International Forum of Allergy & Rhinology最新文献

{"title":"Real-world predictors of dupilumab prescription in patients with chronic rhinosinusitis with nasal polyps.","authors":"Christina Dorismond, Mason R Krysinski, Yash Trivedi, Rory J Lubner, Rakesh K Chandra, Naweed I Chowdhury, Justin H Turner","doi":"10.1002/alr.23483","DOIUrl":"https://doi.org/10.1002/alr.23483","url":null,"abstract":"<p><strong>Background: </strong>Despite increasing dupilumab use for chronic rhinosinusitis with nasal polyps (CRSwNP), little is known about the factors influencing its use in real-world practice. We aimed to identify factors that may predict dupilumab prescription in CRSwNP patients who have undergone endoscopic sinus surgery (ESS).</p><p><strong>Methods: </strong>A single-institution, retrospective cohort study of patients who underwent ESS for CRSwNP between 2015 and 2023 was conducted. Demographics, comorbidities, 22-item sinonasal outcome test (SNOT-22) scores, and dupilumab prescription date were extracted from patient records. Intraoperative nasal mucus cytokine levels were measured using a multiplex bead assay. Univariate logistic regression analysis was performed to identify factors associated with dupilumab prescription, and multivariate logistic regression was used to adjust for surgery date.</p><p><strong>Results: </strong>A total of 299 CRSwNP patients were included, including seventy (23.4%) who were prescribed dupilumab postoperatively. Patients were more likely to be prescribed dupilumab if they had asthma (odds ratio [OR] 2.304), aspirin-exacerbated respiratory disease (AERD, OR 3.375), elevated tissue eosinophils (OR 1.005), and higher 3-month postoperative SNOT-22 scores (OR 1.027). Patients prescribed dupilumab also had greater odds of having elevated mucus interleukin (IL)-5 (OR 1.128) and IL-13 (OR 1.213). When adjusting for surgery date, associated factors included: asthma (OR 2.444), AERD (OR 3.750), allergic rhinitis (OR 1.833), higher tissue eosinophils (OR 1.005), elevated 3-month SNOT-22 scores (OR 1.028), and higher IL-5 (OR 1.123) and IL-13 (OR 1.202) levels.</p><p><strong>Conclusion: </strong>Asthma, AERD, allergic rhinitis, and elevated tissue eosinophil, IL-5, and IL-13 levels are predictive of dupilumab prescription in CRSwNP patients. These may serve as clinical and inflammatory biomarkers and can aid in counseling patients about expected disease trajectory.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619671","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}

{"title":"Evaluation of mucosal barrier disruption due to Staphylococcus lugdunensis and Staphylococcus epidermidis exoproteins in patients with chronic rhinosinusitis.","authors":"Mahnaz Ramezanpour, Sholeh Feizi, Hashan Dilendra Paththini Arachchige, George Bouras, Clare Cooksley, Gohar Shaghayegh, Peter-John Wormald, Alkis James Psaltis, Sarah Vreugde","doi":"10.1002/alr.23481","DOIUrl":"https://doi.org/10.1002/alr.23481","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis (CRS) is a persistent inflammatory condition of the sinus mucosa. While Staphylococcus aureus has been shown to play a significant role in mucosal barrier disruption in CRS patients, coagulase-negative staphylococci (CoNS) such as Staphylococcus epidermidis and Staphylococcus lugdunensis are also implicated in CRS pathophysiology. This study investigates the effects of exoproteins secreted by planktonic and biofilm forms of clinical isolates of S. epidermidis and S. lugdunensis on the nasal epithelial barrier.</p><p><strong>Methods: </strong>Thirty-one clinical isolates of CoNS were grown in planktonic and biofilm forms, and their exoproteins were concentrated. The epithelial barrier structure was assessed by measuring transepithelial electrical resistance (TEER) and the permeability of fluorescein isothiocyanate-dextran. Toxicity and inflammatory response were also studied.</p><p><strong>Results: </strong>Our findings demonstrate that exoproteins from all planktonic forms of S. lugdunensis disrupted the mucosal barrier, whereas only nine of 16 biofilm-derived exoproteins had similar effects. Conversely, 11 of 15 exoproteins from planktonic S. epidermidis significantly disrupted barrier integrity; however, biofilm exoproteins did not. The study also showed that some exoproteins from planktonic S. epidermidis significantly reduced cell viability, while exoproteins from planktonic and biofilm forms of S. lugdunensis and biofilm S. epidermidis did not induce any statistically significant change in cell viability. Notably, four of 16 biofilm exoproteins from S. lugdunensis induced higher interleukin-6 (IL-6) secretion, whereas none of the S. epidermidis isolates showed a significant increase in IL-6 secretion.</p><p><strong>Conclusion: </strong>Our results suggest that CoNS exoproteins may contribute to CRS etiopathogenesis.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604430","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}

{"title":"Guidance for the evaluation by payors of claims submitted using Current Procedural Terminology codes 95165, 95115, and 95117","authors":"J. Allen Meadows MD,&nbsp;Gary N. Gross MD,&nbsp;Anita N. Wasan MD,&nbsp;Dole P. Baker MD,&nbsp;Amber Patterson MD,&nbsp;Robert Puchalski MD,&nbsp;Anil Nanda MD,&nbsp;Jami Lucas BS,&nbsp;J. Wesley Sublett MD, MPH,&nbsp;Paul V. Williams MD","doi":"10.1002/alr.23480","DOIUrl":"10.1002/alr.23480","url":null,"abstract":"<p>This Guidance was jointly developed equally by the American Academy of Allergy Asthma and Immunology (AAAAI), the American Academy of Otolaryngic Allergy (AAOA), and the American College of Allergy, Asthma and Immunology (ACAAI) to advise insurance companies and other payors of the documentation that they should, and should not, require in their review of claims for payment for services covered by Current Procedural Terminology (CPT) codes 95165, 95115, and 95117. The goal of the Guidance is to assist payors to develop a process for reviewing claims submitted under these 3 codes in a manner that is efficient, fair, and not unduly burdensome. This document supersedes any document or manual published previously by the above organizations.</p><p>The Guidance is divided into 2 parts. The first part explains each of the 3 codes, the services that are covered by these codes, and the medical necessity of those services. The second part describes what the 3 organizations believe are reasonable requests for documentation and what we submit are unreasonable requests. It first addresses code 95165 and then codes 95115 and 95117.</p><p>The AAAAI, AAOA, and ACAAI recognize that it is reasonable for insurance companies and other payors to request documentation to show that a claim submitted under CPT code 95165, 95115, or 95117 is for a medically necessary service that has been performed and has been properly coded. Accordingly, in this Guidance, we have presented the documentation that in our judgment is reasonable for payors to request. This documentation is itself quite substantial.</p><p>At the same time, we respectfully submit that demands for several kinds of additional documentation that have been made by some insurers are unnecessary. These demands serve only to make the claims process less efficient and to impose an undue burden on the entity submitting the claim—at least when the payor has no sound reason to believe that a particular claimant has acted improperly. Whenever we have characterized a particular category of requested documentation as excessive, we have sought to explain the reasons for our position.</p><p>All 3 organizations would be pleased to meet with any payor that would like to discuss this Guidance. As noted at the outset, our goal is to work with payors to assist them in developing a process for review of claims under codes 95165, 95115, and 95117 that is efficient, fair, and not unduly burdensome.</p><p>The authors declare no conflicts of interest.</p><p>The authors have no funding sources to report.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 1","pages":"5-8"},"PeriodicalIF":7.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alr.23480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery versus biologics for nasal polyposis: Perspective on contemporary data","authors":"Michael J. Ye MD,&nbsp;Rodney J. Schlosser MD,&nbsp;Zachary M. Soler MD, MS,&nbsp;Jonathan B. Overdevest MD, PhD,&nbsp;David A. Gudis MD","doi":"10.1002/alr.23486","DOIUrl":"10.1002/alr.23486","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"14 12","pages":"1845-1848"},"PeriodicalIF":7.2,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581880","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}

{"title":"Making \"scents\" of nutrients: Investigating the relationship between olfactory dysfunction and vitamin intake.","authors":"Sophie E Yu, Youn Soo Jung, Margaret B Mitchell, Simon Chiang, Mitali Banerjee, Mengyuan Ruan, Tanujit Dey, Sarah E Fleet, Stella E Lee","doi":"10.1002/alr.23488","DOIUrl":"https://doi.org/10.1002/alr.23488","url":null,"abstract":"<p><strong>Key points: </strong>Decreased overall dietary consumption of micronutrients may be linked to an increased risk of olfactory dysfunction (OD) including subjective report of OD, subjective report of phantosmia, and objective OD. Interactions were identified between these micronutrients, suggesting that outcomes may vary depending on the mixture of micronutrients taken.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581790","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}

{"title":"Ambient particulate matter and frequency of outpatient visits for chronic rhinosinusitis in the United States.","authors":"Hong-Ho Yang, David Grimm, Esther Velasquez, Peter H Hwang","doi":"10.1002/alr.23477","DOIUrl":"https://doi.org/10.1002/alr.23477","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence has underscored the harmful effects of air pollution on the upper airway. We investigated the relationship between ambient particulate matter (PM) level and the frequency of outpatient visits for chronic rhinosinusitis (CRS).</p><p><strong>Methods: </strong>We conducted an ecological cohort study of US adults enrolled in The Merative MarketScan outpatient database from 2007 to 2020. For each geographical subunit (core-based statistical area [CBSA]), we calculated the annual rate of CRS-related outpatient visits per 1000 well-patient checkup visits (CRS-OV). Using data from the Environmental Protection Agency's Air Quality System, we mapped the rolling statistical average of daily PM_2.5 and PM₁₀ over the preceding year onto each CBSA × year combination. We employed multivariable negative binomial regression modeling to estimate the association between PM levels and subsequent CRS-OV.</p><p><strong>Results: </strong>Across 3933 observations (CBSA × year combinations), encompassing ∼4 billion visits, the median CRS-OV was 164 (interquartile range 110-267). The mean PM_2.5 level was 8.9 µg/m³ (SD 2.6) and the mean PM₁₀ level was 20.2 µg/m³ (SD 7.2). Adjusting for patient demographics and respiratory comorbidities, a compounded rise in subsequent CRS-OV was observed with increasing PM levels. Each µg/m³ rise in PM_2.5 independently predicted a 10% increase in CRS-OV (adjusted incidence rate ratio [aIRR]) 1.10, 95% confidence interval [CI] 1.08-1.13) and each µg/m³ rise in PM₁₀ independently predicted a 3% increase in CRS-OV (aIRR 1.03, 95% CI 1.02-1.04).</p><p><strong>Conclusion: </strong>Elevated ambient PM_2.5 and PM₁₀ levels are associated with a subsequent compounded increase in the frequency of CRS-OV, with PM_2.5 predicting a more pronounced rise compared to PM₁₀.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545275","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}

{"title":"Viral infection as an inciting event for development of chronic rhinosinusitis: A population-based study.","authors":"Najm S Khan, Heli Majeethia, Vincent Provasek, Faizaan Khan, Zain Mehdi, Aatin K Dhanda, Jeffrey T Vrabec, Edward D McCoul, Chadi A Makary, Masayoshi Takashima, Omar G Ahmed","doi":"10.1002/alr.23482","DOIUrl":"https://doi.org/10.1002/alr.23482","url":null,"abstract":"<p><strong>Key points: </strong>Viral infections lead to a greater than twofold increased risk of developing chronic rhinosinusitis within 1 year. Viral infections lead to a greater than twofold increased risk of developing chronic rhinosinusitis within 1 year. Recurrent viral infections pose a greater risk of chronic rhinosinusitis than single episodes.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545276","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}

{"title":"Letter to the editor regarding “Role of social determinants of health on quality of life in pediatric chronic rhinosinusitis”: Enhancing patient-centered care in underdeveloped regions","authors":"Huimin Du MMed,&nbsp;Tong Wu MMed","doi":"10.1002/alr.23479","DOIUrl":"10.1002/alr.23479","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"14 12","pages":"1967-1968"},"PeriodicalIF":7.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499714","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}

{"title":"Development and validation of the four-item Concise Aging adults Smell Test to screen for olfactory dysfunction in older adults.","authors":"Zachary M Soler, Mathew J Gregoski, Preeti Kohli, Kristina A LaPointe, Rodney J Schlosser","doi":"10.1002/alr.23476","DOIUrl":"https://doi.org/10.1002/alr.23476","url":null,"abstract":"<p><strong>Background: </strong>Olfactory dysfunction (OD) in the elderly is common and associated with numerous comorbidities, yet often underrecognized. This study sought to develop an instrument for widespread screening of this condition.</p><p><strong>Methods: </strong>Demographic factors, comorbidities, and olfactory-related questions were examined in a focus group (N = 20) and development cohort (N = 190). The 4-item Concise Aging adults Smell Test (4-CAST) screening instrument was then developed to predict OD on Sniffin Sticks testing. An independent validation cohort (N = 147) was then examined to confirm ability of the 4-CAST to predict OD on Smell Identification Test 40 (SIT40).</p><p><strong>Results: </strong>The most important variables for predicting olfactory loss in older subjects were age, type II diabetes status, Visual Analog Scale (VAS) of overall rating of smell, and VAS of impact of smell upon safety. In the development cohort, the 4-CAST model yielded predictive probability (area under the curve) of 0.805 (p < 0.001) for predicting the bottom 25th percentile on Sniffin Sticks. Results were similar in the validation cohort, as the 4-CAST accurately classified 83.8% subjects (area under the curve [AUC] 0.789, p < 0.001) in the bottom 25th percentile of SIT40 testing. The 4-CAST was able to accurately classify 89.4% of subjects with anosmia.</p><p><strong>Conclusion: </strong>The 4-CAST is a quick screening instrument for predicting OD in older adults and has similar performance characteristics in independent populations using the two most common validated olfactory tests. Given the high prevalence of unrecognized olfactory loss in this population, this can be a useful tool for practitioners to determine which subjects may benefit from more extensive olfactory testing.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499713","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}

{"title":"A cradle-to-grave life cycle assessment of the endoscopic sinus surgery considering materials, energy, and waste.","authors":"Zeinab Mousania, Darpan Kayastha, Ryan A Rimmer, John D Atkinson","doi":"10.1002/alr.23474","DOIUrl":"https://doi.org/10.1002/alr.23474","url":null,"abstract":"<p><strong>Background: </strong>Operating rooms generate 1.8 million tons of waste annually, or 20%‒30% of the total healthcare waste in the United States. Our objective was to perform a life cycle assessment (LCA) for endoscopic sinus surgeries (ESSs) in order to analyze its environmental impact.</p><p><strong>Methods: </strong>A comprehensive LCA of ESS was performed considering energy, climate, and water use impacts associated with the materials and processes used. It focuses on the ESS performed at a large tertiary academic hospital and then extends the impacts to consider annual US surgeries. The assessment considers end-of-life waste management at both landfills and incinerators.</p><p><strong>Results: </strong>Single-use instrument production constitutes 89%‒96% of the total impacts throughout the life cycle of an ESS. Waste-to-energy incineration is shown to be a preferred end-of-life destination, as it recovers much of the input production energy of plastic items, ultimately reducing the input to 36%, although this is done at the expense of higher greenhouse gas emissions. For multi-use items, decontamination dominates environmental impact (>99% of totals), but consideration of reusable items reduces overall energy consumption and global warming potential (GWP) by 25%‒33%.</p><p><strong>Conclusion: </strong>Single-use items dominate the total environmental impact of ESS. While multi-use items require additional decontamination over their lifetimes, results show that their incorporation reduces energy consumption and GWP by 25%‒33%, demonstrating the clear environmental benefit.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499711","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}