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Over the past quarter century, tremendous technological advances have been made in bone marrow and solid organ transplantation. Despite these advances, an enduring problem for the transplant recipient is infection. As immunosuppressive regimens have become more systematic, it is apparent that different pathogens affect the transplant recipient at different time points in the posttransplantation course, since they are influenced by multiple intrinsic and extrinsic factors. An understanding of this evolving risk for infection is essential to the management of the patient following transplantation and is a key to the early diagnosis and treatment of infection. Likewise, diagnosis of infection is dependent upon the quality of laboratory support, and services provided by the clinical microbiology laboratory play an important role in all phases of clinical transplantation. These include the prescreening of donors and recipients for evidence of active or latent infection, the timely and accurate microbiologic evaluation of the transplant patient with suspected infection, and the surveillance of asymptomatic allograft recipients for infection. Expert services in bacteriology, mycology, parasitology, virology, and serology are needed and communication between the laboratory and the transplantation team is paramount for providing clinically relevant, cost-effective diagnostic testing.

In patients undergoing total knee replacement we carried out a longitudinal cohort study to determine the efficacy and safety of a postoperative autologous blood reinfusion system, as an alternative to homologous, banked blood transfusions. Fifty patients received reinfusion of unwashed, filtered, shed blood, supplemented with banked blood transfusions as required. A control group of 50 patients in whom standard suction drains were used received homologous blood transfusions as required. In the study group, the homologous blood requirement was reduced by 80%. There was no significant difference in the postoperative haemoglobin values between the two groups. None of the patients developed any adverse reactions after reinfusion. Chez des patients opérés par arthroplastie totale du genou nous avons fait une étude par cohorte longitudinale pour déterminer l'efficacité et la sécurité d'un système de réinfusion du sang de drainage postopératoire, comme une alternative aux transfusions de sang homologue. Cinquante patients ont eu une reinfusion du sang autologue filtré, complété par des transfusions de sang homologue selon les besoins. Un groupe témoin de 50 patients avec drainage standard a reçu des transfusions de sang homologue comme nécessaire. Dans le groupe de l'étude, la nécessité de sang homologue a été réduite de 80%. Il n'y avait aucune différence notable des taux postopératoires d'hémoglobine entre les deux groupes. Aucun des malades n'a présenté d'effet secondaire après reinfusion.

A case of recurring digital fibroma of childhood is presented. The natural history of this condition over several years is documented. The literature is reviewed, with particular reference to the management of the condition. Surgeons should be aware of the clinical features and the principles of management of this condition, as patients may be referred because of associated finger or toe deformities.

A case of recurring digital fibroma of childhood is presented. The natural history of this condition over several years is documented. The literature is reviewed, with particular reference to the management of the condition.Surgeons should be aware of the clinical features and the principles of management of this condition, as patients may be referred because of associated finger or toe deformities.