Method for predicting serous meningitis outcomes in children
SUBSTANCE: method involves making lumbar puncture and measuring liquor pressure, taking pleocytosis into account, making ultrasonic transcranial Doppler flowmetric examination of brain, determining linear blood circulation speed on interior carotid artery and posterior cerebral artery, detecting intracranial venous discharge disorders through orbital and vertebral veins. Regression coefficient is calculated from a formula
where X1 is patient age (in years); X2 is the pleocytosis in the first lumbar sample (in cells number per 1 mcl of liquor); X3 is the meningitis symptoms duration (in days); X4 is the focal symptoms availability (1- yes, 0- no); X5 is the general cerebral symptoms duration (in days); X6 is the liquor pressure when taking the first lumbar puncture (in mm of mercury column); X7 is the linear blood circulation speed in interior carotid artery (in Hz/s); X8 is the linear blood circulation speed in posterior cerebral artery (in Hz/s); X9 is the intracranial venous discharge disorders based on ultrasonic transcranial Doppler flowmetric examination data; retrograde discharge through orbital veins, increased one through vertebral veins and others (1- yes, 0- no). Value of y≤0.5, unfavorable outcome is to be predicted with cerebroasthenic, asthenoneurotic and hypertension syndromes being formed. If y>0.5, favorable infectious process outcome is to be predicted.
EFFECT: high accuracy of diagnosis.
The invention relates to medicine, namely to diagnosis. Determination of the nature of the disease and early prediction of outcome of serous meningitis allows you to optimize therapy to reduce the severity of neurological disorders at all stages of the infection process.
Serous meningitis are common lesions of the Central nervous system, the frequency of which in the structure of the CNS reaches 25-30%. Children and adolescents constitute elm), 65-78% among patients with serous meningitis. In the age structure of serous meningitis in children predominantly (55-75%) are over the age of 8 years, compared with children up to 3 years (5-10%). Currently, there is an increase in patients under the age of 3 years (8-10%) compared with previous years (3-5%). In recent years there has been an increase in the incidence of serous meningitis, in the etiology of which are not only viruses: enteroviruses, herpes viruses, West Nile virus, HIV, and others, but also bacteria, such as tuberculosis coli, Leptospira, Borrelia burgdorferi, Ehrlichia. Healthy after suffering serous meningitis remain 30-62% of patients. The outcome of the disease is described mainly zerebrasteniceski (39-45%), neurasthenic (12-30%) and hypertensive (8,6-12%) syndromes. Zerebrasteniceski and asthenoneurotic the ical syndromes occur in the early period of convalescence, 2-3 week of illness. The symptoms disappear for 8-12 month after suffering meningitis. Possible transformation Serebryanicheskaya syndrome in hypertensive syndrome after 1-3 months in 5-16% of patients, focal brain damage 3-7%, epilepsy 1-3%. Hypertensive syndrome occurs in 15-35% in residual period of serous meningitis, in 2/3 of the cases occurs a month after the illness, in 1/3 of cases 3 months, mostly diagnosed in older children. Long liquidynamics violations have a damaging effect on the optic nerve, causing venous congestion or atrophy of the optic nerve papilla on the inner ear, forming a sensorineural hearing loss. Diencephalic syndrome after suffering serous meningitis develops after 3 months after suffering serous meningitis, lasts for years 2-4,5% recovered. In 1-5% recover focal CNS and epileptiform seizures occur 6 months after suffering serous meningitis.
In this regard, there is no doubt the need for accurate prediction of the outcomes of serous meningitis in children in the early stages of the disease to improve outcomes through the application of differential treatment.
Known conventional schemes predicted what I outcomes of serous meningitis (Gadimova M.A., Protosevich P.M. Acute serous meningitis and encephalitis in children. - Leningrad. - 1974. - p.55-58; Fomin V.V. and other Enterovirus neuroinfections in children. - Yekaterinburg. - 1991. - p.92-96) is that the possibility of residual increases in severe disease, increasing of the period of restoration of the liquor, is determined by the state of cellular immunity. This method of forecasting outcomes of serous meningitis is lengthy and expensive. When serous meningitis important early diagnosis outcomes, as early and adequate therapy reduces the risk of residual effects.
There are predictions of outcomes of neuroinfections by examining EEG and transcranial dopplerography (rosin Y.A. Dissertation on competition of a scientific degree of the doctor of medical Sciences. Bioelectric activity and hemodynamics of the brain in acute CNS in children: diagnostic criteria and prognosis of neurological complications. - Saint-Petersburg. - 1999. - p.153-171), comprising predicting the outcomes of meningitis and viral encephalitis in children using EEG and transcranial ultrasound dopplerography. The author using Doppler and electroencephalographic parameters assessed the outcomes of meningitis and viral encepha itov. When serous meningitis this method is not possible with sufficient accuracy to predict such residual violations zerebrasteniceski and neurasthenic syndromes, most commonly occurring in the outcome of serous meningitis.
In connection with the above, the technical result of the present invention is to improve the prediction accuracy, provided early diagnosis. This is achieved by using clinical assessment and ultrasound transcranial Doppler study of the cerebral vessels, the authors propose according to the method comprehensively to perform a lumbar puncture to measure CSF pressure, given pleocytosis, ultrasonic transcranial dopplerography of the brain, determine the linear speed of blood flow in the internal carotid and posterior cerebral arteries detect a violation of intracranial venous outflow by orbital and pozvonocnik veins, then calculate the formula of the mathematical model and whenpredicted a favorable outcome, and when- an unfavorable outcome. The model obtained by the method of logistic regression analysis statistically significant (p<0.0001)and reliable information (72%).
Using this model, the calculations can is to be made by the physician on the PC or on a programmable calculator in 3-5 days from the receipt of the patient to the hospital.
A significant contrast to the known methods for predicting outcome of serous meningitis is the fact that to determine the prognosis of disease outcome uses a combination of clinical and Doppler signs in the acute period of the disease, each of the signs receive a score on the basis of the obtained formula calculates the regression coefficient, which significantly improves the forecasting accuracy. The present method put we established the fact that none of the previously used signs, including signs, based on the assessment of clinical symptoms, data, research tools, in itself, is not sufficient to reliably predict the outcome of serous meningitis. Only their combined assessment gives an accurate prediction of outcome in the early stages of the disease. 32 we analyzed the characteristics most important for determining the outcome of the disease was 9 characteristics, the correlation coefficient was (r)>2,5 (p<0,05). For the convenience of mathematical processing all the children were divided into 2 groups: 1 - the favorable outcome (n=48), 0 - negative (n=76). The correlation coefficient was calculated using equation coefficient using the SPT EXEL and the most important among them were:
|The characteristics included in the model.|
|Designation in the model||Signs|
|X1||The patient's age (years)|
|X2||Placitas at the first lumbar puncture (CL/1 µl CSF)|
|X3||The duration of meningeal symptoms (in days)|
|X4||The presence of focal symptoms (1 -, 0 - no)|
|X5||Duration cerebral symptoms (in days)|
|X6||Spinal fluid pressure at the first lumbar puncture (mm Hg)|
|X7||The linear speed of blood flow in the internal carotid artery (in Hz/sec)|
|X8||The linear speed of blood flow in the posterior cerebral artery (in Hz/sec)|
|X9||Violations of intracranial venous outflow USTDV brain: retrograde blood flow through the ophthalmic veins, increased blood flow in the veins of a vertebrate, etc. (1 - available, 0 - no)|
|The correlation coefficient (r) (p<0,05)|
As can be seen from table 2, the outcome will have a direct influence of the age of the patient, Placitas, duration cerebral meningeal symptoms, the presence of focal symptoms, spinal fluid pressure. Diplomaticheskii indicators: linear speed of blood flow in the internal carotid artery, the violation of intracranial venous outflow, at the same time, the linear speed of blood flow in the posterior cerebral artery has an inverse dependence on the outcome of the disease.
Using the formula logistic regression in the SPT NCSS 2000 mathematical model of the outcome of serous meningitis:
|The equation coefficients obtained using logistic regression analysis and their significance levels for the model|
|Sign||The model coefficients||The level of significance, p|
The offered method is as follows. At the time of hospitalization of the patient is performed lumbar puncture in the supine position on the right side, at the level of L4-L5on line Jacobi, under local anesthesia and aseptic conditions. With a measurement of spinal fluid pressure (in mm Hg), mm water column was transferred to mm Hg, as follows: 1 mm VODL=9,81 PA, 1 mm Hg=133 PA. Calculate pleocytosis in the cerebrospinal fluid normal Svetovid the microscope, the cells in 1 μl of CSF. Before lumbar puncture performed ultrasound transcranial Doppler study of the internal carotid and posterior cerebral artery using a pulse sensor at 2 M Hz at a depth of 60-80 mm, modified by the I angle sensor and the depth of the control volume are seeking the location of the maximum flow velocity and determine its value. Define impaired venous outflow brain by identifying the retrograde blood flow in the ophthalmic and vertebrate veins show increased blood flow in pozvonocnik veins (1 - available, 0 - no). Take into account the patient's age (years), duration of meningeal and cerebral symptoms in days.
The outcome of the patient is calculated by substituting the obtained data in the following formula:
When- a favorable outcome;- an unfavorable outcome.
The following examples perform a method of determining the outcome of serous meningitis in children.
Daniel U., 5 years, no history of the disease 3417, received 7.08.02 issued 26.08.02. Ds: Serous meningitis moderate form of enteroviral etiology (entero 70 of liquor from 8.08.02). Concomitant diagnosis: Herpes lobialis.
History of disease: ill 7.08.02 with severe headache, vomiting 2% amid severe headache, photophobia. The history of life: Growing and developing according to age, immunizations according to age, VCI in the hospital, the specialists were not observed, childhood infections was not sick, injury denies. Heredity and risk factors is not burdened. Complaints received at a severe headache, photophobia. When receiving SOS is the right moderate due to the symptoms of intoxication and severity of VCG. Meningeal symptoms positive, stiff neck+, symptom of Cernica+, the upper and lower symptoms Brudzinskogo+. Performed lumbar puncture 8/08: transparent liquor, liquor pressure of 9 mm Hg, lymphocytosis 18 cells in 1 μl of CSF protein has 0.168, lymphocytes 92%, neutrophils 8%, sugar 2.9 mmol/l, chlorides 115 mmol/L. the ultrasound transcranial Doppler cerebral blood vessels: blood flow in the carotid system normokinetic symmetric, signs of venous discirculatory no. (The linear speed of blood flow in the internal carotid artery 2 Hz/sec, the linear speed of blood flow in the posterior cerebral artery - 1,9 Hz/sec).
In the dynamics of observations obstipation syndrome was arrested on the 2nd day of hospitalization, meningeal and cerebral symptoms cropped the next day hospitalization. When re PL on the 17th day of hospitalization 23/08: lymphocytosis - 3 cells/ml, at the expense of mononuclear cells, protein - 0.06 g/l
The calculation was made of the likely outcome of the patient on the 3rd day of hospitalization:
- expected favorable outcome of the disease.
Issued on the 19th day of hospitalization with recovery during the follow-up monitoring within 1 year of the complaints, the child does not impose, neurological symptoms are not present. EEG age norm. The outcome of RA is valuable as a complete recovery.
Marina F., case history No. 2541, 14 years old, was admitted 30.04.2002, issued 2.06.02. The diagnosis of Mumps is a viral infection: serous meningitis+submaxima, severe; and concomitant diagnosis: vaccination against mumps from 12.04.2002 g (series 0860, 0.5 dose). Anamnesis morbi: pain in acute 29.04.2002, (on the 17th day after revaccination against the disease. mumps), with increasing temperature 39,1, vomiting up to 6 times. Diagnosed with SARS, meningitis? focused on admission to the Department of neuroinfection NEEDY. Complaints received at a severe headache, vomiting and fever. Objectively at entry: moderately grave condition due to symptoms of intoxication. Meningeal symptoms at admission questionable: the rigidity of the muscles of the nape+/-, other meningeal symptoms are not present. On day 2 of hospitalization (2.05.2002 g) meningeal symptoms clear: the rigidity of the muscles of the neck+, symptom of Cernica+. Increased muscle tone along the pyramidal type symmetrically, increased tendon reflexes symmetrical, coordinatorsee violations within 4 days. To exclude meningitis performed lumbar puncture: CSF transparent, spinal fluid pressure of 15 mm Hg, lymphocytosis 866 cells in 1 μl of CSF, mononuclear cells 65%, segmented 45%, protein 3.88 g/l, sugar 2.8 mmol/l, chloride 106 mmol/l Of liquor selected antigen of the virus of epidemic pairs is Titus. Found in the blood of antibodies of class Ig M and Ig G in saliva selected antigen mumps. Conducted transcranial Doppler cerebral vessels 2.05.02: blood flow in the carotid system normokinetic symmetric, retrograde blood flow through the ophthalmic veins, increased blood flow in the veins of a vertebrate. (The linear speed of blood flow in the internal carotid and posterior cerebral arteries - 2 Hz/s, the index of the circulatory resistance supraclavicular and anterior cerebral arteries - of 0.54 and 0.59 respectively, disorders of intracranial venous outflow - 1).
In the Department of child fever continues to subfebrile figures within 6 days. Meningeal symptoms were observed up to 5.05.2002, (6 days). On the 13th day of hospitalization, the 14th day of the disease (12.05.2002, appears submaxima more to the right, in connection with which the child transferred to the isolation ward. With repeated lumbar puncture on the 24 day 25 day of hospitalization diseases (23.05.2002,): lymphocytosis 62/3 by mononuclear 61/3, neutrophile 1/3 protein 0,265 g/L. In General, the analysis of blood for admission: stab shift 12%, neutrophiles 63%, erythrocyte sedimentation rate, white blood cells, red blood without features; currently the General analysis of blood within the age limit.
The calculation was made of the likely outcome of the patient on the 6th day of hospitalization:
- predicted poor outcome.
Issued on the 30 day of hospitalization in a satisfactory condition. During the follow-up observation of the child within 3 months were found to have symptoms of intracranial hypertension and asthenoneurotic syndrome, 6 months after discharge on EEG during hyperventilation paroxysmal activity of the cerebral cortex generalized character.
Yang B., 13 years old, no history of the disease 4386, received 2.10.02., discharged 16.10.02. The diagnosis of Serous meningitis enteroviral etiology (ECHO 6 of liquor from 3.10.), the intermediate form.
Complaints received at a severe headache, photophobia.
History of disease: ill 1.10 with severe headache, vomiting 5 times, photophobia.
The history of life: Growing and developing according to age, immunizations according to age, VCI in the hospital, the specialists were not observed, childhood infections chickenpox chickenpox, the concussion in 6 years. Heredity and risk factors is not burdened.
When entering a state of moderate severity due to the symptoms of intoxication and severity of intracranial hypertension. Meningeal symptoms slabopolozhitelnym, stiff neck±a symptom of Cernica+, the upper and lower symptoms Brudzinski is -.
Performed lumbar puncture 3.10: the liquor flowed transparent, under normal pressure of 7 mm Hg, lymphocytosis 67 cells in 1 μl of CSF due to mononuclear 60%, protein 0.3 g/l sugar in the liquor 3 mmol/l, chloride in the liquor 109 mmol/L.
Conducted transcranial Doppler ultrasound 3.10: the blood flow in the carotid system normokinetic, symmetric, signs of venous discirculatory no. (The linear speed of blood flow in the internal carotid artery and posterior cerebral artery: 2 Hz/sec).
Conducted EEG 7.10: moderate diffuse disorders of bioelectric activity with irritating of the cerebral cortex.
In the dynamics of observations obstipation and cerebral symptoms cropped on day 2 of hospitalization, meningeal symptoms cropped on the 3rd day of hospitalization.
Calculation of the likely outcome of the patient on the 4th day of hospitalization:
- predicted a favorable outcome.
Discharged on the 14th day of hospitalization with recovery. On follow up had no complaints, neurological status without features. EEG 6 months after discharge: age norm Exodus regarded as complete recovery.
Roman Century, 9 years old, no history of the disease 3806, received 1.09.02 issued 19.09.02. The diagnosis of Serous m is ningit, the intermediate form, enteroviral etiology (ECHO 15 of liquor from 2.09).
Complaints received at a severe headache, vomiting.
History of disease: Ill 28.08 with headache and fever up to 39.5°C. 29.08 temperature and feeling normal. 31.08 again raising the temperature up to 37.5°With headache. 1.09 severe headache, vomiting, body temperature 36,6°C.
The life history: life History: Grew and developed according to the age, immunizations according to age, VCI in the hospital, the specialists were not observed, childhood infections chickenpox - chickenpox, measles, rubella, infectious mononucleosis. Trauma and surgery denies. Heredity and risk factors is not burdened.
When entering a state of moderate severity due to the symptoms of intoxication and severity of intracranial hypertension. Meningeal symptoms slabopolozhitelnym, stiff neck±a symptom of Cernica+, the upper and lower symptoms Brudzinskogo-.
Performed lumbar puncture 2.09: the liquor flowed transparent, under high pressure of 16 mm Hg, lymphocytosis 108 cells in 1 μl of CSF due to mononuclear 77%, protein 0,165 g/l, sugar in the liquor 2.5 mmol/l, chloride in the liquor 106 mmol/L.
Conducted transcranial Doppler ultrasound 3.10: the blood flow in the carotid system is e normokinetic, symmetric, signs of venous discirculatory no. (The linear speed of blood flow in the internal carotid artery and posterior cerebral artery: 2 Hz/sec).
In the dynamics of monitoring cerebral symptoms cropped on day 1 of hospitalization, meningeal symptoms cropped on the 5th day of hospitalization. With repeated lumbar puncture: 16.09: liquor flowed transparent with normal pressure of 7 mm Hg, lymphocytosis - 6 by mononuclear 90%protein - a 0.1
Calculation of the likely outcome of the patient on the 4th day of hospitalization:
- predicted a favorable outcome
Issued on the 19th day of hospitalization with recovery.
On follow up had no complaints, neurological status without features. EEG 6 months after discharge: age norm. The outcome is regarded as complete recovery.
|The test of the proposed method compared with the real.|
|The group of patients||The prototype (people)||Real outcomes (people)|
|Patients with residual phenomena||62||76|
|Patients without residual effects||36||48|
In the group of patients with unfavorable outcome (n=76) investigated the model provides the coincidence of the predicted results with the actual in 81,6% of cases (62 of 76 cases). In the group with a favorable outcome (n=48); in the group of patients with a favorable outcome match the predicted outcomes and the actual was 75% (36 out of 48 cases). Statistical significance of the model is (p<0,0001), information accuracy of 72%.
This method allows after the relief of cerebral and meningeal symptoms to predict the possible outcome of the patient, which is an important factor in reducing the frequency of residual neurological effects after suffering serous meningitis by adequate therapy in the acute period, and at the stage of follow up.
A method for predicting outcomes of serous meningitis in children, including the assessment of the clinical and research vessels of the brain by ultrasound, transcranial Doppler, characterized in that to determine the patient's age in years (X1), Placitas at the first lumbar puncture in CL/1 µl of CSF (x2), duration meningeal symptoms in days (X3), presence of focal symptoms: 1 -, 0 - no (X4), duration cerebral symptoms in days (X5), measure the CSF pressure at the first l is malnoy puncture in mm Hg (X6), the linear speed of blood flow in the internal carotid artery in Hz/sec (X7), the linear speed of blood flow in the posterior cerebral artery in Hz/sec (8x), detect the presence of disorders of intracranial venous outflow vertebrate eye and veins: 1 - available 0 - no (X9), then calculates the regression coefficientaccording to the formula:
and whenpredict adverse outcome with the formation Serebryanicheskaya, asthenoneurotic and hypertensive syndromes, and whena favorable outcome of infection.
FIELD: medicine, oncology.
SUBSTANCE: one should cytologically study tumor punctate before therapy for the purpose to verify morphological diagnosis, smears should be restained by Felgen's technique to detect average values for the area of tumor cells nuclei in sq. mcm and DNA content in ploidy units (c) and ploidy value should be compared with a rated one calculated by the following formula: MD = 0.0357 MS. If ploidy value is below a rated one it is possible to predict favorable result of the disease, and if it is above a rated one - unfavorable result should be predicted.
EFFECT: higher accuracy of prediction.
1 dwg, 2 ex, 1 tbl
FIELD: medicine, parasitology.
SUBSTANCE: method involves centrifugation of blood sample, addition biologically active substance, proteolytic enzyme pepsine (trypsin), to a precipitate that is stained then with 1% methylene blue an aqueous solution. Among destroyed blood cells trichomonas cells of round and amoebiform and irregular form stained with blue-green color and brightly expressed and more intensively stained envelope are detected. Invention provides enhancing precision in detection of changed and atypical cells of protozoan by destroying lymphoid cells that are similar morphologically with protozoan cells.
EFFECT: improved detecting method.
SUBSTANCE: method involves filtering 5-8 ml of bronchial lavage sample taken from patient, cell suspension is filtered and precipitated with centrifuging at 2500 rpm during 15 min, resuspended in Hanks solution and repeatedly centrifuged at 1500 rpm during 10 min. The obtained precipitate is resuspended in 1 ml of Hanks solution. Phagocyte concentration in the suspension is brought to 2 mln/ml. Cell suspension of phagocyte concentration in the sample equal to 1 mln is introduced into reaction mixture for recording luminol-depended chemiluminescence. Luminescence maximum of spontaneous chemiluminescence being observed in the bandwidth of 2731 to 6200 conditional units, bronchial asthma is to be diagnosed. The value being greater than 6201 conditional units, chronic obstructive bronchitis is diagnosed. Reference values are considered to be not greater than 2730 conditional units.
EFFECT: high accuracy of diagnosis; simplified test method.
1 dwg, 1 tbl
FIELD: medicine, infectology.
SUBSTANCE: the suggested innovation deals with analyzing anamnestic, clinical and laboratory data to detect the values of diagnostic criteria for prognostically valuable signs in points according to special scale followed by calculating the sum of points to predict the result of disease by the value of this sum. Thus, the innovation enables to predict the result of disease in 1 mo of inspection already, and in 6 mo it demonstrates coincidence of prediction in 95% patients. This method could be applied at in-patient stage of therapy and during out-patient stage, as well.
EFFECT: higher accuracy and efficiency of prediction.
2 cl, 4 ex, 6 tbl
SUBSTANCE: method involves determining lactate content in peripheral venous blood sample taken from cadaver. The value being less than 16 mmole/l, hypoglycemic coma is diagnosed.
EFFECT: high reliability of diagnosis independently on death outcome time.
SUBSTANCE: method involves estimating bactericide activity of semen. Semen sample is incubated with test culture suspension taken in 1x1020 (test sample) concentration at 37° C during 30 min, comparing it to control samples. The reaction is stopped by diluting one case and two control samples. Control sample No 1 is the nutrition broth with no test culture and semen sample. Control sample No 2 is the nutrition broth with test culture without semen. Optical density is determined in all samples and percentage of survived microbes is determined from formula BAS=(C-(A+B))x100, where BAS is the bactericide activity of semen in %. A is the optical density in control sample No1. B is the optical density in control sample No2. C is the optical density in case sample. BAS growth when compared to an initial value is interpreted in terms of therapy effectiveness.
EFFECT: high sensitivity and accuracy of the method; simplified method.
FIELD: medicine, oncology.
SUBSTANCE: method involves study for the presence of genetic marker of immunoglobulin Gml in serum of persons living in ecologically unfortunate conditions. Analysis involves a method for erythrocyte agglutination inhibition followed by microscopic evaluation. The predisposition to development of lung cancer is prognosticated in the presence of genetic marker of immunoglobulin Gml (+), and the resistance to development of lung cancer is prognosticated in the presence of genetic marker of immunoglobulin Gml (-). Method provides simplicity for reproducibility of analysis.
EFFECT: improved method for prognosis.
1 tbl, 3 ex
FIELD: forensic medicine.
SUBSTANCE: method involves applying immunoenzyme analysis using worksheet bearing immobilized narcotic substance antigen and introducing medium under study into worksheet cells. The medium is diluted in advance X times with phosphate buffer having pH=6.5. Antibodies bound to enzyme label are added to morphine and incubated at 18-20°C. The immunoenzyme analysis results are recorded in spectrophotometric way. No opiates case is detected from optical density (OD) of diluted medium under study (ODus) being equal to optical density of negative control solution (ODneg.cs). Permissible error value is not to be greater than 30% of ODneg.cs value. Opiate availability is established to be in diagnostically significant concentration of 300 ng/ml from ODus being in the range of ODpositive cs≥ODus>0. ODus=0 being the case, finite dilution is carried out until ODus becomes unequal to zero. Then, narcotic substances of opiate group are to be quantitatively determined by using a formula.
EFFECT: simplified and accelerated method.
FIELD: veterinary medicine.
SUBSTANCE: method involves determining general blood serum protein level. Protein quantity being found to be greater than 50 g/l, the animals are estimated to have low natural resistance level.
EFFECT: simplified and accelerated method.
SUBSTANCE: method involves determining quantitative and qualitative composition of short chain fatty acids of C2-C4 fraction in feces and peripheral blood serum to evaluate fatty acids metabolism at various levels (hepatic, vesicular and intestinal).
EFFECT: high accuracy in measuring metabolism characteristics at various levels; accelerated process.
FIELD: medicine, ophthalmology.
SUBSTANCE: the present innovation deals with methods for diagnostics of vascular pathology of optic nerve (ischemic opticopathies) and, also, predicting vascular pathology of optic nerve lesion and counterlateral eyeball. One should perform dopplerographic registration of circulatory parameters: peak systolic velocity PSV cm/sec and end diastolic velocity EDV cm/sec on the 2nd, 3d min both before and at the background of functional loading: dealing with lifting legs up to 90° in area of internal carotid artery, central retinal artery and ciliary artery. Moreover, calculation of resistant index RI c. u. should be performed by the following formula (PSV cm/sec - EDV cm/sec)/PSV cm/sec and reactivity index RY c.u. by the following formula PSV cm/sec after loading/PSV cm/sec before loading. At RI value being above 0.7 and RY value being below 1.0 one should detect deterioration of visual functions and the absence of circulatory reserves in tested eye and counterlateral one. At RI value being below 0.7 and RY value being above 1.0 it is possible to detect the maintenance of visual functions and circulatory reserves in tested and counterlateral eyes. The innovation enables to accelerate and simplify the trial and carry out it with available physical loading for a patient without applying any additional appliances and medicinal preparations.
EFFECT: higher efficiency and accuracy of diagnostics and prediction.
6 dwg, 3 ex, 2 tbl
FIELD: medicine, cardio-vascular surgery.
SUBSTANCE: one should perform ultrasound scanning of the 1st volar metacarpal artery both before and at the background of radial artery compression, moreover, at decreased peak systolic rate of circulation in the 1st volar metacarpal artery at the background of compression by 40% or less against peak systolic rate of circulation before compression one should diagnose ulnar type of wrist's circulation and at decreased peak systolic rate of circulation at the background of compression by more than 40% against peak systolic rate of circulation before compression or at appearance of retrograde circulation one should diagnose radial type of wrist's circulation.
EFFECT: higher efficiency and accuracy of diagnostics.
6 dwg, 2 ex
FIELD: medicine, otorhinolaryngology.
SUBSTANCE: one should detect amplitude-frequency circulatory characteristics in mucosal microcirculation system of inferior concha at the side of lesion due to laser Doppler flowmetry: AmaxCF/σ - circulatory fluctuations synchronized with cardiorhythm; IFM - index of flux motions, the ratio between active and passive mechanisms of circulatory regulation in microcirculation system. In 3-4 d all measurements should be repeated. If AmaxCF/σ value is increased at simultaneous decrease of IFM value one should consider the treatment to be efficient. The present innovation enables to obtain objective parameters of maxillary sinus state.
EFFECT: higher accuracy of detection.
FIELD: medicine, cardiology.
SUBSTANCE: one should perform colored duplex sonography by measuring the resistance index in tibial arteries to evaluate the degree of functional insufficiency in lower limbs, that is at R1 being above 1.0 - the first stage, at R1 being 1.0-0.4 - the second stage, at R1 being below 0.4 and up to 0.2 - the third stage and at R1 being below 0.2 - the fourth stage should be detected. The method enables to objectively and quantitatively evaluate ischemic stages in case of occluding arterial diseases of lower limbs.
EFFECT: higher efficiency of evaluation.
12 dwg, 2 ex, 1 tbl
FIELD: medicine, juvenile neurology.
SUBSTANCE: one should measure the values of cerebral hemodynamics, calculate the index of resistance (IR) in fetal internal carotid artery in pregnant woman at 38-41-wk-long gestation due to ultrasound dopplerography. At IR values ranged 0.8 and higher one should predict the development of perinatal cerebral lesion of light and average severity degree, and at 0.6 and lower - severe degree. The method applies more adequate value of circulation.
EFFECT: higher accuracy of prediction.
3 ex, 1 tbl
SUBSTANCE: method involves making clinical investigation of digestive apparatus. Doppler flowmetric examination of main visceral arteries and biochemical blood test are carried out. Blood circulation speed drop in abdominal aorta being found to be equal to or greater than 9%, in celiac trunk 33.6% and more, in superior mesenteric artery 25% and more, and cholesterol concentration growth being greater than 38% and triglyceride 23% and more, chronic digestive apparatus ischemia is to be diagnosed.
EFFECT: high diagnosis accuracy.
SUBSTANCE: method involves examining eyeball and retrobulbary styate and retrobulbary space by means of multi-functional ultrasonic scanner device. Ultrasonic gray-scale orbit scanning in real-time mode is carried out. Kinematic test is performed for estimating extraocular muscle function condition. When recording full eye movement amplitude within 15° to 40° without extraocular direct muscles thickness change being found, normal muscle function condition is diagnosed. When recording incomplete movement amplitude within to 15° with extraocular direct muscles thickness change being found, disturbed muscle function is recorded and pathological state is diagnosed.
EFFECT: high objectivity of obtained information; detected morbid muscle changes not detectable in clinical examination; high accuracy of diagnosis.
FIELD: medicine, juvenile surgery, urology.
SUBSTANCE: the present innovation deals with ultrasound studying patient's scrotal organs to detect maximal systolic circulatory velocity VSM and final diastolic circulatory velocity VD, moreover, circulatory evaluation should be carried out by integral hemodynamic index J by the following formula J = 1 + (JS - Jr), where JS - hemodynamic index of systolic result-producing nature; Jr - hemodynamic index of reverse circulation. Moreover, JS should be calculated by the following formula: where tS - systolic time, TCC - time of cardiac cycle, as for Jr it should be calculated by the following formula: where VDM - minimal diastolic circulatory velocity, tRC - time for reverse circulation. Application of the present method enables to increase information value in evaluating hemodynamics of gonads due to applying indices taking into account temporal parameters of vascular circulation.
EFFECT: higher efficiency of evaluation.
1 dwg, 1 ex, 1 tbl
SUBSTANCE: method involves introducing radioactive preparation of 99mTc-metoxyisobutylisonitryl or 99mTc-tetrophosmine. Parameters reflecting arterial blood circulation intensity are analyzed. Standard physical activity is applied not earlier as at the second day. Radiopharmaceutical preparation is immediately introduced at the same dose. Extremity muscle ischemia diagnosis is set on the basis of increased blood circulation intensity after having applied exercise stress.
EFFECT: high reliability of diagnosis.
FIELD: medicine, obstetrics.
SUBSTANCE: due to dopplerometry one should register circulatory rates curves (CRC) in fetal middle cerebral artery (MCA) and either zero or negative value of diastolic component CRC MCA during labor-pains is considered to be the indication for abdominal type of delivery. The method increases the number of diagnostic means.
EFFECT: higher efficiency.
3 ex, 6 tbl
FIELD: medical engineering.
SUBSTANCE: device has casing with lumen, cannula and sharp tip. It is connected to Waldmann unit for measuring current and filling sterile solution. The casing has a lateral opening soldered acute end and mandrin having through canal. The mandrin has cannula and is set in the lumen to enable the lateral opening to be fully overlapped.
EFFECT: enhanced effectiveness in measuring intraosseous pressure and making medullary canal puncture.
2 cl, 3 dwg