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INTRODUCTION: The impact of lameness on fertility in dairy cows has already been investigated, however predominantely in Holstein cows. The aim of this study was to evaluate the impact of lameness during the dry period, between calving and first service and between calving and conception (days open) on selected fertility traits in Austrian Fleckvieh cows. Locomotion scoring of dairy cows was performed during the course of routine performance testing in 2014 and 2015. Using the observed maximum locomotion score (MLSC) during pre- and postcalving periods, the cows were classified into three groups: cows never lame (MLSC 1), cows that showed MLSC 2, and cows with MLSC ≥3 during these defined periods. Data sets of 3,998 lactations of 3,058 Austrian Fleckvieh cows from 97 dairy herds could be evaluated. In several statistical models the fixed effects of MLSC (1, 2, ≥ 3), farm, year and season of calving, parity*age class at calving, and early fertility disorders were considered for analysis of the traits days from calving to first insemination, interval from first to last insemination, days from calving to conception and calving interval (CI), as well as the non-return-rate90 (NRR90). Mean lameness prevalence during the dry period was 19,43 %, and reached 27,70 % in the period between calving and conception. Lameness (MLSC ≥ 3) during the dry period significantly (P = 0,030) prolonged the period between calving and conception, and lameness (MLSC ≥ 3) during the period from calving to first service had a significantly detrimental effect on the periods calving to first insemination, days open and CI (P < 0,001). Further, highly significant associations (P < 0,001) in cows showing MLSC ≥ 2 during the period between calving and conception on all fertility traits were determined. Apart from lameness, farm, year and season of calving, parity*-age class at calving, early fertility disorders and, partly, the interaction of the latter two effects significantly (P.

INTRODUCTION: L'impact de la boiterie sur la fertilité chez les vaches laitières a déjà été étudié, mais principalement chez les vaches Holstein. Le but de cette étude était d'évaluer l'impact de la boiterie pendant la période de tarissement, entre le vêlage et la première saillie et entre le vêlage et la conception (« days open ¼) sur certains indices de fertilité chez les vaches autrichiennes Fleckvieh. La notation de la locomotion des vaches laitières a été effectuée au cours des tests de performance de routine en 2014 et 2015. À l'aide de la note de locomotion maximale observée (MLSC) pendant les périodes de pré-vêlage et de post-vêlage, les vaches ont été classées en trois groupes : vaches jamais boiteuses (MLSC 1), vaches ayant montré un MLSC 2 et les vaches avec MLSC ≥3 pendant ces périodes définies. Des ensembles de données de 3 998 lactations de 3 058 vaches autrichiennes Fleckvieh de 97 troupeaux laitiers ont pu être évalués. Dans plusieurs modèles statistiques, les effets fixes de la MLSC (1, 2, ≥ 3), de l'exploitation, de l'année et de la saison de vêlage, de la classe d'âge au vêlage et des troubles de la fertilité précoce ont été pris en compte pour l'analyse des caractéristiques de fertilité : jours du vêlage à la première insémination, intervalle de la première à la dernière insémination, jours du vêlage à la conception et intervalle de vêlage (IC), ainsi que taux de non-retour90 (NRR90). La prévalence moyenne de boiterie pendant la période sèche était de 19,43 % et atteignait 27,70 % entre le vêlage et la conception. La boiterie (MLSC 3) pendant la période tarie (P = 0,030) prolongeait significativement la période entre le vêlage et la conception et la boiterie (MLSC ≥ 3) pendant la période allant du vêlage à la première insémination avait un effet significativement néfaste sur les périodes vêlage-première insémination, « days open ¼ et IC (P < 0,001). De plus, des associations hautement significatives (P < 0,001) chez les vaches présentant une MLSC 2 pendant la période entre le vêlage et la conception sur tous les traits de fertilité ont été relevées. Hormis la boiterie, l'exploitation, l'année et la saison de vêlage, la classe d'âge au vêlage, les troubles de la fertilité précoce et, en partie, l'interaction de ces deux derniers effets a affecté de manière significative (P < 0,05) à très significative (P < 0,001) les caractères de fertilité étudiés. Des associations négatives significatives sur certains caractères de fertilité uniques et tous ceux étudiés ont été évaluées chez des vaches souffrant de MLSC ≥ 2, et en particulier de MLSC ≥ 3, pendant trois périodes définies avant et après le vêlage. La prévention ou la réduction de la boiterie chez les vaches présentant une MLSC2 pendant la période de tarissement et de « days open ¼ aurait probablement un effet bénéfique significatif sur la fertilité et le bien-être des vaches laitières.

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RATIONALE: The spread of foam sclerotherapy has resulted in the renaissance of sclerotherapy as a non-invasive treatment method for varicosis. An expanded European expert committee meeting in Tegernsee in April 2006 was prompted by new findings and continuous further development of the method and worked especially on the topics "The role of (duplex) ultrasound in Foam sclerotherapy" and "Evaluation of therapeutic effects of foam Sclerotherapy". It was felt that these criteria are"non-specific" to foam sclerotherapy and would possibly also be suitable for other endovenous ablative procedures. The organisers of the 2nd European Consensus Meeting on foam sclerotherapy (2nd ECMFS) were then asked to publish these recommendations in this separate publication. The entire recommendations of the 2nd ECMFS are published in an extensive overview in this journal (VASA 2008; 37; Supplement 71: 1-32). METHODOLOGY: The 29 participants were sent a comprehensive questionnaire in advance covering all the relevant aspects of foam sclerotherapy. The organisers drew up various preliminary statements on the basis of the results. During the meeting itself the participants revised and/or approved and/or rejected these statements. For the "non-specific" topics, two working groups were given the task of conducting the concluding assessment of these items. Their final results were presented in March and April 2007. RESULTS: For foam sclerotherapy, duplex ultrasound is important in pre-treatment diagnosis, treatment monitoring/guidance, post-treatment efficacy evaluation and surveillance. In the pre-treatment diagnosis of varicose veins, the exact localisation of the insufficient saphenous, communicating and perforating veins is important. Duplex ultrasound is the accepted gold standard for this purpose. The application of ultrasound imaging during foam sclerotherapy increases the safety of accessing the vein in certain indications, and it can help when making a decision concerning the foam volumes to be injected, the patients' position or specific movements the patients should perform. Following treatment, the findings of duplex ultrasound, the clinical findings and the patients' symptoms can be arranged according to the recommended definitions. This allows grading of the therapeutic outcome and enables a better comparability between different treatment protocols or different treatments. Besides the evaluation of treatment success, duplex ultrasound is the method of choice to exclude or confirm complications such as deep venous thrombosis or disease progression.

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RATIONALE: The spread of Foam Sclerotherapy has resulted in the renaissance of sclerotherapy as a non-invasive treatment method for varicosis. The use of sclerosant foam for various forms of varicosis has now become established world-wide as safe and effective. An expanded European expert committee meeting in April 2006, in Tegernsee was prompted by new findings and continuous further development of the method, but also because it had not been possible to consider all the relevant aspects of Foam Sclerotherapy in depth at the first meeting. OBJECTIVES: To revise and update the results of the 1st European Consensus Meeting and to include new, important topics in the development of Foam Sclerotherapy. To provide practical information for less experienced colleagues. METHODOLOGY: The 29 participants were sent a comprehensive questionnaire in advance covering all the relevant aspects of Foam Sclerotherapy. The organisers drew up various preliminary statements on the basis of the results. During the meeting itself the participants revised and/or approved and/or rejected these statements. An additional analysis of the questionnaire data also enabled preparation of an illustrative description of the broad spectrum of individual procedures used in this form of treatment. RESULTS: Foam Sclerotherapy has become an established treatment option for varicosis and has undoubtedly improved the management of varicose veins. European experts met Tegernsee for a second time to revise and expand their previous recommendations. In addition, individual working groups focused extensively on important issues. The current consensus, recommendations and descriptions of the individual aspects of the methods concern such issues as the indications for Foam Sclerotherapy, concentration and volume of the liquid sclerosants, relative and absolute contraindications, access and puncture options as well as clinical and ultrasound-guided recording of the treatment results. This final document reflects the experts' opinions on the principles of the effective and, above all, safe use of sclerosant foam for various indications and correct monitoring of the results of Foam Sclerotherapy.

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BACKGROUND: Sclerotherapy is the targeted elimination of intracutaneous, subcutaneous, and/or transfascial varicose veins (perforating veins) as well as the sclerosation of subfascial varicose vessels in the case of venous malformation by the injection of a sclerosant. With duplex-guide sclerotherapy and foam sclerotherapy, modified methods came into use. OBJECTIVE: The objective was to create a guideline, based on the available publications and on the European Consensus Document on foam sclerotherapy from April 2003. METHODS: This guideline was drafted on behalf of the German Society of Phlebology (Deutsche Gesellschaft für Phlebologie) and adopted by the committee and scientific advisory board of the Deutsche Gesellschaft für Phlebologie on June 15, 2001, and amended on December 5, 2003. The guideline considers the present state of knowledge as reflected in the literature. CONCLUSIONS: This guideline represents the recent state of the art of sclerotherapy of varicose veins in Germany including foam sclerotherapy.

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