Silver Trauma Review Clinic: a novel model of care to manage non-operative injuries in older patients.

Background: Increasing numbers of older patients are presenting to the ED following trauma. These patients require multidisciplinary care that the traditional trauma model fails to provide. A Silver Trauma Review Clinic (STRC) was developed in conjunction with the geriatric ED and multidisciplinary services to improve the post-discharge care of patients with non-operative traumatic injuries.

A new low frequency antigen Lia (Livesey).

Three examples of an antibody which detect a new low frequency antigen Lia (Livesey) are described. The antigen is shown to be inherited as an autosomal dominant character, its possible linkage with the Lutheran blood group system is discussed.

Formaldehyde induced anti-N: a possible cause of renal graft failure.

Treatment of human red cells with low concentrations of formaldehyde induces an antigenic change which makes them react very strongly with the anti-N sera found in certain patients treated by haemodialysis. This supports the idea that formaldehyde sterilisation of reusable home dialysers leads to the development of anti-N in these patients' sera. The clinical problems produced by this antibody are discussed together with ways of overcoming them.

Haemolytic disease of the newborn caused by anti-Lan antibody.

The first recorded example of anti-Lan associated with haemolytic disease of the newborn is reported. This emphasizes the importance of screening for atypical antibodies early in pregnancy, even though prophylactic use of anti-D immunoglobulin will eventually reduce the incidence of haemolytic disease due to anti-D antibody.