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CNAA / Theses / 2010 / June /

Bronchial asthma evolution and control in schoolchildren


Author: Selevestru Rodica
Degree:doctor of medicine
Speciality: 14.00.09 - Pediatrics
Year:2010
Scientific adviser: Svetlana Şciuca
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Grigore Friptuleac
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 29 June, 2010
Approved by NCAA on the 6 October, 2010

Abstract

Adobe PDF document0.33 Mb / in romanian

Keywords

bronchial asthma, schoolchildren, risk factors, asthma control, secretory IgA.

Summary

This thesis include introduction, five capitols, conclusions, bibliography of 303 sources, 117 pages of basically text, 17 tables, 43 figures and 6 annexes. The results of this thesis were published in 30 scientifically publications.

Field of research: pediatrics.

Aim of the study: To evaluate the clinical and explorative peculiarities of bronchial asthma in schoolchildren from different occupational and residential conditions for optimize the control of the disease.

Objectives: to study the level of asthma morbidity in students of classes I to IV in the city, assessing risk factors of asthma among students, respiratory functional assessment indices and immuno-allergic mechanisms of asthma in children of different hygienic conditions, assessing the effectiveness of immunological rehabilitation program in children with asthma, clinical monitoring and functional control of asthma evolution in students.

Novelty and scientific originality. Study allowed the assessment of unfavorable occupational and residential conditions in the development of asthma in schoolchildren. It was rated the familial and personal predisposing risk factors in schoolchildren with asthma, conducted according to gender, age and disease severity. Functional and immunological investigations performed in the study allowed the assessment of respiratory function disorders and local immunological changes in schoolchildren with asthma according to unfavorable residential conditions. The presence of immunopathological mechanisms through functional impairment of nonspecific reactivity caused by adverse influences of the unfavorable residential ambient was demonstrated. It was confirmed the clinical phenotype of asthma according to schoolchildren age and disease severity.

Theoretical signification. This paper contributes to the development of the complex methodology of analysis and study in diagnosis, etiopathogeny, prophylaxis and treatment problems of asthma in children in relation to occupational and environmental residential conditions, according to the principles of international research in the field.

Applicative value of the study. The correlation between the incidence of asthma and risk factors, as a basis for estimating disease risk in children was revealed. In the base of obtained results was developed a well structured algorithm for evidence of active screening of risk factors, assessment of functional respiratory, allergic and immunological disorders in children with asthma.

Scientific results are implemented in the lectures for students and medical residents; the measures prepared in accordance with methodological recommendations contribute to perfecting the local hygienic norms in school institutions and to improving the management of diagnosis and of the treatment in pediatric asthma in primary care.