Face pareidolia in Parkinson's disease patients

openLe pareidolie sono illusioni visive, fenomenologicamente simili alle allucinazioni visive, si basano sulla tendenza del cervello umano ad attribuire un significato a immagini e pattern ambigui e complessi e si formano dall’interazione dell’esperienza sensoriale con le conoscenze pregresse e l’immaginazione dell’individuo che le sperimenta. Un esempio di pareidolia è quello di riconoscere un animale o un volto umano nelle forme indefinite che assumono le nuvole. Esistono vari tipi di pareidolia, ma la tipologia più diffusa è quella delle illusioni pareidoliche facciali, ovvero della percezione illusoria di volti umani, in pattern ambigui. Sebbene queste illusioni siano frequentemente esperite da soggetti sani, consapevoli della natura illusoria di tali percetti, possono anche essere provocate da sostanze psicotomimetiche o rientrare tra i sintomi di malattie neurodegenerative, come nel caso della demenza a corpi di Lewy o in quello del morbo di Parkinson. Questo elaborato si propone di affrontare il tema della pareidolia facciale calata nei pazienti affetti dal morbo di Parkinson, analizzando le cause dell’insorgenza di questo sintomo non motorio, i fattori predittivi che ne caratterizzano la produzione e gli effetti sul paziente a livello percettivo e neuropsicologico. Inizialmente verrà delineato il fenomeno delle pareidolie facciali, definendolo e analizzandolo a livello percettivo, verrà poi relazionato alla percezione dei volti reali, in quanto a meccanismi di espressione facciale, che sembrano essere i medesimi di questi ultimi e al vantaggio condiviso dai volti reali e pareidolici nella ricerca visiva, in termini di velocità di detezione, rispetto a oggetti non assimilabili a volti. Ci si concentrerà in seguito, sui rispettivi correlati neurali. Successivamente verrà affrontata la malattia di Parkinson nella sua forma idiopatica, delineando prima le caratteristiche principali della patologia, per poi concentrarsi sui sintomi non motori e in particolare sul verificarsi di illusioni e allucinazioni visive, che includono le pareidolie facciali e che riguardano più della metà dei pazienti, nello stadio avanzato del disturbo. Prima di entrare nel vivo degli effetti delle illusioni pareidoliche nei pazienti affetti da Parkinson e dei relativi substrati neurali, verranno affrontati brevemente la psicosi da Parkinson e l’impiego del Levo-Dopa e degli agonisti della dopamina nella cura farmacologica del Parkinson idiopatico, al fine di comprendere meglio la relazione tra questa patologia e il manifestarsi di sintomi psicotici e allucinatori, dovuti all’incremento del livello di dopamina, prodotto della somministrazione dei farmaci prima citati, che possono risultare in una maggiore frequenza di produzione di illusioni pareidoliche facciali in questi pazienti. Si porrà di conseguenza l’attenzione sulle differenze degli effetti delle illusioni pareidoliche facciali nei pazienti con tale patologia rispetto ai campioni normativi, analizzandone i fattori predittivi e i correlati cognitivi e neurali, in termini di cambiamenti nella regolazione dei processi top-down di elaborazione dello stimolo, di deficit attentivi e di movimenti oculari e potenziali presaccadici

THE NEED OF INTERDISCIPLINARITY APPROACH ON LANDSLIDES RESEARCH IN ROMANIA

According to the World Atlas of Natural Hazards (McGuire et al., 2004), the landslides are the most frequent and worldwide developed natural hazard. It can occur on any type of terrain where exist the proper conditions concerning the soil or bedrock, groundwater and slope. The landslides usually occur accompanying the other natural hazards like heavy rainfall, floods and earthquakes. In time, all subgroups of natural hazards (cosmic, geological, hydro-meteorological and biological) have been recorded in Romania. Types of natural hazard are very numerous (over 67). But five from the most important hazards, regarding the number of dead or affected persons, or economic damages, are the earthquakes, floods, droughts, excessive temperatures and landslides (Marinescu et al., 2010).Actually, the landslides affect strong many country’s regions. The high frequency of landslides on land have great importance in the evolution and shaping of the landscape. Large areas of agricultural land suffered from landslides which also damaged various buildings both in villages and cities, and destroyed roads, railways, etc. Damage in industrial areas is also important. Landslide terrains could seal some running rivers causing partial or total blocking of leakage. The landslide research involves considerable human and financial efforts. Being on very complex process, its survey implies the using of many scientific disciplines. The need for interdisciplinary approach within the landslides, who to conduct at better knowledge and, finally at more adequate stabilization solutions, is the main objective of this paper

THE NEED OF INTERDISCIPLINARITY APPROACH ON LANDSLIDES RESEARCH IN ROMANIA

According to the World Atlas of Natural Hazards (McGuire et al., 2004), the landslides are the most frequent and worldwide developed natural hazard. It can occur on any type of terrain where exist the proper conditions concerning the soil or bedrock, groundwater and slope. The landslides usually occur accompanying the other natural hazards like heavy rainfall, floods and earthquakes. In time, all subgroups of natural hazards (cosmic, geological, hydro-meteorological and biological) have been recorded in Romania. Types of natural hazard are very numerous (over 67). But five from the most important hazards, regarding the number of dead or affected persons, or economic damages, are the earthquakes, floods, droughts, excessive temperatures and landslides (Marinescu et al., 2010).Actually, the landslides affect strong many country’s regions. The high frequency of landslides on land have great importance in the evolution and shaping of the landscape. Large areas of agricultural land suffered from landslides which also damaged various buildings both in villages and cities, and destroyed roads, railways, etc. Damage in industrial areas is also important. Landslide terrains could seal some running rivers causing partial or total blocking of leakage. The landslide research involves considerable human and financial efforts. Being on very complex process, its survey implies the using of many scientific disciplines. The need for interdisciplinary approach within the landslides, who to conduct at better knowledge and, finally at more adequate stabilization solutions, is the main objective of this paper

Diabetes and Cancer: Is there a Link?

Cancer and diabetes are two major health problems worldwide, and incidence is increasing globally for both diseases. Type 2 diabetes is characterized by hyperinsulinemia and insulin resistance and the effect of insulin and insulin growth factor I on cancer development and progression have been demonstrated in animal and human studies. The relationship between diabetes and cancer was reported for more than 60 years. Many epidemiological studies conducted over time suggested the association between diabetes and cancer. Epidemiological studies show an increased risk in type 2 diabetic patients for colon, breast, liver, pancreas, bladder cancers and non-Hodgkin’s lymphoma, and a decrease risk for prostate cancer. Lung cancer does not appear to be related to diabetes and for renal cancer data are inconclusive. Diabetes, beside the fact that it is an independent risk factor for different type of cancer, can also have an impact on prognosis of cancer, and studies shown an increased cancer mortality in patients with diabetes

Metabolic Risk Factors in Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the most frequent primary malignancy of the liver and it is one of the leading causes of cancer-related deaths worldwide. The global burden of hepatocellular carcinoma is growing nowadays. Most cases of hepatocellular carcinoma develop in the background of chronic hepatitis C and B and liver cirrhosis‑well-known risk factor. But despite the reducing incidence of chronic hepatitis infections, an increase in the incidence of hepatocellular carcinoma was observed in the last decades. This could be explained by the increasing prevalence of obesity, type 2 diabetes mellitus, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), which are becoming important risk factors in hepatocellular carcinoma. Regular surveillance, as performed for patients with viral hepatitis, is required for patients with metabolic risk factors

Metformin and Its Implication in Cancer Therapy

Metformin has been used for almost half a century as the first line of treatment for type 2 diabetes. Mechanisms of action are still incompletely known, recent studies have shown that metformin exerts its effects through several mechanisms, including the stimulation of AMP-activated protein kinase, decreasing production of cyclic AMP, inhibition of mitochondrial complex I of the electron transport chain, targeting glycerophosphate dehydrogenase and altering gut microbiota. In recent years, studies have shown that patients with type 2 diabetes mellitus have a lower risk of developing cancer, and patients with cancer and type 2 diabetes have a lower mortality. Experimental studies have demonstrated that metformin has anti-tumor activity by inhibiting mTORC1 signaling pathway and mitochondrial complex, inhibiting tumor growth and proliferation, and inducing cellular apoptosis. There are multiple studies showing that combination of metformin with different types of anti-cancer therapies may reduce toxicities and tumor resistance. This chapter is focused on the progress made in understanding the anti-tumor effect of metformin and its association with cancer therapy

Management of Ascites Associated with Severe Hyponatremia

Advanced liver cirrhosis requiring hospitalization is frequently associated with electrolytic disturbances, the most common finding being serum hyponatremia. The goal of treatment in patients with decompensated liver cirrhosis complicated with severe hyponatremia is to normalize the increased amount of water in the body and to improve the sodium concentration. Fluid restriction is recommended at 1.5 L/day to prevent sodium depletion in the serum, but the lack of efficacy is probably due to a poor patient compliance. Discontinuation or adjustments of diuretic dosages are sometimes required. Albumin associated with vasoconstrictors as midodrine can increase the effective arterial blood volume and seems to improve the serum sodium concentration. A promising therapeutic option targeting the pathophysiological mechanism of hyponatremia consists of improving solute-free water excretion, which is markedly impaired in these patients. The use of agents such as k opioid agonists has been attempted, but has been dropped due to the severe side effects. Recently, a new therapeutic class called vaptans has taken an important place in the treatment of hypervolemic hyponatremia. The main side effects during the administration of these drugs in patients with liver cirrhosis are reversible after discontinuing therapy. Therefore, it is recommended to use vaptans for short periods of time

Management of biliary lithiasis in pregnancy – an updated overview

It is estimated that 2% of pregnant women develop gallstones during pregnancy. Symptoms of biliary lithiasis may vary during pregnancy, from a slight added digestive discomfort to biliary colic of varying intensity, acute cholecystitis, or acute pancreatitis. Ultrasonography is the gold standard for diagnosis of sludge and gallstones, being both highly sensitive and specific. Initial management overlaps with the out-of-pregnancy management, initiating conservative, supportive care, as well as an adequate diet. Laparoscopic cholecystectomy is considered a safe intervention in pregnancy, being the second most common surgery after appendicectomy. If open laparoscopy is preferred, the major risk - perforation of the uterus - is avoided. Important complications of gallstones in pregnancy, jaundice and acute pancreatitis can be resolved safely and quickly by cholangiopancreatography (ERCP) techniques, with stone removal, sphincterotomy or stent mounting. After remission of pancreatic symptoms, laparoscopic cholecystectomy can be performed. Recent scientific data and current practice suggest an increase of biliopancreatic emergencies during pregnancy (probably due to rising incidence of obesity, age of gravida, prolonged use of oral combined contraceptives, dyslipidemia, etc.). Surgeons, as well as obstetricians, should be aware of the prompt modern management of these cases

A MSFD complementary approach for the assessment of pressures, knowledge and data gaps in Southern European Seas : the PERSEUS experience

PERSEUS project aims to identify the most relevant pressures exerted on the ecosystems of the Southern European Seas (SES), highlighting knowledge and data gaps that endanger the achievement of SES Good Environmental Status (GES) as mandated by the Marine Strategy Framework Directive (MSFD). A complementary approach has been adopted, by a meta-analysis of existing literature on pressure/impact/knowledge gaps summarized in tables related to the MSFD descriptors, discriminating open waters from coastal areas. A comparative assessment of the Initial Assessments (IAs) for five SES countries has been also independently performed. The comparison between meta-analysis results and IAs shows similarities for coastal areas only. Major knowledge gaps have been detected for the biodiversity, marine food web, marine litter and underwater noise descriptors. The meta-analysis also allowed the identification of additional research themes targeting research topics that are requested to the achievement of GES. 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license.peer-reviewe