In a prospective study, 280 patients with phlebographically proven deep venous thrombosis intravenous heparin infusion; 224 of the patients were subjected to control phlebography after 5–8 days of treatment. Females above 70 years showed least phlebographic improvement despite similar heparin dosage and heparin activity. Heparin activity in daily drawn blood samples was determined by four different assays. Chromogenic substrate (CS) assay (Coatest heparin), activated partial thromboplastin time (Cephotest), and thrombin time with recalcified plasma (CaTT) showed weak but significant correlations with thrombus resolution judged by phlebography (p=0.004, 0.003 and 0.018, respectively). A linear prediction equation showed that the phlebographic result was about equally influenced by the mean dose and by the result of any of the three heparin assays. Thrombin time with citrated plasma showed no correlation. CS assay and CaTT showed significantly lower mean heparin activity in patients with (n=13) than without clinically diagnosed pulmonary embolism (p=0.012 and 0.001, respectively).
ABSTRACT. Prosthetic valve implantation was performed in 36 patients with bacterial endocarditis. Thirty‐two of them were in functional class III or IV (NYHA). The early mortality rate was 16.7%. In six patients perivalvular fistulas occurred and were of haemodynamic significance in three of them. At follow‐up after 44 months on average, the clinical condition was excellent (functional class I or II) in 20 of the 26 survivors. The results encourage an active attitude towards surgical intervention in patients with valvular insufficiency due to bacterial endocarditis.
Hypoglycemia was induced in ten healty male volunteers during medication with atenolol, metoprolol and propranolol. The p-blockers abolished the tachycardia during hypoglycemia. In some subjects bradycardia, and in two nodal bradycardia was observed on propranol. The physiologic blood pressure responses were dampend during the fll-selective blockade. With propranolol a rise in blood pressure was recorded, in two subjects up to 160/105. The blockers had no effect on degree of hypoglycemia or glucose recovery.
Haemostasis parameters alone are often insufficient in distinguishing between disseminated intravascular coagulation (DIC) and liver disease. We have determined the concentration of five additional plasma proteins in 6 patients with DIC and 10 patients with liver disease. All patients had antithrombin III (AT) and normotest (NT) levels at 60 per cent or lower. Prealbumin and albumin were clearly subnormal in all patients with similar mean values in both two groups. It is suggested that this might reflect insufficient protein synthesis even in the patients with DIC. The mean fibronectin concentration was somewhat lower in DIC than in the group with liver disease. C reactive protein (CRP) and the leucocyte derived protein LI were much higher in the DIC patients, probably reflecting the underlying infection.
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