The prevalence of orthostatic hypotension (OH) in an elderly outpatient population was assessed according to the most common criteria given in the literature. Short-term OH variability and relationships between OH and its known risk factors were also analysed. A sample of 3858 elderly outpatients aged 65 years or more was randomly recruited by 444 Italian general practitioners. The patients' blood pressure (BP) and heart rate were recorded in both lying and standing positions at two visits 7 days apart. Three definitions were used for the identification of OH: (1) a decrease in systolic BP greater than 20 mmHg (SOH); (2) a decrease in both systolic (greater than 20 mmHg) and diastolic (greater than 10 mmHg) BP (SDOH); (3) any decrease in systolic BP associated with symptoms (SyOH). Prevalence figures for SOH were 13.8% at the first and 12.6% at the second visit, and respectively 5.3 and 4.8% for SDOH, 14.1 and 11.8% for SyOH. All the criteria were met by less than 2% of subjects at each visit. The diagnosis of OH was confirmed at both visits in 36.3% of cases for SOH, in 25.7% for SDOH, and in 43.9% for SyOH. Each different OH definition identifies a population subgroup characterized by different sets of risk-factors. The presence and prevalence of OH is difficult to define because different people may be identified by the currently accepted criteria or by the same criterion over a short time.

Donor skin and dermal grafts are used in several types of loss of substance for different clinical purposes. As biological physiological medication, donor skin grafts can promote re-epithelization, shorten healing time, alleviate pain and protect dermal and subcutaneous structures such as cartilage, tendons, bones and nerves. Though a great variety of dermal matrices and skin equivalents, both synthetic and semisynthetic, are now available for wound treatment, viable human skin allografts remain an important therapeutic choice for extensive deep burns and hard-to-heal wounds. In such cases, viable skin allografts have significantly better clinical outcomes than unviable human-derived allografts or synthetic medications. The demand for human-derived skin bioproducts continues to be a reason for the existence of skin banks. Skin bank organization is complex and requires continuous updating. Careful donor selection, thorough microbiological and serological donor screening for transmissible diseases and rigorous quality control during tissue preparation are necessary to minimize the risk of transmission of pathogenic agents. Skin banks must also observe standardized reproducible procedures to ensure tissue traceability and biological safety in all phases of processing and to avoid new biological contamination. Constant training and periodic checks are needed to keep skin bank operators attentive and responsible. Finally, skin banks should guarantee collection and storage of highly viable skin. Here, we discuss available tissue storage methods and the different types of skin bioproducts.

No abstract

No abstract

No abstract