ABSTRACT
Context: Puerto Rico experienced four natural disasters in 4 years (2017-2021): Hurricanes Irma and Maria, thousands of earthquakes reaching 6.4 magnitude, and the COVID-19 pandemic. In this context, our team sought to understand the impact of disaster aid distribution on poverty and economic inequality, and their relationship to the spread of COVID-19 across Puerto Rico. Rapid research was required to ensure we could collect perishable data within this ever-changing context. Challenges: Our mixed methods design relied on both secondary and primary data. Because analyses of the former were to inform where and how to collect the latter, timing was of the essence. The data sources identified were not readily available to the public, and thus required gaining access through direct requests to government agencies. The requests coincided with a transition between administrations after an election. This resulted in unexpected delays. Once in the field, the team had to balance the rapid nature of the research with the mindful work to avoid compounding traumas experienced by participants, heightened risk for re-traumatization and fatigue, the risk of COVID-19, the digital divide, and intermittent electrical and telecommunication services. Adaptations: In response to the delayed access to secondary data, we adjusted our research question. We continued to collect data as they became available, incorporating some immediately into analyses, and cleaning and storing others for future research opportunities. To overcome ongoing trauma challenges and prevent fatigue, we recruited and hired a large temporary team, including members of communities where we collected data. By recruiting participants and co-researchers at the same time and place, we both collapsed time between these activities and increased our team's contextual competency. To adapt to challenges presented by the pandemic, we created hybrid data collection procedures where some data were collected online, and some in person, while maintaining COVID-19 protections. We used similar adaptations for dissemination. Lessons: Rapid research needs to be agile. Working within a convergence framework to investigate wicked problems had the unexpected added benefit of providing our team with a variety of disciplinary approaches which proved helpful in adapting to the changing conditions in the field. In addition to the resourcefulness of a transdisciplinary team, it is important to be willing to pivot in response to changes and to collect data where and when you can. To increase participation, opportunities need to be designed with flexibility, mindful of competing demands faced by individuals willing to collaborate. Collecting and analyzing data iteratively and utilizing local resources can enable rapid research that is rigorous and yields rich data. Contributions: Our team applied the lessons learned to structure a rapid and iterative dissemination plan. We combined member-checking with community-level dissemination, enabling us to hone findings further before presenting to policy makers and media. Rapid research creates opportunities to make data-informed program and policy adjustments when they can be most impactful. Both the media and policy makers pay closer attention to research on current events. Hence, our recommendation is to do more rapid research! The more we do, the better we will get at it, and the more accustomed community leaders, policy makers, and program designers will become to using data to inform decisions.
ABSTRACT
RESUMEN El pseudotumor inflamatorio hepático es una lesión muy infrecuente, sin una etiología ni patogenia claras. Su diagnóstico preoperatorio no es habitual pero, en caso de realizarse, puede evitar la cirugía. Presentamos el caso de un paciente joven, con antecedente de lupus cutáneo que, tras debutar con una pancreatitis aguda, presenta episodios de colangitis y cuyos hallazgos radiológicos no permiten descartar la presencia de un colangiocarcinoma, por lo que se realiza hepatectomía izquierda, siendo el diagnóstico histológico final de pseudotumor inflamatorio hepático.
ABSTRACT Inflammatory pseudotumors of the liver are rare and lack clear etiology and pathogenesis. The preoperative diagnosis is seldom made but it avoids unnecessary surgery. We report the case of a young male patient with a history of cutaneous lupus and episodes cholangitis after an acute pancreatitis. As the imaging tests could not rule out cholangiocarcinoma, a left liver resection was performed, and the final histologic diagnosis was inflammatory pseudotumor of the liver.
Subject(s)
Humans , Male , Adult , Granuloma, Plasma Cell/surgery , Liver Diseases , Cholangitis/complications , Cholangiopancreatography, Endoscopic Retrograde , Granuloma, Plasma Cell/pathology , Granuloma, Plasma Cell/diagnostic imaging , HepatectomySubject(s)
Adenoma/diagnostic imaging , Adrenal Gland Neoplasms/diagnostic imaging , Ampulla of Vater/diagnostic imaging , Carcinoma, Signet Ring Cell/diagnostic imaging , Pancreatic Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography , Adenoma/pathology , Adrenal Gland Neoplasms/pathology , Adrenal Glands/diagnostic imaging , Carcinoma, Signet Ring Cell/pathology , Endosonography , Female , Humans , Magnetic Resonance Imaging , Middle AgedABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Pulmonary Embolism/complications , Pulmonary Embolism/diagnostic imaging , Echinococcosis, Pulmonary/etiology , Pulmonary Embolism/therapy , Immunoglobulin E , Anaphylaxis , Edema/complications , Edema/drug therapy , Echinococcosis, Pulmonary/diagnostic imagingABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Adult , Echinococcosis/diagnostic imaging , Echinococcosis, Hepatic/diagnostic imaging , Pelvic Infection/parasitology , Echinococcosis/surgery , Echinococcosis, Hepatic/surgery , Multidetector Computed Tomography/methodsABSTRACT
Hydatid disease is a zoonosis, still endemic in some Spanish geographical areas. Extrahepatic-extrapulmonary lesions account for only 10%, with pelvic lesions being exceptional. We present two patients with pelvic hydatidosis, with or without concomitant liver injury. Treatment depends on the cyst, location and symptoms. Surgery is mandatory if there is any complication.
Subject(s)
Echinococcosis/diagnostic imaging , Pelvic Infection/diagnostic imaging , Adult , Echinococcosis, Hepatic/diagnostic imaging , Female , Humans , Male , Multidetector Computed Tomography , Pelvis/diagnostic imagingSubject(s)
Echinococcosis/diagnosis , Pulmonary Embolism/etiology , Echinococcosis/complications , Humans , Male , Middle AgedABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Thrombophlebitis/drug therapy , Thrombophlebitis/microbiology , Staphylococcus aureus , Staphylococcal Infections/drug therapy , Defibrillators, Implantable , Bacteremia/drug therapy , Jugular Veins/microbiologySubject(s)
Anti-Bacterial Agents/therapeutic use , Defibrillators, Implantable/microbiology , Jugular Veins/microbiology , Prosthesis-Related Infections/drug therapy , Staphylococcal Infections/drug therapy , Teicoplanin/analogs & derivatives , Thrombophlebitis/etiology , Anti-Bacterial Agents/administration & dosage , Bacteremia/drug therapy , Bacteremia/etiology , Bacteremia/microbiology , Defibrillators, Implantable/adverse effects , Humans , Jugular Veins/diagnostic imaging , Male , Middle Aged , Positron Emission Tomography Computed Tomography , Prosthesis-Related Infections/etiology , Prosthesis-Related Infections/microbiology , Pulmonary Embolism/etiology , Staphylococcal Infections/microbiology , Staphylococcus aureus , Teicoplanin/administration & dosage , Teicoplanin/therapeutic use , Thrombophlebitis/diagnostic imaging , Thrombophlebitis/microbiologyABSTRACT
Diagnostic imaging is an important tool to evaluate pancreatic neoplasms. We describe the imaging features of pancreatic malignancies and their benign mimics. Accurate detection and staging are essential for ensuring appropriate selection of patients who will benefit from surgery and for preventing unnecessary surgeries in patients with unresectable disease. Ultrasound, multidetector computed tomography with multiplanar reconstruction and magnetic resonance imaging can help to do a correct diagnosis. Radiologists should be aware of the wide variety of anatomic variants and pathologic conditions that may mimic pancreatic neoplasms. The knowledge of the most important characteristic key findings may facilitate the right diagnosis.
ABSTRACT
No disponible
Subject(s)
Humans , Female , Aged, 80 and over , Intestinal Obstruction/etiology , Ileus/diagnosis , Cholelithiasis/complications , Multidetector Computed Tomography/methods , Gallstones/complicationsABSTRACT
No disponible