Translational research : the journal of laboratory and clinical medicine
-
A newly developed rapid immunoassay method for plasma soluble E-selectin (sES) was examined to determine whether it can predict the development of acute respiratory distress syndrome (ARDS) in critically ill patients with systemic inflammatory response syndrome (SIRS). Plasma levels of sES were measured on admission (day 1) to the emergency unit. Development of various types of organ failures including ARDS was compared in the first 5 days of admission (from day 1 to day 5) between patients with normal plasma levels of sES and those with elevated plasma levels of sES. ⋯ Development of ARDS was significantly higher in the D(A)E group (15/22, 68.2%) than in the D(A)N group (4/28, 14.3%) (P < 0.001) and that of cardiovascular system failure, renal failure, and coagulation system failure was also significantly higher in the D(A)E group than in the D(A)N group. The mortality rate at 28 days after admission was higher in the D(A)E group (27.3%) than in the D(A)N group (0%) (P < 0.05). Determination of sES levels by this new rapid assay method might be useful for prediction of the development of ARDS in critically ill patients with SIRS, a pathologic condition that has the potential risk for development of multiple organ failure.
-
Comparative Study
Micronutrients in African-Americans with decompensated and compensated heart failure.
Heart failure is thought to be more common and of greater severity in African-Americans (AAs). Potential mechanisms remain uncertain. The importance of micronutrient deficiencies in the pathophysiologic expression of congestive heart failure (CHF) in AAs remains to be explored, including hypovitaminosis D, which can promote secondary hyperparathyroidism (SHPT), together with hypozincemia and hyposelenemia, the 2 most crucial trace minerals integral to diverse biologic functions. ⋯ Serum Zn was below normal in 11 of 15 patients with protracted CHF, in 8 of 15 patients with shorter duration CHF, and in 5 of 10 patients with compensated failure. Serum Se was reduced in all patients with >or=4 weeks, 60% with short-term CHF, and 90% of compensated patients. Concomitant to hypovitaminosis D, hypozincemia, and hyposelenemia, SHPT is a covariant of CHF in housebound AAs.