title: Oxidative stress and acute-phase response in patients with pressure sores.
abstract: OBJECTIVE
  We investigated the relation between oxidative stress and the occurrence of the acute-phase response with serum ascorbic acid and alpha-tocopherol levels in patients with pressure sores.
  
  
  METHODS
  The following groups of patients were studied: 1) those who had patients with pressure sores, 2) those who had pneumonia, and 3) those who did not develop pressure sores or any type of infection (control). Concentrations of total proteins, albumin, creatinine, iron, ferritin, transferrin, C-reactive protein, alpha1-acid glycoprotein, total iron-binding capacity, ascorbic acid, alpha-tocopherol, and malondialdehyde were measured during the first days of hospitalization.
  
  
  RESULTS
  Albumin concentrations were significantly lower (P < 0.05) and C-reactive protein concentrations were significantly higher (P < 0.05) in patients with pressure sores compared with controls. Concentrations of ascorbic acid and alpha-tocopherol were significantly decreased (P < 0.05) in patients who had pressure sores or infection, whereas malondialdehyde concentrations were significantly increased (P < 0.05) compared with control patients. Five of 11 patients (55.56%) with pressure sores and 10 of 12 patients (83.33%) with pneumonia presented serum ascorbic acid concentrations below the reference value (34 to 91 micromol/L). Concentrations of ascorbic acid and alpha-tocopherol versus malondialdehyde were significantly correlated in the three patient groups (r = -0.44, P < 0.05; r = -0.55, P < 0.01, respectively).
  
  
  CONCLUSIONS
  Patients with pressure sores and acute infection present a systemic inflammatory response accompanied by an increase in lipid peroxidation that is associated with decreased serum ascorbic acid and alpha-tocopherol levels, suggesting that these patients may be at risk for important nutritional deficiencies.
authors: Department of Internal Medicine, School Medicine of Triângulo Mineiro, Uberaba, Brazil. mbcfmtm@mednet.com.br
authors: Maria Bernarda Cavalcanti
authors: MB
authors: Cordeiro
authors: Elida Juliana
authors: EJ
authors: Antonelli
authors: Daniel Ferreira
authors: DF
authors: da Cunha
authors: Alceu Afonso Jordão
authors: AA
authors: Júnior
authors: Virmondes Rodrigues
authors: VR
authors: Júnior
authors: Helio
authors: H
authors: Vannucchi
mesh_terms: D000210:Acute-Phase Reaction / Q000378:metabolism*; D000368:Aged; D000975:Antioxidants / Q000378:metabolism*; D001205:Ascorbic Acid / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D006760:Hospitalization; D006801:Humans; D007501:Iron / Q000097:blood; D015227:Lipid Peroxidation; D008297:Male; D008315:Malondialdehyde / Q000032:analysis; D008875:Middle Aged; D009752:Nutritional Status; D010084:Oxidation-Reduction; D018384:Oxidative Stress / Q000502:physiology; D011014:Pneumonia / Q000378:metabolism; D003668:Pressure Ulcer / Q000378:metabolism*; D012709:Serum Albumin / Q000032:analysis; D024502:alpha-Tocopherol / Q000097:blood*
chemical_list: D000975:Antioxidants; D012709:Serum Albumin; D008315:Malondialdehyde; D002097:C-Reactive Protein; D003404:Creatinine; D007501:Iron; D024502:alpha-Tocopherol; D001205:Ascorbic Acid