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Application of computer technologies in differential diagnosis of chronic peripheral arterial occlusive disease of the lower limbs
Conclusion: the analysis of the use of different methods of treatment of patients with cervical cancer at a young age showed that the use of himioterapiya radiation lecheniya combined with radiomodification provides a real opportunity to increase the effectiveness of treatment, reduce relapse rates and metastases. Study of remote results of combination treatment with CRT showed that
the performance of 3-year survival when using radiation therapy in combination with CRT on average 10-24%higher than in the other groups. Maintaining the high quality of life allows us to consider the study in determining a promising direction in Oncology, and also enables a more personalized approach to each case depending on the size, shape of tumor growth and age aspects.
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DOI: http://dx.doi.org/10.20534/ESR-16-9.10-123-124
Rasulov Ulugbek Abdugafurovich, Central Military Hospital of the Ministry of Defense of the Republic of Uzbekistan, Head surgeon Ministry of Defense of the Republic of Uzbekistan.
E-mail: uli4-67@mail.ru
Application of computer technologies in differential diagnosis of chronic peripheral arterial occlusive disease of the lower limbs
Abstract: Is a block diagram of the diagnosis of chronic peripheral arterial occlusive disease of the lower limbs, which was developed on the basis of a computer program that allows you to make a differential diagnosis of these diseases and establish the correct diagnosis quickly and accurately.
Keywords: atherosclerosis, diagnostic algorithm, computer program.
The relevance of research. The prevalence of chronic peripheral arterial occlusive disease of the lower limbs is from 0.6 to 7.5% of the population [1; 3]. According to the report by WHO experts, chronic obliterating diseases of lower extremities arteries, is caused by intermittent claudication, affects about 5% of the elderly [7; 9]. Their structure is dominated obliterating atherosclerosis, followed by nonspecific aortoartheriit, diabetic angiopathy, thromboangiitis obliterans, Raynaud's disease and other rare diseases of the arteries.
Among the diseases oflower extremities arteries leading position firmly holds atherosclerosis, the frequency of lesions, according to different authors, 80-90% [2; 4]. The share of thromboangiitis obliterans, according to data of the same authors, there are only 1.4%. European statistics also notes a very low numbers of thromboangiitis obliterans (0.5-2%) among chronic peripheral arterial occlusive disease of the lower limbs [6; 8] Despite this, we should pay serious attention to the patients who suffering from thromboangiitis obliterans, since this disease, in contrast to atherosclerosis, mainly hurts younger males, and in this age group leading over atherosclerosis [5; 6; 8]. At the same time in recent years, cases ofatherosclerotis lesions oflower limb arteries increased at young adults [1; 4]. It is true that thromboangiitis obliterans hurts mainly vessels of small and medium diameter, and atherosclerosis are the largest and medium-sized, and therefore the greatest difficulties in the differential diagnosis arise in lesions of
the femoropopliteal segment, which occurs in 70% of patients with atherosclerosis obliterans and 20% suffering from thromboangiitis obliterans [7]. Despite the fact that the differential diagnosis of chronic peripheral arterial occlusive disease of the lower limbs problem the subject of many studies, the percentage of diagnostic errors according to different authors is 20-30% [2; 5], which leads to the wrong tactics oftreatment ofpatients. In the differential diagnosis ofchronic peripheral arterial occlusive disease of the lower limbs in addition to the clinical diagnosis are widely used instrumental and laboratory research methods, but they do not have sufficient specificity and does not clarify the clinical picture. For the correct diagnosis is necessary to make a differential diagnosis between these diseases, it is important to determine the treatment strategy.
The purpose of research. Improving the diagnosis of chronic peripheral arterial occlusive disease of the lower limbs on the basis of the algorithm and computer program.
Materials and methods of research. The Department of Thoracic and Cardiovascular Surgery of the Central Military Clinical Hospital Ministry of Defence of the Republic of Uzbekistan on the basis of our innovative research methods for the analysis of patients with chronic peripheral arterial occlusive disease of the lower limbs. 96 patients were subjected to the analysis, 83 (86%) were male, 13 (14%) — women. Of these atherosclerosis in 79 (82.3%), thrombo-
Sectiom 6. Medical science
angiitis obliterans 5 (5.2%), nonspecific aortoarteriitis in 3 (3.2%), diabetic angiopathy in 9 (9.3%) patients. The average age of the surveyed — 52 years. There were used a complex clinical, laboratory, instrumental, statistical research methods and beam diagnostics. In compiling the computer program in accordance with the algorithm for improving the diagnosis of patients with chronic peripheral arterial occlusive disease of the lower limbs used modern programming language — BorlandDelphi 7.
Results and discussion. For diagnosis chronic peripheral arterial occlusive disease of the lower limbs patients passed a comprehensive examination, including innovative research methods. According to the algorithm of diagnosis clinical examination include: complaints of patients, etiological factors, objective study, functional tests, the determination of the shoulder-ankle index oxitenzometry.
Laboratory studies include: general clinical blood tests, blood chemistry, coagulation.
Radial diagnostics includes: ultrasound duplex sonography, MSCT angiography, x-ray angiography.
As a result of a comprehensive survey of patients with chronic peripheral arterial occlusive disease of the lower limbs formed the database, based on which is installed the correct diagnosis and treatment strategy is determined.
Based on the diagnostic algorithm of chronic peripheral arterial occlusive disease of the lower limbs developed by us, a computer program has been complied, which received a patent for Intellec-
tual Property Agency of the Republic of Uzbekistan (number DGU 02579 from 31.07.2012.).
A computer program consists of one project (Diag.dpr) and three modules (Modl.pas, Mod2.pas, Mod3.pas) and provides necessary image printouts for doctors.
When you click "OK" on the 2nd module screen appears. The relevant elements of the window are entered the necessary data (name of the patient, gender, age, as well as the results of the survey). The window of this module consists of three pages, "Clinical examination", "Laboratory tests" and "Radial diagnostics".
After entering the required data press the "Diagnosis" and displays a window 3rd modul. This window displays the results of the diagnosis, which if necessary can be printed or saved to a file.
Conclusions: In created by us diagnostic algorithm of chronic peripheral arterial occlusive disease of the lower limbs, were used available clinical and laboratory parameters. As a result, processing and entering data into a computer program is not only determined the most likely diagnosis of the three possible diseases — obliterating atherosclerosis, obliterating endarteritis and nonspecific aortoarteritis, but also creates a database for each patient. The use of this computer program greatly facilitates work and saves time of surgeons.
Using the developed diagnostic algorithm of chronic peripheral arterial occlusive disease of the lower limbs can achieve a statistically significant reduction in the frequency of diagnostic errors and to reduce the diagnosis time and determine the correct treatment strategy.
Refences:
1. Bokeria LA And others. Cardiovascular Surgery - 2013. Diseases and congenital anomalies of the system krovoobrascheniya.- M.: NTSSSH them. AN Bakuleva, - 2014. - 220 p.
2. Gavrilenko, A. B. and others. The results of surgical and conservative treatment ofpatients younger than 50 years with arterial lesions in the femoral-tibial segment//Annals of Surgery. - 2007. - № 2. - P. 49-53.
3. Zatevakhin II et al. Obliterans trombangiit. - M., - 2002. - 317 p.
4. Kohan EP et al. Selected lectures on angiologii. - M.: Nauka, - 2000. - 379 p.
5. Basil, etc. Diagnosis and treatment of nonspecific aortoarteritis: A Guide for vrachey. - M.: Iris, - 2003. - 144 p.
6. Yudin RY Thromboangiitis obliterans (clinic, diagnostics, treatment): Abstract. Dis. d. m. n. - M., - 2001. - 34 p.
7. Norgen L. et al. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II)//J Vasc Surg. - 2007. - Jan; 45. - Suppl R. 65-67.
8. Resource El. URL: http://www.tiensmed.ru/news/obliteriit-v3a.html occlusive disease - causes, diagnosis, treatment (treatment date - 25/05/2014).
9. Resource E. URL: http://diabeticfoot.ru/d/176414/d/rossiyskiy_konsensus.pdf Russian consensus diagnosis and treatment of patients with critical extremities ischemia (reference date 05/25/2014).
DOI: http://dx.doi.org/10.20534/ESR-16-9.10-124-126
Rakhimova Gulnara Nishanovna, Head of the Department of Endocrinology, Tashkent Institute of Advanced Medical Studies, Ministry of Health of the Republic of Uzbekistan
E-mail: shahnoz74@yandex.com Azimova Shakhnozakhon Sharafutdinovna, Republican Specialized Scientific and Practical Medical Center of Endocrinology under the Ministry of Health of the Republic of Uzbekistan, Tashkent, Uzbekistan
Head of the Department of Pediatric Endocrinology E-mail: shahnoz74@yandex.com
Insulin resistance in children and teenagers with exogenous constitutive obesity
Abstract: The study consisted of100 children and teenagers with exogenous constitutive obesity (ECO) of Uzbek population aged from 6 to 16. The mean age of the patients was 11,7±0,25 years old. The conducted researches showed that the values
