Uso do cateter central de inserção periférica em pacientes adultos: uma perspectiva para a enfermagem oncológica / Use of the peripherally inserted central catheter in adult patients: a perspective for oncology nursing / Uso del catéter central de inserción periférica en pacientes adultos: una perspectiva para la enfermería oncológica

Objetivo: Identificar a perspectiva para a enfermagem oncológica da utilização do PICC em pacientes adultos. Método: Revisão integrativa estruturada por estudos indexados nas bases de dados LILACS, MEDLINE e SciELO, incluindo artigos publicados entre os anos de 2015 e 2019, que abrangessem a experiência do PICC em pacientes adultos oncológicos. Resultados: Identificou-se inicialmente um total de 140 publicações, das quais nove compuseram a amostra final. O conteúdo permitiu a estruturação de quatro subtemas: comparação com outros dispositivos de acesso vascular; percepções de médicos e enfermeiros sobre o acesso venoso; experiência do paciente; e eventos adversos relacionados ao cateter. Assim, epilogou-se o aproveitamento de PICCs para o tratamento anticâncer, obtendo uma imagem clara do cenário de sua utilização na assistência de enfermagem oncológica. Conclusão: O PICC cresceu no escopo da enfermagem oncológica como tecnologia para acesso vascular. Entretanto, a perenidade do seu sucesso está inegavelmente vinculada à classificação adequada do cliente quanto à vulnerabilidade em desenvolver complicações e aos cuidados de enfermagem pós-inserção. A depender da preferência pessoal de oncologistas e usuários, o cenário futuro do PICC no tratamento de pacientes adultos com câncer é incerto.(AU)

Objective: To identify the perspective for oncology nursing of the PICC use in adult patients. Method: Integrative review structured by studies indexed in LILACS, MEDLINE, and SciELO databases, including articles published between the years 2015 and 2019 covering the experience of the PICC in adult oncology patients. Results: Initially, a total of 140 publications were identified, nine of which comprised the final sample. The content allowed the structuring of four subthemes: comparison with other vascular access devices; physicians' and nurses' perceptions of venous access; patient experience; and catheter-related adverse events. Thus, the use of PICCs for anticancer treatment was compiled, obtaining a clear picture of the scenario of their use in oncology nursing care. Conclusion: The PICC has grown in the scope of oncology nursing as a technology for vascular access. However, the longevity of its success is undeniably linked to the appropriate classification of the client as to vulnerability to develop complications and to the post-insertion nursing care. Depending on the personal preference of oncologists and users, the future scenario of the PICC in the treatment of adult cancer patients is uncertain.(AU)

Objetivo: Identificar la perspectiva para la enfermería oncológica del uso de PICC en pacientes adultos. Método: Revisión integradora estructurada por estudios indexados en las bases de datos LILACS, MEDLINE y SciELO, incluyendo artículos publicados entre los años 2015 y 2019, que abarquen la experiencia de PICC en pacientes oncológicos adultos. Resultados: Se identificó inicialmente un total de 140 publicaciones, de las cuales nueve conformaron la muestra final. El contenido permitió estructurar cuatro subtemas: comparación con otros dispositivos de acceso vascular; percepciones de médicos y enfermeros sobre el acceso venoso; experiencia del paciente; y eventos adversos relacionados con el catéter. Así, se epilogó el uso de los PICC para el tratamiento del cáncer, obteniendo un panorama claro del escenario de su uso en los cuidados de enfermería oncológica. Conclusión: El PICC ha crecido en el ámbito de la enfermería oncológica como tecnología para el acceso vascular. Sin embargo, la continuidad de su éxito está innegablemente ligada a la adecuada clasificación del cliente en cuanto a la vulnerabilidad en el desarrollo de complicaciones y a los cuidados de enfermería tras la inserción. Dependiendo de las preferencias personales de los oncólogos y de los usuarios, el escenario futuro del PICC en el tratamiento de pacientes adultos con cáncer es incierto.(AU)

Liquid-based cytology and HPV DNA testing using intra-anal specimens from HIV-negative women with and without genital HPV-induced lesions.

BACKGROUND: Screening for anal cancer using cytology has not been considered in immunocompetent women. The aim of this study was to identify cytological atypia and human papillomavirus (HPV) DNA in intra-anal specimens from human immunodeficiency virus (HIV)-negative women with and without genital HPV lesions. METHODS: This study was a cross-sectional analysis of 142 women who were negative for the HIV: 80 with genital lesions that were associated with HPV and 62 without HPV-induced lesions. The women were evaluated at the Federal University of Ceará from October 2011 to June 2012. The statistical analysis included the Fisher exact test and the odds ratio (CI 95%). RESULTS: Atypical anal cytology was observed in 24 (29.3%) patients in the study group and in 11 (17.8%) patients in the control group. In cases with at least two sites of HPV-associated lesions, 12 (41.4%) presented atypical cytology (P = 0.0220; OR = 2.7621, 1.1579-6.5889). When the practice of anal sex was evaluated, atypical cytology was observed in 22/43 (34%) [P = 0.0214; OR = 2.519, 1.146-5.534]. HPV DNA was detected in 17/27 (63%) cases with at least two sites of lesions (P = 0.0293, OR = 2.4855, 1.0960-5.6367). In the 33 cases who presented positive HPV DNA test results, the liquid-based cytology results were atypical (P = 0.0212, OR = 2.8, 1.1665-6.7208). CONCLUSION: Based on the results, liquid-based cytology may be used to detect intra-anal lesions, especially among women who have a history of anal intercourse or who have genital HPV-associated lesions at multiple sites.