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Motorcycle crashes resulting in death and hospitalisation. II: Traffic crashes.

This is the second paper in a series of three that describe the epidemiology of motorcycle crashes in New Zealand that result in death and hospitalisation. The first paper presented an overview of all motorcycle crashes. This paper focuses on traffic crashes. The source of the fatality data was national mortality data files for the years 1978 to 1987 inclusive. The source of the hospitalisation data was the 1988 national morbidity file which records all public hospital discharges in New Zealand. For the period 1978 to 1987, 1,175 fatalities were identified resulting in a mortality rate of 3.5 per 100,000 persons per year. Males aged 15-19 and 20-24 had very high rates (25.2 and 26.4, respectively), especially labourers (40.0) and forestry workers (32). Maori and non-Maori had similar rates. The majority (63%) of the deaths were attributable to a collision with another motor vehicle. During 1988 2,222 motorcyclists were hospitalised giving an incidence rate of 68.1 per 100,000 persons per year. Males aged 15-19 and 20-24 had very high rates (409 and 416, respectively), especially labourers (355). Maori had a higher morbidity rate than non-Maori (99 versus 61). The most common (40%) crash was a collision with another motor vehicle. The most common sites of injury were the lower limb (43%) and head (23%). Collision crashes were more likely to result in lower limb injury, be more severe, and result in longer stays in hospital.

Abbreviated Injury Scale↗

The polarized light microscopy and ultrastructure of Polynesian pigmented tooth enamel.

Transmitted and polarized light microscopy of unerupted and erupted teeth affected by a pigmented anomaly found in two geographically isolated Polynesian populations, the New Zealand Maori and the French Polynesian Marquesas Islander, showed similar histological characteristics. Mounted in water, the pigmented areas were positively birefringent and covered with a thin negatively birefringent surface layer 200-250 microns thick. Cervical areas were negatively birefringent. Transmission electron microscopy of argon-ion-beam thinned specimens of affected enamel revealed large voids, disruption in the packing of crystals and spacing at prism boundaries. In the surface layer of enamel from erupted and unerupted teeth, the intra- and interprismatic spaces were occluded by fine crystals or amorphous material. A well-defined prism structure and close crystal packing were found in cervical enamel. The ultrastructure of these pigmented enamels was similar to and consistent with a hypomaturation type of amelogenesis imperfecta.

Birefringence↗

The protein of pigmented Polynesian dental enamel.

This enamel contained 1.4-3.7% protein, calculated from amino acid residues, in which glutamic acid and leucine were the most generally abundant and lysine was the most abundant basic amino acid. The amino acid profiles of both French Polynesian and Maori pigmented enamel protein were similar and closely resembled that of tuft protein and certain non-amelogenins. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis of extracts of pigmented enamel showed an absence of amelogenin protein and the presence of two principal proteins at M(r) 55,000-66,000, indicating that the protein of pigmented Polynesian enamel was non-amelogenin. This contrasts with hypomaturation amelogenesis imperfecta in which the protein has the amino acid profile of amelogenin.

Adolescent↗

Malignant melanoma in Maoris and Polynesians in New Zealand.

In 1896, Matas was the first to comment on the relative infrequency of malignant melanoma in negroes and this observation has been repeated for all pigmented races (McGovern, 1977a) A review of malignant melanoma in Maoris and Polynesians in New Zealand was performed to see if the above statement was true with respect to the pigmented people of a country with the second highest incidence of the disease in the world (Little et al., 1980).

Adult↗

Unusual presentations of genital tract tuberculosis.

Three cases of genital tract tuberculosis (GTB) are described. This disease is uncommon in developed countries. Patients may present with infertility, non-specific menstrual disturbance, pain or abdominal distention. The genital tract is usually infected by hematogenous spread from a distant focus, with the fallopian tubes most commonly involved. Diagnosis is often made retrospectively, and once confirmed medical management is the mainstay of treatment. Future fertility is doubtful in these patients.

Adult↗

Hyperlipemia and arteriosclerotic cardiovascular disease in the Polynesian population of Rarotonga.

Total cholesterol, total triglyceride and high density lipoprotein (HDL) cholesterol and their relation to arteriosclerotic cardiovascular disease (ASCVD) were investigated in a population of Polynesian Maoris in Rarotonga who are becoming increasingly westernized. 8.5% of the population had plasma triglyceride elevations (triglyceride greater than or equal to 200 mg/dl), and the occurrence of hypertriglyceridemia was significantly higher in males than females. 5.8% of the population had elevations of total cholesterol (cholesterol greater than or equal to 250 mg/dl), and the proportion with elevation of total cholesterol was similar for males and females. 3.2% of the population had elevations of both triglyceride and cholesterol. HDL cholesterol concentrations were relatively low, and no sex differences were observed at any age. Analysis of lipoprotein cholesterol and triglyceride in a subset of those who had hyperlipemia indicated that the elevations of total cholesterol and triglyceride were mainly due to elevations of low density lipoprotein (LDL) cholesterol and very low density lipoprotein (VLDL) triglyceride, respectively; furthermore, elevations of VLDL triglyceride and LDL cholesterol were significantly correlated with increase in VLDL apolipoprotein B (apo B) and LDL apo B, respectively. Although an appreciable prevalence of diabetes was observed in this population (male: 6.7%, female: 8.4%), the diabetes could not account for the hyperlipemia. Among 693 subjects between the ages of 30 and 59 years, approx. 3% of males and 1% of females had Q-wave changes, and 16% of females and 4% of males had ST-T changes. Among males with Q-wave abnormalities, hyperlipemia was more frequent. There was also increased frequency of hypertension in those with elevated lipids. The data indicate the occurrence of some hyperlipemia in this population which could be of the familial-combined type; the elevated plasma lipids may contribute to the increased frequency of coronary heart disease.

Adult↗

Elevation of systolic and diastolic blood pressure associated with migration: the Tokelau island migrant study.

Cross-sectional univariate and multivariate analyses estimated differences between the blood pressure of adult Tokelauan migrants to New Zealand and non-migrants still living on three Polynesian atolls. Response rates were 97 and 99% in the two locations. Among males, the difference between migrants and non-migrants after adjustment for significant covariates was 7.2 mmHg systolic pressure (p less than 0.001) and 8.1 mmHg diastolic pressure (p less than 0.001). Among females, adjusted systolic pressure was not significantly higher in migrants compared to non-migrants (1.8 mmHg, p = 0.065) and diastolic pressure was only 3.0 mmHg higher (p less than 0.001). Body mass is significantly correlated with blood pressure in this study group; nonetheless, differences in body mass explain only a small proportion of the observed migrant/non-migrant differential in blood pressure. Estimates of blood pressure differences preceding migration are also reported. These indicate that blood pressure was neither consistently nor significantly higher among those who subsequently migrated. This report provides compelling evidence linking Westernization and the development of chronic disease.

Adolescent↗

The use of a free connective tissue graft to increase the width of attached gingiva.

Various techniques have been employed for increasing the width of keratinized gingiva. In recent years free gingival grafting has been shown to produce more predictable results than previous methods. Wound-healing studies, however, have shown that the surface epithelium of free gingival grafts degenerates and re-epithelizes by cells proliferating from adjacent tissues. In addition, the donor site is left to heal by secondary intention and requires a dressing for 10 to 14 days. Most studies on epithelial-mesenchymal interactions support the concept that epithelium differentiates under the influence of stimuli from the underlying connective tissue. If this is so, then grafting of gingival connective tissue alone should induce keratinization in the proliferating epithelium. A case is presented which illustrates this principle. The graft effectively increased the width of keratinized gingiva. The donor site healed by primary intention, and no dressing was needed.

Adult↗

Comparison of immunoglobulin G enzyme-linked immunosorbent assay (IgG-ELISA) and haemagglutination inhibition (HI) test for the detection of dengue antibodies. Prevalence of dengue IgG-ELISA antibodies in Tahiti.

An immunoglobulin G enzyme-linked immunosorbent assay (IgG-ELISA) for the detection of dengue antibodies is described and compared to the haemagglutination inhibition test (HI). The sensitivity, specificity and agreement rate between the 2 techniques were good. The coefficients of correlation between IgG-ELISA and HI results, using dengue 1-4 antigens, were highly significant (P less than 0.001 for either antigen). IgG-ELISA was rapid, and easy to perform and suitable for large-scale studies. Between April and June 1987, a baseline serosurvey of the prevalence of dengue antibodies in age-stratified samples of children was carried out in Tahiti using IgG-ELISA. 327 children were tested against each dengue serotype. There was no significant difference between sex. Overall rates ranged from 7.4% in children under 5 years to 83.1% in those aged 15-19 years. Dengue 4 being the only serotype involved since 1979, specific responses to dengue 4 were found in higher proportion among children under 8 years old, while the IgG-ELISA responses were more widely reactive among children aged above 8 years (P less than 0.001). The acquisition rate of dengue 4 antibodies was 2.95% on average per year in children under 8 years of age.

Age Factors↗