Myringosclerosis in patients with chronic renal failure: comparative analysis with a control group

Myringosclerosis is a scar of the tympanic membrane lamina propria, resulting from trauma or inflammation, characterized by proliferation of collagen, hyalinization, calcium and phosphate deposits and cartilaginous or osseous metaplasia of the middle ear mucosa, a sequence that is similar to that taking place in other types of pathologic calcification, common in chronic renal failure (CRF).

Aim

To verify the influence of chronic renal failure on the prevalence of myringosclerosis.

Method

The otoscopic examination was done in 341 chronic renal failure patients and in 356 normal control individuals. The frequency of positive otoscopies was compared between the two groups, based on individual variables and those pertaining to CRF.

Results

11.7% of the patients had a positive otoscopy in the CRF group, compared to 5.1% in the control group. There was no statistical diference in the frequency of myringosclerosis acording to gender, ethnic group, time of dialysis or serum minerals. The groups had a wide age range.

Conclusion

Although the findings of this study suggest a higher ocurrence of myringosclerosis in patients with renal disease, they do not provide a basis for stating that there is any relation between renal failure and tympanic alterations.

Hearing impairment diagnosis in Pernambuco: services of intermediate complexity--2003

Universal and equal access to health care, granted to the population as of the brazilian constitution of 1988, made it easier the early diagnosis of hearing impairment. Thus, through the sistema único de saúde (sus), public and private health care providers granted this health coverage to the whole brazilian population, in the different levels of complexity.

Aim

this paper aims at studying the supply of intermediate complexity hearing impairment diagnosis in pernambuco in the first semester of 2003.

Materials and Methods

a study of series analyzed 17669 procedures and 372 professionals in the field of hearing impairment in the 185 municipalities in the state of pernambuco - brazil - data taken from the outpatient information system of the ministry of health.

Results

the results showed that the procedures are being carried out in only five municipalities, most of them managed in municipal units. We also identified an unequal distribution of diagnostic procedures.

Conclusion

we then concluded that much is still necessary to provide hearing impairment diagnostic in a horizontal fashion, considering the community differences through an universal, integrated and efficient model, as the one proposed by the sistema único de saúde.

Diagnóstico da deficiência auditiva em Pernambuco: oferta de serviços de média complexidade - 2003

O acesso universal e igualitário às ações e serviços públicos garantido através da Constituição de 1988 tornou mais acessível o diagnóstico precoce da deficiência auditiva. Desta forma, por meio do Sistema Único de Saúde (SUS), prestadores públicos e privados de serviços proporcionam essa cobertura a toda população, nos diferentes níveis de complexidade. OBJETIVO: O trabalho tem como objetivo estudar a oferta de serviços de diagnóstico da Deficiência Auditiva na média complexidade em Pernambuco no 1º semestre de 2003. MATERIAL E MÉTODO: Através de um estudo de séries foram analisados 17669 procedimentos e 372 profissionais da área de diagnóstico da deficiência auditiva nos 185 municípios do estado de Pernambuco, dados retirados do Sistema de Informação Ambulatorial do Ministério da Saúde. RESULTADOS: Os resultados mostraram que os procedimentos estão sendo realizados em apenas cinco municípios, a maioria em unidades geridas pela esfera municipal. Também, identificou-se uma distribuição não-eqüitativa da oferta dos procedimentos de diagnóstico. CONCLUSÃO: Concluiu-se que muito ainda precisa ser feito para que o acesso e oferta do diagnóstico da deficiência auditiva ocorram de forma horizontal, respeitando as diferenças da comunidade através de um modelo universal, integrativo e eficiente como propõe o Sistema Único de Saúde.

Profile of hospitalizations due to otorhinolaryngologic morbidity requiring surgical treatment. Brazil, 2003

Aim

To analyze the profile of the surgical procedures related to otorhinolaryngology in Brazil in the year 2003.

Study Design

This was an observational, descriptive, cross-sectional study.

Methods

We analyzed 80,030 surgical procedures performed in 27 Brazilian States during the period from January to December 2003. The data were obtained from the Hospital Information System of the Ministry of Health. The inclusion factor was a surgical procedure in otorhinolaryngology (ORL). All files were processed with the TABWIN software.

Results

In 2003, 80,030 ORL-related surgical procedures were performed in Brazil. The Southeast region had the largest number of procedures (53.08%), followed by the South and Northeast regions (19.6% and 15.6%, respectively). Regarding the group of procedures, surgeries of the pharynx represented 45% of ORL procedures. Procedures of high complexity were more numerous in the ear surgery group. Regarding the distribution of the type of attending institution, the highest concentration of surgical procedures occurred in philanthropic hospitals, followed by state and university public hospitals. The table adopted by SUS for payment of ORL surgical procedures has not been updated for the procedures currently performed, with the consequent inappropriate notification of some types of surgery.

Conclusion

Knowledge about the profile of surgical hospitalizations related to ORL permits the identification of the peculiarities of the different regions that can help health-managing authorities to make decisions in order to guarantee the principles recommended by SUS regarding access to health services.

Influence of Hypercalcemia in the Formation of Tympanosclerosis in Rats

HYPOTHESIS

Hypercalcemia is thought to perform an important role in the etiopathogenesis of tympanosclerosis. The purpose of the present study was to assess the influence of hypercalcemia in the development of tympanosclerosis in rats with or without acute otitis media.

BACKGROUND

The pathogenesis of tympanosclerosis is still unclear. Histologically, it is characterized by a hyaline degeneration in the lamina propria of the middle ear and mastoid mucosa and may lead to a calcification process. The process of calcification is similar to that of other pathologically calcified tissues, such as vessels, heart valves, cornea, and others, which depend on calcium serum levels.

METHODS

Twenty-four Wistar rats were divided into two different groups, with one group submitted to hypercalcemia status through calcium diet supplementation and the other used as a control group (normal calcium content diet). Both were submitted to induction of tympanosclerosis by inoculation of Streptococcus pneumoniae on the right middle ear only. Otomicroscopy was conducted every 15 days, and after 7 weeks of inoculation, the animals were killed and the tympanic bullae were resected to be analyzed through light and electron microscopy.

RESULTS

The group submitted to hypercalcemia presented a prevalence of tympanosclerosis of 25% against 16.7% in the control group, presenting a relative risk of 1.27 (p=0.72).

CONCLUSION

The results suggest that hypercalcemia can have an influence in the development of tympanosclerosis.

Perfil sócio-epidemiológico demográfico das mulheres idosas da Universidade Aberta à Terceira Idade no estado de Pernambuco

OBJETIVOS: identificar o perfil sócio-epidemiológico demográfico das mulheres idosas que freqüentam o Programa Universidade Aberta à Terceira Idade, da Universidade Federal de Pernambuco (UnATI/UFPE), comparando com determinados estudos sobre universidades da terceira idade. MÉTODOS: estudo epidemiológico descritivo de corte transversal e censitário com 308 idosas, a partir dos 60 anos, do UnATI/UFPE. Foi utilizado um instrumento multidimensional, o Brazil Old Age Schedule composto por um questionário estruturado, através do qual investigou-se a situação pessoal e familiar, a condição econômico-social e os aspectos relativos à autonomia e independência funcional para o desempenho das atividades de vida diária e à ocupação do tempo livre. RESULTADOS: em relação à situação pessoal e familiar, predominam as idosas jovens (60 a 69 anos), com escolaridade de segundo grau completo, cuja maioria é viúva; referem satisfação com a vida; apresentam importantes níveis de autonomia e independência funcional; são capazes de realizar sozinhas as atividades de vida diária e as atividades instrumentais vida diária. A maior parte oferece a seus familiares ajuda financeira e de moradia. CONCLUSÕES: os perfis sócio-epidemiológico e demográfico são bastante semelhantes aos de experiências análogas, aproximando-se da realidade de mulheres idosas que participam de outros programas do tipo Universidades Abertas à Terceira Idade.