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Biomedical subjects

M Uhari

Publications and source records attributed to M Uhari.

At least 55 records · Page 3Linked to original sources
PubMed1998

The common cold: effects of intranasal fluticasone propionate treatment.

OBJECTIVE: A double-blind, randomized, placebo-controlled trial was conducted to study the effect of the intranasal corticosteroid, fluticasone propionate (FP), in the naturally occurring common cold. METHODS: One hundred ninety-nine young adults received high-dose FP (200 microg four times daily) or placebo beginning 24 to 48 hours after onset of the common cold for 6 days. All symptoms were recorded on diary cards on days 1 to 20, and clinical examinations were carried out on days 1, 7, and 21. Nasopharyngeal aspirates were collected on days 1 and 7 for detection of rhinoviruses (found in 105 subjects) and Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis (found in 52 subjects) in the nasopharynx. RESULTS: In general, FP treatment had no clinically recognizable effects on the symptoms of the common cold, although it significantly reduced nasal congestion and cough on some study days. After treatment, rhinoviruses were cultured more often in the FP treatment group (37% vs 14%, p < 0.001), but this had no effect on the symptoms of common cold. FP treatment produced no changes in the colonization of pathogenic bacteria in the nasopharynx. Some symptoms of common cold were significantly more severe during days 1 to 10 (p < 0.05) in subjects found to have positive cultures for S. pneumoniae, H. influenzae, or M. catarrhalis in the nasopharynx on day 1 (n = 33). CONCLUSION: FP treatment does not have any marked effects on the symptoms of the common cold. FP treatment induced prolonged shedding of viable rhinoviruses. Some symptoms of the common cold were significantly more severe in subjects with pathogenic bacteria in the nasopharynx.

Administration, Intranasal↗
PubMed1998

A nation-wide, population-based survey of otitis media and school achievement.

The purpose of the study was to evaluate whether there is an association between early recurrent otitis media and later school achievement. A nation-wide, population-based random cluster sampling of 1708 children in 119 school classes was performed throughout Finland. Data were collected with questionnaires sent to the parents and teachers of the children. Teachers evaluated each child's performance at school, and the association between the number of episodes of early otitis media and school achievement was determined. Recurrent otitis media episodes before the age of 3 years associated significantly with lower performance in mathematical skills (risk ratios [RR] 1.2-1.4, 95% confidence intervals [95% CI] 1.0-1.7, P-values 0.04-0.02) and classroom concentration (RR 1.4, 95% CI 1.1-1.8, P-value 0.02) among the girls. The boys with recurrent otitis episodes performed more poorly in reading (RR 1.3, 95%, CI 1.0-1.6, P-value 0.05) and oral performance (RR 1.2, 95% CI 1.1-1.4, P-value 0.01). No association between otitis episodes after the age of 3 years and school achievement was found. Our findings suggest that recurrent otitis media episodes before the age of 3 years have adverse long-term consequences even when treated actively. Even though the risk ratios were low our finding is important because recurrent otitis media is a common problem during infancy and school achievement has many practical influences on a child's future.

Age Distribution↗
PubMed1998

Risk of recurrence and outcome after the first febrile seizure.

After their first febrile seizure, 180 children were prospectively monitored to provide data for a quantitative and qualitative analysis of the factors affecting the risk of recurrence of febrile seizures and to evaluate the influence of recurrences on the outcome. Of these children, 153 had subsequent febrile episodes and were included in the risk-factor analysis. The outcome was evaluated after a 2-year follow-up in 156 children. Each febrile episode increased the risk of recurrence by 18%. Each degree of increase in temperature (Celsius) during subsequent infections almost doubled the risk of recurrence. Age, sex, the type of initial seizure, the temperature during the initial seizure, or a family history of febrile seizures or epilepsy did not influence the recurrence rate significantly. The results indicate that procedures that minimize the probability of febrile infections would decrease the risk of recurrences of febrile seizures.

Acetaminophen↗
PubMed1998

Prolonged pacifier-sucking and use of a nursing bottle at night: possible risk factors for dental caries in children.

At the baseline of this cohort study we determined risk factors for colonization of oral lactobacilli and candida in a group of children (n = 166) whose mean age was 2.5 years. The results showed that pacifier-sucking and the use of a nursing bottle at night increase the occurrence of both salivary lactobacilli and candida. In the present study these children were followed for 2 years, and the progression of caries was recorded with particular reference to the etiologic factors measured before. The results of the logistic regression analysis showed prolonged pacifier-sucking (> or = 24 months) to be a significant risk factor for caries development in children, with a rather high relative risk (RR) of 3.5 (95% confidence interval (CI), 1.5-8.2; P= 0.003). Prolonged use of a nursing bottle at night (> or = 24 months) was also a risk factor, but less significant than pacifier-sucking (RR, 2.6; CI, 1.1-6.4; P= 0.03). On the grounds of this study we conclude that prolonged pacifier-sucking (> or = 2 years) and use of a nursing bottle at night are risk factors for dental caries in children.

Bottle Feeding↗
PubMed1998

Rotaviral antibodies in the treatment of acute rotaviral gastroenteritis.

The efficacy of hyperimmune bovine colostrum received from cows immunized with simian rotavirus SA11 in the treatment of rotavirus gastroenteritis was compared in a randomized double-blind trial to colostrum and ordinary milk preparations. One hundred and thirty-five children aged 6-30 months with rotaviral gastroenteritis received either hyperimmune bovine colostrum (n=42), ordinary colostrum (n=42) or milk (n=41) as a 100 ml solution four times/d for 4 d. Even though the differences were in favour of hyperimmune bovine colostrum in all the variables evaluated [greater weight gain (403 vs 343 g), shorter duration of diarrhoea (3.1 vs 3.6 d), fewer stools during 6 d (11.5 vs 13.6) and fewer stools during the first 3 d (9.3 vs 11.3)], all the differences were statistically insignificant. Differences of this size are clinically unimportant in well-nourished immunocompetent children, but we suggest that the hyperimmune bovine colostrum tested in our trial had some effects in the treatment of acute rotaviral gastroenteritis and should be evaluated further.

Animals↗
PubMed1998

Changes in day care attendance rates and in the occurrence of adenoidectomies and tympanostomies.

The care of a child in a day care center is a marked risk factor for acute otitis media. In a nationwide questionnaire survey we found that the rate of tympanostomies and adenoidectomies was 59-67% higher for the children cared for at a day care center before the age of 3 y. When the local authorities in Finland at the beginning of 1990 were obliged by law to arrange day care for all children under 3 y, the number of adenoidectomies performed on children at this age increased by 30%.

Adenoidectomy↗
PubMed1998

Antiadhesive effects of xylitol on otopathogenic bacteria.

The exposure of either epithelial cells or pneumococci or both to 5% xylitol reduced the adherence of pneumococci. Exposure of epithelial cells or bacteria alone to xylitol did not reduce the adherence of Haemophilus influenzae, although the exposure of both cells and bacteria to xylitol reduced the adherence significantly. The adherence of Moraxella catarrhalis remained low irrespective of the exposure.

Bacterial Adhesion↗
PubMed1998

Intranasally administered immunoglobulin for the prevention of rhinitis in children.

OBJECTIVE: To determine the efficacy of intranasally administered immunoglobulin in preventing symptoms of rhinitis in children. METHODS: Forty children ages 1 to 4 years who attended day-care centers in Turku, Finland, were enrolled in the double blind, placebo-controlled study. The children were randomly assigned to receive treatment with immunoglobulin, composed mainly of immunoglobulin A, or placebo, both administered as nasal sprays twice daily for 8 weeks. During this medication period and an additional 8-week follow-up period, the parents recorded the symptoms of the children daily in the diaries provided. One child who met an exclusion criterion was withdrawn from the study after a few days of medication. RESULTS: During the 8-week medication period the 19 children in the immunoglobulin group had 42% fewer days with rhinitis than the 20 children receiving placebo (mean, 10.8 vs. 18.7 days; P=0.004). The total numbers of episodes of rhinitis in the immunoglobulin and placebo groups were 33 and 51, respectively. No significant differences were observed between the groups during the postmedication follow-up period. CONCLUSIONS: Intranasal administration of immunoglobulin appears to be an effective method to prevent symptoms of rhinitis in children, and further studies of this approach are needed.

Administration, Intranasal↗
PubMed1998

Symptoms of acute otitis media.

BACKGROUND: The decision to seek medical advise for children during upper respiratory infections is largely based on the parental assumption that the child's symptoms are related to acute otitis media. The symptoms related to acute otitis media, however, are considered nonspecific. METHODS: Altogether 857 healthy day-care children (mean age, 3.7 years) were followed up for 3 months, and the symptoms of each child were compared during upper respiratory infections with and without acute otitis media. RESULTS: A total of 138 children had upper respiratory infections with and without acute otitis media. The symptom with the strongest association with acute otitis media was earache [relative risk (RR), 21.3; 95% confidence intervals (CI), 7.0 to 106, P < 0.0001] but sore throat (RR = 3.2; CI = 1.1 to 11; P = 0.027), night restlessness (RR = 2.6; CI = 1.1 to 6.9; P = 0.024) and fever (RR = 1.8; CI = 1.1 to 3.2; P = 0.025) also had significant associations. Logistic regression analysis showed 71% of the cases to be correctly diagnosed on the basis of the symptoms of earache and night restlessness. The parents were able to predict the presence of acute otitis media with a sensitivity and specificity of 71 and 80%, respectively (positive predictive value, 51%; negative predictive value, 90%). CONCLUSIONS: Despite the limited value of symptoms in differentiating acute otitis media from upper respiratory infection, the parents are able to predict acute otitis media somewhat reliably. More symptoms than have been reported earlier appeared to be associated with acute otitis media.

Acute Disease↗
PubMed1998

Gender and teachers' rating of linguistic skills among second-grade schoolchildren.

The aim of the study was to evaluate the possible differences in linguistic skills and school achievement between girls and boys. In a nation-wide study, the achievement of 1,936 second-grade Finnish girls and boys was appraised according to the teachers' rating. The results were compared with the linguistic test performance of 364 pupils from the nearby area. The mean rates of girls in writing, reading, oral performance and attention were significantly higher than those of boys as evaluated by the teachers (p < 0.01). Also, the risk of boys to be below the median in their achievement rates compared with girls was higher (risk ratios 1.3-1.6, 95% confidence intervals 1.2-1.7, p < 0.01). In multiple regression analysis where birth order, duration of nursery day care, number of otitis media episodes and parental education were controlled for, male gender proved to be a risk factor for linguistic skills as graded by the teachers. Yet, performance in linguistic tests did not support the superiority of girls in linguistic skills. Professionals taking care of linguistic problems in children should be aware that teachers' evaluations are influenced by the gender of the pupil.

Child↗
PubMed1998

A novel use of xylitol sugar in preventing acute otitis media.

BACKGROUND: Xylitol, a commonly used sweetener, is effective in preventing dental caries. As it inhibits the growth of pneumococci, we evaluated whether xylitol could be effective in preventing acute otitis media (AOM). DESIGN: Altogether, 857 healthy children recruited from day care centers were randomized to one of five treatment groups to receive control syrup (n = 165), xylitol syrup (n = 159), control chewing gum (n = 178), xylitol gum (n = 179), or xylitol lozenge (n = 176). The daily dose of xylitol varied from 8.4 g (chewing gum) to 10 g (syrup). The design was a 3-month randomized, controlled trial, blinded within the chewing gum and syrup groups. The occurrence of AOM each time the child showed any symptoms of respiratory infection was the main outcome. RESULTS: Although at least one event of AOM was experienced by 68 (41%) of the 165 children who received control syrup, only 46 (29%) of the 159 children receiving xylitol syrup were affected, for a 30% decrease (95% confidence interval [CI]: 4.6%-55.4%). Likewise, the occurrence of otitis decreased by 40% compared with control subjects in the children who received xylitol chewing gum (CI: 10.0%-71.1%) and by 20% in the lozenge group (CI: -12.9%-51.4%). Thus, the occurrence of AOM during the follow-up period was significantly lower in those who received xylitol syrup or gum, and these children required antimicrobials less often than did controls. Xylitol was well tolerated. CONCLUSIONS: Xylitol sugar, when given in a syrup or chewing gum, was effective in preventing AOM and decreasing the need for antimicrobials.

Acute Disease↗
PubMed1997

Trends in serum lipid levels during 1980-1992 in children and young adults. The Cardiovascular Risk in Young Finns Study.

To assess secular trends in serum lipid levels in Finnish children and young adults, the authors examined a total of 3,517, 2,769, 2,392, 352, and 880 subjects who had complete data on serum lipids in 1980, 1983, 1986, 1989, and 1992, respectively, in a longitudinal follow-up study. Trend analyses were carried out among subjects aged 15 (n = 1,835) or 18 (n = 1,562) years to exclude the confounding effect of age on the study variables. Data on obesity, physical activity, smoking, and alcohol use were available from each study year, and data on diet were available for the study years 1980, 1986, and 1992. Between 1980 and 1992, mean total cholesterol levels decreased from 4.88 to 4.47 mmol/liter (from 189 to 173 mg/dl), and low density lipoprotein cholesterol levels decreased from 3.06 to 2.85 mmol/liter (from 119 to 110 mg/dl). The mean high density lipoprotein cholesterol levels decreased by 19%, from 1.43 to 1.15 mmol/liter (55.2 to 44.6 mg/dl). During 1986-1992, triglyceride levels increased by 15%, from 0.88 to 1.01 mmol/liter (78.2 to 89.9 mg/dl). During 1980-1992, body mass index values increased from 20.8 to 21.8 kg/m2, parallel to increases in skinfold thickness. In the diet, the ratio of polyunsaturated to saturated fatty acids increased from 0.26 to 0.39. Alcohol and oral contraceptive use became more frequent, and the subjects tended to become less physically active. In conclusion, a change in the lipid profile in Finnish adolescents aged 15 and 18 years and young adults during 1980-1992 was observed, characterized by a decrease in low density lipoprotein cholesterol and high density lipoprotein cholesterol levels and an increase in triglyceride level. Possible determinants for these changes include alterations in diet and a trend toward increased obesity.

Adolescent↗
PubMed1997

Use of micronutrients and alternative drugs by children with acute lymphoblastic leukemia.

The use of alternative therapies is thought to be common among cancer patients. To clarify the popularity of micronutrients among children with cancer, we performed a controlled follow-up survey. The use of micronutrients and alternative drugs by 15 families of children with acute lymphoblastic leukemia (ALL) receiving chemotherapy (62 members) and 26 control families (106 members) was monitored by means of daily diaries from November 1987 to December 1989. Forty percent of children with ALL (6 of 15) and 7.7% of their controls (2 of 26) took alternative medicines, the usage among the children with ALL being statistically significantly more common (difference, 32.3%; 95% confidence interval for difference [CI] 7.1, 57.5%; P < 0.04). All children with ALL and 50.0% of the control children (13 of 26) took vitamins (difference, 50.0%; 95% CI, 20.4-79.6%; P < 0.01). A total of 27.7% of the other members of the ALL families (13 of 47) and 11.1% of their counterparts in the control families (10 of 90) took alternative medicines, the usage in the index families being statistically significantly more common (difference, 16.6%; 95% CI, 3.4-29.7%; P < 0.03). The malignancy increased the use of alternative medicines among all members of the family and of vitamins and trace elements among the affected children.

Child↗
PubMed1997

A meta-analytic review of the preventive treatment of recurrences of febrile seizures.

OBJECTIVE: To assess the efficacy of various medications in the prevention of recurrent febrile seizures. STUDY DESIGN: A meta-analysis of all published randomized, placebo-controlled trials of the preventive treatment of febrile seizures published in English; 45 articles were found, but only 9 trials were randomized and placebo-controlled--4 using phenobarbital; 3, diazepam; 1, pyridoxine; and 1, phenytoin. In one of the phenobarbital trials, valproate was also compared with placebo. RESULTS: The risk of recurrences was significantly lower in children receiving continuous phenobarbital therapy than placebo (odds ratio 0.54, 95% confidence intervals 0.33 to 0.90, p = 0.017). The odds ratio for recurrences in the valproate group was 0.09, 95% CI 0.01 to 0.78, p = 0.011. No difference in the risk was found for recurrences between children receiving intermittent diazepam and placebo (odds ratio 0.81, 95% CI 0.54 to 1.22, p = 0.31). The risk for recurrences in children receiving pyridoxine or phenytoin did not differ from the risk among children receiving placebo. Four children would have to be treated with valproate (95% CI 2 to 11) or eight children would have to be treated with phenobarbital (95% CI 5 to 27), continuously, to prevent one febrile seizure. CONCLUSIONS: Because both agents found to be effective in prevention of recurrent febrile seizures have known adverse effects, prophylaxis of febrile seizures cannot be recommended.

Anticonvulsants↗
PubMed1997

Lack of association between copper, zinc, selenium and blood pressure among healthy children.

Contradictory results have been published about the relation between copper, zinc and selenium and blood pressure (BP). To evaluate the role of these trace elements in BP regulation, we analysed the correlations between BP and copper, zinc and selenium, measured from serum, diet and hair among 3596 healthy children in a 6-year follow up. Fasting blood samples were used in serum copper, zinc and selenium analyses. The dietary intake of trace elements and energy were determined by the 48-h recall method. The hair copper and zinc analyses were performed from the naturally coloured hair samples. Correlation analysis was used to show the relation between BP and copper, zinc or selenium in each study year and during a 3- or 6-year follow-up period. The zinc-to-copper ratio in serum, diet and hair was calculated. In the correlation analyses the data was adjusted for weight and the daily intake of energy. Neither serum and diet copper or zinc, nor the zinc-to-copper ratio correlated uniformly with BP measured in the same year (correlation coefficients varying from -0.12 to 0.18) or in the subsequent years. Hair copper and zinc correlated weakly negatively with BP (correlation coefficients varying from -0.17 to -0.01). Serum selenium correlated weakly positively with systolic and diastolic BP measured in the same year (correlation coefficients varying from 0.03 to 0.14), but not with subsequent BP measured in the second or third survey. Dietary selenium had an inconsistent effect on BP (correlation coefficients varying from -0.14 to 0.26). In conclusion, copper, zinc, their ratio or selenium did not associate with BP, nor did they have any effect on subsequent BP.

Adolescent↗
PubMed1997

Change in blood pressure during pubertal insulin resistance.

To examine the levels and relationship of blood pressure and insulin during puberty, blood pressure and serum insulin were measured in 3596 subjects, aged 3-18 y, whose pubertal status was graded according to the Tanner classification. The same study protocol was repeated in two follow-up surveys 3 and 6 y later for 2991 6-21-y-old subjects and 2799 9-24-y-old subjects, respectively. There was a 37-66% increase in insulin at Tanner stage 3 (pubic hair) among the female subjects and at Tanner stage 5 (pubic hair) among the male subjects, after which insulin started to decrease. The mean systolic and diastolic blood pressure increased steadily throughout puberty. The rise in blood pressure continued during early adulthood, despite the decrease in serum insulin. The correlation between systolic blood pressure and insulin measured in the same year was weak at each pubertal stage after standardization for weight, except among the female subjects at mid puberty. There was no relation between diastolic blood pressure and insulin. Adult systolic blood pressure could be predicted by pubertal insulin among the male subjects after adjustment for age and weight (partial correlation coefficient 0.21), but among the female subjects this relation was trivial (partial correlation coefficient 0.08). We conclude that the correlation between insulin and actual blood pressure vanishes during puberty, whereas pubertal insulin and future adult male systolic blood pressure seem to correlate.

Adult↗