs églises, aussi bien que des fidèles attentifs aux recommandations récurrentes dans des manuels de confesseurs de l'époque. Basé sur un original situé à la Bibliothèque Publique Municipale de Porto, le présent volume cherche à présenter non seulement une lecture plus approfondie des constitutions de D. Diogo de Sousa, mais aussi à donner un aperçu de l'action pastorale attribuée à ce prélat diocésain de la fin du Moyen Âge et du début des temps modernes. En tant qu'édition modernisée, ce livre propose une nouvelle transcription de l'une des œuvres clés de la production édifiante en langue portugaise du XVIe siècle. À la fin du livre, le lecteur peut également se reporter au fac-similé du document. The synodal constitutions of D. Diogo de Sousa promulgated in Braga in 1505 testify the Church policy that aimed to reform the practices of the clergy, religious and laymen. Compiled from the synodal constitutions this same prelate had promulgated in the diocese of Porto in 1496, the work now published in Les Livres d'e-Spania collection once nurtured the Christian hope of forming more active clerics in their churches and also faithful more attentive to the recurring recommendations in manuals of confessors of that time. Based on an original text located in the Municipal Public Library of Porto, this book sought to present not only a deeper reading of D. Diogo de Sousa's constitutions, but also an overview of the pastoral action attributed to the diocesan prelate between the late Middle Ages and the beginning of modern era. As a modernized edition, the present work offers a new transcription of one of the key works of the edifying production in Portuguese-language from the beginning of the 16th century. At the end of the book, the reader may also refer to the document facsimile.

O tecido ósseo é afetado tanto pela obesidade como por tratamentos radicais, com acentuada perda de peso. A Cirurgia Bariátrica (CB) tem se mostrado mais efetiva para o tratamento da obesidade grave, mas com dados de deterioração de massa óssea e até aumento de risco de fraturas. Este estudo visou avaliar o impacto da perda rápida de peso induzida por CB em períodos recente (um ano) e tardio (cinco anos) sobre a massa óssea de sujeitos obesos. Em particular, houve interesse em investigar a associação da Adiposidade de Medula Óssea (AMO) com a massa óssea, sendo avaliados três grupos: um formado por indivíduos normais controles; um por obesos após o 1º ano de CB; e o grupo de obesos após o 5º ano de CB. Realizaram-se exames de densitometria óssea; espectroscopia por ressonância magnética de coluna e abdome; exames bioquímicos para avaliação da massa óssea, AMO, e gordura visceral e hepática; e avaliação hormonal e de fatores sistêmicos que influenciam o metabolismo ósseo e energético. Foi feito um ajuste da Densidade Mineral Óssea (DMO) pelo peso a partir do cálculo da taxa de DMO, dividido por quilo de peso, sendo a DMO QT maior no grupo Controle, intermediária no grupo 1º Ano CB e menor no grupo 5º Ano CB. Houve associação do peso com a DMO, mostrando a influência daquele sobre a massa óssea e presença de fratura por fragilidade nos grupos operados. Notaram-se o incremento de Paratormônio (PTH), a redução de calcemia em longo prazo e a correlação negativa de PTH com DMO de antebraço também em longo prazo. O telopeptídeo do colágeno tipo I (CTX) se correlacionou negativamente com a DMO L1-L4 no grupo 5º Ano CB, e não houve correlação entre os valores de insulina, osteocalcina, leptina, adiponectina e grelina com a massa óssea. Foi documentado o aumento de AMO nos pacientes submetidos à CB em longo prazo (cinco anos), além de associação negativa do constituinte saturado da AMO com a DMO L3. Constataram-se maiores valores de Tecido Adiposo Subcutâneo (TAS) nos obesos cirúrgicos, a despeito de quantidades semelhantes de Tecido Adiposo Visceral (TAV) em todos os grupos, sinalizando uma melhor composição corporal após a CB. A partir de um comportamento diferente de AMO, TAS e TAV, propõe-se a hipótese de que a AMO pode servir de depósito de energia nesse estado de deprivação/disabsorção. Bone tissue is affected by both obesity and radical treatments, with marked loss of weight. Bariatric Surgery (BS) has been shown to be more effective for the treatment of severe obesity, but with data on bone mass deterioration and even an increased risk of fractures. The study aimed to evaluate the impact of rapid weight loss induced by BS in recent (one year) and late (five years) periods on the bone mass of obese subjects. In particular, there was an interest in investigating the association of Bone Marrow Adiposity (BMA) with bone mass, and three groups were evaluated: one was formed by normal control individuals; one for obese patients after the first year of BS; and the obese group after the 5th year of BS. Bone densitometry tests; magnetic resonance spectroscopy of spine and abdomen; biochemical tests for evaluation of bone mass, BMA, visceral and liver fat; and evaluation of hormonal and systemic factors that influence the bone and energy metabolism were performed. Bone Mineral Density (BMD) was adjusted by weight from the calculation of BMD rate, divided by kilogram of weight, with BMD QT being higher in the Control group, intermediate in the 1styear BS group and lower in the 5th-year BS group. There was an association between weight and BMD, showing its influence on bone mass and the presence of fracture by fragility in the operated groups. The increase in Parathormone (PTH), the reduction of calcemia in the long term and the negative correlation of PTH with the BMD of forearm were also noted in the long term. Telopeptide of type I procollagen (CTX) correlated negatively with L1-L4 BMD in the 5th-year BS group, and there was no correlation between insulin, osteocalcin, leptin, adiponectin and ghrelin levels with bone mass. It was documented the increase of BMA in patients submitted to BS in the long term (five years), besides a negative association of the saturated constituent of BMA with L3 BMD. Greater values of Subcutaneous Adipose Tissue (SAT) were observed in obese patients, despite similar amounts of Visceral Adipose Tissue (VAT) in all groups, signaling a better body composition after BS. From a different behavior of BMA, SAT and VAT, the proposed hypothesis is that BMA can serve as a deposit of energy in this state of deprivation/disabsorption.

This study aimed to investigate factors associated with condoms among employees of large works (SGOT). Studies show the negative effects of weak social network and being away from home in the sexual life of workers, also related the style of work in the construction of large works with alcohol abuse and risky sexual behaviors, including a negative association between self-esteem and condom use. We interviewed 288 TGOS housed in the vicinity of large buildings in different Brazilian regions that responded to a questionnaire conducted by individual researchers. Most of the sample had an elementary or middle education. The distribution among those who were in a current relationship and those who were not involved was nearly equal. Of the respondents, the majority declared itself exclusively heterosexual (92%). Most of the sample reported consistent condom use (64%), however, more than 65% of respondents had never received an HIV test. The group formed by young and married men had the most consistent use of condom. The index of self-esteem reached M = 19.06 (SD = 3.51). Participants who achieved an average level of self-esteem reported a more consistent use than those with low or high level. Este estudo objetivou investigar fatores associados ao uso de preservativo entre trabalhadores de grandes obras (TGOs). Estudos mostram efeitos negativos da rede social frágil e do afastamento da família na vida sexual dos trabalhadores, também relacionaram o estilo de trabalho em construções de grandes obras com o abuso de álcool e comportamentos sexuais de risco, incluindo uma associação negativa entre autoestima e uso de preservativo. Foram entrevistados 288 TGOs alojados nas imediações de grandes construções em diferentes regiões brasileiras que responderam a um questionário individual. A maior parte da amostra tinha um nível de escolaridade fundamental ou médio. Dos entrevistados, a grande maioria se declarou exclusivamente heterossexual (92%). A maior parte da amostra relatou um uso de camisinha consistente (64%), no entanto, mais de 65% dos entrevistados nunca fizeram teste de HIV. O uso de camisinha foi mais consistente entre os grupos de homens mais jovens e em relacionamento estável. O índice auto-estima atingiu M=19,06 (DP=3,51). Os participantes que atingiram um nível médio de auto-estima relataram uso mais consistente do que os com nível baixo ou alto.