A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Desafíos y perspectivas en la investigación sobre el magisterio Challenges and prospects in the research on teaching

En investigación en general y en investigación educativa y sobre el magisterio importa precisar el "para qué" y el "para quién". Ambas decisiones se deberían conjugar en la opción de transformar la sociedad. Esto es posible hacerlo en nuestros países, a pesar del rasgo de desigualdad y de relativo control existente en el desarrollo investigativo. En investigación magisterial, deberíamos superar el control económico-financiero, de enfoque metodológico y el que, a veces, se esconde bajo el rótulo de hacer "incidencia política". En América Latina, hemos ido precisando la temática de investigación sobre el magisterio. Pero, su enfoque ha tenido que ver, por un lado, con los postulados neoliberales y de la investigación cualitativa-etnográfica y, por otro lado de la educación liberadora y de las prácticas sociales del magisterio latinoamericano. Desde esta última opción surgen importantes perspectivas que hay necesidad de precisar y concertar.<br>In research in general and in research on education and teaching it is worth specifying "what for" and "who for". Both decisions should combine in the option of transforming society. This can be done in our countries, in spite of the inequality divide and of the relative control on the development of research. In research on teaching, we should overcome the economical-financial control, with its methodological focus, and the one that - sometimes - hides under the name of making "political incidence". In Latin America, we have specified the themes of research on teaching. Nevertheless, their focuses have to do with the assumptions of neo-liberalism and qualitative-ethnographic research, on the one hand, and with those of the liberating education and of the social practices of Latin-American teaching, on the other. Important prospects emerge from this last option, which need to be specified and coordinated

Focal therapy of prostate cancer index lesion with irreversible electroporation. A prospective study with a median follow-up of 3 years

Purpose: Our aim was to assess oncologic, safety, and quality of lifeerelated outcomes of focal therapy with irreversible electroporation in men with localized prostate cancer. Materials and Methods: This was a single-center, phase II study. Inclusion criteria: prostate cancer International Society of Urological Pathology grade 1-2, prostate specific antigen 15 ng/ml, cT2b. Patients were selected based on multiparametric magnetic resonance imaging and transperineal systematic and targeted magnetic resonance imagingeultrasound fusioneguided biopsy. Ablation of index lesions with safety margin was performed. Primary end point was cancer control, defined as the absence of any biopsy-proven tumor. A control transperineal biopsy was planned at 12 months and when suspected based on prostate specific antigen and/or multiparametric magnetic resonance imaging information. Quality of life was assessed using Expanded Prostate Cancer Index Composite Urinary Continence domain, International Index of Erectile Function, and International Prostate Symptom Score. Results: From November 2014 to July 2021, 41 consecutive patients were included with a median follow-up of 36 months. Thirty patients (73%) had International Society of Urological Pathology grade 1 tumors, 10 (24%) grade 2, and 1 (2.4%) grade 3. Recurrence was observed in 16 of 41 (39%) of the whole cohort, and 16 of 33 (48.4%) who underwent biopsy. In-field recurrence was detected in 5 (15%) and out-of-field in 11 (33.3%). Ten of 41 (24.6%) including 3 of 5 (60%) with in-field recurrences had significant tumors (Gleason pattern 4-5; more than 1 core or any >5 mm involved). Median recurrence-free survival was 32 months (95% CI 6.7-57.2). Twentysix patients (63.4%) were free from salvage treatment. All patients preserved urinary continence. Potency was maintained in 91.8%. Conclusions: Irreversible electroporation can achieve satisfactory 3-year in-field tumor control with excellent quality of life results in selected patients

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally