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Biomedical subjects

K Prellner

Publications and source records attributed to K Prellner.

At least 73 records · Page 4Linked to original sources
PubMed1990

Acute respiratory tract infections in children. A three-year follow-up from birth.

Respiratory tract infections (RTIs) in small children account for a considerable proportion of health care expenditure. In 113 children, followed for the first three years of life, we studied the frequency of acute RTI and its relationship to the factors: type of day-care, age, sex, family size, living conditions, allergic predisposition, family smoking habits, and season. To elucidate the influence of age, the frequency of acute RTI and its relationship to type of day-care was longitudinally studied on a quarterly basis. The frequency of acute RTI diagnosis increased gradually from birth culminating in a peak at the beginning of the second year. Besides age and season, type of day-care was the only factor studied to show any relationship with the frequency of acute RTI diagnosis. Up to the age of almost 2 1/2 years, children attending day-care centres accounted for more RTI diagnoses than did those in home care or family day-care, categories with comparable frequencies.

Acute Disease↗
PubMed1990

Responses to rubella, tetanus, and diphtheria vaccines in otitis-prone and non-otitis-prone children.

Delayed immunologic maturation--among other things based on a selective lack of antibodies against some acute purulent otitis media (AOM)-associated pneumococcal types--has been proposed in children with recurrent AOM (rAOM). To further elucidate the immunologic response in these children, we compared the antibody responses to diphtheria, tetanus, and rubella vaccinations in 13 children with rAOM and 29 children without AOM. The children took part in a prospective study from birth to the age of 3 years. The antibody response to the rubella vaccine was significantly lower in the children with rAOM. The responses to tetanus and to diphtheria did not differ between children with and without rAOM. Thus, the results indicate that in addition to the known lack of antibodies against pneumococcal polysaccharide antigens, a lower antibody response against at least one protein antigen may exist in otitis-prone children.

Antibody Formation↗
PubMed1990

Quantification of nasopharyngeal bacteria for diagnosis of respiratory tract infection in children.

Agreement between clinical signs of bacterial respiratory tract infections and quantities of respiratory tract pathogens in nasopharynx was studied in 77 children, aged 6-13 years. Specimens were obtained from 27 clinically bacterial and 51 clinically non-bacterial respiratory tract infections, and in 124 instances from healthy children. Viable counts of Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catarrhalis, and beta-haemolytic streptococci were made from swab specimens suspended in saline before being plated on agar media. The frequency of these species in children with clinically bacterial, non-bacterial and no signs of respiratory tract infections were 85%, 47% and 26%, respectively. Bacterial counts greater than 10(4) colony-forming units (CFU)/ml of the pathogens occurred in 59% of clinically bacterial infections, as compared with 18% in clinically non-bacterial infections (p less than 0.001), the corresponding figures for counts greater than 10(3) CFU/ml being 85% and 41% (p less than 0.01), respectively. At neither level of bacterial count (i.e. greater than 10(4) or greater than 10(3], was there a significant difference between the healthy and those with a clinically non-bacterial infection. The quantification of bacteria in nasopharyngeal samples may thus be of clinical diagnostic value.

Bacteria↗
PubMed1989

Age-related variations in anti-streptococcal antibody levels.

The present study was undertaken to determine the upper 95% confidence limits (CL) for titres of antibodies to streptolysin O (ASO) and streptococcal DNase B (ADNB) using 741 sera from a general population. The ASO titres in sera from children increased abruptly with increasing age, from a mean of 21 (CL 67) in infants of 3 years or less to 211 (CL 462) in children 7 to 8 years old. In children 9 to 12 years of age titres exhibited a plateau with mean values of 168-258 (CL 436-611). In individuals over 20 years the mean ASO titre diminished with increasing age, individuals of 70 years or more showing a mean titre of 83 (CL 169). A similar variation was seen for ADNB. Infants 3 years of age or younger exhibited no detectable ADNB whereas individuals 70 years or more had a mean titre of 11 (CL 91). A maximal mean ADNB titre of 184 (CL 706) was detected in 9-year-old-children. It was concluded that age-related reference values for anti-streptococcal antibodies increase the clinical relevance of the tests.

Adolescent↗
PubMed1989

Pneumococcal serum antibody concentrations during the first three years of life: a study of otitis-prone and non-otitis-prone children.

One hundred and thirteen children were followed prospectively from birth until the age of 3, serum being obtained from cord blood, and at the ages of 3, 6, 12, 18, 24, 30 and 36 months. Thirteen children developed recurrent acute otitis media (rAOM), 29 remained very healthy and the remaining children formed an intermediate group. Cord serum concentrations were determined of total IgG class, of IgG1 and IgG2 subclasses, as well as of specific IgG antibodies against the pneumococcal capsular types, 3, 6A and 19F. The specific pneumococcal IgG as well as IgA and IgM antibodies were also followed in the sequential serum samples up to the age of 3 in the rAOM and healthy children. Despite total IgG class and IgG1 and IgG2 subclass concentrations being of the same magnitude in cord serum of rAOM (median: 11.15, 7.48 and 2.16 g/l for IgG, IgG1 and IgG2, respectively) as in that of healthy children (median: 10.21, 8.16 and 2.16 g/l, respectively), both in cord serum and in most serum samples drawn during the first year of life, specific IgG antibodies against types 6A and 19F, but not against type 3, were significantly lower in the rAOM group than in the healthy children. In the intermediate group, cord serum concentrations of specific IgG antibodies to type 6A were of the same magnitude as in the healthy children. The only significant difference in specific IgM and IgA antibody concentrations against types 3, 6A and 19F between the two groups was noted for type 6A antibodies at 36 months of age where rAOM children exhibited lower values. The results indicate an association between pre-existing low specific IgG antibody levels against AOM-associated pneumococcal types and the development of rAOM.

Acute Disease↗
PubMed1989

Serum antibodies against respiratory tract viruses: a prospective three-year follow-up from birth.

Acute otitis media (AOM) has been epidemiologically related to viral respiratory tract infections, and viral antigens have also been detected in middle ear secretion in some AOM episodes. Successive serum samples from children followed prospectively for three years from birth were analysed for IgG antibodies against respiratory syncytial virus (RSV), adenoviruses and influenza A virus. Values from serum antibody activity gradually decreased during the first six months of life, followed by a gradual increase. Various relationships were found to obtain between age and the increases of antibody activity against the different viruses. Thus, three quarters of those tested had manifested increased antibody activity against RSV by 18 months of age, and against adenoviruses by 30 months of age. No increase of antibody activity against influenza A was noted before 12 months of age, and then only seen in two thirds of those tested during the entire three-year observation period. With regard to age, however, the proportion of children with increased antibody activity to RSV, adenoviruses or influenza A virus did not differ between otitis-prone and non-otitis-prone children. Thus, as compared to non-otitis-prone children, development of the ability to produce antibodies against these viruses was not found to be delayed in otitis-prone children.

Acute Disease↗
PubMed1989

C1q and C1 subcomponent complexes in otitis-prone and non-otitis-prone children. A prospective study of children during their first years of life.

Children with recurrent acute otitis media (rAOM) often show reduced C1q concentrations and an excess of (C1r-C1s)2 complexes. It is not known if such C1 aberrations precede development of rAOM or are a consequence of the infections. For this reason, serial investigation of C1q and C1 subcomponent complexes from birth until the age of three was performed in 113 children, 13 of whom developed rAOM. C1q concentrations at birth were found to be lower in the rAOM group than in children who did not experience acute otitis media, and were also correlated with age at the time of the first AOM episode. However, the wide variation of C1q within the groups precluded the use of C1q as a predictive marker. Excess (C1r-C1s)2 complexes were consistently absent at birth. High concentrations were found in children with established otitis media and the complexes persisted in association with recurrent disease. In conclusion, the C1 aberrations characteristic of rAOM were mainly acquired as a result of infection.

Acute Disease↗
PubMed1989

Humoral immune response in acute otitis media.

A short summary of the middle ear mucosal defence system and the characteristics of the infecting bacteria associated with purulent acute otitis media (AOM) is given. Data on humoral immune factors in middle ear effusions and serum during AOM are presented and the possibility that children with frequent recurrences of AOM exhibit an impaired ability to produce antibodies against AOM-associated antigens is discussed.

Acute Disease↗
PubMed1989

A rat model for bacterial otitis media.

Rat middle ear was exposed to challenge with viable pneumococci, type 3 and 6A, and the course of changes in the middle ear was observed by otomicroscopy and analysis of bacterial samples from blood, nasopharynx and middle ear effusions. Microscopical examination of changes in the middle ear mucosa during and after the acute infection was also made. Depending on the type and concentration of pneumococci, three different results were observed: otitis media with purulent effusion, otitis media with serous effusion, or no reaction at all. The mortality rate was low and most animals recovered within 10 days without postinfectional changes visible by otomicroscopy. The microscopical examination of the middle ear mucosa revealed distinct changes. Inoculation of rat middle ear with pneumococci causes a self-limiting infection that closely resembles acute otitis media in the human. Thus the rat would seem to be a suitable animal model for the study of bacterial otitis media.

Acute Disease↗
PubMed1988

Antibody response to pneumococcal vaccination as related to tonsillectomy.

In each of twelve matched pairs of patients undergoing tonsillectomy one patient was vaccinated with Pneumovax, a pneumococcal polysaccharide antigen, prior to tonsillectomy, the other patient being vaccinated after tonsillectomy. Sera were tested for antibody response to three different pneumococcal types of IgG, IgA and IgM classes. The patients with intact tonsils at vaccination did not develop higher antibody response than did those tonsillectomised prior to vaccination. On the contrary, in the case of pneumococcus type 6A, the IgM antibody response in tonsillectomised patients was significantly higher than that in patients with intact tonsils at vaccination (p = 0.021). Thus, the present study did not support the notion that tonsillectomy affects antibody response against pneumococcal vaccination. The palatine tonsils' role as an immunologically reactive organ is also discussed.

Adolescent↗
PubMed1988

Discrepancy between effects of in vivo and in vitro administration of gammaglobulin on phagocytic killing of Streptococcus pneumoniae in an antibody-deficient serum.

Phagocytic killing of Streptococcus pneumoniae serotypes 6A, 14, 18C, 19F and 23F was investigated in the dysgammaglobulinemic serum of a patient with recurrent pneumococcal infections. Previous studies with this serum had established combined IgG2, IgG4 and IgA deficiency, deficiency with regard to specific antipolysaccharide antibodies and essentially normal complement functions. Phagocytic killing of all serotypes was reduced in the patient's serum. Addition of immunoglobulin in vitro enhanced both classical and alternative complement pathway mediated opsonization. In constitution experiments neither purified Clq nor CRP influenced phagocytic killing. Surprisingly, intramuscular administration of a fairly small dose of gammaglobulin to the patient was associated with a rapid increase in the serum opsonic activity for serotype 23F. The increased opsonization occurred before specific anticapsular antibodies were detectable in serum. The findings suggest that the possible effects of gammaglobulin treatment may not exclusively be related to the acquisition of serotype-specific antibodies.

Complement Activating Enzymes↗
PubMed1987

Concentrations of C1q, factor B, factor D and properdin in healthy children, and the age-related presence of circulating C1r-C1s complexes.

The concentrations of C1q, factor B, factor D and properdin were determined in healthy children belonging to various age groups of one through five years of age. All concentrations were found to be age-dependent, though they varied from one component to another with regard to ontogenetic pattern. Thus, the concentrations of factor B were high, and those of factor D low throughout the age range studied. C1q and properdin levels were lowest in the younger children, who also showed a fairly high incidence of C1r-C1s complexes in excess of C1q. Since the concentrations of C1q are influenced by those of IgG, the presence of C1r-C1s complexes might partly have reflected maturation of immunoglobulin synthesis during ontogeny.

Age Factors↗
PubMed1986

Beta-lactamase production in the upper respiratory tract flora.

In order to determine the recovery rate of species of the genera Haemophilus and Moraxella (including subgenus Branhamella) from the upper respiratory tract and the incidence of beta-lactamase production within these genera, cultures were made of nose and throat swab specimens and adenoid tissue in 50 children undergoing adenoidectomy. Haemophilus influenzae was isolated from 92% of the children. All children harboured strains of Haemophilus spp. and in 46%, at least one strain produced the TEM-1 beta-lactamase. Branhamella catarrhalis and/or Moraxella nonliquefaciens were isolated from 82% of the children and strains producing the BRO-1 beta-lactamase from 34%. Overall, TEM-1 and/or BRO-1 producing strains were recovered from 60% of the investigated patients. The beta-lactamase production was found to be transferable by conjugation within the respective genera. It is suggested that the apathogenic species may be a source of transferable determinants mediating beta-lactamase production in the upper respiratory tract.

Adolescent↗
PubMed1986

Treatment of pneumococcal postsplenectomy sepsis in the rat with human gamma-globulin.

A rat model was used to evaluate the possible effect on experimental postsplenectomy sepsis of a human gamma-globulin preparation for intravenous use (Sandoglobulin). Sixty splenectomized male Sprague-Dawley rats were given 3 X 10(3) Streptococcus pneumoniae type 1 intravenously. Twelve of the animals received no treatment and all died, in contrast to 12 sham-operated controls which all survived the challenge. The remaining splenectomized rats were divided into four groups, each consisting of 12 animals. One group was given 120 mg human gamma-globulin twice intraperitoneally (0.3 g/kg body wt), at 18 and 42 hr, after challenge; 10 of the 12 survived, in contrast to none of the 12 in the second group receiving 120 mg human albumin instead of gamma-globulin (P = 0.00003). When the injections were delayed to 24 and 48 hr, 9/12 gamma-globulin-treated animals still survived, in contrast to 0/12 in the albumin group. These findings point to new possibilities for treatment and perhaps prevention of overwhelming postsplenectomy sepsis by administration of high doses of gamma-globulins.

Albumins↗
PubMed1986

The effect of intravenous immunoglobulin treatment in recurrent acute otitis media.

The effect of serial intravenous infusion of human immunoglobulin on the frequency of acute otitis media (AOM) episodes and on other upper respiratory tract infections was prospectively studied in a group of 22 otitis-prone children, 1-4 years old. After pair-matching, the children were allocated to immunoglobulin treatment or to a control group. Increased specific IgG antibody activities against pneumococcal types associated with recurrent AOM (rAOM) were generally achieved, but no significant difference was noted in the frequency of AOM attacks or other respiratory tract infections between the immunoglobulin-treated children and their pair-matched untreated controls. The results indicate that, although serum antibody activities against bacteria associated with AOM are increased by immunoglobulin infusions, this does not prevent the development of AOM in children suffering from rAOM.

Acute Disease↗
PubMed1986

The effect of serial intravenous immunoglobulin infusion on type-specific anti-pneumococcal antibodies in children.

The effect of a series of five immunoglobulin G infusions--at 3-4 week interval--on serum IgG antibody concentrations against some pneumococcal types commonly associated with acute otitis media (AOM) was studied in 11 children, 1-4 years old, suffering from recurrent AOM. Increase of specific IgG antibody concentrations was observed when the initial concentrations were low. However, once higher antibody concentrations had been achieved as a result of the treatment, subsequent infusions resulted in a decrease of the antibodies. In two children with initially high specific antibody concentrations, antibodies successively decreased in response to repeated immunoglobulin infusions.

Antibodies, Bacterial↗
PubMed1986

Synergism between gammaglobulin prophylaxis and penicillin treatment in experimental post-splenectomy sepsis in the rat.

In spite of long-term antibiotic prophylaxis and pneumococcal vaccination, there still exists a proportion of highly susceptible splenectomized or functionally hyposplenic patients at risk of contracting fatal overwhelming infections. We have studied the effect of gammaglobulin prophylaxis in experimental sepsis among splenectomized rats. Administration of 37.5 mg human gammaglobulin/kg body weight 24 h before challenge with 10(3) pneumococci resulted in the survival of 19 of 24 rats, in contrast to 1 of 24 controls. A dose of 19 mg/kg body weight was not protective (7 of 23 survived). However, treatment with penicillin 18 h after challenge in the gammaglobulin-pretreated group of animals saved 21 of 24 animals, although penicillin without gammaglobulin prophylaxis showed no effect. These data indicate that even relatively low circulating concentrations of specific antibody after gammaglobulin prophylaxis might nonetheless be adequate to render septic disease easier to treat.

Animals↗