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Patients with cardiac implantable electronic device (CIED) and Staphylococcus aureus bacteraemia (SAB) are at risk of having CIED infection, pocket infection or endocarditis. To avoid treatment failures, guidelines recommend that the CIED should be extracted in all cases of SAB butrecent studies indicate low extraction rates and low risk of relapse. The aim of the study was to describe a Swedish population-based cohort of patients with CIED and SAB, the rate of extraction, and treatment failure measured as recurrent SAB. Patients identified to have SAB in the Karolinska Laboratory database, serving a population of 1.9 million, from January 2015 through December 2019 were matched to the Swedish ICD and Pacemaker Registry. Patients with CIED and SAB were included. Clinical data were collected from medical records. A cohort of 274 patients was identified and 38 patients (14%)had the CIED extracted. Factors associated with extraction were lower age, lower Charlson comorbidity index, shorter time since CIED implantation, and non-nosocomial acquisition, but not mortality. No patient was put on lifelong antibiotic treatment. Sixteen patients (6%) had a recurrent SAB within one year, two in patients subjected to extraction (5%) and 14 in patients not subjected to CIED-extraction (6%). Three of the 14 patients were found to have definite endocarditis during the recurrent episode. Despite a low extraction rate, there were few recurrences. We suggest that extraction of the CIED might be omitted if pocket infection, changes on the CIED, or definite endocarditis are not detected. [ABSTRACT FROM AUTHOR]

Greece, like the rest of the Mediterranean countries, faces wildland fires every year. Besides their short-term socioeconomic impacts, ecological destruction, and loss of human lives, forest fires also increase the burnt areas' risk of flash flood phenomena, as the vegetation, which acted in a protective way against runoff and soil erosion, is massively removed. Among the most severe wildland fire events in Greece were those of summer 2021, which were synchronous to the very severe heat waves that hit the broader area of the Balkan Peninsula. More than 3600 km2 of land was burnt and a significant amount of natural vegetation removed. Three of the burnt areas are examined in this work, namely, Attica, Northern Euboea, and the Peloponnese, in order to assess their risk of future flash flood events. The burnt areas were mapped, and their geological and geomorphological features studied. Flash flood hazard assessment was accomplished through a Boolean logic-based model applied through Geographic Information Systems (GIS) software, which allowed the prioritization of the requirement for protection by identifying which locations were most prone to flooding. The largest part of our study areas is characterized by geomorphological and geological conditions that facilitate flash flood events. According to our findings, in almost all study areas, the regions downstream of the burnt areas present high to very high flash flood hazard, due to their geomorphological and geological features (slope, drainage density, and hydrolithology). The only areas that were found to be less prone to flood events were Vilia and Varimpompi (Attica), due to their gentler slope inclinations and overall geomorphological characteristics. It is known that vegetation cover acts protectively against flash floods. However, in this case, large areas were severely burnt and vegetation is absent, resulting in the appearance of flash floods. Moreover, imminent flooding events are expected to be even more intense in the areas downstream of the burnt regions, possibly bearing even worse impacts on the local population, infrastructure, etc. [ABSTRACT FROM AUTHOR]

Background Demography is changing, with people living longer with comorbidities. In this nationwide population-based study, we investigated the serotype-specific invasive pneumococcal disease (IPD) risk in individuals with comorbidities, and effects of the pneumococcal conjugated vaccine (PCV) child immunization program. Methods Cases included 14 096 IPD episodes in Sweden during 2006–2015. Controls (n = 137 289), matched to cases by age, sex, region, and calendar time, were selected from the general population. Comorbidity data was obtained through health registers and grouped as immunocompromising (IC) or chronic medical conditions (CMC). Results The prevalence of CMC and IC among elderly cases was 33.9% and 39.4%. New risks identified for IPD were sarcoidosis, inflammatory polyarthropathies, systemic connective tissue, and neurological diseases. The odds ratio (OR) for IPD caused by non-PCV13 compared with PCV13 serotypes was higher in individuals with CMC/IC. Serotypes associated with the highest risk were 16F, 15C, 35F, 19F, and 23A (OR 3–5 for CMC, >10 for IC). Most comorbidities increased post-vaccination, and absolute increases of IPD caused by non-PCV13, PPV23–non-PCV13, and non-PCV13/non-PPV23 serotypes were higher in individuals with IC/CMC compared with healthy persons. Non-PCV13 serotypes 6C, 9N, 11A, 22F, 23A and 35F increased more in those with comorbidities. Mortality due to non-PCV13 serotypes increased in individuals with IC/CMC, while remaining stable in persons without comorbidities. Conclusions The PCV child immunization program associates with an increased disease burden of non-vaccine serotypes in individuals with comorbidities. These data are important for vaccine design and optimization of current vaccination strategies. [ABSTRACT FROM AUTHOR]

The wildfires of summer 2021 in Greece were among the most severe forest fire events that have occurred in the country over the past decade. The conflagration period lasted for 20 days (i.e., from 27 July to 16 August 2021) and resulted in the devastation of an area of more than 3600 Km2. Forest fire events of similar severity also struck other Mediterranean countries during this period. Apart from their direct impacts, forest fires also render an area more susceptible to runoff erosion by massively removing its vegetation, among other factors. It is clear that immediately after a forest fire, most areas are much more susceptible to erosion. In this paper, we evaluate the erosion hazard of Attica, Northern Euboea, and the Peloponnese that were devastated by forest fires during the summer of 2021 in Greece, in comparison with their geological and geomorphological structures, as well as land cover and management. Given that a very significant part of these areas were burnt during the major conflagrations of this summer, erosion risk, as well as flood risk, are expected to be very high, especially for the coming autumn and winter. For the evaluation of erosion risk, the burnt areas were mapped, and the final erosion-risk maps were constructed through GIS software. The final maps suggest that most of the burnt areas are highly susceptible to future surface runoff erosion events. [ABSTRACT FROM AUTHOR]

The Greek region is known as one of the most seismically and tectonically active areas and it has been struck by some devastating tsunamis, with the most prominent one being the 365 AD event. During the past decade significant research efforts have been made in search of geological and geomorphological evidence of palaeotsunamis along the Greek coasts, primarily through the examination of sediment corings (72% of studies) and secondarily through boulders (i.e., 18%). The published data show that some deposits have been correlated with well-known events such as 365 AD, 1303 AD, the Minoan Santorini Eruption and the 1956 Amorgos earthquake and tsunami, while coastal studies from western Greece have also reported up to five tsunami events, dating as far back as the 6th millennium BC. Although the Ionian Islands, Peloponnese and Crete has been significantly studied, in the Aegean region research efforts are still scarce. Recent events such as the 1956 earthquake and tsunami and the 2020 Samos earthquake and tsunami highlight the need for further studies in this region, to better assess the impact of past events and for improving our knowledge of tsunami history. As Greece is amongst the most seismically active regions globally and has suffered from devastating tsunamis in the past, the identification of tsunami prone areas is essential not only for the scientific community but also for public authorities to design appropriate mitigation measures and prevent tsunami losses in the future. [ABSTRACT FROM AUTHOR]