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.

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

UNLABELLED: 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.