The citizen scientist: Community-academic partnerships through Translational Advisory Boards.

OBJECTIVE: To describe the effectiveness of engaging patient partners as "citizen scientists" in the research process to boost patient centered outcomes research in underrepresented populations. METHODS: Translational Advisory Boards in South Texas have effectively collaborated with University researchers to develop community-based patient centered research. Here we describe innovative approaches in research to engage patients and offer practical methods to enhance partnerships between patients and researchers to facilitate patient engagement. RESULTS: Three health issues identified by the TABs were diabetes, obesity and teen pregnancy Examples of other community inspired research topics include air and water quality, methicillin-resistant staphylococcus aureus, intimate partner violence, chronic pain, and human papilloma virus and hepatitis C vaccinations. CONCLUSION: Patient engagement of underrepresented populations is inverse to the vast disparities they experience. In order to adequately address our nation's deficits in providing equitable healthcare, we must fully integrate disparate partners into the research process. By engaging community champions, academic health centers can fully integrate meaningful interventions on topics of interest to the catchment area in which they serve. PRACTICE IMPLICATIONS: These lessons can be used in developing local and regional collaborations across the country to boost active participation of patient stakeholder in PCOR to reduce healthcare disparities and improve our healthcare systems.

Lesiones intramedulares que simulan tumor / Spinal cord lesions that mimic neoplasms

Objetivo. Analizar las características clínicas y neurorradiológicas de las distintas lesiones intramedulares con la finalidad de poder diferenciar las lesiones no-tumorales de las tumorales y reservar la exploración quirúrgica sólo para aquellos pacientes sin diagnósticoy con sintomatología rápidamente progresiva. Material y métodos. Se revisaron las historias clínicas de 44 pacientes operados consecutivamente con diagnóstico presuntivo de tumor intramedular entre enero de 1988 y diciembre de 2007. No se incluyeron en el análisis los tumores bulbomedulares ni los del cono y filum ni tampoco los lipomas, teratomas y quistes dermoides.Resultados. Se identificaron 4 pacientes (9.1%), 3 masculinos y 1 femenino, con edad media de 9 años, que presentaban deterioro neurológico progresivo e IRM espinal compatible con tumor intramedular. El resultado histopatológico confirmó en los cuatro casos lesiones no tumorales: infiltrado inflamatorio inespecífico, edema, micosis y gliosis respectivamente.Conclusiones. El minucioso análisis clínico, de laboratorio y el estudio de las imágenes en IRM puede ayudar a la correcta distinción entre tumores y lesiones no-tumorales evitando la exploración quirúrgica que sólo está justificada en los casos muy dudososacompañados de rápido deterioro neurológico funcional del paciente.(AU)

Objective. To analyze the clinic and neuro-imaging characteristicsof the intra spinal lesions in order to differentiate the non-neoplasticlesions from neoplastic lesions and to spare surgical exploration only for non-diagnosed patients with rapid deterioration. Materials and method. Fourty-four medical charts of patientsoperated on spinal cord lesions between January 1988 and December 2007 have been analyzed. Results. In four patients (3 male, 1 female ¹ mean age: 9 years)who were operated with diagnosis of intra-spinal tumor, their lesions turned out to be non-neoplastic: non-specific inflammation, edema, mycosis and gliosis, respectively. Conclusions. The thorough clinical and laboratory investigation together with the study of the imaging can help distinguishbetween non-neoplastic lesions from neoplastic lesions in order to avoid surgical exploration which is only suitable in very doubtful cases with rapid deterioration.(AU)

Lesiones intramedulares que simulan tumor / Spinal cord lesions that mimic neoplasms

Objetivo. Analizar las características clínicas y neurorradiológicas de las distintas lesiones intramedulares con la finalidad de poder diferenciar las lesiones no-tumorales de las tumorales y reservar la exploración quirúrgica sólo para aquellos pacientes sin diagnósticoy con sintomatología rápidamente progresiva. Material y métodos. Se revisaron las historias clínicas de 44 pacientes operados consecutivamente con diagnóstico presuntivo de tumor intramedular entre enero de 1988 y diciembre de 2007. No se incluyeron en el análisis los tumores bulbomedulares ni los del cono y filum ni tampoco los lipomas, teratomas y quistes dermoides.Resultados. Se identificaron 4 pacientes (9.1%), 3 masculinos y 1 femenino, con edad media de 9 años, que presentaban deterioro neurológico progresivo e IRM espinal compatible con tumor intramedular. El resultado histopatológico confirmó en los cuatro casos lesiones no tumorales: infiltrado inflamatorio inespecífico, edema, micosis y gliosis respectivamente.Conclusiones. El minucioso análisis clínico, de laboratorio y el estudio de las imágenes en IRM puede ayudar a la correcta distinción entre tumores y lesiones no-tumorales evitando la exploración quirúrgica que sólo está justificada en los casos muy dudososacompañados de rápido deterioro neurológico funcional del paciente.

Objective. To analyze the clinic and neuro-imaging characteristicsof the intra spinal lesions in order to differentiate the non-neoplasticlesions from neoplastic lesions and to spare surgical exploration only for non-diagnosed patients with rapid deterioration. Materials and method. Fourty-four medical charts of patientsoperated on spinal cord lesions between January 1988 and December 2007 have been analyzed. Results. In four patients (3 male, 1 female – mean age: 9 years)who were operated with diagnosis of intra-spinal tumor, their lesions turned out to be non-neoplastic: non-specific inflammation, edema, mycosis and gliosis, respectively. Conclusions. The thorough clinical and laboratory investigation together with the study of the imaging can help distinguishbetween non-neoplastic lesions from neoplastic lesions in order to avoid surgical exploration which is only suitable in very doubtful cases with rapid deterioration.

Tratamiento neuroendoscopico de los quistes aracnoideos supratentoriales sintomáticos / Neuroendoscopy treatment of supratentorial arachnoid symptomatic cysts

Objective: Symptomatic supratentorial cysts are complicated lesion often associated with complex brain malformation and hydrocephalus. The traditional treatment was microsurgical technique or shunts. We present our experience of neuroendoscopic treatment of these lesions. Method: Between 1999 and 2007, 28 consecutive patients with symptomatic supratentorial cysts underwent neuroendoscopic treatment in our department. Results: The mean age was 3.1 years (range 1 month to 15 years), 18 were male and 10 female, In 5 patients a prenatal diagnosis was established. Eighteen patients presented increased intracranial pressure, 5 developmental delay, 3 seizures and 3 hemiparesis. According to its localization we have clasificated the cysts in: interhemispheric (8), intraventricular (7), cuadrigerminal (5), paraventricular (5) and suprasellar (3). We have excluded the temporal cysts of this series. All patients underwent neuroendoscopic treatment involving cystoventriculostomy in 24 and cystocisternostomy in 4. The complications were: 1 CFS leak, 3 patients required ventriculo-peritoneal shunt, 1 cystoperitoneal shunt and 1 subdural peritoneal shunt. There were no surgery-related morbidity or death. Conclusion: Endoscopic treatment of symptomatic supratentorial cysts can be considered a useful alternative to traditional treatment.