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De la Herrán-Arita AK, González-Galindo C, Inzunza-Leyva GK, Valdez-Flores MA, Norzagaray-Valenzuela CD, Camacho-Zamora A, Batiz-Beltrán JC, Urrea-Ramírez FJ, Romero-Utrilla A, Angulo-Rojo C, Guadrón-Llanos AM, Picos-Cárdenas VJ, Camberos-Barraza J, Rábago-Monzón ÁR, Osuna-Ramos JF. Clinical Predictors of Monkeypox Diagnosis: A Case-Control Study in a Nonendemic Region during the 2022 Outbreak. Microorganisms 2023; 11:2287. [PMID: 37764131 PMCID: PMC10535336 DOI: 10.3390/microorganisms11092287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/24/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Monkeypox (Mpox) is an emerging zoonotic disease with the potential for severe complications. Early identification and diagnosis are essential to prompt treatment, control its spread, and reduce the risk of human-to-human transmission. This study aimed to develop a clinical diagnostic tool and describe the clinical and sociodemographic features of 19 PCR-confirmed Mpox cases during an outbreak in a nonendemic region of northwestern Mexico. The median age of patients was 35 years, and most were male. Mpox-positive patients commonly reported symptoms such as fever, lumbago, and asthenia, in addition to experiencing painful ulcers and a high frequency of HIV infection among people living with HIV (PLWH). Two diagnostic models using logistic regression were devised, with the best model exhibiting a prediction accuracy of 0.92 (95% CI: 0.8-1), a sensitivity of 0.86, and a specificity of 0.93. The high predictive values and accuracy of the top-performing model highlight its potential to significantly improve early Mpox diagnosis and treatment in clinical settings, aiding in the control of future outbreaks.
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Affiliation(s)
- Alberto Kousuke De la Herrán-Arita
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
| | | | - Gerardo Kenny Inzunza-Leyva
- Dirección de Prevención y Promoción de la Salud, Secretaría de Salud de Sinaloa, Culiacán Rosales 80020, Sinaloa, Mexico;
| | - Marco Antonio Valdez-Flores
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
| | | | - Alejandro Camacho-Zamora
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
| | - José Candelario Batiz-Beltrán
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
- Hospital Regional Dr. Manuel Cárdenas de la Vega, ISSSTE, Culiacán Rosales 80230, Sinaloa, Mexico
| | - Francisco Javier Urrea-Ramírez
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
- Hospital Regional Dr. Manuel Cárdenas de la Vega, ISSSTE, Culiacán Rosales 80230, Sinaloa, Mexico
| | - Alejandra Romero-Utrilla
- Departamento de Anatomía Patológica, Instituto Mexicano del Seguro Social, Culiacán Rosales 80230, Sinaloa, Mexico
| | - Carla Angulo-Rojo
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
- Maestría en Ciencias en Biomedicina Molecular, Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico
| | - Alma Marlene Guadrón-Llanos
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
- Doctorado en Ciencias en Biomedicina Molecular, Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico
| | - Verónica Judith Picos-Cárdenas
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
| | - Josué Camberos-Barraza
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
| | - Ángel Radamés Rábago-Monzón
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
| | - Juan Fidel Osuna-Ramos
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
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Provision of Palliative Care during the COVID-19 Pandemic: A Systematic Review of Ambulatory Care Organizations in the United States. ACTA ACUST UNITED AC 2021; 57:medicina57101123. [PMID: 34684160 PMCID: PMC8540351 DOI: 10.3390/medicina57101123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022]
Abstract
Background and objectives: Ambulatory (outpatient) healthcare organizations continue to respond to the COVID-19 global pandemic using an array of initiatives to sustain a continuity of palliative care. Continuance of palliative care during major crises has been previously accomplished; however, the global pandemic presents new challenges to the US healthcare industry. Materials and methods: This systematic review queried four research databases to identify applicable studies related to the provision of palliative care during the pandemic in outpatient organizations within the United States. Results: There are two primary facilitators for the ongoing provision of palliative care for the outpatient segment of the United States healthcare industry: technology and advanced care planning. Researchers also identified two primary barriers in the outpatient setting impacting the continuance of palliative care: lack of resources and accessibility to care. Conclusions: This systematic review identified facilitators and barriers for palliative care initiatives in the United States that can further assist future outpatient (ambulatory care) providers at a global level as the pandemic and associated public health initiatives continue.
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