BACKGROUND Ganglion impar block alone or pulsed radiofrequency alone are effective options for treating perineal pain.However,ganglion impar block combined with pulsed radiofrequency(GIB-PRF)for treating perineal pain...BACKGROUND Ganglion impar block alone or pulsed radiofrequency alone are effective options for treating perineal pain.However,ganglion impar block combined with pulsed radiofrequency(GIB-PRF)for treating perineal pain is rare and the puncture is usually performed with X-ray or computed tomography guidance.AIM To evaluate the safety and clinical efficacy of real-time ultrasound-guided GIBPRF in treating perineal pain.METHODS Thirty patients with perineal pain were included and were treated by GIB-PRF guided by real-time ultrasound imaging between January 2015 and December 2016.Complications were recorded to observe the safety of the ultrasound-guided GIB-PRF procedure,and visual analogue scale(VAS)scores at 24 h before and after treatment and 1,3,and 6 mo later were analyzed to evaluate clinical efficacy.RESULTS Ultrasound-guided GIB-PRF was performed successfully in all patients,and no complications occurred.Compared with pretreatment scores,the VAS scores were significantly lower(P<0.05)at the four time points after treatment.The VAS scores at 1 and 3 mo were slightly lower than those at 24 h(P>0.05)and were significantly lower at 6 mo after treatment(P<0.05).There was a tendency toward lower VAS scores at 6 mo after treatment compared with those at 1 and 3 mo(P>0.05).CONCLUSION Ultrasound-guided GIB-PRF was a safe and effective way to treat perineal pain.The 6-mo short-term clinical efficacy was favorable,but the long-term outcomes need future study.展开更多
Objective: To understand an unusual complication of a low risk procedure. Design: This article chronicles the side effect of a Ganglion Impar Block. Setting: Loyola University Medical Center Outpatient Chronic Pain Cl...Objective: To understand an unusual complication of a low risk procedure. Design: This article chronicles the side effect of a Ganglion Impar Block. Setting: Loyola University Medical Center Outpatient Chronic Pain Clinic. Patients: One. Results: Our patient had tachycardia after a Ganglion Impar Block. Conclusions: An unusual complication of a ganglion impar block can be increased heart rate.展开更多
Progression of normal glucose tolerance(NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance(IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diab...Progression of normal glucose tolerance(NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance(IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diabetes mellitus(type 2 DM) and even normoglycemic IGT patients manifest these defects. Beta cell dysfunction and insulin resistance also contribute to the progression of IGT to type 2 DM. Improving insulin sensitivity and/or preserving functions of beta-cells can be a rational way to normalize the GT and to control transition of IGT to type 2 DM. Loosing weight, for example, improves whole body insulin sensitivity and preserves beta-cell function and its inhibitory effect on progression of IGT to type 2 DM had been proven. But interventions aiming weight loss usually not applicable in real life. Pharmacotherapy is another option to gain better insulin sensitivity and to maintain beta-cell function. In this review, two potential treatment options(lifestyle modification and pharmacologic agents) that limits the IGT-type 2 DM conversion in prediabetic subjects are discussed.展开更多
文摘BACKGROUND Ganglion impar block alone or pulsed radiofrequency alone are effective options for treating perineal pain.However,ganglion impar block combined with pulsed radiofrequency(GIB-PRF)for treating perineal pain is rare and the puncture is usually performed with X-ray or computed tomography guidance.AIM To evaluate the safety and clinical efficacy of real-time ultrasound-guided GIBPRF in treating perineal pain.METHODS Thirty patients with perineal pain were included and were treated by GIB-PRF guided by real-time ultrasound imaging between January 2015 and December 2016.Complications were recorded to observe the safety of the ultrasound-guided GIB-PRF procedure,and visual analogue scale(VAS)scores at 24 h before and after treatment and 1,3,and 6 mo later were analyzed to evaluate clinical efficacy.RESULTS Ultrasound-guided GIB-PRF was performed successfully in all patients,and no complications occurred.Compared with pretreatment scores,the VAS scores were significantly lower(P<0.05)at the four time points after treatment.The VAS scores at 1 and 3 mo were slightly lower than those at 24 h(P>0.05)and were significantly lower at 6 mo after treatment(P<0.05).There was a tendency toward lower VAS scores at 6 mo after treatment compared with those at 1 and 3 mo(P>0.05).CONCLUSION Ultrasound-guided GIB-PRF was a safe and effective way to treat perineal pain.The 6-mo short-term clinical efficacy was favorable,but the long-term outcomes need future study.
文摘Objective: To understand an unusual complication of a low risk procedure. Design: This article chronicles the side effect of a Ganglion Impar Block. Setting: Loyola University Medical Center Outpatient Chronic Pain Clinic. Patients: One. Results: Our patient had tachycardia after a Ganglion Impar Block. Conclusions: An unusual complication of a ganglion impar block can be increased heart rate.
文摘Progression of normal glucose tolerance(NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance(IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diabetes mellitus(type 2 DM) and even normoglycemic IGT patients manifest these defects. Beta cell dysfunction and insulin resistance also contribute to the progression of IGT to type 2 DM. Improving insulin sensitivity and/or preserving functions of beta-cells can be a rational way to normalize the GT and to control transition of IGT to type 2 DM. Loosing weight, for example, improves whole body insulin sensitivity and preserves beta-cell function and its inhibitory effect on progression of IGT to type 2 DM had been proven. But interventions aiming weight loss usually not applicable in real life. Pharmacotherapy is another option to gain better insulin sensitivity and to maintain beta-cell function. In this review, two potential treatment options(lifestyle modification and pharmacologic agents) that limits the IGT-type 2 DM conversion in prediabetic subjects are discussed.
