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Exercise and exerkine upregulation:Brain-derived neurotrophic factor as a potential non-pharmacological therapeutic strategy for Parkinson’s disease

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BIOCELL 2024年第5期48卷 693-706页

作者： VIRAAJ vishnu PRASAD JENNIFER SALLY SAMSON VENKATACHALAM DEEPA PARVATHI Department of Biomedical Sciences Sri Ramachandra Institute of Higher Education and ResearchChennai600116India

Physical activity and exercise have several beneficial roles in enhancing both physiological and psychological well-being of an *** addition to aiding the regulation of aerobic and anaerobic metabolism,exercise can stimulate the synthesis of exerkine hormones in the circulatory *** several exerkines that have been investigated for their therapeutic potential,Brain-derived neurotrophic factor(BDNF)is considered the most promising candidate,especially in the management of neurodegenerative *** to the ability of physical activity to enhance BDNF synthesis,several experimental studies conducted so far have validated this hypothesis and produced satisfactory results at the pre-clinical *** review highlights some of the recent animal model studies that have evaluated the efficiency of exercise in enhancing BDNF synthesis and promoting neuroprotective ***,this review focuses on understanding the therapeutic benefits of exercise-induced exerkine synthesis as a non-pharmacological strategy in Parkinson’s disease(PD).Regarding physical activity and exerkine induction,the neuromuscular electrical stimulation(NMES)strategy could be considered as an alternate treatment modality for patients affected with PD.

关键词： Exercise therapy Dopaminergic neurons Parkinson’s disease Brain-derived neurotrophic factor Electrical stimulation

Ibrutinib and atrial fibrillation:An in-depth review of clinical implications and management strategies

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World Journal of Cardiology 2024年第5期16卷 269-273页

作者： Moiud Mohyeldin Shitij Shrivastava Sai vishnu Vardhan Allu Internal Medicine University of Medical Sciences and TechnologyKhartoum 11111Sudan Internal Medicine Bronxcare Health SystemBronxNY 10457United States

Ibrutinib,a targeted therapy for B-cell malignancies,has shown remarkable efficacy in treating various hematologic ***,its clinical use has raised concerns regarding cardiovascular complications,notably atrial fibrillation(AF).This comprehensive review critically evaluates the association between ibrutinib and AF by examining incidence,risk factors,mechanistic links,and management *** an extensive analysis of original research articles,this review elucidates the complex interplay between ibrutinib’s therapeutic benefits and cardiovascular ***,it highlights the need for personalized treatment approaches,vigilant monitoring,and interdisciplinary collaboration to optimize patient outcomes and safety in the context of ibrutinib *** review provides a valuable resource for healthcare professionals aiming to navigate the intricacies of ibrutinib’s therapeutic landscape while prioritizing patient well-being.

关键词： Ibrutinib Bruton’s tyrosine kinase inhibitor Atrial fibrillation Cardiovascular risk Management strategies

Comparative efficacy of sodium glucose cotransporter-2 inhibitors in the management of type 2 diabetes mellitus:A real-world experience

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World Journal of Diabetes 2024年第3期15卷 463-474页

作者： Lubna Islam Dhanya Jose Mohammed Alkhalifah Dania Blaibel vishnu Chandrabalan Joseph M Pappachan Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Department of Community Medicine Goa Medical CollegeGoa 403202India Department of Family Medicine King Faisal Specialist HospitalRiyadh 11564Saudi Arabia Department of Data Science Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityAll Saints BuildingManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom

BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SGLT-2i medications is *** To study the comparative efficacy and safety of SGLT-2i using real-world clinical *** We evaluated the comparative efficacy data of 3 SGLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes *** on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded *** Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were *** diabetes duration was 16.0(9.0)years,and the duration of SGLT-2i use was 3.6(2.1)***-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)*** respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(P<0.001 for all comparisons from baseline).Significant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)*** reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(P<0.001)respectively were also observed.A significant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects

关键词： Sodium glucose cotransporter-2 inhibitors Empagliflozin Canagliflozin Dapagliflozin Type 2 diabetes mellitus Cardiovascular disease Albumin creatinine ratio Diabesity

Quantitative assessment of the impact of a triage physician on the Accreditation Council for Graduate Medical Education resident milestones in the emergency department

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World Journal of Emergency Medicine 2024年第3期15卷 220-222页

作者： Julie Cueva Duncan Grossman vishnu Muppala Arlene Chung Mahlaqa Butt Jefferson Drapkin Antonios Likourezos Errel Khordipour Department of Emergency Medicine Maimonides Medical CenterNew York 11219USA

The “door-to-doctor” time for patients to be seen by a physician is an increasingly studied *** may shorten this time by implementing a triage physician (TP).The exact role of a TP may vary across *** put in preliminary orders for lab work,imaging,and treatment,and decide treatment location for further *** the prevalence of TPs grows,its effect on resident education in academic emergency departments (EDs) remains *** implemented a TP in the spring of 2016 and assessed resident physicians before and after implementation.

关键词： physician doctor treatment

Recent advancements in the diagnosis and treatment of acral melanoma

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2024年第2期25卷 106-122页

作者： Ahmad ALHASKAWI Sohaib Hasan Abdullah EZZI Yanzhao DONG Haiying ZHOU Zewei WANG Jingtian LAI Chengjun YAO vishnu Goutham KOTA Mohamed Hasan Abdulla Hasan ABDULLA Hui LU Department of Orthopedics the First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou310003China Department of Orthopaedics Third Xiangya HospitalCentral South UniversityChangsha410013China Zhejiang University School of Medicine Hangzhou310058China Alibaba-Zhejiang University Joint Research Center of Future Digital Healthcare Zhejiang UniversityHangzhou310058China

Acral melanoma(AM)is the most common histologic subtype of melanoma in dark-skinned patients and is associated with a worse prognosis and a high mortality rate,largely due to the inconspicuous nature of early-stage lesions,which can lead to late *** of the overlapping clinical and histopathological features of AM with other forms of cutaneous melanomas,early detection of AM requires a multidisciplinary approach that integrates various diagnostic modalities,including clinical examination,dermoscopy,histopathology,molecular testing,radiological imaging,and blood *** surgery is the preferred method of treatment for AM,other therapeutic options may be employed based on the stage and underlying etiology of the *** checkpoint inhibitors,molecular targeted therapy,radiotherapy,chemotherapy,and oncolytic virotherapy represent promising advanced treatment options for *** this review,we provide an overview of the latest advancements in diagnostic and therapeutic methods for AM,highlighting the importance of early detection and the prompt,individualized management of this challenging disease.

关键词： Acral melanoma Acral lentiginous melanoma Acral nevus Cutaneous malignant melanoma Dermoscopy Oncolytic virotherapy

Adverse events associated with the gold probe and the injection gold probe devices used for endoscopic hemostasis:A MAUDE database analysis

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World Journal of Gastrointestinal Endoscopy 2024年第1期16卷 37-43页

作者： vishnu Charan Suresh Kumar Mark Aloysius Ganesh Aswath Division of Gastroenterology and Hepatology SUNY Upstate Medical UniversitySyracuseNY 13202United States

BACKGROUND Gastrointestinal(GI)bleeding accounts for over half a million admissions annually and is the most common GI diagnosis requiring hospitalization in the United *** electrocoagulation devices are used for the management of gastrointestinal *** is no data on device-related adverse events for gold probe(GP)and injection gold probe(IGP).AIM To analyze this using the Food and Drug Administration(FDA’s)Manufacturer and User Facility Device Experience(MAUDE)database from 2013 to *** We examined post-marketing surveillance data on GP and IGP from the FDA MAUDE database to report devicerelated and patient-related adverse events between *** MAUDE database is a publicly available resource providing over 4 million records relating to medical device *** analyses were performed using IBM SPSS Statistics V.27.0(IBM Corp.,Armonk,NY,United States).RESULTS Our search elicited 140 reports for GP and 202 reports for IGP,respec-tively,during the study period from January 2013 to August *** reportedly occurred in 130 cases for GP,and actual patient injury or event occurred in 10 patients.A total of 149 patients(74%)reported with Injection GP events suffered no significant consequences due to the device failure,but 53 patients(26%)were affected by an *** GP and IGP are critical in managing gastrointestinal *** study of the FDA MAUDE database revealed the type,number,and trends of reported device-related adverse *** endoscopist and support staff must be aware of these device-related events and be equipped to manage them if they occur.

关键词： Hemostasis Gastrointestinal bleeding Endoscopy Device failure Bipolar coagulation Cautery Risks

Impact of glucagon-like peptide receptor agonists on endoscopy and its preoperative management: Guidelines, challenges, and future directions

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World Journal of Gastrointestinal Endoscopy 2024年第6期16卷 292-296页

作者： Sahib Singh vishnu Charan Suresh Kumar Ganesh Aswath Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Division of Gastroenterology and Hepatology State University of New York Upstate Medical UniversitySyracuseNY 13210United States

Glucagon-like peptide receptor agonists(GLP-1RA)are used to treat type 2 diabetes mellitus and,more recently,have garnered attention for their effect-iveness in promoting weight *** have been associated with several gastrointestinal adverse effects,including nausea and *** side effects are presumed to be due to increased residual gastric *** the potential risk of aspiration and based on limited data,the American Society of Anesthesi-ologists updated the guidelines concerning the preoperative management of patients on GLP-1RA in *** included the duration of mandated cessation of GLP-1RA before sedation and usage of“full stomach”precautions if these medications were not appropriately held before the *** has led to additional challenges,such as extended waiting time,higher costs,and increased risk for *** this editorial,we review the current societal guidelines,clinical practice,and future directions regarding the usage of GLP-1RA in patients undergoing an endoscopic procedure.

关键词： Glucagon-like peptide receptor agonists Endoscopy Adverse events Intubation Aspiration Semaglutide Healthcare burden Guidelines

Semaglutide for the management of diabesity:The real-world experience

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World Journal of Methodology 2024年第3期14卷 68-77页

作者： Mohammed Alkhalifah Hafsa Afsar Anindya Shams Dania Blaibel vishnu Chandrabalan Joseph M Pappachan Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Department of Family Medicine King Faisal Specialist HospitalRiyadh 11211Saudi Arabia Department of Data Science Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine&HealthThe University of ManchesterManchester M139PLUnited Kingdom

BACKGROUND Diabesity(diabetes as a consequence of obesity)has emerged as a huge healthcare challenge across the globe due to the obesity *** use of antidiabetic medications including semaglutide is important for optimal management of diabesity as proven by multiple randomized controlled ***,more real-world data is needed to further improve the clinical *** To study the real-world benefits and side effects of using semaglutide to manage patients with *** We evaluated the efficacy and safety of semaglutide use in managing patients with diabesity in a large academic hospital in the United *** parameters were analyzed including demographic information,the data on improvement of glycated hemoglobin(HbA1c),body weight reduction and insulin dose adjustments at 6 and 12 months,as well as at the latest follow up *** data was obtained from the electronic patient records between January 2019 to May *** 106 patients(56 males)with type 2 diabetes mellitus(T2DM),mean age 60.8±11.2 years,mean durations of T2DM 12.4±7.2 years and mean semaglutide treatment for 2.6±1.1 years were *** treatment was associated with significant improvement in diabesity outcomes such as mean weight reductions from baseline 110.4±24.6 kg to 99.9±24.9 kg at 12 months and 96.8±22.9 kg at latest follow up and HbA1c improvement from baseline of 82±21 mmol/mol to 67±20 at 12 months and 71±23 mmol/mol at the latest follow *** insulin dose reduction from mean baseline of 95±74 units to 76.5±56.2 units was also observed at the latest follow *** effects were mild and mainly gastrointestinal like bloating and nausea improving with prolonged use of *** Semaglutide treatment is associated with significant improvement in diabesity outcomes such as reduction in body weight,HbA1c and insulin doses without major adverse *** of largescale real-world data are expected to inform better clinical

关键词： Type 2 diabetes mellitus Diabesity Glucagon-like peptide 1 receptor agonists Semaglutide Insulin dose reduction Weight loss

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肢端黑色素瘤的诊断和治疗进展（英文）

Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2024年第2期 106-123页

作者： Ahmad ALHASKAWI Sohaib Hasan Abdullah EZZI 董延钊周海英王泽伟来经天姚成俊 vishnu Goutham KOTA Mohamed Hasan Abdulla Hasan ABDULLA 卢荟浙江大学医学院附属第一医院骨科中南大学湘雅三医院骨科浙江大学医学院阿里巴巴-浙江大学未来数字医疗联合研究中心

肢端黑色素瘤（AM）是深色皮肤患者中最常见的黑色素瘤组织学亚型，常伴有更差的预后和高死亡率，主要原因为早期病变的不典型特征导致诊断延误。由于AM的临床和组织病理学特征与其他形式的皮肤黑色素瘤相近，其早期检测需要综合各种诊... 详细信息

肢端黑色素瘤（AM）是深色皮肤患者中最常见的黑色素瘤组织学亚型，常伴有更差的预后和高死亡率，主要原因为早期病变的不典型特征导致诊断延误。由于AM的临床和组织病理学特征与其他形式的皮肤黑色素瘤相近，其早期检测需要综合各种诊断模式的多学科方法，包括临床检查、皮肤镜检查、组织病理学检查、分子检测、放射学成像和血液检测。虽然手术是AM的首选治疗方法，但是根据疾病的分期和潜在病因，也可以采用其他治疗方案。免疫检查点抑制剂、分子靶向治疗、放疗、化疗和溶瘤病毒治疗在AM治疗上具有应用前景。在本文中，我们概述了AM诊断和治疗方法的最新进展，强调了早期发现和及时、个性化管理在这一具有挑战性疾病诊疗上的重要性。

关键词：肢端黑色素瘤肢端雀斑样黑色素瘤肢端痣皮肤恶性黑色素瘤皮肤镜检查溶瘤病毒治疗