Skip to main content
Erschienen in: Obesity Surgery 8/2008

01.08.2008 | Research Article

The Increase in Serum Visfatin After Bariatric Surgery in Morbidly Obese Women is Modulated by Weight Loss, Waist Circumference, and Presence or Absence of Diabetes Before Surgery

verfasst von: José I. Botella-Carretero, Manuel Luque-Ramírez, Francisco Álvarez-Blasco, Roberto Peromingo, José L. San Millán, Héctor F. Escobar-Morreale

Erschienen in: Obesity Surgery | Ausgabe 8/2008

Einloggen, um Zugang zu erhalten

Abstract

Background

Previous studies addressing the changes in serum visfatin levels after bariatric surgery yielded conflicting results.

Methods

We measured serum visfatin levels in 41 morbidly obese women before bariatric surgery and after losing at least 15% of the initial weight, and analyzed the results taking into account the type of surgery, reproductive and diabetic status, among others. Body mass index, waist circumference, lipid profile, and insulin resistance determined by homeostasis model assessment (HOMA-IR) were also measured.

Results

Patients lost 30.3 ± 6.1% of the initial body weight, and serum visfatin levels increased from 22.2 ± 20.9 to 32.2 ± 27.6 ng/ml (P = 0.031). A multiple regression model (R 2 = 0.314, F = 3.555, P = 0.017) including the percentage of weight loss, changes in waist circumference, HOMA-IR, high-density lipoprotein-cholesterol, and triglycerides (also expressed as percentage from baseline), the surgical procedure, time elapsed since surgery, and previous diabetic status as independent variables showed that weight loss (β = −0.670, P = 0.010), previous diabetic status (β = −0.330, P = 0.036), and change in waist circumference (β = 0.556, P = 0.031) were the main determinants of the percentual increase in serum visfatin levels observed after bariatric surgery.

Conclusion

Serum visfatin increased after bariatric surgery in relation to the amount of weight lost and to the changes in waist circumference, and this increase was higher in diabetic patients.
Literatur
1.
Zurück zum Zitat Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–17.PubMedCrossRef Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–17.PubMedCrossRef
2.
Zurück zum Zitat Shah M, Simha V, Garg A. Review: long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab. 2006;91:4223–31.PubMedCrossRef Shah M, Simha V, Garg A. Review: long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab. 2006;91:4223–31.PubMedCrossRef
3.
Zurück zum Zitat Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of life lost due to obesity. JAMA. 2003;289:187–93.PubMedCrossRef Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of life lost due to obesity. JAMA. 2003;289:187–93.PubMedCrossRef
4.
Zurück zum Zitat Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.PubMedCrossRef Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.PubMedCrossRef
5.
Zurück zum Zitat Sugerman HJ, Wolfe LG, Sica DA, Clore JN. Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg. 2003;237:751–6; discussion 7–8.PubMedCrossRef Sugerman HJ, Wolfe LG, Sica DA, Clore JN. Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg. 2003;237:751–6; discussion 7–8.PubMedCrossRef
6.
Zurück zum Zitat Escobar-Morreale HF, Botella-Carretero JI, Alvarez-Blasco F, Sancho J, San Millan JL. The polycystic ovary syndrome associated with morbid obesity may resolve after weight loss induced by bariatric surgery. J Clin Endocrinol Metab. 2005;90:6364–9.PubMedCrossRef Escobar-Morreale HF, Botella-Carretero JI, Alvarez-Blasco F, Sancho J, San Millan JL. The polycystic ovary syndrome associated with morbid obesity may resolve after weight loss induced by bariatric surgery. J Clin Endocrinol Metab. 2005;90:6364–9.PubMedCrossRef
7.
Zurück zum Zitat Fukuhara A, Matsuda M, Nishizawa M, et al. Visfatin: a protein secreted by visceral fat that mimics the effects of insulin. Science. 2005;307:426–30.PubMedCrossRef Fukuhara A, Matsuda M, Nishizawa M, et al. Visfatin: a protein secreted by visceral fat that mimics the effects of insulin. Science. 2005;307:426–30.PubMedCrossRef
8.
Zurück zum Zitat Stephens JM, Vidal-Puig AJ. An update on visfatin/pre-B cell colony-enhancing factor, an ubiquitously expressed, illusive cytokine that is regulated in obesity. Curr Opin Lipidol. 2006;17:128–31.PubMedCrossRef Stephens JM, Vidal-Puig AJ. An update on visfatin/pre-B cell colony-enhancing factor, an ubiquitously expressed, illusive cytokine that is regulated in obesity. Curr Opin Lipidol. 2006;17:128–31.PubMedCrossRef
9.
Zurück zum Zitat Pilz S, Mangge H, Obermayer-Pietsch B, Marz W. Visfatin/pre-B-cell colony-enhancing factor: a protein with various suggested functions. J Endocrinol Invest. 2007;30:138–44.PubMed Pilz S, Mangge H, Obermayer-Pietsch B, Marz W. Visfatin/pre-B-cell colony-enhancing factor: a protein with various suggested functions. J Endocrinol Invest. 2007;30:138–44.PubMed
10.
Zurück zum Zitat Krzyzanowska K, Mittermayer F, Krugluger W, Kopp HP, Schernthaner G. Increase in visfatin after weight loss induced by gastroplastic surgery. Obesity (Silver Spring). 2006;14:1886–9.CrossRef Krzyzanowska K, Mittermayer F, Krugluger W, Kopp HP, Schernthaner G. Increase in visfatin after weight loss induced by gastroplastic surgery. Obesity (Silver Spring). 2006;14:1886–9.CrossRef
11.
Zurück zum Zitat Manco M, Fernandez-Real JM, Equitani F, et al. Effect of massive weight loss on inflammatory adipocytokines and the innate immune system in morbidly obese women. J Clin Endocrinol Metab. 2007;92:483–90.PubMedCrossRef Manco M, Fernandez-Real JM, Equitani F, et al. Effect of massive weight loss on inflammatory adipocytokines and the innate immune system in morbidly obese women. J Clin Endocrinol Metab. 2007;92:483–90.PubMedCrossRef
12.
Zurück zum Zitat Haider DG, Schindler K, Schaller G, Prager G, Wolzt M, Ludvik B. Increased plasma visfatin concentrations in morbidly obese subjects are reduced after gastric banding. J Clin Endocrinol Metab. 2006;91:1578–81.PubMedCrossRef Haider DG, Schindler K, Schaller G, Prager G, Wolzt M, Ludvik B. Increased plasma visfatin concentrations in morbidly obese subjects are reduced after gastric banding. J Clin Endocrinol Metab. 2006;91:1578–81.PubMedCrossRef
13.
Zurück zum Zitat Li L, Yang G, Li Q, et al. Changes and relations of circulating visfatin, apelin, and resistin levels in normal, impaired glucose tolerance, and type 2 diabetic subjects. Exp Clin Endocrinol Diabetes. 2006;114:544–8.PubMedCrossRef Li L, Yang G, Li Q, et al. Changes and relations of circulating visfatin, apelin, and resistin levels in normal, impaired glucose tolerance, and type 2 diabetic subjects. Exp Clin Endocrinol Diabetes. 2006;114:544–8.PubMedCrossRef
14.
Zurück zum Zitat Lopez-Bermejo A, Chico-Julia B, Fernandez-Balsells M, et al. Serum visfatin increases with progressive beta-cell deterioration. Diabetes. 2006;55:2871–5.PubMedCrossRef Lopez-Bermejo A, Chico-Julia B, Fernandez-Balsells M, et al. Serum visfatin increases with progressive beta-cell deterioration. Diabetes. 2006;55:2871–5.PubMedCrossRef
15.
Zurück zum Zitat Tan BK, Chen J, Digby JE, Keay SD, Kennedy CR, Randeva HS. Increased visfatin messenger ribonucleic acid and protein levels in adipose tissue and adipocytes in women with polycystic ovary syndrome: parallel increase in plasma visfatin. J Clin Endocrinol Metab. 2006;91:5022–8.PubMedCrossRef Tan BK, Chen J, Digby JE, Keay SD, Kennedy CR, Randeva HS. Increased visfatin messenger ribonucleic acid and protein levels in adipose tissue and adipocytes in women with polycystic ovary syndrome: parallel increase in plasma visfatin. J Clin Endocrinol Metab. 2006;91:5022–8.PubMedCrossRef
16.
Zurück zum Zitat Scopinaro N. Biliopancreatic diversion: mechanisms of action and long-term results. Obes Surg. 2006;16:683–9.PubMedCrossRef Scopinaro N. Biliopancreatic diversion: mechanisms of action and long-term results. Obes Surg. 2006;16:683–9.PubMedCrossRef
17.
Zurück zum Zitat Rosenthal RJ, Szomstein S, Kennedy CI, Soto FC, Zundel N. Laparoscopic surgery for morbid obesity: 1,001 consecutive bariatric operations performed at The Bariatric Institute, Cleveland Clinic Florida. Obes Surg. 2006;16:119–24.PubMedCrossRef Rosenthal RJ, Szomstein S, Kennedy CI, Soto FC, Zundel N. Laparoscopic surgery for morbid obesity: 1,001 consecutive bariatric operations performed at The Bariatric Institute, Cleveland Clinic Florida. Obes Surg. 2006;16:119–24.PubMedCrossRef
18.
Zurück zum Zitat Zawadzki JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: toward a rational approach. In: Dunaif A, Givens JR, Haseltine FP, Merriam GR, editors. Polycystic ovary syndrome. Boston: Blackwell Scientific Publications; 1992. pp. 377–84. Zawadzki JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: toward a rational approach. In: Dunaif A, Givens JR, Haseltine FP, Merriam GR, editors. Polycystic ovary syndrome. Boston: Blackwell Scientific Publications; 1992. pp. 377–84.
19.
Zurück zum Zitat Botella-Carretero J, Alvarez-Blasco F, Martinez-Garcia MA, Luque-Ramirez M, San Millan JL, Escobar-Morreale HF. The decrease in serum IL-18 levels after bariatric surgery in morbidly obese women is a time-dependent event. Obes Surg. 2007;17:1199–208. Botella-Carretero J, Alvarez-Blasco F, Martinez-Garcia MA, Luque-Ramirez M, San Millan JL, Escobar-Morreale HF. The decrease in serum IL-18 levels after bariatric surgery in morbidly obese women is a time-dependent event. Obes Surg. 2007;17:1199–208.
20.
Zurück zum Zitat Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab. 1999;84:3666–72.PubMedCrossRef Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab. 1999;84:3666–72.PubMedCrossRef
21.
Zurück zum Zitat Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.PubMedCrossRef Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.PubMedCrossRef
22.
Zurück zum Zitat Zahorska-Markiewicz B, Olszanecka-Glinianowicz M, Janowska J, et al. Serum concentration of visfatin in obese women. Metabolism. 2007;56:1131–4.PubMedCrossRef Zahorska-Markiewicz B, Olszanecka-Glinianowicz M, Janowska J, et al. Serum concentration of visfatin in obese women. Metabolism. 2007;56:1131–4.PubMedCrossRef
23.
Zurück zum Zitat Jian WX, Luo TH, Gu YY, et al. The visfatin gene is associated with glucose and lipid metabolism in a Chinese population. Diabet Med. 2006;23:967–73.PubMedCrossRef Jian WX, Luo TH, Gu YY, et al. The visfatin gene is associated with glucose and lipid metabolism in a Chinese population. Diabet Med. 2006;23:967–73.PubMedCrossRef
24.
Zurück zum Zitat Pagano C, Pilon C, Olivieri M, et al. Reduced plasma visfatin/pre-B cell colony-enhancing factor in obesity is not related to insulin resistance in humans. J Clin Endocrinol Metab. 2006;91:3165–70.PubMedCrossRef Pagano C, Pilon C, Olivieri M, et al. Reduced plasma visfatin/pre-B cell colony-enhancing factor in obesity is not related to insulin resistance in humans. J Clin Endocrinol Metab. 2006;91:3165–70.PubMedCrossRef
25.
Zurück zum Zitat Garcia-Fuentes E, Garcia-Almeida JM, Garcia-Arnes J, et al. Plasma visfatin concentrations in severely obese subjects are increased after intestinal bypass. Obesity (Silver Spring). 2007;15:2391–5.CrossRef Garcia-Fuentes E, Garcia-Almeida JM, Garcia-Arnes J, et al. Plasma visfatin concentrations in severely obese subjects are increased after intestinal bypass. Obesity (Silver Spring). 2007;15:2391–5.CrossRef
26.
Zurück zum Zitat Fernandez-Real JM, Moreno JM, Chico B, Lopez-Bermejo A, Ricart W. Circulating visfatin is associated with parameters of iron metabolism in subjects with altered glucose tolerance. Diabetes Care. 2007;30:616–21.PubMedCrossRef Fernandez-Real JM, Moreno JM, Chico B, Lopez-Bermejo A, Ricart W. Circulating visfatin is associated with parameters of iron metabolism in subjects with altered glucose tolerance. Diabetes Care. 2007;30:616–21.PubMedCrossRef
27.
Zurück zum Zitat Takebayashi K, Suetsugu M, Wakabayashi S, Aso Y, Inukai T. Association between plasma visfatin and vascular endothelial function in patients with type 2 diabetes mellitus. Metabolism. 2007;56:451–8.PubMedCrossRef Takebayashi K, Suetsugu M, Wakabayashi S, Aso Y, Inukai T. Association between plasma visfatin and vascular endothelial function in patients with type 2 diabetes mellitus. Metabolism. 2007;56:451–8.PubMedCrossRef
28.
Zurück zum Zitat Bottcher Y, Teupser D, Enigk B, et al. Genetic variation in the visfatin gene (PBEF1) and its relation to glucose metabolism and fat-depot-specific messenger ribonucleic acid expression in humans. J Clin Endocrinol Metab. 2006;91:2725–31.PubMedCrossRef Bottcher Y, Teupser D, Enigk B, et al. Genetic variation in the visfatin gene (PBEF1) and its relation to glucose metabolism and fat-depot-specific messenger ribonucleic acid expression in humans. J Clin Endocrinol Metab. 2006;91:2725–31.PubMedCrossRef
29.
Zurück zum Zitat Chan TF, Chen YL, Lee CH, et al. Decreased plasma visfatin concentrations in women with gestational diabetes mellitus. J Soc Gynecol Investig. 2006;13:364–7.PubMedCrossRef Chan TF, Chen YL, Lee CH, et al. Decreased plasma visfatin concentrations in women with gestational diabetes mellitus. J Soc Gynecol Investig. 2006;13:364–7.PubMedCrossRef
30.
Zurück zum Zitat Haider DG, Handisurya A, Storka A, et al. Visfatin response to glucose is reduced in women with gestational diabetes mellitus. Diabetes Care. 2007;30:1889–91.PubMedCrossRef Haider DG, Handisurya A, Storka A, et al. Visfatin response to glucose is reduced in women with gestational diabetes mellitus. Diabetes Care. 2007;30:1889–91.PubMedCrossRef
31.
Zurück zum Zitat Haider DG, Mittermayer F, Schaller G, et al. Free fatty acids normalize a rosiglitazone-induced visfatin release. Am J Physiol Endocrinol Metab. 2006;291:E885–90.PubMedCrossRef Haider DG, Mittermayer F, Schaller G, et al. Free fatty acids normalize a rosiglitazone-induced visfatin release. Am J Physiol Endocrinol Metab. 2006;291:E885–90.PubMedCrossRef
32.
Zurück zum Zitat Dogru T, Sonmez A, Tasci I, et al. Plasma visfatin levels in patients with newly diagnosed and untreated type 2 diabetes mellitus and impaired glucose tolerance. Diabetes Res Clin Pract. 2007;76:24–9.PubMedCrossRef Dogru T, Sonmez A, Tasci I, et al. Plasma visfatin levels in patients with newly diagnosed and untreated type 2 diabetes mellitus and impaired glucose tolerance. Diabetes Res Clin Pract. 2007;76:24–9.PubMedCrossRef
33.
Zurück zum Zitat Chen MP, Chung FM, Chang DM, et al. Elevated plasma level of visfatin/pre-B cell colony-enhancing factor in patients with type 2 diabetes mellitus. J Clin Endocrinol Metab. 2006;91:295–9.PubMedCrossRef Chen MP, Chung FM, Chang DM, et al. Elevated plasma level of visfatin/pre-B cell colony-enhancing factor in patients with type 2 diabetes mellitus. J Clin Endocrinol Metab. 2006;91:295–9.PubMedCrossRef
34.
Zurück zum Zitat Krzyzanowska K, Krugluger W, Mittermayer F, et al. Increased visfatin concentrations in women with gestational diabetes mellitus. Clin Sci (Lond). 2006;110:605–9.CrossRef Krzyzanowska K, Krugluger W, Mittermayer F, et al. Increased visfatin concentrations in women with gestational diabetes mellitus. Clin Sci (Lond). 2006;110:605–9.CrossRef
35.
Zurück zum Zitat Hsieh CH, He CT, Lee CH, Wu LY, Hung YJ. Both slow-release and regular-form metformin improve glycemic control without altering plasma visfatin level in patients with type 2 diabetes mellitus. Metabolism. 2007;56:1087–92.PubMedCrossRef Hsieh CH, He CT, Lee CH, Wu LY, Hung YJ. Both slow-release and regular-form metformin improve glycemic control without altering plasma visfatin level in patients with type 2 diabetes mellitus. Metabolism. 2007;56:1087–92.PubMedCrossRef
36.
Zurück zum Zitat Hammarstedt A, Pihlajamaki J, Rotter Sopasakis V, et al. Visfatin is an adipokine, but it is not regulated by thiazolidinediones. J Clin Endocrinol Metab. 2006;91:1181–4.PubMedCrossRef Hammarstedt A, Pihlajamaki J, Rotter Sopasakis V, et al. Visfatin is an adipokine, but it is not regulated by thiazolidinediones. J Clin Endocrinol Metab. 2006;91:1181–4.PubMedCrossRef
37.
Zurück zum Zitat Arner P. Visfatin-a true or false trail to type 2 diabetes mellitus. J Clin Endocrinol Metab. 2006;91:28–30.PubMedCrossRef Arner P. Visfatin-a true or false trail to type 2 diabetes mellitus. J Clin Endocrinol Metab. 2006;91:28–30.PubMedCrossRef
38.
Zurück zum Zitat Prins JB, O’Rahilly S. Regulation of adipose cell number in man. Clin Sci (Lond). 1997;92:3–11. Prins JB, O’Rahilly S. Regulation of adipose cell number in man. Clin Sci (Lond). 1997;92:3–11.
39.
Zurück zum Zitat Loftus TM, Kuhajda FP, Lane MD. Insulin depletion leads to adipose-specific cell death in obese but not lean mice. Proc Natl Acad Sci U S A. 1998;95:14168–72.PubMedCrossRef Loftus TM, Kuhajda FP, Lane MD. Insulin depletion leads to adipose-specific cell death in obese but not lean mice. Proc Natl Acad Sci U S A. 1998;95:14168–72.PubMedCrossRef
Metadaten
Titel
The Increase in Serum Visfatin After Bariatric Surgery in Morbidly Obese Women is Modulated by Weight Loss, Waist Circumference, and Presence or Absence of Diabetes Before Surgery
verfasst von
José I. Botella-Carretero
Manuel Luque-Ramírez
Francisco Álvarez-Blasco
Roberto Peromingo
José L. San Millán
Héctor F. Escobar-Morreale
Publikationsdatum
01.08.2008
Verlag
Springer-Verlag
Erschienen in
Obesity Surgery / Ausgabe 8/2008
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-007-9369-7

Weitere Artikel der Ausgabe 8/2008

Obesity Surgery 8/2008 Zur Ausgabe

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

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

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.