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Toxocariasis: medical-social aspects; clinical-evolutionary manifestations; managerial and therapeutic conduct


Author: Plăcintă Gheorghe
Degree:doctor habilitat of medicine
Speciality: 14.00.33 - Social Medicine and Management
Year:2019
Scientific consultants: Sava Ţibuleac
doctor habilitat, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Constantin Eţco
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 8 February, 2019
Approved by NCAA on the 15 March, 2019

Abstract

Adobe PDF document – 1.50 Mb / in romanian

Thesis

CZU 616.995.132 (043.2)

Adobe PDF document 3.52 Mb / in romanian
267 pages

Keywords

toxocariasis, epidemiology, evolution determinants, co-morbidities, therapeutic yield

Summary

Structure of the thesis: introduction, 6 chapters, general conclusions and recommendations, bibliography consisting of 340 titles, 231 pages of basic text, 47 tables, 44 figures, 12 clinical cases, 7 appendices. The results of the study are published in 44 scientific papers. Keywords: toxocariasis, epidemiology, evolution determinants, co-morbidities, therapeutic yield.

Research area: tropical infectious diseases and medical parasitology. Aim: Assessment of epidemiological aspects of toxocartic and other parasitosis invasion, determination of toxocaric seroprevalence, evidence of clinical and evolutionary particularities and treatment to reduce infestation determinants and morbidity of the population. Research objectives: comparative analysis of epidemiological peculiarities of toxocartic invasion and other parasitic entities in Moldova (2004-2016); identification of factors in installing the high level of toxocariasis invasion; determination of toxocaric seroprevalence in apparently healthy and morbid persons; elucidation of clinical-evolutionary variants of toxocartic invasion in adults and children; clinical-pathogenic and paraclinical manifestations depending on the duration of the toxocariasis invasion, evaluation of therapeutic efficacy; evidence the evolutionary differences between monoinvasive toxocariasis and association with other parasitic entities and chronic viral hepatitis, identifying pathological prevalence; determining the characteristics of immune deviations according to the form of manifestation; determining the influence of toxocartic invasion on the effectiveness of postvaccinal response in children; determining the influence of toxocartic invasion on the effectiveness of postvaccinal response in children; the role of clinical determinants and laboratory determinations in establishing the different evolution of visceral toxocarasis (recovery, exacerbation, remission, latent evolution, evolution in leaps, re-invasion); the development of an algorithm for diminishing the determinants of the population's infestation and morbidity, and the conduct of a distinct case.

Scientific novelty. Elucidation of disease prevalence factors, identification of different evolutionary laws of larval toxocarasis, drawing up the vast spectrum of manifestations, the expansion of the vision in knowledge of pathology by clinicians, which offers the possibility of a distinct management, with cost reductions, personalized to the patient.

Fundamentally new results. The predictive factors that determine the different evolution of the disease, and the differences in toxocariasis monoinvasion with parasitic comorbidities and HCV have been established, the algorithm of conduct has been developed, offering new therapeutical solutions in the cases of rebel toxocariasis.

Theoretical and practical significance. Approaching toxocariasis as a chronic disease with different clinical variants, which have been previously under the cover of syndromic diagnosis, the algorithm of conduct has been developed according to each case. Implementation of scientific results.

The results have been implemented in the teaching process at the State Medical and Pharmaceutical University "Nicolae Testemitanu", in the training of family doctors in the territory, according to the MH order; the Centre of Medical Parasitology and Tropical Diseases has been opened.