ДЕВОН-КАМЕННОУГОЛЬНЫЙ МАГМАТИЗМ И ОРУДЕНЕНИЕ ЮЖНО-УРАЛЬСКОЙ АККРЕЦИОННО-КОЛЛИЗИОННОЙ СИСТЕМЫ

The oceanic stage in the history of the South Urals completed in the Ordovician – Early Silurian. The Ordovician through Devonian events in the region included the formation of an island arc in the East Ural zone from the Middle Ordovician to Silurian; westward motion of the subduction zone in the Late Silurian – Early Devonian and the origin of a trench along the Main Ural Fault and the Uraltau Uplift; volcanic eruptions and intrusions in the Magnitogorsk island arc system in the Devonian. The Middle-Late Paleozoic geodynamic evolution of uralides and altaides consisted in successive alternation of subduction and collisional settings at the continent-ocean transition. The greatest portion of volcanism in the major Magnitogorsk zone was associated with subduction and correlated in age and patterns of massive sulfide mineralization (VMS) with Early – Middle Devonian ore-forming events in Rudny Altai. Within-plate volcanism at the onset of volcanic cycles records the Early (D1e2) and Middle (D2ef2) Devonian slab break off. The volcanic cycles produced, respectively, the Buribay and Upper Tanalyk complexes with VMS mineralization in the Late Emsian; the Karamalytash complex and its age equivalents in the Late Eifelian – Early Givetian, as well as the lower Ulutau Formation in the Givetian. Slab break off in the Late Devonian – Early Carboniferous obstructed the Magnitogorsk island arc and supported asthenospheric diapirism. A new subduction zone dipping westward and the Aleksandrovka island arc formed in the Late Devonian – Early Carboniferous. The Early Carboniferous collision and another event of obstructed subduction led to a transform margin setting corresponding to postcollisional relative sliding of plates that produced another slab tear. Postcollisional magmatism appears as alkaline gabbro-granitic intrusives with related rich Ti-magnetite mineralization (C1). Transform faulting persisted in the Middle Carboniferous through Permian, when the continent of Eurasia completed its consolidation. The respective metallogenic events included formation of Cu-Ni picritic dolerites (C2–3), as well as large-scale gold and Mo-W deposits in granites (P1–2).Завершение океанической стадии на Южном Урале произошло в ордовик – раннесилурийское время. В среднем ордовике в Восточно-Уральской зоне начала формироваться среднеордовикско-силурийская островная дуга. В позднем силуре – раннем девоне произошел перескок зоны субдукции на запад, формирование глубоководного желоба в зоне Главного Уральского разлома – Уралтауского антиклинория и началось образование вулкано-интрузивных формаций Магнитогорской островодужной системы (D1–D3). В среднепозднепалеозойской геодинамической эволюции уралид и алтаид произошло последовательное чередование субдукционных и трансформно-коллизионных обстановок в зоне перехода континент – океан. На Южном Урале с субдукционной обстановкой связан главный объем вулканических ассоциаций Магнитогорской мегазоны. В раннем (D1e2) и среднем (D2ef2) девоне произошли разрывы слэба, фиксирующиеся проявлениями внутриплитного вулканизма, приуроченного к начальным этапам раннедевонского позднеэмсского и позднеэйфельско-раннеживетского колчеданоносных вулканических циклов. В позднем девоне – раннем карбоне произошла блокировка Магнитогорской островной дуги с разрывом слэба, и, как следствие, – главный этап астеносферного диапиризма. На рубеже позднего девона – раннего карбона сформировалась новая зона субдукции западного падения и возникла Александровская редуцированная островная дуга. Раннекаменноугольная коллизия и повторная блокировка субдукционной зоны привели к трансформной обстановке, отвечавшей постколлизионному скольжению литосферных плит, и вновь – к появлению астеносферного окна («slab-tear»). В этой обстановке были сформированы габбро-гранитные интрузивы повышенной щелочности и связанные с ними Ti-Mgt месторождения мирового класса (С1). Трансформная геодинамическая обстановка оставалась ведущей на протяжении среднего карбона – перми, когда произошла окончательная консолидация Евразийского континента

Comparison of Pheochromocytoma-Specific Morbidity and Mortality among Adults with Bilateral Pheochromocytomas Undergoing Total Adrenalectomy vs Cortical-Sparing Adrenalectomy

Importance: Large studies investigating long-term outcomes of patients with bilateral pheochromocytomas treated with either total or cortical-sparing adrenalectomies are needed to inform clinical management. Objective: To determine the association of total vs cortical-sparing adrenalectomy with pheochromocytoma-specific mortality, the burden of primary adrenal insufficiency after bilateral adrenalectomy, and the risk of pheochromocytoma recurrence. Design, Setting, and Participants: This cohort study used data from a multicenter consortium-based registry for 625 patients treated for bilateral pheochromocytomas between 1950 and 2018. Data were analyzed from September 1, 2018, to June 1, 2019. Exposures: Total or cortical-sparing adrenalectomy. Main Outcomes and Measures: Primary adrenal insufficiency, recurrent pheochromocytoma, and mortality. Results: Of 625 patients (300 [48%] female) with a median (interquartile range [IQR]) age of 30 (22-40) years at diagnosis, 401 (64%) were diagnosed with synchronous bilateral pheochromocytomas and 224 (36%) were diagnosed with metachronous pheochromocytomas (median [IQR] interval to second adrenalectomy, 6 [1-13] years). In 505 of 526 tested patients (96%), germline mutations were detected in the genes RET (282 patients [54%]), VHL (184 patients [35%]), and other genes (39 patients [7%]). Of 849 adrenalectomies performed in 625 patients, 324 (52%) were planned as cortical sparing and were successful in 248 of 324 patients (76.5%). Primary adrenal insufficiency occurred in all patients treated with total adrenalectomy but only in 23.5% of patients treated with attempted cortical-sparing adrenalectomy. A third of patients with adrenal insufficiency developed complications, such as adrenal crisis or iatrogenic Cushing syndrome. Of 377 patients who became steroid dependent, 67 (18%) developed at least 1 adrenal crisis and 50 (13%) developed iatrogenic Cushing syndrome during median (IQR) follow-up of 8 (3-25) years. Two patients developed recurrent pheochromocytoma in the adrenal bed despite total adrenalectomy. In contrast, 33 patients (13%) treated with successful cortical-sparing adrenalectomy developed another pheochromocytoma within the remnant adrenal after a median (IQR) of 8 (4-13) years, all of which were successfully treated with another surgery. Cortical-sparing surgery was not associated with survival. Overall survival was associated with comorbidities unrelated to pheochromocytoma: of 63 patients who died, only 3 (5%) died of metastatic pheochromocytoma. Conclusions and Relevance: Patients undergoing cortical-sparing adrenalectomy did not demonstrate decreased survival, despite development of recurrent pheochromocytoma in 13%. Cortical-sparing adrenalectomy should be considered in all patients with hereditary pheochromocytoma

DEVONIAN-CARBONIFEROUS MAGMATISM AND METALLOGENY IN THE SOUTH URAL ACCRETIONARY-COLLISIONAL SYSTEM

The oceanic stage in the history of the South Urals completed in the Ordovician – Early Silurian. The Ordovician through Devonian events in the region included the formation of an island arc in the East Ural zone from the Middle Ordovician to Silurian; westward motion of the subduction zone in the Late Silurian – Early Devonian and the origin of a trench along the Main Ural Fault and the Uraltau Uplift; volcanic eruptions and intrusions in the Magnitogorsk island arc system in the Devonian. The Middle-Late Paleozoic geodynamic evolution of uralides and altaides consisted in successive alternation of subduction and collisional settings at the continent-ocean transition. The greatest portion of volcanism in the major Magnitogorsk zone was associated with subduction and correlated in age and patterns of massive sulfide mineralization (VMS) with Early – Middle Devonian ore-forming events in Rudny Altai. Within-plate volcanism at the onset of volcanic cycles records the Early (D1e2) and Middle (D2ef2) Devonian slab break off. The volcanic cycles produced, respectively, the Buribay and Upper Tanalyk complexes with VMS mineralization in the Late Emsian; the Karamalytash complex and its age equivalents in the Late Eifelian – Early Givetian, as well as the lower Ulutau Formation in the Givetian. Slab break off in the Late Devonian – Early Carboniferous obstructed the Magnitogorsk island arc and supported asthenospheric diapirism. A new subduction zone dipping westward and the Aleksandrovka island arc formed in the Late Devonian – Early Carboniferous. The Early Carboniferous collision and another event of obstructed subduction led to a transform margin setting corresponding to postcollisional relative sliding of plates that produced another slab tear. Postcollisional magmatism appears as alkaline gabbro-granitic intrusives with related rich Ti-magnetite mineralization (C1). Transform faulting persisted in the Middle Carboniferous through Permian, when the continent of Eurasia completed its consolidation. The respective metallogenic events included formation of Cu-Ni picritic dolerites (C2–3), as well as large-scale gold and Mo-W deposits in granites (P1–2)

New national and regional bryophyte records, 66

This publication represent the first report of Sarmentypnum trichophyllum for Italy and the second for central and southern Europe. The present report of S. trichophyllum in Italy is an important confirmation and extension of range southwards

Comparison of Pheochromocytoma-Specific Morbidity and Mortality Among Adults With Bilateral Pheochromocytomas Undergoing Total Adrenalectomy vs Cortical-Sparing Adrenalectomy

IMPORTANCE Large studies investigating long-term outcomes of patients with bilateral pheochromocytomas treated with either total or cortical-sparing adrenalectomies are needed to inform clinical management.OBJECTIVE To determine the association of total vs cortical-sparing adrenalectomy with pheochromocytoma-specific mortality, the burden of primary adrenal insufficiency after bilateral adrenalectomy, and the risk of pheochromocytoma recurrence.DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from a multicenter consortium-based registry for 625 patients treated for bilateral pheochromocytomas between 1950 and 2018. Data were analyzed from September 1, 2018, to June 1, 2019.EXPOSURES Total or cortical-sparing adrenalectomy.MAIN OUTCOMES AND MEASURES Primary adrenal insufficiency, recurrent pheochromocytoma, and mortality.RESULTS Of 625 patients (300 [48%] female) with a median (interquartile range [IQR]) age of 30 (22-40) years at diagnosis, 401 (64%) were diagnosed with synchronous bilateral pheochromocytomas and 224 (36%) were diagnosed with metachronous pheochromocytomas (median [IQR] interval to second adrenalectomy, 6 [1-13] years). In 505 of 526 tested patients (96%), germline mutationswere detected in the genes RET (282 patients [54%]), VHL (184 patients [35%]), and other genes (39 patients [7%]). Of 849 adrenalectomies performed in 625 patients, 324 (52%) were planned as cortical sparing and were successful in 248 of 324 patients (76.5%). Primary adrenal insufficiency occurred in all patients treated with total adrenalectomy but only in 23.5% of patients treated with attempted cortical-sparing adrenalectomy. A third of patients with adrenal insufficiency developed complications, such as adrenal crisis or iatrogenic Cushing syndrome. Of 377 patients who became steroid dependent, 67 (18%) developed at least 1 adrenal crisis and 50 (13%) developed iatrogenic Cushing syndrome during median (IQR) follow-up of 8 (3-25) years. Two patients developed recurrent pheochromocytoma in the adrenal bed despite total adrenalectomy. In contrast, 33 patients (13%) treated with successful cortical-sparing adrenalectomy developed another pheochromocytoma within the remnant adrenal after a median (IQR) of 8 (4-13) years, all of which were successfully treated with another surgery. Cortical-sparing surgery was not associated with survival. Overall survivalwas associated with comorbidities unrelated to pheochromocytoma: of 63 patients who died, only 3 (5%) died of metastatic pheochromocytoma.CONCLUSIONS AND RELEVANCE Patients undergoing cortical-sparing adrenalectomy did not demonstrate decreased survival, despite development of recurrent pheochromocytoma in 13%. Cortical-sparing adrenalectomy should be considered in all patients with hereditary pheochromocytoma.Diabetes mellitus: pathophysiological changes and therap