ABSTRACT
BACKGROUND: Grading of the ink impression made by the palm of the hand has been proposed as a means of screening diabetic patients in whom tracheal intubation may be difficult because of glycosylation of both metacarpal and cervical joints. The current study was designed to test the predictability of the palm print and other airway evaluation indices in a diabetic population. METHOD: 83 adult, diabetic patients scheduled for surgery under general anesthesia were evaluated preoperatively using 4 physical examination indices predictive of difficult laryngoscopy and intubation: Mallampati classification, thyromental distance, head extension, and palm print. Following induction of anesthesia and neuromuscular relaxation, laryngoscopy was performed and the laryngoscopic view scored. The sensitivity, specificity and positive predictive value of each airway evaluation index was calculated. RESULTS: The palm print had the highest sensitivity of all indices (100%). The other 3 indices failed to detect 9 to 13 difficult laryngoscopies. CONCLUSION: We believe that in the diabetic population, the palm print index may be a sensitive marker of difficult intubation. It is possible that other airway evaluation indices would prove more sensitive, and have greater utility, in distinct populations as compared to when they are applied to all patients.
Subject(s)
Dermatoglyphics , Diabetes Mellitus/surgery , Intubation, Intratracheal , Adult , Aged , Female , Humans , Laryngoscopy , Male , Middle Aged , Sensitivity and SpecificityABSTRACT
Las enfermedades ampollosas adquiridas autoinmunes representan un grupo heterogéneo de entidades caracterizadas por la formación de ampollas producidas por alteraciones inmunológicas. Debido al gran interés e importancia de estas enfermedades, es muy necesario conocer las técnicas de inmunofluorescenca así como su interpretación para su clasificación y diagnóstico. El propósito de esta revisión es recordar algunos de los signos clínicos, hallazgos histológicos y de inmunofluorescencia de las enfermedades ampollosas autoinmunes