[Trauma scores in the management of politrauma patients: which one and what for?]. / Trauma scores na avaliação de politraumatizados: quais e para quê?

BACKGROUND: The improvement rescue and transport of politrauma patients (PTP) increases the number of patients admitted to the Emergency departments in very severe conditions. The early prediction of later complications and bad outcomes is paramount for a good strategy. The aim of this study was to evaluate the severity of PTP in the Trauma Room (TR) of a Level 1 Hospital, using the ISS, RTS, TRISS scores and define variables associated with bad outcomes, namely ICU admission (ICU), ARDS, MODS and Death. MATERIAL/METHODS: Prospective study with data collection of demographic, clinical, laboratory and imaging parameters of all PTP admitted to the TR. The ISS was calculated by the Abbreviated Injury Scale, RTS and TRISS by Trauma.org site formulas. Statistical analysis was performed in SPSS. RESULTS: 278 patients were admitted in TR after Manchester screening during 6 months: 244 (185 men, 59 women) were studied, average age 39,32±19.32 years. Hospital admission- 157 patients (ICU-46, Intermediate Care Unit-29, Surgery Services-82) and 85 discharged. Submitted to Surgery-75. Scores: ISS-13,58±19,32, RTS-7,30±1,01; TRISS-92,42±15,85; Glasgow Coma Score (GCS)-13,00±3,61.Severe complications: ARDS-8%; SIRS-40%; MODS-18%; Death-14%. DISCUSSION: There is statistical correlation between Surgery Type: ICU and MODS; GCS, ISS, RTS, TRISS: ICU, ARDS, MODS and Death. Multivariate analysis shows that Surgery Type, GCS and TRISS predict ICU admission (ROC-0,884); TRISS predicts ARDS (ROC-0,844); TRISS predicts MODS (ROC-0,876); TRISS and age predicts Death (ROC-0,887). CONCLUSIONS: This study confirms scores validity in PTP assessment, as they are able to predict severe complications. TRISS seems to be the best score for prediction of bad outcomes.

Stability of isoenzyme and kinetoplast DNA (k-DNA) patterns in successively cloned Trypanosoma cruzi populations

Four Trypanosoma cruzi strains from zymodermes A, B, C and D were successively clonedon BHI-LIT-agar-blood BLAB). Twenty clones from the first generation (F1), 10 from The second (F2) and 4 from the third (F3) from the strains A138, B147 and C23 were isolated. The D150 strain provied 29 F1 and F2 clones. The strains and clones had their isoenzyme and K-DNA patterns determined. The clones from A138, Bl47 and C231 strains presented isoemzyme and K-DNA patterns identical between thewmselves and their respective parental strains. Therefore showing the homogenety and stability of isoenzyme and K-DNA patterns after successive cloning. The Dl50 strain from zymodeme D (ZD) showed heterogeneity. Twenty-eight out of 29 clones of the first generation were of zymodeme A and only one was of zymodeme C, confirming previous reports that ZD strains consisted of ZA and ZC parasite populations. The only D150 strain clone of zymodeme C showed a K-DNA pattern identical to its parental strain. The remining clones although similar among themselves were different from the parental strain. Thus the T. cruzi strains had either homonogeneus or heterogeneous populations. The clones produced by successive cloning provided genetically homonogeous populations. Their experimental use will make future results more reliable and reproducible

An improved silver staining procedure for schizodeme analysis in polyacrylamide gradient gels

A simple protocol is described for the silver staining of polyacrylamide gradient gels used for the separation of restriction fragments of kinetoplast DNA [schizodeme analysis of trypanosomatids (Morel et al., 1980)]. The method overcomes the problems of non-uniform staining and strong background color which are frequently encountered when conventional protocols for silver staining of linear gels. The method described has proven to be of general applicability for DNA, RNA and protein separations in gradient gels