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PubMed1993

Patterns of patient attendance and dental service utilization in northern Labrador 1985-1989.

The purpose of the present study was to identify patterns of dental patient attendance and service utilization using both epidemiological and service record data from six satellite clinics in Northern Labrador, Canada, between 1985-1989. Baseline attendances were derived for the region from the analysis of 1985-1988 data, the period prior to the introduction of a non-insured health benefit scheme. The results demonstrated that females and persons under the age of 21 years frequented the dentist the most. The effects of this non-insured health benefit scheme introduced in January 1989, was then compared to the baseline pattern of attendance. This dental coverage removed all financial barriers for dental treatment for a population of Inuit origin in this northern area (or 91% of the population). An increase in the uptake of all dental treatments by 10-40%, and a doubling of fillings and denture treatments was observed. About 7% more patients frequented the dentist in 1989. Attendances of the middle-aged and elderly patients increased by 4%. Mean number of appointments per person per year increased from the baseline level of 1.8 to 2.5. The largest increase in population attendances was observed in Hopedale, while Nain remained the community with the best attendance record. No better monthly patterns of attendance were identified for 1989 compared to the baseline. Future studies should continue to evaluate changes in treatment needs, demands and service utilization in the area on a longitudinal basis. There is also a need for more literature on patterns of dental attendances in northern areas.

Adolescent↗
PubMed1995

Residents' assessment of a community-based alcohol initiative in the Canadian Arctic.

This paper evaluated a community-based initiative to control alcohol abuse in the Canadian Arctic by identifying, from an Inuit perspective, what components have been successful in the reduction of alcohol abuse and what components require improvement. Data were collected through interviews with community leaders, supplemented by a broadly-based survey. The most successful strategy in the reduction of alcohol abuse was the imposition of restrictions on the availability of alcohol. Counselling services did to some extent heighten community awareness about the deleterious effects of alcohol misuse, but have had marginal impact on the reduction of abuse. Residents and community leaders involved in running the alcohol program believe that a combination of the establishment of self-help groups, further counsellor training, increased community support, and improved outreach strategies would provide a greater impetus for change leading to the reduction of alcohol abuse within the community.

Adolescent↗
PubMed1977

Lead shot appendicitis in northern native people.

Acute perforated appendicitis due to large numbers of inspissated lead shot occurred in two inuit who hunted and ate game regularly. Both lived in remote villages distant from a hospital.

Appendicitis↗
PubMed1996

Aboriginal health.

OBJECTIVE: To inform health care workers about the health status of Canada's native people. DATA SOURCES: A MEDLINE search for articles published from Jan. 1, 1989, to Nov. 31, 1995, with the use of subject headings "Eskimos" and "Indians, North American," excluding specific subject headings related to genetics and history. Case reports were excluded. Material was also identified from a review of standard references and bibliographies and from consultation with experts. STUDY SELECTION: Review and research articles containing original data concerning epidemiologic aspects of native health. Studies of Canadian populations were preferred, but population-based studies of US native peoples were included if limited Canadian information was available. DATA EXTRACTION: Information about target population, methods and conclusions was extracted from each study. RESULTS: Mortality and morbidity rates are higher in the native population than in the general Canadian population. The infant mortality rates averaged for the years 1986 to 1990 were 13.8 per 1000 live births among Indian infants, 16.3 per 1000 among Inuit infants, and only 7.3 per 1000 among all Canadian infants. Age-standardized all-cause mortality rates among residents of reserves averaged for the years 1979 to 1983 were 561.0 per 100,000 population among men and 334.6 per 100,000 among women, compared with 340.2 per 100,000 among all Canadian men and 173.4 per 100,000 among all Canadian women. Compared with the general Canadian population, specific native populations have an increased risk of death from alcoholism, homicide, suicide and pneumonia. Of the aboriginal population of Canada 15 years of age and older, 31% have been informed that they have a chronic health problem. Diabetes mellitus affects 6% of aboriginal adults, compared with 2% of all Canadian adults. Social problems identified by aboriginal people as a concern in their community include substance abuse, suicide, unemployment and family violence. Subgroups of aboriginal people are at a greater-than-normal risk of infectious diseases, injuries, respiratory diseases, nutritional problems (including obesity) and substance abuse. Initial data suggest that, compared with the general population, some subgroups of the native population have a lower incidence of heart disease and certain types of cancer. However, knowledge about contributing factors to the health status of aboriginal people is limited, since the literature generally does not assess confounding factors such as poverty. CONCLUSIONS: Canadian aboriginal people die earlier than their fellow Canadians, on average, and sustain a disproportionate share of the burden of physical disease and mental illness. However, few studies have assessed poverty as a confounding factor. Future research priorities in native health are best determined by native people themselves.

Canada↗
PubMed1998

Whither dermatology. Thoughts generated after holding a dermatology clinic on Baffin Island.

In February 1998, I spent 3 days at the regional hospital at Iqaluit (Figure 1) on Baffin Island, 2578 km north of New York, NY (Figure 2). Two thirds of the patients here were Inuit, many having been flown in from outposts hundreds of miles away where daily continuing care was provided by nurses, with only occasional visits by physicians. One third of the patients had moderate to severe atopic dermatitis, displaying a great variety of morphological patterns. One tenth had alopecia areata totalis or universalis. About one half could not speak English, and there was no patient information literature available in their language; many believed that I was going to cure them. The challenges that the management of these conditions presented in this population were formidable; the hands-on effort required to care for these patients in a straight-forward and honest manner was great. By the end of several 12-hour days, with a noon break each day to give an in-service lecture, I felt exhausted but satisfied.

Canada↗
PubMed1997

Comparative studies of the CAG repeats in the spinocerebellar ataxia type 1 (SCA1) gene.

The CAG repeat tract at the autosomal dominant spinocerebellar ataxia type 1 (SCA1) locus was analyzed in SCA1 families and French-Acadian, African-American, Caucasian, Greenland Inuit, and Thai populations. The normal alleles had 9-37 repeats, whereas disease alleles contained 44-64 repeats. The CAG repeat tract contained one or two CAT interruptions in 44 of 47 normal human chromosomes and in all five chimpanzees examined. In contrast, no CAT interruptions were found in Old World monkeys or expanded human alleles. The number and positions of CAT interruptions may be important in stabilizing CAG repeat tracts in normal chromosomes. At least five codons occupy the region corresponding to the polyglutamine tract at the SCA1 locus in mice, rats, and other rodents. They comprise three or four CCN (coding for proline) in addition to one or two CAG repeats.

Amino Acid Sequence↗
PubMed1988

Piebaldism-Waardenburg syndrome: histopathologic evidence for a neural crest syndrome.

Piebaldism, an autosomal dominant trait, is characterized by patchy hypopigmentation of the face, anterior chest, abdomen, and limbs, heterochromia/bicolored irises, congenital megacolon, and deafness. A 4-month-old Inuit (Eskimo) boy with these manifestations also had left pulmonic artery stenosis, ocular ptosis, and unilateral duplication of the renal collecting system. Evidence is presented for both qualitative and quantitative derangement of neural crest derivatives in this syndrome. Histologically, hypoganglionosis, hyperganglionosis, and ectopic ganglia in lamina propria (neuronal colonic dysplasia [NCD]) were documented in the rectum. The appendix, proximal to the clinical transition zone, showed similar dysplasia. In the hypopigmented skin, multiple microscopic sections were devoid of melanocytes, with no melanin in adjacent basal cells. The hyperpigmented skin contained melanin throughout the basal layer, but the melanocytes were unevenly distributed. Most tissues affected in this boy are of neural crest origin; pathogenesis could be due to faulty migration along the established pathways involving either the borders (basal laminae) or the components of the extracellular matrix (fibronectin, cytotactin, laminin, glycosaminoglycans, and collagen). The similarities between piebaldism and the Waardenburg syndromes are discussed.

Abnormalities, Multiple↗
PubMed1988

Immunoglobulin (GM and KM) allotypes and relation to population history in native peoples of British Columbia: Haida and Bella Coola.

Differences in the frequencies of GM haplotypes among native peoples of the Americas support the hypothesis that there were three distinct waves of migration from northeast Asia into the Americas: Paleo-Indian, Na-Dene, and Inuit (Eskimo)-Aleut (Salzano and Steinberg: Am. J. Hum. Genet. 17:273-279, 1965; Sukernik and Osipova: Hum. Genet. 61:148-153, 1982; Williams et al.:Am. J. Phys. Anthropol. 66:1-19, 1985; Szathmary: In R Kirk and E Szathmary (eds): Out of Asia: Peopling of the Americas and the Pacific. Canberra: The Journal of Pacific History, Canberra Australian National University, pp. 79-104, 1985). We studied GM allotypes in two linguistically unique populations of Canadian west coast native peoples, the Haida and the Bella Coola, and compared them to GM frequencies in populations that are supposed descendants of the three migrations, in order to investigate the possible genetic relationships of these British Columbia (BC) groups to other native populations. We also estimated the amount of European admixture from the frequency of the Caucasian haplotype, Gm3;5. Results showed that the frequencies in both BC populations of the three common native haplotypes (Gm1,17;21, Gm1,2,17;21, and Gm1,17;15,16), were intermediate between the frequencies in supposed descendants of Paleo-Indian and Na-Dene. These genetic findings are consistent with the controversial hypothesis of archeologist C. Borden (Science 203:963-971, 1979) that, following deglaciation about 13,000 years ago, British Columbia was repopulated by peoples from the north (?Na-Dene) and by culturally distinct peoples from the south (?Paleo-Indian). Caucasian admixture estimates suggested that the Haida and Bella Coola have also experienced moderate amounts (12-20%) of genetic input from European-originating peoples.(ABSTRACT TRUNCATED AT 250 WORDS)

British Columbia↗
PubMedDate not supplied

Population genetics of factor V Leiden in Europe.

We have analyzed 5971 control individuals originating from 26 geographically defined populations in Europe and neighboring countries for the presence of factor V Leiden, an important genetic risk factor in venous thromboembolism. The mean frequency of the mutation in the populations studied is 0.027%, with a peak value incidence of more than 12% in Cyprus; the mutation is absent in Inuits and is at low incidence in French Basques. A west to east increasing cline of allele factor V Leiden prevalence (r = 0.479, p < 0.02) was observed in Europe, together with a decreasing south to north cline (r = -0.801, p < 0.001) of these values-but in this last situation only when southwest populations are excluded from the analysis. Based on these findings, an interpretation is proposed of the history of factor V Leiden expansion in Europe during the Neolithic period, from a probable Anatolian center of origin in Turkey.

Europe↗
PubMed1999

Fish consumption and contaminant exposure among Montreal-area sportfishers: pilot study.

A 1995 pilot study assessed sport fish consumption and contaminant exposure among Montreal-area residents fishing the frozen St. Lawrence River. Interviews conducted among 223 ice fishers met on-site were used to create an index of estimated exposure to fish-borne contaminants. A second-stage assessment of sport fish consumption and tissue contaminant burdens included 25 interviewees at the highest level of estimated contaminant exposure (of 38, or 66% of those solicited) and 15 low-exposure fishers (of 41, or 37% of those solicited). High-level fisher-consumers reported eating 0. 92+/-0.99 sport fish meals/week during the previous 3 weeks compared to 0.38+/-0.21 (P<0.05) for the low-level group. Based on the product of consumption frequency times mass of sport fish meals consumed, high-level consumers ate a mean of 18.3 kg of sport fish annually versus 3.3 kg for the low-level consumers. Tissue contaminant assessments showed significant (P<0.05) groupwise differences: 0-1 cm hair mercury (median 0.73 microgram/g for the high versus 0.23 microgram/g for the low group), lipid-adjusted plasma PCB congeners (Aroclor 1260: median 0.77 microgram/g versus 0.47 microgram/g), and lipid-adjusted plasma DDE (median 0.35 microgram/g versus 0.26 microgram/g). No participant had a hair mercury or plasma DDE concentration above Health Canada recommendations but 2/25 high-level participants (8%) had plasma Aroclor 1260 concentrations above recommended limits. The results of this pilot study suggest that a small number of Montreal-area sportfishers consume their catch as often as three times weekly and that those consuming sport fish frequently have significantly higher tissue levels of mercury, PCBs, and DDE than do infrequent consumers. On the other hand, compared to other groups in Quebec, such as the Inuit or commercial fishers on the North Shore of the Gulf of St. Lawrence, Montreal-area sportfishers eat less fish and have lower tissue concentrations of fish-related contaminants.

Adult↗
PubMed1995

P1 blood group antigen expression and epidemic hemolytic uremic syndrome.

P1 blood group positivity has been postulated as a host factor which may provide protection against the development of post-enteropathic hemolytic uremic syndrome (HUS). In this study, blood group status in 20 Inuit survivors of Escherichia coli O157:H7-associated HUS was compared with age- and sex-matched controls from the same community who had experienced uncomplicated diarrheal illness due to the same pathogen. Of 20 HUS survivors, 6 were P1 antigen positive compared with 8 of the 20 controls (P = 0.7). We conclude that P1 antigen positivity was not protective against HUS in this population. Further studies of this condition to clarify the role of host factors in verotoxin-induced endothelial damage are indicated.

Aged↗
PubMed1994

Cardiac tamponade as a terminal event in the hemolytic uremic syndrome in childhood.

The case of a 6-year-old Inuit female with the epidemic form of hemolytic uremic syndrome (HUS) with myocardial involvement and probable cardiac tamponade is presented. This case illustrates the multisystemic nature of the syndrome, and to our knowledge, cardiac tamponade as a probable terminal event in HUS has not been reported previously.

Cardiac Tamponade↗
PubMed1994

Fish oil and the prevention and regression of atherosclerosis.

Epidemiological studies in the seventies have put forward that dietary rather than genetic factors are responsible for the lower incidence of ischemic heart disease in Greenland Inuit and have generated a large body of both in vitro and in vivo experimental studies, exploring the putative favorable effects of fish (oil) on atherogenesis and its risk factors. The first part of this report reviews the in vivo animal studies, concentrating on the hypercholesterolemic models and the arterialized vein graft model. In the hypercholesterolemic animal studies, the results are inconclusive as the studies reporting a protective effect are matched by the number of studies showing no effect or an adverse effect. The diversity in species, dose of fish oil, duration of study, type of vessel studied and type of fish oil preparation (content of n-3 fatty acids, unesterified n-3 fatty acids, ethylesters or triglycerides) could all contribute. Furthermore, the definitions and criteria used in the literature to evaluate atherogenesis are diverse and it appears that while one parameter is affected, another is not necessarily modified in the same direction, stressing the importance of extending the analysis of the effects on atherogenesis to more than one parameter. We also believe that it is time to reach a consensus as to which animal model mimics most closely a particular human situation. Only in appropriate models, investigating more than one atherosclerosis variable, can the effects of a putative anti-atherogenic drug or diet be verified. In the veno-arterial autograft model, mimicking the patient after coronary bypass grafting, dietary fish oil has been consistently effective in preventing accelerated graft intima proliferation. It could therefore be of interest to evaluate the effects of fish oil on graft patency in patients after coronary bypass surgery after a period of years. The results from studies on restenosis after percutaneous transluminal angioplasty are also reviewed and it is concluded that the two large scale trials, that are currently underway, might reliably answer the question whether fish oil is effective as a non-pharmacological adjuvants in the prevention of restenosis. Lastly, the studies on the effects of fish oil on the regression of experimental atherosclerosis are reviewed. In view of the small number of studies (i.e., four) investigating the effects of fish oil on the regression of atherosclerosis, it is premature to draw any conclusion, and therefore further experimental work is required.

Animals↗
PubMed1990

The solar wind and human birth rate: a possible relationship due to magnetic disturbances.

Data obtained from the literature on the annual pattern of human conceptions and plasma melatonin at high latitudes indicated that simple annual rhythms do not exist. Instead, prominent semiannual rhythms are found, with equinoctial troughs and solsticial peaks. A prominent semiannual environmental event is the magnetic disturbance induced by the solar wind. The semiannual magnetic disturbances are worldwide, but most pronounced in the auroral zones where the corpuscular radiation enters the atmosphere. Magnetic indices that predominantly reflect these events were obtained from the literature and correlated with the melatonin and conception data. Significant and inverse correlations were found for Inuit conceptions and the melatonin data. The correlations obtained for 48 contiguous states of the United States indicated that only the extreme northern states exhibited this relationship. These data were compared with a previous correlational study in the United States which established that sunshine was correlated with conceptions in the middle latitude and southern states. An hypothesis of dual control by electromagnetic and magnetic energies is proposed: melatonin is a progonadal hormone in humans controlled by both factors, depending on their relative strength. Other studies are reviewed regarding the possible factors involved in determining the annual pattern of human conceptions. Demographic studies of geographic variation in temporal patterns of conceptions, with particular regard to variations of the magnetic fields on the earth's surface, may provide some insight into the efficacy of these different factors.

Birth Rate↗
PubMed2003

Vitamin D insufficiency in Greenlanders on a westernized fare: ethnic differences in calcitropic hormones between Greenlanders and Danes.

We studied the influence of age, gender, latitude, season, diet and ethnicity on plasma 25-hydroxyvitamin D 25 OHD, PTH, 1,25-dihydroxyvitamin D, vitamin D-binding protein, bone-specific alkaline phosphatase, and osteocalcin levels in 46 Greenlanders living in Nuuk (64 degrees N) on a traditional fare (group A), 45 Greenlanders living in Nuuk on a westernized fare (group B), 54 Greenlanders (group C), and 43 Danes (Group D) living in Denmark (55 degrees N) on a westernized fare. Blood specimens were drawn both summer and winter. Vitamin D insufficiency (plasma 25 OHD <40 nmol/l) was common in all four study groups during summer (23-74%) and winter (42-81%). Compared to groups A and D, vitamin D insufficiency was significantly more frequent in groups B and C. In all groups, summer levels of 25 OHD were above winter levels. Multiple regression analysis revealed a significant effect of ethnicity. Compared to Danes, Greenlanders had higher 1,25-dihydroxyvitamin D levels, but lower 25 OHD and PTH levels despite relatively low plasma calcium concentrations. In addition to ethnicity, 25(OH)D levels were influenced by age, season (summer > winter), and diet (a traditional Inuit diet>westernized diet). Ethnic differences exist between Greenlanders and Danes. Our results suggest that Greenlanders may have an inherent lower "set-point" for calcium-regulated PTH release or an enhanced renal 1,25(OH)(2)D production. In addition to ethnicity, age, season, and diet were important determinants of vitamin D status. Changes from a traditional to a westernized fare are associated with a reduced vitamin D status in Greenlanders. Vitamin D supplementation should be considered.

Adult↗
PubMed2002

Results of multiyear international interlaboratory comparison program for mercury in human hair.

Since 1990, Laboratory Services, First Nations and Inuit Health Branch (Health Canada) conducted an interlaboratory comparison program for mercury in human hair. Laboratory Services initiated this program to compare the performance of participating laboratories, analyzing mercury in human hair samples by a variety of analytical methods and instrumental detection techniques. The results of the quality assurance program, which included 31 participants on four continents, are described. Of the participating laboratories, 92% consistently meet QA/QC performance limits for the determination of Hg in human hair. A variety of analytical methods using different digestion and instrumental techniques gave similar results. The most frequently used instrumental techniques were: CV-AA, CV-AFS, and ICP-MS. A summary of results from 24 rounds is provided. The feedback from this program has assisted some laboratories in improving their results and solving some of their analytical problems.

Environmental Exposure↗
PubMed2000

Lymphepithelioma-like carcinoma of the lacrimal gland.

In this report a patient with a lymphoepithelioma (LE)-like carcinoma of the lacrimal gland is described for the first time in the literature. LE-like carcinomas outside the nasopharynx rarely occur in the major and minor lacrimal glands of natives of Greenland, Inuit or natives of southern China. The patient's tumor was extirpated using a Kronlein approach followed by total parotidectomy and modified radical neck dissection on the ipsilateral side after the detection of suspicious lymph nodes by ultrasound transmission. Adjuvant radiochemotherapy with cisplatin and 5-fluorouracil was then carried out. Three years later there is no sign of recurrence. As a result of this case we recommend careful examination of the orbit and lacrimal gland in cases of LE-like cancer with an unidentified primary tumor.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2001

Clinical trial evidence for the cardioprotective effects of omega-3 fatty acids.

The notion that marine omega (w)-3 fatty acids might have beneficial cardiovascular effects was first suggested by epidemiologic studies in Greenland Inuits published in the late 1970s. These simple observations spawned hundreds of other studies, the confluence of which strongly suggests a true cardioprotective effect of w-3 fatty acids. The strongest confirmation has come from the publication of three randomized clinical trials, all of which reported benefits to patients with preexisting coronary artery disease. The most convincing of these was the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico (GISSI)-Prevezione study, in which 5654 patients with coronary artery disease were randomized to either w-3 fatty acids (850 mg/d) or usual care. After 3.5 years, those taking the w-3 fatty acids had experienced a 20% reduction in overall mortality and a 45% decrease in risk for sudden cardiac death. These findings support the view that relatively small intakes of w-3 fatty acids are indeed cardioprotective, and suggest that they may operate by stabilizing the myocardium itself.

Clinical Trials as Topic↗