ABSTRACT
Abstract Background There is currently some discussion over the actual usefulness of performing preoperative upper airway assessment to predict difficult airways. In this field, modified Mallampati test (MMT) is a widespread tool used for prediction of difficult airways showing only a feeble predictive performance as a diagnostic test. We therefore aimed at evaluating if MMT test would perform better when used as a screening test rather than diagnostic. Methods An accuracy prospective study was conducted with 570 patients undergoing general anesthesia for surgical procedures. We collected preoperatively data on sex, age, weight, height, body mass index (BMI), ASA physical status, and MMT. The main outcome was difficult laryngoscopy defined as Cormack and Lahane classes 3 or 4. Bivariate analyses were performed to build three different predictive models with their ROC curves. Results Difficult laryngoscopy was reported in 36 patients (6.32%). Sex, ASA physical status, and MMT were associated with difficult laryngoscopy, while body mass index (BMI) was not. The MMT cut-off with the highest odds ratio was the class II, which also presented significantly higher sensitivity (94.44%). The balanced accuracy was 67.11% (95% CI: 62.78-71.44%) for the cut-off of class II and 71.68% (95% CI: 63.83-79.54) for the class III. Conclusion MMT seems to be more clinically useful when the class II is employed as the threshold for possible difficult laryngoscopies. At this cut-off, MMT shows the considerable highest sensitivity plus the highest odds ratio, prioritizing thus the anticipation of difficult laryngoscopies.
Subject(s)
Humans , Intubation, Intratracheal/methods , Larynx , Prospective Studies , Laryngoscopy/methodsABSTRACT
Staphylococcus aureus is the main causative agent of bovine mastitis. The activity of several extracts from ten medicinal plants traditionally used in Brazil as antiseptic was investigated against fifteen strains of Staphylococcus aureus isolated from animals with mastitis manifestation by the disc diffusion method and broth microdilution assay. The interference of the extracts on cell in the form of adherent colonies was also evaluated. MIC values ranged from 0.5 mg/mL to 1.0 mg/mL and biofilm inhibitory concentration (BIC) were between 0.25 mg/mL and 0.8 mg/mL. Results revealed the potential of extracts of Senna macranthera, Artemisia absinthium, Cymbopogon nardus and Baccharis dracunculifolia as antibacterial agents against S. aureus strains isolated from bovine mastitis and support the possible use of these phytotherapic agents in the clinical management of the disease.
Staphylococcus aureus é o principal agente causador de mastite bovina. A atividade de diversos extratos de dez plantas medicinais tradicionalmente usadas no Brasil como anti-sépticas foi investigada contra quinze cepas de Staphylococcus aureus isoladas de animais com manifestação de mastite pelo método de difusão em ágar e ensaio de microdiluição. A interferência dos extratos na célula bacteriana em forma de colônias aderidas também foi avaliada. Os valores de MIC variaram de 0.5 mg/mL a 1.0 mg/mL e a concentração inibitória de biofilme (BIC) variou de 0.25 mg/mL a 0.8 mg/mL. Os resultados revelaram o potencial dos extratos de Senna macranthera, Artemisia absinthium, Cymbopogon nardus e Baccharis dracunculifolia como agentes antibacterianos contra cepas de S. aureus isolados de mastite bovina e suportam o possível uso destas plantas no manejo clínico da doença.