Method for predicting osseous fractures in rheumatoid arthritis-suffering women
FIELD: medicine, therapy, rheumatology.
SUBSTANCE: one should detect mineral density of bony tissue in lumbar vertebral department, in column femoris; from patient's life anamnesis one should detect risk factors for osseous fractures: duration of menopause, duration and index of disease severity degree, systemic manifestations of rheumatoid arthritis (RA), solitude, dosage and duration for the intake of glucocortico-steroid (GCS) preparations to establish their gradations and digital values: no risk factor - the sign has got digital value "0", if risk factor is available - "1". Then it is necessary to detect prognostic coefficients F1 and F2 by the following formulas: F1 = -38.72 - 7.27*X1 + 9.77*X2 + 6.30*X3 +4.25*X4 + 7.41*X5 + 9.66*X6 + 32.97*X7 + 3.62*X8 + 8.96*X9 + 38.04*X10 - 0.55*X11 - 0.50*X12; F2 = -5.41 - 4.32*X1 + 3.22*X2 + 2.91*X3 + 3.28*X4 + 3.24*X5 +3.93*X6 + 7.43*X7 +1.35*X8 + 1.08*X9 + 9.07*x10 - 0.11*X11 - 0.19*X12, where X1-12 - gradations and digital values of risk factors (X1 - age is above 45, X2 - postmenopause is above 5 years, X3 - RA duration is above 10 years, X4 - severity degree index is above 5 points, X5 - RA systemic manifestations, X6 - solitude, X7 - intake of GCS preparations is above 2 years, X8 - cumulative dosage of GCS is above 5000 mg, X9 - mineral density of bony tissue in lumbar vertebral department by T-criterion is below -2.5, X10 - mineral density of bony tissue in collum femoris by T-criterion is below -2.5, X11 - mineral density of bony tissue in collum femoris is below 0.700 g/sq. cm, X12 - mineral density of bony tissue in lumbar vertebral department is below 0.900 g/sq. cm). At F1≥F2 one should predict high risk for fracture possibility, and at F1<F2 - low risk for fracture chance. The innovation enables to take into consideration the sum of common and specific risk factors.
EFFECT: higher accuracy of prediction.
4 ex, 1 tbl
The present invention relates to medicine, namely to therapy and rheumatology, and can be used to predict fractures in women with rheumatoid arthritis and no clinical signs of osteoporosis.
Osteoporosis is one of the most common metabolic diseases of the skeleton, which is manifested by a decrease in bone mass and impaired microarchitecture bones, which leads to increased brittleness of the bones and, accordingly, increases the risk of fractures [Guide to osteoporosis. Edited Benevolensky LI - M.: BINOM. Knowledge laboratory, 2003. - P.10].
It is known that among patients with rheumatic diseases, the frequency of osteoporosis is higher. So, J.Hooyman notes that the relative risk of fractures in rheumatoid arthritis increased in 1,5-2,5 times [Hooyman J.R., Melton L.J.III, Nelson A. M., O'fallon W.M., Riggs B.L. Fractures after rheumatoid arthritis: a population-based study. Arthritis Rheum. - 1984. No. 9. - P.1353-1361].
A known method for predicting the development of secondary osteoporosis and bone fractures in women suffering from rheumatoid arthritis, including the identification of risk factors - receiving glucocorticosteroid (GCS) drugs in postmenopausal women [Zotkin EVGENIY Osteoporosis in certain rheumatic diseases: Dis...Dr. med. Sciences: 14.00.05/St. Petersburg Academy of Sciences. the honey. Academ. policyplan. education. M., 2002. - P.113-114].
In this way to OC the NCI impact SCS therapy on the development of compression fractures conduct logistic regression analysis, which showed that the risk of vertebral fractures in women with rheumatoid arthritis who took corticosteroids therapy for more than 12 months, was to 3.67 times higher than in the group of patients who have never taken the SCS.
The disadvantages of this method include the fact that the influence of only one stand-alone risk factor for fractures - admission GCS and not taken into account the interaction between other risk factors.
Closest to the present invention is a method for predicting the development of osteopenic syndrome and bone fractures in patients with rheumatoid arthritis, including ultrasonic measurement of bone density in the calcaneus and the experimental selection of polynomial regression models, reflecting the dynamics of changes in bone mass by T-criterion depending on age [Zotkin EVGENIY Osteoporosis in certain rheumatic diseases: Dis... Dr. med. Sciences: 14.00.05 / St. Petersburg Academy of Sciences. the honey. Academ. policyplan. education. M., 2002 - S-98].
According to who recommendations the diagnosis of osteoporosis was determined by T-test (variance of BMD from peak bone mass in healthy young adults), which should be less of-2.5 SD (standard deviations), osteopenia from 1,0 to SD and 2.5 SD [Guide to osteoporosis. Edited Benevolensky LI - M.: BINOM. Knowledge laboratory, 2003. - S-140]. For Nord who have adopted mineral bone density (BMD) above - 1,0 SD.
The sensitivity of the progression of osteoporosis in this method of forecasting with such risk factors as disease duration of RA, is 63,6%.
The disadvantages of this method include low accuracy of the prediction of the development of bone fractures, because the method is based on the analysis of two risk factors - mineral bone density (BMD) in combination with the woman's age, a patient with rheumatoid arthritis.
The disadvantages of this method should also include the use of ultrasound is called, the accuracy of which is much lower than x-ray. So, the work of a number of authors have shown that the results of ultrasound densitometry of the calcaneus may not be used as a predictor of bone fractures [A. Massie, D.M. Reid et al. Screening for osteoporosis: Comparison between dual energy x-ray absorptiometry and broadband ultrasound attenuation in 1000 perimeno-pausal women.//Osteoporosis Int., 1993; 3: 107-110].
The task of the invention is to develop a predictor of bone fractures in women with rheumatoid arthritis who do not have clinical manifestations of osteoporosis.
The technical result of the proposed method is to improve the accuracy of prediction of the risk of bone fractures in women with rheumatoid arthritis taking into account a set of General and specific risk factors.
the Technical result of the proposed method is achieved by the prediction of bone fractures in women with rheumatoid arthritis (RA), includes the determination of mineral bone density in the calcaneus and the establishment of the age of the patient.
The difference lies in the fact that further define the mineral bone density in the lumbar spine, in the neck of the femur, identify risk factors for fractures of the history of life (duration of menopause, duration and severity index disease, systemic manifestations of RA, loneliness, acceptance, dose and duration of intake glucocorticosteroid (GCS) drugs), establish their grades and numeric values, and then determine the prognostic factors F1and F2by the formulas:
respectively, where X1-12- grades and numerical values of risk factors (X1- age greater than 45 years, X2- more than 5 years postmenopausal, X3- duration RA for more than 10 years, X4the severity index is greater than 5 points, X5- systemic manifestations of RA, X6- loneliness, X7- receiving corticosteroids for more than 2 years, X8- the cumulative dose of corticosteroids more than 5000 mg; X9- mineral bone density in the lumbar spine T - criterion of less -2,5, X10mineral tightly the th bone in the neck of the femur by T-criterion of less -2,5; X11- mineral density of bone tissue in the neck of the femur less 0,700 g/cm2X12- mineral bone density in the lumbar spine less to 0.900 g/cm2). When the numerical values of F1≥F2predict a high risk, and a value of F1<F2- low risk of fracture in women with rheumatoid arthritis who do not have clinical manifestations of osteoporosis.
Comparative analysis of the proposed method and the prototype showed that the proposed method differs from the known fact that to determine the impacts of aggregate both shared with specific due to rheumatoid arthritis, risk factors for fracture: age of women older than 45 years, the duration of postmenopause more than 5 years, duration of rheumatoid arthritis for more than 10 years, the severity index for rheumatoid arthritis more than 5 points, systemic disease, loneliness, the duration of the administration of corticosteroids for more than 2 years, the cumulative dose of corticosteroids for more than 5,000 mg, T-criterion in the L2-L4 less -2,5, T-score at the femoral neck less than - 2.5, the BMD in the femoral neck less 0,700 g/cm2, BMD in L2-L4 less to 0.900 g/cm2.
Establish grades and numerical values of risk factors, then expect prognostic factors F1and F2on visa evidendy formulas. When F1≥F2 predict a high risk of fractures, when F2>F1the risk of fracture is low.
Thus, the proposed solution meets the criteria of the invention of "novelty."
The analysis of patent and literature the authors found that the proposed method has characteristics that distinguish it not only from the prototype, but also other technical solutions in this and related fields of medicine.
In the available literature we found no way of forecasting the development of fractures in rheumatoid arthritis, taking into account the totality of General and specific risk factors.
A set of techniques proposed method can improve the accuracy of the prediction of bone fractures in women with rheumatoid arthritis, by identifying the specific and General risk factors.
Thus, the proposed method meets the criterion of "inventive step".
A method for predicting bone fractures in women with rheumatoid arthritis, comprising the invention, is intended for use in health care. The implementation of its capabilities is confirmed as described in the application techniques and equipment. From the above it follows that the claimed invention meets the condition of patentability "industrial " use the ity".
The proposed method is as follows. According to the results of clinical, laboratory and radiological surveys and life history of the subject patient (rheumatoid arthritis) identify the established risk factors.
The activity of rheumatoid arthritis assessed according to a set of clinical (articular index of joint account) and laboratory signs (erythrocyte sedimentation rate in mm/h, hemoglobin level in g/l) at points [Ivanova N.M., Karataev CU and al. Clinical course variants of rheumatoid arthritis and the choice of method is the drug therapy//Clinical rheumatology. - 1994. No. 4. - S-28].
Radiographic stage of rheumatoid arthritis is determined by the classification of Steinbrocker, functional disorders of the joints are divided into 4 degrees of severity, depending on the ability to self-service, non-professional and professional activities [Rheumatic diseases: a Guide to internal medicine/ edited Vaasanai, Nvenue. - M.: Medicine, 1997. - S-284].
The severity index for rheumatoid arthritis set depending on x-ray stage, functional disability, disease activity, which is assessed in points [Ivanova N.M., Karataev CU and al. Clinical course variants of rheumatoid arthritis and the choice of method is medicamentosas therapy// Clinical rheumatology. - 1994. No. 4. - S-28].
Mineral bone density determined by x-ray two-photon absorptiometry apparatus DPX-JQ" company "Lunar" (USA).
To predict the development of fractures in patients with RA was applied the method of linear discriminant analysis. Using statistical criteria specified analysis revealed the most significant risk factors and determined the coefficients of the discriminant functions [Glanz S. biomedical statistics. 1999. - 459 S.].
As a result, the authors of the proposed method were selected significant features, the most distinguished group of patients with fractures from a group of patients without fractures.
The following table summarizes the characteristics of the signs and the coefficients of the discriminant functions.
The coefficients of the discriminant functions (K1j, K2j) and constants F1=-38.72 and F2=-5.41 established by the authors empirically (table 1).
|1. Age > 45 years||0-no, 1-||-7.27||4.32|
|2. Post-menopause >5 years||0-no, 1-||9.77||3.22|
|3. Duration PA>10 l is t||0-no, 1-||6.30||2.91|
|4. The severity index >5 points||0-no, 1-||4.25||3.28|
|5. Consistency PA||0-no, 1-||7.41||3.24|
|6. Loneliness||0-no, 1-||9.66||3.93|
|7. Admission GCS > 2 years||0-no, 1-||32.97||7.43|
|8. The cumulative dose of corticosteroids> mg||0-no, 1-||3.62||1.35|
|9. T-criterion in the L2-L4<-2,5||0-no, 1-||8.96||1.08|
|T-criterion in the femoral neck<-2,5||0-no, 1-||38.04||9.07|
|NOT in the femoral neck<0,700 g/cm2||0-no, 1-||-0.55||-0.11|
|NOT in L2-L4<to 0.900 g/cm2||0-no, 1-||-0.50||-0.19|
F1- for a group of patients with fractures. F2for the group of patients without fractures.
Constant for F1=-38.72; Constant for F2=-5.41.
The results of discriminant equations allow us to predict the development of fractures in women with rewma odnim arthritis.
If the value of F1≥F2that predict a high risk of fractures, when F2>F2the risk of fracture is low.
The proposed method is as follows.
From the anamnesis of life and patient with rheumatoid arthritis identifies the established risk factors. During the inspection determine articular index of joint account. Conduct laboratory studies to determine the level of hemoglobin and erythrocyte sedimentation rate. The apparatus of the digital x-ray graphy conduct examination of patients. On rentgenoradiometricheskim image determine the stage of rheumatoid arthritis according to the classification of Steinbrocker. Using a standardized questionnaire to determine the degree of functional disability. Then together clinical and laboratory data to calculate the severity index for rheumatoid arthritis. Conduct inspection apparatus DPX-JQ" company "Lunar" (USA). Acquired risk factors assign grades and numeric values. Then establish prognostic factors F1and F2compare their numerical characteristics and assess the risk of fractures.
The proposed method for predicting the development of fractures in women with rheumatoid arthritis, illustrated by examples of specific performance.
Patient N. born in 1945 surveyed in the osteoporosis Centre (CSC) in 2002. When interviewing the following risk factors: patient age older than 45 years (X1=l), duration of more than 5 years postmenopause (X2=l), duration of RA for more than 10 years (X3=1), the severity index RA of more than 5 points (X4=1), systemic RA (X5=1), X6=0, taking corticosteroids for more than 2 years, (X7=1), the cumulative dose of corticosteroids for more than 5,000 mg (X8=l), X9=0, the mineral bone density (BMD) T-criterion in the L2-L4 is less than - 2.5 in the neck of the femur (X10=1), BMD in femoral neck bone less 0,700 g/cm2(X11=1). X12=0
F1>F2, the risk of bone fractures is high. In 2003 at the age of 58 in a given patient has been a fracture of the left femur when falling from a height of around two meters.
Patient L., born in 1938 Surveyed in CSC 2002. The following risk factors for fracture: patient age older than 45 years (X1=1), duration of more than 5 years postmenopause (X2=1), duration of RA for more than 10 years (X3=1), the severity index of more than 5 points (X4=1), systemic RA (X5=1), BMD T-criterion in the spine less -2,5 (X9=1), BMD in the spine less to 0.900 g/cm2(X12=1).
F1<F2patient misses a high risk of fractures. With the re-examination in the MDGs and monitoring osteodensitometry in 2003, signs of secondary osteoporosis have been identified.
The patient Was Surveyed in 2001. born in 1950, Established the following risk factors for osteoporosis: patient age over 45 years (X1=1), duration of more than 5 years postmenopause (X2=1), duration of RA for more than 10 years (X3=1), systemic RA (X5=1), loneliness (X6=1), corticosteroids for more than 2 years, (X7=1), BMD T-criterion of less than - 2.5 in the neck of the femur (X10=1), BMD in femoral neck bone less 0,700 g/cm2(X11=1).
Fi>F2the risk of fractures, the patient is high. In 2003, there was a spontaneous fracture of the ribs.
Patient L., born in 1963 Surveyed in 2002. The following risk factors for secondary osteoporosis: a disease duration of more than 10 years, (X3=1), systemic manifestations (X5=1), BMD T-criterion in the spine less -2,5 (X9=1), BMD in the spine less to 0.900 g/cm2(X12=1). X1,2,4,6.7,8,10,11=0
F1<F2the risk of fracture is low. With the re-examination in the MDGs and monitoring osteodensitometry in 2003, signs of secondary osteoporosis have been identified.
Monitoring of patients with RA was carried out in 2000 in the Irkutsk regional center for prevention of osteoporosis. Evaluation of the effectiveness of the proposed method of forecasting was conducted in a group of 126 women, patients with rheumatoid arthritis, the accuracy of prediction was 85.5%. In a group of 58 women with rheumatoid arthritis and secondary osteoporosis correct recognition was 100%.
The proposed method for forecasting allows you to select among patients with rheumatoid arthritis of persons at risk of developing fractures, which makes it possible for individual early treatment and preventive measures. On the basis of the prediction system can be implemented a strategy to prevent the development of secondary osteoporosis and bone fractures in patients with rheumatoid arthritis.
A method for predicting bone fractures in women with rheumatoid arthritis (RA), which includes the determination of bone density and age of the patient, characterized in that further define the mineral bone density in the lumbar spine, in the neck of the femur, sananes life identify the risk factors of fractures: the duration of menopause, the duration and severity index disease, systemic manifestations of RA, loneliness, dose and duration of intake glucocorticosteroid (GCS) drugs, establish their grades and numeric values, namely: there is no risk factor - sign assigns the numeric value "0", "1", and then determine the prognostic factors F1and F2by the formulas:
respectively, where X1-12- grades and numerical values of risk factors, and X1- age greater than 45 years, X2- more than 5 years postmenopausal, X3- duration RA for more than 10 years, X4the severity index is greater than 5 points, X5- systemic manifestations of RA, X6- loneliness, X7- receiving corticosteroids for more than 2 years, X8- the cumulative dose of corticosteroids more than 5000 mg; X9- mineral bone density in the lumbar spine T-criterion of less - 2,5, X10- mineral density of bone tissue in the neck of the femur by T - criterion of less -2,5; X11- mineral density of bone tissue in the neck of the femur less 0,700 g/cm2X12- mineral bone density in the lumbar spine less to 0.900 g/cm2and when F1≥F2predict high risk, and a value of F1<F2 - low risk of fracture.
SUBSTANCE: the present innovation deals with radionuclide diagnostics of any inspecific inflammatory processes of motor system. Moreover, it deals with intravenous injecting 199Tl-chloride followed by planar scintigraphy and visual detection for the area of its increased accumulation. Moreover, 199Tl-chloride should be injected in the dosage of 5.0 mCi, planar scintigraphy should be performed polypositionally and according to maximal value ER obtained 20 min after intravenous injection of 199Tl-chloride and corresponding to counterlateral area one should diagnose the presence and local activity of inflammatory process. In the wrist, in the foot, in the forearm at ER being below 1.21 - no inflammation should be detected, at ER ranged 1.21-2.69 - inactive inflammatory process should be detected or its subacute or chronic phase, at ER being above 2.69 - active inflammatory process, acute phase should be determined. In hip joint, femur, shin and scapula at ER ranged 1.07-2.31 - inactive inflammatory process, subacute or chronic phase, at ER being above 2.31 - active inflammatory process and acute phase should be detected. The present innovation enables to apply new scintigraphic differential-diagnostic criteria of inspecific inflammatory processes of motor system.
EFFECT: higher diagnostic efficiency of scintigraphy.
FIELD: medical equipment, in particular, instruments of radiocontrolled surgery, applicable for detection of malignant tumors.
SUBSTANCE: the hand probe for local radiometry has a detector of gamma radiation, having a photodetector, optically conjugate to a scintillator and a collimator, fastened on a handle with an electric wire passing inside it, which connects the detector of gamma radiation to a connector installed in the base of the handle. It is also provided with a second detector of gamma radiation fastened on a dial, whose axle passes through the optical axis of the second gamma detector, the optical axes of the two detectors of gamma radiation are in the plane passing perpendicularly to the dial axle, and the dial zero readout is positioned on a straight line parallel with the optical axis of the first detector. Besides, the hand probe has a dial turning mechanism and an angle-of-turn indicator.
EFFECT: enhanced aiming of delivery of the surgical instrument.
4 cl, 6 dwg
FIELD: medicine; cardiology.
SUBSTANCE: perfusion scintigraphy of lungs is conducted for patients having complaints, which provide lower or medium clinical possibility of thromboembolism of lung artery. In case the perfusion defects are found, anticoagulant therapy is prescribed. In 5 to 6 days after the therapy is over, the perfusion scintigraphy is carried out once more and percentage of scintillation count is determined in symmetrical areas above the lungs. If scintigraphy is more significant at the side of damage is equal or 10-15% bigger than initial value, the thromboembolism of small branches of lung artery is diagnosed.
EFFECT: improved precision; improved truth of diagnostics.
1 ex, 2 dwg
FIELD: medicine, orthopedics.
SUBSTANCE: one should perform clinical survey of a patient to detect the density of mineral substances in the caput, in area of epiphyseal growth and, also, in the upper and the lower departments of column femoris. In case of available functional disorders in patient's hip joint and corresponding density of mineral substances in all the points under testing one should diagnose osteochondropathy of hip joint.
EFFECT: earlier diagnostics of pathological process.
4 dwg, 2 ex
FIELD: medicine; X-ray computer tomography.
SUBSTANCE: headrest can be used for imparting necessary position to head of patient laid onto horizontal surface. Headrest has head support provided with rotary-fixing unit which provides lifting and lowering, and lean plate attached to table. Rotary sector provided with radius groove is mounted between head support and lean plate. Rotary-fixing unit of head support is mounted onto turning sector by means of arms. Sector is mounted for movement for angle of 0-45 ° to the left or to the right relatively horizontal axis within radius groove. Scale for measuring angle of turn is drawn onto external side of rotary sector. Lean plate is provided with rod having thread which rod enters radius groove of rotary sector. Nut is put onto rod with thread which nut fixes rotary sector to lean plate.
EFFECT: widened diagnostic abilities of computer tomography tests.
SUBSTANCE: method involves applying flexible dental cappa plates having built-in radiopaque net set congruently to gingiva contour when being manufactured, and radiopaque thread placed on dental pocket bottom around teeth under study. Mesh diameter is equal to 1 mm. Several dental pocket depth values are measured. Total failure scale in periodontium is determined from formula CP=(D1+D2+…+Dn)/(L1+L2+…+Ln)*100%, where CP is the periodontium destruction degree, D1,D2,…Dn mean depth of each bone pocket in mm, L1,L2,…Ln is the total length of tooth root in mm. CP value being below 20%, I degree periodontium failure is diagnosed. The value being from 20 to 50%, II degree periodontium failure is diagnosed. The value being higher than 50%, III degree periodontium failure is diagnosed.
EFFECT: high quality of diagnosis.
FIELD: medical equipment.
SUBSTANCE: medical x-ray cassette belongs to cassettes with amplifying x-ray screens. Universal cassette has case made of sheet material. Case is provided with front and back caps. Front and back amplifying screens sensitive in green range of spectrum are mounted inside the case for placing x-ray film between them; the film has two-sided emulsion layer. Front amplifying screen is made to be sensitive in blue range of spectrum. Linear ration of amplifying influence of the screens depends on power of x-ray radiation.
EFFECT: improved sensitivity of x-ray photos within the whole range of energy of x-ray radiation.
3 cl, 2 dwg, 2ex
SUBSTANCE: method involves carrying out topographic examination and topographic parameters estimation. Segmental kinematical analysis is carried out. The kinematical parameters estimation is carried out allover the whole deformed vertebral column length from a formula: CAA+ AAA +CVA+SGSA+CADS+CADF x10=the number of points, where CAA is the central angle adjustment of basic deformity arc in percents, AAA is the apical angle adjustment of basic deformity arc in percents; CADF is the absolute value of corps axis deviation in frontal plane from vertical axis after operation; CVA is the chest volume asymmetry as difference before and after correction in mm3; SGSA is the shoulder girdle spread angle relative to pelvis as difference before and after correction in degrees; CADS is the absolute value of corps axis deviation in sagittal plane after operation in degrees. Points are assigned to the parameters. Sum of the points being greater than 100, the result is evaluated as excellent; the value being equal to 99 to 50, the result is evaluated as good, 49 to 25, the result is evaluated as satisfactory, less than 25 as unsatisfactory.
EFFECT: high accuracy and objectiveness degree.
SUBSTANCE: method involves scanning X-ray picture with a scanner. Optical density difference is determined between fracture place and cortical layer thereof. The value being equal to 1.0-1.2, finished consolidation is concluded to be the case. The value being equal to 1.21-1.8, sufficient consolidation is concluded to be the case. The value being equal to 1.81-2.0, insufficient consolidation is concluded to be the case. The value being greater than 2.0, no consolidation is to be diagnosed.
EFFECT: high objectivity in evaluating consolidation quality.
2 dwg, 2 tbl
FIELD: medical engineering.
SUBSTANCE: device has casing manufactured from rigid light-impermeable material containing light-emitting member inside for illuminating viewer screen fixed in lateral casing window and provided with image locker units. The light unit has matrix-type modulator optically coupled with the viewer screen via objective and mirror. The modulator operation is controlled with digital processor unit connected to unit for controlling image position and image brightness distribution on the viewer screen mounted on the external casing side. The digital processor unit has desk for controlling operation modes.
EFFECT: enhanced effectiveness of X-ray diagnostics quality control.
5 cl, 2 dwg
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.
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, 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