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Gm and Inv studies on eight Iranian populations with distance measures among the six from the Caspian Littoral.

Serum samples from six populations living in the Caspian Littoral anf from two populations (Armenians and Muslims) living in Teheran were tested for Gm(1,2,3,5,6,10,11,13,14,17,21,24,26) and for Inv(1). The Gm data show that all six populations from the Littoral have African and Mongoloid admixture. Genetic distance among these six populations was estimated using Nei's standard distance measure, and its standard error, based on the 11 loci analyzed by Kirk et al. (1977); on these 11 loci plus Gm; and on the foregoing 12-plus Inv. Only the distance measures for populations 1 and 4, 2 and 3 are significantly different in all three measures of distances, and then only at the 5% level. More loci will have to be studied before firmly based conclusions may be drawn concerning the relation of these populations to each other. The Armenian population, unlike the remaining seven populations, shows no evidence of African admixture, but it does show Mongoloid admixture. The Muslim population shows African and Mongoloid admixture and, in addition, has the unusual haplotype Gm3,5,10,11,14,17,26 at polymorphic frequencies.

Armenia↗

The enlarging clinical, genetic, and population spectrum of tumor necrosis factor receptor-associated periodic syndrome.

OBJECTIVE: To characterize the frequency, clinical signs, and genotypic features of tumor necrosis factor receptor-associated periodic syndrome (TRAPS) in a series of 394 patients of various ethnic origins who have recurrent inflammatory syndromes. METHODS: Sequencing of the coding region of the TNFRSF1A gene was performed in 128 patients in whom there was a high suspicion of TRAPS, and denatured high-performance liquid chromatography was used to systematically screen for TNFRSF1A in 266 patients with recurrent inflammatory syndrome and no or only 1 Mediterranean fever gene (MEFV) mutation. RESULTS: TNFRSF1A mutations were found in 28 (7.1%) of 394 unrelated patients. Nine (32%) of the 28 patients had a family history of recurrent inflammatory syndromes. In 13 patients, the length of the attack of inflammation was fewer than 5 days. Three of the mutations (Y20H, L67P, and C96Y) were novel. Two mutations, R92Q and (mainly) P46L, found in 12 and 10 patients, respectively, had lower penetrance compared with other mutations. TNFRSF1A mutations were found in patients of various ethnic origins, including those at risk for familial Mediterranean fever (FMF): Armenians, Sephardic Jews, and especially Arabs from Maghreb. Only 3 (10.7%) of the 28 patients had amyloidosis. CONCLUSION: TRAPS is an underdiagnosed cause of recurrent inflammatory syndrome. Its presence in the population of persons of Mediterranean ancestry and the short duration of the attacks of inflammation can lead to a fallacious diagnosis of FMF. Because an accurate diagnosis in patients with recurrent inflammatory syndromes is crucial for proper clinical management and treatment, genetic screening for TNFRSF1A is warranted.

Adolescent↗

A high-resolution genetic map of the familial Mediterranean fever candidate region allows identification of haplotype-sharing among ethnic groups.

Familial Mediterranean fever (FMF) is a recessive disorder of inflammation caused by mutations in a gene (designated MEFV) on chromosome 16p13.3. We have recently constructed a 1-Mb cosmid contig that includes the FMF critical region. Here we show genotype data for 12 markers from our physical map, including 5 newly identified microsatellites, in FMF families. Intrafamilial recombinations placed MEFV in the approximately 285 kb between D16S468/D16S3070 and D16S3376. We observed significant linkage disequilibrium in the North African Jewish population, and historical recombinants in the founder haplotype placed MEFV between D16S3082 and D16S3373 (approximately 200 kb). In smaller panels of Iraqi Jewish, Arab, and Armenian families, there were significant allelic associations only for D16S3370 and D16S2617 among the Armenians. A sizable minority of Iraqi Jewish and Armenian carrier chromosomes appeared to be derived from the North African Jewish ancestral haplotype. We observed a unique FMF haplotype common to Iraqi Jews, Arabs, and Armenians and two other haplotypes restricted to either the Iraqi Jewish or the Armenian population. These data support the view that a few major mutations account for a large percentage of the cases of FMF and suggest that some of these mutations arose before the affected Middle Eastern populations diverged from one another.

Alleles↗

Gm and Inv [Km] allotypes among Libyan and Ashkenazi jews, and Armenians living in Israel.

Serum samples from Armenians, and from Libyan and Ashkenazi Jews living in Israel were tested for Gm (1, 2, 3, 5, 6, 10, 11, 13, 14, 17, 21, 24, 26) and for Inv(1) [Km (1)]. The Gm data indicate that all three populations have Negroid and Mongoloid admixture. The minimum amount of admixture varies from 3.1% (Armenians) to 5.5% (Libyan Jews). This admixture had not been detected by the study of other polymorphisms, thus once again underlining the sensitivity of the Gm system. The haplotype frequencies among the Libyan Jews are markedly different from those among the Ashkenazi Jews. Surprisingly (coincidentally?) the haplotype frequencies among the Ashkenazi Jews and the Armenians are similar. The Libyan Jews have a significantly higher frequency of Inv1 than to the Ashkenazi Jews and among the latter, Inv1 is at least twice as frequent among Polish Jews as it is among Russian Jews.

Armenia↗

Disaster relief work: an assessment of training effectiveness.

This study evaluates the applicability of the training and operational practices of a group of firefighters to disaster search and rescue duties. Using schema theory it is hypothesized that training effectiveness could be evaluated by assessing the incidence with which event characteristics are perceived as stressors. A comparison of the propensity of a group of firefighters and a group of predominantly nonemergency service volunteers (who were specifically trained for disaster relief work) to define event characteristics as stressors provided the means of testing the hypothesis. The results suggest that the training and experience of these firefighters did not prepare them for major disaster work. The difference in stressor susceptibility serves as a basis for identifying training and response factors that appeared to promote an adaptive response. The implications of schema theory for the design of training programs is discussed.

Adult↗

Coping with Ottoman Turkish Genocide: an exploration of the experience of Armenian survivors.

This study explored the experiences of the survivors of the Ottoman-Turkish Genocide of the Armenians (1915-1923). Coping strategies, communication patterns and the impact of continuing Turkish denial of the events were the specific research areas. Semi-structured interviews were administered to 40 Genocide survivors, residing at two Armenian homes for older adults in the mid-Atlantic United States. Destruction of life, physical harm, deportation, pillaging, and loss of status were identified by respondents as stressors experienced. Religion, family, work, denial, and resignation were identified as coping methods and sources of survival. Most respondents had not discussed their experiences with others. When asked about their reactions to the Turkish denial, respondents expressed a range of negative affect, including resentment, hatred, and rage. When asked about sources of pride in their lives, respondents cited accomplishments such as surviving the Genocide, surviving as Armenians and procreating. The social, developmental, and psychiatric implications of the findings were discussed.

Adaptation, Psychological↗

Familial Mediterranean fever: clastogenic plasma factors correlated with increased O2(-)--production by neutrophils.

Familial Mediterranean fever (FMF) is an autosomal recessive disease predominantly affecting Armenians and non-Ashkenazi Jews. The disease begins in childhood with paroxysmal attacks of pain and fever accompanied by peritonitis, pleuritis, and synovitis. During the acute phase, there is a massive influx of polymorphonuclear leukocytes into the serosal membranes, connected with degranulation of the neutrophils and with secretion of lysosomal enzymes and pyrogenic substances. An increase in the lipoxygenase product, leukotriene B4, a chemotactic agent, and a decrease in the activity of the inhibitor of chemotaxis, C5a, in serosal fluids have been considered responsible. Previous work from our laboratories had shown that the chromosomal instability observed in blood cultures of patients with FMF is secondary to circulating clastogenic factors (CFs), and that the antioxidant enzyme superoxide dismutase, as well as lipoxygenase inhibitors, reduce the chromosome damaging effects. CFs are observed in chronic inflammatory diseases and in various other pathological conditions accompanied by oxidative stress. Similar clastogenic materials were found in supernatants of neutrophils and monocytes after a respiratory burst and were shown to contain lipid peroxidation products and cytokines. In the present study we compared the clastogenic effects exerted by plasma ultrafiltrates from 20 adult patients with FMF to the unstimulated O2- production of their neutrophils. In comparison to 20 age- and sex-matched controls, which were studied simultaneously, the O2- production by patient's neutrophils was routinely higher than that of controls. The clastogenic effects of patient's plasma, expressed as the number of chromosomal aberrations induced in test cultures of healthy donors, were correlated with the importance of O2- production by their neutrophils (r = 0.5235). Even if the relative contribution of disturbance in arachidonic acid metabolism, neutrophil activation, and CF formation in the disease process remains unclear, the demonstration of oxidative stress in this genetic disorder suggests the use of antioxidants and free radical scavengers, in particular during acute attacks, when the classical colchicine treatment is without effect.

Adolescent↗

Correlates of HIV risk and preventive behaviors in Armenian female sex workers.

This study describes HIV risk and preventive behaviors and their correlates among Armenian female commercial sex workers (CSWs) as a prerequisite to developing gender and culturally appropriate interventions. Ninety-eight CSWs from three Armenian cities were interviewed using a structured questionnaire. Quantitative findings were further elaborated by focus group discussions (N = 25) and key informant interviews (N = 8). Inconsistent condom use with all types of sexual partners was reported, as were condom tear/slippage, alcohol and drug use, and sex with drug injecting clients. Prominent misconceptions regarding HIV transmission, prevention and disease manifestations were noted. Correlates of condom use intentions included history of substance use, attitudes regarding condom use, risk perception, and comfort negotiating condom use. Intentions to use condoms were strongly associated with recent frequency of condom use. Understanding the relationship between condom use and its determinants is critical in the design and implementation of effective prevention programs tailored for Armenian CSWs.

Adolescent↗

The work of the South Manchester Accident Rescue Team (SMART).

Skills acquired in the hospital do not necessarily translate to the scene of an accident. However, training in certain hospital specialties, particularly accident and emergency medicine, will expose doctors to dealing with very ill patients in a less rigidly structured environment. The operating theatre is a disciplined and controlled environment. Skill in anaesthesia, monitoring and operating, if tested only in these circumstances may be found to be gravely inadequate when exposed to the fluctuant and hostile environment at the site. Doctors who wish to do this sort of work or are designated to do it, must undergo regular and frequent training, especially if they are not trained in accident and emergency departments. This has long been recognised by the British Association for Immediate Care. In combination with the Royal College of Surgeons of Edinburgh they have now established a diploma in Immediate Medical Care. In urban areas the need for a doctor to attend at the scene of an accident is usually limited to entrapment. These occasions are likely to be infrequent and this can result in a lack of preparedness for such events. Interhospital transfer, primarily from peripheral hospitals to the specialist services of a teaching hospital, often involves critically ill and injured patients. The management of these cases by the mobile team provides regular, frequent exposure to working in a 'hostile' environment. Relationships with the rescue services are developed and staff become familiar with equipment and call-out procedures. The care of transported patients is improved. None of our patients have died in transit or within 6 h of arrival at base.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents↗

Continuous arteriovenous hemofiltration with dialysis (CAVH-D): an alternative to hemodialysis in the mass casualty situation.

Renal failure is a common sequela of mass casualty, particularly when crush injury is involved. Traditional management of renal failure with hemodialysis equipment may be difficult or inaccessible due to lack of electricity and water supply or damage to existing equipment. Furthermore, a sudden new population of renal failure patients may overwhelm an existing dialysis program. The rapid mobilization of traditional hemodialysis equipment may be delayed due to limited supply, manufacturing delays, or inventory shortages. For these reasons, we propose the use of continuous arteriovenous hemofiltration with dialysis (CAVH-D) as an alternative renal support modality for the mass casualty situation.

Acute Kidney Injury↗

CVD prevention strategies with urban and rural African American women.

Using Pender's Health Promotion Model, this study tested a work site cardiovascular disease (CVD) risk factor reduction intervention among low-income African American (LAAW) women. Individual CVD risk profiles were identified at the work site through (1) health risk appraisal, (2) blood pressure measurement, (3) body mass index calculation, (4) individual interviews about diet and exercise behaviors, and (5) total cholesterol analysis. Two LAAW groups, one urban and one rural, exhibited higher or similar pretest CVD relative risks (RR) when statistically compared with a national sample of African American women. The LAAW study samples were younger and more educated. Pretest cholesterol and fat intake for the rural women were higher than for the urban women (<.05). Posttest changes in cholesterol and fat intake risks were more significant in rural LAAW than in urban LAAW (<.05).

Adult↗