Background: The high consumption of fat and sugar contributes to the development of obesity and co-morbidities, such as diabetes, and cardiovascular and kidney diseases. Different strategies have been used to prevent these diseases associated with obesity, such as changes in eating habits and/or the addition of dietary components with anti-inflammatory and anti-oxidant properties, such as gamma-oryzanol (γOz) present mainly in bran layers and rice germ. Methods: Animals were randomly divided into four experimental groups and fed ad libitum for 20 weeks with control diet (C, n = 8), control diet + γOz (C + γOz, n = 8), high-sugar and high-fat diet (HSF, n = 8), and high-sugar and high-fat diet + γOz (HSF + γOz, n = 8). HSF groups also received water + sucrose (25%). The dose of γOz was added to diets to reach 0.5% of final concentration (w/w). Evaluation in animals included food and caloric intake, body weight, plasma glucose, insulin, triglycerides, uric acid, HOMA-IR, glomerular filtration rate, protein/creatinine ratio, systolic blood pressure, and Doppler echocardiographic. Results: Animals that consumed the HSF diet had weight gain compared to group C, increased insulin, HOMA, glucose and triglycerides, there were also atrial and ventricular structural alterations, deterioration of systolic and diastolic function, decreased glomerular filtration rate, and proteinuria. Gamma-oryzanol is significantly protective against effects on body weight, hypertriglyceridemia, renal damage, and against structural and functional alteration of the heart. Conclusion: Gamma-oryzanol shows potential as a therapeutic to prevent Cardiorenal Metabolic Syndrome.

The kidney is an important organ in the maintenance of body homeostasis. Dietary compounds, reactive metabolites, obesity, and metabolic syndrome (MetS) can affect renal filtration and whole body homeostasis, increasing the risk of chronic kidney disease (CKD) development. Gamma oryzanol (γOz) is a compound with antioxidant and anti-inflammatory activity that has shown a positive action in the treatment of obesity and metabolic diseases. Aim. To evaluate the effect of γOz to recover renal function in obese animals by high sugar-fat diet by modulation of adiponectin receptor 2/PPAR-α axis Methods. Male Wistar rats were initially randomly divided into 2 experimental groups: control and high sugar-fat diet (HSF) for 20 weeks. When proteinuria was detected, HSF animals were allocated to receive γOz or maintain HSF for more than 10 weeks. The following were analyzed: nutritional and biochemical parameters, systolic blood pressure, and renal function. In the kidney, the following were evaluated: inflammation, oxidative stress, and protein expression by Western blot. Results. After 10 weeks of γOz treatment, γOz was effective to improve inflammation, increase antioxidant enzyme activities, increase the protein expression of adiponectin receptor 2 and PPAR-α, and recover renal function. Conclusion. These results permit us to confirm that γOz is able to modulate PPAR-α expression, inflammation, and oxidative stress pathways improving obesity-induced renal disease.

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The exposure to unethical and unprofessional behavior is thought to play a major role in the declining empathy experienced by medical students during their training. We reflect on the reasons why medical schools are tolerant of unethical behavior of faculty. First, there are barriers to reporting unprofessional behavior within medical schools including fear of retaliation and lack of mechanisms to ensure anonymity. Second, deans and directors do not want to look for unethical behavior in their colleagues. Third, most of us have learned to take disrespectful circumstances in health care institutions for granted. Fourth, the accreditation of medical schools around the world does not usually cover the processes or outcomes associated with fostering ethical behavior in students. Several initiatives promise to change that picture. THE ORATOR'S SPEECHR ecently, we attended the graduation ceremony of medical graduates at our medical school. It is satisfying to see the glowing faces of our students and their families, as these young men and women perform this last ritual towards becoming physicians. As the orator gave her speech, she thanked the professors and health care professionals who had taught her and fellow graduates important lessons of competent and humane care of sick patients, and also faculty who had provided them with examples of "pure unethical behavior." She justified her "gratitude" by saying that they had learned 2 eloquent lessons: how to behave professionally and how not to behave toward patients, their families, and colleagues.In the next few days after the ceremony, we asked other faculty members and other professionals who had attended the graduation ceremony about their thoughts on the speech. Surprisingly, no one seemed uneasy about the not-so-subtle allegation of unethical behavior of faculty in our medical school. In fact, no one had approached the orator or her fellow graduates to verify the claims of disrespectful and unethical behavior.We wondered what would have happened if that speech had been presented at another type of institution. Would the CEO respond by reaffirming the organization's commitment to ethical behavior? Would the orator and her fellow graduates be asked to substantiate the claims and assist with investigations to protect not only the organization's customers and employees, but also the organization's mission and reputation? We hope that the answer to those questions would be yes.Why then is unethical behavior tolerated in medical schools? This is not a local problem and unfortunately there are several examples in the medical literature describing how common such unprofessional situations are around the world.3-8 Most, if not all, medical schools confront harassment and discrimination as described by a recent systematic review. 9For the purposes of this essay we will define unethical behaviors as those that infringe any aspect of the medical code of ethics. We will also consider professionalism as a subset of health care ethics as proposed by Brody and Doukas 1 a...