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Biomedical subjects

O Pettay

Publications and source records attributed to O Pettay.

At least 19 recordsLinked to original sources
PubMed1989

Neonatal herpes simplex virus infection: a report of 43 patients.

We present a series of 43 infants with neonatal herpes simplex virus infection treated at the Children's Hospital, University of Helsinki, during a 16-year period from 1970 to 1985. Twelve mothers (28%) had a history of genital herpes during pregnancy, and two had had labial herpes infection. Eight infants (19%) were delivered by cesarean section. In 14 (33%) infants symptoms appeared within 24 hours and in 26 (61%) they appeared within 7 days. The presenting symptoms were neurologic in 79%, cutaneous in 30%, respiratory in 19%, cyanosis/pallor/grayish skin in 16%, irritability in 12% and fever in 7%. Herpes simplex virus was detected most early and frequently in pharyngeal swabs, in one-third on Postnatal Days 2 to 5. Cerebrospinal fluid contained an increased amount of protein and/or pleocytosis in 72%. Abnormal electroencephalographic background activity appeared in 56% and electrical paroxysms in 41%. Six infants (14%) died, 9 (21%) were damaged severely and 6 (14%) were moderately or mildly damaged. Poor prognosis was associated with acute maternal illness at delivery, prematurity, visceral involvement and/or electrical paroxysms in the electroencephalograms. This study underlines the occurrence of intrauterine transmission of herpes virus, infections with neurologic manifestations, early symptomatology and the need for prompt diagnosis, brain biopsy in selected patients and antiviral therapy in neonates with herpes virus infection.

Adolescent↗
PubMed1986

Outbreak of Kawasaki syndrome in Finland.

During a ten-month period from June 1981 to March 1982 83 patients with Kawasaki syndrome were diagnosed in Finland. The attack rate was 26/100 000 children under five years of age, corresponding to an annual attack rate of 31/100 000 children under five years. The course of the outbreak suggested geographic spreading. 20% of the patients had clinical and ECG evidence of carditis, and ECG abnormalities were found in 59% of the patients. One patient died from a ruptured coronary aneurysm. Neurologic manifestations were seen in 10% of the patients. This is the first reported outbreak of Kawasaki syndrome outside Japan, Korea and the United States of America.

Adolescent↗
PubMed1986

Vaccination of children during treatment for leukemia.

Forty-one children receiving maintenance treatment for leukemia were vaccinated with inactivated mumps virus, meningococcal polysaccharide groups A and C and polyvalent pneumococcal polysaccharide vaccines. Antibodies against pneumococcal types 3, 18C, 19F and 23F and against meningococcal groups A and C were measured by radioimmunoassay. Mumps antibodies were determined by complement fixation, hemolysis-in-gel and enzyme-linked immunosorbent assays. The antibody responses tended to be lower than those of healthy age-matched controls. The individual responses were unpredictable; the magnitude of the response correlated neither with the age nor sex of the patient, duration of the chemotherapy nor with the prevaccination antibody concentration. Nevertheless, most patients achieved and even exceeded the geometric mean of the antibody concentrations of the healthy children, considered protective against infection.

Acute Disease↗
PubMed1983

EEG in neonatal herpes simplex encephalitis.

The EEGs of 21 newborns with herpes simplex encephalitis were analysed. The diagnosis was based on the demonstration of herpes simplex infection in association with neurological symptoms, other etiological factors being excluded. Sixteen of 21 babies (76%) showed in their EEGs electrical seizures, either focal or unilateral. These paroxysms consisted of sharp waves or slow waves repeating at pseudo-periodic intervals, usually of 0.5-2 sec. Individual paroxysms had a duration of 10-20 sec in 6 babies and 1-2 min in 10 patients. During the same period, 20 other babies displayed the same EEG finding. Of these, 11 had encephalitis of unknown etiology. In our series there appeared to exist a correlation between both the duration of the electrical seizures and the degree of EEG background abnormality and the clinical outcome. Babies with markedly abnormal background and long-lasting paroxysms tended to have a poor prognosis. It is concluded that in newborns with clinical signs of encephalitis who show in their EEGs paroxysms of the type described, the possibility of herpes simplex encephalitis should be considered.

Electroencephalography↗
PubMed1978

Haemophilus influenzae meningitis. A comparison between chloramphenicol and ampicillin therapy with special reference to impaired hearing.

131 patients suffering from meningitis due to Haemophilus influenzae or parainfluenzae were re-examined after 1-15 years, using hospital records, questionnaires, and audiological examination, especially to compare chloramphenicol and ampicillin therapy. Mortality was 3.8%. Subdural effusions occurred in 14.5% of cases uni- or bilaterally. There was deafness in 2.3%, and moderate hearing loss in 8.4%. Convulsions appeared later in 6.9%. The final outcome was good in 60%. The most important factors in prognosis seemed to be the severity of the symptoms and the condition of the patient on admission to hospital. No clear difference was seen between the results of chloramphenicol and ampicillin therapy, but total loss of vestibular function was found in 3 cases in the ampicillin group, and in none in the chloramphenicol group. In mortality and deafness, the differences in outcome were similar, although not statistically significant. As these observations show, the therapy used in Haemophilus influenzae meningitis needs re-evaluation.

Ampicillin↗
PubMed1978

Epidemiology of cytomegalovirus infections during pregnancy and infancy. A prospective study.

The occurrence and possible consequences of cytomegalovirus (CMV) infections were studied in 200 mothers and their children by means of immunofluorescent antibody assays in serum, virus isolation from urine and regular clinical and neurological examinations. The prospective study covered the time from early pregnancy to 1 year post partum. The frequency of intrauterine infections was 2%, while 30% of the children became perinatally infected as indicated by the onset of virus excretion and an antibody response at the age of 2--4 months. Later on the occurrence of CMV infections declined sharply. 23 mothers had no CMV antibodies and none of their children contracted CMV during the first year of life. Maternal antibodies seemed unable to protect the child from CMV infections or to delay the onset of virus excretion in perinatally infected children. Intrauterine infections did not correlate with significant increases in the antibodiy titres of the mothers or the presence of IgM antibodies either in the mother's sera or in the cord sera. Perinatal infections were often associated with the presence of IgM antibodies both in the child and in the mother and in these mothers significant increases in CMV antibody titres were frequently seen, probably indicating an activated latent infection. Immunofluorescent antibody assay correlated well with virus isolations and was more sensitive than complement-fixing antibody assay.

Adult↗
PubMed1977

Clinical efficacy of meningococcus group A capsular polysaccharide vaccine in children three months to five years of age.

We performed field trials in the course of an epidemic in Finland to learn whether Group A memingococcal capsular polysaccharide vaccine protects infants and young children from meningitis. The first trial involved 130,178 children between the ages of three months and five years; 49,295 children received the vaccine, 48,977 received a control Haemophilus influenzae Type b polysaccharide vaccine, and 31.906 remained unvaccinated. No cases of meningitis or sepsis caused by Group A meningococci were seen in the first year of observation among the children vaccinated with meningococcal vaccine whereas six occurred among those vaccinated with the H. influenzae vaccine and 13 among those not vaccinated. In the second trial 21,007 children of the same ages received the meningococcal vaccine. No cases caused by Group A occurred among those vaccinated, although five to seven would have been expected within the year. Meningococcal Group A vaccine appears efficacious in young infants and children.

Antibodies, Bacterial↗
PubMed1977

Perinatal cytomegalovirus infection in man.

In a prospective study of 148 children from urbanized southern Finland 3 were found to be congenitally and 48 perinatally infected with cytomegalovirus (CMV), while 6 developed "late" infection during the first year of life. During pregnancy and the first year after delivery 23 of the mothers had no CMV antibodies; none of the children of these seronegative mothers developed any type of CMV infection. Fresh blood exchange transfusions did not increase the risk of CMV infection. The data support the hypothesis that the mother is the source of perinatal CMV infection. Children with a low birthweight not due to prematurity, and first children seem to run a greater risk of acquiring perinatal CMV infection. If the child is breast fed up to the age of 2 months the risk seems to be increased. Perinatal CMV infection gave rise to no symptoms or signs and had no effect on growth or on motor and psychosocial development during the first year of life.

Birth Order↗
PubMed1976

Vaccination against meningococcal group A disease in Finland 1974-75.

Meningococcal group A polysaccharide vaccine was used in children 3 months to 5 years of age in the winter 1974-75 during an epidemic caused by sulphanamide-resistant group A meningococci. In 3 provinces, the vaccine was offered on a double-blind basis, using Haemophilus influenzae type b polysaccaride vaccine as control. Approximately 100 000 children were vaccinated with either one of the vaccines. In the Kymi province, approximately 22 000 children representing 90% of the child population of this age received the meningococcus vacine. Infants below 18 months received a booster dose of vaccine 3 months after the first dose. The meningococcus vaccine caused local symptoms in 71%, mild systemic reactions in 37%, and high fever (38.5 degrees C or more) in 1.8% The haemophilus vaccine produced fewer side effects. No clinical infections caused by group A meningococci were reported in the first 6 months after vaccination among those who had received the meningococcal vaccine. At the same time, group A cases continued to appear in other age groups and other areas of the country.

Adolescent↗
PubMed1976

An epidemic due to sulphonamide-resistant group A meningococci in the Helsinki area (Finland). Epidemiological and clinical observations.

An epidemic due to sulphonamide-resistant group A meningococci started in Finland in January 1973. By the end of 1974 the number of cases exceeded 1300. This report describes epidemiological and clinical observations in 370 patients treated in Helsinki 1973-1974. The incidence was about 65 per 100 000 per year in children under 7 years of age and about 10 per 100 000 in adults. More than one case occurred in 3.8% of the families and in 36% of the lodging-houses of the lowest social group. The fatality rate of patients treated in hospital was 4.1%. Persistent neurological damage was noticed in 4.6%.

Adolescent↗