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    11/03/2010
The League History
Past, present and future and relations with ISTH
by Jasone Monasterio

In the 1960’s, Thrombosis even though an important cause of mortality and morbidity, was not yet recognised as an important medical problem, and progressive efforts were needed for it to be accepted as a specific medical entity requiring clinical studies and research.

In the clinical practise, thrombosis occurred always as a complication causing vascular obstruction, infarction or necrosis; nevertheless morbidity or mortality was attributed clinically to the failure of some particular organ systems such as the heart, lungs or brain, but not to the originating thrombosis.

A Similar situation existed in the field of research. There was not much interdisciplinary study and communication neither was there a multidisciplinary approach amongst researchers in thrombosis.

They were more concerned with elucidating which defects were underlying haemorrhagic problems rather than the factors and mechanisms responsible for thrombosis, which were much more unknown and complex.

During this decade, in the world there were no International Scientific Societies in Thrombosis except the Task Force on Thrombosis in 1965 promoted by Sol Sherry and JM Stengle, who also were responsible for the International Committee of Haemostasis and Thrombosis with yearly meetings.

Within this atmosphere, and after four years clinical stage at the National Blood Transfusion Centre with Prof JP Soulier, in Paris, and in University Public Hospitals with leading experts in Haematology and Haemostasis ( Dr. Samama, Dr.Leroux, Dr Josso..), I returned to Bilbao and with the initiative and support of Dr JA. Iriarte from the Institute of Procardíacos ( devoted to heart illnesses), we attracted the attention of Dr M.M.Samama to organise the First HISPANO-FRANCES Symponium on “ Haemorrhagic Syndromes and Thromboembolic Diseases”, in Bilbao in 1967, in order to get in contact with French and Spanish leaders in Haemostasia, Angiology, Cardiology and other disciplines, who would be interested in Thrombosis.

Amongst the speakers were Drs. Babío, Balaguer, Calderón, Castillo, Ezcurra, Iriarte JA, Iriarte M, Landa, Monasterio, Raichs and Rey Baltar from Spain and Drs.Bodineau, Bondil, Bordes, Goglin, Leroux, Samama, Raby, Vairel, Veber and Yver from France.

In the Symposium book, published in Spanish in 1967, there were papers on the following topics, demonstrating our interest for thrombosis:
- Double aspects of hypercoagulability.
- Hypercoagulability as biological and clinical syndrome
- Hypercoagulability as potential cause of the venous fibrin thrombus
- Risk factors in the myocardial infarct and its social consequences.
- Other Haemostasis alterations in diabetes beside haemorrhages and their relations with pathogenetic mechanisms.
- Control of anticoagulant therapy through thromboelastography
- Abdominal vascular occlusions - Subcutaneous prophylactic heparin as advanced therapeutics
- Distal members arterial embolism treated with streptokinase in 67 patients from 1961 (Prof. Samama).
- Fibrinolysis diagnostics especially in hyperfibrinolysis states

At the end of this First Hispano-Francés Symposium , it was agreed to hold another meeting in two years time inviting leaders from Italy ( as Prof. De Nicola) and from other Mediterranean Countries (Prof De Vries, Ulutin, Mandalaki….).

It was agreed as well at the end of this First Spanish and French Symposium to establish a protocol for the diagnosis and treatment of Thromboembolism. This First Hispano-Francés Symposium was the seed from which the Mediterranean League against Thromboembolic Diseases (MLTD) originated. Enclosed you will find the agreement made and published in Spanish in the SYMPOSIUM BOOK.

At the end of the 1960’s, researchers and clinicians started to recognise thrombosis as an specific entity associated with many pathologies such as arteriosclerosis and traumatisms and to risk factors which modify vessels wall, blood components and blood flow, that undertake a different participation in the genesis of arterial and venous thrombosis.

The First Mediterranean Congress on Thromboembolism was held again in Bilbao (Spain) on 22nd-25th October, 1969. In the General Assembly held at the end of this Congress, the Mediterranean League was founded officially as seen in the enclosed document, published in the Congress Book (in Spanish Language).

The Founding Countries and Counsellors were: Bulgaria (Dr. Anastassoff), France (Dr. Samama), Greece (Dr. Mandalaki), Israel (Dr. DeVries), Italy (Dr. de Nicola), Spain (Dr. Aznar) and Turkey (Dr. ON Ulutin). Dr. JA Iriarte was appointed as General Secretary.

According to its Bye-Laws, The Mediterranean League against Thromboembolic Diseases (hereafter called The LEAGUE or MLTD) was founded for scientific and educational purposes and had as its objectives and aims to promote the study, the origin and causes of Thromboembolic diseases as well as their diagnosis, prophylaxis and treatment and to gather professionals interested in thrombosis and Haemostasis from the basic to clinical sciences.

To achieve the above mentioned objectives, League's members would promote clinical research studies on patients with Thromboembolic diseases, would participate ordinarily in this research and would foster exchange and diffusion, with all League’s members, regarding achievements obtained either individually or in teams in order to establish Thrombosis: a) etiopathogenesis b) diagnosis c) treatment d) epidemiology, e) genetics f) nutrition, in order to achieve the patients full incorporation into their previous normal activities. For this purpose The League would periodically organise in adequate places, in all countries of the Mediterranean area, Congresses, Educational Courses and Conferences, Seminars, Symposia, Publications and any other event towards achieving its objectives.

The following 3 International Thrombosis Congresses were held in the founding Countries and organised by the Founding Councillors, Dr. Orhan N Ulutin in Istanbul (Turkey) in 1971, Dr. A De Vries in Tel Aviv ( Israel) in 1973 and Dr. Titika Mandalaki in Athens (Greece) in 1976. Official Languages were French and English.

THE MEDITERRANEAN LEAGUE’s INTERNATIONAL THROMBOSIS CONGRESSES
Nº PLACE COUNTRY DATE MONTH YEAR PRESIDENT
I Bilbao Spain 22 - 25 October 1969 J.A. Iriarte
II Istanbul Turkey 11 - 14 October 1971 O.N. Ulutin
III Tel Aviv Israel 3 - 8 June 1973 A. de Vries
IV Athens Greece 2 - 6 May 1976 T. Mandalaki

Due to the increasing success of attendance and to the high scientific level of these meetings, the founding Councillors advised the General Secretary to register the Mediterranean League as a Scientific Society legally in Spain. It was officially registered on June 19th, 1980 with the number 36.121 in the National Register of Associations of Spain according to the Law of December 24th, 1964.

Now-a-days, following the latest Spanish Law 1/2002, MLTD has been legally updated to this Law on February 2nd, 2007.

During this first decade, four Countries from the three Mediterranean Continents were incorporated into the League: Egypt (with Dr. Hassanein as Councillor), in 1971, and Tunisia, Lebanon and Yugoslavia with Dr. Houissa-Kastally, Dr. Taleb, and Dr. Baklaja as their respective Councillors in 1973. Rumania with Dr. Pieptea was accepted as observer Country.

The following decade, from V International Thrombosis Congress, (ITC) organised by Dr. Sergio Coccheri in Bologna in June 1978 until the X ITC held in Athens in 1988 under the organisation of Dr T.Mandalaki, gave the MLTD a sound and consolidated ground as an International Scientific Society in the field of Thromboembolic diseases. There were 600 attendants at the X ITC of Athens in 1988. That represented a significant jump and growth in the international success and acceptance of MLTD.

The MLTD had to update its original Bye-laws to keep pace with the increasing number of countries and scientific activities. The new By-Laws were approved and legally registered in Spain on 27th July 1989.

THE MEDITERRANEAN LEAGUE’s INTERNATIONAL THROMBOSIS CONGRESSES
Nº PLACE COUNTRY DATE MONTH YEAR PRESIDENT
V Bologna Italy 29 - 2 May - June 1978 S. Coccheri
VI Montecarlo France 23 - 25 October 1980 M.M. Samama
VII Valencia Spain 13 - 16 October 1982 J. Aznar
VIII Istanbul Turkey 4 - 7 June 1984 O.N. Ulutin
IX Jerusalen Israel 1 - 6 June 1986 U. Seligsohn
X Athens Greece 22 - 27 May 1988 T. Mandalaki


Drs M.Samama, J.Aznar, ON Ulutin , U Seligsohn and T. Mandalaki organised increasingly successful ITCs in Montecarlo ( 1980), Valencia ( 1982), Istanbul (1984), Jerusalem (1986) and Greece ( 1988) respectively.

At the Councillors meeting held in Istambul in 1984, an agreement was reached between the MLTD and the CLAHT to interchange scientific knowledge and to invite two speakers in to their respective International Congresses. This Agreement was ratified again in Brussels in 1987.

THE MEDITERRANEAN LEAGUE’s INTERNATIONAL THROMBOSIS CONGRESSES
Nº PLACE COUNTRY DATE MONTH YEAR PRESIDENT
XI Ljubljana Yugoslavia 24 - 28 June 1990 D. Keber
XII Firence Italy 18 - 23 May 1992 G. Neri Serneri
XIII Bilbao Spain 6 - 10 June 1994 J.A. Iriarte
XIV Montpellier France 14 - 18 October 1996 M.M. Samama
XV Antalya Turkey 16 - 21 October 1998 O.N. Ulutin


The third decade until 1998 witnesses the flourishing of the MLTD with bigger ITCs, whose registered delegates reached 1.300 attendants from about 40 countries from all over world having leading international experts in Thrombosis as speakers.

In 1990, within the counsellors meeting held at the X ITC of Ljubljana (Yugoslavia), Dr. F. Meriane applied for a meeting to be held in Algeria. In 1992 Dr Houissa- Kastally asked the Councillors Board for a symposium to be organised in May/June 1993 in Tunisia.

New countries were incorporated into MLTD. In 1992, Slovenia with Dr Keber as a Country Councillor and Dr M Stegnar as member of the Scientific Committee; Portugal ( with Drs. Campos and Cunya Ribeiro as Country Councillors) in 1994, and Morocco (with Dr. N. Benchemsi as Country Councillor) in 1996.

In 1996, MLTD’s By-laws were translated by Dr. M. Sánchez Moya into English after updating its management organs in collaboration with Drs Samama, Coccheri, Seligsohn, Monasterio and Iriarte.

In 1996, at the Montpellier’s ITC, under the proposal of Dr Monasterio and Dr. H. C. Hemker, as Managing Editor, Haemostasis Journal (to-day, Pathophysiology of Haemostasis and Thrombosis) was appointed the Official Journal of the MLTD with Dr Sylvian Levi-Toledano as editor on behalf of MLTD.

THE MEDITERRANEAN LEAGUE’s INTERNATIONAL THROMBOSIS CONGRESSES
Nº PLACE COUNTRY DATE MONTH YEAR PRESIDENT
XVI Porto Portugal 5 - 8 May 2000 M. Campos
XVII Bologna Italy 26 - 30 October 2002 S. Coccheri
XVIII Ljubljana Slovenia 20 - 24 June 2004 M. Stegnar
XIX Tel Aviv Israel 14 - 19 May 2006 D.Varon
XX Athens Greece 25 - 28 June 2008 C.H. Liapis


The fourth decade confirmed the flourishing of MLTD with the four congresses held in Porto 2000 (Dr. Campos) Bologna 2002 ( Dr. Coccheri), Ljubljana 2004 ( Dr. Stegnar) and Tel Aviv 2006 ( Dr. Varon) reaching 1.600 attendants from 47 world countries.

At the beginning of this last decade, Dr. Monasterio was appointed MLTD’s General Secretary within the Councillors Meeting of the XVII ITC held at Bologna due to her active dedication to MLTD since its foundation as founding Member. She had previously acted as General Secretary in 1994-1996, while Dr. Iriarte was President. Three Managing Boards were introduced into the Bye-Laws: Trustees Board, Executive Board and Education Board.

In April 2004, under request of MLTD’s President, Dr. S.Coccheri, Dr. M. Sanchez-Moya, created the WEB SITE. www.medleague-thrombosis.org as a modern tool for effective and global diffusion of MLTD’s activities.

Saudi Arabia (2000) and Cyprus (2004) were incorporated into MLTD with Dr. A.K. Al Momen and Dr. Nicolaides as their respective Country Councillors.

Dr.Nicolaides was the organiser of a meeting in Cyprus where an International Consensus on Thrombophylia and Venous Thromboembolism was reached with the participation of MLTD Members (Dr. Samama, Dr. Coccheri, Dr. J. Conard and Dr. Sami Guermazi).


Relations with International Society of Thrombosis and Haemostasis.

Relations with the International Society of Thrombosis and Haemostasis (ISTH) have always been a model of solidarity and support to the objectives and aims of MLTD.

In 1974, Prof. Sol Sherry and Dr James Stengle, President and Secretary of the ISTH were nominated Honours Members of the Spanish Society of Haemostasis and Thrombosis (SETH). The birth of the SETH was decided by Spanish MLTD Members during the III ITC held in Tel Aviv in 1973. Dr Stengle, representing the ISTH, attended the first General Assembly of the SETH in 1974, in Barcelona, invited by Dr. J. Monasterio, offering full support to the aims of the SETH and of the Mediterranean League against Thromboembolic Diseases, founded 5 years before 1969.

Throughout the whole life of the MLTD, the ISTH has always offered MLTD facilities to celebrate its Annual Councillors Meeting within ISTH’s International Congresses, due to the friendly relation between the ISTH Authorities and Mediterranean League Councillors and Secretariat.

ISTH’s Logo appears on the Home Page of MLTD’s WEB Page as a symbol of two related Societies, as a major sister of MLTD

Lately, the relations have deepened into a close collaboration to hold joint Educational Courses in Mediterranean Countries( where MLTD’s congresses have not yet been organised ), thanks to the coordination of Prof. Uri Seligsohn, MLTD’s Councillor and ISTH Education Committee Head.

The first Joint Educational Course on VENOUS AND ARTERIAL THROMBOSIS was held in Casablanca in May 2004, organised by the MLTD Educational Board President, Prof. S. Coccheri, and financed by ISTH and MLTD.

The second Educational Course on Thrombosis, being held now in Tunis, in May 2007, is again a joint effort of the MLTD and ISTH with the Collaboration of your active National Tunisian Society of Thrombosis and Haemostasis (ATHETH) under the Patronage of the Ministries of Health of the Republics of Tunisia and Italy.

In October 2005, a Euro-Argentinean Course on Thrombosis and Antithrombotic Therapies in Cardiovascular Disease, was held in Buenos Aires, (Argentina) organised and supported by the University of Bologna , (Italy) under the Auspices of ISTH with a small financial help and collaboration from MLTD.

An Acta of each Educational Course is handed to the ISTH Educational Committee Head with the summary of the conferences and of the conclusions obtained, together with the evaluation given by the participants and attendants to the Course.


MLTD's Future

In June 2008, MLTD will undertake its XX ITC in Athens with a scientific programme including recent hot topics, whose final programme will be decided this July in Geneva at the MLTD’s Councillors Meeting on occasion of the XXI ISTH’s International Congress on Haemostasis and Thrombosis. The main relevant aspect of this ITC will be multidisciplinary as the President organising the Congress, Prof. Christos Liapis, is a renowned angiologists in Greece and internationally as President of the European Society of Angiology. The following Congress will be organised in Milan, in 2010, by Prof. P.M. Mannucci, internationally reknown Haematologist.

There is one other task to be undertaken: Nets of Working Teams, which will be the basic working axis of MLTD Society with the collaboration of MLTD Members from the Mediterranean and other international experts to establish Thrombosis epidemiology, diagnosis and treatment in international studies with an evaluation by clinical follow up of patients and by bringing up newest methods for biological evaluation of patients with both venous Thromboembolism and arterial thrombosis.

Development of an Homologated MLTD’s Page Web, as a means of communication, diffusion and exchange of knowledge between leaders and members of MLTD. Web’s homologation has been certified by the Official College of Physicians of Barcelona this 10th of May, 2007.

MLTD’s projects are:
- to attract renowned experts and leaders from National Thrombosis Societies from the Mediterranean Countries and to encourage them to participate in MLTD’s objectives as Members of the Society.

- to participate more actively in the Official Journal of the MLTD, Pathophysiology of Haemostasis and Thrombosis (PHT). All active members have now free access to the current journal 2006-2007 issues.

There is a proposal to submit papers to PHT in the original language of each Country ( Arab, Spanish, Greek etc..) for a first evaluation of whether they are worth being published or not, before being finally translated into English for its publication in PHT.

An important goal is the full integration of all Mediterranean Countries as I mentioned before. These Countries have got an enormous human and scientific potential.

In this 40th anniversary of MLTD’s birth, which will be celebrated in Athens during MLTD’s XX ITC, we expect to offer the official creation of a MLTD FOUNDATION, whose full activities will be developed in all the Mediterranean Countries, following the unanimous agreement granted at the Councillors and General Assembly Meetings held last June 2006, in Tel Aviv.

The objectives and aims of the MLTD FOUNDATION, its Name, Management and Bye-Laws, will be the same ones as those of the MLTD Society. We are hoping that this MLTD FOUNDATION will attract necessary financial funds from Public and Private Institutions interested in the developing of the Mediterranean:
- To integrate all Mediterranean Countries, not yet incorporated, into the MLTD.
- To create Prizes to highlight projects in clinical and basic research in Thrombosis
- To establish Grants for young researchers in Thrombosis interested in participating in MLTD’s International Thrombosis Congresses
- To create Prizes to promote integration of MLTD’s Members in the Net of Working Teams
- To promote more Educational Courses in all countries that are not yet integrated into MLTD Society, giving then facilities to register as Members of MLTD
- To publish a collaborative “Manual of Validated New Methods in Vascular Biology, Haemostasis and Thrombosis”


Last but not least, the future of MLTD is you yourselves, young researchers and multidisciplinary clinicians interested in fighting against Thromboembolic diseases.
(Conference given in the II Educational Course, held in Tunis, May 18-19th, 2007)

PRIMER SYMPOSIUM FRANCO-ESPAÑOL SOBRE DIAGN´STICO Y TRATAMIENTO DE LAS ENFERMEDADES TROMBOEMBÓLICAS Y HEMORRÁGICAS

ACUERDOS DE LA ASAMBLEA FRANCO-ESPAÑOLA
Bilbao, 8 de junio de 1967
PRIMERO: Celebrar una próxima reunión, dentro de dos años, sobre estos temas. El profesor Leroux se pondrá en contacto con colegas italianos, a fin de que el próximo Symposium abarque a varios pueblos latinos.

SEGUNDO: Unificar criterios en Francia y España sobre diagnóstico y control de tratamiento clínico y biológico de estas enfermedades, que son la primera causa de muerte en todos los paises civilizados. Por parte de España están de momento de acuerdo en realizar investigaciones conjuntas, y prevención de estas enfermedades, centros especializados de las siguiente provincias: Barcelona, Burgos, Córdoba, Madrid, Sevilla, Vizcaya y las provincias que se vayan sumando a los criterios que hemos establecido en trabajos de próxima publicación, de acuerdo con las conversaciones matenidas con colegas franceses y normas internacionales.
Los resultados estadísticos de estas profilaxis serán presentadas a nuestras autoridades sanitarias.

TERCERO: Expresar todos los participantes de este Primer Symposium Franco-Español, nuestro agradecimiento al Excmo. Sr. Jefe Provincial de Sanidad de Vizcaya, doctor Natalio Sánchez Plaza y al Excmo. Sr. Director General de Sanidad que ha dado su consentimiento a esta Reunión, presentándole los resultados y los fervientes deseos de esta Asamblea Hispano-Francesa arriba expuestos.




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Last Update 21/1/2009
MLTD Technical Secretariat: tel.(+34) 963 511 632 - fax (+34) 963 942 558 - mltd@geyseco.es