Metabolic rate and substrate oxidation of young males with obesity at the different sleep stages

ObjectiveInsufficient and poor-quality sleep among young adults is closely related to obesity and may impact metabolic processes. The mobilization and use of endogenous substrates during sleep, especially fat oxidation, is essential for energy metabolism. This study investigated whether there are differences in sleep structure, metabolic rate, substrate oxidation, and the respiratory quotient (RQ) between young males with normal weight and obesity according to sleep stages and overnight sleep.MethodsFifteen young males with normal weight and fifteen with obesity posited electrodes of polysomnography (PSG) and slept in the metabolic chamber for estimation of sleep structure, sleep metabolic rate (SMR), carbohydrate oxidation (CHOO), fat oxidation (FATO), and RQ. Fat-free mass (FFM) was measured by bioelectrical impedance analysis.ResultsThe sleep period time (p = 0.038) and total sleep time (p = 0.032) were significantly shorter in the obesity group than in the normal-weight group. The obesity group also had a longer sleep latency (p = 0.034) and more sleep-turning events (p = 0.018). CHOO/FFM and the RQ were higher in the obesity group while FATO/FFM was significantly higher in the normal-weight group. FATO/FFM was also higher in the normal-weight group in each sleep stage whereas the RQ was higher in the obesity group (p < 0.05).ConclusionsYoung males with obesity showed lower fat oxidation and more dominant carbohydrate-derived fuel oxidation than normal-weight during sleep and experienced shorter sleep periods and total sleep time.     

Infection prevention and surgery in the pandemic era

The COVID-19 pandemic has had a significant impact on surgical specialties. COVID-19 carries a significant risk to the surgical patient and the healthcare workers looking after them, with an increased incidence of pulmonary complications and mortality in patients who test positive perioperatively. Appropriate infection prevention and control measures are critical to ensure appropriate care is given and to reduce the risk of onward transmission. This article will discuss the measures that have been instigated and contributed to infection control in surgery, such as testing, patient isolation, personal protective equipment and ventilation. The COVID-19 pandemic has led to healthcare workers across many specialities working together to provide essential clinical care. This collaborative approach is critical to maintain excellent infection prevention and control practices required during this pandemic, which protect patients and preserve surgical services.     

Copper-inhibition of the growth of oral streptococci and actinomyces

Copper ions were found to inhibit the rate of growth in broth culture of Streptococcus mitis, Streptococcus mutans, Streptococcus salivarious, Streptococcus sanguis, Actinomyces viscosus and Actinomyces naeslundii. In all cases, 10^?3 M copper inhibited the rate of growth, whereas 10^?4 M and lower concentrations had little or no effect. At the concentrations used in mouthwashes one mode of action of copper ions is to reduce the rate of growth of oral bacteria in vitro.     

The role of 5-hydroxytryptophan (5-HTP) in the regulation of the sleep/wake cycle in parachlorophenylalanine (p-CPA) pretreated rat: a multiple approach study

Summary In the rat, the insomnia which follows the administration of parachlorophenylalanine (p-CPA), a serotonin synthesis inhibitor, is transiently reversed either by intra-cisternal injection of L-5-HTP or by an associated injection of 5-HTP and an L-aromatic-aciddecarboxylase inhibitor (benserazide). Histochemical, immunohistochemical and chemical investigations showed that 5-HTP administration does not lead to a detectable increase in cerebral 5-HT. These findings suggest that the restoration of sleep after p-CPA treatment could be mediated by the central action of 5-HTP.     

Effect of sleep deprivation on tolerance of prolonged exercise

Summary Acute loss of sleep produces few apparent physiological effects at rest. Nevertheless, many anecdotes suggest that adequate sleep is essential for optimum endurance athletic performance. To investigate this question, heavy exercise performance after 36 h without sleep was compared with that after normal sleep in eight subjects. During prolonged treadmill walking at about 80% of the max, sleep loss reduced work time to exhaustion by an average of 11% (p=0.05). This decrease occurred despite doubling monetary incentives for subjects during work after sleeplessness. Subjects appeared to fall into “resistant” and “susceptible” categories: four showed less than a 5% change in performance after sleep loss, while four others showed decrements in exercise tolerance ranging from 15 to 40%. During the walk, sleep loss resulted in significantly greater perceived exertion (p<0.05), even though exercise heart rate and metabolic rate ( and ) were unchanged. Minute ventilation was significantly elevated during exercise after sleep loss (p<0.05). Sleep loss failed to alter the continuous slow rises in _E and heart rate that occurred as work was prolonged. These findings suggest that the psychological effects of acute sleep loss may contribute to decreased tolerance of prolonged heavy exercise. Supported in part by Public Health Service grant PHS S07 RR 5371, and by Grant DAMD-17-81-C-1023 from the U.S. Army     

Nocturnal Paroxysmal Dystonia with Short-Lasting Attacks: Three Cases with Evidence for an Epileptic Frontal Lobe Origin of Seizures

The epileptic or nonepileptic origin of nocturnal paroxysmal dystonia (NPD) has been debated. We studied three patients with frequent attacks during non-REM sleep. During prolonged video-EEG monitoring, two patients had a convulsive seizure after a typical NPD episode and on these occasions EEG showed epileptiform discharge. In the three patients, attacks occurred repeatedly with different intensity, representing "fragments" of the same seizure. These fragments of the attack could occur periodically every 20-40 s. We postulate that short NPD attacks are actually epileptic seizures originating from the frontal lobes. The rhythmicity of the episodes may be due to rhythmic oscillation of cortical function during non-REM sleep.     

剥夺睡眠—睡眠联合诱发脑电图在癫痫诊断中的应用

目的研究剥夺睡眠-睡眠联合诱发试验在癫痫诊断中的价值及适应症。方法对58例临床诊断为癫痫的患者行常规脑电图(EEG)和剥夺睡眠-睡眠联合诱发EEG检查,并将两种方法进行比较;剥夺睡眠后清醒时EEG描记结果与睡眠时EEG描记结果进行比较。结果剥夺睡眠-睡眠EEG痫样放电检出率比常规EEG痫样放电检出率明显提高,前者为86.2％(50/58),后者为41.4％(24/58),两者比较有极其显著性差异(P<0.001)。剥夺睡眠清醒时EEG与剥夺睡眠后睡眠EEG痫样放电检出率比较,有显著性差异(P<0.05)。剥夺睡眠后睡眠EEG可起补充作用,且很易记录到睡眠EEG。结论剥夺睡眠-睡眠联合诱发EEG对痫样放电的检出率有明显提高,对癫痫 的诊断、治疗有重要意义。     

睡眠呼吸暂停综合征患者T细胞,NK细胞功能的研究

目的：检测睡眠呼吸暂停综合征（ＳＡＳ）患者外周血Ｔ淋巴细胞、ＮＫ细胞的变化,探讨ＳＡＳ对细胞免疫功能的影响。方法：应用ＡＰＡＡＰ桥联酶标法测定外周血淋巴细胞表型。结果：ＳＡＳ患者组ＣＤ３＾＋细胞与正常对照组差异无显著性（Ｐ〉０．０５）,ＣＤ４＾＋、ＣＤ４＾＋／ＣＤ８＾＋、ＣＤ１６＾＋、ＣＤ２５＾＋细胞ＳＡＳ组均低于正常对照组,而ＣＤ８＾＋细胞高于正常对照组（Ｐ〈０．０５,Ｐ〈０．０１）。结论：ＳＡ     

阻塞性睡眠呼吸暂停综合征患者快速眼动睡眠呼吸损伤的特点

目的 :根据阻塞性睡眠呼吸暂停综合征 (obstructivesleepapneasyndrom ,OSAS)患者多导睡眠仪(polysomnography ,PSG)监测信号 ,研究OSAS患者快速眼动睡眠损伤的特点。方法 :( 1)使用呼吸事件新分型法对 33例OSAS患者及正常打鼾者PSG监测信号进行分型 ,根据Ⅱ、Ⅲ型曲线的发生率将 33例OSAS患者分为轻度 ,中度和重度阻塞性呼吸暂停 3组 ;( 2 )比较 3组患者REM期睡眠时间长度 ;REM期呼吸紊乱特点。结果 :( 1) 3组患者REM期睡眠时间分别为 37.9± 11.3min ;12 .8± 3.1min ;7.3± 3.6min ,轻度组患者REM期睡眠时间较长 ,重度组患者REM期睡眠时间短 ,且易消失 ;( 2 )轻度组患者REM期RDI、RIT及SIT90 指数均较NREM期加重 ;重度组患者REM期RDI指数较NREM期显著减少 ,但RIT及SIT90 指数REM和NREM差异无显著性。结论 :( 1)根据新分型进行病情轻重分类能够反映患者REM期的损害程度 ,病情较重的患者REM期减少甚至消失 ;( 2 )轻度组患者REM期病情较NREM期加重 ,表现为RDI、RIT及SIT90 指数均显著增加 ;重度组患REM期较NREM期RDI减少 ,但呼吸及血氧损害程度无显著变化 ,显然是REM期呼吸紊乱的平均持续时间延长所致     

医学生睡眠质量与焦虑抑郁情绪关系的探讨

目的 研究医学生睡眠质量与焦虑抑郁情绪的相关性,并对影响睡眠质量的有关因素进行探讨。方法 以匹慈堡睡眠质量指数（PSQI）、焦虑自评量表（SAS）、自评抑郁量表（SDS）为评价工具,采用分层整群抽样方法,调查某医学院1－4年级医学本科生睡眠障碍的发生率及分布特征。结果 医学生睡眠障碍的发生率为15．75％,男生（9．42％）女生（6．34％）间无显著性差异。19．18％的学生有抑郁情绪,男女生分别为10．10％和9．08％（P＜0．05）,15．75％的学生存在焦虑,并且10．27％的学生焦虑、抑郁情绪并存。PSQI总分与SAS、SDS得分均呈显著正相关。回归分析表明,影响PSQI总分的因素依次为睡眠效率、睡眠障碍、入睡时间、睡眠质量、日间功能、催眠质量、日间功能、催眠药物、睡眠时间。结论 焦虑、抑郁情绪是影响医学生睡眠质量的重要因素,提高医学生的心理素质,增强其适应环境的能力,对于保持良好的健康状态是十分必要的。