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.

First Report on the Transmission of 'Candidatus Liberibacter americanus' from Citrus to Nicotiana tabacum cv. Xanthi.

Huanglongbing (HLB), also known as greening, is one of the most important diseases of citrus worldwide. The causal agent is a gram-negative bacterium known to inhabit the phloem of infected plants. Three different candidate species infect citrus: 'Candidatus Liberibacter africanus' found in the African continent; 'Ca. L. asiaticus' found in Asia, Brazil, and the United States; and 'Ca. L. americanus' found in Brazil. (1). Tobacco is an easily transformable plant species that can be used as an experimental host system to quickly screen for candidate genes useful to control plant pathogens. However, no evidence exists on the ability of this plant species to sustain populations of 'Ca. L. americanus'. With the purpose of transmitting 'Ca. L. americanus' from citrus to tobacco, fragments of healthy stems of Cuscuta spp. (dodder) were used to connect an HLB-infected sweet orange plant to each of 10 healthy plants of Nicotiana tabacum L. cv. Xanthi and allowed to remain connected for 30, 45, and 50 days. Three different HLB-infected orange plants and 30 tobacco plants were used in three independent experiments. Most HLB-exposed Xanthi plants exhibited chlorotic leaves after 50 days of exposure probably because of the parasitic effect of dodder; however, an average of 6, 1, and 3 Xanthi plants exhibited a unique blotchy mottle symptom after 30, 45, and 50 days of exposure, respectively. Symptomatic and asymptomatic leaves were collected and analyzed by PCR. The results consistently confirmed the presence of 'Ca. L. americanus' only in symptomatic leaves. Sequencing of the PCR product and comparison to the NCBI database also confirmed the identity of the pathogen as 'Ca. L. americanus'. Electron microscopy analysis of four symptomatic leaves indicated the presence of bacterium-like bodies with round to elongated bacilliform shapes and surrounded by two membranes. These bodies resembled those already described in HLB-infected citrus in Brazil (1). The evidence presented above confirms the successful transmission of 'Ca. L. americanus' from citrus to Xanthi using the parasitic plant Cuscuta spp. Reference: (1) F. A. O. Tanaka et al. Fitopatol. Bras. 31:99, 2006.