Biomedical subjects

Terhi Tapiainen

Publications and source records attributed to Terhi Tapiainen.

9 recordsLinked to original sources

PubMed2006

Dynamics of gut colonization and source of intestinal flora in healthy newborn infants.

The aim of the study was to evaluate the dynamics of gut colonization and the main source of intestinal bacterial flora in infancy in a quantitative manner using computerized analysis of bacterial cellular fatty acid (CFA) profiles. Each stool was collected from 10 healthy newborn infants during their first 2-7 days of life and a follow-up sample at 6 months of age. Stool samples were collected from mothers and nurses for comparison. Gas-liquid chromatography of the 159 stool samples was used to produce bacterial cellular fatty acid (CFA) profiles by means of a previously developed computerized program. The CFA profiles for the infants fluctuated from hour to hour during the first days of life and resembled those for both the mothers and the nurses, doing so all the more in the case of the five infants examined 6 months after birth. Gut colonization fluctuated markedly from hour to hour in the perinatal period. The effect of the maternal flora on the initial gut colonization may be less than expected as the fecal flora of infants started to resemble both the fecal flora of the mother as well as that of the first nurse.

Birth Weight↗

PubMed2005

Effect of injection site on reactogenicity and immunogenicity of acellular and whole-cell pertussis component diphtheria-tetanus-pertussis vaccines in infants.

The effect of injection site on reactogenicity and specific immunogenicity was assessed in participants in a pertussis vaccine efficacy trial. The percent of DTwP and DTaP recipients with any reaction was slightly lower in subjects injected in the buttock compared with those injected in the thigh. This finding was most common in DTwP recipients. Geometric mean antibody values to pertactin, filamentous hemagglutinin and fimbriae (Bordetella pertussis antigens) were lower in DTaP vaccinees when buttock was utilized as the injection site. Our findings present evidence against the use of the buttock as the site of immunization for DTaP vaccines since the benefit with regards to reactogenicity is minimal and the immunologic response to an important antigen of B. pertussis, pertactin, is decreased.

Antibodies, Bacterial↗

PubMed2005

Evaluation of the Brighton Collaboration case definition of acute intussusception during active surveillance.

To evaluate the Brighton Collaboration case definition of acute intussusception, we reviewed all episodes reported to the Swiss Paediatric Surveillance Unit (SPSU) during 1 year (4/2003--3/2004). Of 96 confirmed episodes 86 (90%, 95% CI 83--96) were captured by the case definition. Of the remaining 10 episodes, 9 resolved spontaneously following presentation with clinical signs and symptoms, and ultrasound findings compatible with intussusception. Eighty-two episodes met level 1 of the definition, the highest level of diagnostic certainty. Compared to level 1, the sensitivity of level 2 (intermediate level) and level 3 (lowest level) was 65% (CI 55--74) and 30% (CI 20--40), respectively. In conclusion, the case definition was useful and applicable to assess the background rate of intussusception in the light of potential future rotavirus immunization.

Child, Preschool↗

PubMed2005

Influenza vaccination among healthcare workers in a university children's hospital.

OBJECTIVES: To evaluate the attitudes of pediatric healthcare workers (HCWs) toward influenza vaccination and to increase their rate of immunization. METHODS: A survey was conducted among pediatric HCWs using an anonymous questionnaire. Survey results were used to design an intervention to increase the immunization rate of staff. Immunization rates before (2003-2004) and after (2004-2005) intervention were assessed using immunization clinic records. SETTING: A university children's hospital in Switzerland. INTERVENTIONS: (1) An informational letter based on misconceptions noted in the survey, (2) educational conversations with head nurses, (3) more "walk-in" immunization clinics, and (4) a direct offer of influenza immunization on the wards. RESULTS: Among vaccine nonrecipients, doubts about the efficacy and necessity of influenza immunization were prevalent and more often reported by nurses than physicians (75% vs 41%, P = .002; and 55% vs 23%, P = .001, respectively). Physicians more often than nurses reported lack of time as a reason for not receiving influenza vaccination (23% vs 5%, P = .01). After intervention, the immunization rate of HCWs increased from 19% to 24% (P = .03). The immunization rate of physicians increased from 43% to 64% (P = .004). No change was noted among nurses (13% vs 14%) and other HCWs (16% vs 16%). CONCLUSIONS: Misconceptions about influenza vaccination were prevalent among pediatric staff, particularly nurses. Active promotion and educational efforts were successful in increasing the immunization rate of physicians but not nurses and other HCWs.

Attitude of Health Personnel↗

PubMed2005

Fever following immunization.

Fever is a frequent systemic adverse event following immunization, especially in infants and young children. Any fever after immunization may be caused by immunization or may coincide temporally as an indication of underlying disease, usually an infectious one. The time pattern of fever attributable to immunization has characteristic features depending on the vaccine used. Comparability of fever rates associated with different vaccines, or the same vaccines in different studies, is frequently hampered by the use of different definitions and/or assessment techniques for fever. A recent analysis by the Brighton Collaboration has provided a standardized case definition for fever, the use of which should be strongly encouraged.

Fever↗

PubMed2004

Ultrastructure of Streptococcus pneumoniae after exposure to xylitol.

OBJECTIVES: Xylitol is a sugar alcohol which reduces the growth of Streptococcus pneumoniae and the adherence of pneumococci and Haemophilus influenzae to nasopharyngeal cells. Xylitol prevents acute otitis media but does not decrease nasopharyngeal carriage of pneumococci. We hypothesized that xylitol could affect the surface structures of viable pneumococci, which would further explain the mechanism of action of xylitol in preventing acute otitis media. METHODS: We exposed five strains of pneumococci to 0.5%-5% xylitol, 5% glucose, 5% fructose and 5% sorbitol or control medium (brain heart infusion) for 0.5-2 h and examined the ultrastructure of bacteria by electron microscopy. RESULTS: The cell wall of pneumococci became more diffuse, the polysaccharide capsule became ragged and the proportion of damaged pneumococci increased after exposure to xylitol for 2 h, but not after exposure to other sugars or control medium. The phenotype of all pneumococcal strains was opaque before xylitol exposure and became almost transparent both in xylitol and in control medium during the experiment. CONCLUSIONS: This study demonstrates further that xylitol has a harmful effect on pneumococci. The observed changes in the polysaccharide capsule and the cell wall of pneumococci could affect the adherence and virulence of pneumococci, explaining the good clinical efficacy of xylitol in the prevention of acute otitis media.

Culture Media↗

PubMed2003

Paranasal sinus findings in children during respiratory infection evaluated with magnetic resonance imaging.

OBJECTIVE: The spreading of acute respiratory infection into the paranasal sinuses in children is poorly defined. The main objective of this study was to evaluate the frequency and spontaneous resolution of paranasal sinus abnormalities in children with acute respiratory infection using magnetic resonance imaging (MRI). METHODS: We examined 60 children with MRI (mean age: 5.7 years) with symptoms of acute respiratory infection. Twenty-six children with major abnormalities in the first MRI scan had a follow-up MRI taken 2 weeks later. RESULTS: The children had had symptoms of uncomplicated acute respiratory infection for an average of 6 days before the first examination (mean duration: 6.5; standard deviation: 3.0). Approximately 60% of the children had major abnormalities in their maxillary and ethmoidal sinuses, 35% in the sphenoidal sinuses, and 18% in the frontal sinuses. The most common abnormal finding was mucosal swelling. The mean overall MRI scores correlated significantly with the symptom scores (r(s) = 0.3). Of the individual symptoms, nasal obstruction, nasal discharge, and fever were significantly related to the MRI scores. Among the 26 children with major abnormalities in the first MRI, the findings subsequently improved significantly (mean [standard deviation] score: 12.7 [5.6] to 5.7 [5.2]), irrespective of the resolution of symptoms. CONCLUSIONS: These observations indicate that acute respiratory infection mostly spreads into the paranasal sinuses of children in the form of mucosal edema and that these abnormalities tend to resolve spontaneously without antimicrobial treatment.

Anti-Bacterial Agents↗

PubMed2002

Tularemia of the middle ear.

We report the case of a 10-year-old boy with prolonged fever who was found to have tularemia of the middle ear. Otolaryngologic cases including oropharyngeal and glandular or ulceroglandular forms of the head and neck region are estimated to account for 12% of all tularemia cases, but to date we have not seen a report of tularemia in the middle ear. The possibility of tularemia may not occur to a physician because of the wide variation of clinical manifestations.

Anti-Bacterial Agents↗

PubMed2002

Xylitol administered only during respiratory infections failed to prevent acute otitis media.

OBJECTIVE: As regular administration of xylitol had been effective in preventing acute otitis media (AOM) in children, we tested whether xylitol administered only at times of acute respiratory infection (ARI) reduces the occurrence of AOM. METHODS: Healthy children (N = 1277) were recruited from child care centers and randomized after screening with tympanometry to receive either control mixture (n = 212), xylitol mixture (n = 212), control chewing gum (n = 280), xylitol chewing gum (n = 286), or xylitol lozenges (n = 287) during an ARI. The trial was randomized and double blinded within the mixture and chewing gum groups. The parents began administering the products to their children at the onset of symptoms of ARI. The follow-up lasted until resolution of the symptoms or up to 3 weeks. RESULTS: A total of 1253 of the 1277 randomized children were eligible for the analysis. Altogether, 980 (78%) of 1253 children had at least 1 episode of ARI during the 4 months that the trial lasted. The occurrence of AOM during this episode was 34 (20.5%) of 166 in the xylitol mixture group, as compared with 32 (20.4%) of 157 among the children who received the control mixture. Among the older children who received control chewing gum, xylitol chewing gum, or xylitol lozenges, AOM was experienced by 24 (11.0%) of 218, 31 (14.1%) of 220, and 34 (15.5%) of 219, respectively. None of the differences between the groups was statistically significant. CONCLUSIONS: Xylitol administered only during an ARI was ineffective in preventing AOM.

Acute Disease↗