Mayo Clinic Talks

What You Need to Know About E-Cigarettes, Vaping, and IQOS

Guest: J. Taylor Hays, M.D. (@jtaylorhays)

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

What’s the difference between e-cigarettes, vaping, and the newly FDA authorized “heat-not-burn” or IQOS devices? Do they really help our patients stop smoking and what data is available on the safety of these products? Listen now to hear Dr. Taylor Hays discuss these points and more.

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

Deeper Dive:

• The FDA Authorization of IQOS: https://bit.ly/2XV2cLw 
• A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy: https://www.nejm.org/doi/full/10.1056/NEJMoa1808779 

Preventive Therapies for Breast Cancer

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

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

How can we help women at high risk of breast cancer manage their risk? How do you rank these risks and approach their management? Dr. Pruthi discusses what you can do and tools that you can use to help calculate risk and what to do with the information you have.

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

Deeper Dive:

• Breast cancer risk assessment tools:
  • Gail model https://bcrisktool.cancer.gov/
  • IBIS tool http://www.ems-trials.org/riskevaluator/ 

Meeting the Needs of Our Female Veterans

Guest: Ashley Laganiere, CVSO 

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

Female veterans can face significant barriers to receiving proper care. As the number of female service members increases, what can we do to help address these barriers and facilitate access to the care they need? What resources exist and how do we identify this population if they do not readily self-identify as veterans? 

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

Deeper Dive: 

• National Association of County Veterans Service Officers: https://www.nacvso.org/
• Minnesota Association of County Veterans Service Officers: https://www.macvso.org/index.html
• VA Women’s Health Research Network: https://www.hsrd.research.va.gov/for_researchers/womens_health/ 
• Military Health and Health Care https://www.rand.org/topics/military-health-and-health-care.html 

Lyme Disease: When to Test, When to Treat

Guest: Bobbi S. Pritt, M.D. (@ParasiteGal) 

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

How do you detect Lyme’s disease without the rash? What are the implications for our patients if we miss it? If you practice in an endemic area what are the guidelines for treatment when your patient has been bitten by a tick? Dr. Bobbi Pritt discusses Lyme disease detection, prophylaxis, and some of the long-term consequences of Lyme disease. Listen now to learn the ABCs of tick bite prevention. 

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

Deeper Dive:

• CDC Guidelines for Tick Bite Prophylaxis: https://www.cdc.gov/ticks/tickbornediseases/tick-bite-prophylaxis.html
• Dr. Pritt's “Creepy, Dreadful, Wonderful Parasites” blog https://parasitewonders.blogspot.com/ 

Perception of Care and Quality of Care: Finding the Sweet Spot in Patient Experience Data

Guest: Kenneth G. Poole, Jr., M.D., M.B.A. 

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

Does perception of care equal quality of care? Healthcare is increasingly consumer-centric and patient experience data can inform us about how we compare within our own institution and across healthcare. But the data can also be influenced by the nature of your practice and implicit bias present in our patients. What are some of the unintended implications of patient experience data? How can we responsibly interpret and utilize it? What scores should we be striving for? What is the sweet spot?

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

Deeper Dive:

• Dr. Poole’s article in the New England Journal of Medicine: https://www.nejm.org/doi/full/10.1056/NEJMp1813418 
• A brief webcomic by Whit Taylor and Chris Kindred on the Tuskegee Experiment: https://thenib.com/tuskegee-experiment?utm_campaign=web-share-links&utm_medium=social&utm_source=link 

Management of HIV and the Barriers to a Cure

Guest: Stacey A. Rizza, M.D. (@DrStaceyRizza) 

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

How close are we to having an immunization for HIV? What’s on the horizon? When should your patients be referred to an HIV center or clinic for care? How do you connect a patient that wants local care when a center isn’t close by? Dr. Rizza discusses the management of HIV, pharmacotherapy, and goals of treatment in the second episode of this two-part HIV mini-series.

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

Screening for HIV: Who Are You Missing?

Guest: Stacey A. Rizza, M.D. (@DrStaceyRizza) 

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

Can you predict who has HIV and who doesn’t? Do you order universal HIV screening? What screening tests should be ordered and what happens when the results are positive or equivocal? When is a false negative possible? What is the effective window for post-exposure prophylaxis? Dr. Stacey Rizza discusses HIV and progression to AIDS, medical exposures, and screening in the first episode of this two-part HIV mini-series.

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

Deeper Dive:

• Universal screening: https://doi.org/10.1016/j.mayocp.2012.06.021 

The Rising Cost of Prescription Drugs

Guest: S. Vincent Rajkumar, M.D. (@VincentRK) 

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

Why are prescription drug costs so high in the United States? What role does the rebate system potentially play in drug availability? What is value-based pricing? Vincent Rajkumar, M.D. discuss research in this area and provides resources for health care providers to have discussions with patients about drug affordability. 

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

Deeper Dive:

• https://doi.org/10.1016/j.mayocp.2012.07.007 
• https://doi.org/10.1016/j.mayocp.2015.01.014 

The Five-Finger Approach to Restoring Patient Function

Guest: Jeffrey S. Brault, D.O. (@JeffBrault) 

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

When should patients be referred to a physiatrist versus a physical therapist? What services can you expect when referring your patient to physical medicine and rehabilitation? Can they help your patients avoid surgery? What resources do they utilize to decrease pain and increase function? Listen as Dr. Jeff Brault discusses his five-finger approach to treatment of chronic and degenerative disease. 

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

Time’s Up Healthcare: Accelerating a Safe, Equitable, Dignified Workplace

Guest: Sharonne N. Hayes, M.D. (@SharonneHayes) 

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

The healthcare system is not immune to bias, harassment, and discrimination. How do we create a climate of mutual respect? How do we empower bystanders to step up? How do we create systems and procedures to ensure consistent messaging and action when these things occur? Listen in as Dr. Sharonne Hayes discusses the Time’s Up Healthcare movement and what you can do to get involved. 

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

Deeper Dive:

• https://www.timesuphealthcare.org 

Dementia: Things You Shouldn’t Forget

Guest: Richard J. Caselli, M.D. 

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

When does forgetfulness become a red flag for dementia? What’s normal aging and what’s underlying disease process? When is a mental status exam not enough and what should you do next? Dr. Richard Caselli discusses dementia diagnosis, risk factors, treatment, and research. 

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

Finding Balance and Harmony in the Face of Illness: Integrative Medicine

Guest: Ying Ying (Christina) Chen, M.D. 

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

How does integrative medicine differ from alternative and complementary medicine? Are the practices evidence-based? How and when can these techniques be applied in your current practice? Listen as Dr. Christina Chen discusses the practice of integrative medicine and its impact on her patients. 

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

Be Sure to Pack Humility, Teachability, and Adaptability: Making a Difference in Global Health Disparities

Guest: Stephen P. Merry, M.D. 

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

Primary care providers can make a difference in the health disparities experienced internationally. Impact can range from directly providing care to educating staff and building enduring local capacity. Listen for some points to consider when planning a global health trip or medical mission. How do you get started? What skills do you need as a health care provider? How do you pick a location? Where can you find more reliable in-depth information on global health? 

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

Understanding Stress Traps in the Human Brain

Guest: Anjali Bhagra, M.D. (@anjalibhagramd) 

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

How does our brain react to stress and setback? How can we harness what neuroscience tells us about these responses to combat the stresses in our lives we cannot currently change? Dr. Anjali Bhagra steps through the three F’s- focus, fatigue, and fear, to dig a little deeper into how we’re geared to respond and what we can do to intentionally navigate our responses. 

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

Turning the Tables: Getting to Know the Host

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

Host:  Thomas C. Shives, M.D. (@DrTomShives) 

The tables turn as Thomas Shives, M.D., long-time host of Mayo Clinic Radio, interviews Darryl Chutka, M.D., about his career highlights and how he became involved in the Mayo Clinic Talks Podcast.

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

What you Need to Know About Medical Cannabis

Guest: Thomas P. Pittelkow, D.O., M.P.H. 

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

Does medical marijuana have proven benefits? Who can prescribe it? What are the potential harms in using it? Dr. Thomas Pittelkow, a Mayo Clinic anesthesiologist specializing in pain management for cancer patients and advanced interventions in end of life care, discusses the differences between recreational and medical marijuana. Listen in for more on hopes and limitations in cannabis research, best practices for patient conversations, state vs. federal regulations, and the importance of communication with dispensaries. 

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

Deeper Dive: 

• Detailed information about Medical Cannabis, visit https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/medical-marijuana/art-20137855. 
• State-to-state regulations, visit http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx. 

Communicating with Humility: Lessons Learned

Guest: Katherine W. Arendt, M.D. (@arendt_katie)

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

We practice effective communication with our patients but how effectively do we communicate with our co-workers? At home after a long day? Dr. Katie Arendt discusses how to utilize humility and emotional intelligence to communicate effectively and build awareness of confirmation bias and ladders of inference.

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

Breast Cancer: Screening versus Diagnostic Imaging and the Appropriate Utilization of Genetic Testing

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

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

Dr. Sandhya Pruthi, a breast disease specialist in Mayo Clinic’s Breast Diagnostic Clinic, discusses why we don’t use ultrasound as a primary screening test for breast cancer. Listen in for the pros and cons of different types of imaging studies and which are used for screening versus diagnostic testing. Also discussed is the role genetic testing should play in breast cancer screening, who should have testing done, and what tests are available, including when a care plan should include a genetic counselor.

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

Prostate-Specific Antigen (PSA) Testing: A Urologist's Perspective

Guest: Mitchell R. Humphreys, M.D. (@MayoMitch)

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

Prostate cancer is a very common malignancy in men, second only to skin cancer. Despite the fact that it’s one of the more treatable malignancies, it remains the 2nd leading cause of cancer death in men. When diagnosed early, it has an excellent prognosis. The 5-year survival rate approaches 100% in those with local or regional disease. Although screening for prostate cancer is available, the use of screening tests has been controversial and recommendations regarding its use, confusing. Listen in to get a urologist’s perspective.

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

Treating Musculoskeletal Pain: The Role of Platelet-Rich Plasma Injections and Stem Cell Therapy

Guest: Jacob L. Sellon, M.D. (@jlsellon)

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

Dr. Jacob Sellon discusses advances in treatment of musculoskeletal pain and osteoarthritis, covering common questions about platelet-rich plasma and stem cell injections. Do they work? What’s the efficacy demonstrated in literature so far? What are the benefits and risks we need to discuss with our patients? What is FDA compliant versus FDA approved treatment and how does this influence insurance coverage and care management? Where does regenerative medicine research need to go?

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

Provider and Patient Bias: What Do We Do About Culture's Thumbprint in Medicine?

Guest: Sharonne N. Hayes, M.D. (@SharonneHayes) 

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

Dr. Sharonne Hayes discusses the impact of unconscious bias in medicine and how providers can take steps to acknowledge, address, and mitigate these cultural imprints on our automatic thought processes. She then turns the tables discussing patient bias and how health systems and providers can protect and support staff who have been harassed, along with processes that can be put in place to systematically address existing practices that fosters bias. 

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

Deeper Dive: 

• Project implicit can be found at: https://implicit.harvard.edu/implicit/takeatest.html

Pediatric Traumatic Brain Injury and Concussion

Guest: Sherilyn W. Driscoll, M.D. 

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

Traumatic brain injury in children represents a significant public health problem and they account for over one-half million emergency department visits per year. It’s estimated that traumatic brain injuries affect as many as one in five children by the age of 15. These brain injuries can have lifelong effects on a child’s development, including their ability to learn and participate effectively in social activities. Today we’re joined by Dr. Sherilyn Driscoll, a consultant in Pediatric Physical Medicine and Rehabilitation at the Mayo Clinic Children’s Center in Rochester. Her areas of interest include brain and spinal cord injury, cerebral palsy, and spina bifida.

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

Deeper Dive: 

• For the CDC’s Heads Up program, visit https://www.cdc.gov/headsup/

Does Size Really Matter? Benign Prostatic Hyperplasia (BPH): Evaluation, Management, and Treatment

Guest: Mitchell R. Humphreys, M.D. (@MayoMitch)

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

Our topic for discussion today is benign prostatic hyperplasia, or BPH. By age 60, it’s estimated that 50% of men will have some symptoms of BPH. While BPH is not a life-threatening condition, and only rarely does it result in serious health consequences, it commonly causes symptoms affecting men’s lifestyle. Our guest today is Dr. Mitchell Humphreys, chair of the Department of Urology at Mayo Clinic Arizona and Dean of the Mayo Clinic School of Continuous Professional Development.

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

Exercise is Medicine: Adding Years to Life and Life to Years

Guest: Robert Scales, Ph.D., M.S. 

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

We’ve all heard this many times “Exercise is good for you.” We know we should all participate in some form of exercise and we commonly recommend exercise to our patients. We’re very busy, our patients are very busy. So how do we develop a regular exercise program that we can adhere to and how do we get our patients to realize the benefits they can achieve with exercise? To help answer these questions, we have with us today Dr. Robert Scales, an exercise physiologist and director of Cardiac Rehabilitation & Wellness at Mayo Clinic, Arizona.

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

 

You Did What? Uncovering What Kids Are Ingesting

Speaker: Charlotte S. Van Dorn, M.D. 

Today’s special episode is an excerpt from the Mayo Clinic Pediatric Days Conference. This annual conference provides an interdisciplinary update in the latest strategies for providing timely and effective evidence-based diagnosis and management plans for multiple aspects of pediatric and young adult health. Today’s selected presentation, “You Did What? Uncovering What Kids are Ingesting” is presented by Dr. Charlotte S. Van Dorn, a Mayo Clinic Pediatric and Intensive Care Specialist.