Adolescent health in medieval Serbia: signs of infectious diseases and risk of trauma

Cribriotic lesions in archaeological human skeletal remains. Prevalence, co-occurrence, and association in medieval and early modern Netherlands

OBJECTIVE

This paper studies the prevalence, co-occurrence, and association of cribra orbitalia, cribra humeri, and cribra femora to contribute to the complex debate on cribriotic lesions and their relationship with one another.

MATERIALS

179 adults and 53 non-adults from the medieval/early modern Netherlands (800-1600 CE) for whom all three lesions could be observed are included in this study.

METHODS

Presence or absence of cribriotic lesions was studied macroscopically. Prevalence, co-occurrence, and association of lesions and their link to sex and age-at-death were assessed.

RESULTS

A clear link between prevalence of the lesions and age-at-death is found. Co-occurrence and association of all three lesions is uncommon. There is a significant moderate correlation for cribra humeri-femora in non-adults.

CONCLUSIONS

Lesion prevalence is connected to age-at-death. However, while a similar age distribution and associations between pairs of lesions are noted, due to limited co-occurrence of the three lesions, the presence of a 'cribrous syndrome' cannot supported.

SIGNIFICANCE

This is the first study investigating the prevalence, co-occurrence and association of cribra orbitalia, cribra humeri, and cribra femora in non-adults and adults contributing to discussions about the nature and the much-debated aetiology of these commonly encountered skeletal lesions.

LIMITATIONS

The number of non-adults in this study is limited, potentially obscuring meaningful patterns, as the cribrous lesions are significantly more common in younger individuals.

SUGGESTIONS FOR FURTHER RESEARCH

More research into the prevalence of the post-cranial lesions and their co-occurrence as well as into bone growth and remodelling is warranted.

Cribra orbitalia is correlated with the meningo-orbital foramen and is vascular and developmental in nature

Cribra orbitalia is a phenomenon with interdisciplinary interest. However, the etiology of cribra orbitalia remains unclear. Recently, the appearance of cribra orbitalia was identified as vascular in nature. This study assessed the relationship between anatomical variation of vasculature, as determined by the presence of meningo-orbital foramina, and the presence of cribra orbitalia in 178 orbits. Cribra orbitalia was identified in 27.5% (49:178) of orbits (22.7%, 35:154 adult orbits and 58.3%, 14:24 subadult orbits) and meningo-orbital foramina were identified in 65.8% (100:152) of orbits. Among the 150 total intact adult orbits (i.e., orbital roof and posterior orbits both intact), cribra orbitalia was found in 35 (23.3%). Of these 35 occurrences of cribra orbitalia, 32 (91.4%) had the concurrent finding of a meningo-orbital foramen. However, in the absence of the meningo-orbital foramen, cribra orbitalia was only found in three sides out of the total sample of intact orbits (3:150; 2.0%). Fisher's exact test revealed that the presence of cribra orbitalia and the meningo-orbital foramen were statistically dependent variables (p = .0002). Visual evidence corroborated statistical findings-vascular impressions joined cribra orbitalia to meningo-orbital foramina. This study identifies that individuals who possess a meningo-orbital foramen are anatomically predisposed to developing cribra orbitalia. Conversely, cribra orbitalia is unlikely to occur in an individual who does not possess a meningo-orbital foramen. Thus, the antecedent of cribra orbitalia is both vascular and developmental in nature. This report represents an important advancement in the understanding of cribra orbitalia-there is an anatomical predisposition to the development of cribra orbitalia.

Giant cell tumor of bone in an eighteenth-century Italian mummy

Giant cell tumor (GCT) of the bone is a locally aggressive and rarely metastasizing neoplasm. It is composed of neoplastic mononuclear stromal cells with a monotonous appearance admixed with macrophages and osteoclast-like giant cells. In a small subset of cases, GCT is malignant. Terminology previously related to this entity, and which is no longer supported by the World Health Organization, includes osteoclastoma and benign fibrous histiocytoma (BFH). Giant cells occur in numerous other pathologic conditions of the bone, which accounts for the misrepresentation of these non-GCT tumors in the early literature. Non-ossifying fibroma (NOF), aneurysmal bone cyst, and chondroblastoma have been erroneously labeled GCT for this reason. A single description of an ancient GCT was reported by Brothwell and Sandison and subsequently mentioned by Aufderheide and Rodrìguez-Martìn who were astonished that more of these tumors had not been identified in archaeological cases. To the best of our knowledge, no other cases of ancient GCT have been cited in the paleopathology literature. The study of this type of neoplasm in antiquity can be used as a means to better understand its characteristics and behavior and to expand the depth of time of the etiology of these lesions. We report a case of GCT of the left femur observed following the total body CT imaging of a partially mummified adult female, dating to eighteenth century.

Bone porosity and longevity in early medieval Southern Croatia

Porosity of the skull and skeletal remains, especially of the orbital roof, are one of the most frequent pathological findings on ancient human skeletal remains. There are several presumed causes of this condition and anthropologists consider skull porosities as a marker of physical and nutritional stress. A total of 115 graves were discovered at the early-medieval graveyard near Zadar (Croatia) that contained 128 partially preserved skeletons. Average estimated age at death was 37.2 ± 12.6 years for men, 31.9 ± 13.9 for women, and 5.3 ± 3.6 years for subadults. Pathological bone porosity was analysed. Cribra orbitalia was observed on 21 skulls (28.7%), signs of temporal porosity were noticed on six skulls and signs of subperiosteal bleeding on three skulls. Nineteen skulls had bone porosities in other areas. There was a significant difference (p = 0.039) in achieved age of adults with and without cribra orbitalia as those with cribra orbitalia lived on average 8.1 years longer. The bone porosity was probably caused by malnutrition that might have had a beneficial effect on longevity of adults, similar to effects of restricted food intake on extending lifespan through epigenetic signatures influencing gene expression.