Apocynin Attenuates Diabetes-Induced Skeletal Muscle Dysfunction by Mitigating ROS Generation and Boosting Antioxidant Defenses in Fast-Twitch and Slow-Twitch Muscles.

In response to diabetes mellitus, skeletal muscle is negatively affected, as is evident by reduced contractile force production, increased muscle fatigability, and increased levels of oxidative stress biomarkers. Apocynin is a widely used NADPH oxidase inhibitor, with antioxidant and anti-inflammatory potential. It has been effective for amelioration of a variety of disorders, including diabetic complications. Therefore, the present study was conducted to evaluate the effects and action mechanisms of apocynin in slow- and fast-twitch diabetic rat muscles. Male Wistar rats were rendered diabetic by applying intraperitoneally a single dose of streptozotocin (45 mg/kg). Apocynin treatment (3 mg/kg/day) was administered over 8 weeks. Fasting blood glucose (FBG), insulin tolerance and body weight gain were measured. Both slow (soleus) and fast (extensor digitorum longus, EDL) skeletal muscles were used for muscle function evaluation, oxidative stress markers, and evaluating gene expression using qRT-PCR. Treatment with apocynin significantly reduced FBG levels and enhanced insulin tolerance. Apocynin also prevented muscle contractile dysfunction in EDL muscle but had no significant effect on this parameter in soleus muscles. However, in both types of muscles, apocynin mitigated the oxidative stress by decreasing ROS levels and increasing total glutathione levels and redox state. Concomitantly, apocynin also statistically enhanced Nrf-2 and GLU4 mRNA expression and downregulated NOX2, NOX4, and NF-κB mRNA. Collectively, apocynin exhibits properties myoprotective in diabetic animals. These findings indicate that apocynin predominantly acts as an antioxidant in fast-twitch and slow-twitch muscles but has differential impact on contractile function.

Nicorandil decreases oxidative stress in slow- and fast-twitch muscle fibers of diabetic rats by improving the glutathione system functioning.

AIMS/INTRODUCTION: Myopathy is a common complication of any diabetes type, consisting in failure to preserve mass and muscular function. Oxidative stress has been considered one of the main causes for this condition. This study aimed to search if Nicorandil, a KATP channel opener, could protect slow- and fast-twitch diabetic rat muscles from oxidative stress, and to unveil its possible mechanisms. MATERIALS AND METHODS: Diabetes was induced in male Wistar rats by applying intraperitoneally streptozotocin (STZ) at 100 mg/kg doses. Nicorandil (3 mg/kg/day) was administered along 4 weeks. An insulin tolerance test and assessment of fasting blood glucose (FBG), TBARS, reduced (GSH), and disulfide (GSSG) glutathione levels, GSH/GSSG ratio, and mRNA expression of glutathione metabolism-related genes were performed at end of treatment in soleus and gastrocnemius muscles. RESULTS: Nicorandil significantly reduced FBG levels and enhanced insulin tolerance in diabetic rats. In gastrocnemius and soleus muscles, Nicorandil attenuated the oxidative stress by decreasing lipid peroxidation (TBARS), increasing total glutathione and modulating GPX1-mRNA expression in both muscle's types. Nicorandil also increased GSH and GSH/GSSG ratio and downregulated the GCLC- and GSR-mRNA in gastrocnemius, without significative effect on those enzymes' mRNA expression in diabetic soleus muscle. CONCLUSIONS: In diabetic rats, Nicorandil attenuates oxidative stress in slow- and fast-twitch skeletal muscles by improving the glutathione system functioning. The underlying mechanisms for the modulation of glutathione redox state and the transcriptional expression of glutathione metabolism-related genes seem to be fiber type-dependent.

Capacitación y adherencia al lavado de manos y su efecto en la infección nosocomial / Impact of hand hygiene training and adherence in nosocomial infections

Resumen

Introducción: el lavado de manos deficiente sigue siendo un problema hospitalario. Cumplir con las recomendaciones internacionales ofrece seguridad en el cuidado.

Objetivo: evaluar el impacto de la capacitación en técnica de lavado de manos con alcohol gel en terapias intensivas pediátricas y adultos.

Metodología: se evaluaron 68 trabajadores de la salud en un Hospital de Tercer Nivel. El estudio se realizó en tres etapas, en la primera se evaluó la técnica de lavado de manos según los seis momentos que sugieren las directrices de la Organización Mundial de la Salud (OMS). En la segunda, se efectuó capacitación sobre lavado de manos según estos lineamientos y en la tercera por un estudio de sombra se evaluó adherencia al lavado de manos (ALM) y su efecto en la infección nosocomial.

Resultados: en la primera etapa 97.3% no uso alcohol gel, la mayoría utilizó clorhexidina en los momentos I y IV. Después de la capacitación incrementó la ALM en todos los momentos, excepto en el III y V donde descendió ligeramente, ambos sin significancia estadística. Tampoco hubo diferencia entre profesiones, número de pacientes, personal y estado del paciente.

Discusión y conclusión: La capacitación y la inclusión del alcohol gel influyeron en la ALM. La técnica y tiempo de lavado no se modificaron. El patrón de lavado parece seguir más una conducta antigua creada en el desarrollo de los profesionales, que en la comprensión de la importancia de un lavado “electivo” aunque no se perciban las manos sucias.

Abstract

Introduction: The deficient hand hygiene is still a fundamental hospital problem. Fulfilling international recommendations offers security in care.

Objective: Evaluate the impact of training in the hand hygiene technique with alcohol-gel over adherence and nosocomial infection frequency in adult and pediatric intensive care units.

Methodology: 68 health professionals working in a 3ra level hospital were evaluated. The study was developed in three stages. In the first phase, the hand hygiene technique was assessed according to the six moments suggested by World Health Organization guidelines. The second phase consisted on training on hand hygiene according to those guidelines and on the third stage, through shadow study, adherence to hand hygiene and its effect on frequency of nosocomial infections was evaluated.

Results: On the first stage 97.3% of professionals did not use alcohol - gel. Most of them only used chlorhexidine in moments I and IV. After training the adherence increased in all moments, except in III and V moments where adherence decreased in a slight way, both without any statistic significance. There was no difference among professionals, number of patients, personnel and patients’ condition.

Discussion and Conclusión: Training and alcohol - gel use inclusion influenced the adherence to hand hygiene practices. The technique and time did not change. The pattern of hand hygiene seems to follow a former conduct created in the development of health care professionals rather than the comprehension of «elective¼ washing required to assistance even though the hands are not perceived dirty.

CYP2E1 phenotype in Mexican workers occupationally exposed to low levels of toluene.

UNLABELLED: CYP2E1, an inducible enzyme present in different human tissues, metabolizes several potentially toxic substances including many volatile organic compounds (VOCs). One indirect way to monitor exposure to VOCs may be, therefore, the assessment of CYP2E1 activity in vivo using the chlorzoxazone (CHZ) test. GOAL: To compare CYP2E1 activity in two groups of workers: one with a known occupational exposure to VOCs (exposed group) and the other employed in administrative tasks at two universities (control group) from the city of León, Guanajuato, México. MATERIAL AND METHODS: (1) Passive diffusion monitors were used to evaluate individual levels of exposure to toluene, benzene and ethylbenzene in 48 persons (24 tannery workers and 24 administrative controls) during a 8h work shift; (2) after 12h fasting 500mg CHZ, a selective probe for assessing CYP2E1 activity, was orally administered and, after 2h, a venous blood sample was collected for HPLC plasmatic quantitative determination of CHZ and its mean metabolite 6-hydroxychlorzoxazone. RESULTS: Toluene mean exposure levels were higher in the exposed group (2.86±2ppm vs. 0.05±0.005ppm; p<0.001). Also, in this group CYP2E1 activity was lower (p<0.05) and it decreased as the accumulated months of labor exposure increased (negative correlation, p<0.05). These results are in line with previous findings obtained from shoemakers exposed to various solvents but, interestingly, they are partly in contrast with those of another study in printers. CONCLUSION: In spite of the relatively low levels of toluene exposure found for tannery workers, an effect on CYP2E1 activity was evident. Although the mechanism of this interaction is still unknown, the decrease in CYP2E1 activity per se might represent a health risk, considering that these workers may be less protected against other CYP2E1 substrates present in the labor setting or derived from an intentional exposure.