COVID-19 and flu vaccination in Romania, post pandemic lessons in healthcare workers and general population.

BACKGROUND: Influenza and corona viruses generate vaccine preventable diseases and have pandemic potential, frequently dramatic. A co-infection with these viruses, may be a new worldwide threat, researchers name it flurona. The aim of our study is to assess flu and COVID-19 Romanian vaccination for 2022-2023 season and the factor associated with higher odds to receive flu and COVID-19 vaccine. METHODS: An analytical cross-sectional observational survey was conducted in the general population; a self-administered questionnaire was used. RESULTS: 1056 responders were analyzed, mean age 32.08 ±13.36 years (limits:18-76), majority, 880 (83.33%), from urban areas, 608 (57.58%), high school graduated, 400 (37.88%) parents. More than half of the responders were healthcare workers, 582 (55.11%), also considered study population. In the study group, 796 (73.37%) responders consider flurona vaccination useful; and 872 (82.57%) responders consider that no sanctions are needed for not flurona vaccinating. In the 2022-2023 season, 162 (15.34%) responders vaccinated against the flu and 300 (28.41%) against COVID-19. The factor associated with higher odds to receive flu and COVID-19 vaccine was the habit of flu vaccination: for flu (OR = 58.43; 95% CI: (34.95-97.67)) and for COVID-19 (OR = 1.67; 95% CI: (1.21-2.31)). Other factors such as having university degree (OR = 1.46; 95% CI: (1.08-1.98)) and being a healthcare worker, (OR = 1.41; 95% CI: (1.07-1.87)) were influencing factors only for adult COVID-19 vaccination in the 2022-2023 season. In the parents' group, in 2022-2023 season, only 48 (12%) vaccinated their children against the flu and 68 (17%) against COVID-19, mostly parents that vaccinated themselves, p<0.001. In the 2022-2023 season, there were only 82 (7.65%) responders vaccinated against both diseases. Logistic regression analysis showed that no factor analyzed influenced the flurona vaccinated parent's decision to vaccinate their children for flu and for COVID-19. CONCLUSIONS: In the season 2022-2023, in Romania, the vaccination against flu and COVOD-19 is low, in adults and children as well. More efforts must be done to increase flurona vaccination, public health educational programs are strongly needed. Children, that are at greater risk when co-infecting with these viruses, must be vaccinated, school vaccination programs should be considered.

Natural Bio-Compounds from Ganoderma lucidum and Their Beneficial Biological Actions for Anticancer Application: A Review.

Ganoderma lucidum (G. lucidum) has been known for many centuries in Asian countries under different names, varying depending on the country. The objective of this review is to investigate the scientific research on the natural active bio-compounds in extracts obtained from G. lucidum with significant biological actions in the treatment of cancer. This review presents the classes of bio-compounds existing in G. lucidum that have been reported over time in the main databases and have shown important biological actions in the treatment of cancer. The results highlight the fact that G. lucidum possesses important bioactive compounds such as polysaccharides, triterpenoids, sterols, proteins, nucleotides, fatty acids, vitamins, and minerals, which have been demonstrated to exhibit multiple anticancer effects, namely immunomodulatory, anti-proliferative, cytotoxic, and antioxidant action. The potential health benefits of G. lucidum are systematized based on biological actions. The findings present evidence regarding the lack of certainty about the effects of G. lucidum bio-compounds in treating different forms of cancer, which may be due to the use of different types of Ganoderma formulations, differences in the study populations, or due to drug-disease interactions. In the future, larger clinical trials are needed to clarify the potential benefits of pharmaceutical preparations of G. lucidum, standardized by the known active components in the prevention and treatment of cancer.

Ageing People Living with HIV/AIDS, PLWHA; More Dental Challenges; the Romanian Dental Professional's Point of View.

BACKGROUND: In Romania, HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome) were first acknowledged in 1989. Getting older with HIV/AIDS is now possible due to antiretroviral treatment, but it can bring dental problems due to HIV itself or to the reluctance of dental professionals to treat dental problems. Our study aims to assess the attitudes, knowledge, and practices of Romanian dental professionals regarding aging PLWHA. METHODS: An analytical cross-sectional observational survey based on a self-administered questionnaire was conducted for Romanian dental professionals from October 2022 to January 2023. RESULTS: The responders' group profile was as follows: a mean age of 39.09 ± 0.36 years (limit: 19-75), a majority of 991 (90.01%) from urban dental offices, and 364 (33.06%) with more than twenty years' experience. A total of 517 (46.95%) responders had an unprofessional attitude and declared that, if possible, they would avoid taking part in performing dental treatments for people living with HIV/AIDS (PLWHA). There were 89 (8.08%) dental professionals that refused to work with PLWHA. Only 363 (32.97%) had worked with one previously. The dental professionals in rural areas refused PLWHA more frequently: 20% (N = 22) of rural dental professionals vs. 6.76% (N = 67) of urban dental professionals refused to work with PLWHA (OR = 0.30; 95% CI: 0.16-.56). The logistic regression applied for the 1101 responders revealed after stepwise selection that the most influential factor for their refusal to work with PLWHA in our study group was being previously exposed to HIV during dental practice (OR = 14.45; 95% CI: 8.55- 24.42; p = 0.000). CONCLUSIONS: Dental educators and health care planners should promote the knowledge of prophylaxis and positive attitudes towards the treatment of PLWHA. Successful resolution of these concerns is time consuming and expensive but necessary if dentists are to satisfy their professional obligations to HIV/AIDS patients.

Cumulative Antibiogram: A Rapid Method to Hinder Transmission of Resistant Bacteria to Oral Cavity of Newborn Babies.

BACKGROUND: A rapid bacterial diagnostic is needed more and more in the treatment of patients, because of the emergence of antibiotic resistance. The cumulative antibiogram, an annual report that monitors antimicrobial resistance trends in health care facilities, may provide a profile of empirical therapy useful in diverse emergency situations, such as transmission of resistant bacteria to oral cavity of newborn babies. We aimed to draw a profile of antibiotic resistance encountered. METHODS: We assessed the antibiotic resistance (ABR) profile in childbearing women and newborn babies in Ploiesti Obstetrics and Gynecology Hospital by the disk diffusion method characterizing the multidrug-resistant organisms after isolation and identification by phenotypic tests. Extended-spectrum ß-lactamase (ESBL)-producing Enterobacterales (ESBL-E), Carbapenem-resistant Enterobacterales (CRE), vancomycin-resistant Enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin resistant Group B Streptococcus (VR-GBS) were detected. RESULTS: The prevalence of antibiotic resistance was 11.32% (53/468), while the prevalence of the ESBL-E, MRSA, VRE and VR-GBS strains was 8.34% (39/468). Within the bacteria isolated from fifty-three childbearing women, the prevalence of ESBL-E, MRSA, VRE and VR-GBS was 22.64% (12/53), 32.08% (17/53), 11.32% (6/53) and 7.55% (4/53). In the whole studied group, the prevalence was 2.56% (12/468), 3.63% (17/468), 1.28% (6/468) and 0.86% (4/468). Resistant bacteria were detected at birth in the oral cavity of the newborn babies in all cases. Maternal and neonatal isolates shared similar characteristics. CONCLUSIONS: Cumulative antibiogram is useful in case of empiric treatment needed in diverse emergencies, such as transmission of resistant bacteria to oral cavity of newborn babies.

Barriers and Facilitators of Romanian HPV (Human Papillomavirus) Vaccination.

BACKGROUND: Many countries had initial success with HPV vaccination campaigns worldwide. The HPV vaccine coverage during the COVID-19 pandemic dropped consistently. The aim of our research is to assess the barriers and facilitators of the current Romanian HPV vaccination campaign. METHODS: An analytical cross-sectional observational survey was conducted in the Romanian general population; a self-administered questionnaire was used. RESULTS: 1122 responders were interviewed; 666 (59.36%) were parents, and 67 (5.97%) HPV vaccinated themselves. A multinominal logistic regression carried out in the parents' category showed that women with university studies and informed from medical sources have greater chances to HPV vaccinate. Reticence regarding vaccination comes from the high cost of the vaccine and a lack of information. Only 118 (10.51%) vaccinated against HPV. From the logistic regression analysis, gender (ORa 0.461 = 95% CI: (0.196; 1.083)), geographic area of residence (ORa = 0.517; 95% CI: (0.331; 0.807)), and the inclusion of the HPV vaccine in the National Vaccination Program (ORa = 2.4; 95% CI: (1.361; 4.235)) were the factors found most associated with HPV vaccination. CONCLUSIONS: In the general population, the inclusion of HPV vaccination in the National Vaccination Program would be the most important facilitator of HPV vaccination in Romania. In parents that did not vaccinate their children, one important barrier to HPV vaccination was the high cost of the HPV vaccine and the lack of proper information. The acceptability of HPV vaccination in Romania is low; therefore, public health educational programs are needed.

COVID-19 Parental Vaccine Hesitancy in Romania: Nationwide Cross-Sectional Study.

BACKGROUND: COVID-19 vaccination started in Romania in December 2020. Child vaccination started in 2021 with children aged 12-15 years in August. For children aged 5-11 years, vaccination started in January 2022. The aim of our study was to describe COVID-19 vaccination hesitancy in Romanian children and vaccine acceptability in the general population. As parental consent is required for child vaccination in Romania, these aspects have a significant association. METHODS: An analytical cross-sectional survey was conducted in October and November 2021 during the peak of the 4th COVID-19 wave. RESULTS: After validation, 1645 participants formed the main study group: median age 35 years, 72.83% women, and 35.44% from the medical domain. In total, 1311 (79.70%) participants were vaccinated against COVID-19 and 188 (11.42%) had vaccinated their 12-18-year-old children against COVID-19. Parents' level of education, geographic area of residence, and COVID-19 vaccination status were significantly associated with COVID-19 vaccination. The hesitancy factors of child vaccination included the novelty of COVID-19 vaccines (62, 47.32%), fear of adverse reactions (32, 24.42%), and anti-vaccinism in general (29, 22.13%). In the studied group, only 188 (11.42%) participants recommended vaccination of 5-11-year-old children. Vaccine acceptability was higher in the general population (1311, 79.70%) than in the medical domain (326 out of 583, 55.91%). General vaccine hesitancy was based mainly on beliefs regarding inefficiency (131, 39.22%) and fears about the side effects of the vaccine (76, 22.75%). CONCLUSIONS: Overall, the acceptability of COVD-19 vaccines in the Romanian population was influenced by the level of education, area of residence, and being a COVID-19-vaccinated parent. Public health intervention programs are essential.

SARS-CoV-2 Infection Anxiety, Knowledge and Attitudes in University Degree Pregnant Women from Romania-A Cross-Sectional Observational Survey in the First Two Pandemic Years.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had a high economic cost, morbidity, and death toll. Due to high rates of mortality and morbidity from coronavirus disease 2019 (COVID-19), pregnant women were at particular risk during this pandemic. We designed and conducted a cross-sectional observational survey in Romanian pregnant women to evaluate the outcome of the SARS-CoV-2 pandemic along with the preventive measures taken by authorities. We applied a 43-item questionnaire. We included 147 women over 18 years old from Romania who were pregnant or gave birth between March 2020 and March 2022. All pregnancies were monitored, most of them by a gynecologist, and only 23% faced rescheduled pregnancy visits. The majority (84%) were screened through the TORCH panel, 95.91% felt anxious because of the pandemic, 87% followed SARS-CoV2 preventive recommendations, and 82% were not infected with the coronavirus. Additionally, 80% were vaccinated against COVID-19. They felt the consequences of the pandemic through anxiety, and their level of anxiety influenced their vaccination decisions, the TORCH testing and the method of giving birth despite the level of education. Fortunately, their pregnancies were monitored properly, and there were no consequences noticed for fetuses at birth.

Early COVID-19 Vaccination of Romanian Medical and Social Personnel.

BACKGROUND: In December 2020, the first doses of COVID-19 vaccines arrived in Romania and were made available to medical and social staff. Vaccine hesitancy appeared as a barrier to effectively ending the pandemic. The opinions of medical and social staff influence the opinion of the general population. This study assesess the attitudes, knowledge, and opinion of medical and social personnel toward COVID-19 vaccines and vaccination and the influencing factors. METHODS: 1025 persons participated in an online cross-sectional study from March until July 2021. RESULTS: Out of 1021 eligible responders, 719 (70.42%) had been vaccinated: 227 with one dose (22.23%) and 492 with two doses (48.18%). There were 302 responders who were not vaccinated at all. Out of them, 188 refused vaccinations. The participants showed a good understanding and knowledge of SARScoV-2 transmission and treatment. Geographic area, medical profession, and medical experience influenced COVID-19 vaccination (p < 0.001). There were no associations between willingness to vaccinate and vaccine/virus knowledge. Most of the responders who were vaccinated or wanted to be vaccinated indicated an mRNA vaccine as their first choice. The variables that were significantly associated with reporting COVID-19 vaccine acceptance after logistic regression were: living in an urban area (Ora = 1.58, 95% CI: 0.98-2.56), being female (Ora = 1.59; 95% CI:1.03-2.44), and being a medical doctor (Ora = 3.40; 95% CI: 1.84-6.26). CONCLUSIONS: These findings show that vaccine hesitancy persists in medical and social personnel in Romania, and, hence, it may be reflected in the hesitancy of the general population toward vaccination.