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At least 721 records · Page 40Linked to original sources
PubMed1986

Q-switched neodymium-YAG laser iridotomy. A field trial with a portable laser system.

The efficacy of a small, portable, battery-operated, Q-switched neodymium-YAG laser with a slit-lamp delivery system was evaluated in a short-term pilot study. Iridotomies were created in 44 Eskimo eyes (23 patients) with occludable angles in Alaska's Kotzebue region. The laser was transported as regular baggage, was used in three villages (utilizing available facilities), and was operational within five minutes. Patent iridotomies were achieved in all eyes and with one pulse in 18 eyes (44%). Complications included transient bleeding from the iridotomy site in 23 eyes (52%), focal corneal opacities in 11 eyes (25%), and a transient immediate postoperative intraocular pressure elevation in nine eyes (20%). This appears to be the first portable laser system that can be used in frontier areas and underdeveloped nations to prophylactically treat pupillary-block glaucoma.

Aged↗
PubMed1987

The prevalence of glaucoma among Eskimos of northwest Alaska.

Data collected during a population-based general ophthalmic prevalence survey among Alaska's northwestern Eskimos were analyzed to determine the prevalence of glaucoma. Of the 1686 Eskimos examined, 11 cases (0.65%) of glaucoma were found, including ten cases of angle closure glaucoma (both chronic and acute forms) and a single case of open angle glaucoma. This indicates the rarity of open angle glaucoma in Eskimo eyes and a reversal of the typical pattern found in the general US population. Narrow angle glaucoma occurred at a rate of 2.65% in Eskimos older than 40 years of age, the prevalence increasing with age in both sexes. Women were afflicted almost four times as often as men, and the sex difference persisted across all age groups. Anterior chamber angles appeared clinically narrower with age and among women. Seventeen percent of all Eskimos older than 50 years had occludable angles by gonioscopy. These findings target older Eskimo women as a group particularly at risk for angle closure glaucoma.

Adult↗
PubMed2000

Asthma and bronchiolitis hospitalizations among American Indian children.

OBJECTIVE: To compare asthma and bronchiolitis hospitalization rates in American Indian and Alaskan native (AI/AN) children and all children in Washington State. METHODS: A retrospective data analysis using Washington State hospitalization data for 1987 through 1996. Patients were included if asthma or bronchiolitis was the first-listed diagnosis. American Indian and Alaskan native children were identified by linking state hospitalization data with Indian Health Service enrollment data. RESULTS: Similar rates of asthma hospitalization were found for AI/AN children older than 1 year compared with all children. In AI/AN children younger than 1 year, hospitalization rates for asthma (528 per 100,000 population; 95% confidence interval [CI], 346-761) and bronchiolitis (2954 per 100,000 population; 95% CI, 2501-3456) were 2 to 3 times higher than the rates in all children (232 per 100,000 population [95% CI, 215-251] and 1190 per 100,000 population [95% CI, 1149-1232], respectively). Hospitalization rates for asthma and bronchiolitis increased 50% between 1987 and 1996 for all children younger than 1 year and almost doubled for AI/AN children younger than 1 year. CONCLUSIONS: American Indian and Alaskan native children have significantly higher rates of hospitalization for wheezing illnesses during the first year of life compared with children of other age groups and races. Furthermore, the disparities in rates have increased significantly over time. Future public health measures directed at managing asthma and bronchiolitis should target AI/AN infants.

Adolescent↗
PubMed2005

Is Pacific race a retinopathy of prematurity risk factor?

BACKGROUND: Black race affords some protection from retinopathy of prematurity (ROP), but more ROP was previously found in another darkly pigmented race, the Alaskan natives. DESIGN: From fall 1989 through summer 2003, all Alaskan infants with a birth weight of 1500 g or less were examined, documenting mother's stated race, prenatal care, and neonatal intensive care unit course. RESULTS: Retinopathy of prematurity was classified as to predefined threshold for peripheral ablative treatment (region of avascular retina and fibrovascular ridge and vessel tortuosity) in 873 infants. Threshold ROP was more prevalent in Alaskan natives (24.9%) and Asians (15.9%) (10% overall), with no significant difference between Alaskan natives and Asians (P = .24). Alaskan native males had more threshold ROP (69%) compared with non-Alaskan native males (51%). Compared with threshold nonnatives, Alaskan native threshold infants had greater birth weights (829 +/- 222 vs 704 +/- 186 g), required less time on ventilation (46 +/- 22 vs 70 +/- 75 days), and progressed to treatment at a younger age (35.5 +/- 2.2 vs 36.2 +/- 2.6 weeks' gestational age) (data are given as mean +/- SD). CONCLUSIONS: In this limited study, we find increased risk of threshold ROP in 2 northern Pacific races. Threshold Alaskan natives had similar or better prenatal and neonatal intensive care unit variables than did threshold nonnatives; however, Alaskan native males were still at a greater risk.

Alaska↗
PubMed1978

Jaundice and breast-feeding among Alaskan Eskimo newborns.

The course, incidence, and severity of neonatal jaundice was studied in 95 Alaskan Eskimo infants. Breast-fed infants had higher bilirubin concentrations than bottle-fed babies. Both groups experienced high bilirubin levels, similar to those previously reported in Navajo and Oriental infants but greater than those observed in whites and blacks. A marked capacity to inhibit hepatic glucuronyl transferase was observed in breast-milk specimens but only partly accounted for the bilirubin differences between breast-fed and bottle-fed Eskimo infants. These data suggest that in some racial groups predisposed to neonatal jaundice, feeding practices significantly alter the course and severity of hyperbilirubinemia.

Alaska↗
PubMed1980

Acute glomerulonephritis and streptococcal skin lesions in Eskimo children.

Poststreptococcal acute glomerulonephritis often follows impetigo and can occur in epidemics. From 1975 through 1977, an epidemic of poststreptococcal acute glomerulonephritis occurred in Alaska. Fifty children required hospitalization, while 25 less seriously ill children were treated as outpatients. Sixty-seven percent of these 75 children had direct evidence of recent skin infections. Serotypes 49-14 and NT-14 were the most common streptococcal isolates. In villages in the epidemic area, approximately 15% of children had impetigo and more than 60% of lesions cultured were positive for group A streptococci. Impetigo rates in the epidemic area were similar to those found in nonepidemic areas. However, the introduction of the nephritogenic streptococcal serotypes not recently present in this population apparently led to the development of the epidemic.

Acute Disease↗
PubMed1994

Trends in asthma-related admissions among American Indian and Alaskan native children from 1979 to 1989. Universal health care in the face of poverty.

OBJECTIVE: To describe changes in asthma-related hospitalizations in Indian Health Service facilities and compare with national trends. DESIGN: Trend analysis. PATIENTS AND SETTING: Hospital discharge records of patients aged 17 years and younger treated by the Indian Health Service between 1979 and 1989. MAIN OUTCOME MEASURES: Patients discharged with asthma as the first listed diagnosis. RESULTS: The rates of asthma-related hospitalizations increased an average of 2.6% (95% confidence interval [CI], 0.1 to 5.2) per year between 1979 and 1989 among American Indian and Alaskan Native children aged 0 to 17 years. The increase was 3.7% among the 0- to 4-year age group (95% CI, 2.0 to 5.5) and 0.3% (95% CI, 0.26 to 0.3) among the 5- to 17-year age group. Boys tended to have a higher rate of increase (4.3% [95% CI, -0.1 to 8.7]) compared with girls (2.6% [95% CI, -0.2 to 5.4]). The rates for any hospitalization decreased during this period for 0- to 4-year-olds (-7.5% [95% CI, -10.5 to -4.5]). Little change was noted in hospitalization rates for lower respiratory tract diseases. Diagnostic transfer from bronchitis/bronchiolitis to asthma could not explain the increase. Both first admission and readmission for treatment of asthma contributed to the increase. Compared with previously published data, 0- to 4-year-old American Indian and Alaskan Native children more closely approximate white children than black children in both rates of hospitalization (1979-1987) and annual percentage increase in hospitalization (1979-1989 for American Indian and Alaskan Native children and 1979-1987 for white and black children) for the treatment of asthma. CONCLUSIONS: American Indian and Alaskan Native children who are cared for by the Indian Health Service have asthma-related hospitalization patterns that are similar to those seen in white children despite having socioeconomic characteristics more similar to those of black children.

Adolescent↗
PubMed1975

Alcoholism as a mental health problem of Native Americans. A review of the literature.

Alcoholism among North American Indians and Eskimos is generally considered a major public health and community mental health problem, and increasingly so. All too often alcoholism and alcoholic (and the simple avoidance of these terms) are used indiscriminantly, obscuring important avenues for serious consideration. A major consideration is the extent to which the heavy drinking so common among indian men corresponds to "alcoholism" in the dominant culture. Considerations of culture stress (deculturative and acculturative) and cultural intoxication-permitting factors are essential in any dynamic formulation of Native Americans' problem drinking. A crucial individual motive is that drunkenness can provide short-cut gratification by providing fantasy solutions to culture-bound problems.

Alcoholism↗
PubMed1997

Pervasive occult gastrointestinal bleeding in an Alaska native population with prevalent iron deficiency. Role of Helicobacter pylori gastritis.

OBJECTIVE: To confirm prevalent iron deficiency among Yupik Eskimos living in Alaska and to explore the frequency of and potential lesions accounting for occult gastrointestinal bleeding. DESIGN: Descriptive survey. SETTING: Rural Arctic community. SUBJECTS: A total of 140 adult volunteers from 3 villages in the Yukon-Kuskokwim Delta region of western Alaska. MAIN OUTCOME MEASURES: Daily iron intake, hematologic and biochemical indexes of iron status, fecal hemoglobin levels, stool parasites, and endoscopic findings. RESULTS: While dietary iron intake by Yupiks was similar to that of a reference population, iron deficiency prevalence was increased 13-fold in Yupik men and 4-fold in Yupik women. Fecal hemoglobin levels were elevated in 90% of subjects contrasted with only 4% of a reference group; median levels were 5.9 and 0.5 mg of hemoglobin per gram of stool, respectively. Among 70 Yupik subjects with elevated fecal hemoglobin levels who had endoscopy performed, 68 (97%) had an abnormal gastric appearance consisting of erythema, mucosal thickening, diffuse mucosal hemorrhages, erosions, or ulcerations. Gastric biopsies revealed chronic active gastritis with associated Helicobacter pylori in 68 (99%) of 69. No other hemorrhagic gastrointestinal disease was detected. CONCLUSIONS: Based on this study sample, occult gastrointestinal bleeding appears to be pervasive in the Yupik population and likely underlies the prevalent iron deficiency. An atypical hemorrhagic gastritis associated with H pylori infection is present almost universally and may represent the bleeding source.

Adult↗
PubMed2001

Acute respiratory tract infections and mannose-binding lectin insufficiency during early childhood.

CONTEXT: Hospital-based studies have found that increased susceptibility to certain infections is associated with low serum levels of mannose-binding lectin (MBL) due to MBL variant alleles. However, the contribution of MBL insufficiency to incidence of common childhood infections at a population level is unknown. OBJECTIVE: To investigate the effect of MBL insufficiency on risk for acute respiratory tract infection (ARI) in unselected children younger than 2 years. DESIGN AND SETTING: Population-based, prospective, cohort study conducted in Sisimiut, Greenland. PARTICIPANTS: Two hundred fifty-two children younger than 2 years who were followed up weekly between August 1996 and August 1998 for morbidity surveillance. MAIN OUTCOME MEASURE: Risk of ARI, based on medical history and clinical examination, compared by MBL genotype, determined from blood samples based on presence of structural and promoter alleles. RESULTS: A 2.08-fold (95% confidence interval [CI], 1.41-3.06) increased relative risk (RR) of ARI was found in MBL-insufficient children (n = 13) compared with MBL-sufficient children (n = 239; P<.001). The risk association was largely restricted to children aged 6 to 17 months (RR, 2.92; 95% CI, 1.78-4.79) while less effect (RR, 1.47; 95% CI, 0.45-4.82) and no effect (RR, 1.00; 95% CI, 0.42-2.37) was shown among children aged 0 to 5 months and 18 to 23 months, respectively. CONCLUSION: These data suggest that genetic factors such as MBL insufficiency play an important role in host defense, particularly during the vulnerable period of childhood from age 6 through 17 months, when the adaptive immune system is immature.

Acute Disease↗
PubMed2004

Long-term efficacy of BCG vaccine in American Indians and Alaska Natives: A 60-year follow-up study.

CONTEXT: The duration of protection from tuberculosis of BCG vaccines is not known. OBJECTIVE: To determine the long-term duration of protection of a BCG vaccine that was previously found to be efficacious. DESIGN: Retrospective record review using Indian Health Service records, tuberculosis registries, death certificates, and supplemental interviews with trial participants. SETTING AND PARTICIPANTS: Follow-up for the period 1948-1998 among American Indians and Alaska Natives who participated in a placebo-controlled BCG vaccine trial during 1935-1938 and who were still at risk of developing tuberculosis. Data from 1483 participants in the BCG vaccine group and 1309 in the placebo group were analyzed. MAIN OUTCOME MEASURES: Efficacy of BCG vaccine, calculated for each 10-year interval using a Cox regression model with time-dependent variables based on tuberculosis events occurring after December 31, 1947 (end of prospective case finding). RESULTS: The overall incidence of tuberculosis was 66 and 138 cases per 100 000 person-years in the BCG vaccine and placebo groups, respectively, for an estimate of vaccine efficacy of 52% (95% confidence interval, 27%-69%). Adjustments for age at vaccination, tribe, subsequent BCG vaccination, chronic medical illness, isoniazid use, and bacille Calmette-Guérin strain did not substantially affect vaccine efficacy. There was slight but not statistically significant waning of the efficacy of BCG vaccination over time, greater among men than women. CONCLUSION: In this trial, BCG vaccine efficacy persisted for 50 to 60 years, suggesting that a single dose of an effective BCG vaccine can have a long duration of protection.

BCG Vaccine↗