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(1146)

Podcast # 335: Blunt Head Trauma

Podcast # 335: Blunt Head Trauma

Author: Peter Bakes, M.D. Educational Pearls: Epidural hematomas have a characteristic convex appearance on CT while a subdural hematoma will have a concave appearance. Indications for operative ...

29 Touko 20188min

Podcast #334 - Resuscitative Thoracotomy

Podcast #334 - Resuscitative Thoracotomy

Author: Dylan Luyten, MD Educational Pearls: Resuscitative thoracotomies are most commonly used for treatment of cardiac tamponade and to selectively perfuse the brain and heart in setting of hemor...

25 Touko 20187min

Podcast #333 - TBI Prognosticators

Podcast #333 - TBI Prognosticators

Author: Michael Hunt, MD Educational Pearls: Studies have shown that patients with decreasing GCS scores have worse outcomes, however GCS of 4 has worse outcome than GCS 3. Alternative scoring sy...

23 Touko 20183min

Podcast #332 - Door To Furosemide Time

Podcast #332 - Door To Furosemide Time

Author: Nick Hatch, MD Educational Pearls: Recent study argues that CHF patients receiving furosemide within 60 minutes of arrival had a lower in-hospital mortality than those receiving it after (2...

21 Touko 20182min

Podcast # 331:  Oral Rehydration Therapy (ORT)

Podcast # 331: Oral Rehydration Therapy (ORT)

Author: Nick Hatch, MD Educational Pearls: The sodium-glucose cotransporter in the gut is essential for rehydration. Oral rehydration therapies require an equimolar concentration of glucose and s...

19 Touko 20184min

Podcast # 330:  Behcet Disease

Podcast # 330: Behcet Disease

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 concernin...

17 Touko 20184min

Podcast # 329:  Hypokalemic Periodic Paralysis

Podcast # 329: Hypokalemic Periodic Paralysis

Author: Dylan Luyten , MD Educational Pearls: Rare autosomal dominant condition that is often misdiagnosed as a psychiatric illness. Presents as profound muscle weakness with frank paralysis that...

15 Touko 20183min

Podcast # 328:  Sleep Deprivation

Podcast # 328: Sleep Deprivation

Author: Sam Killian, MD Educational Pearls: Insufficient sleep and disrupted circadian rhythms are a major health problem today Millions of dollars, thousands of deaths, and millions of injuri...

11 Touko 20185min

Suosittua kategoriassa Tiede

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