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ESA VILLAGE KIADVÁNY TERVEZET
CÍMLAP
MAGYAR ANESZTEZIOLÓGIA ÉS INTENZÍV TERÁPIÁS TÁRSASÁG (MAITT)
HUNGARIAN SOCIETY OF ANAESTHESIOLOGY AND INTENSIVE THERAPY
(HSAIT)
Address: Semmelweis Egyetem Aneszteziológiai és Intenzív
Terápiás Klinika
1125 Budapest; Kútvölgyi út 4; Hungary
Telephone: +36 - (1) 356-5068
Fax: +36 – (1) 355- 7975
Website: www.anesztinfo.hu
E-mail: [email protected]
Established: 1966
Current President: Professor László Vimláti
Current Vice-President: Professor Lajos Bogár
Fully registered anaesthesiologists: 790
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Anaesthesiology trainees: 722
Affiliations: WFSA - WFSICCM - ESA - FEEA- UEMS - ESICM
Hungary is a landlocked country in the Carpathian
Basin of Central Europe bordered by Slovakia, Ukraine, Romania,
Serbia, Croatia,
Slovenia and Austria. Its landscape is mostly flat, with low
mountains in the northern
areas. Lake Balaton, a popular tourist centre, is the largest
lake in Central Europe.
The ancestors of the ethnic Hungarians were the Magyar tribes,
which moved into
the Carpathian Basin in 896, conquering the people already
settled in the region.
Hungary became a Christian kingdom under St. Stephen in the year
1000. The
Hungarian language is unrelated to those of its geographic
neighbours and only
distantly related to Finnish and Estonian.
The capital city, Budapest, which originally consisted of two
separate cities - Buda &
Pest – straddles the River Danube. It is rich in history and
culture and famed for its
curative thermal springs.
Hungary is a highly musical country whose traditional folk music
inspired such of its
great composers as Liszt, Bartók and Kodály.
There are 159 hospitals in Hungary where Anaesthesia and
Intensive Care service is
provided.
MILESTONES OF HUNGARIAN ANAESTHESIA (kis képek mellette)
Member States of the EU
Hungary
Year of EU entry: 2004
Political system: Republic
Capital city: Budapest
Total area: 93 000 km²
Population: 10.1 million
Currency: Forint
Listen to the official EU language:Hungarian
http://europa.eu/abc/european_countries/languages/hungarian/index_en.htm?_hu
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February 11th, 1847: 4 months after Morton’s narcosis in Boston,
Janos Balassa
performed its first ether anaesthesia in Budapest.
March 9th, 1847: Council of Governor-General of Pest (later
Budapest) issued a
statutory rule that required licensed physician supervision
during ether anaesthesia.
March 10th, 1847: The world’s third monograph on ether
anaesthesia was published
by Jozsef Rosenfeld, a Hungarian physician in Leipzig,
Germany.
1848-1849: Hungarian War of Independence was the first war in
Europe where
ether and chloroform anaesthesia were used in the field.
April 1949: First endotracheal anaesthesia was performed in
Budapest.
May 1953: The first full-time anaesthetist, Dr. Laszlo Palos was
appointed in
Budapest.
1958: Section of Anaesthesia was established by the Hungarian
Society of Surgery.
1961: The first national conference on anaesthesia was held in
Pécs.
1966: Hungarian Society of Anaesthesia and Intensive Care was
established (HSAIC,
president: Dr .Laszlo Lencz).
2008: 36th National Conference of HSAIC was held in
Balatonfüred.
WHAT WAS HUNGARY ’S CONTRIBUTION TO WORLD ANAESTHESIA?
1., F I RS T HUN GARI AN BOOK ON ANAEST HESI A W AS P UBLIS HED
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March 10th, 1847: World’s third monograph on ether anaesthesia
was published by
Jozsef Rosenfeld, a Hungarian physician in Leipzig, Germany.
2., VI LMOS VAJN A , (1854-1932)
a Hungarian physician, invented a glass facemask that was
popular for open ether
and chloroform anaesthesia. It was provided with a rubber edge
for proper sealing
and prevention of burns on the eyes and skin caused by ether.
Later, the glass
facemask was modified by D.W. Buxton who popularised it in the
1860’s.
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3., FRANCI S F. FO LDES (1910-1997)
was a world-renowned pharmacologist who made great discoveries
and research in
the field of analgetics and peripheral muscular relaxants. At
the age of 31 he left
Hungary and initially worked as an anaesthetist at the
Massachusetts General
Hospital, Harvard University; later on at the Mercy Hospital,
Pittsburgh, Columbia
University as well as the Albert Einstein University. Professor
Foldes introduced 2-
chloroprocain and naloxone to the practice, developed the
technique of continuous
muscle relaxant infusion and invented low flow anaesthesia.
4. oldal:
ACTIVITIES OF THE SOCIETY - Organising the annual national
congress (participation: 1500 delegates)
- Organising international congresses
- Establishing and holding trainings and education programs
- Running a full-scale simulation training center
- Editing a bi-monthly journal,
- Editing textbooks for teaching in Hungarian
- Setting up and maintenance of the official Website
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INT ERN ATION AL CON FER EN CES OR GANIS ED BY MAITT
• 1992: EACTA
• 1993: IGSC
• 1999: EAA
• 2001: ESCTAIC
• 2005: EACTA
• 2007: NATA
MEMBERS HIP O F T HE HUN GARIAN SO CI ET Y O F AN AEST HESI A
AND INT EN SIV E CAR E (1966-2007)
(Population of Hungary: 10.1 million)
0
200
400
600
800
1000
1200
1400
1600
1966-1970
1971-1980
1981-1990
1991-2000
2001-2005
2006-2007
NATIONWIDE REPORTING SYSTEM
Hungarian Society of Anaesthesia and Intensive Care developed
the ANESZTINFO
NRS (Nationwide Reporting System) with contributions from the
Ministry of
Information and Communications for collecting nationwide data
for our specialities.
Website: www. anesztinfo.hu
The HSAIT established its own web-page called www.anesztinfo.hu
in 1998. Here the
Society handles its daily affairs, such as membership registry,
newsletters, society
updates.
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HUNGARIAN ANAESTHESIA SIMULATION CENTRE Hands-on practice of
several skills in anaesthesia and intensive care
Computer simulation of anaesthetic techniques (VIMA, TCI,
etc.)
Simulation of characteristic scenarios of Anaesthesia and
Intensive Care on manikins.
PROFESSIONAL SECTIONS (I would not repeat the word „section”
below)
CARDI O-V AS CULAR PAIN MANAGEMENT TR AN SO ESO PHAGEAL
ECHOCARDIO GRAPHY DONOR MAN AGEMENT A IRW AY MAN AGEMEN T
recently launched
REGIONAL SECTIONS (DIVISIONS?)
CENTR AL REGION NORT H-EAST REGION SOUT H-EAS T REGIO N SOUT
H-WEST REGION NORT H-WES T REGI ON
SCIENTIFIC ACTIVITY IN HUNGARY The scientific activity of the
Hungarian Society of Anaesthesiology and Intensive
Therapy (HSAIT) is organised through national and regional
forums. In addition to
the HSAIT’s Scientific Committee, there are 5 regional sections
(divisions?)
responsible for holding scientific symposia, workshops and
conferences within their
area. There are several smaller symposia all over the country
mainly for the local
members of the region throughout the whole academic year, whilst
two large
regular conferences are held annually with attendants from every
corner of Hungary.
One of them takes place in Debrecen (north-east Hungary), the
other one is
wandering around year-by-year in the beautiful cities of the
South-Trans-Danubian
region.
The most eagerly awaited event in our society’s life is the
national annual
conference which is organised by the HSAIT and the Scientific
Committee. The
number of participants usually exceeds 1200, including nurses
and doctors from
anaesthesia and intensive care as well as other specialities.
The conference lasts for
3 days, with the first day being reserved for courses and
workshops. There is also a
possibility of submitting abstracts either in Hungarian or
English, which are then
reviewed by the Scientific Committee and the selected ones are
thence orally-
presented or displayed as a poster.
A competition awards the eponymous Wittek Prize and the Boros
Prize - named
after the legendary Hungarian anaesthetists - to junior doctors
and researchers.
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The (pharmaceutic?) industry shows a keen interest and actively
takes part at our
national meetings. This year, more than 50 companies
participated and held 7
symposia.
The real scientific work and the actual research are done at the
4 universities. The
society has no influence on their activities but can support by
funding certain
projects and sponsoring young researchers to present their
results at international
meetings.
PUBLICATIONS FROM THE LAST YEARS C. Molnár, G. Settakis, P.
Sárkány, S. Kálmán, S. Szabó, B. Fülesdi. Effect of sevoflurane on
cerebral blood
flow and cerebrovascular resistance at surgical level of
anaesthesia: a transcranial Doppler study. Eur J
Anaesthesiol. 2007 Feb;24(2):179-84
Settakis G, Páll D, Molnár C, Katona E, Bereczki D, Fülesdi B.
Hyperventilation-induced cerebrovascular
reactivity among hypertensive and healthy adolescents. Kidney
Blood Press Res. 2006;29(5):306-11
Katona E, Settakis G, Varga Z, Juhász M, Paragh G, Bereczki D,
Fulesdi B, Páll D. Both nitric oxide and
endothelin-1 influence cerebral blood flow velocity at rest and
following hyper- and hypocapnic stimuli in
hypertensive and healthy adolescents. Kidney Blood Press Res.
2006;29(3):152-8
Katona E, Settakis G, Varga Z, Paragh G, Bereczki D, Fülesdi B,
Páll D. Target-organ damage in adolescent
hypertension. Analysis of potential influencing factors,
especially nitric oxide and endothelin-1. J Neurol Sci.
2006 Sep 25;247(2):138-43
Peták F, Habre W, Babik B, Tolnai J, Hantos Z. Crackle-sound
recording to monitor airway closure and
recruitment in ventilated pigs. Eur Respir J. 2006
Apr;27(4):808-16
Reis HJ, Teixeira AL, Kálmán J, Bogáts G, Babik B, Janka Z,
Teixeira MM, Palotás A. Different inflammatory
biomarker patterns in the cerebro-spinal fluid following heart
surgery and major non-cardiac operations.
Curr Drug Metab. 2007;8(6):639-42
Bogáts G, Piros G, Tiszlavicz L, Iványi B, Sasi V, Csepregil L,
Simon J, Babik B, Csillik A, Kardos L, Palkó A,
Matin K, Hanzély Z, Korányi K, Nyáry I, Végh M, Kolozsvári L,
Kahán Z, Bajcsay A, Tóth A, Balázs G, Simor T,
Pávics L, Palotás A. Erdheim-Chester's disease of the heart: a
diagnostic conundrum and collision with the
same mass in the orbit. Heart Surg Forum. 2006;9(1):E549-54
Kálmán J, Juhász A, Bogáts G, Babik B, Rimanóczy A, Janka Z,
Penke B, Palotás A. Elevated levels of
inflammatory biomarkers in the cerebrospinal fluid after
coronary artery bypass surgery are predictors of
cognitive decline. Neurochem Int. 2006 Feb;48(3):177-80
Zöllei E, Csillik A, Rabi S, Gingl Z, Rudas L. Respiratory
effects on the reproducibility of cardiovascular
autonomic parameters. Clin Physiol Funct Imaging. 2007
Jul;27(4):205-10
Kertai MD, Bax JJ, Boersma E, van Urk H, Poldermans D. The
prognostic value of dobutamine stress
echocardiography in patients with abdominal aortic aneurysm and
concomitant coronary artery disease. J
Cardiovasc Surg (Torino) 2003; 44; 423-430.
Kertai MD, Bogar L, Gal J, Poldermans D. Preoperative coronary
revascularization: an optimal therapy for
high-risk vascular surgery patients? Acta Anaesthesiol Scand
2006;50:816-827.
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Székely A, Balog P, Benkö E, Breuer T, Székely J, Kertai MD,
Horkay F, Kopp MS, Thayer JF. Anxiety predicts
mortality and morbidity after coronary artery and valve surgery
a 4-year follow-up study. Psychosom Med.
2007;69: 625-631.
J. Gal, T. Kovesi, D. Royston, N. Marczin: Dynamics of
nitroglycerin-induced exhaled nitric oxide following
lung transplantation: evidence of pulmonary microvascular
injury? Journal Heart and Lung Transplantation,
2007. 26(12):1300-5
J. Gal, B. Riedel, G. Jancsó, M.D. Kertai, Gy. Acsády, E. Rőth,
D. Royston. Effects of fructose-1,6-diphosphate
on endo- and myocardial purine metabolism during coronary artery
bypass graft surgery. Journal of
Cardiovascular Surgery, 2007. Dec ;48 (6):751-6.
J Gal, L Bogar, G. Acsady, M. Kertai: Cardiac risk reduction in
non-cardiac surgery: the role of anesthesia and
monitoring techniques. European Journal of Anesthesiology, 2006.
23. No. 8. 641-648.
Hauser B, Gröger M, Ehrmann U, Albicini M, Bruckner UB, Schelzig
H, Venkatesh B, Li H, Szabó C, Speit G,
Radermacher P, Kick J: The PARP-1 inhibitor INO-1001 facilitates
hemodynamic stabilization without
affecting DNA repair in porcine thoracic aortic
cross-clamping-induced ischemia/reperfusion. Shock
2006;25:633-640.
Hauser B, Kick J, Iványi Z, Asfar P, Ehrmann U, Muth CM,
Albicini M, Wachter U, Vogt J, Bauer M, Brückner
UB, Radermacher P, Bracht H: Effects of
15-deoxyΔ12,14-prostaglandin-J2 during hyperdynamic porcine
endotoxemia. Intensive Care Med 2006;32:759-765.
A. Csomos Diagnosis Related Group (DRG) funding for intensive
care. ICU Management, 2007;7(2):9.
A. Csomos. Cost containment and patient safety. ICU Management,
2007;7(4):7.
Hupuczi P, Rigó B, Sziller I, Szabó G, Szigeti Zs, Papp Z.
Follow up analysis of pregnancies complicated by
HELLP syndrome. Fetal Diag Ther 2006; 21:519-522.
Hupuczi P, Nagy B, Sziller I, Rigo B, Hruby E. and Pappp Z.
Characteristic laboratory changes in pregnancies
complicated by HELLP syndrome. Hypertension in Pregnancy 2007;
26:389-401.
MEDICAL EDUCATION IN HUNGARY
GR ADUAL EDUCATIO N : 6 Y EAR S
3 year “basic sciences”
2 years “clinical sciences”
1 year internship
Final state examination at the end of the 6th year
The university curricula include 40hours of training in
Anaesthesia and Intensive Care as well as 20hours of
Pre-Hospital Emergency Care during the 5th year education
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Medical Universities in Hungary
3 professors
340 students1 professor
122 students
3 professors
130 students1 professor
154 students
SPECI ALI ST T R AININ G
– Basic Specialities; total of 5 years including:
• 2 years “Formative Residency Training” at universities or
accredited teaching
hospitals
• 3 years detailed training program at base hospital where
doctor employed on
contractual terms; requires a minimum of partial
accreditation
– Subspecialization: 2 years
Logbook
• 100 credit hours
• Participation in organized courses and scientific meetings
accepted by the Accreditation Board
AN A E S T H E S I A M I N I M A L T R A I N I N G P E R I O D
S
1. Abdominal Surgery (incl. Urology & Vascular Surg.) 8
month
2. Traumatology (incl. orthopaedic surgery) 3 month
3. Paediatric Surgery 2 month
4. Gynaecology & Obstetrics 2 month
5. Neurosurgery 1 month
6. Thoracic Surgery 1 month
7. Ophthalmic Surgery 1 month
8. Ear-Nose-Throat, Head & Neck, Dental Surgery 1 month
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9. Cardiac Surgery 1 month
10. Selected compulsory topic 4 month
24 month
AN A E S T H E S I A M I N I M U M N U M B E R O F C A S E S :
1200 C A S E S O F A N A E S T H E S I A , I N C L U D I N G A T L
E A S T
G E N E R A L A N AE S T H E S I A
Caesarean Section 15
Paediatric operations 40
Intracranial operations 15
Pulmonary operations (selective endobronchial intub.) 15
Laparoscopic procedures 25
Fiberoscopic intubation 15
Nasal intubation 10
Day-case anaesthesia 25
R E G I O N A L A N A E S T H E S I A
Epidural anaesthesia 50
Spinal anaesthesia 50
Peripheral nerve block 50
EX A M I N A T I O N S
MCQ examination by end of 4th year
Final examination: two parts:
1: practical
• 1 week clinical practice, tutor-supervised
2: Board Examination:
• basic science
• anaesthesia
• intensive care
CONTIN UIN G MEDI CAL ED UCATION
H I S T O R I C A L B A C K G R O U N D
– obligatory by law since 1958
• 1 postgraduate course in 5 years minimum
• financed by state
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• central institutional basis:
Postgraduate Medical School, 1958
• centrally managed programs
• multi-level, structured courses
NE W R E G U L A T I O N : O R D E R O N CME, 1999
obligatory for licence renewal every 5 years by the Medical
Chamber
organized by medical universities
under patronage of Boards of Medical Specialities and the
Medical Chamber
supervized by the State (Bodies of Ministry of Health)
based on credit hours
accredited courses and scientific meetings
minimum: 250 credit hours / 5 year
DIRECTORY BOARD OF MAITT, 2008
PR ESI DENT
Dr. Vimláti László
MEMBERS
Dr. Janecskó Mária Former President
Dr. Bogár Lajos Vice-President
Dr. Nagy Géza Secretary-General
Dr. Csomós Ákos Secretary
Dr. Völgyes Barbara Treasurer
Dr. Molnár Zsolt Scientific Commitee
Dr. Fülesdi Béla Education Commitee
Dr. Babik Barna Youth Committee
Dr. Bede Antal Legal Commitee
Dr. Morvay Balázs Ethics and Discipline Commitee
Dr. Kerekes László Audit Commitee
PRO FES SION AL SECTIO NS
Dr. Babik Barna Cardio-vascular
Dr. Budai Erika Pain manegement
Dr. Gál János Transoesophageal Echocardiography
Dr.Méray Judit Airway Management Section
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REGIO N AL SE CTIONS
Dr. Bobek Ilona Central Region
Dr. Jobbágy Lajos North-West Region
Dr. Márton Sándor South- West Region
Dr. Mikos Borbála North-East Region
Dr. Havas Attila South.East Region
PRO ANAESTHESIA ET THERAPIA INTENSIVA HONOURS LIST Dr. Aranyosi
János
Dr. Barna Béla
Dr. Boros Mihály (†)
Dr. Darvas Katalin
Dr. Félegyházi Árpád
Dr. Forgács István (†)
Dr. Gurdon János
Dr. Incze Ferenc (†)
Dr. Jakab Tivadar (†)
Dr. Janecskó Mária
Dr. Makláry Elek (†)
Dr. Oszwald Péter
Dr. Pálos László (†)
Dr. Széll Kálmán
Dr. Tekeres Miklós
Dr. Török Endre (†)
Dr. Ugocsai Gyula
Dr. Uray Éva
Dr. Varga Péter (†)
Dr. Vass-Eyssen Ervin
Dr. Wittek László (†)
HONORARY MEMBERS Francis F. Foldes (†) (USA)
Paul Goldiner (USA)
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Günter Hempelmann (Germany)
Barankay András (Germany))
Josef A. Richter (Germany)
George Silvay (USA)
Hans Sonntag (Germany)
Dietrich Kettler (Germany)
Elena Damir (Russia)
Dag Lundberg (Sveden)
Werner List (Austria)
Gaby Gurmann (Israel)
Simon de Lange (Holland)
Szabó Zoltán (Hungary)
Kulka Frigyes (†) (Hungary)