Heavy metals in the bottom sediments of the Furo of Laura estuary, Eastern Amazon, Brazil.

The Furo of Laura is an economically important river in the Amazon estuary. Thus, in the present study, we evaluated the metal distribution (Al, Cd, Co, Cu, Cr, Fe, Ni, and Mg) in the bottom sediments of this river. The sediments were sampled at four points every 2months for a year with an Ekman-Birge sampler. After microwave acid digestion, the metal levels were determined by optical emission spectrometry with inductively coupled plasma. The particle size and organic matter content influenced the concentration of the metals. The sediments were not enriched by the analyzed metals; the estuary therefore retained the characteristics of an uncontaminated environment, thus serving as a reference environment for comparison.

Efeito da lactulose sobre os teores séricos de ureia, creatinina, cálcio e fósforo em cães não azotêmicos / Effect of lactulose on serum urea, creatinine, calcium and phosphorus in non-azothemic dogs

The present study evaluated serum levels of urea, creatinine, calcium and phosphorus in non-azothemic dogs by continued use of lactulose orally. Serum levels of urea, creatinine, calcium and phosphorus were determined in Beagle dogs, clinically healthy and without biochemical changes (non-azothemic), undergoing oral treatment with lactulose (n = 6), for a period of 30 days. The prebiotic showed no significant lowering effect on serum urea and creatinine, but the values of calcium and phosphorus, as well as their relation, were modified with reduced serum phosphorus levels in animals treated with lactulose compared to controls, with a significant difference...

Efeito da lactulose sobre os teores séricos de ureia, creatinina, cálcio e fósforo em cães não azotêmicos / Effect of lactulose on serum urea, creatinine, calcium and phosphorus in non-azothemic dogs

The present study evaluated serum levels of urea, creatinine, calcium and phosphorus in non-azothemic dogs by continued use of lactulose orally. Serum levels of urea, creatinine, calcium and phosphorus were determined in Beagle dogs, clinically healthy and without biochemical changes (non-azothemic), undergoing oral treatment with lactulose (n = 6), for a period of 30 days. The prebiotic showed no significant lowering effect on serum urea and creatinine, but the values of calcium and phosphorus, as well as their relation, were modified with reduced serum phosphorus levels in animals treated with lactulose compared to controls, with a significant difference.(AU)

High sensitivity C-reactive protein concentrations, birthweight and cardiovascular risk markers in Brazilian children.

BACKGROUND/OBJECTIVES: High sensitivity C-reactive protein (hs-CRP) and low birthweight have emerged as predictors of cardiovascular diseases (CVDs). In studies involving adults, higher concentrations of hs-CRP have been associated with low birthweight. This study assessed the relationship between hs-CRP and birthweight, and other risk markers for CVDs in childhood. SUBJECTS/METHODS: A total of 459 Brazilian children aged 5-8 years were included in the study. hs-CRP was measured by particle-enhanced immunonephelometry. The nutritional status of the children was assessed by BMI and waist circumference. Total cholesterol and fractions, triglycerides and glucose were measured by enzymatic methods. Insulin sensitivity was determined by the homeostasis model assessment (HOMA) method. Blood pressure was measured by the HDI/Pulse Wave CR-2000 equipment (Hypertension Diagnostics, Eagan, MN, USA). A multivariate linear regression analysis investigated the association between hs-CRP and birthweight, and risk markers for CVDs. RESULTS: There were positive associations between hs-CRP and gender (P=0.001), waist circumference (P<0.001) and systolic blood pressure (SBP) (P=0.03), and negative associations between hs-CRP and age (P<0.001), and high-density lipoprotein cholesterol (HDL-c) (P=0.005) (R²=0.14). Abnormal values of hs-CRP, waist circumference, HDL-c and SBP, respectively, were observed in 27.7, 26.4, 14.4 and 34.7% of the children. CONCLUSIONS: Opposite to studies involving adults, there was no association between hs-CRP and birthweight, implying that time may strengthen the relationship, considering that hs-CRP-concentration-associated metabolic changes increase from childhood to adulthood. The associations between hs-CRP and waist circumference, HDL-c and SBP in very young ages is a matter of concern, especially in females, in view of the large number of children with abnormal values of these measurements.

Maternal stress and distress and child nutritional status.

BACKGROUND/OBJECTIVE: To assess the relationship between maternal stress and distress in pregnancy and 5-8 years postpartum and child nutritional status. SUBJECTS/METHODS: Longitudinal cohort study carried out in Jundiai city, Southeast Brazil, involving 409 women followed throughout pregnancy to 5-8 years postpartum, and respective children. Measures of stress and distress were obtained three times in pregnancy (at gestational ages lower than 16 weeks, from 20 to 26 weeks and from 30 to 36 weeks) and 5-8 years postpartum by the Perceived Stress Scale (PSS), General Health Questionnaire (GHQ) and the State-Trait Anxiety Inventories (STAI). The nutritional status of the children was assessed by the World Health Organization body mass index (BMI) z-score for age. The relationship between child BMI z-score for age and scores of the PSS, GHQ and STAI was evaluated by multivariate linear regression, controlling for confounding variables. RESULTS: BMI z-score for age of the children was negatively associated with maternal scores of the PSS 5-8 years postpartum and scores of the GHQ in the second trimester of pregnancy. BMI of the children was positively associated with maternal BMI and birthweight (R(2)=0.13). There was -0.04 (confidence interval -0.07 to -0.9 × 10(-2)) decrease in child BMI per score unit of the PSS increase, and -0.09 (confidence interval -0.18 to -0.6 × 10(-3)) decrease in child BMI per score unit of the GHQ increase. CONCLUSIONS: This study detected a relationship between maternal mental and nutritional status and child nutritional status, implying that if the mother is not physically or mentally well, her capacity for caring for her child may be impaired.

Celiac artery with a pulmonary branch in dog: a rare variation

Hepatic, lienal and left gastric arteries are the "classical branches" of the celiac artery in dogs. This report describes a rare case in which the celiac artery emitted a branch to the caudal lobe of the right lung in an adult male mongred dog. The celiac artery and its proximal branches were dissected in situ, and measured with a digital pachymeter.This vascular variation was not previously known in the canine species. The knowledge about the presence of the celiac artery variations in dogs will contribute to a better understanding of the anatomical alterations that can occur in the vascularization of the abdominal region in dogs. The report is also important for angiographic, surgical and clinical procedures that involve this region.

Antibody seroprevalences against rabies in dogs vaccinated under field conditions in Bolivia.

Bolivia currently has one of the highest numbers of cases for human and canine rabies and is thus clue to the elimination process. The objective of the present study was to assess antibody seroprevalences against rabies in dogs vaccinated under field conditions and other factors that might influence the success of the on-going rabies control programmes in an endemic area of the disease, Santa Cruz de la Sierra, Bolivia. All 240 study animals, selected using area-stratified random sampling, were investigated in April 2007. Test prevalences were adjusted for the imperfect test characteristics using the Rogan-Gladen estimator (deterministic and stochastic functions) and Bayesian inference. Ninety-four of the tested 240 vaccinated dogs were classified as test-positive for rabies-specific antibodies. With regard to adjusted overall antibody seroprevalence, Bayesian true prevalence estimates (41%, 95% CI: 37-46%) were lower than both of the Rogan-Gladen estimates. The effect of various epidemiological factors on post-vaccination response was also assessed.

Antibody response to an anti-rabies vaccine in a dog population under field conditions in Bolivia.

Rabies remains an important public health issue in Bolivia, South America. Public concern and fears are most focussed on dogs as the source of rabies. The objective of the present study was to assess immunity of an inactivated suckling mouse brain vaccine against canine rabies used for the official vaccination campaigns under field conditions in an endemic area of rabies in Bolivia. A total of 236 vaccinated and 44 unvaccinated dogs in Santa Cruz de la Sierra, selected using stratified random sampling, were investigated in order to obtain owned dog characteristics and antibody titres against rabies in April 2007. The proportion of vaccinated dogs with an antibody titre exceeded the protection threshold value of 0.5 EU/ml was 58% [95% confidence intervals (CI): 52-65], indicating that vaccination is likely to elicit an antibody response (odds ratio 6.3, 95% CI: 1.2-11.5). The range of geometric mean of antibody titre for vaccinated dogs (0.89 EU/ml; 95% CI: 0.75-1.04) was considered to meet the minimal acceptable level indicating an adequate immune response to the vaccine. However, the titre level was not satisfactory in comparison with the results from other field investigations with inactivated tissue culture vaccines. It is recommended for public health authorities to (1) consider modernizing their vaccine manufacturing method because the level of immunity induced by the current vaccine is comparably low, (2) conduct frequent vaccination campaigns to maintain high levels of vaccination coverage, and (3) actively manage the domestic dog population in the study area, which is largely responsible for rabies maintenance.

Rabies-vaccination coverage and profiles of the owned-dog population in Santa Cruz de la Sierra, Bolivia.

The Bolivian government issued a regulation for rabies control in November 2005, owing to increasing the prevalence of dog and human rabies cases in recent years. An assessment of rabies-vaccination coverage and other factors that might influence the success of the on-going vaccination campaign was needed. The objective of this study was to investigate dog rabies vaccination coverage and risk factors associated with dogs being unvaccinated against rabies, and profiles of the owned-dog population in Santa Cruz de la Sierra, Bolivia, where dog rabies was endemic. Mainly due to logistical reasons, the WHO's expanded programme on immunization cluster-survey method was used. The 390 households were included in the study. Information about dog population and management characteristics was obtained for 542 dogs from 301 households. On average, households had 1.4 dogs and 1.8 dogs per dog-owning household (median = 1). The human-to-dog ratio was 4.6 : 1. During the last 1 year prior to the study, of the 539 dogs aged >or=1 month, 463 (85%; 95% CI 79-91; design effect 3.6) were classified as vaccinated. Amongst the study dogs, dogs aged 1-11 months were the higher risk of dogs not being vaccinated (OR = 8.2; 95% CI 4.3-15.6; P < 0.01). Almost two-thirds of the study dogs were allowed to roam freely throughout the day or in part. Community education efforts should address the importance of dog ownership and movement restriction, and the need to vaccinate young dogs.

Descriptive spatial and spatio-temporal analysis of the 2000-2005 canine rabies endemic in Santa Cruz de la Sierra, Bolivia.

The authors analysed laboratory samples testing positive for rabies virus collected between 2000 and 2005 from Santa Cruz de la Sierra, Bolivia, to assess the spatial and spatio-temporal distribution of the endemic of canine rabies. According to the results of the spatial analysis, canine rabies was not evenly distributed in the city. Significant spatio-temporal clustering of canine rabies cases showed a trend towards clusters with high incidence rates in two particular areas compared with surrounding areas in the city. Benefits obtained from each of the analytical techniques utilised are described and practical difficulties in conducting and interpreting the results are discussed.

Periodontal disease as reservoir for multi-resistant and hydrolytic enterobacterial species.

AIMS: This investigation aimed to isolate enteric rods from subgingival sites of patients presenting chronic periodontitis lesions, and to assess antimicrobial resistance and expression of hydrolytic enzymes. METHODS AND RESULTS: Enterobacteriaceae were isolated from 20% patients, and assayed for antimicrobial susceptibility and hydrolytic enzymes with specificity to different substrates. Isolates comprised seven Enterobacter cloacae (43.75%), five Serratia marcescens (31.25%), one Klebsiella pneumoniae (6.25%), one Enterobacter aerogenes (6.25%), one Pantoea agglomerans (6.25%), and one Citrobacter freundii (6.25%). Gelatinase activity was observed for 75% strains; caseinase and elastase was produced by six and two strains, respectively. DNase, lecithinase and lipase were expressed by S. marcescens. Most of strains were resistant to ampicillin (93.75%) and amoxicillin/clavulanic acid (81.25%). The majority of strains were susceptible to cephalosporins and aztreonam. Enterobacteria remained susceptible to imipenem, streptomycin and fluoroquinolones. Resistance to gentamicin, amikacin, sulfamethoxazole/thrimethoprim, tetracycline, and chloramphenicol were also observed. Eight strains presented multiple drug resistance. CONCLUSIONS: Subgingival sites from periodontal diseases contain multi-resistant and hydrolytic enzyme-producing enterobacteria that may contribute to overall tissue destruction and spreading. SIGNIFICANCE AND IMPACT OF THE STUDY: Enterobacteria isolated from patients generally considered as healthy individuals poses periodontal diseases as reservoir for systemic infections particularly in immunocompromised and hospitalized hosts.

Restored insulin inhibition on insulin secretion in nondiabetic severely obese patients after weight loss induced by bariatric surgery.

OBJECTIVE: To examine the impact of important weight loss on insulin inhibition of its own secretion during experimentally induced hyperinsulinemia under euglycemic conditions. DESIGN: Longitudinal, clinical intervention study--bariatric surgery (vertical banded gastroplasty--gastric bypass--Capella technique), re-evaluation after 4 and 14 months. SUBJECTS: Nine obese patients class III (BMI=54.6+/-2.6 kg/m2) and nine lean subjects (BMI=22.7+/-0.7 kg/m2). MEASUREMENTS: Euglycemic hyperinsulinemic clamp (insulin infusion: 40 mU/min m2), C-peptide plasma levels, electrical bioimpedance methodology, and oral glucose tolerance test (OGTT). RESULTS: BMI was reduced in the follow-up: 44.5+/-2.2 and 33.9+/-1.5 kg/m2 at 4 and 14 months. Insulin-induced glucose uptake was markedly reduced in obese patients (19.5+/-1.9 micromol/min kg FFM) and improved with weight loss, but in the third study, it was still lower than that observed in controls (35.9+/-4.0 vs 52.9+/-2.2 micromol/min kg FFM). Insulin-induced inhibition of its own secretion was blunted in obese patients (19.9+/-5.7%, relative to fasting values), and completely reversed to values similar to that of lean ones in the second and third studies (-60.8+/-4.2 and -54.0+/-6.1%, respectively). CONCLUSION: Weight loss in severe obesity improved insulin-induced glucose uptake, and completely normalized the insulin inhibition on its own secretion.

Brain single-photon emission computed tomography and magnetic resonance imaging in Machado-Joseph disease.

BACKGROUND: Machado-Joseph disease (MJD) is one of the most frequently encountered spinocerebellar ataxias. However, few reports on brain single-photon emission computed tomographic (SPECT) imaging (BSI) with hexylmethylpropylene amineoxine labled with technetium Tc 99m and magnetic resonance imaging (MRI) have been performed for the evaluation of patients with MJD. OBJECTIVES: To investigate possible abnormalities with BSI and MRI in patients with MJD and to correlate these findings with the duration of symptoms; cerebellar, extrapyramidal, and pyramidal syndromes; and the molecular characteristics of the MJD mutation. PATIENTS AND METHODS: Twelve patients (8 males and 4 females [mean age, 39 years]) with genetically proven MJD were studied. The patients underwent BSI and MRI on the same day. Brain SPECT imaging was performed after an intravenous injection of 99mTc-hexylmethylpropylene amineoxine. The transaxial, coronal, and sagittal BSIs obtained were submitted to visual and semiquantitative analyses. Magnetic resonance imaging was obtained in a 2-T system with coronal, sagittal, transaxial, and 3-dimensional (volumetric) acquisitions. The volumes of the cerebellar hemispheres and vermis were calculated. Control groups for BSI (22 female and 20 male subjects [mean age, 33 years]) and MRI (13 female and 4 male subjects [mean age, 32.2 years]) were included for comparison. RESULTS: Correlation was observed between the perfusion abnormalities identified by visual analysis in the BSI with the structural abnormalities observed on MRI in the parietal lobes and vermis. Brain SPECT imaging identified (by visual analysis) more perfusion abnormalities in the inferior portion of the frontal lobes, mesial and lateral portions of the temporal lobes, basal ganglia, and cerebellar hemispheres. Magnetic resonance imaging identified more abnormalities in the pons and superior portions of the frontal lobes. Olivary atrophy was identified by MRI. Semiquantitative analysis showed a statistically significant difference of perfusion in the inferior and superior portions of the frontal lobes, lateral portion of the temporal lobes, parietal lobes, left basal ganglia, cerebellar hemispheres, and vermis when compared with the control group. A significant difference was noted between the vermis and cerebellar volumes on MRI when compared with the control group. A significant relationship was observed between the perfusion of the left parietal lobe (P =.05) and extrapyramidal syndrome. There was a tendency toward an inverse relationship between the duration of symptoms and the perfusion of the cerebellar hemispheres (rho = -0.37; P =.24) and volume of the vermis (rho = -0.30; P =.34); between the length of the expanded (CAG)n repeat and the perfusion of the left parietal lobe (rho = -0.32; P =.36), vermis (rho = -0.28; P =.43), and pons (rho = -0.28; P =.42). A direct association was observed between the length of the expanded (CAG)n repeat and the perfusion of the lateral portion of the right temporal lobe (rho = 0.67; P =.03). CONCLUSIONS: Brain SPECT imaging and MRI were capable of identifying subclinical abnormalities in individuals with MJD. These findings may be helpful for a better understanding of the pathophysiology of this disease.

Lack of insulin inhibition on insulin secretion in non-diabetic morbidly obese patients.

OBJECTIVE: Insulin inhibition of insulin secretion has been described in normal lean subjects. In this study, we examined whether this phenomenon also occurs in the morbidly obese who often have severe peripheral insulin resistance. SUBJECTS: Twelve obese patients, normotolerant to glucose (8 F/4 M, body mass index (BMI)=54.8+/-2.5 kg/m(2), 39 y) and 16 lean control subjects (10 F/6 M, BMI=22.0+/-0.5 kg/m(2), 31 y). DESIGN AND MEASUREMENTS: An experimental study using various parameters, including an euglycemic hyperinsulinemic clamp (280 pmol/min/m(2) of body surface), an oral glucose tolerance test (OGTT), electrical bioimpedance and indirect calorimetry. RESULTS: The obese subjects were insulin resistant (M=19.8+/-1.6 vs 48.7+/-2.6 micromol/min kg FFM, P<0.0001) and hyperinsulinemic in the fasted state and after glucose ingestion. Fasting plasma C-peptide levels (obese 1425+/-131 pmol/l vs lean 550+/-63 pmol/l; P<0.0001) decreased less during the clamp in the obese groups (-16.9+/-6.9% vs -43.0+/-5.6% relative to fasting values; P=0.007). In the lean group, the C-peptide decrease during the clamp (percentage variation) was related to insulin sensitivity, M/FFM (r=0.56, P=0.03), even after adjustment for the clamp glucose variation. CONCLUSION: We conclude that, in lean subjects, insulin inhibits its own secretion, and this may be related to insulin sensibility. This response is blunted in morbidly obese patients and may have a role in the pathogenesis of fasting hyperinsulinemia in these patients.

Activation of the growth plates on three-phase bone scintigraphy: the explanation for the overgrowth of fractured femurs.

Children with an uncomplicated femoral fracture, treated with superimposition of fragments and intentional shortening, usually develop overgrowth of the fractured femur and the ipsilateral tibia which may compensate for the initial shortening and enable the limb in question to reach a length similar to that on the normal side. The overgrowth is evaluated clinically and by scanography. The increased metabolic activity of the growth plates that support this overgrowth has not been documented by any laboratory method. In order to evaluate the metabolic activity of the growth plates, 18 patients (11 males, seven females; mean age 6.1 years) with fractures of the femur were studied at three different time intervals (2-5 months, 6-12 months and 18-24 months). Three-phase bone scintigraphy was performed in all patients. Ten children (five males, five females; mean age 7.5 years) who had had bone imaging for other reasons were used as the control group. Visual analysis of the flow and equilibrium phases was performed for the distal femoral and proximal tibial growth plates. Visual and semi-quantitative analyses of the delayed images were performed for the distal femoral and proximal and distal tibial growth plates. Semi-quantitative analyses yielded the following activity ratios: (a) the distal femoral growth plate of the fractured femur to the contralateral one (FR); (b) the proximal growth plate of the tibia on the side of the fractured femur to the contralateral one (TpR); (c) the distal growth plate of the tibia on the side of the fractured femur to the contralateral one (TdR); and (d) in the control group, the distal growth plates of both femora (FCG) and the proximal (TCGp) and distal (TCGd) growth plates of the tibiae. Visual analysis of the blood flow, equilibrium and delayed images showed increased activity in the distal femoral growth plates during the first and second time intervals, but not during the third. No significant activity changes were found in the proximal and distal tibial growth plates during any of the phases analysed. The mean and standard deviation for FR in the three time intervals were: FRI=1.22+/-0.27, FRII=1.17+/-0.16 and FRIII=1.09+/-0.20. FR values were significantly higher than in the control group (FCG=0.99+/-0.03) (P=0.033). The mean and standard deviation for TpR in the three time intervals were: TpRI=1.08+/-0.18, TpRII=0.94+/-0.09 and TpRIII=0.96+/-0.20. TpR values were not significantly different from those in the control group (TCGp=1.00+/-0.05). However, TpRI was significantly higher than TpRII (P=0.043). The mean and standard deviation for TdR in the three time intervals were: TdRI=1.10+/-0.41, TdRII=1.05+/-0.15 and TdRIII=1.13+/-0.36. TdR values were not significantly higher than in the control group (TCGd=1.00+/-0.04) (P=0.777). These results support the concept that three-phase bone imaging is able to quantify and determine that activation occurs in the distal femoral and proximal tibial growth plates of fractured femora. This phenomenon may explain the overgrowth observed in this injured bone structure.

Cluster and velocity effects on yields and kinetic energy distributions of Li+ desorbed from LiF.

MeV N+ and N2+ ions were used to induce Li+ desorption from LiF. The contributions due to elastic atomic collisions and electronic excitation processes to the sputtering yield could be unambiguously separated. In the case of N2+ ions, a Li+ yield enhancement, i.e., Y(N2+)>2Y(N+), was found only for the electronic process. The maximum sputtering yield was observed in a projectile velocity range where the projectile electronic energy loss still increases. These results are simultaneously explained using the radial distribution of the deposited energy rather than the electronic energy loss.

Evidences of gentamicin resistance amplification in Klebsiella pneumoniae isolated from faeces of hospitalized newborns.

The intestinal microbiota, a barrier to the establishment of pathogenic bacteria, is also an important reservoir of opportunistic pathogens. It plays a key role in the process of resistance-genes dissemination, commonly carried by specialized genetic elements, like plasmids, phages, and conjugative transposons. We obtained from strains of enterobacteria, isolated from faeces of newborns in a university hospital nursery, indication of phenotypical gentamicin resistance amplification (frequencies of 10(-3) to 10(-5), compatible with transposition frequencies). Southern blotting assays showed strong hybridization signals for both plasmidial and chromosomal regions in DNA extracted from variants selected at high gentamicin concentrations, using as a probe a labeled cloned insert containing aminoglycoside modifying enzyme (AME) gene sequence originated from a plasmid of a Klebsiella pneumoniae strain previously isolated in the same hospital. Further, we found indications of inactivation to other resistance genes in variants selected under similar conditions, as well as, indications of co-amplification of other AME markers (amikacin). Since the intestinal environment is a scenario of selective processes due to the therapeutic and prophylactic use of antimicrobial agents, the processes of amplification of low level antimicrobial resistance (not usually detected or sought by common methods used for antibiotic resistance surveillance) might compromise the effectiveness of antibiotic chemotherapy.

[Newborn intestinal colonization by multidrug resistant enterobacteria in a neonatal unit] / Colonização intestinal de recém-natos por enterobactérias multirresistentes a antimicrobianos em unidade neonatal.

OBJECTIVE: To evaluate the occurrence of intestinal colonization in newborns by multidrug-resistant enterobacteria strains (MDRES) during hospital stay after birth. We used selective media in an attempt to determine the relationship between isolation of these strains and some of the presumed colonization risk factors. METHOD: A sequencial inclusion study of 30 newborns was carried out in the neonatal unit of the HUPE, State University Hospital, a general 600-bed tertiary care hospital. We obtained clinical and epidemiological information from medical records and collected a fecal sample from each newborn, which was plated in gentamicin (8mg/ml) medium and potassium tellurite (25mg/ml) medium. The isolated strains were biochemically identified and also submitted to tests of antimicrobial susceptibility. Nine MDRES were submitted to an assay for plasmid conjugational transfer. RESULTS: We isolated 56 distinct MDRES from 14 among 30 newborns (46.7%). Klebsiella pneumoniae was the most common bacterial species (38/56 (68%). We found statistical association between individual MDRES isolation and presence of 3 or 4 of the following colonization risk factors considered: antimicrobial use, low weight (<2.500g), more than 6 days of hospitalization and artificial milk feeding (p< 0.02). We could detect plasmid resistance transfer by bacterial conjugation for 8 among 9 MDRES. CONCLUSION: The seletive cultura media were useful to detect the high frequence of newborns colonized by MDRES in association with well established infection risk factors. We emphasize the importance of reinforcing control rules aiming at preventing intestinal colonization viewed as a risk of nosocomial infection.

Fasciíte necrotizante cervical: uma complicaçäo de abscesso de origem dentária / Cervical necrotizing fasciatis: a complication due to an abscess of dental origin

Relatamos um caso de Fasciíte Necrotizante da regiäo cérvico-facial após abcesso dentário, em um paciente portador de Diabetes melito descompensado. Esta infecçäo aguda resultou numa invasividade profunda com necrose da fáscia, gordura subcutânea e pele da regiäo cervical. O sucesso do tratamento baseou-se no diagnóstico precoce da doença básica, na terapia antibiótica de largo espectro e no desbridamento agressivo