Tetrabenzoporphyrin and -mono-, - Cis -di- and tetrabenzotriazaporphyrin derivatives: Electrochemical and spectroscopic implications of meso CH Group replacement with nitrogen

Nonperipherally hexyl-substituted metal-free tetrabenzoporphyrin (2H-TBP, 1a) tetrabenzomonoazaporphyrin (2H-TBMAP, 2a), tetrabenzo-cis-diazaporphyrin (2H-TBDAP, 3a), tetrabenzotriazaporphyrin (2H-TBTAP, 4a), and phthalocyanine (2H-Pc, 5a), as well as their copper complexes (1b-5b), were synthesized. As the number of meso nitrogen atoms increases from zero to four, Îmax of the Q-band absorption peak becomes red-shifted by almost 100 nm, and extinction coefficients increased at least threefold. Simultaneously the blue-shifted Soret (UV) band substantially decreased in intensity. These changes were related to the relative electron-density of each macrocycle expressed as the group electronegativity sum of all meso N and CH atom groups, âχR. X-ray photoelectron spectroscopy differentiated between the three different types of macrocyclic nitrogen atoms (the Ninner, (NH)inner, and Nmeso) in the metal-free complexes. Binding energies of the Nmeso and Ninner,Cu atoms in copper chelates could not be resolved. Copper insertion lowered especially the cathodic redox potentials, while all four observed redox processes occurred at larger potentials as the number of meso nitrogens increased. Computational chemical methods using density functional theory confirmed 1b to exhibit a Cu(II) reduction prior to ring-based reductions, while for 2b, Cu(II) reduction is the first reductive step only if the nonperipheral substituents are hydrogen. When they are methyl groups, it is the second reduction process; when they are ethyl, propyl, or hexyl, it becomes the third reductive process. Spectro-electrochemical measurements showed redox processes were associated with a substantial change in intensity of at least two main absorbances (the Q and Soret bands) in the UV spectra of these compounds

Preoperative risk factors for complications after flexible and rigid ureteroscopy for stone disease: A French multicentric study

International audienc

Educational program in onco-urology for young urologists: What are their needs?

International audiencePurposeThe emergence of new communication media such as digital contents are progressively replacing more traditional medias in the field of educational programs. Our purpose was to assess urologist in training aspirations regarding urological education.MethodsMembers of a national urologist in training association were sent an anonymous online questionnaire regarding their medical formation in the field of urology. Responders interest for urological sub-specialty or education support (new tools and traditional support) were evaluated through a 5-point Likert scale.ResultsOverall, 109 young urologists (26%) responded to the survey. Most of the respondents worked during their training in an academic hospital (n = 89, 82%). The three favorite tools for training chosen by the responders were: videos, workshop or masterclass, and podcasts (responders very interested were respectively n = 64 (58.7%), n = 50 (45.9%), and n = 49 (45%)). E-mail newsletters were reported as the less useful educational tool by participants (n = 38, 34.9%). Participants were very interested in improving their surgical skills and their radiological knowledge. Responders who were the most attracted by PCa were much more looking to improve their systemic treatment and radiological knowledges.ConclusionsUrologic-oncology was a priority regarding education for urologists in training. A majority of participants expressed a lack in their surgical education, revealing a reduced OR access and underlining utilization of new tools such as simulation. New digital contents such as social media or podcast achieved high interest for the participants, instead of more traditional media. There is a need that educational content evolve and uses new digital media.ButDans la formation médicale, les nouveaux médias de communication tels que les contenus numériques se développent très rapidement et tendent à remplacer les médias plus traditionnels. Notre objectif était d’évaluer les aspirations des urologues en matière de formation en onco-urologie.MatérielLes membres de l’Associations française des urologues en formation ont répondu à un questionnaire en ligne anonyme concernant leur formation en onco-urologie. L’intérêt des participants pour les différents moyens de formation ainsi que pour les spécialités d’organes ont été évalués avec une échelle de Likert à 5-points.RésultatsAu total, 109 urologues en formation ont répondu à l’enquête (26 %). La plupart ont effectué leur formation exclusivement dans un hôpital universitaire (n = 89, 82 %). Les trois outils de formation préférés des participants étaient : les supports vidéo, les ateliers ou masterclass, et les podcast (étaient très intéressés respectivement n = 64 (59 %), n = 50 (46 %) et n = 49 (45 %)). Les newsletters ont été considérées comme l’outil éducatif le moins utile (n = 39, 35 %). Les participants étaient très intéressés par l’amélioration de leurs compétences chirurgicales et de leurs connaissances radiologiques. Les participants qui s’intéressaient le plus au cancer de la prostate cherchaient à consolider leurs connaissances sur les traitements systémiques ainsi qu’en radiologie.ConclusionL’onco-urologie est une priorité pour les urologues en formation. Les nouveaux contenus numériques tels que les réseaux sociaux ou les podcasts ont suscité un grand intérêt chez les participants, supplantant les médias plus traditionnels. Il est nécessaire que le contenu éducatif évolue et se repose sur les nouveaux médias numériques

Residents and patients benefit from surgical simulation on a live porcine model, could we consider it as ethical?

International audienceIntroduction: The objective was to evaluate, by self-questionnaire, the feeling of participants in surgical training sessions on a live porcine model.Methods: A computerized questionnaire (GoogleForm ©) was sent to the members of the French Association of Urologists-in-Training (AFUF) (fellows and residents). Only questionnaires from Urologists-in-training who had participated in surgical training sessions were included. The sessions consisted of performing surgeries such as laparoscopic nephrectomies or laparoscopic cystectomies.Results: Overall, 198 met the inclusion criteria. A total of 36.4% (72/198) of the participants were fellows and 63.6% (126/198) were residents. According to the participants, the main interest of sessions was to be able to train for emergency situations. A total of 79.8% (158/198) of the participants wanted surgical simulation to become compulsory. To their opinion, the main advantage of surgical simulation on a live porcine model was: technical progress in 87.4% (173/198) of cases. A total of 13.1% (26/198) of the participants found it was unethical to perform the first technical procedures on live animal models. A total of 65.7% (130/198) of the participants considered that there is currently no system of substitution.Conclusion: For the participants, surgical training on a live porcine model allows technical progress while training for serious emergency situations. Surgeons and patients could benefit from this risk-free mock surgical scenario.Level of evidence: 3

Comparing oncological and perioperative outcomes of open versus laparoscopic versus robotic radical nephroureterectomy for the treatment of upper tract urothelial carcinoma: A multicenter, multinational, propensity score-matched analysis

Introduction & Objectives: The growth of minimally invasive methods for radical nephroureterectomy (RNU) has significantly changed the surgical treatment of upper tract urothelial carcinoma (UTUC). Laparoscopic and robotic RNU (LRNU and RRNU) increased during the last two decades while open RNU (ORNU) decreased. However, the current evidence regarding oncologic and perioperative outcomes between LRNU, RRNU and ORNU is weak. The aim of the study was to compare survival and perioperative outcomes between these approaches using a large, multicenter database. Materials & Methods: Multi-institutional, retrospective study including high-risk non-metastatic UTUC patients who underwent RNU between 1990 - 2020. Multiple imputation by chained equations was used to impute missing data. Patients were divided into 3 groups based on their surgical treatment and were adjusted by 1:1:1 propensity score matching (PSM). The primary objective was to compare survival outcomes between surgical approaches with bladder recurrence-free survival (BRFS), recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS) as primary endpoints. The secondary objective was to compare perioperative outcomes with intraoperative bloos loss, length of inpatient stay (LOIS), overall and major postoperative complications (MPC) as secondary endpoints. Results: Of the 2434 patients included, 756 remained after PSM with 252 in each group. The three groups had similar clinico-pathological characteristics. The median follow-up was 32 months. Kaplan-Meier and log-rank tests showed similar RFS, CSS, OS between groups, while a better BRFS was found in favor of ORNU. In multivariable regression analyses, LRNU and RRNU were shown to be independent predictors of worse BRFS (HR 1.66, 95% CI 1.22- 2.28; p = 0.001 and HR 1.73, 95%CI 1.22- 2.47; p = 0.002 respectively). LRNU and RRNU were an independent predictor of shorter LOIS (beta -1.1, 95% CI -2.2- 0.02; p = 0.047 and beta -6.1, 95% CI -7.2- 5.0; p \u3c 0.001, respectively) and less MPC (OR 0.5, 95% CI 0.31- 0.79; p = 0.003 and OR 0.27, 95% CI 0.16- 0.46; p \u3c 0.001, respectively). Conclusions: We could confirm previous findings that ORNU, LRNU and RRNU have comparable RFS, CSS and OS. However, LRNU and RRNU were shown to have a significantly worse BRFS, highlighting the need to improve the bladder-cuff technique and the importance of postoperative intravesical chemotherapy. LRNU and RRNU were independent predictors of shorter LOIS and less MPC