Healio Rheuminations

In this episode of Rheuminations, guest host Leonard H. Calabrese, DO, sits down with David Chernoff, MD, chief medical officer of SetPoint Medical, to discuss the vagus nerve and recent developments in immune mediated disease.

·       The story of Kevin Tracey, MD. 5:08

·       Going from cytokines to the vagus nerve to immune mediated inflammatory disease. 7:23

·       The ups and downs of non-surgically implanted devices. 13:28

In this episode of Rheuminations, host Adam J. Brown, MD, will walk you through the history of pleural effusions in rheumatoid arthritis. He discusses topics ranging from fascinating case studies to how pleural effusions are treated today. 

·        Diving into pleural effusions. 2:38

·        What's in the fluid? 12:01

·        When did pleural effusions become linked to RA? 15:18

·        The glucose talk. 27:04

·        Green effusions. 32:40

We'd love to hear from you! Send your comments/questions to Dr. Brown at rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations

Not all jaw claudication is giant cell arteritis. Hear some interesting cases and learn about things to look for in the labs to suspect an alternative diagnosis along with co-host Leonard H. Calabrese, DO.

·        When GCA isn't GCA, walking through mimic cases 2:43

·        Infectious mimics 14:36

·        Large vessel involvement cases 16:47

·        GCA as a medical emergency 22:05

·        Erdheim-Chester disease 23:40

We'd love to hear from you! Send your comments/questions to Dr. Brown at

In this week's episode we interview Kinanah Yaseen, MD, a rheumatologist from Cleveland Clinic's department of rheumatic and immunologic diseases about using ultrasound for giant cell arteritis.

· Intro by Adam J. Brown, MD 0:12

· Dr. Brown's recent patient 1:34

· History of ultrasound and GCA 3:20

· Episode overview 7:05

· History of echolocation; how bats helped us invent ultrasound 8:00

· What is a bat bomb? 14:56

· How the Titanic helped us invent ultrasound 16:48

· Neurologists bring ultrasound to medicine 20:09

· OB/GYN is next to use ultrasound 23:11

· Ultrasound image quality be...

In this week's episode we interview Joseph Parambil, MD, staff member in the department of pulmonary, allergy and critical care medicine at Cleveland Clinic, about the current challenges of interstitial lung disease, or ILD.

· Intro by Adam J. Brown, MD 0:12

· Welcome back Joseph Parambil, MD 0:32

· But first, some medical history on ILD 1:04

· ILD vs. IPF 2:26

· A quick aside into silicosis and bleomycin 4:27

· Trying to describe pulmonary fibrosis 5:23

· The different types of ILD 9:44

· Finding a slow progression of disease and autoimmune conditions 10:59

· Pulmonary...

This special edition episode features the latest installment of Healio Community's book club. Physician author Kevin J. Tracey, MD, discussed his book, The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes in which he explores the potential of stimulating the vagus nerve to treat rheumatoid arthritis and other diseases.

·        Intro by Adam J. Brown, MD 0:14

·        A warm welcome from Leonard H. Calabrese, DO 0:25

·        Introducing Kevin J. Tracey, MD 0:58

·        The connection between the brain and the immune system 3:25

·        Where was the switch that combined neural networks and immune

To celebrate 101 episodes, I sit with Leonard H. Calabrese, DO, to discuss his unique career in Rheumatology, spanning immunology, HIV, MECFS, IRES, CNS vasculitis and more. We also discuss how medical history shaped our careers. 

·        Intro 0:12

·        Welcome Leonard H. Calabrese, DO 3:11

·        A quick friendship begins over medical history 4:14

·        How Healio Rheuminations began and where the show is now 5:38

·        How Dr. Calabrese got interested in medical history 7:11

·  

What does a goiter and syphilis have in common with the first descriptions of giant cell arteritis? Join us as we dive into the history of the most common type of vasculitis!

The story of rheumatoid factor could be a 10 minute episode, but in this episode, we dig deep into the history of the lab techniques leading up to this discovery…that happened twice. 

Active or not active, that is the question. In this week's episode we interview Alexandra Villa-Forte, MD, MPH, a staff physician in the Center for Vasculitis Care and Research at Cleveland Clinic and a leading vasculitis expert, on a pragmatic approach to recognizing disease activity in patients with ANCA vasculitis.

This special edition episode features the latest installment of Healio Community's book club. Physician author Eric Topol, MD, discusses his book, Super Agers: An Evidence-Based Approach to Longevity, a guide to the science of living a long life free of debilitating diseases with Leonard H. Calabrese, DO, chief medical editor of Healio Rheumatology.

· Intro by Adam J. Brown, MD 0:01

· A warm welcome by Leonard H. Calabrese, DO 0:47

· Introducing Eric Topol, MD 1:12

· "Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again" but did you think it would happen this fast? 1:54

...

In this episode, we focus on the history of researchers discovering the clinical applicability of the IL 23/17 axis, with a particular emphasis on psoriasis, psoriatic arthritis and axial SpA

In this episode, we dive into a two-part story of intrigue starting from a paradigm shift in understanding of T cell biology because of a mouse model of post-measles encephalopathy, to the eventual recognition of the IL-23/17 immune axis.

•    Intro 0:01
•    In this episode 0:12 
•    Interleukin-17 (IL-17) is a relatively recent discovery 1:34
•    The beginning of TH-17 2:20
•    Looking at autoimmune encephalopathy: A story of measles 03:30
•    1790's woman with post measles inflammatory process in the brain 10:26
•    What is causing post-infection encephalitis? 12:00
•    Acute disseminated encephalomyelitis 12:30
•    How did we find out the immune system was behind this - The rabies vaccine 13:0...

In this episode, we dive into the history of polymyalgia rheumatica, how it was discovered and its link to giant cell arteritis.

In the final part of this series, Joseph Parambil, MD, walks us through the approach of managing pulmonary hypertension, reviews the pathophysiology and digs into the mechanisms and the differences in the medications.

In this episode, we dive into the early therapies and how our understanding of vascular physiology drastically changed the management of pulmonary hypertension.

In part 2, we dig into the history of pulmonary hypertension. How did this strange diagnosis first get recognized, what does it have to do with cows with thick necks and urinary catheters in the heart?

We'd love to hear from yo...

In this series, we dive into what rheumatologists should know about pulmonary hypertension, starting an interview with Joseph Parambil, MD, where we learn about the disease, when to suspect and how to work up!

On this episode, hear the 2024 updates on COVID-19, long COVID and the latest developments in research in rheumatology. Hosted by Dr. Leonard Calabrese.

Leonard H. Calabrese, DO, is the chief medical editor, Healio Rheumatology, and professor of medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University...

It's that time of year again, everyone rolling up their sleeves to get a flu shot. This throwback episode dives into the history of the struggles pinning down the causative agent of flu and the journey to the vaccine!

Disclosures: Brown reports no relevant financial disclosures.

We'd love to hear f...

In the third episode of the NSAIDs saga, we focus on COX-2 inhibition! Did the hopes and dreams of selective COX-2 inhibition pan out? What can the rise and fall of VIOXX teach us about physiology?

In this episode, we dive into the story of aspirin and the development of ibuprofen, ending with the experiments that showed the mechanism of how aspirin actually works.

Humans have had an insatiable appetite for inhibiting production of prostaglandins for centuries! This series delves into the history of aspirin and NSAIDs, looking at the understanding of the prostaglandin pathway.

· Intro 0:12

· In this episode 0:23

· What are NSAIDs? 0:53

· Prostaglandins 5:50

· What are prostaglandins? 7:19

· Where do prostaglandins come from? 8:45

· So, what do we do with prostaglandins? 13:15

· How did they figure out prostaglandins? 13:55

· Naming the prostaglandin 21:25

· Phospholipids 24:46

· Arachidonic acid 25:28

· Arachidonic acid into prostaglandins: how do you prove it? 26:32

· Ho...

This episode digs into the pathophysiology of urticaria vasculitis from anti-C1q to the story of bradykinin.

· Intro 0:11

· In this episode 0:22

· Review of episode 83 1:23

· Listen to previous episode, The Complement System for Dunces 4:09

· Anti-C1q antibodies 6:26

· Lupus, anti-C1q and lupus nephritis 9:33

· What happens when you inject anti-C1q in a mouse? 12:56

· The allergy component: anti-C1q, urticaria and angioedema 17:36

· Bradykinin-mediated angioedema and C1q deficiency 24:20

· What is the kinin kallikrein system? 26:21

· French researchers in 1909: human urine injected in...

Is it an allergy or an autoimmune vasculitis, or a little of both? Find out the story of urticarial vasculitis, how this disease was recognized and eventually sorted out from other types of urticaria.

· Intro 0:12

· In this episode 0:21

· Case study 1:22

· Chronic spontaneous urticaria, hives and nettles 7:57

· Dermatographism and witchcraft? 10:15

· Causes of urticaria 11:17

· Theory of inflammation and histamines 11:40

· Urticaria and treatments with histamines 12:09

· Types of urticaria 13:02

· Mayo Clinic study 13:39

· Chronic urticaria as a manifestation of necrotizing venulitis 16:10

· Conne...

What should rheumatologists know about what we've learned about COVID-19 and long COVID in 2023? Hosted by Dr. Leonard Calabrese.

· Intro 0:11

· In this episode 0:21

· 2023: current status and controversies 0:35

· What is going on with COVID-19? 01:53

· What do we know about vaccine responses? What should we be telling our patients about vaccines in our immunocompromised population? 2:58

· Lancet Rheumatology MELODY study summary 3:08

· What about patients within the rheumatic and autoimmune disease space? 4:15

· Who is immunocompromised and why does it matter? 5:11

· What is the immunosuppression we are givin...

It's that time of year again, everyone rolling up their sleeves to get a flu shot. This episode dives into the history of the struggles pinning down the causative agent of flu and the journey to the vaccine!

· Intro 0:12

· In this episode 0:17

· The history of the flu: 1892 3:10

· Rabies and dead virus 10:52

· A Sickness in the Serum, Part 2 14:31

· Vaccines and trials 19:13

· Pig influenza 23:21

· Influenza: a filterable agent we can't see 27:10

· The trials of 1942 33:18

· PS: 1918 influenza 39:13

· Finding the 1918 influenza vaccine 39...

What is silica? How does it impact your risk of developing autoimmunity if you inhale it, inject it or even snort it up your nose? Listen and find out!

·       Intro 0:12

·       In the previous episodes 0:28

·       The Ajax incident of 1979 1:15

·       Silica and its association with autoimmune disease 4:11

·       The history of silica and the health risks 5:21

·       Rheumatoid scleroderma, etc. 8

In this episode, we dig through the data of lupus in Africa and speak with experts on the Lupus Gradient, the impact of malaria and what we can learn from it all.

· Intro 0:12

· In the previous episode 0:30

· Lupus Gradient 2:01

· Back to Dr. Brian Greenwood 3:48

· Polyarthritis 4:04

· Rates of autoimmune diseases 6:00

· Malaria and mouse models 7:33

· Back to lupus 8:48

· First case of lupus 15:14

· Prevalence of lupus 17:15

· Papers on lupus 21:23

· Dr. Mickael Essouma 23:38

· Dr. Essouma, how did you conduct t...

This episode delves into what we can learn about the impact of the environment on autoimmunity, digging into how rates of autoimmunity can vary drastically in different parts of the world.

· Intro 0:12

· In this episode 0:16

· Dr. Brian Greenwood 0:22

· The geography of autoimmunity 7:01

· Type 1 diabetes 10:31

· Finland and type 1 diabetes 13:57

· Socioeconomics 17:59

· Genetics and autoimmune diseases 24:19

· Migration studies 24:53

· Denmark and multiple sclerosis 30:06

· Coming up in part 3 36:02

· Thanks for listening 38:16

Disclosures: Brown reports no relevant financial disclosures.

We'd...

This episode delves into the history of the hygiene hypothesis. What do we know about different exposures changing risk for asthma and allergies, and do these exposures have the same protection for autoimmunity?

· Intro 0:12

· In this episode 0:18

· Hygiene hypothesis 0:33

· Allergic rhinitis (or Hay fever) 2:32

· Pollen and the allergy skin test 8:58

· Exposure and cleanliness 10:22

· Allergic rhinitis and Cree Native Americans 11:51

· Appendicitis 13:10

· Family size and asthma 14:36

· Rural versus urban populations 17:41

· Dust 18:31

· Children, day care and infections 22:43

· The "o...

On this special episode of Rheuminations, I interview comedian and ophthalmologist William Flanary, MD, and Kristin Flanary, also known as the Glaucomfleckens, on hypermobility and physician burnout.

Kristen Flanary highlights what it's like to live with hypermobility, and Dr. William Flanary discusses his thoughts on physician burnout and using their podcast, Knock Knock, Hi, as comedy relief.

· Intro 0:11

· In this episode 0:45

· Interview with Dr. William and Kristin Flanary, also known as Doctor and Lady Glaucomflecken 2:49

· Rheumatology and ophthalmology overlap 3:11

· Can you tell me a few things about yours...

Was your psoriasis caused by the Black Death? Learn more than you might have wanted to know about the Black Death and delve into the data on the immunologic/autoimmune ramifications of wiping out nearly half of Europe.

· Intro 0:11

· In this episode 1:09

· The Black Death 1:24

· The History of IV Immunoglobulin episode 2:07

· How the Black Death happened 4:07

· How many people died from the Black Death? 6:49

· Record keeping 6:53

· The modern immune system, the Black Death and HIV 8:43

· What is CCR5? 8:55

· Current data on au...

In this episode we explore ways in which the extracellular matrix can be manipulated, including the story of doxycycline, TGF-beta in Marfan syndrome and whether beta blockers can reduce vascular events in vascular EDS.

· Intro 0:12

· Review of previous episode 0:28

· In this episode 2:26

· The pressure against the vessels 4:06

· The pressure against the wall 8:44

· Matrix metalloproteinases 10:16

· Tadpole study – collagen breakdown 10:35

· Tetracycline antibiotics 14:05

· Rat model – periodontal disease and hydroxyproline 14:24

· Chemically modified tetracyclines 20:14

· Mouse model – tetracycline use 22:00

· Tetracyclines and other autoimmune c...

Dive into vascular Ehlers-Danlos syndrome. What is it? How does it present? Get clues to its diagnosis and learn more about collagen than you ever wanted to know.

In this episode, Dr. Benjamin Claytor walks us through his approach to suspected sensory ganglionopathies. I also cover other neurologic complications of Sjogren's syndrome and some interesting history on vitamin B6.

A sensational (or lack thereof) series on the signs and symptoms of the spellbinding sensory ganglionopathies.

Disclosures: Brown reports no relevant financial disclosures.

We'd...

In part two, Leonard Calabrese, DO, discusses the symptoms of long COVID and the role that rheumatologists play in diagnosing and treating patients with long COVID.

Brought to you by Tremfya.

In this episode, Leonard Calabrese, DO, reviews the history and controversies of post-infection sequelae, as well as the facts and epidemiology of long COVID.

Disclosures: Calabrese reports...

How is the synovial fluid produced? Who figured it out? It's a ripping yarn involving corpses, cats, anti-hypertensives, steroids and streptococcus.

Brought to you by Tremfya.