Lerco MM, Spadella CT, Machado JLM, Schellini SA, Padovani CR. Caracterização de um modelo experimental de Diabetes mellitus, induzido pela aloxana em ratos. Estudo clínico e laboratorial. Acta Cir Bras [serial online] 2003 Mar-Abr;18(2). Disponível em URL: http://www.scielo.br/acb. RESUMO Objetivo: O presente estudo teve por objetivo caracterizar as alterações clínicas e laboratoriais do rato portador de Diabetes Mellitus induzido pela administração endovenosa de aloxana. Métodos: Os animais foram distribuídos, por sorteio, em dois grupos experimentais: Grupo Controle Normal (G1), constituído de 25 animais sadios, e Grupo Diabético (G2), formado por 25 animais diabéticos graves, que foram avaliados em cinco momentos (1, 3, 6, 9 e 12 meses) de seguimento, tendo sido estudados os seguintes parâmetros: evolução clínica (peso, ingestão hídrica, ingestão alimentar e diurese) e exames bioquímicos (glicemia de jejum, glicose urinária, glicosúria, cetonúria, colesterol total, colesterol HDL, triglicérides e lipídios). Resultados: A injeção de aloxana 2% na via endovenosa do rato acompanhou-se de um índice de mortalidade de 39%, tendo produzido diabetes grave também em 39% dos animais. O diabetes foi caracterizado por queda progressiva do peso corporal, elevação substancial da ingestão hídrica, ingestão alimentar e da diurese, com valores glicêmicos acima de 300 mg/dl, glicosúria 3+ e, eventualmente, cetonúria. O diabetes não altera o perfil de colesterol e lípides de ratos a longo prazo. Conclusão: Nossos estudos revelam que a aloxana produz, no rato, alterações clínicas e laboratoriais características de diabetes grave, as quais possibilitam estudos a longo prazo do diabetes.

-Context -In the gastroesophageal reflux disease (GERD), a highly prevalent digestive disorder, gastric content may return to the esophagus and reach the mouth, thus leading to a small number of carious lesions and high incidence of dental erosion. Since saliva plays a major role in oral homeostasis, evaluating salivary parameters is necessary in attempting to explain such outcome. Objectives -This study aimed at analyzing salivary parameters (salivary flow, pH and buffering capacity), bacterial count, caries index and dental erosion in patients with GERD. Materials -Sixty patients were studied, and of these, 30 had GERD (group 1), and 30 were controls (group 2). Gastroesophageal reflux disease diagnosis confirmation was achieved by means of endoscopy, manometry and pH metric esophageal monitoring. The above mentioned salivary parameters were evaluated in patients from groups 1 and 2. Results -The number of erosions in patients with GERD (group 1) was larger than in controls (P<0.001). The number of carious teeth was smaller in group 1 than in group 2 (P<0.001). Salivary flow (non-stimulated and stimulated) and pH did not show differences between the 2 groups (P = 0.49; P = 0.80 and P = 0.85, respectively). Salivary buffering capacity in patients with GERD showed lower values in controls (P = 0.018). The number of bacteria (Lactobacilli and Streptococci) was smaller in patients with gastroesophageal reflux disease than in controls (P = 0.0067 and P = 0.0017, respectively). Conclusion -It was concluded that the large number of erosions must be a result of GERD patients reduced salivary buffering capacity. The reduced number of caries of patients in group 1 can be explained by the low prevalence of bacteria (Lactobacilli and Streptococci), observed in the saliva of patients with chronic reflux.

PURPOSE:To analyze the epidemiological features of patients with esophageal cancer according to the histopathological types: squamous cell carcinoma or adenocarcinoma. METHODS:A total of 100 patients with esophageal cancer, being 50 squamous cell carcinomas and 50 adenocarcinomas were analyzed for demographics, nutritional factors, lifestyle habits, benign pathological conditions associated, like Barrett's esophagus and megaesophagus, tumor stage and survival rates. The nutritional factors evaluated included body mass index, percent weight loss, hemoglobin and albumin serum levels. RESULTS:Esophageal cancer occurred more often in men over 50 years-old in both histological groups. No significant differences on age and gender were found between the histological groups. Squamous cell carcinoma was significantly more frequent in blacks than adenocarcinoma. Alcohol consumption and smoking were significantly associated with squamous cell carcinoma. Higher values of body mass index were seen in patients with adenocarcinoma. Barrett's esophagus was found in nine patients (18%) with adenocarcinoma, and megaesophagus in two patients (4%) with squamous cell carcinoma. The majority of patients were on stages III and IV in both histological groups. The mean survival rates were 7.7 ± 9.5 months for patients with squamous cell carcinoma and 8.0 ± 10.9 months for patients with adenocarcinoma. No significant differences on tumor stage and survival rates were detected between the histological groups.CONCLUSION: Epidemiological features are distinct for the histopathological types of esophageal cancer. Squamous cell carcinoma is associated with black race, alcohol and smoking, while adenocarcinoma is related to higher body mass index, white race and Barrett's esophagus.

Helicobacter pylori (H. pylori) is believed to predispose carriers to gastric cancer by inducing chronic inflammation. The inflammatory processes may result in the generation of reactive oxygen and nitrogen species that damage DNA. In this study, we investigated the relationships between DNA damage in the gastric mucosa and cagA, vacA, and iceA genotypes of H. pylori. The study was conducted with biopsies from the gastric antrum and corpus of 98 H. pylori-infected and 26 uninfected control patients. H. pylori genotypes were determined by PCR and DNA damage was measured in gastric mucosal cells by the Comet assay (single cell gel electrophoresis). All patients were nonsmokers, not abusing alcohol, and not using prescription or recreational drugs. Levels of DNA damage were significantly higher (P < 0.0001) in the H. pylori-infected patients than in uninfected patients. In comparison with the level of DNA damage in the uninfected controls, the extent of DNA damage in both the antrum (OR = 8.45; 95% CI = 2.33-37.72) and the corpus (OR = 6.55; 95% CI = 2.52-17.72) was related to infection by cagA+/vacAs1m1 and iceA1 strains. The results indicate that the genotype of H. pylori is related to the amount of DNA damage in the gastric mucosa. These genotypes could serve as biomarkers for the risk of extensive DNA damage and possibly gastric cancer.

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2RESUMO -Racional -A doença do refluxo gastroesofágico, afecção de elevada e crescente incidência, pode se manifestar através de sintomas típicos (pirose e regurgitação) e atípicos (pulmonares, otorrinolaringológicos e bucais). Objetivo -Analisar as alterações na cavidade oral de pacientes com a doença do refluxo gastroesofágico. Métodos -Foram estudados 100 pacientes, sendo 50 acometidos por doença do refluxo gastroesofágico (grupo 1) e 50 controles (grupo 2). Todos os pacientes foram submetidos a exame clínico oral e questionário específico, e naqueles do grupo 1, foram realizadas endoscopia digestiva alta e manometria e pHmetria esofágicas. Resultados -A endoscopia digestiva alta demonstrou esofagite em todos os pacientes, sendo erosiva em 20, não-erosiva em 30 e hérnia hiatal em 38. A pressão média no esfíncter inferior do esôfago foi de 11 ± 4,8 mm Hg e no superior de 75 ± 26,5 mm Hg. Em 42 pacientes do grupo 1 (84%) foi observado refluxo gastroesofágico patológico. O exame clínico oral mostrou: erosões dentárias no grupo 1: 273 faces e no grupo 2: 5; dentes cariados no grupo 1: 23 e 115 no grupo 2; abrasão no grupo 1: 58 e no grupo 2: 95; desgaste por atrito: 408 no grupo 1 e 224 no grupo 2. A face dental mais acometida foi a palatina. No grupo 1, 21 pacientes referiam queixas de aftas freqüentes, 35 sensibilidade dentária, 26 ardência bucal e 42 gosto azedo na boca. Naqueles do grupo 2 estas queixas foram observadas em menor número de pacientes. Conclusões -Os doentes com doença do refluxo gastroesofágico apresentam maior incidência de erosões dentárias, aftas, ardência bucal, sensibilidade dentária e gosto azedo que os controles e menor incidência de lesões cariosas em relação aos controles. DESCRITORES -Refluxo gastroesofágico, complicações. Boca. Erosão de dente. INTRODUÇÃOConsiderada afecção digestiva de elevada prevalência e incidência em ascensão, a doença do refluxo gastroesofágico (DRGE) compromete a qualidade de vida dos pacientes, em virtude da gravidade das complicações, intensidade e diversidade dos sintomas (9,16,20,25,26,28,31) . O diagnóstico clínico da DRGE é bastante sensível, pois a maioria dos pacientes apresenta os sintomas clássicos da doença, representados por pirose e regurgitação. Todavia, outros sintomas podem ser referidos pelos refluidores, tais como rouquidão, pigarro, tosse crônica, crises de asma e precordialgias, classificados como atípicos. Tais sintomas podem se apresentar associados aos anteriores ou isoladamente (10,17,19,30,34,37) . Recentemente vários autores têm sugerido que os doentes com DRGE podem apresentar, além dos sintomas citados, manifestações bucais, pois o refluxo, ao atingir a cavidade oral, pode causar lesões nos tecidos moles (aftas) ou mesmo nos dentes, levando a desmineralização, fenômeno conhecido por perimólise (2,5,6,7,15,21) .Os objetivos da presente pesquisa foram analisar as alterações na cavidade oral de pacientes com a DRGE e compará-las com as observadas em indivíduos controles. MÉTODOSForam avaliados 100 pacientes, 41 homens e 59 mulheres, co...

PURPOSE: To determine the number of podocyte, slit diaphragms, slit diaphragm extensions and GBM thickness in diabetic nephropathy. METHODS: Sixty "Rattus Wistar"of both sexes weighing 200-300g were divided in two experimental groups: normal group 10 animals, and alloxan diabetic rats - 50 animals. Alloxan was administered in a single IV dose of 42mg/kg body weight. Body weight, water and food intake, diuresis, and blood and urine glucose were determined in both groups before alloxan injection and two weeks, six and twelve months after alloxan injection. Proteinuria was measured at 12 months in both groups. After 12 months animals were sacrificed, and the right kidney processed for electron microscopy. RESULTS: Clear clinical and laboratory signs of severe diabetes were seen, in all alloxan-diabetic rats at all follow-up times. Glomerular basement membrane (GBM) thickening, podocyte number, and slit diaphragm number and extension were determined. GBM of all diabetic rats was significantly thicker (median=0.29µm; semi-interquartile range=0.065µm) than in the normal rats (0.23µm; 0.035µm). Diabetic rat podocyte number (8; 1), slit diaphragm number (4; 1), and slit diaphragm extension (0.021µm; 0.00435µm) were significantly lower than in normal rats (11; 1) and (7; 1.5), and (0.031µm; 0.0058µm). Diabetic rat proteinuria (0.060mg/24h; 0.037mg/24h) was higher than in normal rats (0.00185mg/24h; 0.00055mg/24h). CONCLUSION: Experimental diabetes is associated with significant (p<0.05) changes in podocyte foot process, slit number, slit diaphragm extension, and GBM thickness.

ABSTRACT ABSTRACTObjective Objective Objective Objective Objective: To evaluate the postoperative outcome of patients with pharyngoesophageal diverticulum submitted to surgical and endoscopic treatments. Methods Methods Methods Methods Methods: We retrospectively analyzed 36 patients with pharyngo-esophageal diverticulum treated at the Hospital of the Medical School of Botucatu -UNESP. Patients were divided into two groups, depending on the treatment: group 1 (n = 24): diverticulectomy associated myotomy through a left cervicotomy; group 2 (n = 12): endoscopic diverticulostomy with linear stapler. Results Results ResultsResults Results: Operative mortality was zero in both groups. Early complications: group 1-two patients developed cervical fistula and two, hoarseness; group 2 -none. Late complications: group 1 -none; group 2: recurrence of dysphagia in four patients (p = .01). Mean follow-up was 33 months for group 1 and 28 months for group 2. Conclusion Conclusion Conclusion Conclusion Conclusion: Both procedures were effective in remission of dysphagia. Surgical treatment showed superiority to endoscopy, with resolution of dysphagia with a single procedure. Endoscopic treatment should be reserved for the elderly and those with comorbidities.