Performance of galactomannan testing from endotracheal aspirate to guide bronchoalveolar lavage in the diagnosis of invasive aspergillosis.

Purpose: Invasive aspergillosis is a major threat to immunocompromised individuals. Galactomannan (GM) is used as a biomarker for invasive aspergillosis. Investigations recommended in current guidelines include GM testing of bronchoalveolar lavage (BAL) fluids.

Modulation of monocytic lipopolysaccharide-induced tissue factor expression and tumor necrosis factor alpha release by estrogen and calcitriol.

Objective: Modulatory effects of estrogens on both the immune and the coagulation system are only partially understood. In severe infections high estrogen levels have been observed both in men and postmenopausal women and are associated with increased mortality. Monocyte-derived tissue factor (TF) expression can activate the coagulation system and worsen the course of severe infection.

Selenium in Intensive Care (SIC): results of a prospective randomized, placebo-controlled, multiple-center study in patients with severe systemic inflammatory response syndrome, sepsis, and septic shock.

Objective: Sepsis is associated with an increase in reactive oxygen species and low endogenous antioxidative capacity. We postulated that high-dose supplementation of sodium-selenite would improve the outcome of patients with severe sepsis and septic shock.

Design: Prospective randomized, placebo-controlled, multiple-center trial.

New disseminated intravascular coagulation score: A useful tool to predict mortality in comparison with Acute Physiology and Chronic Health Evaluation II and Logistic Organ Dysfunction scores.

Objective: To compare the performance of a coagulation score-the new scoring system for diagnosing disseminated intravascular coagulation (DIC)-with the Acute Physiology and Chronic Health Evaluation (APACHE) II and Logistic Organ Dysfunction score in mortality prediction.

Design: Single-center retrospective study.

Setting: Medical intensive care unit of the University of Munich.

Outcome in elderly patients with severe infection is influenced by sex hormones but not gender.

Objective: The influence of gender as a prognostic variable in patients with severe infections is still controversial. Sex steroid hormones have an important impact on the immune system and vice versa, and prospective studies on the hormonal changes during severe infection are lacking. The objective was to compare the influences of gender and adrenal sex steroid hormone levels on hospital mortality rate in patients with infections.

Selenium substitution has no direct effect on thyroid hormone metabolism in critically ill patients.

Background: In severe illness, plasma selenium levels are decreased; a decreased activity of the selenoenzyme 5'-deiodinase has been hypothesized to contribute to low tri-iodothyronine (T3) levels in non-thyroidal illness (NTI) syndrome in these patients.

Objective: To analyse the influence of selenium substitution on thyroid hormone metabolism in patients with severe sepsis.

Design: A prospective, randomized, controlled study at the medical internal intensive care unit of the University of Munich.

D-dimer as marker for microcirculatory failure: correlation with LOD and APACHE II scores.

The relevance of plasma d-dimer levels as marker for morbidity and organ dysfunction in severely ill patients is largely unknown. In a prospective study we determined d-dimer plasma levels of 800 unselected patients at admission to our intensive care unit. In 91% of the patients' samples d-dimer levels were elevated, in some patients up to several hundredfold as compared to normal values.

Treatment of intoxication with Cortinarius speciosissimus using an antioxidant therapy.

The authors present the case reports of a 30-year-old man and his 29-year-old wife who ingested a mushroom meal containing Cortinarius speciosissimus. Features of this intoxication include gastrointestinal symptoms such as nausea, vomiting, and diarrhea as well as back pain. The toxin orellanine is nephrotoxic and can lead to acute renal failure.

Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations.

In areas with severe selenium deficiency there is a higher incidence of thyroiditis due to a decreased activity of selenium-dependent glutathione peroxidase activity within thyroid cells. Selenium-dependent enzymes also have several modifying effects on the immune system. Therefore, even mild selenium deficiency may contribute to the development and maintenance of autoimmune thyroid diseases.