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 Medi-cal 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

Koszorúér bypass-műtétek sikerességének összefüggése az angiotenzin konvertáz enzim expressziójával

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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 Medi-cal 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

Hasüregbe vándorolt epicardialis pacemaker

Migration of a permanent pacemaker generator from their intramuscular pocket to the abdominal cavity is a less frequent, but potentially life-threatening complication. The authors present the case of a 69-year-old woman, who visited the emergency department of the clinic, with complains of non-specific abdominal symptoms. Her past medical history included a complete atrioventricular block diagnosed in 2009 during the mitral valve replacement and since then she had an epicardial permanent pacemaker; the pulse generator was placed into an intramuscular pouch created in the left subcostal region. Surprisingly, radiologic examinations showed that the generator migrated into the pouch of Douglas. Considering patient safety, first a new intracardiac pacemaker was implanted and then the migrated device was removed surgically. The patient was discharged on the seventh postoperative day

A Semmelweis Egyetem extracorporalis membránoxigenizációs programja – az 5 éves Városmajori-eredmények függvényében = The Semmelweis University extracorporeal membrane oxygenation program – 5 years’ results and perspectives

Absztrakt: A mechanikus keringéstámogatás az elmúlt 5 évben programmá fejlődött a Városmajori Szív-és Érgyógyászati Klinikán. Mindehhez szükséges volt a megfelelő Szívtranszplantációs és Szívelégtelenségi Intenzív Osztály kialakítása, valamint a megfelelő eszköz- és humánerőforrás-fejlesztés. Jelenleg már a teljes mechanikus keringéstámogatási arzenállal rendelkezünk, aminek köszönhetően minden indikációban és minden stratégiában ellátást tudunk biztosítani mind rövid, mind közép-, mind pedig hosszú távon a végleges műszívbeültetéssel bezárólag. Munkánkban megvizsgáltuk az elmúlt 5 évben végzett extracorporalis membránoxigenátor (ECMO-) beültetéssel szerzett eredményeinket. Klinikánkon 2012 és 2017 között összesen 140 betegnél alkalmaztunk mechanikus keringéstámogatást, valamennyi esetben konvencionális terápiával nem stabilizálható szívelégtelenség esetén. ECMO-terápiát 111 alkalommal végeztünk: szívátültetést követően 33 alkalommal, 18 alkalommal szívműtét utáni postcardiotomiás szindróma miatt, 37 esetben akut myocardialis infarctus utáni akut keringési elégtelenség miatt, 14 alkalommal végstádiumú szívelégtelen betegek akut keringésmegingása miatt, 4 esetben súlyos légzési elégtelenség, 1 esetben gyógyszermérgezés miatti malignus ritmuszavar, 3 esetben szövődményes katéteres aortaműbillentyű-implantáció állt a háttérben. A 2018. első félévi adataink a korábbi adatok és indikációk tendenciáját tükrözik, az esetszám jelentős emelkedésével. Eredményeink szerint a terápia összesített mortalitása 46% volt. A mechanikus keringéstámogatás eredményeinek vizsgálatakor elengedhetetlen a paradigmaváltás. A mortalitási adatokat nézve betegeink felét elveszítettük, ugyanakkor ebben a betegcsoportban a betegek 100%-a meghalt volna a konvencionális terápia mellett, vagyis az ECMO-terápia sikerességének megítélésekor nem a mortalitási, hanem a túlélési adatokat kell tekinteni. Orv Hetil. 2018; 159(46): 1876–1881. | Abstract: The mechanical circulatory support (MCS) program of the Semmelweis University Heart and Vascular Centre has become established over the last five years. The main requirements of our MCS program to be developed first were the Heart Transplantation and Heart Failure Intensive Care Unit and a well trained medical team. The wide range of mechanical circulatory support devices provides suitable background for the adequate treatment of our patients in all indications. In this review, we present our results related to extracorporeal membrane oxygenation (ECMO) supports performed in the last five years. Between 2012 and 2017, we applied MCS support in 140 cases, among them 111 patients received ECMO support. The leading indications of ECMO support were the following: primary graft failure after heart transplantation (33 cases), postcardiotomy cardiogenic shock (18 patients), acute decompensation of end-stage heart failure (14 patients), acute myocardial infarction complicated with refractory cardiogenic shock (37 patients), cardiogenic shock developed after transcatheter aortic valve implantation (3 patients), malignant arrhythmia due to drug intoxication (1 patient) and acute respiratory distress syndrome (4 cases). The mortality of patients receiving ECMO support was 46%. The analysis of the results of ECMO support needs to change our approach. The mortality results show that we lost the half of our patients. However, the mortality in the conventionally treated patients would have been 100% without ECMO. In fact, we could save the life of half of these patients. Orv Hetil. 2018; 159(46): 1876–1881