ABSTRACT Introduction: Peritoneal dialysis patients are at increased risk of developing abdominal wall complications, including hernias. This study aimed to determine the incidence of hernias in peritoneal dialysis patients, identify risk factors, and evaluate their impact on technique survival. Methods: A retrospective cohort study was conducted, including prevalent peritoneal dialysis patients in a single center, from January 2010 to October 2020. Data on baseline characteristics, previous abdominal surgeries, and hernia history were collected. Patients with diagnosed hernias during peritoneal dialysis were compared to a control group. Results: Among 155 peritoneal dialysis patients, hernias occurred in 29% (n=45) of the population, with an incidence rate of 0.09 hernias/patient/year. Umbilical hernias were the most common subtype. Autosomal dominant polycystic kidney disease (OR (odds ratio) 3.925; 95% confidence interval (CI), 1.208 - 12.75) history of surgical repaired hernias (OR 5.586; 95% CI 1.540 - 20.255) and a higher number of previous abdominal surgeries (OR 1.680; 95% CI 1.025 - 2.752) were independent predictors of hernia development. Surgical treatment was performed in 59.3% of cases, with a 18.8% recurrence rate. Higher daytime infusion volumes were associated with hernia recurrence (p=0.045). Peritoneal dialysis technique survival did not differ significantly between the hernia and control groups (p=0.700). Conclusion: Hernias are frequent in peritoneal dialysis patients, with autosomal dominant polycystic kidney disease, previous abdominal surgeries, and history of surgically repaired hernias as identified risk factors. Hernias do not significantly interfere with peritoneal dialysis technique survival, but comprehensive management strategies, including early surgical repair and peritoneal dialysis prescription adaptations, can optimize outcomes.

ABSTRACT Cardiovascular disease continues to be the most frequent cause of death in peritoneal dialysis patients and an important obstacle for the improvement of technique survival. Heart failure diagnosis and management is particularly challenging among dialysis patients, and this condition remains underdiagnosed and undertreated in this population. The most common phenotype of heart failure among peritoneal dialysis patients is heart failure with preserved ejection fraction, diastolic disfunction and left ventricular hypertrophy. Unfortunately, unlike what happens with heart failure with reduced ejection fraction, there is lack of evidence to support a specific drug regimen to treat heart failure with preserved ejection fraction. Several conditions associated with end stage kidney disease, such as anemia, hyperphosphatemia, secondary hyperparathyroidism, inflammation, and insulin resistance seem to be involved in the pathogenesis of heart failure with preserved ejection fraction and for this reason, the term uremic cardiomyopathy has been proposed. There is a lack of evidence regarding the optimal heart failure treatment for peritoneal dialysis patients and more studies are needed to assess the efficacy and safety of the new drugs available for heart failure treatment. This review explores the spectrum of heart failure on peritoneal dialysis, its pathogenesis, risk factors and possible therapeutic and preventive measures.

ABSTRACT Chronic kidney disease is an increasingly common diagnosis in the very elderly and identifying the patients who benefit from a nephrologist’s intervention and the ones who would not might avoid wasteful or harmful interventions. The aim of this study is to identify the risk factos for progressive versus non‑progressive chronic kidney disease in a population aged over 80 years old. We performed a cohort single‑center retrospective study including 101 patients over 80 years old with chronic kidney disease diagnosed for at least five years and followed regularly by a nephrologist. Progressive disease was defined as glomerular filtration rate declines greater than 5 mL/min/1.73 m2/year. Of the 101 patients, 33.7% had progressive chronic kidney disease. The median glomerular filtration progression rate was 3.0 [2.1‑6.0] mL/min/1.73m2/year. Hypertension and diabetes mellitus prevalence was similar between groups. Nephrology follow‑up time was longer in the progressive group (5.0 vs 2.0 years, p=0.01). Regarding chronic kidney disease complications, 37.6% had anemia and half of these needed erythropoiesis‑stimulating agents. None of the patients had hyperphosphatemia. About 18.8% presented metabolic acidosis. In multivariable analysis, after adjusting for covariables such as age, hypertension, and diabetes mellitus only the presence of metabolic acidosis (OR 0.4, CI: 0.1‑0.8) was associated with the development of progressive chronic kidney disease. Progressive chronic kidney disease group presented higher mortality (log rank 4.5, p=0.03). Ischemic cardiomyopathy (OR: 0.5, CI: 0.2‑0.9) and progressive chronic kidney disease (OR: 0.6, CI:0.3‑0.8) were associated with all‑cause mortality. Our results showed that most elderly patients have non‑progressive chronic kidney disease. Patients with metabolic acidosis seem to be at an increased risk for developing progressive disease. Most elderly patients die before reaching end‑stage kidney disease, so it is importante to look at progressive kidney disease in those patients as an important marker of comorbidity and privilege cardioprotective measures.

ABSTRACT Coronavirus disease 2019 (COVID-19) has affected millions worldwide, and in particular the care of patients on maintenance hemodialysis. These patients are thought to be at high risk of severe SARS-CoV-2 infection due to their older age and multiple comorbidities. The aim of this study was to compare hemodialysis and non-dialysis COVID-19 patients and find possible risk factors for mortality in hemodialysis patients. We developed a single-center retrospective cohort study, from March 1st to December 31st, 2020, that included maintenance hemodialysis patients hospitalized with laboratory confirmed SARS-CoV-2 infection, and age and sex propensity matched non-dialysis patients also hospitalized with a laboratory confirmed SARS-CoV-2 infection (1:1). A total of 34 hemodialysis patients were included, 70.6% male, mean age 76.5 years and on maintenance hemodialysis for 3.0 [0.5-23] years. At admission, 50.0% needed oxygen supply. Median hospital stay duration was 11.0 [5.8-17.0] days, and 38.2% developed bacterial superinfection. Maintenance hemodialysis patient mortality rate was 32.4%. When matched to the non-dialysis group, the hemodialysis group developed more often respiratory insufficiency (50.0% vs 8.8%, p<0.001) and had higher ferritin (1658.0 vs 623.5, p=0.004) and troponin T (130.0 vs 31.0, p<0.001) levels, whereas the non-dialysis group had higher transaminases levels. There was no statistical difference regarding hospitalization time, bacterial superinfection, or mortality between groups. When the logistic regression was performed, only bacterial superinfection was a predictor for mortality in hemodialysis COVID-19 patients (0.01 [0.00-0.26]). There was no difference in hospital stay nor in death rate between hemodialysis and non-dialysis COVID-19 patients. Despite these results, we must emphasize that mortality in the dialysis group was particularly high, with up to 32% of in-hospital mortality, and that bacterial superinfection has been shown to be an independent predictor of mortality. These results highlight the importance of interventions, such as full vaccination coverage, to mitigate the burden of COVID-19 in hemodialysis patients.

Abstract The use of immune checkpoint inhibition (ICI) has revolutionized cancer treatment. However, these medications are associated with significant and potentially debilitating immune-related adverse events or even life threathing. While the majority of toxicities have been well studied, rheumatic complications have been less widely recognized and characterized. We describe a case study in which both performance status and quality of life of a patient where affected by rheumatological toxicity as wells the nurses’ role in the early recognition and toxicity’ management in order to enhance the patient’ quality of life.

Resumo Os Inibidores do Checkpoint Imunitário (ICI) revolucionaram o tratamento oncológico. Os efeitos adversos da imunoterapia decorrentes da administração dos inibidores do checkpoint imunitário podem ser graves e potencialmente fatais. Embora a maioria das toxicidades seja bem estudada e sobejamente relatada, as complicações reumatológicas são menos reconhecidas e caracterizadas. Descreve-se um estudo de caso em que tanto Performance Status como a qualidade de vida (QdV) de um doente foram afetados pela imunotoxicidade reumatológica bem como o papel do enfermeiro na sua deteção precoce e os cuidados de enfermagem prestados de forma a minimizar o seu impacto na QdV.

RESUMO A vasculite de Churg–Strauss, granulomatose eosinofílica com poliangeíte (EGPA), é uma vasculite sistêmica que afeta vasos de pequeno e médio calibre. É rara e pertence ao grupo de vasculites associadas a anticorpos anticitoplasma de neutrófilos (Anca). Apresenta-se um homem de 37 anos, com antecedentes de asma, que recorre ao SU por tosse produtiva com dois meses de evolução, dispneia ocasional em esforço, febre (uma semana de evolução), astenia e anorexia. Ao exame objetivo apresentava-se subfebril e taquicárdico. Analiticamente com leucocitose (17,00 x10^9/L) e eosinofilia de 20,0% (3,4 X10^9/L), creatinina de 1,5 mg/dL, discreta alteração das provas de função hepática e PCR de 10,82 mg/dL. Na radiografia de tórax objetivava-se infiltrado na base pulmonar direita. Por elevada suspeita de EGPA, iniciou prednisolona 80 mg desde a admissão. Anca MPO+, com restante estudo de autoimunidade negativo. Realizou TC tórax (sob corticoterapia) sem alterações de relevo, bem como lavado bronco-alveolar, sem sinais macroscópicos de hemorragia alveolar. Por sedimento urinário ativo, proteinúria na faixa nefrótica (6,56 g/24h) e lesão renal aguda, realizou biópsia renal que revelou glomerulonefrite crescêntica pauci-imune, com achados predominantemente agudos (no contexto de Vasculite Anca-MPO - EGPA). Após biópsia, realizou três pulsos de 1 g de metilprednisolona e iniciou ainda ciclofosfamida. Ficou assintomático e com recuperação da função renal. Este caso realça a importância de integração de todos os achados num só cenário a fim de evitar que escape o diagnóstico de uma doença mais complexa e com um tratamento específico.

SUMMARY Churg–Strauss syndrome, Eosinophilic granulomatosis with polyangiitis (EGPA), is a systemic vasculitis that affects small– to medium-sized vessels. It is rare and part of the Anti-neutrophil cytoplasm antibody-associated vasculitis (ANCA) group. We present a 37-year-old man, with a previous history of asthma, that was sent to the ED due to 2 weeks of productive cough, occasional dyspnea on exertion, fever (one week), asthenia, and anorexia. Upon physical examination, he was subfebrile and tachycardic. He had leukocytosis (17.00 x10^9/L) and eosinophilia of 20.0 % (3.4 X10^9/L), creatinine level of 1.5 mg/dL, subtle elevation on liver function tests and CRP of 10.82mg/dL. On Chest X-Ray, there was infiltrate on the right pulmonary base. Due to a strong suspicion of EGPA, he was started on 80mg of prednisolone from admission. ANCA MPO was positive, with the remaining auto-immune study negative. He underwent Thorax CT (under corticotherapy) without relevant changes, as well as bronchoalveolar lavage, without macroscopic signs of alveolar hemorrhage. Because of active urinary sediment, nephrotic proteinuria (6.5g/24h), and acute renal failure he underwent a renal biopsy, which revealed pauci-immune crescentic glomerulonephritis, with predominantly acute findings (in the context of ANCA-MPO Vasculitis – EGPA). After the biopsy, he received three 1g methylprednisolone pulses and was started on Cyclophosphamide. He remained asymptomatic and renal function was restored. This case highlights the importance of integrating all findings in one clinical scenario to prevent a more complex disease diagnosis, with a specific treatment, from being missed.

Resumo Contexto As varizes dos membros inferiores representam uma das doenças mais prevalentes na população mundial e resultam em grande impacto na qualidade de vida dos pacientes devido às limitações nas atividades diárias e no desempenho funcional. Vários autores têm ressaltado a importância da avaliação da qualidade de vida na abordagem de pacientes portadores de doença venosa crônica. Objetivos Avaliar a qualidade de vida antes e após o tratamento cirúrgico de pacientes portadores de varizes dos membros inferiores. Métodos Através de estudo de antes e depois, foram avaliados 92 portadores de varizes dos membros inferiores submetidos a tratamento cirúrgico. Os pacientes foram divididos em grupos de acordo com a faixa etária e a classificação clínica CEAP. A qualidade de vida foi avaliada através do questionário VEINES QOL/SYM, aplicado no pré-operatório e 60 dias após a operação. Resultados Do total de 92 indivíduos analisados, 82,6% (76) eram mulheres. Com relação à idade, a média foi de 45,7±12,11. A classe CEAP 2 foi a mais encontrada, em 57,6% dos pacientes. Foi encontrada diferença significativa entre os escores antes e após a cirurgia para os pacientes na faixa etária entre 30 e 40 anos. Não houve diferença entre os escores nos momentos pré e pós-operatório entre os grupos CEAP. Conclusões Não foi encontrada diferença na qualidade de vida antes e após a cirurgia na maioria dos pacientes do estudo.

Abstract Background Lower limb varicose veins are one of the most prevalent diseases in the global population. The disease is chronic and has a great impact on patients’ quality of life, limiting daily activities and functional performance. Several authors have emphasized the importance of including quality of life assessment in management of patients with chronic venous disease. Objectives To evaluate quality of life before and after surgical treatment of patients with varicose veins. Methods A before and after study design was employed. Ninety-two people with varicose veins of the lower limbs were treated surgically. Patients were divided into subsets according to age and CEAP clinical classification. Quality of life was assessed using the VEINES QOL/SYM questionnaire, administered during the preoperative period and 60 days after the operation. Results The sample comprised 92 subjects, 82.6% (76) of whom were women and mean age was 45.7±12.11 years. CEAP class 2 was the most frequent clinical classification, in 57.6% of patients. There was a significant difference in scores before and after surgery among patients aged from 30 to 40 years. There was no difference between preoperative and postoperative scores between different CEAP groups. Conclusions No difference in quality of life was observed after surgery in most of the patients in the present study.

Introdução: A obesidade infantil é um problema de Saúde Pública, para o qual os hábitos alimentares inadequados e a insuficiente prática de atividade física são fatores de risco e, atualmente, frequentes na população infantil. Objetivos: Este trabalho pretendeu avaliar a evolução ponderal e dos comportamentos de saúde de um grupo de crianças e adolescentes com pré-obesidade ou obesidade, utentes de uma Unidade de Cuidados de Saúde Primários portuguesa, seguidos em consulta de Nutrição. Avaliaram-se, também, alguns comportamentos de saúde nos respetivos cuidadores e averiguou-se se existia associação entre os comportamentos de ambos. Metodologia: Este estudo combinou uma vertente retrospetiva, com recolha de dados antropométricos e de comportamentos de saúde, a partir do processo clínico do utente e uma vertente transversal, com recolha de informação durante a consulta em que o participante aceitou pertencer ao estudo. Os cuidadores responderam a um questionário sobre os seus hábitos alimentares e de atividade física. Resultados: As 36 crianças e jovens incluídos no estudo (44,4% do sexo feminino; idade mediana de 14 anos) estavam a ser acompanhados, em mediana, há 3,6 anos, tendo o Z-Score para o Índice de Massa Corporal mediano descido significativamente desde a primeira consulta até à avaliação presente (2,70 vs. 2,18; p<0,001). Relativamente à aquisição de hábitos salutogénicos, a totalidade dos participantes passaram a tomar pequeno-almoço (no início faziam 91,7%), aumentou a proporção de crianças e adolescentes que ingeriam hortícolas ao almoço diariamente (30,6% vs. 69,4%), bem como de crianças que passaram a comer três peças de fruta por dia (11,1% vs. 33,3%). Os adolescentes eram os que mais praticavam o número de horas de atividade física recomendado. Não se observaram associações entre os hábitos dos cuidadores e os dos respetivos educandos. Conclusões: O acompanhamento de crianças e adolescentes com sobrecarga ponderal em consulta de Nutrição, nos Cuidados de Saúde Primários, mostrou-se eficaz na aquisição de hábitos salutogénicos e melhoria do estado nutricional.

Introduction: Childhood obesity is a Public Health challenge, for which inadequate food habits and insufficient physical activity are major risk factors and very common among children, nowadays. Objectives: The aim of this research was to assess the weight gain and health behaviors in a group of overweight or obese children and adolescents, accompanied by a nutritionist in a Portuguese primary health care unit. Some health behaviors were also evaluated in the caregivers and it was investigated if there was any association between the behaviors of both. Methodology: This study combined a retrospective approach, with collection of anthropometric and health behaviors from clinical records and a cross-sectional approach with data collection during the appointment where participant agreed to participate in the study. Caregivers answered a questionnaire about their food habits and physical activity. Results: The 36 children and adolescents, included in the study (44.4% females; median age of 14 years old) were followed-up for 3.6 years (median) and the median Z-Score for body mass index significantly decreased since the first appointment (2.70 vs. 2.18; p<0.001). Concerning the acquisition of salutogenic habits, it was observed that all participants started to eat breakfast (at the beginning only 91.7% took it), the proportion of youngers that daily consumed vegetables at lunch increased (30.6% vs. 69.4%), as well as the proportion of youngers that consumed three portions of fruit per day (11.1% vs. 33.3%). Adolescents are the ones that more frequently practice the recommended hours of physical activity. There were no associations between the behaviors of children and their caregivers. Conclusions: The follow-up of overweight and obese children and adolescents by a nutritionist, in primary health care, was effective in the acquisition of salutogenic behaviors and in the improvement of nutritional status.

Recently, Zika virus infection has been rapidly spreading, rising the cases of fetal abnormalities. A review was performed from February 2016 to January 2017, selecting articles that evaluated the fetal repercussions of maternal infection, considering fetal autopsies, clinical examinations and imagiology. The most frequent abnormalities were in the central nervous system, namely microcephaly, intracranial calcifications and ventriculomegaly. Death and fetal growth restriction were also reported. Anomalies in other systems were found to a lesser extent. Despite enough evidence proving this causality, it is important to document all these changes, allowing the comprehension of the virus' full width

A veia safena magna é usualmente utilizada como conduto em derivações vasculares. Sua degeneração e dilatação aneurismática são raras e têm causas desconhecidas. Este relato trata-se de um paciente masculino de 32 anos, hígido, que evolui, 19 anos depois de uma reconstrução arterial com enxerto venoso, com o aneurisma do enxerto. Foi tratado com substituição do mesmo por prótese de PTFE, evoluindo sem intercorrências. A microscopia mostrou área de dissecção da parede do enxerto com deposição de células espumosas.

The saphenous vein is usually used as a conduit in vascular bypass. Its degeneration and aneurysm are rare and have unknown causes. This report comes from a male patient 32 years old, healthy, evolving, 19 years later of an arterial reconstruction with venous graft with the aneurysm of this graft. He was treated with replacement of it by PTFE bypass, evolving without complications. Microscopy showed dissection area of the graft wall with deposition of foam cells.

CONTEXTO: A insuficiência renal crônica é uma doença de alta prevalência e morbidade, o que determina queda da qualidade de vida. Pacientes em hemodiálise necessitam de um acesso vascular que permita a conexão da circulação do paciente ao circuito externo de hemodiálise. Dentre os acessos disponíveis, as fístulas arteriovenosas (FAV) são as que mais se aproximam do acesso ideal. OBJETIVO: Avaliar a perviedade precoce das FAV, identificando os fatores relacionados ao insucesso destas. MÉTODOS: Foram acompanhados todos os pacientes submetidos à confecção das FAV no Hospital do Servidor Público Municipal de São Paulo, no período de agosto de 2008 a janeiro de 2009, avaliando-se a perviedade destas no 1º, 10º e 30º pós-operatório. Foram realizadas 31 FAV no período, apresentando-se média de idade de 63,06 anos, sendo 18 pacientes do sexo masculino e 13 do feminino. RESULTADOS: Vinte e seis FAV foram distais, todas radiocefálicas; quatro foram proximais, das quais duas braquiocefálicas e duas braquiobasílicas superficializadas; uma FAV confeccionada com alça de politetrafluoretileno (PTFE) fêmoro-femoral esquerda. A taxa de perviedade no primeiro mês foi de 71% dos casos. O uso de cateteres venosos centrais apresentou-se como fator de risco para oclusão da FAV (p=0,01). As FAV continuam sendo o acesso vascular para hemodiálise mais aceito e mais seguro. A indicação precoce para confecção das FAV é de fundamental importância, evitando-se, assim, o uso de cateteres e suas complicações. CONCLUSÕES: A perviedade precoce encontrada neste estudo é semelhante à da literatura, e o uso prévio de cateteres é o fator de risco mais significativo para oclusão precoce desta.

BACKGROUND: Chronic renal failure is a disease of high prevalence and high morbidity, which impairs the patients' quality of life. Patients on hemodialysis need a vascular access for connection with the hemodialysis equipment. Arteriovenous fistulas (AVF) are the best option for this purpose. OBJECTIVE: To evaluate the early patency of AVFs and to identify the causes of their failure. METHODS: All patients AVF underwent operations for dialysis from August, 2008 to January, 2009. The AVF patency was evaluated on the 1st, 10th and 30th postoperative days. Thirty-one operations for AVF were performed in our hospital in the period; 18 patients were males and the mean age was 63.03 years. RESULTS: Twenty-six AVF were distal, all radial-cephalic; four were proximal, out of which two were brachiocephalic and two were brachiobasilic; one AVF was a femoral-femoral loop PTFE graft. The patency rate in the first month was of 71%. The use of central venous catheters was a risk factor for AVF occlusion (p=0.01). AVF remains the most accepted and safe vascular access. Early performance of the AVF is very important to avoid the complications resulting from long-term use of central venous catheters. CONCLUSIONS: Data regarding early patency found in this study were similar to those found in literature, and the use of central venous catheters before performing AVF is an important risk factor for occlusion.

A insuficiência renal crônica (IRC) tem alta prevalência e a maior parte dos pacientes acometidos está em programa de hemodiálise necessitando, portanto, de acesso vascular. As fístulas arteriovenosas (FAV) são os acessos mais indicados e duradouros. Mesmo em casos de complicações, deve-se tentar o salvamento desses acessos. Trabalhos da literatura mostram a possibilidade de salvamento das FAV's, mesmo de maneira tardia. Deve-se tentar sempre a reparação do acesso atual, evitando o esgotamento do sistema venoso. Este trabalho relata o caso de uma paciente de 69 anos com IRC apresentando uma trombose de FAV braquiocefálica com drenagem para veia basílica por ramos colaterais, o que a tornou maturada. Essa veia foi utilizada no reparo do acesso, evitando o uso de cateteres.

Chronic renal insufficiency (CRI) has high prevalence and the majority of the patients are in hemodialysis program and, then, they need a vascular access. Arteriovenous fistulas (AVF) are the more indicated accesses and have a long term use. Even in cases of complications, the salvage of theses accesses must be tried. Researches of literature show the possibility of access salvage of AFV's, even in a long time after the complication. The repair of thepresent access must always be tried, avoiding the depletion of the venous system. This study is a case report of a 69 years-old female patient with CRI presenting thrombosis of a brachial-cefalic AFV with drainage to basilic vein by collateral branches, which maturated that vein. Basilic vein was used on the access repair, avoiding catheter use.

A luxação traumática do joelho está associada a extensos danos músculo-ligamentares. Quando lesões neurovasculares estão presentes, o prognóstico é agravado e a viabilidade da extremidade torna-se francamente ameaçada. Em caso de lesão arterial poplítea, a abordagem deve ser feita o quanto antes sob pena de perda do membro, que, em algumas séries, alcança 80%. Os autores relatam o caso de um paciente jovem vítima de luxação traumática do joelho esquerdo associada a fraturas do acetábulo e da diáfise do fêmur ipsilaterais, com diagnóstico tardio (no quinto dia pós-trauma) de lesão da artéria poplítea. O paciente foi submetido a revascularização do membro e teve evolução satisfatória apesar da gravidade da lesão vascular, contrariando a evolução encontrada na literatura do trauma de artéria poplítea tratado tardiamente.

Traumatic knee dislocation is associated with massive muscle damage. When there are neurovascular lesions, prognosis is even worse and the limb viability is threatened. Popliteal artery lesions should be treated as soon as possible to prevent risk of limb loss, which can reach up to 80% in some case series. We report a case of a young patient who had traumatic knee dislocation associated with ipsilateral acetabular and femoral body fractures with late diagnosis (on the fifth day after the trauma) of popliteal artery lesion. The patient underwent limb revascularization with good outcome despite the severity of the lesion, which is in disagreement with the usual outcomes reported in the literature for the popliteal artery trauma with delayed treatment.

Cateteres venosos de longa permanência são amplamente utilizados em pacientes com necessidade de acesso venoso por período prolongado. A infecção relacionada a esses cateteres permanece um desafio na prática clínica. Revisamos a literatura acerca da epidemiologia e tratamento das infecções relacionadas a cateteres. Staphylococcus aureus é a bactéria mais comumente isolada. Os cateteres semi-implantáveis apresentam taxas de infecção maiores que os totalmente implantáveis. O tratamento pode ser feito com locks, antibioticoterapia sistêmica e até mesmo com retirada do cateter, dependendo do tipo de infecção, do microrganismo isolado e das condições clínicas do paciente. O salvamento do cateter deve ser tentado sempre que possível.

Long-term venous catheters are widely used in patients with needs of venous access for prolonged periods. The infection related to these catheters remains a challenge in clinical practice. We reviewed the literature about infection epidemiology and treatment related to catheters. Staphylococcus aureus is the most common isolated bacteria. Tunneled catheters present higher infection rates than implanted ports. Treatment may consist in the use of locks, systemic antibiotics, and even catheter removal, depending on the kind of infection, the isolated microorganism, and the patient's clinical conditions. Catheter salvation should be tried whenever possible.