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Understanding and Managing Childhood Asthma
Dr. Shipra Singh, a Pediatric Pulmonologist, outlines the challenges of diagnosing asthma in children due to symptoms resembling other respiratory issues. It's particularly difficult to identify in infants and young children, who may not clearly exhibit breathing difficulties. Asthma, often confused with bronchitis, croup, or allergies, is a significant chronic illness causing school absenteeism, as per the CDC. Risk factors include prenatal smoking and family history of allergies or asthma. Infants and toddlers are more susceptible due to smaller airways and respiratory viruses, which can exacerbate conditions like colds and bronchitis. How can I tell if my child has asthma? Unfortunately small children are unable to describe their symptoms, making asthma difficult to diagnose. Your child may even be active, playing and smiling, although they are experiencing chest tightness or labored breathing. Observe your child and let the child’s doctor know if: Your child’s breathing behavior has changed (coughing, wheezing, rapid breathing) Your child’s breathing pattern changes (day vs. night, with rest or activity, inside vs. outside) You have a family history of asthma or allergies Your child’s breathing is triggered by any foods or allergies With your help, your child’s doctor can make the best diagnosis to determine if your child has asthma. A pediatric pulmonologist (lung specialist) or pediatric allergist may also have to be consulted for special testing. Tests may include lung function testing, allergy tests, blood tests and X-rays for an accurate diagnosis. What is the treatment for infants and toddlers? Young children can use many of the same medications as older children and adults, although the way they take them and the dosage will differ. A nebulizer (or breathing machine) creating a medicated mist for your child to breathe through a mask may be used. An inhaler with a small spacer tube connected to a mask is also common to help your child breath medication into their lungs. Either of these options are effective. Asthma in children is treated with both fast-acting and long-term medicines to open up airways quickly for easy breathing and also to lessen asthma symptoms over time. Communicate with your child’s medical providers to create a personalized asthma management plan for them. How can I manage my child’s asthma? Recognize your child’s breathing habits and be aware of worsening symptoms. Consult with your child’s doctor on a daily asthma action plan to recognize worsening symptoms and track medications. Here’s an example of an asthma action plan provided by the U.S. Department of Health and Human Services’ National Institutes of Health). Be consistent with the plan and talk to your doctor before changing it. Have an emergency plan in case of a serious asthma attack. Know where the closest ER is and know who can take care of your other children. Also know what the medical treatment coverage is under your insurance plan. Dr. Singh explains, "Discussing asthma with your child may be difficult. Some kids find the subject frightening or confusing. Others, especially the older kids, may resent the treatment and may not be interested in doing it. Talk to your doctor about advice to build an open and trusting relationship regarding your child's asthma care."
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Donde hay humo, puede haber más dolores de cabeza, náuseas y tos
El equipo de Renown Urgent Care lo prepara para mantenerse a salvo esta temporada y está disponible los siete días de la semana en 11 ubicaciones del norte de Nevada. Millones de personas en todo el oeste viven en zonas donde la contaminación atmosférica puede causar graves problemas de salud. Local air quality can affect our daily lives. Like the weather, it can change from day to day. The Northern Sierra Air Quality Management District issued an Air Quality Health Advisory for Plumas County, to notify the public of the possibility of poor air quality conditions resulting from the Beckwourth Complex Fire in addition to other wildfires in northern California. In addition, there is the potential for wind shifts to carry smoke to other parts of Plumas County from the Beckwourth and several other regional wildfires. Air quality is expected to vary greatly depending on fire behavior and weather conditions, with smoke settling in low areas at night and in the early mornings as long as these fires are active. The advisory mentions, “Exposure to elevated PM2.5 (fine particulate matter in smoke) concentrations can result in eye and throat irritation, headaches, nausea, shortness of breath, congestion, coughing, impaired lung function and chest pain, especially among sensitive individuals such as the elderly, children, people with asthma, people with heart or lung conditions, pregnant women and anyone who is exercising or working hard outdoors.” Kouros Farro, MD, a physician with Renown Urgent Care advises that there are people who are more likely to be affected when fine particle pollution reaches an unhealthy level. People who have asthma or other breathing conditions like chronic obstructive pulmonary disease (COPD). People who have heart disease or high blood pressure. Children and older adults. People of all ages who are doing extended or heavy, physical activity like playing sports or working outdoors. “Everyone should take precautions when the air quality is unhealthy. Air pollution can aggravate heart and cardiovascular disease as well as lung diseases like asthma and COPD. When the air quality is unhealthy, people with these conditions may experience symptoms like chest pain, shortness of breath, wheezing, coughing, or fatigue. Si experimenta alguno de estos síntomas, use sus inhaladores según las indicaciones y comuníquese con su proveedor de atención médica”, recomienda el Dr. Farro, que está certificado por el consejo en medicina familiar y ejerce en Renown Urgent Care en 975 Ryland St, Reno. “If you do not have a health care provider, know we have a Renown Urgent Care office on almost every corner, with providers ready to see you.” Dr. Farro advises the following: Take it easy and listen to your body. Limit, change, or postpone your physical activity level. If possible, stay away from local sources of air pollution like busy roads and wood fires. If you have asthma or other breathing conditions like COPD make sure you have your relief/rescue inhaler with you. People with asthma should review and follow guidance in their written asthma action plan. Make an appointment to see your health provider to be sure you have an asthma action plan. “Even just one hour of smoke exposure can affect our lungs and hearts, and these consequences can reach people far beyond the direct area endangered by the fire. Children, older adults, pregnant women, people with preexisting cardiopulmonary disease, communities of color, economically disadvantaged communities, and people with preexisting chronic health conditions like asthma, diabetes, and obesity are all especially vulnerable to the air pollution that wildfires cause," says Dr. David Lemak, Division Chief of Urgent Care at Renown. Renown Urgent Care brinda tratamiento para una amplia gama de lesiones, enfermedades e inquietudes médicas leves que son urgentes, pero no suponen un riesgo para la vida y que requieren atención médica en el mismo día. También le evita los tiempos de espera prolongados y los altos precios de la sala de emergencias en los 11 centros convenientes, incluidos Reno, Sparks, Carson City, USA Parkway, Fallon y Fernley. You can walk-in or book ahead online. You can get the latest fire and smoke information at the Washoe County Health District’s Be Smoke Smart webpage. It includes information about air pollution levels and how to protect yourself from the smoke. An on-line subscription page allows you to sign up for EnviroFlash, notifying you about air quality. Acerca de Renown Health Renown Health es una red de atención médica integrada de administración local y sin fines de lucro que brinda servicios al norte de Nevada, Lake Tahoe y el noreste de California. Renown es uno de los mayores empleadores privados de la región y cuenta con una fuerza laboral de más de 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to continually improve the care and the health of our community. Visite renown.org para obtener más información.
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Research Shows Genetic Approaches to Breast Cancer Screenings Yield More Accurate Results
Clinical researchers with the Healthy Nevada Project co-author research paper with findings that emphasize the need for a comprehensive approach to breast cancer risk assessment – including a focus on genetic medicine – to help ensure that individuals at high risk are identified and supported proactively rather than reactively. Breast cancer is a leading cause of cancer death among women in the United States. According to the American Cancer Society, about 1 in 8 women will develop breast cancer and about 1 in 39 women will die from breast cancer. Breast cancer is associated with increased age, hereditary factors, obesity, and alcohol use. Since 1990, breast cancer death rates have declined progressively due to advancements in treatment and detection. In Nevada there are an estimated 2,310 new breast cancer cases a year, and genetic mutations such as in the genes BRCA1 or BRCA2 remain a top risk factor for this prevalent disease. Recognizing the urgency for progress in breast cancer research, a collaborative effort between physicians, advanced practice providers and scientists from the Healthy Nevada Project® (HNP) and Helix have unveiled groundbreaking research. This study explores how genetic screenings are a necessary supplement to traditional testing methods, together offering more accurate insights into a patient's likelihood of developing breast cancer in the future. HNP is operated by Renown Genomic Medicine and the Institute for Health Innovation and is one of the largest community-based population health studies in the country. Their team works in collaboration with Helix, a leader in precision health that delivers comprehensive genomic solutions. Together, this dynamic partnership aims to understand breast cancer risk factors and pave the way for more effective preventative measures. The combined research team studied 25,591 female HNP participants to evaluate the performance of different genetic screening approaches to identify women at high risk of breast cancer. The results of this research suggest that a combined monogenic, or single-gene, and polygenic, or multi-gene, approach to breast cancer screenings helped produce more accurate results and more closely identify study participants who have a high genetic risk of developing the disease. "Based on this research, we are advocating a shift in approach which would improve breast cancer risk assessment through a combination of effective family history ascertainment and genetic screening,” said Joseph Grzymski, PhD, principal investigator of the Healthy Nevada Project, research professor at the University of Nevada, Reno School of Medicine and co-author of the breast cancer research paper. “This tailored approach, founded on the assessment of individual genetic risk, not only intends to elevate patient well-being but also will improve efficiency and equity in healthcare." Complementing the team’s research on leveraging genetics to identify women at low genetic risk of breast cancer that could safely defer mammogram screenings by five to 10 years that was released in late 2023 in JAMA Oncology, the study suggests that incorporating genetic information can assist in personalizing breast cancer screenings and optimizing the use of screening resources. "Existing disparities persist across various facets of breast cancer screening and treatment; however, genetic screening is clearly a powerful tool to help facilitate early intervention for those at higher risk,” said Jamie Schnell Blitstein, APRN, a primary care nurse practitioner at Renown Health and co-author of the breast cancer research paper. “By placing a heightened focus on risk, we underscore the pivotal role of preventative breast cancer screening.” Despite the availability of effective methods for early screening, co-authors of this research found that 78 percent of women with a family history of breast cancer had their risk ascertained only after a breast cancer diagnosis. The findings emphasize the need for a comprehensive approach to breast cancer risk assessment – including a focus on genetic medicine – to help ensure that individuals at high risk are identified and supported proactively rather than reactively. “These findings that can profoundly impact how healthcare is delivered were only made possible by all the participants who were willing to consent to research,” said Alex Bolze, PhD from Helix and co-author of the publication. “Broad-scale collaboration projects like these between Renown Health and UNR that engage large populations where participants share both their genetic information as well as electronic health records drive advancements in preventative medicine, as well as fundamental biological research.” The research paper was officially accepted on Jan. 29, 2024, and will be published by Elsevier, Inc. on behalf of the American College of Medical Genetics and Genomics. The contents of the paper will appear in the international journal Genetics in Medicine Open. Read the full article by visiting sciencedirect.com. The Healthy Nevada Project is currently recruiting new study participants. Free to all Nevadans with a saliva sample or blood draw, participants and their referring providers receive access to whole-exome sequencing and clinical grade results that help provide insight into their unique genetic risks tied to heart disease and certain cancers. If you are interested in enrolling in the study, schedule a Virtual Consent Appointment through MyChart or contact the Renown Institute for Health Innovation at RenownIHI@renown.org or (775) 982-6914 to be connected to a Genomic Representative. About Renown Health Renown Health is the region’s largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. Con una fuerza laboral diversa de más de 7,000 empleados, Renown ha fomentado una cultura de excelencia, determinación e innovación de larga data. La organización se compone de un centro de urgencias, dos hospitales de cuidados agudos, un hospital infantil, un hospital de rehabilitación, un grupo médico y una red de atención de urgencias y Hometown Health, la compañía de seguros sin fines de lucro más grande de la región y de propiedad local, Hometown Health. Renown is currently enrolling participants in the largest community-based genetic population health study, the Healthy Nevada Project®. To join the Renown Health team, visit renown.org/careers. Acerca de Helix Helix es la compañía líder en genómica y vigilancia viral de la población cuyas operaciones se basan en el cuidado clínico, la investigación y el análisis de datos. Helix enables health systems, life sciences companies, payers, and government partners to accelerate the integration of genomic data into patient care and public health decision-making. Learn more at helix.com.
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Gilead Sciences y el Renown Institute for Health Innovation anuncian una colaboración estratégica para promover la comprensión de la esteatohepatitis no alcohólica (EHNA)
Gilead Sciences, Inc. (Nasdaq: GILD) and the Renown Institute for Health Innovation (IHI) today announced a strategic collaboration to collect and analyze genetic and electronic health data that can enhance the understanding of nonalcoholic steatohepatitis (NASH) and potentially inform development of treatment options for the disease. En virtud de los términos del acuerdo de colaboración y licencia, Gilead proporcionará fondos al Renown IHI para secuenciar y analizar el ADN de 15,000 personas que viven con EHNA o con enfermedad de hígado graso no alcohólico (EHGNA), así como de una cohorte de control de 40,000 personas en el estado de Nevada. “Combining the sequencing of protein coding DNA, with extensive electronic health record data will enable a deep analysis of the roles of genetics and environment in NASH incidence and progression,” said John McHutchison, AO, MD, Chief Scientific Officer and Head of Research and Development, Gilead Sciences. “The analysis of these large datasets in collaboration with Renown IHI could help identify genetic variants that impact the risk of developing NASH and thereby advance the discovery and development of new treatments for this disease.” Renown Health es la red de atención médica más completa e integrada de Nevada y mantiene registros médicos electrónicos para 1.02 millones de pacientes registrados. En 2016, Renown Health y el Desert Research Institute crearon el Healthy Nevada Project (HNP), el primer estudio de salud poblacional basado en la comunidad del país. En 2017, el HNP comenzó una sociedad con Helix para aprovechar sus servicios de salud poblacional, la secuenciación Exome+™ y las herramientas de participación del consumidor. The HNP is now an ongoing collaboration between Renown IHI, the Desert Research Institute, a global leader in environmental data and applied research, and Helix, a personal genomics company. HNP combines genetic, environmental, social and clinical data to address individual and community health needs with the goal of improving health across the state and the nation. El HNP actualmente tiene 40,000 participantes. “Combining genetic sequencing with large sets of data can play a critical role in understanding and identifying serious health risks, including diseases like NASH. We are excited to collaborate with Gilead to better understand the condition and its complexities,” said Anthony Slonim, MD., DrPH. “Any genetic variants identified in participants through the collaboration may be shared with the participants for patient care purposes.” About NASH Nonalcoholic steatohepatitis (NASH) is a chronic form of liver disease characterized by excess fat in the liver, inflammation, and liver cell damage. Inflammation and liver cell damage can cause scarring of the liver, or fibrosis, and ultimately lead to cirrhosis or liver cancer. La EHNA es más frecuente en personas con ciertas afecciones, que incluyen obesidad y diabetes tipo 2. There are currently limited approved treatments for patients living with NASH. About Gilead Sciences Gilead Sciences, Inc. is a research-based biopharmaceutical company that discovers, develops and commercializes innovative medicines in areas of unmet medical need. The company strives to transform and simplify care for people with life-threatening illnesses around the world. Gilead opera en más de 35 países alrededor del mundo, con sede central en Foster City, California. Para obtener más información sobre Gilead Sciences, visite el sitio web de la empresa en www.gilead.com. About Renown Health Renown Health is a locally governed and locally owned, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. Renown es uno de los mayores empleadores privados de la región y cuenta con una fuerza laboral de más de 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown Health’s commitment has extended beyond traditional health care to include community health and well-being. Renown Health works to improve health care through science, research and genetics; forge community partnerships that improve lives and develop innovative models that are improving health care in Nevada. For more information, visit renown.org. About Helix Helix’s mission is to empower every person to improve their life through DNA. Helix is accelerating the integration of genomic data into clinical care and broadening the impact of large-scale population health programs by providing comprehensive expertise in DNA sequencing, bioinformatics, and individual engagement. Mediante el uso de su ensayo Exome+™ de propiedad exclusiva, un exoma de tipo panel mejorado con más de 300,000 regiones no codificantes informativas, Helix ofrece a los sistemas de salud una solución escalable que permite el descubrimiento de información genética médicamente relevante y que potencialmente puede salvar vidas. Additionally, Helix offers a suite of DNA-powered products for continued individual engagement and discovery. Helix is headquartered in the San Francisco Bay Area and has one of the world’s largest CLIA-certified, CAP-accredited Next Generation Sequencing labs, located in San Diego, California. Obtenga más información en www.helix.com. Helix, the Helix logo, and Exome+ are trademarks of Helix Opco, LLC. Gilead Forward-Looking Statement This press release includes forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 that are subject to risks, uncertainties and other factors, including the risk that the parties may not realize the potential benefits of this collaboration, and Gilead may fail to discover, develop and commercialize any product candidates for the treatment of NASH. All statements other than statements of historical fact are statements that could be deemed forward-looking statements. These risks, uncertainties and other factors could cause actual results to differ materially from those referred to in the forward-looking statements. The reader is cautioned not to rely on these forward-looking statements. Estos y otros riesgos se describen en detalle en el Informe Trimestral de Gilead en el Formulario 10-Q para el trimestre que finalizó el 31 de marzo de 2019, presentado ante la Comisión de Bolsa y Valores de los EE. UU. All forward-looking statements are based on information currently available to Gilead, and Gilead assumes no obligation to update any such forward-looking statements. For more information on Gilead Sciences, please visit the company’s website at www.gilead.com, follow Gilead on Twitter (@GileadSciences) or call Gilead Public Affairs at 1-800-GILEAD-5 or 1-650-574-3000. Additional Media Contact: Sung Lee, Investors 650-524-7792 Arran Attridge, Media 650-425-8975
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El humo de los incendios forestales es más peligroso que cualquier otro tipo de contaminación atmosférica para las personas con asma
El Índice de calidad del aire de fase 2 y los alarmantes estudios de investigación del DRI, Renown Health y el Distrito de Salud del Condado de Washoe conducen a un aviso de salud pública; se debe buscar atención médica si es necesario. Para las personas que padecen asma, el humo de los incendios forestales es más peligroso que cualquier otro tipo de contaminación atmosférica, según un estudio del Desert Research Institute (DRI), el Renown Institute for Health Innovation (Renown IHI) y el Distrito de Salud del Condado de Washoe (WCHD). El estudio publicado en la revista Environmental Health examinó las asociaciones entre las partículas en el aire (particulate matter, PM) procedentes de fuentes como los incendios forestales, el transporte y la industria, y las visitas médicas por asma en los departamentos de emergencia y centros de Urgent Care de Renown Health en Reno, Nevada, durante el período de seis años comprendido entre 2013 y 2018. In places like Reno, where wildfire events occur regularly during parts of the year and are expected to become more frequent in the future, an accurate understanding of the impacts of wildfire smoke on population health is critical. We have an exceptional process in place through our urgent care sites, Renown Medical Group offices and hospital emergency departments to screen, diagnose and treat members of our community who come to us for care related to asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema, and other upper respiratory diseases that may be exacerbated by wildfire smoke. At the same time, we continue to develop and refine, in real-time, the data that supports our predictive analytic models. We are using every tool and resource-including scientific data and clinical reporting, to ensure that we are meeting both the health and healthcare needs of the people we serve. En el estudio, los investigadores descubrieron que la calidad del aire en el área de Reno se vio afectada por el humo de los incendios forestales en un total de 188 días durante el periodo del estudio. En total, se produjeron 18,836 visitas a la sala de emergencias y atención de urgencia relacionadas con el asma durante el mismo período de cinco años, lo que indica que es importante comprender la influencia del humo de un incendio forestal y otros tipos de contaminación atmosférica en esta afección médica. La Air Quality Management Division (AQMD) del Distrito de Salud del condado de Washoe ha emitido una advertencia de contaminación del aire de fase 2 debido al humo de los incendios en el área. La calidad del aire en el área de Reno-Sparks ahora es “muy poco saludable” y tiene un Índice de calidad del aire de 247. La advertencia de fase 2 significa que todos los residentes deben permanecer en sus residencias y reducir los niveles de actividad debido a la susceptibilidad de mayores riesgos para la salud. To see current air quality in Reno-Sparks, click here. Brion Hill, MD who practices at the Renown Urgent Care - Los Altos location warns, “This is an important health advisory, exposure to elevated PM2.5 (fine particulate matter in smoke) concentrations can result in eye and throat irritation, headaches, nausea, shortness of breath, congestion, coughing, impaired lung function and chest pain. Everyone should take precautions when the air quality is unhealthy. Air pollution can aggravate heart and cardiovascular disease as well as lung diseases like asthma and COPD. When the air quality is unhealthy, people with these conditions may experience symptoms like chest pain, shortness of breath, wheezing, coughing, or fatigue. If you are experiencing any of these symptoms, use your inhalers as directed and contact your health care provider,” says Dr. Hill. “Si no tiene un proveedor de atención médica, tenemos 11 consultorios de Renown Urgent Care convenientemente ubicados con proveedores listos para atenderlo los 7 días de la semana”. Dr. Joseph Grzymski, a research professor at Desert Research Institute, a corresponding author on the study and Chief Scientific Officer, Renown Health, says, “This air is very bad for your health. Given today’s Air Quality Index in Reno, being outside and breathing this air for a day equals about smoking half a package of cigarettes.” Información adicional: The full text of the article “Particulate matter and emergency visits for asthma: a time-series study of their association in the presence and absence of wildfire smoke in Reno, Nevada, 2013–2018” (Partículas en el aire y visitas de emergencia por asma: un estudio de series temporales de su asociación en presencia y ausencia de humo de incendios forestales en Reno, Nevada, entre y ) está disponible en Environmental Health: https://ehjournal.biomedcentral.com/articles/10.1186/s12940-020-00646-2 Para obtener más información sobre el Renown Institute for Health Innovation, visite: https://www.dri.edu/renown-ihi/ Renown Urgent Care brinda tratamiento para una amplia gama de lesiones leves, enfermedades e inquietudes médicas que son urgentes, pero no suponen un riesgo para la vida y que requieren atención médica en el mismo día. También le evita los tiempos de espera prolongados y los altos precios de la sala de emergencias en los 13 centros convenientes, incluidas Reno, Sparks, Carson City, USA Parkway, Fallon y Fernley. You can walk-in or book ahead online. The Washoe County Health District offers online health information on its Be Smoke Smart website, including fire information, daily air quality information, fire and smoke maps and how to protect yourself. About the Desert Research Institute The Desert Research Institute (DRI) is a recognized world leader in basic and applied interdisciplinary research. Committed to scientific excellence and integrity, DRI faculty, students, and staff have developed scientific knowledge and innovative technologies in research projects around the globe. Desde 1959, la investigación del DRI ha profundizado el conocimiento científico, ha apoyado la diversificación de la economía de Nevada, ha proporcionado oportunidades educativas científicas y ha informado a legisladores, líderes empresariales y miembros de la comunidad. With campuses in Reno and Las Vegas, DRI serves as the non-profit research arm of the Nevada System of Higher Education. Para obtener más información, visite www.dri.edu. Acerca de Renown Health Renown Health es una red de atención médica integrada de administración local y sin fines de lucro que brinda servicios al norte de Nevada, Lake Tahoe y el noreste de California. Renown es uno de los mayores empleadores privados de la región y cuenta con una fuerza laboral de más de 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown tiene una larga trayectoria y un compromiso de larga data con la mejora de la atención y la salud de nuestra comunidad. Visite renown.org para obtener más información.