A pragmatic approach to monitor for adrenal axis recovery after a failed short synacthen test.

Objective: To identify a morning cortisol threshold value which confirms non-recovery of the adrenal axis and therefore negates the need for a Short Synacthen test (SST) in those with known adrenal axis insufficiency.

Methods: We collected data from all SSTs (n=1,570 tests; n=952 individuals) conducted in our hospital over a 10-year period spanning between 01/02/2013 and 30/01/2023. We included all tests where baseline cortisol levels were taken before 9:30am.

Abnormal breathing pattern features in chronic refractory cough.

Background: Chronic refractory cough (CRC) is a challenging condition that responds to speech pathology intervention. Clinical observation suggests abnormal breathing patterns occur in CRC and may be indirectly addressed as part of behavioural treatment, yet breathing pattern changes in CRC are poorly understood. The aims of this study were to 1) describe breathing patterns in patients with CRC, 2) compare breathing pattern features between patients with CRC and inducible laryngeal obstruction (ILO), and 3) estimate the effect of breathing pattern features on clinical measures of laryngeal sensory and motor dysfunction.

Immune checkpoint inhibitor induced hypophysitis: a specific disease of corticotrophs?

Introduction: The aim of this study was to define functional and anatomical pituitary disease at the time of presentation following immune checkpoint inhibitor (ICI) therapy and to describe any changes in pituitary function over time.

Methods: We conducted a retrospective observational audit of patients on ICI therapy at our centre between January 2013 and September 2023. We reviewed all patients on ICI therapy under the care of the oncology department at University Hospital Plymouth, a 1000-bedded hospital serving a population of 500,000 people.

Targeting both GD2 and B7-H3 using bispecific antibody improves tumor selectivity for GD2-positive tumors.

Objectives: Disialoganglioside 2 (GD2), overexpressed by cancers such as melanoma and neuroblastoma, is a tumor antigen for targeted therapy. The delivery of conventional IgG antibody technologies targeting GD2 is limited clinically by its co-expression on nerves that contributes to toxicity presenting as severe neuropathic pain. To improve the tumor selectivity of current GD2-targeting approaches, a next-generation bispecific antibody targeting GD2 and B7-H3 (CD276) was generated.