Global warming and planetary health: An open letter to the WHO from scientific and indigenous people urging for paleo-microbiology studies.

This article, written by a collective of international researchers and worldwide representatives of indigenous populations, is an open letter to the WHO, based on the latest elements from the scientific literature, and the latest climatological data. It takes stock of the health consequences of global warming, and urges research organizations to take an interest in infectious agents formerly stored in the layers of ground (frozen or not) and now mobilized, then released from a distance.

[Lucy's fatal childbirth? About materno-foetal mortality in the ancient times]. / L'accouchement tragique de Lucy ? À propos de la mortalité maternofœtale de la préhistoire à l'époque médiévale.

OBJECTIVES: Skeletal remains of pregnant woman whit fetus still in the pelvic region are scarce in the archaeological record. We aimed to review the different cases of maternal and fetal death in the ancient times. METHODS: A review of literature using Medline database and Google about mortality during pregnancy in Prehistory, Antiquity and middle age. The following key words were used: ancient times; paleopathology; immature fetus; medieval; pregnancy; mummies; Antiquity; maternal mortality. RESULTS: Thirty articles were found and we added one personal unpublished case. There were 64 female skeletons with mainly infectious abnormalities (10 dental abscesses and 2 pneumoniae) followed by traumatic lesions (2 frontal fractures and 1 femur luxation). There were 48 fetal remains and 3 twins. We noted 8 obstructed labors (3 breech presentations, 4 transverse lies and one possible shoulder dystocia). CONCLUSIONS: The fact that there were only few cases of maternal deaths with fetal remains raises the questions of the cause of death and the relationship between death and obstetric disorders. Beside the underestimation of these archaecological cases, the reasons of both fetal and maternal death must be looking for among several diseases or anomalies of both or of one of them, related with poor environmental conditions (such as malnutrition and high morbidity from infections) and lack of care the mother and fetus need.

A new definition of health? An open letter of autochthonous peoples and medical anthropologists to the WHO.

Currently, for many practitioners (hospital and liberals) and researchers (including public health), the WHO definition of health is outdated: first it seems more utopian than pragmatic; then, it proves unsuitable for a large part of the world population. There is clearly a need to refine this definition or propose additional criteria to be more relevant or discriminating. In this perspective, what can indigenous people offer in the elaboration of a new definition of health? In this article, leaders or representatives of autochthonous peoples, anthropologists and physicians from many cultural origins (Amazonia, Patagonia, Papua New-Guinea, Inuit, North-American Indian, sub-Saharan Africa, India, China, Melanesia and Polynesia) have tried to identify and explain several key concepts that WHO should reintegrate into its new definition of health: human equilibrium in nature, accepted spirituality and adaptation. On the sidelines of the application of COP21 decisions that should give back to man his place into the environment, autochthonous people leaders, anthropologists and MDs explain why these three concepts are fundamental and universal health determinants, and need to be included in a new WHO definition of health.

[Lucy's cancer(s): A prehistorical origin?] / Le(s) cancer(s) de Lucy : une origine préhistorique ?

OBJECTIVES: The recent discovery of the earliest hominin cancer, a 1.7-million-year-old osteosarcoma from South Africa has raised the question of the origin of cancer and its determinants. We aimed to determine whether malignant and benign tumors exist in the past societies. METHODS: A review of literature using Medline database and Google about benign and malignant tumors in prehistory and antiquity. Only cases with morphological and paraclinical analysis were included. The following keywords were used: cancer; paleopathology; malignant neoplasia; benign tumor; leiomyoma; myoma; breast cancer; mummies; soft tissue tumor; Antiquity. RESULTS: Thirty-five articles were found in wich there were 34 malignant tumors, 10 benign tumors and 11 gynecological benign tumors. CONCLUSIONS: The fact that there were some malignant tumors, even few tumors and probably underdiagnosed, in the past may be evidence that cancer is not only a disease of the modern world. Cancer may be indeed a moving target: we have likely predisposing genes to cancer inherited from our ancestors. The malignant disease could therefore appear because of our modern lifestyle (carcinogens and risk factors related to the modern industrial society).

A species' Odyssey: evolution of obstetrical mechanics from Australopithecus Lucy to nowadays.

OBJECTIVE: Study of obstetrical mechanics of Australopithecus Lucy, Homo neanderthalensis and Homo erectus relative to modern Homo sapiens and the Catarrhines. STUDY DESIGN: The material comprised a total of 360 pelves: 3 fossil pelves reconstructed using casts (Australopithecus afarensis Lucy or AL 288-1, Homo erectus KNM-WT 15000, H. neanderthalensis or Kebara 2), 305 female modern adult pelves and 52 female Catarrhine pelves (29 gorillas, 18 chimpanzees, 5 orang-utans). All these pelves were reconstructed in order to carry out 11 pelvimetric measurements. Each measurement was carried out twice and by two different operators. RESULTS: The pelvis of Lucy was platypelloid at each pelvic plane. The pelvic inlet of H. neanderthalensis was anteroposteriorly oval whereas the midplane and the outlet were transversely oval. The pelvis of H. erectus was globally round. In modern women, the inlet was transversely oval. The pelvic midplane and outlet were anteroposteriorly oval. In the great apes, the shape of all three pelvic planes was anteroposteriorly oval. The discriminating value of the various pelvimetry measurements place Australopithecus Lucy, H. neanderthalensis Kebara 2, and H. erectus KNM-WT 15000 close to modern humans and less similar to the great apes. CONCLUSION: Obstetrical mechanics evolved from dystocic delivery with a transverse orientation in Australopithecus to delivery with a modern human-like rotational birth and an increase in the anteroposterior diameters in H. erectus, H. neanderthalensis and modern H. sapiens.

The influence of body posture on the kinematics of prehension in humans and gorillas (Gorilla gorilla).

Much of our current understanding of human prehension in a comparative context is based on macaque models in a sitting, constrained body posture. In a previous study, we clearly showed differences in the amplitude of the forelimb joints between five primate species (lemur, capuchin, chimpanzee, gorilla and human) during unconstrained grasping where the animals were free to choose their body posture. One of our interrogations was to know if these differences could be due to the body posture. To address this question, this study compares humans with new data for gorillas during an unconstrained food prehension task in two body postures, a sitting and a quadrupedal one. The objective is to determine the behavioral and kinematic strategies (amplitudes and patterns of evolution of the articular angles) as well as differences and invariants of trunk and forelimb motions between species. The subjects were recorded by five cameras, and landmarks were digitized frame by frame to reconstruct 3D movement. Our results show that (1) despite significant influences of body postures on ranges of motion in gorillas and humans, species preserve their specific forelimb joint and trunk contribution; (2) body posture has a limited effect on the basic pattern of wrist velocity. Our study indicates that different primate species have specific kinematic features of limb coordination during prehension, which dose not alter with changes in posture. Therefore, across varying species, it is possible to compare limb kinematics irrespective of postural constraints and unconstrained condition need to be explored in other primates to understand the evolution of primate prehension.

[Lucy's parturition, a way towards extinction?]. / La parturition de Lucy, chemin vers l'extinction ?

OBJECTIVES: To compare pelvic cavities in australopithecines, modern humans and non-hominid primates in order to discuss the obstetrical mechanisms in australopithecines MATERIAL AND METHODS: Bony pelves from fossil material (Australopithecus afarensis AL 288-1, Australopithecus africanus Sts14, Australopithecus Stw 431 and Mh2), 133 modern humans (82 adult females and 51 adult males) and 67 anthropoid primates (36 gorilla, 26 Pan troglodytes, 5 Pongo pygmaeus) were reconstructed and compared (shape and morphometric analysis) using 16 pelvimetric mesasurements. RESULTS: Pelves of australopithecines were characterized by lower anteroposterior (AP) and transverse (TRV) diameters in inlet pelvis than in other species. Index (AP/TRV) of pelvic inlet, midpelvis and pelvic outlet in the australopithecines were the lowest (<100) and the pelvic shape was platypelloid. A logarithmic factorial analysis showed that the pelvic morphology of australopithecines was different from humans and non-hominid primates but nearer the humans. DISCUSSION AND CONCLUSION: In contrast with apes where obstetrical mechanics seem to be easier, and because of platypelloidy, mechanism of birth in australopithecines was as difficult as in modern homo sapiens. Birth without cesarean was probably possible in an asynclitic TRV orientation.

Tetanus: a diagnostic challenge in the Western world.

Tetanus is a very serious neuromuscular disease caused by a powerful exotoxin, tetanospasmin, from the Clostridium tetani bacillus. Its incidence in the developed world has diminished considerably since the introduction of primary vaccination. Tetanus is diagnosed clinically, through recognition of the characteristically inducible muscle spasms. Three clinical forms described in adults are generalised, localised and cephalic tetanus. Management of tetanus aims at removing the source of tetanospasmin, neutralising circulating toxin, and providing adequate supportive care for muscle spasms, respiration and autonomic instability. Tetanus is a forgotten disease in developed countries since many practicing primary care physicians have not seen a single case in their career. We present a case of tetanus and review briefly the pathogenesis, clinical features and therapy in order to educate the internist in recognising and adequately treating this disease.

Substrate optimization in nut cracking by capuchin monkeys (Cebus apella).

We conducted an experiment to examine the effect of substrate on the nut-cracking behavior of a group of semicaptive capuchin monkeys. We wanted to determine whether tufted capuchin monkeys were selective in choosing the substrate on which they pound nuts, and whether the choice of substrate affected the outcome. Eight adult females and eight juveniles were provided with nuts in the outdoor facility. We found that 1) all adult females and three young capuchins succeeded in cracking nuts; 2) they preferred the hardest substrates (concrete and stone); 3) there is a link between the substrate and the amount of time needed to crack a nut; 4) most young capuchins used various substrates, some of which were inadequate, in a haphazard manner; and 5) there are different forms of nut cracking. We conclude that adult capuchins choose the hardest substrates, and that these substrates support efficient cracking.

Cryptococcoma unresponsive to antifungal treatment in a 63-year-old non-HIV-infected male.

Cryptococcosis is an invasive fungal infection mainly due to Cryptococcus neoformans which has become increasingly prevalent in immunocompromised patients. The majority of patients with disseminated infection are immunocompromised due to AIDS, prolonged treatment with corticosteroids, organ transplantation, or malignancy. Invasive cryptococcal infection is rare in healthy immunocompetent individuals. We present a case of cerebral cryptococcoma in a previously healthy individual with development of meningitis and multiple intracerebral lesions in spite of persistently negative cultures and refractory to conventional antifungal therapy. The diagnosis was confirmed by two independent anatomopathological examinations.

The first australopithecine 2,500 kilometres west of the Rift Valley (Chad)

The first sites with Pliocene and Pleistocene mammals west of the Rift Valley in Central Africa in northern Chad were reported in 1959 (ref. 1), and documented the presence of mixed savannah and woodland habitats. Further sites and a probable Homo erectus cranio-facial fragment were subsequently discovered. In 1993 a survey of Pliocene and Pleistocene formations in the Borkou-Ennedi-Tibesti Province of Chad (B.E.T.) led to the discovery of 17 new sites in the region of Bahr el Ghazal (classical Arabic for River of the Gazelles) near Koro Toro. One site, KT 12 (15 degrees 58'10"N, 18 degrees 52'46"E) yielded an australopithecine mandible associated with a fauna biochronologically estimated to be 3.0-3.5 Myr old. Australopithecine species described since 1925 are known from southern Africa and from sites spread along the eastern Rift Valley from Tanzania to Ethiopia (Fig. 1). This new find from Chad, which is most similar in morphology to Australopithecus afarensis, documents the presence of an early hominid a considerable distance, 2,500 km, west of the Rift Valley.

[The anatomical and functional origin of the first bipedalism]. / L'originalité anatomique et fonctionnelle de la première bipédie.

This communication is the synthesis of ten years of researchers of comparative anatomy done by the author or under his control on fossil Hominids, three million years old, found by his expeditions in Eastern Ethiopia. It brings, for the first time, the odd picture of a skeleton adapted to arboricolism and bipedalism together. The rachis has already the curves of an erect being but with at least a thoraco-lumbar cyphosis a bit more elongated than in our own rachis; the pelvis is wide and shallow like the pelvis of a biped but with many particular features like the width of the iliac wings, a great biacetabular diameter, the small size of the coxo-femoral joints; the femur is short with a special long neck, a very oblique diaphysis like in Man and an intercondylar fossa, deep and wide like in chimp; the tibia is also short, its spines very tight in such a way that the knee shows a great laxity. The foot is short and flat, with an abducted hallux and long curved toes; the scapular, elbow and wrist joints show, at the opposite of the knee joint, a great solidity, but both characteristics of the hind and fore-limb joints are not in contradiction: they are, as in chimpanzees again, functionally adapted to climbing and moving in the trees where are needed firm grip of the hands as well as mobility of the knee and of the foot. It seems that the early Australopithecine' bipedalism was original, different from ours and quite instable: short steps were necessary to maintain equilibrium as well as a strong rotation of the pelvis around the vertebral axis (50 to 60 degrees on each side). This analysis is then demonstrating a real evolution of bipedalism which was not at all, at once, the bipedalism of Homo sapiens, as it has been claimed. This paper is also showing that bipedalism anatomic organization is taking place from the pelvis to the foot and not the other way round. At last, as we have found, also in Ethiopia, stone-tools more than three million years old in association with Australopithecus, it seems that the very first made tools were the invention of prehumans who did not have yet the hands completely free from locomotion.

[Morphological evolution of the first lower premolar of some higher primates]. / E'volution morphologique de la première prémolaire infériure chez certains primates supérieurs.

Recent discoveries in Africa, in Asia and in Europe of new fossils attributed to the Ramapithecinae and/or to the Australopithecinae seem to point out the monocuspid origin of Man's first lower premolar the bicuspidy of the Gigantopithecidae, the Oreopithecidae' and the Hominidae' first lower premolar, reached at different geological ages, give an example of parallel evolution.