Mayo Clinic Talks

Host: Darryl S. Chutka, M.D.  Guest: Bhanu Kolla, M.D.  We commonly take sleep for granted. That is, until our sleep quantity or quality is compromised. This can result in both mental and physical health problems, including daytime fatigue and sleepiness. Sleep disorders are quite common and often undiagnosed, yet they can contribute to diabetes, cognitive impairment, and cardiovascular disease, potentially leading to premature mortality. Primary care clinicians play a major role in the identification and management of sleep disorders. What are the most common disorders we see in the outpatient setting? What are the presenting symptoms we should watch for? What tests should we do to establish a diagnosis and when should we refer patients we feel may have a sleep disorder? The topic for today’s podcast is sleep disorders, and these are questions I’ll be asking my guest, Dr. Bhanu Kolla, a psychiatrist and sleep medicine specialist from the Center for Sleep Medicine at the Mayo Clinic.   This episode of Mayo Clinic Talks is the first of three podcasts celebrating a remarkable milestone in Mayo Clinic’s history – the 100th anniversary in April this year of our renowned journal, Mayo Clinic Proceedings. Proceedings first appeared in April 1926 and has been in continuous publication ever since. Many significant clinical breakthroughs, pioneered at Mayo Clinic, were first published in the journal, and today the journal brings primary care providers relevant, timely, and important papers on conditions and disorders that are frequently seen in the practice. A great deal of content in Mayo Clinic Proceedings is freely available for you to browse—just go to mayoclinicproceedings.org to incorporate this terrific resource in your library. Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

Host: Darryl S. Chutka, M.D.  Guest: Brittni A. Scruggs, M.D., Ph.D.  There are a variety of eye disorders which involve the retina, and they all have the potential to cause significant vision loss or blindness if not detected early. Two of the most common retinal disorders we see in primary care include diabetic retinopathy and macular degeneration. Since most health conditions affecting the retina are asymptomatic early in their course making patient screening and risk factor management an important task for primary care clinicians. Appropriate referrals to an ophthalmologist can result in effective treatment and improved outcomes. Which patients are at risk of retinal disorders? What are some “red flag” symptoms which should give us concern? Which medications we prescribe can affect the retina? This podcast is about retinal disorders, and I’ll be asking these questions and more of my guest, Dr. Brittni Scruggs, an ophthalmologist and retinal surgeon at the Mayo Clinic.  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

Host: Darryl S. Chutka, M.D.  Guest: Stephen Kopecky, M.D.  Cardiovascular disease is highly prevalent in our society. Fortunately, we have a variety of treatment options to lower the risk of developing its complications. Over the past decade, there’ve been many changes in managing hyperlipidemia, one of the most important risk factors for cardiovascular disease. This includes a change in assessing our patients’ risk, identification of new risk factors, new testing options, and new pharmacologic options for treating hyperlipidemia. We’ll cover all of these topics in this podcast. My guest is Dr. Stephen Kopecky, a preventive cardiologist at the Mayo Clinic, and we’ll be discussing “Update in the Management of Hyperlipidemia”.  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

Host: Darryl S. Chutka, M.D.  Guest: Kathryn del Valle, M.D.  Chronic liver disease can result in a variety of complications which can involve multiple organs. One of these complications can occur in the pulmonary vascular system. Two of the most clinically significant include hepatopulmonary syndrome and Portopulmonary hypertension. Patients with these syndromes may present to their primary care provider and if the medical condition is unrecognized, it can affect morbidity and ultimately the prognosis of the patient. What are the early symptoms and physical findings of hepatopulmonary syndrome and Portopulmonary hypertension? How are they diagnosed, and should we be screening patients with chronic liver disease for these pulmonary vascular disorders? My guest for this podcast is Dr. Kathryn del Valle, from the Division of Pulmonary and Critical Care at the Mayo Clinic and we’ll be discussing “Pulmonary Vascular Complications of Liver Disease”.  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

Host: Darryl S. Chutka, M.D.  Guest: Stephen Ansell, M.D., Ph.D.  Non-Hodgkin’s Lymphoma is a group of hematologic malignancies originating in the lymphatic system. There are over 60 subtypes of lymphoma with varying degrees of aggressiveness. It can present with a variety of rather subtle symptoms, often making the diagnosis challenging. Although Non-Hodgkin’s Lymphoma is typically managed by a hematologist or oncologist, the primary care provider plays a role in its recognition, preliminary diagnostic tests and supporting patients through their treatment. What are some of the more common symptoms and signs of Non-Hodgkin’s Lymphoma? Which ones should prompt an urgent referral, and what preliminary tests should we do prior to referring the patient? These are some of the questions I’ll be asking my guest, Dr. Stephen Ansell, Chair of the Division of Hematology at the Mayo Clinic. The topic for this podcast is Non-Hodgkin’s Lymphoma.  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

Host: Darryl S. Chutka, M.D.  Guest: Stephen Ansell, M.D., Ph.D.  Hodgkin’s Lymphoma is an uncommon but very curable malignancy involving the lymphatic system. It most commonly presents in young adults as well as middle-aged and older individuals. Although Hodgkin’s is generally managed by hematologists or oncologists, the primary care provider plays a major role in its recognition, hopefully leading to a timely diagnosis and eventual staging. What are some early signs of Hodgkin’s and what preliminary work-up should we do prior to referring the patient for definitive care? How do we monitor those who have had successful treatment of Hodgkin’s? These are some of the questions I’ll be asking my guest, Dr. Stephen Ansell, Chair of the Division of Hematology at the Mayo Clinic as we discuss Hodgkin’s Lymphoma.  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

Host: Darryl S. Chutka, M.D.  Guests: Jae K. Oh, M.D., Tahir S. Kafil, M.D.  Diastolic heart failure is also known as heart failure with preserved ejection fraction. Although we don’t hear the term all that often, it actually represents a fairly large percentage of all cases of heart failure. Some studies suggest it represents the majority of heart failure cases. Older adults are most commonly affected with symptoms similar to those of systolic heart failure. So how do we suspect diastolic heart failure? How should the diagnosis be established, and how does the treatment differ from systolic heart failure? Finally, what role do primary care providers play in the management of the condition? These are some of the questions I’ll be asking my guests, Dr. Jae Oh and Dr. Tahir Kafil, both cardiologists in the Department of Cardiovascular Disease at the Mayo Clinic as we discuss “Diastolic Heart Failure”.   Mayo Clinic Talks: Heart Health | Mayo Clinic School of Continuous Professional Development  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

Host: Darryl S. Chutka, M.D.  Guest: Balaji Tamarappoo, M.D., Ph.D.  With advances in oncology, patients are living longer than ever following a diagnosis of cancer. Newer treatments have dramatically improved survival. However, we’re also seeing an increasing number of cancer survivors who are at risk for cardiovascular complications; at times during treatment, and sometimes years later. Complications such as heart failure, cardiac arrhythmias, hypertension, and accelerated coronary disease are not uncommonly seen in our primary care practice.  As primary care clinicians, what do we need to know? I’m joined today by Dr. Balaji Tamarappoo, M.D., Ph.D., a cardiologist with expertise in cardio-oncology. We’ll discuss which cancer therapies pose the highest cardiac risks, what baseline and surveillance testing is recommended, if the risk of cardiotoxicity be decreased, and how primary care can partner effectively with oncology and cardiology to protect our patients’ hearts while they battle their malignancy. The topic for today’s podcast is “Cardiotoxicity of Cancer Therapies.”  Mayo Clinic Talks: Heart Health | Mayo Clinic School of Continuous Professional Development  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

Host: Darryl S. Chutka, M.D.  Guest: Hema Narayanasamy, M.B.B.S.  Pericardial disease represents a spectrum of both inflammatory and non-inflammatory disorders which involve the pericardium, with acute pericarditis being the most common disorder. Although not often seen in a primary care practice, we still need to consider pericarditis as it can masquerade several other more commonly seen conditions. It’s important to recognize pericardial disease early and decide who needs an urgent referral or hospitalization for appropriate treatment. What are some of the more common causes of pericardial disease? What are the most commonly encountered symptoms, physical exam findings, imaging results, and lab abnormalities? What are the potential complications? The topic for today’s podcast is pericardial disease, and my guest is Dr. Hema Narayanasamy, from the Department of Cardiovascular Disease from the Arizona campus of the Mayo Clinic.  Mayo Clinic Talks: Heart Health | Mayo Clinic School of Continuous Professional Development  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

Host: Darryl S. Chutka, M.D.  Guest: Stephen Kopecky, M.D.  We have a variety of pharmacologic options and lifestyle changes we recommend to our patients to reduce their cardiovascular risks. One frequent recommendation is participation in a regular exercise program. One specific type of exercise is high intensity interval training. It’s been shown to improve a variety of metabolic parameters. What does high intensity interval training consist of? What are the specific metabolic benefits? Can all patients participate in this type of exercise? What’s the recommended duration and frequency of training and how good is patient adherence to interval training? The topic for this podcast is “High Intensity Interval Training and Reducing Cardiovascular Risk” and my guest is Dr. Stephen Kopecky, a preventive cardiologist in the Department of Cardiovascular Disease at the Mayo Clinic.  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

Host: Darryl S. Chutka, M.D.  Guest: George Wang, M.D.  Bicuspid aortic valve is a relatively common congenital heart disease. It can be associated with other genetic disorders such as Turner’s Syndrome or exist as an isolated entity. In most cases, patients with a bicuspid aortic valve are initially asymptomatic; however later in the course, they may develop symptoms related to a subsequent aortic stenosis or regurgitation. It’s also associated with a dilated ascending aorta with potential rupture if unrecognized. Therefore, it’s in the patient’s best interest to diagnose the condition as early as possible. What are the early symptoms and when should we suspect the patient may have a bicuspid aortic valve? What type of surveillance should be performed and when is surgery indicated? These are some of the questions I’ll be asking my guest, Dr. George Wang, a cardiologist in the Department of Cardiovascular Medicine at the Arizona Campus of the Mayo Clinic as we discuss “Bicuspid Aortic Valve Disease”.  Mayo Clinic Talks: Heart Health | Mayo Clinic School of Continuous Professional Development  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

Host: Darryl S. Chutka, M.D.  Guest: Julie Rosenthal, M.D.  Cardiac amyloidosis is not a common condition, but it is important for primary care clinicians to recognize it in our patients. It’s commonly underdiagnosed as the symptoms are often assumed to be due to other, more common cardiac problems. Early recognition is important since this can result in improved treatment options and better patient outcomes. So how do we recognize cardiac amyloidosis? What are the presenting symptoms and what’s the best way to establish an accurate diagnosis? I’ll be asking my guest these questions as we discuss cardiac amyloidosis. My guest for tis podcast is Dr. Julie Rosenthal, a cardiologist in the Department of Cardiovascular Medicine at the Arizona campus of the Mayo Clinic.   Mayo Clinic Talks: Heart Health | Mayo Clinic School of Continuous Professional Development  Connect with us! Mayo Clinic Talks Podcast Season 6 | Mayo Clinic School of Continuous Professional Development 

 Host: Darryl S. Chutka, M.D. Guest: Matthew B. Anastasi, M.D. Patients with concussions are commonly seen in primary care practices and concussions don’t spare any particular age group. Children, young adult athletes and older individuals are all at increased risk. They’re a form of traumatic brain injury and while most are self-limiting, they require an accurate assessment, proper management and appropriate follow-up to make sure the patient is recovering and not experiencing complications. When should we suspect a concussion? What questions should we be asking in order to make an accurate diagnosis? What’s the best management of a patient who has had a concussion and finally, when can that patient return to their normal activities? The topic for this podcast is “Concussions: What Every Primary Care Provider Should Know” and my guest is Dr. Matthew Anastasi, a family medicine and sports medicine physician at the Arizona campus of the Mayo Clinic. Learn more at https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D.  Guest: Stephen Kopecky, M.D.  One of the biggest surprises we’ve seen in medicine in the past several years has been the numerous health benefits realized from the GLP-1 agonists. Originally developed for the management of diabetes, they’ve shown significant potential to improve cardiovascular risks, beyond controlling blood glucose and lowering hemoglobin A1c. Several studies have shown reductions in cardiovascular events including MI, stroke as well as reducing overall cardiovascular death. What is the mechanism of action for these cardiovascular benefits? Are there any differences in the various GLP-1 medications available and who’s a candidate for a GLP-1 medication? I’ll get answers to all of these questions and more in this podcast as I speak with Dr. Stephen Kopecky, a preventive cardiologist at the Mayo Clinic. We’ll be discussing “GLP-1 Agonists and Reducing Cardiovascular Risk”.  Rx for Weight Loss: A Closer Look Series | Mayo Clinic School of Continuous Professional Development  Learn more at https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Host: Darryl S. Chutka, M.D.  Guests: Tamim I. Rajjo, M.D., M.P.H.; Meera Shah, M.B., Ch.B.  The class of medications known as the GLP-1 agonists is very popular with our patients. Although initially indicated for management of diabetes, they’re frequently taken for the weight loss they commonly produce. How long should these medications be taken? Is there anything we can do to help maintain the weight loss achieved with these medications? How significant is the loss of muscle mass which can occur as part of the weight lost with these medications and can this be minimized. Finally, how safe are the compounded and unapproved versions of these medications patients often find more affordable? These are a few of the questions we’ll address in podcast on the GLP-1 medications used for weight loss and we’ll tackle the “Controversies and Future of the GLP-1 Medications”. My guests include Dr. Meera Shah and Dr. Tamim Rajjo, both from the Division of Endocrinology at the Mayo Clinic.  Rx for Weight Loss: A Closer Look Series | Mayo Clinic School of Continuous Professional Development  Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts 

Host: Darryl S. Chutka, M.D.  Guest: Tamim Rajjo, M.D., M.P.H.  Using GLP-1 medication for weight loss has become very popular with our patients. In the recent past, this has produced a shortage of these medications available, and those taking them for management of diabetes have found them difficult to obtain. Although in most cases, they are quite successful in producing substantial weight loss, many have regained weight after the medication was discontinued. How much weight can patients expect to lose with these medications? When should these medications be stopped, or should they? Are there strategies that have shown benefit to help patients maintain the weight they lose once the medication is discontinued? This podcast is the second of three on using the GLP-1 medications for weight loss and we’ll discuss “The Importance of Lifestyle Changes with the Use of GLP-1 Medications for Weight Loss”. My guest is Dr. Tamim Rajjo, a physician trained in Preventive Medicine and Obesity Medicine from the Mayo Clinic.  Rx for Weight Loss: A Closer Look Series | Mayo Clinic School of Continuous Professional Development  Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts 

Host: Darryl S. Chutka, M.D. Guests: Tamim I. Rajjo, M.D., M.P.H.; Meera Shah, M.B., Ch.B. Using GLP-1 medications for weight loss has become extremely popular. Is this the latest fad in losing weight, or will these medications completely change our approach to managing obesity? They do appear to be very effective in promoting substantial weight loss. What is the history of these medications? Are there differences in the various GLP-1 medications available? What are the potential adverse effects of this drug class? This podcast is the first in a series of three on the GLP-1 medications prescribed for weight loss. The topic for this podcast is “Who Is a candidate for a GLP-1 Medication?” and my guests include Dr. Meera Shah and Dr. Tamim Rajjo, both from the Division of Endocrinology and Metabolism at the Mayo Clinic. Check out the series! Rx for Weight Loss: A Closer Look Series | Mayo Clinic School of Continuous Professional Development Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts 

WELCOME TO SEASON 6 OF THE MAYO CLINIC TALKS PODCAST! Host: Darryl S. Chutka, M.D. Guest: Warren G. Thompson, M.D. Alcohol can offer a variety of social and potential health benefits when consumed in moderation. However, alcohol is also associated with a variety of health risks, including addiction, increased likelihood of accidents, impaired judgment, cardiovascular problems, hepatic disease and even malignancy. Other than the social benefits, are there true health benefits of alcohol? Is there an amount of alcohol that’s considered safe? How can we as primary care clinicians convey the health risks of alcohol to our patients? The topic for this podcast is the “Risks and Benefits of Alcohol” and these are some of the questions I’ll be asking my guest, Warren G. Thompson, M.D., an internist and preventive medicine specialist at the Mayo Clinic. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts   

HAPPY HOLIDAYS! Enjoy this re-release from Season 3 of Mayo Clinic Talks: Host: Darryl S. Chutka, M.D.  Guest: Amy S. Oxentenko, M.D.   It’s estimated that less than 1/3 of individuals with celiac disease have been properly diagnosed. When those with celiac disease ingest gluten, an immune response develops which attacks the small intestine leading to inadequate absorption of nutrients. If left untreated, celiac disease can lead to a variety of nutritional deficiencies as well as other serious consequences. Those with celiac disease are also at increased risk for coronary disease and small bowel cancers. In this podcast we’ll review celiac disease and gluten sensitivity with our guest, Amy S. Oxentenko, M.D., a gastroenterologist at the Mayo Clinic. We’ll discuss the symptoms of celiac disease, how to diagnose the condition and how patients with celiac disease should be managed.   Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts 

HAPPY HOLIDAYS! Enjoy this re-release from Season 3 of Mayo Clinic Talks:   Host: Darryl S. Chutka M.D. Guest: Lisa Lammert, R.D.N., L.D.   Cardiovascular disease is the leading cause of death to individuals in the U.S. Many feel that our typical American diet with its high saturated fat content is a major contributor to this. There’s good evidence that shows plant-based diets are cost-effective in lowering the risk factors for cardiovascular disease including obesity, hyperlipidemia, hypertension, and diabetes. They may also lower the number of medications an individual needs to take to manage their chronic diseases. So, are there any disadvantages to a plant-based diet? Are all plant-based diets healthy and what are the nutritional challenges for a patient on a plant-based diet? We’ll discuss these questions in this podcast on “Plant-Based Diets”. Our guest is Lisa Lammert, a registered dietician and nutritionist at the Mayo Clinic.   Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts