Matti Korppi

University of Eastern Finland, Kuopio, Eastern Finland Province, Finland

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Publications (351)907.63 Total impact

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    ABSTRACT: In 169 Finnish infants hospitalized for bronchiolitis at age <6 months in 2008-2010, nasopharyngeal aspirates were tested by PCR for Bordetella pertussis and 16 viruses. Respiratory viruses were detected in 89% (71% with RSV), but no infant had B. pertussis. The latter finding may reflect a positive effect from the broadening of the Finnish pertussis vaccination program in 2005.
    The Pediatric Infectious Disease Journal 11/2015; DOI:10.1097/INF.0000000000000973 · 2.72 Impact Factor
  • Antti Kunnamo · Matti Korppi · Merja Helminen ·
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    ABSTRACT: Background: The Finnish Current Care Guidelines on diagnostics and treatment of sore throat recommend the treatment of only group A streptococcus (GAS) positive cases with penicillin. The aim of the study was to evaluate how these guidelines are followed in the pediatric emergency unit. Methods: We analyzed retrospectively the data on microbiological studies and blood tests done, and data on prescribing of antibiotics, of 200 children admitted for febrile exudative tonsillitis. Results: After the clinical diagnosis of exudative tonsillitis, antigen test and/or culture for GAS identification was done in >95% of cases. All the 32 (16%) children with GAS infection, but also 52 (38%) of the 137 children without any evidence of bacterial infection received antibiotics. Additional laboratory studies were done in 96% of children. Serum C-reactive concentrations or white blood cell counts were not able to separate streptococcal from non-streptococcal tonsillitis. No serious bacterial infection was diagnosed. Conclusions: The Finnish Current Care Guidelines lead to over-treatment with antibiotics. None of the 200 children returned after discharge, suggesting that undertreatment did not happen.
    World Journal of Pediatrics 11/2015; DOI:10.1007/s12519-015-0054-y · 1.05 Impact Factor
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    ABSTRACT: Aim: This was a follow up of 28 schoolchildren with cows' milk allergy (CMA) who attended a randomised double-blind placebo-controlled oral immunotherapy (OIT) study. In the original study, 26 (92.9%) completed the six-month escalation phase, and 25 (89.3%) used milk daily at 12 months and 24 (85.7%) at 36 months. This study evaluated the outcome seven years later, with special attention paid to milk consumption and symptoms. Methods: Outcome data were collected through a postal questionnaire completed three, four and five years after enrolment and by a phone questionnaire after seven years. We asked about the daily dose of milk products, any adverse reactions, any medication needed and possible discontinuation of daily milk consumption. Results: Data was available at the seven-year point for 24 children and 14 (58.3%) of these continued to use milk (>200mL) or milk products (protein >6,400mg) daily for seven years. However, three (21.4%) of these still reported symptoms associated with milk consumption. Of the 10 remaining children, two children used milk products daily but consumed less due to symptoms and eight (33.3%) had discontinued milk consumption. Conclusion: Oral immunotherapy was an effective and safe way of desensitising schoolchildren with persistent CMA. This article is protected by copyright. All rights reserved.
    Acta Paediatrica 10/2015; DOI:10.1111/apa.13251 · 1.67 Impact Factor
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    ABSTRACT: Aim: Interleukin-10 (IL-10) has been associated with wheezing and asthma in children and the genetic variation of the IL-10 cytokine production may be linked to post-bronchiolitis lung function. We used impulse oscillometry (IOS) to evaluate the associations of IL10 polymorphisms with lung function at a median age of 6.3 years in children hospitalised for bronchiolitis before six months of age. Methods: We performed baseline and post-exercise IOS on 103 former bronchiolitis patients. Data on single nucleotide polymorphisms (SNP) of IL10 rs1800896 (-1082G/A), rs1800871 (-819C/T), rs1800872 (-592C/A) were available for 99 children and of IL10 rs1800890 (-3575T/A) for 98 children. Results: IL10 rs1800896, rs1800871 and rs1800872 combined genotype AA+CT+CA and carriage of haplotype ATA, respectively, were associated with higher resistance and lower reactance in baseline IOS in adjusted analyses. At IL10 rs1800890, the A/A-genotype and carriers of A-allele were associated with lower reactance in baseline IOS. There were no significant associations between the studied SNPs and airway hyper-reactivity to exercise. Conclusion: Low-IL-10-producing polymorphisms in the IL-10 encoding gene were associated with obstructive lung function parameters, suggesting an important role for IL-10 in development of lung function deficit in early bronchiolitis patients.
    PLoS ONE 10/2015; 10(10):e0140799. DOI:10.1371/journal.pone.0140799 · 3.23 Impact Factor
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    ABSTRACT: Background: The incidence of invasive Group A Streptococcus (iGAS) infections varies in time and geographically for unknown reasons. We performed a nation-wide survey to assess the population-based incidence rates and outcomes of children with iGAS infections. Methods: We collected data on patients from hospital discharge registries and the electronic databases of microbiological laboratories in Finland for the period 1996-2010. We then recorded the emmtypes or serotypes of the strains. The study physician visited all university clinics and collected the clinical data using the same data entry sheet. Results: We identified 151 children with iGAS infection. Varicella preceded iGAS infection in 20% of cases and fasciitis infection in 83% of cases. The annual incidence rate of iGAS infection was 0.93/100 000 in 1996-2000, 1.80 in 2001-2005, and 2.50 in 2006-2010.The proportion of emm 1.0 or T1M1 strains peaked in 1996-2000 and again in 2006-2010, to 44% and 37% of all typed isolates. The main clinical diagnoses of the patients weresevere soft tissue infection (46%), sepsis (28%), empyema (10%), osteoarticular infection (9%), and primary peritonitis (5%). Severe pain was the most typical symptom for soft tissue infections. More than half of the patients underwent surgery and received clindamycin. The readmission rate was 7%, and the case fatality rate, 2%. Conclusions: The incidence rate of pediatric iGAS infections tripled during our study. The increase was not, however, the result of a change in the strain types causing iGAS. Varicella immunization would likely have prevented a significant number of the cases.
    The Pediatric Infectious Disease Journal 10/2015; DOI:10.1097/INF.0000000000000945 · 2.72 Impact Factor
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    ABSTRACT: SETTING: Complications arising from bacille Calmette-Guérin (BCG) vaccination were recorded in a national register in Finland until 1988. In the period 1960–1988, 222 patients suffered from BCG osteitis. OBJECTIVE: To evaluate whether single nucleotide polymorphisms (SNPs) in the promoter region of the gene encoding interleukin 10 (IL-10) are associated with BCG osteitis after vaccination in neonates. DESIGN: Blood samples of 132 former BCG osteitis patients now aged 21–49 years were analysed in a controlled study for IL10 rs1800896 (−1082G/A), rs1800871 (−819C/T), rs1800872 (−592C/A) and rs1800890 (−3575T/A) polymorphisms. RESULTS: The frequencies of genotypes of IL10 rs1800896, rs1800871, rs1800872 and rs1800890, the frequencies of variant genotypes and the frequencies of major or minor alleles did not differ between patients and controls. Furthermore, the frequencies of the eight possible combinations of the three IL10 alleles located close to each other (IL10 rs1800896, IL10 rs1800871 and IL10 rs1800872) were surprisingly similar. CONCLUSION: Our results suggest that polymorphisms of the IL-10 encoding gene do not play a central role in the development of complications due to BCG vaccination, although the IL10 gene, especially IL10 rs1800896 (−1082G/A) polymorphism, is known to be associated with tuberculosis risk in Europeans and North Americans.
    The International Journal of Tuberculosis and Lung Disease 09/2015; 19(10):1158-1162. DOI:10.5588/ijtld.15.0348 · 2.32 Impact Factor
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    ABSTRACT: Evidence-based guidelines are needed to harmonise and improve the diagnostics and treatment of children's lower respiratory tract infections (LRTI). Following a professional literature search, an inter-disciplinary working group evaluated and graded the available evidence and constructed guidelines for the treatment of community-acquired pneumonia and pertussis. The clinical guidelines state that chest radiography is not needed if the child is diagnosed with pneumonia and treated at home. Complications should be considered if there is no improvement after antimicrobial therapy and a paroxysmal cough can indicate pertussis, which is life-threatening in unvaccinated infants and can lead to respiratory failure. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Acta Paediatrica 09/2015; DOI:10.1111/apa.13177 · 1.67 Impact Factor
  • Matti Korppi · Terhi Tapiainen ·
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    ABSTRACT: The most common causative agents of laryngitis are parainfluenza viruses. The diagnosis of laryngitis in children is a clinical one, typical symptoms including dry, often barking cough and inspiratory difficulty and wheezing. Typical age of occurrence is 0.5 to 3 years. In children under one year of age the structural and functional anomalies causing symptoms resembling laryngitis in connection with an infection should not be disregarded. Most patients can be nursed at home. An orally administered glucocorticoid and inhaled racemic adrenalin are effective drugs in emergency service.
    Duodecim; lääketieteellinen aikakauskirja 08/2015; 131(2):157-61.
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    ABSTRACT: Evidence-based guidelines are needed to harmonise and improve the diagnostics and treatment of children's lower respiratory tract infections. Following a professional literature search, an inter-disciplinary working group evaluated and graded the available evidence and constructed guidelines for treating laryngitis, bronchitis, wheezing bronchitis and bronchiolitis. Currently available drugs were not effective in relieving cough symptoms. Salbutamol inhalations could relieve the symptoms of wheezing bronchitis and should be administered via a holding chamber. Nebulised adrenaline or inhaled or oral glucocorticoids did not reduce hospitalisation rates or relieve symptoms in infants with bronchiolitis and should not be routinely used. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2015; DOI:10.1111/apa.13162 · 1.67 Impact Factor
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    ABSTRACT: Strict milk protein avoidance has been the standard therapy of cows' milk allergy (CMA) in children, but oral immunotherapy (OIT) seems to provide an alternative treatment. The aim of this paper was to evaluate the impact of OIT on milk consumption during the first 2.5 years after a start of OIT. This open-label, non-controlled, real-life OIT study was conducted in 74 children with CMA, who were age five to 15. It included a six-month induction phase and a two-year maintenance phase. Data on the complete 2.5-year trial were available for 57 children. Most of the children (82%) completed the six-month induction phase and were able to consume at least 200ml of milk or 6,400mg of milk protein a day. After the two-year maintenance phase, half were consuming milk daily. Risk factors for OIT failure during the induction phase were asthma and high milk-specific immunoglobulin E, but a history of anaphylaxis before OIT was not. Allergies to eggs or wheat decreased the risk of immediate OIT failure. This study confirmed the efficacy of milk OIT in real life, including the whole spectrum of persistent CMA at school age and revealed certain risk factors associated with OIT failure. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Acta Paediatrica 07/2015; DOI:10.1111/apa.13131 · 1.67 Impact Factor
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    ABSTRACT: Infant bronchiolitis may be the first manifestation of asthma. To evaluate the association of early-childhood risk or protective factors for asthma and lung function reduction in adults 30 years after bronchiolitis in infancy. Forty-seven former bronchiolitis patients attended the clinical study at the median age of 29.5 years, including doctoral examination and measurement of post-bronchodilator lung function with flow-volume spirometry. Data on early-life risk factors including blood eosinophil counts on admission for bronchiolitis and on convalescence 4-6 weeks after bronchiolitis were available. Low blood eosinophil count <0.25x10E9/l on admission for bronchiolitis was a significant protective factor and high blood eosinophil count >0.45x10E9/l on convalescence was a significant risk factor for asthma in adulthood independently from atopic status in infancy. Parental asthma and high blood eosinophil count >0.45x10E9/l during bronchiolitis were significant risk factors for irreversible airway obstruction (FEV1/FVC-ratio below the 5(th) percentile lower limit of normality after bronchodilation). Our adjusted analyses confirmed that eosinopenia during infant bronchiolitis predicted low asthma risk and eosinophilia outside infection predicted high asthma risk up to the age of 28-31 years. Parental asthma and eosinophilia during bronchiolitis were recognized as risk factors for irreversible airway obstruction. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Pediatric Allergy and Immunology 07/2015; 26(7). DOI:10.1111/pai.12448 · 3.40 Impact Factor
  • Matti Korppi ·
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    ABSTRACT: The different view by Rodriguez-Martinez and Castro-Rodriguez on infant bronchiolitis criticised the 2004 guidelines from the American Academy of Pediatrics (1), which no longer recommend a trial of bronchodilators (2). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Acta Paediatrica 07/2015; DOI:10.1111/apa.13107 · 1.67 Impact Factor
  • Matti Korppi ·

    The Pediatric Infectious Disease Journal 07/2015; 34(7):799-800. DOI:10.1097/INF.0000000000000730 · 2.72 Impact Factor
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    ABSTRACT: Hyperimmunoglobulinemia D syndrome (HIDS) is an autoinflammatory disorder that is caused by mevalonate kinase deficiency (MKD). Recent advances in the pathogenesis of MKD, including the proposed mechanisms of inflammasome activation, provide the basis for the development of new treatment modalities. So far, feedback on the treatment of HIDS with biological medicines has come from case reports with limited numbers of patients. In this review, we summarize the data that is currently available on the treatment of HIDS in children, with the emphasis on new therapies, and present three Finnish pediatric cases treated with anakinra. Case reports have been published on 33 pediatric HIDS patients who have been treated with biological medicines, and in some cases, they were treated with more than one drug. Of these patients, 21 were treated with anakinra and 16 with etanercept, resulting in complete or partial responses in 90 and 50 % of cases, respectively. A further five patients were treated with canakinumab, with complete or partial responses. Conclusion: The accumulating evidence on the efficacy and safety of biological drugs in pediatric HIDS suggests that the anti-interleukin-1 agent anakinra is the drug of choice for HIDS in children. What is Known: • Various biologic drugs have been tried for the treatment of HIDS. What is New: • Based on the 90 % response rate, anakinra seems to be the drug of choice for HIDS in children.
    European Journal of Pediatrics 02/2015; 174(6). DOI:10.1007/s00431-015-2505-9 · 1.89 Impact Factor
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    ABSTRACT: Excess moisture and visible mold are associated with increased risk of asthma. Only a few studies have performed detailed home visits to characterize the extent and location of moisture damage and mold growth. Structured home inspections were performed in a birth cohort study when the children were 5 months old (on average). Children (N = 398) were followed up to the age of 6 years. Specific immunoglobulin E concentrations were determined at 6 years. Moisture damage and mold at an early age in the child's main living areas (but not in bathrooms or other interior spaces) were associated with the risk of developing physician-diagnosed asthma ever, persistent asthma, and respiratory symptoms during the first 6 years. Associations with asthma ever were strongest for moisture damage with visible mold in the child's bedroom (adjusted odds ratio: 4.82 [95% confidence interval: 1.29-18.02]) and in the living room (adjusted odds ratio: 7.51 [95% confidence interval: 1.49-37.83]). Associations with asthma ever were stronger in the earlier part of the follow-up and among atopic children. No consistent associations were found between moisture damage with or without visible mold and atopic sensitization. Moisture damage and mold in early infancy in the child's main living areas were associated with asthma development. Atopic children may be more susceptible to the effects of moisture damage and mold. Copyright © 2015 by the American Academy of Pediatrics.
    Pediatrics 02/2015; 135(3). DOI:10.1542/peds.2014-1239 · 5.47 Impact Factor
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    ABSTRACT: AimToll-like receptors (TLR) 1, 2, 6 and 10, the TLR2 subfamily, are known to be associated with immunity against tuberculosis. We evaluated whether polymorphisms in genes encoding TLR1, TLR2 and TLR6 were associated with osteitis in infants who received the Bacillus Calmette-Guérin (BCG) vaccination soon after birth.Methods Blood samples from 132 adults aged 21-49 who had BCG osteitis in early childhood, were analysed in a controlled study for TLR1 T1805G (rs5743618), TLR2 G2258A (rs5743708) and TLR6 C745T (rs5743810) gene single nucleotide polymorphisms.ResultsThe frequencies of the variant genotypes differed between the cases and controls: 11.4% versus 5.7% for TLR2 G2258A (p=0.033) and 77.3% versus 61.6% for TLR6 C745T (p=0.001). The TLR2 and TLR6 variant genotypes were associated with a higher risk of BCG osteitis, with adjusted odds ratios (aOR) of 2.154 (95%CI 1.026-4.521) and 1.907 (95%CI 1.183-3.075), respectively. The frequency of the TLR1 T1805G variant genotype was 19.7% in the cases and 33.6% in the controls (p=0.003). The TLR1 variant genotype was associated with a lower risk of BCG osteitis (aOR 0.554, 95%CI 0.336-0.911).Conclusion Gene polymorphisms that regulate the function of the TLR2 subfamily play a role in the development of BCG osteitis in vaccinated infants.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 01/2015; 104(5). DOI:10.1111/apa.12927 · 1.67 Impact Factor
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    ABSTRACT: The aim of the study was to evaluate the association between previous use of ICS and bone mineral density (BMD) at school age in a cohort followed after early childhood wheezing. As part of a prospective follow-up study after hospitalization for wheezing at <24 months of age, BMD was measured in 89 children at 12.3 (median) years of age. Data on ICS use were collected by interviewing the parents, and this was supplemented with data from patient records. Cumulative doses and the duration of ICS use were calculated. Areal BMD (BMDareal , g/cm(2) ) was measured by dual energy X-ray absorptiometry (DXA), and apparent volumetric BMD (aBMDvol , g/cm(3) ) was calculated, for the lumbar spine and femoral neck. Weight, height and pubertal stage were recorded. Age, sex, and pubertal stage were significantly associated with BMDareal and aBMDvol of the lumbar spine and BMDareal of the femoral neck. The regular use of ICS for >6 months at age <6 years was associated with a lower BMD of the lumbar spine. A lower BMDareal and aBMDvol of the femoral neck were associated with higher cumulative doses of ICS at age 0-12.3 (median) years. The results were robust to adjustment for age, sex, pubertal stage, height, weight, and use of systemic steroids. ICS use during childhood may be related to a decrease in BMD at late school age. It is important to use the lowest possible ICS dose that maintains adequate asthma control. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc.
    Pediatric Pulmonology 01/2015; 50(1). DOI:10.1002/ppul.22968 · 2.70 Impact Factor
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    ABSTRACT: BACKGROUND: Elevated serum Mead acid as a proportion of total fatty acids is an indirect marker of a deficiency of essential fatty acids (EFA). The aim of the study was to evaluate the symptoms and nutrition of food-allergic children with elevated or normal serum Mead acid. METHODS: Serum fatty acid compositions from 400 children were studied by clinical indications, mostly by suspicion of deficiency of EFA due to inadequate nutrition. A Mead acid level exceeding 0.21% (percentage of total fatty acids) was considered to be a specific sign of an insufficient EFA supply. From a total of 31 children with elevated Mead acid (MEADplus group), 23 (74%) had food allergy. The symptoms and dietary restrictions of this MEADplus group of food allergic children were compared to 54 age-and sex-matched controls with food allergy but normal Mead acid proportions (MEADminus group) before and 6 months after the serum fatty acid determination. RESULTS: At the beginning of the 6-month follow-up, 44% of the food allergic children in both MEADplus and MEADminus groups were on an elimination diet. These diets did not differ between the two groups and we were not able to document an association between the severity of elimination diet and elevated Mead acid proportion. However, the MEADplus children were on average more symptomatic than MEADminus children. In the MEADplus group, food allergy presented with skin symptoms in 100% (vs. 70% in the MEADminus group, p < 0.001) and with vomiting or diarrhea in 70% (vs. 44% in the MEADminus group, p < 0.05). Clinical suspicion of malnutrition resulted in increase in the use of vegetable oil and milk-free margarine in both groups from <50% to 65-74% during the follow-up. After 6 months, 64% of the MEADplus children with food allergy had been sent to a control serum fatty acid analysis. Of these children, Mead acid had declined to normal level in 69%, and remained elevated in 31%. CONCLUSIONS: Severe symptoms of food allergy combined with elimination diets in children may lead to insufficient nutrition presenting with elevated serum Mead acid. Adding of supplementary polyunsaturated fat to the diet should be considered in these children.
    Lipids in Health and Disease 12/2014; 13(1):180. DOI:10.1186/1476-511X-13-180 · 2.22 Impact Factor
  • Paula Heikkilä · Leena Forma · Matti Korppi ·
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    ABSTRACT: Up to 3% of infants with bronchiolitis under 12-months-of-age are hospitalised and up to 9% require intensive care. We evaluated the costs of bronchiolitis hospitalisation, with a special focus on whether infants needed intensive care. Baseline and cost data were retrospectively collected, using electronic hospital files, for 80 infants under 12-months-old who were treated in the paediatric intensive care unit (PICU) for bronchiolitis during a 13-year period. We calculated the daily costs for patients admitted to the PICU and compared them with 104 admitted to inpatient wards and 56 outpatients treated in the emergency department. The mean hospitalisation cost for PICU patients was €8,061 (95%CI 6,193-9,929), compared to €1,834 (1,649-2,020) for other inpatients and €359 (331-387) for the outpatients. The hospitalisation cost per patient was associated with length of hospital stay, but not gender, age on admission or gestational age. There was no constant increase or decrease in hospitalisation costs during the study period. The hospitalisation costs of infants treated in the PICU for bronchiolitis at less than 12-months-of-age were approximately four times more than for other inpatients and over 20 times more than for outpatients. Strategies are needed to reduce the need for intensive care This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Acta paediatrica (Oslo, Norway: 1992). Supplement 11/2014; 104(3). DOI:10.1111/apa.12881
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    ABSTRACT: AimThe role of inflammation in the bronchopulmonary dysplasia (BPD) survivors is indistinct. We evaluated lung function in relation to inflammatory markers in plasma, exhaled breath condensate and exhaled air in school-aged very low birth weight (VLBW) survivors with and without radiographic BPD.Methods Pre- and post-bronchodilator impulse oscillometry were performed by 21 six to 14-years-old VLBW children with radiographic BPD, 19 VLBW children without radiographic BPD and 19 age-matched non-asthmatic term controls. Eosinophilic cationic protein, interleukins 6 and 8, adiponectin, adipsin, leptin and resistin in plasma, leukotriene B4 and 8-isoprostane in exhaled breath condensate, andbronchial andalveolar nitric oxideoutput were measured.ResultsAbnormal lung function was found in 12.5% of the former VLBW children. Airway resistance at 5Hzwashighest in the radiographicBPD, but bronchodilator responses were most prominent in the nonBPD group.Plasma adiponectinhad a modest positive correlation with obstructionand with bronchodilatorresponses, and alveolar nitric oxideand plasma interleukin 6 withbronchodilator responses.ConclusionVLBW children with radiographic BPD had poorestlung function. The most pronounced bronchodilator responses were found in VLBW children without radiographic BPD. Current detected inflammatorymarkers had only a minor association with lung function in school-aged BPD survivorsThis article is protected by copyright. All rights reserved.
    Acta Paediatrica 10/2014; 104(3). DOI:10.1111/apa.12837 · 1.67 Impact Factor

Publication Stats

6k Citations
907.63 Total Impact Points


  • 2015
    • University of Eastern Finland
      • School of Medicine
      Kuopio, Eastern Finland Province, Finland
  • 2007-2015
    • University of Tampere
      • Paediatric Research Centre
      Tammerfors, Pirkanmaa, Finland
    • Tampere University Hospital (TAUH)
      Tammerfors, Pirkanmaa, Finland
  • 1988-2011
    • Kuopio University Hospital
      • Department of Paediatrics
      Kuopio, Northern Savo, Finland
  • 2010
    • The Chinese University of Hong Kong
      • Department of Medicine and Therapeutics
      Hong Kong, Hong Kong
  • 1999-2010
    • University of Kuopio
      • Department of Paediatrics
      Kuopio, Northern Savo, Finland
  • 2009
    • University of Udine
      Udine, Friuli Venezia Giulia, Italy
  • 2001
    • Pohjois-Karjalan Sairaanhoito
      Yoensu, Eastern Finland Province, Finland
  • 1996
    • National Public Health Institute
      Helsinki, Southern Finland Province, Finland
  • 1986-1993
    • University of Turku
      • Department of Paediatrics
      Turku, Province of Western Finland, Finland
  • 1989-1991
    • Helsinki University Central Hospital
      Helsinki, Uusimaa, Finland