Method for efficacy of preparation berodual for rapid relief of episode of bronchial asthma in child

FIELD: medicine.

SUBSTANCE: there are determined: peak expiratory flow rate (PEFR), l/min, and reference peak expiratory flow rate (PEFRR), l/min; child's age (A), completed years, height (H), cm; body weight (W), kg accurate to 0.1 kg; coefficients are established as followed: sexual identity (S) - 1 for males, 0 - for females; severity of the clinical course (S) - 1 mild BA, 2 moderate BA, 3 severe BA; baseline therapy (BT) prescribed - 1 if the child has been receiving the therapy for one pre-examination year, 0 has not; a degree of severity of BA episode (SE) - 1 mild degree of severity of the episode, 2 - moderate degree of severity of the episode, and 3 severe episode. A peak expiratory flow rate coefficient (PEFRC) is calculated as the relation (PEFR/PEFRR)×100%. Cardiointervalography is performed, and a vagosympathetic balance coefficient is calculated (LF/HF). An efficacy coefficient (K) of the preparation Berodual for rapid relief of the bronchial asthma episode is described by formula; if K>12, the rapid relief of the bronchial asthma episode the preparation Berodual is considered to be effective.

EFFECT: method enables providing more reliable assessment of using the preparation Berodual for rapid relief of the bronchial asthma episode in a child that is ensured by collective assessment of clinical and functional signs of the patient's health.

3 ex

 

The invention relates to medicine, namely to Pediatrics, and can be used to evaluate the effectiveness of the drug "Berodual" for the relief of bronchial asthma attacks in children.

Bronchial asthma (BA) is the most common among chronic respiratory diseases in childhood (Nenasheva N. M. Bronchial asthma: Pocket guide for medical practitioners. - M.: Publishing holding "Atmosphere", 2011. - S. 9). Modern diagnostic and treatment approaches in asthma in children is reflected in international conciliation document on this disease - GINA and the National program "Bronchial asthma in children. Strategy of treatment and prevention" (national program "Bronchial asthma in children. Strategy of treatment and prevention". - 4-e Izd., revised and enlarged extra - M.: the Original layout, 2012. - S. 16, 19). According to these documents, cupping BA must inhalational administration of bronchodilator drugs: β2-agonists, anticholinergics and combined bronchodilator (national program "Bronchial asthma in children. Strategy of treatment and prevention". - 4-e Izd., revised and enlarged extra - M.: the Original layout, 2012. - P. 113-115).

According to numerous studies it is a combined broncholytic drug Berodual has better �the efficiency and low incidence of side effects (Geppe N. And. Inhalation therapy of exacerbations of asthma in children / N. And. Geppe N. G. Kolosova // Pulmonology. - 2011. - No. 5. - P. 34-37. Yurenev G. L. Advantages of combined bronchodilator drugs in the treatment of broncho-obstructive syndrome / G. L. Yurenev // Atmosphere. Pulmonology and Allergology. - 2012. - Vol. 3, No. 46. - P. 13-18). But despite that its effectiveness is largely dependent on the individual characteristics of each child.

Therefore, the evaluation of the effectiveness of the drug "Berodual" for the relief of an attack of asthma is an actual problem of modern Pediatrics.

Conducted a search in scientific medical and patent literature found various ways to assess the effectiveness of bronchodilator drugs for edema attack BA.

Thus, according to GINA (global strategy for treatment and prevention of bronchial asthma (revision 2011) / ed. by A. S. Belevsky. - M.: Russian respiratory society, 2012. - P. 81) a criterion for the effectiveness of an inhaled bronchodilator is a complete reversal attack: peak exhalation rate (PSV) is returned to the value exceeding 80% of the needs or the best individual values, and this improvement persists for 3-4 hours, and the need for additional drugs is absent.

Fault�m this method is the lack of confidence in the assessment of the effectiveness of bronchodilators, because it does not take into account the individual characteristics of the child's body.

In the patent of Russian Federation №2365330 (publ. 27.08.2009) "Method of evaluation of bronchodilator therapy in children with bronchial asthma" is described a method of evaluating the effectiveness of bronchodilators for relief of asthma attack children. Evaluating the effectiveness of bronchodilator therapy is carried out by monitoring the child's condition. To do this, on the background of basic therapy of the patient is carried out pharmacological tests with bronchodilators. Enter the data in the diary of symptoms and graphically display data peak flow before and after each pharmacological effects, followed by computer processing of the obtained graphs and represent in a numerical form the space between them to visualize the zone of insufficient asthma control".

The disadvantage of this method is the lack of confidence in the assessment of the effectiveness of bronchodilator drugs because it does not take into account the individual characteristics of the child's body.

The closest technical solution adopted for the prototype, is a method of evaluating the effectiveness of a bronchodilator drug for the relief of asthma attack children, as described in the patent of Russian Federation №2236219 (publ. 20.09.2004) "Method of treatment of bronchial asthma in children in the period of exacerbation W�the disease". The method consists in the fact that perform an examination of the child patient of asthma and assess the magnitude of the peak flow. Next, record the forced expiratory volume in 1 second, then carry out the inhalation of one of the drugs of the group of β2-agonists and re-evaluate the same metrics. In the case of their increase relative to the source by more than 15%, the child is prescribed a treatment with this drug.

The disadvantage of this method is the lack of confidence in the assessment of the effectiveness of bronchodilator drugs because it does not take into account the individual characteristics of the child's body.

The object of this invention is to provide a method of evaluating the effectiveness of the bronchodilator drug Berodual" for the relief of bronchial asthma attacks in children.

The technical result is to increase the reliability of estimation of efficiency of application of a bronchodilator drug Berodual" for the relief of bronchial asthma attacks in children.

The technical result is achieved in that carry out the examination of the child with the attack of bronchial asthma (BA) and measure the value of peak exhalation rate (PSV), l/min. Determine the age of the child (C) - the number of full years of growth (R) in cm, body mass (M) in kg to the nearest 0.1 kg; set kOe�ficiency: gender (Π) - 1 for males, 0 for females; the severity of the disease (RS) - 1 for easy BA, 2 moderate flow BA, 3 severe BA; basic therapy (BT) - 1 child received basic therapy during the year preceding the survey, 0 did not receive; severity of attack BA (TP) - 1 mild attack, 2 moderate degree 3 severe; also determine the proper value of peak exhalation rate (PSVD), l/min, and calculate the ratio of peak expiratory flow rate (CPSU) as the ratio (PSV/PSVD)×100%; perform cardiointervalography, determine the value of the coefficient vagosympathetic balance (LF/HF) and calculate the value of the coefficient of efficiency of a preparation "Berodual" for the relief of bronchial asthma attacks in children (K) by the formula:

K=the sum of 38.08+1,23×In-0,32×P+0,01×M-0,18×R+3,56×BT-0,12×KSV-0,80×TP-0,12×TK-0,52×LF/HF,

and when the value of K>12 mild attack BA drug Berodual" assessed as effective.

Drug Berodual", registration number Π №015914/01 from 15.03.2010, pharmaceutical group is a combined broncholytic drug. Contains two components having bronchodilator activity: ipratropium bromide and fenoterol hydrobromide. In a joint application in the composition of the combination drug of two active bronchodilating substances effect the achievement�recover it by exposure to various pharmacological target. These substances complement each other, resulting in enhanced antispasmodic effect on the muscles of the bronchi and provides a large breadth of therapeutic action in bronchopulmonary diseases, accompanied by constructia respiratory tract. Indicated for use in acute asthma attacks.

Detailed description of the method

Perform examination of a child with severe asthma (BA).

Measure the value of peak exhalation rate (PSV), l/min For this method peak flow (national program "Bronchial asthma in children. Strategy of treatment and prevention", M., 2012. - p. 68) using, for example, MicroPeak peak flow meter manufacturing company MICRO MEDICAL LTD (England) determine the values of peak exhalation rate (PSV), l/min

According to a survey of parents to determine the time of the study child's age (In) - the number of full years.

With the help of stadiometer, such as medical metal stadiometer type MSC-233, measure height of child (P) to see

With the help of health scales, such as electronic scales, "Health" EF-932, accurate to 0.1 kg measured body weight of the child (M) in kg.

Determine the coefficient of gender (P), and for males the value of Π is taken to equal 1, for females - 0.

On the basis of medical history determine the degree thee�esti course of the disease (national program "Bronchial asthma in children. Strategy of treatment and prevention". - 4-e Izd., revised and enlarged extra - M.: the Original layout, 2012. - Pp. 84-85). Then determine the coefficient of severity of the disease (TK), thus, if a child has been easy for BA, the value of TK is assigned a numeric value equal to 1, in the case of moderate severity BA - 2, in severe BA - 3.

Also determine the ratio of basic therapy (BT). The value of BT is assigned a numeric value of 1 if the child received basic therapy during the year preceding the survey, and a numeric value of 0 if basic therapy was absent during the year preceding the survey.

Assess the severity of the attack (the national program "Bronchial asthma in children. Strategy of treatment and prevention". - 4-e Izd., Rev. and supplementary M: the Original layout, 2012. - Pp. 84-85). Determine the coefficient of severity of attack (TA), the value of which in the case of mild attack assign a value of 1 in the case of moderate degree - 2 in the case of severe - 3.

Determine the proper value of peak expiratory flow rate in children (PSVD), l/min, (table 5.2. "Due to the value of PEF (l/min)" (national program "Bronchial asthma in children. Strategy of treatment and prevention", M., 2012. - Pp. 68-69)). Calculate the ratio of peak expiratory flow rate (CPSV), % as�wearing (PSV/PSV D)×100%.

Child perform cardiointervalography, for example, with the help of kardioanalizator "ANKAR-131" production company "Medicom MTD", Taganrog (Russia), and determine the value of the coefficient vagosympathetic balance (LF/HF).

Then compute the value of the coefficient of efficiency of the drug Berodual" for the relief of bronchial asthma attacks in children (K) by the formula:

K=THE SUM OF 38.08+1,23×IN-0,32×Π+0,01×M-0,18×Ρ+3,56×BT-0,12×KSV-0,80×TP-0,12×TK-0,52×LF/HF.

If the condition K>12 mild attack BA drug Berodual" assessed as effective.

The feasibility of the proposed method is illustrated by examples from clinical practice.

Example 1: patient Α., 12 years, the case history No. 2157/157 was transported by ambulance to children's hospital №2 of Rostov-on-don with an attack of ASTHMA. Preliminary diagnosis: bronchial asthma, atopic form, moderate flow, the period of exacerbation. An objective examination of the child: a serious condition. Pronounced expiratory dyspnea, respiratory rate 40 breaths per minute, the participation of auxiliary muscles pronounced, marked wheezing, the child is frightened, takes a forced position of the body, speech is difficult. Percussion over the lungs is determined by the box sound, ausco�tative - on the weakening of breath, scattered dry wheezing on exhalation from both sides. Heart sounds loud, the rhythm speeded up.

The decision was made for the relief of the asthma attack patient to use a bronchodilator medication Berodual".

To assess the efficacy of the drug Berodual" for the relief of asthma attack in a child A., a study was conducted according to the claimed method.

Measured the value of peak exhalation rate (PSV), l/min For this method peak flow (national program "Bronchial asthma in children. Strategy of treatment and prevention". M., 2012. - P. 68) using the MicroPeak peak flow meter manufacturing company MICRO MEDICAL LTD (England) has identified the value of peak exhalation rate (PSV), l/min PSV=205 l/min

According to the survey, parents identified at the time of the study, the age of the child (C), the number of full years. In=12 years.

With the help of stadiometer, medical metal stadiometer type MSC-233, measured the child's growth (R) in cm Ρ=165 cm

Using electronic scales medical Health EF-932, accurate to 0.1 kg, measured the body weight of the child (Μ). Μ=45,1 kg.

Determined the sex ratio (P). As patient A. - male, Π=1.

Estimation of the degree of severity of the disease (national program "Bronchial asthma in children. Page�the course of treatment and prevention". - 4-e Izd., revised and enlarged extra - M.: the Original layout, 2012. - Pp. 84-85). Since our patient has moderate flow BA, TK=2.

Also determined the ratio of basic therapy (BT). Since kid A. not received basic therapy, BT=0.

Estimated coefficient of the severity of the attack (TA) (national program "Bronchial asthma in children. Strategy of treatment and prevention". - 4-e Izd., revised and enlarged extra - M.: the Original layout, 2012. - Pp. 84-85). Because A. patient was identified severe attack of BA, the value of TP was assigned a value of 3: TP=3.

Based on these data: age, height and sex of the child determined the proper value of peak exhalation rate (PSVD), l/min (table 5.2. "Due to the value of PEF (l/min)" (national program "Bronchial asthma in children. Strategy of treatment and prevention". M., 2012. - Pp. 68-69)). PSVD=368 l/min

Then calculated the ratio of peak expiratory flow rate (CPSV), %: KSV=(PSV/PSVD)×100%=(205/368)×100%=55,7%.

The child complied with the cardiointervalography using kardioanalizator "ANKAR-131" and determined the value of the coefficient vagosympathetic balance (LF/HF): LF/HF=2,3.

Next, the calculated value of the coefficient of efficiency of a preparation "Berodual" for the relief of bronchial asthma attacks in children (K) by the formula:

K=THE SUM OF 38.08+1,23×IN-0,32×P+0,01×M-0,18×R+3,56×BT-0,12×KPS�-0,80×TP-0,12×TK-0,52×LF/HF=38,08+1,23×12-0,32×1+0,01×45-0,18×165+3,56×0-0,12×55,7-0,80×3-0,12×2-0,52×2,3=38,08+14,76-0,32+0,45-29,7+0-6,68-2,4-0,24-1,20=12,75.

Since it was made a condition K=12,75>12, mild attack BA drug Berodual" was assessed as effective.

The child was made inhalation therapy with the drug "Berodual", and attack BA was docked. In applying the drug Berodual" side effects were noted.

Example 2: sick girl I., 10 years old, the case history No. 2549/746, was admitted to children's city hospital №2 of Rostov-on-don with an attack of ASTHMA. Preliminary diagnosis: bronchial asthma, atopic form, mild. At admission, there were complaints of shortness of breath, cough, shortness of breath. First of obstructive syndrome developed at the age of 3 years due to acute respiratory disease. In the next 1 year the child endured obstructive bronchitis, not accompanied by fever. An objective examination of the child condition was considered as moderate. Shortness of breath: 26 breaths per minute, with feebly marked the participation of auxiliary muscles, wheezing noted at the end of exhalation, physical activity and conversation saved. Percussion over the lungs is determined by the sound from the box shade, auscultation - the background hard breathing scattered dry wheezing on exhalation. The distinct heart sounds, rhythm teaching�Yong.

The decision was made for the relief of an attack of asthma of the patient to use a bronchodilator medication Berodual".

To assess the efficacy of the drug Berodual" for the relief of asthma attack in a child I. the study was conducted according to the claimed method.

Measured the value of peak exhalation rate (PSV), l/min For this method peak flow (national program "Bronchial asthma in children. Strategy of treatment and prevention". M., 2012. - P. 68) using the MicroPeak peak flow meter manufacturing company MICRO MEDICAL LTD (England) has identified the value of peak exhalation rate (PSV), l/min PSV=135 l/min

According to the survey, parents identified at the time of the study, the age of the child (C), the number of full years. In=10 years.

With the help of stadiometer, medical metal stadiometer type MSC-233, measured the growth of the baby (P), see Ρ=125 cm

Using electronic scales medical Health EF-932, accurate to 0.1 kg, measured the body weight of the child (Μ). Μ=35,2 kg.

Determined the sex ratio (P). As patient I. - female, Π=0.

Estimation of the degree of severity of the disease (national program "Bronchial asthma in children. Strategy of treatment and prevention". - 4-e Izd., revised and enlarged extra - M.: the Original layout, 2012. - P. 84-85). Since our patient is �egcoa for BA, TK=1.

Also determined the ratio of basic therapy (BT). As the child I. received basic therapy, BT=1.

Estimated coefficient of the severity of the attack (TA) (national program "Bronchial asthma in children. Strategy of treatment and prevention". - 4-e Izd., revised and enlarged extra - M.: the Original layout, 2012. - Pp. 84-85). Because the patient I. was defined mild degree of severity of an attack BA, the value of TP was assigned a value of 1: TP=1.

Based on these data: age, height and sex of the child determined the proper value of peak exhalation rate (PSVD), l/min (table 5.2. "Due to the value of PEF (l/min)" (national program "Bronchial asthma in children. Strategy of treatment and prevention". M., 2012. - Pp. 68-69)). PSVD=156 l/min

Then calculated the ratio of peak expiratory flow rate (CPSV), %: KSV=(PSV/PSVD)×100%=(125/156)×100%=80,1%.

The child complied with the cardiointervalography using kardioanalizator "ANKAR-131" and determined the value of the coefficient vagosympathetic balance (LF/HF): LF/HF=0,4.

Next, the calculated value of the coefficient of efficiency of a preparation "Berodual", for the relief of bronchial asthma attacks in children (K) by the formula:

K=THE SUM OF 38.08+1,23×IN-0,32×Π+0,01×M-0,18×R+3,56×BT-0,12×KSV-0,80×TP-0,12×TK-0,52×LF/HF=38,08+1,23×10-0,32×0+0,01×35,2-0,18×125+3,56×1-0,12×80,1-0,80×1-0,12×1-0,52×0,4=38,08+12,30-0+0,35-22,50+3,56-9,61-0,80-0,12-0,21=21,05.

Oskolkova the condition K=21,05> 12, mild attack BA drug Berodual" evaluated as effective.

Child e was conducted inhalation therapy with the drug "Berodual", and attack BA was docked. In applying the drug Berodual" side effects were noted.

Example 3: V. baby girl, 9 years old, medical history, No. 1536/345 was transported by ambulance to children's hospital №2 of Rostov-on-don with an attack of ASTHMA. Preliminary diagnosis: bronchial asthma, atopic form, severe course. At admission, there were complaints of shortness of breath, cough, shortness of breath. First, the diagnosis of BA was set at the age of 2 years. An objective examination of the child condition was considered as moderate. Shortness of breath: 24 breaths per minute, with feebly marked the participation of auxiliary muscles, wheezing noted at the end of exhalation, physical activity and conversation saved. Percussion over the lungs is determined by the sound from the box shade, auscultation - the background hard breathing scattered dry wheezing on exhalation. The distinct heart sounds, rhythm speeded up.

The decision was made for the relief of an attack of asthma of the patient to use a bronchodilator medication Berodual".

For the purpose of evaluating the effectiveness of the p�of Ephrata "Berodual" for the relief of asthma attack in child V. a study was conducted according to the claimed method.

Measured the value of peak exhalation rate (PSV), l/min For this method peak flow (national program "Bronchial asthma in children. Strategy of treatment and prevention". M., 2012. - P. 68) using the MicroPeak peak flow meter manufacturing company MICRO MEDICAL LTD (England) has identified the value of peak exhalation rate (PSV), l/min PSV=212 l/min

According to the survey, parents identified at the time of the study, the age of the child (C), the number of full years. In=9 years.

With the help of stadiometer, medical metal stadiometer type MSC-233, measured the growth of the baby (P), see Ρ=140 cm

Using electronic scales medical Health EF-932, accurate to 0.1 kg, measured the body weight of the child (Μ). Μ=32,5 kg.

Determined the sex ratio (P). As patient B. - female, Π=0.

Estimation of the degree of severity of the disease (national program "Bronchial asthma in children. Strategy of treatment and prevention". - 4-e Izd., revised and enlarged extra - M.: the Original layout, 2012. - Pp. 84-85). Because our patient has severe BA, TK=3.

Also determined the ratio of basic therapy (BT). As the child V. received basic therapy, BT=1.

Estimated coefficient of the severity of the attack (TA) (national program "Bronchial asthma in children. Stra�area adjacent to the treatment and prevention". - 4-e Izd., revised and enlarged extra - M.: the Original layout, 2012. - Pp. 84-85). As was defined mild degree of severity of an attack BA, the value of TP was assigned a value of 1: TP=1.

Based on these data: age, height and sex of the child determined the proper value of peak exhalation rate (PSVD), l/min (table 5.2. "Due to the value of PEF (l/min)" (national program "Bronchial asthma in children. Strategy of treatment and prevention". M., 2012. - Pp. 68-69). PSVD=236 l/min

Then calculated the ratio of peak expiratory flow rate (CPSV), %: KSV=(PSV/PSVD)×100%=(212/236)×100%=89,8%.

The child complied with the cardiointervalography using kardioanalizator "ANKAR-131" and determined the value of the coefficient vagosympathetic balance (LF/HF): LF/HF=3,5.

Next, the calculated value of the coefficient of efficiency of a preparation "Berodual" for the relief of bronchial asthma attacks in children (K) by the formula:

K=THE SUM OF 38.08+1,23×IN-0,32×Π+0,01×M-0,18×R+3,56×BT-0,12×KSV-0,80×TP-0,12×TK-0,52×LF/HF=38,08+1,23×9-0,32×0+0,01×32,50-0,18×140+3,56×1-0,12×89,8-0,80×1-0,12×3-0,52×3,5=38,08+11,07-0+0,33-25,20+3,56-10,78-0,80-0,36-1,82=14,08.

Since it was made a condition K=14,08>12, mild attack BA drug Berodual" was assessed as effective.

Child V. was held inhalation therapy with the drug "Berodual", and attack BA was docked. In applying the drug Berodual" PSP�to link phenomena were noted.

Using the proposed method in Children's city hospital №2 of Rostov-on-don was carried out to assess the efficacy of the drug Berodual" cupping BA 62 children aged 6 to 15 years, among them girls was 14 (22,6%), boys 48 (77,4%). Easy for BA occurred in 46 patients (74.2 per cent), moderate in 12 (19.4 per cent), heavy 4 patients (6.4 percent). Among the surveyed children mild attack of BA was observed in 24 patients (38,7%), moderate - in 28 (45.2 per cent), severe attack BA - in 10 patients (16.1 per cent). The vast majority of the surveyed patients (75,35%) received basic therapy. I 52,11% of the examined children showed burdened allergological anamnesis.

Defined in the study according to the claimed method the value of the coefficient of efficiency of the drug Berodual" for the relief of bronchial asthma attacks in children (To) all 62 patients exceeded the numeric value of 12. Therefore mild attack BA for all 62 patients drug Berodual" was seen as effective.

Conducted inhalation drug Berodual provided mild attack all 62 patients, thus confirming the high accuracy of the proposed method.

A method of evaluating the effectiveness of drug Berodual" for the relief of an attack of bronchial asthma (BA)the child, including its examination and determination of the peak exhalation rate (PSV), l/min, characterized in that it further determine the age of the child (C) - the number of full years of growth (R) in cm, body mass (M) in kg to the nearest 0.1 kg; set ratios: sex (Π) - 1 for males, 0 for females; the severity of the disease (RS) - 1 for easy BA, 2 moderate flow BA, 3 severe BA; basic therapy (BT) - 1 child received basic therapy during the year preceding the survey, 0 did not receive; severity of attack BA (TP) - 1 mild attack, 2 moderate degree 3 severe; also determine the proper value of peak exhalation rate (PSVD), l/min, and calculate the ratio of peak expiratory flow rate (CPSU) as the ratio (PSV/PSVD)×100%; perform cardiointervalography, determine the value of the coefficient vagosympathetic balance (LF/HF) and calculate the value of the coefficient of efficiency of a preparation "Berodual" for the relief of bronchial asthma attacks in children (K) by the formula:
K=the sum of 38.08+1,23×In-0,32×P+0,01×M-0,18×R+3,56×BT-0,12×KSV-0,80×TP-0,12×TK-0,52×LF/HF,
and when the value of K>12 mild attack BA drug Berodual" assessed as effective.



 

Same patents:

FIELD: medicine.

SUBSTANCE: 1-second forced expiratory volume is determined by spirography for the purpose of a surgical intervention in the patients suffering from pancreatic diseases complicated with tracheal compression. If the measured volume is from 35% to 54%, an urgent surgery is performed. If the 1-second forced expiratory volume is less than 35%, an emergent surgery is performed.

EFFECT: method enables determining the surgery date with the greatest accuracy in the patients requiring the emergent surgery that in its turn provides the more adequate pre-operative preparation and the improved outcome of surgical management.

1 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: method enables a cycloergometric pre-measurement of exercise tolerance according to PWC170 test, a minute pulmonary ventilation (MPV) by means of pneumotachography, and arterial oxygenation by means of an ear sensor of an oxyhemograph. If observing a decrease of exercise tolerance at power less than 1 W/kg for 2 minutes, an increase of MPV more than 350% of initial values, with an increase of arterial saturation more than 98%, a treatment starts with a manual therapy covering spinal motion segments in the number of 3 procedures every two days. That is followed by a balneotherapy in the form of thermal low-radon siliceous baths at temperature 38°C, for 10 minutes in the number of 6 procedures within the therapeutic course.

EFFECT: method reduces probability of chronic processes in bronchi, reduces rate of recurrent bronchitis ensured by normalising the external respiration function by eliminating the functional blocks in the spinal motor segments.

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to pulmonology and allergology, and can be used for treating bronchial asthma (BA) in children and adolescents. That is ensured by determining clinical, functional, cytological, biochemical, immunological allergic inflammation activity markers (AIAMs). These markers are evaluated according to the developed scales. The total score is calculated according to each scale separately. Allergic inflammation activity indices (AIAIs) are calculated by the certain formulas taking into account the calculated total scores according to each scale. An integrative AIAI is calculated. An allergic inflammation activity degree (AIAD) is determined depending on the integrative AIAI. If the AIAD is 0, therapy required for the stage I basic anti-inflammatory therapy of BA is conducted. The 1st AIAD requires therapy corresponding to the stage II basic therapy. The 2nd AIAD requires therapy corresponding to the 3rd stage therapy; the 3rd AIAD provides therapy corresponding to the 4th stage basic anti-inflammatory therapy of BA.

EFFECT: method provides a differentiated approach to selecting a volume of basic therapy of the given disease by accurate diagnosing of a degree of activity of the allergic inflammatory process in the airway walls that in its turn provides reducing a rate of attacks and length of aggravations in prolonging BA remission.

2 ex, 10 tbl

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to pulmonology, and can be applied for predicting risk of formation of cold airway hyperreactivity (CAH) in patients with bronchial asthma. For this purpose DNA is genotyped by polymorphic locus Argl6Gly of gene ADRB2 (rs 1042713) by means of method of polymerase chain reaction. After that, volume of forced exhalation for the first second (VFE1) before and 15 minutes after inhalation of two doses of fenoterol hydrobromide is determined. The results of the test are used to determine change of volume of forced exhalation for the first second in % of the proper value. In addition, fact of intake of inhalation glucocortocoids for the previous 12 weeks is made more exact. Importance of each parameter is expressed in points. After that, risk (F) and probability (P) of CAH formation are calculated by certain mathematical formulas. After that, obtained probability is compared with boundary value. If P value is higher than 0.3, increased risk of CAH formation is predicted.

EFFECT: method ensures accuracy of prediction of CAH formation in patient with BA and makes it possible to start pathogenically conditioned therapy in due time in case of necessity.

2 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine and medical equipment. Bipolar method of poly-frequency impedancemetry . Module value of impedance (Z) and phase angle (φ) at frequencies 20, 98, 1000, 5000, 10000, and 20000 Hz of alternating electric current of low power during inhalation of 0.9% of sodium chloride solution. In the process of measurement the first electrode is installed into mouthpiece of ultrasound nebuliser, the second is placed on chest skin or in the region of examination, or joining electrodes, installed on symmetrical sections of chest. If deviations of Z and/or φ values are less than 5 or more than 95 percentiles from the normal values, impairment of respiratory function is diagnosed. To carry out diagnostics computer appliance, which contains measurement unit, mouthpiece, nebuliser inhalator, as well as electrodes, one of which is installed on patient's chest, the other is installed in mouthpiece of ultrasound nebuliser inhalator.

EFFECT: invention makes it possible to increase reliability of respiratory function diagnostics.

2 cl, 2 dwg, 18 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to pulmonology and can be used for predicting course of moderate to severe chronic obstructive lung disease (COLD). Volume of forced exhalation for the first second (VFE1) is measured. Bronchi-provoking pharmacological test with 0.33% methacholine solution is performed. Change of volume of forced exhalation for the first second (ΔVFE1) from the initial value is registered. On the basis of said parameters determined are: post-bronchodilation residual volume of lungs and degree of hypersensitivity of respiratory ways, which are considered to be a risk factor. Other risk factors: patient's age, disease duration, number of exacerbations pre year, are also taken into account. Each risk factor is given a numerical value and gradation, which are used to determine prognostic coefficients F1 and F2 with further comparison of these values. If F2 is larger than F1, unfavourable course of COLD with progressing dyspnea is predicted. If F1 value is larger than F2, favourable clinical course of disease with low risk of severe dyspnea development is predicted.

EFFECT: method makes it possible to predict clinical course of said disease and activate pathogenetically justified therapy in due time.

2 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to pulmonology, therapy and allergology and can be used for predicting risk of development of uncontrolled course of severe bronchial asthma (BA). For this purpose, parameters of respiratory function: PEF, FVCL, MVR25, MVR50, MVR75, FEV1 and FEV1 after the test with salbutamol are determined and ΔFEV1 is calculated. Value of ACT-test and indices of gas concentration in exhaled air CO, NO, NO2 are also taken into account. After that, indices of probability of referring patient to group with high (R1) and low risk (R2) of development of uncontrolled course of severe BA are calculated by certain mathematical formulas. If R1 > R2, high risk of development is predicted, if R1 < R2, low risk of development of uncontrolled course of said disease is predicted.

EFFECT: method makes it possible to predict probability of development of uncontrolled BA course in response to basic therapy and in this way provides possibility to elaborate optimal plan for management of each patient.

2 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to anesthesiology and resuscitation. Height (H) and weight (W) of patient's body are determined, area of body surface is calculated by formula S=0.0235·H0.42246·W0.51456. 2 hours before pre-medication duration of threshold apnea is determined. If apnea value is lower than 30 seconds, correspondence of correction coefficient 0.7 l per min per m2 of body surface area is determined. If value of arbitrary threshold apnea is 31-60 seconds, correction coefficient is determined - minus 0.3 l per min per m2 of body surface area. If value of arbitrary threshold apnea is more than 60 seconds, correction coefficient is determined - minus 0.55 l per min per m2 of body surface area. After that required minute volume of ventilation (MVV) is determined by formula: MVV= (m/10+1)+k×S, where m is patient's weight in kg, S is area of body surface in m2, k is correction coefficient.

EFFECT: method makes it possible to reduce quantity of complications associated with gas exchange irregularities.

3 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: by method of spirometry value of volume of forced exhale during first second (VFE1) in % to proper volume and forced vital lung capacity (FVLC) in % to proper capacity are determined, index of smoking person (IS) is calculated and discriminant equation: D=0.179×VFE1+0.085×FVLC-0.319×IS is solved. If D is more than 8.49 bronchopulmonary dysplasias in patients with chronic obstructive lung disease are diagnosed.

EFFECT: method provides screening and possibility of broncopulmonary dysplasia diagnostics in patients with chronic obstructive lung disease in general clinical practice.

2 ex

FIELD: medicine.

SUBSTANCE: indices of densitometry (D) in % and planimetry (P) in % are measured in both lungs, value of forced exhale during first second (VFE1) is determined in % to proper volume, discriminant equation D=0.041×VFE1+0.182×D+0.126×P is solved. If D is less than 9.43 progression of respiratory tract obstruction is predicted.

EFFECT: method allows to increase accuracy of prognosis connected with combination of chronic obstructive lung disease with bronchopulmonary dysplasias.

2 ex

FIELD: medicine.

SUBSTANCE: patient's monitor comprising: EEG recorder (14, 20) controlling patient's (10) electrocardiographic signal (40); a secondary physiological signal monitor (16, 20) controlling a second patient's physiological signal (50) simultaneously with the EEG recorder controlling patient's electrocardiographic signal; an a alarm detector (42, 44) configured to detect the alarm on the basis of the patient's electrocardiographic signal; alarm verification device (52, 54, 56) configured to verify the alarm on the basis of pulse component regular pattern of the simultaneously controlled second patient's physiological signal; and an alarm indicator (24, 26, 58) configured to generate the perceived alarm by the alarm detector and to verify the alarm by the alarm verification device.

EFFECT: alarm verification.

12 cl, 5 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medicine, and can be used in cardiology, endocrinology, functional diagnostics and can find application in diagnostics and selecting a therapeutic approach to ischemic heart disease. The following risk factors are detected in the patients suffering from diabetes mellitus accompanied by cardiovascular disorders: blood plasma glucose, glycated haemoglobin (HbAlc), total blood plasma cholesterol, blood plasma low density lipoprotein cholesterol, blood pressure, load St segment depression, signs of carotid wall thickening, an ankle-brachial index and brachial endothelium-dependent vasodilatation as shown by the Doppler ultrasound, duration of diabetes mellitus; the derived values are scored. The derived scored values are summed up, and a risk of coronary artery atherosclerosis is stated to be low, moderate, high or very high.

EFFECT: method enables determining the risk of coronary artery atherosclerosis in the patients suffering from diabetes mellitus accompanied by cardiovascular disorders by assessing the clinical laboratory values and conducting instrumental tests, including electrocardiography, Doppler ultrasound and coronary angiography.

1 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: mother's and foetus's heart rate variability is measured. A coefficient of variation the foetus's full array of RR intervals in the original state CV F I, a resistance index of the umbilical artery RI, a coefficient of variation of the mother's full array of RR intervals in the original state CV M, mother's RRmin in the period of recovery of a mental test RRmin M III are determined. ∑1, ∑2, ∑3 are calculated by formulas: ∑1=2 (original foetus's CV less than 5.4)+3 (RI less than 0.58)+3 (original mother's CV less than 7.8)+2 (original mother's RRmin less than 531); ∑2=2 (CV F I less than 5.4)+3 (RI more than 0.58)+2 (CV M I less than 0.78)+4 (RRmin M I less than 531); ∑3=3 (CV F I less than 5.4)+3 (CV M I less than 7.8)+3 (RI more than 0.58). The values ∑1 falling within the range of 0 to 2 show a low risk; within the range of 3 to 5 points - a moderate risk; from 6 to 10 points - a high risk; the values ∑2 from 0 to 2 show a low risk, from 3 to 5 points - a moderate risk, from 6 to 11 points - a high risk; the values ∑3 from 0 to 3 testifies to a low risk, from 4 to 9 points - to a high risk of unfavourable perinatal outcomes. The risks derived from the three values: ∑1, ∑2, ∑3 are used to evaluate a risk level of the unfavourable perinatal outcomes in intrauterine infection.

EFFECT: higher prediction accuracy.

3 ex, 6 tbl, 3 dwg

FIELD: medicine.

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

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

11 tbl, 5 ex

FIELD: medicine.

SUBSTANCE: cardiorhythmography is recorded during an active orthostatic test, and a heart rate variability (HRV) is analysed. During the active orthostatic test, the patient is placed in an initial horizontal position, then transferred into the vertical position, and then into the horizontal position again. If the amplitude of HF waves initially increases more than LF waves in the horizontal position by more than 30%, a prevailing parasympathetic effect is diagnosed. If the amplitude of HF and LF waves decreases after the patient is transferred into the vertical position by more than 30% of the values in the initial horizontal position, vegetative insufficiency is diagnosed. If the amplitude of HF waves decreases after the patient is transferred into the vertical position by more than 80% of the initial value in the horizontal position, a fast adjustment of the parasympathetic department to the changes is diagnosed. If the amplitude of VLF waves increases after the patient is transferred into the vertical position by more than 30% of the initial value in the horizontal position, activation of the supra-segmentary vegetative nervous system is diagnosed.

EFFECT: method provides more reliable diagnosing that is ensured by determining the mechanism of orthostatic test adaptation.

2 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: intraoesophageal pH monitoring and Holter monitoring are recorded daily. The heart rate variability is estimated in the aggregate with an analysis of a nocturnal heart rate trend. If finding more than 5 episodes of high heart rate dispersion coinciding with reflux episodes, or if a nocturnal structure comprises more than 50% of the episodes, the disturbed vegetative regulation of heart rhythm related to gastrooesophageal reflux disease is diagnosed.

EFFECT: technique enables diagnosing the extra-oesophageal manifestations of gastrooesophageal reflux disease at the early stage of the disease after the subjective manifestations have been observed.

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment. An ECG monitoring system for detecting infarct-related coronary artery associated with acute myocardial infarction comprises the number of electrodes for data collection by electrical cardiac activity from various observing points spaced from the heart. An ECG data collection unit is related to the electrodes. An ECG processor responses to electrode signals to form a set of lead signals and detects ST rises in the lead signals. The display responses to the detected ST rises and graphically displays each set of the given ST rise in relation to the anatomical positions of the leads. The graphical display identifies the suspected infarct-related coronary artery or branch associated with acute ischemic stroke. The ECG signals is n-leads are received. The ECG signals are analysed for the consistency with the ST rise data. The each set of ST rises is graphically displayed in relation to the anatomical body positions. The stages of receiving and analysing are repeated some time later. The each set of ST rises derived some time later are graphically displayed and compared to the previous displayed ST rises. A comparative graphic display is used to display the time variation of a coronary disease symptom associated with the specifically identified coronary artery or branch.

EFFECT: using the invention enables reducing the length of diagnosing.

15 cl, 18 dwg

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to cardiology. ECG examination is performed to patient. Registration of signal-averaged ECG and transesophageal electrocardiostimulation (TE ECS) are carried out. Duration of filtered wave "P" (FiP-P) of signal-averaged ECG, dispersion of wave "P" (Pd), frequency threshold of arrhythmia induction (FTAI) and its duration are determined by means of TE ECS, risk of atrium fibrillation development (RAFD) being determined by original mathematical formula. If RAFD values are to 0.5, high during 1-3 months risk of AF development is identified. If values are from 0.5 to 1.5 - average from 3 months to 1 year risk of AF development. If values are higher than 1.5 - low, more than 1 year risk of AF development is identified after the first examination of patient.

EFFECT: method increases accuracy of determining risk of AF development after the first examination due to analysis of interaction of ECG and TEECS indices.

5 tbl, 4 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, specifically surgery and functional diagnostics. The supine heart rate is recorded and represents a baseline test, while the standing heart rate measured is an orthostatic test for 30 sec. The regulatory system activity index (RSAI) is described in points 1 to 10. An increase of this value relates to the deteriorating body adaptive possibilities; the RSAI value of 3-10 points enables predicting the postoperative wound complications.

EFFECT: method enables predicting the postoperative complications following the replacing hernia repair for postoperative hernias.

4 dwg, 3 tbl

FIELD: medicine.

SUBSTANCE: invention relates to medicine, particularly endocrinology and diabetology. There are involved examining heart rate variability (HRV) followed by spectroscopic analysis and functional testing. Those are added with determining non-linear values: deterrent fluctuation analysis (DFA) and approximated entropy (ApEn). If observing the initial amplitude decay of the HRV spectral components - VLF less than 30 points, LF less than 15 points, HF less than 15 points, DFA more than 0.7, ApEn less than 180, lack of functional response - autonomic cardiac sympathovagal neuropathy is diagnosed. If observing the normal amplitude of the HRV spectral component -VLF more than 30 points, low LF values less than 15 points, HF less than 15 points, DFA more than 0.7, ApEn less than 180, lack of functional response LF, HF - autonomic cardiac vagal neuropathy is diagnosed. If observing the initially normal amplitudes of the HRV spectral component -VLF more than 30 points, LF more than 15 points, HF more than 15 points, DFA more than 0.7, ApEn more than 180, lack of functional response LF, HF - autonomic cardiac subclinical neuropathy is diagnosed.

EFFECT: method enables early diagnosing and typing of autonomic cardiac neuropathy for the purpose of specifying a therapeutic approach.

3 tbl, 3 ex

FIELD: medicine, cardiology.

SUBSTANCE: one should register rhythmocardiogram, measure current total power in low-frequency and high-frequency areas of dynamic row of cardiointervals. Evaluation of psychophysiological state should be performed by the value of stress index S calculated due to original mathematical formula by taking into account the power of low-frequency and high-frequency constituents of the range of dynamic row of cardiointervals. In case of standard conditions of measurement - the rest lying at one's back position the value of S stress index should be considered to be equal to 1. The method enables to rapidly and noninvasively detect and range human psychophysiological state.

EFFECT: higher accuracy of evaluation.

2 dwg, 1 ex, 2 tbl

Up!