Publications by authors named "Gatt D"

Rationale: Patients with Primary Ciliary Dyskinesia (PCD) experience acute pulmonary exacerbations (PEx). In Cystic Fibrosis (CF), PEx treated with oral antibiotics (oPEx) were found to be related to short and long-term lung function deficits, however the impact oPEx on lung function in patients with PCD has not yet been assessed.

Objective: To assess the impact of oPEx on lung function recovery in PCD and determine the factors associated with poorer response.

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Introduction: Primary Ciliary Dyskinesia (PCD) is a complex mostly autosomal recessive disorder characterized by dysfunction of primary motor cilia, leading to multisystemic manifestations, primarily affecting the rhino-sinopulmonary system. Despite advancements in understanding its pathogenesis, genotype-phenotype correlations are not fully elucidated. Utilizing sibling cohorts offers a promising approach to investigate these genotype-phenotype correlations in PCD.

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Article Synopsis
  • The study explores the impact of the age at which patients are diagnosed with primary ciliary dyskinesia (PCD) on their long-term clinical outcomes.
  • Researchers analyzed data from 110 patients diagnosed with PCD from 2000 to 2022, categorizing them into three groups based on age at diagnosis: early (<1 year), typical (1-7 years), and late (8-14 years).
  • Results indicated that patients diagnosed later had worse lung function (measured by FEV1) and higher rates of pulmonary issues, highlighting the disadvantages of late diagnosis in managing PCD effectively.
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Background: Primary ciliary dyskinesia (PCD) is a rare multisystem genetic disease caused by dysfunctional motile cilia. Despite PCD being the second most common inherited airway disease after cystic fibrosis, PCD continues to be under-recognised globally owing to nonspecific clinical features and the lack of a gold standard diagnostic test. Commonly repeated prevalence estimates range from one in 10 000 to one in 20 000, based on regional epidemiological studies with known limitations.

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The presence of comorbidities (CM) in congenital lobar emphysema (CLE) has been previously described with varying rates. However, the clinical implication of CM on the clinical presentation and patient outcome in CLE is unclear. This was a retrospective cohort study between 2000 and 2022 in a single institution.

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Introduction: Paediatric cerebellar glioblastoma is an exceptionally rare clinical entity, with very few cases described in the literature. In the majority of reported cases, prognosis is extremely poor, despite surgical and oncological management. The paucity of data results in lack of consensus as to the optimal management of these patients, with the objective of prolonging survival.

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Though PCD usually presents after birth in term neonates, diagnosing PCD during the neonatal and infancy stages is uncommon, particularly in children who do not exhibit laterality defects. We report our recent experience with the diagnosis of PCD in the neonatal and early infantile period in a highly consanguine population. This was achieved by implementing a novel genetic-based diagnostic approach based on direct testing for recognized regional genetic variants.

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Article Synopsis
  • Thermal epiglottitis is a rare, non-infectious cause of airway obstruction that mimics symptoms of infectious epiglottitis, observed in a study of pediatric cases over 16 years in southern Israel.
  • Among nearly 600,000 pediatric ER visits, only seven cases were diagnosed, primarily affecting very young boys, with symptoms like stridor and respiratory distress; most were treated with steroids and antibiotics.
  • The study concludes that thermal epiglottitis should be considered in children with acute airway obstruction, emphasizing the need to ask about accidental hot beverage ingestion, especially when there's no fever or inflammatory markers.
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Background: The American Thoracic Society guidelines for the diagnosis of primary ciliary dyskinesia (PCD) consider the presence of a bi-allelic pathogenic variant confirmatory for the diagnosis of PCD, with genetic testing recommended when other confirmatory diagnostic tests are less accessible. We present our experience with genetic testing as first line with a proposed algorithm for high consanguinity populations.

Methods: Patients with a suspected diagnosis of PCD underwent genetic testing according to a diagnostic algorithm composed of three steps: (1) patients with a previously known causative familial/Bedouin tribal pathogenic variant completed direct testing for a single variant; (2) if the initial test was negative or there was no known pathogenic variant, a PCD genetic panel was completed; (3) if the panel was negative, whole exome sequencing (WES) was completed.

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Background: Reversible airway obstruction is common in children with primary ciliary dyskinesia. However, the diagnostic value of adding bronchodilator (BD) response testing to routine spirometry is unclear.

Methods: This is a retrospective analysis of pulmonary function test results obtained from children with primary ciliary dyskinesia seen as outpatients at the Hospital for Sick Children, Toronto.

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Unlabelled: Foreign body aspiration (FBA) is a common cause of pediatric morbidity, but a standardized protocol to guide decision-making about bronchoscopy is lacking. We aimed to validate a new Foreign body aspiration score (FOBAS) for the pediatric emergency department (ED). Patients aged 0-18 years referred to the ED for suspected FBA were prospectively enrolled.

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Background: Obstructive sleep apnea (OSA) is a heterogeneous disorder with a prevalence of 25%-60% in children with obesity. There is a lack of diagnostic tools to identify those at high risk for OSA.

Method: Children with obesity, aged 8-19 years old, were enrolled into an ongoing multicenter, prospective cohort study related to OSA.

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Background: Although parental checklists are well-known for their potential in indexing young children's lexicon size, they can also be used to track children's acquisition of individual words. Word-level data can be used to identify the checklist words most and least commonly employed across groups of children. Like parent-completed vocabulary checklists, samples of spontaneous language use collected from multiple children can also generate measures of word commonality, concerned with the numbers of children producing individual words.

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Article Synopsis
  • - The study aimed to evaluate how effective the Curaçao criteria are over time for diagnosing hereditary hemorrhagic telangiectasia (HHT) in children, using data from a Toronto HHT clinic over a 19-year period.
  • - Out of 116 patients studied, only 41% met the criteria for a definite diagnosis at their first visit, with younger children showing even lower rates; however, by the end of follow-up, 63% reached a definitive diagnosis.
  • - While the number of patients meeting specific diagnostic criteria, like epistaxis and telangiectasia, increased over time, the overall accuracy for diagnosis remained low, suggesting that relying on clinical criteria alone may not adequately diagnose HHT in pediatric
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Foreign Body Aspiration (FBA) is a common medical emergency among young children, but the evaluation and management of a suspected FBA case can vary across physicians and centers. We aimed to identify which clinical, laboratory, and radiological findings can predict FBA in children and to evaluate a clinical score to improve FBA prediction. This is a retrospective cohort study of patients aged 0-18 years admitted to Soroka University Medical Center between 2010 and 2020 with suspected FBA.

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Article Synopsis
  • Pulmonary exacerbation (Pex) is a common issue in children with primary ciliary dyskinesia (PCD), but changes in lung function (FEV1pp) during these events are not well understood.
  • The study analyzed data from 2010 to 2022, examining the lung function changes during Pex treated with IV antibiotics, finding that 78% of patients achieved near baseline FEV1pp by the end of treatment.
  • Results indicated that most improvement in lung function occurred within the first week, and lower body mass index (BMI) was linked to a higher likelihood of not recovering well.
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Respiratory syncytial virus (RSV) is a leading cause of severe lower respiratory tract disease, especially in young children. Despite its global impact on healthcare, related to its high prevalence and its association with significant morbidity, the current therapy is still mostly supportive. Moreover, while more than 50 years have passed since the first trial of an RSV vaccine (which unfortunately caused enhanced RSV disease), no vaccine has been approved for RSV prevention.

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Introduction: Surgical (OP) management for symptomatic congenital lobar emphysema (CLE) is the standard of care with nonoperative (NOP) approach applied for asymptomatic cases. The aim of this study is to report the outcomes for NOP approach to the care of symptomatic CLE infants.

Methods: A retrospective study of CLE patients treated 2000-2021 at a single institution.

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Article Synopsis
  • Chronic infection with Pseudomonas aeruginosa (PsA) worsens lung issues in children with primary ciliary dyskinesia (PCD), but evidence for effective treatment (antibiotic eradication therapy, AET) is limited.
  • A retrospective study evaluated the effectiveness of a stepwise AET protocol in treating newly acquired PsA infections in pediatric PCD patients from 2010 to 2022, focusing on achieving PsA-negative cultures.
  • Results showed a 97% overall success rate in clearing PsA after treatment, with 74% negative cultures for asymptomatic patients after the first step and a 70% likelihood of remaining PsA-free for at least a year post-AET
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The effect of banning of nonessential services during the novel coronavirus disease 2019 (COVID-19) pandemic led to a perceived change in the volume of trauma cases and injury patterns. Literature indicates trends toward less trauma overall, with a decrease in outdoor, sporting, and motor vehicle injuries. However, studies focusing on outpatient orthopaedic trauma are less common.

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