A problem in palaeopathology

Summary Palaeopathology makes possible investigations into the origin of diseases. So the aim of this editorial is to explore all the palaeopathologic remains supposed to be related to the origin of thalassemia in Italy. This last is a problem which has led to much speculation. Two theories have been proposed. The first sees the earliest evidence of thalassemia as going back to the upper Palaeolithic era, and the second suggests that thalassemia originated in Greece and spread to Italy when it was colonized by the Greeks between the 8th and 6th centuries B.C. The second view seems to be supported by the fact that at present the incidence of thalassemia is highest in the areas where ancient Greek immigration was most intense — Sicily, Sardinia, Calabria, Lucania, Apulia and the mouth of the Po.The conclusion is drawn that all the skeletal remains showing porotic hyperostosis found so far in Italy are unable to provide a solution to the problem of the origins of thalassemia in this country, owing to the impossibility of reaching a clearcut decision as to whether to accept or reject a diagnosis of thalassemia. This difficulty derives from the fact that porotic hyperostosis is common to a large group of haematologic disorders involving erythroblastic hyperplasia, especially if the disease develops at an early age. So, it appears obvious that, when haematological findings are not available, data of other type should be considered in the attempt to identify — as far as possible exactly — the nature of the blood disease responsible for the skeletal changes in each case. Some main methodological principles are considered in order to make investigations more rewarding in future.     

Osteopoikilosis in an ancient skeleton: more than a medical curiosity

We describe the palaeopathologic and radiographic findings of the human skeletal remains that belonged to a female who lived in Mexicos viceroyship period (seventeenth and eighteenth centuries A.D.). Radiographic studies showed numerous, radiodense, ovoid, small and well-defined foci in the long tubular bones, sacrum, scapulae and iliac bones. Computed tomography (CT) examination revealed multiple hyperdense foci located in the central marrow portion of the bones. Measurements of attenuation coefficient revealed +1548 HU. The findings are consistent with osteopoikilosis, an uncommon, benign sclerosing bone dysplasia transmitted in an autosomal dominant fashion, which in the clinical setting is important to set apart from different bone pathologies to avoid unnecessary interventions and treatments. To the best of our knowledge, this is the first report of osteopoikilosis in ancient human remains.     

Meta-analysis of teeth from European populations before and after the 18th century reveals a shift towards increased prevalence of caries and tooth loss

Based on single studies, it has been hypothesised that Europeans have suffered less frequently from caries before the 18th century than after the 18th century and that females have higher caries prevalence, but systematic European-wide overviews are sparse.We collected published data on dental diseases (publication between 1981 and 2015 with reports on 29 cohorts with 4998 individuals and a total of 85817 teeth).Meta-analyses revealed that, over several hundred years, including the post-18th century era, Europeans had relatively constant frequencies of caries and ante-mortem tooth loss, but since the 18th century, the mean frequencies of these dental diseases increased (each p < 0.05). Tooth loss correlated with caries and odontogenic abscesses (each p < 0.05). Although the mean caries and ante-mortem tooth loss frequencies increased since the 18th century, there are overlaps with many pre-18th century cohorts. In addition, in contrast to previous hypotheses, no general increase of caries prevalence in females could in fact be verified.It is likely that changes in nutrition (more sugar) and dental health (possibly higher frequency of tooth extraction) could be the underlying factors which led to this minor to moderate shift of dental disease frequencies in Europe.     

Metastatic carcinoma of presumed prostatic origin in cremated bones from the first century A.D.

 A cremated pelvis dating from the first century A.D. showed evidence of osteosclerotic metastasis, presumably secondary to prostate carcinoma. The case demonstrates the importance of microradiography in palaeopathology as well as some of the structural changes seen in cremated bone. Received: 26 November 1996 / Accepted: 18 February 1997     

Hemifacial microsomia (oculo-auriculo-vertebral spectrum) in an individual from the Teramo Sant’Anna archaeological site (7th–12th centuries of the Common Era,Italy)

BackgroundThis study is based in an analysis of the skeletal remains of an adult male from the Teramo Sant’Anna archaeological site (7th–12th centuries of the Common Era, Teramo, Italy).Results and discussionThe individual shows distinct abnormalities that principally involve asymmetric hypoplasia and dysmorphogenesis of the facial skeleton. The combination of these findings and the absence of abnormalities of the spine strongly suggest diagnosis of the congenital malformation known as hemifacial microsomia. This very heterogeneous syndrome affects primarily aural, ocular, oral and mandibular development. Despite the lack of clinical information and the absence of soft tissue, it was possible to perform a differential diagnosis for this palaeopathological case. Mastication was probably altered considering that the mandible is extremely asymmetric and lacks true condyles. The temporomandibular joints are present, but the right one is hypoplastic and abnormal in shape. There is evidence of bilateral dislocation, and the facial muscles are hypertrophic.ConclusionsThis case represents an important contribution to the palaeopathological literature because this is an uncommon condition that has not been widely documented in ancient skeletal remains.