Despite improvements in care and rehabilitation of burned patients, infections still remain the main complication and death cause. Catheter-related infections are among the four most common infections and are associated with skin damage and insertion site colonization. There are few studies evaluating this kind of infection worldwide in this special group of patients. Padre Albino Hospital Burn Care Unit (PAHBCU) is the only reference center in the Northwestern São Paulo for treatment of burned patients. This paper presents the results of a retrospective study aiming at describing the epidemiological and clinical features of catheter-related infections at PAHBCU.

OBJETIVOS: avaliar o desempenho da colpocitologia oncológica (CO) e da Captura de Híbridos II (CHII) para o diagnóstico de lesão cervical histológica significativa (NIC2/3) em mulheres encaminhadas com CO contendo atipias celulares de significado indeterminado (ASCUS) ou lesão escamosa intra-epitelial de baixo grau (LSIL). MÉTODOS: estudo de corte transversal no qual foram incluídas 161 mulheres encaminhadas, entre agosto de 2000 e setembro de 2002, devido a CO com resultado de ASCUS ou LSIL. As mulheres responderam a questionário específico sobre características sociodemográficas e reprodutivas e foram submetidas a exame ginecológico com coleta de CO e CHII, sendo realizada colposcopia com eventual biópsia de áreas suspeitas. Foi aplicado o teste do qui-quadrado para as associações da idade, uso de condom, uso de anticoncepcional oral e tabagismo com os resultados da CHII. Foram calculados a sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo da CO e da CHII para detectar NIC2/3. Todos os cálculos foram realizados com intervalos de confiança estatística de 95%. RESULTADOS: sessenta e sete porcento das mulheres com menos de 30 anos de idade tiveram testes positivos para o HPV. A CO e CHII tiveram sensibilidade de 82% em detectar NIC2/3 quando considerados como positivos ASCUS, LSIL ou HSIL. Quando se consideram como positivas apenas as CO com HSIL, este exame apresenta acentuado ganho de especificidade (de 29 para 95%) e valor preditivo positivo (de 12 para 50%), superando a CHII, porém com redução igualmente significativa de sua sensibilidade (de 82 para 41%). CONCLUSÕES: nossos resultados indicaram grande potencial da CHII para detectar mulheres com NIC2/3 entre as pacientes com ASCUS/LSIL na CO de encaminhamento.

OBJECTIVE: to assess the ability of Pap smear and hybrid capture II (HCII) to detect clinically significant cervical lesions (CIN2/3) in women referred to hospital due to atypical squamous cells of unknown significance (ASCUS) or low-grade squamous intraepithelial lesions (LSIL). METHODS: a cross-sectional study comprising 161 women referred to the Taubaté University Hospital due to ASCUS/LSIL, between August 2000 and September 2002. All women responded to a questionnaire regarding sociodemographic and reproductive characteristics and were subjected to gynecological examination with specimen collection for Pap test and HCII, along with colposcopy and eventual cervical biopsy. The relationship between HCII results and age, use of condom, oral hormonal contraception, and smoking were evaluated by the chi-square test. The sensitivity, specificity, positive and negative predictive values of both Pap test and HCII were calculated. All calculations were performed within 95% confidence intervals. RESULTS: sixty-seven percent of the women that tested positive for HPV were less than 30 years old. Pap smear and HCII showed the same 82% sensitivity in detecting CIN2/3 when the threshold for a positive Pap result was ASCUS, LSIL or HSIL. Pap smear specificity and positive predictive values were substantially increased when only HSIL results were considered as positive (from 29 to 95% and 12 to 50%, respectively). These figures were superior to those of HCII, but at the expense of an expressive loss of sensitivity (from 82% to 41%). CONCLUSIONS: our results substantiate the potential of HCII in detecting CIN2/3 among women referred due to ASCUS/LSIL.

OBJETIVO: avaliar a presença do DNA do papilomavírus humano (HPV) de alto risco oncológico antes e quatro meses após excisão da zona de transformação com alça diatérmica em mulheres com neoplasia intra-epitelial cervical (NIC). MÉTODOS: neste estudo clínico prospectivo foram incluídas 78 mulheres submetidas à excisão da zona de transformação tratadas no período de fevereiro a dezembro de 2001. Todas foram submetidas a colposcopia, citologia oncológica e captura híbrida II (CH II) antes da cirurgia e após 4±1,25 meses. Para análise estatística utilizou-se o cálculo do odds ratio (OR) com intervalo de confiança de 95% (IC 95%). RESULTADOS: antes da excisão, 67 (86%) mulheres apresentavam CH II positiva para DNA-HPV de alto risco oncológico e destas, apenas 22 (33%) mantiveram a CH II positiva quatro meses após. A detecção do DNA-HPV após o tratamento não se relacionou com a carga viral prévia, presença de doença nas margens da peça cirúrgica ou idade da mulher. Após quatro meses, a detecção do DNA-HPV associou-se significativamente com a presença de alterações citológicas (OR = 4,8; IC 95% = 1,7-13,7), porém não se relacionou com doença residual ou recidiva histológica (OR = 6,0; IC 95% = 0,8-52,3). CONCLUSÃO: após o tratamento da NIC, a detecção do DNA-HPV diminuiu significativamente porém não se observou relação com a presença de doença residual ou recidiva histológica.

PURPOSE: to evaluate the detection of high oncogenic risk human papillomavirus DNA (HPV-DNA) immediately before and 4±1.25 months after large loop excision of the transformation zone (LLETZ) in the treatment of cervical intraepithelial neoplasia (CIN). METHODS: in this clinical prospective study, 78 patients submitted to LLETZ from February to December 2001 were enrolled. All patients were submitted to colposcopic evaluation and had Pap smear and hybrid capture II (HC II) specimens collected immediately before LLETZ and four months after the procedure. Statistical analysis was made through odds ratio (OR) calculations with 95% confidence interval (95% CI). RESULTS: before excision, 67 (86%) women had positive HC II for high oncogenic risk HPV-DNA, while four months afterwards only 22 (33%) maintained positive HC II results. Positive results of HPV-DNA after treatment were not associated with previous viral load, compromised margins in the surgical specimen or age. Four months after the procedure, detection of HPV-DNA was significantly associated with cytological abnormalities (OR = 4.8; CI 95%: 1.7-13.7) but not with histological residual disease or relapse (OR = 6.0; CI 95%: 0.8-52.3). CONCLUSION: HPV-DNA detection was significantly reduced after treatment of CIN, but was not associated with the presence of histologic residual disease or relapse.