Platelet aggregation in response to ADP, collagen, ristocetin and polymerizing des‐AA fibrin monomers was studied in six patients in chronic, stable, renal failure on maintenance haemodialysis. Fibrin induced aggregation was markedly inhibited prior to but normalized after dialysis. ADP, collagen and ristocetin induced a normal aggregation response both before and after dialysis. The Ivy bleeding time remained prolonged after dialysis.
The streptokinase titrated initial dose (TID) was estimated in 312 patients consecutively admitted to a medical department in Oslo. 93 % had a TID below 250,000 IU, 97 % below 425,000 IU and 98.5 % below 650,000 IU. No differences were found between the two sexes. The highest values were found in patients 50–60 years old. Otherwise, no differences were found between different age groups from 10 to 90 years of age. Two patients with extremely high TID values were both anamnestically prone to streptococcal infections.
It is concluded that our standard initial dose of 250,000 IU of streptokinase is sufcient for the great majority of our patients. Pre‐treatment test for TID is recommended only when recent streptococcal infections are suspected.
In the presence of heparin and antithrombin III, activated factor VII was progressively inactivated. Inactivation occurred in plasma as well as in preparations of highly purified factor VII and antithrombin III. The inactivation process was slow, and could only be demonstrated at temperatures below 37° C. Neutralisation of heparin with polybrene (after incubation) did not lead to regain of factor VII activity, suggesting that inactivation is irreversible. Whether also non-activated factor VII is affected by heparin and antithrombin III, remains to be settled.
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