Publications by authors named "Goldbart A"

Background: Respiratory syncytial virus (RSV) infection in the first year of life has been linked with an increased risk for asthma. Some propose that RSV-induced inflammation leads to lasting airway changes, while others contend that RSV bronchiolitis is a marker for underlying predisposition. Social distancing adopted during the COVID-19 pandemic has led to a dramatic reduction in RSV activity, providing an unexpected opportunity to investigate this debate.

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Unlabelled: The implementation of an in-hospital fracture liaison service facilitated prompt initiation of anti-osteoporosis treatment following a hip fracture (HF), increasing follow-up and treatment rates. This led to a 48% reduction in the risk of subsequent HF and a 29% decrease in mortality rates.

Purpose: To demonstrate the impact of an institutional fracture liaison service (FLS) which allowed in-hospital anti-osteoporosis treatment following hip fracture (HF) on subsequent HF and mortality rate.

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Unlabelled: Pneumonia remains the primary cause of mortality among children under age 5. Cleft palate (CP) poses various challenges including velopharyngeal disfunction, potentially increasing rates of pneumonia. However, clinical evidence linking pneumonia to defect is lacking.

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Background: The respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections in infants and is associated with an increased risk of asthma development. Palivizumab, an RSV prophylactic, reduces RSV-related hospitalizations in high-risk infants, but its impact on long-term asthma outcomes remains unclear. This study compares asthma-related healthcare utilization in preschool children born prematurely between those who received Palivizumab (the Prophylaxis (+) group) and those who did not (the Prophylaxis (-) group).

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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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Unlabelled: Bronchopulmonary dysplasia (BPD) poses a significant challenge as the most common late morbidity of preterm infants. This study aimed to evaluate airway abnormalities in infants with BPD who underwent flexible bronchoscopy (FB) to gain insights into the prevalence of upper airway obstruction and associated complications. A retrospective case-control study was conducted on BPD patients who underwent FB at a tertiary center between 2013 and 2023.

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Viral load measurement of Respiratory syncytial virus (RSV) in acute bronchiolitis depends on specimen collection, viral load quantification, and transport media. The aim of this study was to investigate viral load in three-way-comparative analyses; nasal swab versus nasal wash, quantitative real-time polymerase chain reaction (RT-PCR) versus cell tissue culture, and various transport media. A prospective cohort study of infants aged < 12 months, admitted to the Soroka Medical Center, due to acute bronchiolitis, was conducted.

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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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Article Synopsis
  • Acute bronchiolitis is a leading cause of hospitalization in infants globally, and this study examines the relationship between an infant's weight and the severity of RSV bronchiolitis.
  • A retrospective analysis of 1,936 infants revealed that underweight infants experienced higher rates of PICU admissions (9.1%) and longer hospital stays (3.13 days) than normal-weight infants (3.5% and 2.79 days).
  • The findings indicate that underweight infants are at a greater risk for severe disease complications, suggesting the need for closer monitoring of this vulnerable group.
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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: Lung maldevelopment due to in-utero events may potentially cause respiratory morbidity during childhood. Maternal nutritional status during pregnancy is critical for lung development. This study is contributing to the understanding of the interplay between maternal nutrition status during pregnancy, fetal lung development and the risk for respiratory diseases in early life.

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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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Unlabelled: In growing children, temporomandibular joint (TMJ) ankylosis and septic arthritis are uncommon. Retrognathia and micrognathia affect airway patency and can cause obstructive sleep apnea (OSA). No unified diagnostic criteria have been established for the management of this pathology.

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Objective: Acute bronchiolitis is the most common cause of hospitalization in young children. Data on monocyte-to-lymphocyte-ratio (MLR) and neutrophil-to-lymphocyte-ratio (NLR) as biomarkers are limited. We aim to evaluate these ratios in children hospitalized with respiratory syncytial virus (RSV) bronchiolitis and their value as biomarkers for severe clinical outcomes.

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Article Synopsis
  • This study investigated the oral RSV fusion protein inhibitor AK0529 for treating infant patients hospitalized with respiratory syncytial virus (RSV) infection, as current therapies are ineffective.
  • In a Phase 2 trial, infants were given AK0529 or a placebo, with no significant safety issues reported and promising results showing reduced viral load and respiratory symptoms with the higher dose of AK0529.
  • Overall, AK0529 was well-tolerated and indicated a potential for effective treatment in reducing RSV-related morbidity in young children.
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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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Asthma is the most common chronic respiratory disease in children. The neutrophil-to-lymphocyte ratio (NLR) is a marker of a chronic inflammatory state; however, data on the association of NLR with acute asthma exacerbations in children is lacking. In this cross-sectional study, between 2016 and 2021, children aged 2-18 years who were referred to the emergency department (ED) due to asthma exacerbation, were included.

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Background: The prevalence of nontuberculous mycobacteria (NTM) infections is rising in people with cystic fibrosis (pwCF). NTM infection, especially infection with Mycobacterium abscessus complex (MABC), is commonly associated with severe lung deterioration. The current treatment modalities, including multiple intravenous antibiotics, frequently fail to achieve airway eradication.

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Unlabelled: Chest X-ray (CXR) is an important tool in the assessment of children with suspected foreign body aspiration (FBA), although it can falsely be interpreted as normal in one-third of the cases. The aim of this study is to evaluate the positive predictive value of CXR in children hospitalized with suspected FBA, when interpreted by three disciplines: pediatric pulmonology, pediatric radiology, and pediatric residents. This is a retrospective study that included children aged 0-18 years, admitted with suspected FBA, between 2009 and 2020 in one tertiary center.

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Data on the impact of paediatric atopic dermatitis on parental sleep are scarce. The aim of this study was to examine the effects of paediatric atopic dermatitis on the quality of parents' sleep. This cross-sectional study included parents of patients with atopic dermatitis and parents of healthy children who completed validated Pittsburgh Sleep Quality Index questionnaires.

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Article Synopsis
  • Children with Down syndrome (DS) often need flexible bronchoscopies (FB) because of common respiratory issues, leading to a study examining their indications and outcomes.
  • Between 2004 and 2021, a study compared 50 pediatric DS patients with 150 controls on demographics and findings from FB, finding higher rates of obstructive sleep apnea and abnormal results in DS patients.
  • Complications from the procedure were more common in DS patients, especially those with pre-existing cardiac issues and pulmonary hypertension, highlighting the need for careful monitoring in this group.
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