The impact of seasonal influenza vaccination uptake on COVID-19 vaccination attitudes in a rural area in Greece.

INTRODUCTION: Promoting vaccination for coronavirus disease 2019 (COVID-19), especially for high-risk groups such as the elderly and persons with comorbidities, is important for reducing the incidence of severe disease and death. METHODS: Retrospective cross-sectional study of factors associated with COVID-19 vaccination, including previous influenza vaccination, among all persons who received medical services in a rural area in Crete, Greece, between October 2020-May 2021. RESULTS: Among 3129 participants, receipt of influenza vaccination in 2020-21 was strongly associated with COVID-19 vaccination, as was influenza vaccination in 2019-20, albeit to a lesser extent. In addition, persons older than 59 years (with exception of those 90 + years old) and those who lived closer to the hospital/health center, were more likely to vaccinate for COVID-19. Persons younger than 40 years of age, females, persons with mental illness or neurologic disease, were also less likely to vaccinate for COVID-19 (all p < 0.001). CONCLUSIONS: COVID-19 vaccination was more likely among those who were vaccinated for influenza before and during the pandemic. Access to healthcare services and specific comorbidities, were important influencers for vaccination, underlying the importance of tailored interventions to enforce vaccination in high-risk groups.

Assessing the knowledge, attitudes and perceptions of junior doctors on antimicrobial use and antimicrobial resistance in Greece.

OBJECTIVES: Understanding antimicrobial prescribing attitudes and perceptions, especially in the early stages of medical training, is an important driver for appropriate interventions. This study examined junior doctors' knowledge, attitudes and perceptions regarding antimicrobial use and antimicrobial resistance in Greece. METHODS: A self-administered, internet-based questionnaire survey was completed by trainees and residents of all primary care centres and hospitals in Crete, Greece. RESULTS: From the 313 invited junior doctors, 214 (68.4%) fully completed the questionnaire. The mean correct knowledge score (four items) was 60%. The highest confidence rates with prescribing were recorded in accurately diagnosing an infection that needs antimicrobial treatment, selecting an appropriate administration route, and selecting the appropriate dosage. The lowest confidence rates were recorded in modifying antimicrobial treatment based on clinical and/or microbiological evidence, prescribing antimicrobial combinations and not prescribing an antimicrobial in a febrile patient without severity criteria and uncertain diagnosis of infection. Use of guidelines and expert consultation were perceived as the most important factors influencing antimicrobial prescribing practices. Most participants were aware of the antimicrobial resistance problem in Greece, and considered excessive prescribing of antimicrobials and broad-spectrum antimicrobials to be the most important causes. Availability of local and national guidelines and antimicrobial resistance data, senior consultation and infectious diseases specialist consultation were the preferred interventions to improve antimicrobial prescribing. CONCLUSIONS: The findings of this study will contribute to the design of appropriate interventions, based on local evidence, for the establishment of antimicrobial stewardship programs in a country characterised by excessive use of antimicrobials and high resistance rates.

Differentiating Rhinitis in the Paediatric Population by Giving Focus on Medical History and Clinical Examination.

Chronic rhinitis is defined as an inflammation of the nasal epithelium, and is characterized by the presence of two or more specific nasal symptoms including obstruction, rhinorrhea, sneezing, and/or itching for at least 12 weeks. In childhood, this clinical entity is very common and carries a significant socioeconomic burden. The impact on the physical, social, and psychological well-being of family cannot be underestimated. Rhinitis is an umbrella term which includes different phenotypes of rhinitis with distinct underlying pathophysiologic mechanisms. In most cases the diagnosis of rhinitis is rather straightforward; however, sometimes when based on clinical symptomatology, characterization may be challenging. Herein, we provide guidance for getting all the data needed for the differential diagnosis of rhinitis based on medical history and clinical examination.

Varicella-zoster virus meningitis with hypoglycorrhachia in a young immunocompetent adult without rash: A case report and literature review.

Overt aseptic meningitis rarely complicates varicella-zoster virus (VZV) reactivation in young and immunocompetent adults. Many of the cases of VZV meningitis are associated with an exanthem. We describe an otherwise healthy 36-year-old adult who had aseptic meningitis without skin rash, caused by reactivation of varicella-zoster virus. Cerebrospinal fluid (CSF) analysis revealed lymphocytosis, increased total protein, and low glucose. Diagnosis was made by polymerase chain reaction in CSF. The present case highlights the fact that VZV should be considered as a cause of aseptic meningitis with hypoglycorrhachia in healthy and young individuals, even in the absence of an exanthem.

Contemporary Use of Corticosteroids in Rhinology.

PURPOSE OF REVIEW: Exogenously administered corticosteroids are widely used today in the field of rhinology. Allergic rhinitis (AR), non-allergic rhinitis (NAR), acute rhinosinusitis (ARS), chronic rhinosinusitis with (CRSwNP) and without (CRSsNP) nasal polyps, and autoimmune disorders with nasal manifestations are common diseases treated effectively with intranasal and oral glucocorticoids. We focus on physiological pathways, therapeutic benefits, indications, contra-indications, and side effects of glucocorticoid utilization in the treatment of rhinologic disorders such as AR, NAR, ARS, CRSsNP, and CRSwNP. RECENT FINDINGS: Second-generation intranasal steroid (INS) agents have pharmacokinetic characteristics that minimize their systemic bioavailability, resulting in minimum risk for systemic adverse events. Several studies have demonstrated the symptomatic efficacy of both intranasal and oral corticosteroids in ARS. Moreover, intranasal and systemic steroid administration has been repeatedly proven beneficial in the conservative and perioperative management of CRSwNP. For patients with AR, there is no need for oral steroids, with the exception of severe cases, as there is lack of superiority to INS. SCUAD patients challenge currently available treatment schemes, underlining the importance of research in the field. Corticosteroids' effectiveness in the treatment of various rhinologic disorders is indisputable. However, their characteristics, and potential side effects, make a clear consensus for utilization difficult.