Differential diagnosis method for distinguishing the cases of all-year allergic rhinitis and vasomotor rhinitis

FIELD: medicine.

SUBSTANCE: method involves applying Doppler flowmetry approach for studying response to stimulating sympathetic nasal cavity mucosa and left forearm back side blood microcirculation innervation by comparing Doppler flowmetric laser patterns taken in carrying out respiratory tests from mucous membrane of lower nasal turbinate surface in nasal cavity and from left forearm back side skin. Doppler flowmetric laser patterns taken from mucous membrane of lower nasal turbinate surface in nasal cavity being not normal and differing from one taken from the left forearm back side skin, vasomotor rhinitis is considered to be the case. Doppler flowmetric laser patterns taken from mucous membrane of lower nasal turbinate surface in nasal cavity being normal and similar to one taken from the left forearm back side skin, all-year allergic rhinitis is considered to be the case.

EFFECT: enhanced accuracy of differential diagnosis.

9 dwg

 

The invention relates to medicine, namely to otorhinolaryngology.

There is a method of differential diagnosis of perennial allergic rhinitis and vasomotor rhinitis, based on the study of sensitivity to allergens by performing skin tests. This method is chosen for the prototype (Clinical immunology and Allergology. Edited Galore Jr., Tfisher, Thielman. TRANS. with English. - M., Practice, 2000. - 806 C.). The disadvantage of this method is the possibility of provoking allergic reactions and additional sensitization of the organism.

The objective of the invention is to increase safety differential diagnosis of perennial allergic rhinitis and vasomotor rhinitis. This is achieved by studying the response to stimulation of the sympathetic innervation of blood microcirculation of the mucous membrane of the nasal cavity and skin of the back side of the left forearm by comparing the configurations of laser Doppler flowgram taken during respiratory samples from the mucous membrane of the lower turbinate of the nasal cavity and skin of the back side of the left forearm, and if the configuration of the laser Doppler programme taken by the mucous membrane of the lower turbinate of the nasal cavity than normal and the configuration of the laser dopplers the Oh programme, taken from the skin of the back side of the left forearm, it is considered that the patient vasomotor rhinitis; and if the configuration of the laser Doppler programme taken by the mucous membrane of the lower turbinate of the nasal cavity, normal or similar to the configuration of the laser Doppler programme removed from the skin of the back side of the left forearm, it is considered that in a patient with perennial allergic rhinitis.

Examined 20 patients with perennial allergic rhinitis, 22 patients with vasomotor rhinitis (classification Piskunova G.Z. and Piskunov SZ, 1997) and 10 healthy persons (control group). In 20 patients with perennial allergic rhinitis was confirmed by the data of history and skin tests.

The control group consisted of 10 people from 15 to 60 years (5 men, 5 women).

Presents laser Doppler programme (LDF-gram) vessels of the mucous membrane of the anterior end of the lower turbinate healthy person, taken during respiratory samples (holding the breath for 15 seconds at the height of inspiration) (Figure 1). The first dashed line (left to right) corresponds to the wave of breath increases the speed of blood flow during inhalation, then between the first and second dashed line - retentions, there is a reduction of flow velocity, between the second and third dashed line is the period of the backside of the LCD breath, the maximum amplitude of the oscillations does not exceed the amplitude of teeth and exhalation, between the third and fourth dashed line exhale, the fourth dotted line is a sharp increase in blood flow velocity (prong exhalation). Microcirculation index to inhale (original) less restored index of microcirculation after exhalation. Configuration LDF-grams, taken in a healthy person with the skin of the back side of the left predica during respiratory samples, similar to the configuration of the LDF-grams taken from the same man from the front end of the lower turbinate.

If the configuration LDF-grams taken from the mucous membrane of the lower turbinate (Ltfn), non-normal, then we can talk about pathological reactions microvascular mucous membrane of the nasal cavity to the stimulation of the sympathetic innervation. Such pathological LDF-gram, taken from the mucous membrane of the lower turbinate (Ltfn), compared with LDF programme, taken from the skin of the back side of the left forearm (Ldfp). If the configuration of these LDF-gram is similar, then, obviously, impaired sympathetic innervation such a patient is nadsegmentarnae character as sympathetic innervation of the vessels of the mucous membrane of the nasal cavity is made from the superior cervical ganglion, and the vessels of the skin of the forearm from IV-VII prudnichenkov. If Ldfp has a normal configuration, and Ldfn - modified, violation of the sympathetic innervation of local character.

We examined 20 patients with perennial allergic rhinitis ranging in age from 17 to 74 years (9 men, 11 women). In 17 patients after stimulation of the sympathetic innervation revealed no pathological changes Ldfn. 2 patients had baseline microcirculation was more recovered microcirculation index. But these changes are identified and Ldfp, i.e wore nadsegmentarnae character. One patient identified local changes on Ldfn.

Examined 22 patients with vasomotor rhinitis aged 15 to 64 years (12 men, 10 women). After stimulation of the sympathetic innervation in 20 patients showed local pathological reaction microvascular mucous membrane of the nasal cavity, in 15 changes were asymmetric, i.e. configuration changes Ldfn right differed from the changes on the left. Observed the following changes (in all the following figures, the left dotted line corresponds to the beginning of the breath at the height of inspiration, right, dashed line - the end of exhalation after a delay of breath):

1. Microcirculation index source (to breath) was more than microcirculation restored (after expiration) (2).

2. Outline the effective period of reduced blood flow velocity after breath hold up to 30-40 seconds (normal 15-20 sec) (Figure 2).

3. Paradoxical reaction (during breath - significant increase in blood flow velocity) (Figure 3).

4. There are no changes of blood flow velocity after stimulation of the sympathetic innervation (Figure 4).

The method is as follows: in patients with chronic rhinitis with similar clinical symptoms, with a prevalence of one or more symptoms associated with seasonal effects (long-term violation of nasal breathing, swelling of the mucous membranes of the nose, profuse mucous discharge from the nasal passages, sneezing), using laser Doppler flowmetry define the configuration LDF-grams taken during respiratory samples (holding the breath for 15 seconds at the height of inspiration) from the mucous membranes of the lower turbinate of the nasal cavity, and the configuration of the LDF-grams taken during respiratory samples from the skin of the back side the left forearm; if the configuration LDF-Grammy removed from the lower turbinate mucosa of the nasal cavity than normal and, depending on the configuration of the LDF-Grammy removed from the skin of the back side of the left forearm, it is considered that the patient vasomotor rhinitis; and if the configuration of the laser Doppler programme taken by the mucous membrane of the lower turbinate of the nasal cavity, normal or similar to the configuration of the laser dopplers is some programme, taken from the skin of the back side of the left forearm, it is considered that in a patient with perennial allergic rhinitis.

Clinical example 1. The patient And, 55 years old, diagnosed with perennial allergic rhinitis. History of allergic reaction to house dust, a positive skin test to house dust. Complaints about difficulty in nasal breathing, profuse mucous discharge from the nasal passages. The nose mucosa is pink with a bluish olencom, edema in the nasal passages copious amounts of mucus. Configuration LDF-grams taken from the lower turbinate during respiratory samples, normal (Figure 5) and a similar configuration LDF-grams taken from the skin of the back side of the left forearm.

Clinical example 2. Patient I-I, 37 years old, diagnosed with perennial allergic rhinitis. History of allergic to cat's fur, confirmed allergic skin breakdown. Complaints about the difficulty of nasal breathing, sneezing. Hoc - pink mucous edema in the nasal passages of mucus. Configuration LDF-grams taken from the lower turbinate during respiratory samples than normal: microcirculation index to inhale (original) more restored index of microcirculation after exhalation (6). Configuration LDF-grams taken from the skin of the back side of the left forearm during respiratory p is ordinary, also different from normal, but it changes similar to the changes LDF-grams taken from the lower turbinate: microcirculation index to inhale (original) more restored index of microcirculation after exhalation (Fig.7). The obtained data suggest midsegment violation of sympathetic regulation of microcirculation of blood.

Clinical example 3. Patient C, 54 years old, diagnosed with vasomotor rhinitis. Complaints about difficulty in nasal breathing, profuse mucous discharge from the nose. Hoc mucosa pink, edematous, in the nasal passages copious mucous discharge. History of Allergy no skin tests on standard allergens negative. Configuration LDF-grams taken from the lower turbinate during respiratory samples than normal: during breath holding is not a reduction but an increase in the flow velocity (Fig). Configuration LDF-grams taken from the skin of the back side of the left forearm during respiratory samples, normal (Fig.9). The obtained data testify to a local violation of the sympathetic regulation of microcirculation of blood in the mucous membranes of the nasal cavity.

The method of differential diagnosis of perennial allergic rhinitis and vasomotor rhinitis, based on the study of neurohumoral reg the regulation of the body, characterized in that study the response to stimulation of the sympathetic innervation of blood microcirculation of the mucous membrane of the nasal cavity and skin of the back side of the left forearm by comparing the configurations of laser Doppler flowgram taken during respiratory samples from the mucous membrane of the lower turbinate of the nasal cavity and skin of the back side of the left forearm, and, if the configuration of the laser Doppler programme taken by the mucous membrane of the lower turbinate of the nasal cavity than normal and, depending on the configuration of the laser Doppler programme removed from the skin of the back side of the left forearm, it is considered that the patient vasomotor rhinitis, and if the configuration laser Doppler programme taken by the mucous membrane of the lower turbinate of the nasal cavity, normal or similar to the configuration of the laser Doppler programme removed from the skin of the back side of the left forearm, it is considered that in a patient with perennial allergic rhinitis.



 

Same patents:

FIELD: medicine; medical engineering.

SUBSTANCE: method involves applying ultrasonic Doppler echolocation techniques for scanning blood circulation at selected area of cardiovascular system, determining blood circulation velocity vector projections and calculating blood circulation speed. Echolocation is carried out by using at least three non-complanar probing ultrasonic rays set at angles relative to selected area of cardiovascular system in the range of 0-80°. Selected blood circulation area orientation angles are measured relative to scanning ultrasonic rays and Doppler frequency shifts in each measuring channel are determined. Blood circulation speed is calculated as where ω0i is the radiation frequency of ultrasonic oscillation in ray I, Δωi is the Doppler frequency shifts in measuring channel i, V is the ultrasonic wave propagation speed in the medium, ϑk is the blood circulation speed in selected area, ϑki is the blood circulation velocity projection to scanning ray i, a,b,c,h,k,n11,n12,n13 are the coefficients depending on ultrasonic rays orientation. The device has measuring unit having ultrasonic transducers and electronic unit having switch, high frequency oscillator, calculating unit, indication and control unit. The measuring unit is manufactured as bracelet which segments are connected to each other by means of adjustable hinges and has gages for measuring lateral segment orientation angles relative to the central segment and gages for measuring ultrasonic transducer orientation angles relative to the i-th segment where i = 1,2,3, connected to calculating unit, switch, indication and control unit connected to high frequency oscillator, ultrasonic transducers of the measuring unit are connected via the switch to the high frequency oscillator.

EFFECT: high accuracy of measurements; wide range of functional applications.

2 cl, 2 dwg

The invention relates to medicine, vascular surgery

The invention relates to medicine, to medical devices for measuring blood flow velocity and can be used to assess blood flow in the eye, skin, surgery for intraoperative studies of blood flow in various organs, for the study of microcirculatory blood flow in grafts in plastic surgery and cosmetology

The invention relates to medicine, cardiology

The invention relates to medicine, cardiovascular disease
The invention relates to medicine, namely to vascular neurosurgery, and can be used to evaluate the radical removal or embolization of arteriovenous malformations

The invention relates to medical instrumentation and can be used to control blood flow in the capillaries of the superficial tissues of man and experimental animals

The invention relates to medicine and can be used for the diagnosis of endotoxemia

The invention relates to medicine, namely to traumatology and is intended for the diagnosis of suppurative inflammation of the soft tissues in the treatment apparatus of external fixation external fixation

FIELD: medicine; medical engineering.

SUBSTANCE: method involves applying ultrasonic Doppler echolocation techniques for scanning blood circulation at selected area of cardiovascular system, determining blood circulation velocity vector projections and calculating blood circulation speed. Echolocation is carried out by using at least three non-complanar probing ultrasonic rays set at angles relative to selected area of cardiovascular system in the range of 0-80°. Selected blood circulation area orientation angles are measured relative to scanning ultrasonic rays and Doppler frequency shifts in each measuring channel are determined. Blood circulation speed is calculated as where ω0i is the radiation frequency of ultrasonic oscillation in ray I, Δωi is the Doppler frequency shifts in measuring channel i, V is the ultrasonic wave propagation speed in the medium, ϑk is the blood circulation speed in selected area, ϑki is the blood circulation velocity projection to scanning ray i, a,b,c,h,k,n11,n12,n13 are the coefficients depending on ultrasonic rays orientation. The device has measuring unit having ultrasonic transducers and electronic unit having switch, high frequency oscillator, calculating unit, indication and control unit. The measuring unit is manufactured as bracelet which segments are connected to each other by means of adjustable hinges and has gages for measuring lateral segment orientation angles relative to the central segment and gages for measuring ultrasonic transducer orientation angles relative to the i-th segment where i = 1,2,3, connected to calculating unit, switch, indication and control unit connected to high frequency oscillator, ultrasonic transducers of the measuring unit are connected via the switch to the high frequency oscillator.

EFFECT: high accuracy of measurements; wide range of functional applications.

2 cl, 2 dwg

FIELD: medicine.

SUBSTANCE: method involves applying Doppler flowmetry approach for studying response to stimulating sympathetic nasal cavity mucosa and left forearm back side blood microcirculation innervation by comparing Doppler flowmetric laser patterns taken in carrying out respiratory tests from mucous membrane of lower nasal turbinate surface in nasal cavity and from left forearm back side skin. Doppler flowmetric laser patterns taken from mucous membrane of lower nasal turbinate surface in nasal cavity being not normal and differing from one taken from the left forearm back side skin, vasomotor rhinitis is considered to be the case. Doppler flowmetric laser patterns taken from mucous membrane of lower nasal turbinate surface in nasal cavity being normal and similar to one taken from the left forearm back side skin, all-year allergic rhinitis is considered to be the case.

EFFECT: enhanced accuracy of differential diagnosis.

9 dwg

FIELD: medicine.

SUBSTANCE: method involves applying Doppler flowmetry approach for studying response to stimulating sympathetic nasal cavity mucosa and left forearm back side blood microcirculation innervation by comparing Doppler flowmetric laser patterns taken in carrying out respiratory tests from mucous membrane of lower nasal turbinate surface in nasal cavity and from left forearm back side skin. Doppler flowmetric laser patterns taken from mucous membrane of lower nasal turbinate surface in nasal cavity being not normal and differing from one taken from the left forearm back side skin, vasomotor rhinitis is considered to be the case. Doppler flowmetric laser patterns taken from mucous membrane of lower nasal turbinate surface in nasal cavity being normal and similar to one taken from the left forearm back side skin, all-year allergic rhinitis is considered to be the case.

EFFECT: enhanced accuracy of differential diagnosis.

9 dwg

FIELD: medicine.

SUBSTANCE: method involves recording dental pulp blood vessels rheodendogram and determining vascular tone index value. Patient electrocardiogram is recorded during the whole dental treatment course before and after tooth odontopreparation concurrently with dental pulp blood vessels rheodentogram recording. Parasympathetic division of nervous system activity index is measured. Vascular tone index ratio with respect to parasympathetic division of nervous system activity index value is determined. The value is compared to a reference value corresponding to its value measured before carrying out odontopreparation. The received value deviating from norm and being not greater than 30%, inflammation process progress in dental pulp is considered to be the case and removal of tooth pulp is advised.

EFFECT: high accuracy and information capacity of evaluation results.

1 tbl

FIELD: medicine.

SUBSTANCE: method involves selecting blood vessels on area under study and measuring their parameters. Marked bone segments are selected as the area under study and radiopaque substance is introduced, angiographic examination is carried out in two projections. The area under study is marked with a contour and its area is measured. Blood vessels are marked out on image in carrying out interactive segmentation and a binary image with maximum blood vessel intensity is built. Total blood vessel area is measured in the region and blood supply index is calculated as Ifpbs=Sbvfp/Srfp, Ibssp=Sbvsp/Srsp, Irbs=(Ifpbs + Ispbs)/2, where Irbs is the blood supply index of area under study, Ifpbs is the blood supply index of area under study in frontal projection, Ibssp is the blood supply index of area under study in sagittal projection, Sbvfp, Sbvsp is the total blood vessel area in frontal and sagittal projection, Srfp, Srsp is the area of region under study in frontal and sagittal projection. Then, blood vessel diameters are measured and their orientation degree is determined.

EFFECT: high accuracy of assessment results.

6 dwg

FIELD: medicine, functional diagnostics.

SUBSTANCE: one should study microcirculatory route of ocular conjunctiva due to videobiomicroscopy. Moreover, one should calculate the size of varicosis of post-capillary venules, the area of capillary glomerules, amplitude and the length of microvessel's coiled section, amplitude and frequency coefficients, the size of postcapillary venule, the size of intravascular conglomerate of sludged erythrocytes, the coefficient of correlation between sludging and the degree of sludge-phenomenon. Depending upon the values of the above-mentioned parameters one should diagnose initial disorders of pulmonary capillary circulation, moderate disorders of pulmonary capillary circulation or pronounced disorders of pulmonary capillary circulation. The innovation enables to diagnose affected circulation in patients in case of pulmonary cancer in pre-operational period and carry out corresponding medicinal therapy.

EFFECT: higher accuracy of diagnostics.

3 ex

FIELD: medicine.

SUBSTANCE: method involves evaluating blood microcirculation parameters in urethral mucous membrane before tuberculin test and 48 h thereafter. The microcirculation parameters growing worse by 8-12% and higher, tuberculosis is to be diagnosed. The value remaining unchanged or their values not exceeding 8%, nonspecific urinary tract inflammation is to be diagnosed.

EFFECT: high accuracy of diagnosis.

2 tbl

FIELD: medicine, urology.

SUBSTANCE: method involves carrying out the echo-dopplerographic study of the male genital system before physiotherapy course followed by carrying out pharmaco-echo-dopplerography of genital system vessels by using vardenofil in an average single dose 10-20 mg given in 30-45 min after oral administration of the preparation. In case of increasing linear blood stream rates in the genital system vardenofil is prescribed in one-half single dose, once time per 24 h additionally to physiotherapy during all course of treatment, and also prostatilen, rectal suppositories and microenemas and every day massage of prostate by fingers. Also, the rational psychotherapy of "syndrome in waiting failure" and "examination syndrome" is carried out; then administration of vardenofil for 6 months is prescribed in one-half single dose in each other 24 h or 2 times per a week and then similar course is repeated 4-5 times with break for 6 months. Method provides improving results of treatment due to carrying out the selective vasoactive therapy of genital system in patients suffering with chronic prostatitis and with parallel decreasing erectile and psychosexual function. Invention can be used in treatment of patients with chronic prostatitis in combination with copulative disorders.

EFFECT: improved and enhanced treatment method.

6 tbl, 1 ex

FIELD: medicine.

SUBSTANCE: the present innovation deals with studying the system of microhemocirculation. Moreover, it is necessary to introduce a laser light guide probe of a special device (LAKK-02) into biopsy canal of a fibrobronchoscope to apply it at certain part of bronchial mucosa being 1.0 cm above the carina of right-hand upper lobar bronchus. Then one should register and analyze the data obtained that enables to exclude the error in the course of trial implementation.

EFFECT: higher accuracy of diagnostics.

6 ex

FIELD: medicine, surgery, traumatology, anesthesiology, physiotherapy, curative physical training.

SUBSTANCE: before carrying out curative physical training it is necessary to fulfill anesthesia of brachial plexus at the side of affected limb due to injecting pharmacological solution consisted of 45 ml 0.5%-lidocaine solution and 0.3 ml 1%-adrenaline solution; anesthesia should be fulfilled twice or thrice per the course of curative physical training in 5-6 d; curative physical training should be started in 1.5-2 h after anesthesia. The present innovation increases the volume of movements due to removing muscular hypertension, improving muscular circulation in area of the lesion that, in its turn, prevents complications in tissues of areas of operated limb, it, also, increases efficiency of curative physical training and shortens restorative period 2-fold.

EFFECT: higher efficiency of rehabilitation.

2 ex, 4 tbl

FIELD: medicine.

SUBSTANCE: method involves applying Doppler flowmetry approach for studying response to stimulating sympathetic nasal cavity mucosa and left forearm back side blood microcirculation innervation by comparing Doppler flowmetric laser patterns taken in carrying out respiratory tests from mucous membrane of lower nasal turbinate surface in nasal cavity and from left forearm back side skin. Doppler flowmetric laser patterns taken from mucous membrane of lower nasal turbinate surface in nasal cavity being not normal and differing from one taken from the left forearm back side skin, vasomotor rhinitis is considered to be the case. Doppler flowmetric laser patterns taken from mucous membrane of lower nasal turbinate surface in nasal cavity being normal and similar to one taken from the left forearm back side skin, all-year allergic rhinitis is considered to be the case.

EFFECT: enhanced accuracy of differential diagnosis.

9 dwg

Up!