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At present, most common initial treatment of deep vein thrombosis is anticoagulant therapy with i.v. heparin. Recently, some reports in literature suggest the efficacy of low molecular weight heparin fractions administered also to outpatients. Thrombolytic therapy as compared to heparin seems to be favorable as for the valvular integrity and function with minor postphlebitic sequels. It is however burdened with a higher incidence of hemorrhagic complications. Probably, it should be reserved for those patients with massive phlebothrombosis or phlebothrombosis associated with relevant clinical signs. At present, it has not definitely been proved that one of the commonly used drugs, streptokinase, urokinase and r-TPA affords substantial advantages in terms of efficacy and safety. Locoregional administration by a catheter inserted into the thrombus with the protection of a caval filter enhances the efficacy of thrombolytic agents, even if data on long-term results of this method are still lacking. Discordant opinions exist on the validity of thrombectomy. As a prophylaxis of pulmonary embolism, thrombus removal has been replaced by caval filters. At present it is commonly indicated for phlegmasia coerulea dolens. In the other forms, even if the vascular patency is restored in a good percentage of cases, it is not similarly effective in preventing the postphlebitic syndrome. For these reasons it should be applied in selected cases.

Venous thromboembolism is a relevant social and health care problem for its high incidence, pulmonary embolism-related mortality, and long-term sequels which may be disabling. In the United States, there are at least 100,000 deaths per year from pulmonary embolism, found in over 10% non selected autopsy findings. The use of noninvasive diagnostic procedures has improved our knowledge on venous thromboembolism, with reference to surgery in particular. Deep vein thrombosis represents one of most common postoperative complications. Fatal pulmonary embolism is observed at least in one over thousand operated patients. From data of literature and in the authors' experience, the incidence of pulmonary embolism is decreasing in last years. Deep vein thrombosis is caused by several factors associated with Virchow's triad. Its evolution is site-related. While deep vein thrombosis of the calf can be considered a "benign" pathological condition for the incidence and severity of the embolic complication, as well as for the long-term outcomes, when the proximal venous trunks are involved, it is related to a high incidence of severe pulmonary embolism and relevant postphlebitic sequels. Pulmonary embolism is often the first manifestation of thromboembolism. Mobilization of thrombi is easier in the first phases, when they do not adhere as yet to the venous wall. Of 52 consecutive cases of pulmonary embolism, 21% occurred in the absence of signs or symptoms of deep vein thrombosis. In rare cases, thrombosis may be massive with total block of venous return flow and onset of ischemia. These forms have a severe prognosis apart from the embolic complication.

Anticoagulant treatment with heparin is definitely the most widely used therapeutic modality in pulmonary embolism. Its efficacy is conditioned by the need for an adequate level of anticoagulation to be rapidly attained. Thrombolytic therapy, as compared to heparin seem to favour a more rapid pertusion of obstructed arteries, a decrease in mean pulmonary pressure, a more rapid improvement in right ventricular function, with however no significant decrease in mortality. It is indicated in case of massive pulmonary embolism with or without shock or in case of perfusion defects in at least one lobe.

Microleakage of class V restorations in posterior teeth was studied, using different types of materials and cavity varnish. Significantly less microleakage was recorded by applying some layers of cavity varnish and using spherical alloy.

The case of a patient with myelofibrosis who developed polycythaemia vera after corticosteroid therapy, splenectomy and Busulphan therapy is reported. The possible pathogenetic role of each of these agents is discussed.

HIV infection prevalence and CD4/CD8 ratio alterations in asymptomatic heroin abusers. Authors evaluated HIV infection prevalence and presence of possible CD4/CD8 ratio alteration in a asymptomatic heroin abusers' sample. Drug addicts consecutively arrived to Local Health Unit No 12-Drug Addicts Advisory Unit. In this sample, there was a 41% prevalence of HIV infection and significant changes, not attributable to HIV infection, in the CD4/CD8 ratio were not found by comparison with 17 healthy controls.

Twenty-five scleroderma patients have been studied to evaluate blood coagulative and fibrinolytic parameters. An increase in FVIII related activities and a reduction in fibrinolytic activity was observed. These changes may be related to the endothelial damage present scleroderma patients I the consequent "in loco" activation of blood coagulation may cause the microthrombosis that is very often observed in the earliest phases of the disease.

In order to investigate the factor VIII complex trend in atherosclerosis, 96 patients suffering from atherosclerosis, divided in 6 groups (angina pectoris, previous myocardial infarction, transient ischemic attacks, previous cerebral thrombosis, diabetes without symptoms of vascular injury and diabetes with vascular complications), were studied and compared to a control group of normal subjects. Plasma levels of Factor VII Coagulant (VIII C), Factor VIII-Related von Willebrand Factor (VIII-RWF) and Factor VIII-related Antigen (VIII ARg) were measured in all subjects. A significant rise of VIII RAg was noticed in all groups of patients as compared to the control group: this increase appears to be related to the severity of vascular injury. A significant rise of VIII RWF, parallel to the VIII RAg increase, was also noticed in all groups. Besides, all groups of patients showed a significant and uniform increase of VIII C. The average ratio of VIII RAg/VIII C was raised in all groups, except diabetics without complications; but the increase was statistically significant only in those patients with a heavier vascular injury which is related to the marked rise of VIII RAg in such clinical situations. The findings of this study are discussed in relation to the literature data. The significance of the determination of VIII RAg/VIII C ratio and of the VIII RAg assay as methods for monitoring the severity of the vascular injury in atherosclerosis are also discussed.

Neurological involvement in acute myeloid leukaemia has become more common in recent years. The increase seems to be related to the longer survival rates made possible by more intensive treatment protocols. The predictive elements appear to be the tumour mass, cytomorphological variety M5, splenomegaly and serum LDH. Prophylaxis with craniospinal radiotherapy or spinal chemotherapy does not modify the course of the leukaemia or diminish the frequency of neuromeningeal complications. Six cases of AML involving the central nervous system were examined, two at onset and 4 at first relapse. Neuromeningeal complications are to be feared since they are extremely difficult to eradicate completely and the prognosis is extremely unfavourable especially if a bone marrow relapse occurs simultaneously.

The Authors point out principal patology find on 354 childs, among these result prevalent incidence of caries and occlusal patology. The Authors emphasize scarce importance assigned to primary dentition by examined population.

The recent studies, related in medical literature, indicate a reduced activity of fibrinolysis in patients with low back-pain caused by multiple factors (lumbar disc disease, post-laminectomy, post myelography) and suggest a new pathogenetic hypothesis of this disease and new therapeutic implications. The authors conducted a research based on the study of fibrinolysis in patients affected by post-surgical lumbar adhesive syndrome, with the aim of finding, eventually, a relationship between reduced fibrinolytic activity and clinical symptoms. The results are referred and discussed.