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Most insulin is secreted in discrete pulses at an interval of ϳ6 min. Increased insulin secretion after meal ingestion is achieved through the mechanism of amplification of the burst mass. Conversely, in type 2 diabetes, insulin secretion is impaired as a consequence of decreased insulin pulse mass. ␤-cell mass is reported to be deficient in type 2 diabetes. We tested the hypothesis that decreased ␤-cell mass leads to decreased insulin pulse mass. Insulin secretion was examined before and after an ϳ60% decrease in ␤-cell mass achieved by a single injection of alloxan in a porcine model. Alloxan injection resulted in stable diabetes (fasting plasma glucose 7.4 ؎ 1.1 vs. 4.4 ؎ 0.1 mmol/l; P < 0.01) with impaired insulin secretion in the fasting and fed states and during a hyperglycemic clamp (decreased by 54, 80, and 90%, respectively). Deconvolution analysis revealed a selective decrease in insulin pulse mass (by 54, 60, and 90%) with no change in pulse frequency. Rhythm analysis revealed no change in the periodicity of regular oscillations after alloxan administration in the fasting state but was unable to detect stable rhythms reliably after enteric or intravenous glucose stimulation. After alloxan administration, insulin secretion and insulin pulse mass (but not insulin pulse interval) decreased in relation to ␤-cell mass. However, the decreased pulse mass (and pulse amplitude delivered to the liver) was associated with a decrease in hepatic insulin clearance, which partially offset the decreased insulin secretion. Despite hyperglycemia, postprandial glucagon concentrations were increased after alloxan administration (103.4 ؎ 6.3 vs. 92.2 ؎ 2.5 pg/ml; P < 0.01). We conclude that an alloxan-induced selective decrease in ␤-cell mass leads to deficient insulin secretion by attenuating insulin pulse mass, and that the latter is associated with decreased hepatic insulin clearance and relative hyperglucagonemia, thereby emulating the pattern of islet dysfunction observed in type 2 diabetes. Diabetes 50: [2001][2002][2003][2004][2005][2006][2007][2008][2009][2010][2011][2012] 2001 T ype 2 diabetes is characterized by impaired glucose-mediated insulin secretion (1,2). This has been documented by demonstrating reduced first-phase insulin release in response to intravenous glucose (3,4) and impaired insulin release after glucose ingestion (1,5) and during a hyperglycemic clamp (6). Further analyses indicate that most insulin secretion is derived from discrete insulin secretory bursts (7,8), the mass of which is diminished in patients with type 2 diabetes (9). In addition, it has been reported that ␤-cell mass may be decreased in patients with type 2 diabetes (10), although this remains controversial. Indeed, the role of any decrease in the ␤-cell mass in the pathogenesis of impaired insulin secretion and the pathogenesis of hyperglycemia in type 2 diabetes remains uncertain.In the present study, we addressed the hypothesis that defective insulin secretion in type 2 diabetes can be recapitulated by a selective decreas...

."g scale A study was designed to investigate the association between heart rate, respiratory rate and pupil dilation and a subjective pain score allocated using a numerical rating scale (NRS). Four groups of dogs (n = 17 to 20 per group) were included: orthopaedic surgery cases, soft tissue surgery cases, dogs with medical conditions and healthy dogs. Each dog was examined by five veterinary surgeons within a four-hour period. When examining each dog, the observers recorded heart rate, respiratory rate, pupil dilation (present or absent) and a pain score using a NRS (range 0 to 10). For surgical cases, all study assessments were carried out between 21 and 27 hours following the end of surgery. The correlation coefficients between physiological parameters and NRS score were small but, depending on the analysis, were significant for heart rate and NRS score (P < 0.05). However, the size of the coefficient, 0.168, indicated that the relationship was not biologically significant. There was no association between respiratory rate and NRS score. Analysis of the relationship between NRS score and pupil dilation indicated that there was an association between this factor and pain, depending on the analysis. This was significant for the surgical groups (P < 0.05) but not for the other groups.These findings indicate that heart rate and respiratory rate are not useful indicators of pain in hospitalised dogs. It is also unlikely that pupil dilation will be a useful tool in the assessment of pain.

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This preliminary study investigated the attitudes, and evaluated the current practice of a sample of the veterinary profession in the UK in relation to the management of pain in horses. In June 2001, a questionnaire was posted to 260 veterinarians in specialised equine practice, and 140 veterinarians in general practice with a significant equine caseload. There was a 25 per cent response rate to the questionnaire, which recorded information about the availability and prescription of analgesic drugs, the factors influencing the selection of analgesics and their administration, and estimates of the severity of pain associated with selected clinical conditions. There were considerable variations in the practices applied to manage pain in horses, implying that there are similar attitudinal barriers to the optimal management of pain in horses as have been identified in other domestic spedes.

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The short-term outcome following thoracic surgery is influenced by diagnosis. The thoracic approach is determined by intrathoracic disease, but may influence outcome by affecting the incidence of postoperative wound complications. The risk of thoracic drain complications increases with drain duration, which is influenced by the underlying disease. Drains should be maintained for the minimal amount of time possible.