Factors Affecting Optimal Titration Pressure of Continuous Positive Airway Pressure Device in Patients with Obstructive Sleep Apnea Syndrome

Objective: To assess the effects of anatomical, clinical parameters, and pulmonary respiratory function on the therapeutic titration pressure of continuous positive airway pressure (CPAP) device in obstructive sleep apnea syndrome (OSAS).Methods: The study comprised 41 OSAS patients whose optimum CPAP titration pressures were measured. Each patient underwent an otorhinolaryngologic and thoracic examination, and data was recorded for height, weight, body mass index, neck-waist circumferences, Mallampati classification, tonsillar hypertrophy, hypopharyngeal collapse, soft palate-tongue base obstruction scores, peak nasal inspiratory flow and acoustic rhinometry measures, and CPAP device therapeutic pressures. Forced vital capacity, forced expiratory volume, FEV1/FVC ratio and peak expiratory flow values were noted.Results: Median CPAP optimal pressure cut-off value was determined as 9 mmH2O. Statistical analysis was made in two groups as CPAP titration optimal pressure ≤9 and >9 mmH2O. In the optimal pressure >9 group, neck and waist circumferences, hypopharyngeal collapse score, retropalatal and retrolingual lateral wall collapse scores were significantly higher (p<0.05). In multivariate and univariate model analysis, neck and waist circumferences, hypopharyngeal collapse score, retropalatal and retrolingual lateral wall collapse scores were observed to be significant in predicting high and low pressures in univariate model.Conclusion: For the prediction of optimal CPAP titration pressure in OSAS treatment, wide neck and waist circumferences, high hypopharyngeal collapse score and retropalatal and retrolingual lateral wall collapse grades may be determinative

Salivary Eosinophil Cationic Protein in Allergic Rhinitis

Objective: Eosinophil cationic protein (ECP) plays a significant role in the pathogenesis of atopic diseases such as allergic rhinitis (AR) and asthma. Using saliva as a diagnostic material is a non-invasive, simple method. Analysis of ECP in saliva was shown as an alternative diagnostic contribution in patients with asthma. In this study we aimed to assess a possible association between the levels of salivary ECP and the diagnosis of AR by comparing serum ECP and salivary ECP levels.Methods: Thirty-five allergic rhinitis patients (study group) sensitive to Dermatophagoides farinae (D2) in skin prick test (SPT) and 35 nonallergic, SPT negative, healthy volunteers (control group) were included in the study. Salivary ECP, serum ECP and specific IgE D2 levels were measured.Results: Distribution of age and gender were similar in the study and the control groups (p>0.05). Serum specific IgE D2 levels were significantly higher in the study group compared to the control group (p<0.001). ECP levels in saliva and serum did not show any significant difference in between study and control groups (p=0.738; p=0.796, respectively). No significant difference was found between the levels of ECP in between the serum and the saliva of study and control groups. (p=0.504; p=0.589, respectively). There was no significant correlation between saliva and serum ECP levels of both groups.(r=-0.191/ p=0.114).Conclusion: Serum and saliva ECP levels seem close to each other and were comparable in both groups, but we did not find any correlation between them Although we hypothesized that saliva ECP may be used as a non-invasive method for the diagnosis of AR, it seems that this parameter is not helpful in diagnosis of AR