Skip to main content
Erschienen in: Digestive Diseases and Sciences 1/2017

18.08.2016 | Original Article

Ischemic Preconditioning-Induced SOCS-1 Protects Rat Intestinal Ischemia Reperfusion Injury via Degradation of TRAF6

verfasst von: Sheng-zhi Liu, Xue-mei He, Xu Zhang, Fan-cai Zeng, Fang Wang, Xiang-yu Zhou

Erschienen in: Digestive Diseases and Sciences | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

The inflammatory immune response plays an important role in mesenteric ischemia and ischemia–reperfusion injury. Toll-like receptor 4 (TLR4) is a critical receptor in transduction of the inflammatory response and plays an important role in intestinal homeostasis. Tumor necrosis factor receptor-associated factor 6 (TRAF6), known as a key adaptor protein downstream of TLR4, is involved in the inflammatory response by activating multiple apoptotic signaling pathways. However, mechanisms of the suppressor of cytokine signaling-1 (SOCS-1) in regulating cell inflammation and apoptosis are still obscure.

Objectives

To investigate the TLR4–TRAF6 signaling pathway in intestinal ischemia and reperfusion injury, as well as SOCS-1 expression after ischemic preconditioning in the rat intestine.

Methods

The small bowel ischemia, ischemia–reperfusion, and preconditioning models were induced using ligation of the superior mesenteric artery in male Sprague–Dawley rats; then, the mRNA and protein levels of TLR4, TRAF6, and SOCS-1 were analyzed using real-time PCR, Western blot, and immunohistochemistry, respectively.

Results

The expression of TLR4 and TRAF6 was gradually increased with increasing intestinal ischemia duration, but increased substantially after ischemia–reperfusion injury. After ischemic preconditioning, TLR4 and TRAF6 expressions decreased; however, expression of SOCS-1 and the TLR4–TRAF6 pathway inhibitor was increased.

Conclusion

These data show that ischemic preconditioning may induce the activation of SOCS-1 to inhibit the TLR4–TRAF6 signaling pathway, thereby playing a protective role in ischemia–reperfusion injury.
Literatur
1.
Zurück zum Zitat Akyildiz HY, Sozuer E, Uzer H, Baykan M, Oz B. The length of necrosis and renal insufficiency predict the outcome of acute mesenteric ischemia. Asian J Surg. 2015;38:28–32.CrossRefPubMed Akyildiz HY, Sozuer E, Uzer H, Baykan M, Oz B. The length of necrosis and renal insufficiency predict the outcome of acute mesenteric ischemia. Asian J Surg. 2015;38:28–32.CrossRefPubMed
2.
Zurück zum Zitat Yadav V, Hussain A, Sahoo K, Awasthi V. Remediation of hemorrhagic shock-induced intestinal barrier dysfunction by treatment with diphenyldihaloketones EF24 and CLEFMA. J Pharmacol Exp Ther. 2014;351:413–422.CrossRefPubMedPubMedCentral Yadav V, Hussain A, Sahoo K, Awasthi V. Remediation of hemorrhagic shock-induced intestinal barrier dysfunction by treatment with diphenyldihaloketones EF24 and CLEFMA. J Pharmacol Exp Ther. 2014;351:413–422.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Williams TM, Waksman R, De Silva K, Jacques A, Mahmoudi M. Ischemic preconditioning—an unfulfilled promise. Cardiovasc Revasc Med. 2015;16:101–108.CrossRefPubMed Williams TM, Waksman R, De Silva K, Jacques A, Mahmoudi M. Ischemic preconditioning—an unfulfilled promise. Cardiovasc Revasc Med. 2015;16:101–108.CrossRefPubMed
4.
Zurück zum Zitat Shi LB, Huang JH, Han BS. Hypoxia inducible factor-1 mediates protective effects of ischemic preconditioning on ECV-304 endothelial cells. World J Gastroenterol. 2007;1316:2369–2373.CrossRef Shi LB, Huang JH, Han BS. Hypoxia inducible factor-1 mediates protective effects of ischemic preconditioning on ECV-304 endothelial cells. World J Gastroenterol. 2007;1316:2369–2373.CrossRef
5.
Zurück zum Zitat Elshiekh M, Kadkhodaee M, Seifi B, Ranjbaran M, Ahghari P. Ameliorative effect of recombinant human erythropoietin and ischemic preconditioning on renal ischemia reperfusion injury in rats. Nephrourol Mon. 2015;7:e31152.CrossRefPubMedPubMedCentral Elshiekh M, Kadkhodaee M, Seifi B, Ranjbaran M, Ahghari P. Ameliorative effect of recombinant human erythropoietin and ischemic preconditioning on renal ischemia reperfusion injury in rats. Nephrourol Mon. 2015;7:e31152.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat He GZ, Zhou KG, Zhang R, Chen XF. The effects of n-3 PUFA and intestinal lymph drainage on high-mobility group box 1 and Toll-like receptor 4 mRNA in rats with intestinal ischaemia–reperfusion injury. Br J Nutr. 2012;108:883–892.CrossRefPubMed He GZ, Zhou KG, Zhang R, Chen XF. The effects of n-3 PUFA and intestinal lymph drainage on high-mobility group box 1 and Toll-like receptor 4 mRNA in rats with intestinal ischaemia–reperfusion injury. Br J Nutr. 2012;108:883–892.CrossRefPubMed
7.
Zurück zum Zitat Salcedo R, Cataisson C, Hasan U, et al. MyD88 and its divergent toll in carcinogenesis. Trends Immunol. 2013;34:379–389.CrossRefPubMed Salcedo R, Cataisson C, Hasan U, et al. MyD88 and its divergent toll in carcinogenesis. Trends Immunol. 2013;34:379–389.CrossRefPubMed
8.
Zurück zum Zitat Jakus PB, Kalman N, Antus C, et al. TRAF6 is functional in inhibition of TLR4-mediated NF-κB activation by resveratrol. J Nutr Biochem. 2013;24:819–823.CrossRefPubMed Jakus PB, Kalman N, Antus C, et al. TRAF6 is functional in inhibition of TLR4-mediated NF-κB activation by resveratrol. J Nutr Biochem. 2013;24:819–823.CrossRefPubMed
9.
Zurück zum Zitat Starska K, Forma E, Lewy-Trenda I, Stasikowska O, Brys M, Krajewska W. The expression of SOCS1 and TLR4-NF-κB pathway Molecules in neoplastic cells as potential biomarker for the aggressive tumor phenotype in laryngeal carcinoma. Folia Histochem Cytobiol. 2009;47:401–410.PubMed Starska K, Forma E, Lewy-Trenda I, Stasikowska O, Brys M, Krajewska W. The expression of SOCS1 and TLR4-NF-κB pathway Molecules in neoplastic cells as potential biomarker for the aggressive tumor phenotype in laryngeal carcinoma. Folia Histochem Cytobiol. 2009;47:401–410.PubMed
10.
Zurück zum Zitat Zhou X, Liu Z, Cheng X, Zheng Y, Zeng F, He Y. Socs1 and Socs3 degrades Traf6 via polyubiquitination in LPS-induced acute necrotizing pancreatitis. Cell Death Dis. 2015;6:e2012.CrossRefPubMedPubMedCentral Zhou X, Liu Z, Cheng X, Zheng Y, Zeng F, He Y. Socs1 and Socs3 degrades Traf6 via polyubiquitination in LPS-induced acute necrotizing pancreatitis. Cell Death Dis. 2015;6:e2012.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Song MY, Tian FF, Liu H, et al. Expression of SOCSs and TLRs in the hippocampus of pentylenetetrazole kindling model. Clin Lab. 2014;60:233–240.PubMed Song MY, Tian FF, Liu H, et al. Expression of SOCSs and TLRs in the hippocampus of pentylenetetrazole kindling model. Clin Lab. 2014;60:233–240.PubMed
12.
Zurück zum Zitat Lloris Carsi JM, Cejalvo Lapeña D, Toledo AH, Zaragoza Fernandez C, Toledo Pereyra LH. Pentoxifylline protects the small intestine after severe ischemia and reperfusion. Exp Clin Transplant. 2013;11:250–258.CrossRefPubMed Lloris Carsi JM, Cejalvo Lapeña D, Toledo AH, Zaragoza Fernandez C, Toledo Pereyra LH. Pentoxifylline protects the small intestine after severe ischemia and reperfusion. Exp Clin Transplant. 2013;11:250–258.CrossRefPubMed
13.
Zurück zum Zitat Minjae K, Sang WP, Mihwa K, Vivette D, Thomas L. Isoflurane postconditioning protects against intestinal ischemia-reperfusion injury and multi-organ dysfunction via transforming growth factor-β1 generation. Ann Surg. 2012;255:492–503.CrossRef Minjae K, Sang WP, Mihwa K, Vivette D, Thomas L. Isoflurane postconditioning protects against intestinal ischemia-reperfusion injury and multi-organ dysfunction via transforming growth factor-β1 generation. Ann Surg. 2012;255:492–503.CrossRef
14.
Zurück zum Zitat Jr StefanToth, Pekarova Timea, Varga Jan, et al. Trehalase as a possible marker of intestinal ischemia–reperfusion injury. Acta Biochim Pol. 2013;60:411–416. Jr StefanToth, Pekarova Timea, Varga Jan, et al. Trehalase as a possible marker of intestinal ischemia–reperfusion injury. Acta Biochim Pol. 2013;60:411–416.
15.
Zurück zum Zitat Chiu CJ, McArdle AH, Brown R, et al. Intestinal mucosal lesion in low-flow states. I. A morphological, hemodynamic, and metabolic reappraisal. Arch Surg. 1970;101:478–483.CrossRefPubMed Chiu CJ, McArdle AH, Brown R, et al. Intestinal mucosal lesion in low-flow states. I. A morphological, hemodynamic, and metabolic reappraisal. Arch Surg. 1970;101:478–483.CrossRefPubMed
16.
Zurück zum Zitat Chen Y, Miao L, Yao Y, et al. Dexmedetomidine ameliorate CLP-induced rat intestinal injury via inhibition of inflammation. Mediat Inflamm. 2015;2015:918361. Chen Y, Miao L, Yao Y, et al. Dexmedetomidine ameliorate CLP-induced rat intestinal injury via inhibition of inflammation. Mediat Inflamm. 2015;2015:918361.
17.
Zurück zum Zitat Chen W, Wang X, Huang LI, Liu BO. Hepcidin in non-alcoholic fatty liver disease regulated by the TLR4/NF-κB signaling pathway. Exp Ther Med. 2016;11:73–76.PubMed Chen W, Wang X, Huang LI, Liu BO. Hepcidin in non-alcoholic fatty liver disease regulated by the TLR4/NF-κB signaling pathway. Exp Ther Med. 2016;11:73–76.PubMed
18.
Zurück zum Zitat Deng W, Deng Y, Deng J, Wang DX, Zhang T. Losartan attenuated lipopolysaccharide-induced lung injury by suppression of lectin-like oxidized low-density lipoprotein receptor-1. Int J Clin Exp Pathol. 2015;8:15670–15676.PubMedPubMedCentral Deng W, Deng Y, Deng J, Wang DX, Zhang T. Losartan attenuated lipopolysaccharide-induced lung injury by suppression of lectin-like oxidized low-density lipoprotein receptor-1. Int J Clin Exp Pathol. 2015;8:15670–15676.PubMedPubMedCentral
19.
Zurück zum Zitat Blazquez-Medela AM, Garcia-Sanchez O, Quiros Y, et al. Increased Klk9 urinary excretion is associated to hypertension-induced cardiovascular damage and renal alterations. Medicine. 2015;94:e1617.CrossRefPubMedPubMedCentral Blazquez-Medela AM, Garcia-Sanchez O, Quiros Y, et al. Increased Klk9 urinary excretion is associated to hypertension-induced cardiovascular damage and renal alterations. Medicine. 2015;94:e1617.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Yang CC, Hsu SP, Chen KH, Chien CT. Effect of adenoviral catalase gene transfer on renal ischemia/reperfusion injury in rats. Chin J Physiol. 2015;58:420–430.CrossRefPubMed Yang CC, Hsu SP, Chen KH, Chien CT. Effect of adenoviral catalase gene transfer on renal ischemia/reperfusion injury in rats. Chin J Physiol. 2015;58:420–430.CrossRefPubMed
21.
Zurück zum Zitat Stack J, Hurst TP, Flannery SM, et al. Poxviral protein A52 stimulates p38 mitogen-activated protein kinase (MAPK) activation by causing tumor necrosis factor receptor-associated factor 6 (TRAF6) self-association leading to transforming growth factor β-activated kinase 1 (TAK1) recruitment. J Biol Chem. 2013;288:33642–33653.CrossRefPubMedPubMedCentral Stack J, Hurst TP, Flannery SM, et al. Poxviral protein A52 stimulates p38 mitogen-activated protein kinase (MAPK) activation by causing tumor necrosis factor receptor-associated factor 6 (TRAF6) self-association leading to transforming growth factor β-activated kinase 1 (TAK1) recruitment. J Biol Chem. 2013;288:33642–33653.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Akcilar R, Akcilar A, Kocak C, et al. Effects of Ukrain on intestinal apoptosis caused by ischemia-reperfusion injury in rats. Int J Clin Exp Med. 2015;8:22158–22166.PubMedPubMedCentral Akcilar R, Akcilar A, Kocak C, et al. Effects of Ukrain on intestinal apoptosis caused by ischemia-reperfusion injury in rats. Int J Clin Exp Med. 2015;8:22158–22166.PubMedPubMedCentral
23.
Zurück zum Zitat Fan Z, Yao J, Li Y, Hu X, Shao H, Tian X. Anti-inflammatory and antioxidant effects of curcumin on acute lung injury in a rodent model of intestinal ischemia reperfusion by inhibiting the pathway of NF-κb. Int J Clin Exp Pathol. 2015;8:3451–3459.PubMedPubMedCentral Fan Z, Yao J, Li Y, Hu X, Shao H, Tian X. Anti-inflammatory and antioxidant effects of curcumin on acute lung injury in a rodent model of intestinal ischemia reperfusion by inhibiting the pathway of NF-κb. Int J Clin Exp Pathol. 2015;8:3451–3459.PubMedPubMedCentral
24.
Zurück zum Zitat Marques GM, Rasslan R, Belon AR, et al. Pentoxifylline associated to hypertonic saline solution attenuates inflammatory process and apoptosis after intestinal ischemia/reperfusion in rats. Acta Cir Bras. 2014;29:735–741.CrossRefPubMed Marques GM, Rasslan R, Belon AR, et al. Pentoxifylline associated to hypertonic saline solution attenuates inflammatory process and apoptosis after intestinal ischemia/reperfusion in rats. Acta Cir Bras. 2014;29:735–741.CrossRefPubMed
25.
Zurück zum Zitat Akdogan RA, Kalkan Y, Tumkaya L, Alacam H, Erdivanli B, Aydin I. Influence of infliximab pretreatment on ischemia/reperfusion injury in rat intestine. Folia Histochem Cytobiol. 2014;52:36–41.CrossRefPubMed Akdogan RA, Kalkan Y, Tumkaya L, Alacam H, Erdivanli B, Aydin I. Influence of infliximab pretreatment on ischemia/reperfusion injury in rat intestine. Folia Histochem Cytobiol. 2014;52:36–41.CrossRefPubMed
26.
Zurück zum Zitat Moore-Olufemi SD, Olufemi SE, Lott S. Intestinal ischemic preconditioning after ischemia/reperfusion injury in rat intestine: profiling global gene expression patterns. Dig Dis Sci. 2010;55:1866–1877.CrossRefPubMed Moore-Olufemi SD, Olufemi SE, Lott S. Intestinal ischemic preconditioning after ischemia/reperfusion injury in rat intestine: profiling global gene expression patterns. Dig Dis Sci. 2010;55:1866–1877.CrossRefPubMed
27.
Zurück zum Zitat Juraver-Geslin HA, Durand BC. Early development of the neural plate: new roles for apoptosis and for one of its main effectors caspase-3. Genesis. 2015;53:203–224.CrossRefPubMed Juraver-Geslin HA, Durand BC. Early development of the neural plate: new roles for apoptosis and for one of its main effectors caspase-3. Genesis. 2015;53:203–224.CrossRefPubMed
28.
Zurück zum Zitat Chu W, Li S, Wang S, Yan A, Nie L. Ischemic postconditioning provides protection against ischemia–reperfusion injury in intestines of rats. Int J Clin Exp Pathol. 2015;8:6474–6481.PubMedPubMedCentral Chu W, Li S, Wang S, Yan A, Nie L. Ischemic postconditioning provides protection against ischemia–reperfusion injury in intestines of rats. Int J Clin Exp Pathol. 2015;8:6474–6481.PubMedPubMedCentral
29.
Zurück zum Zitat Arumugam TV, Okun E, Tang SC, Thundyil J, et al. Toll-like receptors in ischemia-reperfusion injury. Shock. 2009;32:4–16.CrossRefPubMed Arumugam TV, Okun E, Tang SC, Thundyil J, et al. Toll-like receptors in ischemia-reperfusion injury. Shock. 2009;32:4–16.CrossRefPubMed
30.
Zurück zum Zitat Moses T, Wagner L, Fleming SD. TLR4-mediated Cox-2 expression increases intestinal ischemia/reperfusion-induced damage. J Leukoc Biol. 2009;86:971–980.CrossRefPubMedPubMedCentral Moses T, Wagner L, Fleming SD. TLR4-mediated Cox-2 expression increases intestinal ischemia/reperfusion-induced damage. J Leukoc Biol. 2009;86:971–980.CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Victoni T, Coelho FR, Soares AL, et al. Local and remote tissue injury upon intestinal ischemia and reperfusion depends on the TLR/MyD88 signaling pathway. Med Microbiol Immunol. 2010;199:35–42.CrossRefPubMed Victoni T, Coelho FR, Soares AL, et al. Local and remote tissue injury upon intestinal ischemia and reperfusion depends on the TLR/MyD88 signaling pathway. Med Microbiol Immunol. 2010;199:35–42.CrossRefPubMed
32.
Zurück zum Zitat Luo H, Guo P, Zhou Q. Role of TLR4/NF-κB in damage to intestinal mucosa barrier function and bacterial translocation in rats exposed to hypoxia. PLoS One. 2012;7:e462–e491.CrossRef Luo H, Guo P, Zhou Q. Role of TLR4/NF-κB in damage to intestinal mucosa barrier function and bacterial translocation in rats exposed to hypoxia. PLoS One. 2012;7:e462–e491.CrossRef
33.
Zurück zum Zitat Chassin C, Hempel C, Stockinger S, et al. MicroRNA-146a-mediated downregulation of IRAK1 protects mouse and human small intestine against ischemia/reperfusion injury. EMBO Mol Med. 2012;4:1308–1319.CrossRefPubMedPubMedCentral Chassin C, Hempel C, Stockinger S, et al. MicroRNA-146a-mediated downregulation of IRAK1 protects mouse and human small intestine against ischemia/reperfusion injury. EMBO Mol Med. 2012;4:1308–1319.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat De Araujo RF, Jr ReinaldoMP, Brito GA, et al. Olmesartan decreased levels of IL-1β and TNF-α, down-regulated MMP-2, MMP-9, COX-2, RANK/RANKL and up-regulated SOCs-1 in an intestinal mucositis model. PLoS One. 2014;9:e114923.CrossRefPubMedPubMedCentral De Araujo RF, Jr ReinaldoMP, Brito GA, et al. Olmesartan decreased levels of IL-1β and TNF-α, down-regulated MMP-2, MMP-9, COX-2, RANK/RANKL and up-regulated SOCs-1 in an intestinal mucositis model. PLoS One. 2014;9:e114923.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Rosentreter D, Funken D, Reifart J, Mende K, Rentsch M, Khandoga A. RIP1-dependent programmed necrosis is negatively regulated by caspases during hepatic ischemia–reperfusion. Shock.. 2015;44:72–76.CrossRefPubMed Rosentreter D, Funken D, Reifart J, Mende K, Rentsch M, Khandoga A. RIP1-dependent programmed necrosis is negatively regulated by caspases during hepatic ischemia–reperfusion. Shock.. 2015;44:72–76.CrossRefPubMed
36.
Zurück zum Zitat Ofengeim D, Yuan J. Regulation of RIP1 kinase signalling at the crossroads of inflammation and cell death. Nat Rev Mol Cell Biol. 2013;14:727–736.CrossRefPubMed Ofengeim D, Yuan J. Regulation of RIP1 kinase signalling at the crossroads of inflammation and cell death. Nat Rev Mol Cell Biol. 2013;14:727–736.CrossRefPubMed
37.
Zurück zum Zitat Koshinuma S, Miyamae M, Kaneda K, Kotani J, Figueredo VM. Combination of necroptosis and apoptosis inhibition enhances cardioprotection against myocardial ischemia–reperfusion injury. J Anesth. 2014;28:235–241.CrossRefPubMed Koshinuma S, Miyamae M, Kaneda K, Kotani J, Figueredo VM. Combination of necroptosis and apoptosis inhibition enhances cardioprotection against myocardial ischemia–reperfusion injury. J Anesth. 2014;28:235–241.CrossRefPubMed
38.
Zurück zum Zitat Bruhn RS, Distelmaier MS, Hellmann-Sokolis M, et al. Early detection of acute mesenteric ischemia using diffusion-weighted 3.0-T magnetic resonance imaging in a porcine model. Invest Radiol. 2013;48:231–237.PubMed Bruhn RS, Distelmaier MS, Hellmann-Sokolis M, et al. Early detection of acute mesenteric ischemia using diffusion-weighted 3.0-T magnetic resonance imaging in a porcine model. Invest Radiol. 2013;48:231–237.PubMed
39.
Zurück zum Zitat Ben DF, Yu XY, Ji GY, et al. TLR4 mediates lung injury and inflammation in intestinal ischemia–reperfusion. J Surg Res. 2012;174:326–333.CrossRefPubMed Ben DF, Yu XY, Ji GY, et al. TLR4 mediates lung injury and inflammation in intestinal ischemia–reperfusion. J Surg Res. 2012;174:326–333.CrossRefPubMed
40.
Zurück zum Zitat Li C, Li YS, Xu M, et al. Limb remote ischemic preconditioning for intestinal and pulmonary protection during elective open infrarenal abdominal aortic aneurysm repair: a randomized controlled trial. Anesthesiology. 2013;118:842–852.CrossRefPubMed Li C, Li YS, Xu M, et al. Limb remote ischemic preconditioning for intestinal and pulmonary protection during elective open infrarenal abdominal aortic aneurysm repair: a randomized controlled trial. Anesthesiology. 2013;118:842–852.CrossRefPubMed
41.
Zurück zum Zitat Pasupathy S, Homer-Vanniasinkam S. Surgical implications of ischemic preconditioning. Arch Surg. 2005;140:405–409.CrossRefPubMed Pasupathy S, Homer-Vanniasinkam S. Surgical implications of ischemic preconditioning. Arch Surg. 2005;140:405–409.CrossRefPubMed
Metadaten
Titel
Ischemic Preconditioning-Induced SOCS-1 Protects Rat Intestinal Ischemia Reperfusion Injury via Degradation of TRAF6
verfasst von
Sheng-zhi Liu
Xue-mei He
Xu Zhang
Fan-cai Zeng
Fang Wang
Xiang-yu Zhou
Publikationsdatum
18.08.2016
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 1/2017
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-016-4277-0

Weitere Artikel der Ausgabe 1/2017

Digestive Diseases and Sciences 1/2017 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.