[Robotic enucleation of pancreatic insulinoma]. / Robot-assistirovannaya enukleatsiya insulinomy podzheludochnoi zhelezy.

We demonstrate robot-assisted treatment of a patient with benign pancreatic insulinoma. A 31-year-old patient suffered from attacks of weakness, numbness of the fingertips and «turbidity of consciousness¼ for 2 years. These symptoms occurred on an empty stomach and regressed after eating. We found pancreatic insulinoma. The patient underwent robotic enucleation of pancreatic tumor. Surgery time was 145 min. Postoperative period proceeded without complications. Hyperglycemia up to 10.5 mmol/l on the first postoperative day was followed by normalization after 4 days. The patient was discharged in 6 days after surgery. Minimally invasive robotic enucleation of insulinoma minimizes surgical trauma and provides precise resection of tumor. The key aspect of safe enucleation is localization of tumor at a distance of at least 2 mm from the pancreatic duct.

[Potentially preventable causes of mortality in acute calculous cholecystitis: a population-based study]. / Potentsial'no predotvratimye prichiny letal'nosti pri ostrom kal'kuleznom kholetsistite: populyatsionnoe issledovanie.

OBJECTIVE: To analyze potentially preventable causes of mortality from acute calculous cholecystitis (ACC) at the population level. MATERIAL AND METHODS: A retrospective study of causes of ACC-related mortality was conducted. We used online survey of state hospitals and estimated fatal outcomes following ACC considering appropriate annual e-database. RESULTS: There were 1.500 deaths among 142.975 patients aged ≥18 years with acute cholecystitis. We received responses to the proposed questionnaire about 1154 deaths (76.9%). Analysis included 648 cases of ACC (K80.0). Mean age of patients was 76.0 years (31-100). There were 256 (39.5%) men and 392 (60.5%) women. ACC severity was assessed according to the Tokyo guidelines (2018). Mild (I) degree was noted in 24 (3.7%) cases, moderate (II) - 270 (41.7%), severe (III) - 354 (54.6%) patients. Cardiovascular diseases and complications caused death in mild ACC regardless of treatment method in 16 (66.7%) cases, in moderate ACC - 106 (39.3%), in severe ACC - 97 (27.4%) cases. ACC caused death in 3 (12.5%) patients with mild disease, 111 (41.1%) with moderate disease and 200 (56.5%) ones with severe disease. Postoperative complications caused death in 4 (16.7%) patients with mild disease, 29 (10.7%) ones with moderate disease and 30 (8.5%) patients with severe disease. Other causes comprised 4.1% (n=1), 8.9% (n=24) and 7.6% (n=27), respectively. Potentially preventable causes of death were identified in 33.0% of cases. CONCLUSION: ACC-related mortality is mainly associated with comorbidity in elderly and senile patients, late presentation and complicated course of disease. Delayed surgical treatment due to diagnostic and tactical problems, as well as technical intraoperative errors is potentially preventable causes of death.

[Synchronous left atrial myxoma and gastric cancer: a case report]. / Sinkhronnye miksoma levogo predserdiya i rak zheludka. Klinicheskii sluchai.

The authors present a 57-year-old patient with synchronous left atrial myxoma and gastric cancer undergoing staged treatment. Distal gastrectomy with gastroduodenostomy at the first stage was followed by resection of the left atrial myxoma after 22 days. Postoperative period was uneventful after both interventions. The follow-up examination revealed favorable clinical status and no cancer progression.

[External-internal sigmoid-vesical fistula following sigmoid diverticulum perforation into the patent urachus]. / Naruzhno-vnutrennii sigmovidno-mochepuzyrnyi svishch kak oslozhnenie perforatsii divertikula sigmovidnoi kishki v nezarashchennyi urakhus.

A patient with external-internal sigmoid-vesical fistula is presented. The authors describe surgical intervention (urachus excision, removal of infiltrate with resection of bladder bottom and fistula-related segment of sigmoid). Surgical challenges due to localization of fistula and appropriate literature data are discussed.

SRPES and STM data for the model bimetallic Pd-In/HOPG catalysts: Effects of mild post-synthesis oxidative treatments.

Post-synthesis treatment of bimetallic catalysts in different gas phases resulting in the adsorption-induced segregation is among promising approaches to enhance their activity not compromising selectivity towards a number of low-temperature reactions. Our recently published paper (M.A. Panafidin, A.V. Bukhtiyarov, I.P. Prosvirin, I.A. Chetyrin, A.Yu. Klyushin, A. Knop-Gericke, N.S. Smirnova, P.V. Markov, I.S. Mashkovsky, Y.V. Zubavichus, A.Yu. Stakheev, V.I. Bukhtiyarov, A mild post-synthesis oxidative treatment of Pd-In/HOPG bimetallic catalysts as a tool of their surface structure fine tuning. Appl. Surf. Sci.) reports on Pd-In intermetallic formation regularities and their evolution after storage in air as well as during treatment in oxygen at submillibar pressures. The current paper gives an extended representation of experimental ex situ/in situ synchrotron-based photoelectron spectroscopy (SRPES) and scanning tunnelling microscopy (STM) data used to derive scientific conclusions in the paper quoted above.

[Minimally invasive treatment of post-burn esophageal perforation]. / Miniinvazivnoe lechenie posleozhogovoi perforatsii pishchevoda.

Perforation of the esophagus is a serious and dangerous condition due to progressive development of mediastinitis and sepsis. This disease is often fatal. In the last decade, endoscopic stenting of the esophagus became more common in these patients as an alternative to traditional surgery. We report successful minimally invasive endoscopic treatment of esophageal perforation with post-burn necrosis of its wall.

[Restoration and reconstruction of extrahepatic bile ducts in high strictures using enteric autotransplant of variable diameter].

AIM: To develop technique incorporating favorable aspects of gastroenterostomy in common hepatic duct anastomosis, providing bile drainage into duodenum and preventing duodenobiliary reflux. MATERIAL AND METHODS: It is presented developed operations for high strictures of extrahepatic bile ducts using enteric autotransplant of variable diameter. RESULTS: Good remote postoperative results were observed in 10 survived patients. There were no recurrence of stricture, cholangitis and normal biochemical parameters were observed. It has been proved that suggested methods may be alternative to Roux-en-Y hepaticojejunostomy.

[Plasty of extrahepatic biliary ducts with the use of ileal autotransplantate].

A method of extrahepatic biliary duct plasty with the use of tubular ileal autotransplantate of 1 sm in diameter was presented in 19 patients with benign strictures. The transplantate on the vascular pedicle was created by resection of the antimesenterial side of the intestinal loop. Distally the anastomosis was performed with the common bile duct, including, thus, papilla Vateri into the bile passage (4 patients). By the impossibility of the latter, the anastomosis was performed with the vertical part of duodenum (16 patients). Postoperative follow-up variated from 1 to 15 years. 18 patients demonstrated good long-term result, 1 patients had a stricture recurrence.

Modelling the unidentified mortality burden from thirteen infectious pathogenic microorganisms in infants.

Official statistics routinely underestimate mortality from specific microorganisms and deaths are assigned to non-specific syndromes. Here we estimate mortality attributed to specific pathogens by modelling non-specific infant deaths from laboratory reports and codes on death certificates for these pathogens, 1993-2000 in England and Wales using a generalized linear model. In total, 22.4-59.8% of non-specific deaths in infants (25-66 deaths a year) are attributable to specific pathogens. Yearly deaths from Bordetella pertussis in neonates are 6.8 [95% confidence interval (CI) 1.5-11.9]. In post-neonates 9.4 (95% CI 2.3-16.6) deaths a year are attributable to Neisseria meningitidis, 7.3 (95% CI 2.4-12.3) to Streptococcus pneumoniae, from 2.8 (95% CI 0.8-4.9) to 15.1 (95% CI 9.4-20.9) to respiratory syncytial virus (RSV) and 3 (95% CI 0.3-5.9) to parainfluenza type 2. Our results suggest there is substantial hidden mortality for a number of pathogens in infants. A considerable proportion of deaths classified to infectious syndromes are non-infectious, suggesting low specificity of death certification. Laboratory reports were the more reliable source, reinforcing the asset of strong surveillance systems.

Hepatitis A virus infection control: an audit of practice in England and Wales prior to guidelines being published.

This survey was conducted in September 2001 to audit the practice of Consultants in Communicable Disease Control (CsCDC) and to gain a systematic picture of pre-guideline approaches to the control of hepatitis A virus infection in England and Wales. An audit form was distributed to all CsCDC by email and responses were entered in a database and analysed. Response rate is estimated at 44%. CsCDC predominantly recommend vaccination for prevention. For 31% of the CsCDC, index cases were not reported within a week of the onset of illness. As a result, vaccine was often used sub-optimally. By contrast 95% of the CsCDC were informed of an index case within two weeks of onset of illness, in time for effective use of human normal immunoglobulin (HNIG). CsCDC were cautious in the use of HNIG for a number of reasons including concerns about variant Creutzfeldt-Jacob Disease (vCJD). A substantial proportion (between 5% and 28% for different age groups) of CsCDC did not recommend any active prevention among close family contacts of a case. Important ways to improve practice include facilitating use of HNIG and speeding up reporting by doctors and laboratories.