[Da Vinci robotic complex in hernia repair surgery]. / Ispol'zovanie roboticheskogo kompleksa Da Vinci v khirurgii gryzh. Opyt kliniki.

OBJECTIVE: To review the first robotic hernia repairs performed at the Ilyinsky Hospital, evolution of this technology, learning curve and early outcomes. MATERIAL AND METHODS: There were 17 procedures at the Ilyinskaya Hospital between 2021 and 2023 (13 men and 4 women). Mean age was 60 years, body mass index 28 kg/m2. ASA grade 1 was observed in 1 patient, grade 2 - 14 ones, grade 3 - 2 patients. Ventral, inguinal and umbilical hernias were diagnosed in 7, 8 and 2 cases, respectively. Ventral hernias required IPOM+ procedure in 3 cases, eTEP-RS procedure in 2 cases and eTEP-RS-TAR procedure in 2 cases. Patients with inguinal hernia underwent transabdominal preperitoneal hernia repair. In case of umbilical hernia, TARUP procedure was performed in 1 case and vTAPP procedure in 1 case. RESULTS: Mean surgery time was 2 hours 38 min (min 1 hour 35 min, max 10 hours 11 min). There was one intraoperative complication (bleeding from epigastric artery). The follow-up period ranged from 3 months to 3 years. There were no recurrent hernias. Postoperative complications were noted in 2 cases. One patient was diagnosed with epididymitis after TAPP, 1 patient - with seroma after eTEP-RS procedure. All complications were relieved by conservative treatment. Bleeding from a. epigastrica inferior was diagnosed after removal of the trocar at the end of surgery. This event required suturing. CONCLUSION: Robotic hernia repair appears to be technically feasible and safe. This approach provides favorable results regarding quality of life and recurrence rate.

[Robotic sleeve gastrectomy: single-center experience]. / Roboticheskaya «rukavnaya gastrektomiya¼: opyt kliniki.

OBJECTIVE: To demonstrate safe introduction of a new technology (Da Vinci robotic system) into laparoscopic bariatric practice. MATERIAL AND METHODS: We analyzed treatment outcomes in patients with morbid obesity who underwent robot-assisted sleeve gastrectomy between 2020 and 2023. The same team of surgeons performed all operations. Evolution of technique and preparation of the operating theatre were recorded. Demographic data of patients, surgery time (docking and total surgery time), simultaneity of intervention, intraoperative and postoperative complications, as well as weight loss after 6 months were retrospectively analyzed. RESULTS: There were 15 robot-assisted sleeve gastrectomies between 2020 and 2023. Of these, 14 patients underwent surgery without complications. One patient was diagnosed with portal vein thrombosis that required anticoagulation. Median surgery time 194 [173.5; 241] min, period between incision and docking - 35 [30; 36] min. The length of hospital-stay was 3 days. The median weight loss after 6 months was 37.5% [29.5; 51.2]. CONCLUSION: This study demonstrates safe introduction of a new technology to prepare the bariatric team for more complex surgical interventions in the future.

[Evaluation of the association of polymorphisms of the CYP2C8 gene with the efficacy and safety of ketorolac in patients with postoperative pain syndrome].

AIM: To evaluate the possible association of CYP2C8 gene polymorphisms with the clinical efficacy and safety of ketorolac in relation to postoperative pain. MATERIALS AND METHODS: The study included 107 patients after video laparoscopic cholecystectomy, who received ketorolac (30 mg 2.0 w/m 3 r/d) as postoperative pain relief. All patients were genotyped for CYP2C8. The pain syndrome was assessed using the visual analog scale, the McGill pain questionnaire. The profile of adverse reactions was assessed by the dynamics of red blood counts, as a possible trigger for the development of gastrointestinal bleeding according to the method of global assessment of triggers (Global Trigger Tool GTT). RESULTS: According to visual analog scale data: in carriers of the genotype CYP2C8*3 (rs10509681) and CYP2C8*3 (rs11572080) after 12, 24, 36, 48 hours the intensity of pain syndrome is lower than in carriers of the wild type (p0.05). According to the McGill pain questionnaire, there were no statistically significant differences in pain intensity between the two groups. CONCLUSION: In carriers of the genotype CYP2C8*3 (rs10509681) and CYP2C8*3 (rs11572080), the effectiveness of anesthesia with ketorolac is higher than in carriers of the wild type. Carriage of the genotype CYP2C8*3 (rs10509681) and CYP2C8*3 (rs10509681) does not affect the risk of developing adverse reactions after ketorolac anesthesia.

Mixed Bubbles in Bose-Bose Mixtures.

Repulsive Bose-Bose mixtures are known to either mix or phase separate into pure components. Here we predict a mixed-bubble regime in which bubbles of the mixed phase coexist with a pure phase of one of the components. This is a beyond-mean-field effect that occurs for unequal masses or unequal intraspecies coupling constants and is due to a competition between the mean-field term, quadratic in densities, and a nonquadratic beyond-mean-field correction. We find parameters of the mixed-bubble regime in all dimensions and discuss implications for current experiments.

Beyond-Mean-Field Effects in Rabi-Coupled Two-Component Bose-Einstein Condensate.

We theoretically calculate and experimentally measure the beyond-mean-field (BMF) equation of state in a coherently coupled two-component Bose-Einstein condensate (BEC) in the regime where averaging of the interspecies and intraspecies coupling constants over the hyperfine composition of the single-particle dressed state predicts the exact cancellation of the two-body interaction. We show that with increasing the Rabi-coupling frequency Ω, the BMF energy density crosses over from the nonanalytic Lee-Huang-Yang scaling ∝n^{5/2} to an expansion in integer powers of density, where, in addition to a two-body BMF term ∝n^{2}sqrt[Ω], there emerges a repulsive three-body contribution ∝n^{3}/sqrt[Ω]. We experimentally evidence these two contributions, thanks to their different scaling with Ω, in the expansion of a Rabi-coupled two-component ^{39}K condensate in a waveguide. By studying the expansion with and without Rabi coupling, we reveal an important feature relevant for observing BMF effects and associated phenomena in mixtures with spin-asymmetric losses: Rabi coupling helps preserve the spin composition and thus prevents the system from drifting away from the point of the vanishing mean field.

[The mental reactions of psychiatrists and narcologists against the background of COVID-19 pandemic].

The article considers various mental reactions of psychiatrists and narcologists against the background of the SARS-CoV-2 pandemic, based on a brief scientific analysis of publications and experimental psychological research methods. The purpose of study was to identify impact of the COVID-19 pandemic on mental health of psychiatrists and psychiatrists-narcologists. The results of survey of psychiatrists and narcologists are presented. The study was carried out using such test techniques as life quality scale SF-36 (Health Status Survey), Lazarus questionnaire "Coping Behaviors" adjusted to conditions of Russia and Hamilton scales to assess depression and anxiety (HDRS, HARS). The results.The low level of psychological well-being, moderate degree of preference for all coping strategies were established. The anxiety was determine in 34.8% of respondents and depression in 8.7%. It was established that actually, the impact of the COVID-19 pandemic on medical workers is conditioned by complex of mental reactions (from anosognosia to expressed anxiety and depressive disorders) and is accompanied by increasing general anxiety.

[The analysis of failures of intra-familial relationships in families with children suffering of diabetes mellitus].

The article presents the results of study of in-family (child-parents) relationships in families with children suffering with diagnosed diabetes mellitus type I. The purpose of study is to investigate the disorders of family relationships in families of such kind. The established disorders allow to develop psychotherapeutic measures both for children and their parents. Materials and methods. The study covered 30 families with children of primary school age (7-10 years old) with diabetes mellitus. The families with children with severe concomitant diseases and broken families were excluded of the sampling. The control group consisted of 30 relevant families with healthy children. The in-family relationships were explored using a number of psychological tests applied to children and their mothers. The results. In mothers of the studied families prevailed authoritarian type of upbringing, which was expressed in tendency to hyper-protect and to over-control. The phobia of losing child and the tendency to reject it were also established. The children suffered from high level of anxiety. They had more positive attitude to mother than to father. The conclusion. The established disorders of in-family relationships in families with children with diabetes mellitus can serve as targets for psychotherapeutic activities both with children and their parents.

[The medical social problems and methods of diagnostic of cognitive disorders in patients taking "Spice"].

The article presents the results of pilot study implemented to determine cognitive disorders in patients taking "Spice". The purpose of research is to identify targets of psychological correction interventions to prevent cognitive deficiency in patients addicted to synthetic cannabinoids. The pilot sampling consisted of 30 patients taking "Spice". The control group consisted of 30 healthy individuals. Along with social consequences, one of the important focuses of the study was investigation of cognitive sphere of patients. A number of pathopsychologic tests was applied. The study established that patients demonstrated disorders of various functions of memory, attention, mental pace and thinking. In particular, disorders of short-term, long-term and mediate memory and mental tempo were revealed. Also, reduced activity of attention took place. The distortion and decreasing of generalization and poor prehension occurred reliably more often as compared with control group. The established cognitive disorders in patients taking "Spice" can be considered as targets for psychological correction interventions to prevent cognitive deficiency in patients addicted to synthetic cannabinoids.

Characterization of the iron oxide phases formed during the synthesis of core-shell FexOy@C nanoparticles modified with Ag.

Core-shell FexOy@C nanoparticles (NPs) modified with Ag were studied with x-ray diffraction, transmission electron microscopy, energy dispersive elemental mapping, Mössbauer spectroscopy, static magnetic measurements, and optical magnetic circular dichroism (MCD). FexOy@C NPs synthesized by the pyrolysis process of the mixture of Fe(NO3)3 · 9H2O with oleylamine and oleic acid were added to a heated mixture of oleylamine and AgNO3 in different concentrations. The final product was a mixture of iron oxide crystalline NPs in an amorphous carbon shell and Ag crystalline NPs. The iron oxide NPs were presented by two magnetic phases with extremely close crystal structures: Fe3O4 and γ-Fe2O3. Ag is shown to form crystalline NPs located very close to the iron oxide NPs. An assumption is made about the formation of hybrid FexOy@C-Ag NPs. Correlations were obtained between the Ag concentration in the fabricated samples, their magnetic properties and the MCD spectrum shape. Introducing Ag led to a approximately linear decrease of the NPs saturation magnetization depending upon the Ag concentration, it also resulted into the MCD spectrum shift to the lower light wave energies. MCD was also studied for the Fe3O4@C NPs synthesized earlier with the same one-step process using different heat treatment temperatures, and MCD spectra were compared for two series of NPs. A possible contribution of the surface plasmon excitation in Ag NPs to the MCD spectrum of the FexOy@C-Ag NPs is discussed.

Stable p-Wave Resonant Two-Dimensional Fermi-Bose Dimers.

We consider two-dimensional weakly bound heterospecies molecules formed in a Fermi-Bose mixture with attractive Fermi-Bose and repulsive Bose-Bose interactions. Bosonic exchanges lead to an intermolecular attraction, which can be controlled and tuned to a p-wave resonance. Such attractive fermionic molecules can be realized in quasi-two-dimensional ultracold isotopic mixtures. We show that they are stable with respect to the recombination to deeply bound molecular states and with respect to the formation of higher-order clusters (trimers, tetramers, etc.).

[Minimally invasive treatment of rare forms of mechanical intestinal obstruction]. / Miniinvazivnoe lechenie redkikh form obturatsionnoi kishechnoi neprokhodimosti.

AIM: To develop medical algorithms for reduction of morbidity and mortality in rare forms of mechanical intestinal obstruction. MATERIAL AND METHODS: 17 patients with mechanical intestinal obstruction have been operated in Sklifosovsky Research Institute for Emergency Care for the period 2010 - 2016. There were 13 women and 4 men aged 56 (44,5-74,5) years on the average. Phytobezoar was detected in 7 patients (41.2%), tumor in 7 patients (41.2%) and gallstone ileus in 3 patients (17.6%). RESULTS: There were no complications in group 1. In group 2 postoperative complications occurred in 3 patients: gastrocnemius vein thrombosis followed by successful medication (Clavien-Dindo type II), abdominal abscess drained under ultrasonic control (Clavien-Dindo type IIIa) and 1 (8.3%) death (Clavien-Dindo type V). Postoperative mortality in group 2 was 8.3%. CONCLUSION: Despite small sample size and no statistically reliable results the advantages of minimally invasive access are obvious. However, further trials are required to ensure the reliability of the results.

[ONSTEP procedure for inguinal hernia repair]. / Allogernioplastika onstep v lechenii pakhovykh gryzh.

AIM: To evaluate early and long-term outcomes of ONSTEP procedure including their comparison with those of Liechtenstein hernia repair. MATERIAL AND METHODS: The study consists of 2 parts - retrospective and prospective. There were 472 patients in retrospective part. Prospective analysis included 30 patients after ONSTEP hernia repair and 30 patients after Liechtenstein procedure. RESULTS: Postoperative complications and chronic pain syndrome occurred in 2.9% and 0.4% of cases after ONSTEP surgery, respectively. Moreover, ONSTEP procedure was followed by 2 cases or recurrence. There were no any significant differences between ONSTEP and Liechtenstein procedures. CONCLUSION: ONSTEP technique is highly effective and safe procedure that can be used in inguinal hernia management.

[The use of genetic engineering constructions as control samples on evaluation of diagnostic kits for reveal of rna of hazard and extremely hazard agents of virus infections by reverse transcription - polymerase chain reaction.]

The reverse transcription - polymerase chain reaction method (RT-PCR) has leading position on diagnostic infections, caused by RNA-containing viruses. This method presents severe requirements to carrying out of everybody stages of analysis (extraction of nucleic acid, carry out reverse transcription, amplification of DNA). It is necessary to account the possibility of false positive or false negative results appearance. The use on RT-PCR only positive (PCS) and negative (NCS) control samples is insufficient for the control of stages of RNA extraction and reverse transcription. That is way there is necessity the construction of inner control sample (ICS) to control of these stages. The main goal of present is the ground of use genetic engineering constructions (GEC) as control samples (PCS and ICS) on evaluation of diagnostic kits for reveal of RNA of hazard and extremely hazard agents of virus infections by RT-PCR. The vector recombinant plasmids, containing the insertion of cDNA of agent´s genomic RNA are used as PCS, RNA was packed in membrane protein of MS2 bacteriophage, is used as ICS. It is demonstrated that ICS does no influence on sensitivity of RT-PCR both for use of native agents and for use of synthetic nucleic acids of Ebola, Marburg, Lassa, Machupo, Venezuelan encephalitis equine (VEE), Rift Valley fever and rabies viruses. The possibility of use of PCS and ICS for standardization of diagnostic kits is discussed.

Five-Body Efimov Effect and Universal Pentamer in Fermionic Mixtures.

We show that four heavy fermions interacting resonantly with a lighter atom (4+1 system) become Efimovian at mass ratio 13.279(2), which is smaller than the corresponding 2+1 and 3+1 thresholds. We thus predict the five-body Efimov effect for this system in the regime where any of its subsystem is non-Efimovian. For smaller mass ratios we show the existence and calculate the energy of a universal 4+1 pentamer state, which continues the series of the 2+1 trimer predicted by Kartavtsev and Malykh and 3+1 tetramer discovered by Blume. We also show that the effective-range correction for the light-heavy interaction has a strong effect on all these states and larger effective ranges increase their tendency to bind.

Adaptive dynamics of cuticular hydrocarbons in Drosophila.

Cuticular hydrocarbons (CHCs) are hydrophobic compounds deposited on the arthropod cuticle that are of functional significance with respect to stress tolerance, social interactions and mating dynamics. We characterized CHC profiles in natural populations of Drosophila melanogaster at five levels: across a latitudinal transect in the eastern United States, as a function of developmental temperature during culture, across seasonal time in replicate years, and as a function of rapid evolution in experimental mesocosms in the field. Furthermore, we also characterized spatial and temporal changes in allele frequencies for SNPs in genes that are associated with the production and chemical profile of CHCs. Our data demonstrate a striking degree of parallelism for clinal and seasonal variation in CHCs in this taxon; CHC profiles also demonstrate significant plasticity in response to rearing temperature, and the observed patterns of plasticity parallel the spatiotemporal patterns observed in nature. We find that these congruent shifts in CHC profiles across time and space are also mirrored by predictable shifts in allele frequencies at SNPs associated with CHC chain length. Finally, we observed rapid and predictable evolution of CHC profiles in experimental mesocosms in the field. Together, these data strongly suggest that CHC profiles respond rapidly and adaptively to environmental parameters that covary with latitude and season, and that this response reflects the process of local adaptation in natural populations of D. melanogaster.

Ultradilute Low-Dimensional Liquids.

We calculate the energy of one- and two-dimensional weakly interacting Bose-Bose mixtures analytically in the Bogoliubov approximation and by using the diffusion Monte Carlo technique. We show that in the case of attractive inter- and repulsive intraspecies interactions the energy per particle has a minimum at a finite density corresponding to a liquid state. We derive the Gross-Pitaevskii equation to describe droplets of such liquids and solve it analytically in the one-dimensional case.

Anisotropic Expansion of a Thermal Dipolar Bose Gas.

We report on the anisotropic expansion of ultracold bosonic dysprosium gases at temperatures above quantum degeneracy and develop a quantitative theory to describe this behavior. The theory expresses the postexpansion aspect ratio in terms of temperature and microscopic collisional properties by incorporating Hartree-Fock mean-field interactions, hydrodynamic effects, and Bose-enhancement factors. Our results extend the utility of expansion imaging by providing accurate thermometry for dipolar thermal Bose gases. Furthermore, we present a simple method to determine scattering lengths in dipolar gases, including near a Feshbach resonance, through observation of thermal gas expansion.

[The results of open and laparoscopic appendectomy in pregnant women with acute appendicitis]. / Rezul'taty traditsionnoi i laparoskopicheskoi appendektomii pri ostrom appenditsite u beremennykh.

AIM: To compare conventional and laparoscopic appendectomy in pregnant women. MATERIAL AND METHODS: The study included 86 patients with acute appendicitis who were surgically treated. In group 1 (42 women) laparoscopic approach was used, in group 2 (44 patients) - laparotomy. RESULTS: Postoperative complications were observed in 2 (4.8%) and 3 (6.8%) patients in groups 1 and 2 respectively. All complications related to Clavien-Dindo class I-II. There were no premature births and abortions in laparoscopy group. In case of conventional surgery premature births and abortions were observed in 2 (4.5%) and 1 (2.27%) observations respectively. Other women had timely childbirth in terms of 36-41 weeks. CONCLUSION: Risk of delay exceeds risk of vain appendectomy. All pregnant women with acute appendicitis should be examined by obstetrician-gynaecologist, surgeon, urologist, anesthesiologist. If acute appendicitis can not be excluded based on clinical data the patient should be operated. Diagnostic laparoscopy and laparoscopic appendectomy are advisable in case of pregnancy up to 24 weeks. Woman should be under observation of obstetrician-gynaecologist in perioperative period to prevent premature birth and abortion.

Quantum Mechanical Stabilization of a Collapsing Bose-Bose Mixture.

According to the mean-field theory a condensed Bose-Bose mixture collapses when the interspecies attraction becomes stronger than the geometrical average of the intraspecies repulsions, g_{12}^{2}>g_{11}g_{22}. We show that instead of collapsing such a mixture gets into a dilute liquidlike droplet state stabilized by quantum fluctuations thus providing a direct manifestation of beyond mean-field effects. We study various properties of the droplet and find, in particular, that in a wide range of parameters its excitation spectrum lies entirely above the particle emission threshold. The droplet thus automatically evaporates itself to zero temperature, the property potentially interesting by itself and from the viewpoint of sympathetic cooling of other systems.

Stable Dilute Supersolid of Two-Dimensional Dipolar Bosons.

We consider two-dimensional bosonic dipoles oriented perpendicularly to the plane. On top of the usual two-body contact and long-range dipolar interactions we add a contact three-body repulsion as expected, in particular, for dipoles in the bilayer geometry with tunneling. The three-body repulsion is crucial for stabilizing the system, and we show that our model allows for stable continuous space supersolid states in the dilute regime and calculate the zero-temperature phase diagram.