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Background: After an acute deep venous thrombosis (DVT) of the lower limb, 20% to 63% of patients develop post-thrombotic syndrome (PTS). In this review, we address the efficacy of compression therapy in the treatment of acute DVT of the lower limb, and for the prevention of PTS. Methods: 12 randomized controlled trials (RCTs) and one meta-analysis, with a total of 3751 patients, were identified in a structured literature search. Results: Two RCTs showed that adding compression therapy to drug treatment in the first 9 days of the acute phase of lower limb DVT led to more rapid pain relief (p<0.050) and less swelling (remaining difference in circumference, 1 cm versus 3 cm, p<0.050). As for the prevention of PTS, four RCTs showed a short-term benefit or no benefit of compression therapy. In three further RCTs, medical compression stockings (MCS) brought about a 16% to 27% absolute reduction of the frequency and severity of PTS (47% vs. 20 %, p<0.001; 40% vs. 21% (95% confidence intervals [29.9; 50.1] and [12.7; 29.5], respectively; and 58% vs. 42%, relative risk [RR] 0.73 [0,55; 0.96]). The benefit of MCS was also confirmed in a recent meta-analysis (RR 0.66 [0.44; 0.99], I2 = 88%). Thigh-length MCS were not superior to knee-length MCS for the prevention of PTS (33% vs. 36%, hazard ratio [HR] 0.93 [0.62; 1.41]). Individual, symptom-oriented tailoring of the duration of treatment was not inferior to a fixed treatment duration of 24 months (29% vs. 28%; odds ratio [OR] 1.06 [0.78;1.44]). Conclusion: Compression therapy relieves symptoms in acute DVT and lessens the frequency and severity of PTS. It is therefore recommended as standard treatment. [ABSTRACT FROM AUTHOR]

The dyeing behavior of yarns is an important quality criterion for the textile industry. Different depth of shade during the production of textiles is caused by different dyeing behavior and leads to textiles of lower quality. The consequence is intensive dyeability testing to divide the PET yarns into different categories of dyeability. [ABSTRACT FROM AUTHOR]

Temperate forests cover 25% of the world's forest area and most of them are managed for timber production. To increase yields, native deciduous trees have been commonly replaced by fast-growing conifers, especially in Western and Central Europe. Despite the importance of forest soils for a variety of ecosystem functions, the effects of forest management intensity on soil biological processes have not yet been sufficiently understood. Using a standardized sampling protocol that covers 200 plots across four regions with different abiotic site conditions, our study aims at disentangling the effects of individual components of forest management intensity such as (i) share of native deciduous trees, (ii) timber harvesting volume, and (iii) natural deadwood volume on soil biological processes. Our findings indicate that the effects of management practices on soil biological processes are as important as abiotic factors, such as subsoil pH value and soil texture. Piecewise structural equation modeling revealed that forest management has both direct and indirect effects on soil biological processes via humus form and topsoil pH. Generally, the ratio of deciduous and coniferous trees had the most significant effect on nutrient cycling and soil properties, followed by nutrient extraction through timber harvesting and natural deadwood volume. The strength of the observed effects was modified by regional variations in climate, topography, and bedrock. Our findings underline the high diagnostic value of humus form as an indicator of biological processes in mineral topsoil (particularly pH, C/N, and microbial characteristics can be predicted) that can guide forest managers in evaluating soil quality and identifying management impacts., (© 2024 The Author(s). Global Change Biology published by John Wiley & Sons Ltd.)

Women have a higher lifetime risk of venous thromboembolism (VTE) than men. Hormone-associated risk factors such as pregnancy, contraception and hormone replacement therapy contribute significantly to this. Contraception with combined hormonal contraception increases the risk of VTE in young women, with the extent of the increase in risk being determined by the level of the estrogen dose and the progestin component. After hormone associated VTE, temporary anticoagulation is sufficient in many cases, provided there are no additional persistent risk factors. Affected women should be informed that the risk of VTE recurrence is increased in a subsequent pregnancy and usually requires VTE prophylaxis with low molecular weight heparin during pregnancy. If the suspicion of recurrent VTE arises during pregnancy, diagnostics must be carried out promptly so that deep vein thrombosis and/or pulmonary embolism can be reliably confirmed or ruled out., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

In the recently updated German S2k Guideline "Diagnostics and Therapy of Venous Thrombosis and Pulmonary Embolism," a new chapter was incorporated about recurrent venous thromboembolism (VTE) in patients on anticoagulation treatment. Despite the high efficacy of anticoagulation in most patients, approximately 2% experience a recurrent VTE event while receiving anticoagulant drugs. The proper diagnosis of the recurrent VTE is important and possible only with the knowledge of localization and thrombus burden of the primary VTE event. Possible reasons for recurrent VTE events in patients on anticoagulation are non-adherence to medication, sub-therapeutic drug levels due to resorption disorders or drug interactions, or concomitant disease with high thrombogenicity. Cancer is the most common underlying disease, but it is important to investigate and understand possible other causes whenever a breakthrough VTE event occurs. This results in the recommendation that in patients with VTE recurrence on therapeutic anticoagulation, in particular, the presence of malignant disease, antiphospholipid syndrome, and rare diseases like paroxysmal nocturnal hemoglobinuria or Behçet's disease should be considered. For VTE recurrence during heparin therapy, heparin-induced thrombocytopenia type II needs to be ruled out, even if platelet counts are within the normal range. Although the mechanisms of recurrence on anticoagulation can be evaluated in a certain degree, clinical evidence for the management of recurrent VTE in anticoagulated patients is minimal and mainly based on expert opinion. Switching anticoagulant medication and intensifying anticoagulant treatment are possible options., Competing Interests: R.K. received research grants from Bayer, CSL Behring, Leo Pharma, Octapharma and honoraria from Bayer, CSL Behring, Daiichi Sankyo, Leo Pharma, Novo Nordisk, Octapharma, Pfizer, Sanofi, Takeda, Viatris.H.R. received honoraria from Bayer, Bristol-Myers Squibb/Pfizer, Viatris.J.B.W. received research grants from Bayer, Daiichi Sankyo, LEO, Pfizer, Alexion, AstraZeneca and honoraria from Bayer, Daiichi Sankyo, LEO, Pfizer, Alexion, AstraZeneca, Norgine, Sanofi.B.L. received honoraria from Bayer, Bristol-Myers Squibb, Daiichi Sankyo, LEO Pharma, Lumira DX, Pfizer, Sanofi, Viatris., (Thieme. All rights reserved.)

It is an honor and a great pleasure for us to be guest editors for this special issue of Hämostaseologie - Progress in Haemostasis , which addresses important issues surrounding the complex of venous thromboembolism (VTE). In February 2023, the revised guideline on "Diagnostics and Therapy of Venous Thrombosis and Pulmonary Embolism" has been published on the website of the Association of the Scientific Medical Societies in Germany (AWMF)1. This guideline was drawn up under the leadership of the German Society of Angiology (DGA), and representatives of 17 scientific societies contributed to its content. As an S2k guideline, its recommendations are consensus based and are the result of a systematic review and evaluation of current evidence and consideration of the benefits and harms of diagnostic and therapeutic options. In this special issue, guideline authors provide a comprehensive overview of selected guideline topics which might be of clinical relevance to our readers and our community of haemostaseologists., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Patients with cancer are prone to develop venous thromboembolism (VTE) with negative impact on quality of life, morbidity, and mortality. Treatment of established VTE is often complex in patients with cancer. Treatment of cancer-associated VTE (CAT) basically comprises initial and maintenance treatment, for 3 to 6 months, secondary preventions, and treatment in special situations. Therapeutic anticoagulation is the treatment of choice in CAT. In addition to the efficacy and safety of low-molecular-weight heparin (LMWH) that had been recommended for decades, direct oral anti-factor Xa inhibitors, a subgroup of direct oral anticoagulants (DOACs), demonstrated their advantages along with the accompanying concerns in several randomized controlled treatment trials of CAT. The latest guidelines, such as the German AWMF-S2k Guideline "Diagnostics and Therapy of Venous Thrombosis and Pulmonary Embolism," agree with each other on most aspects with respect to the treatment of CAT. Encompassing recent clinical studies, and meta-analyses, as well as the focus on some special management aspects of CAT, the objective of this review is to present a current overview and recommendations for the treatment of CAT., Competing Interests: HR took participation on a Data Safety Monitoring Board or Advisory Board and he got payment or honoraria for lectures, presentations, speakers bureaus or educational events from Bayer, Bristol-Myers Squibb, Pfizer and Viatris., (Thieme. All rights reserved.)

Deep vein thrombosis (DVT) and pulmonary embolism (PE) are the most common manifestations of venous thromboembolism (VTE). Most DVTs affect the lower-extremity veins. Since the symptoms of DVT are non-specific, a prompt and standardised diagnostic work-up is essential to minimise the risk of PE in the acute phase and to prevent thrombosis progression, post-thrombotic syndrome and VTE recurrence in the long-term. Only recently, the AWMF S2k guidelines on Diagnostics and Therapy of Venous Thrombosis and Pulmonary Embolism have been revised. In the present article, we summarize current evidence and guideline recommendations focusing on lower-extremity DVT (LEDVT). Depending on whether the diagnostic work-up is performed by a specialist in vascular medicine or by a primary care physician, different diagnostic algorithms are presented that combine clinical probability, D-dimer testing and diagnostic imaging. The diagnosis of ipsilateral recurrent DVT poses a particular challenge and is presented in a separate algorithm. Anticoagulant therapy is an essential part of therapy, with current guidelines clearly favouring regimens based on direct oral anticoagulants over the traditional sequential therapy of parenteral anticoagulants and vitamin K antagonists. For most DVTs, a duration of therapeutic-dose anticoagulation of at least 3 to 6 months is considered sufficient, and this raises the question of the risk of VTE recurrence after discontinuation of anticoagulation and the need for secondary prophylaxis in the long-term. Depending on the circumstances and trigger factors that have contributed to the occurrence of DVT, management strategies are presented that allow decision-making taking into account the individual bleeding risk and patient's preferences., Competing Interests: BL took participation on a Data Safety Monitoring Board or Advisory Board from Bayer Vital, Bristol-Myers Squibb, Lumira DX, Pfizer and Viatris. She got Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Bristol-Myers Squibb, Daiichi Sankyo, LEO Pharma, Pfizer, Sanofi and Viatris. She got consulting fees from Bayer Vital, Bristol-Myers Squibb, Lumira DX, Pfizer and Viatris., (Thieme. All rights reserved.)

For the diagnosis of a lower-extremity deep vein thrombosis (LEDVT), venous duplex ultrasound is the method of first choice. If a qualified ultrasonography is not timely available, D-dimer testing, and limited ultrasound protocols (point-of-care ultrasound, POCUS) can contribute to therapeutic decision-making when clinical probability is low. A DOAC-based treatment regimen is preferable to a vitamin K antagonist for both acute therapy and secondary prophylaxis of venous thromboembolism (VTE). Treatment with DOACs is unproblematic up to a body weight (BW) of 120 kg or a body mass index (BMI) of 40 kg/m². Weight restrictions are no longer recommended for apixaban and rivaroxaban, but determination of DOAC trough and peak levels is recommended in the extremely obese and patients after bariatric surgery. In cancer-associated VTE, the direct factor Xa inhibitors are a good and safe alternative to low-molecular weight heparins (LMWH) for many patients; the adherence to oral therapy is also higher. Meaningful initial documentation and structured follow-up after LEDVT and pulmonary embolism (PE) are important in order to make an individualized risk-benefit assessment at the end of the therapy phase with regard to continued pharmacological secondary prophylaxis and to reassess patients' symptoms indicating post-thrombotic syndrome (PTS) or chronic thromboembolic pulmonary hypertension (CTEPH)., Competing Interests: BL: Vortrags- und/oder Beratertätigkeit: Bayer, BMS, Daiichi-Sankyo, LEO, Pfizer, Viatris/Mylan, AWMF, IQWIG KM: Vortragstätigkeit: AMGEN, Bayer, BMS, LEO, Pfizer RK: Vortrags- und/oder Beratertätigkeit: Bayer, Daiichi Sankyo, LEO, Pfizer, BMS, Sanofi, (Thieme. All rights reserved.)

Thrombosis and embolism are among the most common causes of death worldwide and, in addition to venous thromboembolism with the two main manifestations of deep venous thrombosis and pulmonary embolism, also include arterial thrombotic disease such as myocardial infarction, stroke and systemic arterial embolism. It is often the interaction of several predisposing factors that leads to the formation of an intravascular thrombus. Changes in the vascular wall, the blood flow and the composition of the blood (Virchow's triad) play a decisive role in both the arterial and venous vascular systems. The management of thromboembolic diseases requires a dedicated clarification of the cause and classification of the disease process in order to minimize the risk of recurrence and embolic complications through differentiated antithrombotic therapy. For this purpose, a risk-benefit analysis based on the individual case and regular reassessment are of particular importance. In this article, the pathophysiological concepts of venous and arterial thrombosis and the main therapeutic implications resulting from this are reviewed., Competing Interests: Linnemann: Forschungsunterstützung: Bayer Vital, Leo Pharma, Viatris; Vortragstätigkeit und Unterstützung von Veranstaltungen: Bayer Vital, Bristol-Myers Squibb, Daiichi Sankyo, LEO Pharma, Pfizer, Sanofi, Siemens Healthcare; Beratertätigkeit: Bayer Vital, BMS, Boehringer Ingelheim, Lumira DX, Pfizer. Espinola-Klein: Vortragstätigkeit, Beratertätigkeit, Unterstützung von Veranstaltungen: Amarin Germany GmbH, Amgen GmbH, Bayer Health Care, Boehringer Ingelheim, Bristol-Myers Squibb, Cordis, Daiichi Sankyo, Novartis Pharma, Pfizer Pharma GmbH, Sanofi-Aventis GmbH., (Thieme. All rights reserved.)

Competing Interests: Linnemann: Forschungsunterstützung: Bayer Vital, Leo Pharma, Viatris; Vortragstätigkeit und Unterstützung von Veranstaltungen: Bayer Vital, Bristol-Myers Squibb, Daiichi Sankyo, LEO Pharma, Pfizer, Sanofi, Siemens Healthcare; Beratertätigkeit: Bayer Vital, BMS, Boehringer Ingelheim, Lumira DX, Pfizer. Espinola-Klein: Vortragstätigkeit, Beratertätigkeit, Unterstützung von Veranstaltungen: Amarin Germany GmbH, Amgen GmbH, Bayer Health Care, Boehringer Ingelheim, Bristol-Myers Squibb, Cordis, Daiichi Sankyo, Novartis Pharma, Pfizer Pharma GmbH, Sanofi-Aventis GmbH.