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PubMedDate not supplied

Pancreatitis in northern Newfoundland and Labrador: a 20-year review of the Grenfell Regional Health Services experience.

A retrospective review of the Grenfell Regional Health Services experience with pancreatitis over a 20-year period (1968-1987) has been presented. The small number of cases in this series precludes meaningful statistical analysis, however, in general, one can state that native peoples are represented in this study in roughly the same proportion as they are represented in the population served. We have demonstrated that pancreatitis in its chronic form does occur in the Inuit of Northern Labrador. Given the prominent role that alcohol abuse plays in the social and behavioral ills of Labrador's native peoples as reflected in the high incidence of family violence, accidental deaths, and suicides, one might anticipate a disproportionately high incidence of pancreatitis and its chronic sequelae among the Inuit. The answer to this seeming paradox may be found through future study of the nature of the alcohol consumed, its pattern of consumption or of genetically-determined differences in the metabolism of alcohol and its toxic effects within the body, of differences in the composition of pancreatic secretions, or of environmental and dietary factors.

Adult↗
PubMed2007

Cadmium concentrations in tissues of willow ptarmigan (Lagopus lagopus) and rock ptarmigan (Lagopus muta) in Nunavik, Northern Québec.

Willow and rock ptarmigan were obtained from Northern Québec. Willow ptarmigan were found to have mean cadmium concentrations of 179.7 microg/g (dw) in the kidneys and 25.8 microg/g (dw) in the liver; these levels were three times higher than those found in the rock ptarmigan. The cadmium levels in the ptarmigan were below the threshold above which adverse effects can be observed in birds. The difference between the two ptarmigan species in cadmium content is explained by the diet. A comparison of their diet showed that willow, which stores cadmium, is an important food resource for willow ptarmigan but not for rock ptarmigan. Because there is limited information available on the consumption of ptarmigan kidneys and liver by the Inuit, and the fact that this is a traditional way of life and provides nutritional benefits to the Inuit population, no consumption guidelines are proposed.

Air Pollutants↗
PubMed2005

Human health implications of environmental contaminants in Arctic Canada: A review.

The objectives of this paper are to: assess the impact of exposure to current levels of environmental contaminants in the Canadian Arctic on human health; identify the data and knowledge gaps that need to be filled by future human health research and monitoring; examine how these issues have changed since our first assessment [Van Oostdam, J., Gilman, A., Dewailly, E., Usher, P., Wheatley, B., Kuhnlein, H. et al., 1999. Human health implications of environmental contaminants in Arctic Canada: a review. Sci Total Environ 230, 1-82]. The primary exposure pathway for contaminants for various organochlorines (OCs) and toxic metals is through the traditional northern diet. Exposures tend to be higher in the eastern than the western Canadian Arctic. In recent dietary surveys among five Inuit regions, mean intakes by 20- to 40-year-old adults in Baffin, Kivalliq and Inuvialuit communities exceeded the provisional tolerable daily intakes (pTDIs) for the OCs, chlordane and toxaphene. The most recent findings in NWT and Nunavut indicate that almost half of the blood samples from Inuit mothers exceeded the level of concern value of 5 microg/L for PCBs, but none exceeded the action level of 100 microg/L. For Dene/Métis and Caucasians of the Northwest Territories exposure to OCs are mostly below this level of concern. Based on the exceedances of the pTDI and of various blood guidelines, mercury and to a lesser extent lead (from the use of lead shot in hunting game) are also concerns among Arctic peoples. The developing foetus is likely to be more sensitive to the effects of OCs and metals than adults, and is the age groups of greatest risk in the Arctic. Studies of infant development in Nunavik have linked deficits in immune function, an increase in childhood respiratory infections and birth weight to prenatal exposure to OCs. Balancing the risks and benefits of a diet of country foods is very difficult. The nutritional benefits of country food and its contribution to the total diet are substantial. Country food contributes significantly more protein, iron and zinc to the diets of consumers than southern/market foods. The increase in obesity, diabetes and cardiovascular disease has been linked to a shift away from a country food diet and a less active lifestyle. These foods are an integral component of good health among Aboriginal peoples. The social, cultural, spiritual, nutritional and economic benefits of these foods must be considered in concert with the risks of exposure to environmental contaminants through their exposure. Consequently, the contamination of country food raises problems which go far beyond the usual confines of public health and cannot be resolved simply by risk-based health advisories or food substitutions alone. All decisions should involve the community and consider many aspects of socio-cultural stability to arrive at a decision that will be the most protective and least detrimental to the communities.

American Indian or Alaska Native↗
PubMed1999

Human health implications of environmental contaminants in Arctic Canada: a review.

This paper assesses the impact on human health of exposure to current levels of environmental contaminants in the Canadian Arctic, and identifies the data gaps that need to be filled by future human health research and monitoring. The concept of health in indigenous groups of the Arctic includes social, cultural, and spiritual dimensions. The harvesting, sharing and consumption of traditional foods are an integral component to good health among Aboriginal people influencing both physical health and social well-being. Traditional foods are also an economic necessity in many communities. Consequently, the contamination of country food raises problems which go far beyond the usual confines of public health and cannot be resolved by health advisories or food substitutions alone. The primary exposure pathway for the contaminants considered in this paper is through the traditional northern diet. For the Inuit, the OCs of primary concern at this time from the point of view of exposure are chlordane, toxaphene, and PCBs. Exposures are higher in the eastern than in the western region of the North. For Dene/Metis, exposure to OCs is in general below a level of concern. However, estimated intake of chlordane and toxaphene has been found to be elevated for certain groups and is a cause for concern if exposures are elevated on a regular basis. The developing foetus and breast-fed infant are likely to be more sensitive to the effects of OCs and metals than individual adults and are the age groups at greatest risk in the Arctic. Extensive sampling of human tissues in the Canadian north indicate that a significant proportion of Dene, Cree and Inuit had mean maternal hair mercury levels within the 5% risk-range proposed by the WHO for neonatal neurological damage. Based on current levels, lead does not appear to pose a health threat while cadmium is likely only a major risk factor for heavy smokers or consumers of large amounts of organ meats. Consumers of traditional foods are exposed to an approximately seven-fold higher radiation dose than non-consumers of traditional foods due predominantly to the bioaccumulation of natural radionuclides in the food chain. Risk determination for contaminants in country food involves a consideration of the type and amounts of food consumed and the sociocultural, nutritional, economic, and spiritual benefits associated with country foods. Risk management options that minimize the extent to which nutritional and sociocultural aspects of Aboriginal societies are compromised must always be considered.

Adult↗
PubMed1999

Comparison of risk of conductive hearing loss among three ethnic groups of Arctic audiology patients.

The purpose of the study was to investigate the relative contributions of age, gender, ethnic background, and a history of middle ear disease on the amount of conductive hearing impairment among native and non-native audiology patients in the Canadian North. A second goal of the study was to determine risk factors for conductive hearing loss in the patients studied. Three ethnic groups were represented among the 3,094 patients: Inuit, American Indian, and non-native. Loglinear and logit statistical models were applied, and these data were best explained by a 3-way interaction of history of middle ear disease, ethnic group, and hearing loss, and the 2-way interaction of age and hearing loss. The Inuit appear to be at higher risk for conductive hearing impairment than the other ethnic groups. Conductive hearing loss also appears to increase as age increases through the teenage years for all the patients regardless of ethnic group membership. Preschoolers were at the lowest risk for conductive hearing loss. The trend for the amount of hearing impairment to increase throughout childhood suggests that children living in the Arctic may manifest a unique and more serious form of the disease not often observed in audiology patients who are Caucasian in southern Canada or the United States or that they may be exposed to additional risk factors.

Adult↗
PubMed2005

Anterior tooth growth periods in Neandertals were comparable to those of modern humans.

A longstanding controversy in paleoanthropology surrounds the question of whether Neandertals shared the prolonged growth periods of modern humans. To address this question, this investigation compares the duration of enamel formation in Neandertals with that of three comparative modern human groups. Because dental and somatic growth are correlated with each other, dental growth periods are indicative of overall periods of growth. Growth increments on the anterior teeth of Neandertals, modern Inuit, and modern people from Newcastle and southern Africa were counted and their means compared. In addition, potential variation in the time spans represented by growth increments was considered and incorporated into the analysis of enamel formation times. These analyses show that Neandertal imbricational enamel formation times, although likely to have been faster than those of the Inuit, are not likely to have been faster than those of the Newcastle sample and for some teeth are clearly slower than those of the southern African sample. Thus, Neandertal tooth growth and, by extension, somatic growth, appears to be encompassed within the modern human range of interpopulation variation.

Analysis of Variance↗
PubMed1999

Perinatal vitamin D and calcium status of northern Canadian mothers and their newborn infants.

OBJECTIVE: This study was undertaken to examine the vitamin D and calcium status of mothers and their newborns. METHODS: The intakes of vitamin D and calcium were determined prenatally in 121 women including 33 Caucasians, 51 Inuits, and 37 Native Indians, living in the Inuvik zone of the Northwest Territories. Plasma concentrations of 25-(OH)-D and calcium were also measured in mothers as well as in their offspring at delivery. RESULTS: The daily mean vitamin D intake of native mothers, including Inuits and Indians, with (8.1+/-5.5 microg) and without supplements (3.4+/-2.5 microg) was significantly lower than that of non-native mothers (13.2+/-5.9 microg and 5.8+/-4.3 microg, respectively). According to the predicted prevalence of low vitamin D intake, there existed a higher risk of vitamin D deficiency without supplementation in both native (88.6% vs 48.4%) and non-native (63.5% vs. 15.1%) mothers. The trend for calcium intakes with and without supplementation was similar to vitamin D intake. At the point of delivery, the plasma levels of 25-(OH)-D were lower in native mothers (50.1 19.3 nmol/L) and their offspring (34.2+/-13.1 nmol/L) than their counterparts (59.8+/-29.4 nmol/L and 41.4+/-23.5 nmol/L, respectively). Its plasma levels in newborn infants averaged only 67% of their mothers. None of these infants showed clinical evidence of vitamin D deficiency. In fact, their plasma calcium levels were significantly higher than their mothers. CONCLUSIONS: Plasma 25-(OH)-D concentrations of 60 to 70% of maternal levels may represent a "normal" range for newborn infants. However, a supplementation in native northern Canadian mothers during pregnancy and in their neonates during infancy may have a role to play in the prevention of vitamin D deficiency.

Calcifediol↗
PubMed1989

Vitamin E status of northern Canadian newborns: relation of vitamin E to blood lipids.

Vitamin E status was determined in two groups of Canadian newborns: a northern group, mainly aboriginal (Indian and Inuit), and a southern group, mainly nonnative. Serum vitamin E, cholesterol, and triglyceride levels were measured in cord blood and ratios of vitamin E to both cholesterol (E:chol) and cholesterol plus triglyceride (E:chol + TG) were calculated. For the combined groups the mean serum concentration of vitamin E (8.71 +/- 2.45 mumol/L), cholesterol (1.77 +/- 0.46 mmol/L), and triglyceride (0.65 +/- 0.30 mmol/L) as well as the ratios E:chol (5.00 X 10(-3) +/- 1.26 X 10(-3) and E:chol + TG (3.60 X 10(-3) +/- 0.77 X 10(-3) were within normal limits. Significant north-south differences were found only in the mean triglyceride concentration, which was lower (p = 0.03), and E:chol + TG, which was higher (p = 0.002), in the northern than in the southern group. No differences attributable to differences in race were found. Only one infant, an Inuit in the northern group, was found to be deficient in vitamin E.

Adult↗
PubMed2004

Arctic indigenous peoples experience the nutrition transition with changing dietary patterns and obesity.

Indigenous Peoples globally are part of the nutrition transition. They may be among the most extreme for the extent of dietary change experienced in the last few decades. In this paper, we report survey data from 44 representative communities from 3 large cultural areas of the Canadian Arctic: the Yukon First Nations, Dene/Métis, and Inuit communities. Dietary change was represented in 2 ways: 1) considering the current proportion of traditional food (TF) in contrast to the precontact period (100% TF); and 2) the amount of TF consumed by older vs. younger generations. Total diet, TF, and BMI data from adults were investigated. On days when TF was consumed, there was significantly less (P < 0.01) fat, carbohydrate, and sugar in the diet, and more protein, vitamin A, vitamin D, vitamin E, riboflavin, vitamin B-6, iron, zinc, copper, magnesium, manganese, phosphorus, potassium, and selenium. Vitamin C and folate, provided mainly by fortified food, and fiber were higher (P < 0.01) on days without TF for Inuit. Only 10-36% of energy was derived from TF; adults > 40 y old consistently consumed more (P < 0.05) TF than those younger. Overall obesity (BMI > or = 30 kg/m(2)) of Arctic adults exceeded all-Canadian rates. Measures to improve nutrient-dense market food (MF) availability and use are called for, as are ways to maintain or increase TF use.

Adult↗
PubMed2003

Gestational exposure to persistent organic pollutants: maternal liver residues, pregnancy outcome, and effects on hepatic gene expression profiles in the dam and fetus.

Dietary exposure of Inuit people to a mixture of pesticides and polychlorinated biphenyls, or persistent organic pollutants (POPs), during pregnancy is a public health concern. We examined the consequences of administering the mixture of 28 POPs found in the Inuit diet (at doses representing 10-1000 times dietary levels) by gavage to pregnant Sprague-Dawley rats either during gestation days 0-19 or 8-19. The levels of individual components of the POPs mixture in the maternal liver were measured by high-resolution mass spectrometry. On gestation day 20, dams were sacrificed and pregnancy outcome determined. RNA isolated from maternal and fetal livers was 32P-labeled for gene expression profiling. The concentrations of individual POPs were increased in maternal livers of dams gavaged with the 1000x POPs mixture by 10- to 500-fold. While exposure to POPs had no significant effects on pregnancy outcome, dramatic changes were observed in the gene expression profiles of both the maternal and fetal livers. The gene expression profiles of maternal and fetal female and male liver were distinct with respect to the numbers of transcripts detected, the genes expressed exclusively in control or POPs-exposed livers, and those for which expression was up- or downregulated. While different genes were affected in each group, the overall consequence of POPs exposure on hepatic gene expression profiles was to decrease both the numbers of genes expressed and the relative intensity of expression. Thus, in utero exposure to POPs alters hepatic gene expression in the dam and the fetus; these changes may have functional implications.

Animals↗
PubMed1991

Nasopharyngeal carcinoma treated at the Finsen Institute, Copenhagen 1965-1985: survival and some prognostic factors.

Clinical data from 218 patients consecutively treated for nasopharyngeal carcinoma at the Finsen Institute in Copenhagen during the period 1965 through 1985 have been analyzed for factors of prognostic importance. Of the 218 patients, 47 were Greenland Inuit eskimos and 169 were white Danish. The 5-year crude survival for the entire group of patients was 30%. The two groups of patients differed with respect to the importance of different prognostic factors. Keratinizing tumors were only present in the Danish population. These patients had a highly significant worse outcome than the rest of the Danish (P less than 0.00001). Age, stage, and T classification were important prognostic factors in the Danish population, but not in the Inuit population.

Adolescent↗
PubMed2000

Interethnic differences of drug-metabolizing enzymes.

Polymorphisms exhibited by drug-metabolizing enzymes are well known and have been investigated for many years. Recently, the exploding field of pharmacogenetics has focused not only on the characterization of enzymes responsible for drug biotransformation but also, on describing the sources of variability in enzyme activity. While initial observations and studies focused on populations of Caucasian origin, reports for other populations followed. The incidence of a poor or slow metabolizer phenotype for a given enzyme caused by allelic variants may vary significantly between populations. The question arises as to whether a prediction of the phenotype (i.e. distribution and/or enzyme activity) can be accurately ascertained from genotype information gathered in a related population. This is exemplified by NAD(P):quinone oxidoreductase (NQO1) investigated in Canadian Native Indian (CNI), Inuit and Chinese populations and the cytochromes P4502C19 and 2D6. While the two North American Native populations are genetically distinct, they are both descendants from northern Asia. Consequently, one might suspect that on a pharmacogenetic basis, CNI and Inuit would be more comparable to Chinese as opposed to Caucasian populations. This is certainly not the case as demonstrated for all three enzymes. Also, for a reliable phenotype prediction, one needs to pay attention to ethnic "mixing" which occurs between certain populations. Ethnic diversity constitutes both a challenge and an opportunity to prudently apply pharmacogenetics so that variability in both drug disposition and effect may be better understood.

Aryl Hydrocarbon Hydroxylases↗
PubMed1998

Tuberculosis: finding a community solution.

The Tuberculosis Surveillance Project set out to gain community and health care worker support for and participation in the development and implementation of a tuberculosis control program which would address the high incidence of tuberculosis in Innu and Inuit communities in Labrador. The underlying principle of this project is that a tuberculosis control program must have the support of both the communities and the health care workers if it is to succeed. A three-person tuberculosis steering committee, with representation from the Innu Nation, the Labrador Inuit Association, and the Labrador Health Services Board, supervised initial tuberculosis data collection and analysis and workshop planning. Community Health Representatives, community physicians, and community nurses participated in a workshop to develop a tuberculosis protocol for the region. In addition, community tuberculosis control strategies were developed in workshops in each community in an effort to ensure community and health care worker support for the protocol and tuberculosis control in its broadest sense. This project illustrates how partnerships between communities and health care workers can be achieved. Future tuberculosis incidence rates will be used to evaluate the effectiveness of the partnership.

Adolescent↗
PubMed1998

Prevalence of diabetes mellitus and obesity in the Keewatin District of the Canadian Arctic.

Through a medical chart review, the prevalence of diagnosed diabetes mellitus in Inuit of the Keewatin District of the Canadian Northwest Territories was determined to be 0.27%. All cases were in adults, and no cases of gestational diabetes were noted. The prevalence and pattern of obesity were determined from measurements of body mass index (BMI), skinfold thickness, and waist-hip ratio obtained during the 1990-91 Keewatin Health Assessment Study. Thirty-one percent of 414 randomly identified adults (29% of men, 37% of women) were overweight (BMI > 27). Central fat patterning was more prevalent in women and less prevalent in men from the Keewatin compared to the general Canadian population. Comparison of skinfold thickness values to published measurements obtained from earlier arctic surveys supports the hypothesis that changes in diet and activity levels associated with urbanization have resulted in increased obesity in the Inuit.

Adolescent↗
PubMed1999

Intratympanic cholesteatoma.

Cholesteatomas occurring behind an intact TM are relatively unusual, and intratympanic keratomas are even less common. This article presents the case of a Baffin Zone Inuit gentleman with an intratympanic cholesteatoma confined to the membranous portion of his TM. Although it is generally accepted that many native populations, including the Inuit, demonstrate an elevated preponderance of aural disease, cholesteatoma formation, particularly within the TM, in an individual from this area of the high Arctic is extremely rare.

Adult↗
PubMed1987

[Fiessinger-Leroy-Reiter syndrome in Greenland. Clinical and epidemiological aspects].

A clinical and epidemiological study of the Fiessinger Leroy Reiter syndrome was undertaken in Inuits from four Greenland cities, because of the frequency of HLA B27 antigen and venereal diseases in this population. A mean prevalence of 0.67 p. cent was found in Inuits from the west coast, of which 27.5 p. cent are carriers of the HLA B27 antigen. In Amassalik, on Greenland's east coast, where the frequency of B27 was estimated at 6.5 p. cent, the prevalence of the syndrome is 0.32 p. cent. Immunogenetic and preliminary familial data show that HLA B27 is present in 87.5 p. cent of the patients and that 34 p. cent have a close relative with the disease. Clinical data are comparable to those reported in the literature. Evolution is marred by frequent recurrences: 85 p. cent of the patients followed for more than ten (10) years present at least one recurrence. The total frequency of ankylosing spondylarthritis is 16.7 p. cent. It increases, in retrospect, to reach 45 p. cent in 22 patients followed for more than 15 years.

Adolescent↗
PubMed1977

Total parenteral nutrition in malnourished infants with intractable diarrhea.

Thirty-four infants (25 Inuit and 9 Caucasians) with protein-energy malnutrition and intractable diarrhea were treated with total parenteral nutrition (TNP) consisting of a casein hydrolysate, a soybean emulsion and dextrose. Initially peripheral veins were used in all the infants, and 22 were treated successfully without resort to a central venous catheter. The mean duration of treatment by the peripheral route was 29 days. Although mean energy intake and protein intake were high, weight gain was poor and growth continued at the prehospitalization percentiles. There were two deaths, both from complications of the use of central lines. Specific diagnoses were established for 7 of the 9 Caucasian infants but only 2 of the 25 Inuit infants. Concentrations of serum glutamic oxaloacetic transaminase (SGOT) were elevated in 80% of the patients at the time of admission, increased further in 82% when TPN was begun, but decreased towards normal before discharge in all patients. Eosinophilia was common during TPN. Liver biopsy in seven patients with elevated SGOT values showed eosinophilia, increased pigment in the Kupffer cells and slight lymphocytosis in the portal tract. Intercurrent infections occurred frequently and were often preceded by a short period of lipid intolerance or neutropenia, or both. Tolerance to lipids returned after the infections resolved. Thus, peripheral TPN is a safe and relatively simple method of providing adequate nutrition during episodes of diarrhea in malnourished infants.

Catheterization↗
PubMed1995

Spindle cell malignant lymphoepithelial lesion of the parotid gland: clinical, light microscopic, ultrastructural, and in situ hybridization findings in one case.

Malignant lymphoepithelial lesions (MLEL) are rare tumors of the salivary glands that show high incidence in Inuit Canadians, Alaskans, and Greenland Eskimos. The tumors are usually anaplastic or poorly differentiated squamous cell carcinomas. Focal spindle cell elements have been rarely reported. The tumors have been epidemiologically linked to Epstein-Barr virus infection. We present a case of malignant lymphoepithelial lesion showing exclusive spindle cell morphology. The patient is a 44-year-old male Inuit Canadian who presented with a long-standing history of a left parotid mass. The mass did not show evidence of rapid growth or facial nerve involvement. Parotidectomy was performed. The tumor was histologically composed of spindle cells nodules in a background of lymphocytes. The spindle cells showed no evidence of cytologic atypia but were mitotically active. Immunohistochemical staining for low-molecular-weight cytokeratin was only focally positive. The differential diagnosis included a mesenchymal neoplasm and malignant lymphoepithelial lesion. Electron microscopic examination confirmed the squamous nature of the neoplasm. Intracytoplasmic viral particles were also identified ultrastructurally. In situ hybridization for Epstein-Barr virus mRNA using a 30-base oligonucleotide probe specific for the EBER-1 gene showed very high level of expression in the tumor cells. No expression was noted in the adjacent parotid gland tissue. Our findings confirm the squamous nature of malignant lymphoepithelial lesions despite the spindle cell morphology occasionally seen in these neoplasms. They also confirm the strong role of Epstein-Barr virus infection in the pathogenesis of these tumors. This may have further diagnostic and therapeutic implications.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗