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Biomedical subjects

M Korppi

Publications and source records attributed to M Korppi.

108 records · Page 6Linked to original sources
PubMed1991

Mixed infection is common in children with respiratory adenovirus infection.

The presence of concomitant viral or bacterial infection was evaluated in 20 patients hospitalized for adenovirus infection of the middle or lower airways by using new serological methods for detection of both antigens and antibodies. Adenovirus infection was identified by measurement of antibodies with complement fixation test or by direct detection of viral antigen in nasopharyngeal aspirates. Mixed infection was present in 11 (55%) of the 20 patients. Viral coinfection was demonstrated in five (25%) and bacterial in nine (45%) patients. Bacterial coinfection was common, 67%, in children with an infection focus, pneumonia or acute otitis media, but rare, 13%, in those without it. Seroconversion to nontypable Haemophilus influenzae was indicated in six children; four of them were infants, four had pneumonia and three acute otitis media. Pneumococcal infection was indicated in two patients with pneumonia, both aged over two years. Chlamydia trachomatis was involved in one case. The results indicate that bacterial coinfection is common in respiratory adenovirus infection affecting lower airways, especially if pneumonia is present.

Acute Disease↗
PubMed1990

Bacterial involvement in parainfluenza virus infection in children.

37 children with serologically confirmed parainfluenza virus (PV) infection were studied by new serological methods for evidence of concomitant bacterial infection. 24 of the children were hospitalized because of croup and 13 because of lower respiratory tract infection. Serological evidence of bacterial involvement was found in 4 (11%) of the 37 children, in none of the 24 children with croup but in 31% of the 13 children with PV infection of the lower airways (p less than 0.05). Streptococcus pneumoniae was implicated in 3 cases and Haemophilus influenzae in 1. Serological evidence of staphylococcal involvement was not seen in any case. The 3 patients with pneumococcal involvement had pneumococcal antigen in the acute serum. In all of them pneumonia was associated with PV type 1 or 3, and in 2 serum C-reactive protein was elevated. The data presented support the view, that secondary bacterial infection is rare in children with croup, but common in lower respiratory tract infection caused by PV.

Acute Disease↗
PubMed1989

Bacterial coinfection in children hospitalized with respiratory syncytial virus infections.

Clinical and bacterial findings were prospectively studied in 90 children hospitalized because of middle or lower respiratory tract infection caused by respiratory syncytial virus (RSV) during a surveillance period of 12 months. The results were compared with those of RSV-negative children hospitalized with identical indications during the 3 peak months of the RSV epidemic (N = 91) or for the 3 months after the outbreak (N = 99). A high frequency of pneumonia and acute otitis media were found in both RSV-positive and RSV-negative children during the epidemic, but not in control patients after the epidemic. Bacterial infection, based on a significant rise of antibody titer and/or on detection of pneumococcal antigen in serum or urine, was observed in 39% of the children with RSV infection. The respective figures were 24% in RSV-negative children hospitalized during the epidemic and 8% after the epidemic. Our observations stress the role of RSV as a predisposing agent for secondary bacterial infection in the airways of children. The most common bacteria involved in the mixed RSV-bacterial infections were Streptococcus pneumoniae and Haemophilus influenzae, the latter being found only in pneumonic patients. The presence or absence of pneumonia or acute otitis media was not significantly correlated with evidence of pneumococcal infection. We conclude that a bacterial pathogen should be actively sought when managing patients with lower respiratory tract syndromes, especially in those who have evidence of RSV infection.

Acute Disease↗
PubMed1989

Atopy in children with and without a family history of atopy. I. Clinical manifestations, with special reference to diet in infancy.

The influence of a family history of atopy on atopic morbidity, and relationships between diet in infancy and allergic manifestations at the ages of one and five years were prospectively studied in 91 children. A control group consisted of 72 children with no family history of atopy. At the age of one year, atopic manifestations were found in 19% of 163 children, in 23% of those with a family history of atopy and in 14% of those with no such history. Skin problems were more common in children with a family history of atopy (43%) than in the control children (19%). Of the children with a family history of atopy, 23% had prolonged rhinorrhoea during infancy. The corresponding figure in children with no family history of atopy was 10%. Prolonged rhinorrhoea during infancy correlated with parental smoking only in children with a family history of atopy (47% vs. 18%). At the age of five years, atopic disease was found in 17% of 128 children, 24% of those with a family history of atopy and 9% of those with no such history. Atopic eczema was more common in children with a family history of atopy, irrespective of the diet consumed during infancy. Atopic signs were found in about half of all the children with a family history of atopy. If atopy had been present in the family, the child usually exhibited the same manifestation. Onset of atopic manifestations was not prevented or delayed.

Breast Feeding↗
PubMed1988

The role of parainfluenza viruses in inspiratory difficulties in children.

Viral findings were prospectively studied in middle and lower respiratory tract infections in 449 hospitalized children during a 12-month follow-up period. A viral aetiology was found in 30 of the 65 children (46%) with inspiratory difficulties. Parainfluenza viruses were the infective agents in 24 of the 30 cases with viral diagnoses (80%), type 2 being the most prominent. There were 38 cases of parainfluenza infections, type 2 being the infective agent in 58% of the 24 cases of parainfluenza infections with inspiratory difficulties but in only 21% of the 14 cases of parainfluenza infections without inspiratory difficulties. Type 2 parainfluenza virus produced inspiratory difficulties in 82% of the cases as opposed to 56 and 50% of the cases for type 1 and 3, respectively. It is concluded that the type 2 parainfluenza virus has a particular association with inspiratory difficulties in children. Viral diagnosis was reached using direct antigen detection in nasopharyngeal specimens by radioimmunoassay in 59% and using complement fixation serology in 76% of parainfluenza infections. Direct antigen detection was especially useful in infants. We suggest that direct antigen detection should be used as a primary virological diagnostic method in small children with middle and lower respiratory tract infections.

Age Factors↗
PubMed1988

Compliance with a dietary manipulation programme in families with infants prone to atopy.

The success of familial compliance with a dietary manipulation programme was studied prospectively in 91 newborn babies from atopic families for up to 12 months. The control group consisted of 72 infants from non-atopic families. The percentages of infants breast-fed at the age of six months were 58% and 38% in the study group and control group, respectively. The introduction of cow's milk based formulas was postponed until the age of three months in 63% of the infants in the study group and 47% of the infants in the control group. Solid food was avoided during the first three months in 76% and 45% of the infants in the study group and control group, respectively. Maternal age, smoking and low social class were associated with poor compliance. The existence of atopic dermatitis in any member of the family was associated with good compliance. The main advantages of our programme were the increased number of children breast-fed until the age of six months, and the reduced number of infants introduced to cow's milk based formulas or solid food before three months of age.

Adult↗
PubMed1988

Viruses and airborne allergens as precipitants of obstructive respiratory difficulties in children.

Findings of virus infection were prospectively studied in 133 episodes of obstructive respiratory difficulty in 90 children aged 2 to 15 years. A viral infection was confirmed in 16 episodes (12%). In a further 11% of cases serological evidence of a recent viral infection was found. Respiratory syncytial virus (RSV) accounted for half of the positive viral results. Skin prick tests were performed after the second episode of bronchial obstruction. Of the 79 children tested, 57% had at least one positive result to house dust mite allergen and/or to one of the four seasonal allergens studied. Reactivity to birch pollen was most common. There was no significant correlation between the frequency of episodes in children with birch, timothy grass and mugwort pollens or with Cladosporium herbarum allergies and counts of the respective pollens or spores in the air. Blood eosinophilia was found in 34% of cases immediately after the episodes, but no seasonal variation occurred. It was impossible to differentiate the episodes initiated by viruses from those initiated by seasonal allergens. Thus exposure to seasonal allergens is a less common precipitant of respiratory difficulties from bronchial obstruction than are virus infections.

Adolescent↗
PubMed1986

Viral findings in children under the age of two years with expiratory difficulties.

Viral findings were prospectively studied in lower respiratory tract infections in small children with and without expiratory difficulties. On first admission, a viral aetiology was found in 71 of 127 children (56%). On re-admission, a viral etiology was found in only two of 31 cases (6%). Respiratory syncytial viruses (RSV) were responsible for 71% of the cases with viral diagnoses. A recently-developed method for the direct detection of viral antigens in nasopharyngeal specimens by radio-immunoassay was more sensitive than complement fixation serology, especially in patients aged less than six months. Viral diagnosis was reached using this new method alone in 43% of infections caused by RSV and in 27% of infections caused by other viruses. In children under six months, RSV were found in 89% by direct antigen detection and in 22% by serology. We suggest that direct antigen detection should be used as the primary virological method in small children with lower respiratory tract infections. The aetiological agents were the same in cases with and without expiratory difficulties, RSV being found in about 40% of children in both instances. It is concluded that host factors are critical to the development of expiratory difficulties.

Adenoviruses, Human↗
PubMedDate not supplied

Mucha-Habermann disease: a diagnostic possibility for prolonged fever associated with systemic and skin symptoms.

The severe form of Mucha-Habermann disease with systemic symptoms is a rarely diagnosed disease which should be considered for children with prolonged fever, impaired general condition, skin manifestations and elevated C-reactive protein concentration and/or erythrocyte sedimentation rate. Eleven cases have been described previously in children. We describe two acute episodes of this syndrome in a three-year-old child; the diagnosis was based on clinical, dermatological and histological findings. During both episodes, the fever lasted for more than one week, C-reactive protein concentration increased to more than 150 mg/l, and there was extensive lymph node enlargement. Skin eruption was initially maculopapulous, then vesiculous and finally pustulous. On skin biopsy, vasculitic changes were observed. We treated the second attack of our patient with high-dose gamma globulin; the first attack appeared to resolve itself spontaneously.

Arthritis, Juvenile↗
PubMedDate not supplied

Atopy in childhood and diet in infancy. A nine-year follow-up study. I. Clinical manifestations.

A national program for the prevention of atopy in children has been in progress in Finland since 1979. Its aim is to prevent or at least to reduce atopic symptoms in childhood. Since the start of the program we have followed a group of 119 children with and without a family history of atopy. Half the atopy-prone children kept to the diet intended to prevent atopy, i.e., breast-feeding prolonged up to age 3 months and introduction of solid food and formulae based on cow's milk after age 3 months. All children were examined at ages 5 and 10 years. In addition to clinical examination and interview, skin-prick tests using eight common inhalant allergens were performed. At age 9 to 10 years, 38 of the 119 children (32%) exhibited at least one atopic illness (bronchial asthma, allergic rhinitis, allergic conjunctivitis, atopic eczema or food allergy). Forty percent of children with family histories of atopy had atopic illness, independent of diet in infancy. The occurrence of atopic manifestations in the children of nonatopic families was 21%. Only half the children who had atopic symptoms at age 12 months had symptoms 9 years later. Asthma, allergic rhinitis, and positive skin-prick test results at age 5 years, however, correlated well with the subsequent occurrence of respiratory allergy. Our observations indicate that the preventive measures in early infancy intended to reduce the risk of atopy had no influence on atopic manifestations 9 years later.

Child↗