Med Klin
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Randomized Controlled Trial Clinical Trial
[Effect of selenium administration on various laboratory parameters of patients at risk for sepsis syndrome].
Low selenium plasma levels were often measured in ICU patients with polytrauma, major surgery or various severe diseases. Activation of selenium-dependent functions of the antioxidant metabolism and the immune system is suggested to be causally. ⋯ 1. Rapid normalization of selenium plasma levels can be achieved with the applied selenium dosage. 2. Parameters of radical metabolism are significantly reduced following selenium administration. 3. T3 synthesis correlates closely with the selenium levels. 4. Excessive stimulation of the immune system does not appear in the applied dosage.
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Randomized Controlled Trial Clinical Trial
[Selenium administration in patients with sepsis syndrome. A prospective randomized study].
In this study the effect of antioxidative therapy with sodium selenite was investigated in patients with systemic inflammatory response syndrome (S. I. R. S.) and multiple organ failure. 40 patients were included in this prospective randomized study. The patients were observed over a period of 28 days. The letality rate within 28 days was excepted as main criteria. The Apache-II and the MOF-Score of Goris were used as clinical parameters. 20 patients were treated with sodium selenite over a period of 28 days. ⋯ This antioxidative therapy reduced the letality rate from 40 to 15%.
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In all organisms with a metabolism of oxygen, radicals/reactive oxygen species appear. Normally a balance exists between formation and destruction of radicals. Many diseases show a disturbance of this balance with the destruction of biological structures. Results in patients with sepsis, terminal renal failure, bone marrow transplantation and cancer are given. ⋯ To avoid a possible pro-oxidative effect (vitamins C and E) and intoxications (selenium), before substitution a monitoring is necessary.
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Randomized Controlled Trial Clinical Trial
[Selenium administration in sepsis patients].
It has been hypothesized that low serum selenium concentrations, associated with low glutathione peroxidase activities in critical ill patients may contribute to decreased cleavage from free radicals and deteriorate the clinical outcome. ⋯ Selenium substitution significantly improves clinical outcome and reduces the incidence of acute renal failure.
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Adult onset Still's disease (AOSD) is an uncommon, systemic, inflammatory disorder of unknown etiology, characterized by the triad of fever, arthritis and rash. ⋯ The differential diagnosis of fever of unknown origin should always include AOSD, because these patients could be spared from invasive and unnecessary diagnostic measures. Increased serum ferritin levels are of particular value in the diagnosis of acute AOSD and the normalization of the serum ferritin value is a reliable indicator of therapeutic success.