Background: Several studies have suggested that selenium may influence the natural history of autoimmune thyroiditis (AIT). Recently, IFNγ-inducible chemokines (CXCL-9, -10 and -11) were shown to be elevated in AIT patients. Objective: This prospective, randomized, controlled study was conducted to evaluate the effect of two doses of selenomethionine (Semet; 80 or 160 µg/day) versus placebo in euthyroid women with AIT, in terms of reduction of anti-thyroid antibodies, CXCL-9, -10 and -11 and improvement of thyroid echogenicity, over 12 months. Patients and Methods: Sixty patients, aged 21-65 years, were equally randomized into 3 groups: placebo, 80 µg/day of Semet (80-Semet) or 160 µg/day of Semet (160-Semet). Results: Anti-thyroperoxidase antibody (TPOAb) levels remained unaffected by Semet supplementation; anti-thyroglobulin antibody levels showed a significant reduction in the 160-Semet and the placebo group at 12 months. No significant change in thyroid echogenicity, thyroid volume and quality of life was observed within and between the groups. Subclinical hypothyroidism was diagnosed in 2 patients of the placebo group versus 1 patient in each Semet group. Serum CXCL-9 and -10 were significantly reduced in both Semet groups at 6 and 12 months, while they remained unchanged or increased in the placebo group. CXCL-11, TNFα and IFNγ showed a transient decrease at 6 months in both Semet groups but returned nearly to the basal levels at 12 months. Conclusions: Semet supplementation had no positive effect on thyroid echogenicity or TPOAb in our patients. However, we observed a Semet-dependent downregulation of the IFNγ-inducible chemokines, especially CXCL-9 and -10, which may serve as helpful biomarkers in future selenium supplementation trials.

Selenium-binding protein 1 (SELENBP1) is an intracellular protein that has been detected in the circulation in response to myocardial infarction. Hypoxia and cardiac surgery affect selenoprotein expression and selenium (Se) status. For this reason, we decided to analyze circulating SELENBP1 concentrations in patients (n = 75) necessitating cardioplegia and a cardiopulmonary bypass (CPB) during the course of the cardiac surgery. Serum samples were collected at seven time-points spanning the full surgical process. SELENBP1 was quantified by a highly sensitive newly developed immunological assay. Serum concentrations of SELENBP1 increased markedly during the intervention and showed a positive association with the duration of ischemia (ρ = 0.6, p < 0.0001). Elevated serum SELENBP1 concentrations at 1 h after arrival at the intensive care unit (post-surgery) were predictive to identify patients at risk of adverse outcome (death, bradycardia or cerebral ischemia, “endpoint 1”; OR 29.9, CI 3.3–268.8, p = 0.00027). Circulating SELENBP1 during intervention (2 min after reperfusion or 15 min after weaning from the CPB) correlated positively with an established marker of myocardial infarction (CK-MB) measured after the intervention (each with ρ = 0.5, p < 0.0001). We concluded that serum concentrations of SELENBP1 were strongly associated with cardiac arrest and the duration of myocardial ischemia already early during surgery, thereby constituting a novel and promising quantitative marker for myocardial hypoxia, with a high potential to improve diagnostics and prediction in combination with the established clinical parameters.

Aim: Headache is a common neurological complaint in emergency departments (EDs). However, potential sex-related differences in triage assessment, diagnostic evaluation, and management remain poorly understood. This study examined sex differences across the emergency care pathway among patients presenting with headache. Methods: We conducted a cross-sectional observational study of adult patients presenting with headache to a large university hospital ED between 5 May 2023, and 5 May 2025. Sex differences were analyzed across key stages of emergency care, including Manchester Triage System (MTS) assignment, pain intensity, ED process times, diagnostic procedures, acute treatment, and final diagnoses. Multivariable logistic regression models were used to assess associations between sex and clinical management outcomes while adjusting for potential confounders. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated. Results: Among 95,150 ED presentations during the study period, 1825 adults (1.9%) presented with headache (61.9% women; mean age 48.5 ± 19.7 years). Women were more frequently assigned higher-urgency triage categories, whereas male sex was associated with lower odds of higher-urgency triage (aOR 0.79, 95% CI 0.62–0.99). Use of cranial CT and lumbar puncture did not differ by sex, while men had lower odds of cranial MRI (aOR 0.48, 95% CI 0.26–0.90). Men were more likely to be diagnosed with secondary headache due to serious pathology (aOR 1.54, 95% CI 1.08–2.19) and less likely with primary headache disorders (aOR 0.73, 95% CI 0.54–0.98). Women more often received repeated non-opioid analgesics (aOR 1.60, 95% CI 1.06–2.44) and antiemetics (aOR 1.69, 95% CI 1.16–2.45). No evidence of systematic sex-based delays in ED care delivery was observed. Conclusion: Sex differences in emergency headache care emerge early in the clinical pathway. Lower perceived urgency despite a higher likelihood of serious pathology among men suggests a potential mismatch between triage assessment and underlying clinical risk. These findings highlight the need to further evaluate sex-related factors in triage and diagnostic pathways for patients presenting to the ED with headache.