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Paleoepidemiology of a central California prehistoric population from Ca-Ala-329: II. Degenerative disease.

Degenerative lesions are scored and frequencies of involvement are computed for a skeletal collection from Ca-Ala-329, a prehistoric site on the southeastern side of San Francisco Bay, dating from 500 A.D. up to European contact. A large earthmound site, excavations conducted there by San Jose State University retrieved close to 300 burials. For this epidemiological analysis, reasonably complete and aged skeletons representing 77 adult females and 90 adult males are available. Degenerative changes are scored macroscopically in an ordinal fashion for the large fibro-cartilagenous joints between adjacent vertebral bodies (vertebral osteophytosis) as well as the small apophyseal articulations of the spine. In addition, in the peripheral skeleton degenerative changes are scored in the temporo-mandibular, shoulder, elbow, hip, and knee joints as well as the small articulations of the hands and feet. The most common degenerative changes in the spine are seen between the vertebral bodies of the lower lumbar region. In the peripheral skeleton the highest involvement of degenerative disease is seen in the hands and feet. Compared to other relevant osteological samples, this group of hunting-gathering California Indians shows more degenerative changes than settled agriculturists (from Pecos Pueblo, New Mexico) but substantially less frequent involvement than in arctic hunters (Alaskan Eskimos).

California↗

Dimensions of face in Asia in the perspective of geography and prehistory.

Data from 24 craniofacial dimensions were compiled for samples representing all the human populations of the world. These were converted into C scores and used to construct Euclidean Distance dendrograms. The populations of the world are best depicted as 8 major regional clusters representing: Africa, Amerind, Asia-Mainland, Australo-Melanesia, Eskimo-Siberia, Europe, India, and Jomon-Pacific. The mainland Asian cluster divided into northern and southern components. The Neolithic in both areas is less clearly associated with the northern or southern components and may represent the form of their undifferentiated precursors. This needs to be tested by the addition of further specimens and an adequate sample from South China. Mongols are peripheral members of the Asia-Mainland cluster and should not be thought of as typifying the region as a whole. The use of the term "Mongoloid" is inappropriate in both theory and practice.

Asia↗

Brief communication: variation in the frequency and form of the lower permanent molar middle trigonid crest.

The frequency and form of the middle trigonid crest (MTC) in lower permanent molars is reported for 1,131 dental casts of Bushman (San), Bantu, Solomons, Hawaiians, Pima, Eskimo, Navajo, Chinese, and American whites. The MTC occurs most often on the first molar. We found very little intra-trait variation, so observations were scored on a present-absent basis. The MTC is most frequent in the African samples and rare in those of the other populations. Two reference plaques can be obtained to add to the existing series in the ASU dental anthropology system.

Animals↗

Macroanatomy of the renicule of the bowhead whale (Balaena mysticetus).

The macroanatomy of renicules and surrounding tissues from the kidneys of five Eskimo-harvested bowhead whales, Balaena mysticetus , was examined. These renicules are similar in overall structure to those of other cetaceans and intermediate in size. There are several important differences including the presence of arcuate vessels within the sporta perimedullaris , the extension of connective tissue from the sporta deep into the peripheral cortex, and the presence of very large, thin-walled veins that occupy the interrenicular spaces. Arterial and venous plexuses outside the substance of the sporta reported in other cetaceans were not observed in the bowhead .

Animals↗

Microanatomy of the lung of the bowhead whale Balaena mysticetus.

The lungs from six bowhead whales harvested by Alaskan Eskimos have been examined with light and electron microscopes. Airways ranging from 1 to 40 mm in luminal diameter are lined by a pseudostratified ciliated epithelium containing numerous mucus-secreting cells. The underlying lamina propria-tela submucosa of these airways contains tubuloalveolar glands, plasma cells, and lymphatic accumulations in addition to both elastic and collagenous fibrillar elements. Cartilage extends to the level of the respiratory airways, but smooth muscle is absent from airways larger than 3 mm, and tubuloalveolar glands are absent from airways smaller than 3 mm. Respiratory airways are lined by pseudostratified, simple cuboidal, and simple squamous epithelia. Alveolar ducts are lined by simple squamous epithelium exclusively. A connective tissue core composed mostly of elastic fibers supports the walls of the alveolar ducts. Neither smooth muscle nor cartilage has been observed in these structures. Alveoli contain the typeical cetacean double capillary bed separated by a thick septum composed mainly of collagenous connective tissue. Alveoli are lined by a simple squamous epithelium similar to that encountered in alveolar ducts and respiratory airways. This epithelium is composed of type I and II pneumocytes closely appressed to an underlying capillary network. The type II pneumocytes contain typical lamellar bodies and tubular myelin can be seen in the air spaces. The lung is surrounded by a thick (X = 2.5 mm) visceral pleura rich in blood vessels and elastic fibers.

Animals↗

High serum coenzyme Q10, positively correlated with age, selenium and cholesterol, in Inuit of Greenland. A pilot study.

Greenlanders (Eskimos) have low prevalence of ischaemic heart disease, partly explained by a lower extent of atherosclerosis and a low n-6/n-3 ratio of polyunsaturated fatty acids. As atherosclerosis is also a result of oxidative stress, the total antioxidative readiness could have a substantial impact. From a health survey we chose the subpopulation from the most remote area, where the traditional Greenlandic diet with high intake of sea mammals and fish predominates. The mean (SD) of S-CoQ10 in males was 1.495 (0.529) nmol/ml and 1.421 (0.629) nmol/ml in females, significantly higher (p < 0.001) compared to a Danish population. In a linear multiple regression model the S-CoQ10 level is significantly positively associated with age and S-selenium in males, and S-total cholesterol in females. The high level of CoQ10 in Greenlanders probably reflects diet, since no bioaccumulation takes place, and it could probably be a substantial part of the antioxidative defense.

Adult↗

Thromboxane (TX)A3 and prostaglandin (PG)I3 are formed in man after dietary eicosapentaenoic acid: identification and quantification by capillary gas chromatography-electron impact mass spectrometry.

The low incidence of myocardial infarction in Greenland Eskimos has been related to their traditional marine diet rich in eicosapentaenoic acid. However, whether dietary eicosapentaenoic acid is indeed transformed in man to antiaggregatory PGI3 and weakly proaggregatory TXA3 has not been clarified. In our studies we ingested either cod liver oil or mackerel both rich in eicosapentaenoic acid. Formation of TXB3, the hydrolysis product of TXA3, in platelet-rich plasma stimulated ex vivo with collagen was traced by capillary GC/EIMS. Via external standard, TXB3 formation in platelets was estimated to be 5-15% of TXB2 formation. From urine we extracted dinor metabolites of PGI according to a selective method. We utilized delta 17-2,3-dinor-6-keto-PGF1 alpha (PGI3-M) as an index of total body production of PGI3 in analogy to 2,3-dinor-6-keto-PGF1 alpha (PGI2-M), the major urinary metabolite of PGI2. We separated PGI2-M and PGI3-M as the Me, MO, Me3Si derivatives by capillary gas chromatography and identified PGI3-M by EI mass spectrometry. Excretion of PGI3-M, which was not detectable under control conditions, was 83 +/- 25 ng/24 h (SD) after ingestion of cod liver oil and 134 +/- 38 ng/24 h after mackerel ingestion, while excretion of PGI2-M was 162 +/- 52 ng/24 h and 236 +/- 32 ng/24 h, respectively. Our findings with diets rich in EPA show that it is possible in man to change in vivo the spectrum of biologically active prostanoids by nutritional means and alter it in a favourable direction.

Blood Platelets↗

Nonpharmacologic treatment of hypertriglyceridemia: focus on fish oils.

Early studies in Greenland Eskimos stimulated interest in evaluating the effect of Omega-3 fatty acids on coronary artery disease. Subsequent studies showed a significant decrease in triglyceride levels in patients receiving high doses of fish oil containing DHA and EPA. Slight increases in LDL were also observed in patients receiving fish oil supplements. These studies have also shown a dose-response effect which persists as long as supplementation continues. Later trials, specifically the Diet and Reinfarction Trial and the Indian Experiment of Infarct Survival, have demonstrated a reduction in cardiac death rates and in the incidence of cardiac symptoms in patients receiving fish oil.

Controlled Clinical Trials as Topic↗

Variations between individuals and populations in the acetylation of isoniazid and its significance for the treatment of pulmonary tuberculosis.

Isoniazid is the most effective and widely used antituberculosis drug. The metabolism of isoniazid is noninducible and the primary metabolic route determining the rate at which isoniazid is eliminated from the body is acetylation. There are large diffrences between individuals in the rates at which isoniazid and certain other hydrazides and some sulfonamides are acetylated. The acetylation of isoniazid is inherited in a simple Mendelian fashion, individuals being either slow, heterozygous rapid, or homozygous rapid acetylators. Improved methods of discriminating between the different phenotypes have recently been described that are also more convenient to use. The proportion of slow acetylators among Japanese and Eskimos is about 10%; among Chinese about 20%; among Caucasians, Negroes, and South Indians about 60%. The results of a series of meticulously controlled clinical trials carried out in India, East Africa, Hong Kong, Singapore, Czechoslovakia, and Britain have shown the isoniazid acetylator status of tuberculosis patients treated with isoniazid-containing regimens is of no prognostic significance when treatment is given on daily basis. It may, however, be of significance when twice-weekly regimens are employed, especially in circumstances in which only a short period of initial daily chemotherapy is given, and where the companion drug employed during the twice-weekly continuation phase is relatively weak. The acetylator phenotype is, however, extremely important in once-weekly treatment, rapid acetylators always having fared considerably worse than slow acetylators on all the regimens evaluated so far. Experimental studies of the action of isoniazid against Mycobacterium tuberculosis in vitro and in vivo have enabled these findings to be understood.

Acetylation↗

Application of plasminogen polymorphism to forensic hemogenetics.

Plasminogen polymorphism (PLG) has attained considerable importance in forensic hemogenetics. PLG comprises two common, codominant autosomal alleles, PLG*A and PLG*B, more than 18 variants, and the silent allele PLG*Q0. Isoelectric focusing followed by functional or immunochemical detection seems to be the optimal method for the determination of phenotypes. PLG*A is the most common allele in all populations, having its highest frequency in Mongoloids, Amerindians and Eskimos, the lowest in Caucasoids. The functionally inactive plasminogen M5 so far has been seen exclusively in Japanese individuals. Silent PLG alleles were only observed in the heterozygous state. No clear differences in functional activity or plasma level could be ascertained for any of the other allotypes. PLG polymorphism is now widely used for many haemogenetic investigations. From the allele distribution in European Caucasoids a single exclusion chance of 17.2% for non-fathers in paternity testing may be calculated. The major prerequisites of a new genetic marker in the parentage expertise, established Mendelian inheritance, favorable distribution of common alleles, low frequency of silent alleles, and simple reproducible typing technology, are fulfilled.

Alleles↗

Lymphoepithelial carcinoma of the parotid gland.

BACKGROUND: Primary lymphoepithelial carcinoma of the parotid gland is a rare tumor with an increased incidence among Eskimos and Orientals. We reviewed our experience with parotid lymphoepithelial carcinoma and investigated its pathophysiology and possible association with Epstein-Barr virus. METHODS: We performed a retrospective review of records of patients diagnosed with lymphoepithelial carcinoma of the parotid gland. RESULTS: We identified two women of Hispanic origin diagnosed with primary lymphoepithelial carcinoma of the parotid gland. In one of the cases, the carcinoma was intimately associated with a benign lymphoepithelial lesion. In both cases, there was no demonstration of Epstein-Barr virus. CONCLUSION: Primary lymphoepithelial carcinoma of the parotid gland may arise from malignant transformation of a benign lymphoepithelial lesion.

Aged↗

Prevalence of HTLV-I in Arctic regions.

Sera of native inhabitants of Arctic regions were assayed for antibodies to HTLV-I by the ELISA technique followed by competition experiments to confirm antibody specificity. Residents of 7 widely separated Alaskan villages exhibited prevalence rates of 0 to 12% for HTLV-I antibodies. Less than 1% of Greenland Eskimos were HTLV-I antibody-positive. Residents of 3 northern Swedish regions ranged in HTLV-I antibody prevalence from 0 to 5%. Sera of healthy native inhabitants of Alaska and northern Sweden were similarly assayed for antibodies to HTLV-II. No additional sera were shown to be positive for HTLV-II antibodies. While some of the HTLV-I antibody-positive sera exhibited cross-reactivity with HTLV-II antigens, competition experiments using disrupted HTLV-II or purified HTLV-I p24 as test antigens indicated that the primary antibody response in all cases tested was elicited by HTLV-I. Our results show that HTLV-I distribution is not restricted to endemic areas in warm, humid climates, but extends to Arctic regions. Within these regions, HTLV-I exhibits the same restricted distribution seen in other areas where virus infection is prevalent. The Arctic does not seem to be a reservoir for HTLV-II infection. The origin of HTLV-I in Arctic areas is not known. One may speculate that foreign visitors introduced the virus into Aleut and Lapp populations, and that it has been maintained there and restricted in its distribution as a result of close familial relationships.

Adolescent↗

Extension of the epidemiology of hepatitis B in circumpolar regions through a comprehensive serologic study in the Northwest Territories of Canada.

We conducted a seroepidemiologic study of hepatitis B virus (HBV) infection among 14,198 Inuit (Eskimo), Dene (Indian), and non-native inhabitants of the Northwest Territories (NWT, total 1982 population 47,053) between April 1983 and March 1985. Participants represented almost all of the NWT communities and included approximately half of the total indigenous population. Sera were screened for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBs) by radioimmunoassay. A total of 428 persons (3.0%) were positive for HBsAg; their mean age was 41.5 years and 68.7% were greater than 30 years old. Anti-HBs was detected concomitantly in 153 (35.7%) of these persons and present as a single marker in 2,943 sera (20.7%). Overall prevalence rates for HBsAg were marginally higher among Inuit than Dene (3.9% and 2.9%, respectively; P less than 0.05), as were rates for anti-HBs (24.5% and 21.5%, respectively; P less than 0.01). Marker rates among the 2,776 participants of other ethnic groups, predominantly whites, were distinctly lower (HBsAg 0.3%, anti-HBs 8.5%) than among Inuit or Dene populations (P less than 0.01). The prevalence of HBsAg and anti-HBs increased with each decade of life in all five geographic regions, but there were marked differences among the regions as well as among communities within regions. The greatest concentration of HBV markers was in the Baffin Region (36.0% positive for HBsAg or anti-HBs). Hepatitis B e antigen (HBeAg) was detected in only 37 of 421 persons (8.8%) positive for HBsAg; most were less than or equal to 20 years old and were clustered in a few communities with the highest HBV marker rates.

Adolescent↗

Comparative seroepidemiology of cytomegalovirus infection in the Canadian Arctic and an urban center.

We conducted a seroepidemiologic study of cytomegalovirus (CMV) infection among 9,928 Inuit (Eskimo), Dene (Indian) and non-native inhabitants of the Northwest Territories (NWT) of Canada between April 1983 and March 1985. 4,184 inhabitants of Edmonton, a large predominantly white urban center served as controls. Sera were screened for antibody to CMV by enzyme-linked immunosorbent assay (ELISA). The prevalence rates of CMV antibody increased with age in all ethnic groups. By the age of two years 69.2 percent of Dene, 63.5 percent of Inuit, 33.3 percent of non-native and 22.9 percent of Edmonton children had CMV antibody. Over the age of five years Inuit children had higher rates of CMV antibody than Dene children (P less than .05) reflecting differences in infant adoption, breastfeeding practices and patterns of child care in the two native groups. By the age of 15 to 19 years 81.1 percent of Dene and 88.5 percent of Inuit women had CMV antibody compared to 48.8 percent of non-native and 50.9 percent of Edmonton women (P less than .05). Native children had higher prevalence rates than non-native children living in the NWT (P less than .05). Compared to similarly aged Edmonton residents, non-native children in the NWT 2 to 4 years and 5 to 9 years of age had a higher prevalence of CMV antibody (P less than .05). We observed a higher prevalence rate of CMV antibody among non-native children (10-14 years) and young women (15-19 years) living in predominantly native communities compared to those living in predominantly non-native communities in the NWT (P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Inappropriate prescriptions for the aging population of the United States: an analysis of the National Ambulatory Medical Care Survey, 1997.

PURPOSE: Generally, elderly patients in the United States tend to consume more prescriptions than younger adults. The purpose of the study is to examine nationwide prescription patterns for elderly patients who visited physicians' offices in 1997. METHODS: The database of a nationwide sample survey of practicing physicians participating in the National Ambulatory Medical Care Survey, 1997 was used. Inappropriate medicines for the elderly were identified using previously published and widely accepted criteria. RESULTS: During 1997, patients aged 65 years or older made more than 191 million visits to physicians' offices in the United States. Four or more prescriptions per visit were issued with the following frequencies: 17.7% for females; 16.4% for males; 17.0% for Whites, 22.7% for Blacks, and 6.1% for other minorities including American Asians, Indians, Eskimos, Aleuts and Pacific Islanders. The frequencies with which at least one inappropriate medication per visit was prescribed were: 10.8% for females; 8.9% for males; 10.3% for Whites; 9.7% for Blacks; and 1.9% for other minorities. DISCUSSION: Four or more prescriptions issued per visit and inappropriate prescriptions for the elderly in the United States were evident, and may put a vulnerable aging population at risk of adverse drug events.

Aged↗

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↗

Uridine monophosphate kinase and susceptibility to invasive Haemophilus influenzae type B disease.

A polymorphic genetic variant of the pyrimidine pathway enzyme, uridine monophosphate kinase-3 (UMPK-3), was positively associated with invasive Hib disease. All UMPK 3-3 homozygotes in this study were Hib cases, and we found that in cases and controls, there was no difference between UMPK phenotype and serum levels of total Hib antibody as measured by radioimmunoassay. This suggests that UMPK-3 may play a role in mediating the non-humoral immunity to Hib. However, unlike other enzyme variants in the nucleoside synthesis pathways which result in syndromes of severe immunodeficiency, this gene appears to confer a more subtle disease susceptibility. Thus, the UMPK-3 allele, although rare in Caucasians, is associated with an increased risk of invasive Hib infection in Alaskan Eskimos.

Alaska↗

Mortality differentials in Canada, 1951-1971: French, British, and Indians.

Mortality differentials reflect in part the social and economic conditions of groups in society. In this paper, the relationship between ethnic origin and mortality is investigated from the point of view of convergence and minority group status hypotheses. Multivariate methods are used to study differences among the French, the British and Native Indian (includes Metis and Eskimos) populations of Canada over three census periods from 1951 to 1971. A significant downward trend in the death rates of all three subpopulations is noted, but substantial differences persist, as the pace of mortality decline over time varies across the three ethnic groups. In the twenty-year interval between 1951 and 1971, Native Indians have experienced spectacular reductions in their overall death rates, but in comparative terms, their mortality levels still exceed those of the French (who show intermediate levels) and the British ethnic groups. The multivariate analysis provides strong support for the minority status effect, which is taken to suggest that the roots of inequalities in survival probabilities are partly a result of social and economic disparities. The convergence thesis received some support: over time the general pattern is one of declining mortality with some narrowing of the differences. An examination of four broad causes of death (neoplasms, cardiovascular, accidents-violence, and "other") suggests that Native Indians are characteristic of populations undergoing epidemiologic and demographic transitions. Their elevated risk of accidents-violence reflects social disruption in the process of modernization. Causes of death of the French and British populations are characterized by higher risks of cancer and cardiovascular diseases, typical of advanced societies.

Accidents↗