Hello Reno Families!

This is Leslie Greenberg.  I am a family medicine doctor in Reno, Nevada.  I attended University of Nevada School of Medicine and have recently relocated back in my hometown.  I trained and practiced medicine in the Midwest (Indiana and Kansas) for 20 years before moving back West.  I consider myself a teacher and educator.  I  have  taught family medicine residents for 18 years.  I currently teach at the family medicine residency program in Reno and also see private patients.  I invite you to read my blog.  If you would like to become a patient, please call 775-682-8200.

Medical Disclaimer

Please remember that medical information provided by myself, in the absence of a visit with a health care professional, must be considered an educational service only.  This blog should not be relied upon as a medical judgement and does not replace a physician’s independent judgement about the appropriateness or risks of a procedure or condition for a given patient.  I will do my best to provide you with information that may help you make your own health care decisions.

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Posted in Uncategorized

This is a powerful read. Assault weapons are a medical problem.

This is a powerful read.  Assault weapons are a medical problem.  Read on to appreciate the “smashed melon…”

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https://www.theatlantic.com/politics/archive/2018/02/what-i-saw-treating-the-victims-from-parkland-should-change-the-debate-on-guns/553937/

Posted in General Medicine- Adults, Uncategorized | Tagged , , , , , , , , , , , , , , ,

Are you a woman concerned about breast cancer?

Are you a woman concerned about breast cancer?  There is a fantastic online tool to help you figure out your risk of having breast cancer.

mammo breast CA

http://www.vhct.org breast cancer

https://www.cancer.gov/bcrisktool/

 

Posted in Cancer, General Medicine- Adults, Uncategorized | Tagged , , , , , , , , , ,

What kind of doctor is your “doctor?”

What kind of doctor is your “doctor?”  I recently talked to a girlfriend who saw a practitioner but did not know their schooling or specialty.

You should care about and KNOW what kind of medical professional you are seeing.  Do you?  Here is a great article to help you know more about WHO you see and  what their skill set is.

img_0851Get involved in your care.

https://mydoctorfriend.wordpress.com/2018/02/12/what-kind-of-doctor-is-your-doctor/#more-239

Posted in General Medicine- Adults, Uncategorized | Tagged , , , , , , , , , , ,

Peanut allergies in infants

Peanut allergies in infants.  The New England Journal of Medicine published an update on peanut allergies in infants and what to do to decrease them.

Did you know?

  • 2% of US children have a peanut allergy
  • Peanut allergy is the leading cause of death from food-induced anaphylaxis in the US.
  • Risk of developing peanut allergy is significantly higher among Jewish children living in the UK compared with Jewish children living in Israel (UK children typically do not ingest peanuts until after one year of age and Israeli children do).   This observation helped brainstorm the following study…

A unique study, called the Learning Early about Peanut Allergy (LEAP) was conducted in children from 4 to 11 months with severe eczema, egg allergy or both.  The study lasted until age 5.  The prevalence of peanut allergy was 17.2% in those who AVOIDED peanuts and 3.2% among those who CONSUMED peanuts.

This study helped shape the guidelines that the National Institute of Allergy and Infectious Diseases (NIAID) made in 2017 that infants with severe eczema, egg allergy or both should consider peanut-specific immunoglobulin E measurement and/or skin prick test.  Then, based on the test result, introduce age-appropriate peanut-containing foods as early as 4 to 6 months to REDUCE peanut allergy risk.  For infants with no eczema or food allergies, they may have peanut-containing foods introduced at any age in accordance with “family and cultural preferences.”

I hope this helps.peanut

Posted in allergies, Pediatrics, Uncategorized | Tagged , , , , , , , , , ,

Insurance company Medical director admits that denials made without looking at the patient’s chart?!

Insurance company Medical director admits that denials made without looking at the chart?!

Interesting. And upsetting. If you, as a patient, have been denied imaging, testing, specialty referral…. there’s a chance it’s been denied without your case ever being reviewed.

Read on….

https://www.cnn.com/2018/02/11/health/aetna-california-investigation/index.html

Posted in Uncategorized

Acne: how to manage this age-old problem.

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Acne:  how to manage this age-old problem.  The American Academy of Dermatology updated their acne care guidelines.  Here is a synopsis…

Overall:

  • 40 million Americans have acne.
  • 74% of adolescents experience acne
  • Nearly 20% of adult women have acne.

What to do first?  Topical over-the-counter preparations like benzoyl peroxde and salicylic acid are recommended for intial control and maintenance of acne.  These are both inexpensive and available in a variety of preparations and strengths.  Beyond that clindamycin 1% solution or gel is the preferred topical antibiotic (as it is more effective than erythromycin and acne bacteria is less resistant to clindamycin).

If you need more help, then consider systemic (oral) antibiotics.  Doxycycline and minocycline are more effective than tetracycline.  Erythromycin should be restricted because of increased risk of bacterial resistance to this antibiotic.  Systemic antibiotic use should only be used for 3-4 months to decrease the risk of antibiotic resistance.

Do birth control pills work?  For females, there are four combination oral contraceptive pills that have been approved by the Food and Drug Administration (FDA) for management of acne.

Is there a pill to help women with acne and polycystic ovary syndrome?  Yes!  Spironolactone which is a “water-pill” also greatly helps with acne.

What about Accutane?  Yes.  This is still available.  This is usually prescribed by dermatologists as there is an”iPLEDGE risk management program”that is stringent and needs for extra testing and contraception usage to use Accutane.  Accutane is an oral isotretinoin that is known to cause fetal anomalies/malformations and so extra strict programs need to be in place to help decrease this risk.

Do diet changes help decrease acne? No.

I hope this helps.

Posted in Dermatology, Dermatology, General Medicine- Adults, Pediatrics, Uncategorized, Women's Health | Tagged , , , , , , , , , , ,

Children liquid medication dosing errors. What should you do?

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flickr.com/photos/mattallworth/3924392510

Children liquid medication dosing errors.  What should you do?

In 2015, the American Academy of Pediatrics published a recommendation that metric-based dosing for all orally administered liquids be used with a tool with standard markings.  This is because children often receive liquid medication from medicine cups, teaspoons or tablespoons and that these doses are often wrong.  84% of parents made one or more dosing errors.

What is the best way to avoid giving the wrong dose of medication?  Affix colored tape to a syringe at the appropriate dosing level for that child on that medication.  This will help make the right dose be more visually apparent.

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