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The prevalence of the HPV 16 genome, integrated viral status and p53 genotype in cervical cancer population of north-eastern Hungary, the correlation with the established markers of tumour progression.

OBJECTIVES: To evaluate the prevalence of the HPV 16 integrated status and the p53 genotype in cervical cancer in north-eastern Hungary and their correlation with the established prognostic factors. STUDY DESIGN: Parallel with the routine histological examination, Southern blot hybridisation and multiplex PCRs were used to detect type/physical state of HPV DNA in primary tumours and in regional lymph nodes combined with p53 genotyping of 83 patients. RESULTS: 46.9% (39/83) prevalence rate of HPV 16 genome was found. The frequency of viral integration (76.9% in primary tumours and 95.2% in regional lymph nodes) and that of the p53Arg homozygous genotype (64.1%) proved to be higher than reported from other parts of the world. The HPV 16 integration and the p53 genotype, failed to correlate with the FIGO stage and lymphatic spread. CONCLUSION: The prevalence of the integrated status of the HPV 16 genome combined with homozygous p53Arg genotype is relatively high in Hungary. These factors however failed to show a strong correlation with the established markers of tumour progression.

Adult↗

Change in immunisation schedule and sudden infant death syndrome in Hungary.

Infant mortality in Hungary was higher than in other European countries; however, the reported incidence of sudden infant death syndrome (SIDS) has been lower than those for Western Europe and the United States. Childhood immunisation has been reported to be a protective factor for SIDS. In Britain, the change to an earlier immunisation schedule for diphtheria, pertussis, and tetanus appeared to be associated with a shift in the age distribution of SIDS. In 1999, immunisation for Haemophilus influenzae type b (Hib) was introduced for Hungarian infants at the age of 2 months. Data for total infant mortality and SIDS in Hungary were analysed between 1990 and 2002. Infection was the major cause of death among Hungarian infants followed by SIDS. Following introduction of Hib immunisation, there was a decrease in deaths due to meningitis from an average of 3.5% of all infant deaths between 1990 and 1998 to an average of 1% of all infant deaths between 1999 and 2002 (p=0.00). There was also a significant decrease in the proportion of SIDS in the age range > or =2 months from 48% in the earlier period to 39% after introduction of the vaccine (p=0.03). The decrease in SIDS might be due in part to decrease in unrecognised Hib infections or to induction of antibodies by the tetanus toxoid to which the Hib polysaccharide is conjugated that are cross reactive with bacterial toxins implicated in SIDS.

Haemophilus Infections↗

Listeria monocytogenes food monitoring data and incidence of human listeriosis in Hungary, 2004.

Food samples were monitored for contamination with Listeria monocytogenes, and the incidence of human listeriosis was evaluated according to the data obtained in Hungary in the year 2004. Of the food samples tested, the bacterium was most often detectable in milk and dairy products, as 72.1% of all L. monocytogenes strains were isolated from these samples. The food samples most commonly yielded strains of serotype 1/2a (45.1%) and 4b (27.0%). In 2004, 3 perinatal and 14 nonperinatal human listeriosis cases were diagnosed in Hungary. These disease cases were most often caused by strains belonging to serotype 4b (52.8%) and serotype 1/2a (23.5%). On the basis of the antibiotic sensitivity test results of strains isolated from the disease cases, penicillin and aminoglycoside antibiotics or a combination thereof were found to be effective.

Adult↗

Reduced completed suicide rate in Hungary from 1990 to 2001: relation to suicide methods.

BACKGROUND AND METHOD: Changes in the rate of completed suicides and in the suicide methods used in Hungary between 1990 and 2001 were evaluated using the database of the Hungarian Central Statistical Office. RESULTS: During this period of time, the suicidal mortality rate decreased by 27.9%. A major part (62%) of this decrease was due to the less frequent use of poisonous substances and drug overdose, particularly of psychotropics. CONCLUSION: Beside the more widespread treatment of depression and other mental disorders, the improved safety of pharmacotherapy and the removal of the most toxic pesticides and chemicals from everyday use might have contributed to the reduction of the suicide rate in Hungary.

Adult↗

Epidemic spread of recombinant noroviruses with four capsid types in Hungary.

BACKGROUND: Noroviruses are common pathogens in gastro-enteritis outbreaks in humans worldwide. Noroviruses are genetically diverse group of viruses with multiple genogroups (GG) and genotypes. More recently, naturally occurring recombinant noroviruses were described. These viruses had a distinct polymerase gene sequence (designated GGIIb/Hilversum) and were disseminated through waterborne and food-borne transmission in Europe. OBJECTIVES: Our aim was to characterize these emerging recombinant noroviruses causing outbreaks of gastro-enteritis in Hungary. STUDY DESIGN: From January 2001 to May 2004, samples containing "GGIIb/Hilversum polymerase" (GGIIb-pol) were selected for analysis of the viral capsid region (ORF2) by reverse transcription-polymerase chain reaction (RT-PCR) and sequencing. RESULTS: Thirty-four (14.4%) of 236 confirmed norovirus outbreaks were caused by the variant lineage with the GGIIb-pol. Four different recombinants were detected with capsids of Hu/NLV/GGII/Mexico/1989 (n=9, 43%), Hu/NLV/GGII/Snow Mountain/1976 (n=6, 28%), Hu/NLV/GGII/Hawaii/1971 (n=4, 19%) and Hu/NLV/GGII/Lordsdale/1993 (n=1, 5%). CONCLUSIONS: In Hungary, emerging recombinant noroviruses became the second most common norovirus variants-next to GGII-4/Lordsdale virus-causing epidemics of gastroenteritis in the last 4 years.

Caliciviridae Infections↗

Evaluation of indoor radon measurements in Hungary.

The RAD Laboratory measured annual means of radon activity concentrations in 15 277 first-floor rooms of dwellings and in 325 rooms on upper floors in Hungary (1994-2004). The original purpose of the survey was to find radon-prone area in Hungary. The maximum measured value was 5800 Bq m(-3), while the minimum was 10 Bq m(-3). Due to geological diversity and different structures of buildings, the data set of first-floor rooms did not follow the lognormal distribution. Therefore, strata were chosen so that the measured data fitted the lognormal distribution. The numbers of dwellings above a given radon level were determined in each stratum. The national distribution was then taken as the sum of the individual distributions of all strata. This distribution was not lognormal. The parameters of the best fitting lognormal distribution were GM = 58 Bq m(-3), GSD = 2.2. The weighted averages of strata values GM = 62 Bq m(-3), GSD=2.1 were obtained corresponding to 92% of Hungarian dwellings.

Air Pollution, Indoor↗

Ethical considerations behind the limitation of cardiopulmonary resuscitation in Hungary--the role of education and training.

INTRODUCTION: Although the long term success of cardiopulmonary resuscitation (CPR) is still less than hoped for, its value cannot be questioned when carried out appropriately in selected cases. Resuscitation frequently brings only short-term success, and several patients suffer severe consequences also causing an economic, medical and ethical burden to society. The issue of limitation of resuscitation, including Do Not Attempt Resuscitation (DNAR) and the termination of resuscitation has been surveyed in many European countries using a structured questionnaire. In Hungary no such comprehensive study has been conducted yet. The goal of this investigation was to recognise the ethical factors limiting resuscitation in Hungary. METHODS: We contacted 72 doctors personally during 2003, who were working actively at an intensive care unit (ICU) and asked them to answer a structured questionnaire in strict anonymity. We investigated the role of different ethical issues in beginning and suspending resuscitation efforts in conjunction with medical experience, sex, ideology, and education using a five point visual analogue scale. The answers given were categorised to autonomy, futility, obtainable quality of life, resource utilization, and to "another" category detailed later on. The questionnaire and the plan of this investigation was approved by the Semmelweis Medical University's Ethical Committee (SE-TUKEB 109/2003). RESULTS: The decision not to attempt resuscitation was mostly dictated by the opinion of the head of department and the doctor in charge of the patient (3.53 +/- 1.30), and after this the presumed obtainable quality of life (3.13 +/- 1.40), objective futility (3.11 +/- 0.94), and patient autonomy (2.02 +/- 1.63). The other objective (0.57 +/- 1.59), and subjective (1.04 +/- 1.21) factors, as well as resource utilization (0.29 +/- 0.66) played a less important role. The decision to terminate resuscitation efforts was mostly dictated by the objective futility criteria (3.39 +/- 0.88), obtainable quality of life (3.31 +/- 1.50), subjective futility (3.19 +/- 1.47), and autonomy (1.57 +/- 1.67) to a smaller extent. Among the doctors who participated in an appropriate-an internationally accredited (ERC/RC(UK)/AHA)-Advanced Life Support (ALS) training-the frequency of the appearance of the principle of modern bioethics-such as autonomy-was significantly higher and the same tendency could be observed in those who completed their studies at the medical university in the last 5 years. CONCLUSIONS: The results underline the original presumption that the Hungarian resuscitation practice is at first influenced by professional (or "thought to be professional") standpoints. The quality of life, and patient autonomy plays an important role in the decision making about limitation of resuscitation efforts. Current CPR education emphasizes the importance of ethical considerations, and this could be observed clearly in the answers.

Attitude of Health Personnel↗

Babesia canis canis in dogs from Hungary: detection by PCR and sequencing.

Canine babesiosis in Hungary has always been a severe and frequent disease, attributed to infection with Babesia canis transmitted by Dermacentor reticulatus. Identification of the disease agent has been based merely on size and morphology of the intraerythrocytic parasites and no evidence has been found concerning the subspecies (genotype) of B. canis. Therefore, a molecular survey on natural Babesia infection of dogs in Hungary using PCR and sequence analysis was attempted to clarify the subspecies (genotype) and to obtain information on the occurrence of B. canis. A total of 44 blood samples from dogs showing clinical signs of babesiosis were collected. A piroplasm-specific PCR amplifying the partial 18S rRNA gene yielded an approximately 450 bp PCR product in 39 (88.6%) samples. Thirteen positive samples originated from Budapest and 26 from 21 other locations. Five PCR products were chosen randomly for sequencing. The partial 18S rDNA sequences were submitted to GenBank (accession numbers AY611729; AY611730; AY611731; AY611732 and AY611733). The sequences showed 100% homology to one another or differed by one nucleotide. BLAST search against GenBank revealed the highest similarity (99.8 or 100%) with Babesia canis canis. The implication of these data, for the further study and diagnosis of canine babesiosis is discussed.

Animals↗

Ixodid tick species attaching to dogs in Hungary.

A survey was carried out to investigate the occurrence of hard tick species (Acari: Ixodidae) infesting domestic dogs in Hungary. Forty veterinary clinics from a wide geographical area were asked to collect hard ticks from dogs and to complete a questionnaire. In total, 25 veterinary clinics submitted 900 ticks from 310 dogs. Intensity of infestation ranged from one to 78 per dog. The most preferred sites of tick attachment in decreasing order were head, neck and legs. The majority of ticks (91.7%) were adults, which were identified to species level, the others were nymphs. Six species were found: Dermacentor reticulatus (48.9%), Ixodes ricinus (43.2%), Ixodes canisuga (5.6%), Haemaphysalis concinna (2%) and there was one specimen of both Dermacentor marginatus and Ixodes hexagonus. Single species infestation with I. ricinus or D. reticulatus was found on 145 (46.8%) and 120 animals (38.7%), respectively. Mixed infestation caused by these two species was detected on 24 dogs (7.7%). I. canisuga and H. concinna were found on seven and five dogs, respectively. D. reticulatus and I. ricinus were collected almost throughout the year, except for a single month. The activity peaks were in spring and in autumn for both species. Based on clinical signs, canine babesiosis was diagnosed by the veterinarians in 66 (21.3%) tick infested dogs. These dogs were more frequently infested with D. reticulatus than the others. Our data contribute to the understanding of geographical and seasonal distribution of ixodid tick species infesting dogs in Hungary. The implication of these data, for the risk of canine tick borne diseases is discussed.

Animals↗

Canine neosporosis in Hungary: screening for seroconversion of household, herding and stray dogs.

In order to assess the seroprevalence of canine neosporosis 651 blood samples were collected from 586 household, 41 herding and 24 stray dogs, at small animal clinics in four large cities and other places of Hungary. Nineteen (2.9%) showed positivity in the IFAT with titres between 1:80 and 1:10240. Two dogs with high titres of antibodies to Neospora caninum had neuromuscular signs (imbalance, tremor) and a further one developed papulomatous, ulcerative and necrotizing dermatitis. There was no correlation between titers and age, sex, breed or keeping place. Although more male dogs had antibodies to N. caninum than females in case of both household and herding dogs, this association was not significant. No breed predisposition was observed. However, dogs with seroconversion were significantly more prevalent among rural (6%) than among urban dogs (1%), indicating that dogs in the countryside may have contact with or access to potentially infected offal from cattle and other intermediate hosts more frequently than those in large cities. Furthermore, significantly more herding dogs (29.3%) had antibodies to N. caninum than household dogs (1.2%), confirming the association between the occurrence of neosporosis and dog keeping on farms. The 12 dogs found seropositive among herding ones lived on 6 farms, on 5 of which seropositive cattle were also identified. This is the first report on the prevalence of N. caninum infection in dogs in Hungary.

Animals↗

Temporal distribution of Ixodes ricinus, Dermacentor reticulatus and Haemaphysalis concinna in Hungary.

A survey was carried out over a 4-year period to describe the temporal distribution of three 'anthropophilic' tick species, Ixodes ricinus, Dermacentor reticulatus and Haemaphysalis concinna in Hungary. Altogether 4658 adult ticks belonging to the three species were collected from 1931 red foxes (Vulpes vulpes) killed in an area of about 70,000 km(2) representing all major climatic areas of the country. The seasonal activity of the three species was different. I. ricinus ticks were most active between April and June with an activity peak in May. A less marked increase of activity was also observed in September and October. The highest activity of D. reticulatus ticks was seen between September and November with an activity peak in October, nevertheless, a marked increase of activity could also be observed in April. Small number of I. ricinus and D. reticulatus were collected in all other months. H. concinna ticks were active from May to July with an activity peak in June and completely disappeared between October and March. The temporal distribution of the three tick species might be used for predictions on the seasonality of tick-borne diseases in Hungary.

Animals↗

Mutations causing biotinidase deficiency in children ascertained by newborn screening in Western Hungary.

In Hungary the national newborn screening programme for the detection of biotinidase deficiency was launched in 1989. In this study, we determined the genotypes of all patients identified at the Budapest Screening Centre that covers half of the country. The incidence of the disorder in Western Hungary is about three times the worldwide incidence. Overall, 21 different mutations were identified in 49 patients, including four novel mutations. Ten mutations proved to be unique to the Hungarian population.

Alleles↗

First national survey of atmospheric heavy metal deposition in Hungary by the analysis of mosses.

The atmospheric deposition of Cd, Cr, Cu, Fe, Ni, Pb, V and Zn in Hungary was investigated by using moss species as bioindicators. Our research was part of an international mapping project (Atmospheric Heavy Metal Deposition in Europe) [NORD 21 (1987) 1-44; NORD 9 (1994)] carried out in the most European countries in the 1990s to determine and to compare atmospheric heavy metal background pollution by standardized methods. Sampling was performed at 116 sites distributed over Hungary in the autumn of 1997. Moss species of Hypnum cupressiforme (72.4%) were preferred. But where it could not be collected, other species were taken. Unwashed, dried samples were digested with H(2)O(2)/HNO(3), and the concentrations of heavy metals were determined by ICP-AES. The results reflect local emission points. Background mean levels of Cd, Fe and Ni were mildly elevated in comparison to European means [NORD 9 (1994)]. Probably, that was due not only to pollution, but to the use of Hypnum cupressiforme, which can accumulate higher concentrations of heavy metals compared to other species. The results are presented on colored contour maps obtained with the SURFER program (Golden Software Inc. Co).

Air Pollutants↗

Should all sexually active young women in Hungary be screened for Chlamydia trachomatis?

OBJECTIVE: Cost-effectiveness analysis was carried out to develop screening strategy for Chlamydia trachomatis to assess the possibility of preventing pelvic inflammatory disease and its sequelae. STUDY DESIGN: An 18 months epidemiological study of prevalence of chlamydial infection among pregnant women was carried out in Hungary. RESULTS: The policy of testing and treating was less cost-effective than neither testing nor treating, unless the cost of the diagnostic test were less than or equal to US$ 10, or the prevalence of infection in women were greater than 8.3. CONCLUSIONS: Since the prevalence of chlamydial infection amongst 15-24 years old women in this study was 8.0%, the cost of screening in Hungary only barely outweighs the benefit in economic terms. Given the undesirable potential consequences of the infection, it is thus recommended that Hungarian clinicians should screen all young, sexually active women for C. trachomatis at the same time as they perform routine pelvic examinations.

Adolescent↗

Ectoparasite infestations of red foxes (Vulpes vulpes) in Hungary.

A survey was carried out to investigate the ectoparasite infestations of 100 red foxes (Vulpes vulpes) in Hungary. The overall prevalence of flea and tick infestation was high (62 and 86% with the dominance of the anthropophil Pulex irritans and Ixodes ricinus), but the number of parasites was low to moderate. Felicola vulpis was not found in the present study, and the prevalence of Otodectes cynotis was only 2%. Based on prevalence (21%), mange lesion scores, and the negative correlation between lesion scores and condition of foxes, Sarcoptes infestation should be considered as the most important parasitosis of foxes in Hungary. Besides the ecological significance of these parasites, the high overall prevalence of mange and anthropophil flea and tick infestations of foxes and the appearance of these animals in the synanthropic environment as a result of the increasing population size, may result in the increasing incidence of flea, tick and accidental mite infestation of man and domestic animals, and may enhance the transmission rate of some vector-borne diseases.

Animals↗

Characterization of virulence plasmid types in Rhodococcus equi isolates from foals, pigs, humans and soil in Hungary.

Rhodococcus equi isolates (204) obtained from foals (lung abscesses, lymph nodes, nasal discharge, rectal swabs) bred in 15 studs located throughout Hungary, isolates from soil samples, lymph nodes of pigs and from lesions of human patients were examined to determine genotypic diversity of virulence-associated plasmids. Isolates were tested for the presence of 15-17 kDa virulence-associated protein antigen (VapA) and 20k Da (VapB) genes by polymerase chain reaction (PCR). Plasmid DNAs were isolated and analysed by digestion with restriction endonucleases for estimation of size and comparison of polymorphisms. Of 146 clinical isolates from foals in 15 studs, 129 (88.3%) gave positive results for the VapA gene, showing a 564 bp product of the expected size in the PCR amplification. Of the 129 clinical isolates from foals, 123 contained an 85 kb type I plasmid and the remaining six contained an 87 kb type I plasmid. Of 48 soil isolates from two horse studs, 26 (54.2%) were positive for VapA gene and contained an 85 kb type I plasmid. Of three pig isolates, one was positive for VapA gene and contained an 85 kb type I plasmid, and the remaining two were positive for the VapB gene, showing a 827 bp product of the expected size in the PCR amplification and were R. equi of intermediate virulence which contained a 95 kb type S5 plasmid. Of the seven human isolates, five were positive for VapB gene by PCR, these were R. equi of intermediate virulence, which contained a 95 kb type S5 plasmid. These results revealed that virulent R. equi strains harbouring a virulence plasmid of 85 kb type I or 87 kb type I, which have been found in clinical isolates from Europe and North and South America, are widespread in Hungary. Furthermore, same intermediately virulence plasmid type was found in both human and pig isolates.

Actinomycetales Infections↗

Comparative analysis of differences by gender in sudden infant death syndrome in Hungary and Japan.

We examined the sex ratio in sudden infant death syndrome (SIDS) cases in Hungary, in Tokyo and Japan between 1985 and 1996. From all the infant death cases in Hungary 395 (240 male, 155 female) were SIDS (odds ratio (OR)=1.179, with 95% confidence interval (CI)=0.961, 1.446), in Japan 4348 (2550 male, 1798 female) were SIDS (OR=1.145, with 95% CI=1.076, 1.218) and in Tokyo 307 (178 male, 129 female) were SIDS (OR=1.128, with 95% CI=0.894, 1.423). Male infants showed a significantly higher birth rate than females. The male infants are more vulnerable (p<0.005), however, higher mortality among male infants should not be considered a characteristic feature for SIDS.

Female↗

Lack of evidence of teratogenicity of benzodiazepine drugs in Hungary.

In order to investigate possible teratogenic effects of commonly used benzodiazepines (diazepam, chlordiazepoxide, nitrazepam) in Hungary, four approaches were used: 1. A retrospective case-control study of 630 cases with isolated cleft lip +/- cleft palate, 179 cases with isolated cleft palate, 392 cases of multiple congenital anomalies including cleft lip and/or cleft palate, and their matched control cases; 2. The Case-Control Surveillance System of Congenital Anomalies in Hungary, 1980 to 1984, involving 355 cases with isolated cleft palate, 417 cases with multiple congenital anomalies, and 186 cases with Down's syndrome (as positive controls). Benzodiazepines were taken by 14.9% of 11,073 control pregnant women studied; 3. A prospective study of 33 pregnant women attending the Counselling Clinic following ingestion of benzodiazepines during the first trimester of pregnancy; 4. An observational study involving 12 pregnant women who attempted suicide and one with accidental overdosage with benzodiazepines during pregnancy. None of these four approaches gave any indication of an association between facial clefting and in utero exposure to these substances.

Abnormalities, Drug-Induced↗