ABSTRACT
A quantificação do bacilo realizada pelo exame baciloscópico e histopatológico apresenta sensibilidade limitada. Portanto, o emprego de uso de técnicas moleculares permite o diagnóstico direto do material clínico com elevada especificidade e sensibilidade. A PCR em tempo real (qPCR) é um ensaio sensível e específico que permite a quantificação do número de bacilos a partir de diversas amostras, além de poder ser utilizada no diagnóstico diferencial de muitos patógenos. Pacientes multibacilares hansenianos liberam o bacilo Mycobacterium leprae através da secreção nasal, sendo a coleta deste realizada por procedimento não invasivo. Até o momento, nenhum estudo avaliou a sensibilidade e especificidade da qPCR para o diagnóstico da hanseníase utilizando amostras de secreção nasal.
ABSTRACT
While the health status of individuals depends on many factors-ranging from the cultural, environmental, economic, and political context of society at large to personal behavioral, occupational, and nutritional considerations-of paramount importance are the services that society provides in response to the health problems and needs of its population. Since the 19th century, health services have evolved in response to changes in medicine, epidemiology, and the investigative tools used to explore biomédical events and attributes in general populations or defined groups within populations; today they have coalesced into hierarchical, cooperative, and partially integrated, coordinated configurations that vary from country to country. For its part, health services research, a relatively recent field of scholarship, comprises a wide range of áreas of interest including, but not limited to, clinical epidemiology, technology assessment, clinical decision analysis, operations research, health economics, médical sociology, and médical anthropology. This anthology attemps both to illustrate the develoment of the field throughout the 20th century, especially in the Américas, and to provide a selection fo some of the most representative article on the various topics covered in the health services research literature. Because health institutions and services need improvements in various respects, many of the articles included in this volume deal with the equity, efficacy, effectiveness, and quality of health services. Others expound quantitatively on the development or application of appropriate research methods. Still others represent what were at the time of their públication significant contributions to an understanding of the policies, organization, and practice of health sevices. Together the 100 articles in this collection will prove instructive and valuable to scientists, health policymakers, producers and consumers of health services, as well as to students in the field