Method of predicting risk of reduction of child's health level at age of 12-16

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to pediatrics, and can be applied for predicting reduction of child's health level at the age of 12-16. For this purpose an hour after meal and 15 minutes before mouth fluid sampling oral cavity is washed with 0.9% sodium chloride solution. Analysis of child's mouth fluid with determination of ratio of immunoglobulin A concentration to immunoglobulin G concentration is performed. Analysis is carried out twice with difference in 14 days. In case of 1.4 fold and higher reduction of immunoglobulin A concentration to immunoglobulin G concentration ratio during second analysis child is allocated to group of risk of health level reduction.

EFFECT: application of claimed method makes it possible to carry out screening in the process of carrying out prophylactic medical examination to plan health-improving procedures in groups of dispensary observation.

2 ex

 

The technical field to which the invention relates

The invention relates to medicine, namely to Pediatrics.

The level of technology

The formation of children's health is one of the main tasks of domestic medicine. [Kuchma V. R. guidelines on hygiene and health of schoolchildren. Moscow: Russian public health Association, 2000. - P. 18]. Sharply raises the issue of developing a publicly accessible, inexpensive, informative methods of predicting the risk of reducing the level of health of the child. Such screening is required during clinical examination, and for planning recreational activities in groups of dispensary observation.

There are various ways of predicting the risk of reducing the level of health of the child. The most informative are invasive immunological methods, for most of them it is necessary to perform venous blood sampling, which requires special equipment, trained personnel and the consent of the child's parents [Method of predicting the risk of reducing the level of resistance of the organism to acute respiratory diseases in children aged 3-7 years on immunological indicators / Fedotova, T. A., Zhukov S. V., Kushnir, S. M., Antonova L. K., Kalinina O. V. // RF Patent for the invention №2445630 from 20.03.2012]. At the same time, there are methods and non-invasive methods.

The known� “a Method of predicting the decline and adverse health outcomes in children of early age” [a Method of predicting the decline and adverse health outcomes in children of early age/ Antonova L. K., Kushnir S. M., Malinin, A. N., Shmatov G. P., Kulakova N. And. // RF patent for the invention №2411002 from 10.02.2011]. The authors propose to judge about the risk of reducing the level of child health indicators of autonomic regulation. The methodology proposed for newborns, but can be applied to older children. However, the technique requires special equipment (electrocardiograph, or vegetarische) and the trained professional, which complicates its use in mass screening. It should be noted that in adolescence often occurs syndrome vegetative dystonia, in addition, the autonomic nervous system older child exposed to emotional stress and the nature of microsocial relations before the examination. Thus, the use of indicators of the autonomic nervous system to predict the risk of reducing the level of health of the child aged 12-16 years are not appropriate.

One of the most promising variants to predict risk of reducing the level of health of the child at any age is the assessment of immunological parameters in the saliva of the child. In this case, it is possible to identify a violation of one of the components of the immune response. The methodology is applied to predict the risk of reducing the level of resistance of the organism to acute respiratorysystem in children [Method of predicting the risk of reducing the level of resistance of the organism to acute respiratory diseases in children aged 3-7 years, according to the index of the avidity of immunoglobulin A / Fedotova T. A., Zhukov S. V., Kushnir, S. M., Antonova L. K., Kalinina O. V. // RF Patent for the invention №2445915 on 27.03.2012].

As a prototype we have chosen “Method of predicting the risk of reducing the level of resistance of the organism to acute respiratory diseases in children aged 3-7 years, according to the index of the avidity of immunoglobulin A” [a Method of predicting the risk of reducing the level of resistance of the organism to acute respiratory diseases in children aged 3-7 years, according to the index of the avidity of immunoglobulin A / Fedotova, T. A., Zhukov S. V., Kushnir, S. M., Antonova L. K., Kalinina O. V. // RF Patent for the invention №2445915 on 27.03.2012].

The inventive method consists in the fact that the child determine the concentration of secretory immunoglobulin A in saliva in parallel in two samples, one of which is added urea (0,3 mol/l), determine the avidity index by dividing the value of the concentration of secretory immunoglobulin A in the sample with urea at concentrations of secretory immunoglobulin A in the sample without urea, and when the value of the avidity index of less 0,089 or more of 0.27 of a child is considered at risk of reducing the level of resistance of the organism to acute respiratory diseases

The disadvantage of this method is that:

- examines only one element of the immune response - protect the mucous membranes of dyatel�different ways from infections,

- for research requires trained specialist (preparation of two solutions with the addition of the precise concentration of urea),

use in mass surveys is difficult due to the need to maintain two parallel samples, the probability of error due to the inclusion of one child samples from different children,

- difficulties in applying standard tablets for ELISA studies (requires changes (the urea) in half of the cells),

- does not take into account the possibility of changes in the concentration of immunoglobulin a in saliva associated with food intake or prolonged lack of food intake,

- ignores the dynamics of the intensity of the immune response.

In the inventive method listed deficiencies have been corrected.

Disclosure of the invention

The object of the invention is to assess the risk of reducing the level of health of the child at the age of 12-16 years.

The technical result of the method is to increase the informative value of clinical and laboratory examination of the child through the use of study the ratio of the concentration of immunoglobulin A concentration of immunoglobulin G in oral fluid dynamics (14 days) to identify among children aged 12-16 years group risk reduction level of health.

The implementation of the invention

The claimed technical�th result is achieved by defining in the oral fluid of a child aged 12-16 concentrations of immunoglobulin A and the concentration of immunoglobulin G twice the difference in 14 days and the mouth for 15 minutes prior to collection of oral fluid is flushed with a solution of sodium chloride 0.9%, in the case of reducing the concentration ratio of antibody And the concentration of immunoglobulin G in the second study, 1.4 times or more the child is considered at risk of reducing the level of health. The intake of oral fluid is an hour after a meal, thus reducing the impact of hypersalivation due to the anticipation of food intake or eating food.

Just in the manner we examined 90 children aged 12-16 years, 70 of them children II health groups (children with a low resistance index in the frequency of acute diseases with risk of transition in III group of health - chronic bronchopulmonary pathology (study group) and 20 children I health group (control group).

The material for the study served as oral fluid collected after pre-rinsing the mouth with a solution of sodium chloride 0.9% over 15 minutes before collecting the oral fluid. Were oral fluid intake in a volume of 1 ml in special vials for collection and centrifugation of venous blood. The tubes were signed and were transported to the laboratory in cooling the cold box. In the laboratory were conducted to determine the concentration of immunoglobulin A and immunoglobulin G. Then calculated related�e concentration of immunoglobulin A concentration of immunoglobulin G.

After 14 days, the examination was repeated.

In the case of reducing the concentration ratio of antibody And the concentration of immunoglobulin G in the second study, 1.4 times or more the child is considered at risk of reducing the level of health.

The novelty of the proposed method lies in the fact that the first proposed to predict the risk of reducing the level of health of a child aged 12-16 directly exploring non-invasive method the intensity of the immune response in the dynamics. The method is widely available, cheap, allows the use of standard test systems without any additional modifications. The distinguishing features of the method:

- the child twice, with a difference of 14 days, determine the concentration of immunoglobulin A and the concentration of immunoglobulin G in oral fluid;

- the research is conducted in an hour after eating;

- in 15 minutes prior to collection of oral fluid the mouth is washed with sodium chloride solution of 0.9%;

- when you reduce the ratio of the concentration of immunoglobulin A concentration of immunoglobulin G in the second study, 1.4 times or more the child is considered at risk of reducing the level of health.

The proposed method is illustrated by the following examples.

Clinical example No. 1.

The child, at the age of 13. A child by her third pregnancy, first birth. Breastfeeding up to 8 m�S. Attended kindergarten for 3 years. Currently enrolled in secondary school. The study of oral fluid by the proposed method. Identified reducing the concentration ratio of antibody And the concentration of immunoglobulin G in the second study in 0.3 times the risk of decrease of a level of health missing. The child was observed during the year. Last year it was 2 cases of acute respiratory infections. The forecast was confirmed.

Clinical example No. 2.

The child, at the age of 14. Child from first pregnancy. Artificial feeding from birth. Kindergarten did not attend. The study of oral fluid by the proposed method. Identified reducing the concentration ratio of antibody And the concentration of immunoglobulin G in the second study, 1.8 times revealed a high probability of the risk reduction level of health. The child was observed during the year. During the year there were 7 cases of acute respiratory disease, pneumonia. The forecast was confirmed.

A method of predicting the risk of reducing the level of health of the child aged 12-16, which consists in the study of the oral fluid of a child with the determination of the concentration of immunoglobulin A and immunoglobulin G, characterized in that the research is conducted in an hour after meal, twice with a difference of 14 days, the mouth for 15 minutes prior to collection of oral fluid by promvestsistem of sodium chloride 0,9%, calculated the ratio of the concentration of immunoglobulin A concentration of immunoglobulin G, in the case of reducing the concentration ratio of antibody And the concentration of immunoglobulin G in the second study, 1.4 times or more the child is considered at risk of reducing the level of health.



 

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5 tbl, 1 ex

FIELD: medicine.

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