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PubMed1998

[The spread of HIV in Greenland. Heterosexual epidemic--risk or reality? A 10-year review of HIV transmission and preventive care].

With the first report of an HIV-positive Inuit in 1985 Greenland was considered a high risk area for a self-sustained heterosexual HIV-epidemic, due to high incidences of sexually transmitted diseases. In 1986 a national HIV-intervention programme began with two major aims: Firstly, improved STD treatment and incitation to change of sexual high-risk behaviour, secondly, close monitoring of HIV-antibody test activity, partner notification and repeated surveys of knowledge and sexual behaviour in selected populations. Very early the spread of HIV in Greenland became heterosexually transmitted and self-sustained, with repeated local small-scale epidemics in a subpopulation characterized by frequent STD's, alcoholism, lack of education and vulnerable social and economic resources. From 1994 to 1997 a marked increase in new cases was reported, and in November 1997 the total number was 76 HIV-positives in the Greenlandic population of 50,000 Inuits. The successful defeat of STD's, such as gonorrhoea and syphilis has not been followed by a change in sexual behaviour among the youth in Greenland. High incidences of genital chlamydial infections, early sexual debut and high frequencies of excessive promiscuity render Greenland an alarming potential for a future HIV-epidemic. This threat calls for an intensified national prevention programme, with close monitoring of the known HIV-positives and the potentially infected persons in the population at risk, and new campaigns to reduce high-risk sexual behaviour among the youth.

Disease Outbreaks↗
PubMed1998

Methods for improving the efficiency of estimating total osteon density in the human anterior mid-diaphyseal femur.

In order to preserve whole bone integrity and minimize destruction, paleohistologists often rely on histomorphometric data obtained from small areas (1.5-50 mm2) sampled within the anterior mid-diaphyseal femur. Because bone exhibits significant histological variation, the validity of results based on such sampling is questionable. The accuracy of various subareas (columns, rows, squares approximating dimensions and locations assessed by paleohistologists) in predicting total osteon density in the anterior mid-diaphyseal femur is assessed in the present study. Thirty-five specimens (12.7 mm wide, 100 microm thick, average area 56.7 mm2) were chosen at random from a skeletal population of 94 Inuits and Pueblo agriculturists. The specimens were photographed and enlarged; an acetate grid (12 columns, 10 rows, 120 squares, square = 1 mm2 of bone surface) was superimposed over the photograph; and secondary osteons and fragments were identified. Alternate columns (50% total area, T.Ar) predicted over 98% of entire section total osteon density. Two column combinations (15% T.Ar), separated by at least one column, predicted 91 to 95% of total osteon density. Individual column (8% T.Ar) predictability ranged from 48 to 86%. Two row combination (32 to 40% T.Ar) predictability values ranged from 86 to 95%. Individual rows (<1 to 20% T.Ar) predicted from 45 to 92% of total variation. Combinations of squares approximating areas and locations assessed by other paleohistologists ranged in predictability values from 80 to 94%. The results demonstrate that subareas of as little as 15% predict 95% of variation in total osteon density in the entire anterior mid-diaphyseal femoral section. A minimization of histological area evaluated without the loss of accuracy allows for a minimization of time invested in data collection and the utilization of partially damaged specimens.

Adolescent↗
PubMed1993

Familial clusters of nasopharyngeal carcinoma and salivary gland carcinomas in Greenland natives.

BACKGROUND: Nasopharyngeal carcinoma (NPC) and anaplastic salivary gland carcinoma (SGC), both associated with Epstein-Barr virus (EBV), are common among Inuit from Greenland, Canada, and Alaska. Because immigrant studies have shown that factors acting early in life are important for the development of NPC, the authors interviewed new patients in Greenland with either NPC or SGC about their lifestyles during childhood and additional cases in their families. METHODS: On admission, new patients from Greenland with either NPC or SGC were interviewed about childhood life-style, family size, and other cases of NPC or SGC within the family. Additional cases were confirmed by review of the medical records concerning these patients. RESULTS: During the 11 years from 1980 through 1990, 17 of 63 (27%) cases in Greenland were found in familial clusters among first-degree relatives. There were no differences in the life-styles of multiple-case families and single-case families. CONCLUSIONS: The high rate of familial clusters among natives of Greenland is of interest because EBV is believed to play a role in the origin of these two diseases similar to that of Marek disease in neurolymphomatosis of chickens. Therefore, the familial clustering of NPC and SGC may indicate that an enhanced oncogenic potential of an EBV strain may occur more frequently in Greenland than in other parts of the world.

Adolescent↗
PubMed2002

Asymmetrical spondylolysis.

The objective of this study was to examine examples of spondylolysis in which the pattern of separation was clearly asymmetrical, in order to learn more about the process of bone separation that produces this condition. Although the primary focus was on unilateral complete separation, examples of asymmetry represented by incomplete separation and by complete bilateral separation where the separation sites are in different locations on the two sides were included. Two collections were used, one consisting of Canadian Inuit skeletons curated at the Canadian Museum of Civilization, and the other of 48 individual examples of asymmetrical spondylolysis from sites in a variety of localities curated by several different institutions. The first collection was studied primarily to observe early manifestations of spondylolysis, particularly incomplete separation, while various patterns of asymmetrical complete separation were the focus of the second. The results indicate that asymmetry is part of the earliest osteological picture of spondylolysis, with right-sidedness predominating, a condition perhaps related in some way to handedness. The right-side predominance appears to decrease with age. The ratio of unilateral to bilateral separation ranges from 3-33% in different studies, and a significant number of the unilateral separations have spina bifida occurring in the same vertebra. Overall, the specimens examined here, considered along with clinical cases, nicely illustrate a progression of spondylolysis. A unilateral separation may heal, it may progress to bilateral separation, or it may remain as a permanent condition, producing a pattern of degenerative changes that can include spondylolisthesis. A unilateral healing of bilateral complete separation is likely a rare phenomenon, at least after the separations have reached a certain level of maturity.

Arctic Regions↗
PubMed1986

Dimensional and discrete dental trait asymmetry relationships.

Inuit (Eskimos) from the Foxe Basin region of the Northwest Territories, Canada, were studied to ascertain the amount of dimensional and morphological asymmetry in their dentitions. The results indicate that dimensional asymmetry does not appear to be greater on either the maxillary or mandibular teeth. Both types of asymmetry show partial conformity to the model of tooth fields with an increasing amount of asymmetry as one goes distally in each tooth group. The morphological asymmetry exception, the mandibular incisors, follows Dahlberg's "Field Concept." Rank-order correlations between the amount of dimensional asymmetry and morphological asymmetry reveal no detectable patterns. There appear to be no associations between the presence or absence of morphological asymmetry and the size of the tooth. This lack of association might be explained by differences in developmental timing of tooth dimensions and morphological traits; however, such a hypothesis requires experimental testing. In this population and those for which published results are available, it is practically impossible to overcome the "noise" level and test recent hypotheses regarding random dental asymmetry.

Canada↗
PubMed1999

Cytochrome P450 CYP1A1 enzyme activity and DNA adducts in placenta of women environmentally exposed to organochlorines.

Organochlorine compounds bioaccumulate in fishing and hunting products included in the daily diet of many coastal populations. Prenatal and perinatal exposure to large doses of PCBs and PCDFs was shown to be deleterious on fetal and neonatal development, but information is scarce regarding possible effects of chronic low-dose exposure. This study investigates biomarkers of early effects in newborns from women exposed to organochlorines through the consumption of species from marine food chains, in two remote coastal regions of the province of Quebec (Canada). A CYP1A1-dependent enzyme activity (EROD) and DNA adducts were measured in placenta samples obtained from 30 women living on the Lower-North-Shore of the St. Lawrence River and 22 Inuit women from Nunavik (Arctic Quebec). These biomarkers were also assessed in 30 women from a Quebec urban center (Sept-Iles) as a reference group. Prenatal organochlorine exposure was determined by measuring these compounds in umbilical cord plasma. The amount of bulky polycyclic aromatic hydrocarbon (PAH)-related DNA adducts was significantly greater in the Lower-North-Shore group than in the reference group. Placental EROD activity and the amount of less bulky (OC-related) DNA adducts were significantly higher in the Nunavik group than in the reference group. For both biomarkers, smoking was found to be an important confounding factor. Organochlorine exposure was significantly associated with EROD activity and DNA adduct levels when stratifying for smoking. This study confirms that CYP1A1 enzyme induction and DNA adducts in placental tissue constitute useful biomarkers of early effects induced by environmental exposure to organochlorines.

Analysis of Variance↗
PubMed2005

Diabetes mellitus and impaired fasting glucose in Alaska Eskimos: the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) study.

AIMS/HYPOTHESIS: We aimed to: (1) define the prevalence of type 2 diabetes and IFG in Eskimos in Norton Sound, Alaska; (2) determine correlates of prevalent diabetes in this population; and (3) compare the prevalence of diabetes in the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) Study with other samples of Eskimos, Inuit, American Indians and US blacks, whites and Mexican Americans. METHODS: The GOCADAN Study enrolled 1,214 participants >or=18 years who were members of extended pedigrees from the Norton Sound region of Alaska. Diagnosed type 2 diabetes was based on reported use of insulin or hypoglycaemic medications and a medication inventory. Fasting glucose measurements were obtained to ascertain IFG status and undiagnosed diabetes according to American Diabetes Association (ADA) criteria. OGTTs were performed to ascertain diabetes according to the World Health Organization (WHO) definition. We used logistic regression analysis to model factors that were significantly associated with odds of prevalent ADA diabetes. RESULTS: The prevalences of ADA diabetes and IFG were 3.8% (5.0% of women; 2.2% of men) and 15.6% (13.9% of women; 17.7% of men), respectively. In the subset of 787 participants who took the OGTT, the prevalences of ADA and WHO diabetes were 5.1 and 6.9%, respectively. The adjusted odds of ADA diabetes was 2.8 times higher in participants meeting Adult Treatment Panel III criteria for abdominal obesity than in those who did not. The statistically significant sex-related difference in diabetes prevalence did not persist in multivariable analyses. CONCLUSIONS/INTERPRETATION: Alaska Eskimos have a low prevalence of type 2 diabetes. The high prevalence of IFG indicates that diabetes may become increasingly problematic in this population. Abdominal obesity in women may help explain why diabetes prevalence differs according to sex.

Adult↗
PubMed2000

Human cathepsin S gene (CTSS) promoter -25G/A polymorphism.

We found a novel G-->A change at nucleotide -25 within the promoter of the CTSS gene encoding the elastase cathepsin S. The CTSS -25G/A polymorphism could be detected by digestion with endonuclease BfmI. The frequency of the CTSS -25A allele was 0.457 in Caucasians and 0.431 in Canadian Inuit. Because of the importance of the CTSS gene product in vascular matrix remodeling, this polymorphism may be useful in the study of associations with atherosclerosis and related phenotypes.

Alleles↗
PubMed1986

Arctic trichinosis presenting as prolonged diarrhea.

We describe an outbreak of trichinosis after the consumption of raw walrus meat in 10 Inuit inhabitants of a northern community. During the presentation of the illness, diarrhea was found in all subjects and was the dominant symptom in 8 of the 10 cases. Myalgia (60%) and muscle weakness (50%) were much less prominent complaints. The diarrhea was characteristically prolonged, lasting up to 14 wk (average 5.8 wk), as opposed to comparatively short episodes of myalgia (average 5.4 days) and muscle weakness (average 4.5 days). Prolonged diarrhea with little or no muscle symptomatology in an epidemic form represents a previously unrecognized clinical presentation of trichinosis. It remains to be determined whether this new clinical presentation is related to variant biological behavior of arctic Trichinella, to previous exposure to the parasite, or to other factors.

Adult↗
PubMed1984

Ten year evaluation of a trial of chemoprophylaxis against tuberculosis in Frobisher Bay, Canada.

A trial of chemoprophylaxis to prevent tuberculosis in Canadian Inuit (Eskimos) was carried out in Frobisher Bay, Canada during 1971-1974. A completely supervised regimen of isoniazid and ethambutol thrice weekly for 18 months was administered. A 10-year evaluation of 370 treated persons and 217 control subjects demonstrates the sustained value of adequate chemoprophylaxis in reducing the risk of developing active tuberculosis in the 3 groups under study--1, those with a previous episode of active tuberculosis, 2, positive tuberculin reactors with normal chest X-ray and 3, BCG vaccinated individuals with large tuberculin reactions. There were 3 cases of active disease in the treated group, a risk of 0.1% per annum, and 13 cases among the controls, a risk of 1.0% per annum.

Adolescent↗
PubMed1991

Undifferentiated carcinoma of the salivary gland in Greenlandic Eskimos: demonstration of Epstein-Barr virus DNA by in situ nucleic acid hybridization.

Paraffin sections of 11 undifferentiated salivary gland carcinomas of lymphoepithelioma type (malignant lymphoepithelial lesion) arising in Greenlandic Eskimos (Inuit) were examined for the presence of Epstein-Barr virus (EBV) using in situ nucleic acid hybridization with a 35S-labeled EBV-specific probe. Epstein-Barr virus genomes were detected in each case in malignant epithelial cells, but were not found in lymphoid stroma or in residual benign salivary epithelium. Eight undifferentiated salivary gland carcinomas from non-Eskimo patients (including two with lymphoepithelioma-like features) were negative for EBV-DNA. Our results confirm the existence of a consistent and specific association between EBV and tumor cells of undifferentiated salivary gland carcinoma of lymphoepithelioma type arising in Greenlandic Eskimos.

Carcinoma, Squamous Cell↗
PubMed1994

Unusually high blood cadmium associated with cigarette smoking among three subgroups of the general population, Quebec, Canada.

Blood cadmium levels were measured in 554 persons without any known professional exposure to this metal. They were grouped in three samples; one entirely of 142 Inuit, one of 212 caucasian city dwellers and one of 200 caucasian rural residents. While blood cadmium levels measured in non-smokers are comparable to those reported in published reports, those of current cigarette smokers were 10-20 times higher than non-smokers. These blood cadmium values stand in sharp contrast to what has been published so far and make the average smokers of Canadian-made cigarettes medically unfit for employment in jobs associated with potential cadmium exposure.

Adolescent↗
PubMed1990

Secular trends and the pattern of growth in arctic populations.

Examinations of growth patterns in Arctic populations suggest that Inuit/Inupiat (Eskimo) children display a unique pattern relative to European or continental U.S. children. This pattern--high weight for height--becomes established early in life and it has existed for as long as researchers have Inuit or Inupiat data. This paper will examine the growth pattern relative to the NCHS reference standard, using recent data from the Arctic and several indices combining height and weight. Of particular concern will be the persistence of this pattern in the face of secular trends in growth that have occurred over the past 50 years. Trends for height increase have been greater than those for weight but weight for height still remains well above the 50th percentile of the U.S. reference for these Arctic groups.

Anthropometry↗
PubMed2005

Occult hepatitis B virus infection in a North American community-based population.

BACKGROUND/AIMS: Occult hepatitis B virus (HBV) infection [HBV-DNA detection in hepatitis B surface antigen (HBsAg)-negative individuals] may cause acute and/or chronic liver disease. The objective of this study was to document the prevalence of occult HBV in an isolated, North American Inuit community. METHODS: Four hundred and eighty seven HBsAg negative sera (61% of the community population) were available for HBV-DNA testing by real time PCR. Of these, 80 (Group 1) had serologic evidence of resolved HBV infection and 407 (Group 2) were HBV-seronegative. RESULTS: HBV-DNA was detected in 14/80 (18%) and S-variants in 12/14 (86%) samples from Group 1. In Group 2, HBV-DNA was detected in 33/407 (8.1%) and S-variants in 17/33 (52%). In all cases (Groups 1 and 2) viral loads were low (<10(5) viral copies/ml) and clinical or biochemical features did not distinguish HBV-DNA positive from negative individuals. However, S-variants were more common (P<0.0001) in older age groups. CONCLUSIONS: The results of this study indicate that in this community-based population; (1) the prevalence of occult HBV infection is 18% in those with serologic evidence of previous HBV infection and 8.1% in HBV seronegative individuals, (2) age, gender and liver biochemistry findings do not identify those with occult HBV and (3) S-variants are present in the majority of individuals with occult HBV.

Adolescent↗
PubMed2006

Did the lateral enamel of Neandertal anterior teeth grow differently from that of modern humans?

The formation of lateral enamel in Neandertal anterior teeth has been the subject of recent studies. When compared to the anterior teeth of modern humans from diverse regions (Point Hope, Alaska; Newcastle upon Tyne, England; southern Africa), Neandertal anterior teeth appear to fall within the modern human range of variation for lateral enamel formation time. However, the lateral enamel growth curves of Neandertals are more linear than those of these modern human samples. Other researchers have found that the lateral enamel growth curves of Neandertals are more linear than those of Upper Paleolithic and Mesolithic modern humans as well. The statistical significance of this apparent difference between Neandertal and modern human lateral enamel growth curves is analyzed here. The more linear Neandertal enamel growth curves result from the smaller percentage of total perikymata located in the cervical halves of their teeth. The percentage of total perikymata in the cervical halves of teeth is therefore compared between the Neandertal sample (n=56 teeth) and each modern human population sample: Inuit (n=65 teeth), southern African (n=114 teeth), and northern European (n=115 teeth). There are 18 such comparisons (6 tooth types, Neandertals vs. each of the three modern human populations). Eighteen additional comparisons are made among the modern human population samples. Statistically significant differences are found for 16 of the 18 Neandertal vs. modern human comparisons but for only two of the 18 modern human comparisons. Statistical analyses repeated for subsamples of less worn teeth show a similar pattern. Because surface curvature is thought to affect perikymata spacing, we also conducted measurements to assess surface curvature in thirty teeth. Our analysis shows that surface curvature is not a factor in this lateral enamel growth difference between Neandertals and modern humans.

Animals↗
PubMed2006

Inupiat youth suicide and culture loss: Changing community conversations for prevention.

Inupiat living in Northwest Alaska have one of the highest youth suicide rates in the world. Other circumpolar peoples share this disturbing distinction. This demographic and ethnic health disparity has spurred research that investigates acculturation stress as a cause of Inuit youth suicide. Despite this body of knowledge, few studies describe how local people connect suicide to culture loss, even though this understanding is crucial for developing effective prevention and intervention strategies. This article describes how Inupiat understand and talk about youth suicide and suicide prevention within public settings. I have used participatory action research (PAR) to illuminate the meanings and processes that surround youth suicide. In meetings focused on suicide prevention, local people clearly link self-destruction with historical oppression, loss of the Inupiaq culture and current manifestations of these realities in alcoholism, abuse and neglect. This narrative typically focuses on young people and the Inupiaq community's current failure to lead them to a bright future. The article describes these understandings and offers suggestions to expand them in order to create new possibilities for community-based prevention and the promotion of wellness in circumpolar communities.

Alaska↗
PubMed2000

Organochlorines and heavy metals in pregnant women from the Disko Bay area in Greenland.

Recent studies from Greenland and the Canadian Arctic have shown high concentrations of heavy metals, such as mercury, and organochlorines in the blood and fatty tissue of the Inuit. This is attributed in particular to their high consumption of the meat and blubber of marine mammals. In the present study, 180 pregnant women and 178 newborn babies were studied, amounting to 36% of the total number of births in the Disko Bay area during 1994-1996. The pesticides found in the highest concentrations in maternal blood were DDE (4.8 micrograms/l wet wt.), trans-nonachlor (1.6 micrograms/l) and hexachlorobenzene (1.2 micrograms/l) while the total concentration of PCB (Aroclor 1260) was 19.1 micrograms/l. Calculated on a lipid basis, concentrations were slightly higher in maternal than in cord blood. The mercury concentrations were 16.8 micrograms/l in maternal blood and 35.6 micrograms/l in cord blood. In a linear regression analysis, the concentrations of organochlorines, mercury and selenium increased with maternal age. Concentrations of mercury and cadmium increased with the consumption of marine mammals, and cadmium was associated with smoking. The contaminants are potentially toxic for several organ systems but the high concentrations of pollutants have so far not been shown to influence health in Greenland.

Adult↗
PubMed2000

Comparison of contaminants from different trophic levels and ecosystems.

The present paper provides an overview of the priority contaminants and media from the Greenland part of the Arctic Monitoring and Assessment Program. Levels and accumulation patterns of heavy metals, POPs and a radionuclide (137Cs) are compared from the terrestrial, freshwater and marine ecosystems. Of the nine compounds presented, seven (Cd, Hg, Se, sigma PCB, sigma DDT, sigma HCH, HCB) increased in concentration towards higher trophic levels. For these contaminants the concentrations in soil and aquatic sediment were in the same order of magnitude, whereas the concentrations in marine biota were higher than found in the freshwater and terrestrial ecosystems probably due to the presence of longer food chains. Pb and 137Cs showed the reverse pattern compared with the other compounds. The concentrations in soil and aquatic sediments decreased in the order terrestrial, freshwater and marine ecosystems, which was reflected in the biota as well. Reindeer had similar or lower levels of Pb and 137Cs than lichens. Levels of Pb and 137Cs in marine biota did not show the same clear increase towards higher trophic as found for the other analysed compounds. Greenland Inuit contains considerably less mercury but higher levels of sigma PCB, sigma DDT and HCB than other Arctic marine top consumers.

Animals↗