A recent archaeological discovery at Paliokastro (Thasos, Greece), and the subsequent study of the human skeletal remains interred in four monumental funerary contexts, provide for the first time ...through the archaeological record of the region a unique insight of the mounted archers and their female kin during the turbulent ProtoByzantine period.
Searching through interdisciplinary research to recover echoes of the human condition ingrained as they may be in the skeletal record of the ancients, there have been few cases in the forty year ...experience of the author which in defiance to the relentless passage of Chrόnos and even the chthonic potency of the waters of Léthe to dissolve all strings relating to Mnenosỳne could offer compelling evidentiary data, critical for generating meaningful interpretive answers as a nexus to life pathways and experiences in antiquity, reflective of dynamics and circumstances, that were not always possible to be recorded or spoken of by the attendants of Cléo. And yet in rare cases, millennia later, ostensibly through the works of Láchesis, a synergy between the fields of Archaeological Anthropology and Bioarchaeology may offer a unique portal whereby the dictum mortui vivos docent may be reiterated. Sharing in the objectives of an ongoing archaeo-anthropological endeavor, aiming to better decipher and elucidate facets of the human condition while carrying out funerary archaeological research of Hellenistic to Roman periods family graves at the extensive ancient necropolis of Thasos, the most northern Aegean island, this essay addresses a case of unique forensic / bioarchaeological interest involving an older male individual, a member of one of the clusters of burials, who had been placed as a single interment in a most conspicuous limestone cyst grave of the Hellenistic period. While odontological, cranio-infracranial skeleto-anatomic manifestations and palaeopathologies revealed a detailed rostrum on aspects of his developmental growth, of acquired and degenerative somatic changes, reflective of his life experiences which involved long term most active participations in physically demanding yet specialized activities, a staggering ‘through and through’ sternal trauma of astonishing preservation, provided for a distinct opportunity to conduct a unique cross-disciplinary investigation on the nature of the weapon reconstructed in bronze, the archaeometry on the trajectory and factors of speed and force at the deliverance of the strike, along with the diagnostic assessments of the thoracic tissues pierced consecutively and their moribund consequences. A review of historical references on the implementation of capital punishment either through the decision of a dicastic or ephetic court, and/or execution carried out as a result of outlawry are evaluated in relevance to funerary practices as these pertained to the interment of the Thasian male within the context of the burial ground, offering in retrospect assessments on the probable cause of his violent death.
Osteoporosis and atherosclerosis, two multifactorial and degenerative entities, are major public health problems. These diseases accompany the aging process and share common risk factors. ...Furthermore, several common pathophysiological factors have been suggested. These include similar molecular pathways involving bone and vascular mineralization, estrogen deficiency, parathyroid hormone, homocysteine, lipid oxidation products, inflammatory process, as well as vitamin D and K. Moreover, the use of statins, biphosphonates, beta-blockers and experimental dual-purpose therapies based on the biological linkage of the above entities may simultaneously benefit bone loss and vascular disease. This review considers a potential link between osteoporosis and atherosclerosis beyond aging. These common factors may lead to appropriate treatment strategies.
Osteoporosis is a common disease, characterized by low bone mass with micro‐architectural disruption and skeletal fragility, resulting in an increased risk of fracture. A substantial number of ...studies has examined the possible relationship between body weight, bone mineral density and fracture risk in post‐menopausal women, with the majority of them concluding that low body weight correlates with increased risk of fracture, especially hip fracture. Controversies about the potential protective effect of obesity on osteoporosis and consequent fracture risk still exist. Several recent studies question the concept that obesity exerts a protective effect against fractures, suggesting that it stands as a risk factor for fractures at specific skeletal sites, such as upper arm. The association between body weight and fracture risk is complex, differs across skeletal sites and body mass index, and is modified by the interaction between body weight and bone mineral density. Some potential explanations that link obesity with increased fracture risk may be the pattern of falls and impaired mobility in obese individuals, comorbidities, such as asthma, diabetes and early menopause, as well as, increased parathyroid hormone and reduced 25‐hydroxy‐vitamin D concentrations.
Graves' orbitopathy (GO) is an autoimmune condition, which is associated with poor clinical outcomes including impaired quality of life and socio-economic status. Current evidence suggests that the ...incidence of GO in Europe may be declining, however data on the prevalence of this disease are sparse. Several clinical variants of GO exist, including euthyroid GO, recently listed as a rare disease in Europe (ORPHA466682). The objective was to estimate the prevalence of GO and its clinical variants in Europe, based on available literature, and to consider whether they may potentially qualify as rare. Recent published data on the incidence of GO and Graves' hyperthyroidism in Europe were used to estimate the prevalence of GO. The position statement was developed by a series of reviews of drafts and electronic discussions by members of the European Group on Graves' Orbitopathy. The prevalence of GO in Europe is about 10/10,000 persons. The prevalence of other clinical variants is also low: hypothyroid GO 0.02-1.10/10,000; GO associated with dermopathy 0.15/10,000; GO associated with acropachy 0.03/10,000; asymmetrical GO 1.00-5.00/10,000; unilateral GO 0.50-1.50/10,000.
GO has a prevalence that is clearly above the threshold for rarity in Europe. However, each of its clinical variants have a low prevalence and could potentially qualify for being considered as a rare condition, providing that future research establishes that they have a distinct pathophysiology. EUGOGO considers this area of academic activity a priority.
Ectopic parathyroid glands result from aberrant migration during early stages of development and lack of successful identification may lead to lack of success in parathyroid surgery. They constitute ...a common etiology of persistent or recurrent hyperparathyroidism, when they are missed at initial diagnosis. Their prevalence is about 2-43% in anatomical series and up to 16% and 14% in patients with primary and secondary hyperparathyroidism, respectively. Ectopic inferior parathyroids are most frequently found in the anterior mediastinum, in association with the thymus or the thyroid gland, while the most common position for ectopic superior parathyroids is the tracheoesophageal groove and retroesophageal region. Neck ultrasound and 99mTc Sestamibi scan are first-line imaging modalities, although with low sensitivity and specificity. However, their combination with modern techniques, such as single photon emission computed tomography (SPECT) alone or in combination with CT (SPECT/CT) increases their diagnostic accuracy. Fine needle-aspiration cytology of a lesion suspicious for parathyroid tissue and measurement of parathyroid hormone (PTH) in the aspired material further assist to the successful preoperative localization of ectopic glands. Common sites for surgical investigation are the upper thyroid pole and the upper vascular thyroid stalk behind the hypopharynx and cervical esophagus for the superior parathyroids, and the carotid artery bifurcation and the thymic tongue, for the inferior parathyroids. Radioguided minimally invasive parathyroidectomy after successful localization, assisted by rapid PTH measurement postoperatively, significantly improves surgical outcomes in patients with ectopic parathyroid adenomas.
Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) are increasingly recognised for their role in cardiovascular (CV) physiology. The GH-IGF-1 axis plays an essential role in the development ...of the CV system as well as in the complex molecular network that regulates cardiac and endothelial structure and function. A considerable correlation between GH levels and CV mortality exists even among individuals in the general population without a notable deviation in the GHIGF- 1 axis functioning. In addition, over the last decades, evidence has demonstrated that pathologic conditions involving the GH-IGF-1 axis, as seen in GH excess to GH deficiency, are associated with an increased risk for CV morbidity and mortality. A significant part of that risk can be attributed to several accompanying comorbidities. In both conditions, disease control is associated with a consistent improvement of CV risk factors, reduction of CV mortality, and achievement of standardised mortality ratio similar to that of the general population. Data on the prevalence of peripheral arterial disease in patients with acromegaly or growth hormone deficiency and the effects of GH and IGF-1 levels on the disease progression is limited. In this review, we will consider the pivotal role of the GH-IGF-1 axis on CV system function, as well as the far-reaching consequences that arise when disorders within this axis occur, particularly in relation to the atherosclerosis process.
Despite high levels of sunshine, maternal hypovitaminosis D during pregnancy is prevalent in the Mediterranean region. The aim of this study is to systematically review trials that investigated ...vitamin D concentrations during pregnancy in this region, in order to determine predictors of hypovitaminosis D and explain this phenomenon. After applying inclusion/exclusion criteria, 15 studies were entered into the systematic review involving 2649 pregnant women and 820 neonates. The main outcome was maternal vitamin D status, assessed by serum 25-hydroxy-vitamin D (25(OH)D) concentrations. Possible predictors of the outcome included maternal age, body mass index (BMI), race, socioeconomic status, skin type, gestational age, sun exposure, calcium and vitamin D intake and supplementation, smoking status, parity and season of delivery. Studies differed widely in vitamin D deficiency criteria, method of measurement and outcomes. The prevalence of vitamin D insufficiency ranges from 9.3 to 41.4%, whereas that of vitamin D deficiency from 22.7 to 90.3%. A positive association with 25(OH)D concentrations exists for light skin color, white race, uncovered dressing pattern, maternal vitamin D supplementation and season of gestation (spring/summer). An inverse association exists for BMI and gestational age, whereas data for smoking and socioeconomic status are controversial. We concluded that vitamin D deficiency in pregnancy seems to be quite common, even in the Mediterranean region. Racial, social and cultural habits, as well as the absence of preventive supplementation/dietary strategies, seem to negate the benefits of sun exposure.
Bisphosphonates are first-line agents used for the treatment of osteoporosis in postmenopausal women and men. Although their efficacy in the reduction of vertebral, non-vertebral and hip fracture ...risk has been established, some concerns have arisen associated with their long-term use. These include osteonecrosis of the jaw and atypical (subtrochanteric and femoral shaft) fractures. The latter may result from accumulation of fatigue damage due to oversuppression of bone turnover in susceptible individuals. In this respect, the concept of a 'drug holiday' after completion of a reasonable period of bisphosphonate therapy has emerged. Theoretically, this allows bone turnover to increase and permits normal skeletal maintenance and repair, although there is as yet no good evidence that bisphosphonate discontinuation will reduce the risk of these adverse events. Current data derive from studies in postmenopausal women and support a beneficial effect of alendronate or zolendronate continuation in high-risk groups, such as those with T-score < −2.5 or prevalent vertebral fractures after completion of 5 or 3 years, respectively. The optimal length of a 'drug holiday' has not been established but existing data suggest up to 5 years with alendronate, 3 years with zoledronate and 1 year with risedronate. A decision to recommence therapy should then probably be based on regular reassessment of bone mineral density and fracture risk.
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