MetS frequency was higher in RA patients than in controls. Among RA patients, MetS was associated with disease activity. The higher prevalence of cardiovascular risk factors in RA suggests that inflammatory processes play a notable role in the development of cardiovascular disease (CVD), and indicates that tight control of systemic inflammatory activity and CVD modifiable risk factors should be recommended.

-One third of cases of cerebral ischemia have no clear etiology. A humoral response to the atherosclerotic plaques components beta2-glycoprotein I (beta2-gpI) and heat-shock proteins (Hsp) might be involved in the pathogenesis of stroke. This case-control study includes a complete profile of anti-beta2-gpI antibodies and testing of IgG antibodies to the 60/65 kilodaltons (kDa) Hsp in stroke patients. Ninety-three patients with acute ischemic stroke and 93 controls were evaluated for age, sex, race, hypertension, smoking, previous cardiopathy, diabetes mellitus, hypercholesterolemia and previous history of cerebral ischemia. IgG/ IgM/IgA anticardiolipin (aCL) and anti-beta2-gpI antibodies, as well as IgG antibodies to human 60 kDa Hsp and to Mycobacterium bovis 65 kDa Hsp, were detected by immunoassay. Adjusted odds ratios (OR) were calculated by logistic regression. The adjusted OR for IgA anti-beta2-gpI antibodies was 4.6 (90%CI 1.5 to 14.3; p = 0.025). The non-adjusted OR for IgG antibodies to Hsp 60 was 26.1. The adjusted OR for IgG antibodies to Hsp 65 was 3.2 (90%CI 1.2 to 8.3; p = 0.044). The adjusted OR for IgG to any Hsp (60 or 65) was 4.8 (90%CI 1.9 to 12.1; p = 0.006). This study demonstrates that elevated IgA anti-beta2-gpI and IgG antiHsp 60/65 antibodies are associated with increased risk of ischemic stroke. The association occurred independently of other risk factors. This humoral response might link autoimmunity, thrombophilia and atherosclerosis in stroke patients.KEY WORDS: anti-beta2-gpI antibodies, anti-Hsp 60/65 antibodies, acute cerebral ischemia.Anticorpos contra os componentes da placa aterosclerótica beta2-glicoproteína I e proteínas de choque Anticorpos contra os componentes da placa aterosclerótica beta2-glicoproteína I e proteínas de choque Anticorpos contra os componentes da placa aterosclerótica beta2-glicoproteína I e proteínas de choque Anticorpos contra os componentes da placa aterosclerótica beta2-glicoproteína I e proteínas de choque Anticorpos contra os componentes da placa aterosclerótica beta2-glicoproteína I e proteínas de choque térmico como fatores de risco para isquemia cerebral aguda térmico como fatores de risco para isquemia cerebral aguda térmico como fatores de risco para isquemia cerebral aguda térmico como fatores de risco para isquemia cerebral aguda térmico como fatores de risco para isquemia cerebral aguda RESUMO -Um terço dos casos de isquemia cerebral não apresenta etiologia clara. Uma resposta humoral contra os componentes da placa aterosclerótica beta2-glicoproteína I (beta2-gpI) e proteínas de choque térmico ("heat-shock proteins", Hsp) pode estar envolvida na patogênese do infarto cerebral. Este estudo de caso-controles inclui um perfil completo de anticorpos anti-beta2-gpI e a testagem de IgG anti-Hsp de 60/65 kilodaltons (kDa) em pacientes com isquemia cerebral. Noventa e três pacientes com isquemia cerebral aguda e 93 controles foram avaliados quanto a idade, sexo, raça, hipertensão arterial, tabagismo, cardiopatia prévia, diabete mellitus, hip...

In the past 20 years, the life expectancy of patients with rheumatoid arthritis (RA) has been shown to be reduced by three to ten years as compared to that of the general population. Currently, cardiovascular disease (CVD) is the major cause of death in patients with RA, and acute myocardial infarction can be up to four times more frequent in these patients. The autoimmune systemic infl ammatory response, along with the presence of metabolic syndrome (MetS), doubles the risk for fatal or non-fatal CVD and coronary atherosclerosis, regardless of age and sex. Rheumatoid arthritis has been associated with increased prevalence of MetS, but its role in the different characteristics of the disease, such as disease duration, activity, and treatment with glucocorticoids, is not well defi ned. This study aimed at reviewing the prevalence of MetS and the factors implicated in the development of atherosclerosis in RA patients, assessing the clinical aspects of RA and its association with the development of MetS.

A doença de Still do adulto é uma desordem inflamatória rara, caracterizada por picos febris diários, rash evanescente, artrite e envolvimento de múltiplos órgãos. Manifestações oculares têm sido descritas associadas às manifestações clínicas clássicas da doença. Será descrito um caso de pseudotumor orbitário, condição clínica incomum, em uma paciente com diagnóstico de doença de Still do adulto.

Cardiopulmonary arrest is a medical emergency in which the lapse of time between event onset and the initiation of measures of basic and advanced support, as well as the correct care based on specific protocols for each clinical situation, constitute decisive factors for a successful therapy. Cardiopulmonary arrest care cannot be restricted to the hospital setting because of its fulminant nature. This necessitates the creation of new concepts, strategies and structures, such as the concept of life chain, cardiopulmonary resuscitation courses for professionals who work in emergency medical services, the automated external defibrillator, the implantable cardioverter-defibrillator, and mobile intensive care units, among others. New concepts, strategies and structures motivated by new advances have also modified the treatment and improved the results of cardiopulmonary resuscitation in the hospital setting. Among them, we can cite the concept of cerebral resuscitation, the application of the life chain, the creation of the universal life support algorithm, the adjust-ment of drug doses, new techniques--measure of the end-tidal carbon dioxide levels and of the coronary perfusion pressure--and new drugs under research.