A new memory space: The urology museum “Prof. Dr. Néstor Vigo“ from the Faculty of Medical Sciences of the UNLP

La Universidad Nacional de La Plata, desde la normalización, ha desarrollado una política de acercamiento a la comunidad local y nacional mediantela educación no formal. Para ello ha incentivado la generación de Museos Universitarios nucleados enuna Red cuya finalidad es mostrar cómo la ciencia, el arte, la tecnología y la educación han contribuido al mejoramiento de la calidad de vida. En la Facultad de Ciencias Médicas existen los Museos de Anatomíahumana normal Dr. “Alberto Leonardo Poli”, de Historia de la Medicina “Dr. Santiago Gorostiague” y el de Urología “Dr. Néstor J. Vigo”.Fil: Tobia Gonzalez, Sebastian Gregorio. Universidad Nacional de La Plata. Facultad de Ciencias Médicas; ArgentinaFil: Tobia González, Ignacio P.. Universidad Nacional de La Plata. Facultad de Ciencias Médicas; ArgentinaFil: Sempe, Maria Carlota. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Análisis Cerámico; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentin

A new memory space: The urology museum “Prof. Dr. Néstor Vigo“ from the Faculty of Medical Sciences of the UNLP

La Universidad Nacional de La Plata, desde la normalización, ha desarrollado una política de acercamiento a la comunidad local y nacional mediantela educación no formal. Para ello ha incentivado la generación de Museos Universitarios nucleados enuna Red cuya finalidad es mostrar cómo la ciencia, el arte, la tecnología y la educación han contribuido al mejoramiento de la calidad de vida. En la Facultad de Ciencias Médicas existen los Museos de Anatomíahumana normal Dr. “Alberto Leonardo Poli”, de Historia de la Medicina “Dr. Santiago Gorostiague” y el de Urología “Dr. Néstor J. Vigo”.Fil: Tobia Gonzalez, Sebastian Gregorio. Universidad Nacional de La Plata. Facultad de Ciencias Médicas; ArgentinaFil: Tobia González, Ignacio P.. Universidad Nacional de La Plata. Facultad de Ciencias Médicas; ArgentinaFil: Sempe, Maria Carlota. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Análisis Cerámico; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentin

Multicenter comparative study of open, laparoscopic, and robotic pyeloplasty in the pediatric population for the treatment of ureteropelvic junction obstruction (UPJO)

Introduction: Dismembered open pyeloplasty described by Anderson and Hynes is the "gold standard" for the treatment of ureteropelvic junction obstruction. The aim of our study was to compare the results of open (OP) vs laparoscopic (LP) vs robotic (RALP) pyeloplasty. Material and Methods: A multicenter prospective review was conducted of pyeloplasty surgeries performed at five high-volume centers between 2014 and 2018. Demographic data, history of prenatal hydronephrosis, access type, MAG3 renogram and differential renal function, surgery time, length of hospital stay, and complication rate (Clavien-Dindo) were recorded. Access type was compared using the Kruskal-Wallis, Chi-square, or Fisher's exact tests. Results: A total of 322 patients were included: 62 OP, 86 LP, and 174 RALP. The mean age was 8.13 (r: 1-16) years, with a statistically significant lower age (mean 5 years) in OP (p < 0.001). There were no significant differences in the distribution of the side affected. Operative time was 110.5 min for OP, 140 min for LP, and 179 min for RALP (p < 0.0001). Hospital stay was significantly shorter in the RALP group than in the other groups (p < 0.0001). There were no differences in postoperative complications and reoperations between the three groups. Conclusions: Minimally invasive surgery for the management of UPJO in children is gaining more acceptance, even in patients younger than 1-year-old. Operative time continues to be significantly shorter in OP than in LP and RALP. Hospital stay was shorter in RALP compared to the other techniques. No differences were found in complication rates, type of complications, and reoperation rate

Hereditary Renal Cell Carcinoma: Is Age an Independent Criterion for Genetic Testing? A Large Cohort from a Latin America Referral Center

Although age younger than 46 years has been an independent criterion for genetic testing in hereditary renal cell carcinoma (hRCC), there is a lack of evidence in the literature. This study aims to analyze whether a 46-year-old cut-off should be considered an independent genetic testing criterion and to elucidate risk factors predicting a positive genetic test. Observational study from January 2010 to December 2021. All patients under 46 years with a non-metastatic kidney mass and surgical indication were included. We assume patients who relapse in the first 5 years of follow-up could have a positive genetic test. As risk factors for relapse, ergo positive genetic test, we consider those patients who presented multifocal, bilateral, or previous renal tumor. Of 2,232 nephrectomies for kidney cancer, 301 patients met the inclusion criteria. The median follow-up was 60 months (IQR 29-101). The estimated five-year RFS was 94.4% (95% CI 91.3-97.5). Tumor size, previous renal tumor, multifocality, bilaterality, and pT3 or pT4 stage were independent recurrence risk factors. Genetic testing was performed on 24 patients. 10 patients had pathogenic variants in the test, 8 of which recurred during their life. 46-year-old cut-off has shown low performance in genetic testing. Therefore, we recommend that it be considered only if other hRCC risk criteria exist. Multifocality, bilaterality, and previous renal tumor could predict a positive genetic test

Predictive variables of patient satisfaction in the pediatric outpatient clinic of El Cruce-Néstor Kirchner Hospital

INTRODUCCIÓN: El papel de los pacientes en los sistemas sanitarios es cada vez más relevante. Su satisfacción aparece como uno de los principales indicadores al evaluar la gestión sanitaria y la calidad asistencial. El objetivo del estudio fue determinar variables predictoras de satisfacción con la atención médica en la consulta externa pediátrica del Hospital El Cruce-Néstor Kirchner. MÉTODOS: Se realizó un estudio de corte transversal. Se incluyó a pacientes en edad pediátrica que concurrieron al Hospital a partir de junio de 2018. Se completaron encuestas CAHPS (Consumer Assessment of Healthcare Providers and Systems) después de la visita. Se utilizó test de Kruskal-Wallis para comparar distribución de cada variable predictora; para variables independientes categóricas, se realizó tabla n x p buscando significancia por test de chi cuadrado ajustada por número de comparaciones y chi cuadrado de tendencia lineal buscando asociación entre categorías predictoras ordenadas y variable respuesta. RESULTADOS: Un total de 423 personas respondieron el cuestionario; 368 eran mujeres, 390/415 eran padre o madre. La mayoría estaba conforme; sólo 3 asignaron puntajes menores a 7 (mínimo 0, máximo 10). Ninguna de las variables predictoras analizadas se asoció significativamente con peor evaluación del profesional y satisfacción con la atención. DISCUSIÓN: Hay un alto grado de satisfacción con la atención. Los motivos podrían ser abordados en profundidad mediante estudios cualitativos.INTRODUCTION: The role of patients in health systems is increasingly relevant. Their satisfaction appears as one of the main indicators to evaluate health management and quality of care. The objective of the study was to determine predictive variables of satisfaction with medical care in the pediatric outpatient clinic of El Cruce Néstor Kirchner Hospital. METHODS: A cross-sectional study was conducted. It included pediatric patients who attended the Hospital since June 2018. Post-visit CAHPS (Consumer Assessment of Healthcare Providers and Systems) surveys were completed. Kruskal-Wallis test was used to compare the distribution of each predictor variable; for categorical independent variables, n x p table was performed looking for significance by chi-square test adjusted for number of comparisons and chisquare of linear trend looking for association between ordered predictor categories and response variable. RESULTS: A total of 423 people answered the questionnaire; 368 were female, 390/415 were father or mother. Most respondents reported being satisfied; only 3 of them assigned scores lower than 7 (minimum 0, maximum 10). None of the predictive variables analyzed were significantly associated with worse evaluation of professionals and satisfaction with care. DISCUSSION: There is a high level of satisfaction with the attention. Qualitative studies would help to thoroughly explain the reasons.Facultad de Ciencias Médica

Positive surgical margins are predictors of local recurrence in conservative kidney surgery for pT1 tumors

ABSTRACT Objectives: The clinical significance of positive surgical margin (PSM) after a Nephron Sparing Surgery (NSS) is controversial. The aim of this study is to evaluate the association between PSM and the risk of disease recurrence in patients with pT1 kidney tumors who underwent NSS. Materials and Methods: Retrospective cohort study. A total of 314 patients submitted to a NSS due to stage pT1 renal tumor between January 2010 and June 2015 were included. Recurrence-free survival was estimated. The Cox model was used to adjust the tumor size, histological grade, pathological stage, age, surgical margins and type of approach. Results: Overall PSM was 6.3% (n=22). Recurrence was evidenced in 9.1% (n=2) of patients with PSM and 3.5% (n=10) for the group of negative surgical margin (NSM). The estimated local recurrence-free survival rate at 3 years was 96.4% (95% CI 91.9 to 100) for the NSM group and 87.8% (95% CI 71.9 to 100) for PSM group (p=0.02) with no difference in metastasis-free survival. The PSM and pathological high grade (Fuhrman grade III or IV) were independent predictors of local recurrence in the multivariate analysis (HR 12.9, 95%CI 1.8-94, p=0.011 / HR 38.3, 95%CI 3.1-467, p=0.004 respectively). Fuhrman grade proved to be predictor of distant recurrence (HR 8.1, 95%CI 1.6-39.7, p=0.011). Conclusions: The PSM in pT1 renal tumors showed to have higher risk of local recurrence and thus, worse oncological prognosis

Hereditary Renal Cell Carcinoma: Is Age an Independent Criterion for Genetic Testing? A Large Cohort from a Latin America Referral Center

Although age younger than 46 years has been an independent criterion for genetic testing in hereditary renal cell carcinoma (hRCC), there is a lack of evidence in the literature. This study aims to analyze whether a 46-year-old cut-off should be considered an independent genetic testing criterion and to elucidate risk factors predicting a positive genetic test. Observational study from January 2010 to December 2021. All patients under 46 years with a non-metastatic kidney mass and surgical indication were included. We assume patients who relapse in the first 5 years of follow-up could have a positive genetic test. As risk factors for relapse, ergo positive genetic test, we consider those patients who presented multifocal, bilateral, or previous renal tumor. Of 2,232 nephrectomies for kidney cancer, 301 patients met the inclusion criteria. The median follow-up was 60 months (IQR 29-101). The estimated five-year RFS was 94.4% (95% CI 91.3-97.5). Tumor size, previous renal tumor, multifocality, bilaterality, and pT3 or pT4 stage were independent recurrence risk factors. Genetic testing was performed on 24 patients. 10 patients had pathogenic variants in the test, 8 of which recurred during their life. 46-year-old cut-off has shown low performance in genetic testing. Therefore, we recommend that it be considered only if other hRCC risk criteria exist. Multifocality, bilaterality, and previous renal tumor could predict a positive genetic test

The LARCG Latin American Renal Cancer Group: Achievements in Support, Teaching, Research, Collaboration, and Advocacy

The Latin American Renal Cancer Group (LARCG) was founded in 2013. This is a non-profit collaborative group designed to foster scientific knowledge in all areas of kidney cancer, and to establish international cooperation among well-recognized oncologic institutions. Since its creation, LARCG has reported data from Latin America to the scientific community and has promoted accredited information and advocacy principles for patients, lay people, and medical colleagues. Currently, it consists of 44 centers in 7 Latin American countries and Spain. In this paper, we report our achievements in assistance, teaching, research, and advocacy, and we discuss the successful international collaborations

Exploring Urological Experience in the COVID-19 Outbreak: American Confederation of Urology (CAU) Survey

PURPOSE: To explore the current situation faced by Latin American urology departments during the COVID-19 Outbreak in terms of knowledge, actions, prioritization of urology practices, and implementation of internal clinical management protocols for inpatients and outpatients. MATERIAL AND METHODS: A non-validated, structured, self-administered, electronic survey with 35 closed multiple choice questions was conducted in Spanish, Portuguese, Italian, and English and Deutsch versions from April 1st to April 30th, 2020. The survey was distributed through social networks and the official American Confederation of Urology (CAU) website. It was anonymous, mainly addressed to Latin American urologists and urology residents. It included 35 questions exploring different aspects: 1) Personal Protective Equipment (PPE) and internal management protocols for healthcare providers; 2) Priority surgeries and urological urgencies and 3) Inpatient and outpatient care. RESULTS: Of 864 surveys received, 846 had at least 70% valid responses and were included in the statistical analyses. Surveys corresponded to South America in 62% of the cases, Central America and North America in 29.7%. 12.7% were residents. Regarding to PPE and internal management protocols, 88% confirmed the implementation of specific protocols and 45.4% have not received training to perform a safe clinical practice; only 2.3% reported being infected with COVID-19. 60.9% attended urgent surgeries. The following major uro-oncologic surgeries were reported as high priority: Radical Nephrectomy (RN) 58.4%, and Radical Cystectomy (RC) 57.3%. When we associate the capacity of hospitalization (urologic beds available) and percentage of high-priority surgery performed, we observed that centers with fewer urological beds (10-20) compared to centers with more urological beds (31-40) performed more frequently major urologic cancer surgeries: RN 54.5% vs 60.8% (p=0.0003), RC 53.1% vs 64.9% (p=0.005) respectively. CONCLUSIONS: At the time of writing (May 13th 2020) our data represents a snapshot of COVID-19 outbreak in Latin American urological practices. Our findings have practical implications and should be contextualized considering many factors related to patients and urological care: The variability of health care scenarios, institutional capacity, heterogeneity and burden of urologic disease, impact of surgical indications and decision making when prioritizing and scheduling surgeries in times of COVID-19 pandemic