Atypical diagnosis for typical lung carcinoid

Background - The diagnosis of lung typical carcinoid tumors results challenging when limited size and unfavorable sampling location is associated. It has been reported that bronchoscopy with endobronchial ultrasound (EBUS) significantly increases the diagnostic yield of peripheral nodules smaller than 2 cm. Case presentation - A 70-year-old Caucasian male complained of persistent fever and cough despite several antibiotic courses and steroid treatment. Chest radiology revealed the presence of a small single nodular opacity in the left upper lobe, whose standardized maximum uptake value (SUV) at fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) was significantly high (4.5). The patient underwent bronchial endoscopy but any appreciable sign of endobronchial or intramural involvement was detected. Only radial ultrasound-guided bronchoscopy (R-EBUS) allowed transbronchial sampling whose pathological analysis revealed a typical carcinoid tumor. The patients underwent surgical lobectomy and clinic-radiological follow was started. Conclusions- With this case we aim at stressing the importance of ultrasound in the diagnostic process of lung small peripheral carcinoid, especially if they present without mucosal or sub mucosal involvement

A hot cocoon in the ultralong GRB 130925A: hints of a PopIII-like progenitor in a low density wind environment

GRB 130925A is a peculiar event characterized by an extremely long gamma-ray duration ($\approx$7 ks), as well as dramatic flaring in the X-rays for $\approx$20 ks. After this period, its X-ray afterglow shows an atypical soft spectrum with photon index $\Gamma$$\sim$4, as observed by Swift and Chandra, until $\approx 10^7$ s, when XMM-Newton observations uncover a harder spectral shape with $\Gamma$$\sim$2.5, commonly observed in GRB afterglows. We find that two distinct emission components are needed to explain the X-ray observations: a thermal component, which dominates the X-ray emission for several weeks, and a non-thermal component, consistent with a typical afterglow. A forward shock model well describes the broadband (from radio to X-rays) afterglow spectrum at various epochs. It requires an ambient medium with a very low density wind profile, consistent with that expected from a low-metallicity blue supergiant (BSG). The thermal component has a remarkably constant size and a total energy consistent with those expected by a hot cocoon surrounding the relativistic jet. We argue that the features observed in this GRB (its ultralong duration, the thermal cocoon, and the low density wind environment) are associated with a low metallicity BSG progenitor and, thus, should characterize the class of ultralong GRBs.Comment: 6 pgs, 3 figs, fig1 revised, ApJL in pres

rates of latent tuberculosis infection using different diagnostica test

Background.The interferon−g−release assays (IGRA) are emerging as an attractive alternative to the tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection (LTBI).The absence of a gold standard for LTBI hampers the assessment of any diagnostic test. Methods.In a prospective study,229 patients (mean age 35.5±24.6 y) from different ward of the Hospital (Respiratory Diseases,Dermatology, Rheumatology, Pediatrics, Infectious Diseases, Hematology and Transplant Unit) were simultaneously tested for a suspect of either LTBI or active tuberculosis using all commercially available diagnostics: TST,QuantiFERON−TB Gold (QFT−2G), QuantiFERON−TB Gold In−Tube(QFT−3G) and T−SPOT.TB(TS.TB). Results. 42(18.3%),37(16.2%),59(25.8%) and 79(34.5%) patients were positive with TST,QFT−2G,QFT−3G and TS.TB, respectively.TS.TB(p<0.001) and QFT−3G(p=0.016) provided more positive results than TST, while no difference was found for TST and QFT−2G(p=0.53).All IGRA showed a good overall agreement (TS.TB vs QFT−2G,k=0.55; TS.TB vs QFT−3G,k=0.72;QFT−2G vs QFT−3G, k=0.62). In 22 subjects (9.6%) QFT−3G was positive and QFT−2G negative. Indeterminate results were more frequent with QFT−2G(18.3%) and QFT−3G (12.7%) than with TS.TB(1.3%,p<0.0001). Conclusion. Rates of LTBI as detected by different diagnostic tests may have significant variations. Performances of various IGRA formats were variable in this population

Cardiovascular Risk Profile in Subjects With Prediabetes and New-Onset Type 2 Diabetes Identified by HbA 1c According to American Diabetes Association Criteria

OBJECTIVE We investigated the cardiovascular risk profile in subjects with prediabetes and new-onset type 2 diabetes identified by glycated hemoglobin A 1c (HbA 1c ) according to the new American Diabetes Association criteria. RESEARCH DESIGN AND METHODS Arterial stiffness, intima-media thickness (IMT), soluble receptor for advanced glycation end products (sRAGEs), and oral glucose tolerance test (OGTT) were evaluated in 274 subjects without a previous history of diabetes. The subjects were stratified into three groups according to the HbA 1c levels. RESULTS The subjects with prediabetes ( n = 117, HbA 1c 5.7–6.4% [39–46 mmol/mol]) showed a higher augmentation (Aug), augmentation index (AugI), and IMT compared with those with lower HbA 1c ; however, these values were similar to those of subjects with HbA 1c >6.5% (48 mmol/mol). When we further analyzed the subjects with prediabetes but included only subjects with normal glucose tolerance (NT) in the analysis, AugI and IMT still remained significantly higher than their levels in control subjects with HbA 1c 1c , age, and sRAGE were significantly correlated with the IMT, whereas age and 1-h postload glucose were the major determinants of AugI. CONCLUSIONS Our data show that subjects with prediabetes according to HbA 1c , but with both NT according to the OGTT and normal fasting glycemia, have an altered IMT and AugI. These data suggest that a simple, reproducible, and less expensive marker such as HbA 1c may be better able to identify prediabetic subjects at high cardiovascular risk compared with fasting glycemia or OGTT alone

Spring honey bee losses in Italy

Honey bee poisoning incidents and monitoring schemes Background: During last years several cases of bee losses have been reported during the period of corn sowing in different European countries. In Italy an institutional system for bee losses survey does not exist and therefore some Italian regions decided to organise an official network to collect data and analyse dead bee samples. Results: Collected data indicate that the higher number of bee losses events occurred in intensively cultivated flat areas, located in the North of Italy, mainly during or after corn sowing. The chemical analyses of dead bees revealed the presence of three neonicotinoid residues: imidacloprid was found in 25.7% of the sample, thiamethoxam in 2.8%, clothianidin in 25.7%, both imidacloprid and thiamethoxam in 4.7%. The visual examination and the virological analyses excluded pathological causes. Conclusion: The spatial and temporal correlation between hive damages and corn sowing and the presence of residues of active ingredients used for seed dressing (imidacloprid, thiamethoxam and clothianidin) in almost half of the samples confirms the connection between spring mortality and the sowing of corn seed dressed with neonicotinoids. Keywords: honeybee mortality, neonicotinoids, seed dressing, corn sowing, dust dispersion.      

Formation of N,N,N′,N′-tetramethylformamidinium disulphide from the chemical and electrochemical oxidation of tetramethylthiourea : Vibrational spectra and crystal structure of the chloride dihydrate salt

The N,N,N′,N′-tetramethylformamidinium disulphide (TMFDS) was prepared from either the electro-oxidation of tetramethylthiourea (TMTU) on platinum electrodes in aqueous perchloric acid solution or the chemical oxidation of TMTU with hydrogen peroxide in hydrochloric acid-containing absolute ethanol. The electrochemical formation of TMFDS at different potentials was followed by in situ FTIRRAS spectroscopy. The IR and Raman spectra of TMFDS chemically formed as a chloride dihydrate were determined and compared to the product produced electrochemically. The crystal structure of the chloride salt [N(CH3)2]2C=S-S=C [N(CH3)2]2Cl2·2H2O, as determined by X-ray diffraction, crystallises in the monoclinic C2/c space group with a = 23.267(1), b = 10.824(1), c = 17.774(1) Å, β = 126.91(1)°, and Z = 8. The structure was solved from 2489 reflections with I > 2σ(I) and refined to an agreement R1-factor of 0.0405. The two molecular halves of the dimeric [N(CH3)2]2CSSC[N(CH3)2]22+ ion are linked by a disulphide single bond [d(S-S) = 2.0454(9) Å] and related to each other by a non-crystallographic pseudo two-fold axis. DFT structure optimisation and normal mode frequencies were calculated using the 6-311G(d,f) basis set at DFT theory level. An estimation of the free energy for the dimer formation and rate ratio for the homogeneous and heterogeneous processes are presented. These data are consistent with the electrochemical mechanism of the anodic formation of TMFDS2+ from TMTU electro-oxidation in acid solutions.Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicada

Crystal and molecular structure and spectroscopic properties of tris(o-phenanthroline)iron(II) nitroprusside dihydrate: [Fe(o-phen)₃]-[Fe(CN)₅NO]·2H₂O

The crystal and molecular structure of the title compound has been determined by X-ray diffraction methods. It crystallizes in the monoclinic space groupP2₁/n witha=10.072(2),b=19.434(7),c=19.462(3) Å,β=101.07(1)° andZ=4. The anion has a geometry similar to that observed in other related complexes. The two water molecules are hydrogen bonded to each other and are located at van der Waals distances from nitrogen atoms of neighbor nitroprusside anions.Facultad de Ciencias Exacta

Searching for the radio remnants of short duration gamma-ray bursts

Neutron star mergers produce a substantial amount of fast-moving ejecta, expanding outwardly for years after the merger. The interaction of these ejecta with the surrounding medium may produce a weak isotropic radio remnant, detectable in relatively nearby events. We use late-time radio observations of short duration gamma-ray bursts (sGRBs) to constrain this model. Two samples of events were studied: four sGRBs that are possibly in the local (<200 Mpc) universe were selected to constrain the remnant non-thermal emission from the sub-relativistic ejecta, whereas 17 sGRBs at cosmological distances were used to constrain the presence of a proto-magnetar central engine, possibly re-energezing the merger ejecta. We consider the case of GRB~170817A/GW170817, and find that in this case the early radio emission may be quenched by the jet blast-wave. In all cases, for ejecta mass range of M_ej \lesssim 10^{-2} (5 * 10^{-2}) M_sun, we can rule out very energetic merger ejecta E_ej \gtrsim 5 * 10^{52}(10^{53}) erg, thus excluding the presence of a powerful magnetar as a merger remnant.Comment: 13 pages, 8 figures, 3 tables. Submitted to MNRA

Late-time radio observations of the short GRB200522A: constraints on the magnetar model

GRB200522A is a short duration gamma-ray burst (GRB) at redshift $z$=0.554 characterized by a bright infrared counterpart. A possible, although not unambiguous, interpretation of the observed emission is the onset of a luminous kilonova powered by a rapidly rotating and highly-magnetized neutron star, known as magnetar. A bright radio flare, arising from the interaction of the kilonova ejecta with the surrounding medium, is a prediction of this model. Whereas the available dataset remains open to multiple interpretations (e.g. afterglow, r-process kilonova, magnetar-powered kilonova), long-term radio monitoring of this burst may be key to discriminate between models. We present our late-time upper limit on the radio emission of GRB200522A, carried out with the Karl G. Jansky Very Large Array at 288 days after the burst. For kilonova ejecta with energy $E_{\rm ej} \approx 10^{53} \rm erg$, as expected for a long-lived magnetar remnant, we can already rule out ejecta masses $M_{\rm ej} \lesssim0.03 \mathrm{M}_\odot$ for the most likely range of circumburst densities $n\gtrsim 10^{-3}$ cm$^{-3}$. Observations on timescales of $\approx$3-10 yr after the merger will probe larger ejecta masses up to $M_{\rm ej} \sim 0.1 \mathrm{M}_\odot$, providing a robust test to the magnetar scenario