Skeletal manifestations of rickets in infants and young children in a historic population from England

Gross and radiographic changes characteristic of inadequate bone mineralization due to rickets are described in 21 immature skeletons from a 19th century urban population from Birmingham, England. The aims of the study are as follows: to evaluate and if possible augment existing dry-bone criteria for the recognition of rickets in immature skeletal remains; to investigate the value of radiography for the paleopathological diagnosis of rickets; and to compare and contrast the expression of rickets in this group with that previously documented for a rural agrarian population from Wharram Percy, England. Some gross skeletal signs of rickets which were not previously well-documented in paleopathological studies are noted. The worth of radiography for evaluating structural changes to both cortical and trabecular bone in the disease is demonstrated, and features useful for the interpretation of vitamin D deficiency are discussed. The pattern of skeletal elements affected and the severity of changes differs in the Birmingham group from that seen in the comparative rural population. It is emphasized that a variety of factors may influence the expression of rickets in paleopathological material, including rate of skeletal growth, age cohort affected, and intensity of vitamin D deficiency. Nevertheless, careful analysis, not only of the frequency of rickets but also of the degree of severity of lesions and the patterning with respect to skeletal elements affected, may enable more nuanced understanding of the biocultural context of the disease in earlier populations.     

Possible Brucellosis in an Early Hominin Skeleton from Sterkfontein,South Africa

We report on the paleopathological analysis of the partial skeleton of the late Pliocene hominin species Australopithecus africanus Stw 431 from Sterkfontein, South Africa. A previous study noted the presence of lesions on vertebral bodies diagnosed as spondylosis deformans due to trauma. Instead, we suggest that these lesions are pathological changes due to the initial phases of an infectious disease, brucellosis. The macroscopic, microscopic and radiological appearance of the lytic lesions of the lumbar vertebrae is consistent with brucellosis. The hypothesis of brucellosis (most often associated with the consumption of animal proteins) in a 2.4 to 2.8 million year old hominid has a host of important implications for human evolution. The consumption of meat has been regarded an important factor in supporting, directing or altering human evolution. Perhaps the earliest (up to 2.5 million years ago) paleontological evidence for meat eating consists of cut marks on animal remains and stone tools that could have made these marks. Now with the hypothesis of brucellosis in A. africanus, we may have evidence of occasional meat eating directly linked to a fossil hominin.     

Prehistoric tuberculosis in america: adding comments to a literature review

Tuberculosis is a prehistoric American human disease. This paper reviews the literature and discusses hypotheses for origins and epidemiological patterns of prehistoric tuberculosis. From the last decades, 24 papers about prehistoric tuberculosis were published and 133 cases were reviewed. In South America most are isolated case studies, contrary to North America where more skeletal series were analyzed. Disease was usually located at the deserts of Chile and Peru, Central Plains in USA, and Lake Ontario in Canada. Skeletal remains represent most of the cases, but 16 mummies have also been described. Thirty individuals had lung disease, 19 of them diagnosed by the ribs. More then 100 individuals had osseous tuberculosis and 26 also had it in other organs. As today, transmission of the infection and establishment of the disease were favored by cultural and life-style changes such as sedentarization, crowding, undernutrition, use of dark and insulated houses, and by the frequency of interpersonal contacts. The papers confirm that despite previous perceptions, tuberculosis seems to have occurred in America for millennia. It only had epidemiological expression when special conditions favored its expansion. Occurring as epidemic bursts or low endemic disease, it had differential impact on groups or social segments in America for at least two millennia.     

Rheumatoid arthritis "in the buff": erosive arthritis in defleshed bones

Examination of isolated bones from patients with unequivocal rheumatoid arthritis provides only a glimpse of the disease but has been the only "gold standard" for recognition of osseous lesions as compatible with the diagnosis of rheumatoid arthritis. Documentation of skeletal pathologic changes in confidently diagnosed individuals has been a major missing link in the transition from clinical to skeletal analysis. Availability of appropriate skeletal material from two patients with long-standing, well-documented rheumatoid arthritis provided the opportunity for acquiring such information. The osseous appearance, skeletal distribution, and distinguishing features of rheumatoid arthritis "in the buff" were delineated in two contemporary patients and in a skeletal population of 2,906 individuals. The preconceived notion of anticipated severity of disease has hereby been tested and found wanting. Severe lesions are not recognizable or distinguishable from artifact in relatively fragile rheumatoid arthritis-affected bones, whether freshly prepared or remotely sampled. Characterization of the nature and epidemiology of osseous alterations in two contemporary skeletal populations permitted the development of a standard for recognition of the disease in skeletal populations.     

Paleopathology of the Late Roman-Early Byzantine cemeteries at Sayala,Egyptian Nubia

The paleopathological pattern of three large burial complexes CI-CIII and of cemetery N (but not of cemetery A) at Sayala, Egyptian Nubia, shows a predominance of traumatism over other pathologies. Males compared with females were more often afflicted by injuries. In the skull, mostly the frontal and parietal regions, and more often the left than the right side, show traumatic changes. Cuts are most common, suggesting their origin from swords and daggers. Also traumatism of the vertebral column is high, comprising more compression fractures than post-traumatic synostoses of vertebrae, and afflicting mostly the lumbar, lower thoracic and lower cervical regions. This suggests falls in a sitting position, probably while riding camels. In the remaining postcranial skeleton, mostly fractures are present, most often afflicting the antebrachial bones, especially on the left side. The majority of the ulnar fractures are typical parry fractures. Most injuries are well healed, only some showing quick death after affliction. The overall pattern suggests fighting as the leading cause of the traumatism. Among other pathologies, osteophytosis, especially in males, occurs rather commonly and more intensively than with the comparative sample of the C-Group people. Evidence of inflammations and tumours is rare. Some senile changes, many congenital anomalies, occasional orthopaedic deviations, and affections of unknown origin complement the paleopathological picture. Some functional changes disclose overloading of both extremities. According to these findings, the way of life and the question of ethnic identification of the people are discussed.     

Sex differences in activity-related osseous change in the spine and the gendered division of labor at Ensay and Wharram Percy, UK

Sex differences in the distribution of vertebral degenerative and plastic change were examined and compared within and between samples of 51 individuals from the historically and ethnographically documented 16th-19th century site of Ensay, the Outer Hebrides, and 59 individuals from the medieval site of Wharram Percy, the Yorkshire Wolds. Both populations have a known gendered division of labor between males and females and known activity-related stresses on the spine. Osseous changes normally associated with degenerative joint disease (osteoarthritis) of the apophyseal facets and osteophytosis of the vertebral bodies were scored and reported separately. Inter- and intrasite differences were found in the frequency and distribution of osseous change down the spine. Overall, the Ensay sample was more highly stressed than that from Wharram Percy. Furthermore, differences between males and females at Ensay could be identified as relating to different types of activities. Distinctions between males and females at Wharram Percy were less marked, suggesting broadly similar lifestyles. These results accorded with expectations regarding contrasting levels of activity-related stress at the two sites and the division of labor between males and females. In particular, the prevalence and distribution of facet remodeling, facet sclerosis/eburnation, and osteophytosis in Ensay females could be related to load-bearing using creels (a form of basket), which disrupted "normal" patterns of osseous change along the spine. Importantly, morphologically distinct osseous modifications recorded on the apophyseal facets produced dissimilar distributions, suggesting that they may have different etiologies. These results highlight the need for a high degree of discrimination in recording, analyzing, and exploring activity-related osseous change.     

Health Is not always written in bone: Using a modern comorbidity index to assess disease load in paleopathology

Paleopathology has revealed much about disease in the past but is usually limited to conditions with osteological manifestations; this often excludes acute soft tissue infections and causes of death for most individuals in the past and present. Our understanding of the evolution of disease is essential for contextualizing and predicting the epidemiological shifts that are happening in modern society, as high rates of infectious disease coexist alongside high rates of chronic disease in rates unlike those observed previously in human history. Moreover, many physiological states not previously classified as “disease” (obesity) have become pathologized, influencing our conception of disease and what defines health. By using the Galler Collection, a pre‐antibiotic and pre‐chemotherapeutic osteological series with modern autopsy records, our research quantifies disease burden of the past using the Charlson Index (CI), a modern comorbidity index of disease severity. Galler Collection remains and autopsy records were scored with the Charlson Index to correlate bone findings with soft tissue findings, and statistical analysis was performed for cumulative scores and absolute diagnosis counts, with patients stratified by sex and cause of death (pneumonia or cancer). Osteological diagnosis counts were more predictive of soft‐tissue autopsy disease counts than were associated cumulative CI scores. Diagnosis counts and CI scores for osteological data were more closely related to associated soft tissue data for cancer patients than for pneumonia patients. This research indicates how interdisciplinary paleopathological analysis assists in making more reliable assessments of health and mortality in the past, with implications for trending and predicting future epidemiological shifts. Am J Phys Anthropol 154:215–221, 2014. © 2014 Wiley Periodicals, Inc.     

Skeletal evidence of tuberculosis in a modern identified human skeletal collection (Certosa cemetery,Bologna, Italy)

The diagnosis of tuberculosis (TB) in osteoarcheological series relies on the identification of osseous lesions caused by the disease. The study of identified skeletal collections provides the opportunity to investigate the distribution of skeletal lesions in relation to this disease. The aim of this study was to examine the skeletal evidence for TB in late adolescent and adult individuals from the identified human collection of the Certosa cemetery of Bologna (Italy, 19th–20th c.). The sample group consists of 244 individuals (138 males, 106 females) ranging from 17 to 88 years of age. The sample was divided into three groups on the basis of the recorded cause of death: TB (N = 64), pulmonary non‐TB (N = 29), and other diseases (N = 151). Skeletal lesions reported to be related to TB were analyzed. The vertebral lesions were classified into three types: enlarged foramina (EnF, vascular foramina with diameter of 3–5 mm), erosions (ER), and other foramina (OtF, cavities of various shapes > 3 mm). A CT scan analysis was also performed on vertebral bodies. Some lesions were seldom present in our sample (e.g., tuberculous arthritis). OtF (23.7%) and subperiosteal new bone formation on ribs (54.2%) are significantly more frequent in the TB group with respect to the other groups. The CT scan analysis showed that the vertebrae of individuals who have died of TB may have internal cavities in the absence of external lesions. These traits represent useful elements in the paleopathological diagnosis of TB. Am J Phys Anthropol 157:389–401, 2015. © 2015 Wiley Periodicals, Inc.     

On secondary hyperparathyroidism in orang-utans, Pongo satyrus (Linnaeus, 1758)

Orang-utan crania with alterations in bone structure which could be determined morphologically were studied and evaluated. The alterations in bone structure were referred to in the literature up to about 1939 as "rickets"; when vitamin D was given to the animals, the alterations diminished, until they were almost unnoticeable. From about 1941/52, the alterations were diagnosed as "Morbus Paget". Research on orang-utan crania has become possible through comparison of a larger number of single symptoms, occurring in a number of individuals. Out of a larger sample, the study was carried out on 5 individuals, showing these alterations in varying degrees. The individuals also covered various age groups, both sexes and both subspecies of orang-utans. The findings permit a diagnosis of secondary (or tertiary) hyperparathyroidism (= Morbus Engel-von Recklinghausen = fibrous cystic osteitis). The study also showed that orang-utans fall prey to Morbus Engel-von Recklinghausen in a shorter period and suffer more severely than humans. The frequency of orang-utans suffering from this disease, which are kept captive in zoos, is statistically far higher than the occurrence in humans. Orang-utans living under natural conditions do not suffer from the disease at all; according to the study of 500 animals. The authors also believe that there is a psychogenic basis for the occurrence of Morbus Engel-von Recklinghausen in zoo animals; psychological conditions such as apathy, disinterest, etc. are part of the illness, and these symptoms are also shown by animals having no outward signs of fibrous cystic osteitis. The authors believe that improved prophylaxis of orang-utans in zoos would lead to discovery of Morbus Engel-von Recklinghausen in early stages, and allow early therapy to arrest the disease. This is necessary for preservation of the species.     

Scurvy in the Great Irish Famine: evidence of vitamin C deficiency from a mid-19th century skeletal population

Scurvy has increasingly been recognized in archaeological populations since the 1980s but this study represents the first examination of the paleopathological findings of scurvy in a known famine population. The Great Famine (1845-1852) was a watershed in Irish history and resulted in the death of one million people and the mass emigration of just as many. It was initiated by a blight which completely wiped out the potato-virtually the only source of food for the poor of Ireland. This led to mass starvation and a widespread occurrence of infectious and metabolic diseases. A recent discovery of 970 human skeletons from mass burials dating to the height of the famine in Kilkenny City (1847-1851) provided an opportunity to study the skeletal manifestations of scurvy-a disease that became widespread at this time due to the sudden lack of Vitamin C which had previously almost exclusively been provided by the potato. A three-scale diagnostic reliance approach has been employed as a statistical aid for diagnosing the disease in the population. A biocultural approach was adopted to enable the findings to be contextualized and the etiology and impact of the disease explored. The results indicate that scurvy indirectly influenced famine-induced mortality. A sex and stature bias is evident among adults in which males and taller individuals displayed statistically significantly higher levels of scorbutic lesions. The findings have also suggested that new bone formation at the foramen rotundum is a diagnostic criterion for the paleopathological identification of scurvy, particularly among juveniles.     

Spontaneous and induced chromosome instability in patients with fragile X syndrome

Spontaneous and degranol- and dimatiph-induced chromosomal instability in the lymphocyte culture of patients with fra-X syndrome was investigated. The cultures contained TC 199 and 5% FC serum. It was found that the frequency of spontaneous chromosomal aberrations (CA) was 7.3% in cells from patients with fra(X), 3.9% in patients with MR of unknown origin, and 1.3% in normal individuals. Spontaneous break-points in the patients with fra(X) were localized in 1p, 2q, 3p, 6q, 7q, 16 q more often than in normal individuals. No significant difference was found in SCEs. The cells of patients with fra(X) were not sensitive to the induction of CA by degranol. It was found that chromosomal telomeric changes (CTC) were mutagen-independent, remaining at the spontaneous level: in the patients with fra(X) CTC were 10.5% (9.5% fra-Xq27, and 1% autosomal telomeric changes); in normal individuals CTC were 0.1%.     

Histological enamel indicator of childhood stress in prehistoric skeletal samples.

Although previous paleopathological studies have used disturbances in enamel formation as indicators of childhood stress, the full potential of this technique has not been realized. This paper presents a test case which demonstrates that the frequency of disturbed enamel formation (i.e., Wilson bands) is associated with other stress indicators (i.e., probability of dying and infectious lesions) in three prehistoric skeletal samples representing the Middle Woodland (10.3%), Mississippian Acculturated Late Woodland (21.4%), and the Middle Mississippian (40.0%). Additionally, the mean ages at death of individuals with at least one Wilson band are lower than those without bands.These results suggest that Wilson bands are an indicator of the relative proportion of individuals who are high susceptibles in prehistoric populations. The data also corroborate the hypothesis that the adoption of maize agriculture in the prehistoric American Midwest is associated with increased stress.     

A health assessment of high status Christian burials recovered from the Roman-Byzantine archeological site of Elaiussa Sebaste, Turkey.

The purpose of this study is to assess the state of health of 116 individuals whose remains were excavated from Byzantine period burials underneath the floor of an important Christian basilica from the site of Elaiussa Sebaste, Turkey. Elaiussa Sebaste was a Mediterranean coastal community, which began as a Roman town and continued as an early Christian Byzantine community until the end of the 7th century AD. The burials date from the middle of the 6th through the middle of the 7th centuries AD. We attempt to determine how high social status has influenced the type and frequency of skeletal lesions exhibited in this sample. All strata of this population show a number of chronic and acute health problems as indicated by skeletal lesions. Yet, only the frequency of degenerative joint disease (DJD) differs by sex, with males exhibiting a higher rate of DJD than females, p=0.09. There is no difference in the frequency of trauma among adult males and females. Non-specific skeletal lesions (cribra orbitalia, porotic hyperostosis, and periostitis) often associated with dietary and general stressors, but also with specific systemic diseases, are common in both sexes. The sub-adults primarily exhibit periostitis of the long bones and do not show skeletal lesions specific to malaria. It seems that high social ranking did not prevent serious ailments from affecting the health of individuals living in the Elaiussa Sebaste community.     

PUBLIC HEALTH ASPECTS OF LYMPHOGRANULOMA VENEREUM

The clinical symptoms of lymphogranuloma venereum with the serious pathologic changes often occurring in the late stages of the disease warrant greater attention to the disease.The reported ratio of cases of lymphogranuloma venereum to cases of syphilis and gonorrhea is much higher in San Francisco than in other metropolitan ports of western United States, apparently because of greater use of diagnostic tests for the disease.Tests of persons likely to be exposed and other persons not likely to be exposed to venereal diseases indicate that a positive reaction to a Frei test implies past or present infection with lymphogranuloma venereum.Positive reactions to complement fixation tests are notably more frequent than positive response to Frei tests. The complement fixation test appears to be an unreliable diagnostic aid.The frequency of positive reactions associated with other venereal diseases, and their infrequency otherwise, suggests that lymphogranuloma venereum may exist, unrecognized, in many persons, who may be, potentially at least, carriers of the disease.     

Oral health and frailty in the medieval English cemetery of St Mary Graces

The analysis of oral pathologies is routinely a part of bioarcheological and paleopathological investigations. Oral health, while certainly interesting by itself, is also potentially informative about general or systemic health. Numerous studies within modern populations have shown associations between oral pathologies and other diseases, such as cardiovascular disease, certain types of cancer, and pulmonary infections. This article addresses the question of how oral health was associated with general health in past populations by examining the relationship between two oral pathologies (periodontal disease and dental caries) and the risk of mortality in a cemetery sample from medieval England. The effects of periodontitis and dental caries on risk of death were assessed using a sample of 190 individuals from the St Mary Graces cemetery, London, dating to ～AD 1350–1538. The results suggest that the oral pathologies are associated with elevated risks of mortality in the St Mary Graces cemetery such that individuals with periodontitis and dental caries were more likely to die than their peers without such pathologies. The results shown here suggest that these oral pathologies can be used as informative indicators of general health in past populations. Am J Phys Anthropol, 2010. © 2009 Wiley‐Liss, Inc.     

POLYPHENISM IN SPADEFOOT TOAD TADPOLES AS A LOCALLY ADJUSTED EVOLUTIONARILY STABLE STRATEGY

I examined the evolutionary factors maintaining two environmentally induced morphs in ponds of variable duration. Larvae of New Mexico spadefoot toads (Scaphiopus multiplicatus) often occur in the same pond as a large, rapidly developing carnivorous morph and as a smaller, more slowly developing omnivorous morph. Previous studies revealed that carnivores can be induced by feeding tadpoles live fairy shrimp and that morph determination is reversible. Field and laboratory experiments indicated that the ability of an individual to become a carnivore or an omnivore is maintained evolutionarily as a response to variability in pond longevity and food abundance. Carnivores survived better in highly ephemeral artificial ponds, because they developed faster. Omnivores survived better in longer-duration artificial ponds, because their larger fat reserves enhanced postmetamorphic survival. The two morphs also occupy different trophic niches. Experimental manipulations of morph frequency in ponds of intermediate duration revealed that increased competition for food among individuals of the more common morph made the rarer form more successful. Morph frequency within each pond was stabilized at an equilibrium by frequency-dependent morph reversal, which reflected frequency-dependent natural selection on size at metamorphosis: larger metamorphs had higher survival, and individuals reared at a frequency above the pond's equilibrium frequency were smaller at metamorphosis than were individuals of that morph reared at a frequency below the pond's equilibrium. Because neighboring ponds often differed in pond longevity and food abundance, each pond possessed a unique equilibrium morph frequency. This implies that morph determination in Scaphiopus is a locally adjusted evolutionarily stable strategy (ESS).     

Changing patterns of health and disease among the Aleuts

Compared to other regions of North America, there have been relatively few paleopathological studies of arctic populations to date, particularly those aimed at elucidating patterns of health and disease prior to contact, and assessing temporal changes in disease patterns. In the present study, four Aleut skeletal samples representing one pre-contact population from Umnak Island in the eastern Aleutian Islands (N=65), and three late pre-contact/early contact period populations from Umnak, Kagamil, and Shiprock Islands (N=227), were examined macroscopically for indicators of health status. The analysis revealed some evidence of declining health in the late pre-contact/early contact period. Statistical comparisons of the earlier and later samples indicated a significantly higher frequency of cribra orbitalia and cranial infection in the later sample compared to the earlier one. Archaeological, epidemiological, and historical data point to several possible explanations for these findings, including the introduction of new pathogens by Europeans.     

Differential visibility of treponemal disease in pre‐Columbian stratified societies: Does rank matter?

Treponemal disease is known to be associated with the compromised community health of permanent village settlement. This association explains its high visibility in the village‐based, arguably chiefdom level, agriculturalist societies of late prehistoric (AD 1300–1600) North America. Within chiefdom‐level societies, health differences have often been demonstrated between mortuary‐defined “elite” and “nonelite” individuals. This theoretically should predict status‐based differences in treponemal disease visibility. The prediction is tested in a five‐site osteological sample (N = 650) from the Dallas phase (AD 1300–1550), a simple mortuary‐defined two‐tiered presumptive chiefdom level maize agriculturalist socioeconomic context from lower east Tennessee. The Dallas phase results affirm a general pre‐Colombian North American pattern of no sex differences and display comparable adult to subadult frequencies. The study also reveals that given a sufficient sample size, “elites” do indeed exhibit a significantly lower frequency of tertiary stage treponemal disease. This can be attributed to better baseline health, which has been previously demonstrated in this sample. It may also be affected by the mortuary inclusion of achieved status individuals whose good health may have facilitated sociopolitical advancement. Another pattern that emerged is an apparent young adult age bias in disease visibility. This suggests that tertiary treponemal disease morbidity may either directly or synergistically factor in early adult age at death. Future research will address the veracity of this association. Am J Phys Anthropol, 2011. © 2010 Wiley‐Liss, Inc.     

A medico-genetic study of isolates in Uzbekistan. III. Results of a cytogenetic study]

The cytogenetic examination of the population of the villages of Karakent and Ishan consisted of two directions: the study on the frequency of chromosome aberrations in the culture of lymphocytes and the diagnostics of anomalies and variants of karyotype. The frequency of chromosome aberrations of 40 individuals was studied. It is shown that the frequency of cells with chromosome aberrations of the individuals in different villages does not differ and on the average is 1,4%. The distribution of lymphocyte culture according to the number of aberrations corresponds to that of theoretical Puassonian. Chromatide breaks are the main type of the aberrations. Among 250 karyotypically examined individuals no evident structure reformations were found. In the caryotype of a 7-year old girl trisomia of the 21st autosome was detected. On the basis of differential staining of chromosomes by Hiemse's dye 18 individuals (7,2%) were diagnosed to have insignificant changes in morphology of some chromosomes, considered as variants of caryotype. In the majority of cases these changes were of a family nature. On the medical examination mnay individuals were diagnosed to have different pathological features, though we did not succeed in revealing any correlation between a certain microanomaly of chromosomes and a pathological feature.