Bloodstream infections in the era of the COVID-19 pandemic: Changing epidemiology of antimicrobial resistance in the intensive care unit.

The Coronavirus disease 2019 (COVID-19) pandemic increased the burden of critically ill patients who required hospitalization in the intensive care unit (ICU). Bacterial and fungal co-infections, including bloodstream infections (BSIs), increased significantly in ICU patients with COVID-19; this had a significant negative impact on patient outcomes. Reported data pertaining to BSI episodes from the ICU setting during the COVID-19 pandemic were collected and analyzed for this narrative review.

Validation of Sequential ROX-Index Score Beyond 12 Hours in Predicting Treatment Failure and Mortality in COVID-19 Patients Receiving Oxygen via High-Flow Nasal Cannula.

Background: High-flow nasal cannula (HFNC) is an oxygen delivery method shown to reduce the risk of intubation and mortality in patients with type 1 respiratory failure. The ROX-index score can predict HFNC failure. This study aims to evaluate sequential ROX-index assessments as predictors of HFNC failure and mortality.

Protection of vaccination versus hybrid immunity against infection with COVID-19 Omicron variants among Health-Care Workers.

Background Aim: The Omicron COVID-19 variants BA.1* and BA.2* evade immune system leading to increased transmissibility and breakthrough infections.

A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients.

We aimed to search for laboratory predictors of critical COVID-19 in consecutive adults admitted in an academic center between 16 September 2020−20 December 2021. Patients were uniformly treated with low-molecular-weight heparin, and dexamethasone plus remdesivir when SpO2 < 94%. Among consecutive unvaccinated patients without underlying medical conditions (n = 241, 49 year-old median, 71% males), 22 (9.

Vaccination Hesitancy among Health-Care-Workers in Academic Hospitals Is Associated with a 12-Fold Increase in the Risk of COVID-19 Infection: A Nine-Month Greek Cohort Study.

Health-Care-Workers (HCWs) are considered at high risk for SARS-CoV-2 infection. We sought to compare rates and severity of Coronavirus disease 2019 (COVID-19) among vaccinated and unvaccinated HCWs conducting a retrospective cohort study in two tertiary Academic Hospitals, namely Laiko and Attikon, in Athens, Greece. Vaccinated by BNT162b2 Pfizer-BioNTech COVID-19 mRNA vaccine and unvaccinated HCWs were included and data were collected between 1 January 2021 and 15 September 2021.

Alterations in cortisol and interleukin-6 secretion in patients with COVID-19 suggestive of neuroendocrine-immune adaptations.

Purpose: The beneficial effect of glucocorticoids in coronavirus disease (COVID-19) is established, but whether adrenal cortisol secretion is impaired in COVID-19 is not fully elucidated. In this case-control study, we investigated the diurnal free bioavailable salivary cortisol secretion in COVID-19 patients.

Methods: Fifty-two consecutive COVID-19 patients-before dexamethasone treatment in cases required-recruited between April 15 to June 15, 2021, (NCT04988269) at Laikon Athens University-Hospital, and 33 healthy age- and sex-matched controls were included.

Developing a risk prediction model for 30-day unplanned hospitalization in patients receiving outpatient parenteral antimicrobial therapy.

Objectives: Outpatient parenteral antimicrobial therapy (OPAT) is increasingly used to treat a wide range of infections. However, there is risk of hospital readmissions. The study aim was to develop a prediction model for the risk of 30-day unplanned hospitalization in patients receiving OPAT.

Outpatient parenteral antimicrobial therapy (OPAT) in the UK: a cross-sectional survey of acute hospital trusts and health boards.

This study reviews the current OPAT service provision in the UK and evaluates concordance with the national OPAT practice guidelines (standards of care). We conducted a survey of acute hospital trusts and health boards in the UK regarding OPAT practices between June and September 2017. 165 (93%) of the 178 acute hospital trusts/health boards that were contacted responded to the survey.

Syphilis infection in an HIV patient presenting with leukemoid reaction: Case report and review of the literature.

Leukemoid reaction (LR) is an uncommon though dreadful sign for the treating physician, as it is related to increased mortality. In the few series that have addressed its incidence and clinical significance, infectious causes count for about half of the cases of LR, the rest accounting for cancer, drugs or rarer causes. In the HIV setting, it represents an even rarer event, owing probably to the impaired granulocytic response of AIDS patients to bacterial agents.

Clinical efficacy, cost analysis and patient acceptability of outpatient parenteral antibiotic therapy (OPAT): a decade of Sheffield (UK) OPAT service.

Outpatient parenteral antimicrobial therapy (OPAT) has evolved relatively slowly in the UK. This study describes the OPAT service based in a large UK teaching hospital in Sheffield, and examines the clinical efficacy, patient acceptability and costs saved over a 10-year period. Data on 3812 episodes of OPAT administered between January 2006 and January 2016 were retrieved from a prospectively maintained electronic database.

The clinical evidence and the role of imiquimod in the extramammary Paget disease.

Extramammary Paget disease is a rare disease. Different treatment options are used for its management, among them treatment with imiquimod. Our aim is to clarify the efficacy and safety of the use of topical imiquimod cream in the treatment of extramammary Paget disease.

Ant mandibles as staples in the era of Greek patriot Ioannis Makriyannis (1797-1864).

The use of ant mandibles as surgical clips was documented by the ancient Indian physicians Susruta and Charaka as early as 1000 BC and continued in some world areas into the early 1900s. According to the memoirs of the Greek revolutionary general Ioannis Makriyannis, this technique was also applied in the battlefields of the Greek Revolution for Independence between 1821 and 1832.

Ultrasensitive amplification refractory mutation system real-time PCR (ARMS RT-PCR) assay for detection of minority hepatitis B virus-resistant strains in the era of personalized medicine.

Resistance to antiviral treatment for chronic hepatitis B virus (HBV) has been associated with mutations in the HBV polymerase region. This study aimed at developing an ultrasensitive method for quantifying viral populations with all major HBV resistance-associated mutations, combining the amplification refractory mutation system real-time PCR (ARMS RT-PCR) with a molecular beacon using a LightCycler. The discriminatory ability of this method, the ARMS RT-PCR with molecular beacon assay, was 0.

Amphiaraos of Attica: the "Second Asclepius".

Amphiaraos is one of the most prominent Greek heroes. He was the son of god Apollo and student of Centaur Chiron from whom he learned the art of medicine. He was thought to be the "Second Asclepius" and he had many sanctuaries around Greece of which the most well known is the Amphiaraeion of Oropos, near Athens.

Classic congenital adrenal hyperplasia with virilisation and salt-wasting: from birth to the adult life.

Aim: Our objective was to show the way the classic CAH presents after birth as a severe condition and develops to the adult life, effecting growth, height and weight, appearance, fertility, relationships and quality of life.

Case: We report the case of a 23-years-old female with the classic Congenital Adrenal Hyperplasia (CAH) from birth, diagnosed due to genital pigmentation, clitoromegaly and salt-wasting crisis, treated with glucocorticoid replacement (hydrocortisone, fludrocortisone and NaCI), followed by genital surgery, until the adult life when she continues treatment with fludrocortisone and prednisolone.

Conclusion: A treatment challenge is to effectively control the excess androgen symptoms by using the lowest possible glucocorticoid dose.

Guillain-Barre syndrome presenting with sensory disturbance following a herpes virus infection: a case report.

Introduction: We present a case of an unusual clinical manifestation of Guillain-Barre syndrome following a pre-existing herpes virus infection. Although there have been several reports describing the co-existence of herpes virus infection and Guillain-Barre syndrome, we undertook a more in-depth study of the cross-reactivity between herpes viruses and recommend a follow-up study based on serology tests.

Case Presentation: A 39-year-old healthy Caucasian man with Guillain-Barre syndrome presented to our facility initially with sensory disturbance, followed by an atypical descending pattern of clinical progression.

Aseptic meningitis with urinary retention: a case report.

Introduction. Aseptic meningitis is serious inflammation of the meninges caused by agents including viruses, non-viral pathogens, non-infectious conditions and chemicals. Case Presentation.

β-D-glucan assay for the diagnosis of invasive fungal infections: a meta-analysis.

We aimed to assess the accuracy of measuring serum or plasma (1→3)-β-D-glucan (BDG) for the diagnosis of invasive fungal infections (IFIs) by means of a meta-analysis of relevant studies. We searched in bibliographic databases for relevant cohort or case-control studies. We primarily compared BDG between patients with proven or probable IFIs (excluding Pneumocystis jirovecii infections), according to the criteria of the European Organization for Research and Treatment of Cancer/Mycoses Study Group or similar criteria, and patients without IFIs (excluding healthy individuals as controls).

Complications in pregnancy after bariatric surgery.

Introduction: The application of bariatric surgery has recently spread among obese women including women of reproductive age.

Materials And Methods: We sought to present three cases of obese women undergoing bariatric surgery, their monitoring and complications during pregnancy.

Conclusion: We suggest that conception should be postponed for at least 18 months after bariatric operation to avoid complications concerning both mother and fetus mainly associated with nutritional deficiencies due to the anatomical and physiological changes of such operations.

Do PubMed and Google searches help medical students and young doctors reach the correct diagnosis? A pilot study.

Background: In the era of the World Wide Web we sought to examine whether the use of PubMed and Google can help physicians to improve their diagnostic skills.

Methods: Twenty-six diagnostic cases presented in the case records of the New England Journal of Medicine during 2005 were used for our analysis. Three investigators (one trainee doctor and two final year medical students), tried determining the diagnosis, initially without and afterwards with the use of PubMed and Google.

Fournier's gangrene in a patient after third-degree burns: a case report.

Introduction: Fournier's gangrene is characterized by tissue ischemia leading to rapidly progressing necrotizing fasciitis.

Case Presentation: We present the case of a patient with Fournier's gangrene after third-degree burns. Clinical manifestations, laboratory results and treatment options are discussed.

Quantitative detection of the M204V hepatitis B virus minor variants by amplification refractory mutation system real-time PCR combined with molecular beacon technology.

Mutations in the highly conserved tyrosine-methionine-aspartate-aspartate (YMDD) motif are frequently associated with resistance to antivirals and represent a major concern in the treatment of hepatitis B virus (HBV) infection. Conventional methods fail to detect minority populations of drug-resistant viral quasispecies if they represent less than 25% of the total sample virus population. The amplification refractory mutation system real-time PCR (ARMS RT-PCR) was combined with molecular beacon technology using the LightCycler system.

Detection of large histiocytes in pap smears: role in the prediction of endometrial pathology?

Objective: The objective of this study was to clarify the prognostic significance of large histiocytes in Papanicolaou smears.

Method: During a 2-year period, 893 smears were assessed by the Cytology Laboratory of our Hospital. Twenty-one smears were reported including large histiocytes (2.

Preeclampsia or initial diagnosis of chronic renal disease during pregnancy.

An unusual case of early nephrotic syndrome without hypertension which slightly resolved after delivery is documented. Renal biopsy was performed postpartum and the diagnosis was focal and segmental glomerulosclerosis with moderate chronic renal changes. It is questioned whether the case was due to preeclampsia or was the initial diagnosis of chronic renal disease which was made during pregnancy.

Candida albicans versus non-albicans bloodstream infection in patients in a tertiary hospital: an analysis of microbiological data.

Considerable changes in the relative frequency of systemic infections due to various Candida species as well as their in vitro susceptibility patterns have been noted in several parts of the world. We performed an analysis of microbiological data of patients with candidaemia at the University general (tertiary) hospital of Heraklion, Greece. During the study period (March 2001 to July 2006) 140 patients had candidaemia.