Mayo Clinic Talks

* 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.

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.

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.

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.

This episode is shared from Mayo Clinic Q&A and was recorded in February, 2021 Guest:  Gregory A. Poland, M.D. (@drgregpoland)  Host: Halena M. Gazelka, M.D. (@hmgazelkamd)    People may be curious, confused or critical of what seem to be changing messages related to the COVID-19 pandemic. Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group, reminds folks that messages change because data changes and the science evolves. "As we learn new science, we use that science to modify our recommendations," says Dr. Poland. "It's not that scientists are flip-flopping. It is that new data allows us to begin expanding those recommendations." For instance, COVID-19 cases and deaths in the U.S. are currently declining. But, Dr. Poland says, there are new data predicting the possibility of another surge of COVID-19 infections in March because of U.K. variant transmission. In this Mayo Clinic Q&A podcast Dr. Poland talks about several issues, including the U.K. variant, vaccine development and the public’s COVID-19 fatigue. 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: Ravindra Ganesh, M.B.B.S., M.D. and Raymund R. Razonable, M.D.  Host: Amit K. Ghosh, M.D. (@AmitGhosh006)  In this episode, Ravindra Ganesh, M.B.B.S., M.D. and Raymund R. Razonable, M.D. join Amit K. Ghosh, M.D. to review the use of monoclonal antibody as a new antiviral agent in the treatment of COVID-19 infection.  Who is most likely to benefit from monoclonal antibody infusions? Drs. Ganesh and Razonable, discuss recent studies on monoclonal antibody infusions in patients with mild to moderate COVID-19 infections. Also discussed are the logistical challenges faced and the innovative solutions that were implemented while administering this therapy, particularly navigating the acceptance of treatment, its real and perceived side effects, and lack of awareness due to inequity and poverty. Research on the development of subcutaneous or intramuscular administration for prophylaxis against COVID-19 in patients at high risk for complications or at high risk for being exposed to SARS-CoV-2 is also discussed in this episode.  Additional resources:  AskMayoExpert COVID-19 Navigator: https://askmayoexpert.mayoclinic.org/navigator/COVID-19  Weinreich DM, Sivapalasingam S, Norton T, et al. REGN-COV2, a neutralizing antibody cocktail, in outpatients with Covid-19. N Engl J Med 2021;384:238-251.  Chen P, Nirula A, Heller B, et al. SARS-CoV-2 neutralizing antibody LY-CoV555 in outpatients with Covid-19. N Engl J Med 2021;384:229-237.  Gottlieb RL, Nirula A, Chen P, et al. Effect of Bamlanivimab as Monotherapy or in Combination With Etesevimab on Viral Load in Patients With Mild to Moderate COVID-19: A Randomized Clinical Trial.JAMA. Published online January 21, 2021. doi:10.1001/jama.2021.0202  An EUA for Bamlanivimab—A Monoclonal Antibody for COVID-19. JAMA. Published online December 11, 2020. doi:10.1001/jama.2020.24415  Monoclonal Antibodies: Update on this COVID-19 Experimental Therapy  https://discoverysedge.mayo.edu/2021/02/17/monoclonal-antibodies-update-on-this-covid-19-experimental-therapy/  Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Guest: Greg Vanichkachorn, M.D., M.P.H. Host: Amit K. Ghosh, M.D. (@AmitGhosh006) For some patients who have had COVID-19, symptoms of the disease may last long after the infection is over. Long-haulers syndrome due to COVID-19 could include profound fatigue, shortness of breath, and long-term neurological complaints, including headache, dizziness, or weakness. Mayo Clinic has launched the COVID Activity Rehabilitation Program, or CARP, to help these patients return to daily life and work. CARP is not just for folks who are trying to get back to work, but for anyone trying to get back to their baseline life. In this episode, Dr. Greg Vanichkachorn, a Mayo Clinic preventive, occupational and aerospace medicine specialist who leads the CARP program, gives an overview of COVID long haulers and how post-COVID symptoms affects patients. He also shares the goals and results of Mayo Clinic CARP program. 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 Answers from the Lab and was originally published February 2, 2021.  Guest: Matthew J. Binnicker, Ph.D. (@DrMattBinnicker) Host: William G. Morice, II M.D., Ph.D. (@moricemdphd) Matthew Binnicker, Ph.D., vice chair of practice for Mayo Clinic's Department of Laboratory Medicine and Pathology, joins William Morice II, M.D., Ph.D., president of Mayo Clinic Laboratories, for this week's "Answers From the Lab" leadership update. In this episode, Dr. Binnicker and Dr. Morice discuss the impact that emerging COVID-19 variants could have on virus testing, vaccine and spread. For more, follow the Mayo Clinic Labs on Twitter @mayocliniclabs or visit https://news.mayocliniclabs.com/podcast/answers-from-the-lab/ to check out all of their episodes.

Guest: Ravindra Ganesh, M.B.B.S., M.D. Host: Amit K. Ghosh, M.D. (@AmitGhosh006) The Mayo Clinic COVID Frontline Healthcare Team (CFCT) is an integrated team comprised of doctors and support staff, including nurses, remote monitoring technicians, medical assistants, and desk staff. These teams are responsible for evidence-based management of all newly diagnosed COVID-19 patients. We’re joined by CFCT Codirector Ravindra Ganesh, M.B.B.S., M.D., to discuss the essential roles of CFCT’s during the pandemic. Topics include how they: Notify all patients who receive a COVID positive test result in Mayo/Mayo Clinic Health service in the Midwest region through phone call or portal messaging with attached questionnaire Conduct outpatient monitoring and follow-up as well as identify patient at high risk for decompensation Prevent COVID positive patients from coming to the Mayo Clinic facilities by remote monitoring and risk assessment Reinforce social isolation recommendations from public health to all COVID positive patients and assess safety to come off isolation 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 February, 2021 To claim credit visit: https://ce.mayo.edu/covid19podcast  Guest:  David B. Soma, M.D. (@DrDaveSoma); Talha Niaz, M.B.B.S. Host: Angela C. Mattke, M.D. (@DrAngelaMattke) There are many benefits to sports participation for children and adolescents. However, during the COVID-19 pandemic, activities such as youth sports have been put on hold or modified to decrease the spread of COVID-19. Also, the scientific community is learning about when it is safe to return to sports participation following COVID-19 infection.   On the Mayo Clinic Q&A podcast, "Ask the Mayo Mom" host and Mayo Clinic pediatrician, Dr. Angela Mattke is joined by Dr. David Soma, a pediatric sports medicine physician at Mayo Clinic Children's Center, to discuss sports participation during the COVID-19 pandemic and what you need to know about return to play after COVID-19 infection. Also joining Drs. Mattke and Soma is Dr. Talha Niaz, a pediatric cardiologist at Mayo Clinic.  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.