Development of clinical criteria for the evaluation of indirect restorations.

OBJECTIVE: To propose the development and validation of criteria for evaluating the clinical performance of indirect restorations, considering the variables related to the operator, material, and/or patient. MATERIALS AND METHODS: The experimental design of this study was divided into three stages. Stage 1: development of the new criteria items by specialists in Prosthodontics. Step 2: creation of the criteria, named UERJ criteria, with the description of the parameters that indicate the quality of the restoration, the possible associated complications, and a detailed description of each classification. As well as the development of a form of variables. Step 3: validation of the UERJ criteria. RESULTS: Cohen's Kappa statistic registered for both intra- and inter-examiner agreements a coefficient >0.91 with a p-value <0.0001. The validity of the UERJ criteria was evaluated by tests of sensitivity (0.96) and specificity (0.91) and had a satisfactory accuracy (92.7%), a positive (10.99), and negative (0.05) likelihood ratio and high values predictive variables, with positive (PPV) 0.84 (high specificity) and negative (VPN) 0.98 (high sensitivity), with a confidence interval of 95%. CONCLUSION: The UERJ criteria is a valid instrument for evaluating the clinical performance of indirect restorations. CLINICAL SIGNIFICANCE: The UERJ criteria, developed exclusively for the analysis of indirect restorations, elucidates the details necessary to identify the causes of failures and complications of these restorations.

Nivel y accesibilidad estadística en artículos originales publicados en una revista de pediatría / Statistical level and accessibility in original articles published in a pediatric journal

Describir las herramientas estadísticas las herramientas estadísticas empleadas para la presentación de resultados de investigación en los artículos publicados en la revista Archivos Argentinos de Pediatría a fin de evaluar el nivel y accesibilidad de aquéllas. Estudio observacional, descriptivo y retrospectivo. Se analizaron las publicaciones del período 2015-2019. Aplicando la escala de Mora Ripoll adaptada por Praena Fernández, fueron revisados 236 trabajos que cumplieron con los criterios de inclusión en la sección Artículos originales de la revista Archivos Argentinos de Pediatría. El 14,4% de los artículos correspondió al nivel I, 22,9% al nivel II y 62,7% al nivel III. Así, un lector cuyo repertorio de conocimientos estadísticos equivaliera al nivel I accedería al 14,4% de los artículos mientras que quien contara con un nivel II elevaría la accesibilidad al 37,3%. Del análisis de los artículos originales publicados en los AAP, resulta evidente que quien desee realizar un análisis crítico de la totalidad de los hallazgos presentados en la revista, deberá contar con un apropiado nivel de conocimiento que, lamentablemente, no suele alcanzarse en la carrera de grado de Medicina.

Describes the statistical tools used to present research results in articles published in the Argentine Archives of Pediatrics to assess their level and accessibility. Observational, descriptive and retrospective study. Publications for the period 2015-2019 were analyzed. Applying the Mora Ripoll scale, adapted by Praena Fernández, 236 papers satisfying the inclusion criteria were reviewed in its original articles section. 14.4% of the articles corresponded to level I, 22.9% to level II and 62.7% to level III. Thus, a reader whose repertoire of statistical knowledge equals level I would access 14.4% of the articles, while a reader with a level II would increase accessibility to 37.3%. From the analysis of the original articles published in the AAP, it is evident that anyone who wishes to carry out a critical analysis of all the findings presented in the journal, must have an appropriate level of knowledge that, unfortunately, it is not usually achieved in the undergraduate degree of Medicine.

Vocal Tract Discomfort Scale: Validation of the Argentine Version.

OBJECTIVE: The objective of this study was to validate the Vocal Tract Discomfort Scale (VTD) Argentine version. STUDY DESIGN: Nonrandomized, cross-sectional prospective study with control group. MATERIAL AND METHODS: The VTD Scale was culturally and linguistically adapted to Argentinian Spanish according to the recommended requirements of translation, closely observing the methodology that was suggested (translation, summary, review and back-translation). The scale Argentine version (Escala de disconfort del tracto vocal) was administered to 107 patients with muscle-tension dysphonia (MTD) (23 men and 84 women, mean ages being: 32.30 ± 9.09 years old for MTD type I, and 31.23 ± 8.45 years old for MTD type II) and 30 volunteers with no vocal pathology (9 men and 21 women, mean ages being: 44.3 ± 8.72 years old). All patients completed the Escala de disconfort del tracto vocal before and after Mathieson Laryngeal Manual Therapy. The results of the VTD Scale administered in both patients and vocally healthy subjects were initially compared; the changes arising from pre and post therapy were also compared in the second phase. The internal consistency of the VTD Scale was assessed using Cronbach alpha coefficient. RESULTS: The internal consistency assessed was considered acceptable for both subscales within the VTD Scale. The values obtained for frequency, severity, and total score of the Scale were similar in patients with MTD I and MTD II, marking a difference with those obtained in the control group of healthy volunteers. A lump feeling in the throat was one of the most frequent symptoms in both MTD and vocally healthy groups. CONCLUSION: The VTD Scale shows an acceptable consistency, so it is a highly reproducible, reliable, and valuable instrument of evaluation to assess Argentinian patients with voice disorders.

[Is it necessary to have advanced statistical knowledge to access medical literacy?] / ¿Es necesario tener conocimientos avanzados de estadística para acceder a las publicaciones médicas?

The introduction of statistical analysis in biomedical journals should be attributed to Dunn and Greenwood in the 1930s, who reflect the concepts of statistical analysis and interpretation. The aim of this study was to analyze the use of different statistical tests and the level of accessibility analysis-dependent and article-dependent of the original articles published in the journal Medicina (B Aires) in the period 2008-2017. A bibliometric, descriptive, observational, cross-sectional study was carried out, in which the original articles were evaluated according to the scale proposed by Mora Ripoll et al. From the 301 articles in Spanish reviewed, 96% presented statistical analyses. Among the 215 articles that used some inferential statistics technique, 49.7% used the chi-square test, z tests for proportions, the Fisher exact test or the McNemar test; 29.2% used student t-tests and z-tests, including the use of these techniques or the use of confidence intervals for medium-conformance contrasts, and/or median-homogeneity (two samples), in paired or independent samples. The results indicate that a reader who knows about the tests included in Level II will have statistical access to 75% of the original articles published. It was found that it is not necessary to have advanced knowledge of statistics to access most publications, but it is important that these contents are developed with emphasis on statistical reasoning over the application and use of software or the choice of the appropriate test.

La introducción de análisis estadísticos en revistas biomédicas debe atribuirse a Dunn y a Gree wood en la década del 30, quienes reflejan los conceptos del análisis e interpretación estadística. El objetivo del trabajo fue analizar la utilización de distintas pruebas estadísticas y el grado de accesibilidad análisis-dependiente y artículo-dependiente de los artículos originales publicados en la revista Medicina (B Aires) en el período 2008-2017. Se realizó un estudio bibliométrico, descriptivo, observacional, de corte transversal, en el cual se incluyeron los artículos originales que fueron evaluados de acuerdo a la escala propuesta por Mora Ripoll y col. Se revisaron 301 artículos en idioma español, el 96% presentó análisis estadísticos. Entre los 215 artículos que emplearon alguna técnica de estadística inferencial, el 49.7% utilizó la prueba chi-cuadrado, pruebas z para proporciones, el test exacto de Fisher o prueba de McNemar. El 29.2% empleó pruebas t de student y pruebas z, incluyendo el uso de estas técnicas o de intervalos de confianza para contrastes de conformidad de medianas, y/o homogeneidad de medianas (dos muestras), en muestras apareadas o independientes. Los resultados indican que un lector conocedor de las pruebas incluidas en el Nivel II tendrá acceso estadístico al 75% de los artículos originales publicados. Se comprobó que no es necesario tener conocimientos avanzados de estadística para acceder a la mayoría de las publicaciones, pero sí es importante que estos contenidos sean desarrollados haciendo hincapié en el razonamiento estadístico por sobre la aplicación y utilización de software o la elección del test adecuado.

¿ Es necesario tener conocimientos avanzados de estadística para acceder a las publicaciones módicas? / Is it necessary to have advanced statistical knowledge to access medical literacy?

La introducció;n de análisis estadísticos en revistas biomó;©dicas debe atribuirse a Dunn y a Greewood en la dó;©cada del 30, quienes reflejan los conceptos del análisis e interpretació;n estadística. El objetivo del trabajo fue analizar la utilizació;n de distintas pruebas estadísticas y el grado de accesibilidad análisis-dependiente y artículo-dependiente de los artículos originales publicados en la revista Medicina (B Aires) en el período 2008-2017. Se realizó; un estudio bibliomó;©trico, descriptivo, observacional, de corte transversal, en el cual se incluyeron los artículos originales que fueron evaluados de acuerdo a la escala propuesta por Mora Ripoll y col. Se revisaron 301 artículos en idioma espaó;±ol, el 96% presentó; análisis estadísticos. Entre los 215 artículos que emplearon alguna tó;©cnica de estadística inferencial, el 49.7% utilizó; la prueba chi-cuadrado, pruebas z para proporciones, el test exacto de Fisher o prueba de McNemar. El 29.2% empleó; pruebas t de student y pruebas z, incluyendo el uso de estas tó;©cnicas o de intervalos de confianza para contrastes de conformidad de medianas, y/o homogeneidad de medianas (dos muestras), en muestras apareadas o independientes. Los resultados indican que un lector conocedor de las pruebas incluidas en el Nivel II tendrá acceso estadístico al 75% de los artículos originales publicados. Se comprobó; que no es necesario tener conocimientos avanzados de estadística para acceder a la mayoría de las publicaciones, pero sí es importante que estos contenidos sean desarrollados haciendo hincapí en el razonamiento estadístico por sobre la aplicació;n y utilizació;n de software o la elecció;n del test adecuado.

The introduction of statistical analysis in biomedical journals should be attributed to Dunn and Greenwood in the 1930s, who reflect the concepts of statistical analysis and interpretation. The aim of this study was to analyze the use of different statistical tests and the level of accessibility analysis-dependent and article-dependent of the original articles published in the journal Medicina (B Aires) in the period 2008-2017. A bibliometric, descriptive, observational, cross-sectional study was carried out, in which the original articles were evaluated according to the scale proposed by Mora Ripoll et al. From the 301 articles in Spanish reviewed, 96% presented statistical analyses. Among the 215 articles that used some inferential statistics technique, 49.7% used the chi-square test, z tests for proportions, the Fisher exact test or the McNemar test; 29.2% used student t-tests and z-tests, including the use of these techniques or the use of confidence intervals for medium-conformance contrasts, and /or median-homogeneity (two samples), in paired or independent samples. The results indicate that a reader who knows about the tests included in Level II will have statistical access to 75% of the original articles published. It was found that it is not necessary to have advanced knowledge of statistics to access most publications, but it is important that these contents are developed with emphasis on statistical reasoning over the application and use of software or the choice of the appropriate test.

Conocimientos básicos en bioestadística y epidemiología y actitudes hacia la estadística en estudiantes de posgrado de medicina / Basic knowledge in biostatistics and epidemiology and attitudes towards statistics in postgraduate medical students

Objetivos: Describir los conocimientos en bioestadística y epidemiología, así como las actitudes hacia la estadística en estudiantes del posgrado de la facultad de medicina de una universidad española, y explorar la relación entre los conocimientos en bioestadística y epidemiología y las actitudes hacia la estadística. Sujetos y métodos: Estudio observacional, de corte transversal y analítico, de médicos residentes. Para indagar acerca de los conocimientos en bioestadística y epidemiología se aplicó el cuestionario de Novack, y para medir la actitud hacia la estadística, el Survey of Attitudes Toward Statistics-28 (SATS-28). Se consideraron las siguientes variables: edad, sexo, especialidad médica y año de residencia. Además, se indagó si poseían conocimientos previos de estadística (cursos realizados y manejo de programa estadístico). Resultados: En la evaluación de los conocimientos en bioestadística y epidemiología el porcentaje de respuestas correctas superó el 70%. El 50% obtuvo 8 puntos o más (sobre 10). En cuanto a las puntuaciones de las subescalas, así como la puntuación global del SATS-28, la mayoría de los posgraduados médicos mantuvieron actitudes positivas hacia la estadística, de modo que la puntuación media fue de 4,43 ± 0,72, que fue significativamente superior a la neutral. Existe una correlación positiva y estadísticamente significativa entre la puntuación total en el cuestionario de conocimientos y la puntuación total en el SATS-28. Conclusiones: Los resultados sugieren que los residentes de medicina poseen buenos conocimientos en bioestadística y epidemiología, que se incrementan en quienes tienen una mayor actitud positiva hacia la estadística

Aims: To report the knowledge in biostatistics and epidemiology, as well as attitudes toward statistics in postgraduate students of the Faculty of Medicine of a Spanish university, and to explore the relationship between knowledge in biostatistics and epidemiology and attitudes towards statistics. Subjects and methods: Observational, cross-sectional and analytical study of resident physicians. To investigate the knowledge in biostatistics and epidemiology, the Novack questionnaire was applied and to measure the attitude towards statistics the Survey of Attitudes Toward Statistics-28 (SATS-28). The following variables were considered: age, sex, medical specialty, year of residence. In addition, it was inquired if they had previous knowledge of statistics (courses conducted and statistical software management). Results: In the evaluation of knowledge in biostatistics and epidemiology, the percentage of correct answers exceeded 70%. 50% got 8 points or more (out of 10). Regarding subscale scores, as well as the overall score of SATS-28, the majority of medical postgraduates maintained positive attitudes towards statistics, so that the average score was 4.43 ± 0.72, being significantly superior to neutral. There is a positive and statistically significant correlation between the total score in the knowledge questionnaire and the total score in the SATS-28. Conclusions: The results of this study suggest that medicine residents possess good knowledge in biostatistics and epidemiology, increasing in those with a greater positive attitude towards statistics

Índice de colapsabilidad de la vena cava inferior como predictor de hipotensión intraoperatoria / Inferior vena cava collapsibility index of the as a predictor of intraoperative hypotension

OBJECTIVE: To evaluate the lower vena cava Collapse Index (CI) as a predictor parameter of hypotensive episodes after general anesthesia induction in ASA I and II patients who were scheduled for elective surgery. MATERIALS AND METHODS: A prospective, observational and simple blind study was designed. A sample of 80 patients was recruited. In the preoperative stage, they underwent protocolarized sedation and CI was obtained. Prior to induction, the baseline values ​​of heart rate, non-invasive mean arterial pressure and continuous electrocardiographic tracing in DII were noted. In the post-orotracheal intubation stage, the aforementioned hemodynamic monitoring variables were recorded manually for 10 minutes. RESULTS: The data of 78 individuals are presented. After anesthetic induction, 8 (10.3%) patients developed hypotension. The adjustment of the univariate logistic regression model for CI shows a good diagnostic capacity, with the area under the ROC curve equal to 0.76. The chance of presenting hypotension is increased by 62% by increasing the CI by 5 points (p = 0.003). Regarding the negative predictive value, we found that with values ​​corresponding to the cutoff points between 39% and 46%, a probability of at least 93.1% of not presenting hypotension was obtained. The optimal cutoff point of the CI to predict hypotension is estimated at 43%, with a sensitivity of 62.5% and a specificity of 92.9%. CONCLUSION: A lower IC was associated with a lower probability of developing intraoperative hypotension. The use of this tool could be useful to anticipate which patients will be prone to intra-surgical hypotension.

OBJETIVO: Evaluar el índice de colapsabilidad (IC) de la vena cava inferior (VCI) como predictor de episodios hipotensivos posinducción de anestesia general en cirugía electiva de pacientes ASA I y II. MATERIALES Y MÉTODOS: Se diseñó un estudio prospectivo, observacional y simple ciego. Se reclutó una muestra de 80 pacientes. En etapa preoperatoria fueron sometidos a una sedación protocolizada y se obtuvo el IC. Previo a la inducción, se anotaron los valores basales de la frecuencia cardíaca, la presión arterial media y el trazado electrocardiográfico continuo en DII. Posintubación orotraqueal, se registraron manualmente las variables hemodinámicas mencionadas durante 10 minutos. RESULTADOS: Se presentan datos de 78 individuos. Luego de la inducción, 8 (10,3%) pacientes desarrollaron hipotensión. El ajuste del modelo de regresión logística univariado para IC muestra una buena capacidad diagnóstica, siendo el área bajo la curva ROC igual a 0,76. La chance de presentar hipotensión se incrementa en un 62% al aumentar el IC en 5 puntos (p = 0,003). En cuanto al valor predictivo negativo, encontramos que con valores correspondientes a los puntos de corte entre 39% y 46%, se obtenía una probabilidad de 93,1% de no presentar hipotensión. El punto de corte óptimo del IC para predecir hipotensión se estima en 43%, con una sensibilidad del 62,5% y una especificidad del 92,9%. CONCLUSIÓN: Un menor IC se asoció con una menor probabilidad de desarrollar hipotensión intraoperatoria. El uso de esta herramienta podría ser de utilidad para anticipar qué pacientes serán propensos a hipotensión intraquirúrgica.

The eSS rat, a nonobese model of disordered glucose and lipid metabolism and fatty liver.

BACKGROUND: eSS is a rat model of type 2 diabetes characterized by fasting hyperglycemia, glucose intolerance, hyperinsulinemia and early hypertriglyceridemia. Diabetic symptoms worsen during the second year of life as insulin release decreases. In 12-month-old males a diffuse hepatic steatosis was detected. We report the disturbances of lipid metabolism of the model with regard to the diabetic syndrome. METHODS: The study was conducted in eight 12-month-old eSS male rats and seven age/weight matched eumetabolic Wistar rats fed with a complete commercial diet al libitum. Fasting plasmatic glucose, insulin, triglycerides, total cholesterol, low-density and high-density lipoprotein, and nonesterified fatty acids levels were measured. Very low density and intermediate-density lipoproteins were analyzed and hepatic lipase activity was determined. RESULTS: eSS rats developed hyperglycemia and hyperinsulinemia, indicating insulin resistance. Compared with controls, diabetic rats exhibited high plasmatic levels of NEFA, triglycerides (TG), total cholesterol (Chol) and LDL-Chol while high-density lipoprotein (HDL) cholesterol values were reduced. eSS rats also displayed TG-rich VLDL and IDL particles without changes in hepatic lipase activity. CONCLUSION: The nonobese eSS rats develop a syndrome characterized by glucose and lipid disorders and hepatic steatosis that may provide new opportunities for studying the pathogenesis of human type 2 diabetes.

Visualización de clases construidas para el análisis de registros continuos de parámetros clínicos / Visualization of classes constructed for the analysis of continuous recordings of clinical parameters / VisualizaÇÃO de classes construidas para a análise de registros continuos de ParÂmetros Clínicos

Se procesaron registros de la presión arterial sistólica (PAS), diastólica (PAD) y de la frecuencia cardíaca (FC) efectuados durante todo el día en situación basal y a las 6, 26 y 52 semanas de tratamiento. Para ello se aplicaron técnicas multidimensionales de datos con el enfoque de la escuela francesa (análisis de correspondencias múltiples seguido de la construcción de clusters sobre coordenadas factoriales), logrando una partición en tres clases. Se consideró luego cada clase como un objeto simbólico y se realizaron gráficos de estrellas multivariantes que pusieron en evidencia los diferentes perfiles de las clases, posibilitando una satisfactoria visualización gráfica.

Systolic and diastolic arterial blood pressure and heart frequency performed all along the day under basal conditions and at 6, 26 and 52 weeks of treatment were processed. Multidimensional data techniques were applied with the French school approach (multiple correspondence analysis followed by construction of clusters on factorial coordinates), achieving partition in three classes. Thereafter, each class was considered as a symbolic object and multivariant star graphs were drawn to show the different class profiles, making possible a satisfactory graphic visualization.

Processaram-se registros da pressão arterial sistólica (PAS), diastólica (PAD) e da freqüência cardíaca (FC) efetuados durante todo o dia em situação basal e as 6, 26 e 52 semanas de tratamento. Para isto se aplicaram técnicas multidimensionais de dados com o enfoque da escola francesa (análise de correspondências múltiples seguido da construção de clusters sobre coordenadas fatoriais), logrando uma partição em três classes. Consideraram-se em seguida cada classe como um objeto simbólico e se realizaram gráficos de estrelas multivariantes que puseram em evidência os diferentes perfis das classes, possibilitando uma satisfatória visualização gráfica.

[Dynamic modifications in islets of Langerhans in two lines of spontaneously diabetic rats]. / Modificaciones dinámicas en los islotes de Langerhans de dos lineas de ratas espontáneamente diabéticas.

The eSMT rat is derived from the crossing of eSS and beta, both lines belonging to the IIM strain, while eSS is a model of type 2 diabetes without overweight and beta develops moderate obesity and late glucose intolerance. Metabolic characteristics and histopathological findings in endocrine pancreas of eSS and eSMT were compared. Young eSMT animals are more robust than eSS and develop more intense fasting hyperglycemia and glucose intolerance at an earlier age. eSMT males of 6 and 9 months show islets with altered shapes and fibrosis, as well as sporadic images of apoptosis. At 12 months of age, islets are reduced in number and size, resembling the histoarchitecture of eSS males during their second year of life; eventually islets undergo disruption and, at the same time, occasional mitoses and nesidioblastosis are seen. These dynamic modifications may be expressing a response to hyperglycemia. eSS females preserve their insular structure for a longer time and have less glycemic alterations. Sexual dimorphism of the diabetic syndrome of eSMT is attenuated when compared with eSS. The construction of a typology of individuals through multivariate analysis separated three clusters, evidencing genetic, age and sex differences.

Os efeitos de um programa de fisioterapia como promotor de saúde na capacidade funcional de mulheres idosas institucionalizadas / The functional impact of a program of health promotion in physical therapy on the functional capacity of elderly women in institutions

Com o aumento da população idosa mundial, tornou-se preocupação de várias áreas do conhecimento identificar as condições que permitem envelhecer com qualidade. A instituição asilar se torna um tema relevante, pois se observa uma demanda aumentada por instituições de longa permanência. A preservação e a manutenção da capacidade funcional são objetivos prioritários na saúde do idoso. Objetivo: analisar os efeitos de um Programa de Fisioterapia como promotor de saúde na capacidade funcional e identificar as variáveis sociodemográficas e clínicas em relação ao desempenho das atividades funcionais em mulheres idosas institucionalizadas. Métodos: realizou-se estudo descritivo, intervencionista e quantitativo, utilizando questionário de capacidade funcional (HAQ) e estudo qualitativo por meio de entrevista grupal (grupo focal). A amostra foi constituída de 42 idosas divididas em 2 grupos: experimental (n=22) e grupo controle (n=20). Os dados foram analisados por meio dos testes de correlação de Pearson e t “student” e adotou-se nível de significância de (p<0,05). Resultados: No grupo experimental, 60 por cento das idosas obtiveram melhora significativa no desempenho das atividades funcionais após a intervenção, enquanto que, no grupo controle, apenas 35por cento apresentaram desempenho satisfatório nas atividades funcionais avaliadas. Houve correlação positiva (r=0,622) entre as variáveis: idade, patologias associadas e maior comprometimento nas atividades funcionais cotidianas. Entre as influências qualitativas, relacionamos: melhora do sono, velocidade do andar, adoção de medida de segurança para executar as atividades. Conclusão: o Programa de Fisioterapia foi eficaz e propiciou melhora significativa no desempenho das atividades funcionais, contribuindo para redução das incapacidades e limitações funcionais em mulheres idosas institucionalizadas.

As the world elderly population increases, several areas of knowledge are concerned with the identification of conditions that allow aging with more quality. The elderly institution becomes a relevant topic as, when relating aging to health care, one can observe an increased demand for those long-term stay institutions. The preservation and maintenance of the functional capacity are priorities in the health of the aged. Objectives: this study analyzes the effects of a health promotion Physiotherapy Program on the functional capacity, and identifies socio-demographic and clinical variables concerning functional performance of elderly institutionalized women. Methods: it is a descriptive, interventionist and comparative study employing quantitative and qualitative approaches. Research was carried out using the Health Assessment Questionnaire (HAQ) and interviews were applied to a focus group. Forty-two elderly women participated,. Results: the experimental group presented significant improvement (60%), in the performance of main everyday activities with a positive and meaningful correlation (r=0.6222), in the following variables: age, associated pathologies, and impairment in functional activities. Conclusion: the Physiotherapy Program was effective and provided significant improvement on the performance of the everyday activities of elderly instutionalized women.

Modificaciones dinámicas en los islotes de Langerhans de dos Líneas de ratas espontaneamente diabeticas / Dynamic modifications in islets of Langerhans in two lines of spontaneously diabetic rats

La rata eSMT derivó del cruzamiento de eSS y b, líneas de la cepa IIM. eSS es un modelo de diabetes tipo 2 sin sobrepeso; b desarrolla obesidad moderada e intolerancia tardía a la glucosa. Fueron comparados características metabólicas y hallazgos histopatológicos del páncreas endocrino entre eSS y eSMT. Cotejados con eSS, los animales eSMT jóvenes son más corpulentos y desarrollan hiperglucemia de ayuno e intolerancia a la glucosa más precoces e intensas. En los machos eSMT de 6 y 9 meses existen islotes de formas alteradas y con fibrosis, detectándose esporádicas imágenes de apoptosis. En los de un año se tornan más pequeños y escasos, remedando la histoarquitectura de los machos eSS en el segundo año de vida; posteriormente los islotes van disgregándose, a la vez que muestran ocasionales mitosis y se observa nesidioblastosis. Se sugiere que estas modificaciones dinámicas constituyen una respuesta a la hiperglucemia. Las hembras eSS conservan por más tiempo la estructura insular y tienen menores alteraciones de la glucemia. El dimorfismo sexual del síndrome diabético de eSMT es atenuado respecto de eSS. La construcción de una tipología de individuos mediante el análisis multivariado separó tres clusters, evidenciando diferencias genéticas, etáreas y de sexo.

The eSMT rat is derived from the crossing of eSS and b, both lines belonging to the IIM strain, while eSS is a model of type 2 diabetes without overweight and b develops moderate obesity and late glucose intolerance. Metabolic characteristics and histopathological findings in endocrine pancreas of eSS and eSMT were compared. Young eSMT animals are more robust than eSS and develop more intense fasting hyperglycemia and glucose intolerance at an earlier age. eSMT males of 6 and 9 months show islets with altered shapes and fibrosis, as well as sporadic images of apoptosis. At 12 months of age, islets are reduced in number and size, resembling the histoarchitecture of eSS males during their second year of life; eventually islets undergo disruption and, at the same time, occasional mitoses and nesidioblastosis are seen. These dynamic modifications may be expressing a response to hyperglycemia. eSS females preserve their insular structure for a longer time and have less glycemic alterations. Sexual dimorphism of the diabetic syndrome of eSMT is attenuated when compared with eSS. The construction of a typology of individuals through multivariate analysis separated three clusters, evidencing genetic, age and sex differences.

Modificaciones dinámicas en los islotes de Langerhans de dos Líneas de ratas espontaneamente diabeticas / Dynamic modifications in islets of Langerhans in two lines of spontaneously diabetic rats

La rata eSMT derivó del cruzamiento de eSS y b, líneas de la cepa IIM. eSS es un modelo de diabetes tipo 2 sin sobrepeso; b desarrolla obesidad moderada e intolerancia tardía a la glucosa. Fueron comparados características metabólicas y hallazgos histopatológicos del páncreas endocrino entre eSS y eSMT. Cotejados con eSS, los animales eSMT jóvenes son más corpulentos y desarrollan hiperglucemia de ayuno e intolerancia a la glucosa más precoces e intensas. En los machos eSMT de 6 y 9 meses existen islotes de formas alteradas y con fibrosis, detectándose esporádicas imágenes de apoptosis. En los de un año se tornan más pequeños y escasos, remedando la histoarquitectura de los machos eSS en el segundo año de vida; posteriormente los islotes van disgregándose, a la vez que muestran ocasionales mitosis y se observa nesidioblastosis. Se sugiere que estas modificaciones dinámicas constituyen una respuesta a la hiperglucemia. Las hembras eSS conservan por más tiempo la estructura insular y tienen menores alteraciones de la glucemia. El dimorfismo sexual del síndrome diabético de eSMT es atenuado respecto de eSS. La construcción de una tipología de individuos mediante el análisis multivariado separó tres clusters, evidenciando diferencias genéticas, etáreas y de sexo.(AU)

The eSMT rat is derived from the crossing of eSS and b, both lines belonging to the IIM strain, while eSS is a model of type 2 diabetes without overweight and b develops moderate obesity and late glucose intolerance. Metabolic characteristics and histopathological findings in endocrine pancreas of eSS and eSMT were compared. Young eSMT animals are more robust than eSS and develop more intense fasting hyperglycemia and glucose intolerance at an earlier age. eSMT males of 6 and 9 months show islets with altered shapes and fibrosis, as well as sporadic images of apoptosis. At 12 months of age, islets are reduced in number and size, resembling the histoarchitecture of eSS males during their second year of life; eventually islets undergo disruption and, at the same time, occasional mitoses and nesidioblastosis are seen. These dynamic modifications may be expressing a response to hyperglycemia. eSS females preserve their insular structure for a longer time and have less glycemic alterations. Sexual dimorphism of the diabetic syndrome of eSMT is attenuated when compared with eSS. The construction of a typology of individuals through multivariate analysis separated three clusters, evidencing genetic, age and sex differences.(AU)

Conducta alimentaria y perfil glucémico en dos líneas de ratas con diabetes genética: eSS y eSMT / Feeding behavior and glycemic profile in two lines of rats with genetic diabetes

Introducción. La alimentación puede agravar la diabetes de humanos y modelos animales. Entre ellos, la rata eSMT presenta un curso más exacerbado y mayor biomasa que la línea parental eSS. Objetivo. Estudiar la conducta alimentaria de ratas macho eSMT y eSS ante oferta ilimitada y bajo restricción alternada, analizando su incidencia sobre el peso y la glucemia. Materiales y métodos. Se registró el consumo ad libitum en etapas de crecimiento y mantenimiento. Un grupo de eSMT recibió durante 5 semanas a partir del destete, una dietarestringida intermitente seguida de oferta ilimitada, y otro fue restringido hasta el año de edad, midiéndose el peso y el perfil glucémico en distintas edades. Resultados. Durante el crecimiento, eSMT aumentó de peso más que eSS con ingestas similares, y en la etapa de mantenimiento sustentó mayor biomasa con menor consumo. Larestricción intermitente posterior al destete indujo un patrón de crecimiento más lento y menor peso adulto. A los 5 meses presentaron valores de G0 normales (85±12 mg/dl) y los controles mostraron cifras alteradas (119±14 mg/dl). En los animales restringidos la posterior oferta ilimitada produjo glucemias de ayuno compatibles con diabetes (163±25 mg/dl) y un incremento ponderado 75 por ciento superior a los alimentados ad libitum. Conclusión. La alternancia prolongada hambre-saciedad indujo en eSMT desaceleración de su metabolopatía mientras que la realimentación se asoció con incrementos superiores de peso y glucemia, atribuibles a un aumento de la eficiencia de conversión inducida por el ayuno. Estos resultados enfatizan la importancia de mejorar el conocimiento sobre las relaciones entre crecimiento, alimentación y diabetes

[Feeding behavior and glycemic profile in two lines of rats with genetic diabetes]. / Conducta alimentaria y perfil glucémico en dos líneas de ratas con diabetes genética: eSS y eSMT.

INTRODUCTION: Food intake can aggravate diabetes in humans and in animal models. In rat model systems, the eSMT rat strain shows increased diabetes expression and higher biomass than its eSS parental line. OBVJECTIVE: The feeding behavior of eSMT and eSS males was compared under conditions of ad libitum versus restrictive food intake. The effects on rat weight and glycemia were examined. MATERIALS AND METHODS: Unrestricted food intake during growth and maintenance stages was recorded. One group of eSMT was submitted to intermittent dietary restriction for 5 weeks after weaning, followed by ad libitum food availability. A second group was restricted until one year of age. Weights and glycemic profiles were measured at periodic intervals. RESULTS: During the growth stage, eSMT showed weight increases higher than the eSS with similar food intake. In the maintenance stage, eSMT reached higher biomass with less intake. Post-weaning alternate restriction induced a slower growth pattern and lower adult weight. After five months of fasting, glycemia was normal (85 +/- 12 mg/dl) and controls showed altered values (119 +/- 14 mg/dl). Ad libitum nutrition after restriction resulted in glycemia levels compatible with diabetes (163 +/- 25 mg/dl) and a weight gain 75% higher than in ad libitum-fed animals. CONCLUSIONS: Prolonged hunger-satiety alternation induced slowing of the eSMT metabolopathy, whereas refeeding was associated with higher increases of weight and glycemia. This was imputed to an augmented conversion efficiency caused by fasting. These results emphasize the importance of understanding the relations between growth, feeding and diabetes.

Hepatic delta9, delta6, and delta5 desaturations in non-insulin-dependent diabetes mellitus eSS rats.

Both diabetes mellitus type 1 and diabetes mellitus type 2 are widespread diseases that alter carbohydrate and lipid metabolism. e Stilmann-Salgado (eSS) rats are experimental animals that spontaneously evolve to a state similar to that of young people affected by non-insulin-dependent diabetes mellitus (NIDDM; type 2). Using 6-mon-old eSS rats that, according to the literature [Martinez, S.M., Tarrés, M.C., Montenegro, S., Milo, R., Picena, J.C., Figueroa, N., and Rabasa, S.R. (1988) Spontaneous Diabetes in eSS Rats, Acta Diabetol. Lat. 25, 303-313], had already developed insulin resistance, we investigated the changes evoked on delta9, delta6, and delta5 liver desaturases. The abundance of mRNA and enzymatic activities were measured, as well as the FA composition of liver microsomal lipids. Compared to control rats, the mRNA content and activity of SCD-1 (stearoyl CoA-desaturase, isoform of the delta9 desaturase) were significantly higher, whereas the mRNA and activities of delta6 and delta5 desaturases were not significantly modified. Correspondingly, the proportion of 18:1n-9 and the ratios of 18:1n-9/18:0 and 16:1/16:0 in lipids were significantly increased, whereas the proportion of 20:4n-6 was unaltered. These effects were found while glycemia was constant or increased. The results are completely opposite those described in insulin-dependent diabetes mellitus (type 1), in which a depression of all the desaturases is found. They suggest that in eSS rats, the activities of the desaturases were not modified by an insulin-resistance effect. Moreover, we suggest that the enhancement of SCD-1 activity might be considered as another typical sign of the NIDDM syndrome, because it has also been found in other animal models of NIDDM, for example, the ones evoked by the sucrose-rich diet and in the Zucker rat.

[Chronic bronchial dilatations in different colonies of laboratory rats]. / Dilataciones bronquiales crónicas en differentes colonias de ratas de laboratorio.

Bronchiectasis occurred naturally in 12-month-old spontaneously diabetic eSS male rats. The lungs of 3 and 6-month-old eSS rats were compared in eumetabolic eSS rats from three inbred lines consisting of inbred spontaneously diabetic eSS derived from IIM strain; these were compared with eumetabolic, outbred Wistar rats, paired by sex and age. Acrylic casts of bronchial tree were obtained after injection of a plastic substance. The casts were pruned to focus on the first four bronchial branchings. Diameter and volume of the conductive bronchial tree were determined using a binocular magnifier. Histological sections were obtained. All lines showed multiple bronchiectasis, mostly fusiform, bronchial dilatation and inflammatory response with lymphocytic infiltrates. These symptoms were much more severe in 180-day-old eSS males. Bacteria were isolated from the lungs in 70% of cases (n = 32), except in eSS rats. Pseudomonas spp. (38%) and Gram-positive cocci as coagulase-negative Staphylococcus spp. (20%) were detected. Neither pathogenic bacteria nor saprophyte fungi were found. Although all lines were affected, diabetes in eSS appears to be an aggravating factor.

Dilataciones bronquiales crónicas en diferentes colonias de ratas de laboratorio / Bronchial chronic dilatations in different colonies of laboratory rats

Ante la aparición espontánea de bronquiectasias en ratas macho eSS diabéticas, se examinaron los pulmones de ratas eSS de 3 a 6 meses de edad y los de ratas eumetabólica de tres líneas: eSS endocriada con diabetes espontánea tipo 2 derevida de la cepa IIM; líneas e, m y alfa endocriadas, y Wistar eumetabólica y exocriada, agrupadas según sexo y edad. Se obtuvieron moldes se recortaron y se concentró la observación en las primeras cuatro ramificaciones bronquiales; se determinaron el diámetro y el volumen con la lente binocular de aumento. Además, se obtuvieron cortes histológicos. Aunque en todas las líneas se observaron bronquiectasias múltiples, principalmente fusiformes, la dilatación bronquial y la respuesta inflamatoria con los infiltrados linfocíticos fueron mucho más graves en los machoos eSS de 180 días de edad. En el 70 por ciento de los casos (n=32) se aislaron bacterias en los pulmones, excepto en las ratas eSS. Se detectaron Pseudomona spp. (38 por ciento) y cocos Gram positivos en forma de Staphylococcus spp. coagulasa negativos (20 por ciento). No se encontraton hongos patógenos ni saprofíticos. Si bien todas las líneas aparecen afectadas, la diabetes de eSS sería un factor agravante

Relacion entre dieta, biomasa y expresion de la diabetes en la rata eSS / Relation between diet, body mass and expression of diabetes in eSS rats

Se valoró el efecto a largo plazo de alimentar ratras machos eSS desde el destete con tres dietas comerciales: de más alto contenido de grasas (A), de glúcidos y fibras (B) y de proteínas (C). Los animales C, de mayor crecimiento, alcanzaron la categoría de diabéticos a los 4 meses, presentando los valores más latos de triglicéridos, colesterol total y HDL-colesterol. Los A, diabéticos desde los 6 meses, tuvieron más elevado el peso, la glucemia tras sobrecarga glúcida y la insulenemia a partir de los 13 meses. Los B, de menor peso, no expresaron la diabetes hasta los 10 meses. Los animales A mostraron a los 23 meses paquetes adiposos retroperitoneal y epididmatrios de más peso, en tanto que el grupo C presentó cataratas totales y bilaterales. En A las cataratas fueron menos graves y B no las mostró. El examen histológico reveló en C menor número de islotes de Langerhans y lesiones renales ms intensas. No se comprobó daño renal en B. Se concluye que dietas ricas en proteínas y grasas que inducen mayor peso constituyen factores agravantes de la diabetes eSS mientras que una dieta con menor densidad calórica y abundante en fibra retarda su comienzo (AU)

Relacion entre dieta, biomasa y expresion de la diabetes en la rata eSS / Relation between diet, body mass and expression of diabetes in eSS rats

Se valoró el efecto a largo plazo de alimentar ratras machos eSS desde el destete con tres dietas comerciales: de más alto contenido de grasas (A), de glúcidos y fibras (B) y de proteínas (C). Los animales C, de mayor crecimiento, alcanzaron la categoría de diabéticos a los 4 meses, presentando los valores más latos de triglicéridos, colesterol total y HDL-colesterol. Los A, diabéticos desde los 6 meses, tuvieron más elevado el peso, la glucemia tras sobrecarga glúcida y la insulenemia a partir de los 13 meses. Los B, de menor peso, no expresaron la diabetes hasta los 10 meses. Los animales A mostraron a los 23 meses paquetes adiposos retroperitoneal y epididmatrios de más peso, en tanto que el grupo C presentó cataratas totales y bilaterales. En A las cataratas fueron menos graves y B no las mostró. El examen histológico reveló en C menor número de islotes de Langerhans y lesiones renales ms intensas. No se comprobó daño renal en B. Se concluye que dietas ricas en proteínas y grasas que inducen mayor peso constituyen factores agravantes de la diabetes eSS mientras que una dieta con menor densidad calórica y abundante en fibra retarda su comienzo