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Background: Severe acute pancreatitis is a common diagnosis in emergency general surgery and can be a cause of significant morbidity and mortality. A consequence of severe acute pancreatitis is thrombus in the splanchnic veins. These thrombi can potentially lead to bowel ischemia or hepatic failure. However, another complication of severe acute pancreatitis is retroperitoneal bleeding. At this time, it is unclear if treating patients for splanchnic vein thrombosis in the context of severe acute pancreatitis is associated with any outcome benefit. A systematic review might clarify this question., Data Sources: A two-fold search strategy (one broad and one precise) looked at all published literature. The review was registered on PROSPERO (ID: CRD42018102705). MEDLINE, EMBASE, PubMed, Cochrane and Web of Science databases were searched and potentially relevant papers were reviewed independently by two researchers. Any disagreement was reviewed by a third independent researcher. Primary outcome was reestablishment of flow in the thrombosed vein versus bleeding complications., Results: Of 1462 papers assessed, a total of 16 papers were eligible for inclusion. There were no randomized controlled trials, 2 were case series, 5 retrospective single-center studies and 9 case reports. There were a total of 198 patients in these studies of whom 92 (46.5%) received anticoagulation therapy. The rates of recanalization of veins in the treated and non-treated groups was 14% and 11% and bleeding complications were 16% and 5%, respectively. However, the included studies were too heterogeneous to undertake a meta-analysis., Conclusions: The systematic review highlights the lack evidence addressing this clinical question. Therefore a randomized controlled trial would be appropriate to undertake., (Copyright © 2020 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights reserved.)

Research in 1984 indicated that the cadmium body burden was higher in a village where the soil is contaminated with cadmium (Luyksgestel) than in a control village (Zeeland). The distribution of kidney function parameters also differed between the two villages. The aim of this study is to estimate the lifetime accumulated cadmium intake from food for the people from both villages. Various data sets describing dietary patterns in the Netherlands were used. The assessed average lifetime accumulated cadmium intake from food by the study subjects (aged 30-69 years) was 435 mg (+/- 131 mg) in Luyksgestel and 394 (+/- 113 mg) in Zeeland. The estimated lifetime accumulated cadmium intake for a hypothetical allotment gardener of 55 years was 520 mg from vegetables grown on uncontaminated soil, and 655 mg for lifelong consumption of vegetables from contaminated soil. The Luyksgestel subjects' estimated cadmium intake from food was well below the provisional tolerable weekly intake as proposed by the WHO, of 400-500 micrograms or 1124-1404 mg for the lifelong intake by a 55-year-old man.