Estudo histológico e ultra-estrutural da mucosa do seio maxilar em pacientes com rinossinusite crônica e polipose nasossinusal Histology and ultrastructural study of the mucosa of the maxillary sinus in patients with chronic rhinosinusitis and nasosinusal polyposis

Na rinossinusite crônica, a inflamação da mucosa nasossinusal provoca alterações qualitativas e quantitativas do epitélio respiratório que recobre toda a cavidade nasossinusal, levando à manutenção do quadro inflamatório. FORMA DE ESTUDO: Caso-controle. MATERIAL E MÉTODO: Foram avaliados histopatologicamente dez pacientes com rinossinusite crônica (RC) e polipose nasossinusal (PN) por meio da história clínica e alérgica, estudo microbiológico, microscopia óptica, eletrônica de transmissão e varredura. RESULTADO: A diminuição do número de células colunares ciliadas, o aumento das células caliciformes, a diminuição do número de cílios por célula afetada e a metaplasia escamosa foram alterações freqüentemente encontradas nos casos de rinossinusite, explicando a persistência do quadro pela destruição no epitélio e quebra do sistema mucociliar.<br>In chronic rhinosinusitis, inflammation of the rhinosinusal mucosa provokes qualitative and quantitative changes in the respiratory epithelium that lines the entire rhinosinusal cavity, leading to the maintenance of an inflammatory picture. STUDY DESIGN: Case-control. MATERIAL AND METHOD: In the present study we evaluated histopathologically ten patients with chronic rhinosinusitis on the basis of clinical and allergic history, microbiological study, and light, electron and scanning electron microscopy. RESULTS: A reduced number of ciliated columnar cells, an increase in goblet-like cells, a reduction in the number of cilia per affected cell and squamous metaplasia were changes frequently detected in the cases of rhinosinusitis, explaining the persistence of the signs and symptoms due to the destruction of the epithelium and to the breakdown of the mucociliary system

Inequalities in access and utilization of dental services: a cross-sectional study in an area covered by the Family Health Strategy

This cross-sectional study aimed to investigate the presence of inequalities in the access and use of dental services for people living in the coverage area of the Family Health Strategy (FHS) in Ponta Grossa, Paraná State, Brazil, and to assess individual determinants related to them. The sample consisted of 747 individuals who answered a pre-tested questionnaire. Data analysis was performed by chi-square test and Poisson regression analysis, obtaining explanatory models for recent use and, by limiting the analysis to those who sought dental care, for effective access. Results showed that 41% of the sample had recent dental visits. The lowest visit rates were observed among preschoolers and elderly people. The subjects who most identified the FHS as a regular source of dental care were children. Besides age, better socioeconomic conditions and the presence of a regular source of dental care were positively associated to recent dental visits. We identified inequalities in use and access to dental care, reinforcing the need to promote incentives to improve access for underserved populations