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Acute fluoride poisoning from a public water system.

https://arctichealth.org/en/permalink/ahliterature35935
Source
N Engl J Med. 1994 Jan 13;330(2):95-9
Publication Type
Article
Date
Jan-13-1994
Author
B D Gessner
M. Beller
J P Middaugh
G M Whitford
Author Affiliation
Division of Field Epidemiology, Centers for Disease Control and Prevention, Atlanta.
Source
N Engl J Med. 1994 Jan 13;330(2):95-9
Date
Jan-13-1994
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alaska - epidemiology
Child
Child, Preschool
Confidence Intervals
Disease Outbreaks
Equipment Failure
Female
Fluoridation - instrumentation
Fluoride Poisoning - epidemiology - urine
Fluorides - analysis
Humans
Infant
Male
Middle Aged
Odds Ratio
Research Support, U.S. Gov't, P.H.S.
Risk
Water Supply - analysis
Abstract
BACKGROUND. Acute fluoride poisoning produces a clinical syndrome characterized by nausea, vomiting, diarrhea, abdominal pain, and paresthesias. In May 1992, excess fluoride in one of two public water systems serving a village in Alaska caused an outbreak of acute fluoride poisoning. METHODS. We surveyed residents, measured their urinary fluoride concentrations, and analyzed their serum-chemistry profiles. A case of fluoride poisoning was defined as an illness consisting of nausea, vomiting, diarrhea, abdominal pain, or numbness or tingling of the face or extremities that began between May 21 and 23. RESULTS. Among 47 residents studied who drank water obtained on May 21, 22, or 23 from the implicated well, 43 (91 percent) had an illness that met the case definition, as compared with only 6 of 21 residents (29 percent) who drank water obtained from the implicated well at other times and 2 of 94 residents (2 percent) served by the other water system. We estimated that 296 people were poisoned; 1 person died. Four to five days after the outbreak, 10 of the 25 case patients who were tested, but none of the 15 control subjects, had elevated urinary fluoride concentrations. The case patients had elevated serum fluoride concentrations and other abnormalities consistent with fluoride poisoning, such as elevated serum lactate dehydrogenase and aspartate aminotransferase concentrations. The fluoride concentration of a water sample from the implicated well was 150 mg per liter, and that of a sample from the other system was 1.1 mg per liter. Failure to monitor and respond appropriately to elevated fluoride concentrations, an unreliable control system, and a mechanism that allowed fluoride concentrate to enter the well led to this outbreak. CONCLUSIONS. Inspection of public water systems and monitoring of fluoride concentrations are needed to prevent outbreaks of fluoride poisoning.
PubMed ID
8259189 View in PubMed
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An assessment of potential injury surveillance data sources in Alaska using an emerging problem: all-terrain vehicle-associated injuries.

https://arctichealth.org/en/permalink/ahliterature6295
Source
Public Health Rep. 1989 Sep-Oct;104(5):493-8
Publication Type
Article
Author
S M Smith
J P Middaugh
Author Affiliation
Division of Injury Epidemiology and Control, Centers for Disease Control, Atlanta, GA 30333.
Source
Public Health Rep. 1989 Sep-Oct;104(5):493-8
Language
English
Publication Type
Article
Keywords
Alaska - epidemiology
Coroners and Medical Examiners
Data Collection - economics - methods
Death Certificates
Government Agencies
Humans
Information Systems - utilization
Off-Road Motor Vehicles
Wounds and Injuries - epidemiology - etiology - mortality
Abstract
Using injuries associated with three-wheeled all-terrain vehicles in Alaska as an example, the existing injury data bases were assessed for usefulness, cost, simplicity, acceptability, flexibility, sensitivity, specificity, representativeness, and timeliness. In this study strengths and weaknesses of existing data for all-terrain vehicles were identified and ways to improve data collection and linkages across data systems are suggested. Based on this evaluation, linked death certificates and medical examiner data provide an excellent mechanism for monitoring vehicle-related fatalities. Information sources for nonfatal and nonvehicle-related injuries require further development. Police records provide supplemental information, but they are limited to the events reported to police. Although other sources were explored, they added no advantage to the primary sources. Data processing, analysis, and dissemination--traditional responsibilities for public health and other governmental agencies--can transform these data sources into meaningful mechanisms to define injury trends and monitor injury-specific intervention strategies.
PubMed ID
2508179 View in PubMed
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Apolipoprotein E and atherosclerosis in Alaska Natives.

https://arctichealth.org/en/permalink/ahliterature6857
Source
Atherosclerosis. 1995 Apr 24;114(2):197-202
Publication Type
Article
Date
Apr-24-1995
Author
W D Scheer
D A Boudreau
G T Malcom
J P Middaugh
Author Affiliation
Department of Pathology, Louisiana State University Medical School, New Orleans 70112, USA.
Source
Atherosclerosis. 1995 Apr 24;114(2):197-202
Date
Apr-24-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Alaska
Alleles
Apolipoproteins E - genetics
Arteriosclerosis - genetics - pathology
Child
Cholesterol - blood
Female
Gene Frequency
Genotype
Humans
Inuits - genetics
Male
Middle Aged
Research Support, U.S. Gov't, P.H.S.
Abstract
Arterial, liver, and serum specimens were collected from 130 Alaska Natives who underwent forensic necropsy (mean age, 36.9 years; age range, 9-85 years; 38 females and 92 males). Based upon the observed frequencies of the six common apo E genotypes, the estimates of the relative frequencies of the corresponding alleles in the population are 0.020 +/- 0.009 for E2, 0.787 +/- 0.026 for E3 and 0.193 +/- 0.025 for E4. Analysis showed significant differences, by apo E genotype, in the extent of total surface lesion involvement in both the right and left coronary arteries. In all but the abdominal aorta, the pattern of lesion involvement by genotype is consistent with a decrease in lesions for genotypes with the E2 allele and an increase in lesions for the genotypes with the E4 allele, relative to the E3 homozygotes. After adjustment for low + very low density lipoprotein cholesterol (LDL + VLDL-C), the differences fell below statistically significant levels. Analysis by genotype of total serum cholesterol, high density lipoprotein cholesterol (HDL-C) and LDL + VLDL-C showed no statistically significant differences in analyte levels among genotypes. However, evidence is seen of a pattern in which total cholesterol and VLDL + LDL-C is less in genotypes with the E2 allele and greater in those with the E4 allele. We conclude that there does appear to be an effect by apo E genotype upon extent of atherosclerosis in the coronary arteries of Alaska Natives and this effect is likely due to the previously reported effect of apo E polymorphisms on serum cholesterol, particularly LDL + VLDL-C.
PubMed ID
7605388 View in PubMed
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Atherosclerosis in Alaska Natives and non-natives.

https://arctichealth.org/en/permalink/ahliterature5191
Source
Lancet. 1993 Apr 24;341(8852):1056-7
Publication Type
Article
Date
Apr-24-1993
Author
W P Newman
J P Middaugh
M T Propst
D R Rogers
Author Affiliation
Louisiana State University Medical School, New Orleans 70112.
Source
Lancet. 1993 Apr 24;341(8852):1056-7
Date
Apr-24-1993
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alaska - epidemiology
Aorta, Abdominal - pathology
Aortic Diseases - epidemiology - mortality - pathology
Arteriosclerosis - epidemiology - mortality - pathology
Coronary Arteriosclerosis - epidemiology - mortality - pathology
Coronary Vessels - pathology
Female
Humans
Indians, North American
Inuits
Male
Middle Aged
Research Support, U.S. Gov't, P.H.S.
Abstract
Low mortality from coronary heart disease (CHD) among Eskimos has been attributed to less atherosclerosis in the coronary arteries because of a high dietary intake of omega-3 fatty acids. Other investigators attribute this low mortality to the fact that Eskimos have a high mortality from other causes before middle age, when CHD is common. However, most studies have been epidemiological, either by death-certificate review or risk-factor evaluation. We evaluated the extent of atherosclerotic lesions in the coronary arteries and aortas from Alaska Natives. Standardised comparisons between samples from 103 Native and 101 non-native residents show that the extent of raised lesions increases with age in both groups, but the prevalence of raised lesions in native specimens was consistently lower than in those from non-natives. This difference was statistically significant. The data suggest that the differences in CHD mortality between Alaska Natives and non-natives are, at least in part, the result of less atherosclerosis in natives.
PubMed ID
8096960 View in PubMed
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Balancing fish consumption benefits with mercury exposure.

https://arctichealth.org/en/permalink/ahliterature4863
Source
Science. 1997 Dec 12;278(5345):1904-5
Publication Type
Article
Date
Dec-12-1997
Author
G M Egeland
J P Middaugh
Author Affiliation
Section of Epidemiology, Division of Public Health, Alaska Department of Health and Social Services, Anchorage, AK 99524-0249, USA.
Source
Science. 1997 Dec 12;278(5345):1904-5
Date
Dec-12-1997
Language
English
Publication Type
Article
Keywords
Animals
Fishes
Food
Food Contamination
Humans
Maximum Allowable Concentration
Methylmercury Compounds - administration & dosage - adverse effects
Nutrition Policy
Risk factors
Seafood
United States
United States Environmental Protection Agency
World Health Organization
Notes
Comment In: Science. 1998 Jan 23;279(5350):459, 4619454336
Comment In: Science. 1998 Jan 23;279(5350):4619454337
Comment In: Science. 1998 Jan 30;279(5351):639; author reply 6419471722
Comment In: Science. 1998 Jan 30;279(5351):640-1; author reply 6419471723
PubMed ID
9417640 View in PubMed
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Botulism among Alaska Natives. The role of changing food preparation and consumption practices.

https://arctichealth.org/en/permalink/ahliterature2310
Source
Western Journal of Medicine. 1990 Oct; 153(4):390-393.
Publication Type
Article
Date
1990
Author
N. Shaffer
R B Wainwright
J P Middaugh
R V Tauxe
Author Affiliation
U.S. Centers for Disease Control
Source
Western Journal of Medicine. 1990 Oct; 153(4):390-393.
Date
1990
Language
English
Geographic Location
U.S.
Publication Type
Article
Physical Holding
Alaska Medical Library
Keywords
New Stuyahok
Goodnews Bay
Manokotak
Ekuk
Dillingham
Diet, traditional
Clostridium botulinum
Epidemics
Adult
Aged
Alaska - epidemiology
Botulism - epidemiology
Disease Outbreaks - statistics & numerical data
Female
Food Habits
Food Handling
Food Preservation
Humans
Indians, North American
Inuits
Life Style
Middle Aged
Prevalence
Risk factors
Abstract
Alaska Natives have one of the highest rates of food-borne botulism worldwide. All outbreaks have been associated with the consumption of native foods, but in recent years outbreaks have occurred in previously unaffected areas and have involved new food items. Five botulism outbreaks occurred between 1975 and 1985 in an area of southwestern Alaska without previous confirmed outbreaks and among one ethnic group, the Yupik Eskimo. Of the 5 outbreaks, 3 were associated with fermented beaver tail, a nontraditional native food recently introduced into the region. Preparation techniques vary widely within villages and among ethnic groups. Traditional fermentation techniques have changed over the past 50 years; current preparation methods used by some families and ethnic groups may be more favorable for Clostridium botulinum growth. Prevention efforts should be targeted at high-risk subgroups of Alaska Natives who appear to have modified traditional practices and increased their risk of food-borne botulism.
Notes
From: Fortuine, Robert et al. 1993. The Health of the Inuit of North America: A Bibliography from the Earliest Times through 1990. University of Alaska Anchorage. Citation number 1850.
Cites: J Bacteriol. 1967 Apr;93(4):1461-25340312
Cites: Appl Microbiol. 1969 Nov;18(5):950-14905610
Cites: Appl Microbiol. 1972 Feb;23(2):427-84552895
Cites: Can Med Assoc J. 1974 Jan 19;110(2):191-7 passim4855671
Cites: Can J Public Health. 1963 Jul;54:293-30814028483
Cites: JAMA. 1976 Jan 5;235(1):35-8945998
Cites: Alaska Med. 1976 Jul;18(4):47-9970583
Cites: CMAJ. 1985 Dec 1;133(11):1141-62866023
Cites: J Infect Dis. 1988 Jun;157(6):1158-623373020
Cites: Can J Microbiol. 1975 Jun;21(6):920-61097074
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Comparison of atherosclerosis in alaska Natives and nonnatives.

https://arctichealth.org/en/permalink/ahliterature5173
Source
Arch Pathol Lab Med. 1997 Oct;121(10):1069-75
Publication Type
Article
Date
Oct-1997
Author
W P Newman
J P Middaugh
M A Guzman
M T Propst
D R Rogers
Author Affiliation
Department of Pathology, Louisiana State University School of Medicine, New Orleans 70112, USA.
Source
Arch Pathol Lab Med. 1997 Oct;121(10):1069-75
Date
Oct-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alaska - epidemiology
Aorta, Abdominal - pathology
Cause of Death
Comparative Study
Coronary Arteriosclerosis - ethnology - mortality - pathology
Coronary Vessels - pathology
Female
Humans
Inuits
Male
Middle Aged
Prevalence
Research Support, U.S. Gov't, P.H.S.
Tunica Intima - pathology
Abstract
OBJECTIVE: To test the hypothesis that Alaska Natives have fewer atherosclerotic lesions in the coronary arteries and aorta than nonnative Alaska residents. DESIGN: Systematic standardized collection and evaluation of coronary arteries and aortas collected at autopsy. SETTING: Forensic autopsy service in Alaska. SUBJECTS: One hundred thirty Alaska Natives and 115 Alaska nonnatives who underwent forensic autopsy between February 1989 and December 1993. INTERVENTION: None. MAIN OUTCOME MEASURES: Prevalence and extent of atherosclerotic lesions in the aortas and coronary arteries in both populations studied. RESULTS: Alaska Natives had significantly lower prevalence and extent of raised atherosclerotic lesions in the abdominal aorta and coronary arteries than nonnative Alaska residents. CONCLUSIONS: Differences in coronary heart disease mortality between Alaska Natives and nonnatives are, at least in part, the result of fewer atherosclerotic lesions in Alaska Natives.
PubMed ID
9341586 View in PubMed
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Confirmed previous infection with Chlamydia pneumoniae (TWAR) and its presence in early coronary atherosclerosis.

https://arctichealth.org/en/permalink/ahliterature3512
Source
Circulation. 1998 Aug 18;98(7):628-33
Publication Type
Article
Date
Aug-18-1998
Author
M. Davidson
C C Kuo
J P Middaugh
L A Campbell
S P Wang
W P Newman
J C Finley
J T Grayston
Author Affiliation
Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA.
Source
Circulation. 1998 Aug 18;98(7):628-33
Date
Aug-18-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alaska
Antibodies, Bacterial - blood
Autopsy
Cause of Death
Chlamydia Infections - complications - diagnosis - immunology
Chlamydophila pneumoniae - isolation & purification
Coronary Arteriosclerosis - complications - epidemiology - mortality
Coronary Vessels - microbiology - pathology
Female
Heart - microbiology
Humans
Immunoglobulin A - blood
Immunoglobulin G - blood
Immunoglobulin M - blood
Immunohistochemistry
Indians, North American
Male
Middle Aged
Myocardium - pathology
Polymerase Chain Reaction
Research Support, Non-U.S. Gov't
Risk factors
Abstract
BACKGROUND: Chlamydia pneumoniae has been identified in coronary atheroma, but concomitant serum antibody titers have been inconsistently positive and unavailable before the detection of early or advanced atherosclerotic lesions. METHODS AND RESULTS: This retrospective investigation was performed on premortem serum specimens and autopsy tissue from 60 indigenous Alaska Natives at low risk for coronary heart disease, selected by the potential availability of their stored specimens. Serum specimens were drawn a mean of 8.8 years (range, 0.7 to 26.2 years) before death, which occurred at a mean age of 34.1 years (range, 15 to 57 years), primarily from noncardiovascular causes (97%). Coronary artery tissues were independently examined histologically and, for C pneumoniae organism and DNA, by immunocytochemistry (ICC) and polymerase chain reaction (PCR) with species-specific monoclonal antibody and primers. Microimmunofluorescence detected species-specific IgG, IgA, and IgM antibody in stored serum. C pneumoniae, frequently within macrophage foam cells, was identified in coronary fibrolipid atheroma (raised lesions, Stary types II through V) in 15 subjects (25%) and early flat lesions in 7 (11%) either by PCR (14, 23%) or ICC (20, 33%). The OR for C pneumoniae in raised atheroma after a level of IgG antibody > or =1:256 >8 years earlier was 6.1 (95% CI, 1.1 to 36.6) and for all coronary tissues after adjustment for multiple potential confounding variables, including tobacco exposure, was 9.4 (95% CI, 2.6 to 33.8). CONCLUSIONS: Serological evidence for C pneumoniae infection frequently precedes both the earliest and more advanced lesions of coronary atherosclerosis that harbor this intracellular pathogen, suggesting a chronic infection and developmental role in coronary heart disease.
PubMed ID
9715854 View in PubMed
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Enforcement of school immunization law in Alaska.

https://arctichealth.org/en/permalink/ahliterature5891
Source
JAMA. 1978 May 19;239(20):2128-30
Publication Type
Article
Date
May-19-1978
Author
J P Middaugh
L D Zyla
Source
JAMA. 1978 May 19;239(20):2128-30
Date
May-19-1978
Language
English
Publication Type
Article
Keywords
Age Factors
Alaska
Child
Humans
Immunization
Immunization Schedule
Legislation, Medical
Measles - prevention & control
School Health Services
Vaccination
Abstract
Investigation of measles outbreaks during the fall of 1976 led to the discovery that Alkaska's school immunization law was not being enforced. In an effort to control a large outbreak of measles in Fairbanks, children were required to show proof of measles vaccination or be excluded from school. Of the Fairbanks schoolchildren, 25% were vaccinated against measles; 1,251 (11%) of 11,727 unvaccinated schoolchildren were excluded in January, and no further cases of measles occurred. Subsequently, the school law was enforced statewide, and on March 1, 1977, all children not immunized against diphtheria, tetanus, pertussis, polio, measles, and rubella were excluded from school (7,418 [8.3%] of 89,108). One month later, fewer than 51 children still did not meet immunization requirements. More than 35,000 children were vaccinated in the immunization campaign; no adverse side effects to any vaccine were reported.
PubMed ID
642153 View in PubMed
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39 records – page 1 of 4.