Visual Analogue Scale for the Evaluation of Olfactory and Gustatory Dysfunction of COVID-19 Patients in Northwestern Greece.

Background The visual analogue scale (VAS) has been used as a diagnostic tool for the evaluation of the severity of olfactory and gustatory dysfunction (OGD) caused by SARS-CoV2 infection. The main objective of the present study was the evaluation of OGD with VAS in COVID-19-positive patients in Northwestern Greece and its possible association with the patients' self-reported symptoms of olfactory and gustatory dysfunction. Methods The presence of olfactory and gustatory symptoms and their severity were assessed by questionnaire along with the use of specific odorants and tastant ingredients, in three time periods: prior to COVID-19, during COVID-19 (initial diagnosis) and post-COVID-19 disease (at four weeks from disease onset). Three hundred COVID-19-positive patients (home-quarantined and hospitalized) tested with RT-PCR test in the University Hospital of Ioannina Greece were included in this study. Statistical analysis was performed on SPSS Statistics 26.0 (IBM Corp., Armonk, NY) Results Out of a total of 300 patients, 146 and 190 patients had mild hyposmia and hypogeusia respectively, followed by patients with severe hyposmia or hypogeusia (118 and 88 respectively), at the time of COVID-19 onset (initial diagnosis). An increase in the number of patients with recovery of symptoms was observed during the follow-up period, during which only eight patients had non-resolving severe symptoms (six patients with hyposmia and two with hypogeusia). On further analysis, a statistically significant association was found between the severity of symptoms (assessed by VAS score) and the self-reported symptoms of sensory dysfunction by the patients. There was a significant association between the groups of patients with mild hyposmia and patients that reported no loss of smell; between the patients with moderate hyposmia and the patients who reported "loss of smell"; and between the patients with severe hyposmia and the group of patients who reported a loss of smell, at the COVID-19 onset period. Similarly, patients with mild hyposmia were associated with those that reported a loss of smell at the same time. The severity of hyposmia was also associated with the reported symptom of "loss of taste" at the time of COVID-19 diagnosis. Similar findings were observed regarding the severity of hypogeusia and the reported symptom of "loss of taste" among the groups of patients. Finally, the severity of hypogeusia was associated with smell loss at the time of initial diagnosis of the infection. Conclusion Similar to the literature data, our findings indicate that hyposmia and hypogeusia are common symptoms of COVID-19 disease with varying severity. In our study, most of the patients exerted a complete recovery of these OGD symptoms. In addition, we found an association between olfactory dysfunction and self-reported sensory of taste as well as gustatory dysfunction and sensory of smell. Finally, we found that the VAS score was a reliable diagnostic tool in the estimation of OGD in this cohort of patients. However, our results need to be confirmed by larger-scale trials.

A Study of Airborne Pollen Grains and Fungal Spores in the Region of Epirus (Northwestern Greece).

INTRODUCTION: In the region of Epirus (Northwestern Greece) there are characteristic climatic and geographical conditions that facilitate the growth of typical vegetation with the production of allergic pollen. Aerobiological research into airborne pollen diversity and seasonal variation in pollen counts and fungi spores has become essential due to the growing incidence of allergic rhinitis, allergic asthma, and other pollen-related and spore-related allergic conditions. Furthermore, weather conditions and other factors like air pollution may affect the intensity, the onset, and the duration of the pollen season, and the impact on the patient's symptomatology. METHODS: The diversity of airborne pollen grains (grains/m3) and fungal spores (spores/m3) in the region of Epirus were measured volumetrically using Burgard trap for 13 months, from May 1, 2017 to May 31, 2018. RESULTS: Totally, 10 pollen families and two fungi were recognized. The six most common taxa were Cupressaceae, Pinaceae, Urticaceae, Poaceae, Betulaceae, and Compositeae. The fungi taxa were Cladosporium and Alternaria. Peak pollen centralization was recorded from May to September. Urticaceae had the longest pollen season while Oleaceae and Pinaceae had the shorter. Fungal spores were recorded during all the months of the year. Also, there was a correlation between meteorological parameters and most pollen taxa. CONCLUSION: The pollen and spore calendar shows the concentration of pollen grains and fungal spores in the region of Epirus. This knowledge is important for physicians and allergic patients as it could improve the management of the allergic respiratory disease.

Parenchymal Brain Abscess as an Intracranial Complication After Sinusitis.

Brain abscesses caused by sinusitis are rare in the antibiotic era. The purpose of the current manuscript was to report a rare case of a brain abscess located mainly in the frontal lobe after sinusitis, which was initially thought to be meningitis or encephalitis. A 39-year-old man was transferred to our hospital from another neighbouring hospital with tonic-clonic seizures, severe headache, and purulent nasal secretions. For one week, he was taking antibiotics for sinusitis. The computed tomography indicated lesions in the right sinuses but not in the parenchymal brain and thus antibiotics along with antiepileptic drugs were given. However, due to the deterioration of symptoms, magnetic resonance imaging was executed, which revealed an abscess in the frontal lobe. Afterward, an anterior ethmoidectomy and middle maxillary antrostomy were performed in order to drain the purulent content from the right sinuses. Ten days later, the patient presented disorientation and thus an open craniotomy for successful removal of the parenchymal abscess was performed. One month later, the patient was discharged with mild irritability, which was eliminated gradually over the next two months. Conclusively, brain abscesses can be caused by local spread from an infection of the paranasal sinus. The contribution of imaging modality is very significant not only for the early diagnosis but also for the therapeutic management of such cases. Frequently antibiotic treatment is insufficient and surgery may be required.

Ear Involvement in Inflammatory Bowel Disease: A Review of the Literature.

Inflammatory bowel disease (IBD) is a multisystemic disease. The ear is a rare but recognized site of extraintestinal manifestations of IBD. In external ear, the more common manifestations of IBD are pyoderma gangrenosum, metastatic Crohn's disease and relapsing polychondritis and the treatment includes corticosteroids and anti-TNF agents. Sensorineural hearing loss (SNHL) is the most common ear disease in IBD and especially in patients with ulcerative colitis. In most cases of IBD patients with SNHL, the hearing loss is attributable to autoimmune inner ear disease (AIED). Diagnosis of AIED is based on clinical presentation, the demonstration of a progressive sensorineural hearing loss in periodic audiological tests, a response to immunosuppressive drugs and exclusion of other causes of SNHL. The only diagnostic test that is available for clinical use is the Otoblot test (Western blot for antibodies against 68 kD protein-inner ear antigens). Initial therapy is usually steroids, with a step up to anti-TNF-a therapy and cochlear implantations with failure of treatment. Furthermore, Cogan's syndrome, a chronic disease characterized by deafness, vertigo keratitis and aortitis, has been associated with IBD and mainly with Crohn's disease.

Overcoming difficulties in implementing a universal newborn hearing screening program.

The aim of this paper was to present our experience with a universal newborn hearing screening program, including the specific problems and difficulties faced since its beginning, along with the measures used to overcome them and to improve its efficiency. We analyzed data from 22,195 newborns screened by transiently evoked otoacoustic emissions (TEOAE) performed during the first days after birth. 84.8% of the newborns passed on the first test and another 12.15% passed on rescreening before hospital discharge. This produced a "not pass" rate (false-positive and true positive) of 3.05%. The rate of newborns who did not undergo screening and the rate of "lost to follow-up" newborns were reduced in time, due to various applied modifications to the protocol. It may be thus concluded that our protocol proved to be successful in attaining low refer rates for follow-up screening. A major problem that remains unresolved is the absence of effective follow-up.