Collecting and communicating perishable data in a post-disaster context: rapid research and rapid dissemination.

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.

Pseudotumor inflamatorio hepático, una entidad de difícil diagnóstico / Inflammatory pseudotumor of the liver: a condition hard to diagnose

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.

Embolia pulmonar por hidatidosis / Hydatidic pulmonary embolism

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Hidatidosis pélvica como localización excepcional / Pelvic hydatidosis: an exceptional location

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Pelvic hydatidosis: an exceptional location.

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.

Tratamiento con dalbavancina en paciente con tromboflebitis séptica yugular por Staphylococcus aureus tras la inserción de un desfribilador automático implantable / Treatment with dalbavancin in a patient with septic thrombophlebitis of the internal jugular vein due to Staphylococcus aureus after insertion of an implantable cardioverter defibrillator

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Radiology of pancreatic neoplasms: An update.

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.

Síndrome de Bouveret con TC multidetector / Bouveret’s syndrome: Evaluation with multidetector CT

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Hemangiomas múltiples hepáticos y esplénicos / Multiple liver and spleen haemangiomas

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