We report a case of monkeypox in a man who returned from Nigeria to Israel in 2018. Virus was detected in pustule swabs by transmission electron microscopy and PCR and confirmed by immunofluorescence assay, tissue culture, and ELISA. The West Africa monkeypox outbreak calls for increased awareness by public health authorities worldwide.

Background-Defining the presence, extent, and nature of the dysfunctional myocardial tissue remains a cornerstone in diagnostic cardiology. A nonfluoroscopic, catheter-based mapping technique that can spatially associate endocardial mechanical and electrical data was used to quantify electromechanical changes in the canine chronic infarction model. Methods and Results-We mapped the left ventricular (LV) electromechanical regional properties in 11 dogs with chronic infarction (4 weeks after LAD ligation) and 6 controls. By sampling the location of a special catheter throughout the cardiac cycle at multiple endocardial sites and simultaneously recording local electrograms from the catheter tip, the dynamic 3-dimensional electromechanical map of the LV was reconstructed. Average endocardial local shortening (LS, measured at end systole and normalized to end diastole) and intracardiac bipolar electrogram amplitude were quantified at 13 LV regions. Endocardial LS was significantly lower at the infarcted area (1.2Ϯ0.9% [meanϮSEM], PϽ0.01) compared with the noninfarcted regions (7.2Ϯ1.1% to 13.5Ϯ1.5%) and with the same area in controls (15.5Ϯ1.2%, PϽ0.01). Average bipolar amplitude was also significantly lower at the infarcted zone (2.3Ϯ0.2 mV, PϽ0.01) compared with the same region in controls (10.3Ϯ1.3 mV) and with the noninfarcted regions (4.0Ϯ0.7 to 10.2Ϯ1.5 mV, PϽ0.01) in the infarcted group. In addition, the electrical maps could accurately delineate both the location and extent of the infarct, as demonstrated by the high correlation with pathology (Pearson's correlation coefficientϭ0.90) and by the precise identification of the infarct border. Conclusions-Chronic myocardial infarcted tissue can be characterized and quantified by abnormal regional mechanical and electrical functions. The unique ability to assess the regional ventricular electromechanical properties in various myocardial disease states may become a powerful tool in both clinical and research cardiology. (Circulation. 1998;98:2055-2064.)

BACKGROUND Catheter navigation and 3-dimensional (3D) cardiac mapping are essential components of minimally invasive electrophysiological procedures. OBJECTIVE The purpose of this study was to develop a novel 3D mapping system (KODEX-EPD, EPD Solutions, Best, The Netherlands) that measures changing electric field gradients induced on intracardiac electrodes to enable catheter localization and real-time 3D cardiac mapping. METHODS We first validated the accuracy of the system's measurement and localization capabilities by comparing known and KODEX-EPD-measured distances and locations at 12 anatomical landmarks in both the atria and ventricles of 4 swine. Next, in vivo images of 3D porcine cardiac anatomy generated by KODEX-EPD and widely used CARTO 3 system (Biosense Webster, Inc., Diamond Bar, CA) were compared with gold standard computed tomography images acquired from the same animals. Finally, 3D maps of atrial anatomy were created for 22 patients with paroxysmal atrial fibrillation (Dielectric Unravelling of Radiofrequency ABLation Effectiveness trial). RESULTS First, the mean error between known and measured distances was 1.08 6 0.11 mm (P , .01) and the overall standard deviation between known and measured locations in 12 areas of the porcine heart was 0.35 mm (P , .01). Second, an expert comparison of 3D image quality revealed that KODEX-EPD is noninferior to CARTO 3. Third, the system enabled 3D imaging of atrial anatomy in humans, provided real-time images of atrioventricular valves, and detected important anatomical variations in a subset of patients. CONCLUSION The KODEX-EPD system is a novel 3D mapping system that accurately detects catheter location and can generate high-resolution images without the need for preacquired imaging, specialty catheters, or a point-by-point mapping procedure.

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Combined IS and EBC measurements detect underlying inflammation in airways of asymptomatic welders. It emerged that airway inflammation is present in asymptomatic welders, and that the particle burden, inflammatory cells, and level of oxidative stress are a function of the type and the duration of welding. Am. J. Ind. Med. 51:503-511, 2008.