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Clinical peculiarities and multidimensional evaluation of elderly patients with chronic obstructive pulmonary disease


Author: Corlăteanu Alexandru
Degree:doctor of medicine
Speciality: 14.00.05 - Internal Diseases (with specification: Pulmonology, Gastroenterology, Hepatology, Nephrology, Functional Diagnostics and Endoscopy)
Year:2010
Scientific adviser: Victor Botnaru
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific council: DH 50-14.00.05-27.03.08
Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 23 December, 2009
Approved by NCAA on the 18 March, 2010

Abstract

Adobe PDF document – 0.29 Mb / in romanian

Keywords

chronic obstructive pulmonary disease, elderly, BODE index, quality of life, St. George’s respiratory questionnaire, Clinical COPD questionnaire, dyspnea, MRC.

Summary

Structure of the thesis: introduction, 5 chapters, conclusions, it consists of 143 text pages, 11 figures, 37 tables and 213 references. The main results of the Doctoral Thesis were published in 25 scientific papers.

Field of the study: internal medicine, respiratory medicine, geriatry. Aim of the study: Study of the clinical, paraclinical and quality of life peculariaties in elderly COPD patients.

Objectives of the thesis: Study of functional parameters and quality of life in relation with stage of COPD in elderly; evaluation of dyspnea in elderly COPD patients by different methods: MRC (Medical Research Council), OCD (Oxygen Cost Diagram), Borg modified, Borg CR 10, Borg RPE Scale and VAS (Visual Analogue Scale); study of the prevalence and association of anemia with clinical and physiological parameters in elderly COPD patients; evaluation of the efficiency of treatment with salmeterol/fluticazone in severe and very severe stage of COPD; estimation of applicative role of BODE index, as a multidimensional system of evoluation COPD; estimation of applicative role of HADO and SAFE scores in comparison with BODE index.

Metohods: 158 consecutive patients with chronic obstructive pulmonary disease (COPD) were included into the study. The cohort consisted of 78 younger patients and 80 older patients. Scientific novelty and originality: Optimization of evaluation, diagnosis and appreciation of the quality of life in elderly COPD patients. For the first time in Republic of Moldova were applied for evaluation of the quality of life 2 specific questionnaires: St. George’s respiratory and Clinical COPD questionnaire and EuroQol.

Theoretic significance: Results of the study argumented utility and informativity of BODE/BOD index in COPD patients. The BODE staging system, helps to predict better the worsening of quality of life in elderly and younger COPD patients, correlates strongly and better than COPD stage with rate of COPD exacerbations and the quality of life: all domains of SGRQ and CCQ.

Practical application: Results of the study were utilised for elaboration of the algorithm of the managent and treatment of COPD.

Implementation of the scientific results: Recomendations are used in pulmonology department of hospital „Sf. Arh. Mihail” and therapy department of Republican hospital, for preparing doctors in department of Internal medicine Nr.1.