Diagnostic technique for ischemic heart disease

FIELD: medicine.

SUBSTANCE: diagnostic technique for the ischemic heart disease is implemented by stating risk factors, symptoms and ECG findings, diagnostic characters (DC) of which are distributed into groups and assigned with certain numerical scores. Conditional probabilities of the presence or absence of IHD in a specific patient are calculated. The findings are used to establish the diagnosis of IHD or not.

EFFECT: technique enables providing establishing the more accurate diagnosis of IHD by taking into account a complex of various DCs, the records of which are processed by a mathematical model.

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The invention relates to the field of medicine and medical equipment and can be used to assess the condition of the cardiovascular system (CVS) of a person, including implementation of an automated e-diagnosis by remote monitoring of cardiac data, and during preventive examinations of the population in order to identify the risk of developing coronary heart disease (CHD).

A known method for predicting the risk of coronary heart disease in workers with anthracosilicosis (patent RU №2210304, publ. 20.08.2003). For implementing the method in miners with anthracosilicosis determined by the following markers: genetic markers system AVO; type earwax; growth; consitutitional-morphological type (KMT), as a diagonal crease in the ear lobe (DSA); the presence or absence of arterial hypertension (AH), diabetes mellitus (DM), burdened by ischemic heart disease heredity, overweight (BMI) according to the Quetelet index, the relationship of waist circumference to hip circumference (ON/ABOUT), hypercholesterolemia, (GHS), Hyper β-lipoproteinemia (Hyper β-PL)the number of phenotypic traits - hair color, baldness, early graying, iris color, the shape of the ear lobe, the ratio of II and IV fingers of the right hand, blood group RH. Further, according to the t values obtained for each token on it appoint prognostic factor, calculated on the basis of the Bayesian estimates and the method of likelihood Wald. Then all prognostic factors stack and when the sum value prediction coefficients (+5) points and above predict a high risk of developing coronary heart disease in miners with anthracosilicosis. The method has limited application, as it allows to assess the risk of developing CHD in patients not belonging to the group of miners with anthracosilicosis.

The closest in technical essence is a method for predicting the risk of coronary heart disease (patent RU №2345701, publ. 10.02.2009), namely, that determine the presence of the following risk factors: emotional stress; hypertension; age older than 50 years; dyslipidemia - elevated levels of cholesterol, triglyceride and β-lipoproteins; behavioral type And history, the presence of each of the signs is estimated as 1 point, no - 0 points. Next are calculated according to the formula rate risk:

A=0,043+0,631·stress+0,129-AG+0,154·age 50+0,077-dyslipidemia+0,234-behaviour. type a

If the indicator is 0,043-0,451 used the risk of developing coronary heart disease is regarded as low, from 0,452 to 0,859 medium, from 0,860 to were 1,268 - as high.

The main disadvantage of the prototype is not high enough doscover the industry forecast. The above-mentioned disadvantage of the prototype is due to the fact that when evaluating the risk of coronary heart disease do not take into account such factors as: the results of ECG studies in the form of diagnostic conclusions, which are mainly used in medical practice for diagnosing coronary artery disease; and there is no more detailed classification used risk factors. For example, the risk factor age into account only the number of years more or less 50 years, it does not take into account the fact that the risk of developing coronary heart disease at the age of 45 years more than 20 years of age, especially for male patients. The disadvantage of the prototype is due to the fact that it does not provide a quantitative estimate of the probability of the risk of developing CHD, and give ultimately a qualitative assessment of the risk of developing coronary artery disease (low, medium, high risk), which does not allow the cardiologist to unambiguously interpret in this way the results and decide on the basis of these data, the patient has CHD or not.

The task is to create a method for the diagnosis of ischemic heart disease, free from the disadvantage of the prototype.

The technical result is to increase the reliability of diagnosis of CHD by calculating a quantitative assessment of the probability of having coronary artery disease on the basis of the classification status of the cardiovascular system (CVS) man on risk factors, the symptoms, conclusions on the ECG-research diagnostic criteria (hereafter DP) are classified in groups, where group 1 - DP is not defined, group 2 - DP is, the group of 3 - APS no, for a number of APS are classified additional groups.

The required technical result when the task is achieved by the fact that unlike the prototype:

1) use a more detailed classification of the risk factors for CHD, which is used in the prototype that allows you to more accurately assess their contribution to increase or decrease the risk of developing coronary artery disease;

2) use unlike the prototype additional diagnostic signs of risk factors, symptoms and findings on ECG study, which allows us to differentiate various, including cardiovascular, diseases with similar clinical picture with coronary heart disease, which reduces the number of false-positive diagnoses of CHD, that is, it increases the accuracy of the final diagnosis of coronary artery disease.

3) even in case of failure of primary APS patients allows you to make a preliminary diagnosis of the risk of developing coronary artery disease, with its subsequent refinement and increased reliability as you collect additional diagnostic characters.

A method for the diagnosis of coronary heart disease (CHD), as in the prototype, is carried out by determining the existence of f is Ktorov risk (FR), which classify the state of the cardiovascular system (CVS) person: emotional stress; arterial hypertension; age; dyslipidemia - elevated levels of cholesterol, triglyceride and β-lipoproteins; behavioral type in history.

In this case, applying a more detailed classification of these FR:

- "emotional stress" is classified according to the groups: 1 - not defined; 2 -; 3 - no;

- "hypertension" are classified in groups according to the classification of JNC-VI: 1 - not defined; 2 - optimal blood pressure (hereafter BP), i.e. systolic blood pressure (the GARDEN) is less than 120 mm Hg and diastolic blood pressure (hereinafter DBP) less than 80 mm Hg; 3 - normal AD, i.e. GARDEN 120-129 and DBP 80-84 mm Hg; 4 - vysokotermalnaya HELL, i.e. GARDEN 130-139 and DBP 85-89 mm Hg; 5 - first degree of arterial hypertension, i.e. GARDEN 140-159 and diastolic 90-99; 6 - second degree arterial hypertension, i.e. GARDEN 160-179 and DBP 100-109; 7 - third degree of arterial hypertension, i.e. GARDEN more than 180 and DBP more than 110; 8 - Isolated systolic hypertension, i.e. GARDEN not less than 140 and DBP of at least 90;

"age" is classified according to the groups: 1 - not defined; 2 - 0-17; 3 - 18-44 years; 4 - 45-64 years; 5 - 65-74 years; 6 - 75-84 years; 7 - >85 years;

"dyslipidemia" is classified according to the groups: 1 - not defined; 2 -; 3 - no;

- "povidence the cue type in history" is classified according to the groups: 1 - not defined; 2 - a; 3 - type B.

In addition, unlike the prototype for diagnosing CHD additionally classify the following diagnostic characters (PD) risk factors, symptoms and findings on ECG study to their respective groups:

- risk factors:

1) DP "floor", are classified in groups: 1 - not defined; 2 male; 3 female;

2) DP "diabetes": 1 not defined; 2-I, 3-II type; 4 - no;

3) DP "Smoking": 1 not defined; 2 - smokes; 3 - do not smoke;

4) DP "obesity": 1 not defined; 2 - severely underweight body, when the body mass index (BMI)<16 kg/m2; 3 - normal and edge values of body weight, when 16≤BMI≤30 kg/m2; 4 - obesity, with a BMI>30 kg/m2;

5) DP "physical inactivity" (low physical activity): 1 - not defined; 2 -; 3 - no;

6) DP "consumption of alcohol: 1 - not defined; 2 - do not drink alcohol; 3 - moderate consumption (up to 30 g per day in terms of pure ethanol); 4 - frequent alcohol consumption (≥30 g / day in terms of pure ethanol);

7) DP "burdened by CHD heredity: 1 - not defined; 2 - CHD sick of both parents; 3 - CHD was sick one of the parents; 4 - CHD hurt both parents;

- symptoms:

8) DP "having pain": 1 not defined; 2 - pain does not occur; 3 - there is pain;

9) DP duration of pain without ispolzovanii.izvinyayus": 1 - not defined or pain does not occur; 2 - up to 15 minutes; 3 - 15 minutes or more;

10) DP action pain medications for pain: 1 - not defined or pain does not occur; 2 - nitrate is not effective for pain relief; 3 - the pain stopped using nitrates;

11) DP "localization of pain: 1 - not defined or pain does not occur; 2 - chest pain; 3 - abdominal pain; 4 - pain in the throat; 5 - pain in the arm; 6 - pain in shoulder blade; 7 - pain in lower jaw; 8 - pain in other parts of the body;

12) DP "start condition is the occurrence of pain": 1 not defined or pain does not occur; 2 - when standing; 3 - at the beginning of the walk; 4 - at the beginning of physical exertion (running, carry heavy bags, etc.);

13) DP "excessive sweating for no apparent reason": 1 not defined; 2 -; 3 - no;

14) DP "shortness of breath": 1 not defined; 2 -; 3 - no;

15) DP "loss of consciousness": 1 not defined; 2 -; 3 - no;

16) DP "the patient has suffered a myocardial infarction previously: 1 - not defined; 2 - Yes; 3 - no;

17) DP "indigestion (heartburn, nausea, colic)": 1 - not defined; 2 -; 3 - no;

18) DP "vertigo": 1 not defined; 2 -; 3-no;

- findings on ECG study:

19) DP "normal sinus rhythm": 1 not defined; 2 -; 3 - no;

20) se "with the th bradycardia": 1 - not defined; 2 -; 3 - no;

21) DP "ectopic atrial rhythm: 1 - not defined; 2 -; 3 - no;

22) DP "migration of the driver of a rhythm: 1 - not defined; 2 -; 3 - no;

23) DP AV nodal rhythm": 1 not defined; 2 -; 3 - no;

24) DP "accelerated idioventricular rhythm: 1 - not defined; 2 -; 3 - no;

25) DP "sinus tachycardia": 1 not defined; 2 -; 3 - no;

26) DP "atrial fibrillation": 1 not defined; 2 -; 3 - no;

27) DP "atrial flutter": 1 not defined; 2 -; 3 - no;

28) DP "paroxysmal AV nodal reciprocal tachycardia": 1 not defined; 2 -; 3 - no;

29) DP "orthodromy supraventricular tachycardia in WPW syndrome": 1 not defined; 2 -; 3 - no;

30) DP "atrial tachycardia (automatic or reciprocal vnutriepreserdna)": 1 - not defined; 2 -; 3 - no;

31) DP "sinoatrial reciprocal tachycardia": 1 not defined; 2 -; 3 - no;

32) DP ' atypical form of paroxysmal AV nodal reciprocal tachycardia": 1 not defined; 2 -; 3 - no;

33) DP "orthodromy supraventricular tachycardia with a slow retrograde conduction": 1 not defined; 2 -; 3 - no;

34) DP "polytopia atrial tachycardia": 1 not defined; 2 -; 3 - no;

35) DP "paroxysmal atrial tachycardia with AV-blockade: 1 - not defined; 2 -; 3 - the em;

36) DP "ventricular tachycardia": 1 not defined; 2 -; 3 - no;

37) DP "supraventricular tachycardia with aberrant conduction": 1 not defined; 2 -; 3 - no;

38) DP "pirueta tachycardia": 1 not defined; 2 -; 3 - no;

39) DP "ventricular fibrillation": 1 not defined; 2 -; 3 - no;

40) DP "aberrant conduct": 1 not defined; 2 -; 3 - no;

41) DP "ECG during tachycardia with wide QRS complexes": 1 not defined; 2 -; 3 - no;

42) DP "atrial extrasystoles": 1 not defined; 2 -; 3 - no;

43) DP "blocked atrial extrasystoles": 1 not defined; 2 -; 3 - no;

44) SE AV nodal extrasystoles": 1 not defined; 2 -; 3 - no;

45) DP "ventricular extrasystoles": 1 not defined; 2 -; 3 - no;

46) DP alternate AV nodal reduction": 1 not defined; 2 -; 3 - no;

47) DP "replacement idioventricular reduction": 1 not defined; 2 -; 3 - no;

48) DP "sinoatrial blockade: 1 - not defined; 2 -; 3 - no;

49) DP "AV block 1st degree: 1 - not defined; 2 -; 3 - no;

50) DP "AV block 2nd degree type Mobitz I (with periodicals, Wenkebach)": 1 - not defined; 2 -; 3 - no;

51) DP "AV block 2nd degree type Mobitz II: 1 - not defined; 2 -; 3 - no;

52) DP "complete AV block": 1 not defined; 2 -; 3 - no;

53) DP "position electr the political axis of the heart: 1 - not defined; 2 - normal position (0° to +90°); 3 - deviation to the right (+91° to +180°); 4 - a sharp deviation to the right (+181° to +269°); 5 - deviation to the left (from +270° to +329°); 6 - permissible deviation from its normal position (+330° to +359°);

54) DP "normal 12-lead ECGs": 1 not defined; 2 - normal; 3 - normal;

55) SE "blockade of the anterior branch of the left bundle branch": 1 not defined; 2 -; 3 - no;

56) DP "blockade of the posterior branch of the left bundle branch": 1 not defined; 2 -; 3 - no;

57) DP "incomplete blockade of the left bundle branch": 1 not defined; 2 -; 3 - no;

58) DP "incomplete blockade of the right bundle branch": 1 not defined; 2 -; 3 - no;

59) DP "block of right bundle branch": 1 not defined; 2 -; 3 - no;

60) DP "blockade of the left bundle branch": 1 not defined; 2 -; 3 - no;

61) DP "blockade of the right bundle branch and one branch left bundle branch": 1 not defined; 2 -; 3 - no;

62) SE "violation nutrigold spectacle conductivity": 1 not defined; 2 -; 3 - no;

63) DP "left ventricular hypertrophy": 1 not defined; 2 -; 3 - no;

64) DP "right ventricular hypertrophy": 1 not defined; 2 - no; 3 - a; 4 - Type 5 - Type;

65) DP "hypokalemia": 1 not defined; 2 -; 3 - no;

66) DP "hyperkalemia": 1 not defined; 2 - no; 3 - Easy to 5.5-6.5 mEq/l); - Moderate (about 6.5-8.0 mEq/l); 5 - Severe (9-11 mEq/l);

67) DP "hypocalcemia": 1 not defined; 2 -; 3 - no;

68) DP "hypercalcemia": 1 not defined; 2 -; 3 - no;

69) DP "atrial fibrillation": 1 not defined; 2 -; 3 - no;

70) DP "reduced voltage peaks": 1 not defined; 2 - no; 3 - Yes, in standard leads; 4 - Yes, in most leads;

71) DP "nonspecific changes of repolarization processes": 1 not defined; 2 - no, not observed; 3 - Yes (without localization); 4 - Yes, in the apical top-side wall.

Next, determine the conditional probability of the presence and absence of coronary artery disease in each individual patient in accordance with the equation:

P(Ai|B)=P(Ai)*j(P(Bjk|Ai))i(P(Ai)*j(P(Bjk|Ai) )),(1)

where:

P(Ai|In) is the conditional probability of the truth of hypotheses; when the event occurs, In the event that corresponds to the situation when it produced the classification status of CCC certain patient groups diagnostic signs, that is, risk factors, symptoms, findings on ECG study, the corresponding formal description of the current state of CVS of the patient; and Aihypothesis corresponding to the assumption about the alternative of presence or absence of coronary artery disease in a patient, where i=1 - sick CHD; i=2 - no sick CHD, while always executes the identity P(Ai|B)+P(A2|B)=l;

P(Ai) - a priori probability of the truthfulness of the hypothesis Aicalculate in accordance with the equation:

P(Ai)k(ajki+1)ik(ajk +1),ppand(j|ik(ajki+1)=max(ik(ajki+1))),(2)

whereajkithe number of patients in the training set, whose state CCC was classified on the j-th PD CHD in the k-th group, and they had recorded the execution of the i-th hypothesis.

j is the number of APS CHD in the formal description of the current state of CVS of the patient;

k is the number of j-th PD, which corresponds to a formal description of the current state of CVS of the patient;

Bjk- the event corresponding to the classification condition CCC patient in the k-th group of the j-th PD;

P(Bjk|Ai) is the conditional probability of event occurrence (Bjk) the classification status of CCC patients in the k-th group of the j-th PD when the East is nasty the i-th hypothesis (A i), which is calculated in accordance with the equation:

{P(BjK|Al)=0,5,ppandk=1;P(BjK|Al)=αjki+1k=2Kj(αjki+1),ppandk1,(3)

where Kj- total number of groups in the j-th PD.

Then found using equation (1) values of P(A1|(B) determine the value of the conditional probability of having CHD P(A1|B) or absence of CHD P(a2|In) to the patient at the time of diagnosis.

Then, on the basis of the calculated data do one of the following conclusions:

- diagnosed as "sick CHD" if the condition P(A1|B)≥0,8;

- diagnosed as "not sick CHD" if the condition P(a2|In)≥0,8;

- collect additional data on the status of CCC patients on PD, in which the classification was chosen group 1 - "not defined", in the case of non-fulfillment of the conditions P(A1|B)≥0.8 and conditions P(a2|In)≥0,8, and perform calculations repeated to achieve the specified conditions.

This invention allows the diagnostics of ischemic heart disease not only with the full data set, but in the case of uncertainty, when the number of diagnostic features due to the lack of data it is impossible to classify the state of CVS of the person and for these APS select group No. 1 ' is Not defined" (k=1). In this case, calculate a preliminary assessment of the probabilities of the presence or absence of coronary artery disease before receiving the results of longer-term diagnostic procedures. The resulting additional error in the calculations eliminate later, upon receipt of the missing diagnostic signs and recalculate the values of conditional probabilities of the presence and absence of coronary artery disease based on new data.

Examples of specific implementation.

1. Patient No. 4: at the time of diagnosis had the following characteristics:

age 58 years (DP "Age", group # 4); female gender (DP "is", group # 3); sore diabetes first degree (DP "diabetes"group # 2); did not smoke (DP "Smoking", group # 3); normal weight (DP "Obesity", group # 3); do not use alcohol (DP "alcohol Consumption", group # 2); the results of blood pressure measurement correspond to the first degree of arterial hypertension (DP "hypertension", group # 5); 't see causeless excessive sweating (DP "Excessive sweating for no apparent reason", group No. 3); see shortness of breath (DP "Shortness of breath", group # 2); the patient has suffered previously myocardial infarction (DP "the Patient has suffered a myocardial infarction before", group # 2); digestive disorders (PD "indigestion (heartburn, nausea, colic)", group # 2); dizziness (DP "vertigo", group # 2); findings on ECG: normal sinus rhythm (DP "Normal sinus rhythm", group # 2), the ECG is not a normal 12-lead (DP "Normal 12-lead ECGs", group # 3); hypertrophy of the left ventricle (DP "left ventricular Hypertrophy", group # 2); nonspecific changes of repolarization processes in the apical top-side wall (DP "Nonspecific changes of repolarization processes", group # 4). For the rest of the DP was chosen group No. 1.

In the result of the calculation of conditional probabilities of the presence and absence of coronary artery disease for whom and with a ratio of (1) were obtained the following values: P(A 1|B)=0,8893; P(a2|In)=0,1107, which confirms the conclusion that the presence of CHD. In the diagnosis of this patient's cardiologist was diagnosed that he has coronary artery disease.

2. Patient No. 8: at the time of diagnosis had the following characteristics:

age 55 years (DP "Age", group # 4); female gender (DP Sex, group No. 3); does not smoke (DP "Smoking", group # 3); normal weight (DP "Obesity", group # 3); low physical activity is not supervised (DP "physical Inactivity (low physical activity), group No. 3); do not use alcohol (DP "alcohol Consumption", group # 2); the results of blood pressure measurement with the second degree of arterial hypertension (BP "Hypertension", group # 6); there are headaches that occur during intense physical activity and passing through more than 15 minutes, if you do not use painkillers (DP "the Presence of pain", group No. 3; DP Duration of pain without the use of pain", group No. 3; DP "Localization of pain", group # 8; DP "start Condition is the occurrence of pain", group # 4); 't see causeless excessive sweating (DP "Excessive sweating for no apparent reason", group # 3); see shortness of breath (DP "Shortness of breath", group # 2); the patient has not previously had a myocardial infarction (DP "the Patient has suffered a myocardial infarction before", group # 3); eating pixelart is I (DP "indigestion (heartburn, nausea, colic)", group # 2); dizziness (DP "vertigo", group # 2); findings on ECG: normal sinus rhythm (DP "Normal sinus rhythm", group # 2), the ECG is not a normal 12-lead (DP "Normal 12-lead ECGs", group No. 3); the blockade of the anterior branch of the left bundle branch (DP "Blockade of the anterior branch of the left bundle branch, group # 2); nonspecific changes of repolarization processes in the apical top-side wall (DP "Nonspecific changes of repolarization processes", group # 4). For the rest of the DP was chosen group No. 1.

In the result of the calculation of conditional probabilities of the presence and absence of CHD in accordance with equation (1) yielded the following values: P(A1|B)=0,0132; P(a2|In)=0,9868, which is consistent with the conclusion about the absence of CHD. In the diagnosis of this patient's cardiologist was diagnosed that he had no coronary artery disease.

The invention also allows monitoring the state of the cardiovascular system through the implementation of remote transmission of cardiological data using telemedicine technologies into the workplace cardiologist, for example remote transmission of ECG signal using transtelephonic data;

preliminary self-test of the patient via the Internet, which gives who is very useful for providing remote medical assistance to populations in remote regions. Also the invention allows to reduce the time spent on diagnosis means that calculates a preliminary assessment of the probability of the presence or absence of coronary artery disease in patients for which hindered the process of gathering all the necessary cardiac data. In this case, the assessment of the presence of CHD is calculated on the basis of the data that have been collected, thus increasing the chance of a favorable treatment at the expense of early therapeutic interventions. Upon receipt of the missing diagnostic signs shall recalculate the values of probabilities of the presence of coronary artery disease with the aim of eliminating arise because of the uncertainty error in calculations.

A method for the diagnosis of coronary heart disease (CHD) by determining the presence of risk factors, which classify the state of the cardiovascular system of man: mental stress; arterial hypertension; age; dyslipidemia - elevated levels of cholesterol, triglyceride and β-lipoproteins; behavioral type in history, characterized by the fact that classify additional diagnostic signs (BP) risk factors, and symptoms and findings on ECG study groups, and the classification (DP) are as follows:
risk factors:
- On the psychological and emotional stress a person is classified according to the groups: 1 - not defined; 2 -; 3 - no;
- DP arterial hypertension classified by groups according to the classification of JNC-VI: 1 - not defined; 2 - optimal blood pressure (blood pressure) - GARDEN (systolic blood pressure) <120 and DBP (diastolic blood pressure) <80 mm Hg; 3 - Normal AD-GARDEN 120-129 and DBP 80-84 mm Hg; 4 - Vysokotermalnaya HELL GARDEN 130-139 and DBP 85-89 mm Hg; 5 - first degree of AG-GARDEN 140-159 and diastolic 90-99; 6 - second degree of AG-GARDEN 160-179 and DBP 100-109; 7 - third degree of AG-GARDEN >180 and DBP >110; 8 - Isolated systolic hypertension - GARDEN ≥140 and DBP <90;
- DP classified by age groups: 1 - not defined; 2 - 0-17; 3 - 18-44 years; 4 - 45-64 years; 5 - 65-74 years; 6 - 75-84 years; 7 - >85;
- DP dyslipidemia is classified according to the groups: 1 - not defined; 2 -; 3 - no;
- DP behavioral type in history is classified according to the groups: 1 - not defined; 2 - a; 3 - B;
- DP floor, are classified in groups: 1 - not defined; 2 male; 3 female;
- DP diabetes: 1 - not defined; 2 - I, 3 - II type; 4 - no;
- DP Smoking: 1 - not defined; 2 - smokes; 3 - do not smoke;
- DP obesity: 1 - not defined; 2 - severely underweight body, when the body mass index (BMI) <16 kg/m2; 3 - normal and edge values of body weight, when 16≤BMI≤30 kg/m2; 4 - obesity, with a BMI >30 kg/m2;
- PD physical inactivity: 1 - not defined; 2 -; 3 - no;
- DP on the consumption of alcohol: 1 - not defined; 2 - do not drink alcohol; 3 - moderate consumption of up to 30 g per day in terms of pure ethanol; 4 - frequent alcohol consumption ≥30 g / day in terms of pure ethanol;
- DP burdened by CHD heredity: 1 - not defined; 2 - CHD sick of both parents; 3 - CHD was sick one of the parents; 4 - CHD hurt both parents;
symptoms:
- DP the presence of pain: 1 - not defined; 2 - pain does not occur; 3 - there is pain;
- DP duration of pain without the use of painkillers: 1 - not defined or pain does not occur; 2 - up to 15 minutes; 3 - 15 minutes or more;
- DP action pain medications for pain: 1 - not defined or pain does not occur; 2 - nitrate is not effective for pain relief; 3 - the pain stopped using nitrates;
- DP localization of pain: 1 - not defined or pain does not occur; 2 - chest pain; 3 - abdominal pain; 4 - pain in the throat; 5 - pain in the arm; 6 - pain in shoulder blade; 7 - pain in lower jaw; 8 - pain in other parts of the body;
- DP start condition is the occurrence of pain: 1 - not defined or pain does not occur; 2 - when standing; 3 - at the beginning of the walk; 4 - at the beginning of a physical exertion;
- DP excessive sweating for no apparent reason: 1 - not defined; 2 -; 3 - no;
- DP shortness of breath: 1 - not defined; 2 - the EU is ü; 3 - no;
- DP loss of consciousness: 1 - not defined; 2 -; 3 - no;
- DP the patient has suffered a myocardial infarction before: 1 - not defined; 2 - Yes; 3 - no;
- DP digestive disorders: 1 - not defined; 2 -; 3 - no;
- DP the presence of dizziness: 1 - not defined; 2 -; 3 - no;
findings on ECG study:
- PD Normal sinus rhythm: 1 - not defined; 2 -; 3 - no;
- DP Sinus bradycardia: 1 - not defined; 2 -; 3 - no;
- DP Ectopic atrial rhythm: 1 - not defined; 2 -; 3 - no;
- DP Migration of pacemaker: 1 - not defined; 2 -; 3 - no;
- DP AV nodal rhythm: 1 - not defined; 2 -; 3 - no;
- DP Expedited idioventricular rhythm: 1 - not defined; 2 -;
3 - no;
- DP Sinus tachycardia: 1 - not defined; 2 -; 3 - no;
- DP Atrial fibrillation: 1 - not defined; 2 -; 3 - no;
- DP atrial Flutter: 1 - not defined; 2 -; 3 - no;
- DP Paroxysmal AB-node reciprocal tachycardia: 1 - not defined; 2 -; 3 - no;
- DP Orthodromy supraventricular tachycardia in WPW syndrome: 1 - not defined; 2 -; 3 - no;
- DP atrial tachycardia: 1 - not defined; 2 -; 3 - no;
- DP Sinoatrial reciprocal tachycardia: 1 - not defined; 2 -; 3 - no;
- DP Atypical form of paroxysmal AB-node reciprocal tachycardia: 1 - not defined; 2 -; 3 - no;
- DP is redrama supraventricular tachycardia with a slow retrograde conduction: 1 - not defined; 2 -; 3 - no;
- DP Polytopia atrial tachycardia: 1 - not defined; 2 -; 3 - no;
- DP Paroxysmal atrial tachycardia with AB-blockade: 1 - not defined; 2 -; 3 - no;
- DP Ventricular tachycardia: 1 - not defined; 2 -; 3 - no;
- DP Supraventricular tachycardia with aberrant conduction: 1 - not defined; 2 -; 3 - no;
- DP Pirueta tachycardia: 1 - not defined; 2 -; 3 - no;
- DP Fibrillation: 1 - not defined; 2 -; 3 - no;
- DP Aberrant conduction: 1 - not defined; 2 -; 3 - no;
- DP ECG during tachycardia with wide QRS complexes: 1 - not defined; 2 -; 3 - no;
- DP Atrial extrasystoles: 1 - not defined; 2 -; 3 - no;
- BF Blocked atrial extrasystoles: 1 - not defined; 2 -; 3 - no;
- DP AB-anchor extrasystoles: 1 - not defined; 2 -; 3 - no;
- DP Ventricular extrasystoles: 1 - not defined; 2 -; 3 - no;
- DP Replacement AB-anchor abbreviations: 1 - not defined; 2 -; 3 - no;
- DP Replacement idioventricular abbreviations: 1 - not defined; 2 -; 3 - no;
- DP Sinoatrial block: 1 - not defined; 2 -; 3 - no;
- DP AB-blockade of degree 1: 1 - not defined; 2 -; 3 - no;
- DP AB block 2nd degree type Mobitz I periodicals, Wenkebach: 1 - not defined; 2 -; 3 - no;
- DP AB block 2nd degree type Mobitz II: 1 - not certain what Elena; 2 -; 3 - no;
- Full DP AB-blockade: 1 - not defined; 2 -; 3 - no;
- DP Position of the electrical axis of the heart: 1 - not defined; 2 - Normal position from 0° to +90°; 3 - deviation to the right from +91° to +180°; 4 - a Sharp deviation to the right of +181° to +269°; 5 - Deviation to the left of +270° to +329°; 6 - Permissible deviation from its normal position from +330° to +359°;
- PD Normal 12-lead ECGs: 1 - not defined; 2 - normal; 3 - normal;
- DP Blockade of the anterior branch of the left bundle branch: 1 - not defined; 2 -; 3 - no;
- DP blockade of the posterior branch of the left bundle branch: 1 - not defined; 2 -; 3 - no;
- DP Incomplete left bundle branch block of GIS: 1 - not defined; 2 -; 3 - no;
- DP Incomplete blockade of the right bundle branch: 1 - not defined; 2 -; 3 - no;
- DP Blockage right bundle branch: 1 - not defined; 2 -; 3 - no;
- DP Blockage of the left bundle branch: 1 - not defined; 2 -; 3 - no;
- DP Blockade of the right bundle branch and one branch left bundle branch: 1 - not defined; 2 -; 3 - no;
- DP Violation of intraventricular conduction: 1 - not defined; 2 -; 3 - no;
- DP left ventricular Hypertrophy: 1 - not defined; 2 -; 3 - no;
- DP Hypertrophy of the right ventricle: 1 - not defined; 2 - no; 3 - A; 4 - B; 5 - C;
- DP Hypokalemia: 1 - not defined; 2 -; 3 - no;
- DP Hyperkalemia: 1-not defined; 2 - no; 3 - Lightweight at 5.5-6.5 mEq/l; 4 - Moderate at 6.5 to 8.0 mEq/l; 5 - Heavy when 9-11 mEq/l;
- DP Hypocalcemia: 1 - not defined; 2 -; 3 - no;
- DP Hypercalcemia: 1 - not defined; 2 -; 3 - no;
- DP Atrial fibrillation: 1 - not defined; 2 -; 3 - no;
- DP Reduced voltage peaks: 1 - not defined; 2 - no; 3 - Yes, in standard leads; 4 - Yes, in most leads;
- DP Nonspecific changes of repolarization processes: 1 - not defined; 2 - no, not observed; 3 - Yes, without localization; 4 - Yes, in the apical top-side wall,
next, calculate the conditional probability of the presence and absence of coronary artery disease in a specific patient in accordance with the ratio:
,
where
P(Ai|B) is the conditional probability of the truthfulness of the hypothesis Aiupon the occurrence of event B, where B is the event that corresponds to the situation when it produced the classification status of CCC certain patient groups diagnostic signs (that is, risk factors, symptoms, findings on ECG test; then DP)corresponding to the formal description of the current state of CVS of the patient; and Aihypothesis corresponding to the assumption about the alternative of presence or absence of coronary artery disease in a patient, where i=1 - sick CHD; i=2 - no sick CHD, while always executes the identity P(A1|B)+P(A2|B)=1;
P(Ai) - the a priori probability of the truthfulness of the hypothesis Aicalculate in accordance with the ratio:
,
where ajkithe number of patients in the training set, whose state CCC was classified on the j-th PD CHD in the k-th group, and they had recorded the execution of the i-th hypothesis, corresponds to the value in the training set;
j is the number of APS CHD in the formal description of the current state of CVS of the patient;
k is the number of j-th PD, which was classified state CCC diagnosed patient, corresponds to the value in the formal description of the current state of CVS of the patient;
Bjk- the event corresponding to the situation when it produced the classification status of CCC particular patient in the k-th group of the j-th PD;
P(Bjk|Ai) is the conditional probability of event occurrence (Bjk) the classification status of CCC patients in the k-th group of the j-th PD when the truth of the i-th hypothesis (Ai), calculated in accordance with the ratio:
,
where Kj- total number of groups in the j-th PD;
determine on detected values of P(Ai|B) the probability of having CHD P(A1|(B) (i=1) and the absence of CHD P(A2|(B) (i=2);
diagnosed as "sick CHD" if the condition P(A1|B)≥0,8; diagnosed as "not sick CHD" if the condition P(A2|B)≥0,8 does not make a diagnosis of the presence or absence of coronary artery disease when the condition: P(A 1|B)<0.8 and P(A2|B)<0.8, the in this case, collect additional data on the status of CCC patients in the PD, in which the group was "not determined" if k=1, and re-calculate the conditional probability of the presence and absence of coronary artery disease in accordance with the described method, if the second time is executed, the condition P(A1|B)<0.8 and P(A2|B)<0,8, then the decision about the presence or absence of CHD only accepts cardiologist.



 

Same patents:

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to diagnostics and physiology. The RR intervals are recorded, and the derived sequence is processed. The RR sequence length is specified not less than 300 sec. That is followed by dividing the RR sequence into data windows A1…An of the length of 75 sec≤A≤300 sec at a window shift pitch B of 1 sec≤B≤10 sec. Further, for each data window: the frequency Fourier transform is used to derive power distribution of the initial window; the derived power distributions are integrated at all frequencies within not less than 0.015-0.6 Hz to produce total power TP of the heart rate variability; low frequency power PLF is calculated by not less than 0.04-0.15 Hz; high frequency power PHF is calculated by not less than 0,15-0.6 Hz; the relation PLF/PHF is calculated; the derived TP sets and PLF/PHF relations are normalised to produce standard values X1…n of the derived TP sets and standard values Y1…n of the PLF/PHF set. That is followed by calculating a synchronism analysis function of each data window f1…n=(sinX1…n-sinY1…n)/|sinX1…n-sinY1…n|. The presence or absence of the stress condition is stated by analysing the derived values f1…n.

EFFECT: method enables providing more reliable diagnosis of the beginning individual's stress condition by analysing the RR interval.

2 ex, 1 dwg

FIELD: oil and gas industry.

SUBSTANCE: treating bronchial asthma (BA) in a child suffering from a mild, moderate or severe episode involves measuring a peak expiratory flow rate (PEFR). The child's age, height and sex are stated. The derived data are used to determine the adequate peak expiratory flow rate. That is followed by calculating the peak expiratory flow rate coefficient by specific formula. The following data of the past medical history are taken into account: the child's duration of the disease, the length of basic therapy, completed months, for one year preceding the acute period of the disease, as well as the presence of allergic diseases in immediate maternal and paternal relatives. A severity of the BA episodes is assessed. Each value derived from the past medical history is assigned with numerical values reflecting their prognostic significance. Heart rates are measured. Cardiointervalography is performed, and a vagosympathetic balance coefficient is determined. That is followed by calculating a risk of cardiohaemodynamic disorders (CHD) taking into account the above criteria by specific formula. If CHD<0.34, Fenoterol selective β2-adrenoceptor agonist is selected as a bronchial spasmolytic in the acute period of the disease. If 0.34≤CHD≤0.46, ipratropium bromide m-cholinoblocker is selected as the bronchial spasmolytic. If CHD>0.46, combined ipratropium bromide + Fenoterol is used as the bronchial spasmolytic.

EFFECT: reduced number of cardiovascular complications in the above category of children.

3 part-s

FIELD: medicine.

SUBSTANCE: invention relates to methods and devices of identifying reasons of cardiac rhythm disturbance. Method consists in perception of signals of heart excitation in multitude of locations with application of multitude of sensors, collection of data from multitude of sensors. Collected data include sensor location for each sensor and time of heart excitation origination in each sensor location, so multitude of times of excitation origination in multitude of locations of sensors are collected, and then their sequence is formed. Obtained data are then analysed and approximate central areas, connected with excitation pathway, pointing to reasons of said cardiac rhythm disturbance, are determined.

EFFECT: application of invention makes it possible to determine location of reasons of cardiac rhythm disturbance for the following treatment with minimally invasive, surgical and other methods.

37 cl, 16 dwg

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine and can be applied as a method of predicting an unfavourable outcome of cerebral circulation impairment. A level of stab neutrophils and erythrocyte sedimentation rate are determined in blood tests. The presence of displacement of midline brain structures is identified on a computer tomography scan. A number of ventricular and supraventricular extrasystoles is determined on an electrocardiogram. If the value of stab neutrophils is 3.5-4.5%, erythrocyte sedimentation rate is 12-20 mm/h, displacement of midline structures is 7 mm and more, an average day value of ventricular and supraventricular extrasystoles is respectively 490-670 and 1530-1880, and in case of blood presence in liquor, an unfavourable outcome of cerebral circulation impairment is predicted.

EFFECT: method makes it possible to increase the prediction reliability.

2 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, labour safety, vocational selection of rescue workers. The invention can be used for vocational selection in the sectors of industry using personal protective equipment, as well as for the workers labour safety in the sectors of industry with harmful working conditions. The method involves vocational selection and duty control on the basis of electroencephalogram (EEG) values and cardiological findings. The examination is performed prior to and when using the personal protective equipment. The cardiological examination involves assessing the heart rate variability with using the amplitude-frequency spectrum Fourier analysis VLF at a vibration frequency within the range of 0.0033-0.04 Hz, LF - at a frequency of 0.05-0.15 Hz and HF - at a frequency of 0.16-0.80 Hz, and is five-staged: initial resting state, mental work load, recovery of mental work load, hyperventilation load, recovery of hyperventilation load. At the beginning, the heart rate variations and EEG are examined prior to using the personal protective equipment. If any of the five stages of the heart rate variation examination shows the pulse more than 90 beats per minute, as well as changes from the normal values of: approximating entropy - less than 180, LF - less than 6 point, an alpha wave amplitude - to 12 vibrations per second and the presence of the paroxysmal activity by EEG, the prevailing sympathetic nervous system is stated, or if any stage of the heart rate variation examination shows the pulse less than 60 beats per minute, as well as changes from the normal values of: blood pressure - more than 140/90 mmHg, VLF - more than 130 points, HF - more than 16 points, an alpha wave amplitude - less than 25 mcV, the prevailing parasympathetic nervous system is stated; a low level of adaptation to the personal protective equipment is predicted, and a rescue work is not recommended during the vocational selection; the examination is terminated. If the heart rate variation and EEG prior to using the personal protective equipment fall within the normal values, the heart rate variation when using the personal protective equipment is started with the patient examined when using the personal protective equipment and performing a cycle ergometer test, and recording the hyperadaptotic changes of the assessed values: VLF - more than 130 points in relation to the normal value when using the personal protective equipment and LF and HF vibrations; an incomplete or unfinished adaptation to the personal protective equipment, and the rescue worker is suspended from work for several hours; if VLF is more than 130 points recorded 10-15 min after activating the personal protective equipment, a good adaptation level to the personal protective equipment is predicted.

EFFECT: method enables assessing the vegetative nervous function and predicting the rescue workers' adaptation level to the personal protective equipment.

11 tbl, 5 ex

FIELD: medicine.

SUBSTANCE: invention can be used to identify a high risk of developing impaired glucose tolerance in patients with stable effort angina with underlying administering beta-adrenergic blocking agents with no additional vasodilating properties. Therapy is preceded by conducting 2 exercise tests on the same day to achieve a threshold load power according to the same protocol, initially and 2 hours after administering a single dose of the beta-adrenergic blocking agents. If observing an interval gain of 120 seconds and more from the beginning of the load to the angina attack and/or reduction of an ischemic ST segment on the electrocardiogram not less than 1 mm at the 2nd load as compared to the 1st load, a risk of impaired glucose tolerance is considered to be high. A glucose tolerance test is carried out in these patients 4-5 weeks after the scheduled administration of the beta-adrenergic blocking agents. If impaired glucose tolerance is detected, administering the beta-adrenergic blocking agents is withdrawn. If the 2nd load as compared to the 1st load shows an interval to the angina attack and/or reduction of the ischemic ST segment on the electrocardiogram at a depth not less than 1 mm increasing less than by 120 seconds, a risk of developing impaired glucose tolerance is considered to be negligible. Treatment of these patients with the beta-adrenergic blocking agents is continued without the glucose tolerance test required.

EFFECT: method provides preventing carbohydrate metabolic disorders by the early identification of the high risk of developing impaired glucose tolerance in the given patients by detecting a compensatory increase of the glucose consumption with insulin resistance and a lower availability of free fatty acids to provide myocardial energy needs.

6 ex

FIELD: medicine.

SUBSTANCE: according to one version, the method involves studying the heart rate variability and a motion state, dietary nutrition, baths with mineral water, mineral water intake, physiotherapeutic procedures. The dietary regimen is specified taking into account the measured immunoglobulin IgG values to detect food intolerance and elimination thereof from the nutrition. Low-salt sulphate calcium-magnesium-sodium mineral water is taken. The baths are taken with mineral water from a water-bearing formation of Middle Devonian at a depth of 1100-1278 m by using mineral water representing a salt brine of Devonian Sea M 240-260 g/dm3 of sodium-chloride composition Cl>95, Na++K+>80 mg-eq.%, with an acid reaction of the medium, at pH 4.7-5.5. According to the other version, the method additionally contains massage sessions and acupuncture taking into account the patient's heart rate variability.

EFFECT: group of inventions provides more effective health improvement by taking into account individual food intolerance and the patient's autonomic nervous system features.

2 cl, 3 ex

FIELD: medicine.

SUBSTANCE: continuous electric cardiac signal (ECS) is filtered and presented in the form of discrete readouts. Then it is smoothed by amplitude averaging of adjacent readouts of the electric cardiac signal. That is followed by isolating R-R interval and a cardiac cycle, limiting a search area of the beginning of the ventricular repolarisation to the left and right in relation to R wave, specifying two numbers of the ECS readouts X1={xa÷xb} and X2={xc÷xd}in the search area, calculating arithmetical mean amplitudes M1 and M2 of the readouts from the numbers X1 and X2, calculating an absolute difference of mean ECS amplitudes D=|M1-M2|, and unless D gets more than the ECS limit, calculating M1, M2 and D is repeated for the numbers X1 and X2 displaced one element to the right until reaching the right limit of the search area, isolating the readout Jj,i=xa in each j-th deflection for which D falls below the ECS limit. Thereafter the latest Jj,i value is determined; the determined value represents the beginning of ventricular repolarisation in the i-th cardiocycle.

EFFECT: method provides higher reliability of isolating R-wave and stating the beginning of ventricular repolarisation.

13 dwg

FIELD: medicine.

SUBSTANCE: auricular extrasystole recorded in the patient is analysed by calculating a relative coupling interval (RCI). The value is calculated by dividing a cardiac contraction interval immediately preceding the auricular extrasystole by the coupling interval. The derived RCI is assessed. If the value exceeds the value of 1.7, a high risk of developing paroxysmal atrial fibrillation is diagnosed in the patient.

EFFECT: method enables predicting a high probability of developing paroxysmal atrial fibrillation within the next hour.

2 ex, 2 dwg, 3 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly cardiology. A 24-hour electrocardiogram is recorded in a post-myocardial infarction patient s. A standard mean deviation of RR intervals is evaluated and low and high frequency waves and QT interval variability are related. An echocardiography is recorded to evaluate an ejection fraction. The clinical findings are used to predict severity of arrhythmia syndrome.

EFFECT: method enables determining severity of arrhythmia syndrome more accurately without any load tests thereby reducing a health risk.

2 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to ophthalmology, and aims at predicting the maximum daily variations of the intraocular pressure (IOP) in patients with ocular manifestations of pseudoexfoliative syndrome (PES). Ocular PES is staged. The IOP and average blood pressure (BPav) are measured. The presence or absence of myocardial infarction in the past medical history is stated. The maximum daily variations of the IOP (ΔIOPmax) is calculated by formula: ΔIOPmax=0.37*PES+0.89*MI+0.029*BPav+0,123*IOP-1.95, wherein: PES is the PES stage falling within the range of 1 to 3; MI is the myocardial infarction in the past medical history, 1 - yes, 0 - no; BPav is the average blood pressure, mmHg calculated as (systolic blood pressure + diastolic blood pressure)/2, and IOP is the initial IOP, mmHg measured three times at the moment of initial polyclinic consultation to calculate an average value of the calculations; 1.95 is an independent constant.

EFFECT: method enables the accurate measurement of maximum daily variations of the IOP accessible in polyclinics in the patients suffering from PES taking into account both local factors (PES stage, IOP value), and peculiarities of the general patient's somatic status (blood pressure, myocardial infarction in the past medical history).

2 ex

FIELD: medicine.

SUBSTANCE: invention refers to agents for non-contact respiratory monitoring. A method for detecting a patient's expiration to inspiration variations or vice versa involving the stages of emitting an electromagnetic signal towards the patient and receiving the signal reflected from the patient, transforming the reflected signal to produce the first signal, dephasing the reflected electromagnetic signal and transforming it to produce the second signal, using a computing unit to detect simultaneous first zero transients in a time derivative of the first signal and in a time derivative of the second signal, simultaneous second zero transients in the time derivative of the first signal and in the time derivative of the second signal, and simultaneous third zero transients in the time derivative of the first signal and in the time derivative of the second signal, determining the first and second vectors and calculating their scalar product as an indicator value for the patient's expiration to inspiration variations or vice versa comparing the indicator value to the pre-set threshold value and specifying the patient's expiration to inspiration variations or vice versa, if the indicator value is less than the threshold value. A device for implementing the method involves a two-channel Doppler radar sensor and the computing unit.

EFFECT: using the invention enables providing more accurate measurement and detection of the respiratory rate.

6 cl, 6 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery, and can be used in cholecystectomy in patients with cholelithiasis. That is preceded by determining a patient's body weight index (BWI), glycaemia, glucosuria; blood pressure is measured; spinal osteochondrosis and gonarthrosis are detected. The derived results are assessed and scored. If the BWI equals to 28-30 kg/m2,10 points are assigned. If the BWI equals to 30-35 kg/m2,15 points are assigned. If the BWI is more than 35 kg/m2,20 points are assigned. If glycemia is more than 5.5 mmole/l, 3 points are assigned. If the patient suffers from glucosuria, 5 points are assigned. Arterial hypertension of more than 140/190 mm Hg requires assigning 3 points. The detected spinal osteochondrosis is assigned with 3 points, diagnosed gonarthrosis is assigned as 3 points. The derived points are summed up. If the total score is 23, a cholecystectomy with a biliopancreatic diversion is performed. If the total score is 14 to 22 points, laparoscopic cholecystectomy is performed. If the derived value makes 13 points, conventional cholecystectomy is performed.

EFFECT: invention provides selecting the type of cholecystectomy taking into account the metabolic status and a degree of obesity and as a consequence, normalizing the body weight and compensating the components of the metabolic syndrome.

2 tbl, 3 ex

FIELD: oil and gas industry.

SUBSTANCE: treating bronchial asthma (BA) in a child suffering from a mild, moderate or severe episode involves measuring a peak expiratory flow rate (PEFR). The child's age, height and sex are stated. The derived data are used to determine the adequate peak expiratory flow rate. That is followed by calculating the peak expiratory flow rate coefficient by specific formula. The following data of the past medical history are taken into account: the child's duration of the disease, the length of basic therapy, completed months, for one year preceding the acute period of the disease, as well as the presence of allergic diseases in immediate maternal and paternal relatives. A severity of the BA episodes is assessed. Each value derived from the past medical history is assigned with numerical values reflecting their prognostic significance. Heart rates are measured. Cardiointervalography is performed, and a vagosympathetic balance coefficient is determined. That is followed by calculating a risk of cardiohaemodynamic disorders (CHD) taking into account the above criteria by specific formula. If CHD<0.34, Fenoterol selective β2-adrenoceptor agonist is selected as a bronchial spasmolytic in the acute period of the disease. If 0.34≤CHD≤0.46, ipratropium bromide m-cholinoblocker is selected as the bronchial spasmolytic. If CHD>0.46, combined ipratropium bromide + Fenoterol is used as the bronchial spasmolytic.

EFFECT: reduced number of cardiovascular complications in the above category of children.

3 part-s

FIELD: oil and gas industry.

SUBSTANCE: treating bronchial asthma (BA) in a child suffering from a mild, moderate or severe episode involves measuring a peak expiratory flow rate (PEFR). The child's age, height and sex are stated. The derived data are used to determine the adequate peak expiratory flow rate. That is followed by calculating the peak expiratory flow rate coefficient by specific formula. The following data of the past medical history are taken into account: the child's duration of the disease, the length of basic therapy, completed months, for one year preceding the acute period of the disease, as well as the presence of allergic diseases in immediate maternal and paternal relatives. A severity of the BA episodes is assessed. Each value derived from the past medical history is assigned with numerical values reflecting their prognostic significance. Heart rates are measured. Cardiointervalography is performed, and a vagosympathetic balance coefficient is determined. That is followed by calculating a risk of cardiohaemodynamic disorders (CHD) taking into account the above criteria by specific formula. If CHD<0.34, Fenoterol selective β2-adrenoceptor agonist is selected as a bronchial spasmolytic in the acute period of the disease. If 0.34≤CHD≤0.46, ipratropium bromide m-cholinoblocker is selected as the bronchial spasmolytic. If CHD>0.46, combined ipratropium bromide + Fenoterol is used as the bronchial spasmolytic.

EFFECT: reduced number of cardiovascular complications in the above category of children.

3 part-s

FIELD: medicine.

SUBSTANCE: quick recording and remote transmission of the physiological parameters of human and animal cardiovascular and respiratory systems experimentally is enabled by using a receiver comprising three recording units of signal picking-up and transmission from three patients or animals simultaneously. Each of them comprises three piezoelectric detectors for ECG recording and one strain gauge for respiration depth and rate recording - a respiratory potential. The receiver is provided with a bioelectrical amplifier, an analogue-to-digital converter, RS485 interface with a board providing digital signal coding, conversion and transmission in the form of a radio signal. The latter is trapped by means of Bluetooth adapter with using a radio signal receiving and ECG and respiratory potential transmission unit. Each unit channel is checked up to receive signals from its recorder and to transmit to an ECG and respiration processing and storage unit arranged at a distance up to 30 m from the recorder. It comprises a laptop with a screen displaying one channel of cardio signal and respiratory potential channels independently from each patient or animal. Each patient or animal's data can be saved as a separate file on the signal processing and storage unit.

EFFECT: method provides fast, qualitative real-time recording of the physiological parameters with creating the conditions of a distant control of the patients both in hospitals and polyclinics, and in remote locations, in emergency and other abnormal situations.

7 dwg

FIELD: medicine.

SUBSTANCE: invention refers to endovascular neurosurgery, and can be used for diagnosing a functional value of the internal carotid artery (ICA) in the patients with giant aneurysm of the internal carotid artery (ICA), mixed carotid-cavernous fistulas, tumours of neck and base of skull with the ICA involved into the tumour process. A cerebral blood auto-regulation (CBAR) velocity in an ipsilateral medial cerebral artery (MCA) is assessed before and after finger compression of the ICA on the neck. The CBAR is assessed by continuous recording of a linear blood flow rate (LBFR) and a system blood pressure (SBP) for at least 4 minutes. A cross-spectral analysis of the above time sequence is used to calculate a phase shift between spontaneous oscillations of LBFR and SBP in the ipsilateral MCA within the M-wave range before and against the time finger compression of the ICA. If observing a phase shift by more than 50% as compared to the reference before the ICA compression, the high functional value of the ICA is diagnosed.

EFFECT: higher information value of the diagnosis of the postoperative functional value of the ICA by the quantitative evaluation of the CBAR velocity in the ipsilateral MCA.

8 dwg, 2 ex

FIELD: medicine.

SUBSTANCE: slit lamp and video camera are used to record vascular bed fragments. The prepared video clips are introduced into a video player a window of which generates a moving object at a pre-set velocity and direction. The blood velocity at video biological microscopy of conjunctival vessels is determined by a moment of visual matching of the blood velocity and direction in the vessel and the object moving at the known velocity and in the same direction.

EFFECT: method enables the qualitative assessment of the blood velocity in mm/s apart from the structure and degree of the intravascular blood aggregation by increasing the measurement objectivity.

2 dwg

FIELD: medicine.

SUBSTANCE: waist circumference (WC), height and weight are measured to calculate a body weight index (BWI), to determine glucose and lipids. The WC more than 80 cm requires prescribing a moderately hypocaloric diet that implies limiting an energy value of food ration by 500-600 kkal a day with the daily food ration composed taking into account as follows: total fat consumption less than 30% of total energy consumption; carbohydrates - up to 50%; protein content in the food ration - 15-20%; dietary fibre - 20-30 mg; fresh fruit and vegetables - 400-500 g; nuts, cereals, beans - 30 g; table salt - less than 5 g; 1000 mg of calcium a day for females taking hormonal contraception or replacement hormonal therapy (RHT), and 1500-2000 mg in females taking no hormonal contraception or RHT, vitamin D - 800 IU, polysaturated fatty acids 0.5-1.0 g, folic acid - 400 mcg, vitamin C - 60 mcg, vitamin E - 30 Units; physical exercises - not less than 40 min a day and not less than 5 times a week; alternating aerobic and anaerobic exercises. If BWI falls within the range of 25 to 29.9 kg/m2, a normal glucose and lipid level, combined oral contraceptives (COC) with natural oeastrogen and dienogest, or the COC with drosperinone are taken. The BWI within the range of 30 kg/m2 and more, the normal glucose and lipid level, pure progestin oral contraceptives (PPOC) are administered. If the BWI exceeds 25 kg/m2, and fasting hyperglycemia, impaired glucose tolerance (IGT) and/or dyslipidemia are observed, pure progestin oral contraceptives (PPOC) are administered. If a postmenopausal female has the BWI less than 30 kg/m2 and suffers climacteric syndrome, a combined replacement hormonal therapy (RHT) containing drospirenone is prescribed. The BWI more than 30 kg/m2 requires administering meldonium into postmenopausal females.

EFFECT: method enables individual prevention of oestrogen-dependent diseases.

6 cl, 14 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: female is examined for: total cholesterol, mmole/l, systolic blood pressure (BP), mm Hg, smoking status, age (years), sex. The derived data are used to evaluate a ten-year risk of cardiovascular mortality according to SCORE table. Besides, an aortic pulse wave velocity (aoPWV), m/s is determined. A regression equation is used to scale an age norm of aoPWV: Y=3.713+0.042*x, wherein x is age, years old. The examined female is considered to suffer a high risk at total risk of more than 5% according to SCORE table with the aoPWV more than the age norm, or at total risk of less than 5% according to SCORE table (a group of a moderate and low risk) with the aoPWV more than the age norm.

EFFECT: method enables evaluating the risk of cardiovascular complications in postmenopausal females.

3 dwg

FIELD: measurement equipment.

SUBSTANCE: method to train a user how to use a set for analyte (such as glucose) detection in a body fluid sample (for instance, a whole blood sample) includes activation of an analytical meter of a set, besides, the analytic meter includes a training module on the basis of a display. Besides, the display-based training module includes a user interface with a visual display, a memory module, where the training program is saved, and a microprocessor module made as capable of control and coordination in respect to the user interface and memory module. Besides, the training program saved in the memory module has sections, besides, each section comprises one or more training images illustrating use of the set. Besides, the user interface, the microprocessor module and the memory module are functionally connected and configured for event-controlled display on the basis of the section of training images for the user on the visual display. The method also includes training of the user on how to use the set by display of section-based training images in the event-controlled manner.

EFFECT: method improvement.

10 cl, 33 dwg

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