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At least 343 records · Page 19Linked to original sources
PubMed1997

Pervasive occult gastrointestinal bleeding in an Alaska native population with prevalent iron deficiency. Role of Helicobacter pylori gastritis.

OBJECTIVE: To confirm prevalent iron deficiency among Yupik Eskimos living in Alaska and to explore the frequency of and potential lesions accounting for occult gastrointestinal bleeding. DESIGN: Descriptive survey. SETTING: Rural Arctic community. SUBJECTS: A total of 140 adult volunteers from 3 villages in the Yukon-Kuskokwim Delta region of western Alaska. MAIN OUTCOME MEASURES: Daily iron intake, hematologic and biochemical indexes of iron status, fecal hemoglobin levels, stool parasites, and endoscopic findings. RESULTS: While dietary iron intake by Yupiks was similar to that of a reference population, iron deficiency prevalence was increased 13-fold in Yupik men and 4-fold in Yupik women. Fecal hemoglobin levels were elevated in 90% of subjects contrasted with only 4% of a reference group; median levels were 5.9 and 0.5 mg of hemoglobin per gram of stool, respectively. Among 70 Yupik subjects with elevated fecal hemoglobin levels who had endoscopy performed, 68 (97%) had an abnormal gastric appearance consisting of erythema, mucosal thickening, diffuse mucosal hemorrhages, erosions, or ulcerations. Gastric biopsies revealed chronic active gastritis with associated Helicobacter pylori in 68 (99%) of 69. No other hemorrhagic gastrointestinal disease was detected. CONCLUSIONS: Based on this study sample, occult gastrointestinal bleeding appears to be pervasive in the Yupik population and likely underlies the prevalent iron deficiency. An atypical hemorrhagic gastritis associated with H pylori infection is present almost universally and may represent the bleeding source.

Adult↗
PubMed2000

Periodontal disease in American Indians and Alaska Natives.

OBJECTIVE: The primary purpose of this paper is to provide information on the periodontal disease status of Native Americans using a variety of data sources. The impact of periodontal disease on the provision of dental care within the Indian Health Service (IHS) is also discussed. METHODS: Four data sources were used to evaluate the periodontal disease status of Native Americans: IHS periodontal disease monitoring system (1962-78), 1984 IHS Patient Oral Health Survey, 1990 WHO community-based survey (ICS-II), and the 1991 IHS Patient Oral Health Survey. RESULTS: There appears to be a trend toward a higher prevalence of incipient and overt periodontal disease among Native Americans over time. The prevalence of overt periodontal disease (periodontal pockets > 5.5 mm) is higher among Native American diabetic patients than nondiabetic patients (34% vs 19%). CONCLUSIONS: Due to the variety of indices used by the IHS during the last 20 years, it is difficult to make direct comparisons of the available periodontal disease data. However, it appears that the prevalence of periodontal disease among Native Americans is increasing. Type II diabetes accounts for significant increases in periodontal disease and tooth loss in Native American populations. Certain forms of early onset periodontal disease also may pose significant threats to the oral health of Native Americans.

Adult↗
PubMed1966

Acute purulent meningitis in Alaska natives: epidemiology, diagnosis and prognosis.

During the period 1957-1964, 69 cases of purulent meningitis were treated at the U.S. Public Health Service Hospital in Bethel, Alaska, a 65-bed facility serving about 10,000 Eskimos and Indians in the remote Yukon-Kuskokwim Delta area. Nearly two-thirds of the patients were infants, among whom the case fatality rate was 37.2%, compared with the overall fatality rate of 30.4%. In 52% of the cases no causative organism could be demonstrated on smear or culture. Of the bacteriologically positive cases, one-third were due to pneumococci and one-third to meningococci. Prognosis was not affected by previous treatment or recovery of the organism. Since 1957, an annual average of one out of 74 infants in the area has had purulent meningitis; one out of 200 has died of the disease. Chronic otitis media, poor nutrition, a high incidence of respiratory disease and the relative inaccessibility of medical care are significant factors.

Adolescent↗
PubMed1999

Improved access to women's health services for Alaska natives through community health aide training.

This project demonstrates the effect of increasing the skills of Community Health Aides (CHAs) on the use of specific preventive health services by women in remote Alaska villages. Eight CHAs were trained in specimen collection for Pap and sexually transmitted disease testing, and in clinical breast examination. Skill competency was monitored. Computerized medical records of all women between the ages of 18 and 75 in the four villages with trained CHAs and in four comparison villages (n = 1093) were checked for Pap status prior to CHA training and again 12 months later. All eight CHAs achieved competency and provided services in their village clinics with telephone support from an experienced clinician. The post-training year Pap test rate of women who were overdue for a Pap test was 0.44 in the villages with trained CHAs; the rate among the women in the comparison villages was 0.32 (p = .079).

Adolescent↗