Podcast 577:  Immunotherapies

Podcast 577: Immunotherapies

Contributor: Don Stader, MD

Educational Pearls:

  • Checkpoint inhibition normally helps our body detect abnormal cells and terminate it but cancerous cells often are able to avoid this countermeasure
  • Monoclonal antibodies that bind to checkpoint inhibitors can stop cancerous cells from turning off immunologic T cells and allows the immune system to continue to attack cancers.
  • These therapies carry risks of exacerbating autoimmune problems due to the ramped up immune response
  • Most often this autoimmune attack leads to skin and GI symptoms but can affect many other organ systems. In the emergency room this can present many different ways, but the mainstay of treatment is steroids to stop these exacerbations.
  • Chimeric Antigen Receptor (CAR) T-cell Therapy is another immunotherapy where antigens to a cancerous cell are re-introduced to spur a directed immune response
  • Cytokine release syndrome can occur in these patients and mimic other presentations such as septic shock, a result of tumor break down
  • This is treated with steroids and monoclonal antibodies that help thwart the cytokine release

References

Hay, KA. Cytokine release syndrome and neurotoxicity after CD19 chimeric antigen receptor-modified (CAR-) T cell therapy. Br J Haematol. 2018 Nov;183(3):364-374. doi: 10.1111/bjh.15644. Epub 2018 Nov 8.

Hryniewicki AT, Wang C, Shatsky RA, Coyne CJ. Management of Immune Checkpoint Inhibitor Toxicities: A Review and Clinical Guideline for Emergency Physicians. J Emerg Med. 2018;55(4):489-502. doi:10.1016/j.jemermed.2018.07.005

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

Jaksot(1145)

Podcast 656: Rashes

Podcast 656: Rashes

Contributor:  Peter Bakes, MD Educational Pearls: Lyme disease gives a single expanding target lesion with central clearing called erythema chronicum migrans Erythema multiforme is another targetoid ...

7 Huhti 20217min

Podcast 655: Hypothermia in Sepsis

Podcast 655: Hypothermia in Sepsis

Contributor: Adam Barkin, MD Educational Pearls: Fever is an adaptive response to infection, but elderly and immunocompromised patients may not be able to mount a hyperthermic response in sepsis Pati...

6 Huhti 20213min

Podcast 654: Depression in COVID

Podcast 654: Depression in COVID

Contributor: Aaron Lessen, MD Educational Pearls: Survey study compared depression symptom prevalence in the United States at the beginning of COVID compared to data acquired by a similar survey for...

5 Huhti 20213min

Podcast 653: Nitroglycerin Disimpaction

Podcast 653: Nitroglycerin Disimpaction

Contributor: Ricky Dhaliwal, MD, JD Educational Pearls: Glucagon administered intravenously has a high rate of adverse events (nausea/vomiting) with very weak evidence NItroglycerin too has very lim...

30 Maalis 20212min

Podcast 652: Prosthetic Hip Dislocation

Podcast 652: Prosthetic Hip Dislocation

Contributor: Jared Scott, MD Educational Pearls: While it is rare to have a native hip dislocation, it is relatively common to dislocate a prosthetic hip The mechanism for dislocation is usually add...

29 Maalis 20215min

Dr. Don Stader Shares Personal Experience of Losing his Mother to COVID-19 and Ruminates on the Culture of Death in Medicine (UnfilterED #12 Excerpt)

Dr. Don Stader Shares Personal Experience of Losing his Mother to COVID-19 and Ruminates on the Culture of Death in Medicine (UnfilterED #12 Excerpt)

A heartfelt excerpt from our most recent UnfilterED episode with Dr. Don Stader.

26 Maalis 202120min

Podcast 651: Hereditary Angioedema

Podcast 651: Hereditary Angioedema

Contributor: Katie Sprinkel, MD Educational Pearls: Hereditary angioedema (HA) is an autosomal dominant bradykinin-mediated disease affecting the airway, skin or gastrointestinal tract and typically...

23 Maalis 202110min

Podcast 650: PNES

Podcast 650: PNES

Contributor: Katie Sprinkel, MD Educational Pearls: Psychogenic Non-Epileptic Seizures (PNES) are due to a psychogenic rather than an epileptic cause Despite common assumption, PNES are not always v...

22 Maalis 20216min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-duodecim-lehti
docemilia
filocast-filosofian-perusteet
rss-ammamafia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-sosiopodi
utelias-mieli
radio-antro
rss-astetta-parempi-elama-podcast
rss-tiedetta-vai-tarinaa