Mayo Clinic Talks

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.

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.

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.

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.

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.

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.

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.

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.

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.

* 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.