RESUMEN
PURPOSE OF THE STUDY: The objective was to demonstrate the contribution of somatometry and vascular impedance measurement to the evaluation of somatic status and nutrition, particularly the state and function of the vascular system of lower extremities, in patients with arthropathy of the weight-bearing joints. MATERIAL: Impedance plethysmography and impedance phlebography appeared to be the best methods for assessment of vascular hemodynamics; pulse oxymetry, carried out on toes, was most convenient for measurement of haemoglobin saturation with oxygen (HbO2). The state of vessels was determined according to the CEAP classification. Somatometric methods included measurement of the circumference and volume of calves, and assessment of body height, at the anthropometric wall, and weight to calculate the body mass index (BMI). RESULTS: The lower extremities affected by arthropathy were compared with the unaffected ones by means of CEAP classes and related to the body mass values of patients. It was found that only 15 men and 26 women had normal body mass. The rest of the patients were overweight or obese (grade I and II). Only 14 men and 17 women were free of signs of vascular insufficiency, the others were classified in the range of C1 to C4 of the CEAP system. Impedance measurements showed lower mean values for affected extremities and for overweight or obese patients. A comparison of the parameters of arterial and venous hemodynamics between the affected and unaffected extremity by means of the paried t-test gave statistically significant results in patients with higher BMI grades and higher classes of vascular insufficiency, regardless of their gender. The results of HbO2 saturation measurement showed normal values in both men and women. DISCUSSION: To meet the requirements of orthopaedists, the Biophysical Laboratory carried out non-invasive measurements of somatometric parameters and vascular impedance values in patients with arthropathy of the weight-bearing joints of lower extremities. The results were similar to those of a large Framingham cohort study on knee arthropathy and obesity. The data derived from measurement of basic impedance, specific impedance and pulse-related impedance changes show that it is important to record and evaluate skin lesions and oedema because they are related to vascular disease. The finding that an increasing volume the calf was indirectly related to a decreasing basic impedance of calf vessels was confirmed by our results. This information is important for the evaluation of impedance measurement results in order to make diagnosis in individual patients. CONCLUSIONS: Our results showed that, in the group investigated, (i) there was a high proportion of overweight and obese patients; (ii) assessment by CEAP classification revealed higher grades of vascular insufficiency; (iii) affected extremities showed a significant decrease in arterial and venous haemodynamics, particularly in women with higher-grade vascular insufficiency; (iv) there was no difference in HbO2 saturation measured on toes.
Asunto(s)
Antropometría , Artropatías/fisiopatología , Pierna/irrigación sanguínea , Pletismografía de Impedancia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Artropatías/patología , Pierna/patología , Masculino , Persona de Mediana Edad , Oximetría , Flebografía , Insuficiencia Venosa/complicaciones , Insuficiencia Venosa/diagnósticoRESUMEN
The authors present outcomes of simple somatometric and impedance measurements of the condition of venous hemodynamics after the total replacement of weight bearing joints with a simultaneous prophylactic application of low molecular heparines (LMH). Measurements in a group of 125 patients (86 females and 39 males) showed increase of circumferences up to symptoms of a swelling on proximal portions of the limb operated on in an early postoperative period; as a rule it reached its peak between 6th and 8th day with a subsequent subsidence in the next period, i. e. until the dismissal of the patient from the hospital. As compared to non-operated extremities the statistical evaluation of circumferences on proximal parts showed a high significance (p = 0,001). Dynamics of these changes reaching the maximum on 6th-8th postoperative day necessitated the adjustment of antithrombotic regimen of administration of low-molecular heparines in the form of therapeutic dosage in 3 of 39 males and 17 of 86 females. There were no clinical symptoms of either venous thrombosis or pulmonary embolization during the hospital treatment. Results of our clinical study document great significance of somatometric measurements of horizontal proportionality of the lower extremity in the post-operative period after total replacement of weight bearing joints for the adjustment of prophylactic administration of LMH and prevention of the incidence of thromboses of deep venous system. Key words: deep venous thrombosis, periodicity of the risk of venous thrombosis, prevention by lowmolecular heparines, somatometric measurements, venous stasis.
RESUMEN
The authors submit an analysis of the nutritional status assessed by anthropometric methods in a clinical group of 70 patients (mean age 58 years) where on account of the X-ray and the clinical finding of arthritis of the knees an alloplastic operation was performed. The results of the examination are compared with the analysis of the nutritional status of a group of 20 without X-ray and clinical signs of arthritis of the knee. The patients belonged to a similar age bracket. The authors used somatometric measurements of anthropometric parameters focused on assessment of the relative body weight. The results confirmed an age-dependent decline of height, known from epidemiological studies, the difference being statistically significant, p = 0.05 in the group of men in the Huporal group, as compared with men in the control group. A similar trend was found in median values of sitting height in both clinical groups and in the height of the trunk in men. Using linear regression, they revealed that the increase of Brock's index corresponded to the increase of pelvic circumference in women in different groups, while in men of all investigated groups this relationship is apparent in the abdominal circumference. Evaluation of the nutritional status by Broca's index revealed in the control group a 50 % incidence of clinical obesity, while in the clinical Huporal group it was 89 %, and in the clinical TEP group 87 % were in the group of overweight and obesity. Also tables of the nutritional status based on BMI confirm the marked predominance of overweight and obesity in patients of both clinical groups. Key words: osteoarthropathy of the lower extremities, alloplasty of the knee joints, anthropometric parameters, relative body weight.
RESUMEN
The creation of an experimental group for digitalization of two-dimensional X-ray pictures of bones was the starting point for the application of selected procedures for their computer-assisted analysis. During processing of the picture first the primary digitalized picture was corrected (e. g. subtraction of the background, correction of the non-homogenity of the scanning element and light source) and subsequently the picture was prepared by spot or local transformations (e. g. semithresholding, equalization, Sobel's operator and subtraction of two differently prepared pictures) while preserving the geometry of the original objects on the picture. On treated pictures of bony structures then graphic procedures of identification of important spots, lines, angles and derived indices and of mutual relations of bones were verified. For creation of prerequisites of the long-term development of osseous changes, in particular in patients with non-cemented implants of the hip joints, possibilities of and quantitative requirements of filing of digitalized two-dimensional X-ray pictures of the bones in information media were tested as well as the possibility to transmit them in the local computer network. Finally the authors draw attention to the advantages of digitalization and analysis of two-dimensional X-ray pictures of bones by a microcomputer from the aspect of impact on information, economic aspects and in particular preserving of information in digital form. Key words: digitalization of X-ray pictures, digital processing of X-ray pictures, filing of X-ray pictures.
RESUMEN
After selecting anthropometric parameters for preventive examinations of the population and elaborating a computer program, the authors analyzed a series of 1000 probands with respect to their nutritional state. The occurrence rate of latent and clinically manifest obesity was in the given series 22.70% in men and 15.49% in women when the classification according to the total fat percentage was applied. Measurements of circumference showed higher abdominal than thoracic circumference to occur in men only in clinically manifest obesity, whereas in women predominance of abdominal circumference was recorded in both types of obesity. On applying criteria of relative body weight, the occurrence rate of obesity amounted in men to 24.72% and in women to 28.83%. (Tab.6,Ref.19).
Asunto(s)
Obesidad/diagnóstico , Tejido Adiposo/patología , Adulto , Anciano , Antropometría , Peso Corporal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/prevención & control , Servicios Preventivos de SaludRESUMEN
Hitherto the siderophore-pattern analysis included bioassays to detect enterobactin,aerobactin and other siderophores of Enterobacteriaceae. In addition, 2,3-dihydroxybenzoic acid, the precursor of enterobactin, and new hydroxamate siderophores could be examined by means of two new Salmonella mutants as indicator strains. In this manner the siderophore pattern analysis extends its discriminating ability. Among 167 Salmonella typhimurium strains tested, we detected 5 siderophore patterns. 6 siderophore patterns could be detected among a total of 204 E. coli strains. Using siderophore pattern analysis for clinical-epidemiological and ecological purposes appropriate technical methods can be recommended.
Asunto(s)
Escherichia coli/clasificación , Ionóforos/análisis , Quelantes del Hierro/análisis , Hierro/metabolismo , Salmonella typhimurium/clasificación , Bioensayo , Enterobactina/análisis , Escherichia coli/metabolismo , Ferricromo/análisis , Ácidos Hidroxámicos/análisis , Hidroxibenzoatos/análisis , Salmonella typhimurium/metabolismo , Serina/análogos & derivados , Serina/análisis , SideróforosRESUMEN
The authors elaborated an automated preventive system and examined by means of it 1000 probands with regard to the incidence of cardiovascular and bronchopulmonary diseases and analyzed the results. In the submitted paper they present the results of an analysis of agreement of conclusions of examination made in the traditional way by the doctor and those obtained in the automated diagnostic preventive system. Agreement in the sense of a positive statement (presence of disease) was recorded in 54.1%, agreement in the sense of a negative finding (disease not detected) was recorded in 28.7%. Falsely negative conclusions (the doctor detected the disease, the system did not) were found in 5.6% and falsely positive conclusions (the doctor did not detect the disease, the system did) were found in 11.6% of the patients. The calculated sensitivity of the system is 0.90 and the specificity 0.72.
Asunto(s)
Enfermedades Cardiovasculares/diagnóstico , Diagnóstico por Computador , Enfermedades Respiratorias/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Servicios Preventivos de Salud , Sensibilidad y EspecificidadRESUMEN
The authors describe possibilities regarding the use of computing technique in the sphere of preventive examinations. They present examples of typical sub-systems and proposals for the whole system of preventive examinations. In the conclusion they describe the Czechoslovak medical computing technique which can be used for building a system of preventive examinations in this country.