Trepanation to Treat a Head Wound: A Case of Neurosurgery from 13th-Century Tuscany.

During the archaeological excavations conducted in the 13th century cemetery of the Church of Sant'Agostino in Poggibonsi (Tuscany, Italy), a skull with evidence of neurosurgical intervention was brought to light. The skull, belonging to an adult male, shows two traumatic lesions produced by bladed instruments. The first lesion, located on the anterior part of the parietal bones, involved only the outer cranial table; bone remodeling indicates that the individual survived the injury for a long time. The second lesion, located on the frontal bone, involved all the thickness of the bone; the absence of reparative processes allows a diagnosis of peri mortem lesion. To treat this wound, the patient underwent surgical intervention. In fact, in correspondence to the lesion, an oval bone loss, with clean and well-defined cutting edges, can be interpreted as the result of a trepanation, probably performed to clean the wound and to remove any bone splinters. Half of the bone "rondella" was found in situ; it can be hypothesized that the surgeon decided to replace the bony piece to protect the brain. However, the surgical intervention failed, and the patient died soon afterwards. Trepanation for the treatment of cranial traumas is described by several medical classical and medieval authors, whose texts were available in the 13th century. This case represents rare Middle Ages evidence of neurosurgery used to treat a bone injury.

Red wine consumption prevents vascular oxidative stress induced by a high-fat meal in healthy volunteers.

In order to investigate the effect of red wine on plasma lipid and oxidative stress parameters after a high-fat meal, fifteen healthy volunteers were studied: three days after a high-fat meal with 250 mL of water, they received the same meal with 250 mL of red wine. During both periods, serial blood samples were drawn before and 2, 4, and 8 hours after the meal to evaluate plasma lipids (cholesterol and triglycerides; retinyl palmitate), oxidative stress (D-ROM, and malondialdehyde) and antioxidant (total plasma antioxidant levels and uric acid) parameters. During the meal without wine, plasma lipid parameters increased significantly, whereas plasma total plasma antioxidant levels decreased, and a trend toward reduction of uric acid levels was seen). A similar trend in lipid parameters was observed after the meal with wine; no significant difference in individual lipid parameter trends after a meal with and without wine was observed. Wine ingestion induced higher total plasma antioxidant levels and uric acid; malondialdehyde levels remained constant after wine ingestion. Plasma D-ROM showed a significant postprandial increase in both experiments, but it was significantly lowered after wine ingestion. Our results give evidence of oxidative stress following a fat-rich meal in healthy subjects, suggesting that ingestion of red wine during a high-fat meal significantly reduces oxidative stress without inducing any significant modification in postprandial lipemia.