Porotic hyperostosis, formerly called osteoporosis symmetrica, is an overgrowth of the spongy marrow space of the skull. In children, other bones may also be affected. The disease is a consequence of one of the thalassemias or sicklemia. These anemias are balanced polymorphisms which are apparently maintained by falciparum malaria. Falciparum malaria spread over the anopheline belts of the Old World in coincidence with porotic hyperostosis, but did not penetrate the New World. Here some other parasitism or deficiency anemia must have been the cause of porotic hyperostosis in ancient times. In Anatolia, Greece, and Cyprus from the seventh to second millennia B.C., porotic hyperostosis occurred frequently in early farmers who lived in marshy areas, but rarely in inhabitants of dry or rocky areas or in latest Paleolithic hunters. As shown by skeletal samples from Greece, the frequency of the disease decreased as farming methods improved. However, from Hellenistic to Romantic times it again increased together with increases in the incidence of malaria and in poorer farming. There are correlations between porotic hyperostosis and adult stature and fertility. The mutations producing falciparum malaria therefore must antedate seventh millenium B.C. and I think may have an Eastern Mediterranean origin.

Adult↗

PubMed1960

Viking Fund medalist for 1959 (William W. GREULICH).

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Anthropology↗

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Migration within the island of Korcula, Yugoslavia.

For several centuries the village populations on the Yugoslav island of Korcula have remained essentially isolated from each other and from the mainland. Historical, linguistic and biological data indicate that systematic population pressure predominantly came from the coastal area of the Balkan peninsula westward onto the island. To examine short and long range migration on the island, data on the place of birth of parents of adult inhabitants (1168 subjects) were presented and migration matrices analysed applying a gamma function. Most examinees were born in the same village as their parents (86.39%); only 6.33% of the parents migrated between villages on the island; and village endogamy is quite high for the past four generations (75%). When inter-village migration has occurred, migration density is greatest at a distance of 8-12 km, rather than from the immediate neighbourhood. Short range migration occurs up to a mean distance of 33.98 km, long range migration over distances greater than 28 km.

Emigration and Immigration↗

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The reaction area of the femoral neck.

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Aged↗

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Physical comorbidity and medical care use in children with emotional problems.

As family disruption, violence, and the decline of community become more common, an ever-growing number of children are exposed to psychological and social stressors that can lead to serious emotional problems. For many children emotional problems can interfere with normal psychological and social development and can have serious long-term effects. In this study data from a large national survey are used to examine patterns of emotional and physical comorbidity and the uses of general medical and mental health services by children ages 4 to 11. Results indicate that emotional problems are common among children with physical illnesses and that emotional problems increase general medical care use. Emotional problems are clearly exacerbated by factors associated with poverty. The data also show that a larger proportion of children in single-parent than in two-parent families experience emotional problems and use mental health services. We discuss the implications of these findings for general pediatric practice.

Affective Symptoms↗