The method of determining the effectiveness of treatment of pain syndrome in patients after combined treatment of breast cancer
The invention relates to medicine, namely to Oncology, and can be used in neurology, traumatology, surgery, forensic medical examination to determine pain syndrome. The method includes determining a maximum threshold of pain sensitivity through exposure blunt needle stiletto regarding him with a fixed graduated scale, which is fixed indicators. The impact of exercise on the symmetric point zones of the branches of the brachial plexus in healthy and diseased parts of the body. To reduce differentials between healthy and diseased parts of the body are judged on the effectiveness of treatment. The method allows to increase the accuracy and objectivity of determining the effectiveness of the treatment of pain. 1 Il., 4 table.
The invention relates to medicine, namely to Oncology, and can be used in neurology, traumatology, surgery, forensic and sports medicine to determine pain syndrome.
In patients with breast cancer during surgery and subsequent radiation damage all elements of the peripheral nervous system: placage pain syndrome, difficult to treat. There is a method of definition of pain by the visual analogue scale (VAS) or verbal scale assessments (SVA) (N. A. Losev. Modern methods of assessment of cancer patients with chronic pain. Paliativa medicine and rehabilitation, No. 1, 1998, 28-32). However, the known method shows the subjective attitude of a person to pain, reflecting the total complex of his suffering and cannot assess the effectiveness of the treatment.
The closest achieved a positive result is a method of determining pain sensitivity using a sharp needle (Century, the Archangel. A guide to practical training in neuropathology. - M.: Medicine, 1971, S. 14-19). However, the known method only determines the subjective feeling of pain.
The authors proposed a simple and affordable way with high accuracy objective to determine the effectiveness of treatment and adjust it over time. To date there is no objective way to accurately determine the change in local pain sensitivity and to judge the effectiveness of the treatment over time.
A positive result saleemul the presumed fact, what does the impact on the symmetric parts of healthy and diseased parts of the body subject with blunt end and to reduce the difference of the indices determined on a graduated scale, judged on the effectiveness of treatment.
The method is as follows. Patients with chronic pain syndrome after combined treatment of breast cancer to determine the maximum threshold of pain sensitivity on the symmetric parts of healthy and diseased parts of the body, identifying the zone change pain sensitivity and the degree of change in pain sensitivity, so that in the course of treatment to determine its effectiveness. The method consists in pressing on the skin in symmetrical areas of healthy and diseased parts of the body fixture (drawing). The device consists of a spring-loaded stiletto 1 3 mm in diameter with blunt (not damaging the skin) bullet-shaped end 2 and fixed with respect to the stiletto 1 graduated scale 3. Each division on the scale 3 corresponds to 50 grams compressed stiletto spring. The measure of the displacement of the stylet is fixed at the limit of patience of the patient. The difference in performance when pressed on symmetrical parts healthy and diseased parts of the body ukazi sensitivity. Reducing differentials or alignment indicators on healthy and diseased parts of the body, as well as reducing the damage zone indicates the effectiveness of the treatment.
Example 1. Patient K., 1948 birth, the mammary gland T3N0M0The state after the combined treatment in 1999 brachioplasty left. Chronic pain in the past 2 years. Lymphostasis left upper extremity 1 tbsp. Received complex treatment in the form of magnetic therapy, acupuncture, pneumomassage, drug therapy simultaneously with a duration of 15 sessions. The indicators of maximum pain threshold (the point selected freely) Fig.1, scale 1.
The approximation of maximum pain threshold with the patient body part to the indicators of a healthy testifies to the effectiveness of treatment.
Example 2. Patient D. B. 1951. Diagnosis: cancer of the left breast, T3N0M0. Received combined treatment (surgery and radiation therapy) 2.5 years ago. 8 months ago I had a strong pain syndrome on the background of significant fibrosis what about the pain threshold showed: (points selected freely, their number is not limited) Fig. 2, 3, 4.
Before treatment (table. 2)
After 8 sessions: the pain has not decreased and the difference of the indices has not changed (table. 3).
Received treatment (magnetic therapy, acupuncture, troksevazina ointment and pills) was replaced by a magneto-therapy, iontophoresis with Dimexidum, ultrasound with Hidrocortizonum, Fraxiparine, sedative therapy. Held 10 sessions, after which the pain has decreased significantly. Research the maximum pain threshold showed that the difference in performance between healthy and diseased parts of the body decreased (table. 4).
The approximation of maximum pain threshold with the patient side to the indicators of a healthy hand testifies to the effectiveness of the treatment.
A total of 86 studies.
The claimed method is simple, affordable and has a high accuracy of determining the effectiveness of treating patients with lesions of the peripheral nervous system and chronic pain syndrome.
In addition Tom;">Claims
The method of determining the effectiveness of treatment of pain syndrome in patients after combined treatment of breast cancer, comprising determining the maximum pain threshold using impact blunt needle stiletto regarding him with a fixed graduated scale, which record the performance, and the impact of exercise on the symmetric point zones of the branches of the brachial plexus in healthy and diseased parts of the body and to reduce differentials between healthy and diseased parts of the body are judged on the effectiveness of treatment.
FIELD: medicine, clinical toxicology.
SUBSTANCE: at patient's hospitalization one should gather the data of clinical and laboratory values: on the type of chemical substance, patient's age, data of clinical survey and laboratory values: body temperature, the presence or absence of dysphonia, oliguria being below 30 ml/h, hemoglobinuria, erythrocytic hemolysis, exotoxic shock, glucose level in blood, fibrinogen and creatinine concentration in blood serum, general bilirubin, prothrombin index (PTI), Ph-plasma, the state of blood clotting system. The state of every sign should be evaluated in points to be then summed up and at exceeding the sum of points being above "+20" one should predict unfavorable result. At the sum of "-13" prediction should be stated upon as favorable and at "-13" up to "+20" - prediction is considered to be doubtful.
EFFECT: higher accuracy of prediction.
2 ex, 3 tbl
SUBSTANCE: method involves studying blood samples with venous blood mixed with vital stain like methylene blue. Degree of vital stain absorption by erythrocytes is determined by applying photocolorimetry. The value drop being more than 25%, extracorporal detoxication is to be predicted as ineffective.
EFFECT: simplified method.
SUBSTANCE: method involves evaluating prognostic signs and calculating their prognostic weight. Consciousness disorders and diagnosis set at prehospital stage are used as the prognostic signs. Calculations are carried out from formula: lethal outcome %= -15.99+19.1•C+14.7•DS-2.79•C•DS, where C is the ranged consciousness disorder degree, DS is the diagnosis set prehospital stage. The higher is the value, the higher is lethal outcome probability.
EFFECT: accelerated and simplified prognosis method.
SUBSTANCE: method involves evaluating proliferating processes by calculating index of positive cell nuclei (Ki-67). The Ki-67 value being from 6 to 16%, erosive ulcerating stomach lesions accompanied by stomach hemorrhage and hemorrhagic shock is to be predicted. The value being from 17 to 30%, erosive ulcerating stomach lesions without hemorrhage is to be predicted.
EFFECT: high accuracy of prognosis.
FIELD: medicine, urology.
SUBSTANCE: the present innovation deals with differential diagnostics of prostatic cancer and other prostatic diseases at the stage of primary inspection. The method includes the detection of PCA and calculation of probability coefficient for prostatic cancer (PCC) by the following formula: where e - the foundation of natural logarithm (e=2.718…), PCA - the level of total blood PCA in ng/ml, V - patient's age in years. At PCC value being above 0.2 one should diagnose prostatic cancer and to establish final diagnosis one should perform polyfocal prostatic biopsy. The method enables to increase accuracy of diagnostics at decreased number of unjustified prostatic biopsies.
EFFECT: higher efficiency of diagnostics.
SUBSTANCE: method involves determining homeostasis values and absolute number of neutrophils and lymphocytes in particular. Low neutrophil number being determined in a child during a number of years and low number of lymphocytes in the persons from the nearest child surrounding, the persons are to be examined for given psychosomatic pathology availability with following medical treatment to be applied to eliminate the detected pathology and to normalize homeostasis values and lymphocyte number among others.
EFFECT: enhanced effectiveness of prophylaxis.
SUBSTANCE: method involves measuring radio signals and low frequency spectra of signals emitted by oral cavity organs and tissues in maxillofacial area. Decoding and comparison of the spectra to healthy organs and tissues spectra is carried out. Then, modulated information signals in infra-low frequency bandwidth corresponding to healthy organs and tissues signals are applied. Low frequency radio signals and spectra are measured. Treatment with modulated signals in infra-low frequency bandwidth is applied directly to organ or its location zone via skin.
EFFECT: enhanced effectiveness in diagnosing and treating oral cavity organs and tissues in maxillofacial area.
5 cl, 3 tbl
FIELD: medical engineering.
SUBSTANCE: device has bottom and cover joined in inseparable way so that no chance is available to mismatch covers belonging to different containers. The bottom and internal part of cover are lined with sponge so that the allergenic disks are kept in uniformly wetted state. Grate with holes is attached to lower sponge, the holes narrowing downward as cones so that the allergenic disks are kept in stable vertical position.
EFFECT: simplified access to disks using forceps; excluded misidentification risk.
5 cl, 6 dwg
FIELD: medicine, operative gynecology.
SUBSTANCE: at final stage of laparoscopic operation for 5-7 min one should introduce 16 U lidase in 1 ml 2%-lidocaine solution into uterine mesentery from both sides, and then, by not removing a needle - a half of single dose of antimicrobial preparation in 1 ml 2%-lidocaine solution, then in postoperational period - an antimicrobial preparation applied during laparoscopy lymphotropically under mucosa of lateral vaginal arch from both sides for 5-7 d once daily and one antimicrobial preparation - intravenously for 5-7 d, moreover, as antimicrobial preparations one should apply gentamicin, metrogyl and other preparations permitted for intravenous application. The present innovation stimulates lymphatic drainage in area of inflammation and activates interstitial humoral transport of antimicrobial preparations that, in its turn, favors complete sanitation of inflammation foci and prophylaxis of disease relapses.
EFFECT: higher efficiency of therapy.
1 cl, 1 ex
SUBSTANCE: method involves applying biological indicator as mixture composed of 0.1% aqueous solution of amino acids: leucine, glycine, proline, serine, phenylalanine, histidine, oxyproline, arginine, glutamic amino acid and aspartic amino acid, 0.5% aqueous solution of neuromediators like dopamine and histamine, 12% aqueous solution of magnesium sulfate in proportion of amino acids : neuromediators : magnesium sulfate = 4:1:5. Indicator kept on neck surface in thyroid gland projection during 3-5min. It is dried at T=+35-40°C, studied in polarized light with quartz compensator. Columnar, columnar-and-striated, sheaf-like crystals and discharged polygonal variegated chambers being observed, thyroid gland hyperfunction is to be diagnosed.
EFFECT: high accuracy of diagnosis.