Prenosological diagnostic technique for sportsmen health
SUBSTANCE: technique involves the clinical-laboratory examination of a sportsman who completed heavy physical activity 12-16 hours ago. The examination extent is determined taking into account the organs and systems most vulnerable to the physical activity while deriving the prognostically significant criteria of the morphofunctional body state. The examination involves measuring and analyzing the biochemical, haematological, immunological and functional values, as well as vitamin-mineral saturation. And if the above values are stably unchanged, reliably different from the norm, nonspecific changes of the sportsman's organs and systems are diagnosed.
EFFECT: technique provides the early diagnosis of the significant changes of the organs and systems during trainings and competitions that enables taking further timely measures to prevent the further progression of pathological conditions and maintaining thereby occupational performance and achieving stable high sport results.
The technical field to which the invention relates.
The invention relates to medicine, sports medicine, namely, to the way prenosological diagnosis of the health of athletes through a comprehensive clinical and laboratory studies of the health of the athletes in the deferred period after 12-16 hours after the cessation of heavy exercise, taking into account the most vulnerable to the effects of physical activity of organs and systems, prognostically important criteria morphofunctional state of the body; including the identification and analysis of biochemical, hematological, immunological, sanitary-chemical diagnosis of vitamin-mineral saturation of the organism, functional parameters, and provided that performance has been consistently changed - significantly different from normal values and on its basis the implementation of early diagnosis of nonspecific changes of organs and systems of organism of athletes during training and competition cycle, to prevent the development of psycho-physiological and pathological conditions, maintaining professional performance and achieve consistently high results.
The level of technology
At the present stage professional sports can mean for a person to whom asalnya physical, neuro-psychiatric, emotional stress, sometimes at the limit of their physiological capabilities, which ultimately can lead to wear STRESSOMETER body systems and the development of maladjustment or overtraining (in athletes of high qualification) [11, 12, 14]. In the sport of high achievements in sport person experiences the maximum load, as a result of which the incomplete restoration of physical health may fail, the divergence in the activity of functional systems of the body. A so-called state of overwork, over-voltage, over-training, which subsequently can lead to the development of disease[4, 6, 8, 12].
Causes of illness in athletes can be divided into two large groups: 1) is not associated with sports and 2) associated with sports (Dembo A., 1991) [11, 12, 14].
The first group includes all of the external environment (hypothermia, infections, etc). Of course, any athlete in one way or another affected by these factors. However, the reaction of the athlete on these factors, with regard to the state of his health, physical development, has certain differences from the reaction of the human body that are not involved in sports. This is, primarily, a more benign than what those who is not engaged in sports, during the process, the better the effect of therapy, a large percentage of recovery or a prolonged remission.
The second largest group is the cause of illness associated with sports. This group can be divided into two subgroups. The first subset includes the reasons that stem from improper training, improper use of tools and techniques of training, lack of or insufficient of individualization of the degree of physical load on the training that leads to overload and overvoltage individual systems and organs. The second subset includes diseases of athletes that can occur with proper organization and methodology of training, but in certain conditions[4, 6, 11, 12].
On the incidence of athletes has a significant influence nature of the training process, because the function and morphology of the athlete's body form in certain variations of physical exercises used in the training process. The nature of these exercises is determined not so much a sport as the physical quality which you need to develop in this sport. In different sports are produced in varying degrees of the same qualities: endurance, speed, strength, agility and the combination of hypoxia. Thus, the basis of the distribution of the main sports based on various combinations of the three criteria that characterize physical activity: primary power operation during exercise (maximal, submaximal, large, moderate, intensity); the predominant periodicity or acyclicity; primary development of those or other motor skills[6, 11, 13, 14].
In athletes, training for endurance, significantly more often than in other specialties, there is degeneration of the myocardium due to physical stress, neuroses (including peertranet) and hypertensive status. Similar phenomena occur in athletes igrovih [11, 12]. Diseases of the musculoskeletal system is dominated by the gymnasts, figure skaters, skiers (ski slalom, downhill, ski jumping ski jumping), jumping into the water[8, 12, 19].
One of the important ways to prevent the development of diseases in athletes is carrying out activities aimed at identifying early nonspecific changes in the body that occur during sports activities and in the initial stages, seemingly invisible to the athlete.
The study of changes of organs and systems at the level of biochemical, physiological, immunological reactions in the body chelovekom the significant impact of physical activity in the absence of disease included in the scope of prenosological diagnostics.
Disallowance diagnostics in sports is a system of methods of research, aimed at determining the level of health of the athlete, the degree of adaptation possibilities and resources of the organism.
Prenosological diagnostics of the athlete's body will allow you to evaluate the level of physical preparedness of the athlete, to properly monitor and manage sports activities, and timely preventive measures aimed at improving the health of the athlete and prevent the development of pathology [20-22].
To date, there are methods of diagnosis, including diagnosis, and subsequent correction of morphological or functional state of athletes in the course of their professional activities, which in most cases is aimed at determining the functionality of any one or two organs, systems (e.g. cardiovascular, respiratory or musculoskeletal systems), or their condition, different from the norm; used in pre-or postderegulation periods of their training [20-26]. As examples, here are some known methods that can be considered as analogs of the present invention:
- "The way prenosological differentialdiagnosis of the human condition" (EN 98108082 AND, 10.02.2000). The invention relates to medicine, functional diagnostics. Method of diagnosis the differential diagnosis of the human condition by registering omega-potentials before and after functional loading and analysis of omega-potentials, characterized in that, in a patient in a state of calm register initial potential (IP) as the zero time point and the beginning of the 7-minute sweep omega-potentials, and after functional loading carry out measurements of omega-potentials on the 10th, 20th, 30th seconds, then record the omega-potential every 30 seconds to 4 minutes, from which every subsequent 10 seconds until the 5th minutes, subsequent measurements are recorded on the 6th and 7th minutes and build a 7-minute scan of the dynamics of omega-potentials, diagnose the human condition by means of a comparative analysis of the obtained 7 - minute scan with scan idealized healthy person, and from 0 to 1 min 7-minute sweep of the dynamics of omega-potential diagnose the operational abilities of perception, when lifting values from 1.25•(PI) to 1.50•(PI) and the decrease in the value from 1.00 to 0.75•(PI) diagnosed dullness of perception and memory, 1.50•(PI) up to 1.60•(FE) and higher and lower values of 0.75•(PI) to 0.50•(PI) di is Gnostic immunity information and less than 0,50•(PI) diagnosed as very severe painful condition, from 1 min to 4 min sweep of the dynamics of omega-potentials diagnosed for 1 min buds, 1 min 30 sec diagnose bladder, 2 min diagnose stomach, 2 min 30 sec diagnose pancreas, 3 min diagnose liver, 3 min 30 sec diagnose the spleen, and when lifting values between 1.20•(PI) and above diagnosed with acute or chronic diseases of the organs, depending on the form 7-minute scan, and a value of 0.20•(FE) - vertebrogenic disorders, from 4 min to 7 min diagnose the state of the cardiovascular system, and when the value of 0.75•(PI) to 0.50•(FE)and higher 1,50 - diagnose predpolozhenie state, and below 0,50•(PI) a disease of the cardiovascular system. Medical norm is the scheme of the dynamics of the 7-minute sweep of omega-potential idealized healthy person.
This method has drawbacks:
the method is very time-consuming because of the multiple fixation time indicators and omega-potentials before and after functional loading and subsequent analysis to determine the result only of the body (system)-"targets" for further more detailed study;
for psycho-physiological assessment comprising the Oia of the body is only the method of functional diagnostics is estimated only one indicator - omega-potential, which is woefully inadequate for complete, accurate and objective assessment of the functional state of organs and systems, diagnosis of pathological conditions at an early stage of development of pathology;
get the results of execution of the method subjective information, determines only the direction of further research.
- "The way preclinical diagnosis of hypertension index Petrova" (EN 2367343 C1, 20.09.2009). The invention relates to medicine, and more specifically to active prenosological diagnosis of hypertension. Determine the index Pine, measure aphatie settings, neck, head, waist, abdomen, the size of the chest and predict the possibility of developing hypertension according to the set of indices (P1-P4)defined by the following dependency:where W - oshatny neck size (cm)G - oshatny head size (cm), and when the index value of P1more 63,84±3,23% in boys and 57,75±0.35% of girls the risk of developing hypertension is 20 percent;where T - chest circumference (cm), T1- oshatny waist size (cm), and when the index value of P2more 84,79±2,44% in boys and 80,05±2,35% in girls the risk of developing hypertension status is made by 20 percent; where G is oshatny the size of the abdomen (cm), T - oshatny size chest (cm), and when the index value of P3less 93,05±7,99% in boys and 87,46±6.30%, and among girls the risk of developing hypertension is 20 percent;where G is oshatny the size of the abdomen (cm), T1- aphatie size waist (cm), and when the index value of P4more 93,05±7,99% in boys and 87,46±6.30%, and among girls the risk of developing hypertension is 20 percent. On the basis of population identified by the index values of P1-P4risks predict preclinical development of hypertension. The method allows to predict on anthropometric indexes the degree of risk in subjects with arterial hypertension on stage functional changes, and also provides the possibility of adopting measures to reduce the risk of illness through exposure to physical and breathing exercises for certain muscle groups.
This method has drawbacks:
the method involves psycho-physiological assessment of functional status of only the cardiovascular system and its parameters, namely the degree of risk of development of hypertension;
the degree of accuracy and objectivity forecast of development of hypertension in this way is inadequate is high, given the importance of this disease to humans.
"The method of functional diagnostics of bronchial asthma in athletes" (EN 2312590 C1, 20.12.2007). The invention relates to medicine, namely to sports medicine and exercise physiology sport. The method includes determining the speed parameters of external respiration in the background of bronchomotor test, characterized in that at rest, determine the parameters of heart rate variability (HRV), and indicators of external respiration function register against the background of the test with the introduction of salbutamol at a dose of 400 µg and when indicators of HRV LF/HF>1,5, VLF>40%, Total<2,5 mc2when the growth of the original normal speed parameters of external respiration function in the test with salbutamol FEV1, PEF, FEF50%, 75%≥15% of diagnosed asthma. The method allows for early diagnosis the diagnosis of asthma in athletes.
This method has drawbacks:
the method involves psycho-physiological assessment of functional status of a limited number of body systems (only the cardiovascular and respiratory) and their parameters;
functional diagnostics of changes in the body of athletes in the method is carried out on the background of the exhaustion of adaptive resources in athletes (as noted in the methodology of way), that is, in training and competition is erode or early period, immediately after the cessation of stress, when the above changes are not stable, and the deferred period (after 12-16 hours complete cessation of physical activity) may vary and therefore does not always reflect the true state of the organism at the time of diagnosis;
the method applies the maximum daily therapeutic dose of salbutamol (800 mcg) - two breaths every 10 minutes at a dose of 400 mg, which is based on the availability side effects, contraindications, and individual sensitivity to the components of the aerosol may lead to undesirable reactions of the athlete's body, especially against the background of the depletion of adaptation resources in athletes (as noted in the method, i.e. the method is not universal to use for all.
"Method for the diagnosis of stress cardiomyopathy" (EN 2292046 C2, 20.01.2007). The invention relates to the field of laboratory diagnostics, can be used for early diagnosis of heart disease in athletes. The essence of the method is that in the serum with the help of response inhibition passive haemagglutination assays determine the presence of cardiac antigen and at lower titers of therapy for anti-myocardial test serum in the presence of serum of the studied persons in two or more times diagnosed with stress cardiomyopathy.The technical result is the identification of stress cardiomyopathy in preclinical stages of development.
This method has drawbacks:
the method involves psycho-physiological assessment of functional status of only the cardiovascular system and its parameters;
not taken into account the timing of the study, defining desynchronise or stability changes of indicators that reflect the true state of organs and systems;
for early diagnosis of heart disease is only used laboratory method, is estimated only one indicator analysis of blood serum, which is woefully inadequate for complete, accurate and objective assessment of the functional state of the cardiovascular system, her diagnosis of pathological conditions in the early stage of the disease.
From the above it follows that each of these methods separately does not reflect sufficiently complete diagnostic picture of psycho-physiological state of the human body, in particular athletes, and does not provide the possibility of early development forecast they pathological conditions.
The fundamental difference of our invention from the other ones is a comprehensive clinical and laboratory studies of the health of the athletes in the deferred period after 12-16 hours after the cessation of heavy exercise, taking into account the most vulnerable to D. setiu physical activity of organs and systems, prognostically significant criteria morphofunctional state of the body; including the identification and analysis of biochemical, hematological, immunological, sanitary-chemical diagnosis of vitamin-mineral saturation of the organism, functional parameters, and provided that performance has been consistently changed - significantly different from normal values, and based on the implementation of early diagnosis of nonspecific changes of organs and systems of organism of athletes during training and competition cycle, to prevent the development of psycho-physiological and pathological conditions, maintaining professional performance and achieve consistently high results.
The closest analogue of the present invention on the objectives, principles and means of its achievement is the "Method for the diagnosis of stress cardiomyopathy" (EN 2292046 C2, 20.01.2007), which is adopted for the prototype (discussed above).
Disclosure of inventions
One of the important problems of preventive medicine is the preservation of the health of the people whose professional activity is connected with strenuous muscular activity. A special group consists of people whose work is characterized by a General intense muscular exertion involving more than 2/3 of mysecretpass person. To this group of people are the sportsmen of high qualification, as well as other related physical exertion activities (miners, miners, loggers) .
Numerous studies have established that intensive muscle load and overload often leads to fatigue, stress and have adverse effects on the human body, leading to a serious malfunction of organs and systems. Even people trained, capable of a long time to carry out intense muscle activity such condition may cause rough shifts in the body, migrating to temporary illness or persistent disease.
It is believed that under the action of heavy physical loads and overloads may occur inhibition of nonspecific factors of protection, impaired immune system, the development of oxidative stress that contributes to colds, infections and various somatic diseases .
When monitoring the health of these persons need to pay close attention to the psycho-physiological detection of changes of organs and body systems, timely evaluation of its functional state and adaptive capacity in the period when there are no obvious signs of disease, and identified Nar the decision can be reversed.
Intense muscle activity, with considerable metabolic disorders, leads to rapid release into the blood of the numerous products of metabolism. In this regard, biochemical and immunochemical methods occupy one of leading places in General complex surveys and monitoring body of persons whose activities are accompanied by different intensity of muscular exertion. Biochemical and immunological parameters significantly complement and enhance the assessment of the functional state of the organism can objectively judge the course of metabolic processes and to properly assess the degree of certain deviations in health status.
Because during exercise in a process involving all body systems, the selection of the most informative and sensitive indicators of early disruption of a particular system is the actual problem. Until the end of the unresolved question of what the most suitable indicators for assessing the state of health of persons working during heavy exercise. Because of their significant physiological and individual variability of each individual test will not give a General idea of the condition of organs and systems. The use of complex laboratory tests in the conjunction with functional (clinical) indicators will give more complete information about the state of health of the subject.
Based on the study of complex biochemical, hematological, immunological, sanitary-chemical diagnosis of vitamin-mineral saturation of the organism, functional parameters, made in the FBSI "NDIIPP" of Rospotrebnadzor (2012)identified the most vulnerable to the effects of physical activity of the organs and systems of the body. Found that heavy physical exertion lead to metabolic disorders in the body of athletes, as a consequence, the biggest change is subjected to the cardiovascular system, power supply system of muscle activity, blood, respiratory, immune, endocrine system. One of the pathogenetic factors of violations is an imbalance in the system of the oxidants-antioxidants. Identified latent iron deficiency and iron-deficiency erythropoiesis, the violation of the balance between lactate and oxygen energy systems, leading to the accumulation of lactate and acidosis, as well as signs of secondary immunodeficiency.
When prenosological diagnostics and monitoring the state of health of persons engaged in heavy physical labor (in particular, the sportsmen of high qualification), for an accurate assessment of indicators of health status, it is recommended that deferred examination of athletes through 12-16 hours on the Le stop heavy physical activity (training and competition periods). These recommendations due to the fact that in the early period after cessation of stress of training and competition, which can be equated to the stress and its variants depending on the final result achieved by the athlete (distress and eustress), in the body occur desynchrony changes in various indicators of the condition of organs and systems. The figures, obtained in this period may not reflect the true health of the athlete, because there remains a strong mental stress of all organs and systems of the Central nervous, endocrine, immune systems, energy supply systems. After a period of recovery indicators reflecting the status of all organs and systems of the athlete's body, come to a normal level; if they remain consistently changed - significantly different from normal values, should be considered as early criteria for the development of psycho-physiological state of the organism and it is necessary to conduct in-depth re-examination, with subsequent determination of recommendations for training, rest, nutrition, and behavior of the athlete .
To diagnose the condition of the cardiovascular system (CVS) in athletes it is recommended to study the following physiological parameters - set is of the heart rate (HR), systolic and diastolic blood pressure (SBP, DBP) at rest, immediately after exercise and recovery period; must be conducted ECG examination in 12 standard leads, the sample with the maximum physical load. According to the pulse pressure (PP) and heart rate calculate the coefficient of endurance (KB). The increase in KB that is associated with a decrease in PD is a measure of detenidamente cardiovascular system.
Under the influence of prolonged aerobic physical activity heart working in these conditions adapts to physical activity, heart cavity increases, and the muscular walls become thicker. In athletes, this heart is called "sports". Distinctive features of athlete's heart: a rare pulse, a heart murmur (40% of cases), increased volume of the heart. ECG: bradycardia, in 60% of cases, the arrhythmia may be atrial fibrillation, heart block (conduction disturbance is closely connected with workout intensity and disappears after the termination load). At rest, constantly engaged in heavy physical activity of the person, the heart rate may be only 30-50 beats per minute, respiratory rate of 6-10 per minute.
In the serum it is necessary to define the following biochemical indicators of the activity of the enzymes aspartate transferase (AST), CPK - muscle fibers (CPK-MB), total lactate dehydrogenase (LDH), myoglobin, troponin 1.
In particular, the basis for use as a diagnostic test troponin 1 was evidence that for troponin ratio of their concentration in intramuscular cells to the concentration in plasma is much higher than for enzymes and myoglobin, which makes these proteins are highly sensitive cardiac markers. Installed, for example, that the peak concentration of troponin 1 is observed after 14-20 hours after the onset of chest pain, and after 7 hours of acute pathology of the myocardium concentration of troponin 1 is increased at the 95,0% of patients. Concentrations above 2.0 ng/ml have a high prognostic value in relation to the development of acute pathology of the myocardium. Smaller concentrations, but beyond the upper limits of the reference boundaries, can be taken as a criterion for prenosological diagnostics of the cardiovascular system.
Isoenzyme of creatine kinase - MB (ck-MB) is relatively specific for myocardium, as in cardiomyocytes its activity is 15-42% of the total activity of creatine kinase, while in the tissue of skeletal muscle its content does not exceed 1-4% and only in red, slow-twitch muscle fibers. This should be remembered when combin the Institute in athletes during exercise damage to skeletal muscles and pain in the chest, when it is impossible to put a definitive diagnosis. If you exercise the activity of ck-MB is high, then you should pay attention to the condition of the heart muscle.
Sensitive and early test in the diagnosis of disorders of the myocardium is the determination of myoglobin (MG) in the serum, the increase observed in the earliest period of myocardial damage, ahead of the appearance of serum troponin 1 and increased activity of ck-MB. This indicator can be used to diagnose not only the condition of the heart muscle, but the working skeletal muscles. Unlike troponin 1 MG increases when microtrauma to skeletal muscle, the syndrome of their compression.
To diagnose the condition of the heart muscle is used, the determination of serum AST and total LDH. Increased AST in the serum indicates significant loads on the CCC. The activity of AST additionally increases the damage of the liver, kidneys, muscles.
LDH and components of this index is the fraction of LDH 1,2 considered a specific marker in the pathology of the myocardium. The increase in total activity of LDH indicates the presence of minor damage in the heart muscle. The level of LDH provides valuable information about the condition of the heart muscle in the dynamics of the observation.
Diagnostics of the system svobodno the radical oxidation. The status of the membranes of cardiac cells may contribute to the strengthening of processes of lipid peroxidation (LPO), excessive formation of peroxide oxidation, in particular aldehydes and peroxides and free radicals. Excessive accumulation of these products in the blood can lead to the disturbance of the synthesis of ubiquinone, enzymes of the respiratory chain, the consumption of oxygen required for aerobic ensure muscle activity. All this leads to reduced efficiency, endurance athlete, adaptation to physical stress, fatigue and slower recovery after exercise. Increased release of free radicals is also responsible for many cases of anemia in athletes caused by oxidative lysis of red blood cells.
For assessment of antioxidant status in the serum define the content of malondialdehyde (MDA), ceruloplasmin (CP), the activity of catalase (cat), etc. They have the ability to bind free radicals under oxidative stress that occurs during intense exercise, and, thus, to achieve maximum detoxification. Furthermore, using the definition of total antioxidant and oxidative activity of serum.
If the deferred period is after 12-16 hours, the concentration of MDA, total antioxidant and oxidative activity of serum is not normal, then you should say that physical load exceeds the adaptive capacity of the organism. Thus recycling of oxidized metabolites occurs slowly, indicating a reduced capacity of energy metabolism involving oppression redox reactions, leading to an imbalance between the intensity of lipid peroxidation (LPO) and total antioxidant activity (AOA) of serum. The unhealthy state of oxidative-antioxidative system is the risk for the occurrence of violations of various organs and body systems.
The result of decrease of antioxidant activity is increased in the serum concentration of malondialdehyde peroxides. During heavy exercise increases the level of oxidative stress. In the serum is determined by an increased amount of peroxides.
Diagnosis of disorders of energy supply to muscle activity. In the body there are different systems of energy supply security of muscular activity - phosphate, oxygen and lactate.
Phosphate (anaerobic or alchata) the system is very fast resin is Tom ATP from ADP and effective only for a very short time. At maximum exercise phosphate system is depleted within 10 seconds. It is important for short-term, rapid, vigorous forms of physical activity.
Oxygen or aerobic system is the most important for athletes in endurance since it supports in a long time. Muscle activity when the system power supply is provided by the breakdown of fats and carbohydrates. While carbohydrates are a more effective substrate than fats because their oxidation is required by 12.0% less oxygen. The performance of the oxygen system depends on the amount of oxygen that is able to assimilate the human body. Under the influence of aerobic training human abilities increase. Until consumed enough oxygen for the oxidation of carbohydrates and fats, lactic acid in the body to nakalyaetsya will not.
Lactate or anaerobic system is included in the power supply due to lack of oxygen. The only source of energy are the only carbohydrates. The higher the intensity, the greater the contribution of carbohydrates into energy formation. During the transition to a fully anaerobic energy supply, the intensity of the load within a few seconds or minutes, depending on intensity naked is narrow and the level of preparedness of the athlete, sharply reduced, or eliminated altogether. The reason for this is lactic acid is a by - product of ATP resynthesis in the system. It accumulates in the working muscle, leading to acidosis muscle. There is pain in the legs, arms, i.e. you receive the muscle fatigue. Under the influence of acidosis damaged membranes of muscle cells and in the blood can detect the increase of urea, ck-MB, AST and Alt, which indicate damage to the walls of the muscle cells. High levels of lactate increase the risk of injury in athletes. Acidosis muscle tissue leads to microreserves (minor damage to the muscles that can cause injury in case of insufficient recovery).
The most appropriate criterion for assessing functional capacity in athletes endurance is anaerobic or lactate threshold. Under anaerobic threshold refers to the intensity level of the load, above which the content of lactate in the blood increases dramatically. The lactate content at the level of anaerobic threshold is about 4.0 mmol/l
The concentration of lactate (lactic acid) in the blood is a very important indicator, which can serve as a criterion for evaluating the intensity of the load. Alone in a healthy person, the lactate concentration is 1.0-2.0 mmol/l After heavy physical the ski loads, this rate increases. Even a relatively small increase in the concentration of lactate (up to 6.0-8.0 mmol/l) may affect the coordination of the athlete. Regularly high levels of lactate impair aerobic capacity of the athlete.
Training recommended under the control of heart rate and lactate content in the blood. A small increase of the lactate to 5.0-6.0 mmol/l is acceptable when training sprinters. In athletes endurance during training indicators lactate should not exceed 3.0 to 4.0 mmol/l, the recovery Time should be at least 5-8 minutes.
Diagnosis of iron deficiency. Anemia is one of the most frequent causes of a malfunction of the oxygen transport system. However, in order to prevent the development of anemia, timely diagnosis preceding stage of latent iron deficiency or iron depletion and stage of iron deficiency erythropoiesis.
Found that heavy physical exertion cause of iron deficiency, which in the absence of timely correction can lead to the development of iron deficiency anemia. The presence of a number of specific causes of iron deficiency associated with professional activities athletes, led to the emergence of the concept of "sports anemia".
Iron deficiency anemia (IDA) is a syndrome characteristics is soumise reduced content of hemoglobin iron with a subsequent decrease in hemoglobin in the erythrocyte and depression of erythropoiesis due to iron deficiency. Hipposideros associated with tissue iron deficiency, is necessary for normal trophism of tissues and organs. Already in the early stages of development of iron deficiency reduced its reserves in tissues and observed changes in the most sensitive to the deficiency of tissue iron systems. To modern methods of early diagnosis of hipposideros and iron deficiency anemia include: determining the concentration of iron in serum total iron-binding capacity of serum (TIBC), transferrin, ferritin and erythropoietin in serum, hemoglobin, RBC indices (absolute content of erythrocytes), MCV (mean volume of erythrocytes in cubic micrometers, μm) or femtolitre, FL), sit (the average amount of hemoglobin in a single red blood cell in absolute units), hematocrit (Ht) - the ratio of the volume of formed elements in the blood plasma (in %). Characteristic features of iron deficiency anemia is a low level of hemoglobin (less than 130 g/l in men and 120 g/l in women), serum iron (less than 7 mmol/l), ferritin (less than 10 μg/l)TIBC more than 75 µmol/l, transferrin saturation less than 10%.
Erythropoietin is a glycoprotein hormone, more specifically a cytokine, the primary regulator of erythropoiesis, which stimulates the formation of erythrocytes from late progenitor cells and increases the release of reticulocytes from the bone marrow based on the oxygen consumption. Until not impaired tissue oxygenation, the concentration of erythropoietin as well as the number of circulating erythrocytes, remains constant. The only physiological stimulus that increases the amount of erythropoietin synthesizing cells, is hypoxia. The key factor that controls the differentiation of cells of the erythroid series, is circulating in the blood erythropoietin. Erythropoietin causes increased consumption of bone marrow iron, copper, vitamin b12which leads to a decrease in their levels in plasma, as well as lower levels of transport proteins - ferritin and transcobalamin.
The oxygen-transport function depends on the level of iron in serum. Iron concentration in the serum should not be below normal values. Reduced iron concentration in serum, low ferritin with normal hemoglobin level and erythropoietin testify about the depletion of iron stores or iron deficiency erythropoiesis. Data deficient States are a direct diagnosis by symptom of iron deficiency anemia.
Diagnostics of carbohydrate, lipid and protein metabolism. In prenosological diagnostics of the health of athletes performing heavy exercise, as indicators of what she carbohydrate metabolism recommended assessment of glucose and insulin in blood serum; lipids - total cholesterol (LDL), cholesterol, low-density lipoprotein (LDL-C), cholesterol high density lipoprotein (HDL-C), triglycerides (TG); protein - total protein, protein fractions (albumin, alpha-, beta - and gamma-globulins), creatinine of blood.
Total protein determines the physico-chemical properties of the blood - density, viscosity and oncotic pressure. Plasma proteins are the major transport proteins. Albumins and globulins are low molecular weight proteins in blood plasma. They perform various functions in the body: part of the immune system, protect the body from infections, which are involved in maintaining the pH of the blood, transport of various organic and inorganic substances are used to build other substances. Proportion in the blood at a relatively constant rate and reflects the person's state of health. The ratio of these proteins changes with fatigue, many diseases and can be used in sports medicine as a diagnostic indicator of health status.
Albumin is the most homogeneous fraction of plasma proteins. Their main function is to maintain oncotic pressure. In addition, a large surface molecules of albumin plays a significant role in the transfer of fatty acids, bilirubin, bile salts. Albumin is vyzyvaet a significant part of the calcium ions. After performing the physical activity, the concentration of albumin in serum, taken on an empty stomach should not change. The decrease in the albumin fraction during exercise indicates fatigue or violation of the processes of adaptation to physical loads.
Alpha-globulin - fraction of proteins, including glycoproteins. The main function is the transfer of hydrocarbons, as well as transport proteins for hormones, vitamins and minerals. Carry out the transport of lipids (triglycerides, phospholipids, cholesterol). After running the load sportsmen concentration of alpha-globulins in the blood taken on an empty stomach is reduced in comparison with the level of peace. The rate of return of this indicator to normal levels indicates a good adaptive ability of an athlete to physical activity.
Beta-globulin fraction of blood proteins involved in the transport of phospholipids, cholesterol, steroid hormones, cations, transports iron in blood. After the athletes physical activity the concentration of beta-globulins in the blood increases significantly. The decrease in the fraction of beta-globulin after exercise indicates a lack of adaptive capacity of the organism during execution of loads.
Thus, the decrease in the albumin fraction, alpha and Beth is-globulin after performing physical activity shows the reduction of adaptive reserves.
Gamma globulin - class globulin of blood plasma proteins, characterized by specific mobility by separation by electrophoresis of blood proteins. The most important gamma globulins are immunoglobulins are proteins specific humoral immunity.
Diagnosis of hormonal status in athletes. Portability, the adequacy of physical activity is determined by what the reserves are expended by the body in the process of adaptation. Regulation of internal organs occurs through changes in the activity of the various divisions of the autonomic nervous and endocrine systems.
The first response to the load is increased tone of sympathoadrenal system, which is based on catecholamines and other biologically active substances. This increases the heart rate, changes in blood pressure, increases muscle activity, and so on
As the load reacts parasympathetic division, activation of which leads to the opposite effects (decrease in heart rate, decrease in blood pressure, change in vascular tone and others)
The sympathetic division gives the strongest response, but quickly depleted. If the body is not able to quickly adjust to the increased activity of the sympathoadrenal system, developing processes, connected the with the toxic effects of catecholamines on the cells, depleted energy reserves of organs and tissues. It is excessive stimulation of the sympathetic division of the autonomic nervous system in case of lack of energy resources, imperfect processes of correction sympathotony is the main cause of sudden deaths and fatal rhythm disturbances from the heart during physical training and sports.
The endocrine system controls all types of metabolism and, depending on the situation, can activate reserve forces of the body. At the biochemical diagnosis of the functional state of the athlete informative indicators is the level of hormones in the blood. To change the content of hormones in the blood can be judged on the adaptation of the organism to physical activity, intensity of regulated metabolic processes, development processes of fatigue. Timely to assess the state of gipotalyamo-pituitary-adrenal system in athletes is very important, because only a balanced operation of the system can contribute to achieving high performance athlete. From a wide range of hormones are of particular importance anabolic and catabolic hormones. Catabolic hormones provide the release of large amounts of energy in the form of adenosine triphosphate, anabolic, on the contrary, lead by the son of synthesis using ATP. Anabolism of muscle tissue is largely dependent on the level of growth hormone, insulin and testosterone in blood plasma, catabolism depends on cortisol. To evaluate hormonal status of athletes in serum recommended the following definition of the hormones cortisol, testosterone, insulin, thyroxine, adrenocorticotropic hormone (ACTH).
Prenosological diagnosis of immune disorders. The influence of physical loads and overloads may result in deviations in the functioning of many body systems and, above all, the immune system is a secondary immunodeficiency and reduce humoral immunity.
Therefore, the observation of dynamic changes in the basic immunological parameters can be used as a marker transferability of the proposed training loads. The influence of unfavorable factors leads to changes in many parameters of innate and adaptive immunity. Changes from systemic immunity is manifested primarily by an imbalance of the production of immunoglobulins and cytokines. Set certain characteristics of the immune response depending on the severity and duration of physical activity.
Currently, it is widely known that the so-called sports immunodeficiencies underlie the increased morbidity that occurs most often in the statutory responsible workout periods - during use of large loads and participation in competitions [9, 11]. The risk of disease increases with the importance of starts, due to the important role of the emotional component of competitive stress. The main criteria in prenosological diagnostics are the levels of immunoglobulins (Ig). The Ig content is an integral indicator of virtually all components of the immune system and the most important cytokines.
Determining the level of Ig remains an important and reliable assessment criterion In the immune system, one of the main methods of diagnosis of all forms of immunodeficiency. The determination of the number of Ig can be judged not only on the functioning of the In-system, but also indirectly on the T-system of immunity. The most important is the determination of the fractions of immunoglobulins, especially IgG, IgA, and IgM.
IgG is the main component of the γ-globulin fraction and is 80,0% Ig serum, are the major effectors of humoral immunity. For IgG are a variety of antibodies against bacteria, their toxins, viruses and other antigens. They are not only in the bloodstream, but also easily penetrate into extravascular space, where they perform a protective function due Coccinellidae, and neutralizing bacterial activity. The decrease in the content of IgG indicates nedostate the activity of humoral immunity.
IgA include two types of proteins - serum and secretory. IgA in the serum contained in the monomer form (90,0% IgA), is the fraction of β-globulin and is to 15.0% Ig serum. Reduction of the concentration of IgA indicates a failure of humoral and local immunity, the violation of synthesis or increased catabolism IgA, as well as adsorption on his immune complexes.
IgM belongs to the γ-globulin fraction and accounts for approximately 5.0 percent. They were first released in response to acute infection, carrying antibacterial immunity. Because IgM appear on the first stage of the immune response and are found primarily in the bloodstream, they play an important protective role in bacteremia in the early stages of infection. The decrease of their content indicates a deficiency of humoral immunity, the violation of synthesis or increased catabolism of IgM, as well as adsorption on his immune complexes in inflammatory processes.
C-reactive protein (CRP) is a universal indicator of inflammatory processes. CRP belongs to the major proteins of acute phase of inflammation - CRP levels increased within 6-10 hours in the reactions of acute inflammation in 20,0-100,0 times .
This indicator can be used for differential diagnosis of viral infections from bacterial: increasing the concentration of the promotion of DRR from 10.0 to 50.0 mg/l may occur in viral and local bacterial infections, from a 50.0 to 150.0 mg/l mainly in bacterial infections, higher 150,0 mg/l in severe bacterial infections .
A basic level of C-reactive protein (up to 3.0 mg/l) - this term refers to the concentration of CRP, which is revealed in healthy persons or in the absence of acute inflammatory process. The baseline is of practical importance because it is directly related to the risk of development of cardiovascular diseases and their complications.
Diagnosis of vitamin-mineral saturation of the organism. Vitamins function in the body as regulators of metabolism, affecting many physiological processes important for health during exercise. Many of the vitamin b complex are involved in the metabolism of proteins, fats and carbohydrates, the production of energy from carbohydrates and fats. Several types of vitamins is essential for the formation of hemoglobin in red blood cells, which are a major determinant of oxygen delivery to the muscles during aerobic exercise endurance. Vitamins a, C and E function as antioxidants. Vitamin a is necessary for growth and reproduction of cells, is involved in the accumulation of body glycogen is the main energy storage. Vitamin C is involved in the metabolism of carbohydrates and proteins, improves the immune system .
the o enable increases substances essential for many metabolic and physiological processes, what is happening in the human body. For athletes important minerals involved in several physiological functions: muscle contraction, normal heart rhythm, the transmission of nerve impulses, oxygen transport, oxidative phosphorylation, activation of enzymes, immune function, antioxidant activity, bone health, and acid-base balance in the blood (iron, copper, zinc, magnesium, potassium, inorganic phosphorus, sodium, chloride) .
Therefore, it is extremely relevant to diagnosis the diagnosis of the health of athletes is to determine the level of vitamin-mineral saturation of the organism.
The present invention is to develop a method prenosological diagnostics athletes ' health, providing early diagnosis of nonspecific changes of organs and systems of organism of athletes during training and competition cycle, when using prognostically important criteria morphofunctional state of the body, to prevent the development of psycho-physiological and pathological conditions, maintaining professional performance and achieve consistently high results.
The achievement of the technical result, the solution of the problem provided by the fact that the proposed method is based on the realization kompleksnog the clinical and laboratory studies of the health of the athletes in the deferred period after 12-16 hours after the cessation of heavy physical activity, including the identification and analysis of biochemical, hematological, immunological, sanitary and chemical diagnostics of vitamin-mineral saturation of the organism, functional parameters, and assuming that the latter remain consistently changed - significantly different from normal values, taking into account previously established for the most vulnerable to the effects of physical activity of organs and systems, prognostically important criteria morphofunctional state of their body.
The technical result of the present invention is the rationale and development of an original method of prenosological diagnosis of the health of athletes through a comprehensive clinical and laboratory studies of the health of the athletes in the deferred period after 12-16 hours after the cessation of heavy exercise, taking into account the most vulnerable to the effects of physical activity of organs and systems, prognostically important criteria morphofunctional state of the body; including the identification and analysis of biochemical, hematological, immunological, sanitary-chemical diagnosis of vitamin-mineral saturation of the organism, functional parameters, and provided that the performance is capable of stably modified - significantly different from normal values, and based on the implementation of early diagnosis of nonspecific changes of organs and systems of organism of athletes during training and competition cycle, to prevent the development of psycho-physiological and pathological conditions, maintaining professional performance and achieve consistently high results.
The present invention is fundamentally different from the prototype that provides a comprehensive, highly informative and objective clinical and laboratory assessment of functional status of athletes ' health for early diagnosis and prognosis of a wide spectrum of pathology.
In addition, it is important to note that this method mainly differs from analogs and prototypes that:
for prenosological diagnosis of the health of athletes is used exclusively complex clinical and laboratory study of the most versatile, meaningful, objective, informative (and at the same time, available for definitions) indicators and evaluation systems health; marked interdependence, interdependence of measure and evaluate the totality of the chosen indicators;
for accurate and objective assessment of indicators of health status, the study is the way the Chennai period after 12-16 hours after the cessation of heavy physical load, i.e. the deferred recovery period;
- an essential condition for the implementation of early diagnosis of nonspecific changes of organs and systems of organism of athletes is the use of physiological indicators that the deferred period remain consistently changed - significantly different from normal values.
The implementation of the invention
The effectiveness of the proposed method prenosological diagnosis of the health of athletes consider the example of results of complex research of Nizhny Novgorod research Institute of hygiene and occupational pathology, obtained using laboratory material.
As object of research were selected athletes rowing related to cyclic sport endurance and affecting more than 2/3 of muscular activity during exercise. Athletes in the amount of 34 people aged 17-20 years were examined immediately after heavy physical exertion, which corresponded to training and competition periods, and delayed the recovery period. For prenosological diagnostics health working with hard physical activity was chosen deferred period of their survey: after 12-16 hours the donkey stop heavy physical exertion.
Functional (clinical) examination included:
- carrying out of electrocardiography using electrocardiograph "Myocardium-12", "Standard ECG" (produced in Russia);
- determination of the basic parameters of external respiration function with the use of device "Spirolab III" (made in Italy);
- conducting of Bicycle ergometry with the use of device "Kettler (Germany) by the method Astrand: for men - from 150 W to achieve a heart rate (HR) 120 min when reaching a heart rate over 140 min load is decreased; for women, from 100 watts to a heart rate of 120 / min with a gradual decrease of the load. Bicycle test was performed to determine the heart rate, power output and maximal oxygen consumption (IPC).
Laboratory studies included: hematological, biochemical, immunochemical, sanitary-chemical methods and performed by certified and standard methods.
All surveyed were performed General clinical blood analysis using generalizatio "Hemalux 19" (produced by "Mindray, China). Sets out the key indicators of blood hemoglobin and erythrocytes, the average volume of red blood cells, the average amount of hemoglobin in the erythrocytes, leukocytes (neutrophils band and the segment is nuclear, basophils, eosinophils, monocytes, lymphocytes), platelets, hematocrit.
While biochemical studies have used analyzers:
- photometer biochemical semi-automatic "Clima" 15MS (produced by "TESSA PARA EL LABORATORIO", Spain);
- automated biochemical analyzer "ROKI-6T" (produced by "olivex Diagnosticum", Russia);
- spectrophotometer SF-102 (manufacturing LLC Interfacetest", Russia);
- photometer Multiskan Ascent (production of "thermo Labsystems, Finland).
Indicators of carbohydrate metabolism
To determine the concentration of glucose in blood serum was used glucoseoxidase method Trinder (Trinder P., 1969). Used set of reagents company "olivex diagnosticum".
The level of lactate in blood plasma were determined by enzymatic colorimetric method using lactate dehydrogenase using a set of reagents "Lactat FS" company "Dia Sys Diagnostic Systems GmbH, Germany. To determine blood lactate was taken in vacutainer with anticoagulant EDTA and inhibitor of glycolysis is sodium fluoride. In order to inhibit glycolysis blood after taking immediately cooled in the vessel with ice, then centrifugals, after centrifugation the plasma was immediately taken in other test tubes and were used for analysis of lactate.
Determined total cholesterol (LDL), cholesterol, low-density lipoprotein (LDL-C), cholesterol high density lipoprotein (HDL-C), triglycerides (TG). Were used kits company "olivex diagnosticum". Total cholesterol and triglycerides were determined by enzymatic colorimetric method Trinder to determine XC-LPIP and HDL-C were used precipitating reagent with subsequent determination of total cholesterol.
The level of lipids and lipoproteins was assessed according to the classification of the expert group of the National educational program on cholesterol (NCEP) in the United States and the European society for the study of atherosclerosis.
Indicators of protein metabolism
The concentration of uric acid was determined by enzymatic colorimetric method without deproteinization, creatinine-pseudoceramides method based on the Jaffe reaction without deproteinization. Total protein in serum was determined by biuret method (Weichelbaum I.e., 1946). To determine these parameters were used kits company "olivex diagnosticum".
The concentration of myoglobin, troponin 1, ferritin, erythropoietin and C-reactive protein in the serum was determined by enzyme-linked immunosorbent assay using a reagent kit for the company "Vector-best". For the study of C-reactive protein used set of "SLO-ELISA - the BEST (high is acoustically)".
Protein fractions were determined by electrophoresis using devices electrophoresis of serum proteins on the films of cellulose acetate of UEF-01 "Astra" (the production of the NGO "Astra", ,Ufa, Russia).
The activity of alanine aminotransferase (Alat), Apartamentos-feraz (AST) were determined by enzymatic kinetic method using a reagent kit for the firm "DEACON-DS". The activity of lactate dehydrogenase (LDH), MB fraction of creatine kinase (ck-MB) - kinetic UV method using a reagent kit for the company "Vector-best".
Indicators of hormonal status
To evaluate hormonal status in the serum was determined by the content of cortisol and insulin enzyme-linked immunosorbent assay. Used kits company "Vector-best", and set "Accu-Bind ELISA Microwells, USA.
The insulin concentration was determined using a set of reagents "Accu-Bind Elisa Microwels INSULIN" BY Monobind Inc., USA, adrenocorticotropic hormone - kit "ACTH (Adrenocorticotropic Hormone) ELISA" company "BIOMERICA, Germany, adrenaline - kit "Adrenalin ELISA," the company "IBL", Germany.
Indices of antioxidant system
To assess the state of the antioxidant system in blood serum was determined by the content of malondialdehyde (MDA) and ceruloplasmin (CPU).
MDA content was determined Colo is eletricheskimi method with thiobarbituric acid. At high temperature in an acidic environment of malonic dialdehyde (MDA) is reacted with 2-thiobarbituric acid with the formation of colored trimethylboron complex with a maximum absorption at 532 nm.
For determination of ceruloplasmin used colorimetric method Revin. The method is based on recording the optical density at 530 nm colored products formed during the enzymatic oxidation of ceruloplasmin hydrochloric acid of paraphenylenediamine.
Evaluation of humoral immunity
When immunochemical studies were used photometer Multiskan Ascent (the production of Heat Labsystems, Finland).
To assess humoral immunity in serum was conducted studies globulin fractions - IgA, IgM, IgG by ELISA using kits company "Vector-best".
Assessment of vitamin saturation of an organism
Conducted analysis of vitamins in serum and whole blood: (A, E, b1and In2the analyzer bioliquids "Fluorat-02-ABLF-T" luminescence-photometric.
Vitamin A. the Analysis was carried out according to the Methodical recommendations (method M 07-01-2001)approved 15.02.2001, NPF "Lumex", SPb. The method is based on measuring fluorescence of retinol in the hexane extract, serum, previously, for example, is by the action of water and ethanol.
Vitamin E. the Analysis was carried out according to the Methodical recommendations (method M 07-02-2001)approved 27.03.2001, NPF "Lumex", SPb. The method is based on measuring fluorescence of alpha-tocopherol in hexane extract serum, pre-exposed to water and ethanol.
Vitamin B1. The analysis was carried out according to the Methodical recommendations (method M-2001), NPF "Lumex", SPb. The method is based on the analysis of the decay product of vitamin b1-pyruvic acid. The principle of the method is based on the interaction of pyruvic acid with 2,4-diphenylhydrazine with the formation of the hydrazone, which in alkaline medium acquires a brown-red color, the intensity of which is directly proportional to the concentration of pyruvic acid.
Vitamin b2. Determination in whole blood was performed according to the method of measurement (mm) mass concentration of the vitamin in Birch, Bessey and Lowry on the analyzer bioliquids "Fluorat-02-ABLF-T". Determine the concentration range of 0.1-1.0 µg/cm3without dilution. The method is based on extracting various forms of Riboflavin from the blood trichloroacetic acid, followed by acid hydrolysis of flavinadeninnukleotid (FAD) and fluorometrically the determination of the content of Riboflavin.
Determination of trace elements in blood serum
To determine microelement is found in the serum were used kits company "olivex diagnosticum". The concentration of iron and magnesium in the serum was determined by the colorimetric method without deproteinization using Chromogens Nitro-PAPS and chilidronolo blue. To determine the concentration of potassium in serum was applied values method without deproteinization using tetraphenylborate. Calcium concentration in the serum was determined using a unified method with o-cresolphthalein the combined. Inorganic phosphorus in the serum was determined by a spectrophotometric method without deproteinization. The method is based on the ability of phosphate to form with ammonium molybdate phosphate-molybdate complex, the optical density of which is proportional to the concentration of inorganic phosphorus in the sample. Sodium concentration was determined by colorimetric method using a precipitating reagent. The chloride concentration was determined by colorimetric method using thiocyanate mercury.
Determination of trace elements zinc, copper, iron serum
The analysis was carried out for guidance:
1. MUK 4.1.1897-04 "Atomic absorption measurements of mass concentrations of lead, cadmium, zinc and Nickel in blood", approved 01.05.2004;
2. MUK 4.1.777-99 "Determination of zinc, Nickel, copper and chromium in blood by atomic absorption", approved 06.09.1999.
Zinc, copper, iron was determined by atomic absorption spectrometer "quantum-2A" with a fiery way atomization of the sample and the deuterium background corrector.
Statistical processing of results was performed by standard methods of variation statistics on a personal computer using the program "Statistica 6.1".
Found that the glucose concentration of the blood serum immediately after performing heavy exercise and in the recovery period was not significantly changed and was within reference limits. This testified to the maintenance of normal mechanisms responsible for the use of glucose during exercise, sufficient speed of oxidation in the tissues during the muscle activity and timely mobilization of glycogen from the liver.
A total cholesterol level of the examined individuals immediately after the load was increased, this increase amounted to 14.5% of initial value (4,42±0.22 and 3,86±0,18, respectively). In the recovery period, the cholesterol level was decreased, but remained at 9.6 percent above the original value.
Defined trend to lower cholesterol high density lipoprotein on all stages of the survey sportsmen: absolute reduction - 0,073 mm/l, the rate of decline of 4.6 per cent.
Immediately after heavy physical activity has increased the concentration of cholesterol low-density lipoprotein 38.2% from the original value, while in the deferred period is reduced, almost to the initial Velich is n (1,94±0,22 and 1.86±0.17 mm/l, respectively.
Triglyceride levels ranged from average reference values.
Total protein under the influence of heavy physical activity were within the reference values, with a slight downward trend (to 6.0%). Significant differences in the ratio of protein fractions under the influence of physical activity was not detected.
The 45,0±8.9% of athletes immediately after heavy physical activity in the serum of the marked increase in the content of troponin 1 to 0.14±0.06 ng/ml, which was much higher than its normal value (0,03±0,03 ng/ml), and individuals were reached of 0.18 to 0.21 ng/ml In the deferred period 93,6±4.3% of the target concentration of troponin 1 in serum were decreased and reached normal values, and 6.4% of the surveyed concentration of troponin 1, being enhanced, immediately after heavy exercise, remained high and the deferred period exceeding rate 4-5 times.
The activity of ck-MB immediately after heavy physical activity was elevated in 58,0±8.8% of the surveyed. The activity value was 34.6±9,5 U/l, significantly exceeding the normal level and reaching in individuals 38,0-64,0 U/L. In the deferred period, the enzyme activity was normalized at 78,0±7.4% of the surveyed, falling to 17.0±4,4 U/L. At 16.1 per cent of the surveyed activity of ck-MB remained elevated throughout the period observed the expression.
The analysis of the dynamics of myoglobin in the serum showed an increase of this marker in 55.5±8.9% of the surveyed. His concentration was increased to 115±31 µg/l In the deferred period elevated myoglobin remained in 11.2% of patients.
The activity of AST and LDH immediately after a heavy load has been raised, respectively, of 35.4±8,6% and 48.3±8,9% target and has reached level AST 35,0±2,9 U/l at the rate of 25.0±3,7 U/l for LDH - 401,0±83,6 U/l at norm 320,0±25,4 U/L. In the deferred period, the activity of AST remained increased in 31.0% of the patients, the activity of LDH - 45,0%.
Significant changes in the system of the oxidants-antioxidants aimed towards reducing antioxidant protection against free radicals. This has decreased the total antioxidant capacity of serum and the activity of its individual components - catalase, ceruloplasmin. The decrease in total antioxidant activity to 204,3±11.0 µmol/l was observed in 70.0% of respondents (in norm 280±20,4 µmol/l). Almost half of respondents saw a decrease of catalase activity to 13.7±2.5 µmol/l at the rate of 26.6±4.5 mmol/l and ceruloplasmin by 20.0-30.0% from the initial level.
Half of the surveyed individuals were detected average level of oxidative stress, 23.3% were identified with a high level of peroxides in the serum (357,0±13,6 µmol/is), indicating the high oxidative stress. Revealed back in a strong correlative relationship between antioxidant activity and the level of oxidative stress.
The content of malondialdehyde immediately after heavy physical activity was increased in half of the surveyed 2-3 times relative to normal levels, reaching in some individuals 3,8-4,2 mmol/l at the rate of 1.4±0.4 µmol/l In 20% of the surveyed violation in the system of the oxidants-antioxidants were preserved during the deferred period.
During heavy exercise half of the surveyed after 12-16 hours of the recovery period, the concentration of lactate in serum were higher than 2.0 mmol/l, from 13.0% in the surveyed lactate concentration reached a 4.3-5.3 mmol/l, i.e. exceeding the anaerobic threshold (4 mmol/l). This means that neutralization of lactate was not fully and subsequent work was carried out at an elevated lactate concentrations. Thereby suffered aerobic system of energy supply, therefore there could be a risk of infringing activity of organs and body systems.
When adequate physical exercise, the reduction of iron concentration in serum was observed in 50.0% of cases. Thus the value of the level of iron in women reached to 5.3±2.0 µmol/l in men and 8.9±1.7 µmol/l With increasing physical activity frequency of detection of persons with Pont is defined by the concentration of iron was increased to 60,0-70,0%. While iron concentration could be reduced to 1.3-3.8 ámol/L.
The level of ferritin in adequate physical activity was decreased in 30% of cases. When its value was decreased to 7.0 ng/ml in women and up to 10.0 ng/ml in men (below threshold reference values). With increasing physical activity frequency of detection of individuals with a low concentration of ferritin was increased to 45-50%.
Hemoglobin levels did not change and remained at the level of 149.0±8.7 g/l and 146,0±8,4 g/l for men and 127,0±6.8 g/l and 129,0±6.2 g/l for women with adequate and heavy physical activity, respectively. Indicators RBC, MCV, sit, Ht remained within normal values.
The erythropoietin level fluctuated within the reference limits. However, it was determined a significant increase in its level after performing heavy physical exertion. Probably against this background, the tendency to increase the number of erythrocytes, the average volume of an erythrocyte, the average amount of hemoglobin in them testified to the effect on the oxygen tank and oxygen transport in tissue. This was an indicator of impairment aerobic capacity of the body and activate compensatory mechanisms.
Cortisol levels immediately after severe physical and emotional stress was increased in is 83.8±6.7% of the surveyed. The value of its concentration exceeded the normal level and costal the La 646,0±63 nmol/l at norm 350,8±70,0 nmol/L. In the deferred period, the concentration of the hormone was decreased to normal values, remaining high at 8.3 percent, exceeding the rate 16.0%.
Multidirectional nature of the changes in the content of insulin in the serum of examined persons Immediately after heavy exercise at 50% concentration was reduced to 5.8±0.4 MCAD/l at the rate of 8.2±0.7 MCAD/L. In deferred period has seen an increase in the level of this hormone in 80,8%. At some level reached 28-30 MCAD/L. In other entities (19,1%) insulin concentration remained reduced. The correlation analysis of the relationship between cortisol and insulin revealed inverse correlative relationship of the average force only in the deferred period.
Testosterone levels immediately after intense physical activity was elevated in 100% of cases have a relatively normal values of 35.0±9.1 nmol/l in boys and 4.2±1.7 nmol/l in girls (rate of 20.6±2.8 nmol/l and 1.6±0.4 nmol/l, respectively). In the deferred period, the concentration of testosterone in most cases examined decreased to normal values - 21,0±6.4 nmol/l in boys and 1.8±0.6 nmol/l in women. However, 22.3% of boys the concentration of testosterone is 30% above the normal level.
Immediately after heavy exercise at 90% of subjects showed lower levels of ACTH to 15.2±7,3 nmol/l, of whom 40,0% hormone level was 3-4 times lower than the norm is lnyh values. In the deferred period, the concentration of the hormone was reached normal levels (24,7±4.4 nmol/l).
The analysis of thyroid-stimulating hormone in serum showed that the level of all Gomonov immediately after heavy exercise did not go beyond their reference values. However, drew the attention of TSH level, even within the reference values was 2 times lower than the norm. In the deferred period was marked tendency to its increase. Found no dependence of the concentration of T3 and T4 on the degree of physical load.
The results obtained studying the humoral immunity showed that in heavy physical activity decline was observed in all fractions of immunoglobulins IgA, IgM, IgG, respectively, 50,0±9,1%, 16,0±6,7%, 33,3±8,5% surveyed. The concentration of IgA decreased by 37.3±12%, IgM - 44.4±12%, IgG - 50.0±11.8 percent. Several people the IgA concentration was decreased to 0.15 g/l, IgM - to 0.35 g/l, IgG - up to 6.0 g/l
We 30,0% surveyed immediately after heavy physical activity was found increased in the serum content of SRO from 3.6 to 8.0 mg/l in individuals, the concentration of CRP was reached 12,0-24,0 mg/l In the deferred period, the CRP concentrations remained elevated at 12.0 percent of the subject.
In the period monitored the levels of magnesium, phosphorus in serum was not significantly different. The dynamics and the level of calcium in the blood serum of them is whether the same dependence. However, 13.3% of the athletes by the end of the observation of decreased levels of this mineral.
By the end of the observation showed a significant reduction in serum potassium by 8.6% compared to the initial value.
Decreased levels of iron in the blood. When a 25.0-64.2% of the surveyed persons level of iron was below the reference boundaries.
Dynamics in sodium levels in General were not identified. However, 14,2-33.3% of athletes immediately after loading the sodium was lower than normal.
In the dynamics of observations the observed decrease in serum chloride 9.6%. By the end of the observation 16.6% of the level of chlorides was lower than normal.
The content of copper in the serum were within the reference values, was not significantly changed, however, by the end of the observation in 38.5% of cases, this level was lower than normal.
The saturation of the body with zinc were within the reference limits. By the end of the observation 50,0% persons decreased levels of zinc.
In the dynamics of the observation identified significant decrease in the level of vitamin a in the blood by 25.8%. It was increased and the proportion of individuals who had identified the reduction of vitamin a from 41.6% to 100.0% by the end of the observation.
Individual indicators marked increase in the proportion of individuals who have the vitamin E levels in serum were decreased relative to the reference boundaries - from 15.4% to 61.5%) by the end of the observed who I am. The concentration of vitamin E was decreased from 9.6±0.8 µg/l to 7.7±0.3 ág/L.
Data for the estimation of saturation of the organism with vitamins a & E confirmed the decreased activity of the mechanisms of antioxidant protection of the organism.
In 100.0% of cases in athletes throughout the observation saturation of the body with vitamin b1was below normal, but by the end of the observation 58,3% marked further deterioration in the saturation of the body with the vitamin.
By the end of the observation in 66.7% of the surveyed athletes noted a significant reduction of the saturation of the body with vitamin b2.
Thus, biochemical, immunological, sanitary-chemical indicators testified to the presence of psycho-physiological changes in the body condition 6.4 (70.0% of athletes.
Clinically defined the following. With the absence of the surveyed athletes complaints to heart ECG analysis revealed they have enough frequent deviations from the norm. The athletes rowing normal ECG was observed in 7 people, 15 showed a marked sinus arrhythmia, 5 surveyed block right bundle branch, 5 - repolarization violations, the shortening of the segment PQ - 3, violation of intraventricular conduction - 2, supraventricular extrasystole had 3 people, the atrial rate is at 1. Signs of left ventricular hypertrophy marked the us in 5 patients. All of the above deviations from the classical ECG standards are part of a syndrome called "heart of an athlete".
In the group of athletes with unchanged ECG immediately after exercise significantly increased the concentration of troponin 1 have been identified, whereas in the group with impaired repolarization processes increased troponin level 1 to 0.15 ng/ml, from individuals to 0.5-0.6 ng/ml Increase in the concentration of troponin 1 more than 0.1 ng/ml after performing the maximum physical exercise (cycle Ergometer) in athletes correlates with disruption of the processes of repolarization and negative dynamics of teeth T in response to AutoProbe. The data obtained indicate the existence of a relationship of repolarization abnormalities of the heart in athletes with higher levels of troponin 1 on physical activity, possibly due to metabolic disorders in the cardiac muscle, or micro-damage of myocardial tissue.
After starting heavy loads systolic blood pressure athletes were increased, then tended to decrease. The marked increase in diastolic blood pressure, by the end of the observation it was higher by 5.1%, than in the initial state. Heart rate also tended to increase: the increase to the end of follow-up was 3.4 per cent.
After starting heavy the th load was augmentation DD, it was considered a positive result. Further, after completion of load - reduction of PD, which were registered before the end of the observation. However, it decreased by 16.8%, which showed a significant stress on the body of athletes and the voltage of the cardiovascular system. This was proved by the data on the determination of the coefficient of endurance, which increased.
Confirmed the effectiveness of the heavy load and the data of Bicycle ergometry: noted the increase in pulse pressure, a tendency to decrease in the heart rate, which resulted in a decrease of the coefficient of endurance. Power of performed work at the initial stage of loading is not changed, this background was determined the growth trend of the IPC. However, with further heavy load, the power dropped and was not restored to its original level. IPC was reduced and remained at this level until the end of the observation.
The test marked the reducing power of the work performed in 54.5% of the athletes. Heart rate increased, and PD decreased from 45.5 per cent, the IPC has also decreased from 45.5% of the surveyed persons These data also confirmed the fact of an adverse impact on the health of athletes considerable physical exertion.
Thus, the carried out researches have allowed to formulate the following were elaborated to the prenosological diagnosis of the health of athletes.
1. The examination should be deferred period: after 12-16 hours after the cessation of heavy exercise, when the indicators reflecting the status of all organs and systems of the athlete's body must correspond to the normal level. If these indicators remain changed - significantly different from normal values, they can be considered as early harbingers of the development of psycho-physiological conditions.
2. When analyzing the state of the cardiovascular system, it is necessary to assess biochemical parameters of blood serum (troponin 1, the activity of AST, CPK-MB, LDH, myoglobin) in conjunction with the indicators on the ECG (save repolarization processes), performance curves, GARDEN, DBP after dosed physical load.
3. The status of the antioxidant defense system to assess the level of concentration of MDA, peroxides, total antioxidant capacity of serum, in particular the activity of catalase, ceruloplasmin.
4. The power supply system of muscle activity in athletes to evaluate the content of lactate in the blood serum.
5. The oxygen-transport system as a criterion of activity of the respiratory system to assess for indicators of iron metabolism (serum iron, hemoglobin, ferritin, erythropoietin), IPC - dosed on the power
6. Hormonal status to assess the performance level of cortisol, insulin, testosterone in serum.
7. The immune status should be determined by the levels of fractions of immunoglobulins IgG, IgA and IgM.
8. As a universal indicator of inflammatory processes in the body to identify and evaluate C-reactive protein.
9. Metabolic disorders in the body to assess indicators of protein (total protein, protein fraction, creatinine), lipid (total cholesterol, lipoprotein and high density) and carbohydrate metabolism (insulin, blood sugar), and vitamins (vitamins a, E, b1In2and mineral saturation (magnesium, phosphorus, calcium, potassium, sodium, chlorides, copper, zinc serum, iron blood in the body.
10. Condition psycho-physiological assessment of athletes ' health is the use of an integrated approach in the diagnosis of this condition.
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7. Dembo, A., Basic principles of functional diagnostics in sports medicine: Lectures. - Leningrad: Izd-vo GDOIFK them. P. F. Lesgaft, 1986. - 37 S.
8. Dembo, A., Pathological condition in athletes. The lectures. - L.: 1981.
9. Dembo, A., Contemporary issues sports medicine: Lectures. 4.4. - L., 1976.
10. Dubrovsky Century. And. Massage for injuries and diseases in athletes. - M.: Physical culture and sport, 1979. - 128 S.
11. Dubrovsky Century. And. Sports medicine. - M.: Humanitarian publishing center VLADOS, 1998. - 480 S.
12. Epifanov Century A. Therapeutic physical culture and sports medicine: a Textbook. - M.: Medicine, 1999 - 304 S.
13. Ivanov, K. M., Pavlovich L. P. Medical supervision for young athletes with microanalyse heart: Handbook for physicians. - Orenburg, 2003.
14. Chapman C. L. Sports medicine. - M.: Physical culture and sport, 1980. - 349 S.
15. Kulinenko O. S. Pharmacological help the athlete: correction factors limiting the performance.- M: Soviet sport, 2007. - 240 S.
16. Menshikov Century Century techniques of clinical laboratory the research. - Moscow, 2009. 2. - S. 303.
17. Melvin H Williams. Dietary Supplements and Sports Performance: Introduction and Vitamins. Journal of the International Society of Sports Nutrition 2004, 1:1-6
18. Melvin H Williams. Dietary Supplements and Sports Performance: Minerals. Journal of the International Society of Sports Nutrition, 2005, 2:43-49.
19. Mironov 3.C. Merkulova P. I., Bogutskaya E. B., Badmin I. A. Strain musculoskeletal system in athletes. - M.: Physical culture and sport, 1982. - 95 S.
20. Perunov A. M. Essays on psycho-physiological functional diagnostics in sports. / Under the scientific editorship of Professor B. A. Poleev. - M.: REMEBRE, 2006.
21. Perunov A. M. Integral indicators of functional fitness athletes in psycho-physiological aspect, Zh. RENMINBI, №1 (21), 2007. - S. 35-42.
22. Poliaev B. A., Perunov A. M., Sidorov, SP., The native I. T. System analysis diagnostic psycho-physiological conditions in athletes // Mater. the Intern. scient. Conf. on the state and prospects of development of medicine in the sport of high achievements "SPORTMED-2008", Zh. RENMINBI, №4 (27), 2008. - S. 57-63.
23. EN 2156086 C1, 20.09.2000
24. EN 2306720 C1, 27.09.2007
25. EN 2375923 C2, 20.12.2009
26. EN 2448527 C1, 27.04.2012
27. Khrushchev C. C. Medical supervision for physical education students. 2nd ed. - M.: Medicine, 1980. - 224 S.
The way prenosological diagnosis of the health of athletes through a comprehensive clinical and laboratory studies of the health of the athletes from recendy period after 12-16 hours after the cessation of heavy exercise, taking into account the most vulnerable to the effects of physical activity of organs and systems, prognostically important criteria of the functional state of the organism, including the identification and analysis of biochemical, hematological, immunological, sanitary-chemical diagnosis of vitamin-mineral saturation of the organism, functional parameters, and provided that performance has been consistently changed - significantly different from normal values, and based on the implementation of early diagnosis of nonspecific changes of organs and systems of organism of athletes during training and competition cycle.
SUBSTANCE: efficiency of treatment of patients with high grade non-Hodgkin malignant lymphoma is determined by the likelihood of achieving remission, and 5-year total and relapse-free survival. The method comprises the study of polymorphism G13494A 6th intron of gene TP53 of the patient. In case of revealing in the patient of homozygous genotype G/G in a given locus the low efficiency of treatment is predicted, namely, low likelihood of 5-year survival of the patient and low likelihood of absence of relapse. In the case of revealing in the patient of the genotype A/A or G/A in a given locus, the high efficiency of treatment is predicted, namely the high likelihood of remission and 5-year survival of patient.
EFFECT: invention enables to assess the efficiency of treatment of patients with high grade non-Hodgkin malignant lymphoma on the degree of polymorphism G13494A of 6th intron of gene TP53.
5 dwg, 10 tbl, 2 ex
SUBSTANCE: invention represents a diagnostic technique for the disturbed thrombocyte aggregation accompanying mucoviscidosis in children involving a thrombocyte aggregation test using the Multiplate aggregometer inducers. Trays with a magnetic mixer and electrodes are added with NaCl 400 mcl at 37°C and immediately added with whole blood 400 mcl from a hirudin test tube, incubated in the chamber for two minutes; the tray is added with 30 mcl of an aggregation inducer specified in a group: soluble thrombin receptor - peptid-6, adenosine diphosphate, arachidonic acid. The thrombocyte aggregation rate is displayed on the screen in the form of a curve, and the sub-curve area U is automatically calculated; the sub-curve area U shows the thrombocyte aggregation state as compared to reference values in the group of healthy children; if the threshold area U has appeared to exceed the reference, the thrombocyte hyperaggregation, while the threshold area U being less than the reference, the thrombocyte hypoaggregation is stated.
EFFECT: invention provides the timely diagnosis of microcirculatory disorders accompanying mucoviscidosis.
2 ex, 1 dwg
SUBSTANCE: invention relates to the field of microbiology, namely to a method of microorganism characteristic. The essence of the method consists in the following: (a) obtaining a sample to be tested, about which it is known that it contains or can contain microorganisms; (b) layering the tested sample on a density buffer in a container, where the said density buffer possesses a uniform density from approximately 1.025 to approximately 1.120 g/ml; (c) addition of an identifier into the said tested sample and/or into the said density buffer; (d) centrifugation of the said container in order to separate microorganisms from other components of the said tested sample and to form a deposit of microorganisms; (e) spectroscopic analysis of the deposit and/or the said one or more than one identifier with obtaining measurements, which characterise the microorganisms, where the said spectroscopic analysis is carried out when the said deposit is located in the said container; and (f) characteristic of the microorganisms in the deposit on the basis of the obtained measurements and/or the presence or absence of the said identifier or a metabolised form of the said identifier in the deposit, where the said microorganisms are characterised by one or more classification models, selected from the group, consisting of Gram groups, clinical Gram groups, therapeutic and functional groups.
EFFECT: application of the claimed invention makes it possible to increase the accuracy of the microorganism characteristic.
15 cl, 5 dwg, 1 tbl, 4 ex
SUBSTANCE: invention refers to medicine, namely to qualitative differential instant diagnostic technique for benign and malignant periglottis new growths as shown by oral fluid biomarkers. Substance of the method consists in measuring a quantity of matrix metalloproteinase 2 (MMP 2) in patient's oral fluid; the clinical reference is the level of 1.7-2.9 ng/ml; if the MMP 2 content is 14.4-24.3 ng/ml, patient's periglottis papilloma is diagnosed; if the patient's oral fluid MMP 2 content is 4.1-6.8 ng/ml, periglottis cancer is diagnosed. A biomarker for the qualitative differential instant diagnosis of the periglottis new growths is a tissue inhibitor of metalloproteinase 2 (TIMP 2); the clinical reference is a level of 6.44-11.23 ng/ml; if the TIMP 2 content 29.25-48.75 ng/ml, patient's periglottis papilloma is diagnosed; the TIMP 2 content being 57.23-95.03 ng/ml, periglottis cancer is diagnosed.
EFFECT: using the declared technique enables providing more accurate differential diagnosis of the benign and malignant periglottis new growths.
2 cl, 6 ex
SUBSTANCE: method is implemented by preparing an incubation solution No.1 containing sulphanilic acid 500 mg in 1 M HCl 50 ml, and solution No.2 consisting of NaNO2 125 ml in distilled water 2.5 ml. Each solution is taken in an amount of 1 ml, mixed in a test tube and added with whole blood with a coagulate 200 mcl. The reaction is carried out for 10 min at a room temperature, and a drop of the suspension is used to produce a multilayer smear on a slide, dried and studied by computed cytophotometry.
EFFECT: more accurate determination.
SUBSTANCE: invention refers to medicine, namely diagnostics and can be used for assessing threatened foetal death following the aggravated cytomegalovirus infection at the early stages of gestation. To this effect, with the underlying cytomegalovirus infection, peripheral blood of a pregnant woman is analysed to measure the anti-cytomegalovirus IgG antibody titre and progesterone level. If the anti-cytomegalovirus IgG titre is 1:1600, and the progesterone level is 18.5±0.8 nmole/l, a threatened spontaneous miscarriage is stated.
EFFECT: method enables stating the threatened spontaneous miscarriage if any at the early stages of gestation.
SUBSTANCE: invention refers to medicine, and represents a method for the prediction of a risk of congenital infections by measuring specific Ig M and Ig G antibodies in a biological material, differing by the fact that the biological material is presented by the first-screening cervical smear at the 12th week of gestation; the smears are tested for the IgG antibodies to the rubella virus, cytomegalovirus, B19V parvovirus, toxoplasm viruses, type 1 and 2 herpes simplex viruses and an avidity of the specific Ig G to this agents; additionally, the same smear is tested for secretory non-specific Ig A by IFA to cytomegalovirus, Chlamydia, Mycoplasm antigens, and a genetic material of this microorganisms by PCR, and depending on the findings, groups of a high, moderate and low risk of congenital infections are predicted.
EFFECT: invention provides the more accurate prediction of the risk of the most actual congenital infections by the integral assessment of a collection of clinical anamnestic data, and the qualitative parameters of the laboratory findings at the first pregnancy screening.
SUBSTANCE: invention aims at assessing an efficacy of therapeutic agents (TA) for improving individual's cognitive functions. The patient's blood serum is examined for the HLDF protein, titres of idiotypic and anti-idiotypic HLDF antibodies before and after the TA is administered, and the above derived data are used to calculate MMSE before and after the TA is administered by formula; the derived MMSEs are compared, and the TA efficacy is assessed by the comparison result.
EFFECT: invention enables more real-time selection of one or another TA or the length of the course of administration, including the real-time prescription of this course if the patient's condition deteriorates.
3 tbl, 2 ex
SUBSTANCE: invention can be used to assess a risk of cervical cancer accompanying cervical intraepithelial neoplasia and a human papilloma virus (HPV) carrier state in fertile females. That is ensured by sampling cells from the exocervical surface to recover RNA and measuring the gene mRNA expression levels: MKI67, CDKN2A, PGR, BAX. Relating the mRNA expression levels provides calculating a linear discriminant function (LDF): LDF=1.2*lg[CDKN2A]/[BAX]-lg[PGR]/[MKI67]-1, wherein [CDKN2A]/[BAX] is the relation of the CDKN2A and BAX mRNA expression levels, [PGR]/[MKI67] is the relation of the progesterone receptor and MKI67 mRNA expression levels, and if LDF≤0, a low risk of neoplastic transformation is stated; LDF>0 shows a higher risk of neoplastic transformation.
EFFECT: method enables assessing a risk of cervical cancer by the representation of reference genes mRNAs.
2 dwg, 1 ex
SUBSTANCE: invention concerns determining a degree of severity of psychosomatic disorders in patients with discirculatory encephalopathy. That is ensured by a standard therapeutic, neurologic, instrumental examination. That is added with measuring primary anti-S100B protein antibody (AT) titres in blood serum. If the measured titre is up to 150, they should be taken into account in stating degree 3 discirculatory encephalopathy with cognitive disorders reaching moderate or severe dementia accompanied by severe affective and behavioural disorders.
EFFECT: higher specificity, accuracy, sensitivity and reliability of the molecular diagnostic technique.
SUBSTANCE: left ventricular systolic volume as shown by echocardiography is determined in the children and adolescents suffering from essential arterial hypertension; blood serum lead is measured, and a systolic day-time hypertension time index is calculated by a regression analysis formula: SAT TI day-time=0.12+0.0035*SV+0.13*Pb blood serum, wherein SAT TI day-time is the systolic day-time hypertension time index; SV is the left ventricular systolic volume as shown by echocardiography; Pb blood serum is the blood serum lead content. If the systolic day-time hypertension time index falls within the range of 0.25 to 0.50, the form of essential arterial hypertension is considered to be labile, and if the value is more than 0.50, the stable form of essential arterial hypertension is stated.
EFFECT: method enables defining the form of essential arterial hypertension in the children and adolescents by measuring the blood serum lead content as shown by atomic absorption spectrophotometry and determining the left ventricular systolic volume according to echocardiography.
1 tbl, 3 ex
SUBSTANCE: heart mass relative to body weight, % (X), heart beat number (A) and pulmonary alveolar air oxygen, % (CO2) are measured. The following formula is used for calculation: α=(0.25/T)·CO2, wherein α is an entropy, %, T is an erythrocyte turnaround time with the circulating blood flow, seconds, herewith T=[(0.44·75)/(X·A)]·21.5.
EFFECT: method enables measuring the body characteristics combining the living systems that can be used to determine the biological age, the health state, to study the effect of various health disorders prevention and life prolongation means.
FIELD: physics; control.
SUBSTANCE: invention relates to recording time spent by a person, specifically to monitoring mobile workers in companies with a large staff and many branches and separate subdivisions. Biological information on pulse waves of all workers in the system from their sensors 1 is transmitted to a base terminal 2 and signals from all sensors 1 at certain moments in time are compared with each other in a comparison unit 3. If no matches of information from the sensors 1 are found, the comparison unit outputs a signal to a display unit 4, which indicates the number of sensors 1 which matches the number of workers in the system. If a complete match or other link between signals from two or more sensors 1 is detected, then said sensors are on the body of one person. In that case, the comparison unit 3 outputs a signal to a display unit 5, which displays unauthorised use of specific sensors by a certain worker in the system.
EFFECT: detecting unauthorised use of portable electronic devices when monitoring the number of workers and honest discharge of duties.
2 cl, 1 dwg
SUBSTANCE: invention refers to medicine, namely pulmonology, allergology, cardiology, functional diagnostics. Elastic and functional properties of the aorta are assessed by analysing the pulse wave characteristics recorded by non-invasive arteriography. The derived data provide a basis to calculate the principal characteristics of an arterial rigidity: the aortal pulse wave velocity - APWV and the augmentation index - AI. If observing the APWV value of 7 m/s and more and the AI value of 30% and more, the diastolic dysfunction of both ventricles is predicted.
EFFECT: method enables the timely diagnosing to begin corrective therapy in the patients suffering from bronchial asthma by assessing the pulse wave velocity in the aorta and the augmentation index.
1 tbl, 3 ex
SUBSTANCE: group of inventions refers to medicine. The method is implemented by generating an electric cardiosignal. Diastolic pressure (D) and an electric cardiosignal sampling are determined. An analysis window 0.4-0.5 s long is formed and moved along the signal at a pace equal to the electric cardiosignal sampling interval. Each pace involves determining statistical expectation and dispersion related to the statistical expectation in the window, and the dispersion related to the statistical expectation of each pace of the window is determined. Two variation coefficients are calculated for each pace, and a difference is calculated. The derived value is compared to a threshold of 0.5-1, and a threshold exceedance number (n1) is calculated. Then, a clock pulse, the frequency of which is equal to the electric cardiosignal sampling frequency is formed, and these pulses are counted (n2). Thereafter, n1 and n2 are related, and the derived value is divided by D. This value is transformed into a vegetation index by formula:
EFFECT: group of inventions can provide the more reliable and accurate real-time determination of the operator's vegetation index and the based assessment of the functional state, having QRS cardiac complexes different from standard.
2 cl, 2 dwg
SUBSTANCE: device for the pulse data collection comprises a sensor component with the above sensor component comprising a built-in electric machine, a screw coupled with the above electric machine, a lifting structure outside from the above screw, and a sensor probe fastener in a base of the above lifting structure. The electric machine is coupled to the screw with a possibility of the latter being rotated to ensure lifting and dropping of the above lifting structure in relation to the screw. The sensor component comprises two optrons fastened in a side wall of the body. The lifting structure comprises a projecting portion passing through the above optrons when the above lifting structure is lifted or dropped. The optrons are respectively arranged in positions of the projecting portion when the sensor probe is advanced into the initial position and the extreme position. What is disclosed is a method for the pulse data collection.
EFFECT: providing the automatic pulse signal collection with giving protection ensured by the protective structure.
9 cl, 5 dwg
SUBSTANCE: invention refers to medicine, forensic medicine, diagnostic measurements, including in investigative practice. An interactive psychophysiological testing (PPT) involves presenting a person being tested test questions, determining, analysing the psychogenesis parameters with using the person's physical parameter sensors, indicating the results and estimating. The test questions are typed as follows: first-version questions Q1, second-version questions Q2, neutral questions N. The questions Q1 and Q2 have an alternative meaning and equal power and are characterised by an equal presentation time, a consistency of comparing the questions according to the alternative versions, a minimised subjective personal effect of the PPT test expert by sound colour and level, an unconscious emotional support on the person's question perception, as well as an identity of putting the questions to be compared, their length and a fixation of the meaningful word and/or word combination in similar segments of both questions to be compared. The test is put in accordance with a concatenation as follows X:0→C,…,C→Q11.Q21→N→ →Q21.Q22→N→…→Q1n.Q2n→N, wherein X is a person's identification index; 0 is a non-estimated zero question; C is a question relieving an expectation stress; Q1i is the first-version question, wherein i=1, 2,…, n; Q2i is the second-version question, wherein i=1, 2,…, n; N is a neutral question; n is a number of specific circumstances of the event or action; ":", "→", "." are devisors. The questions are put taking into account the staging of the tested event, including the confirmed facts or data only and excluding the expert's conjectures or versions. The results are used to state one of the two alternative versions and to estimate the respective status of the person being tested. The psychogenesis is determined and analysed with using a polygraph, while putting the questions of the two alternative versions, indicating and processing the PPT data are conducted with a computer with relevant software.
EFFECT: method provides higher information value, accuracy, reliability, objectiveness of the PPT results as compared to the previously known tests up to 90-95% with avoiding the distortion and ambivalence of the results.
5 cl, 1 dwg
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.
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).
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
SUBSTANCE: clinical medical history data are determined as follows: body weight index (BWI), kg/m2; waist circumference (WC), hip circumference (HC), waist-to-hip ratio, type 2 diabetes mellitus diagnosed in close relatives, arterial hypertension (AH) diagnosed. The laboratory data are measured as follows: plasminogen activator inhibitor-1 (PGAI-1), nmole/l; nitrogen oxide (NO) metabolites, %; resistin, ng/ml; insulin resistance (IR), mIU/ml; triglycerides (TG), mmole/l; high density lipoprotein cholesterol (HDLPC), mmole/l; fibrinogen, mg/dl; impaired fasting glucose (IFG), mmole/l; glycosylated haemoglobin (HbAlc), %; impaired glucose tolerance (IGT), mmole/l; homocystein (HC), mcmole/l; TNF-α, pg/ml; C-reactive protein, mg/l; endothelin and fibrinogen. The derived values are scored. The total score is used to determine a risk of atherosclerosis in the patients suffering from type 2 diabetes mellitus: extremely high, high, moderate and low. Taking into account the detected degree of risk, a dosage of aspirin and statins are determined, as well as a monitored mode of blood lipids, urinary albumin and blood creatinine is specified.
EFFECT: method enables determining a degree of risk of the atherosclerosis progression as shown by the clinical medical history and laboratory data, as well as specifying individual pathogenetic therapy for the patient that leads to reducing developing cardiovascular complications.
4 tbl, 1 ex