Spontaneous intra-adrenal massive hematoma: possible extreme evolution of a non-secreting untreated adrenal adenoma

The spontaneous adrenal hematoma is a rare event. An 83-year-old male patient presented a 26-cm asymptomatic retroperitoneal mass of doubtful renal-adrenal origin. He had been evaluated 10\ua0years before for an adrenal incidentaloma of 2.3\ua0cm and had refused surgery when it had reached 7\ua0cm. Later, the mass enlarged to 26\ua0cm and was surgically removed through an open anterior approach. The histopathology showed a solid 4\ua0kg mass of fibrinoid-hemorrhagic material, partially necrotic, mixed with adrenal tissue, with a well-vascularized capsule. No relapse is present at 6-month follow-up. This is the largest case described of spontaneous intra-adrenal hematoma in a case with previous non-secreting adrenal adenoma. The hematoma (a 4\ua0kg mass) developed 10\ua0years after the first diagnosis and exposed the patient to potential damage of the surrounding organs and to high-risk abdominal surgery. Long-term follow-up of non-secreting adrenal adenomas should be recommended

Plain fundamentals of Fundamental Planes: Analytics and algorithms

The coefficients a and b of the Fundamental Plane relation R ~ Sigma^a I^b depend on whether one minimizes the scatter in the R direction or orthogonal to the Plane. We provide explicit expressions for a and b (and confidence limits) in terms of the covariances between logR, logSigma and logI. Our analysis is more generally applicable to any other correlations between three variables: e.g., the color-magnitude-Sigma relation, the L-Sigma-Mbh relation, or the relation between the X-ray luminosity, Sunyaev-Zeldovich decrement and optical richness of a cluster, so we provide IDL code which implements these ideas, and we show how our analysis generalizes further to correlations between more than three variables. We show how to account for correlated errors and selection effects, and quantify the difference between the direct, inverse and orthogonal fit coefficients. We show that the three vectors associated with the Fundamental Plane can all be written as simple combinations of a and b because the distribution of I is much broader than that of Sigma, and Sigma and I are only weakly correlated. Why this should be so for galaxies is a fundamental open question about the physics of early-type galaxy formation. If luminosity evolution is differential, and Rs and Sigmas do not evolve, then this is just an accident: Sigma and I must have been correlated in the past. On the other hand, if the (lack of) correlation is similar to that at the present time, then differential luminosity evolution must have been accompanied by structural evolution. A model in which the luminosities of low-L galaxies evolve more rapidly than do those of higher-L galaxies is able to produce the observed decrease in a (by a factor of 2 at z~1) while having b decrease by only about 20 percent. In such a model, the Mdyn/L ratio is a steeper function of Mdyn at higher z.Comment: 11 pages, 1 figure, associated IDL code, MNRAS accepte

Full-length TrkB variant in NSCLC is associated with brain metastasis

Despite remarkable therapeutic advances have been made in the last few decades, non-small cell lung cancer (NSCLC) is still one of the leading causes of death worldwide. Brain metastases are a common complication of a wide range of human malignancies and in particular NSCLC. Brain-derived neurotrophic factor (BDNF), binding its high-affinity tyrosine kinase B receptor, has been shown to promote cancer progression and metastasis. We hereby investigated the expression of the BDNF and its TrkB receptor in its full-length and truncated isoform T1, in samples from primary adenocarcinomas (ADKs) of the lung and in their metastasis to evaluate if their expression was related to preferential tumor entry into the central nervous system (CNS). By immunohistochemistry, 80% of the ADKs that metastasize to central nervous system expressed TrkB receptor compared to 33% expressing of ADKs without CNS metastasis. Moreover, ADKs with CNS metastasis showed an elevated expression of the full-length TrkB receptor. The TrkB receptor FL/T1 ratio was statistically higher in primary ADKs with brain metastasis compared to ADKs without brain metastasis. Our data indicate that TrkB full-length isoform expression in primary ADK cells may be associated with higher risk to develop brain metastasis. Therefore, TrkB receptor may possess prognostic and therapeutic implications in lung ADK

Further constraining galaxy evolution models through the Size Function of SDSS Early-type galaxies

We discuss how the effective radius Phi(Re) function (ERF) recently worked out by Bernardi et al. (2009) represents a new testbed to improve the current understanding of Semi-analytic Models of Galaxy formation. In particular, we here show that a detailed hierarchical model of structure formation can broadly reproduce the correct peak in the size distribution of local early-type galaxies, although it significantly overpredicts the number of very compact and very large galaxies. This in turn is reflected in the predicted size-mass relation, much flatter than the observed one, due to too large (~3 kpc) low-mass galaxies (<10^11 \msun), and to a non-negligible fraction of compact ( 10^11 \msun). We also find that the latter discrepancy is smaller than previously claimed, and limited to only ultracompact (Re < 0.5 kpc) galaxies when considering elliptical-dominated samples. We explore several causes behind these effects. We conclude that the former problem might be linked to the initial conditions, given that large and low-mass galaxies are present at all epochs in the model. The survival of compact and massive galaxies might instead be linked to their very old ages and peculiar merger histories. Overall, knowledge of the galactic stellar mass {\em and} size distributions allows a better understanding of where and how to improve models.Comment: 15 pages, 10 Figures. Accepted by MNRA

Sizes and ages of SDSS ellipticals: Comparison with hierarchical galaxy formation models

In a sample of about 45,700 early-type galaxies extracted from SDSS, we find that the shape, normalization, and dispersion around the mean size-stellar mass relation is the same for young and old systems, provided the stellar mass is greater than 3*10^10 Msun. This is difficult to reproduce in pure passive evolution models, which generically predict older galaxies to be much more compact than younger ones of the same stellar mass. However, this aspect of our measurements is well reproduced by hierarchical models of galaxy formation. Whereas the models predict more compact galaxies at high redshifts, subsequent minor, dry mergers increase the sizes of the more massive objects, resulting in a flat size-age relation at the present time. At lower masses, the models predict that mergers are less frequent, so that the expected anti-correlation between age and size is not completely erased. This is in good agreement with our data: below 3*10^10 Msun, the effective radius R_e is a factor of ~2 lower for older galaxies. These successes of the models are offset by the fact that the predicted sizes have other serious problems, which we discuss.Comment: 13 pages, 9 Figures, 1 Table. Accepted by MNRA

Social cognition in people with schizophrenia: A cluster-analytic approach

Background The study aimed to subtype patients with schizophrenia on the basis of social cognition (SC), and to identify cut-offs that best discriminate among subtypes in 809 out-patients recruited in the context of the Italian Network for Research on Psychoses. Method A two-step cluster analysis of The Awareness of Social Inference Test (TASIT), the Facial Emotion Identification Test and Mayer-Salovey-Caruso Emotional Intelligence Test scores was performed. Classification and regression tree analysis was used to identify the cut-offs of variables that best discriminated among clusters. Results We identified three clusters, characterized by unimpaired (42%), impaired (50.4%) and very impaired (7.5%) SC. Three theory-of-mind domains were more important for the cluster definition as compared with emotion perception and emotional intelligence. Patients more able to understand simple sarcasm (14 for TASIT-SS) were very likely to belong to the unimpaired SC cluster. Compared with patients in the impaired SC cluster, those in the very impaired SC cluster performed significantly worse in lie scenes (TASIT-LI <10), but not in simple sarcasm. Moreover, functioning, neurocognition, disorganization and SC had a linear relationship across the three clusters, while positive symptoms were significantly lower in patients with unimpaired SC as compared with patients with impaired and very impaired SC. On the other hand, negative symptoms were highest in patients with impaired levels of SC. Conclusions If replicated, the identification of such subtypes in clinical practice may help in tailoring rehabilitation efforts to the person's strengths to gain more benefit to the person

Social cognition in people with schizophrenia: A cluster-analytic approach

Background The study aimed to subtype patients with schizophrenia on the basis of social cognition (SC), and to identify cut-offs that best discriminate among subtypes in 809 out-patients recruited in the context of the Italian Network for Research on Psychoses. Method A two-step cluster analysis of The Awareness of Social Inference Test (TASIT), the Facial Emotion Identification Test and Mayer-Salovey-Caruso Emotional Intelligence Test scores was performed. Classification and regression tree analysis was used to identify the cut-offs of variables that best discriminated among clusters. Results We identified three clusters, characterized by unimpaired (42%), impaired (50.4%) and very impaired (7.5%) SC. Three theory-of-mind domains were more important for the cluster definition as compared with emotion perception and emotional intelligence. Patients more able to understand simple sarcasm (14 for TASIT-SS) were very likely to belong to the unimpaired SC cluster. Compared with patients in the impaired SC cluster, those in the very impaired SC cluster performed significantly worse in lie scenes (TASIT-LI &lt;10), but not in simple sarcasm. Moreover, functioning, neurocognition, disorganization and SC had a linear relationship across the three clusters, while positive symptoms were significantly lower in patients with unimpaired SC as compared with patients with impaired and very impaired SC. On the other hand, negative symptoms were highest in patients with impaired levels of SC. Conclusions If replicated, the identification of such subtypes in clinical practice may help in tailoring rehabilitation efforts to the person's strengths to gain more benefit to the person

Prolonged higher dose methylprednisolone vs. conventional dexamethasone in COVID-19 pneumonia: a randomised controlled trial (MEDEAS)

Dysregulated systemic inflammation is the primary driver of mortality in severe COVID-19 pneumonia. Current guidelines favor a 7-10-day course of any glucocorticoid equivalent to dexamethasone 6 mg·day-1. A comparative RCT with a higher dose and a longer duration of intervention was lacking