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Biomedical subjects

K E Petersen

Publications and source records attributed to K E Petersen.

At least 19 recordsLinked to original sources
PubMed2000

Relevance of carcass palpation in lambs to protecting public health.

We recently reviewed the Food Safety and Inspection Service's (FSIS's) inspection procedures for lambs. As a result, FSIS published a Federal Register notice informing the public of its intent to change from an inspection system that requires extensive carcass palpation to an inspection system that requires no carcass palpation for lambs. This decision was based on the following three points. (i) Extensive carcass palpation in lambs does not routinely aid in the detection of food safety hazards that result in meat-borne illnesses. (ii) Hands are capable of spreading or adding contamination to the carcasses. (iii) FSIS inspection systems must reflect science-based decisions as they pertain to meat-borne illnesses consistent with a Pathogen Reduction/Hazard Analysis and Critical Control Point environment.

Animals↗
PubMed1998

Agents, vehicles, and causal inference in bacterial foodborne disease outbreaks: 82 reports (1986-1995).

OBJECTIVE: To examine the study design of, and the practice of causal inference in, investigations of bacterial foodborne disease outbreaks occurring in the United States and to summarize agents and vehicles identified. DESIGN: Retrospective study. PROCEDURE: An online medical reference database was searched for reports of bacterial foodborne disease outbreak investigations published between 1986 and 1995. Reports were retrieved and reviewed for use of 9 causal criteria in investigations. Information on etiologic agents, vehicles, seasonality, and primary study design from each outbreak was also retrieved. RESULTS: 82 reports were retrieved and reviewed. Coherence, consistency, temporality, and strength of association were the causal criteria most commonly used in foodborne disease outbreak investigations. Coherence was used in all investigations. The number of criteria used ranged from 3 to 7. Meat (n = 20) and eggs (12) were the most commonly implicated vehicles. Salmonella sp and Escherichia coli O157:H7 accounted for 55% of agents reportedly isolated. Cohort and case-control methods were the most common study designs. CLINICAL RELEVANCE: Patterns were found in the use of causal criteria in foodborne disease outbreak investigations. These criteria can provide veterinarians and other public health practitioners with a means to effectively conceptualize, communicate, and summarize causal conclusions. The 4 most commonly used criteria may represent core criteria that investigators consider most useful in explaining food-borne disease outbreaks.

Animals↗
PubMed1992

Relationship between insulin injection regimen and metabolic control in young Danish type 1 diabetic patients. The Danish Study Group of Diabetes in Childhood.

In 1987 and 1989 nationwide screening for HbA1c was carried out in Denmark. Twenty-one paediatric departments treating children with diabetes participated in the first study and twenty-two in the second. During this 2-year period metabolic control deteriorated despite the fact that the use of multiple injection regimens increased from 39% to 54%. The possible reasons for the deterioration in metabolic control were examined in the 429 children (> or = 9 years, 1987) and adolescents (< 18.8 years, 1989) who participated in both studies. All had diabetes duration of greater than one year (1987) and all were treated by the same departments during the study period. The children were divided into three subgroups according to injection regimen. Group A (n = 128) received twice-daily insulin injections; group B (n = 171) were on multiple injections (three or more) while group C (n = 130) shifted from twice-daily insulin to multiple injections during the 2-year period. A deterioration of blood glucose control as assessed by HbA1c was observed in all three treatment groups. For group C the 2-year increase in daily insulin dose was more pronounced for males (19%) than for females (6%). Body mass index increased significantly in all treatment groups during the study period. The 1989 mean levels were higher in group B (males 20.6 kg m-2, females 22.0 kg m-2) than group A (males 19.3 kg m-2, p = 0.002; females 20.7 kg m-2, p = 0.000003) and group C (males 19.4 kg m-2, p = 0.0005; females 20.7 kg m-2, p = 0.008).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Knemometry in the assessment of short-term linear growth in a population of healthy school children.

Short-term lower leg length increments were monitored with weekly knemometry measurements during 3 months in 27 healthy school children aged 8-12 years. One year after the first visit the children were measured once again. The mean short term velocity of lower leg growth was 0.40 mm/week (SD 0.12 mm/week). The mean short-term and annual ratios between height velocity and lower leg growth velocity were identical (2.8). The relative variation between two observers was 0.08%. Knemometry is a suitable method for monitoring short-term linear growth in populations of children. Two trained observers may substitute for each other in group studies.

Anthropometry↗
PubMed1991

Gonadal development and growth in 46,XX and 46,XY individuals with P450scc deficiency (congenital lipoid adrenal hyperplasia).

We have investigated gonadal development and growth in 4 individuals (3 with 46,XY and 1 with 46,XX karyotype) with P450scc deficiency. One patient died at 2 months of age from adrenal insufficiency, while the remaining 3 individuals were healthy and developed normally (age at follow-up: 18, 10 and 8 years). In the surviving individuals, the diagnosis was established during the first 2-4 months of life by extensive endocrine studies of blood and urine. In the remaining patient, the diagnosis was made on the basis of karyotype (46,XY), anatomy of internal and external genitalia and adrenal pathology. Gonadectomy was performed in the 2 surviving 46,XY individuals at the age of 7 years, and histological examination showed normal testicular morphology but very few germ cells. Postmortem examination of the testes of the 2-month-old subject showed normal testicular histology, and quantitative analysis revealed a normal number of germ cells. Ultrasound of the 46,XX individual showed normal internal female genitalia including ovaries with follicles. The 3 surviving patients grew along the 75th (46,XY), the 90th (46,XY) and the 50th percentile (46,XX), respectively. The oldest girl experienced normal breast and pubic hair development after oral estrogen replacement and topical testosterone administration. The glucocorticoid and mineralocorticoid replacement was adjusted in accordance with repeated measurements of serum sodium and serum potassium, plasma renin concentration and blood pressure. No attempts were made to normalize serum ACTH. We conclude that prenatal testicular maturation and development of female internal genitalia may take place in the absence of normal steroid hormone production. Normal growth and development may be obtained in P450scc-deficient individuals with adequate hormone replacement.

Adolescent↗
PubMed1990

Nitrofurantoin versus trimethoprim prophylaxis in recurrent urinary tract infection in children. A randomized, double-blind study.

The efficiency of nitrofurantoin and trimethoprim prophylaxis in preventing recurrent urinary tract infections (UTI) was compared by means of actuarial percentage recurrence-free curves in a randomized, double blind study in 130 children (126 girls, 4 boys) aged 1 to 14 years (mean 7.5). The children received the antibiotics for 6 months. Nitrofurantoin proved to be the most efficient prophylactic drug in patients with abnormal urography and/or reflux (n = 60) as evaluated by actuarial percentage recurrence-free analysis (p = 0.0025). However, no differences was found in patients without urinary tract abnormalities. Nitrofurantoin prophylaxis altered neither the pattern of resistance nor the bacteriological constellation, while patients receiving trimethoprim prophylaxis had 76% trimethoprim resistant bacteria during prophylaxis, compared with 8% before (p less than 0.0001) and 17% after (p less than 0.0001) prophylaxis. The percentage of recurrences due to E. coli (70-80%) was unaffected by trimethoprim prophylaxis, but the proportion due to trimethoprim resistant E. coli was significantly higher during prophylaxis (65%) than before (6%, p less than 0.0001) and after (11%, p less than 0.001). The percentage of Staphylococcus epidermidis UTI was significantly higher during trimethoprim prophylaxis (27%) than before (2%, p less than 0.0003). Following prophylaxis there was no difference in the actuarial percentage recurrence-free curves of the two regimens. Side effects occurred more frequently in the nitrofurantoin group (37%) than in the trimethoprim group (21%) (p = 0.05). The majority of side effects in the nitrofurantoin group derived from gastrointestinal symptoms. In conclusion, nitrofurantoin is recommended as the first choice prophylactic treatment of children with recurrent UTI and urinary tract abnormalities.

Adolescent↗
PubMed1988

A nation-wide cross-sectional study of glycosylated haemoglobin in Danish children with type 1 diabetes.

A nation-wide screening for HbA1c was carried out in Denmark. Twenty-one paediatric departments treating children with Type 1 diabetes participated. During a period of 4 months 884 children were included, 93% of all those followed at these centres, representing approximately 70-80% of all children and adolescents with Type 1 diabetes in Denmark. Among the children 351 were less than or equal to 12 years and 533 were adolescents between 12 and 18 years. Children less than or equal to 12 years had a HbA1c concentration of 8.9 +/- 1.5 (+/- SD)% and an insulin dose of 0.71 +/- 0.3 U kg-1 24-h-1. For adolescents HbA1c was significantly higher 9.7 +/- 2.0% (p less than 0.001) and insulin dose significantly increased 0.85 +/- 0.3 U kg-1 24-h-1 (p less than 0.001). Normal range for HbA1c is 4.0-6.5 (mean 5.3)% of total haemoglobin. Boys and girls less than or equal to 12 years had similar HbA1c, but girls received 13% more insulin (p less than 0.001). In the group of adolescents, girls had a HbA1c 4% higher than boys (9.9 +/- 2.0 vs 9.5 +/- 2.0%, p less than 0.025), received 11% more insulin (p less than 0.001), and had 6% higher body mass index (p less than 0.001). A weak correlation was found between insulin dose and the HbA1c level (r = 0.29, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Glucose tolerance and insulin receptor binding to monocytes and erythrocytes in patients with cystic fibrosis.

Cystic fibrosis (CF) is the most frequent life threatening hereditary disease in the Western World with an incidence of approximately 1:2000. Due to increasing survival rates the high frequency of abnormal glucose tolerance has become an important problem. We compared insulin concentrations during oral glucose tolerance test and insulin receptor binding to both monocytes and erythrocytes from 9 patients with CF, with results from 10 healthy controls of similar body weight. The insulin: glucose ratio was increased in the fasting state (p less than 0.05) in patients with CF compared to controls, indicating an increased insulin resistance in CF-patients. The total insulin secretion during oral glucose tolerance test as judged by the area beneath the insulin curve was similar in the two groups, but insulin secretion was significantly delayed in patients with CF. Insulin receptor binding to monocytes and the number of receptors were significantly increased (p less than 0.01 and 0.02, respectively) in patients with CF whereas the dissociation constant was similar in patients with CF and controls. No difference was observed in insulin receptor binding to erythrocytes between the two groups. No correlations were found between insulin receptor binding to monocytes or erythrocytes and glucose tolerance or insulin concentrations.

Adolescent↗
PubMed1988

Proinsulin, insulin, and C-peptide in cystic fibrosis after an oral glucose tolerance test.

The beta-cell response to an oral glucose load was studied in 22 patients with cystic fibrosis (CF) by means of insulin, C-peptide and proinsulin, and the results compared with those from 20 healthy sex and age matched controls. According to WHO criteria two had diabetes mellitus, eight had impaired glucose tolerance and twelve had normal glucose tolerance. All patients showed lower insulin and C-peptide levels than the controls at 30 minutes. However the insulin and C-peptide responses were sustained so that the areas under the curves were comparable between controls, CF patients with normal glucose tolerance, and CF patients with impaired glucose tolerance. By contrast, the area under the proinsulin curve was significantly higher in the CF patients with impaired glucose tolerance compared with both controls (p less than 0.05) and with the CF normal glucose tolerance group (p less than 0.02). In the CF patients with impaired glucose tolerance the proinsulin level was significantly elevated at 120 minutes (median 50 pmol/l) and at 180 minutes (29 pmol/l) as compared with the controls (24 and 19 pmol/l p less than 0.01) and with the CF patients with normal glucose tolerance (21 and 16 pmol/l p less than 0.01). These data confirm that impaired glucose tolerance and diabetes is frequent in cystic fibrosis. The elevated proinsulin immunoreactive material in CF patients with impaired glucose tolerance may partly compensate for the relative insufficient insulin response found in these patients.

Adolescent↗
PubMed1986

Treatment of Cushing's disease in childhood and adolescence by stereotactic pituitary irradiation.

Eight children with Cushing's disease aged 6-18 years were treated with external radiation to the pituitary gland using 60Co gamma radiation given with stereotactic technique. The dose given varied between 50 and 70 Gy. The observation time was 2.6 to 6.75 years. Seven children had a clinical remission with normal urinary cortisol excretion. One child had insufficient effect of two irradiations and underwent bilateral adrenalectomy. In the patients in remission the growth velocity increased during the first year after treatment but growth retardation occurred again during the second year. Insufficient growth hormone secretion was demonstrated in all subjects. Two patients were given thyroxine substitution and three showed evidence for secondary hypogonadism. In conclusion, stereotactic pituitary irradiation was effective in normalizing the excessive glucocorticoid production in children with Cushing's disease. However, with the doses used, it was not possible to maintain a normal anterior pituitary function.

Adolescent↗
PubMed1985

Carcinoma in situ of the testis in children with 45,X/46,XY gonadal dysgenesis.

The frequency of gonadal tumors in intersex patients with a karyotype including a Y chromosome is very high. In other at-risk groups, testicular germ cell tumors have been shown to be preceded by carcinoma in situ (CIS) changes. We investigated gonadal tissue from four children, aged 1 month to 18 years, with 45,X/46,XY gonadal dysgenesis, and with male or ambiguous genitalia, for the presence of CIS germ cells. Twelve gonadal biopsies and gonadectomy specimens were analyzed by means of conventional histology and densitometric DNA measurements. CIS changes were detected in specimens from all four patients, and aneuploid DNA distributions of the CIS germ cells confirmed the malignant potential of these cells. In one case, electron microscopic analysis revealed the same ultrastructural features of the CIS germ cells as previously described in seminoma cells. These observations indicate that in all patients with 45,X/46XY gonadal dysgenesis and a male phenotype, gonadal biopsies should be considered as soon as the syndrome is diagnosed. We believe that the finding of CIS warrants gonadectomy.

Adolescent↗
PubMed1985

Higher plasma somatomedin A (biological) and C (immunological) levels with sc than with im growth hormone replacement therapy.

In a short-term cross-over study the effect of daily sc human growth hormone was compared with that of thrice weekly im treatment. At the end of each 6-week treatment period the 10 growth hormone deficient children were admitted to hospital for evaluation of diurnal plasma levels of hormones and intermediary metabolites. Somatomedin A as well as C levels were higher in 9 of 10 children after sc than after im growth hormone therapy. This may be the basis for previous observations of improved growth after change to sc treatment.

Adolescent↗
PubMed1984

A new familial skeletal dysplasia with severely retarded ossification and abnormal modeling of bones especially of the epiphyses, the hands, and feet.

Three brothers with a constitutional skeletal dysplasia characterized by an excessively retarded ossification, principally of the epiphyses, the pelvis, the hands and the feet, are reported. In the hands and feet the retarded ossification is combined with an abnormal modeling of the bones. All the children appeared normal at birth. At the time of examination a moderate degree of dwarfism could be predicted. There was no mental retardation. All laboratory investigations including chromosomal analyses and examination for acid mucopolysaccharides in the urine were normal. Parental consanguinity suggest an autosomal recessive inheritance. There is no resemblance of this disorder to any of the hitherto described groups of constitutional diseases of bones.

Bone Diseases, Developmental↗
PubMed1984

ACTH in normal children and children with pituitary and adrenal diseases. II. Plasma ACTH (cortisol and growth hormone) values during insulin hypoglycaemia--patients with idiopathic hypopituitarism and intracranial tumour.

During insulin hypoglycaemia (IH) reference values for plasma ACTH are 10 to 88 pg/ml at 0 min and 50 to 300 pg/ml at 40 min. Plasma cortisol reference values are above 400 nmol/l at 40 min. A negative correlation between age and ACTH response was found in normal children. ACTH response during IH in 43 children and adolescents with deficient production of one or several pituitary hormones was significantly lower (median 81 pg/ml at 40 min), than the response in normal children (median 149 pg/ml). Thirty-six patients with idiopathic hypopituitarism could be grouped into 21 with normal, 6 with borderline (50 to 70 pg/ml at 40 min), and 9 with abnormal ACTH response. In 7 patients with intracranial tumour 2 had normal, 3 borderline, and 2 abnormal ACTH response. A good correlation between the ACTH peak at 40 min and the cortisol value at 40 min was found in patients with idiopathic hypopituitarism. ACTH response also correlated well with the plasma growth hormone (GH) response in the patients. It is recommended to study ACTH together with GH when IH is performed, multiple disturbances are often found in children with GH deficiency and demonstration of an ACTH defect has therapeutic implications.

Adolescent↗