Mayo School of Continuous Professional Development 16th Annual Mayo ClinicEndocrine Course January 29 – February 2, 2013 Marco Island Marriott SOUTHWEST FLORIDA Virtual Interactive Attendance Option! Workshop Opportunities Thyroid Ultrasound January 30 & 31, 2013 ABIM Maintenance of Certification Live Learning Session January 30, 2013 #MayoEndo www.mayo.edu/cme/endocrinology
General InformationCourse Description & ObjectivesDesigned for endocrinologists and interested internists and surgeons, the 16th MayoClinic Endocrine Course will offer the latest material on the diagnosis and treatment ofendocrine disorders. Faculty are selected from Mayo Clinic for their expertise,knowledge and clinical acumen. This 3 ½ day course will span the full spectrum ofendocrinology through lectures, debates, clinicopathologic sessions, “clinical pearls”sessions, panel discussions, and roundtable discussions with experts. There will beplenty of opportunity for interaction with the course faculty.Learning ObjectivesUpon completion of this educational activity, participants should be able to:• Summarize the role for molecular markers in the evaluation of indeterminate thyroid nodules and the management of differentiated thyroid cancer.• Apply new guidelines for the evaluation and management of hypertriglyceridemia.• Recognize limitations to safety and efficacy of medications targeting hypertriglyceridemia.• Distinguish between endocrine disease and normal changes of aging in the elderly patient.• Describe modifications to usual interpretation and management of thyroid function in the elderly patient.• Recall and apply guidelines for thyroid disease in pregnancy.• Summarize key steps in preparing patients to undergo endocrine surgeries.• Critique the definition, evaluation and management of polycystic ovary syndrome by comparing and contrasting a “metabolic approach” with an “endocrine approach.”• Discuss the endocrinologist’s role in improving the system of care for patients who have sustained an osteoporotic hip fracture.• Begin to apply quality improvement strategies to detect deficiencies, implement strategies and measure outcomes related to osteoporosis management post hip fracture.• List approaches to safely and effectively utilize U-500 insulin in the management of diabetes mellitus.• Summarize the evaluation of suspected hypercortisolism and list important caveats to the interpretation of pivotal diagnostic testing.• Explain how organ transplantation and immunosuppressive therapy may cause endocrine disorders and modify the approach to treatment.Date and LocationThe 16th Mayo Clinic Endocrine Course will be held January 29 – February 2, 2013, atthe Marco Island Marriott Resort, Marco Island, Florida. Explore a world of paradiseat Marriott’s exclusive Marco Island, Florida resort near Naples. This world-classMarco Island resort is situated on three miles of pristine beachfront property andoffers an exhilarating retreat from the ordinary. The resort features a lavish spa, twoprivate 18-hole championship golf courses, eight unique restaurants and spaciousaccommodations with premier amenities, technology upgrades, and views of theFlorida Gulf Coast. This Marco Island resort’s amenities provide guests with anidyllic retreat just miles from Naples and Fort Myers. Nearby, guests can enjoyexciting water sports, parasailing, shelling cruises, and sightseeing adventures.
General InformationIntended AudienceThis course is intended for endocrinologists, endocrine surgeons, and generalinternists with an interest in endocrine disorders.RegistrationOnline registration is preferred at http://www.mayo.edu/cme/endocrinology or request apaper form to mail or fax by contacting firstname.lastname@example.org or fax 507-255-6155 or phone 507-255-6869. The registration fee is $850 for physicians and $640 forretirees, trainees, and NP/PAs. This fee includes tuition, comprehensive electronicsyllabus, breakfasts, break refreshments, lunch on Friday, Welcome Reception andthe Gala Dinner.Although it is not Mayo Clinic Endocrine Course policy to limit the number ofregistrants for a course, facilities may necessitate closing of enrollment. Therefore,early registration is advised and the option of onsite registration is not guaranteed.If available, onsite registration will incur an additional cost of $75 USD. A letter ofconfirmation will be sent upon receipt of payment and completed registration form.Please be prepared to present the confirmation letter when checking in at themeeting registration desk.Cancellation PolicyRegistrants may cancel their registration at any time. If the cancellation is mademore than 14 days prior to the start of the course (before January 15, 2013), a refundwill be made less an administration fee of $75. If a cancellation request is received onor after January 15, 2013 no refund will be made. All refunds will be made using thesame method as the payment. Written notification of intent to cancel registration ispreferred via email to email@example.com otherwise by fax 507-255-6155 or phone507-255-6869.Continuing Education CreditAccreditationCollege of Medicine, Mayo Clinic is accredited by the Accreditation Council forContinuing Medical Education to provide continuing medical education forphysicians.College of Medicine, Mayo Clinic, designates this live activity for a maximum of:16th Mayo Clinic Endocrine Course onsite or virtual live attendance = 22 hoursThyroid Ultrasound Workshop = 7 hoursABIM MOC Shared Learning Session = 4 hoursAMA PRA Category 1 Credits™. Physicians should claim only the credit commensuratewith the extent of their participation in the activity.”Educational Grants“This course is supported in part by educational grants in accordance with ACCMEStandards. At the time of this printing, a complete list of commercial supporters wasnot available. Appropriate acknowledgment will be given to all supporters at thetime of the meeting.”
General InformationDisclosure PolicyAs a provider accredited by ACCME, College of Medicine, Mayo Clinic (MSCPD)must ensure balance, independence, objectivity and scientific rigor in its educationalactivities. Course Director(s), Planning Committee Members, Faculty, and all otherswho are in a position to control the content of this educational activity are requiredto disclose all relevant financial relationships with any commercial interest related tothe subject matter of the educational activity. Safeguards against commercial biashave been put in place. Faculty also will disclose any off-label and/or investigationaluse of pharmaceuticals or instruments discussed in their presentation. Disclosure ofthis information will be published in course materials so those participants in theactivity may formulate their own judgments regarding the presentation.TravelAirport: The nearest international airport to the Marco Island Marriott Resort isSouthwest Florida International Airport (RSW) in Ft. Myers. This airport is one hournorth of the resort.Taxis: The Marco Island Marriott Resort highly recommends using On DemandTransportation. Reservations are required 24 hours in advance. Please call 239-580-9046 to make reservations.On Demand Transportation has a wide variety of transportation options to fit yourneeds. Taxi, town car, limo and van services are available for hire. Taxis and towncars will cost approximately $78-$100/one way, Limos will cost approximately$115/one way and a 4-8 passenger van will cost approximately $135/one way.There are many taxi companies available outside of baggage claim at RSW.However, some companies will charge excesive fees if they are not accustomed todriving into Marco Island. Please beware of this when making transportation plans.Car Rental: All major car rental agencies are represented at RSW. Please contactyour preferred agency to seek information about specific costs. The Mayo Clinicsecured a special lowered parking rate at the resort for $6/day. Valet parking is alsoavailable for $20/night.Lodging AccommodationsRooms have been reserved for course participants and guests at the Marco IslandMarriott Resort, located near Naples, FL. To ensure accommodations at this specialgroup rate, make your reservation before Friday, January 4, 2013. The Marco IslandMarriott Resort, at their sole discretion, may continue to accept reservations afterthis cut-off date on a space available basis at the group rates.Mayo Group Rates: $259 single/double plus tax.Reservations can be made by contacting:Marco Island Marriott Resort400 South Collier Blvd.Marco Island, FL, 34145Reservations: 800-228-9290 or 239-394-2511For more information about the Marco Island Marriott Resort, please visit thefollowing website: http://www.marcoislandmarriott.com/
General InformationSyllabusThe 16th Mayo Clinic Endocrine Course will feature an electronic syllabus that may bedownloaded from the course website approximately two weeks before the start ofthe course and also distributed to each attendee by USB flash drive at registration.Course Welcome Reception and Gala DinnerThe following social activities are complimentary for all course registrants.Additional guest tickets covering both events are available and can be requested onthe course registration form. The guest ticket fee for adults is $75 USD. Childrenunder 18 years of age are complimentary.Welcome ReceptionTuesday, January 29, 20136:00 p.m. – 7:00 p.m.Featuring light appetizers and select beverages, this casual reception welcomesattendees to Marco Island and offers the perfect opportunity to meet new colleaguesin a relaxed setting. Pre-registration is requested.Course Gala DinnerFriday, February 1, 20137:00 p.m. Reception; 8:00 p.m. DinnerJoin us for this special reception and dinner featuring select foods from the regionwith a spectacular ocean view. Pre-registration is requested.Recreation/Leisure ActivitiesMarco Island is all about the water. Just about every water activity imaginable isavailable for you to “dive” into! There are fishing tours, luxury cruises, sailing,parasailing, wave runners, kayaking and water skiing just to name a few. Guestscan also take advantage of the endless array of activities and recreating options forindividuals, families, groups and children that are available on hotel property.Marco Island Marriott offers tennis, beach volleyball, Discovery Camp, Dive-InMovies, shelling tours, golf and much more. If you prefer a more leisurely schedule,you may want to take advantage of the breathtaking scenery, worldly museums,boutique shopping and fine dining. Please visit www.marcoreview.com or www.marcoislandmarriott.com/marco-island-florida/resort-hotel-recreation-5.html formore information. You may also call the Marco Island Marriott Resort ConciergeDesk at 239-394-2511.Course HighlightsTeaching CasesParticipants are invited to submit a case for consideration for presentation duringone of the Teaching Case sessions. This is a brief presentation of a case by anattendee. A Mayo Clinic faculty member will discuss the case and make a probablediagnosis or suggest the next best step in the evaluation. The presenter will thenprovide the “answer/conclusion” to the case. Learning points will then besummarized by both the presenter and discussant.If interested in submitting a case for presentation, please send a brief abstract (<250words) including title and co-authors by January 11, 2013, to firstname.lastname@example.org
General Informationor FAX to the attention of Dr. Kurt Kennel at 507-255-6155. Two cases will beselected for presentation. Authors of selected cases will receive additionalinformation from course directors prior to the course.Short Lectures• All didactic lectures will be limited to 25 minutes.• Open panel question and answer periods will follow each group of 3 to 4 lectures.Case-Based Debates• A case will be presented by the moderator.• The moderator will ask structured questions for comment from the debaters and attendees.• Using an audience response system, the attendees will vote for “treatment A” or “treatment B.”• Two debaters will present their arguments.• After hearing the debate, the audience will re-vote on the treatment options.Clinicopathologic Conference (CPC)• Unknown cases are presented to faculty members.• Using a test menu system, a faculty member works through the case step-by-step.Clinical Pearls• Clinical “Pearls” are concise practical insights relevant to the practicing endocrinologist, but not widely appreciated or represent changes to historical practice.• This session is case-based and fast-paced.• The faculty presents brief clinical cases illustrating important teaching points.• Attendees should leave each pearl session with a rich list of important clinical pearls that are directly applicable to patient carePanel Discussions• The moderator presents 2 – 4 cases based on the session theme to a subspecialist panel.• The panel responds to questions from the moderator and audience regarding management.• Teaching points are many with panelists providing clinical pearls related to the theme.Breakfast Roundtable Discussions• Each day, attendees will have the opportunity to informally discuss cases or issues in the diagnosis or management of endocrine disorders.Key Scientific Articles in Endocrinology 2012• At the conclusion of each themed session, Mayo Clinic faculty will introduce key articles published in 2012 that have significant implications for clinical practice.Setbacks in Endocrinology• Mayo Clinic faculty will share setbacks encountered in patient management and the lessons that they learned.DISCLAIMERAttendance at this Mayo course does not indicate nor guarantee competence orproficiency in the performance of any procedures that may be discussed or taught inthis course.
Program ScheduleTUESDAY, JANUARY 29, 2013Noon – 6:00 p.m. Registration6:00 – 7:00 p.m. Welcome ReceptionWEDNESDAY, JANUARY 30, 20136:30 a.m. Registration, Continental Breakfast and Exhibits7:30 a.m. Welcome and Opening Comments Kurt A. Kennel, MD & Melanie L. Richards, MDModerator: Victor Bernet, MD7:45 a.m. Molecular Markers in the Evaluation of Thyroid Nodules Bryan McIver, MBChB, PhD8:15 a.m. Advanced Thyroid Cancer: New Guidelines & Clinical Trials Robert C. Smallridge, MD8:40 a.m. Thyroid Function Testing Course Faculty9:05 a.m. Clinical Pearls: Preparing Patients for Endocrine Surgery Geoffrey B. Thompson, MD9:40 a.m. Panel Question and Answer Session10:00 a.m. Refreshment Break and ExhibitsModerator: Vahab Fatourechi, MD10:30 a.m. Case-based debate: Does this patient require central compartment lymph node dissection? Case: Vahab Fatourechi, MD “Yes” – Geoffrey B. Thompson, MD “No” – Melanie L. Richards, MD11:00 a.m. Molecular Markers in the Management of Thyroid Cancer Bryan McIver, MBChB, PhD11:25 a.m. Key Clinical Articles in Thyroid 2012 Course Faculty11:50 a.m. Panel Question and Answer Session12:30 p.m. Adjourn for the day1:00 – 5:15 p.m. Optional Workshops—pre-registration required Thyroid Ultrasound Workshop (Part 1) ABIM MOC Shared Learning Session
Program ScheduleTHURSDAY, JANUARY 31, 20136:30 a.m. Registration, Continental Breakfast and Exhibits Breakfast Roundtable Discussions • Endocrine Surgery Geoffrey B. Thompson, MD • Pituitary, Gonad, Adrenal William F. Young, Jr., MD • Thyroid Victor Bernet, MD • Thyroid Cancer Robert C. Smallridge, MD • Molecular Markers in Thyroid Bryan McIver, MBChB, PhD • Transplant Endocrinology Pankaj Shah, MD • Osteoporosis Ann E. Kearns, MD, PhDSymposium on AgingModerator: Steven A. Smith, MD7:30 a.m. Case Presentation Steven A. Smith, MD7:40 a.m. Growth Hormone and IGF-1 Axis in Aging Johannes D. Veldhuis, MD8:00 a.m. Thyroid Disease in Aging John C. Morris, III, MD8:20 a.m. Bone in Aging Sundeep Khosla, MD8:40 a.m. Testosterone in Aging Todd B. Nippoldt, MD9:00 a.m. Metabolic Disease in Aging Robert A. Rizza, MD9:20 a.m. Panel Question and Answer Session10:00 a.m. Refreshment Break and Exhibits10:30 a.m. Small Group Discussions • Endocrine Disorders in Patients s/p Bariatric Surgery Manpreet S. Mundi, MD & Kurt A. Kennel, MD • Challenging Hypertriglyceridemia Cases Vinaya Simha, MD • Current Role of Insulin Sensitizers in Clinical Practice K. Sreekumaran Nair, MD, PhD • Endocrine Care of the Post-hip Fracture Patient Ann E. Kearns, MD, PhD
Program Schedule11:30 a.m. Small Group Discussions • Management of Persistent Cushing’s Syndrome William F. Young, Jr., MD • Pediatric & Adolescent Endocrine Cases Larry A. Binkovitz, MD & Siobhan Pittock, MD • Endocrine Care of the Post-transplant Patient Pankaj Shah, MD • Thyroid Disease in Pregnancy Robert C. Smallridge, MD12:30 p.m. Adjourn for the day1:00 – 5:15 p.m. Optional Workshop—pre-registration required Thyroid Ultrasound (Part 2)FRIDAY, FEBRUARY 1, 20136:30 a.m. Registration, Continental Breakfast and Exhibits Breakfast Roundtable Discussions • Bone Sundeep Khosla, MD • Pituitary Johannes D. Veldhuis, MD • Diabetes Robert A. Rizza, MD • Bariatric Surgery Manpreet S. Mundi, MD • Pediatric Endocrine Larry A. Binkovitz, MD & Siobhan Pittock, MD • Thyroid Function John C. Morris, III, MD • Insulin Resistance K. Sreekumaran Nair, MD, PhDModerator: Todd B. Nippoldt, MD7:30 a.m. Case Snapper Kurt A. Kennel, MD7:45 a.m. Endocrine Hypertension 2012 William F. Young, Jr., MD8:10 a.m. Robotic and Minimally Invasive Endocrine Surgery Melanie L. Richards, MD8:35 a.m. Evaluation of Hypercortisolism: Pitfalls and Pearls Alice Y. Chang, MD9:00 a.m. CPC: Pituitary, Gonad, Adrenal Case Presented by: Todd B. Nippoldt, MD Discussed by: William F. Young, Jr., MD
Program Schedule9:30 a.m. Panel Question and Answer Session10:00 a.m. Refreshment Break and Exhibits10:30 a.m. Small Group Discussions (repeated from Thursday) • Management of Persistent Cushing’s Syndrome William F. Young, Jr., MD • Pediatric Endocrine Cases Larry A. Binkovitz, MD & Siobhan Pittock, MD • Endocrine Care of the Post-transplant Patient Pankaj Shah, MD • Thyroid Disease in Pregnancy Robert C. Smallridge, MD11:30 a.m. Small Group Discussions • Endocrine Disorders in Patients s/p Bariatric Surgery Manpreet S. Mundi, MD & Kurt A. Kennel, MD • Challenging Hypertriglyceridemia Cases Vinaya Simha, MD • Current Role of Insulin Sensitizers in Clinical Practice K. Sreekumaran Nair, MD, PhD • Endocrine Care of the Post-hip Fracture Patient Ann E. Kearns, MD, PhD12:30 p.m. Adjourn from small groups12:45 p.m. Lunch with Lecture: Who is Your Endocrine Surgeon? David R. Farley, MD1:15 p.m. BreakModerator: Kurt A. Kennel, MD1:30 p.m. Panel Discussion: Polycystic Ovary Syndrome Moderator: Kurt A. Kennel, MD Endocrine Perspective: Alice Y. Chang, MD Gynecology Perspective: Guest Faculty2:15 p.m. Key Clinical Articles in Pituitary, Gonad & Adrenal 2012 Course Faculty2:30 p.m. Clinical Pearls: Hypercalcemia Robert A. Wermers, MD3:10 p.m. Panel Question and Answer Session3:30 p.m. Refreshment Break and ExhibitsModerator: Ann E. Kearns, MD, PhD4:00 p.m. Emerging Therapies for Osteoporosis Sundeep Khosla, MD
Program Schedule4:25 p.m. CPC: Bone Case: Michael D. Whitaker, MD Discussant: Robert A. Wermers, MD4:55 p.m. All That is “Thin” is Not Osteoporosis Michael D. Whitaker, MD5:20 p.m. Key Clinical Articles in Bone & Calcium 2012 Course Faculty5:35 p.m. Panel Question and Answer Session6:00 p.m. Adjourn for the day7:00 p.m. Course Gala DinnerSATURDAY, FEBRUARY 2, 20136:30 a.m. Continental Breakfast and Exhibits Breakfast Roundtable Discussions • Endocrine Surgery Melanie L. Richards, MD • Pituitary, Gonad, Adrenal Alice Y. Chang, MD • Dyslipidemia Vinaya Simha, MD • Hypercalcemia Robert A. Wermers, MD • Osteoporosis Michael D. Whitaker, MD • Diabetes Steven A. Smith, MD • Inpatient Hyperglycemia Ananda Basu, MBBS, MDModerator: Maria L. Collazo-Clavell, MD7:30 a.m. Case Snapper Maria L. Collazo-Clavell, MD7:45 a.m. Pathogenesis of Diabetes and Pre-diabetes: Implications for Therapy Robert A. Rizza, MD8:10 a.m. Inpatient Hyperglycemia: Where to Next? Ananda Basu, MBBS, MD8:35 a.m. Case-Based Debate: Should this Patient with Type 2 Diabetes be Treated with CSII or MDI? Case: Pankaj Shah, MD “CSII” – Ananda Basu, MBBS, MD “MDI” – Steven A. Smith, MD
Program Schedule9:05 a.m. The Psychology of Diabetes Steven A. Smith, MD9:30 a.m. Panel Question and Answer Session10:00 a.m. Refreshment Break and ExhibitsModerator: Kurt A. Kennel, MD10:30 a.m. Optimal Use of U-500 Insulin Vinaya Simha, MD10:55 a.m. Key Clinical Articles in Metabolic Disease 2012 Course Faculty11:20 a.m. Setbacks in Endocrinology Course Faculty11:40 a.m. Panel Question and Answer Session12:00 p.m. Learning Assessment & Course Evaluation12:30 p.m. Adjourn
Additional Learning OpportunitiesSecond Life Virtual Live AttendanceFee: $250 for physicians. $175 for retirees, trainees, and NP/PAs.Laptop or desktop computer with high speed internet connection requiredIf you’re unable to attend the onsite symposium, you can participate virtuallythrough Second Life! Second Life is an on-line virtual world where people arerepresented by characters (avatars) that interact with each other and theenvironment of the virtual world. This symposium is being offered in Second Lifeand will feature the same leading experts in the field, who will be presenting at theonsite symposium in real time. Participants will have access to presentation slidesand live audio including interactive chat for question and answer through sessionmoderators. General sessions and small group discussions being held in the mainauditorium will be available in this format. Participants completing the entireworkshop may claim 22 hours of AMA PRA Category 1 Credits™.To register online, visit http://www.mayo.edu/cme/endocrinology and select the virtualcourse registration option. Those attending with this option will receive additionalinstruction and support prior to the course to assure your computer is set-up for anoptimal experience.Optional Workshop: ABIM MOC Live Learning Session1:00 – 5:15 p.m., Wednesday, January 30Fee: $125 includes boxed lunch and refreshment breaksIn this optional session, experts representing each subspeciality area ofendocrinology and metabolism will facilitate a discussion of the 30 questions thatcomprise the ABIM Self-Evaluation of Medical Knowledge Module 2012 Update inEndocrinology (A3-M). Registrants will be given instructions on how to register withABIM to enroll in ABIM’s Maintenance of Certification (MOC) program andpurchase the 2012 Update in Endocrinology module for completion onsite or afterthe course. The 2012 Update in Endocrinology counts as 10 points toward the Self-Evaluation of Medical Knowledge component of ABIM Maintenance of Certification(MOC) and is available for use toward MOC through May 8, 2015. Participantscompleting the entire workshop may claim 4 hours of AMA PRA Category 1 Credits™.Optional Workshop: Thyroid Ultrasound1:00 – 5:15 p.m., Wednesday, January 30 (Part 1)1:00 – 5:15 p.m., Thursday, January 31 (Part 2)Fee: $250 includes boxed lunch and refreshment breaks both daysPre-registration required. Enrollment is limited to 48 participants.Designed for endocrinologists, this introductory workshop will include normalthyroid and head and neck anatomy; examination of thyroid nodules, abnormalparathyroid glands, and lymph nodes; and offer a practicum with hands on use ofultrasound equipment and ultrasound-guided biopsy. Attendees with a range ofthyroid ultrasound experience from those needing an introduction to othersinterested in reviewing current technologies and techniques are welcome Faculty toparticipant ratio will be kept at 8:1 or less. Participants completing the entireworkshop may claim 7 hours of AMA PRA Category 1 Credits™.
Course FacultyCourse Directors Bryan McIver, MBChB, PhD John C. Morris, III, MDMaria L. Collazo-Clavell, MD Manpreet S. Mundi, MDKurt A. Kennel, MD K. Sreekumaran Nair, MD, PhDMelanie L. Richards, MD Todd B. Nippoldt, MD Siobhan Pittock, MDCourse Planning Committee Melanie L. Richards, MD Robert A. Rizza, MDDiana S. Dean, MD Pankaj Shah, MDVahab Fatourechi, MD Vinaya Simha, MDAnn E. Kearns, MD, PhD Steven A. Smith, MDTodd B. Nippoldt, MD Geoffrey B. Thompson, MDSteven A. Smith, MD Johannes D. Veldhuis, MD Robert A. Wermers, MDCourse Faculty William F. Young, Jr., MDMayo Clinic Rochester Course FacultyAnanda Basu, MBBS, MD Mayo Clinic ArizonaLarry A. Binkovitz, MDAlice Y. Chang, MD Michael D. Whitaker, MDMaria L. Collazo-Clavell, MDDiana S. Dean, MD Course FacultyDavid R. Farley, MD Mayo Clinic FloridaVahab Fatourechi, MDAnn E. Kearns, MD, PhD Victor Bernet, MDKurt A. Kennel, MD Robert C. Smallridge, MDSundeep Khosla, MDFaculty DisclosureAs a provider accredited by ACCME, the Mayo Clinic Division of Endocrinology,Diabetes, Metabolism, and Nutrition must ensure balance, independence, objectivityand scientific rigor in its educational activities. Course directors, planningcommittee, faculty, and all others who are in a position to control the content of thiseducational activity are required to disclose all relevant financial relationships withany commercial interest related to the subject matter of the educational activity.Safeguards against commercial bias have been put in place. Faculty also willdisclose any off-label and/or investigational use of pharmaceuticals or instrumentsdiscussed in their presentation. Disclosure of this relevant information will bepublished in course materials so those participants in the activity may formulatetheir own judgments regarding the presentation.DisclaimerAttendance at this Mayo course does not indicate nor guarantee competence orproficiency in the performance of any procedures that may be discussed or taught inthis course.