Patients recovering from an operation will often find themselves given elasticated stockings to wear and injections of subcutaneous heparin to undergo. These are ways of trying to prevent clots forming in the deep veins of the legs. Pulmonary thromboembolism caused by the migration of such clots remains a potentially fatal complication of surgery. Cancer can put patients at risk of venous thrombosis, but all too often, even when there is a family history of this condition, laboratory tests throw no light on the cause. That was the position until 1993. Since then, a series of studies, most notably from groups in Malmö Sweden, and Leiden, the Netherlands, has changed everything. Papers No. 3 and No. 5 are just two examples of the important publications from these groups.

The delicate, complex balance between coagulation and anticoagulation attracts both admiration and some wonderment that things do not go wrong more often. The...

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