Lung Function Recovery from Pulmonary Exacerbations Treated with Oral Antibiotics in Primary Ciliary Dyskinesia
Bibliographic record
Abstract
Abstract Rationale Patients with primary ciliary dyskinesia (PCD) experience acute pulmonary exacerbations (PExs). In patients with cystic fibrosis (CF), PExs that were treated with oral antibiotics (oPExs) were found to be related to short- and long-term lung function deficits; however, the impact of oPExs on lung function in patients with PCD has not yet been assessed. Objectives We sought to assess the impact of oPExs on lung function recovery in PCD and determine the factors associated with poorer response. Methods This was a retrospective study of pediatric patients with PCD who were followed from 2000 to 2022 at The Hospital for Sick Children (Toronto, Ontario, Canada). PExs were defined as an increase in baseline symptoms with a physician’s decision to treat with systemic intravenous or oral antibiotics. Lung function recovery was defined as a forced expiratory volume in 1 second (FEV1) measurement ⩾90% of a stable baseline within 12 months before the PEx. Univariate and multivariate analyses were completed to identify risk factors for nonresponse. Results A total of 337 PEx events in 85 patients were included in this analysis, of which 297 (88%) were treated with oral antibiotics. The mean follow up time for patients was 6.7 years (SD = 3.5), and the mean age of patients with an oPEx was 12.5 years (SD = 3.2). Patients with an oPEx had a significant drop from baseline in mean FEV1 values at the time of the PEx (85.1–69.5%), with absolute and relative changes of −10.4% and −12.9%, respectively. At follow up (3 mo post PEx) and up to 12 mo post PEx, the means for FEV1 were 79.6% and 84.1%, respectively. A total of 73.2% of the patients had lung function recovery at the follow up visit, which increased to 84.2% within 1 year postevent. We identified two risk factors for nonresponse: being a nonresponder on the last PEx and younger age at time of the oPEx. Conclusions oPExs in patients with PCD show a similar pattern previously seen in patients with CF who showed a decrease in FEV1 during exacerbation and an improvement posttherapy. Most oPEx events recover to baseline FEV1 within the year postexacerbation, with younger age and being a nonresponder in the last PEx identified as risk factors for nonresponse.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".