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This study reports on 382 COVID-19 patients having undergone allogeneic ( n  = 236) or autologous ( n  = 146) hematopoietic cell transplantation (HCT) reported to the European Society for Blood and Marrow Transplantation (EBMT) or to the Spanish Group of Hematopoietic Stem Cell Transplantation (GETH). The median age was 54.1 years (1.0–80.3) for allogeneic, and 60.6 years (7.7–81.6) for autologous HCT patients. The median time from HCT to COVID-19 was 15.8 months (0.2–292.7) in allogeneic and 24.6 months (−0.9 to 350.3) in autologous recipients. 83.5% developed lower respiratory tract disease and 22.5% were admitted to an ICU. Overall survival at 6 weeks from diagnosis was 77.9% and 72.1% in allogeneic and autologous recipients, respectively. Children had a survival of 93.4%. In multivariate analysis, older age ( p  = 0.02), need for ICU ( p  < 0.0001) and moderate/high immunodeficiency index ( p  = 0.04) increased the risk while better performance status ( p  = 0.001) decreased the risk for mortality. Other factors such as underlying diagnosis, time from HCT, GVHD, or ongoing immunosuppression did not significantly impact overall survival. We conclude that HCT patients are at high risk of developing LRTD, require admission to ICU, and have increased mortality in COVID-19.

Introduction: Heart rhythm disorders are associated with increased morbidity and mortality. However, triggers and implications in patients with heart transplantation are not clear. Objectives: The purpose of this research paper is to identify and explain the determinants for the onset of electrical conductivity alterations in patients with a heart transplant, as well as to describe the most common arrhythmias and their pathological implications. Materials and methods: A literature review was made in the PubMed online database for a total of 411 results. In addition, clinical practice guidelines on cardiac transplantation, cardiovascular electrophysiology and infective endocarditis were searched. Sixty articles related to the objectives of this study were chosen. Results: Surgical technique, heart denervation, sinus node trauma, graft rejection, endomyocardial biopsies and infections are the main factors that compromise organ viability and the life of transplanted patients. These factors can be observed as sinus rhythm disturbances. Conclusions: When a cardiac arrhythmia is detected, the medical team must provide a treatment that is not limited to symptomatic and sinus rhythm control. An active search of the etiology must be initiated since it may indicate an underlying pathological process.

Abstarct Objective: to analyze the quality of life of kidney transplant receivers in the State of Amazonas. Method: a cross-sectional, descriptive study, performed with 222 individuals after renal transplantation registered in a private clinic and in a health public ambulatory. Data collection took place through structured interviews where the quality of life was measured by the Kidney Disease Quality of Life - Short Form. Descriptive statistics were used for data analysis. Results: the quality of life scores found ranged from 36.5 to 83.1. The quality of life domains, specifics of renal disease, have proved to be superior to generic ones. The most compromised were work situation; sleep; physical function and emotional function, with scores of 36.5; 53.7; 52.4; 55.1, respectively, and correlated moderately and significantly with each other. Conclusion: the majority (63.2%) of the quality of life domains obtained high scores and the specific component of renal disease had higher scores than the generic component. Objetivo: analisar a qualidade de vida de receptores de transplante renal no Estado do Amazonas. Método: estudo transversal, descritivo, realizado com 222 indivíduos pós-transplante renal cadastrados em uma clínica privada e em um ambulatório público de saúde. A coleta de dados deu-se por meio de entrevista estruturada onde a qualidade de vida foi medida pelo Kidney Disease Quality of Life - Short Form. Para a análise dos dados, foi utilizada estatística descritiva. Resultados: os escores de qualidade de vida encontrados variaram de 36,5 a 83,1. Os domínios de qualidade de vida específicos da doença renal mostraram-se superiores aos genéricos. Os mais comprometidos foram Situação de trabalho; Sono; Função física e Função emocional, com escores 36,5; 53,7; 52,4; 55,1, respectivamente, e correlacionados moderada e significativamente entre si. Conclusão: a maioria (63,2%) dos domínios de qualidade de vida obtiveram escores elevados e o componente específico da doença renal teve pontuações superiores ao componente genérico. Objetivo: analizar la calidad de vida de las personas receptoras de trasplante renal en el Estado de Amazonas. Método: estudio transversal descriptivo, realizado con 222 personas, con posterioridad a la realización de un trasplante renal, inscriptos en una clínica privada y en un hospital público. La recolección de datos se realizó mediante entrevista semiestructurada y se midió la calidad de vida por medio del Kidney Disease Quality of Life - Short Form. En el análisis de datos, se utilizó la estadística descriptiva. Resultados: El puntaje de calidad de vida obtenido osciló de 36,5 a 83,1. Los dominios de calidad de vida propios de la enfermedad renal, tuvieron un puntaje superior al genérico. Los más comprometidos fueron: situación laboral, sueño, función física y función emocional, con puntajes de 36,5; 53,7; 52,4; 55,1, respectivamente, y correlacionados moderada y significativamente entre sí. Conclusión: la mayoría (63,2%) de los dominios relativos a la calidad de vida obtuvieron puntajes elevados y el componente específico de la enfermedad renal obtuvo un puntaje superior al componente genérico.

Scientific and biotechnological advances always go hand in hand with ethical problems, some of which can be identified in The Island. An ecological disaster threatens the survival of humankind and individuals are no longer allowed to take decisions freely and voluntarily, deprived of their moral condition so that they can be used as a means. The goal that is pursued in the film (organ transplant to save lives) does not justify the means employed (the cloning of donors who are unaware of their condition and are thus sacrificed). Living donations must always be voluntary and free, carried out after an appropriate information process. Reproductive human cloning is unanimously rejected, but even if it is developed for therapeutic or research purposes, and even though it is legally allowed, it remains a matter of great ethical controversy.

ABSTRACT Objective: to analyze the evidence available in the literature on the alterations in the sexuality of candidates and recipients of liver transplantation. Method: integrative review of the literature with search for primary studies in the databases MEDLINE (via PUBMED), CINAHL e LILACS, published in English, Portuguese and Spanish. Results: the 16 primary studies included were grouped into three categories: 1) female sexuality (n=5), 2) male sexuality (n=5) and 3) male and female sexuality (n=6). In category 1, the subjects investigated were contraception, pregnancy, sexual dysfunction, presence of gynecological symptoms and sexually transmitted infections. In category 2, the main focus of the studies was erectile dysfunction, sexual desire and satisfaction, and consequences of the immunosuppressive regimen with mycophenolic acid in men. In category 3, the evaluation of sexual function was the main topic. Conclusion: the scientific evidence generated provides support to encourage health professionals to incorporate the topic of sexuality in the routine of care. Knowledge gaps were identified and new studies should be conducted in order to implement interventions to prevent, minimize and/or control changes related to the patient’s sexuality. RESUMO Objetivo: analisar as evidências disponíveis na literatura sobre as alterações na sexualidade de candidatos e receptores de transplante de fígado. Método: revisão integrativa com busca dos estudos primários nas bases de dados MEDLINE (via PUBMED), CINAHL e LILACS, publicados em inglês, português ou espanhol. Resultados: os 16 estudos primários incluídos foram agrupados em três categorias: 1) sexualidade feminina (n=5), 2) sexualidade masculina (n=5) e 3) sexualidade masculina e feminina (n=6). Na categoria 1, os temas investigados foram contracepção, gravidez, disfunção sexual, presença de sintomas ginecológicos e infecção sexualmente transmissível. Na categoria 2, o foco principal dos estudos foi disfunção erétil, desejo e satisfação sexual e consequências do regime imunossupressor com ácido micofenólico em homens. Na categoria 3, a avaliação da função sexual foi o principal tema abordado. Conclusão: as evidências científicas geradas fornecem subsídios para encorajar os profissionais de saúde na incorporação da temática sexualidade na rotina de atendimento, bem como a identificação de lacunas do conhecimento para a condução de novas pesquisas com o propósito de implementar intervenções para prevenir, minimizar e/ou controlar as alterações relacionadas à sexualidade do paciente. RESUMEN Objetivo: analizar las evidencias disponibles en la literatura sobre las alteraciones de la sexualidad de candidatos y receptores de trasplante de hígado. Método: revisión integradora mediante la búsqueda de estudios primarios en MEDLINE (vía PUBMED), CINAHL y LILACS, publicados en inglés, portugués o español. Resultados: los 16 estudios primarios incluidos se agruparon en tres categorías: 1) sexualidad femenina (n=5), 2) sexualidad masculina (n=5) y 3) sexualidad masculina y femenina (n=6). En la categoría 1, los temas investigados fueron contracepción, embarazo, disfunción sexual, presencia de síntomas ginecológicos e infección sexualmente transmisible. En la categoría 2, el foco principal de los estudios fue la disfunción eréctil, el deseo y la satisfacción sexual y las consecuencias del régimen inmunosupresor con ácido micofenólico en los hombres. En la categoría 3, la evaluación de la función sexual fue el principal tema abordado. Conclusión: las evidencias científicas halladas contribuyen para alentar a los profesionales de la salud a incorporar la temática sexualidad en la rutina de atención, así como identificar lagunas de conocimiento en la conducción de nuevas investigaciones con el propósito de efectuar intervenciones para prevenir, minimizar y/o controlar los cambios relacionados con la sexualidad del paciente.

Introduction: Biliary atresia (BA) is the most common cause of obstructive jaundice in the first months of life. If not treated promptly, BA rapidly progresses to biliary cirrhosis and eventually leads to early death. Objective: To estimate the incidence of BA in children under 1 year of age in Colombia and its territorial divisions (32 departments and one special district) for the period 2018-2021. Materials and methods: Cross-sectional study using secondary data. Cases of BA in children under 1 year of age officially reported in Colombia to the National Institute of Health (INS by its Spanish acronym) between 2018 and 2021 were analyzed. The annual incidence of BA was calculated by dividing the number of BA cases reported each year for children under 1 year of age at the time of notification by the number of live births (LBs) in that same year. Incidence was also calculated at the national level and in each of the country's territorial divisions (32 departments and 1 special district) for the period 2018-2021. Results: Between 2018 and 2021, 82 cases of BA were reported in children under 1 year of age in Colombia, of which 58.54% involved girls. The median age at the time of notification was 4.89 months. The incidence of BA in Colombia for the period 2018-2021, based on the number of cases reported for children under 1 year of age at the time of official notification of the event to the INS, was 3.23 cases per 100 000 LBs (annual range: 2.19 and 4.05 cases). The departments of Boyacá, Santander and Cauca had the highest incidence rates (7.5, 7.212 and 6.374 cases per 100 000 live births), while the departments of Magdalena, Córdoba and Bolívar had the lowest (0.747, 0.98 and 1.02 per 100 000 live births). Conclusions: The incidence of BA in Colombia for the period 2018-2021, based on the number of cases in which the age of notification was under 1 year, was 3.23 cases per 100 000 LBs, which is lower than what has been reported in other countries and regions. Introducción. La atresia biliar (AB) es la causa más común de ictericia obstructiva en los primeros meses de vida. Si no se trata de forma oportuna, la AB progresa rápidamente a cirrosis biliar y eventualmente lleva a la muerte temprana. Objetivo. Estimar la incidencia de la AB en menores de 1 año en Colombia y en sus divisiones territoriales (32 departamentos y un distrito especial) para el periodo 2018-2021. Materiales y métodos. Estudio transversal realizado con datos de fuente secundaria. Se analizaron los casos de AB en menores de 1 año notificados oficialmente en Colombia ante el Instituto Nacional de Salud entre 2018 y 2021. La incidencia anual de AB se calculó dividiendo el número de casos de AB reportados cada año en niños que eran menores de 1 año al momento de la notificación por el número de recién nacidos vivos (NV) en ese mismo año. También se calculó la incidencia nacional y en cada una de las divisiones territoriales del país (32 departamentos y 1 distrito especial) para el periodo 2018-2021. Resultados. Entre 2018 y 2021 se notificaron 82 casos de AB en menores de 1 año en Colombia, de los cuales 58.54% eran niñas. La mediana de edad al momento de notificación fue de 4.89 meses. La incidencia de AB en Colombia para el periodo 2018-2021, basada en el número de casos reportados en niños que tenían menos de 1 año al momento de la notificación oficial del evento ante el INS, fue 3.23 casos por cada 100 000 NV (rango anual: 2.19 y 4.05 casos). Los departamentos de Boyacá, Santander y Cauca tuvieron las tasas de incidencia más altas (7.5, 7.212 y 6.374 casos por cada 100 000 NV), mientras que los departamentos de Magdalena, Córdoba y Bolívar, las más bajas (0.747, 0.98 y 1.02 por cada 100 000 NV). Conclusiones. La incidencia de AB en Colombia para el periodo 2018-2021, basada en el número de casos en los que la edad de notificación fue menor a 1 año, fue de 3.23 casos por cada 100 000 NV, la cual es inferior a la reportada en otros países y regiones.

ABSTRACT Objective: to know the care provided by family caregivers of children submitted to hematopoietic stem cell transplantation. Method: the Grounded Theory was used as methodology. The study comprised four sample groups, comprising 36 caregivers. Data were collected by semi-structured interviews and analyzed according to the coding proposed by Strauss and Corbin in three phases: open, axial and selective. Results: eight propositions were identified for the care provided to the child in the researched context, namely administering medications; attention to cleaning issues; care with water and food intake; care with the body; experiencing protective isolation; addressing the child’s need for emotional support; addressing the child’s self-care; and facing complications. Conclusion: the different aspects in which the caregiver acts in the care of the child were understood. Such care equips the health team to elaborate measures for guidance and preparation of home care that are effective and directed to the needs of the patient and their family. The understanding of the care that they accomplish enables the caregiver a greater understanding of their role, as well as of the decisions they will make by their being under treatment. RESUMEN Objetivo: conocer los cuidados realizados por el cuidador familiar del niño después del trasplante de células madre hematopoyéticas. Método: se utilizó la Grounded Theory como metodología; comprendió cuatro grupos de muestreo, totalizando 36 cuidadores; utilizó datos recogidos por medio de entrevistas semiestructuradas, los datos fueron analizados según la codificación propuesta por Straus y Corbin, en tres fases: abierta, axial y selectiva. Resultados: fueron identificadas ocho proposiciones para los cuidados realizados al niño en el siguiente contexto investigado: administrar medicaciones; prestar atención a las cuestiones de limpieza; cuidados con ingesta hídrica y alimentar; cuidados con el cuerpo; experimentar el aislamiento protector; trabajar la necesidad de dar apoyo emocional al niño; abordar el autocuidado del niño; y, encarar las complicaciones. Conclusión: fueron comprendidas las diferentes vertientes en las cuales el cuidador actúa en el cuidado al niño. Esos cuidados instrumentalizan al equipo de salud para orientar la elaboración de medidas de orientación y preparación, para el cuidado domiciliar, que sean efectivas y dirigidas a las necesidades del paciente y su familia. La comprensión de los cuidados que realiza viabiliza al cuidador obtener mayor entendimiento de su papel, así como de las decisiones que tomará auxiliar a su familiar en tratamiento. RESUMO Objetivo: conhecer os cuidados realizados pelo cuidador familiar da criança em pós-transplante de células-tronco hematopoiéticas. Método: utilizou-se a Grounded Theory como metodologia; compreendendo quatro grupos amostrais, perfazendo 36 cuidadores; com dados coletados por entrevistas semiestruturadas. Os dados foram analisados segundo a codificação proposta por Strauss e Corbin, em três fases: aberta, axial e seletiva. Resultados: foram identificadas oito proposições para os cuidados realizados com criança no contexto pesquisado: administrar medicações; atentar às questões de limpeza; cuidados com ingesta hídrica e alimentar; cuidados com o corpo; experienciar o isolamento protetor; trabalhar a necessidade de apoio emocional da criança; abordar o autocuidado da criança; e encarar complicações. Conclusão: compreenderam-se as diferentes vertentes em que o cuidador atua no cuidado com a criança. Esses cuidados instrumentalizam a equipe de saúde ao nortear a elaboração de medidas de orientação e preparo para o cuidado domiciliar que sejam efetivas e direcionadas às necessidades do paciente e da família. A compreensão dos cuidados que realiza viabiliza ao cuidador maior entendimento do seu papel, bem como das decisões que tomará pelo seu ente em tratamento.

Abstract Objective: to identify the model, average length of stay on site and complications of central venous catheter in patients undergoing transplant of hematopoietic stem cells and verify the corresponding relationship between the variables: age, gender, medical diagnosis, type of transplant, implanted catheter and insertion site. Method: a retrospective and quantitative study with a sample of 188 patients transplanted records between 2007 and 2011. Results: the majority of patients used Hickman catheter with an average length of stay on site of 47.6 days. The complication fever/bacteremia was significant in young males with non-Hodgkin's lymphoma undergoing autologous transplant, which remained with the device for a long period in the subclavian vein. Conclusion: nurses should plan with their team the minimum waiting time, recommended between the catheter insertion and start of the conditioning regimen, as well as not to extend the length of time that catheter should be on site and undertake their continuing education, focusing on the prevention of complications. Resumen Objetivo: identificar el modelo, el tiempo medio de permanencia y las complicaciones del catéter venoso central en pacientes sometidos a trasplante de células madre hematopoyéticas y estimar la relación de correspondencia entre las variables: edad, sexo, diagnóstico médico, tipo de trasplante, catéter implantado y sitio de inserción. Método: estudio retrospectivo y cuantitativo con una muestra de registros de 188 pacientes trasplantados entre 2007 y 2011. Resultados: la mayoría de los pacientes utilizó el catéter Hickman con una permanencia media de 47,6 días. La complicación fiebre/bacteriemia fue significativa en los varones jóvenes con linfoma no Hodgkin sometidos a trasplante autólogo, que permanecieron con el dispositivo durante un largo período en la vena subclavia. Conclusión: los enfermeros deben planificar con el equipo, el tiempo de espera mínimo recomendado entre la inserción del catéter y el inicio del tratamiento de condicionamiento, así como no extender el período de permanencia del catéter y realizar su formación continua, centrándose en la prevención de complicaciones. Resumo Objetivo: identificar o modelo, tempo médio de permanência e complicações de cateter venoso central em pacientes submetidos ao transplante de células-tronco hematopoiéticas e verificar a relação de correspondência entre as variáveis: idade, sexo, diagnóstico médico, tipo de transplante, cateter implantado e local de inserção. Método: retrospectivo, quantitativo, com amostra de prontuários de 188 pacientes transplantados, entre 2007 e 2011. Resultados: a maioria dos pacientes utilizou o cateter de Hickman com permanência média de 47,6 dias. A complicação febre/bacteremia foi significante em jovens do sexo masculino, com linfoma não Hodgkin, submetidos ao transplante autólogo, que permaneceram com o dispositivo por longo período, em veia subclávia. Conclusão: os enfermeiros devem planejar com a equipe o aguardo do tempo mínimo preconizado entre o implante do cateter e início do regime de condicionamento, assim como não estender o período de permanência e realizar educação permanente, enfocando a prevenção das complicações.

El objetivo de este artículo es analizar el proceso de (in)securitización de las movilidades por salud definidas como “turismo de trasplante”. Específicamente indaga el surgimiento y circulación de la categoría “turismo de trasplantes”, así como ciertos usos políticos del concepto en regulaciones sobre trasplante y migración en Argentina. Sostiene que el “turismo de trasplantes” fue construido como un problema de (in)seguridad asociado a los peligros y amenazas que determinadas movilidades representan para el “orden nacional” de los trasplantes y para la “seguridad internacional” a partir de su asociación con modalidades ilícitas de extracción y comercialización de órganos. El artículo adopta una metodología cualitativa que articula análisis de diversas fuentes documentales y entrevistas con funcionarias/os de gobierno del contexto argentino. This article seeks to analyze the process of in(in)securitization of health mobilities defined as \"transplant tourism.” It focusses on the emergence and circulation of the \"transplant tourism\" category, as well as certain political uses of the concept in transplant and migration regulations in Argentina. It argues that \"transplant tourism\" was constructed as a problem of (in)security associated with the dangers and threats posed by certain types of mobilities to the \"national order\" of transplants and “international security,” because of its association with illicit forms of organ extraction and commercialization. The article uses a qualitative methodology combining the analysis of documentary sources with interviews with government officials in the Argentinean context.