A reassessment of the PROPATRIA study and its implications for probiotic therapy.

The PROPATRIA (Probiotics in Pancreatitis Trial) study was a multicenter, double-blind, placebo-controlled clinical trial that aimed to reduce infectious complications in patients with predicted severe acute pancreatitis by the enteral use of a multispecies probiotic preparation. An unprecedented 24 of 152 patients (16%) in the group receiving probiotics died versus 9 of 144 (6%) in the placebo group. This high mortality rate in the probiotic-treated group contrasts strongly with observations from a previous smaller study and from our observations regarding the effects of abundant intestinal lactobacilli in patients with short small bowel (SSB) syndrome.

Quality of life in adults with childhood-onset of Complex Regional Pain Syndrome type I.

Introduction: The clinical presentation of Complex Regional Pain Syndrome type I (CRPS I) in children differs compared to the presentation in adults. Reported results of treatment of CRPS I in children are usually more favourable and seem better than the reported treatment of adults with CRPS I. We investigated the quality of life (QoL) in adults who have been treated for childhood-onset CRPS I.

Pancreatic injury in children: good outcome of nonoperative treatment.

Purpose: Treatment of blunt injury of the pancreas in children remains controversial. Some prefer nonoperative treatment, whereas others prefer operative management in selected cases. This report reviews the treatment of patients with blunt pancreatic trauma admitted to a level I pediatric trauma center in The Netherlands.

Gastrointestinal zygomycosis due to Rhizopus microsporus var. rhizopodiformis as a manifestation of chronic granulomatous disease.

A case of gastrointestinal zygomycosis in a 10-month-old boy with chronic granulomatous disease (CGD) is presented. Zygomycetes are an uncommon cause of fungal disease in CGD patients and gastrointestinal zygomycosis has not been previously described in individuals with CGD. To improve outcome, a timely and correct diagnosis is of utmost importance.

Preduodenal portal vein and malrotation: what causes the obstruction?

Aim And Method: Preduodenal portal vein is a rare congenital abnormality, and occurs either as a single malformation, in association with other malformations or as part of "polysplenia" syndrome. Preduodenal portal vein has seldom been reported as a cause of intestinal obstruction, however corrective surgery is nearly always performed. We conducted a 25-year retrospective study in a single centre to investigate the cause of obstruction in patients with preduodenal portal vein.