Method of diagnosing ischemic heart disease by method of stress-echocardiography with combined isometric and psychoemotional stress

FIELD: medicine.

SUBSTANCE: test is carried out by an application of a combined approach with simultaneous application of isometric and psychoemotional stress. Isometric stress is performed by means of two ring expanders, which a patient compresses in each hand with the maximal effort for the maximally possible time interval - usually for 2-3 minutes. In the process of performing an isometric test additional psychoemotional stress in the form of constant psychological setting of the patient to the maximal pressure of the hand expanders for the entire test is carried out. Simultaneously a registration of echocardiographic scans is performed from the apical access in a projection of a four-chamber and two-chamber section with an application of 16-segmented model in a combination with ECG AND AP registration.

EFFECT: method makes it possible to increase an accuracy and self-descriptiveness of non-invasive ultrasonic diagnostics of ischemic heart disease in clinical practice due to the creation of the powerful synergic effect from two stressing factors.

 

The invention relates to medicine, namely to ultrasound diagnostics in clinical cardiology.

Coronary heart disease (CHD) for many years is the main cause of mortality in many developed countries, including in Russia. Mortality from circulatory diseases in the Russian Federation is about 56 per cent of the total deaths, of which about half falls on mortality from coronary heart disease (Oganov RG, shalnova S.A., Kalinina A.M. Prevention of cardiovascular disease: guide. M: GEOTAR-Media, 2009. - 216 C.).

Currently, along with the attempts with the help of primary prevention to reduce the value of CHD in the number of cardiac pathology raises the problem of early diagnosis and timely secondary prevention of this disease.

Important role in the diagnosis of coronary artery disease play a functional load tests, and in particular the sample with dosed physical load test with electrical stimulation of the heart and pharmacological tests (Aronov D.M., lupanova VP Functional tests in cardiology. Medpress-inform, 2007. - 328 S.).

Most common in clinical practice received samples with dosed physical load and check electrocardiography (ECG): exercise test and treadmill test. However, beings who have factors significantly restrict the execution of these samples. Thus, the sample does not informative in the case of the blockade of the left bundle branch, marked hypertrophy of the left ventricle, WPW syndrome. To extracardiac reasons that restrict the execution of tests, with dosed physical load on the treadmill and the cycle Ergometer, include arthritis of large joints, leg injuries, obesity, old age, etc. (Aronov D.M., lupanova VP Functional tests in cardiology. Medpress-inform, 2007. - 328 C.). According to British authors only in 40% of patients with suspected coronary artery disease may conduct a load test using the dosed physical load and ECG registration (Senior R., Monaghan, M., Becher H. et al. Stress echocardiography for the diagnosis and risk t op of patients with suspected or known coronary artery disease: a critical appraisal. Supported by the British Society of Echocardiography // Heart. - 2005. No. 91(4). - P.427-36). In this regard, the currently widespread echocardiographic control when performing various functional tests (stress echocardiography). Stress echocardiography (stress Echocardiography) is a method of non-invasive ultrasonic diagnostic induced myocardial ischemia and/or changes in intracardiac hemodynamics in combination with the basic functional tests. Diagnostics induced myocardial ischemia is based on identifying preho the yaschih violations of local contractility of the left ventricle (LV) using two-dimensional echocardiography (EchoCG) (Rybakova, M.K., The Alekhin, Mitkov CENTURIES a Practical guide to ultrasound diagnostics. Echocardiography. - M.: Vidar-M., 2008. - 544 S.).

Stress Echocardiography has several advantages compared to traditional non-invasive instrumental methods of detecting myocardial ischemia: from ECG and radionuclide stress tests. Stress Echocardiography has a high sensitivity and specificity, availability of research and for inpatient and outpatient phases of diagnosis, the possibility of repeated, the absence of ionizing radiation, can be used at the source of the modified ECG signs of hypertrophy of the left ventricle, intraventricular disorders conductivity, electrolyte disorders, effects of drugs and other).

For stress Echocardiography are used in practically all known types of metered loads used in modern cardiology. The most widespread drug samples with transesophageal stimulation (CPAS) and samples with physical exercise.

From the pharmacological tests most often used dobutamina and dipyridamole samples. The main disadvantages of pharmacological tests are a high incidence of side effects, until the development of severe rhythm disorders of the heart (dobutamina sample) and low is diagnosticheska importance in the initial stages of coronary artery disease (dipyridamole test) (Aronov D.M., Lupanova VP Functional tests in cardiology. Medpress-inform, 2007. - 328 S.).

In some instances, CPAS in combination with Echocardiography is an alternative to pharmacological stress tests (Atar S., Nagai T., Cercek Century. et al. Pacing stress echocardiography: an alternative to pharmacologic stress testing // JACC. - 2000. - 36(6). - P.1935-41). The main limitations and disadvantages of this method are associated with the difficulty of insertion of the probe into the esophagus and discomfort for the patient.

Samples with dosed physical load is quite widespread in clinical practice. However, it should be noted that the samples with dynamic physical loads commonly used option exercise induced stress Echocardiography, in which the main echocardiographic position register after the cessation of stress, which is a significant drawback of this method.

Also known combined methods of stress Echocardiography in the diagnosis of coronary artery disease, for example a combination of pharmacological tests with dosed physical load or CPES (Vasiliev, A., N. Mikheev. Combined methods of stress echocardiography with dipyridamole in combination with steam room, exercise breakdown and transesophageal stimulation of the Atria in the diagnosis of coronary heart disease // Russian cardiology journal. - 2005. - 5. - S-86). This combination of samples leads to significant uslog the structure of the methodology of stress Echocardiography, demanding technical equipment ultrasound study. When using dipyridamolee samples, a necessary condition is the presence of cooked antidote of aminophylline. All this leads to an increase in the duration of the procedure and its cost. At the same time combining data samples increases the risk of serious complications (Sicaril R., Nihoyannopoulos P., Evangelista A. et al. Stress Echocardiography Expert Consensus Statement Executive Summary. European Heart Journal. - 2009. - 30. - P.278-289).

A number of advantages possesses the sample with an isometric (static) exercise, namely: simplicity and accessibility of the method, high security, use in patients who are conducting stress tests with dynamic physical activity impossible or difficult (obesity, diseases of the musculoskeletal, vascular lesions of the lower extremities, total detraining and so on).

A known method for the diagnosis of coronary artery disease using stress Echocardiography with the use of metered isometric load, based on the execution of two-dimensional Echocardiography and evaluation of local contractility of the left ventricle during the execution of patient dosed isometric load. Interpretation of stress Echocardiography is based on the local changes of systolic myocardial function and first and foremost local thickening of the myocardium in response to isometric load. Originally OC the evaluation of systolic thickening of each of the segments of the myocardium and global systolic function in the initial state. Further analysis of contractility segments of the myocardium at the height of the load. (Mitamura h, Ogawa S., Hori, S., et al. Two dimensional echocardiographic analysis of wall motion abnormalities during handgrip exercise in patients with coronary artery disease // Am J Cardiol. - 1981. - 48(4). - P.711-719).

In patients with hemodynamically significant stenocereus lesions of the coronary arteries segmental thickening of the myocardium decreases due to the imbalance between the increasing needs of the working myocardium for oxygen and its delivery. The area of infarction krovosnabjaemah stenosed coronary artery, will be detected by systolic thickening and/or decreasing the amplitude of the wall motion in systole (zone violations of local contractility of the left ventricle), thus allowing you not only to detect a transient ischemia of the myocardium, but also to assess the localization and prevalence of coronary lesions (Sicari R, Nihoyannopoulos P., Evangelista, A., et al. Stress Echocardiography Expert Consensus Statement Executive Summary: European Association of Echocardiography (EAE) (a registered branch of the ESC) // Eur Heart J. - 2009. - 30(3). - P.278-89).

According to this method isometric test is carried out with a hand dynamometer that allows you to give the subject a measured load on the upper extremities. In this case, initially determined by the maximum pressure that can be created by the patient. He then continues to squeeze the dynamometer with two hands for 5 minutes with the power of avnoj 50% of the maximum. The sample is considered positive for violations of local contractility of the left ventricle at rest or on the height of the isometric load. (Mitamura h, Ogawa S., Hori, S., et al. Two dimensional echocardiographic analysis of wall motion abnormalities during handgrip exercise in patients with coronary artery disease // Am J Cardiol. - 1981. - 48(4). - P.711-719).

However, the method has several disadvantages. The relatively low increase in heart rate (HR) and systolic blood pressure (BP) at the height of the load leads to a slight increase of the double works reflecting the consumption of oxygen by the myocardium (Peter S.A., Jones, R.H. Effects of isometric handgrip and dynamic exercise on left-ventricular function // J Nucl Med. - 1980. - 21(12). - R-1138). This, in turn, does not allow you to diagnose disorders of the coronary blood flow in some patients, because the level of the generated load of the test is insufficient for inconsistency, coronary blood flow needs of the myocardium in oxygen, which leads to the low sensitivity of the method is about 40% (Mitamura h, Ogawa S., Hori, S., et al. Two dimensional echocardiographic analysis of wall motion abnormalities during handgrip exercise in patients with coronary artery disease // Am J Cardiol. - 1981. - 48(4). - P.711-719). According to other sources, the sensitivity of this method is 30%, and the diagnostic value only 47% (Loimaala a, Groundstroem K, Pasanen M., et al. Comparison of bicycle, heavy isometric, dipyridamole-atropine and dobutamine stress echocardiography for diagnosis of myocardial ischemia // Am J Cardiol. - 1999. - 84(12). - P.1396-100). Low sensitivity and diagnostic value of doing this test is hardly applicable in clinical practice.

A known method for the diagnosis of coronary artery disease using stress Echocardiography using samples with mental tension. According to this sample as the emotional stress is a method of mathematical account in mind. During the sample be registered standard Echocardiography positions. The sample is considered positive for violations of local contractility of the left ventricle. (M.G. Modena, Corghi F., Fantini g et al. Echocardiographic monitoring of mental stress test in ischemic heart disease // Clin Cardiol. - 1989. - 12. - P.21-24).

However, this modification has a number of significant limitations. First, the modeling technique of psycho-emotional stress is difficult to standardize, that the difficulty of quantifying results. Secondly, this technique is more suitable for patients with a particular psychological profile, the characteristics of the personality which is expressed aggression, anger, irritability. Thirdly, it is the low sensitivity of the methods of 73.5% (M.G. Modena, Corghi F., Fantini g et al. Echocardiographic monitoring of mental stress test in ischemic heart disease // Clin Cardiol. - 1989. - 12. - P.21-24). According to the study, Burg M, et al. only 45% of patients with coronary atherosclerosis revealed dysfunction of the myocardium of the left ventricle according to Echocardiography during mental load is Ki (Burg M.M., Jain D., Soufer R., et al. Role of behavioral and psychological factors in mental stress-induced silent left ventricular dysfunction in coronary artery disease // J Am Coll Cardiol. - 1993. - 22(2). - P.440-448). All this greatly limits the use of samples with mental tension.

It is also known that emotional test "mathematical" and metered manual isometric load are informative methods in the detection of hemodynamic disturbances in patients with arterial hypertension (AH) (ALEXANDER Shabalin et al. Informative psychoemotional stress test "mathematical" and metered manual isometric load in the diagnosis of stress-dependence in patients with essential arterial hypertension. Arterial hypertension. 2003. - N 3. - P.98-101). However, these samples were used to identify the stress-dependence in patients with hypertension, the diagnostic efficiency of these methods for detection of myocardial ischemia demonstrated was not.

The objective of the invention is to improve the accuracy and usefulness of non-invasive ultrasound diagnosis of coronary artery disease using the combined samples from isometric and emotional load.

To solve the problem in the diagnosis of coronary artery disease, including stress Echocardiography, with subsequent evaluation of local contractility of the left ventricle, conduct a combined sample of isometric and pehoe otionally load.

The essence of our proposed method for the diagnosis of coronary artery disease using stress Echocardiography is the use of a combined approach with simultaneous application and isometric, and emotional stress. This combination of samples, on the one hand, allows to achieve the highest possible level of intensity isometric burden for the patient, on the other hand, causes an additional activation of sympathoadrenal system during emotional stress.

Conduct stress Echocardiography combined isometric and emotional load was performed on the ultrasonic IE 33 (Philips, Germany-USA) phased array transducer 4-2 MHz. The test was carried out according to the method negazirovannoy load using two wrist ring expander, the patient with maximum effort clutched in each hand for the maximum possible period of time (usually 2-3 minutes). This method isometric load differs from the above standard dosed methods isometric load, in which the patient squeezes the dynamometer at a certain level from the maximum volitional efforts. This modification allows you to achieve a higher increase in blood pressure and heart rate during the test. In addition, during the isometric load the doctor constantly psychologically configures the patient on the Mac is kalinoe pressure applications up to the maximum pressure in the brush over the entire sample. Emotional encouragement of the patient increases due to the compression and lengthens the time of the load, thereby creating a synergistic effect. Similar reception performance improvement through psychological customize (auto-suggestion) for maximum results use in professional athletes (Control mentality of the athlete, 20.02.2011, On line http://www.swiming.kiev.ua/index.php/articles/500-swimming-artikles.html). But the application of this approach in patients extremely difficult, as it requires the involvement of a psychiatrist and additional time to conduct Psihologiya workout. In our case the emotional encouragement of the patient is the doctor of ultrasonic diagnostics, and this is an encouragement in itself is an additional load stress factor. In this modification on the patient's affected by two kinds of physical and emotional. During the emotional load is further increased heart rate and HELL due to increased secretion of catecholamines, increased vascular resistance with vasoconstriction of the coronary arteries, impaired microcirculation in the myocardium, which leads to a significant increase in the demand of oxygen. Simultaneous registration of echocardiographic scans the apical access projection chetyrehkamernoe and two-chamber cross-section, using the 16-segment model in combination with the ECG registration and HELL. The course of the study were recorded in the form of clips on the hard disk of the device.

Regional airway walls of the left ventricle was assessed from the apical access in the projection of the four-chamber and two-chamber cross-sections using the 16-segment model. Expected impairment index local contractility of the left ventricle at rest and at the peak isometric load, using a four-point scale: 1 - normokinetic, 2 - hypokinesia, 3 - akinesia, 4 - dyskinesia (Rybakova, M.K., Alekhin, Mitkov CENTURIES a Practical guide to ultrasound diagnostics. Echocardiography. - M.: Vidar-M., 2008. - 544 C.). Visual analysis of regional LV contractility was performed by two independent operators in a blind mode, when the difference in diagnosis of the study was assessed by the third independent operator. The sample was regarded as positive and stopped for violations of local contractility at least two segments of the left ventricle.

Coronary angiography as the reference method for diagnosis of coronary artery disease was performed in all patients within three days after conducting stress Echocardiography combined isometric and emotional load.

The study included 87 people aged from 37 to 70, the average age 53,8±7.3 years with the potential for the Oh or typical angina, designed by a cardiologist for a stress-EchoCG to verify the latent myocardial ischemia.

The study included individuals with regular sinus rhythm, the ejection fraction of the left ventricle more than 55% and safe global systolic left ventricular function, no violations of local contractility of the myocardium according to standard transthoracic Echocardiography. The exclusion criteria were: age older than 70 years, unstable angina, myocardial infarction in anamnesis, diabetes or disturbed tolerance to carbohydrates, valvular heart diseases, disorders of atrioventricular and intraventricular conduction, organic diseases of the pharynx and esophagus. 2-3 days before the examination the patient was taken off all medications.

Violations of local contractility of the left ventricle were detected in 53 patients, of which 92.5% of cases (49 patients) were found hemodynamically significant coronary lesions according to selective koronaroangiografii. During the isometric test is violation of local contractility of the left ventricle was detected in 84,5% of patients with diagnosed coronary heart disease according to angiography. Thus, the specificity of the method was 85,7%, sensitivity of 84.5%, which is 40%-45% higher than in normal samples with isometries the th load. The positive predictive value of the test increased by 91.9%. It should be noted that according to the literature, the sensitivity and specificity of stress Echocardiography with dobutamine breakdown in the diagnosis of CHD in average 86,3% 84,1%, respectively, and stress-Echo-KG dynamic exercise - 79% and 82%, respectively (Sicari R, Nihoyannopoulos P., Evangelista A. et al. Stress Echocardiography Expert Consensus Statement Executive Summary: European Association of Echocardiography (EAE) (a registered branch of the ESC) // Eur Heart J. - 2009. no. 30(3). - S-289).

Thus, stress-Echocardiography combined isometric and emotional load allows to increase the sensitivity of Echocardiography in detecting coronary artery disease, to improve the predictive value of the technique. Method is available, cost-effective and quick to use in the diagnosis of coronary artery disease in the outpatient setting. Sample safe, we did not observe any complications. The resulting asynergia attack completely reversible after discontinuation of the sample.

The essential features characterizing the invention, shown in the inventive combination of new properties that are not explicitly derived from the prior art and are not obvious to the expert.

Identical set of features not found in the patent and medical literature.

The proposed method can be used in health care practice, does not require special conditions is s, economical in time, is simple in operation.

Based on the foregoing should be considered as the invention with the relevant conditions of patentability of "novelty", "inventive step", "industrial applicability".

A method for the diagnosis of coronary heart disease using stress echocardiography combined isometric and emotional load, characterized in that the sample is done using a combined approach with the simultaneous application of isometric and emotional load, isometric load is performed by means of two ring expander, the patient with maximum force compresses in each hand for the maximum possible period of time - usually within 2-3 minutes, and that during the execution of the isometric tests conducted additional emotional burden in the form of permanent psychological setting up the patient at the maximum pressure of the hand balls throughout the sample.



 

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9 cl, 6 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: rested and fatigue person being tested is presented with variable-frequency signals formed as test to be solved, a presentation rate of which is changed proportionally wto its solution rate, and a quantity is specified equal for the rested and fatigue person being tested. Response measurements of the person being tested on the presented signals; a degree of fatigue measurements variation are described by expressions Tav.f=Ttotal.f/Kcor.f, Tav.r=Ttotal.r/Kcor.r, wherein Tav.f is an average time for correct solution of one test in the fatigue state. Tav.r is an average time for correct solution of one test in the rest state, Ttotal.f is the total time for solution of the pre-set quantity of tests in the fatigue state, Ttotal.r is the total time for solution of the pre-set quantity of tests in the rest state, Kcor.f is the quantity of the correct tests in the fatigue state, Kcor.r is the quantity of the correct tests in the rest state. A sequence of the presented tests in the rest and fatigue human operator is pre-set equal; an average time for one correct test in the rest human operator (Tav.r) is determined by a limited quantity of 3-5 series of 10 tests and used as a reference for further examinations. The tests to be solved include logical and dynamic tests performed by the operator together with a machine. A time for performing each test is determined taking into account repeated solutions required to correct the result and to fulfil the accuracy requirements of the specific test. The psychological tests involve measuring the human operator's physiological parameters. If at least one of them goes beyond admissible levels, the human operator load is reduced by limiting the quantity of tests to be solved in the fatigue state. A degree of the human operator fatigue variation is assessed taking into account limiting the quantity of tests by a relative variation of an average time of the correct solution of the tests in the fatigue state, and respective analogous tests in the rest state.

EFFECT: method enables providing higher reliability ensured by increasing psychological, mental and lower visual component of the load, higher safety of the human operator in the process of examination and reducing time and material costs when implementing the method.

2 cl

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to cardiology, and may be used for prediction of the medical-social effectiveness of the integrated treatment of the patients suffering arterial hypertension (AH). There are determined prognostic factors: clinical-laboratory data: total blood cholesterol, daily AH monitor: daily average systolic blood pressure, intracardiac hemodynamics: posterior wall thickness in diastole (PWTd), quality of life indicators on the scale of physical activity (PF) of the questionnaire SF-36. Further, a multiple regression analysis is used to make an equation calculating the number of days of temporary disability. The result is used to predict the number of days of temporary disability for the following 12 months after the integrated treatment that enables assessing the medical-social effectiveness of the drug-induced therapy in a combination with training programs.

EFFECT: method enables predicting the medical-social effectiveness of the integrated treatment of the patients with AH as shown by the number of days of temporary disability with using the regression analysis by the integrated clinical-functional examination.

4 ex

FIELD: medicine.

SUBSTANCE: current normal baseline physiological parameters of a person being tested are recorded by means of a polygraph. Visual information associated with human personalities, including a set of stimuli presented to the person being tested is pre-selected. To assess an individual semantic space of the person being tested, the latter is suggested to select the significant visual information from the set of stimuli to be assessed and distributed among the stimuli pre-selected by means of psychosemantic and factor analysis. A database for the following ranging of the selected stimuli is formed from the selected stimuli distributed by a sematic differential, and also extra control and neutral stimuli. The person being tested is presented with 6-8 stimuli together with the control and neutral stimuli on a demonstration monitor of an eye motion recording device to assess the subjective significance of the selected stimuli. An eye position, motion, a path of motion and fixation length is recorded; zones of preferential passive concentration fixation are recorded. The derived data are analysed to select a primary gaze zone and to determine a gaze length. The stimuli drawing much attention are determined; when presenting the selected stimuli on the screen of the eye motion recording device, synchronous measurements of the physiological parameters of the person being tested are taken by using the polygraph. The physiological parameter variations of the person being tested are assessed by excursion of their current values from the pre-recorded baseline values. The physiological parameter variations of the person being tested specific for perceiving the subjectively significant information and being simultaneous with the primary gaze moments; the stimuli having the most emotional impact on the person being tested are determined.

EFFECT: method enables determining the occupational guidance and providing the accuracy of the obtained data by the psychophysiological study.

FIELD: sports.

SUBSTANCE: athletes are tested by the device psychophysiological testing UPFT-1/30-"Psychophysiology" assessing complex visual-motor response by presenting a series of 110 light stimuli with a random distribution of green and red colours. First 5 signals consisting of 3 red and 2 green signals are training. Then three groups of signals are presented, consisting of 20 red and 15 green signals. In the first group the red signal is quenched with the key "NO", green - the key "YES", each subsequent signal is presented after 3-5 s. after the response. In the second group, on the contrary, the red signal is quenched with the key "YES", green - the key "NO", each subsequent signal is presented after 3-5 s. after the response. .In the third group the green signal is missed, the red signal is quenched by the key "YES", the exposure of the green signal is 2 s., after the red signal the subsequent signal is presented after 3-5 s. The device measures the response time for each stimulus and the number of erroneous actions with the determining of parameters: the average reaction time of excitation and inhibition processes; mobility of nervous processes and the number of errors made on the processes of excitation, inhibition and mobility of nervous processes. With an average response time of excitation processes of 556.90-643.26 ms, with an average reaction time of inhibition processes of 449.02-498.4 ms, mobility of nervous processes of 422.64-472.92 ms, the number of errors made on the process of excitation of 2.69-4.43, inhibition process of 0.6-1.4, mobility of nervous processes of 1.12-2 the athlete is recommend to do billiard sports.

EFFECT: method enables to carry out the selection of athletes objectively and accurately for doing billiard sport by determining the sensorimotor qualities.

5 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: what is involved is psychodiagnostics that provides a basis for a short-term positive and rational psychotherapy. Then, three types of breathing are trained: diaphragm breathing technique; pre-labour breathing technique that provides a deep chestful breath-in alternated with a deep breath-out every time labour arrives, in a relation of breath-in : breath-out - pause 4:6, repeated for at least 5 times. The breathing technique for the period of intensive labours is trained to provide a deep mouth breath-out, a chestful breath-in, in the relation of breath-in : breath-out 4:4; and a shallow breathing is trained. After the breathing types are trained, a pregnant woman is subject to a positive non-conscious exposure for 30 minutes according to SOMVI technique for the purpose of the desensitisation of negative expectations of the forthcoming delivery and the correction of the psychosomatovegetative state; the preparation course is 8-10 sessions.

EFFECT: method enables provides the more effective psychotherapeutic preparation of the women at the late pregnancy by normalising the high anxiety level and reducing the subjective feeling of the labour pain, that in turn leads to reducing the drug-induced load accompanying the labour, and reduces a probability of obstetric and perinatal complications in birth and after-birth periods.

FIELD: medicine.

SUBSTANCE: patient passes a psychological pre-testing to determine an anxiety level and a self-efficacy level that are used to derive the number for visits, which are supposed to include the motivational interviewing preceding the dental intervention. If the patients have the low anxiety and the low self-efficacy, the motivational interviewing is only included in the first visit with the demonstration of empathy. The patients showing the medium anxiety and the high self-efficacy require the motivational interviewing on the first three visits to demonstrate empathy by reflexive listening with argues and straight confrontation to be avoided. In the patients with the medium anxiety and the low self-efficacy, the motivational interviewing is used on the first five visits with each visit started with demonstrating empathy to the patient to relieve a resistance to the treatment if any. The patients with the high anxiety and the high self-efficacy require the motivational interviewing on each visit to relieve a resistance to the treatment if any, to demonstrate empathy, to intensify a contradictory nature of the patient's judgments, to support a positive self-feeling; the first visit includes no traumatic interventions; the visits are appointed not less than every 10 days. The patients with the high anxiety and the lower self-efficacy passes the motivational interviewing on each visit; on the first 3 visits, no traumatic injuries are included with demonstrating empathy, relieving a patient's resistance to the treatment, intensifying intensify a contradictory nature of the patient's judgments, and supporting a positive self-feeling. On each visit, the patient is accompanied by people who give the moral support with the visits appointed not less than every 7 days.

EFFECT: method enables reducing the state anxiety on the outpatient dental visit by normalising the functional values that reduces a probability of medical emergencies.

10 tbl, 5 ex

FIELD: medicine.

SUBSTANCE: neuropsychological testing aims at determining an analytic-synthetic thinking index; a depression index; a trait anxiety index; a state anxiety index; a mental alertness index; a psychomotor activity rate, and recording an electroencephalography to measure β1-rhythm and β2-rhythm. A diagnostic function F is calculated; the derived value is compared to a constant, and if F is more than the constant, the cognitive disorders accompanying encephalopathy caused by an effect of alcohol are diagnosed; if F is equal to or less than the constant, the cognitive disorders accompanying chronic mercury intoxication are diagnosed.

EFFECT: technique enables providing more accurate differentiation of the cognitive disorders accompanying toxic encephalopathy caused by the effect of mercury, and alcoholic encephalopathy.

2 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: invention is related to medicine, in particular to psychiatry, psychophysiology, psychology, and it can be used for mental health prognosis in applicants to military higher educational institutions. Persons under tests are offered to take psychological tests: KP - 3-85: performance efficiency of the test for assessment of complex analogies, visual memory, image thinking, verbal memory, setting regularities; data processing rate coefficient; indicators in L, D, Pd, Mf, Pa scales of MMPI test. According to the testing results mental health prognosis is suggested as favourable or unfavourable.

EFFECT: method allows objective early diagnosis of potential mental distress signs in the period before disease progress.

2 ex

FIELD: sports.

SUBSTANCE: test person is offered to perform for the given time at the maximum rate the movements with a probe sequentially on the contact pads located in the corners of a flat triangular or polygonal figure, touching the contact points located in the centre of the contact pads. The contact points are surrounded by N concentric zones isolated from each other and from the contact point. The contact points and the concentric zones of the contact pads are connected to the inputs of the computer. The distance between the adjacent concentric zones and between the inner concentric zone and the contact point corresponds to the diameter of the probe. The test person makes movements with the probe on the contact pads, trying to touch the contact points. Hitting the outer concentric zone with the probe corresponds to 1 point, hitting each successive inner zone corresponds to 1 point more, the contact point - (N+1)-th point. In case of hitting with the probe between the concentric zones or between the inner concentric zone and the contact point when the probe touches them at the same time, is estimated as a number of points corresponding to the inner concentric zone or the contact point, respectively. The computer calculates the total number of movements, equal to the number of touches with the probe of the contact pads, and the number of scored points as a result of touches. Speed of movement is estimated by the total number of movements, accuracy of movements - by the number of scored points.

EFFECT: method enables to improve the accuracy of estimate characterising the accuracy of movements by the number of scored points as a result of the probe touches.

1 dwg

FIELD: medicine.

SUBSTANCE: method involves forming signals as tests requiring solution. The tests are shown with frequency changed proportionally to the frequency they are solved. The number of tests is set to be the same in the cases of recovered and tired state. General amount of time spent for finding solution for given number of tests and the number of tests having right solutions are determined in each state. Mental fatigue degree is evaluated from relative change of mean time needed for finding the right test solution using a relationship like (Tm.r- Tm.t)100%/Tm.t, where Tm.t = Tsum.t/Kr.t, Tm.r = Tsum.r/Kr.r, Tm.t is the time spent for finding the right answer in tired state, Tm.r is the time spent for finding the right answer in recovery state, Tsum.t is the total time spent to solve given number of tests in tired state, Tsum.r is the total time spent to solve given number of tests in recovered state, Kr.t is the number of right answers to the tests in tired state, Kr.r is the number of right answers to the tests in recovered state.

EFFECT: reliable estimation of fatigue degree.

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