[Neck phlegmon with an odontogenic cause]. / Een halsflegmone met dentogene oorzaak.

BACKGROUND: When an odontogenic infection extends into the neck, a life-threatening situation may develop as a result from airway obstruction, sepsis or mediastinitis. However, this is quite rare. Prompt treatment is important to minimise these complications. CASE DESCRIPTION: A 49-year-old woman presented to the oral and maxillofacial surgery outpatient clinic of a general hospital with extensive abscesses in the neck after a molar extraction. Because of the aggressive course of the disease, the patient was transferred to a university hospital. After several surgeries, during which the neck was widely opened and drained, tracheostomy and admission to the intensive care department, the infection was under control. CONCLUSION: In case of a patient with a progressive swelling in the neck, an odontogenic cause should be considered. When, in addition to the swelling, there are also signs of worsening, such as fever, swallowing problems and locked jaw, the patient should be urgently referred to an oral and maxillofacial surgeon.

Application of biomarkers for exposure and effect of polyhalogenated aromatic hydrocarbons in naturally exposed European otters (Lutra lutra).

In the serious decline of European otters (Lutra lutra) over the last decades, polychlorinated biphenyls (PCBs) are considered to be one of the major factors. As no experiments can be conducted with otters, an eco-epidemiological study was performed to derive no observed effect concentrations (NOECs) for PCBs in the otter. A strong negative correlation was found between hepatic vitamin A and polychlorinated biphenyl (PCB) concentrations expressed as TCDD-equivalents (TEQs), coinciding with a higher incidence of infectious diseases. The no-effect concentration for vitamin A reduction was 2 ng TEQ/g lipid, 10-fold reduction was already found in animals with 5 ng TEQ/g lipid. The TEQ-levels measured with a reporter gene assay based on chemical-activated luciferase expression (the CALUX assay) correlated well with the TEQ levels calculated based on non- and mono-ortho PCB concentrations. The TEQ levels in blood and liver correlated well when expressed on a lipid basis. In living captive otters blood plasma TEQ levels (either measured based on gas chromatography (GC) or CALUX measurement) were lower than in the feral otters, and positively correlated with plasma total and free thyroid hormone but not with plasma retinol levels. Hepatic vitamin A concentration was found to be a physiologically relevant effect parameter. The NOEC for hepatic vitamin A reduction was translated into TEQ levels in fish and sediment. The CALUX response in 50-500 µl blood plasma proved to be a sensitive non-destructive biomarker for quantification of internal TEQ levels.