Background: Plastic bronchitis (PB) is a rare, variable, and potentially fatal disease. This study aimed to assess the efficacy of fiberoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL) in treating children with PB. Methods: In total, 15 children with PB, between 2012 and 2020, were enrolled in our study. Within 12 hours of admission, FOB and BAL were performed and reviewed under local anesthesia and sedation. Before and after FOB, clinical findings and chest imaging were evaluated. Results: Regarding the onset of symptoms before FOB, all cases had prominent cough for 7.00 ± 4.55 days, and 14 had persistent high fever. In total, 13 cases had complete obstruction from bronchial casts, consistent with consolidated lesions; 2 had partial airway obstruction. Within 3 days, complete resolution was revealed in nine cases. Overall, six cases underwent repeated FOB (range, 2-3 times) for persistent atelectasis and airway obstruction. Except for two cases with type 2 PB, cast histology confirmed type 1 PB for all cases. Only eight children had minor intraand post-procedure complications. Reverse transcription-polymerase chain reaction for Mycoplasma pneumoniae in sputum and BAL samples were positive in 13 cases. Next-generation sequencing of the BAL samples was positive for adenovirus and Human parainfluenza virus in one case, respectively. During 1 month to 7 years of follow-up, no patient developed PB recurrence, asthmatic attacks, or chronic cough. Conclusions: Early FOB and BAL were effective in alleviating clinical findings, atelectasis, and airway obstruction. Serial FOB could be performed in patients with recurrent symptoms.

No abstract

Endovascular intervention is safe and efficacious for the treatment of primary entire-IVC occlusion.

Background: Sepsis is the leading cause of mortality in children. Several scoring systems are used to predict outcome and mortality for pediatric patients with sepsis, but how they compare to each other in terms of sensitivity and specificity is unclear. Methods: The systematic literature review was performed following PRISMA guidelines. Publically accessible search engines and study databases such as PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar were scanned for articles published from January 1990 to March 2021 using relevant key words. All relevant studies were analyzed separately by two reviewers. A random-effects model was used to calculate the pooled sensitivity and pooled specificity with a 95% confidence interval (CI). Heterogeneity was evaluated using I 2 , which estimates the percentage of variation between study results due to heterogeneity rather than sampling error. Results: Eleven studies met inclusion criteria and evaluated the SOFA scoring system. The pooled sensitivity, specificity, and SROC for prediction of mortality were 83% (95% CI: 76% e88%), 72% (95% CI: 60%e81%), and 85% (95% CI: 82%e88%), respectively. Six studies examined the SIRS system. Pooled sensitivity, specificity, and SROC were 80% (95% CI: 64%e90%), 36% (95% CI: 23%e51%), and 59% (95% CI: 55%e63%), respectively. Conclusion: This meta-analysis shows that SOFA was superior to SIRS for predicting mortality in PICU patients with sepsis. Additional prospective multi-centric studies are needed to better evaluate and validate this finding.