Clusterin Plasma Concentrations Are Decreased in Sepsis and Inversely Correlated with Established Markers of Inflammation.

Clusterin is a multifunctional protein that is recognized to mediate cellular stress response associated with organ failure, systemic inflammation, and metabolic alterations. The aim of this study was to determine the value of clusterin as a clinical biomarker in critical ill patients with or without sepsis. We analyzed clusterin plasma concentrations in 200 critically ill patients (133 with sepsis, 67 without sepsis) on admission to the medical intensive care unit (ICU).

[Patients requiring ICU treatment for acute poisoning-a 20-year single-center retrospective : Acute poisoning in intensive care].

Background: This study presents a relevant collective of patients with acute poisoning admitted to a medical intensive care unit (ICU) of a tertiary care center in Germany during the past two decades.

Objectives: Our study aims at providing an overview of patients' motivation for intoxication, their behavioral patterns, and subsequent treatment regimens.

Materials And Methods: A total of 1030 patients admitted to the medical ICU of the RWTH Aachen University Hospital due to acute poisoning from January 1999 to December 2019 were included in our study.

Weakly supervised end-to-end artificial intelligence in gastrointestinal endoscopy.

Artificial intelligence (AI) is widely used to analyze gastrointestinal (GI) endoscopy image data. AI has led to several clinically approved algorithms for polyp detection, but application of AI beyond this specific task is limited by the high cost of manual annotations. Here, we show that a weakly supervised AI can be trained on data from a clinical routine database to learn visual patterns of GI diseases without any manual labeling or annotation.

Low Serum Levels of Soluble Receptor Activator of Nuclear Factor κ B Ligand (sRANKL) Are Associated with Metabolic Dysregulation and Predict Long-Term Mortality in Critically Ill Patients.

Soluble receptor activator of nuclear factor κ B ligand (sRANKL) is a member of the tumor necrosis factor receptor superfamily, and therefore, involved in various inflammatory processes. The role of sRANKL in the course of bone remodeling via activation of osteoclasts as well as chronic disease progression has been described extensively. However, the potential functional importance of sRANKL in critically ill or septic patients remained unknown.

Serum Perilipin 2 (PLIN2) Predicts Multiple Organ Dysfunction in Critically Ill Patients.

Perilipin 2 (PLIN2) is a lipid droplet protein with various metabolic functions. However, studies investigating PLIN2 in the context of inflammation, especially in systemic and acute inflammation, are lacking. Hence, we assessed the relevance of serum PLIN2 in critically ill patients.

CT-based determination of excessive visceral adipose tissue is associated with an impaired survival in critically ill patients.

Objective: Obesity is a negative prognostic factor for various clinical conditions. In this observational cohort study, we evaluated a CT-based assessment of the adipose tissue distribution as a potential non-invasive prognostic parameter in critical illness.

Methods: Routine CT-scans upon admission to the intensive care unit (ICU) were used to analyze the visceral and subcutaneous adipose tissue areas at the 3rd lumbar vertebra in 155 patients.

Association of Serum Calprotectin Concentrations with Mortality in Critically Ill and Septic Patients.

Calprotectin is present in the cytosol of neutrophil granulocytes and released upon activation. Fecal calprotectin is applied in the clinical management of inflammatory bowel disease whereas serum calprotectin has been discussed as a biomarker in inflammatory disorders. However, its long-term prognostic relevance in critical illness remains unclear.

Midregional Proadrenomedullin (MRproADM) Serum Levels in Critically Ill Patients Are Associated with Short-Term and Overall Mortality during a Two-Year Follow-Up.

Adrenomedullin (ADM) is a peptide with pleiotropic effects in systemic inflammation. Its more stable precursor protein midregional proadrenomedullin (MRproADM) can be measured more reliably compared to ADM. Our objective was to investigate the potential role of MRproADM as a diagnostic and prognostic biomarker in critically ill patients at the intensive care unit (ICU).

Low Myostatin Serum Levels Are Associated with Poor Outcome in Critically Ill Patients.

Growth differentiation factor 8, GDF-8 (Myostatin), is a protein released by myocytes inhibiting muscle growth and differentiation. Serum concentrations of Myostatin can predict poor survival in different chronic diseases, but its role in critical illness and sepsis is obscure. Our aim was to investigate Myostatin levels as a potential prognostic biomarker in critically ill patients with sepsis.

[Diagnosis and treatment of severe acute pancreatitis in critical care].

Acute pancreatitis is a potentially life-threatening disease that requires intensive care, especially in severe cases. The present article is intended to illustrate the possibilities of a rational diagnosis of acute pancreatitis as well as to provide an overview of the stage-adapted therapy, which includes both conservative measures and interventional interdisciplinary treatment strategies.

Elevated circulating CD14CD16 intermediate monocytes are independently associated with extracardiac complications after cardiac surgery.

Elective cardiac surgery has low procedural complications. However, about 40% of patients develop extracardiac complications including delirium and acute kidney injury. We hypothesized that inflammatory processes and immune cell activation might be associated with these complications.

Differential Gene Expression in Circulating CD14 Monocytes Indicates the Prognosis of Critically Ill Patients with Sepsis.

Critical illness and sepsis are characterized by drastic changes in the systemic innate immune response, particularly involving monocytes. The exact monocyte activation profile during sepsis, however, has remained obscure. Therefore, we prospectively analyzed the gene expression profile of circulating CD14 monocytes from healthy volunteers ( = 54) and intensive care unit (ICU) patients ( = 76), of which = 36 had sepsis.

Erratum: Hohlstein, P. et al. Prognostic Relevance of Altered Lymphocyte Subpopulations in Critical Illness and Sepsis. 2019, , 353.

The authors wish to make the following corrections to this paper [...

Correction to: Neutrophils are a main source of circulating suPAR predicting outcome in critical illness.

[This corrects the article DOI: 10.1186/s40560-019-0381-5.].

Neutrophils are a main source of circulating suPAR predicting outcome in critical illness.

Background: Circulating levels of soluble urokinase plasminogen activation receptor (suPAR) have been proposed as a prognostic biomarker in patients with critical illness and sepsis. However, the origin of suPAR in sepsis has remained obscure. We investigated the potential cellular sources of suPAR by analyzing membrane-bound urokinase plasminogen activator receptor (uPAR, CD87) and evaluated its clinical relevance in critically ill patients.

Prognostic Relevance of Altered Lymphocyte Subpopulations in Critical Illness and Sepsis.

Lymphopenia and functional defects in lymphocytes may impact the prognosis in patients with critical illness or sepsis. Therefore, we prospectively analyzed peripheral blood leukocytes from 63 healthy volunteers, 50 non-critically ill standard care (SC) patients with infections, and 105 intensive care unit (ICU) patients (52 with sepsis, 53 without sepsis) using flow cytometry. Compared to healthy volunteers, SC and ICU patients showed significant leukocytosis, especially in sepsis, while lymphocyte numbers were significantly decreased.

Risk factors for remaining liver injury in patients with virological elimination of chronic hepatitis C.

Background And Aims:  Disease activity, but also demographics, lifestyle, and comorbidities, may influence alanine aminotransferase (ALT) levels in hepatitis C virus (HCV)-infected patients. Direct-acting antiviral agents (DAA) achieve virological cure in > 90 % of patients, regardless of HCV genotype and fibrosis stage. This allows assessing determinants for ALT levels before and after elimination of HCV.

Visfatin Serum Levels Predict Mortality in Critically Ill Patients.

The adipokine visfatin, also termed pre-B-cell colony-enhancing factor (PBEF), is mainly derived from adipose tissue but has been implicated in the regulation of innate immune responses. We hypothesized that visfatin could be a potential circulating biomarker in critical illness and sepsis. We therefore measured serum levels of visfatin in a cohort of 229 critically ill medical patients upon admission to the intensive care unit (ICU).

High Circulating Caspase-Cleaved Keratin 18 Fragments (M30) Indicate Short-Term Mortality in Critically Ill Patients.

Caspase-cleaved fragments of the intermediate filament protein keratin 18 (cytokeratin-18 (CK18)) can be detected in serum as M30 levels and may serve as a circulating biomarker indicating apoptosis of epithelial and parenchymal cells. In order to evaluate M30 as a biomarker in critical illness, we analyzed circulating M30 levels in 243 critically ill patients (156 with sepsis, 87 without sepsis) at admission to the medical intensive care unit (ICU), in comparison to healthy controls ( = 32). M30 levels were significantly elevated in ICU patients compared with healthy controls.

Clinical relevance of copeptin plasma levels as a biomarker of disease severity and mortality in critically ill patients.

Background: Copeptin, also termed C-terminal pre-pro-vasopressin or CTproAVP, mirrors endogenous vasopressin (anti-diuretic hormone, ADH) activity and might thereby serve as a biomarker reflecting the biological stress level. We therefore hypothesized that copeptin plasma concentrations are associated with disease severity in critically ill patients and could predict mortality.

Methods: We analyzed plasma copeptin levels in a prospective, single-center, observational study comprising 218 critically ill patients at admission to the medical intensive care unit (ICU).

[Management of Clostridium difficile infections at German intensive care units - results from a survey among intensivists].

Background: Clostridium difficile associated colitis is a frequent cause of nosocomial diarrhea at the intensive care unit (ICU) and is associated with poor prognosis in critically ill patients. Few studies have evaluated the efficacy of treatment options or adherence to guideline recommendations of Clostridium difficile infections at the ICU.

Methods: Therefore, on behalf of the Gastroenterology Intensive Care Medicine working group of the DGVS, we have conducted an online-based survey among leading intensivists in Germany.

High mobility group box 1 as a biomarker in critically ill patients.

Background: Extracellular release of high mobility group box 1 (HMGB1) acts as a danger-associated molecular pattern, thereby "alarming" the immune system and promoting systemic inflammation. We investigated plasma HMGB1 concentrations as a potential diagnostic and prognostic biomarker in critical illness.

Methods: Our study included 218 critically ill patients (145 with sepsis, 73 without sepsis), of whom blood samples were obtained at the time-point of admission to the medical intensive care unit (ICU).

Growth Differentiation Factor-15 Is a Predictor of Mortality in Critically Ill Patients with Sepsis.

Growth differentiation factor-15 (GDF-15) is a member of the transforming growth factor- superfamily related to inflammation and macrophage activation. Serum concentrations of GDF-15 can predict poor survival in chronic diseases, but its role in sepsis is obscure. Therefore, we investigated GDF-15 as a prognostic biomarker in critically ill patients.

Prevalence and nature of potential drug-drug interactions among kidney transplant patients in a German intensive care unit.

Background Complex polypharmacotherapy makes kidney transplant patients vulnerable to drug-drug interactions (DDIs). Objective To study prevalence and nature of potential DDIs (pDDIs) in kidney transplant patients. Setting Internal medicine ICU, University Hospital RWTH Aachen.