Healio Rheuminations

ILD for the rheumatologist: Digging through the past and making sense of the present

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 ILD, or interstitial lung disease. ·        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 fibrosis diagnoses in 1963 14:41 ·        The modern era of ILD 16:22 ·        Nonspecific interstitial pneumonia 20:12 ·        Handing things over to Dr. Parambil 23:01 ·        Helping rheumatologists understand ILD/The alphabet soup 24:34 ·        The shift from biopsies and using immunosuppression 33:07 ·        Is the workup similar for UIP and NSIP? 35:26 ·        Is there a standard protocol for workup in terms of serologies? 36:30 ·        The danger of choosing the wrong treatment 38:43 ·        Immunosuppression in patients with pulmonary hypertension and ILD 40:52 ·        UIP and ANCA vasculitis 42:12 ·        Compared to ten years ago, how are we doing with treatments? 43:10 ·        Where are we with lung transplants? 50:49 ·        Looking at hematopoietic stem cell transplants 53:24 ·        The importance of early diagnosis 54:14 ·        Antifibrotic medicines 56:15 ·        Chronic and acute interstitial lung diseases 58:41 ·        Thank you, Dr. Parambil 1:03:54 ·        A conclusion from Dr. Brown 1:04:20 ·        Thank you for listening 1:04:55 We'd love to hear from you! Send your comments/questions to Dr. Brown at rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum. Joseph Parambil, MD, is a staff member in the Respiratory Institute and the director of the HHT Center of Excellence and the Vascular Anomalies Center at the Cleveland Clinic. He is associate professor of medicine at Cleveland Clinic's Lerner College of Medicine. He is certified by the American Board of Internal Medicine with additional specialty certification in pulmonary medicine and critical care medicine. References: Homolka J. CMAJ. 1987;PMID:3315158 Liebow A, et al.  : "Frontiers of Pulmonary Radiology." The interstitial pneumonias, pp. 102-141. 1969. Grune & Stratton. Liebow A, et al. Calif Med. 1969;PMID:PMC1501512 Noble PW, et al. Am J Respir Cell Mol Biol. 2005;doi:10.1165/rcmb.F301 Scadding JG, et al. Thorax. 1967;doi:10.1136/thx.22.4.291 Disclosures: Brown and Parambil report no relevant financial disclosures.

Healio Community Book Club: A conversation between Leonard Calabrese, DO and Kevin Tracey, MD, author of The Great Nerve

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 response? 5:55 ·        A brief summary of the main parts of The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes 9:18 ·        The science of vagal nerve stimulation 11:03 ·        What are the pros and cons of different strategies of stimulating the vagus nerve? 16:28 ·        Different inflammatory responses to implant devices 17:35 ·        Data on vagus nerve stimulation 21:38 ·        Adopting new technology 25:40 ·        Enhancing immune health through brain health 28:35 ·        Wellness behaviors 32:55 ·        A motivated patient 36:16 ·        Thank you, Dr. Tracey 38:03 ·        Thanks for listening 39:26 Don't miss out! To engage in future conversations like this with physician authors on Healio Community, register here. We'd love to hear from you! Send your comments/questions to Dr. Brown at rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.  

Celebrating 101 episodes of Healio Rheuminations with Dr. Leonard Calabrese

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 ·        Serotherapy 10:52 ·        Why patients get certain diseases 12:33 ·        Dr. Calabrese's career trajectory 14:43 ·        One day in 1981… 17:52 ·        A few things happened in the 90's 20:20 ·        Tell us about CNS vasculitis 21:53 ·        Don't be afraid to reinvent yourself 24:30 ·        Checkpoint inhibitors 25:09 ·        How do you keep up? 26:43 ·        Placebo science 28:25 ·        Do you think we'll ever be able to answer where diseases come from? 29:33 ·        Thank you, Dr. Calabrese 31:01 ·        Thanks for listening 31:26 We'd love to hear from you! Send your comments/questions to Dr. Brown at rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.

The history of giant cell arteritis: Infections, injections and the man who couldn't wear a hat

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! Intro 0:13 GCA at ACR 2025 00:30 How Brown has approached framing this episode 1:01 A primer leading us to GCA 3:15 Let's get to the story 4:02 The man who couldn't wear a hat 4:57 Dr. Bayard Horton's 7:40 A tangent on cluster headaches 8:27 Let's get back to GCA 13:16 The first temporal artery biopsy 14:28 Vision loss and other puzzle pieces of GCA 16:27 What about jaw claudication? 21:15 Could GCA be transmissible? Injecting ground temporal arteries into healthy volunteers 24:13 Oxygen? Histamines? Adrenal cortical extract? Looking for GCA treatments 26:55 Steroids and GCA 28:40 A quote from the 1959 Mayo Clinic Board of Governors 32:24 Extracranial involvement in GCA 33:24 When did we recognize aorta involvement? Syphilis enters the picture 35:08 A recap of the history of GCA 41:25 Thanks for listening 42:19 We'd love to hear from you! Send your comments/questions to Dr. Brown at rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum. References: Boes CJ, Cephalalgia. 2007;doi:10.1111/j.1468-2982.2007.01238.x Cummer CL, et al. JAMA. 1912;doi:10.1001/jama.1912.04270080101004 Horton BT, Proc Cent SOC Clin Res. 1946 Sproul EE, et al. Am J Pathol. 1937;PMID: 19970328 Disclosures: Brown reports no relevant financial disclosures.

The Unnecessarily Complex Story of Rheumatoid Factor

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.  ·        Intro 0:04 ·        Rheumatoid factor quick background and history 00:22 ·        Rheumatology blood tests 2:47 ·        What is Rheumatoid factor? 3:39 ·        Spiderman and latex agglutination: Testing for rheumatoid factor 4:49 ·         4:54 ·        The double discovery of rheumatoid factor 7:52 ·        Putting agglutination on the medical map in 1896 10:03 ·        Pop Quiz! 11:04 ·        Serotherapy 13:00 ·        When did we start using agglutination for testing? 14:07 ·        First discovery of blood groups 14:44 ·        The complement fixation test 17:12 ·        Testing for syphilis with complement fixation and agglutination 20:53 ·        The first discovery of rheumatoid factor 24:02 ·        We forget about rheumatoid factor 27:48 ·        Rediscovering rheumatoid factor 28:20 ·        Analytical ultracentrifugation 32:55 ·        What rheumatoid factor is used for 35:50 ·        Thanks for listening 38:09   We’d love to hear from you! Send your comments/questions to Dr. Brown at rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum. References: Assadian O et al. Wien Klin Wochenschr. 2010;doi:10.1007/s00508-009-1297-1 Edelman GM, et al. J Exp Med. 1958;doi:10.1084/jem.108.1.105 Franklin EC, et al. J Exp Med. 1957;doi:10.1084/jem.105.5.425 Fraser KJ. Semin Arthritis Rheum. 1988;doi:10.1016/0049-0172(88)90035-2 Jonsson R. Ann Rheum Dis. 2020;doi:10.1136/annrheumdis-2019-216822 Mohd Noor NH, et al. Cureus. 2024;doi:10.7759/cureus.68903 Tan EM, et al. J Exp Med. 2016;doi:10.1084/jem.20160792 Disclosures: Brown reports no relevant financial disclosures.