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

Avsnitt(1146)

Podcast #375: Retrograde Urethrogram

Podcast #375: Retrograde Urethrogram

Author: Jared Scott, MD Educational Pearls: Blood at urethral meatus in trauma can be a sign of bladder/urethral injury Blind placement of a Foley catheter can make an undiagnosed urethral injur...

6 Sep 20185min

Podcast #374:  Iliac Artery Endofibrosis

Podcast #374: Iliac Artery Endofibrosis

Author:  Sue Chilton, MD Educational Pearls:   An unusual cause of leg pain that can mimic sciatica/claudication Predominantly occurring in high endurance athletes, particularly cyclists and runner...

4 Sep 20183min

Podcast # 373: Legionnaires Disease

Podcast # 373: Legionnaires Disease

Author: Gretchen Hinson, MD Educational Pearls: Legionnaires disease refers to a severe pneumonia caused by Legionella pneumophilia and occurs typically at the extremes of age Associated gastroi...

1 Sep 20183min

Podcast # 372:  The Latest on Epinephrine in Cardiac Arrest

Podcast # 372: The Latest on Epinephrine in Cardiac Arrest

Author: Don Stader, MD Educational Pearls: 8014 patients with out-of-hospital cardiac arrest randomized to epinephrine vs placebo 30-day survival was not dramatically better between groups (3.2%...

30 Aug 20183min

Podcast # 371: EKG changes of Hyperkalemia

Podcast # 371: EKG changes of Hyperkalemia

Author: Jared Scott, MD Educational Pearls: EKG changes do not necessarily correlate to degree of hyperkalemia Traditional progression through peaked T-waves, flattened p-waves, QRS widening, an...

28 Aug 20183min

Podcast # 370:  Rapid Fire Neonatal Resuscitation

Podcast # 370: Rapid Fire Neonatal Resuscitation

Author:  Erik Verzemnieks, MD Educational Pearls:   In the panic of a precipitous ED delivery, remember: Warm. Dry. Stim.  It will solve most of your problems in most scenarios Start compressions i...

24 Aug 20181min

Podcast # 369:  Five powerful toxins - the definitive list?

Podcast # 369: Five powerful toxins - the definitive list?

Author: Michael Hunt, MD Educational Pearls: Here is a list of some very toxic natural substances:     #5: Tetrodotoxin: Found in pufferfish and other aquatic species #4: Ricin: made from castor beans...

22 Aug 20183min

Podcast # 368: Prehospital Plasma

Podcast # 368: Prehospital Plasma

Author: Aaron Lessen, MD Educational Pearls: Non-blinded randomized study assessing 30-day mortality benefit from plasma-first resuscitation in patients at risk hemorrhagic shock Study involved a...

20 Aug 20182min

Populärt inom Vetenskap

dumma-manniskor
svd-nyhetsartiklar
p3-dystopia
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
rss-ufo-bortom-rimligt-tvivel
rss-vetenskapsradion
pojkmottagningen
sexet
rss-vetenskapsradion-2
dumforklarat
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
medicinvetarna
halsorevolutionen
bildningspodden
rss-experimentet
rss-spraket
hacka-livet
vetenskapsradion