Cribra orbitalia,sinusitis and linear enamel hypoplasia in Swedish Roman Iron Age adults and subadults

Maxillary and frontal sinusitis, cribra orbitalia and linear enamel hypoplasia were recorded as indicators of nutritional and environmentally related stress in an Early Iron Age (0–260 AD ) population from Sweden. The material comprised the skeletal remains of 99 adults and 45 subadults (aged 20 years and under). Maxillary sinusitis and cribra orbitalia were recorded in the majority of subadults and adults. In contrast, linear enamel hypoplasia was uncommon and occurred mainly in the subadults. In seven cases (12.7%) there was a clear co‐occurrence of periapical lesions and maxillary sinusitis. A significant co‐occurrence of maxillary sinusitis and frontal sinusitis was found in the adults. The least common combination in sex‐determined adults was cribra orbitalia and enamel hypoplasia, only 7.7% exhibiting both lesions. The significantly higher incidence of this combination among subadults suggests an association with life‐threatening conditions. Overall, the results showed that the Early Iron Age community studied suffered foremost from upper respiratory diseases. Copyright © 2010 John Wiley & Sons, Ltd.     

The relationship between harris line formation and bone growth and development

The leg bones of 54 juveniles from the Romano-British cemetery at Poundbury, Dorset were examined radiographically for Harris lines. No correlation was found between presence/absence of Harris lines and femoral length, cortical index or total cortical thickness, although all three were significantly correlated with dental age for both groups. These results are compared with those of previous studies and differences are interpreted in terms of the nature of the environmental stress which gave rise to the Harris line. In the light of these findings a strategy is suggested which might be adopted for future research in this area.     

Porotic lesions in immature skeletons from Stara Torina,late medieval Serbia

Porotic lesions of immature skeletons have been attracting scientific attention for more than a century. These changes have been documented worldwide and are considered to be one of the indicators of health and/or nutritional status of past human populations. These lesions have frequently been referred to as a nutritional stress indicator, a manifestation of iron‐deficiency anaemia, and a condition caused by chronic infections. In this study, 327 immature skeletons from the medieval graveyard of Stara Torina (Serbia) were examined for macroscopic signs of four types of porotic lesions: cribra orbitalia, femoral cribra, humeral cribra, and porotic hyperostosis. Femoral cribra was observed in 83.25% of femora, humeral cribra in 58.46% of cases, cribra orbitalia in 46.12% of orbits, while porotic hyperostosis was recorded in only 2.94% of skulls. The majority of skeletons affected by cribra presented symmetrical lesions. Association between all types of cribra was recorded in 33.33% of skeletons. Historical data supported the hypothesis that the investigated population was exposed to frequent infections, especially parasitic ones, which led to the development of porotic bone lesions via several mechanisms: parasite‐induced blood loss and diarrhoea (both iron and magnesium malabsorption) or anaemia as a hepcidin‐mediated body adaptive response to infection. Copyright © 2008 John Wiley & Sons, Ltd.     

Cribra orbitalia: a non‐human primate perspective

Cribra orbitalia, a porous lesion involving the orbital roofs, is one of the most‐studied skeletal pathologies in bioarchaeology, and yet uncertainty still exists regarding its aetiology and significance. In contrast to the hundreds of reports of cribra orbitalia in human skeletal remains, little is known of this condition in non‐human primates. Previously, cribra orbitalia has only been reported in catarrhines, with just two cases in cercopithecoids. To provide a broader, phylogenetic perspective on cribra orbitalia, a sample of primate skeletal material was examined to evaluate the occurrence of this condition. The taxonomically diverse sample consists of 380 non‐hominoid (non‐ape) modern primates from both wild and captive populations. Cribra orbitalia is present in 16 individuals, including cercopithecines, colobines, platyrrhines and a prosimian, substantially expanding the known taxonomic range of this condition. Modern primates—with their varied habitats, diets, levels of parasitism, etc.—provide a set of natural experiments regarding conditions and physiologies which may influence the aetiology and impact of cribra orbitalia. More generally, it is suggested here that studies of non‐human primate skeletal pathologies have the potential for providing significant insight on human paleopathologies. Copyright © 2009 John Wiley & Sons, Ltd.     

Health Consequences of European Contact in the Great Plains: A Comparison of Systemic Stress Levels in Pre‐ and Post‐Contact Arikara Populations

The biocultural effects of European contact varied considerably throughout the Americas. Some populations were decimated by colonialism, while others benefited from trade relationships and access to new technologies. It has been suggested that initial contact with European fur traders and explorers was economically favourable for Plains village populations, thereby facilitating a period of cultural florescence. In this study, we evaluate the hypothesis that Plains groups were better off than their predecessors during the initial contact period by comparing frequencies of enamel hypoplasia, cribra orbitalia, and porotic hyperostosis in pre‐ and post‐contact Arikara skeletal assemblages. We included both juveniles and adults in our sample to capture variation in the stress experience of different segments of the population. Our analysis revealed similarly low frequencies of cribra orbitalia in the pre‐ and post‐contact groups and no observed cases of porotic hyperostosis. Enamel hypoplasia, however, was significantly more prevalent among post‐contact Arikara villagers when compared to their pre‐contact counterparts, which suggests that stress levels were higher after European contact. Additionally, enamel hypoplasia was most common among post‐contact juveniles. The elevated frequency of enamel hypoplasia in the post‐contact sample combined with the low frequencies of cribra orbitalia and porotic hyperostosis suggests that disease stress, rather than nutritional deficiencies, was likely responsible for the decline in overall health following European contact. These results also suggest that juveniles are sensitive indicators of systemic stress within a population and should be included in bioarchaeological analyses of prehistoric health when available. Copyright © 2015 John Wiley & Sons, Ltd.     

Cribra orbitalia and porotic hyperostosis in a Greek colonial population (5th to 3rd centuries BC) from the Black Sea

Cribra orbitalia and porotic hyperostosis in Greek skeletal remains have typically been attributed to a genetic anaemia, most notably thalassemia due to the presence of endemic malaria in the Mediterranean region. This paper reports the results of an analysis of cribra orbitalia and porotic hyperostosis in a Greek colonial population (5th to 3rd centuries BC) from the Black Sea. Archaeological evidence, stable isotopic data, and other skeletal indicators of physiological stress are examined to determine the most likely cause(s) of these lesions. While the possibility that some of the colonists of Apollonia suffered from thalassemia cannot be entirely discounted, the skeletal evidence examined in this study is not consistent with a diagnosis of thalassemia. We must therefore be cautious in assuming that cribra orbitalia and porotic hyperostosis in Greek skeletal remains, and indeed skeletal remains from any region where malaria was endemic in the past, is always indicative of this condition. Nutritional deficiencies and exposure to infectious diseases probably played an equally, if not more, important role in the development of these lesions. Copyright © 2006 John Wiley & Sons, Ltd.     

Child Health in Five Early Medieval Irish Sites: A Multidisciplinary Approach

With the aim to reconstruct child health in five early medieval (5th–12th c. CE) Irish sites, an osteoarchaeological study of three biological stress indicators – cribra orbitalia, linear enamel hypoplasia (LEH) and periostitis – has been conducted on 229 skeletons. In addition, Irish early medieval written sources testifying on child health during this period were consulted. These data were furthermore combined with the results of stable isotope analyses (nitrogen and carbon) conducted on subadult bone specimens. Cribra orbitalia was found in 27.5% of the studied individuals (48.6% of subadults were affected), with only two cases active at the time of death. The prevalence of LEH per individual is 63.5% (78.9% in subadults and 59.7% in adults). The age ranges of LEH formation vary between 1.9 and 4.8 years for the maxillary teeth and between 1.8 and 6.2 years for the mandibular teeth. Periosteal inflammations were recorded in over one third of the studied subadults (36.2%) with six cases active at the time of death. The stable isotope results suggest a diet based on terrestrial food sources, with little or no marine input. The presented data strongly suggest that most of the individuals were exposed to a high level of physiological stress during their childhood, and as such does not support the so called ‘osteological paradox’ hypothesis. The observed disturbances were probably caused by a synergistic effect of various biological and socio‐cultural factors. Although the historical records indicate certain differences in diet and lifestyle between social classes and the sexes, this study showed that the children of all ages had poor health in all social classes across a wide geographical location for the full time period of the early medieval. Copyright © 2016 John Wiley & Sons, Ltd.     

Porotic hyperostosis in a Late Upper Palaeolithic skeleton (Villabruna 1, Italy)

Porotic hyperostosis (PH) is a well‐recognised skeletal indicator of physiological stress occurring during the early years of childhood growth. Although frequently found starting from the Neolithic, PH is poorly documented among earlier Palaeolithic hunter–gatherers. This study reports a case of PH in a Late Upper Palaeolithic skeleton (Villabruna 1) from northern Italy. Macroscopic and radiographic examinations of the skeleton show symmetric porotic lesions of the cranial vault, hair‐on‐end appearance, thinning of the cortical bone, diploic expansion and very slight cribra orbitalia (CO). All lesions are highly remodelled and suggest a condition suffered long before death. A differential diagnosis, carried out in order to discriminate between infectious and acquired conditions, points to anaemia as likely aetiology for the changes observed. Absence of postcranial involvement, lesion healing and survival to adulthood suggest a diagnosis of acquired anaemia. Among acquired anaemias, both dietary and infectious models are discussed in light of the individual's skeletal characteristics, as well as geographic location, paleoenvironmental data, subsistence modality and dietary information. The combined analysis of these data suggests that parasitic infestation resulted in megaloblastic anaemia in this individual. Copyright © 2009 John Wiley & Sons, Ltd.     

Bioarchaeological Analysis of Iron Age Human Skeletons from Zambia

The Ingombe Ilede and Isamu Pati Iron Age sites in Zambia provide 47 human burials for analyses. Our new study provides demographic information (sex and age), evidence of trauma, infectious diseases as well as physiological and mechanical indicators of stress. We found a high mortality rate for infants and children. Most of the sample (65%) lacked indications of stress or infectious diseases, but a few had cribra orbitalia, osteoarthritis, osteophytosis and various dental pathologies. These conditions are known to be caused by diet, food processing, nutritional intake and cultural systems. In addition, there were low levels of degenerative joint disease and no evidence of trauma. The stature and body mass estimates show that these Iron Age people were similar in size and shape compared with contemporary South Africans. These data indicate a relatively healthy population with a well‐balanced diet and low afflictions of infectious and parasitic diseases. Copyright © 2012 John Wiley & Sons, Ltd.     

Amino acids in archaeological bone (2)

Amino acid levels were compared in archaeological bone from four prehistoric Pacific populations: two from New Zealand and two from Papua New Guinea. One group from each region showed cribra orbitalia or porotic hyperostosis. The fewest significant differences were found between the two skeletally healthy groups, and the greatest number of significant differences between the two groups showing pathology. However, canonical discriminant analysis revealed a distinctive amino acid profile for each of the four groups. While the pre- and post-mortem environment may influence amino acid profiles, it is premature to draw specific conclusions as to the influence of diet, disease and burial conditions.     

Relationship between cribra orbitalia and enamel hypoplasia in the early medieval Slavic population at Borovce,Slovakia

Cribra orbitalia and enamel hypoplasia were examined in an early medieval (8^th to beginning of 12^th century AD) skeletal sample of 451 individuals from Borovce, Slovakia. More than 40% of these individuals died before reaching 20 years of age. The relationship between the occurrence of orbital and enamel lesions was analysed by focusing on the age‐specific distribution, and on its influence on demographic parameters. Both features were found in 11.2% of the observed skulls. The presence of orbital and dental lesions showed a considerable impact on mortality as well as the life expectancy. Generally, the highest mortality was observed among 0–4 year old individuals. The greatest discrepancy in the demographic parameters, however, appeared between the affected and unaffected individuals aged 10–14 and 15–19 years. In these two age groups the co‐occurrence of both lesions was most frequently recorded. These individuals obviously had a history of sickness, and thus could not cope with further bouts of disease and with the increased physiological demands of pubertal growth. The missing correlation in younger age categories can be largely explained by the difficulty of macroscopically examining the permanent dentition, since an interrelationship between the age at hypoplasia development and the occurrence of cribra orbitalia was detected. Several differences between the individuals with enamel defects and both conditions were observed in the distribution of age at hypoplasia formation. According to these results, several factors, such as impaired health status, growth demands and diet, influence the development of enamel hypoplasia and cribra orbitalia in a particular population. It is possible that after reaching a certain threshold, the underlying factors act synergistically in a kind of vicious cycle as the balance between the immune system, metabolism, and exogenous factors such as pathogens and nutrition, is disturbed. Copyright © 2007 John Wiley & Sons, Ltd.     

Age-dependent bone loss in the femur in a medieval population

Age-dependent bone loss in femurs in a medieval skeletal assemblage from Wharram Percy, England was studied. Dual energy X-ray absorptiometry (DXA) was used to measure bone mineral density (BMD) in the proximal femur; radiogrammetry was used to measure cortical index (FEMCI) at the femur mid-shaft. Age-related loss of BMD was found in the proximal femur in both sexes. Females but not males showed loss of FEMCI. Patterning in bone loss with respect to age, sex and site in the skeleton resembled that seen in recent subjects. In this respect the results are similar to those of a previous study of metacarpal cortical bone in the same archaeological assemblage. Given the large difference in lifestyles, and that lifestyle factors are widely held to influence the severity of bone loss in osteoporosis, the similarities between the medieval and modern populations in the patterns of bone loss are surprising. These findings support those from an earlier study of these skeletons in calling into question the role of lifestyle factors in influencing the severity of bone loss in osteoporosis. © 1998 John Wiley & Sons, Ltd.     

Nutritional and disease stress of juveniles from the Dakhleh Oasis,Egypt

Bioarchaeologists use skeletal health indicators to measure how ancient populations adapted to their physical, cultural and biological environments. Skeletons of infants and children are rarely included in these kinds of analyses because of factors such as poor preservation, small sample size, incomplete recovery or research design. In this study, skeletal remains of juveniles aged from foetal to 15 years (N = 238) from Kellis 2, a Romano‐Byzantine cemetery in the Dakhleh Oasis, Egypt, are analysed to shed light on how infants and children were affected by Roman policies during the early years of the Christianisation of Egypt. Non‐specific indicators of physiological stress (cribra orbitalia, enamel hypoplasia and osteoperiostitis) are analysed for post‐natal individuals and interpreted in the context of the physical, cultural and biological landscapes. Results from these analyses suggest moderate levels of skeletal and dental stress with a marked improvement in general health from pre‐Roman times. This study contributes to a better understanding of juvenile paleoepidemiology and mortuary practices in Egypt during the Romano‐Byzantine period. Copyright © 2010 John Wiley & Sons, Ltd.     

Thalassaemia: Its diagnosis and interpretation in past skeletal populations

The diagnosis of thalassaemia in archaeological populations has long been hindered by a lack of pathogonomic features, and the non‐specific nature of cribra orbitalia and porotic hyperostosis. In fact, clinical research has highlighted more specific diagnostic criteria for thalassaemia major and intermedia based on changes to the thorax (‘rib‐within‐a‐rib’ and costal osteomas). A recent re‐examination of 364 child skeletons from Romano‐British Poundbury Camp, Dorset revealed children with general ‘wasting’ of the bones and three children who demonstrated a variety of severe lesions (e.g. zygomatic bone and rib hypertrophy, porotic hyperostosis, rib lesions, osteopenia and pitted diaphyseal shafts) that are inconsistent with dietary deficiency alone, and more consistent with a diagnosis of genetic anaemia. Two of these children displayed rib lesions typical of those seen in modern cases of thalassaemia. The children of Poundbury Camp represent the first cases of genetic anaemia identified in a British archaeological population. As thalassaemia is a condition strongly linked to Mediterranean communities, the presence of this condition in a child from England, found within a mausoleum, suggests that they were born to wealthy immigrant parents living in this small Roman settlement in Dorset. This paper explores the diagnostic criteria for genetic anaemia in the archaeological literature and what its presence in ancient populations can contribute to our knowledge of past human migration. Copyright © 2010 John Wiley & Sons, Ltd.     

A Case of Maternal and Perinatal Death in Neolithic Southern Vietnam,c. 2100–1050 BCE

Despite ostensibly elevated rates of young female mortality in the past, believed to be associated with the risks of pregnancy and child birth, surprisingly few cases of pregnant female burials are reported in the bioarchaeological literature. This paper describes and discusses the case of a young female who died and was interred with an unborn full‐term breech foetus at the Neolithic site of An Son, southern Vietnam c. 2100–1050BCE. Her exceptionally poor oral health, evidence for cribra orbitalia, linear enamel hypoplasia, small stature and compromised gynaecological competence, contributes to a differential diagnosis that explores a range of additional complications that may have contributed to the death of both mother and unborn child. An examination and appreciation of this case contribute to our knowledge of the reproductive age and health of young females in Neolithic Southern Vietnam and the challenges they faced during pregnancy and childbirth. Copyright © 2011 John Wiley & Sons, Ltd.     

Cribra orbitalia and cribra cranii in Roman skeletal remains from the Ravenna area and Rimini (I–IV century AD)

Cribra orbitalia and cribra cranii are considered good indicators of the health and nutritional status of ancient populations, as their presence is often associated with chronic acquired anaemia. The distribution of these lesions in two Roman samples from the Ravenna area and Rimini was considered as a measure of health in relation to their respective environments. Enamel hypoplasia was also assessed as it is symptomatic of childhood physiological stresses such as malnutrition, infectious diseases, physiological traumas, and the like. The differential analysis suggests that the lesions observed are due to chronic acquired anaemia, probably caused by a poor diet, worm infestation, infections and parasitic diseases. Copyright © 2004 John Wiley & Sons, Ltd.     

A Possible Case of Hydrocephalus in a Medieval Child from Doonbought Fort,Co. Antrim,Northern Ireland

Hydrocephalus is a condition that is rarely found in the palaeopathological record. It has been demonstrated in a modern study of untreated cases of hydrocephalus that 50 per cent of children suffering from the disease die within the first 18 months of life. It is probable that the situation was the same in archaeological populations and that the delicate nature of neonatal and infant crania accounts for the paucity of palaeopathological evidence. As far as the author is aware there are approximately 30 possible cases of hydrocephalus known in the archaeological record throughout the world and only two of these cases originated in the British Isles. The following report presents evidence of a case of possible hydrocephalus in a 6–7-year-old juvenile from Northern Ireland. The skeleton was recovered from a post-thirteenth century context during excavations at the secular medieval fort of Doonbought, Co. Antrim. The diagnosis of hydrocephalus has been made on the basis of the abnormal and enlarged morphology and increased cranial capacity of the cranium. The only other palaeopathological lesion present in the remains was cribra orbitalia.