Method for estimating treatment effectiveness in atherosclerotic lower extremity ischemia patients

FIELD: medicine.

SUBSTANCE: method involves carrying out microscopic examination of blood serum samples taken from femoral vein and cubital vein. Femoral vein sample is taken on injured side. The examination is carried out before and after treatment. The blood serum samples are placed on fat-free glass slide in the amount of 0.01-0.02 ml as drops, dried at 18-30°C for 18-24 h. The set of pathological symptoms becoming larger or not changed after the treatment in comparison to sample taken before treatment, and morphological picture of samples under comparison taken from the cubital vein showing no changes or being changed to worse, the treatment is considered to be effective.

EFFECT: enabled medicamentous treatment evaluation in course of treatment to allow the treatment mode to be changed in due time; avoided surgical intervention (amputation); retained active life-style of aged patients.

4 dwg

 

The invention relates to medicine, in particular to laboratory method of research.

Obliterating atherosclerosis of vessels of lower extremities is a disease that affects mainly people of elderly and senile age. At this age, most patients have complex somatic pathology that makes use of only conservative treatment, which requires continuous and objective monitoring blood flow to the legs and body in General. This control is necessary for the timely correction of therapy, an additional inclusion in the complex of therapeutic measures detoxification funds intra-arterial infusion of drugs, often allowing to avoid amputation and, if necessary, to do it with minimal risk to the life of the patient.

In order dynamic control over the degree of ischemia of the lower extremities obliterative vascular disease, the use of some biochemical parameters of blood plasma, in particular, the content of phospholipids (Cossacks SCI, Belchenko DI, Hawks GN. Prediction of treatment outcome of patients with atherosclerotic occlusion of lower limb arteries in lipid metabolism. // Surgery. - 1993. - 2. - p.12-15), and the level of molecules of average weight in blood, urine and lymph (Kungurtsev CENTURIES, Simanco A.I., Fishermen G.S., Mn the skin of CU, Slyunkov CENTURIES Detoxification therapy in patients with chronic occlusal lesions of the lower limb arteries. // Surgery. - 1988. - 12. - p.8-11).

The closest is the way of the study of lactate in the blood taken from the femoral and ulnar veins to assess the effectiveness of treatment of obliterating Takayasu (zoloev G.K., Pourovskii VI, Sokolovich G., Poyarkov E, Beloglazov ME, Berman, A. M., Evasin N.P., Shilnikov MG Study the concentration of lactate in regional blood obliterative arterial diseases. //Surgery. - 1990. - 11. - pp.33-36, prototype)

However, in all these methods, each diagnostic indicator reflects the homeostasis of the whole organism, and the results obtained in patients of elderly and senile age can relate mainly to comorbidity. Thus, according to the A.V. Pokrovsky (Pokrovsky A.V. diseases of the aorta and its branches. M, Medicine. - 1979. - S.), in the study of 20 biochemical parameters in the blood taken from the arm and the femoral vein of the patient limb in patients with varying degrees of atherosclerotic ischemia was not statistically significant differences in quantitative parameters even during ischemia stage III.

Therefore, the relevance of the problem of developing methods that allow dynamic control of the degree of atherosclerotic ischemia of the extremities and adequa the activity of the treatment, no doubt.

The task was to eliminate this drawback and the creation of such a diagnostic method, which would allow in the study of blood serum taken from the arm and the femoral vein on the side of the lesion, to identify morphological features that indicate shifts in the direction of improvement or deterioration of hemodynamics in the affected limb.

For this purpose, the method of evaluating the efficiency of treatment of patients with atherosclerotic ischemia of lower extremities, including microscopic examination of samples of blood serum from hip and elbow vein, the proposed sample from the femoral vein to take from the defeat, and the serum to explore before and after treatment, apply the serum samples of blood to skim a glass slide in a quantity of 0.01-0.02 ml in the form of drops, dried at a temperature of 18-30°C for 18-24 hours, and if the set of pathological signs in the sample from the femoral vein after treatment has increased or not changed compared with the sample before treatment and morphological picture of the compared samples from the cubital vein has not changed or has changed for the worse, the treatment is not effective, if the set of pathological signs in the sample from the femoral vein after treatment decreased compared with the sample before the treatment, while the morphological to the rtina compared samples from the cubital vein has changed for the worse, the treatment is effective.

It is known that the biological body fluids contain all components of the intracellular and extracellular metabolism, being, thus, information media integrated homeostasis both at the organism and organ (system) level. Digidrirovanny drop of serum is a thin slice of non-cellular tissue, reflecting specific physico-chemical composition of the blood of patients with one or another pathological process.

In figure 1, 2 presents samples of blood serum from the arm and the femoral vein, respectively, analyzed before treatment; figure 3, 4 blood samples from the arm and the femoral vein, respectively, analyzed after treatment (example 1).

The method is as follows.

Serum blood of the patient is obtained from the elbow and femoral veins by settling them in test tubes or centrifuge. Then, each sample applied to skim a glass slide in a quantity of 0.01-0.02 ml in the form of drops, dried at a temperature of 18-30°C for 18-24 hours. Further samples microscopists and held their comparative mapping:

if the set of pathological signs prevails in the blood serum sample obtained from the femoral vein of the patient limb after treatment, namely, when preobladanie the pigmentation or tictacti the sample surface, number three-beam cracks, the presence of structures of type “list” in the marginal zone, judged significant deterioration in hemodynamics affected limb, i.e. about strengthening ischemia of the limb; and if there are no morphological changes in the compared samples of blood serum from the cubital vein before and after treatment, or morphological picture deteriorated, then talk about the ineffectiveness of the treatment.

if the set of pathological signs in qualitative and quantitative composition prevails with the blood serum sample obtained from the cubital vein after treatment, with a range of pathological signs in the sample from the femoral vein after treatment decreased judged on the improvement in the hemodynamics of the affected limb and the emission of ischemia of the affected limb in the overall flow, i.e. the effectiveness of the treatment.

Example 1.

Patient M., aged 80. Obliterating atherosclerosis of the left leg. Ischemia of the III degree. A comparative study of two samples of blood serum proposed method to treatment:

in the blood serum sample from the cubital vein is defined marker sclerosing (leaf structure in the marginal zone) and slight token of stagnation (three-beam cracks in small numbers) (figure 1);

in the blood serum sample from the femoral vein are defined marker sclerotherapy the Oia (leaf structure in the marginal zone), pronounced marker of stagnation (three-beam cracks in large quantities), a marker of intoxication (expressed uneven pigmentation around the nodule, toxic plaques), a marker of microcirculation disorders and angiospasm (grebeshkov patterns on the edge of the facies (figure 2).

After 10 days of complex conservative treatment of newly discovered serum, taken from the femoral and ulnar veins. At the same time revealed the following morphological picture:

in the blood serum sample from the cubital vein is defined marker sclerosing (leaf structure in the marginal zone), slight token of stagnation (a single three-beam cracks in the Central zone), a marker of intoxication (tictacti and weak pigmentation peripheral surface facies, toxic plaques) (figure 3). The set of symptoms after treatment has increased;

in the blood serum sample from the femoral vein is marked pronouncedly marker of stagnation (moderate amount of three-beam cracks), mild marker sclerosing (leaf structure on the edge of the facies clearly expressed) (figure 4). The set of symptoms after treatment has decreased.

Conclusion about the effectiveness of treatment: when matching morphological patterns of sera obtained from the femoral vein of the patient limb before and p is after the treatment there is a lack of markers of intoxication and disturbance of microcirculation, of angiospasm, as well as a significant weakening of the manifestations of the markers sclerosing and stagnation after 10 days of drug therapy.

When comparing the morphological picture of the sera obtained from the cubital vein before and after treatment, there is a slight deterioration of the picture after treatment due to symptoms marker intoxication. However, this is a positive fact, as it shows the emissions in the total blood products congestion by improving the hemodynamics of the affected limb. The treatment outcome is positive.

According to the retrospective observation of the patient during the year was observed a stable remission of the disease.

Example 2.

Patient N., 69 years. Obliterating atherosclerosis of the left leg. Ischemia of the III degree.

A comparative study of two samples of blood serum of the proposed method before treatment:

in the sample of serum from the cubital vein is marked token sclerosing and moderate expression of the marker stagnation;

in the blood serum sample from the femoral vein is marked token sclerosing, pronounced marker of stagnation and a marker of intoxication.

After a comprehensive conservative treatment after 10 days, the newly discovered serum, taken from the femoral and ulnar veins. At the same time revealed the following mo the essay picture:

in the blood serum sample from the cubital vein is marked token sclerosing, moderate expression of the marker congestion, signs of intoxication; a set of symptoms increased.

in the serum sample of blood from the femoral vein is marked token sclerosing, moderately expressed marker of stagnation and marker intoxication, i.e. a set of symptoms has not changed.

Conclusion about the effectiveness of treatment: when matching morphological patterns of sera obtained from the femoral vein of the patient limb before and after treatment there is a decrease in the severity marker of stagnation after 10 days of drug therapy. When comparing the morphological picture of the sera obtained from the cubital vein before and after treatment, there was a slight deterioration of the picture after treatment by displaying signs of intoxication. That is, the treatment gives a slight improvement in hemodynamics of the affected limb, as there was a slight release of products of stagnation in the overall flow. The result of the treatment is ineffective.

On the basis of the treatment strategy was changed - drugs were injected directly into the femoral artery of the patient's legs. The effectiveness of the treatment in the new K is de was evaluated in accordance with example 1.

Example 3.

Patient L., 78 years. Obliterating atherosclerosis of the left leg. Ischemia of the III degree.

A comparative study of two samples of blood serum of the proposed method before treatment:

in the blood serum sample from the cubital vein is marked mild markers sclerosing and stagnation;

in the blood serum sample from the femoral vein is marked token sclerosing, pronounced marker of stagnation and a marker of intoxication.

After a comprehensive conservative treatment after 10 days, the newly discovered serum, taken from the femoral and ulnar veins. At the same time revealed the following morphological picture:

in the blood serum sample from the cubital vein is marked mild markers sclerosing and stagnation; the set of pathological signs unchanged.

in the blood serum sample from the femoral vein is marked token sclerosing, pronounced marker of stagnation and marker intoxication, a set of pathological signs unchanged.

Conclusion about the effectiveness of treatment: when matching morphological patterns of sera obtained from the femoral vein of the patient limb before and after treatment, any changes are not marked.

Morphological picture of the sera obtained from the cubital ve is s, before and after treatment of the same type. The treatment ineffective.

On the basis of the treatment strategy was changed - medications were administered not in the vein and directly into the femoral artery of the patient's legs. The effectiveness of the treatment under the new approach was evaluated in accordance with example 1.

Example 4.

Patient H., 62 years. Obliterating atherosclerosis of vessels of the right leg. Ischemia of the III degree.

A comparative study of two samples of blood serum of the proposed method to treatment:

in the blood serum sample from the cubital vein is marked token sclerosing and a weak marker of stagnation;

in the serum sample of blood from the femoral vein is marked token sclerosing, moderately expressed marker of stagnation and a marker of intoxication.

After a comprehensive conservative treatment after 10 days, the newly discovered serum, taken from the femoral and ulnar veins. At the same time revealed the following morphological picture:

in the sample of serum from the cubital vein is marked token sclerosing, moderately expressed marker congestion and moderate marker intoxication; i.e. a set of symptoms increased.

in the blood serum sample from the femoral vein is marked token sclerosing, pronounced Mar the EP stagnation, pronounced marker of intoxication and a marker of microcirculation disorders, angiospasm, a set of symptoms increased.

Conclusion about the effectiveness of treatment: when matching morphological patterns of sera obtained from the femoral vein of the patient limb before and after treatment marked deterioration of the picture by increasing manifestations marker congestion, toxicity and the emergence marker disturbance of microcirculation and angiospasm.

Morphological picture of the sera obtained from the cubital vein before and after treatment is increased severity markers of stagnation and toxicity after drug therapy. The treatment result is negative.

This conclusion was the basis for an urgent surgical intervention, which confirmed the correctness of the chosen course of treatment (joined the complication is thrombosis of the lower limb).

The present invention allows to evaluate the effectiveness of drug treatment in order to adjust, allowing you to avoid surgery (amputation). A way to keep an active lifestyle in elderly and senile age with sclerotic lesion of vessels.

The method of evaluating the efficiency of treatment of patients who atherosclerotic ischemia of lower extremities, includes a study of serum samples of blood from the femoral and ulnar veins, characterized in that the sample from the femoral vein taken from the side of the lesion, the study was conducted before and after treatment, the samples of blood serum applied to skim a glass slide in a quantity of 0.01-0.02 ml in the form of drops, dried at a temperature of 18-30°C for 18-24 h, and if a set of symptoms in samples of blood serum after treatment has not changed or has changed for the worse compared to the morphological pattern of the respective samples before treatment, it is not effective if the set pathological signs in the sample from the femoral vein after treatment decreased compared with the sample before the treatment, and morphological picture of the compared samples from the cubital vein has changed for the worse, the treatment is effective.



 

Same patents:

FIELD: medicine.

SUBSTANCE: invention relates to laboratory methods for blood analysis. Plasma is dropped in copper sulfate solution with density 1.023 g/cm3, not above, and time for drop falling on bottom of graduated cylinder with column height 243 mm is measured. The blood plasma density value is calculated by the formula:

wherein is the unknown blood plasma density (g/cm3); is copper sulfate solution density measured by areometer (g/cm3); t is average falling time of plasma drop in the copper sulfate solution (as seconds); 0.260130126 and 0.00290695 are correction coefficients. Temperature of plasma and copper sulfate solution is 20oC. Method is simple and suitable and allows carrying out analysis of small volumes of blood plasma and to reduce analysis time.

EFFECT: improved assay method.

2 ex

The invention relates to medicine, namely to surgery

The invention relates to medicine, namely to laboratory methods, and relates, in particular, the method of evaluating the efficiency leprosy medicines

The invention relates to medicine, namely to laboratory diagnosis

The invention relates to medicine, namely to Hematology

The invention relates to medicine and biology, in particular to physical therapy and immunology for the correction of immunodeficiency and associated diseases when exposed to light different areas of a person

The invention relates to medicine and can be used to determine the magnitude of blood loss in clinical practice, extreme and military surgery

FIELD: medicine, biotechnology, pharmacy.

SUBSTANCE: invention relates to agents used for treatment of pathological states associated with disorder of synthesis of neuromediating substances. Method involves the development of pharmaceutical composition and a method for it preparing. Pharmaceutical composition represents subcellular synaptosomal fractions: synaptic membranes, "light" synaptosomes and "heavy" synaptosomes prepared from gray matter of cerebral hemispheres from experimental animals based on the goal-seeking modification of humoral mediators of nerve endings transformed to synaptosomes in development and regression of malignant processes. The composition provides inhibiting the growth of tumor cells, to elevate span-life of patients with ascite Ehrlich's sarcoma, breast adenocarcinoma Ca-755, Wolker's carcinosarcoma-256.

EFFECT: valuable medicinal and anti-tumor properties of composition.

12 cl, 3 tbl, 3 ex

FIELD: medicine, phthisiology, microbiology.

SUBSTANCE: diagnostic material is poured preliminary with chlorohexidine bigluconium solution, homogenized, kept at room temperature for 10-12 h and centrifuged. Precipitate is poured with Shkolnikova's liquid medium, incubated at 37oC for 3 days, supernatant part of Shkolnokova's medium is removed, fresh Shkolnikova's medium is added, and precipitate is stirred and inoculated on the dense cellular egg media. Sensitivity of the strain is determined in 3 weeks by the presence of growth in the control tube only. Invention provides enhancing precision and reducing time for assay. Invention can be used in assay for medicinal sensitivity of tuberculosis mycobacterium.

EFFECT: improved assay method.

3 ex

FIELD: molecular biology.

SUBSTANCE: the suggested innovation deals with the fact that nucleic acids should be isolated directly out of the sample without pipetting stage but with the help of interconnected reservoirs being prepared beforehand. The above-mentioned vessels should be applied either separately or being interconnected according to standard microtitrating format. The sample should be mixed with a lyzing buffer and nucleic acids are bound with matrix in closed system including, at least, two interconnected reservoirs. Forced movement of sample's mixture and buffer back and forth from one reservoir into another one for several times through narrow passage provides their thorough intermixing. The method provides quick and safe isolation of nucleic acids.

EFFECT: higher efficiency.

44 cl, 4 dwg, 1 ex

FIELD: medicine, urology.

SUBSTANCE: one should conduct subcutaneous prevocational tuberculin test and, additionally, both before the test and 48 h later it is necessary to perform the mapping of prostatic vessels and at decreased values of hemodynamics one should diagnose tuberculosis. The information obtained should be documented due to printing dopplerograms.

EFFECT: more reliable and objective information.

1 ex, 1 tbl

FIELD: medicine, psychiatry.

SUBSTANCE: one should isolate DNA out of lymphocytes of peripheral venous blood, then due to the method of polymerase chain reaction of DNA synthesis one should amplify the fragments of hSERT locus of serotonin carrier gene and at detecting genotype 12/10 one should predict the risk for the development of hallucino-delirious forms of psychoses of cerebro-atherosclerotic genesis.

EFFECT: more objective prediction of disease development.

3 ex

The invention relates to medicine, namely to laboratory methods of skin diseases and can be used to diagnose common progressive psoriasis
The invention relates to the field of medicine, but can also be used in veterinary medicine to determine the level of nonspecific resistance of the organism (UNRO) both human and animal

The invention relates to medicine and relates to damage mitochondrial DNA as a prognostic sign of atherosclerotic coronary heart disease

The invention relates to medicine, namely, neurology, and can be used for the diagnosis of multiple sclerosis

FIELD: medicine, psychiatry.

SUBSTANCE: one should isolate DNA out of lymphocytes of peripheral venous blood, then due to the method of polymerase chain reaction of DNA synthesis one should amplify the fragments of hSERT locus of serotonin carrier gene and at detecting genotype 12/10 one should predict the risk for the development of hallucino-delirious forms of psychoses of cerebro-atherosclerotic genesis.

EFFECT: more objective prediction of disease development.

3 ex

Up!