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: anesztinfo@doki.net

Established: 1966

Current President: Professor László Vimláti

Current Vice-President: Professor Lajos Bogár

Fully registered anaesthesiologists: 790

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

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 ?

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.

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

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.

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.

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.

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

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

• 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

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)

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)