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Biomedical subjects

T Vesikari

Publications and source records attributed to T Vesikari.

At least 109 records · Page 6Linked to original sources
PubMed1985

Neonatal septicaemia.

A total of 410 proved cases of neonatal septicaemia from seven Finnish hospitals seen between 1976 and 1980 were reviewed. The annual incidence of neonatal septicaemia was 3 per 1000 births, and overall mortality was 23%. Onset was early in most patients. Symptoms of septicaemia occurred within the first 24 hours of life in 44% and within the first week of life in 90%. In the very early onset disease (within 24 hours) mortality was 30%, compared with 17% in all other cases. Group B streptococcus was the leading cause in very early onset disease (52%) but mortality from infection with this organism was similar to that in other very early onset cases. It is concluded that very early onset neonatal septicaemia, probably of intrauterine origin and caused by group B streptococcus in one half of the cases, constitutes the major form of neonatal septicaemia in Finland and should receive the highest priority in preventive measures.

Enterococcus faecalis↗
PubMed1984

Protection of infants against rotavirus diarrhoea by RIT 4237 attenuated bovine rotavirus strain vaccine.

A randomised, double-blind, placebo-controlled trial was conducted to evaluate the ability of RIT 4237 live attenuated bovine rotavirus (subgroup 1) vaccine strain to protect against natural rotavirus infection in children. 178 infants aged 8 to 11 months received a single oral dose of RIT 4237 vaccine or placebo and were followed up serologically and clinically during a subgroup 2 rotavirus epidemic. No side-effects attributable to the vaccine were observed. During the 5 months' observation after vaccination 2 of the 86 vaccine recipients and 18 of 92 placebo recipients had rotavirus diarrhoea lasting more than 24 h (p less than 0.001). The vaccine-protection rate was thus 88%. The 2 children in the vaccine group with rotavirus diarrhoea were regarded as primary vaccine failures since they had no detectable serum antibody responses after vaccination. Vaccine prepared from RIT 4237 strain of attenuated bovine rotavirus thus seems to protect children against heterologous subgroup 2 rotavirus diarrhoea.

Animals↗
PubMed1984

Clinical trial of a new trivalent measles-mumps-rubella vaccine in young children.

Trivalent measles-mumps-rubella virus vaccines, containing either Schwarz (two dosage levels), Urabe Am 9, and RA 27/3 strains or Moraten, Jeryl Lynn, and RA 27/3 strains, were evaluated in 174 children aged 14 to 24 months. Each of the three vaccines induced a nearly 100% seroconversion for measles and mumps and a full 100% seroconversion for rubella. Close home monitoring disclosed a high incidence and a relatively constant pattern of vaccine-associated reactions, similar for all three vaccines. Febrile reactions of greater than or equal to 39 degrees C between days 5 and 12 after vaccination were more frequent among the recipients of "high"-dose Schwarz strain vaccine (35%) than among the recipients of corresponding "low"-dose vaccine (13%). The Schwarz-Urabe Am 9-RA 27/3 was equally immunogenic and, with a low dose of measles virus, no more reactogenic than the Moraten-Jeryl Lynn-RA 27/3 trivalent vaccine.

Antibodies, Viral↗
PubMed1984

Evaluation of a serum IgA-class reticulin antibody test for the detection of childhood celiac disease.

Serum IgA class reticulin antibody (RA) was found in 28 (97%) of 29 children with flat small bowel mucosa, and in low titer in four (2%) of 245 with normal or near normal mucosa on small intestinal biopsy. Thus the sensitivity of the IgA-RA fluorescent antibody test for screening of celiac disease was 97% and the specificity 98%. IgA-RA was superior to IgG-RA for the detection of celiac disease. During follow-up of patients receiving a gluten-free diet, the IgA-RA rapidly decreased and in most cases disappeared within a year, suggesting that the test may be useful for clinical follow-up of celiac disease as well.

Adolescent↗
PubMed1984

Clostridium difficile in young children. Association with antibiotic usage.

Clostridium difficile was isolated from the stools of 11/52 (21%) of children aged 0 to 2 years hospitalized with diarrhoea, and from 17/52 (33%) of a control group of hospitalized children with no diarrhoea; this difference was not significant. Direct demonstration of C. difficile toxin from the stools was positive in 1 case with diarrhoea and in 5 control cases. The children with positive stool culture for C. difficile had had significantly more treatments with antibiotics or chemotherapeutics than those with negative C. difficile culture (3.3 +/- 2.7 vs. 1.6 +/- 1.8, p less than 0.001), but there was no significant difference in the incidence of diarrhoea in the past. During a 4-6-month follow-up, C. difficile disappeared from the stools of 24 out of 28 initially culture-positive children; 3 of the 4 children with persistent C. difficile had received antibiotics during the follow-up period. We conclude that the presence of C. difficile is common in the stools of young children up to the age of 2 years, and that C. difficile is more frequently found in children who have received antimicrobial therapy. Most cases of C. difficile carriage state are symptomless at this age.

Anti-Bacterial Agents↗
PubMed1984

Pseudomembranous colitis with recurring diarrhoea and prolonged persistence of Clostridium difficile in a 10-year-old girl.

A 10-year-old girl developed, after treatment with amyxocillin, a clinically and sigmoidoscopically apparent pseudomembranous colitis with positive Clostridium difficile stool culture. Treatment with vancomycin resulted in rapid clinical cure, but there was a relapse of diarrhoea and reappearance of C. difficile, with no pseudomembranous colitis, within one month. Clinical symptoms subsided spontaneously but C. difficile persisted for 2 more months in the stools. This case reflects three different aspects of C. difficile infection in one child: pseudomembranous colitis, ordinary diarrhoea, and symptomless carrier state.

Amoxicillin↗
PubMed1984

Increased prevalence of coeliac disease in diabetes.

A total of 215 diabetic children were screened for coeliac disease by determination of class specific serum reticulin antibody. Nine children were positive for reticulin antibody and all underwent biopsy of the small intestine. Four new cases of coeliac disease were found; all of these children had IgA reticulin antibody. Two of three other children with a low titre of IgA reticulin antibody had partial villous atrophy. It was concluded that IgA class reticulin antibody was a good marker of coeliac disease in diabetic children. The prevalence of coeliac disease in these children was 1:43 (including one previously diagnosed case) and we suggest that diabetic children be screened routinely for reticulin antibody.

Adolescent↗
PubMed1983

Immunogenicity and safety of live oral attenuated bovine rotavirus vaccine strain RIT 4237 in adults and young children.

A candidate oral live rotavirus vaccine, strain RIT 4237, of bovine origin, was tested for immunogenicity and safety in man. In adults the vaccine did not cause clinical symptoms, and a booster response in rotavirus serum antibodies was seen in 2/20 subjects. In seronegative young children one oral dose induced seroconversion to homologous virus in 15/17 (88%) children seronegative by enzyme immunoassay and in 13/19 (68%) children seronegative by a neutralisation assay. The vaccine did not produce gastrointestinal or constitutional symptoms in the children, nor did it cause rotavirus excretion in the stools. The results suggest that the RIT 4237 strain is a promising candidate for a vaccine against human rotavirus, and the vaccine-induced immunity against natural human rotavirus infection should be evaluated in future trials.

Administration, Oral↗
PubMed1983

Evaluation in young children of the Urabe Am 9 strain of live attenuated mumps vaccine in comparison with the Jeryl Lynn strain.

Urabe Am 9, a new strain of mumps vaccine, originally developed in Japan, was evaluated in children 14 to 20 months of age in a comparative trial with the Jeryl Lynn strain. Both vaccines performed well. The antibody responses were measured using a neutralization test and a haemolysis-in-gel test. The seroconversion rates at six weeks, as detected with either one or both tests, were 55/58 (94.8%) after the Urabe Am 9 and 58/60 (96.7%) after the Jeryl Lynn vaccine. Only mild infrequent adverse reactions were observed. It is concluded that both strains of live attenuated mumps vaccine are immunogenic and well-tolerated in this age group.

Antibodies, Viral↗
PubMed1983

Comparison of the Urabe Am 9-Schwarz and Jeryl Lynn-Moraten combinations of mumps-measles vaccines in young children.

Two mumps-measles vaccine combinations were evaluated for their reactogenicity and immunogenicity in children aged 14 to 20 months. The Urabe Am 9-Schwarz combination vaccine was given to 108 double seronegative children. The seroconversion rate at six weeks after vaccination was 99.1% for measles (haemagglutination-inhibition test) and 92.6% for mumps (neutralization and haemolysis-in-gel tests). The Jeryl Lynn-Moraten vaccine was administered to 85 double seronegative children; the seroconversion rates were 95.3% for measles and 83.5% for mumps. The reported post-vaccination signs and symptoms resembled those seen after monovalent measles vaccine but were more accentuated. Fever over 37.5 C degrees was reported in 66.7% and unusual restlessness and irritability in 68.5% of the Urabe Am 9-Schwarz double seronegative vaccines compared to 55.3% (p less than 0.05) and 54.1% (p less than 0.05), respectively, in the recipients of the Jeryl Lynn-Moraten vaccine. These relatively high reaction rates probably reflect the close observation of the children by their parents during the study. Nevertheless, the tendency towards increased reaction rate and, possibly, reduced immunogenicity of bivalent mumps-measles vaccines as compared to the corresponding single vaccines should be taken into account in the planning of large scale vaccination of young children.

Antibodies, Viral↗
PubMed1983

Adherence and toxicity of Yersinia enterocolitica 0:3 and 0:9 containing virulence-associated plasmids for various cultured cells.

Plasmid (47 and 44 Mdal, respectively) containing strains of Yersinia enterocolitica 0:3 and 0:9 adhered to and were toxic for HEp-2 human epithelial and Y-1 adrenal cells in vitro, At 37 degrees C, but not at room temperature, the adhesion of the bacteria lead to rounding and partial detachment of the cultured cells. UV-inactivated plasmid-positive Y. enterocolitica were neither adherent nor toxic for the cells but were readily endocytosed by HEp-2 cells. The adherence of plasmid-positive Y. enterocolitica 0:3 and 0:9 on epithelial cells may be pathogenetically important as an initial step for intestinal colonization, and possibly in Y. enterocolitica-induced diarrhoea. Plasmid-positive Y. enterocolitica also adhered to the surface of cultured human macrophages and were apparently not phagocytosed as effectively as the plasmid-negative derivatives of the same bacteria. Thus resistance to phagocytosis may form an additional plasmid-dependent virulence property of Y. enterocolitica 0:3 and 0:9.

Adhesiveness↗
PubMed1983

Pathogenicity of 42-44 Mdal plasmid positive and negative Yersinia pseudotuberculosis I and Yersinia enterocolitica 0:8 and 0:9 studied in the guinea pig eye model (Serény test).

When virulence plasmid (42-44 Mdal) positive and negative Yersinia pseudotuberculosis I and Yersinia enterocolitica 0:8 and 0:9 were tested in the guinea pig eye model the following order of pathogenicity was observed: Plasmid-positive Y. pseudotuberculosis I (death of the animal) greater than plasmid-negative Y. pseudotuberculosis I approximately equal to plasmid-positive Y. enterocolitica 0:8 (severe conjunctivitis) greater than plasmid-positive Y. enterocolitica 0:9 (mild conjunctivitis) greater than plasmid-negative Y. enterocolitica 0:8 and 0:9 (no effect).

Animals↗
PubMed1983

Epidemiologic background for the need of rotavirus vaccine in Finland. Preliminary experience of RIT 4237 strain of live attenuated rotavirus vaccine in adults.

Epidemiologic evidence from Finland indicates a dramatic change in the seasonal pattern of acute diarrhoea over the past 30 years. While in the 1950's the majority of cases occurred in late summer the seasonal peak in the 1970's was in winter and spring, coinciding with the prevalence of rotavirus infections. It is not possible to determine retrospectively the aetiologic agents involved in the summer diarrhoea, but EPEC may have been one of them, as EPEC are quite rare in Finland today compared to the 1950's. Another change over the time period is a shift in the age distribution of acute diarrhoea from neonates towards older infants. Rotavirus is today associated with approximately 50% of the cases of acute diarrhoea in children in Finland. Based on experience in one Central Hospital it was estimated that the treatment of rotavirus infections may require some 7300 hospital days in Finland annually, which figure is comparable to that of mumps. As a recent cost-benefit analysis in Finland indicated that a mumps vaccination programme would be economically quite efficacious, the same could be assumed to be true for rotavirus vaccination, provided that an effective and safe vaccine was available. In a preliminary trial of RIT 4237 strain of live attenuated rotavirus vaccine in 20 healthy adult volunteers no clinical symptoms and no excretion of vaccine virus were observed. Rotavirus ELISA antibody booster response was found in 1/20 vaccinees.

Adult↗