Assessment of the workload and financial burden of Bosniak IIF renal cyst surveillance in a tertiary referral hospital.

BACKGROUND: The Bosniak classification is a CT classification which stratifies renal cysts based on imaging appearances and therefore associated risk of malignancy. Bosniak IIf cysts are renal which have complex features and therefore require surveillance. AIMS: The aim of this study is to assess the economic and workload burden of diagnosing and following up Bosniak IIf cysts on the urology service in a tertiary hospital in the West of Ireland. METHODS: All patients with a diagnosis of Bosniak IIf renal cysts attending our urology service between 1st of January 2012 and 31st December 2020 were analysed. The following data were collected: number and modality of follow up scans, number of MDT discussions, number and type of outpatient appointments, surgical intervention, and length of follow up. Financial data were provided by the hospital finance department. RESULTS: One hundred and sixty-two patients were included. Total cost of follow up was €164,056, costing €1,012.7 per patient. Cost of outpatient visits was €77,850. Follow-up length ranged from 1 to 109 months, median follow up time 17.5 months. Overall cost of imaging was €74,518. There were a total of 80 MDT discussions at an overall cost of €11,688. CONCLUSIONS: This study demonstrates that surveillance of patients with Bosniak IIf renal cysts represents a significant burden upon both radiology and urology services. Surveillance for these patients could be streamlined in the future through a number of initiatives such as virtual OPDs and dedicated MDTs.

Conservation of vegetable genetic diversity in Transylvania-Romania.

The conservation of plant and animal genetic heritage is not a purpose in itself, but it represents the sine qua non condition for practicing a sustainable agriculture and to ensure nutrition and food security on long-term. Our research focused on identifying the areas with the richest genetic diversity of vegetables in Transylvania, Romania, as well as the main vulnerabilities related to seed production for the local vegetables. Our trips included 210 locations where 338 small seed producers were surveyed. The questionnaire method with fixed questions and undisguised multiple-choices was used. A number of 316 out of 565 cultivars taken into study have been proven to be authentic and valuable landraces, meaning 55.9%. In Transylvania, the richest genetic diversity of vegetables is found in the counties of Maramures, Bistrita-Nasaud and Hunedoara-where the cooperativization was lower before the year 1989. The most important risk in losing vegetable landraces is the old age of small growers (68.4%). However, it is encouraging that many NGOs interested in identifying, conserving and promoting local varieties have emerged in the last decade. Therefore, so-called "seed houses" have been set up to facilitate the exchange of seeds, and on the other hand, the expansion of organic farming requires local varieties that are better adapted to harsh environmental conditions.