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Clinical, pathogenetic aspects and treatment options of thyrotoxicosis in patients with primarily diagnosed diffuse toxic goiter


Author: Harea Dumitru
Degree:doctor of medicine
Speciality: 14.00.03 - Endocrinology
Year:2010
Scientific adviser: Zinaida Anestiadi
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"

Status

The thesis was presented on the 25 November, 2009
Approved by NCAA on the 11 February, 2010

Abstract

Adobe PDF document0.24 Mb / in romanian

Keywords

diffuse toxic goiter, subclinical hyperthyroidism, antithyroperoxidase antibodies, anti-TSH receptor antibodies, clinical manifestations, remission, lipid metabolism, thyroid ultrasound

Summary

The thesis main text covers 113 pages and comprises: an introduction, 6 chapters and bibliography (191 sources), containing 23 tables and 19 figures. 6 scientific papers were published based on the research results.

The research subject is Diffuse Toxic Goiter (DTG) at its debut. The aim and objectives of the research: the study of clinical manifestations, thyroid hormone status, antithyroid antibodies and thyroid ultrasound changes in patients with primarily diagnosed DTG, depending on the severity of hyperthyroidism; evolution of clinical symptoms, thyroid hormone level dynamics, TSH and antithyroid antibodies during treatment and the evaluation of the probability of remission depending on the severity of hyperthyroidism.

The performed research was a clinical, analitical, prospective study. The examined groups were homogenous. Selecting data for clinical research was „case-control” type. The scientific novelty of the study consists in the evaluation of the clinical, paraclinical and evolutional aspects of hyperthyroidism, depending on severity and its degree of manifestation in patients with primarily diagnosed DTG; in determining specific antithyroid antibodies, including anti-TSH receptor antibodies, the intrathyroid haemodynamic indices on ultrasound study and the assessment of probability of remission depending on the severity of hyperthyroidism at the time of making the diagnosis.

The scientific practical value consists in determining the specific clinical, hormonal, immunological, ultrasound particularities at the beginning of the clinical course and during the treatment period, depending on the severity of the disease. Obtaining remission in the majority of patients with initial forms of the disease (72,5%) demonstrates the necessity of diagnosing and initiating treatment in early stages (subclinical, mild).

The study results were implemented in the clinical practice at the Clinical Republican Hospital and Medical Centre “Excellence”, Chisinau.