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Juvenile idiopathic arthritis: clinical features-evolutionary, systems endogenous oxidation/antioxidant, nitric oxide and curative management effectiveness


Author: Druşcă Angela
Degree:doctor of medicine
Speciality: 14.00.09 - Pediatrics
Year:2012
Scientific adviser: Nineli Revenco
doctor habilitat, associate professor (docent), State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific council: DH 53-14.00.09
Public Medical Sanitary Intitution Scientific Research Institute of Mother and Child Health Care

Status

The thesis was presented on the 3 April, 2012
Approved by NCAA on the 23 May, 2012

Abstract

Adobe PDF document0.52 Mb / in romanian

Keywords

juvenile idiopathic arthritis (JIA), oxidative stress, free radicals of oxygen, prooxidants index, antioxidants index, nitric oxide, antioxidant treatment

Summary

The thesis contains 119 pages of the basic text: it consists of: introduction, 4 chapters, the assessment of the obtained results, conclusions, pratical recommendations, bibliography (211 sources), 12 annexes, 41 tables, 32 figures. The results are published in 20 scientific journals, 3 innovator certificates.

Field of study: pediatrics. The purpose of the study: assessing the role of endogenous lipid peroxidation system, antioxidant protection, pathogenetic mechanisms of nitric oxide in JIA and assessment of antioxidant efficacy in different types of JIA evolution.

Study objectives: to determine the clinical, paraclinical particularities of JIA in different stages of disease; to assess the state of the endogenous systems of the lipid peroxidation and antioxidant protection in patients with JIA in dependence with its evolving character and in different stages of the disease, assessing the correlation between nitric oxide level and the progression of the JIA, the influence of various treatment programs on indices of lipid peroxidation, antioxidant system and nitric oxide in patients with JIA.

The methodology of scientific research: the research methods used in the study: survey, clinical examination of patients, laboratory investigations, special investigations (determining indices prooxidant, antioxidant, nitric oxide), statistical methods.

The scientific novelty and originality was to reveal clinical and diagnostic importance in determining radiological scores – Steinbrocker and Sharp in the JIA, the identification of favorable and unfavorable prognostic factors for the development of JIA; it was determined the important role of oxidative stress in the pathogenesis of JIA.

The important scientific problem solved in the thesis. It was elucidated the role of oxidative stress and NO in the pathogenesis of JIA. The antioxidant preparation influenced positive on the prooxidant indexes and halted the joint damage.

The theoretical and practical importance of the study was to reveal the clinical features of JIA, endogenous systems of oxidation/antioxidant, nitric oxide in the JIA and the effectiveness of various treatment programs on indices of lipid peroxidation, antioxidant system and nitric oxide in patients with JIA, we help early diagnosis of disease and therapeutic approach allows us to improve the efficiency and quality of life.

The findings were implemented in clinical practice in the rheumatology department of Scientific Research Institute Mother and Child Health Care and ideas are included in courses for students and residents in the Pediatrics Department of „Nicolae Testemitanu” State Medical and Pharmaceutical University