Want to decrease your dementia risk?

Posted on April 3, 2025 by drlesliegreenberg

A new studies shows that receiving the shingles vaccine may decrease dementia risk.

The New York Times reported yesterday about a study in the journal Nature that The“found that people who received the shingles vaccine were 20 percent less likely to develop dementia in the seven years afterward than those who were not vaccinated.” Other studies like this have been done and found a decreased dementia risk, but this study was able to rule out “other dementia-protective characteristics, like healthier lifestyles, better diets or more years of education.” These results “provide some of the strongest evidence yet that some viral infections can have effects on brain function years later and that preventing them can help stave off cognitive decline.”

We suggest that shingles vaccines be given at age 50. Shingrix is a 2-vaccine shot regimen with the two doses being given 2 months or more apart. I have seen two memorable patients over my 30 years of doctoring who both had postherpetic neuralgia (after-shingles-nerve-pain) and when they would see me for unrelated issues. They would periodically jump in their seat due to zinging pain in the dermatome that their shingles rash was present years before. Consequently, the week I turned 50 I got my first shingrix vaccine. It is true that you may feel “flu-ish” the day after the shingrix vaccine. But, I urge you to not wait until you have an unencumbered 3-day weekend to get the shingles vaccine. Life happens, time gets away from us. And, not getting the shingrix vaccine may mean that you get shingles before you are vaccinated (as I have seen this scenario countless times).

In this study it “tracked people in Wales who were around 80 when receiving the world’s first-generation shingles vaccine over a decade ago.” So, this study does not specifically address what is the rate of dementia when patients get the shingles vaccine at age 50, but I can appreciate that viral illnesses may increase the strain on the brain and decrease its ability to cognitively function as we age.

​FamilyDoctor.org emphasizes that the best way to prevent shingles is through vaccination. They recommend vaccinating children against chickenpox to reduce their risk, as shingles can only occur in individuals who have previously had chickenpox. ​

The Centers for Disease Control and Prevention (CDC) recommends Shingrix for adults aged 50 and older, as well as for immunocompromised individuals aged 19 and above. Shingrix has been shown to be over 90% effective in preventing shingles and its complications.

I hope this helps.

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States Simplify Licensing for Foreign-Trained Doctors

Posted on March 4, 2025 by drlesliegreenberg

States Ease Licensing Requirements For Foreign-Trained Physicians To Ease Staff Shortages

I read this morning in my family medicine update email that per KFF Health News (3/3, Zionts) reports, “A growing number of states have made it easier for doctors who trained in other countries to get medical licenses, a shift supporters say could ease physician shortages in rural areas.”

Since 2023, at least nine states, including Florida and Illinois, have eliminated the requirement for these doctors to repeat residency training in the US. Supporters argue this change could help meet health care needs, while opponents “worry about patient safety and doubt the licensing change will ease the doctor shortage.”

The Federation of State Medical Boards and other health organizations “published its recommendations to help lawmakers and medical boards make sure these new pathways are safe and effective.”

As a medical educator, Annually, I recruit and train 8 family medicine physicians in Reno, Nevada. But, more than 8 per year locally leave medicine (retire, die, move away) and we are seemingly not making any headway.

Indeed, we do have a physician shortage in the US which is being filled (or not filled at all!) with mid-level providers (nurse practitioners and physician assistants). Foreign-trained physicians offer more extensive training and may come to the US with years (or decades!) of medical experience. This is an interesting solution to a worsening medical environment in the US. I will follow along…

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I am starting a menopause clinic!

Posted on February 19, 2025 by drlesliegreenberg

I was tasked with making a brochure to market the new clinic. This new venture has come with lots of new experiences for me: passing the Menopause certification test, winning over “stakeholders,” making a business plan, teaching residents and medical students about menopause treatment, and making informational materials and brochures.

Here’s my rough-draft of the brochure.

Renown University Health Menopause Clinic: Personalized Care for Your Menopause Journey

Are you experiencing symptoms of perimenopause or menopause? You’re not alone—millions of women experience this natural transition, but everyone is unique. That’s why Renown University Health Menopause Clinic is here to offer expert, compassionate, and personalized care to support you every step of the way.

Meet Dr. Leslie Greenberg

Leading our clinic is Leslie Greenberg MD, a highly experienced physician dedicated to helping women navigate menopause with confidence and comfort.

  • Board-Certified Family Physician with 30 years of experience
  • Certified by the Menopause Society
  • Personally sees every patient to ensure individualized care

Common Symptoms We Help Manage

  • Hot flashes and night sweats
  • Mood changes and anxiety
  • Sleep disturbances
  • Vaginal dryness and discomfort
  • Weight gain and metabolism changes
  • Decreased libido

No matter what symptoms you’re facing, we offer evidence-based treatments to help you feel your best.

Why Choose Renown’s University Health Menopause Clinic?

  • Expert Care: Specialized treatments based on the latest research
  • Personalized Approach: Every care plan is designed just for you
  • Comfortable Environment: A supportive, patient-centered experience

Location & Contact Information

University Health Family Medicine Office
745 West Moana Lane, Reno, NV

Schedule Your Appointment Today!
Call 775-657-2014 to book a consultation with Dr. Leslie Greenberg and take the first step toward a healthier, more comfortable menopause journey.

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The flu is not over for this year!

Posted on February 12, 2025 by drlesliegreenberg

How to Avoid Influenza: Expert-Backed Prevention Strategies

I have seen a lot of flu in the hospital and in the office this week. This seems LATE to me…and yet it is true. Influenza (flu) season is in full swing, but the good news is that there are proven ways to protect yourself and others. According to the American Academy of Family Physicians (AAFP) and the Centers for Disease Control and Prevention (CDC), the most effective way to prevent the flu is through vaccination. I suggest getting vaccinated every fall in October.

However, other important measures such as proper hand hygiene, staying home when sick, and wearing a mask can also significantly reduce the spread of the virus. Here’s what you need to know to stay healthy this flu season.

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1. Get Your Flu Vaccine – It’s Not Too Late!

The CDC and AAFP strongly recommend that everyone (even during pregnancy!) aged 6 months and older receive an annual flu vaccine. Even if flu season has already started, getting vaccinated now can still protect you for the remainder of the season, which can last well into the spring. The flu shot reduces the risk of severe illness, hospitalizations, and complications, particularly in high-risk groups such as young children, the elderly, pregnant individuals, and those with chronic health conditions.

Some people worry that the flu shot might give them the flu, but this is a myth. The vaccine is made from inactivated or weakened virus components that cannot cause the flu. Side effects, if any, are usually mild and temporary, such as soreness at the injection site or a slight fever.

2. Wash Your Hands Often

One of the easiest and most effective ways to prevent the flu is frequent handwashing. The flu virus spreads through droplets from coughing, sneezing, or touching contaminated surfaces. The CDC recommends washing hands with soap and water for at least 20 seconds, especially:

  • Before eating
  • After coughing or sneezing
  • After using the restroom
  • After touching shared surfaces such as doorknobs, phones, and public transportation handrails

If soap and water aren’t available, use an alcohol-based hand sanitizer with at least 60% alcohol.

3. Stay Home If You Feel Sick

One of the biggest contributors to flu spread is going to work, school, or public places while sick. The CDC advises that people with the flu stay home for at least 24 hours after their fever has gone (without the use of fever-reducing medication). This helps prevent spreading the virus to others, especially those who may be more vulnerable to severe illness.

Encourage workplaces and schools to support sick leave policies that allow people to recover at home without pressure to return too soon.

4. Wear a Mask in High-Risk Settings

Masks have become a familiar tool in reducing respiratory illness transmission. If you are feeling unwell, wearing a mask can prevent you from spreading the flu to others. In crowded areas such as public transportation, hospitals, or during flu outbreaks, wearing a mask can add an extra layer of protection, particularly for those at higher risk.

Final Thoughts

Influenza is highly contagious, but by following these expert-recommended prevention strategies, you can reduce your risk and help protect those around you. The flu vaccine remains the most powerful tool in flu prevention, and it’s not too late to get vaccinated. Combine vaccination with good hygiene, staying home when sick, and wearing a mask when necessary to navigate flu season as safely as possible.

For more information, visit the CDC website. Stay healthy and flu-free!

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Shigellosis outbreak in Northern Nevada

Posted on December 24, 2024 by drlesliegreenberg

A recent email sent to Northern Nevada physicians outlines a shigellosis outbreak in Northern Nevada.


NNPH Identifies Shigellosis Outbreak
Shigella is a bacterium that causes diarrhea and other symptoms resulting in the disease known as Shigellosis – see prevention tips   Dec. 20, 2024. Reno, Sparks, Nev. – Northern Nevada Public Health (NNPH) has identified a Shigellosis outbreak after an influx of new cases and hospitalizations were reported.

Since late October, at least 14 cases and nine hospitalizations were reported, although the actual number of cases is expected to be much higher. Based on Nevada State Public Health Laboratory analysis and epidemiologic investigation, greater than 50 percent of the Shigellosis cases were among individuals experiencing homelessness. There is currently a low risk of transmission to the public at large.

As a result of this increase, NNPH is working to educate people about the risks of infection and prevention measures. NNPH staff are working with several agencies who serve or work with affected populations to mitigate the outbreak.

Shigellosis (pronounced “shih-guh-low-suhs”) is an intestinal (bowel) infection that causes diarrhea (sometimes bloody), fever, stomach pain, and the feeling of the need to pass a stool (poop) even when the bowels are empty. If you think you might have Shigellosis, contact your doctor or other healthcare provider.

Shigellosis can be spread by coming into contact with the poop of an infected person, eating or drinking contaminated food or water, or through sexual contact (oral, hand, anus).

According to the Centers for Disease Control and Prevention (CDC), Shigellosis can be difficult to treat. Prevention is critical to reducing the spread of the infection, which includes: Hand Hygiene: Wash hands frequently with soap and water for at least 20 seconds after using the toilet, before preparing food, and after caring for a sick person.Avoid Food Preparation and Recreational Water: If you think you have Shigellosis or come into contact with it, do not prepare or share food with others, and avoid swimming in pools, lakes, or other recreational water sources while symptomatic and for at least two weeks after recovery.Safe Sex Practices: Refrain from sexual activity (vaginal, anal, oral) during illness and for two weeks following recovery. Safe sexual practices include using barriers like condoms or dental dams and washing hands after touching used barriers. Sex toys should be washed before and after use with soap and water.Stay Home from Work or School: Avoid work (especially in food service, healthcare, or childcare), school, or daycare until cleared by public health authorities. Individuals experiencing symptoms are encouraged to seek medical care.

NNPH has created flyers to help educate people in the community. Download English FlyerDownload Spanish Flyer Healthcare providers can find more information at this CDC link.
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Please note the Washoe County Health District changed its name to Northern Nevada Public Health on Aug. 31, 2023. More information is here.
 
Northern Nevada Public Health (NNPH) is nationally accredited by the Public Health Accreditation Board and has jurisdiction over all public health matters in Reno, Sparks, and Washoe County through the policy-making District Board of Health. NNPH consists of five divisions: Administrative Health Services, Air Quality Management, Community and Clinical Health Services, Environmental Health Services and Epidemiology & Public Health Preparedness. More info can be found here.
    Learn More about NNPH
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Pertussis is rampant!

Posted on November 5, 2024 by drlesliegreenberg

Pertussis is rampant!

Are you up to date on the Tdap vaccine?  The “p” of this vaccine stands for pertussis.  Pertussis is also known as whopping cough. 

The Washington Post recently stated that there are five times as many pertussis cases mid-October 2024 as compared to October 2023. 

The CDC guidelines are for DTaP to be given to children and Tdap to be given to adults.  DTAP is a 5-dose series (age 2 months, 4 months, 6 months, 15 months and 4-6 years of age).

TdaP is given at age 12 and then “once as an adult.”  Other caveats for TdaP as an adult are all pregnant persons should have one dose  in the early part of gestational weeks 27-36 or for those who have exposure to newborns.

When I was pregnant with our third child, my husband contracted pertussis.  He was treated with appropriate antibiotics and yet he whooped (coughed until he has NO air left in his lungs and then made a whooping sound as he filled his lungs back up with air) for 6 months.  He was miserable, even though he was no longer infectious or contagious.  I urge you to ask your primary care physician if you are due for a Tdap booster.

I hope this helps.

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Do you want a non-hormonal medication to treat hot flashes and night sweats?

Posted on October 7, 2024 by drlesliegreenberg

Do you want a non-hormonal medication to treat hot flashes and night sweats? 

Veozah (fezolinetant) is an FDA-approved non-hormonal medication to treat moderate to severe hot flashes and night sweats.  

Hot flashes and night sweats are common, and often overwhelming, symptoms of perimenopause and menopause. Fezolinetant is a daily oral pill.

The main safety concern with fezolinetant is its effect on liver function.  It should not be taken for people with cirrhosis or severe kidney impairment.

Fezolinetant is well-tolerated.  1-2% of patients may have abdominal pain, diarrhea, back pain or insomnia.  Fezolinetant has not been studied head-to-head with menopausal hormonal therapy and is thought to be less effective in treating hot flashes or night sweats than estrogen.  Fezolinetant does not affect bone density or treat vaginal dryness.  The cost of fezolinetant without insurance can cost $540/month. 

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Flu vaccines decrease hospitalizations!

Posted on October 4, 2024 by drlesliegreenberg

Flu vaccines decrease hospitalizations!

Why should you get the flu vaccine now?  One humanitarian answer would be that we live on this planet with others and we should look out for one another.  But, the selfish reason would be that it significantly decreases your risk of being hospitalized with influenza.

Who can get the vaccine? Anyone 6 months of age and older. (Persons with an egg allergy can receive any influenza vaccine (egg-based and non-egg-based) appropriate for age and health status.)

A Centers for Disease Control and Prevention (CDC) study showed that this year’s flu vaccine  reduced the risk of hospitalization from fly by 35% in five Southern Hemisphere countries. 

This decrease of 35% is less than the nearly 52% decrease in hospitalization of last year’s flu vaccine. 

I got my flu vaccine last week and had no side effects from the vaccine. 

If you would like to decrease your risk of being sick enough to need to spend the night in the hospital, decrease your risk of altering your life because you feel ill, and want to help not spread influenza to your community, I urge you to get the influenza vaccine. 

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Over-the-counter hearing aids

Posted on September 16, 2024 by drlesliegreenberg

Hearing loss is associated with depression, disability, social isolation, unmet medical needs and geriatric frailty. Most patients are aware of 10 years of hearing loss before hearing aids are used.  If you are having symptoms, let your physician know so that they can help you get the care you need.

When can hearing loss be suspected?

  • Asking others to speak louder/ slower/ more clearly/ repeat what was said
  • Feeling fatigued with prolonged listening
  • Difficulty hearing in a group/noisy area/on the phone
  • Difficulty hearing loud sounds or difficulty hearing speech in quiet places

What are warning symptoms that require additional evaluation?

  • Asymmetric hearing loss
  • Feeling of blockage of the ear canal
  • History of excessive ear wax
  • New onset of ringing
  • New sensation of dizziness or vertigo
  • Pain or discomfort in the ear
  • Sudden hearing loss or acute worsening of chronic hearing loss

There are prescription and over-the-counter hearing aids.  Audiologists are the specialists who advise the choice of hearing aid type and style. Prescription hearing aids are an expensive option and may cost $1,000 to $6000 out of pocket.

Over the counter hearing aids include preset and self-fitting and assorted styles.  There are in-the-ear aids and behind-the-ear styles. The behind-the ear style often has a better sound quality and filters background noise more effectively. There is also a self-fitting OTC device. 

I hope this helps.

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FREE Skin Cancer Screening in Reno

Posted on April 26, 2024 by drlesliegreenberg
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