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Ham AC, Temple DH, Klaus HD, Hunt DR. Evaluating life history trade-offs through the presence of linear enamel hypoplasia at Pueblo Bonito and Hawikku: A biocultural study of early life stress and survival in the Ancestral Pueblo Southwest. Am J Hum Biol 2020; 33:e23506. [PMID: 32924230 DOI: 10.1002/ajhb.23506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 08/23/2020] [Accepted: 08/25/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Due to the indelible nature of enamel, bioarchaeologists use linear enamel hypoplasia (LEH) to detect early investments in surviving stress and have identified an association between LEH presence and constraints in growth and maintenance as well as an increased susceptibility to future stress events. This study evaluates heterogenous frailty and susceptibility to death in relation to episodes of early life stress, as reflected by LEH presence, in the Ancestral Pueblo Southwest. This study hypothesizes that LEH presence will be associated with decreased survivorship and an increased likelihood of mortality in both samples. MATERIALS AND METHODS This study uses two samples, one from Pueblo Bonito (A.D. 800-1200; n = 28) and the second from Hawikku (A.D. 1300-1680; n = 103). Kaplan-Meier survival analysis with a log-rank test was used to evaluate the effect of LEH presence on survivorship for the two samples. RESULTS Survival analysis reveals statistically significant differences in mortality risk between individuals with and without LEH for the Hawikku sample, but no significant differences for the Pueblo Bonito sample. CONCLUSION The results demonstrate differences in the response to early life stress at the Hawikku and Pueblo Bonito sites, likely reflecting context. The Pueblo Bonito sample represents a high-status group, and survival following LEH may be the result of cultural buffering. Hawikku dates to a period associated with increased levels of disease and malnutrition as well as Spanish colonization. This environment may have exacerbated mortality risk for individuals in the region who survived early life stress and signifies the consequences of European colonialism in the New World.
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Affiliation(s)
- Allison C Ham
- Department of Anthropology, University of South Carolina, Columbia, South Carolina, USA
| | - Daniel H Temple
- Department of Sociology and Anthropology, George Mason University, Fairfax, Virginia, USA
| | - Haagen D Klaus
- Department of Sociology and Anthropology, George Mason University, Fairfax, Virginia, USA
| | - David R Hunt
- Physical Anthropology Division, Department of Anthropology, National Museum of Natural History, Smithsonian Institution, Washington, District of Columbia, USA
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O'Donnell L, Hill EC, Anderson ASA, Edgar HJH. Cribra orbitalia and porotic hyperostosis are associated with respiratory infections in a contemporary mortality sample from New Mexico. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 173:721-733. [PMID: 32869279 DOI: 10.1002/ajpa.24131] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 07/23/2020] [Accepted: 08/04/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Cribra orbitalia (CO) and porotic hyperostosis (PH) are porous cranial lesions (PCLs) classically associated with iron-deficiency anemia in bioarchaeological contexts. However, recent studies indicate a need to reassess the interpretation of PCLs. This study addresses the potential health correlates of PCLs in a contemporary sample by examining relationships between the known cause of death (COD) and PCL presence/absence. METHODS This study includes a sample of 461 juvenile individuals (6 months to 15 years of age) who underwent examination at the University of New Mexico's Office of the Medical Investigator between 2011 and 2019. The information available for each individual includes their sex, age at death, and their COD and manner of death. RESULTS Odds ratio of having CO (OR = 3.92, p < .01) or PH (OR = 2.86, p = .02) lesions are increased in individuals with respiratory infections. Individuals with heart conditions have increased odds of having CO (OR = 3.52, p = .03) lesions, but not PH. CONCLUSION Individuals with respiratory infection are more likely to have CO and/or PH. CO appears to have a greater range of health correlates than PH does, as indicated by the heart condition results. However, individuals with congenital heart defects are at higher risk for respiratory infections, so bony alterations in cases of heart conditions may be due to respiratory illness. Since respiratory infection remains a leading cause of mortality today, CO and PH in bioarchaeological contexts should be considered as potential indicators of respiratory infections in the past.
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Affiliation(s)
- Lexi O'Donnell
- Department of Sociology and Anthropology, University of Mississippi, Oxford, Mississippi, USA
| | - Ethan C Hill
- Department of Anthropology, University of New Mexico, Albuquerque, New Mexico, USA
| | | | - Heather J H Edgar
- Department of Anthropology, University of New Mexico, Albuquerque, New Mexico, USA.,Office of the Medical Investigator, University of New Mexico, Albuquerque, New Mexico, USA
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Klaus HD. Metabolic diseases in Andean paleopathology: Retrospect and prospect. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2020; 29:54-64. [PMID: 31377145 DOI: 10.1016/j.ijpp.2019.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/01/2019] [Accepted: 06/29/2019] [Indexed: 06/10/2023]
Abstract
John Verano's 1997 synthesis of Andean paleopathology guided two decades of research and was instrumental in establishing modern Andean paleopathology. This paper reviews the current state and new directions in the study of skeletal metabolic disorders in the Central Andean archaeological record. Key historical, ecological, methodological, and contextual issues intersect with the study of metabolic bone diseases in Andean paleopathology. This paper further examines known temporal and spatial distribution of these disorders, as well as the strengths and weaknesses of the record of linear enamel hypoplasias, cribra orbitalia, porotic hyperostosis, scurvy, and rickets. Many other metabolic bone diseases have yet to be documented such as pellagra, hypophosphatasia, osteomalacia, and mucopolysaccharidosis among others. This work closes with considerations in the search for these undocumented diseases, but such an effort is only one part of new wave of advancements just on the horizon. The study of metabolic diseases in Andean paleopathology can lead the development of more sophisticated approaches to data collection, analysis, and interpretation - especially regarding theoretical interpretations from various bodies of social theory to the Developmental Origins of Health and Disease hypothesis, life history approaches, and phenotypic adaptive plasticity and constraint.
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Affiliation(s)
- Haagen D Klaus
- Department of Sociology and Anthropology, George Mason University, United States; Museo Nacional Sicán, Peru; Museo Nacional de Arqueología y Etnografía Hans Heinrich Brüning de Lambayeque, Peru.
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O'Donnell L. Indicators of stress and their association with frailty in the precontact Southwestern United States. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 170:404-417. [DOI: 10.1002/ajpa.23902] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 05/18/2019] [Accepted: 06/28/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Lexi O'Donnell
- Department of AnthropologyUniversity of New Mexico Albuquerque New Mexico
- Laboratory of Human OsteologyMaxwell Museum of Anthropology Albuquerque New Mexico
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5
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Hens SM, Godde K, Macak KM. Iron deficiency anemia, population health and frailty in a modern Portuguese skeletal sample. PLoS One 2019; 14:e0213369. [PMID: 30845224 PMCID: PMC6405098 DOI: 10.1371/journal.pone.0213369] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 02/19/2019] [Indexed: 02/02/2023] Open
Abstract
Introduction Portugal underwent significant political, demographic and epidemiological transitions during the 20th century resulting in migration to urban areas with subsequent overcrowding and issues with water sanitation. This study investigates population health during these transitions and interprets results within a framework of recent history and present-day public health information. We investigate skeletal evidence for anemia (cribra orbitalia and porotic hyperostosis) as indicators of stress and frailty–i.e., whether the lesions contribute to susceptibility for disease or increased risk of death. Methods The presence and severity of skeletal lesions were compared against known sex and cause of death data to investigate potential heterogeneity in frailty and the relationship between lesions and risk of dying over time. Additionally, we tested for the presence of selective mortality in our data (i.e., whether or not the sample is biased for individuals with higher frailty). Our sample derives from a large, documented, modern Portuguese collection from Lisbon and is the first study of its kind using a documented collection. The collection represents primarily middle-class individuals. Results and conclusions Analyses indicated that porotic hyperostosis became more common and severe over time, while cribra orbitalia severity increased over time. Neither process was linked to cause of death. However, there was a significant relationship to sex; males exhibited a higher prevalence and severity of lesions and increased mortality. A Gompertz function showed decreased survivorship in early life but increased survivorship over age 60. Using comorbidities of anemia, we were unable to detect selective mortality–i.e., in our sample, lesions do not represent a sign of poor health or increased frailty and are not significantly linked with a decreased mean age-at-death. However, lesion prevalence and severity do reflect the socioeconomic processes in urban Lisbon during the 1800s and 1900s and the possibility of water-borne parasites as the contributing factor for iron deficiency anemia.
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Affiliation(s)
- Samantha M. Hens
- Department of Anthropology, California State University Sacramento, Sacramento, California, United States of America
- * E-mail:
| | - Kanya Godde
- Department of Sociology and Anthropology, University of La Verne, La Verne, California, United States of America
| | - Kristin M. Macak
- Department of Anthropology, California State University Sacramento, Sacramento, California, United States of America
- Department of Sociology and Criminal Justice, Old Dominion University, Norfolk, Virginia, United States of America
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Rivera F, Mirazón Lahr M. New evidence suggesting a dissociated etiology forcribra orbitaliaand porotic hyperostosis. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2017; 164:76-96. [DOI: 10.1002/ajpa.23258] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 05/15/2017] [Accepted: 05/19/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Frances Rivera
- Department of Archaeology & Anthropology, Leverhulme Centre for Human Evolutionary Studies; University of Cambridge; United Kingdom
| | - Marta Mirazón Lahr
- Department of Archaeology & Anthropology, Leverhulme Centre for Human Evolutionary Studies; University of Cambridge; United Kingdom
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Zariņa G, Sholts SB, Tichinin A, Rudovica V, Vīksna A, Engīzere A, Muižnieks V, Bartelink EJ, Wärmländer SKTS. Cribra orbitalia as a potential indicator of childhood stress: Evidence from paleopathology, stable C, N, and O isotopes, and trace element concentrations in children from a 17 th-18 th century cemetery in Jēkabpils, Latvia. J Trace Elem Med Biol 2016; 38:131-137. [PMID: 27289401 DOI: 10.1016/j.jtemb.2016.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/20/2016] [Accepted: 05/23/2016] [Indexed: 11/30/2022]
Abstract
Cribra orbitalia (CO), or porotic hyperostosis (PH) of the orbital roof, is one of the most common pathological conditions found in archaeological subadult skeletal remains. Reaching frequencies higher than 50% in many prehistoric samples, CO has been generally attributed to a variety of factors including malnutrition (e.g., megaloblastic anemia) and parasitism. In this study, we tested the relationship between CO, trace element concentrations, and stable isotope values (δ13C, δ15N, δ18O) in subadult skeletons from a 17th to 18th century cemetery in the historic town of Jēkabpils, Latvia. A total of 28 subadults were examined, seven of which (25%) showed evidence of CO. Bioarchaeological evidence indicated high mortality for children in this cemetery: half of the burials were subadults under the age of 14, while a third were under the age of four. Life expectancy at birth was estimated to have been only 21.6 years. Trace element concentrations measured by Inductively Coupled Plasma - Mass Spectrometry (ICP-MS) showed no relationship between presence or absence of CO and levels of manganese, zinc, strontium, barium, copper, cadmium, or lead in the bones (p>0.05). However, a significant correlation (p<0.05) was found between the presence of CO and decreased levels of iron. The correlations between CO and decreased levels of copper and lead approached significance (p=0.056 for both elements). Individuals with CO furthermore displayed significantly lower δ15N isotope values, suggesting greater consumption of lower trophic level food resources than those unaffected by CO; δ13C and δ18O values, in contrast, showed no significant differences. These results suggest that the prevalence of CO may be related to dietary deficiencies. In this case, low iron levels may also signify a diet low in other key vitamins (e.g., B9 and B12), which are known to cause megaloblastic anemia.
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Affiliation(s)
- Gunita Zariņa
- Institute of the Latvian History at the University of Latvia, Riga, Latvia
| | - Sabrina B Sholts
- Department of Anthropology, National Museum of Natural History, Smithsonian Institution, Washington DC, USA
| | - Alina Tichinin
- Department of Anthropology, California State University, Chico, CA, USA
| | - Vita Rudovica
- Department of Analytical Chemistry, University of Latvia, Riga, Latvia
| | - Arturs Vīksna
- Department of Analytical Chemistry, University of Latvia, Riga, Latvia
| | | | | | - Eric J Bartelink
- Department of Anthropology, California State University, Chico, CA, USA
| | - Sebastian K T S Wärmländer
- Division of Biophysics, Stockholm University, Sweden; Cotsen Institute of Archaeology, UCLA/Getty Conservation Programme, UCLA, Los Angeles, CA, United States.
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Smith-Guzmán NE. Cribra orbitalia in the ancient Nile Valley and its connection to malaria. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2015; 10:1-12. [PMID: 29539534 DOI: 10.1016/j.ijpp.2015.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 03/04/2015] [Accepted: 03/11/2015] [Indexed: 05/26/2023]
Abstract
Cribra orbitalia is a common skeletal lesion found on ancient human remains excavated from the Nile Valley. Recent etiological research implicates hemolytic anemia as a main factor leading to the formation of cribra orbitalia. Further, an association between the hemolytic anemia caused by malaria and cribra orbitalia has been demonstrated. The presence of malaria in the ancient Nile Valley has been verified directly through genetic and immunologic studies of Egyptian mummies, but its prevalence and spread remain unknown. As some models have pointed to the Nile Valley as the pathway of malarial dispersion during the Egyptian Dynastic period, variability in cribra orbitalia rates should provide a way to track the disease spread. This study surveyed cribra orbitalia frequencies at 29 ancient Nile Valley sites, representing 4760 individuals ranging from prehistoric to Christian periods and situated between the 3rd Cataract and Nile Delta. Results showed high cribra orbitalia rates, with an overall mean of 42.8% of the total population affected. Over time and space, the data showed no significant correlation, suggesting high levels of anemia affected individuals in the Nile Valley equally from late pre-dynastic to Christian periods. These findings suggest widespread endemic malaria in the Nile Valley before Dynastic Egypt.
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Affiliation(s)
- Nicole E Smith-Guzmán
- Department of Anthropology, University of Arkansas, 330 Old Main, Fayetteville, AR 72701, United States.
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9
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Domínguez-Rodrigo M, Pickering TR, Diez-Martín F, Mabulla A, Musiba C, Trancho G, Baquedano E, Bunn HT, Barboni D, Santonja M, Uribelarrea D, Ashley GM, Martínez-Ávila MDS, Barba R, Gidna A, Yravedra J, Arriaza C. Earliest porotic hyperostosis on a 1.5-million-year-old hominin, olduvai gorge, Tanzania. PLoS One 2012; 7:e46414. [PMID: 23056303 PMCID: PMC3463614 DOI: 10.1371/journal.pone.0046414] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 08/29/2012] [Indexed: 11/23/2022] Open
Abstract
Meat-eating was an important factor affecting early hominin brain expansion, social organization and geographic movement. Stone tool butchery marks on ungulate fossils in several African archaeological assemblages demonstrate a significant level of carnivory by Pleistocene hominins, but the discovery at Olduvai Gorge of a child's pathological cranial fragments indicates that some hominins probably experienced scarcity of animal foods during various stages of their life histories. The child's parietal fragments, excavated from 1.5-million-year-old sediments, show porotic hyperostosis, a pathology associated with anemia. Nutritional deficiencies, including anemia, are most common at weaning, when children lose passive immunity received through their mothers' milk. Our results suggest, alternatively, that (1) the developmentally disruptive potential of weaning reached far beyond sedentary Holocene food-producing societies and into the early Pleistocene, or that (2) a hominin mother's meat-deficient diet negatively altered the nutritional content of her breast milk to the extent that her nursing child ultimately died from malnourishment. Either way, this discovery highlights that by at least 1.5 million years ago early human physiology was already adapted to a diet that included the regular consumption of meat.
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Beňuš R, Obertová Z, Masnicová S. Demographic, temporal and environmental effects on the frequency of cribra orbitalia in three Early Medieval populations from western Slovakia. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2010; 61:178-90. [DOI: 10.1016/j.jchb.2010.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2008] [Accepted: 10/25/2009] [Indexed: 10/19/2022]
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Walker PL, Bathurst RR, Richman R, Gjerdrum T, Andrushko VA. The causes of porotic hyperostosis and cribra orbitalia: A reappraisal of the iron-deficiency-anemia hypothesis. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2009; 139:109-25. [DOI: 10.1002/ajpa.21031] [Citation(s) in RCA: 470] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Buzon MR. Health of the non-elites at Tombos: Nutritional and disease stress in New Kingdom Nubia. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2006; 130:26-37. [PMID: 16353219 DOI: 10.1002/ajpa.20303] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
During the New Kingdom period, Egypt succeeded in occupying most of Nubia. Colonial towns were built, which served as centers of government and redistribution. This paper uses a bioarchaeological approach to address the effects of this cultural contact on non-elites. Skeletal remains from the site of Tombos (N = 100), a cemetery in Upper Nubia dating to this important time, are analyzed, in addition to 1,082 individuals from contemporaneous Egyptian and Nubian sites, in order to shed light on the social, political, and economic processes at play and to determine how the people at Tombos were affected during this transitional period. In many ways, the Tombos population appears to have been affected by similar stressors as the other populations under study. However, a few small differences in the subadult frequencies of pathological lesions, especially remodeling rates, are significant in the overall picture of health at Tombos. These analyses suggest that, although the people of Tombos may have been integrated into the Egyptian colonial network, the additional resources they may have obtained could not protect them from nutritional and disease stress. A lower childhood survival through bouts of ill health at Tombos is suggested. While status may have played a role in the differences seen in the comparative populations, it is likely that parasites and/or other infections led to childhood illness and death.
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Affiliation(s)
- Michele R Buzon
- Department of Anthropology, University of Alberta, Edmonton, Alberta T6G 2H4, Canada.
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14
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Rothschild B. Porotic hyperostosis as a marker of health and nutritional conditions. Am J Hum Biol 2002; 14:417-8; discussion 418-20. [PMID: 12112562 DOI: 10.1002/ajhb.10078] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Hershkovitz I, Rothschild BM, Latimer B, Dutour O, Léonetti G, Greenwald CM, Rothschild C, Jellema LM. Recognition of sickle cell anemia in skeletal remains of children. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1997; 104:213-26. [PMID: 9386828 DOI: 10.1002/(sici)1096-8644(199710)104:2<213::aid-ajpa8>3.0.co;2-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The present study discusses in detail the osteological changes associated with sickle cell anemia in children and their importance in differential diagnosis. Posterior calcaneal and specific articular surface disruptive metacarpal lesions are diagnostic for sickle cell anemia. Calvarial thickening, tibial and femoral cortical bone thickening, and bowing are of more limited utility in differential diagnosis. Granular osteoporosis, pelvic demineralization and rib broadening are nonspecific. Localized calvarial "ballooning," previously not described, may have diagnostic significance. Bone marrow hyperplastic response (porotic hyperostosis) in sickle cell anemia produces minimal radiologic changes contrasted with that observed in thalassemia and blood loss/hemolytic phenomenon. Two other issues, the osteological criteria for discriminating among the anemias and the purported relationship between porotic hyperostosis and iron deficiency anemia, are also discussed. There is sufficient information to properly diagnose the four major groups of anemias, and further, to establish that iron deficiency is only indirectly associated with porotic hyperostosis. The hyperproliferative bone marrow response (manifest as porotic hyperostosis) to blood loss or hemolysis exhausts iron stores, resulting in secondary iron deficiency.
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Affiliation(s)
- I Hershkovitz
- Cleveland Museum of Natural History, Ohio 44106-1767, USA.
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Abstract
The analysis of a sample of skeletons from the 4,000-year-old site of Khok Phanom Di on the coast of central Thailand has identified a number of individuals with skeletal evidence suggestive of severe anemia. The differential diagnosis of the lesions is discussed and the presence of one of the thalassemia syndromes is proposed. The implications of this for southeast Asian prehistory are discussed. The presence of these conditions has been suggested in previous analyses of prehistoric southeast Asian populations, but this is the first population in which the evidence, including postcranial responses, is presented in detail.
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Affiliation(s)
- N Tayles
- Department of Anatomy and Structural Biology, University of Otago Medical School, Dunedin, New Zealand
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In the wake of Columbus: Native population biology in the postcontact Americas. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1994. [DOI: 10.1002/ajpa.1330370606] [Citation(s) in RCA: 88] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Grauer AL. Patterns of anemia and infection from medieval York, England. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1993; 91:203-13. [PMID: 8317561 DOI: 10.1002/ajpa.1330910206] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
An assessment of the presence and patterns of porotic hyperostosis and periosteal reactions in the skeletal population (n = 1,014) from St. Helen-on-the-Walls, York, are used to examine health and disease in urban medieval England. The analyses of these two lesions indicate that 58% of the population display evidence of porotic hyperostosis and that 21.5% of the population display periosteal reactions. Through differential diagnosis it is asserted that porotic hyperostosis is associated with iron-deficiency anemia, and that periosteal reactions may be the result of endemic treponematosis and/or non-specific infection, including parasitic infestation. An association between the presence of remodeled lesions and adulthood is noticeable for both porotic hyperostosis and periosteal reactions, as is a pattern of increased average age at death for those displaying both conditions.
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Affiliation(s)
- A L Grauer
- Department of Sociology and Anthropology, Loyola University of Chicago, Illinois 60626
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Stuart-Macadam P. Porotic hyperostosis: a new perspective. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1992; 87:39-47. [PMID: 1736673 DOI: 10.1002/ajpa.1330870105] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Porotic hyperostosis is a paleopathologic condition that has intrigued researchers for over a century and a half. It is now generally accepted that anemia, most probably an iron deficiency anemia, is the etiologic factor responsible for lesion production. Although there can be a number of factors involved in the development of iron deficiency anemia, a dietary explanation has often been invoked to explain the occurrence of porotic hyperostosis in past human skeletal populations. In fact, porotic hyperostosis has been referred to as a "nutritional" stress indicator. Traditionally those groups with a higher incidence of porotic hyperostosis have been considered to be less successful in adapting to their environment or more nutritionally disadvantaged than other groups. A new perspective is emerging that is challenging previous views of the role of iron in health and disease, thus having profound implications for the understanding of porotic hyperostosis. There is a new appreciation of the adaptability and flexibility of iron metabolism; as a result it has become apparent that diet plays a very minor role in the development of iron deficiency anemia. It is now understood that, rather than being detrimental, hypoferremia (deficiency of iron in the blood) is actually an adaptation to disease and microorganism invasion. When faced with chronic and/or heavy pathogen loads individuals become hypoferremic as part of their defense against these pathogens, thus increasing their susceptibility to iron deficiency anemia. Within the context of this new perspective porotic hyperostosis is seen not as a nutritional stress indicator, but as a indication that a population is attempting to adapt to the pathogen load in its environment.
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Affiliation(s)
- P Stuart-Macadam
- Department of Anthropology, University of Toronto, Ontario, Canada
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Fairgrieve SI. Size of the sella turcica and its relation to iron deficiency anemia: a prehistoric example. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1990; 83:111-21. [PMID: 2221025 DOI: 10.1002/ajpa.1330830113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This paper examines the usefulness of volume and area assessments of the sella turcica from radiographs in order to aid in the differential diagnosis of iron deficiency anemia in past populations. Lateral and posterior-anterior radiographs were taken of each cranium in the sample. The length, depth, and width of the sella turcica were then measured directly from the appropriate view, and subsequently the volume and area were calculated for each. The 20-25 year-old cohort was found to yield the most promising results; however, a statistical difference was not found to exist using the volume or area. The width dimension was found to be of far more use than any other in this study. In no instance was any feature of typical porotic hyperostosis, visually or radiographically, found to be statistically correlated with any difference in the dimensions of the sella turcica. A discussion of how the various dimensions of the sella turcica react to changes in size of the hypophysis cerebri is presented.
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Affiliation(s)
- S I Fairgrieve
- Department of Anthropology, Erindale College, University of Toronto, Mississauga, Ontario, Canada
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Palkovich AM. Endemic disease patterns in paleopathology: porotic hyperostosis. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1987; 74:527-37. [PMID: 3126663 DOI: 10.1002/ajpa.1330740411] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Recent research has shown that constitutional factors can elicit a porotic skeletal lesion pattern related to iron-deficiency anemia, even when adequate dietary iron is available. This study considers the pattern of skeletal involvement under conditions of chronic or endemic dietary stress. Analysis focused on 54 subadults aged 0-10 years at death from the Arroyo Hondo site. Early age of onset is documented in the pattern of coincident active periosteal reactions and porotic lesions under 6 months. Endemically inadequate diets affecting pregnant females and their fetuses, acting synergistically with immediately acquired infections, not weaning diets, are the probable major underlying causes for the early onset of iron-deficiency anemia at Arroyo Hondo.
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Affiliation(s)
- A M Palkovich
- Department of Sociology/Anthropology, George Mason University, Fairfax, Virginia 22030
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Stuart-Macadam P. A radiographic study of porotic hyperostosis. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1987; 74:511-20. [PMID: 3327383 DOI: 10.1002/ajpa.1330740409] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Skull lesions known as porotic hyperostosis have been of interest to researchers since the mid-19th century. The etiology of porotic hyperostosis has long been a matter for speculation yet there has never been complete acceptance or substantiation of any one of the many theories proposed. Today the most widely accepted theory suggests that anemias of either acquired or genetic origin are responsible for porotic hyperostosis. The present study tests this hypothesis using criteria which were chosen after the examination of clinical radiographs of patients with various types of anemia. These criteria are: the presence of "hair-on-end" trabeculation, outer table thinning, texture changes, diploic thickening, orbital roof thickening, orbital rim changes, and the underdevelopment of frontal sinuses. A comparison of these criteria from the clinical X-rays with X-rays of skulls with porotic hyperostosis provides a more rigorous, repeatable, and standardized method upon which to base a diagnosis. This approach enables radiography to provide the necessary link between the clinical and anthropological with which to investigate the origin of porotic hyperostosis.
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Mensforth RP, Lovejoy CO, Lallo JW, Armelagos GJ. Part Two: The role of constitutional factors, diet, and infectious disease in the etiology of porotic hyperostosis and periosteal reactions in prehistoric infants and children. Med Anthropol 1978; 2:1-59. [DOI: 10.1080/01459740.1978.9986939] [Citation(s) in RCA: 118] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
A well-preserved mummified child from about A.D. 1200 was recovered fron Canyon de Chelly in northeastern Arizona in 1971. Striking skull changes were found and microscopic, ultrastructural, and cytochemical studies confirm the diagnosis of porotic hyperostosis that resulted in spongy bone appearance. We suggest that a possible cause for this condition could be iron deficiency of a severity seldom found in modern societies.
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El-Najjar MY, Ryan DJ, Turner CG, Lozoff B. The etiology and porotic hyperostosis among the prehistoric and historic Anasazi Indians of Southwestern United States. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1976; 44:477-87. [PMID: 937525 DOI: 10.1002/ajpa.1330440311] [Citation(s) in RCA: 59] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Porotic hyperostosis was studied in 539 crania from maize-growing prehistoric and historic groups who occupied two dissimilar ecological zones of the Plateau country of Arizona and New Mexico--canyon bottoms and sage plain. Defined as abnormal localized sieve-like structural changes involving the hematopoietic areas of the cranium, it was found in 185 (34.3%) of these skulls. More frequent in children than in adults, it shows significant frequency differences between both children and adults of the two ecological zones. The two ecological zones differ in the availability of iron in the diet; the canyon inhabitants depended heavily on maize (which interferes with iron absorption) while the sage plain people consumed more iron-rich animal products. We hypothesize that an increased dependence on maize produced more iron deficiency anemia and resulted in more porotic hyperostosis. Maize is known to have permitted a food surplus which in turn allowed for increased Southwestern population growth in marginal areas like the canyon bottoms. Heavy dependency on a single food type with consequent hematologic problems may have been an important reason for the subsequent abandonment of the Anasazi region.
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