The first positive evidence that training improves triage decisions in Greece: evidence from emergency nurses at an Academic Tertiary Care Emergency Department.

BACKGROUND Triage refers to the process of patient prioritisation in the emergency department (ED). This is based on the severity of the patient's illness and is performed by emergency nurses (ENs). This has a pivotal role in ensuring patient safety and in ensuring that the ED operates smoothly - so continuous and accurate training are essential. As Emergency Nursing has been formally established in Greece since 2019, it is of the uppermost importance that all Greek ENs should be trained in the use of a standardised triage system. The present study aimed to evaluate the effect of triage training of ENs in the use of the Swiss Triage System (STS) after an intervention of one week. METHODS The effect of triage training was studied experimentally by comparing performance before and one week after training. A sample of thirty-six ENs from the University Department of Emergency Medicine at AHEPA University Hospital took part. The role of training in triage by the STS was assessed by completing the same self-administered questionnaire before and after a 45-minute e-learning program (presentation video of STS but with simulation scenarios) which was available during the period of a week. The post-training test was taken 2 weeks later, after the training process. RESULTS The most promising finding was that there was a significant improvement in the number of correct answers after the training in triage (p<0.001). A significant improvement was also detected (p<0.001) in the questions that tested vigilance in providing safe health services by ENs, whereas there was no significant association between the number of correct answers and years of emergency experience or level of education, - either before or after the intervention. CONCLUSIONS Triage training seems to successfully improve effective and efficient triage. To the best of our knowledge, this is the first study that has demonstrated that triage training has a significant positive impact on triage performance by ENs in Greece. It is planned to support these findings by real time studies in an ED

Mental illness through the perspective of undergraduate medical students in Greece: a cross-sectional study at Aristotle University of Thessaloniki

IntroductionNumerous studies reveal that mental health-related stigma, stereotypes, and prejudices negatively affect the patients, jeopardizing their health, prognosis, and social opportunities. Healthcare professionals, who are in the first line of combating mental disease, are expected to play a significant role in drastically changing discriminatory and stigmatizing attitudes toward psychiatric patients and in diminishing the existing healthcare and social disparities. In this study, we aimed to explore and highlight the views of Greek medical students—that is of the future physicians—toward mental illness and people suffering from it.Materials and methodsIt is a cross-sectional, observational study, in which 324 undergraduate students from the most populous Greek medical school of the Aristotle University of Thessaloniki, participated online, during the spring semester of 2022. The tools used were the Opinions about Mental Illness Scale (OMI) that assesses one’s viewpoints about mental illness, the Social Distance Scale (SDS) that captures the desired degree of social distancing from patients with mental disorders, and the Level of Contact Report (LCR-12) that estimates the level of familiarity with them.ResultsParticipants displayed rather positive attitudes regarding the etiology of mental illness, social integration, and discrimination toward psychiatric patients [as evaluated with the respective OMI subscales; Etiology mean score (μ):8.87 ± 4.68, Social Integration (μ):17.79 ± 5.42, Social Discrimination (μ):13.54 ± 11.17], and more clearly favorable opinions concerning the need for social provision or the enactment of restrictive measures [as expressed with the relative OMI subscales; Social Care (μ):22.74 ± 4.56, Social Restriction (μ):13.27 ± 8.98], while claiming to be quite familiar with mental disorders and individuals experiencing them (as assessed with LCR; μ: 8.71 ± 2.16), and relatively willing to interact with them (as measured with SDS; μ:8.95 ± 4.23). Degree of familiarity with mental illness was directly proportional to the desire for contact with patients living with it, while the higher both were, the more improved most of the aforementioned OMI sectors were found to be. Female sex, clinical medical education, previous clinical psychiatric training, and living with or being a person with a mental disorder were the factors that defined a statistically refined profile in many of the aspects above.ConclusionOur findings are in accordance with many prior and recent studies, while showing improved opinions compared to those of previous research in Greek student and healthcare population. They are calling for vigilance, rather than complacency, as well as educational and social interventions, in order to enable current and future healthcare professionals to perform their function to its fullest extent. Implications of our results and further research suggestions are included

Piperacillin/Tazobactam as Cause of Acute Generalized Exanthematous Pustulosis

Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous adverse reaction mainly attributed to antibiotics. It is characterized by numerous, nonfollicular, sterile pustules, arising on an exanthematous and edematous base. It is a serious adverse reaction accompanied by fever and leukocytosis. Piperacillin/tazobactam is indicated for the treatment of patients with moderate to severe infections. Herein is reported a case of AGEP caused by piperacillin/tazobactam. A 78-year-old woman with metastatic breast cancer was presented to the emergency department reporting fever and groin pain. The laboratory analysis and more specifically urine cultivation showed a urinary tract infection by E. coli with sensitivity to piperacillin/tazobactam. She had no known allergies. She was started on intravenous piperacillin/tazobactam; she improved clinically on the second day, but on the fourth day of intravenous therapy, she developed extensive pustular rash on the folds and anterior proximal thighs, accompanied by fever and neutrophilia. Piperacillin/tazobactam administration was interrupted and she was given prednisolone for ten days. The patient improved clinically and her laboratory tests returned to normal after two weeks. AGEP is an uncommon side effect of piperacillin/tazobactam treatment and there are few cases reported

Fungal Infections and Nail Psoriasis: An Update

The relationship between psoriasis and onychomycosis is controversial, and the exact nature of this association remains to be clearly elucidated. In healthy nails, the compact nail plate acts as a barrier, preventing any infection. In psoriatic nails, the nail plate involvement, together with abnormalities in the blood capillaries, may lead to decreased natural defenses against microorganisms. Moreover, onycholysis (detachment of the nail plate) induces a humid environment that may favor fungal proliferation. Treatment with immunosuppressive drugs may additionally enhance onychomycosis. In this comprehensive review, we present data regarding the incidence and pathogenic action of dermatophytes and other fungi in the development of fungal infection in psoriatic nails