BACKGROUND & OBJECTIVES Postmenopausal women constitute an ideal model for studying the extent of hypothalamo-pituitary gonadal (HPG) axis suppression in critical illness as the gonadotropins are normally high and non-cyclical in them. The objective was to assess the impact of acute severe illness in postmenopausal women on the HPG axis and the activities of the hypothalamo-pituitary-adrenal (H...

The high prevalence and pervasive impact of delirium in critically ill patients has been demonstrated in multiple studies. Subsequently there has grown a body of literature regarding delirium assessment in critical illness. The present commentary briefly discusses delirium screening in an intensive care unit environment.

OBJECTIVE Glycemic control in the critically ill intensive care unit (ICU) patient has been shown to improve morbidity and mortality. We sought to investigate the effect of early glycemic control in critically ill emergency department (ED) patients in a small pilot trial. METHODS Adult non-trauma, non-pregnant ED patients presenting to a university tertiary referral center and identified as c...

INTRODUCTION Anemia is a common problem in critically ill patients. The etiology of anemia of critical illness is often determined to be multifactorial in the clinical setting, but the pathophysiology remains to be elucidated. Erythropoietin (EPO) is an endogenous glycoprotein hormone that serves as the primary stimulus for erythropoiesis. Recent evidence has demonstrated a blunted EPO response...

INTRODUCTION Adiponectin plays an important role in the regulation of tissue inflammation and insulin sensitivity. Perturbations in adiponectin concentration have been associated with obesity and the metabolic syndrome. Data on adiponectin pathophysiology in critical illness are limited. METHODS Twenty three critically ill patients (9 severe sepsis, 7 burns, 7 trauma). Adiponectin assays on D...

Often critical care providers think that critically ill patients are too sick to tolerate vigorous activity in the early phase of their illness, thereby incurring “unavoidable” prolonged immobilization. Prolonged immobilization is a substantial contributor to neuromuscular abnormalities, resulting in weakness that may complicate the clinical course of a majority of critically ill patients.1-5 I...

D iarrhea is a common problem in critically ill patients. The reported incidence of diarrhea in enterally fed intensive care unit (ICU) patients varies according to the criteria used to define diarrhea, but may be between 15% and 40% or higher. It can be a serious clinical problem , with potential significant detrimental effects on fluid and electrolyte balance, hemodynamic stability, skin inte...

INTRODUCTION Impaired skeletal muscle function has important clinical outcome implications for survivors of critical illness. Previous studies employing volitional manual muscle testing for diagnosing intensive care unit-acquired weakness (ICU-AW) during the early stages of critical illness have only provided limited data on outcome. This study aimed to determine inter-observer agreement and cl...

INTRODUCTION Prolonged critically ill patients reveal low circulating thyroid hormone levels without a rise in thyroid stimulating hormone (TSH). This condition is labeled "low 3,5,3'-tri-iodothyronine (T3) syndrome" or "nonthyroidal illness syndrome (NTI)" or "euthyroid sick syndrome". Despite the low circulating and peripheral tissue thyroid hormone levels, thyrotropin releasing hormone (TRH)...

BACKGROUND Tuberculosis is one of the leading causes of death from infectious diseases worldwide, mainly after the human immunodeficiency virus (HIV) epidemics. Patient with HIV-related illness are more likely to present with severe TB due to immunosuppression. Very few studies have explored HIV/TB co-infection in critically ill patients. The goal of this study was to analyze factors associated...