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Biomedical subjects

O Ruuskanen

Publications and source records attributed to O Ruuskanen.

At least 109 records · Page 6Linked to original sources
PubMed1990

Serologic diagnosis of pertussis: evaluation of pertussis toxin and other antigens in enzyme-linked immunosorbent assay.

IgM, IgA, and IgG antibodies to Bordetella pertussis were measured in paired sera from 34 patients who were culture-positive for pertussis by enzyme-linked immunosorbent assay (ELISA) with disrupted B. pertussis bacteria, purified pertussis toxin, or outer membrane proteins (OMP) as antigens. Paired sera from 50 patients with other respiratory infections were used as controls. The sensitivities of the assays from paired sera were 61%, 90%, and 90% and specificities were 98%, 92%, and 72%, respectively. Of the patients culture-positive for pertussis, 68% had positive levels of antibody to pertussis toxin antigen in their first serum samples, obtained at the same time as samples for culture. Infants had antibody responses to pertussis toxin antigen, in contrast to weak antibody responses measured by B. pertussis antigen. The results from this study indicate that ELISA, especially measuring pertussis toxin IgA, is a valuable additional tool for diagnosing pertussis and can be used as a complementary test with cultures.

Adolescent↗
PubMed1990

Rapid detection of respiratory syncytial virus and influenza A virus in cell cultures by immunoperoxidase staining with monoclonal antibodies.

Peroxidase-labeled monoclonal antibodies against respiratory syncytial virus (RSV) and influenza A virus were used for immunoperoxidase staining (IPS) of cell cultures inoculated with nasopharyngeal aspirates. Cells were grown in 24-well plates, and specimens were inoculated by low-speed centrifugation. Cultures were incubated for 2 days at 37 degrees C and then fixed, stained, and observed by light microscopy. IPS was compared with standard virus isolation by using cultures of human diploid fibroblasts and Vero, HEp-2, and HeLa cell lines for RSV and Madin-Darby canine kidney cells for influenza A virus; these cultures were inoculated with specimens that were previously stored at -70 degrees C. Of 40 known RSV-positive specimens, 30 were found to be positive on reinoculation by both methods, and an additional 5 specimens were found to be positive by IPS only. Of 190 specimens tested for influenza A virus, 14 were positive by IPS and in tubes, and a further 8 specimens were positive by IPS only. IPS was also compared with direct detection of viral antigens in nasopharyngeal aspirates by a time-resolved fluoroimmunoassay (TR-FIA). Fresh nasopharyngeal aspirates were inoculated into human diploid fibroblasts and Madin-Darby canine kidney cells and tested for RSV and influenza A virus, respectively, by IPS. Of 110 specimens tested for RSV, 37 were positive in total, 32 were positive by IPS, and 33 were positive by TR-FIA. Of 150 specimens tested for influenza A virus, 39 were positive in total, 35 were positive by IPS, and 34 were positive by TR-FIA. IPS of cultures inoculated by centrifugation and incubated for 2 days is a sensitive method for the diagnosis of respiratory virus infections, and 24-well plates allow for the easy processing of a large number of specimens.

Animals↗
PubMed1990

Rhinovirus in otitis media with effusion.

We studied rhinovirus in the middle ear fluid of 61 children with subacute or chronic otitis media with effusion. Rhinovirus was recovered from the middle ear fluid of 5 children with subacute otitis media with effusion. The minimum duration of effusion was 32 to 60 days. Additionally, 1 patient had middle ear fluid that was positive for adenovirus. Bacterial pathogens were cultured from the middle ear fluid of 20 of 61 patients. Our finding that rhinovirus can be isolated from middle ear fluid after an asymptomatic period of several weeks suggests its possible role in the development of otitis media with effusion.

Bacteria↗
PubMed1990

A randomised comparison of ceftazidime and piperacillin, both in combination with flucloxacillin for treatment of febrile episodes in neutropenic children. Finnish Three-Centre Study.

111 febrile episodes in 98 neutropenic children were randomly treated with either ceftazidime (CAZ) 150 mg/kg/day or with piperacillin (PIP) 200 mg/kg/day, both combined with flucloxacillin (FLUC) 50 mg/kg/day. A total of 37/47 (79%) eligible episodes in the CAZ group and 41/53 (77%) in the PIP group were cured without needing to stop the initial therapy. The success without modification of the treatment in the verified septicaemias in the CAZ group was 8/18 (44%) and in the PIP group 5/18 (28%). Of the bacteriologically documented infections, 13/24 (54%) in the CAZ group and 11/24 (46%) in the PIP group were cured without modification of the therapy. Similarly, 17/31 (55%) of all the isolated bacteria in the CAZ group and 14/33 (42%) in the PIP group were eradicated with the initial therapy. Overall there were 13 deaths of which 4 in the CAZ group and 5 in the PIP group occurred during the infection. An increasing granulocyte count exceeding 0.25 x 10(9)/l at the end of the therapy was a good prognostic sign for the outcome of the infection. This study indicates that CAZ is as effective as PIP in the treatment of infections in neutropenic children.

Adolescent↗
PubMed1990

Clinical role of respiratory virus infection in acute otitis media.

The clinical characteristics of acute otitis media in relation to coexisting respiratory virus infection were studied in a 1-year prospective study of 363 children with acute otitis media. Respiratory viruses were detected using virus isolation and virus antigen detection in nasopharyngeal specimens of 42% of the patients at the time of diagnosis. Rhinovirus (24%) and respiratory syncytial virus (13%) were the two most common viruses detected. Adenovirus, parainfluenza viruses, and coronavirus OC43 were found less frequently. The mean duration of preceding symptoms was 5.9 days before the diagnosis of acute otitis media. Ninety-four percent of the children had symptoms of upper respiratory tract infection. Fever was reported in 55% and earache in 47% of cases. Patients with respiratory syncytial virus infection had fever, cough, and vomiting significantly more often than patients with rhinovirus infection or virus-negative patients. No significant differences were found in the appearance of the tympanic membrane and outcome of illness between virus-negative and virus-positive patients with acute otitis. Most patients respond well to antimicrobial therapy despite the coexisting viral infection. If the symptoms of infection persist, they can be due to the underlying viral infection, and viral diagnostics preferably with rapid methods may be clinically useful in these patients.

Acute Disease↗
PubMed1989

Acute otitis media and respiratory virus infections.

We studied the association of acute otitis media with different respiratory virus infections in a pediatric department on the basis of epidemics between 1980 and 1985. Altogether 4524 cases of acute otitis media were diagnosed. The diagnosis was confirmed by tympanocentesis in 3332 ears. Respiratory virus infection was diagnosed during the same period in 989 patients by detecting viral antigen in nasopharyngeal mucus. There was a significant correlation between acute otitis media and respiratory virus epidemics, especially respiratory syncytial virus epidemics. There was no significant correlation between outbreaks of other respiratory viruses and acute otitis media. Acute otitis media was diagnosed in 57% of respiratory syncytial virus, 35% of influenza A virus, 33% of parainfluenza type 3 virus, 30% of adenovirus, 28% of parainfluenza type 1 virus, 18% of influenza B virus and 10% of parainfluenza type 2 virus infections. These observations show a clear association of respiratory virus infections with acute otitis media. In this study on hospitalized children Haemophilus influenzae strains were the most common bacteriologic pathogens in middle ear fluid, occurring in 19% of cases. Streptococcus pneumoniae was present in 16% and Branhamella catarrhalis in 7% of cases. There was no association between specific viruses and bacteria observed in this study.

Female↗
PubMed1989

Regulatory T-cell function in primary humoral immunodeficiency states.

The function of B cells and highly purified T-cell subpopulations was studied in patients with various primary humoral immunodeficiencies. In the presence of normal T4+ cells B cells of the patients with X-linked agammaglobulinemia (XLA) were not capable either for IgM or IgG synthesis, whereas B cells of the patient with hyper-IgM syndrome and three of eight patients with common variable immunodeficiency (CVI) could produce normal amounts of IgM, but not IgG. All patients with XLA and the patient with hyper-IgM syndrome exhibited normal helper function by T4+ cells for both IgG and IgM synthesis of normal B cells. The function of CVI T4+ cells was variable. When the function of the patients' T8+ cells was tested against normal B cells, one CVI patient had overactive suppression capacity; in other patients the suppressor cell activity was normal. The findings indicate considerable heterogenicity in the function of lymphocyte subpopulations of the CVI patients.

Adolescent↗
PubMed1988

Kawasaki disease: monitoring of circulating immune complexes.

We followed the levels of circulating immune complexes (CIC) in 27 patients with Kawasaki disease (KD) from the acute stage of the disease through convalescence, using the test for platelet-reactive IgG-IC, and C1q-binding and conglutinin-binding enzyme immunoassays. CIC were detected by one or more techniques in all but one patient. Positive results were obtained most often with the test for platelet-reactive IgG-IC. Measurement of complement components C3 and C4 in 14 patients revealed an increase in C3 levels during the first few weeks of the disease and normal levels of C4. The blood platelet count correlated directly with the level of platelet-reactive IgG-IC. The highest levels of CIC were found during weeks 3 through 7 after the onset of disease. Measurement of CIC is, however, not applicable to the clinical follow-up of patients with KD.

Antigen-Antibody Complex↗
PubMed1988

Adenovirus infection in families.

Eighteen families were followed up for four to six weeks after one member of each family was diagnosed as having an adenovirus infection. In 17 of 18 index cases the diagnosis was based on the rapid detection of adenovirus hexon antigen in the nasopharyngeal mucus specimens and in one case (the only adult index case) on isolation of the virus. All index cases had high temperatures associated most commonly with tonsillitis, acute otitis media, gastroenteritis, or febrile convulsions. In 14 of the 16 families with symptomatic contacts the index case was the first symptomatic case, or one of the first symptomatic cases, in that family. Fifteen (94%) of the siblings and 20 (56%) of the parents had signs and symptoms of acute infection during the follow up period. In 10 (63%) and eight (20%) of these cases, respectively, adenovirus was confirmed. The mean (SD) incubation period of confirmed adenovirus infections was 10 (3) days. The observations show that adenovirus infection spreads actively to other siblings in the family. Rapid diagnosis permits parents to be informed prospectively about the expected spread and clinical picture of the illness in the family.

Adenoviridae Infections↗
PubMed1987

Childhood bacterial meningitis: initial symptoms and signs related to age, and reasons for consulting a physician.

The relationship of symptoms and signs to age and the reasons for consulting a physician were analyzed in 110 cases of culture-proven childhood bacterial meningitis. H. influenzae caused 74, meningococci 28, pneumococci 6 and streptococci 2 of the cases. Apart from fever (present in 94%), the most common symptoms according to age were as follows: 1-5 months: irritability (85%), 6-11 months: impaired consciousness (79%), 12 months or more: vomiting (82%) and neck rigidity (78%). Absence of neck rigidity at diagnosis was associated with young age (less than 12 months, P less than 0.001) and, in older children, to a short duration of symptoms (P less than 0.01) but not to the degree of CSF pleocytosis. Symptoms of meningitis caused by H. influenzae differed from those of meningococcal meningitis. Meningitis should be suspected in irritable or lethargic febrile children despite absence of neck rigidity. Fever and vomiting were the most frequent reasons for consulting a physician (60% and 31%, respectively). Despite the frequency and alarming character of irritability, impaired consciousness and neck rigidity, their presence led infrequently to a consultation (6%, 22% and 3%, respectively). Parental ignorance of such symptoms or of their importance may cause treatment delay, despite readily available medical services.

Adolescent↗
PubMed1987

A nursery outbreak of group A streptococcal infection.

We report an outbreak of 23 neonatal group A streptococcal infections including two cases of septicaemia in a nursery for the newborn. At the same time, 19 mothers had puerperal endometritis. The outbreak lasted for about 2 months and could not be eradicated by ordinary hygienic measures. In a colonisation study, 19 of 90 umbilical stumps studied on the day of discharge from hospital harboured group A streptococci, all of the same epidemic strain T28 provisional M-type 2841/opacity factor positive (T28/MPT2841/OF+). Chlorhexidine gluconate was therefore applied daily to the umbilical stumps. The outbreak came to an end with the introduction of this procedure. The time interval between delivery and recognition of infection was shorter in infants than in mothers. There were also only two infected mother-infant pairs. Taken together, this suggests that infected umbilical stumps on symptomless infants were a likely source of the maternal infections. Throughout 1 year from the introduction of the chlorhexidine treatment, we have not seen a case of group A streptococcal infection in neonates. Surveillance cultures from umbilical cords after the outbreak have also been negative. We conclude that bacteriological surveillance of umbilical stumps is valuable in recognising an outbreak and should be seriously considered when a group A streptococcal infection has been recorded in a nursery.

Disease Outbreaks↗
PubMed1986

Fever in respiratory virus infections.

The case records of 258 children with adenovirus; influenza A or B virus; parainfluenza 1, 2, or 3 virus; or respiratory syncytial virus infections were studied retrospectively with special attention to the degree and duration of fever. A temperature of 39.0 degrees C or higher was most frequently recorded in adenovirus, influenza A, and influenza B virus infections (in 68%, 84%, and 65%, respectively). The mean highest degree of fever in respiratory virus infections (39.2 degrees C +/- 0.6 degrees C) during hospitalization did not differ from that in defined serious bacterial infections, ie, meningitis, epiglottitis, sepsis, and urinary tract infections (39.3 degrees C +/- 0.7 degrees C). The mean duration of fever varied from 2.5 days (parainfluenza 2) to 5.2 days (influenza B). Of all children with respiratory virus infections, 37% had fever lasting five days or longer. The data show that high and prolonged fever is frequently associated with respiratory virus infections in hospitalized children and that it does not differ significantly from fever in severe bacterial infections.

Adenovirus Infections, Human↗
PubMed1986

C-reactive protein in the differentiation of adenoviral, Epstein-Barr viral and streptococcal tonsillitis in children.

Sixty-two children with febrile exudative tonsillitis were studied to explore whether quantitative measurements of serum C-reactive protein (CRP) are useful in differentiating viral from streptococcal tonsillitis. There were 23 cases of adenoviral tonsillitis, 21 of EB viral tonsillitis and 18 of streptococcal tonsillitis. Measurements of CRP, WBC counts and erythrocyte sedimentation rates (ESR) were not useful in distinguishing viral from streptococcal tonsillitis. Seventy-four percent of patients with adenoviral tonsillitis were under the age of 3 years and 71% of the patients with Epstein-Barr (EB) viral tonsillitis were under the age of 6 years whereas 72% of the patients with streptococcal tonsillitis were over the age of 6 years. Age was clearly the most important factor in distinguishing between viral and bacterial tonsillitis in children.

Adenoviridae Infections↗
PubMed1986

C reactive protein in the evaluation of febrile illness.

We studied prospectively 154 febrile children to determine the diagnostic value of the quantitative serum C reactive protein concentrations (CRP). Children with acute otitis media, acute tonsillitis, or treated with antibiotics during the two previous weeks and infants less than 2 months of age were excluded. Ninety seven children were from private paediatric practice and 57 were patients who had been admitted to hospital. The comparison group consisted of 75 children with confirmed bacterial infections whose CRP values were recorded retrospectively. In the study group 35 (23%) children had a confirmed viral infection, 92 (59%) had a probable viral infection as judged from the clinical picture and outcome of the illness, and 27 (18%) had a bacterial or probable bacterial infection. When the duration of the disease was more than 12 hours and the CRP value less than 20 mg/l, all children had a confirmed or probable viral infection. Nine children (one from the study group and eight from the comparison group) were found to have a septic infection and a CRP value of 20 mg/l or less. In all these cases, however, the duration of the symptoms was less than 12 hours. In addition CRP less than or equal to 20 mg/l was found in five (14%) children with urinary tract infection in the comparison group. CRP values of 20-40 mg/l were recorded in children with both viral and bacterial infections. A CRP value greater than or equal to 40 mg/l detected 79% of bacterial infections with 90% specificity. Our data show that determination of serum CRP concentrations is a valuable tool in evaluating children who have been ill for more than 12 hours.

Adolescent↗