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Toronto dancer tells of excruciating pain, isolation and stigma of monkeypox infection – Global News

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Peter Kelly was still bouncing back from COVID-19 when a case of monkeypox gave him the “worst pain” of his life.

The 28-year-old Toronto resident had only just returned to work as a dancer and physical trainer in late May when he developed a fever.

“I was so delirious,” he said in an interview, as he described the agonizing symptoms associated with the disease and the sense of isolation during about three weeks of home quarantine.

“I must have been really sick and I didn’t even know. For two days I didn’t really move, I would just go to the washroom and go back to bed and sleep some more. It was super high fever and night chills. I was wearing a winter jacket in bed, I was so cold.”

Read more:

Public Health Ontario reports 230 monkeypox cases, up from 156 in last update

Kelly’s fever broke on the third day and soon after he said he noticed red rash. He said he immediately began to search the web for what the rash might be.

“You start Googling this and that’s the worst thing you could ever do.”

Doctors suspected it was herpes, which Kelly said “freaked” him out.

“That started to really affect my mental health because you can’t cure it. You can just control that over the years.”

But he looked at the pictures more closely, and wondered if it was monkeypox.

Read more:

Is monkeypox now a global crisis? WHO to consider again

He went to the local hospital and told the authorities: “I need a monkeypox test, please.” The result came back positive.

Kelly said he was one of the first people in Ontario to be infected with that virus and is now part of a study among former patients being conducted at St. Michael’s Hospital in Toronto.

The Public Health Agency of Canada has recorded more than 600 cases of monkeypox, or MPXV as it is known in the scientific community, since the first report in early June. Quebec has the highest number of cases at over 300, followed by 230 in Ontario, 40 in British Columbia and about a dozen in Alberta. The disease has mostly been reported among men who have sex with men.

There are over 6,000 lab-confirmed cases across the globe and three people have died from the disease, showed data from the World Health Organization. Local transmission of monkeypox has been recorded with no epidemiological links to countries that have previously reported monkeypox, such as western or central parts of Africa, it said.

Kelly said his rash and lesions were some of the most painful things he has had to endure and the simple act of rolling over was “excruciating.”

It was when the rash started to turn into boils that the pain became unimaginable, he recalled.

Read more:

More monkeypox vaccines soon to be sent to U.S., health officials say

“That is when the pain was throbbing. And I mean throbbing,” he said. “It felt like electric shocks. I didn’t sleep for probably like 30 hours or something. It was just so painful. I had a washcloth between my teeth trying to clamp on it, just to rock myself through the pain. But I couldn’t handle it. It was insane.”

One lesion on his left foot began to pool blood because he had to put his weight on it to walk, he said.

Adding to the physical pain was the mental stress, he said.

Apart from visits to hospitals and clinics, Kelly remained isolated in his tiny Toronto apartment.

“I felt helpless because I’m being told to isolate for God only knows how long and I’m in excruciating pain,” he said.

During those three weeks, Kelly said he lost all his dancing and training work but his bills kept piling up.

He spent $50 a week at the coin-operated laundry in his building, and $120 on bandages and sterile supplies.

Friends dropped off food and groceries and coins for the laundry. Toronto Public Health gave him a grocery store gift card, although he didn’t know how to use it while in isolation.


Click to play video: 'Monkeypox: With cases jumping 59% in Canada, what are the signs you need to know?'



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Monkeypox: With cases jumping 59% in Canada, what are the signs you need to know?


Monkeypox: With cases jumping 59% in Canada, what are the signs you need to know?

As one of the first diagnosed cases of monkeypox in Toronto, Kelly said he felt “he was a bit of a guinea pig.”

He was told to “triple bag” all his garbage and label it as hazardous waste, to be picked up by a team, he said.

Kelly said he “for sure” contracted the virus at a bathhouse. “I got it because I like to have sex,” he said.

While he got a lot of support, he also received some hateful messages on social media.

“’You got the gay pox’, or ‘you’re disgusting’, or ‘you deserve to get it,”’ he said recalling some of the messages.

Kelly said that there was a stigma to contracting monkeypox, and he initially worried how people would react to his infection. But be decided to be open about it.

“I’m going to tell someone about this because there are more people, it’s not just me. They’re in the same situation at home isolating and there’s no one talking about it. There’s no resources or anything.”

He said he would like the government and public health agencies to devote more resources to fighting the spread of monkeypox.

His isolation period ended on June 21 and Kelly said he found a whole new appreciation for the outdoors.

“I’m getting on with my life.”

© 2022 The Canadian Press

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'Similar strategy' needed for global CVD prevention in men, women: PURE – Healio

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September 23, 2022

2 min read

Disclosures:
One author reports receiving speaker and consultant fees from Bayer and Janssen for work unrelated to this study. Walli-Attaei and the other authors report no relevant financial disclosures.

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The magnitude of associations with major CVD for most risk factors are similar in women and men, despite sex differences in risk factor levels, according to an analysis of the PURE study.

In a comprehensive overview of the prevalence of metabolic, behavioral and psychosocial risk factors for CVD in women and men globally, researchers also found that diet was more strongly associated with CVD in women than in men. However, high concentrations of non-HDL and related lipids and symptoms of depression were more strongly associated with risk for CVD in men than in women. Patterns remained consistent across countries regardless of income level.

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“Existing studies, mostly from high-income countries, have reported that hypertension, diabetes, and smoking are more strongly associated with cardiovascular disease in women than in men,” Marjan Walli-Attaei, PhD, a research fellow at the Population Health Research Institute of McMaster University and Hamilton Health Sciences, and colleagues wrote in The Lancet. “Such findings would imply that women would benefit to a greater extent in reducing cardiovascular disease risk from control of these risk factors than would men. However, the burden of cardiovascular disease is greatest in low-income and middle-income countries, for which prospective data on the association of risk factors with cardiovascular disease are sparse, with a paucity of analysis by sex.”

Marjan Walli-Attaei

Walli-Attaei and colleagues analyzed data from 155,724 adults aged 35 to 70 years at baseline without a history of CVD enrolled in the PURE study, which included participants from 21 high-, middle- and low-income countries, and followed them for approximately 10 years (58% women; mean baseline age, 50 years). Researchers recorded information on participants’ metabolic, behavioral and psychosocial risk factors; all participants had at least one follow-up visit. The primary outcome was a composite of major CV events, defined as CV death, MI, stroke and HF. Researchers reported the prevalence of each risk factor in women and men, HRs and population-attributable fractions associated with major CVD.

As of the data cutoff of Sept. 13, 2021, researchers observed 4,280 major CVD events in women (age-standardized incidence rate, 5 events per 1,000 person-years) and 4,911 in men (age-standardized incidence rate, 8.2 per 1,000 person-years).

Compared with men, women presented with a more favorable CV risk profile, especially at younger ages. HRs for metabolic risk factors were similar in women and men, except for non-HDL, for which high non-HDL was associated with an HR for major CVD of 1.11 in women (95% CI, 1.01-1.21) and 1.28 in men (95% CI, 1.19-1.39; P for interaction = .0037), with a consistent pattern for higher risk among men than women with other lipid markers.

Researchers also observed that maintaining a diet with a PURE score of 4 or lower (score range, 0-8) was more strongly associated with major CVD in women than in men, with HRs of 1.17 (95% CI, 1.08-1.26) and 1.07 (95% CI, 0.99-1.15; P for interaction = .0065), respectively.

In contrast, symptoms of depression were more strongly associated with CVD in men than in women, with the HRs for symptoms of depression being higher in men than in women (P for interaction = .0002). “The HRs of other behavioral and psychosocial risk factors, as well as grip strength and household air pollution, were similar among women and men,” the researchers wrote.

The total population-attributable fractions associated with behavioral and psychosocial risk factors were greater in men than in women (15.7% vs. 8.4%) mostly due to the larger contribution of smoking to population-attributable fractions in men (10.7%) vs. women (1.3%).

“Our results emphasize the importance of a similar strategy for the prevention of cardiovascular disease in both sexes,” the researchers wrote. “However, the increased risk of cardiovascular disease in men might be substantially attenuated with better reductions in tobacco use and lipid concentrations.”

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Blood Clot Risk Remains Higher Almost a Year After COVID – The Suburban Newspaper

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FRIDAY, Sept. 23, 2022 (HealthDay News) — An increased risk of blood clots persists for close to a year after a COVID-19 infection, a large study shows.

The health records of 48 million unvaccinated adults in the United Kingdom suggest that the pandemic’s first wave in 2020 may have led to an additional 10,500 cases of heart attack, stroke and other blood clot complications such as deep vein thrombosis, in England and Wales alone.

The risk of blood clots continues for at least 49 weeks after infection, the study found.

“We have shown that even people who were not hospitalized faced a higher risk of blood clots in the first wave,” said study co-leader Angela Wood, associate director of the British Heart Foundation Data Science Centre.

“While the risk to individuals remains small, the effect on the public’s health could be substantial and strategies to prevent vascular events will be important as we continue through the pandemic,” Wood said in a news release from Health Data Research UK, which sponsors the center.

Researchers found that the risks did lessen over time.

Patients were 21 times more likely to have a heart attack or stroke in the week after their COVID diagnosis. After four weeks, the risk was 3.9 times greater than usual.

Heart attacks and strokes are mainly caused by blood clots blocking arteries.

The risk of clots in veins was 33 times greater in the week after COVID diagnosis, dropping to eight times greater after four weeks. Conditions caused by these clots include deep vein thrombosis and pulmonary embolism, which can be fatal.

By 26 to 49 weeks after a COVID diagnosis, the risk dropped to 1.3 times more likely for clots in arteries and 1.8 times more likely for clots in veins, the study showed.

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While people who were not hospitalized had a lower risk, it was not zero, the study found.

Overall, individual risk remains low, the authors said. Men over 80 years of age are at highest risk.

“We are reassured that the risk drops quite quickly — particularly for heart attacks and strokes — but the finding that it remains elevated for some time highlights the longer-term effects of COVID-19 that we are only beginning to understand,” said study co-leader Jonathan Sterne, director of the NIHR Bristol Biomedical Research Center and of Health Data Research UK South West.

The authors said steps such as giving high-risk patients blood pressure-lowering medication could help reduce cases of serious clots.

Researchers are now studying newer data to understand how vaccination and the impact of new COVID variants may affect blood clotting risks.

The findings were recently published in the journal Circulation.

More information

The U.S. Centers for Disease Control and Prevention has more on blood clots.

SOURCE: Health Data Research UK, news release, Sept. 20, 2022

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MPs, Senators debate requirements for medically assisted dying with mental disorders

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OTTAWA — An expert told a special joint committee of the House of Commons and Senate that people with mental disorders can suffer for decades, and their distress is equally as valid as someone suffering physical pain.

People suffering solely from mental disorders are due to become eligible for assisted dying in March, and Dr. Justine Dembo, a psychiatrist and medical assistance in dying assessor, also cautioned the committee about perpetuating stigma about mental illness.

Mental health advocates warn it is harder to predict the outcomes and treatments of mental illnesses, and a wish to die is often a symptom, but an expert panel earlier this year said existing eligibility criteria and safeguards in medically assisted dying legislation would be adequate.

Both arguments were made today by a handful of witnesses appearing before the committee, which is deliberating what policies to recommend to lawmakers ahead of the March deadline.

Ellen Cohen, a coordinator advocate for the National Mental Health Inclusion Network, told committee members Canada needs laws to help patients, not hurt them.

“I don’t believe there were any safeguards recommended,” she said.

She resigned from the federal government’s expert panel on MAID and mental illness in December 2021. She said there was no space to identify how vulnerable people could be protected.

The panel released its report May 13, concluding that existing eligibility criteria and safeguards would be adequate “so long as those are interpreted appropriately to take into consideration the specificity of mental disorders.”

Dembo, who was one of the expert panel members, said following those guidelines for people with mental disorders “would ensure an extremely comprehensive, thorough and cautious approach.”

She told the committee people with mental disorders can suffer for decades.

“To say someone with mental illness just shouldn’t be eligible, with that big of a blanket statement, where people don’t even get the chance to be assessed as individuals unique in their circumstances, to me is very stigmatizing,” she said.

While the interim report released earlier this year stops short of making recommendations of its own,  it concludes by urging the government to take steps to implement the recommendations of the expert panel “in a timely matter.”

A final report from the committee, complete with recommendations that address other areas including access for mature minors, advance requests, the state of palliative care and the protection of people with disabilities, is due on Oct. 17.

Cohen called the timeline for the legislation to be expanded by March unrealistic.

“I’d like to see this government push this deadline back,” she said.

But Dembo disagreed, telling MPs and senators that assessors are already gaining experience following the existing guidelines.

“Whether or not March 2023 is a realistic deadline depends on how committed and efficient various provincial bodies and local bodies can be in implementing guidelines based on the panel report. I’m hoping they can do that,” she said.

The committee’s review was mandated in the MAID legislation that required that a parliamentary review be initiated five years after the law came into effect in 2016. The committee began its work in 2021 before it was dissolved ahead of the federal election last fall.

The panel and the committee use the terminology “mental disorders,” rather than “mental illness,” stating in their reports that there is no standard definition for the latter and its use could cause confusion.

Conservative MPs on the committee offered a dissenting interim report earlier this year, saying it would be “problematic” to simply endorse the panel’s recommendations.

The MPs argued there are “far too many unanswered questions” on the subject, and nothing precludes the committee from revisiting whether assisted dying should be offered to this category of people at all.

“Legislation of this nature needs to be guided by science, and not ideology,” the Conservatives wrote in May, warning that an outcome that could “facilitate the deaths of Canadians who could have gotten better” would be completely unacceptable.

This report by The Canadian Press was first published Sept. 23, 2022

 

The Canadian Press

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