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5月29日

GCA mimics: How to spot them, a case-based discussion with Dr. Leonard H. Calabrese, DO

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 rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
5月22日

An overview of Rome V

In this episode, Lin Chang, MD, and Jan Tack, MD, PhD, discuss the history and evolution of Rome criteria, developing guidelines for multifactorial disorders in Rome V and more. · Lin Chang, MD, and Jan Tack, MD, PhD 1:04 · How has the Rome Foundation evolved over the last ten years? 4:26 · What are the Rome criteria, and why should clinicians care about them? 7:20 · How did these guidelines become the Rome criteria? 10:32 · What is the timeline of developing these criteria? 12:35 · Can you tell us about how the Rome Foundation got to the name "DGBI", and why it makes sense for multifactorial conditions? 22:22 · What are the highlights and most important changes from Rome V? 26:38 · How will this information be disseminated so clinicians can learn about it? 34:22 · What lessons did you learn from the Rome V process? 37:40 · What's next for the Rome Foundation? 40:04 Lin Chang, MD, is professor of medicine and vice chief of the Vatche and Tamar Manoukian Division of Digestive Diseases at David Geffen School of Medicine at UCLA. Jan Tack, MD, PhD, is president of the Rome Foundation. He also serves as professor of medicine at KU Leuven and chief of the division of gastroenterology and hepatology at Leuven University Hospitals. We'd love to hear from you! Send your comments/questions to guttalkpodcast@healio.com. Follow us on X @HealioGastro @sameerkberry @umfoodoc. Disclosures: Chey and Tack report no financial disclosures. Chang reports consulting roles with Ardelyx, Atmo, Eli Lilly & Co., FoodMarble, GSK, Ironwood Pharmaceuticals and Ono Pharmaceutical; speaking fees from Bausch Health; research grants from AnX Robotica and Ironwood; serving on the Rome Foundation Board of Directors; and having unvested stock options with FoodMarble, ModifyHealth, PICO Health and Trellus Health. Reference: · Drossman DA, et al. Gastroenterology. 2026;doi:10.1053.j.gastro.2026.02.014.
2024/10/24

The Story of the Flu Vaccine (Re-Release)

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! Intro 0:40 In this episode 1:11 The history of the flu: 1892 1:41 What do we know about viruses? 6:29 Rabies and dead virus 11:17 A Sickness in the Serum, Part 2 14:43 1918 16:44 Vaccines and trials 19:13 Pig influenza 23:12 Influenza: a filterable agent we can't see 27:01 The trials of 1942 33:02 PS: 1918 influenza 38:57 Thanks for listening 47:42 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: Hicks DJ, et al. Clin Exp Immunol. 2012;doi:10.1111/j.1365-2249.2012.04592.x. Rosenau MJ. Experiments Upon Volunteers to Determine the Cause and Mode of Spread of Influenza, Boston, November and December, 1918. https://quod.lib.umich.edu/f/flu/3750flu.0016.573. Published February 1921. Accessed December 6, 2023. Rosenau MJ, et al. JAMA. 1925;doi:10.1001/jama.1925.02670070040019. Taubenberger JK, et al. Antivir Ther. 2007;12(4 Pt B):581-91. Tobin J. The first flu shot. https://heritage.umich.edu/stories/the-first-flu-shot/. Accessed December 6, 2023.
2025/05/30

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.
2024/04/18

Urticarial Vasculitis, Part 2: Walking the Balance Beam of Allergy and Rheumatology

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 dogs 27:30 · How is this relevant to urticarial vasculitis? 31:08 · SERPING1 gene mutation 31:23 · Summary 32:06 · COPD association with urticarial vasculitis 33:51 · Coming up in episode 85 35:28 · Thanks for listening 35:45 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: Busse P, et al. J Allergy Clin Immunol Pract. 2022;doi:10.1016/j.jaip.2021.11.011. Davis MDP, et al. J Allergy Clin Immunol Pract. 2018;doi:10.1016/j.jaip.2018.05.006. Dorn JM, et al. Ann Allergy Asthma Immunol. 2023;doi:10.1016/j.anai.2023.06.014. Marzano AV, et al. J Allergy Clin Immunol. 2022;doi:10.1016/j.jaci.2022.02.007. Siegert CE, et al. Clin Immunol Immunopathol. 1993;doi:10.1006/clin.1993.1066. Stojan G, et al. Lupus. 2016;doi:10.1177/0961203316645205. Venzor J, et al. Clin Rev Allergy Immunol. 2002;doi:10.1385/CRIAI:23:2:201. Wisnieski JJ, et al. Medicine. 1995;doi:10.1097/00005792-199501000-00003.
2025/02/26

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.
2025/09/29

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.
2022/12/15

Making Sense of Sensory Ganglionopathies and Sjogren's Syndrome

A sensational (or lack thereof) series on the signs and symptoms of the spellbinding sensory ganglionopathies. Intro :12 Today's episode :16 Anatomy review 1:32 Large fiber vs. small fiber nerves 4:47 Case presentation 6:11 Neurologic examination of patient 8:31 What is pseudoathetoid posturing? 10:11 What does it mean to be length independent? 14:30 What is sensory ganglionopathy? 16:19 How did the differential evolve throughout history? 18:50 How do things get out of the synovium? 23:19 Why does rheumatology get involved? 26:12 Case series of patients with Sjogren's syndrome and sensory ganglionopathy 28:20 How do we treat it? 32:48 Summary 34:09 Thank you 36:59 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: Amato AA, et al. N Engl J Med. 2020;doi:10.1056/NEJMra2023935. Denny-Brown D. J Neurol Neurosurg Psychiatry. 1948;doi:10.1136/jnnp.11.2.73. Griffin JW, et al. Ann Neurol. 1990;doi:10.1002/ana.410270313. Malinow K, et al. Ann Neurol. 1986;doi:10.1002/ana.410200416.
2021/08/06

This Week's Headlines: August 2, 2021

This week, Pfizer says a third dose of the vaccine boosts protection, even against the delta variant; US News and World Report ranks Mayo Clinic number 1 for pulmonology and lung surgery; the FDA approves IV selexipag for adults with PAH; and more. Read the full coverage here: Pfizer says third dose of vaccine boosts protection, including against delta variant CDC alters mask guidance, says even vaccinated Americans need them in some places Mayo Clinic ranked No. 1 hospital in US for pulmonology, lung surgery FDA approves selexipag for IV use in adults with PAH FDA approves Saphnelo, first new lupus treatment since 2011 References: AstraZeneca press release. Lupus Research Alliance press release. Pfizer. Second quarter 2021 earnings teleconference. July 28, 2021. https://s21.q4cdn.com/317678438/files/doc_financials/2021/q2/Q2-2021-Earnings-Charts-FINAL.pdf. Accessed on July 28, 2021. Press Conference. Press Release. U.S. News & World Report.
2025/06/30

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.

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