Moreover, approximately 25% of the travelers indicated that traveling by bus or car seems to have a risk of TT Veliparib purchase at least as high as those of air travel. Therefore, travelers seeking medical advice

before any LHT might also expect to get some recommendation to prevent TT not only when intending air travel but also before LHT by bus or car. According to our data, the major trigger for the kind of recommended TP was travelers’ individual TR. Therefore, physicians seem to give appropriate recommendations to the travelers although there were still more than 10% of the travelers with a high TR according to both recommendations24,25 which had not been advised to perform any specific prophylaxis (Figures 1 and 2). A limitation of our study was that the TR of the traveler see more was assessed by medical history taking during the consultation. Therefore, the physicians might have missed some thrombotic risks of the travelers which could have led to a different classification. However, the aim of our study was to give insight in the daily practice. Therefore, assessing travelers’ TR only by their medical history and not performing additional laboratory tests seemed

to be more appropriate to us in our approach. The kind of travel and the duration of travel did not influence the recommended TP which, on the first glance, seemed to be surprising to us as air travel and especially longer journeys being placed in a seated position had been found to be associated

with higher risk of TT as already mentioned above.5,6,9,10,16–20 This result, however, should be taken with caution. With regard to the mode of travel, more than 80% of the travelers seeking medical advice planned Low-density-lipoprotein receptor kinase LHT by air which might cause a bias. Nevertheless, this result seems to be in accordance with the majority of published data on the pathogenesis of TT. Overall, being seated in a cramped position seems to be the most important risk factor for the development of a thrombotic event irrespective of the means of transport. The specific environment (eg hypobaric hypoxia) in the aircraft might not further increase the risk of TT in general and for all travelers.5,26,27 However, for travelers with preexisting thrombotic risks, the interaction of hypobaric hypoxia being present in aircrafts and prothrombotic alterations may induce the development of a thrombotic event.5 Statements with regard to the duration of travel should also be handled carefully, because it had been categorized in three groups only (<5, 5–8, and >8 h) with most of the travelers in the >8 hours category (67%). However, when we planned this study, we hypothesized that a significant influence between the duration of travel and the given recommendation might exist. Only LHT being placed in a seated position of 5 hours or more seems to be associated with an approximately doubled increased risk for TT.