Graduate and postgraduate state university education of laboratory specialists in Hungary: medical doctors, pharmacists and laboratory analysts.

The authors focus on the description of graduate and postgraduate training of specialists working in clinical laboratories in Hungary. All training schemes are regulated by government decrees and, after obtaining an MSc degree, medical doctors and pharmacists may enter a specialty program for Medical Laboratory Diagnostics. For biologists, chemists and medical research laboratory analysts with an MSc degree a clinical biochemistry specialty training program is open. Regulated by law, the trainings are uniform in Hungary and are assigned to accredited medical universities. The candidates should complete a 26-month core program followed by 36 months' specific education. After a successful final examination including both practical skills and theoretical questions, specialists get a full license which will enable them to supervise laboratory work and validate test results. Laboratory specialists should join a continuous (lifelong) learning program and collect scores by attending special training courses. To receive a scientific degree, specialists may join PhD programs at any of the accredited universities.

[The comparison of in vivo and in vitro elution of gentamycin from bone cement]. / Gentamicin csontcementbol történo in vivo és in vitro emissziójának összehasonlítása.

INTRODUCTION: The authors report their in vivo and in vitro results of the elution characteristics of gentamycin sulfate from bone cement, which is the most commonly used way of local antibiotic prophylaxis in Europe in the field of orthopedic surgery. AIM: The aim of this study was to investigate the elution of the gentamycin sulfate from bone cement, describe the dynamics of the emission in time and evaluate the relationship between the minimal inhibitory concentration (MIC) and the eluted concentration of the antibiotic. METHODS: The in vivo investigation samples were taken from 9 patient from drain fluids to evaluate the eluted antibiotic concentration by fluorescent polarisation immunoassay method (FPI). The in vitro emission-dynamics of two different bone cement-Gentamycin sulphate complex were analysed by plate diffusion method during one-year period after mixing. RESULTS: Their results showed that 24 hours after the operation the gentamycin concentrations in the drain fluid taken from around the endoprosthesis implanted with Palacos-R bone cement diminished, yet remained above the MIC level. High but rapidly decreasing antibiotic level was detected by the in vitro method within the first week, reading an almost steadily low concentration by the end of the first month. Surprisingly, after one year it was still possible to demonstrate the inhibitory effect of the drug from both tested types of cements. CONCLUSIONS: It is concluded that the gentamycin is able to elute from the bone cement in useful concentration after the implantation of endoprosthesis. However, this in vitro method is a useful and reproducible technique for the measurement of the efficacy of antibiotic emission from bone cement, the conversation of the results to the in vivo remains to be obscured. Nevertheless, the usage of local antibiotic prophylaxis seems to be useful during orthopaedic major intervention.