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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↗
PubMed1996

Spondylolysis of the sacrum in Alaskan and Canadian Inuit skeletons.

Spondylolysis of the lower back, particularly that involving the isthmus between the superior and inferior articular processes (pars interarticularis), is generally attributed to stress fracturing caused by movement of the affected vertebra relative to the vertebra below. The finding of isthmic spondylolysis in the first vertebra of a fused sacrum is thus unusual and requires explanation. Although unrepresented in the clinical literature, sacral spondylolysis has been reported for archaeological specimens and appears to be especially prevalent in North American Inuit. A study of 373 Inuit sacra from Alaska and Canada produced 16 examples of spondylolysis (eight from each area). All but one of the affected individuals were male, and nearly all were young adults, many between 18 and 20 years of age. All cases of sacral spondylolysis observed in this study were judged to have resulted from stress fracturing that occurred while S1 was still unfused, and most appear to have been in the process of healing, following fusion of S1 with S2, when death occurred. The high frequency observed in these people is attributed to unusual stresses becoming concentrated in the lower back of adolescent males due to such activities as weight lifting, wrestling, kayak paddling, and harpooning, combined with, and perhaps even contributing to, delayed maturation (S1-S2 fusion) of the sacrum.

Adolescent↗
PubMed1998

Skeletal evidence of health and disease in pre-contact Alaskan Eskimos and Aleuts.

There have been relatively few paleopathological studies of arctic populations to date, compared to other regions of North America. Studies aimed at elucidating patterns of health and disease in arctic peoples prior to contact and assessing inter- and intraregional differences in disease patterns have been particularly few. In the present study, five pre-contact skeletal samples (N = 193), representing 4 Eskimo populations from northern coastal Alaska and 1 Aleut population from the eastern Aleutian Islands, were examined macroscopically for the following indicators of health status: cribra orbitalia, porotic hyperostosis, trauma, infection, dental caries, abscesses, antemortem tooth loss, periodontal disease, and dental attrition. In addition, archeological and epidemiological data were used to help reconstruct the health of these populations. The goals of the analysis were 2-fold: 1) to assess the pre-contact health of North Alaskan Eskimos and Aleuts in order to provide a baseline comparison for the post-contact health of these groups, and 2) to determine if any differences in disease patterns exist between the Eskimos and Aleuts that might be related to differences in their physical environment, subsistence patterns, and cultural practices. The analysis revealed that both groups suffered from a variety of health problems prior to contact, including iron deficiency anemia, trauma, infection, and various forms of dental pathology. Statistical comparisons of the 2 groups revealed that Eskimos and Aleuts had different patterns of health and disease prior to contact. Most notably, the Aleuts had a significantly higher frequency of cranial trauma and infracranial infection than the Eskimos, while the latter had a significantly higher frequency of enamel hypoplasia. An examination of the physical and cultural environment of the 2 groups reveals several possible explanations for these differences, including warfare, subsistence pursuits, and housing practices. The documentation of these differences indicates that variability in pre-contact disease patterns can be identified between hunter-gatherer populations living in similar environments and exhibiting similar general lifestyles.

Alaska↗
PubMed1998

Patterns of cancer mortality among Native Americans.

BACKGROUND: Native Americans have been reported to have lower cancer incidence and mortality than other racial groups in the U.S., although some have questioned whether this was due to racial misclassification. This study provides improved estimates of cancer mortality, determined from a sampling of people who live on Indian reservations. METHODS: The authors reviewed death certificates from U.S. counties that contain Indian lands, excluding certain areas with known problems of racial misclassification. Age-adjusted mortality rates for specific types of cancer were calculated using U.S. Census population figures, and these rates were compared with rates for all races in the U.S. RESULTS: This sample included 38% of the American Indian and Alaska Native populations. The age-adjusted annual mortality rate for all cancers combined was 148.2 per 100,000 for both genders, 133.1 for females, and 167.2 for males. The rates for males and for both genders combined, but not for females, were significantly lower than the U.S. rates for all races (P < 0.05). Females had significantly lower rates of death from carcinoma of the lung and breast and significantly higher rates of death from carcinoma of the cervix and gallbladder (P < 0.05). Males had significantly lower rates of death from carcinoma of the lung, colon, and prostate, and significantly higher rates of liver carcinoma. Both genders combined had significantly lower rates of death from lung and colon carcinoma and significantly higher rates of death from stomach, liver, kidney, and gallbladder carcinoma. Geographic differences were substantial, with the Northern and Plains regions experiencing much higher mortality from lung, colon, and breast carcinoma than the Southwest region. CONCLUSIONS: Compared with the general U.S. population, Native Americans experience quite different patterns of cancer mortality. Cancer prevention and control programs should be designed specifically for this minority population.

Alaska↗
PubMed2000

Urban native American health issues.

BACKGROUND: This article presents an overview of urban-dwelling American Indians and Alaska Natives, including a summary of data issues and a brief overview of historical and related social changes resulting in migration from reservations to urban areas. METHODS: A literature search was performed and documented focus groups were held; in addition, Native Sisters' field records from Los Angeles, California, and Denver, Colorado, were reviewed. RESULTS: Urban Indian communities are intertribal and represent over half of the Native American population in the U.S., yet they lack access to sufficient health services. Urban Indian clinics are greatly underfunded. CONCLUSIONS: A greater proportion of funding needs to be allocated to community-driven, culturally respectful, multiyear behavioral research to improve the screening, treatment, and survival of American Indian women with breast carcinoma.

Alaska↗
PubMedDate not supplied

Common set of genes regulates low-density lipoprotein size and obesity-related factors in Alaskan Eskimos: results from the GOCADAN study.

Increasing incidence of cardiovascular disease in traditionally low-risk Alaskan Eskimos is a cause for concern. The purpose of this study was to examine the genetic and environmental correlations of low-density lipoprotein (LDL) subfractions with obesity-related factors in Alaskan Eskimos, using data from the first 954 participants of the Genetics of Coronary Artery Disease in Alaska Natives Study. Estimates of genetic and environmental influence were calculated using a maximum likelihood variance component method implemented in SOLAR. Mean values of weight, body mass index (BMI), and waist were 73.4 +/- 0.5 kg, 27.6 +/- 0.2 kg/m2, and 88.0 +/- 0.4 cm, respectively. LDL, and its small (LDL1), medium (LDL2), and large (LDL3) subfractions, had mean values of 115.8 +/- 1.2 mg/dl, 8.3 +/- 0.4 mg/dl, 19.6 +/- 0.8 mg/dl, and 71.5 +/- 1.5 mg/dl, respectively. Bivariate analysis displayed significant genetic correlations between LDL subfractions and obesity-related factors: LDL1 with BMI (rhoG = 0.67, P < 0.05), waist (rhoG = 0.80, P < 0.001), and subscapular and tricep skinfolds (rhoG = 0.93, P < 0.005, and rhoG = 0.78, P < 0.05, respectively); LDL2 with BMI (rhoG = 0.52, P < 0.05), waist (rhoG = 0.46, P < 0.05), and tricep skinfold (rhoG = 0.60, P < 0.05); and mean LDL size with BMI (rhoG = -0.36), waist (rhoG = -0.42,), and subscapular and tricep skinfolds (rhoG = -0.44 and -0.43, respectively) (P < 0.005). These results show that a common set of genes is influencing LDL size and obesity-related factors in Alaskan Eskimos.

Adolescent↗
PubMed1981

Population structure of Alaskan and Siberian indigenous communities.

Genetic data consisting of 14 red cell antigen groups and 11 serum and erythrocytic protein marker systems from four Eskimo populations of the Norton Sound area of Alaska are reported. The population structure of these four groups in analyzed both separately and within the larger context by comparison to 15 other circumpolar groups. These analyses reveal a good fit between genetic structure, geographic distribution, linguistic affiliation, and the ethnohistory of the region.

Alaska↗
PubMed1989

The genetic structure of populations of Chuckotka Peninsula Eskimos and Chuckchi based on study of 13 loci of serum and erythrocyte proteins and enzymes.

The Eskimos and Chuckchi of the Chuckotka Peninsula were studied at 13 loci of serum and erythrocyte proteins and enzymes by electrophoresis. Six loci-including albumin, transferrin, carbonic anhydrase I and II, monoamine oxidase, and superoxide dismutase-were monomorphic in the studied populations. The mean frequencies of alleles in nine polymorphic loci of Chuckotka Eskimos and Chuckchi, Eskimos of Alaska, Canada, and Greenland, some Mongoloid populations of Siberia, American Indians, and Lapps of circumpolar areas of Western Europe were obtained. The genetic distances between these populations were calculated. The Eskimos of Chuckotka were closest to the Alaskan Eskimos. The relative heterozygosity of Chuckotka Eskimos was calculated and was the highest in Chuckchi. The average heterozygosity in Eskimo populations increased in the following order, from least to greatest: Chuckotka Eskimos, St. Lawrence Island Eskimos, Alaskan Eskimos, Greenland Eskimos, and Canadian Eskimos. The average heterozygosity of the Chuckchi was similar to that of Western Hemisphere Eskimos.

Alaska↗
PubMed2006

The "Spirit of Eagles" legacy.

American Indians and Alaska Natives (AI/ANs) suffer from inordinate morbidity and mortality from various cancers. The Spirit of Eagles is a national Special Populations Network that has developed the community infrastructure to support culturally appropriate, long-range, comprehensive cancer control activities. Subcontracts were developed that involved major cancer centers, nonprofit organizations, policy boards, professional societies, and educators. Community-based cancer control grants were distributed through the Spirit of Eagles program. Community-based participatory research involved 38 communities in a broad range of cancer control activities. The key to long-range improvement in cancer morbidity and mortality in AI/AN communities lies in building infrastructure to support strong partnerships enabling community-based participatory research. Cancer 2006. (c) 2006 American Cancer Society.

Alaska↗
PubMed2005

Technology and managed care: patient benefits of telemedicine in a rural health care network.

Rural health providers have looked to telemedicine as a technology to reduce costs. However, virtual access to physicians and specialists may alter patients' demand for face-to-face physician access. We develop a model of service demand under managed care, and apply the model to a telemedicine application in rural Alaska. Provider-imposed delays and patient costs were highly significant predictors of patient contingent choices in a survey of ENT clinic patients. The results suggest that telemedicine increased estimated patient benefits by about $40 per visit, and reduced patients' loss from rationing of access to physicians by about 20%.

Adolescent↗
PubMed1989

Hepatitis B-associated polyarteritis nodosa in Alaskan Eskimos: clinical and epidemiologic features and long-term follow-up.

We analyzed the demographic, clinical, laboratory and histologic features of 13 patients who were diagnosed as having polyarteritis nodosa associated with hepatitis B virus infection over a 12-year period, 1974 to 1985. All 13 patients were Yupik Eskimos and resided in southwest Alaska, an area hyperendemic for hepatitis B virus infection. The annual incidence of hepatitis B virus-associated polyarteritis nodosa for this population is 7.7 cases per 100,000 population. All patients presented with multisystem disease, and all had biopsy or angiographic findings consistent with polyarteritis nodosa. All 13 were positive for hepatitis B surface antigen and hepatitis B e antigen at diagnosis. Two untreated patients and two of five patients who received corticosteroids died, vs. none of six who received corticosteroids plus cyclophosphamide. None of the patients who survived the initial bout of polyarteritis nodosa has relapsed after a mean follow-up of 55 months, but all have become chronic HBsAg carriers. In eight patients, clinical or serologic evidence indicated that polyarteritis nodosa followed recent hepatitis B virus infection. We concluded that hepatitis B virus-associated polyarteritis nodosa is a serious, life-threatening complication that occurs early in the course of hepatitis B virus infection, is ameliorated by immunosuppressive therapy and can be prevented by hepatitis B vaccine.

Alaska↗
PubMed1985

Prevalence of HTLV-I in Arctic regions.

Sera of native inhabitants of Arctic regions were assayed for antibodies to HTLV-I by the ELISA technique followed by competition experiments to confirm antibody specificity. Residents of 7 widely separated Alaskan villages exhibited prevalence rates of 0 to 12% for HTLV-I antibodies. Less than 1% of Greenland Eskimos were HTLV-I antibody-positive. Residents of 3 northern Swedish regions ranged in HTLV-I antibody prevalence from 0 to 5%. Sera of healthy native inhabitants of Alaska and northern Sweden were similarly assayed for antibodies to HTLV-II. No additional sera were shown to be positive for HTLV-II antibodies. While some of the HTLV-I antibody-positive sera exhibited cross-reactivity with HTLV-II antigens, competition experiments using disrupted HTLV-II or purified HTLV-I p24 as test antigens indicated that the primary antibody response in all cases tested was elicited by HTLV-I. Our results show that HTLV-I distribution is not restricted to endemic areas in warm, humid climates, but extends to Arctic regions. Within these regions, HTLV-I exhibits the same restricted distribution seen in other areas where virus infection is prevalent. The Arctic does not seem to be a reservoir for HTLV-II infection. The origin of HTLV-I in Arctic areas is not known. One may speculate that foreign visitors introduced the virus into Aleut and Lapp populations, and that it has been maintained there and restricted in its distribution as a result of close familial relationships.

Adolescent↗
PubMed1990

Comparison of enzyme immunoassay with radioimmunoassay for the detection of antibody to hepatitis B core antigen as the only marker of hepatitis B infection in a population with a high prevalence of hepatitis B.

Enzyme immunoassay (EIA) and radioimmunoassay (RIA) for the detection of antibody to hepatitis B core antigen (anti-HBc) were compared using serum specimens from Alaska Natives screened during a hepatitis B control program that were initially positive by EIA for only anti-HBc. Of 36 specimens from persons previously HBsAg positive but who were now only anti-HBc positive by EIA, 94.4% were anti-HBc positive by both assays, with anti-HBc levels exceeding 93% inhibition. Low-level antibody to hepatitis B surface antigen (anti-HBs) (less than 10 SRU) and antibody to hepatitis Be (anti-HBe) were also present in 50% and 48% of specimens positive for anti-HBc, respectively. Of 148 specimens from persons initially positive for only anti-HBc by EIA who had no previous documentation of any hepatitis B virus (HBV) infection, 64.5% were positive by repeat testing for anti-HBc by both assays, and anti-HBc levels in this sample exceeded 70% in 91.6% and 80.2% of specimens by EIA and RIA, respectively. Low-level anti-HBs and anti-HBe were present in 45.8% and 15.6%, respectively. EIA detection of anti-HBc was found to be less specific than RIA. Of specimens positive for anti-HBc by EIA, 14.8% were negative by RIA. The specificity of the EIA could be improved with respect to RIA by increasing the cut-off from 48% to 68%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Individualized services for children.

In Alaska, the development of a model of individualized services has been beneficial to children with neurobiological disorders. The AYI program has successfully demonstrated that even the most disabled children can be served in communities. This finding promotes a new level of less restrictive and more therapeutic alternatives tailored to the needs of children and their caring families.

Adolescent↗
PubMed1982

On the meaning of sports: cross cultural observations of super stress.

The definition of sports medicine indicates the possible therapeutic and research importance of games in the work of social scientists and clinicians. A cross-cultural comparison of super stressful competitions provides one insight into the importance of games in human societies. Fourteen such comparisons are made between Indians in Mexico who run 250-mile foot races and Americans in Alaska who conduct 1049-mile dog sled races. It is concluded that sports can help understand how a society defines itself and regulates violence. Games may be an essential "human-specific' need which provide entertainment, retain survival skills, ameliorate existential anxiety and promote religious and/or secular socialization. In this study, humans seem willing, if not insistent, to deploy considerable resources of time and material to sustain competitions among their own species, as well as between and with other species. A "sports history' is important for all individuals.

Adolescent↗
PubMedDate not supplied

Comorbidity: meaning and uses in cross-cultural clinical research.

American Indians and Alaska Natives were the subject of a workshop sponsored by the National Institute of Mental Health and the Indian Health Service. Comorbidity of anxiety, depression, and substance abuse is highly prevalent in these two populations, and this was the focus of the meeting. This paper introduces the topic of psychiatric comorbidity, and considers the topics of culture, psychiatric diagnosis, and assessment. Future research directions and a brief summary of the papers presented at the workshop, which are included in this issue, are provided.

Alaska↗
PubMedDate not supplied

Primary angle-closure glaucoma among Alaskan Eskimos.

An epidemiological study of the occurrence of angle-closure glaucoma was made under the Eskimos population of the Norton Sound and Bering Straits region of Alaska. Among 1673 Alaskan Natives examined 14 cases (0.8%) of angle-closure glaucoma were found, in 0.5% of the men and 1.2% of the women; for persons above the age of 40 years these figures were 2.1% and 5.5% respectively. Angle-closure glaucoma was found in 11.8% of women above the age of 60 years. A shallow anterior chamber was seen twice as frequently in women as in men. Above the age of 30 years the chamber angle was considered to be occludable in 2% of men and 7.5% of women on gonioscopic examination. The average intra-ocular pressure of the right eyes of men was 11.7 mm Hg (s.d. 3.3) and of women 12.0 mm Hg (s.d. 3.4). Primary open-angle glaucoma was not seen in the population being studied.

Adolescent↗
PubMed1995

Metachromatic leukodystrophy among southern Alaskan Eskimos: molecular and genetic studies.

Metachromatic leukodystrophy (MLD) is an autosomal recessive disorder resulting from the inability to metabolize sulphatide, an important component of myelin. Although there is significant clinical variability between patients, most have the late-infantile form. It is one of the most common lysosomal disorders involving mental deterioration and is found throughout the world. The great majority of the cases have a deficiency of arylsulphatase A activity. Accurate diagnosis of MLD is complicated by the presence of so-called pseudodeficiency alleles and the need to receive specimens for biochemical testing within 24-48 h of collection. We report the identification of the mutation (a g-to-a transition in the first nucleotide of intron 4) in the arylsulphatase A gene causing late-infantile MLD among the Eskimo population of southern Alaska. As all patients and family members from living and deceased patients had the same mutation, a mutation-based test was developed to identify patients and carriers that can be done on dried blood spots sent via regular mail service. A possible genetic link between this population and the Navajo Indians of the southwestern United States is proposed.

Alaska↗