Porosities in the outer table of the cranial vault (porotic hyperostosis) and orbital roof (cribra orbitalia) are among the most frequent pathological lesions seen in ancient human skeletal collections. Since the 1950s, chronic iron-deficiency anemia has been widely accepted as the probable cause of both conditions. Based on this proposed etiology, bioarchaeologists use the prevalence of these conditions to infer living conditions conducive to dietary iron deficiency, iron malabsorption, and iron loss from both diarrheal disease and intestinal parasites in earlier human populations. This iron-deficiency-anemia hypothesis is inconsistent with recent hematological research that shows iron deficiency per se cannot sustain the massive red blood cell production that causes the marrow expansion responsible for these lesions. Several lines of evidence suggest that the accelerated loss and compensatory over-production of red blood cells seen in hemolytic and megaloblastic anemias is the most likely proximate cause of porotic hyperostosis. Although cranial vault and orbital roof porosities are sometimes conflated under the term porotic hyperostosis, paleopathological and clinical evidence suggests they often have different etiologies. Reconsidering the etiology of these skeletal conditions has important implications for current interpretations of malnutrition and infectious disease in earlier human populations.

The causes of porotic hyperostosis and cribra orbitalia: a reappraisal of the iron-deficiency-anemia hypothesis.

A group of 19 healthy elderly subjects previously shown to differ in terms of their cortisol levels over a 4 year period were administered a neuropsychological test battery assessing memory, attention, and language. Correlational analyses performed on various corticosteroid measures showed that the slope of the change in cortisol levels over time predicted cognitive deficits in this elderly population. Aged subjects showing a significant increase in cortisol levels with years and with high current basal cortisol levels were impaired on tasks measuring explicit memory and selective attention when compared to aged subjects presenting either decreasing cortisol levels with years or increasing cortisol levels with moderate current basal cortisol levels. We further showed that subjects presenting a decrease in cortisol levels with years performed as well as young healthy subjects with regard to cognitive performance. Thus, impaired cognitive performance was associated with recent evidence of hypothalamic-pituitary-adrenal (HPA) dysregulation and elevated basal cortisol levels. These results are consistent with recent animal studies showing the existence of subpopulations of aged rats that differ in HPA activity and cognitive performance. Finally, the pattern of cognitive results related to the cortisol history of subjects is in agreement with a role played by the hippocampus in age-related HPA dysfunction and cognitive performance.

https://www.jneurosci.org/content/jneuro/14/5/2893.full.pdf

Basal cortisol levels and cognitive deficits in human aging

http://www.utdallas.edu/~tres/aging_seminar2011/Lupien.2005.pdf

Stress hormones and human memory function across the lifespan

Nucleation time: a key factor in the pathogenesis of cholesterol gallstone disease.

Although a large number of diseases, conditions, and syndromes associated with mental retardation have been described, it has been the discouraging experience of physicians dealing with retarded children that relatively few cases may be specifically classified or diagnosed despite intensive evaluations. Many of the children manifest facial peculiarities along with other physical findings and often resemble neither their parents nor their siblings. The clinician frequently has the feeling that the child should "fit into some syndrome"; however, each case usually presents an isolated and unique group of findings not resembling the picture seen in other retarded children who are evaluated. It was a rather unusual and exciting experience to find two unrelated children who seemed to resemble each other closely enough to make one wonder if they might not have the same "syndrome." After studying these two patients with their array of similar clinical findings, their reports and photographs were

Broad Thumbs and Toes and Facial Abnormalities: A Possible Mental Retardation Syndrome

In this study the influence of old age on adrcnocortical function and cortisol metabolism was investigated, along with renal, hepatic and thyroid function in 15 young men (25–40 years old) and 50 old men (60–96 years old). By the criteria of 8-a.m. plasma levels of free and conjugated 17-hydroxycorticosteroids (17-OH-CS) and the plasma corticoid response to ACTH stimulation, no significant change in adrenocortical function could be demonstrated with advancing age. However, there was a progressive and significant decrease in the urinary excretion of 17-OH-CS with aging. Following intravenous administration of a standard dose, cortisol disappeared from the circulation at a significantly slower rate in the old men. The maximal levels of plasma conjugated 17-OH-CS observed after cortisol infusion were statistically the same for all ages, but the rate of decay from peak values was slower in the older subjects. These alterations in cortisol metabolism were associated with a significant increase in the level of ...

Adrknocortical function and cortisol metabolism in old age

In subjects with chronic renal disease, levels of free 17-hydroxycorticosteroids (17-OHCS) in plasma were measured at 8 a.m. and were normal. Conjugated levels were elevated, correlating inversely with endogenous creatinine clearance (Clcr.). After standard infusions of cortisol, free levels decayed exponentially but more slowly than normal, while conjugated levels rose further than in normal subjects. Conjugated, but not free, 17-OHCS again correlated inversely with Clcr. Cortisol was partially identified in the free fraction and tetrahydrocortisol and tetrahydrocortisone in the conjugated fraction of plasma following infusion. Urinary excretion of 17-OHCS and the increment after infusion were less than normal and correlated directly with Clcr. A patient with anasarca provided an exception to the noted patterns and correlations. In subjects with acute renal failure, elevated levels of conjugated 17-OHCS in plasma did not decline with the onset of diuresis but fell in parallel with levels of blood urea. D...

Metabolism of free and conjugated 17-hydroxycorticosteroids in subjects with uremia.

Levels of free and conjugated 17-hydroxycorticosteroids (17-OHCS) in plasma were measured after intravenous infusions of cortisol, tetrahydrocortisone (Tetra E) and adrenocorticotropic hormone (ACTH) in subjects wi h hyperthyroidism and hypothyroidism. After administration of cortisol to hyperthyroid patients, the levels of free 17-OHCS decayed more rapidly than normal, while those of conjugated 17-OHCS rose faster and to higher values than in normal subjects. The opposite occurred in hypothyroid patients. Conjugation of administered Tetra E was increased in hyperthyroid patients but was normal in those with hypothyroidism. Plasma concentrations of free 17-OHCS were influenced more by the rate of removal from plasma than by the adrenal response to ACTH in both types of subjects. Accordingly the level of free 17-OHCS after ACTH was a misleading index of adrenocortical function, as the rise was greatest in hypothyroid patients and least in those with hyperthyroidism. The level of conjugated 17-OHCS after in...

Metabolism of free and conjugated 17-hydroxycorticosteroids in subjects with thyroid disease.

https://www.gastrojournal.org/article/0016-5085(78)90774-6/pdf

Cimetidine, antacid, and hospitalization in the treatment of benign gastric ulcer: A multicenter double blind study

Examination of ova and parasites from coprolites of probable human origin revealed eggs of the phylum Acanthocephala. Specimens were gathered from Danger Cave in Utah, an area heavily populatd with definitive rodent hosts for the Acanthocephala species Moniliformis clarki. It is postulated that prehistoric man developed Acanthocephala infection by ingesting the arthropod intermediate host, or that he was a victim of false parasitism by ingesting the whole rodent.

http://science.sciencemag.org/content/sci/163/3873/1324.full.pdf

Edwin Englert

Papers

Adrknocortical function and cortisol metabolism in old age

Metabolism of free and conjugated 17-hydroxycorticosteroids in subjects with uremia.

Metabolism of free and conjugated 17-hydroxycorticosteroids in subjects with thyroid disease.

Cimetidine, antacid, and hospitalization in the treatment of benign gastric ulcer: A multicenter double blind study

Thomy-Headed Worm Infection in North American Prehistoric Man