4. Türk Dış Politikasında Dinamizm ve Kurumsal Altyapı
4.1. Devlet ve Özerk Kurumlar
4.1.1. Dışişleri Bakanlığı
O presente estudo sugere que a resposta ao tratamento realizado no hospital de referência tem sido bastante satisfatório quando comparado à literatura. Nossos resultados desfavoráveis foram com frequência associados ao complexo M. chelonae-M. abscessus. Este
problema tem sido encontrado em outros países do mundo e novas opções terapêuticas estão sendo testadas. Porém, a maioria com resultados pouco satisfatórios. Há uma necessidade premente de novas pesquisas para melhorar o prognóstico desses pacientes.
Foi observado um aumento no número de casos de casos de doença pulmonar por MNT a partir de 2010. Há necessidade de um acompanhamento mais prolongado da prevalência da doença pulmonar por MNT em nossa região, para estabelecer se está ocorrendo um real aumento do número de casos ou apenas um aumento no número de diagnósticos de casos já existentes em decorrência da normativa do Ministério da Saúde publicada em 2010.
É necessário maior conhecimento e maior aderência ao protocolo do Ministério da Saúde para evitar que os pacientes de MNT pulmonar tenham um diagnóstico tardio e já se apresentem com sintomas respiratórios mais graves e extenso comprometimento radiológico, como foi observado neste estudo.
As principais comorbidades associadas a MNT pulmonar foram tratamento prévio para tuberculose e presença de bronquiectasias.
Os dados demonstram que a doença pulmonar por MNT é mais frequentemente causada por M. intracellulare e M. massiliense.
Não foram observadas diferenças radiológicas entre as diversas espécies, exceto na
análise das radiografias de tórax, onde encontramos atelectasias mais frequentemente nos grupo M. massiliense que no grupo de M. abscessus.
A aplicabilidade deste estudo é a demonstração da eficácia observada no tratamento realizado no hospital de referência. Em nossa região, as formas pulmonares de MNT acometem principalmente pacientes com história prévia de tuberculose, situação bastante comum na prática diária. É necessária maior atenção às recomendações do Ministério da Saúde para que o diagnóstico dos pacientes com MNT seja mais precoce, já que o diagnóstico tardio implica em pior evolução do tratamento.
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