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    • Tuesday, Apr 20, 2021

    Researchers at Renown Seek Convalescent Plasma Study Participants

    Physician researchers seek to understand how the immune system responds to COVID-19 and create a healthier Nevada. During the early stages of the pandemic, convalescent plasma was considered the only viable treatment option available for patients with COVID-19. Convalescent plasma is the component of the blood from recovered patients that may contain COVID-19 antibodies that help fight the infection. The National Institutes of Health has since developed treatment guidelines for COVID-19 based on clinical trial data and many studies are still underway worldwide assessing various additional treatment options. Convalescent plasma was in high demand but difficult to locate for COVID-19 patients in the northern Nevada area. A 24-year-old nursing assistant, Austin Meegan, was hospitalized and spent weeks staving off kidney and lung failure before learning he was eligible for an experimental blood transfusion that showed promise in treating COVID-19. Doctors estimated Meegan had only about a 3% chance of tracking down a donor to match his rare blood type. A COVID-19 survivor, Thomas Gibson, a Texas resident with the same blood type, traveled to Reno to donate his viral antibodies and a convalescent plasma donation credited with helping to save Meegan’s life. Physician clinical researchers and scientists at Renown and the University of Nevada, Reno School of Medicine (UNR Med) knew they needed to create better options for patients and physicians. Clinical researchers developed a study to help other patients like Austin, and pleaded for donations from recovered COVID-19 patients to donate their convalescent plasma. The researcher teams looked to understand how the body’s immune system responds to the virus over time, to aid them in developing new treatments for COVID-19. “The world’s capacity to get through the COVID crisis will depend on four things — science, technology, innovation and partnerships, says Tony Slonim, MD, DrPH, President and CEO of Renown Health.  “Taking lab bench discoveries to the bedside of patients in an efficacious and timely manner is not easy, but with UNR Med and our partners, we are making great strides in advancing clinical research which has the power to save lives and to create a healthier Nevada.” “It’s tremendously promising to partner on clinical research that will not only help us better understand the disease, but help inform treatment for those combatting COVID-19 that has had such a devastating impact on Nevadans, our nation and the world,” says UNR Med Dean Thomas L. Schwenk, MD. Renown, UNR Med and other area health care partners collaborated with Vitalant to collect plasma from recovered donors for a study on the treatment's efficacy. Eligible donors are at least 18 years old, weigh more than 110 pounds and are healthy. Donors had fully recovered from a confirmed diagnosis of COVID-19. Project coordinators at the Renown Research Office were overwhelmed by the community’s support and plasma blood donations. Additional partnerships with the Washoe County Health District, the State of Nevada and the Governor’s office, Saint Mary’s Medical Center, Northern Nevada Medical Center, Carson Tahoe Health and the VA Sierra Nevada Health Care System, along with many area health care providers helped the team meet their goals of enrolling 120 eligible participants in the study. “Our success in this study rests heavily on the support of our great community, as well as the innovation and collaboration demonstrated by Renown and UNR Med,” said Sara Healy, MD, MPH, principal investigator of the study and a pediatric infectious disease physician at Renown Children’s Hospital and UNR Med. “We are proud to be at the forefront of conducting essential research during such a pivotal time in history, and look forward to our continued partnership as we continue this important work.” “The control of COVID-19 in our communities relies on testing. The study that is being launched to develop a sensitive, specific and easier way to collect specimens (blood) is advancing the field and brings promise towards getting to our common goal of having the right diagnostic test for the right clinical situation at the right time,” says Mark Riddle, MD, DrPH, FISTM, associate investigator of the study and associate dean for clinical research and professor at UNR Med's Department of Internal Medicine and Medical Research. The research team is now asking area residents to participate in a study to analyze the efficacy of two COVID-19 tests. Participants will undergo two blood tests: one being a finger stick to provide results for a rapid test, and the other is a traditional venipuncture draw confirming the presence or absence of COVID-19 antibodies. This study is a collaboration with InBios International, Inc., a leading biotechnology company based in Seattle. Researchers are seeking: Individuals who have confirmed positive for COVID-19 and who have recently recovered from the virus. Study participants must be within 7-28 days from the onset of their symptoms. Individuals who have recently tested negative for COVID-19 and have never tested positive. Those who are interested in participating in the study may contact project coordinators at the Renown Research Office at (775) 982-3646, or via e-mail at covidplasmascreening@renown.org, 7:30 A.M. – 5:00 P.M., Monday through Friday. Individuals aged 18-75 in general good health are encouraged to consider participating in this ongoing study. There is no cost to participate in this study and participation is voluntary. An individual’s decision to participate will not affect their current or future relations with their health care provider(s), health district, or the community. Those who decide to participate are free to withdraw at any time. “Time is of the essence with COVID. If we can get test results to people and their clinicians in a more timely way, we can make a faster diagnosis of a patient's condition, says Christopher M. Kozlowski, MD, MHA, Renown's institutional research officer and Medical Director/VP of Renown Institute for Heart & Vascular Health. “As we refine the accuracy of our testing; we are applying sensitivity and specificity testing for true negative and true positive results. This provides people with more timely and accurate results and better quality care.”     About Renown Health Renown Health is a locally governed, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown is one of the region’s largest private employers with a workforce of more than 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to improve the care and the health of our community.     About the University of Nevada, Reno School of Medicine The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Established in 1969, UNR Med is improving the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu.

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    • Pediatric Care
    • Toddler Health

    Ask the Expert: What is Scoliosis?

    Posture is important, but for those children diagnosed with scoliosis (spinal curvature) it can be a difficult issue. The Washoe County School District Student Health Services Department screens 7th grade students for scoliosis as growth spurts often reveal the condition and, if diagnosed early, scoliosis can stop progressing. We asked Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis to answer some frequently asked questions about scoliosis. What is scoliosis? There are many types of scoliosis: early onset (occurs before age 10), congenital scoliosis is when the bones of the spine do not form correctly, neuromuscular scoliosis which is due to children’s neurologic and muscle disease, and the most common is Adolescent Idiopathic Scoliosis. The term “idiopathic “ means the exact cause is unknown, although we do know it runs in families. This type of scoliosis occurs in 2-3 percent of adolescents and is mainly seen during their growth spurt. This is why middle school screenings are recommended. Both genders get scoliosis but girls are 8 times more likely to have their curves progress and become larger. What are the signs that my child may have scoliosis? A few signs for parents to watch for are: One shoulder might be higher than the other. One leg may seem longer. A hip may be higher or look more prominent. The waist may not look the same from side to side (asymmetry). The trunk or rib cage may be more prominent on one side or shifted. When they bend forward they may have a bump on their back. How is scoliosis diagnosed? It can be noticed by a pediatrician at a physical, school screening nurse, PE teacher or parents. Once the curve is suspected the child is usually referred to a pediatric orthopedic surgeon scoliosis expertise. At the initial visit the doctor will perform a thorough physical including a complete neurologic exam to assess the amount of curvature. Once the exam is completed the physician will determine if a spinal x-ray is needed. The curve on the x-ray is measured utilizing the cobb angle (a measurement in degrees) which helps guide the treatment. What are common treatments for scoliosis? The treatment depends on the size of the spinal curve and the amount of growth the child has remaining. An x-ray of the child’s hand is used to determine the amount of growth remaining. This allows the determination of the child’s bone age, and based on the hands growth plates it can determined if the child is in their rapid phase of growth. Treatments include: Observation - For curves less than 20-25 degrees. This entails visits every 6-9 months with a repeat scoliosis x-ray. Since scoliosis curves increase only 1-2 degrees per month, and variations in measurements can be 3-5 degrees, an x-ray is not recommended before 6 months. If the curve remains less than 25 degrees the child is followed until their growth is completed (usually age 16-18). Progressing Curve - If growth is finished and the curve is less than 40 degrees, the risk of more curvature into adulthood is small. If growth is completed and the curve is over 45 degrees, the child is followed for several years as these curves can progress into adulthood. If the patient is still growing and the curve has progressed greater than 25 degrees but still in the non-operative range (less than 45-50 degrees) bracing is used to stop the progression of the curve. Bracing - Indicated for curves over 25 degrees but less than 45 degrees. If a brace is required you will be referred to an orthotist (bracing specialist). The orthotist assesses your child, reviews the x-ray and then fits the brace. (Having a brace made usually takes 2-3 weeks.) Once the brace is fit, your child will visit the scoliosis specialist for an x-ray in the brace to ensure it fits correctly. The primary goal of bracing is to halt progression of the curve and prevent the need for surgery. The brace must be worn for about 16 hours per day to be effective. In a recent bracing study 72% of the patients who wore their braces as prescribed prevented the need for surgery compared to the group who did not wear their brace. Surgery: When a curve reaches 45-50 degrees, and a child is still growing, surgery is usually recommended because the curve is likely to continue progress. If a curve is over 50 degrees and the child is done growing surgery also may be recommended. This is because when curves are over 50 degrees they tend to increase 1-2 degrees per year for the rest of your life. As curves get larger the amount of lung function tends to decrease which could cause breathing problems later in life. The goals of surgery are to stop the progression of the curve and safely correct any misalignment. This is accomplished by attaching implants (rods, screws, hooks and bands) to the spine. Bone graft is then placed around the implants to encourage the spine to fuse (grow together). This then forms a solid column of bone with metal rods in place, preventing the curve from changing. Most patients are back to their regular sports and activities six months post surgery.

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