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Users manual - Medical Devices sro

1. rona cora gt ance oro al Di Dive dev v p O Hg tancum _ ro waa e tenoron eromena O Uctancens ve nacre kung Slane 17 4 The CRAB system usage 17 4 1 Plugging the remote modules of ECG registration Electrodes should be applied to patient s wrists with the contact pads facing the inner side of the hand The ap propriate areas of patient s skin should be vastly moistened with water or with physiologic saline Patient can be sitting or laying and should be in a calm position An electrode with the red connector attached should be ap plied to the right hand An electrode with the black connector attached should be applied to the left hand of a patient Note In some cases when the R peak amplitude is too low one electrode should be applied to the right wrist and the other to the left ankle vastly moistened as well Important notice To reduce the noise during ECG recording it is necessary to follow the below rules a Patient s hands should be still
2. Microsoft p 4 Press Finish 3 98 ipu lt High Tisai Senal Correta soe ett una rna rm rcm T nee T is 74 6 After installing USB device drivers the new device USB Serial Port will be found by the system The proce dure of driver installation is the same as the above NOWCKA 25 M i noce NARO quxdupeea SARE uer ey RET T LSE TY pA ree MO HO Aat Crees Aon e nos ne e
3. OK Please wait while printing the first move the paper from printer s out box to inbox without inverting the paper Click OK or hit Enter to print the second page You can also form the printing report manually by pressing sequentially icons of all required analysis methods Then press Print to send the report to the printer 67 15 USEFUL FUNCTIONS 15 1 Search patient by name You don t have to look through all groups to find a person Just use a quick search by patient s name or by it s part See 12 3 1 Search patient for details 15 2 Web cam usage If a PC has a Web cam attached you can insert a patient s photo into his individu al card See 12 3 2 Add new patient for details 15 3 Selective report You can create a report for patients in a group containing basic indices of pa tient s health for the selected period of time See 12 2 5 Group Report for details 15 4 Network support If other PCs on the network have Dinamika Medicine software installed there is an opportunity to browse the group stored on remote PCs from the database win dow See 12 2 7 Group from network for details 68 16 TROUBLESHOOTING 16 1 Problems with recording The signal of the ECG record can be missing or can be displayed incorrectly because of o
4. 69 16 1 3 Incorrect AC frequency A EU t NER TUA 69 Ze WALA ASC TT TI Lt 70 6 3 SCCM OY YUN AUN OM eiie eo aee ede eSI ee EI A 70 16 4 3D breath mode doesn t oov PEORES 70 Ig DE poc c 71 DED livery pa CI 71 17 2 PC hardware T6quiF ee ils 22551525 ces Pos ma 2 3o 92 EAEN EAER Padua sa Ed sede ded 71 1723 Plusmo CRAB Sy Sten 0 d 72 17 3 4 USB devic OH 73 Ihe RAB Ssyslenm US a0 6 MM IMMMRDME 74 17 4 1 Plugging the remote modules of ECG registration eese 74 Te e ers A A A 74 i gh 17 1 INTRODUCTION 1 1 Common Info Dinamika Medicine the digital analyzer of biorhythms is a hardware software complex intended to analyze human heart and brain rhythms extracted from an electrocardiosignal in the broadband frequency The system is based on a new information analysis technology of non linear signals of a different physical nature a so called Fractal Neurodynamics Designing the system the latest achievements in theoretical and clinical medicine and physiology were used and a number of new highly informative health evaluating indices are offered Dinamika Medicine allows in the
5. a USB Serial Port COM15 51 2ME 034 Fe E USB Serial Port COM16 hp 9 USB Serial Port COM2 USB Serial Port COM23 USB Serial Port COM4 USB Serial Port COME 9 888 88 There should be 7 items named USD Serial Port COM Make sure that all port numbers are unique and there are no yellow questions or exclamation marks 73 17 3 1 USB device driver installation When ECG recording module Omega 5 0 USB is plugged for the first time the new device will be found by Windows and the Add Hardware Wizard will be started 1 Select Install from a specified location and press Next Fror PRA EET M PS DDSI eser CT PRT USE High Speed Serial Converter quc BT ane pr Peep OST Bee C Oa rcr ir coton pr c mgr c 8 reca ee are ro 2 In the next window please deselect Search on
6. 3 3187208 amp 213975 01255 Aas iepjiuc Hb udis EP mema si mi FHH 0498 2006 1909 0267 8 5 2084 1952 47 0313 oi GO ES Smith f d Leg Left part of the window will display the list of groups of patients 4 E 2 rris Ready The symbol means that the group is open the list of the patients is shown The symbol means that the group is closed Double click on the name of group or single click on the symbol to open close the group The number of patients contained in the group is show to the right of the group name The group without any symbol is empty The list of patients is alphabetically sorted alphabetically The selected patient name is colored yellow The right part of the window represent the list of the ECG s of the current patient sorted by the date of obser vation All functional buttons are in the upper string of the window ECG Registration Screening Diagnostics 1 Dynamic Observation and Forecast Variation Analysis of Heart Rhythms EA Neurodynamic Analysis Charting of Brain Biorhythms Fractal Analysis ECG 12 Registration lemon Monitoring Biological Feedback help minimize XJ close 17 5 2 Creating a Group of Patients 1 To create a group of patients right click on the Card File string in the l
7. Patients Group report Get From ARCHIVE Fut BASE Ea HIVE Enable network Enable 3D Breath This will process all records from the database even records processed earlier 12 2 5 Group Report The Group report is used to create tables containing the observation results of all patients of a group To run the report left click to select the group name right click to open a pop up menu and choose the item Group report group name gt Groups Patients PROCESSING of group DEMO E croup report DEMO Get From ARCHIVE Group DEMO to ARCHIVE 177 Enable network Enable 3D Breath 53 In the Save As window choose the folder and the filename of the future report and press Save SystemNTFS Documents and Settings Software 3 Downloads ad Some lad Games 2 TPFiles CjoldPC data WINDOWS ic Program Files primer Projects Excel 5 7 xls M Please select the period of creating records for the report and press OK Group report Choose the perod t 10 minutes lt P t 24 hours 48 hours Week Mot limited All records The Excel 5 7 xls file will be created This file will contain patient s name birth date record number record date pulse rate and indices of functional s
8. check box and select Search in the specified folder Browse to the folder D Drivers Omega5 drv and press Next Jag irre ape pua CGR Piae potui eno pepe B AHH EETA portione ta nga reet fuc acest Fan Pr este ADR pipi HIC Ta LL LACE rumen bs cse ren Aumont ae neanswcr corte i enero nic Dr Weeds O raa dew Hg nonce cara pep H3 Wirtierd lt sarum mo gea peematt peines CAET mma OLA HEC Oboe NUT es mcm 3 Press Continue anyway in the following warning window A USB High Speed Serial Converter He Ha Windows
9. ua sui Uie 54 LEON UNE 55 12 3 Working with patients files isccccsccccccsssccsssscssssvssvesectsecccsesacseasenteshavesssceeeasweeussnanssessesssueesasesessaansccsasesseestvstaaseesesasanate 56 Peerke ONEI osi 56 Adding new patient NR NER 57 emn 59 Pe MOVING To Omer TT 60 61 iS Ecol cm 9 61 Laaer MOARE 62 124 NV ORS yth ECG ROC ORS RTT UU TN 63 OG BLD e c 64 IJ COMPEESN PREN onde 65 Search 67 2 WS AGC T 67 15 5 9 m 67 SU 070 PRSE E E E E E E ee 67 IG TEROUBDBSHOOTINU 68 16 1 Problems With FeCOFGOIDP 68 16 1 1 The selected device type is incorrect cece esee enne nennen nnne 68 SEN c
10. 27 3 The PQRST window This window displays a cardio complex relevant to an RR interval selected on the rhythmogram Blue marks are reflecting P Q R S amp T peaks Select with the left mouse button the necessary rectangle of the graph to zoom in Click right mouse button to zoom back Double click left mouse button to switch to the manual mea suring mode For gauging amplitude time parameters according to accepted stan dards it is necessary to place markers P and T of peaks on a beginning and an end P and T peaks accordingly 4 The Histogram window A B C The histogram represents the chart of a relation of quantity of RR intervals in different intervals of their dura tion Duration of RR intervals is shown along the abscissa axis Axis of ordinates represents probability of their occurrence i e number of RR intervals in the relevant gamut Artifacts are marked with red Histogram s step is 0 04 sec Gamut of the histogram s basement is between 0 32 amp 1 64 sec In the state of a vegetative equili brium columns are centered and the highest one Moda is between 0 7 1 0 sec fig A Columns are essen tially biased to the left and the histogram s basement is not so wide fig B in case of influence of the sympa thetic department of the vegetative nervous system And vice versa in case of para sympathetic influence fig C 5 The Scatterogram window A B C R R intervals scatterogram is a two
11. EP E sympathetic department of vegetative nervous system and 30 2 HFnu n yas leading level of operation of sinus node TP Vegetative Index of a Rhythm VIR 1 Mo AX allows to evaluate vegetative balance from a point of view of an es HRV index timation of activity of an independent contour of a regula tion As this activity grows VIR decreases then the ve getative balance biases to the predominance of the para sympathetic department of the vegetative nervous system Stain Index SI AMo 2 AX Mo of the regulation systems reflects a level of centralization of a control of the heart rhythm The normalized indices of the vegeta tive regulation are shown in the center of the window Computer conclusion regarding the vegetative regulation is blow The results of different kinds of analysis of a variability of the heart rhythm are shown in the bottom of the window All analysis meet Standards of Measur ing physiologic interpretation and clinic usage of variability of the heart rhythm by the Task Force of the Euro pean Society of Cardiology and the North American Society of Racing and Electrophysiology 1996 The medical physiological interpretation is given below Statistic Analysis RRNN average duration of the R R intervals It reflects the final result of numerous regulation influences to a sinoatrial rhythm of the usual balance between para sympathetic and sympathetic departments of vegetative nervous system SDNN
12. Volosova E V Ready 12 1 The Card Box window Volodchenkova N _ DATE TIME _ 31 07 2006 20 50 42 2 31 07 2006 21 15 30 3 31 07 2006 21 30 26 4 5 04 08 2006 19 52 47 DUR 03 22 03 36 03 55 03 13 RR PS 29476 GD 29406 D 29109 P 2960 4 49 nec scs fe ovufmvar DA mec mre 2 XC COMMENT The symbol means that the group is open the list of the patients is shown The symbol means that group is closed Double click on the name of group or single click on the symbol to open close the group The number of patients contained in the group is show to the right of the group name The group without any symbol is empty The list of patients is alphabetically sorted alphabetically The selected patient name is colored yellow The right part of the window represents the list of the ECG s of the current patient sorted by the date of obser vation All functional buttons are in the upper string of the window ECG Registration Screening Diagnostics Dynamic Observation and Forecast Variation Analysis of Heart Rhythms Neurodynamic Analysis Charting of Brain Biorhythms Fractal Analysis ECG 12 Registration lemon Monitoring Biological Feedback help M minimize X close 50 12 2 Working with groups The Dinamika Medicine s
13. Use Tab or Shift Tab to switch between fields Or use a mouse Fields First Name Second Name Birth Date and Gender are required Birth Date has to be entered in DD MM YY format i e 17 01 45 You can also use a drop down list To enter Gender City Region Group please use drop down list which are activated by button Click OK or press Enter when done 3 In the left part of the window the name of a new patient will appear 19 6 ECG REGISTRATION 6 1 Plugging the remote module of ECG registration 1 Place electrodes onto patient s wrists contacts inside It is also recommended to moisten the skin A patient should sit or lay still You do not have to observe polarity Note Sometimes when the amplitude of R peaks is too low the red electrode should be placed on the right wrist but the yellow one on the left ankle which also has to be moistened very well Attention Please follow these reduce noise during the ECG registration a patient s arms have to be relaxed and lay still b there should be nobody else in 1 5 2 meters around C do not place the remote module near sources of magnetic and electrical fields TV Sets old models of com puter displays etc d patient should try to be in most comfortable and relaxed position It is NOT recommended to disturb a pa tient by talking or to demonstrate a computer display with ECG being recorded
14. creme ss 4 Microsoft Windows 6 pun A Professional ae 2002 m Service Pack 1 gt USB H1 55693 0EM 001 3917 41056 3 j Brother MFC 8840D USB Intel R F 4 LPT1 Celeron R CPU 2 60GHz re e tatur 9 use Serial Port COMI 2 60 i
15. 0 25 neurodynamical codes and normal changed or broken structure Tet 4 8H 55 10 4075 3 Alpha 8 13Hz 258 normal limits are shown the brackets Beta 13 25Hz 37 5 10 80 The indices of the power resources are shown in the middle part of the Oe ocean window The integral indices of the central regulation are below All D2 regulation reserves 71 60 100 values are normalized and shown in per cents Normal values are shown in brackets PSYCHO EMOTIONAL STATE IS NORMAL THE PHASE OF NORMAL ACTIVATION Hit ESC key of left click mouse button on any place on the Conclusion window to close it Press EXIT or hit ESC to close the Brain biorhythm chart module 43 9 4 Fractal analysis of the organism s biorhythms Click left mouse button to select a patient s record in the right pane of database window The selected record will be colored yellow Press the FAB button to run the Fractal Analysis program DEMO 2 Ivanov P V A E atient Smith John dfsfsdfs sex male age 0 observation date 28 03 200 The fractal analysis is intended for the evaluation of the harmonization degree of biorhythms at different control levels and for definition and forecast of sporting form index for a relatively long period up to 10 days The fractal portrait in the center is formed by the biorhythms of an examined patient In windows there are standards corre
16. Continue button A USB High Speed Serial Converter He c Windows XP o Microsoft 4 Press Finish to finish the installation e USB High Speed Serial Converter 5 OPERATION ORDER 5 1 Starting Software 1 Double click the Dinamika Medicine2 icon on your desktop to run the program 2 The database window will appear E 1 TIME DUR RR PS COMBENT 1 3187 20 2053 47 01 22 hit a 17018 7D 211530 134 OD 20
17. standard deviation of the NN interval It is an integral index reflecting the variability of the heart rhythm in common It depends of the influences of para sympathetic and sympathetic departments of vegeta tive nervous system to a sinoatrial rhythm Increasing or decreasing of this index shows the biasing of the ve getative balance to one of the vegetative nervous system departments CV SDNN RRNN 100 Coefficient of variation It is very close to SDNN but also helps to take pulse rate into account during analysis RMSSD standard deviation of the subtraction of RR intervals and their average value NN5O amount of pairs of sequential RR intervals which difference is more than 50 ms pNN5O their percentage from the total amount of intervals being analyzed Histogram Analysis Moda Mo is the most frequent value of RR It represents the dominant level of the sinoatrial node function ing At sympathonia it is minimal at vagotonia maximal Normal value of Moda is between 0 7 and 0 9 Moda Amplitude AMo is a cent relation of number of RR intervals which values are equal to Mo to the total number of intervals This index reflects the degree of a rigidity of a rhythm Its normal value is about 30 50 The magnification AMo will testify to predominance of sympathetic influences on a sine knot and consi derable rigidity of a rhythm At vagotonia this index decreases Variation Total Amplitude VTA is a result of subtracti
18. After completing the report the window Print Server will appear OMEGA Print server File Help EET Date of creation Screening Smith John dfsfsdfs 30 03 2007 10 05 19 Use ZOOM button to preview Use PRINTER button to start printing Use menu File gt Printer Settings to configure parameters 8 DYNAMICAL MONITORING AND FORECAST 30 The mode of dynamic observation is applied at nonsingular two and more surveys for comparison purposes of exponents of a physical state of the patient In this mode all discharged records an ECG are handled excluding artifacts for which the pretreatment was yielded Choose a patient using mouse The name of a selected person will be colored yellow Select several ECG record in the right part of the database window Press DYN button to run this module REC scn enyn lavar ewon egre lazaz 2 X TIME RR PS COMMENT enkov S V E Pr moe j pe shenko ft M Ei 55 EATA see Volodchenkova L em presens LEN M LJ A hy is 11 1 gt y d adl 4 4 4 i 2i E iu A41 ET Dynamic observation The Dynamical Observation and Forecast window will appear N Date 1 31 07 2006 0 50 4 2 31 07 2006 1 15 3 31 07 2006 1 30 010206 30 4 10 6 TREND ent Volodchenkov A V sex male
19. DINAMIKA the research laboratory SYSTEM OF COMPLEX COMPUTER AIDED INSPECTION OF THE FUNCTIONAL CONDITION OF A HUMAN ORGANISM DINAMIKA MEDICINE User s Manual Saint Petersburg Russia 2007 www dyn ru Table of contents TEN PRODUC TION c 5 Li ommon in og ccc sacs cease A E TOA 5 5 1 5 Systemi Capa DINOS e 6 OY SU CMI BOA UGS EET TT TR 6 1 5 yy hats new IH CUTFENL 7 P VIDERI SEN UI f H 8 P N EMI ASIC 8 2 2 8 RWC DESCRIP TION sclecescscctucavacdeseacacstacavacdesescacsdacavaedeseacacetacevaciesesceccdasavecdeseacacstacevecies 8 3 1 Remote ECG registration module with embedded blood pressure measurer ecce eee eee eene 8 2 2 Technical CAVE CS oou aep eie 9 GNE M Mn 9 34 Warranty ICI air E E 9 10 e E 10 4 2 Preparation for the first start and the
20. m t zi mih 4 ALS Lm 74 5 2 The ECG Registration window will open r 3 Press START button The ECG signal will appear in the upper window If no signal appears see TroubleShooting 4 Before starting to record you have to achieve stable ECG signal in which precise R peaks are marked with vertical markers Follow these steps to do it a Choose positive polarity of the ECG by pressing the POLARITY button Positive polarity Negative polarity b Establish appropriate scale by regulator Source signal Scaled signal c Remove all noises There are 3 types of noises 0 05 0 06 0 07 V E NW 22 Some people are walking near there should be nobody in 1 5 2 meters around Patient moves his hands patient hand should be still Be contact between electrodes and patients skin moist the skin and clean the elec trode s contacts No contact between the electrodes and the remote module Check the lead cable Remote module s batteries are off charge the batteries Incorrect device type selected Please select Omega 7 1 device 16 1 1 0 08 0 10 Note Sometimes when the R peaks amplitude is too low or contact between electrodes and a patient s skin is weak the algorithms of R peaks extraction may do not work properly It is recommended to move the elec trode from the left wrist to the left ankle the 2 lead s
21. 2 Cuff placing order 20 a Drag the edge of the cuff through the metal contour so that the entry point of the air tube should be placed on the outer side of an arm upon the elbow b Pass the arm through the result ring to place the air tube towards the patient s palm c Place the cuff in 2 3 cm from the elbow Attention The white line on the cuff 3 cm length should be right upon patient s arterial d Densely but not hardly tighten a blood pressure cuff The cuff should tightly fir an arm otherwise the results of observation would be incorrect Do not place the cuff upon the clothes e Place the arm on the table so that the entry point of an air tube would be on the elbow and on the heart height Be sure that the tube is not over wound f Ask patient to relax and sit still for 2 minutes before the ECG registration Attention You can use either left or right arm Anyway you should use only one arm 6 2 Blood pressure measuring After placing the cuff you can start measuring 1 Press the 0 1 MEMORY button The device will be switched on It will start pumping the cuff automatically and the value of the cuff pressure will be shown on the display After reaching the estimated limit the air will be releasing automatically In the left part of the display the speed of pressure decrease will be shown The pulsing sound signal will report of detecting a pulse and the symbol will be shown on the display The lon
22. House 0 20 Apt 0 Workplace Growth i H Phone Weight Note Group DEMO Besides Individual card of the patient this window contains six additional tabs Diagnoses Observations tool Advices of the experts Out patient observations Computer observations Conclusion To switch to the desirable tab just click on its name 59 60 12 3 4 Copying Moving to other group Click right mouse button on a patient s name to open a pop up menu Choose Patient gt Copy or Move ECG TIME DUR 1 28 03 2007 15 55 20 03 22 2 30 03 2007 12 22 53 01 42 3 30 03 2007 12 29 33 04 55 Patients PROCESSING patient Smith J F 3roup report Mave Ike 4 T fo Get from ARCHIVE L s zi 15 Patient Smith 7 F to ARCHIVE f irj Enable network BLATT w Enable 3D Breath In the Copy Move dialog choose the new group name and press OK Copy to selected group cancel If such name already exists in a new group the following dialog will appear Patient Smith John F male birth date 28 02 2007 already exist What it is necessary to make Add records to the existing patient C Add records to the new patient 5 mith 1 5 Hohn F d Yes for all Skip Cancel You can either add new records to existing pat
23. and do cumentation Due to constant up dating of the software this manual may differ to some extent from its later ver sions 2 DELIVERY SETS 2 1 Basic Set ECG remote module Software on a CD The Skintact F 9024 AC cardiographic electrodes Blood pressure cuff on a forearm Interface cable USB uU A W N Medical bag 2 2 Portable Set Basic Set 2 1 Portable PC Notebook Pentium IV Ink jet color printer Computer bag 3 TECHNICAL DESCRIPTION 3 1 Remote ECG registration module with embedded blood pressure measurer Lead cable plugging socket Interface cable plugging socket Blood pressure cuff socket ECG registration mode display Blood pressure and pulse display Oo uU KR WW N Power on off button The computer s USB interface with photon coupled junction is used as the power supply of cardiograph card Four batteries of AA type are used as the power supply of built in tonometer In case turning on the tonometer there is the symbol of discharged battery on the display then replace of bat teries is needed Note With some lap top models operating by means of outer source not by means of accumulator while writ ing the ECG some noise appears To remove this noise it is recommended to turn off the alternating current adapter from the outer source and to use accumulator as a power supply for the lap top In case there is hum while using a desk comput
24. and relaxed If a patient sits his hands should be placed over his lap If a pa tient lays his hands should be placed along the body b Unauthorized people should not walk within 1 5 2 meters around the patient c During recording the ECG a patient has to be in a comfortable and relaxed state A patient should NOT be disturbed by any talking or by demonstrating him the computer display with the ECG recording 17 4 2 ECG recording 1 Select the group of patients in the left pane of the database window by left clicking the name of the group will be colored yellow Press REC button to start recording ECG in multi channel mode 75 2 The window Multi channel ECG recording will appear _ Demo 3 Make sure that the ECG signal is stable for all patients before starting the recording process R peaks should be well marked with triangle marks To achieve this you have to a Choose a positive polarity of the ECG signal by pressing the button Positive polarity Negative polarity b Make sure that there are no noises and eliminate them if any discovered There can be several types of noises Tee Some people are walking close to the pa BRR tients no one should walk 1 5 2 me Pm HALLE ters distance from the patients ft SOSS D NS SS ESN S SS S Patient is moving his hands patien
25. calculated according to the last record but the dynamics diagram will use all selected records Right click over selected records and choose Complex print COMMENT PROCESSING Select all Delete record s Complex print gt gt ECG Recording gt gt ECG12 Recording gt gt Monitoring gt Dynamic observation and Forecast gt Breath gt Breath export eros epi Volodchenkova L N Volosova E V In the Printing Settings window press the Auto button in order to form the report automatically The re port will contain all methods of analysis Setup complex print Meuradynamic analysis Print Print Print For customization of the necessary analysis press the appropriate button Different modes of analysis will appear on the screen sequentially This process can take up to 2 3 minutes which depends on the hardware capabilities After completing the report Print Server window will appear 65 66 __ OMEGA Print server Application Initials Pagecount Date of creation 1 plex print Smith John F 02 04 2007 17 33 48 Press Zoom button for preview Use menu File gt Printer Settings to configure printing parameters Turn the printer on and press PRINTER button The device will start printing and you will see the following window X 1
26. dimensional display of the heart rhythm which allows receiving the so called mnemopictures characteristic of the main types of the heart rhythm disturbances Along the abscissa axis is the value of RRj interval in seconds Axis of ordinates represents the value of RRj i interval in seconds Artifacts are marked with red Uniform distribution fig A means and equilibrium in the vegetative nervous system state Higher density of the scatterogram cloud and it s biasing towards the bottom left corner fig B means the predominance of the sympathetic department of the vegetative nervous system And considerable straggling of points of scattero gram and biasing to the right fig C speak about predominance of influences of a vagus nerve on a sine node 28 6 The FS Chart window This diagram show normalized values of index of a physical state _ 55 66 70 71 65 adaptation level of cardiovascular system B index of a vegetative regulation C index of a central regulation D psycho emotional state aR integral index of a functional state Double click left mouse button upon the histogram graph to open this window Co lored graphs represent changes of current indices of physical state during the record ing process AA c amp Health The ab scissa axis shows numbers of RR intervals from 50 to 300 8 Semaphore Colors of the semaphore correspond to different levels of func
27. dream etc detecting drug users including using drugs at a working place O The scientific practical centers of sports medicine sports clubs sports schools health centers O oOo O O ue Oo XE O O O O O Express monitoring of acclimatization of the sportsman to exercise stresses training level and power re sources estimation Evaluation of a level of a self regulation in the biological feedback mode and monitoring of the psycho emotional condition of a sportsman during competitions Dynamic observation over parameters of the sports form during post trauma aftertreatment and during bolstering and corrective medicament and physiotherapeutic treatment 1 3 System Capabilities ECG registration in any standard lead and real time monitoring of the functional condition parameters Blood pressure measuring while ECG registration Self regulation level estimating in the biological feedback mode Screening and diagnostics of the functional condition of a patient Dynamical monitoring of changes of the functional conditions parameters health calendar and clock Daily forecast of the psycho physical activity in the biological clock mode n Estimation of the cardiovascular condition and neuro humoral regulation according to the golden section on the ECG timing parameters Estimation of the vegetative regulation parameters using statistic time and spectral methods of heart rhythms analysis Estima
28. first start 4 ccce ecce eee e eee eee e e e reete eee ee ettet ee eee eese esses sse eate eee e eee 12 o reis VISTA USES mE 12 4 2 2 First start Dinamika Medicine software 13 4 3 Plugging the Remote 14 4 3 1 INStallation the USB device drIVErS 14 SOPERA HON ORDER e 16 SONWALE 16 5 2 d Group of VE moo NR IRN 17 5 9 AGGING a Patient mto th Database 18 O ECG REGISTRA 2 32 0290 0902990900952 aa araa ana iienaa nianna 19 6 1 Plugging the remote module of ECG registration c ccce eee e eee eee eee e e e ee ette esee eee eee senses s eee e teet teer eee 19 6 2 Blood pressure measure c o cousin aiia E ESTA NES UE dS 20 TG TRC OTI aa T c c U m 21 SCREENING AND DIAGNISTICS 26 8 DYNAMICAL MONITORING AND FORECAST eeeesseccccscccccccccccscccc
29. window displays a cardio complex relevant to an RR interval selected on the rhythmogram Blue marks are reflecting P Q R S amp T peaks Select with the left mouse button the necessary rectangle of the graph to zoom in Click right mouse button to zoom back Double click left mouse button to switch to the manual measuring mode For gauging amplitude time parameters accord ing to accepted standards it is necessary to place markers P and T of peaks on a beginning and an end P and T peaks accordingly The Histogram window The histogram represents the chart of a relation of quantity of RR intervals in different intervals of their duration Duration of RR intervals is shown along the abscissa axis Axis of ordinates represents probability of their occurrence i e number of RR intervals in the relevant gamut Artifacts are marked with red R R intervals scatterogram is a two dimensional display of the heart rhythm which allows receiving the so called mnemopictures characteristic of the main types of the heart rhythm disturbances Along the abscissa axis is the value of RR interval in seconds The ordinates axis represents the value of RRj 1 interval in seconds Artifacts are marked with The Functional condition window This indicator displays the normalized value of the current integral index of the functional state of the patient The first value of the index appears after 60 intervals of record and updat
30. 2 MFC Application Editor Editor MFC Application E S 3 L Ly 16 3 Security violation If the software loads with the window Security violation Safety violation Code 701 That means that the software has been damaged or a hardware configuration has been changed To solve this problem you have to delete the License folder from the working folder of the software C Program Files Dinamika Dinamica Medicine and follow the instructions from 4 2 Software registration 16 4 3D breath mode doesn t work To solve this problem you have turn on the 3D breath mode See 11 Controlled respiration in the biological feed back mode for details 71 17 MULTI CHANNEL SYSTEM CRAB FOR SIMULTANEOUS OBSERVATION OF 7 PATIENTS The system CRAB based on Dinamika Medicine device is designed for ECG recordings of up to 7 patients simultaneously 17 1 Delivery package ECG recording module Omega 5 0 USB 7 pcs Cardiograph electrodes Skintact F 9024 14 pcs USB hub D Link USB2 0 for 7 ports 1 unit 8 9 MR 2 17 2 PC hardware requirements Recommended configuration Celeron M 1 7 GHz Operation System Windows XP Windows Vista 72 17 3 Plugging CRAB system to a PC 1 Plug USB hub D Link to any free U
31. CTIVITY IS HIGH The conclusion regarding state of the central regulation mechanisms includes 5 variants NORMAL CENTRAL REGULATION SUPERACTIVITY OF THE REGULATION SYSTEM NORMAL CENTRAL REGULATION NORMAL ACTIVITY OF THE REGULATION SYSTEM NORMAL CENTRAL REGULATION LOWER REGULATION ACTIVITY SIGNS OF MALFUNCTION OF THE CENTRAL REGULATION MECHANISMS MALFUNCTION OF THE CENTRAL REGULATION MECHANISMS Hit ESC key of left click mouse button on any place on the Conclusion window to close it Press EXIT or hit ESC to close the Neurodynamic Analysis module 40 9 3 Charting of brain biorhythms Click left mouse button to select a patient s EGC record in the right part of the window The selected record will be colored yellow Press the EEG button to run the Brain Biorhythm Charting module Livanov P V 5 Smithi d Dynamica 15 3 y ty u Di 4 Winns enari 0 delta theta alpha beta beta2 a atient Smith John dfsfsdfs sex male age 0 observation date 28 03 2007 15 55 20 1 The Phase Spectrum window Colors of the spectrum correspond to different rhythms The width of sectors is defined according to the mod ulation indices of the correspondent parts of the spectrum The maximum colors mean normal activity In case of functional and pathologic malfu
32. Double click on an ECG record to run the analysis program The Monitoring Analysis window will appear Bx 3 hr 3 24 Use the scroll in the upper part of the rhythmogram to choose the part of the ECG signal going to investigate The diagram of the dynamics of the functional indices updates simultaneously You can select a part of the rhythmorgam by dragging a mouse The length of the selection must be more than 57 RR intervals Release the mouse button to calculate all indices of the selected part The diagram to the left will show the results of calculation 48 11 CONTROLLED RESPIRATION IN THE BILOGICAL FEEDBACK MODE The program of controlling the respiration in the biological feed back mode is used for correction psycho emotional and physiological state after physical and mental loads in stressful situations at appearance of indi cations of fatigue for rising efficacy of medicines and medical procedures The regular respiratory gymnastics under this program allows essentially to increase the basic parameters of health and first of all energy re sources of an organism and parameter of immunodefence Besides the controlled respiration program can be used as an active test of organism s functional resources Please taka 5 min pause before repeating the ECG registration after finishing the respiration session Order of work 1 Complete a background ECG registration n 2 Left cl
33. Enable network 5 5 O w Enable 3D Breath Fill in the Editing Group Information form and press OK Change group Hame 5 portsmens 01 Note 12 2 3 Deleting Click right mouse button on the group s name in the left pane of the database window to open a pop up menu Choose Groups gt Delete PROCESSING of group Sportsmens 01 Group report Sportsmens 01 Get From ARCHIVE Group Sportsmens 01 to ARCHIVE 2 Enable network _ Enable 3D Breath Confirm the operation by pressing Yes in the Caution dialog Note All operations listed above can be done using keyboard Ins create new group Enter edit Del delete 52 12 2 4 Processing After observation of several users simultaneously in multi channel mode of the ECG recording using the CRAB system the processing of a group is commonly used Such processing allows preparing the data for the group report Select the name of the imported group by clicking the left mouse button Open the pop up menu by clicking the right mouse button Then left click the item PROCESSING of group Patients Group report DEMO Get From ARCHIVE Group DEMO to ARCHIVE Enable network After finishing of the processing all data will be available for any system analysis mode You can process the whole database by running this option over Card Box in common
34. GA 1 PnP USB Wating interval before recording In seconds Device sound 50 Hz AC Frequency 70 16 2 Database problems If some patients or groups disappeared from your database you have to delete the file db swp from the working folder of Dinamika Medicine software C Program Files Dinamika Dinamica Medicine by default ev Omega M2 EAER a rd 2 15 C Program Files Omega Omega M2 E Light Alloy Marvell Messenger Microsoft ActiveSync E O Microsoft Device Emule E O microsoft Frontpage Microsoft Office E O Microsoft SQL Server i Microsoft SQL Server 2 Microsoft visual Source Microsoft visual Studio i Microsoft Visual Studio Microsoft Visual Studio p db c Microsoft Works Microsoft Office Microsoft gc 8 Miranda Movie Maker Mozilla Firefox MSBuild 73 MSDN E msn gaming zone E MSN Messenger MSXML iini Ecg12A 3 NetMeeting Ecg12A MFC Application ce Omega RE I Omega M2 D FA Amana r ractai Fractal MFC Application T o Breath Sound Breath MFC Application DB MFC Application DinPro DinPro MFC Application 12 91
35. SB port in your PC 2 Plug the first ECG recording module Omega 5 0 USB to the first port in USB hub D Link 3 Install USB device drivers see 17 3 1 USB device driver installation gt 4 After installation of the driver repeat the procedure described in items 3 and 4 for each six remained units of registration of an electrocardiogram in ascending order of indexing 5 It is highly recommended to reboot a PC after drivers installation and check the Device Manager after wards Right click on My Computer icon and select Properties in the pop up menu In the System Proper ties window switch to the tab Hardware and press the Device Manager button Select Ports COM amp LPT from the list of hardware waits m82 H cu gt a
36. Workplace Growth H Phone Weight Note Group DEMO Use Tab or Shift Tab to switch between fields use a mouse Fields First Name Second Name Birth Date and Gender are required Birth Date has to be entered in DD MM YY format i e 17 01 45 You can also use a drop down list To enter Gender City Region Group please use drop down list which are activated by E button Note Our system allows importing a photo into the patient s file Double click the square in the upper right corner of the form and choose the file with a picture Picture should be in BMP JPG or GIF format Click OK or press Enter when done 58 You can also insert a patient s photo into the observation card 1 If there is a Web cam attached to the PC the picture from the Web cam will appear in the image area of the Add new patient window Just click on this image to save it Add new patient Individual card Patient information chart N Lastname Smith Firstname John Middle name DOB Nr 16 03 2007 Sex Male 0 HOME ADRESS City Saint Peterburg District m Street Moskovskoe sh House 10 3 Apt 45 Workplace Growth 180 H Phone Weight 67 Note Group DEMO 2 If there is Web cam attached to the PC you have to insert a photo from by doubl
37. a 26 7 SCREENING AND DIAGNISTICS Click left mouse button to select the patient s ECG record in the right part of the database window The selected record will be colored yellow Press the SCR button to run the Screening Diagnostics module E 1 The ECG window Time from the beginning of the record in minutes and seconds is shown along the abscissa axis The axis of ordinates represents amplitude of ECG Vertical lines are marking extracted R peaks By default the scale of ECG is 25 mm sec To change the scale to 12 5 MM 25 mm 50 mm please use the SCALE button Use mouse to drag the graph along vertical and horizontal axis 2 The Rhythmogram window This window shows the dependence of the RR interval duration from the number of the evaluation cycle The artifacts are marked with red color Along the abscissa axis the numbers of the evaluation cycles are shown The time in seconds is along the ordinate axis Rhyth mogram can be represented in two modes 300 and 100 cycles The button 100 300 is used to switch between these modes The RR intervals counter is shown above the rhythmograml 309730079 It represents total amount of recorded RR intervals number of clear inter vals and number of artifacts Click left mouse button to select an RR interval Selected interval will be colored yellow and the ECG window will display the corresponding part of a cardio signal
38. age 38 1 The ECG records window In the upper left window the list of patient s ECG records is shown To move across this list please use Home End PgUp PgDn buttons or a mouse The selected record is colored red The last record in the list is selected by default 31 2 The FS Chart window 68 79 74 77 75 Normalized values of the indices of functional state are represented on this dia gram Cardiovascular system adaptation level B Vegetative regulation index C Central regulation index B Psycho emotional state integral functional state index A C D HEALTH BP 120 80 Blood pressure for the selected record DD Dynamic gamut difference between maximum and minimum values of the integral index of 0 14 15 the physical state 0 01 3 The Indices Trend window 48 35 27 25 34 Press the COMPARE button to activate this window It represents the difference i between indices of two selected records By default two latest records are selected E Selecting records to compare can be done in the ECG records window During com paring previous record is subtracted from the next one Graphs of corresponding colors represent normalized values of in dices of a functional state 3 D amp Health Id numbers of the ECG records are Shown along the abscissa axis Up to 26 records can be represented in one wind
39. base to archive by running this option over Card Box in common To extract the group from archive do the following click left mouse button on the Card Box string to open a pop up menu choose From archive to complete the operation Patients PROCESSING of group Dynamica Group repart Dynamica Geb From ARCHIVE Group Dynamica to ARCHIVE Enable network Enable 3D Breath 55 Select the folder containing the archive and press OK Gao SystemNTFS 4 Documents and Settings Software C Downloads ag Some ad Games 2 TPFiles CjoldPC data WINDOWS 9 Program Files Projects 2 12 2 7 Group from network If there is another PC on the network on which Dinamika Medicine software is installed you can browse the groups stored on this remote PC in the database window To enable this opportunity you have to open the pop up menu by right clicking in the database window and switch on the Enable network item ECG e MON DUR Patients PROCESSING of group DEMO Group report DEMO Get from ARCHIVE Group DEMO to ARCHIVE Enable network v Enable 3D Breath 56 12 3 Working with patients files The following commands are used to operate patients files Patien
40. central and independent contours a dynamic series RR is more organized the autocorrelogram damps slowly and value Ik and mO above fig A The prompt initial wane of the Autocorrelation function with the subsequent slow sig nal attenuation testifies to presence of confronting influences of an independent and central contour on a heart rhythm fig B 34 1 0 590 m0 35 C Pathologic regulation 4 VR indices tion 5 Semaphore This diagram shows normalized values of the integral indices of a vegetative regula regulation level regulation resources Colors of the semaphore correspond to different levels of vegetative nervous system Normal vegetative regulation High function resources Moderate strain of the veget ative regulation system Normal functional resources Hard strain of the vegetative regulation system Low func tional resources Malfunction of the vegetative regulation system Too low functional resources Functional malfunctions of the vegetative regulation No functional resources Minimal or optimal exertion of regulation systems Good organism s adaptation to the environmental conditions State of a physical strain manifested by mobilization of
41. cscccccsececccecccccececssseeeeoo 30 LENS DLL PNE RUIN M c R 32 9 1 Variation analysis 32 9 2 Neurody namic analy SiS eio ee oS ER PII SR RO I VENUE 37 9 3 Charting of prain biorhythms ois pui ERIS YE ET EUR YEETESEREN E IURIS AFFERT ees 40 9 4 Fractal analysis of the organism s biorhythms cce e eee eee eee eee eese eese eee ees eese e esee esses ss eaae ee esee eee 43 DE NUM cse bou ERE 44 SUI TEES IIO 45 PROC OF EET 45 10 AAI mee 47 11 CONTROLLED RESPIRATION IN THE BILOGICAL FEEDBACK MODE 48 12 WORKING WITH DATABASE reves 49 12i Win OW REM UAR URN VERA a AP NUNG 49 12 2 withi TOUDS 50 Sg igo a NEW OrOUD RR 50 col EM I E 51 A E 51 pug gis 52 mE CI IM TS aE 52 12 2 6 Into Archive From Archive obi otis ibd uso
42. e clicking the image area in the upper right corner of the window Then just browse for the file containing patient s photo BMP JPG and GIF formats are supported ESE a SERM After filling in all required fields press OK and confirm entered information by pressing Yes in the dialog window The string with the patient s name will appear on the database pane 12 3 3 Editing Data Click right mouse button on a patient s name to open a pop up menu Choose Patients gt Edit TIME DUR 1 28 03 2007 15 55 20 03 22 2 30 032007 12 22 53 01 42 3 30032007 12 29 33 0455 gt Patients ERU PROCESSING patient Smith J F ca araup report Move EM EET EU Delete rj A gel Get from ARCHIVE EJ zm E EA Patient Smith J F to ARCHIVE i553 di Enable network vs Enable 3D Breath The window Modify patient information will appear Modify patient information Out patient observations Computer observations Conclusion Individual card Diagnoses Observations tool Advices of the experts Patient information chart N Last name Firstname John Middle name DOB Cp 28 02 2007 Sex Male 0 years HOME ADRESS City District Street
43. e recording by pressing the RECORD button Attention If a patient has obviously expressed violations of a cardiac rhythm such as extrasystole and differ ent sorts of arrhythmias the calculation of metrics of a functional state will be yielded incorrectly Estimation of the functional state metrics and processing an ECG in all modes can be done only if the patient does not have any violations of a cardiac rhythm See 6 3 7 7 If the patient s blood pressure was measured before the ECG registration it can be entered in the conform ing window in the right bottom corner of the window L9 values Use Tab key to switch between fields Click on the field to enter the 8 You can leave any comments during the recording Click mouse button on the comment string to edit it 47 9 The following dialog box will appear after finishing the recording OMEGA M2 ECG Monitoring m Press Yes to save the record ave Fecord 10 Press EXIT to close the window Note to quit before the end of recording you have to press RECORD and START buttons sequentially and the press EXIT 11 After closing the Monitoring window the right part of the display will contain the string with the number date and duration of the saved record 10 2 Analysis This mode is intended for processing data recorded during the ECG registration in the Monitoring mode It can also process records imported from the Aelita system
44. e the rhythmogram the RR intervals counter resides This counter shows the total amount of RR intervals recorded amount of clear RR intervals amount of RR intervals filtered with 1st and 2nd level filters 2 The Spectrogram window The spectral analysis is based on a physical transformation of the heart rhythm oscillations of the simple har monic oscillations with various frequencies Thus the sequence of cardiac cuttings is conversed to a spectrum of power of oscillations of duration of RR intervals RR frequencies representing sequences describing dynamics of heart rhythms to each of which there corresponds particular density amplitude of oscillations As measure of an estimate the area restricted curve of spectral power relevant to some particular frequency band is used C Predominance of cerebral ergotropic and or humoral metabolic influences 3 The Autocorrelation function window Click amp button to activate this function The autocorrelation function diagram is built according to the values of a series of correlation factors between an initial dynamic series of RR intervals and new series obtained at se quential biases on one value The steepness of wane of an autocorrelogram can be determined on value of a correlation factor after the first detrusion Ik Besides the exponent Mo is entered which displays through how much of detrusions there is a first negative value of a correlation factor At strong connection between
45. earched using different system analysis methods The Self Regulation window This indicator shows the normalized value of the self regulation index It represents the Vegetative Homeostasis the organism s ability to adapt to the environmental conditions The Functional State window This indicator shows the normalized value of the current functional index The first value is shown after 60 counts from start of the recording and is updated every 10 counts Double click left mouse button upon the histogram graph as to open this window Colored graphs represent changes of See current indices of physical state during the recording 7 process The abscissa axis shows numbers of RR intervals The first value is shown after 60 counts from a a a start of the recording and is updated every 10 counts 100 150 200 250 6 You have to control quality of the ECG signal periodically If any noises noticed stop the record by pressing the RECORD button figure out the reason of noises press the CLEAR button to reset the record and repeat record by pressing RECORD button The duration of record is controlled by the number or RR intervals indicator which is upon the Rhythmogram window 12871 the first value is the number of recorded RR intervals the second value is the number of artifacts The record will stop automatically after 300 clear RR intervals You can interrupt th
46. ed archive file C NDINAMIKA MEDICINE2 Archive by default and press OK All operations listed above copying moving deleting processing export import archive operations can be applied on several patients at once All you need is to select several patients Selecting multiple items can be done by the following means moving mouse pointer across the patients list with holding left mouse button pressed clicking left mouse button with pressed Ctrl key on the keyboard using cursor keys v PgUp PgDn with pressed Shift key Names of selected patients will be colored yellow 63 12 4 Working with ECG Records Click left mouse button to select patient s name The right pane of the database window will represent the list of ECG registrations of the selected patient sorted by the observation date ascending LOCAL TIME DUR RR PS COMMENT 4 amp DEMO Q 1 31 07 2006 20 50 42 03 22 2976 2 31 072006 21 15 30 03 36 29406 XD no ees 3 31 07 2006 21 30 26 03 55 29109 XP M 4 ndareva E 5 04 08 2006 19 52 47 03 13 29604 P Volodchenkova N Volosova E V The record string includes number of a record date and time of observation duration of a record number rec orded of cardio cycles and number of artifacts The FS column represents the level of functional state visually Comments are given in the right part of the string Records that were not processed are colored ligh
47. ee 7 1 4 1 5 Press RECORD to start recording The PREPARE mode will start and after 5 seconds of countdown the RECORD mode will begin working All diagrams will be regenerated Hystogram 04 06 08 10 12 14 16s 0 45 O8s 085 1 05 12s dfsfsdfs age 0 now 28 03 2007 15 49 49 Patient Smith John 100 125 150 175 200 225 250 275 300 BCS racorsdins 01 13 RECORD PQRST chart 3 108 0 RESET Scatterogram Functional state HELP 0 85 aet EXIT nds 41 859 LA 23 The ECG window Time from the beginning of the record in minutes and seconds is shown along the abscissa axis The axis of ordinates represents amplitude of ECG Vertical lines are marking extracted R peaks By default the scale of ECG is 25 mm sec To change the scale to 12 5 25 mm 50 please use the SCALE button Use mouse to drag the graph along vertical and horizontal axes The Rhythmogram window This window shows the dependence of the RR interval duration from the number of the evaluation cycle The artifacts are marked with red color Along the abscissa axis the numbers of the evaluation cycles are shown The time in seconds is along the ordinate axis Rhyth mogram can be represented in two modes 300 and 100 cycles The button 100 300 is used to switch between these modes The PQRST window This
48. eft part of the window and choose the Groups gt New item in the pop up menu REL PSCR 1 DYN VAR pal EEG IFAB ECG eMON e FB or EOE croups SM TIME 171 Patients Edi EIU TI Ip C Delete PROCESSING of BASE z t j Group report j d Get From ARCHIVE ng Put BASE to ARCHIVE T an and Enable network w Enable 3D Breath ey or Rar 2 Fill the New Group form and press OK Notes is an optional field Add new group Name DEMO Note demo group 3 The new group will appear in the left part of the window _ DATE TIME DUR Buntes 1 18 5 3 Adding a Patient into the Database 1 Click on the name of the group name to select a group Right clock to open a pop up menu then select Pa 5 gt New Group report DEMO Set From 4RCHIVE Group DEMO to ARCHIVE p Enable network w Enable 3D Breath 2 Fill the Add a new patient form Add new patient Individual card Patient information chart Nz Last name Smith First name John Middle name DOB Nr 16 03 2007 Sex Male 0 years HOME ADRESS City SamPetebua gt District Street Moskovskoe sh House 10 3 Apt 45 Workplace Growth 180 H Phone Weight Note Group bema
49. ent s name to open a pop up menu choose Patients into archive to complete the operation 1 28 03 2002 2 30 03 2007 3 3nn3 2002 T Groups Patients H PROCESSING patient Smith 2 F Sek From ARCHIVE Patient Smith J to ARCHIVE Enable network w Enable 30 Breath TIME 15 55 20 03 22 12 22 53 01 42 12 29 33 04 55 The New Archive windows enter the name of new archive and in Path field choose the folder where new archive should reside Press OK to create new archive Creation of ARCHIVE Location C OMEGA M2_Archive fan to one User size in Kb Tom size Cancel The default values of NAME and PATH are ARCH_ lt date gt _ lt time gt and C DINAMIKA MEDICINE2_ Archive You can split the archive into 1 44Mb volumes in order to copy it on 3 5 diskettes To extract the patient from archive do the following click left mouse button on the group string to open a pop up menu choose From archive to complete the operation DATE 1 28 03 200 2 30 03 2007 2n Groups Patients Ld Beeren rnnt PROCESSING patient Smith 7 From ARCHIVE Patient Smith J F to ARCHIVE Enable network w Enable 3D Breath TIME 15 55 20 03 22 12 22 53 01 42 12 29 33 04 55 Choose the folder that contains the desir
50. er it is recommended to use ground connection Also the printer connected via USB interface can be the origin of hum To avoid the noise it is recommended to disconnect printer from the computer while recording the ECG 3 2 Technical Features Input voltage range avec r E 0 03 5 mV Input impedance mot less MOON VIVIDE M RE Sua dud on ra Internal noise level not more 9 10 mkV Attenuation factor of co phased signals on 50 Hz frequency not less sss 110 dB Direct current in a chain of the patient not more 0 1 MKA sis o M UG gt SEAUOM Gly value of UME rm 3 2 sec Sampling 2 2 LOOO AZ N nmber or discharges OF GQUANUZALION iri REIR eaaa 12 Transmission rate on a sequential data link RS232C 38 Kbod Independent power supply voltage a 5V Time of continuous operation without recharging a nnn n n 20 hrs 3 3 Requirements for a PC Recommended configuration CPU Intel Celeron M 1 7 RAM 1024 M6 Free disk space ov
51. er 200 M6 Operating system Windows XP Windows Vista Display Adapter ATI Radeon 9000 nVidia GeForce 5200 Any windows compatible printer device can be used for printing the results of an observation 3 4 Warranty Statement The warranty operational period is 36 months from installation All warranty operations will be held in compa ny s Service Center in Saint Petersburg Russia Within the warranty period in case of the system s malfunc tion the Company provides a free replacement of the system either in part or in whole in conformity with the delivery set checklist The Company will adapt the software to the Customer s working conditions During the applicable warranty pe riod the Company will inform Customer of the upgraded software versions and in case of interest the Compa ny will install them at a lower price 10 4 GETTING STARTED 4 1 Software installation 1 Turn the PC on 2 Insert the software CD 3 Installation of the software will begin automatically if it has not occured start installation manually by means of file Setup exe 4 In the Welcome window press the Next button to begin the installation OMEGA M2 Welcome to OMEGA M2 Setup program This program will install OMEGA M2 on your computer It is strongly recommended that you exit all Windows programs before running this Setup Program Click Cancel to quit Setup and close any programs you have running Click Next to co
52. es sary at holding survey of the sportsmen Namely it is necessary to expand boundary of norm to those in a state of a moderate vagotonia at the not trained people At the same time values close to moderate sympa thonia will speak about the expressed infringement of system of a regulation of heart rhythm and drop of a re serve of acclimatization at the given sportsman 37 9 2 Neurodynamic analysis Click left mouse button to select a patient s EGC record in the right part of the window The selected record will be colored yellow Press NDA button to run the Neurodynamic Analysis module COMMENT C1 Hystogram of codes Energy pyramid ys yz ys pes es pes s e e ys e ys es e s 799919717171 5 5 5 5 5 5 4 AREER Patient Smith John dfsfsdfs sex male age 0 observation date 28 03 2007 15 55 2 1 The Wave frame of an EGC signal window allows estimating visually the variability of different rhythms from the PQRST complex In the upper left corner the Golden Section parameter is shown which is a re lation of the duration of the whole complex to the period of the cardio signal The Golden Section parame ter can vary from 0 to 0 62 Its normal value is more than 0 15 In pathology this value never exceeds 0 01 2 The Neurodynamic Matrix window characterizes the information inte
53. es every 10 intervals 24 The Dynamics of indices of functional state window Click the amp button to open this window Colored graphs represent changes of current indices of physical state during the recording process M B c Health The abscissa axis shows numbers of RR intervals from 50 to 300 The first value of the index appears after 60 inter vals of record and updates every 10 intervals The first value of the index appears after 60 intervals of record and updates every 10 intervals level of acclimatization of cardiovascular system index of a vegetative regulation index of a central regulation D psycho emotional state H ealth integral index of a functional state 6 You have to control quality of the ECG signal periodically If any noises noticed stop the record by pressing the RECORD button figure out the reason of noises press the CLEAR button to reset the record and repeat record by pressing RECORD button The duration of record is controlled by the number or RR intervals indicator which is upon the Rhythmogram window t 128 1 the first value is the number of recorded RR intervals the second value is the number of artifacts The record will stop automatically after 300 clear RR intervals You can interrupt the recording by pressing the RECORD button Attention If a patient has obviously expressed violations of a cardiac rhythm such as extrasystole and dif
54. f work press OK if your computer is connected to the Internet you can be registered having pressed the button Register by E mail 4 Registration Complete 14 4 3 Plugging the Remote Module 1 Connect electrodes to the lead cable and fix them using screws 2 Connect the blood pressure cuff to the remote module 3 Plug the interface cable to the USB port Connect the cable and the remote module 4 Complex is ready to work 4 3 1 Installation the USB device drivers After the connection of the remote module to the computer is done the new device will be detected and new devices installing master will run 1 In appeared window check Installation from current place and push Next button USB High Speed Serial Converter c lt gt 15 2 In the next window u
55. fer ent sorts of arrhythmias the calculation of metrics of a functional state will be yielded incorrectly Estimation of the functional state metrics and processing an ECG in all modes can be done only if the patient does not have any violations of a cardiac rhythm Typical view of the Rhytmogram Histogram and Scatterogram windows when the patient has cardiac rhythm violations are shown on the pictures below Fibrillation Doubled rhythm 7 If the patient s blood pressure was measured before the ECG it can be entered in the conform ing window in the right bottom corner of the window Click on the field to enter the values Use Tab key to switch between fields 8 You can leave any comments during the recording Click mouse button on the comment string to edit it 25 9 The following dialog box will appear after finishing the recording OMEGA M2 ECG Recording Press Yes to save the record Save record 10 Press EXIT to close the window Note to quit before the end of recording you have to press RECORD and START buttons sequentially and the press EXIT 11 After closing the ECG Registration window the right part of the display will contain the string with the number date and duration of the saved record SCL SCR DYN VAR NDA SEG is B cG eMoN eBFB 127276 LA AL DATE TIME DUR RR PS COMMENT ax ae e EE 2 WD mamic
56. g sound signal means the end of measuring All air will be released from the cuff automatically The dis play will show values of the arterial pressure and pulse 2 Press the 0 1 MEMORY to switch the device off otherwise it will be powered down automatically after 5 minutes 3 Most frequent user errors Please take into account that all measuring should be done in the same conditions As usual blood pressure measuring is carried out in a spacehold Every gain of a patient i e horn on an arm may cause the blood pressure to increase Make sure that the pa tient s body is relaxed especially the used arm Incorrectly placed cuff may cause the incorrect measures To avoid incorrect results please make a 1 minute pause between two measuring 4 Using the memory functions The device can keep the results of last measuring in its memory Press and hold for 3 seconds the 0 1 MEMO RY button to view these results on a display 5 Stop the measuring If it is required to stop the measuring i e it s causing pain to a patient just press the 0 1 MEMORY button The device will be switched off and all air will be released 21 6 3 ECG Recording 1 Click to select a patient on the left panel The selected patient s name will be colored yellow Press the REC button to start recording the ECG T a Fm amp B Ir Zr a TAR amm amr a i mm e p
57. g to different states of the organism are shown in the picture below i ns DORA DOSA DO SA DOA Da DOA DOA D D D D D A A OTHER Mee E uuu 29117111 nmm mnnn num Soccer Perr 4 44 444444444444444444444494444 4 4444444444444444444 13444 mummuuuuEuEEEENEEENENEEE n Mi FTT TATS T Cri Cri Optimal energy Lowered energy Signs of emacia balance resources tion Emaciation 5 The CR Diagram window This diagram represents the normalized values of integral indices of the central regu lation compensation level compensation resources 39 6 The Conclusion window In the upper part of the window you can see the relations between the Codes with normal structure 150 1001 neurodynamical codes and normal changed or broken structure Rees wae medior normal limits are shown in the brackets The indices of the power resources are shown in the middle part of the IE e window The integral indices of the central regulation are below All nergy balance Energy exchange values are normalized and shown in per cents Normal values are Energy restoring 50 300 Energy spending 150 300 shown In brackets C1 compensation level 0 6 1 0 C2 compensation reserves 0 6 1 0 THE CENTRAL REGULATION MECHANISMS ARE NORMAL THE REGULATION A
58. hange and the countdown of recorded cardio intervals in each channel will start 6 The quality of the recorded signal should be controlled periodically during the ECG recording process In case of noise in most of the channels simultaneously it s recommended to stop recording by pressing the button 4 again The recording will be stopped for all channels Restart the recording after eliminating the reasons of noise If noise is detected only in some channels it s recommended to wait until the end of recording in other channels PULSE nc Duration of the recording is controlled according to the counter of RR intervals the first number represents the total number of recorded intervals the second number RR 008 000 number of artifacts Recording will be stopped automatically upon achieving of 300 clean RR intervals 7 Duration of recording may vary for different channels Depending on the patient s pulse rate it can take from 3 to 6 min to reach 300 cardio intervals After finishing the recording of the last channel the following window will be displayed Record is successfully completed For patients Bondareva Press Yes to save recorded signals From the very beginning and to the end of recording process all patients should stay on their places and should not disturb each other Caution If a patient has a fibrillation or pronounced extrasystole the estimation of functional indices will be done incorrectly Es
59. ick on the just made ECG record to select it and press BFB to run the Controlled Respiration program 3 Breathe according the rhythm and the amplitude of the breathing sphere keeping all pauses precise ly The depth of respiration must correspond to the size of the sphere the sphere is bigger the inspi ration is deeper the sphere is smaller the expiration is more completely The duration of this session is about 5 minutes Caution Each patient have to breathe according to his own unique breathing sphere which is cal culated based on the ECG recorded exactly before the breathing session The respiration controlled by another s sphere or by sphere recorded earlier is strongly prohibited Note to change the display mode of the sphere you have to right click in the left database pane and switch on off the Enable 3D Breath item DATE TIME DUR mS 28 03 2007 B 5 55 20 03 22 Patients 30 03 2007 12 22 53 01 42 0 03 2007 12 29 33 04 55 3 04 2007 13 49 42 03 51 Group report Get From ARCHIVE Put BASE to ARCHIVE Enable network Left part of the window will display the list of groups of patients 12 WORKING WITH DATABASE s Bondareva E l p Konashkova V El P V Emar ozubenko V M aksimova V F Miheeva T S ji Novik L M Prohorenkov S V Prohorenkov B S Sorokina N E Timoshenko T M olives Mites RS 1 aU f ad d un
60. ient or create a new patient with the name entered in the field below Press OK when done 61 12 3 5 Deleting Click right mouse button on a patient s name to open a pop up menu Choose Patients gt Delete Patients PROCESSING patient Smith J Group report Get From Patient Smith J F to ARCHIVE Enable network Erit v Enable 3D Breath c Confirm the operation by pressing Yes in the Caution dialog Note All operations listed above can be done using keyboard Ins create new group Enter edit Del delete 12 3 6 PROCESSING You have to implement the pre processing of a patient s records after importing the data from the archive Se lect the patient by left clicking on his name and open the pop up menu with the right click Choose the item PROCESSING Patient lt patient name gt Groups Patients PROCESSING patient Smith 2 Rae i Group report Get From ARCHIVE Patient Smith J F to ARCHIVE Enable network w Enable 3D Breath After finishing of the processing all data will be available for any system analysis mode 62 12 3 7 Into Archive From Archive The Into archive From Archive operations are used to store data or to transfer it to another PC To add a group to the archive please do the following click right mouse button on the pati
61. ioreverberatory therapy etc The only limiting factor is the condition of ainesia of the patient during a monitoring 10 1 Recording 1 Left click mouse button on the patient s name in the left window to select a patient The patient s name will be colored yellow Press the MON button to run the Monitoring program 3 The START button The ECG signal will appear in the upper window If no signal appears see TroubleShooting 4 You have to achieve the steady signal before staring the recording There must be clear R peaks marked with vertical markers See 6 3 4 5 Press the RECORD button to start recording The mode selecting dialog will appear Record Select record mode Record ECG 300 RR 46 The Monitoring mode is intended for permanent ECG registration Only values of RR intervals are recorded the Rhythmogram The cardio signal will not be saved Use the special program Analysis to process results of recording You can also place special markers to distinguish beginning and end of different procedures Press the PAUSE button to stop recording temporary Press it again to proceed recording Duration of the Analysis program has no limitations The ECG Recording 300 RR mode the ECG registration is also permanent and the signal is saved in blocks of 300 RR intervals which allows recording several consequent blocks one after another Then record ed data can be res
62. ministrator rights For this purpose click the right mouse but ton on a program icon in the desktop and in the appeared menu choose Property item Further in the opened window first choose a Shortcut tab and then press button Advanced Check the item Run as Administrator in the appeared window and press button OK Open locaton r 23 Crepain cor g iing Cater TP Pre OW igen B apana B scare a n aL un a apaia DU rst a mad This option allows you to run this shortcutasan administrator while protecting your computer from s DHNAMI1MEL Nomad window Restore previous versions fend i L Open Bie Location Change icon Advanced Shartcut Drkat Pranic Now you can go to 4 2 2 Note Another way and also for more comfortable work in Windows Vista it is possible to turn off the User Account Control UAC For that press a combination of WinKey R in the and type msconfig in the appeared window In the opened window System Configuration press the Tools tab choose the Disable User Account Control list item press the Start button and restart the Window
63. n and to correct psycho emotional state of a patient Printed report of the observation can be completed with a patient s photo in case of using a digital camera Independent power supply allows examining patients in any environment and conditions 1 5 What s new in current version New type of the remote module of signal registration was developed for the Dinamika Medicine complex It is supplied with embedded blood pressure measurer A new photon coupled cable is used for transmitting an ECG signal New model distinguishes improved noise stability high quality of a registered signal reliability in maintenance longer session of continuous work At development of the software the experience of five years operation of system in medical establishments of Russia and abroad and wishes and notes of the users was taken into account Software of the Dinamika Medicine complex is designed for Windows 98 and uses all capabilities of modern operation system Modules of real time monitoring biological feedback screening and diagnostics 12 leads ECG registration and analysis were developed for the new version The electronic medical card file of the patient ensuring an intrusion in medicine of paperless technology was designed A specially designed converter program provides usage the medical database of the previous versions The system designers will appreciate any comments and recommendations on the software
64. ncheck Search on the portable sources and check Search in the following folder Press Browse button and choose D Drivers Omega5 drv directory then press Next button Pea tant Y C D DriversNO drv He Windows 3 In the Device installation notifying window press
65. nctions of an organism the level of phase portrait saturation decreases rapid ly 2 Frequency spectrum The spectral power is calculated for gamut a delta theta alpha betal and beta2 rhythms delta theta alpha betal betaz delta theta alpha betal beta delta theta alpha betal betaz Hyper activity Normal activity Hypo activity 41 3 Spline maps are two dimensional representations of the central nervous system biorhythms in the functional Spaces of the brain and characterize integral activity of central nervous system in these spaces The brain functional spaces are formed discreetly in the periodically repeated spans of time and are built in the brain cel lular structure by the neuron ensembles which are activated at the moments defined by the periods of their refractivity The spline map is built on results of an interpolation of the amplitude values of common brain rhythms compared to each other These maps are templates of probabilities of shifting of basic rhythms in brain s space The following figure represents the topographic map of the shifting template which shows the probabilities of shifting of basic rhythms Del Tetta Alpha Beta 59 69 2 DEED Topographic map of the shifting template The charting mode is intended for monitoring and virtual visualization on the screen of the maps with power spectrums of the brain biorhythms The set of spline cards completes the
66. ne of the following rea SONS 1 The selected device type is incorrect 2 AC power noise 3 Incorrect AC frequency is used t IS incorrec type ice The selected devi 1 1 16 If a wrong device type is selected the signal looks like the following To solve this problem please double click in the upper part ECG Recording window in the caption area je 1 E A 322021 In the Configuration window select the device OMEGA 7 1 PnP USB and press OK c a 10 c u n en Selected device OMEGA 7 1 USB B OMEGA 2 2 OMEGA 5 1 LISBA CDM IMEGA 7 1 PrP U Device sound Configuration AC Frequency T 50 Hz 69 16 1 2 AC power noise If there are noises in power network the signal is as follows This problem occurs mostly when using a notebook plugged to an AC power To solve the problem it s recom mended to unplug the notebook from the AC power supply and continue the ECG recording using notebook s built in batteries Note If the problem occurs while using a desktop PC it s recommended to plug a PC through an AC filter or an UPS 16 1 3 Incorrect AC frequency is used If the AC frequency is incorrect the signal is as follows To solve this problem please double click in the upper part ECG Recording window in the caption area Selected pork COM 1 Selected device OME
67. noise in the signal too much artifacts or extrasyslies This program allows placing R peaks markers manually It can be started from the pop up menu of the selected record Volodchenkovy V age 38 inspection date 04 08 2006 19 30 43 2 ECG Editor File Calculate Edit Zoom Help X Q Q Q Move graph Add label Delete label ZoomECG 25 ZoomECGSO Zoom 100 Reset mm s mms mmjs 2 300 Clear 297 Filter 1 0 Filter Vitta 3 Ready The edition of the ECG record is as follow Click right mouse button on the part of rhythmogram colored red The upper window will display the part of ECG needed to be corrected Drag incorrect markers to the exact maximum on the nearest R peak You can also add markers by pressing Add Marker if required Press Delete Marker to erase the incorrect marker Move to the next red part of the rhythmogram and repeat the above operations You can use Move Diagram and Scale buttons Save the record and close the window when done 14 COMPLEX PRINT The Complex print program is intended for forming the complete observation card of a patient and printing via any printing device Click left mouse button to select a patient in the left pane of the database window The selected patient will be colored yellow If a patient has several records in the right pane select all of them in order to observe the dy namics of his indices The observation card will be
68. ntinue with the Setup program WARNING This program is protected by copyright law and international treaties Unauthorized reproduction or distribution of this program or any portion of it may result in severe civil and criminal penalties and will be prosecuted to the maximum extent possible under law 5 Select Destination Location J3 OMEGA M2 Destination Location Setup will install OMEGA M2 in the following folder To install into a different folder click Browse and select another folder You can choose not to install OMEGA M2 by clicking Cancel to exit Setup Destination Folder C Program Files Dinamika Omega M2 En Browse 6 Select Program Manager Group J3 2 Select Program Manager Group Enter the name of the Program Manager group to add OMEGA M2 icons to Dinamika Lab DAEMON Tools Exclusive G ames Internet Office Wise Solutions A4T ech 7 Press the Next button to start installation J3 2 Start Installation You are now ready to install OMEGA M2 Click the Next button to begin the installation or the Back button to reenter the installation information Cancel 12 4 2 Preparation for the first start and the first start 4 2 1 For Windows Vista Users The program should be started with the ad
69. on of maximum and minimum values of the RR intervals width of the histogram basement VTA is a para sympathetic index As it is higher the valal influ ence on a heart rhythm is more expressed The normal values of the VTA are from 0 15 to 0 45 HRV index is calculated upon a histogram built with 8 ms interval by division of the total number of analyzed RR intervals to frequency of occurrence of RR intervals relevant to a Moda 36 Spectrum analysis HF High Frequency 0 15 0 40 Hz Oscillations in the above frequency band are built by the para sympathetic department of the vegetative nervous system The power in this frequency band is incremented during respiration with particular frequency and depth at cold influences Sportsmen and well trained people have higher power of HF than others Their HF power is much more than low frequency power Decreasing of this power means stain of the regulation heart systems means over training though its excessive magnifica tion speaks about danger of infringement of a sinoatrial rate Low Frequency LF 0 04 0 15 Hz The physiological interpretation of this index is ambiguous It is consi dered that power in this frequency band is influenced by change of tone para sympathetic and sympathetic departments of nervous system The relation between sympathetic and para sympathetic influences is reflected by LF HF relation When tone of a sympathetic department increases this index increases rapidl
70. ow simultaneously The selected record is marked red Moving along the graph can be done using cur sor keys Home End PgUp PgDn keys or using mouse 14 dJe 99 5 The Health calendar and Health clock windows June 2006 July 2006 August 2006 September 2006 forecast 2990 Tu Fr 5a Su Tu Fr 5a Su Tu we Th Fr 5a Tu we Th Fr Sa Su 20 2 l a a d 2 1 2 385 6 anra 19 5 a e p E 3 10 1 a 4 5 b uw E E S 10 1 5 6 7 8 9 10 9 o5 12 13 14 15 16 17 18 10 11 12 13 14 15 16 14 15 16 17 18 13 20 Vee 11 16 1617 19 20 21 22 23 24 25 12 18 13 20 21 22 23 2 22 23 24 25 26 ay 18 13 20 21 22 23 24 1 9 4 26 27 28 29 30 Jp 25 26 27 28 29 3l eo 29 30 31 25 26 2f 20 29 3 oq These windows can be activated by pressing the CALENDAR button Color marked dates on the calendar and time on the clock represent date and time of observations The color corresponds to the health level Digital value in the center of the clock shows the average value of the integral index of the functional state By scrol ling calendar to the left one can see the history of observations and by scrolling to the right forecast for the next month 6 EXPORT This function allows to export all calculated indices to an Excel xls file 7 Click EXIT button or hit ESC key to close the window 32 9 SYSTEM ANALYSIS System analysis includes four stages 1 Varia
71. protective me chanisms Raise of activity of the sympatho adrenal system and the pituitary bodies paranephroses system Overstrain Lack of adaptation and protective mechanisms Disability to provide optimum proper response of an organism to action of envi ronmental factors Malfunction of the adaptation mechanisms Attrition of the regulation mechanisms Predominance of the non specific changes Premorbidal state with prevailing of particular changes 35 6 The Conclusion window Indices of a heart activity are shown in the upper part of Pulse rate 89 60 90 the window These indices are calculated using standard Yegetative balance parameter 156 0 PIF gt 745 Rhythm vegetative factor 0 35 10 25 0 61 methods of the variation analysis of the heart rhythms Regulation processes adequacy parameter 54 4 15 50 N f h h h h Tension parameter 121 9 10 100 orma Values o eac parameter are snown to t e rg t and a text conclusion regarding current state is shown be low Coefficient of vegetative equilibrium AMo AX shows rela Regulation level B1 58 60 100 tion between activity of the sympathetic and Regulation reserves B2 66 60 100 i sympathetic departments of vegetative nervous system THE SYSTEMS OF VEGETATIVE REGULATION ARE IN THE STATE OF OVER TENSION Index of adequacy of processes of a regulation AMo Mo 2 reflects correspondence between activity of
72. raction between the heart rhythms Separate matrix elements correspond to different neurodynamic code exposition windows The color of an ele ment defines the failure degree of the code structure The twelve grades of the color scale correspond to differ ent degrees of the code structure failure ranging from pathologic to optimal Norm Norm Hyper Activity Hypo activity Functional disorders Pre illness state 38 3 The Codes Histogram window represents the distribution of neurodynamic codes according to the degree of their structural failure In the red field there are codes with defective structure in the yellow field there are codes with modified structure in the green area are the codes whose structure corresponds to the normal functioning of the body Norm Norm Hyper Activity Hypo activity Functional disorders Pre illness state 4 The Energy Pyramid window the dynamic display of the energy balance in different control systems of the body The correlation between the right and left parts of the pyramid characterizes the dynamics of anabolic and catabolic processes the left part corresponds to the accumulation period while the right one corresponds to the consumption period by different organs and systems of the organism The energy pyramid is characte rized by the following indices the anabolism index the energetic resource the energetic balance the catabol ism index Examples of energy pyramids correspondin
73. rvation over parameters of the functional condition of a patient during therapeutic treatment selecting schemes and optimization of the different methods of treatment multi functional monitoring in surgeries resuscitations and intensive care chambers monitoring and forecast of the functional condition parameters during an aftertreatment O Polyclinics centers of preventive medicine studies of functional diagnostics private medical studies express diagnostics of the functional and psychophysical condition of a patient with printing of a computer report by results of survey detection of the patients requiring for additional clinical survey at the doctors in profile medical establish ments detection of the patients of an oncology types including at early stages of disease evaluation of effectiveness of traditional and non conventional methods of therapy during a treatment O The specialized medical departments of atomic stations airlines police banks etc selecting the staff for operating work with completing a personal database of physiological parameters screening and diagnostics during medical observations of staff monitoring and forecast of a psychophysical condition of operators dispatchers pilots drivers and other persons in requirements of a nervous emotional strain and monotonic work individual choice of optimum agents of regeneration at overwork and chronic overstrain vitamin balance normalization of
74. s After switching off of the User Account Control you can go to 4 2 2 Remember that the given action lowers safety of your computer Lj System Configuration General Boot services Startup Tools Tool Name Description a Type the name of a program folder document or Internet Met Quis resource and Windows will open it for you Internet Protocol Configurat View and configure network address settings Performance Monitor Monitor the reliability and performance of local or remote computers Task Manager View details about programs and processes running on your computer Enable UAC Enable User Account Control requires reboot Command Prompt Open a command prompt window Registry Editor Make changes to the Windows registry HE Selected command C Windows System32 cmd exe k windir System32 yeg exe ADD HKLM SOFTWARE Microsoft Windows 13 4 2 2 First start Dinamika Medicine software 1 Double click on the Dinamika Medicine icon on your desktop to run the program 2 Fill the registration form Name User Company Dinamika This data will be used for print To open this window later double click left mouse button in the top of main window area If your computer is connected to the internet please register by e mail Register by E mail DK 3 For continuation o
75. screening mode to estimate a level and reserves of a cardiovascular vegetative and central regula tion and to evaluate deflections of these parameters from normal values to estimate a level of indemnification and power resources of an organism at various levels of a regulation in the biological feedback mode to estimate capabilities of the self regulation to evaluate and forecast psycho physical condition of a patient in the dynamical monitoring mode to monitor a functional condition of the patient and to estimate the effec tiveness of various methods of therapy at realization of treatment and prophylactic measures to create a medical report and give necessary recommendations as the results of a computer aided analysis The Dinamika Medicine system helps doctors of any field of medicine to monitor all parameters of the func tional condition of a patient to predict their changes to estimate the organism s resources and to evaluate the effectiveness of the treatment In cooperation traditional and non traditional therapy the hardware software complex Dinamika Medicine allows to create the unique diagnostically therapeutic mini studies with the com pleted cycle diagnostics therapy monitoring forecast in various environmental conditions 1 2 Application areas O The profile medical research institutes hospitals private clinics first aid posts of the industrial enterprises and establishments dynamic obse
76. sponding to different harmonization degrees of the biorhythms ranging from the maximum window to the minimum window 8 The harmony of biorhythms at all levels of control testifies to high energetic resources and an optimal energy balance windows x 2 A partial disharmony in biorhythms at certain control levels is seen in fractal portraits 4 decrease of energy resources and changes energy balance are characterized by the bio rhythms dishar mony windows lel A complete emaciation of energy resources is shown in the fractal portraits of windows 8 If the fractal index is more than integral index in the express diagnostics mode then the health stat will im prove otherwise it will be worse 44 9 4 1 Biological age Biological age is calculated by results of formation gerontological rhythm which is under construction a method of transposing of the measured functional condition 100 50 45 10 MONITORING This mode is intended for ECG registration and real time monitoring of the functional indices Such monitoring can be very helpful for the express control of patient s condition in the following cases evaluation of the anesthesia depth evaluation of the effectiveness and dosage of physiotherapeutic procedures express control of any kind of non traditional therapies stylostixis b
77. t s hands should be relaxed and still Bad contact between an electrode and pa tient s skin moisten patient s skin and wash electrode s contact pad There is no contact between electrodes and a remote module Check the connection ca ble Decoding file is missing Copy the file Hard ware id from the CD folder D Dinamika Medicine2 eng Key into the working folder of the software C Program Files Dinamika Dinamica Medicine 76 Note Sometimes if an amplitude of the R peak is low or if the contact between electrode and patient s skin is weak the algorithm of R peaks extraction can generate errors It s recommended to swap the electrode from patient s left wrist to his left foot standard lead 2 see 7 1 4 1 for details oas 337 O 998 _ 7 09 7 11 T1 OMEGA M7 Multichannel ECG Registration Dynamica 4 Click to open a drop down list for selecting a patient s name Connection cables are numbered from 1 to 7 for easy detection which channel is occupied by which patient Select patient s name for each channel being recorded Bondareva The record will not be saved for the channel with no patient selected Konashkova Kozubenco P Y Kazubenko Maksimova Y F 5 To start recording all channels simultaneously press the button Miheeva 5 Novik L M 4 any window The color of displayed signal will c
78. t gray These records have no RR and FS information and can t be analyzed by the system Incorrect records are colored red These are too short records or records with too much noise You have to de lete these records or to edit them by the ECG Editor program 12 leads records are colored green Such records can be analyzed only by the ECG 12 Analysis program Records made by the BOS Monitoring program are colored magenta These records have no source ECG signal and can be analyzed only by the Monitoring Analysis program All other records are colored blue and can be processed by any kind of analysis Use cursor keys PgUp PgDn Home End key or mouse to navigate through the list of records The selected record is colored yellow Press functional buttons in the upper string of the window to run the corresponding analyzing method The Dynamical monitoring and Forecast the DYN button analyzes all selected records To enter a comment select a record and start entering a comment using keyboard Double click or press Enter on a selected record to start the Screening and Diagnostics program Besides running any kind of analyzing method is available from the pop up menu click right mouse button on a record Use the Del key or Delete command from the pop up menu to delete selected record 64 13 ECG EDITOR The ECG Editor program is intended for manual edition of the recorded ECG signal in case of too much
79. t of vegetative equilibrium AMo AX shows relation between idR activity of the sympathetic and para sympathetic departments of vegeta Saca aU RR E tive nervous system Index of adequacy of processes of a regulation AMo Mo reflects cor respondence between activity of a para sympathetic department of ve getative nervous system and leading level of operation of the sinus node Vegetative Index of Rhythm VIR 1 Mo AX allows to evaluate ve getative balance from a point of view of an estimation of activity of an independent contour of a regulation As this activity grows VIR decreas es then the vegetative balance biases to the predominance of the para sympathetic department of the vegetative nervous system Stain Index SI AMo 2 AX Mo of the regulation systems reflects a level of centralization of a control of the heart rhythm The central part of the window is intended for entering the medical conclusion and name of a doctor Click on a field to enter the information This data will be saved and used while printing the report Click left mouse button on any place of the window of hit ECS key to close the window 10 The Print button Pressing the Print buttons completes the full observation report which includes all current elements of win dow Thus it is recommended to choose the interesting ECG fragment scale it place all markers and calculate the PORST complex parameters before starting to print
80. t search Add new patient Edit patient s data Copy Move to other group Delete Processing N Q Ww BR W MN nto archive From archive 12 3 1 Search Patient To find a patient you can look through all groups or use a quick search by the name of a patient To see the list of all patients of a group just click on the symbol near the name of the group double click on the group name Look through the list to find a patient TIME DUR T 10 39 res _ 1 28 38 04 49 6 fre 05 21 To use a quick search just click in the database pane left side of the window and type the name of a patient Use Alt Shift or Ctri Shift to switch between languages Press and hold Shift for capital characters TIME DUR TOTA Kes 5 17 51 40 E E SS m Grama LA 4 r 25 MIN 57 12 3 2 Adding new patient To add new patient to a group do the following click right mouse button on a group s name to open a pop up menu choose Patients gt New DATE TIME DUR Patients PROCESSING of group DEMO Group report DEMO Get From AR CHIVE group DEMO to ARCHIVE 2 Enable network O w Enable 3D Breath Fill in the Adding New Patient form Add new patient Individual card Patient information chart Nz Lastname First name Middle name DOB Sex Male 0 HOME ADRESS City District Street House 0
81. tate for all patients of a group calculated upon the last record of the selected period Note To include information from all records into the report not only the last one please check the AII Records check box Group report Choose the period 10 minutes Phew Cancel 48 hours 24 hours Week m Mat limited 54 12 2 6 Into Archive From Archive gt gt The Into archive From Archive operations are used to store data or to transfer it to another PC To add a group to the archive please do the following click right mouse button on the group s name to open a pop up menu choose Group to archive to complete the operation Patients PROCESSING of group Dynamica Group report Dynamica ek From ARCHIVE A u Group Dynamica to SRCHIVE EJ Enable network w Enable 3D Breath The New Archive windows enter the name on new archive and in the Path field choose the folder where new archive should reside Press OK to create new archive Creation of ARCHIVE Name ARCH 02 04 2007 n Location CAOMEBAMZ Archive Tam size Alto one User size in Kb The default values of NAME and PATH are ARCH_ lt date gt _ lt time gt and C DINAMIKA MEDICINE2 Archive You can split the archive into 1 44Mb volumes in order to copy it on 3 5 diskettes You can add the whole data
82. timation of the functional state indices and the ECG processing in all modes can be carried out only if a patient has no disorders of heart rate 8 To close the Multi channel ECG recording mode just press the button 77 17 4 3 Monitoring recording 1 Select a group of patients in the left pane of the database windows The name of the group will be colored yellow Press the button MON to start multi channel monitoring of the ECG OMEGA M2 Multichannel monitoring Dynamica 2 The window Multi channel monitoring will appear 1 1 00 00 READY Click to open drop down list for selecting a patient s name tion cables are numbered from 1 to 7 for easy detection which channel is occupied by which patient Select patient s name for each channel being recorded The record will not be saved for the channel with no patient selected 3 To start recording all channels simultaneously press the button 4 To pause the recording press 5 To stop recording press once more Recording will be stopped for all channels
83. tion analysis of heart rhythms evaluation of the vegetative regulation indices using methods of statis tic time and spectral analysis of the heart rhythms 2 Neurodynamic analysis evaluation of the central regulation indices and the endocrine system state using the neurodynamic analysis of the organism s biological rhythms 3 Charting of brain biorhythms evaluation of the patient s psycho emotional condition using methods of phase analysis and of brain biorhythms charting 4 Fractal analysis evaluation of the harmonization degree of organism s biorhythms and estimation of the immune status using methods of the fractal analysis 9 1 Variation analysis of heart rhythms Click left mouse button to select a patient s EGC record in the right part of the window The selected record will be colored yellow Press VAR button to run the Variation Analysis module The Variation analysis of heart rhythms window will appear oma p 00 300 299 297 0 0 NC USION 33 1 The Rhythmogram window This window shows the dependence of the RR interval duration from the number of the evaluation cycle The artifacts are marked with red color Along the abscissa axis the numbers of the evaluation cycles are shown The time in seconds is along the ordinate axis Rhythmogram can be 0 50 100 450 200 250 ag represented in two modes 300 and 100 cycles The button 100 300 is used to switch between these modes Abov
84. tion of the central regulation parameters and the endocrine system by the methods of neurodynam ics analysis of the human biological rhythms Estimation of the psycho physical condition o f the patient by the methods of the phase analysis and the brain biorhythms mappings Estimation degree of a harmonization of biorhythms of an organism and evaluation of an information pa rameter of the immune status by the fractal analysis method Controllable psycho physiological therapy the dope effect in the biological feedback mode Sequential 12 leads ECG registration with the visual monitoring of the recording quality Automatic evaluation of the PQRST parameters with the ability of manual correction Giving the complex medical report as the results of computer aided analysis Saving and printing the re sults of survey Individual medical card file of an ambulatory with a built in database on 15000 diagnoses Electronic patients file which can be exported imported and archived 1 4 System features ECG registration at any standard lead during 5 minutes is completely enough to get all necessary information A patient may sit or lay Brain rhythms are extracted from the ECG signal registered in a wide range of frequencies No encephalogram is needed Monitoring of the parameters of the functional condition is implemented exactly during the ECG registration The biological feedback mode is applied to evaluate parameters of self regulatio
85. tional state NORMAL FUNCTIONAL STATE HIGHER ACTIVITY NORMAL FUNCTIONAL STATE INAPPRECIABLE DIVERSIONS OF A FUNCTIONAL STATE FROM A NORMAL STATE IT IS RECOMMENDED TO REPEAT THE OBSERVATION ABNORMAL FUNCTIONAL STATE FURTHER OBSERVATION IS RECOMMENDED PRE ILLNESS STATE SIGNS OF PATHALOGICAL CHANGES CLINICAL OBSERVATION IS STRONGLY RECOMMENDED 29 9 The Conclusion window Indices of a physical state are shown in the upper part of the window EE These parameters were calculated using unique methods of mathematical analysis of human biorhythms All indices are in per cents Computer conclusion is giver for each parameter separately and regarding an or ganism s condition in common 24 hours forecast of changes of level of psycho emotional and physical activity of a patient is given in the bottom part of a window Green levels of psycho emotional and physical activity are high op timal adaptation medium activity levels normal adaptation low activity levels low adaptation Use cursor key PgDn key to switch to the second page use 7 or PgUp to return to the first one Indices of a heart activity are shown on the second page of the window These indices are calculated using standard methods of the variation analysis of the heart rhythms Normal values of each parameter are shown to the right and a text conclusion regarding current state is shown below Coefficien
86. visual analysis of a recorded total bio electric signal of the central nervous system and enables one to evaluate the space changes in the brain bio rhythms activity on 8 maps of power spectrums simultaneously This makes it possible to locate the beginning of the activity growth of any rhythm observe solitary flashes of biorhythms activity generalized in different brain spaces and to analyze the biorhythms power and frequency asymmetry The consecutively completed set of the spline maps corresponds to different functional spaces of the brain and their colors are conditioned by different levels of the electric activity in the brain The color scale of activity is given on the right hand side of the window 9 Hyper Activity Normal Activity Hypo activity Signs of depression Pathologic state 4 The Control Diagram window 71 729 This diagram shows normalized values of the integral parameters of control self regulation level DA Self regulation resources 42 5 Semaphore Colors of the semaphore correspond to different levels of a psych physical condition of an organism PERFECT PSYCHO EMOTIONAL STATE HYPER ACTIVITY GOOD PSYCHO EMOTIONAL STATE NORMAL ACTIVITY NORMAL PSYCHO EMOTIONAL STATE NERVOUS STRAIN AND SIGNS OF WEAKNESS NERVOUS STRESS AND SIGNS OF DEPRESSION 6 Conclusion In the upper part of the window you can see the relations between the Delta 0 4Hz 29 3
87. y And vice versa at vagotonia Reciprocal changes in powers of LF and HF were observed in many cases Essential increment of the LF power was also observed during orthostatic probe psychological stress and medium physical stain Therefore point of view recently wide spreads that power in a gamut LF as well as exponent LF HF can serve an exponent of activity of a sympathetic department of vegetative nervous system Very Low Frequency VLF 0 003 0 04 Hz and Ultra Low Frequency ULF lower than 0 003 Hz The phy siological interpretation of this index is ambiguous But there is an opinion that the power of these frequencies essentially increases at attrition of an organism s regulation systems Complete frequency spectrum Total less than 0 40 Hz It is an integral index and reflects both para sympathetic and sympathetic departments of an independent nervous system Thus the intensifying of the sympathetic influences gives the decrease of the total power of a spectrum and the activation of a vagus gives an inverse action The given index is equivalent to a root mean square deviation and variation total amplitude At interpreting data of the time analysis of dynamics of heart rhythms of the sportsmen it is necessary to take into account that the considerable predominance of para sympathetic influences to a sinoatrial rate is a normal appearance for them Therefore the adjusting of boundaries of norm of numerical values of statistics is nec
88. ystem allows creating groups of patients User can create any number of groups and use them to store patients file unite by any common feature Number of patients in one group is not limited but too much patients in one group can reduce the speed of database response It is recommended to store less than 100 patients files in one group The following commands are used to operate groups Create new group Edit Delete Process Group Report Into archive From archive Nn QD OW A Group from network 12 2 1 Creating a new group Right click on the Card Box string in the left pane of the database window Choose Groups gt New in the pop up menu Patients PROCESSING of BASE From ARCHIVE Fut BASE to ARCHIVE Enable network rj Enable 3D Breath 00 c M Fill in the Add new group form and press OK Add new group Name The Notes field is optional 5 portamens Note New group will appear in the left pane of the database window 12 2 2 Editing 51 Click right mouse button on the group s name in the left pane of the database window to open a pop up menu Choose Groups gt Edit to change group s name and notes Patients PROCESSING of group 5partsmens Group report 5porbtsmens Get From ARCHIVE Group Sportsmens to ARCHIVE

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