Spring 2011
New clinical expertise for patients

synapse: University of Nevada, Reno School of Medicine

Tarek Ammar, M.D.

Tarek Ammar, M.D., assistant professor of medicine, is one of two gastroenterologists the School of Medicine recently recruited. For the first time ever, the school now offers patients clinical care for digestive disorders. Photo by Edgar Antonio Nunez

Striving to provide the best clinical care across the state, the University of Nevada School of Medicine continues to expand its medical expertise for patients.

By Anne McMillin, APR

The School of Medicine's clinical practice, University Health System, is now offering sleep medicine centers in both Elko and Sparks with Aditya Bhargava, M.D., a board certified sleep medicine internist, serving as medical director.

Both locations offer full-service diagnosis and treatment for adult and pediatric patients.

"Our goal is treating our patients with competence, comfort and compassion," said Bhargava, who has been specializing in sleep medicine for more than 10 years.

"These centers offer personalized care with one doctor, and we have state-of-the-art technology that improves our ability to collect information and treat these conditions."

According to the American Academy of Sleep Medicine, more than 50 million people in the U.S. suffer from a sleep disorder. Relief through diagnosis and treatment is available at the American Academy of Sleep Medicine accredited SpectREM Sleep Center in Sparks and the Northeastern Nevada Regional Hospital Sleep Medicine Program in Elko. Both locations offer sleep disorder treatment for conditions ranging from common sleep apnea to insomnia and narcolepsy.

SpectREM Sleep Medicine Center provides evaluation and treatment for common sleep-related breathing and movement disorders, parasomnias and circadian rhythm sleep disorders.

Bhargava sees new patients on referral from their primary care physician or from self-referral. Interpreting sleep studies to relate those outcomes to his patients, he consults with patients, diagnoses them through overnight monitoring at the sleep centers' labs and then treats the condition with the appropriate therapy.

Women's Wellness

Elsewhere in the Reno internal medicine department, a new program to assess women's health and wellness has been established by Jennifer Zebrack, M.D.

"The Complete Women's Health and Fitness Assessment is a wellness program designed for women who are busy with their roles of wife, mother, daughter, caretaker, career woman and friend, and often ignore their own health," Zebrack said.

Tailored to the multi-tasking woman, the assessment program is both comprehensive and efficient. It includes an "executive-style" physical, with labs and tests arranged in advance so all results can be reviewed at the time of the patient's appointment.

The assessment package consists of a complete history and physical examination including vital signs, oxygen saturation, weight, height, waist circumference, body mass index and a vision screen along with lab analysis of blood count, metabolic and lipid panels, thyroid test, cardiac test, Vitamin D screen and urinalysis.

Other tests in the assessment include an electrocardiogram and body fat analysis by DeXA imaging. Additional services include Pap and HPV tests, mammograms, X-rays, lung function tests, colonoscopy and hearing screenings.

Zebrack, who is board certified in internal medicine, uses her expertise to interpret all these tests to make health risk assessments for heart disease, stroke, diabetes, osteoporosis and fractures, cancer and breast cancer, stress and emotional health, menstrual and menopause symptom evaluation, and obesity and metabolic syndrome evaluation.

She also reviews indicators of a woman's fitness health, such as diet, exercise, weight and percentage body fat, and makes recommendations to help patients reach their fitness goals.

Patients receive a comprehensive health summary, which includes all test results, risk scores, and individual recommendations to reach optimal health and fitness goals.


In Las Vegas, the School of Medicine is moving forward to provide more quality care for Southern Nevadans by establishing a gastroenterology division.

"This is an interesting opportunity for us as gastroenterology is in the top two specialties within internal medicine," said John Varras, M.D., interim chair of the internal medicine department in Las Vegas.

The specialty of gastroenterology is a focus at academic medical centers because of its good potential for resident research.

The division's two gastroenterologists see outpatients at University Health System's Patient Care Center and in-patients for consultation at University Medical Center. Recruiting is underway for a third specialist.

Christian D. Stone, M.D., chief of the gastroenterology division and director of inflammatory bowel disease, has the clinical expertise to see patients with digestive disorders who formerly left Nevada for treatment.

"I'm able to see the most challenging cases in Crohn's disease, ulcerative colitis and inflammatory bowel disease," said the Spanish-speaking Stone, who also has a dual master's of public health in epidemiology and biostatistics and previously served as director of inflammatory bowel disease at Washington University in St. Louis.

Stone's expertise and interest also extends to research where he plans investigative clinical trials to help find solutions and positive outcomes for patients who have exhausted their pharmaceutical options for treatment.

Tarek Ammar, M.D., the school's director of endoscopy, is one of only a few gastroenterologists in Las Vegas trained in endoscopic ultrasound procedures.

He works closely with colleagues at the Nevada Cancer Institute and UMC to address the needs of patients with digestive disorders.

Varras sees the new division as being advantageous not only for its research and care aspects, but also in his department's ability to offer additional training opportunities.

"Students and residents will be able to rotate with the gastroenterologists and see those procedures," he said. "Eventually, we'd like to develop a GI fellowship."

Diabetes Center

Using an $800,000 federal appropriation, the Las Vegas internal medicine department is well into the process of establishing a "center of excellence" for the treatment of diabetes under the medical direction of Ken Izuora, M.D.

Also located in the Patient Care Center in renovated spaces, the new diabetes center will afford patients the chance for one-stop clinical care in the diagnosis and treatment of diabetes and other endocrinology disorders.

"Patients will be able to come in and see a nutritionist, get tested for sugars, have their glucose monitored, speak with a certified diabetes educator registered nurse and have the advantage of collaboration with other specialists who can help treat their condition," said Varras.

The center and its specialists will serve as another avenue to train medical students and residents, conduct general clinical trials to stimulate research and educate patients on using the equipment needed for living with diabetes.

The diabetes center is scheduled to open this spring.