Prevalence of cocaine and derivatives in blood and urine samples of trauma patients and correlation with injury severity: a prospective observational study.

PURPOSE: The abuse of cocaine and its derivatives presents a likely risk factor for injury. Trauma incurred by cocaine and derivative abusers may be more severe than that incurred by non-users. OBJECTIVES: To ascertain the presence of cocaine and its derivatives in trauma patients and to correlate RTS (Revised Trauma Score) and ISS (Injury Severity Score) with the presence of cocaine and its derivatives in blood and urine samples. METHODS: All trauma victims treated in an emergency unit between November 11, 2012 and September 15, 2013 were included in the study. Blood and urine samples were collected on admission to hospital. RTS and ISS scores were then compared with the presence or absence of cocaine and its derivatives in the samples. The associations between RTS < 7.84 and ISS > 16 and the independent variables were evaluated by the gross odds ratio values, determined by univariate logistic regression. Multivariate analysis was performed using multivariate logistic regression. RESULTS: Of 453 patients (83.7% male) included in the study, 28.6% presented ISS > 16 and 33.6% presented RTS < 7.84. A total of 435 samples were collected, and 86 (19.8%) provided positive samples for cocaine, 48 (11%) for crack and 69 (15.9%) for cocaethylene. Compared to other patients, drug users showed a greater probability of RTS < 7.84 (2.18 times greater) and a greater probability of ISS > 16 (1.76 times greater). CONCLUSION: For the trauma patients included in our study, the use of cocaine and its derivatives was shown to be associated with more severe traumas, as demonstrated by their RTS and ISS scores.

Rotavirus serotypes and electrophoretypes among children attending three paediatric hospitals in Belem, Brazil.

From March to September 1988 stool specimens of 101 hospitalized diarrhoeic infants and children, aged 1-24 months were examined by enzyme-linked immunosorbent assay (ELISA) for the presence of rotavirus antigen. This agent was found in 40 (40 per cent) of the 101 episodes of acute diarrhoea, and strains were both characterized by analysis of RNA in polyacrilamide gel and serotyped by ELISA using serotype-specific monoclonal antibodies. The highest frequency of rotavirus positivity was 80 per cent in the 16-18 month age group. All 11 (28 per cent) serotyped strains belonged to serotype 3 whereas absence of Vp7, the major outer capsid glycoprotein, did not allow serotyping in 29 (73 per cent) of the 40 rotavirus-positive specimens. Four distinct electrophoretypes were detected and the predominant one had the IbIIbIIIgIV a profile, accounting for 62 per cent of the classified strains. Unclear patterns did not allow us to determine the electrophoretype of six rotavirus strains. The clinical picture in study children was in general of moderate/severe nature.