Method of internal hemorrhage diagnostics
SUBSTANCE: hematocrit is determined in patient's blood and in drainage content. Ratio of drainage content hematocrit to blood hematocrit is calculated. If its value is less than 0.05 absence of hemorrhage is diagnosed, if the value is from 0.05 to 0.2 capillary hemorrhage is diagnosed, from 0.2 to 0.5, diffusive hemorrhage is diagnosed, over 0.5 vascular hemorrhage is diagnosed.
EFFECT: methods application makes it possible to increase accuracy of internal hemorrhage diagnostics in short terms and at early stages of disease.
The invention relates to medicine, surgery, anesthesiology and reanimatology and intensive care, and can be used to diagnose internal bleeding.
Internal bleeding is one of the most common pathologies in patients of intensive care.
While diagnosing internal bleeding is often a very difficult task. The main signs of internal bleeding - functional and Hematology. Functional manifested by pallor of the skin, reduction of arterial and Central venous pressure, reducing the rate of diuresis. The disadvantage of using functional traits is their nespecificnomu. The symptoms included in the number of patients in critical States can have almost any reason (Marino, P. Intensive therapy (Per. s angl.) / Pyrina. - M, GEOTAR - Medicine, 1998).
Hematological manifestations are characterized by a decrease in the dynamics of the number of erythrocytes, haemoglobin concentration, hematocrite value. Hematological manifestations of internal bleeding, confirming functional, have a significant delay in time, appearing after 4-12 h from the beginning that can lead to delayed diagnosis threatening condition (Cashiers, I.A. Klinicheskaya Hematology. / Iascinski, Gaaleries. - M.: Medicine, 1970).
The closest way to diagnose is to evaluate the discharge to drains, catheters and probes located at the alleged source of bleeding (Emelyanov, SR General surgery. / Siemeling, Muddebihal, A.v.fedorov. - M: Medical information Agency, 2003). However, this method has the disadvantage of excessive subjectivity of the method, since the determination of the nature of the discharge occurs solely by it's color.
We first proposed a method for the diagnosis of internal bleeding, which in comparison hematocrit of the patient's blood with a hematocrit separated by drainage (catheter probe), which is in the cavity of the body or the place of operative intervention.
To use this method, you must have a functioning drainage (catheter tube) at the place of intended bleeding. If you suspect internal bleeding blood samples were taken from a vein of the patient. In the blood sample is determined hematocrite value. Is the fence contents of the drainage catheter, probe), which is determined by the same indicator. Methods for the laboratory testing of blood and the contents of the drainage catheter, probe) does not matter; it is used routine method for determination of hematocrit, Rinata in a particular clinic. It is determined by the amount of blood and the contents of the drainage catheter, probe).
After the results are intercomparison of the studied blood parameters and contents of a drainage catheter, probe); calculated index Sadchikov by the formula:
where Hta - hematocrit content of drainage,
Htb - hematocrit of venous blood,
Is - index Sadchikov.
Depending on the size of the index, we identify three quality, which indicates the index:
|State||No bleeding||Capillary bleeding||Diffuse bleeding||Vascular bleeding|
|Index value||Less than 0.05||of 0.05-0.2||0,2-0,5||0,5-1,0|
We studied 52 patients with functional features it was supposed to be internal bleeding. Of these 22 patients with suspected bleeding from ulcers of the gastrointestinal tract, 18 patients with suspected bleeding from the bladder, 12 patients with alleged paleoprecipitation. They have to arm/exclusion diagnosis applied the proposed method, verified by using fibroesofagogastroduodenoscopia (patients with ulcers of the gastrointestinal tract), videocategory (patients with suspected bleeding from the bladder), revisions in the area of operation (patients with presumed postoperative bleeding).
The control group was 27 patients with similar patterns of causes of bleeding; the control group differed from the basic fact that for arming/exclusion diagnosis was used the traditional method (functional performance and character of the discharge from the drainage).
|Functional characteristics and nature of the discharge from the drainage||The proposed method|
|The true result||False||Average time diagnostics||The true result||False||Average time diagnostics|
|Defined bleeding||16(80%)||4(20%)||4 h||40(93,02%)||3(5,8%)||30 min|
|Defined no bleeding||5(71,42%)||2(28,52%)||8(88,88%)||1(11,12%)|
Compared with the traditional way, using the proposed method decreased the number of erroneous diagnosis of bleeding, as well as the obvious advantage that less time is required for diagnosis.
Specificity is 88,88%, which in combination with the sensitivity 93,02% accounts for its high diagnostic value.
The value of the designated index Sadchikov not depend on the indices of Central venous pressure and circulating blood volume. The simplicity of the proposed method accounts for its technical reproducibility.
Example 1. Sick Gonchar SCI, 72 years, the case history No. 7207. Date of receipt of the oar KB them. Sriratana SSMU 24.07.10. Diagnosis: Primary: prostatic Hypertrophy. Complications: Acute urinary retention. Bilateral pyelonephritis. Background: Chronic renal failure.
The patient was performed percutaneous needle nephrostomy, then for several days in the urine of nephrostomes observed what up blood, evaluated by different experts from moderate to severe. Discussed the question about the necessity of surgical intervention for the purpose of hemostasis. Was made on the determination of hematocrit in the blood and urine of nephrostomes. In urine hematocrit of 2%in the blood - 33%, the calculated index Sadchikov is 0.06, indicating that capillary bleeding. The need for surgical intervention was rejected. Hematocrit urine in the patient consistently declined over the two days, the third day blood in the urine was not significantly detected.
Example 2. Sick of Darina A.I., 82 years. Case history No. 7608. Date: 9.08.10. Diagnosis: Primary: Cancer of the antrum. Condition after antral resection of the stomach. The failure of the gastrojejunostomy. Arrozivnym bleeding.
In the postoperative period lasted Department scant serous-hemorrhagic content from drains. For 8 days the patient's condition deteriorated: there are hypotension, tachycardia, paleness of the skin. Sample collection blood and the contents of the drainage. Blood hematocrit was 32%, in the discharge of drainage 30%, the index Sadchikov 0,94%, indicating a vascular bleeding.
Was relaparotomy identified and eliminated the source of bleeding: the vessel in the area of the anastomosis.
As can be seen from the description of the deposits, in the following examples, the proposed method allows to diagnose internal bleeding in the early stages, requires significantly less time, is more objective and accurate than the traditionally used methods.
The way to diagnose internal bleeding, including determination of hematocrit in the blood of the patient, characterized in that it further determine the hematocrit content of drainage, calculate the ratio of hematocrit drainage of the content to the hematocrit of the blood and when it is less than 0.05 diagnose the absence of bleeding, a value of from 0.05 to 0.2 diagnose capillary bleeding, from 0.2 to 0.5 diagnosed diffuse bleeding, above 0.5 diagnose vascular bleeding.
SUBSTANCE: invention relates to field of medicine. For laboratory diagnostics of early disorders of liver functional state activity of ALT, AST, LDH, GGT, ALP, total bilirubin are measured. Additionally carried out is 3-minute long occlusion of shoulder vessels - "cuff test" (CT) to create short-timer hypoxia. Indices of liver functional activity are determined by the following formulas: ALT index=((ALT after CT - ALT before CT)/ALT before CT)*100%; AST index=((AST after CT - AST before CT/AST before CT)*100%; LDH tot = ((LDH after CT - LDH before CT)/LDH before CT)*100%; ALP index=((ALP after CT - ALP before CT)/ALP before CT)*100%; GGT index=((GGT after CT - GGT before CT)GGT before CT)*100%; Bilirubin index=((Bilirubin after CT - Bilirubin before CT)/Bilirubin before CT)*100%. If said indices increase by more than 10%, early disorder of liver functional state is diagnosed.
EFFECT: method increases diagnostics efficiency due to early detection of liver functional state disorders, preceding registered by laboratory methods changes in its functioning.
2 ex, 4 tbl
SUBSTANCE: pregnant woman suffering hypotheriosis and obesity on their 2-12 weeks of gestation are examined for a fT4 level. If the fT4 values are less than 10 pmol/l, macrosomic delivery is predicted.
EFFECT: use of the method enables high-accuracy prediction of macrosomic delivery.
SUBSTANCE: multiple urine samples are taken during external exposure on a body for one day. Each sample is examined for the concentrations of thiols and urochrome that is followed by calculation of a thiol-urochrome coefficient (TUC) as a relation of the concentrations of thiols and urochrome. If the TUC value is 1.46±0.2, the body status is stated to be satisfactory. The TUC value more than 1.66 or less than 1.26 enables to state the status beyond the satisfactory limits.
EFFECT: use of the method allows analysing dynamics of the antioxidant body status, response to the external exposure, including to cosmophysical.
3 tbl, 3 ex, 3 dwg
SUBSTANCE: pH of thrombocyte-poor plasma, and a diagnostic coefficient D is calculated by formula: D=const1xPPP-const2, where D is a diagnostically significant coefficient, PPP is a pH value of thrombocyte-poor plasma of an examined patient, const1=18.877, const2=139.381. If D is less than 0.25, thrombocyte hyperaggregation is stated reliably, and the value of D exceeding 0.25 makes to state reliably the absence of thrombocyte hyperaggregation signs.
EFFECT: use of the declared technique allows high-accurate and sensitive evaluation of thrombocyte hyperaggregation.
SUBSTANCE: invention describes a method for determining antibacterial resistance of a human body in diseases caused by a staphylococcus infection, based on blood neutrophil analysis; functional activity of neutrophilic granulocytes of patient's peripheral blood is determined by chemoluminescence with calculating a bacterial activation index (the BAI-index) of neutrophils representing the relation of an area under a curve of neutrophilic granulocyte chemoluminescence induced by Staphylococcus epidermidis bacteria to an area under a curve of spontaneous neutrophilic granulocyte chemoluminescence, and if the derived value is less than 1.47, a high level of antibacterial resistance is stated, while the derived values 1.47 and more shows a low level of antibacterial body resistance.
EFFECT: method is informative, precise, complies with the modern requirements for laboratory diagnostic techniques and allows predicting a nature, a clinical course period and bacterial complications in the patients of various groups.
1 ex, 2 tbl
SUBSTANCE: method for prediction of rate of acute infectious diseases in infants with determining the immune status values on the first and fifth postnatal day: absolute lymphocyte count, differentiation marker carriers CD3, CD4, CD8, CD 19, CD56, CD95, a spontaneous nitroblue tetrazolium test value (NBTsp), a level of a phagocytic coefficient (PC), blood serum immunoglobulin A, M, G (IgA, IgM, IgG) concentrations, and further calculating a forecasting index (Ifor) with using a certain equation of multiple linear regression if Ifor does not exceed 3.2, a probability of no more than one acute infectious disease in an infant is concluded; if Ifor is within 3.2-3.7, 2 to 5 probable acute infectious diseases in an infant is stated; if Ifor exceeds 3.7, probability of more than 5 acute infectious diseases in an infant is concluded.
EFFECT: higher prediction accuracy.
SUBSTANCE: complete blood count is performed, and the leukogram components are used to calculate integral hematological values: Calph-Caliph leucocytic intoxication index - LII1, Ostrovsky leucocytic intoxication index - LII2, stress index - SI, neutrophil-lymphocyte index - NLI, neutrophil-monocyte index - NMI, lymphocyte-monocyte index - LMI. If observing the values LII1≤2.5, LII2≤2.75, SI≤1.0, NLI≤11.0, NMI≤16.0, LMI≤2.0, a mild severity is detected. The values LII1 2.6 to 4.5, LII2 2.76 to 5.0, SI 1.1 to 2.0, NLI 11.1 to 15.0, NMI 16.1 to 24.0, LMI 2.1 to 2.5 enables to predict a moderate severity level. A severe level is ensured by LII1> 4.5, LII2> 5.0, SI> 2.0, NLI> 15.0, NMI> 24.0, LMI> 2.5.
EFFECT: use of the declared method allows higher objectivity of determining severity level of acute pancreatitis.
4 ex, 2 tbl
SUBSTANCE: method of early solid malignant disease staging (at the stage of provisional clinical diagnosis) by cell number with stable ontogenetic disorders detected in patient's peripheral blood lymphocytes by quantitative and qualitative analysis of stable chromosomal and genomic disorders in metaphase plates from patient's peripheral blood lymphocytes.
EFFECT: method enables following disease change shift in response to treatment and determining clinical effectiveness.
5 ex, 1 tbl
SUBSTANCE: method of diagnosing rejection of kidney allotransplant includes determination of phase height PH of peripheral blood live lymphocytes by method of phase-interference microscopy, determination of quantity of lymphocytes with phase height PH≤1.5 mcm, 1.5 mcm<PH≤2 mcm, 2 mcm<PH≤2.5 mcm, PH>2.5 mcm, selection of lymphocyte activity coefficients for each limit, said phase heights of lymphocytes equal k3=3, k2=2, k1=1, k0=0 respectively. Obtained data are used to determine functional activity of lymphocytes in sample by formula: FA=(k3n3+k2n2+k1n1+k0n0)/n, where n is number of lymphocytes in sample, n3 is number of lymphocytes with PH≤1.5 mcm, n2 is number of lymphocytes with 1.5 mcm<PH≤2 mcm, n1 is number of lymphocytes with 2 mcm<PH≤2.5 mcm, n0 is number of lymphocytes with PH>2.5 mcm, k3, k2, k1, k0 are coefficients of lymphocyte activity, and if value of lymphocyte functional activity is within FA=1.8-2.0, rejection of kidney transplant is diagnosed.
EFFECT: application of claimed method makes it possible to set diagnosis in due time, which considerably increases efficiency of anti-crisis therapy in post-transplantation period.
2 ex, 1 tbl
SUBSTANCE: claimed is method of diagnosing antioxidant function of membranes of erythrocytes in case of exacerbation of herpes-viral infection. Method lies in determination of superoxide dismutase concentration and titre of antibodies to herpes virus by method of immunosorbent assay (ELISA) of peripheral blood in pregnant women after exacerbation of herpes-virus infection. If superoxide dismutase concentration is 297.63±13.16 Unit/gHb (control - 386.77±13.12 Unit/gHb), titre of antibodies to herpes virus in peripheral blood of pregnant woman constituted 1:3200. If titre of antibodies is 1:6400, superoxide dismutase concentration decreased to 243.85±7.71 Unit/gHb (control - 386.77±13.12 Unit/gHb; p<0.001).
EFFECT: reduction of superoxide dismutase concentration in erythrocytes of peripheral blood in pregnant women during exacerbation of herpes-virus infection predicts reduction of protective reaction of toxic impact of lipid peroxidation on membranes of erythrocytes, increasing risk of their destruction.
SUBSTANCE: invention relates to laboratory methods for blood analysis. Plasma is dropped in copper sulfate solution with density 1.023 g/cm3, not above, and time for drop falling on bottom of graduated cylinder with column height 243 mm is measured. The blood plasma density value is calculated by the formula:
wherein is the unknown blood plasma density (g/cm3); is copper sulfate solution density measured by areometer (g/cm3); t is average falling time of plasma drop in the copper sulfate solution (as seconds); 0.260130126 and 0.00290695 are correction coefficients. Temperature of plasma and copper sulfate solution is 20oC. Method is simple and suitable and allows carrying out analysis of small volumes of blood plasma and to reduce analysis time.
EFFECT: improved assay method.
SUBSTANCE: method involves carrying out microscopic examination of blood serum samples taken from femoral vein and cubital vein. Femoral vein sample is taken on injured side. The examination is carried out before and after treatment. The blood serum samples are placed on fat-free glass slide in the amount of 0.01-0.02 ml as drops, dried at 18-30°C for 18-24 h. The set of pathological symptoms becoming larger or not changed after the treatment in comparison to sample taken before treatment, and morphological picture of samples under comparison taken from the cubital vein showing no changes or being changed to worse, the treatment is considered to be effective.
EFFECT: enabled medicamentous treatment evaluation in course of treatment to allow the treatment mode to be changed in due time; avoided surgical intervention (amputation); retained active life-style of aged patients.
FIELD: medicine, obstetrics, gynecology.
SUBSTANCE: in the first trimester of pregnancy one should study the content of CD8+CD11b lymphocytes and at their values being either equal or above 2% it is possible to predict gestosis. The present innovation enables to choose correct tactics of treating pregnant women that, in its turn, leads to decreased frequency of this complication of pregnancy and the risk for the development of fetal and neonatal pathology.
EFFECT: higher accuracy of prediction.
3 ex, 1 tbl
SUBSTANCE: the present innovation deals with studying and treating diseases of inflammatory, autoimmune and degenerative genesis. One should perform sampling of heparinized blood followed by its sedimentation to obtain blood plasma with leukocytes and centrifuging to isolate the latter which are washed against erythrocytic and serumal admixtures, and, also, it deals with calculating the number of cells in samples out of leukocytic suspension after incubation (B) for 1.5 h at 37 C in holes of plastic microplotting board, out of leukocytic suspension one should additionally prepare two samples, one should be applied to calculate total number of leukocytes before incubation (A), the second sample undergoes incubation at the same mode at addition of autoserum to calculate the number of cells remained after incubation (C). One should state upon adhesive properties of leukocytes by the index of spontaneous adhesion (D), where D=(A-B)/B.100%, and effect for enhanced cellular adhesion under the impact of autoserum should be detected by the value of K=(B-C)/C.100% at K ≥ 30%, where B - C - the number of cells undergone additional adhesion after addition of autoserum. The present innovation widens functional possibilities of the suggested method due to obtaining additional values depicting adhesive properties of blood leukocytes.
EFFECT: higher accuracy of detection.
FIELD: medicine, diagnostics.
SUBSTANCE: the present innovation deals with blood sampling, separating plasma against erythrocytes, moreover, in plasma on should detect activity of antithrombin III, proteins C and S, XIIa-dependent fibrinolysis and concentration of plasminogen obtained results should be expressed as relative units followed by calculating integral parameter that characterizes the state of anticoagulant-fibrinolytic potential (IPAFP) by the following formula: IPAFP = [(C1 + C2)/(C3 + C4)] x 100, where C1 - the ratio of observed value of antithrombin III activity to the value of inferior border of the range of analogous parameter norm; C2 - the ratio of observed value for the activity of proteins C and S system to the value of inferior border of the range of this parameter norm; C3 - the ratio of the value of inferior border of plasminogen concentration under normal conditions to observed value of analyzed parameter; C4 - coefficient calculated with the help of regression equation: C4 = 0.9 + (0.01 x X), where X - terms of lysis of patient's euglobulin clot/min, and at IPAFP value of 101.4 U and higher one should state anticoagulant-fibrinolytic blood potential to be in norm, in interval of 64.8 - 101.3 -as insufficient, and at 64.7 and below - as critical. The present method simplifies the procedure of evaluating the state of endogenous anticoagulants and activity of XIIa-dependent fibrinolysis.
EFFECT: increased diagnostic value of obtained results.
3 ex, 1 tbl
FIELD: medicine, laboratory diagnosis.
SUBSTANCE: method involves determination of the patient blood content of globulin-alpha 1, globulin-beta, globulin-gamma and the total bilirubin content followed by calculation of diagnosis indices for the patient (Y1, Y2, Y3) by using the computer program "Statistica 1.5" and introducing values X1, X2, X3 and X4 in computer wherein X1 means globulin-alpha 1 value; X2 means globulin-beta value; X3 means globulin-gamma value; X4 means total bilirubin value. Obtained values of diagnosis indices for the individual patient (Y1, Y2, Y3) are compared with average values of diagnosis indices (Y1', Y2', Y3') for different urogenital infections followed by comparison by sign and value. By the maximal coincidence of diagnosis index values for the individual patient with average diagnosis index values urogenital disease is diagnosed and the following diagnosis index average values are used: for chlamydiosis: Y1' = -2; Y2' = -0.1; Y3' = -0.2; for mycoplasmosis: Y1' = 2; Y2' = 0.8; Y3' = -0.04; for ureaplasmosis: Y1' = 2; Y2' = -1; Y3' = 0.02; for health persons: Y1' = -2; Y2' = 0.1; Y3' = 0.2. Invention provides the development of a method for express-diagnosis of infection at initial stage and diagnosis of atypical forms that occur in these diseases, and differential diagnosis of chlamydiosis, mycoplasmosis and ureaplasmosis. Invention can be used for carrying out the differential diagnosis of chlamydiosis, mycoplasmosis and ureaplasmosis.
EFFECT: improved method for express-diagnosis.
2 tbl, 4 ex
SUBSTANCE: method involves determining absolute value of ratio between lymphocyte number and absolute value of monocyte number in peripheral blood at the end of combine radiation therapy. The ratio is divided by 4.05. The result value being greater than 1, no disease relapse occurrence is predicted during the first observation year. The value being less than 1, tumor growth progress is stated and carcinoma relapse is predicted at the first year after treatment.
EFFECT: enhanced accuracy in detecting pathological process progress before observing clinical manifestations.
SUBSTANCE: method involves determining infrared radiation absorption coefficient in blood plasma in bandwidth of 1543-1396 cm-1. The infrared radiation absorption coefficient is determined in %. The value being equal to 29.7±1.1%, catarrhal cholecystitis is diagnosed. The value being 26.4±1.4%, phlegmonous cholecystitis is diagnosed. The value being 21.2±1.8%, gangrenous cholecystitis is diagnosed. The value being equal to 18.6±0.5%, gangrenous perforated cholecystitis case is diagnosed. The value in norm is equal to 32.4±0.8%.
EFFECT: high accuracy and specificity of diagnosis.
SUBSTANCE: the present innovation deals with biomedical measuring technologies, in particular, to those to detect bactericide activity of blood serum according to the level of its inhibiting impact upon luminescence intensity of sulfur-sensitive luminescent bacteria (ΣimpO) against control - luminescence intensity the same sulfur-sensitive luminescent bacteria that had no contact with blood serum (ΣimpK), then one should calculate the value of bactericide activity of blood serum by the following formula:
As sulfur-sensitive luminescent bacteria one should apply either natural or recombinant microorganisms being characterized by direct proportionality between intensity of decreased spontaneous bioluminescence level and degree of bactericide effect. For example, it is possible to apply Escherichia coli strain with genes of Photobacterium leiognathi luminescent system. The suggested method enables to shorten the duration for detecting bactericide activity of blood serum and decrease its labor intensity.
EFFECT: higher efficiency of detection.
1 cl, 1 ex, 1 tbl
SUBSTANCE: method involves determining blood insulin I and thyroxin T content and phagocytic leukocyte activity (PLA). Activity coefficient is calculated on the basis of formula KA=IxPLA/T. KA value being found greater than 2.8 units, considerable amelioration treatment effect is predicted. The value being from 1.4 to 2.8 units, amelioration is predicted. KA being less than 1.4 units, lower treatment efficiency is predicted.
EFFECT: high reliability of prognosis.