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Located on the 5th floor of the Tahoe Tower, Renown’s newly updated Level III Neonatal Intensive Care Unit (NICU) is decorated with colorful artwork on the walls, the lights dim for the newborns resting, and parents conversing next to the bassinet with nurses on their baby’s journey to health. In the quiet, shuffling hallways stands Mariah DaSilva, a Renown NICU Nurse, whose own birth story showed her true compassion and professional dedication to what it means to care for the tiniest and most vulnerable patients. From the Medical Floor to the NICU Mariah started her nursing career on the medical floor at Renown; however, after a year, she was excited to see her dream job open in the NICU and helping to provide compassionate care for the most fragile patients. “I’ve always known that I wanted to work with babies so being a NICU nurse was a dream of mine,” said Mariah. “I truly love what I do, and I can’t imagine being anywhere else than the NICU.” A high-stakes environment, the NICU is where babies are transferred to after birth when they require medical intervention. They care for babies as young as 23 weeks gestation, up to full-term babies. Any babies born less than 35 weeks are automatically admitted into the NICU for treatment. Other than prematurity, babies can be admitted to the NICU for respiratory distress, low blood sugar (hypoglycemia), cardiac anomalies, birth defects, seizures and other medical conditions that need treatment or assessment. A Day in the NICU: The Heart of Care A typical day for Mariah starts with reviewing her assignments and receiving a detailed report from the night shift. Preparing for the day involves scrubbing in and wiping down patient care areas to maintain a clean environment. Once everything is set, she begins a series of scheduled care tasks, which include performing assessments, feeding, changing diapers and facilitating parent involvement in their baby’s care “There are so many exciting ‘firsts’ that happen in the NICU; parents holding their baby for the first time, parents' first time changing their baby’s diaper, bathing their baby for the first time, first time breast-feeding or bottle-feeding, the baby’s first time taking a full bottle, watching a baby breathe on their own without any respiratory support, etc.,” said Mariah. “There are so many big milestones that happen in the NICU that I am so incredibly lucky to be a part of.” The NICU nurses work closely with neonatologists, nurse practitioners, respiratory therapists, speech therapists, physical therapists, occupational therapists and other specialists to deliver comprehensive care. This teamwork and collaboration ensure that each baby receives the best care possible for their health journey. Mariah shared a reflection on her team: “Our NICU team is amazing. Being a part of a team that is so compassionate and collaborative is amazing. We all work closely together to ensure we’re providing the best care possible for every single baby that comes to the NICU. We are all very protective of the babies that we care for in the NICU and truly want the best outcomes for them and their families. Taking care of such a vulnerable population comes with a lot of responsibility and we take pride in what we do each day.” As with all healthcare professionals, NICU nurses require immense strength and compassion to care for the youngest patients in a highly sensitive environment. “More often than not, we have really good days in the NICU, but we also have really hard days that affect every single person in the NICU,” said Mariah. “The loss of a baby, delivering bad news to a parent, an extended NICU stay and a baby withdrawing from drugs are all situations that we unfortunately deal with in the NICU. These situations are all very challenging, but we have to stay strong for the babies and their families.”

Read More About From Renown NICU Nurse to NICU Mom: Mariah DaSilva’s Inspiring Journey

In the fast-paced world of healthcare, productivity is always a focus. Care teams need accurate and timely information to make decisions that directly impact our patients. However, without a reliable system to analyze and deliver complex data, noticing areas for improvement and making impactful changes can become overwhelming. This is where the power of data and analytics comes into play.  Renown Health’s Enterprise Data & Analytics (EDA) department are the leaders of this transformation. This team cares for the caregiver by delivering key data and insights with thorough analytics. Their data-driven approach ensures we are moving towards consistent progress and excellence in patient care, creating a better healthcare experience for everyone.  Dedicated Data Deliverers From patient volumes to quality-of-care metrics, our EDA department drives a lot of decisions that directly affect our patients and caregivers. A day-in-the-life as an EDA team member is where creativity meets science.  “Data is the lifeblood of the department and my role,” said Clayton Pettit, Senior Data Analyst. “Every day, I'm working with data – figuring out how to get certain pieces of data, visualizing it to provide users with clear insights and helping users of the data glean those insights and analyze the data.”  “We are builders of data tools, collaborating with team members and IT teams,” added Michelle Ebesu, Data Analyst. “We problem solve and design the most efficient way to deliver data. We work on large projects, small report requests and answer reporting related questions. We investigate and research daily.”  According to this team, every day brings a blend of exploration, engagement and discovery. Their role within our health system is central to turning data into useful ideas that drive meaningful change for all.  “A day on the Enterprise Data & Analytics team involves responding to diverse requests, some well-defined and others more open-ended, requiring exploratory collaboration with stakeholders,” said Kevin Crofton, Senior Data Analyst. “We harness the vast institutional knowledge within our organization to inform our analytics projects. This collaborative approach not only enhances our insights but also extends their impact across various groups within the organization.”  “Each day in EDA is fast paced,” added Ryan Fernandez, Manager of Data Analytics. “Our days are filled with a variety of different tasks ranging from data wrangling, building visualization to tell a meaningful story, responding to urgent business questions with analysis, training other team members on how to use analytical tools, and constantly learning more about the different clinical service lines and how to interpret their data.”  No two days are the same in EDA. In fact, every day brings a new challenge. And the best part? They’re never alone. This team thrives on working together, emulating Renown’s cultural commitment of Collaboration to a tee.  “Every day is different,” said Susan McDonald, Senior Data Analyst. “On larger projects we collaborate together, with each person taking a piece. We'll meet daily to gauge progress, exchange ideas and assist each other when needed. We'll sometimes have to troubleshoot issues that may come up with some reports. We often meet with our end users to get further details on their needs or to present their requested reports.”  “Up until the last couple of months, my day-to-day was creating, updating and fixing reports for all aspects of Hometown Health,” added Ryan Zinck, Data Analyst. “For the past two months we have begun the development of what will be an extensive reporting system in PowerBI that's intended to serve most groups within the company.”  Working with digital healthcare information that impacts how a health system operates and makes needed improvements can be complicated, since information is entered in various ways like calculations, statistics or measurements. Susan McDonald said it best: “It’s like solving puzzles every day.”   “We are Business Intelligence,” said Michele Warner, Data Analyst. “We answer questions the business proposes. We write queries and design reports/dashboards. We dig into the tables that store the data that is input by everyone at Renown through EPIC and other applications. We tell a story that will help the business be more efficient, make better decisions, solve a problem or report to government agencies.”  “We dive deeper into the front-end data and analyze it to get more detailed information and insights regarding the performance and certain project,” added Boqun Yin, Data Analyst. “Then, our colleagues working at the front line can utilize it when making strategic business decisions.”  EDA takes the definition of trendsetting to a whole new level. With the unique ability to predict future trends, this department can provide crucial information that helps care teams on the floor care for their patients to the best of their ability today, tomorrow and forever.  “I deliver data on all sorts of topics for Renown,” said Clayton Pettit. “With this data, I help Renown see where we are and where we need to improve. Beyond that, the data I provide can help us see how we can improve, what things we need to focus on and processes we need to change.”  “Our organization needs up to date robust data to ensure quality and integrity so that it’s reliable, secure and accurate,” added Uriel Duran, Data Engineer. “We also provide analytics and insights that can provide/predict patient outcomes and trends. For our patients, improving patient care is critical – and that can be done with data.”  Making Your Lives Easier As stated by Brian, Howell, Manager of Data Engineering, “we’re here to make everyone’s lives easier.” And Brian is exactly right – the EDA department’s work impacts the people who care for patients. Their data analysis and engineering skills help our care teams answer questions, give them information they can make decisions with and inform them statistically about well they are doing, along with showing opportunities for growth.  “EDA professionals like to think of themselves as the ‘wizard behind the curtain,’ a nuance from the ‘All Knowing’ Wizard of Oz; we are custodians of the company's data and we take that responsibility seriously,” said Dr. Justin Coran, Chief Analytics Officer. “When we partner with our clinical or administrative counterparts, we can help evolve decision-making from emotional to rational. The shift to rational decision-making allows the company to understand cause and effect of their business or clinical decisions.”   “I work directly with our customers on a daily basis to determine how our department can help them achieve their goals,” added Brian Howell. “I have been involved in data for over 20 years and love the technology, ever-changing landscape and challenges.”  The proof of their influence is in the numbers and the words they hear from our front-line care teams, from a significant financial impact to words of enthusiasm from providers. This reinforcement encourages the EDA team to continue going above and beyond.  “My goal is to make life easier for our clinicians and staff who do provide direct care,” said Helen Bahrke, Senior Data Analyst. “I feel accomplished if my work helps other staff reduce their time spent running reports or finding the data they need. Some providers have their own research questions they are studying in their patient population. Helping them get the data they need so they can provide better and more efficient care makes me happy.”  “Though we may not be the most visible department at Renown, the work we do and content we output drives decision making at the highest level,” added Sean Gollos, Data Analyst. “We make it easier for physicians to track patients, provide key employee data to the HR department and help ensure our organization is compliant with several requirements set by our industry.”  “I have seen my work bring in millions of dollars so that Renown can provide better care where it’s needed,” added Sean Richards, Senior Data Analyst.  Both patients and providers can lean on the EDA department for support in helping unravel data that may seem complex to the everyday eye, which has a direct impact on productivity and care quality.  “We take care of those who take care of patients,” said Mark Templeton, Manager of Data Analytics. “From descriptive analytics to measurements and dashboards, we provide a lot of support to those who manage patient care and productivity.”  “Our team provides critical datasets and insights into specific medical data that informs decision making stakeholders, which indirectly impacts patient quality of care,” added Sergio Pascutiu, Senior Data Engineer.  The impact of this team’s expertise can be felt beyond the hospital floor. Renown Health Leadership relies on the EDA to deliver data that affects important decisions at the top organizational level.  “A typical day for me revolves around data integration and extract, transfer, load (ETL) operations,” said Ken Vogel, Data Engineer. “The data and reporting that we provide to our end users and Renown leadership drive the decisions that impact the organization as a whole, which in turn impacts our patients.”  “Renown Leadership has business experience and training in order to navigate the challenges and opportunities that constantly present themselves,” added Michael Jesser, EDA Project Manager. “EDA helps them test their proposals with real data. This has been the meat and potatoes for our department if you've got a question about any process then we'll find the data that helps you form a reasonable answer.”   "We provide timely information to Renown leadership so that they may optimize our operational efficiencies that allow for improved patient outcomes,” added Todd Nicholas, Data Engineer.  This team thrives on challenges. Ryan Fernandez explains it beautifully: “I love challenges and learning new things, which is what happens almost every day being an analyst in healthcare, and that is what keeps me in this industry.”  Fighting the Good Fight for Today and Tomorrow Throughout the past year, the EDA department has been hard at work with many transformative projects that have improved several processes at Renown. What many may not know is just how large of a role these team members played in several of these endeavors, from a time-keeping platform upgrade for our employees to creating a one-stop-shop data warehouse.  As one can likely imagine, many of these projects are a large source of pride for this department, and deservedly so: “I am most proud of the Renown Regional Medical Center wall board conversion project, converting the patient lists that previously displayed to an Epic dashboard that displays data that is pertinent to the staff taking care of patients. The new wall boards provide at-a-glance information requested by nursing leadership.” - Michelle Ebesu “The last 12 months within EDA has been transformational. In May 2023, the data needed to run operations was scattered across 200 source systems and files, 20,000+ SQL tables and thousands of columns of data. Led by the vision of our executives, the team onboarded the technology (Microsoft Azure) and completed the development of a foundational Enterprise Data Warehouse (EDW) within 8 months, when the process usually takes 1.5-2 years. EDA produced Renown's first in-house developed risk stratification algorithm to optimize care for our Hometown Health members and produced a brand-new state-of-the-art reporting system for primary care.” - Dr. Justin Coran  “Our team contributed to the integration with the new UKG enterprise resource planning (ERP) system which comprises of a multi-tenant integration package that sources data from the UKG system.” - Sergio Pascutiu “I'm proud of the role our department has played in migrating from Kronos to UKG. It was a project that took over a year from planning to implementation, but our team had a key role that I think really opened people's eyes to how much they rely on the data that our team maintains.” - Sean Gollos Since this team’s work involves a large collaborative effort between the clinicians and themselves, according to them, the work that our care teams do generates “a gold mine” of health services data for them to dig through and answer crucial questions to create solutions, such as “What has happened in the past?” “What is currently happening?”  While figuring out the answers to those questions that will affect the future of healthcare at Renown, one solution often comes to the forefront: artificial intelligence.  “Under the direction of our new Chief Analytics Officer, the tool sets that EDA uses will expand into machine learning and artificial intelligence (AI),” said Michael Jesser. “We'll be answering questions about what is likely to happen or what data could influence an answer that we don't normally associate with the question. This is big – and getting bigger. EDA will put Renown at the forefront of this powerful future.”  “The new data science team that will onboard in 2025 will be able to utilize AI and machine learning (ML) applications that may impact patient care directly,” added Dr. Justin Coran. “EDA is looking forward to partnering alongside our clinicians and nurses to create the future in AI / ML healthcare products.”  Virtually everyone in the EDA department was excited about a career in high tech. To make matters even better, many of them had a passion for healthcare and the non-profit world.  “My healthcare experience led me to an understanding that there was a need for someone that understood healthcare workflows in the IT field, so I joined as an Epic analyst to help design those workflows and eventually found my way onto the EDA reporting team,” said Raffi Kilejian, Data Analyst. “The work-life balance, along with the fact that I work for a non-profit that gives back to the community are my main reasons for working for Renown.”  Other team members didn’t originally intend to use their technical talents in healthcare but are glad that they ended up taking the road to Renown. From the department’s strong culture to our health system’s impact on the community, this team consistently reports enjoying the work they do every day for Renown.  “I chose to work at Renown because of its stellar reputation as a leader in community-focused healthcare and the sense that individual contributions could genuinely drive change,” said Kevin Crofton. “Although I hadn't originally planned a career in healthcare, I've found a profound synergy in this department, where multiple disciplines converge to address diverse challenges. This welcoming and collaborative atmosphere has been key to our success. My transition into healthcare has been immensely rewarding, allowing me to apply my skills in ways that meaningfully impact our community's health and well-being.”  Finding “better ways to do things,” as the EDA team puts it, transcends the backend data. That philosophy also feeds into their departmental culture, always finding ways to bring each other together and uplift one another’s accomplishments and ambitions.  “I'm proud that we've been able to bring back some former valuable Renown employees,” added Brian Howell. “It is a testament to the culture at Renown that people recognize the meaningful work we do. I love working for a healthcare organization that makes a difference in people's lives."  “I was referred to Renown by a good friend during job hunting; since I started to work for Renown, I've seen the changes and effort that the EDA leadership has put into the development of the team,” added Boqun Yin. “I am glad to be part of this journey. That's why I choose to stay.”  “Renown also offers great benefits which I have taken advantage of, such as tuition reimbursement for my online MS in Analytics program I am currently enrolled in,” added Ryan Fernandez.  As proudly stated by Michelle Ebesu, “I believe in the values we have here at Renown.” And at the end of the day, this is what matters most to all who work in EDA.  “The opportunity to drive meaningful change and contribute to a mission that goes beyond profit—to truly focus on improving people’s lives—continues to inspire and keep me deeply committed to our cause,” closes Kevin Crofton.

Read More About Department Spotlight: Enterprise Data & Analytics

Men are generally less likely to visit their doctor for exams, screenings, and consults compared to women. To address this, we've collaborated with Dr. Bonnie Ferrara of Renown Health, to compile a list of eight essential screenings that can help men maintain their health. 1. Blood Pressure Tests Ages 20+ Blood Pressure tests measure the pressure in your arteries as your heart pumps. Biennial (every two years) checks are recommended if you have normal blood pressure or more frequently if you have high blood pressure (hypertension) or low blood pressure (hypotension). The United States Preventative Services Taskforce cites normal blood pressure below 120 systolic (top number) and 80 diastolic (bottom number). 2. Cholesterol Screening Ages 20+ High levels of cholesterol increase your risk of stroke and heart disease. A simple blood test will help your healthcare provider determine your numbers and if you're at risk. If you have a family history of diabetes or heart disease, you may need yearly screenings. But, again, your doctor can provide the best course of action.

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Is a man in your life struggling with depression? Many men find it difficult to acknowledge when they need help. Recognize their unique warning signs of depression with insights from psychologist Dr. Herbert Coard. Over 6 million men are diagnosed annually, often displaying symptoms like anger and aggression instead of sadness. Learn how to support them and understand these often-misinterpreted indicators. Behavioral Signs of Depression in Men High levels of the hormone cortisol are released during stressful situations affecting the neurotransmitter, serotonin (a feel-good hormone), contributing to depression. You can identify depression or suicidal tendencies by paying close attention to the following behavioral changes: Anger, irritability, or aggression Avoiding family or social situations Losing interest in family responsibilities, passions and hobbies Lack of sex drive Becoming controlling/abusive in relationships Risk-taking behavior such as; unsafe sex, overspending or gambling Not being able to concentrate or remember details Excessive drinking or drug use Having frequent thoughts about death Talking about suicide Attempting suicide Factors That Lead to Depression in Men Life Events Work stress or long-term unemployment can be huge contributing factors relating to depression. This type of life event can be overwhelming, making it impossible for a man to cope. Changes in Relationships The loss of a relationship can be a significant contributing factor to the emergence of depressive symptoms and past experienced physical, sexual, or emotionally abusive relationships. With this in mind, counseling can often help individual to overcome this type of trauma. Grief and Loss Overwhelming sadness due to the loss of a loved one can trigger depression. Although normal, each person goes through their own grieving period. For example, normal responses to death are insomnia, poor appetite and loss of interest in activities. Pay attention if grief seems prolonged or out of the ordinary. Health Problems In particular, depression coexists with medical conditions. As men age, this can be passed off as normal aging, but it could be more serious. In addition, illnesses such as thyroid disorders, Addison’s disease and liver disease can cause depressive symptoms. Diabetes, cancer, heart disease, or Parkinson’s disease can affect any age, thus triggering or worsening depression. Some older men also feel like they may be suffering from dementia because of difficulties with memory this may be a symptom of depression. A trip to the doctor may be in order to help alleviate concern and worry. Depression in Men and Suicide Frequently the emotional pain occurring with depression can distort a man’s ability to see a solution beyond suicide. Individuals with depression become very rigid and constricted in the way they solve problems. The statistics below speak for themselves, helping us understand the need to reach out to those who need our support. Male suicide rates are on rising – men die by suicide 3.53 times more often than women, accounting for 70% of all suicides. Sadly, every day 129 men commit suicide. White males accounted for 69.67% of suicide deaths in 2017. In 2017, firearms accounted for 50.57% of all suicide deaths. Middle aged Men who are middle aged have the highest suicide rates. 40% of those identifying as transgender have attempted suicide in their lifetime. Males who are guy or transgendered are at an increased risk for suicide attempts, especially before age 25. Veterans often suffer from post-traumatic stress disorder (PTSD) and depression, and are more likely to act on a suicide plan. How You Can Help Now that you can identify some of the warning signs of depression, here’s how you can help: Talk about your concern and communicate that you’re there to help him. Let him know depression is a medical condition and will usually get better with treatment. Suggest professional help from a Primary Care Provider, Psychologist or Therapist. Help set up appointments and offer to accompany him – let him make the decision, but make it clear you’re there for him, no matter what he decides. If you feel he is in a dire or life-threatening situation, contact 911. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to talk to a trained counselor. Call the Veteran’s Crisis Line at 1-800-273-TALK (1-800-273-8255) and press “1”

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Deciding on hospice care for a loved one is a deeply personal and challenging decision, balancing their wishes and medical realities. Rebecca Edwards, DNP, from Renown Hospice Care, explains the signs indicating when it might be time for hospice and offers guidance on navigating this decision with compassion and clarity. Understanding Hospice Care  Before exploring the decision-making process, it’s crucial to have a clear understanding of what hospice means. Hospice care represents a shift in how we approach living with a terminal condition, emphasizing comfort, dignity, and quality of life above all else. When there is no longer a pathway to a cure, side effects of treatment outweigh the benefits, or someone is simply tired of frequent hospital visits, then it may be time for hospice. Hospice care is mainly done in the home, where most people wish to be. It's a compassionate, team approach to care that focuses on meeting the physical, emotional, and spiritual needs, supporting their families, and honoring individual preferences. 5 Critical Signs to Be Aware Of Decline in Overall Health: When a loved one's health continues to decline despite ongoing medical interventions, this may be a sign that these treatments are no longer effective.  Increasing Pain and Symptoms: When managing symptoms such as pain, nausea, fatigue or shortness of breath becomes increasingly challenging, hospice can offer specialized support and expertise in symptom management.  Frequent Hospitalizations: Repeated hospitalizations or emergency room visits can signify that the disease has progressed to a point where managing symptoms and providing comfort at home or in a hospice setting is a more appropriate approach.  Difficulty with Daily Activities: If your loved one is experiencing difficult with activity of daily living such as dressing, bathing, or mobility, it may be a sign that they require additional support and assistance. Prognosis of Six to 12 Months: Hospice Care is typically recommended for patients with a prognosis of about one year or less if the disease follows its normal course. However, it’s important to remember that every individual is unique and prognosis can vary.

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Obstetrician-gynecologists (OBGYNs) see patients from menses (the monthly menstrual cycle that occurs as a part of the female reproductive system), pregnancy and childbirth through menopause and play a pivotal role in managing reproductive health and overall wellness. Dr. James Alexander with Renown Women's Health explains. "As experts in women's health, we are uniquely positioned to recognize subtle changes or symptoms that might indicate broader health issues. This comprehensive approach allows us to serve as a valuable first touchpoint for various health concerns." Preventive Screenings: A Proactive Approach One key aspect is an OBGYN's ability to recommend preventive screenings based on your symptoms, age, lifestyle and medical history. For instance, lipid screenings are critical for monitoring cholesterol levels, which can be a significant factor in women’s heart disease. An OBGYN keeps up with the current guidelines for routine screening as well as in women with risk factors such as high blood pressure, diabetes, or a family history of heart disease during your visit. By identifying risks and abnormal screening early, they can collaborate with you to implement lifestyle changes or treatments to reduce your risk of heart conditions. Schedule Your Screening Appointment Make an Appointment by Phone: 775-982-5000

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Embarking on the path to bariatric surgery is a unique and deeply personal journey. Individuals like Mary Escobar choose this life-changing route for reasons ranging from improved cardiovascular health to managing diabetes or finding relief from various health complications. In Mary's case, her two-decade-long healthcare journey not only underscores the challenges she faced but also highlights the support and expertise that ultimately led to her successful transformation through bariatric surgery. Mary's Resilience: December 2002 through February 2003 More than two decades ago, Mary experienced unforeseen health complications just days after giving birth via c-section. Septic shock, hemolytic uremic syndrome, thrombocytopenia, renal failure and a blood clot in her lung plunged her into a critical state. Intensive care, plasma exchange and a long recovery followed. After being discharged with compromised kidney function, Mary faced complete renal failure two years later, leading to dialysis and a spot on the donor list. Mary's brother, a perfect match, selflessly donated his kidney on Dec. 14, 2007, marking a turning point in Mary's health. However, the post-transplant period brought new challenges, including diabetes, high blood pressure and a significant weight gain, reaching 230 pounds. Determined to regain control, Mary explored various diets without success until she consulted with a bariatric doctor. Journey to Bariatric Surgery: November 2009 - April 2021 In November 2009, Mary opted for a gastric band, shedding 40 pounds within a year. Despite initial success, issues with the gastric band arose, prompting a consultation with Dr. John Ganser at Renown Health in April 2021. Together, they decided to transition to a gastric sleeve, with comprehensive education provided to ensure long-term success.

Read More About A Transformative Journey: Mary's Bariatric Surgery Story at Renown Health

Dr. Carilyn Hoffman with Renown's Women's Health explains the symptoms, causes and treatments of Polycystic Ovary Syndrome (PCOS) (also referred to as Polycystic Ovarian Disease (PCOD)), a prevalent condition among women of reproductive age that influences hormonal balance, metabolism and fertility. Make an appointment with Renown Women's Health Click here to schedule Call to schedule: 775-982-5000 PCOS Defined PCOS is a constellation of symptoms characterized by two of the three criteria: multiple small cysts on the ovaries visible via ultrasound, irregular periods and signs of hyperandrogenism. Other symptoms include infertility, insulin resistance, and increased risk of cardiovascular disease. Symptoms of PCOS The symptoms of PCOS can vary from woman to woman, but some of the most common include: Irregular menstrual cycles: This is often one of the first signs of PCOS. Women may experience fewer than nine periods a year, more than 35 days between periods, frequent spotting, and/or abnormally heavy periods. Excess androgen levels: High levels of male hormones may result in physical signs such as excess facial and body hair (hirsutism), severe acne and male-pattern baldness. Polycystic ovaries: Enlarged ovaries containing numerous small cysts can be detected via ultrasound.     Causes and Risk Factors The exact cause of PCOS is unknown, but several factors may play a role: Genetic predisposition: A family history of PCOS increases the risk. Insulin resistance: High insulin levels might increase androgen production, causing difficulty with ovulation. Obesity: Women with elevated BMI’s are more likely to have PCOS, although 20% of women with PCOS are not obese. Diagnosis and Treatment Dr. Hoffman outlines that diagnosing PCOS requires a medical history review, a physical exam, blood work and an ultrasound to evaluate the ovaries. Treatment options can range from lifestyle modifications, like diet and exercise and weight loss, to medications for menstrual regulation, fertility assistance, and rarely surgery. Lifestyle Changes A healthy lifestyle is a cornerstone of managing PCOS. Regular exercise, a nutritious diet, and weight management can help reduce symptoms and the risk of long-term health issues. In overweight patients, weight loss as little as 5% has been shown to improve symptoms of PCOS. Medication Medications may include hormonal contraceptives to regulate menstrual cycles, anti-androgens to reduce hair growth and acne, and Metformin to address insulin resistance. Fertility Treatment For women with PCOS who are trying to conceive, ovulation induction with clomiphene or letrozole is sometimes necessary. Sometimes a referral to a reproductive endocrinologist and infertility specialist is needed for more advanced technologies like IVF. Health Implications PCOS is not just about cystic ovaries or irregular periods; it can have profound implications on a woman's overall health. Women with PCOS are at an increased risk for several conditions, including type 2 diabetes, high blood pressure, heart disease, and endometrial cancer.

Read More About What is Polycystic Ovary Syndrome (PCOS)?

According to the American Cancer Society, approximately 13,820 new cases of invasive cervical cancer will be diagnosed, and 4,360 women will die from cervical cancer. However, cervical cancer is preventable with regular screening tests and the HPV vaccine. It’s important to note that medical advances have allowed progress in diagnosing and treating cervical cancer. While it used to be one of the most common causes of cancer death for American women, the incidence of death has significantly declined. What to Know About the HPV Vaccine HPV vaccination is the best way to prevent cervical cancer and is recommended for all youth starting as early as age 9, or for teens and adults up to age 45 who didn’t start or finish the series. In Nevada, only 50.1% of teens ages 13-17 have been vaccinated for HPV.  There are 13 types of HPV, and the vaccine Gardasil 9 protects against 9 of those HPV strains, greatly reducing the incidence of cervical cancer among vaccinated individuals. What to Know About Cervical Cancer Screenings The CDC says the most important thing you can do to help prevent cervical cancer is to have regular screening tests starting at age 21. And there are two common tests that can detect early stages of cervical cancer (or precancer) and improve health outcomes. The pap test (or pap smear). This screening looks for precancers. Women should begin getting pap smears when they’re 21. The human papillomavirus (HPV) test looks for the virus that can cause these cell changes. Cervical Cancer Screening Schedule The American Cancer Society offers the following guidelines for screenings: All women should begin cervical cancer screening at 21. Women between 21 and 29 should have a pap test every three years. Beginning at 30, the preferred way to screen is with a pap test combined with an HPV test every five years. This is called co-testing and should continue until age 65. A pap test (or pap smear) is performed during a regular screening appointment to look for precancers, cell changes on the cervix that might become cervical cancer if they are not evaluated or appropriately treated. Typically outpatient procedures can reduce the risk of long-term health impacts that prevent pre-cancerous cells from becoming cancer cells. Women over 65 who have had regular screenings in the previous ten years should stop cervical cancer screening as long as they haven’t had any severe precancers found in the last 20 years. How to Get Screened Request an appointment with your primary care physician or OBGYN to schedule a screening.

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Managing weight is a complicated and often difficult journey for many individuals, and obesity stands as a common and serious chronic health condition. In fact, the Center for Disease Control and Prevention reports that the prevalence of obesity in the US is greater than 40% in adults and 20% in children, and those numbers are continuing to climb. In Nevada, according to the 2020 Behavioral Risk Factor Surveillance System, 28.7% of adults reported being obese. By 2030, almost 80% of American adults may be overweight and half of them will be obese. But obesity isn't just about the numbers on the scale; it's a multifaceted, lifelong, neurobehavioral disease triggered by a combination of factors. These include abnormal eating patterns, reduced physical activity levels, environmental stressors, genetics and various other contributors. Obesity extends far beyond appearance, often leading to the development of numerous medical conditions such as diabetes, heart disease, elevated blood pressure, stroke, sleep apnea, liver disease, various cancers and infertility. Join us as we delve into the complexities of obesity and explore strategies for effective weight management available right here in northern Nevada. Why Can Losing Weight be so Difficult? The challenge behind weight loss finds its roots in the Set-Point Theory of Obesity, a concept that says our bodies have a predetermined weight, or fat mass, within a defined set-point range. In other words, when an individual's weight deviates from this set point, the body initiates mechanisms to bring it back to the established range. So, if someone loses weight below their set point, the body may respond by increasing hunger and reducing metabolism, making it challenging to sustain weight loss. There Isn’t One Right Answer, But Renown is Here to Help Various weight management strategies can be utilized by patients struggling with obesity, which may lead to substantial weight loss, resolution of associated medical conditions and improved psychosocial health. In fact, the most successful strategy involves a multidisciplinary approach under the guidance of trained specialists that includes a combination of tactics, including: Behavioral adaptations Dietary modifications Physical exercise  Anti-obesity medications  Weight loss surgery

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Ensuring a healthier and more inclusive future for LGBTQIA+ children and teens is of utmost importance to health systems in our community, especially Renown. Supporting the physical and mental health of youth in this community is key to those efforts, especially as they face unique challenges in terms of identity acceptance and social integration.   Dr. Caroline Barangan, Adolescent Medicine Physician with Renown Children’s Pediatric Specialty Care, discusses what you as a parent, caregiver, friend or support system can do to be a safe space for children and teens who identify as LGBTQIA+. 1.  Create a Safe Space at Home The most important action you can take for your LGBTQIA+ teen or child is to accept and support them for who they are, regardless of how they identify. “Being a teenager is already difficult enough, especially within the LGBTQIA+ community, which puts them at risk of being stigmatized, rejected and targets for bullying,” said Dr. Barangan.  Your supportive words and actions can make a huge difference as a profound expression of love and understanding. Being patient and willing to learn are the foundations to a healthy and loving relationship with your LGBTQIA+ teen or child.  2.  Encourage Regular Check-Ups with a Primary Care Provider (PCP)  Establishing your child or teen with a PCP is not only important when an illness occurs but also for annual preventative visits and regular check-ups. “A primary care provider can screen for high-risk behaviors that would put a patient’s health in jeopardy, such as sexual experience, substance use, suicidality and self-harm,” said. Dr Barangan. “These screenings are an opportunity to provide the education and support these kids and teens need to stay healthy.”  One of the main concerns LGBTQIA+ youth often have is that they will experience judgment from their provider, or the PCP will disclose sensitive information, including their sexuality or gender identity to their parents, when they are not ready to do so. Dr. Barangan emphatically reminds us that this legally cannot happen. “If a patient asks me to keep something confidential, unless they disclose that they have plans to harm themselves or others, I am legally not allowed to share that information with anyone without their permission,” said Dr. Barangan.  3.  Locate Local Resources  Northern Nevada is home to a variety of resources for the LGBTQIA+ community at large, including youth members of this community. "Finding resources to help them develop in a positive way and provide them with the information they need, whether it be in school, the household, the community or through a medical or mental health provider, is incredibly important,” said Dr. Barangan.  Below is a list of local LGBTQIA+ community resources open to you and your children:  Our Center LGBTQIA+ Health Services at Northern Nevada HOPES Northern Nevada Pride Festival & Community Parade (happens every July in Reno) Sassabration (happens every September in Carson City) Lake Tahoe Pride (events and resources shared on Facebook)  © alessandrobiascioli via Canva.com

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Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs.  Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health.  PrEP and PEP  Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months.  Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days.  PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location.   HPV Immunization  All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime.  The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never!

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