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OBJECTIVE: Kidney shortage for pediatric kidney transplantation (PKT) entails the need to use low-weight and age donors, despite the apprehension. The aim of this study was to analyze the pediatric deceased donor kidney transplantations (pDDKT) outcomes in the first year after the procedure, stratified by donor age. METHOD: Retrospective cohort of pDDKTs carried out between January 2013, and January 2018, at a PKT reference hospital in Southern Brazil. Donors were divided into group 1 (≤ 6 years), and group 2 (> 6 years); the analysis of the outcomes was carried out in the same period. RESULTS: There were 143 pDDKTs; 51 (35.66%) in group 1; and 92 (64.34%) in group 2. In both groups there were 17 graft losses (11.8%), with vascular thrombosis as the main cause (group 1: 5; group 2: 4). Among the complications, renal artery stenosis (RAS) with indication for angioplasty and stenting was more frequent in group 1 (7.8%; group 2: 2.2%). The 1-year Renal Transplant Recipients' and graft survival did not show significant differences between the groups, (p = = 0.95). However, the Glomerular Filtration Rate analysis was higher in group 2, reaching, in the 12th month, 79.3 mL/min/1,73m2, compared to 69.7 mL/min/1,73m2 in group 1(p = = 0.033). CONCLUSIONS: Small donors can be considered for pDDKTs, as long as there is an expert team to perform the transplantation.
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Trasplante de Riñón , Humanos , Niño , Estudios Retrospectivos , Rechazo de Injerto/etiología , Donantes de Tejidos , Riñón , Supervivencia de Injerto , Resultado del TratamientoRESUMEN
Abstract Objective Kidney shortage for pediatric kidney transplantation (PKT) entails the need to use low-weight and age donors, despite the apprehension. The aim of this study was to analyze the pediatric deceased donor kidney transplantations (pDDKT) outcomes in the first year after the procedure, stratified by donor age. Method Retrospective cohort of pDDKTs carried out between January 2013, and January 2018, at a PKT reference hospital in Southern Brazil. Donors were divided into group 1 (≤ 6 years), and group 2 (> 6 years); the analysis of the outcomes was carried out in the same period. Results There were 143 pDDKTs; 51 (35.66%) in group 1; and 92 (64.34%) in group 2. In both groups there were 17 graft losses (11.8%), with vascular thrombosis as the main cause (group 1: 5; group 2: 4). Among the complications, renal artery stenosis (RAS) with indication for angioplasty and stenting was more frequent in group 1 (7.8%; group 2: 2.2%). The 1-year Renal Transplant Recipients' and graft survival did not show significant differences between the groups, (p= = 0.95). However, the Glomerular Filtration Rate analysis was higher in group 2, reaching, in the 12th month, 79.3 mL/min/1,73m2, compared to 69.7 mL/min/1,73m2 in group 1(p= = 0.033). Conclusions Small donors can be considered for pDDKTs, as long as there is an expert team to perform the transplantation.
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Objetivo: elaborar um modelo técnico-assistencial de enfermagem para pacientes de transplante renal. Método: desenvolvimento de modelo técnico-assistencial fundamentado nas teorias de Orem e Watson baseado na pesquisa convergente assistencial. O cenário foi um Centro Transplantador da região sul do Brasil. Coleta de dados - diagnóstico das atividades realizadas no serviço de transplante renal; entrevista semiestruturada com pacientes; e três grupos focais com enfermeiros. Participaram nove pacientes de transplante renal e dez enfermeiros que atuam nas fases do perioperatório. Utilizou-se análise de conteúdo. Resultados: categorias emergidas dos pacientes - expectativas do transplante renal; informação sobre o tratamento após transplante; mudança no estilo de vida após o adoecimento; importância do autocuidado; sentimentos envolvidos no transplante renal e melhorias do centro transplantador. Conclusão: o modelo desenvolvido foi fundamentado nas teorias de Watson e Orem contemplando integralidade, promoção do autocuidado e atuação do enfermeiro, bem como necessidades apontadas pelos pacientes.
Objective: to develop a model of nursing technical care for kidney transplant patients. Method: development of a technical care model based on the theories of Orem and Watson based on convergent care research. The setting was a Transplant Center in southern Brazil. Data collection - diagnosis of activities performed in the kidney transplant service; semi-structured interview with patients; and three focus groups with nurses. Nine kidney transplant patients and ten nurses who work in the perioperative period participated. Content analysis was performed. Results: categories emerged from patients - expectations of kidney transplantation; information about treatment after transplantation; lifestyle changes after illness; importance of self-care; feelings involved in kidney transplantation; and transplant center improvements. Conclusion: the developed model was based on Watson and Orem's theories and contemplated comprehensiveness, promotion of self-care and the role of nurses, as well as needs identified by patients.
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Trasplante de Riñón , Modelos de Atención de Salud/tendencias , Enfermería PerioperatoriaRESUMEN
Com a recente atualização do Código de Ética dos Profissionais de Enfermagem, essa tornou-se conhecida apenas por parte dos profissionais. Objetivo: avaliar o conhecimento dos enfermeiros sobre o Código de Ética dos Profissionais de Enfermagem. Método: Trata-se de um estudo observacional, descritivo e transversal, com dados coletados no período de setembro a outubro de 2018, por meio de um questionário online, via Plataforma Google Forms®. Participaram da pesquisa 217 enfermeiros, sendo 190 (87,46%) do sexo feminino e 27 (12,44%) do sexo masculino. Resultado: Em relação aos direitos, os participantes obtiveram respostas semelhantes, considerando a alternativa mais coerente. Quanto aos deveres e proibições, apresentaram grande diversidade e discordância entre as alternativas escolhidas, demonstrando dúvida ou equívoco por parte dos participantes. Conclusão: Foi possível observar que o conhecimento dos enfermeiros acerca do Código de Ética Profissional de Enfermagem é limitado em relação aos deveres e proibições da profissão.(AU)
With the recent update of the Nursing Professionals Code of Ethics, this became known only by professionals. Objective: to evaluate nurses' knowledge of the Nursing Professionals Code of Ethics. Method: This is an observational, descriptive and cross-sectional study, with data collected from September to October 2018, through an online questionnaire, via the Google Forms® Platform. 217 nurses participated in the research, 190 (87.46%) female and 27 (12.44%) male. Result: Regarding rights, the participants obtained similar responses, considering the most coherent alternative. As for duties and prohibitions, they showed great diversity and disagreement between the alternatives chosen, showing doubt or misunderstanding on the part of the participants. Conclusion: It was possible to observe that the nurses' knowledge about the Nursing Professional Code of Ethics is limited in relation to the duties and prohibitions of the profession.(AU)
Con la reciente actualización del Código de Ética de los Profesionales de Enfermería, esto solo se dio a conocer por los profesionales. Objetivo: evaluar el conocimiento de los enfermeros sobre el Código de Ética para Profesionales de Enfermería. Método: Se trata de un estudio observacional, descriptivo y transversal, con datos recolectados de septiembre a octubre de 2018, a través de un cuestionario en línea, vía Google Forms® Platform. En la investigación participaron 217 enfermeras, 190 (87,46%) mujeres y 27 (12,44%) hombres. Resultado: En cuanto a derechos, los participantes obtuvieron respuestas similares, considerando la alternativa más coherente. En cuanto a deberes y prohibiciones, mostraron gran diversidad y desacuerdo entre las alternativas elegidas, mostrando dudas o incomprensiones por parte de los participantes. Conclusión: se pudo observar que el conocimiento de las enfermeras sobre el Código de Ética Profesional de Enfermería es limitado en relación a los deberes y prohibiciones de la profesión.(AU)
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Humanos , Códigos de Ética , Ética en Enfermería , Ética Profesional , Conocimiento , Rol de la Enfermera , Enfermeras y EnfermerosRESUMEN
O artigo tem o objetivo de determinar a frequência de neoplasia intraepitelial cervical (NIC) e de papilomavírus humano (HPV) no Rio Grande do Sul (RS). Tratou-se de um estudo retrospectivo, em que se analisou a frequência de NIC e de HPV no RS durante o período de janeiro de 2015 a junho de 2018. Foram analisados 1.249 laudos histopatológicos de colo uterino, tendo sido possível observar na análise global que a maioria dos casos se manteve estável (183 casos), porém 107 progrediram em um nível. Dos 64 casos de NIC I em 2015, 12 apresentaram a presença de HPV; em 2016, 19 casos de NIC I, e todos com HPV; em 2017 teve uma diminuição de casos de NIC I mais HPV (12 casos). Até junho de 2018, apenas 2 casos de HPV foram registrados. Com este estudo, ficou evidente que, na população estudada, houve diminuição no número de casos de NIC (22%), o que pode estar relacionado a campanhas e incentivo aos cuidados com a saúde e prevenção.(AU)
The article aims to determine the frequency of cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV) in Rio Grande do Sul (RS). This was a retrospective study, in which the frequency of CIN and HPV in RS, from January 2015 to June 2018, was analyzed. 1,249 cases of histopathological reports of the cervix were analyzed, being It is possible to observe in the global analysis that the majority of cases remained stable (183 cases), but 107 progressed at one level. Of the 64 cases of CIN I in 2015, 12 presented the presence of HPV, in 2016, 19 cases of CIN I, and all with HPV, in 2017 there was a decrease in cases of CIN I plus HPV (12 cases). As of June 2018, only 2 cases of HPV have been reported. With this study it was evident that in the studied population there was a decrease in the number of CIN cases (22%), which may be related to campaigns and incentives to health care and prevention.(AU)
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Humanos , Femenino , Neoplasias del Cuello Uterino/epidemiología , Infecciones por Papillomavirus/epidemiología , Papillomaviridae/patogenicidad , Brasil/epidemiología , Registros de Enfermedades , Estudios Transversales , Indicadores de SaludRESUMEN
The aim of this study was to investigate whether co-culture of human islets with adipose-derived stem cells (ASCs) can improve islet quality and to evaluate which factors play a role in the protective effect of ASCs against islet dysfunction. Islets and ASCs were cultured in three experimental groups for 24 h, 48 h, and 72 h: 1) indirect co-culture of islets with ASC monolayer (Islets/ASCs); 2) islets alone; and 3) ASCs alone. Co-culture with ASCs improved islet viability and function in all culture time-points analyzed. VEGFA, HGF, IL6, IL8, IL10, CCL2, IL1B, and TNF protein levels were increased in supernatants of islet/ASC group compared to islets alone, mainly after 24 h. Moreover, VEGFA, IL6, CCL2, HIF1A, XIAP, CHOP, and NFKBIA genes were differentially expressed in islets from the co-culture condition compared to islets alone. In conclusion, co-culture of islets with ASCs promotes improvements in islet quality.