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In Hungary, changes in the White Stork population are monitored using two methods that involve a large number of volunteers: nest surveys since 1941, and since 1999 within the framework of the Common Bird Monitoring Scheme (MMM) programme. In our article, we briefly present the results of the nest survey data between 1999 and 2021, the population trend calculated on the basis of them, and the comparison of the latter with the trends shown by the MMM programme, which – among other species – counts all stork individuals on 2.5×2.5 km sample areas. Both sets of data show a decreasing trend, but there is a significant difference between them, which may be partly due to the inaccuracies of the nest database, considering the fact that the MMM also counts non-breeding adult and immature individuals. However, both methods have the characteristics that make them suitable for monitoring population trends. [ABSTRACT FROM AUTHOR]

A national White Stork (Ciconia ciconia) census was organised in Hungary in 2019. The 14th country-wide nest count was coordinated by MME/BirdLife Hungary, also involving local branches and volunteers of the society and national park directorates. Altogether 5,018 nests and 2,358 White Stork nest holders without nest material were reported. 89.2% of occupied nests were built on electric poles. Although 80 years ago every third nests were found on trees, in 2019, only 6 were reported at that location. Successful pairs raised 2.62 nestlings on average, breeding success for all breeding pairs was 2.19, which is lower than typical, probably due to chilly and rainy weather during the breeding season. Based on 3,540 reported breeding pairs and former census data, the White Stork population of Hungary is estimated to be 3,860–4,020 pairs in 2019. The size of the population was ca. 15–16 thousand pairs in 1941, which halved by 1958 and decreased to 5 thousand pairs by the late 1960s. For four decades, the population fluctuated between 4,800 and 5,500 pairs but in the last twenty years, the number of breeding pairs slightly decreased in the country. The population decline is stronger in hilly areas of W Hungary, i.e. in Somogy, Vas and Zala counties is about 60%. [ABSTRACT FROM AUTHOR]

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Streptococcus pneumoniae is responsible for a significant amount of morbidity and mortality worldwide. Healthy carriers, mainly young children, are the most important sources of infections. In the current study, we aimed to determine the changes that have occurred since the introduction of PCV-7 in Hungary. Nasal specimens were collected from 1,022 healthy children aged 3-6 years attending day-care centres. After thorough identification, pneumococcal isolates were serotyped, and their antibiotic sensitivity was determined. The carriage rate was found to be 34.9 %. A huge serotype rearrangement was detected compared to earlier results, with the previously leading serotype 14 having completely disappeared. Serotypes 11A, 35F, 19A, 6B, 15B, 3 and 38 were most prevalent, and 29 different types were identified in total. The PCV-7 types were responsible for 16.5 % of all serotypes, and 36.0 % are not covered by any pneumococcal vaccines. The isolates were sensitive to most tested antibiotics, except erythromycin (resistance was 21.6 %). Only one penicillin-resistant strain was found. The newly and rapidly emerging non-vaccine serotypes are much more sensitive, except serotype 19A. Conclusion: Due to PCV vaccination, a complete serotype arrangement occurred also in Hungary. The old 'paediatric' serotypes were replaced by serotypes 11A, 35F, 19A, 6B, 15B, 3 and 38. [ABSTRACT FROM AUTHOR]

Analysis of mitochondrial mutations in the HVS-I region is an effective method for ancient human populational studies. Discontinuous haplotype data between the first farmers and contemporary Europeans has been described before. Our contribution is based on a survey initiated on the Neolithic skeletons from Hungarian archaeological sites in the Alföld. This Lowland, the Hungarian Plain, is well excavated as an important region for spread of Neolithic culture from Near East and Balkans toward Central and Western Europe, started circa 8000 years ago. HVS-I sequences from nt15977 to nt16430 of 11 such specimens with sufficient mitochondrial DNA preservation among an extended Neolithic collection were analysed for polymorphisms, identifying 23 different ones. After assigning all single-nucleotide polymorphisms, a novel, N9a, N1a, C5, D1/G1a, M/R24 haplogroups were determined. On mitochondrial control mutations at nt16257 and nt16261, polymorphic PCRs were carried out to assess their distribution in remains. Neolithic data set was compared with contemporary Vác samples and references, resulting in higher frequency of N9a in Alföld as a remarkable genetic discontinuity. Our investigation is the first to study mutations form Neolithic of Hungary, resulting in an outcome of Far Eastern haplogroups in the Carpathian Basin. It is worth further investigation as a non-descendant theory, instead of a continuous population history, supporting genetic gaps between ancient and recent human populations. [ABSTRACT FROM AUTHOR]

Abstract: An Agreement of Cooperation was concluded in 2008 on the setting up of an Energy Security Centre amongst the Hungarian Ministry of Defence, the Ministry of Economy and Transport, the Ministry of Foreign Affairs, the National Office for Research and Technology and the Prime Minister''s Office. This paper summarizes the findings for the setting up of the Centre and creating the necessary conditions required for its operation. The main idea is that qualitatively new conditions to facilitate effective problem solving to meet the demands of mankind for energy are needed. The key part of this work is the creation of the structures of a global problem solving network. It will function as a network of energy security knowledge centres (KC). A number of KC with different specialisation will be built on these structures, resulting in a global network with new synergies, which will in return foster the development of new capabilities and the emergence of new way of thinking. The paper discusses the results related to the application of a global approach to energy security and points out the necessity of regarding energy security and environmental protection as integral parts of the system. [Copyright &y& Elsevier]

Introduction: Pseudomonas aeruginosa and Acinetobacter baumanii are important nosocomial pathogens with wide intrinsic resistance. However, due to the dissemination of the acquired resistance mechanisms, such as extended-spectrum beta-lactamase (ESBL) and metallo beta-lactamase (MBL) production, multidrug resistant strains have been isolated more often. Case presentation: We report a case of a Hungarian tourist, who was initially hospitalized in Egypt and later transferred to Hungary. On the day of admission PER-1-producing P. aeruginosa, PER-1 producing A. baumannii, SHV-5-producing Klebsiella pneumoniae and VIM-2-producing P. aeruginosa isolates were subcultured from the patient's samples in Hungary. Comparing the pulsed-field gel electrophoresis (PFGE) patterns of the P. aeruginosa strains from the patient to the P. aeruginosa strains occurring in this hospital, we can state that the PER-1 -producing P. aeruginosa and VIM-2-producing P. aeruginosa had external origin. Conclusion: This is the first report of PER-1-producing P. aeruginosa,and PER-1 -producing A. baumanii strains in Hungary. This case highlights the importance of spreading of the beta-lactamase-mediated resistance mechanisms between countries and continents, showing the importance of careful screening and the isolation of patients arriving from a different country. [ABSTRACT FROM AUTHOR]

The article discusses a study which examines the determination of a blaVIM-4 gene in the Klebsiella pneumoniae ST11 clone and in a Klebsiella oxytoca strain in Hungary. The VIM-type metallo-β-lactamases (MBLs) have been seen in Pseudomonas aeruginosa and Acinetobacter spp. worldwide. In Hungry, a CTX-M-15-producing epidemic clone was found. The author emphasizes the importance of epidemiology to the study of the dynamics of VIM-producing strains.

The globally threatened Eastern Imperial Eagle Aquila heliaca has been one of the flagship species of Hungarian bird conservation efforts since the 1980s. Due to these conservation activities and positive land-use changes during the last 2 decades, the Hungarian Imperial Eagle population increased from as few as approximately 20 pairs in the early 1980s to 81 pairs by 2006. Between 2002 and 2005 as part of a LIFE-Nature project, MME/Birdlife Hungary carried out particularly intensive monitoring, conservation, research, and public awareness actions. The main goal of the project was to secure the long-term sustainable increase in the Imperial Eagle population after Hungary's European Union accession in 2004. New methods were developed and applied to census and monitor the breeding and wintering population sizes. Standardized baseline land-use mapping and surveys were introduced to detect long-term land-use and prey density changes in priority areas for Imperial Eagles and to monitor the effects of key mortality factors, such as electrocution. Historical information and data gathered before and during the project period were assimilated using a Geographic Information System and incorporated into a comprehensive set of Imperial Eagle Management Guidelines. [ABSTRACT FROM AUTHOR]

The decline of farmland and grassland biodiversity is one the major conservation concerns nowadays. The European roller is a secondary cavity nester species typically inhabiting grasslands and farmlands. It has suffered large declines both in size and range of the population since the 1960s, but this negative trend has been reversed in several countries by applying direct conservation actions. As part of this study we aimed to evaluate the current habitat suitability of the historical breeding area of the species within Hungary, to promote the recolonization and the enlargement of the breeding range in the Carpathian Basin, and to evaluate the potential significance of the Natura 2000 network in this process. We applied species distribution modelling (SDM) based on nest-box occupancy data to map potential areas for nest-box supplementation. Grasslands, broad-leaved forests and agricultural sites with significant areas of natural vegetation were found to be the most important predictors. The majority (71%) of the predicted area has no occupied nest-boxes. A significantly larger proportion of grid cells with archive data still preserve suitable land cover composition for rollers, than cells where former breeding was not confirmed, and only a small proportion of former breeding area has become completely unsuitable for the species. Our results indicate large overlaps between the Natura 2000 network and the predicted area, of which 28.3% overlaps with Special Protection Area (SPA) sites and 23.8% with Special Area of Conservation (SAC/SCI) sites. Our study highlights the importance of promoting the recolonization of the European roller in the Transdanubian region of Hungary and provides a useful tool for direct conservation planning for the species. Our results also suggest that a coordinated network of protected areas such as Natura 2000 can potentially serve as core areas in the recolonization processes. [ABSTRACT FROM AUTHOR]

Investigations on the impact of genetic factors on the development of obesity have been limited regarding the Roma population—the largest and most vulnerable ethnic minority in Europe of Asian origin. Genetic variants identified from genetic association studies are primarily from European populations. With that in mind, we investigated the applicability of data on selected obesity-related single nucleotide polymorphisms (SNPs), obtained from the Hungarian general (HG) population of European origin, on the Hungarian Roma (HR) population. Twenty preselected SNPs in susceptible alleles, known to be significantly associated with obesity-related phenotypes, were used to estimate the effect of these SNPs on body mass index (BMI) and waist circumference (WC) in HG (N = 1783) and HR (N = 1225) populations. Single SNP associations were tested using linear and logistic regression models, adjusted for known covariates. Out of 20 SNPs, four located in FTO (rs1121980, rs1558902, rs9939609, and rs9941349) showed strong association with BMI and WC as continuous variables in both samples. Computations based on Adult Treatment Panel III (ATPIII) and the International Diabetes Federation's (IDF) European and Asian criteria showed rs9941349 in FTO to be associated only with WC among both populations, and two SNPs (rs2867125, rs6548238) in TMEM18 associated with WC only in HG population. A substantial difference (both in direction and effect size) was observed only in the case of rs1801282 in PPARγ on WC as a continuous outcome. Findings suggest that genetic risk scores based on counting SNPs with relatively high effect sizes, defined based on populations with European ancestry, can sufficiently allow estimation of genetic susceptibility for Roma. Further studies are needed to clarify the role of SNP(s) with protective effect(s). [ABSTRACT FROM AUTHOR]

Abstract: The year 2010 was a milestone in the history of transplantation in Hungary. Hungarian politicians became interested in solving the serious problems facing organ transplantation in our country. The State Secretary announced a program to (1) increase waiting lists, (2) raise donor numbers, (3) establish a lung transplant program, (4) promote education and increase the knowledge base regarding transplantation for the public and the medical profession, and finally, (5) to begin the negotiations for Hungary to join Eurotransplant. Joining Eurotransplant has been a priority of the transplant community. Finally, this year saw the Budapest Transplant Center perform 20% of their transplants from living kidney donors, up from 5% historically. [Copyright &y& Elsevier]

Electrocutions of birds on power structures is a global conservation concern that has not been thoroughly reported in all areas where it occurs. Here we provide information from citizen scientists describing 3,400 avian carcasses of at least 79 species found at the bases of 57,486 electrical pylons in Hungary. Of these carcasses, 3% were found at the bases of pylons retrofitted to reduce electrocution risk. On average, one carcass was found per 15 nonretrofitted pylons surveyed compared one carcass per 89 retrofitted pylons, an 83% difference in frequency. Electrocutions included 4 species of conservation concern in Hungary: Red-footed Falcons (Falco vespertinus), European Rollers (Coracias garrulous), Saker Falcons (Falco cherrug), and Eastern Imperial Eagles (Aquila heliaca). Only 3 of 104 (3%) electrocutions involving these species occurred on retrofitted pylons. Across birds of various sizes (small ≤25 cm long, medium 26–49 cm long, and large ≥50 cm long), differences in electrocution frequencies on nonretrofitted and retrofitted pylons were smallest for small birds, apparently because small birds could walk across the unprotected gaps in coverage directly below energized conductors. In this study, citizen scientists documented the breadth of the electrocution problem in Hungary but were not trained to record detailed pylon-specific configuration details. Rather, each pylon surveyed was categorized into one of 8 general configurations. Pylons with terminal connections were the most dangerous, accounting for 8% of pylons and 24% of electrocutions. Future mitigation may benefit from professional scientists conducting detailed analyses of how electrocutions occurred on retrofitted pylons. A madarakat érő áramütés egy globális természetvédelmi probléma, amelynek dokumentálása azonban nem minden területen történik meg, ahol a probléma előfordul. Ebben a cikkben önkéntesek bevonásával gyűjtött információkat mutatunk be minimum 79 madárfaj 3,400 teteméről, amelyek összesen 57,486 elektromos oszlop környezetében kerültek elő. A tetemek 3%-a olyan oszlopoknál volt, amelyeken már történtek madárvédelmi technikai beavatkozások. Átlagosan 15 felmért átalakítás nélküli oszlopra jutott egy tetem, míg az átalakított oszlopok esetében minden 89 oszlopra jutott egy áldozat, ami 83%-os gyakoriságbeli eltérést jelent. Az áramütés négy olyan fajt is érint, amelyek a magyar természetvédelem számára kiemelt fontosságúak, úgymint: a kék vércse (Falco vespertinus), a szalakóta (Coracias garrulus), a kerecsensólyom (Falco cherrug) és a parlagi sas (Aquila heliaca). Az ezeket a fajokat érintő 104 áramütés közül csak 3 eset (3%) történt átalakított oszlopokon. A madarak méretét tekintve (kicsi ≤25 cm, közepes 26-49 cm és nagy ≥50 cm testhossz) az átalakított és átalakítás nélküli oszlopok között mutatkozó áramütés-gyakoriságbeli eltérés a kis testű madarak esetében volt a legkisebb, valószínűleg azért, mert a kis testű madarak át tudnak sétálni a burkolatlan elemek között és az áram alatt lévő vezetékek alatt. A felmérésekbe bevont önkéntesek dokumentálták a probléma magyarországi nagyságrendjét, de a vizsgált oszlopok konfigurációs sajátosságainak rögzítéséhez nem rendelkeztek megfelelő képzettséggel. Ehelyett minden egyes felmért oszlopot 8 oszlopkategóriába soroltak. A legveszélyesebbnek a feszítő elemekkel ellátott oszlopok bizonyultak, amelyek az összes oszlop 8%-át teszik ki, de az áramütések 24%-áért felelősek. A jövőbeli madárvédelmi beavatkozások számára hasznos lehet a már madárvédelmi szempontból átalakított oszlopokon tapasztalt áramütések tudományos módszerekkel történő részletes feltárása. Kulcsszavak: áramütés, elektromos távvezetékek, mortalitás, oszlopok, ragadozó, sasok, varjúfélék. [ABSTRACT FROM AUTHOR]

Hungary joined Eurotransplant International (ET) to improve the chance of transplantation for Hungarian patients and patient outcomes, including access and graft and patient survival. After 5 years of full membership, the evaluation of numbers and quality indicators is possible. A comparison was made between 5 years prior to a preliminary cooperation agreement (2007-2011) and 5 years after full ET membership (2014-2018). During the 2 study periods, we analyzed numbers and circumstances of deceased organ donors, multiorgan donors, donated organs, and transplantations in Hungary and development of waiting lists along with international organ exchanges. The number of actual organ donors increased by 22.09% (729 vs 890), an additional 823 organ removals represents an increase of 42.71% (1927 vs 2750). There were 46.51% more transplants managed in the selected periods (1561 vs 2287). The number of new patients on the waiting list increased (2305 vs 3247; 40.87%). The mean kidney mismatch number decreased from 3.21 to 2.96. Joining ET has been an effective and efficient in terms of increasing access to organs and the lives of patients on the Hungarian waiting list posttransplant. It is also a benefit for patients with special needs because the number of organ transplants is greater than the increased number of donors. [ABSTRACT FROM AUTHOR]

Pesticides play a very important role for ensuring food security and economic growth but their use can cause harmful effects to human health and to the environment. The study aimed to investigate the level of knowledge, health risk perceptions, and experiences on the practice of pesticide use and management among extension officers in Ethiopia and plant doctors in Hungary. A questionnaire survey among 326 officers was conducted in the two study areas and data were analyzed by ordinal logistic regression. According to the findings, Hungarian officers had much better knowledge of pesticide products (92%), and less frequently experienced pesticide poisoning among applicators (7%) than the Ethiopians (66% and 41%, respectively). Hungarian officers perceived less health risk of pesticide use (AOR = 0.46, 95%, Cl: 0.27-0.80), were ten times more likely to deem the pesticide management system effective (AOR = 10.23, 95%, Cl: 5.68-18.46) and were nine times more likely to report that applicators used personal protective equipment (AOR = 8.95, 95%, Cl: 4.94-16.28). A significant proportion of officers from both countries reported inappropriate methods of pesticide residue disposal. These observations point out that the situation of pesticide use and knowledge and management of pesticide products is definitely better in Hungary; nevertheless, the issue continues to need more attention in both settings.

The first kidney transplantation was performed in Hungary by András Németh in 1962. It was a living donor procedure. After many years of silence, organized cadaveric programs were established in Budapest (1973), Szeged (1979), Debrecen (1991), and Pécs (1993). The heart program was initiated by Professor Zoltán Szabó in 1992 and the liver transplant program by Professor Ferenc Perner in 1993. The pancreas transplantation program was started in Pécs in 1998 by Károly Kalmár-Nagy, followed another in Budapest by Robert Langer in 2004. The lung transplant program was started in cooperation with Vienna in 1996. This fruitful collaboration continues today, even though that the national Hungarian program was established by Ferenc Rényi-Vámos and Professor György Lang in 2015, as it is detailed in this special issue. As a framework, the Hungarian Society of Organ Transplantation was founded in 1997 to give a scientific background for the transplant professionals. The coordination and organ allocation from deceased donors is carried out in collaboration with Eurotransplant. Usually more than 200 potential cadaveric donors are reported yearly, and 168 actual donation after brain death (DBD) donors (17.17 pmp) were utilized in 2018. The multiorgan donor rate was 65.5% among all DBDs in 2018; 505 organs were donated for transplant purposes. To date, more than 10,000 organ transplantations have been performed. The living related kidney transplant program was established in all transplant centers, led by Budapest. In this paper the authors summarize the activity of the Hungarian transplant community and of the Society over the last few decades., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Purpose: Surveillance of the bacterial spectrum and antibiotic-resistance patterns of locally occurring uropathogens is essential to serve as a basis for empirical treatment of urinary tract infections (UTIs), as antibiotic-resistance rates may vary geographically with significant differences between countries and regions, and with time., Methodology: We retrospectively analysed all urine samples taken in the department of urology in a tertiary care hospital in Hungary from January 2004 to December 2015.Results/Key findings. The five most commonly occurring bacteria were Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae, Pseudomonas aeruginosa and Proteus mirabilis. Resistance of Escherichia coli to ciprofloxacin increased significantly from 19 to 25 %. Although the resistance of Escherichia coli against cephalosporins showed an increasing trend, it still remained generally low. However, resistance rates of K. pneumoniae to cephalosporins were very high, reaching 60 %, due to the high rate of extended-spectrum-β-lactamase-positive Klebsiella strains. We observed a significant increase in the rate of carbapenem-resistant Pseudomonas aeruginosa., Conclusion: Fluoroquinolones cannot be recommended for empirical treatment in our region. Cephalosporins can be a good empirical choice for treating Gram-negative UTIs, but should be avoided when multi-drug resistant (MDR) bacteria are suspected. Increases in the rate of carbapenem-resistant Pseudomonas aeruginosa, and in the general rate of MDR bacteria, are both a very alarming trend. We recommend practising prudent antibiotic policy, preferably using antibiotics with the narrowest possible spectrum.

Aims: The aim of our study was to explore differences in genetic predisposition to obesity between the Hungarian general and Roma populations., Methods: A total of 1,152 samples from the Hungarian Roma population and 1,743 samples from the Hungarian general population were genotyped for 20 single nucleotide polymorphisms (SNPs) associated with the risk of obesity. Two types of multilocus genetic risk scores were constructed to estimate the combined effect of selected SNPs., Results: Risk allele frequencies differed significantly between the two populations for 11 SNPs, with no enrichment in any of the two study groups. Variants (rs1558902, rs1121980, rs9939609, and rs9941349) in the fat mass and obesity-associated (FTO) gene exhibited strong but ethnicity-independent association with obesity. Genetic risk scores showed stronger associations with obesity in the Roma population compared with the Hungarian general population; however, without significant gene-population interaction., Conclusion: Differences in obesity prevalence between the Hungarian general and Hungarian Roma populations could not be explained by their distinct genetic susceptibility, rather by ethnicity-related environmental and behavioral factors. Nonetheless, particular gene-environment interactions might contribute to the distinct penetrance of the obesity-associated genetic factors in populations of different ethnic backgrounds., (© 2017 The Author(s) Published by S. Karger GmbH, Freiburg.)

In the decade prior to the turn of the millennium, great interest was raised, and rightly so, by the STD (syphilis and HIV/AIDS) epidemic that developed in the Eastern-Central European Region. Its coincidence with the far-reaching political and economic changes that took place at that time suggested a link between the two events.Hungary, where these infections had had low incidence before the period investigated, also experienced an increase in STD incidence. The trend in syphilis infection during the 20 years between 1985-2004, that preceded the turn of the millennium and when finally Hungary joined the European Union, have been analyzed. Due to the nature of venereological epidemiological surveillance in Hungary, syphilis prevalence data are appropriate for further analysis from socio-demographic aspects. Behavioural changes underlying the specific features of the epidemics in Hungary had developed several years earlier and cannot be linked to the political and economic changes that started in the early 90s. The only exception is the phenomenon of growing migration that appeared simultaneously with the political changes and had a decisive impact on the spread and level of infection in some areas in the country. As shown by our data, trends seen in specific demographic groups (females, rural population) preceded the suddenly occurring political changes by about 15 years.

The first Hungarian kidney transplantation was performed by András Németh in Szeged in 1962, approximately 50 years ago. A preliminary agreement with Eurotransplant was signed in 2011, and special patient groups gained benefit from this cooperation in 2012, wnich lead to a full membership to Eurotransplant. This event inspired the authors to review the history of Hungarian kidney transplantation of the past 50 years, from the first operation to recent via the specific cornerstones of the transplant program. The donor of the first Hungarian kidney transplantation was the brother of the recipient. The operation itself was technically successful, but the lack of immunosuppression caused graft rejection, and the patient died after 79 days. His brother, the donor, is still healthy, after 50 years, and he encourages everybody to donate organs. Organized kidney transplant program started more than 10 years later, such as 1973, in Budapest. The program was supported by the Ministry of Health. New centers joined the program later, Szeged in 1979, Debrecen in 1991 and Pécs in 1993. These four transplant centers work currently in Hungary, and 6611 kidney transplantation has been performed up to the end of year 2012.

Streptococcus pneumoniae is responsible for a high level of morbidity and mortality, especially among children. For a long time, only the polysaccharide vaccine was available against pneumococcal infections, but in the last decade special conjugate vaccines were developed for paediatric use. These vaccines have made a deep impact on serotype distribution all over the world, by suppressing those serotypes included in the vaccines, while new, previously rare types emerged. These changes have been monitored closely in numerous publications all over the world. Nevertheless, data on pneumococcal serotypes in Hungary were mostly published in Hungarian, therefore not available in the international literature. In this meta-analysis, our aim was to collect and summarise all available data, and try to follow the changes observed after the introduction of the conjugate vaccines.

Frequencies of genetic polymorphisms of the three most frequent HIV-1 resistance-conferring alleles playing an important role in HIV-1 pathogenesis were analysed in Vlach Gypsy populations living in Hungary, as the largest minority. Mutations in the encoding genes, such as CCR5-∆32, CCR2-64I and SDF1-3'A are shown to result in protective effects against HIV-1 infection and disease progression. 560 samples collected from Vlach Gypsy individuals living in 6 North-East Hungarian settlements were genotyped by PCR-RFLP method. Overall allele frequencies of CCR5-∆32, CCR2-64I and SDF1-3'A were found as 0.122, 0.186 and 0.115 respectively. All the observed genotype frequencies were in accordance with Hardy-Weinberg equilibrium . In regions, however, Vlach Gypsies live in majority and in ethnically homogenous communities, a higher CCR5-∆32 mutations were found, with allele frequencies of 0.148 and 0.140 respectively, which are remarkably higher than those in general Hungarian people, and ten times higher than in regions of North-Western India from where present day Hungarian Gypsies originated in the Middle Ages. In the background of this higher CCR5-∆32 allele frequency in the population analysed in our study a genetic founder effect could be assumed. Allele frequency of CCR2-64I was found to be among the highest in Europe. SDF1-3'A allele frequency in Vlach Gypsies was significantly lower than in ethnic Hungarians. 63% of the total 560 individuals tested carried at least one of the mutations studied. These results could partially explain the low incidence of HIV/AIDS among Vlach Gypsies in Hungary.

Streptococcus pneumoniae is responsible for a significant amount of morbidity and mortality worldwide, especially among children <5 years. Healthy carriers are the most important sources of infections and the carriage also peaks in the first years of life, especially among children attending communities. In this study, for the first time in Hungary, we surveyed the nasal carriage of healthy children, just before the use of the conjugate vaccine started increasing.Nasal specimens of 358 children were cultured and pneumococci isolated. The strains were serotyped with antisera and PCR, genotyped by PFGE and their antibiotic sensitivity determined by agar dilution method.The carriage rate was 37.71%. The isolates were sensitive to most tested antibiotics, except for macrolides. In this cohort of specimens still the widespread, so-called "pediatric serotypes" dominated (14, 19F, 23F, 6A, 6B in ranking order), but three of the previously rare types: 15B, 11A and 13 were represented already by 21.5% of all strains and also a few other rare non-vaccine types (e.g. 10A or 37) were detected.The calculated vaccine coverage was 55.6% for PCV-7, 69.6% for PCV-13 and 86.7% for Pneumovax. In this cohort, only 15.9% of the children (n = 57) were vaccinated. The carriage rate of PCV-7 vaccinated children was significantly lower (30.4%) than that of the non-vaccinated group (39.2%). The clonality of the isolates was significant within each group, revealing the extensive bacterium exchange among children.

Vancomycin-resistant enterococci (VRE) are common nosocomial pathogens; however, until now they have been rarely encountered in Hungary. In the present study, we investigated the prevalence of VRE in the teaching hospitals of the University of Debrecen. Of 7,271 Enterococcus-containing clinical samples collected between 2004 and 2009, we identified 16 VRE. Species-specific polymerase chain reaction was used to detect Enterococcus faecalis, Enterococcus faecium, Enterococcus casseliflavus, and Enterococcus gallinarum. Multiplex polymerase chain reaction was performed to identify the vancomycin resistance genes: vanA, vanB, vanC1/C2, vanD, vanE, and vanG. Restriction digestion with SalI and HindIII was introduced to differentiate the vanC1 and vanC2 genes from each other. Genetic relationships between the strains were investigated by pulsed-field gel electrophoresis. Overall, we identified the vanC1 resistance gene in 14 E. gallinarum and the vanC2 resistance gene in two E. casseliflavus strains. Except for two samples, the isolates had different pulsed-field gel electrophoresis types, suggesting sporadic emergence of the resistant bacteria. In addition, antibiotic resistance profile was determined by E-test. Three E. gallinarum strains proved to be resistant to gentamicin because of the presence of the aacA-aphD gene. Although the prevalence of VRE in Debrecen is rather low, the appearance of multiple resistances is of concern.

The year 2010 was a milestone in the history of transplantation in Hungary. Hungarian politicians became interested in solving the serious problems facing organ transplantation in our country. The State Secretary announced a program to (1) increase waiting lists, (2) raise donor numbers, (3) establish a lung transplant program, (4) promote education and increase the knowledge base regarding transplantation for the public and the medical profession, and finally, (5) to begin the negotiations for Hungary to join Eurotransplant. Joining Eurotransplant has been a priority of the transplant community. Finally, this year saw the Budapest Transplant Center perform 20% of their transplants from living kidney donors, up from 5% historically., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Background and Aims: The 7-valent conjugate pneumococcal vaccine (Prevenar) was introduced as a recommended (but not yet obligatory) vaccine in Hungary in April 2009 and there was a sharp increase in the number of children vaccinated. Hence there is an urgent need for in-depth epidemiological data on invasive pneumococci before vaccination becomes widespread. Such a study has never been done before in Hungary., Methods: 144 pneumococcal isolates, obtained from invasive infections or pneumonia, were collected from eight Hungarian diagnostic laboratories between 2000 and 2008. After confirmation of species identity, their susceptibilities to nine antibiotics were determined by Etest and agar dilution method. The serotypes and pulsed-field gel electrophoresis genotypes of the strains were also determined., Results: In this cohort, most of the isolates were from patients at the extreme of life. Only 1.4% of the strains were resistant to penicillin, but nearly 40% were resistant to erythromycin (mainly due to erm(B) gene). Higher incidences of resistance were found in the very young and very old. The most prevalent serotypes in the cohort in descending order were 14, 6A, 6, 6B, 23F, 3, 19F and 11A., Conclusions: Results showed a similar but not identical profile to previously examined strains causing pulmonary infections in Hungary. The serotypes could be correlated to patient groups. Furthermore, there were examples of serotype switching in strains showing identical genotype but different serotype. The study also shows a good coverage by the conjugate vaccines over the invasive pneumococcal strains in Hungary based on the detected serotypes.

At the 25th anniversary of the identification of HIV virus as the causative agent of AIDS, virologist and clinician authors provide an overview of the discovery and identification of HIV, its significance in the development of clinical diagnosis of HIV/AIDS, which led to the development of effective antiretroviral treatment. Besides the epidemiological and sociological aspects of the infection, authors provide a detailed chronology of the special aspects of the fight against HIV/AIDS in Hungary, from the diagnosis of the first HIV and AIDS cases, through the establishment of the nationwide screening network and counseling units to the appearance of drug resistant virus mutants, and the recent penetration of African HIV strains to the country. Further actions are urged locally and worldwide for the better understanding the interactions of the human host organism and the HIV virus for the more effective treatment. For these political consensuses, a large scale long term financial support, views based on scientific and public health evidences, and cooperation of the whole society worldwide are needed.

Cytotoxin genes in 128 Austrian (AT) MSSA, 48 MRSA, 94 Hungarian (HU) MSSA, 110 MRSA and 67 Macedonian (MK) MSSA, 81 MRSA strains were examined. The presence of alfa-haemolysin gene (hla) was more common in HU MSSA strains compared to AT and MK (99%, 86%, 72%: p<0.001). AT and MK MRSA harboured hlb genes more frequently compared to HU (60%, 62%, 33%: p<0.001). HU and MK MRSA strains carried gamma-haemolysin gene (hlg) in higher percentage in contrast to AT (88%, 83%, 69%: p=0.01). Haemolysin gamma-variant gene (hlgv) was more prevalent in HU MSSA compared to AT and MK (84%, 56%, 69%: p<0.001). Panton-Valentine leukocidin genes were found only in AT, HU, MK MSSA and MK MRSA in 2.3%, 4%, 1.5% (p=0.53) and 1% (p=0.38), respectively. The 3-gene combination pattern comprising of hla, hlg and hld genes showed increased prevalence among AT MSSA compared to HU (27%, 11%: p<0.001). The 4-gene pattern composed of hla, hlg, hlgv and hld genes was significantly characteristic for HU MRSA in contrast to AT and MK MRSA (56%, 12.5%, 27%: p<0.001). Frequency of certain cytotoxin genes and combinations differed significantly in Staphylococcus aureus strains according to geographical origin and methicillin-resistance.

The presence of the vanA gene was determined in enterococci from healthy poultry, originating from the Hungarian resistance monitoring system between 2001 and 2004. Enterococci (n = 562) were collected from intestinal samples of slaughtered broiler chickens. The presence of van genes was detected by polymerase chain reaction (PCR). The vancomycin-resistant enterococcus (VRE) strains carried only the vanA gene. Genus- and species-level identification of the vanA gene carrier strains was carried out by PCR using specific primers. In 2001, 25 out of the 289 isolated strains (8.6%) were vanA carriers (1 Enterococcus mundtii, 13 E. durans and 11 E.faecium). In 2002 (n = 87), 20 (23%) strains were vanA positive (11 E. durans and 9 E. faecium). In 2003 and 2004, none of the strains (n = 95 and 91, respectively) were positive for the most common van genes. In 2003, there was only one strain for which higher minimum inhibitory concentrations (MIC) of vancomycin (4 mg/L) and teicoplanin (8 mg/L) were found. In 2004 there were three strains for which the MIC of vancomycin was 8 mg/L, and 2 strains and 1 strain with teicoplanin MICs of 4 mg/L and 8 mg/L, respectively. The potential similarity of these strains was studied by pulsed-field gel electrophoresis (PFGE). The VRE strains were not closely related to one another. The annual data of vancomycin resistance indicate an association between the recovery of vancomycin-resistant enterococci and the use of avoparcin in animal feeds. This study indicates that with the reduced use of antibiotics in food animals, it is possible to decrease the rate of resistant bacteria. Although the use of avoparcin had been banned in 1998, the VRE strains disappeared only five years later.

Our knowledge of Gastrointestinal Stromal Tumours (GIST) has been broadened in the last few years by the discovery of the key function of c-kit tyrosine kinase mutation in their pathogenesis. A single institution database is presented and a hypothesis is examined regarding probable connection between GIST and other gastrointestinal malignancies. Between 2000 and 2004 20 patients were admitted to our department with GIS tumour. With the addition of three cases detected between 1991 and 2000, and proved to be GIST retrospectively, 23 cases are followed. Mean age was 64.52 years, male to female ratio 11:12. Ten tumours originated from the stomach, ten from small bowel, one from rectum and two from mesenterium. All patients underwent surgery, 16 operations were completed with R0 radicality, one R1 and four R2 resections were performed. Follow-up ranged from 1 to 157 months. Five out of 23 patients died (21.7%), six patients live with metastatic disease, twelve are disease free. Amongst patient-, tumour- and treatment-related factors the prognostic significance of Fletcher's risk and radicality of resection was demonstrated (p<0.05). Significantly more synchronous or metachronous gastrointestinal malignancies were found is this population of GIST patients, when compared to the prevalence of malignancies in normal Hungarian population (p<0.001).

Introduction: Simultaneous pancreas kidney (SPK) transplantation is the only routinely used therapeutic option which can provide insulin independence, euglycemia and good renal replacement., Aims: Analysis of the five years' experience of the first Hungarian SPK transplants., Material: From 29 October 1998. through 31 December 2003. 32 SPK transplants were performed from 53 type 1 diabetes mellitus patients with ESRD on the waiting list. Enteric drainage was performed in all transplanted patients in 20 combined with systemic venous drainage, whereas in 12 patients portal venous drainage was used. In 18 patients only maintenance immunosuppression was administered without ATG induction therapy. Anti IL-2R antibody, daclizumab was given as induction therapy in 14 patients., Results: 24 patients out of 32 transplanted are insulin independent with excellent renal function. 2 patients were lost in the perioperative period due to septic complication. 2 patients died 5 months after transplantation. 1 patient became insulin dependent in 7 month following the SPK transplant, while preserving a marginal renal function. One patient became insulin dependent 2 years after the SPK transplant and was returned to chronic hemodialysis treatment one more year later. 2 patients are insulin independent but lost his renal graft due to therapy resistant rejection., Conclusion: SPK transplant is a routinely used therapeutic option with good survival rate and good quality of life for type I diabetes mellitus patients with ESRD.