ABSTRACT Oral myiasis is a rare parasitic disease that requires immediate treatment once diagnosed. However, no standard treatment protocol can be found in the literature. Through a clinical-surgical report, we present the case of an 82-year-old man with lesions extending through the vestibule and alveolar ridge of the maxilla on both sides, in addition to occupying a large part of the palate, with a considerable number of larvae. The patient was initially treated with a single dose of systemic ivermectin (6 mg orally) and topical application of a tampon soaked in ether. The larvae were then surgically removed and debridement of the wound was performed. A crushed tablet of ivermectin 6 mg was applied topically for 2 days, the remaining larvae were again mechanically removed, and the patient received intravenous antimicrobial therapy. Treatment with systemic and topical ivermectin combined with antibiotic therapy and debridement proved to be effective in treating oral myiasis.

Resumen La enfermedad de Alzheimer es un desorden neurodegenerativo cuya etiología aún se discute, al punto de que existen diferentes hipótesis que pretenden esclarecerla; además, dada su naturaleza multifactorial, existen diferentes factores de riesgo asociados a su desarrollo. Respecto al diagnóstico, los avances en las técnicas de detección de moléculas a escalas femtomolares han permitido discernir entre sujetos sanos y enfermos en estadios relativamente tempranos, aunque todavía hay mucho por hacer. Aducanumab es un anticuerpo monoclonal dirigido contra Aβ, cuya aprobación por parte de la Food and Drug Administration para comercializarse ha sido cuestionada por la comunidad médica internacional, dados los resultados controversiales en los ensayos clínicos. La aprobación de este anticuerpo como tratamiento modificador de la enfermedad de Alzheimer abre la puerta para seguir utilizando este tipo de tratamientos, pero con blancos terapéuticos diferentes, como, por ejemplo, la proteína tau. Finalmente, dada la tendencia de la población hacia la longevidad, padecimientos como la enfermedad de Alzheimer están tomando importancia epidemiológica, por lo que resulta imperativo analizar y vincular lo que se está haciendo en los ámbitos social, familiar, clínico y de investigación y, sobre todo, encontrar esas áreas de oportunidad en beneficio del paciente.

Abstract Alzheimer’s disease is a neurodegenerative disorder whose etiology continues to be discussed, to the point that there are different hypotheses that seek to clarify it, in addition to the fact that, given its multifactorial nature, there are different risk factors associated with its development. As regards diagnosis, advances in molecule detection techniques at femtomolar scales have allowed to distinguish between healthy and diseased subjects at relatively early stages, although there is still much to be done. Aducanumab is a monoclonal antibody targeted against Aβ, whose marketing approval by the Food and Drug Administration has been questioned by the international medical community, given the controversial results in clinical trials. Approval of this antibody as a disease-modifying treatment for Alzheimer’s disease opens the door to continue using this type of treatments, but with different therapeutic targets, such as, for example, tau protein. Finally, given the population tendency towards longevity, conditions such as Alzheimer’s disease are gaining epidemiological importance, which is why it is imperative to analyze and link what is being done in the social, familiar, clinical and research fields and, most importantly, to find those areas of opportunity for the benefit of the patient.

Abstract The loss of continuity of the nerve structure interrupts the transmission of nerve impulses and leads to the disorganization of functional activities. Many methods, as the use of neurogenic factors, aid in the process of neural regeneration by accelerating or improving peripheral nerves neoformation. The adipose tissue is abundant in the human body, and it has presented promising results in the regeneration of peripheral nerves. We carried out a randomized controlled study in 9 months, using 45 male Wistar rats, 80 days old, and the sciatic nerve was chosen for analysis. The control animals were divided into three groups – Initial group (IG), Final group (FG), and denervated group (DG) – with seven animals each. The experimental groups, with twelve animals each, were polyethylene tube filled with fat (EGF) and polyethylene tube without filling (EGwf). All groups, except IG, were submitted to 10 sessions of hyperbaric oxygen treatment of 1h 45 min in alternating days. Functional evaluation by walking-track was assessed using the Catwalk XT® software and tissues were harvested and stained with 1% toluidine blue for histological analysis. Quantitative data were first analyzed with the Kolmogorov Smirnov normality test. Comparison between the four groups was analyzed by ANOVA followed by Tukey Test. We concluded that hyperbaric oxygen therapy had positive results on morphometric and functional parameters. However, no significant differences were found regarding the use of autologous fat graft.

This study proposes the use of a porous polyethylene (PPE) tube as the conductive element in the regeneration in the sciatic nerve sectioning and evaluates the use of fill with autologous fat. The subject was divided randomly into five groups, 3 control and 2 experimental (PPE tube graft with/ without autologous fat). Each group was selected for functional, histological and morphometric evaluation of the sciatic nerve. Functional analysis of the sciatic nerve occurred through the "footprint" values near -100 refer sectioned sciatic nerve, near 0 (zero) refer to control group. On histological analysis of the experimental groups lots of dense connective tissue replacing nerve tissue was observed. In morphometric analysis the group EGPGf got higher performance in all of variables. The use of PPE has shown promise in nerve regeneration with favorable results when associate with fat as a trophic factor in the regeneration.

Este estudio propone el uso de un tubo de polietileno poroso (PPE) como elemento conductor en la regeneración del nervio ciático seccionado y evaluar el uso de relleno con grasa autóloga. Al azar se formaron cinco grupos, 3 y 2 de control experimental (PPE prótesis tubular con / sin grasa autóloga). Cada grupo fue seleccionado para estudiar la forma funcional, histológica y evaluación morfométrica del nervio ciático. Un análisis funcional del nervio ciático se produjo a través de los valores de "huella", cerca de -100 se refiere al nervio ciático seccionado; cerca de 0 (cero) se refiere al grupo control. En el análisis histológico de los grupos experimentales se observó una gran cantidad de tejido conjuntivo denso que sustituye el tejido nervioso. En el análisis morfométrico, el grupo experimental de injerto de polietileno lleno de grasa (EGPGf) obtuvo un mayor rendimiento en todas las variables. El uso de PPE ha mostrado ser prometedor en la regeneración del nervio, con resultados favorables cuando se asocia con la grasa como un factor trófico en la regeneración.

Prostate cancer represents the most frequent non-cutaneous neoplasia in males. This type of neoplasia can develop peculiar patterns of evolution, presenting, in many cases, precocious relapses and metastasis. Bone metastasis in the mouth is extremely rare, and represents 1% of all malignant mouth neoplasias. The aim of the present study is to report a clinical case of bone metastasis in the mandibular region associated with a tumoral prostate adenocarcinoma, as well as to discuss connected aspects about diagnosis, prognosis and integrated treatment of this condition.

O conceito de memes surgiu em 1976 com Richard Dawkins, como um análogo cultural dos genes. Deveria ser possível estudar a cultura através do processo de evolução por seleção natural de memes, ou seja, de comportamentos, ideias e conceitos. O filósofo Daniel Dennett utilizou tal conceito como central em sua teoria da consciência e pela primeira vez divulgou para o grande público a possibilidade de uma ciência dos memes chamada "memética". A pesquisadora Susan Blackmore (1999) foi quem mais se aproximou de uma defesa completa de tal teoria. No entanto, a memética sofreu pesadas críticas e ainda não se constituiu como uma ciência, com métodos e uma base empírica bem definida.

The concept of memes was created by Richard Dawkins in 1976 as a cultural analogue of genes. It suggests the possibility of studying culture through a process of evolution through natural selection of memes, that is, of behaviors, ideas and concepts. The concept became central for the philosopher Daniel Dennett, who employed it in his theory of consciousness and made the possibility of a science of memes, called "memetics", known to the general public. Susan Blackmore (1999) comes closest to giving a complete defense of such a theory. However, memetics has been the target of heavy criticism, and has still not established itself as a science, with specific methods and a well-defined empirical basis.

A eimeriose é responsável por causar graves problemas avícolas caracterizados, principalmente, por redução do ganho de peso e alteração na conversão alimentar, gerando grandes perdas econômicas. O objetivo deste trabalho foi avaliar a epidemiologia da eimeriose em frangos de corte na região de Araguaína, Estado do Tocantins, Brasil. Amostras de cinco propriedades foram colhidas e encaminhadas ao Laboratório de Higiene e Saúde Pública da Escola de Medicina Veterinária e Zootecnia da Universidade Federal do Tocantins. Após análise parasitológica, comprovou-se que todas as propriedades avaliadas apresentaram positividade para espécies do gênero Eimeria, tendo 63,1% dos galpões positivos, sendo encontrados oocistos de E. maxima, E. acervulina, E. mitis e E. tenella. Conclui-se que todas as propriedades avaliadas, apresentaram positividade para quatro espécies do gênero Eimeria comprovando que as estratégias sanitárias adotadas nas criações apresentam falhas que possibilitam a disseminação do patógeno nos lotes avícolas.

Eimeriosis is responsible for causing serious problems in poultry, mainly characterized by reduced weight gain and abnormalities of food conversion efficiency, thereby causing great economic losses. The aim of this study was to evaluate the epidemiology of eimeriosis in broiler chickens in the Araguaina region, State of Tocantins, Brazil. Samples from five farm properties were collected and sent to the Hygiene and Public Health Laboratory, School of Veterinary Medicine and Zootechnics, Federal University of Tocantins. From the parasitological analysis, it was shown that all the properties examined were positive for Eimeria species. 63.1% of the sheds were positive, with findings of oocysts of E. maxima, E. acervulina, E. mitis and E. tenella. It was concluded that all properties evaluated were positive for four species of the genus Eimeria, thus demonstrating that the sanitary strategies followed in poultry rearing had flaws that allowed pathogens to spread in poultry pens.

This study analyzes data on the biology of sperm whales, Physeter macrocephalus Linnaeus, 1758, obtained between 1965 and 1980 by the COPESBRA at the Costinha Whaling Station, Paraíba, Brazil. The data come from the log books of the whaling ships and from the spreadsheets containing biological information filled out by employees of the SUDEPE at the flensing plan of the whaling station. The catches occurred from June to December, in an area delimited by 06º22'-07º52'S and 33º26'-34º58'W. A total of 641 sperm whales were killed in this period. The average sex ratio was 2.05 females to each male. The mean largest frequency of females was recorded in the first and the last months of the season, and that of males in July/August. The mean total length (TL) of males was 11.4 m (minimum 7.2 m, maximum 17.6 m). The females had a mean TL of 10.1 m (minimum 8.6 m, maximum 12.9 m). A decrease was observed in the TL of females along the years. Fetuses were observed in 8.3% of the catches. They had TL between 0.24 and 4.3 m. All sperm whales had food in their stomachs, showing that they feed in the area. As in other places north to the 40ºS, there was a higher frequency of females than males. The difference between the time of maximum catch of males and females may reflect a temporal segregation in the arrival of sperm whales in the area. The reproductive activity of sperm whales in these tropical waters occurs year-round.

JUSTIFICATIVA E OBJETIVOS: O emprego da anestesia regional, em especial dos bloqueios nervosos periféricos (BNP) tem aumentado na prática anestesiológica devido à menor necessidade de instrumentação de vias aéreas, menor custo e excelente analgesia pós-operatória. Entretanto, sua utilização sofre restrições causadas pela falta de treinamento, maior tempo de realização, temor de complicações neurológicas e toxicidade sistêmica. O objetivo desse estudo foi medir as atitudes de anestesiologistas e médicos em especialização nos Centros de Ensino e Treinamento (CET/SBA) em relação aos BNP. MÉTODO: Foi construído um questionário com 25 itens sendo disponibilizado eletronicamente e por correio aos responsáveis de 80 CET, seus instrutores e médicos em especialização. RESULTADOS: Quarenta e dois CET (52,5%) devolveram 188 questionários, sendo 62 (32%) médicos em especialização (ME) e 126 (68%) anestesiologistas. O coeficiente de confiabilidade de Cronbach do questionário foi 0,79. A análise fatorial revelou seis fatores, que explicaram 53% da variância dos escores: fator 1 - atitudes positivas, responsável por 18,34 % da variância; fator 2 - treinamento/aplicação, responsável por 11,73 % da variância; fator 3 - aspectos negativos, responsável por 7,11 % da variância; fator 4 - fatores limitantes, responsável por 6,39 % da variância; fator 5 - anestesia regional como diferencial de competência, responsável por 5,79% da variância; e fator 6 - respeito pelo paciente, responsável por 5,4 % da variância. CONCLUSÕES: O questionário mostrou-se uma ferramenta fidedigna para medida de atitudes com relação à anestesia regional. Os anestesiologistas demonstraram maior interesse nos aspectos relacionados aos pacientes enquanto os ME tiveram como foco principal a aquisição de habilidades técnicas.

BACKGROUND AND OBJECTIVES: The use of regional blocks especially peripheral nerve blocks (PNB) has been increasing in anesthesiology due to the reduced need to manage the airways, lower cost, and excellent postoperative analgesia. However, its use has restrictions due to the lack of training, that it takes longer to be done, fear of neurological complications, and systemic toxicity. The objective of this study was to measure the attitude of anesthesiologists and anesthesiology residents at Teaching and Training Centers (CET/SBA) regarding PNBs. METHODS: A 25-item questionnaire was developed and it was available, via the Internet and by mail, to those responsible for the 80 CETs, their instructors and residents. RESULTS: Forty-two CETs (52.5%) returned 188 questionnaires, 62 (32%) from anesthesiology residents and 126 (68%) from anesthesiologists. The Cronbach's alpha coefficient of the questionnaire was 0.79. Factor analysis revealed six factors that explain 53% of scores variance: factor 1 - positive attitude, responsible for 18.34% of the variance; factor 2 - training/use, responsible for 11.73% of the variance; factor 3 - negative aspects, responsible for 7.11% of the variance; factor 4 - limiting factors, responsible for 6.39% of the variance; and factor 5 - regional block as a competence differential, responsible for 5.79% of the variance; and factor 6 - respect for the patient, responsible for 5.4% of the variance. CONCLUSIONS: The questionnaire proved to be a reliable tool to measure the attitude regarding regional blocks. Anesthesiologists demonstrated greater interest for patient-related aspects, while the main focus of residents was the acquisition of technical abilities.

JUSTIFICATIVA Y OBJETIVOS: El uso de la anestesia regional, en especial de los bloqueos nerviosos periféricos (BNP) ha aumentado en la práctica anestesiológica, debido a una menor necesidad de instrumentación de las vías aéreas, a un menor coste y a una excelente analgesia postoperatoria. Sin embargo, su utilización sufre restricciones causadas por la falta de entrenamiento, un mayor tiempo de realización, el temor de las complicaciones neurológicas y la toxicidad sistémica. El objetivo de este estudio, fue medir las actitudes de anestesiólogos y médicos en especialización en los Centros de Enseñanza y Entrenamiento (CET/SBA) con relación a los BNP. MÉTODO: Se constituyó un cuestionario con 25 ítems, quedando a disposición electrónicamente y por correo, para los responsables de 80 CET, sus instructores y médicos en especialización. RESULTADOS: Cuarenta y dos CET (52,5%) devolvieron 188 cuestionarios, siendo 62 (32%) médicos en especialización (ME) y 126 (68%) anestesiólogos. El coeficiente de confiabilidad de Cronbach del cuestionario fue de 0,79. El análisis factorial reveló seis factores que explicaron un 53% de la variancia de los puntajes: factor 1 - actitudes positivas, responsables de un 18,34 % de la variancia; factor 2 - entrenamiento/aplicación, responsable de un 11,73 % de la variancia; factor 3 - aspectos negativos, responsable de un 7,11 % de la variancia; factor 4 - factores limitantes, responsable de un 6,39 % de la variancia; factor 5 - anestesia regional como diferencial de competencia, responsable de un 5,79 % de la variancia; y factor 6 - respecto del paciente, responsable de un 5,4 % de la variancia. CONCLUSIONES: El cuestionario pareció ser una herramienta fidedigna para mensurar las actitudes con relación a la anestesia regional. Los anestesiólogos demostraron un mayor interés en los aspectos relacionados con los pacientes, mientras los ME tuvieron como foco principal la adquisición de habilidades técnicas.

Objective: To present a case of giant suprarenal carcinoma assisted by the Urology Service of the "Camilo Cienfuegos Gorriarán" General University Hospital of Sancti Spíritus, Cuba. Methods: 32 - year - old male patient who attended the emergency urology consultation, presenting left flank pain and a thirty - pound loss of weight in a three - month period. The radiological studies showed a great tumoral mass with displacement and infiltration of neighbor structures. Pathological study confirmed the diagnosis of suprarenal carcinoma. Results: The treatment applied was surgical excision surgery via thoracico-abdominal approach. The postoperative evolution was satisfactory. Several parameters of bad prognosis such as weight and elevated size, necrosis, pattern of diffuse growth and capsular invasion were present. Death took place 6 months after intervention due to the progression of the illness. Conclusions: The big dimensions of the tumor determined a wide excision surgery which didn't stop the progression of the disease and the death of the patient 6 months after being operated.

Objetivo: Presentar un caso con carcinoma suprarrenal gigante atendido en el Servicio de Urología Hospital General Universitario Camilo Cienfuegos de Sancti Spíritus, Cuba. Método: Paciente de 32 años de edad masculino que acudió a consulta de urgencia de Urología por presentar dolor en flanco izquierdo y pérdida de treinta libras de peso en un periodo de tres meses aproximadamente. Los estudios imagenológicos mostraron una gran masa tumoral con desplazamiento e infiltración de estructuras vecinas. En el estudio histológico se comprobó el diagnóstico de carcinoma suprarrenal. Resultados: El tratamiento aplicado fue la cirugía de exéresis por vía toraco-abdominal. La evolución postoperatoria fue satisfactoria. Se presentaron varios parámetros de mal pronóstico, como peso y tamaño elevados, necrosis, patrón de crecimiento difuso e invasión capsular. El fallecimiento se produjo a los 6 meses de la intervención por progresión de la enfermedad. Conclusiones: Las grandes dimensiones del tumor determinaron una cirugía de exéresis amplia, lo cual no impidió la progresión de la enfermedad y el fallecimiento del paciente a los 6 meses de operado.

O Argumento dos Zumbis proposto por Chalmers, ao contrário de defender o dualismo, bane as qualia para um "mundo" onde elas não podem influenciar o julgamento que fazemos sobre nós mesmos. Por este motivo, pelo próprio argumento, podemos ser um zumbi e não saber. A isso Chalmers chamou de The Paradox of Phenomenal Judgment. O problema é que ele aceita tal paradoxo como parte de sua própria teoria. No entanto, este movimento filosófico não é aceitável e este paradoxo mina a teoria de Chalmers por dentro mostrando que o argumento dos zumbis é, na verdade, um argumento contra o dualismo. Chalmers tenta resolver este problema com uma série de argumentos que tem como base o fato de que a consciência é um bruto explanandum indubitável. No entanto, tal tentativa fracassa por uma série de razões que mostram que mesmo se ele estivesse correto, ainda poderíamos ser um zumbi e não saber.

The Zombie Argument proposed by Chalmers, instead of working as a defense of dualism, banishes qualia to a 'world' where they cannot influence our judgments about ourselves. For this reason, according to the argument itself, we may be all zombies and not know it. This is what Chalmers called The Paradox of Phenomenal Judgment. The problem is that he accepts this paradox as part of his theory. This philosophical move, however, is not acceptable, for the paradox undermines Chalmers' theory, by showing that the zombie argument is, actually, an argument against dualism. Chalmers tries to solve this problem with many arguments based on the status of consciousness as brute indubitable explanandum. However, this attempt is a failure by a series of reasons showing that, even if he were right, we could still be zombies and not know it.

Chalmers e Dennett se encontram em lados opostos da discussão do problema da consciência. Para Chalmers, ela é um dado indubitável que não pode ser explicada em termos de outra coisa. Para Dennett, o que existe verdadeiramente são múltiplos julgamentos sobre nossa consciência. Cada um acusa o outro de circularidade. Isto só é possível porque a diferença entre estas duas teorias é verdadeiramente uma diferença de princípios. A mesma oposição que encontramos no aparato teórico encontramos também em suas pressuposições mais básicas e fundamentais. Este fato torna extremamente difícil escolher entre as duas ao mesmo tempo em que radicaliza a diferença entre elas. De um lado temos que argumentos podem refutar intuições, de outro temos que é preciso primeiro sondar nossas intuições para depois criar argumentos a partir delas. Entre um extremo e outro nos encontramos com o velho dilema de "o que vem primeiro?". No entanto, mais importante do que escolher lados é mostrar o quanto é difícil escolher.

Chalmers and Dennett are at opposite sides of the debate on the problem of conciousness. For Chalmres, conciousness is an unquestionable fact that cannot be explained by something else. For Dennett, what exists is really multiple judgements about our conciousness. Each author accuses the other of circularity. This is only possible because the difference between the two theories is actually a difference of principles. The same opposition that we find in their theoretical apparatus we also find on their more fundamental and basic premises. This feature .makes it very difficult to choose one of the two theories, while it also radicalizes the difference bewteen them. On one side we have arguments that can refute intuitions, on the other we find that that one must first scrutinize our intuitions to then create arguments based on them. Between the two extreems we meet with the old dilemma of "what came first?". However, more important than to choose sides is to show how difficult the choice is.