Transtracheal puncture: a forgotten procedure

Transtracheal puncture has long been known as a safe, low-cost procedure. However, with the advent of bronchoscopy, it has largely been forgotten. Two researchers have suggested the use of α-amylase activity to diagnose salivary aspiration, but the normal values of this enzyme in tracheobronchial secretions are unknown. We aimed to define the normal values of α-amylase activity in tracheobronchial secretions and verify the rate of major complications of transtracheal puncture. From October 2009 to June 2011, we prospectively evaluated 118 patients without clinical or radiological signs of salivary aspiration who underwent transtracheal puncture before bronchoscopy. The patients were sedated with a solution of lidocaine and diazepam until they reached a Ramsay sedation score of 2 or 3. We then cleaned the cervical region and anesthetized the superficial planes with lidocaine. Next, we injected 10 mL of 2% lidocaine into the tracheobronchial tree. Finally, we injected 10 mL of normal saline into the tracheobronchial tree and immediately aspirated the saline with maximum vacuum pressure to collect samples for measurement of the α-amylase level. The α-amylase level mean ± SE, median, and range were 1914 ± 240, 1056, and 24-10,000 IU/L, respectively. No major complications (peripheral desaturation, subcutaneous emphysema, cardiac arrhythmia, or hemoptysis) occurred among 118 patients who underwent this procedure. Transtracheal aspiration is a safe, low-cost procedure. We herein define for the first time the normal α-amylase levels in the tracheobronchial secretions of humans.

Avaliação da atividade antibacteriana do óleo essencial de Lippia origanoides frente à Staphylococcus sp. isolados de alimentos de origem animal / Assessment of the antibacterial activity of the essential oil of Lippia origanoides in relation to Staphylococcus sp. isolated from food of animal origin

Objetivou-se no trabalho avaliar a ação antibacteriana do óleo essencial de Lippia origanoides frente à isolados de Staphylococcus sp. de alimentos de origem animal. Para tanto, realizou-se análise química da composição do óleo, teste de sensibilidade das bactérias frente a dez antibióticos de uso terapêutico e ao óleo essencial de Lippia origanoides, além da determinação da concentração inibitória mínima (CIM) e da concentração bactericida mínima (CBM). A análise cromatográfica do óleo apresentou o timol como composto majoritário (48,70%), além de pequena quantidade de carvacrol (1,14%). No teste de sensibilidade frente aos antibióticos, 75% dos isolados apresentaram resistência a, no mínimo, três antibióticos. Em relação ao óleo essencial, os isolados de Staphylococcus sp oriundos de leite bovino mostraram-se mais resistentes e os isolados de carne ovina apresentaram-se mais sensíveis. A CIM foi maior para os Staphylococcus sp. isolados de leite bovino e leite ovino (60µL/mL). Enquanto que para os isolados de carcaça de ovinos e queijo, a CIM foi de 15µL/mL e 30µL/mL respectivamente. A CBM, consequentemente, foi maior para os isolados de leite bovino e leite ovino, sendo de 240µL/mL e 120µL/mL respectivamente. O óleo essencial de Lippia origanoides apresenta atividade antimicrobiana sobre Staphylococcus sp. isolados de alimentos.

The aim of this study was to evaluate the antibacterial activity of the essential oil of Lippia origanoides in relation to Staphylococcus sp. isolated from food of animal origin. For this purpose, we performed the chemical analysis to determine the oil composition, evaluated the bacteria sensibility to ten antibiotics of therapeutic use and determined the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). The chromatographic analysis showed that tymol was the main compound (48.70%) and that carvacrol was present in a small amount (1.14%). In the test of antibiotic susceptibility, 75% of the microorganism isolates were resistant to at least three of the ten antibiotics tested. The Staphylococcus sp isolated from bovine milk was more resistant to the essential oil of Lippia origanoides, and the microorganism isolated from sheep meat was more susceptible to this oil. The Staphylococcus sp. isolated from bovine or sheep milk showed a MIC of 60µL/mL and for those isolated from sheep carcass and cheese the MIC was 15µL/mL and 30µL/mL, respectively. Consequently, the MBC was higher for isolates from cow's (240µL/mL) and sheep's milk (120µL/mL) when compared with other food sources. These results suggest that the essential oil of Lippia origanoides has antimicrobial activity against staphylococcus sp. isolated from food.