Desenvolvimento e validação de métodos analíticos para determinação do cloridrato de epinastina em comprimidos revestidos

O cloridrato de epinastina é um agente não sedativo, antagonista H1 da histamina, utilizado no tratamento da asma ou como anti-histamínico, comercializado no Brasil na forma farmacêutica comprimido revestido com o nome de Talerc ®. Embora, seja um medicamento amplamente comercializado não há referências relativas aos métodos de análise da forma farmacêutica. Este trabalho teve como objetivos o desenvolvimento e a validação de métodos analíticos para o controle de qualidade do cloridrato de epinastina nos comprimidos revestidos, bem como a realização de estudos preliminares de estabilidade térmica e de fotoestabilidade e determinação da cinética de reação do anti-histamínico em estudo.A análise qualitativa do cloridrato de epinastina foi realizada por ressonância magnética nuclear de próto n, determinação da faixa de fusão, espectrofotometria na região do infravermelho e do ultravioleta, cromatografia em camada delgada e por cromatografia a líquido de alta eficiência. Para análise quantitativa, foram validados os métodos por espectrofotometria na região do ultravioleta derivada de primeira ordem e por cromatografia a líquido de alta eficiência. A validação foi efetuada de acordo com as guias de validação disponíveis na literatura. No estudo preliminar de estabilidade térmica utilizou-se a forma farmacêutica submetida a temperatura de 80 °C por 10 dias. A fotoestabilidade foi realizada em câmara de luz ultravioleta de 254 nm por um período de 18 horas. Os métodos qualitativos foram úteis para identificação do cloridrato de epinastina. Os métodos quantitativos propostos foram validados de acordo com os parâmetros analíticos preconizados, podendo ser perfeitamente intercambiáveis. O estudo preliminar de estabilidade térmica não apresentou degradação da amostra nas condições de análise empregadas. O estudo de fotoestabilidade apresentou degradação intensa obedecendo uma cinética de reação de primeira ordem.

Market coupling in the power markets

A dissertação analisa o esforço dos sindicatos europeus para criar um mercado pan- europeu de electricidade integrada baseada em "mercados combinados", como o mecanismo de alocação de capacidade de transferência de energia entre diferentes sistemas. Assim, o foco principal do estudo é se a integração do mercado leva a uma convergência de preços nos mercados interligados, e como isso afeta o comportamento dos preços de energia elétrica. Os métodos de investigação são uma revisão bibliográfica estruturada qualitativa e uma análise quantitativa de dados de preços de energia elétrica. A análise quantitativa se baseia em estatísticas descritivas das diferenças de preços absolutos e em uma análise de cointegração de acordo com a abordagem de Engle e Granger (1987). As principais conclusões são que os mecanismos de leilões implícitos, tais como a integração de mercado são mais eficientes que os leilões explícitos. Especialmente, o método de acoplamento de preços leva a uma convergência de preços nos mercados envolvidos, a ganhos de bem-estar social e reduz a o poder dos produtores no mercado, como mostra o exemplo da integração mercado TLC. A iniciativa mercados combinados entre a Alemanha ea Dinamarca, por outro lado, é avaliada como de menor sucesso e ilustra a complexidade e as dificuldades de implementação de iniciativas de integração de mercado. A análise de cointegração mostra que as séries temporais já estavam cointegradas antes da data de integração, mas a significância estatística aumentou. A tese sugere que a integração do mercado leva a uma convergência dos preços dos mercados envolvidos e, portanto, funciona como método para criar um mercado de eletricidade único e integrado na Europa.

Condicionantes políticos das reformas tributárias na América Latina

Seriam as reformas tributárias condicionadas por fatores políticos? Verificando a escassez de trabalhos empíricos sobre o tema, elaboramos definição própria de reforma tributária e adotamos uma tipologia para esses fenômenos. Em seguida, compilamos a base de dados de reformas tributárias a partir das respostas aos formulários da pesquisa de campo IPES 2006, realizada pelo Banco Interamericano de Desenvolvimento, com apoio do Centro Interamericano de Administrações Tributárias (CIAT). Esses formulários foram preenchidos por funcionários especialistas dos ministérios de finanças latino-americanos, que reportaram reformas entre 1990 e 2004. Depois, construímos os índices de reformas tributárias, que foram utilizados como variáveis dependentes em nossos modelos. Os índices contribuem para o desenvolvimento de estudos quantitativos sobre reformas tributárias, portando flexibilidade para testar diversas hipóteses. Eles tornaram possível analisar separadamente os determinantes das reformas da tributação da renda e do consumo, das reformas gerais e direcionadas, das reformas tendentes a aumentar ou reduzir tributos. Nos testes, destacou-se a influência da lista fechada, indicando que a disciplina parlamentar é importante para aprovar reformas. Em menor número de especificações, foram também relevantes a magnitude distrital, o bicameralismo, o poder de decreto do presidente da república e seu ciclo eleitoral. Não captamos evidência de fatores políticos conjunturais, como a ideologia partidária e maioria do governo no parlamento. Do mesmo modo, a influência dos poderes presidenciais de agenda e veto não se confirmou. O domínio de um partido na coalizão de governo foi relevante somente quando vinculado à lista fechada nas eleições. Em geral, os resultados confirmam o impacto de fatores político-institucionais sobre reformas tributárias, não se observando o mesmo para fatores político-conjunturais. Além disso, foram observadas diferenças nos condicionantes políticos que definem reformas na tributação da renda e do consumo, direcionadas e gerais, expansivas e redutoras (incentivos). O estudo contribui para análise quantitativa dos condicionantes políticos das reformas tributárias na América Latina e fornece dados antes indisponíveis. Oferece evidência empírica, considerando diferentes tipos de reformas e de fatores políticos. O estudo conclui pela necessidade de incorporar as variáveis políticas nas análises que envolvam reformas tributárias, até então marcadas pelo domínio dos argumentos econômicos. Além disso, sugere que o aperfeiçoamento das instituições políticas é importante para melhorar as decisões de política tributária na América Latina.

A nicotina atua como fator deletério na reparação da parede abdominal

Objetivo: Avaliar o efeito da nicotina na cicatrização da camada musculoaponeurótica da parede abdominal. Métodos: Estudo experimental em que foram usados 16 ratos da raça Wistar pesando em média 210±8g, separados aleatoriamente em 2 grupos de 8. Nos animais do grupo A foi implantado disco de nicotina (Nicotinel Ò) na dose de 5mg/Kg de peso/dia no subcutâneo da região dorsal, trocado a cada dois dias, a partir do 5º dia antes da operação em que foi feita laparotomia mediana de 5 cm, até o 10o dia de observação. No grupo B (controle) foram usados discos de celulose com o mesmo diâmetro. Tubo de silicone multiperfurado foi implantado no subcutâneo a 1cm da lesão da parede abdominal. A camada musculoaponeurótica e a pele foram suturadas com fio de nylon 5-0. No 10º dia pós-operatório foi colhido 1ml de líquido seroso do tubo de silicone por punção percutânea para dosagem de pO2 e os animais receberam dose letal de anestésico. Foi ressecado um segmento da camada musculoaponeurótica com 2cm de largura para tensiometria, em seguida processado e corado em HE e tricrômico de Masson para análise quantitativa dos dados histopatológicos em sistema digitalizado. A análise estatística foi feita pelo ANOVA e teste Newman-Keuls, com significância 0,05. Resultados: No grupo A a pO2 do líquido tecidual atingiu o valor 17,75±3,4 mmHg e no grupo B (controle) a pO2 = 40,75±6,4 mmHg (p<0,01). A resistência à tensão apresentou o valor de 728,5±161,75gf no grupo A e 1241,6±232gf no grupo de controle (p<0,01), coincidindo com os achados da pO2. A densidade média dos elementos histopatológicos estudados foi de 105±17,1 nos animais do grupo A e 146,2±8,8 no grupo B (p<0,01). Conclusão: após avaliação da pO2 tecidual, tensiometria e histopatologia, concluiu-se que a nicotina por via subcutânea exerce efeito deletério sobre a cicatrização de lesões da parede abdominal de ratos

Repercussões histopatológicas da colostomia no coto colônico distal desfuncionalizado: estudo experimental em ratos

O objetivo deste trabalho foi evidenciar as repercussões histopatológicas da colostomia no segmento desfuncionalizado e, dessa forma, criar um modelo experimental da colite de derivação fecal (CO). Foram utilizados 65 ratos, adultos, da raça Wistar, com peso variando de 220 a 300 g. Os animais foram divididos em 13 grupos, contendo cinco ratos. Do grupo 1 ao grupo 12, os animais foram submetidos a laparotomia mediana, sendo realizada uma colostomia terminal tipo boca única, e observados, por períodos variados de tempo, com o máximo de cem dias. Os animais, após serem mortos, foram necropsiados e retirado o segmento co1ônico desfuncionalizado para a avaliação histopatológica. Essa avaliação consistia de uma análise quantitativa, através da medida da espessura da mucosa colônica, e de uma análise qualitativa, mediante avaliação subjetiva: da presença de infiltrado inflamatório agudo ou crônico na lâmina própria; das alterações na arquitetura das criptas colônicas; da presença de hiperplasia folicular linfóide e de linfócitos na luz dos vasos da submucosa; e da presença de eosinófilos na luz intestinal. No grupo 12, após o 100° dia de pós-operatório (OPO), foi realizada a reconstrução do trânsito intestinal, e, após trinta dias, o cólon descendente foi retirado para a análise histopatológica. O método de Tukey e o teste "t" de Student foram utilizados como parte da análise dos resultados. Verificou-se uma redução estatisticamente significante da espessura da mucosa colônica a partir do 4000PO. Concluiu-se que a colostomia desfuncionalizante realizada em ratos reproduziu alterações histopatológicas compatíveis com a colite de derivação, e que estas mostraram-se reversíveis após a reconstrução do trânsito intestinal

Perfil das condições de seguimento terapêutico em portadores de hipertensão arterial

A proposta foi investigar os aspectos comportamentais referentes ao seguimento da terapêutica farmacológica e não farmacológica e o grau de adesão ao tratamento anti-hipertensivo de um grupo específico. Estudo observacional descritivo com análise quantitativa, realizado no Centro de Referência da Assistência Social em Fortaleza-CE, de agosto/2008 a maio/2009. Dados obtidos de 49 indivíduos por entrevista e exame físico. Mais de 50% dos participantes seguiam as terapêuticas não farmacológicas. Prevaleceram a terapia combinada (53%) e as classes medicamentosas de diuréticos (72%) e inibidores da enzima conversora de angiotensina (55%). Muitos participantes (49%) referiram reações adversas. Destas, as mais citadas foram poliúria e tontura (29%). Quanto ao grau de adesão, a média correspondeu ao conceito não adesão leve. A avaliação dos comportamentos de seguimento terapêutico e a caracterização clínico-epidemiológica são necessárias para o enfermeiro planejar estratégias educativas. Ambas possibilitam ajustes no planejamento das intervenções, contribuindo para a melhor adesão terapêutica dos indivíduos

Gestão Social em Empreendimentos Econômicos Solidários: uma abordagem no Oeste Potiguar

The central research question was to search for data to ratify the theory and discourse of the so-called practitioners of economic solidarity, by defending the substantive rationality should guide the principles of economic solidary, designing the space economy incidental and not the primacy of relations in determining social as well, reflecting the predominance of dimensions of social management in administrative practices of ESS's. For both analyzed the theoretical dimensions of social management - sociopolitical, economic, organizational and environmental - manifested in organizational practices supportive of economic organization Potiguar West. For the success of the research realized the triangulation involving a combination of quantitative and qualitative methodological approaches. At first the research will use a quantitative approach, from the cluster analysis, to verify the behavior of the sample chosen for this study. In the second stage of the qualitative study was carried out focus group technique (FLICK, 2002) for further analysis of the dimensions of social management on organizational practices supportive of economic organization, related to the principles of Solidary Economy, established in a quantitative approach. In quantitative analysis, the socio-political dimension, it was clear that the more equity instruments of internal and external, from the purposeful living in public spaces, the best monetary results. Another point worth stressing concerns the economic dimension, with the practice reciprocity prevailing in market. Thus, the qualitative approach was possible to understand the processes of exchange of product or service. Rural enterprises surveyed in the allocation of the agro-ecological products have the following scale of priority, sequentially: self-consumption (domestic), market and exchange. The research leads to the fact that training and practices that enhance the socio-political dimension (knowledge, empowerment, sense of belonging) become the guiding principle for the strengthening of the social management in the context of other dimensions, leading to gains sociopolitical, economic, organizational and environmental. Despite the weaknesses found in the organizational dimension and environment, both in a quantitative as in qualitative, we determined that the practices of ESS's Potiguar West incorporate predominantly elements of social management and economic solidarity, with a preponderance of substantive rationality in the primacy of the instrumental. Finally, research has brought information that the participants of the ESS's do not give the money economy primacy in determining social relations, which in turn leads to the confirmation that, in practice the solidarity economy, prevailing the dominance of substantive rationality, as a guide for organizational practices

Quantificação de Fases Cristalinas de Incrustações em Colunas de Produção de Petróleo pelo Método Rietveld

The scale is defined as chemical compounds from inorganic nature, initially soluble in salt solutions, which may precipitate accumulate in columns of production and surface equipment. This work aimd to quantify the crystalline phases of scale through the Rietveld method. The study was conducted in scale derived from columns production wells in development and recipients of pigs. After collecting samples of scale were performed the procedure for separations of inorganic and organic phase and preparation to be analyzed at the X-ray Laboratory. The XRD and XRF techniques were used to monitor whether identifying and quantifying crystalline phases present in the deposits. The SEM technique was used to visualize the morphology of the scales and assess their homogeneity after the milling process. XRD measurements were performed with and without milling and with or without the accessory spinner. For quantify crystalline phases the program DBWStools was used. The procedure for conducting the first refinement was instrumental in setting parameters, then the structural parameters of the phases in the sample and finally the parameters of the function profile used. In the diffraction patterns of samples of scale observed that the best measures were those that passed through the mill and used the accessory spinner. Through the results, it was noted that the quantitative analysis for samples of scale is feasible when need to monitor a particular crystalline phase in a well, pipeline or oil field. Routinely, the quantification of phases by the Rietveld method is hardwork because in many scale was very difficult to identify the crystalline phases present

Aspectos ambientais e sociais envolvidos na transmissão da L. chagasi no município de Parnamirim/RN

Visceral leishmaniasis hás adapted in the past 20 years to periurban and urban areas, and in Natal, Rio Grande do Norte, it became endemic. Thid study aimed to evaluate the environmental and social aspectsof Leishmania chagasi infection and its epidemiologic transmission chain in an urban, periurban and rural area of Parnamirim-RN. A study with three sections was conducted: Section 1: Sectional study of the human and canine infection by L. chagasi and its environmental and social determinants. Section 2: Observational longitudinal cohort to evaluate the dynamics of the canine infection. Section 3: Longitudinal study to evaluate the behavior of Lu. Longipalpis vector and the seasonal factors related to its dynamics. To include in the study the hauses were randomly selected and georreferenciated. Montenegro skin test was done in the human population and blood samples were collected for anti-Leishmania antibody detection. The canine population was examinated for L. chagasi infection by RIFI, ELISA and ELISA for rK39. An entomologic surveillance was monthly done with CDC light trapsin 10 houses of each locality. Quantitative and qualitative analyses was done using STATISC 6.0. Probality and prediction maps were done using ArcGis 9.0 model. In the human population L. chagasi infection was associated with the area of the hause, age, sex, population densyti, vegetation, kind of the floor of thr hause, water and resides destiny. In the canine population L. chagasi infection was associated with the breed, size, time of living in the hause, presence of dogs in the neighborhood, presence of horses and donkeys in the neighborhood, vegetation, kind of the floor and walls of the hause. The human infection was associated with canine infction only when analyzed taking into account the locality. In the prospective study, serum conversion and antibody lost observed in 30,8% and 22% of the animals examined, respectively. The human infection rate by L. chagasi was 24,6%, by the presence of anti-Leishmania antibody and 38,6% by the Montenegro skin test. The canine infection rate 32,5% by the presence of anti-Leishmania antibody. The vector Lu longipalpis showed an atypical behavior. These results indicate that environmental and social factors are important variables associated with L. chagasi infection in humans and canines, with punctual association of thr last two. Control measures of the infection on the studied points are necessary, in the aim to reduce the endemic focus of the disease in the study area. This research was carried out in a multidisciplinary involving the categories of: doctor, biologist, veterinarian, statistical, pharmaceutical and biochemical

Micropartículas de poli (ácido lático-co-ácido glicólico) obtidas por spray drying para a liberação prolongada de metotrexato

Methotrexate (MTX) is a drug used in the chemotherapy of some kind of cancers, autoimmune diseases and non inflammatory resistant to corticosteroids uveits. However, the rapid plasmatic elimination limits its therapeutic success, which leads to administration of high doses to maintain the therapeutic levels in the target tissues, occurring potential side effects. The aim of this study was to obtain spray dried biodegradable poly-lactic acid co-glycolic acid (PLGA) microparticles containing MTX. Thus, suitable amounts of MTX and PLGA were dissolved in appropriate solvent system to obtain solutions at different ratios drug/polymer (10, 20, 30 and 50% m/m). The physicochemical characterizing included the quantitative analysis of the drug using a validate UV-VIS spectrophotometry method, scanning electron microscopy (SEM), infrared spectrophotometry (IR), thermal analyses and X-ray diffraction analysis. The in vitro release studies were carried out in a thermostatized phosphate buffer pH 7.4 (0.05 M KH2PO4) medium at 37°C ± 0.2 °C. The in vitro release date was subjected to different kinetics release models. The MTX-loaded PLGA microparticles showed a spherical shape with smooth surface and high level of entrapped drug. The encapsulation efficiency was greater then 80%. IR spectroscopy showed that there was no chemical bond between the compounds, suggesting just the possible occurrence of hydrogen bound interactions. The thermal analyses and X-ray diffraction analysis shown that MTX is homogeneously dispersed inside polymeric matrix, with a prevalent amorphous state or in a stable molecular dispersion. The in vitro release studies confirmed the sustained release for distinct MTX-loaded PLGA microparticles. The involved drug release mechanism was non Fickian diffusion, which was confirmed by Kornmeyer-Peppas kinetic model. The experimental results demonstrated that the MTX-loaded PLGA microparticles were successfully obtained by spray drying and its potential as prolonged drug release system.

Caracterização e quantificação de marcadores químicos do extrato hidroetanólico das folhas de Kalanchoe brasiliensis Cambess

Kalanchoe brasiliensis Cambess (Crassulaceae), commonly known as saião , coirama branca , folha grossa , is originally from Brazil and commonly found in São Paulo to Bahia, mainly in the coastal zone. Regarding of biological activities, most preclinical studies were found in the literature, mainly about the anti-inflammatory activity of extracts obtained from leaves and / or aerial parts of K. brasiliensis. As regards the chemical constitution, it has been reported mainly the presence of flavonoids in the leaves of the species, but until this moment did not knows which are the active compounds. Although it is a species widely used in traditional medicine in Brazil, there is no monograph about the quality parameters of the plant drug. In this context, this study aims to characterize and quantify the chemical markers of hydroethanolic extract (HE) from the leaves of K. brasiliensis, which can be used in quality control of plant drug and derivatives obtained from this species. The methodology was divided into two parts: i. Phytochemical study: to fractionate, isolate and characterizate of the chemical (s) marker (s) of the HE from the leaves of K. brasiliensis; ii. To Developed validate of analytical method by High Performance Liquid Chromatography (HPLC)-diode array detector (DAD) to quantify the chemical (s) marker (s) of the EH. i. The EH 50% was prepared by turbo extraction method. It was then submitted to liquid-liquid partition, obtaining dichloromethane, n-butanol and ethyl acetate (AcOEt) fractions. The AcOEt fraction was selected to continue the fractionation process, because it has a chemical profile rich in flavonoids. The acOEt fraction was submitted to column chromatography using different systems for obtaining the compound Kb1. To identify this compound, it was submitted to UV analysis ii. For quantitative analysis, the EH was analyzed by HPLC, using different methods. After selecting the most appropriate method, which showed satisfactory resolution and symmetrical peaks, it was validated according to parameters in the RE 899/2003. As result, it was obtained from the AcOEt fraction the compound Kb1 (2.7 mg). Until this moment, the basic nucleus was characterized by UV analysis using shift reagents. The partial chemical structure of the compound Kb1 was identified as a flavonol, containing hydroxyls in 3 , 4 position (ring A), 5 and 7 free (ring B) and a replacement of the C3 hydroxyl by a sugar. As the analysis were performed in the HPLC coupled to a DAD, we observed that the UV spectrum of the major peaks of EH from K. brasiliensis shown similar UV spectrum. According to the literature, it has been reported the presence of patuletin glycosydes derivatives in the leaves of this species. Therefore, it is suggested that the compound Kb1 is glycosylated patuletin derivative. Probably the sugar (s) unit(s) are linked in the C3 in the C ring. . Regarding the development of HPLC analytical method, the system used consists of phase A: water: formic acid (99,7:0,3, v / v) and phase B: methanol: formic acid (99,7:0,3, v / v), elution gradient of 40% B - 58% B in 50 minutes, ccolumn (Hichrom ®) C18 (250x4, 0 mm, 5 μm), flow rate 0.8 mL / min, UV detection at 370 nm, temperature 25 ° C. In the analysis performed with the co-injection of thecompound Kb1 + HE of K. brasiliensis was observed that it is one of the major compounds with a retention time of 12.47 minutes and had a content of 15.3% in EH of leaves from K. brasiliensis. The method proved to be linear, precise, accurate and reproducible. According to these results, it was observed that compound Kb1 can be used as a chemical marker of EH from leaves of K. brasiliensis, to assist in quality control of drug plant and its derivatives

Preparação e caracterização de complexos multicomponentes contendo ciclodextrinas com metotrexato

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Educação em saúde em hanseníase: estratégia na educação básica, Parnamirim/RN

Leprosy is an ancient disease that still stands as a public health problem worldwide, especially in the considered developing countries. Of these, Brazil still has large areas of endemicity. The disease remains high among those younger than 15 years old. In this group, the national index achieves 0.6 every 10 000 inhabitants and reaches 2 in the North and Midwest of Brazil. Therefore, the plan of the Ministry of Health is to prioritize the fight against disease in critical areas, providing early diagnosis and timely treatment, especially for patients under 15 years old. This research aimed to: identify the knowledge of students from three schools of basic education in Parnamirim/RN about the risk of getting ill in leprosy; conduct them health education on this topic. An exploratory-descriptive study with quantitative and qualitative nature. Data collection consists of two steps: questionnaire and health education on leprosy. The study was approved by the Research Ethics Committee (REC) of UFRN through the opinion nº 204/2009. Quantitative data obtained were organized, categorized, typed and submitted to the Microsoft Office - Excel for quantitative analysis with simple percentage. Qualitative data were subjected to a content analysis according to Bardin. The sample consisted of 164 students of basic education, most of which is: 1st year of high school, from 11 to 15 years, in the afternoon shift, female gender, skin color white and residents in the municipality of Parnamirim/RN. Still, each student living with four people curiously did not respond in relation to occupation of the father. But the same answered their mother as a housewife and a family income of one to less than four minimum wages. There have been significant results compared the performance of health education in leprosy. Initially, students possessed little knowledge about leprosy. Subsequent to health education, most knew the answer about the disease, transmission, cause, where to get help in case of suspicion of leprosy and the need for the people who lives with leprosy patients to also seek for help, the understanding about if it is treatable or not. Content analysis has established the following themes: axis I, what I do not know about leprosy: cure, fear and prejudice. Axis II, what I know about leprosy, we identified: cure, effectiveness of health education and social exclusion in the past. It is considered the scope of the proposed objectives by matching the effectiveness of health education on leprosy in basic education in Parnamirim/RN; emphasizes, therefore, the importance of understanding the knowledge of public school students. It is expected of them to detect early cases of leprosy in their communities; encourage adherence to treatment as quickly as possible; prevent disability; reduce the stigma surrounding the disease.

Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose

Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.