Monkeypox: Clinical Considerations,Epidemiology, and Laboratory Diagnostics

Monkeypox virus (MPXV) has garnered recent attention as outbreaks are continually reported outside historic regions of endemicity in Africa. Consequently, MPXV is becoming routinely included in the differential diagnosis of rash illnesses, requiring clinicians and laboratorians alike to quickly adapt to a new public health emergency. This review discusses the epidemiology, clinical presentation, and laboratory testing of MPXV in the context of recent outbreaks.     

Post-traumatic stress disorder,suggestibility, and dissociation related to alleged alien abductions

ObjectivesThousands of people throughout the world are convinced that they have been abducted by aliens. We aimed to assess the emotional reaction to such an implausible event and propose some explanations alternative to severe psychopathology.MethodsA total of 19 individuals who reported memories of having been abducted by aliens were compared to a control group of 32 participants. We employed a battery of tests measuring post-traumatic stress disorder, suggestibility, and dissociation within all participants.ResultsThe abductee group showed higher scores in measures of post-traumatic stress disorders and dissociation, but lower in suggestibility. Nevertheless, these differences were statistically significant only in suggestibility.ConclusionsThe emotional reaction to memories of an implausible experience can be similar to an individual's response to a genuinely traumatic event. Dissociation might be involved in the clarification of some cases. Explanations alternative to psychosis for these testimonies are proposed.     

Validation of an on-screen application-based measurement of shoulder range of motion over telehealth medium

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A high-pressure situation

An 8-year-old boy presented with acute visual loss in the right eye and nausea, vomiting, and diplopia. Imaging revealed a right orbital apex mass. Biopsy showed Langerhans cell histiocytosis (LCH), and the patient was diagnosed with isolated orbital LCH causing an orbital apex syndrome. A 12-month cytarabine chemotherapy course was begun, during which the patient developed bilateral optic disc edema. He was diagnosed with cytarabine-induced intracranial hypertension, which was successfully treated with acetazolamide. The cytarabine course was completed with complete resolution of the LCH lesion. The ophthalmologic relevance of this rare disorder is discussed.     

A systematic review of the methodological quality of economic evaluations in genetic screening and testing for monogenic disorders

PurposeUnderstanding the value of genetic screening and testing for monogenic disorders requires high-quality, methodologically robust economic evaluations. This systematic review sought to assess the methodological quality among such studies and examined opportunities for improvement.MethodsWe searched PubMed, Cochrane, Embase, and Web of Science for economic evaluations of genetic screening/testing (2013-2019). Methodological rigor and adherence to best practices were systematically assessed using the British Medical Journal checklist.ResultsAcross the 47 identified studies, there were substantial variations in modeling approaches, reporting detail, and sophistication. Models ranged from simple decision trees to individual-level microsimulations that compared between 2 and >20 alternative interventions. Many studies failed to report sufficient detail to enable replication or did not justify modeling assumptions, especially for costing methods and utility values. Meta-analyses, systematic reviews, or calibration were rarely used to derive parameter estimates. Nearly all studies conducted some sensitivity analysis, and more sophisticated studies implemented probabilistic sensitivity/uncertainty analysis, threshold analysis, and value of information analysis.ConclusionWe describe a heterogeneous body of work and present recommendations and exemplar studies across the methodological domains of (1) perspective, scope, and parameter selection; (2) use of uncertainty/sensitivity analyses; and (3) reporting transparency for improvement in the economic evaluation of genetic screening/testing.