The aim of this study was to examine the evidence, and consider the differential diagnosis, for tuberculosis (TB) in juvenile individuals from early 20th century documented skeletons. There are 66 male and female juvenile individuals in the Coimbra Identified Skeletal Collection (CISC) with an age at death ranging from 7-21 years. The individuals died between 1904 -1936 in different areas of Coimbra, Portugal. Eighteen of these individuals died from TB affecting different parts of the body. Thirteen (72.2%) showed skeletal lesions that may be related to this infection. Of the 48 individuals with a non-tuberculous cause of death, only 2 (4.2%) had skeletal changes that could be attributed to TB. The distribution of skeletal manifestations caused by the types of TB under study, based on macroscopic and radiological findings, is described and discussed. In addition, the medical records from 6 tuberculous individuals who died in Coimbra University Hospital (CUH) were analysed, and the information, including their diet and access to treatment, is presented. This work, based on data arising before antibiotics became available for treatment, can contribute to the future diagnosis of TB in non-documented skeletal material, and will facilitate a more reliable diagnosis of TB in juvenile individuals. Am
In the last 20 years, studies on human identified skeletal collections have revealed a significant relationship between new bone formation on the visceral surface of ribs and pulmonary tuberculosis (TB). To improve methods of differential diagnosis of respiratory diseases in archaeological skeletons, an investigation was conducted on 197 individuals from the Human Identified Skeletal Collection of the Museu Bocage (Lisbon, Portugal). This sample included 109 males and 88 females who lived during the 19th-20th centuries, with ages at death ranging from 13-88 years. The skeletons were grouped according to cause of death: 1) pulmonary TB (N ¼ 84); 2) pulmonary non-TB diseases (N ¼ 49); and 3) a control group (N ¼ 64) composed of individuals randomly selected among the extrapulmonary non-TB causes of death. The ribs, sterna, scapulae, and clavicles were macroscopically observed. New bone formation on the visceral surface of ribs was recorded in 90.5% (76/84) of individuals who died from pulmonary TB, in 36.7% (18/49) with a pulmonary non-TB disease as cause of death, and in 25.0% (16/64) of the control group. These differences were statistically significant (P < 0.001). Furthermore, in individuals with pulmonary TB, the bony lesions presented mainly as lamellar bone on the vertebral end of the upper and middle thoracic rib cage. Proliferative alterations also occurred on one sternum and in nine clavicles and eight scapulae. This work strongly supports the results of similar studies performed on other documented collections, suggesting that new bone formation on ribs, although not pathognomonic, is a useful criterion for the differential diagnosis of pulmonary TB. Am J Phys Anthropol 130:190-200, 2006.
The role of new bone formation on visceral surfaces of ribs in the diagnosis of tuberculosis (TB) in past human populations has been explored by many researchers, using both skeletal remains with known causes of death and archaeological samples. This study focuses, firstly, on adult skeletons from the Coimbra Identified Skeletal Collection in Portugal and investigates the skeletal manifestations of individuals known to have died from TB; secondly, this study focuses on the role of rib lesions in the diagnostic criteria for TB. One hundred and fifty-seven males and 106 females aged between 22-87 years were examined; causes of death were assigned as pulmonary TB, extrapulmonary TB, and pulmonary non-TB; a control group, extrapulmonary non-TB, was selected from the remaining individuals. Of individuals with rib lesions, 85.7% (69/81) had pulmonary or extrapulmonary TB as an assigned cause of death, while 17.8% (16/90) of individuals with rib lesions had a non-TB cause of death. Rib lesions were significantly more common in individuals who had died from TB, although the lesions cannot be considered pathognomonic for TB. In individuals dying from pulmonary TB, ribs in the central part of the rib cage were most affected, at their vertebral ends. The lower part of the rib cage may be a marker for peritoneal TB, and ''corallike'' new bone formation on ribs may be an indicator of neoplastic disease. Further work on rib involvement in TB in clinical contexts, and the study of further documented skeletal collections, are recommended. Am J
Tuberculosis has been a scourge of humans over many millennia, but questions remain regarding its evolution and epidemiology. Fossil biomarkers, such as DNA and long-chain mycolic acids, can be detected in ancient skeletal and other materials. The phthiocerol dimycocerosate waxes are also robust biomarkers for tuberculosis and sensitive methods are available for the detection of their mycocerosic acid components. The presence of mycocerosic acids was investigated in 49 individuals from the 1837-1936 Coimbra Identified Skeletal Collection (Portugal), half with documentary data indicating tuberculosis as a cause of death. Samples were hydrolysed, acidic components converted to pentafluorobenzyl esters, the non-hydroxylated long-chain esters isolated, and this fraction separated into multimethyl-branched and other esters by normal phase high performance liquid chromatography. Negative ion chemical ionisation gas chromatography mass spectrometry was used to detect diagnostic C29, C30 and C32 mycocerosic acids. Mycocerosic acids were detected in archaeological material for the first time, illustrating that they are valuable biomarkers for the diagnosis of ancient tuberculosis. A 72% correlation with the Coimbra burial record supported TB as the major cause of death. In addition, 30% of the skeletons, positive for mycocerosates, showed the presence of related long-chain mycolipenic acids.
Sex estimation in non-adult skeletons is crucial in bioarchaeology and forensic anthropology. It was not extensively considered in the past, mainly because it was stated that the dimorphic osteological features were difficult to identify before adulthood. Over the past few years, this statement was disproved, and the study of numerous dimorphic non-adult skeletal traits was approached. This paper presents a new methodology that evaluates the auricular surface of the non-adult ilia. Several morphological and continuous variables were recorded for 34 individuals (21 females and 13 males) aged between 7 and 18 from the Coimbra Identified Skeletons Collection (University of Coimbra, Portugal).The results show low intra and inter-observer errors for all the variables, which renders the methodology replicable. Two ratios related to the shape of the anterior area of the auricular surface offer the most dimorphic data (proportions of cases correctly assigned: 0.82 and 0.88; sexual allocation probabilities: 0.85 for both variables). A discriminant function and a logistic regression were developed, which correctly classified the 82.35 and the 88.23% of the individuals, respectively. Moreover, two qualitative variables, referred to as the overall morphology and the apex morphology, also show statistically significant differences between males and females (proportions of correct assignation: 0.82 and 0.76; sexual allocation probabilities: 0.79 and 0.76).These variables can be incorporated in a multifactorial approach together with other indicators already available in the specialised literature in order to help improve the accuracy of the results obtained. This methodological procedure has to be applied with other identified samples, including younger individuals, so as to test whether the trends presented in this context are maintained and are useful in populations from a different geographical provenience.
Apical periodontal cysts are benign lesions developing in relation to the apices of non-vital teeth due to inflammatory response from the infective pulp. These are epithelium-lined bony cavities containing fluid. Despite being widely reported in medical/dental literature, this common condition is poorly diagnosed and documented in the archaeological literature. We aim to clarify the correct terminology, demonstrate bony manifestations at different stages of pathogenesis of chronic periapical dental lesions into granuloma and apical periodontal cysts, and to describe diagnostic criteria which would provide practical guidelines for the diagnosis of these conditions. Three identified skulls from the International Exchange Collection, housed in the Anthropological Museum at the University of Coimbra, are used to identify the progression of this condition from a small periapical granuloma to a large apical periodontal cyst with expansion of alveolar and facial bones. The pathogenesis of this condition is described, together with its surgical management in the early 20 th century in Portugal, which is the period in which these individuals lived. Confusion resulting from the different terminologies can be avoided if the term periapical granuloma is used to define apical bony lesions smaller than 3 mm at their maximum intra-bony diameter, and the term apical periodontal cysts for the larger lesions. We recommend that these terminologies and parameters be used as a standard in future studies. This will make inter-observer and inter-population comparisons more accurate.
A navegação consulta e descarregamento dos títulos inseridos nas Bibliotecas Digitais UC Digitalis, UC Pombalina e UC Impactum, pressupõem a aceitação plena e sem reservas dos Termos e Condições de Uso destas Bibliotecas Digitais, disponíveis em https://digitalis.uc.pt/pt-pt/termos.Conforme exposto nos referidos Termos e Condições de Uso, o descarregamento de títulos de acesso restrito requer uma licença válida de autorização devendo o utilizador aceder ao(s) documento(s) a partir de um endereço de IP da instituição detentora da supramencionada licença.Ao utilizador é apenas permitido o descarregamento para uso pessoal, pelo que o emprego do(s) título(s) descarregado(s) para outro fim, designadamente comercial, carece de autorização do respetivo autor ou editor da obra. Na medida em que todas as obras da UC Digitalis se encontram protegidas pelo Código do Direito de Autor e Direitos Conexos e demais legislação aplicável, toda a cópia, parcial ou total, deste documento, nos casos em que é legalmente admitida, deverá conter ou fazer-se acompanhar por este aviso. ). The chief goal of the organizing committee was to provide a productive environment where researchers could discuss the methodologies and terminology employed for the study of MSM as well as assessing how well these enthesopathies serve as markers of occupational stress. The Workshop was organized in three major sessions, each one introduced by a keynote lecture: (1) Methodological issues; (2) MSM studies of archaeological samples and Identified Skeletal Collections; and (3) The multifactorial etiology of enthesopathies. The meeting was concluded with a Plenary Session where two annotators discussed the presentations; this was followed by a general discussion and the formation of three working groups focused on the topics of Methods, Terminology, and Occupations. Details of the Workshop and the presentations presented are available for download at http://www.uc.pt/en/cia/msm/. A blog (http:// coimbraworkshopmsm.blogspot. com/) was created to facilitate communications about individual experiences and to share knowledge among researchers in this field. We hope that this Workshop will help to standardize methodologies and terminology and promote the creation of a more integrated scientific approach to future studies of MSM. Palavras-chave Estandardização; entesopatias; actividade ocupacional; terminologia; metodologia. The Coimbra Workshop in Musculoskeletal Stress Key words
Among the many factors suggested as potential sources of variation in the rate of ageing of the pubic symphysis is occupational/physical activity, but this has yet to be demonstrated. This study's main goal is to determine whether occupational/physical activity influences the aging process in the pubic symphysis. We analyzed a sample of 161 males (18-96 years) from two Portuguese identified skeletal collections, where age-related features were recorded in the pubic symphysis as absent/present. The sample was divided in two groups according to the occupation of the individuals (manual and non-manual) and in two groups according to the femoral robusticity index (robust and gracile). The manual and robust groups represent individuals with more physically demanding occupations while the non-manual and gracile groups represent less physically demanding occupations. The possible influence of occupational/physical activity on the rate of ageing was evaluated by comparing the transition age for each age-related feature, between the two groups, using logistic regression. Only the ligamentous outgrowths on the ventral beveling showed a statistically significant younger age in the robust group, indicating a possible faster rate or early timing of change in the individuals with a more physically demanding activity compared with their gracile counterparts. Thus, these results do not provide significant support to the hypothesis that individuals with a greater demanding occupation or physical activity show greater pubic symphysis degeneration. Further testing of this hypothesis in other samples with individuals from known occupation is required.
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