Recent Contact Research Articles

Unilateral eyelid itching with eyelash loss after travelling.

Tinea blepharitis is a rare dermatophyte infection. The characteristic broken eyelash is an important diagnostic clue by trichoscopy or slit lamp examination. Other clinical clues suggesting dermatophytosis include pruritic scaly annular erythema and a history of recent contact with pets.

Epidemiology of Culture-Negative Pulmonary Tuberculosis-Alameda County, 2010-2019.

Patients with culture-negative pulmonary TB (PTB) can face delays in diagnosis that worsen outcomes and lead to ongoing transmission. An understanding of current trends and characteristics of culture-negative PTB can support earlier detection and access to care. Describe epidemiology of culture-negative PTB. We utilized Alameda County TB surveillance data from 2010 to 2019. Culture-negative PTB cases met clinical but not laboratory criteria for PTB per US National Tuberculosis Surveillance System definitions. We calculated trends in annual incidence and proportion of culture-negative PTB using Poisson and weighted linear regression, respectively. We further compared demographic and clinical characteristics among culture-negative versus culture-positive PTB cases. During 2010-2019, there were 870 cases of PTB, of which 152 (17%) were culture-negative. The incidence of culture-negative PTB declined by 76%, from 1.9/100 000 to 0.46/100 000 ( P for trend <.01), while the incidence of culture-positive PTB reduced by 37% (6.5/100 000 to 4.1/100 000, P for trend =.1). Culture-negative PTB case-patients were more likely than culture-positive PTB case-patients to be younger (7.9% were children <15 years old vs 1.1%; P < .01), recent immigrants within 5 years of arrival (38.2% vs 25.5%; P < .01), and have a TB contact (11.2% vs 2.9%; P < .01). Culture-negative PTB case-patients were less likely than culture-positive PTB case-patients to be evaluated because of TB symptoms (57.2% vs 74.7%; P < .01) or have cavitation on chest imaging (13.1% vs 38.8%; P < .01). At the same time culture-negative PTB case-patients were less likely to die during TB treatment (2.0% vs 9.6%; P < .01). The incidence of culture-negative PTB disproportionately declined compared with culture-positive TB and raises concern for gaps in detection. Expansion of screening programs for recent immigrants and TB contacts and greater recognition of risk factors may increase detection of culture-negative PTB.

The impact of SARS-Cov-2 pandemic on mental health in medical staff

IntroductionSARS-Cov-2 pandemic resulted in a great amount of mental health suffering both in patients, families and medical staff.ObjectivesTo assess the personal impact of SARS-Cov-2 management in hospital health care staff.MethodsThe study included 300 participants, comprising medical staff, 150 of which directly treated patients with SARS-Cov-2 infection, whilst the rest did not. Participants were asked to fill in online self-assessment scales: PSS-10 (Perceived Stress Scale), BAI (Beck Anxiety Inventory), BDI (Beck Depression Inventory), and SSOSH (Self Stigma of Seeking Psychology Help Scale). The data were collected at the end of 2021 during the COVID-19 pandemic with the Omicron variant.Results238 (79.3%) women and 62 (20.7%) men responded to the online assessment. Participants working in COVID wards had higher scores for anxiety and depression (χ²=12.21, p=0.007). The intensity of depression and anxiety (BDI / BAI) depends on the professional degree (higher in senior specialists and specialists than in nurses and residents), working in shifts (χ²=8.77, p=0.01) and recent contact with patients infected with SARS-Cov-2 (χ²=76.10, p&lt;0.0001). Regarding PSS-10 total scores, participants that had contact with 1-10 SARS-Cov-2 patients during the past month had significantly higher scores than those who did not. SSOSH showed that participants who had more than 5 on-calls per month had significantly higher scores than the participants who had one on-call per month (p=0.008). Logistical regression showed that participants who had higher BDI scores had a probability of 136.67 times higher (95% CI [16.42; 1137.53]) to present high stress levels.ConclusionsRespondents who had higher scores in the BDI (and not other assessment scales) had by far the highest probability of developing high stress levels.Disclosure of InterestNone Declared

Global concerns about camel flu: outbreak, etiology, genomic structure, transmission, symptoms, diagnostic tests, prevention, and treatment - correspondence.

Global concerns about camel flu: outbreak, etiology, genomic structure, transmission, symptoms, diagnostic tests, prevention, and treatment - correspondence.

Abstract PD12-06: PD12-06 Longitudinal analysis of breast density change assessed by digital mammogram is associated with breast cancer

Abstract Mammographic breast density is a well-established and strong risk factor for breast cancer. Widespread use of digital mammography has opened new potential for assessment of density changes over time. The underlying premise is that changes in breast tissue due to evolving structures that support cancer development should translate to quantifiable differences between the two breasts over time. To address this hypothesis, we draw on extensive digital mammography data and bring repeated measures over up to 10 years to evaluate the association between change in mammographic breast density and risk of breast cancer. Women were recruited from November 2008 to April 2012 through the mammography service at the Joanne Knight Breast Health Center at Washington University in St Louis. Baseline questionnaire risk factors and screening mammograms were collected from 12,153 women. Of these, 1,672 were excluded for prior history of any cancer (except non-melanoma skin) or diagnosis of breast cancer within 6 months of registration for the study, for a total of 10,481 women. Follow-up is through linking to electronic health records, tumor registry and death register. Routine screening mammograms are collected every 1 to 2 years. Follow-up of cohort participants through December 2020 was: 78% seen in 2019 or 2020; a further 4.4% seen most recently in 2018 and a further 2.4% in 2017 giving over 80% active follow-up for women seen within the last 36 months. The median number of mammograms is 5 (min = 1, max = 10; sd = 2.43). The average person-years of follow-up through most recent contact is 9.2 person-years. We have excluded women who are diagnosed within the first 6 month of baseline mammogram date in all analyses, leaving 259 cases and 695 controls with a total number of 8,966 crandiocaudal (CC) view mammograms for analysis. For these 954 women, the mean number of years between mammograms is 1.3 (10th percentile: 1.0, 90th percentile: 2.0). For the cases, the mean number of years from last mammogram date to diagnosis date was 2.0 years (10th percentile: 1.0, 90th percentile: 3.9) after excluding mammograms that are within 6 months of diagnosis. The percentage volumetric density (MD) within each digital CC-view mammogram is estimated with an automated pixel-thresholding algorithm ADAPT implemented within the Division of Public Health at WashU. The skin around the breast is automatically removed using a boundary detection algorithm prior to estimating the dense areas. The percent density (MD) is then estimated using the dense area divided by the total breast area which normalizes the difference in breast size across women. The correlation between average MD generated from our automated algorithm with Volpara is 0.82. Initial analyses use linear mixed effects with average density between breasts (fitted with R package lmer). We performed test of assumptions for all linear mixed effects models, including the normality of residuals, linearity, and homogeneity of residual variance. Assessing the averaging density between 2 breasts controlling for age, BMI, histology confirmed benign breast disease, family history, parity, and alcohol, MD decreases significantly over follow-up (time in years) (P &amp;lt; 0.01). At baseline, postmenopausal women had lower density than premenopausal women after controlling for the same set of risk factors. The average MD over all time points was significantly different for the case vs. control women (P &amp;lt; 0.01). For overweight women, the trajectory of MD over time was significantly different for the case vs. control women (P &amp;lt; 0.01). Drawing on over 10 years of follow-up we observe, for the first time, a dynamic effect for breast density such that divergence in density over time is related to risk for breast cancer. Citation Format: Graham A. Colditz, Shu Jiang. PD12-06 Longitudinal analysis of breast density change assessed by digital mammogram is associated with breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD12-06.

The National Prevalence of Clinically Diagnosed Psoriatic Arthritis in Sweden 2017.

Psoriatic arthritis (PsA) prevalence estimates vary across studies; studies based on national data are few. We aimed to estimate the prevalence of clinically diagnosed PsA in Sweden in 2017, overall and stratified by sex/age/education/geography, and to quantify disease-modifying anti-rheumatic drug (DMARD) use among those in contact with specialized rheumatology care 2015-2017. Individuals, 18-79 years (y), alive, residing in Sweden on December 31, 2017, with a prior PsA diagnosis were identified from the National Patient Register (NPR) and/or the Swedish Rheumatology Quality Register (SRQ). The PsA prevalence was estimated according to a base case (BC) definition (≥1 main PsA ICD-code from rheumatology or internal medicine departments in NPR, or a PsA diagnosis in SRQ), four sensitivity analysis definitions, and for those seen in specialized rheumatology care 2015-2017. In the latter group, DMARD use during 2017 was also assessed. Data for stratifications were retrieved from national registers. The crude national prevalence of PsA (18-79y) was estimated at 0.39% (BC), 0.34% after accounting for diagnostic misclassification and 0.32-0.50% across all sensitivity analyses. The prevalence was lower in males and in those with higher level of education. The prevalence for those seen in specialized rheumatology care 2015-2017 was estimated at 0.24%. In this population, 32% received biologic or targeted synthetic DMARDs, and 41% conventional synthetic DMARDs only, during 2017. The prevalence of clinically diagnosed PsA (18-79y) in Sweden in 2017 was around 0.35%. Among PsA cases in recent contact with specialized rheumatology care, almost 3/4 received DMARD therapy in 2017.

Transverse myelitis following bivalent COVID‐19 booster vaccine and quadrivalent seasonal influenza vaccine

Transverse myelitis following bivalent <scp>COVID</scp>‐19 booster vaccine and quadrivalent seasonal influenza vaccine

Associations of Country-Specific and Sociodemographic Factors With Self-Reported COVID-19-Related Symptoms: Multivariable Analysis of Data From the CoronaCheck Mobile Health Platform.

The COVID-19 symptom-monitoring apps provide direct feedback to users about the suspected risk of infection with SARS-CoV-2 and advice on how to proceed to prevent the spread of the virus. We have developed the CoronaCheck mobile health (mHealth) platform, the first free app that provides easy access to valid information about the risk of infection with SARS-CoV-2 in English and German. Previous studies have suggested that the clinical characteristics of individuals infected with SARS-CoV-2 vary by age, gender, and viral variant; however, potential differences between countries have not been adequately studied. The aim of this study is to describe the characteristics of the users of the CoronaCheck mHealth platform and to determine country-specific and sociodemographic associations of COVID-19-related symptoms and previous contacts with individuals infected with COVID-19. Between April 8, 2020, and February 3, 2022, data on sociodemographic characteristics, symptoms, and reports of previous close contacts with individuals infected with COVID-19 were collected from CoronaCheck users in different countries. Multivariable logistic regression analyses were performed to examine whether self-reports of COVID-19-related symptoms and recent contact with a person infected with COVID-19 differed between countries (Germany, India, South Africa), gender identities, age groups, education, and calendar year. Most app users (N=23,179) were from Germany (n=8116, 35.0%), India (n=6622, 28.6%), and South Africa (n=3705, 16.0%). Most data were collected in 2020 (n=19,723, 85.1%). In addition, 64% (n=14,842) of the users were male, 52.1% (n=12,077) were ≥30 years old, and 38.6% (n=8953) had an education level of more than 11 years of schooling. Headache, muscle pain, fever, loss of smell, loss of taste, and previous contacts with individuals infected with COVID-19 were reported more frequently by users in India (adjusted odds ratios [aORs] 1.3-8.3, 95% CI 1.2-9.2) and South Africa (aORs 1.1-2.6, 95% CI 1.0-3.0) than those in Germany. Cough, general weakness, sore throat, and shortness of breath were more frequently reported in India (aORs 1.3-2.6, 95% CI 1.2-2.9) compared to Germany. Gender-diverse users reported symptoms and contacts with confirmed COVID-19 cases more often compared to male users. Patterns of self-reported COVID-19-related symptoms and awareness of a previous contact with individuals infected with COVID-19 seemed to differ between India, South Africa, and Germany, as well as by gender identity in these countries. Viral symptom-collecting apps, such as the CoronaCheck mHealth platform, may be promising tools for pandemics to support appropriate assessments. Future mHealth research on country-specific differences during a pandemic should aim to recruit representative samples.

Painful facial, oral, and genital ulcers

Painful facial, oral, and genital ulcers

Assessment of potential risk factors for COVID-19 among health care workers in a health care setting in Delhi, India -a cohort study.

Healthcare workers (HCW) are most vulnerable to contracting COVID-19 infection. Understanding the extent of human-to-human transmission of the COVID-19 infection among HCWs is critical in managing this infection and for policy making. We did this study to estimate new infection by seroconversion among HCWs in recent contact with COVID-19 and predict the risk factors for infection. A cohort study was conducted at a tertiary care COVID-19 hospital in New Delhi during the first and second waves of the COVID-19 pandemic. All HCWs working in the hospital during the study period who came in recent contact with the patients were our study population. The data was collected by a detailed face-to-face interview, serological assessment for anti- COVID-19 antibodies at baseline and end line, and daily symptoms. Potential risk factors for seroprevalence and seroconversion were analyzed by logistic regression keeping the significance at p<0.05. A total of 192 HCWs were recruited in this study, out of which 119 (62.0%) were seropositive. Almost all were wearing Personal protective equipment (PPE) and following Infection prevention and control (IPC) measures during their recent contact with a COVID-19 patient. Seroconversion was observed among 36.7% of HCWs, while 64.0% had a serial rise in the titer of antibodies during the follow-up period. Seropositivity was negatively associated with being a doctor (odds ratio [OR] 0.35, 95% Confidence Interval [CI] 0.18-0.71), having COVID-19 symptoms (OR 0.21, 95% CI 0.05-0.82), having comorbidities (OR 0.14, 95% CI 0.03-0.67), and received IPC training (OR 0.25, 95% CI 0.07-0.86), while positively associated with partial (OR 3.30, 95% CI 1.26-8.69), as well as complete vaccination for COVID-19 (OR 2.43, 95% CI 1.12-5.27). Seroconversion was positively associated with doctor as a profession (OR 13.04, 95% CI 3.39-50.25) and with partially (OR 4.35, 95% CI 1.07-17.65), as well as fully vaccinated for COVID-19 (OR 6.08, 95% CI 1.73-21.4). No significant association was observed between adherence to any IPC measures and PPE adopted by the HCW during the recent contact with COVID-19 patients and seroconversion. Almost all the HCW practiced IPC measures in these settings. High seropositivity and seroconversion are most likely due to concurrent vaccination against COVID-19 rather than recent exposure to COVID-19 patients. Further studies using anti-N antibodies serology may help us find the reason for the seropositivity and seroconversion among HCWs.

Folk taxonomical distinction between Irvingia gabonensis and I. wombolu (Irvingiaceae) in the Volta Forest region, West Africa

Description of the subject. Irvingia gabonensis and I. wombolu produce edible kernels, with their fruit pulp tasting sweet and bitter, respectively. The overlap of their morphological and ecological traits creates taxonomic uncertainty. Objectives. This study assessed the efficiency of folk classification system for the separation between I. gabonensis and I. wombolu, in the Volta Forest region (Togo), where both species co-occur. Method. Interviews were conducted with 114 respondents of the five main sociolinguistic groups in the Volta Forest region, in order to identify distinctive traits between both species. Field reconnaissance and confirmation test were used to identify I. gabonensis and I. wombolu trees, which were evaluated against ecological features in folk classification system. Results. Variations existed within each species but were not botanically delimited. The folk classification system was mostly based on fruit pulp taste and some ecological traits. Old local residents only trusted fruit taste to separate these species. Only young Akposso men additionally considered ecology and leaf shape in classification. The reconnaissance survey confirmed the consistency of their folk classification system. Dendrometric parameters of I. gabonensis depended on environmental factors, while land use system and soil geomorphology significantly influenced the occurrence of I. wombolu. Conclusions. Fruit pulp taste and flowering seasons were widely used to distinguish between species, while young men used ecological and botanical features. This demonstrates their recent contact with these taxa. It is also likely that domestication is narrowing differences between I. gabonensis and I. wombolu.

The Veterans Health Administration's integrated model of care increases accessibility and delivery of mental health services.

Depression and posttraumatic stress disorder (PTSD) are two of the most common mental health conditions experienced by veterans. It is unclear what individual and system level factors are associated with receiving mental health treatment for these concerns. Using a national sample of Gulf War Era veterans who endorsed lifetime diagnoses of either depression or PTSD (N = 425), regression analyses were used to predict past-year treatment utilization. Predictor variables were those indicated in the behavioral model of health care utilization, including predisposing demographic variables (e.g., age, race), enabling variables (e.g., service connection, enrollment in Veterans Health Administration [VHA]), and need-based variables (e.g., current symptom severity). VHA enrollment was associated with a three- and five-times higher odds of being treated for depression or PTSD, respectively. Income and symptom severity were also positively associated with treatment utilization. Among individuals with diagnoses of depression and/or PTSD, VHA enrollment was the strongest predictor of receiving mental health treatment for these diagnoses, controlling for all other variables in the model including recent contact with the health care system, current symptom severity, and the presence of other enabling resources. Results suggest that the VHA's integrated model of care increases accessibility and delivery of effective mental health services. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Epidemiologic and Clinical Features of Mpox in Transgender and Gender-Diverse Adults — United States, May–November 2022

As of November 9, 2022, a total of 28,730 cases of monkeypox (mpox) had been reported in the United States,* primarily among adult cisgender men reporting recent male-to-male sexual contact (1). Transgender and gender-diverse persons, who constitute an estimated 0.5% of the U.S. adult population,† face unique health disparities and barriers to care (2-4). However, data on the epidemiologic and clinical features of Monkeypox virus infections in this population are limited (5). CDC analyzed U.S. case surveillance data on mpox cases in transgender and gender-diverse adults reported during May 17-November 4, 2022. During this period, 466 mpox cases in transgender and gender-diverse adults were reported, accounting for 1.7% of reported cases among adults. Most were in transgender women (43.1%) or gender-diverse persons (42.1%); 14.8% were in transgender men. Among 374 (80.3%) mpox cases in transgender and gender-diverse adults with information available on sexual or close intimate contact, 276 (73.8%) reported sexual or close intimate contact with a cisgender male partner during the 3 weeks preceding symptom onset. During the ongoing outbreak, transgender and gender-diverse persons have been disproportionately affected by mpox. Members of this population frequently reported recent sexual or close intimate contact with cisgender men, who might be in sexual networks experiencing the highest incidence of mpox. These findings highlight the importance of tailoring public health prevention and outreach efforts to transgender and gender-diverse communities and could guide strategies to reduce mpox transmission.

BOLSTERING SOCIAL CONNECTEDNESS DURING COVID-19: COMMUNICATION BETWEEN ESSENTIAL CONTACTS AND OLDER ADULTS

Abstract Social isolation may increase morbidity and mortality, particularly for aging adults. Research suggests that COVID-19 has significantly disrupted social networks, exacerbating isolation and risk. However, the extent of disruption and its implications for older adults and their essential contacts (ECs) is unknown. ECs, those who provide support/engagement to older adults, play a significant role in networks and help shape communication patterns. Understanding the effects of COVID-19 on social connectedness between ECs and older adults is vital to promoting their well-being. The purpose of this study was to investigate ECs’ patterns of communication with adults aged 60+ during the COVID-19 pandemic , considering preferences, needs, and barriers. Self-identified ECs (N=546, Aged 19+, MAge=44.3±14.2) completed a Qualtrics survey via Amazon Mechanical Turk. Participants were ECs for community-dwelling (CDECs=57.3%) and institutionalized adults (IECs=42.7%). In addition to likert-style questions, the survey included free-response sections, examining communication quality, frequency, and method. Content analysis was conducted independently by two reviewers, using inductive coding. Qualitative results revealed distanced communication was widely utilized. Audiovisual/video communication was more frequently noted as desirable by IECs (32.8%) than CDECs (11.85%). Further, preference for audiovisual communication negatively correlated to expression of COVID-19-related barriers (IECs=12.5%, CDECs=7.7%, (r(546)= -.128, p=.01). Comparisons suggested that IECs reported absence of in-person contact with older adults more frequently than CDECs (recent contact=Never: 51% and 13.4% respectively). This may support the utility of video-communication to meaningfully supplement connectedness in the absence of in-person contact. The experiences described can reveal avenues for loneliness interventions and may guide future technology innovations.

SARS-CoV-2 infection among healthcare workers whom already received booster vaccination during epidemic outbreak of omicron variant in Taiwan

Background/PurposeHealthcare workers (HCWs) are at risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to occupational exposure. We aim to investigate the prevalence and risk factors of SARS-CoV-2 infection among HCWs during epidemic outbreak of omicron variant in Taiwan. MethodsSequential reserved serum samples collected from our previous study during December 2021 and July 2022 were tested for antibodies against SARS-CoV-2 nucleocapsid protein (NP). Diagnosis of SARS-CoV-2 infection was defined as positive either of anti-SARS-CoV-2 nucleoprotein, rapid antigen test or polymerase chain reaction. Retrospective chart review and a questionnaire were used to access the symptoms and risk factors for SARS-CoV-2 infection. ResultsTotally 300 participants (69.3% female) with a median age of 37.9 years were enrolled. A significant increase incidence of SARS-CoV-2 infection was found before and during community outbreak (11.91 versus 230.93 per 100,000 person-days, P < 0.001), which was a trend paralleling that observed in the general population. For 61 SARS-CoV-2 infected participants, nine (14.8%) were asymptomatic. Multivariate analysis revealed recent contact with a SARS-CoV-2 infected household (odds ratio [OR], 7.01; 95% confidence interval [95% CI], 3.70–13.30; P < 0.001) and co-existed underlying autoimmune diseases (OR, 4.46; 95% CI, 1.28–15.51; P = 0.019) were significant risk factors associated with acquisition of SARS-CoV-2 infection among HCWs. ConclusionCommunity factors, such as closely contact with SARS-CoV-2 infected individuals and underlying immune suppression status, were significant factors for acquisition of SARS-CoV-2 infection among HCWs. We suggest the application of appropriate infection control measures for HCWs should be maintained to reduce risk of SARS-CoV-2 infection.

A STUDY ON CLINICAL PROFILE AND NON-COVID RESPIRATORY VIRAL INFECTIONS IN A NON-COVID TERTIARY CARE HOSPITAL IN KOLKATA DURING COVID PANDEMIC

Objectives: To evaluate the clinical picture and viral aetiologies (other than SARS-CoV-2) of acute respiratory tract infections in under- ve children during the COVID-19 pandemic. Methods: This was a hospital based, prospective, observational and cross-sectional study carried out among under-ve children admitted at IPGME &amp; R, Kolkata, satisfying both inclusion and exclusion criteria. During the study period of one and a half year, after taking consent from the parents, clinical data were collected in pre-formed questionnaire and rt-PCR was implemented to detect respiratory viral pathogen. The statistical analysis was done by using Statistica version 8. Results: A total of 142 children of mean age 13.18 months with Acute Respiratory Infection (ARI) and COVID RT-PCR negative were included in this study. Passive smoking (p-value 0.023), partially completed vaccination (p-value 0.041), non-exclusive breast-feeding in rst 6 months of life (p-value 0.031), history of low birth weight (p-value 0.044) and family history of recent contact of ARI has statistically signicant positive correlation with ARI (0.018). Rhinorrhoea was the most common symptom (prevalence 84%). RSV-A was the most common viral pathogen (33.10%). The death was most strongly associated with adenovirus (RR= 7.962; OR= 28.846; 95%CI= 2.795- 297.719). Congestive cardiac failure, secondary bacterial pneumonia, acute otitis media and acute gastroenteritis were the most prevalent complications. Conclusion: The results provided aetiology, prevalence, seasonality, and clinical manifestations of upper respiratory tract infections and the association of complications and death with each pathogen during the COVID-19 pandemic. Further studies will detect broader range of viruses for better clinico-virological correlation.

The rapid implementation of a pharmacy student vaccination program with the Department of Health to increase the delivery of intradermal monkeypox vaccinations

AbstractThe monkeypox virus is an orthopoxvirus, which is in the same family of viruses as the variola virus that causes smallpox. The United States (US) has documented the largest number of monkeypox globally with a reported 28 000 people infected. The greatest number of cases in the United States have been reported in men, ages 31–40. More than 90% of US cases between 17 May and 22 July 2022 were reported in men who reported recent sex or close contact with a man. Because of New Mexico's unique experience with pharmacist‐administered tuberculin skin testing, pharmacists and pharmacy students were in a position to fill a community needs to provide intradermal monkeypox vaccinations. Pharmacy students at the University of New Mexico administered 355 subcutaneous doses and 534 intradermal doses of the monkeypox vaccine. The purpose of this manuscript is to highlight how pharmacy student interns can be successfully trained to vaccinate using the intradermal route of administration and provide patient care during this public health outbreak.

Predictors of consistent condom use among young psychoactive substance users in Kampala's informal settlements, Uganda.

The use of psychoactive substances increases the likelihood of unprotected sexual intercourse with individuals whose health status is not known, and consequently sexually transmitted infections, especially among young people. Despite this risk, there is limited evidence of the predictors of consistent condom use among young psychoactive substance users (YPSUs) in informal settings. This study examined the predictors of condom use among YPSUs in Kampala's informal settlements, Uganda. A cross-sectional study was conducted among 768 YPSUs. Respondent-driven sampling was used to recruit respondents. A structured questionnaire was used to collect respondent data on condom use. Data were analysed using Stata version 15.0. Prevalence ratios (PR) were used to determine the predictors of consistent condom use. Out of the 744 YPSUs, only 37.4% of the respondents reported consistent condom use in the last 30 days. The prevalence of condom use was statistically lower among young people aged 20-24 years (35.4%) compared to those aged 18-19 years (43.7%), and among the married (17.3%) compared to respondents with a "single" marital status (43.0%). Being married (PR 0.42, 95% CI: 0.30-0.59), longer duration between meeting the most recent partner and having initial sexual contact with them (7 months to 1 year: PR 0.56, 95% CI: 0.36-0.88; more than a year: PR 0.36, 95% CI: 0.17-0.75) was negatively associated with consistent condom use. Spending less than 24 h between meeting the most recent partner and having initial sexual contact was positively associated with consistent condom use (PR 1.60, 95% CI: 1.24-2.08). The prevalence of consistent condom use in the last 30 days among YPSUs was low. Marital status and the duration between meeting the most recent partner and initial sexual contact predicted consistent condom use. There is a need to intensify awareness on the importance of consistent condom use among young people.

A Shallow Large Ulcer on the Ileocecal Valve in a Young Man With Ulcerative Proctitis

Question: A 25-year-old man was presented to the emergency department with fever, abdominal pain, diarrhea, fatigue, and malaise for a week. He denied any history of cough, weight loss, chills, night sweats, upper respiratory tract symptoms, nausea, or vomiting. There was no history of smoking, chronic use of medications such as nonsteroidal antiinflammatory drugs (NSAIDs), recent sick contact, recent travel, or known ingestion of contaminated foods.

Corynebacterium ulcerans as filamentous branching rods

A 33-year-old man presented at the hospital because of a left axillary adenitis which appeared one month before. He had no prior medical history and was up-to-date on his vaccinations. He had two dogs and had been in recent contact with cattle in the course of his work as a rat exterminator. Physical examination revealed a growing and inflammatory axillary lesion associated with a dry cough. Blood analysis revealed hypereosinophilia (eosinophils count: 2.53x109/L). The Gram staining of the lymph node aspiration showed Gram-variable filamentous branching rods (Fig.