The Anglo-Saxon migration and the formation of the early English gene pool.

The history of the British Isles and Ireland is characterized by multiple periods of major cultural change, including the influential transformation after the end of Roman rule, which precipitated shifts in language, settlement patterns and material culture1. The extent to which migration from continental Europe mediated these transitions is a matter of long-standing debate2-4. Here we study genome-wide ancient DNA from 460 medieval northwestern Europeans-including 278 individuals from England-alongside archaeological data, to infer contemporary population dynamics. We identify a substantial increase of continental northern European ancestry in early medieval England, which is closely related to the early medieval and present-day inhabitants of Germany and Denmark, implying large-scale substantial migration across the North Sea into Britain during the Early Middle Ages. As a result, the individuals who we analysed from eastern England derived up to 76% of their ancestry from the continental North Sea zone, albeit with substantial regional variation and heterogeneity within sites. We show that women with immigrant ancestry were more often furnished with grave goods than women with local ancestry, whereas men with weapons were as likely not to be of immigrant ancestry. A comparison with present-day Britain indicates that subsequent demographic events reduced the fraction of continental northern European ancestry while introducing further ancestry components into the English gene pool, including substantial southwestern European ancestry most closely related to that seen in Iron Age France5,6.

Prevalence of undisclosed osteoporosis in patients with minimal trauma fractures: a prospective cohort study.

Despite epidemiologic evidence for the presence of osteoporosis in patients with minimal trauma fractures, screening programs have not been routinely established in Australian ambulatory care clinics. Our study assessed the prevalence of osteoporosis and osteopenia in patients at a tertiary care hospital to gather local data to support policy change that favors bone mineral density screening. Our prospective observational study enrolled 115 patients, aged > 40 years, who had experienced a minimal trauma fracture. Inclusion criteria required that the patient had no history of testing for osteoporosis or metabolic bone disease/major pathology. The patients were recruited over a 6-month period. Eleven participants were excluded and 7 participants withdrew from the study, with a total of 97 patients completing the study. Participants were assessed for osteoporosis risk via bone mineral density measurement by dual-energy x-ray absorptiometry and blood screening for bone mineral levels, 25-hydroxyvitamin D, and parathyroid hormone levels. In our study patients, the prevalence of previously undiagnosed osteoporosis was 19%, undiagnosed osteopenia, 50%, and the standard bone mineral density was 32%. The most common risk factors for osteoporosis/osteopenia were smoking (22%), alcohol intake (16%), and corticosteroid use (9%). In 67% of patients, 25-hydroxyvitamin D level was in the low clinical range in 51% of patients, magnesium levels were in the high range and 18% of patients had elevated serum parathyroid levels. At month 12 of our study, 80 participants were available for follow-up: 2 patients had sustained a second fracture (1 was minimal trauma); 6 patients had required further surgery (3 fracture fixations, 3 for removal of internal fixation devices); 26 patients continued treatment regimens with calcium and 25-hydroxyvitamin D supplementation; and 28 patients had been prescribed bisphosphonates, with 22 patients complying with the prescription. The high prevalence of previously undiagnosed low bone mass in our study patient population, each of whom had experienced minimal trauma falls, provides impetus for the provision of osteoporosis screening programs and corresponding treatment as needed.

A probable case of rheumatoid arthritis from the middle Anglo-Saxon period.

We present here a case of erosive polyarthropathy in an incomplete skeleton from a middle-Saxon period (c. AD 650-900) cemetery site in Sedgeford, Norfolk, England. After a differential diagnosis that includes erosive osteoarthritis and psoriatic arthritis, we believe rheumatoid arthritis (RA) to be the most probable cause. This example may therefore add to the evidence for an early date for the appearance of RA in Europe.