Pasi Lehtinen - Academia.edu (original) (raw)
Papers by Pasi Lehtinen
Duodecim; lääketieteellinen aikakauskirja, 1994
JAMA, 2003
IRUSES THAT CAUSE RESPIRAtory tract infections are often present in the middle ear exudate of chi... more IRUSES THAT CAUSE RESPIRAtory tract infections are often present in the middle ear exudate of children with acute otitis media (AOM). 1 These viruses may play an important role in the pathogenesis of AOM and may slow the response to antimicrobial therapy. 2,3 Accordingly, it seems reasonable to expect that the administration of vaccines effective against viral infections might also serve to lessen morbidity from AOM. Influenza vaccines (inactivated trivalent administered intramuscularly or intranasally or live attenuated trivalent administered intranasally) have been found effective in preventing AOM in 4 previous studies involving children mainly
Influenza and Other Respiratory Viruses, 2020
Every year, seasonal influenza viruses are estimated to cause globally >100 million episodes of i... more Every year, seasonal influenza viruses are estimated to cause globally >100 million episodes of illness and 870 000 hospitalizations for acute lower respiratory infection among children under 5 years of age. 1 Children under 1 year of age are at the highest risk for influenza-attributable hospitalizations, and the youngest infants are frequently admitted due to sepsis-like symptoms. 2-7
Emerging Infectious Diseases, 2009
Human bocavirus (HBoV) is a widespread respiratory virus. To improve diagnostic methods, we condu... more Human bocavirus (HBoV) is a widespread respiratory virus. To improve diagnostic methods, we conducted immunoglobulin (Ig) G and IgM enzyme immunoassays with recombinant virus-like particles of HBoV as antigen. Acutephase and follow-up serum samples from 258 wheezing children and single serum samples from 115 healthy adults in Finland were examined. Our assays had a sensitivity of 97% and a specificity of 99.5%. Of adults, 96% had immunity; none had an acute infection. Of 48 children with serologically diagnosed acute HBoV infections, 45 were viremic and 35 had virus in nasopharyngeal aspirates (NPAs). Of 39 HBoV NPA PCR-positive children co-infected with another virus, 64% had a serologically verified HBoV infection. HBoV caused illness of longer duration than rhinovirus and of equal severity to that of respiratory syncytial virus. Among children with bronchiolitis, >25% had acute HBoV infections. Accurate HBoV diagnosis requires serologic analysis or PCR of serum; PCR of NPAs alone is insufficient.
Archives of Disease in Childhood, 2003
Although bladder function is thought to be unaffected in Duchenne muscular dystrophy, 46/88 boys ... more Although bladder function is thought to be unaffected in Duchenne muscular dystrophy, 46/88 boys interviewed had urinary problems. Nine underwent video urodynamics, showing in eight a small capacity, hyperreflexic bladder, and in the ninth (post spinal surgery) hyperreflexia and detrusor sphincter dyssynergia. Urinary dysfunction is a treatable feature of DMD.
Pasi Lehtinen Acute expiratory wheezing in young children
European Respiratory Journal, 2013
Background: Rhinovirus-associated early wheezing has been recognized as a new and important risk ... more Background: Rhinovirus-associated early wheezing has been recognized as a new and important risk factor for asthma in children. Objective: To investigate whether rhinovirus etiology or other factors affect the duration of daily asthma controller therapy in children. Methods: This post hoc analysis of 111 infants, hospitalized for the first wheeze and participating in a larger randomized double-blind trial (Vinku-study) comparing 3 days’ oral prednisolone course with placebo. They were followed-up for 7 years. We analyzed whether virus etiology (rhinovirus, RSV), atopic sensitization (cut-off >0.35 kU/L for common food and aeroallergens), atopic features (eczema, blood eosinophil count), prednisolone, and other host or environmental risk factors for asthma (age, sex, parental asthma) obtained at study entry affected the duration of daily asthma controller therapy (in years). Cox model was used and adjusted to age, rhinovirus, eczema, blood eosinophil count >0.4 x 10 9 /L, and p...
European Respiratory Journal, 2014
Background: Risk factors for childhood asthma have not been stratified according to asthma phenot... more Background: Risk factors for childhood asthma have not been stratified according to asthma phenotype. Objectives: To investigate risk factors at the first wheeze for current atopic and non-atopic asthma at age 7 years. Methods: A cohort of 64 children hospitalized for their first wheezy episode was followed-up for 7 years. The primary outcomes were current atopic and non-atopic asthma at age 7 years. Risk factors were analyzed post hoc , including sensitization (allergen specific IgE > 0.35 kU/l for common allergens), comprehensive viral aetiology and other known asthma risk factors. Logistic regression was used in statistics. Results: At study entry, the median age of the subjects was 12 months (range 3-35), 16% were sensitized and 92% were virus-positive. The overall univariable risk factors for current asthma at age 7 years were allergic rhinitis by 7 yrs (odds ratio 4.7; 95% CI 1.1-19; P = .033) and sensitization at study entry (5.0; 0.97-26; P = .054, respectively). The univ...
Clinical & Experimental Allergy
This is an open access article under the terms of the Creat ive Commo ns Attri bution License, wh... more This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
The Journal of Infectious Diseases
Background Although many infants with respiratory syncytial virus (RSV) infection are hospitalize... more Background Although many infants with respiratory syncytial virus (RSV) infection are hospitalized, most infants are treated as outpatients. Limited data are available on the burden of RSV in outpatient infants. Methods In a prospective study, we enrolled 431 newborn infants and followed them up for a 10-month period (September–June). During each respiratory illness, we examined the infants and obtained nasopharyngeal specimens for the detection of RSV. The parents completed daily symptom diaries throughout the study. Results Among 408 active participants, the seasonal incidence rate of RSV illness was 328.4 per 1000 (95% confidence interval [CI], 275.2–389.0). Infants with ≥1 sibling had a 1.9-fold higher incidence of RSV illness than those without siblings (95% CI, 1.3–2.8; P < .001). Acute otitis media developed in 103 (76.9%) of 134 infants with RSV infection, and 95 (70.9%) were treated with antibiotics. Nine infants with RSV (6.7%) were hospitalized, for a seasonal incidenc...
Journal of Allergy and Clinical Immunology, 2017
Background: Persistent childhood asthma is mainly atopy driven. However, limited data exist on th... more Background: Persistent childhood asthma is mainly atopy driven. However, limited data exist on the risk factors for childhood asthma phenotypes. Objective: We sought to identify risk factors at the first severe wheezing episode for current asthma 7 years later and separately for atopic and nonatopic asthma. Methods: One hundred twenty-seven steroid-naive children with the first severe wheezing episode (90% hospitalized/10% emergency department treated) were followed for 7 years. The primary outcome was current asthma at age 8 years, which was also analyzed separately as atopic and nonatopic asthma. Risk factors, including sensitization, viral cause, and other main asthma risk factors, were analyzed. Results: At study entry, median age was 11 months (interquartile range, 6-16 months); 17% were sensitized, and 98% were virus positive. Current asthma (n 5 37) at 8 years was divided into atopic (n 5 19) and nonatopic (n 5 18) asthma. The risk factors for current atopic asthma at study entry were sensitization (adjusted odds ratio [OR], 12; P < .001), eczema (adjusted OR, 4.8; P 5 .014), and wheezing with rhinovirus (adjusted OR, 5.0; P 5 .035). The risk factors for nonatopic asthma were the first severe respiratory syncytial virus/rhinovirus-negative wheezing episode (adjusted OR, 8.0; P 5 .001), first wheezing episode at age less than 12 months (adjusted OR, 7.3; P 5 .007), and parental smoking (adjusted OR, 3.8; P 5 .028). Conclusions: The data suggest diverse asthma phenotypes and mechanisms that can be predicted by using simple clinical markers at the time of the first severe wheezing episode. These findings are important for designing early intervention strategies for secondary prevention of asthma.
Clinical Infectious Diseases, 2008
European Respiratory Journal, Sep 1, 2014
European Respiratory Journal, Sep 1, 2014
European Respiratory Journal, Sep 1, 2013
The Pediatric infectious disease journal, Jan 6, 2015
In 169 Finnish infants hospitalized for bronchiolitis at age <6 months in 2008-2010, nasophary... more 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.
Pediatric Allergy and Immunology, 2015
Duodecim; lääketieteellinen aikakauskirja, 1994
JAMA, 2003
IRUSES THAT CAUSE RESPIRAtory tract infections are often present in the middle ear exudate of chi... more IRUSES THAT CAUSE RESPIRAtory tract infections are often present in the middle ear exudate of children with acute otitis media (AOM). 1 These viruses may play an important role in the pathogenesis of AOM and may slow the response to antimicrobial therapy. 2,3 Accordingly, it seems reasonable to expect that the administration of vaccines effective against viral infections might also serve to lessen morbidity from AOM. Influenza vaccines (inactivated trivalent administered intramuscularly or intranasally or live attenuated trivalent administered intranasally) have been found effective in preventing AOM in 4 previous studies involving children mainly
Influenza and Other Respiratory Viruses, 2020
Every year, seasonal influenza viruses are estimated to cause globally >100 million episodes of i... more Every year, seasonal influenza viruses are estimated to cause globally >100 million episodes of illness and 870 000 hospitalizations for acute lower respiratory infection among children under 5 years of age. 1 Children under 1 year of age are at the highest risk for influenza-attributable hospitalizations, and the youngest infants are frequently admitted due to sepsis-like symptoms. 2-7
Emerging Infectious Diseases, 2009
Human bocavirus (HBoV) is a widespread respiratory virus. To improve diagnostic methods, we condu... more Human bocavirus (HBoV) is a widespread respiratory virus. To improve diagnostic methods, we conducted immunoglobulin (Ig) G and IgM enzyme immunoassays with recombinant virus-like particles of HBoV as antigen. Acutephase and follow-up serum samples from 258 wheezing children and single serum samples from 115 healthy adults in Finland were examined. Our assays had a sensitivity of 97% and a specificity of 99.5%. Of adults, 96% had immunity; none had an acute infection. Of 48 children with serologically diagnosed acute HBoV infections, 45 were viremic and 35 had virus in nasopharyngeal aspirates (NPAs). Of 39 HBoV NPA PCR-positive children co-infected with another virus, 64% had a serologically verified HBoV infection. HBoV caused illness of longer duration than rhinovirus and of equal severity to that of respiratory syncytial virus. Among children with bronchiolitis, >25% had acute HBoV infections. Accurate HBoV diagnosis requires serologic analysis or PCR of serum; PCR of NPAs alone is insufficient.
Archives of Disease in Childhood, 2003
Although bladder function is thought to be unaffected in Duchenne muscular dystrophy, 46/88 boys ... more Although bladder function is thought to be unaffected in Duchenne muscular dystrophy, 46/88 boys interviewed had urinary problems. Nine underwent video urodynamics, showing in eight a small capacity, hyperreflexic bladder, and in the ninth (post spinal surgery) hyperreflexia and detrusor sphincter dyssynergia. Urinary dysfunction is a treatable feature of DMD.
Pasi Lehtinen Acute expiratory wheezing in young children
European Respiratory Journal, 2013
Background: Rhinovirus-associated early wheezing has been recognized as a new and important risk ... more Background: Rhinovirus-associated early wheezing has been recognized as a new and important risk factor for asthma in children. Objective: To investigate whether rhinovirus etiology or other factors affect the duration of daily asthma controller therapy in children. Methods: This post hoc analysis of 111 infants, hospitalized for the first wheeze and participating in a larger randomized double-blind trial (Vinku-study) comparing 3 days’ oral prednisolone course with placebo. They were followed-up for 7 years. We analyzed whether virus etiology (rhinovirus, RSV), atopic sensitization (cut-off >0.35 kU/L for common food and aeroallergens), atopic features (eczema, blood eosinophil count), prednisolone, and other host or environmental risk factors for asthma (age, sex, parental asthma) obtained at study entry affected the duration of daily asthma controller therapy (in years). Cox model was used and adjusted to age, rhinovirus, eczema, blood eosinophil count >0.4 x 10 9 /L, and p...
European Respiratory Journal, 2014
Background: Risk factors for childhood asthma have not been stratified according to asthma phenot... more Background: Risk factors for childhood asthma have not been stratified according to asthma phenotype. Objectives: To investigate risk factors at the first wheeze for current atopic and non-atopic asthma at age 7 years. Methods: A cohort of 64 children hospitalized for their first wheezy episode was followed-up for 7 years. The primary outcomes were current atopic and non-atopic asthma at age 7 years. Risk factors were analyzed post hoc , including sensitization (allergen specific IgE > 0.35 kU/l for common allergens), comprehensive viral aetiology and other known asthma risk factors. Logistic regression was used in statistics. Results: At study entry, the median age of the subjects was 12 months (range 3-35), 16% were sensitized and 92% were virus-positive. The overall univariable risk factors for current asthma at age 7 years were allergic rhinitis by 7 yrs (odds ratio 4.7; 95% CI 1.1-19; P = .033) and sensitization at study entry (5.0; 0.97-26; P = .054, respectively). The univ...
Clinical & Experimental Allergy
This is an open access article under the terms of the Creat ive Commo ns Attri bution License, wh... more This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
The Journal of Infectious Diseases
Background Although many infants with respiratory syncytial virus (RSV) infection are hospitalize... more Background Although many infants with respiratory syncytial virus (RSV) infection are hospitalized, most infants are treated as outpatients. Limited data are available on the burden of RSV in outpatient infants. Methods In a prospective study, we enrolled 431 newborn infants and followed them up for a 10-month period (September–June). During each respiratory illness, we examined the infants and obtained nasopharyngeal specimens for the detection of RSV. The parents completed daily symptom diaries throughout the study. Results Among 408 active participants, the seasonal incidence rate of RSV illness was 328.4 per 1000 (95% confidence interval [CI], 275.2–389.0). Infants with ≥1 sibling had a 1.9-fold higher incidence of RSV illness than those without siblings (95% CI, 1.3–2.8; P < .001). Acute otitis media developed in 103 (76.9%) of 134 infants with RSV infection, and 95 (70.9%) were treated with antibiotics. Nine infants with RSV (6.7%) were hospitalized, for a seasonal incidenc...
Journal of Allergy and Clinical Immunology, 2017
Background: Persistent childhood asthma is mainly atopy driven. However, limited data exist on th... more Background: Persistent childhood asthma is mainly atopy driven. However, limited data exist on the risk factors for childhood asthma phenotypes. Objective: We sought to identify risk factors at the first severe wheezing episode for current asthma 7 years later and separately for atopic and nonatopic asthma. Methods: One hundred twenty-seven steroid-naive children with the first severe wheezing episode (90% hospitalized/10% emergency department treated) were followed for 7 years. The primary outcome was current asthma at age 8 years, which was also analyzed separately as atopic and nonatopic asthma. Risk factors, including sensitization, viral cause, and other main asthma risk factors, were analyzed. Results: At study entry, median age was 11 months (interquartile range, 6-16 months); 17% were sensitized, and 98% were virus positive. Current asthma (n 5 37) at 8 years was divided into atopic (n 5 19) and nonatopic (n 5 18) asthma. The risk factors for current atopic asthma at study entry were sensitization (adjusted odds ratio [OR], 12; P < .001), eczema (adjusted OR, 4.8; P 5 .014), and wheezing with rhinovirus (adjusted OR, 5.0; P 5 .035). The risk factors for nonatopic asthma were the first severe respiratory syncytial virus/rhinovirus-negative wheezing episode (adjusted OR, 8.0; P 5 .001), first wheezing episode at age less than 12 months (adjusted OR, 7.3; P 5 .007), and parental smoking (adjusted OR, 3.8; P 5 .028). Conclusions: The data suggest diverse asthma phenotypes and mechanisms that can be predicted by using simple clinical markers at the time of the first severe wheezing episode. These findings are important for designing early intervention strategies for secondary prevention of asthma.
Clinical Infectious Diseases, 2008
European Respiratory Journal, Sep 1, 2014
European Respiratory Journal, Sep 1, 2014
European Respiratory Journal, Sep 1, 2013
The Pediatric infectious disease journal, Jan 6, 2015
In 169 Finnish infants hospitalized for bronchiolitis at age <6 months in 2008-2010, nasophary... more 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.
Pediatric Allergy and Immunology, 2015