Mayo Clinic Talks

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.