Nasal Lymphoma Presenting With Contralateral Proptosis and Vision Changes: A Case Report and Literature Review.

Non-Hodgkin lymphoma (NHL) is a hematological malignancy that can sometimes originate from the nasal cavities and paranasal sinuses. Patients who present with these tumors typically report sinonasal symptoms. However, a diagnostic challenge can arise when a patient's primary complaints include unique complex symptoms limited to the contralateral side of the tumor. This report describes the case of an 83-year-old man who presented to our center with a left-sided mass and right-sided proptosis with vision loss. After a nasal biopsy was taken, the patient was referred to the ophthalmology department to diagnose the cause of his ocular symptoms, which were not believed to be related to the mass. When biopsy results later returned as diffuse large B-cell lymphoma (DLBCL), an emergent repeat biopsy following lymphoma protocol was performed to confirm the diagnosis. A CT scan of the head and orbits showed generalized enlargement of the right optic nerve and extraocular muscles, and a positron emission tomography (PET) scan showed increased 18F-fluorodeoxyglucose (FDG) uptake in the right ethmoid sinus and orbit. The left-sided mass and right-sided symptoms resolved simultaneously with chemotherapy. This is the first documented case of a sinonasal mass causing ocular symptoms exclusively on the contralateral side. The presented diagnostic challenge highlights the importance of thorough investigations.

SimLEARN Musculoskeletal Training for VHA Primary Care Providers and Health Professions Educators.

A simulation-based training curricula applied to the primary care evaluation and management of shoulder and knee pain resulted in improved access to care for veterans and cost savings for the health care system.

Improving Self-Esteem and Building Self-Confidence in Adolescent Mothers: Implementation of Self-Efficacy-Focused Activity Sessions.

Adolescent mothers have been shown to have lower self-esteem than nonparenting adolescents. The purpose of the current clinical project was to explore the feasibility of adopting a school-based support group model to provide education and skills for increasing self-esteem and self-confidence among adolescent mothers using self-efficacy-focused activity sessions. This project took place at an alternative public school for pregnant and/or parenting female adolescents. Participants attended self-efficacy-focused activity sessions, and completed the General Self-Efficacy Scale. Increased confidence in finding solutions demonstrated statistical correlation with the number of sessions attended. Development of positive self-esteem and self-confidence remain important concerns during the adolescent period. Implementing self-efficacy activities in a school-based setting is one potential approach to improving self-esteem. Further exploration into ways to foster positive mental health and build confidence in adolescents is recommended. [Journal of Psychosocial Nursing and Mental Health Services, 57(8), 11-15.].

A specific inhibitor of PfCDPK4 blocks malaria transmission: chemical-genetic validation.

Malaria parasites are transmitted by mosquitoes, and blocking parasite transmission is critical in reducing or eliminating malaria in endemic regions. Here, we report the pharmacological characterization of a new class of malaria transmission-blocking compounds that acts via the inhibition of Plasmodia CDPK4 enzyme. We demonstrate that these compounds achieved selectivity over mammalian kinases by capitalizing on a small serine gatekeeper residue in the active site of the Plasmodium CDPK4 enzyme. To directly confirm the mechanism of action of these compounds, we generated P. falciparum parasites that express a drug-resistant methionine gatekeeper (S147 M) CDPK4 mutant. Mutant parasites showed a shift in exflagellation EC50 relative to the wild-type strains in the presence of compound 1294, providing chemical-genetic evidence that CDPK4 is the target of the compound. Pharmacokinetic analyses suggest that coformulation of this transmission-blocking agent with asexual stage antimalarials such as artemisinin combination therapy (ACT) is a promising option for drug delivery that may reduce transmission of malaria including drug-resistant strains. Ongoing studies include refining the compounds to improve efficacy and toxicological properties for efficient blocking of malaria transmission.