Fábio Lessa

Situação da filariose bancroftiana na Região Metropolitana do Recife: estudo em uma área endêmica no Município de Jaboatão dos Guararapes, Pernambuco, Brasil

This article analyzes the results of an epidemiological survey on the occurrence and distribution of lymphatic filariasis in Cavaleiro, a district in the city of Jaboatão dos Guararapes in Greater Metropolitan Recife, Pernambuco State, Brazil. The district was divided into 12 areas, and a cross-sectional technique was used to examine 9,520 individuals, of whom 2.2% were found to be infected. There were positive cases in 11 of the areas. The prevalence rate ranged from 0% to 5.15%. The majority (64.3%) of infected individuals were males (p < 0.05). Infected individuals were identified in all age groups. The results show that lymphatic filariasis is still an important public health problem in the Cavaleiro district and that it deserves attention by municipal authorities and health planners.

Hearing impairment in patients with tuberculosis from Northeast Brazil

The aim of this paper is to describe the auditory profile of subjects who were given streptomycin treatment for tuberculosis in the years 2000 and 2001, in Recife, Northeast Brazil. The Injury Notification Database at the Municipal Department of Health was consulted and 78 individuals who had been on streptomycin during the period under study were selected. Forty-two individuals were excluded, of whom five were over 59 years of age and two were under 18 years. Nineteen turned out to be deceased, 13 could not be found, two were serving prison terms and one refused to participate. As a result, only 36 subjects participated in the study. These 36 individuals were interviewed and underwent meatoscopy and audiometry. The mean age of the group under study was 38.8 years old and males predominated (79.4%). Twenty-seven patients (75%) showed hearing impairment, the bilateral sensorineural type (63.9%) being the most frequent, mainly affecting the high frequencies over 4000 Hz. In the light of findings showing a high percentage of hearing impairment complaints among users of streptomycin, this issue seems to warrant an in-depth investigation, as does the implementation of an auditory follow-up routine for patients undergoing such chemotherapy for tuberculosis.

Diagnóstico da deficiência auditiva em Pernambuco: oferta de serviços de média complexidade - 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 unico de saude (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 unico de saude.

Assessment of pre and postoperative symptomatology in patients undergoing inferior turbinectomy

UNLABELLED Partial inferior turbinectomy is a procedure directed to treat nasal obstruction secondary to hypertrophy rhinitis. This study evaluates the impact of this procedure in the quality of life of the patients, analyzing the improvement of other symptoms such as rhinorrhea, nasal itching and sneezing after six months of the surgical procedure. STUDY DESIGN Clinical prospective. MATERIAL AND METHOD Forty-nine patients submitted to turbinectomy associated or not with septoplasty, received questionnaires to grade the intensity of symptoms. Through the comparison of severity of symptoms before and after six months of the surgery, it was possible to evaluate the degree of improvement of each symptom. The results were classified as null, good, moderate and great, and we subtracted postoperative score from the preoperative score. RESULTS The nasal obstruction presented good or great results in 98% of the patients. For rhinorrhea, the surgery has resulted in good or great improvement in 49% of the cases. Sneezing presented good or great results in 81.6% of the patients and, nasal itching, 45%. CONCLUSION The study showed that the clinical benefits obtained with the partial inferior turbinectomy are not limited to nasal obstruction, extending also to others symptoms of rhinitis, mainly in relation to sneezing crisis.

Avaliação da sintomatologia pré e pós-operatória de pacientes submetidos à turbinectomia inferior

Partial inferior turbinectomy is a procedure directed to treat nasal obstruction secondary to hypertrophy rhinitis. This study evaluates the impact of this procedure in the quality of life of the patients, analyzing the improvement of other symptoms such as rhinorrhea, nasal itching and sneezing after six months of the surgical procedure. STUDY DESIGN: clinical prospective. MATERIAL AND METHOD: Forty-nine patients submitted to turbinectomy associated or not with septoplasty, received questionnaires to grade the intensity of symptoms. Through the comparison of severity of symptoms before and after six months of the surgery, it was possible to evaluate the degree of improvement of each symptom. The results were classified as null, good, moderate and great, and we subtracted postoperative score from the preoperative score. RESULTS: The nasal obstruction presented good or great results in 98% of the patients. For rhinorrhea, the surgery has resulted in good or great improvement in 49% of the cases. Sneezing presented good or great results in 81.6% of the patients and, nasal itching, 45%. CONCLUSION: The study showed that the clinical benefits obtained with the partial inferior turbinectomy are not limited to nasal obstruction, extending also to others symptoms of rhinitis, mainly in relation to sneezing crisis.

A filariose bancroftiana no município de Moreno - Pernambuco, Brasil

No Brasil, estima-se que 49 mil pessoas estejam infectadas pela Wuchereria bancrofti, residindo em tres areas consideradas endemicas: Maceio-AL, Belem-PA e Regiao Metropolitana do Recife-PE; esta ultima apresenta a maior casuistica no pais. Este estudo tem como objetivo identificar o limite entre municipios com e sem transmissao ativa, em Pernambuco. Para tal foi realizado um estudo seccional no municipio de Moreno, localizado na Regiao Metropolitana do Recife. O inquerito epidemiologico foi constituido de entrevistas utilizando questionarios fechados contendo informacoes relacionadas a filariose e a pesquisa parasitologica. Dentre os 2.513 exames realizados, dois casos foram detectados, ambos provenientes do Recife-PE. Quanto a manifestacao clinica, 65 (2,6%) individuos relataram queixas correlatas com filariose. Em relacao ao tratamento previo para filariose, 24 pessoas (0,9%) afirmaram ja terem tomado a dietilcarbamazina. A importância deste trabalho decorre do desconhecimento da extensao da endemia na Regiao Metropolitana do Recife e da constatacao de que Moreno apresenta os componentes para manter o ciclo parasitario. Desta forma, a vigilância epidemiologica municipal devera identificar as areas com maior risco de transmissao e assim criar estrategias para evitar sua fixacao.

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

UNLABELLED 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 difference in the frequency of myringosclerosis according 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 occurrence 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.

Miringosclerose em pacientes com insuficiência renal crônica: análise comparativa com um grupo controle

A miringoesclerose e uma alteracao cicatricial da lâmina propria da membrana timpânica caracterizada por proliferacao de fibras colagenas, seguida de hialinizacao, deposicao de calcio e fosforo, seguindo uma sequencia semelhante ao que ocorre em outros tipos de calcificacao patologica comuns em pacientes com doenca renal cronica. OBJETIVO: Verificar a influencia da insuficiencia renal cronica (IRC) na prevalencia da miringoesclerose. METODO: Foi realizada otoscopia em 341 pacientes com IRC em hemodialise e em 356 individuos de um grupo controle. Foi comparada a frequencia de otoscopia positiva entre os dois grupos, procurando-se relacionar com variaveis pessoais e relacionadas a IRC. RESULTADOS: O grupo de pacientes apresentou 11,7% de otoscopia positiva contra 5,1% do grupo controle. Nao houve influencia do sexo ou cor na frequencia da miringoesclerose. Porem, os grupos foram heterogeneos em relacao a faixa etaria. Tambem nao houve diferenca importante no tempo de dialise nem nos niveis sericos de minerais e do PTH entre os pacientes do grupo de estudo que apresentavam otoscopia positiva ou negativa. CONCLUSAO: Os achados, embora apontem para uma maior ocorrencia da miringoesclerose nos pacientes renais cronicos, nao nos permitem concluir com certeza que exista alguma relacao entre a IRC e as alteracoes timpânicas.

Perfil de internamento por morbidade otorrinolaringológica com tratamento cirúrgico. Brasil, 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.

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.