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SUMMARYBCG vaccination induces heterologous protection against respiratory tract infections, and in children improves survival independently of tuberculosis prevention. The phase III ACTIVATE-2 study assessed whether BCG could also protect against COVID19 in the elderly. In this double-blind, randomized trial, elderly Greek patients were randomized (1:1) to receive either BCG revaccination or placebo at hospital discharge, followed by 6 months observation for incidence of COVID19 infection. BCG revaccination resulted in 68% risk reduction for total COVID19 clinical and microbiological diagnoses (OR 0.32, 95% CI 0.13-0.79). Five patients in the placebo group and one in the BCG-vaccinated group had severe COVID19 that necessitated hospitalization. 3 months after BCG vaccination 1.3% of placebo and 4.7% of BCG-vaccinated volunteers had anti-SARS-CoV-2 antibodies. These data argue that BCG revaccination is safe and protects the elderly against COVID19. BCG revaccination may represent a viable preventive measure against COVID19.

Summary Context: The diagnosis of the cause and the establishment of the manner of death in submersion cases are routine challenge for forensic pathologists as it presents considerable diagnostic difficulties. Objective: To concisely review the main questions during a submersion death investigation and to give the respective documented answers. Data sources: The search strategy included a literature search of PubMed, Medline and Google Scholar databases, as well as a review of the cited references by the identified studies and a hand search of relevant textbooks and reference works. Conclusions: A complete autopsy, histopathological examination and full toxicological screening are important to determine whether death indeed followed submersion in the water, or to see whether any natural disease or substance use have contributed or caused death. In ambiguous situations, the co-estimation of circumstantial evidence may be of invaluable importance toward the conclusion concerning the cause and the manner of death. The thorough forensic investigation of the submersion deaths not only serves the justice administration, but it also presents considerable benefits for the public health.

Background Except for the established risk factors, presence of target organ damage has an important role in the treatment of hypertensive subjects. The aim of the present study was to estimate the prevalence of target organ damage in primary care subjects. Methods This multi-centre, cross-sectional survey of 115 primary care physicians recruited 1095 consecutive subjects with hypertension: 611 men (55.8%); and 484 women (44.2%). A detailed history for the presence of cardiovascular disease and a thorough clinical examination was performed to each subject. Results Of the total study population, 44.5% (n = 487) had target organ damage (33.0% had left ventricular hypertrophy, 21.8% increased carotid intima media thickness, 11.0% elevated plasma creatinine levels and 14.6% microalbuminuria). Target organ damage was more prevalent in males than in females (P = 0.05). In addition, males had more often increased carotid intima media thickness than females (P = 0.009). On the contrary, females had more often microalbuminuria (P = 0.06) than males. No differences were observed between the two genders regarding left ventricular hypertrophy (P = 0.35) and elevated plasma creatinine levels (P = 0.21). Logistic regression analysis showed associations between target organ damage and dyslipidemia (P < 0.001), presence of metabolic syndrome (P = 0.005), diabetes (P < 0.001) and coronary artery disease (P < 0.001). Conclusion A significant proportion of hypertensive subjects in primary care had documented associated target organ damage, with left ventricular hypertrophy being the most prevalent target organ damage.

Objectives : The aims of this study were to estimate the hepatitis B vaccination coverage levels among nurses and understand the reasons for receiving or not receiving the preventive vaccination. Methods : This cross-sectional study was based on a self-reported questionnaire, which was administered to 788 nurses working in 17 hospitals in Greece. Results : Overall, 606 out of 784 participants (77.3%) completed the survey. Of these, 63.2% nurses reported that they were fully vaccinated. The majority of immunized nurses (66%) were female (P = 0.008), and 72.6% of the fully-vaccinated nurses were working in Intensive Care Units (ICUs). Conclusions : This study showed that almost 40% of nurses are not protected against hepatitis B infection. There is a need for a more aggressive approach to increase the vaccination coverage among nurses.

OBJECTIVE To examine the prevalence and determinants of obesity and associated cardiovascular risk factors in a sample of Greek children. METHODS This is a cross-sectional, school-based study of 780 students (9.2 +/- 1.8 years old, 415 boys) conducted in Eastern Attica, the greater area of the city of Athens. The study protocol included anthropometric, blood pressure (BP), and biochemical measurements, as well as dietary and lifestyle habits assessment. A review of Greek studies on childhood obesity was also performed. RESULTS Approximately 22% of the participants were overweight and 8% were obese, which is in accordance with the results of 24 previous Greek studies showing the childhood overweight/obesity prevalence in the range of 30%. Overweight/obese children compared with normal-weight children had higher BP, lower high-density lipoprotein cholesterol (HDL-C), and higher triglycerides (p < 0.05 for all). Parental weight, consumption of sweets and fast-food, and decreased physical activity were independent determinants of being overweight/obese. Furthermore, overweight/obesity predicted the presence of high BP, low HDL-C, and high triglycerides. CONCLUSION A close association was revealed between obesity and metabolic abnormalities, underlining the need for early screening and intervention in overweight children in order to address the emerging childhood obesity epidemic in Greece.