Rheumatoid arthritis in the Pima Indians of Arizona: an assessment of the clinical components of the New York criteria.

When a prevalence study of Rheumatoid Arthritis (RA) was made in the adult Pima Indian population living on the Gila River Reservation, a high prevalence was found using the New York criteria (5-9 per cent). This was mainly due to the high frequency of limitation of motion which brought in many undesirable subjects. After excluding it as a component of New York criteria we found a prevalence for RA of 3 per cent with a predominance among the females (3-8 as against 2-0 per cent in males). The group so defined fulfilled the requirements of the Rome criteria, showed a higher concordance with serological or radiological evidence of RA, and appeared to identify subjects in whom the experienced clinical rheumatologist would more often agree with the diagnosis.

Completeness and accuracy of reporting induced abortions performed in Hawaii's hospitals, 1970--74.

This study examined the completeness and accuracy of reporting induced abortions to the official agency by following up documented cases of abortions performed in hospitals in Hawaii for the years 1970--74. The following two sets of records were initially linked by computer on the basis of first name, maiden name, date of the event, age, and ethnic background: (a) a total of 18,531 induced abortions ascertained in hospitals with complete linking information and (b) official fetal death and live birth records filed at the State health department. Overall, 96.1 percent of the hospital abortions were matched in the official certificates. Of 17,550 abortions classified as elective, 98.7 percent were so recorded in the certificate file, whereas the remainder were reported as mostly either therapeutic or unknown for cause of fetal death. When the probability of matches for those abortions without complete linking information and possible errors in the information were considered, the estimates of underreporting to the health department were a maximum of 3.9 percent and a minimum of 1.2 percent; the mean value was 2.6 percent. The extent of underreporting of induced abortions is becoming serious with the widespread practice of abortion procedures in nonhospital institutions in recent years. The results of the study also demonstrated the utility of the record-linkage process in checking data for completeness and accuracy or studying separate vital events on the same persons.

Adolescent fertility in Hawaii: implications for planning.

PIP: Computer printouts of cross tabulations of selected data from the vital records for live births, infant and fetal deaths, marriages, and divorces which took place in Hawaii during 1968, 1969, 1970, 1971 and 1972 were studied in order to describe the characteristics of young parenthood in Hawaii from 1968-1972; identify special at-risk populations during preconception, interconception, pregnancy and parenting; identify children of at-risk mothers; identify trends which may affect the planning, delivery, and evaluation of needed programs and services; and determine the need for and nature of specific, modified, and innovative services to teens and preteens. Findings reported by school districts showed marked differences in pregnancy rates, premature births, and infant deaths. The 3 schools with the highest fetal death and induced abortion ratios had the lowest live birth and pregnancy rates. The 6 with lowest fetal death ratios had the highest live birth and pregnancy rates. The findings enable planning of specific health care delivery and school health programs for school districts with the highest pregnancy, premature birth, and infant death rates. Included among the recommendations are the following: 1) the data presented should be used as a bseline for program and service evaluation; 2) family life education efforts in those schools showing the greatest need should be increased; 3) prenatal care should be made more readily available and acceptable to young mothers in the high priority school district; and 4) support services for single-parent families should be planned to meet the increasing need for such services.^ieng

Frequency of reproductive dysfunction in Hawaii by race and judicial district 1968-1982.

PIP: The frequency of births with congenital defects, infants with very low birth weight, late fetal loss, and neonatal deaths is contrasted with pesticide/herbicide usage in Hawaii, using the variables percent of agricultural workers, type of agriculture, race of mother, and judicial district of mother's residence for the 5 year periods around 1970, 1975, and 1980. Rates per 1000 live births are calculated for each geographic group, for each of the time periods, and for the total combined time period; similar rates for Caucasian, Chinese, Filipino, Hawaiian, Part Hawaiian, Japanese, and Negro mothers are calculated for the entire 15 year period. Results show that: 1) there were more birth defects in 1968-1972 than in 1978-1982 in the state as a whole; 2) there was no correlation between the total and per capita use of pesticides by county and the frequency of reproductive dysfunctions; 3) there was a negative correlation between the ranks for neonatal deaths and percent of agricultural workers when they were ranked from lowest to highest; and 4) the correlation between the ranks of birth defects, low birth weight infants, and late fetal deaths, and the ranks of percent of agricultural workers, were not significant. This study shows that there has been considerable variation between birth defects, low birth weight infants, late fetal loss, and neonatal mortality from one judicial district to another. However, it is not possible to evaluate the correlation between the districts with high rates of a reporductive dysfunction and possible exposure to known environmental toxins.^ieng

The epidemiology of sudden infant death syndrome in Hawaii.

PIP: Sudden Infant Death Syndrome (SIDS) is the sudden death of any infant which is unexpected by history and in which a thorough post mortem examination fails to demonstrate an adequate cause of death. This study defines the incidence of SIDS in Hawaii and identifies any factors that may be characteristic of this population. Data collected from the Department of Health Hawaii Health Surveillance Program, and the Neonatal Intensive Care Unit at Kapiolani Women's and Children's Medical Center are used to determine risk factors per 1000 live births for both SIDS and non-SIDS groups. Results reveal that: 1) all socioeconomic groups are affected in the same proportion; 2) 72% of the infants died between 1-3 months; 3) low birth weight is a significant risk factor for SIDS; 4) the rate for twin births is a significant risk factor at 4.24; 5) SIDS occur more frequently in males than in females; and 6) the SIDS rates by race are: 0.71 for Asians, 1.49 for Part Hawaiians, and 1.88 for Blacks. Other significant factors include: time of day of the death, seasonal trends, maternal age, and legitimacy of birth. Factors that are not associated with SIDS include prenatal care, maternal education, previous fetal death, and birth order. These results show that SIDS in Hawaii is epidemiologically similar to the problem reported elsewhere and extends the findings of previous studies in Hawaii.^ieng

GM allotypes in Native Americans: evidence for three distinct migrations across the Bering land bridge.

We report the results of typings, for immunoglobulin G allotypes, of 5392 Native Americans from ten samples, the typings having been performed over the last 20 years. Four cultural groups are represented: the Pimans-Pima and Papago; the Puebloans-Zuni and Hopi; the Pai-Walapai; and the Athabascans-Apache and Navajo. The haplotype Gm1;21 has the highest frequency in each population while Gm1,2;21 is polymorphic in all except the Hopi. The Mongoloid marker Gm1;11,13 is found primarily in the Athabascans. The Caucasian haplotype Gm3;5,11,13 is found at polymorphic frequencies in several of the populations but its frequency is very low or absent among nonadmixed individuals. Although Nei's standard genetic distance analysis demonstrates genetic similarity at the Gm and Km loci, the heterogeneity that does exist is consistent both with what is known about the prehistory of Native Americans and traditional cultural categories. When the current Gm distributions are analyzed with respect to the three-migration hypothesis, there are three distinct Gm distributions for the postulated migrants: Gm1;21 and Gm1,2;21 for the Paleo-Indians 16,000 to 40,000 years ago; Gm1;21, Gm1,2;21, and Gm1;11,13 for the second wave of Na-Dene hunters 12,000 to 14,000 years ago; and Gm1;21 and Gm1;11,13 for the Eskimo-Aleut migration 9,000 years ago. The Pimans, Puebloans, and the Pai are descendents of the Paleo-Indians while the Apache and Navajo are the contemporary populations related to the Na-Dene. Finally, the Gm distribution in Amerindians is found to be consistent with a hypothesis of one migration of Paleo-Indians to South American, while the most likely homeland for the three ancestral populations is found to be in northeastern Asia.