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Biomedical subjects

L Jokipii

Publications and source records attributed to L Jokipii.

At least 19 recordsLinked to original sources
PubMed1996

Immunodetection of Pneumocystis carinii in bronchoalveolar lavage specimens compared with methenamine silver stain.

Immunodetection of Pneumocystis carinii, based on immunofluorescence and use of a monoclonal antibody specific for an antigen located within the cyst wall and detectable after trypsin digestion only, was compared with a methenamine silver stain in 553 bronchoalveolar lavage specimens from immunosuppressed patients. P. carinii was found by immunofluorescence in 72 (86%) and by silver stain in 68 (81%) of the total of 84 positive samples detected by either or both of these methods.

Bronchoalveolar Lavage Fluid↗
PubMed1996

Late onset Pneumocystis carinii pneumonia following allogeneic bone marrow transplantation.

We retrospectively reviewed all positive Pneumocystis carinii findings among adult patients who had received an allogeneic BM transplant at the Helsinki University Central Hospital between July 1990 and December 1993. The aim was to define the incidence of late onset Pneumocystis carinii pneumonia (PCP) in BMT patients who had routinely received PCP prophylaxis for 6 months post-BMT. In 110 BMT patients, 16 episodes of PCP were documented. Only one patient had been receiving PCP prophylaxis at the onset of PCP. Fourteen of the episodes occurred more than 6 months post-BMT. (median 10.5, range 4-42 months); three of them beyond 1 year. All three had extensive chronic GVHD. Of the 11 patients with an onset between 7-12 months post-BMT, all but one were on methylpredisolone because of chronic GVHD (n = 7) or cytopenia (n = 2) and five of them were in relapse of their hematological malignancy. No mortality from PCP was detected. The risk of developing PCP between 7-12 months post-BMT among patients at risk was 13.4%. We conclude that PCP prophylaxis should be continued until 1 year post-BMT in patients receiving corticosteroid treatment as well as in those with a hematological relapse. Long-term prophylaxis beyond 1 year should be considered in cases with extensive chronic GVHD.

Adolescent↗
PubMed1995

Complement resistance of parasites.

The complement system is a first-line defence mechanism against parasites. All parasites causing deep infections and getting into contact with human plasma must, in one way or another, avoid the destructive effect of this powerful defence system. Several specific strategies of complement resistance of parasites have been reported, and this rather large spectrum of regulatory mechanisms covers the whole cascade of complement activation. Analysis of the known and elucidation of the yet unknown mechanisms will probably help in the development of new therapeutic and preventive approaches to control the different parasitic diseases. This paper will review the complement resistance mechanisms reported and their utilization by various parasites.

Animals↗
PubMed1995

Microbiological quality in Finnish public swimming pools and whirlpools with special reference to free living amoebae: a risk factor for contact lens wearers?

To assess the possible risk of microbial keratitis associated with swimming or bathing in public pools, the microbiological quality as well as the presence of free living amoebae in 16 halogenated swimming pools and whirlpools, located in Helsinki, Finland, was determined. Five additional whirlpools situated in the ferries cruising from Finland to Sweden were included in the study. Other parameters investigated were the total bacterial count, identification of Pseudomonas aeruginosa and Staphylococcus aureus, measurement of free residual and combined chlorine, potassium permanganate index, urine, pH, and turbidity. Amoebae were detected in 41% of the pool water samples studied. Seven of 11 whirlpools and four of 10 swimming pools were shown to contain amoebae. An Acanthamoeba species was isolated from only one outdoor swimming pool; the other amoebae belonged to the genera Vexillifera, Flabellula, Hartmannella, and Rugipes. Although not a single verified case of Acanthamoeba keratitis has been found in Finland, the findings show that there is a theoretical risk of amoebic and bacterial keratitis associated with swimming or bathing in properly cleaned public pools. Consequently, we do not recommend swimming or bathing with contact lenses.

Amoeba↗
PubMed1992

Leishmaniasis diagnosed from bronchoalveolar lavage.

A 51-year-old renal transplant patient, whose spleen had been removed 11 years ago, was admitted to hospital for elective surgery, which was cancelled as she developed spiking fever and nonproductive cough and her general condition deteriorated. After 2 weeks, leishmaniasis was unexpectedly diagnosed from a bronchoalveolar lavage specimen, which had been subjected to parasitological examination under the suspicion of pneumocystosis. Isoenzyme typing identified the parasite as Leishmania infantum. The patient had visited Malaga, Spain, twice a year, the last trip taking place 1 month before admission. Specific treatment was followed by rapid recovery without relapse during 1.5 years. Splenectomy and immunosuppressive medication obscured the clinical suspicion of leishmaniasis. The case is a reminder of the interstitial pneumonitis in leishmaniasis and emphasizes the value of broad-spectrum methods detecting a variety of parasites.

Animals↗
PubMed1990

Acute phase response in Pneumocystis carinii pneumonia.

The acute phase response induced by 19 episodes of Pneumocystis carinii pneumonia (PCP) was analysed in a retrospective study. There were 9 men and 1 woman with HIV, aged 25-45 years (mean 37.2) and 4 men and 4 women with other immunodeficiencies, aged 18-35 years (mean 26.2). The outcome of these two groups with PCP did not differ: in the HIV group 4 died and in the non-HIV group 2 died. In the HIV group, peak serum C-reactive protein (S-CRP) ranged 41-228 mg/l, mean 126 (77.3), and in the non-HIV group 19-290 mg/l, mean 105 (89.1) (NS). The patients with a fatal outcome had higher mean peak S-CRP: 186 (73.8) mg/l versus 85.3 (63.5) mg/l in the survivors (p = 0.007). The HIV infection itself did not increase the S-CRP concentration, which was normal before or after PCP in all 7 survivors of the 11 episodes. Thus, PCP induces a clear-cut S-CRP response, which may be used for monitoring the treatment and evaluating the prognosis of the patient.

Acute-Phase Reaction↗
PubMed1989

Coincidence of deficient delayed hypersensitivity and intestinal protozoa in homosexual men.

Stool samples of 134 subjectively and apparently healthy male homosexual volunteers were studied, and in 86 men (64.2%) 190 parasite infestations, up to 6 per host, were identified. The most frequent species were Endolimax nana (40), Entamoeba coli (38), Entamoeba histolytica (34), Entamoeba hartmanni (32), and Iodamoeba bütschlii (22); Cryptosporidium was not found. All 11 isolates of Entamoeba histolytica analysed belonged to a noninvasive zymodeme: 10 were of zymodeme I and I of zymodeme III. In 172 healthy control adults 6 parasite infestations were found. In the homosexual men, a negative tuberculin test was more frequent in the presence than in the absence of parasites. Entamoeba histolytica (p = 0.005) Entamoeba coli (p = 0.013) and Iodamoeba bütschlii (p = 0.004) were associated with the anergy.

Amoeba↗
PubMed1988

Antibodies to cysts of Giardia lamblia in primary giardiasis and in the absence of giardiasis.

The significance of serum antibodies binding to cysts of Giardia lamblia was evaluated by indirect immunofluorescence. Titers of 10 or higher were found in 85.6% of adults, who had probably never had giardiasis. Titers in 118 adults (geometric mean, 29.9) were higher than in 35 children (16.4), and titers in women (42.3) were higher than in men (20.0). Titers in 150 patients with primary giardiasis (80.4) were higher than in control adults, but overlapping precluded serological diagnosis. Titers increased with the duration of infection. Female patients had higher titers (100.5) than did males (66.1), but men who had been infected longer than 45 days had high titers (132). Titers in second serum samples taken from 26 patients 2 weeks to 3 months after successful nitroimidazole treatment (58.1) were lower than before treatment (151.7) but higher than in 118 controls. We conclude that most people have antibodies which cross-react with G. lamblia but which are induced by other immunogens and that primary giardiasis induces protracted systemic antibody responses.

Adult↗
PubMed1988

Semiquantitative culture results and pathogenic significance of obligate anaerobes in peritonsillar abscesses.

We studied the bacteria in consecutive peritonsillar abscesses using semiquantitation of the primary culture findings and correlated the results to clinical parameters. Puncture-aspirated pus from 42 abscesses yielded 133 isolates. Group A streptococci were isolated 10 times and, unlike other bacteria, were isolated 4 times in pure culture; other beta-hemolytic streptococci were found in 8 abscesses, and anaerobes were found in 28. The infections were polymicrobial, with two to seven bacteria in 83%. Anaerobes were more abundant than nonanaerobes; members of the genera Streptococcus, Bacteroides, Peptostreptococcus, and Fusobacterium were the most important quantitatively, considering both frequency and abundance. In patients with ongoing antibiotic treatment, nonanaerobes (but not anaerobes) were less abundant than in untreated patients. The abundance of obligate anaerobes (specifically cocci and gram-positive rods) correlated to the severity of illness as defined by fever and short duration before hospitalization. With other groups of bacteria, no such correlation was found. The correlation was not explained by a difference between the antibiotic-treated and the untreated patients. The results indicate the value of the semiquantitation of culture data and the frequency and pathogenic significance of obligate anaerobes in peritonsillar abscesses.

Adolescent↗
PubMed1987

Gas chromatographically quantitated lactate in empyema and other pleural effusions.

To determine the value of gas chromatographically measured lactate in distinguishing between empyema and other causes of pleural effusion, consecutively collected samples of pleural fluid were studied. In 15 cases of empyema the mean lactate concentration was 11.60 mM and higher than in 41 patients with other diagnoses (mean 3.98 mM). The concentration of lactate remained unchanged during storage at 4 degrees C for two years. Gas chromatographic quantitation of lactate is useful in the presumptive diagnosis of empyema, and stability of the lactate concentration allows retrospective analyses.

Adult↗
PubMed1987

Comparative activity of metronidazole and tinidazole against Clostridium difficile and Peptostreptococcus anaerobius.

Broth dilution MICs of metronidazole against 38 strains of Clostridium difficile (0.13 microgram/ml) and 11 strains of Peptostreptococcus anaerobius (0.11 microgram/ml) were lower than those of tinidazole (0.16 and 0.17 microgram/ml, respectively). As molar concentrations the nitroimidazoles were equally active. The MICs of the two drugs correlated positively, and the relative activity of tinidazole increased with decreasing susceptibility of both species.

Clostridium↗
PubMed1986

Timing of symptoms and oocyst excretion in human cryptosporidiosis.

To determine the timing of symptoms and oocyst excretion after the acquisition of cryptosporidium infection, we used a screening parasitologic stool examination to identify patients and then contacted them for the collection of retrospective histories and follow-up stool specimens. The study included 68 otherwise healthy patients with an identifiable source and time of infection. All 68 had diarrhea, 61 had abdominal pain, most also had other gastrointestinal symptoms, 33 had fever, and all recovered spontaneously. Among the 50 patients who submitted follow-up stool samples, more than 90 percent of the 610 symptomatic days and of the 136 oocyst-positive stools occurred between days 7 and 28 of infection, the mean incubation period was 7.2 days (range, 1 to 12), and the mean duration of illness was 12.2 days (range, 2 to 26). During the oocyst-excretion period cryptosporidium was detected in 90 percent of Ziehl-Neelsen-stained fecal concentrates. The end of oocyst excretion could be accurately determined in 26 patients; 19 (73 percent) had positive stools after the cessation of symptoms for a mean period of 6.9 days (range, 1 to 15). Fourteen patients were studied for two or more months, and in three of them asymptomatic episodes of oocyst excretion were detected up to two months after clinical recovery. We conclude that many cases of symptomatic cryptosporidiosis occur among immunocompetent patients, some of whom may excrete oocysts even when they have become asymptomatic. Conversely, infected symptomatic patients may occasionally have intermittently negative stools.

Abdomen↗
PubMed1986

Volatile fatty acid findings in vaginal fluid compared with symptoms, signs, other laboratory results, and susceptibility to tinidazole of malodorous vaginal discharges.

The relevance of volatile fatty acids as a diagnostic test in 79 women with abnormal vaginal discharge was evaluated by a blind, randomised, and placebo controlled trial of tinidazole as a single oral 2 g dose. Automated gas chromatography of ether extracts of discharges taken before treatment showed volatile fatty acids in 18. Volatile fatty acids correlated with malodorous, colour, and microscopically assessed altered bacterial flora and clue cells. At follow up one week later, the odour, colour, and volatile fatty acids in the vaginal discharge of women treated with tinidazole had become normal more often than in those receiving placebo. The disappearance of volatile fatty acids correlated with clinically assessed improvement in women treated with tinidazole. The volatile fatty acid test as an indicator of anaerobic bacterial flora is objective, technically simple and fast, has few problems of sample size and transportation, and may be useful in the aetiological classification and follow up treatment of non-specific vaginal discharges.

Body Fluids↗
PubMed1986

Outbreak of cryptosporidiosis among veterinary students.

We describe an outbreak of human cryptosporidiosis in 5 veterinary students in contact with experimentally infected calves. All persons experienced symptoms of gastroenteritis, with the main complaint of diarrhoea lasting for 1-13 days. The persons recovered spontaneously; one was hospitalized for 10 days. The diagnosis was based on the demonstration of Cryptosporidium oocysts from stools by the smear method and the formalin-ether concentration method, both combined with the acid-fast staining technique. Both methods gave almost equal results. The role of Cryptosporidium as an occupational risk is discussed.

Adult↗