A paleoepidemiological approach to the challenging differential diagnosis of an isolated 1500-year-old anomalous molar from Panamá

IF 1.3 3区地球科学 Q3 PALEONTOLOGY

International Journal of Paleopathology Pub Date : 2022-12-01 DOI:10.1016/j.ijpp.2022.07.002

Nicole E. Smith-Guzmán

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引用次数: 0

Abstract

Objective

This study seeks to quantify the presence and prevalence of specific genetic and infectious diseases in the pre-Colombian Panamanian population and uses these data to consider the plausibility of these diseases as causative factors in the development of an abnormal supernumerary cusp morphology in a 1500-year-old isolated molar recovered from Cerro Juan Díaz (Los Santos, Panama).

Materials

267 individuals from pre-Columbian sites throughout Panama.

Methods

The anomalous tooth was analyzed through macroscopic, odontometric, and radiographic means. Tentative differential diagnosis was performed using inferences from paleopathological features of the broader regional population.

Results

The regional sample showed evidence of treponemal infection and developmental anomalies in 10.1% and 10.9% of individuals, respectively.

Conclusions

While not able to rule out three potential genetic conditions, more evidence was found to support the differential diagnosis of congenital syphilis as the causative agent leading to the development of abnormal supernumerary cusps in the isolated molar.

Significance

This study demonstrates how characterizing disease experience in the population can assist in differential diagnoses at the individual level and cautions against the assumption that any one lesion in isolation is unique to only one specific pathological condition.

Limitations

The timing discrepancy between clinical descriptions of congenital syphilis and genetic disorders, lack of knowledge on pathophysiological mechanisms of the former, poor preservation of Treponema pathogen ancient DNA, and deficiencies in modern public health data from Panama limit the differential diagnosis.

Suggestions for further research

Inclusion and serious contemplation of genetic diseases in paleopathological differential diagnoses is necessary.

查看原文本刊更多论文

古流行病学方法对来自巴拿马的一颗1500年前的异常臼齿进行具有挑战性的鉴别诊断

本研究旨在量化前哥伦比亚巴拿马人口中特定遗传和传染病的存在和流行，并利用这些数据考虑这些疾病作为在Cerro Juan Díaz (Los Santos, Panama)中发现的1500年前的分离臼齿异常多尖形态发展的致病因素的合理性。资料:来自巴拿马前哥伦布时代遗址的267个人。方法采用肉眼、牙镜、x线摄影等方法对异常牙进行分析。根据更广泛地区人群的古病理特征推断进行初步鉴别诊断。结果区域样本中分别有10.1%和10.9%的个体存在密螺旋体感染和发育异常。结论虽然不能排除三种潜在的遗传条件，但更多的证据支持先天性梅毒作为导致离体磨牙出现异常多尖的病原体的鉴别诊断。意义:本研究证明了在人群中描述疾病经历如何有助于在个体水平上进行鉴别诊断，并提醒人们不要假设任何一种单独的病变只针对一种特定的病理状况。局限性先天性梅毒的临床描述与遗传疾病的时间差异、对前者病理生理机制的了解不足、梅毒原体古代DNA保存不佳以及巴拿马现代公共卫生数据的不足，限制了鉴别诊断。在古病理鉴别诊断中，有必要对遗传病进行结论和认真思考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Paleopathology PALEONTOLOGY-PATHOLOGY

CiteScore

2.90

自引率

25.00%

发文量

期刊介绍： Paleopathology is the study and application of methods and techniques for investigating diseases and related conditions from skeletal and soft tissue remains. The International Journal of Paleopathology (IJPP) will publish original and significant articles on human and animal (including hominids) disease, based upon the study of physical remains, including osseous, dental, and preserved soft tissues at a range of methodological levels, from direct observation to molecular, chemical, histological and radiographic analysis. Discussion of ways in which these methods can be applied to the reconstruction of health, disease and life histories in the past is central to the discipline, so the journal would also encourage papers covering interpretive and theoretical issues, and those that place the study of disease at the centre of a bioarchaeological or biocultural approach. Papers dealing with historical evidence relating to disease in the past (rather than history of medicine) will also be published. The journal will also accept significant studies that applied previously developed techniques to new materials, setting the research in the context of current debates on past human and animal health.