Investigation of Repeatability of Peak Nasal Inspiratory Flow Rate Measurements Under Baseline Conditions and After Administration of 0.05% Oxymetazoline.

OBJECTIVES: Peak nasal inspiratory flow (PNIF) measurement is an inexpensive and user-friendly method to assess nasal patency. However, the repeatability of PNIF measurements, as well as the threshold value of a change in PNIF, which can be considered significant remain unclear. This study aims to investigate the repeatability of PNIF measurements and the change in PNIF after the administration of 0.05% oxymetazoline. METHODS: Repeated measurements of PNIF (Clement Clarke In-Check nasal inspiratory flow meter; Clement Clarke International, Ltd, Harlow, Essex, UK) were obtained in 333 healthy volunteers (174 women). Based on age, participants were categorized into three groups (6-7 years, 13-14 years, and 20-45 years). We obtained five measurements in each participant. PNIF was remeasured in 294 subjects 30 min after administration of 0.05% oxymetazoline. The variability in PNIF measurements was assessed using the coefficient of variation (CV = standard deviation × 100%/mean). RESULTS: The first four PNIF measurements significantly differed from each other. The difference in PNIF measurements ceased to be statistically significant only between the fourth and fifth measurements (p = 0.19). PNIF repeatability was acceptable; the median CV was 15.5% (0-66), which did not significantly differ between age groups. The administration of 0.05% oxymetazoline led to a statistically significant increase in the PNIF value by 14.3% (-45, 157%) (p = 0.000000). CONCLUSIONS: 1. No statistically significant difference was observed in PNIF values only between the fourth and fifth measurements; therefore, at least three measurements are essential to draw meaningful conclusions. 2. PNIF measurements were satisfactorily characterized by a relatively low CV (15%). 3. The administration of 0.05% oxymetazoline led to an increase in PNIF by approximately 14% over the baseline value.

[An attempt to estimate potentially useful parameters to evaluate the normal range of nasal peak inspiratory flow]. / Próba oceny parametrów przydatnych do wyznaczenia normy dla nosowego szczytowego przeplywu wdechowego.

INTRODUCTION: Measurement of peak nasal inspiratory flow (PNIF, peak nasal inspiratory flow) seems to be a cheap and simple method to assess nasal patency. Unfortunately, due to the lack of reference values a single measurement does not take any information about the degree of nasal obstruction. Therefore, the purpose of this study was to establish parameters useful for estimating PNIF reference values. MATERIAL AND METHODS: 221 respondents, from Wroclaw, answered a questionnaire based on ECRHS II and ISAAC. Sample was randomized based on the personal number, stratified and representative of age and sex. Subjects were divided into three groups on the basis of their age (6-7, 13-14 and 20-45 years). The PNIF was measured using an In-Check portable nasal inspiratory flow meter (In-Check's Clement-Clark). The highest of the five PNIF values was used as the measure of PNIF for each subject in subsequent analyses (PNIF MAX). Patients with rhinitis and/or asthma were withdrawn from the study. RESULTS: Repeated measurements of PNIF were performed in 221 healthy volunteers. PNIF values were higher in males compared to women and this difference was statistically significant. There was a statistically significant correlation between height and PNIF MAX, and there was no such correlation between age and PNIF MAX. Stepwise linear regression that included gender, height, age revealed that only sex and height were independent significant predictors of PNIF. Obtained dependence PNIF MAX = -137.7 - 22.5 x + 1.7 y, where x is the sex (a woman, 0 - male) and the y - height. Coefficient of determination (R(2)) was 0.45 which means that regression equation explains about 45% of the observed PNIF MAX variability. CONCLUSIONS: A correlation was found between PNIF value and sex and height of the patients, while age is irrelevant in this regard. Difficulty of establishing standards for the PNIF parameter are probably due to anatomical differences in the construction of the nose.

The Impact of Sex and Age on the Prevalence of Clinically Relevant Sensitization and Asymptomatic Sensitization in the General Population.

The objective of our study was to evaluate the impact of sex and age on the prevalence of sensitization to inhalant allergens. The study was performed as a part of Polish Epidemiology of Allergic Diseases study, and data concerning citizens of Wroclaw were analyzed. The participants were divided into three age groups (6-7, 13-14, and 20-44 years) with a subdivision according to sex. We randomly selected 1409 individuals, 439 people complied; the complete set of tests was performed on 421 of them. We found that 37.7 % of the study population demonstrated sensitization to at least one of the allergens tested. Positive skin tests were found more frequently in males than in females (p = 0.003); among 6-7-year-old children, the sensitization was independent of sex (p = 0.26), while in two other groups, it was higher in males (p = 0.002 and p = 0.03, respectively). Clinically asymptomatic sensitization (AS) was found more often in females than in males (p = 0.04). The higher rate of AS in women was observed only in the two younger age groups, while in the 20-44-year-old group AS did not differ between the sexes (p = 0.72). Female sex hormones may contribute to a later change in the nature of sensitization from clinically asymptomatic to symptomatic. Further studies are needed to confirm the results of our study.

[Blood and tissue eosinophilia in patient with angioedema caused by inhibitor of angiotensin converting enzyme (ACE)--case report and a view of literature]. / Eozynofilia obwodowa i tkankowa u pacjenta z obrzekiem naczynioruchowym wywolanym inhibitorem enzymu konwertujacego angiotensyne (ACE)--opis przypadku i przeglad pismiennictwa.

A case of angioedema caused by enalapril, undiagnosed for 5 years was presented. Enhanced blood and tissue eosinophilia shown in nasal smear was observed. In addition increased activity of coagulation system was shown manifested by enhance of concentration of Hageman factor and cardiolipin antibodies IgM and IgA isotype. The role of coagulation, complement and fibrinolysis systems in pathogenesis of ACE-inhibitors induced angioedema was discussed. The influence of bradykinin on activity of eosinophils was analyzed.