Mayo Clinic Talks

Host: Darryl S. Chutka, M.D. Guest: Bhanu Kolla, M.D. We commonly take sleep for granted. That is, until our sleep quantity or quality is compromised. This can result in both mental and physical health problems, including daytime fatigue and sleepiness. Sleep disorders are quite common and often undiagnosed, yet they can contribute to diabetes, cognitive impairment, and cardiovascular disease, potentially leading to premature mortality. Primary care clinicians play a major role in the identification and management of sleep disorders. What are the most common disorders we see in the outpatient setting? What are the presenting symptoms we should watch for? What tests should we do to establish a diagnosis and when should we refer patients we feel may have a sleep disorder? The topic for today’s podcast is sleep disorders, and these are questions I’ll be asking my guest, Dr. Bhanu Kolla, a psychiatrist and sleep medicine specialist from the Center for Sleep Medicine at the Mayo Clinic. This episode of Mayo Clinic Talks is the first of three podcasts celebrating a remarkable milestone in Mayo Clinic’s history – the 100th anniversary in April this year of our renowned journal, Mayo Clinic Proceedings. Proceedings first appeared in April 1926 and has been in continuous publication ever since. Many significant clinical breakthroughs, pioneered at Mayo Clinic, were first published in the journal, and today the journal brings primary care providers relevant, timely, and important papers on conditions and disorders that are frequently seen in the practice. A great deal of content in Mayo Clinic Proceedings is freely available for you to browse—just go to mayoclinicproceedings.org to incorporate this terrific resource in your library. Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guest: Brittni A. Scruggs, M.D., Ph.D. There are a variety of eye disorders which involve the retina, and they all have the potential to cause significant vision loss or blindness if not detected early. Two of the most common retinal disorders we see in primary care include diabetic retinopathy and macular degeneration. Since most health conditions affecting the retina are asymptomatic early in their course making patient screening and risk factor management an important task for primary care clinicians. Appropriate referrals to an ophthalmologist can result in effective treatment and improved outcomes. Which patients are at risk of retinal disorders? What are some “red flag” symptoms which should give us concern? Which medications we prescribe can affect the retina? This podcast is about retinal disorders, and I’ll be asking these questions and more of my guest, Dr. Brittni Scruggs, an ophthalmologist and retinal surgeon at the Mayo Clinic. Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guest: Stephen Kopecky, M.D. Cardiovascular disease is highly prevalent in our society. Fortunately, we have a variety of treatment options to lower the risk of developing its complications. Over the past decade, there’ve been many changes in managing hyperlipidemia, one of the most important risk factors for cardiovascular disease. This includes a change in assessing our patients’ risk, identification of new risk factors, new testing options, and new pharmacologic options for treating hyperlipidemia. We’ll cover all of these topics in this podcast. My guest is Dr. Stephen Kopecky, a preventive cardiologist at the Mayo Clinic, and we’ll be discussing “Update in the Management of Hyperlipidemia”. Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guest: Kathryn del Valle, M.D. Chronic liver disease can result in a variety of complications which can involve multiple organs. One of these complications can occur in the pulmonary vascular system. Two of the most clinically significant include hepatopulmonary syndrome and Portopulmonary hypertension. Patients with these syndromes may present to their primary care provider and if the medical condition is unrecognized, it can affect morbidity and ultimately the prognosis of the patient. What are the early symptoms and physical findings of hepatopulmonary syndrome and Portopulmonary hypertension? How are they diagnosed, and should we be screening patients with chronic liver disease for these pulmonary vascular disorders? My guest for this podcast is Dr. Kathryn del Valle, from the Division of Pulmonary and Critical Care at the Mayo Clinic and we’ll be discussing “Pulmonary Vascular Complications of Liver Disease”. Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guest: Stephen Ansell, M.D., Ph.D. Non-Hodgkin’s Lymphoma is a group of hematologic malignancies originating in the lymphatic system. There are over 60 subtypes of lymphoma with varying degrees of aggressiveness. It can present with a variety of rather subtle symptoms, often making the diagnosis challenging. Although Non-Hodgkin’s Lymphoma is typically managed by a hematologist or oncologist, the primary care provider plays a role in its recognition, preliminary diagnostic tests and supporting patients through their treatment. What are some of the more common symptoms and signs of Non-Hodgkin’s Lymphoma? Which ones should prompt an urgent referral, and what preliminary tests should we do prior to referring the patient? These are some of the questions I’ll be asking my guest, Dr. Stephen Ansell, Chair of the Division of Hematology at the Mayo Clinic. The topic for this podcast is Non-Hodgkin’s Lymphoma. Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guest: Stephen Ansell, M.D., Ph.D. Hodgkin’s Lymphoma is an uncommon but very curable malignancy involving the lymphatic system. It most commonly presents in young adults as well as middle-aged and older individuals. Although Hodgkin’s is generally managed by hematologists or oncologists, the primary care provider plays a major role in its recognition, hopefully leading to a timely diagnosis and eventual staging. What are some early signs of Hodgkin’s and what preliminary work-up should we do prior to referring the patient for definitive care? How do we monitor those who have had successful treatment of Hodgkin’s? These are some of the questions I’ll be asking my guest, Dr. Stephen Ansell, Chair of the Division of Hematology at the Mayo Clinic as we discuss Hodgkin’s Lymphoma. Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guests: Jae K. Oh, M.D., Tahir S. Kafil, M.D. Diastolic heart failure is also known as heart failure with preserved ejection fraction. Although we don’t hear the term all that often, it actually represents a fairly large percentage of all cases of heart failure. Some studies suggest it represents the majority of heart failure cases. Older adults are most commonly affected with symptoms similar to those of systolic heart failure. So how do we suspect diastolic heart failure? How should the diagnosis be established, and how does the treatment differ from systolic heart failure? Finally, what role do primary care providers play in the management of the condition? These are some of the questions I’ll be asking my guests, Dr. Jae Oh and Dr. Tahir Kafil, both cardiologists in the Department of Cardiovascular Disease at the Mayo Clinic as we discuss “Diastolic Heart Failure”. Mayo Clinic Talks: Heart Health | Mayo Clinic School of Continuous Professional Development Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guest: Balaji Tamarappoo, M.D., Ph.D. With advances in oncology, patients are living longer than ever following a diagnosis of cancer. Newer treatments have dramatically improved survival. However, we’re also seeing an increasing number of cancer survivors who are at risk for cardiovascular complications; at times during treatment, and sometimes years later. Complications such as heart failure, cardiac arrhythmias, hypertension, and accelerated coronary disease are not uncommonly seen in our primary care practice. As primary care clinicians, what do we need to know? I’m joined today by Dr. Balaji Tamarappoo, M.D., Ph.D., a cardiologist with expertise in cardio-oncology. We’ll discuss which cancer therapies pose the highest cardiac risks, what baseline and surveillance testing is recommended, if the risk of cardiotoxicity be decreased, and how primary care can partner effectively with oncology and cardiology to protect our patients’ hearts while they battle their malignancy. The topic for today’s podcast is “Cardiotoxicity of Cancer Therapies.” Mayo Clinic Talks: Heart Health | Mayo Clinic School of Continuous Professional Development Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guest: Hema Narayanasamy, M.B.B.S. Pericardial disease represents a spectrum of both inflammatory and non-inflammatory disorders which involve the pericardium, with acute pericarditis being the most common disorder. Although not often seen in a primary care practice, we still need to consider pericarditis as it can masquerade several other more commonly seen conditions. It’s important to recognize pericardial disease early and decide who needs an urgent referral or hospitalization for appropriate treatment. What are some of the more common causes of pericardial disease? What are the most commonly encountered symptoms, physical exam findings, imaging results, and lab abnormalities? What are the potential complications? The topic for today’s podcast is pericardial disease, and my guest is Dr. Hema Narayanasamy, from the Department of Cardiovascular Disease from the Arizona campus of the Mayo Clinic. Mayo Clinic Talks: Heart Health | Mayo Clinic School of Continuous Professional Development Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guest: Stephen Kopecky, M.D. We have a variety of pharmacologic options and lifestyle changes we recommend to our patients to reduce their cardiovascular risks. One frequent recommendation is participation in a regular exercise program. One specific type of exercise is high intensity interval training. It’s been shown to improve a variety of metabolic parameters. What does high intensity interval training consist of? What are the specific metabolic benefits? Can all patients participate in this type of exercise? What’s the recommended duration and frequency of training and how good is patient adherence to interval training? The topic for this podcast is “High Intensity Interval Training and Reducing Cardiovascular Risk” and my guest is Dr. Stephen Kopecky, a preventive cardiologist in the Department of Cardiovascular Disease at the Mayo Clinic. Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guest: George Wang, M.D. Bicuspid aortic valve is a relatively common congenital heart disease. It can be associated with other genetic disorders such as Turner’s Syndrome or exist as an isolated entity. In most cases, patients with a bicuspid aortic valve are initially asymptomatic; however later in the course, they may develop symptoms related to a subsequent aortic stenosis or regurgitation. It’s also associated with a dilated ascending aorta with potential rupture if unrecognized. Therefore, it’s in the patient’s best interest to diagnose the condition as early as possible. What are the early symptoms and when should we suspect the patient may have a bicuspid aortic valve? What type of surveillance should be performed and when is surgery indicated? These are some of the questions I’ll be asking my guest, Dr. George Wang, a cardiologist in the Department of Cardiovascular Medicine at the Arizona Campus of the Mayo Clinic as we discuss “Bicuspid Aortic Valve Disease”. Mayo Clinic Talks: Heart Health | Mayo Clinic School of Continuous Professional Development Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guest: Julie Rosenthal, M.D. Cardiac amyloidosis is not a common condition, but it is important for primary care clinicians to recognize it in our patients. It’s commonly underdiagnosed as the symptoms are often assumed to be due to other, more common cardiac problems. Early recognition is important since this can result in improved treatment options and better patient outcomes. So how do we recognize cardiac amyloidosis? What are the presenting symptoms and what’s the best way to establish an accurate diagnosis? I’ll be asking my guest these questions as we discuss cardiac amyloidosis. My guest for tis podcast is Dr. Julie Rosenthal, a cardiologist in the Department of Cardiovascular Medicine at the Arizona campus of the Mayo Clinic. Mayo Clinic Talks: Heart Health | Mayo Clinic School of Continuous Professional Development Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guest: Matthew B. Anastasi, M.D. Patients with concussions are commonly seen in primary care practices and concussions don’t spare any particular age group. Children, young adult athletes and older individuals are all at increased risk. They’re a form of traumatic brain injury and while most are self-limiting, they require an accurate assessment, proper management and appropriate follow-up to make sure the patient is recovering and not experiencing complications. When should we suspect a concussion? What questions should we be asking in order to make an accurate diagnosis? What’s the best management of a patient who has had a concussion and finally, when can that patient return to their normal activities? The topic for this podcast is “Concussions: What Every Primary Care Provider Should Know” and my guest is Dr. Matthew Anastasi, a family medicine and sports medicine physician at the Arizona campus of the Mayo Clinic. Learn more at https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guest: Stephen Kopecky, M.D. One of the biggest surprises we’ve seen in medicine in the past several years has been the numerous health benefits realized from the GLP-1 agonists. Originally developed for the management of diabetes, they’ve shown significant potential to improve cardiovascular risks, beyond controlling blood glucose and lowering hemoglobin A1c. Several studies have shown reductions in cardiovascular events including MI, stroke as well as reducing overall cardiovascular death. What is the mechanism of action for these cardiovascular benefits? Are there any differences in the various GLP-1 medications available and who’s a candidate for a GLP-1 medication? I’ll get answers to all of these questions and more in this podcast as I speak with Dr. Stephen Kopecky, a preventive cardiologist at the Mayo Clinic. We’ll be discussing “GLP-1 Agonists and Reducing Cardiovascular Risk”. Rx for Weight Loss: A Closer Look Series | Mayo Clinic School of Continuous Professional Development Learn more at https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guests: Tamim I. Rajjo, M.D., M.P.H.; Meera Shah, M.B., Ch.B. The class of medications known as the GLP-1 agonists is very popular with our patients. Although initially indicated for management of diabetes, they’re frequently taken for the weight loss they commonly produce. How long should these medications be taken? Is there anything we can do to help maintain the weight loss achieved with these medications? How significant is the loss of muscle mass which can occur as part of the weight lost with these medications and can this be minimized. Finally, how safe are the compounded and unapproved versions of these medications patients often find more affordable? These are a few of the questions we’ll address in podcast on the GLP-1 medications used for weight loss and we’ll tackle the “Controversies and Future of the GLP-1 Medications”. My guests include Dr. Meera Shah and Dr. Tamim Rajjo, both from the Division of Endocrinology at the Mayo Clinic. Rx for Weight Loss: A Closer Look Series | Mayo Clinic School of Continuous Professional Development Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guest: Tamim Rajjo, M.D., M.P.H. Using GLP-1 medication for weight loss has become very popular with our patients. In the recent past, this has produced a shortage of these medications available, and those taking them for management of diabetes have found them difficult to obtain. Although in most cases, they are quite successful in producing substantial weight loss, many have regained weight after the medication was discontinued. How much weight can patients expect to lose with these medications? When should these medications be stopped, or should they? Are there strategies that have shown benefit to help patients maintain the weight they lose once the medication is discontinued? This podcast is the second of three on using the GLP-1 medications for weight loss and we’ll discuss “The Importance of Lifestyle Changes with the Use of GLP-1 Medications for Weight Loss”. My guest is Dr. Tamim Rajjo, a physician trained in Preventive Medicine and Obesity Medicine from the Mayo Clinic. Rx for Weight Loss: A Closer Look Series | Mayo Clinic School of Continuous Professional Development Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guests: Tamim I. Rajjo, M.D., M.P.H.; Meera Shah, M.B., Ch.B. Using GLP-1 medications for weight loss has become extremely popular. Is this the latest fad in losing weight, or will these medications completely change our approach to managing obesity? They do appear to be very effective in promoting substantial weight loss. What is the history of these medications? Are there differences in the various GLP-1 medications available? What are the potential adverse effects of this drug class? This podcast is the first in a series of three on the GLP-1 medications prescribed for weight loss. The topic for this podcast is “Who Is a candidate for a GLP-1 Medication?” and my guests include Dr. Meera Shah and Dr. Tamim Rajjo, both from the Division of Endocrinology and Metabolism at the Mayo Clinic. Check out the series! Rx for Weight Loss: A Closer Look Series | Mayo Clinic School of Continuous Professional Development Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

WELCOME TO SEASON 6 OF THE MAYO CLINIC TALKS PODCAST! Host: Darryl S. Chutka, M.D. Guest: Warren G. Thompson, M.D. Alcohol can offer a variety of social and potential health benefits when consumed in moderation. However, alcohol is also associated with a variety of health risks, including addiction, increased likelihood of accidents, impaired judgment, cardiovascular problems, hepatic disease and even malignancy. Other than the social benefits, are there true health benefits of alcohol? Is there an amount of alcohol that’s considered safe? How can we as primary care clinicians convey the health risks of alcohol to our patients? The topic for this podcast is the “Risks and Benefits of Alcohol” and these are some of the questions I’ll be asking my guest, Warren G. Thompson, M.D., an internist and preventive medicine specialist at the Mayo Clinic. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

HAPPY HOLIDAYS! Enjoy this re-release from Season 3 of Mayo Clinic Talks: Host: Darryl S. Chutka, M.D. Guest: Amy S. Oxentenko, M.D. It’s estimated that less than 1/3 of individuals with celiac disease have been properly diagnosed. When those with celiac disease ingest gluten, an immune response develops which attacks the small intestine leading to inadequate absorption of nutrients. If left untreated, celiac disease can lead to a variety of nutritional deficiencies as well as other serious consequences. Those with celiac disease are also at increased risk for coronary disease and small bowel cancers. In this podcast we’ll review celiac disease and gluten sensitivity with our guest, Amy S. Oxentenko, M.D., a gastroenterologist at the Mayo Clinic. We’ll discuss the symptoms of celiac disease, how to diagnose the condition and how patients with celiac disease should be managed. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

HAPPY HOLIDAYS! Enjoy this re-release from Season 3 of Mayo Clinic Talks: Host: Darryl S. Chutka M.D. Guest: Lisa Lammert, R.D.N., L.D. Cardiovascular disease is the leading cause of death to individuals in the U.S. Many feel that our typical American diet with its high saturated fat content is a major contributor to this. There’s good evidence that shows plant-based diets are cost-effective in lowering the risk factors for cardiovascular disease including obesity, hyperlipidemia, hypertension, and diabetes. They may also lower the number of medications an individual needs to take to manage their chronic diseases. So, are there any disadvantages to a plant-based diet? Are all plant-based diets healthy and what are the nutritional challenges for a patient on a plant-based diet? We’ll discuss these questions in this podcast on “Plant-Based Diets”. Our guest is Lisa Lammert, a registered dietician and nutritionist at the Mayo Clinic. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guest: Cory Ingram, M.D. As primary care providers, we have the privilege of guiding our patients through their healthcare journey, healing their medical conditions, managing them through chronic illness and at times, assisting them through the final chapters of their life. The topic for today’s podcast is “Hospice”, an important though often underutilized part of that journey. Hospice is not about giving up, it’s about changing the direction and goal of our care from cure to comfort. It prioritizes quality of life and maintaining dignity for patients going through a very challenging period of their life. My guest is Cory Ingram, M.D., a family medicine and palliative care physician from the Mayo Clinic who has extensive experience and insight into this topic. He’ll guide us through when we should consider hospice, who qualifies for hospice and the importance of good communication skills in helping patients and their families during this last period of their life. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guest: Andrew R. Jagim, Ph.D. Nutritional supplements are very popular with our patients. They are supposed to provide benefits that may not be present in our typical diet. Vitamins and minerals are the most common supplements taken, followed closely by sports nutrition products such as protein powders and energy drinks. Consumers buy supplements because they’re readily available, relatively low cost and they believe that supplements will help them achieve health benefits. Patients often assume that supplements are safe, yet some can cause significant health problems, especially when taken in higher doses. Some have the potential to interact with various prescription medications. Are there nutritional supplements our patients should be taking? Which ones are potentially harmful? How safe are these products and do supplements have any regulatory oversight? These are questions I’ll be asking my guest, Andrew R. Jagim, Ph.D., Director of Sports Medicine Research at the Mayo Clinic as we discuss “Nutritional Supplements”. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guest: Cory Ingram, M.D. There are a couple outcomes in taking a medical history. Obviously, one is information gathering. You need to hear the patient’s symptoms to help form your differential diagnosis. The second, and equally important, is to help establish a relationship with that patient. There are several reasons a good provider-patient relationship is important. The patient is more likely to feel positive about their medical encounter, they’re more likely to be adherent to your recommendations regarding their health conditions, and they tend to be more forgiving if they experience an adverse event. What makes up a good provider-patient relationship? What can we do as clinicians to help establish a good relationship with our patients? Can we still establish a good relationship when we practice telemedicine? These are questions I’ll be asking my guest, Cory Ingram, M.D., a palliative care physician at the Mayo Clinic as we discuss “Provider-Patient Relationship Skills”. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guests: William J. Casey III, M.D. and Andrea L. Cheville, M.D. There are numerous reasons a patient may develop swelling of an extremity. One of the less common reasons, but often misdiagnosed or undiagnosed is lymphedema. What is lymphedema, why does it occur and who’s at risk for it? Early recognition is important to prevent complications and primary care providers play a crucial role in identifying patients with lymphedema, coordinating their care and providing follow-up. How can we differentiate lymphedema from other causes of swelling? What are the potential complications if lymphedema is not correctly diagnosed and finally, what are some of the latest treatments available for the management of lymphedema? The topic for this podcast is “Lymphedema: Challenges and Success” and my guests include Andrea L. Cheville, M.D., a physician in the Department of Physical Medicine and Rehabilitation and William J. Casey, III, M.D., a physician in the Department of Plastic Surgery, both at the Mayo Clinic. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts To hear more about this series: https://ce.mayo.edu/content/mayo-clinic-talks-vascular-medicine-series

Host: Darryl S. Chutka, M.D. Guest: Martin G. Ellman, D.P.M. We don’t really appreciate our feet until they hurt and then we become extremely aware of every step we take. Plantar fasciitis, bunions, metatarsalgia; all foot disorders which can result in foot pain and represent common reasons for an outpatient visit. What’s the role of the primary care clinician in the evaluation of foot pain? How should these conditions be managed? I’ll be reviewing common causes of foot problems as well as the management of foot pain with Martin G. Ellman, D.P.M., a podiatrist at the Mayo Clinic as we discuss “The Agony of De-Feet”. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guest: Christina Chen, M.D. Alzheimer’s Disease affects not only the patient but also has a significant impact on that patient’s family. The family becomes stressed as emotional and physical burdens develop. The role of the primary care clinician in managing a patient with Alzheimer’s is not only to care for the patient but also help and support families as they go through a very complex, emotional journey. Today’s podcast will cover the changes in family dynamics which commonly occur in Alzheimer’s Disease including caregiver burden, legal decisions which need to be made, and difficult ethical choices which will be made as the disease progresses. What are some common sources of conflict within families as they care for their loved one with Alzheimer’s? What can we do as a clinician to help families through this difficult journey? How do we approach a situation where there’s disagreement in the family regarding management? These are some of the questions I’ll be asking my guest, Christina Chen, M.D., an internist and geriatrician in the Division of Community Internal Medicine at the Mayo Clinic as we discuss “Alzheimer’s Disease and Family Dynamics”. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guest: Ronald C. Petersen, M.D., Ph.D. We all experience cognitive changes as we age. If you doubt this, try learning to play the piano with a group of 7-and 8-year-olds and see who sounds best at the recital. We tend to have difficulty with new learning and can struggle with short term memory. When do these cognitive changes become pathologic? Dementia results in a gradual decline in cognitive abilities, memory and behavior, severe enough to interfere with daily life. Between the cognitive changes that occur with aging and those with dementia, there is another medical entity, mild cognitive impairment. How does it differ from the normal cognitive changes of aging? How does it differ from dementia? And is it important for us to recognize it? These are some of the questions I’ll be asking my guest for today’s podcast, Ronald C. Petersen, M.D., Ph.D., a neurologist and internationally recognized expert in the field of dementia as we discuss “Mild Cognitive Impairment”. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guest: Daniel M. Frendl, M.D., Ph.D. Prostate cancer is quite common in middle age and older men and represents the second most common malignancy diagnosed in this population. Only skin cancer is more common. Early diagnosis is important and carries an excellent prognosis. There are several management options available for localized disease and some new treatments which can be used for both aggressive and more advanced disease. When should active surveillance be used when prostate cancer has been diagnosed? How does radiation therapy compare to surgical prostatectomy regarding long-term outcomes and what are some of the newer treatment options available for advanced disease? These are some of the questions I’ll be asking my guest, Daniel M. Frendl, M.D., Ph.D., a urologist from the Department of Urology at the Arizona campus of the Mayo Clinic as we discuss “Prostate Cancer”. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guest: Daniel M. Frendl, M.D., Ph.D. If your practice includes middle age and older men, you’ve very likely diagnosed prostate cancer. It’s the most diagnosed non-skin cancer in men in the U.S. Its incidence rises with age, with a median age of around 66 years. When found early, prostate cancer is very treatable, and in most cases, curable. Prostate specific antigen, or PSA is very effective in detecting early prostate cancer, but its use has been controversial due to the risk of overdiagnosis and overtreatment. What are the current recommendations for prostate cancer screening with PSA? What’s the role of the digital rectal exam? How should we be using the PSA and what other tests are available for prostate cancer screening? The topic for this podcast is “Prostate Cancer Screening” and I’ll be asking these questions to my guest, Daniel M. Frendl, M.D., Ph.D., a urologist at the Arizona campus of the Mayo Clinic. Tune in this Thursday for our next episode on "Prostate Cancer" releasing October 30, 2025. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Guest: Rebecca Smith, Ph. D, APRN, CNM Hosts: Danielle O’Laughlin, PA-C, MS and Jenna Wygant, APRN, CNP, DNP Rebecca Smith provides a comprehensive overview of labor and delivery, including the stages of labor, assessment techniques, and monitoring practices. The episode also addresses potential complications and their management. Learning Objectives: Describe the stages, duration, and monitoring of labor and delivery. Compare and contrast complications that may arise during pregnancy and delivery. Learn more about this series: Mayo Clinic Talks: Obstetric and Gynecologic Health | Mayo Clinic School of Continuous Professional Development Connect and listen with Mayo Clinic Podcasts | Mayo Clinic School of Continuous Professional Development

Guest: Julie Lamppa, APRN, CNM Hosts: Danielle O’Laughlin, PA-C, MS and Jenna Wygant, APRN, CNP, DNP Julie Lamppa discusses complications that can arise during pregnancy, including gestational diabetes, preeclampsia, and other abnormalities. This episode emphasizes early recognition and multidisciplinary management. Learning Objectives: Differentiate various pregnancy complications and their clinical implications. Learn more about this series: Mayo Clinic Talks: Obstetric and Gynecologic Health | Mayo Clinic School of Continuous Professional Development Connect and listen with Mayo Clinic Podcasts | Mayo Clinic School of Continuous Professional Development

Guest: Jenna Wygant, APRN, CNP, DNP Hosts: Danielle O’Laughlin, PA-C, MS and Jenna Wygant, APRN, CNP, DNP Jenna Wygant discusses common gynecologic pain disorders such as endometriosis and pelvic inflammatory disease. The episode highlights diagnostic challenges and treatment strategies to improve patient outcomes. Learning Objectives: Identify conditions contributing to gynecologic pain. Review signs/symptoms, risk factors, diagnostic approaches, and treatment options. Learn more about this series: Mayo Clinic Talks: Obstetric and Gynecologic Health | Mayo Clinic School of Continuous Professional Development Connect and listen with Mayo Clinic Podcasts | Mayo Clinic School of Continuous Professional Development

Guest: Casey Lawler, P.A.-C Hosts: Danielle O’Laughlin, PA-C, MS and Jenna Wygant, APRN, CNP, DNP This episode provides an overview of gynecologic cancers, including cervical, ovarian, uterine, and vulvar cancers. Casey Lawler shares insights into the causes, risk factors, and clinical management of these conditions. Learning Objectives: Describe the major types of gynecologic cancers. Compare and contrast causes, risk factors, signs/symptoms, diagnostic methods, and treatment options. Learn more about this series: Mayo Clinic Talks: Obstetric and Gynecologic Health | Mayo Clinic School of Continuous Professional Development Connect and listen with Mayo Clinic Podcasts | Mayo Clinic School of Continuous Professional Development

Guest: Susan Kok, M.D. Hosts: Danielle O’Laughlin, PA-C, MS and Jenna Wygant, APRN, CNP, DNP Dr. Susan Kok joins the podcast to explore both non-invasive and invasive breast cancers. This episode covers risk factors, symptom recognition, diagnostic tools, and treatment modalities, with a focus on individualized care and shared decision-making. Learning Objectives: Understand the spectrum of non-invasive breast cancers. Identify risk factors, symptoms, and diagnostic tools for invasive breast cancers. Discuss treatment options tailored to diagnosis and patient preferences. Learn more about this series: Mayo Clinic Talks: Obstetric and Gynecologic Health | Mayo Clinic School of Continuous Professional Development Connect and listen with Mayo Clinic Podcasts | Mayo Clinic School of Continuous Professional Development

Guest: Danielle O’Laughlin, PA-C, MS Hosts: Danielle O’Laughlin, PA-C, MS and Jenna Wygant, APRN, CNP, DNP In this episode, Danielle O’Laughlin discusses benign breast tumor conditions and other non-cancerous growths. Listeners will gain insight into the clinical presentation, diagnostic evaluation, and management strategies for these common breast findings. Learning Objectives: Review the types of benign breast tumors and their clinical features. Differentiate between symptoms, diagnostic approaches, and treatment options for various benign breast conditions. Learn more about this series: Mayo Clinic Talks: Obstetric and Gynecologic Health | Mayo Clinic School of Continuous Professional Development Connect and listen with Mayo Clinic Podcasts | Mayo Clinic School of Continuous Professional Development

Host: Darryl S. Chutka, M.D. Guest: Matthew (Mark) Melin, M.D. Vascular wounds can be quite challenging. If untreated, they can lead to infection, even sepsis, hospitalization and occasionally, amputation. Effective treatment requires an accurate diagnosis and recognition of the specific type of vascular wound you’re dealing with. Even when the type of wound is correctly identified and is being treated appropriately, healing can be slow. What diagnostic tools are available to help us? How does a venous insufficiency ulcer differ from an arterial ulcer? What’s the best treatment for these wounds and when should we refer our patient to a vascular specialist? The topic for this podcast is “Vascular Wound Treatments” and these are some of the questions I’ll be asking my guest, Matthew (Mark) Melin, M.D., a vascular specialist from the Department of Cardiovascular Medicine at the Mayo Clinic. Mayo Clinic Talks: Vascular "What's Circulating" | Mayo Clinic School of Continuous Professional Development Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guest: Neha P. Raukar, M.D., M.S. Women in medicine have made significant strides over the past few decades, yet some still face a variety of challenges and barriers. They commonly encounter inequalities that can affect their professional growth and overall well-being. Common issues include pay disparity, underrepresentation in leadership positions and gender discrimination, just to name a few. Some medical specialties tend to be male-dominated and can be less welcoming to women. As a result, women physicians have higher rates of professional burnout and often experience a less satisfying career. My guest for this podcast is Neha P. Raukar, M.D., M.S., an emergency medicine physician at the Mayo Clinic. The topic we’ll be discussing is “Claiming Your Voice and Why Women in Medicine Need a Clear Professional Narrative”. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guests: Haraldur Bjarnason, M.D.; and Megha M. Tollefson, M.D. Vascular malformations are anomalies of vessels that can cause a variety of potentially serious health problems depending on their type, location, and size. They may involve arterial, venous or lymphatic vessels. They’re often progressive and may enlarge over time. They’re best diagnosed with one or more imaging studies and the treatment depends on the type of vascular malformation. Management usually requires a multi-disciplinary approach in order to be most effective. What are the most common types of vascular malformations? What organs are typically involved? What are some of the more serious medical complications they may cause and how should we manage them? The topic for this podcast is “Vascular Malformations” and these are questions I’ll be asking my guests, Haraldur Bjarnason, M.D., an interventional and vascular radiologist and Megha M. Tollefson, M.D., a dermatologist, both from the Mayo Clinic. Mayo Clinic Talks: Vascular Medicine Series | Mayo Clinic School of Continuous Professional Development Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guests: Sam Farres, M.D.; and Ryan A. Meverden, PA-C Thoracic outlet syndromes is a great masquerader and often mistaken for a variety of other health conditions including cervical radiculopathy, carpal tunnel syndrome, rotator cuff injury or even multiple sclerosis. It has several causes which account for the variety of its clinical presentations. Because of this, the diagnosis is commonly delayed or diagnosed incorrectly. Yet, it’s crucial to establish an early and accurate diagnosis as this can prevent potential progression of neurologic damage or in some cases life-threatening vascular complications. It also prevents unnecessary treatments and inappropriate interventions. The topic for this podcast is “Thoracic Outlet Syndrome” and my guests include Ryan Meverden, PA-C, a physician assistant in the Vascular Center at the Rochester campus of the Mayo Clinic and Sam Farres, M.D., Division Chair of Vascular Surgery at the Florida campus of the Mayo Clinic. As we discuss thoracic outlet syndrome, we’ll review the variety of presenting symptoms, potential complications, appropriate tests to evaluate patients and effective management strategies. Mayo Clinic Talks: Vascular Medicine Series | Mayo Clinic School of Continuous Professional Development Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guest: Stan Henkin, M.D. Peripheral arterial disease is a manifestation of atherosclerosis and becomes more common with advancing age. In its early stages, it can be quite difficult to diagnose. Although claudication is the most classic symptom, many remain asymptomatic, especially if they have limited ability to ambulate. Although risk factor modification is important in disease management, overall treatment options have been somewhat disappointing. How can we diagnose PAD early and are there advantages in recognizing the disease in an early stage? What are the best ways to establish a diagnosis and what treatment options do we have available? Our topic for this podcast is “Peripheral Arterial Disease” and these are questions I’ll asking my guest, Stan Henkin, M.D., a vascular medicine specialist from the Department of Cardiovascular Medicine at the Mayo Clinic. Mayo Clinic Talks: Vascular Medicine Series | Mayo Clinic School of Continuous Professional Development Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D. Guest: Ana I. Casanegra, M.D., M.S. For many decades, we really only had one option for providing chronic anticoagulation, warfarin. We learned how to manage the many drug and food interactions, frequently changing the warfarin dose as we tried to keep our patients in therapeutic range. Now we have a variety of choices with the direct-acting oral anticoagulants, or DOAC’s. How do the newer agents compare to warfarin in effectiveness? Are they really safer than warfarin? Do they ever require any monitoring? What’s the latest on reversing the anticoagulant effect? I’ll be discussing these topics and more with my guest, Ana I. Casanegra, M.D., M.S., a vascular medicine specialist at the Mayo Clinic. The topic for this podcast is “How to Choose Your Anticoagulant”. Mayo Clinic Talks: Vascular Medicine Series | Mayo Clinic School of Continuous Professional Development Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts