Trends in congenital anomalies in Europe from 1980 to 2012.

BACKGROUND: Surveillance of congenital anomalies is important to identify potential teratogens. METHODS: This study analysed the prevalence of 61 congenital anomaly subgroups (excluding chromosomal) in 25 population-based EUROCAT registries (1980-2012). Live births, fetal deaths and terminations of pregnancy for fetal anomaly were analysed with multilevel random-effects Poisson regression models. RESULTS: Seventeen anomaly subgroups had statistically significant trends from 2003-2012; 12 increasing and 5 decreasing. CONCLUSIONS: The annual increasing prevalence of severe congenital heart defects, single ventricle, atrioventricular septal defects and tetralogy of Fallot of 1.4% (95% CI: 0.7% to 2.0%), 4.6% (1.0% to 8.2%), 3.4% (1.3% to 5.5%) and 4.1% (2.4% to 5.7%) respectively may reflect increases in maternal obesity and diabetes (known risk factors). The increased prevalence of cystic adenomatous malformation of the lung [6.5% (3.5% to 9.4%)] and decreased prevalence of limb reduction defects [-2.8% (-4.2% to -1.5%)] are unexplained. For renal dysplasia and maternal infections, increasing trends may be explained by increased screening, and deceases in patent ductus arteriosus at term and increases in craniosynostosis, by improved follow up period after birth and improved diagnosis. For oesophageal atresia, duodenal atresia/stenosis and ano-rectal atresia/stenosis recent changes in prevalence appeared incidental when compared with larger long term fluctuations. For microcephaly and congenital hydronephrosis trends could not be interpreted due to discrepancies in diagnostic criteria. The trends for club foot and syndactyly disappeared once registries with disparate results were excluded. No decrease in neural tube defects was detected, despite efforts at prevention through folic acid supplementation.

Palaeopathology of human remains from the Roman Imperial Age.

The increasing attention of archaeological and anthropological research towards palaeopathological studies has allowed to focus the examination of many skeletal samples on this aspect and to evaluate the presence of many diseases afflicting ancient populations. This paper describes the most interesting diseases observed in skeletal samples from five necropolises found in urban and suburban areas of Rome during archaeological excavations in the last decades, and dating back to the Imperial Age. The diseases observed were grouped into the following categories: articular diseases, traumas, infections, metabolic or nutritional diseases, congenital diseases and tumors, and some examples are reported for each group. Although extensive epidemiological investigation in ancient skeletal records is impossible, palaeopathology allowed highlighting the spread of numerous illnesses, many of which can be related to the life and health conditions of the Roman population.

[From teratology to mythology: ancient legends]. / De la tératologie aux monstres de la mythologie et des légendes antiques.

The mythology of the Greeks and Romans is full of monsters of fiction: giants, cyclops, centaurs, hydras, Gorgons… The accounts of travelers, reproduced in the Natural History of Pline l'Ancien reported the existence, in distant countries, of men with a dog's head (baboons), of men with a single tall foot (sciapode), beings whose face is embedded in the chest (or acephala blemmyes), to which must be added a wide variety of men with no mouth, no nose, or equipped with giant ears or feet turned backwards, as well as hermaphrodites. Teratology reports on monstrous births, which have constituted the factual basis from which the imagination conceived adults whose morphology corresponds to the monsters of legend. Newborns sirenomelia were behind the legend of sciapode and sirens. Cyclopia have inspired the legend of the cyclops. Anencephaly probably explains the description of headless or blemmyes. The genesis of the legend of baboons may have multiple origins: firstly the existence of people suffering from congenital hypertrichosis, on the other hand, the influence of Egyptian mythology where the god Anubis has a dog's head. The acardiac fetus may explain some monstrous forms, features the work of Hieronymus Bosch. The significance of the monsters of legend, their genesis, their persistence through the ages is complex. By approaching teratology, we added a new field of exploration of real monsters of antiquity and Middle Ages.

Disease in the neolithic population of the Lengyel culture (4300-4000 B.C.) from the Kujawy region in north-central Poland.

In this paper the skeletal sample from Oslonki near Wloclawek (Kujawy region) is analysed. It is dated back to 4300-4000 B.C. The material consists of skeletal remains of 92 individuals (being one of the largest samples from the neolithic period in Poland). Skeletons were examined for the presence of congenital malformation, traumatic and degenerative changes, diseases of the masticatory system, and cribra orbitalia. Some interesting results have been achieved by comparing the incidences of diseases regarding sex groups: pathological alterations were observed with greater frequency in male than female skeletons.

Birth malformations in Babylon and Assyria.

In this paper, we intend to study the oldest systematic descriptions of birth malformations in the history of medicine, as they appear in cuneiform texts written four millennia ago in the land between the two rivers, Mesopotamia, the cradle of civilization, the land of Assyro-Babylonian culture. The core of our work will be an omen text, which was published in 1970 and, since then, has remained confined to the field of Assyriological studies; thus, the history of medicine and disease have not taken advantage of its knowledge. This text is known in Assyriology by its Akkadian name: "shumma izbu" (Izbu), "if an anomaly" [Leichty, 1970: The Omen series shumma izbu, Texts from Cuneiform Sources IV].

[Human abnormalities--their importance in the world view during antiquity and the early Middle Ages]. / Die Missgestalt des Menschen--ihre Deutung im Weltbild von Antike und Frühmittelalter.

In consideration of the experience that also in our present day society the development of a handicapped baby is understood by some as the visible result of a morally guilty behaviour of the parents, the present study raises the question, whether the identification of physical appearance and moral attitude has been in a certain historical epoch the preferred approach in science for understanding the origin of human malformations. After the treatment of the teratological theories in greek medicine and aristotelian natural philosophy the question of the origin of human malformation is examined in Pliny's "Historia naturalis" and Augustine's "De civitate dei". A comparison between the theories presented shows that the moral interpretation of human malformation is an inevitable consequence of the augustinian theological thinking.