Abstract. High-fat diets induce an expansion of the adipose tissue (aT) that can be characterized by chronic low-grade inflammation. AT is an important source of adipokines and pro-inflammatory cytokines. The purpose of this study was to evaluate the effects of a shift from a high-fat diet to high-carbohydrate (CHO) diet on the blood levels of adipokines and pro-inflammation cytokines in mice fed a high-fat diet. Six-week-old male C57BL/6 mice were fed a high-fat diet (40% of the total calories) for 9 weeks to induce obesity, and then the diet was shifted to a high CHO diet (70% of the total calories) for 3 weeks. Body weight and organ weight as well as blood lipid levels were measured. The serum levels of adipokines and pro-inflammatory cytokines were analyzed. Shifting the diet from high fat to high CHO decreased significantly body weight, adipose tissues, and liver weight (p < 0.05). The lipid blood levels (TG, Total-chol, and LDLchol) decreased. The leptin and resistin blood levels significantly decreased after the diet was shifted to a high-CHO diet (p < 0.05); however, the adiponectin concentrations did not change. The IL-6 levels were also significantly decreased by the high-CHo diet (p < 0.05). The IL-13 serum levels were significantly increased by the high-CHO diet (p < 0.05). Further, the serum levels of the TNF-α and supernatant IL-1β concentrations in mice fed a high-carbohydrate diet were significantly increased after the mice were shifted to a high-fat diet. On the other hand, the serum IL-4 and supernatant levels did not change. Conclusively, reduction of body weight and adipose tissues through shifts from a high-fat diet to a high-carbohydrate diet effectively improved low-grade inflammation states in mice fed a high-fat diet. Particularly, the reduction of body weight was associated with the levels of leptin, resistin, and IL-6.

The incidence, severity, and associated costs of Clostridium difficile (C. difficile) infection (CDI) have dramatically increased in hospitals over the past decade, indicating an urgent need for strategies to prevent transmission of C. difficile. This article describes a multifaceted collaborative approach to reduce hospital-onset CDI rates in 35 acute care hospitals in the New York metropolitan region. Hospitals participated in a comprehensive CDI reduction intervention and formed interdisciplinary teams to coordinate their efforts. Standardized clinical infection prevention and environmental cleaning protocols were implemented and monitored using checklists. Monthly data reports were provided to hospitals for facility-specific performance evaluation and comparison to aggregate data from all participants. Hospitals also participated in monthly teleconferences to review data and highlight successes, challenges, and strategies to reduce CDI. Incidence of hospital-onset CDI per 10,000 patient days was the primary outcome measure. Additionally, the incidence of nonhospital-associated, community-onset, hospital-associated, and recurrent CDIs were measured. The use of a collaborative model to implement a multifaceted infection prevention strategy was temporally associated with a significant reduction in hospital-onset CDI rates in participating New York metropolitan regional hospitals.