These guidelines were developed jointly by the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), and the Society for Healthcare Epidemiology of America (SHEA). This work represents an update to the

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Clinical practice guidelines for antimicrobial prophylaxis in surgery

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Clinical practice guidelines for antimicrobial prophylaxis in surgery.

Impaired wound healing in the elderly presents a major clinical and economic problem. With the aging population growing in both number and percentage, the importance of understanding the mechanisms underlying age-related impairments in healing is increased. Normal skin exhibits characteristic changes with age that have implications for wound healing. Additionally, the process of wound healing is altered in aged individuals. Although historically healing in the aged was considered defective, there is now consensus that healing in the elderly is delayed but the final result is qualitatively similar to that in young subjects.

Aging and wound healing.

Risk of cancer in renal-transplant recipients

Part I highlights the mechanisms of glomerular filtration and tubular reabsorption of plasma proteins, selected characteristics of urinary proteins based upon electrophoretic properties and recent advances in clinical laboratory analysis of proteinuria. Both structural characteristic of the glomerular capillary wall and molecular properties of plasma proteins are important determinants of glomerular filtration. Proteins filtered by the glomerulus subsequently appear in urine only after escaping the efficient mechanisms of tubular reabsorption. Albumin is one such protein and constitutes the major protein in normal urine although trace amounts of alpha, beta, and gamma globulins are also detectable. Several techniques of protein analysis have thus been developed to specifically measure albumin as well as other plasma proteins. Other methods have been adapted to measure total urinary protein content enabling the clinician to readily monitor renal function in health and disease. The second part of this review will consider conditions associated with proteinuria in both asymptomatic individuals and patients with renal disease. Asymptomatic proteinuria encompasses states of excess protein excretion during conditions of orthostasis, exercise, travel to high altitude of fever. Proteinuria during renal disease has received considerable interest as a means to monitor kidney function. It is therefore classified according to the type of damage incurred: (1) glomerular-type where large molecular weight proteins are excreted (2) tubular-type where small molecular weight proteins are excreted and (3) mixed-type characterized by both large and small molecular weight proteinuria.

Normal and abnormal aspects of proteinuria: Part I: Mechanisms, characteristics and analyses of urinary protein. Part II: Clinical considerations

Comparative results of cadaver and related donor renal homografts in man, and immunologic implications of the outcome of second and paired transplants.

Some urological aspects of 93 consecutive renal homotransplants in modified recipients.

The homotransplantation of kidneys and of fetal liver and spleen after total body irradiation.

The prolongation of functional survival of canine renal homografts by 6-mercaptopurine.

Serum samples collected pre- and post-transplant nephrectomy were screened for alloreactive lymphocytotoxins. Three patients demonstrated circulating anti-B cell antibodies with markedly increased cytotoxicity titers after nephrectomy, suggesting that there was active binding of antibodies within the renal allograft. Two of the postnephrectomy serum samples after absorption with platelets and B cells reacted by immunofluorescence with cultured primary kidney cells but not against B or T cells from the same donor. To clarify further the role of such alloreactive antibodies, eluates were prepared from 14 rejected renal allografts and were analyzed for reactivity to cultured primary kidney cells against different leukocyte targets and endothelial cells. Reactivity toward B cells and kidney cells was demonstrated with 80% of the eluates. Absorption experiments of the positive eluates demonstrated multiple types of alloreactive antibodies. In addition to anti-DR activity, eluates had antibodies reactive to kidney cell antigens, monocytes, macrophages, endothelial cells, and polymorphonuclear leukocytes. The demonstration of multispecific alloantibodies in eluates of rejected kidneys is consistent with an important role(s) in maintenance and/or rejection of the kidney allograft.

Hyung M. Lee

Papers

Comparative results of cadaver and related donor renal homografts in man, and immunologic implications of the outcome of second and paired transplants.

Some urological aspects of 93 consecutive renal homotransplants in modified recipients.

The homotransplantation of kidneys and of fetal liver and spleen after total body irradiation.

The prolongation of functional survival of canine renal homografts by 6-mercaptopurine.

Serological characterization of antibodies eluted from chronically rejected human renal allografts.