El estudio de la cognición: hacia una perspectiva corporizada / O estudo da cognição: em direção a uma perspectiva incorporada / The study of cognition: towards an embodied perspective / L'étude de la cognition: vers une perspective incarnée

Resumen El campo de la cognición ha tenido una larga historia en la que los modelos formales, el cuerpo y la interacción con el mundo físico y social han tenido significados y papeles variados. En los últimos años, las propuestas han intentado reintroducir el cuerpo y la variabilidad cognitiva resultante de la sensibilidad a contextos ricos e impredecibles. Este artículo presenta el enactivismo autopoiético, una de las versiones esenciales de las teorías encarnadas dentro de las ciencias cognitivas, señalando algunas limitaciones de las teorías clásicas de procesamiento de la información y sus nociones de representación. En este distanciamiento, las ciencias cognitivas han recuperado el cuerpo, la sensibilidad y flexibilidad de los procesos cognitivos, la naturaleza dinámica de la experiencia y el valor de los sistemas culturales que sustentan la actividad cognitiva.

Resumo O campo da cognição tem uma longa história na qual modelos formais, o corpo, e a interação com o mundo físico e social tiveram significados e papéis variados. Nos últimos anos, as propostas tentaram reintroduzir o corpo e a variabilidade cognitiva resultante da sensibilidade a contextos ricos e imprevisíveis. Este artigo apresenta o enativismo autopoiético, uma das versões essenciais das teorias corporizadas dentro das ciências cognitivas, apontando algumas limitações das teorias clássicas de processamento de informação e as suas noções de representação. Nesse distanciamento, as ciências cognitivas recuperaram o corpo, a sensibilidade e flexibilidade dos processos cognitivos, a natureza dinâmica da experiência e o valor dos sistemas culturais que sustentam a atividade cognitiva.

Abstract The field of cognition has had a long history where formal models, the body, and interaction with the physical and social world have had varied meanings and roles. In recent years, proposals have tried to reintroduce the body and the cognitive variability resulting from sensitivity to rich and unpredictable contexts. This article presents the autopoietic enactivism, one of the essential versions of embodied theories within the cognitive sciences, pointing out some limitations of classical information processing theories and their notions of representation. In this distancing, cognitive sciences have recovered the body, the sensitivity and flexibility of cognitive processes, the dynamic nature of experience, and the value of the cultural systems that support cognitive activity.

Résumé Le domaine de la cognition a connu une longue histoire dans laquelle les modèles formels, le corps et l'interaction avec le monde physique et social ont eu des significations et des rôles variés. Ces dernières années, des propositions ont tenté de réintroduire le corps et la variabilité cognitive résultant de la sensibilité à des contextes riches et imprévisibles. Cet article présente l'enactivisme autopoïétique, l'une des versions essentielles des théories incarnées au sein des sciences cognitives, en soulignant certaines limites des théories classiques du traitement de l'information et de leurs notions de représentation. Avec cet écartement, les sciences cognitives ont récupéré le corps, la sensibilité et la flexibilité des processus cognitifs, la nature dynamique de l'expérience et la valeur des systèmes culturels qui soutiennent l'activité cognitive.

Lung Injury in COVID-19 Has Pulmonary Edema as an Important Component and Treatment with Furosemide and Negative Fluid Balance (NEGBAL) Decreases Mortality.

The SARS-CoV2 promotes dysregulation of Renin-Angiotensin-Aldosterone. The result is excessive retention of water, producing a state of noxious hypervolemia. Consequently, in COVID-19 injury lung is pulmonary edema. Our report is a case-control study, retrospective. We included 116 patients with moderate-severe COVID-19 lung injury. A total of 58 patients received standard care (Control group). A total of 58 patients received a standard treatment with a more negative fluid balance (NEGBAL group), consisting of hydric restriction and diuretics. Analyzing the mortality of the population studied, it was observed that the NEGBAL group had lower mortality than the Control group, p = 0.001. Compared with Controls, the NEGBAL group had significantly fewer days of hospital stay (p < 0.001), fewer days of ICU stay (p < 0.001), and fewer days of IMV (p < 0.001). The regressive analysis between PaO2/FiO2BAL and NEGBAL demonstrated correlation (p = 0.04). Compared with Controls, the NEGBAL group showed significant progressive improvement in PaO2/FiO2 (p < 0.001), CT score (p < 0.001). The multivariate model, the vaccination variables, and linear trends resulted in p = 0.671 and quadratic trends p = 0.723, whilst the accumulated fluid balance is p < 0.001. Although the study has limitations, the promising results encourage more research on this different therapeutic approach, since in our research it decreases mortality.

Pulmonary Edema in COVID-19 Treated with Furosemide and Negative Fluid Balance (NEGBAL): A Different and Promising Approach.

In COVID-19, pulmonary edema has been attributed to "cytokine storm". However, it is known that SARS-CoV2 promotes angiotensin-converting enzyme 2 deficit, increases angiotensin II, and this triggers volume overload. Our report is based on COVID-19 patients with tomographic evidence of pulmonary edema and volume overload to whom established a standard treatment with diuretic (furosemide) guided by objectives: Negative Fluid Balance (NEGBAL approach). Retrospective observational study. We reviewed data from medical records: demographic, clinical, laboratory, blood gas, and chest tomography (CT) before and while undergoing NEGBAL, from 20 critically ill patients. Once the NEGBAL strategy was started, no patient required mechanical ventilation. All cases reverted to respiratory failure with NEGBAL, but subsequently two patients died from sepsis and acute myocardial infarction (AMI). The regressive analysis between PaO2/FiO2BAL and NEGBAL demonstrated correlation (p < 0.032). The results comparing the Pao2Fio2 between admission to NEGBAL to NEGBAL day 4, were statistically significant (p < 0.001). We noted between admission to NEGBAL and day 4 improvement in CT score (p < 0.001), decrease in the superior vena cava diameter (p < 0.001) and the decrease of cardiac axis (p < 0.001). Though our study has several limitations, we believe the promising results encourage further investigation of this different pathophysiological approach.

Quiste de duplicación gástrica: diagnóstico mediante ecografía, TC y RM / Gastric duplication cyst: US, CT and MRI features

Los quistes de duplicación gástrica son una patología poco frecuente que suele diagnosticarse en forma incidental en un estudio de diagnóstico por imágenes. Suelen encontrarse durante la infancia, pero pueden ser hallados en adultos. Los estudios de diagnóstico por imágenes colaboran en el hallazgo y presunción diagnóstica de los mismos, siendo el diagnóstico definitivo el análisis anatomopatológico de la pieza. Presentamos el caso de una adolescente de 15 años con dolor abdominal persistente (dominante en epigastrio), en la que se observó en una ecografía, una imagen quística ubicada por detrás del estómago y en íntimo contacto con el páncreas, el riñón izquierdo y la gándula suprarrenal izquierda. La TC y RM contribuyeron a una mejor delimitación anatómica. Se procedió a escisión laparoscópica sin complicaciones. La anatomía patológica reveló un quiste de duplicación gástrica, sin ulceración (AU)

Parametriectomía radical posthisterectomía por carcinoma inadvertido de cuello uterino / Radical Parametriectomy for Occult Cervical Carcinoma Detected Posthysterectomy

En algunas oportunidades, el estudio del útero extirpado por patología benigna, revela sorpresivamente la presencia de un cáncer cervical invasor. No existen estudios randomizados que comparen las dos modalidades terapéuticas para esta situación (cirugía o radioterápia), y las tasas de sobrevida en ausencia de tumor residual aparenta ser similar con cualquiera de las dos opciones. Presentamos nuestra experiencia con la reoperación radical para el tratamiento del carcinoma oculto del cuello uterino