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Early latent syphilis and differential diagnosis with false positive serological reactions


Author: Tabuica Oleg
Degree:doctor of medicine
Speciality: 14.00.11 - Dermatology and Venerology
Year:2013
Scientific adviser: Gheorghe Muşet
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific council: DH 50-14.00.04
State University of Medicine and Pharmacy "Nicolae Testemitanu"

Status

The thesis was presented on the 12 December, 2012
Approved by NCAA on the 14 June, 2013

Abstract

Adobe PDF document0.52 Mb / in romanian

Keywords

early latent syphilis, false positive reaction, immunoblot, seroresistant syphilis, sensitivity and specificity of serological tests

Summary

The work includes 115 pages of basic text, and consists on introduction, 3 chapters, obtained results’ discussion, conclusions, practical recommendations, bibliography comprising 293 references, 3 annexes, 25 tables, and 19 figures.

Domain of study: Dermatovenerology

Purpose of study: evaluation of clinical-immunological and anamnestic features of early latent syphilis for the elaboration of an algorithm for differential diagnosis with false-positive reactions, using modern immunological tests.

Research objectives: evaluation of clinical-anamnestic features and of medical-social aspects of patients with early latent syphilis; comparative assessment of diagnostic performance of immunological methods for latent syphilis and false positive serological reactions; correlational evaluation of diseases associated to various pathological conditions of patients with false-positive serological reactions; development of a differential diagnostic algorithm of early latent syphilis and false-positive reactions.

Methodology of scientific research: The research is prospective analytical. The patients were selected randomly. The type of data collection was simply blind, longitudinal and prospective.

Scientific novelty and originality: For the first time in Republic of Moldova, based on a reliable clinical material, the diagnostic performance of the immunoblot technique in latent syphilis and serological identification of false positive reactions was estimated.

Scientific problem solved in thesis: it was documented the greater sensitivity and specificity of immunoblot technique in comparison with current ELISA,TPHA tests, and its use can improve the reliability of syphilis serology.

Theoretical significance of the research: The current study allowed the elucidation of the multidimensional differential diagnosis of early latent syphilis with false positive reactions problem and the development of a diagnostic algorithm.

Applicative value of the research: The optimization of the serological diagnosis of latent syphilis allows a prompt establishing of the diagnosis and the avoidance of unjustified treatment for patients with false-positive serological reactions, which will improve the quality of medical assistance.

Implementation of scientific results. The results have been implemented in practical activities of the Municipal Dispenser of Dermatovenerology of Chisinau. The study results are used in undergraduate and postgraduate training of the medical staff.