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PubMed1987

Recurrent invasive Haemophilus influenzae type b disease in Alaskan Natives.

Alaskan Natives (Indians and Eskimos) have an extraordinary incidence of invasive Haemophilus influenzae type b (Hib) disease (500 cases/100,000 children younger than 5 years of age) and also an increased incidence of recurrent disease. However, the incidence of primary Hib disease and recurrent disease are not excessive in non-Native children in Alaska (mainly Caucasian). Twelve recurrent cases in Alaskan Natives were studied, 10 of which were detected in surveillance activities between 1971 and 1984. These recurrent episodes occurred 23 to 197 days after the initial episodes (median, 51 days); the overall rate of recurrent disease was 3.5%. The ages of the patients with recurrent disease were significantly younger than single episode cases. To determine if disease recurrence was a manifestation of the high disease incidence and earlier age at onset of disease, we calculated an expected number of recurrent cases for our study population, based on the incidence observed in children with first episodes and the period of observed follow-up. The expected number of recurrent cases was only 1.9, significantly fewer than the 10 observed, indicating that age and the high incidence of disease alone were not the only factors contributing to the recurrent disease. No other significant clinical or epidemiologic risk factors could be identified. Patients who develop recurrent invasive Hib disease may represent a subset of this population with unusual disease susceptibility.

Alaska↗

PubMed1996

Dietary fish oil and blood lipids.

Triglyceride lowering is the most consistent effect of fish oils, having been observed in Greenland Eskimos and subsequently in controlled clinical trials. Although total cholesterol levels are not altered, LDL levels may rise, especially in hypertriglyceridemic patients. The persistence of the hypotriglyceridemic effect has been documented in two recent trials following large numbers of patients from 6-9 months. These studies also provided evidence that the LDL raising effect may not persist. The safety of fish oils was also supported in these studies because problems with excessive bleeding and worsening glycemic control did not materialize. However, in one of these studies fish oils proved ineffective in slowing the rate of restenosis after coronary angioplasty.

Angioplasty, Balloon, Coronary↗

PubMed1981

Platelet - vessel wall interaction: influence of diet.

The interaction of platelets with the vessel wall is influenced by the diet. Of major importance is the dietary polyunsaturated fatty acids (PUFA). Epidemiological evidence from Greenland Eskimos with low incidences of acute myocardial infarction has drawn attention to the role of the n - 3 PUFA family. Experiments in vitro have demonstrated an anti-aggregatory effect of eicosapentaenoic acid (EPA). However, EPA does not inhibit vascular prostacyclin production. Antiaggregatory substances generated from EPA have not yet been demonstrated in vivo. Studies in vivo in both animals and humans have demonstrated an antithrombotic effect of EPA. In a study where volunteers were given 6 g EPA per day for 3 weeks, moderate decreases in collagen-induced and ADP-induced platelet aggregation, lower thromboxane B2 (TXB2) synthesis and prolongation of bleeding time were found. These observations indicate the dietary factors modulate the interaction of platelets and the vessel wall. Dietary advice aiming at lowering the incidence of ischaemic diseases must include this aspect. This necessitates a re-evaluation of advice hitherto given to the population in general.

Blood Platelets↗

PubMed2004

The use of developmental rehabilitation services. Comparison between Bedouins and Jews in the south of Israel.

Some communities have peripheral zones inhabited by persons with a different culture than the majority of the general population, such as the Aboriginals in Australia, the Native Americans in the U.S. and Canada, the Eskimos in Lapland, and the Bedouins in Israel. These citizens are not receiving the same medical or rehabilitation services as the citizens of the metropolitan areas due to the fact that health and welfare programs are not adapted to their unique needs. At the Soroka University Medical Center in Beer-Sheva, Israel, the health and rehabilitation services have a very large and heterogeneous catch-up population serving most of the south of Israel. The purpose of this study was to look at the utilization and the number of appointments for child rehabilitation services by the Bedouin population compared to the general population in the south of Israel at the Zusman Child Development Center (CDC). The records of appointments to the CDC between the years 1995-1999 inclusive were studied and we randomly chose to limit the study to January, April, July, and October of each year, and randomly chose the daily records of nine therapists, three from each discipline (occupational therapy [OT], physical therapy [PT], and speech and language therapy [SLT]). There were 8,504 appointments during these 4 months of the years 1995-1999, 2,255 of which were for Bedouin and 6,249 for Jewish children. Noncompliance with therapy appointments (NCTA) for the same period for both the Bedouins (31%) and Jewish children (26%), with a significant difference between the two populations, was noted. Of all the Jewish childrens' appointments, the percentage of all three services was similar: 33% to PT, 38% to OT, and 29% to SLT, but for the Bedouin children, the percentage between the three services was significantly different: 62% to PT, 34% to OT, and 3% to SLT. These results seem to indicate that the Bedouin families prefer the PT and OT over the SLT. Our results enhanced the need for planning a model for supplying health services adapted to clients coming from different cultures. According to this model, we need to take into consideration the cultural differences, the accessibility to rehabilitation services, and the economical impact on the family; all in all, to give a better solution to the patient with special needs.

Appointments and Schedules↗

PubMed1984

The bacterial flora of the forehead and back of Alaskan native villagers in summer and in winter.

The bacterial flora of the forehead and back of Eskimo and Indian villagers in arctic Alaska was determined in midsummer and in winter (temperature -29 degrees to -46 degrees C). Specimens collected by the wet swab method were transported overnight, chilled, to Seattle in buffered diluent with Triton X-100. Control tests showed good survival of principal skin organisms with moderate or large initial populations and a disproportionately greater loss with an initial sparse population. Results of these studies are compared with earlier studies of the forehead flora of a Seattle urban population. On most Alaskan subjects Propionibacterium acnes was more abundant than staphylococci on both sites and both organisms had greater population densities on the forehead than on the back. Population densities for P. acnes varied from none detected to more than 10(6) per cm2 on the forehead and 10(5) per cm2 on the back. For coagulase-negative staphylococci the range was from none detected to more than 10(5) per cm2 on the forehead and the back. The proportion of subjects with relatively abundant or relatively sparse populations of P. acnes and of staphylococci did not change seasonally. Of 51 staphylococcal isolates, 65% were S. epidermidis, 22% S. capitis, and 10% S. hominis. P. saccharolyticus was found on a minority of subjects on both sites. The kinds of organisms found on the forehead and their variable individual population densities were essentially the same on the Alaskan villagers and the Seattle subjects.

Adolescent↗

PubMed1994

Office-based physician services provided by dermatologists in the United States in 1990.

Published epidemiologic data regarding dermatologic practice may no longer be current. The National Ambulatory Medical Care Survey conducted in 1990 provides a comprehensive assessment of ambulatory medical practice including patient demographics, chief and secondary complaints, diagnoses, and drug treatments prescribed. Many specialties including dermatology were represented in the sampling technique. The database was reviewed for descriptive aspects of visits to dermatologists surveyed. Using standardized weighting techniques, we estimated the total number of physician visits. Dermatologists had an estimated 24.0 million patient encounters in 1990. Dermatologists treated a disproportionately large number of female and younger patients. After adjusting for their proportion of the population, Asians and Whites had greater numbers of dermatologic encounters than Blacks and Native Americans. Patients had two or more complaints 27.2% of the time, and received two or more diagnoses 28.9% of the time. The most common complaints accounting for 49.7% of visits included "pimples," "rash," "discoloration," "skin lesion," "wart," and "skin growth." The most common diagnoses, accounting for 52.7% of all encounters, were acne, keratosis, wart, dermatitis or eczema, benign neoplasm, and malignant neoplasm. This paper presents demographic information, chief and secondary complaints, and chief and secondary diagnoses of patients visiting dermatologists in the United States in 1990. Whites and Asian or Pacific Islanders have increased utilization of services compared with Blacks and Native Americans or Eskimos; this disparity correlates with median family income.

Adolescent↗

PubMed1987

A new type of human papillomavirus associated with oral focal epithelial hyperplasia.

Lesions from 10 patients suffering from focal epithelial hyperplasia (FEH) of the oral mucosa, including those of 4 Greenlandic Eskimos, were investigated for the presence of human papillomavirus (HPV) DNA sequences by blot hybridization experiments. Two distinct HPVs were detected in the DNA extracted from these lesions, and their genomes were molecularly cloned and characterized. One of these HPVs, detected in 4 patients, was found to be identical with HPV13, whose association with FEH was already known. The other one, detected in 6 patients, was only weakly related to HPV13 and to the other HPVs associated with lesions of the mucous membranes, and constituted a new HPV type, tentatively named HPV32. Lesions from other types of oral papillomas, obtained from 14 additional patients, were also analyzed. Human papillomavirus DNA sequences were detected in the DNA preparations extracted from 5 specimens: HPV6 DNA in a condyloma and in a papilloma, 2 as yet uncharacterized HPV DNAs in 2 papillomas, and HPV32 DNA in a papilloma which showed histologic similarities to FEH. Thus, it seems likely that FEH of the oral mucosa is a disease associated with 2 specific HPVs--HPV13 and HPV32.

Adolescent↗

PubMed1985

The fatty acid composition of 12 North-European fish species.

Cardiovascular diseases among Greenland Eskimos are rare because their diet is rich in fatty fish and marine mammals. The beneficial effect of the fish diet appears to be mediated, at least in part, by the high amount of eicosapentaenoic acid in fish. We investigated the total lipid amount and fatty acid composition of 12 commonly eaten North-European fish species. Most of the detected fatty acids were unsaturated, and the content of eicosapentaenoic acid varied usually between 6 and 16%. The amount of total lipid varied between 3.5 and 216 mg/g wet tissue. The total amount of lipid in different fish species seems to be more important than the respective fatty acid composition when considering which fish should be especially beneficial in the diet. Herring, salmon, Baltic herring, turbot and trout seem to contain most abundantly eicosapentaenoic acid.

Animals↗

PubMed1987

The fatty acid composition of Northern-Canadian marine and terrestrial mammals.

The low mortality from cardiovascular disease in Greenland Eskimos has been attributed to their consumption of diets rich in omega-3 fatty acids. These fatty acids are found in fish and marine mammal lipids. Whereas the fatty acid composition of several fish species has been documented, information is more limited on the mammals which feature significantly in the diets of many Arctic populations. This study investigated the fatty acid composition of commonly eaten marine mammals, as well as the polar bear and caribou. The tissue fatty acid composition was species-dependent, probably reflecting to some degree differences in feeding habits. The marine mammals and the amphibious polar bear, but not the caribou, contained substantial quantities of long chain omega-3 fatty acids. These studies further document the transfer of omega-3 fatty acids through the food chain to man and suggest that marine mammal and polar bear lipids are significant sources of omega-3 fatty acids.

Animals↗

PubMed2006

Focal epithelial hyperplasia (Heck's disease): report of a case in a girl of Brazilian Indian descent.

Summary. Background. This report describes the case of a patient with focal epithelial hyperplasia (FEH), a rare but distinctive entity of viral aetiology with characteristic clinical and histopathological features. Case report. The condition is usually seen in children and adolescents of American Indian and Eskimo background. Surgical removal of papillomatous lesions is the treatment of choice, either for aesthetic reasons, or when the lesions interfere with function or are readily traumatized. Recurrence and the site of new lesions are unpredictable, and continued review of the patient is often necessary. The patient described here has been followed for 24 months without recurrences or changes in the aspect of the remaining lesions. Conclusion. This case highlights a possible genetic predilection for FEH, since the patient is a descent of a Brazilian Xavante Indian.

Adolescent↗

PubMed1989

Genetic epidemiology of Greenland.

The Inuit (Eskimo) gene pool is in many respects similar to that of East Asian populations. Some polymorphisms imply frequent occurrence of disorders comparatively rare in Western Europe (e.g. lactose and sucrose malabsorptions). Low frequencies of alleles for slow isoniazid acetylation and sparteine/debrisoquine oxidation indicate slow elimination of a multitude of drugs. Autoimmune disorders (e.g. rheumatoid arthritis, insulin-dependent diabetes mellitus, Graves' disease and psoriasis) are rare, possibly explained by the associations of these disorders with HLA-alleles rare in the Inuit (e.g. HLA-B8). A correspondingly high incidence of reactive arthritis may be explained by a frequent HLA-B27 allele. The prevalence of disorders due to instability of mesenchymal tissues (e.g. spondylolisthesis, osteoarthrosis, hernia, heart block) still requires a biochemical explanation. Attention is drawn to the urgency of genetic studies in the Arctic because of the accelerating hybridization of the Inuit in all circumpolar areas.

Genetic Diseases, Inborn↗

PubMed1975

Serotyping for MLC gene products: I. Presumptive evidence that ABCIL may detect MLC factors.

Serum from a grand multiparous Inuit (Eskimo) woman, who is HL-A identical but stimulatory in MLC with cells of her husband, contains strong ABCIL reactivity. This serum is operationally monospecific against a cell membrane determinant on lymphocytes, but not platelets, of some unrelated persons. Cells of those who are ABCIL positive with this serum always give a lower MLC stimulation index compared with their MLC responsiveness to cells that are ABCIL negative. This serum also contains good MLC inhibitory activity but only in those one way MLC reactions in which it reacts, by ABCIL, with the stimulating cells. It is postulated that the ABCIL activity is directed against a common MLC factor on lymphocytes.

Antigen-Antibody Reactions↗

PubMed1993

Malignant lympho-epithelial lesion of the salivary gland: a case report and review of the literature.

Malignant lympho-epithelial lesion of the salivary gland is an undifferentiated squamous cell carcinoma which is associated with a prominent lymphocyte-rich stroma. This study reviews the current literature pertaining to this rare tumour with reference to the single recorded case of malignant lympho-epithelial lesion of the salivary gland presenting in Auckland, New Zealand. This 26 year old Caucasian male developed a rapidly growing lesion in the right parotid gland and multiple ipsilateral cervical lymph nodes. Treatment consisted of surgery and radiotherapy. The patients is currently disease free. One hundred and eight other cases have been reported in the literature, 82 of whom have Mongolian ancestry (Eskimos and southern Chinese) and 15 of whom are Caucasian. More than 50% of these patients (all Mongolian) have elevated titres of serum immunoglobulin A against Epstein-Barr virus capsid antigen. The age at presentation is variable, ranging from 10 to 86 years, with a slight female predominance. Forty-one per cent of patients present with regional lymph node metastases and 20% with distant metastases. Given the rarity of this disease, treatment is controversial. Current data suggest that early radical combined modality treatment using surgery and radiotherapy leads to prolonged survival and cure with 5 year survival rates greater than 50%.

Adult↗

PubMed1989

Transcutaneous bilirubinometry in normal Japanese infants.

We performed TcB readings in healthy full-term breast-fed Japanese infants from birth to seven days, and attempted to establish the normal range. TcB readings from Japanese infants were significantly higher over a longer period compared with Caucasian infants. The age of peak TcB readings in Japanese newborn infants was day 6, significantly later than that of Caucasian infants, day 3-4. We also attempted to estimate the total serum bilirubin concentrations using regression line relating TcB readings to serum bilirubin concentrations. Our study demonstrated that estimated total serum bilirubin concentration from forehead TcB readings was 0.56 +/- 0.35 mg/dl at birth, thereafter increasing to 6.8 +/- 0.5 mg/dl on day 1 and reaching a maximum of 12.6 +/- 2.5 mg/dl on day 6. These values and pattern in Japanese neonatal jaundice were significantly different from those of Caucasian children, but were similar to values and patterns from American Indians, Alaskan Eskimo, and other Asian full-term newborn infants. Thus TcB measurement may be useful for observation of the course of neonatal jaundice.

Bilirubin↗

PubMed1985

A population study of alpha-keto acid reductase.

An electrophoretic survey of 509 individuals of Japanese, Mexican American, American Negro, Eskimo, Amerindian and Anglo-American origin failed to reveal genetically determined variation at the alpha-keto acid reductase locus by starch gel electrophoresis. Additional screening of 232 individuals by thin layer isoelectric focusing in polyacrylamide gels detected a single phenotype. Interspecific variation at the alpha-keto acid reductase locus is clearly resolved using either method. These results indicate that the alpha-keto acid reductase locus is monomorphic in most human population groups despite earlier results suggesting the existence of genetic polymorphism.

Alcohol Oxidoreductases↗

PubMed2006

Hypertension in minority populations.

The US population, by percentage, shows a trend toward increased proportions of citizens identified as minorities. Whereas in 2000, according to the US Census Bureau, 71.4% of the population was self-identified as white; this group is expected to decrease to 61.9% by 2025. The proportion of blacks and African Americans from 2000 vs. 2025 is expected to increase from 12.2% to 12.9%. Also, in the smaller population of American-Indian, Eskimo, and Aleutian natives, growth is projected from 0.7% to 0.8%. Asians and Pacific Islanders as a category will become a larger proportion, from 3.9% to 6.2%. The largest increase in proportion will be seen in those identified as Hispanic (of any race), from 11.8% in 2002 to 18.2% in 2025.

Black or African American↗

PubMedDate not supplied

Comparison of AccuLevel and TDx: evaluation of on-site monitoring of antiepileptic drugs.

Therapeutic drug monitoring, an important aid in antiepileptic drug (AED) therapy, has a lag time before results are obtained from clinical laboratories. The AccuLevel test is an enzyme immunochromatographic method for quantitative measurement of AEDs including phenobarbital (PB), phenytoin (PHT), and carbamazepine (CBZ), with results available within 20 min. A comparison between AccuLevel and TDx, (fluorescence polarization immunoassay) was conducted in 233 paired blood samples from patients with AED therapy, including 12 Eskimo children receiving treatment in Greenland. Forty-five blood samples were analyzed for PB, 80 for PHT, and 108 for CBZ. Linear regression analysis showed good agreement between the two methods (r = 0.951, 0.958, and 0.945, respectively). The test is easy to perform, but care must be taken to follow the correct procedure, or inaccuracies will result. That happened in some of our results. A reduction in lag time, using on-site drug monitoring, was demonstrated. The AccuLevel is a rapid, accurate, and convenient method for use in AED monitoring.

Anticonvulsants↗

PubMed1983

Earlobe type, race, and age: effects on earlobe creasing.

There has been much discussion of the utility and validity of the earlobe crease as a warning sign of cardiovascular disease. The authors postulated that the mixed findings were due to the neglect of three variables: age, race, and earlobe shape. Age and earlobe shape were studied in 324 healthy adult subjects from three racial groups: southwestern Alaskan Eskimos (70), Navajos (167), and whites (87). It was found that creases develop with age in healthy adults, that creasing is related to earlobe shape, that the age of onset of creasing varies according to race, and that the frequencies of occurrence of different earlobe shapes differ by race. Future studies of earlobe creases should therefore include the variables of age, race, and earlobe shape.

Adult↗