Visual reminders of death enhance nociceptive–related cortical responses and event-related alpha desynchronisation

Previous research suggests that prompting individuals to think on their own mortality affects their perception of painful somatic stimuli and related brain activity. Grounded on the assumption that reminders of mortality may recruit threat-defence mechanisms similar to the ones activated by painful nociceptive stimuli, we hypothesize that the effects exerted by linguistic reminders of death on pain perception and brain activity would be elicited by passive observation of death-related pictures vs. more generic threat-related pictures. Results showed an increase of the laser evoked P2 amplitude and oscillatory theta activity when participants observed death-related images. However, no change in pain ratings was found. Moreover, observation of death-related content was linked to increased oscillatory alpha desynchronisation but not to variations of visual evoked potentials amplitude. Our findings indicate that pairing potentially noxious stimuli with death-related images exerts a preferential modulation of nociceptive and visual cortical representations

Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Mortality salience modulates cortical responses to painful somatosensory stimulation: Evidence from slow wave and delta band activity

Social psychology studies show that awareness of one's eventual death profoundly influences human cognition and behaviour by inducing defensive reactions against end-of-life-related anxiety. Much less is known about the impact of reminders of mortality on brain activity. Here we tested whether reminders of mortality can induce a modulation of the slow electroencephalographic activity triggered by somatosensory nociceptive or auditory threatening stimulation and if this modulation is related to mood and anxiety as well as personality traits. We found a specific slow wave (SW) modulation only for nociceptive stimulation and only following mortality salience induction (compared to reminders of an important failed exam). The enhancement of SW negativity at the scalp vertex was associated with increased state anxiety and negative mood, whereas higher self-esteem was associated with reduced SW amplitude. In addition, mortality salience was linked to an increased amplitude of frontal delta band, which was correlated also with increased positive mood and higher self-esteem. The results indicate that SW and delta spectral activity may represent both proximal and distal defences associated with reminders of death and that neurophysiological correlates of somatosensory representation of painful and threatening stimuli may be useful for existential neuroscience studies

Error, rather than its probability, elicits specific electrocortical signatures: A combined EEG-immersive virtual reality study of action observation

Detecting errors in one’s own actions, and in the actions of others, is a crucial ability for adaptable and flexible behavior. Studies show that specific EEG signatures underpin the monitoring of observed erroneous actions (error-related negativity, error positivity, mid-frontal theta oscillations). However, the majority of studies on action observation used sequences of trials where erroneous actions were less frequent than correct actions. Therefore, it was not possible to disentangle whether the activation of the performance monitoring system was due to an error, as a violation of the intended goal, or to a surprise/novelty effect, associated with a rare and unexpected event. Combining EEG and immersive virtual reality (IVR-CAVE system), we recorded the neural signal of 25 young adults who observed, in first-person perspective, simple reach-to-grasp actions performed by an avatar aiming for a glass. Importantly, the proportion of erroneous actions was higher than correct actions. Results showed that the observation of erroneous actions elicits the typical electrocortical signatures of error monitoring, and therefore the violation of the action goal is still perceived as a salient event. The observation of correct actions elicited stronger alpha suppression. This confirmed the role of the alpha-frequency band in the general orienting response to novel and infrequent stimuli. Our data provide novel evidence that an observed goal error (the action slip) triggers the activity of the performance-monitoring system even when erroneous actions, which are, typically, relevant events, occur more often than correct actions and thus are not salient because of their rarity

Management of anaplastic thyroid carcinoma spread over the trachea with mediastinal extension

Introduzione. Descrivere il caso di un carcinoma anaplastico della tiroide con invasione tracheale ed estensione mediastinica. Metodi. Vengono presentati il “case report” e la revisione della letteratura medica sul trattamento del carcinoma anaplastico tiroideo. Risultati. Il ruolo della chirurgia nel trattamento del carcinoma anaplastico rimane controverso. Nel nostro caso sottolineiamo due questioni, ovvero l’importanza della corretta opzione chirurgica nel trattamento del carcinoma con invasione extra-tiroidea e di quello con invasione mediastinica, controllando i grossi vasi sanguigni del collo. Sebbene non sia curativa, la resezione chirurgica può immediatamente ridurre le dimensioni del tumore facilitando l’efficacia della radioterapia post-operatoria e/o della chemioterapia e consentendo quindi un buon controllo locale per evitare la necessità di una successiva tracheotomia palliativa. Quando il tumore coinvolge il mediastino superiore si deve obbligatoriamente procedere alla sternotomia per una più completa possibile resezione della massa tumorale. La ministernotomia mediana superiore rappresenta una preziosa alternativa che permette la riduzione del trauma chirurgico migliorando la qualità di vita dei pazienti. Conclusioni. La resezione completa di tutta la massa tumorale, senza sacrificare le strutture vitali, può portare ad una maggiore sopravvivenza. Sebbene non si possa ottenere una exeresi completa del carcinoma anaplastico tiroideo con invasione mediastinica, la resezione chirurgica può ridurre immediatamente le dimensioni tumorali consentendo un controllo locale della malattia ad evitare la tracheotomia palliativa

Management of anaplastic thyroid carcinoma spread over the trachea with mediastinal extension

Trattamento del carcinoma tiroidea anaplastico con infiltrazione della trachea e invasione mediastinic