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The Risks of Vaping and E cigarettes
In this article reprinted with permission from the Galena Times, Dr. Max J Coppes, Physician-in-Chief, Renown Children’s Hospital, and Nell J. Redfield, Chair of Pediatrics, UNR Med, talk about adolescents vaping, and how an estimated additional 10 million teens are at risk to start using e-cigarettes. What are E-cigarettes? E-cigarettes are battery-operated devices heating a liquid (e-juice) into an aerosol to be inhaled. Breathing in this flavor vapor, which usually contains nicotine, anti-freeze or other cancer-causing chemicals is called ‘vaping.’ There are many forms of these electronic nicotine delivery devices - and they're not always obvious. They not only appear to be cigarettes, cigars, or pipes, but also pass for everyday items, such as flashlights, flash drives or pens. The Effects of Vaping and E-cigarettes Regardless of the nicotine delivery, vaping is addictive and is quickly becoming a public health concern. Nicotine levels in e-cigarettes vary greatly, and they may also contain toxic chemicals. Currently there is a wide range of variability among vaping products. In other words - they deliver different ingredients, hardware, levels of nicotine, and possible toxic chemicals to the user. This makes it challenging to create an overall public health recommendation on their use. Nevertheless, there is no confusion about the harmful effects of the chemicals used in e-cigarettes to the young brain, which develops until age 25. Studies show e-cigarette use serves as an introductory product for teens to go on using ‘regular’ tobacco products. The American Academy of Pediatrics has several recommendations on their use. Such as increasing the minimum age to buy tobacco products, including e-cigarettes, to age 21 nationwide. (Update: nationwide the age as of January 2, 2020 is now 21.) A common misunderstanding with teenagers is the belief e-cigarettes are less harmful than other tobacco products. Moreover, there is a wide range of flavor choices, from mint, mango, crème brûlée to cucumber to attract users. As of September 6, 2019, The Centers for Disease Control and Prevention is reporting over 450 possible cases of lung illness associated with the use of e-cigarette products in 33 states. What Should Parents Know about Vaping? Parents and teachers should know JUUL is a very popular e-cigarette among teenagers, capturing about 68% of the market. JUUL is sleek, small, hides easily, and resembles a flash drive. Surprisingly it charges in an USB port, and can also instantly be mistaken for a real flash drive. One JUUL cartridge contains twice the nicotine found in other e-cigarette cartridges. This roughly equals the amount of nicotine in an entire pack of cigarettes. To repeat, the use of JUUL in young people continues to grow, and this is why parents and teachers need to be aware. Be alert, teach, communicate, and talk to your child about the serious risks of smoking in all forms, whether at home or parties. Tell them how difficult it is to quit and why they should not start. Loving your children is caring; caring for their current and future health and well-being.
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Department Spotlight: Infection Prevention
Hygiene in healthcare is an essential backbone to providing the safest, most optimal care to every patient. From everyday handwashing techniques and getting all necessary vaccinations to surveilling our health system before the onset of outbreaks, at Renown Health, creating and maintaining a low-infection environment is a group effort. From ensuring fundamental infection prevention practices are carried out to identifying process improvement opportunities, Renown’s Infection Prevention (IP) department is here to help care teams be successful in their role. This effort is led by members who are devoted in sharing evidence-based best practices to our patients, employees, healthcare organization partners and community. Making “Zero” A Reality Reducing healthcare-associated infections is possible when core infection prevention practices are incorporated into the daily care of our patients. These team members are dedicated to Renown’s commitment to creating a culture of Excellence, caring for our healthcare environment, and our care teams. “Often times, when asked what we do in our work it can be a challenge to answer because unpredictability is built into almost every day; and in that, we as a team must divide and conquer,” said Susanne James, Manager of Infection Prevention. Every day, each team member is assigned a day to perform required surveillance activities. Whether they are reviewing patients’ infections and isolation and evaluating lab orders for possible infectious processes or reporting communicable diseases to the local health authorities and the CDC, every Infection Preventionist participates in improvement projects and address issues as they arise. The Infection Prevention team plans, organizes, manages and evaluates the Infection Prevention Program and ensures IP policies reflect current best practice. They work closely with all departments at Renown in order to achieve high levels of standards that are implemented to reduce transmission of infection. “As a team, we perform ‘Infection Prevention Environment of Care Rounding’ on all units and departments to ensure our environment complies with regulatory requirements,” said Erika Clark, Operations Analyst at Renown Health. "We work together with Facilities and Site Practice Leaders to ensure a safe environment.” The pandemic challenged all Renown teams to find creative solutions for issues no one ever imagined. Our Infection Prevention department worked tirelessly alongside Renown's Hospital Incident Command Structure (HICS) and care teams in creating several lines of defense against COVID-19, including: Launching Renown's Alternate Care Site to meet the need for critical patients. Bringing on the new lab tests and specimen collection criteria. Managing demand for personal protective equipment (PPE). Bringing vaccines to staff and then to the community. Managing ill employees and our visitors. Keeping all locations informed on pandemic status and changes (which were occurring at breakneck speed). These initiatives enabled Renown's care teams to focus on providing the safest care possible to patients saving countless lives. This solidified the fact that together, the team can accomplish anything. “Infection Prevention is proud to be a valued and respected member of the care team,” said Susanne James. “We appreciate being a trusted resource and take this responsibility seriously as this enables us to provide staff the best possible tools to be successful.” Fight the Good Fight Against the Spread of Disease Educating patients and providers plays a huge part on the Infection Prevention stage. This team provides educational materials on a range of topics, some of the most important are, proper hand hygiene and the use of PPE. All these materials can be found throughout our health system and serve as an important reminder – infection prevention starts with all of us. “We partner with every aspect of the health system – environmental services, nutrition services, lab services, facilities, pharmacy, physical therapy and occupational therapy, respiratory care, patient access, security, nurses, providers and quality...just to name a few!” said Susanne James. Our Infection Prevention team also partners with Washoe County Health District and other public health agencies to report – and in turn, stop the spread of – diseases and exposures. These close partnerships poise our team to do what we do best: Fight the Good Fight. “I greatly appreciate everyone in the IP department for sharing their expertise as I learned a new position,” said Erika Clark. “I love working with my team and how closely we work with other departments to ensure excellence in all we do.” Our health system is ever-changing. But according to the experts in our Infection Prevention department, the three main ways to prevent illness and disease that remain the same time and time again are to: Clean your hands. Hand hygiene is the most effective way of preventing the spread of infections. The CDC recommends washing your hands with warm soap and water for 15-20 seconds or using an alcohol-based hand sanitizer. Clean your hands often and assist our patients to do the same. Learn expert hand-washing advice here. Get vaccinated. Immunizations are one of the top methods you can embrace the fight against preventable diseases, such as COVID-19, flu, measles, tetanus and more. Discover how you can get vaccinated with Renown. Keep germs from spreading. Practice good hygiene by covering your cough or sneeze or wearing a mask and sanitizing frequently touched spaces. Stay home if you feel ill to prevent the spread of illness and infection. Be sure to bring up any illness concerns with your primary care provider. “Every aspect of our health system has an infection prevention component, and we work daily to ensure our staff, patients and visitors are providing and receiving care free from potential harm or infections,” said Susanne James. “We are often the first call staff make when they have questions, concerns or just need someone to help improve process or outcomes.” Reveling with Renown Proudly defining themselves as a “small but mighty” team, the six-person Infection Prevention department moves mountains to ensure the safety of anyone who walks through Renown’s doors. The tight-knit nature of this team can be felt from miles away, and to them, being “small but mighty” is not a hindrance, as they have the support of the IP Champions and the entire health system. “I originally came to Renown in 2018 as a nurse traveler, the facility and people I worked with immediately made an impact on me,” said Brian Stroud, Infection Preventionist at Renown Health. “My wife and I chose Renown and Reno due to the positive impact the people had on us. Everyone is welcoming, helpful and caring. Now, I am a full-time employee, and the team has made my transition into infection prevention trouble-free." Renown’s mission of providing a genuine difference for the health and wellbeing of the community is heightened and echoed by the Infection Prevention team. “I chose Renown because of the reputation Renown has earned in the community because of the excellent care and level of services provided,” said Shannon Oriola, Infection Preventionist at Renown Health. “I absolutely love this team and my Renown family!” “What brought me to Renown was the opportunity to acquire diverse skills which then motivated me to pursue my master’s degree,” added Paul DeLeon, Infection Preventionist at Renown Health. “What keeps me here is the people – Renown attracts hard working, ethical and caring people.” "My wife and I loved coming out to the Nevada mountains on vacations," added Russ Laarman, Infection Preventionist at Renown Health. "After being in Michigan for 47 years, we took the plunge and made NV our home. The experience has been great! I work with a great team that is very knowledgeable and works hard to ensure positive outcomes for our patients and colleagues at Renown.” Their pride shines through with their own individual accolades, both inside and outside of work. This past year: Shannon Oriola received a scholarship from the Association for Professionals in Infection Control and Epidemiology (APIC) for “improving outcomes through knowledge and practice,” which provided her with a $1,000 scholarship to attend the annual APIC conference in Indianapolis. Paul DeLeon earned his Certification in Infection Control and Prevention from APIC. Erika Clark completed Renown’s High Potential program, a six-month program that gives employees hands-on learning experience with several competencies, including emotional intelligence, effective communication, building successful relationships and organizational knowledge. Brian Stroud and his wife Charla became official Nevada residents. Russ Laarman scaled Mount Whitney. ...And the list keeps growing! Charged with the goal of keeping disease spread at bay, our Infection Prevention team remains vigilant and dedicated to their mission. Their commitment to Renown and to keeping our health system clean and healthy proves the age-old saying true: not all heroes wear capes. “I’m so very proud of the work Infection Prevention does every day, working with the vast teams throughout the health system to improve lives,” said Susanne James. “We would like to thank all of you for protecting the health and safety of your colleagues, our patients and the community.”
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The Healthy Nevada Project Changed My Life: A Local Mom's Story
Read about Jordan Stiteler, a local mom who says the Healthy Nevada Project provided insights into her family’s genetic makeup — and the likely cause of her dad and great grandfather’s deaths. Now she is changing her life due to her new diagnosis of familial hypercholesterolemia, which will allow her to take steps toward preventing the same fate. Jordan Stiteler’s dad died suddenly of a stroke nearly ten years ago — at only 45 years old. His grandfather died at age 40. Now through the Healthy Nevada Project’s no-cost genetic testing, she is closer to understanding why that may have happened. And she can take proactive steps to prevent the unhealthy symptoms that often lead to a stroke and heart problems. After getting her Geno 2.0 by National Geographic ancestry report, Stiteler got a call from Renown Institute for Heart & Vascular Health Cardiologist and Renown IHI Director of Research, Dr. Christopher Rowan. “They told me that I have FH, which is familial hypercholesterolemia,” she said. “I have genetically very high cholesterol because I have a non-functioning gene that doesn’t get rid of my cholesterol like a normal body would.” Familial Hypercholesterolemia: Simple Life Changes Dr. Rowan told Stiteler it is curable with medication and a change in lifestyle. Stiteler has embraced healthy lifestyle changes by exercising more and eating healthier. “It is so important. Being a mom, I think you have so much more to live for. Having this information has changed my life.” Stiteler feels confident FH affected her Dad. “It is helping my family realize that we need to get tested,” she said. “There were big milestones that my Dad missed. He didn’t get to see either of us get married or have our children. That was huge.” She has become passionate about sharing the need to join the Healthy Nevada Project as her way of helping to prevent other families from possibly going through what she and her family did with the early loss of her Dad. In addition to FH results, the Healthy Nevada Project is returning clinical results on BRCA 1/2 (hereditary breast and ovarian cancer) and Lynch syndrome (colorectal and endometrial cancer) to consenting study participants. To sign up for the Healthy Nevada Project, go to HealthyNV.org. Join the Healthy Nevada Project Recruitment for phase two is still open. In addition to opting in to receive clinical results, participants receive National Geographic’s Geno 2.0 ancestry app at no cost. They also have the chance to pick an additional app for health and wellness after completing a follow-up survey. Learn More or Sign Up
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CEO Blog: Improving Health Through Genetics and Big Data
Renown Health President and CEO Tony Slonim, MD, DrPH, discusses efforts nationwide to develop a more effective and efficient way to deliver care. explains the benefits of Renown Health’s population health study with the Desert Research Institute and 23andMe.
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Staying Heart-Healthy with Genetic Screening
February is American Heart Month. While cardiac care is crucial every time of year – especially as heart disease stays the number one killer in the United States – American Heart Month serves as a great reminder to stay on top of your heart health. We spoke with Malina Ruiz, a cardiology nurse practitioner at Renown Health, on three key ways to embrace heart-healthy living and how genetic screening can help inform you of certain genetic risks that can play a role on the cardiac life stage. 1. Invest in a heart-healthy diet. Eating a diet that is rich in fruits, vegetables, whole grains and healthy fats (including monounsaturated fats such as avocados and polyunsaturated fats such as sunflower oil) is a key defense in protecting your cardiac health, according to Malina. While you are filling your plate with these nutritious foods, remember to keep an eye on your saturated and trans-fat intake, and try limiting foods that are high in those fats. “No matter what age we are, maintaining a heart-healthy diet will always be important,” said Malina. Need help finding cardiac-friendly meals? The National Heart, Lung and Blood Institute makes it easy with heart-healthy recipes and tips from experts. 2. Do an exercise audit. “Keeping an active lifestyle during our younger years is one of the most important factors that affect heart health in future years,” said Malina. Maintaining a regular exercise regimen that allows you to raise your heart rate and break a sweat can help prevent future cardiac events. A good rule of thumb is to aim for 150 minutes a week of moderate-intensity exercise, which averages out to 30 minutes a day on 5 days out of the week. It’s never too late to start a regular exercise routine! Exercise doesn’t have to be something you dread – leverage American Heart Month to find activities that you enjoy. The American Heart Association can help you discover new ways to move your body. At the end of the day, as Malina emphasizes, “any movement is better than nothing!” 3. Don't skip those check-ups. Regular preventative visits with your primary care provider can help you identify possible risk factors for heart conditions before they start actively affecting your life. “Check-ups become even more important as we age, along with being aware of the signs and symptoms of heart disease, heart attack and stroke,” added Malina. There’s no time better than the present – call our expert scheduling team today at 775-982-5000 to request a preventative check-up with your primary care provider.
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How to Talk to Your Children About Vaping
According to the Centers for Disease Control (CDC), e-cigarette use isn’t just up among adults, but it has also tripled in usage for teens. Dr. Jose Cucalon Calderon, a Pediatrics Physician at Renown Health and an Assistant Professor of Pediatrics at the University of Nevada, Reno School of Medicine, provides helpful insight into e-cigarettes and the dangers it poses to kids and teens. What Are E-Cigarettes? E-cigarettes are electronic nicotine delivery devices. e-cigarettes use liquid nicotine as an alternative to traditional smoked cigarettes. e-cigarettes contain nicotine which is an addictive substance with known toxic side effects that, when released in very high doses, that can have health consequences and causes addiction. Nicotine is described as “toxic,” but the most "toxic" part of e-cigarettes' is everything else within the E-juice. Nicotine mainly keeps people coming back for more. According to the CDC, e-cigarettes are also advertised using the same themes and tactics that have been shown to increase youth use of other tobacco products, including cigarettes. In 2021, approximately 76% of students reported exposure to tobacco product marketing through traditional sources, and approximately 74% of students who used social media had seen e-cigarette–related content. What Does This Mean for the Health My Teen? We know that nicotine can affect brain development in kids and teens, so it is important to educate your teen on the risks of exposure. If you have young children in the home, it is important to be vigilant as well. One teaspoonful of liquid nicotine can be fatal for a young child. How Do I Monitor My Teen for E-Cigarette Use? Monitoring your children can be tricky for parents. E-cigarettes can be harder to detect, unlike traditional cigarettes that were easy to detect by smell and residual odor. E-cigarette use, or “vaping,” is often associated with a dry cough or chronic throat/mouth irritation. Overall, increasing research shows strong links between mental health conditions and posterior combustible tobacco use along with increased risk of marijuana use. Nicotine is addictive, but it does not cause altered mental status like the other drugs of abuse can. All parents are strongly encouraged to talk to their children about the potential dangers of e-cigarettes. What are the health risks of vaping? Vaping devices have been on the market for a relatively short period of time, with evidence-based health effects and complications still being discovered. Vaping effects poses many harmful risks to children and teens. The risks of vaping include: Chest pain Difficulty breathing Dizziness Headaches Impaired response to infection in the airway Inflammatory problems of the airway Nausea Nicotine addiction Seizures Vomiting For more information for both parents and teens about quitting smoking or vaping, you can click here. Parents can also use this tip sheet from the U.S. Surgeon General to talk to their child about vaping. The Substance Abuse and Mental Health Services Administration free national helpline number is 1-800-662-4357 (HELP). It is available 24/7, 365 days a year offering confidential treatment referral and information (in English and Spanish). If you or someone you know is facing a substance (or mental health) problem, please reach out to them.
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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. Committed to scientific excellence and integrity, DRI faculty, students who work alongside them, and staff have developed scientific knowledge and innovative technologies in research projects around the globe. Since 1959, DRI’s research has advanced scientific knowledge on topics ranging from humans’ impact on the environment to the environment’s impact on humans. DRI’s impactful science and inspiring solutions support Nevada’s diverse economy, provide science-based educational opportunities, and inform policymakers, business leaders, and community members. With campuses in Las Vegas and Reno, DRI serves as the non-profit research arm of the Nevada System of Higher Education. 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. Learn more at https://www.uhcancercenter.org. Like us on Facebook at facebook.com/UHCancerCenter. Follow us on Twitter @UHCancerCenter.
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Taking Control of Her High Cholesterol and Health
In 2018, Jordan Stiteler became a Healthy Nevada Project advocate. Her DNA results revealed that she had Familial Hypercholesterolemia (FH). FH is a genetic condition that can cause high cholesterol. Since then, Jordan’s taken action to lower her cholesterol and make her family aware of this potentially dangerous condition. Read Part I of Jordan’s story Taking Control of High Cholesterol Looking at Jordan, an active young mother, you would never suspect she has high cholesterol. However, because of FH, Jordan’s cholesterol levels are unusually high. She chose to take action when learning of her FH gene, in order to maintain her long-term health. Jordan started by exercising more and eating healthier. “I’ve definitely been checking all the labels to see if the food has a lot of cholesterol, trans fats, or saturated fats,” she explains. She now eats a 100% plant-based diet which helps to lower her cholesterol naturally. Additionally, Jordan partnered with Dr. Michael Bloch, a lipid specialist, to monitor and manage her cholesterol. She told Dr. Bloch that she and her husband were planning on having a second baby. With this in mind, he helped Jordan create a plan to accommodate her pregnancy. Several months after giving birth to her beautiful daughter Logan, it was time to revisit her cholesterol treatment plan. Dr. Bloch prescribed Jordan a statin called Lipitor. It successfully cut her total cholesterol by half in just three months. “I had blood work done in November 2019 and my total cholesterol was 293 (normal is less than 199). I started taking cholesterol medication in February 2020. I had blood work done in June 2020 and my total cholesterol was 149, ” Jordan shares. “My LDLs went from 219 to 78! I am so grateful that the medication worked so well and so quickly! It’s a weight lifted off of my shoulders.” Although Jordan no longer limits herself to a strictly vegan diet, she is mindful of what she eats and how it affects her cholesterol. She’s thrilled that her cholesterol is now at a healthy level!
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Renown Institute Expands Partnership to Offer ELF Testing
Together, will test over 30,000 qualifying study participants by 2023 for risk of cirrhosis and liver-related illnesses. 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. Nonalcoholic fatty liver disease (NAFLD), which includes NASH, is prevalent in Nevada and under-diagnosed, likely affecting more than 500,000 adult Nevadans. If undetected and untreated, NASH can result in liver cirrhosis and may require liver transplantation or lead to death. There are more than 12,000 people on a waitlist for liver transplantation in the U.S. and this number continues to rise due to the increasing prevalence of NAFLD. “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. It’s incredibly rewarding to be able to report clinical findings to help our 50,000 volunteer study participants, and to assist healthcare providers in helping their patients.” The provision of the ELF Test builds on a previously announced strategic collaboration between the Renown IHI and Gilead in July 2019. This ongoing partnership aims to collect and analyze de-identified genetic and electronic health data from 60,000 qualifying study participants to enhance the understanding of NAFLD and NASH and to potentially inform development of treatment options for these diseases. About NAFLD and NASH NAFLD is a build-up of fat in the liver of people who do not have a history of alcohol misuse. It is normal for the liver to contain some fat, but if more than 5 percent of the liver content is fat, it’s considered a fatty liver (steatosis). 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. About one-third of people with NASH develop cirrhosis or irreversible liver damage (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. For more information or to enroll, please contact RenownIHI@renown.org or (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. With a diverse workforce of more than 7,000 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 region’s largest, locally owned not-for-profit insurance company, 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. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the 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 is Nevada’s most comprehensive and integrated healthcare network and maintains electronic health records for 1.02 million registered patients. In 2016, Renown Health and the Desert Research Institute established the Healthy Nevada Project (HNP), the nation’s first community-based population health study. In 2017 HNP began a partnership with Helix to leverage its population health services, Exome+™ sequencing, and consumer engagement tools. 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. The HNP currently has over 60,000 participants. 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. In fiscal 2020, which ended on September 30, 2020, Siemens Healthineers, which has approximately 54,000 employees worldwide, generated revenue of €14.5 billion and adjusted EBIT of €2.2 billion. Further information is available at www.siemens-healthineers.com.Media Contact for Siemens Healthineers: Lance LongwellM: 610-448-6341E: lance.longwell@siemens-healthineers.com
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Population Health Study Goes Statewide and Opens Enrollment
The study could expand to a quarter million people, making Nevada the only state in the U.S. to offer such a program. Las Vegas, Nev. (May 2, 2019) – The Healthy Nevada Project, a first-of-its-kind, community-based population health study combining genetic, clinical, environmental and social data, is expanding enrollment to Las Vegas. The Project aspires not only to offer genetic testing to every Nevadan interested in learning more about their health and genetic profile but ultimately, to develop and expand the Project for communities across the United States to drive positive health outcomes nationwide. Adding 25,000 Study Volunteers in Southern Nevada The Healthy Nevada Project is announcing a statewide expansion – opening 25,000 testing slots in Las Vegas. With southern Nevada welcoming the study, the Healthy Nevada Project will offer no-cost genetic testing through a simple spit sample to 25,000 study volunteers. Study volunteers will take Helix’s clinical-grade DNA saliva test and will receive their ancestry and traits, at no cost, through the My Healthy Nevada Traits app. Participants will then be given a chance to answer a follow-up health survey from Renown Institute for Health Innovation (Renown IHI), and upon survey completion, will be entered to win an iPhone. In addition, study participants can agree to be notified about genetic test results that could impact their health, and which could be used to improve their medical care. This return of clinical results, plus genetic counseling and other genetic services as appropriate, will be provided by Genome Medical, the leading network of clinical genetics specialists. Healthy Nevada Project’s Evolution & Ongoing Expansion With more than 35,000 study participants enrolled in just over two years, the Healthy Nevada Project has become the fastest-enrolling genetic study in the country. The Project was created by Renown IHI – a collaboration between Reno, Nev.-based not-for-profit health network, Renown Health, and the world leader in environmental data, Desert Research Institute (DRI). Leveraging Renown’s forward-thinking approach to community health care and DRI’s data analytics and environmental expertise, Renown IHI has grown its capabilities to lead a larger, more complex research study of significance that will analyze and model public health risks in Nevada and serve as a national model for future population health studies working to improve overall health through clinical care integration. During the Project’s pilot launch in September 2016, more than 10,000 community members signed up for DNA testing in just 48 hours. In March 2018, phase two offered full genomic sequencing through a simple spit test from Helix to northern Nevadans. In October 2018, the Project announced the return of clinical results for study participants, notifying them of their risk for CDC Tier 1 conditions including familial hypercholesterolemia, BRCA positive 1 and 2, and Lynch syndrome, a precursor to colon cancer. These conditions affect more than one percent of the population and are inherited so they impact family members as well. Now, the Project announced its next phase – expanding enrollment to 25,000 people in southern Nevada. Serving as a National Model This expansion to Las Vegas truly makes this the “Healthy Nevada Project” with a statewide impact making Nevada the only state in the U.S. to offer such a program. “Nevada was ripe to advance population health goals because, sadly, our state ranks near the bottom in health outcomes. The Healthy Nevada Project is working to change that,” said Anthony Slonim, M.D., DrPH, FACHE, president and CEO of Renown Health and president of Renown IHI. “Our researchers are working on a number of clinical programs and scientific studies to determine why in Washoe County, the county in which Renown Health is located, Nevada’s age-adjusted death rates for heart disease, cancer and chronic lower respiratory disease are 33 percent higher than the national rate. Imagine if we can gather more data like this on a national scale and use it to change the future of health and health care? That is what the Healthy USA Project is looking to do in the years to come.” “The Healthy Nevada Project is committed to providing study participants clinically actionable data that will help improve their health,” said Joseph Grzymski, Ph.D., associate research professor at DRI, principal investigator of the Healthy Nevada Project and chief scientific officer for Renown Health. “We are providing this information at the individual level so study volunteers can make lifesaving changes to reduce their risk. We’re also doing it on the community level to develop leading-edge research on health determinants for entire neighborhoods, states and eventually, the country.” Expanding to Become the Healthy USA Project The accelerated speed of the Project is made possible thanks to the ever-decreasing cost of sequencing. Today, Helix is able to sequence an entire exome – which allows reporting on most actionable genomic knowledge – for a fraction of what it would have cost just 10 years ago. Additionally, advances in digital health mean Helix and Project researchers can capture unprecedented amounts of health data digitally, making significant contributions to advancing precision health. The partnership has managed to remove the traditional barriers of population health studies, including the difficulty in recruiting participants, establishing quality high through put lab systems, and scaling interpretation and return of results. This development will be key as other health systems around the country join the Project. “We are thrilled to see the constant, fast-paced evolution of this Project with Renown IHI,” said Justin Kao, CoFounder of Helix. “In less than a year, we have sequenced the DNA of thousands of study participants and are now preparing to offer this incredible study in other states. Combining environmental, clinical, social and genetic data allows us to discover risk factors within communities and help people take action to live longer, healthier lives. That’s what makes the next step of the Healthy USA Project so exciting for all of us. ”Full details on study’s evolution and southern Nevada enrollment will be revealed at a press event in Las Vegas on Tuesday, May 7 at 3 p.m. 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 https://healthynv.org/. Helix is a genomics company with a simple but powerful mission: to empower every person to improve their life through DNA. Our affordable, turnkey population health solution enables institutions to quickly scale projects that engage communities and accelerate research and discovery, ultimately allowing every person to benefit from the power of genomics. We've also created the first marketplace for DNA-powered products where people can explore diverse and uniquely personalized products developed by high-quality partners, providing powerful tools to increase engagement and speed the pace of population-scale genomics. Helix is headquartered in the San Francisco Bay Area, has an office in Denver, Colorado and operates a CLIA-certified and CAP-accredited next-generation sequencing lab in San Diego powered by Illumina (NASDAQ: ILMN) NGS technology. Helix was created in 2015. Learn more at www.helix.com. Helix, the Helix logo and Exome+ are trademarks of Helix Opco, LLC. All other trademarks referenced herein are the property of their respective owners. Additional Media Contacts: Tracy Bower DRI 702-862-5404 media@dri.edu Eric Schubert Seismic for Helix 415-939-4366 press@helix.com
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Study Shows Importance of Ensuring Participant and Provider Follow-up After a Genetic Screening Result
Released in partnership with the Desert Research Institute: New research from the Healthy Nevada Project® finds that a confirmed diagnosis does not always result in changes to patient care. Presenting individuals with potentially life-altering health information doesn’t mean the individuals – or their healthcare providers – will act on it. Follow-up education and conversations about actionable care plans with patients and their doctors are key next steps, according to new research from the Healthy Nevada Project. The Healthy Nevada Project is a genetic screening and research project that launched in 2016 as a partnership between DRI and Renown Health. The project now has more than 50,000 participants, with genetic sequencing provided by Helix. Between September 2018 and September 2020, the Healthy Nevada Project successfully notified 293 participants that they were genetically at risk for hereditary breast and ovarian cancer syndrome, Lynch syndrome, or familial hypercholesterolemia – three common genetic conditions known collectively as the Centers for Disease Control and Prevention (CDC) Tier 1 conditions. In a study published today in Frontiers in Genetics, Healthy Nevada Project scientists looked at the impact that notifying a patient of a positive finding for a CDC Tier 1 condition had on the care that the patient received in the months and years that followed. According to their results, among the 293 Healthy Nevada Project participants who were notified of their genetic risk of a CDC Tier 1 condition, 71 percent of participants with electronic health records shared their findings with healthcare providers. However, only 30 percent of the electronic health records for these patients contained documentation of the genetic diagnosis, and only 10 percent of examined patients experienced a possible change in care after receiving the results of their genetic screening. “The Healthy Nevada Project was implemented with a ‘hands-off’ approach where the participants receive their findings and decide with whom and when to share those findings. The findings were not automatically added to their electronic health records,” said Dr. Gai Elhanan, health data scientist at DRI and co-lead author of the study. “What we’re learning now is that to ensure that important genetic findings are integrated into the care journey it is important to make their inclusion into the electronic health records part of the study.” This study builds on previous Healthy Nevada Project research published in Nature Medicine demonstrating the importance of screening for CDC Tier 1 conditions, which affect about one in 75 individuals and can be mitigated or even prevented from developing into disease when detected early. This study found that as many as 90 percent of the CDC Tier 1 cases are missed by clinical providers during normal clinical care screenings and examinations. During the current study, the Healthy Nevada Project scientists found that 19 percent of studied participants had already developed one of the CDC Tier 1 conditions, and thus would have potentially benefited from earlier notification about their condition. The study team hopes that their findings will encourage individuals in Nevada to obtain genetic testing for these relatively common conditions. Even if individuals are older or have already suffered from diseases related to these conditions, testing could also prove beneficial to siblings, children, and grandchildren who may also be at risk and who could subsequently be screened in the event of a positive finding. The study team also encourages informing health care providers of the importance of incorporating genetic diagnoses into the pharmaceutical (for example, for Familial Hypercholesterolemia) and treatment advice given to patients. “As a result of this analysis, the clinicians at Renown Health and the Healthy Nevada Project researchers have made significant changes, including obtaining informed consent from participants to report positive findings from their genetics reports directly into their electronic medical record,” said Daniel Kiser, M.S., assistant research scientist of data science at DRI and co-lead author of the study. “This will help both participants, their clinical providers, and the whole state maximize the long-term benefits of the Healthy Nevada Project voluntary population-based genetic screening.” Additional information: The full text of the study, Incomplete Penetrance of Population-Based Genetic Screening Results in Electronic Health Record, is available from 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. This project was funded by Renown Health, the Renown Health Foundation, and the Nevada Governor’s Office of Economic Development. Study authors included Gai Elhanan (DRI), Daniel Kiser (DRI), Iva Neveux (DRI), Shaun Dabe (Renown Health), Alexander Bolze (Helix), William Metcalf (DRI), James Lu (Helix), and Joseph Grzymski (DRI/Renown Health). For more information on the Healthy Nevada Project® or to request genetic screening, please visit: https://healthynv.org/ About DRI The Desert Research Institute (DRI) is a recognized world leader in basic and applied environmental research. Committed to scientific excellence and integrity, DRI faculty, students who work alongside them, and staff have developed scientific knowledge and innovative technologies in research projects around the globe. Since 1959, DRI’s research has advanced scientific knowledge on topics ranging from humans’ impact on the environment to the environment’s impact on humans. DRI’s impactful science and inspiring solutions support Nevada’s diverse economy, provide science-based educational opportunities, and inform policymakers, business leaders, and community members. With campuses in Las Vegas and Reno, DRI serves as the non-profit research arm of the Nevada System of Higher Education. For more information, please visit www.dri.edu. About Renown Health Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 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 region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®. For more information, visit renown.org. About Helix Helix is the leading population genomics and viral surveillance company operating at the intersection of clinical care, research, and data analytics. 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 www.helix.com.
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Could Private Well Water Unlock Health Insights?
The Healthy NV Project® launches a new study to identify how private well water could impact the health of those living in the household. You use your faucet to wash your hands, make coffee and fill your water bottle. However, for approximately 41,000 people in Washoe and Churchill Counties who rely on private well water, there may be unseen contaminants present in their H2O, which could be affecting their health. The Healthy Nevada Project®, with support from the National Institutes of Health (NIH), is launching a new study to discover how private well water quality impacts the health of well owners. By providing free water testing kits to interested Healthy Nevada Project® participants, researchers will collect samples and give results back to well owners, along with resources for potential treatment options. Data from previous studies in Nevada show elevated concentrations of heavy metals in some private, household wells. Since water from household wells is not monitored for quality by government agencies, well water testing helps ensure water does not contain dangerous levels of heavy metals, such as lead, which can lead to adverse health impacts. Those with a household well interested in receiving a free water testing kit must be enrolled in the Healthy Nevada Project’s population genetic screening study and consent to be a part of further research. People interested in joining the study can simply sign up to receive a genetic spit test kit in the mail or join the waitlist to be notified when in-person testing resumes. “The goals of the Healthy Nevada project are to improve population health and better understand processes that increase disease risks, such as cancer. In this study, we engage with our study participants and inform them about the impact of the environment on their health, while researching environmental contaminants that may elevate cancer risk,” said Joseph Grzymski, Ph.D., research professor at DRI, principal investigator of the Healthy Nevada Project® and chief scientific officer for Renown Health. “During a time where people are spending more time at home, we’re excited to launch this multi-disciplinary study that dives into possible health impacts of a household’s water source.” “As the Healthy Nevada Project continues to serve over 54,000 research volunteers, we are proud to provide helpful information to participants, so they can make life-changing improvements to their home environment,” said Tony Slonim, M.D., DrPH, FACHE, president and CEO of Renown Health and co-director of the Healthy Nevada Project. “This allows every person with well water in Nevada, to have important information, at no charge, to help live healthier and better lives and to protect their family’s health.” The Healthy Nevada Project® is the fastest-enrolling genetic study in the country. 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. To enroll in the Healthy Nevada Project, please visit healthynv.org. 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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