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Rectal bleeding following colorectal anastomosis is common but usually self-limited. Continuous hemorrhage is rare, and when it occurs, often requires further treatment. The most frequently used strategies for treatment of stapled anastomotic hemorrhage are clinical observation with or without blood transfusion, rectal packing, angiographic identification of the bleeding site with vasopressin infusion or embolization, and endoscopic eletrocoagulation. We report the case of a 49-year-old man with uncomplicated diverticular disease who was treated by laparoscopic sigmoidectomy, with double-stapled colorectal anastomosis. Six hours later, the patient presented intense rectal bleeding and was taken to the operation room for urgent colonoscopic examination. After complete removal of blood clots inside the rectum, a bleed localized at the anastomotic site was identified and submucosal peri-anastomotic injection of 10 ml adrenaline (1:200 000) in saline was performed with immediate bleeding control.

PURPOSE:To find out the prevalence of hypertension in employees of the Hospital and relate it to social demographic variables.METHODS: Blood pressure measurement was performed with a mercury sphygmomanometer, using an appropriate cuff size for arm circumference, weight, and height in a population sample of 864 individuals out of the 9,905 employees of a University General Hospital stratified by gender, age, and job position.RESULTS: Hypertension prevalence was 26% (62% of these reported being aware of their hypertension and 38% were unaware but had systolic/diastolic blood pressures of ≥140 and/or ≥90 mm Hg at the moment of the measurement). Of those who were aware of having hypertension, 51% were found to be hypertensive at the moment of the measurement. The prevalence was found to be 17%, 23%, and 29% (P <.05) in physicians, nursing staff, and "others", respectively. The univariate analysis showed a significant odds ratio for the male gender, age ≥50 years, work unit being the Institute of Radiology and the Administration Building, educational level ≤elementary school, length of work ≥10 years, and body mass index ≥30 kg/m 2 . The multivariate logistic regression model revealed a statistically significant association of hypertension with the following variables: gender, age, skin color, family income, and body mass index.CONCLUSIONS: Hypertension prevalence was high, mainly in those who were not physicians or members of the nursing staff. High-risk groups (obese, non-white, men, low family income) should be better advised of prevention and early diagnosis of hypertension by means of special programs.

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. headings -Stomach Neoplasms. Helicobacter pylori.abstRact -Background -Etiology of gastric cancer (GC) remains controversial and several factors have implicated in its carcinogenesis process, including Helicobacter pylori (Hp) infection. Hp infection's role on GC remains uncertain, with several conflicting studies. Aim -To look for any correlation between H. Pylori and gastric cancer fom gastric specimen after gastrectomy. Method -Ninety-one patients with diagnosis of adenocarcinoma of the stomach treated by surgical resection were reviewed. Pathological examination was repeated in all patients to determine the presence of Hp infection, intestinal metaplasia (IM) and confirmation of the hystologic type by conventional haematoxylin-eosin staining. Statistical analysis was performed using Chi-quadrate and log-rank tests. Results -IM was observed in 81 tumours (89%). Overall, the presence of Hp infection was observed in 46 tumours (50.5%). There was no association between age and Hp status. In the group of patients with early and advanced GC, Hp infection was present in 47.7% and 54% of tumours. Hp infection was present in 40 tumours (49%) in the group of patients with IM. In patients with tumours without IM Hp was present in five (50%) tumours. Proximal tumours had more Hp infection when compared to distal tumours. Conclusions -The infection rate had no significant association with histologic type, IM, gender or stage. These results may indicate that participation of Hp infection during GC development cannot be ruled out; however, it is probably not essential during all stages of GC development and the mechanism may be distinct of the chronic gastritis and IM progression. Finally, it is possible that the proposed association is merely coincidental and that there is no actual influence of the bacteria in the carcinogenesis process.Resumo -Racional -A causa do câncer gástrico (CG) é controversa e tem vários fatores envolvidos no seu processo de carcinogênese, incluindo o Helicobacter pylori (Hp) O papel da infecção pelo Hp no CG permanece incerto, com vários estudos controversos. Objetivo -Correlacionar a presença da infecção pelo Hp com câncer gástrico, através de exame anatomopatológico convencional do estômago ressecado. Método -Noventa e um pacientes tratados por ressecção cirúrgica foram revistos. O exame anatomopatológico foi feito em todos os pacientes para determinar a presença de infecção por Hp, metaplasia intestinal (MI) e confirmação do tipo histológico por hematoxilina-eosina. A análise estatística foi realizada através do qui-quadrado e testes de log-rank. Resultados -MI foi observada em 81 tumores (89%). Em geral, a presença de infecção pelo Hp foi observada em 46 casos (50,5%). Não houve associação entre idade e Hp. Nos grupos de pacientes com CG avançado e precoce, a infecção pelo Hp estava presente em 47,7% e 54% dos tumores. A infecção pelo Hp ocorreu em 40 tumores (49%) no grupo de pacientes com MI. Nos com tumores sem MI, Hp estava presente em cinco (50%). Tumores proximais tiveram mais infecç...

the data corroborate the safety of the colonoscopy exam and points to a reduction in major complications rates.

Ependimomas são tumores raros de sistema nervoso central, sendo os de cauda eqüina mais freqüentes. Esses tumores raramente metastatizam. Descreve-se o caso de um homem de 35 anos que apresentou, nove anos após ressecção de ependimoma em região coccígea, queixa de dor pleurítica, dispnéia aos esforços, tosse e sudorese noturna. A radiografia pulmonar evidenciou derrame pleural e nódulos metastáticos nos pulmões. Os exames histopatológico e imuno-histoquímico de tecido obtido por biópsia pulmonar a céu aberto confirmaram o diagnóstico de ependimoma. Com quimioterapia o paciente tem boa evolução, com seguimento de 43 meses.