Method for determination of immunopathological response type in children with atopic dermatitis

FIELD: medicine.

SUBSTANCE: to determine the immunopathological response in children with atopic dermatitis, sections of gastrointestinal biopsy material are exposed to morphological examination. There are examined intraepithelial lymphocytes and lymphoid nodules in tissue of antral stomach and (or) duodenum and direction of lymphocyte migration. If lymphoid nodules observed are combined with lymphocyte migration in a mantle region faced the epithelial cover, and intraepithelial lymphocytes with lysis zones prevail, the response is determined as delayed hypersensitivity.

EFFECT: method improves clinical effectiveness for atopic dermatitis in children, with respect to determining delayed hypersensitivity and well-timed change of therapeutic approach on the basis of individual approach.

3 ex

 

The invention relates to medicine, namely to pediatric gastroenterology and can be used for a differentiated approach to the treatment of children with atopic dermatitis.

Atopic dermatitis is the most frequent clinical manifestation of food Allergy in children. At the same time, food Allergy in children is accompanied by changes in the blood that reflect allergic reaction to oral input allergen (Balabolkin I.I. Gastrointestinal food Allergy in children. Pediatrics, 1997; No. 1, p.63-67, Smirnov G.I. the Allergic children. M., 1998, pp. 197-211).

Immune hypersensitivity underlying as skin and gastrointestinal manifestations of food Allergy occurs due to various mechanisms.

Known 4 types of reactions, which are determined by the immunopathological mechanism and are divided into: type I - atopy, type II - cytotoxicity, type III - formation of toxic immune complexes, type IV - delayed hypersensitivity (Inflammation. A guide for physicians. Edited WAV, Vsaugov. M.: Medicine, 1995, str).

I - type reagin-dependent, mediated by specific IgE antibodies, the type of allergic reactions is the basis of atopic diseases. Morphologically manifested tissue eosinophilia with increasing amounts bezepitelialnye easy filnik granulocytes, the increase in the number JgE-plasma cells, mast cells.

Type II is defined by severe cellular and tissue destruction.

Type III is determined by circulating immune complexes and immune damage.

Type IV - delayed hypersensitivity (GST) is the main type of immune response to different viruses, fungi, protozoa and parasites.

Determining the type of response helps to clarify the immunopathogenesis of the disease, to identify the nature of its current and determines the approach to the treatment of children with atopic dermatitis.

Because the mucosa of the gastrointestinal tract and the skin is the barrier fabric of the human body, manifested symptoms of damage indicate the impact on the child's body antigenic factors. It is well known that in the mucous membrane of the digestive tract inflammation with immunopathological manifestations of type I hypersensitivity.

This fact resulted in a number of ways of determining immunopathological reactions of immediate type by morphological studies of biopsies of the gastrointestinal tract.

So the known method, including morphological examination of the biopsy of the small intestine, allowing for ultrastructural and immunohistochemical markers to identify allergies of the immediate type (M.Shiner. Ultrastructural fe atures allergic manifetation in the small intestine of children. Scand. J. Gastroenterol. Suppl. - 1981. - V.16 (Suppl. 70) P.49-64).

The method is technically very difficult, for practical health care is unavailable.

There is also known a method of determining the reaction of the delayed type by morphological studies of biopsies of the gastrointestinal tract. (General pathology of man. A guide for physicians. Edited Auistralia, WAV, Dscherbinova - M.: Medicine, p.95).

The authors determine the type of immune response by identifying lymphocytic-macrophage infiltrate, destroy cancer of the stomach at the optical level, and killer effect of T-lymphocytes in relation to the glandular epithelium at the electron microscopic level.

A set of indicators optical and ultrastructural level allows you to define a reaction of hypersensitivity of the delayed type.

This method was used in viral chronic active hepatitis. The method is complex to implement, as it requires special equipment. Preparation of tissue samples stretched in time, a comprehensive analysis requires special training of clinical pathologist.

A prototype of the proposed method is taken, the method of determining the type of immunopathological reactions in children with atopic dermatitis, which includes morphological study of sections of biopsies of the gastrointestinal tract (patent No. 2128836 from 10.7.96 year, the authors Casanova N.E., Venacava L.N., Novikov A.V., Khokhlov NM).

The method is based on morphometric study of tissue section of the small intestine.

However, this method, as mentioned above, technically complex, requiring biopsy downward Department of the duodenum.

In addition, morphometric analysis is available only highly specialized gastroenterological centers.

The objective of the proposed method is a simplified method for achieving high accuracy.

The solution of this problem is achieved in that in the method of determining the type immunopathologically reactions in children with atopic dermatitis, including morphological study of sections of biopsies of the gastrointestinal tract,

explore intraepithelial lymphocytes and lymphoid nodules in the tissue of the antrum of the stomach and or duodenal ulcers and direction of migration of lymphocytes, and in the identification of lymphoid nodules in conjunction with the migration of lymphocytes to the site of the mantle facing the epithelium, and the predominance of intraepithelial lymphocytes with zones of lysis determine the reaction as hypersensitivity of the delayed type.

The novelty of the proposed method is based on the fact that the available scientific, technical and practical information to solve the first problem the proposed solution was not used, as well as the proposed solution provides properties that do not match the properties of the known solutions, it involves an inventive step.

Declared distinctive features are new, so as to diagnose GST with atopic dermatitis in children indicators of the directed migration of lymphocytes to the site of the mantle facing the epithelium, with parallel-defined intraepithelial lymphocytes with zones of lysis were not previously used.

The new method is that established new criteria of the diagnostic process including evaluation of the directed migration of lymphocytes in the lymphoid nodules located in the tissue of the gastroduodenal mucosa in the area of the mantle facing the epithelium and parallel to the defined high content of intraepithelial lymphocytes with zones of lysis.

Application of the method helps to identify the characteristics of the course of atopic dermatitis, allows you to justify differential pathogenetic treatment.

The efficiency of the method was confirmed in the survey of 104 children with atopic dermatitis, of which a selected group of 29 people with GST.

The accuracy of the method amounted to 95%.

The method is as follows.

In patients with abdominal pain and read the tion on gastro against the background of atopic dermatitis in order to identify the pathology of the upper digestive tract are fibrogastroduodenoscopy with biopsy of the antrum and duodenum the intestine.

Conduct standard histological preparation and painting sections of the mucous membrane.

Further explore intraepithelial lymphocytes, lymphoid nodules in the tissue of the antrum of the stomach and or duodenal ulcers and direction of migration of lymphocytes, and in the identification of lymphoid nodules in conjunction with the migration of lymphocytes to the site of the mantle facing the epithelium, and the predominance of intraepithelial lymphocytes with zones of lysis determine the reaction as hypersensitivity of the delayed type.

Examples of specific performance are given in the form of extracts from the records.

1 clinical example from the case history No. 765

C. Dima, 6 years., surveyed in Nizhny Novgorod research Institute of pediatric gastroenterology repeatedly: in 1992 and in 1995 he Received 4 times with complaints of allergic skin rashes, and in 1993 joined abdominal pain. History of - artificial feeding from birth, cutaneous manifestations of food Allergy one year of age, first on the face, then spread to the trunk and extremities, recurrent furunculosis in 2 years, 3 years and 5 years. Were constantly observed by a dermatologist, before entering the Institute was treated at the hospital Regional children's clinical hospital with the diagnosis of Atopic dermatitis, a common, children form, severe, study the flare-up" without much effect.

When you first enroll in the Institute due to the severity of the condition and the severity of allergic skin manifestations was hospitalized in an intensive care unit, where he conducted infusion therapy with the inclusion of prednisolone session UBI and hemosorption. The disease wore recurrent torpid nature, with frequent exacerbations.

The next hospitalized in the clinic of the Institute in March 1995 complained of persistent changes on the skin accompanied by itching, pain in the abdomen. State upon receipt of moderate severity. There was a General dryness of the skin with symptoms of pityriasis peeling. In the elbow and knee creases, in the area of the wrist joints on the rear kisley remnants of infiltration, papular rash in a small amount, isolated scratches on the background of reduced elasticity of the skin, signs of lichenification. Peripheral lymph nodes I-II order. Tongue coated white bloom. Heart - systolic murmur at the apex and along the left edge of the sternum. The abdomen is soft, moderately painful in the epigastrium and the point of the gall bladder, the edge of the liver is palpated at the level of the costal arch. In the hemogram: ESR 11 mm/h, HB 132 g/l, Le 4,8×109/l pet. CL 2%, and fell. 2%, segm. 51%, limp. 30%, mon. 7%, EOS. 7%, databases. 1%. In the analysis of urine: modified erythrocytes - 2/1, leukocytes - 1-2/1. Coprogram without features, worm eggs and cysts of Giardia is not barouni, in perianal scraping the eggs of pinworms is not revealed. Seeding with skin: Golden staph, pronounced growth. The sowing of the throat: Golden staph, pronounced growth.

In connection with pains in the abdomen performed fibroesofagogastroduodenoscopia. Conclusion: gastritis and duodenitis hypertrophic, with greater activity of the inflammatory process in the stomach. Chromovitrectomy: in the stomach on an empty stomach high kislotoobrazovanie compensation antrum.

Morphological examination of biopsy specimens: the mucous membrane of the antrum obtained at the level of the muscle plate. Determined dystrophy cover-pit epithelium and epithelium of the glands. Detected tissue eosinophilia. Layer glands narrowed at the expense of lymphoid nodules. Helicobacter not found.

Duodenum: in biopsy samples obtained at the level of the muscle plate, is determined by the morphological picture of diffuse duodenitis. Tissue eosinophilia.

Clinical diagnosis: Atopic dermatitis, children form a common, severe, subacute stage of deterioration, with the prevalence of food allergies.

Chronic gastroduodenitis, not associated with Helicobacter pylori infection, with high acid-forming function of the stomach, the period of exacerbation.

2 clinical example from the case history No. 2249

M Sasha, 6 years old, was admitted in the clinic is at the Institute of pediatric gastroenterology, 25.10.91 with complaints of pain in the abdomen during the year, often after a meal, allergic reactions on the skin, sometimes accompanied by itching. History: early transfer to artificial feeding (2 months), after which appeared cutaneous manifestations of food Allergy in the first months of life, first in milk, then for dessert, chicken eggs, fish. In the following was observed and treated at the allergist about formed a limited atopic dermatitis food etiology. Allergodermatozy wore resistant torpid course, though without obvious periods of exacerbation.

When entering the child's condition is moderate, marked pallor of the skin, dry skin, peeling eyelids, cracks in the corners of the mouth. In elbow and knee pits - strengthening skin picture, dryness, dull erythema, single excoriation. Limited erythema in skin folds on the neck. Skin itching is variable. Peripheral lymph nodes are small. Tongue coated white bloom. In the lungs vesicular breathing. Heart sounds distinct. The abdomen is soft, painful to palpation in the epigastrium, the projection of the gallbladder; liver is palpated by 1.0-1.5 cm from under the costal arch. Chair decorated. In the hemogram: erythrocyte sedimentation rate of 14 mm/h, HB 124 g/l, Le 5,2×109/l in the formula neutrophilia 57%, mild eosinophilia 5%. Urine analysis and coprogram persons without whom NOSTA. Three-time research on eggs a worm and Giardia negative. The scraping on the pinworm eggs of pinworms is not detected. The level of IgE in the serum increased - 208,4 IU/ml, in a dynamic, 617,0 IU/ml Seeding with skin: pronounced growth of epidermal Staphylococcus. The sowing of the pharynx: a single colony of Staphylococcus aureus hemolytic. Gastric intubation: kislotoobrazovanie stored in the stomach, the acid values correspond.

Fibrogastroduodenoscopy: the esophagus is freely pass, kardia closed completely. Mucous cardia hypermonogenic. In the stomach on an empty stomach large amount of turbid fluid, mixed with mucus. The tone of the stomach is raised sharply. The mucous membranes of the body and antrum of the stomach is pale pink with a rough surface. The folds of the stomach is thickened, bad deal. The gatekeeper comminuted thickened pylorus, bad deal. Mucous gatekeeper swollen and hypermonogenic. The bulb of the duodenum is not deformed. Mucous her and further divisions of the duodenum with focal hyperemia. The tone of the duodenum increased.

Conclusion: mixed gastro in a phase of moderate exacerbation. Pelorat.

Morphological examination of biopsy specimens: the mucosa of the gastric body normal structure; draws attention to the presence of wazeecha the s and stasis of red blood cells in the superficial division of the mucous membrane.

In the biopsy of the antrum, obtained at the level of the muscle plate, is determined by superficial gastritis. Draws attention to the presence of intraepithelial lymphocytes with zones of lysis, vasoactive in the surface and a few in the deep division of the mucous membrane.

In the biopsy of the duodenum is determined by the decrease in villus height, is determined ectopia crypts. Lymphoplasmocytic infiltration own plates with the presence of eosinophilic granulocytes strengthened. The epithelium of the villi and the number of crypts contains intraepithelial lymphocytes with zones of lysis. In biopsy samples is determined lymphoid nodule with the directional migration of lymphocytes to the site of the mantle facing the epithelium of the villi and adjacent crypts. Conclusion:

diffuse duodenitis; histological pattern characteristic of hypersensitivity of the delayed type. Given the torpid course allergodermatosis, the presence of the morphological picture of the mucous membrane of the signs of delayed-type hypersensitivity were continued research aimed at identifying concomitant pathology of the gastrointestinal tract, which could occur at the tissue level (mucosa) signs of hypersensitivity reactions of the delayed type. This type of reactions, as is well known, is not peculiar to atopy the definition process, which is an allergic inflammation of the I-th IgE-mediated type, with marked tissue eosinophilia and elevated levels of bezepitelialnye eosinophils.

First of all, continued the search for helminthic parasitic infestations. Three studies on eggs a worm and protozoa and re-perianal swabs on the eggs of pinworms were negative. Then the baby had undergone duodenal intubation, with all portions of bile detected Giardia.

Clinical diagnosis: Atopic dermatitis, limited, children form, moderate for the period of incomplete remission.

Chronic gastroduodenitis, not associated with Helicobacter pylori, saved acid-forming function of the stomach, a period of moderate exacerbation.

Giardiasis.

Thus, signs of tissue immunopathological reactions hypersensitivity of the delayed type were due to the presence of the child undetected giardiasis, which, in turn, supported torpid course of atopic dermatitis.

3 clinical case: a case history No. 2132

Century Luba, 4 years old, was admitted to the hospital Nizhny Novgorod research Institute of pediatric gastroenterology in October 1991 with complaints of pain in the abdomen, in the last year, often after a meal, rare vomiting, reduced appetite, allergic changes in the skin accompanied by itching. A history of cutaneous manifestations of food Allergy one year of age, there allergist diagnosed with Atopic dermatitis, limited.

When enrolling the child closer to the center of gravity. It was noted the pallor of the skin, the periorbital shadows. In elbow - dryness, increased skin illustration, a single excoriation, areas of pigmentation. Around the mouth - residual effects heylita in the form of dryness, enhance skin picture, easy peeling; in the corners of the mouth - eating. Tongue thickly coated with white bloom. Peripheral lymph nodes are small. Vesicular breathing in lungs. Heart sounds rhythmic and distinct. The abdomen is tender to deep palpation, pain in the epigastric area and piloroduodenalnoy. The edge of the liver is palpated at the level of the costal arch. Chair decorated. In the hemogram: ESR 10 mm/h, HB 140 g/l, Le 8,2×109/l, segm. 40%, limp. 55%, mon. 3%, EOS. 1%, databases. 1%. In the General analysis of urine: moderate leukocyturia; after taking a urine catheter analysis without deviation from the norm. Coprogram: detritus 3+, fatty acids 2+, soap 2+. Three-time research on eggs a worm and Giardia negative. In perianal swab for enterobiasis found eggs of pinworms. Seeding with skin: microbial flora is not selected. The sowing of the pharynx: a single colony of epidermal Staphylococcus. Gastric intubation: kislotoobrazovanie. Duodenal intubation: the signs of biliary dyskinesia. Ultrasound examination of abdominal organs: liver, ovens, pancreas pathology it is not revealed; gallbladder - bend the upper third, wall smooth.

Fibrogastroduodenoscopy: the esophagus is freely pass, kardia closed completely. Mucous cardia pale pink. In the stomach on an empty stomach the usual amount of turbid fluid. The tone of the stomach is normal. The mucous membranes of the body and antrum of the stomach pale pink with lots of traumas. The pylorus is closed. The bulb of the duodenum is not deformed. Mucous her and further divisions of the duodenum with multiple areas of hyperplasia. Mucous downward Department of the duodenum with a touch of white on the type of "semolina".

Conclusion: mixed gastro out of aggravation.

Morphological examination of biopsy specimens: the mucosa of the gastric body normal structure without obvious inflammatory changes.

Surface antrum-gastritis. Helicobacter not found.

In the biopsy of the duodenum is determined by the picture diffuse duodenitis with a reduction in villus height, ectopia of the crypts, enhanced infiltration own plates, lymphostasis, capillarisation. Determined intra who epithelially lymphocytes with zones of lysis and revealed lymphoid nodules in conjunction with the migration of lymphocytes to the site of the mantle, facing the epithelium. Morphological data characteristic of hypersensitivity of the delayed type.

Showed signs of cellular reactions were due to the presence of the child enterobiasis, which resulted in immunopathological reaction.

Clinical diagnosis: Atopic dermatitis, limited, children form remission stage, food etiology.

Chronic gastroduodenitis, not associated with Helicobacter pylori infection, with saved acid-forming function of the stomach, the period of incomplete clinical remission.

Enterobiasis.

The technical result of the task is to increase the effectiveness of treatment of atopic dermatitis in children in connection with the detection of delayed-type hypersensitivity and timely change of tactics of treatment based on an individual approach.

The method of determining the type of immunopathological reactions in children with atopic dermatitis, including morphological study of sections of biopsies of the gastrointestinal tract, wherein explore intraepithelial lymphocytes and lymphoid nodules in the tissue of the antrum of the stomach and or duodenal ulcers and direction of migration of lymphocytes, and in the identification of lymphoid nodules in conjunction with the migration of lymphocytes to the site of the mantle, facing the side of the epithelium, and the predominance of intraepithelial lymphocytes with zones of lysis define response as delayed-type hypersensitivity.



 

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2 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: invention concerns medicine, namely urology and endocrinology and can be used in androgen therapy caused by physiologically impaired production of testosterone in men. The questioning is presented on the rating scale of age-specific androgen deficiency symptoms (RSAADS). The blood is tested for total testosterone level. The investigations to detect prostate and breast cancer are conducted. That is followed by androgen preparation test, the RSAADS questioning and blood analysis for total testosterone level. The absence of prostate and breast cancer, and increased number of RSAADS points by 9 and more, change of total testosterone level within 25.2 nmol/l to 38.3 nmol/l, then latent androgen deficiency is diagnosed.

EFFECT: method allows detecting the latent forms of androgen deficiency that improves clinical effectiveness in age-specific androgen-deficient conditions and life quality in men.

1 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: group of inventions relates to field of medicine, namely to diagnostics. In order to detect endogenous organism intoxication blood serum or plasma are tested by method of wedge dehydration and if present are peculiarities of line: dashed, parallel, concentric, multi-ray, rounded and round cracks, cracks in form of black net, in form of fish scales, wrinkles, Wallner lines and Arnold tongues, endogenous intoxication is diagnosed. In order to evaluate degree of endogenous organism intoxication severity, presence of range of characteristic peculiarities is determined by ten-point scale and by size of area occupied by said peculiarities. Inflammatory character of endogenous intoxication is determined if rounded, round cracks are present in central zone of dehydrated drop. If cracks in form of black net are present in its central zone necrotic character of endogenous intoxication is determined. Lipid exchange disturbances are determined by detecting cracks in form of fish scales in intermediate zone. If multi-ray cracks are present in central zone, endogenous intoxication caused by renal insufficiency is determined.

EFFECT: increase of accuracy of endogenous organism intoxication diagnostics.

3 cl, 15 dwg, 2 tbl, 9 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to neurology. In order to predict severity of tick-borne infection course totality of results of clinic and laboratory analyses is estimated at the onset of disease. Determined is sum of diagnostic coefficients assigned to most pathognomic symptoms of disease: duration of incubation period, respiratory disorder, depression of consciousness, leukocytic index, intensity of central pareses of extremities, bulbar syndrome, fibrin-monomer blood complexes, percentage ratio of blood B-lymphocytes, titre of specific G-immunoglobulins to tick-borne encephalitis virus. If sum is (+)7 points and higher light and medium-severe course of tick-borne infections is predicted, (-)12 points and lower - development of unfavourable outcome of disease is predicted. In case of intermediate values of sums of said diagnostic coefficients are obtained, when one of thresholds is not reached, prognosis for disease course is determined during repeated analyses.

EFFECT: method allows to evaluate patients' state in disease dynamics objectively, trace main tendencies of pathologic process and predict outcome of tick-borne neuron-infections at initial stage of disease.

2 ex, 1 tbl

FIELD: veterinary science.

SUBSTANCE: method includes intracutaneous injection of PPD-tuberculin in dose of 0.2 ml to animals into right part of neck with simultaneous injection of atypical mycobacteria complex (AMC) into left part of neck, accounting and evaluation of reaction to tuberculin and AMC in 72 hours by measurement of skin fold of injection spot, division of animals into groups that "do not react to tuberculin and AMC", "react to AMC (-)", "react to tuberculin (+)", and "react to tuberculin and AMC (=)" and definition of statistical validity of differences in reactions to tuberculin and AMC, on the basis of which conclusion is made on infection of animals with mycobacteria of tuberculosis or atypical mycobacteria. Additionally each animal of diagnosed group independently from its diagnostic index "do not react to tuberculin and AMC", "react to AMC (-)", "react to tuberculin (+)", and "react to tuberculin and AMC (=)" is exposed to venous blood draw on an empty stomach with immediate injection of solution of hydrocortisone-acetate in dose of 5 ml intramuscularly with further draw of venous blood in 3 and 6 hours for the possibility to detect indices of activity of blood serum ferment - lactate dehydrogenase (LDG) in dynamics. Afterwards indices of LDG activity in dynamics are detected, average indices of LDG fermentative activity are compared in dynamics, those that are defined in group of animals who "do not react to tuberculin and AMC", to indices of fermentative activity of each animal in all other groups. If LDG activity increases in 3 hours by less than 8%, and in 6 hours by less than 17%, compared to average indices of fermentative activity of LDG, animals that "do not react to tuberculin and AMC", "react to AMC (-)", "react to tuberculin (+)", and "react to tuberculin and AMC (=)" are included in group of truly tuberculosis diseased animals of diagnosed group.

EFFECT: method makes it possible to improve accuracy of tuberculosis diagnostics.

2 tbl, 1 ex, 1 dwg

FIELD: medicine.

SUBSTANCE: invention relates to medicine and can be used for express-estimation of severity of state of patient with burn disease. Laboratory analysis is carried out, degree of natural colonisation of buccal epithelium cells with bacteria Streptococcus salivarius, average number of bacteria Streptococcus salivarius adhesed on one buccal epithelium cell - index of natural colonisation of buccal epithelim cells (INCBEC), and if INCBEC value is greater than 10, conclusion about light degree of severity of patient's with burn disease state is made, of INCBEC value is from 5 to 10 - about medium degree of severity of patient's with burn disease state is made, and if INCBEC value is lower than 5 - about severe degree of severity of patient's with burn disease state.

EFFECT: method is simple in realisation, takes little time, non-traumatic, eliminates risk of infection.

3 ex

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to clinical physiology, cardiosurgery and cardiology. In particular person of age - A (years), (1≤A≤80 years) and sex the following parametres are measured: height H (cm); body weight - M (kg); hemoglobin concentration - n (g/l); artery blood oxygenation ya (%), and by definite formulas calculated are: body area, specific heat production both for males and for females, rate of oxygen consumption by whole organism, specific consumption of oxygen by person's heart both for males and for females, radius of tissue cylinder via calculation of specific oxygen consumption by heart by definite equation, rate of blood flow in capillary, number of capillaries in heart, volume of capillary blood, and in such way, evaluate anatomical/functional parametres of capillary bed of human heart.

EFFECT: method allows to evaluate number of all capillaries in heart, their density, length, rate of blood movement in them and volume of all capillary blood in coronary bed of heart, their connection with patient's anthropometric data, as well as other parametres - radius and volume of tissue cylinder.

1 tbl, 1 dwg

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to anesthesiology and reanimatology, and can be used for post-anesthesia managing of patients. Immediately after operation essential indices are determined in complex: severity of patient's state by APACHE III (A) scale, reduction of average arterial pressure during anesthesia from pre-operation level (ΔAP), reduction of saturation of venous blood hemoglobin with oxygen during anesthesia lower than 65% (ΔSvO2), central temperature at the moment of anesthesia termination (T), operation volume (O). Basing on description table 1 each index is given corresponding points: ΔAP=0÷2, ΔSvO2=0÷2, 0=1÷4, criteria A and T are taken into account by absolute values. After that by formula PC=0.0518*A+1.51*"ДАД"+1.024*ASvO2-0.04*T+1.67*O, prognostic coefficient (PC) is determined. If PC value is lower than 3.3 duration of recovery during 1 hour is predicted, if PC= 3.4-6.4 duration of recovery longer than 1 hour and to 6 hours is predicted, if PC= 6.5-9.3 duration of recovery longer than 6 hours is predicted, and if PC is greater than 9.3 duration of recovery longer than 9 hours is predicted.

EFFECT: method allows to increase self-descriptiveness and reliability of detecting possible states after long operative interventions.

5 tbl, 4 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to cardiosurgery. In order to diagnose viable myocardium, in cardiosurgical patients, rate of scintillation count is determined by means of gamma-probe during operative intervention. As marker for determining border of viable and non-viable tissue radiopharmacological preparation fatty acid, radiolabelled with isotope 123I, is used. If rate of scintillation count above the area of viable tissue exceeds scintillation count above the regions of scar tissue on 40% and more viable myocardium is diagnosed.

EFFECT: method increases accuracy of viable myocardium diagnostics, allows to perform coronary artery bypass grafting in the most efficient way.

1 ex, 7 dwg

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

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