Article
Medicine, General & Internal
Sun Y. Lee, Katherine L. Modzelewski, Anica C. Law, Allan J. Walkey, Elizabeth N. Pearce, Nicholas A. Bosch
Summary: This study compared the effectiveness of propylthiouracil and methimazole in the treatment of thyroid storm, and found no significant differences in mortality or adverse events between the two medications. Therefore, current guidelines recommending propylthiouracil over methimazole for the treatment of thyroid storm may need to be reevaluated.
Article
Biochemistry & Molecular Biology
Albert Figueras Castilla, Maria A. Ballesteros Vizoso, Amanda Iglesias Coma, Antonia Barcelo, Jesus A. Barea-Mendoza, Paula Argente del Castillo, Begona Guardiola, Jon Perez-Barcena, Juan A. A. Llompart-Pou
Summary: The mechanisms of thyroid dysfunction in critically ill COVID-19 patients are not clear. This prospective study aimed to explore the correlation between thyroid response and inflammatory cytokines profile in critically ill COVID-19 patients. Seventy-eight patients were included in the study, and the correlation and regression analysis were performed to investigate the relationship between continuous variables. The study found weak correlation between thyroid stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and inflammatory cytokines at ICU admission, but an inversely correlation was found between fT4 and IL-10 at day 5.
Article
Critical Care Medicine
Dipti Saha, Saurabh Chattopadhyay, Sayak Sovan Dutta, Anup Kumar Roy
Summary: The purpose of this study was to understand the cytomorphological basis of non-thyroidal illness (NTI) by examining the histopathology of the thyroid gland in autopsies of critically ill patients. The results showed that critical illness has metabolically damaging effects on the thyroid gland and leads to thyroid dysfunction. These changes are more pronounced in burn injury and cerebral stroke patients.
JOURNAL OF CRITICAL CARE
(2023)
Article
Medicine, General & Internal
Maria Antonieta Ballesteros Vizoso, Albert Figueras Castilla, Antonia Barcelo, Joan Maria Raurich, Paula Argente del Castillo, Daniel Morell-Garcia, Julio Velasco, Jon Perez-Barcena, Juan Antonio Llompart-Pou
Summary: By analyzing the thyroid profile in critically ill COVID-19 patients, variables associated with mortality and the predictive ability of mortality were identified. The study found that fT4 on day 5 after ICU admission was associated with in-hospital mortality.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Critical Care Medicine
Swarna Rajagopalan, Aarti Sarwal
Summary: Critically ill patients are at high risk of acute brain injury. Bedside neuromonitoring techniques can provide early detection of neurologic deterioration before clinically manifest signs occur. Neuromonitoring provides measurable parameters of brain injury that can be used as a target for investigating therapeutic interventions, monitoring treatment responses, and testing clinical paradigms to improve clinical outcomes.
CRITICAL CARE MEDICINE
(2023)
Article
Endocrinology & Metabolism
W. Gao, W. Guo, Y. Guo, M. Shi, G. Dong, G. Wang, Q. Ge, J. Zhu, X. Zhou
Summary: This study aimed to investigate the characteristics of thyroid hormone levels in COVID-19 patients, finding significantly lower free T3 concentrations in severe patients, with reduced FT3 independently predicting increased all-cause mortality in patients with severe COVID-19.
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION
(2021)
Review
Physiology
Matthieu Petit, Antoine Vieillard-Baron
Summary: This review article focuses on the mechanism of ventricular interdependence, which is a commonly encountered phenomenon, especially in critically ill patients. It is explained by the anatomy of the heart, with two ventricles sharing a common wall called the septum and nested in an acutely inextensible envelope known as the pericardium. In pathological situations, it results in abnormal movements of the interventricular septum driven by respiration, leading to abnormal filling of one or the other ventricle. Ventricular interdependence has several clinical applications and can explain hemodynamic impairments in various conditions.
FRONTIERS IN PHYSIOLOGY
(2023)
Article
Medicine, General & Internal
Narakorn Muentabutr, Worapaka Manosroi, Nutchanok Niyatiwatchanchai
Summary: This study found that thyroid hormone and cortisol levels are significantly associated with ICU mortality, and these hormones can enhance the predictive ability of APACHE II scores for ICU mortality.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Pharmacology & Pharmacy
Xiangru Luo, Shiyi Wang, Dong Li, Jun Wen, Na Sun, Guangjun Fan
Summary: The study aimed to develop a pharmacokinetic model for tigecycline in critically ill patients and optimize dosing regimens. Results showed that APACHEII score and age significantly influenced the drug's clearance and distribution volume. The standard dose regimen often failed to achieve satisfactory therapeutic effects for critically ill patients.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Agustin Clemente-Moragon, Juan Martinez-Milla, Eduardo Oliver, Arnoldo Santos, Javier Flandes, Iker Fernandez, Lorena Rodriguez-Gonzalez, Cristina Serrano del Castillo, Ana-Maria Ioan, Maria Lopez-Alvarez, Sandra Gomez-Talavera, Carlos Galan-Arriola, Valentin Fuster, Cesar Perez-Calvo, Borja Ibanez
Summary: In this study, metoprolol treatment in patients with COVID-19-associated ARDS was shown to be safe and effective in reducing lung inflammation and improving oxygenation, resulting in fewer days on invasive mechanical ventilation. Repurposing metoprolol for COVID-19-associated ARDS could be a cost-effective strategy to alleviate the burden of the pandemic.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Computer Science, Information Systems
Chao Yan, Cheng Gao, Ziqi Zhang, Wencong Chen, Bradley A. Malin, E. Wesley Ely, Mayur B. Patel, You Chen
Summary: A machine learning model was developed to predict changes in brain function status of ICU patients, achieving high accuracy and generalizability. By identifying influential factors, a compact model was developed for quick decision-making by clinicians, aiding in efficient hospital resource allocation.
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
(2021)
Review
Medicine, General & Internal
Bruno De Oliveira, Nahla Aljaberi, Ahmed Taha, Baraa Abduljawad, Fadi Hamed, Nadeem Rahman, Jihad Mallat
Summary: Patient-ventilator dyssynchrony refers to a mismatch between the patient's respiratory efforts and mechanical ventilator delivery, which can occur at any phase throughout the respiratory cycle. There are different types of dyssynchrony, including trigger dyssynchrony, flow dyssynchrony, and cycling dyssynchrony, each with different mechanisms and potential management. Dyssynchrony is associated with patient outcomes, underscoring the importance of recognizing and addressing it at the bedside.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Medicine, General & Internal
S. Rodriguez-Villar, J. A. Kraut, J. Arevalo-Serrano, S. G. Sakka, C. Harris, I Awad, M. Toolan, S. Vanapalli, A. Collins, A. Spataru, P. Eiben, V Recea, C. Brathwaite-Shirley, L. Thompson, B. Gurung, R. Reece-Anthony
Summary: This study investigated the impact of acidemia on cardiac function in a large cohort of critically ill patients. The findings suggest that acidemia is associated with impaired cardiac function, highlighting the potential value of early diagnosis and improvement of arterial pH in these patients.
Article
Biology
Melanie Fromentin, Jean-Damien Ricard, Damien Roux
Summary: The historical hypothesis of sterility of the lungs has been invalidated by studies that prove the existence of diverse bacterial populations in the normal lung, and the association between pulmonary dysbiosis and chronic respiratory diseases. Dysbiosis occurs rapidly during mechanical ventilation, leading to a decline in diversity and the dominance of bacterial pathogens. In acute respiratory distress syndrome, there is an enrichment of intestinal bacteria, but its role in the pathogenesis of ventilator-associated pneumonia and acute respiratory distress syndrome is not fully understood. Further exploration of microbial populations, viruses, and fungi, as well as understanding the host-microbiome interaction, is necessary to fully elucidate the role of the microbiome in acute diseases.
Review
Microbiology
Georgios Papathanakos, Ioannis Andrianopoulos, Menelaos Xenikakis, Athanasios Papathanasiou, Despoina Koulenti, Stijn Blot, Vasilios Koulouras
Summary: Sepsis, a life-threatening infection-induced disorder of organ function, is a major cause of mortality worldwide, particularly in intensive care units. With an incomplete understanding of its complex pathophysiology, sepsis exhibits great heterogeneity in clinical expression, patient response to treatment, and outcomes. This heterogeneity poses a significant challenge for improving treatment in critical care. However, artificial intelligence and machine learning techniques offer promise for identifying clinical phenotypes and distinguishing individuals based on various factors such as temperature, hemodynamics, organ dysfunction, fluid status, ICU trajectories, and outcome. Ultimately, this approach may allow for targeted therapeutic interventions and optimal timing in septic patients.
Article
Endocrinology & Metabolism
Matthew D. Ettleson, Ava Raine, Alice Batistuzzo, Samuel P. Batista, Elizabeth McAninch, Maria Cristina T. V. Teixeira, Jacqueline Jonklaas, Neda Laiteerapong, Miriam O. Ribeiro, Antonio C. Bianco
Summary: This study investigated the factors and patient concerns related to brain fog symptoms in patients receiving treatment for hypothyroidism. The results showed that fatigue and cognitive symptoms were most frequently associated with brain fog. Additionally, several patient concerns associated with brain fog were identified, which are typically not addressed in thyroid-specific questionnaires.
ENDOCRINE PRACTICE
(2022)
Letter
Endocrinology & Metabolism
Mohamed K. M. Shakir, Daniel I. Brooks, Elizabeth A. McAninch, Tatiana De Lourdes Fonseca, Vinh Q. Mai, Antonio C. Bianco, Thanh D. Hoang
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Article
Endocrinology & Metabolism
Fabyan Esberard de Lima Beltrao, Daniele Carvalhal de Almeida Beltrao, Giulia Carvalhal, Fabricia Elizabeth de Lima Beltrao, Jair de Souza Braga Filho, Jocyel de Brito Oliveira, Joice dos Santos de Jesus, Gabriel Jeferson Rodriguez Machado, Hatilla dos Santos Silva, Helena Mariana Pitangueira Teixeira, Juliana Lopes Rodrigues, Camila Alexandrina Viana de Figueiredo, Ryan dos Santos Costa, Fabio Hecht, Antonio C. Bianco, Maria da Conceicao Rodrigues Goncalves, Helton Estrela Ramos
Summary: Research on Thr92Ala-DIO2 polymorphism in COVID-19 patients showed that the Thr/Ala genotype is associated with lower intrahospital mortality rates, indicating a protective role of this genotype.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Review
Endocrinology & Metabolism
Laszlo Hegedus, Antonio C. Bianco, Jacqueline Jonklaas, Simon H. Pearce, Anthony P. Weetman, Petros Perros
Summary: The treatment of hypothyroidism has not seen major innovations since the 1970s when thyroid extract was replaced by levothyroxine. The definition of subclinical hypothyroidism is debated and indiscriminate screening has led to overdiagnosis and treatment initiation at lower TSH levels. While levothyroxine substitution can improve quality of life, it may not always normalize it, especially for individuals with mild hypothyroidism.
NATURE REVIEWS ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Alexandra M. Dumitrescu, Erin C. Hanlon, Marilyn Arosemena, Olga Duchon, Matthew Ettleson, Mihai Giurcanu, Antonio C. Bianco
Summary: The study aimed to evaluate the pharmacokinetics and pharmacodynamics of PZL-derived T3 in healthy volunteers, showing that PZL exhibited more stable pharmacokinetic properties compared to LT3. This indicates the potential for PZL to provide hypothyroid patients with stable levels of serum T3.
Article
Medicine, General & Internal
Arno Teblick, Lisa Van Dyck, Nathalie Van Aerde, Sarah Van der Perre, Lies Pauwels, Inge Derese, Yves Debaveye, Pieter J. Wouters, Ilse Vanhorebeek, Lies Langouche, Greet Van den Berghe
Summary: This study found tissue-specific expression changes of receptor-regulatory factors in critically ill patients, which adaptively guide the action of glucocorticoids in different tissues. These findings are important for understanding the importance of glucocorticoid resistance and glucocorticoid treatment.
Review
Medicine, Research & Experimental
Arno Teblick, Jan Gunst, Lies Langouche, Greet Van den Berghe
Summary: Sepsis is a life-threatening organ dysfunction caused by a dysregulated response to infection. Preclinical and clinical research have shown that there is a biphasic pattern in the neuroendocrine responses to sepsis, contributing to the development of severe metabolic alterations. Early full feeding in the acute phase induced harm, while the benefits of metabolic alterations such as hyperglycemia are still unclear.
Article
Multidisciplinary Sciences
Ruben Weckx, Chloe Goossens, Sarah Derde, Lies Pauwels, Sarah Vander Perre, Greet Van den Berghe, Lies Langouche
Summary: This study investigated the therapeutic efficacy and safety of ketone ester 3HHB in septic mice. Continuous infusion of 3HHB improved muscle force and avoided toxicity, while bolus injections of 3HHB increased severity of illness and mortality.
SCIENTIFIC REPORTS
(2022)
Article
Endocrinology & Metabolism
Richard Sinko, Petra Mohacsik, Dora Kovari, Veronika Penksza, Gabor Wittmann, Lilla Macsai, Tatiana L. Fonseca, Antonio C. Bianco, Csaba Fekete, Balazs Gereben
Summary: The study in THAI mice mimicking NTIS induced by infection or fasting showed different patterns of TH signaling in different tissues, suggesting that TH levels alone may not be a reliable marker of tissue TH signaling.
Review
Medicine, General & Internal
Greet Van den Berghe, Arno Teblick, Lies Langouche, Jan Gunst
Summary: The traditional model of increased systemic glucocorticoid availability in response to sepsis and hyperinflammation-induced critical illness has been challenged in recent research, revealing a more complex and time-dependent set of responses. Cortisol production driven by ACTH is only temporarily increased, followed by orchestrated peripheral adaptations to maintain increased cortisol availability for target tissues without the need for continued production, along with changes at target tissues to guide cortisol action according to tissue-specific needs.
Article
Behavioral Sciences
Julia Zaccarelli-Magalhaes, Gabriel R. Abreu, Andre R. Fukushima, Lorena P. Pantaleon, Beatriz B. Ribeiro, Camila Munhoz, Marianna Manes, Mayara A. de Lima, Julia Miglioli, Jorge C. Florio, Ivo Lebrun, Paula A. F. Waziry, Tatiana L. Fonseca, Barbara M. L. C. Bocco, Antonio C. Bianco, Esther L. Ricci, Helenice S. Spinosa
Summary: Postpartum depression is a common mental disorder that has negative effects on both women and children. By studying a rat model of postpartum depression caused by maternal separation, it was found that offspring displayed anxiety and poor maternal care due to the stress of separation. Female offspring also exhibited permanent impairment in sociability during adulthood.
BEHAVIOURAL BRAIN RESEARCH
(2023)
Review
Endocrinology & Metabolism
Lies Langouche, Arno Teblick, Jan Gunst, Greet Van den Berghe
Summary: Based on recent insights, the classical concept of an activated hypothalamus-pituitary-adrenocortical axis in response to critical illness is in need of revision. Peripheral adaptations play a more significant role in maintaining increased systemic cortisol availability and action in response to critical illness than centrally activated cortisol production and secretion. These adaptations include suppressed cortisol metabolism, alterations in expression of certain proteins, and negative feedback inhibition at the pituitary level. Prolonged critical illness may lead to central adrenal insufficiency.
Article
Cell Biology
Wouter Vankrunkelsven, Steven Thiessen, Sarah Derde, Ellen Vervoort, Inge Derese, Isabel Pintelon, Hanne Matheussen, Alexander Jans, Chloe Goossens, Lies Langouche, Greet Van den Berghe, Ilse Vanhorebeek
Summary: Critical illness is characterized by severe stress and organ damage. Fibroblast growth factor 21 (FGF21) has been shown to rise during critical illness and may have both protective and detrimental effects on muscle function. This study investigated the role of FGF21 in critical illness-induced muscle weakness and found that endogenous FGF21 may partially protect muscle force and reduce cellular stress, while exogenous FGF21 supplementation did not improve muscle function or reduce cellular stress, suggesting limited clinical applicability of FGF21 supplementation in protecting against muscle weakness during critical illness.
Article
Critical Care Medicine
Jan Gunst, Astrid De Bruyn, An Jacobs, Lies Langouche, Inge Derese, Karolijn Dulfer, Fabian Gueiza, Gonzalo Garcia Guerra, Pieter J. Wouters, Koen F. Joosten, Sascha C. Verbruggen, Ilse Vanhorebeek, Greet van den Berghe
Summary: Delaying parenteral nutrition in critically ill children can improve recovery and protect against long-term emotional and behavioral problems. However, this intervention increases the risk of hypoglycemia, which may have negative effects. Hypoglycemia in the PICU is associated with worse neurodevelopmental outcomes, particularly in cases of spontaneous/recurrent hypoglycemia.
Article
Oncology
Laura Boucai, Federico Salas-Lucia, Gnana P. Krishnamoorthy, Eric Sherman, Charles M. Rudin, Alexander Drilon, Antonio C. Bianco, James A. Fagin
Summary: This study investigated the mechanisms of selpercatinib-induced thyroid dysfunction in RET-mutant MTC and NSCLC patients. The study found that selpercatinib had a nontranscriptional effect on D2 activity, leading to a reduction in T3 levels, primarily observed in patients without a thyroid. Supplementing Liothyronine restored normal thyroid function.
JCO PRECISION ONCOLOGY
(2022)