Rheumatology is an incredibly fast-moving and exciting field of medicine that can be difficult to keep up with. This Healio podcast provides busy clinicians with quick updates in the field of autoimmunity, with emphasis on new medications, treatment guidelines and explorations into the pathophysiology of diseases. The show will also feature historical perspectives in the field of rheumatology, as well as fascinating case presentations of medical mysteries complete with discussions from experts in the field.
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Données mises à jour le 04/07/2026
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Disclosures: Brown reports no relevant financial disclosures.
Pulmonary hypertension, part 4: The therapeutics, with Dr. Joseph Parambil
Saison 1 · Épisode 93
mercredi 23 avril 2025 • Durée 01:08:19
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
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.
Pulmonary hypertension, part 3: Early therapies and vascular physiology
Saison 1 · Épisode 92
mardi 25 mars 2025 • Durée 47:44
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
Why are we using nitric oxide to treat pulmonary hypertension? 31:31
Tachyphylaxis 33:48
TNT factories 35:09
Nitrous oxide and tachyphylaxis 36:52
Pfizer in the 1980s 38:06
Understanding the trigger of pulmonary hypertension 40:53
PDE5 and nitric oxide and pulmonary hypertension
Pulmonary hypertension and the rheumatologist, part 2: The history
Saison 1 · Épisode 91
mercredi 26 février 2025 • Durée 48:58
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
Pulmonary hypertension and the rheumatologist, part 1: A bit of background
Saison 1 · Épisode 90
mercredi 12 février 2025 • Durée 52:39
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 pulmonary hypertension. 12:26
What is pulmonary hypertension and what does that mean for a rheumatologist? Where is pulmonary hypertension happening? 13:25
Describe the different groups of pulmonary hypertension. 19:51
A note about Dr. Chatterjee 20:25
Brown and Parambil discuss the groups of pulmonary hypertension. 23:35
What should we know about evaluating patients with pulmonary hypertensions? 26:51
Brown and Parambil discuss bendopnea and other signs of pulmonary hypertension. 29:58
What about the heart sound? 33:06
What should we look for in patients who we suspect to have pulmonary hypertension? 36:52
What should we look for in the tricuspid jet? 38:18
Brown and Parambil discuss the use of echocardiograms in pulmonary hypertension. 39:28
Tell us about the threshold of diagnosis. 40:47
What is the difference between the mean pressure and the wedge pressure? 41:41
What about the role of the pulmonary function test?
COVID's role in autoimmunity and where we are in the world of long COVID
Saison 1 · Épisode 89
mercredi 22 janvier 2025 • Durée 33:39
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.
Leonard H. Calabrese, DO, is the chief medical editor, Healio Rheumatology, and professor of medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and RJ Fasenmyer chair of clinical immunology at the Cleveland Clinic.
Disclosures: Calabrese reports professional relationships with AbbVie, AstraZeneca, Bristol Myers Squibb, Galvani, Genentech, GlaxoSmithKline, Janssen, Novartis, Regeneron, Sanofi and UCB.
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!
Rosenau MJ. Experiments Upon Volunteers to Determine the Cause and Mode of Spread of Influenza, Boston, November and December, 1918. Accessed December 6, 2023.
NSAIDs, Part 3: The rise, fall and rise again of COX-2 inhibition
Saison 1 · Épisode 87
jeudi 29 août 2024 • Durée 37:44
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 more NSAID studies: colon cancer, Alzheimer’s disease and COX-2 inhibitors 18:41
VIOXX: Why is myocardial infarction risk occurring? 22:34
Animal models and the Goldilocks theory of thromboxane and prostacyclin 23:49
NSAIDs, Part 2: The Dawn of the Anti-Inflammatories
Saison 1 · Épisode 86
mercredi 26 juin 2024 • Durée 46:59
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: manipulating salicylic acid and aspirin 8:47
How widespread was the use of aspirin for rheumatoid arthritis? 12:04
1938: problems with aspirin and endoscopies 14:58
1950s: long-term use of aspirin and chronic renal impairment 17:12
Dr. Lawrence Craven: the use of aspirin to treat myocardial infarction 18:13
Overview of what we’ve learned so far 20:48
Stewart Adams: the development of ibuprofen 21:40
A paper lost to time 23:29
How do you test if a drug is anti-inflammatory? 25:25
How do you make better aspirin? 26:55
1960: a trial comparing ibuprofen, baby aspirin and prednisone in patients with rheumatoid arthritis 30:03
Aspirin, ibuprofen and other NSAIDs 32:49
Nobel Prize winner Dr. John Vane 33:40
Dr. Vane: what triggered prostaglandin production? 35:42
Another guinea pig experiment
The Discovery of Non-Steroidal Anti-inflammatory Drugs (NSAIDs), Part 1
Saison 1 · Épisode 85
jeudi 16 mai 2024 • Durée 38:05
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
· Phospholipids 24:46
· Arachidonic acid 25:28
· Arachidonic acid into prostaglandins: how do you prove it? 26:32
· How does arachidonic acid turn into prostaglandins? 27:27
· Cyclo-oxygenase 28:36
· mRNA and COX-2 32:50
· On the next episode 35:55
· Summary 36:38
· Thanks for listening
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Disclosures: Brown reports no relevant financial disclosures.
43:55
Summary 46:41
Do you think the pulmonary hypertension in scleroderma and lupus are different entities? 48:37
Brown and Parambil discuss the connection of autoimmune disease and pulmonary hypertension. 50:49
Coming up in episode 91 51:50
Thanks for listening 52:25
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.
