ANALYSIS OF MARKERS OF DISEASE AND HEALTH STATUS ON HUMAN SKELETONS.

One of the main aims of the forensic anthropological practice regards the proper identification of human remains. Years of studies and research provided many instruments for the reconstruction of the so-called “biological profile” (e.g. age at death, sex, stature, race); nevertheless, and despite the numerous information that it can provide, the pathological investigation of skeletons still displays many uncertainties. The identification of pathological signs from bones can in fact narrow the field of research in case of the recovery of unknown human remains, and can provide valuable data for the definition of a possible cause of death. However, the difficulties encountered when analyzing skeletal remains, due to taphonomic and environmental variables, non-specificity of the bone reaction and the monotony of bone tissue manifestation to stimuli, make pathological identification of diseases one of the most difficult fields of forensic anthropology. The aim of this research project is that of trying to narrow and clarify some aspects of skeletal pathology and forensic anthropology, by analyzing skeletons from three cemeteries of Milan, which are part of the Milano Cemetery Skeletal Collection. The main feature of this collection regards the availability, for many of its individuals, of ISTAT death certificates that make the observers aware of the main cause of death and related pathological conditions of such subjects. After collecting this information the attention then focused on the macroscopic investigation of specific pathologies, those that were more widespread in the available sample, to include: cancer metastases, diabetes, Cardiovascular Disease (CVD) and Human Immunodeficiency Virus (HIV) related to drug abuse. The skeletons of this research were selected and cleaned in a proper way; subsequently, the specific pathologic investigation was carried on after an accurate literature search, aimed at finding the most characteristic features that permit the correct identification of the pathology from bones. The analyses performed allowed the demonstration of the difficulties encountered in unequivocally describe and identify such diseases, despite the previous studies conducted, mainly due to the aspecific and often altered structures acquired by the stimulated areas on bones. The modifications caused by taphonomy, together with the subjectivity of the responses and the paucity of available reference data made the investigation quite difficult. However, the available causes of death permitted a baseline to better understand the observations in identifying and describing pathologic-related skeletal lesions, and to set the basis for a more detailed and comprehensive macroscopic pathologic investigation. Such macroscopic investigation, however, has it limits, as it can not go over a certain level of certainty; for this reason, additional investigation methods (such as x-rays, biochemistry, histology and so on) or additional antemortem data are necessary for increasing the amount of information we can gain from the examination of bare skeleton.