Clinician's Roundtable

Host: Larry Kaskel, MD Guest: Paul Howard, MD Other than the name, Doctor-Prescribed steroids have little in common with the steroids that often get bad rap from athletic abuse. Our guest today, Dr. Paul Howard, President of Arthritis Health begins the conversation explaining the differences between anabolic and medical steroids. He and host, Larry Kaskel MD, talk about the various types of steroids, when they should be used, and for how long they can be used. They also explore the differences between Disease Modifying Agents (DMA's) and steroids.

Host: Larry Kaskel, MD Guest: John Cantwell, MD Are you qualified to be the next CMO of the Olympic Games? Our guest, Dr. John Cantwell, Cardiologist and CMO of the 1996 summer games in Atlanta share his experiences managing the health of the athletes, their families and 1.5 million spectators as the CMO of the Atlanta Games in 1996. What were the greatest challenges? Were they prepared for the bomb? Join host Dr. Larry Kaskel to learn how Dr. Cantwell's preparation differs from the types of preparation required of the 2008 medical team heading to Beijing.

Host: Bill Rutenberg, MD Guest: Anna Penn, MD, PhD While medical advances have significantly increased our ability to give life to pre-term infants, more cognitive disabilities and disadvantages are present when these children reach school age. Is the deficit is due to early separation from the mother, or possibly our post-delivery treatments? Dr. Anna Penn, assistant professor of pediatrics at Stanford University School of Medicine, and a neonatologist at Packard Children's Hospital, talks with host Dr. Bill Rutenberg about her current research in this area. Dr. Penn specifically addresses how hormone levels impact the brain development of preemies.

Host: Bill Rutenberg, MD Guest: George Sheldon, MD The largest health problem in our country is a physician shortage, says guest, Dr. George Sheldon, Professor of Surgery at The University of North Carolina. There are 26% fewer surgeons today than in 1998. Why the shortage? In this segment host Dr. Bill Rutenberg explores with our guest many contributing factors and some solutions to the physician shortage problem. Learn how the physician gap will be filled and why a primary care directed health system may not be dependent on doctors in the future.

Do you believe that if a patient is worried that they are developing Alzheimer's that it can't be dementia? What do you do when a high functioning patient complains of being unable to remember names? Say, "Me too!"? Perhaps we all have a thing or two to learn about working up forgetfulness. Host Dr. Leslie Lundt welcomes Investigative journalist Cathryn Jakobson Ramin to discuss some of the interventions for patients with midlife forgetfulness.

The late Yale neuroscientist Patricia Goldman-Rakic said that working memory is the mental glue that links a thought through time from its beginning to its end. What happens when this system goes haywire? Investigative journalist Cathryn Jakobson Ramin joins host Dr. Leslie Lundt to discuss the frontal lobe overload.

Anyone older than forty knows that forgetfulness can be unnerving, frustrating and sometimes terrifying. Investigative journalist Cathryn Jakobson Ramin embarked on a three year journey to revive her brain using the latest that science has to offer. She joins host Dr. Leslie Lundt to discuss what she learned.

Host: Leslie P. Lundt, MD Guest: Stephan Poulter, PhD Your patients' mothers continue to play a constant role in their lives, no matter how old they are. What are the types of mothering styles and how do they influence our psychology? Clinical psychologist and author of The Mother Factor, Dr. Stephan Poulter joins host Dr. Leslie Lundt to describe how mothering styles may affect patients' current lives.

Host: Leslie P. Lundt, MD Guest: Stephan Poulter, PhD Mothers have gotten a bad rap for everything, from schizophrenia to breast cancer. What are the realties and misperceptions about mothers? Author of "The Mother Factor", Dr. Stephen Poulter, joins host Dr. Leslie Lundt to give the audience a quiz on what we know about mothers and their impacts on daughters and sons.

Host: Leslie P. Lundt, MD Guest: Stephan Poulter, PhD You may remember the work of Dr. John Bowlby from your first psychology class. He taught us about attachment theory and how important bonding is. Today's guest helps us to understand how the type of attachment that our patients had with their mother may impact their current lives. Dr. Stephen Poulter, author of "The Mother Factor", joins host Dr. Leslie Lundt to discuss maternal attachment.

Host: Danny Petrasek, MD, PhD Guest: Jeffrey Kaye, MD Dr. Jeffrey Kaye, professor of neurology and biomedical engineering, and director of the Oregon Center for Aging and Technology at Oregon Health and Science University, provides his perspective on where recent advances in technology will guide health care for the elderly over the next several years. Dr. Danny Petrasek hosts.

Host: Danny Petrasek, MD, PhD Guest: Jeffrey Kaye, MD Our best evidence suggests that nursing homes and other assisted-living facilities will likely not be able to keep up with the demands of our rapidly aging population, which today stands at more than 40 million, a number that is expected to more than double by 2050. As a result, a premium is being placed on new remote monitoring devices that allow medical professionals to track patients for medical data from the comfort of patients' own homes, thereby allowing more elderly patients to live independently for longer. Dr. Jeffrey Kaye, professor of neurology and biomedical engineering, and director of the Oregon Center for Aging and Technology at Oregon Health and Science University, joins host Dr. Danny Petrasek to project where recent advances in these technologies will guide us over the next several years.

Host: Michael Greenberg, MD Guest: Katrina Hedberg, MD Who chooses to participate in Oregon's Death With Dignity Act? What's their education level? What type of diagnosis is required? How does religion come into play? In further exploring Oregon's Death With Dignity Act, epidemiologist, Dr. Katrina Hedberg, from the Oregon Department of Human Services addresses the facts and figures with your host, Dr. Michael Greenberg, including the rights and regulation of those physicians writing the lethal prescription.

Host: Michael Greenberg, MD Guest: Katrina Hedberg, MD Is Oregon's Death with Dignity Act a violation of the Hippocratic Oath or a humane solution? ReachMD's Dr. Michael Greenberg discusses this originally citizen-led initiative, and current law with epidemiologist, Dr. Katrina Hedberg, from the Oregon Department of Human Services. Dr. Hedberg addresses the requirements for patients to opt for this non-euthanasian, yet lethal prescription. The consent, patient motivations, controversy, and the statistics of those who've chosen to take advantage of Oregon's law are discussed.

Host: Susan Dolan, RN, JD Guest: Anne Louise Peters, MD Athletes with diabetes face particular challenges. Dr. Anne L. Peters, author of the book Conquering Diabetes: A Cutting-Edge Comprehensive Program for Prevention and Treatment, has treated diabetic Olympic and other competitive athletes. Dr. Peters discusses issues and protective measures with host Dr. Susan Dolan.

Host: Maurice Pickard, MD Guest: William Gahl, MD, PhD Guest: Stephen Groft, PharmD Some patients wait years for a definitive diagnosis. Using a combination of scientific resources and medical expertise at the National Institutes of Health (NIH), the Undiagnosed Diseases Program now provides a place for physicians to refer patients when a diagnosis eludes them. In this segment, host Dr. Maurice Pickard, speaks with Dr. William Gahl, director of the Undiagnosed Diseases Program, and Stephen Groft PharmD, director of the Office of Rare Diseases at the NIH, about program logistics and resources, and the referral process for doctors.

Host: Mark Nolan Hill, MD Guest: Bert Mandelbaum, MD It's an array of sporting events, many occurring simultaneously, in sites and cities across a nation. The 2008 Summer Olympic Games in China presents an extraordinary challenge, in terms of providing health care to injured athletes and suddenly-ill spectators alike. Dr. Bert Mandelbaum, a practicing orthopedic surgeon and president of the Santa Monica Orthopedic and Sports Medicine Research Foundation in Santa Monica, Calif., served as chief medical officer (CMO) for the 1999 and 2003 Women's World Cup of Soccer. He joins host Dr. Mark Nolan Hill to discuss the challenges of providing care in this setting. For instance, how does the CMO coordinate with the various team physicians, many of whom will not possess the necessary license to practice medicine in the country where their team is playing?

Host: Mark Nolan Hill, MD Guest: Bert Mandelbaum, MD Intense competition and year-round scheduling demands are now common trademarks of adolescent sports. As a result, we see more and more sports-related injuries, including the all-too-frequent anterior cruciate ligament (ACL) injuries. Dr. Bert Mandelbaum, president of the Santa Monica Orthopedic and Sports Medicine Research Foundation in Santa Monica, Calif., and principal investigator of the ACL Prevention Project, shares details of his potentially groundbreaking program, with results published in the American Journal of Sports Medicine. When should young athletes begin this prevention regimen? Taking the mechanisms of prevention a step further, can we teach athletes to run, jump and land in ways that will lessen their risk of injury? Dr. Mark Nolan Hill hosts.

Host: Mark Nolan Hill, MD Guest: Bert Mandelbaum, MD We're making great progress in the diagnosis and treatment of anterior cruciate ligament (ACL) injuries suffered by young athletes. It's no longer the injury that ends a sports career, but an ACL tear can still quickly end a season. Taking our work a step further, how can we equip our athletes with strategies to prevent ACL injuries before they happen? Dr. Bert Mandelbaum, president of the Santa Monica Orthopedic and Sports Medicine Research Foundation in Santa Monica, California, is the principal investigator of the ACL Prevention Project, with results published in the American Journal of Sports Medicine. He shares details of this potentially groundbreaking program with host Dr. Mark Nolan Hill.

Host: Matthew J. Sorrentino, MD, FACC, FASH Guest: John Buse, MD, PhD What went wrong with the glucose-lowering arm of the ACCORD (Action to Control Cardiovascular Risk in Diabetes) Trials? Intensive therapy was expected to reduce cardiovascular events in Type 2 diabetics at high risk of cardiovascular disease. Instead, it appears to have led to an increase in mortality. Dr. John Buse, president of the American Diabetes Association and vice chair of the ACCORD Trials Steering Committee, details the confounding results of ACCORD and offers a few ideas to explain the unexpected outcomes. Dr. Matthew Sorrentino hosts.