Mayo Clinic Talks

Guest: Carol L. Kuhle, D.O., M.P.H. (@clkejd) Host: Anjali Bhagra, M.D. (@anjalibhagramd) Anjali Bhagra, M.D., and Carol L. Kuhle, D.O., M.P.H., discuss the narrative they recently published in Mayo Clinic Proceedings, which outlines and highlights the further widening of preexisting gender disparities in response to the COVID-19 pandemic. What can we do to identify and mitigate these issues? Additional resources: Nordhues, HC. Bhagra, A. Stroud, NN. Vencill, JA. Kuhle, CL. COVID-19 gender disparities and mitigation recommendations: a narrative review. Mayo Clin Proc. 2021 April 20; 96(7): 1907-1920. doi: https://doi.org/10.1016/j.mayocp.2021.04.009 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded August, 2021 Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) A fourth COVID-19 surge is blanketing the U.S., and the delta variant is the culprit. "Where did this delta variant come from? It came from unvaccinated people getting infected in large numbers allowing the virus to continue mutating," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. In the past, a person with COVID-19 might infect two to four people. But with the delta variant, one person can infect nine people, according to Dr. Poland. He says if you want to protect yourself and your family, wear a mask, especially indoors, and get vaccinated with an appropriate series of one of the COVID-19 vaccines. "These are the most studied vaccines in the history of the world," Dr. Poland emphasizes. "There have never been this many people who have received this many doses of vaccines during this amount of time with as much scrutiny as these COVID-19 vaccines have had." In this Mayo Clinic Q&A podcast, Dr. Poland answers questions about a person's waning immunity and the likelihood of COVID-19 booster shots. He also explains the two phases of immunity and goes into detail about the extensive Federal Drug Administration license approval process for COVID-19 vaccines. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Steve G. Peters, M.D. Host: Sanjeev Kakar, M.D. (@sanjkakar) No doubt you’ve heard the term “artificial intelligence,” by now; but what is it exactly? How can medicine use AI to improve patient care and outcomes? Will it one day replace doctors’ years of training? Steve Peters, M.D. a pulmonary and critical care medicine consultant, with a special interest in AI, at Mayo Clinic’s Rochester campus. Dr. Peters will help us take a look into the not-so-distant future as we explore AI and its role in medicine. Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded July, 2021 Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) Transmission of the COVID-19 delta variant is increasing. "We're in this constant spiral, right now,” says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. “The delta variant is so highly contagious,” he says. “The number of delta viral particles in the upper respiratory system is reportedly 1,000 times higher than with the original COVID-19 virus. If we can't find ways to get people vaccinated, we are going to be in a world of hurt. And I don't say that to be alarmist. I say it to be a realist, based on what’s happening right in front of us.” But Dr. Poland says the spiral can be stopped by getting higher rates of immunization. "Getting a COVID-19 vaccine will prevent the development of worse and worse variants. It will prevent severe cases of hospitalization and death, even in the face of a variant,” he says. "The alternative is to lose another 600,000-plus Americans. Only this time it will, unfortunately, involve younger people." Dr. Poland explains further, "Every time somebody gets infected with the delta variant, there's the opportunity for that virus to mutate and transmit to other people," says Dr. Poland. "This means that immunization rates to control herd immunity will probably have to be in the 85% to 95% range." In this Mayo Clinic Q&A podcast, Dr. Poland continues to talk about the delta variant, breakthrough infections, booster shots and much more. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Shelagh A. Cofer, M.D. (@ShelaghCoferMD) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Stridor is a musical sound due to disrupted airflow in an individual’s airway. In many instances it’s due to a benign cause but it can also represent a serious problem, possibly even life-threatening. In today’s podcast, we’ll learn about the various causes of stridor and when we need to be concerned that it represents a serious health issue. Our guest for this podcast is Dr. Shelagh Cofer, a pediatric otolaryngology specialist at the Mayo Clinic. We’ll discuss how stridor differs from wheezing, the most common causes of stridor in both children and adults and what symptoms we should be watching for that might suggest a serious cause for stridor. We’ll also cover the evaluation of patients with stridor, which imaging studies may be helpful and when an ENT consultation is warranted. Specific topics: Definition of stridor Difference between stridor, stertor, and wheezing Most common causes of stridor in both children and adults Croup as a form of stridor Important questions we should be asking our patients about stridor to identify those at risk for airway obstruction – including the SPECS-R mnemonic Tests and imaging studies which may be helpful in the evaluation of a patient with stridor Treatments for the more common causes of stridor Additional resources: Zoumalan, R; Maddalozzo, J; Holinger, LD. Etiology of stridor in infants. Ann Otol Rhinol Laryngol. 2007; 116(5):329-334. doi: 10.1.1896.429 https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.896.429&rep=rep1&type=pdf Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded July, 2021 Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) The delta variant is being blamed for hot spots in the U.S. where cases of COVID-19 are on the rise. These hot spots account for most cases in the U.S. They are also the geographical areas that tend to have the lowest vaccination rates. "It's no surprise that the two go together," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "This (delta variant) is the bad actor that we predicted it would be," adds Dr. Poland. "Our seven-day average is getting up to 19,000 cases a day in the U.S. We were down to 3,000. So we're starting to see, just as we predicted, a surge as people took masks off and as restrictions were lifted before we had achieved high rates of immunization." In this Mayo Clinic Q&A podcast, Dr. Poland expands on how the highly transmissible delta variant continues to spread. He also talks about the possibility of COVID-19 vaccine boosters, explains how the Vaccine Adverse Event Reporting System works, and much more as he answers listener questions. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Isabel C. Green, M.D. Host: Darryl S. Chutka, M.D. (@ChutkaMD) Pelvic pain can be challenging. It can have a variety of presenting symptoms since it can originate from a variety of organ systems. When pelvic pain becomes chronic, it becomes even more challenging. It’s associated with significant direct medical costs as well as indirect costs as it frequently results in work absenteeism. Patients with chronic pelvic pain are often initially evaluated by primary care providers, but referral to specialists is quite common. Due to the variety of symptoms associated with chronic pelvic pain, multiple specialties often are asked to evaluate these patients. This frequently results in patients being passed back and forth between various medical specialties. It therefore becomes important for primary care providers to become comfortable evaluating and managing patients with pelvic pain. Our guest for this podcast is Dr. Isabel Green, a physician from the Department of Obstetrics and Gynecology at the Mayo Clinic. We’ll discuss how to effectively evaluate patients with pelvic pain, “red flag symptoms” to watch for, useful laboratory tests to order, and common imaging studies which can be helpful in establishing a cause for the pain. We’ll also discuss the benefits of a multi-disciplinary approach to pelvic pain. Specific topics: Categorization of pelvic pain Appropriate evaluation of pelvic pain including the clinical history, physical exam, laboratory tests and imaging studies Relationship of chronic pelvic pain with other symptoms such as anxiety, depression, insomnia, and work/relationship issues Chronic pelvic pain representing a form of centralized pain Advantages of a multi-disciplinary approach to evaluating and managing chronic pelvic pain Additional resources: Chronic pelvic pain: ACOG practice bulletin, number 218. Obstet Gynecol. 2020 Mar; 135(3):e98-e109. doi: 1097/AOG.0000000000003716. Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Brian J. Linder, M.D. (@brianjlinder) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Patients rarely mention urinary incontinence to us as a problem as many assume it’s a normal change of aging. However, it’s a major quality-of-life issue. Many with incontinence are reluctant to go out in public and those who do, usually know the location of all the nearby restrooms. Yet, with proper evaluation and treatment, essentially all patients can be helped, and in many cases, they can be cured. In this podcast, we’ll discuss urgency urinary incontinence, one of the most common forms of incontinence. We’ll cover the questions you should ask your patients to make a diagnosis, what evaluation you should do, and what treatment options are available. Our guest for this topic is Dr. Brian Linder, a urologist at the Mayo Clinic. Specific topics: The various types of urinary incontinence Important questions to ask patients to make a diagnosis Effective use of a voiding diary Physical exam recommendations Helpful laboratory tests When urodynamic studies are indicated Non-pharmacologic treatment options Medications useful in treating urgency incontinence Treatment options for the refractory patient Additional resource: https://www.auanet.org/guidelines/overactive-bladder-(oab)-guideline Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded June, 2021 Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) "The reason we have the COVID-19 delta variant, the reason we have the delta plus variant is because of unimmunized people who get infected," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. He adds that 99.2% of the recorded COVID-19 deaths in the U.S. are in people not vaccinated against the virus. This is why he cautions folks who may be traveling this Fourth of July holiday and throughout the summer. "You don't know what variants people are carrying, how symptomatic they are, the health of their immune system, or if they've been vaccinated," says Dr. Poland. "When you are around groups of people indoors that are not in your bubble, so to speak, I think you should still wear a proper mask." In this Mayo Clinic Q&A podcast, Dr. Poland explains why, even if you are fully vaccinated for COVID-19, you should still consider being masked in some situations. He also discusses breakthrough infections in certain subpopulations, and what that may mean for needing booster shots. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Jeremy K. Cutsforth-Gregory, M.D. (@JCGneuro) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Postural Orthostatic Tachycardia Syndrome, or POTS, is a medical condition manifested by tachycardia that occurs after standing or prolonged sitting and is often associated with symptoms such as dizziness, fatigue, and occasionally syncope. POTS can be difficult to diagnose as patients often present with a variety of vague, and what seem like unrelated, symptoms. Management of patients with POTS can be equally difficult as there’s no one treatment which is effective in all patients. However, patients with POTS often have typical symptoms and objective findings on physical exam. Once a diagnosis is made, effective treatment is available and many patients with POTS can be helped with non-pharmacologic therapy. To help us understand POTS and its management, we’ll speak with Dr. Jeremy Cutsforth-Gregory, a neurologist at the Mayo Clinic. We’ll discuss the proposed theories regarding the cause of POTS, the different types of POTS, pathologic findings in patients with POTS, and the management of patient with POTS. Specific Topics: Typical symptoms of POTS Risk factors for POTS Theories regarding the cause of POTS Description of the varieties of POTS How to diagnose POTS Pathologic and pharmacologic abnormalities related to POTS Management of patients with POTS Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline Guest: Drew M. Witter, CCRP Host: Darryl S. Chutka, M.D. (@ChutkaMD) “Stem Cell Clinics” throughout the U.S. promote stem cell therapy for a variety of health conditions including osteoarthritis, autism, macular degeneration, Parkinson’s Disease, Alzheimer’s Disease and most recently COVID-19 infections. How can our patients be assured that the regenerative medicine therapy effectively treats their health condition and the products they receive are safe? In this podcast, we discuss regulations regarding regenerative medicine, the process of obtaining FDA-approval and which regenerative medicine therapies are FDA-approved. Our guest will be Drew Witter, a Program Manager from the Office of Research and Regulatory Support at the Mayo Clinic. Specific topics discussed: Process of taking regenerative medicine from the research lab to the clinical practice How regulators ensure the safety and effectiveness of regenerative therapies The process of acquiring FDA-approval Regenerative medicine therapies that are FDA-approved How patients and clinicians learn of FDA-regulated regenerative medicine clinical trials Additional resources: Clinical Trials available at Mayo Clinic through the Center for Regenerative Medicine: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/patient-care/clinical-trials U.S. National Library of Medicine: https://www.clinicaltrials.gov/ Center Watch: https://www.centerwatch.com/ Additional educational opportunities from Mayo Clinic: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/ Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Matthew K. Tollefson, M.D. (@MattTollefsonMD) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Other than skin cancer, prostate cancer is the most common cancer in men in the United States and will affect 1 in every 6 men 65 years and older. Fortunately, when detected early, it is very treatable. Long-term follow-up of patients with treated prostate cancer is usually performed by primary care providers. How often should these patients be seen? How much of an exam is recommended? Which tests should be ordered? When are imaging tests indicated and which studies are the most helpful? This podcast will address these questions and more as we discuss the primary care management of the post-prostate cancer patient with Dr. Matthew Tollefson, a urologist from the Mayo Clinic. Specific topics discussed: Current treatment options for prostate cancer Determinants for choosing one of the treatment options for prostate cancer When and how often patients should receive follow-up for prostate cancer Laboratory tests recommended for the follow-up of prostate cancer patients When a detectable PSA is concerning following prostate cancer treatment Imaging studies recommended for following prostate cancer patients and when they are indicated Treatment options for recurrent prostate cancer Future treatment options for prostate cancer which have potential Additional resources: https://www.auanet.org/guidelines/advanced-prostate-cancer https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087 https://www.mayoclinic.org/medical-professionals/urology Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded June 21, 2021 To claim credit visit: https://ce.mayo.edu/covid19podcast Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) Summer and fall are going to be a dangerous time for people in the U.S. who have not been vaccinated for COVID-19, according to Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "I really think this exponential rise in the number of sequences that are delta must be taken seriously," says Dr. Poland. "We are seeing a surge again, in hospitalizations in the UK, because of the delta variant in people who have not been vaccinated or who only got one dose of vaccine. This is a really critical message for the public to hear because in the U.S. we are stalled in vaccination rates." In this Mayo Clinic Q&A podcast, Dr. Poland talks more about a possible COVID-19 surge and being emotionally ready for the pandemic to be over. He also answers listener questions about COVID-19 reinfection, the latest on antiviral development for COVID-19, and the latest news about COVID-19 vaccines affecting menstrual cycles and sperm quality. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline Guest: Atta Behfar, M.D., Ph.D. (@AttaBehfar) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Traditional treatment of cardiac disease, especially advanced congestive heart failure has been limited. Transplantation has potential for benefit; however, organ shortage remains a barrier. It’s anticipated that regenerative medicine will help solve this unmet need with new treatment options to repair damaged heart tissue. This podcast will discuss regenerative medicine for cardiovascular disease with Dr. Atta Behfar, a Mayo Clinic cardiologist with expertise in advanced heart failure and transplantation. We’ll review the progress made in regenerative medicine in management of cardiovascular disease, what treatment options are currently available and the potential treatment options which will become available in the future. Specific topics discussed: Regenerative potential of the cardiovascular system Current challenges in management of patients with cardiovascular disease Progress in regenerative medicine for the cardiovascular system Limitations in regenerative cardiac therapy using regenerative medicine Future potential for regenerative medicine treatment of cardiovascular disease Patients who are candidates for cardiac regenerative therapies Additional resources: Clinical Trials available at Mayo Clinic through the Center for Regenerative Medicine: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/patient-care/clinical-trials U.S. National Library of Medicine: https://www.clinicaltrials.gov/ Center Watch: https://www.centerwatch.com/ Additional educational opportunities from Mayo Clinic: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/ Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded June 14, 2021 Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices is holding an emergency COVID-19 meeting this week to discuss COVID-19 vaccine safety as it relates to news that young people may develop myocarditis after receiving a second dose of a messenger RNA COVID-19 vaccine. Myocarditis, which is an inflammation of the heart muscle, is usually caused by a viral infection. But it can result from a reaction to a drug or be part of a more general inflammatory condition. Signs and symptoms include chest pain, fatigue, shortness of breath and arrhythmias. "There have been about 789 cases reported," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "And that can happen for a whole variety of reasons." In this Mayo Clinic Q&A podcast, Dr. Poland details the concerns about the myocarditis reports. He also discusses the latest news on the COVID-19 delta variant, and he explains what scientists are calling the "two-track pandemic." AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Terry D. Schneekloth, M.D. Host: Darryl S. Chutka, M.D. (@ChutkaMD) According to the 2019 National Survey on Drug Use and Health, nearly 26% of individuals 18 and older reported that they engaged in binge drinking and slightly over 6% engaged in heavy alcohol use within the past month. Binge drinkers were 70 to 90 times more likely to have an alcohol-related emergency department visit. Based on their data from this study, they estimated that nearly 15 million people ages 12 and older had alcohol use disorder. It’s also known that those with alcohol use disorder commonly seek care from primary care providers for alcohol-related medical problems. Our guest for this podcast is Terry Schneekloth, M.D., a psychiatrist and addiction specialist at Mayo Clinic. Specific topics discussed: Definition of alcohol use disorder Risk factors for alcohol use disorder Role of genetics Questions primary care providers should ask to explore the possibility of an alcohol use disorder in patients Physical exam or lab findings which could suggest an alcohol use disorder Available treatment options and their alcohol use disorder effectiveness Additional Resources: World Health Organization (WHO). Alcohol Use Disorders Identification Test (AUDIT). 2001 November 18; https://www.who.int/publications/i/item/audit-the-alcohol-use-disorders-identification-test-guidelines-for-use-in-primary-health-care National Institute on Alcohol Abuse and Alcoholism (NIAAA). National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) study: https://www.niaaa.nih.gov/research/nesarc-iii Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline Guest: Nathan Staff, M.D. (@NathanStaffMD) Host: Darryl S. Chutka, M.D. (@ChutkaMD) The cells in our nervous system are extremely specialized, especially those in the brain. Unfortunately, nervous tissue does not have a great potential to regain function once it is lost. Exciting research is being done in the field of neuro-regenerative medicine which will give hope for improvement to those with chronic neurodegenerative disease or nerve damage from injury. Dr. Nathan Staff, a Mayo Clinic neurologist, joins us regarding the challenges with the current management of chronic neurodegenerative diseases and the future potential for treating such conditions as Parkinson’s Disease, Alzheimer’s Disease, ALS and other neurodegenerative disease with regenerative medicine therapies. Specific topics discussed: Current research in regenerative medicine treatment for chronic neurodegenerative disease Currently used regenerative medicine in neurologic conditions New treatment options on the horizon for chronic neurodegenerative disease using regenerative medicine therapy Additional educational opportunities from Mayo Clinic: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/ Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Daniel B. Ryssman, M.D. Host: Darryl S. Chutka, M.D. (@ChutkaMD) Generally, we take our feet for granted. It’s not unusual for a person to take 8- to 10-thousand steps per day. That translates to over 115,000 miles in a lifetime. By the time we reach 70 years old, the average person will have walked the equivalent of 4 times around the globe. Yet, we stop taking our feet for granted when they hurt, and it’s estimated that 75% of Americans will experience foot problems of varying degrees of severity during their lifetime. In this podcast, we’ll discuss foot and ankle pain with Daniel Ryssman, M.D., an orthopedist and sports medicine physician from Mayo Clinic. We’ll review some of the common injuries to the ankle such as sprains and fractures as well as common chronic conditions of the foot such as plantar fasciitis and bunions. Dr. Ryssman delves into the best ways to prevent, diagnose, and treat these conditions as well as what, if any, imaging to order. Specific topics discussed: Ankle sprains Ankle fractures Achilles’ tendon rupture Plantar fasciitis Bunions Metatarsalgia Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded June, 2021 To claim credit visit: https://ce.mayo.edu/covid19podcast Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) If you've been vaccinated for COVID-19, you're able to go shopping, eat in restaurants and travel on airplanes without the same worry of becoming infected with COVID-19 that existed just months ago. But for those who are unvaccinated, getting infected with COVID-19 — even with just minor symptoms — should be a concern, according to Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "For those who have been vaccinated, life is resuming back to a sense of normalcy," says Dr. Poland. "But for the unvaccinated, they now live in a dangerous phase of the pandemic, where we're seeing circulating variants that are much more transmissible and may cause worse cases of the disease than what happened last year at this time. I think the people who are unvaccinated may not realize that." In this Mayo Clinic Q&A podcast, Dr. Poland also offers information on more COVID-19 studies underway and he talks about COVID-19 vaccine research protocols that will be able to help scientists with other vaccine research, such as HIV vaccine research. Also, he answers listener questions, such as, "Does someone who has already been infected with COVID-19, really need to be fully vaccinated for COVID-19 or would just a booster be needed?" AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline Guest: Daniel Saris, M.D., Ph.D. (@sarisnl) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Osteoarthritis of the knee is extremely common, and it’s estimated that 1 in 2 people are likely to develop symptomatic knee osteoarthritis in their lifetime. Its known that damaged cartilage is the precursor to osteoarthritis. Many individuals have had partial or complete meniscectomies for meniscal tears in the past and those individuals were then likely to eventually develop knee osteoarthritis. What if damaged cartilage was repaired instead of surgically removed? Could that be an effective treatment recommendation we could give to our patients to help prevent or treat osteoarthritis? Our podcast guest today is Dr. Daniel Saris and he has some fascinating information related to cartilage damage and repair using regenerative medicine techniques. Specific topics discussed: How meniscal damage relates to osteoarthritis Ability of cartilage to repair itself when damaged Repairing a damaged meniscus instead of a partial or complete meniscectomy Specific techniques of repairing cartilage Success in treating patients with cartilage repair Future treatment options for osteoarthritis using regenerative medicine Additional educational opportunities from Mayo Clinic: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/ Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Erin K. O'Brien, M.D. (@ErinOBrienMD) Host: Amit K. Ghosh, M.D. (@AmitGhosh006) Erin O’Brien, M.D., division chair of Rhinology in Rochester, MN, joins us again to provide an evidence-based update on anosmia and its prevalence in post-COVID patients. She reviews the postulated mechanism by which anosmia occurs in this group of patients, and how this effects patients’ safety, mental health, and overall wellbeing. Dr. O’Brien also gives an overview of treatment options, such as various methods of olfactory training, and what physicians need to know when counseling their patients with post-COVID anosmia. Additional resources: Video on olfactory training: https://www.youtube.com/watch?v=Qrr0so6pFOs Abscent – resources for patients with anosmia: https://abscent.org/ Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline Guest: Shane A. Shapiro, M.D. (@ShaneShapiroMD) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Musculoskeletal pain is extremely common and when severe, patients often gain significant benefit from joint replacements. However, until our patients reach the point where surgery is an option, our efforts to help patients with the chronic joint pain often leave much to be desired. A relatively new treatment approach has appeared in the past decade, musculoskeletal regenerative medicine. But does the research back up the numerous claims of benefit? This podcast will review the current treatment options available and future potential of regenerative medicine for musculoskeletal problems with Dr. Shane Shapiro, a sports medicine physician in the Department of Orthopedics at the Mayo Clinic. We’ll discuss the current regenerative products and therapies available to optimize patient outcomes, potential adverse effects of the therapies and the numerous claims by many clinicians regarding the benefit potential for regenerative medicine in musculoskeletal disease. Specific topics discussed: Challenges of currently available traditional treatment for musculoskeletal conditions Benefits of stem cell injections for osteoarthritis Potential adverse effects of stem cell injections Currently available regenerative medicine therapies that have shown benefit to patients Validity of the many claims made by clinicians regarding the benefits of stem cell injections Additional educational opportunities from Mayo Clinic: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/ Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Tyler S. Oesterle, M.D., M.P.H. (@OesterleMD) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Opioid abuse remains a significant problem, and as law enforcement and regulatory agencies tighten access to prescription analgesics, individuals are seeking alternatives. It’s been discovered that when taken at very high doses, loperamide can produce similar effects to the opioid analgesics and the drug is inexpensive when compared to the price of both illicit and prescription opioids. As a result, loperamide abuse has become a significant problem. In this episode we discuss loperamide abuse with Tyler Oesterle, M.D., M.P.H., a psychiatrist at Mayo Clinic’s Rochester campus. We’ll review the typical central nervous system effects of high dose loperamide and the associated safety issues. Specific topics: Current status of the opioid crisis in the U.S. Effects of loperamide in both therapeutic and excessive doses Reasons behind taking high dose loperamide in excessive doses Safety issues associated with high dose loperamide Potential of high dose loperamide leading to drug dependence Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded May 24, 2021. To claim credit visit: https://ce.mayo.edu/covid19podcast Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) The number of COVID-19 cases, hospitalizations and deaths in the U.S. continues to decline. However, cases of COVID-19 are increasing in younger populations. "It's becoming a childhood disease," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "Children have composed over 16,000 hospitalizations for COVID-19 and about 300 have died." Meanwhile, each day brings fresh research news, including updates on possible side effects of the COVID-19 vaccines. "We're collecting information as we go and have data on about 4.5 million people now," says Dr. Poland. "That's larger than we would have for any other vaccine." In this Mayo Clinic Q&A podcast, Dr. Poland expands on these latest news items and puts the data in perspective. He also discusses vaccination rates, the possibility of mixing and matching vaccines for COVID-19 boosters, vaccination rates, and much more. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline Guest: Saranya Wyles, M.D. (@SWylesMDPhD) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Much of regenerative medicine is relatively new and some of the future treatment capabilities have the potential to significantly change the way we practice medicine. How do you educate established clinicians as well as clinicians in training regarding this new practice? How do you educate the general public which has been misled by a variety of false claims regarding which medical conditions regenerative medicine can currently effectively treat? This podcast discusses how a relatively new medical field puts together an education program to inform others of its potential. Our guest is Saranya Wyles, M.D., a resident in the Department of Dermatology who has considerable experience in regenerative medicine education. Specific topics discussed: Specific groups who need educating regarding the capabilities of regenerative medicine The importance in training the medical workforce regarding regenerative medicine What regenerative medicine means for the next generation of healthcare providers How to incorporate regenerative medicine concepts into an established medical school curriculum How to educate more advanced learn years such as residents and healthcare providers Obtaining an advanced degree in the field a regenerative medicine Additional resources: International Society for Stem Cell Research (ISSCR): https://www.isscr.org/ The ISSCR Patient Handbook on Stem Cell Therapies: https://www.closerlookatstemcells.org/patient-resources/ Regenerative medicine curriculum for next-generation physicians: https://www.nature.com/articles/s41536-019-0065-8 Digital regenerative medicine and surgery pedagogy for virtual learning in the time of COVID-19: https://www.futuremedicine.com/doi/full/10.2217/rme-2020-0106 Additional educational opportunities from Mayo Clinic: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/ Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded in May, 2021 To claim credit visit: https://ce.mayo.edu/covid19podcast Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) Recent COVID-19 masking guidelines announced by the Centers for Disease Control and Prevention, continue to generate a public conversation. "The decision about masking needs to be nuanced," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "Wearing a mask should be based on the risk of infection, the percentage of the population vaccinated, a person's own immune system, and then the role of vaccine variants with the durability of our immune response." In this Mayo Clinic Q&A podcast, Dr. Poland discusses masking guidelines in further detail. Also, he offers an update on COVID-19 vaccine research for children, and he shares positive news about the decreasing numbers of COVID-19 cases and deaths. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Carrie A. Thompson, M.D. (@CaThompsonMD) Host: Darryl S. Chutka, M.D. (@ChutkaMD) It’s common for a patient to see their primary care provider after they’ve discovered an enlarged lymph node and they’re usually concerned that it represents a serious illness. Fortunately, in most cases it’s due to a benign cause and most patients can be reassured once we perform a careful history and physical examination. However, on occasion lymphadenopathy can represent serious disease. Carrie Thompson, M.D. a hematologist, at Mayo Clinic’s Rochester campus joins us to discuss how to tell when lymphadenopathy is due to a benign or serious cause. We’ll review the characteristics of both benign and malignant lymph nodes and the evaluation which should be done both for an enlarged solitary lymph node as well as generalized lymphadenopathy. Specific topics discussed: Prevalence of malignancy in patients who seek a medical evaluation for lymphadenopathy Categories of disease which can have associated lymphadenopathy Characteristics of benign and malignant lymph nodes Diagnostic approach for a solitary enlarged lymph node Diagnostic approach or multiple or generalized lymphadenopathy Fine needle aspirate vs. excisional biopsy for evaluation of lymphadenopathy Additional resources: Gaddey, HL. Riegel, AM. Unexplained lymphadenopathy: evaluation and differential diagnosis. Am Fam Physician.2016 December 1; 94(11): 896-903. https://www.aafp.org/afp/2016/1201/p896.html Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline Guest: Saad J. Kenderian, M.B., Ch.B. (@kenderian_ss) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Regenerative immunotherapy is a treatment that uses the power of our own immune system to fight malignancy. It can include targeted antibodies, cancer vaccines, or tumor infecting viruses to name a few. Some immunotherapy treatments use genetic engineering to enhance our immune cell’s cancer fighting properties and can be used in combination with more traditional treatments including surgery, chemotherapy, or radiation. It’s FDA-approved as a first line treatment of multiple cancers and may also be effective in the management of malignancies that have been resistant to more traditional therapy. This podcast will address regenerative immunotherapy with Dr. Saad Kenderian, a hematologist at the Mayo Clinic. We’ll review the relationship between cancer and our immune system, how we can use our immune system to treat malignancy and which malignancies which have shown the best responses to regenerative immunotherapy. Specific topics discussed: Relationship between cancer and our immune system How we can use our body’s immune system to fight malignancy Malignancies which can be currently be effectively treated with regenerative immunotherapy Malignancies which have had the best responses to regenerative immunotherapy Limitations in regenerative immunotherapy Additional educational opportunities from Mayo Clinic: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/ Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Kathryn J. Ruddy, M.D. (@KathrynRuddyMD) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Breast cancer in men is very uncommon, about 1/100th as common as in women. It’s expected that this year, just under 3000 men are likely to be diagnosed with it, and just over 500 men will die from breast cancer. Because it’s so uncommon, there are very few good studies which have been completed to educate us about this disease. Kathryn Ruddy, M.D., an oncologist at Mayo Clinic’s Rochester campus joins us to discuss breast cancer in men and what we should do as primary care clinicians to care for our male patients who may be at increased risk to develop it. We’ll cover how breast cancer in males differs from that in females, its risk factors, how it’s diagnosed, and the survival rates of men with a diagnosis of breast cancer. Specific topics: Prevalence of breast cancer How most breast cancers in men are found The recommended evaluation of a male patient with suspected breast cancer Risk factors for breast cancer in men Treatment for male breast cancer Survival rates for breast cancer in men Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline Guest: Richard E. Hayden, M.D. Host: Darryl S. Chutka, M.D. (@ChutkaMD) Currently reconstructive surgery involves taking the patient’s tissue from one area of their body and using it elsewhere to rebuild diseased or damaged tissue. Regenerative reconstructive surgery will allow the patient to grow their own replacement tissue from stem cells. This has incredible potential for allowing significantly better reconstructive surgical results. Currently regenerative reconstructive surgery is in its infancy, however in the next several years this should develop into a new standard of care for patients who need reconstructive surgery. This podcast features Dr. Richard Hayden, a reconstructive surgeon/otolaryngologist. We discuss the future of reconstructive surgery using regenerative medicine techniques, the difficulties in enabling patient access to regenerative therapies, the education that’s needed for not only providers but also for patients, and the future of regenerative reconstructive surgery. Specific topics discussed: Role regenerative medicine plays and reconstructive surgery Importance in adopting and delivering regenerative care Challenges in current standard of care approaches in reconstructive surgery Difficulties enabling patient access to regenerative therapies Educational needs in regenerative reconstructive surgery The future of regenerative reconstructive surgery Additional educational opportunities from Mayo Clinic: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/ Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Laura J. Orvidas, M.D. Host: Darryl S. Chutka, M.D. (@ChutkaMD) Tonsils and eustachian tubes often get taken for granted until they cause problems. Eustachian tube dysfunction is quite common and usually resolves on its own, however some patients will develop recurrent eustachian tube dysfunction and it can result in recurrent episodes of otitis media, especially in children. Although recurrent tonsillitis used to be the most common indication for tonsillectomy, more children are having this procedure for disordered breathing conditions, such as obstructive sleep apnea. In this episode, we’ll discuss disorders of the eustachian tube and tonsils with Laura J. Orvidas, M.D., an otolaryngologist at the Mayo Clinic. Specific topics discussed: Purpose of the eustachian tube Definition of eustachian tube dysfunction Physical exam findings of eustachian tube dysfunction Recurrent eustachian tube dysfunction in children and potential for recurrent episodes of otitis media When pressure equalization tubes are indicated Relationship between pharyngitis and tonsillitis Viral versus bacterial causes of tonsillitis How to suspect a peritonsillar abscess Indications for tonsillectomy Management of tonsil stones Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded in May 2021. To claim credit visit: https://ce.mayo.edu/covid19podcast Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: DeeDee Stiepan (@deedeestiepan) COVID-19 cases are falling in the U.S. because 245 million doses of one of the available COVID-19 vaccines have been administered, according to Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "But at the same time, there are still people who need more information about the safety and the value of getting a COVID-19 vaccine," says Dr. Poland. While still hopeful, Dr. Poland says he's concerned herd immunity won't be reached in the U.S. through vaccination. And that will mean more tragic deaths due to COVID-19 infection. "My guess is, because we're such an interconnected global community until everybody's safe, none of us are safe. And we're going to likely see continued circulation of the virus, and that virus will seek out whoever is not immune," says Dr. Poland. In this Mayo Clinic Q&A podcast, Dr. Poland also addresses when we will need COVID-19 vaccine boosters will be needed and the latest on masking guidelines from the Center for Disease Control and Prevention. Plus, he will provide an update on COVID-19 treatments and how to handle those who want to visit a newborn baby. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline Guest: Dennis Wigle, M.D., Ph.D. (@DrWigle) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Regenerative Medicine has some amazing capabilities and in the near future, it’s likely to significantly change how we practice medicine. It faces some challenges in educating both the medical community as well as the general public regarding its current realistic capabilities. There are many unsubstantiated claims made by practitioners to the public regarding the benefits of regenerative medicine therapy. We’ll discuss how the true potential of regenerative medicine is conveyed to both clinicians and the public with Dr. Dennis Wigle, a thoracic surgeon and chair of the Division of General Thoracic Surgery at the Mayo Clinic. We’ll discuss some of the common misperceptions of regenerative medicine and how a consultation service can educate both the public and medical community regarding the benefits of regenerative medicine. Specific topics discussed: How to provide education to the public and the medical community When and why the regenerative consultation service was formed How the regenerative medicine consultation service works Common misperceptions community regarding the realistic benefits of regenerative medicine Additional resources: For more information about Mayo Clinic’s Regenerative Medicine Consult Service, visit: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/patient-care/regenerative-medicine-consult-service Additional educational opportunities from Mayo Clinic: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/ Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline Guest: Fredric B. Meyer, M.D.; Andre Terzic, M.D., Ph.D. Host: Darryl S. Chutka, M.D. (@ChutkaMD) Imagine a patient who has suffered a massive myocardial infarction leaving a significant amount of damaged and non-functioning ventricular myocardium. Treatment for this patient’s subsequent congestive failure does not involve diuretics and beta blockers but rather an injection of the patient’s modified stem cells into surrounding viable ventricular myocardium resulting in the regeneration of new, functioning myocardial cells restoring the cardiac output. This is not science fiction but represents ongoing work by investigators in Regenerative Medicine. This week’s podcast will explore this amazing field of medicine which has the potential to change how medicine is practiced. We’ll discuss the origins of regenerative medicine, what currently be done in regenerative medicine as well as the potential for the future. Our guests today are Andre Terzic, M.D., Ph.D., director of the Mayo Clinic Center for Regenerative Medicine and Fredric B. Meyer, M.D., a neurosurgeon and the Executive Dean for Education at the Mayo Clinic. Specific topics discussed: When the field of regenerative medicine began Which current medical conditions can currently be managed with regenerative medicine How to determine which patients have potential for regenerative medicine therapies Additional educational opportunities from Mayo Clinic: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/ Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded in April, 2021 Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) While the number of people being vaccinated for COVID-19 is dropping, the Centers for Disease Control and Prevention and other medical experts continue to strongly encourage people to get vaccinated for COVID-19. And that means that those who are being vaccinated with the Moderna and Pfizer COVID-19 vaccine should get their first and second doses on schedule. “About 8% of people who got their first dose have not returned for the second dose and this is concerning when you're getting close to 1 in 10," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "When you measure in the short term, one dose in a healthy person offers about 80% protection. But that's not 95% protection, like you get after two doses." In this Mayo Clinic Q&A podcast, Dr. Poland expands on why people need that second COVID-19 vaccine dose and he talks about whether people should mix and match the different COVID-19 vaccines for their second dose. He also speaks about the status of COVID-19 vaccines for young people, and he addresses listener questions about traveling, being together after vaccination, and the latest rise of additional COVID-19 variants. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Tobias S. Kohler, M.D., M.P.H. Host: Darryl S. Chutka, M.D. (@ChutkaMD) Erectile dysfunction not only causes lifestyle changes, but it may also be the first symptom of peripheral vascular disease. Since many men are reluctant to mention erectile dysfunction to their healthcare provider, it’s important for us to ask our patients whether it is a problem and be knowledgeable in the appropriate evaluation of patients who have it. This reluctance may cause many to seek out readily available but ineffective treatments from questionable sources, even though there are a variety of proven, effective treatments that can be prescribed. Tobias S. Kohler, M.D., M.P.H., a Mayo Clinic Urologist, joins us to discuss the impact of erectile dysfunction, the currently available effective treatments, as well as the unproven, ineffective products currently being used. Specific topics discussed: The first historical appearance of treatments for erectile dysfunction Most common causes of dysfunction Appropriate evaluation of patients who present with erectile dysfunction Review of the currently available effective treatment options Reasons men are reluctant to mention the topic of erectile dysfunction to their provider Review of some ineffective treatments currently being promoted Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded on April 19, 2021. To claim credit visit: https://ce.mayo.edu/covid19podcast Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group says COVID-19mutations and the virus spread are happening because of people who don't wear masks, who don't get vaccinated and who don't adhere to safety recommendations. "I believe that we should be radically transparent and honest," says Dr. Poland. "The more time this virus passes through one person after another, the more likely it continues to mutate. As a result of those mutations, two things are happening. Some of the mutations are making vaccines and plasma monoclonal antibodies less effective. The other thing is that the virus will likely become something that we have to live with for the rest of our lives." Dr. Poland reminds people that vaccine protection is not 100%. Breakthrough infections can occur. "Remember that in the clinical trials, 95% means that compared to unvaccinated people, your risk is reduced by 95% — not 100%," he says. "You might have a mild case of COVID-19,but you can still spread it to others, including those who are immune compromised, such as cancer patients. That's why we continue to wear masks until we get very widespread immunization." In this Mayo Clinic Q&A podcast, Dr. Poland talks more about breakthrough infections and the Johnson & Johnson COVID-19 vaccine pause, and he answers listeners' questions. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded in April, 2021 To claim credit visit: https://ce.mayo.edu/covid19podcast Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) As spring break travelers return home and the highly transmissible U.K. COVID-19 variant is discovered in all 50 U.S. states, the country is on the verge of a fourth COVID-19 pandemic surge. That's according to a number of health experts, including Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. However, Dr. Poland says there is some good news related to the transmission of COVID-19 on surfaces. "Wisdom resides in changing your mind and your recommendations as new data and science becomes available," says Dr. Poland. "What the Centers for Disease Control and Prevention is doing is modifying those guidelines, saying that the risk of touching a contaminated surface and then getting infected is very low." In this Mayo Clinic Q&A podcast Dr. Poland explains more about the CDC guidelines and he addresses other COVID-19 topics in the news, including recent data that says men are more vaccine-hesitant than women. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Devin L. McCaslin, Ph.D. Host: Darryl S. Chutka, M.D. (@ChutkaMD) Being dizzy means different things to different patients and most patients find dizziness difficult to describe. Providers find it difficult to evaluate patients with dizziness and also which specialties can be asked for help in managing the dizzy patient. Dr. Devin McCaslin is the Director of the Vestibular and Balance Laboratory at the Mayo Clinic and an expert in evaluating the dizzy patient. He will discuss such topics as the role of vestibular balance laboratory testing in assessing patients, the most common findings from these evaluations, the multi-disciplinary approach to evaluating patients with dizziness, and how artificial intelligence is being used in the evaluation of a patient complaining of dizziness. Specific Topics Discussed: The multi-disciplinary approach to evaluating patients complaining of dizziness. Most common findings in the evaluation of a patient with dizziness. The role of vestibular balance laboratory testing in assessing patients who are candidates for these tests. How artificial intelligence is being used in the evaluation of patients with dizziness. Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded in April, 2021 To claim credit visit: https://ce.mayo.edu/covid19podcast Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) If you're fully vaccinated for COVID-19 you can travel domestically and where travel is allowed internationally, according to new interim travel guidelines from the Centers for Disease Control and Prevention (CDC). Even with those recommendations the CDC continues to recommend not traveling unless it is essential. Regardless, the CDC strongly recommends people continue to wear a face mask, practice social distancing and sanitize their hands. Meanwhile, COVID-19 vaccine research is continuing in teenagers. "The early data show equal safety in young people aged 12 to 16," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "I think this is going to imply that, somewhere between this fall and Christmas, we're going to be able to offer the (COVID-19) vaccine to every age group." In this Mayo Clinic Q&A podcast, Dr. Poland answers a number of listener questions, including how long the COVID-19 vaccines are predicted to last and if the current transmission research still supports wiping down household items. Dr. Poland also explains why someone who has had COVID-19 should still get a COVID-19 vaccine. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Scott D. Eggers, M.D. (@sdze) Host: Darryl S. Chutka, M.D. (@ChutkaMD) The complaint of dizziness is a common symptom our patients experience. It has a variety of causes; fortunately, most of them are benign. Despite the fact we frequently see patients with this medical concern, we still struggle evaluating them. Part of the difficulty is that dizziness means different things to different people and the cause of dizziness can be caused by disorders in one of several organ systems. To help us evaluate dizziness, Dr. Scott Eggers, a neurologist at the Mayo Clinic, reviews why dizziness is so difficult to evaluate and how we should evaluate a patient who complains of dizziness. We also explore the most common causes of dizziness including benign positional vertigo and vestibular neuritis. Finally, Dr. Eggers reviews symptoms that are suspicious for an ominous cause of dizziness. Specific topics discussed: Why dizziness is difficult to evaluate How to evaluate the complaint of dizziness Most common causes of dizziness Dizziness symptoms which are ominous for serious disease Description of benign positional vertigo Description of vestibular neuritis Description of vestibular migraines Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Central sensitization (CS) describes pathophysiologic changes in the central nervous system, including alterations in neurochemistry, CNS receptors, endogenous opioid system hyperactivity, cytokine and HPA axis dysregulation, and sympathetic hyperactivity. Collectively, these changes result in amplification of pain and sensory signals, leading to widespread pain, fatigue and other sensory sensitivities. Fibromyalgia and Chronic Fatigue Syndrome are established diagnoses/manifestations of central sensitization. In the era of the COVID-19 pandemic, we continue to learn about Post-Acute COVID-19 Syndrome, a manifestation of central sensitization similar to other post-infectious forms of CS, which underlies the persistent symptoms that many people experience after initial recovery from COVID-19. Elizabeth C. Wight, M.D. joins us to talk about Mayo Clinic’s treatment approach to central sensitization, which is rooted in empowering patients with education and a framework for a self-management program. This includes stress management, moderation, positive thinking, decreasing focus on symptoms, sleep hygiene, and Cognitive Behavioral Therapy among others. Additional resources: Post-COVID Recovery on Mayo Clinic Connect: https://connect.mayoclinic.org/page/post-covid-recovery/ Mayo Clinic’s “A Systematic Approach to Medically Unexplained Symptoms 2021” course can be found at https://ce.mayo.edu/internal-medicine/content/systematic-approach-medically-unexplained-symptoms-2021#group-tabs-node-course-default1 Clauw DJ. Fibromyalgia: A clinical review. JAMA. 2014;311(15):1547-1555. doi:1001/jama.2014.3266 Clauw DJ. Fibromyalgia and related conditions. Mayo Clin Proc. 2015 May;90(5):680-92. https://doi.org/10.1016/j.mayocp.2015.03.014 Harte, SE, Harris, RE, Clauw, DJ. The neurobiology of central sensitization. J Appl Behav Res. 2018; 23(2): e12137. https://doi.org/10.1111/jabr.12137 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Jan L. Kasperbauer, M.D. Host: Darryl S. Chutka, M.D. (@ChutkaMD) Thyroid nodules are commonly found in patients by primary care providers, either by physical exam or incidentally by a variety of imaging studies. Fortunately, the vast majority of thyroid nodules are benign, however as primary care providers we need to be comfortable in evaluating them to rule out the possibility that they represent a thyroid cancer. Joining us is Dr. Jan Kasperbauer, an otolaryngologist at the Mayo Clinic. We discuss risk factors for thyroid cancer, how a primary care provider should evaluate and manage patients with thyroid nodules, various types of thyroid cancer, and treatment options as well as the recommended follow-up for patients with thyroid cancer. Specific topics discussed: Risk factors for thyroid cancer Detecting thyroid cancers How primary care provider should evaluate and manage patients with thyroid nodules Review of the various types of thyroid cancer Treatment options for thyroid cancer Recommendations for primary care providers in following patients with treated thyroid cancer Additional resources: Classification for risk stratification and follow up recommendations: Grant, EG, et al. Thyroid ultrasound reporting lexicon: white paper of the ACR thyroid imaging, reporting and data system (TIRADS) committee. J Am Coll Radiol. 2015 Dec; 12(12): 1272-1279. doi: https://doi.org/10.1016/j.jacr.2015.07.011 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded in March, 2021 Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: Halena M. Gazelka, M.D. (@hmgazelkamd) The COVID-19 virus mutates and replicates when people let down their guard and don't follow safety protocols, such as practicing social distancing and wearing a mask. "I think most of us expect a major surge because of spring break travel and the relaxation of restrictions," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "And the sort of COVID fatigue that all of us feel, in one way or another." In this Mayo Clinic Q&A podcast, Dr. Poland addresses the potential of a fourth COVID-19 surge, new information regarding the COVID-19 vaccines for pregnant women and he discusses research for next generation vaccines for COVID-19 variants. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Jennifer L. Elmer, APRN, CNS, D.N.P.; Brianna M. Skrukrud, APRN, C.N.P. Host: Amit K. Ghosh, M.D. (@AmitGhosh006) Pressure injuries in bedridden patients present significant challenges​, which are compounded in the patient with a COVID-19 diagnosis. In this episode we discuss the problems encountered in preventing, diagnosing, and managing skin alterations in patients with COVID-19. Jennifer L. Elmer, APRN, CNS, D.N.P. and Brianna M. Skrukrud, APRN, C.N.P., two wound care experts at Mayo Clinic, discuss situations ​in which, despite best efforts, pressure injuries are unavoidable and why COVID-19 poses a great risk for skin alterations in hospitalized patients. They also discuss the 2020 position statement of National Pressure Injury Advisory Panel (NPIAP) on the management of skin alterations during the COVID-19 crisis. Additional resources: Unavoidable Pressure Injury during COVID-19 Pandemic: A Position Paper from the National Pressure Injury Advisory Panel https://cdn.ymaws.com/npiap.com/resource/resmgr/white_papers/Unavoidable_in_COVID_Pandemi.pdf Skin Manifestations with COVID-19: The Purple Skin and Toes that you are seeing may not be Deep Tissue Pressure Injury https://cdn.ymaws.com/npiap.com/resource/resmgr/white_papers/COVID_Skin_Manifestations_An.pdf Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded in March 2021. Guest: Gregory A. Poland, M.D. (@drgregpoland) Host: DeeDee Stiepan (@deedeestiepan) Millions of people in the U.S. are being vaccinated for COVID-19. However, discussion is ongoing as to whether people who are immunocompromised, such as patients undergoing cancer treatment, or people who have autoimmune diseases, should be vaccinated for COVID-19. "Both of those categories (of people) should be vaccinated," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "Those are not contraindications. Those are indications to get the vaccine." He adds that research is ongoing, but current information demonstrates the benefits far outweigh the theoretical risks. In this Mayo Clinic Q&A podcast, Dr. Poland talks about vaccine hesitancy, and patients who are immunocompromised or have autoimmune conditions. Also, he discusses next steps in the journey to vaccinate children for COVID-19. And he reviews recent guidance from the Centers for Disease Control and Prevention Control about in-person gatherings. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

* WARNING: This episode discusses suicide and suicidal ideation. * Guest: J. Michael Bostwick, M.D.(@DrBostwick) Host: Amit K. Ghosh, M.D. (@AmitGhosh006) In this episode, professor of psychiatry and international authority on suicide risk and challenges in suicide prevention, J. Michael Bostwick, M.D. from Mayo Clinic in Rochester joins us. He’ll discuss epidemiological-based research looking at the utilization patterns of medical care by individuals who have contemplated or committed suicide. Dr. Bostwick will describe the concept of suicide crisis including risk factors, current events/warning signs, and mental status/agitation. He’ll also explain self-agency, stigma of discussing mental illness, potential value-based societal approach to individuals in distress and despair, and potential solutions to the suicide prevention. Additional resources: Suicide Prevention in Primary Care Medicine; Huguet, Nathalie et al.; Mayo Clinic Proceedings, Volume 90, Issue 11, 1459 – 1461; https://doi.org/10.1016/j.mayocp.2015.09.011 Grappling With Suicide Risk; Sublette, M. Elizabeth; Mayo Clinic Proceedings, Volume 93, Issue 6, 682 – 683; https://doi.org/10.1016/j.mayocp.2018.04.006 Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew; Bostwick, J. Michael et al.; Amer Journal of Psychiatry; Volume 173, Issue 11, November 01, 2016, 1094-1100; https://doi.org/10.1176/appi.ajp.2016.15070854 If you're feeling overwhelmed by thoughts of not wanting to live or you're having urges to attempt suicide, get help now. Call 911 or your local emergency number immediately. Call a suicide hotline. In the U.S., call the National Suicide Prevention Lifeline at 1-800-273-8255 any time of day — press "1" to reach the Veterans Crisis Line or use Lifeline Chat. For a list of suicide hotline numbers outside of the U.S., visit: https://www.opencounseling.com/suicide-hotlines Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

This episode is shared from Mayo Clinic Q&A and was recorded in March, 2021. Guest: Billie A. Schultz, M.D. Host: Halena M. Gazelka, M.D. (@hmgazelkamd) Fatigue and what's being called "brain fog" are turning out to be some of the most common issues for long-hauler patients recovering from COVID-19. The National Institutes of Health calls these and other symptoms, which can last for several months, post-acute sequelae of SARS-CoV-2, or PASC. Those suffering from brain fog may experience short-term memory loss, confusion, difficulty concentrating, or just feeling different than they did before they had COVID-19, even if it was a mild case of the infection. And Dr. Billie Schultz, a Mayo Clinic physical medicine and rehabilitation expert, says, though older patients more often to have these symptoms more often, younger people are also showing up with brain fog. In this Mayo Clinic Q&A podcast, Dr. Schultz says brain fog seems to be more inflammatory than infection, but there are more questions than answers about this neurological concern. Meanwhile, efforts are underway to develop rehabilitation programs to help patients recover. AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19 Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Ravindra Ganesh, M.B.B.S., M.D. Host: Amit K. Ghosh, M.D. (@AmitGhosh006) It has been estimated that as many as 10-30% of patients who have recovered from COVID-19 have an array of symptoms, ranging from minor to disabling, that persist more than four weeks post-COVID infection. These symptoms have not only been identified in patients who had severe symptoms of COVID-19 requiring intensive care unit treatment, but also those who only experienced mild-to-moderate symptoms. The exact cause of this state, most popularly called post-COVID long hauler syndrome, is still under investigation. The symptoms range from mild to disabling fatigue, body aches, atypical chest pain, loss of sense of taste and smell, brain fog, among others and many of these patients need additional evaluation and management to deal with their disabling symptoms. In this podcast Dr. Ravindra Ganesh, the consultant in General Internal Medicine who leads the COVID Frontline Care Team (CFCT) efforts, as well as the Post-COVID Clinic, at Mayo Clinic Rochester, discusses the array of symptoms, management strategies, and research possibilities, as well as opening of an upcoming clinic in Mayo Clinic Rochester that would address the concern of the patient's and deal with the post COVID long hauler symptoms Additional Resources: Post-COVID Syndrome on Ask Mayo Expert: https://askmayoexpert.mayoclinic.org/ To refer a patient to or request an appointment at Mayo Clinic, visit: https://www.mayoclinic.org/appointments Post-COVID Recovery on Mayo Clinic Connect: https://connect.mayoclinic.org/page/post-covid-recovery/ Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Guest: Maria I. Vazquez Roque, M.D. (@MVazquezRoqueMD) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Clostridium difficile is a toxin-producing bacterium that can result in a severe form of antibiotic-associated diarrhea known as clostridium difficile infection or CDI. Cases can vary from mild diarrhea to severe colitis that at times can be fatal. There’s been a dramatic increase in the number as well as severity of CDIs in the U.S. over the past 20 years. Although CDI typically occurs following the use of antibiotics, it can also be spread from one individual to another, especially in hospitals and skilled nursing facilities. Antibiotics have been the traditional treatment for patients with CDI, however recurrent symptoms have been a problem. There’s now a new treatment for CDI, felt to be effective in over 90% of patients with the illness. Our guest to discuss this topic is Dr. Maria Vazquez Roque, a gastroenterologist at the Mayo Clinic. We’ll review the common presenting symptoms, laboratory tests needed to establish a diagnosis, and the current recommendations for treatment including the latest of fecal transplantation. Additional resources: Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): https://doi.org/10.1093/cid/cix1085 Specific topics discussed: The typical presentation of C. difficile infection Patients who are at increased risk for a C. difficile infection Laboratory tests to order to confirm a case of C. difficile infection Treatment options for C. difficile infection including fecal transplantation Potential benefit of probiotics for preventing a C. difficile infection Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.