V: Anna Gyarmathy

Johns Hopkins Bloomberg School of Public Health | JHSPH · Department of Health, Behavior and Society

Objectives Little is known about the motivations to apply for emergency contraception (EC). Our first aim was to explore the motivating circumstances to use EC as fast as possible. Our second aim was to explore the contraceptive method of the population seeking EC. Study design This present retrospective observational study between July 2021 and S...

Introduction: The COVID-19 pandemic highlighted that surges in critical care demand can overwhelm existing healthcare infrastructures, most evident in the acute shortage of mechanical ventilators across the globe. Despite efforts to encourage urgent authorization of newly developed emergency ventilators, the currently available testing protocols ar...

Objective: Neonates with congenital heart disease (CHD) and perinatal stroke have high mortality and survivors are at risk for poor long-term neurodevelopmental outcome. The aim of this study was to assess the risk factors and outcome of neonates with both CHD and MRI-confirmed perinatal stroke (Study Group) and compare those to the risk factors an...

Addiction research suggests that recovery narratives share common structural elements. For further investigation of this topic, the current study invoked Propp’s folktale theory and method to identify narratemes within retrospectives to depict the stages of recovery. Semi-structured interviews were recorded about the experiences of six recovering h...

Proper hemodynamic management is necessary among post-cardiac arrest patients to improve survival. We aimed to investigate the effects of PiCCO™-guided (pulse index contour cardiac output) hemodynamic management on mortality in post-resuscitation therapy. In this longitudinal analysis of 63 comatose patients after successful cardiopulmonary resusci...

Introduction : The pooled worldwide prevalence of low-back pain related presentations in primary care varies between 6.8% and 28.4% in the high-income countries rendering it a major healthcare/economy problem. To best manage this complex bio-psycho-social condition a 360-degree approach is needed, as the psycho-social components are often more impo...

Cannabis use among patients with inflammatory bowel disease Pain perception in inflammatory bowel disease (IBD) is beyond a purely somatic process. In-depth understanding of psychologic elements might enable more effective management in this patient group. Anxiety disorders and certain maladaptive coping strategies like smoking and alcohol consumpt...

Objectives Conditions that have similar initial presentations as sepsis may make early recognition of sepsis in an emergency room (ER) difficult. We investigated whether selected physiologic and metabolic parameters can be reliably used in the emergency department to differentiate sepsis from other disease states that mimic it, such as dehydration...

Összefoglaló. Gyulladásos bélbetegségben (IBD) a fájdalomérzés komplex szomatikus és pszichés jelenség. Ez utóbbi komponens pontosabb megértése segíthet a megfelelő kezelési stratégia megállapításában. A szorongásos hangulati zavarok és egyes maladaptív viselkedési minták (dohányzás és alkoholfogyasztás) előfordulási gyakorisága jól dokumentált IBD...

The prevalence of familial hypercholesterolemia (FH) is about 1 in 200–500 in the general population, but approximately less than 1% of those affected are actually diagnosed. One of the most promising approaches to treat FH is utilizing human monoclonal antibodies. This is a case study describing a 47-year-old male patient who presented to the Emer...

Small scale observational evidence suggested that Vitamin E (VE) might play beneficial role in human and animal respiratory conditions of various origin by stabilizing surfactant functions. The intra-aleveolar VE level is directly proportionate to the lung’s response to inflammation. Electronic cigarette or vaping associated lung injury was a domin...

Abstract Background It has been shown that home mechanical ventilation improves quality of life, but it has not been widely studied which particular patient groups benefit the most from starting this type of therapy. The purpose of this prospective observational study was to evaluate quality of life change patterns 6 months after initiation of home...

Purpose There has been a recent increase in interest in chia seeds as a growing number of people try to observe a healthy lifestyle, particularly healthy eating habits. Given the increasing popularity of chia seeds in Hungary as well, we performed a study to examine what information on chia seeds is available on Hungarian websites. Materials and M...

Absztrakt Az elektronikus cigaretták és/vagy vaporizálással összefüggő tüdősérülés (electronic cigarette and vaping associated lung injury, EVALI) szindrómát először az Amerikai Egyesült Államokban (USA) írták le, és összefüggésbe hozták a kannabinoidok használatával (e-szívás) és az E-vitamin-acetát-expozícióval (amely egy [a kannabinoidok hígítás...

Aim: We investigated the effect of age on post-cardiac arrest treatment outcomes in an elderly population, based on a local database and a systemic review of the literature. Methods: Data were collected retrospectively from medical charts and reports. Sixty-one comatose patients, cooled to 32-34 °C for 24 h, were categorized into three groups: y...

Previous research has shown the importance of time perspectives (TP) in future-oriented decision making. However, the possible associations between time perspectives and seeking out psychological help in need have not been examined extensively, especially taking further influencing factors into consideration. Therefore, this study aimed to assess a...

In the summer of 2019, the Center for Disease Control and Prevention (CDC) declared an emergency of electronic cigarettes and/or vaping (vaping)-associated lung injury (EVALI) in the USA. The outbreak abated by January 2020, which the CDC attributed to heightened public awareness, ‘user actions to reduce risk’ and potentially the removal of vitamin...

Objective We assessed the diagnostic and prognostic implications of early cardiac magnetic resonance (CMR), CMR-based deformation imaging and conventional risk factors in patients with troponin-positive acute chest pain and non-obstructed coronary arteries. Methods In total, 255 patients presenting between 2009 and 2019 with troponin-positive acut...

Background Post-cardiac arrest syndrome and target temperature management have an influence on hemodynamics in a complex way. Proper hemodynamic monitoring is necessary among post-cardiac arrest patients. The aim of our study was to investigate the effects of PiCCO™-guided hemodynamic management on short- and long-term mortality in post-resuscitati...

Background: Little is known about the potential role of central obesity among men. Our first aim was to confirm what is already known from prior research, namely that both BMI and WHR are inversely associated with selected semen parameters. Our second aim was to examine the potential role of central obesity by assessing if there was a difference b...

Background In Hungary the psychological care provided during the rehabilitation of patients with chronic illnesses is insufficient. Patients with addiction, on the other hand, appear to make more use of psychological services. Narratives of patients recovering from addiction and patients with various chronic illnesses were examined in order to gain...

Background: Desktop scanners are devices for digitization of conventional impressions or gypsum casts by indirect Computer-Aided Design/Computer-Assisted Manufacturing (CAD/CAM) in dentistry. The purpose of this in vitro study was: 1, to investigate whether virtual models produced by the extraoral scanner have the same trueness as sectioned casts;...

Background Proper basic life support (BLS) is key in improving the survival of out-of-hospital cardiac arrest. BLS skills deteriorate in three to 6 months after training. One method to improve skill retention may be using the “testing effect” to test skills at the end of a BLS course. The aim of our study was to investigate whether either testing o...

Discrimination that LGBTQ individuals experience in health care settings might affect their health and intention of using health care services. However, health needs of LGBTQ patients are still inappropriately addressed in the medical curriculum. First-, third-, and fourth-year medical students (N = 569) from the four Hungarian medical universities...

Aim In the present study, we aim to assess the prevalence and certain psychological and other correlates of orthorexic tendencies: health and exercise behaviors and demographic variables among gym attendees in Hungary. Methods Altogether, responses of 207 gym attendees who filled out an online questionnaire (03/2017–10/2017) were analyzed. The mea...

Background When shared by people who inject drugs, needles and syringes with different dead space may affect the probability of HIV and hepatitis C virus (HCV) transmission differently. Methods We measured dead space in 56 needle and syringe combinations obtained from needle and syringe programs across 17 countries in Europe and Asia. We also calcu...

Background Before 2014 (the year of closure of the two largest needle exchange programs in Hungary, which halved the number of available syringes in the country despite increased injecting risk practices) no HIV was reportedly acquired in Hungary among people who inject drugs (PWIDs) who were not also men who had sex with other men (MSM). In 2014,...

2 Abstract Identity work and the perception and transformation of the addicted self are the most important processes during recovery from psychoactive substance addiction. While synthetic cannabinoids (SCs) have become increasingly popular among drug users in recent years, little is known about how the users of SCs perceive their identities. Semi-s...

Background Until about 2010, people who inject drugs (PWIDs) injected almost exclusively heroin and amphetamines in Hungary. After 2010, self-reported studies have indicated a dominance of new psychoactive substances on the drug market for injectable drugs. Methods Between March 2015 and February 2016, we collected used and discarded injecting par...

The appearance and spread of new psychoactive substances (NPS) is a phenomenon seen throughout Europe since 2008. Synthetic cathinones, a group of NPS, have been self‐reported as the drug injected by the vast majority of people who inject drugs (PWID) in Hungary. This study aims at updating our knowledge of what exactly are the compounds injected b...

Background New psychoactive substances (NPS) have been increasingly consumed by people who use drugs in recent years, which pose a new challenge for treatment services. One of the largest groups of NPS is synthetic cannabinoids (SCs), which are intended as a replacement to cannabis. While there is an increasing body of research on the motivation an...

Media monitoring is an important method to inform public health and prevention services about emerging health issues, such as new psychoactive substances (NPS). This study assessed the portrayal of NPS in online Hungarian media in 2015 using qualitative content analysis. Hungarian online media considers the dealer to be the main cause of drug use,...

Media monitoring is an important method to inform public health and prevention services about emerging health issues, such as new psychoactive substances (NPS). This study assessed the portrayal of NPS in online Hungarian media in 2015 using qualitative content analysis. Hungarian online media considers the dealer to be the main cause of drug use,...

Background The two largest needle exchange programs (NEPs) in Hungary were forced to close down in the second half of 2014 due to extreme political attacks and related lack of government funding. The closures occurred against a background of rapid expansion in Hungary of injectable new psychoactive substances, which are associated with very frequen...

We assessed the portrayal of new psychoactive substances (NPS) in online Hungarian printed media between January 1, 2014 and December 31, 2014 using content analysis. Altogether five topics were identified: 1: effects/side effects from the point of view of an outsider; 2: motivation of drug use; 3: type of NPS mentioned; 4: location of consumption...

Until the mid-1990s, the prevalence and incidence of HIV infection was uniformly low in countries across the Central and Eastern European region. In the past decade, however, this has changed dramatically, with a rapid increase in HIV infections in the region, especially in Eastern Europe where 41% of new HIV infection cases were among injecting dr...

Background: There has been an almost exponential growth in the number of new psychoactive substances (NPS) on the drug markets in Europe during the past decade. While most users of NPS use them by routes other than injecting, percutaneous use of NPS is associated with very frequent injecting episodes and paraphernalia sharing. Methods: We assess...

Recovering helpers play an increasing role in addiction treatment. In this study, we assessed the process of how addicts become recovering helpers. Semi-structured interviews were conducted with six recovering helpers, and the transcribed interviews were analyzed using interpretative phenomenological analysis. Four turning points were identified du...

As a consequence of the massive restructuring of drug availability, heroin injection in Hungary was largely replaced by the injecting of new psychoactive substances (NPS) starting in 2010. In the following years in our sero-prevalence studies we documented higher levels of injecting paraphernalia sharing, daily injection-times, syringe reuse, and H...

The aim of the study was to assess-while controlling for individual risk characteristics-how certain social network structural characteristics (degree, eigenvector, and betweenness centrality) are related to HIV infections. Injecting drug users (N = 299) in Vilnius, Lithuania were recruited using incentivized chain referral sampling for a cross-sec...

The aim of this article is to explore the prevalence of primary illicit stimulant use among people who enter drug treatment in Europe. Drawing on information provided by European Union treatment centres in 2009 (excluding Latvia, Lithuania, Portugal and Norway), the European Monitoring Centre for Drug and Drug Addiction showed data in relation to t...

Background: Heart rate (HR), mean arterial pressure (MAP) and carotid intima-media thickness (cIMT) are moderately heritable cardiovascular traits, but the environmental effects on the longitudinal change of their heritability have never been investigated. Methods: 368 Italian and Hungarian twins (107 monozygotic, 77 dizygotic) underwent oscillo...

Following the 2003 publication of the European Union (EU) Council Recommendations and the 2005–2008 and 2009–2012 EU Drugs Action Plans, increasing attention has been given in EU member states’ drug policies to populations that are vulnerable to problem drug use (PDU). Monitoring data reported to the EMCDDA by designated agencies from 30 countries...

Alcohol injecting may cause intense irritation, serious vein damage, and additional risks. What little is known about alcohol injecting points to the potential role of social marginalisation. Injecting drug users (N=215) were recruited between October 2005 and December 2006 in Budapest, Hungary from non-treatment settings. Multivariate logistic reg...

We examined the association of individual demographic and behavioral attributes, partnership (dyad) and social network characteristics with unprotected sex in the heterosexual dyads of IDUs in St. Petersburg, Russia. Of the individual-level characteristics female gender and younger age; and of the dyad-level characteristics sharing injecting equipm...

In Hungary, there is a need for widely accessible HIV and HCV testing and counseling for injecting drug users. Theoretically, free and confidential rapid HIV and HCV testing would be the most suitable for this purpose. Low threshold agencies, such as needle and syringe programs, would provide ideal premises for such a testing system, Here, particip...

Noninjecting heroin users (NIUs) were recruited in New York City during 1996-2003. Cumulative logistic regression was used to analyze the correlates of HIV sexual risk from injecting drug users (IDUs) among HIV seronegative NIUs engaging in heterosexual vaginal or anal sex in the past 30 days (N = 347). Participants were 67% male and 70% African Am...

Aims: To assesses the extent of the gender gap among the treated population of drug users across Europe. Methods: This analysis reports data on 363,170 clients from 4647 treatment units in 23 countries (22 European Union member states and Switzerland). Findings: Overall, males outnumber females by four, but the gender ratio varies not only by geogr...

The aim of this study was to assess the prevalence and correlates of disclosure to network members of being hepatitis C virus (HCV)- or human immunodeficiency virus (HIV)-infected among injecting dyads of infected injection drug users (IDUs) in Budapest, Hungary and Vilnius, Lithuania,. Multivariate generalized estimating equations (GEE) were used...

Despitevery similar political, drug policy and HIV prevention backgrounds, HIV and HCV prevalence is considerably different in Hungary (low HIV and moderate HCV prevalence) and Lithuania (high HCV and moderate HIV prevalence). Wecompared the drug use profile of Hungarian (n = 215) and Lithuanian (n = 300) injecting drug users (IDUs). Overall, compa...

In the case of risk behaviors where infection transmission occurs through social relationships (e.g. via sharing drugs and injecting equipment, or through sexual relations), prevention should follow (among others) the path of the social network. Previous studies have shown that sharing of injecting equipment is more likely to occur in larger and de...

This volume brings together data from a wide variety of sources as it describes Europe’s current drug injecting problem and plots its trends in recent years. Responses to drug injecting and measures to reduce the harm caused by this form of drug use are also reviewed. The report finds that the available data point to a stable or declining trend of...

Every year, some 30 000 pregnant women are estimated to be using opioids in Europe. In an article published in Eurosurveillance, EMCDDA authors explore the public health challenges related to problem drug use and pregnancy in Europe today as well as the intervention strategies likely to alleviate them (1). The article reviews four challenges in par...

The prevalence of hepatitis C virus infection (HCV) is currently about 35% among injecting drug users in Budapest, Hungary, and it is under 20% outside of the capital, and no verified case of human immunodeficiency virus (HIV) have been detected so far. Mathematical models describe that the co-occurrence of HIV and HCV among injecting drug users is...

This chapter describes the diversity of problem drug use patterns across Europe, the different harms that may arise, and the implications for harm reduction responses. Harm reduction developed in response to concern about heroin injecting in the 1980s in western Europe. Since then, other patterns of problem drug use have increased and the geographi...

We assessed whether syringe type, syringe cleaning and distributive syringe sharing were associated with self-reported and laboratory-confirmed HCV infection among Hungarian IDUs. Injecting drug users (N = 215) were recruited from non-treatment settings in Budapest, Hungary between October 2005 and December 2006. Multivariate logistic regression mo...

In this study, we investigated how individual attributes, dyad characteristics and social network characteristics may influence engaging in receptive syringe sharing, distributive syringe sharing and sharing cookers in injecting partnerships of IDUs in St Petersburg, Russia. We found that all three levels were associated with injecting equipment sh...

Drug-related infectious diseases are among the major health consequences of drug use, and any existing drug-related infection may predispose injecting drug users (IDUs) to other infections. We assessed among IDUs in Budapest, Hungary the prevalence of and vulnerability to selected drug-related infections and co-infections. The sample consisted of 1...

Problem drug use in pregnancy affects a sizeable population in Europe. A literature review was carried out of articles in PubMed, European Monitoring Centre for Drugs and Drug Addiction publications, and related documents in order to assess public health challenges and possible intervention strategies related to problem drug use and pregnancy in Eu...

To assess among injecting drug users (IDUs) in St. Petersburg, Russia, the urban environment, social norms and individual correlates of unsafe injecting. Between December 2004 and January 2007, 446 IDUs were interviewed in St. Petersburg, Russia. Prevalence of HCV was 96% and HIV 44%. 17% reported receptive syringe sharing after an HIV-infected IDU...

We assessed the prevalence of HIV and selected blood-borne and sexually transmitted infections among a convenience sample of 64 residents of Dzsumbuj, a predominantly Roma (Gypsy) neighbourhood in Budapest, Hungary. No cases of HIV were detected, while the prevalence of hepatitis B infection (anti-HBc) was 27% and syphilis prevalence was 2%. Romas...

Comparing drug-injecting risk between cities that differ in the legality of sterile syringe distribution for injection drug use provides a natural experiment to assess the efficacy of legalizing sterile syringe distribution as a structural intervention to prevent human immunodeficiency virus (HIV) and other parenterally transmitted infections among...

Since only about one third of people who are dependent on drugs are in treatment, there is a need to promote both treatment entry and retention. Previous research has described the role of individual and social characteristics in drug user treatment participation, but little is known about the interaction of individual and social factors. Injecting...

We examine in the heterosexual partnerships (dyads) of IDUs the correlates of engaging in unprotected sex on three levels: individual attributes, social network characteristics, and dyad characteristics. Unprotected sex was significantly less likely to occur in dyads where the participant injected daily or had high safe-sex attitude scores, and in...

We examine injecting and sexual risk correlates of hepatitis B (HBV) and hepatitis C (HCV) seroprevalence among new injecting drug users (IDUs) (age 18-30 years, injecting < or =6 years). Participants were interviewed/serotested (HIVab, HBVcAb, HCVab) in New York City, February 1999-February 2003. Gender-stratified, multivariate logistic regression...

To examine gender differences in drug injection equipment sharing at injecting initiation. Young injecting drug users (IDUs) in New York City February 1999-2003 were surveyed about injection risk behaviors and circumstances at initiation. Analyses were gender-stratified and excluded participants who initiated alone. Multiple logistic regression est...

Many heroin users do not inject drugs but may still be at risk of infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), via sexual or other noninjection-related activity. Noninjecting heroin users (NIUs) in New York City who were recruited and prospectively followed during March 1996-February 2003...

In central European states, rates of HIV among injection drug users (IDUs) have been low although Hepatitis C (HCV) infection is widespread. The goal of our study was to assess HIV infection, risk perceptions and injecting equipment sharing among IDUs in Budapest, Hungary. Altogether 150 IDUs were interviewed (121 structured interviews between 1999...

Ethnographic interviews and focus groups were conducted between May 2003 and January 2004 among injection drug users (IDUs; n=29) in Budapest, Hungary, to assess knowledge related to HIV, hepatitis B (HBV), and hepatitis C (HCV) and norms, attitudes, and behaviors. Participants perceived themselves at low risk for infection with HIV but at high ris...

To determine the incidence/predictors of transitions to injecting among noninjecting heroin users (NIUs). Street-recruited NIUs in New York City, March/1996-March/2003, were interviewed for a prospective cohort study about social network influence (communication promoting injecting; exposure to injectors) and individual susceptibility. A transition...

The discrepancy in HIV rates among Eastern and central European injecting drug users (IDUs) suggests that, in addition to risk behaviors, social contact patterns also play an important role. We identify two groups of IDUs in Budapest, Hungary, marginalized IDUs (M-IDUs) and socially integrated IDUs (SI-IDUs) and compare their HIV/hepatitis B virus...

We assess HIV and hepatitis testing and counseling in drug treatment programs in Hungary, a country with low rates of HIV but high rates of hepatitis C among injection drug users. The official context of drug treatment programs is described, and using key informants from representative drug treatment programs, the practice of HIV and hepatitis test...

As part of an intervention in correctional facilities in Hungary, we conducted research on AIDS-related attitudes and the HIV risk behavior history of 551 male and 81 female inmates to assess needs for and to tailor AIDS education programs. Although lifetime injection drug use was uncommon (8% of men, 3% of women), many Hungarian inmates had engage...

The aim of this research was to evaluate a school-based AIDS education programme in Eastern Europe. Four evaluation segments were undertaken: process and outcome evaluations of the training of AIDS educators and of the educational activities for students. While most AIDS education curricula focus on the content of the education, our findings demons...

To examine lifetime correlates of HIV and hepatitis B and C (HBV and HCV) infections among noninjecting heroin users (NIUs). Between March 1996 and March 2001, 483 eligible NIUs were tested for HIV, HBV, and HCV antibodies and administered structured interviews. Multivariate logistic regression analyses were stratified by injecting history. Among n...

While rates of HIV and STD infection in Eastern Europe are increasing rapidly, little is known about sexual behaviour, including condom use, among Eastern European youths. The Study of Hungarian Adolescent Risk Behaviours was designed to assess the knowledge, attitudes, and behaviours of adolescents studying in secondary schools in Budapest, Hungar...

Although Wisconsin's clean indoor air law prohibits or restricts smoking in certain areas, it specifically exempts manufacturing and assembly workplaces from its provisions. We conducted a mail survey of 1500 randomly selected employers to determine the nature and extent of smoking policies in Wisconsin's blue-collar workforce. Of the 1042 (70%) re...