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Biomedical subjects

J A Hildes

Publications and source records attributed to J A Hildes.

At least 19 recordsLinked to original sources

Respiratory poliomyelitis: a follow-up study.

Data from the medical records of 113 patients living in Manitoba who had contracted respiratory poliomyelitis between 1952 and 1959 were compared with information obtained from interviews with these patients in 1980. The study was designed to determine whether the patients' respiratory function, mobility, ability to perform daily tasks, and employment, residential and marital status had changed between 1 year after the onset of polio and 1980. The patients' dependence on mechanical aids and other people was also studied. More than half (56%) of the patients perceived their respiratory impairment to be the same as it was 1 year after the onset of polio, 27% perceived the impairment to be increased, and 17% perceived it to be decreased. There was an association between level of respiratory function, mobility and ability to perform daily tasks. The 69 patients who lived at home had better respiratory function, mobility and ability to perform daily tasks than the 24 patients who were assisted by a home care program and the 20 who lived in hospital. The latter group had the lowest levels of respiratory and functional ability.

Activities of Daily Living↗

The changing picture of neoplastic disease in the western and central Canadian Arctic (1950-1980).

Data on 239 verified cases of malignant disease diagnosed from January 1950 through December 1980 in 104 male and 135 female Inuit from the western and central Canadian Arctic were reviewed. Tumours of the salivary glands, kidney and nasopharynx were the most frequent between 1950 and 1966, but their frequency declined thereafter. The most frequent tumours in the most recent period studied were lung, cervical and colorectal cancers. Breast cancer was absent before 1966 and was found in only 2 of 107 Canadian Inuit women stricken with cancer from 1967 to 1980, whereas the recent rates in the longer-acculturated Inuit of Alaska and Greenland have approached those prevailing in modern Western women. The Inuit appeared to be more prone than other North Americans to cancer of the esophagus, liver and ampulla of Vater but less prone to cancer of the skin, prostate, pancreas and stomach. The gradual reduction in the relative frequency of tumours typical for traditional Inuit and their replacement by "modern" tumours appear to reflect the history of local acculturation. Various factors in the environment, nutritional habits and lifestyle may contribute to the unusual and changing epidemiologic patterns of cancer in Canadian Inuit.

Adult↗

Meningitis in the central Arctic: a 4-year experience.

There were 37 cases of meningitis during a 4-year period among the native and white populations served by the Churchill Health Centre in northern Manitoba, an annual incidence of 128 per 100 000 in the overall population and of 202 per 100 000 among the Inuit. Bacterial meningitis predominated; Neisseria meningitidis and Haemophilus influenzae each accounted for one third of the cases. There were five deaths, and 14 of the survivors had severe sequelae. Therefore, although the doctors and nurses involved in the study had improved access to telecommunication and air transportation services in caring for patients in isolated northern settlements, and despite their efforts to be vigilant for possible cases of meningitis and to begin vigorous treatment early, the incidence, morbidity and mortality of this disease remained relatively high, particularly among the Inuit.

Arctic Regions↗

Respiratory function impairment and cardiopulmonary consequences in long-time residents of the Canadian Arctic.

Spirometry, roentgenography and electrocardiography were performed during community health surveys in 1976-78 in 176 Inuit and other long-time residents of the northeastern (Arctic Bay) and western (Inuvik) Canadian Arctic, and the results were related to age, ethnic origin, occupation and history of climatic exposure, smoking and hospitalization for tuberculosis. In Arctic Bay the young men showed excellent respiratory function, normal-sized pulmonary arteries and normal electrocardiograms, but abnormalities of all three types were increasingly frequent and severe after age 25. The forced mid-expiratory flow (FMF) fell to less than 50% of the norm by age 40, and dilatation of the pulmonary artery, hypertrophy of the right ventricle, right bundle branch block and a pseudoinfarction pattern on the ECG were frequently associated. In contrast, the men in Inuvik, an urbanized centre, maintained above normal respiratory function until age 40, and the FMF and pulmonary artery diameter remained normal in the older men except for Inuit and white trappers over 60 years old who had run fox trap lines along the Arctic coast in the 1920s and 30s. These data suggest that inhalation of extremely cold air at maximum ventilation may be a prime factor in the chronic obstructive lung disease of Inuit hunters, whereas smoking has only a minor role and hospitalization for tuberculosis appears to protect from rather than contribute to this disorder.

Adolescent↗

The changing pattern of neoplastic disease in Canadian Eskimos.

The records of the two main referral centres for the western and central Arctic were reviewed for Eskimo patients with cancer diagnosed between 1949 and 1974 inclusive. To these were added the records for the past 6 years of patients from the eastern Arctic, giving the toatal of 180 histologically proved cases of malignant disease. Athe data were analysed for prevalence, relative frequency, geographic distribution and changes with time of the various neoplasms. Salivary gland and renal neoplasms have in recent years been displaced by cancer of the lung and uterine cervix as the most common malignant tumours in Canadian Eskimos. The prevalence of lung cancer in Eskimo women, particularly of the central Artic, is striking. Cancer of the nasopharynx kept the same relative position during early and late years of the survey period. Breast cancer is still uncommon in Eskimos. Lactation rather than gestation history appeared to be an important protective factor. Cases of cervical cancer outnumbered those of breast cancer by 18 to 4, in sharp contrast to the relative proportions of these tumours in all Canadian women.

Adolescent↗

Twenty-four hour urinary excretion of vitamins, minerals and nitrogen by Eskimos.

In 1971-1972, urines were collected over 24 hours from ambulatory Iglooligmiut who ranged in age from 6 to 76 years. Collections were made every 3-4 months over a calendar year. The mean of each individual's two to four collections was used as the best estimate of that person's average daily excretion for nitrogen, thiamin, riboflavin, N'-methylnicotinamide, calcium, phosphorus, and magnesium. The excretion of the three B vitamins by all age groups was high when compared with interpretive standards. Urea nitrogen comprised 80-90% of total nitrogen excreted by all age groups. Twenty-four-hour mineral excretions did not differ with age and sex group except that adult men excreted significantly more phosphorus. Urinary urea nitrogen and phosphorus were linearly related, suggesting that they have a common source; namely, meat. Winter was generally the season of lowest excretion of the nutrients assayed. Since these nutrients are available from imported foods, particularly during the winter, it would appear that even in the winter the Iglooligmiut are more dependent on hunting and fishing for sources of these nutrients than on the well-stocked commercial grocery outlets.

Adolescent↗

Gastric cooling for massive upper gastrointestinal bleeding.

The treatment of massive upper gastrointestinal hemorrhage by gastric hypothermia was studied clinically in 23 patients: five with peptic ulcer, six with multiple gastric erosions, nine with portal hypertension and varices, and three with coagulation defects. Hemorrhage was controlled in 13 of the patients. The high mortality (14 out of 23 patients) was attributed to the severity of the bleeding and to the underlying disease, particularly in patients with liver failure. This form of treatment is a useful method of treating selected patients with upper gastrointestinal hemorrhage.

Adult↗

The elusive source of psittacosis in the Arctic.

Eskimos and Arctic Indians have a high incidence of psittacosis antibodies. The following Arctic birds were therefore examined in an endeavour to find the reservoir of infection: snow geese in their Arctic nesting grounds; migrating geese in the spring and in the fall; ptarmigan, raven, and snow bunting on the Arctic Circle in the late winter. Psittacosis virus was not recovered from any of the birds examined, but a percentage of migrating geese had psittacosis antibodies. The source of human and avian antibodies in the Arctic remains elusive.

Animals↗

Surveys of respiratory virus antibodies in an Arctic Indian population.

A study was undertaken to determine the etiological agents responsible for epidemics in a small and relatively isolated Arctic community.Three serological surveys were carried out over a four-year period employing complement fixation tests. Clinical information from the resident nurse was also available.The results indicated that of the two clinical epidemics of "influenza" which occurred during the period of study one was due to influenza virus type A; the other was unidentified. However, influenza virus type B affected approximately 30% of the population at some time during a two-year period without being clinically recognized. An epidemic affecting mainly children, which was clinically considered to be whooping cough, was probably caused by an adenovirus. A mumps epidemic with a high attack rate for all age groups which had occurred a few months prior to the first survey was confirmed. Sendai virus and psittacosis virus are probably endemic in this community.

Adenoviridae Infections↗