Matti Korppi

Tampere University Hospital (TAUH), Tammerfors, Pirkanmaa, Finland

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Publications (361)932.93 Total impact

  • Olli Lohi · Merja Helminen · Matti Korppi
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    ABSTRACT: Aim: In Finland specialist paediatrics training is led by university hospitals, but half of it is carried out in regional central hospitals. We audited the training provided by four regional central hospitals in the tertiary care area covered by Tampere University Hospital, in 2003, 2008 and 2015. Methods: The audits comprised hospital visits and discussions with the chief doctor of the paediatric clinic, the trainees and the specialists who trained them. A modified version of the European Union of Medical Specialists 1997 protocol was used and the key areas that performed poorly in the audits were followed up. Results: In 2008 and 2015, most of the key follow-up issues had improved, but two main areas in need of further development were identified in 2015. These were that educational objectives should be clarified, and their implementation systemically followed up, and that trainees should spend more time working in outpatient settings. Conclusion: Since 2003 a marked improvement had taken place in the paediatric training provided by regional central hospitals, partly because of the increase in paediatric specialist resources. This study underlines the importance of repeat audits and the need for co-operation between the university hospital and regional hospitals, including regular visits. This article is protected by copyright. All rights reserved.
    No preview · Article · Jan 2016 · Acta Paediatrica
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    ABSTRACT: Aim: Toll-like receptors (TLR) play a crucial role in innate immunity, protecting the host from pathogens such as viruses. Genetic variations in TLRs have been associated with the severity of viral bronchiolitis in infancy and with the later occurrence of post-bronchiolitis asthma. The aim of the present study was to evaluate if there are any exploratory associations between TLR gene polymorphisms and lung function at 5 to 7 years of age in former bronchiolitis patients. Methods: We performed impulse oscillometry (IOS) at the median age of 6.3 years for 103 children who had been hospitalized for bronchiolitis at less than six months of age. The main parameters evaluated were airway resistance and reactance at 5Hz in baseline and post-exercise measurements. Data on single nucleotide polymorphisms (SNP) of TLR1 rs5743618, TLR2 rs5743708, TLR6 rs5743810 and TLR10 rs4129009 (TLR2 subfamily) and TLR3 rs3775291, TLR4 rs4986790, TLR7 rs179008, TLR8 rs2407992 and TLR 9 rs187084 were available for analyses. Results: The TLR4 rs4986790 wild genotype A/A was associated with a greater Rrs5 response (0.72 vs. -0.42, p = 0.03) to exercise. In TLR6 rs5743810, the minor allele T was associated with greater Rrs5 response (0.80 vs. -0.03, p = 0.04) to exercise. In TLR7 rs179008, the major allele A was associated with baseline decline in dRrs/df (-1.03 vs 0.61, p = 0.01) and increased Fres (2.28 vs. 0.89, p = 0.01) in girls. Conclusion: Among the nine studied TLRs, only TLR7 rs179008 showed some exploratory associations with post-bronchiolitis lung function deficiency, and polymorphisms of TLR4 rs4986790, and TLR6 rs5743810 in particular, with airway reactivity. These findings call for further confirmatory studies.
    Full-text · Article · Jan 2016 · PLoS ONE
  • Matti Korppi

    No preview · Article · Jan 2016 · Acta Paediatrica
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    ABSTRACT: Background: Our aim was to evaluate the association between viral findings during bronchiolitis and the use of asthma controller medication (primary outcome) and systemic corticosteroids (secondary outcome) during the first post-bronchiolitis year. Methods: We enrolled 408 children hospitalized for bronchiolitis at age <24 months in a prospective, 3-center, 1-year follow-up study in Finland. Viruses were detected with polymerase chain reaction in nasopharyngeal aspirates. The parents underwent a structured interview during hospitalization. Twelve months later, the use of asthma medication was asked in a structured questionnaire. Multivariable logistic regression was used for statistical analysis. Results: In total, 365 (89%) children completed the 1-year follow-up. The use of long-term asthma controller medication was highest in the rhinovirus-positive group (61% vs. 15% in RSV-positive group; adjusted OR 7.5, 95%CI 3.7-15.3), followed by children negative for both RSV and rhinovirus (36%; adjusted OR 2.6, 95%CI 1.3-5.3). Likewise, rhinovirus etiology was associated with more courses of systemic corticosteroids during the follow-up. The main findings were similar in a subset of infants aged <12 months with first wheezing. Conclusions: Children hospitalized for rhinovirus-positive bronchiolitis used long-term asthma controller medication more often than those hospitalized for rhinovirus-negative bronchiolitis during first year after hospitalization. Copyright
    No preview · Article · Dec 2015 · The Pediatric Infectious Disease Journal
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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.
    No preview · Article · Nov 2015 · The Pediatric Infectious Disease Journal
  • 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.
    No preview · Article · Nov 2015 · World Journal of Pediatrics
  • Matti Korppi

    No preview · Article · Nov 2015 · Pediatric Pulmonology
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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.
    No preview · Article · Oct 2015 · Acta Paediatrica
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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.
    Full-text · Article · Oct 2015 · PLoS ONE
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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.
    No preview · Article · Oct 2015 · The Pediatric Infectious Disease Journal
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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.
    No preview · Article · Sep 2015 · The International Journal of Tuberculosis and Lung Disease
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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.
    No preview · Article · Sep 2015 · Acta Paediatrica
  • 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.
    No preview · Article · Aug 2015 · Duodecim; lääketieteellinen aikakauskirja
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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.
    No preview · Article · Aug 2015 · Acta Paediatrica
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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.
    No preview · Article · Jul 2015 · Acta Paediatrica
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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.
    No preview · Article · Jul 2015 · Pediatric Allergy and Immunology
  • 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.
    No preview · Article · Jul 2015 · Acta Paediatrica
  • Matti Korppi

    No preview · Article · Jul 2015 · The Pediatric Infectious Disease Journal
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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.
    Preview · Article · Feb 2015 · European Journal of Pediatrics
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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.
    No preview · Article · Feb 2015 · Pediatrics

Publication Stats

7k Citations
932.93 Total Impact Points

Institutions

  • 2007-2016
    • Tampere University Hospital (TAUH)
      Tammerfors, Pirkanmaa, Finland
    • University of Tampere
      • Paediatric Research Centre
      Tammerfors, Pirkanmaa, Finland
  • 2015
    • University of Eastern Finland
      • School of Medicine
      Kuopio, Eastern Finland Province, 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
  • 1996
    • National Public Health Institute
      Helsinki, Southern Finland Province, Finland
  • 1991
    • ORTON Foundation, Helsinki, Finland
      Helsinki, Uusimaa, Finland
  • 1989-1991
    • Helsinki University Central Hospital
      Helsinki, Uusimaa, Finland
  • 1986-1988
    • University of Turku
      Turku, Province of Western Finland, Finland