Method for detecting the degree of polyfunctional insufficiency manifestation in senile patients with polymorbidity
FIELD: medicine, functional diagnostics, clinical geriatrics.
SUBSTANCE: one should register functional values of different systems: cardio-vascular, respiratory, autonomic and muscular, calculate the deviation of absolute value in every tested parameter (X1) against normative value (X0), values for each concrete parameter should be taken out of table 1. Then one should calculate the deviation of function value against standardized value (%) by taking into consideration that X0 being equal to 3δ corresponds to 100%-measurement of the parameter, then one should calculate the value for the stability of systemic organization of functions (VSSOF) which is equal to the sum of deviation squares of all relative values of tested parameters referred to the number of tested parameters. If VSSOP is below 920 one should detect relative norm, at VSSOF ranged 920-1380 - I degree of polyfunctional insufficiency manifestation, and at VSSOF ranged 1380-1840 - II degree, and VSSOF above 1840 - III degree. The method enables to improve evaluation of complex functional disorders based upon detection of functional state in senile patients with polymorbidity at conducting medico-social examination and to control the efficiency of restorative therapy.
EFFECT: decreased functional disorders.
The invention relates to medicine, functional diagnostics, clinical geriatrics, and is intended to improve the assessment of complex functional disorders on the basis of the determination of the functional status of elderly patients with polymorbidity medical and social expertise, to monitor the effectiveness of rehabilitation treatment aimed at reduction of functional disorders. Existing approaches in determining the severity of functional impairments in elderly people with polymorbidity not take into account their politicamente on the background involutive changes in the body.
There is a method of assessing the functional state of human organism, which consists in the simultaneous recording of ECG, respiratory rate, electromyograms of the neck muscles, blood pressure, body temperature, with the subsequent definition deviates from the normalized values and setting of function, limiting the functional state of the organism as a whole unit. certificate No. 1692548 A1, A 61 5/ 02 - the prototype.
Functional failure in the elderly due to the involutive changes and state polymorbidity that leads to the formation of polyfunctional failure (PFN).
For implementing the method conduct a comprehensive functional obledo the tion, including electrocardiography (ECG), spirometry with samples on the breath on the inhale (SDD) and exhalation (ZDV), reovasographiya vessels of the lower extremities and the head, cardiometry, dynamometry, measurement of blood pressure and body mass index.
The survey results are statistically treated using a system of multivariate analysis (Biaglow, Hepatalgia, Mwhoa, 1994) , carried out the selection of indicators that have the highest weighting factor and, therefore, which have the most significant effect on the formation of polyfunctional failure for their subsequent use in determining the level of functional status.
To assess the degree of PFN on the level of the functional state count rate stability system organization functions (PSSI), characterizing the stability of their relationship (Tsarev A.N., Zavialov AV, 1998) . Its magnitude is directly proportional to the degree of imbalance of the functional inter-relationships and stress regulatory mechanisms.
The method of determining the functional state of the body in old age largest PSOF takes to assess PFN, due to a combination of polymorbidity and involutive changes in the various systems and organs, to objectify the assessment of the degree of severity of PHN patients on elago age.
To calculate PSOF first by calculating the relative comparable (dimensionless) parameters, taking into account variability (variability) of each sign. Deviation indicator X1from its standard value (X0)equal to 3δthat is assessed as 100% change (accepted normative parameters of functions in the elderly without polymorbidity) (Table 1).
Normalized values of functional performance in the elderly
|Functional indicators||X0; δ|
|GARDEN, mm Hg||138,2; 12|
|DBP, mm Hg||82,6; 7,8|
|VC, l||27; 07|
|Sdvd, s||37,8; 19,7|
|ZDV sec||28,6; 14,8|
|RI legs||0,68; 0,15|
|RI stop||0,81; 0,13|
|RI Sutil. region||0,64; 0,1|
|Dynamometry right hand (kg)||26; and 7.7|
|Dynamometry left hand (kg)||23,3; 8,2|
|Body weight, kg||71,1; 12|
PSOF equal to the sum of the squared deviations of all otnositel the x values of the investigated functions of their medium, correlated to the number of the studied functions. Its value is directly proportional to the degree of imbalance intersystem integration functions, what they are, the greater the imbalance. The determination of the degree of polyfunctional insufficiency largest PSOF is suggested in accordance with the selected levels of PFN on the basis of the degree of deviation of the functional parameters from their normalized values: deviation less than 50%, PSOF less than 920 - relative norm; deviation 50-75%, PSOF from 920 up to 1380 - I degree, deviation 75-100%, PSOF from 1380 until 1840 - II degree; a deviation of more than 100%, PSOF more 1840 - III degree. For regulatory accepted values PSOF persons in the comparison group in 837±61; δ-334. Note that the normative values PSOF depend on the environmental situation of the region, which contributes to the pace of development evolutionay component of PFN. Therefore calculation of standard values PSSI should be carried out on the population living in this territory.
The proposed method is used to determine the severity of PPHN 68 older people (aged 60-74 years, the average age 67,3±3,4 years) with polymorbidity, the index number of diseases/one patient (Lubny, 2000)  - 4,8±0.7 and 32 persons of similar age without polymorbidity (comparison group). Values PSSI was calculated using programmepaulgoriup (table 2).
Examples of calculation PSOF in elderly people with polymorbidity women 63 years (W 63) with a diagnosis of CHD. Atrial fibrillation, tachysystolic form, N IIA. Atherosclerosis of cerebral vessels. Dyscirculatory encephalopathy I tbsp. Widespread osteochondrosis in men 65 years (M 65) with a diagnosis of Chronic obstructive bronchitis. Emphysema NAM I. Obliterating atherosclerosis of vessels of lower extremities II senior Osteochondrosis of the cervical spine. Atherosclerosis of cerebral vessels Art. I
|Group||Values PSOF, M±m||P|
|Persons with PFN-I Art. n=22||1174±22||<0.001|
|Persons with PFN-II Art. n=25||1617±29||<0.001|
|Persons with PFN-III Art. n=21||2172±43||<0.001|
After conducting functional studies and determine the weights of indicators for further calculations we used the following: heart rate (HR), the values of systolic (SBP) and diastolic (DBP) blood pressure, vital capacity (VC), the duration of the breath is the breath (SDD) and exhalation (ZDV), eographically index (RI) of the blood vessels of the legs, feet and back of the head, the rate of dynamometry (DM) both brushes, body weight (MT) (see table 3).
Conclusion: Based on the calculated values PSOF and in accordance with the proposed ranges of estimates, the woman 63 years you can set III the severity of PPHN, men 65 years of age - first degree.
The severity installed polyfunctional violations should be taken into account when making clinical and functional diagnosis of medical-social examination of elderly patients.
1. Zavialov, A.V. Perspective the use of integral indicators of the system organization of physiological functions to assess the functional state of operating in the conditions of influence of production factors. / Avishalom, All, Viglacera, Antares. - Sat. scientific papers on selected issues of medicine. Scientific research, creativity and memory. Kursk, 1999. Pp.5-36.
2. Practical geriatrics / Ed. by Prof. Lublanka. - M., 2002.
3. Angles, B.A... fundamentals of statistical analysis and mathematical modeling in biomedical research. / Baglow,. Hepatalgia, Mwhaa - Samara. - 1994. - 67 C.
The way to define the population of severity polyfunctional failure in the elderly with polymorbidity, which consists in registration of the functional parameters of various systems: cardiovascular, respiratory, autonomic and muscular, characterized in that the calculated deviation of the absolute values of each of the studied parameters (X1from normative values (X0)whose values for each indicator selected from table 1, then compute the variance of the indicator function of the normalized values (%), assuming that X0equal 3δ 100% corresponds to the variable, and then calculate the index of stability of the system organization functions (PSSI), which is equal to the sum of the squared deviations of all the relative values of the studied parameters are related to the number of parameters and the value PSOF less than 920 determine the relative norm, PSOF from 920 up to 1380 - I severity of polyfunctional failure, PSOF from 1380 until 1840 - II degree, PSOF more 1840 - III degree.
SUBSTANCE: method involves carrying out infrared saliva spectroscopy and determining mean values of infrared radiation pass band in frequency ranges of 3085-2832 cm-1, 2120-1880 cm-1, 1600-1535 cm-1, 1543-1425 cm-1, 1430-1210 cm-1, 1127-1057 cm-1. Mean value in the range of 1600-1535 cm-1 being greater than 35.9, in the range of 1543-1425 cm-1 being greater than 57.9, in the range of 1430-1210 cm-1 being greater than 54.5, compensated chronic tonsillitis is considered to be the case. The mean value in the range of 1600-1535 cm-1 being less than 32.5, in the range of 1543-1425 cm-1 being less than 65.2, compensated chronic tonsillitis is to be diagnosed. The mean value in the range of 1600-1535 cm-1 being less than 35.9, in the range of 3085-2832 cm-1 being greater than 72.8, compensated chronic tonsillitis is to be diagnosed. The mean value in the range of 1600-1535 cm-1 being less than 35.9, in the range of 1127-1057 cm-1 being greater than 51.7, compensated chronic tonsillitis is to be diagnosed. The mean value in the range of 1600-1535 cm-1 being less than 35.9, in the range of 2120-1880 cm-1 being greater than 79.7, compensated chronic tonsillitis is to be diagnosed. The mean value in the range of 1600-1535 cm-1 being less than 35.9, in the range of 2120-1880 cm-1 being less than 79.7, decompensated chronic tonsillitis is to be diagnosed.
EFFECT: high reliability and simplicity of differential diagnosis.
SUBSTANCE: method involves fills questionnaire in early postoperative period according to scheme 1, doctor builds a map for estimating life quality of surgical patient in early postoperative period according to scheme 2 using the obtained data. Next to it, clinically significant changes are determined between control points on the map according to scheme 2. The changes being 5-10 points heavy, weakly expressed differences are found to be the case. The value being 10-20 points heavy, the differences are found to be of moderate severity degree. The value being greater than 20 points, the differences are found to be of marked severity in the early postoperative period.
EFFECT: high accuracy in determining general life quality dynamics.
FIELD: veterinary medicine.
SUBSTANCE: method involves separating oviduct from uterus. The oviduct is plunged into reservoir filled with liquid. Air is introduced with overpressure through oviduct infundibulum. Oviduct obstruction is estimated from air discharge rate from the uterine end and pressure drop degree.
EFFECT: high accuracy of diagnosis; simplified instruments used.
1 dwg, 1 tbl
FIELD: medicine; medical engineering.
SUBSTANCE: method involves creating electrostatic field around human body. Field intensity is to provide luminescence of cotton fabric in front of biologically active points having increased electric conductivity. Luminous sites positions are fixed relative to human body outline in dark chamber on the background of illuminated screen. The positions are compared to biologically active point pattern maps. The luminous cotton fabric areas are filmed with digital photographic apparatus or video camera. The luminous cotton fabric areas positions comparison to biologically active point pattern maps is carried out by fitting map scales and superimposing the images. Biologically active points of increased electric conductivity are determined from four sides. Device has dark chamber, electrodes, constant voltage source, unit for moving positive electrode, unit for fixing luminous cotton fabric areas and highlightable background screen. The screen is positioned at a distance from the positive electrode to have enough space for placing human body.
EFFECT: high speed in determining meridian states of biologically active points on human body.
11 cl, 1 dwg
SUBSTANCE: method involves applying chromato-mass-spetrometric techniques for determining small and large intestine bioptate fatty acids content. The number of microbial cells is determined from chromato-mass-spetrogram peak areas. The calculated proportions are interpreted for diagnosing irritated intestine syndrome.
EFFECT: high accuracy of diagnosis.
SUBSTANCE: method involves applying computer-aided processing of general plan survey X-ray films with one or several zones of interest being detected on digitalized image corresponding to the number of osteogenesis foci. Quantitative osteogenesis intensity estimate is obtained by applying test grid and interpreting ratio of areas corresponding to distraction regenerate mineralization degree. Boundaries are determined in each zone of interest for delimiting intensity ranges characterizing tissue mineralization degrees at osteogenesis stages and reference points are marked. The first reference point is selected on proximal bone fragment end turned to diastasis. Lower boundary line of the proximal test grid, composed of parallel lines being perpendicular to long bone axis, is superposed with the first reference point. The second one is selected on distal bone fragment end turned to diastasis and the upper line of the distal test grid is superposed with it. Every region belonging to a zone of interest confined by neighboring test grid lines is segmented within the scope of established boundaries into intensity ranges and intensity range area shares in the total area of each region belonging to zone of interest. The intensity range area share proportions are used for estimating osteogenesis intensity.
EFFECT: wide range of functional applications.
FIELD: medicine, stomatology.
SUBSTANCE: in patients with defects of dental rows one should conduct masticatory testing, masticatiography and registration of somatoautonomic values (arterial pressure, heart rate) simultaneously before, during and after the end of orthopedic therapy to calculate the index of adaptive effect of masticatory system that characterizes the profitable ness of masticatory system. Due to comparing the values of the index of adaptive effect of the system with average values of efficiency optimum for different types of prostheses one should evaluate the result of orthopedic therapy and adaptational body capacities to plan further rehabilitation measures. The innovation enables to obtain objective evaluation of masticatory functional activity in patients in the process of orthopedic therapy.
EFFECT: higher efficiency of evaluation.
2 ex, 2 tbl
FIELD: medicine, obstetrics.
SUBSTANCE: the present innovation deals with predicting disadaptive processes in women in dynamics of menstrual cycle. During menstrual cycle beginning since the 1st d to the 21st d one should detect the dynamics for alteration in coefficient of activity of syntoxic adaptation programs (CASAP), calculated by the following formula:
where CST - concentration of blood serotonin, AAT-III - activity of antithrombin III, Aaoa - total antioxidizing activity of plasma, CCD8 + - concentration of T-suppressors, Cad - concentration of blood adrenalin, Cα2MG - concentration of α2-macroglobulin, CMDA - concentration of malonic dialdehyde, CCD4 + - concentration of T-helpers. Moreover, normally CASAP value alters two-fold against the first day of the cycle - since 0.70 up to 1.40 on the 21st d of the cycle, at no alterations in CASAP value one should diagnose female disadaptive alterations leading to failed pregnancy. The innovation enables to perform diagnostics of disadaptive processes in women in dynamics of menstrual cycle followed by prognostic conclusion upon future pregnancy.
EFFECT: higher accuracy of diagnostics.
FIELD: medicine, oncourology.
SUBSTANCE: one should choose the number of points for biopsy : 1 point of biopsy/5 cu. cm of an organ, then it is necessary to detect the portion of cancerous parenchyma in bioptates in percentage morphometrically due to analyzing of not less than 1000 points minimum in 5 sections of preparation, the volume of cancerous parenchyma in an organ should be detected by the following formula:
where X - average value for the portion of cancerous parenchyma in an organ, in %; ΣA - the portion of cancerous parenchyma in bioptate in %; N - the number of bioptates. The present innovation enables to detect cancerous parenchyma both in case of interrupted and diffused forms of prostatic cancer.
EFFECT: higher accuracy of detection.
1 dwg, 3 ex
FIELD: medicine, pathological anatomy.
SUBSTANCE: the present innovation deals with detecting viability in neonatals of 22-27-wk-long gestation, at their body weight up to 1 kg based upon evaluation of thymic morphological maturity. Moreover, in 10 visual fields in medullary substance in thymic lobules one should calculate the content of Hassal's bodies and reticuloepithelial cells. If the content of reticuloepithelial cells is above 10 and Hassal's bodies - above 2 one should consider a neonatal to be a viable one, at the content of reticuloepithelial cells being below 9 and Hassal's bodies - below 2 - as nonviable one. This method enables to detect quantitative criteria in evaluating the viability in neonatals at extremely low body weight by thymic state for the first time, helps to increase accuracy and simplify pathologoanatomical diagnostics of viability and objectively evaluate tactics and purposefulness of resuscitation procedures.
EFFECT: higher accuracy and efficiency of evaluation.
3 ex, 1 tbl
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.