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Kanaal • 10 programma’s

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Bijgewerkt 20-04-2022
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Bijgewerkt 17 apr
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Bijgewerkt 10-05-2022

24 MRT

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 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 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.

24 mrt

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1 u 5 m
25-11-2025

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.

25-11-2025

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43 min.
28-07-2025

The Astounding Account of the IL-17 and Spondylarthritis

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 Intro 0:15 In this episode 0:27 Leonard Calabrese, DO, is listening! 1:07 Recap of last episode 3:23 Putting the pieces together 5:32 Quick overview of this science heavy episode 6:27 What is psoriasis? 7:42 Immunosuppressants for psoriasis/ Throwing meds at people and seeing what happens 10:20 In the modern world of 1986 – olive oil placebo trial 11:45 A quick aside into fungi 12:44 What kind of T-cells are involved here? 16:50 The TH-1 hypothesis 18:31 IL-23 and IL-17 are doing something 19:38 Going back to the drawing board in 2004 20:12 p40 + p19 = IL-23 21:08 IL-23 via minicircle DNA in mice 23:09 Brand new and shiny TH-17 25:30 The family of IL-17 26:40 What do we know about IL-17 and psoriasis? 27:17 IL-17A vs IL-17F in mouse studies 27:42 Finding the difference between IL-17A and IL-17F in humans 28:30 What exactly is IL-17 doing? 29:51 The articular manifestations of psoriatic arthritis 31:13 Spondylarthritis and the IL 23/17 axis 34:10 T-cells we haven't talked about 35:49 Summary of this episode 39:17 Thanks for listening 41:38 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: Bashyam H. J Exp Med. 2007;doi:10.1084/jem.2042fta Bjerke R J. Acta Derm Venereol. 1982;PMID:6179355 Cargill M, et al. Am J Hum Genet. 2007;doi:10.1086/511051 Chan J R, et al. J Exp Med. 2006;doi:10.1084/jem.20060244 Cuthbert R J, et al. Ann Rheum Dis. 2019;doi:10.1136/annrheumdis-2019-215210 Ellis C N, et al. JAMA. 1986;doi:10.1001/jama.1986 Ettehadi P, et al. Clin Exp Immunol. 1994;doi:10.1111/j.1365-2249.1994.tb06244.x Furue M, et al. Int J Mol Sci. 2020;doi:10.3390/ijms21041275 Gooderham M J, et al. J Eur Acad Dermatol Venereol. 2018;doi:10.1111/jdv.14868 Lee E, et al. J Exp Med. 2004;doi:10.1084/jem.20030451 Leonardi C L, et al. Lancet. 2008;doi:10.1016/S0140-6736(08)60725-4 Mease P J, et al. Lancet. 2000;doi:10.1016/S0140-6736(00)02530-7 Menon B, et al. Arthritis Rheumatol. 2014;doi:10.1002/art.38376 Moos S, et al. J Invest Dermatol. 2019;doi:10.1016/j.jid.2019.01.006 Muelle W, et al. N Engl J Med. 1979;doi:10.1056/NEJM197909063011016 Papp K A, et al. Lancet. 2008;doi:10.1016/S0140-6736(08)60726-6 Reinhardt A, et al. Arthritis Rheumatol. 2016;doi:10.1002/art.39732 Sherlock J P, et al. Nat Med. 2012;doi:10.1038/nm.2817 Tribe H T. Mycologist. 1998;doi:10.1016/S0269-915X(98)80100-6 Yawalkar N, et al. J Invest Dermatol. 1998;doi:10.1046/j.1523-1747.1998.00446.x Zaba L C, et al. J Allergy Clin Immunol. 2009;doi:10.1016/j.jaci.2009.08.046 Disclosures: Brown reports no relevant financial disclosures.

28-07-2025

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42 min.
30-06-2025

The Tumultuous Tale of Th17-and the IL23/IL17 immune axis

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 13:09 • Similarity between the rabies vaccine and infections like measles 16:04 • T-cell lymphocytes 17:12 • The forgotten thymus 18:00 • What's the function of T-cells? 19:35 • How do you tell T-cells apart? 21:14 • The Human Leukocyte Differentiation Antigens Party 24:05 • The godfather of T-cells 24:45 • The TH-1 and TH-2 axis 27:30 • Experimental Autoimmune Encephalomyelitis model screwed everything up 29:16 • Interferon gamma 32:32 • What's missing? IL-23 surprise 33:40 • IL-17 in the 1990's 36:44 • The world is introduced to TH-17 39:12 • Let's recap what we learned 40:30 • That is the end! 42:30 • Thanks for listening 42:39 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: Bashyam H. J Exp Med. 2007;doi:10.1084/jem.2042fta Bennetto L, et al. J Neurol Neurosurg Psychiatry. 2004;doi:10.1136/jnnp.2003.034256 Berche P. Presse Med. 2022;doi:10.1016/j.lpm.2022.104149 El-behi M, et al. J Neuroimmune Pharmacol. 2010;doi:10.1007/s11481-009-9188-9 Gooderham MJ, et al. J Eur Acad Dermatol Venereol. 2018;doi:10.1111/jdv.14868 Hawkes JE, et al. J Immunol. 2018;doi:10.4049/jimmunol.1800013 Rogozynski N, et al. Immunol Lett. 2024;doi:10.1016/j.imlet.2024.106870 Sospedra M, et al. Annu Rev Immunol. 2005;doi:10.1146/annurev.immunol.23.021704.115707 Steinman L. Nat Med. 2007;doi:10.1038/nm1551 Disclosures: Brown reports no relevant financial disclosures.

30-06-2025

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43 min.
31-01-2023

Vascular Ehlers-Danlos Syndrome, Part 1

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. Intro 0:12 In this episode 0:17 Why vascular Ehlers-Danlos syndrome? 0:28 Case study: Dr. Mories 2:20 What can we learn about vascular Ehlers-Danlos syndrome? 05:02 Collagen and elastin 05:57 Collagen: horses and glue 07:07 More about collagen 10:35 Why is it a problem to miss a little bit of collagen? 14:14 The problem in vascular Ehlers-Danlos syndrome 15:06 The history of vascular EDS 15:41 How is vascular Ehlers-Danlos syndrome diagnosed? 16:36 A vascular Ehlers-Danlos syndrome diagnosis 22:33 Mouse models 23:29 Clinical and genetic features of vascular Ehlers-Danlos syndrome 24:39 Question of vasculitis 25:55 The skin: the most common symptom of vascular EDS 28:00 Family history, de novo mutations and pregnancy 29:43 Surgery or vascular intervention 31:39 How do patients do in the long-term? 32:54 Summary 34:00 Preview of part 2 35:42 Thanks 36:25 Disclosures: Brown reports no relevant financial disclosures. 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: Barabas AP. J Cardiovasc Surg (Torino). 1972;13(2):160-7. Chow MJ, et al. Biophys J. 2014;doi:10.1016/j.bpj.2014.05.014. Liu X, et al. Proc Natl Acad Sci USA. 1997;doi:10.1073/pnas.94.5.1852. Mories A. Scott Med J. 1960;5:269-72. Pepin M, et al. N Engl J Med. 2000;doi:10.1056/NEJM200003093421001. Pepin MG, et al. Genet Med. 2014;doi:10.1038/gim.2014.72. Piez KA. Matrix Biol. 1997;doi:10.1016/s0945-053x(97)90037-8. Pope FM, et al. Proc Natl Acad Sci USA. 1975;doi:10.1073/pnas.72.4.1314. Wagenseil JE, et al. J Cardiovasc Transl Res. 2012;doi:10.1007/s12265-012-9349-8. Zilocchi M, et al. AJR Am J Roentgenol. 2007;doi:10.2214/AJR.07.2370.

31-01-2023

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37 min.
23-04-2025

Pulmonary hypertension, part 4: The therapeutics, with Dr. Joseph Parambil

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. Intro 0:12 In this episode 0:17 Interview with Joseph Parambil, MD 2:53 Reviewing and clarifying pathophysiology prior to initiating therapeutics 4:13 Evaluating patients in terms of their functional status and how does that play a role in initiating therapies 4:25 Vasoreactivity testing 10:21 The categories of medications 14:40 Endothelin receptor antagonists 37:07 TGF pathway 42:13 Scleroderma patient and treatment 50:19 Do patients get a repeat right-heart catheterization? 55:51 What about the TGF-beta? 56:55 Thank you, Dr. Parambil 58:34 Thanks for listening 59:17 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. Disclosures: Brown and Parambil report no relevant financial disclosures. 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.

23-04-2025

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1 u 8 m
29-09-2025

Don't forget the toes: Managing patients with ANCA vasculitis

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. · Intro 0:01 · Welcome Alexandra Villa-Forte, MD, MPH 0:10 · Dr. Brown sketches a potential patient that may be seen in practice 0:40 · How are you monitoring patients' kidneys? 1:28 · How reliable are 'no casts' results in urinalysis tests? 4:15 · What is happening in the glomeruli? 5:23 · The importance of monitoring the urinalysis of patients with ANCA vasculitis 7:06 · Symptoms to watch for when tapering off medications 7:43 · Different scenarios with lung symptoms 9:35 · Evaluating patients with GPA; looking at the nose, ear and sinuses 12:20 · Neurologic symptoms in ANCA vasculitis 14:24 · Laboratory monitoring 15:52 · Should ANCA titers be a part of routine vasculitis monitoring? 17:05 · What is your approach using PJP prophylaxis in ANCA-associated vasculitis? 18:05 Thank you, Dr. Villa-Forte! 20:25 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. Disclosures: Brown reports no relevant financial disclosures. Healio was unable to confirm relevant financial disclosures for Villa-Forte at the time of publication.

29-09-2025

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22 min.
29 JAN

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.

29 jan

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32 min.
30-05-2025

History of polymyalgia rheumatica: The origin of the pain & link to giant cell arteritis

In this episode, we dive into the history of polymyalgia rheumatica, how it was discovered and its link to giant cell arteritis. Intro 0:01 In this episode 0:10 What is polymyalgia rheumatica (PMR)? 0:24 The history of PMR 02:12 PMR in the 1950s: A formally recognized disease 04:52 What was probably PMR in the 1880s 06:27 Naming PMR: Senile rheumatic gout 07:26 1957: The witch's shot and finally landing on polymyalgia rheumatica 08:30 Where is PMR coming from? 14:42 Injecting joins with saline 16:39 A biopsy study in 1964 19:54 Technetium bone scintigraphy in 1971 and bone scan history 23:01 First look at a PMR ultrasound in 1993 27:00 1997: First use of MRI on PMR patients in Italy 27:49 Going back to 1962: PMRs association with giant cell arteritis 30:40 A paper on muscular involvement in giant cell arteritis: 80-year-old 'robust' partially blind seaman 32:15 First systematic approach: The link between PMR and giant cell arteritis 35:14 80 cases of PMR 38:13 Swedish autopsy studies 41:07 Introduction of advanced imaging in the 1990s 42:40 Summing up PMR through the decades 43:28 That is the end! 45:25 Thanks for listening 45:50 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: Bruk MI. Ann Rheum Dis. 1967;doi:10.1136/ard.26.2.103. Cantini F, et al. J Rheumatol. 2001;28(5):1049-55. De Miguel E, et al. Rheumatology (Oxford). 2024;doi:10.1093/rheumatology/kead189. Dixon AS, et al. Ann Rheum Dis. 1966;doi:10.1136/ard.25.3.203. Hamrin B, et al. Ann Rheum Dis. 1968;doi:10.1136/ard.27.5.397. Salvarani C, et al. Ann Intern Med. 1997;doi:10.7326/0003-4819-127-1-199707010-00005. Shah S, et al. Rheumatology (Oxford). 2025;doi:10.1093/rheumatology/keae569. Disclosures: Brown reports no relevant financial disclosures.

30-05-2025

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46 min.
26-02-2025

Pulmonary hypertension and the rheumatologist, part 2: The history

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? Intro 0:11 In this episode 0:17 Recap of part 1 0:26 How was pulmonary hypertension discovered? 2:38 1891 3:51 1901 5:07 1935 7:02 Hilar dance 12:58 Cardiac catheterization: 1929 15:03 When did cardiac catheterization become relevant? 20:10 1965: Aminorex 24:40 World Health Organization: 1975 26:37 1980s: toxic oil syndrome of Spain 28:20 Preview of part 3 33:15 Back to cardiac catheterization 34:08 Briskets disease 35:45 1947 37:56 Pulmonary physiology and prostaglandin therapies (in the next episode) 38:41 Schistosomiasis outbreaks in Egypt 1938 40:26 Chronic thromboembolism 45:03 Thanks for listening 48:16 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: Barst RJ. Ann Thorac Med. 2008;doi:10.4103/1817-1737.37832. Bodo R. J Physiol. 1928;doi:10.1113/jphysiol.1928.sp002447. Dresdale DT, et al. Am J Med. 1951;doi:10.1016/0002-9343(51)90020-4. Egypt. Stanford.edu. Published 2015. https://schisto.stanford.edu/pdf/Egypt.pdf. Hewes JL, et al. Pulm Circ. 2020;doi:10.1177/2045894019892801. Johnson S, et al. Am J Respir Crit Care Med. 2023;doi:10.1164/rccm.202302-0327SO. Newman JH. Am J Respir Crit Care Med. 2005;doi:10.1164/rccm.200505-684OE. Weir EK, et al. Circulation. 1996;doi:10.1161/01.cir.94.9.2216. Disclosures: Brown reports no relevant financial disclosures.

26-02-2025

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49 min.

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