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Biomedical subjects

P Kuusisto

Publications and source records attributed to P Kuusisto.

At least 19 recordsLinked to original sources
PubMed2002

Epidemiology of Sindbis virus infections in Finland 1981-96: possible factors explaining a peculiar disease pattern.

Pogosta disease (PD), an epidemic rash-arthritis occurring in late summer is caused by Sindbis virus (SINV) and is transmitted to humans by mosquitoes. Altogether 2183 PD cases were serologically confirmed 1981-96 in Finland, with an annual incidence of 2.7/100000 (18 in the most endemic area of Northern Karelia). The annual average was 136 (varying from 1 to 1282) with epidemics occurring in August-September with a 7-year interval. Studies on 6320 patients with suspected rubella (1973-89) revealed 107 PD cases. The depth of snow cover and the temperature in May-July seemed to predict the number of cases. The morbidity was highest in 45- to 65-year-old females and lowest in children. Subclinical SINV infections were 17 times more common than the clinical ones. The SINV-antibody prevalence in fertile-age females was 0.6% in 1992; the estimated seroprevalence in Finland is about 2%. Among game animals the tetraonids (black grouse and capercaillie) had the highest seroprevalence (65%) in the epidemic year of 1981.

Adolescent↗
PubMed1999

Epidemiological study of nephropathia epidemica in Finland 1989-96.

This study presents data on 33,000 serum samples studied from July 1989 to June 1996 in Finland, with 6,701 serologically confirmed Puumala virus (PUU) infections. In addition, a PUU serosurvey of 8,000 sera from Finland is presented. On average, 957 PUU infections were detected annually, resulting in an incidence of 19/100,000; mortality was less than 0.1%. The infection was most common in the district of Ita-Savo with an incidence of 90/100,000. The seasonal peak was in November-December; however, the urban population had its incidence peak in August. Local epidemics mirrored bank vole densities, with 3-4-y cycles. Males contracted the disease at a mean age of 40 y, females at 44 y (male:female ratio 2:1). The disease was relatively rare in children and elderly people. The nationwide PUU antibody prevalence for women entering Finnish maternity clinics was 3%, suggesting 5% for the total population. The highest prevalences (7% for young women) were encountered in eastern Finland. In the district with the highest clinical alert, approximately 30% of all PUU infections were estimated to lead to clinical disease with serological confirmation.

Adolescent↗
PubMed1998

Stimulated salivary flow rate and composition in asthmatic and non-asthmatic adults.

The number of decayed, missed and filled permanent teeth (DMFT), the degree of periodontal inflammation (Periodontal Status Index, PSI), stimulated salivary flow rate and the concentrations of total protein, lactoferrin, lysozyme, myeloperoxidase, salivary peroxidase, calcium, potassium, sodium and thiocyanate in whole saliva of 26 adult asthma patients were compared with those of 33 non-asthmatic controls. The saliva was also analysed for mutans streptococci, lactobacilli, total anaerobic flora and Candida spp. The mean PSI (p < 0.05; 95% confidence interval for the difference between means (95% CI) 2.47-25.30) was higher and the mean stimulated salivary flow rate (p < or = 0.05; 95% CI 0.57-0.55) was lower in the asthmatic group than in the control group. No differences were found between the groups in non-immune defense factors, except for myeloperoxidase. The myeloperoxidase concentrations were higher in asthmatics than in non-asthmatics (p < 0.05; 95% CI 4.4-134.0 ng/ml). No differences in microbial counts were found. It was concluded that stimulated salivary flow rates decrease while myeloperoxidase concentrations increase in adult asthmatic patients compared with non-asthmatic adults. The higher concentrations of myeloperoxidase are explained by a higher PSI in asthmatics.

Adult↗
PubMed1998

Pogosta disease: clinical observations during an outbreak in the province of North Karelia, Finland.

OBJECTIVE: To characterize the clinical picture of Pogosta disease. METHOD: The data of 73 patients who had had Pogosta disease in 1981 and who then had been seen by a local physician in North Karelia were analysed. RESULTS: The main manifestations were fever (23%), rash (88%) and joint symptoms (93%). The joint symptoms in some patients lasted for several months and were severe enough to cause immobilization. The clinical picture was identical in those patients who had a definite serological diagnosis and those who did not have a detectable antibody response. CONCLUSION: The symptoms of Sindbis virus-induced Pogosta discase consist of fever, rash and joint symptoms, whic may be severe and prolonged.

Adolescent↗
PubMed1998

Comparison of the oral health status and salivary flow rate of asthmatic patients with those of nonasthmatic adults--results of a pilot study.

The oral health status and stimulated salivary flow rate of 33 adult asthmatic outpatients were compared with those of 33 nonasthmatic controls. The groups were matched by age and sex, and an adjustment for education was made in the statistical analysis. In the oral examination, a small difference in the prevalence of caries was observed when the sums of decayed, missing, and filled teeth (DMFT) were compared. The mean (SD) crude DMFT score was 20.1 (5.8) in the asthma group and 18.4 (7.6) in the control group. A statistically significant difference was seen in the amount of periodontal inflammation and in the stimulated salivary flow rate between the groups. The mean (SD) crude periodontal status index (PSI) was 52.7% (23.8%) in the asthmatics and 37.1% (20.4%) in the controls. The 95% confidence interval (95% CI) for the difference in adjusted means of PSI ranged from 0.1% to 21.9% (P = 0.05). In the stimulated salivary flow rate, crude mean values were 1.0 (0.5) ml/min and 1.3 (0.5) ml/min, respectively, and the 95% CI for the difference was from 0.05 ml/min to 0.57 ml/min (P = 0.01). Mucosal lesions in the oral cavity were found in 15 asthmatics (45%) and in eight controls (24%). In conclusion, the results of this study support the hypothesis that adult asthmatics have a higher risk of oral diseases than nonasthmatic subjects.

Adult↗
PubMed1996

Randomised comparison of guided self management and traditional treatment of asthma over one year.

OBJECTIVE: To compare the efficacy of self management of asthma with traditional treatment. DESIGN: 12 month prospective randomised trial. SETTING: Outpatient clinics in Finland. SUBJECTS: 115 patients with mild to moderately severe asthma. INTERVENTIONS: Patient education and adjustment of anti-inflammatory therapy guided by peak flow measurements. MAIN OUTCOME MEASURES: Unscheduled admissions to hospital and outpatient visits, days off work, courses of antibiotics and prednisolone, lung function, and quality of life. RESULTS: The mean number of unscheduled visits to ambulatory care facilities (0.5 v 1.0), days off work (2.8 v 4.8), and courses of antibiotics (0.4 v 0.9) and prednisolone (0.4 v 1.0) per patient were lower and the quality of life score (16.6 v 8.4 at 12 months) higher in the self management group than in the traditionally treated group. In both groups admissions for asthma were rare. CONCLUSIONS: Self management reduces incidents caused by asthma and improves quality of life.

Adult↗
PubMed1994

Comparison of immunologic tests in the diagnosis of occupational asthma and rhinitis.

In this study, three immunologic tests, skin prick test, RAST, and basophil histamine-release test (BHRT), were compared by provocation in the diagnosis of occupational asthma and rhinitis. Twenty-three positive bronchial or nasal challenges were performed on 16 patients (six farmers, six bakery workers, and four food industry workers) and asthma or rhinitis was diagnosed as caused by cereal flour or grain, cow epithelium, storage mites, garlic, or soy dust. A control group consisted of 12 patients, of whom four (two bakery workers, one food industry worker, and one farmer) were challenge-negative, and the rest suffered from pollen allergy and seasonal rhinitis and were not challenged. The sensitivity and specificity of the prick test, RAST, BHRT, and a panel of them were as follows: 74 and 89%, 57 and 86%, 78 and 93%, and 91 and 71%, respectively. The overall concordance among these three type I allergy tests or between immunologic tests and challenge was relatively good.

Adult↗
PubMed1989

Activated charcoal in the treatment of hypercholesterolaemia: dose-response relationships and comparison with cholestyramine.

The dose-response relationship of activated charcoal in reducing serum cholesterol was determined and the effects of charcoal and cholestyramine were compared in patients with hypercholesterolaemia. In a cross-over study 7 patients ingested charcoal 4, 8, 16 or 32 g/day, and finally bran, each phase lasting for 3 weeks. Serum total and LDL-cholesterol were decreased (maximum 29% and 41%, respectively) and the ratio of HDL/LDL-cholesterol was increased (maximum 121%) by charcoal in a dose dependent manner. Ten further patients with severe hypercholesterolaemia ingested daily for 3 weeks, in random order, activated charcoal 16 g, cholestyramine 16 g, activated charcoal 8 g + cholestyramine 8 g, or bran. The concentrations of total and LDL-cholesterol were reduced by charcoal (23% and 29%, respectively), cholestyramine (31% and 39%) and their combination (30% and 38%). The ratio of HDL/LDL-cholesterol was increased from 0.13 to 0.23 by charcoal, to 0.29 by cholestyramine, and to 0.25 by their combination. Serum triglycerides were increased by cholestyramine but not by charcoal. Other parameters, including the serum concentrations of vitamin A, E and 25(OH)D3 remained unaffected. The changes in lipids only partly subsided during the 3-week bran phase. In general, the acceptability by the patients and the efficacy of activated charcoal, cholestyramine and their combination were about equal, but there were individual preferences for particular treatments.

Adult↗
PubMed1989

The mechanism of the hypocholesterolaemic effect of activated charcoal.

The hypocholesterolaemic mechanism of activated charcoal was studied in seven patients with primary hypercholesterolaemia. The reduction of serum cholesterol was correlated with the serum concentrations of cholesterol precursors and of two plant sterols. Activated charcoal, 8 g t.i.d. for 4 weeks, reduced serum concentration of total cholesterol by 27% (P less than 0.01). The effect was accompanied by a moderate elevation (P less than 0.05) in serum squalene and desmosterol concentrations and by a marked increase (up to 300-700%) in serum lathosterol and delta 8 lathosterol concentrations. The levels of two plant sterols, campesterol and beta-sitosterol, were unchanged or only slightly decreased by the use of activated charcoal. The decrease of serum cholesterol concentration had significant negative correlations with serum lathosterol and delta 8 lathosterol, and significant positive correlations with serum cholestanol and beta-sitosterol. These observations suggest an increased cholesterol synthesis upon treatment with activated charcoal, probably caused by the interference with the enterohepatic circulation of bile acids.

Anticholesteremic Agents↗
PubMed1986

Effect of activated charcoal on hypercholesterolaemia.

Seven patients with hypercholesterolaemia were treated for 4 weeks with activated charcoal at a dose of 8 g three times a day. Plasma total cholesterol and LDL-cholesterol decreased by 25% and 41%, respectively, whereas HDL-cholesterol increased by 8%. Side-effects were negligible.

Blood Pressure↗
PubMed1986

Lack of clinical exacerbations in adults with chronic asthma after immunization with killed influenza virus.

The effects of immunization with killed influenza virus vaccine were assessed by comparison with placebo in a double-blind study of 318 adult patients with chronic asthma. The patients were randomly allocated to active vaccine and placebo. No difference was observed in peak expiratory flow rate or in clinical symptoms of bronchial obstruction between the groups receiving active vaccine and placebo during the first week after immunization. The data were analyzed separately for age, sex, duration of the disease, hypersensitivity to aspirin (acetylsalicylic acid), atopic status, patients with a history of attacks of asthma induced by viral infections, patients with a diurnal variation of baseline peak expiratory flow of 20 percent or more, and patients receiving continuous oral steroid medication, but none of these factors seemed to predict any short-term adverse effects of vaccination. Follow-up for eight months after the vaccination revealed no differences in asthmatic symptoms between the patients treated with active vaccine and those receiving placebo. The antiviral antibody response to vaccination was normal. The possible protection provided by the vaccination against exacerbation of asthma induced by influenza could not be evaluated, since the influenza epidemic expected during the season failed to occur in Finland. It is concluded that immunization with killed influenza vaccine is safe and is not associated with any significant side effects in adult patients with chronic asthma.

Adult↗
PubMed1986

Elevated serum immune complex levels in Pogosta disease, an acute alphavirus infection with rash and arthritis.

Circulating immune complexes (CIC) were studied in Pogosta disease, an acute alphavirus infection with fever, rash and arthritis. The disease is caused by a virus antigenically closely related to Sindbis virus. 75 serum specimens from 25 patients with serologically verified infection were obtained from 1-87 days after the onset. Six different CIC detection methods were used and CICs were observed in all patients at least with one test. Tests based on CIC binding onto human platelets followed the natural course of the disease and maximal values were observed between 10-15 days after onset. Slightly elevated levels were observed 2-3 months after onset. The mean conglutinin binding test values were slightly elevated during the whole follow-up period. The severity of arthritis did not directly correlate to CIC levels. C3c and C1q-binding test were positive only in a few cases. Latex and enzyme immunoassay tests for rheumatoid factors gave low positive values in some of the sera. Agarose gel electrophoresis of serum proteins revealed non-specific changes in alpha 1-alpha 2 interzone characteristic of an acute infectious disease. The presence of CIC in the sera of patients with Pogosta disease may indicate body's natural clearange mechanisms of viral antigens. CIC may have a pathogenic role in the prolonged arthritis, even though no direct correlation with CIC levels and severity of arthritis was observed.

Acute Disease↗
PubMed1983

Exposure of water consumers to mesophilic actinomycetes.

In autumn 1978 an epidemic of respiratory disease resembling allergic alveolitis occurred in a small Finnish community. The disease was caused by repeated exposures to tap water aerosol. The raw water of the community and the sand filters of the purification system were heavily contaminated with mesophilic actinomycetes. Fourteen different strains of actinomycetes were isolated. Exposed persons with and without symptoms as well as unexposed control persons were tested for antibodies against five of these actinomycetes and against Enterobacter agglomerans. Both the exposed and the control persons had antibodies to actinomycetes but the exposed persons had antibodies against more actinomycete strains than the control persons. Precipitating antibodies against E. agglomerans were also found in control persons as well as in patients. There was a significant difference between the patients and the exposed healthy persons in bacterial agglutination tests with flagellar antigen of one E. agglomerans strain. However, the role of mesophilic actinomycetes and E. agglomerans in the aetiology of the disease could not be firmly established.

Aerosols↗
PubMed1982

An epidemic of bath water fever--endotoxin alveolitis?

In August, 1978, in Linnavuori industrial community an epidemic broke reaching nearly one half of the population. The acute disease was manifested by severe respiratory symptoms, fever, cough, and dyspnea. The symptoms were connected with the use of hot water. The symptoms of the disease resembled those of allergic alveolitis or humidifier fever. The tap water of the region was found to be heavily polluted. Besides an ample microbial growth a high endotoxin concentration was found. Specific antibodies to the microbes or radiographic lung changes referring to allergic alveolitis were not found. Leukocytosis and reduced diffusion capacities indicating an inflammatory reaction at the alveolar level were in the acute phase. It may be a toxic lung inflammation caused by endotoxins, at least partly at the bronchiolar-to-alveolar level. According to the follow-up, to date the disease has not caused lung damages.

Adolescent↗