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 ...
Jun 30, 2025•43 min•Season 1Ep. 95
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 1...
May 30, 2025•46 min•Season 1Ep. 94
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 t...
Apr 23, 2025•1 hr 8 min•Season 1Ep. 93
In this episode, we dive into the early therapies and how our understanding of vascular physiology drastically changed the management of pulmonary hypertension. Intro 0:12 In this episode 0:18 Recap of part 1 & 2 0:31 What part 3 is about 2:31 WHO conference in 1975: Treating pulmonary hypertension 3:48 The Discovery of Non-Steroidal Anti-inflammatory Drugs (NSAIDs), Part 1 5:20 Epoprostenol 6:18 Prostacyclin 10:37 Endothelin antagonists 11:41 Phosphodiesterase type 5 (PDE5) inhibitors 14:08...
Mar 25, 2025•48 min•Season 1Ep. 92
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 26:3...
Feb 26, 2025•49 min•Season 1Ep. 91
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! Intro 0:11 In this episode 0:16 Preview of the four-part series 4:46 Interview with Joseph Parambil, MD 6:27 How did you become interested in pulmonary hypertension? 7:02 Brown and Parambil discuss the histology of pulmonary hypertension. 10:13 Brown and Parambil discuss a case of pulmonar...
Feb 12, 2025•53 min•Season 1Ep. 90
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. Intro 0:12 In this episode 0:21 Coming up on Healio Rheuminations 0:56 COVID-19, long COVID and the rheumatologist with Leonard Calabrese, DO 2:19 Questions 3:12 Long COVID 4:46 Calabrese’s bias 10:15 The evidence 13:08 Auto antibodies 14:54 Why does the body develop auto antibodies? 17:47 COVID-19 and epidemiologic association 22:25 New clinica...
Jan 22, 2025•34 min•Season 1Ep. 89
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 tria...
Oct 24, 2024•48 min•Season 1Ep. 88
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? Intro 0:11 Recap of part 1 & 2 0:28 In this episode 1:44 Cyclooxygenase 2 (COX-2) and the rat experiment 3:12 What do we know about the prostaglandins? And what about COX-2 7:54 What does prostacyclin do? 10:33 The first COX-2 inhibitor: VIOXX 10:56 What is COX-2 doing?: Pfizer and Merck 12:15 Two...
Aug 29, 2024•38 min•Season 1Ep. 87
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. Intro 0:12 Review of part 1 0:28 In this episode 1:04 Blocking prostaglandins and willow leaves 2:26 Edward Stone 3:45 Johann Andreas Buchner 4:16 The chemical structure of salicylic acid and creating the synthetic compound 4:44 Dr. TJ MacLagan: The first trial in 1876 and treating acute rheumatism 5:16 Felix Hoffmann: manipulat...
Jun 26, 2024•47 min•Season 1Ep. 86
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 ...
May 16, 2024•38 min•Season 1Ep. 85
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 ...
Apr 18, 2024•36 min•Season 1Ep. 84
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...
Feb 28, 2024•26 min•Season 1Ep. 83
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 dis...
Jan 04, 2024•29 min•Season 1Ep. 82
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 3...
Dec 07, 2023•48 min•Season 1Ep. 81
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. 8:14 · Cardiff pneumoconiosis medical panel 9:49 · Databases 12:51 · Silica exposure and the development of serologies 15:02 · What...
Nov 15, 2023•24 min•Season 1Ep. 80
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...
Oct 30, 2023•45 min•Season 1Ep. 79
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 ...
Aug 17, 2023•38 min•Season 1Ep. 78
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 v...
Jul 12, 2023•38 min•Season 1Ep. 77
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 ...
Jun 28, 2023•46 min•Season 1Ep. 76
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...
Apr 03, 2023•32 min•Season 1Ep. 75
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 – periodont...
Feb 28, 2023•42 min•Season 1Ep. 74
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 Ehl...
Jan 31, 2023•37 min•Season 1Ep. 73
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. Intro 0:12 In this episode 0:46 Neurologic complications of Sjogren’s Syndrome 1:55 Intro of Dr. Benjamin Claytor 6:00 The interview 6:49 Case study: process of diagnosis 7:17 Dorsal root ganglion in Sjogren’s 10:46 Facial numbness in sensory ganglionopathies 11:42 Dorsal root gangl...
Jan 18, 2023•29 min•Season 1Ep. 72
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 do...
Dec 15, 2022•38 min•Season 1Ep. 71
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. Intro 1:06 Calabrese introduction 1:11 In this episode 1:36 Defining long COVID 1:49 Reviewing symptoms of long COVID 2:51 Long COVID fatigue 3:44 Studies and research on fatiguability 4:38 Phenomena of post-exertional malaise 6:18 Chronic fatigue syndrome 7:25 Neurocognitive dysfunction 7:52 Co-factors of ...
Oct 10, 2022•24 min•Season 1Ep. 69
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. Intro :12 Calabrese introduction :15 COVID-19 and the history of modern medicine :48 In this episode 1:39 The course of COVID-19 2:05 COVID-19 vaccines and immunity 2:50 Controversy, facts, fascination, long COVID 3:16 The history of post-acute sequelae 3:59 Post-infectious sequelae 10:15 What is long COVID and how do we define it? 11:02 H...
Sep 30, 2022•21 min•Season 1Ep. 68
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. Intro :11 Today’s episode :15 Synovium 101 :22 Overview of the synovium and synovial fluid 2:06 How they figured it out? Dr. Marian Ropes 5:37 Investigating synovial fluid 7:46 Cows experiment and where synovial fluid comes from 11:25 Clinical review of synovial fluid 14:57 What’s inside the fluid? 18:54 What makes up the ...
Aug 25, 2022•35 min•Season 1Ep. 67
What does the PAPA spectrum disorder teach us about SAPHO? Is SAPHO an autoinflammatory condition or part of the SpA spectrum? Why have antibiotics been used to treat this condition? Find out in this episode! Brought to you by Tremfya. Intro :01 Welcome to another exciting episode of Rheuminations :11 About today’s episode :17 A summary of SAPHO Part 1 :24 What to expect in this episode 1:28 Earlier long-term data 2:27 A more recent paper from Italy 6:47 Therapeutics in detail 12:17 Summary so f...
Jul 26, 2022•44 min•Season 1Ep. 66
What is SAPHO? What does the ‘H’ stand for, again? This episode explores some basics about the condition and delves into the history of how this disease came to be. Intro :01 Welcome to another exciting episode of Rheuminations :11 About today’s episode :17 What does the acronym ‘SAPHO’ stand for? :37 How do you define this condition? 2:35 So, what is SAPHO syndrome? 4:59 Are any of the letters specific for SAPHO syndrome? 15:20 How the puzzle pieces were put together 15:48 Over the next ensuing...
May 20, 2022•47 min•Season 1Ep. 65
