Abstract:
:Despite extensive investigations, some patients have no identifiable cause for their cholestatic liver enzyme abnormalities. The aim of this study was to document the clinical, laboratory, radiologic and histologic features of adult patients with idiopathic cholestasis (AIC). A computerised database of referred patients to a tertiary care hospital outpatient department for assessment of hepatobiliary disorders between 2005 and 2015 was employed to identify and describe features associated with AIC. Of 6,560 patient referrals, sufficient documentation to warrant a diagnosis of AIC was present in 17 (0.26%) cases. Of the 17, a disproportionate number were Canadian Inuit (7/60, 12% Inuit referrals vs. 10/6,500, 0.16% non-Inuit referrals, p<0.0001). The median age of the 17 subjects was 57 years and nine (53%) were female. Clinical and/or laboratory evidence of autoimmune disorders was present in six (35%) cases. Clinical features of hepatic decompensation, radiologic findings in keeping with cirrhosis and histologic confirmation of cirrhosis were present in 47%, 31% and 42% of individuals, respectively. There were no significant improvements in cholestatic liver enzymes and function tests in those treated with ursodiol and/or immunomodulants (n=7) compared to those left untreated (n=10). In conclusion, AIC is a rare condition diagnosed by exclusion. It appears to be more common in the Canadian Inuit population and those with autoimmune disorders. Advanced liver disease is a frequent finding at presentation. Intervention with ursodiol and/or immunomodulants does not appear to be of therapeutic value.
journal_name
Int J Circumpolar Healthjournal_title
International journal of circumpolar healthauthors
Minuk GY,Pollock G,Uhanova Jdoi
10.1080/22423982.2017.1388104subject
Has Abstractpub_date
2017-01-01 00:00:00pages
1388104issue
1eissn
1239-9736issn
2242-3982journal_volume
76pub_type
杂志文章abstract::Arctic peoples are spread over eight countries and comprise 3.74 million residents, of whom 9% are indigenous. The Arctic countries include Canada, Finland, Greenland (Denmark), Iceland, Norway, Russia, Sweden and the United States. Although Arctic peoples are very diverse, there are a variety of environmental and hea...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v65i1.17889
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Arctic residents can be exposed to a wide range of contaminants through consumption of traditional (country) foods (i.e. food from wild animals and plants that are hunted, caught or collected locally in the Arctic). Yet these foods provide excellent nutrition, promote social cohesion, meet some spiritual nee...
journal_title:International journal of circumpolar health
pub_type: 杂志文章,评审
doi:10.3402/ijch.v75.33822
更新日期:2016-12-13 00:00:00
abstract:BACKGROUND:Serum thyroid hormones, plasma catecholamines and mood were examined in 10 male members of the 16th Chinese Antarctic Expedition who spent the 2000 austral winter at Great Wall Station. STUDY DESIGN:Samples were taken prior to deployment to Antarctica (December, 1999) and upon return to China 54 weeks later...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v62i3.17562
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVES:To assess the distribution of blood lipids, lipoprotein and apoB/apoA-1 ratio in a multi-ethnic population of Sami, Kvens and Norwegians in Norway. Study design. A population-based cross-sectional study was carried out in 2003-2004 in an area with a mixed Sami, Kvens/Finns and Norwegian population, the SAMIN...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:With invasive Haemophilus influenzae serotype b (Hib) disease controlled by vaccination with conjugate Hib vaccines, there is concern that invasive disease due to non-serotype b strains may emerge. OBJECTIVE:This study characterized invasive H. influenzae (Hi) isolates from Nunavut, Canada, in the post-Hib ...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v75.29798
更新日期:2016-01-12 00:00:00
abstract:OBJECTIVES:To describe the method, data collection procedure and participation in The Population-based Study on Health and Living Conditions in Areas with both Sami and Norwegian Settlements - the SAMINOR 2 questionnaire study. STUDY DESIGN:Cross-sectional and semi-longitudinal. METHODS:In 2012, all inhabitants aged ...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v73.23147
更新日期:2014-06-18 00:00:00
abstract::We examined whether dietary supplementation with seal oil influenced the risk factors of atherosclerosis in healthy volunteers. Two intervention studies were carried out as preliminary steps in a larger project which aim at elucidating the disease preventive potential of seal oil. In study I ten healthy volunteers add...
journal_title:International journal of circumpolar health
pub_type: 临床试验,杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Community-acquired methicillin-resistant Staphylococcus aureus and methicillin-sensitive S. aureus infections are common to south-western Alaska and have been associated with traditional steambaths. More than a decade ago, recommendations were made to affected communities that included preventive skin care, ...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v75.30603
更新日期:2016-02-23 00:00:00
abstract:OBJECTIVES:Community based physiotherapy services are an integral component of the recent implementation of a medical rehabilitation program in the Kivalliq Region of Nunavut. Since the year 2000, the Inuit people of Canada's central Arctic have had direct access to physiotherapy in their home communities. STUDY DESIG...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v63i0.17866
更新日期:2004-01-01 00:00:00
abstract::Climate change could cause changes in the incidence of infectious diseases in Arctic regions. Higher ambient temperatures in the Arctic may result in an increase in some temperature sensitive foodborne diseases such as gastroenteritis, paralytic shellfish poisoning and botulism. An increase in mean temperature may als...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v64i5.18029
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Changing Directions, Changing Lives, the Mental Health Strategy for Canada, prioritizes the development of coordinated continuums of care in mental health that will bridge the gap in services for Inuit populations. OBJECTIVE:In order to target ways of improving the services provided in these contexts to ind...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v74.27186
更新日期:2015-05-14 00:00:00
abstract::The relationship between cell-mediated immunity and alcohol intake was studied in an Antarctic wintering group. Cell-mediated immune responses have previously been shown to be significantly lowered on the Antarctic Continent. The cause for this is yet to be elucidated. The cutaneous CMI Multitest was used to assess ce...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v61i3.17454
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVES:To compare 3 questionnaires used to evaluate early developmental problems, emotional disturbances and competence in 18-month-old infants. STUDY DESIGN:A follow-up study with parents of infants 8 to 36 months of age who responded to a developmental questionnaire. METHODS:Fifty infants (18 months of age) wer...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v68i4.17365
更新日期:2009-09-01 00:00:00
abstract::It is well documented that dietary patterns have been changing for northern indigenous peoples as they adapt to a contemporary lifestyle. Recent dietary research among Chukotka Native adults showed a higher intake of saturated fatty acids (15% of energy) and sugar, and lower content of polyunsaturated fatty acids (5%)...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::In 1991 and 1992, changes were made to the rate structure and eligibility requirements of the Northern Air Stage Program. To determine the effect of these changes on the affordability of a nutritious diet, food price surveys were conducted in 20 isolated communities, staging points, and selected southern cities and us...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVES:Aboriginal communities have a high prevalence of diabetes and heart disease, and limited resources to address them. The objective of this study was to test the effectiveness of prioritizing care with audit and feedback on cholesterol management of diabetic patients. STUDY DESIGN:A controlled before-after in...
journal_title:International journal of circumpolar health
pub_type: 杂志文章,随机对照试验
doi:10.3402/ijch.v69i4.17629
更新日期:2010-09-01 00:00:00
abstract::The reasons for the rapidly increasing prevalence of diabetes (NIDDM) among Alaskan Eskimos are only partly understood. This study examines the association of fatty acid metabolism in 68 Alaskan Eskimos with NIDDM or impaired glucose tolerance (IGT) and 386 with normal glucose tolerance > 24 years old. The prevalence ...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:1999-04-01 00:00:00
abstract::Thyroid hormones are important for metabolic regulation. A number of studies have dealt with the effect of arctic living on thyroid hormone secretion and metabolism in healthy animals and humans. Little is however known of the effect of arctic living on the occurrence of thyroid diseases. In a study from Upernavik, Gr...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:Cochlear implant (CI) treatment was introduced to the world in the 1980s and has become a routine treatment for congenital or acquired severe-to-profound hearing loss. CI treatment requires access to a highly skilled team of ear, nose and throat specialists, audiologists and speech-language pathologists for e...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v72i0.20974
更新日期:2013-08-05 00:00:00
abstract::Ethical appraisal of medical protocols for research is now well accepted, and needed when research may carry side effects and risks that may be difficult to understand for the people invited to take part in research. We argue that time has come for Greenland to establish a formal medical research ethics committee with...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v63i0.17878
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Subsistence norms are part of the "ecosophy" or ecological philosophy of Alaska Native Peoples in the sub-Arctic, such as the Inupiat of Seward Peninsula. This kind of animistic pragmatism is a special source of practical wisdom that spans over thousands of years and which has been instrumental in the Iñupia...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v72i0.21224
更新日期:2013-08-05 00:00:00
abstract:BACKGROUND:Kivalina is a northwest Alaska barrier island village of 400 people vulnerable to storm surges exacerbated recently by delayed winter sea and shore ice formation. The village has no in-home piped water or sewage; the "washeteria" is the only structure providing public showers, laundry facilities and flush to...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v72i0.21233
更新日期:2013-08-05 00:00:00
abstract::Problems with alcohol, marijuana and gambling are major public health challenges in Greenland but their prevalence in a hospital setting has not been explored. Healthcare facilities play a significant role in Greenland. One important aspect is their provision of both primary and secondary healthcare services to a smal...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.1080/22423982.2020.1771950
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:The US commercial fishing industry is hazardous, as measured by mortality data. However, research on non-fatal injuries is limited. Non-fatal injuries constitute the majority of occupational injuries and can result in workers' lowered productivity and wages, lost quality of life, and disability. In the Unite...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v75.30070
更新日期:2016-01-14 00:00:00
abstract::Cold causes cardiopulmonary stress often perceived as shortness of breath or chest pain, and causes exacerbation of these symptoms in persons suffering heart or lung disease. We investigated the prevalence of these symptoms and their association with sex, age and cold exposure in a population-based sample of 1,785 per...
journal_title:International journal of circumpolar health
pub_type: 杂志文章,多中心研究
doi:
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVES AND METHODS:Three community health promotion projects have been implemented in Greenland in the municipalities of Upernavik, Ittoqqortoormiit and Qasigiannguit. Based on project reports and other written material, this paper describes experiences from the three projects and discusses the implications of the ...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v64i3.17993
更新日期:2005-06-01 00:00:00
abstract::The Canadian First Nations population is disproportionately burdened by diabetes and diabetes complications. Body weight management is purported to be important in the prevention and management of diabetes. In this study, we sought to describe weight change in a First Nation cohort according to diabetes status and man...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.1080/22423982.2017.1340548
更新日期:2017-01-01 00:00:00
abstract::In recent decades, there has been a decline in active school transportation (AST). Parents play an important role as the key decision-makers of children's AST, and there is a need of more knowledge about the decision-making process and parents' beliefs towards AST. The overall aim of this study was to explore parents'...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.1080/22423982.2020.1798113
更新日期:2020-12-01 00:00:00
abstract::A prevalence study methodology developed for use in rural and frontier settings is described. The general method was developed over a 15 year period and has been successfully adapted and used in studies of 14 different childhood onset developmental disorders. Subjects were the 168,000 school aged children from North D...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVES:Experiences in one's family of origin, especially the relationship to one's parents, supposedly form the basis of relationships in adulthood. The connection between traumatic childhood events and later life has been studied intensively, whereas average childhood growth experiences have been given less attent...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v70i2.17805
更新日期:2011-04-01 00:00:00