Vaccination coverage and predictors of influenza, pneumococcal, herpes zoster, tetanus, measles, and hepatitis B vaccine uptake among adults in Greece.

OBJECTIVES: Insufficient adult vaccination coverage rates remain an international challenge. This nationwide study aimed at exploring vaccination coverage and predictors of influenza, pneumococcal, herpes zoster, tetanus, measles, and hepatitis B vaccine uptake, following the recommendations of the National Immunization Program for adults. STUDY DESIGN: This was a multicenter, mixed-methods study conducted at 23 primary care units in six different regions of Greece. METHODS: A pretested questionnaire was administered to three randomly selected adults who visited each practice daily for 30 consecutive working days. RESULTS: Among the 1571 participants, vaccination coverage for influenza in the high-risk groups was 55%, 36% for pneumococcal disease, 12% for herpes zoster (HZ), 21% for tetanus, 33% for measles, and 11% for hepatitis B. Perception of low susceptibility to disease due to good health status, concerns about side-effects and vaccines' efficacy, and mistrust in pharmaceutical companies were among common factors associated with the vaccines uptake. The strongest factor associated with the participants' vaccination status was their doctor's recommendation (odds ratio [95% confidence interval] influenza: 6.06 [4.52-8.14], pneumococcal disease: 15.73 [10.98-22.52], HZ: 17.01 [9.05-31.96], tetanus: 23.93 [16.20-35.35], measles: 33.47 [16.85-66.47], and hepatitis B: 73.92 [17.47-312.74]). Being well-informed about each vaccine was also a predictor of its uptake. CONCLUSIONS: Vaccination coverage was suboptimal and especially low in tetanus, HZ, and hepatitis B immunization. Person-centered approach, with provision of appropriate information about vaccines' safety and efficacy, responding to each patient's needs, as well as physicians' strong recommendation for vaccination are considered crucial to advocate against the spread of vaccine misinformation and increase vaccination coverage.

[Malformations of the first branchial cleft and facial nerve]. / Missbildungen der ersten Kiemenfurche und des Nervus facialis.

First branchial cleft anomalies are a rare but interesting group of congenital anomalies of the neck. They produce a great variety of clinical manifestations and have a close relationship with the facial nerve and the auditory canal. Surgery is the only effective treatment of these anomalies and complete surgical removal must be achieved to avoid recurrence. Our experience with 1 11 cases operated on in the last 9 years in our clinic is presented in this paper. The relationship of the facial nerve with the congenital anomaly is emphasized.

[Congenital fistula of the 4th pharyngeal pouch and cleft]. / Kongenitale Fistel der 4. Kiemenfurche und Schlundtasche.

This is the first description of a fistula arising from both the fourth branchial cleft and the fourth pharyngeal pouch in a 62-year-old woman. This developmental anomaly ran from the piriform sinus to the skin of the left side of the neck. A small quantity of liquid was seen to flow from the external opening of the fistula during drinking or swallowing. Surgery revealed a tract inferior to the superior laryngeal nerve and lateral to the recurrent laryngeal nerve. This fistula penetrated the larynx in the region of the cricothyroid joint and ended in the piriform sinus. This patient had neither suffered infection of the fistula, nor had undergone a prior surgical procedure.

Comparison of roxithromycin with co-amoxiclav in patients with sinusitis.

In an open, randomized study of 60 patients with acute or recurrent sinusitis, the bacteriological and clinical efficacy of roxithromycin 150 mg bd were compared with those of po co-amoxiclav (625 mg) tds. Of 52 patients who underwent sinus puncture for isolation of causative organisms, 48 had pathogens sensitive to both antibiotics. Satisfactory clinical response was obtained in 93.1% (27/29) evaluable patients receiving roxithromycin and 88.8% (24/27) receiving co-amoxiclav. Tolerability was significantly better in the roxithromycin group, with 1/29 (3.4%) patients in this group experiencing gastrointestinal side-effects, compared with 7/27 (25.9%) patients in the co-amoxiclav group (P < 0.05). Although the study had limited power to detect differences, roxithromycin demonstrated clinical, bacteriological and overall efficacy similar to that of co-amoxiclav, but with better tolerability. Roxithromycin thus appears to be an effective and well-tolerated drug for the treatment of acute and recurrent sinusitis.