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Role of gut microbiota in cardiovascular diseases

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World Journal of Cardiology 2020年第4期12卷 110-122页

作者： Marko Novakovic Amit Rout Thomas Kingsley Robert Kirchoff Amteshwar Singh Vipin Verma Ravi Kant rahul chaudhary Department of Internal Medicine Sinai Hospital of BaltimoreBaltimoreMD 21215United States Department of Internal Medicine Division of Hospital Internal MedicineMayo ClinicRochesterMN 55905United States Department of Internal Medicine Division of Hospital MedicineJohns Hopkins University School of MedicineBaltimoreMD 21205United States Department of Internal Medicine Medical University of South Carolina/AnMed CampusCharlestonSC 29425United States Division of Endocrinology Diabetes and NutritionMedical University of South Carolina/Anmed CampusAndersonSC 29621United States

The human gut is colonized by a community of microbiota,primarily bacteria,that exist in a symbiotic relationship with the *** microbiota-host interactions play a critical role in the regulation of human *** changes to the composition of gut microbiota,referred to as gut dysbiosis,has been linked to the development and progression of numerous diseases,including cardiovascular disease(CVD).Imbalances in host-microbial interaction impair homeostatic mechanisms that regulate health and can activate multiple pathways leading to CVD risk factor *** CVD risk factors,including aging,obesity,dietary patterns,and a sedentary lifestyle,have been shown to induce gut *** is associated with intestinal inflammation and reduced integrity of the gut barrier,which in turn increases circulating levels of bacterial structural components and microbial metabolites,including trimethylamine-N-oxide and short-chain fatty acids,that may facilitate the development of *** article reviews the normal function and composition of the gut microbiome,mechanisms leading to the leaky gut syndrome,its mechanistic link to CVD and potential novel therapeutic approaches aimed towards restoring gut microbiome and CVD *** CVD is the leading cause of deaths globally,investigating the gut microbiota as a locus of intervention presents a novel and clinically relevant avenue for future research.

关键词： Cardiovascular disease Coronary artery disease Gut microbiota Dysbiosis Thrombosis

PCSK9 inhibitors: A new era of lipid lowering therapy

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World Journal of Cardiology 2017年第2期9卷 76-91页

作者： rahul chaudhary Jalaj Garg Neeraj Shah Andrew Sumner Department of Medicine Sinai Hospital of BaltimoreJohns Hopkins University Division of Cardiology Lehigh Valley Health Network

Hyperlipidemia is a well-established risk factor for developing cardiovascular disease(CVD). The recent American College of Cardiology and American Heart Association guidelines on lipid management emphasize treatment of individuals at increased risk for developing CVD events with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors(statins) at doses proven to reduce CVD events. However, there are limited options for patients who are either intolerant to statin therapy, develop CVD despite being on maximally tolerated statin therapy, or have severe hypercholesterolemia. Recently the Food and Drug Administration approved two novel medications for low-density lipoprotein(LDL)-cholesterol reduction: Evolocumab and Alirocumab. These agents target and inactivate proprotein convertase subtilsinkexin type 9(PCSK9), a hepatic protease that attaches and internalizes LDL receptors into lysosomes hence promoting their destruction. By preventing LDL receptor destruction, LDL-C levels can be lowered 50%-60% above that achieved by statin therapy alone. This review explores PCSK-9 biology and the mechanisms available to alter it; clinical trials targeting PCSK9 activity, and the current state of clinically available inhibitors of PCSK9.

关键词： Hyperlipidemia Statins Proprotein convertase subtilsin-kexin 类型 9

Bilirubin in coronary artery disease:Cytotoxic or protective?

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2016年第4期7卷 469-476页

作者： Nancy Gupta Tavankit Singh rahul chaudhary Sushil K Garg Gurprataap Singh Sandhu Varun Mittal rahul Gupta Roxana Bodin Sachin Sule Department of Medicine Westchester Medical CenterNew York Medical College Department of Medicine Cleveland Clinic Department of Medicine Sinai Hospital of BaltimoreJohns Hopkins University Department of Medicine University of Minnesota Department of Medicine University of Pittsburgh Einstein Healthcare Network Government Medical College Division of Gastroenterology and Hepatobiliary Disease New York Medical College

Bilirubin has traditionally been considered a cytotoxic waste ***,recent studies have shown bilirubin to have anti-oxidant,anti-inflammatory,vasodilatory,anti-apoptotic and anti-proliferative *** properties potentially confer bilirubin a new role of protection especially in coronary artery disease(CAD),which is a low grade inflammatory process exacerbated by oxidative *** fact,recent literature reports an inverse relationship between serum concentration of bilirubin and the presence of *** this article,we review the current literature exploring the association between levels of bilirubin and risk of *** conclude that current evidence is inconclusive regarding the protective effect of bilirubin on CAD.A causal relationship between low serum bilirubin level and increased risk of CAD is not currently established.

关键词： Bilirubin 细胞毒素保护抗氧化剂反煽动性反冠的动脉疾病类脂化合物 peroxidation 吉伯

Erythropoietin therapy after out-of-hospital cardiac arrest:A systematic review and meta-analysis

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World Journal of Cardiology 2017年第12期9卷 830-837页

作者： rahul chaudhary Jalaj Garg Parasuram Krishnamoorthy Kevin Bliden Neeraj Shah Nayan Agarwal rahul Gupta Abhishek Sharma Karl B Kern Nainesh C Patel Paul Gurbel Department of Medicine Sinai Hospital of BaltimoreBaltimoreMD 21215United States Division of Cardiology Lehigh Valley Health NetworkAllentownPA 18103United States Department of Medicine Division of CardiologyEinstein Healthcare NetworkPhiladelphiaPA 19141United States Inova Heart and Vascular Institute Inova Medical CenterFairfaxVA 22042United States Division of Cardiovascular Medicine University of FloridaGainesvilleFL 32611United States Queens Cardiac Care QueensNY 11428United States Division of Cardiovascular Medicine State University of New YorkBrooklynNY 12246United States Division of Cardiology University of Arizona College of MedicineTucsonAZ 85721United States

AIM To assess safety and efficacy of early erythropoietin(Epo) administration in patients with out-of-hospital cardiac arrest(OHCA).METHODS A systematic literature search was performed using PubM ed,MEDLINE,EMBASE,EBSCO,CINAHL,Web of Science and Cochrane databases,of all studies published from the inception through October 10,*** criteria included:(1) Adult humans with OHCA and successful sustained return of spontaneous circulation;and(2) studies including mortality/brain death,acute thrombotic events as their end *** efficacyoutcome was "brain death or Cerebral Performance Category(CPC) score of 5".Secondary outcomes were "CPC score 1,and 2-4","overall thrombotic events" and "acute coronary stent thrombosis".RESULTS We analyzed a total of 606 participants(n = 276 received Epo and n = 330 with standard of care alone) who experienced OHCA enrolled in 3 clinical *** significant difference was observed between the Epo and no Epo group in brain death or CPC score 5(OR = 0.77;95%CI:0.42-1.39),CPC score 1(OR = 1.16,95%CI:0.82-1.64),and CPC score 2-4(OR = 0.77,95%CI:0.44-1.36).Epo group was associated with increased thrombotic complications(OR = 2.41,95%CI:1.26-4.62) and acute coronary stent thrombosis(OR = 8.16,95%CI:1.39-47.99).No publication bias was *** Our study demonstrates no improvement in neurological outcomes and increased incidence of thrombotic events and acute coronary stent thrombosis in OHCA patients who were treated with Epo in addition to standard therapy.

关键词： Erythropoietin Thrombosis Cardiac arrest Cardiopulmonary resuscitation

Radical cystoprostatectomy with orthotopic neobladder for a case of treatment emergent neuroendocrine prostate cancer presenting as bladder mass with hematuriaea rare instance of tumor remission after local control

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Asian Journal of Urology 2021年第4期8卷 444-447页

作者： rahul Jena Hira Lal Nandita chaudhary Uday Pratap Singh Department of Urology and Renal Transplant Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia Department of Radiodiagnosis Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia Department of Pathology Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia

Dear editor Treatment emergent neuroendocrine prostate cancer(tNEPC)is most commonly observed after development of resistance to androgen deprivation therapy(ADT)and is associated with rapid progression and widespread metastases with survival less than 1 year from diagnosis[1].Management of this disease is mainly through cytotoxic chemotherapy and there is no published evidence of treating the primary prostatic lesion in this stage of the disease,unlike that of localized prostate cancer or castrate sensitive metastatic prostate cancer[2].In this letter,we report the only known case of t-NEPC who presented with an initial diagnosis of bladder urothelial carcinoma and was treated by early radical surgery and chemotherapy,which led to longterm disease control and preservation of quality of life.

关键词： bladder diagnosis chemotherapy