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The role of some so-called primary and secondary (or oligo-elements) elements in the physiopathology of the cardiocirculatory system has been well known from a number of years and they have been regularly included in the treatment protocols. Some, including K, Ca, Mg and Zn, are extremely well known and widely used in clinical practice. Recently, however, a growing number of studies have focused on the biological importance of other oligo-elements in the pathogenetic mechanisms of atherogenesis and its clinical manifestations. This study aimed to verify the exact role of free cobalt in the physiopathology of the chronic obstructive arterial diseases (COAD). A total of 80 patients affected by 2nd stage COAD were examined and the levels of some oligo-elements, including Co, were assayed. Constantly low levels were found (85% of cases) in relation to other oligo-elements studied (Cu, Zn, Mg, Ca). This findings is particularly interesting since it confirms the biochemical hypothesis of atherosclerosis according to which parietal damage plays a central role in the pathogenetic mechanism. Some enzymatic deficiencies, which lead to changes in membrane stability at the level of the endothelial cells, are closely related to the presence of tissutal and humoral peroxidation products. These peroxides (lipid peroxides), which are formed following the interaction of fatty acids with oxygen free radicals, have been identified by a number of studies as being responsible for endothelial damage. Several authors have shown that lipid peroxidation is involved in the atherogenic process through several mechanisms entailing monocytic activity and reduced prostacyclin (PG2) synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Seventeen cases of ischaemising phlebitis and 5 of venous gangrene are reported. Attention is given to the aetiopathogenetic factors that lead to massive thrombosis and dramatic progression of the disease: depression of vascular heparin, polyglobulia, serious dysproteinaemia, marked involvement of the arterial district, etc. Treatment may be medical or surgical, based on large doses of anticoagulants, low-weight dextrane and thrombolytic drugs, though the results expected are not always obtained. At present, early venous disobstruction with a Fogarty catheter, coupled with prolonged anticoagulant management is the best course. Prognosis is certainly better in ischaemia. When gangrene sets in, prognosis is particularly poor, even as far as survival is concerned, due to serious concomitant shock.