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Enterovirus infections are associated with the induction of beta-cell autoimmunity in a prospective birth cohort study.

https://arctichealth.org/en/permalink/ahliterature187748
Source
J Med Virol. 2003 Jan;69(1):91-8
Publication Type
Article
Date
Jan-2003
Author
Kimmo Salminen
Karita Sadeharju
Maria Lönnrot
Paula Vähäsalo
Antti Kupila
Sari Korhonen
Jorma Ilonen
Olli Simell
Mikael Knip
Heikki Hyöty
Author Affiliation
Juvenile Diabetes Research Foundation Center for Prevention of Type 1 Diabetes in Finland.
Source
J Med Virol. 2003 Jan;69(1):91-8
Date
Jan-2003
Language
English
Publication Type
Article
Keywords
Adenoviridae Infections - immunology - virology
Antibodies, Viral - blood
Autoantibodies - blood
Autoimmunity
Cohort Studies
Diabetes Mellitus, Type 1 - complications - epidemiology - immunology - virology
Enterovirus Infections - complications - epidemiology
Female
Finland - epidemiology
Humans
Immunoglobulin A - blood
Immunoglobulin G - blood
Infant
Infant, Newborn
Male
Prospective Studies
Reverse Transcriptase Polymerase Chain Reaction
Abstract
Enterovirus infections have been associated with the manifestation of clinical type 1 diabetes in a number of reports, and recent prospective studies have suggested that enterovirus infections may initiate the autoimmune process, leading to the disease. In the present study, we analyzed the role of enterovirus infections in a Finnish birth cohort study, Diabetes Prediction and Prevention (DIPP), in which all newborn infants are screened for diabetes-associated HLA-DQB1 alleles, and those with an increased genetic risk are invited for prospective follow-up. Enterovirus infections were diagnosed by serology and reverse transcriptase-polymerase chain reaction (RT-PCR) from serum samples taken from birth every 3-6 months. Case children included 41 infants who became positive for diabetes-associated autoantibodies during the observation. Control children comprised altogether 196 infants who remained autoantibody negative and were matched for the time of birth, sex, and HLA-DQB1 alleles. Enterovirus infections were more frequent in case children than in control children (P = 0.004), and the average enterovirus antibody levels were also higher in the case children (P = 0.003). Enterovirus infections were particularly frequent during the 6-month period preceding the first detection of autoantibodies: 51% of the case children compared with 28% of the control children had an infection in that time interval (P = 0.003). There was no difference in the frequency of adenovirus infections between the groups (P = 0.9). The present results imply that enterovirus infections are associated with the appearance of beta-cell autoantibodies. A possible causal relationship is supported by the clustering of infections to the time when autoantibodies appeared.
PubMed ID
12436483 View in PubMed
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Fecal transplantation, through colonoscopy, is effective therapy for recurrent Clostridium difficile infection.

https://arctichealth.org/en/permalink/ahliterature128949
Source
Gastroenterology. 2012 Mar;142(3):490-6
Publication Type
Article
Date
Mar-2012
Author
Eero Mattila
Raija Uusitalo-Seppälä
Maarit Wuorela
Laura Lehtola
Heimo Nurmi
Matti Ristikankare
Veikko Moilanen
Kimmo Salminen
Maaria Seppälä
Petri S Mattila
Veli-Jukka Anttila
Perttu Arkkila
Author Affiliation
Department of Infectious Diseases, Helsinki University Central Hospital, Helsinki, Finland. eero.mattila@hus.fi
Source
Gastroenterology. 2012 Mar;142(3):490-6
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Clostridium difficile - pathogenicity
Colonoscopy - adverse effects - mortality
Enterocolitis, Pseudomembranous - microbiology - mortality - therapy
Feces - microbiology
Female
Finland
Humans
Male
Middle Aged
Polyethylene Glycols - administration & dosage
Recurrence
Retrospective Studies
Therapeutic Irrigation
Time Factors
Treatment Outcome
Virulence
Young Adult
Abstract
Treatment of recurrent Clostridium difficile infection (CDI) with antibiotics leads to recurrences in up to 50% of patients. We investigated the efficacy of fecal transplantation in treatment of recurrent CDI.
We reviewed records from 70 patients with recurrent CDI who had undergone fecal transplantation. Fecal transplantation was performed at colonoscopy by infusing fresh donor feces into cecum. Before transplantation, the patients had whole-bowel lavage with polyethylene glycol solution. Clinical failure was defined as persistent or recurrent symptoms and signs, and a need for new therapy.
During the first 12 weeks after fecal transplantation, symptoms resolved in all patients who did not have strain 027 C difficile infections. Of 36 patients with 027 C difficile infection, 32 (89%) had a favorable response; all 4 nonresponders had a pre-existing serious condition, caused by a long-lasting diarrheal disease or comorbidity and subsequently died of colitis. During the first year after transplantation, 4 patients with an initial favorable response had a relapse after receiving antibiotics for unrelated causes; 2 were treated successfully with another fecal transplantation and 2 with antibiotics for CDI. Ten patients died of unrelated illnesses within 1 year after transplantation. No immediate complications of fecal transplantation were observed.
Fecal transplantation through colonoscopy seems to be an effective treatment for recurrent CDI and also for recurrent CDI caused by the virulent C difficile 027 strain.
Notes
Comment In: Gastroenterology. 2012 Aug;143(2):e19; author reply e19-2022732575
PubMed ID
22155369 View in PubMed
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High treatment persistence rate and significant endoscopic healing among real-life patients treated with vedolizumab - a Finnish Nationwide Inflammatory Bowel Disease Cohort Study (FINVEDO).

https://arctichealth.org/en/permalink/ahliterature294908
Source
Scand J Gastroenterol. 2018 Feb; 53(2):158-167
Publication Type
Journal Article
Multicenter Study
Date
Feb-2018
Author
Tero Ylisaukko-Oja
Jaakko Aaltonen
Heikki Nuutinen
Timo Blomster
Airi Jussila
Markku Pajala
Kimmo Salminen
Veikko Moilanen
Kalle Hakala
Mikko Kellokumpu
Kari Toljamo
Henna Rautiainen
Juha Kuisma
Markku Peräaho
Pauliina Molander
Jouni Silvennoinen
Ville Liukkonen
Hans Henricson
Jyrki Tillonen
Mirva Esterinen
Christian Nielsen
Eija Hirsi
Margus Lääne
Ulla-Maija Suhonen
Ilkka Vihriälä
Petri Mäkelä
Mika Puhto
Jari Punkkinen
Hannu Sulonen
Sauli Herrala
Jari Jokelainen
Klaus Tamminen
Taina Sipponen
Author Affiliation
a Takeda Oy , Helsinki , Finland.
Source
Scand J Gastroenterol. 2018 Feb; 53(2):158-167
Date
Feb-2018
Language
English
Publication Type
Journal Article
Multicenter Study
Keywords
Adult
Antibodies, Monoclonal, Humanized - adverse effects - therapeutic use
Biological Therapy
Colitis, Ulcerative - drug therapy
Crohn Disease - drug therapy
Endoscopy
Female
Finland
Gastrointestinal Agents - adverse effects - therapeutic use
Humans
Male
Middle Aged
Remission Induction
Retrospective Studies
Severity of Illness Index
Wound Healing - drug effects
Young Adult
Abstract
The efficacy and tolerability of vedolizumab in the treatment of inflammatory bowel diseases (IBD) has been demonstrated in an extensive GEMINI clinical trial programme. Clinical trials represent highly selected patient populations and, therefore, it is important to demonstrate effectiveness in real-life clinical practice. We set out to assess real-world treatment outcomes of vedolizumab in a nationwide cohort of treatment refractory Finnish Crohn's disease (CD) and ulcerative colitis (UC) patients.
This was a nationwide, retrospective, non-interventional, multi-centre chart review study. All adult patients from 27 Finnish gastroenterology centers with a diagnosis of UC or CD who had at least one vedolizumab infusion since the availability of the product in Finland, were included in the study. Data were collected retrospectively from medical charts at baseline, week 14, and month 6. The primary outcome measure was treatment persistence 24 weeks post-vedolizumab initiation.
A total of 247 patients were included (108?CD, 139 UC). A total of 75.0% (n?=?81) of all CD patients and 66.2% (n?=?92) of all UC patients, were persistent on vedolizumab therapy for 6 months post treatment initiation. At month 6, 41.8% (28/67) of the treatment persistent CD patients and 73.3% (63/86) of the treatment persistent UC patients achieved clinical remission. Significant improvement in endoscopic scores were observed among treatment persistent patients (CD, n?=?17, ?SES-CD=-5.5, p?=?.008; UC, n?=?26, ?Mayo endoscopic score?=-0.5, p?=?.003) at month 6.
Vedolizumab provides an effective and well-tolerated treatment option in real-world clinical practice even among treatment refractory IBD patients.
PubMed ID
29258369 View in PubMed
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