Healio Rheuminations talked burnout with the Glaucomfleckens, tackled autoimmunity in 2023
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Move over, Marc Maron. Step aside, Sharon Says So. Make way for Adam Brown, MD, of the Cleveland Clinic, host of the “Healio Rheuminations” podcast.
Rheuminations began in 2018 as a way for Brown to wax nostalgic about his love for the history of medicine. In the ensuing years and into 2023, it evolved into so much more. Even if you missed these highlights the first time around, they are still available for your enjoyment.
In one particularly gripping episode, Brown discussed possible associations between the Black Death — also known as yersinia pestis — and autoimmunity. He stayed true to his roots and offered a history of both the plague and IV immunoglobulin before diving into possible connections to HIV and CCR5.
Endoplasmic reticulum aminopeptidase 2 and the inflammasome are discussed, as is Mediterranean fever. Any rheumatologist would be thrilled to hear how these manifestations may occur in their patients.
From the past to the present, Brown later spent an “Afternoon with the Glaucomfleckens,” aka comedian and ophthalmologist William Flanary, MD, and his wife Kristin Flanary. The couple host their own podcast called “Knock Knock, Hi.”
Brown’s conversation with the couple covered two topics: hypermobility and physician burnout.
Kristin Flanary described life with hypermobility, while Dr. Flanary zeroed in on the potential of artificial intelligence to help keep overworked rheumatologists afloat.
Brown also discussed relevant clinical topics from 2023. One episode covered the environment and autoimmunity. Specifically, he discussed whether different environmental exposures can impact asthma and allergy development, and whether those exposures can be protective for autoimmunity.
Specific components of the conversation ranged from the “hygiene hypothesis” to allergic rhinitis, skin tests and appendicitis. Environmental exposures in rural, urban, Native American and Amish communities are covered, along with topics pertaining to mice and dust mites.
Speaking of urban and rural communities, another episode features the geography of autoimmunity. Brown and guest Dr. Brian Greenwood dig into how rates of autoimmunity can vary drastically in different parts of the world.
Type 1 diabetes rates in Finland are addressed, as is multiple sclerosis. Brown and Greenwood talk about migration studies and socioeconomic factors in the context of autoimmunity.
For those who wish to continue the deep dive into geography, Brown reviews data regarding lupus in Africa. Dr. Greenwood is back to discuss the so-called “lupus gradient,” along with the impact of malaria in the region. Other guests include Dr. Mickael Essouma, a physician from Cameroon, and Dr. Sandro Vento, from Cambodia, both of whom weigh in on the lupus gradient as well.
Moving from geography to the atmosphere, Brown tackles the presence of silica in the air and its potential to cause autoimmunity. The episode describes what silica is and how inhaling or injecting it can be triggering in some individuals.
A general overview of the history of silica includes the Ajax incident of 1979, commentary on rheumatoid scleroderma, Cardiff pneumoconiosis and ANCA-associated vasculitis.