RESUMO
INTRODUCTION: In the absence of skeletons or written narrations, information about diseases in past societies may be acquired from icono-diagnosis. From the observation of a masterpiece presenting pathological features, we tried to make retrospective diagnosis. MATERIAL AND METHOD: A pre-Columbian Mexican statuette originating from the Chupicuaro culture and dated 600 BC to 200 AD - conserved in the Louvre Museum in Paris (Section of the quai Branly - Jacques Chirac museum) was examined; it was found to display a huge spinal curvature with excessive dorsal kyphosis and obesity. RESULTS: The appearance of the figurine with large head, shortened stature and limbs, may suggest a form of dwarfism; however, many statuettes in the Chupicuaro culture were found displaying large head and relatively short limbs, suggesting that these pictorial features are more of an artistic style. On the contrary, uncommon kyphosis and obesity led us to diagnose a case of either Pott disease associated with neuro-endocrine complications, or of Cushing's disease. CONCLUSION: Although icono-diagnosis could have allowed us to contribute to the health mapping of ancient Americas and propose the presence of complicated tuberculosis in central Mexico between 600 BC and 200 AD, we believe "Choupi" portrays here an individual having suffered from hypercortisolism (Cushing's disease). Even though considerations related to cultural and artistic context may constitute limitations to interpretation, iconotopsy/iconodiagnosis are important for a better description of the natural history of diseases, as a complement to morphological analyses of human remains (paleopathology) and laboratory exams (DNA or immunology testing).
Assuntos
Síndrome de Cushing , Cifose , Hipersecreção Hipofisária de ACTH , Humanos , Síndrome de Cushing/diagnóstico , Síndrome de Cushing/etiologia , Cifose/complicações , México/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Hipersecreção Hipofisária de ACTH/complicações , Estudos RetrospectivosRESUMO
INTRODUCTION: We define a fluid library as a library of samples of different biological fluids (from humans, animals or vectors) collected and properly stored on filter paper, which allows retrospective studies, especially of diagnosis or detection of infectious agents in these samples, using different techniques. The objective of this work was the retrospective diagnosis of American trypanosomiasis by PCR in a Venezuelan endemic area using a fluid library. METHODS: A fluid library with samples that had been collected on filter paper, 5 years ago, was used for the detection of Trypanosoma cruzi DNA. 165 blood samples of humans, 30 samples of 25 animals (Didelphis marsupialis, Canis familiaris, Equus asinus and Felis catus) and 8 samples of vectors from endemic areas of Anzoátegui state, were analysed by PCR. RESULTS: The results revealed that 16.4% of the humans samples were positive, 11.1% of those detected positive were children younger than 10 years old, and 26.72% young people aged 11-20 years, suggesting that T. cruzi infection has been active for the past two decades. 56% of the animal samples showed amplification; Didelphis marsupialis 66%, Canis familiaris 54.5%, Equus asinus 50%, and Felis catus 33.3%. On the other hand, positivity (50%) was detected in the studied vectors, of which the 3 most important species in Venezuela (Rhodnius prolixus, Triatoma maculata and Panstrongylus geniculatus) were involved. CONCLUSIONS: The PCR using a fluid library allowed the detection of T. cruzi DNA in old samples from the three host of the epidemiological chain, suggesting that retrospective diagnosis can be made through this strategy and demonstrate that there has been active transmission, which helps to clarify the epidemiological situation in areas where there are no previous reports.
Assuntos
Doença de Chagas , Trypanosoma cruzi , Adolescente , Animais , Gatos , Cães , Humanos , Insetos Vetores , Estudos Retrospectivos , Venezuela/epidemiologiaRESUMO
The authors present a case of a probable Pott disease from central/southern Mexico, dated 300 BC to 500 AD. This case highlights the importance of iconotopsy/iconodiagnosis for a better description of the natural history of diseases, especially as a complement to morphological analyses of human remains (paleopathology) and laboratory exams (DNA or immunology testing).