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Morbidity and mortality from cardiovascular disease are more common in colder seasons, especially in elderly people. Previous studies have shown higher fibrinogen levels in old people in the winter months. The present studies of haemostatic factors in relation to age and season have shown that fibrinogen, tissue plasminogen activator (tPA), protein S and protein C levels are higher in old (aged 75 years and over) than young (aged 25-30 years) subjects while antiplasmin levels are lower in old people. Antiplasmin and protein C levels are lower in winter in both young and old while plasminogen activator inhibitor (PAI) is higher, and tPA higher in old people only. This study illustrates the complex interrelationships of the haemostatic system and may suggest that in 'successful' elderly people the fibrinolytic system may alter to maintain the delicate balance between thrombogenic and fibrinolytic activity. Nevertheless, the results presented here suggest that both old age and cold weather may increase the risk of atherothrombotic disease.

Red blood cell deformability (RCD) was measured by a filtration technique in 12 patients with sudden sensorineural deafness. Five patients had reduced deformability, including 3 out of 4 patients with a recent upper respiratory tract infection. This may be an important factor in sudden deafness, more likely as a complicating factor of other disorders rather than as a truly primary aetiology. Factors and diseases which alter RCD are discussed and a possible link between the viral and vascular causes of idiopathic sudden deafness is suggested. While several lines of therapy seem promising there is still no clinically proved method for improving RCD. With the development of an acceptable therapeutic regimen, we feel that the possibility of reduced RCD should be considered and that a deformability test be included in the work-up of patients with a sudden sensorineural hearing loss.

Using a simple filtration method, red cell deformability was measured in healthy control subjects and in patients with peripheral vascular disease. Impaired red cell deformability was demonstrated in patients with rest pain or gangrene and in patients with intermittent claudication. An improvement in red cell deformability was demonstrated after successful reconstructive vascular surgery in both patient groups. An improvement in red cell deformability was demonstrated in patients undergoing major limb amputation.