- 1106 Budapest, Maglódi út 89-91.
- +36 1 432-7500, +36 1 432-7600
Location of Departments and Outpatient Clinics by buildings
Please click on the image to enlarge
Please click on the image to enlarge
Basement: Central Physiotherapy, Physical Therapy, Stone Lithotripsy Laboratory ESWL, Call Centre, Central Storage
Ground Floor: Department IV of Internal Medicine (Cardiology, Cardiac Intensive Care Emergency ), Ergometry, ECHO, Holter Monitoring (ABPM), Section of VIP Hotel Services
1st Floor: Department of Surgery (General Surgery, Vascular Surgery, Thoracic Surgery ), Orthopaedics, Outpatient Clinic (Vascular Surgery, Colo-Practology)
2nd Floor: Urology, Vascular Surgery
3rd Floor: Department and Outpatient Clinic of Obstetrics and Gynaecology
4th Floor: Department of Otolaryngology (Ear, nose, throat), Allergology, Audiology, Speech Therapy, Otoneurology, Ophthalmology Department, Ophthalmology Outpatient Clinic, Specialty Outpatient, Clinic of Cornea, Cataract and Glaucoma; Gynaecology Ultrasound, Genetics Consultation, Laboratory of Genetics
5th Floor: Hospital Chapel
Ground Floor: Human Resources, Financial Group, IT, Civil Servant Board, Cash Desk
1st Floor: Directorates (Director General, Medical Director, Financial Director, Director of Nursing), Finance, Legal Officer, Board Meeting Room
2nd Floor: Materials Management, Instrument Management, IT, Controlling, Procurement Department, Quality Management Group, Central Registry, Institutional Account for Data Security and Patients’ Complaint, PR Manager, Customer Service Manager
Ground Floor: Gastroenterology Outpatient Clinic, Endoscopy, Hygiene Group
1st – 2nd floor: Department I of Internal Medicine , Gastroenterology
Ground Floor: Oncology Department, Oncology Treatment
1st Floor: Psychiatry Outpatient Clinic, Diabetes Outpatient Clinic, Specialty Outpatient Clinic for Diabetic Foot, Pulmonology, Endocrinology, Specialty Outpatient Clinic for Immuno-Nephrology
Basement: Cytology Outpatient Clinic, Department of Patology, Storages
Ground Floor: Department of Immuno-Nephrology, Department of Patology and Histology, Dialysis Centre
1st Floor: Department III of Internal Medicine (Angiology, Endocrinology)
2nd Floor: Department of Neurology, EEG Outpatient Clinic, Neurology Treatment
3rd Foor: Department of Cardiac Rehabilitation, Cardiac Rehabilitation Outpatient Clinic
Basement: Sterilizer Centre, Storages
Ground Floor: Patient Admissions Office, Emergency Care Unit, Buffet, Detoxification Unit
1st Floor: Imaging Diagnostics Department (Mammography, X-Ray, Ultrasound), Cardiovascular Catheterization Laboratory (Angiography, Haemodynamic)
2nd Floor: Angiology Outpatient Clinic, Angiology Treatment Service, Central Laboratory, DSA (Digital Subtraction Angiography), Microbiology Laboratory
3rd Floor: Anesthesiology Outpatient Clinic, Pain Clinic, Operating Rooms I-IV.
4th Floor: Central Operating Rooms V-VIII., Standby Operating Room
5th Floor: Central Department of Anesthesiology and Intensive Care
CT, MR, Osteoporosis Examination
„Borostyán” Pharmacy (Pharmacy of the Institute)
“Paula” Department V of Internal Medicine for Chronic Patients H-1106 Budapest, Méhes Street 4
“Gizella” Department VI of Internal Medicine for Chronic Patients, Department of Musculoskeletal Rehabilitation, Nephrology Treatment H-1105 Budapest, Kőrösi Csoma Sándor Road 24-26
Ground Floor: Maintenance and Repair Yards
1st Floor: Technical Operation Department, Energetics
IT Department, Transportation Group
Main Entrance from Lavotta Street (Outpatient Admission)
Internal Medicine I – Gastroenterology
Chief Doctor of the department:
PhD., MSc. Dr. József HAMVAS
PhD of Medicine
The short summary of the history of the department:
The formation of the profile (sicknesses of the digestive system) of the general Internal Medicine Department No. I has started in 1983 and since 1989 it has been functioning as the gastroenterology Internal Medicine Department. The care of the gastrointestinally bleeding patients has been launched in 1996 within the on-call system of Budapest and for the first time in Budapest a gastrointestinal sub-intensive unit was set up in 1998.
Number of hospital beds: since 2002 30/40, then since 2012 45 beds are available for the accommodation of gastroenterology patients and 35 beds for the internal medicine patients. The renovation of the in-patient department took place in 2003, in 2008 a new endoscope lab was set up that fulfils the requirements of the 21st Century (4 air-conditioned, radiation safety examining rooms) and a gastroenterology clinic with 4 rooms was built in a new location with totally new equipment.
In 2009 6 new sub-intensive supervision rooms have been set up, and the wards and sanitary rooms have been also partially renovated. In August 2014 the Internal Medicine Department No. I. received a new medical device: the value of the Olympus Evis exera 2 CV-190 newest colonoscopy examination station exceeds HUF 25 million and this contains a mobile tower, a full HD image unit, an endoscope and a monitor. This device means a great improvement in recognizing and prevention of the cancer of the large intestine.
We possess all the therapeutic opportunities to handle everything from the first complaint to the endoscopic surgeries and minimal invasive interventions in close cooperation with the Surgery Department.
The department has repeatedly received the former 3rd progressivity level (ÁNTSZ classification) pursuant to the 2012 GYEMSZI-TEK classification. In accordance with this we carry out:
- operative endoscopic bile duct surgical intervention, if necessary with urgency also at the weekends: ERCP, EST, drainage 300 cases/year
- endoscopic ultrasound examinations (mostly in Budapest), surgical interventions with diagnostic and therapeutic equipment, FNAB, Pancreas pseudocyst ureteroenterostomy, palliative bile duct surgical interventions, 350 cases/year
- gastroscopy with high resolution, digital biological marking polypectomy, mucosectomy 3500 cases/year
- complex treatment of pancreatitis, minimal invasive surgery and jejunal probe feeding 100 cases/year
- treatment of gastroenterologically bleeding patients, 24 on-call with combined methods 300 cases/year
- colonoscopy with zoom, adenoma testing, attenuation of bleeding 2800 cases/year
- routine trans-abdominal diagnostic ultrasound (2000 cases/year), ultrasound controlled core biopsy of abdominal organs (150 cases/year). All colonoscopy takes place with narcotization but we also execute the examinations with anaesthesia if ordered by the doctor.
Number of invasive examinations: 7000 cases/year
Other diagnostic and therapeutic activities:
- artificial feeding with the experience gained from the great number of patients,
- 24-hour pH measuring, oesophagus and rectal manometry (80-30 cases/year)
- H2 exhalation test, UBT (Helicobacter) examination (6-800 cases/year)
Devices: Olympus EXERA II, “Endobase” archivation digital picture processing system, CV 160/180: 4 towers, GF-UE 160 endoscopic ultrasound radial and lineal device, 3 TJF 145 operative duodenoscopes, 6 gastroscopes, 4 colonoscopes, (also suitable for bed-side examinations), 1
bronchoscope. 2 pieces of „C” arch digital X-ray device Argon-plasma coagulator, unipolar (Heat probe) electrode device, photodynamic laser (PDT), 2 pieces of ultrasound devices,
Motility lab: pH measuring device, manometer (rectal and oesophageal).
Cooperation among the institutes:
Our patients come from different hospitals from Budapest and from the different parts of the country as between 2007 and 2012 only our institute carried out endoscopic ultrasound examination in Budapest in our endoscope lab and in an excessive number. The cooperation is close with the Surgery Clinic No. I of SOTE, with the Internal Medicine Clinic no. II, with the Oncology Department of the United Szent István and Szent László (ESZSZK) Hospital, with the Transplantation Clinic and with the National Oncology Institute. We examine patients regularly at the request of gastroenterology and surgery departments from Budapest and the rest of Hungary.
Educational and scientific activities:
The department has full accreditation in the basic and partial training of medical specialists in internal medicine and gastroenterology.
Since September 2012 we train paramedics regularly as the assigned education department of the Semmelweis University.
Since the existence of the department several internal medicine specialist and gastroenterology specialist obtained their qualification here. In the last 7 years the department produced 6 internal medicine specialists and 5 gastroenterology specialists. The training of the specialists is also currently underway and the department takes part (partially based on a hospital application) in the training of residents. The scientific activity of the department includes the individual organizing of the Oftex courses, managing hospital and GP trainings, regular participation in congresses (MGT, FIGAMU, Internal Medicine Society, MMTT). The department published several articles and publications.
Number of doctors:
Currently 5 gastroenterology specialists (3 permanent doctors and 2 part-time doctors with contracts) take care of the special tasks (2 gastroenterology specialists and 2 internal medicine specialists are on maternity leave). 4 residents and 3 specialist doctor candidates work in an enthusiastic, young and dynamic team in the department in shifts. A 24-hour gastroenterology specialist on-call system takes care of the gastrointestinal acute bleedings and is available in case of other problems requiring the help of specialist doctors.
Number of professional workers:
28 qualified nurses take care of the nursing duties under the lead of 4 nurses with degrees. The head nurse is the nursing vice-director of the hospital. There are three qualified assistants in the endoscope lab and two in the specialized clinic.
Specialist clinic for Respiratory Medicine and Bronchology:
There is the specialist clinic for respiratory medicine and bronchology beside the gastroenterology clinics. All the latest invasive (bronchoscopy, transthoracalic biopsy) and non-invasive examinations are available for our patients. We are capable of the complex examination and therapy of all respiratory diseases – including lung cancer – with the most modern devices and methods.
Internal Medicine Training Department No. III
(Endocrinology-metabolism diseases, Angiology, Internal medicine)
Chief Doctor of the department:
Prof. Dr. György JERMENDY
Doctor of the Hungarian Scientific Academy, university professor
Our inpatient department operates on Floor I of Building E with 63 beds. During the past years the modernization of the wards has taken place, most of the wards have separate bathrooms.
The clinics and the unit providing cure-like treatment constitute a significant part of the operation of our department. The angiology clinic is located on Floor II of Building H, the patients with vascular problems are welcomed by modern facilities. The Diabetology and the Endocrinology clinics operate in Building D.
On average our department is visited by 2,500 inpatients annually. The endocrinology, the diabetology and the angiology all operate as inpatient units with progressivity level III. The number of visitors of our clinics is significant and has a growing tendency throughout the years. 6,500 out-patients show up at the angiology clinic, 12,000 out-patients at the diabetes clinic and 3,000 out-patients at the endocrinology clinic annually. The angiologic cure-like therapy is popular, ca. 950 patients are treated annually in this program.
Our department operates as one of the diabetology centres of the capital. The diabetes is a really common disease, the treatment takes place usually within the GP system but the patients requiring insulin and the patients with adverse reactions often need hospital or specialized clinic treatment. There are 6 diabetology specialist doctors in our department, the 2 external colleagues working in the clinic also possess specialized qualification in this field. It is an important circumstance that the dietetic specialist of the department and 5 diabetology specialized nurses are all at our help. During the diabetes treatment we carry out the diabetology treatment of pregnant women suffering from gestational diabetes, this obviously mostly takes place in the clinic. Twice a week we operate a special diabetes leg clinic where the external colleagues provide a lot of help for diabetic people with leg problems. This is also where the patients receive the special diabetic protective or corrective shoes.
In connection with the diabetology activities we also operate the North-Hungarian Neuropathy Centre where we accept diabetic patients based on a waiting list twice a week and treat them with neuropathic problems and symptoms. The angiology treatment has a great tradition in our hospital, there are also internal medicine activities in our department. It means great assistance that the whole scope of the treatment of the people with vascular problems can be accessed within the hospital. The patients can go to angiology examinations or to radiology intervention or to a vascular surgical intervention after a short waiting time.
It meant a significant progress in the internal medicine treatment of the people with vascular problems that we have requested years ago the operation of a daytime hospital unit that was approved and this provided the ground for the cure-like treatment of today. We accept the patients after prior registration, for an 8-10-day period within the framework of this cure-like treatment. In all cases the cardiovascular risks are revealed and if necessary they are treated properly. The patients receive diabetic consultation, if necessary they are also taught the basics of the vascular gymnastics. Mainly patients with lower limb obliterative vascular sclerosis are treated in the angiology clinic but we also treat patients with chronic venous insufficiency, deep venour thrombosis or Raynaud-disease. The number of chronic lymphoedemic people is growing on whom we carry out ambulanter lymphopress-treatment.
Our department is also one of the hypertension and lipidology centre of the capital. It is not surprising that we were awarded the qualification of Cardiometabolic Centre a few years ago. Basically the individual components of our recent activities are mixed in this award. As an acknowledgment of the regular educational activity the Internal Medicine Department No. III won the title of Educational Department of the Semmelweis University in 2009.
The scientific field of the department is in connection with the diabetology. We have carried out several clinical examinations about which we made presentations in national and international congresses. The head of the department was the secretary of the Hungarian Diabetes Society (1995-2004) then president of same (2004-2007), later vice-president (2007-2012). The head of department is member of the management of the Hungarian Internal Medicine Society and the Hungarian Hypertension Society, chief doctor in the capital in the field of internal medicine (2002-2012), commission member of the Medical Department of the Hungarian Scientific Academy, member of the ETT ISZT, court expert in medicine, president of the Scientific Committee. The head of department was the member of the Internal Medicine Professional group in two periods (2003-2007, 2007-2011), then from 2011 the president of the Internal Medicine, Endocrinology, Diabetes and Metabolism diseases unit of the Professional group.
The head of department is a doctor of the Hungarian Scientific Academy (DSc), university teacher of the Semmelweis University and the University of Debrecen. The following member of the department obtained the PhD. Title during the recent years: Dr. Klára FARKAS, Dr. Judit NÁDAS, Dr. Zsuzsanna PUTZ and Dr. János OSZTOVITS.
Internal Medicine Department No. IV
Chief Doctor of the department: Dr. PhD. Péter ANDRÁSSY
The Internal Medicine – Cardiology Department No. IV. founded by Dr. Imre Zárday and built on great tradition started a new era in the field of the cardiology by setting up the first coronary supervision in Hungary and continued the legacy of professor Dr. Gyula Kerkovits under the lead of Dr. Károly Zámolyi from 1996. In the field of the examination of heart diseases besides continuing the work of the already operating Holter- and stress ECG lab, the operation spread out and new, non-invasive methods have been introduced.
From 2000 the creation of the heart and peripheral catheter lab has reformed the marking of the coronary artery, the neck vascular marking and the peripheral angiographies and the perfection of the invasive diagnostic procedure and also the therapeutic toolset (acute infarct treatment, opportunity for the implantation of a stent) and with this it joined the centres offering the most modern cardiology treatment. We can fulfil the needs of greater Budapest and the surrounding towns and villages with the coronary artery marking and if necessary with the therapeutic intervention performed on every day of the week.
Since January 2003 our catheter lab has joined the other 5 centres forming the unit that takes care of infarct in on-call schedule in Budapest and operates in 24 hours a day and treats the patients with acute myocardial infarct. In 2005 our coronary supervision (ICE) was modernized and our therapeutic toolset has been supplemented with new modern beds, 10 new monitors and artificial respiration machine. The new building opened in 2006 and enabled further developments, the invasive catheter lab can now operate on two operating tables simultaneously. We are one of the departments providing the most data to the Infarct Register launched 2 years ago. We have excellent relationship with the National Cardiology Institute where we have the heart surgeries made. The heart team set up together with them decides about the next step regarding the patients and about the method of the surgical intervention.
We send the patients for the implantation of pacemakers and ICDs to the Cardiology Centre of the Semmelweis University or to the Cardiology Department of the Budai Irgalmasrendi Hospital. Full electrophysiology examinations and catheter ablation are also carried out in the latter one.
New and old cardiology diagnostic methods:
The so-called stress echo load examinations carried out with dobutamin or dipyridamol and the heart ultrasound examinations are carried out by professionals with great experience. In those 2,400 bicycle stress examination cases every year in which the examination did not result in a clear outcome, with this examination the diagnosis most likely can be refined. Our cardiology department makes the second most stress echo examination in the country.
In the echocardiographic lab the number of examinations grows from year to year, from the 2000’s there have been 20 – 40 examinations daily and we do not only serve the partner departments of our hospital but we also accept patients from different parts of the city. Carrying out the transesofageal examinations as a routine is the result of the practice of the last 15 years. In critical situations – lung embolism, aorta dissection, tear of the chordae tendineae or of the ventricle, artificial key thrombosis or discovering thrombus- it is a crucial tool for the rapid and accurate diagnosis. We used it 200-250 times a year for the treatment of our patients.
Three colleagues from the department have learned the ultrasound diagnostics of the carotid (carotis duplex ultrasound examination) and this way we can keep the vascular system of the patients in the catheter laboratory under an even more thorough control and the arteriograph provides us with information about the rigidity of the wall of the veins. We have received a useful help at the evaluation of an annual 1,500 examination by receiving the Holter examinations and the blood pressure measuring monitoring system (ABPM) in order to set up the correct diagnosis for the fast and slow rhythmic errors and the high blood pressure.
The ventricle electrophysiology examination is at our great help when clarifying the life-threatening rhythmic errors. We also carry out these examinations in the coronary supervision. In our cardiology intensive care unit with nine beds the treatment is of high standard thanks to the help of our qualified professionals. We can carry out all sorts of interventions (pacemaker treatment, pericardial puncture, etc.). We possess two artificial respiration machines and we also carry out intra-aortic balloon pump treatments.
The doctor team of the department consists of prepared specialists and a lot of younger doctors eager to learn. Our goal is to provide these doctors with a long-term plan by providing them with proper training. There is real scientific work in our department including regular training and some research work. We have three qualified doctors, one of them is writing the PhD paper. We take part in numerous foreign drug examinations. The department with its 15 beds is also operating as general internal medicine that requires the employment of internal medicine residents.
The operation of the Cardiology clinic:
Our department operates a cardiology clinic with 6 opening hours every day of the week with our specialist doctors. Annually 9,000-10,000 patients visit the clinic. The Anticoagulant Clinic works well at the same place. We provide professional supervision for the Cardiology Professionalized Clinic in District X and with this the professional level has significantly elevated and we made the route of the patients in the health care system shorter. Recently the Cardiac arrhythmias Clinic started its operation under the management of Dr. Károly ZÁMOLYI.
Cardiovascular Catheter Lab
Chief Doctor of the department:
Dr. Béla NAGYBACZONI
The Cardiovascular Catheter Lab operates as an independent organizational unit within the Diagnostic and Surgery wing.
The Cardiovascular Catheter Lab as a part of the surgery wing of the hospital is equipped with two expensive X-ray machines (GE, Innova 2001, Siemens AXIOM), it fulfils European requirements from every aspect.
The Catheter Lab operates in close cooperation with the Cardiology Department, especially with its invasive part with the help of doctors employed as public-sector employees or with contracts and specialized surgery workers. On average 10, mainly coronary diagnostics and intervention (PCI), in a small number peripheral angiography and intervention are carried out on one surgery table daily. The Catheter Lab operates in tight cooperation with the Cardiology, Internal Medicine, Angiology, Vascular Surgery, Neurology and the Nephrology Department, especially with its invasive part with the help of doctors employed as public-sector employees or with contracts and specialized surgery workers.
In urgent cases the above interventions are accessible 24 hours a day even when there is no on-call day.
The special devices used for the catheter therapy are available, like the intracoronary pressure measurement and the intravascular ultrasound (FFR, IVUS OCT). The attached charts provide information on the operation, performance and efficiency of the catheter lab for the last 10 years with a quick view to the other catheter labs of the country as well.
Obstetrics and Gynaecology Department
Chief Doctor of the department:
University Prof. Dr. Ádám LÁSZLÓ
Professional profiles, treatment of patients
Our department takes care of the treatment of almost all kinds of diseases in the field of obstetrics and gynaecology. Besides the surgeries the followings belong here: gynaecological cancer screening, ante-natal care, courses for the preparation for the birth, pregnant gymnastics, treatment in the labour room, furthermore the special professionalized clinics: abdominal and vaginal ultrasound, menopause and osteoporosis, furthermore minor gynaecology clinic. We have out-patient clinics in three locations: at the department, and in the Specialized Clinics in Districts X and XVII.
The ratio of the number of births/abortion is not only one of the most important indicators for the obstetrics department and its medical field but also for the standard of the obstetrics and health care of the whole country. In the field of the department we have managed in the last 15 years to significantly increase this number. The number of child birth has been growing by 5-10% from year to year after 1999, in 2006 the number exceeded 1000 and in 2011 it almost reached 1700 while in the meantime we managed to decrease the number of abortions from 1424 to less than half of this number. The significant increase in the number of child births is owed to the modern labour rooms enabling also alternative child birth opportunities, to the higher comfort of the department with child beds (formation of wards for 1-3 persons), to the 24-hour rooming-in system and to the approach and attitude that places the woman and the foetus and patient into the focus.
The special profile of the department is the so-called gynaecological endoscopy. With this the uterus cavity can be directly viewed with the adequate equipment (so-called hysteroscopy) or the abdominal cavity (so-called laparoscopy). We carry out both the laparoscopy and the hysteroscopy in an outstanding number and quality not only compared to Budapest but also country-wide. A more important indicator: ca. 95% of our laparoscopies is operative that is the revealed deformation (pregnancy outside of the uterus, cyst, etc.) can be also solved by the laparoscopy machine in ca. 95% of all cases. We started to utilize the latest and most developed laparoscopy technologies, namely the myomectomy and the womb removal in 2012. The surgeries done with the laparoscopy technology has several advantages for the patient compared to opening up the patient: the hospital stay is 1-2 days long, there is no wound on the stomach, the period for the full recovery (ability to work again) is less than 2 weeks, etc. Our outstanding endoscopy activity is also indicated by the title of “Joint Department of the Hungarian Gynaecologist Endoscopic Society” that was awarded to our department in 2010.
Genetics clinic and out-patient treatment:
The Genetics Specialized Clinic is improving from year to year: in 2011 there were 1853 attendants in the genetics counselling and 1197 pregnant women have been referred to our department for a genetic invasive intervention (chorionic biopsy or amniocentesis). Our daily number of patients is rather high: in both clinics there are ca. 60-70 patients on daily average.
Chief Doctor of the department:
Dr. Zsolt BÁNYÁSZ
The opening of one of the most significant and greatest improvements of the Bajcsy-Zsilinszky Hospital and Clinic took place on 30 September 2006. The new diagnostics and surgery wing of the hospital was the largest health care investment of the country – worth more than 10 billion HUF – that was financed from health care budgetary and local government funds. A new diagnostics and surgery wing has been created that fulfils all requirements of the modern ages. The machinery and the environment of the new wing were fulfilling the highest standards in that age when the diagnostics and surgery wing was opened.
The laparoscopic towers, the manual devices, the intra-operative non-invasive radiology devices were provided to facilitate the rapid and effective treatment of the patients. In 2011 the surgery wards of the Surgery Department were modernized also. By 2012 the department has been transformed.
One of the focal thoracic surgery clinics of the capital operates in the hospital. The former chief of this department was Dr. Zsolt MÉSZÁROS who introduced a new technology in the field of the bronchial resections. Currently the unit works under the management of Dr. Miklós JUHÁSZ who carried out a laparoscopy lobus pulmanis resection for the first time in Hungary.
Dr. András BODNÁR also works in the Surgery Department who, beside his surgery work, also introduced the gallstone crushing technology. We have at our disposal in the department as a supplementary service the ESWL – outer shock wave stone crushing device. With the help of this device the gallstones not containing lime can be removed without surgery primarily within the out-patient treatment.
The chief of the department is Dr. Zsolt BÁNYÁSZ who places great emphasis on the development of the laparoscopy technologies. We use the laparoscopy procedure as a daily routine for the treatment of bile diseases, hernia and appendicitis. We place great emphasis on the use modern devices, modern operative techniques thus we introduced several novelties in Hungary in the field of laparoscopy in the recent years.
We use the laparoscopy technology nowadays in case of several disease patterns and this can shorten the hospital stay after the surgery and reduces the pain after the surgery and also the size of the wounds. The laparoscopy technology can be used for the following diseases: deformations in the bowel, stomach and the adrenal glans, hernia of the groin and the claustrum.
Chief Doctor of the department:
Dr. Géza BÖSZÖRMÉNY-NAGY
Founder of the department: Prof. Dr. Ernő ROSDY
The Urology Department of the Bajcsy-Zsilinszky Hospital opened on 1 October 1975 with 53 beds. The founder, Dr. Ernő Rosdy can be characterized as a person with progressive views, unheard of workload, with his love for his profession and his mind open to the novelties and this enabled the department to join the top of this field. After Professor Rosdy retired in 1993, his former deputy Dr. Tamás KISS became his successor as a result of a tendering procedure. The change in the management did not lead to any setback in the operation of the department and the work continued with the former attitude. In 2007, after Dr Tamás KISS retired Dr. Géza BÖSZÖRMÉNYI-NAGY was appointed as the chief doctor of the department.
The new diagnostics and surgery wing of the hospital realized with a vast amount of funds started its operation at the same time. As a part of this modernization the machinery of the urology was also modernized in line with the needs of the modern urology. Holmium laser, flexible cytoscope, ureteroscopes, laparoscopic devices are all available. The machinery of the specialized clinic has been also modernized, in the place of the former surgery rooms the clinical treatment can be carried out among excellent conditions with specialized treatments.
We managed to modernize the treatment of the urology patients by making use of the facilities of the hospital with ambitious work. The modern diagnostics background and the central anaesthesiology enabling the thorough examinations before surgery created the steady basis that was supplemented by the advantages offered by the fellow professions that are also on a high level. From these the most important was the endoscopic technology that was launched around this time in the manual department as well, the pathology examinations of high standard that were striving for standardization and the nephrologic and oncologic background. The examination of the patients takes place within the framework of the out-patient treatment except for the acute cases and this way the workload of the department has significantly decreased. This tendency was further supported by the start of the Emergency Treatment Department. The activity of the department covers the whole palette of urology with a few exceptions.
The examination of the nephrolith takes place quickly and efficiently up to today’s standards. The treatment of the nephrology patients takes place with the whole palette of the therapies. In the department external shock wave treatment (ESWL) is accessible every day. With this most of the stones can be crushed within one day. The removal of the stones can be also carried out in the modern surgery with an endoscope (“video surgery), no open surgeries has been made in the last 10 years. The endoscopic interventions are carried out with thin fibre optics devices or flexible ureteroscope and with the most modern laser (100 Watt Holmium laser).
The cancer patients are also treated in line with the standards required by our age. The emphasis is placed on the early detection. In case of prostate cancer with the systematic PSA (prostate specific antigen) examination carried out within the out-patient visiting for years now it has been reached that the significant rate of the men in the endangered ages take part regularly in the examinations. As a result of this the most prostate cancers are revealed in a stage when they are still curable. The main tool for the treatment is the laparoscopic prostate removal thanks to which beside the excellent oncology result the recovery is rapid and the patients can return to their daily life. The advanced cancer cases are treated together with the Oncology Department and the radiation therapy specialist. In the recent years they took part in several international clinical drug tests providing a chance for the treatment of such patients who are incurable with the traditional methods as far as we know today. In case of bladder cancer they are also capable of the radical removal of the bladder and to create a new bladder from the small intestine that is also not a wide-spread intervention. The examination and treatment of the female urinary retention problems (urodynamia) is also carried out on a high standard.
The setting up of the andrology, the clinic of the male health is also meant an improvement where prepared specialists deal with the erection and fertility problems with proper confidentiality.
More and more patients go to the surgeries from year to year with a shorter and shorter recovery period. The case/mix ratio of the department is above the country average and the number of the endoscopic and laparoscopic surgeries are increasing from year to year. The careful preparation for the surgery, the planning and execution are all characterized by the low number of the reoperations and adverse reactions. All this could be realized with the steady staff of doctors and the qualified workers. The group of experienced doctors that provides a steady basis is supplemented properly by the enthusiastic and prepared young specialist doctors and specialist doctor candidates. The patients of the department had arrived from Districts X and XVII but since 2012 also District XIX belongs here, furthermore the urology inpatient treatment of Ecser, Gyömrő, Kóka, Maglód, Mende, Monor, Péteri, Sülysáp, Tápiószecső, Úri and Vasad is also taken care of by the department. The Urology Department can take on the challenges of the modern urology among rather good conditions with new energy and equipment. The Urology Department of the Bajcsy-Zsilinszky Hospital received a new device: a HD optical and monitor system. The significantly better picture quality means a better recognition of the tissues during the surgeries and a more accurate anatomical preparation which also mean less blood loss, shorter surgery length, less adverse reactions, shorter recovery period and of course less expenses. The surgeries became safer this way and there is a room for improvement also. The significantly advanced technology enables such surgeries that we could not carry out so far with adequate safety.
The best example for this in urology is the technique in the laparoscopic prostatectomy that protects the nerves. During this intervention we can separate the nerves and veins responsible for the erection and we can protect them. This kind of surgery can and must be made only with the help of HD technology. But it also means a great help with surgeries carried out after medical history like prostate or bladder surgeries, radiation therapies or other medical treatments. The pyelon plastic surgery that can be considered as a microsurgery procedure that also belongs here when the small tubes of the renal pelvis and of the renal tube with the diameter of a few millimetres are cut across and then stitched up.
The visual material for the education and medical training that is either projected or recorded and that may be presented at any time is available in a much better quality. The media may be recorded and a video / scientific evaluation may be prepared. The introduction of this system is an important feature for our institute that became a training hospital. Based on our previous experience and based on the surgeries carried out we already deem this device essential.
Ear-, Nose-, Throat and Head and Neck Surgery Department
Chief Doctor of the department:
Dr. Bálint LIKTOR
The infrastructure and mentality of the department has renewed as a result of the years-long hard work that is still ongoing up to today and now our department is able to provide more ideal circumstances for the treatment of our patients.
Description of the activities of the department:
The ENT department works with 23 beds since the decrease of the number of hospital beds. The average treatment period is 2.74 days and the case-mix index is 0.6228 that is higher than the country average. We have managed to shorten the treatment periods in order to decrease our expenses.
The strength of the scientific work of the department is indicated by that fact that currently 5 of our doctors do quality work in abroad. There are three colleagues with scientific titles working in the department, one of them in a contractual relationship.
The colleagues of the department held 14 congressional presentations in the last 3 years and they published 14 Hungarian and 3 English articles as main or supplementary authors and also a part of a medical book was published.
The most important characteristic of the activities of the department is to stand on “three pillars”. We have to cultivate all three branches of our profession with full effect: excellent otological and rhinological work, up to par neck and salivary gland surgeries and cancer surgery in cooperation with the Oncology Department.
We provide inpatient and out-patient services to the citizens of District X and XVII furthermore we also provide the emergency care for the South-East Budapest region on every third day with on-call schedule.
The ENT department and its audiology station have been modernized in the recent years, both regarding the infrastructure and the professionalism. The audiology station was supplemented with modern silent chambers, an otoneurologic and objective audiologic examining room have been also set up with state-of-the-art computer equipment where we provide the background for the examination of the decrease of hearing and dizziness. We introduced the screening for the damage of hearing of the new-borns with the help of the measurement of the otoacoustic emission.
We provide comfortable accommodation for our patients in 10 renovated wards with bathrooms. There are two wards with 2 beds and eight wards with 3 beds respectively and a part of these wards is air-conditioned and separate bathrooms have been installed in the wards.
As a special service it is possible to hire VIP wards in our institute for monetary consideration.
The new clinic has been opened with new modern IT devices and furniture with two examining microscopes, and with examination infrastructure for nose endoscopy, with videostroboscope and stiff and flexible fiberoscope. There are 5 examining units available for simultaneous examinations with on-line access to the central database of the inpatient and outpatient system. Two reception desks provide the organizing of the patient traffic and there is a separate examining unit for carrying out special allergology examinations.
After the opening of the central surgery wing the really needed septic / aseptic bandage room was formulated recently in the room of the former surgery and this enables small clinical surgical interventions. As part of the complex modernization pleasant doctors’ rooms has been created as well.
Besides the infrastructural change and improvement also the professional treatment spectrum of the department was broadened as well. As a result of this process an ear surgery centre with one of the highest patient load in Hungary has been set up where we accept minor and adult patients from the whole country. Our surgical solutions for the growth irregularities, for the otosclerosis, the chronic middle ear inflammatory diseases and for the different hearing troubles formed next to the closed, pneumatophore tympanic cavity are extremely important for the whole country.
We are dealing with the treatment of all kinds of ear diseases. The department is first in the country regarding the treatment of qualified ear surgeries, including university hospitals as well. Our department operates as national centre, its accentuated profile is the surgical hearing reparation that is on top of the progressive treatment. The patients are directed to our department from all over the country as a consequence of which the number of the surgeries is higher than the number of the university hospitals.
We present the numbers of the ear surgeries in our department to back this up. The number of otosclerosis patients amounts to 240-280 cases annually for the whole country. The following chart shows the ratio of the stapedectomies carried out in the ENT department of the Bajcsy-Zsilinszky Hospital:
As we can see we have been performing one fifth of all national cases in our department since 2008. The ratio is similar regarding other ear surgeries as well.
Pursuant to the date of the OEP (National Health Insurance) there are ca. 1,500 tympanoplastic surgeries performed annually in Hungary.
In our hospital the annual average number of the ear surgeries has been above 200 in the recent years as you can see in the chart. This is 15% of the number of the Hungarian surgeries.
The endoscopic sinus surgery is also an accentuated profile that is supported by the professional knowledge and one of the surgeries with the best equipment in the country. We introduced the osteoplastic and the advanced combined endoscopic-osteoplastic frontal sinus surgeries that only we perform in the capital in case of recidive frontal sinus inflammatory diseases.
We also deal with the pains of the ear, throat and the head – neck region, the diseases of the balancing organ, respiratory allergies, head – neck tumours, hearing dysfunctions, disorders of speech, ear and sinus inflammatory diseases, just to mention the most frequent cases.
In the framework of our tumour surgery we are striving for treating the cancers of the mouth cavity, the throat and the trachea with the least harm that can be done. The department also hosts a high standard dental surgery launched by a complete dentist – dental surgeon team.
The central surgery that has been available since February 2007 was created and equipped in a way that fulfils the standards of the 21st century. We can perform surgical interventions in two surgical units without time restrictions, while the emergency care is located in a separate septic surgery room. The equipment and toolset of the central surgery fulfils even the latest requirements. The unit with endoscope and 2 microscopes that is also equipped with video projection enables presentation and education functions. We also use surgical CO2 and Neodym – YAG LASER, cryo-technology, furthermore high-frequency and Argon plasma coagulator. The number of patients of the department in the last 5 years has been steady. The number of patients scheduled for surgery is 2000 on average, the number of surgeries is 1700 and the number of outpatients is around 55,000. We treat ca. 25,000 patients annually at the specialized clinics of the department (Allergology, Phoniatry, Audiology, ENT), in the specialized clinics in the districts another 30,000.
The department has been providing the ENT regional outpatient care in the Specialized Medical Treatment Centres of the District X and XVII as a tradition since 1981. Our doctors work in both districts based on a revolving schedule. The qualified assistants based on the locations steadily provide a steady background for the professional work.
ENT specialized clinic:
Daytime it provides ENT care for the patients of the fellow departments of the hospital and provides a professional background for the specialized treatment centres belonging to the hospital (Districts X, XVII and XVIII). We also provide emergency outpatient care for the citizens between 8 am and 8 pm on every third day within the framework of the on-call schedule. The specialized clinic performs the examination, preparation for surgery and after treatment of patients referred to the hospital. The regional care is performed in the specialized treatment centres of the Districts X, XVII and XVIII.
Audiology specialized clinic:
We perform the whole audiological examination of the patients referred to us pursuant to the referral order, also providing them with hearing aids, if necessary. We also take care of the patients with hearing impediments regularly. All of the subjective and objective hearing examination can be performed here.
Three doctors specialized in audiology work in the department. The leader of the specialized clinic is Assistant Professor Dr. Györgyi FÜLÖP. The detailed otoneurologic examination of patients with problems with dizziness is performed in the otoneurologic clinic.
The free hearing screenings that takes place at the age of 6 weeks is performed by Dr. Györgyi Fülöp. This screening is not supported by the National Health Insurance.
Allergology specialized clinic:
This clinic provides in Districts X and XVII the examination of the patients showing up with respiratory allergic complaints and their continuous check-up and care. The leader of this clinic is Dr. Réka CSAJBÓK allergologist and specialized ENT doctor.
Phoniatry specialized clinic:
The leader of this clinic is chief doctor Dr. Hajnalka SZABADKA. In this clinic different disorders of speech are diagnosed, treated and also the rehabilitation of patients after trachea surgery is performed here as well. The voice rehabilitation, the phoniatric therapy, speech therapy and psychological activities are led by Teodóra PETŐ. The patients whose trachea has been removed visit the group therapy on every Thursday between 12-1 pm.
Chief Doctor of the department:
Dr. PhD. Ágnes KERÉNYI
The Ophthalmology Department (with progressivity level 3) provides a special profile for the hospital. The professionalism of our colleagues and the technical equipment enable a complex treatment of high standard for a wide scope of the eye diseases.
Due to the great number of patients the cataract surgeries are the most frequent interventions in our department.
Ca. 1900 cataract surgeries are performed annually with phacoemulsification technology. The patient is free to choose whether s/he wants to be operated on within the one-day surgery system or as an inpatient. The department is suitable for any kind of complicated cataract cases, for cases requiring combined surgeries, for complex front and rear segment reconstruction surgeries and we can also treat every possible adverse consequence of the cataract surgeries. The outstanding standard of the work of the department concerning the cataract surgeries is indicated by the numerous scientific presentations, publications and award winning audio-visual presentation that deal with the introduction of novelties regarding the treatment of special cases of the cataract.
One of the special profiles of our department is the treatment of the diseases of the eye surface and the corneal.
We were the first to publish results in Hungary about the treatment of the eye surface diseases with amnion transplantation. We have great expertise in all kind of keratoplastic surgeries. We introduced special front and rear lamellar keratoplastic surgery techniques as a novelty in Hungary in 2006-2007. The rear lamillar keratoplastic surgeries can be called a revolutionary novelty in the field of keratoplastics as it enabled the selective replacement of the chronic endothel layer. It is much less invasive and offers a much faster recovery as the perforating keratoplastic techniques.
In 2/3 of our keratoplastic cases in 2012 we used the lamellar method. In a national comparison our department is ranked at the third place regarding the number of ketaroplastics cases in 2011 and this can be considered as the acknowledgement of the professional standard and also our department performed 68% of all lamellar keratoplastic surgeries that year. Modern diagnostic and therapeutic equipment is available for these treatments.
The other accentuated profile of the department is the surgeries on the vitreous body and the retina, the performance of vitrectomy for which a prepared group is available. The department is ready for even the most complicated vitrectomies. One third of our pars plana vitrectomies are combined surgeries. Beside the surgeries of the detachment of the retina and the macula, the deterioration of the retina and the vitreous body that emerges as an adverse consequence of diabetes is one of the most important field of this surgery method. This way our department is capable to treat the ophthalmological adverse consequences of the diabetes in a complex way from the laser treatment of the fundus to the surgeries concerning the retina and the vitreous body. For the diagnosis several modern equipment is at our disposal from the digital fundus camera used for the vein marking examinations through the ophthalmological ultrasound device to the most modern Optical Coherence Tomography that can produce sectional photos of the retina with a resolution of a few micrometers.
The possession of the personnel and material conditions for the microsurgery involving the front and rear segments of the eye enable the high level treatment of the eye injuries in our department. The acute surgeries of the injured patients are taken care of by our institute together with three other hospitals in the capital with on-call schedule.
The procedures performed in the clinic are in close connection with the special profile of the department as they are not permitted without special inpatient facilities. Among these procedures we consider as the most outstanding those treatments with drugs injected into the vetrious body that primarily is gaining acknowledgement in connection with the wet form of the deterioration of the retina in elder patients but also regarding other ophthalmological diseases (e.g.: adverse consequences at the fundus caused by diabetes, thrombosis in the fundus). A great number of such treatments are performed pursuant to the individual OGYI permit and within the framework of international studies that are enabled – beside the outstanding professional knowledge and the excellent equipment – by the circumstance that the Ophthalmology Department does not only dispose over an own surgery in the central surgery facility that fulfils even the most modern requirements but also a surgery in the department that intra-vitreal injection treatments provide sufficient background and opportunity.
We perform more than 500 clinical eyelid surgeries in this surgery room and these are performed with different procedures from the simple chalazion surgeries, through the correction of the incorrect stand of the eyelids to the extensive plastic surgeries that are not beauty related.
The diagnostic background and the therapeutic surgery equipment background – from more types of lasers to the microsurgery procedures – of the glaucoma is also on a high level in the department as it is very significant due to the frequency of the cases and the risk of the severe deterioration of the eyesight. The participation in the international studies dealing with the glaucoma surgery and the substrates lowering the eye pressure also indicate the professional standards of our department.
17 thousand outpatients visit our clinic annually. Our specialized clinics (vitreoretinal and macula, diabetes retinopathia, cornea, cataracta, glaucoma, eyelid, ultrasound specialized clinic) cover a wide scope of the ophthalmology. The state-of-the-art examination devices are at our disposal for the diagnosis.
The Ophthalmology Department of our hospital has a leading role in the modern health care service as you can see from the above: the activities are wide-spread, it offers complex treatments in case of complex and multidisciplinary cases, takes care of the treatment of the most complex cases and the adverse consequences and our department is also rather flexible as it is suitable for one-day surgeries and inpatient care in complicated cases as well.
Chief Doctor of the Department:
Dr. Attila OROSZ
The Bajcsy-Zsilinszky Hospital has been focusing on kidney patients from the second half of the 1970’s. Since January 1977 it is possible to perform regular dialysis treatment. As a result of the continuous improvement nowadays there is an individual impatient unit with 15 beds with a nephrology and peritoneal dialysis clinic and an artificial kidney station with 24 places operated by the Diaverum dialysis service provider and this station has a progressivity level II. qualification and provides nephrologic treatment. Our service area includes Districts X and XVII of Budapest but also stretches to Gyömrő, Mende, Sülysáp, Kóka, Monor, Úri, Ecser, Maglód, Péteri, Vecsés, Üllő, Tápiószecső, Tóalmás, Vasad meaning ca. 275,000 citizens. Within the framework of the complex treatment we perform all-around examination, histology sampling, immune-suppressive drug treatment if necessary, acute and chronic dialysis treatment, mobile dialysis treatment at intensive / sub-intensive clinics, clinical peritoneal dialysis. We have been functioning as the Chronic Peritoneal Dialysis Centre of the Hungarian Nephrology Society since 2005.
The ratio of the kidney patients is on the rise every year. Thus also the need for inpatient and outpatient care is also continuously growing. The capacity of the department provided by the TVK is totally used up. We provide the treatment of previously unknown patients and also patients who we already treated. Parallel with the improvement of the treatment of the chronic patients we also take care of the treatment of adverse effects and accompanying diseases that often mean a great challenge. Our institute can take on these challenges as well with the help of the fellow departments. This is also proven by the case-mix index that was higher than the country average in 2011: 1.33516 versus 1.12155.
In 2012 the number of the patients of the Nephrology Clinic kept on growing. 342 new patients registered at the outpatient specialized clinic. Their examinations were performed and if necessary we also provide their care. The number of patients was 1,200 in 2006 according to our register and this rose to 2560 patients at the end of 2012. Beside the treatment of the annual average of 80-90 acute kidney patients another 40-60 patients join the chronic dialysis program. On average 120-140 patients receive chronic dialysis treatment.
Registration is needed for the specialized clinic, we do not have a long waiting list but it is getting longer and longer parallel with the growth of the number of patients. Currently we can examine the new patients within an average of 2-4 weeks. The group of patients receiving EPO treatment that stimulates the blood formation, requires monthly supervision. This group is also growing from year to year, at the end of 2012 there were 180 patients monthly.
The number of kidney patients is dynamically growing all over the world, the service area of the Bajcsy-Zsilinszky Hospital is no exception to this. The last 35 years proved that the formation of the nephrology profile was much needed and its continuous development is still necessary in the hospital.
Neurology Department and Stroke Division
Chief Doctor of the Department:
Dr. Ágnes Köves
The Neurology Department started its operation as an individual department in 2000, thereby following such international trend in accordance with which psychiatrics and neurology qualify as two different professional fields. The Department is currently being operated on the 2nd floor of Building E with 40 beds.
Professional programme, location and build-up of the Department:
Inpatient and outpatient care:
Since 2006 significant changes and improvements have taken place in respect of the professional work of the department and the build-up thereof as part of the programme the objective of which was to realize the comprehensive care of people having vascular diseases in the Bajcsy-Zsilinszky Hospital to a unique level of complexity throughout the entire capital. In the hospital there is a world class catheter lab, a modern cardiology centre and the Angiology Department taking care of patients having aortic sterosis in their legs which provides care for such part of atherosclerosis which affects other organs and the Stroke Centre curing vascular diseases of the brain is the integral part of the department.
The Stroke Centre is being operated as part of the General Neurological Department and it is also managed by the same. Previously, our department took care of the entire neurological care of the population of Districts X, XVII and XIX (220,000 people), including the treatment of stroke, thereafter, as from 1 July 2012, the number of population who had to be treated increased significantly due to the integration of various settlements neighbouring Budapest and the reorganization of territorial treatment obligation. Currently, the population to be treated on one bed exceeds 6,000.
In 2007 significant architectural renovation and reconstruction was carried out at the area of the Department within the frames of which the so-called specific supervision room was formed with 6 beds in which we can provide sub-intensive treatment – with equipments between the levels of general hospital beds and the central Intensive Care Unit – for patients requiring acute treatment and neurological patients with being in severe condition. Thus, staying alive and having good chances of recovery has much better odds than in traditional departments. At least 70 per cent of the patients of the Department suffered strokes.
As from January 2011 we have been participating in the so-called acute stroke systematic (intravenous) thrombolysis treatment which qualifies as the sole specific treatment for acute thrombosis and the development of which is a national programme. We possess all such modern and fundamental instruments and equipments without which neurologic treatment and the treatment of stroke may not be carried out. /CT, MR, DSA, Ultrasound/
In the aspect of neurology we cure each and every clinical pictures /brain tumour, waist pain, extrapyramidalis etc./. The annual number of inpatients of the Department is between 1,100 and 1,300, while the annual number of outpatients is between 300 and 400 (within the frames of cure-like treatment). The entire clinic circulation represents 3,000 – 4,000 patients annually.
An EEG lab, neurosonologic clinic – an ultrasound examination in the course of which the stenosis and thrombosis of carotids pumping blood to the brain and the main pulses running on the skull-base may be examined – and EMG lab are operated at the Department.
We have formed so-called specific professional clinics in line with the different groups of diseases. Such patients are welcome to these divisions who have been through general neurological examinations and who require specific treatment. As from 2007 the so-called immune modulant /sclerosis multiplex/ clinic has been operated as a specific clinic with an increasing number of patients and wider and wider opportunities in terms of therapies, and in connection with this, we participate in more and more research programmes. Our general neurological clinic carries out the hospital consultations and the non-specific general neurological treatment /on the basis of the queries of family doctors/ at the ground floor of Building H.
Scientific work, professional training
The Chief Doctor of the Department is the member of the Hungarian Stroke Association and the management of the Neurosonologic Association, she participates in the organization of the conferences of these associations which are held bi-annually and also in giving professional training lectures. Besides the above, she actively contributes to the so-called “Stroke-day” serving the provision of information to the population in connection with ultrasound vascular examinations and the screening of the disease. This programme is very successful every year, the people are concerned about the screening of their health and we attempt to draw their attention to the importance of providing treatment within 3 hours.
The Department was accredited in the training of specialists in 2010 and in the resident training in 2011.
Chief Doctor of the Department:
Dr. habil András Telekes
History of oncological treatment in the Bajcsy Hospital
The oncological treatment of outpatients started in the Hosptial in 2002 (Dr. Magdolna CSEPREGHY, Dr. Gizella RÁCZ). Four years later, on 1 January 2006, the inpatient department was opened with 10 beds which has been extended to 15 beds as of 1 May 2006 (deputy department head: Dr. Éva PÁDI, associates: Dr. Tünde ÁRVAY, Dr. Judit KÓSA, Dr. Csaba PETNEHÁZI). The current Chief Doctor of the Department has been in office since 1 January 2009.
The Department has conducted active scientific activities besides the treatment of patients during the past three years the results of which are various congress lectures, announcements and book chapters. The scientific acknowledgment of the Department is strengthened by the 2010 habilitation degree and the 2011 private university lecturer appointment of the Chief Doctor of the Department received by the Semmelweis University.
The Oncological Department is capable to treat the entire spectrum of solid tumours (that is not hemopoietic tumours) in the aspect of clinical oncology that is it has sufficient experience in applying the most modern medicine therapies as well. Treatment at the department has been limited to the oncological patients of Districts X and XVII since March 2011, previously, there was no territorial limit. Until the territorial limitation the number of oncological treatments significantly increased. In 2006, 656 treatments were carried out and this number increased to 2,077 in 2010. Due to the territorial limitation, the figure decreased to 1,705. In respect of the biological treatments – which qualify as the cutting edge treatments in oncology – the Oncological Department of the hospital – proportionately – is among the first few institutions in Hungary. It is a pity, however, that notwithstanding the sufficient experience, we have not received entitlement for the application of all medicines. The Department puts significant emphasis on the treatment of elderly patients. Due to the increased average lifespan of the population the proportion of elderly people having oncological diseases has also been increasing. Taking into consideration the frequent diseases of elderly people (e.g.: diabetes, high blood pressure etc.) and the side effects of the medicines applied in the course of the tumour therapy, geriatric-oncology is under formation within the frames of oncology. In our Department all elderly patients have been provided with such modern treatments which were possible to be provided on the basis of their state. Age in itself is not a contraindication of any oncological treatment. Tumorous diseases are often go hand in hand with pain. Therefore, one of the specific profiles of the Department is decreasing pain (the first Hungarian language scientific book in this subject was actually written by the current Chief Doctor of the Department). New medicines are continuously being developed and clinically tested in the field of oncology.
There are various examinations going on at the Oncological Department. Thereby, the patients have the possibility to get acquainted with further therapies, while the hospital generates income.
Oncological treatments require specific professional knowledge and experience. These are necessary not only in the course of selecting the treatments but also when curing the possible side-effects. Taking into consideration the accessibility of other departments (e.g. cardiology, diabetology, gastroenterology etc.) the Oncological Department is capable to treat both the side effects and the possible acute oncological cases (e.g. thrombosis, embolism etc.) at the highest level which is currently available. Treatment of patients is assisted by the Department’s part-time psychologist who is available twice a week and clinical treatment is also possible.
Treatment of patients is based on a complex decision-making process (oncological team). The oncological team – if possible – conducts consultation with the patients prior to the operations but in case of urgent interventions, this occurs following the operation. Currently the following oncological teams operate in the hospital: breast-, digestive system-, head-neck-, gynaecological-, urological- and lung oncological teams.
Infusions applied in the course of the treatments are mixed by the institution pharmacy on the basis of the list provided by the Department.
The most important data of the outpatient professional clinic linked to the Oncology Department:
- Its duty is to operate the oncology team covering all tumorous locations jointly with the Oncological Cure-like Clinic.
- Area of supply: population of Districts X and XVII linked to the area of supply of the Bajcsy-Zsilinszky Hospital and the patients with tumours operated by other professionals within the hospital, as well as external patients following conciliations in advance.
- In case of the histology results point out a tumour and in case there is a solid suspicion of a tumorous disease – clinical examination.
- Organization of clinical control examination during and following treatments.
Oncological nursing facilities
The oncological nursing facilities operated in integration with the Department in Districts X and XVII.
In District XVII nursing is carried out by senior doctor Dr. Tamás NAGYKÁLNAI, while the doctors of the department visit District X for such purpose.
Order of assignment, on the basis of schedules:
- Through meeting the senior doctor at the Oncological Department.
- Through the Oncological Clinic.
- Recalling for ongoing chemotherapy.
- Leukopenia with fever, high degree anemia as a result of chemotherapy (except if caused by bleeding – acute GI, ORL, GY bleedings – in which case reception by the respective department – on the basis of localization – may become necessary.
- Heavy vomiting, diarrhoea, and exsicosis etc. as a result of chemotherapy.
Central Anaesthesiology, Intensive Therapy and Emergency Department
Chief Doctor of the Department:
Dr. Barbara Völgyes
In the course of the comprehensive reconstruction of the hospital at the end of 2006 the new Diagnostic and Operation block was opened with 9 modern operating-tables and with the Intensive Care Unit of European level having 12 beds. In September 2008 the Emergency Department started its operation at the ground floor of Building H with 3 examination beds, 1 bed with equipments for intensive care and with 4 laying beds. Senior doctor Dr. Ágota TÓTH was entrusted with the division head duties. The Emergency Department prefers a professionally new patient care which is more modern and more efficient than the previous methods. The well-functioning Emergency Department – where the diagnostic and therapy equipments are concentrated – increases the efficiency of curing through treating the patients in due course and by taking the appropriate measures. This does not only increase the quality of patient treatment but it also results in long-term cost-efficiency for the hospital.
The activities representing the department’s profile may be split up into 5 professional fields which are built on one another in their operation: anaesthesiology, anaesthesiological and pain clinic, intensive therapy and emergency treatment. Our specific professional profile has a special nature compared to the activities of traditional anaesthesiology and intensive therapy departments which results in continuous qualitative improvement in our activities.
At the area of the Anaesthesiology Department – in line with our previous endeavours – we put great emphasis on comprehensively preparing the patients on the operations – covering each and every organ system – thereby decreasing the awaiting time, the post-operative complications, the nursing time and the expenses. Our motto is the following: “Appropriate pre-operative treatment represents the half of the success of healing.” Our accentuated professional profile: anaesthesia in case of chest surgery, vascular surgery, extended abdominal, urological, gynaecological and laryngology operations which result in increased operational burdens. The anaesthesiology equipments which can be found in the 9 operating rooms of the operating block ensure the highest level of patient care. Our anaesthesiology activities are carried out by relaxometry and parallel sleep monitoring and we apply modern TCIs (target controlled infusions) and TIVAs (total intravenous anaesthesia) pumps. In case of patients with unstable circulation, the possibility for haemodynamic monitoring is given. “Minimal / low flow” anaesthesia is a routine procedure (it is material efficient, and environment- and patient friendly). Chest surgery, vascular surgery, extended abdominal surgery and operations of the minor pelvis are usually carried out by applying combined anaesthesia (regional and systematic). The details of pre-operative preparations started in 2002 have been brought to perfection during the years to which the modern equipments of the new operating block gave a vast drive; our anaesthesiology thereby came through a qualitative development. We are directing the feeding prior to operation, the homeostasis organization, the setting of blood sugar and blood pressure. If necessary, we start pre-operative respiratory physiotherapy and we assess the condition of the patient by way of blood gas analysis carried out within the frames of respiration functionary examination. Our duty – if necessary – is to ensure the central vein, to place the artery or epidural cannula, occasionally placing temporary pacemakers, pre-operative anti-biotic therapy in line with the uniform approach, ensuring stress-ulcus and thrombosis prophylaxis. In case of vascular surgeries (or possibly other surgeries) which result in the loss of blood, cell-savers are applied. We are providing anaesthesiology in case of laryngology and chest surgery operations carried out by way of JET high frequency respiration and intratracheal catheter technique. Our plan and objective is to extend the introduction of the “One-day Surgery” for which the anaesthesiology department is fully ready.
Since the putting into operation of the new operating block the Anaesthesiology Clinic is serving almost five times more patients than previously which results in new organization and professional duties. Its leader is Dr. Judit FAZEKAS. An appropriately equipped examination room and a waiting room are available. Our objective is to realize that following the preparation of the operation plan the patient is only sent to the examinations determined necessary by the anaesthesiology. “Routine” examinations shall be replaced by individual (targeted) examinations. With all these we intend to serve the purposes of preparing the patients for the operations in a more voluble and secure manner.
At the area of the Pain Clinic – headed by senior doctor Dr. TAGÁNYI – activities acknowledged nationwide are carried out covering the entire field of the possibilities of intervention by way of medicine and equipments in the field of systematic and regional pain killing (magnet-bed, TENS treatment, radiofrequency therapy, MUSKEL active treatments). We give lectures on acute and chronic pain killing linked to anaesthesiology operation as a regional centre. In our clinic, besides the modern equipments, we have a room with two beds which are equipped as in the Intensive Care Unit. In case of severe and virulent pain we provide “Acute Pain Service” 24 hours a day.
Our Intensive Therapy Department is located at the 5th floor of Building H with 18 beds and it has equipments which comply with the modern professional demands. We continuously receive patients with critical vital parameters from all departments of the hospital. All beds of our Intensive Care Unit are monitored to a high extent and they are installed with intelligent respirators and central monitor systems. There is an ultrasound equipment next to the bed for the purposes of cardiac and abdominal examinations and we also have a blood gas automat with extended spectrum. By applying bronchoscopia, obtaining endobronchial information and sampling relevant respiratory matter have become possible as a daily routine. The on-the-spot radiology examinations and the prompt digital imaging are available and all previous radiology images may be accessed through the central system.
On an average, approximately 80 per cent of our patients require mechanic respiration, while invasive haemodynamic monitoring occurs in 70 per cent of the cases. We have results in the healing of severe pneumonia which are even more favourable than the international data in case of the application of the new protocol of mechanically respirated patients (vigilant sedation, VAP profilaxis).
One of our main profiles is the post-operative patient treatment, a significant portion of which are the patients who had chest surgeries combined with respiratory malfunctions, the patients who have unstable circulation and the patients of abdominal surgeries, tumorous urological operations and patients of laryngology diseases. We strive for a maximum level of cooperation with the other departments in case of the following patients: patients in critical conditions, patients in shock, patients whose various organs are affected, patients who have respiratory problems, patients with unstable circulation, bleeding patients, patients with severe metabolic problems, patients with restricted conscience, patients in coma. We have achieved impressive results in the lysis handling of thrombotic processes (deep venous thrombosis, right chamber thrombus, massive pulmonic embolismb). Our successful curing of severe pleuropneumonia (parapneumonic pleural fluid) by way of intrapleural fibrinolysis of the pleural fluid content was published.
The two diagrams present the disease severity (SAPS II) and mortality data of the past 3 years. Orange: BZSK-ITO; Blue: represents the average value of other ITO of the Central-Hungarian region. It may be seen that we cure patients in our department whose condition is more severe than the average, however, their mortality data are still lower than the average.
The followings are part of the spectrum-expansion started in the beginning of 2002: active respiration (perioperative) physiotherapy, percutaneous mini-invasive trachaestomia, PEG (percutaneous endoscopic gastrostomy) feeding of patients being unconscious for a longer period, intra-abdominal pressure monitoring by way of a specific catheter in case of patients requiring abdominal observation. Besides the usual respiratory physiotherapy and active mobilisation (prone-position), the followings helped in the successful curing of numerous patients with severe respiratory organ problems: JET high frequency respiration and the application of traditional non-invasive methods (intermittent positive pressure breathing, special face- and mouth masks). Approximately 30-40 per cent of our patients suffer from (primary or secondary) infective diseases. We hold regular hospital training courses for the sake of recognizing of septic conditions in the beginning and for the appropriate handling thereof. As from 2007, we have introduced severe protocols at the intensive care unit in order to roll back nosocomial infections as a result of which the number of infections occurring at the department have significantly decreased.
The Mobile Emergency Team (MET) operating at our department is available 24 hours a day. We are training all departments of the hospital – in line with the international trends – the alerting of the MET instead of the Reanimation Team which – if possible – foregoes the complex reanimation.
Our Emergency Department has been operating for almost 4 years and it fills in the role of the efficient gate-keeper in the life of the hospital. Accordingly, its duties are to classify the patients arriving in acute condition (triage); to set up a direction diagnose by way of the available emergency examination procedures; to provide primary (and/or definitive) care; to dispose. With the operation of the Emergency Department, the possibility is granted for the realization of adequate cure within the hospital in due course to the greatest extent possible which is the pre-condition and quintessence of efficient patient treatment. On the basis of the feedbacks of other departments (internal medicine departments, neurology, surgery), the patient reception and treatment duties of these departments have been simplified and rationalized. All these move the system in the direction of qualitative patient treatment. As a result of our increased level of territorial treatment obligation and thanks to satisfaction of the patients treated at the department, the circulation of the Emergency Department has increased significantly during the previous years. The extension of the department is reflected in the short-term development plan of the hospital. Thus, the professionally trained and very committed personnel of the department will be able to comply with the requirement of efficient and qualitative patient treatment to an even greater extent in the future.
A characteristic index of the cost-efficient operation of the Emergency Department is the so-called gate-keeper function. During the previous years, the Emergency Department has fully fulfilled its duties, it has directed almost two-thirds of the patients – following the necessary examinations and treatment – to the appropriate basic treatment.
In all divisions of the Emergency Department we put accentuated emphasis on operation in accordance with the actual professional directives and on the maximum level of patient safety.
Cardiac Rehabilitation Department
Head of department:
Páder, Katalin M.D.
This unit is the traditional specialty in the field of cardiology at Bajcsy-Zsilinszky Hospital. This tradition was extended in combination with the development of the cardiology department by the establishment of Budapest’s only independent cardiac rehabilitation unit in 1995 allowing care for 44 patients simultaneously who have undergone heart surgery or suffered a heart attack to receive follow-up care and support the return to their normal activities. According to the definition of the World Health Organization (WHO), cardiac rehabilitation is the sum of activities and interventions required to insure chronic patients and patients having suffered an acute cardiovascular event the best possible physical, mental and social conditions so that they may by their own efforts preserve or resume an active life and a normal place in their community. In order to achieve the above results, a rehabilitation programme ideally includes social, mental and medical activities as well. Cardiac rehabilitation is a multi-disciplinary and integrated activity designed to insure comprehensive reduction of coronary risk factors and long term and complete recovery of cardiology patients with special focus on patients with multiple risk factors, based on preventive application of clinical knowledge. An important goal in cardiac rehabilitation programmes and secondary prevention is to minimize the decrease in capacity for work as a result of a heart condition, to insure a stable clinical condition, to reduce the unfavourable physical and mental effects of cardiac disease, to improve the overall functional condition and to promote independent living and good quality of life. The therapy is also intended to reduce the risk of a repeat coronary event, to prevent the progression of arteriosclerotic processes and to eventually decrease morbidity, mortality and hospitalization rates. The objectives of cardiac rehabilitation are generally perceived to fall in line with the goals of secondary prevention therefore cardiac rehabiliation may be seen as the means of secondary prevention. In order to fulfill its objectives, the rehabilitation programme should be integrated in a comprehensive, multi-factor follow-up process that includes inpatient care, application of drug and interventional therapies, risk assessment, physical training, education and counselling to support lifestyle changes and risk reduction as well as behavioural trainings and employment guidance. In addition, long term monitoring and compliance should also be insured. Cardiac rehabilitation practice has seen many changes in the last 30 years. The number of patients requiring indication and rehabilitation has grown. Initially, the goal was to reduce deconditioning and depression as a result of long bedrests in patients having suffered uncomplicated heart attacks. Later, rehabilitation programmes started to receive patients with complicated myocardial infarctions, after interventional or surgical myocardial revascularization or other open heart surgery, with heart defects or suffering from a stable angina. The number and nature of rehabilitation patients is constantly rising.
Cardiac rehabilitation programmes are able to receive many patients with multiple cardivascular risks, hypertension, artery disease, also elderly patients, patients using pacemakers and implantable cardioverter-defibrillator (ICD), patients suffering from arrythmia and congestive heart failure and also patients having undergone heart and/or lungs transplantation. Acute cardiology care and the treatment of coronary heart disease have also significantly changed. New invasive therapies have taken the lead in the treatment of acute coronary syndrome and myorcardial infarction. This has led to decreased hospital mortality rates and shorter hospital stays. Hospital stays for coronary revascularization surgeries have also become shorter.
The number of off-pump heart surgeries has also risen. There has been a swing in the rate of surgical and percutaneous myorcardial revascularization with the latter becoming the dominant treatment. Treatment of myorcardial infarction does not end with stabilizing the patient’s condition. Effective guidelines stress the importance of preparation before discharge involving diagnostic, patient education and lifestyle advice obligations. However, as secondary prevention assessments show shorter hospital stays prevent the consistent implementation of these principles. Cardiac rehabilitation programmes are now seen as part of secondary prevention that are key in the treatment of the various forms of coronary heart disease and congestive heart failure as well as in the comprehensive and long term care of cardiovascular patients. The best validation for multifactorial cardiac rehabilitation is the evidence-based results published in medical professional literature. The proven benefits of core programmes such as physical exercise, health education, counselling and behavioural therapy may be summarized as follows:
- enhanced physical endurance;
- reduced symptoms;
- reduced abnormalities in blood lipids;
- lower number of smokers among heart disease patients;
- improved psychosocial condition and reduced stress levels;
- decreased mortality rates.
Cardiac rehabilitation is a cost-effective activity especially if we look at costs in comparison with the quality years of life given to patients. In recent years, a large amount of scientific data has been published about rehabilitation aspects of patients suffering from heart failure, having received a heart transplant and elderly patients. The latest guidelines of European and American societies of cardiology stress that cardiac rehabilitation forms an organic part of the treatment of coronary diseases. A consensus-based cardiac rehabilitation programme has been developed relying on guidelines and recommendations from American, European and Hungarian scientific associations and professional advisory boards. The components of the programme are: optimal medical monitoring, risk stratification following the acute event, drug therapy for secondary prevention, education to promote a physically more active lifestyle, exercise management, physiotherapy, risk factor modification, weight management, smoking cessation, customized diet and counselling, education to promote a healthy lifestyle, behavioural therapy and psychosocial intervention. Rehabilitation is consequently an active process designed to influence favourably the underlying cause of heart disease and patients should be involved in activities promoting their own health and well-being. These objectives can be achieved with the involvement of health care professionals representing various fields of expertise but the lead role is played by cardiologists.
Components of cardiac rehabilitation programmes:
Medical history and physical examination. Determination of risk factors.
Evaluation of employment conditions, vocational guidance. Resting and exercise ECG
Determination of severity level of disease.
Management of blood lipid levels, evaluation and adjustment as required of diet,
physical activity and drug therapy.
Hypertension therapy, regular blood pressure tests, lifestyle changes, restriction of sodium intake, maintenance of low levels of alcohol consumption, regular exercise is recommended, weight loss is indicated in case of overweight or obese patients. If the patient suffers from diabetes mellitus, chronic heart or kidney failure, drug therapy should be considered.
Documentation of smoking habits and cessation of smoking. Assessment of readiness to quit;
if patient is ready and willing, a deadline should be determined. Recommendation of nicotine replacement therapy and/or bubropion. Behavioural counselling in individual
or group setting.
Expected outcome: long term abstinence from nicotine.
Weight loss is recommended for patients with BMI > 25 or waist > 100 cm (male patients) and 90 cm (female patients) and especially if patient suffers from hypertension, hyperlipidaemia,
diabetes mellitus or insuline resistance. Behavioural and nutritional guidance, monitoring and review of results.
Expected outcome: loss of 5 to 10% of body weight, sustained modification of related risk factors.
Treating diabetes mellitus
Patients with a likelihood of suffering from diabetes mellitus are diagnosed here on the basis of prior treatment history and on laboratory tests. We work out a plan, which includes the regular observation of the patient’s weight, physical training, diet and medicinal therapy applied (antidiabetic medicine, insulin). The patients’ blood glucose is monitored prior to and following the training sessions.
Psychosocial problems such as depression, stress, social isolation, anger or hostility can be detected via interviews or standardized questionnaires. In case of clinically significant problems, we provide psychosocial counselling for both groups and individuals. All of our patients are offered the opportunity to attend sessions to reduce stress.
Family therapy intervention
Objective: to alleviate clinically significant psychosocial problems, and to acquire stress management techniques.
Counselling and physical training to improve physical activity
We survey physical activity and exercise tolerance by using exercise tolerance tests (ETT); we identify which factors may prevent the increase of one’s physical activity. We provide counselling on how to improve physical activity. We work out tailor-made aerobic and resistance training programmes on the basis various factors such as frequency, duration, the degree of intensity and the type of the exercise.
Objective: to do physical activities on a regular basis, to increase patients’ stamina and functional capacity, to encourage patients to do exercises that correspond to the consumption of 1,000 kcal. (More simply put: physical work of 30 minutes’ submaximal exercise or physical training of moderate intensity to be done on a daily basis.)
In Hungary, the recommendation for cardiac rehabilitation defines the process of rehabilitation for patients as follows:
- for acute cardiac conditions (e.g. acute myocardial stroke and cardiac surgery every patient should take part in cardiac rehabilitation, either as an inpatient or an outpatient;
- it is the physician’s responsibility to make sure that his or her patient is involved in a rehabilitation programme directly after the acute event;
- before a patient is labelled as having reduced capacity to work owing to heart disease, s/he must participate in a cardiac rehabilitation scheme.
The Cardiac Rehabilitation Department moved to the refurbished third floor of Building E in 1997. We await our patients who suffered a heart attack, who are scheduled for cardiac surgery or have undergone cardiac surgery in hospital wards with 3, 4 or 5 beds. The department has its own well-equipped gymnasium where daily gymnastics therapy sessions are held.
Our diagnostic unit is also superbly equipped as it boasts a conveyor-belt style treadmill for tolerance tests, a bicycle ergometer, a Holter monitor system, monitors to measure blood pressure and an echocardiogram to provide an ultrasound scan of the heart. Besides the physicians we have qualified nurses, physiotherapists and masseurs as well as dieticians and psychologists to assist and accelerate the process of rehabilitation.
There is another rather busy unit linked to our department functioning under the name of Cardiac Rehabilitation Clinic where outpatients are treated: the unit is responsible for their rehabilitation and for overseeing their condition. Rehabilitated patients may join a self-organised non-governmental organisation called Szívegyesület (“Heart Association”) which currently operates in two districts in Budapest, the 10th and the 17th. This organization promotes health by offering physiotherapy session on a weekly basis, organising lectures on various healthcare issues and taking their members on excursions. This way, the rehabilitation provided for both inpatients and outpatients in our hospital is realised in a wholly unique and systematic way. The staff members of our department are involved in regular in-service training schemes and they participate in the work of the Hungarian Association of Cardiovascular Rehabilitation. Head of the Department Dr. Katalin Páder is the current chair of the Association’s Ethics Committee. The department is also involved in the work of the European Association of Cardiovascular Rehabilitation to work for this field at a European level.
Musculoskeletal rehabilitation Department
Head of department:
Dr. Lippai, Zoltán
The Department and Clinic of Musculoskeletal Rehabilitation operating at the Bajcsy-Zsilinszky Hospital’s is located in the 10th district of Budapest, at 24-26 Kőrösi Csoma Sándor Road; on the ground floor of Building “GIZELLA”. Our department started its work in 1995 with 42 beds, which is also the current figure. As a teaching hospital we are involved in the training of specialists for the rehabilitation of musculoskeletal conditions, and in the training of physiotherapists, rehabilitation therapists, massage therapists as well as nurses.
The department’s medical practice:
Patients need rehabilitation if they, as a result of an accident, have lost some of the abilities that they had learnt in their life previously. An illustrative example may be the various strokes where, in the gravest of the cases, patients are paralysed and they have to relearn basic skills such as how to sit, stand, walk, wash, use their hands, eat, speak, read, write, count or carry out routine chores.
The emphasis is on the reacquisition of a lost ability, and this will be the ultimate goal of the rehabilitation process. Both the patient and his or her family will need to learn to cope with this condition and the patient will need to reach a degree of self-sufficiency where s/he can live without constant supervision. If this is achieved, we have paved the way for the patient to be appreciated as an active member of the society rather than a person with a severe disability.
Our department is renowned for operating as a mixed-profile musculoskeletal rehabilitation unit, which tries to do its utmost to accommodate to individual patients’ needs and the specifications of the impaired area.
We maintain a close relationship with other units of the hospital, the specialist clinics, the physicians working in primary care, the social networks of the districts involved (i.e. the Department of Social Welfare of the 10th and 17th district municipalities, the various home care networks, other supporting networks, senior citizens’ homes, the day-care centres and homeless shelters), as well as with non-governmental organisations (with clubs, the association for people with reduced mobility, and with schools, churches, etc.).
The Department and Clinic of Musculoskeletal Rehabilitation at the Bajcsy-Zsilinszky Hospital provides complex, tailor-made services for individuals both as inpatients or outpatients in terms of physical and social rehabilitation who have suffered a archetypal musculoskeletal impairment as a result of an accident or a disease.
An important prerequisite for the patient is to display a willingness to actively cooperate during the process of rehabilitation, and to have the determination to reacquire the lost skills.
Additionally, patients will have to undergo physical tolerance tests and their treatment at the relevant departments will need to be completed.
Target groups suitable for musculoskeletal rehabilitation:
- Those with a cerebrovascular lesion (irrespective of the fact whether it was motoric, sensory, vegetative, or cognitive);
- those with an obliterative arterial disease and those who underwent surgery for amputation owing to this condition;
- those with a post-traumatic stress disorder (most frequently those with hip fractures, but also that of the lower or upper limbs; possibly with vertebral fractures or following skull or brain damage);
- those whose mobility has been severely reduced and those suffering from rheumatic diseases accompanied with chronic pain syndrome (spondylarthrosis, spondylolisthesis, discus hernia, coxarthrosis, polyarthritis);
- those who have undergone hip endoprothesis surgery (typically after TEP – tracheoesophageal puncture – surgeries);
- those suffering from organic neurological conditions (most frequently polyneuropathia, sclerosis multiplex, Parkinson-syndrome, those with a Heine-Medin condition, those suffering from the disorder of the neuro-muscular system as well as patients with tumours and inflammations);
- those suffering from immobilisation syndrome – and the recurring of all the above resulting in weight loss or the deterioration of the patient’s condition.
Hospitalisation is preceded by a rehabilitation consultation with the patient’s doctor working at an in-patient ward or at the clinic of the department, via telephone.
Prerequisites for rehabilitation:
- the patient has undergone a thorough examination,
- the patient’s treatment has been completed by the active department,
- the patient has the determination to undergo rehabilitation and takes steps to participate,
- the patient can tolerate cardiopulmonary and mental pressure or has the capacity to take such pressure.
Healing is teamwork.
The members of the team are: the patient, his or her relatives, the rehabilitation specialist (who will coordinate the team’s activities) nurses, the physiotherapist, the physical therapist, the rehabilitation therapist, the psychologist, the speech therapist, the social workers involved, the dietician, and other experts coming in from outside such as orthopaedic shoemakers or orthopaedic technicians.
The members of the team are in contact with one another on a daily basis and meet once a week for a team meeting to discuss any information and experience they gained about the patient, and will together specify what actions will need to be taken to continue the process of rehabilitation. At the same time, they will have the opportunity to conduct some supervision as well.
Prior to the final discharge, only those patients will be allowed to take a leave for the weekend who can walk steadily; whose relatives’ assistance will not result in a negative influence on the patient’s walk; and who already use a wheelchair. Another precondition is that both the patient and the relatives have consented to the leave and relatives provide continuous supervision for the patient.
During their leave, patients will be expected to survey the opportunities they are likely to have in terms of getting about in their homes and provide supply for themselves, and they are required to make the necessary steps (i.e. remove furniture blocking their way, or if need be, organize conversion of flat). If it is feasible, the hospital provides the patient with tools to facilitate these activities in order to help them alleviate the anxiety they may experience when the time for going home is approaching.
The date of the final discharge is always determined together with the patient and their family. The date will be finalised one or two weeks before 1-2 the patient’s discharge and, if necessary, we ask the help of our social workers or our colleagues working for the relevant regional social care institutions.
The doctors at the department:
- hold qualifications in the following fields: neurology, musculoskeletal rehabilitation, physiotherapy, internal medicine, pulmonology, laboratory, cardiology and cardiology rehabilitation.
At our clinic we offer specialised rehabilitative examinations where we decide who is suitable for participating in a rehabilitation scheme, which patients needs certain devices, and we also cater for our patients with chronic coronary conditions (stroke, ASO). Our clinic provides treatments and sessions for our outpatients with physiotherapists, psychical therapists, speech therapists and psychologists.
Our department has recently launched a Vascular Prevention Programme with the objective of providing more effective treatments for our patients suffering from coronary artery diseases. To achieve this end, we targeted healthcare staff working in primary care and in the field of acute healthcare provision with focus on rehabilitation. In the framework of the Stroke Club we also carry out secondary prevention activities and visit secondary schools to promote primary prevention schemes. Our Stroke Club has 100 active members. Our aim is to adopt a health-conscious lifestyle so that we can prevent a major coronary catastrophe and to provide help for our patients who have suffered a stroke to recount and share their experiences with other patients.
Department of Chronic Internal Medicine /Gizella/
The Department’s Chief Medical Officer:
Dr. Zoltán Lippai
Our department has its own site on the first and second floor of the Gizella Hospital’s building, located under Kőrösi Csoma u. 24-26, X. district.
Our hospital’s history:
Until 1956 the building hosted the Gizella Maternity Hospital. One of our former colleagues, namely Miklós Tibald chief medical officer was already working in the building as obstetrician.
Later on, the building hosted the Gizella Post treatment centre , the placements were arranged by the Central Bed Registry, mainly dying patients were placed in the centre. In 1990 the department was fully integrated with the Bajcsy Hospital and it was renamed VI. Department of Internal Medicine.
In 1992 – as far as the financial situation of that times allowed – a full reconstruction was carried out, smaller wards were set up in the centre. From then onwards, the department have been operating as the Department of Chronic Internal Medicine. We usually place here the patients coming from the X. and XVII. districts and the belonging villages that are still in need of constant medical treatment, but need no acute care any more.
Besides the internal medical patients, we also have patients from the Departments of Surgery, Psychiatry, Neurology, Urology, Nephrology and Oncology. Our four permanent medical doctors have certification in internal medicine, neurology and psychiatry and are eager to provide care for the mainly aged, incurably ill patients.
We consider that from our part it is an important professional achievement that we are able to send home an increasing number of patients in stable conditions, the department’s death rate , although only to a minor extent, is decreasing.
Many of our nurses have been working at our department for decades. They are doing a very hard, demanding job. They are mostly taking care of incapacitated patients who are unable to take care of themselves even on a basic level.
Their example is an evidence of real professionalism.
On the ground floor, the building is hosting the Department of Musculoskeletal Rehabilitation. We have tight professional and friendly relations with them.
We have good professional relations with the other departments of the hospital too, even despite of the geographical distance.
Department of Pathology
The Department’s Chief Medical Officer:
Prof. Dr. Zoltán Sápi
Since the 1st of January of 2012 the Hospital’s Department of Pathology is operated by Onkopatológiai Diagnosztikai Kft., headed by the professors Dr. Zoltán Sápi and Dr. András Matolcsy.
The Department of Pathology is headed by Prof. Dr. Zoltán Sápi, the Section of histology and aspiration is headed by Dr. Anikó Szabó, medical doctor specialized in pathology -cytopathology, the autopsy section is headed by Dr. Sándor Győri chief medical officer, medical doctor specialized in pathology. In the framework of the resident training supported by the Ministry of National Development, one pathology resident, Dr. Ágnes Novák is working at our department. The rest of our medical doctors are coming from the Semmelweis University’s Institute of Pathology and Experimental Cancer Research as part-time employees: Mondays and Tuesdays Dr. Eszter Turányi, Wednesdays Dr. Tamás Micsik. in addition to that, two medical doctors are working two times a week on a monthly rotation: Dr. Péter Nagy professor and Dr. Attila Zalatnai professor. Chief assistant: Attiláné Rimai, 6 assistant are working full time at our department, 5 of them have professional qualifications, 3 of them are full-time cytologist assisticants, 4 of them are full-time administrators and 2 of them are full-time autopsists.
Every surgery documentation of the Bajcsy-Zsilinszky Hospital is examined at our department, we also do immunohistochemical examinations, if necesarry. In addition to that, we assess the materials of the speciality consultations of the districts No. X and XVII. (surgery, dermatology) at our department too.
In the year of 2012, the total number of deceased at the department was 1701, the number of neglected cases was 834, the number of autopsied was 867 and the number of official autopsies was 36.
In 2012, the total number of histological cases was 7977, the number of gynaecological cytologies was 15401.
In addition to that, we also carry out aspiration cytology examinations, mainly in cooperation with the Department of Radiology with UH guided sampling and the examinations of the I. Department of Internal Medicine are also UH guided, taking place on Mondays and Tuesdays. The aspiration cytology consultation without UH guiding takes place on Mondays and Tuesdays between 9-11 AM.
In 2012 the total number of aspiration cytology examinations was 1432. At our department in 2012 the total number of immunohistochemical and immunocytochemical examinations was 5228.
Under the the management of Dr. Károly Tagányi Chief Medical Officer and in cooperation with the Department of Urology we started to apply the large cell block technology for the radical prostatectomies, that made the assessment more accurate and precise and can also be applied for the purpose of scientific processing.
The background for the consultation is ensured by the Semmelweis University’s Institute of Pathology and Experimental Cancer Research, where the medical records of the materials needing a greater volume of immunohistochemical examinations and the consultations related thereto are carried out and they are also involved in the standardisation of lymphomas. Furthermore they are doing special supplementary examinations needed for the oncology treatments (K-ras mutation and EGFR examination), molecular pathology.
The reconstructed section of autopsy was inaugurated on the 1st of October of 2013. The very fast renovation process taking place between the 5th of August of 2013 and the 20th of September involved the reconstruction of the total section of autopsy diagnostics. During the reconstruction we had great consideration for the medical professional expectations and as a result, today we have one of the most modern organizational unit carrying out the work in the basement of the E building and also greatly satisfying the needs of education and training. After the reconstruction, soon we can start with the training of medical students and autopsy experts as well as with the hosting of international surgery technical medical courses.
During the reconstruction we also put emphasis on the aspects of hygienic and tribute. We have completely changed the system of cadaver cooling and storage, we increased the capacity nearly to its double. Furthermore, we have a waiting room and a customer service that fully satisfies the needs of the relatives of the deceased.
Department of Imaging Diagnostics
The Department’s Chief Medical Officer:
Dr. Ildikó Zsigmond
The department is operating in a fully digitalized system, including:
- Reading room: the place where the majority of targeted X Ray records are taken
- Screening and reading room: the place, where we are able to do gastroenterological examinations, urological, gynaecological and surgery examinations and it also has the capacity of targeted records and distance records.
- mammography reading room:
o the place where the mammography records are taken.
o with the information of the taken records the patient is sent to the neighbouring room for an additional ultrasound examination and in case of need the instant sampling is also possible.
- The other two ultrasound rooms are used for the general soft tissue and abdomen exams and for the circulatory exams. The abdomen exams require preparation and are carried out on an empty stomach, therefore they have preference among the other exams, we do them in the morning and in the early hours during the day. The other exams are carried out in later hours.
All of our ultrasound equipments are of prime category. We regularly participate in trainings and we also seek to introduce the most modern exam methods.
The CT, MR and DEXA equipments are located in the territory of our hospital, but in a separate building.
- The modern, 16-slice CT equipment was installed at the end of 2006. The equipment enables us to carry out exams with angiography, perfusion, and virtual endoscope, in addition to the traditional exams.
- Our 1.5-Tesla MR equipment has been assisting us with the exams of our patients since 2007.
In addition to the traditional neurology exams, we also use it for abdomen, small pelvis and angiography exams. Naturally, the equipment also has the capacity for perfusion exams and since 2008 we also have the possibility to do MR mammography exams.
Our specialist offices
The X-ray section of the specialist office of the districts X and XVII. is an integral part of our department. The patient care is provided in the opening hours of the office by the medical specialists working in a rotation system.
The head of the section of our specialist offices is Dr. Erika Takács Chief Medical Officer.
Both specialist offices have the capacity for traditional and ultrasound exams. The ultrasound exam is subject to reservation.
The department’s specialist offices, ambulances, information on reservations
According to the Hungarian law, every radiology exam is subject to admission, therefore we are not able to provide care for the patients without admission.
For CT and MR exams only the special ambulance of in and out-patients may issue admissions.
Contacts for reservations:
- Mammography, ultrasound – telephone: 432-9630, only on workdays, 7.00-14.00
- DEXA – telephone: 432-7550
- CT, MR – telephone: 432-7740
- Specialist office, X. district – telephone: 433-3338
- Specialist office, XVII. district – telephone: 254-0542
Medical doctors working at hour department
All of our medical doctors are highly qualified in the field of X-ray and ultrasound exams. The special exams are summerized in the following table.
Name Function Field
Dr. Ildikó Zsigmond head of department neuroradiology
Dr. Judit Dora chief medical officer mammography
Dr. Anna Érdi specialized medical doctor
Dr. Anikó Klement chief medical officer
Dr. Andrea Marton resident
Dr. Beáta Mezőfi chief medical officer CT, MR
Dr. Rita Péli chief medical officer mammography,
musculoskeletal ultrasound exams
Dr. Gyöngyi Szekér chief medical officer CT, mammography
Dr. Judit Tábory resident
Dr. Erika Takács chief medical officer
Dr. Erika Tóth lecturer mammography
Dr. Viola Ujházy resident
Dr. Beatrix Végvári chief medical officer mammography
Dr. Gábor Vesztergombi lecturer CT
Dr. György Zsiga trainee specialized medical doctor
Our work is assisted by
our administrators and assistants: Judit Nádasiné Ignáth chief assistant, Andrea Buzás, reception.
Head of Department:
Dr. Zsuzsanna Kálmán
As a result of continuous technical developments of Central Laboratory lasting of many years each field of laboratory diagnostics is being represented: hematology, flow-cytometry, hemostaseology, chemistry, immunochemistry, immunology, separation technics (Elfo, HPLC), analytics of urine and other body fluids, blood grouping, infection serology, microbiology, molecular biology and gene technology. The processing of examination documents of patients is computerized and controlled by electronic sample identification.
The laboratory operates in three sites, in the medical units of the X. and XVIII. districts there is only sample taking available, while the processing of examinations is carried out in the hospital’s department. At present approximately 300 different examinations are carried out in the Central Laboratory. Owing to the respective hospital managements, we already possess a wide range of world class laboratory technology. Outstanding products, technical equipment and automatics of Japanese, German, English and US multinational companies allow realizing almost 3 million exams. The laboratory activity is supported by a modern information system. The laboratory corresponds to a high standard hospital laboratory situated in any country of the world.
The interdisciplinary character of the laboratory work is demonstrated in the composition of experts as well. In our laboratory the coordinated work of doctors, biologists, chemists, analysts, professional assistants and assistants ensures the high quality diagnostic background of patient care.
Hospital Pharmacy and Fharmacy ’Borostyán’
Dr. Ilona Higyisán
The Hospital Pharmacy ’Borostyán’ is situated in the block ’L’ inside the complex of the Hospital ’Bajcsy-Zsilinszky’. The university pharmacy, which was built in 2003, is a modern three-story – basement, main floor, first floor – construction meeting the professional standards of staff and equipment conditions. It is connected to other hospital units and departments by a tunnel system; which is regularly used to ensure the drug supply.
The hospital pharmacy performs basic and specialized tasks.
- Preparation of individual magisterial formulas, as well as procurement, maintenance, storage and supplying the departments with registered medicinal products and other medicinal substances (disinfectants, bandages, therapeutic equipment, diagnostic agents and chemicals).
- Preparation of mixed infusions containing cytostatics,
- Patient-specific pharmaceutical distribution,
- Direct public medication – Pharmacy „Borostyán”,
- Committee tasks.
Brief summary of the basic and specialized tasks:
The unique magisterial and aseptic laboratory prepares any possible form of drug in accordance with the local demands. Ointments, solutions, talcum powers and eye drops are prepared in quantities of 1500-2000 kg annually. Our modern drug producing laboratory is also equipped with water distiller and modern washer.
Procurement of drugs
The institution’s Procurement Rules specify our procurement related tasks. Currently the procurement of drugs, x-ray contrast agents, medical gas, disinfectants, bandages, sets of surgical bandages, isolation and ocular viscoelastic materials is carried out based on public procurement or individual institutional transport agreements.
Preparation of mixed infusions containing cytostatics
Our hospital pharmacy has been producing mixed infusions containing cytostatics for oncology patients since July 2006. We started the production gravimetrically in December, controlled by the computer software CATO. Currently this is the internationally accepted up-to-date method of production, the quintessence of which is that each patient receives a dose of drugs in the appropriate time and way calculated in accordance with their body surface area. The production is centralized in one pharmacy, in a specially designed laboratory unit of three rooms. It represents a great advantage and drug safety that each therapy is reviewed and approved by pharmacists, following which the pharmaceutical assistants prepare the mixture which is selected from the oncology protocol by a doctor. An additional advantage of the centralized preparation introduced by us is that the documentation is up-to-date and monitored; additionally, as a result of the unified production the residue from dangerous and expensive substances is reduced. The number of bottles produced at an annual level is between 8000 and 10,000.
The patient-specific medication started in May 2007, in the beginning only the central site was involved, then from January 2012 this was extended to external sites as well.
For patient-specific medication the delivery of the ordered drugs to the hospital pharmacy (having 447 beds in total) is realized through an electronic information channel to computer drug management system called NovoHosp .
The Daily Dose System (DDS) works as follows. The therapy is prescribed by the doctor, the patient-specific medication protocols are registered in a cycle of 24 hours, then electronically forwarded to the pharmacy. The medical needs received in the pharmacy are reviewed by the pharmacists, in case of need (e.g. lack of some drugs, interaction or incorrect dosing interval) they correct or approve the therapies. After the review the pharmaceutical assistants put the pills, patches and capsules in four-rack pill boxes signed with the name of the patient. The injections are packed in separate, named bags. There is a separate rack for injections installed in the medication car. Since cold chains cannot be handled by the medication cars, cold products cannot be part of the patient-specific medication. On weekends and holidays medication in boxes of different colors – green and blue – can be provided for a maximum of three days only.
The method offers an accurate, safe and monitored patient care and therapy. It represents approximately 50-60% of drug usage. It is a significant result since most of the hospitals cannot provide information on pharmaceutical spending by patient. The plans also include the registration of occasional drugs, surgery premedication and post-treatment drugs from the department stock after usage in case of each patient in order to be able to provide more accurate information.
Direct public medication
Our hospital pharmacy performs direct public supply of drugs through the Pharmacy ’Borostyán’ since 2002. The department does not have a separate staff as organizationally it forms part of the Hospital Pharmacy, the personnel works alternatively in both pharmacies in a rotational system.
The pharmacy actively takes part in the work of two committees:
Committee of Drug Therapy: in this committee the chief pharmacist is responsible for secretarial tasks. The task of the committee is to form institutional basic list and its continuous up-dates. The situation of most of the hospitals is significantly simplified – it indicates a European tendency – that by determining the therapy site of the drugs the institutions can form a local pharmaceutical basic list. The pharmaceutical basic list is observed and approved in accordance with the demand of the departments. In our institution the number of agents present on the basic list is 323.
The other highlighted task is the analysis of the institutional use of drugs once per semester, including the evaluation of index of specific use in the proportion of use per care day, use per case and use per weight. In addition, their usage is compared with OEP incomes. Analyzing the data of the first semester of 2012, the indexes of usage have improved. The usage of drugs per OEP income was 4.6%, whereas the relevant number in 2011 was 5.5%. The entire institutional procurement of drugs is 6.94%!
Committee of Institutional Infection Control and Antibiotics: analysis of utilization of antibiotics based on department use is carried out once per semester. The utilization of antibiotics per institutional usage of drugs is presented and the utilization of antibiotics is summarized by divisions, institution, priority departments and departments.
The utilization of antibiotics per institutional use of drugs significantly decreased. The proportion in 2009 was 9.2%, in 2010 9.9%, in 2011 11.1%, while this year it decreased to 8.23%.
In addition to the aforementioned – along with the Department of Hygiene – we are responsible for the evaluation of the usage of necessary disinfectants for the departments, as well as their selection and procurement. From September 2011 we ensure an additional separate framework for disinfectants for the departments in addition to the framework of drugs strengthening by this action our disinfection policy and supporting the hand, equipment and environment hygiene. We expected that by the improvement of hygiene conditions the number of infections and the use of antibiotics would decrease.
We consider it as a recognition of our scientific and professional work that me and my colleague have been the president and secretary of the Hospital Pharmaceutical Organization of the Hungarian Society for Pharmaceutical Sciences for eight years now, as well as that we are both members of the Council of Hospital Clinical Pharmacy of the Health Professional College.
Our young pharmacists won first and special prizes on lecturers’ competitions by presenting our hospital tasks and everyday work. Presentation, posters, articles were published and are being published about our work.