Serpens Endocrania Symmetrica (ses): A New Term And A Possible Clue For Identifying Intrathoracic Disease In Skeletal Populations
Anthropology; dura mater; endocranial changes; Evolutionary Biology; hypertrophic osteoarthropathy; skeletal population; tuberculosis
This paper describes a phenomenon in the endocranial plate, which we have termed "serpens endocrania symmetrica" (SES), and discusses its value as a diagnostic tool. The affected discolored bone area exhibits disruption of the endocranial surface, lending it a maze-like appearance. Histological sections demonstrate that the process is limited to the most superficial portion of the endocranium, with no diploic and ectocranial involvement (sinus areas excepted). Adult skulls (n = 1,884) from the Hamann-Todd collection (HTH), housed at the Cleveland Museum of Natural History, were utilized for the present study. SES was recognized in 32 of the 1,884 skulls studied (1.7%). The frequency of SES among individuals reported to have died from tuberculosis (TB) was 4.4%. The rate of SES in the non-TB sample was only 0.53%. The locations were as follows: limited to sinus area, 28.1%; calvarium (excluding the sinuses), 46.9%; sinus + calvarium, 25.0%. SES was bilateral in 90.9% of cases. Twenty-five of the 32 individuals (78.1%) with SES in the HTH collection had tuberculosis specifically listed as the cause of death. Six of the other 7 individuals had infections other than TB. In 29 of the 32 individuals with SES, infection involved structures within the thorax. As SES was also associated with another osteological phenomenon known to represent pulmonary disease, i.e., hypertrophic osteoarthropathy (HOA; 68.0% of SES individuals also had HOA), SES may be of diagnostic value in paleopathology for the recognition of intrathoracic disease, and perhaps tuberculosis. (C) 2002 Wiley-Liss, Inc.
Hershkovitz I; Greenwald C M; Latimer B; Jellema L M; Wish-Baratz S; Eshed V; DuTour O; Rothschild B M
American Journal of Physical Anthropology
2002
2002-07
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1002/ajpa.10077" target="_blank" rel="noreferrer noopener">10.1002/ajpa.10077</a>
Tuberculosis of the spine (Pott's disease) presenting as 'compression fractures'
diagnosis; bone; rehabilitation; management; Neurosciences & Neurology; compression; tuberculosis; Fracture; immunodeficiency-virus infection; Pott's disease; tuberculosis of spine
Study design: Case reports and survey of literature. Objective: Case reports of two women with tuberculosis (TB) of the spine (Pott's disease) presenting with severe back pain and diagnosed as compression fracture are described. Physicians should include Pott's disease in the differential diagnosis when patients present with severe back pain and evidence of vertebral collapse. Setting: Ohio, USA. Methods: A review of the literature on the pathogenesis, pathophysiology, clinical presentation, diagnostic methods, treatment and prognosis of spinal TB was conducted. Results: After initial delay, proper diagnosis of spinal TB was made in our patients. Microbiologic diagnosis confirmed M. tuberculosis, and appropriate medical treatment was initiated. Conclusions: Although uncommon, spinal TB still occurs in patients from developed countries, such as the US and Europe. Back pain is an important symptom. Vertebral collapse from TB may be misinterpreted as 'compression fractures' especially in elderly women. Magnetic resonance imaging scan (MRI) is an excellent procedure for the diagnosis of TB spine. However, microbiologic diagnosis is essential. Mycobacterium tuberculosis may be cultured from other sites. Otherwise, biopsy of the spine lesion should be done for pathologic diagnosis, culture and stain for M. tuberculosis. Clinicians should consider Pott's disease in the differential diagnosis of patients with back pain and destructive vertebral lesions. Proper diagnosis and anti-tuberculosis treatment with or without surgery will result in cure.
Dass B; Puet T A; Watanakunakorn C
Spinal Cord
2002
2002-11
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1038/sj.sc.3101365" target="_blank" rel="noreferrer noopener">10.1038/sj.sc.3101365</a>
SEROLOGIC REACTIVITY AGAINST MYCOBACTERIUM-PARATUBERCULOSIS ANTIGENS IN PATIENTS WITH SARCOIDOSIS
antibodies; crohns-disease; crohns-disease; elisa; elisa assay; inflammatory bowel disease; linked immunosorbent-assay; mycobacterium-paratuberculosis; Respiratory System; tuberculosis
Although sarcoidosis has clinical and histopathologic similarities to some forms of tuberculosis and other mycobacterial infections, attempts to establish a mycobacterial etiology have not been successful. Using cytoplasmic antigens derived from a wild strain of Mycobacterium paratuberculosis in an enzyme-linked immunosorbent assay, patients with sarcoidosis were found to have immunoglobulin levels significantly higher than those found in a control population in the IgG, but not in IgA or IgM antibody classes. Results were comparable to those reported from patients with Crohn's disease, where M. paratuberculosis has been intensively studied as a possible etiologic agent. To elucidate these relationships, examination of DNA from sarcoid tissues for possible homology with DNA from M. paratuberculosis and closely related organisms, as well as cultural attempts with techniques and media appropriate for M. paratuberculosis may be warranted.
Reid J D; Chiodini R J
Sarcoidosis
1993
1993-03
Journal Article
n/a
Macroscopic anatomy of the vertebral endplate: Quid significat?
Anthropology; back-pain; defleshed bones; degenerative changes; erosive arthritis; intervertebral disc; lumbar spine; prevalence; rheumatoid-arthritis; Schmorl's nodes; Schmorl's nodes; spondyloarthropathy; structural-properties; tuberculosis; Vertebral endplate
Alterations of vertebral endplates have long been a subject of interest, but are of unclear clinical significance. The vertebral columns of a cohort-based sample of 850 individuals were therefore evaluated for vertebral endplate defects, noting adjacent vertebral size and shape variation, bone density and associated pathologies. Defects were found in the vertebral endplates of 458 individuals (Schmorl's nodes in 52.0% and linear defects in 10.6 %). Vertebral centra osteophytes and diffuse idiopathic skeletal hyperostosis were more common; vertebral compression, less common in vertebrae with defects. Linear defects were more disseminated throughout the vertebral column, with individual defects more commonly affected either the interior half or the posterior quarter of the endplate or extended across all quarters form anterior to posterior. Individual Schmorl's nodes were predominantly limited to a single quarter. An inverse relationship was identified with tuberculosis. Spondyloarthropathy was more common in individuals with Schmorl's nodes, but not linear defects. Schmorl's nodes and linear endplate defects should be independently assessed, although they do share implications. Paradoxically, they are associated with phenomena which seem to mark increased ossification potential (osteophytes and diffuse idiopathic skeletal hyperostosis), but not with osteoporosis. Similarly, presence of Schmorl's nodes correlation with spondyloarthropathy, another disorder characterized by increased ossification potential. While correlation is not causality, inverse relationship to tuberculosis is intriguing, given the known relationship of spondyloarthropathy to tuberculosis and its antigens. Previously undescribed surface elevations were commonly associated with the presence of Schmorl's nodes and also correlated with disease, especially inflammatory arthritis, hypertrophic osteoarthropathy.
Rothschild B M; Ho J; Masharawi Y
Anthropologischer Anzeiger
2014
2014
Journal Article
<a href="http://doi.org/10.1127/0003-5548/2014/0365" target="_blank" rel="noreferrer noopener">10.1127/0003-5548/2014/0365</a>
Hyperdisease in the late Pleistocene: validation of an early 20th century hypothesis
arthritis; Bison; erosive disease; extinction; hyperdisease; infection; lesions; mastodon; Pleistocene; Science & Technology - Other Topics; tuberculosis
The hypothesis of disease-related large mammal extinction has new support. A unique pathologic zone of resorption was first noticed in a Hiscock Mammut americanum metacarpal. The pathognomonic zone of resorption was present in fifty-nine (52%) of 113 skeletons with feet available for examination. Metacarpals and metatarsals were most commonly affected. Associated rib periosteal reaction is highly suggestive of tuberculosis and the foot lesions were identical to that documented in Bison as pathognomonic for tuberculosis. Recognizing that only a portion of animals infected by infectious tuberculosis develop bone involvement, the high frequency of the pathology in M. americanum suggests that tuberculosis was not simply endemic, but actually pandemic, a hyperdisease. Pandemic tuberculosis was one of several probable factors contributing to mastodon extinction.tinction.
Rothschild B M; Laub R
Naturwissenschaften
2006
2006-11
Journal Article
<a href="http://doi.org/10.1007/s00114-006-0144-8" target="_blank" rel="noreferrer noopener">10.1007/s00114-006-0144-8</a>
Pulmonary lymphadenopathy
adenopathy; childhood; children; ct; Immunology; Infectious Diseases; manifestations; Pediatrics; sarcoidosis; tuberculosis
Omlor G J
Pediatric Infectious Disease Journal
2001
2001-04
Journal Article
<a href="http://doi.org/10.1097/00006454-200104000-00013" target="_blank" rel="noreferrer noopener">10.1097/00006454-200104000-00013</a>
Unified theory of the origins of erosive arthritis: conditioning as a protective/directing mechanism?
Humans; United States/epidemiology; *Paleontology; Catchment Area (Health); Arthritis; Tuberculosis; Spondylitis; Ankylosing/complications/epidemiology; Osteoarticular/complications/epidemiology; Rheumatoid/epidemiology/*etiology
OBJECTIVE: To validate the western Tennessee River limits of the originally described rheumatoid arthritis (RA) catchment area and to assess the possibility that absence of tuberculosis allowed the original development of RA. The hypothesis that RA was related to tuberculosis was once a driving force in treatment approach. RA initially was very limited in geographic distribution, in contrast to tuberculosis. Classical tubercular lesions were not observed in the rheumatoid catchment area in ancient times. Similarities between clinical and radiologic manifestations of spondyloarthropathy (SpA) and adjuvant arthritis raised the possibility of a potential conditioning role for occurrence of nonrheumatoid erosive arthritis. METHODS: Skeletal samples from ancient RA catchment and non-catchment areas were compared for frequency of tubercular-relatable pathologies. RESULTS: Tubercular-relatable osseous pathologies were found only outside the rheumatoid catchment area (p \textless 0.0001). The original RA catchment area was confirmed not to extend beyond the western portion of the Tennessee River. CONCLUSION: There is an inverse relationship between occurrence of tuberculosis and RA in the Archaic and Early Woodland periods of North America. The virtually universal presence of tuberculosis in contiguous Amerindian populations contrasts dramatically with its absence in the ancient catchment area for RA. Conversely, SpA and tuberculosis do occur in the same populations. Tuberculosis may represent a conditioning agent for development of SpA, but at least potentially provides protection against development of RA.
Rothschild Bruce M; Rothschild Christine; Helbling Mark
The Journal of rheumatology
2003
2003-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Case studies of lower respiratory tract infections: community-acquired pneumonia.
Acute – Microbiology; Adult; Adult/microbiology; Aged; Anti-Bacterial Agents/*therapeutic use; Antibiotics – Therapeutic Use; Antitubercular Agents – Therapeutic Use; Antitubercular Agents/therapeutic use; Community-Acquired Infections – Diagnosis; Community-Acquired Infections – Drug Therapy; Community-Acquired Infections/diagnosis/drug therapy; Cough; Cough – Microbiology; Cough/microbiology/virology; Diagnosis; Differential; Dyspnea; Fatal Outcome; Female; Fever – Microbiology; Fever/microbiology; Hemoptysis – Microbiology; Hemoptysis/microbiology; Human; Human – Complications; Human – Diagnosis; Human/complications/*diagnosis; Humans; Hypotension – Microbiology; Hypotension/microbiology; Influenza; Leukopenia – Microbiology; Leukopenia/microbiology; Male; Methicillin-Resistant Staphylococcus Aureus; Methicillin-Resistant Staphylococcus aureus/*isolation & purification; Miliary/diagnosis/drug therapy; Multiple Organ Dysfunction Syndrome – Microbiology; Multiple Organ Failure/microbiology; Mycobacterium Tuberculosis; Mycobacterium tuberculosis/isolation & purification; Pneumonia – Diagnosis; Pneumonia – Drug Therapy; Pneumonia – Microbiology; Pneumonia – Therapy; Pneumonia/*diagnosis/*drug therapy/microbiology/therapy; Practice Guidelines; Practice Guidelines as Topic; Respiratory Distress Syndrome; Risk Factors; Severity of Illness Index; Severity of Illness Indices; Smoking; Smoking/adverse effects; Staphylococcal Infections – Diagnosis; Staphylococcal Infections – Drug Therapy; Staphylococcal Infections – Microbiology; Staphylococcal Infections – Therapy; Staphylococcal Infections/*diagnosis/*drug therapy/microbiology/therapy; Tuberculosis; Tuberculosis – Diagnosis; Tuberculosis – Drug Therapy
Community-acquired pneumonia (CAP) is a common and potentially serious illness with significant human and economic costs to society. The recent collaborative statement from the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) represents the most up-to-date evidence-based guidelines from North America, incorporating important advances in the management of patients with CAP. The cases presented in this review highlight many of the recent recommendations from the IDSA/ATS guidelines.
File Thomas M Jr
The American journal of medicine
2010
2010-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.amjmed.2010.02.002" target="_blank" rel="noreferrer noopener">10.1016/j.amjmed.2010.02.002</a>