Episodes

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

    ILD for the rheumatologist: Digging through the past and making sense of the present
    Mar 24 2026
    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.
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    1 hr and 5 mins
  • Healio Community Book Club: A conversation between Leonard Calabrese, DO and Kevin Tracey, MD, author of The Great Nerve

    Healio Community Book Club: A conversation between Leonard Calabrese, DO and Kevin Tracey, MD, author of The Great Nerve
    Feb 24 2026

    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.
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    40 mins
  • Celebrating 101 episodes of Healio Rheuminations with Dr. Leonard Calabrese

    Celebrating 101 episodes of Healio Rheuminations with Dr. Leonard Calabrese
    Jan 29 2026

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

    The history of giant cell arteritis: Infections, injections and the man who couldn't wear a hat
    Nov 25 2025

    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.
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    43 mins
  • The Unnecessarily Complex Story of Rheumatoid Factor

    The Unnecessarily Complex Story of Rheumatoid Factor
    Oct 13 2025

    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 0:15
    • Rheumatoid factor quick background and history 00:36
    • Rheumatology blood tests 3:02
    • What is Rheumatoid factor? 3:49
    • Spiderman and latex agglutination: Testing for rheumatoid factor 4:50
    • The double discovery of rheumatoid factor 8:03
    • Putting agglutination on the medical map in 1896 10:08
    • Pop Quiz! 11:21
    • Serotherapy 13:10
    • When did we start using agglutination for testing? 14:17
    • First discovery of blood groups 14:50
    • The complement fixation test 17:22
    • Testing for syphilis with complement fixation and agglutination 21:01
    • The first discovery of rheumatoid factor 24:11
    • We forget about rheumatoid factor 27:44
    • Rediscovering rheumatoid factor 28:20
    • Analytical ultracentrifugation 32:50
    • What rheumatoid factor is used for 36:01
    • Thanks for listening 38:22

    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.
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    39 mins
  • Don't forget the toes: Managing patients with ANCA vasculitis

    Don't forget the toes: Managing patients with ANCA vasculitis
    Sep 29 2025

    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.
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    22 mins
  • Healio Community Book Club: A conversation between Leonard Calabrese, DO and Eric Topol, MD, author of Super Agers

    Healio Community Book Club: A conversation between Leonard Calabrese, DO and Eric Topol, MD, author of Super Agers
    Sep 19 2025

    This special edition episode features the latest installment of Healio Community's book club. Physician author Eric Topol, MD, discusses his book, Super Agers: An Evidence-Based Approach to Longevity, a guide to the science of living a long life free of debilitating diseases with Leonard H. Calabrese, DO, chief medical editor of Healio Rheumatology.

    · Intro by Adam J. Brown, MD 0:01

    · A warm welcome by Leonard H. Calabrese, DO 0:47

    · Introducing Eric Topol, MD 1:12

    · "Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again" but did you think it would happen this fast? 1:54

    · Let's get into "Super Agers" 3:46

    · What's killing most people? 6:33

    · An evidence-based treatise on healthy aging 9:42

    · The role of immune health in longevity 12:55

    · What's next on the horizon? 16:14

    · A candle in the dark 19:40

    · Minimizing the risk of getting old while you age 22:14

    · The influence of health behaviors on immunologic wellness 25:15

    · The hot issues: GLP-1's 26:28

    · A new world for immunology 31:50

    · Thank you, Dr. Topol 33:09

    · Thanks for listening 33:57

    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.

    Disclosures: No products or companies that would require financial disclosure are mentioned in this episode.
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    34 mins
  • The Astounding Account of the IL-17 and Spondylarthritis

    The Astounding Account of the IL-17 and Spondylarthritis
    Jul 28 2025
    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 0:15In this episode 0:27Leonard Calabrese, DO, is listening! 1:07Recap of last episode 3:23Putting the pieces together 5:32Quick overview of this science heavy episode 6:27What is psoriasis? 7:42Immunosuppressants for psoriasis/ Throwing meds at people and seeing what happens 10:20In the modern world of 1986 – olive oil placebo trial 11:45A quick aside into fungi 12:44What kind of T-cells are involved here? 16:50The TH-1 hypothesis 18:31IL-23 and IL-17 are doing something 19:38Going back to the drawing board in 2004 20:12p40 + p19 = IL-23 21:08IL-23 via minicircle DNA in mice 23:09Brand new and shiny TH-17 25:30The family of IL-17 26:40What do we know about IL-17 and psoriasis? 27:17IL-17A vs IL-17F in mouse studies 27:42Finding the difference between IL-17A and IL-17F in humans 28:30What exactly is IL-17 doing? 29:51The articular manifestations of psoriatic arthritis 31:13Spondylarthritis and the IL 23/17 axis 34:10T-cells we haven't talked about 35:49Summary of this episode 39:17Thanks 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.
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    42 mins