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CNAA / Theses / 2017 / June /

Сlinical and paraclinical features of pulmonary infiltrative tuberculosis with severe evolution within DOTS treatment


Author: Caraiani Olga
Degree:doctor of medicine
Speciality: 14.00.26 - Phtisiopneumology
Year:2018
Scientific adviser: Constantin Iavorschi
doctor habilitat, professor, Public Medical Sanitary Intitution Institute of Phthisiopneumology "Chiril Draganiuc"
Scientific consultant: Serghei Ghindă
doctor habilitat, professor, Public Medical Sanitary Intitution Institute of Phthisiopneumology "Chiril Draganiuc"
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 14 June, 2017
Approved by NCAA on the 11 May, 2018

Abstract

Adobe PDF document – 0.67 Mb / in romanian

Thesis

CZU 616.24-002.5+616-097

Adobe PDF document 4.04 Mb / in romanian
151 pages

Keywords

tuberculosis, pneumonia, risk factors

Summary

Thesis structure: the paper is exposed on 127 pages of basic textand contains introduction, 4 chapters, conclusions, practical recommendations, summaries in the Romanian, Russian and English languages, 68 tabels, 11 figures and 2 annexes, as well as a bibliographic index of 185 references. The results are published in 31 scientific papers, including 3 author’s articles, and registered by 2 inventional certificates.

Field of study: 321.07-phthisiolopneumology.

Aim: Assessment of clinical and paraclincal features of pulmonary infiltrative tuberculosis with severe evolution within DOTS treatment, for the elaboration of the management of differential diagnosis.

Objectives:Study of general characteristics, social, economical and epidemiological features of pulmonary infiltrative tuberculosis with severe evolution and of patients with severe communitary pneumonia and long lasting evolution pneumonia; Assessment of clinical signs, radiological aspects, laboratory findings (immunology and bacteriology) and treatment peculiarities of pulmonary infiltrative tuberculosis with severe evolution and patients with severe communitary pneumonia and long lasting evolution pneumonia; Identification of risk factors for severe evolution of pulmonary infiltrative tuberculosis; Elaboration of the differential diagnostic method between pulmonary infiltrative tuberculosis with severe evolution and patients with severe communitary pneumonia and long lasting evolution pneumonia.

Research methodology: Survey was a sample survey, descriptive and prospective; if research-risk groups retrospective observational research in cellular and humoral immunity case study type intervention-observation. Scientiphic novelty: For thefirst time in R. of Moldovw were assessed risk factors of severe evolution of pulmonary infiltrative tuberculosis.

Important scientific problem: Were the elucidated clinical and laboratory characteristics of pulmonary infiltrative tuberculosis with severe evolution. Identified risk factors and it was developed tactics for the differential diagnosis between pulmonary infiltrative tuberculosis with severe evolution and patients with severe communitary pneumonia and long lasting evolution pneumonia.

Theoretical significance: It was realised a large study of social, economical, epidemiological, clinical, radio-imagistical, bacteriological, therapeutical study of pulmonary infiltrative tuberculosis with severe evolution, severe communitary pneumonia and long lasting evolution pneumonia. It was established that younger age, long lasting specific intoxication and broncho-pulmonary symptomatology are the features of tuberculous pulmonary infiltrate. Old age, acut onset of the symptoms, bad general condition, dyspneea and fever caracterised pulmonary infiltrate from community acquired pneumonia.Raising lymphocyte antigen in vitro under the influence of PPD-L applied serum collected as demonstrating the specificity of pulmonary infiltrative tuberculosis, sensitization tests of non-specific antigens (staphylococcus, streptococcus, pneumococcal) can be used as view etiologic differential diagnosis.

Applied value: Results of the study permitted to the elaboration of the differential diagnosis procedure of pulmonary infiltratrative tuberculosis with severe community acquired pneumonia and long lasting pneumonia, to be used by phthysiologists.

Implementation of scientific results: Phthisiopneumology departmens, Immunology and allergology laboratory of the Institute of Phthisiopneumology „Chiril Draganiuc”.