Transvaginal sonography in early human pregnancy

Efforts to employ transvaginal sonography as a method to visualise the internal genitalia and their contents already date from the late 1960's, when it was used to detect the embryonic heart beat and to study the female genital tract. It was reported that embryonic cardiac activity could be detected as early as 46 days menstrual age or 32 days after ovulation, which is much earlier than by then available conventional abdominal ultrasound techniques. However, the equipment was bulky and consisted of a large device producing A-mode images. Creation of two-dimensional images was extremely difficult and soon the method was forgotten. It was only after the introduction of the grey scale technique and of realtime imaging in the mid-seventies that transvaginal sonography became feasible again. However, it took a considerable time before its value was rediscovered. This was probably due more to apprehension on behalf of the investigator than to lack of acceptance by the patient. Although the significance of the transvaginal approach was recognised in the early eighties, notably in the German speaking countries and the United States, the major breakthrough came from IVF centres where it was first employed for the puncture of follicles and later for routine monitoring of induction of follicular growth. It soon became clear that transvaginal sonography could give more detailed information in the field of early embryonic development and gynaecological disease. Recently, a host of data on the first topic has been reported. Its role in late pregnancy is mainly determined by its accuracy in diagnosing placenta praevia

Life in Transition: An osteoarchaeological perspective on the impact of medieval socioeconomic developments in Holland and Zeeland

The socioeconomic developments in the Medieval Holland and Zeeland impacted on the lifestyle of the residents. Not only did the alteration in living conditions affect disease prevalence, diet and activity patterns were most likely also subjected to change as a result of the developments. Although general trends are noted in historical sources, the impact on the physical body of the villagers and townsmen is difficult to study on the basis of written sources alone. Therefore, to gain greater insights into the consequences of the socioeconomic developments in Medieval Holland and Zeeland, three skeletal assemblages (362 individuals) are compared: early rural Blokhuizen (AD1000-1196), late rural Klaaskinderkerke (AD1200-1573), and urban Alkmaar (AD1448-1572). Specifically, differences in disease prevalence, activity markers, and variation in levels of dental disease and nutritional stress between the collections are studied. Results indicate that infectious disease levels increased for the urban individuals, most likely as a result of higher population densities and poorer hygiene. The higher prevalence of dental caries in the urban individuals suggests an increase in the ingestion of carbohydrate rich food products. The skeletal data on activity indicates that the urban residents were less mobile than their rural counterparts, but were experiencing similar degrees of mechanical loading on their joints. Interestingly, the absence of differences in nutritional deficiencies and other non-specific stress markers suggest that living in the urban centre is not the health hazard it is commonly assumed to be. This poster demonstrates how the skeletal data can be used to gain a better understanding of life in medieval societyRoman Provinces, Middle Ages and Modern Perio

Malaise and mosquitos: osteoarchaeological evidence for malaria in the medieval Netherlands

Bioarchaeolog

The spatial distribution of cribra orbitalia in the medieval Netherlands: a relationship with malaria?

Cribra orbitalia, orbital roof porosity, is one of the most frequently scored skeletal lesions in archaeological remains from the Netherlands. Cribra orbitalia is generally associated with childhood anaemia, but the underlying cause of this red blood cell disorder is still debated. Gowland and Westen (2012) showed a clear correlation between cribra orbitalia prevalence and certain geographic areas in the UK, linking this to malaria. As the Netherlands was plagued by malaria as well, this parasitic infection may have been an important contributing factor to the prevalence of anaemia in the medieval period. To contribute to this complex debate on the aetiology, and to study the hypothesis of malaria as an important causative agent, this research investigates the spatial distribution of cribra orbitalia in the medieval Netherlands. In total, 1629 individuals from 19 different medieval sites have been studied for the presence or absence of cribra orbitalia and severity of the lesions (1 to 3, Stuart-Macadam 1985). Results show a greater prevalence of cribra orbitalia in the areas deemed malarial based on palaeogeographic and 20th century malaria distribution data (10.9% vs. 23.1%, pNWO016.Veni.195.195Bioarchaeolog

Life in transition : an osteoarchaeological perspective of the consequences of mediëval socioeconomic developments in Holland and Zeeland (AD 1000-1600)

  This research investigates the impact of socioeconomic developments on the physical condition of medieval populations in Holland and Zeeland between AD 1000 and 1600 through the analysis of human skeletal remains from three archaeological sites. In a brief period of time, this region went from being scarcely populated to an area characterised by expanding urban centres and flourishing trade systems. These large scale developments had an impact on the daily lives of medieval people. Focusing on several skeletal indicators of disease, activity, and diet, this research has studied the physical consequences of medieval socioeconomic developments from a hitherto unexplored perspective. Although differences are observed between the skeletal collections, the key finding is the absence of a marked distinction between town and country. The noted variations in skeletal indicators of disease, activity, and diet are minor and do not support the traditional idea that towns and villages in medieval Holland and Zeeland had become worlds apart. While urban living is frequently associated with negative consequences, this is not supported by this research. Especially in terms of disease, a more nuanced view is necessary. While the risks appear to have been different, one living environment cannot be considered better than the other.  SNMAPOsteoarchaeology and funerary archaeolog

Cribriotic lesions in archaeological human skeletal remains: prevalence, co-occurrence, and association in medieval and early modern Netherlands

ObjectiveThis paper studies the prevalence, co-occurrence, and association of cribra orbitalia, cribra humeri, and cribra femora to contribute to the complex debate on cribriotic lesions and their relationship with one another.Materials179 adults and 53 non-adults from the medieval/early modern Netherlands (800–1600 CE) for whom all three lesions could be observed are included in this study.MethodsPresence or absence of cribriotic lesions was studied macroscopically. Prevalence, co-occurrence, and association of lesions and their link to sex and age-at-death were assessed.ResultsA clear link between prevalence of the lesions and age-at-death is found. Co-occurrence and association of all three lesions is uncommon. There is a significant moderate correlation for cribra humeri-femora in non-adults.ConclusionsLesion prevalence is connected to age-at-death. However, while a similar age distribution and associations between pairs of lesions are noted, due to limited co-occurrence of the three lesions, the presence of a ‘cribrous syndrome’ cannot supported.SignificanceThis is the first study investigating the prevalence, co-occurrence and association of cribra orbitalia, cribra humeri, and cribra femora in non-adults and adults contributing to discussions about the nature and the much-debated aetiology of these commonly encountered skeletal lesions.LimitationsThe number of non-adults in this study is limited, potentially obscuring meaningful patterns, as the cribrous lesions are significantly more common in younger individuals.Suggestions for further researchMore research into the prevalence of the post-cranial lesions and their co-occurrence as well as into bone growth and remodelling is warranted.NWO016.Veni.195.195Bioarchaeolog

In sickness and in health. An archaeological and osteoarchaeological analysis of St. Gertrude’s infirmary in Kampen (1382-c. 1611)

Bioarchaeolog

Mode of conception of twin pregnancies: Willingness to reply to survey items and comparison of survey data to hospital records.

Based on results from a survey study in a sample of Australian parents of twins, Raj and Morley (2007) reported that questions concerning the mode of conception of twins may be offensive to parents. We looked at the willingness to reply to questions about mode of conception of twin pregnancies in a large survey study that was completed by 20, 150 mothers of twins from the Netherlands Twin Registry. Data collection took place in 2005/2006. The amount of missing data was examined and by using data from earlier survey studies, responders and nonresponders were compared with respect to their answers to questions on assisted reproduction techniques. In addition, we assessed the reliability of the question on mode of conception by comparing the survey data with hospital records in a subsample of 80 mothers of twins. We found no indication that mothers of twins were not prepared to reply to questions on mode of conception. Only a small number of mothers did not fill in the question on mode of conception (0.8%). Also, the use of artificial fertility techniques did not differ between mothers who returned and mothers who did not return the 2005/2006 survey. The comparison of the survey data with the hospital records showed that mothers can accurately report on the mode of conception of their twins

A probable case of metastatic carcinoma in the medieval Netherlands

Despite recent considerable gains, our knowledge of cancer in antiquity is still limited. This paper discusses an adult individual from a Dutch medieval hospital site who demonstrates osteoblastic and osteolytic lesions on the ribs, scapula, clavicle, and vertebrae. The morphology, radiographic appearance, and distribution of the skeletal lesions suggest that this individual was affected by metastatic carcinoma. This case increases the number of publications that present an osteoblastic and osteolytic response to cancer and contributes to the body of evidence for archaeological neoplastic disease. For the Netherlands, this individual presents the first published case of probable metastatic carcinoma with mixed skeletal lesions.BioarchaeologyRoman Provinces, Middle Ages and Modern Perio