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Physiatry NEURO-REHABILITATION CLINIC
What is Physiatry? Physiatry (fuh·zee·a·tree) encompasses the diagnosis, prevention and treatment of all disabilities related to the brain, nerves, bones and muscles. The goal is to maximize physical functioning, significantly decrease or eliminate pain, foster independence and improve the quality of life for those with a disability, chronic pain and physical impairments.
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Leading Experts Convene in Tahoe To Focus On Scientific Advancements And The Prevention Of Cardiovascular Disease, The #1 Cause Of Death Globally
Three-day medical education conference advances research, education, prevention and treatment. Physicians and medical professionals from across the country will convene in Lake Tahoe from Friday, Nov. 4 to Sunday, Nov. 6 to explore the most recent advances and established guidelines for the diagnosis, treatment and prevention of cardiovascular disease, diabetes mellitus, stroke and diseases or problems associated with heart disease. Hosted by Renown's Institute for Heart & Vascular Health and the Nevada Academy of Family Physicians, the 32nd annual three-day Trends in Cardiovascular Medicine conference will bring together national experts to explore challenges and solutions to cardiovascular diseases, the leading cause of death globally, taking an estimated 17.9 million lives each year. "The driving force behind this collaborative event is the shared missions of all our organizations, across the country, to advance progress in cardiovascular research, education, prevention and treatment," says Jayson Morgan, MD, FACC, Director of Cardiovascular Services at Renown. "We will be joined by colleagues from across the country including Mayo Clinic College of Medicine and Science in Rochester, UC San Francisco School of Medicine, David Geffen School of Medicine at UCLA, University of Washington Medical Center, University of Chicago Medicine and locally- with experts from Renown's Institute for Heart & Vascular Health/UNR Med and Northern Surgical Associates - to discuss contemporary trends in providing excellent cardiovascular care and prevention." New research will be presented each day from experts across the country, including the following topics: “What the Fentanyl? Making Sense of a Deadly Epidemic” “COVID-19: Return to Sport or Strenuous Activity Following Infection” “Management of Type 2 Diabetes: Evolving Data, Evolving Guidelines, Evolving Practice” “Coronary Microvascular Disease in Women: Signs, Symptoms, Evaluation and Treatment” “Lipoprotein (a): A Risk Factor for Atherosclerosis and an Emerging Therapeutic Target” “Gut Feeling: The Increased Importance of GLP-1 Therapies for Personalized Obesity Management” "Primary Care Perspectives: Peripheral Vascular Disease” “Prevention of Atrial Fibrillation and Sudden Cardiac Death in Women” “Clinical Practice Guidelines for the Management of Heart Failure in 2022: What Do I as a Primary Care Provider Need to Know?” “Can a Patient be Low Risk without a Calcium Score?” “Obesity & Cardiovascular Disease Risk Reduction: How Does Bariatric Surgery Change the Landscape?” To make an appointment with a provider at Renown's Institute for Heart and Vascular Health, request that your primary care provider make a referral. For more information on Renown's Institute for Heart and Vascular Health, visit renown.org/Health-Services/Heart-Care. About Renown Health Renown Health is Nevada’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 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®.
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Nationally Recognized Vascular Surgeons Join Renown Health
Two vascular surgeons bring a quarter of a century of experience to patients and community. As part of a continuing focus to bring comprehensive care to patients experiencing cardiac and vascular disease across northern Nevada, Renown Health Department of Surgery and Renown Institute for Heart & Vascular announce that vascular surgeons, John C. Hansen, MD, FACS and Benjamin P. Jaquish, MD, FACS have joined Renown Health. "Recognizing the significance of preventing, diagnosing and caring for people with heart and vascular disease, which continues to be on the rise and taking far too many lives, is of critical important to us at Renown," says Christos A. Galanopoulos, MD, MBA, MSc, FACS, VP, Chairman Department of Surgery at Renown Health. "Both Drs. Hansen and Jaquish are superb clinicians, skilled investigators, and effective educators. We are fortunate to have them helping to lead the growth of both the department and the Division of Vascular and Endovascular Surgery." Together, the vascular surgeons have more than 26 years of combined experience caring for northern Nevadans. Dr. Hansen has 20 years of experience in northern Nevada. He is a clinical associate professor of surgery at the University of Nevada, Reno School of Medicine (UNR Med) and currently serves as medical director of vascular and endovascular surgery for Renown Regional Medical Center. "Since 2002, Dr. Hansen has led our region with his expertise and knowledge of aortic stents, grafting for abdominal aortic aneurysms and thoracic aneurysms, as well as treating patients with carotid disease," says Jayson Morgan, MD, FACC, Director, Cardiovascular Services. "Dr. Hansen specializes in the comprehensive management of vascular disorders, including open and endovascular surgeries. He is meticulous, thorough, and compassionate in the extraordinary care he provides to patients. We are thrilled that he has joined the Institute for Heart & Vascular Health team at Renown." Dr. Hansen completed his fellowship in Vascular Surgery at the Mayo Clinic in Rochester, MN, and completed his residency in General Surgery at the University of South Carolina, Greenville. He graduated with his Doctor of Medicine from the University of North Carolina School of Medicine, Chapel Hill, and is board certified in both Surgery and Vascular Surgery from the American Board of Surgery and a Fellow of the American College of Surgeons. Dr. Hansen has an interest in complex and acute vascular surgery and is committed to expanding access to qualified vascular care in the region. His mission is to further develop and establish Renown as a premier vascular center in northern Nevada. "Dr. Jaquish has extensive experience in carotid artery disease, carotid endarterectomy, aortic aneurysm and dissection, and peripheral vascular disease," says Sam Obilie-Mante, MBA, MIS, RDCS, RVT, LBBP, VP Administrator, Cardiovascular Services. "Dr. Jaquish is intelligent, professional, conscientious, and always perseveres on behalf of his patients. How proud we are to have him bringing his time and talent to patients across Renown Health." Dr. Jaquish received both his B.S. in Biochemistry (2005), graduating Magna Cum Laude with his Doctor of Medicine (2009) from the University of Nevada, Reno School of Medicine. Dr. Jaquish completed his fellowship in General Surgery at Ascension St. John Hospital and Medical Center in Detroit and a fellowship in Vascular Surgery at Texas A&M at Baylor, Scott & White Hospitals in Temple, TX. He is board certified in both General Surgery and Vascular Surgery. Dr. Jaquish currently serves as Assistant Professor of Clinical Surgery for UNR Med. Dr. Jaquish is bilingual in Spanish, proficient in American Sign Language and serves as an instructor for Advanced Trauma Life Support. Why Vascular and Endovascular Care Matters to You People with complex and serious conditions of the blood vessels and lymph system (vascular diseases) often find the help they need from Renown Health's vascular and endovascular surgical team. Renown's experts provide coordinated and comprehensive treatment to people of all ages. Renown's surgeons use advanced technology to perform vascular and endovascular surgery, including complex stenting procedures, blood clot removal and bypass surgery. Conditions treated include peripheral artery disease, aortic disease, mesenteric disease, nutcracker syndrome and carotid artery disease. "Our expert vascular and endovascular surgeons and staff treat problems that extend from mild to the most critical of emergencies," says Adnan Akbar, MD, Chief Medical Officer for Renown Acute Care. "Specialized physicians including cardiologists, interventional radiologists, heart and vascular surgeons, emergency medicine and trauma surgeons, neurologists, radiologists, physical medicine and rehabilitation specialists, primary care providers, nurses and other clinicians work as a team to determine the best treatment plan for each patient. We encourage all patients to discuss with their primary care providers whether they should undergo formal screening for early vascular disease." "Renown's reputation as the region's vascular and endovascular care leader has been built over many years. We performed the area's first open-heart surgery, angioplasty, stent and valve replacements decades ago. Renown Regional offers incredible advancements like trans-catheter aortic valve replacement (TAVR) and trans-catheter mitral valve repair (TMVr) with MitraClip therapy, lifesaving alternatives to open-heart surgery for patients considered high-risk or inoperable," says Chris Nicholas, FACHE, Chief Executive Officer of Renown Regional Medical Center. "Offering the highest level of comprehensive care for patients experiencing cardiac and vascular disease, Renown developed its first division of cardiothoracic surgery dedicated to heart surgery patients in 2019." The Renown Institute for Heart & Vascular Health program now offers a Diagnostic Electrophysiology Lab; a Chest Pain Center using the D-SPECT® heart camera; multiple Interventional Labs; Heart Failure Program; several Cardiac Catheterization Labs; Interventional Cardiology and Cardiac Surgery when necessary; and the only Pritikin-certified Healthy Heart Program in the West, creating individualized rehabilitation plans tailored to each patient's needs, so they can exercise safely, eat healthy, manage stress and cook nourishing, balanced meals, all while gaining a healthy mindset. In the most recent US News & World Report Best Hospital rankings, Renown Regional Medical Center was named as the number one hospital in Nevada. No other hospitals in the state met their stringent standards for the 2021 rankings. Renown Health is High Performing, its highest rating possible, in eight procedures and conditions including Heart Failure, Colon Cancer Surgery and Chronic Obstructive Pulmonary Disease, Hip Replacement and Knee Replacement. A hospital's score is based on multiple data categories, including patient outcomes, safety and volumes. Hospitals earning a High Performing rating were significantly better than the national average. The 2021-22 Best Hospitals rankings are drawn from a universe of 4,523 facilities, representing nearly all U.S. hospitals providing inpatient care. Hospitals are evaluated across a wide range of conditions and procedures, including 16 medical specialty areas of care. US News & World Report evaluated 58 hospitals in Nevada. 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®. For more information, visit renown.org. The University of Nevada, Reno School of Medicine (UNR Med), Nevada's first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Since 1969, UNR Med has trained more than 3,900 students, residents and fellows. UNR Med continues to improve 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.
Read More About Nationally Recognized Vascular Surgeons Join Renown Health
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Importance of Well Child Visits
It’s important to establish children with a pediatrician so that their health baselines can be monitored regularly throughout each stage of their life, from infancy to young adulthood. Well-child visits are comprehensive, preventative check-ups that are vital to each child and teen’s overall health and wellbeing. At Renown Children’s Hospital, our Pediatric Primary Care team is dedicated to treating children with personalized medical care – we are focused on each child’s individualized healthcare needs, offering services ranging from well-child visits and immunizations to sports physicals, care for illnesses and minor injuries, mental health support and specialist referrals when needed. Here is an overview of the timeline and importance of well-child visits for you to reference as you care for your children. Well-Child Visit Schedule Renown Children’s Primary Care provides the following well-child visit schedule: Three to five days after birth 2 weeks Two months Four months Six months Nine months One year 15 months 18 months Two years, and yearly after
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Reno Home to 37 of the Nation's Best Patient Communicators
During National Healthcare Week, clinical providers who are “Best of the Best” being honored for demonstrating exceptional communications skills in their clinical practice, as awarded by you, their patients. “Amazing! Phenomenal! Thank you for always showing genuine concern. You are kind, considerate and caring. You are interested in me. You are the best doctor/nurse practitioner I have ever had. I trust you with my life. You act on things right away. You are awesome. You have saved my life, and my family. You are knowledgeable, thorough, intelligent, and compassionate. You are my favorite. You are my angel. You have made me better. You always make me feel like a success, even if I could have tried harder. I love you. I thank you.” These are some of the comments made by patients regarding their doctors and advanced practice providers who will be honored next week by the Patient & Family Advisory Council and Renown Health with a special breakfast celebration in south Reno. In honor of National Healthcare Week, Renown Medical Group, which offers primary and specialty care at locations in Reno, Sparks, Carson City, Fallon, Fernley, and Silver Springs will honor 37 physicians and advanced practice providers at the Dr. John Spellman Excellence in Patient Communications Award Celebration. This annual award, supported by the Renown Health Foundation and a donor family, honors clinicians who demonstrate exceptional communications skills in their clinical practice, as awarded by their patients. Recipients of this award are ranked in the top ten percent nationally in provider communication for 2022, as measured by over 11 thousand patients who responded nationally to the Centers for Medicare & Medicaid Services’ (CG-CAPHS) or Clinician and Group Consumer Assessment of Healthcare Providers and Systems and over 14,000 local patients who gave them top scores on the national patient experience survey. Patients were asked if their medical providers explained things in a way they could understand; if they listened carefully; if they showed respect for what they had to say; if they spent enough time with them; if they read their medical records; if they ordered tests and followed up with them on their results; and to give them a rating on a scale of 1 to 10, where 10 was the highest score. “These incredible medical providers set the gold standard for excellent communications with patients, scoring in the top 10% nationally for compassion, caring, competency and communications,” said Brian Erling, MD, MBA, President & CEO of Renown Health. “We are extremely proud of them and their outstanding dedication to patients, families and our community.” The awards will be given by his family in remembrance of the late Dr. John W. Spellman, human rights advocate, scholar and professor. Dr. Spellman treasured kindness, scholarship, debate and medical providers who demonstrated exceptional communications skills and held their patients in the highest regard. The Recipients of the 2022 Dr. John Spellman Excellence in Patient Communications Award are: Christina Alsop, DNP, AOCNP, Oncology Nurse Practitioner, William N. Pennington Cancer Institute at Renown Pamela Burgio, APRN, Renown Primary Care Jennifer Brown, APRN, Pulmonary & Sleep Medicine Stephanie Carlesen, DNP, Renown Institute for Heart & Vascular Health Carolyn Dennehey, MD, Rheumatology Benjamin Ebner, MD, Renown Institute for Heart & Vascular Health Christopher Driscoll, MD, Pediatrics, Renown Children’s Hospital Kerac Falk, MD, FACOG, Renown Women’s Health Michael Hardacre, MD, Radiation Oncology, William N. Pennington Cancer Institute at Renown Robin Hollen, DNP, FNP-C, APRN, M.Ed., MSN, Breastfeeding Medicine Nurse Practitioner, Renown Women’s Health James Martin Johnston, MD, Pediatric Hematology/Oncology, Renown Children’s Hospital Stephanie Jones, DO, Physical Medicine/Rehabilitation Charlotte Kermode, APRN, Renown Primary Care Michele Kiser, MD, Renown Primary Care Matthew Klippenstein, MD, Renown Primary Care Anamarie Manea, MD, Pediatric Endocrinology, Renown Children’s Hospital Marie McCoramck, MD, Renown Primary Care Catherine Mindeguia, APRN, Renown Primary Care Dean Miyagawa, MD, Internal Medicine, Renown Primary Care Amanda Morgan, MD, Pulmonary Medicine, Renown Medical Group Cecelia O’Dowd, MD, Renown Primary Care Kasie Reynolds, APRN, Renown Children's Hospital, Behavioral Health Jocelyn Schneider, APRN, Renown Institute for Heart & Vascular Health Vanessa Slots, MD, Renown Pediatrics Daniel Spogen, MD, Renown UNR Primary Care, Sports Medicine Jennifer Simcox, APRN, Renown Primary Care Mark Stovak, MD, Renown UNR Primary Care, Sports Medicine Shining Sun, MD, Renown Institute for Heart & Vascular Health Jennifer Sutton, MD, Radiation Oncology, William N. Pennington Cancer Institute at Renown Robert Swackhamer, MD, Renown Institute for Heart & Vascular Health Carl Thomas, MD, Renown Primary Care Katherine Thyssen, DO, Geriatric Medicine, Renown Primary Care Ly Vu, MD, Renown Primary Care Scott Michael Wallace, MD, Renown Pediatrics Kristin Wilson, MD, Renown Pediatrics Bryan Young MD, Internal Medicine, Renown Primary Care Jacob Zucker, MD, Pediatric Hematology & Oncology, Renown Children’s Hospital Since 2018, Renown Medical Group has posted thousands of verified patient ratings and comments of their employed providers online and viewable by the public at renown.org. “Our goal is to consistently exceed customer expectations, every day, and with every encounter. At Renown, we embrace transparency and empower patients,” says Rahul Mediwala, MD, CEO of Renown Medical Group. Dr. Mediwala should know – he is also a highly rated physician by his patients, has practiced for more than 20 years, and sees the ratings program as another way to support employed physicians and providers at Renown Health. Only patients who’ve had an outpatient visit with a Renown Medical Group provider may be selected to receive a survey from CH-CAHPS. This way, Renown can confirm the results are from patients who have been seen by the provider. All comments are posted anonymously, and patients are asked for their permission to use their comments. Feedback is shared with every provider. Renown Health is integrated with the University of Nevada, Reno School of Medicine, Nevada’s first medical school, which serves to enhance the health of the community through increased access to care, innovative health care delivery, expansion of clinical research and training for the next generation of physicians and health care professionals. Almost 700 Renown Medical Group primary care and specialty providers are currently accepting new patients and accept most health insurance plans, including Renown’s not-for-profit insurance plan, Hometown Health. To find the doctor or provider that is best for you visit renown.org, self-schedule with your established provider at MyChart.Renown.org or schedule an appointment with a Renown Medical Group or University Health provider by calling our agents available by phone- Wed-Fri: 7 a.m. to 7 p.m., Sat-Sun: 7 a.m. to 6 p.m., at 775-982-5000. Renown Health is currently hiring in all areas. Search for a new career opportunity and apply online at careers.renown.org. 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.
Read More About Reno Home to 37 of the Nation's Best Patient Communicators
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Awareness Saves Lives: Renown Goes Blue for Colorectal Cancer Awareness Month
After a year of possibly delayed colorectal cancer screenings due to theCOVID-19 pandemic, it’s more important than ever to raise awareness for colorectal cancer. March is National Colorectal Cancer Awareness Month- a time to raise awareness for colorectal cancer and the importance of routine, life-saving screenings. Renown invites the community to join the organization in helping put an end to the preventable disease. Blue is the designated color to bring awareness to colorectal cancer and those impacted by it. The iconic “LOVE” sculpture at the main entrance of Renown Regional Medical Center located at 1155 Mill Street in Reno, Nev. will shine brightly in blue each evening in March, serving as a visual reminder to passersby to schedule a colorectal screening. The Colorectal Cancer Alliance estimates 149,500 new cases of colon cancer will present in 2021 alone. While colorectal cancer may be the second deadliest cancer in men and women combined, it is also one of the most preventable cancers with screenings. “Unfortunately, due to the COVID-19 pandemic, there’s been a decline in colorectal screenings nationwide,” said Tony Slonim, MD, DrPH, President and CEO of Renown Health. “We know early detection is key in preventing the spread of any cancer, and with regular screenings, we know colorectal cancer is easily detectable and treatable. As a cancer survivor, I know how important it is to get back on track with regular screenings and preventive care. Making your health a priority now will help you experience a healthier and brighter tomorrow.” “We invite the community to join us at Renown in spreading awareness about colorectal cancer and its prevention,” said Susan Cox, director of cancer services at the Renown Institute for Cancer. “It takes all of us to put an end to colorectal cancer. If you’re up to date on your screenings, remind a loved one to schedule their next screening--as your reminder may have the power to save their life.” “Colorectal cancer usually forms from precancerous polyps, or abnormal growths, in the colon or rectum, which can become malignant without presenting any symptoms. Screening tests like stool tests, colonoscopies, and others can detect these precancerous polyps, so they can be removed by a physician before turning into cancer. Screening tests can also find colorectal cancer early, resulting in better treatment outcomes,” says Christos Galanopoulos, M.D., MBA, oncologic surgeon, VP Renown Health & Chair of Surgery for Renown Health. Dr. Galanopoulos adds, “Most people begin screening for colorectal cancer after turning 50. However, some individuals may begin screenings earlier if they have an increased risk of colorectal cancer, such as a family history with the disease. Regardless of one’s personal or family history of colorectal cancer, it’s important to talk to your doctor about the right time to begin your screenings.” Max J. Coppes, MD, Cancer Center Director, Renown Institute for Cancer adds, “While routine screenings are the only way to determine colorectal health, some healthy habits may reduce your risk for colorectal cancer. These factors include maintaining a healthy weight, being physically active, eating a diet rich in fresh fruits, vegetables and whole grains, limiting alcohol intake and not smoking.” Dr. Coppes explains that, “1 in 500 Americans will test positive for Lynch Syndrome, a genetic condition that raises your risk of colon cancer, endometrial cancer, and other cancers. It is also known as hereditary nonpolyposis colorectal cancer. People with Lynch Syndrome are also susceptible to colon polyps at a younger age. The Healthy Nevada Project research team is looking at the occurrence of important inherited genetic variants in our population that increase the risk of certain diseases. These include Familial Hypercholesterolemia, Hereditary Breast and Ovarian Cancer Syndrome and Lynch Syndrome.” To enroll in The Healthy Nevada Project, a clinical study (saliva test) offering the opportunity to learn about your ancestry, diet insights and genetic risks linked to heart disease and certain cancers, including prevention strategies, at no cost, enroll here. For a limited time, Nevada residents may request a free DNA test kit that will be shipped to your home. Renown experts encourage every adult to talk to their doctor about their colorectal cancer risk and screening options. Those looking to schedule a screening or establish care with a Renown primary care provider are invited to call us at 775-691-7308 or visit our website for more information. 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 Heath and Neurosciences. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®.
Read More About Awareness Saves Lives: Renown Goes Blue for Colorectal Cancer Awareness Month
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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. 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 largest community-based genetic population health study, the Healthy Nevada Project®. To join the Renown Health team, visit renown.org/careers. 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 helix.com.
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Snakes! 3 Safety Tips for Outdoor Adventures
Seeing a snake while exploring northern Nevada’s trails is somewhat rare and the chance of a snakebite is even less common. However, it’s important to make sure you’re ready for snakes and know what to do in case of a snakebite. Hiking the rugged, stunning and varied landscapes of northern Nevada is a huge draw for many who live here. But it’s important to stay alert and be prepared while you’re out exploring the natural habitats of wildlife, especially if you encounter a snake or get a snakebite. As you prep for your next outdoor adventure, remember these three tips to stay safe in Nevada’s wilderness. 1. Leave snakes alone In general, if you don’t mess with snakes, they won’t mess with you. Seeing a snake is fairly uncommon because of their body camouflage and secretive nature, which are their first defenses in evading predators. According to the Nevada Department of Wildlife (NDOW), most snakebites happen when a person tries to capture or kill the snake. Nevada is home to 52 species of snakes and reptiles, according to NDOW. Only six can be dangerous to people and pets: Western Rattlesnake (this is the most common type of venomous snake in northern Nevada, especially around Yerington and Fallon) Sidewinder Mohave Rattlesnake Speckled Rattlesnake Western Diamondback Gila Monster (these live in southern Nevada’s Mojave Desert) Venomous snakes, like the rattlesnakes, have a wide head and thick body. Non-venomous snakes are usually more slender and have a narrow head. If you see a snake on the trail and you aren’t sure if it’s venomous or not, it’s best to be safe and leave it alone by moving away slowly. 2. Wear the right gear and take care where you walk NDOW and the U.S. Department of Agriculture suggest doing the following to decrease your chances of a snakebite: Wear over-the-ankle boots, thick socks and loose-fitting long pants. Stick to trails and stay out of the bushes or tall grass. Don’t step where you can’t see. If going over a fallen tree or large rock, step on it. Don’t jump over it. A snake might be lying on the other side. Always check stumps or logs for snakes if you’re going to sit on it. If you see one or hear a rattle, move away from the area slowly. Don’t run or make any sudden movements. Don’t handle or move a recently-killed snake as it can still inject venom. And for your dog, the best way to prevent a snake bite is to keep it on a leash. 3. Know what to do (and not do) if you get a snakebite Renown Health primary care physician Aaron A. Bertalmio, MD, reminds us the odds of getting a snakebite are very low. Roughly 7,000 to 8,000 people get bitten annually and only 5 percent die according to the U.S. Food and Drug Administration. But in the event of a snakebite, here’s what to do: Get medical help as soon as possible Stay calm to help keep your heart-rate low Remove constrictive clothing or jewelry Clean the wound with soap and water if available Cover the snakebite with dry, sterile cloth or adhesive bandage if available Keep the bite snakebite area level and below your heart if possible WHAT NOT TO DO IF YOU GET A SNAKEBITE: Apply a tourniquet (a tool used to stop arm or leg blood flow) Ice the bitten area Suck out the venom You’re now prepped and ready on what you need to know about Nevada’s slithery friends so you can stay safe and enjoy the outdoors!
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Study From UNR Med and Renown in JAMA Network Open Highlights Gaps in Genetic Screening for Hereditary Breast and Ovarian Cancer
Data demonstrates that a proactive approach to family history assessment and genetic screening will increase early detection of inherited risk. A new original investigation article published in JAMA Network Open, “Screening Familial Risk for Hereditary Breast and Ovarian Cancer,” by authors from University of Nevada, Reno School of Medicine, Renown Health and Helix for the Healthy Nevada Project® emphasizes the critical need to increase genetic screening in identifying individuals at increased risk of breast and ovarian cancer due to family history. This landmark study calls for enhanced awareness, the adoption of genetic screening practices, and, importantly, the direct screening of family history by individuals using a simple tool such as the FHS-7 questionnaire. Breast and ovarian cancers remain leading causes of cancer-related deaths, with genetic factors playing a key role in up to 10% of cases. The study authors advocate for wider adoption of screening protocols, simple family risk questionnaires and education about the benefits of genetic testing, not only for patients but also their family members who may share similar genetic risks. 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 36 women will die from breast cancer. Since 1990, breast cancer death rates have declined progressively due to advancements in screening, treatment and detection. Here in Washoe County, Nev., the age-adjusted mortality rate for 2020 (last update) is 21 deaths/100,000 females due to breast cancer, which is higher and worse than the national U.S. value of 19.6. Nevada ranks near the bottom in breast and cervical cancer deaths in women according to a recent Commonwealth Fund report. Across the U.S., approximately 1.1 percent of women will be diagnosed with ovarian cancer at some point during their lifetime. The research underscores that individuals with a family history of breast and ovarian cancer have a higher likelihood of carrying genetic mutations in genes such as BRCA1 and BRCA2, which significantly elevate their cancer risk. However, many at-risk individuals remain unaware of their genetic predispositions due to limited screening practices. Evidence suggests that “up to 80% of patients with a pathogenic or likely pathogenic (P/LP) variant in the BRCA1 and BRCA2 genes are unaware of their condition and subsequent risk for hereditary breast and ovarian cancer. Rare or less penetrant P/LP variants in genes such as PALB2, CHEK2 and ATM are even less likely to be detected. This is concerning because the lifetime risk for breast cancer exceeds 50% for women with P/LP variants in BRCA1/2 and 20% for women in P/LP variants in PALB2, CHEK2 and ATM (compared with a baseline risk of 12%).” The study also found that men with family history are just as likely to have pathogenic variants in BRCA1 and BRCA2 as women. This is important because not only are men at increased risk of breast, prostate and other cancers, these risks are passed on to daughters, nieces and other members of the family through inheritance. Men are under-represented in the Healthy Nevada Project® and other similar population health studies. Daniel Kiser, MS, lead author of the study stated, "Our work shows that family history collected during routine medical care can be evaluated using simple criteria and used to identify patients with elevated risk for inherited cancers. Because there are a number of steps that can be taken to reduce risk, both for the patient and for their family members, following up with these patients has the potential to substantially reduce mortality and the incidence of cancer." “Prevention or early detection of disease is such an important part of healthcare,” says Bill Plauth, MD, MMM, CPE, Chief Medical Officer for Renown Health and Associate Dean for Clinical Affairs at the University of Nevada, Reno School of Medicine. “The Healthy Nevada Project® is leading the way in helping Renown Health physicians and clinicians assess family history risk of breast and ovarian cancer syndrome. This in turn, enables us to provide our at-risk patients the best available tools for prevention or to catch cancer at an earlier stage, which affords less aggressive treatment options with significantly improved survival.” The study found that routine genetic screening for individuals with a strong family history of these cancers could lead to more personalized and effective healthcare strategies, including preventative surgeries, increased surveillance, or early interventions. It also highlights the gap in awareness and access to genetic testing, particularly in underserved populations. “One of the lessons from our work is the importance of assessing family history early and often in the healthcare journey of patients,” says Joseph Grzymski, PhD, Chief Genomics Officer of Renown Health, the Principal Investigator of the Healthy Nevada Project, and a faculty member in the Department of Internal Medicine at the University of Nevada, Reno School of Medicine. “We recommend that everyone get screened for CDC Tier 1 conditions but particularly, when family history indicates risks, genetic screening is a powerful tool for risk stratification.” Key Recommendations from the Study Authors Include: Increased Engagement of Patients with Physicians: People with a family history should discuss their history with their primary care physician or health care provider and request a genetic screening. This proactive approach to prevention will save lives. Increased Access to Genetic Testing: The need for more accessible and affordable testing options, like the no-cost screening provided by the Healthy Nevada Project®, particularly for those with a family history of breast or ovarian cancer. Increased Pre-Screening and Genetic Counseling: Providing patients with the necessary counseling to understand the implications of genetic mutations and guide their healthcare decisions. Pre-screening patients with either a personal or family history of cancer with one of several simple family history tools, such as the FHS-7 Questionnaire to determine whether they should be referred for genetic services would also help increase early identification and reduce costs. As of January 2024, the Healthy Nevada Project® had notified 330 individuals with P/LP variants in BRCA1 or BRCA2 genes of their genetic risk, of a study population of more than 53,000 patients. The Healthy Nevada Project®, powered by Renown Health and University of Nevada, Reno School of Medicine, is one of the largest genomic studies in the United States. The genomic study is at no-cost for Nevadans and gives participants insight into different genetic traits, as well as results on their predisposition for three prevalent and serious health conditions known as the CDC Tier 1 conditions because of their significant potential to positively impact public health. Study authors include University of Nevada, Reno School of Medicine, (Daniel Kiser, MS; Gai Elhanhan, MD Iva Neveux, MS; William J. Metcalf, MS; Catherine McCarthy, MD; Leslie A. Greenberg, MD; Joseph J. Grzymski PhD); Helix, Inc. San Mateo, CA (Alexandre Bolze, PhD; Elizabeth T. Cirulli, PhD) and Renown Health, Reno (Savanna Grime, BA; Jamie M. Schnell Blitstein, APRN; William Plauth MD; Joseph J. Grzymski PhD. For more information on the study, please visit JAMA Network. For a media interview, please contact Dr. Joe Grzymski at news@renown.org. The Healthy Nevada Project®, led by Renown Institute for Health Innovation (Renown IHI) was launched in September 2016 as one of the first community-based population health studies in the United States. The study has already enrolled, consented and collected DNA from approximately 53,000 participants. Under the program, researchers and physicians are using genetics, environmental data and individual health information to empower providers with a targeted approach to personal health care and treatment, in turn improving the overall health and well-being of people in the local communities. The University of Nevada, Reno School of Medicine, Nevada’s first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Since 1969, UNR Med has trained more than 3,900 students, residents, and fellows. UNR Med continues to improve 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. 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 7,500 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. For more information, visit renown.org.