Two treatment policies for rectal prolapse were prospectively assessed between April 1986 and January 1989. Sixteen patients had a Marlex mesh posterior rectopexy alone and 13 underwent a sigmoidectomy combined with a sutured posterior rectopexy. Preoperative and post-operative assessment included manometry, a saline infusion test and video-proctography. Hospital stay, control of prolapse and complications were comparable in both groups. Restoration of continence occurred in nine of the 12 incontinent patients after Marlex rectopexy, compared with six of nine after sutured rectopexy and sigmoidectomy. Constipation persisted in three patients who were constipated before operation and in four of 13 who had previously normal bowel habits became constipated after Marlex rectopexy; constipation persisted in one of five previously constipated patients while none with previously normal bowel habits became constipated after sutured rectopexy and sigmoidectomy. Sigmoidectomy combined with sutured rectopexy was safe and as efficient as Marlex rectopexy in prolapse control and improvement of continence; significantly fewer patients were constipated (one of 13) after sigmoidectomy than following rectopexy alone (seven of 16). A randomized trial now seems justified.

Bovine ocular squamous cell carcinoma (OSCC) is the second most common cause of rejection due to neoplasia in slaughterhouses on Sao Miguel Island, Azores, and accounts for significant economic losses. To obtain a better insight into the genesis and neoplastic transformation process of bovine OSCC, abnormal protein expression and proliferation index were assessed by the immunohistochemical evaluation of p53 and Ki67, respectively. OSCC samples were collected from 15 bovines and were classified histologically according to the degree of differentiation into three categories: poorly, moderately, and well differentiated. Immunohistochemistry using polyclonal anti-human p53 antibody and polyclonal anti-human Ki67 antibody was performed. Ten of 15 tumors tested were immunoreactive for p53. Twelve tumors demonstrated Ki67 expression. As in human squamous cell carcinoma, p53 overexpression is frequent in bovine OSCC, providing support for a possible role of the protein in the pathogenesis of this neoplasia. No correlation between the percentage of p53 stained nuclei and the degree of differentiation was observed, although different patterns of staining were seen according to the degree of keratinization of the tumor cells. With the exception of the moderately differentiated OSCC group, Ki67 index showed significant correlation with the histologic pattern, increased proliferation being found in poorly differentiated OSCC (P = 0.013).

-Introduction -The inflammatory bowel diseases are chronic illnesses that significantly affect the quality and patients life expectancy. There is clinical polymorphism and the therapeutic approach has been modified in recent years. Aim -To re-analyze the profile of outpatient patients studying the behavior of the disease, its prevalence and therapeutic approach. Methods -Was conducted a cross-sectional study of the last 2010 update database of patients with inflammatory bowel disease. The items analyzed were age and sex of patients, type of disease (ulcerative colitis or Crohn's disease), disease location, type of medication used, and whether patients were symptomatic or asymptomatic at the last visit. Results -In a total of 171 patients women were found to be predominant (60.8%) and the mean age was 42.3, ranging from 16 to 84 years. Regarding the type of inflammatory disease, ulcerative colitis was more prevalent (58.5%). The most common locations on ulcerative colitis were pancolitis and rectitis, both with 26% (n = 26). In Crohn's disease ileocolic location was the most prevalent, with 47.9% (n = 34), followed by colonic 25.4% (n = 18). Monotherapy was the most used, accounting for 54.4% of patients, the immunosuppressive drugs were the most frequently used (35.5%). The combination of drugs was necessary in 36.3% of cases, being the most frequent combination with systemic salicylate in 33.9%. In patients with ulcerative colitis 82% were using salicylates, whether local or systemic. In Crohn's disease 57.7% were taking immunosuppressive drugs. In relation to the disease in the last visit, 71.3% of patients were asymptomatic. Conclusion -The ulcerative colitis was slightly more prevalent than Crohn's disease, pancolitis and rectitis being the most common locations. In Crohn's disease ileocolic location was the most common followed by colonic. Monotherapy immunosuppressive regimen was the most popular. Most of the patients were asymptomatic at last visit. ABCDDV/793RESUMO -Introdução -As doenças inflamatórias intestinais são enfermidades crônicas, que afetam significativamente a qualidade e expectativa de vida dos pacientes. Existe polimorfismo clínico e a abordagem terapêutica tem sido modificada nos últimos anos. Objetivo -Reavaliar o perfil dos pacientes em acompanhamento ambulatorial analisando o comportamento das doenças, sua prevalência e conduta terapêutica. Métodos -Foi realizado um estudo transversal da última atualização da base de dados dos pacientes de ambulatório de doença inflamatória intestinal em 2010. Os itens analisados foram sexo e idade dos pacientes, tipo da doença (retocolite ulcerativa ou doença de Crohn), localização da doença, tipo de medicação em uso, e se os pacientes estavam sintomáticos ou assintomáticos na última consulta. Resultados -Foram estudados 171 pacientes. O sexo feminino mostrou-se predominante (60,8%) e a média de idade dos pacientes foi de 42,3, variando de 16 a 84 anos. Em relação ao tipo de doença inflamatória, a retocolite ulcerativa mostrou-se mais prevalen...

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Anorectal myectomy has been shown to provide clinical benefit to patients with outlet obstruction. Long-term results of anorectal myectomy have been evaluated in 57 patients operated on between February 1984 and February 1988 with a median follow-up of 24 months. Overall improvement was recorded in only 31 percent of patients. Spontaneous evacuation without the need for laxatives was recorded in only 11 patients (19 percent), while 38 (67 percent) had no functional improvement. Results were independent of preoperative colonic transit or histologic evidence of aganglionosis. Anorectal myectomy identified aganglionosis in 23 percent of patients with chronic constipation, but there was minimal long-term benefit from the procedure.