The bewitchment of our intelligence: Scepticism about other minds in anthropology.

This article aims at characterizing how the problem of scepticism about other minds appears in anthropology. To do so, I offer a close reading of Nils Bubandt's book, The Empty Seashell (2014), a study of witchcraft and doubt on the North Maluku Island of Halmahera. Through its deep engagement with issues revolving around scepticism, I take the book to be an example of the tendency to consider the problem of sceptical doubt about others as a problem of access to the inner thoughts and feelings of other people. By looking closely at its attempts to respond to this problem, I endeavour to shed light on the ways in which, in working the problem of scepticism out, we may be doing exactly the reverse: giving into the sceptical impulse. How does a certain way of asking questions about scepticism nourish the drive to it? I am interested in the drift towards scepticism that precisely takes the form of a claim against it. In showing that such a drift is prompted by a certain use of language, I hope to elucidate some ways in which scepticism is lived and is thus not merely an intellectual conundrum, but an ordinary human condition.

Hemophagocytic syndrome secondary to SARS-Cov-2 infection: a case report.

BACKGROUND: Hemophagocytic syndrome (HPS) is a severe hyperinflammatory disease, whose diagnosis is based on the HLH-2004 criteria. In secondary forms of HLH (sHLH), the primary goal is treating the triggering factors such as COVID-19 (Coronavirus disease 2019). The link between the cytokine storm related to COVID-19 and development of sHLH has already been reported since the onset of pandemic, but little is known about clinical manifestations of HLH which develop after the patient's recovery from mild symptomatic or asymptomatic Sars-CoV-2 infection. CASE PRESENTATION: We describe the case of a woman diagnosed with sHLH related to previous Sars-CoV-2 infection and successfully treated with steroids, colchicine, etoposide and ruxolitinib. CONCLUSIONS: Our report suggests that HLH-like syndrome might be secondary to Sars-CoV-2 infection, even if the patient utterly recovered from the mildly symptomatic viral infection. In addition, we underline the treatment with low dose ruxolitinib plus etoposide as a potential choice for Sars-CoV-2 infection related HLH.

On Cancer, COVID-19, and CT Scans: A Monocentric Retrospective Study.

Background The use of computed tomography (CT) for coronavirus disease 2019 (COVID-19) diagnosis in an area of northern Italy with a high incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may have identified more patients with this disease than RT-PCR in the very early onset of the COVID-19 pandemic. Methods We retrospectively reviewed 148 chest CT scans of oncological patients who were referred to the Radiological Unit of Policlinico S. Marco from 1 February 2020 to 30 April 2020, during the COVID-19 outbreak in Bergamo area. In parallel, we analyzed RT-PCR tests of these 148 patients. Results Among 32 patients with a diagnosis of COVID-19, 17 patients were asymptomatic or had mild symptoms (53.1%), while 15 developed severe disease (46.8%). The incidence of SARS-CoV-2 infection was 22.9%, the mortality rate was 18.8%. We did not find any correlation between disease severity and age, sex, smoking, or cardiovascular comorbidities. Remarkably, patients who were on treatment for cancer developed a milder disease than patients who were not on treatment. Conclusions The acceptance of CT-defined diagnoses in COVID-19 high-incidence areas like Bergamo region highlighted a larger oncological population affected by COVID-19 than RT-PCR, in particular, asymptomatic and mildly symptomatic patients, because only symptomatic patients underwent nasopharyngeal swabbing at the onset of the COVID-19 pandemic. We observed that patients actively treated for their cancer had a milder disease, in agreement with previous studies that suggested a protective role of immunosuppression. Admittedly, the sample of patients in our study was heterogeneous regarding the oncological disease, their prognosis, and the type of treatment; therefore, other studies are needed to confirm our data.

A case report on potential postmortem redistribution of furanyl fentanyl and 4-ANPP.

Fatal intoxications due to accidental or voluntary intake of synthetic opioids represent an actual emerging issue. We report a case where we have analyzed furanyl fentanyl and its metabolite 4-anilino-N-phenetyl-piperidine (4-ANPP) in blood, urine, gastric content, bile and cerebrospinal fluid. In this case, a 53-year-old man was found dead at home with a needle still inserted in a vein; a plastic bag containing a white powder (later identified as a furanyl fentanyl-based product) was discovered in the room. Biological samples were collected during autopsy and extracted/purified onto a SPE cartridge before instrumental analysis. Qualitative and quantitative analyses were performed by LC-MS/MS on peripheral and cardiac blood, urine, cerebrospinal fluid (CSF), bile and gastric content. Furanyl fentanyl was identified and quantified in all the biological fluids collected. Interestingly, gastric content revealed an unexpected high amount of furanyl fentanyl; yet, cardiac blood and femoral blood provided significantly different concentrations (11.8 and 2.7 ng/g respectively). The concentration of furanyl fentanyl in CSF was similar to that measured in femoral blood (2.6 ng/mL), thus confirming that CSF could be a good alternative biological fluid whenever a postmortem redistribution is suspected. Concentrations of 93.5, 50.4, 171.7, 41.9, 10.2 ng/mL(g) were measured for 4-ANPP in cardiac blood, femoral blood, urine, bile and cerebrospinal fluid, respectively. The outcomes from the presented case report suggest that the two substances have been not only injected intravenously, but probably also ingested by the man. Fentanyl derivative and its precursor seemed to undergo an extensive postmortem redistribution.

Unusual case of traumatic carotid artery dissection occurred during a work-related activity. A case report.

Carotid artery dissection secondary to cervical blunt trauma is a rare and potentially life-threatening condition that can cause a variety of clinical presentations, including stroke, headache, neck pain, tinnitus, Horner syndrome and cranial neuropathies and is associated with long-term sequelae. We report a case of a 49-year-old industrial vehicles mechanic who was projected to the ground by the explosion of the tire of a heavy truck he was inflating. In the following hours he presented various neurological signs and symptoms and was admitted to the Emergency Department. During hospitalization the patient underwent clinical and instrumental investigations with AngioCT and MR finding of left internal carotid artery dissection in correspondence of its cervical segment and three acute ischemic lesions in the left temporal, parietal and occipital lobes. Medical management was successful and the patient was discharged from the hospital three weeks after the admission but he wasn't able to get back to work due to neurological sequelae. This case report illustrates that traumatic carotid artery dissection, although rare, should be considered in patients who present neurological symptoms after an explosion, can meet the criteria for a work-related injury and may lead to a permanent decrease in the ability to work.

Canine gastrointestinal pythiosis treatment by combined antifungal and immunotherapy and review of published studies.

Pythium insidiosum is an oomycete, a fungal like microorganism, which infects mammals, causing pythiosis in animals and humans, especially in tropical and subtropical regions around the world. The treatment for this infection is very difficult, and therapeutic options commonly comprise surgery, immunotherapy and antimicrobial drugs. The present report describes the clinical healing of a dog with gastrointestinal pythiosis by treatment with a combination of antifungals and immunotherapy, as well as reviews the cases reported in the literature that used some type of therapy for canine pythiosis. A 2.5-year-old male beagle initially showed sporadic vomiting episodes, and this symptom became more frequent 5 months after the onset of clinical signs. Celiotomy procedure found thickness of the stomach wall extending to the pylorus and duodenum. A biopsy was performed, and the diagnosis of pythiosis was made by mycological, histopathological analyses and molecular identification. Therapy was based on an association of terbinafine plus itraconazole during 12 months and immunotherapy for 2.5 months. The healing of the dog reported here allows us to propose the use of immunotherapy associated with antifungal therapy to treat canine gastrointestinal pythiosis. However, additional studies should be performed on a larger number of patients to establish a standard treatment protocol for canine pythiosis.

Cutaneous and gastrointestinal pythiosis in a dog in Brazil.

The oomycete Pythium insidiosum is the pathogenic cause of pythiosis, a life-threatening disease that affects several animal species. Canines are the second most affected species, and the disease is characterized by the development of cutaneous and gastrointestinal lesions. While concomitant cutaneous and gastrointestinal lesions are rarely found in the same animal, this report documents a case of concurrent cutaneous and gastrointestinal pythiosis in an 18-month-old female Labrador. This dog had an ulcerative cutaneous lesion on the right thoracic region for 12 months that was unresponsive to itraconazole and terbinafine therapy. Two months prior to death and concurrent with the cutaneous lesion, the dog became anorexic with frequent vomiting and bloody stools. At necropsy, a cutaneous lesion that extended subcutaneously into the intercostal muscles was observed. Additionally, the large intestine contained two lesions that caused luminal narrowing. Organs were collected, routinely processed and stained using hematoxylin and eosin and Gomori methenamine silver. Histological examination of the lesions in the large intestine and on the skin revealed areas of necrosis surrounded by a pyogranulomatous infiltrate. Occasionally, black, septate, branching hyphae were detected following staining with Gomori methenamine silver. The diagnosis of pythiosis was confirmed using immunohistochemical methods. This report describes the occurrence of concomitant gastrointestinal and cutaneous lesions in a dog and highlights the therapeutic difficulties encountered with this disease.

Estudo multicêntrico, aberto, fase III, para avaliação da eficácia e segurança da combinação em uma mesma forma galênica de anlodipino 5 mg e losartana 50 mg durante 14 semanas em pacientes portadores de hipertensão arterial estágio 1 / Phase III, open, multicentric study to evaluate efficacy and safety of a fixed combination in one tablet of amlodipine 5 mg and losartan 50 mg during 14 weeks in arterial hypertension stage 1 patients

O objetivo do estudo foi avaliar a eficácia anti-hipertensiva e o perfil de tolerabilidade em um período médio de 12 semanas, após duas semanas de washout, da combinação fixa de anlodipino e losartana em uma mesma forma galênica, em 116 pacientes hipertensos estágio 1. As visitas clínicas foram realizadas a cada quatro semanas com avaliação da pressão arterial na posição supina e ortostática, a freqüência cardíaca, o volume das pernas e a presença de eventos adversos. A eficácia anti-hipertensiva da combinação em estudo já estava significativamente presente nas primeiras quatro semanas de tratamento e se manteve por todo o período não se observando escapes do controle pressórico. Um total de 47,16% dos pacientes atingiu a meta de controle da pressão, na menor dose diária (anlodipino 5 mg/ losartana 50 mg) da combinação fixa. Com o uso de dois comprimidos ao dia, a taxa de controle aumentou para 83,3%. Observamos um aumento no volume das pernas ao final da 12ª semana de tratamento, que foi mais expressivo no grupo que usou a maior dose da combinação anlodipino 10 mg/ losartana 100 mg dia. Houve baixa incidência de eventos adversos, sendo a cefaléia e tontura os mais relatados. Pode-se concluir que a combinação fixa de anlodipino e losartana em uma mesma forma galênica apresenta alta taxa de eficácia, determina um pequeno número de eventos adversos e se constitui em excelente opção terapêutica anti-hipertensiva, permitindo a redução da pressão arterial diastólica e sistólica atualmente preconizada pelas diretrizes de tratamento da hipertensão arterial.