Adiponectinemia Is Associated with Uricemia but Not with Proinflammatory Status in Women with Metabolic Syndrome

Metabolic syndrome (MS) is a cluster of glucose intolerance, hypertension, and dyslipidemia with visceral fat accumulation. This study was undertaken to assess which components of metabolic syndrome (MS), including uric acid and proinflammatory markers, are related to adiponectin levels in overweight and obese women with MS. Ninety-one women (60 with MS and 31 controls) were assessed in relation to classical and inflammatory parameters of MS. In comparison to controls, patients with MS showed significant differences in parameters that are typically associated with MS and in inflammatory markers. Fibrinogen, CRP, and C3 were positively, whereas albumin was inversely correlated with abdominal adiposity and insulin resistance. Adiponectin was inversely correlated with waist circumference and uric acid levels. Activities of adiponectin and proinflammatory markers are not correlated in overweight and obese women with MS. In addition to abdominal adiposity, uric acid may be implicated in a decrease of adiponectin in MS patients

Influence of Insulin Resistance and TNF- α

The aim of this study was to evaluate the involvement of TNF-α and insulin resistance (IR) in the inflammatory process, oxidative stress, and disease activity in patients with rheumatoid arthritis (RA). This cross-sectional study included 270 subjects (control group, n=97) and RA patients (n=173). RA patients were divided into four groups: the first group without IR and not using antitumor necrosis factor-α (TNF-) (G1, IR− TNF−); the second group without IR and using anti-TNF-α (G2, IR- TNF+); the third group with IR and not using anti-TNF-α (G3, IR+ TNF-); and the fourth group with IR and using anti-TNF-α (G4, IR+ TNF+). G3 and G4 had higher (p<0.05) advanced oxidation protein products (AOPPs) and oxidative stress index (OSI) compared to G1. G4 group presented higher (p<0.05) AOPPs and OSI than G2. TRAP was significantly lower in G3 compared to G1. Plasma TNF-α levels were significantly higher in G4 and G2 compared to G1 (p<0.0001) and G3 (p<0.0001 and p<0.01, resp.). The presence of insulin resistance was robustly associated with both oxidative stress and TNF-α levels. More studies are warranted to verify if IR can be involved in therapeutic failure with TNF-α inhibitors. This trial is registered with Brazilian Clinical Trials Registry Register number RBR-2jvj92

Agonia da história clínica e suas conseqüências para o ensino médico

A história clínica, cada vez mais, vem sendo subestimada como ferramenta indispensável à formação médica. Sendo esta desvalorização multifatorial, dois são os fatores que a tornam menos atraente aos olhos dos recém-egressos das universidades e mesmo para alguns profissionais já graduados: o deslumbramento diante de procedimentos high tech e a lenda intelectualista que valoriza apenas aspectos teórico-contemplativos do saber humano. O presente artigo de revisão tem por objetivo analisar as causas que levaram a esse quadro e contribuir com algumas sugestões para que ele possa ser ao menos minimizado