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CNAA / Theses / 2016 / July /

Impact of the immune factor on clinical and evolutionary peculiarities of chronic intestinal diseases in children


Author: Olga Tighineanu
Degree:doctor of medicine
Speciality: 14.00.09 - Pediatrics
Year:2016
Scientific adviser: Ion Mihu
doctor habilitat, professor, Public Medical Sanitary Intitution Scientific Research Institute of Mother and Child Health Care
Institution: Public Medical Sanitary Intitution Scientific Research Institute of Mother and Child Health Care

Status

The thesis was presented on the 22 July, 2016
Approved by NCAA on the 6 October, 2016

Abstract

Adobe PDF document – 0.82 Mb / in romanian

Thesis

CZU 616.34-002-036.12-053.2:612.017.1

Adobe PDF document 4.15 Mb / in romanian
134 pages

Keywords

inflammatory bowel disease, ulcerative colitis, Crohn's disease, immune status, evolution.

Summary

Thesis structure: Introduction, 4 chapters, conclusions and recommendations, bibliographic index of 155 references. The thesis is exposed on 123 pages of printed text. Iconographic material includes 50 figures and 29 tables. The obtained results have been reported in 22 scientific publications.

Field of study: pediatrics, gastroenterology.

Purpose: To evaluate immunological parameters in children with chronic inflammatory bowel diseases, in conjunction with endoscopic and histological examination in order to make a noninvasive diagnosis and curative monitoring of disease adjusted to the evolutionary period.

Objectives:

 To identify factors involved in triggering the onset and persistence of chronic inflammatory bowel diseases in children in the Republic of Moldova.

 To delimitate clinical features of children with ulcerative colitis and Crohn's disease and to monitor them depending on the onset peculiarities.

 To observe follow-up serum levels of proinflammatory cytokines and anti-inflammatory activity as markers of chronic inflammatory process in correlation with clinical, endoscopic and histological features.

 To estimate evolutionary forms for rational curative monitoring and prognostic evaluation of inflammatory bowel diseases.

Methodology: The study was designed in two stages: descriptive and analytical non-experimental case-control study; subject of study – the child confirmed with the diagnosis of ulcerative colitis or Crohn's disease, using general and special methods, at PMSI IMandC during 2010- 2014.

Scientific novelty of results. For the first time in the Republic of Moldova, a scientific research was conducted which aimed at determining the morbidity of inflammatory bowel disease in children and the immune factor defining the impact of clinical and evolutionary peculiarities of these entities.

Scientific problem solved in the researchwas to analyze preconditions of induction, persistence and recurrence of clinical manifestations of inflammatory bowel disease in children, according to clinical practice for more efficient early diagnosis and to streamline ambulatory monitoring, and to correlate immunological markers, endoscopic lesions and histological changes for a non-invasive investigational monitoring, therapeutic management optimization, and improvement of prognosis and quality of life.

Theoretical value and implementation of scientific results.The main research results have a significant practical value, serving as basis for timely and qualitative medical assistance for children with inflammatory bowel diseases.

Implementation of scientific results in the curative activity of the Department of Gastroenterology and Hepatology of PMSI IMC helped to establish early diagnosis of ulcerative colitis or Crohn's disease and to optimize therapeutic conduct.