Podcasts about behcet

El síndrome de Behcet es una enfermedad que se caracteriza por la inflamación de los vasos sanguíneos y que causa problemas en muchas partes del cuerpo.

#54. Live fra NRFs julekurs i 2024. Aksel Thuv Nilsen får presentert følgende diagnostiske utfordring: en etnisk norsk kvinne med orogenitale sår. Har hun Behcet?Tredje sesong av podkasten er muliggjort gjennom et stipend fra Norsk revmatologisk forening. Hosted on Acast. See acast.com/privacy for more information.

#53. Oversiktsepisode. Differensialdiagnoser, diagnostikk, behandling. For detaljert informasjon om behandling av Behcet, se EULARs anbefalinger.Tredje episode av podkasten er muliggjort gjennom et stipend fra Norsk revmatologisk forening. Hosted on Acast. See acast.com/privacy for more information.

#52. Oversiktsepisode.Tredje sesong av podkasten er muliggjort gjennom et stipend fra Norsk revmatologisk forening. Hosted on Acast. See acast.com/privacy for more information.

#51. En litt teknisk (og kanskje noe svevende) bonusepisode i podkast-tetralogien om Behcet.Tredje sesong av podkasten er muliggjort gjennom et stipend fra Norsk revmatologisk forening. Hosted on Acast. See acast.com/privacy for more information.

#50. Runder 50 episoder med den første av flere episoder om Behcet. Denne første er en oversiktsepisode om epidemiologi, symptomer og funn.Lenker til nevnte oversiktsartikler om Behcet: (1) Yazici Y et al 2021, (2) Yazici H et al 2018, (3) Emmi G et al 2024, (4) Saadoun D et al 2024.Tredje sesong av podkasten er muliggjort gjennom et stipend fra Norsk revmatologisk forening. Hosted on Acast. See acast.com/privacy for more information.

Basic knowledge of the common CNS manifestations of rheumatologic diseases and sarcoidosis is important. In the context of many systemic inflammatory diseases, CNS disease may be a presenting feature or occur without systemic manifestations of the disease, making familiarity with these diseases even more important. In this episode, Kait Nevel, MD speaks with Jennifer A. McCombe, MD, author of the article “Neurologic Manifestations of Rheumatologic Disorders,” in the Continuum® August 2024 Autoimmune Neurology issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. McCombe is an associate professor in the Division of Neurology, Department of Medicine at the University of Alberta, Edmonton in Alberta, Canada. Additional Resources Read the article: Neurologic Manifestations of Rheumatologic Disorders Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD Guest: @Div_Dubey Transcript Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology.  Thank you for joining us on Continuum Audio, which features conversations with Continuum's guest editors and authors who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article and have access to exclusive interviews not featured on the podcast. Please visit the link in the episode notes for more information on the article, subscribing to the journal, and how to get CME.   Dr Nevel: Hello. This is Dr Kait Nevel. Today, I'm interviewing Dr Jennifer McCombe about her article on neurosarcoidosis and neurologic involvement of rheumatological disorders, which appears in the August 2024 Continuum issue on autoimmune neurology. Welcome to the podcast, and I would love to have you introduce yourself to the audience.   Dr McCombe: Well, thank you, and thank you for having me. As you said, my name is Jen McCombe. I'm a neurologist in Edmonton, Alberta, Canada, where I spend kind of a third of my time in teaching roles (I coordinate the undergraduate block for our medical school there), I spend about a third of my time in a neuroinflammatory clinic in Edmonton, Alberta, and then about a third of my time doing clinical research.   Dr Nevel: Wonderful. Well, thank you so much for being here today and for chatting with me about your article on this topic.   Dr McCombe: Thank you for having me.   Dr Nevel: To start off, can you share with the listeners a little bit about your career path?   Dr McCombe: Absolutely. Yeah. So, I've had, uh, a bit of a circuitous career path. I did my medical school in Queens (which is in Eastern Canada, in Kingston, Ontario) and then went back to Edmonton, Alberta, for my residency (in Canada, we have a five-year residency program, so a little bit different than the US), but finished my residency and then did a master's degree in Public Health at Johns Hopkins while completing clinical research in HIV, actually, and did this thing we call the Clinical Scholar Training Program – so, kind of like a fellowship, but a little bit more, you know, research and academic-based. So, when I first started, I was focused more on neuroinfectious diseases, and that's kind of what my career path looked like at the time - but, actually, shortly after I finished my residency program, I also had my first child, and he, unfortunately, developed opsoclonus-myoclonus syndrome, and at the time (this was in 2010), it was a rather rare condition, so, I ended up finding myself having to become a bit of a neuroinflammatory disease specialist at the same time. So, at that point, I transitioned into working in the neuroinflammatory clinic with some mentorship but was getting all of the kind of weird and wonderful referrals and diagnostic dilemmas from my colleagues who recognized I kind of developed some expertise, and so decided (actually, mid-career) to take a sabbatical, and in 2021, completed a fellowship in autoimmune neurology at the Mayo Clinic. So, I finished that quite recently and then went back, and now I'm feeling much more, I guess, confident, too. Sometimes, you wonder about, you know, the choices you're making. I recognize most of the conditions I'm dealing with don't have, in fact, any evidence for their treatment, and that was confirmed when I went to the Mayo Clinic and found that, really, it was just trying to gain an understanding of the disease process to make a rational choice to medications and treatments. So, now, I'm back and kind of trying to focus a little bit more on some clinical research in that area since I've kind of solidified that expertise.   Dr Nevel: Wow. Well, thank you for sharing with us your career path and how, you know, unexpected life events kind of changed your interests or molded your interests (changed kind of the things that you became expert in, you know), and being fluid in your career path and willing to kind of take a break and reassess and get additional training. That's really inspiring to, I think, to me, and probably to a lot of listeners, that you can always, you know, develop more expertise in the more niche area or additional area no matter where you are in your stage of life or career path.   Dr McCombe: Yeah.   Dr Nevel: So, can you tell us a little bit more about - you know, you shared with us kind of autoimmune inflammatory disorders and how you became interested in that, neurosarcoidosis, specifically (you know the article focuses on that), and what's your background in neurosarcoidosis, how you became interested in that specifically and in neurologic manifestations of rheumatologic disorders?   Dr McCombe: I started in our neuroinflammatory clinic over a decade ago, and, you know, at the time, a lot of the expertise in any of these neuroinflammatory disorders was quite spread out over the country, and so, as I kind to alluded to before, often some of the more complicated patients where there wasn't necessarily clear-cut evidence or even, you know, a fellowship path to get there, I would end up getting referrals for - and so, I developed quite a cohort of patients with central nervous system primarily, but other types of neuroinflammatory and autoimmune neurologic diseases, and part of that cohort was a rather large (and still growing) group of patients with neurosarcoidosis. And so, I kind of developed some practical expertise, although, as you can see in the article (and as I'm sure you all know), the approach to the treatment is extremely variable. One of the most telling things is when we were at the Mayo Clinic, one of my co-fellows actually pulled all of the neurologists in neuroinflammation at all of the Mayo Clinic sites and asked them, you know, what is your treatment approach to a patient with neurosarcoidosis, and I think got twelve completely different responses as to the medications chosen and the length of time for the tapers and things like that. So, you know, it is very much a part of neurologic disease treatment that we still really don't have great evidence for, and although we do have some kind of rational choices that we can make based on other types of evidence, so -   Dr Nevel: Yeah.   Dr McCombe: And I enjoy working with patients with these types of diseases where we can kind of work together to come up with a treatment plan that makes sense for them and also makes sense based on whatever evidence we do have at this time.   Dr Nevel: Yeah. So, moving on to the article a little bit, knowing that this is a area of neurology where there's a lot of, you know, maybe personal expertise and experience but not a ton of data or evidence to necessarily guide our standardization to our treatments and approach, what do you think is the most important clinical takeaway from your article for our listeners?   Dr McCombe: Well, I mentioned before I coordinate the neuro block for our undergraduate program here, so I've developed over the years (I've been doing that for a number of years) a curriculum that's all based on, kind of, that approach to - and I like to do it that way because it's very practical. I like the students to be able to basically take their class notes and then go to the emergency department on their first shift as a clerk and, you know, use their approach to headache that I've developed for them to kind of take a clinical history and examine a patient with that sort of problem. And so, similar to that, I tried to do an approach to, you know, a couple of the more common presentations that would make you think of a rheumatologic condition or neurosarcoidosis in looking at the approach to CNS vasculitis and the approach to, uh, pachymeningitis - and these are difficult differentials for lots of neurologists, because it really relies on a lot of medicine knowledge, and we graduate from our residencies slightly more confident in our medicine knowledge, because we get a lot of that in our residencies. But as neurologists, as we go through our careers, we get much more confident in our areas of specialty, and at least for myself and many of my colleagues, much less confident in other things like general medicine. And so, it's difficult, because you have to face your areas of potentially less confident knowledge and really think about that in the differential - and so, I think, you know, I put those two big “approach to” sections in there, because they're the most relevant for the conditions that I was covering. But, I think also what I would say to a learner or a more experienced neurologist who might be reading the article, kind of pick out the little things that you might add to your own kind of approach to - you know, when you see that person with an ataxia, remember that Sjogren syndrome is one of the things you might consider that could be a treatable cause, or you want to see a sensory neuronopathy, don't just think paraneoplastic – again, Sjogren syndrome. So, kind of pick out those little pearls and add them to your approach to that patient that we all see, and I think that would be my biggest takeaway.   Dr Nevel: Yeah. Thank you. So, kind of like, keep this information from the article in mind so that you keep rheumatologic disorders in mind as a possibility when you're approaching a patient with whatever neurologic symptoms they're presenting with. So, what do you think is challenging? You kind of already mentioned a little bit, you know, just that it stretches us maybe into the medicine arena and so maybe stretches our medical knowledge, especially as we become more subspecialized or focused in neurology - but what is challenging about identifying, diagnosing neurologic symptoms as being related or due to an underlying rheumatologic disorder?   Dr McCombe: Absolutely. Yeah. Well, as you said, you know, it forces us to kind of face that medicine stuff that we might not be as comfortable with, but I think what else is challenging is that, sometimes, those medical clues aren't there. For the rheumatologic disorders for the most part, they are. Sjogren's is potentially a little bit different in that, potentially, the symptoms are less obvious or a little bit more subtle. But, in particular, with neurosarcoidosis, there's a distinct proportion of the patients that won't, in fact, have any systemic complications of their underlying disease, and so, you have to think about it even when the clues aren't there. That's why you have to add it to those kind of differential diagnoses where it might be considered, because those systemic clues that we all rely on when we do our review of systems and we ask about rashes and joint pain and lung issues, and these sorts of things may not be there - and so, you still have to think about it even when it might be completely isolated to the central nervous system.   Dr Nevel: What is our understanding of why some patients with rheumatologic disorders develop neurologic involvement? Do we have an understanding? Do we know why some patients do and some patients don't? I know that's, you know, kind of, uh - that's a tough question, but that was something that I thought of as I was reading your article, like, why does this happen to some people?   Dr McCombe: Absolutely. I mean, I think, potentially, it's a little bit more clear for some of them, like rheumatoid arthritis, because, typically, if you develop a CNS complication of this, it's, in fact, just because you've had the disease for a very long time, and often, it's uncontrolled, and so you think about the disease “spreading” now to the central nervous system - but for other conditions, like neurosarcoidosis, it is much less clear, and even if you look at the epidemiologic patterns for that, it makes it even more muddied in that in some populations, it appears that they develop more central nervous system disease, whereas in others, less. And so, why that is the case and why certain individuals might develop this complication of these diseases I think is yet to be seen.   Dr Nevel: Yeah, that's always the crux of things if we can figure out the why, then maybe we could prevent it, right?   Dr McCombe: Million-dollar question always.   Dr Nevel: Always. So, what do you find the most intriguing about neurologic involvement of rheumatologic disorders?   Dr McCombe: Well, I think one of the things that, really, I mean, for neurosarcoidosis in particular, so many patients do so well, and that's what I really like about it. You know, you see patients who present with an incredible burden of disease radiologically, and yet, don't look nearly as sick as they should when they're sitting in front of you. And then, you start them on therapies and some of them do so well, and even those with relatively devastating deficits, or moderate disease who do have neurologic symptoms, have a remarkable improvement in their neurologic symptoms with treatment. And so, that's always something that's quite rewarding when you get to see these patients in follow-up, and they're generally quite thankful because they're doing so well. And it's different from many of the neurologic diseases that we treat. I mean, in autoimmune neurology, we're lucky because we do have a number of diseases that are quite treatable and patients can have wonderful outcomes. But, you know, it's always scary when we see patients with devastating neurologic signs and it's great to see improvement with treatment. And so, that really draws me to it.   Dr Nevel: Yeah, absolutely. That's really rewarding when you're able to help somebody get better in such a profound way.   Dr McCombe: Mm hmm.   Dr Nevel: What is one common misconception about neurologic manifestations of rheumatologic disorders? Or what do you think is not well understood by treating clinicians?   Dr McCombe: I think probably one of the things I see the most is, sometimes, an undertreatment of the patient. And so, I see patients who, you know, other clinicians may have seen and have made the diagnosis, and perhaps it's a lack of confidence in the diagnosis and so they kind of want somebody else with a subspecialty to kind of confirm the diagnosis, but that treatment hasn't been initiated despite pathological confirmation on biopsy of another tissue. And these patients, like I alluded to before, they do well, but you need to treat them and you need to treat them adequately, and when their symptoms are quite impairing, you need to treat them adequately now. And so I think, sometimes, that delay in starting a second-line therapy and relying on steroids for too long - those sorts of things can really expose a patient to a lot of different side effects and to a lot of different complications that they may not have had, too. So, that's why I spent some time focusing on the treatment, because I think just gaining a little bit of comfort with some of these more common second-line medications is a good thing, because starting those early, I think, makes sense because you can really save the patient a lot. And then, the other thing, too, is that when you're using steroids, think about all of the systemic things that you're causing - think about the increased risk of infection and the fact that you need to prophylax for certain infections, think about bone health, think about protecting the lining of someone's stomach - so not only kind of thinking about your disease in isolation and what you need to do for treatment, but that you need to ensure that you're appropriately prescribing the patient all of the things they need to do to protect themselves during these times.   Dr Nevel: Yeah. I think that's so important. And I'm glad that you brought that up, because I think, unfortunately, many of us have seen a patient who ended up having PJP pneumonia (or something like that) because they weren't put on antibiotic coverage for prolonged steroid use or, you know, bone health - all of that is really important to think about. So, this may be entering a territory where there's no, you know, great evidence, but you mentioned, you know, starting kind of that maintenance or second-line agent - when do you decide to do that in patients? And maybe we can focus (since it gets a little broad), but, you know, in a patient with neurosarcoidosis, let's say - when you're starting the steroids, when do you decide, okay, this person is also going to need a maintenance therapy? Is that something that you do at the beginning when you're starting the steroids, or is that something that you think about later on depending on how their course goes?   Dr McCombe: Yeah. In my practice, I do it at the outset - again, because I'm quite focused on, you know, as soon as I get them on it, getting people off steroids - and so I start essentially almost all of my patients on it unless there's some other contraindication or complication to their disease. And because I deal with central nervous system complications in the vast majority of my patients, I'm starting a TNF-a inhibitor as well as methotrexate, and that's because I see a lot of patients with cord disease and significant brain disease, and so I want to treat them kind of more aggressively from the outset. And so, typically, they'll be on steroids, um, a TNF-a inhibitor, as well as methotrexate, and then I just back off, actually, as they do well. And so, I try to taper the steroids quite quickly over the course of just a number of weeks, or kind of two to three months at most. I maintain the TNF-a inhibitor, and then in some patients, depending on how they're doing, I might eventually stop the methotrexate. Some patients tolerate it so well that we don't for a number of months - other patients want to try to minimize their medications as quick as they can. So, that's my personal practice. In the province where I live, we don't have to worry about access to these medications, and so I understand that that might be an issue in some centers where people practice and have different access and different funding. Of course, I live in a country where we have universal healthcare, and in our province, I have very good access to these medications and they're funded from my patients regardless of socioeconomic status, and so I have the luxury of making these choices and I understand that other people might not, but that's my personal practice and I find it works quite well in the vast majority of patients.   Dr Nevel: Yeah. And you bring up a really good point that, you know, access to some of these medications for patients with CNS manifestations of sarcoidosis, neurosarcoidosis, sometimes can be challenging to treating the patient with medications that you feel like would be best for them. But that's wonderful that you don't have those access issues where you live. How long do you typically continue the TNF-a inhibitor in patients, since you mentioned, you know, tapering off the steroids, tapering off the methotrexate, potentially depending on patient tolerance and course. What's your approach to the TNF-a inhibitor?   Dr McCombe: Yeah, so, of course I follow them clinically, and then radiologically as well, and it's really satisfying if you can see the resolution of their symptoms as well as resolution of the abnormalities and the MRI, so I let that guide me a little bit. But, in most patients, I keep them on therapy for about one to two years, and then at that point, see if I can cease it in some patients. And I, again, continue to follow them radiologically and clinically after I cease it so that I can ensure that I'm catching their disease more quickly if it does come back and then can just reinitiate therapy, but in lots of patients you're able to stop the medication and they have persisting, kind of, disease freedom after that, and so they don't need to be on anything.   Dr Nevel: Yeah, great. And I'm almost hesitant to focus so much on neurosarcoidosis. (It was the rheumatologic manifestation that you talked about the most in your article.) I'm going to put in a plug for everybody to read your article so that they can read about neurologic manifestations of rheumatoid arthritis, Sjogren's, lupus, Behcet's - many more things. But focusing on neurosarcoidosis, it can be difficult in my experience to definitively diagnose, and people who have neurosarcoidosis particularly, and people who don't seem to have any systemic manifestations or, you know, imaging findings consistent with sarcoidosis - can you share your approach with us? And you outlined this in your article nicely, too, but your personal approach to patients with suspected neurosarcoidosis, and how you make that clinical decision to treat somebody with possible neurosarcoidosis, somebody who maybe you're not able to get pathologic evidence on?   Dr McCombe: Absolutely. Yeah, those ones are difficult. And, you know, whenever possible (as I mentioned in my article), I think pathological evidence of a diagnosis is important, because then when you find yourself a year down the road and a treatment path and you have uncertainty, it's much more difficult to consider continuing medications that can have quite a number of side effects when you're not absolutely certain about that diagnosis. But, in some patients, you know, I've had patients who might have nondiagnostic biopsies (if you attempt to do a biopsy), or they have disease in a site that really just isn't amenable to biopsy, or they have some other reason they can't have a biopsy. So, how I approach that is that, you know, if you think about possible neurosarcoidosis similar to any other nondiagnosed, you know, blow out-like lesion (for lack of a better term) in the CNS, if it's steroid-responsive, I think that kind of going down a path of treating it as a steroid-responsive lesion is kind of the approach that I take - so the diagnosis in the chart might be possible neurosarcoidosis, but in the back of my mind, I'm just thinking of kind of a steroid-responsive nondiagnostic or idiopathic lesion. So, I then follow that up typically with something like methotrexate (so, a more broader- spectrum immunosuppressant-type medication), and if the methotrexate is able to maintain the response that the steroids initiated, then eventually get them off the steroids. And so, you know, if I think about my patients that I've treated in the past, if they have a diagnosis of possible neurosarcoidosis, I probably don't start a TNF-a inhibitor as quickly in them, because in the back of my mind, I'm always wondering what type of inflammatory lesion this is, but that steroid responsiveness really helps me decide to start a second-line or maintenance therapy and then, typically, in those patients, as I mentioned, I'll start something like methotrexate a little bit more soon.   Dr Nevel: Yeah, great. Thanks for sharing that with us. So, what do you think comes next in this field? What excites you? Where do you think our next kind of development or understanding or breakthrough, whether it's diagnostic or treatment-wise?   Dr McCombe: I think, in the field, you know, any immunologic diseases, we've been really gaining a much better understanding of pathophysiology, and that's honestly what excites me the most, when you can know precisely what part of the immune system is at play here (whether it's, you know, complement-mediated or antibody-mediated) and then being able to then rationally choose medications based on a really clear understanding of the disease is something that I think is kind of novel in a way. For so many years, we would use kind of big broad-spectrum immunosuppression - even in multiple sclerosis, still, we use medications that, historically, we've found to be helpful - but we don't have a great understanding sometimes of why the medicines work. So, kind of going at it from the other way, where we're actually determining what is the exact pathophysiology of disease and then making a rational approach to a therapy, or choosing a therapy based on that, I think is what excites me the most, and I think we'll gain a better understanding of even a broader swath of diseases and be able to make those choices more often. That's what I like about this field.   Dr Nevel: Great. Well, thank you so much for sharing that - and looking forward to the future in this area of neurology. And thanks so much for talking with me today and sharing your story and your expertise and knowledge.   Dr McCombe: Well, thank you for having me. It's been fun.   Dr Nevel: And I encourage all the listeners to read your article. Again, today, I've been interviewing Dr Jennifer McCombe, whose article on neurosarcoidosis and neurologic involvement of rheumatologic disorders appears in the most recent issue of Continuum on autoimmune neurology. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today.   Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at Continpub.com/AudioCME. Thank you for listening to Continuum Audio.

In this episode, we review the high-yield topic of ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Behcet Syndrome⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠from the Cardiovascular section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets

Behçet's is a chronic condition resulting from disturbances in the body's immune system. Symptoms affect all parts of the body, including the eyes. Amelia talked to Behcet's UK chair Tony Thornburn OBE to learn more. You can learn more about Behçet's UK and access their information sheets by visiting https://behcetsuk.org/ Call the Behçet's UK helpline on 0345 130 7329. Image: Image shows the RNIB Connect Radio logo. On a white background ‘RNIB' written in bold black capital letters and underline with a bold pink line. Underneath the line: ‘Connect Radio' is written in black in a smaller font.

Voor deze aflevering spraken we met een reumatoloog die zich heel bewust is van haar carbon footprint en vaak zingend door de poli-gangen loopt . Franktien Turkstra specialiseerde zich de ziekte van Behcet en vertelt ons er uitgebreid over! En we krijgen uitleg over haar meest recente focus, de MHC-1-opathies (hoor je meteen ook  hoe je dat woord moet uitspreken!)

NON SCARRING ALOPECIA AFTER HYALURONIC ACID TEMPORAL LIFTING TECHNIQUES Landau M et al (starts at 9:05). Nonscarring alopecia after temporal lifting technique with dermal fillers. JAAD Case Rep. 2023 May 12;37:30-34 Coimbra D.D., and de Oliveira B.S (starts at 10:17). Supra-auricular lifting with fillers: new technique. J Cosmet Dermatol. 2016;8(4):328–335.   CUTIS VERTICES GYRATA DUE TO PSORIASIS Garcia-Rodriquez V et al (starts at 25:19). Cutis verticis gyrata secondary to scalp psoriasis. Int J Dermatol. 2023 Jun 4.   ORAL MINOXIDIL ASSOCIATED HYPERSENSITIVITY PNEUMONITIS Takekosh D et al (starts at 32:35). Minoxidil-induced lung disease, masquerading as hypersensitivity pneumonitis. Respir Med Case Rep. 2023 Apr 29;43:101861.   PTSD AND AUTOIMMUNE DISEASE Hsu TW et al (starts at 43:40). Risk of autoimmune diseases after post-traumatic stress disorder: A nationwide cohort study. Eur Arch Psychiatry Clin Neurosci. 2023 Jun 15.   Song H et al (starts at 49:18). Association of Stress-Related Disorders With Subsequent Autoimmune Disease. JAMA. 2018 Jun 19;319(23):2388-2400.   Dai Y-X et al (starts at 51:00). Posttraumatic Stress Disorder and the Associated Risk of Autoimmune Skin Diseases: A Nationwide Population-Based Cohort Study. Psychosom Med. 2021 Apr 1;83(3):212-217.   PATHERGY IN PATIENTS WITH BEHCET'S DISEASE RECEIVIGING LASER HAIR REMOVAL R Nicolau et al (starts at 53:07). Pathergy-like reaction induced by laser hair removal in a patient with Behçet disease. Reumatismo. 2023 Jul 17;75(2). Van der Ree-Pellikaan C et al (starts at 1:01:48). Oral ulcerations after placement of orthodontic braces and skin pustules after laser hair removal: novel inducers of pathergy reactions in new-onset Behçet's disease. BMJ Case Rep. 2016 Mar 7;2016:bcr2014209208. doi: 10.1136/bcr-2014-209208.

A breakdown of what Behcet's Disease and what you need to know as a patient as well as insight from patients on life with Behcet's. Here's what you'll find in this episode: What is Behcet's? What are the classic symptoms of Behcet's? How is Behcet's Diagnosed? What Causes Behcet's? Who gets Behcet's? How is Behcet's Treated? Side Effects from Medications Life with Vasculitis Patient to Patient Cat's Episode: https://fightlikeamama.libsyn.com/ep-118-vasculitis-interview-with-behcets-disease-warrior-with-cat-ray Cat's Podcast: https://risingfromtheillness.libsyn.com/ Cat on Instagram: https://www.instagram.com/risingfromtheillness/ Please don't forget to click that subscibe button whereever you listen to the podcast and do me a HUGE favor and leave a review! These two things help others find the podcast, find our community, and feel a little less alone in their journey through life with chronic illness! Join us on Instagram: https://www.instagram.com/teamvasculitis Join the Email List: https://teamvasculitis.com/team-vasculitis-email Sources: https://www.mayoclinic.org/diseases-conditions/behcets-disease/symptoms-causes/syc-20351326 https://www.hopkinsvasculitis.org/types-vasculitis/behcets-disease/ https://rarediseases.info.nih.gov/diseases/848/behet-disease  

Continuing our discussion with warrior, Tessa Koller. Tessa manages a rare genetic syndrome called 22Q11.2 Deletion Syndrome which can cause heart defects, poor immune function and more. She has endured several near-death experiences including one due to long haul Covid as well as many surgeries resulting in chronic pain. The diagnoses of Fibromyalgia and Behcet's Syndrome soon followed. Tessa always looks for the lessons each experience and condition has taught her. Through her art and advocacy, she keeps moving forward, supports others and is able to find some peace amidst the chaos. Listen as in Part Two Tessa explains how she handles the unpredictability of it all and offers her tips to others living with chronic illness. To learn about Tessa including her art and blog or to subscribe to her newsletter, go to https://www.tessakollerart.com/.

Meet warrior, Tessa Koller. Tessa manages a rare genetic syndrome called 22Q11.2 Deletion Syndrome which can cause heart defects, poor immune function and more. She has endured several near-death experiences including one due to long haul Covid as well as many surgeries resulting in chronic pain. The diagnoses of Fibromyalgia and Behcet's Syndrome soon followed. Tessa always looks for the lessons each experience and condition has taught her. Through her art and advocacy, she keeps moving forward, supports others and is able to find some peace amidst the chaos. Tune in to Part One as Tessa shares her remarkable story living with her rare conditions as well as some of her near-death experiences and how she handles the unpredictability of it all. To learn about Tessa including her art and blog or to subscribe to her newsletter, go to https://www.tessakollerart.com/.

Trigger warning: This episode includes a discussion of near-death experiences, medical trauma and decisions about quality of life versus prolonging of life.  If you are having a mental health crisis or are struggling with suicidal thoughts, in the US you may call “988” for the Suicide and Crisis Lifeline which is staffed 24 hours a day.In this episode, Hay shares her tumultuous experiences with autoimmune vasculitis. She and Cheryl urge fellow chronic illness warriors to resist trying to fit their experience into a tidy narrative and instead ride the waves of uncertainty.  While extremely challenging, Hay notes that “deep calls unto deep”, allowing shared humanity and connections based on what unites us all.For Full Episode Details Including Transcript:Go to the episode page on the Arthritis Life Website at: https://arthritis.theenthusiasticlife.com/2023/01/17/how-i-survived-survival-mode-marriage-faith-near-death-experiences-with-autoimmune-vasculitis-warrior-hay/Episode at a Glance:Education and work: Hay earned her PharmD (Pharmacy Doctorate) in 2011, but began experiencing chronic illnesses shortly after. She has learned to understand that your value is not based on your productivity.Relationships: Symptoms like fall risk, limitations on leaving the house, and being in “survival mode” have been trying on her marriage, but her husband never gave up.Diagnosis saga: living with Behcet's vasculitis, common variable immune deficiency, Microscopic colitis, and respiratory failure, along with a variety of complicationsTreatment journey: Hay explains how she uses total parenteral nutrition (TPN, aka “vein food”) due to her GI tract not absorbing and has had a lot of trial and error with medications over the years, some even working against each other. She eventually found a promising mix of medications that has recently been helping her improve. She has been working with a team of seven specialists who collaborate on her treatment, especially from a palliative care perspective.Coping and advice: Hay shares the importance of art, faith, clear communication, and having boundaries. She explores how she tries to live life to the fullest within constraints. After having to deal with end of life conservations, she notes that “The way you hold people's stories has to be infinitely more gentle than you thought”. Having been a writer and interning for a literary agent, she is used to stories being explained in 45-65 minutes but life with chronic illness feels like “you're on a blindfolded roller coaster you've never seen before”. Cheryl and Hay discuss the benefits of resisting the urge to force your experience into a tidy narrative.Surviving SURVIVAL MODE: Hay shares how some days have been just living breath to breath and opens up how she's allowed herself to grieve and learned to “riding the waves of uncertainty.” She shares what it's like to have conversations about quality of life vs prolonging life. She explains the importance of connecting to others and exploring our shared humanity, “because deep calls unto deep” - what is happening, why am i here, what connects us, and understanding you're not alone. She also shares how religion and faith have served an important purpose in her life.Medical disclaimer:All content found on Arthritis Life public channels was created for generalized informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.Episode SponsorsRheum to THRIVE, a community support & education program Cheryl created to help people with rheumatic disease go from overwhelmed, confused and alone to confident, supported and connected. Join the waitlist for the next group, which starts in March 2023!

Suffering from inexplicable sores & excruciating pain since he was 5 years old, August searched to uncover what plagued so many years of his life and threatened his mobility.  His dreams of a musical theater career quickly faded away as his condition worsened, so August decided to challenge the constant silencing of his symptoms and fight the cause of the irreversible physical damage. *  *  *  *  *  * ****** SPOILER ALERT BELOW ****** If you're looking for more information on Behcet's, you can check out the American Behcet's Disease Association by heading to www.behcets.com. You can also find August Rocha on Instagram & TikTok @WithLoveAugust.See omnystudio.com/listener for privacy information.

In this episode, we review the high-yield topic of Behcet Syndrome from the Rheumatology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets

La enfermedad de Behçet se incluye dentro de las enfermedades reumáticas autoinmunes sistémicas (ERAS) caracterizadas por la inflamación de los vasos sanguíneos (vasculitis) por causas desconocidas, y que puede afectar a casi cualquier parte del organismo. Aunque no es una enfermedad muy común, se estima que afecta aproximadamente a 5 casos por cada 100.000 habitantes en nuestro país, lo que supone algo más de 2.300 personas, según señala el doctor Jenaro Graña, reumatólogo del Complejo Hospitalario Universitario de A Coruña Los especialistas de la Sociedad Española de Reumatología (SER) explican que sus principales síntomas se localizan en la piel y en las mucosas, como la boca, donde aparecen aftas y úlceras. En ocasiones también esta patología puede también afectar a los ojos, los músculos y las articulaciones. Más info en @lossilenciosdeelan y en http://www.behcet.es/

Today, I continue the journey of sharing how I continue my journey of being a better Me living with Behcet's and taking Remicade. Support the show

Sharing my journey living with Behcet's and Remicade Infusions!!! Support the show

Meet August! This amazing human spends so much of his time spreading not only awareness for the Trans, Asian, and Disabled communities but joy and light too. He has Behcet's Disease and as a Vasculitis warrior he supports others through their process. Connect with August: https://www.instagram.com/withlove_august/ https://www.tiktok.com/@withloveaugust Connect with Team Vasculitis: https://www.instagram.com/teamvasculitis/ https://www.tiktok.com/@teamvasculitis http://teamvasculitis.com  

As I  continue to bring awareness around Behçet's disease, this week I    share more of how I've changed my mindset in how I    deal with this illness!!! Behcet's Awareness Day is May 20th and I'm committed to doing more for my community. Support the show

In honor of Behcet's Awareness Day on May 20th, in this month's Motivational Monday episodes I'm sharing my journey of learning how to live and take control of my life in the midst of this illness. Join me as I    reflect on my past and all the things I've learned. Support the show

Frustrated with the health care system? Want to improve health care access, affordability, and transparency for you or a loved one? Learn how to make your voice heard by decision-makers on Capitol Hill by joining us for our 2022 Patient Uprising Fly-In happening on June 14th and 15th in Washington, D.C. Terry and Dr. Bob outline the top policy priorities for the chronic illness community and fibromyalgia patient advocate Melissa Talwar underscores the importance of patient advocacy and how you can embark on your own advocacy journey.And field correspondent Kate Pecora takes listeners international with her conversation with Megan Staley, who gives listeners a look into her life with Behcet's and endometriosis.Hosts: Terry Wilcox, Executive Director, Patients RisingDr. Robert Goldberg, “Dr. Bob,” Co-Founder and Vice President of the Center for Medicine in the Public InterestKate Pecora, Field CorrespondentGuests: Megan Staley, Patient AdvocateMelissa Talwar, Executive Director, Support Fibromyalgia NetworkLinks: Attend the 2022 Patient Uprising Fly-InPatient EducationAdvocacy Master Class - Patients Rising NowPatients Rising NowEndo Girl - Youtube Channel Hospitals' massive cancer drug markupsContributor: Reform Medicare's Payment Policy to Expand Patient Access to NonopioidsSeason 3 | Episode 13: How PBMs Raise Costs for Patients + PharmaciesPatients Rising NowNeed help?The successful patient is one who can get what they need when they need it. We all know insurance slows us down, so why not take matters into your own hands? Our Navigator is an online tool that allows you to search a massive network of health-related resources using your zip code so you get local results. Get proactive and become a more successful patient right now at PatientsRisingConcierge.orgHave a question or comment about the show, or want to suggest a show topic or share your story as a patient correspondent?Drop us a line: podcast@patientsrising.orgThe views and opinions expressed herein are those of the guest(s)/ author(s) and do not reflect the official policy or position of Patients Rising.

Cat Ray is a Behçet disease warrior. She was diagnosed early in life with a dangerous and rare diagnosis of Behçet Disease. She joins Dr Erica Harris today to discuss her attitude of perseverance and hope. She is an incredible light and force of strength and endurance!

In this episode we will hear from Michelle who lives with Behcet's disease. Behcet's disease (or syndrome), is a rare disorder that causes blood vessel inflammation throughout your body. Those with the disease can experience numerous symptoms that can seem unrelated at first, and can include mouth sores, eye inflammation, skin rashes and lesions.

Today I introduce you to Cat! She shares her journey from challenges as a child, to finally receiving a diagnosis as an adult. After getting a handle on things, she went through major emotional trauma which sent the disease into overdrive. She has a partially paralyzed stomach, suffers from seizures which limit her freedom, and so much more… and yet, she still chooses to continue Rising from the Illness. Find Cat at: https://www.instagram.com/risingfromtheillness (Check out her podcast too!) Follow me and find community at: https://www.instagram.com/TeamVasculitis 

Episode kali ini menjawab pertanyaan sobat imun mengenai Behcet, Lupus, RA, Urtikaria dan Vaksinasi Covid yang sudah masuk ke email binaimun@gmail.com. Simak sampai selesai ya, bisa jadi salah satunya adalah pertanyaanmu juga. Kirimkan pertanyaan, saran dan cerita autoimun/alergi kamu ke email binaimun@gmail.com, email yang terpilih akan kami jawab di sesi Bincang Imun ya. --- Send in a voice message: https://anchor.fm/stevent-sumantri/message

(Club de Revista 066) En este club de revista se discute los resultados a largo plazo de los ensayos clínicos fase 3 de apremilast para el manejo de las úlceras orales en la enfermedad de Behçet.ENLACE: https://bit.ly/3GxYwq1

Esta semana en Mariposas moradas vamos a terminar de ahondar en el conocimiento de una enfermedad crónica, autoinmune y sistémica, también de carácter reumatológico, llamada enfermedad de Behcet, y para ello hablaremos con el doctor Andrés Ariza, reumatólogo del Hospital General Universitario de Ciudad Real. La enfermedad de Behcet es un trastorno poco frecuente que causa la inflamación de los vasos sanguíneos en todo el cuerpo. Esta enfermedad puede provocar numerosos signos y síntomas que, inicialmente, no parecen estar relacionados entre sí. El doctor Ariza nos explicará que se trata de una enfermedad inflamatoria crónica no contagiosa que se caracteriza por la presencia de aftas orales y genitales recurrentes asociadas a manifestaciones oculares, vasculares y cutáneas, por lo que nos aclarará cómo afecta a las relaciones sexuales de los pacientes que la sufren. El doctor nos detallará si puede verse afectada la esperanza de vida para un paciente con lupus y behcet y nos señalará si tener hábitos tóxicos como fumar, llevar una vida sedentaria o la ingesta de alcohol pueden influir en la evolución de la enfermedad. Finalmente hablaremos del papel trascendental de la asociación de lupus y autoinmunes de Castilla La Mancha como una buena forma de ayudar a solucionar los problemas que surjan en la vida diaria, acompañando y asesorando a los pacientes.

Dr. Eoin Flanagan discusses neuro-behcet disease. 

Esta semana en Mariposas Moradas vamos a seguir ahondando en el conocimiento de una #enfermedad crónica, #autoinmune y sistémica, también de carácter reumatológico, llamada enfermedad de Behcet, y para ello hablaremos con el doctor Andrés Ariza, reumatólogo del Hospital General Universitario de #CiudadReal. La enfermedad de Behcet es un trastorno poco frecuente que causa la inflamación de los vasos sanguíneos en todo el cuerpo. Esta enfermedad puede provocar numerosos signos y síntomas que, inicialmente, no parecen estar relacionados entre sí. El doctor Ariza nos explicará que se trata de una enfermedad inflamatoria crónica no contagiosa que se caracteriza por la presencia de aftas orales y genitales recurrentes asociadas a manifestaciones oculares, vasculares y cutáneas. El doctor nos explicará qué pruebas realizan para su diagnóstico y nos aclarará el carácter crónico ya que los síntomas pueden durar desde días a semanas, o pueden persistir durante meses o años. Y es que más del 60% de pacientes no desarrolla manifestaciones graves a lo largo de la enfermedad. Ariza nos señalará que hay que hacer un abordaje multidisciplinar de esta patología. El síndrome de Behçet requiere una valoración multidisciplinar en la que formen parte oftalmólogos, dermatólogos, gastroenterólogos, neurólogos, cirujanos vasculares, etc., pero siempre contando con la visión global del reumatólogo.

Esta semana en Mariposas moradas vamos a conocer una enfermedad crónica, autoinmune y sistémica, también de carácter reumatológico, llamada enfermedad de Behcet, y para ello hablaremos con el doctor Andrés Ariza, reumatólogo del Hospital General Universitario de Ciudad Real. La enfermedad de Behcet es un trastorno poco frecuente que causa la inflamación de los vasos sanguíneos en todo el cuerpo. Esta enfermedad puede provocar numerosos signos y síntomas que, inicialmente, no parecen estar relacionados entre sí. El doctor Ariza nos explicará que se trata de una enfermedad inflamatoria crónica no contagiosa que se caracteriza por la presencia de aftas orales y genitales recurrentes asociadas a manifestaciones oculares, vasculares y cutáneas. Asimismo, el doctor nos aclarará como esta enfermedad es muy poco frecuente, afecta a hombres y mujeres por igual y la edad de comienzo suele situarse entre los 20 y 40 años, aunque puede ocurrir en cualquier edad, incluso en la infancia. Nos señalará el desconocimiento que causa la enfermedad, pero sí se sabe que algunas personas pueden tener cierta predisposición genética. Para finalizar, nuestro reumatólogo nos explicará de forma detallada los síntomas que presenta y nos expondrá pormenorizadamente los tratamientos de que disponen los especialistas para abordarlos.

In this episode of BDU, I tell you 10 interesting facts about Behcet's disease. It's packed with stats, facts, and all sorts of interesting info. By the end of the episode, you'll likely know more about Behcet's than your doctor! You can read the heavily cited article this episode is based off of here: 10 Interesting Facts About Behcet's Disease. It contains links to all the references made in this episode. --- Support this podcast: https://podcasters.spotify.com/pod/show/behcets-disease/support

In recent years, the Food and Drug Administration approved several new treatments specifically for the treatment of multiple sclerosis and neuromyelitis optica spectrum disorder. But what about neuroimmunological conditions that do not have FDA approved options and require off-label use of immunomodulatory medications -- conditions like neurosarcoidosis, neuro-Behcet's, or central nervous system involvement of systemic rheumatologic conditions? There is often a lack of rigorous evidence to guide treatment of these conditions, leaving experts to rely on individual or institutional experience. Our guest on this episode is Dr. Jeffrey Gelfand, neuroimmunologist and Associate Professor of Neurology at UCSF. He specializes in treating patients with rare neuroinflammatory conditions, and he'll talk to us about the new drugs for NMO as well as off-label use of immunomodulatory therapies for a range of neurological conditions. Dr. Gelfand was interviewed by ANA producer Dr. Rohini Samudralwar. Series 2, Episode #9 Disclosures: Dr. Gelfand receives research support to UCSF for clinical trial from Rosch and Genetech; provides consulting to Biogen

I was diagnosed with Behcet's way back in 1997 at the age of sixteen. In this episode, I tell you a little about my personal story living with this rare, unpredictable illness for the past 25 years. But this isn't my whole story: it's really just the tip of the iceberg. If you'd like to hear my full story - the good, the bad, and the downright embarrassing - I wrote a memoir about living with Behcet's. It's available in print, ebook, and audiobook format. I'll add an Amazon link below, but it's also available at Apple, Google, B&N, Kobo, and more. Just search for the title and author at your preferred book seller. Finding Happiness Through Pain and Embarrassment: My Life With Behcet's Disease - A Memoir by Ellis Michaels --- Support this podcast: https://podcasters.spotify.com/pod/show/behcets-disease/support

I Love Pizza skapades 2010. 1982 övertog Pappa Behcet Yuksel en lokal pizzeria i Högsbohöjd och det blev startskottet till vad som idag är I Love Pizza. Idag för de fem bröderna traditionen vidare genom att tillsammans utveckla, marknadsföra och driva I Love Pizza. Jonny Yuksel berättar om familjeverksamheten och drivkraften. Hur viktiga medarbetarna är och att våga släppa på kontrollen. 

Inflammation can occur in any part of the body and the eye is no exception. In this episode, we discuss uveitis and scleritis, two specific inflammatory conditions of the eye. Uveitis, one of the major causes of vision loss, is an intraocular inflammatory condition that can be broken up into three categories: infectious, non-infectious, and traumatic. It can further be classified by where the inflammation occurs in the eye: anterior (front part - iris), intermediate (middle part – ciliary body), posterior (back part – choroid), and panuveitis (entire eye).Infectious uveitis can be caused by bacteria, viruses, fungi, and parasites in the eye or by a systemic infection like herpes, tuberculosis, syphilis, toxoplasmosis, or Lyme disease. Noninfectious uveitis, the most common type, can be caused by autoimmune conditions like rheumatoid arthritis, lupus, sarcoidosis, Reiter syndrome, ankylosing spondylitis, Behcet's disease, psoriatic arthritis, and inflammatory bowel disease. The most common reason for uveitis is called idiopathic – no reason can be found. Symptoms of uveitis will vary according to its location in the eye. Anterior uveitis, also called iritis, can cause ocular pain, photophobia (light sensitivity), red eye, and decreased vision. Uveitis in the back of the eye mainly causes vision loss but usually does not cause pain.After a thorough eye examination, a lab work-up should be performed especially after the second recurrent episode or if the first episode affects both eyes. Ruling out an infectious cause can be done in the office. Bloodwork to rule out some of the autoimmune diseases is the next step. Sometimes a chest x-ray may be necessary to help rule out TB or sarcoidosis.Treatment of infectious uveitis is directed at the pathogen causing the infection. This may involve a combination of topical antibiotics or anti-virals and systemic medications. Steroids are the mainstay of treatment of non-infectious uveitis. Most anterior uveitis is treatable with topical steroid eye drops. Intermediate and posterior uveitis is mainly treated with oral steroids and steroid injections around or in the eye. For patients with chronic or recurrent uveitis, immunomodulatory therapies may be necessary. Some of these medications may include methotrexate, Cellsept, Humira, and Remicade.Scleritis is an inflammatory condition of the outer coating of the eye (sclera). Symptoms include severe eye pain, red eye, and sometimes a decrease in vision. If the back part of the eyewall is inflamed, the eye may not appear red. An ultrasound of the eye may be necessary to properly diagnose this condition. Some of the causes of scleritis include rheumatoid arthritis, HLA-B27-related diseases, and gout. Oral and injectable steroids are the primary treatments for this condition. Sometimes immunomodulatory therapies are also needed to control the inflammation. Here are some more links to learn more about inflammation in the eye.Uveitis.orgPreventblindness.org/uveitis/Scleritis To find out more about Dr. Lou Chorich and his practice, go to Midwest Retina's website.This is intended for informational and educational purposes only, and nothing in this podcast/blog is to be considered as recommending or rendering medical advice or treatment to a specific patient. Please consult your eye care specialist for proper diagnosis and treatment of any eye conditions that you may have.

Testimonio de una paciente de esta enfermedad rara, la licenciada Lucía Realini, nos visita para contarnos de que se trata esta enfermedad, considerada una de las enfermedades raras. Síntomas que se prestan a confusión y cuidados.

This podcast discusses Behcet’s disease. In it, the listener will learn to recognize the presentation of Behcet’s, its diagnostic criteria, how to conduct a focused history and physical examination for the disease, and which investigations and management options to pursue. The podcast was developed by Levi Ansell, a medical student at the University of Alberta, with support form Dr. Dax Rumsey, a pediatric rheumatologist at the University of Alberta’s Stollery Children’s Hospital.

Dr. Nlandu, Infectious Diseases Fellow at the University of South Florida, discusses noninfectious conditions that can mimic everyday infectious diseases diagnoses. He begins by discussing hemophagocytic lymphohistiocytosis (HLH), a life threatening clinical syndrome characterized by extreme immune system activation. Next, he covers Behcet’s disease, a form of vasculitis commonly manifesting as mucocutaneous disease. Familial Mediterranean Fever (FMF) is a rarely diagnosed syndrome seen in persons of Mediterranean descent that can mimic many infectious diseases conditions. Lastly, Adult Onset Still’s disease is a syndrome producing a triad of fever, arthrlagias, and a salmon-covered rash. The diagnosis and management options for each syndrome is characterized.

Uterine Fibroid and heavy bleeding might have a new drug if your normal drug was giving placebo. HPV Vaccine is still awesome and very very safe. Copper IUD has a new kid in town when it comes to emergency contraception and Colchicine should not be used for secondary prevention (at least not when I read the trial) HTTPS://WWW.NEJM.ORG/DOI/FULL/10.1056/NEJMOA2008283 Treatment of Uterine Fibroid Symptoms with Relugolix Combination Therapy international, double-blind, 24-week, phase 3 trials involving women with fibroid-associated heavy menstrual bleeding. Participants were randomly assigned in a 1:1:1 ratio to receive once-daily placebo, relugolix combination therapy (40 mg of relugolix, 1 mg of estradiol, and 0.5 mg of norethindrone acetate), or delayed relugolix combination therapy (40 mg of relugolix monotherapy, followed by relugolix combination therapy, each for 12 weeks). The primary efficacy end point in each trial was the percentage of participants with a response (volume of menstrual blood loss 12 times/year) were 2.5 times more likely to be current smokers, to consume >14 alcoholic drinks/week, and to drink >6 cups of coffee daily. AND THERE WAS A –response relationship with increasing tanning frequency. Many of you will know that a dose response relationshop is one of the keys for causation in observational studies. So could it be the tanning causes the smoking, drinking, and coffee drinking.. not directly. But could it be that the personality traits that cause you do go above and beyond are active in all actions of your life?? YES When you go above and beyong you go above and beyond for everything—its almost never something like well I am crazy about working out but I eat like garbage and vice versa if you eat terrible rarely are you crazy about working out. You burn it at both ends of the stick or you don’t the problem is controlling it in a healthy way which is maybe the key to life. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2775955?guestAccessKey=d35250c2-a79e-486c-80e9-67a886cb9ef1&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=olf&utm_term=021521 #FDA tells the companies but the companies don't tell the public! (thread) #MedTwitter This should be a #publichealth issue. @MedTweetorials If there is question related to a drug products quality, safety, and efficacy then the FDA will issue a "refuse-to-file" to the COMPANY not to the public. However, shouldn't their be transparency? Over a decade ago the #FDA even had a task force for more transparency! https://fdanews.com/ext/resources/files/archives/f/FDA-2009-N-0247-0107.1.pdf https://www.fdanews.com/ext/resources/files/archives/f/FDA-2009-N-0247-0107.1.pdf I will say a "refuse-to-file" is a rare event (thank goodness). Between 2008-2017 only 4% or 103 out of 2475 applications received a refuse to file. BUT guess how many times the public was informed of these "refuse-to-file"? 15.5% of the time! Only 16/103! This is TERRIBLE! It may come as no surprise that NONE of these "refuse-to-file" letters were were published in their entirety but rather as a press release or abbreviated form. Just like there was a large push as one time for authors to post or register their #clinicaltrials I think there should be equal push for companies to register and publish their "refuse-to-file" letters. I didn’t know only copper IUD!! The New England Journal of Medicine Levonorgestrel vs. Copper Intrauterine Devices for Emergency Contraception N. Engl. J. Med 2021 Jan 28;384(4)335-344, DK Turok, A Gero, RG Simmons, JE Kaiser, GJ Stoddard, CD Sexsmith, LM Gawron, JN Sanders In this trial, the researchers randomized women to a copper IUD or levonorgestrel IUD for emergency contraception and found the levonorgestrel IUD to be noninferior to the copper for this purpose. In the US, the copper IUD is currently the only approved IUD for emergency contraception. This trial provides compelling evidence for the use of levonorgestrel for emergency contraception, providing more options for women in the 5 days following unprotected intercourse. Greenberg JC et al. Life saving therapy inhibition by phones containing magnets. Heart Rhythm 2021 Jan 4; [e-pub]. (https://doi.org/10.1016/j.hrthm.2020.12.032) he magnet in the iPhone 12 is strong enough to turn off therapies from implantable cardioverter–defibrillators. Implantable cardioverter-defibrillators (ICDs) are designed so that an application of a reasonably strong (10-gauss) magnet can inactivate the therapy. This safety feature enables the device's therapies to be suspended for surgeries with cauterization and inappropriate shocks caused by rapid atrial fibrillation (AF) and lead fractures, among other issues. Theoretical concerns have been raised about interference of ICDs by cell phones; however, this interaction in real-life patients has rarely, perhaps never, been reported. Apple's new iPhone 12 contains a powerful magnet, which enables it to correctly align with external accessories (e.g., for wireless battery charging). In an experiment with a single person with an implanted Medtronic transvenous ICD, investigators studied whether the magnet in an iPhone 12 could disable ICD therapies. And indeed, whenever the iPhone was brought near the ICD, the device's ventricular therapies were suspended. Inhibition of ICD therapies by an iPhone is a major concern. Cell phones are frequently carried in chest pockets, some of which are close to an implanted ICD. Even a turned-off iPhone might cause this interaction. Patients and physicians must be aware of this possibly harmful, potential inhibition of ventricular therapies by the iPhone 12, and patients must avoid carrying it in a left chest pocket. And speaking of, many people thought that 2020 would be the year that colchicine would find its way back into our hearts What many people call one of the top articles of 2020 was in the NEJM titled Nidorf SM, Fiolet ATL, Mosterd A, et al. Colchicine in patients with chronic coronary disease. N Engl J Med. 2020;383:1838-47. https://pubmed.ncbi.nlm.nih.gov/32865380 Which was a study that looked at the use of low-dose colchicine to reduce the risk of cardiovascular (CV) events? 5522 patients who had evidence of coronary disease and had been clinically stable for ≥6 months were randomized after a 1 month run in phase. During the run in phase pateitns got colchicine, 0.5 mg/d. 15% of the patients were not randomized after randomization. 15%! Keep that in mind Basically 1 out of 6.5 people who were attempted to enter the trial were not able to tolerate the trial Remember a run in phase false elevates the results of the treatment arm. Because instead of having 100% of people taking place and only 85% taking the active drug since 15% could tolerate side effects. You only randomize people that could take the drug so then you have 100% taking the placebo and 100% taking the active arm. This makes it difficult because we don’t get run in phases in clinical practice. And the results were AMAZING! Or at least if you just read the conclusion “””In a randomized trial involving patients with chronic coronary disease, the risk of cardiovascular events was significantly lower among those who received 0.5 mg of colchicine once daily than among those who received placebo.” Not so fast- the risk of cardiovascular events—what is that?? It is the primary end point but what does it mean??? primary end point was a composite of cardiovascular death, spontaneous (nonprocedural) myocardial infarction, ischemic stroke, or ischemia-driven coronary revascularization. If you add enough outcomes you will always always find something…so you need to look at the individual outcomes MI = NNT- 81 ischemia-driven coronary revascularization= NNT 65 (which makes sense, cheating way to add more numbers to your outcome) cardiovascular death- no difference ischemic stroke, no difference now if you are actually reducing the number of heart attacks you would expect to see a decrease in the cardiovascular deaths but remember there was no difference in cardiovascular death. So if you are seeing a decrease in heart attacks and more patients are under going revascularization then these are suppose to be good things so why no change in cardiovascular deahts??? And people say yes but there was a trend towards decrease in cardiovascular dath with 20 in the colchicine arm and 25 in the placebo arm. BUT what no one is talking about is there was was more non cardiovascular deaths in the colchicine arm 53 vs 35 in the placebo arm. HR 1.51 (95% CI 0.99–2.31) which would cross one and suggest not significant but remember it is all a continuum that we make up it is not that at this rate it works and at this rate absolutely no benefit. So when you have 5 few cardiovascular deaths in the colchicine arm but 18 more noncardiovascular deaths in the colchicine arm it works out to a net increase of 13 more deaths from any cause in the colchicine arm. THIS IS BAD We don’t want more death! So was this just magic skills on the part of the trials where you move a few deaths this way and you slide a few more that way so you can say “there was a trend toward decrease cardiovascular death” or was this that maybe colchicine causes increase in nonCV death. OR Is it that MI and revascularization are really not that important?? Or is it that MI and revascularization are soft endpoints…. You ask 10 difference cardiologist if a patient needs to go for a cardiac cath and you might get 10 different answers. I don’t have the answer but I will tell you many people think this was a big practice changer in 2020 and everyone should get colchicine and I think well I think Based on a study that had 1 out of every 6 patients drop out during the run in phase and was only able to show a change in two very soft end points with no change in all cause death and almost a stastically significant negative change in the nonCVD death, I will not be prescribing this medication for my patients for secondary CV prevention anytime soon.

As the legalization of cannabis for both medicinal and recreational use spreads across the United States and other parts of the world, more and more Behcet's sufferers are finding relief from this amazing plant - and I'm one of them. In this episode of Behcet's Disease Uncensored, I talk about using cannabis to treat some Behcet's symptoms, side effects from commonly prescribed drugs, my personal experience, what the science has to say, and more. And if you're interested, you can read the blog post I wrote about this topic on my website here: Cannabis and Behcet's Disease. --- Support this podcast: https://podcasters.spotify.com/pod/show/behcets-disease/support

If you've been diagnosed with Behcet's disease, you likely seen several different types of doctors. In this episode of Behcet's Disease Uncensored, I talk about some of the specialists you might have to see if you've got Behcet's. --- Support this podcast: https://podcasters.spotify.com/pod/show/behcets-disease/support

In this episode, I tell you about some of the medications doctors commonly prescribe to patients with Behcet's disease. --- Support this podcast: https://podcasters.spotify.com/pod/show/behcets-disease/support

In this episode, I tell you about 5 home remedies I've used to treat some of my Behcet's symptoms. To learn more about these remedies including where to get them, check out my blog post with the same name: 5 Home Remedies For Behcet's Disease. --- Support this podcast: https://podcasters.spotify.com/pod/show/behcets-disease/support

If you've been diagnosed with Behcet's disease, even the name can make your skin crawl. But who was Dr. Behcet? In this episode, we take a look at the man Behcet's disease is named after. --- Support this podcast: https://podcasters.spotify.com/pod/show/behcets-disease/support

You've just been diagnosed with Behcet's disease. Now what? In this episode, I tell you about the first things you should do after getting diagnosed. --- Support this podcast: https://podcasters.spotify.com/pod/show/behcets-disease/support

In this episode of Behcet's Disease Uncensored, we take a look at what Behcet's disease is, who gets it, how it's diagnosed, current treatment options, and more. If you're interested in learning more about Behcet's disease and about my personal experience living with it for several decades, I wrote a book about it: Finding Happiness Through Pain and Embarrassment: My Life With Behcet's Disease - A Memoir. --- Support this podcast: https://podcasters.spotify.com/pod/show/behcets-disease/support

This is just a short introduction to Behcet's Disease Uncensored and a little bit about me, Ellis Michaels. --- Support this podcast: https://podcasters.spotify.com/pod/show/behcets-disease/support

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.11.19.389403v1?rss=1 Authors: Jonathan, H. P., Temponeras, I., Kuiper, J., Cortes, A., Korczynska, J., Kitchen, S., Stratikos, E. Abstract: Objective: Polymorphic variation of immune system proteins can drive variability of individual immune responses. ER aminopeptidase 1 (ERAP1) generates antigenic peptides for presentation by MHC class I molecules. Coding single nucleotide polymorphisms (SNPs) in ERAP1 have been associated with predisposition to inflammatory rheumatic disease and shown to affect functional properties of the enzyme, but the interplay between combinations of these SNPs as they exist in allotypes, has not been thoroughly explored. Methods: We used phased genotype data to estimate ERAP1 allotype frequency in 2,504 individuals across five major human populations, generated highly pure recombinant enzymes corresponding to the 10 most common ERAP1 allotypes and systematically characterized their in vitro enzymatic properties. Results: We find that ERAP1 allotypes possess a wide range of enzymatic activities, whose ranking is substrate-dependent. Strikingly, allotype 10, previously associated with Behcet's disease, is consistently a low-activity outlier, suggesting that a significant percentage of individuals carry a sub-active ERAP1 gene. Enzymatic analysis revealed that ERAP1 allotypes can differ in both catalytic efficiency and substrate affinity, differences that can change intermediate accumulation in multi-step trimming reactions. Alterations in efficacy of an allosteric inhibitor that targets the regulatory site of the enzyme suggest that allotypic variation influences the communication between the regulatory and the active site. Conclusion: Our work defines the wide landscape of ERAP1 activity in human populations and demonstrates how common allotypes can induce substrate-dependent variability in antigen processing, thus contributing, in synergy with MHC haplotypes, to immune response variability and to predisposition to chronic inflammatory conditions Copy rights belong to original authors. Visit the link for more info

Erythema nodosum is a symptom complex characterized by tender erythematous nodules that typically appear on the extensor surfaces of the lower legs (but can appear on the arms, face, and trunk). The lesions should range in color from pink to red and be between 1-10 centimeters in diameter. The malady usually lasts for six weeks and can be associated with pregnancy, oral contraceptive use, primary coccidioidomycosis, streptococcosis, tuberculosis, syphilis, diverticulitis, Y enterocolitica, Yersinia pseudotuberculosis, and other deep fungal infections. Erythema nodosum can also be accompanied by inflammatory bowel disease, Behcet disease, or sarcoidosis. The tender erythematous nodules can be preceded by arthralgia, malaise, and fever. The practitioner should evaluate the patient's medication exposure history, and conduct a physical examination for a chest radiograph, a PPD, two consecutive ASO/DNAse B titers at 2 to 4 week intervals, diarrheal illness, symptoms of any deep fungal infection specific to the area, and prior upper respiratory infection. In its late stages, erythema nodosum must be distinguished from simple contusions and bruises. The patient can be treated with NSAIDs which typically takes the form of potassium iodide (5-15 drops three times daily), corticosteroid therapy, dapsone, colchicine, or hydroxychloroquine. Complete bed rest should be ordered if the lesions are painful. The reader should note that erythema nodosum differs from other forms of panniculitis in that it does not ulcerate. Erythema induratum from tuberculosis, though, does create lesions on the posterior surface of the legs and can ulcerate. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Dr. Selk interviews Dr. Lynne Margesson, a dermatologist at Dartmouth, about vulvar ulcers. Discussion topics include common causes of ulcers (infectious and non-infectious), syphilis ulcers, questions to ask on history, Behcet's disease, aphthous ulcers (simple and complex), vulvar manifestations of Crohn's disease, when to biopsy, treatment, how to treat recurrences, managing chronic recurrent aphthous ulcers, managing dysuria, and ulcers associated with vulvar tumors.

Miranda and I chat through her diagnosis of Behcet’s Disease and how that made her start to realize new limitations she now had to cope with in her life. We also touch on how Miranda has since had to pivot her thinking on what she is striving for academically and professionally. Miranda is a Master's student at Columbia University and also works as a personal trainer and online coach under her company, Shaped by Science, LLC. Find Miranda on the Internet: Instagram: @mirandalcard Find Austin on the Internet: Instagram: @austincurrent_ Website: https://www.physiquedevelopment.com If you love the episode and would like to support the podcast, I would ask for you to please head over to iTunes or Apple Podcasts and leave me a 5-star review and tell a friend about the podcast. If you’re here from Instagram, share a screenshot of the podcast on your story — be sure to tag me @austincurrent_. Enjoy the conversation! ---- Produced by: David Margittai | In Post Media Website: https://www.inpostmedia.com/ Email: david@inpostmedia.com © 2020 Austin Current

Karina Machado speaks with Sara, a cardiac diagnostic specialist and mother of three from the Southern Highlands of NSW whose life was forever changed by a near-death experience in late 2018. But immense suffering preceded her NDE - which wasn’t her first, though it was the most powerful - and in part one of our two-part conversation, Sara shares her story publicly for the first time.  In part one, you'll hear about her first NDE and the events that led to her being diagnosed with the rare auto-immune disorder Behcet’s Disease, and how that led to her second NDE, in which she met her beloved mentor and father (himself a renowned cardiologist). Sara also relates the profound impact of her life review and the lessons it carried about the power of choice. “Do we turn to love every moment?” asks Sara.  “We are here to look after and serve one another in love, through love and with love.”  Karina's website. Join Karina on Facebook and Instagram.

Méningite, kératites (herpès, lentilles, sécheresse lacrymale,...), corps étranger, glaucome aigu, hémorragies et tumeurs intracrâniennes, albinisme, alumines, cataracte, dengue, fièvre jaune, fièvre Q, grippe, hyperthyroïdie, migraine, uvéites antérieures aigües (Sarcoïdose, Behcet, Syphilis, Fiessinger-Leroy-Reiter...)...

Dr. Robin Berzin went to medical school at Columbia University with the goal of getting a solid, conventional medicine education that she could use to help patients in a non-conventional way. The combo of studying public health in college and seeing her dad's experience as a primary care doctor showed her that medicine alone wasn't the solution— that things like yoga, nutrition, meditation, and lifestyle changes needed to be the first line of defense in preventing disease. After graduation, she trained at The Institute for Functional Medicine. In 2015, she founded Parsley Health, a boutique membership-based healthcare provider focused on functional medicine. Listen to hear about: Why it's important to use a health coach An incredible autoimmune patient story: A rare condition called Behcet's autoimmune vasculitis left her with numerous ulcers, inflammation, insomnia, weight gain, and acne. Powerful steroids hadn't helped, but Parsley helped her become medication and symptom-free in six weeks! How to get doctors to really learn about nutrition in a useful way Robin's advice on how to advocate for getting the healthcare you want and need to avoid disease and save money in the long run. Click here to watch the video version of this interview: https://getwellbe.com/changemakers/robin-berzin-parsley-health-patient-story While you're there, sign up to become a WellBe Insider and get all of our latest content, special offers and big announcements sent right to you! Oh and hang with us daily on Instagram! www.instagram.com/getwellbe  xx Adrienne & Team WellBe

Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions:  Roshana: Lily is 21 years old college student. She has always been a healthy child and teenager until last spring an ulcer like breakouts in her mouth and genital area, which continued with sores in eye lids ( similar to a chalazion case). After seeing rheumatologist , dermatologists and running all conventional medical test they are suspecting an autoimmune system decease named " Behcet". They are treating her with Steroid based medications. But even that doesn't keep the the flare outs away. I would love her be seen by dr. Cabral.  Roshana  Brittani: Hi there,  Just listening to podcast number 922 at the moment and logged on to view the body type images. For the women, however, I've noticed that pitta-vata isn't pictured, there's one for the men though. I do know this is my type so was hoping for a visual :).  Not that I'm a pro in typing, but in terms of body shape and structure - would Julianne Hough be considered a pitta-vata?  Thanks for your thoughts on this!  Steve: Hello - I have been researching clean and safe dinnerware options lately as I would really like to make the switch to a cleaner option. I have found many endorsements for stainless steel (food grade 304 18/10 or 18/8) but have also found equal warnings regarding chromium & nickel leaching. Can you speak into whether stainless steel is a safe option or not? Thanks, Steve  Breanna: Hello! I had a quick question in regards to the Candida and bacterial overgrowth protocol. I know it helps with chronic yeast infections (yeast) but does it also help with chronic UTIs (E Coli)?  Rachelle: Hi, I started the heavy metal detox this past Saturday and I know it’s a six week protocol. I’m unsure if the products I purchased from equilibrium nutrition will last six weeks with the amount Dr. Cabral recommends I take. Should I purchase another set of supplements for the heavy metal detox? And also, some people take six months to detox heavy metals. Should I be doing this longer than six weeks? I want to ensure maximum benefit for my efforts. I just had my breast implants removed almost 8 weeks ago and I’m looking to completely cleanse my body as they really did a number to my hormones and health. Thank you!  Katie: Hi-  I just started my CBO Protocol Monday. Can I drink Herbal teas and coffee with almond milk?  Also can you send me a link to some CBO recipes? I am part of the detox facebook group but struggling to find some inspiration for yummy CBO approved recipes that arent just a pile of veggies:) I am so excited for this journey!!!! Thank you! -Katie  Anonymous:  Hi Doc! Thanks for your podcast and all you do, changing lives.  Do the world a favor and explain why the Keto diet and the carnivore diet are not suitable long term diets. I’ve had so many peolple debate with me on how great they feel and how it’s healed all their medical ailments that I’ve even started to doubt my own belief on what the base of all diets should be (mostly veggies and moderate protein/fat). I’m constantly doing research to find the best diet for my family and I keep seeing more anecdotes and stories from people have tremendous success with Keto/carni for all around health.  I think the world needs clarification on this and I know you are not bias towards any specific diet so your perception is greatly needed in the health community at the moment to clear things up for us normal folks who want the best for our people.  Could you explain in depth/scientifically why we should avoid these diets except for unique medical cases? Maybe this deserves its own podcast :) :) :)  Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community’s questions! Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community’s questions! - - - Show Notes & Resources: http://StephenCabral.com/1079 - - - Get Your Question Answered: http://StephenCabral.com/askcabral   - - - Dr. Cabral's New Book, The Rain Barrel Effect https://amzn.to/2H0W7Ge - - - Join the Community & Get Your Questions Answered: http://CabralSupportGroup.com - - -   Dr. Cabral’s Most Popular Supplements: > “The Dr. Cabral Daily Protocol” (This is what Dr. Cabral does every day!) - - - > Dr. Cabral Detox  (The fastest way to get well, lose weight, and feel great!) - - - > Daily Nutritional Support Shake  (#1 “All-in-One recommendation in my practice) - - - > Daily Fruit & Vegetables Blend  (22 organic fruit & vegetables “greens powder”) - - - > CBD Oil  (Full-spectrum, 3rd part-tested & organically grown) - - - > Candida/Bacterial Overgrowth, Leaky Gut, Parasite & Speciality Supplement Packages - - - > See All Supplements: https://equilibriumnutrition.com/collections/supplements  - - -   Dr. Cabral’s Most Popular At-Home Lab Tests: > Hair Tissue Mineral Analysis (Test for mineral imbalances & heavy metal toxicity) - - - > Organic Acids Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Thyroid + Adrenal + Hormone Test  (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Adrenal + Hormone Test (Run your adrenal & hormone levels) - - - > Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Omega-3 Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - > Stool Test (Use this test to uncover any bacterial, h. Pylori, or parasite overgrowth) - - - > Genetic Test (Use the #1 lab test to unlocking your DNA and what it means in terms of wellness, weight loss & anti-aging) - - - > Dr. Cabral’s “Big 5” Lab Tests (This package includes the 5 labs Dr. Cabral recommends all people run in his private practice) - - - > View all Functional Medicine lab tests (View all Functional Medicine lab tests you can do right at home for you and your family!)

Author: Nick Hatch, MD Educational Pearls:   Behcet Disease is an autoimmune disease that can affect any organ system. Typical symptoms include recurrent oral and genital ulcers, but more concerning features include skin rashes, ocular problems, and strokes. Patients with Behcet disease with hypotension should have low threshold for giving steroids.   References: Arlt W, Allolio B. Adrenal insufficiency. Lancet, 2003; 361:1881. Sakane T, Takeno M, Suzuki N, Inaba G. Behçet's disease. New England Journal of Medicine. 1999; 341:1284.

This episode covers Ch 108 of Rosens (9th Ed.), SLE and the Vasculitides. These conditions can lead to some pretty varied ED presentations, so we need to know when to suspect lupus or vasculitis, and how to manage it.  Episode Overview: What the pathophysiology of lupus List diagnostic criteria for SLE List drugs that induce lupus Describe the clinical manifestations w/  Classic triad & Symptoms and signs by system in lupus List 3 drug regimens to treat SLE How does neonatal lupus present? What is antiphospholipid syndrome? What is the unusual laboratory feature seen with this condition? What is the pathophysiology of vasculitis? Large vessel vasculitis Medium vessel vasculitis Small vessel vasculitis Hypersensitivity vasculitis Subcutaneous vasculitis Give examples of: Compare the findings for vasculitis List 5 criteria for dx of temporal arteritis + 2 associated features Describe the features of Behcet’s Disease List 10 causes of Erythema Nodosum Compare Buerger’s, Serum sickness and Hypersensitivity Vasculitis List the diagnosis Criteria for HSP   WiseCracks What is the differential for SLE patient and Chest pain? Name and identify 2 pathognomonic clinical features for lupus When should Rheum be involved in the ED with a SLE patient? Spot Diagnosis: A 36 year old female stock trader present with what appears to be necrosis of the nose and ears… Spot diagnosis: 13 year old presents with abdo pain, polyarticular arthritis, foaming urine and the following rash… Rounds Pimper: List 10 side effects of chronic steroid use

This episode covers Ch 108 of Rosens (9th Ed.), SLE and the Vasculitides. These conditions can lead to some pretty varied ED presentations, so we need to know when to suspect lupus or vasculitis, and how to manage it.  Episode Overview: What the pathophysiology of lupus List diagnostic criteria for SLE List drugs that induce lupus Describe the clinical manifestations w/  Classic triad & Symptoms and signs by system in lupus List 3 drug regimens to treat SLE How does neonatal lupus present? What is antiphospholipid syndrome? What is the unusual laboratory feature seen with this condition? What is the pathophysiology of vasculitis? Large vessel vasculitis Medium vessel vasculitis Small vessel vasculitis Hypersensitivity vasculitis Subcutaneous vasculitis Give examples of: Compare the findings for vasculitis List 5 criteria for dx of temporal arteritis + 2 associated features Describe the features of Behcet’s Disease List 10 causes of Erythema Nodosum Compare Buerger’s, Serum sickness and Hypersensitivity Vasculitis List the diagnosis Criteria for HSP   WiseCracks What is the differential for SLE patient and Chest pain? Name and identify 2 pathognomonic clinical features for lupus When should Rheum be involved in the ED with a SLE patient? Spot Diagnosis: A 36 year old female stock trader present with what appears to be necrosis of the nose and ears… Spot diagnosis: 13 year old presents with abdo pain, polyarticular arthritis, foaming urine and the following rash… Rounds Pimper: List 10 side effects of chronic steroid use

Autoimmune and inflammatory diseases on the rise. “Autogens”. Pathogenesis, toxic environmental factors. Diet and lifestyle. Behcet’s disease and cow’s milk proteins. Translating TCM terminology “wind, damp-heat & phlegm.”  Herbal medicine and classical formulas for autoimmune disorders and inflammation, i.e. systemic lupus, MS, ALS, collagen diseases, kidney damage, rheumatoid arthritis, Sjogren’s syndrome, anti-baterial, anti-viral, respiratory tract support, [...]Read More »

Raised by her single mother, Chitoka Webb grew up in the Preston Taylor housing projects, landed her first job in a grocery store at only 13 years old. When a senior in High School, she was told by school authorities she couldn’t graduate with her class just a week before the ceremony due to being one point short in her chemistry class. Now, in her mid-30s, Webb owns several businesses—that she founded. She began her self employed career at 23. In 1999 Webb left Nashville and moved to Atlanta, where she nurtured numerous relationships with professional athletes and successful business leaders. Working as the only female barber alongside 14 other male barbers. Her highlight moment came during Super Bowl XXXIV when she was invited by her client Anthony Dorsett (Son of football great Tony Dorsett) to attend the event as their barber. After much success and accomplishing set goals she returned to Nashville in pursuit of a dream to own her own barbershop, which she opened in October 2001. She worked three full time jobs for three months to make this dream a reality. Her life and business motto is “Do unto others as you would have them do unto you” pulling herself up by the bootstraps these humble beginnings brought more success. After developing two health care agencies and a new state-of-the-art barbershop Webb developed Chitoka L.Webb Holdings, Inc. which oversees her professional ventures, and the early development stages of a Foundation which supports her community service projects Through her impressive business growth, Webb suffered blindness for six months as a result of Behcet’s disease. High doses of Steroidal eye injections and medications corrected her failed eye sight. The Behcet’s diagnosis led Webb to write her memoir, Something Inside of Me. Join Kelli & Gina as they interview Chitoka Webb on August 31, 2011 at 2:00 p.m. EST

Cet enregistrement représente mon interprétation entant qu'étudiant en 2e année de Médecine. Il est fourni entant qu'aide à l'étude et n'a pas comme objectif d'être une ressource primaire. Il ne constitue pas un avis médical. Veuillez pardonner les erreurs grammaticales. Le sujet de cet épisode est les troubles de vision comme signes de maladie systémique. L’œil est un organe complexe et comme tel, il y a plusieurs conditions médicales qui se manifestent par un dérangement de la vision ou par un signe au niveau de l’organe comme tel. Il y a plus d’une façon de classifier les atteintes de l’œil. On peut classifier selon le niveau anatomique de l’atteinte, comme par exemple, l’atteinte des structures qui conduisent la lumière, comme la cornée, le cristallin ou le corps vitré, l’atteinte des structures qui sont impliqués dans l’acquisition, la transmission ou l’interprétation du signal visuel comme la rétine, le nerf optique, les radiations optiques ou le cortex occipital, ou l’atteinte des structures accessoires comme l’orbite, l’appareil lacrymal, les paupières, la conjonctive, la sclère, l’iris, la circulation de l’humeur aqueuse, la circulation sanguine ou les muscles et leur innervation. Une autre façon d’organiser les causes de l’atteinte de l’œil est selon l’étiologie : mécanique, traumatique, inflammatoire, infectieuse, néoplasique, dégénératif, congénital, vasculaire, hémorragique, toxique, métabolique, endocrinologique, nerveuse ou disruption de l’anatomie normale. Cet épisode portera sur les manifestations oculaires de maladies systémiques, mais ne discutera pas la pathogenèse, la prise en charge ou le traitement de ces conditions. • Diabète o La rétinopathie est une source de morbidité majeure chez les diabétiques et une des premières causes de cécité. Le dépistage de routine est important étant donné que la rétinopathie peut être asymptomatique jusqu’aux stades avancés de l’atteinte oculaire. o La rétinopathie diabétique peut être divisée en 3 stades. • Le premier est la rétinopathie de fond. À ce stade, on peut voir des micro anévrysmes, des hémorragies ponctuelles, des hémorragies en flammèches, des exsudats lipidiques (ou hard exsudates) et des infarcissements de la rétine (ou cotton wool spots.) • Le deuxième stade est la rétinopathie préproliférative. Elle comporte les signes de la rétinopathie de fond auxquels on a ajouté un début de néovascularisation et des veines en forme de chapelet. • Le 3e stade est la rétinopathie proliférative. La néovascularisation atteint la rétine et le vitré, et ces nouveaux vaisseaux sont l’origine d’hémorragies vitréennes. Ces hémorragies causent une prolifération de fibroblastes, et la contraction tissulaire qui s’ensuit provoque un décollement rétinien tractionnel. La néovascularisation du segment postérieur peut aussi s’accompagner d’une néovascularisation facilement visible du segment antérieur. • À n’importequel moment, on peut aussi retrouver de l’œdème maculaire causé par l’augmentation de la perméabilité des capillaires dans la zone maculaire. o De plus, les patients diabétiques développent plus rapidement des cataractes, sont plus susceptibles de développer le glaucome à angle ouvert et l’hyperglycémie peut aussi causer des changements réfractaires. o Finalement, la neuropathie diabétique ou l’atteinte microvasculaire en périphérie du nerf optique peut affecter la vision ou les organes accessoires à la vision. • La rétine est un outil pour visualiser le lit vasculaire directement, et est donc très utile dans le suivi de l’hypertension. • L’hypertension chronique peut aussi causer une forme de rétinopathie ressemblant à la rétinopathie diabétique. Les caractéristiques typiques de la rétinopathie secondaire à l’hypertension chronique sont l’encochement artérioveineux, les microhémoragies, des microanévrysmes et des infarcissements (coton wool spots). • L’hypertension maligne peut présenter avec un étoile maculaire et de l’œdème papillaire, mais ce n’est pas la seule cause d’œdème papillaire. Le différentiel pour l’œdème papillaire bilatéral inclut, entre autres : l’augmentation de la pression intracranienne (qui est une urgence médicale), les troubles congénitaux comme les drusen ou les fibres nerveuses intraoculaires myélinisées, et parfois le diabète, l’hyperviscosité, l’hypotension et l’intoxication. • AA o Graves • Les patients atteints de l’hyperthyroïdie ont un retard palpébral, leur donnant l’allure de fixer le regard. • De plus, ¼ des patients atteints d’une hyperthyroïdie de Graves manifesteront une exophtalmie, causée par une inflammation des tissus retrobulbaires, y inclus les muscles et les tissus conjonctifs. • Le retard palpébral est un facteur de risque pour les ulcères cornéens. o SEP • La névrite optique est fortement associée avec la sclérose en plaques. Environ 40% des patients atteints de la sclérose en plaques auront cette perte de vision. La perte est habituellement unilatérale et associé avec une douleur au mouvement des yeux. Une inflammation de la papille optique est observée à l’ophtalmoscopie chez seulement 1/3 des patients. On peut aussi retrouver chez ces patients une ophtalmoplégie internucléaire. o Lupus • Les symptômes universels associés au lupus n’épargnent pas les yeux. La peau des paupières peuvent être atteintes de l’érythème discoïde, ces patients peuvent avoir les yeux secs (syndrome de Sjogren), et, infréquemment, ces patients peuvent aussi avoir une uvéite, une kératite, ou une épisclérite. L’atteinte vasculaire implique souvent la rétine, formant des exsudats ou des microinfarcissements. o Vasculites • Plusieurs vasculites ont une atteinte oculaire. • Un des symptômes de la vasculite de Horton, ou artérite temporale, est une perte de vision transitoire monoculaire (ou amaurose fugace). Ces patients sont à 15 à 20% de risque de cécité permanente suite à un infarcissement du nerf optique, d’une occlusion de l’artère rétinienne ou d’une de ses branches ou d’un infarcissement de la choroïde. L’atteinte ischémique des nerfs oculomoteurs ou du nerf optique à tout point dans son trajet peut causer une diplopie ou des hémianopsies. • Une constellation de signes et symptômes ophtalmologiques accompagnent la granulomatose de Wegener, comme la conjonctivite, l’ulcération cornéenne, l’épisclérite, la sclérite, l’exophtalmie et autres. • Tout clinicien se doit d’avoir un index de suspicion élevé de la maladie de Kawasaki quand un enfant de moins de 5 ans se présente avec la majorité des symptômes suivants : une fièvre de plus de 5 jours, une injection bilatérale des conjonctives, les lèvres gercées, l’érythème et une lymphadénopathie cervicale. o Arthrite • 15 à 20% des patients arthritiques auront les yeux secs suite au syndrome de Sjogren secondaire. À l’examen par lampe à fente, les patients auront une injection de la conjonctive et un épithélium cornéen dévitalisé. • 5% des patients atteints de l’arthrite rhumatoïde auront une sclérite ou une épisclérite. • Comme pour beaucoup d’autres atteintes auto-immunitaires, on peut aussi observer chez les patients arthritiques une kératite ulcérative périphérique de la cornée. o MG • La fatigabilité musculaire de la myasthénie gravis atteint aussi les muscles extraoculaires. Il y a même un sous-type de myasthénie gravis qui est limité aux muscles oculaires. Le signe le plus fréquent et le plus évident est une ptose qui s’empire progressivement au cours de la journée. Les muscles extraoculaires peuvent aussi être atteints. Cependant, la pupille est toujours épargnée dans la myasthénie. o Behcet • La maladie de Behcet est une condition inflammatoire chronique qui se manifeste principalement par des petits ulcères sur la muqueuse orale, mais aussi par plusieurs autres manifestations y inclus une atteinte oculaire. L’uvéite bilatérale sporadique est le signe prédominant, mais il est aussi possible d’avoir un hypopyon (qui est une accumulation de cellules inflammatoires dans le segment antérieur, formant un niveau blanc derrière la cornée), ou presque tout autre atteinte occulaire – comme les occlusions vasculaires, une vasculite rétinienne, une néovascularisation, des cataractes et une ulcération conjonctivale. o Crohn’s • La maladie de Crohn’s, une inflammation inappropriée de l’appareil digestif, peut aussi comporter des manifestations occulaires comme l’uvéite, l’épisclérite et la sclérite. o Sarcoïdose • ¼ des patients atteints de la sarcoïdose auront des manifestations oculaires. Ils sont à risque d’uvéite, de glaucome, des thromboses veineuses rétiniennes et autres. • Génétique o Marfan • La manifestation oculaire cardinale de la maladie de Marfan est l’ectopie lenticulaire. Le cristallin est habituellement délogé vers le haut. Les personnes atteintes du syndrome de Marfan sont aussi plus fréquemment myopes et subissent plus fréquemment des décollements rétiniens. • Insuffisance rénale o Les manifestations ophtalmologiques sont très utiles dans la maladie rénale pour indiquer l’efficacité et le besoin pour le traitement. L’urémie peut s’accompagner d’érythème conjonctival, d’une calcification des structures et d’une cécité corticale transitoire. Les cataractes peuvent être le premier signe d’insuffisance rénale. o Le syndrome d’Alport est un syndrome génétique regroupant défaillance rénale et surdité avant l’âge de 20 ans. Ces patients ont aussi diverses atteintes oculaires, comme une rétinopathie et un cristallin en forme de cône. o L’anémie falciforme peut provoquer une prolifération vasculaire sur la rétine et des stries angioïdes qui ressemblent à des vergetures sur la rétine. Les stries angioïdes peuvent aussi être trouvées dans la maladie de Paget, le syndrome de Marfan et le syndrome Ehlers-Danlos. • Atopie o La conjonctivite la plus fréquente dans la population générale est la conjonctivite allergique, qui est relativement bénigne. • Syndrome du bébé secoué o Un examen ophtalmologique doit être effectué à chaque visite sur tous les bébés. Chez un bébé sans antécédents clairs qui pourraient expliquer les signes, des trouvailles d’hémorragies rétiniennes, sous rétiniennes ou du vitré, ou des plis dans la rétine ou un œdème papillaire, augmente fortement la suspicion d’abus. Un examen complet doit ensuite être effectué et bien documenté pour poser le diagnostique du syndrome du bébé secoué. • Infectieuse o VIH • 75% des patients atteints du VIH ont des signes et symptômes oculaires. • Le VIH comme tel peut causer une rétinopathie caractérisée par des cotton wool spots, des hémoragies rétiniennes. • L’état immunodéprimé rend le patient susceptible aux infections opportunistes, comme les kératopathies, les rétinities ou les choroïdites qui peuvent être causées par un virus herpétique, le CMV, pneumocystis carinii, Candida albicans ou le toxoplasmose. • Suite à un traitement efficace aux antirétroviraux, le système immunitaire peut combattre une rétinite aux CMV, et l’inflammation peut causer une atteinte de la vision. • Le sarcome de Kaposi, un néoplasme vasculaire fortement associé à l’infection au VIH, peut s’exprimer sur la conjonctive palpébrale ou bulbaire.