Background Clostridioides (Clostridium) difficile is an important pathogen of healthcare- associated diarrhea, however, an increase in the occurrence of C. difficile infection (CDI) outside hospital settings has been reported. The accumulation of antimicrobial resistance in C. difficile can increase the risk of CDI development and/or its spread. The limited number of antimicrobials for the treatment of CDI is matter of some concern. Objectives In order to summarize the data on antimicrobial resistance to C. difficile derived from humans, a systematic review and meta-analysis were performed. Methods We searched five bibliographic databases: (MEDLINE [PubMed], Scopus, Embase, Cochrane Library and Web of Science) for studies that focused on antimicrobial susceptibility testing in C. difficile and were published between 1992 and 2019. The weighted pooled resistance (WPR) for each antimicrobial agent was calculated using a random- effects model. Results A total of 111 studies were included. The WPR for metronidazole and vancomycin was 1.0% (95% CI 0–3%) and 1% (95% CI 0–2%) for the breakpoint > 2 mg/L and 0% (95% CI 0%) for breakpoint ≥32 μg/ml. Rifampin and tigecycline had a WPRs of 37.0% (95% CI 18–58%) and 1% (95% CI 0–3%), respectively. The WPRs for the other antimicrobials were as follows: ciprofloxacin 95% (95% CI 85–100%), moxifloxacin 32% (95% CI 25–40%), clindamycin 59% (95% CI 53–65%), amoxicillin/clavulanate 0% (0–0%), piperacillin/tazobactam 0% (0–0%) and ceftriaxone 47% (95% CI 29–65%). Tetracycline had a WPR 20% (95% CI 14–27%) and meropenem showed 0% (95% CI 0–1%); resistance to fidaxomicin was reported in one isolate (0.08%). Conclusion Resistance to metronidazole, vancomycin, fidaxomicin, meropenem and piperacillin/tazobactam is reported rarely. From the alternative CDI drug treatments, tigecycline had a lower resistance rate than rifampin. The high-risk antimicrobials for CDI development showed a high level of resistance, the highest was seen in the second generation of fluoroquinolones and clindamycin; amoxicillin/clavulanate showed almost no resistance. Tetracycline resistance was present in one fifth of human clinical C. difficile isolates.

The purpose of this study was to compare the effects of nonlinear resistance training (NRT) and aerobic interval training (AIT), and detraining on selected inflammatory markers in men who are middle aged and obese. Subjects first were matched by aerobic capacity, age, and percentage body fat and then randomly assigned to NRT (n = 12), AIT (n = 10) and, control (CON, n = 11) groups. The experimental groups performed 3 weekly sessions for 12 weeks followed by a 4-week detraining period. Nonlinear resistance training consisted of 40-65 minutes of weight training with flexible periodization. Aerobic interval training consisted of running on a treadmill (4 × 4 minutes at 80-90% maximal heart rate, with 3-minute recovery intervals). Compared with CON, serum levels of interleukin 6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor alpha (TNF-α) did not significantly change after training, but adiponectin (ADPN) increased significantly only with AIT (5.09 ± 2.29 vs. 4.36 ± 0.84 μg·ml). No significant changes in CRP and TNF-α occurred in both training groups after detraining, but ADPN (NRT: 3.6 ± 1.2 and AIT: 3.4 ± 1.7 vs. CON: 4.7 ± 1.2 μg·ml) and IL-6 (NRT: 5.8 ± 3.3 and AIT: 5.5 ± 2.9 vs. CON: 2.3 ± 1.2 pg·ml) worsened significantly. Both the AIT and NRT were equally effective at reducing soluble intercellular cell adhesion molecule 1 (NRT: 187.2 ± 117.5 and AIT: 215.2 ± 142.4 vs. CON: 416.2 ± 205.9 ng·ml) and insulin (NRT: 4.0 ± 1.0 and AIT: 4.8 ± 2.7 vs. CON: 7.4 ± 3.0 μU·ml) levels, but these variables returned to the pretraining levels after detraining. The practical applications are that both the AIT and NRT and detraining had similar effects on most inflammatory markers in men who are obese, but the AIT seems to have better anti-inflammatory effects (as indicated by ADPN) compared with NRT.

Background:Depression is a common medical condition with a high prevalence leading to emotional abnormality. Despite some drawbacks, depression currently diagnosed using a combination of patient interviews and self-report questionnaires. Recently, there is emerging emphasis to establish biomarkers to diagnosis and clinical management of depression. This case–control study was designed to develop microRNA (miRNA)-based serum biomarker for depression.Materials and Methods:In this study, 39 patients with depression and 36 healthy controls were enrolled. Serum miRNAs gene expression was measured using real-time polymerase chain reaction (PCR) analysis; finally, the data represent as the 2–ΔCt followed by further statistical analysis.Results:The serum level of miR-16 was significantly (P < 0.001) down-regulated (mean: 0.9123 and standard deviation [SD]: 0.06) in compared to normal individuals (mean: 1.6848 and SD: 0.09). The concentration of miR-135a was also catastrophically decreased (P < 0.001) in the patients (mean: 1.160 and SD: 0.07) in compared to control (mean: 1.819 and SD: 0.09). The relative miR-1202 expression levels were significantly lower (P < 0.001) in the patients (mean: 0.1755 and SD: 0.01) than in the healthy individuals (mean: 0.2939 and SD: 0.01). The receiver operating characteristic curve analysis indicated the obvious separation between patient and healthy control, with an AUC of 0.75 (95% confidence interval [CI] = 0.642–0.858, P < 0.001), 0.72 (95% CI = 0.607–0.834, P < 0.001), and 0.74 (95% CI = 0.630–0.861, P < 0.001) for miR-16, miR-135a, and miR-1202, respectively. The data suggest that these miRNAs have a potential to be used as a biomarker of depression with sensitivity 77.8% and specificity of 61.5% for miR-16, 94.4% and 41.0% for miR-135a as well as 86.1% and 61.5% for miR-1202, respectively (P < 0.001).Conclusion:Our findings showed that these miRNA can be used as a biomarker of depression diagnosis. MiR-135a and miR-1202 exhibited better sensitivity and specificity, respectively.