Our data implies that colonization must occur before benefits of probiotics can be realized. Probiotics are, therefore, likely to be of limited benefit in treating diarrheal illnesses of short duration such as viral enteritis. The beneficial effects of probiotics may be limited to prophylactic usage in high-risk populations.

No abstract

By means of the Pettersson scoring system, the degree of severity of haemophilic arthropathy in 128 knee, elbow and ankle joints was estimated by 5 radiologists. Their scores varied on average by approximately 3 points. Minimal and maximal joint involvement were scored consistently; exclusion of haemophilic arthropathy was possible with the highest degree of certainty. With regard to changes of a moderate degree agreement was seldom reached. With precisely defined characteristics, a high degree of consistency between observers was evident. Interobserver variation in the scoring was more marked in the ankle joint than in the other joints. Scoring was more consistent with the more experienced observers.

LB is a valuable and safe procedure in pediatric patients with a low rate of complications. Pediatric patients can be discharged home safely should no complications occur within the first 8-12 h after the procedure.

To date, S. alactolyticus endocarditis complicated by middle cerebral artery aneurysm has not been reported. We describe the case of a 65-year-old female with a history of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction presenting with confusion and a apical holosystolic murmur. Angiography of the brain identified new bilobed left middle cerebral artery aneurysm. Serial blood cultures grew S. alactolyticus, and aortic and mitral valve vegetation were discovered on transesophageal echocardiography. The patient was treated with antimicrobial therapy, mitral and aortic valve replacements, and microsurgical clipping of cerebral aneurysm. This case serves to highlight the pathogenicity of a sparsely described bacterium belonging to the heterogenous S. bovis complex.

The degree of haemophilic osteoarthropathy was assessed by the Pettersson-score in 219 knees, elbows and ankles of 40 children and adolescents suffering from haemophilia. 55.3% of the joints were unaffected and only 8 joints showed score values greater than 8. Enlargement of epiphyses (36.1%) and irregular subchondral surface (32.9%) were the most frequent observations, while osteoporosis (5.4%) was only rarely observed. Haemophilic osteoarthropathy was most severe in the ankles, while the knees were only moderately affected. Among 11 patients 493 bleedings into 61 joints were observed during a four-year period. If the bleedings recurred, more than 3 bleedings per year always resulted in haemophilic osteoarthropathy.

A left orbital arteriovenous fistula (AVF) is diagnosed in a patient presenting with proptosis. Intra-orbital AVFs are rare according to the literature search, and therefore, the best treatment modality remains controversial. We present a case of a patient who presented with non-specific symptoms. He was diagnosed with intra-orbital AVF and underwent a trans-arterial embolization. The procedure was complicated by the central retinal artery occlusion, which is one of the most feared complications associated with this procedure. We discuss the modalities in the diagnosis of intra-orbital AVFs as well as stress the importance of an interdisciplinary approach for its timely and efficient management.

ObjectivesTo evaluate the C-reactive protein serum levels in patients with pulmonary and abdominal sepsis during the first five days of sepsis progression. Methods The present investigation was a retrospective cohort study conducted at the university hospital with 345 patients who were admitted to the intensive care unit and diagnosed with sepsis of pulmonary or abdominal origin. Serum C-reactive protein concentrations were measured by the turbidimetric immunoassay. For analysis of C-reactive protein, day 1 was defined as the day on which the patient was clinically diagnosed with sepsis. Results Thirty-four patients with sepsis (9.8%), 114 patients with severe sepsis (33.0%), and 197 patients with septic shock (57.2%) were evaluated. The age of the patients was 56.4±19.8 years. The serum C-reactive protein concentrations were higher on the day of sepsis diagnosis in the group with abdominal infection compared with the group with pulmonary sepsis (17.8±10.1 mg/dL versus 14.9±11.1 mg/dL, p=0.025) and remained significantly higher during the first five days of sepsis progression. Conclusion The serum C-reactive protein concentrations were significantly higher in the patients with abdominal sepsis compared with the patients with pulmonary sepsis during the first five days of sepsis progression.