High levels of preoperative state-anxiety, administration of less than 0.056 mg x kg(-1) of midazolam, absence of analgesic block and presence of moderate and intense postoperative pain constituted risk factors for immediate postoperative state-anxiety in children. Previous surgery reduced the risk for postoperative anxiety.

Objective: to evaluate and compare the early postoperative period systemic inflammatory response between elderly and non-elderly patients submitted to laparoscopic cholecystectomy, mainly performing a quantitative analysis of interleukin-6 (IL-6), a marker of inflammatory activity systemic. Methods: we compared a series of cases over a period of six months at the Gaffrée and Guinle University Hospital of the Federal University of the State of Rio de Janeiro, involving 60 patients submitted to elective laparoscopic cholecystectomy. We used non-probabilistic sampling for convenience, selecting, from the inclusion criteria, the first 30 patients aged 18-60 years, who comprised group I, and 30 patients with age equal to or greater than 60 years, who formed group II. Results: the 60 patients involved were followed for at least 30 days after surgery and there were no complications. There was no conversion to open surgery. The values of the medians found in the IL-6 dosages for the preoperative period, three hours after the procedure and 24 hours after surgery were, respectively, 3.1 vs. 4.7 pg/ml, 7.3 vs. 14.1 pg/ml and 4.4 vs 13.3 pg/ml. Conclusion: Elderly patients were more responsive to surgical trauma and had elevated IL-6 levels for a longer period than the non-elderly group.

-Background -The main base in surgical treatment of colorectal cancer is en-bloc removal of the tumor with adequate proximal and distal margins, combined with the removal of lymph nodes. Aim -To evaluate factors associated with the number of lymph nodes found in surgical specimens from patients with colorectal cancer. Methods -Analysis of a retrospective data of consecutive patients operated with a diagnosis of colorectal adenocarcinoma. Were excluded those undergoing palliative surgery. Demographic data, operative and histopathological findings were analyzed using the Fisher exact test, chi-square, Wilcoxon rank-sum and a logistic regression model. Results -From 2000 to 2008, were operated 298 patients with colorectal cancer. The data included in the analysis were available for 173 patients. Of these, 85 (49%) were female and median age was 65 (26-94) years. The resection was the most common left colectomy (45%), followed by right colectomy (23%). The median number of lymph nodes were isolated from eight (0-67) and 33% of patients had 12 or more lymph nodes identified in surgical specimens. Patients younger than 50 years and those who underwent right colectomy had a greater number of lymph nodes isolated. Conclusions -Patient age less than 50 years and the type of surgical resection are associated with higher number of lymph nodes found in surgical specimens. ABCDDV/772RESUMO -Racional -A base cirúrgica principal no tratamento do câncer colorretal é a remoção em bloco do tumor com adequadas margens proximal e distal, associada à remoção dos linfonodos mesentéricos.

Smoking-related illnesses are the leading causes of morbidity and mortality in Brazil. Despite a smoking prevalence of approximately 40%, there is limited national effort to reduce tobacco use in Brazil by means of public education and training of health care professionals to promote smoking education. In particular, the need for information about tobacco warrants increased emphasis in undergraduate medical education. An educational program on nicotine addiction during medical school could facilitate the incorporation of smoking cessation interventions into routine medical practice. As a preliminary step toward implementing a tobacco education and intervention program, this study was designed to assess knowledge and attitudes about smoking among Brazilian medical students. Five hundred thirteen (N = 513) medical students from the Federal University of Rio Grande do Sul, the southernmost state of Brazil, completed a self-reported questionnaire during the 1995-1996 academic school year. Most students recognize the adverse health effects of smoking and the importance of their professional role in promoting smoking cessation. In contradiction, however, few medical students currently provide their patients who smoke with even minimal intervention. This discrepancy supports the idea that training in nicotine addiction and smoking cessation techniques will help medical students to develop the skills and confidence needed to successfully intervene with their current and future patients.