Study Objectives: Sleep deprivation is known to be associated with insulin resistance and diabetes risk. This study investigated whether 2-week sleep extension in chronically sleep-deprived individuals would improve glucose metabolism. Methods: A crossover study was conducted in volunteers without diabetes who reported sleeping ≤ 6 h/night. They were randomized to maintain their habitual sleep or extend sleep time for 2 weeks, then crossed over after a washout period. Sleep was monitored by actigraphy. Oral glucose tolerance tests (75 g) with insulin levels was performed at the end of each period. Mixed-effect linear regression analysis, adjusting for sequence and period effects, was applied. Results: A total of 21 participants (19 females) with mean (standard deviation) age of 33.1 (6.1) years completed the protocol. Mean sleep duration during habitual sleep was 318.7 (44.3) minutes and the participants extended their sleep by 36.0 (45.2) minutes during sleep extension. The average washout period was 21 (11) days. There were no significant effects of sleep extension on any metabolic parameters. The per-protocol analysis included eight participants who could sleep more than 6 hours during sleep extension (mean sleep duration 396 [25] minutes, extended by 60.1 [28.5] minutes). Among these individuals, sleep extension improved Homeostatic Model Assessment of Insulin Resistance (adjusted mean difference −0.50 [95% confidence interval [CI] −0.89, −0.11, P = .013]), early insulin secretion (insulinogenic index; mean difference 0.39 [95% CI 0.15, 0.63, P = .001]), and β-cell function (disposition index, mean difference 1.07 [95% CI 0.17, 1.97, P = .02]). Conclusions: Sleep extension in chronically sleep-deprived individuals improved glucose metabolism in only those who could objectively extend their sleep to more than 6 h/night. Our findings suggest that a critical amount of sleep is needed to benefit metabolic outcomes.
the correlation between the %CSA<5 and the radionuclide uptake rate visualized by pulmonary perfusion scintigraphy.Results: The %CSA<5 in the obstructed side of the lung after treatment displayed significant improvements after intervention (p = 0.04). Among the 5 cases that underwent pulmonary perfusion scintigraphy before and after the treatment, the radionuclide uptake rate of the obstructed side improved in all patients, whereas the %CSA<5 improved in 4 of the 5 patients.Conclusion: Measurement of the %CSA<5 might be useful to assess the outcome of interventional bronchoscopy.
AP384Background and Aim: The diagnostic bronchoscopy in acute hypoxemic patients might result in profound hypoxemia requiring intubation. We aimed to study the effectiveness of non-invasive ventilation (NIV) compared with high-flow nasal cannula (HFNC) in those patients requiring the diagnostic bronchoscopy. The primary end point was the lowest oxygen saturation during the procedure.
Although tracheostomy is a well-accepted procedure for airway management, some early and late complications may occur. Fracture of the tracheostomy tube (TT) is a rare complication, particularly in a patient with long-term use. Herein we report a case of fractured metallic TT migrating into the tracheobronchial tree. Rigid bronchoscopy was performed through the tracheostomy stoma and the fractured tube was successfully removed by a balloon catheter. Appropriate cleaning, routine careful examination, and scheduled replacement of the TT may help prevent this complication.
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