Sclerotherapy for the management of rectal prolapse in children

Purpose Rectal prolapse is a commonly occurring and usually self-limited process in children. Surgical management is indicated for failures of conservative management. However, the optimal approach is unknown. The purpose of this study is to determine the efficacy of sclerotherapy for the management of rectal prolapse. Methods This was a retrospective review of children < 18 years with rectal prolapse who underwent sclerotherapy, predominantly with peanut oil (91%), between 1998 and 2015. Patients with imperforate anus or cloaca abnormalities, Hirschprung disease, or prior pull-through procedures were excluded. Results Fifty-seven patients were included with a median age of 4.9 years (interquartile range (IQR) 3.2–9.2) and median follow-up of 52 months (IQR 8–91). Twenty patients (n = 20/57; 35%) recurred at a median of 1.6 months (IQR 0.8–3.6). Only 3 patients experienced recurrence after 4 months. Nine of the patients who recurred (n = 9/20; 45%) were re-treated with sclerotherapy. This was successful in 5 patients (n = 5/9; 56%). Two patients (n = 2/20; 10%) experienced a mucosal recurrence which resolved with conservative management. Forty-four patients were thus cured with sclerotherapy alone (n = 44/57; 77%). No patients undergoing sclerotherapy had an adverse event. Thirteen patients (n = 13/20; 65%) underwent rectopexy after failing at least one treatment of sclerotherapy. Three of these patients (n = 3/13; 23%) recurred following rectopexy and required an additional operation. Conclusions Injection sclerotherapy for children with rectal prolapse resulted in a durable cure of prolapse in most children. Patients who recur following sclerotherapy tend to recur within 4 months. Another attempt at sclerotherapy following recurrence is reasonable and was successful half of the time. Sclerotherapy should be the preferred initial treatment for rectal prolapse in children and for the initial treatment of recurrence

Safety and improved efficacy signals following gene therapy in childhood blindness caused by GUCY2D mutations

A first-in-human clinical trial of gene therapy in Leber congenital amaurosis due to mutations in the GUCY2D gene is underway, and early results are summarized. A recombinant adeno-associated virus serotype 5 (rAAV5) vector carrying the human GUCY2D gene was delivered by subretinal injection to one eye in three adult patients with severe visual loss, nystagmus, but preserved retinal structure. Safety and efficacy parameters were monitored for 9 months post-operatively. No systemic toxicity was detected; there were no serious adverse events, and ocular adverse events resolved. P1 and P2 showed statistically significant rod photoreceptor vision improvement by full-field stimulus testing in the treated eye. P1 also showed improvement in pupillary responses. Visual acuity remained stable from baseline in P1 and P2. P3, however, showed a gain of 0.3 logMAR in the treated eye, indicating greater cone-photoreceptor function. The results show safety and both rod- and cone-mediated efficacy of this therapy

Search for a vector-like quark T′ → tH via the diphoton decay mode of the Higgs boson in proton-proton collisions at s \sqrt{s} = 13 TeV

A search for the electroweak production of a vector-like quark T′, decaying to a top quark and a Higgs boson is presented. The search is based on a sample of proton-proton collision events recorded at the LHC at = 13 TeV, corresponding to an integrated luminosity of 138 fb−1. This is the first T′ search that exploits the Higgs boson decay to a pair of photons. For narrow isospin singlet T′ states with masses up to 1.1 TeV, the excellent diphoton invariant mass resolution of 1–2% results in an increased sensitivity compared to previous searches based on the same production mechanism. The electroweak production of a T′ quark with mass up to 960 GeV is excluded at 95% confidence level, assuming a coupling strength κT = 0.25 and a relative decay width Γ/MT′ < 5%

Measurement of the Higgs boson inclusive and differential fiducial production cross sections in the diphoton decay channel with pp collisions at s \sqrt{s} = 13 TeV

The measurements of the inclusive and differential fiducial cross sections of the Higgs boson decaying to a pair of photons are presented. The analysis is performed using proton-proton collisions data recorded with the CMS detector at the LHC at a centre-of-mass energy of 13 TeV and corresponding to an integrated luminosity of 137 fb$^{−1}$. The inclusive fiducial cross section is measured to be $σ_{fid}$=73.4$^{+5.4}_{−5.3}$(stat)$^{+2.4}_{−2.2}$(syst) fb, in agreement with the standard model expectation of 75.4 ± 4.1 fb. The measurements are also performed in fiducial regions targeting different production modes and as function of several observables describing the diphoton system, the number of additional jets present in the event, and other kinematic observables. Two double differential measurements are performed. No significant deviations from the standard model expectations are observed

A search for new physics in central exclusive production using the missing mass technique with the CMS detector and the CMS-TOTEM precision proton spectrometer

A generic search is presented for the associated production of a Z boson or a photon with an additional unspecified massive particle X, pp → pp + Z/γ + X, in proton-tagged events from proton–proton collisions at √s = 13 TeV, recorded in 2017 with the CMS detector and the CMS-TOTEM precision proton spectrometer. The missing mass spectrum is analysed in the 600–1600 GeV range and a fit is performed to search for possible deviations from the background expectation. No significant excess in data with respect to the background predictions has been observed. odelindependent upper limits on the visible production cross section of pp → pp + Z/γ + X are set

Search for Higgs Boson Decay to a Charm Quark-Antiquark Pair in Proton-Proton Collisions at √s = 13 TeV

A search for the standard model Higgs boson decaying to a charm quark-antiquark pair, H→c¯c, produced in association with a leptonically decaying V (W or Z) boson is presented. The search is performed with proton-proton collisions at √s=13  TeV collected by the CMS experiment, corresponding to an integrated luminosity of 138  fb−1. Novel charm jet identification and analysis methods using machine learning techniques are employed. The analysis is validated by searching for Z→c¯c in VZ events, leading to its first observation at a hadron collider with a significance of 5.7 standard deviations. The observed (expected) upper limit on σ(VH)B(H→c¯c) is 0.94 (0.50+0.22−0.15)pb at 95% confidence level (C.L.), corresponding to 14 (7.6+3.4−2.3) times the standard model prediction. For the Higgs-charm Yukawa coupling modifier, κc, the observed (expected) 95% C.L. interval is 1.1<|κc|<5.5 (|κc|<3.4), the most stringent constraint to date

Measurement of the top quark mass using events with a single reconstructed top quark in pp collisions at s\sqrt{s} = 13 TeV

A measurement of the top quark mass is performed using a data sample enriched with single top quark events produced in the t channel. The study is based on proton- proton collision data, corresponding to an integrated luminosity of 35.9 fb$^{-1}$, recorded at $\sqrt{s}$ = 13 TeV by the CMS experiment at the LHC in 2016. Candidate events are selected by requiring an isolated high-momentum lepton (muon or electron) and exactly two jets, of which one is identified as originating from a bottom quark. Multivariate discriminants are designed to separate the signal from the background. Optimized thresholds are placed on the discriminant outputs to obtain an event sample with high signal purity. The top quark mass is found to be 172.13$^{+0.76}$$_{-0.77}$ GeV, where the uncertainty includes both the statistical and systematic components, reaching sub-GeV precision for the first time in this event topology. The masses of the top quark and antiquark are also determined separately using the lepton charge in the final state, from which the mass ratio and difference are determined to be 0.9952$^{+0.0079}$$_{-0.0104}$ and 0.83$^{+1.79}$$_{-1.35}$ GeV, respectively. The results are consistent with CPT invariance