Annals of Allergy Asthma & Immunology最新文献_第4页

Persistent cat ownership and asthma in a longitudinal study of Puerto Rican youth 对波多黎各青少年进行的一项纵向研究显示，持续养猫与哮喘有关。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2024-11-01 DOI: 10.1016/j.anai.2024.06.021

Background

Epidemiologic studies have reported conflicting findings for cat or dog exposure and childhood asthma. No study has evaluated whether persistent pet exposure from early life to school age is associated with asthma or allergic sensitization in youth.

Objective

To evaluate whether persistent ownership of a cat or a dog throughout childhood is associated with asthma in Puerto Rican youth, a group disproportionately affected with asthma.

Methods

Prospective study of 384 youth who completed a baseline visit at ages 6 to 14 years and a second visit at ages 9 to 20 years. Persistent cat or dog ownership was defined as ownership of a cat or a dog in early life (during pregnancy or the first year of life) at either study visit (at school age). An allergen-specific IgE result was considered positive if more than or equal to 0.35 IU/mL. Logistic regression was used for the multivariable analysis of asthma and allergic sensitization.

Results

In an analysis adjusting for household income, family history of atopy, persistent overweight or obesity, a persistent unhealthy diet, the time interval between study visits, and other covariates, persistent cat ownership was significantly associated with 68% reduced odds of asthma (95% CI for odds ratio = 0.11-0.92) but not with any allergic sensitization or sensitization to cat allergen. In contrast, persistent dog ownership was not significantly associated with asthma or allergic sensitization.

Conclusion

Among school-aged Puerto Rican youth followed for an average of 5 years, persistent cat ownership from early life to school age was inversely associated with asthma.

背景：有关接触猫或狗与儿童哮喘的流行病学研究报告结果相互矛盾。还没有研究表明，从幼年到学龄期持续接触宠物是否与青少年的哮喘或过敏性疾病有关：研究方法：对 384 名波多黎各青少年进行前瞻性研究：方法：对 384 名青少年进行前瞻性研究，他们在 6-14 岁时完成了基线访问，在 9-20 岁时完成了第二次访问。持续养猫或狗的定义是在早年（怀孕期间或出生后第一年）养猫或狗。过敏原特异性 IgE ≥0.35 IU/ml 即为阳性。采用逻辑回归法对哮喘和过敏致敏进行多变量分析：在对家庭收入、家族过敏史、持续超重或肥胖、持续不健康饮食、研究访问之间的时间间隔和其他协变量进行调整后进行的分析中，持续养猫与哮喘发生几率降低 68% 显著相关（几率比的 95% 置信区间= 0.11-0.92），但与任何过敏或对猫过敏原过敏无关。相比之下，长期养狗与哮喘或过敏性敏化没有明显关系：结论：在平均跟踪调查 5 年的波多黎各学龄青少年中，从幼年到学龄期间持续养猫与哮喘呈反向关系。

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引用次数: 0

Authors’ response 作者回复。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2024-11-01 DOI: 10.1016/j.anai.2024.07.032

Yueh-Ying Han PhD, Juan C. Celedón MD, DrPH, ATSF

引用次数: 0

Infant urinary adrenal steroids and childhood asthma development 婴儿尿液中的肾上腺类固醇与儿童哮喘的发展。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2024-11-01 DOI: 10.1016/j.anai.2024.07.002

Chun-Yu Shen MD , Chen-Pi Li MS , Ru-Yin Tsai PhD , Hui-Chin Chang MLS , Shuo-Yan Gau MD

引用次数: 0

Effectiveness of nirsevimab in infants against respiratory syncytial virus and related events 尼舍单抗对婴儿呼吸道合胞病毒的疗效及相关事件

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2024-11-01 DOI: 10.1016/j.anai.2024.10.008

A. Hsiao , J. Hansen , J. Timbol , B. Fireman , O. Zerbo , K. Mari , C. Rizzo , W. La Via , R. Izikson , N. Klein

Background

Nirsevimab is Centers for Disease Control and Prevention–recommended for infants to prevent respiratory syncytial virus (RSV) disease, the most common cause of lower respiratory tract disease (LRTD). Previously published nirsevimab effectiveness has been limited to the hospital setting. This study assessed nirsevimab's effectiveness against RSV, LRTD, and associated medical encounters across all settings in an integrated healthcare delivery system between 2023 and 2024.

Methods

Nirsevimab administration started on October 19, 2023. We included healthy-term infants born in April 2023 or later and excluded infants with high-risk conditions or whose mothers were RSV-vaccinated. The primary endpoint was a polymerase chain reaction positive RSV LRTD diagnosis by the International Classification of Diseases, 10th Revision code in any setting. Nirsevimab effectiveness against RSV LRTD was assessed by Cox regression and estimated as (1-hazard ratio). We estimated the association of nirsevimab treatment with the mean number of encounters per episode by linear regression and the odds of hospitalization by logistic regression.

Results

The study included 31,900 infants; 15,647 of whom received nirsevimab. There were 35 RSV LRTD episodes (6.1/1000 person-years) among nirsevimab-treated infants compared with 462 episodes (58.5/1000 person-years) among untreated infants. The adjusted nirsevimab effectiveness estimate against RSV LRTD was 87.2% (CI: 81.7%-91.1%). Nirsevimab-treated infants with RSV LRTD had a lower mean number of encounters (2.1 vs 2.7, P = .001) and lower hospitalization odds (odds ratio = 0.11, CI: 0.01-0.85).

Conclusion

In this large study, nirsevimab reduced the risk of RSV LRTD by 87% across all healthcare settings. Compared with untreated infants, those who had RSV LRTD after nirsevimab had significantly fewer medical encounters and were less likely to be hospitalized.

背景美国疾病控制和预防中心推荐婴儿使用nirsevimab来预防呼吸道合胞病毒（RSV）疾病，这是下呼吸道疾病（LRTD）最常见的病因。之前公布的 nirsevimab 疗效仅限于医院环境。本研究评估了 nirsevimab 在 2023 年至 2024 年期间在综合医疗保健服务系统的所有环境中对 RSV、LRTD 和相关医疗事件的有效性。我们纳入了 2023 年 4 月或以后出生的健康足月婴儿，但排除了患有高风险疾病或母亲接种过 RSV 疫苗的婴儿。主要终点是根据国际疾病分类第十版代码在任何情况下诊断出聚合酶链反应阳性的 RSV LRTD。通过 Cox 回归评估了 Nirsevimab 对 RSV LRTD 的有效性，估计值为（1-危险比）。我们通过线性回归估算了尼尔赛维单抗治疗与每次发病的平均就诊次数之间的关系，并通过逻辑回归估算了住院几率。在接受过尼舍维单抗治疗的婴儿中，RSV LRTD发作次数为35次（6.1/1000人-年），而在未接受过尼舍维单抗治疗的婴儿中，RSV LRTD发作次数为462次（58.5/1000人-年）。调整后的尼尔赛维单抗对 RSV LRTD 的有效性估计值为 87.2%（CI：81.7%-91.1%）。结论在这项大型研究中，在所有医疗机构中，尼舍单抗可将RSV LRTD的风险降低87%。与未接受治疗的婴儿相比，使用尼尔赛维单抗后出现 RSV LRTD 的婴儿就医次数明显减少，住院的可能性也更低。

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引用次数: 0

Once-daily fluticasone furoate/vilanterol vs once-daily fluticasone furoate in patients with asthma aged 5 to 17 years 5-17岁哮喘患者每日一次糠酸氟替卡松/维兰特罗与每日一次糠酸氟替卡松的对比。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2024-11-01 DOI: 10.1016/j.anai.2024.06.024

Background

Limited data exist comparing inhaled corticosteroid (ICS) plus adjunctive therapy vs ICS alone in pediatric asthma patients.

Objective

To evaluate the efficacy and safety of fluticasone furoate/vilanterol (FF/VI) vs FF in children and adolescents with asthma.

Methods

This phase 3, randomized, double-blind, multicenter study (NCT03248128) included participants aged 5 to 17 years with six months or more asthma history uncontrolled on ICS monotherapy. Participants received 4-week open-label fluticasone propionate (100 µg) twice daily before 1:1 randomization to 24-week double-blind FF (50 µg:100 µg) or FF/VI (50/25 µg:100/25 µg) once daily. Two populations with different primary endpoints were analyzed to meet United States (week 12 weighted mean forced expiratory volume in 1 second [FEV₁; 0-4 hours]; participants aged 5–17 years) and European (change from baseline predose morning peak expiratory flow [ΔAM PEF] averaged over weeks 1-12; participants aged 5-11 years) regulatory requirements.

Results

Overall, 902 participants, including 673 children aged 5 to 11 years, were randomized and treated. In participants aged 5 to 17, week 12 weighted mean FEV₁ (0-4 hours) was greater with FF/VI vs FF (difference: 0.083 L; P < .001). In participants aged 5 to 11, ΔAM PEF over weeks 1 to 12 showed numerical improvement with FF/VI vs FF but was not statistically significant (difference: 3.2 L/min; P = .228). No drug-related serious adverse events or deaths were reported.

Conclusion

FF/VI significantly improved weighted mean FEV₁ (0-4 hours; participants aged 5-17 years), but not ΔAM PEF (participants aged 5-11 years) vs FF. No new safety concerns were apparent.

Trial Registration

ClinicalTrials.gov Identifier: NCT03248128.

背景：在儿童哮喘患者中，比较吸入性皮质类固醇（ICS）加辅助治疗与单用 ICS 的数据有限：评估糠酸氟替卡松/维兰特罗（FF/VI）与糠酸氟替卡松在儿童和青少年哮喘患者中的疗效和安全性：这项 3 期随机、双盲、多中心研究（NCT03248128）的参与者年龄为 5-17 岁，哮喘病史≥6 个月，接受 ICS 单药治疗后未得到控制。参与者先接受为期 4 周、每天两次的开放标签丙酸氟替卡松（100 µg）治疗，然后按 1:1 随机分配到为期 24 周、每天一次的双盲 FF（50 µg：100 µg）或 FF/VI（50/25 µg：100/25 µg）治疗中。对两个主要终点不同的人群进行了分析，以满足美国（第12周加权平均1秒用力呼气容积[FEV1；0-4小时]；参与者年龄5-17岁）和欧洲（第1-12周平均晨间峰值呼气流量[ΔAM PEF]与基线相比的变化；参与者年龄5-11岁）调节器的要求：共有 902 名参与者接受了随机治疗，其中包括 673 名 5-11 岁的儿童。在 5-17 岁的参与者中，FF/VI 与 FF 相比，第 12 周加权平均 FEV1（0-4 小时）更大（差异：0.083 升；P < .001）。在 5-11 岁的参与者中，第 1-12 周的 ΔAM PEF 显示出 FF/VI 相对于 FF 的数值改善，但无统计学意义（差异：3.2 升/分钟；P = .228）。没有与药物相关的严重不良事件或死亡报告：结论：与 FF 相比，FF/VI 能明显改善加权平均 FEV1（0-4 小时；5-17 岁的参与者），但不能改善 ΔAM PEF（5-11 岁的参与者）。没有发现新的安全问题。

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引用次数: 0

Associations between psychosocial stress, child's anxiety, and lung function in mid-childhood 儿童中期社会心理压力、儿童焦虑和肺功能之间的关系。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2024-11-01 DOI: 10.1016/j.anai.2024.07.030

Nadya Y. Rivera Rivera MPH , Hector Lamadrid-Figueroa PhD , Adriana Mercado Garcia MD , Cecilia Sara Alcala PhD , Lourdes Schnaas PhD , Carmen Hernández-Chávez PhD , Martha M. Téllez-Rojo PhD , Robert O. Wright MD , Rosalind J. Wright MD , Maria José Rosa DrPH , Marcela Tamayo-Ortiz ScD

Background

Reducing the risk of respiratory disease during the plastic stages of lung development could have long-term health impacts. Psychosocial stress has been previously linked to adverse childhood respiratory outcomes, but the influence of child's anxiety and sex differences has not been completely elucidated.

Objective

To evaluate the association among maternal stress, child anxiety, and lung function in children and to explore differences by sex.

Methods

Cross-sectional analyses included 294 mother-child pairs from the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) birth cohort in Mexico City. Children's lung function was tested once at ages 8 to 13 years of age, and height- and sex-adjusted z-scores were estimated for forced vital capacity, forced expiratory volume in 1 second, forced expiratory volume in 1 second/forced vital capacity and forced expiratory flow between 25% and 75%. Maternal stress was assessed through the Crisis in Family Systems—Revised (CRISYS-R) survey, used to report negative life events experienced in the past 6 months and dichotomized at the median (<3 and ≥3). Child's self-reported anxiety was assessed using the Revised Children's Manifest Anxiety Scale short form and dichotomized at the clinically relevant cutoff (T-score ≥ 60). The association among maternal stress, child anxiety, and lung function outcomes was evaluated using linear models. Effect modification by sex was evaluated with interaction terms and in stratified analyses.

Results

We did not find any association between maternal stress and any lung function outcome. Clinically elevated child anxiety symptoms were associated with lower forced expiratory volume in 1 second (β = −0.36, 95% CI −0.69 to −0.02). We found no evidence of effect modification by sex.

Conclusion

Results highlight the importance of considering childhood mental health in relation to lung function outcomes.

背景：在肺部发育的可塑阶段降低患呼吸系统疾病的风险会对健康产生长期影响。目的：研究母亲压力、儿童焦虑和儿童肺功能之间的关系，并探讨性别差异：横断面分析包括墨西哥城肥胖、生长、环境和社会压力研究（PROGRESS）出生队列中的 294 对母子。在儿童 8-13 岁时对其肺功能进行了一次测试，并根据年龄、身高和性别估算出了强迫肺活量（FVC）、一秒钟内强迫呼气容积（FEV1）、FEV1/FVC 和肺活量 25-75% 时的强迫呼气流量（FEF25-75%）的调整 Z 分数。产妇压力通过家庭系统危机-修订版（CRISYS-R）调查进行评估，该调查用于报告产妇在过去 6 个月中所经历的负面生活事件，并以中位数进行二分（结果：产妇在过去 6 个月中所经历的负面生活事件与产妇压力之间没有任何关联：我们没有发现产妇压力与任何肺功能结果之间存在关联。临床升高的儿童焦虑症状与较低的 FEV1 相关（β= -0.36，95% CI -0.69，-0.02）。我们没有发现性别对影响有修饰作用的证据：结论：研究结果强调了考虑儿童心理健康与肺功能结果关系的重要性。

{"title":"Associations between psychosocial stress, child's anxiety, and lung function in mid-childhood","authors":"Nadya Y. Rivera Rivera MPH , Hector Lamadrid-Figueroa PhD , Adriana Mercado Garcia MD , Cecilia Sara Alcala PhD , Lourdes Schnaas PhD , Carmen Hernández-Chávez PhD , Martha M. Téllez-Rojo PhD , Robert O. Wright MD , Rosalind J. Wright MD , Maria José Rosa DrPH , Marcela Tamayo-Ortiz ScD","doi":"10.1016/j.anai.2024.07.030","DOIUrl":"10.1016/j.anai.2024.07.030","url":null,"abstract":"<div><h3>Background</h3><div>Reducing the risk of respiratory disease during the <em>plastic</em> stages of lung development could have long-term health impacts. Psychosocial stress has been previously linked to adverse childhood respiratory outcomes, but the influence of child's anxiety and sex differences has not been completely elucidated.</div></div><div><h3>Objective</h3><div>To evaluate the association among maternal stress, child anxiety, and lung function in children and to explore differences by sex.</div></div><div><h3>Methods</h3><div>Cross-sectional analyses included 294 mother-child pairs from the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) birth cohort in Mexico City. Children's lung function was tested once at ages 8 to 13 years of age, and height- and sex-adjusted z-scores were estimated for forced vital capacity, forced expiratory volume in 1 second, forced expiratory volume in 1 second/forced vital capacity and forced expiratory flow between 25% and 75%. Maternal stress was assessed through the Crisis in Family Systems—Revised (CRISYS-R) survey, used to report negative life events experienced in the past 6 months and dichotomized at the median (<3 and ≥3). Child's self-reported anxiety was assessed using the Revised Children's Manifest Anxiety Scale short form and dichotomized at the clinically relevant cutoff (T-score ≥ 60). The association among maternal stress, child anxiety, and lung function outcomes was evaluated using linear models. Effect modification by sex was evaluated with interaction terms and in stratified analyses.</div></div><div><h3>Results</h3><div>We did not find any association between maternal stress and any lung function outcome. Clinically elevated child anxiety symptoms were associated with lower forced expiratory volume in 1 second (β = −0.36, 95% CI −0.69 to −0.02). We found no evidence of effect modification by sex.</div></div><div><h3>Conclusion</h3><div>Results highlight the importance of considering childhood mental health in relation to lung function outcomes.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 5","pages":"Pages 568-573.e3"},"PeriodicalIF":5.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The use of boiled peanut oral immunotherapy in children 在儿童中使用煮花生口服免疫疗法

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2024-11-01 DOI: 10.1016/j.anai.2024.08.027

Kara B. McNamara MD , Earl Poptic BS , Leigh Ann Kerns MD , Alton Melton MD , Jaclyn Bjelac MD

引用次数: 0

Efficacy of dupilumab for severe chronic rhinosinusitis with nasal polyps and asthma 杜必鲁单抗治疗严重慢性鼻窦炎伴鼻息肉和哮喘的疗效：前瞻性研究。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2024-11-01 DOI: 10.1016/j.anai.2024.07.001

Background

Dupilumab exerts clinical effects, including improved sinus opacification, olfactory function, and quality of life, in patients with severe chronic rhinosinusitis with nasal polyps (CRSwNPs). Meanwhile, only a few studies have reported its effects on nasal airway resistance and olfactory function, particularly in the Japanese population. Predictors of response remain unclear.

Objective

To assess the comprehensive efficacy and therapeutic response to dupilumab in patients with severe CRSwNP with comorbid asthma.

Methods

In 16 adult patients with severe CRSwNP with comorbid asthma, the efficacy of 48-week dupilumab treatment, including olfactory function measured by a T&T olfactometer, nasal airway resistance measured by rhinomanometry, nasal polyp score, Lund-Mackay computed tomography score, and 22-item Sinonasal Outcome Test (SNOT-22), was assessed. Regarding asthma, the annualized rate of exacerbations, 7-item Asthma Control Questionnaire (ACQ-7), and spirometry were assessed. Treatment responsiveness was analyzed.

Results

With 48-week dupilumab treatment, olfactory function, nasal airway resistance, nasal polyp score, Lund-Mackay computed tomography score, and SNOT-22 scores improved significantly. Regarding comorbid asthma, the annualized rate of exacerbations decreased, and ACQ-7 scores and lung function improved significantly. According to the European Position Paper on Rhinosinusitis and Nasal Polyps 2020/European Forum for Research and Education in Allergy and Airway Diseases criteria, 15 patients (94%) were moderate-to-excellent responders at 48 weeks of treatment. Patients with higher SNOT-22 scores, ACQ-7 scores, the rate of asthma exacerbations in the previous year, and blood eosinophil counts benefited more from the treatment.

Conclusion

Dupilumab improved upper and lower airway outcomes especially in patients with severe CRSwNP with comorbid, poorly controlled asthma.

Trial Registration

UMIN Clinical Trials Registry: UMIN000038669.

研究背景杜比鲁单抗对严重慢性鼻窦炎伴鼻息肉（CRSwNP）患者具有临床疗效，包括改善鼻窦不通畅、嗅觉功能和生活质量。与此同时，只有少数研究报告了它对鼻腔气道阻力和嗅觉功能的影响，尤其是在日本人群中。目前尚不清楚反应的预测因素：在这项前瞻性观察研究中，我们评估了合并哮喘的重度 CRSwNP 患者对杜必鲁单抗的综合疗效和治疗反应：在 16 名合并哮喘的成年重度 CRSwNP 患者中，我们评估了为期 48 周的杜比鲁单抗治疗的疗效，包括用 T&T 嗅觉仪测量的嗅觉功能、用鼻量计测量的鼻气道阻力、鼻息肉评分、Lund-Mackay 计算机断层扫描评分（LMS）和 22 项鼻窦结果测试（SNOT-22）。在哮喘方面，对哮喘的年加重率、7 项哮喘控制问卷（ACQ-7）和肺活量进行了评估。对治疗反应性进行了分析：结果：经过48周的dupilumab治疗，嗅觉功能、鼻气道阻力、鼻息肉评分、LMS和SNOT-22评分均有显著改善。在合并哮喘方面，病情加重率下降，ACQ-7评分和肺功能明显改善。根据《2022 年欧洲鼻炎和鼻息肉立场文件》/欧洲过敏和气道疾病研究与教育论坛的标准，15 名患者（94%）在治疗 48 周后达到中度到极佳反应。SNOT-22评分、ACQ-7评分、前一年哮喘加重率和血液嗜酸性粒细胞计数较高的患者从治疗中获益更多：结论：杜匹单抗可改善上呼吸道和下呼吸道的治疗效果，尤其是对合并哮喘且治疗效果不佳的重症CRSwNP患者。

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引用次数: 0

Age differences in inducible laryngeal obstruction in adult populations 成人诱发性喉阻塞的年龄差异

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2024-11-01 DOI: 10.1016/j.anai.2024.08.005

Jennilee Luedders MD , Sara May MD , Elizabeth Lyden MS , Andrew Rorie MD , Joel Van De Graaff MD , José Zamora-Sifuentes DO , Rhonda Walenz BS , Jill A. Poole MD

Background

Whereas differences in inducible laryngeal obstruction (ILO) presentation on the basis of age have been observed within pediatric populations, age-based differences in adult populations are lacking.

Objective

To describe differences in ILO on the basis of age in adults.

Methods

Patients aged older than 16 years with confirmed ILO (vocal cord adduction > 50% during inspiration) by means of provocation-challenge rhinolaryngoscopy by their treating allergist were included. An investigator-designed questionnaire was administered using Research Electronic Data Capture with corresponding medical data collection. χ² tests, Student's t tests, analysis of variance, Cochran-Armitage test for trend, and Fisher's exact test were used.

Results

The median age of the 67 patients was 50 years. P values less than .05 were considered significant. Those aged younger than 50 years (n = 31; mean age 35.6 years) reported more symptoms vs age 50 years and older (n = 36; mean age 61.8 years), including shortness of breath at rest and exertion (84% vs 39%, 94% vs 72%), throat tightness (81% vs 50%), chest tightness (81% vs 47%), and difficulty getting air in (81% vs 56%). Those aged younger than 50 years had an increased history of anxiety (68% vs 33%), asthma (55% vs 31%), positive methacholine challenge (52% vs 22%), increasing triggers with time (87% vs 43%), higher Pittsburgh Vocal Cord Dysfunction Index Scores (6.9 vs 5.5), and inspiratory curve flattening (48% vs 24%). Additional age-based subdivisions confirmed significant trends with the lowest reported ILO characteristics and symptoms in those aged 65 years and older.

Conclusion

A high index of suspicion for ILO should be maintained in older adults since they may report less typical ILO symptoms and anxiety associations that prompt ILO evaluation.

背景：虽然在儿科人群中，诱发性喉梗阻（ILO）的表现因年龄而异，但在成人人群中却缺乏基于年龄的差异：本研究的目的是描述成人中基于年龄的 ILO 差异：研究对象包括年龄大于 16 岁、经过敏症主治医师通过诱导挑战鼻咽镜检查确诊为 ILO（吸气时声带内收大于 50%）的受试者。研究人员使用 REDCap 设计了一份调查问卷，并收集了相应的医疗数据。采用了卡方检验、学生 t 检验、方差分析、Cochran-Armitage 趋势检验和费雪精确检验：结果：67 名受试者的年龄中位数为 50 岁。P 值对老年人应保持高度的 ILO 怀疑指数，因为他们可能会报告不太典型的 ILO 症状和焦虑联想，从而促使进行 ILO 评估。

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引用次数: 0

Differences in familiarity with oral immunotherapy among caregivers of White and Black children with food allergy 白人和黑人食物过敏儿童照顾者对口服免疫疗法熟悉程度的差异。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2024-11-01 DOI: 10.1016/j.anai.2024.08.022

Megan Bannon MD , Neil Thivalapill MD , Eirene Fithian BA , Jialing Jiang BA , Linda Herbert PhD , Susan Fox PA-C , Christopher Warren PhD , Hemant Sharma MD , Mahboobeh Mahdavinia MD, PhD , Ruchi Gupta MD , Lucy Bilaver PhD , Amal Assa'Ad MD

Background

Potential racial and ethnic disparities related to oral immunotherapy (OIT) have not been fully described among children with food allergy (FA).

Objective

To characterize the differences in attitudes toward, familiarity with, and utilization of OIT among non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic or Latino (H/L) caregivers of children with FA.

Methods

Surveys were administered to the caregivers of children enrolled in Food Allergy Outcomes Related to White and African American Racial Differences, a prospective, multisite cohort of children with FA. The distribution of responses by caregiver-reported race and ethnicity was described using an analysis of variance for continuous outcomes and χ² tests for categorical outcomes. A logistic regression model was used to determine associations between familiarity with OIT as a treatment option and various other covariates.

Results

The NHB and H/L respondents were more frequently not familiar with OIT compared with NHW responders (54.3% and 62.5% vs 9.2%, P < .001). This finding remained true, even after adjusting for household income (odds ratio: 0.1, 95% CI: 0.1-0.4 for NHB participants and odds ratio: 0.1, 95% CI: 0.0-0.3 for H/L participants). NHB and H/L participants more frequently reported that they had never heard of OIT before the survey compared with NHW participants (76.7% and 50.0% vs 26.7%, P < .001). None of the NHB and H/L respondents initiated OIT compared with 14.8% of NHW participants (P < .001).

Conclusion

In the Food Allergy Outcomes Related to White and African American Racial Differences cohort, familiarity with OIT was lower among caregivers of minoritized racial and ethnic groups, even after adjusting for household income.

背景：在患有食物过敏症（FA）的儿童中，与口服免疫疗法（OIT）相关的潜在种族和民族差异尚未得到充分描述：目的：描述非西班牙裔白人（NHW）、非西班牙裔黑人（NHB）和西班牙裔或拉丁裔（H/L）FA 儿童照顾者对口服免疫疗法的态度、熟悉程度和使用情况的差异：对参加 "与白人和非裔美国人种族差异相关的食物过敏结果"（FORWARD）的儿童的照顾者进行了调查，这是一项前瞻性、多地点的 FA 儿童队列研究。连续结果采用方差分析（ANOVA），分类结果采用卡方检验（chi-squared tests）。使用逻辑回归模型确定对 OIT 作为一种治疗方案的熟悉程度与其他各种协变量之间的关系：与 NHW 受访者相比，NHB 和 H/L 受访者不熟悉 OIT 的比例更高（54.3% 和 62.5% 对 9.2%，p < 0.001）。即使对家庭收入进行调整后，这一结果仍然成立（NHB 参与者的 OR：0.1，95% CI：0.1，0.4；H/L 参与者的 OR：0.1，95% CI：0.0，0.3）。与国家卫生工作者相比，国家卫生工作者和男性/女性参与者更常表示在调查之前从未听说过 OIT（76.7% 和 50.0% 对 26.7%，P < 0.001）。与 14.8% 的 NHW 参与者相比（p < 0.001），没有一个 NHB 和 H/L 受访者开始使用 OIT：在 FORWARD 队列中，即使调整了家庭收入，少数种族和民族群体的护理人员对 OIT 的熟悉程度也较低。

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引用次数: 0