Timely consultations relevant for family medicine, primary care, and general internal medicine topics for physicians, nurse practitioners, physician assistants, and residents. Offering CME credit for most episodes at https://ce.mayo.edu/podcast. Produced by @MayoMedEd.
Episodes
Wednesday May 26, 2021
Wednesday May 26, 2021
This episode is shared from Mayo Clinic Q&A and was recorded in May, 2021
To claim credit visit: https://ce.mayo.edu/covid19podcast
Guest: Gregory A. Poland, M.D. (@drgregpoland)
Host: Halena M. Gazelka, M.D. (@hmgazelkamd)
Recent COVID-19 masking guidelines announced by the Centers for Disease Control and Prevention, continue to generate a public conversation.
"The decision about masking needs to be nuanced," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "Wearing a mask should be based on the risk of infection, the percentage of the population vaccinated, a person's own immune system, and then the role of vaccine variants with the durability of our immune response."
In this Mayo Clinic Q&A podcast, Dr. Poland discusses masking guidelines in further detail. Also, he offers an update on COVID-19 vaccine research for children, and he shares positive news about the decreasing numbers of COVID-19 cases and deaths.
AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Tuesday May 25, 2021
Tuesday May 25, 2021
Guest: Carrie A. Thompson, M.D. (@CaThompsonMD)
Host: Darryl S. Chutka, M.D. (@ChutkaMD)
It’s common for a patient to see their primary care provider after they’ve discovered an enlarged lymph node and they’re usually concerned that it represents a serious illness. Fortunately, in most cases it’s due to a benign cause and most patients can be reassured once we perform a careful history and physical examination. However, on occasion lymphadenopathy can represent serious disease. Carrie Thompson, M.D. a hematologist, at Mayo Clinic’s Rochester campus joins us to discuss how to tell when lymphadenopathy is due to a benign or serious cause. We’ll review the characteristics of both benign and malignant lymph nodes and the evaluation which should be done both for an enlarged solitary lymph node as well as generalized lymphadenopathy.
Specific topics discussed:
- Prevalence of malignancy in patients who seek a medical evaluation for lymphadenopathy
- Categories of disease which can have associated lymphadenopathy
- Characteristics of benign and malignant lymph nodes
- Diagnostic approach for a solitary enlarged lymph node
- Diagnostic approach or multiple or generalized lymphadenopathy
- Fine needle aspirate vs. excisional biopsy for evaluation of lymphadenopathy
Additional resources:
- Gaddey, HL. Riegel, AM. Unexplained lymphadenopathy: evaluation and differential diagnosis. Am Fam Physician.2016 December 1; 94(11): 896-903. https://www.aafp.org/afp/2016/1201/p896.html
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Thursday May 20, 2021
Thursday May 20, 2021
To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline
Guest: Saad J. Kenderian, M.B., Ch.B. (@kenderian_ss)
Host: Darryl S. Chutka, M.D. (@ChutkaMD)
Regenerative immunotherapy is a treatment that uses the power of our own immune system to fight malignancy. It can include targeted antibodies, cancer vaccines, or tumor infecting viruses to name a few. Some immunotherapy treatments use genetic engineering to enhance our immune cell’s cancer fighting properties and can be used in combination with more traditional treatments including surgery, chemotherapy, or radiation. It’s FDA-approved as a first line treatment of multiple cancers and may also be effective in the management of malignancies that have been resistant to more traditional therapy. This podcast will address regenerative immunotherapy with Dr. Saad Kenderian, a hematologist at the Mayo Clinic. We’ll review the relationship between cancer and our immune system, how we can use our immune system to treat malignancy and which malignancies which have shown the best responses to regenerative immunotherapy.
Specific topics discussed:
- Relationship between cancer and our immune system
- How we can use our body’s immune system to fight malignancy
- Malignancies which can be currently be effectively treated with regenerative immunotherapy
- Malignancies which have had the best responses to regenerative immunotherapy
- Limitations in regenerative immunotherapy
Additional educational opportunities from Mayo Clinic:
- https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education
- https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Tuesday May 18, 2021
Tuesday May 18, 2021
Guest: Kathryn J. Ruddy, M.D. (@KathrynRuddyMD)
Host: Darryl S. Chutka, M.D. (@ChutkaMD)
Breast cancer in men is very uncommon, about 1/100th as common as in women. It’s expected that this year, just under 3000 men are likely to be diagnosed with it, and just over 500 men will die from breast cancer. Because it’s so uncommon, there are very few good studies which have been completed to educate us about this disease. Kathryn Ruddy, M.D., an oncologist at Mayo Clinic’s Rochester campus joins us to discuss breast cancer in men and what we should do as primary care clinicians to care for our male patients who may be at increased risk to develop it. We’ll cover how breast cancer in males differs from that in females, its risk factors, how it’s diagnosed, and the survival rates of men with a diagnosis of breast cancer.
Specific topics:
- Prevalence of breast cancer
- How most breast cancers in men are found
- The recommended evaluation of a male patient with suspected breast cancer
- Risk factors for breast cancer in men
- Treatment for male breast cancer
- Survival rates for breast cancer in men
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Thursday May 13, 2021
Thursday May 13, 2021
To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline
Guest: Richard E. Hayden, M.D.
Host: Darryl S. Chutka, M.D. (@ChutkaMD)
Currently reconstructive surgery involves taking the patient’s tissue from one area of their body and using it elsewhere to rebuild diseased or damaged tissue. Regenerative reconstructive surgery will allow the patient to grow their own replacement tissue from stem cells. This has incredible potential for allowing significantly better reconstructive surgical results. Currently regenerative reconstructive surgery is in its infancy, however in the next several years this should develop into a new standard of care for patients who need reconstructive surgery. This podcast features Dr. Richard Hayden, a reconstructive surgeon/otolaryngologist. We discuss the future of reconstructive surgery using regenerative medicine techniques, the difficulties in enabling patient access to regenerative therapies, the education that’s needed for not only providers but also for patients, and the future of regenerative reconstructive surgery.
Specific topics discussed:
- Role regenerative medicine plays and reconstructive surgery
- Importance in adopting and delivering regenerative care
- Challenges in current standard of care approaches in reconstructive surgery
- Difficulties enabling patient access to regenerative therapies
- Educational needs in regenerative reconstructive surgery
- The future of regenerative reconstructive surgery
Additional educational opportunities from Mayo Clinic:
- https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education
- https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Tuesday May 11, 2021
Tuesday May 11, 2021
Guest: Laura J. Orvidas, M.D.
Host: Darryl S. Chutka, M.D. (@ChutkaMD)
Tonsils and eustachian tubes often get taken for granted until they cause problems. Eustachian tube dysfunction is quite common and usually resolves on its own, however some patients will develop recurrent eustachian tube dysfunction and it can result in recurrent episodes of otitis media, especially in children. Although recurrent tonsillitis used to be the most common indication for tonsillectomy, more children are having this procedure for disordered breathing conditions, such as obstructive sleep apnea. In this episode, we’ll discuss disorders of the eustachian tube and tonsils with Laura J. Orvidas, M.D., an otolaryngologist at the Mayo Clinic.
Specific topics discussed:
- Purpose of the eustachian tube
- Definition of eustachian tube dysfunction
- Physical exam findings of eustachian tube dysfunction
- Recurrent eustachian tube dysfunction in children and potential for recurrent episodes of otitis media
- When pressure equalization tubes are indicated
- Relationship between pharyngitis and tonsillitis
- Viral versus bacterial causes of tonsillitis
- How to suspect a peritonsillar abscess
- Indications for tonsillectomy
- Management of tonsil stones
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Friday May 07, 2021
Friday May 07, 2021
This episode is shared from Mayo Clinic Q&A and was recorded in May 2021.
To claim credit visit: https://ce.mayo.edu/covid19podcast
Guest: Gregory A. Poland, M.D. (@drgregpoland)
Host: DeeDee Stiepan (@deedeestiepan)
COVID-19 cases are falling in the U.S. because 245 million doses of one of the available COVID-19 vaccines have been administered, according to Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "But at the same time, there are still people who need more information about the safety and the value of getting a COVID-19 vaccine," says Dr. Poland.
While still hopeful, Dr. Poland says he's concerned herd immunity won't be reached in the U.S. through vaccination. And that will mean more tragic deaths due to COVID-19 infection.
"My guess is, because we're such an interconnected global community until everybody's safe, none of us are safe. And we're going to likely see continued circulation of the virus, and that virus will seek out whoever is not immune," says Dr. Poland.
In this Mayo Clinic Q&A podcast, Dr. Poland also addresses when we will need COVID-19 vaccine boosters will be needed and the latest on masking guidelines from the Center for Disease Control and Prevention. Plus, he will provide an update on COVID-19 treatments and how to handle those who want to visit a newborn baby.
AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Thursday May 06, 2021
Thursday May 06, 2021
To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline
Guest: Dennis Wigle, M.D., Ph.D. (@DrWigle)
Host: Darryl S. Chutka, M.D. (@ChutkaMD)
Regenerative Medicine has some amazing capabilities and in the near future, it’s likely to significantly change how we practice medicine. It faces some challenges in educating both the medical community as well as the general public regarding its current realistic capabilities. There are many unsubstantiated claims made by practitioners to the public regarding the benefits of regenerative medicine therapy. We’ll discuss how the true potential of regenerative medicine is conveyed to both clinicians and the public with Dr. Dennis Wigle, a thoracic surgeon and chair of the Division of General Thoracic Surgery at the Mayo Clinic. We’ll discuss some of the common misperceptions of regenerative medicine and how a consultation service can educate both the public and medical community regarding the benefits of regenerative medicine.
Specific topics discussed:
- How to provide education to the public and the medical community
- When and why the regenerative consultation service was formed
- How the regenerative medicine consultation service works
- Common misperceptions community regarding the realistic benefits of regenerative medicine
Additional resources:
- For more information about Mayo Clinic’s Regenerative Medicine Consult Service, visit: https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/patient-care/regenerative-medicine-consult-service
Additional educational opportunities from Mayo Clinic:
- https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education
- https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Tuesday May 04, 2021
Tuesday May 04, 2021
To claim credit for this episode, visit: www.ce.mayo.edu/regmedonline
Guest: Fredric B. Meyer, M.D.; Andre Terzic, M.D., Ph.D.
Host: Darryl S. Chutka, M.D. (@ChutkaMD)
Imagine a patient who has suffered a massive myocardial infarction leaving a significant amount of damaged and non-functioning ventricular myocardium. Treatment for this patient’s subsequent congestive failure does not involve diuretics and beta blockers but rather an injection of the patient’s modified stem cells into surrounding viable ventricular myocardium resulting in the regeneration of new, functioning myocardial cells restoring the cardiac output. This is not science fiction but represents ongoing work by investigators in Regenerative Medicine. This week’s podcast will explore this amazing field of medicine which has the potential to change how medicine is practiced. We’ll discuss the origins of regenerative medicine, what currently be done in regenerative medicine as well as the potential for the future. Our guests today are Andre Terzic, M.D., Ph.D., director of the Mayo Clinic Center for Regenerative Medicine and Fredric B. Meyer, M.D., a neurosurgeon and the Executive Dean for Education at the Mayo Clinic.
Specific topics discussed:
- When the field of regenerative medicine began
- Which current medical conditions can currently be managed with regenerative medicine
- How to determine which patients have potential for regenerative medicine therapies
Additional educational opportunities from Mayo Clinic:
- https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/education
- https://college.mayo.edu/academics/biomedical-research-training/phd-program/tracks/regenerative-sciences/
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Thursday Apr 29, 2021
Thursday Apr 29, 2021
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.
Tuesday Apr 27, 2021
Tuesday Apr 27, 2021
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.
Thursday Apr 22, 2021
Thursday Apr 22, 2021
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.
Wednesday Apr 21, 2021
Wednesday Apr 21, 2021
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.
Tuesday Apr 20, 2021
Tuesday Apr 20, 2021
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.
Monday Apr 19, 2021
Monday Apr 19, 2021
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.
Tuesday Apr 13, 2021
Tuesday Apr 13, 2021
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.
Tuesday Apr 06, 2021
Tuesday Apr 06, 2021
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.
Tuesday Mar 30, 2021
Tuesday Mar 30, 2021
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.
Friday Mar 26, 2021
Friday Mar 26, 2021
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.
Tuesday Mar 23, 2021
Tuesday Mar 23, 2021
Guest: Jennifer L. Elmer, APRN, CNS, D.N.P.; Brianna M. Skrukrud, APRN, C.N.P.
Host: Amit K. Ghosh, M.D. (@AmitGhosh006)
Pressure injuries in bedridden patients present significant challenges, which are compounded in the patient with a COVID-19 diagnosis. In this episode we discuss the problems encountered in preventing, diagnosing, and managing skin alterations in patients with COVID-19. Jennifer L. Elmer, APRN, CNS, D.N.P. and Brianna M. Skrukrud, APRN, C.N.P., two wound care experts at Mayo Clinic, discuss situations in which, despite best efforts, pressure injuries are unavoidable and why COVID-19 poses a great risk for skin alterations in hospitalized patients. They also discuss the 2020 position statement of National Pressure Injury Advisory Panel (NPIAP) on the management of skin alterations during the COVID-19 crisis.
Additional resources:
- Unavoidable Pressure Injury during COVID-19 Pandemic: A Position Paper from the National Pressure Injury Advisory Panel https://cdn.ymaws.com/npiap.com/resource/resmgr/white_papers/Unavoidable_in_COVID_Pandemi.pdf
- Skin Manifestations with COVID-19: The Purple Skin and Toes that you are seeing may not be Deep Tissue Pressure Injury https://cdn.ymaws.com/npiap.com/resource/resmgr/white_papers/COVID_Skin_Manifestations_An.pdf
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Friday Mar 19, 2021
Friday Mar 19, 2021
This episode is shared from Mayo Clinic Q&A and was recorded in March 2021.
Guest: Gregory A. Poland, M.D. (@drgregpoland)
Host: DeeDee Stiepan (@deedeestiepan)
Millions of people in the U.S. are being vaccinated for COVID-19. However, discussion is ongoing as to whether people who are immunocompromised, such as patients undergoing cancer treatment, or people who have autoimmune diseases, should be vaccinated for COVID-19.
"Both of those categories (of people) should be vaccinated," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "Those are not contraindications. Those are indications to get the vaccine." He adds that research is ongoing, but current information demonstrates the benefits far outweigh the theoretical risks.
In this Mayo Clinic Q&A podcast, Dr. Poland talks about vaccine hesitancy, and patients who are immunocompromised or have autoimmune conditions. Also, he discusses next steps in the journey to vaccinate children for COVID-19. And he reviews recent guidance from the Centers for Disease Control and Prevention Control about in-person gatherings.
AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Thursday Mar 18, 2021
Thursday Mar 18, 2021
* WARNING: This episode discusses suicide and suicidal ideation. *
Guest: J. Michael Bostwick, M.D.(@DrBostwick)
Host: Amit K. Ghosh, M.D. (@AmitGhosh006)
In this episode, professor of psychiatry and international authority on suicide risk and challenges in suicide prevention, J. Michael Bostwick, M.D. from Mayo Clinic in Rochester joins us. He’ll discuss epidemiological-based research looking at the utilization patterns of medical care by individuals who have contemplated or committed suicide. Dr. Bostwick will describe the concept of suicide crisis including risk factors, current events/warning signs, and mental status/agitation. He’ll also explain self-agency, stigma of discussing mental illness, potential value-based societal approach to individuals in distress and despair, and potential solutions to the suicide prevention.
Additional resources:
- Suicide Prevention in Primary Care Medicine; Huguet, Nathalie et al.; Mayo Clinic Proceedings, Volume 90, Issue 11, 1459 – 1461; https://doi.org/10.1016/j.mayocp.2015.09.011
- Grappling With Suicide Risk; Sublette, M. Elizabeth; Mayo Clinic Proceedings, Volume 93, Issue 6, 682 – 683; https://doi.org/10.1016/j.mayocp.2018.04.006
- Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew; Bostwick, J. Michael et al.; Amer Journal of Psychiatry; Volume 173, Issue 11, November 01, 2016, 1094-1100; https://doi.org/10.1176/appi.ajp.2016.15070854
If you're feeling overwhelmed by thoughts of not wanting to live or you're having urges to attempt suicide, get help now.
- Call 911 or your local emergency number immediately.
- Call a suicide hotline. In the U.S., call the National Suicide Prevention Lifeline at 1-800-273-8255 any time of day — press "1" to reach the Veterans Crisis Line or use Lifeline Chat.
- For a list of suicide hotline numbers outside of the U.S., visit: https://www.opencounseling.com/suicide-hotlines
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Wednesday Mar 17, 2021
Wednesday Mar 17, 2021
This episode is shared from Mayo Clinic Q&A and was recorded in March, 2021.
Guest: Billie A. Schultz, M.D.
Host: Halena M. Gazelka, M.D. (@hmgazelkamd)
Fatigue and what's being called "brain fog" are turning out to be some of the most common issues for long-hauler patients recovering from COVID-19. The National Institutes of Health calls these and other symptoms, which can last for several months, post-acute sequelae of SARS-CoV-2, or PASC.
Those suffering from brain fog may experience short-term memory loss, confusion, difficulty concentrating, or just feeling different than they did before they had COVID-19, even if it was a mild case of the infection.
And Dr. Billie Schultz, a Mayo Clinic physical medicine and rehabilitation expert, says, though older patients more often to have these symptoms more often, younger people are also showing up with brain fog.
In this Mayo Clinic Q&A podcast, Dr. Schultz says brain fog seems to be more inflammatory than infection, but there are more questions than answers about this neurological concern. Meanwhile, efforts are underway to develop rehabilitation programs to help patients recover.
AskMayoExpert COVID-19 Resources: https://askmayoexpert.mayoclinic.org/navigator/COVID-19
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Tuesday Mar 16, 2021
Tuesday Mar 16, 2021
Guest: Ravindra Ganesh, M.B.B.S., M.D.
Host: Amit K. Ghosh, M.D. (@AmitGhosh006)
It has been estimated that as many as 10-30% of patients who have recovered from COVID-19 have an array of symptoms, ranging from minor to disabling, that persist more than four weeks post-COVID infection. These symptoms have not only been identified in patients who had severe symptoms of COVID-19 requiring intensive care unit treatment, but also those who only experienced mild-to-moderate symptoms.
The exact cause of this state, most popularly called post-COVID long hauler syndrome, is still under investigation. The symptoms range from mild to disabling fatigue, body aches, atypical chest pain, loss of sense of taste and smell, brain fog, among others and many of these patients need additional evaluation and management to deal with their disabling symptoms.
In this podcast Dr. Ravindra Ganesh, the consultant in General Internal Medicine who leads the COVID Frontline Care Team (CFCT) efforts, as well as the Post-COVID Clinic, at Mayo Clinic Rochester, discusses the array of symptoms, management strategies, and research possibilities, as well as opening of an upcoming clinic in Mayo Clinic Rochester that would address the concern of the patient's and deal with the post COVID long hauler symptoms
Additional Resources:
- Post-COVID Syndrome on Ask Mayo Expert: https://askmayoexpert.mayoclinic.org/
- To refer a patient to or request an appointment at Mayo Clinic, visit: https://www.mayoclinic.org/appointments
- Post-COVID Recovery on Mayo Clinic Connect: https://connect.mayoclinic.org/page/post-covid-recovery/
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Tuesday Mar 09, 2021
Tuesday Mar 09, 2021
Guest: Maria I. Vazquez Roque, M.D. (@MVazquezRoqueMD)
Host: Darryl S. Chutka, M.D. (@ChutkaMD)
Clostridium difficile is a toxin-producing bacterium that can result in a severe form of antibiotic-associated diarrhea known as clostridium difficile infection or CDI. Cases can vary from mild diarrhea to severe colitis that at times can be fatal. There’s been a dramatic increase in the number as well as severity of CDIs in the U.S. over the past 20 years. Although CDI typically occurs following the use of antibiotics, it can also be spread from one individual to another, especially in hospitals and skilled nursing facilities. Antibiotics have been the traditional treatment for patients with CDI, however recurrent symptoms have been a problem. There’s now a new treatment for CDI, felt to be effective in over 90% of patients with the illness. Our guest to discuss this topic is Dr. Maria Vazquez Roque, a gastroenterologist at the Mayo Clinic. We’ll review the common presenting symptoms, laboratory tests needed to establish a diagnosis, and the current recommendations for treatment including the latest of fecal transplantation.
Additional resources:
Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): https://doi.org/10.1093/cid/cix1085
Specific topics discussed:
- The typical presentation of C. difficile infection
- Patients who are at increased risk for a C. difficile infection
- Laboratory tests to order to confirm a case of C. difficile infection
- Treatment options for C. difficile infection including fecal transplantation
- Potential benefit of probiotics for preventing a C. difficile infection
Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.