Evidence for possible involvement of 5-HT(2B) receptors in the cardiac valvulopathy associated with fenfluramine and other serotonergic medications

Background—Serotonergic medications with various mechanisms of action are used to treat psychiatric disorders and are being investigated as treatments for drug dependence. The occurrence of fenfluramine-associated valvular heart disease (VHD) has raised concerns that other serotonergic medications might also increase the risk of developing VHD. We hypothesized that fenfluramine or its metabolite norfenfluramine and other medications known to produce VHD have preferentially high affinities for a particular serotonin receptor subtype capable of stimulating mitogenesis. Methods and Results—Medications known or suspected to cause VHD (positive controls) and medications not associated with VHD (negative controls) were screened for activity at 11 cloned serotonin receptor subtypes by use of ligand-binding methods and functional assays. The positive control drugs were (±)-fenfluramine; (+)-fenfluramine; (−)-fenfluramine; its metabolites (±)-norfenfluramine, (+)-norfenfluramine, and (−)-norfenfluramine; ergotamine; and methysergide and its metabolite methylergonovine. The negative control drugs were phentermine, fluoxetine, its metabolite norfluoxetine, and trazodone and its active metabolite m-chlorophenylpiperazine. (±)-, (+)-, and (−)-Norfenfluramine, ergotamine, and methylergonovine all had preferentially high affinities for the cloned human serotonin 5-HT2B receptor and were partial to full agonists at the 5-HT2B receptor. Conclusions—Our data imply that activation of 5-HT2B receptors is necessary to produce VHD and that serotonergic medications that do not activate 5-HT2B receptors are unlikely to produce VHD. We suggest that all clinically available medications with serotonergic activity and their active metabolites be screened for agonist activity at 5-HT2B receptors and that clinicians should consider suspending their use of medications with significant activity at 5-HT2B receptors

Renal cell carcinoma metastasis to the ciliary body responds to proton beam radiotherapy: a case report

<p>Abstract</p> <p>Introduction</p> <p>We report an unexpected presentation of metastatic renal cell carcinoma (RCC) to the ciliary body and an interesting response to proton beam radiotherapy.</p> <p>Case presentation</p> <p>We encountered a case of angle-closure glaucoma as the initial presentation of ocular metastasis to the ciliary body in a 65-year-old Caucasian man who had undergone right radical nephrectomy for RCC 15 years earlier. He underwent YAG (yttrium aluminium garnet) laser peripheral iridotomy while further metastatic workup took place. His condition was eventually diagnosed as stage IV metastatic RCC of the clear cell type and involved multiple sites, including the ciliary body, brain, lungs, liver, and pancreas. The progression of RCC metastasis to the ciliary body was studied for 16 months. The ciliary body mass continued to grow despite systemic treatment with temsirolimus and interleukin-2 and intravitreal injections of bevacizumab. The tumor size peaked at 6.11 × 6.06 mm before the start of proton therapy, which reduced the tumor size to 5.07 × 4.39 mm.</p> <p>Conclusions</p> <p>RCC can produce metastases involving unusual sites many years after resection of the primary tumor. Proton therapy was found to be effective in treating RCC metastasis to the ciliary body in settings in which other treatment modalities failed.</p

Measurement of the Z boson differential production cross section using its invisible decay mode (Z -> nu(nu)over-bar) in proton-proton collisions at root s=13 TeV

Measurements of the total and differential fiducial cross sections for the Z boson decaying into two neutrinos are presented at the LHC in proton-proton collisions at a center-of-mass energy of 13TeV. The data were collected by the CMS detector in 2016 and correspond to an integrated luminosity of 35.9 fb(-1). In these measurements, events are selected containing an imbalance in transverse momentum and one or more energetic jets. The fiducial differential cross section is measured as a function of the Z boson transverse momentum. The results are combined with a previous measurement of charged-lepton decays of the Z boson. The measured total fiducial cross section for events with Z boson transverse momentum greater than 200 GeV is 3000(-170)(+180) fb.Peer reviewe

Study of Drell-Yan dimuon production in proton-lead collisions at root s(NN )=8.16 TeV

Differential cross sections for the Drell-Yan process, including Z boson production, using the dimuon decay channel are measured in proton-lead (pPb) collisions at a nucleon-nucleon centre-of-mass energy of 8.16 TeV. A data sample recorded with the CMS detector at the LHC is used, corresponding to an integrated luminosity of 173 nb(-1). The differential cross section as a function of the dimuon mass is measured in the range 15-600 GeV, for the first time in proton-nucleus collisions. It is also reported as a function of dimuon rapidity over the mass ranges 15-60 GeV and 60-120 GeV, and ratios for the p-going over the Pb-going beam directions are built. In both mass ranges, the differential cross sections as functions of the dimuon transverse momentum p(T), and of a geometric variable phi* are measured, where phi* highly correlates with p(T), but is determined with higher precision. In the Z mass region, the rapidity dependence of the data indicate a modification of the distribution of partons within a lead nucleus as compared to the proton case. The data are more precise than predictions based upon current models of parton distributions.Peer reviewe

Measurement of differential cross sections for Z bosons produced in association with charm jets in pp collisions at root s=13 TeV

Measurements are presented of differential cross sections for the production of Z bosons in association with at least one jet initiated by a charm quark in pp collisions at root s = 13 TeV. The data recorded by the CMS experiment at the LHC correspond to an integrated luminosity of 35.9 fb(-1). The final states contain a pair of electrons or muons that are the decay products of a Z boson, and a jet consistent with being initiated by a charm quark produced in the hard interaction. Differential cross sections as a function of the transverse momentum p(T) of the Z boson and p(T) of the charm jet are compared with predictions from Monte Carlo event generators. The inclusive production cross section 405.4 +/- 5.6 (stat) +/- 24.3 (exp) +/- 3.7 (theo) pb, is measured in a fiducial region requiring both leptons to have pseudorapidity |eta| 10 GeV, at least one lepton with p(T)> 26 GeV, and a mass of the pair in the range 71-111 GeV, while the charm jet is required to have p(T)> 30 GeV and |eta| < 2.4. These are the first measurements of these cross sections in proton-proton collisions at 13 TeV.Peer reviewe

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe

Probing effective field theory operators in the associated production of top quarks with a Z boson in multilepton final states at root s=13 TeV

Peer reviewe

Measurements of the Electroweak Diboson Production Cross Sections in Proton-Proton Collisions at root s=5.02 TeV Using Leptonic Decays

The first measurements of diboson production cross sections in proton-proton interactions at a center-of-mass energy of 5.02 TeV are reported. They are based on data collected with the CMS detector at the LHC, corresponding to an integrated luminosity of 302 pb(-1). Events with two, three, or four charged light leptons (electrons or muons) in the final state are analyzed. The WW, WZ, and ZZ total cross sections are measured as sigma(WW) = 37:0(-5.2)(+5.5) (stat)(-2.6)(+2.7) (syst) pb, sigma(WZ) = 6.4(-2.1)(+2.5) (stat)(-0.3)(+0.5)(syst) pb, and sigma(ZZ) = 5.3(-2.1)(+2.5)(stat)(-0.4)(+0.5) (syst) pb. All measurements are in good agreement with theoretical calculations at combined next-to-next-to-leading order quantum chromodynamics and next-to-leading order electroweak accuracy