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PURPOSE:To develop experimental models to evaluate the effects of hydrochloric acid associated with the pepsin instilled in the mucosa of the upper esophagus and the esophagogastric junction of young male rats Wistar, simulating injury caused by gastroesophageal reflux on the mucosa of aero-digestive tract in humans as well as the action of the risk exposure of mucosa to cigarette smoke. METHODS:Fifty young male Wistar rats divided in 5 groups with 10 animals each one, respectively simulating pharyngo-laryngeal reflux and gastroesophageal reflux, pharyngo-laryngeal reflux and smoking, smoking only, gastroesophageal reflux and control group. RESULTS:The histopathologic studies no recorded neoplasias, only mild changes and no significant alterations. The hemo-oximetry (carboxyhemoglobin and methemoglobim) and CO2 concentration confirm that the animals were submitted to high intensity of exposure to carcinogens in tobacco and its derivatives. CONCLUSION:The experimental models were highly efficient, practical, easy to use and economical and can be employed in other similar studies to determine the harmful effects by smoking and reflux. Key words: Smoking. Hydrochloric Acid. Pepsin. Gastroesophageal Reflux. Rats. RESUMO OBJETIVO:Desenvolver modelos experimentais para avaliar os efeitos do ácido clorídrico associado a pepsina, instilados na mucosa da parte superior do esôfago e da junção esofagogástrica de jovens ratos Wistar, simulando lesão causada por refluxo gastroesofágico na mucosa do trato aero-digestivo em humanos, bem como a ação da exposição ao risco de mucosa, como a fumaça de cigarro. MÉTODOS:Cinqüenta jovens ratos Wistar divididos em cinco grupos com 10 animais cada um, respectivamente, simulando o refluxo faringo-laríngeo e refluxo gastroesofágico, refluxo faringo-laríngeo e tabagismo, tabagismo só, refluxo gastroesofágico e grupo controle.RESULTADOS: os estudos histopatológicos não registraram neoplasias, apenas leves alterações e não significativas. O hemo-oximetria (carboxiemoglobina e metemoglobina) e concentração de CO2 corroboram que os animais foram submetidos a alta intensidade de exposição a substâncias cancerígenas do tabaco e seus derivados.CONCLUSÃO: os modelos experimentais desenvolvidos foram altamente eficientes, práticos, fáceis de usar e econômicos podendo ser empregados em outros estudos semelhantes para determinar os efeitos prejudiciais causados pelo tabagismo e refluxo.Descritores: Tabagismo. Ácido Clorídrico. Pepsina. Refluxo Gastroesofágico. Ratos. Experimental model of smoking and simulation of reflux with acid and pepsin in rats

A 33-year primiparous woman, 86kg, 1.62m, BMI 32.7kg.m, at 15 weeks of gestation, physical status ASA III, investigated for a reduced level of consciousness. Laboratory tests showed: hypoglycemia (45mg.dL) associated with hyperinsulinemia (24 nUI.mL), glycosylated hemoglobin (4.1%); other laboratory findings and physical examination were normal. Magnetic resonance imaging showed a 1.1cm nodule in the pancreatic tail with suspected insulinoma. Due to the difficult glycemic control with bolus and continuous infusion of glucose, laparotomy was performed for tumor enucleation under total intravenous anesthesia combined with epidural block. Monitoring, central and peripheral venous access, radial artery catheterization, diuresis, and glucosimetry were recorded every 15minutes. Intraoperatively, there was severe hypoglycemia while handling the tumor and shortly before its enucleation, which was controlled through continuous infusion of 10% glucose balanced crystalloid solution (100-230ml.h). The patient's postoperative evolution was uneventful, with resolution of hypoglycemia and total withdrawal of glucose intravenous infusion.