Treadmill Training Effect on the Myokines Content in Skeletal Muscles of Mice With a Metabolic Disorder Model.

The effect of treadmill training loads on the content of cytokines in mice skeletal muscles with metabolic disorders induced by a 16 week high fat diet (HFD) was studied. The study included accounting the age and biorhythmological aspects. In the experiment, mice were used at the age of 4 and 32 weeks, by the end of the experiment-respectively 20 and 48 weeks. HFD feeding lasted 16 weeks. Treadmill training were carried out for last 4 weeks six times a week, the duration 60 min and the speed from 15 to 18 m/min. Three modes of loading were applied. The first subgroup was subjected to stress in the morning hours (light phase); the second subgroup was subjected to stress in the evening hours (dark phase); the third subgroup was subjected to loads in the shift mode (the first- and third-weeks treadmill training was used in the morning hours, the second and fourth treadmill training was used in the evening hours). In 20-week-old animals, the exercise effect does not depend on the training regime, however, in 48-week-old animals, the decrease in body weight in mice with the shift training regime was more profound. HFD affected muscle myokine levels. The content of all myokines, except for LIF, decreased, while the concentration of CLCX1 decreased only in young animals in response to HFD. The treadmill training caused multidirectional changes in the concentration of myokines in muscle tissue. The IL-6 content changed most profoundly. These changes were observed in all groups of animals. The changes depended to the greatest extent on the training time scheme. The effect of physical activity on the content of IL-15 in the skeletal muscle tissue was observed mostly in 48-week-old mice. In 20-week-old animals, physical activity led to an increase in the concentration of LIF in muscle tissue when applied under the training during the dark phase or shift training scheme. In the HFD group, this effect was significantly more pronounced. The content of CXCL1 did not change with the use of treadmill training in almost all groups of animals. Physical activity, introduced considering circadian rhythms, is a promising way of influencing metabolic processes both at the cellular and systemic levels, which is important for the search for new ways of correcting metabolic disorders.

Individual- and community-level risk factors for ESBL Enterobacteriaceae colonization identified by universal admission screening in London.

OBJECTIVES: We evaluated risk factors for gastrointestinal carriage of Enterobacteriaceae which produce extended-spectrum ß-lactamases (ESBL-E), including individual-level variables such as antibiotic use and foreign travel, and community-level variables such as housing and deprivation. METHODS: In an observational study in 2015, all patients admitted to a London hospital group were approached to be screened for ESBL-E carriage using rectal swabs for 4 months. Patients completed a risk factor questionnaire. Those with a residential postcode in the local catchment area were linked to a database containing community-level risk factor data. Risk factors for ESBL-E carriage were determined by binary logistic regression. RESULTS: Of 4006 patients, 360 (9.0%) carried ESBL-E. Escherichia coli was the most common organism (77.8%), and CTX-M-type ESBLs were the most common genes (57.9% CTX-M-15 and 20.7% CTX-M-9). In multivariable analysis, risk factors for phenotypic ESBL-E among the 1633 patients with a residential postcode within the local catchment area were: travel to Asia (OR 4.4, CI 2.5-7.6) or Africa (OR 2.4, CI 1.2-4.8) in the 12 months prior to admission, two or more courses of antibiotics in the 6 months prior to admission (OR 2.0, CI 1.3-3.0), and residence in a district with a higher-than-average prevalence of overcrowded households (OR 1.5, CI 1.05-2.2). . CONCLUSIONS: Both individual and community variables were associated with ESBL-E carriage at hospital admission. The novel observation that household overcrowding is associated with ESBL-E carriage requires confirmation, but raises the possibility that targeted interventions in the community could help prevent transmission of antibiotic-resistant Gram-negative bacteria.

Planning to halve Gram-negative bloodstream infection: getting to grips with healthcare-associated Escherichia coli bloodstream infection sources.

BACKGROUND: A thorough understanding of the local sources, risks, and antibiotic resistance for Escherichia coli bloodstream infection (BSI) is required to focus prevention initiatives and therapy. AIM: To review the sources and antibiotic resistance of healthcare-associated E. coli BSI. METHODS: Sources and antibiotic resistance profiles of all 250 healthcare-associated (post 48 h) E. coli BSIs that occurred within our secondary and tertiary care hospital group from April 2014 to March 2017 were reviewed. Epidemiological associations with urinary source, gastrointestinal source, and febrile neutropenia-related BSIs were analysed using univariable and multivariable binary logistic regression models. FINDINGS: E. coli BSIs increased 9% from 4.0 to 4.4 per 10,000 admissions comparing the 2014/15 and 2016/17 financial years. Eighty-nine cases (36%) had a urinary source; 30 (34%) of these were classified as urinary catheter-associated urinary tract infections (UTIs). Forty-five (18%) were related to febrile neutropenia, and 38 (15%) had a gastrointestinal source. Cases were rarely associated with surgical procedures (11, 4%) or indwelling vascular devices (seven, 3%). Female gender (odds ratio: 2.3; 95% confidence interval: 1.2-4.6) and older age (1.02; 1.00-1.05) were significantly associated with a urinary source. No significant associations were identified for gastrointestinal source or febrile neutropenia-related BSIs. Forty-seven percent of the isolates were resistant to ciprofloxacin, 37% to third-generation cephalosporins, and 22% to gentamicin. CONCLUSION: The gastrointestinal tract and febrile neutropenia together accounted for one-third of E. coli BSI locally but were rare associations nationally. These sources need to be targeted locally to reduce an increasing trend of E. coli BSIs.

Evaluating serial screening cultures to detect carbapenemase-producing Enterobacteriaceae following hospital admission.

BACKGROUND: Carbapenem-producing Enterobacteriaceae (CPE) are on the rise worldwide. National guidelines for the prevention and control of CPE recommend screening for the detection of asymptomatic carriers on admission. AIM: To evaluate the benefit of serial screens for detecting the carriage of CPE and other antibiotic-resistant Gram-negative bacteria following hospital admission. METHODS: All CPE screens, which were cultured on chromogenic media and the presence of a carbapenemase confirmed by polymerase chain reaction, were analysed for a six-month period. National guidelines in England recommend three serial screens for CPE separated by 48 h for admission screening for 'at-risk' patients, during which the patient is isolated. Two screening scenarios were tested. In scenario A, patients received three screens at the specified timepoints, in line with English national guidelines; in scenario B, patients received three consecutive screens, but not necessarily within the specified timepoints, during one admission. General linear models or conditional logistic regression were used to detect any significant change in the rate of carriage. FINDINGS: There was no significant increase in the detected carriage rate of CPE across any of the three timepoints in the scenarios tested. However, there was a significant increase in the detected rate of carriage of Gram-negative bacteria, Enterobacteriaceae, and resistant Enterobacteriaceae (excluding CPE) in scenario B. CONCLUSION: Three serial screens were not useful for the detection of CPE carriage on admission. The increase in the carriage rate of other Gram-negative bacteria may be explained by 'unmasking' of pre-existing carriage, or acquisition. This argues for regular screening of long-stay patients.

Efficacy and acceptability of rectal and perineal sampling for identifying gastrointestinal colonization with extended spectrum ß-lactamase Enterobacteriaceae.

OBJECTIVES: We evaluated 'pre-laboratory' factors associated with the detection of extended spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-E) colonization including anatomical site, and staff and patient factors. METHODS: All admissions to a large London hospital over 3 months were approached to provide rectal and perineal swabs, which were cultured for ESBL-E using chromogenic media. ESBL-E detection rates for patient- or staff-collected rectal or perineal swabs were compared using McNemar tests. Binary logistic regression was used to explore factors associated with patients declining to provide a rectal swab. The impact of simplifying the verbal study description to patients to improve the participation rate was evaluated. RESULTS: Carriage of ESBL-E was significantly higher in rectal swabs than perineal swabs (7.8% of 4006 versus 3.8% of 4006, p <0.001), whether collected by staff or patients; 31.9% of 869 patients did not provide a rectal swab before the change in study description compared with 7.6% of 3690 patients afterwards (p <0.001). In multivariable analysis, factors associated with patients declining to provide a rectal swab were younger age (OR 0.99, 95% CI 0.99-1.00), female gender (OR 1.26, 95% CI 1.04-1.52), transfers from other hospitals (OR 1.77, 95% CI 1.07-2.93) or an unknown admission route (OR 1.61, 95% CI 1.09-2.37), being admitted before the change in study description (OR 0.39, 95% CI 0.31-0.48), and the staff member who consented the patient (p <0.001); ethnicity was not a significant factor. CONCLUSIONS: Rectal swabs are recommended for the detection of ESBL-E colonization. Staff and patient factors influence whether patients participate in prevalence studies, which may skew their findings.

[Secretory Function of Skeletal Muscles: Producing Mechanisms and Myokines Physiological Effects].

Skeletal muscle cells secrete a variety of hormones and cytokines, which are referred to as myokines. Different modes of exercise are the main factor of myokines producing. The myokines expression level is increased in an exponential fashon proportional to the length of exercise and the amount of muscle mass engaged in the exercise. These myokines are described to communicate with cells in an autocrine/ paracrine manner. Thus it ensures the maintenance of homeostasis and adaptarion to physical stress. This myokines role is provided by a vriety of effects. It is assumed that exercise increases myokines transcription via signaling systems that are activated in response to a decrease in the partial pressure of oxygen, increasing the concentration of [Ca²âº] i and AMP. Significant prospects have the myokines investigation of the role in the different disorders correction. So now accumulated enough data for myokines consideration as a single functional system, which plays an important role in the adaptation mechanisms to the habitual exrcise.

Reduction in Clostridium difficile infection associated with the introduction of hydrogen peroxide vapour automated room disinfection.

The clinical impact of implementing hydrogen peroxide vapour (HPV) disinfection of rooms vacated by patients with Clostridium difficile infection (CDI) was evaluated. Breakpoint time series analysis indicated a significant reduction (P<0.001) in the CDI rate at the time when HPV disinfection was implemented, resulting in a reduction in the CDI rate from 1.0 to 0.4 cases per 1000 patient-days in the 24 months before HPV usage compared with the first 24 months of HPV usage. HPV should be considered to augment the terminal disinfection of rooms vacated by patients with CDI.

Isolation demand from carbapenemase-producing Enterobacteriaceae screening strategies based on a West London hospital network.

OBJECTIVE: To estimate the isolation demands arising from high-risk specialty-based screening for carbapenemase-producing Enterobacteriaceae (CPE), and the potential fraction of CPE burden detected. METHODS: Clinical specialty groups from three London hospitals were ranked by incidence of carbapenem resistance among Escherichia coli and Klebsiella spp. Contact precaution bed-days were estimated for three screening strategies: Strategy 1, 'circulation science and renal medicine'; Strategy 2, Strategy 1 plus 'specialist services'; and Strategy 3, Strategy 2 plus 'private patients'. Isolation bed occupancy rates and potential CPE detection rates were estimated. RESULTS: Of 99,105 admissions to the three hospitals in Financial Year 2014/15, Strategies 1, 2 and 3 would have screened 4371 (4.4%), 7482 (7.6%), and 13,542 (13.7%) patients, respectively. The specialties' isolation bed occupancy rates varied between 3% and 696% depending on strategy, number of consecutive tests, and whether or not pre-emptive isolation had been applied. Expected detection rates of the potential CPE burden in the hospital network would have varied between 17.1% and 47.5%. CONCLUSIONS: High-risk specialty-based screening has the potential to detect nearly half of the potential CPE burden, and would be more pragmatic than patient-level risk-factor-based screening. Pre-emptive isolation increases isolation requirements substantially. CPE screening strategies need to balance risk and resources.

[INTERACTION EPITHELIUM AND SMOOTH MUSCLE IN THE WALLS OF THE AIRWAYS IN THE NORMAL CONDITIONS AND WHEN FORMING OF HYPERREACTIVITY].

In the present study was to investigate the effect epithelium on the tone smooth muscle of the airways of guinea pigs under physiological conditions and when forming of experimental asthma. It was found that the amplitude of contractile responses decreased by histaminergic, and serotonergic effects in the presence of epithelium in the control group. Influence epithelium dilatation adrenergic reactions depended on the type of pretreatment factors. The amplitude of the relaxation was reduced in the case of pre-treatment with a solution of potassium, the amount of dilation increased by pretreatment with histamine. The impact of epithelium on contractile responses of smooth muscles disappeared when forming of hyperreactivity.

Contractile reactions of guinea pig airway smooth muscles in the presence of stannum oxide nanosized particles.

Contractile reactions of the guinea pig airway smooth muscles in the presence of stannum dioxide nanosized particles were studied. Contractile reactions to cholinergic and histaminergic stimulation were potentiated by inhalations of nanoparticle aerosol and by exposure of isolated smooth muscle segments to nanoparticle suspension.