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PubMed1969

Partial purification and properties of carbamoyl phosphate synthetase of Alaska pea (Pisum sativum L. cultivar Alaska).

1. Carbamoyl phosphate synthetase was purified up to 45-fold from Alaska pea seedling (Pisum sativum L. cultivar Alaska). 2. The enzyme was most active with and had the lowest K(m) for l-glutamine as compared with NH(4) (+). 3. The purest preparations utilized very poorly or not at all l-asparagine and urea as nitrogen donors. 4. At saturating concentrations of components of the reaction, the K(m) for l-glutamine was 1.2x10(-4)m, and the K(m) for ATP was approx. 3.9x10(-4)m. 5. Although the enzyme was very labile, stability was improved by glutamine, asparagine, ammonium sulphate, dithiothreitol and especially l-ornithine. 6. Free ATP was markedly inhibitory, and MgATP(2-) and Mg(2+) appeared to be the actual substrates utilized. 7. Fe(2+) and Mn(2+) were also utilized, but not as readily as Mg(2+) except at low concentrations. K(+) increased activity significantly. 8. Of the four nucleotides tested (ITP, ATP, GTP and UTP) only ATP served as an effective phosphate donor.

Adenosine Triphosphate↗
PubMed1999

Severe respiratory syncytial virus disease in Alaska native children. RSV Alaska Study Group.

Hospitalization rates for respiratory syncytial virus (RSV) infection range from 1 to 20/1000 infants. To determine the rate and severity of RSV infections requiring hospitalization for infants in the Yukon-Kuskokwim (YK) Delta of Alaska, a 3-year prospective surveillance study was conducted. The annual rate of RSV hospitalization for YK Delta infants <1 year of age was 53-249/1000. RSV infection was the most frequent cause of infant hospitalization. RSV disease severity did not differ among non-high-risk infants in the YK Delta and at Johns Hopkins Hospital (JHH). On average, 1/125 infants born in the YK Delta required mechanical ventilation for RSV infection. During the peak season, approximately $1034/child <3 years of age was spent on RSV hospitalization in the YK Delta. In YK Delta infants </=6 months old, RSV microneutralizing antibody titers <1200 were associated with severe disease (odds ratio=6.2, P=.03). In the YK Delta and at JHH, newborns may be at greater risk for severe RSV illness than previously thought.

Age Factors↗
PubMed2004

Alaska telemedicine: growth through collaboration.

The last thirty years have brought the introduction and expansion of telecommunications to rural and remote Alaska. The intellectual and financial investment of earlier projects, the more recent AFHCAN Project and the Universal Service Administrative Company Rural Health Care Division (RHCD) has sparked a new era in telemedicine and telecommunication across Alaska. This spark has been flamed by the dedication and collaboration of leaders at he highest levels of organizations such as: AFHCAN member organizations, AFHCAN Office, Alaska Clinical Engineering Services, Alaska Federal Health Care Partnership, Alaska Federal Health Care Partnership Office, Alaska Native health Board, Alaska Native Tribal health Consortium, Alaska Telehealth Advisory Council, AT&T Alascom, GCI Inc., Health care providers throughout the state of Alaska, Indian Health Service, U.S. Department of Health and Human Services, Office of U.S. Senator Ted Steens, State of Alaska, U.S. Department of Homeland Security--United States Coast Guard, United States Department of Agriculture, United States Department of Defense--Air Force and Army, United States Department of Veterans Affairs, University of Alaska, and University of Alaska Anchorage. Alaska now has one of the largest telemedicine programs in the world. As Alaska moves system now in place become self-sustaining, and 2) collaborating with all stakeholders in promoting the growth of an integrated, state-wide telemedicine network.

Alaska↗
PubMed2003

Childhood cancer among Alaska Natives.

OBJECTIVE: The primary purpose of this study was to examine the occurrence of cancer in Alaska Native (AN) children (under age 20). Although several studies have compared differences in cancer incidence between white and black children, few have examined cancer among Alaska Natives/American Indians. We know of no published article describing cancer incidence in AN children. We compared our findings with those of American Indian children of New Mexico and of Alaska white children. Data on mortality, survival, and prevalence are also included. Alaska Native is the term used collectively for the inhabitants whose ancestors occupied the area before European contact of what is now the state of Alaska. Alaska Natives include Eskimo, Indian, and Aleut groups. Although the 3 major groups differ in culture, language, and probably genetics, there are similarities in numerous social and economic indicators. The Northern Eskimo of Alaska (Inupiat) are related to Canadian and Greenland Inuit. Indians in Alaska include Athabaskan (in the interior of the state), who share commonalities with Canadian Athabaskan as well as with Navajo and Apache in the southwestern United States. Tlingit, Haida, and Tsimshian groups reside primarily in the southeast panhandle of the state. The panhandle Indian groups are similar to those of British Columbia. METHODS: Data on cancer incidence are from the Alaska Native Tumor Registry, 1969-1996. We studied children under age 20 to make our results comparable to national data as presented in the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Pediatric Monograph. Population data for AN are based on census data and Indian Health Service intercensal estimates. Data for US whites and New Mexico Indians are from the National Cancer Institute's SEER program. Calculations were made using SEERStat software. Data for Alaska whites are for the years 1996-2000. (The Alaska Cancer Registry has collected data for all Alaskans only since 1996). Odds ratios (ORs) of rates with 95% confidence intervals (CIs) were calculated. RESULTS: The rate among all AN children (both sexes) for all cancers combined is similar to that of US whites (OR: 1.0; 95% CI: 0.8-1.1). Examination of childhood cancer rates by ethnicity, however, reveal that rates are significantly lower for Indian (OR: 0.6; 95% CI: 0.4-0.8) but not significantly different for Eskimo or Aleut children. For most International Classification of Childhood Cancers groups, incidence rates for AN children are also similar to those of US whites. However, AN children are at significantly higher risk for hepatic tumors (OR: 13.1; 95% CI: 7.9-20.5), particularly hepatocellular carcinoma (OR: 43.8; 95% CI:24.4-75.1) and retinoblastoma (OR: 2.8; 95% CI: 1.3-5.3). By ethnic group, rates for hepatocellular carcinoma are significantly high only for Eskimo. Rates for all AN children are lower for neuroblastoma (OR: 0.1; 95% CI: 0.1-0.6) and lymphoma (OR: 0.5; 95% CI: 0.3-0.9), particularly Hodgkin's disease (OR: 0.2; 95% CI: 0.0-0.5). On the basis of 5 years of data, rates for Alaska white children do not seem to differ from those of US white children. Because of our findings of differences between AN and US whites, we reviewed data of other relevant populations, specifically American Indian data from the New Mexico SEER registry. Using SEER data and SEER software, we calculated rates for New Mexican American Indians (NMAI) and compared them with US white rates. Rates for all cancers combined among NMAI are significantly lower than for US white (OR: 0.8). However, similar to AN children, the rate among NMAI for retinoblastoma is higher compared with US whites (OR: 2.5; 95% CI:1.4-4.5). Similar to AN, NMAI also seem to be at low risk for neuroblastoma (OR: 0.2; 95% CI: 0.1-0.7), lymphoma as a group (OR: 0.1; 95% CI: 0.0-0.3), and, specifically, Hodgkin's disease (OR: 0.1; 95% CI: 0.0-0.4). Rates among NMAI children are low for central nervous system tumors (OR: 0.5; 95% CI: 0.3-0.7). The average annual age-adjusted cancer mortality rate among AN children is lower but not significantly lower than that of US white children (28.6 vs 37.3 per million). CONCLUSIONS: Comparison of AN rates for all cancers combined are similar to those of US and Alaska white children but seem higher than those of NMAI. Differences between AN and US whites exist for select International Classification of Childhood Cancers groups. The most striking rate differences are found in hepatic tumors, largely because of elevated rates of hepatitis B-associated hepatocellular carcinoma. All children in our study with hepatocellular carcinoma were hepatitis B antigen positive. A statewide hepatitis B virus immunization program was begun in late 1982. Although 16 children who were born before 1983 developed hepatocellular carcinoma, no children who were born in the 20 years since hepatitis B immunization was instituted among infants have received a diagnosis of hepatocellular carcinoma, a significant difference. Comparing AN and US white childhood cancer rates after removing hepatocellular carcinoma cases from both populations results in an OR of 0.8 (95% CI: 0.7-1.0). Thus, if no increase in other childhood cancers occurs in the coming generations, then rates for childhood cancer may soon be significantly lower than those in US white children. Rates are low for all lymphomas, largely because of very low rates of Hodgkin's disease. Rates are also low for neuroblastoma. It is reassuring that rates for AN children are not in excess and do not seem to be increasing. There is concern among the population regarding environmental exposure, including ionizing radiation. Our data do not show excess childhood leukemia or thyroid cancers, malignancies for which radiation is known to increase risk.

Adolescent↗
PubMedDate not supplied

Prevalence of tobacco use among Alaska Natives: a review.

BACKGROUND: Previous reports documented high rates of tobacco use among Alaska Natives (Eskimos, Indians, and Aleuts). In this population, tobacco use is the leading preventable cause of death. Lung cancer is the leading cause of cancer death among Alaska Natives and tobacco is responsible for over one-third of all cancer deaths in this population. Until recently there has been no systematic surveillance of the prevalence of tobacco use in this high-risk population. Data that did exist were not readily available to those primarily responsible for the health care of this population. This is the first time since 1990 that data on Alaska Natives have been collected in one analysis; this permits a more representative evaluation of tobacco use. METHODS: Data on tobacco use were obtained and analyzed from national and state surveys and selected research projects from 1988 to 1993. RESULTS: Alaska Natives have high prevalence of tobacco use, including both cigarettes and smokeless tobacco. Tobacco use prevalence among Alaska Natives exceeds that of Alaska non-Natives, U.S. whites, and American Indians/Alaska Natives in the United States outside of Alaska. Smoking prevalence among Alaska Native women is twice that of non-Native women in Alaska and nearly twice as high among pregnant Alaska Natives than pregnant non-Natives. Overall, prevalence of smokeless tobacco use was four times higher among Alaska Natives than comparative state and national populations. CONCLUSION: Because this population has such high rates of tobacco use, it is important to public health that monitoring and educational programs be in place and that data specific to Alaska Natives be made available.

Alaska↗
PubMed2006

Prostate cancer in Alaska Native men, 1969-2003.

OBJECTIVES: The incidence of prostate cancer differs significantly between US race groups. In prior reviews of cancer in Alaska Natives, the incidence of prostate cancer has been observed to occur at a low rate compared to US Whites and Blacks. However, a detailed report of prostate cancer in this population has not been previously published. STUDY DESIGN: Incidence of prostate cancer in Alaska Native men was determined for the time period 1969-2003 using data from the Alaska Native Tumor Registry. The registry is a population-based registry which participates in the National Cancer Institute Surveillance, Epidemiology and End Results Program, and has collected cancer information on Alaska Natives since 1969. METHODS: Incidence rates were calculated for all Alaska Natives and for each of the three major ethnic groups (Aleut, Eskimo, Indian). Comparisons of incidence rates between Alaska Natives and US Whites were performed using odds ratios. Temporal changes were identified by a Chi square analysis for trend. RESULTS: During the 35-year period of review, 332 Alaska Native men were diagnosed with prostate cancer. The age-adjusted incidence rate of 69.5 per 100 000 in Alaska Native men during 1994-2003 was significantly higher than the rate of 45.5 per 100 000 for the earlier period 1969-1983. The US White rate for 1994-2002 of 169.5 per 100 000 was significantly higher than the rate for Alaska Native men for 1994-2003. Results of comparisons between Alaska Native ethnic groups for 1969-2003 showed that prostate cancer was highest in Indians and Aleuts and lowest among Eskimos. CONCLUSIONS: Compared to the US White population, the incidence of prostate cancer in Alaska Native men is significantly lower. Prostate cancer rates among Alaska Native ethnic groups differ. The reason for these differences remains undetermined.

Adult↗
PubMed1998

Educating medical students for Alaska.

Because Alaska does not have its own medical school, it has become part of WAMI (Washington, Alaska, Montana, Idaho), an educational agreement with the University of Washington School of Medicine (UWSM). Each year, 10 Alaskans are accepted into the entering class of UWSM and spend their first year at the University of Alaska Anchorage (UAA). UWSM third- and fourth-year medical students can obtain some of their clinical experience in Alaska. To meet the needs of Alaska, students are chosen based on academic and personal records, as well as the likelihood of their returning to Alaska for practice. To this end, over the last seven years 30% of accepted students have come from rural communities and 10% are Alaska Natives. The curriculum for the first year includes several sessions dedicated to Alaska health problems, cross-cultural issues, and Alaska's unique rural health care delivery system. Students do two preceptorships--one with a private primary care physician and one with a physician at the Alaska Native Medical Center. Additionally, students have the option to spend a week at a rural site to learn about the community's health care system. An Alaska track is being developed whereby an Alaskan UWSM student can do most of the third year in state via clerkships in family medicine, obstetrics/gynecology, psychiatry, internal medicine, and pediatrics. All UWSM students at the end of their first year can elect to participate for one month in the R/UOP (Rural/Underserved Opportunities Program), which includes several Alaska sites. The overall goals of these approaches are to educate UWSM students, especially Alaskans, about the state's health needs and health care system and to encourage UWSM graduates to practice in the state.

Alaska↗
PubMed2001

Alaska Natives assessing the health of their environment.

The changes in Alaska's ecosystems caused by pollution, contaminants and global climate change are negatively impacting Alaska Natives and rural residents who rely on natural resources for food, culture and community identity. While Alaska commerce has contributed little to these global changes and impacts, Alaska and its resources are nonetheless affected by the changes. While Alaska Natives have historically relied on Alaska's land, water and animals for survival and cultural identity, today their faith in the safety and quality of these resources has decreased. Alaska Natives no longer believe that these wild resources are the best and many are turning to alternative store-bought foods. Such a change in diet and activity may be contributing to a decline in traditional activities and a decline in general health. Contaminants are showing up in the animals, fish and waters that Alaska Natives use. Efforts need to be expanded to empower Alaska Native Tribes to collect and analyze local wild foods for various contaminants. In addition existing information on contaminants and pollution should be made readily available to Alaska residents. Armed with this type of information Alaska Native residents will be better prepared to make informed decisions on using wild foods and materials.

Alaska↗
PubMed1992

Severity and frequency of sequelae of bacterial meningitis in Alaska Native infants. Correlation with a scoring system for severity of sequelae.

OBJECTIVES: To (1) determine the frequency and severity of sequelae of Haemophilus influenzae type b and Streptococcus pneumoniae meningitis in Alaska Native children, (2) compare morbidity and mortality of H influenzae b and S pneumoniae meningitis, and (3) evaluate the applicability of the Herson-Todd prognostic score (HTPS) to both H influenzae b and S pneumoniae meningitis in this population. DESIGN: A retrospective study of all cases of H influenzae b and S pneumoniae meningitis in Alaska Native children younger than age 5 years. Data on meningitis sequelae, obtained from medical charts and records of the Infant Learning Program, were collected, and incidence of sequelae tabulated. Data obtained on admission to the hospital were used to calculate HTPS. SETTING: Indian Health Service facility for the Yukon-Kuskokwin Delta region of southwest Alaska. STUDY SUBJECTS: 51 of 63 Alaska Native children with H influenzae b meningitis and 13 of the same 63 Alaska Native children with S pneumoniae meningitis occurring between 1980 and 1988. One child was infected with both organisms, producing a total of 64 cases for study. SELECTION PROCEDURES: Cases were identified by surveillance for these diseases between January 1, 1980, and December 31, 1988, maintained by the Arctic Investigations Program, Centers for Disease Control. MEASUREMENTS AND RESULTS: Sequelae of bacterial meningitis caused by H influenzae b were equal to or exceeded rates of sequelae described in other children in the United States. After H influenzae b meningitis, motor abnormalities (29%) and hydrocephalus (7%) occurred two to four times more often in Alaska Native children than in children in other parts of the United States. Differences in severity of H influenzae b sequelae could not be accounted for by microbiologic markers of the H influenzae b strain, including ampicillin sensitivity, biotype, outer membrane protein type, or electropherotype. Numbers of cases of S pneumoniae meningitis were too small for statistically valid comparison, but sequelae of S pneumoniae meningitis occurred in roughly equal proportion as sequelae of H influenzae b meningitis. The HTPS was applied to Alaska Native children with H influenzae b meningitis and was found to be very accurate in predicting children with major sequelae. Analysis of the prognostic factors used in deriving the HTPS revealed a unique set of predictors for sequelae in Alaska Native children: seizures at admission, glucose levels in cerebrospinal fluid of less than 1.1 mmol/L; and male gender, with a significant predictive interaction between male gender and age less than 6 months at admission. CONCLUSIONS: Alaska Native children suffer greater neurologic morbidity as a result of H influenzae b meningitis than do their non-Native counterparts. The HTPS was a good predictor of major sequelae in Alaska Native children with H influenzae b or S pneumoniae meningitis and could be useful in determining which patients need referral to a tertiary care center.

Alaska↗