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| 1 | 钠-葡萄糖共转运蛋白-2抑制剂或胰高血糖素样肽-1受体激动剂治疗成人2型糖尿病:临床实践指南显示文摘临床问题对于存在不同心血管风险及肾脏结局的2型糖尿病患者,在原有生活方式干预和/或其他降糖药物的基础上加用钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂的获益及风险是什么?现行做法几十年来,2型糖尿病的治疗决策都以控制血糖为主导。SGLT-2抑制剂和GLP-1受体激动剂在传统观念中常被用于二甲双胍治疗后血糖仍控制不佳的患者。目前这一现状已经发生了改变,这得益于多项临床研究结果。研究显示SGLT-2抑制剂和GLP-1受体激动剂拥有独立于药物降糖作用之外的对于动脉粥样硬化性心血管病(CVD)和慢性肾脏病(CKD)的获益。建议本指南阐述了针对不同风险分层的成人2型糖尿病患者使用SGLT-2抑制剂或GLP-1受体激动剂的建议。•伴有3种或更少的心血管风险因素且不存在CVD或CKD:不建议启动SGLT-2抑制剂或GLP-1受体激动剂治疗。(推荐等级:弱)•伴有3种以上心血管风险因素且不存在CVD或CKD:建议启动SGLT-2抑制剂治疗,不建议启动GLP-1受体激动剂治疗。(推荐等级:弱)•已经存在CVD或CKD:建议启动SGLT-2抑制剂治疗和GLP-1受体激动剂治疗。(推荐等级:弱)•已经存在CVD和CKD:建议启动SGLT-2抑制剂治疗(推荐等级:强)和GLP-1受体激动剂治疗。(推荐等级:弱)•对于那些想要进一步降低CVD和CKD结局风险的患者:推荐优先启用SGLT-2抑制剂治疗而非GLP-1受体激动剂治疗。(推荐等级:弱)这项指南是如何制订的一个由患者、临床医生和方法学家共同组成的国际小组提出了这些推荐意见。这些推荐意见基于可信度较高的指南的标准,并使用GRADE分级方法进行评估。该小组采用了息者个体化的观点。证据一项关于获益与风险的系统综述和网络meta分析(764项随机对照研究,包括421346例参与者)发现SGLT-2抑制剂和GLP-1受体激动剂可以降低总体死亡率、心肌梗死发生率、终末期肾病或肾衰竭的发生率(中等至高等质量的证据)。在不同的亚组中这些药物对卒中、因心力衰竭所致住院和其他主要不良事件有不同的影响。药物绝对获益的程度因患者个体风险的不同有很大的差异。(例如,对于接受了超过5年药物治疗的1000例患者,在最低风险人群中死亡人数减少了5人,在最高风险人群中死亡人数减少了48人)。一项关于预后的综述确认了14种风险预测模型,其中一种(RECODe)在证据总结中报告了大部分基线风险评估数据,小组利用该模型以支持风险分层的建议。考虑到患者的价值观及个体差异,指南推荐的支撑证据包括一项对已发表论文的系统综述、一项患者焦点小组研究、一项临床问题总结,以及一项指南调查。指南解读我们依据不同的CVD和CKD风险水平,综合考虑获益、风险和其他因素的平衡,以及每一个风险组别的实际问题,来对推荐意见进行分层。本指南强烈建议CVD和CKD患者使用SGLT-2抑制剂治疗,这说明专家组认为其具有显著的获益。而对于其他成人2型糖尿病患者,推荐等级较弱,这说明专家组想要在获益、风险及治疗花费上取得一个更好的平衡。临床医生通过该指南可以使用可靠的风险计算模型,如RECODe,来明确其患者的个体心血管和肾脏疾病风险。医患交互式总结临床证据和制订决策有助于患者知晓治疗选择,包括进行共同决策。2型糖尿病人群(全球患病率不断增长1-2)正面临着不断增加的心血管疾病、肾脏病和其他并发症的风险3。数十年来,2型糖尿病的管理始终以控制血糖及糖化血红蛋白(HbA1c)为治疗目标4-5,但是,最近的高质量随机对照研究已经对这种以血糖为中心的治疗模式发起了挑战。研究结果显示,强化血糖控制未必会降低大血管不良事件,它还可能带来不利影响监管机构现在要求新型糖尿病药物必须证明其具有心血管和肾脏获益才能获得批准。对两类新药--钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂(见框图1)的临床试验结果显示,在现有治疗方案(常规治疗)之上加用这些药物,对死亡、心肌梗死、卒中、心力衰竭和肾脏的结局(如进展为终末期肾病)都有获益8-12。 | Sheyu Li Per Olav Vandvik Lyubov Lytvyn Gordon H Guyatt Suetonia C Palmer Rene Rodriguez-Gutierrez Farid Foroutan Thomas Agoritsas Reed A C Siemieniuk Michael Walsh Lawrie Frere David J Tunnicliffe Evi V Nagler Veena Manja Bjφrn Olav Asvold Vivekanand Jha Mieke Vermandere Karim Gariani Qian Zhao Yan Ren Emma Jane Cartwright Patrick Gee Alan Wickes Linda Fems Robin Wright Ling Li Qiukui Hao Reem A Mustafa 无 郭鹤鸣(译) | 2021 | 英国医学杂志中文版2021，24，9： | 7 |
| 2 | PM2.5: global progress in controlling the motor vehicle contribution显示文摘 | Michael Patrick WALSH | 2014 | Frontiers of Environmental Science & Engineering2014，8，1： | 6 |
| 3 | Gastroenterologist perceptions of faecal microbiota transplantation显示文摘AIM: To explore gastroenterologist perceptions towards and experience with faecal microbiota transplantation(FMT).METHODS: A questionnaire survey consisting of 17 questions was created to assess gastroenterologists' attitude towards and experience with FMT. This was anonymously distributed in hard copy format amongst attendees at gastroenterology meetings in Australia between October 2013 and April 2014. Basic descriptive statistical analyses were performed.RESULTS: Fifty-two clinicians participated. Twenty one percent had previously referred patients for FMT,8% more than once. Ninety percent would refer patients with Clostridium difficile infection(CDI) for FMT if easily available,37% for ulcerative colitis,13% for Crohn's disease and 6% for irritable bowel syndrome. Six percent would not refer any indication,including recurrent CDI. Eighty-six percent would enroll patients in FMT clinical trials. Thirty-seven percent considered the optimal mode of FMT administration transcolonoscopic,17% nasoduodenal,13% enema and 8% oral capsule. The greatest concerns regarding FMT were: 42% lack of evidence,12% infection risk,10% non infectious adverse effects/lack of safety data,10% aesthetic,10% lack of efficacy,4% disease exacerbation,and 2% inappropriate use; 6% had no concerns. Seventy seven percent believed there is a lack of accessibility while 52% had an interest in learning how to provide FMT. Only 6% offered FMT at their institution.CONCLUSION: Despite general enthusiasm,most gastroenterologists have limited experience with,or access to,FMT. The greatest concerns were lack of supportive evidence and safety issues. However a significant proportion would refer indications other than CDI for FMT despite insufficient evidence. These data provide guidance on where education and training are required. | Sudarshan Paramsothy Alissa J Walsh Thomas Borody Douglas Samuel Johan van den Bogaerde Rupert WL Leong Susan Connor Watson Ng Hazel M Mitchell Nadeem O Kaakoush Michael A Kamm | 2015 | World Journal of Gastroenterology2015，21，38： | 5 |
| 4 | Simulation in endoscopy:Practical educational strategies to improve learning显示文摘In gastrointestinal endoscopy, simulation-based training can help endoscopists acquire new skills and accelerate the learning curve. Simulation creates an ideal environment for trainees, where they can practice specific skills, perform cases at their own pace, and make mistakes with no risk to patients. Educators also benefit from the use of simulators, as they can structure training according to learner needs and focus solely on the trainee. Not all simulation-based training,however, is effective. To maximize benefits from this instructional modality,educators must be conscious of learners' needs, the potential benefits of training,and associated costs. Simulation should be integrated into training in a manner that is grounded in educational theory and empirical data. In this review, we focus on four best practices in simulation-based education: deliberate practice with mastery learning, feedback and debriefing, contextual learning, and innovative educational strategies. For each topic, we provide definitions,supporting evidence, and practical tips for implementation. | Rishad Khan Michael A Scaffidi Samir C Grover Nikko Gimpaya Catharine M Walsh | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，3： | 3 |
| 5 | 让学生为进入各个行业做好准备--图书馆在虚拟合作世界的作用显示文摘 | Michael Walsh 罗晓鸣(整理) | 2008 | 高校图书馆工作2008，28，1： | 3 |
| 6 | High Prevalence of Sessile Serrated Adenomas With BRAF Mutations: A Prospective Study of Patients Undergoing Colonoscopy显示文摘 | Kevin J. Spring Zhen Zhen Zhao Rozemary Karamatic Michael D. Walsh Vicki L.J. Whitehall Tanya Pike Lisa A. Simms Joanne Young Michael James Grant W. Montgomery Mark Appleyard David Hewett Kazutomo Togashi Jeremy R. Jass Barbara A. Leggett | 2006 | Gastroenterology2006，，5： | 3 |
| 7 | Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study显示文摘 | Julia Granerod Helen E Ambrose Nicholas WS Davies Jonathan P Clewley Amanda L Walsh Dilys Morgan Richard Cunningham Mark Zuckerman Ken J Mutton Tom Solomon Katherine N Ward Michael PT Lunn Sarosh R Irani Angela Vincent David WG Brown Natasha S Crowcroft | 2010 | The Lancet Infectious Diseases2010，，12： | 2 |
| 8 | The Mesocolon: A Histological and Electron Microscopic Characterization of the Mesenteric Attachment of the Colon Prior to and After Surgical Mobilization显示文摘 | Kevin Culligan Stewart Walsh Colum Dunne Michael Walsh Siobhan Ryan Fabio Quondamatteo Peter Dockery J. Calvin Coffey | 2014 | Annals of Surgery2014，，6： | 2 |
| 9 | Beta -TCP bone graftsubstitutes in a bilateral rabbit tibial defect model显示文摘 | Walsh W Vizesi F Michael D | 2008 | Biomaterials2008，29，3： | 1 |
| 10 | The ATHEROMA (Atorvastatin Therapy: Effects on Reduction of Macrophage Activity) Study显示文摘 | Tjun Y. Tang Simon P.S. Howarth Sam R. Miller Martin J. Graves Andrew J. Patterson Jean-Marie U-King-Im Zhi Y. Li Stewart R. Walsh Andrew P. Brown Peter J. Kirkpatrick Elizabeth A. Warburton Paul D. Hayes Kevin Varty Jonathan R. Boyle Michael E. Gaunt And | 2009 | Journal of the American College of Cardiology2009，，22： | 1 |
| 11 | Sessler,Relationship between Intraoperative Mean Arterial Pressure and Clinical Outcomes after Noncardiac Surgery: Toward an Empirical Definition of Hypotension显示文摘 | Michael Walsh Philip J Devereaux Amit X Garg | 2013 | Anesthesiology2013，119，： | 1 |
| 12 | Hepatic Blood Flow Changes in Chronic Hepatitis C Measured by Duplex Doppler Color Sonography: Relationship to Histological Features显示文摘 | Kevin Michael Walsh Eddie Leen Roderick Norman Mciver Macsween Allan John Morris | 1998 | Digestive Diseases and Sciences1998，，12： | 1 |
| 13 | Factors Associated with Prolonged Wound Drainage Mter Primary Total Hip and Knee Arthroplasty显示文摘 | Vipul P Patel Michael Walsh | | 0，，89： | 1 |
| 14 | Antifungal susceptibility testing:practical aspects and current challenges显示文摘 | Michael A Pfaller Thomas J Walsh | 2001 | Clinical Microbiology Reviews2001，14，： | 1 |
| 15 | Surgical Versus Nonsurgical Management of Pancreatic Pseudocysts显示文摘 | Michael D. Johnson R. Matthew Walsh J. Michael Henderson Nancy Brown Jeffrey Ponsky John Dumot Gregory Zuccaro John Vargo | 2009 | Journal of Clinical Gastroenterology2009，，6： | 1 |
| 16 | Maximizing Financial Support for Biodiversity in the Emerg- ing Kyoto Protocol Markets 显示文摘 | Michael J Walsh | 1999 | Science of the Total Environment1999，，240： | 1 |
| 17 | Influence of arm movement on central tip location of peripherally inserted central catheters (PICCs)显示文摘 | Bairbre Connolly Joao Amaral Sharon Walsh Michael Temple Peter Chait Derek Stephens | 2006 | Pediatric Radiology2006，，8： | 1 |
| 18 | Efficacy and safety of oclacitinib for the control of pruritus and associated skin lesions in dogs with canine allergic dermatitis显示文摘 | Sallie B. Cosgrove Jody A. Wren Dawn M. Cleaver David D. Martin Kelly F. Walsh Jessica A. Harfst Stacey L. Follis Vickie L. King Joseph F. Boucher Michael R. Stegemann | 2013 | Vet Dermatol2013，，5： | 1 |
| 19 | Pancreatic Lesions in von Hippel–Lindau Disease? A Systematic Review and Meta-synthesis of the Literature显示文摘 | Michael Charlesworth Caroline Verbeke Gavin Falk Matthew Walsh Andrew Smith Gareth Morris-Stiff | 2012 | Journal of Gastrointestinal Surgery2012，，7： | 1 |
| 20 | A randomised con- trol trial of low glycaemic index carbohydrate diet versus no dietary inter- vention in the prevention of recurrence of macrosomia显示文摘 | Jennifer Walsh Rhona Mahony Michael Foley | 2010 | Pregnancy and Childbirth2010，21，16： | 1 |
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