Mayo Clinic Talks

Genes & Your Health Edition - Genomics and Cancer: Primary Care Impact and Research Advances

To claim credit for this series, visit: Mayo Clinic Talks Podcast: Genes & Your Health  

Guest: Niloy Jewel J. Samadder, M.D. (@J_Samadder)  
Host: Denise M. Dupras, M.D., Ph.D.  

Can we find the cause of a patient’s cancer? Is it possible to provide targeted treatment to prevent future cancers by understanding what genetic predispositions a patient or their family members have? In a recently published study, nearly one in six to one in eight cancer patients, depending on which type of cancer they had, carried a genetic predisposition to the development of their cancer. How can we translate these findings into our practice for the benefit of our patients and their families? Tune in to episode four of our Genes & Your Health Edition from the Mayo Clinic Center for Individualized Medicine.

Additional resources:

• Samadder NJ, Riegert-Johnson D, Boardman L, et al. Comparison of universal genetic testing vs guideline-directed targeted testing for patients with hereditary cancer syndrome. JAMA Oncol. 2021;7(2):230–237. doi: 10.1001/jamaoncol.2020.6252
• Uson, PLS. Riegert-Johnson, D. Boardman, L. Kisiel, J. et al. Germline cancer susceptibility gene testing in unselected patients with colorectal adenocarcinoma: a multicenter prospective study. Clin Gastroenterol Hepatol. 2021 April 20; doi: 10.1016/j.cgh.2021.04.013
• Mayo Clinic’s Center for Individualized Medicine: https://www.mayo.edu/research/centers-programs/center-individualized-medicine 

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

The Evolution of COVID-19 Testing

Guest: Matthew J. Binnicker, Ph.D. (@DrMattBinnicker)

Host: Amit K. Ghosh, M.D. (@AmitGhosh006)

 

In this podcast Matthew J. Binnicker, Ph.D. discusses the development of different types of testing available to diagnose SARS-CoV2 infection. Binnicker discusses the test characteristics of the rapid antigen tests and RT-PCR test and its variability based on the time when the test was performed. He also discusses the optimal timing of diagnostic testing (rapid testing, RT-PCR) and the role and limitations of antibody testing in COVID-19.

 

Additional resources:

Shah AS, Tande AJ, Challener DW, O’Horo JC, Binnicker MJ, Berbari EF. Diagnostic stewardship: An essential element in a rapidly evolving COVID-19 pandemic. Mayo Clin Proc. 2020;95(9):S17-S19. DOI: https://doi.org/10.1016/j.mayocp.2020.05.039

 

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

Genes & Your Health Edition - Pharmacogenomics and its Value for Primary Care

To claim credit for this episode, visit: https://ce.mayo.edu/online-education/content/mayo-clinic-talks-podcast-genes-your-health#group-tabs-node-course-default1

Guest: Jessica A. Wright, Pharm.D., R.Ph.

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

Pharmacogenomics helps to identify how your patients’ DNA may affect their response to medications. But there's a lot of different genes! How do we get started? What resources are out there? Do we have to worry about every drug a patient is on? Find out these answers and more in episode three of the Genes & Your Health Edition from the Mayo Clinic Center for Individualized Medicine.

Additional resources:

• PharmGKB: pharmgkb.org
• Clinical Pharmacogenetics Implementation Consortium (CPIC®): cpicpgx.org
• Basic Pharmacogenomics Nomenclature: https://www.pharmgkb.org/page/glossary
• NIH’s National Human Genome Research Institute: Healthcare Provider Resources: https://www.genome.gov/For-Health-Professionals/Provider-Genomics-Education-Resources
• Mayo Clinic Center for Individualized Medicine: https://www.mayo.edu/research/centers-programs/center-individualized-medicine

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

Regenerative Techniques for the Larynx

Guest: David G. Lott, M.D.

Host: Amit K. Ghosh, M.D. (@AmitGhosh006)

About 60,000 Americans have had their vocal cords removed due to disease or trauma necessitating a laryngectomy. Post-laryngectomy, patients are unable to speak, are at risk for aspiration, and many suffer from significant anguish resulting in depression. Fortunately, there are several treatment options available, the first being laryngeal transplant. While laryngeal transplantation allows patients to smell, taste, swallow, and communicate, it has drawbacks. Currently only a small number of larynx transplants are done in the U.S., and only a select few patients with laryngectomy qualify for larynx transplant. In this episode, Dr. David Lott, division chair of laryngology at Mayo Clinic’s Arizona campus, discusses the role of regenerative medicine, which has shown promise in using 3D printing and a patient’s stem cells in creating a larynx.

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

Genes & Your Health Edition - How Does Viral Genetics Influence Transmission, Diagnosis, and Severity of COVID-19?

To claim credit for this series, visit: https://ce.mayo.edu/online-education/content/mayo-clinic-talks-podcast-genes-your-health#group-tabs-node-course-default1

Guests: Andrew D. Badley, M.D. (@BadleyAndrew); Matthew J. Binnicker, Ph.D. (@DrMattBinnicker)

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

COVID-19. Variants. The future. Does one test fit all?  Will the vaccine continue to provide protection against future variants? What makes the Delta variant more transmissible? Join the second episode of our Genes & Your Health Edition from the Mayo Clinic Center for Individualized Medicine to learn how viral genetics influence transmission, diagnosis, and severity of COVID-19.

Additional resources:

• Mayo Clinic Center for Individualized Medicine: https://www.mayo.edu/research/centers-programs/center-individualized-medicine

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

Genes & Your Health Edition - Genomics and Healthcare, Why Does it Matter?

To claim credit for this episode, visit: https://ce.mayo.edu/online-education/content/mayo-clinic-talks-podcast-genes-your-health#group-tabs-node-course-default1

Guests: Matthew J. Ferber, Ph.D. (@Matt_Ferber); Teresa M. Kruisselbrink, M.S., CGC (@T_Kruisselbrink); William C. Palmer, M.D. (@williampalmermd)

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

For so long we've heard Genetic Testing is coming. Well guess what, it’s here!  We have over 25 million people who have chosen to participate in direct-to-consumer testing alone. What does this mean for primary care, and does it matter? Find out in the first episode of our Genes & Your Health Edition from the Mayo Clinic Center for Individualized Medicine.

Additional resources:

• TAPESTRY Study: https://www.mayo.edu/research/clinical-trials/cls-20477323?_ga=2.268706548.460922620.1627479724-1519128218.1623079535
• Mayo Clinic Center for Individualized Medicine: https://www.mayo.edu/research/centers-programs/center-individualized-medicine

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

Variants, Virulence, and Vaccines, Oh My!

Guest: Elitza S. Theel, Ph.D. (@ElliTheelPhD)

Host: Amit K. Ghosh, M.D. (@AmitGhosh006)

Dr. Elitza Theel, Professor of Laboratory Medicine and Pathology and Director of Infectious Diseases Serology Laboratory at Mayo Clinic’s Rochester Campus, discusses our immune response to vaccination and natural infection and outlines the different types of antibody assays currently available. Dr. Theel also discusses the concept of herd immunity in the context of different circulating SARS-CoV-2 variants and the increased need to get higher rates of vaccination in the community as the infectivity and transmissibility of circulating SARS-CoV-2 variants changes. We also discuss the status of correlates of protective immunity against SARS-CoV-2 and the need for booster vaccine doses for immunocompromised individuals. 

Additional resources:

• Interim Guidelines for COVID-19 Antibody Testing in Clinical and Public Health Settings https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests-guidelines.html

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

Evaluating Hematuria

Guest: Aaron M. Potretzke, M.D. (@potretzke)

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

Microscopic hematuria, and less commonly gross hematuria, are conditions commonly seen by the primary care provider. Malignancy is the most ominous cause of hematuria. Fortunately, other causes are much more likely. Since this is a relatively common health condition, when should we investigate hematuria and what should the evaluation consist of? How do we evaluate a patient’s risk for urinary tract malignancy? Dr. Aaron Potretzke, a urologist at Mayo Clinic joins us to discuss these questions.

Specific topics:

• Definition of hematuria
• Benign causes of hematuria
• Risk of malignancy in low, medium, and high-risk patients
• Stratifying malignancy risk in patients for genitourinary malignancy
• Recommended evaluation for patients with hematuria
• How to manage patients with persistent hematuria despite a negative evaluation
• Role of urine cytology in the evaluation of hematuria

Additional resources:

• American Urological Association hematuria guideline and algorithm: https://www.auanet.org/guidelines/guidelines/microhematuria

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

Exercise is First-Line Treatment for Your Parkinson's Patients

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

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

Daily exercise has so many health and emotional benefits – it can help decrease your blood pressure, promote cardiovascular wellbeing, alleviate stress, and assist with weight loss and blood sugar control. Parkinson’s disease is a condition that affects the central nervous system, and in particular the brain, that can lead to shakiness, poor balance, and frequent falls. Joining us in this episode is Edward Laskowski, M.D., a professor of physical medicine and rehabilitation and sports medicine specialist at Mayo Clinic’s Rochester Campus, to discuss why exercise is first-line treatment for your Parkinson’s patients.

Additional resources:

• Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055
• The Michael J. Fox Foundation for Parkinson’s Research: https://www.michaeljfox.org/

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

Parkinson's Disease - It's More Than Just a Tremor

Guest: Jeremy K. Cutsforth-Gregory, M.D. (@JCGneuro)

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

Parkinson’s Disease is one of the more common neurodegenerative diseases, in fact, patients with Parkinson’s outnumber those with multiple sclerosis, ALS, and muscular dystrophy combined. It tends to affect older patients, although on rare occasions it can be seen in those under the age of 50. It can have a devastating effect on an individual’s lifestyle as the physical symptoms of the disease tend to gradually progress over years. This podcast will feature Dr. Jeremy Cutsforth-Gregory, a neurologist at the Mayo Clinic, as we discuss the evaluation and management of Parkinson’s Disease.

Specific topics:

• Pathophysiology of Parkinson’s Disease
• Common presenting symptoms of Parkinson’s
• Assessing patients with tremor
• Complications of advanced Parkinson’s
• Pharmacologic management of Parkinson’s

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

Working from the Ground Up to Impact Gender Disparities in COVID-19

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.

Mayo Clinic Q&A: The COVID-19 Delta Variant has Changed Everything

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.

Will We Be Replaced by Computers? Artificial Intelligence and Medicine

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.

Mayo Clinic Q&A: Stopping the Spiral of the COVID-19 Delta Variant

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.

What’s That Sound? Maybe It’s Stridor

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.

Mayo Clinic Q&A: On the Verge of Predicted COVID-19 Surge with Delta Variant

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.

Multidisciplinary Approach to Pelvic Pain

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.

Identifying and Treating Urinary Urge Incontinence

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.

Mayo Clinic Q&A: Summer Travel and People Not in Your Bubble During COVID-19 Pandemic

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.

Postural Orthostatic Tachycardia Syndrome (POTS) in Adult Patients

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.

Regenerative Medicine Edition Ep.10: FDA Regulatory Process and Clinical Trials

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.

Primary Care Management of the Post-Prostate Cancer Patient

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.

Mayo Clinic Q&A: COVID-19 Vaccination Rates Stalling, Infections From the Delta Variant Rising

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.

Regenerative Medicine Edition Ep.9: Cardiac Regenerative Therapies

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.

Mayo Clinic Q&A: Examining Reports of Heart Inflammation in Young People After Second COVID-19 Vaccine

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.