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A multidimensional approach to chronic obstructive pulmonary disease


Author: Corlăteanu Alexandru
Degree:doctor habilitat of medicine
Speciality: 14.00.05 - Internal Diseases (with specification: Pulmonology, Gastroenterology, Hepatology, Nephrology, Functional Diagnostics and Endoscopy)
Year:2019
Scientific consultants: Victor Botnaru
doctor habilitat, professor, Public Medical Sanitary Intitution Institute of Phthisiopneumology "Chiril Draganiuc"
Nikos SIAFAKAS
doctor habilitat în științe medicale, profesor universitar, Grecia
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 4 October, 2019 at the meeting of the Scientific Council and now it is under consideration of the National Council.

Abstract

Adobe PDF document1.92 Mb / in romanian

Thesis

CZU 616.233-002.2+616.24-007.63 (043.2)

Adobe PDF document 4.65 Mb / in romanian
203 pages


Keywords

chronic obstructive pulmonary disease, BODE index, quality of life, polygraphy, COPD phenotype

Summary

Structure of the dissertation: introduction, six chapters, conclusions, reference list of 319 sources, 188 pages of main text, 31 figures, 77 tables. The obtained results are published in 79 scientific papers.

Field of study: internal medicine, pulmonology, somnology. Goals of the dissertation: Emphasizing the impact of independent clinically-relevant parameters and phenotypic traits on clinical, functional and management aspects of COPD and developing of a patient-centred approach to COPD.

Objectives of the dissertation: Emphasizing of independent clinically-relevant parameters for patient stratification in order to assess the severity of COPD more objectively; assessment of the prevalence of comorbidities and their assosiation with clinical and functional parameters; assessment of the sensitivity and specificity of different questionnaires for COPD stratification; determination of the impact of obstructive sleep apnea on chronic obstructive pulmonary disease; overall assessment of clinical effectiveness of procalcitonin based protocols to guide the antibiotics administration in patients presenting the AECOPD; comparison of diagnostic, therapeutic and prognostic strategies in COPD and development of a valid model for estimating the risk of COPD exacerbation.

Scientific novelty and originality: On the basis of a complex study the applicative value of several approaches in COPD was assessed: GOLD ABCD clssification, multidimensional indices and phenotypes. New main results for science and practice: A scientific basis for the multidimensional evaluation of COPD has been created, which has led to the development of algorithm of the COPD multilateral evaluation by assessing several clinical and functional variables, quality of life, comorbidities, which has made it possible to determine more accurately the risk of COPD exacerbation with more accurate patient stratification.

Theoretical significance: The study results demonstrated the utility and informativeness of using of the multidimensional indices in patients with COPD. Practical significance: The study results were used to develop an algorithm for the management and treatment of COPD.

Implementation of scientific results: The methodical recommendations are used in the Phthisiopneumology Department of the Institute of Phthisiopneumology and in the Therapy and Allergology Department of the Republican hospital, for didactic training of new medical personnel at the Pulmonology and Allergology Department, State University of Medicine and Pharmacy “Nicolae Testemitanu”.