{"title":"Perspectives on anemia: Factors confounding understanding of past occurrence","authors":"Megan B. Brickley","doi":"10.1016/j.ijpp.2023.12.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>This paper reviews factors confounding the understanding of the past occurrence of anemia. Using the evidence gathered, a framework is presented of ways forward to enable greater confidence in diagnosing acquired anemia in paleopathology, facilitating insights into longer-term perspectives on this globally relevant condition.</p></div><div><h3>Results</h3><p>To date, porotic lesions have been central to paleopathological investigations of anemia. The fact that porotic bone lesions are omnipresent and have multiple causes but are likely to have a relatively low, age-related frequency in individuals with anemia, a condition that will have been common in past communities, is confounding.</p></div><div><h3>Methods</h3><p>Establishing frameworks that move away from porotic lesions is proposed to facilitate higher levels of more accurate anemia diagnoses in paleopathology.</p></div><div><h3>Significance</h3><p>Acceptance of the fundamental principle that anemia may be better considered as a condition requiring metric evaluation of bone structures, supplemented by careful consideration of lesions, will advance understanding of acquired anemia in past communities. Such an approach would provide a clear basis for further consideration of congenital conditions causing anemia, such as sickle-cell disease and thalassemia.</p></div><div><h3>Limitations</h3><p>This paper simply opens the conversation on the better diagnosis of anemia in paleopathology; it starts the iterative process of achieving some consensus and progress on diagnosing anemia in paleopathology.</p></div><div><h3>Suggestions for further research</h3><p>Engagement with ideas presented, sharing data and development of metric parameters will assist in identifying the effects of marrow hyperplasia on bone, enabling more robust work on the important topic of anemia.</p></div>","PeriodicalId":48817,"journal":{"name":"International Journal of Paleopathology","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1879981723000761/pdfft?md5=9ad49c89bed1d28fc836198254146fbb&pid=1-s2.0-S1879981723000761-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Paleopathology","FirstCategoryId":"89","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1879981723000761","RegionNum":3,"RegionCategory":"地球科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PALEONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
This paper reviews factors confounding the understanding of the past occurrence of anemia. Using the evidence gathered, a framework is presented of ways forward to enable greater confidence in diagnosing acquired anemia in paleopathology, facilitating insights into longer-term perspectives on this globally relevant condition.
Results
To date, porotic lesions have been central to paleopathological investigations of anemia. The fact that porotic bone lesions are omnipresent and have multiple causes but are likely to have a relatively low, age-related frequency in individuals with anemia, a condition that will have been common in past communities, is confounding.
Methods
Establishing frameworks that move away from porotic lesions is proposed to facilitate higher levels of more accurate anemia diagnoses in paleopathology.
Significance
Acceptance of the fundamental principle that anemia may be better considered as a condition requiring metric evaluation of bone structures, supplemented by careful consideration of lesions, will advance understanding of acquired anemia in past communities. Such an approach would provide a clear basis for further consideration of congenital conditions causing anemia, such as sickle-cell disease and thalassemia.
Limitations
This paper simply opens the conversation on the better diagnosis of anemia in paleopathology; it starts the iterative process of achieving some consensus and progress on diagnosing anemia in paleopathology.
Suggestions for further research
Engagement with ideas presented, sharing data and development of metric parameters will assist in identifying the effects of marrow hyperplasia on bone, enabling more robust work on the important topic of anemia.
期刊介绍:
Paleopathology is the study and application of methods and techniques for investigating diseases and related conditions from skeletal and soft tissue remains. The International Journal of Paleopathology (IJPP) will publish original and significant articles on human and animal (including hominids) disease, based upon the study of physical remains, including osseous, dental, and preserved soft tissues at a range of methodological levels, from direct observation to molecular, chemical, histological and radiographic analysis. Discussion of ways in which these methods can be applied to the reconstruction of health, disease and life histories in the past is central to the discipline, so the journal would also encourage papers covering interpretive and theoretical issues, and those that place the study of disease at the centre of a bioarchaeological or biocultural approach. Papers dealing with historical evidence relating to disease in the past (rather than history of medicine) will also be published. The journal will also accept significant studies that applied previously developed techniques to new materials, setting the research in the context of current debates on past human and animal health.