Distribution and Characterization of Aeroallergens in the Etiology of Allergic Rhinitis Patients in İstanbul Kartal Region

Aim:Allergic rhinitis (AR) is a common disease and the first step in its treatment is to determine the allergen responsible for its etiology and to take preventive measures. The aim of this study was to determine the distribution of aeroallergens in AR patients in İstanbul Kartal region and to investigate other factors affecting the severity of AR.Materials and Methods:The study was performed in a tertiary hospital on the Anatolian side of İstanbul among patients who were admitted to the allergy and clinical immunology outpatient clinic and diagnosed with AR. Data of patients were obtained from medical records retrospectively. Age, gender, concomitant atopic disease, family transition history, serum total IgE and serum eosinophil (Eo) levels were evaluated. Skin prick tests were performed with 25 allergens.Results:One hundred and sixty patients were included in our study. Ninety-six (65.8%) of the patients were female and the median age of the study population was 31 (18-75) years. Distribution of aeroallergens according to skin test results was as follows; D. pteronyssinus (78.1%), D. farinae (75.2%), Tyrophagus putrescentlae (59.6%), Acurus siro (57.5%), Lepidoglyphus destructor (40.4%), cereals mix (37.7%), and cat hair (33.6%). It was found that there was a significant increase in total IgE levels (p<0.001) consistent with the increase in serum Eo level.Conclusion:In our study, mite sensitivity has been found to be the most common allergen sensitivity in accordance with the geographic and climatic characteristics of the İstanbul region. Secondly, cat hair sensitivity and pollen (grasses mix) sensitivity were similarly high due to the increase in the number of domestic animals in the modern age. We think that our study contributes to the literature by examining the distribution of these allergens that cause AR and patients are guided to take preventive measures in this regard

How Successful is Non-Invasive Ventilation Treatment that is Initiated in the Emergency Department in Cases of COPD Exacerbations with Acute Hypercapnic Respiratory Failure? Can We Predict Treatment Failure?

Objective: We aimed to investigate the success rate of non-invasive ventilation (NIV) in wards and the predictors of failure in cases of chronic obstructive pulmonary disease (COPD)-related acute hypercapnic respiratory failure (AHRF). Methods: The was a retrospective study conducted in a tertiary teaching hospital between May 2011 and 2013. Patients who were admitted to the emergency department (ED) because of COPD with AHRF were evaluated; 544 patients who initially received NIV in ED and were transferred to wards were included. Patient characteristics, baseline and follow-up pH values, and partial arterial carbon dioxide (PaCO2) values were recorded. Baseline pH values were categorized as severe (pH<7.26), moderate (pH≥7.26–7.30), and mild (pH≥7.30) acidosis. According to the in-hospital outcome, patients were classified in 2 groups: Group 1: home discharge, Group 2: death or intensive care unit transfer. Results: Treatment resulted in success in 477 (88%) patients. Albumin levels were significantly low and the mean Charlson index (CI) score was significantly high in Group 2. Admission pH and PaCO2 values did not affect the treatment outcome. Patients in Group 2 had higher PaCO2 and lower pH values as well as a lower level of decrease in PaCO2 values within 2 hours of treatment in ED. Similarly, higher PaCO2 and lower pH values at the end of the first day in wards were indicative of NIV failure (p<0.05). Conclusion: The success rate of NIV in wards in cases of AHRF is high. Patients with low albumin levels and higher CI scores have worse response to treatment. pH or PaCO2 values after a few hours of treatment and not the baseline pH or PaCO2 values are better predictors than the baseline pH and PaCO2 values