Geneology International

Tag: combination

  • Evaluation the effects of red yeast rice in combination with statin on lipid profile and inflammatory indices; a randomized clinical trial | BMC Nutrition

    Evaluation the effects of red yeast rice in combination with statin on lipid profile and inflammatory indices; a randomized clinical trial | BMC Nutrition

    Supplied the detrimental effects of dyslipidemia and in light of sure restrictions to statin use, this randomized medical demo (RCT) sought to assess the outcomes of crimson yeast rice (RYR) in individuals with dyslipidemia currently on statin remedy. We identified that RYR, together with statin remedy, can appreciably lower complete cholesterol amounts devoid of adversely affecting liver enzymes concentrations (AST, ALT).

    Various meta-analyses have verified the potent romance among LDL degrees and the risk of cardiovascular illness (CVD) [18]. Just one meta-assessment by the Cholesterol Cure Trialists’ (CTT) Collaboration worked on data from 14 RCTs and about 90,000 topics. The examine instructed that as the serum level of LDL-C falls, the chance of CVD decreases accordingly [19]. A different CTT meta-investigation on a lot more than 170,000 patients discovered that just about every time the LDL concentration drops by one particular mmol/L, the chance of ischemic stroke, coronary artery disorder, and revascularization drops by over a single-fifth [20]. Simply because of the advantages of LDL-C reduction, lipid-lowering brokers – primarily statins – are extremely well known.

    Not long ago, RYR has acquired acceptance as an substitute LDL-decreasing agent with couple of adverse results [21]. Several meta-analyses have confirmed the outcome of RYR on the reduction of LDL-C. Just one the latest review worked on 20 RCTs and 6663 people it showed that after 2 months to 2 yrs of treatment, RYR diminished the serum LDL-C degree by 1.02 mmol/l (~ 39.4 mg/dl) (with 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} self-confidence) in comparison with the placebo, indicating significant efficacy very similar to that of reduced-depth or small-dose statins (pravastatin 40 mg, simvastatin 10 mg, lovastatin 20 mg). The researchers also verified a slight boost in HDL-C and an insignificant lower in TG [14]. A different examine confirmed that clients acquiring RYR seasoned considerable decrements in serum LDL-C (23.{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) and whole cholesterol (15.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) levels relative to a command group next a sixteen-week treatment interval (P < 0.001) [22]. The lipid-lowering effect of RYR is believed to be due to the presence of monacolin K, which possesses the same structure as lovastatin [23]. It is thought that RYR limits the rate of hepatic cholesterol production by inhibiting the 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase enzyme [17].

    One consideration in the use of novel lipid-lowering agents is hepatotoxicity. A meta-analysis of seven trials [16, 24,25,26,27,28,29] assessed serum AST levels before and after intervention with RYR. The researchers showed that although the serum AST level were considerably higher in those who received RYR relative to controls, they remained within the normal range (0–40 U/L) [Total WMD = 1.55 (95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI: 0.26, 2.84) U/L, I2 = 0{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, P = 0.02, 7 trials (8 comparisons), n = 443]. Our study found that after 1 month of treatment, the serum AST level was only slightly higher in the intervention group than the placebo group (P = 0.074) and remained within the normal range. In the mentioned trials [16, 24,25,26,27,28,29], the serum ALT levels was significantly higher in the intervention group compared with the placebo group but again remained within the normal range (0–40 U/L) [Total WMD = 1.47 (95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI: 0.42, 2.51) U/L, I2 = 0{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, P = 0.006, 7 trials (8 comparisons), n = 443]. At the end of our study, the ALT level was also negligibly higher in the intervention group relative to the placebo group (P = 0.714) and remained within the normal range.

    Another important aspect related to RYR is that it may improve endothelial function. In one study, 50 coronary heart disease patients randomly received either RYR (1200 mg daily, containing 11.4 mg of monacolin K) or a placebo, and the serum hs-CRP concentration was monitored. After 6 weeks, those receiving RYR experienced reductions in hs-CRP (P < 0.001) [30]. However, in our study, changes in hs-CRP levels after 4 weeks of intervention were not significant compared with the placebo (P = 0.78).

    Although some recent studies only worked on the effect of RYR in isolation on LDL-C, our study investigated the effect of RYR when accompanied by another statin (atorvastatin or rosuvastatin) on both total cholesterol and LDL-C levels. Due to our limited sample size, further large-scale studies seem warranted. Another limitation was the significant differences in baseline total cholesterol and LDL levels between the study groups. Although the study was randomized, this may be due to the small sample size. We also measured the effect of RYR with only a one-month follow-up future studies should consider an extended period of follow-up.

    Limitations

    Although in this randomized trial, we showed that use of RYR is sfae with statin, this need further larger trials to show the effect of RYS on lipid profile.

  • Recent Research on Brain Health Suggests that a Combination of Healthy Lifestyle Factors May Help Protect Cognitive Function

    Recent Research on Brain Health Suggests that a Combination of Healthy Lifestyle Factors May Help Protect Cognitive Function

    CHARLESTON, WV (LOOTPRESS) – Life style things these as nourishment and the amount of money of slumber, exercise and the social interaction 1 engages in can positively have an affect on life expectancy. But latest brain health investigate indicates that these components might also stave off cognitive impairment.

    On June 8, the Alzheimer’s Affiliation will host a no cost statewide webinar to examine the most up-to-date innovations in dementia-associated investigation and vital tactics that may assistance to continue to keep the brain balanced at “Brain Conscious: Investigate on Cutting down Dementia Threat.” Dr. Claire Sexton, Senior Director, Scientific Plans & Outreach at the Alzheimer’s Affiliation, will focus on the role of modifiable things in lessening the possibility for Alzheimer’s and dementia at the 6 p.m. program. Dr. Sexton sales opportunities research programs and initiatives to speed up the scientific agenda of the Alzheimer’s Association.

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    A Q&A phase, the place those people in attendance can request queries, will be incorporated. Preregistration is needed at alz.org/R10brainhealth to receive the Zoom url to be part of the event. Persons can also contact 800.272.3900to sign up.

    “A new analyze indicated that way of life variables are not only connected with enhanced daily life expectancy, but also a larger proportion of several years lived with out Alzheimer’s dementia,” Dr. Sexton stated. “In other text, way of life elements might not only help you to dwell for a longer time, but also to stay properly in people yrs,” Dr. Sexton explained.

    Sharon Covert, Executive Director of the Alzheimer’s Association West Virginia Chapter, mentioned, “This party will notify people today on techniques they can consider these days to maximize their prospects of lifestyle with no Alzheimer’s or dementia. With 39,000 people in West Virginia, ages 65 and older, dwelling with Alzheimer’s and dementia we have acquired to discuss about the factors that may delay dementia,” she explained.

    Alzheimer’s is a progressive, deadly mind ailment that kills nerve cells and tissues in the mind, influencing an individual’s ability to remember, feel, prepare, speak, stroll. The Alzheimer’s Association, which is the greatest non-revenue funder of Alzheimer’s and dementia investigation, is supporting a total portfolio of analysis to superior brain wellbeing, from laboratory-based research that analyze the molecular mechanisms that mediate the cognitive benefits of work out, as a result of to local community-centered reports. A single these illustration of the latter is the U.S. Examine to Secure Mind Wellbeing By means of Life-style Intervention to Lessen Risk – recognised as U.S. POINTER – a two-yr medical trial to appraise regardless of whether way of life interventions that concurrently target a number of threat variables can protect cognitive function in more mature grown ups (age 60-79) at elevated danger for cognitive decline.

    “There aren’t any ensures,” Dr. Sexton reported. “Age is the most significant issue and our genetics play a purpose as properly. We know these lifestyle variables do not ensure that anyone will or will not produce dementia, but when we appear at the populace level nevertheless, sure things are involved with lowered danger.”

    Dr. Sexton mentioned there is possible in combining distinct efforts to minimize risk. For case in point, persons really should not just imagine about bodily exercise although disregarding a healthy diet.

    “It’s holistic,” she claimed. “It’s under no circumstances far too early or hardly ever much too late to start out imagining about your risk. Adults of any age can be aware of possibility and can discover about research,” she explained.

  • A combination of luck and risk-taking quickly propel small medical clinic to forefront of Covid testing

    A combination of luck and risk-taking quickly propel small medical clinic to forefront of Covid testing


    By Tony Mecia, The Charlotte Ledger

    To see the lines of cars weaving through parking lots of StarMed testing centers all over Charlotte, it might be tempting to think that the company running the show is drawing on a deep reservoir of healthcare experience.

    In fact, it’s a relative newcomer, an unlikely overnight sensation that has successfully waded into the heavily regulated healthcare industry and become a household name, with more than a dozen testing centers in Mecklenburg County. It’s doing 40,000 Covid tests a week and employs nearly 2,000 people, up from just 100 two years ago.

    StarMed’s voyage from obscurity to Charlotte Covid testing colossus comes from a combination of fortunate timing, acting on hunches and embracing a risk-taking startup mentality — much of it emanating from its fast-moving CEO, Michael Estramonte, a chiropractor who moved here from New York a little more than 20 years ago.

    There have been rough patches along the way. His first medical clinic, in a converted Chinese restaurant off Freedom Drive in west Charlotte, was barely breaking even when Covid hit. As recently as a year ago, he had to take out a $1.5M loan to make payroll. And lately, he’s been feeling the pains of a growing business, with some customers complaining about long waits for test results.

    In an interview Tuesday morning in his office off Tuckaseegee Road in west Charlotte, Estramonte marveled at the run his company has had, recalling a meeting with staff two years ago, as Covid was spreading in China.

    “I remember saying, ‘If this comes over here, we need to find a way to be relevant to the community,” he said. “I had no idea at the time that it would wind up being what it became.”

    A new venture’s rocky start: Estramonte, 46, went to college in Upstate New York, at SUNY-Oswego. He moved to Charlotte in 2000 to join the Keith Clinic of Fletcher Keith, a well-known chiropractor who started in Charlotte in 1960. Keith became Estramonte’s mentor, and Estramonte took over the Keith Clinics on Tuckaseegee and Central Avenue after Keith died in 2010, in addition to the one he owned in Sugar Creek.

    The chiropractic business was successful, and Estramonte saw a need to expand into medicine in underserved areas. In 2018, he took some of the profits from the chiropractic office, spent $3M on upfitting an old Chinese restaurant and hired two doctors and three physician assistants to open a clinic offering primary and urgent care.

    It was expensive, and his projections were off.

    “I lost a lot of money in getting this up and going,” he said. “I remember saying to my [chief operating officer] a few times, ‘Maybe we should just get out of this and open up a bunch of Supercuts and manage those.’”

    StarMed stuck with it, and by 2019, the medical clinic had a new director — Dr. Arin Piramzadian, or “Dr. P.” — and it was financially close to breaking even.

    A gamble on testing: Still, it became clear to Estramonte that the company would need to look somewhere else to make money. In October 2019, he decided to open a lab sophisticated enough to run toxicology tests, instead of shipping them off to big testing companies like Labcorp or Quest Diagnostics. “It was a lot of STD testing,” he said, with a chuckle. “I was like, ‘If somebody is going to get paid for it, we might as well do it.’”

    North Carolina approved the lab in January 2020. At the time, awareness of the coronavirus was starting to increase, though it was mostly isolated to China and, later, Italy. Estramonte needed to order equipment for his new lab and asked his staff what was needed for coronavirus testing, in case it came to the U.S. They ordered the needed equipment, from a company called Thermo Fisher Scientific.

    “I had no idea if it was coming over here,” he said. “I had no idea if we could derive profit from testing. I just knew that, all right, let’s go and get it, and if it works out — I’ve done a lot of that type of stuff over the years. A lot of it fails.”

    In hindsight, it was a smart move. The equipment arrived in May, and by then, everyone wanted one — but they were hard to get.

    Covid testing wound up being financially beneficial for StarMed, which receives reimbursements from insurance companies and the government for tests that are free to patients. The amount of reimbursement varies, but Estramonte says it’s enough to cover StarMed’s costs — which are also ballooning as it quickly hires and trains staff. He said he didn’t want to discuss specifics of the company’s finances.

    The company hit a financial rough patch about a year ago, Estramonte says. Insurance companies were slow to pay, and his company wasn’t billing them fast enough because it lacked workers. He took out a $1.5M loan to make payroll. He says it has since been paid off, after the anticipated payments arrived.

    “I love the complexity and the urgency of stuff as much as I hate it,” he said. “I was told by an old business life coach, ‘The reason you put out fires is because usually you’re the one that creates them.’”

    StarMed made another prophetic move as the Delta variant spread in the middle of last year. It ramped up hiring for an anticipated surge in testing. Its human resources department has increased in size from three people to 25. When Delta took off, followed by Omicron, StarMed had the infrastructure in place to handle increases in testing volume.

    Guerrilla marketing: StarMed has also been breaking the norms of healthcare marketing, which in Charlotte typically consists of conservative approaches intended to be reassuring. StarMed, though, has a chatty and edgy Twitter account, and the company participated with ad agency BooneOakley in a risky marketing stunt in September: painting a black truck with a fictional funeral home name and the message “Don’t Get Vaccinated.” The fake funeral home’s website linked to StarMed — which reported a 22{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} increase in vaccine appointments the following week. It made national news. StarMed later said on Twitter: “We had to resuscitate our Marketing Director with one of our defibrillators and explain that this was all @oakleydavid and his team @booneoakley.”

    Estramonte sounds clearly pained when talking about some of the criticism StarMed has received on social media, like recent frustration about delays in receiving testing results. He released a letter Monday saying the trouble was linked to a technology and communications breakdown with an outside lab the company uses for overflow testing. He says he wishes everyone could receive five-star service, but the company’s quick growth makes it hard. Maybe that’s inevitable when you go from a small business to a larger one. He says he’s unaccustomed to the spotlight, like the long profile Axios Charlotte published of him on Tuesday.

    He says he’s looking forward to Covid settling down, and when it does, he says he envisions using some of the money to open more clinics in underserved areas.

    As Estramonte talks, you can almost feel his mind moving forward to the next topic, the next tangent. Asked how his brain works, he says, “It’s obviously ADHD.” He said he held off taking medication for it until a couple years ago. “I thought I would lose my creativity and my imagination. If anything, it just got enhanced,” he said.

    Matt Hanis, a Charlotte-based business of healthcare expert, says StarMed happened to be “in the right place at the right time.” He says it’s harder for large organizations, like the major hospital systems, to move quickly to change their workflows and information technology.

    Estramonte says he works well with the local hospitals and the health department, and he’s happy to have found a niche.

    “If StarMed’s role in a short period of time is to take the stress off the hospital systems, and we were able to figure that out in Mecklenburg County, that’s probably a service that a lot of other major cities in the country didn’t get,” he says. “That does feel good.”

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    by Tony Mecia, North Carolina Health News
    January 22, 2022

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