Mayo Clinic Talks

Genes & Your Health Edition: Epigenomics Research – Understanding Genetics of Treatment Resistance

Guest:   Alexandre Gaspar Maia, Ph.D. (@gasparma1a)

Host: Denise M. Dupras, M.D., Ph.D.

Epigenomics is a fascinating field in which researchers chart the locations and understand the functions of all chemical tags that mark the genome. The epigenome is the first boundary from the exterior world to our DNA sequence, and it can change dramatically. This episode discusses the state of the art of epigenomics analysis and the epigenome in the context of specific cells. Additionally, it explores the future of epigenomics for individualized medicine and in better understanding genetics of treatment resistance. The guest for this episode is Alexandre Gaspar Maia, Ph.D., an assistant professor in the Functional Genomics Laboratory at Mayo Clinic.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Scoliosis: Around The Bend

Host: Edward R. Laskowski, M.D

Guest: Anthony A. Stans, M.D.

The evaluation and treatment of scoliosis is an area that has created some controversy over the years.  Should we be screening kids in school?  When do we brace kids with scoliosis?  And what are the indications for surgery? To help us answer these questions and more, I am delighted to welcome Anthony A. Stans, M.D., a consultant in the Division of Pediatric Orthopedic Surgery with special interest in the treatment of spinal deformity.  He is past Chair of the Mayo Clinic Division of Pediatric Orthopedic Surgery and past Surgeon in Chief for the Mayo Clinic Children’s Center.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Genes & Your Health Edition: Neurodegenerative Brain Disease

Guest: Bradley F. Boeve, M.D.

Host: Denise M. Dupras, M.D., Ph.D.

Family history is so important in deciphering genetic causes for neurodegenerative disorders. As we study polygenetic situations, we are learning that often it is not just one gene, but the contribution of multiple genes that lead to the presentation of a patient with cognitive or brain function deterioration that occurs at a variable rate. In this episode, we discuss genes and neurodegenerative brain disease, and our guest is Bradley F. Boeve, M.D., a consultant in the Department of Neurology and the Center for Sleep Medicine, as well as a professor of neurology at the Mayo Clinic in Rochester, Minnesota.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Psoriasis: Let’s Talk Rash-tionally

Host: Darryl S. Chutka, M.D. @chutkaMD

Guest: Jason C. Sluzevich, M.D.

Psoriasis is a somewhat atypical dermatologic condition which can come and go over time. In many, there may be seasonal effects and in some, psoriasis can have an associated arthritis. It has a characteristic distribution and while it has no cure, there are a variety of established and new treatment options. In this podcast, we’ll review how to diagnose psoriasis, its characteristic appearance, its associated arthritis, and management strategies with Jason C. Sluzevich, M.D., a dermatologist from the Mayo Clinic.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Genes & Your Health Edition: Breast Cancer & SNPs- What Are They & What Do We Know?

Guests: Sandhya Pruthi, M.D. (@DrSandhyaPruthi)

Host: Denise M. Dupras, M.D., Ph.D.

What is precision prevention? As providers, what can we do to best determine who is at high risk for breast cancer, and when to make appropriate decisions about interventions to reduce an individual’s risk for getting breast cancer? In this episode of our Genes & Your Health edition from the Center for Individualized Medicine, we will learn more about breast cancer, breast cancer genes and the role of single nucleotide polymorphisms (SNPs) in breast cancer risk assessment. Our guest is Sandhya Pruthi, M.D., a Mayo Clinic physician in breast disease and a consultant and Professor of Medicine in the Department of General Internal Medicine in Rochester, Minnesota.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Helping Your Patients Live Younger Longer

Host: Darryl S. Chutka, M.D.  @ChutkaMD

Guest: Stephen Kopecky, M.D.

Most of us want to live longer, but we want to live a healthy life and avoid the many health problems associated with growing older. Many of the health issues associated with aging have significant morbidity and have the potential to significantly affect our quality of life. Do we know how to avoid these health problems and stay healthy into our older ages? What should we be advising our patients to help them live younger longer? We’ll discuss these questions with our guest today, Stephen Kopecky, M.D., a preventive cardiologist at the Mayo Clinic.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Genes & Your Health Edition: Polycystic Kidney Disease & Genetic Testing - Aiming for Accurate Diagnosis

Guest: Fouad T. Chebib, M.D.

Host: Denise M. Dupras, M.D., Ph.D.

What is polycystic kidney disease? Is it all genetic? As providers, what should we be considering and what patients should we think about screening with genetic testing? Join this episode of our Genes & Your Health edition from the Center for Individualized Medicine to learn more about the role of genes in polycystic kidney disease. This episode features Fouad T. Chebib, M.D., a Mayo Clinic nephrologist from Jacksonville, Florida, whose specialty is in polycystic kidney disease.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Genes & Your Health Edition: Exposomics - The Next Frontier

Guest: Konstantinos N. Lazaridis, M.D.

Host: Denise M. Dupras, M.D., Ph.D.

What does the exposome mean? In this episode, we will define the exposome and explore how assessing exposures in an organized fashion will help us better understand the gene environment interaction. The guest for this episode of our Genes & Your Health edition from the Center for Individualized Medicine is Konstantinos N. Lazaridis, M.D., a Mayo Clinic physician in the Division of Gastroenterology and Hematology, as well as the Bernard and Edith Waterman Director, Microbiome Program, Center for Individualized Medicine and Carlson and Nelson Endowed Director, Center for Individualized Medicine.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Monoclonal Gammopathy of Undetermined Significance (MGUS)

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

Guest: Wilson I. Gonsalves, M.D.

Monoclonal gammopathies represent abnormal proteins produced by plasma cells. The most common monoclonal gammopathy is monoclonal gammopathy of undetermined significance or MGUS. While MGUS itself is not a malignancy and doesn’t require treatment, patients with MGUS have an increased risk of developing a variety of hematologic malignancies and therefore do require surveillance. The topic for today’s podcast is monoclonal gammopathy of undetermined significance and our guest is Wilson I. Gonsalves, M.D., a hematologist and oncologist from the Division of Hematology at the Mayo Clinic. We’ll discuss how to diagnose MGUS, who is more likely to develop this condition and how patients with it should be followed. 

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Mayo Clinic Q&A: Updated COVID-19 boosters target omicron variants

This episode is shared from Mayo Clinic Q&A and was recorded on August 31, 2022

Guest: Gregory A. Poland, M.D. (@drgregpoland)

Host: Halena M. Gazelka, M.D. (@hmgazelkamd)

The first significant change to COVID-19 vaccines since their rollout came this week as the Food and Drug Administration granted emergency use authorization for updated Moderna and Pfizer COVID-19 boosters aimed at the omicron variants. The Centers for Disease Control and Prevention (CDC) also signed off on the recommendation, clearing the way for the new COVID-19 booster to be administered.

The new boosters are bivalent vaccines, meaning they target more than one strain of the virus. The new formulation targets the BA.4 and BA.5 omicron variants, in addition to the original coronavirus strain. BA.5 is responsible for nearly 90% of all new COVID-19 cases in the U.S., according to the CDC.

The Pfizer bivalent booster is approved for people 12 and up if they have already received their primary COVID-19 vaccine series and it has been at least two months since their last vaccine dose. The Moderna bivalent booster is available on the same timeline to people 18 and up.

"This booster recommendation is in anticipation that there will be yet another surge as college students, grade school and high school students are gathering back together," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "We're also preparing for cooler weather, meaning more indoor activities, family gatherings and the holidays — often without masks, unfortunately. We still need to take COVID seriously."

Another big concern for vaccine experts is the upcoming flu season. The Southern Hemisphere is often an indicator of what's to come for the U.S. Australia's flu season exceeded its five-year average, particularly affecting children under age 5, according to a recent report.

Experts worry that the relaxing of masking and social distancing recommendations that were in place for COVID-19 purposes the past two winters will be a factor. These measures also protected people from the flu.

"When cold weather moves us indoors, a high viral circulation occurs in schools and other indoor settings. I think we are very likely to see a bad flu year," says Dr. Poland. "Now I know we've been predicting that for two years, but for the most part, people wore masks and it didn't happen. I don't think that'll be the case this year. People are not wearing masks, and we are very likely to get hit hard by influenza."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news and touches on other news, including monkeypox, polio and the upcoming flu season.

 

Plantar Fasciitis: Best Step Forward

Host: Joshua D. Luciew, P.A.-C.

Guest: Arthur J. De Luigi, D.O., M.H.A. (@DrDeLuigi, https://twitter.com/drdeluigi)

Heel and foot pain can be a burdensome symptom for our patients, as discomfort can be experienced with each step they take, hindering locomotion.

Many different patient populations are required to be on their feet for their job or for various wellness goals, which can exacerbate their painful heel and foot or deter them from exercise.

In this episode, we will explore the most common cause of heel and foot pain: plantar fasciitis. Listeners will learn from a Mayo Clinic specialist in Physical Medicine and Rehabilitation how plantar fasciitis develops, how it is properly diagnosed, and learn the best approaches for treatments of this condition to help patients resume their previous physical activities, pain-free.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Peripheral Neuropathies: On Pins and Needles

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

Guest: Julie A. Khoury, M.D.

Peripheral neuropathy is a relatively common neurologic condition we frequently see in primary care. Some patients may describe the symptoms as paresthesias and they represent a minor nuisance, however others may have very painful dysesthesias. Since some peripheral neuropathies are reversible, we need to know when to suspect a peripheral neuropathy, how to evaluate patients who have them and the possible treatment options. We’ll discuss peripheral neuropathies in this podcast with Julie A. Khoury, M.D., a neurologist at the Mayo Clinic in Phoenix, Arizona.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Kidney Stones: This Too Shall Pass

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

Guest: Ivan E. Porter, II M.D.

Kidney stones are quite common and represent one of the most common disorders of the urinary system. When symptomatic, stones are relatively easy to diagnose as they tend to cause a very characteristic clinical presentation. While most stones will pass through the urinary system, others will require a variety of treatment options. The topic for today’s podcast is kidney stones and we’ll discuss the diagnosis, management, and prevention of stones with Ivan E. Porter, II M.D., a nephrologist at the Mayo Clinic.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Managing Hypertension in the Elderly

Guest: Sandra J. Taler, M.D.

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

It’s estimated that over 70% of those 65 and older have hypertension and there’s good evidence to show that less than half of these elderly individuals are adequately controlled. While there are many similarities between hypertension in the elderly and the general population, there are also some important differences. The elderly are more likely to have systolic hypertension, take multiple medications and they’re more likely to experience more frequent and serious adverse drug reactions. In this podcast, we’ll learn more about hypertension in the elderly from Sandra J. Taler, M.D., a nephrologist and hypertension specialist at the Mayo Clinic in Rochester, Minnesota.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Treating Sacroiliac (SI Joint) vs. Chronic Lower Back Pain

Host: Sanjeev (Sanj) Kakar, M.D. (sanjkakar)

Guest: William W. Cross, III, M.D. (@WilliamCross3MD)

Did you know the lifetime prevalence of generalized low back pain is estimated at 60% to 70% in industrialized countries? Often overlooked, the sacroiliac or SI joint can cause approximately one third of these cases. How do you determine the difference between the two? In this week’s podcast, we discuss the diagnosis of SI joint dysfunction and the different modalities for treatment, including non-operative and surgical management with William W. Cross, M.D., an Associate Professor in the Department of Orthopedic Surgery at Mayo Clinic in Rochester, Minnesota.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Resource:  

• Sacroiliac Joint Clinic in Minnesota - Overview - Mayo Clinic

Headache Edition: Status Migrainosus and Headache in the ER

To claim credit for this episode, visit Mayo Clinic Talks Podcast: Headache Edition - Online CME Course.

Guest: Mark A. Whealy, M.D.

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

Headache disorders are extremely common, and patients frequently seek our help in the outpatient setting regarding management of their headaches. On occasion, they may present to the emergency department for more severe or prolonged headaches. With this podcast, we will continue our series on headaches as we discuss intractable migraine, also known as status migrainosus. We’ll also discuss other headaches commonly seen in the emergency department. How serious is status migrainosus? How should patients with these headaches be evaluated and what are the most effective management strategies? We’ll discuss these questions with Mark A. Whealy, M.D., a neurologist and headache specialist at the Mayo Clinic.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Endometriosis: An Issue with Tissue

Guest: Tatnai L. Burnett, M.D.

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

Endometriosis affects approximately one in ten women during their reproductive age and can result in chronic abdominal symptoms, including pelvic pain and at times infertility. It can produce a variety of vague symptoms which commonly causes a delay in establishing a diagnosis. Since women commonly present to their primary care providers, we need to consider endometriosis as a cause of their symptoms. While there is no cure, this chronic condition can be effectively managed. The topic for this podcast is endometriosis and our guest is Tatnai L. Burnett, M.D., from the Department of Obstetrics and Gynecology at the Mayo Clinic.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Headache Edition: Pediatric Headaches

To claim credit for this episode, visit Mayo Clinic Talks Podcast: Headache Edition - Online CME Course.

Guest: Juliana H. VanderPluym, M.D.

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

Headaches in children are relatively common and although there are many similarities to headaches in adults, there are some differences as well. Symptoms can be slightly different, and these differences can make it more difficult to establish a specific diagnosis in a child. This podcast will continue our series on headaches and the topic will be “Headaches in Children”. We’ll cover such topics as: Do infants get headaches? How often are headaches in children serious? And is the management of headaches in children any different than in adults? Our guest for this topic is Juliana H. VanderPluym, M.D., a neurologist at the Mayo Clinic.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Elevated Triglycerides: Implications for Cardiovascular Health

Host: Joshua D. Luciew, MPAS, P.A.-C.

Guest: Abigail K. Stockland, APRN, C.N.P., M.S.N.

Guest: Michaeleen M. Burroughs, M.S., RDN, LD

A fasting lipid panel is part of a patient’s routine health maintenance visit. This common laboratory test has many values on it including total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. This test helps clinicians calculate a patient’s 10-year atherosclerotic cardiovascular disease risk (ASCVD risk) to help guide treatments. If a patient's risk is determined to be high, statin medications can be considered. However, despite using statin therapy and addressing modifiable risk factors, some patients still have elevated triglycerides.  What role do triglycerides play in a patient's health?  Does hypertriglyceridemia contribute to cardiovascular disease? Tune in to this episode to find out more from our panel discussion.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Headache Edition: Serious Secondary Headaches

To claim credit for this episode, visit Mayo Clinic Talks Podcast: Headache Edition - Online CME Course.

Guest: Chia-Chun Chiang, M.D. (@chiachunchiang)

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

Headaches have a variety of causes and for most they are a minor nuisance. Fortunately, most have a benign cause. However, there are some headaches which are associated with a serious health problem. Since many of these patients will present to their primary care providers with their headaches, we need to recognize clues they may describe that allow us to suspect their headache may not be benign. In this podcast, we’ll continue our series on headaches and discuss serious, secondary headaches with Chia-Chun Chiang, M.D., a neurologist at the Mayo Clinic.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

The Outs and Ins of Vitamins

Guest: Donald D. Hensrud, M.D., M.S.

Host: Edward (Edward R.) R. Laskowski, M.D. (@DrEdSportsMed)

A recent Harris poll found that 86% of people take some sort of vitamin or supplement, and a recent research study found that approximately 60% of people report using dietary supplements in the past 30 days.  Multiple claims are made regarding the benefits of vitamins. How do we know which are true?  How do we sift through all the hype? When should we consider taking vitamins or recommending them for our patients? This episode features Donald D. Hensrud, M.D., M.S., an Associate Professor of Nutrition and Preventive Medicine at Mayo Clinic Rochester, Director of the Mayo Clinic Healthy Living Program, and editor of multiple books on healthy eating and living a healthy lifestyle, including The Mayo Clinic Diet and The New Mayo Clinic cookbook.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Mayo Clinic Q&A: BA.5 omicron variant fueling latest COVID-19 surge

This episode is shared from Mayo Clinic Q&A and was recorded in July 2022

Guest: Gregory A. Poland, M.D. (@drgregpoland)

Host: Danielle (DeeDee) J. Stiepan

The BA.5 omicron variant is now the dominant strain in the U.S., and it is leading to a new wave of COVID-19 infections. BA.5 was responsible for nearly 54% of COVID-19 cases in the U.S., and BA.4, a similar variant, accounted for another 17%, according to the latest data from the Centers for Disease Control and Prevention. 

Experts are concerned because this particular variant appears to be good at evading the immune system. 

"This BA.5 variant is hypercontagious, and right behind it, new variants are coming," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "We will continue to generate these variants until people are masked and immunized." 

Dr. Poland explains that the transmissibility of BA.5 represents the evolution of the virus to become more contagious and able to evade immune protection from previous infection or vaccination. 

"Whether you've been vaccinated, whether you've been previously infected, whether you've been previously infected and vaccinated, you have very little protection against BA.5 in terms of getting infected or having mild to moderate infection," says Dr. Poland. "Thankfully, you still do have good protection against dying, being hospitalized or ending up on a ventilator if you are up to date on your vaccinations." 

Due to the consequences of reinfection, including the possibility of long COVID-19, Dr. Poland urges people to continue to take precautions to protect themselves.

"The reality is, it's important to be up to date on the COVID-19 vaccinations that are recommended for your age group, health condition, etc.," says Dr. Poland. "Sometime this fall, we may well have a variant-focused vaccine, so get it when it becomes available. And wear a proper mask properly when you are indoors around people who are not your family or in a crowded outdoor venue."

On the Mayo Clinic Q&A podcast, Dr. Poland shares the latest COVID-19 news and answers listener questions.

Headache Edition: Unusual Headaches

To claim credit for this episode, visit Mayo Clinic Talks Podcast: Headache Edition - Online CME Course.

Guest: Narayan R. Kissoon, M.D.

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

Headaches are quite common and essentially everyone has experienced them; some have more than others. While most headaches are merely an annoyance, others can be quite debilitating and result in missed work and lost productivity. While tension headaches are the most common overall, migraines are the type most often seen by healthcare providers. While tension and migraines represent the majority of headaches, it’s important for healthcare providers to recognize when a headache falls into the unusual category. This podcast will continue our series on headaches with our guest, Narayan R. Kissoon, M.D., a neurologist and headache specialist at the Mayo Clinic as we discuss unusual headaches.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

Selection Criteria for Kidney Transplantation

Guest: Carrie A. Schinstock, M.D. (@caschinstock)

Host: Darryl S. Chutka (@ChutkaMD)

Kidney transplants were initially performed in the early 1950’s; however, most of these early transplants failed due to immune system rejection. Successful transplants were generally limited to those performed in identical twins. With the discovery of immunosuppressant therapy, organ rejection became less of an issue and successful kidney transplants have become more common. Currently, in the U.S. over 20,000 kidney transplants are performed annually. Who is a candidate for a kidney transplant? What is the current success rate and what is the optimal timing for a transplant in patients with end stage renal disease? We’ll discuss these questions in this podcast on kidney transplantation with our guest, Carrie A. Schinstock, M.D., a nephrologist from the Division of Nephrology and Hypertension at the Mayo Clinic.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Headache Edition: Chronic Daily Headaches

To claim credit for this episode, visit Mayo Clinic Talks Podcast: Headache Edition - Online CME Course.

Guest: Rashmi B. Halker Singh, M.D. (@rashmihalker)

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

Essentially everyone has an occasional headache and it is usually nothing more than a minor nuisance. However, there are individuals who have very frequent headaches, and they can have a significant influence on that person’s lifestyle and quality of life. The topic for this podcast is chronic daily headache, which represents a description of a variety of both primary and secondary headaches that occur frequently. Our guest is Rashmi Halker Singh, M.D., a neurologist, and specialist in headache medicine at the Mayo Clinic in Scottsdale, Arizona. We’ll discuss what types of headaches patients with chronic daily headache tend to have, how this syndrome develops, and how you should evaluate and manage these patients.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.