International Journal of Paleopathology最新文献

Objective

This study aims to determine and discuss the prevalence of non-adult scurvy cases from the early medieval Jaun/Podjuna Valley in southern Austria.

Materials

86 non-adult individuals were assessed from three early medieval sites.

Methods

Morphological characteristics associated with suggestive and probable scurvy were observed macroscopically and under 20–40x magnification.

Results

A significant relationship between the prevalence of scurvy and age group was observed. Perinates (46%, 6/13) and children (27.5%, 8/28) showed a high prevalence of skeletal features indicating a diagnosis of scurvy, while no cases of scurvy were observed in adolescents and adults.

Conclusions

In this Alpine region, scurvy occurred frequently in infants and children. Seasonal fluctuations of diet are discussed as factors triggering scurvy.

Significance

This study sheds new light on the prevalence of scurvy in the Alpine region and how the region developed after the fall of the Roman Noricum. It also models ways in which multiple lines of evidence can contribute to the diagnostic process.

Limitations

Poor preservation posed a challenge to identifying probable cases of scurvy. Likewise, non-adult remains are difficult to diagnose due to their developing nature and it is not always possible to distinguish between normal bone growth and pathological growth.

Suggestions for further research

Future applications of biomolecular studies will help illustrate changes in diet that may have contributed to vitamin deficiencies.

Objective

This paper assesses the relationship between the distance between the cemento-enamel junction and alveolar crest and risk factors commonly associated with periodontitis.

Materials

Eighty individuals between 28 and 92 years old with known biological sex and age were analyzed from a 20th century forensic human collection from Merida, Yucatan (Mexico).

Methods

Macroscopic assessment, along with metric analysis, was employed using a probe.

Results

Ante-mortem tooth loss was positively correlated with the distance between the cemento-enamel junction and alveolar crest, as was the presence of root calculus in females.

Conclusions

Cemento-enamel junction to alveolar crest distance is not a reliable indicator of periodontitis since it is not directly related to periodontitis-causing infectious pathogens, and since ante-mortem tooth loss can affect root exposure.

Significance

This study demonstrates that a purely quantitative approach to diagnosing periodontitis in archaeological and forensic human remains can be misleading.

Limitations

The skeletal collection is only representative of the low socioeconomic class of Merida, and its female cohort is underrepresented. In addition, because the Xoclan collection is modern, limitations (particularly with respect to tooth wear) of the applicability of these interpretations to older archaeological remains exist.

Suggestion for further research

A combination of quantitative and qualitative characteristics of alveolar bone is needed to reliably diagnose periodontitis in skeletal populations.

Objective

To develop a differential diagnosis of a mass retrieved alongside skeletal remains in the crypt of the church of Santissima Annunziata of Valenza (Province of Alessandria, Northern Italy).

Material

A calcified mass measuring 40 × 39 mm and 17.62 × 16.3817.62 × 16.38 mm.

Method

The analysis utilized macroscopic assessment and histologic examination (including histochemical and immunohistochemical analyses).

Results

Morphological traits include an irregular and spongy external surface. Holes of different sizes lead toward the inner part of the object. A section of the mass shows an “intertwined bundle” pattern, confirmed by microscopic examination.

Conclusions

Differential diagnosis determined the mass to be consistent with calcified leiomyoma.

Significance

Identifying uterine leiomyoma adds to the paucity of paleopathological literature on the condition and to calcified tumors more broadly. It also allows for an important discussion of women’s gynecological health in the past and potentially among nulliparous women.

Limitations

Neither histochemical staining nor immunohistochemical analysis demonstrated the certain muscular nature of the specimens due to the rehydration and decalcification processes, for which there are no gold standards.

Suggestions for further research

Calcified masses are common in the clinical literature but remain rare in paleopathological literature. Careful excavation and improved recognition of apparently calcified masses are necessary to improve recognition, diagnosis, and interpretation.

Objectives

The objective of the paper is to interpret pathologies on faunal remains in an effort to evaluate the presence of husbandry practices.

Materials

Bones and bone fragments from the Neolithic site of Dispilio, Greece. Those of domestic species were further studied.

Methods

The pathological cases were examined macroscopically, the lesions were described, images were taken, and differential diagnoses were undertaken using published literature.

Results

77 out of the 13,026 bones and bone fragments recovered displayed pathological conditions including oral disease, joint disease, trauma and congenital conditions. Most pathologies were found in the axial skeleton of caprines.

Conclusions

Pathological conditions in caprines are possibly related to the use of overgrazed pastures and fattening of females and castrates. These cases indicate specific husbandry practices used at the site.

Significance

Reconstructing husbandry practices is complex, especially in extremely old sites with fragmentary remains. This study provides one of the very few studies of a large Neolithic animal bone assemblage providing insight into early human-animal interactions in Greece.

Limitations

The research is based on the bone material of the two later occupation phases of the site. It includes material from one site.

Suggestions for further research

The bone assemblage of the earlier occupation phase should be studied for a diachronic investigation of husbandry practices at the site. Investigation of pathological cases in more settlements would provide a larger database for the evaluation of husbandry practices in Neolithic Greece.

This Special Issue has its foundation in presentations delivered in the symposium Disability and Care in Medieval Times: a Bioarchaeological Perspective into Health-related Practices held at the 2019 European Association of Archaeologists conference in Switzerland. It comprises 12 papers, all relevant to aspects of pathology experience and/or care provision in Western Europe during the Early to Late Middle Ages (500 – 1500 CE). Reflecting the 1000 year timespan involved, these papers are characterised by diversity in subject matter and in the lifeways in which they are located, but all contribute to the symposium’s primary aim: to demonstrate that our understanding of the Medieval period is enhanced by cross-disciplinary, bioarchaeological research into individual and collective experiences of disability and care. This Introduction provides the background to the 2019 symposium, and briefly discusses the papers contained in the Special Issue which emerged from this.

Objective

Paleopathological analysis of a below-knee amputation was conducted to explore the sociocultural reasons why the amputation took place.

Materials

Older adolescent male (18–21 years) from the New Englander mass burial at the 18th century Fortress of Louisbourg.

Methods

Macroscopic assessment and archival data.

Results

A surgical amputation of the right tibia and fibula, distal to the knee was identified. The cross-sectional diaphysis of the leg has kerf marks and a splinter (breakaway point) at the posterior-lateral border of the tibia suggesting the leg gave way from its own weight or was manually removed once most of the sawing was complete.

Conclusions

Archival records suggest frostbite from prolonged exposure to freezing temperatures and trauma from unsafe working conditions at the Fortress were the main causes that led to amputation.

Significance

This case study highlights the importance of contextualizing cases of amputation to understand factors leading to the amputation procedure and techniques used in the past, and the social and living conditions of the individual.

Limitations

Observations were restricted to skeletal material as soft tissue decomposed and there was no material evidence suggestive of amputation associated with this individual in their grave.

Suggestions for future research

Full trauma assessment of the Fortress of Louisbourg skeletal collection to provide additional insight into injury sustained at Louisbourg and 18th century surgical practices.

Objective

Diagnosing disease from the past using historic textual sources can be controversial as to its accuracy. To overcome these objections, an empirical approach to the historical clinical data was developed. The approach follows a standardised, objective, and systematic evaluation, satisfying the requirements of the philosophy of science.

Material

Physician-managed medical records of mid-19th century patients reported to have suffered from tuberculosis.

Method

A diagnostic algorithm, quantifying clinical data into a scoring system, was developed based on criteria recorded in the medical sources. The findings were compared to the autopsy results using the Receiver Operating Characteristics method.

Results

The generated scoring system correctly predicted the diagnosis of tuberculosis in 86% of patients in the study. 6% false negatives and 8% false positives were predicted.

Conclusions

It is possible to retrospectively diagnose in a reliable and scientifically robust manner under certain conditions. It is important to embed the clinical data into the historical context. A general rejection of retrospective diagnosis is unsubstantiated. Well-designed, disease-specific, and source adapted medical scoring systems are new approaches and overcome criticism raised against retrospective diagnosis.

Significance

This new approach utilises diverse historic sources and potentially leads to reliable retrospective diagnosis of most common diseases of the past.

Limitations

Selection bias of the records allocated. Quality of the historic sources utilized. Restricted statistical assessment potential of historic sources.

Suggestions for further research

Development of disease- and epoch-specific medical score systems.

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.

Objective

X-ray fluorescence (XRF) is a non-destructive technique that measures the elemental concentration of different materials, including human bone. Recently, it began to be applied to paleopathological studies due to the development of portable devices and their relative ease of use. However, the lack of uniform procedures hampers comparability and reproducibility. This paper aims to provide guidelines for an efficient and standardized evaluation of bone elemental composition with a portable XRF (pXRF) device.

Materials

This technical note is based on the application of the Thermo Scientific Niton XL3t 900 GOLDD+.

Methods

This work includes suggestions for the choice and preparation of human bone samples, both from archaeological context and documented collections, and methodological procedures in pXRF setup, such as choice of calibration, assessment of accuracy, and analysis run time. Additionally, recommendations for data validation and statistical analysis are also included.

Conclusions

This technique has great potential in paleopathology since bone chemical variations may be associated with different pathological conditions, environmental contamination (e.g., lead), and/or administered treatments, such as mercury. Following an expected increase in the number of studies, it is essential to establish good practices that allow results from different researchers to be comparable.

Significance

X-ray fluorescence is a non-destructive technique that measures small concentrations (ppm) of elements from magnesium (12Mg) through bismuth (83Bi).

Limitations

pXRF does not detect elements lighter than Mg, and its lower energy excitation penetrates less than other techniques.

Suggestions for further research

Other research groups should test these guidelines and comment on their usefulness and replicability.

Objective

To differentially diagnose and contextualize pathological lesions suggestive of rheumatoid arthritis.

Materials

The skeletal remains of a 25–30-year-old female dated to c. 1750–1550 BCE from a Nubian Pan-Grave cemetery at the site of Sheik Mohamed, near Aswan, Egypt.

Methods

The skeletal remains were examined macroscopically and a differential diagnosis was conducted following established protocols in the palaeopathological literature.

Results

Symmetrical, bilateral, erosive periarticular lesions with smooth edges were observed in multiple joints (especially in the hands and feet).

Conclusions

Differential diagnosis suggests this individual had rheumatoid arthritis.

Significance

This case suggests the presence of rheumatoid arthritis in ancient Egypt, contributing to a more finely grained understanding of the antiquity and geographical distribution of the condition.

Limitations

It was not possible to radiograph the skeletal remains.

Suggestions for further research

Researchers are encouraged to re-examine any archaeological examples of erosive polyarthropathy using current palaeopathological protocols and to explore the manifestation of rheumatoid arthritis on the African continent.