A Severe Case of Biparietal Thinning in a Medieval Skull From a Northern Italy Necropolis.

ABSTRACT: This study aims at presenting a case of symmetrical and bilateral thinning observed in a skull belonging to the skeleton of a mature woman from the medieval cemetery of Caravate (north Italy). Macroscopical, radiological, and histological analyses were performed to investigate the condition. The analyses allowed us to detect a progressive loss of both the outer table and the diploe, and the sparing of the inner table. As a controversial condition in the clinical and paleopathological literature, this case poses some difficulties in discussing the differential diagnosis. However, the sex determination, estimation of the age-at-death and different characteristics observed at the level of the postcranial bones, in particular the fractures recorded on different vertebral bodies, allowed us to correlate the biparietal thinning found in this subject to ageing and osteoporosis.

Rebury the "Atavistic Skull" Studied by Lombroso?

On May 16, 2017, the judgment of the Italian court ended the legal battle concerning the repatriation request of the famous skull, belonging to the "brigand" Giuseppe Villella. During the autopsy examination on the corpse of Villella, Lombroso observed a median occipital dimple on the skull, a feature visible in other mammals, including primates, but absent in humans. This feature could demonstrate an anomalous dimension of the median lobe of Villella's cerebellum. From this anatomical finding, Lombroso consolidated the atavism theory, which established a close connection between morphological features and behavior.The Lombroso Museum and the University of Turin reiterated the legitimacy of the possession of the skull as cultural property in accordance with the Code of Cultural Heritage and as a find of forensic psychopathology. Finally, the court rejected the request from Villella's hometown, highlighting that the scientific theory is unquestionably invalid, but his existence cannot be denied.The "special" nature of human remains emerges from the special way in which the Code of Ethics of the International Council of Museums treats them, which also implies respect to the other material of the museum collections.

Cranial Trepanation: An Ancient Neurosurgical Therapy? Thoughts of a Follower of Positivist Medicine and Anthropology.

The authors' aim is to define a framework around the history of studies and analyses on cranial trepanation. In addition, based on the analytical approach of Abele de Blasio, the authors would like to reach an understanding of the various different interpretations of the origin and aetiology of the art of cranial trepanation, starting in the prehistoric era. In this brief study, historical discussions are intertwined with ethnoiatric and anthropometric techniques of the author, leading the reader into a fascinating discussion on the practice of trepanation in ancient populations.

Can artificially deforming skulls cause "defects of intelligence"? The observations of a positivist anthropologist on an artificially deformed skull discovered in Naples.

We discuss a particular case of an artificially deformed skull discovered in Naples in 1892 and published in the Italian Journal of Natural Sciences by the anthropologist Abele De Blasio. To comprehend the observations of the researcher about the "defects of intelligence" caused by the artificial deformation of the skull, we will also analyze other articles in which De Blasio presented the deformed skulls of ancient Peruvian mummies.

Luigi Porta's contribution to anesthesia in Europe in the 1800s.

Luigi Porta (1800-1875), an Italian physician who was well known in the field of surgery, played an important role in spreading ethereal anesthesia in Europe. Moreover, he proposed an original method to administer ethereal anesthesia, the Italian method "of the bladder of pig". This paper reminds us of the important role that this physician played in Anesthesiology.

New paleoradiological investigations of ancient human remains from North West Lombardy archaeological excavations.

OBJECTIVE: Since its birth in 1895, radiology has been used to study ancient mummies. The purpose of this article is to present paleoradiological investigations conducted on several medieval human remains in Varese province. Anthropological (generic identification) and paleopathological analyses were carried out with the support of diagnostic imaging (X-ray and CT scans). MATERIALS AND METHODS: Human remains were discovered during excavations of medieval archaeological sites in northwest Lombardy. Classical physical anthropological methods were used for the macroscopic identification of the human remains. X-ray and CT scans were performed on the same scanner (16-layer Hitachi Eclos 16 X-ray equipment). Results Radiological analysis permitted investigating (1) the sex, (2) age of death, (3) type of trauma, (4) therapeutic interventions and (5) osteomas in ancient human remains. In particular, X-ray and CT examinations showed dimorphic facial traits on the mummified skull, and the same radiological approaches allowed determining the age at death from a mummified lower limb. CT analyses allow investigating different types of traumatic lesions in skulls and postcranial skeleton portions and reconstructing the gait and functional outcomes of a fractured femur. Moreover, one case of possible Gardner's syndrome (GS) was postulated from observing multiple osteomas in an ancient skull. CONCLUSION: Among the medical tests available to the clinician, radiology is the most appropriate first-line procedure for a diagnostic approach to ancient human remains because it can be performed without causing any significant damage to the specimen.

Calcified uterine leiomyoma from an 18th-century nunnery in North Italy.

OBJECTIVE: To develop a differential diagnosis of a mass retrieved alongside skeletal remains in the crypt of the church of Santissima Annunziata of Valenza (Province of Alessandria, Northern Italy). MATERIAL: A calcified mass measuring 40 × 39 mm and 17.62 × 16.3817.62 × 16.38 mm. METHOD: The analysis utilized macroscopic assessment and histologic examination (including histochemical and immunohistochemical analyses). RESULTS: Morphological traits include an irregular and spongy external surface. Holes of different sizes lead toward the inner part of the object. A section of the mass shows an "intertwined bundle" pattern, confirmed by microscopic examination. CONCLUSIONS: Differential diagnosis determined the mass to be consistent with calcified leiomyoma. SIGNIFICANCE: Identifying uterine leiomyoma adds to the paucity of paleopathological literature on the condition and to calcified tumors more broadly. It also allows for an important discussion of women's gynecological health in the past and potentially among nulliparous women. LIMITATIONS: Neither histochemical staining nor immunohistochemical analysis demonstrated the certain muscular nature of the specimens due to the rehydration and decalcification processes, for which there are no gold standards. SUGGESTIONS FOR FURTHER RESEARCH: Calcified masses are common in the clinical literature but remain rare in paleopathological literature. Careful excavation and improved recognition of apparently calcified masses are necessary to improve recognition, diagnosis, and interpretation.

Elongated styloid process of an autopsied skull from the Cemetery of Santa Maria Maggiore in Vercelli, 18th-19th century (Piedmont, northern Italy).

We discuss the coexistence of a postmortem cut and a pathological alteration, recorded on a skeleton belonging to an adult man that was discovered during the archaeological investigations of the cemetery of the Church of Santa Maria Maggiore in Vercelli (northern Italy, 18th-19th century). The skull presents an oblique cleft, which from the top of the frontal bone bends towards the occipital, and the left styloid process is elongated compared to normal values (48 mm). The elongated styloid process is due to the ossification of the styloid ligament which has several possible causes. To increase the knowledge about this pathological condition in the past, it was necessary to compare all the data present in the literature today and consider the few cases published in the paleopathological field. In this paper, our main goals are: i) to investigate the reasons for which the craniotomy was performed; ii) to examine the possible cause of the ossification of the styloid process, described as Eagle's syndrome; iii) to enrich the archaeological literature of elongated styloid process cases and iv) to investigate the presence of a hypothetical relationship between the autopsy cut and the diagnosed Eagle's syndrome on this skull.

A possible case of "kissing" osteochondroma and multiple enchondromas in a medieval skeleton from the church of Sant' Agostino in Caravate (Northern Italy).

This work presents the neoplastic bone changes found in the lower limb of a medieval skeleton from the church of Sant' Agostino in Caravate (Northern Italy). After briefly assessing the individual's overall pathological picture, a differential diagnosis for the neoplastic changes is now proposed. These changes were analysed macroscopically and radiographically and subsequently evaluated considering the paleopathological and clinical literature available. The differential diagnosis allowed us to recognize a tibiofibular osteochondroma and some enchondromas in the medullary cavity of the tibia. The results presented here highlight the importance of radiological analyses in the recognition and study of bone neoplasms in the paleopathological field, further contributing to our knowledge of the presence of neoplasms in Medieval Northern Italy.

A possible case of orbital osteomyelitis from the medieval cemetery of Sant' Agostino in Caravate (Varese, Northern Italy).

OBJECTIVES: This paper aims to present one of the first osteoarchaeological cases of orbital osteomyelitis and provides the best diagnostic criteria to identify its pathophysiological changes. MATERIALS: A well-preserved skeleton of an adult male from the medieval cemetery of Sant' Agostino in Caravate, Italy. METHODS: Macroscopic, tomographic, and histological analyses were performed using standard methods. RESULTS: The skeleton shows irregularities in the architecture of the left supraorbital margin. CT analysis reveals the presence of a radiotransparent area involving the diploe and the external cranial table. This area is lateromedially oval-shaped and bordered by a thick irregular radiodense rim, associated with the presence of a cloaca on the roof of the orbit and surrounding periosteal reaction. Microscopic examination shows the formation of a thin layer of cortical bone and an osteoid-like matrix. CONCLUSION: A careful differential diagnosis based on macroscopic, radiological, and histological evidence suggests a case of orbital osteomyelitis. SIGNIFICANCE: This case study represents one of the few osteoarchaeological evaluations of ocular chronic osteomyelitis diagnosed using macroscopic skeletal, computed tomography, and histological analysis. As such, it provides a reference and an investigative criterion for future cases. LIMITATIONS: The diagnosis cannot be stated with certainty, and only probable diagnoses can be proposed. Although we referred especially to clinical literature, it is necessary to consider that the severity of conditions may be modified by modern medical intervention. SUGGESTION FOR FURTHER RESEARCH: This case provides further insights into the presence of this condition in the past.

The fate of stillborns. Perceptions from a historical, anthropological and bioethical reasoning.

Introduction: Issues of disposal of fetal remains and related parental distress do not concern only the present. This contribution aims at offering a glimpse of what grieving management concerning perinatal death must have been in ancient times. The discussion of the topic of death and treatment of perinatal remains is based on historical, anthropological, and bioethical reasoning, in a dialogue that contributes to the current debate on fetal personhood.Methods: We have considered written and archaeological sources to investigate the response of past societies to perinatal death, in parallel with today's bioethical and legislative issues on fetal identity.Results: From historical evidence and archaeological findings, it emerges that lay community compassion and mercy often far exceeded the Church's norms, which for centuries have denied the burial of fetuses and stillborn infants in consecrated cemeteries. Over the centuries, the practices implemented by people have led to a theoretical reflection on the dignity to be recognized to infants.Conclusions: This contribution highlighted how issues about the treatment and burial of infants have interrogated women and men over the centuries. In the past, the development of rituals, even far from ecclesiastical norms, allowed people to endure mourning for the death of their children.Recent legislative initiatives by some States on the burial of embryos and fetuses within cemeteries have reopened the long-standing debate on the value to be attributed to the life of the fetus. The challenge of reaching an agreement on ethically controversial questions gives vigor to the research for strategies capable of settling different needs: the respect for the choice of women, the need to identify forms of protection of human life after death, the development by the community of rites capable of welcoming and accompanying parental mourning.

Accessory sacroiliac joints and the iliosacral complex: two case studies from a medieval and post-medieval cemetery in northern Italy.

The detection of parturition markers on archaeological pelvic bones is relevant for the reconstruction of the biological profiles of female individuals, in whose life history pregnancy represents a crucial biological event. During a preliminary study on a sample of 18 individuals from the medieval and post-medieval cemetery of San Biagio in Cittiglio (northern Italy), two skeletons exhibited evidence of noteworthy bony projections at the sacroiliac level. In clinical studies, these occurrences can be connected to several biological variables such as age, obesity, and multiple births, suggesting that they are a possible consequence of weight-bearing stresses. Here, we address two cases of accessory sacroiliac joints and the iliosacral complex found in two female individuals. The study is part of the anthropological analysis of the sample from the cemetery of Cittiglio (78 individuals have been investigated to date) and, in particular, of the examination of female and male pelves in order to highlight the expression and aspect of pelvic features in both sexes.

Overcoming doubt in vaccinations. The end justifies the means?

Controversies and skepticism about vaccination have existed as long as vaccination itself. Today and yesterday, the authority of religious leaders has a fundamental role to convince members of their congregations to accept or reject vaccination. Our contribution tells of the stratagem used by the Italian doctor Luigi Sacco to make the faithful lean towards the vaccination using their faith as a means. The history of yesterday's end of today opens a current debate on the role and responsibility of religion around vaccination practice. As COVID-19 vaccine mandates grow, so are requests for religious exemptions.

The teaching of the History of Medicine in Italy: a path in progress.

BACKGROUND: The increasing attention to the potential application of technology in medicine represents a dangerous warning in the direction of a reductionist approach. The academic system should therefore be strongly engaged to ensure even in medical practice the greatest enhancement of the human dimension. Targets: How much space is offered to the teaching of History of Medicine (HM) in Italian Universities? This work aims to answer this question through an in-depth analysis of the teaching plans of the degree courses in Medicine and Surgery (CLMC) activated in Italy. MATERIALS AND METHODS: The survey was carried out through the consultation of information, relating to the year 2019-2020, contained in the UniversItaly portal of the Italian Ministry of Education, University and Research, created to accompany students in their studies, as well as through the information published in the web portals of the various universities. RESULTS AND DISCUSSION: In Italy in 43 out of 97 Universities there is the Degree Course in Medicine and Surgery for a total of 66 degree courses; some Universities have activated more degree courses depending on the number of learners or on issues of territorial distribution. The teaching of HM is present in the curricula of 54 CLMC (82%) and in these is mandatory. In 93% of the cases, it is included in integrated courses (CI) and for only 4 CLMC it results as autonomous teaching. For the most part (86%) it is included in the first year's educational plan. The typology of the different CIs is extremely varied, both in terms of denomination, year and content, as well as in the overall CFUs assigned. The current teaching staff is divided as follows: 6 full professors; 12 associate professors; 13 Researchers (RU/RD); 20 contract professors. 19 are the researchers/professors engaged in the scientific field of the HM (MED/02). CONCLUSION: Those findings indicate that the HM subject in the Italian medical education programs is not yet universally recognized as able to stimulate medical students to a holistic view of the person and illness and therefore not sufficiently valued.