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Biomedical subjects

H Peltola

Publications and source records attributed to H Peltola.

At least 163 records · Page 9Linked to original sources
PubMed1984

C-reactive protein as a detector of organic complications during recovery from childhood purulent meningitis.

Twenty-eight bacteriologically proved episodes of purulent meningitis in 27 infants and children were monitored prospectively with sequential determinations of serum C-reactive protein. Except in one rapidly fatal case, all the patients showed decreasing CRP values for about 1 week. In five patients the CRP values than returned to a high level (P less than 0.001). Each of these patients developed an organic complication (subdural effusions in three, transient widening of the ventricles in one, purulent arthritis with osteomyelitis in one). Except for one infant with sensorineural hearing loss, which probably had developed early in the course of meningitis, no permanent sequelae were found in the patients with uncomplicated courses. One infant later had a relapse of Escherichia coli meningitis, reflected in a sharp increase of CRP. We conclude that sequential CRP measurements may be performed routinely to detect potential complications at an early stage of bacterial meningitis.

Adolescent↗
PubMed1984

Fever, C-reactive protein, and erythrocyte sedimentation rate in monitoring recovery from septic arthritis: a preliminary study.

Body temperature, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured sequentially in nine children less than 11 years old during their recovery from culture-positive septic arthritis (SA). The measurements were compared with those of two other children who recovered without antibiotic therapy. A clinical investigation carried out several months after discharge suggested permanent recovery in all cases, including the spontaneously recovered patients. Defervescence and normalization of the primarily elevated CRP and ESR values occurred in a similar manner in both groups. On average, fever lasted 5 days, CRP level decreased below 20 mg/L in 7 days, and ESR reached a value of less than or equal to 20-25 mm/h in 22 days. The normalization time of ESR differed highly significantly (p less than 0.001) both from the duration of fever and from the normalization time of CRP level. Because CRP behaved in a similar manner in both the medicated and the nonmedicated groups, its normalization suggests true extinction of the active inflammatory process. If so, CRP level may be of benefit in monitoring the duration of antibiotic therapy for SA, but the hypothesis has to be confirmed in a larger clinical trial.

Anti-Bacterial Agents↗
PubMed1984

BCG vaccination as a cause of osteomyelitis and subcutaneous abscess.

Ten patients with osteomyelitis and three with a subcutaneous abscess, all caused by BCG vaccination, are described. All patients were less than 3 years old and had as newborns been vaccinated intracutaneously in the left gluteal or hip area. Pain, limping, or a slightly tender subcutaneous induration were the primary symptoms. The sites of predilection of osteomyelitis were the metaphysis or epiphysis of the femur, these being affected in five out of 10 cases. All three subcutaneous abscesses were in the thoracic region. Prolonged (up to 30 months) combined tuberculostatic medication, in addition to appropriate surgical procedures, resulted in healing, but two cases of arthritis and two of secondary abscesses developed. In addition, sequestrectomy and two late operations, for coxa valga and hip subluxation, were deemed to be necessary. Radiographs showed femoral overgrowth of up to 1 cm in two symptomless patients three to seven years after the first discharge. We conclude that the benefits of BCG vaccination should be weighed against the risk of complications, especially in countries with a low incidence of tuberculosis.

Abscess↗
PubMed1984

Systemic Haemophilus influenzae infection in Finland.

A total of 813 patients from the years 1976 to 1980 who had a bacteremic Haemophilus influenzae infection were analyzed. Special attention was paid to disease entities (16.5% of the total) other than meningitis (60.5%) or epiglottitis (23.0%). Ninety-six cases in the nonmeningitis, nonepiglottitis (NMNE) group showed the following distribution: 25 patients with septicemia without specific focus, 21 arthritis, 19 cellulitis, 17 pneumonia, six otitis, four local abscess, two laryngotracheobronchitis, and two with an eye infection. Eighty-eight percent of the cases were children who were less than 5 years old; in the septicemia and pneumonia groups, however, 33 percent were 15 years of age and older, and 10 percent were over 60 years of age. All diseases in the NMNE group were acute; 51 percent of the patients sought medical advice within two days. C-reactive protein (CRP) was elevated constantly at presentation, erythrocyte sedimentation rate (ESR) was increased (greater than 20 mm/hr) in 87 percent, high fever greater than 38.5 degrees C (101.3 degrees F) was measured in 85 percent, and leukocytosis (greater than 15 X 10(9)/l) was present in 71 percent. Various antimicrobial agents were given for an average of 17 days. The mean period of hospitalization was 13 days. Case fatality rate was 4 percent; all deaths occurred among patients with an underlying disease. No permanent damage was observed.

Adolescent↗
PubMed1984

Plasmodium falciparum merozoite vaccine in Aotus monkeys. An evaluation of the tolerableness of three types of adjuvants.

Eight Aotus trivirgatus monkeys were included in a comparative study of adverse reactions caused by 3 types of malarial vaccine. The antigen consisted of late schizonts and merozoites combined with each of 3 adjuvants, a lipoidal amine CP-20,961, a muramyl dipeptide derivative [B30]-MDP, or Freund's complete adjuvant (FCA); 3 monkeys received CP-20,961 and 3 [B30]-MDP, whereas the FCA vaccine was given to 2 animals. All the vaccine combinations caused some adverse reactions, but their nature and intensity varied. Oedema, petechiae and/or ecchymosis, induration, and formation of fluctuating masses at the injection site were the local reactions observed, but except for the FCA group, all reactions disappeared without notable sequelae. Fever was the commonest general reaction, being mildest in the [B30]-MDP group. A transient increase (about 50%) in leukocyte count and a decrease (15-20%) in red blood cell count were observed in all animals, regardless of the type of adjuvant or whether it was a primary or booster injection in question. However, because the vaccine using [B30]-MDP evoked the mildest reactions, this may be the one most promising for future human studies if its protective efficacy is proven.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1984

Serum antibodies after vaccination with Haemophilus influenzae type b capsular polysaccharide and responses to reimmunization: no evidence of immunologic tolerance or memory.

Haemophilus influenzae type b capsular polysaccharide vaccine was given in Finland in 1974 to approximately 50,000 infants and children, whose serum anti-H influenzae type b capsular polysaccharide levels have been followed for 3 1/2 years. The serum antibodies induced by the vaccination proved short-lived (less than 6 months) in the infants younger than 18 months. Elevated serum antibody levels were detectable for 1 1/2 years but less than 3 1/2 years in the children who were vaccinated when 18 to 35 months old. In the children who were 3 to 5 years old when vaccinated, the elevated anti-H influenzae type b capsular polysaccharide levels persisted for at least 3 1/2 years. Therefore, children vaccinated at the age of 18 months may need a new dose of vaccine 1 to 1 1/2 years after the first dose in order to be protected for the period of high susceptibility, until the age of approximately 7 years. Some of the vaccinated children were reimmunized 3 1/2 years after the first dose, and the anti-H influenzae type b capsular polysaccharide levels in their sera were studied in a similar manner. At no time did the anti-H influenzae type b capsular polysaccharide levels after the reimmunization differ from the anti-H influenzae type b capsular polysaccharide levels seen after the first vaccination in children of the same age.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1984

Changes in erythrocyte sedimentation rate and C-reactive protein after total hip arthroplasty.

Uncomplicated total hip arthroplasty (THA) was performed in 40 osteoarthritic patients, and changes in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were registered. The follow-up period was one year. Preoperative ESR appeared to be slightly elevated, and CRP levels were normal, with no exceptions. A postoperative maximum ESR of 64 mm/hour was reached six days after surgery. A slow decrease followed, but ESR remained slightly elevated one year later. The changes in CRP were more rapid; a maximum of 134 mg/l was registered on the second day after surgery, and the values were consistently normalized three weeks after surgery. Thus, uneventful recovery after THA seems to be indicated by a normalizing CRP, regardless of ESR values.

Aged↗
PubMed1983

Acute purulent arthritis in children.

Acute purulent arthritis (APA) in children is a rare disease. A series comprising 25 children with APA seen in 1960-79 was analysed with regard to clinical problems of diagnosis and treatment. The sex ratio of boys to girls was 2.5:1. The knee joint was most commonly affected (76% of the cases). The other joints affected were the hip (16%), ankle (4%), and elbow (4%), 56% of the patients were 1-2 yr old at the onset of the disease. A bacterial etiology was established in 44% of cases; a positive culture in 36%. Staphylococcus aureus, Haemophilus influenzae, streptococci, and pneumococci were isolated. All but 2 patients received antimicrobial therapy; the duration of therapy averaged 35 days. Seven patients were treated operatively. The usual procedure was arthrotomy, and closed irrigation was performed in 2 cases only. The end result was good in all cases. There were no fatalities.

Acute Disease↗
PubMed1983

Trips to the South--a health hazard. Morbidity of Finnish travellers.

In all, 2665 Finns chosen at random who had made short visits to Spain and her islands, to North Africa or to Thailand, or who had taken an around-the-world tour or a West African cruise were asked to answer a questionnaire concerning the state of their health while abroad. One-third (33%) reported they were ill or had been ill; 48% had had some health complaint during the trip which in 93% lasted for 2 weeks or less. The most common health problems were diarrhoea (18%), sunburn (10%), upper respiratory symptoms with or without headache or fever (10%), insect stings (3%), and problems related to excessive consumption of alcohol (1.5%). 7% deemed it possible that they had contracted a venereal disease. The incidence of the complaints varied with the geographical area visited. It is concluded that mass tourism is accompanied by a morbidity whose dimensions are far from fully recognized.

Adolescent↗
PubMed1983

Reactogenicity of a malaria merozoite antigen in Aotus monkeys compared with the effects caused by two new adjuvants, CP-20,961 and [B30]-MDP.

Six Aotus trivirgatus monkeys were included in a clinical study to compare the adverse reactions caused by a Plasmodium falciparum antigen and 2 adjuvants, a lipoidal amine, CP-20,961, and a muramyl dipeptide derivative, [B30]-MDP. Two monkeys were given 2 intramuscular injections, 3 weeks apart, of 1 of these vaccine components. Both the antigen and the two adjuvants caused local and general reactions as well as hematological and biochemical changes. Except for an up to 60% rise in leukocyte count, the antigen caused reactions least, followed by [B30]-MDP. CP-20,961 evoked more vigorous reactions and changes, but none of them reached such an extent that it would contraindicate its potential use in forthcoming vaccine studies. We conclude that both adjuvants are to be considered as relatively safe when combined with an appropriate P. falciparum antigen.

Adjuvants, Immunologic↗
PubMed1983

Efficacy of Haemophilus influenzae type b capsular polysaccharide vaccine on the incidence of epiglottitis and meningitis.

48,997 children of 3 months to 5 years were vaccinated with Haemophilus influenzae type b (Hib) capsular polysaccharide vaccine in a double blind study carried out in Finland in 1974. A clear-cut effect was obtained in the incidence of epiglottitis. The number of patients decreased 58% for three years when compared with the three-year-period before vaccination (p less than 0.002). On the other hand, the number of cases during the three years following vaccination was 65% less than during the next three year period (p less than 0.001). The efficacy implies an exceptionally strong herd immunity, because only 37.7% of the children in the area were vaccinated. Regarding meningitis, no herd immunity was observed but vaccination induced a highly significant (p less than 0.001) individual protection (2 cases in the specifically vaccinated versus 20 in the control group in four years' time), provided the vaccine was given at the age of 18 months or later. No efficacy was obtained before this age limit. It was calculated that approximately 90 per cent of cases of epiglottitis and 50 per cent of meningitis would be prevented with the vaccine currently available. Taking also into account the strong herd immunity tendency, vaccination is likely to offer even larger benefits.

Bacterial Vaccines↗
PubMed1982

Shift in the age-distribution of meningococcal disease as predictor of an epidemic?

Demographic data for several years before, during, and after an epidemic of meningococcal meningitis show that the age-distribution of the disease shifts considerably during an epidemic--although the highest incidence of meningococcal infections was still that among children under 5 years old, the proportion of patients aged greater than 4 years increased significantly. The ratio of the number of cases aged over 4 years to that aged up to 4 years was 0.833 and 0.775 in two non-epidemic periods, but 2.95 and 2.29 in two epidemic years. Careful demographic surveillance may reveal the approach of a meningococcal epidemic sooner than do the present surveillance methods.

Adolescent↗