Method for determining quantitative estimation of state severity degree of patients and victims having injuries and evaluating effectiveness of applied therapy

FIELD: medicine.

SUBSTANCE: method involves determining linear blood circulation speed above and below diaphragm using dopplerography approach. State severity class is determined as healthy, recovering and heavy from measured linear velocities ratio. Applied therapy effectiveness is determined on the measured linear velocities ratio exiting beyond the scope of severity class range, when analyzing patient state dynamics.

EFFECT: high accuracy in estimating patient health state.

4 tbl

 

The invention relates to medicine and can be used in various branches of the profile and in outpatient medical rehabilitation to determine a quantitative assessment of the severity of patients with various diseases and casualties with injuries. The invention can be used to dynamically control the state of the sick and injured in the offices of various profiles, to assess the effectiveness of therapy.

Known methods of determining a quantitative assessment of the severity of the condition, which is a measure of the effectiveness of treatment of patients with injuries and in patients with different pathologies. For example, currently most often in Russia and other countries to determine a quantitative assessment of the severity of the condition is rated on a scale of ARACNE (10). Scale ARACNE-2 recognized in America as the “gold standard”, as it determines the accuracy of other methods for determining the severity of the condition (2).

Proven high reliability of the predicted and actual outcome depending on the severity of the condition on a scale of ARACNE-2 (1). One of the advantages of scale ARACNE-2 is the inclusion in its membership of the scale Glasgow coma (2,10).

However, with all the benefits and high reliability of the scale ARACNE-2, it has the following disadvantages.

- Many of the settings included in this scool is Lu, during the day remain unchanged, in spite of intensive rehabilitation, which makes it impossible to determine the effectiveness of therapy and the dynamics of the process of rehabilitation. For example, during the day and more can remain constant - score coma scale Glasgow, the white blood cell count, hematocrit, and other indicators.

- Indicators RAO2pH, Na, K, creatinine, hematocrit, leukocyte numbers suggest invasive laboratory methods that are not always justified after translation victims and patients from intensive care to the relevant Department and the outpatient phase of treatment.

To use this scale for individual prognosis is doubtful, as its accuracy does not exceed 74% (2).

- To assess the severity of the condition and the effectiveness of the rehabilitation measures for the assessment of 10 points or below on a scale of ARACNE-2 problematic, as many of the indicators of the scale, although by no means normal, but are in the range of 0 points.

Known methods for determining blood flow velocity using dopplerography on the site of the inferior Vena cava (NIP) below the diaphragm (3,6).

However, the known methods do not allow determination of changes of blood flow velocity at the NIP areas depending on the change of the pressure gradient in the HUB (8) and the change of gravity SOS the sustainability of the injured and sick. Not described in literature of the ways to determine the difference in the flow velocity at the NIP area above and below the diaphragm, depending on the pressure gradient in this area (8), so there is no way to assess the severity of the condition and the effectiveness of therapy patients and patients using these indices.

The aim of the invention is the creation of a reliable non-invasive method of determining a change in the quantitative assessment of the severity of patients and injured victims in the various branches of the profile and in outpatient medical care.

This goal is achieved by a method for determining a change in the quantitative assessment of the severity of the condition and the effectiveness of therapy in affected patients and by determining the speed of blood flow in the inferior Vena cava by the Doppler method (3, 6, 8) is that to assess the effectiveness of therapy in Doppler mode, determine the linear velocity of blood flow lbfv first above (V1), and then (V2) diaphragm according to the standard technique (3, 6). For numerical evaluation of the velocity ratio at the time of the study the results of this study compare the measure of the fraction, the numerator of which is the velocity of the blood flow in the NIP above the diaphragm (V1), and the denominator of the rate CROs is Otok in the LEL below the diaphragm (V 2). The resulting ratio of linear velocities indicate Paul's. PAULS=V1/V2. On the received indicator, which is a quantitative assessment of the severity of condition of patients with injuries at this point in time, determine the appropriate class of gravity, which is indicated in the table. Change indicator PAULS in the dynamics and output it outside the range of class severity indicates an improvement or deterioration of patients, the effectiveness or ineffectiveness of therapy.

Description of the invention.

In studying the possibility of objective quantitative assessment of the severity of the condition, all the researchers of this problem came to the conclusion that scales to determine the severity of the condition should include integral indicators of disturbed functions of the body(1, 2, 4, 5, 10). It is known that the centralization of blood circulation, disorders of peripheral blood circulation and impaired respiratory function are key features of the severity of the condition(1, 4, 5, 8, 9).

However, to date no studies on the quantitative characteristics of centralization of blood flow, the main component of which is the deposition of blood in the pool NIP and impaired venous return(7, 8, 9).

To study the quantitative characteristics of centralized crowood the lated patients and patients in the dynamics of decreasing the degree of severity of the condition at various stages of medical care were surveyed 307 people of different sex aged 18 to 70 years. To obtain the normal values was investigated in healthy volunteers - men and women aged 18 to 70 years - 54 (17.6% of all studied).

Casualties with combined injuries and various volumes of the lesions, patients with cardiac symptoms, pneumonia, palsies of different etiologies (multiple sclerosis, cerebral palsy, spinal injury and spinal cord) was 253.

The research was conducted in 3 stages of rehabilitation: in the ICU, in relevant hospital departments and outpatient stage. 139 (54,9%) affected patients and investigated in the intensive care unit. 49 (19.4%) of affected patients and investigated in specialized departments. 65 (25.7 per cent) of victims and patients underwent outpatient treatment.

All victims and patients were divided into 7 groups.

1-5 group was in the intensive care unit, group 6 was in profile of hospital departments, and group 7 were in outpatient treatment (table 1).

group 1. 15 (5,9%) person was in a coma. They were affected with severe concomitant injuries, which were conducted antishock measures in the 1st day after admission to the hospital, stricken with severe head injury (bruises and injuries of the brain), and suffered from injuries incompatible with life, as well as patients with cardiac and pulmonary pathologies the (heart attacks, severe pleuropneumonia).

The reflexes of the studied was not determined. The reaction of pupils to light was absent. Score from ARACNE-2 in 1-St group was from 30 to 35 points and above, the prediction of mortality from 60% to 75% and above.

All investigation was conducted IVL, massive infusion therapy, antibiotic therapy was administered vazopressorov.

group 2. 7 (2,8%) affected patients and was in a coma on a ventilator, but they were determined reflexes to pain stimuli, and also noted the reaction of pupils to light stimuli. They were victims and patients after conducting antishock measures, after emergency surgery (2-3 days). They were transfusion therapy, continued antibiotic therapy, vazopressorov these victims were appointed according to the testimony. Score from ARACNE-2 among those studied was from 25 to 30 points, the prediction of mortality from 50% to 60%.

group 3. 9 (3.5 percent) was investigated in spoor or consciousness of them were confused. They were mechanical ventilation. Reflex activity they had been reduced, were the reaction of pupils to light.

This researched was conducted transfusion therapy, but the volumes were much smaller than those studied in a coma. The vazopressorov these patients was not appointed. Score from ARACNE-2 in these patients was from 23 to 28 points, etc the prognosis mortality up to 50%.

group 4. 17 (6,7%) subjects were on a ventilator mode support, was prescribed inhalations of oxygen. The volume of infusion therapy have been reduced and antibiotics were administered based on the sensitivity of microflora. Score from ARACNE-2 in this group was 20 to 25 points, the prediction of mortality from 30%to 50%.

After repeated commands of the doctor they reacted poorly and could perform simple instructions (“Shake hands”), but to change position on the bed, they could not, and therefore for their coups needed the help of the medical staff.

5 group. 91 (36,0%) people were in mind. The breath they were independent. The cough reflex was reduced, but at the command of the doctor they were able to cough. Infusion therapy from them was minimal. Antibiotic therapy was performed taking into account the sensitivity of microflora. These survivors were able to follow the instructions of the doctor. Blood pressure they were within the lower limit of normal. Score from ARACNE-2 these victims was 10-19 points, and the risk of mortality did not exceed 30%.

6 group. 49 (19.4%) of the studied were in specialized departments. Prevention and treatment given antibiotic therapy symptomatic therapy and special therapy, depending on the diagnosis. Score from ARACNE-2 they were much below 10 points, and the forecast was flying the particular minimum.

7 group. 65 (25.7 per cent) of victims and patients underwent outpatient treatment. These were people with paralysis after suffering a spinal injury and spinal cord, lower paraplegia, evolved as a result of multiple sclerosis, and patients with cerebral palsy. This group consisted of patients with lung diseases and cardiovascular systems that do not require hospitalization.

Thus, the overall clinical picture of the injured and the sick is distinguished by great variability of clinical symptoms, the volume of lesions, complications and different severity of the condition.

In accordance with the clinical characteristics, the number of points on ARACNE-2 and risk of mortality studied were divided into classes of severity of the condition.

When the rankings were guided by the following principles. For any doctor in the first place important to forecast mortality. Of course, that the probabilistic forecast “fifty/fifty” - 50%/50% - although uncertain in terms of mortality, but at the same time, it is most important when sorting victims, mobilizes doctors and directs their efforts to take necessary measures to improve the condition of the victim, reducing quantitative scoring, and hence improve the probabilistic forecast.

It is known that the likelihood of unfavorable outcome sharply surface which agrees with the increase every 3-5 points in the range, starting from 20 points and above(1, 2, 4, 10).

As follows from table 1, the uncertain Outlook “fifty/fifty” - 50%/50% is maintained in the range assessment of severity of condition 20 to 30 points on ARACNE-2, which coincides with the opinion of other researchers (1, 4, 10). This forecast is typical for 2-4 groups.

With more than 30 points on ARACNE-2 (group 1) forecast mortality becomes extremely unfavorable, reaches 75% and above.

When evaluating in the range from 19 to 15 points forecast mortality sharply decreases and does not exceed 20%, and in the interval from 15 to 10 points becomes even less affected patients and are preparing to transfer from the intensive care unit profile Department (group 5).

6 group - patients in specialized departments, on a scale of ARACNE-2 can be estimated at 10 points or less, the risk of mortality among them is minimal.

Of course, victims and patients in outpatient rehabilitation are different in many physiological indicators from healthy people, so they were identified in 7 group.

Based on the above principles and for the convenience of further research all the victims were distributed on the severity of the condition, in accordance with a predicted risk of mortality on the scale of ARACNE-2, 4th grade the severity of the condition (table 2).

0 class was healthy volunteers.

1 class amounted to ambulatory patients and post advsie (group 7).

class 2 was affected and patients with a score on ARACNE-2 10-19 points with the risk of mortality was significantly lower 50% (5-6 group).

class 3 was affected and patients with a score on ARACNE-2 from 20 to 30 points with questionable prognosis mortality 50%/50% (2-4 groups).

class 4 was affected with the assessment by ARACNE-2 >30 points, forecast mortality assessed significantly higher than 50% (group 1).

BFV in NIP investigated the 117 victims and patients of different gender and age, with different amounts of damage, different diseases, in different grades of severity and at different stages of rehabilitation.

To obtain the value of BFV in NIP in healthy individuals, as a criterion for comparison with victims and patients previously conducted study in 29 healthy volunteers of different sex aged 18 to 70 years. To get correct results of all the affected and healthy volunteers investigated no less than 10 minutes after a restful stay in position lying on the back.”

Doppler study of BFV in NIP above and below the diaphragm was performed on the device “HEWLETT-PACKARD”. First explored the LSC on the NIP area above the diaphragm - V1and then investigated the LSC on the NIP area below the diaphragm V2according to the standard technique (3, 6). The ratio of the line who's speed meant PAULS. PAULS=V1/V2.

The obtained values BFV was characterized by high variability, did not depend on age, sex, lesion volumes.

In healthy volunteers in 0 class ranges BFV in NIP above the diaphragm were recorded in the range of 70 cm/sec up to 97 cm/sec, and under the diaphragm is in the range from 63 cm /sec up to 87 cm/sec.

Paul's 0 class was always greater than 1 and averaged 1,125±0,03.

In 4th grade the severity of the condition assessment on ARACNE-2 more than 35 points and the risk of mortality more than 75% of the values obtained in BFV NIP above the diaphragm were recorded in the range from 43,2 to 63.3 cm /sec, and under the diaphragm - from 86.5 to 140,8 cm/sec. Paul's was less than 1 and ranged from 0,87 to 0.32. The lowest PAULS from 0.56 to 0.32 was in casualties with combined injuries incompatible with life, in patients with extensive myocardial infarction. PAULS those investigated in subsequent measurements tended to decrease, despite intensive therapy.

In 13 affected patients and grade 4 assessment 30-32 points and the risk of mortality more than 50% of Paul's was less than 1, but on a background of intensive care the next day he rose and became greater than 1, and score from ARACNE-2 decreased to 25-27 points.

Distinctive features of the studied 4th class (if more than 30 points on ARACNE-2 and the maximum risk of mortality) was the fact that the absolute value of the BFV in NIP above the diaphragm were always less than the values BFV, registered under the diaphragm, and Paul's was always less than 1.

Grade 3 severity of condition BFV in NIP above the diaphragm were recorded in the range from 127 to 145 cm/sec, under the diaphragm, from 104 to 147 cm/sec. With the improvement in the reduction of scoring from 30 to 25±2 points and reduce the risk of mortality, PAULS increased to 1.6-1.7 and the average was 1.65=1=0,05.

The survivors of the 3rd class with a score 20-30 points on ARACNE-2 and questionable prognosis was observed with the following features: mean values of BFV in NIP above the diaphragm were higher than the values of lbfv under the diaphragm. This class was recorded maximum average values PAULS, compared with other groups (p<0,05).

In the tested class 2 severity of condition assessment on ARACNE-2 from 19 to 10 points and trend of mortality risk to a minimum, BFV in NIP above the diaphragm were recorded in the range from 87 cm/sec to 160 cm/sec, under the diaphragm from 70 to 130 cm/sec. Average values PAULS was 1,235±0,03.

Distinctive features in the 2nd class were as follows:

Values BFV in NIP above the diaphragm were always higher than the values of lbfv under the diaphragm (p<0,05).

- Average PAULS in 2 class was less than in Paul's in the 3rd grade, but higher than in the 0 group (p<0,05).

In 1st grade the severity of the condition BFV in NIP above the diaphragm were recorded in the range from 65,6 cm/sec is about 130 cm/sec, and BFV under the diaphragm is in the range from 42,3 cm/sec up to 110 cm/sec.

Paul's in the 1st class was in the range (M±m) 1,19±0,01, lbfv above the diaphragm also always been more than BFV under the diaphragm (p<0,05). Paul's in this group did not reach values which is recorded in healthy persons.

Thus, studies have shown that LCS in the NIP of the studied differed by large ranges of variability did not depend on age and gender, diseases and volume of lesions, and depended on the severity of the condition of the victims. (Table 3).

PAULS, unlike LCS, is a more precise criterion for determining the severity of the condition, because its variability within a class are not so significant in comparison with the variability of lbfv.

The data obtained indicate the continuing signs of depositing the blood, disorders of the venous return from the injured and sick at all stages of medical rehabilitation until recovery.

Paul's is a quantitative integral indicator of impairment of Central hemodynamics CGD, in General, and impaired venous return, Deposit blood in particular. Paul's can be used as an indicator of the effectiveness of rehabilitation measures.

On the basis of the conducted researches it is established ranges PAULS for different classes of severity of their condition, their correlat and assessment for ARACNE -2, draw a table of qualitative and quantitative characteristics of the severity of the condition (table 4).

4 class PAULS registers is always less than 1. The improvement and the reduction marks are below 30 points PAULS has a tendency to spasmodic growth and becomes much greater than 1 (inverse correlation).

PAULS in 1-3 grade of severity was significantly higher than in healthy individuals (p<0,05). When you change the severity of the condition from class 3 to class 1, the lower scoring on ARACNE-2 and risk of mortality below 50% tends to decrease PAULS (direct correlation).

Clinical example.

1. The victim M, 23, was admitted with a diagnosis of Concomitant injury. - Injury. Fracture of vault and skull base. Brain contusion. Blunt trauma to the abdomen.

The victim, who was in a coma, on a ventilator, on ARACNE-2 when entering the first day was 32 points, the risk of mortality more than 75%. BFV above the diaphragm - 54 cm/sec. BFV below the diaphragm - 83 cm/sec. PAULS 0.65, which corresponds to the 4th class of the severity of the condition. The victim about increasing intracranial hematoma performed a decompressive craniotomy. After the operation the casualty's condition has stabilized, but remained heavy. Research BFV was conducted 2 days after the operation, when the victim was in a coma, And The HP Score from ARACNE-2 decreased to 26 points, the risk of mortality is up to 50-60% BFV in NIP above the diaphragm - 127,5 cm/sec, BFV in the LEL below the diaphragm -75,5 cm/sec, PAULS=1,7. These data corresponded to the 3rd class of gravity.

After 2 weeks, against the backdrop of ongoing intensive care state M has improved. He regained consciousness. Ventilation support. Score from ARACNE-2 was equal to 18 points, the risk of mortality was less than 20%. BFV in NIP above the diaphragm - 145 cm/sec, lbfv below the diaphragm - 111 cm/sec, PAULS=1.3, which corresponds to class 2 severity.

After 2 weeks, when the score of 10 points on ARACNE-2 and PAULS=1,2, the victim was transferred to the neurosurgery Department.

The above example shows that when an individual research in the dynamics of Paul's correlates with the assessment of the severity of the condition on ARACNE-2 with the same regularity that we received at the statistical research group in the General population.

2. The victim B. 54, with extensive myocardial infarction who were in a coma, on a ventilator, on ARACNE-2 at the time of the study was 32 points. BFV above the diaphragm - 54 cm/sec. BFV below the diaphragm - 83 cm/sec, PAULS=0,65, which corresponded to the 4th class of gravity. The next day Paul's decreased to 0.51, that is not released outside the range 4 of the class specified in the table. The patient died after 2 days, despite intensive therapy.

This example until the displays, what method can be used for dynamic monitoring of patients and evaluate the effectiveness of remedial measures. In this case, all modern methods of intensive therapy was ineffective, as evidenced by the decrease PAULS in the dynamics.

Table 1.

The main distinctive features in groups.
№/№ GroupsThe number of groupsScore from ARACNE-2Features :

ritika consciousness
Features respirationThe rehabilitation stage
Abs%PointsThe risk of mortality %
1155,930-3560-75NoIVLResuscitation and intensive therapy
272,825-3050-60NoIVL
393,523-2850-60The spoor.IVL
4176,720-25 30-55In consciousnessVentilation support, self -
59136,010-1910-20In consciousnessSelf
64919,4<10→0In consciousnessSelfProfile branch
76525,7<10→0In consciousnessSelfOutpatient
Only253100~----

td align="center"> 10-19
Table 2.

Schematic diagram of the classification of the severity of the condition.
Assessment of severityThe class of gravity
01234
QualityHealthyWithdrawl

Living
Less severeHeavyVery heavy
The points on ARACNE-2-<1020-30>30
The risk of mortality by ARACNE-2 (%)-Risk→0<5050/50>50
Qualitative characteristics of forecastSatisfactorySatisfactoryQuestionableVery poor

Table 3

Average values and indicators of relationship linear velocity of blood flow in the inferior Vena cava have studied.
The analyzed parametersAverage values of ISC and PAULS have studied (M±m)
Classes of severity of condition
01234
V1cm/sec91,5±1,2131,3±1,2144,75±1,02127,18±1,1456,2±1,07
V2cm/sec81,5±1,3110,1±1,1118,75±1,0286,9±1,13132,5±1,05
PAULS=V1:V21,125±0,031,19±0,011,235±0,030,485±0,05

Table 4.

Qualitative and quantitative characterization of the classes of severity of the condition of the injured and the sick.
Assessment of severityClasses of gravity
01234
QualityHealthyRecoveringLess severeHeavyVery heavy
The points on ARACNE-2-<1010-1920-30>30
The risk of mortality by ARACNE-2 (%)-Risk→<5050/50>50
Qualitative characteristics of forecast-SatisfactorySatisfactoryQuestionableVery poor
Ranges PAULS1,05-1,151,16-1,251,26-1,35>1,35<1

The list of references.

1. Romanenko E.K., Boyarintsev CENTURIES, Vasenkov CENTURIES, Suprun T.U. Objective assessment of the severity of the injury // Military-the honey. Journe. - 1996 - T No. 10. - S-24.

2. Ermolov A.S., Bolnicka so-CALLED. Modern ideas about the classification of peritonitis and assess the severity of patients. //Objective methods of assessing the severity of the condition of the sick and injured. The materials of the city workshop. M: NII swap them. Nevskogo. - 2000. - P.19-41.

3. Zubarev, A.R., Grigoryan R.A. Ultrasonic angioscanning. M: “Medicine”. - 1991. - S.

4. Kartavenko VI, Barmina AA// a Modern approach to the classification and definition of severe trauma: a review.// Anesthesiology and resuscitation. - 1997. No. 4. - 74-79.

5. Negovsky V.A. fundamentals of intensive care. M: “Medicine”. 1977. - S.

6. Clinical guidelines for ultrasound diagnostics. Edited ITV. M: “VIDAR”. - 1997. - Volume # 4. - P.185-219.

7. Savel'ev V.S., Gologorsky VA, Kiriyenko A.I. and other Phlebology. - M.: Medicine, 2001. - s.

8. Human physiology. Ed. by R. Schmidt and TEWS, M., “Mir”. 1996, Vol.2, s-520.

9. Shanin YU. Wound disease.// Wound disease and medical rehabilitation. SPb., 1995. P.8-34.

10. Knaus W.A., E.A. Draper, Wagner, D.P., Zimmermann J.E., ARACNE-P a severity of disease classification system // Crit. Care Med. - 1985. - Vol.13. - P.818-829.

The method for determining a quantitative assessment of severity of condition of patients with injuries and evaluate the effectiveness of therapy, including the assessment of the severity classes, characterized in that the method Doppler determine elaut linear blood flow velocity higher at first (V1), and then below (V2) of the diaphragm according to the standard technique, and grade the severity of the condition is determined by the ratio of linear velocities PAULS = V1/V2, healthy - 0 class, PAULS=1,05-1,15, for grade 1 in severity recovering - referred victims and patients with PAULS=1,16-1,25, 2 class - less severe - Paul's $ 1.26 and 1.35 for class 3 - heavy - PAULS>1,35 and for class 4 - very heavy - PAULS<1, the study the dynamics of output PAULS outside the range class of gravity determine the effectiveness of therapy.



 

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9 dwg

FIELD: medicine.

SUBSTANCE: method involves recording mean arterial blood pressure and cardiac index, displaying patient systemic hemodynamic status in real time mode as point of system hemodynamic status represented in coordinate system having its vertical axis as mean arterial blood pressure and horizontal one as cardiac index. Plot area is divided into nine quadrants by drawing lines in parallel to the axes at the level of upper and lower values of cardiac index norm and mean arterial blood pressure and two curves are drawn in the coordinate system to restrict normal value zone of total balance of volemia and inotropy using formula LVMWI±20%= 0.0144(ABPm-PAJP)CI, where 0.0144 is the pressure transformation coefficient (mm of Mercury column) and volume (l) into kg*m; LVMWI is the left ventricle minute work index; 20% is the LVMWI scattering due to physiologic parameter measurement errors; PAJP is the pulmonary artery jamming pressure; CI is the cardia index; ABPm is the mean arterial blood pressure. Two straight lines are drawn on the plot making peripheral blood vessel resistance norm value boundary using a formula of PBVRI±20%=79.96(ABPm-CVP)/CI, where PBVRI is the peripheral blood vessel resistance index; 20% is the PBVRI scattering due to physiologic parameter measurement errors; CVP is the central venous pressure. Parameters of hemodynamic and systemic transport are superposed on the plot by means of abscissa line available on the plot to which the second coordinate axis is added and arterial blood oxygen content is scaled in a way that the normal arterial blood pressure repartition line and arterial blood oxygen content limit repartition line coincide. Two curves restricting normal oxygen delivery index value zone depending on various cardiac index values using a formula D02I=CaO2*CI*10, where D02I is the oxygen delivery index, CaO2 is the arterial blood oxygen content. Graphic presentation as systemic oxygen transport point which position corresponds to patient oxygen delivery index. Complex diagnosis of hemodynamic state and oxygen transport is determined by interpreting systemic hemodynamic status point position on the plot and systemic oxygen transport point position relative to normal value zones of peripheral blood vessel resistance index and normal values of oxygen transport index.

EFFECT: simultaneous estimation of hemodynamic and oxygen transport condition.

17 dwg

FIELD: medicine.

SUBSTANCE: method involves recording electrocardiogram and cardiorhythmogram on the background of medicamentous therapy beginning from 7-10 day of the disease. The cardiorhythmogram is shown to the patient. Respiratory training session is carried out. Inspiration and expiration are to be equal in duration, each making Ѕ of cardiorhythmogram breathing wave.

EFFECT: enhanced effectiveness of treatment.

2 cl, 3 tbl

FIELD: medicine.

SUBSTANCE: method involves recording electrocardiogram and cardiorhythmogram on the background of medicamentous therapy beginning from 7-10 day of the disease. The cardiorhythmogram is shown to the patient. Respiratory training session is carried out. Inspiration and expiration are to be equal in duration, each making Ѕ of cardiorhythmogram breathing wave.

EFFECT: enhanced effectiveness of treatment.

2 cl, 3 tbl

FIELD: biometric authentication of person.

SUBSTANCE: method includes recording biometric data of a person and string these as standard data, repeated recording of biometric data of a person and comparison of these to standard data for determination of likeness between such data types and decision about positive result of person identification is taken, if degree of said likeness is higher than certain preset threshold value. After recording of biometric data of person on basis of his individual properties, affecting sensor registration of biometric data, individual parameter of person is determined and received parameter is stored for later consideration at one of following stages of method. For a fingerprint preset threshold value is decreased if identified person has exclusively dry or moist skin. On the other side, sensitivity of sensor may be decreased or increased in dependence on stored data.

EFFECT: higher reliability of authentication.

3 cl

FIELD: medicine; cosmetics; medical engineering.

SUBSTANCE: method involves checking skin state, giving massage treatment with infrared radiation in remote infrared spectrum zone being used, ozone massage, low frequency wave massage, low frequency vibration wave massage and ultrasonic massage, cleansing skin, giving skin care and introducing nutrients into the skin. Device has units for acting with low frequency waves, infrared radiation in remote infrared spectrum zone, low frequency vibration waves and ultrasound, cleansing skin, checking skin state, and working key unit, presentation unit, memory unit, power supply unit, unit for initiating skin cleaning and skin care.

EFFECT: enhanced effectiveness of treatment.

17 cl, 9 dwg, 3 tbl

FIELD: medicine.

SUBSTANCE: method involves giving grounds and calculating acoustic signal volume at arbitrary frequency from its known intensity (acoustic pressure). Relationship is formulated for energy ratio of equal volume sounds (reference one and one under study). The relationship is interpreted as energy transformation coefficient based on frequency. Weber-Fechner law derivation is shown for arbitrary acoustic wave frequency.

EFFECT: high accuracy of method.

3 cl, 16 dwg

FIELD: medicine.

SUBSTANCE: method involves carrying out ultrasonic scanning examination of subclavian artery over its whole extent in physiological arm position with arterial blood pressure being measured in the middle one third of the arm. Next, when applying compression tests, blood circulation parameters variations are recorded in distal segment of the subclavian artery with arterial blood pressure being concurrently measured. Three degrees of superior thorax aperture syndrome severity are diagnosed depending on reduction of linear blood circulation velocity and arterial blood pressure compared to their initial values. Mild one takes place when linear blood circulation velocity reduction reaches 40% and arterial blood pressure 20% of initial level, moderate one when linear blood circulation velocity reduction reaches 70% and arterial blood pressure 50% and heavy one when linear blood circulation velocity reduction is greater than 70% of initial level and arterial blood pressure is greater than 50% to the extent of no blood circulation manifestation being observed in the subclavian artery.

EFFECT: high accuracy of diagnosis.

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