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Study of Risk Factors, Elaboration of Criteria and Justification of Eczema Prediction Algorithm at Primary Health Care Stage

Journal: Ukrainian journal of medicine, biology and sport (Vol.3, No. 6)

Publication Date:

Authors : ;

Page : 180-187

Keywords : general practice-family medicine; chronic eczema; prognostic criteria; predicting algorithm;

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The purpose of this study was to define the risk factors (frequency, diagnostic value and prognostic value) with the development of criteria and justification of the prediction algorithm for eczema at the primary health care stage. Material and methods. Comparative analysis of frequency, diagnostic informative and predictive value of risk factors in a comparative aspect was performed among 75 patients with chronic eczema and 75 practically healthy patients selected by the copy-couple method. We investigated 43 constitutional-biological phenotypic signs (KBM1-KBM43, phenes) as risk factors, and found out that 14 of them did not show absolute significance in comparison with the frequency of presentation in the control group (CBM4 – CBM6, CBM14, CBM15, CBM17 – CBM19, CBM23, CBM24, CBM27, CBM36, CBM37, CBM42, CBM43. At the same time, 29 phenes were statistically significant for eczema, including 14 with a high level of reliability (at p <0.01), including 2 highly informative phenes (CBM32, KBM40) (at level I> 0,700 bits). We also investigated 20 phenotypic visceral-functional markers (VFM1-VFM20), 6 of them did not show absolute significance (VFM1-VFM4, VFM11, VFM13, VFM18) compared with the frequency of presentation in the control group. At the same time, we proved that 14 visceral-functional phenes, including 7 reliable (at level p <0.010), among which highly informative were 5 phenes (at I> 0.700 bits), were statistically significant in chronic eczema. We ranked distribution (according to the diagnostic value) of reliable and, at the same time, the most informative visceral-functional markers in patients with chronic eczema. Results and discussion. The informative criteria for prediction of chronic eczema at the primary health care stage (presented in the rank sequence) are the following: high level of emotional lability, flatness (longitudinal / transverse / mixed), vegetative vascular dystonia, allergic reactions in history, dysharmonic muscle mass component of the body, the presence of multiple nevus, the presence of angioectazia, recurrent respiratory tract diseases, repetitions of dislocation of the joints, growth of the teeth with violation of the dentition shape. In our study we substantiated the prediction algorithm and the visual-analog scale of assessing the personified risk of chronic eczema based on the complex of the most informative constitutional-biological and somato-functional markers of undifferentiated connective tissue dysplasia. The prediction technology for chronic eczema is fairly simple. After assessing the presence / absence of the listed phenes in the algorithm, we consistently add the corresponding coefficients to the achievement of one of the predictive amounts. This allows a person to assess the risk of chronic eczema with the simultaneous distribution (correlation) of the subjects to one of the three risk groups. Conclusions. Taking into account the above mentioned phenes in the algorithms, we conditionally distinguished three main (most informative) syndromes (with appropriate manifestations): syndrome of psychosocial deadaptation (high emotional lability in combination with vegetative somatised or somatoform disorder), syndrome of neurogenic and stato-locomotor manifestations (violation of the passage due to flatbed, combined with frequent dislocations / subluxations of joints of different localization) and dysmorphic syndrome (disharmonic composition of the body mass in combination with one of the anomalies of the dysbryogenesis with manifestations on the skin or allergic reactions in history of disease).

Last modified: 2019-03-07 04:54:58