Mayo Clinic Talks

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.