Try your hand at this medical mystery, which is followed by some didactics on a fascinating disease which will hopefully make sense of this inscrutable title. Brought to you by GSK. Consider the long-term impact of disease activity, flares and corticosteroid use on patients with active SLE. Learn more now at treatfortodayandtomorrow.com Intro :22 What to expect in each episode :30 The case: A 75-year-old man with Sjogren’s and MALT lymphoma presents with recurrent cerebral infarcts of multiple t...
Mar 27, 2020•39 min•Season 1Ep. 31
In this episode, Leonard H. Calabrese, DO, is joined by his colleague and daughter Cassandra Calabrese, DO, as they discuss specifics of irAEs, including unusual toxicities, rheumatic conditions associated with checkpoint inhibitors and the rheumatologist’s role in this new area of medicine. Brought to you by GSK. Considering a treatment change for patients with active SLE? Learn about a treatment option for your patients at treatfortodayandtomorrow.com. Intro :22 Recap of Part 1 :40 An intervie...
Mar 11, 2020•34 min•Season 1Ep. 30
Checkpoint inhibitors have changed the field of oncology, as well as our understanding of autoimmunity. This episode, hosted by Leonard H. Calabrese, DO, walks us through the history of checkpoint inhibitors — from Dr. William Coley’s use of infections in cancer to the development of PD-1 inhibitors. Brought to you by GSK. Consider the long-term impact of disease activity, flares and corticosteroid use on patients with active SLE. Learn more now at treatfortodayandtomorrow.com Intro :20 In this ...
Feb 20, 2020•44 min•Season 1Ep. 29
Join Peter Grayson, MD, MSc, and I as we discuss a range of topics, including imaging in large-vessel vasculitis, doctors going into research, Twitter, rock ‘n’ roll and Disney World. Intro :10 A bit about Peter Grayson :55 Come see me in Phoenix in February 3:35 The interview 4:07 How did you make it to the NIH? 4:27 Why do you think MDs aren’t going into research these days 6:45 Social media and major meetings 9:43 Tell us about the NIH rock ‘n’ roll band 11:10 What imaging modalities are most...
Jan 27, 2020•34 min•Season 1Ep. 28
This interview with Chester V. Oddis, MD, will have you standing from a seated position without the need to use your arms as we discuss the inflammatory myopathies. We cover the classification, pathophysiology and treatment approaches to these diseases, as well as all the antibodies you must learn about for boards! Intro :20 The interview 1:05 How did you become involved in inflammatory myopathies? 1:12 What’s your approach to a patient with suspected inflammatory myopathy? 1:50 What’s your opin...
Dec 18, 2019•25 min•Season 1Ep. 27
Things get a little nerdy in this episode, which focuses on the basic science of what makes the inflammasome tick in CAPS, as well as data on the use of interleukin 1 inhibition. Hint: Listen to “The Inflammasome for Dunces” episode first, and this one will make more sense. Intro :20 Recap of Part 1 :33 Overview of this episode 1:56 Familial cold autoinflammatory syndrome 3:04 Muckle-Wells syndrome 6:34 The two checkpoint problem 8:36 What do we know about the inhibition of the inflammasome? 11:...
Nov 27, 2019•29 min•Season 1Ep. 26
This first episode delves into the clinical aspects of the Cryopyrin-Associated Periodic Syndromes and includes some helpful tips for sorting out some of the autoinflammatory diseases in the spectrum. Intro :10 Cryopyrin-Associated Periodic Syndromes (CAPS) :25 Outline of Part 1 2:25 What is CAPS? 3:12 Case #1 – a 25-year-old female with urticaria after cold exposure 4:25 Case #2 – a 55-year-old female with progressive deafness 5:45 The index case of familial cold autoinflammatory syndrome 9:00 ...
Nov 07, 2019•32 min•Season 1Ep. 25
A quick take on one of the little-appreciated engines of the innate immune system. Intro :10 A little about this episode :25 The inflammasome is a component of the innate immune system 3:12 Remember NLRP3 4:12 The toll-like receptors 5:05 Triggering the inflammasome 7:05 The proteins 8:04 A medieval battle and a trebuchet 9:56 A disclosure 17:00 I hope you enjoyed this episode 18:06 We’d love to hear from you! Send your comments/questions to [email protected] . Follow us on Twitter...
Oct 01, 2019•19 min•Season 1Ep. 24
“Acute rheumatic fever is proceeded by an infection with Group A strep” is a mantra that all health care workers know. This episode digs through the history of how we came to understand this fact, as well as how our understanding of the pathophysiology and treatment of rheumatic fever developed. Intro :10 Why I made this episode :30 Outline of this episode 1:55 Rheumatic fever was really bad 3:10 The early 1700s 4:10 A big leap 6:15 The Jones criteria 11:07 History of the bacteriology 14:23 The ...
Aug 09, 2019•43 min•Season 1Ep. 23
Join me as I explore a case of fever and migratory inflammatory arthritis, then discuss the case with the double-boarded rheumatologist/infectious disease expert, Cassandra Calabrese, DO . Intro :10 My new book :24 Inside this episode 1:20 Case presentation 1:38 Introducing Dr. Cassandra Calabrese 9:22 The interview 10:40 Was the patient’s presentation typical for rheumatic fever? 10:58 Do most rheumatic fever cases have migratory arthritis? 13:23 How different is this from reactive arthritis? 1...
Aug 01, 2019•35 min•Season 1Ep. 22
John Stone, MD, MPH, is the world leader in the field of IgG4-related disease research. In this episode, he breaks down the histology of IgG4-related disease, important aspects of what is known about the pathophysiology of the disease, as well as future directions in treatment. Intro :10 Inside this episode :13 IgG4-related disease background :31 An anecdote 1:15 The interview 4:09 History of IgG4-related disease 4:18 IgG4 pathology and terms 7:48 What makes IgG4 different from other IgG subclas...
Jul 03, 2019•25 min•Season 1Ep. 21
In this episode, James Rosenbaum, MD, an expert in inflammatory eye disease, breaks down how systemic autoimmune conditions can affect the eye and highlights pearls that Rheumatologists should know. Intro :10 Inside this episode :15 Introducing Dr. Jim Rosenbaum :51 The interview 1:26 Some basic terms 1:45 TEON pneumonic 5:45 Microbiome work 7:06 Evaluation of inflammatory eye disease 9:01 Workup for inflammatory eye disease 10:23 How do ophthalmologists rule out infection? 18:00 Is there anatom...
Jun 11, 2019•37 min•Season 1Ep. 20
We journey into the world of metabolic bone in this episode and explore the varied clinical manifestations of hypophosphatasia. We also interview the head of the center for osteoporosis and metabolic bone disease at the Cleveland Clinic, Chad Deal, MD . Intro :10 The four H’s of chondrocalcinosis :18 What we’ll cover in this episode :52 A general overview 2:33 The first description of hypophosphatasia 3:39 History of this condition 13:00 Two cases 16:00 The interview 17:55 Various presentations ...
May 16, 2019•41 min•Season 1Ep. 19
This ripping yarn delves into the history of tumor necrosis factor in relation to rheumatoid arthritis with emphasis on the original studies that set the stage for the use of TNF inhibition in RA. Intro :11 What we’ll cover here :16 Recap of Part 1 1:25 What I discovered when doing this episode 1:22 What this episode won’t address 2:40 Let the tale begin 3:12 A look at matrix metalloproteinases 3:32 A breakthrough in understanding RA 6:28 Two key players: Dr. Mark Feldman and Dr. Ravinder Maini ...
Apr 17, 2019•48 min•Season 1Ep. 18
In Part 1, we look at the original studies that led to the discovery of TNF in two separate labs where researchers were looking for two completely different things. We’ll learn how these discoveries then fueled the use of TNF in the failed trials as an anti-cancer agent, and the eventual development of antibody therapy against TNF in septic shock. Intro :11 The origins of this episode and what we’ll cover here and in Part 2 :18 What Part 1 will cover 2:01 Early cytokine research in general codis...
Mar 08, 2019•43 min•Season 1Ep. 17
Take a listen to this medical mystery and learn about a not-so-rare condition — depending on where you live. Hear some interesting historical stories about the physicians who helped establish the diagnosis, as well as an interview with a renowned expert. Intro :11 A 57-year-old woman presents with multiple-week history of joint pain. She also complains of lesions on her forearms. :32 Initial lab results 1:30 She arrives at my office 1:50 Review of her vitals 1:57 Physical exam findings and patie...
Feb 15, 2019•46 min•Season 1Ep. 16
In this guest episode, Leonard Calabrese, DO, provides the history of systemic lupus erythematosus, with special emphasis on the discovery of the LE cell and the two clinics involved in its detection. Introduction of Leonard Calabrese, DO :11 In this episode … 1:44 A brief history of systemic lupus erythematosus and the major players 2:15 Laurent-Theodore Biett 2:55 Casanave 3:05 von Hebra 3:24 Moritz Kaposi 4:05 Sir William Osler 5:25 Fast-forward to observations made during WWII era 7:00 The s...
Jan 24, 2019•22 min•Season 1Ep. 15
Richard Furie, MD, is chief, division of rheumatology, at Northwell Health, and professor of medicine at Hofstra/Northwell School of Medicine. Join us in this ACR interview, as we discuss the story of interferon, lupus therapeutics — including B cell depletion — and the future of lupus research and treatments. Intro :10 Background on Dr. Furie :16 The interview :56 What advancements in the pathophysiology of lupus are you most excited about? 1:10 The interferon story 1:23 The interferon story is...
Jan 04, 2019•27 min•Season 1Ep. 14
In this episode, John Stone, MD, MPH, director of clinical rheumatology at Massachusetts General Hospital, sits down to discuss his approach to giant cell arteritis and the results of the GiACTA trial. Learn why Stone believes the most important diagnostic test in GCA is the patient’s history. Intro :10 Background on Dr. Stone :59 The interview 2:10 Differentiating subtle GCA from the “classic case” 2:20 Data from Stone’s recent paper in Rheumatology 5:17 Using bilateral biopsies 9:00 Recommenda...
Dec 13, 2018•32 min•Season 1Ep. 13
John J. O’Shea, MD, is scientific director of the NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases, and chief of their Molecular Immunology and Inflammation Branch. In this ACR interview, he joins me to talk about the JAK/STAT pathway, what we’ve learned from mouse models, current FDA-approved JAK inhibitors and the future of this exciting field. Intro :10 Background on Dr. O’Shea :45 The interview 2:37 How did you start looking into the JAK/STAT pathway? 3:16 What sho...
Nov 29, 2018•28 min•Season 1Ep. 12
In this ACR interview, the walking encyclopedia of medical history, Eric L. Matteson, MD, of The Mayo Clinic, sits down with me to discuss what excites him about medical history and then takes a deep dive into the history of vasculitis! Intro :10 Background on Dr. Matteson :28 The interview 2:00 How did you get into history? Why does it mean so much to you? 2:19 Can you tell us about the archives at Mayo Clinic? 6:49 An appreciation of present time and how we take some medications for granted 7:...
Nov 15, 2018•26 min•Season 1Ep. 11
Martin J. Blaser, MD, is director of the Human Microbiome Program at NYU and author of the book, Missing Microbes . He sat down and spoke with us about how the microbiome plays a role in disease pathogenesis, including autoimmunity, and he also answered the question of whether all of our patients should be on probiotics! Intro :11 Background on Dr. Blaser :35 The interview 1:20 What is the microbiome? 1:25 How unique are individual microbiomes? 1:49 How does an individual’s microbiome change ove...
Nov 01, 2018•22 min•Season 1Ep. 10
In this episode, explore data from the major study proving uric acid crystals are present in the synovial fluid of patients with gout, as well as the tale of two rheumatologists who injected their own knees (while still working in the hospital) with uric acid to prove it is the trigger for inflammation in gout. The episode finishes with some ripping yarns about the history of the medications we use to treat this condition. Intro :10 Controversy surrounding uric acid’s role in gout :45 “Game chan...
Oct 17, 2018•19 min•Season 1Ep. 9
Do you know the etymology of the word “gout,” or how a simple microscope aided in the identification of tophi? Join me as I explore the history of this inflammatory arthritis and highlight the important scientists who shaped the modern era of gout. Intro :10 What to expect in Part 2 :48 A question: Which urate-lowering therapy was made for an expressly different reason than to treat gout? 1:34 The first modern description of gout 1:54 Let’s go back to the Greeks 3:05 Why is it called “gout?” 3:0...
Oct 05, 2018•17 min•Season 1Ep. 8
This episode discusses the case of an 85-year-old man with a history of hypertension and fairly recently diagnosed bladder cancer who presents with oligoarticular asymmetric inflammatory arthritis. Explore the details of this case and learn how bacillus Calmette-Guérin and reactive arthritis are related in this diagnostic conundrum. Intro :10 An 85-year-old man with a history of hypertension and recently diagnosed bladder cancer presents with oligoarticular asymmetric inflammatory arthritis :18 ...
Sep 07, 2018•21 min•Season 1Ep. 7
This episode covers a rare but life-threatening complication of lupus nephritis called complement-mediated thrombotic microangiopathy. Rheumatologist Lisa Zickuhr, MD, helps us better understand this often-overwhelming topic with a clinical case example, treatment options and practice pearls. Intro :10 Introduction of Lisa Zickuhr, MD, rheumatologist :44 Complement-mediated thrombotic microangiopathy in lupus is an overwhelming topic 1:50 Definition of TMA 2:15 What is MAHA? 3:10 Four classic sy...
Aug 16, 2018•26 min•Season 1Ep. 6
A young woman presents with migraine-like headaches, black spots in her vision and emotional lability. Think you know the diagnosis? You may be surprised – this medical mystery is not what it seems. In this episode, learn more about this rare diagnosis, and gain clinical insight from neurologist Devon Conway, MD, and ophthalmologist Arthi Venkat, MD . Intro :11 A 24-year-old woman presents with gradual worsening of a migraine-like headache accompanied by nausea :22 Description of symptoms :37 ER...
Jul 31, 2018•41 min•Season 1Ep. 5
Do you know which U.S. president had Addison’s disease? Or how rumors from WWII led to funding for research on cortisol? In this episode, take a trip down memory lane as we detail the history of steroids and the scientists whose work lead to the discovery of prednisone. Intro :14 A query: What other disease is attributed to Thomas Addison? :40 Overview of the layers of the adrenal gland 1:18 History of the adrenal gland 2:10 Thomas Addison enters the scene 3:39 Kennedy and terminology 6:15 Charl...
Jul 10, 2018•19 min•Season 1Ep. 1
Biosimilars are a fascinating new category of medication and are quickly becoming part of the rheumatologist’s treatment armamentarium, but they can be confusing to understand. This episode will enhance your knowledge of this new class of medications by providing a better understanding of how biologics differ from most other medications, and why biosimilars aren’t just generics of biologics. This episode also takes a brief look into the history of drug regulation with a focus on biosimilars and ...
Jul 10, 2018•20 min•Season 1Ep. 2
Leonard Calabrese, DO, details the clinical manifestations of giant cell arteritis, the complex scenarios rheumatologists face when working with GCA, and the pathogenesis of this disease. Calabrese also shares clinical pearls and tips for success. Introduction of Leonard Calabrese, DO :12 Goals of this episode :31 The disease that rheumatologists love 1:02 History of giant cell arteritis 1:51 Gene Hunder, MD, defines large vessel involvement in late ‘80s, ‘90s 4:18 Epidemiology of giant cell art...
Jul 10, 2018•19 min•Season 1Ep. 3
