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
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
Animals living around people may modify their antipredator behavior as a function of proximity to humans,and this response has profound implications for whether or not a population can coexist with humans.We asked whe...Animals living around people may modify their antipredator behavior as a function of proximity to humans,and this response has profound implications for whether or not a population can coexist with humans.We asked whether inland blue-tailed skinks Emoia impar modified their individual antipredator behavior as a function of differential exposure to humans.We conducted multiple consecutive flushes and recorded 2 measures of antipredator response:flight initiation distance(FID),the distance from a threatening stimulus at which an individual flees,and distance fled,the distance an individual fled after a flush.We used a multiple model comparison approach to quantify variation in individual escape behavior across multiple approaches and to test for differences in between-individual variation among populations.We found that individuals tolerated closer approach and fled shorter distances at locations with relatively less human disturbance than at locations with medium and high human disturbance,respectively.In addition,skinks living at high human disturbance sites had less variable FIDs than at low human disturbance sites.Two theories may explain these results.Selection against less favorable phenotypes has reduced behavioral variation in urban habitats and behavioral plasticity allows individuals to flexibly adjust their behavioral patterns in response to human disturbance.These results highlight the importance of studying variation within populations,at the individual level,which may better elucidate the impact that human disturbance has on the behavioral composition of populations.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
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.
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Animals living around people may modify their antipredator behavior as a function of proximity to humans,and this response has profound implications for whether or not a population can coexist with humans.We asked whether inland blue-tailed skinks Emoia impar modified their individual antipredator behavior as a function of differential exposure to humans.We conducted multiple consecutive flushes and recorded 2 measures of antipredator response:flight initiation distance(FID),the distance from a threatening stimulus at which an individual flees,and distance fled,the distance an individual fled after a flush.We used a multiple model comparison approach to quantify variation in individual escape behavior across multiple approaches and to test for differences in between-individual variation among populations.We found that individuals tolerated closer approach and fled shorter distances at locations with relatively less human disturbance than at locations with medium and high human disturbance,respectively.In addition,skinks living at high human disturbance sites had less variable FIDs than at low human disturbance sites.Two theories may explain these results.Selection against less favorable phenotypes has reduced behavioral variation in urban habitats and behavioral plasticity allows individuals to flexibly adjust their behavioral patterns in response to human disturbance.These results highlight the importance of studying variation within populations,at the individual level,which may better elucidate the impact that human disturbance has on the behavioral composition of populations.
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.
