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Introduction: Migraine, a debilitating neurological disorder characterized by recurrent headaches, affects over 1.1 billion individuals globally. Diabetes mellitus (DM), a chronic metabolic condition marked by high blood sugar levels, affects 463 million individuals according to the International Diabetes Federation. Our study aimed to evaluate the association between migraine and DM and to identify several demographic, socioeconomic, and lifestyle factors, as well as medical and psychiatric comorbidities, associated with migraine among individuals with DM. Methods: This cross-sectional study is based on data from the European Health Interview Surveys conducted in 2009, 2014, and 2019 in Hungary. Pearson's chi-squared tests and multiple logistic regression models were used to assess associations. Statistical significance was set at p<0.05. Results: In multiple regression analyses, we found no significant association between DM and migraine after adjusting for socioeconomic status, various health conditions, and lifestyle factors (OR=0.84, 95% CI: 0.66-1.06). However, adults with DM who had comorbid conditions including stroke (OR=2.08, 95% CI: 1.06-4.08), low back pain (OR=3.52, 95% CI: 2.13-5.84), and depression (OR=4.91, 95% CI: 2.84-8.47) were significantly more likely to suffer from migraine. Discussion: Our study found no significant difference in the prevalence of migraine among adults with and without diabetes mellitus. However, several comorbidities were found to be significantly associated with migraine occurrence in those with DM. Thus, the study's results highlight the need for proper management of diabetes, especially in terms of comorbidities, to mitigate migraine risk factors and improve patient outcomes.
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Comorbilidad , Diabetes Mellitus , Trastornos Migrañosos , Humanos , Trastornos Migrañosos/epidemiología , Trastornos Migrañosos/complicaciones , Estudios Transversales , Masculino , Femenino , Hungría/epidemiología , Persona de Mediana Edad , Adulto , Diabetes Mellitus/epidemiología , Encuestas Epidemiológicas , Anciano , Adulto Joven , Adolescente , Factores de Riesgo , PrevalenciaAsunto(s)
Consumo de Bebidas Alcohólicas , Estilo de Vida , Humanos , Femenino , Masculino , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Fumar/epidemiología , Persona de Mediana Edad , Infertilidad/psicología , Infertilidad/terapia , Hungría/epidemiología , Adulto Joven , Fertilización In Vitro/estadística & datos numéricosRESUMEN
PURPOSE: Invasive Listeria monocytogenes infection is rare, but can lead to life-threatening complications among high-risk patients. Our aim was to assess characteristics and follow-up of adults hospitalized with invasive L. monocytogenes infection. METHODS: A retrospective observational cohort study was conducted at a national referral center between 2004 and 2019. Patients with proven invasive listeriosis, defined by the European Centre for Disease Prevention and Control criteria, were included. Data collection and follow-up were performed using the hospital electronic system, up until the last documented visit. The primary outcome was in-hospital all-cause mortality, secondary outcomes included residual neurological symptoms, brain abscess occurrence, and requirement for intensive care unit (ICU) admission. RESULTS: Altogether, 63 cases were identified (57.1% male, median age 58.8 ± 21.7 years), and 28/63 developed a complicated disease course (44.4%). At diagnosis, 38/63 (60.3%) presented with sepsis, 54/63 (85.7%) had central nervous system involvement, while 9/63 (14.3%) presented with isolated bacteremia. Frequent clinical symptoms included fever (53/63, 84.1%), altered mental state (49/63, 77.8%), with immunocompromised conditions apparent in 56/63 (88.9%). L. monocytogenes was isolated from blood (37/54, 68.5%) and cerebrospinal fluid (48/55, 87.3%), showing in vitro full susceptibility to ampicillin and meropenem (100% each), gentamicin (86.0%) and trimethoprim/sulfamethoxazole (97.7%). In-hospital all-cause mortality was 17/63 (27.0%), and ICU admission was required in 28/63 (44.4%). At discharge, residual neurological deficits (11/46, 23.9%) and brain abscess formation (6/46, 13.0%) were common. CONCLUSION: Among hospitalized adult patients with comorbidities, invasive L. monocytogenes infections are associated with high mortality and neurological complications during follow-up.
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Hospitalización , Listeria monocytogenes , Listeriosis , Humanos , Masculino , Femenino , Persona de Mediana Edad , Listeriosis/mortalidad , Listeriosis/microbiología , Listeriosis/epidemiología , Listeriosis/tratamiento farmacológico , Listeria monocytogenes/patogenicidad , Listeria monocytogenes/aislamiento & purificación , Listeria monocytogenes/efectos de los fármacos , Estudios Retrospectivos , Anciano , Hungría/epidemiología , Adulto , Hospitalización/estadística & datos numéricos , Estudios de Seguimiento , Antibacterianos/uso terapéutico , Antibacterianos/farmacología , Unidades de Cuidados Intensivos/estadística & datos numéricos , Bacteriemia/microbiología , Bacteriemia/mortalidad , Bacteriemia/epidemiología , Bacteriemia/tratamiento farmacológico , Anciano de 80 o más Años , Sepsis/microbiología , Sepsis/mortalidad , Sepsis/epidemiología , Sepsis/tratamiento farmacológico , Mortalidad HospitalariaRESUMEN
INTRODUCTION: Functional neurological disorder (FND) and complex regional pain syndrome (CRPS) are disorders that affect quality of life. CRPS diagnosis is based on Budapest criteria that include various signs/symptoms. Despite the similarity in the etiology/pathophysiology of FND and CRPS, the joint prevalence of these two conditions in youth has not yet been reported. Given that both phenomena are less familiar among pediatric patients, it is crucial to thoroughly characterize them and establish a clear differential diagnosis. This, in turn, holds significant implications for guiding therapeutic interventions. OBJECTIVES: We aimed to examine: 1) the clinical profile of children with FND; 2) the prevalence of CRPS among children with FND; and 3) differences in clinical characteristics and in Budapest's symptoms/signs between children with FND and those with a co-diagnosis of FND and CRPS. METHODS: Sixty-one children (mean age: 13.70+2.93 years; 75.4% females) diagnosed with FND were studied. Sample's demographic, clinical characteristics and the Budapest CRPS classification criteria were collected from medical files. RESULTS: Most children with FND reported sensory (67%) and motor (88%) symptoms. Forty-four percent had a co-diagnosis of FND and CRPS. Among these children, 100% reported sensory and motor/tropical, 74% vasomotor, and 65% sudomotor symptoms. The prevalence of Budapest symptoms, except for motor-function impairment, was significantly higher among children with a co-diagnosis compared to children with FND alone. CONCLUSIONS: The high frequency of symptoms and clinical signs in children with co-incidence of CRPS and FND may indicate a shared developmental mechanism and is important for the development of appropriate rehabilitation interventions.
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Síndromes de Dolor Regional Complejo , Enfermedades del Sistema Nervioso , Humanos , Síndromes de Dolor Regional Complejo/epidemiología , Síndromes de Dolor Regional Complejo/diagnóstico , Síndromes de Dolor Regional Complejo/fisiopatología , Femenino , Adolescente , Niño , Masculino , Prevalencia , Enfermedades del Sistema Nervioso/epidemiología , Enfermedades del Sistema Nervioso/diagnóstico , Diagnóstico Diferencial , Calidad de Vida , Hungría/epidemiologíaRESUMEN
Among malignant diseases, lung cancer has one of the highest mortality and incidence. Most epidemiological studies conclude that Hungary faces the most severe burden in association with this disease. However, for various reasons estimates and population-based studies show discrepancies. In this study, an intense data cleansing was performed on lung cancer cases that were reported to the Hungarian National Cancer Registry in 2018, and the major clinico-pathological parameters as well as survival characteristics were described. Our population-based figures were compared to the European estimates. As a result of our thorough revision, the corrected incidence of lung cancer has fallen below the number of cases that were reported to the Registry from 11,746 to 9,519. We also demonstrate that Hungary did not show the highest incidence and mortality in Europe, but it is still among the ones with the worst raking countries, with 92.9 and 50.6 age standardized rate per 100 thousand capita among males and females, respectively. Analysis of the annually reported case numbers revealed a gender-specific difference in incidence trends: while from 2001 to 2019 it slightly decreased among males, it increased among females. The most dominant subtype was adenocarcinoma, which was more frequent among female patients. Unfortunately, most of the newly diagnosed cases were in advanced stage; thus, 5 year overall survival was 14.8%. We anticipate that in the longer term, a decrease in incidence and improvement in survival rates may be expected as a result of the development of primary and secondary prevention programs in the country.
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Neoplasias Pulmonares , Sistema de Registros , Humanos , Hungría/epidemiología , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/diagnóstico , Masculino , Femenino , Anciano , Persona de Mediana Edad , Incidencia , Adulto , Anciano de 80 o más Años , Adolescente , Adulto JovenRESUMEN
Our knowledge of how society viewed leprosy and treated its victims in the past is still scarce, especially in geographical regions and archaeological periods from where no written sources are available. To fill in some research gaps, we provide the comparative analysis of five previously described, probable cases with leprosy from the Avar-period Trans-Tisza region (Hungary). The five skeletons were subject to a detailed macromorphological (re-)evaluation. Where possible, the biological and social consequences of having leprosy were reconstructed based on the observed bony changes and mortuary treatment, respectively. The retrospective, macromorphology-based diagnosis of leprosy could be established in three cases only. Based on the detected skeletal lesions, all of them suffered from near-lepromatous or lepromatous leprosy. The disease resulted in aesthetic repercussions and functional implications, which would have been disadvantageous for these individuals, and limited or changed their possibilities to participate in social situations. They could have even required heavy time investment from their respective communities. The analysis of the mortuary treatment of the confirmed leprosy cases revealed no evidence of a social stigma. These findings indicate that the afflicted have not been systematically expulsed or segregated, at least in death, in the Early Middle Ages of the Carpathian Basin.
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Paleopatología , Humanos , Masculino , Hungría/epidemiología , Adulto , Femenino , Lepra/historia , Lepra/diagnóstico , Lepra/epidemiología , Persona de Mediana Edad , Historia Antigua , Historia Medieval , Lepra Lepromatosa/historia , Lepra Lepromatosa/diagnósticoRESUMEN
The ectoparasitic copepod Lernaea cyprinacea (anchor worm) has more than 100 host species among teleost fishes and affects cyprinids both in fish farms and natural waters. In addition, while L. cyprinacea infection in amphibians has been recorded in Asia, North and South America, there is no data available in the literature on their presence in Europe. In this study, we first reported L. cf. cyprinacea parasitising an anuran tadpole in Europe. Specimens of L. cf. cyprinacea were observed attached to a tadpole of the agile frog (Rana dalmatina), which was caught during fishing of crucian carp fingerlings (Carassius carassius) from a small fish pond in Hungary during the summer of 2012. The infected tadpole was collected from a rearing pond, where juvenile crucian carps were kept. The tadpole was inspected in the laboratory, and digital photos were taken. The parasites were found attached to the body-tail junction and to the leg of the tadpole (at Gosner stage 41). The parasite species was identified as L. cf. cyprinacea based on morphological traits.
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Copépodos , Larva , Ranidae , Animales , Hungría/epidemiología , Ranidae/parasitología , Infestaciones Ectoparasitarias/veterinaria , Infestaciones Ectoparasitarias/parasitología , Infestaciones Ectoparasitarias/epidemiologíaRESUMEN
AIMS: To estimate prevalence of diagnosed (dDM) and undiagnosed diabetes (uDM) in Hungary and investigate determinants of uDM. METHODS: Data was obtained from the nationally representative H-UNCOVER study. As laboratory measurements were available for 11/19 Hungarian counties, n = 5,974/17,787 people were eligible. After exclusions, 5,673 (representing 4,976,097 people) were included. dDM was defined by self-reporting, while uDM as negative self-reporting and elevated fasting glucose (≥7 mmol/l) and/or HbA1c (≥48 mmol/mol). Logistic regression for complex samples was used to calculate comparisons between dDM and uDM adjusted for age and BMI. RESULTS: Diabetes prevalence was 12.0 %/11.9 % (women/men, 95 %CI:10.7-13.4 %/10.7-13.2 %), while 2.2 %/2.8 % (1.7-2.8 %/2.2-3.6 %) of women/men were uDM. While the proportion of uDM vs. dDM was similar for women ≥ 40, men in their forties had the highest odds for uDM. Neither unemployment (women/men OR:0.58 [0.14-2.45]/0.50 [0.13-1.92]), nor education level (tertiary vs. primary; women/men OR: 1.16 [0.53-2.56]/ 0.53 [0.24-1.18]) were associated with uDM. The risk of uDM was lower in both sexes with chronic morbidities. CONCLUSIONS: We report higher prevalence of diabetes and undiagnosed diabetes than previous Hungarian estimates. The finding that socioeconomic factors are not associated to uDM suggests that universal health care could provide equitable access to diabetes diagnosis.
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Diabetes Mellitus , Humanos , Hungría/epidemiología , Masculino , Femenino , Prevalencia , Persona de Mediana Edad , Adulto , Estudios Transversales , Diabetes Mellitus/epidemiología , Diabetes Mellitus/diagnóstico , Anciano , Adulto Joven , Enfermedades no Diagnosticadas/epidemiología , Glucemia/análisis , Hemoglobina Glucada/análisis , Hemoglobina Glucada/metabolismo , AdolescenteAsunto(s)
Aneurisma de la Aorta Abdominal , Tamizaje Masivo , Atención Primaria de Salud , Humanos , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/epidemiología , Aneurisma de la Aorta Abdominal/diagnóstico , Hungría/epidemiología , Masculino , Tamizaje Masivo/métodos , Anciano , Femenino , Ultrasonografía , Prevalencia , Estudios ProspectivosAsunto(s)
Vacuna contra la Tos Ferina , Tos Ferina , Humanos , Tos Ferina/epidemiología , Tos Ferina/prevención & control , Hungría/epidemiología , Femenino , Vacuna contra la Tos Ferina/administración & dosificación , Embarazo , Incidencia , Recién Nacido , Lactante , Masculino , Vacunación/estadística & datos numéricosRESUMEN
INTRODUCTION: Suicide is a severe public health problem. Impacts of childhood traumas, unsecure adult attachment styles and personality traits have been suggested as possible risk factors for suicide attempts. The aim of this cross-sectional, case-controlled study is to investigate the impact of childhood traumas, adult attachment styles and personality traits on suicide attempt. METHODS: The sample consisted of psychiatric patients who attempted suicide (n=101) on the one hand and those who did not attempt suicide (n=114) on the other. The questionnaires used were the Hungarian validated versions of Adult Attachment Scale (AAS), Childhood Trauma Questionnaire (CTQ), Temperament and Character Inventory (TCI) and a demographic questionnaire. RESULTS: Results indicated that Novelty Seeking (NS) temperament trait [EH=1.043; 95% C.I.=(0.950-1.145)] p=0.376; emotional abuse [EH=1.034; 95% C.I.=(0.966-1.107)] p=0.336; emotional neglect [EH=1.022; 95% C.I.=(0.936-1.116)] p=0.626; and sexual abuse [EH=1.047; 95% C.I.=(0.959-1.142)] p=0.305 were associated with nonsignificant increases in the odds of suicide attempts. Whereas secure attachment style [EH=0.908; 95% C.I.=(0.842-0.980)] p=0.013 appeared to be a significantly protective factor (c2(1)=6.515 p=0.011). Furthermore, when examining the connection between childhood traumas and adult attachment styles it was found that the anxious attachment style had a positive significant correlation with emotional abuse (rs(197)=0.293) p<0.001, avoidant attachment style with emotional neglect (rs(197)= 0.273) p<0.001. CONCLUSION: Our findings suggest that individuals with avoidant attachment style and childhood traumas are likely to present a higher suicide risk. However secure attachment style likely to present a lower risk for suicide.
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Carácter , Apego a Objetos , Intento de Suicidio , Temperamento , Humanos , Intento de Suicidio/psicología , Intento de Suicidio/estadística & datos numéricos , Adulto , Factores de Riesgo , Masculino , Femenino , Hungría/epidemiología , Estudios de Casos y Controles , Estudios Transversales , Persona de Mediana Edad , Encuestas y Cuestionarios , Niño , Abuso Emocional/psicología , Inventario de Personalidad , Adultos Sobrevivientes del Maltrato a los Niños/psicología , Conducta ExploratoriaRESUMEN
Annually, 172 million fall events cause temporary or permanent impairment in older adults, and this number is increasing. Contributing factors that increase the risk for falls include age, polypharmacy, and malnutrition. This study evaluated medications mainly included in the EU(7)-PIM (potentially inappropriate medication) list. From March 21, 2022, to July 6, 2022, 945 patients who experienced a fall and visited the Department of Emergency Medicine at the Albert Szent-Györgyi Health Centre of the University of Szeged in Hungary. Data from 886 patients were collected (study group). The control group included 1364 patient data collected from three general practice in Hungary. The use of ≥ 2 EU(7)-PIM drugs was found to be associated with increased risk for falls (adjusted odds ratio [AOR], 1.38; 95% confidence interval [CI] 1.01-1.88). Piracetam (AOR, 1.81; 95% CI, 1.28-2.57) and trimetazidine (AOR, 1.62; 95% CI, 1.17-2.24) were associated with increased risk for falls. Doxazosin was associated with a low risk for falls (AOR, 0.59; 95% CI, 0.41-0.86). Tiapride (AOR, 3.54; 95% CI, 1.75-7.17), gliclazide (AOR, 1.57; 95% CI, 1.02-2.43), and vinpocetine (AOR, 1.95; 95% CI, 1.29-2.95) are not included in the EU(7)-PIM list; however, they are associated with increased risk for falls. Long-acting benzodiazepines (AOR, 1.79; 95% CI, 1.20-2.68), antidepressants (AOR, 1.89; 95% 95% CI, 1.37-2.61), serotonin-norepinephrine reuptake inhibitor (AOR, 2.82; 95% CI, 1.41-5.67; p < 0.01), and selective serotonin reuptake inhibitor (AOR, 1.88; 95% CI, 1.24-2.85) were also associated with increased risk for falls. However, Z-drugs were associated with a low risk for falls (AOR, 0.57; 95% CI, 0.36-0.92). With the help of this tool, trimetazidine and piracetam are filtered as EU(7)-PIM drugs associated with increased risk for falls.
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Accidentes por Caídas , Prescripción Inadecuada , Lista de Medicamentos Potencialmente Inapropiados , Humanos , Masculino , Accidentes por Caídas/estadística & datos numéricos , Femenino , Anciano , Estudios de Casos y Controles , Anciano de 80 o más Años , Hungría/epidemiología , Prescripción Inadecuada/estadística & datos numéricos , Prescripción Inadecuada/efectos adversos , Factores de Riesgo , PolifarmaciaRESUMEN
Distal sensorimotor polyneuropathy (DSPN) is the earliest detectable and the most frequent microvascular complication in diabetes mellitus. Several studies have previously demonstrated correlations between cardiovascular risk factors in diabetic patients and independent risk factors for diabetic neuropathy. Our objective was to retrospectively analyze data from diabetic patients in the North-East region of Hungary who underwent neuropathy screening at the Diabetic Neuropathy Center, University of Debrecen, between 2017 and 2021. We aimed to investigate the correlations between cardiovascular risk factors and microvascular complications among patients with DSPN. The median age of the patients was 67 years, 59,6% were female, and 91,1% had type 2 diabetes. The prevalence of DSPN among the study subjects was 71.7%. A significantly longer duration of diabetes (p<0.01) was noted in patients with DSPN. Those with DSPN demonstrated a significantly higher HbA1c level (p<0.001) and a greater frequency of insulin use (p = 0.001). We observed a significantly elevated albumin/creatinine ratio (p<0.001) and a significantly lower eGFR (p<0.001) in patients with DSPN. Diabetic retinopathy exhibited a significantly higher prevalence in patients with DSPN (p<0.001). A higher prevalence of myocardial infarction (p<0.05), ischemic heart disease (p<0.001), peripheral arterial disease (p<0.05) and a history of atherosclerosis (p<0.05) was observed in patients with DSPN. In a multivariate logistic regression analysis, the following factors were independently associated with the presence of DSPN: higher HbA1c (OR:2.58, 95% CI:1.89-3.52, p<0.001), age (OR:1.03, 95% CI:1.01-1.05, p = 0.006), albumin/creatinine ratio above 3 mg/mmol (OR:1.23, 95% CI:1.06-1.45, p = 0.008), retinopathy (OR:6.06, 95% CI:1.33-27.53, p = 0.02), and composite cardiovascular endpoint (OR:1.95, 95% CI:1.19-3.19, p = 0.008). Our study revealed that age, elevated HbA1c levels, significant albuminuria, retinopathy, and cardiovascular complications may increase the risk of DSPN. Further investigation of these associations is necessary to understand the impact of patient characteristics during the treatment of diabetic neuropathy.
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Diabetes Mellitus Tipo 2 , Neuropatías Diabéticas , Humanos , Femenino , Masculino , Hungría/epidemiología , Anciano , Neuropatías Diabéticas/epidemiología , Neuropatías Diabéticas/etiología , Persona de Mediana Edad , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Estudios Retrospectivos , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/complicaciones , Factores de Riesgo , Prevalencia , Hemoglobina Glucada/análisis , Hemoglobina Glucada/metabolismo , Retinopatía Diabética/epidemiología , Retinopatía Diabética/complicacionesRESUMEN
The objective of our study was to map county differences in incidence and mortality by cancers and examine their changes over time. Based on the database of National Cancer Registry and Central Statistical Office, age-standardized incidence and mortality rates per 100,000 person-years were calculated for each county for 15 cancer types and 3 time periods. East-West divide was apparent in incidence and mortality of lung cancer, with larger weight in East (Borsod-Abaúj-Zemplén, Heves, Jász-Nagykun-Szolnok, Békés counties). Concentration of lip and oral cavity malignancies was identified in the northeastern periphery (Borsod-Abaúj-Zemplén, Szabolcs-Szatmár-Bereg counties). Breast cancer incidence was the highest in Budapest. As a conclusion, changes in cancer incidence and mortality over time were similar to developed countries; however, values were higher. Differences in spatial distribution follow territorial pattern of social deprivation, which correspond to higher prevalence of health risk factors. Our study contributes to planning of public health programs by pinpointing regional inequalities in different cancer types.
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Neoplasias , Sistema de Registros , Humanos , Hungría/epidemiología , Incidencia , Femenino , Neoplasias/mortalidad , Neoplasias/epidemiología , Masculino , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/epidemiología , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/epidemiología , Factores de Riesgo , Persona de Mediana Edad , Neoplasias de la Boca/mortalidad , Neoplasias de la Boca/epidemiología , Mortalidad/tendencias , Adulto , Anciano , Neoplasias de los Labios/epidemiología , Neoplasias de los Labios/mortalidad , Distribución por SexoRESUMEN
The quality of input data determines the reliability of epidemiological assessments. Thus, the verification of cases reported to the National Cancer Registry is required. The objective of our study was evaluating the reliability of cases diagnosed by lung cancer, exploring the patterns of erroneous reports. The validation of the 11,750 lung cancer cases reported to the Cancer Registry in 2018 was performed with the involvement of the recording hospitals, analyzing the characteristics of reports by gender, age and attributes of the reporting institutions. 81.3 percent of the reported cases was confirmed, in 40.4 percent of the false reports, malignancy was not present at all. Among the erroneous cases women and the elderly age group were overrepresented. The highest deleted rate occurred in Borsod- Abaúj-Zemplén county. As a conclusion, there is a strong need for the improvement of the efficiency in encoding lung cancer. The most common errors: confusion of malignant-benign, cancerous-non-cancerous and primary-metastatic lesions. The reliability is not affected by the role of individual institutions in the hierarchy of health care. The availability of reliable epidemiological data is crucial in the fight against cancer, which requires broad professional cooperation.
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Codificación Clínica , Neoplasias Pulmonares , Sistema de Registros , Humanos , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/patología , Femenino , Masculino , Anciano , Persona de Mediana Edad , Codificación Clínica/normas , Reproducibilidad de los Resultados , Hungría/epidemiología , AdultoAsunto(s)
COVID-19 , Humanos , Hungría/epidemiología , COVID-19/epidemiología , Embarazo , Femenino , Recién Nacido , Parto Obstétrico/estadística & datos numéricos , Adulto , SARS-CoV-2 , PandemiasRESUMEN
Vaccine hesitancy is an inevitable risk for societies as it contributes to outbreaks of diseases. Prior research suggests that vaccination decisions of individuals tend to spread within social networks, resulting in a tendency to vaccination homophily. The clustering of individuals resistant to vaccination can substantially make the threshold necessary to achieve herd immunity harder to reach. In this study, we examined the extent of vaccination homophily among social contacts and its association with vaccine uptake during the COVID-19 pandemic in Hungary using a contact diary approach in two cross-sectional surveys. The results indicate strong clustering among both vaccinated and unvaccinated groups. The most powerful predictor of vaccine uptake was the perceived vaccination rate within the egos' social contact network. Vaccination homophily and the role of the interpersonal contact network in vaccine uptake were particularly pronounced in the networks of close relationships, including family, kinship, and strong social ties of the ego. Our findings have important implications for understanding COVID-19 spread dynamics by showing that the strong clustering of unvaccinated individuals posed a great risk in preventing the spread of the disease.
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COVID-19 , Vacunación , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , COVID-19/psicología , Femenino , Masculino , Adulto , Estudios Transversales , Hungría/epidemiología , Persona de Mediana Edad , Vacunación/psicología , Vacunas contra la COVID-19/administración & dosificación , SARS-CoV-2/inmunología , Red Social , Vacilación a la Vacunación/psicología , Vacilación a la Vacunación/estadística & datos numéricos , Pandemias/prevención & control , Ego , Adulto Joven , Anciano , AdolescenteRESUMEN
PURPOSE: To assess the prevalence, types, sociodemographic factors, and reported dangerous activities of sleep-related behaviors likely representing NREM parasomnia episodes, as well as their association with adverse childhood experiences in Hungary. METHODS: Cross-sectional survey of 1000 adults (aged ≥18 years) representing the Hungarian population, using a non-probability quota sampling with a random walk method and a structured face-to-face interview. A multi-criterion weighting procedure was applied to correct bias along the main sociodemographic variables to the data available. Binary logistic regression estimated the odds of NREM parasomnia-related behaviors associated with sociodemographic factors and adverse childhood experiences. RESULTS: The prevalence of NREM parasomnia-related behaviors was 2.7 %, and self-reported sleep-eating was 0.1 % of the population (4.6 % of parasomnia-like activities). For middle-aged adults, the odds of sleep ambulation were significantly lower than for younger adults (OR 0.3; P = 0.03). A participant's family occurrence of reported parasomnia-like activity increased their odds of having it by more than 7 times (OR 7.1; P < 0.001). Nine participants out of those 27 people reporting NREM parasomnia-related behavior episodes, reported childhood adverse experiences, increasing the odds of parasomnia-related behavior by more than six times (OR 6.2; P < 0.001) compared to those not reporting it. CONCLUSION: This is the first population survey in Hungary on adult sleep-related behaviors likely representing NREM parasomnia episodes and the potential association with childhood traumatic events preceding them. The related dangerous behaviors call for safety measures and prevention. The significant association between adverse childhood events and NREM parasomnia-related behaviors needs further analysis.
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Experiencias Adversas de la Infancia , Parasomnias , Humanos , Femenino , Masculino , Parasomnias/epidemiología , Estudios Transversales , Adulto , Hungría/epidemiología , Persona de Mediana Edad , Experiencias Adversas de la Infancia/estadística & datos numéricos , Adolescente , Prevalencia , Adulto Joven , AncianoRESUMEN
Men who have sex with men (MSM) are at high risk of acquiring hepatitis A virus (HAV) and in recent years several HAV outbreaks mostly affecting MSM have been described. These outbreaks were caused by subtype IA strains circulating in this high-risk population. After years of low incidence, an outbreak among MSM in Hungary caused a significant increase in reported HAV infections in 2022. Samples from 224 HAV IgM-positive patients diagnosed in 2022 were tested for HAV RNA and positive samples were genotyped by sequencing. In 171 patients a unique subtype IB virus was detected with 99.8-100% sequence identity in the VP1/P2A junction. It was distinct from previously published strains, but most closely related to an Egyptian isolate. Sequence analysis revealed one dominant and three minor variants based on VP1/P2A. Whole genome sequencing revealed limited variation among these variants, suggesting a recent common origin. Epidemiological data indicated that sexual transmission was driving the outbreak for most of the year, suggested by the high male to female ratio and the large number of coinfections with HIV and other sexually transmitted infections among the patients. The outbreak was also associated with a restaurant cluster, in which one of the variants was detected and frozen berries were implicated as the source of infections. The outbreak strain was also detected in other countries around Europe and remained frequently detectable in Hungary in 2023. This study provides insights into the molecular and epidemiological characteristics of the described HAV outbreak. The results show that sequencing is not only useful in connecting cases to an outbreak, but also helps to clarify the relatedness of detected variants. Prevention strategies focusing on vulnerable communities may reduce the burden of HAV infections in the future.
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Brotes de Enfermedades , Virus de la Hepatitis A , Hepatitis A , Homosexualidad Masculina , Filogenia , Humanos , Hungría/epidemiología , Hepatitis A/epidemiología , Hepatitis A/virología , Masculino , Adulto , Virus de la Hepatitis A/genética , Virus de la Hepatitis A/clasificación , Persona de Mediana Edad , Genotipo , Frutas/virología , Alimentos Congelados/virología , Femenino , Adulto Joven , ARN Viral/genéticaRESUMEN
BACKGROUND: Human pulmonary dirofilariasis (HPD) is rare in Hungary, and it stems from Dirofilaria immitis, mainly transmitted through mosquito bites, with dogs as primary hosts. Despite its prevalence in veterinary settings, human cases are infrequent. Historically, Mediterranean countries report most HPD cases, but sporadic cases occur in temperate European regions. Radiologically, HPD often manifests in a non-specific manner, resembling pulmonary neoplasms, leading to unnecessary surgery and patient distress. METHODS: This study presents a notable case series from Hungary, encompassing a 12-year period, documenting 5 instances of HPD with the aim to provide baseline estimate of occurrence for future comparison. RESULTS: Among the patients studied, all were of middle age (median: 52 years, range: 37-69) and exhibited tumor-like lesions, primarily localized to the right lung, necessitating lobectomy or wedge resection. Histological examination consistently revealed a necrotizing granulomatous response characterized by remnants of helminths, without the presence of ovules. Furthermore, rigorous diagnostic procedures excluded other potential infectious agents through specialized staining techniques. Polymerase chain reaction analysis definitively confirmed the diagnosis of HPD in each case. CONCLUSIONS: This case series highlights HPD as a seldom zoonosis, with a probable escalation in its occurrence within temperate regions. Therefore, clinicians should maintain a heightened awareness of HPD in the differential diagnosis of pulmonary coin lesions. Early recognition and diagnosis are paramount for appropriate management and prevention of potential complications associated with this increasingly recognized infectious entity.