The ongoing 2022 multi-country outbreak of monkeypox is the largest in history to occur outside of Africa. Monkeypox is an emerging zoonotic virus which for decades has been viewed as an infectious disease with significant epidemic potential because of the increasing occurrence of human outbreaks in recent years. As public health entities work to contain the current outbreak, healthcare professionals globally are aiming to become familiar with the various clinical presentations and management of this infection. We present in this review an updated overview of monkeypox for healthcare professionals in the context of the ongoing outbreaks around the world.

Background Despite a significant survival advantage of kidney transplantation compared to dialysis, nearly one-third of end stage renal disease (ESRD) patients are not educated about kidney transplantation as a treatment option at the time of ESRD diagnosis. Access to individualized, evidence-based prognostic information is needed to facilitate and encourage shared decision making about the clinical implications of whether to pursue transplantation or long-term dialysis. Study Design We utilized a national cohort of incident ESRD patients in the U.S. Renal Data System surveillance registry from 2005 to 2011 to develop and validate prediction models for risk of 1- and 3-year mortality among dialysis vs. kidney transplantation. Using these data, we developed a mobile clinical decision aid that provides estimates of risks of death and survival on dialysis compared to kidney transplantation. Results Factors included in the mortality risk prediction models for dialysis and transplantation included age, race/ethnicity; dialysis vintage, and comorbidities, including diabetes, hypertension, cardiovascular disease, and low albumin. Among the validation cohorts, the discriminatory ability of the model for 3-year mortality was moderate (c-statistic = 0.7047 [95% CI: 0.7029-0.7065] for dialysis and 0.7015 [95% CI: 0.6875-0.7155] for transplant). We used these risk prediction models to develop an electronic, user-friendly, mobile (iPad, iPhone, and website) clinical decision aid called iChoose Kidney. Conclusions The use of a mobile clinical decision aid comparing individualized mortality risk estimates for dialysis vs. transplantation could enhance communication between ESRD patients and their clinicians when making decisions about treatment options.