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Kidney dialysis treatment for victims of the Armenian earthquake.
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Risk factors for coronary artery disease (CAD) in Lebanese-Armenian women.
Coronary artery disease (CAD) is the leading cause of death among women over 50 years of age. Preventive measures through lifestyle modification and management of CAD risk factors have contributed to a decrease in mortality from heart disease. The purpose of this article is to assess risk factors for CAD among the population of Lebanese-Armenian women, so that appropriate intervention strategies for risk reduction could be planned and implemented. A descriptive study to explore risk factors for CAD was conducted in a convenience sample of 83 women who attended a series of panel discussions about risk factors for CAD. Data collection was done using structured interviews and clinical/laboratory studies. Analysis of data was done using frequency distributions. The results indicated that a significant proportion of the sample manifested risk factors for CAD including age, menopausal status, hypertension, hypercholesterolemia, high levels of low-density lipoproteins (LDL), low levels of high-density lipoproteins (HDL), and being overweight. In addition, hypertension was associated positively with age, total cholesterol, LDL and triglyceride levels, lack of physical activity, propensity to anger, and family history of hypertension. The findings suggest the need for further research and health risk reduction programs.
Mutation and haplotype studies of familial Mediterranean fever reveal new ancestral relationships and evidence for a high carrier frequency with reduced penetrance in the Ashkenazi Jewish population.
Familial Mediterranean fever (FMF) is a recessive disorder characterized by episodes of fever with serositis or synovitis. The FMF gene (MEFV) was cloned recently, and four missense mutations were identified. Here we present data from non-Ashkenazi Jewish and Arab patients in whom we had not originally found mutations and from a new, more ethnically diverse panel. Among 90 symptomatic mutation-positive individuals, 11 mutations accounted for 79% of carrier chromosomes. Of the two mutations that are novel, one alters the same residue (680) as a previously known mutation, and the other (P369S) is located in exon 3. Consistent with another recent report, the E148Q mutation was observed in patients of several ethnicities and on multiple microsatellite haplotypes, but haplotype data indicate an ancestral relationships between non-Jewish Italian and Ashkenazi Jewish patients with FMF and other affected populations. Among approximately 200 anonymous Ashkenazi Jewish DNA samples, the MEFV carrier frequency was 21%, with E148Q the most common mutation. Several lines of evidence indicate reduced penetrance among Ashkenazi Jews, especially for E148Q, P369S, and K695R. Nevertheless, E148Q helps account for recessive inheritance in an Ashkenazi family previously reported as an unusual case of dominantly inherited FMF. The presence of three frequent MEFV mutations in multiple Mediterranean populations strongly suggests a heterozygote advantage in this geographic region.
MEFV-Gene analysis in armenian patients with Familial Mediterranean fever: diagnostic value and unfavorable renal prognosis of the M694V homozygous genotype-genetic and therapeutic implications.
Familial Mediterranean fever (FMF) is a recessively inherited disorder that is common in patients of Armenian ancestry. To date, its diagnosis, which can be made only retrospectively, is one of exclusion, based entirely on nonspecific clinical signs that result from serosal inflammation and that may lead to unnecessary surgery. Renal amyloidosis, prevented by colchicine, is the most severe complication of FMF, a disorder associated with mutations in the MEFV gene. To evaluate the diagnostic and prognostic value of MEFV-gene analysis, we investigated 90 Armenian FMF patients from 77 unrelated families that were not selected through genetic-linkage analysis. Eight mutations, one of which (R408Q) is new, were found to account for 93% of the 163 independent FMF alleles, with both FMF alleles identified in 89% of the patients. In several instances, family studies provided molecular evidence for pseudodominant transmission and incomplete penetrance of the disease phenotype. The M694V homozygous genotype was found to be associated with a higher prevalence of renal amyloidosis and arthritis, compared with other genotypes (P=.0002 and P=.006, respectively). The demonstration of both the diagnostic and prognostic value of MEFV analysis and particular modes of inheritance should lead to new ways for management of FMF-including genetic counseling and therapeutic decisions in affected families.
Homozygosity for a novel missense mutation (I175V) in exon 5 of the CFTR gene in a family of Armenian descent.
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The epidemiology of infant deaths in the Armenian parish records of Lebanon.
It is difficult to study time trends in mortality from most developing countries due to the lack of an appropriate data base. The present investigation is based on data from parish records of the Armenian Apostolic churches in Lebanon. Death and baptismal registers have been regularly maintained in these churches from 1863. Infant deaths were identified in the registers of the 13 churches. Available data on these deaths were abstracted, coded and analysed. Denominators for the different periods of study and for the various churches were calculated from baptismal records. The study shows that there has been a constant drop in the infant deaths over the review period. Infant mortality rates were higher in the parishes located in refugee camp areas. The most important recorded causes of death included diarrhoea and pneumonia. A study of clustering of deaths by time and place revealed a major epidemic of measles with high fatality in 1926. This epidemic had been previously unrecorded. The present study demonstrates the use of non-traditional data sources to assess long-term secular trends of mortality.
Patterns of infant mortality from Armenian parish records: a study from 10 countries of the diaspora, 1737-1982.
Using parish records from 10 different countries with small Armenian communities, this study compared patterns of infant mortality in these countries over a period of 245 years. Deaths registered as aged < or = 1 year were used to estimate the numerator for the infant mortality rates (IMR) while the denominator was estimated from births in the same year based on baptisms in the appropriate registers. To check on the validity of using the baptisms as the denominator for the IMR, records of infant deaths were linked with the baptismal records. Thus, from a sample of 273 infant deaths 78.4% had a baptismal record in the registers of the same church in which the death was recorded. Of the deaths 60% had a recorded cause of death. Over the past 245 years, IMR have fallen substantially in all parishes. However, there were notable exceptions to this general pattern of declining IMR over time. For example, the IMR was tripled in Palestine during the decade of the First World War, possibly as a result of the influx of refugees deported from Turkey. A study of the seasonal occurrence of the deaths revealed peaking of deaths between May and August, a pattern influenced by the relative importance of gastroenteritis as a cause of death during the summer months in Egypt where the majority of these infant deaths were recorded. A review of the most important causes of death helped identify an outbreak of undetermined cause in Belgrade in 1737 and an outbreak of dysentery deaths in Alexandria, Egypt, in 1909.(ABSTRACT TRUNCATED AT 250 WORDS)
Patterns of mortality in Armenian parish records from eleven countries.
A study of the trends and distributions of mortality in parish records of Armenian churches from 11 countries spanning over 242 years is the basis of this report. In all parishes, the relative proportion of deaths in the older age groups gradually increased over the study period. Following a review of the most important causes of death, an effort was made to identify clusters and outbreaks of specific causes of death. Thus, in the 19th century, five epidemics of cholera were identified in one parish in Kutahya, Turkey (1831, 1848, 1865, 1871, and 1893). A review of the deaths due to the 1918 influenza pandemic revealed a major peak in October-December 1918 in Cairo, and deaths due to the same cause recorded in November-December 1918 in Rangoon, Dacca, and Calcutta. As observed elsewhere in the classic pattern of this pandemic, the largest number of these deaths were in persons who were in their twenties. In September-December 1942, in Thessaloniki, Greece, 31 deaths of all age groups were ascribed to a fever that was described as "toxic." The nature of this epidemic could not be explained. The observation that large numbers of recorded deaths occurred through violence and hunger during the First and Second World Wars as a result of the atrocities to which these communities were exposed sheds further light on historical events in those years.
Phenotype-genotype correlation in 91 patients with familial Mediterranean fever reveals a high frequency of cutaneomucous features.
OBJECTIVES: To describe the clinical manifestations of familial Mediterranean fever (FMF) in 91 patients from 47 families and provide data from the genetic study. P:atients and methods. We conducted a retrospective chart review of 91 patients (including 83 children aged <15 yr) from 47 families through a questionnaire and a specific database. The genetic analysis included complete screening of known mutations of the MEFV gene on chromosome 16p13.3. A positive diagnosis required at least two mutations, one on each chromosome. RESULTS: Our panel included 52 females and 39 males, with a mean age of 7.27 yr. Of the 47 families, 31 were non-Ashkenazi Jews, 10 were Armenians and six were from other ethnic groups. Clinical features included fever (100%), peritonitis (86%), pleuritis (56%), arthritis (34%) and myalgias (27%). We observed a high rate of cutaneous manifestations (47%); erythema, oedema and recurrent oral ulcers were the most frequent. Phenotype-genotype correlations showed a significant association of M694V homozygosity with earlier age of onset (P: = 0.044), fever >39 degrees C (P: = 0. 002), pleural crisis (P: = 0.0044), splenomegaly (P: = 0.0005) and arthritis (P: = 0.001). Associations with mucocutaneous features were as follows: erysipelas-like erythema (P: = 0.012), oedema (P: = 0.61, not significant) and oral ulcers (P: = 0.45, not significant). CONCLUSION: New phenotype-genotype correlations emerged from our study: homozygosity for the M694V mutation was associated with intensity of fever, splenomegaly and with erysipelas-like erythema. Apart from erysipelas-like erythema, no significant association was found between other cutaneous features and the genotype.
American critical care team at a foreign disaster site: the Armenian experience.
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Teaching the public health core competency of policy development to baccalaureate student nurses.
Teaching the public health core competency of policy development to baccalaureate student nurses was the purpose of this project. This project was implemented through interdisciplinary collaboration of one innovative state health district and the faculty of a large, urban university. Through education in the core competency of policy development, attention to one county's assessed health needs was introduced to its county board of health with the goal of influencing health policy regarding those needs. Data obtained have continued to be used by this county in health planning and grant writing activities and have been built upon by other student groups.
Moral development and psychopathological interference in conscience functioning among adolescents after trauma.
OBJECTIVES: To compare moral development and psychopathological interference with conscience functioning (PI) among adolescents exposed to different degrees of earthquake-related trauma and to investigate the relationship of moral development and PI to exposure to trauma, severity of posttraumatic stress disorder (PTSD) symptoms, postearthquake adversities, and extent of loss of nuclear family members. METHOD: Adolescents (N = 193) from 2 cities at different distances from the epicenter were evaluated. The Stilwell Structured Conscience Interview was used to assess moral development and PI. Structured self-report instruments were used to obtain ratings of severity of earthquake-related trauma, posttraumatic stress symptoms, and postearthquake adversities. RESULTS: Adolescents in the city near the epicenter manifested advanced moral development as compared with their counterparts in the less affected city. Concomitantly, they endorsed responses indicating PI. Levels of PI were significantly correlated with severity of PTSD symptoms. CONCLUSION: In the aftermath of a catastrophic natural disaster, children assume greater responsibilities and confront a multitude of morally challenging interpersonal situations which may result in an advancement of their moral development. Yet, at the same time, PTSD symptoms and negative schematizations of self and others may give rise to disturbances in conscience functioning. The findings suggest that therapeutic consideration should be given to assisting children in integrating the horror of their traumatic experiences and the harshness of posttrauma adversities into an adaptive schema of good and evil in themselves and the world.
Familial Mediterranean Fever in Armenians. Analysis of 100 cases.
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The extraordinary career of Doctor Varaztad Hovhannes Kazanjian.
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Dr. Kazanjian's emigrating to America.
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Familial pemphigus vulgaris: two siblings with unusual localized variant.
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Genetic marker family studies in familial Mediterranean fever (FMF) in Armenians.
Familial Mediterranean fever is an autosomal recessive disease manifested by recurrent short episodes of fever associated with polyserositis. It is common in a variety of Mediterranean and near Eastern populations. The biochemical defect is unknown, and there have been few studies of genetic marker associations or linkage with the disease. We have screened blood samples from members of 14 nuclear Armenian families, the population with the highest known gene frequency, for 19 different polymorphic phenotypic genetic markers. These 14 families included 31 affected and 43 unaffected family members. No association was found with any of the markers studied. Linkage could be excluded at the distance of 0-15% recombination with 14 markers. Linkage could not be excluded with 5 other markers. These results exclude the FMF gene from those portions of the human gene map that are at least 0.5% recombination distance from these 14 genetic markers, and represent the first comprehensive step in the eventual localization and isolation of the FMF gene.