Modulating oxidative stress by increasing endogenous antioxidant defence mechanisms has already been intensively investigated. A new set of data was presented in the journal this year [41] . The administration of pharmacological doses of selenium for 14 days in 75 patients with systemic inflammation or sepsis allowed an increase in glutathione peroxidase activity as compared to 75 untreated patients. However, no change was found in mortality, even in subgroups of patients stratified by severity of disease or organ failures. The modalities and indications for antioxidant strategies should definitely be carefully scrutinised in the future. Paraquat intoxication is a prototypical example of oxidative stress associated with high mortality. In such cases, therapeutic options and antidotes are scarce. A new treatment algorithm (high-dose cyclophosphamide ? high-dose methylprednisolone) has been assessed and compared to the previous treatment (cyclophosphamide ? dexamethasone) in a very large cohort of 111 patients with paraquat poisoning [42] . Mortality was decreased from 92 to 66% in patients randomised to the new algorithm. These important results obviously bring a major contribution to the field of toxicology.