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The SARS-CoV-2 pandemic has affected training opportunities for healthcare professionals partly because face to face courses were cancelled. This study analyzes the results of participation and satisfaction of the AEC Virtual Classroom sessions during the first year.The AEC Virtual Classroom includes a combined format of weekly Webinar broadcast live that can be viewed on a delayed basis in a virtual platform. In this study, the results in its first year are evaluated considering the number of live participants, the delayed views and the global reach; as well as the results of the satisfaction survey in each of the sessions (0-10).From 16/04/2020 to 15/04/2021, 50 sessions of the Virtual Classroom AEC were held. The average scope of the sessions was 509 ± 288 views with a range between 196 and 149. At the times of highest incidence of cases during the pandemic, a decrease in live participants was observed 275 ± 135 vs. 391 ± 233 (P = 0.032). The mean score on the format was 8.46 ± 0.31/10. The best-scored sessions were those of the subject related to coloproctology with a statistically significant difference in the mean score 8.79 ± 0.42 vs. 8.39 ± 0.27 (P = 0.035). 90% of users considered the sessions useful. 97.2% of respondents believe that the sessions should be maintained after the pandemic.The AEC Virtual Classroom has had very good results in the first year, proving to be a useful surgical teaching tool that will foreseeably survive once the pandemic is over.

Tumor-to-tumor metastasis is a rare phenomenon affecting the thyroid gland. Otherwise, it is not unusual for a neoplasm to be detected incidentally, without clinical symptoms. But what is exceptionally rare is that a malignant neoplasm debuts as an incidental finding in the form of a tumor-to-tumor metastasis. We contribute with the case of a previously healthy 41-year-old woman who presented an asymptomatic 39-mm-sized nodule on the left thyroid lobe in a routine health checkup. Ultrasound-guided fine needle aspiration cytology confirmed a papillary thyroid carcinoma. Because of the size, a total thyroidectomy was performed. In the surgical specimen, in addition to a classic papillary carcinoma with an extensive follicular pattern (pT2 pN0), a second component was identified, consisting of a clear cell population with immunostaining profile of renal origin. Subsequent studies found a 110-mm-sized left renal mass. A nephrectomy was performed and the pathological exam confirmed a renal cell carcinoma, pT2 pNX pM1, with metastasis also to the adrenal gland. To our knowledge, this is the first case described of this clinical presentation involving those two neoplasms. We present herein such an unusual clinical case along with a brief clinical and pathological review on tumor-to-tumor metastasis, with special emphasis on renal-to-thyroid ones.

Resumen Las epidemias por virus altamente transmisibles como la enfermedad por virus del Ebola (EVE) pueden generar casos importados a Europa y America. Aunque la probabilidad de actuacion quirurgica en ellas es baja, la Asociacion Espanola de Cirujanos ha elaborado un protocolo de actuacion quirurgica. Indicacion No esta indicada la cirugia electiva. Puede necesitarse cirugia urgente en: personas en observacion, casos probables y casos confirmados en fase precoz. En algunas condiciones de habitual tratamiento quirurgico puede instaurarse una terapia medica conservadora con intencion de evitar la intervencion. Hospitales y equipos Los casos deben concentrarse en hospitales de alta especializacion, unicos centros en los que se practique una eventual intervencion quirurgica. Estos deben garantizar la seguridad de los profesionales. Los equipos quirurgicos han de recibir extensa formacion mediante simulacion. Protocolo quirurgico Las recomendaciones se basan en protocolos de uso del equipo de proteccion individual, guias clinicas de otras sociedades y recomendaciones especificas para el area quirurgica.

Outbreaks of viral haemorrhagic fevers such as Ebola can lead to imported cases in Europe and America. The eventuality of surgery in the setting of Ebola Virus Disease (EVD) is low, but the Spanish Association of Surgeons elaborated a surgical protocol for EVD. Indication Elective surgical procedures are not indicated. Emergency cases can be considered in: persons under investigation, possible cases and early confirmed cases. In some conditions usually treated by surgery a medical treatment can be tested. Hospitals and Teams All cases must be treated in high technology hospitals. These hospitals must be equipped with adequate means for healthcare provider's protection. All members of the healthcare team should practice thorough simulation prior to caring for a possible Ebola patient. Surgical Protocol This protocol is based on international guidelines on use of Personal Protective Equipment, protocols of other scientific societies, and specific recommendations for the operating room environment.

Knowledge about compliance with recommendations derived from the positional statement of the European Society of Endocrine Surgeons on modern techniques in primary hyperparathyroidism surgery and the Third International Workshop on management of asymptomatic primary hyperparathyroidism is scarce. Our purpose was to check it on a bi-national basis and determine whether management differences may have impact on surgical outcomes. An online survey including questions about indications, preoperative workup, surgical approach, intraoperative adjuncts, and outcomes was sent to institutions affiliated to the endocrine surgery divisions of the National Surgical Societies from Spain and Portugal. A descriptive evaluation of the responses was performed. Finally, we assessed the correlation between the different types of management with the achievement of optimal results, defined as a cure rate equal or greater than the median of all interviewed institutions. Fifty-seven hospitals (41 Spanish, 16 Portuguese) answered the survey. First-ordered imaging tests were neck ultrasound and sestamibi scan. Facing negative or non-concordant results, 44 % of surgeons ordered additional tests before first-time surgery, and 84 % before reoperations. When indicated, selective parathyroidectomy was an acceptable option for 95 % of institutions as first-time surgery and for 51 % in reoperations. Intraoperative parathormone measurements were used by 92 % of departments. The surgical outcomes were good in most institutions (median cure rate 97 %) and were influenced mostly by the presence of an endocrine surgery unit in the surgical department (p = 0.038). Practice of Iberian endocrine surgeons is consistent with current recommendations on surgery for primary hyperparathyroidism, with variability in some areas.