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6 Healthcare Action Items for the LGBTQIA+ Community
Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs. Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health. PrEP and PEP Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months. Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days. PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location. HPV Immunization All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime. The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never! STI Testing Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year. Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you. Prostate Exams Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old. These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened. Pap Tests and Pelvic Exams Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer. Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings. Mammograms and Breast Exams People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual. The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project. Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.
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Presentación de Dana, el nuevo quiosco holográfico tamaño real del Renown Institute for Health Innovations
Presented by the Desert Research Institute and Renown Health, DANA will help people learn more about the Healthy Nevada Project® and their own unique, genetic health traits What is the Healthy Nevada Project®? What are the benefits of joining this research study? How can I find out if I carry genes for health risks like heart disease, hereditary breast and ovarian cancer syndrome and Lynch syndrome? What if a holographic avatar, powered by artificial intelligence (AI), could answer all these questions and more? DANA has all the answers, she is a virtual assistant with “DNA” in her name, presented by the Renown Institute for Health Innovation (Renown IHI), a collaboration between Renown Health and the Desert Research Institute (DRI). This life-sized, holographic avatar will greet individuals outside Renown Regional Medical Center’s Sierra Café, and talk to them about the Healthy Nevada Project, the world’s largest community-based genetic population health study. Los representantes de medios de comunicación están invitados a reunirse con DANA esta mañana, desde las 10 a.m. hasta el mediodía. Responda a este correo electrónico o llame al (775) 691-7308 para coordinar una reunión. “Unfortunately, Nevada ranks among the lowest in the nation for health outcomes—and we are working to change that,” said Anthony Slonim, M.D., D.Ph., president and CEO of Renown Health and president of Renown Institute for Health Innovation. “Through the Healthy Nevada Project® , our goal is to offer genetic testing to every Nevadan interested in learning more about their health and genetic profile. Thanks to this advanced technology, DANA will offer people a personalized explanation of the Project, and help them take the next step to better understand their health, and their health risks, so they can modify their behavior and ultimately, live a healthier, happier life.” Con más de 51,000 participantes del estudio inscritos hasta la fecha, el Healthy Nevada Project® se considera el estudio genético de más rápida inscripción del país. The Project is also the first of its kind to return clinical results to study volunteers, which means participants can learn their genetic risks tied to heart disease and certain cancers, as well as lifestyle changes that could potentially help reduce their risk and prevent disease. Furthermore, participants can choose to share their information with their medical provider to improve and enhance their medical care. “We are always happy to engage with our study participants and look forward to having them meet and engage with DANA,” said Joseph Grzymski, Ph.D., research professor at DRI, principal investigator of the Healthy Nevada Project® and chief scientific officer for Renown Health. “At a time of physical distancing and limiting human contact where possible, using tools like an avatar and AI are important for communicating, whether it be for genetics, vaccinations or other important health information.” Visitors can interact with DANA through a touch screen (cleaned and sanitized after every encounter) to learn more about the study, enter their contact information and schedule an appointment to join the free genetics study or receive more information about their test results. Kiosk visitors are asked to maintain physical distance guidelines and use the hand sanitizer and Sani Wipes available next to the kiosk. Renown Institute for Health Innovation is a collaboration between Renown Health - a locally governed and locally owned, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California; and the Desert Research Institute - a recognized world leader in investigating the effects of natural and human-induced environmental change and advancing technologies aimed at assessing a changing planet. Renown IHI research teams are focused on integrating personal healthcare and environmental data with socioeconomic determinants to help Nevada address some of its most complex environmental health problems; while simultaneously expanding the state’s access to leading-edge clinical trials and fostering new connections with biotechnology and pharmaceutical companies. Learn more at healthynv.org.
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Let Those Ears Breathe! Increased Headphone and Ear Bud Use Leads to Ear Wax Build Up; Renown Urgent Cares Offer Relief
Wearing headphones or earbuds is a daily activity for many of us. Listening to music, podcasts, meetings, phone calls; there are endless reasons to stick them in or on your ears. However, if your ears start to feel plugged, full; or you feel dizzy, lightheaded or hear ringing in your ears; you may be experiencing ear wax build up where your ear canals become blocked and affect your hearing. If you’ve tried to clean your ears (please don’t use Q-Tips®), but still have symptoms, pain, or hearing loss, it’s time to see your physician, nurse practitioner, physician assistant or visit Renown Urgent Care. “Ear wax isn’t dirty. It’s normal,” says Ryan Bristol, APRN, Advanced Practitioner of Nursing at Renown Urgent Care. “Ears are self-cleaning miracles, and naturally clean themselves with the help of jaw movement and skin migration. However, wearing headphones or earbuds for hours blocks earwax from naturally draining from the ear. Additionally, the dirt and bacteria that these headphones often carry can cause an infection on their own, and earwax buildup can trap dirt in the ear and block the canal completely. The snug fit of headphones can create a conducive environment for the accumulation of ear wax. It's crucial for individuals to be mindful of this and take necessary precautions to prevent complications." “Individuals experiencing symptoms such as ear pain, decreased hearing, or a sensation of fullness in the ears are encouraged to seek evaluation and treatment at their nearest urgent care facility,” says Rahul Mediwala, MD, CEO of Renown Medical Group. “By addressing ear wax build-up promptly, individuals can mitigate the risk of complications and maintain optimal ear health. Fortunately, prompt, pain-free and effective treatment is available at Renown Urgent Care. We offer professional ear wax removal procedures performed by trained staff, providing relief to those experiencing discomfort or hearing impairment due to excessive ear wax build-up.” The experts at Renown Health gave us some background. What is ear wax and why is it healthy? Ear wax is a protective substance called sebum made of fat, skin cells and sweat. Ear wax is produced by glands in the ear canal. It helps protect the ear from germs and dirt and prevents the sensitive skin of the ear canal from becoming irritated. It is normal and healthy to have a thin lining of ear wax on the canal. Ear wax will sometimes accumulate and move to the outer ear canal, where it would typically fall out or be wiped away. This is also normal. When should I seek care? An ear canal has too much wax if the ear feels plugged or hearing is affected. The accumulation of wax happens very gradually, so ears do not necessarily feel waxy. The problem is usually noticed because of changes in hearing. Over the counter remedies may offer relief. However, in some cases, the earwax has built up or become impacted, and ears need to be treated. What is the treatment? At Renown Urgent Care, we offer professional ear wax removal procedures performed by trained staff, providing relief to those experiencing discomfort or hearing impairment due to excessive ear wax build-up. Wax is flushed from the ear canal using a syringe filled with warm water and saline or diluted hydrogen peroxide. Most patients find the procedure is fast, pain free and effective. How can I prevent earwax buildup from headphones and ear buds? Most people who wear headphones or use earbuds occasionally or intermittently don’t have difficulties with excessive ear wax. Wax accumulation also depends on the size of the ear canals and the productivity of the oil glands in the ear canal. You can choose to use over the ear headphones. If you prefer to use in-ear headphones, the best modes of excess ear wax prevention are to: Clean headphones and earbuds regularly with a cloth or disinfectant wipes; Avoid sharing headphones or earbuds with other people; Take breaks from headphones and earbuds so ears can breathe and get back to normal; Pay attention to your ear health. Should we talk about Q-tips? Yes! Q-tips (and similar products) are rarely helpful for managing ear wax. The cotton on the end of the Q-tip is usually unable to pull the wax out of the canal. Worse, they can push the wax deep inside the ear canal, and it can end up impacted. Where should I seek care? Individuals experiencing symptoms such as ear pain, decreased hearing, or a sensation of fullness in the ears are encouraged to seek evaluation and treatment at a medical facility. By addressing ear wax build-up promptly, individuals can mitigate the risk of complications and maintain optimal ear health. Renown Urgent Care sees patients 365 days a year for medical concerns that are urgent but not life-threatening at many locations across northern Nevada. Reserve con antelación un lugar en una de nuestras diez ubicaciones de Urgent Care. If you do not see time slots that work for you, you can still go to any location that has "walk-ins available" listed. For more information, or to book an appointment, go to renown.org/Health-Services/Urgent-Care. Renown Health is the region’s locally governed, not-for-profit integrated health care network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,200 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health.
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Renown Institute Expands Partnership to Offer ELF Testing
Juntos, realizarán pruebas a más de 30,000 participantes del estudio elegibles antes de 2023 para determinar el riesgo de cirrosis y enfermedades relacionadas con el hígado. Renown Institute for Health Innovation (IHI) announced today that the organization and Gilead Sciences, Inc. will be joining forces with Siemens Healthineers to offer the Enhanced Liver Fibrosis (ELF™) Test to people with risks for nonalcoholic steatohepatitis (NASH) enrolled in the Healthy Nevada Project (HNP). The ELF Test will help identify people most at risk for progressing to cirrhosis and liver-related outcomes and allow healthcare providers to intervene before irreparable damage occurs. This noninvasive blood test uses three serum biomarkers to create an ELF score from a predefined algorithm, which can be used by doctors to help evaluate if a patient requires increased medical care and monitoring for their condition. La enfermedad de hígado graso no alcohólico (EHGNA), que incluye la EHNA, es frecuente en Nevada y está subdiagnosticada, y probablemente afecte a más de 500,000 adultos en nuestro estado. If undetected and untreated, NASH can result in liver cirrhosis and may require liver transplantation or lead to death. Hay más de 12,000 personas en la lista de espera para trasplante de hígado en los EE. UU. y esta cifra continúa aumentando debido al incremento en la prevalencia de la EHGNA. “Thanks to important data collected through our Nonalcoholic Steatohepatitis Liver Disease Genome Atlas study, we now know that NASH is prevalent in the state of Nevada,” said Tony Slonim, M.D., DrPH, FACHE, president and CEO of Renown Health. “We are proud to expand our partnership with Gilead and begin working with Siemens Healthineers to improve health of those with liver disease and to take early detection one step further by offering Enhanced Liver Fibrosis, ELF testing for patients of Renown Health. This test provides our team of highly-skilled physicians an advanced, noninvasive method to actively assess dynamic liver fibrosis in study participants and intervene whenever necessary, contributing to a healthier Nevada.” “Gilead believes that noninvasive tests, including the ELF Test, will help improve the experience of people living with NASH. These tests may help to diagnose liver disease, monitor disease progression and evaluate responses to treatment without the requirement for liver biopsy,” said Rob Myers, MD, Vice President, Liver Fibrosis Clinical Research at Gilead Sciences. “The ELF Test has proven itself to be a valuable tool in NASH management and we hope this partnership will further support its use in routine care.” “We are very pleased that NASH patients in the Healthy Nevada Project now have access to the ELF Test which offers clinically useful prognostic information for their condition with the convenience of a simple blood test. Using our advanced laboratory expertise together with Renown IHI and Gilead, we can work towards better understanding of NASH and liver disease in a representative patient population,” said Sebastian Kronmueller, Head of Molecular Diagnostics at Siemens Healthineers. “We launched the Healthy Nevada Project to help people understand more about their health, to identify serious health risks, and to give people access to innovations like the ELF Test, so they can live their best lives,” said Renown’s chief scientific officer, Dr. Joseph Grzymski, who is also a research professor at the Desert Research Institute and principal investigator of the Healthy Nevada Project. Es increíblemente gratificante poder informar hallazgos clínicos para ayudar a nuestros 50,000 participantes voluntarios del estudio y asistir a los proveedores de atención médica a ayudar a sus pacientes”. La provisión de la prueba de ELF se basa en una colaboración estratégica anunciada previamente entre el Renown IHI y Gilead en julio de 2019. Esta sociedad en curso tiene como objetivo recopilar y analizar datos de salud genéticos y electrónicos anónimos de 60,000 participantes del estudio elegibles con el fin de mejorar la comprensión de la EHGNA y la EHNA y para potencialmente orientar el desarrollo de opciones de tratamiento para estas enfermedades. Acerca de la EHGNA y la EHNA La EHGNA es una acumulación de grasa en el hígado en personas que no tienen antecedentes de abuso de alcohol. Es normal que el hígado contenga algo de grasa, pero si más del 5 por ciento del contenido hepático es grasa, se considera hígado graso (esteatosis). NASH is the most severe form of NAFLD in which a person has liver cell damage and inflammation of the liver. Inflammation and liver cell damage can cause fibrosis, or scarring of the liver, and can cause decreased liver function (1). The symptoms of NASH are often silent or non-specific, making it difficult to diagnose. Aproximadamente, un tercio de las personas con EHNA desarrollan cirrosis o daño hepático irreversible (2). About the ELF™ Test The ELF Test is a noninvasive blood test that can quickly identify which patients are at an elevated risk for developing cirrhosis and other liver-related clinical events (LREs). In contrast to standard liver enzyme tests that reflect liver damage that has already occurred, the ELF Test combines three serum direct biomarkers of active fibrosis. The ELF Test algorithm measures each of these biomarkers to create an ELF score, which can be used as an aid to assess the risk for future disease progression. Doctors may use this ELF score to help evaluate if a patient requires increased medical care and monitoring for their condition. Individuals interested in determining their risk for NASH and its progression are encouraged to enroll in the Nonalcoholic Steatohepatitis Liver Disease Genome Atlas study. Those who have already consented and participated in the study will be contacted with more information on how to receive an ELF blood test. Para obtener más información o para inscribirse, comuníquese a la casilla de correo RenownIHI@renown.org o al teléfono (775) 982-6914. The Enhanced Liver Fibrosis (ELF™) Test kit is not available for sale in the U.S. Product availability may vary from country to country and is subject to varying regulatory requirements. In the U.S., the ELF Testing Service is available from Siemens Healthcare Laboratory, LLC (SHL), a CLIA-certified laboratory located in Berkeley, Calif. The ELF Testing Service, including the establishment of performance characteristics, was developed by SHL. The ELF Test has not been cleared or approved by the U.S. Food and Drug Administration. SHL is regulated under CLIA as qualified to perform high complexity testing. The ELF Test is used for clinical purposes and should not be regarded as investigational use only or research use only. About Renown Health Renown Health is the region’s largest, locally owned and governed, 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’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Health, Neurosciences and Robotic Surgery. Actualmente, Renown está inscribiendo participantes en el estudio genético de salud poblacional basado en la comunidad más grande del mundo, el Healthy Nevada Project®. For more information visit, renown.org. About the Renown Institute for Health Innovation Renown Institute for Health Innovation is a collaboration between Renown Health - a locally governed and locally owned, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California; and the Desert Research Institute - a recognized world leader in investigating the effects of natural and human-induced environmental change and advancing technologies aimed at assessing a changing planet. Renown IHI research teams are focused on integrating personal healthcare and environmental data with socioeconomic determinants to help Nevada address some of its most complex environmental health problems; while simultaneously expanding the state’s access to leading-edge clinical trials and fostering new connections with biotechnology and pharmaceutical companies. Learn more at healthynv.org. 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 más de 60,000 participantes. For more information, visit healthynv.org. About Siemens Healthineers Siemens Healthineers AG (listed in Frankfurt, Germany: SHL) is shaping the future of Healthcare. As a leading medical technology company headquartered in Erlangen, Germany, Siemens Healthineers enables healthcare providers worldwide through its regional companies to increase value by empowering them on their journey towards expanding precision medicine, transforming care delivery, improving the patient experience, and digitalizing healthcare. Siemens Healthineers is continuously developing its product and service portfolio, with AI-supported applications and digital offerings that play an increasingly important role in the next generation of medical technology. These new applications will enhance the company’s foundation in in-vitro diagnostic, image-guided therapy, and in-vivo diagnostics. Siemens Healthineers also provides a range of services and solutions to enhance healthcare providers ability to provide high-quality, efficient care to patients. En el año fiscal 2020, que finalizó el 30 de septiembre de 2020, Siemens Healthineers, que tiene aproximadamente 54,000 empleados en todo el mundo, generó ingresos por €14.5 mil millones y un EBIT ajustado de €2.2 mil millones. Encontrará más información disponible en www.siemens-healthineers.com.Media Contacto de Siemens Healthineers: Lance LongwellM: 610-448-6341E: lance.longwell@siemens-healthineers.com
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Elevated Levels of Arsenic and Other Metals Found In Nevada Private Wells
Study shows that many household wells need better drinking water treatment and monitoring Outside of Nevada’s bustling cities, private wells are the primary source of drinking water, serving 182,000 people. Yet some of the tested private wells in Nevada are contaminated with levels of heavy metals that exceed federal, state or health-based guidelines, a new study published in Science of The Total Environment shows. Consuming water contaminated by metals such as arsenic can cause adverse health effects. Scientists from DRI and the University of Hawaii Cancer Center recruited households with private wells through the Healthy Nevada Project. Households were sent free water testing kits, and participants were notified of their water quality results and recommended actions they could take. More than 170 households participated in the research, with the majority from Northern Nevada around Reno, Carson City and Fallon. “The goals of the Healthy Nevada project are to understand how genetics, environment, social factors, and healthcare interact. We directly engaged our participants to better understand environmental contaminants that may cause adverse health outcomes,” said co-author Joseph Grzymski, PhD, research professor at DRI, principal investigator of the Healthy Nevada Project®, and chief scientific officer for Renown Health. Nearly one-quarter (22%) of the private wells sampled had arsenic that exceeded safe levels determined by the Environmental Protection Agency (EPA) — with levels 80 times higher than the limit in some cases. Elevated levels of uranium, lead, cadmium, and iron were also found. “We know from previous research that Nevada’s arid climate and geologic landscape produce these heavy metals in our groundwater,” says Monica Arienzo, PhD, an associate research professor at DRI who led the study. “It was important for us to reach out to community members with private wells to see how this is impacting the safety of their drinking water.” Fewer than half (41%) of the wells sampled used water treatment systems, and some treated water samples still contained arsenic levels over EPA guidelines. Although average levels of heavy metal contaminants were lower in treated water, many homes were unable to reduce contaminants to levels considered safe. The state leaves private well owners responsible for monitoring their own water quality, and well water testing helps ensure water is safe to drink. This study shows that more frequent testing is needed to ensure Nevada’s rural communities have safe drinking water. This is particularly important as the effects of climate change and population growth alter the chemistry of groundwater, potentially increasing metal concentrations. “The results emphasize the importance of regular water quality monitoring and treatment systems,” said co-author Daniel Saftner, MS, assistant research scientist at DRI. Although the research focused on wells in Nevada, other arid communities in Western states are facing similar risks of water contamination. More information: The full study, Naturally Occurring Metals in Unregulated Domestic Wells in Nevada, USA, is available from Science of The Total Environment: doi.org/10.1016/j.scitotenv.2022.158277. This project was funded by an NIH award (#1R01ES030948-01). The Healthy Nevada Project was funded by grants from Renown Health and the Renown Health Foundation. Study authors included Monica M. Arienzo (DRI), Daniel Saftner (DRI), Steven N. Bacon (DRI), Erika Robtoy (DRI), Iva Neveux (DRI), Karen Schlauch (DRI), Michele Carbone (University of Hawaii Cancer Center) and Joseph Grzymski (DRI/Renown Health). About DRI The Desert Research Institute (DRI) is a recognized world leader in basic and applied environmental research. Comprometidos con la excelencia e integridad científicas, el cuerpo docente del DRI, los estudiantes que trabajan juntos y el personal han desarrollado conocimientos científicos y tecnologías innovadoras en proyectos de investigación en todo el mundo. Desde 1959, la investigación de DRI ha profundizado el conocimiento científico sobre temas que van desde el impacto de los seres humanos en el medioambiente hasta el impacto del medioambiente en los seres humanos. Los hallazgos científicos impactantes y las soluciones inspiradoras del DRI apoyan la economía diversa de Nevada, proporcionan oportunidades educativas basadas en la ciencia e informan a legisladores, líderes empresariales y miembros de la comunidad. El DRI tiene campus en Las Vegas y Reno y funciona como el grupo de investigación sin fines de lucro del Sistema de Educación Superior de Nevada. For more information, please visit dri.edu. About Renown Health Renown Health is Nevada’s largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 6,500 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in a community-based genetic population health study, the Healthy Nevada Project®. About the University of Hawaiʻi Cancer Center The University of Hawaiʻi Cancer Center through its various activities, including scientific research and clinical trials, adds more than $57 million to the Oʻahu economy. It is one of only 71 research institutions designated by the National Cancer Institute. An organized research unit within the University of Hawaiʻi at Mānoa, the UH Cancer Center is dedicated to eliminating cancer through research, education, patient care and community outreach with an emphasis on the unique ethnic, cultural, and environmental characteristics of Hawaiʻi and the Pacific. Obtenga más información en https://www.uhcancercenter.org. Like us on Facebook at facebook.com/UHCancerCenter. Follow us on Twitter @UHCancerCenter.
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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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Un estudio demuestra la importancia de garantizar el seguimiento del participante y del proveedor después de obtener el resultado de un examen de detección genético
Lanzada en asociación con el Desert Research Institute, una nueva investigación del proyecto Healthy Nevada Project® determina que un diagnóstico confirmado no siempre produce cambios en el cuidado del paciente. El hecho de entregar a las personas información de salud que pueda cambiar sus vidas no garantiza que las personas, o sus proveedores de atención médica, actuarán en consecuencia. La educación de seguimiento y las conversaciones sobre los planes de cuidado ejecutables con los pacientes y sus médicos son los próximos pasos clave, de acuerdo con la nueva investigación del Healthy Nevada Project. El Healthy Nevada Project es un proyecto de investigación y detección genética que se lanzó en 2016 como una asociación entre DRI y Renown Health. El proyecto ahora tiene más de 50,000 participantes y cuenta con secuenciación genética proporcionada por Helix. Entre septiembre de 2018 y septiembre de 2020, el Healthy Nevada Project notificó exitosamente a 293 participantes que estaban genéticamente en riesgo de desarrollar cáncer de pecho y ovario, síndrome de Lynch o hipercolesterolemia familiar hereditarios, tres afecciones genéticas comunes conocidas colectivamente como afecciones de Nivel 1 de los Centros para el Control y la Prevención de Enfermedades (Centers for Disease Control and Prevention, CDC). En un estudio publicado hoy en Frontiers in Genetics, los científicos del Healthy Nevada Project analizaron qué impacto tuvo el hecho de notificar a un paciente sobre un resultado positivo para una condición de Nivel 1 de los CDC en el cuidado que recibió el paciente en los meses y años posteriores. Según sus resultados, entre los 293 participantes del Healthy Nevada Project que fueron notificados del riesgo genético de desarrollar una afección del Nivel 1 de los CDC, el 71 % de participantes con registros médicos electrónicos compartieron sus hallazgos con los proveedores de atención médica. Sin embargo, solo el 30 % de los registros médicos electrónicos de estos pacientes contenía documentación del diagnóstico genético, y solo el 10 % de los pacientes examinados experimentó un posible cambio en el cuidado después de recibir los resultados de su examen de detección genético. “El Healthy Nevada Project se implementó con un enfoque ‘sin intervención’ en el que los participantes reciben sus hallazgos y deciden con quiénes y cuándo desean compartirlos. Los hallazgos no se agregaron automáticamente a sus registros médicos electrónicos”, explicó el Dr. Gai Elhanan, científico de datos médicos en DRI y coautor del estudio. “Lo que estamos aprendiendo ahora es que para garantizar que los hallazgos genéticos importantes se integren en el régimen de cuidado, es importante que su incorporación en los registros médicos electrónicos forme parte del estudio”. Este estudio se basa en investigaciones anteriores del Healthy Nevada Project publicadas en Nature Medicine. En ellas se demuestra la importancia de realizar exámenes de detección para las afecciones del Nivel 1 de los CDC, las cuales afectan a aproximadamente a 1 de cada 75 personas y se pueden mitigar e incluso se puede evitar que se conviertan en enfermedades cuando se detectan en forma temprana. Este estudio determinó que hasta el 90 % de los casos con afecciones del Nivel 1 de los CDC no son detectados por los proveedores clínicos en las evaluaciones y los exámenes de detección que se realizan durante las visitas de cuidado clínico habitual. Durante el estudio actual, los científicos del Healthy Nevada Project descubrieron que el 19 % de participantes estudiados ya había desarrollado una de las afecciones del Nivel 1 de los CDC y, por lo tanto, podrían haberse beneficiado de una notificación más temprana sobre su afección. El equipo del estudio espera que sus hallazgos estimulen a los residentes de Nevada a obtener pruebas genéticas para estas afecciones relativamente comunes. Incluso si las personas son mayores o ya han sufrido enfermedades relacionadas con estas afecciones, las pruebas también podrían ser beneficiosas para los hermanos, los niños y los nietos que también pueden estar en riesgo y que posteriormente podrían someterse a exámenes de detección en caso de un hallazgo positivo. El equipo del estudio también incita a informar a los proveedores de atención médica sobre la importancia de incorporar diagnósticos genéticos en las recomendaciones farmacéuticas (por ejemplo, para la hipercolesterolemia familiar) y de tratamiento a los pacientes. “Como resultado de este análisis, los médicos de Renown Health y los investigadores del Healthy Nevada Project han logrado cambios significativos, lo que incluye la obtención del consentimiento informado de los participantes para incorporar hallazgos positivos de sus informes genéticos directamente en su registro médico electrónico”, explicó Daniel Kiser, M.S., científico auxiliar de investigación de ciencia de datos en DRI y coautor del estudio. “Esto ayudará tanto a los participantes como a sus proveedores de cuidado clínico, y a todo el estado a maximizar los beneficios a largo plazo de los exámenes de detección genéticos voluntarios basados en la población del Healthy Nevada Project”. Información adicional: El texto completo del estudio, Incomplete Penetrance of Population-Based Genetic Screening Results in Electronic Health Record, está disponible en Frontiers in Genetics: https://www.frontiersin.org/articles/10.3389/fgene.2022.866169/full?&utm_source=Email_to_authors_&utm_medium=Email&utm_content=T1_11.5e1_author&utm_campaign=Email_publication&field=&journalName=Frontiers_in_Genetics&id=866169. Este proyecto fue financiado por Renown Health, fundación de Renown Health y la Oficina de Desarrollo Económico del Gobernador de Nevada. Entre los autores del estudio se incluyen Gai Elhanan (DRI), Daniel Kiser (DRI), Iva Neveux (DRI), Shaun Dabe (Renown Health), Alexander Bolze (Helix), William Metcalf (DRI), James Lu (Helix) y Joseph Grzymski (DRI/Renown Health). Para obtener más información sobre el Healthy Nevada Project® o para solicitar un examen de detección genético, visite: https://healthynv.org/ Acerca del DRI El Desert Research Institute (DRI) es un reconocido líder mundial en investigación ambiental básica y aplicada. Comprometidos con la excelencia e integridad científicas, el cuerpo docente del DRI, los estudiantes que trabajan juntos y el personal han desarrollado conocimientos científicos y tecnologías innovadoras en proyectos de investigación en todo el mundo. Desde 1959, la investigación de DRI ha profundizado el conocimiento científico sobre temas que van desde el impacto de los seres humanos en el medioambiente hasta el impacto del medioambiente en los seres humanos. Los hallazgos científicos impactantes y las soluciones inspiradoras del DRI apoyan la economía diversa de Nevada, proporcionan oportunidades educativas basadas en la ciencia e informan a legisladores, líderes empresariales y miembros de la comunidad. El DRI tiene campus en Las Vegas y Reno y funciona como el grupo de investigación sin fines de lucro del Sistema de Educación Superior de Nevada. Para obtener más información, visite www.dri.edu. Acerca de Renown Health Renown Health es la red de atención médica integrada de administración local y sin fines de lucro más grande de la región, que presta servicios a Nevada, Lake Tahoe y el noreste de 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. Actualmente, Renown está inscribiendo participantes en el estudio genético de salud poblacional basado en la comunidad más grande del mundo, el Healthy Nevada Project®. Visite renown.org para obtener más información. 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 permite que los sistemas de salud, las empresas de ciencias biológicas, los pagadores y los socios gubernamentales aceleren la integración de los datos genómicos en el cuidado médico del paciente y en la toma de decisiones de salud pública. Obtenga más información en www.helix.com.