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.
Monkeypox eruption starts as pseudopustules at the inoculation site and can be followed by distant pustular lesions. It is transmitted by contact and, although it can be very uncomfortable, no patient in our series died.
Linked Comment: R.E. Watchorn and C.B. Bunker. Br J Dermatol 2022; 187:636–637.
Plain language summary available online
CAR-T-cell therapy against MM currently shows promising results, but usually with serious toxicities. CAR-NK cells may exert less toxicity when redirected against resistant myeloma cells. CARs can be ...designed through the use of receptors, such as NKG2D, which recognizes a wide range of ligands to provide broad target specificity. Here, we test this approach by analyzing the antitumor activity of activated and expanded NK cells (NKAE) and CD45RA
T cells from MM patients that were engineered to express an NKG2D-based CAR. NKAE cells were cultured with irradiated Clone9.mbIL21 cells. Then, cells were transduced with an NKG2D-4-1BB-CD3z-CAR. CAR-NKAE cells exhibited no evidence of genetic abnormalities. Although memory T cells were more stably transduced, CAR-NKAE cells exhibited greater in vitro cytotoxicity against MM cells, while showing minimal activity against healthy cells. In vivo, CAR-NKAE cells mediated highly efficient abrogation of MM growth, and 25% of the treated mice remained disease free. Overall, these results demonstrate that it is feasible to modify autologous NKAE cells from MM patients to safely express a NKG2D-CAR. Additionally, autologous CAR-NKAE cells display enhanced antimyeloma activity demonstrating that they could be an effective strategy against MM supporting the development of NKG2D-CAR-NK-cell therapy for MM.
Social and urban transformations have changed the ways of elaboration of traditional foods. Maize tortilla, the base of the Mexican diet, has experienced these transformations; nevertheless, in spite ...of being an emblematic food in Mexico, little is known about the perceptions by urban consumers. The aim was to analyze the perceptions about tortilla in urban consumers from three contrasting socioeconomic regions. A questionnaire was applied in some cities of northern, central, and southern Mexico to 1,156 consumers. A free word association technique was used as response to the word “tortilla”. Nineteen categories were grouped in 10 dimensions. Results showed there is a sense of national identity regarding maize tortilla; however, coexistence of postmodern and traditional perception is observed. Perception differed by zone according to sociocultural, historical and economic development. In the face of modernizing changes, consumers adopt new perceptions on traditional foods as is happening in many societies in developing countries.
Practical applications
Perceptions are related to sociocultural, historic and economic aspects. In modernizing processes, consumers adapt new perceptions about traditional foods. The associations with the maize tortilla, staple in the Mexican diet, showed several symbolic elements of the daily life of Mexicans. There is a sense of national identity towards tortilla, differentiated by zone. Understanding the perceptions by age and gender and zone of study, can be used to generate marketing strategies and public policy that favoring the development of rural areas and local economies towards traditional foods, as elements that enhance regional or local development.
Objetivo: identificar y describir las variables y herramientas utilizadas en las investigaciones de estilos de vida en México con relación a la alimentación. Metodología: se realizó una revisión ...sistemática de literatura. La búsqueda de documentos se realizó en internet en la plataforma Web of Science de Clarivate, con las palabras “lifestyle”, “food”, “México o mexican” y “habitus”, con una antigüedad de diez años. Resultados: Las tres variables identificadas en la conceptualización de estilos de vida consideran: 1) características de los individuos, gustos y preferencias; 2) interacciones sociales; y 3) aspectos socioeconómicos, sin embargo se han descuidado los aspectos de espacio social y sus interacciones. Las investigaciones se han centrado en temáticas como la obesidad y diabetes principalmente, volcándose en 2020 en las modificaciones alimenticias a partir de la alerta por Covid-19. Limitaciones: no considerar en la selección de documentos otros buscadores y de palabras clave en españo. Conclusiones: el análisis de los estilos de vida hace necesario una visión holística donde las tres variables presentadas permitan tomar decisiones más acertadas sobre política pública, en ese sentido, se hace imperante ahondar en el espacio social y sus interacciones.
PurposeThe study aims to identify the perceived authenticity of cheeses by consumers of different sociological generations in Mexico.Design/methodology/approachAn online questionnaire was applied to ...1,204 consumers. A Free Word Association (FWA) tool was used to determine the perceived authenticity of cheeses creating categories and dimensions. The sample was segmented into sociological generations. A chi-square test and a correspondence analysis were used to identify differences in the perception between generations. The information was complemented with word clouds of the cheeses mentioned and consumer testimonials about cheese consumption.FindingsA total of 29 categories and ten dimensions revealed consumers' perception of cheese authenticity, most important of which were hedonic, rurality and new consumption. Authenticity is a mix of the pleasure of consuming the product, the link to rural life and new consumer values. Perceived authenticity is different in each sociological generation according to the dimensions of raw material, identity, market, new consumption and distrust, since it is related to the experiences of each generation. The results made it possible to contextualise another vision of the reality of the cheeses in the search for a quality seal.Practical implicationsThe information contributes to the typification and promotion of cheeses in the process of patrimonialisation, by creating differentiated marketing tools that allow their valorisation.Originality/valueThis work contributes to the knowledge of the perceived authenticity of cheeses in the sociological generations, due to their differentiation by age, sociocultural, ethical, political and consumer aspects. It enables the knowledge of the consumer's perspective on these products.
The multiple myeloma (MM) landscape has changed in the last few years, but most patients eventually relapse because current treatment modalities do not target clonogenic stem cells, which are ...drug-resistant and can self-renew. We hypothesized that side population (SP) cells represent myeloma clonogenic stem cells and, searching for new treatment strategies, analyzed the anti-myeloma activity of natural killer (NK) cells against clonogenic cells. Activated and expanded NK cells (NKAE) products were obtained by co-culturing NK cells from MM patients with K562-mb15-41BBL cell line and characterized by flow cytometry. Functional experiments against MM cells were performed by Eu-TDA release assays and methylcellulose clonogenic assays. Side population was detected by Dye Cycle Violet labeling and then characterized by flow cytometry and RNA-Seq. Self-renewal capacity was tested by clonogenic assays. Sorting of both kind of cells was performed for time-lapse microscopy experiments. SP cells exhibited self-renewal potential and overexpressed genes involved in stem cell metabolism. NK cells from MM patients exhibited dysregulation and had lower anti-tumor potential against clonogenic cells than healthy donors’ NK cells. Patients’ NK cells were activated and expanded. These cells recovered cytotoxic activity and could specifically destroy clonogenic myeloma cells. They also had a highly cytotoxic phenotype expressing NKG2D receptor. Blocking NKG2D receptor decreased NK cell activity against clonogenic myeloma cells, and activated NK cells were able to destroy SP cells, which expressed NKG2D ligands. SP cells could represent the stem cell compartment in MM. This is the first report describing NK cell activity against myeloma clonogenic cells.
The cervical microbiota is essential in female sexual health, and its altered states seem to have a central role in the dynamic of high-risk papillomavirus (hrHPV) infections. This study aimed to ...evaluate the variation in bacterial communities' compositions according to hrHPV. We collected two samples per woman, with a difference of 12 ± 1 months between them, and performed a follow-up on 66 of these women. The viral load (VL) of the hrHPV was estimated by quantitative PCR (qPCR), then it was normalized (using the
gene as reference) and transformed to the Log
scale to facilitate the interpretation. The VL was categorized as Negative, without hrHPV copies; Low, less than 10
hrHPV copies; Medium, between 10
to 10
hrHPV copies; and High, >10
hrHPV copies. The microbiota composition was described through the Illumina Novaseq PE250 platform. The diversity analyses revealed changes regarding the hrHPV VL, where women with low VL (<10
hrHPV copies) presented high diversity. The community state type (CST) IV was the most common. However, in women with high VL, a lower association with
depletion was found.
and
were the most abundant species in women with high VL, whereas women with low VL had a 6.06 greater probability of exhibiting
dominance. We identified conspicuous differences in the abundance of 78 bacterial genera between women with low and high VL, where 26 were depleted (e.g.,
) and 52 increased (e.g.,
). A multilevel mixed-effects linear regression showed changes in the diversity due to the interaction between the measurement time and the VL, with a decrease in diversity in the second follow-up in women with low VL (Coeff. = 0.47), whereas the women with medium VL displayed an increase in diversity (Coeff. = 0.58). Here, we report for the first time that the cervical microbiota is influenced by the number of copies of hrHPV, where a decrease in the abundance of
, greater diversity, and enrichment of bacterial taxa is relevant in women with low VL.
Our study aims to assess the prevalence of CAPA (COVID-19-associated pulmonary aspergillosis) and describe the associated risk factors and their impact on mortality. A prospective study was ...conducted. We included patients with COVID-19 disease who were admitted to the ICU with a diagnosis of respiratory failur. Mycological culture and other biomarkers (calcofluor staining, LFD, LFA, PCR, GM, and B-D-glucan) were performed. A total of 300 patients were included in the study. Thirty-five patients were diagnosed with CAPA (prevalence 11.7%). During admission, 57 patients died (19%), and, in the group of CAPA patients, mortality was 31.4%. In multivariate analysis, independent risk factors associated with CAPA diagnosis were age (OR: 1.05; 95% CI 1.01-1.09;
= 0.037), chronic lung disease (OR: 3.85; 95% CI 1.02-14.9;
= 0.049) and treatment with tocilizumab during admission (OR: 14.5; 95% 6.1-34.9;
= 0.001). Factors independently associated with mortality were age (OR: 1.06; 95% CI 1.01-1.11;
= 0.014) and CAPA diagnosis during admission (OR: 3.34; 95% CI 1.38-8.08;
= 0.007). CAPA is an infection that appears in many patients with COVID-19 disease. CAPA is associated with high mortality rates, which may be reduced by early diagnosis and initiation of appropriate antifungal therapy, so screening of COVID-19 ARDS (acute respiratory distress syndrome) patients for CAPA is essential.
In order to demonstrate the feasibility of preparing clinical-grade SARS-CoV-2-specific T-cells from convalescent donors and the ability of these cells to neutralize the virus in vitro, we used blood ...collected from two COVID-19 convalescent donors (before and after vaccination) that was stimulated with specific SARS-CoV-2 peptides followed by automated T-cell isolation using the CliniMacs Prodigy medical device. To determine cytotoxic activity, HEK 293T cells were transfected to express the SARS-CoV-2 M protein, mimicking SARS-CoV-2 infection. We were able to quickly and efficiently isolate SARS-CoV-2-specific T lymphocytes from both donors before and after they received the Pfizer-BioNTech vaccine. Althoughbefore vaccination, the final product contained up to 7.42% and 30.19% of IFN-γ+ CD3+ T-cells from donor 1 and donor 2, respectively, we observed an enrichment of the IFN-γ+ CD3+ T-cells after vaccination, reaching 70.47% and 42.59%, respectively. At pre-vaccination, the isolated SARS-CoV-2-specific T-cells exhibited cytotoxic activity that was significantly higher than that of unstimulated controls (donor 2: 15.41%,
-value 3.27 × 10
). The cytotoxic activity of the isolated SARS-CoV-2-specific T-cells also significantly increased after vaccination (donor 1: 32.71%,
-value 1.44 × 10
; donor 2: 33.38%,
-value 3.13 × 10
). In conclusion, we demonstrated that SARS-CoV-2-specific T-cells can quickly and efficiently be stimulated from the blood of convalescent donors using SARS-CoV-2-specific peptides followed by automated isolation. Vaccinated convalescent donors have a higher percentage of SARS-CoV-2-specific T-cells and may be more suitable as donors. Although further studies are needed to assess the clinical utility of the functional isolated SARS-CoV-2-specific T-cells in patients, previous studies using the same stimulation and isolation methods applied to other pathologies support this idea.
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