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Biomedical subjects

M Korppi

Publications and source records attributed to M Korppi.

At least 73 records · Page 4Linked to original sources
PubMed1995

Osteitis caused by bacille Calmette-Guérin vaccination: a retrospective analysis of 222 cases.

To evaluate the frequency, clinical features, and prognosis of patients with osteitis caused by bacille Calmette-Guérin (BCG) vaccination, medical records from Finnish children based on nationwide registration from 1960 to 1988 were retrospectively analyzed. During the study period, three different BCG vaccine preparations were used. In 222 children, diagnostic criteria of BCG osteitis were fulfilled. The age at onset of BCG osteitis varied from 0.25 to 5.7 years. The most common sites of osteitis were metaphyses of the long bones. The lower extremity (58%) was affected more often than the upper (14%). Osteitis was situated in the sternum in 36 patients (15%) and in the ribs in 27 (11%). The frequency of BCG osteitis, but not the clinical parameters, was closely associated with the vaccine preparation used. Only 6 children were left with some sequelae. With adequate treatment, the prognosis for children vaccinated with BCG is good.

BCG Vaccine↗
PubMed1995

Prospective evaluation of Candida antigen and antibody assays for detection of Candida infections in children with malignant disease.

The clinical efficacy of assays for Candida albicans antigens by latex agglutination and for antibodies by indirect haemagglutination were prospectively evaluated in the diagnosis of invasive Candida infections in 38 children suffering from acute leukaemia or other malignant disease. The controls were 74 other patients without any malignancy; 72 of these had no signs or symptoms of fungal infections, but 2 had an invasive C. albicans infection. During a period of 21 months, 302 serum samples were tested by both assays, and the results were compared with clinical and other microbiological data. Invasive fungal infection was diagnosed on clinical grounds in 2 of the immunocompromised children, and periodic gut colonization was demonstrated in 11 of 36 (31%) children in this group. Positive Candida antigen was detected in 14 patients (37%) and a positive antibody titre in 7 patients (18%). Colonization was not correlated with antigen or antibody titre. Compared with the presence of invasive fungal infection, the antibody assay detected all four infections, whereas the antigen assay detected one of the two C. albicans septicaemias. Although the Candida antibody assay performed well, a detectable change in antibody titres appeared only slowly. Thus it was of no clinical help when antifungal treatment was to be considered. Follow-up of antibody titres, however, gave confirmation of the presence of fungal infection as well as the response to antifungal treatment.

Adolescent↗
PubMed1995

Prevalence and characteristics of children with chronic respiratory symptoms in eastern Finland.

The objective of the present study was to assess the prevalence of asthma and asthma-related symptoms in Finland. We also wondered whether chronic cough may be an indicator of occult asthma. Prevalence and characteristics of children with doctor-diagnosed asthma and chronic respiratory symptoms were investigated in 7-12 year old school children from eastern Finland by using a questionnaire on respiratory symptoms. In addition, skin-prick tests, flow-volume spirometry, and serum total immunoglobulin E (IgE) measurements were performed in children reporting chronic respiratory symptoms. The parent-reported prevalence of doctor-diagnosed asthma was 4.4%, of wheezing 5.4%, of attacks of shortness of breath with wheezing 4.6%, and of dry cough at night 12%. Children with dry cough only (n = 195) had less frequent parental asthma, self-reported allergies, daily respiratory medication, and moisture stains or molds at home than asthmatic children (n = 180), but these findings were more frequent than among asymptomatic children (n = 2,169). The prevalence of at least one positive skin-prick test result was 79% among the asthmatic children and 55% among children with dry cough only. There were no differences between the two symptom groups in serum total IgE levels and spirometric lung functions, except in maximal mid-expiratory flow (MMEF) values, which were significantly lower among children with asthmatic symptoms. The present results support the hypothesis that chronic cough may be an indicator of occult asthma. Therefore, to improve the sensitivity of respiratory questionnaires designed to detect asthma, they should also include questions on chronic cough.(ABSTRACT TRUNCATED AT 250 WORDS)

Asthma↗
PubMed1995

Preventive therapy for asthma in children; a 9-year experience in eastern Finland.

The long-term treatment modalities of bronchial asthma were studied in children from a defined Finnish population from 1985 to 1993, with special reference to changes during the study period. The data on maintenance drugs in children with asthma from five years (1985, 1987, 1989, 1991 and 1993) were retrospectively retrieved from the computerized registers. The reliability of the data for the diagnosis and basic treatment of asthma was checked by one of the authors, who compared the data with the patient cards from the hospital. The number of children with doctor-diagnosed asthma increased continuously during the surveillance period. The proportion of children receiving preventive medication increased concomitantly; this increase was most pronounced between 1987 and 1989. The most common preventive drug was sodium cromoglycate; its use increased from 14% in 1985 to 58% in 1993. The use of inhaled steroids remained stable at 17-19% in all surveillance years. Our treatment policy is in accordance with the international consensus statement published in 1989; however, the change towards preventive medication occurred before its publication.

Anti-Asthmatic Agents↗
PubMed1994

Bronchial asthma and hyperreactivity after early childhood bronchiolitis or pneumonia. An 8-year follow-up study.

OBJECTIVE: To determine the infantile risk factors and long-term outcome up to 8 to 10 years of age for bronchial asthma and hyperreactivity in children with early-childhood bronchiolitis or pneumonia. DESIGN: Prospective follow-up of three groups of children. SETTING: University hospital providing primary hospital care and outpatient consultations for all pediatric patients in a defined area. INTERVENTIONS: None. PATIENTS: The study groups consisted of 62 children with early-childhood bronchiolitis, 29 children with early-childhood pneumonia with no wheezing, and 52 control children. METHODS: Infantile risk factors were prospectively registered until 2 years of age. Clinical examination, performed 7 to 8 years later, included recording of atopic and asthmatic symptoms from the preceding 12 months. The methacholine inhalation challenge test was used to assess bronchial hyperreactivity, and mean midexpiratory flow results were used to assess bronchial obstruction. MAIN RESULTS: Bronchial asthma was present in nine (15%) of the 62 children from the bronchiolitis group, compared with 7% in the pneumonia group and 2% in the control group. Bronchial hyperreactivity indicated by methacholine inhalation challenge was far more common; it was present in 62% of the bronchiolitis group and in 45% of the pneumonia group. Both groups differed significantly from the control group. Decreased mean midexpiratory flow values were observed in 29% and 21% of the bronchiolitis and pneumonia groups, respectively. All 10 asthmatic patients had bronchial hyperreactivity, but only 20% of hyperreactive children had asthma. An analysis of infantile risk factors disclosed only one, an early onset of wheezing, with a significant effect on bronchial hyperreactivity at school age. Elevated IgE values measured during infancy were associated with the development of clinical asthma. CONCLUSIONS: The risk of bronchial asthma was increased after infantile bronchiolitis. Moreover, bronchial hyperreactivity was increased after both infantile bronchiolitis and pneumonia. Methacholine inhalation challenge was a sensitive but nonspecific test for diagnosing bronchial asthma. Both bronchiolitis and pneumonia resulting in hospitalization in early childhood distinguish a group of children with an increased risk for long-term lung function abnormalities and pulmonary illnesses.

Asthma↗
PubMed1994

Osteitis after newborn vaccination with three different Bacillus Calmette-Guérin vaccines: twenty-nine years of experience.

Newborns in Finland have been vaccinated with Bacillus Calmette-Guérin (BCG) since the 1950s. Until the end of 1970 the vaccine was made from BCG strain Gothenburg by the Swedish BCG laboratory in Gothenburg and from 1971 on from the same strain in Copenhagen, Denmark. It was replaced by the Glaxo vaccine in 1978. Complications caused by BCG vaccination have been under follow-up, and the data have been collected from nationwide registers. In this study we analyzed the incidence rates of BCG osteitis between the years 1960 and 1988. From 1960 to 1970 the incidence rate was from 2.7 to 13.0/100,000 BCG-vaccinated infants (mean, 7.3; median, 6.9). The incidence increased during the years 1971 to 1978 when it varied between 15.3 and 72.9/100,000 BCG-vaccinated infants (mean, 36.9; median, 30.4). Since 1978 the incidence has varied between 1.7 and 10.1/100,000 BCG-vaccinated infants (mean, 6.4; median, 7.2). In Britain no reports of BCG osteitis have been published despite the use of the same Glaxo vaccine. Our results indicate that the incidence of BCG osteitis in a given population depends on the BCG vaccine used. The follow-up of BCG complications is an essential part of BCG vaccination program.

Animals↗
PubMed1994

Bronchial asthma after early childhood wheezing: a follow-up until 4.5-6 years of age.

Over a period of 12 months from 1981 to 1982, 83 patients aged less than 2 years were treated in hospital for acute bronchiolitis. The children were followed-up prospectively; 68 (83%) completed the study until 4.5-6.0 years of age. At this age, 17 (25%) of the 68 children with bronchiolitis still suffered from wheezing attacks. These 17 asthmatics suffered from both atopic dermatitis (29 versus 6%) and allergic rhinitis (29 versus 8%) more frequently than non-asthmatic children. In contrast, positive results in the skin prick tests were almost equally common (29 and 20%) in asthmatic and non-asthmatic children. In these tests, allergies to birch pollen, timothy grass pollen and house dust mite were most common; asthma was particularly associated with house dust mite allergy. The presence of atopic dermatitis, elevated immunoglobulin E values and repeated wheezing episodes between 1 and 2 years of age were significant risk factors for later asthma. In conclusion, the risk for later asthma is increased after early childhood bronchiolitis; the frequency of asthma was 25% in the present study. Our results confirm that atopics are at a greater risk of developing asthma later in childhood than non-atopics; the risk was significant from 1 year of age onwards.

Acute Disease↗
PubMed1993

Incidence of community-acquired pneumonia in the population of four municipalities in eastern Finland.

Between September 1, 1981, and August 31, 1982, all patients with suspected or confirmed pneumonia among the 46,979 inhabitants of four municipalities in the province of Kuopio, Finland, were reported to a pneumonia register by their attending physicians. In addition, two study pathologists reported all cases of pneumonia found at autopsy, and two permanent registers were checked for retrospective identification of patients. Chest radiographs were obtained from 97% of all patients. The final diagnosis was based on radiologic or autopsy criteria. A total 546 patients (323 males and 223 females) had community-acquired pneumonia; of these, 37% were less than 15 years of age, and 31% were 60 years of age or older. Nineteen percent of the patients had defined chronic conditions, and 42% were admitted to hospital. The case fatality rate was 4%. The overall incidence of community-acquired pneumonia per 1,000 inhabitants per year was 11.6 (13.9 in males, 9.4 in females). The age-specific incidence per 1,000 inhabitants per year was as follows: age < 5 years, 36.0; age 5-14 years, 16.2; age 15-59 years, 6.0; age 60-74 years, 15.4; and age > or = 75 years, 34.2.

Adolescent↗
PubMed1993

A 2- to 3-year outcome after bronchiolitis.

OBJECTIVE: To determine the risk factors and short-term outcome until 3 years of age for subsequent wheezing in children with early childhood bronchiolitis or pneumonia. DESIGN: Prospective follow-up of a patient group. SETTING: University hospital providing primary care for all pediatric patients of a defined area. PATIENTS: One hundred twenty-seven children under 2 years of age hospitalized owing to wheezing (n = 83) or pneumonia (n = 44) during 12 months in 1981 to 1982. One hundred eight children completed the prospective follow-up until 3 years of age. INTERVENTIONS: None. MAIN RESULTS: The wheezing and pneumonia groups had equal viral and bacterial etiologic findings. History of wheezing, atopic eczema, and elevated serum IgE levels were more common in patients with wheezing than with pneumonia. Subsequent wheezing was seen after bronchiolitis in 76% (61 of 80) of the children at 1 to 2 years of age and in 58% (44 of 76) at 2 to 3 years of age. The respective figures were significantly lower, 9% (three of 33) and 16% (five of 32), in patients with pneumonia. An analysis of risk factors did not reveal any with a significant effect on subsequent wheezing. CONCLUSIONS: Subsequent wheezing is common after bronchiolitis, but rare after early childhood pneumonia, although caused by the same viruses or bacteria. Atopic diathesis is the host factor associated with initial wheezing. No genetic or environmental risk factor had significant association with later wheezing.

Asthma↗
PubMed1993

Aetiology of community-acquired pneumonia in children treated in hospital.

Viral and bacterial antigen and antibody assays were prospectively applied to study the microbial aetiology of community-acquired pneumonia in 195 hospitalised children during a surveillance period of 12 months. A viral infection alone was indicated in 37 (19%), a bacterial infection alone in 30 (15%) and a mixed viral-bacterial infection in 32 (16%) patients. Thus, 46% of the 69 patients with viral infection and 52% of the 62 patients with bacterial infection had a mixed viral and bacterial aetiology. Respiratory syncytial virus (RSV) was identified in 52 patients and Streptococcus pneumoniae in 41 patients. The next common agents in order were non-classified Haemophilus influenzae (17 cases), adenoviruses (10 cases) and Chlamydia species (8 cases). The diagnosis of an RSV infection was based on detecting viral antigen in nasopharyngeal secretions in 79% of the cases. Pneumococcal infections were in most cases identified by antibody assays; in 39% they were indicated by demonstrating pneumococcal antigen in acute phase serum. An alveolar infiltrate was present in 53 (27%) and an interstitial infiltrate in 108 (55%) of the 195 patients. The remaining 34 patients had probable pneumonia. C-reactive protein (CRP), erythrocyte sedimentation rate and total white blood cell count were elevated in 25%, 40% and 36% of the patients, respectively. CRP was more often elevated in patients with bacterial infection alone than in those with viral or mixed viral-bacterial infections. No other correlation was seen between the radiological or laboratory findings and serologically identified viral, bacterial or mixed viral-bacterial infections.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Ureaplasma urealyticum infection associated with acute respiratory insufficiency and death in premature infants.

The incidence and outcome of Ureaplasma urealyticum infection were studied in 98 infants born before 34 weeks of gestational age. Infection was defined as the presence of one or more isolations of U. urealyticum in samples obtained from trachea, blood, cerebrospinal fluid, or postmortem brain or lung biopsies. Forty-seven infants were infected. Intact amniotic membranes had no protective effect against infection; intrauterine U. urealyticum infection was detected in 19 infants who were born by cesarean section with intact amniotic membranes. Respiratory distress syndrome, the need for assisted ventilation, severe respiratory insufficiency, and death were significantly more common among infected than among noninfected infants. Our results suggest that U. urealyticum infection is associated with an unfavorable short-term outcome in preterm infants.

Humans↗
PubMed1993

Detection of focal inflammation with Tc-99m HMPAO labeled leukocytes in children.

To evaluate the applicability of Tc-99m HMPAO leukocyte scintigraphy in the assessment of focal infections in children, we retrospectively analyzed 26 studies performed between 1988 and 1992. All patients (n = 25, age range 1 month-15 years) were severely ill and suspected to have invasive bacterial infection. In each case, whole body scintigraphy was performed 2-4 hours after injection of autologous labeled leukocytes. There were 8 true positive and 14 true negative cases; specificity was 88% and sensitivity 80%. The two false negative findings were observed in patients on immunosuppressive therapy; both had fungal infections. In one case, atypical non-specific bowel accumulation of the tracer was falsely interpreted as an abscess. The other false positive finding was hip accumulation in a patient who later turned out to have Mucha-Haberman disease; transient synovitis may explain the finding. Of the eight true positive cases, six had an invasive infection focus and two had an aseptic inflammatory process. Tc-99m HMPAO leukocyte scintigraphy is a valuable method in the assessment of focal inflammation in children, including infants.

Adolescent↗