Consensus ; Critical Illness ; Humans ; Serum Albumin ; Serum Albumin, Human

OBJECTIVETo assess the value of combined detection of copeptin and ischemia modified albumin (IMA) in early diagnosis and prognostic evaluation of myocardial damage in patients with acute organic phosphorus pesticide poisoning (AOPP).

METHODSA total of 126 AOPP patients were examined for blood copepin and IMA levels and myocardial injury markers within 1 h after admission.

RESULTSCopeptin and IMA levels significantly increased in patients with AOPP compared with those in the control subjects. Copeptin and IMA levels were significantly higher in severe AOPP cases than in mild to moderate cases (P<0.05). Logistic regression analysis showed that increased copeptin and IMA levels and severe complications of AOPP were associated with an increased risk of cardiovascular events.

CONCLUSIONEarly detection of copeptin and IMA levels has important clinical value in early diagnosis and prognostic evaluation of myocardial damage in patients with AOPP, and their levels are positively correlated with the severity of the condition.

Biomarkers ; blood ; Early Diagnosis ; Glycopeptides ; blood ; Humans ; Organophosphate Poisoning ; diagnosis ; Pesticides ; poisoning ; Prognosis ; Serum Albumin ; Serum Albumin, Human

Humans ; Adult ; Serum Albumin, Human ; Consensus ; Cardiac Surgical Procedures ; Thoracic Surgery

Malnutrition is one of the most important factors for the development of nosocomial infection (NI). We performed a study of the correlation between abnormal nutritional factors and NI risk by investigating the patients who stayed longer than 3 days in the intensive care unit (ICU) of our university hospital. The patients were classified into three groups based on serum albumin levels and total lymphocyte counts (TLC). The criteria of Group I (well nourished group) were serum albumin level of 3.5 g/dl or higher and TLC of 1, 400/mm3 or higher. The criteria of Group III (severely malnourished group) were serum albumin of less than 2.8 g/dl and TLC of less than 1, 000/mm3. The other patients were classified as Group II (moderately malnourished group). The occurrences of NI were monitored during the study period and the APACHE III Score was calculated. The probability of first NI infection in Group III was 2.4 times higher than that in Groups I and II. The mortality rate of 20.5% was more significantly correlated with APACHE III Score than nutritional status. Nineteen (53%) of the total 36 NI patients were infected within 10 days after ICU admission and they all belonged to Group III. When we compared the gap period between infections, the time to first infection was significant.
Cross Infection/*epidemiology ; Female ; Human ; Incidence ; Intensive Care Units ; Male ; Nutrition Disorders/*complications/immunology ; Serum Albumin/analysis

Albumin is the most abundant protein in human serum. A dye-binding method is commonly used in clinical laboratories for its estimation using different types of dyes. However, all these dye methods were interfered by a variety of compounds. Here we present a method for the detection of albumin in human serum and other biological fluids. The principle is based on the fact that lactate dehydrogenase isoenzyme-5 (LDH-5) binds specifically to Dextran-Blue (DB). Albumin inhibits the binding of LDH-5 with DB. Absence of LDH activity in DB fraction after gel filtration indicates the presence of albumin in sample and vice versa.
Chemistry, Clinical/*methods ; Chromatography, Gel ; Human ; Isoenzymes/metabolism ; Lactate Dehydrogenase/metabolism ; Protein Binding ; Sepharose/chemistry ; Serum Albumin/*analysis

In order to observe the effects of serum albumin and fibrinogen on biophysical surface properties and the morphology of pulmonary surfactant in vitro, we measured the surface adsorption rate, dynamic minimum and maximum surface tension (min-, max-ST) by Pulsating Bubble Surfactometer, and demonstrated ultrastructures on a series of mixtures with varying concentrations of albumin or fibrinogen and Surfactant-TA. The albumin and fibrinogen significantly inhibited the adsorption rate and ST-lowering properties of surfactant through increasing STs of adsorption rate, min-ST, and max-ST. The characteristic morphology of the Surfactant-TA changed from lamellar rod-like structure with open ends into spherical structures with loss of their open ends by mixing with albumin or fibrinogen. These inhibitory effects of albumin and fibrinogen on surface properties of surfactant were dependent upon the increasing concentration of albumin or fibrinogen. We concluded that albumin and fibrinogen significantly altered surfactant function and its ultrastructural morphology in vitro. These findings support the concept that albumin and fibrinogen-induced surfactant dysfunction may play an important role in the pathophysiology of adult respiratory distress syndrome, and this adverse effect of albumin and fibrinogen on surfactant might be overcome by administration of large doses of exogenous surfactant.
Adsorption ; Animal ; Cattle ; Fibrinogen/pharmacology* ; Human ; Pulmonary Surfactants/ultrastructure* ; Pulmonary Surfactants/drug effects ; Serum Albumin, Bovine/pharmacology* ; Surface Properties

BACKGROUND:  Methylprednisolone  Pulse  Therapy  (MPPT)  is standard of care in the management of severe systemic lupus erythematosus (SLE). This treatment, though,  is considered   a   double-edged   sword   due to its life-threatening adverse  effects.  Renal  disease,  liver disease and high dose of the drug are factors proposed to adversely affect outcomes of patients treated  with  MPPT.   Despite   the   widely   accepted use of MPPT, there are no reports describing the outcomes   from   its   use   among   Filipinos   with SLE.
OBJECTIVE: To determine the in-hospital outcomes of patients with SLE treated with MPPT and to identify  factors   associated   with   adverse  outcomes.
GENERAL STUDY DESIGN:  Retrospective
POPULATION:  Adult  patients  with  SLE  who  were  admitted  in Philippine General  Hospital  and  underwent  MPPT from   January   2008   to   December  2012.
METHODS: Patient demographics,  disease  characteristics  on admission, indications for MPPT and in-hospital outcomes   were  extracted.
ANALYSIS: Chi-square test and Fisher's exact  test  were  used  to  elicit  association  of  population  characteristics  to  outcomes.
RESULTS: Forty-two patients  with  SLE  who  underwent MPPT were included. Majority are females  (98%)  and  most (60%) underwent MPPT within one year of SLE diagnosis.  High   disease   activity   is   seen   at   the time
of MPPT with a mean Mex-SLEDAI score  of  14.69. Infection (83%) is the most common comorbidity.  Anemia, hypoalbuminemia and significant  proteinuria  are the most common  laboratory  abnormalities.  The  top indication for MPPT is nephritis (83.3%). The dose received  by the  majority  (66.7%)   is   one   gram/day for   three   days,   which   is   a   high  dose.
Improvement rate is 76% but the in-hospital complication  rate  is  64%  and  mortality  rate   is   21%. Patients with in-hospital complications have significantly lower absolute lymphocyte count (p=0.013), serum albumin (p=0.04) and greater 24-hour proteinuria (p=0.04) at baseline. High-dose MPPT is significantly associated with in-hospital complications (p=0.04) but not mortality. Nephritis (p= 0.04) and low platelet counts at baseline  (p=0.01)  are  associated with  mortality.
CONCLUSION:  In this  population,  there  is   a   high  rate   of  improvement  of   lupus  disease  activity  when  MPPT   is used but there is a corresponding high rate of in-hospital  complications  and   mortality.   High   dose  of MPPT seems to be associated with increased in-  hospital complication, while nephritis and low platelet count showed a probable association with mortality. Further studies  on  a  larger  cohort  are  needed.  For  now, the findings of this study may be helpful in developing guidelines on the use  of  MPPT  among Filipino   patients   with  SLE.

Human ; Male ; Female ; Adult ; Hypoalbuminemia ; Serum Albumin ; Lupus Erythematosus, Systemic ; Nephritis ; Kidney Diseases ; Proteinuria ; Anemia ; Liver Diseases ; Lymphocyte Count ; Methylprednisolone

OBJECTIVETo analyze serum levels of non-esterified fatty acids (NEFA) and albumin (ALB) in children with nephrotic syndrome (NS) and investigate the clinical significance of altered serum NEFA to ALB ratio in children with NS in acute and remission phases.

METHODSSerum levels of NEFA and ALB were measured in 55 NS children in acute phase, in 33 NS children in remission and in 122 healthy control children, and the ratio of NEFA to ALB was calculated. The other lipid/lipoprotein and renal function parameters were also analyzed in these children.

RESULTSCompared with the healthy control children, children with NS had a significantly decreased serum ALB level (t=11.152, P<0.001) and a significantly increased NEFA to ALB ratio (t=4.991, P<0.001). Compared with NS children in remission, those in acute phase showed a significantly decreased ALB (Z=7.822, P<0.001) and an increased NEFA to ALB ratio (t=4.991, P<0.001). In all the NS children, NEFA to ALB ratio was positively correlated with the levels of TC (r=0.564, P<0.001), TG (r=0.444, P<0.001), LDL-C (r=0.625, P<0.001), urea (r=0.437, P<0.001), creatinine (r=0.278, P=0.013), and uric acid (r=0.397, P<0.001), while negatively correlated with the level of total protein (r=-0.461, P<0.001). Multiple linear regression analyses showed that NEFA to ALB ratio was independently associated with serum urea levels (β=0.703, P=0.001; adjusted R=0.494) after adjustment of other related factors.

CONCLUSIONSerum NEFA to ALB ratio is significantly increased in NS children in close association with impaired kidney function, and may function as a novel parameter for assessing the development of NS.

Case-Control Studies ; Child ; Fatty Acids, Nonesterified ; blood ; Humans ; Nephrotic Syndrome ; blood ; Regression Analysis ; Serum Albumin, Human ; analysis

OBJECTIVETo assess the value of an improved ischemia modified albumin (IMA) assay in the diagnosis of early acute myocardial infarction (AMI).

METHODSForty-three patients with AMI were enrolled in this study with 41 patients with chest pain serving as the control. Blood samples were obtained from all the patients within 6 h after the onset. IMA was measured by the albumin cobalt binding test and results were presented by absorbance units (ABSU). Receiver operator characteristic curve (ROC curve) was used to evaluate the optimal cut-off value of the assay.

RESULTSThe mean absorbance in AMI group was obviously higher than that in the control group (1.195-/+0.320 vs 0.855-/+0.068, P<0.001). The area under the receiver of ROC curve was 0.947, and at the cut-off value of 0.906 ABSU, the sensitivity and specificity of the assay were 93.0% and 82.9%, respectively.

CONCLUSIONThe improved IMA assay shows good value in early diagnosis of AMI in patients with acute chest pain.

Acute Coronary Syndrome ; Adult ; Aged ; Aged, 80 and over ; Biomarkers ; blood ; Early Diagnosis ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; blood ; diagnosis ; Myocardial Ischemia ; diagnosis ; Sensitivity and Specificity ; Serum Albumin ; Serum Albumin, Human ; Troponin T ; blood

BACKGROUND: The effect of the redox state of human serum albumin (HSA) on the antioxidant properties of the entire body has been a focus of recent research. The usefulness of HSA redox state as a biomarker for reducing oxidative stress has been investigated in clinical settings; however, evidence for its significance as a health index in non-clinical settings is yet to be established. This study aimed to examine the associations between HSA redox state and the atherosclerotic indices of carotid intima-media thickness (IMT) and plaque formation in a rural Japanese population. METHODS: We conducted a cross-sectional study as part of a health check-up program in the rural area of Hokkaido, Japan, at the end of August 2013. A total of 281 residents (124 men and 157 women) were included in the final analysis. Lifestyle-related data were obtained through a self-reported questionnaire, and ultrasound examinations were performed to measure IMT and determine plaque formation. The high-performance liquid chromatography postcolumn bromocresol green method was used to separate HSA into human nonmercaptalbumin and human mercaptalbumin (HMA). RESULTS: We found a significant negative relationship between the fraction of HMA [f(HMA)] and IMT (standardized β = - 0.132, p = 0.03). Moreover, f(HMA) was significantly associated with plaque formation (p < 0.01) with an odds ratio of 0.89 (95% confidence interval, 0.81-0.97) for every 10% increment in f(HMA). CONCLUSIONS We found that the HSA redox state, as determined by f(HMA), was associated with atherosclerotic indices in Japanese subjects. These results suggest that the HSA redox state indicates the risk of developing atherosclerosis.
Adult ; Aged ; Aged, 80 and over ; Atherosclerosis ; epidemiology ; etiology ; Biomarkers ; Carotid Intima-Media Thickness ; statistics & numerical data ; Cross-Sectional Studies ; Female ; Humans ; Japan ; epidemiology ; Male ; Middle Aged ; Oxidation-Reduction ; Risk Factors ; Serum Albumin ; metabolism ; Serum Albumin, Human ; metabolism