Clinical manifestations of human monkeypox infection: a systematic review and meta-analysis

Little is known about the ongoing monkeypox (mpox) outbreak, and the clinical features of mpox in patients worldwide have not been rigorously analysed. Thus, we aimed to investigate the clinical features associated with mpox infection and understand the pathophysiology and characteristics of the disease. For this systematic review and meta-analysis, we searched PubMed/MEDLINE, Embase, CINAHL, Google Scholar, and the Cochrane Database of Systematic Reviews for articles published till 16 September 2022. We used a random effects model to calculate the pooled prevalence and 95% confidence interval (CI). We used the I2 statistic to assess heterogeneity, Egger's test to assess publication bias, 95% prediction interval to determine the level of uncertainty, and the Newcastle-Ottawa Scale and Joanna Briggs Institute quality assessment tool to assess the risk of bias. Twenty-six relevant articles from 19 countries across 5 continents were included, and data on 5472 mpox patients with 18 unique features were analysed. The pooled prevalence of clinical features of mpox were rash (85.7%, 95% CI: 68.3–94.3; k = 21), chills (77.8%, 95% CI: 70.5–83.7; k = 3), and fever (62.3%, 95% CI: 51.3–71.6; k = 25), lymphadenopathy (58.6%, 95% CI: 47.2–69.2; k = 21), lethargy or exhaustion (46.8%, 95% CI: 30.7–63.5; k = 14), pruritus (40.6%, 95% CI: 28.5–54.0; k = 5), myalgia (36.0%, 95% CI: 24.3–49.7; k = 16), headache (34.6%, 95% CI: 23.4–47.8; k = 17), skin ulcer (31.1%, 95% CI: 18.6–47.1; k = 7), abdomen symptom (24.2%, 95% CI: 17.9–31.9; k = 11), pharyngitis (23.0%, 95% CI: 12.7–37.9; k = 14), respiratory symptom (19.5%, 95% CI: 6.8–44.6; k = 6), nausea or vomiting (13.0%, 95% CI: 4.6–31.9; k = 3), scrotal or penile oedema (10.7%, 95% CI: 6.3–17.7; k = 4), conjunctivitis (7.1%, 95% CI: 2.4–18.9; k = 6), and death (0.9%, 95% CI: 0.4–2.0; k = 26). This is the first international and comprehensive study to examine all clinical presentations of human mpox infection. Our systematic review proposes a comprehensive understanding of the current mpox outbreak and may serve as key data for future studies on the pathological mechanisms and epidemiology of mpox infections

Differences in Pandemic-Related Factors Associated with Alcohol and Substance Use among Korean Adolescents: Nationwide Representative Study

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National trends in physical activity among adolescents in South Korea before and during the COVID‐19 pandemic, 2009−2021

With the ongoing COVID‐19 pandemic, several previous studies from different countries showed that physical activity (PA) decreased during the COVID‐19 outbreak. However, few studies have examined the recent tendency of PA in the adolescent population. Thus, we aimed to investigate the long‐term trend of PA in Korean youth and the prevalence changes between before and during the COVID‐19 pandemic. Data from Korea Youth Risk Behavior Web‐Based Survey (KYRBS) was collected for consecutive years between 2009 and 2021. The period was separated into prepandemic (2009−2019), early‐pandemic (2020), and mid‐pandemic (2021). Self‐reported amount of PA was categorized into four groups (insufficient, aerobic, muscle strengthening, and both physical activities) according to World Health Organization (WHO) PA guidelines. A total of 840 488 adolescents aged 12−18 who fully responded to the survey were selected (response rate: 95.2%). The 13‐year trends in the proportion of adolescents who reported aerobic and muscle‐strengthening activities met or exceeded 2020 WHO exercise guidelines for adolescents plateaued (11.9% from 2009 to 2011, 14.2% from 2018 to 2019, 14.4% from 2020, and 14.0% from 2021); however, the slope decreased during the pandemic (βdiff, −0.076; 95% confidence interval [CI], −0.123 to −0.029). Proportion of sufficient aerobic exercise among adolescents sharply decreased midst the pandemic (28.0% from 2009 to 2011, 29.4% from 2018 to 2019, and 23.8% from 2020; βdiff, −0.266; 95% CI, −0.306 to −0.226) but increased again in 2021 (26.0% from mid‐COVID 19; 95% CI, 25.4−26.7). Similar patterns were observed in Metabolic Equivalent Task (MET) score (MET‐min/week; 804.1 from 2018 to 2019, 720.9 from 2020, and 779.6 from 2021). The mean difference in MET score between pre‐COVID and post‐COVID was −55.4 MET‐min/week (95% CI, −70.5 to −40.3). Through a nationwide representative study, there was no significant difference with regard to the number of Korean adolescents who achieved the PA guidelines (pre and postpandemic); however, the prevalence of recommended levels of PA needs to increase more based on the trend before the COVID‐19 outbreak. The findings of this study suggest reinforcement of the importance of public health policies for Korean youths to be more physically active, especially during and after the pandemic.</p

Global incidence and prevalence of eosinophilic esophagitis, 1976–2022: a systematic review and meta-analysis

Background and AimsOwing to 2018 expanded diagnostic criteria for eosinophilic esophagitis (EoE) and thus a possible increase in diagnosis, previous studies on the global incidence and prevalence of EoE may need to be updated. We aimed to describe global, regional, and national trends in the incidence and prevalence of EoE from 1976 to 2022 and analyze their associations with geographic, demographic, and social factors through a systematic review.MethodsWe searched the PubMed/MEDLINE, Embase, CINAHL, Google Scholar, and Cochrane databases from their inception dates to December 20, 2022, for studies that reported the incidence or prevalence of EoE in the general population. We calculated the global incidence and prevalence of EoE using pooled estimates with 95% confidence intervals (CIs) and performed subgroup analysis based on age, sex, race, geographical area, World Bank income group, and diagnostic criteria of EoE.ResultsForty studies met the eligibility criteria, including over 288 million participants and 147,668 patients with EoE from 15 countries across the five continents. The global pooled incidence and prevalence of EoE were 5.31 cases per 100,000 inhabitant-years (95% CI, 3.98–6.63; number of studies, 27; sample population, 42,191,506) and 40.04 cases per 100,000 inhabitant-years (95% CI, 31.10–48.98; number of studies, 20; sample population, 30,467,177), respectively. The pooled incidence of EoE was higher in high-income countries (vs low- or middle-income countries), males, and North America (vs Europe and Asia). The global prevalence of EoE followed a similar pattern. The pooled prevalence of EoE gradually increased from 1976 to 2022 (1976–2001; 8.18; 95% CI, 3.67–12.69 vs 2017–2022; 74.42; 95% CI, 39.66–109.19 cases per 100,000 inhabitant-years).ConclusionsThe incidence and prevalence of EoE have increased substantially and vary widely across the world. Further research is needed to evaluate the incidence and prevalence of EoE in Asia, South America, and Africa.</p

Efficacy and safety of topical Streptococcus postbiotic emollient in adolescents and adults with mild-to-moderate atopic dermatitis: a randomized, double-blind, vehicle-controlled trial

Atopic dermatitis (AD), a chronic inflammatory pruritic skin disorder, involves significant alternations in the skin microbiome compositions and reduction in filaggrin, a structural protein comprising epidermal barriers. Previous research conducted highlighted the beneficial role of Streptococcus in enhancing skin elasticity, moisture contents, and the expression of filaggrin. Building upon these findings, we designed a proof-of-concept trial to evaluate the efficacy of a topical Streptococcus postbiotic emollient, specifically Strain CX, in 100 participants with mild-to-moderate AD. Our assessment encompassed clinical effects, laboratory parameters, and safety observations over 24 weeks.</p

National trends in alcohol and substance use among adolescents from 2005 to 2021: a Korean serial cross-sectional study of one million adolescents

Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents, more adequate studies are needed to predict the trends of alcohol and substance use during recent periods, including the mid-pandemic period. This study investigated the changes in alcohol and substance use, except tobacco use, throughout the pre-, early-, and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea. Methods Data on 1,109,776 Korean adolescents aged 13–18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency. We evaluated adolescents’ alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes. We define the pre-COVID-19 period as consisting of four groups of consecutive years (2005–2008, 2009–2012, 2013–2015, and 2016–2019). The COVID-19 pandemic period is composed of 2020 (early-pandemic era) and 2021 (mid-pandemic era). Results More than a million adolescents successfully met the inclusion criteria. The weighted prevalence of current alcohol use was 26.8% [95% confidence interval (CI) 26.4–27.1] from 2005 to 2008 and 10.5% (95% CI 10.1–11.0) in 2020 and 2021. The weighted prevalence of substance use was 1.1% (95% CI 1.1–1.2) from 2005 to 2008 and 0.7% (95% CI 0.6–0.7) between 2020 and 2021. From 2005 to 2021, the overall trend of use of both alcohol and drugs was found to decrease, but the decline has slowed since COVID-19 epidemic (current alcohol use: βdiff 0.167; 95% CI 0.150–0.184; substance use: βdiff 0.152; 95% CI 0.110–0.194). The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex, grade, residence area, and smoking status from 2005 to 2021. Conclusion The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage (2020–2021) of the COVID-19 pandemic showed a slower decline than expected given the increase during the prepandemic period (2005–2019)

Efficacy and safety of topical Streptococcus postbiotic emollient in adolescents and adults with mild-to-moderate atopic dermatitis: a randomized, double-blind, vehicle-controlled trial

Atopic dermatitis (AD), a chronic inflammatory pruritic skin disorder, involves significant alternations in the skin microbiome compositions and reduction in filaggrin, a structural protein comprising epidermal barriers. Previous research conducted highlighted the beneficial role of Streptococcus in enhancing skin elasticity, moisture contents, and the expression of filaggrin. Building upon these findings, we designed a proof-of-concept trial to evaluate the efficacy of a topical Streptococcus postbiotic emollient, specifically Strain CX, in 100 participants with mild-to-moderate AD. Our assessment encompassed clinical effects, laboratory parameters, and safety observations over 24 weeks.</p

Estimated prevalence and trends in smoking among adolescents in South Korea, 2005–2021: a nationwide serial study

Background: Although smoking is classified as a risk factor for severe COVID-19 outcomes, there is a scarcity of studies on prevalence of smoking during the COVID-19 pandemic. Thus, this study aims to analyze the trends of prevalence of smoking in adolescents over the COVID-19 pandemic period. Methods: The present study used data from middle to high school adolescents between 2005 and 2021 who participated in the Korea Youth Risk Behavior Web-based Survey (KYRBS). We evaluated the smoking prevalence (ever or daily) by year groups and estimated the slope in smoking prevalence before and during the pandemic. Results: A total of 1,137,823 adolescents participated in the study [mean age, 15.04 years [95% confidence interval (CI) 15.03–15.06]; and male, 52.4% (95% CI 51.7–53.1)]. The prevalence of ever smokers was 27.7% (95% CI 27.3–28.1) between 2005 and 2008 but decreased to 9.8% (95% CI 9.3–10.3) in 2021. A consistent trend was found in daily smokers, as the estimates decreased from 5.4% (95% CI 5.2–5.6) between 2005 and 2008 to 2.3% (95% CI 2.1–2.5) in 2021. However, the downward slope in the overall prevalence of ever smokers and daily smokers became less pronounced in the COVID-19 pandemic period than in the pre-pandemic period. In the subgroup with substance use, the decreasing slope in daily smokers was significantly more pronounced during the pandemic than during the pre-pandemic period. Conclusions: The proportion of ever smokers and daily smokers showed a less pronounced decreasing trend during the pandemic. The findings of our study provide an overall understanding of the pandemic’s impact on smoking prevalence in adolescents. [MediaObject not available: see fulltext.