Mayo Clinic Talks

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.