Improvement of agrotechnology of production of high-quality sunflower seeds

The largest share among the total production costs in the cultivation of sunflower falls on tillage. Its purpose is to increase the reserves of productive moisture in the soil, reduce the rate of its evaporation from the soil surface, improve plant nutrition and accumulation of precipitation, and prevent the accumulation of pathogens of various diseases, pests and weeds. Some of these tasks of soil treatment can be replaced, for example, by the introduction of organomineral fertilizers, the use of various pesticides, mulching of the soil surface with crushed straw, the introduction, in accordance with the specialization of the farm, scientifically based crop rotations with highly productive field crops. In this regard, the studies conducted on leached merged chernozems are devoted to the optimization of some elements of agricultural machinery for the production of sunflower seeds. The effect of dump plowing, shallow and deep non-fallow soil treatments on phytocenotic conditions for the formation of productivity of the sunflower hybrid Gorstar has been established. There was a strong (by 0,06–0,08 g/cm3) compaction of the soil layer of 15–30 cm against the background of shallow non-fall soil treatment than with the other two methods. The reserves of available soil moisture in the 0–150 cm layer with deep tillage and dump plowing were 214,0 and 210,8 mm, respectively, and for shallow tillage – 196,0 mm. At the background of dump plowing, the minimum contamination of sunflower crops was obtained, which is 36,5% less for deep tillage and 63,5% less for shallow. The introduction of a tank mixture of pre-emergence herbicides Acetal Pro, CE and Brig, CS provides an increase in the yield of sunflower seeds by all methods of basic tillage by 0,14–0,27 t/ha, and the introduction of soil herbicide Gardo Gold, CE – by 0,13–0,14 t/ha

Estimation of the efficiency of the «soy – winter wheat» crop rotation link and its influence on soil properties

Crop rotation is a systematic solution to one of the main tasks of agricultural production: rational land management, taking into account their possible effective fertility, biological potential of cultivated plants and available external and internal resources (heat, climate, fertilizers, agricultural machinery and agrochemicals) in order to maintain the most economically efficient management, which is possible with consistently high yields, with consistent reproduction of soil fertility and protection of the external environment. And as a consequence, crop rotation in this case acts as the basis of modern zonal adaptive landscape farming systems. It defines most other systems: soil cultivation and protection from erosion processes, fertilization and plant protection systems, seed production and variety change, irrigation and drainage of lands, technical systems, labor organization, etc. crop rotation «soybean-winter wheat» on merged leached chernozems and its effect on soil properties in the southern foothill zone of the Western Ciscaucasia. As a result of the study, a comprehensive assessment of the productivity of the «soybean-winter wheat» link in the crop rotation has been carried out and its positive effect on agrophysical and agrochemical properties of merged chernozems determined. It has been established that in order to obtain high-quality soybean seeds of the Mentor variety with the corresponding qualities of «the winter wheat» predecessor in the foothill zone of Adygea, it is necessary to use early sevarian conditions at a seeding rate of 0,6 million pieces/ha and a row spacing of 15 and 30 cm. To acieve a high level of production profitability, winter wheat of the Alekseich variety should be placed according to the «soybeans» predecessor against the background of surface tillage (10–12 cm). At the same time, it is proposed to apply mineral fertilizers at a rate of 200 kg/ha in the form of sulfoammophos N20P20S8, with obligatory double spring feeding of 150 kg/ha with ammonium nitrate N51+N51

Outcomes After Minimally-invasive Versus Open Pancreatoduodenectomy: A Pan-European Propensity Score Matched Study

OBJECTIVE: To assess short-term outcomes after minimally invasive (laparoscopic, robot-assisted, and hybrid) pancreatoduodenectomy (MIPD) versus open pancreatoduodenectomy (OPD) among European centers. BACKGROUND: Current evidence on MIPD is based on national registries or single expert centers. International, matched studies comparing outcomes for MIPD and OPD are lacking. METHODS: Retrospective propensity score matched study comparing MIPD in 14 centers (7 countries) performing ≥10 MIPDs annually (2012-2017) versus OPD in 53 German/Dutch surgical registry centers performing ≥10 OPDs annually (2014-2017). Primary outcome was 30-day major morbidity (Clavien-Dindo ≥3). RESULTS: Of 4220 patients, 729/730 MIPDs (412 laparoscopic, 184 robot-assisted, and 130 hybrid) were matched to 729 OPDs. Median annual case-volume was 19 MIPDs (interquartile range, IQR 13-22), including the first MIPDs performed in 10/14 centers, and 31 OPDs (IQR 21-38). Major morbidity (28% vs 30%, P = 0.526), mortality (4.0% vs 3.3%, P = 0.576), percutaneous drainage (12% vs 12%, P = 0.809), reoperation (11% vs 13%, P = 0.329), and hospital stay (mean 17 vs 17 days, P > 0.99) were comparable between MIPD and OPD. Grade-B/C postoperative pancreatic fistula (POPF) (23% vs 13%, P < 0.001) occurred more frequently after MIPD. Single-row pancreatojejunostomy was associated with POPF in MIPD (odds ratio, OR 2.95, P < 0.001), but not in OPD. Laparoscopic, robot-assisted, and hybrid MIPD had comparable major morbidity (27% vs 27% vs 35%), POPF (24% vs 19% vs 25%), and mortality (2.9% vs 5.2% vs 5.4%), with a fewer conversions in robot-assisted- versus laparoscopic MIPD (5% vs 26%, P < 0.001). CONCLUSIONS: In the early experience of 14 European centers performing ≥10 MIPDs annually, no differences were found in major morbidity, mortality, and hospital stay between MIPD and OPD. The high rates of POPF and conversion, and the lack of superior outcomes (ie, hospital stay, morbidity) could indicate that more experience and higher annual MIPD volumes are needed

Implementation and outcome of minimally invasive pancreatoduodenectomy in Europe:a registry-based retrospective study A critical appraisal of the first 3 years of the E-MIPS registry

BACKGROUND: International multicenter audit-based studies focusing on the outcome of minimally invasive pancreatoduodenectomy (MIPD) are lacking. The European Registry for Minimally Invasive Pancreatic Surgery (E-MIPS) is the E-AHPBA endorsed registry aimed to monitor and safeguard the introduction of MIPD in Europe. MATERIALS AND METHODS: A planned analysis of outcomes among consecutive patients after MIPD from 45 centers in 14 European countries in the E-MIPS registry (2019-2021). The main outcomes of interest were major morbidity (Clavien-Dindo grade ≥3) and 30-day/in-hospital mortality. RESULTS: Overall, 1336 patients after MIPD were included [835 robot-assisted (R-MIPD) and 501 laparoscopic MIPD (L-MIPD)]. Overall, 20 centers performed R-MIPD, 15 centers L-MIPD, and 10 centers both. Between 2019 and 2021, the rate of centers performing L-MIPD decreased from 46.9 to 25%, whereas for R-MIPD this increased from 46.9 to 65.6%. Overall, the rate of major morbidity was 41.2%, 30-day/in-hospital mortality 4.5%, conversion rate 9.7%, postoperative pancreatic fistula grade B/C 22.7%, and postpancreatectomy hemorrhage grade B/C 10.8%. Median length of hospital stay was 12 days (IQR 8-21). A lower rate of major morbidity, postoperative pancreatic fistula grade B/C, postpancreatectomy hemorrhage grade B/C, delayed gastric emptying grade B/C, percutaneous drainage, and readmission was found after L-MIPD. The number of centers meeting the Miami Guidelines volume cut-off of ≥20 MIPDs annually increased from 9 (28.1%) in 2019 to 12 (37.5%) in 2021 ( P =0.424). Rates of conversion (7.4 vs. 14.8% P &lt;0.001) and reoperation (8.9 vs. 15.1% P &lt;0.001) were lower in centers, which fulfilled the Miami volume cut-off. CONCLUSION: During the first 3 years of the pan-European E-MIPS registry, morbidity and mortality rates after MIPD were acceptable. A shift is ongoing from L-MIPD to R-MIPD. Variations in outcomes between the two minimally invasive approaches and the impact of the volume cut-off should be further evaluated over a longer time period.</p

Minimally invasive versus open pancreatoduodenectomy for pancreatic and peri-ampullary neoplasm (DIPLOMA-2):study protocol for an international multicenter patient-blinded randomized controlled trial

Background: Minimally invasive pancreatoduodenectomy (MIPD) aims to reduce the negative impact of surgery as compared to open pancreatoduodenectomy (OPD) and is increasingly becoming part of clinical practice for selected patients worldwide. However, the safety of MIPD remains a topic of debate and the potential shorter time to functional recovery needs to be confirmed. To guide safe implementation of MIPD, large-scale international randomized trials comparing MIPD and OPD in experienced high-volume centers are needed. We hypothesize that MIPD is non-inferior in terms of overall complications, but superior regarding time to functional recovery, as compared to OPD. Methods/design: The DIPLOMA-2 trial is an international randomized controlled, patient-blinded, non-inferiority trial performed in 14 high-volume pancreatic centers in Europe with a minimum annual volume of 30 MIPD and 30 OPD. A total of 288 patients with an indication for elective pancreatoduodenectomy for pre-malignant and malignant disease, eligible for both open and minimally invasive approach, are randomly allocated for MIPD or OPD in a 2:1 ratio. Centers perform either laparoscopic or robot-assisted MIPD based on their surgical expertise. The primary outcome is the Comprehensive Complication Index (CCI®), measuring all complications graded according to the Clavien-Dindo classification up to 90 days after surgery. The sample size is calculated with the following assumptions: 2.5% one-sided significance level (α), 80% power (1-β), expected difference of the mean CCI® score of 0 points between MIPD and OPD, and a non-inferiority margin of 7.5 points. The main secondary outcome is time to functional recovery, which will be analyzed for superiority. Other secondary outcomes include post-operative 90-day Fitbit™ measured activity, operative outcomes (e.g., blood loss, operative time, conversion to open surgery, surgeon-reported outcomes), oncological findings in case of malignancy (e.g., R0-resection rate, time to adjuvant treatment, survival), postoperative outcomes (e.g., clinically relevant complications), healthcare resource utilization (length of stay, readmissions, intensive care stay), quality of life, and costs. Postoperative follow-up is up to 36 months. Discussion: The DIPLOMA-2 trial aims to establish the safety of MIPD as the new standard of care for this selected patient population undergoing pancreatoduodenectomy in high-volume centers, ultimately aiming for superior patient recovery. Trial registration: ISRCTN27483786. Registered on August 2, 2023.</p

Laparoscopic versus open extended radical left pancreatectomy for pancreatic ductal adenocarcinoma: an international propensity-score matched study

Background A radical left pancreatectomy in patients with pancreatic ductal adenocarcinoma (PDAC) may require extended, multivisceral resections. The role of a laparoscopic approach in extended radical left pancreatectomy (ERLP) is unclear since comparative studies are lacking. The aim of this study was to compare outcomes after laparoscopic vs open ERLP in patients with PDAC. Methods An international multicenter propensity-score matched study including patients who underwent either laparoscopic or open ERLP (L-ERLP; O-ERLP) for PDAC was performed (2007-2015). The ISGPS definition for extended resection was used. Primary outcomes were overall survival, margin negative rate (R0), and lymph node retrieval. Results Between 2007 and 2015, 320 patients underwent ERLP in 34 centers from 12 countries (65 L-ERLP vs. 255 O-ERLP). After propensity-score matching, 44 L-ERLP could be matched to 44 O-ERLP. In the matched cohort, the conversion rate in L-ERLP group was 35%. The L-ERLP R0 resection rate (matched cohort) was comparable to O-ERLP (67% vs 48%; P = 0.063) but the lymph node yield was lower for L-ERLP than O-ERLP (median 11 vs 19, P = 0.023). L-ERLP was associated with less delayed gastric emptying (0% vs 16%, P = 0.006) and shorter hospital stay (median 9 vs 13 days, P = 0.005), as compared to O-ERLP. Outcomes were comparable for additional organ resections, vascular resections (besides splenic vessels), Clavien-Dindo grade >= III complications, or 90-day mortality (2% vs 2%, P = 0.973). The median overall survival was comparable between both groups (19 vs 20 months, P = 0.571). Conversion did not worsen outcomes in L-ERLP. Conclusion The laparoscopic approach may be used safely in selected patients requiring ERLP for PDAC, since morbidity, mortality, and overall survival seem comparable, as compared to O-ERLP. L-ERLP is associated with a high conversion rate and reduced lymph node yield but also with less delayed gastric emptying and a shorter hospital stay, as compared to O-ERLP

The Russian consensus on the diagnosis and treatment of chronic pancreatitis: Enzyme replacement therapy

The Russian consensus on the diagnosis and treatment of chronic pancreatitis has been prepared on the initiative of the Russian Pancreatology Club to clarify and consolidate the opinions of Russian specialists (gastroenterologists, surgeons, and pediatricians) on the most significant problems of diagnosis and treatment of chronic pancreatitis. This article continues a series of publications explaining the most significant interdisciplinary consensus statements and deals with enzyme replacement therapy

Russian consensus on exoand endocrine pancreatic insufficiency after surgical treatment

The Russian consensus on exo - and endocrine pancreatic insufficiency after surgical treatment was prepared on the initiative of the Russian "Pancreatic Club" on the Delphi method. His goal was to clarify and consolidate the opinions of specialists on the most relevant issues of diagnosis and treatment of exo - and endocrine insufficiency after surgical interventions on the pancreas. An interdisciplinary approach is provided by the participation of leading gastroenterologists and surgeons

Злокачественное новообразование молочной железы в составе синдрома Коудена

Cowden syndrome is a rare disease characterized by multiple hamartomas and increased breast, thyroid, kidney and uterine neoplasm risk. The lifetime breast cancer risk for patients with Cowden syndrome is 85 %, with an average age of diagnosis between 38 and 46 years. The diagnostic criteria for Cowden syndrome have been established by the International Cowden Consortium (ICC) and the National Comprehensive Cancer Network (NCCN), and are regularly revised, but the diagnosis of Cowden syndrome remains difficult due to the variety of phenotypic and clinical features of the disease. At the same time, the genetic variants associated with Cowden syndrome analysis is not a standard for patients with breast cancer.Objective: To demonstrate the non‑BRCA hereditary breast cancer detection using whole genome sequencing on the Cowden syndrome clinical case example.Materials and methods: The article describes a clinical case of a 37‑year‑old female patient with breast cancer, normal intelligence and phenotype, structural abnormalities of the thyroid gland (multinodular goiter). Whole genome sequencing was used to identify clinically significant genetic variants associated with hereditary tumor syndromes.Clinical case: The article presents a brief literature review on the clinical presentation of Cowden syndrome and indications for its molecular diagnosis. Also, the presented clinical case describes patient R., 37 years old female with breast cancer, who underwent treatment in the City Clinical Oncological Hospital № 1 of the Moscow City Health Department in 2021. The patient was fully examined and enrolled in the whole genome sequencing project under the Order № 69 of Moscow Healthcare Department dated February 1, 2021 «Oncogenetic research organization in Moscow». The results revealed a pathogenic variant in the PTEN gene, previously associated with Cowden syndrome.Conclusion: The use of whole genome sequencing allows to identify hereditary tumor syndromes, the clinical manifestation of which may be breast cancer.Синдром Коудена характеризуется наличием множественных гамартом с высоким риском развития доброкачественных и злокачественных опухолей щитовидной железы, молочной железы, почек и эндометрия. Риск развития рака молочной железы у пациентов с синдромом Коудена в течение жизни составляет 85 %, при этом средний возраст постановки диагноза составляет от 38 до 46 лет. Диагностические критерии синдрома Коудена установлены Международным консорциумом по синдрому Коудена (ICC) и Американской ассоциацией онкологов (NCCN) и подвергаются регулярному пересмотру, однако диагностика синдрома Коудена по‑прежнему затруднена ввиду разнообразия фенотипических особенностей и клинических признаков заболеваний. В то же время, анализ генетических вариантов, ассоциированных с синдромом Коудена, не является стандартом обследования при диагностике рака молочной железы.Цель: продемонстрировать выявление методом полногеномного секвенирования наследственных опухолевых синдромов, клиническим проявлением которых могут быть злокачественные новообразования молочной железы, на примере синдрома Коудена.Материалы и методы: в статье описан клинический случай пациентки 37 лет с нормальным интеллектом и фенотипом, структурными поражениями щитовидной железы (многоузловой зоб), обратившейся по поводу рака молочной железы. В рамках научного исследования с целью выявления клинически значимых генетических вариантов, ассоциированных с наследственными опухолевыми синдромами, применен метод полногеномного секвенирования.Клинический случай: в статье представлен краткий обзор литературы, посвященный клинической характеристике синдрома Коудена, и показаний для молекулярной диагностики. Описан клинический случай пациентки Р., 37 лет, которая проходила лечение в ГБУЗ «Городская клиническая онкологическая больница № 1 ДЗМ» в 2021 г. по поводу рака молочной железы. С учетом диагностированного в возрасте до 50 лет злокачественного новообразования молочной железы пациентка включена в научный проект по проведению полногеномных исследований в рамках приказа Департамента Здравоохранения г. Москвы № 69 от 01.02.2021 «Об организации проведения онкогенетических исследований в городе Москве», по результатам генетического исследования выявлен патогенный вариант гена PTEN, ассоциированный с синдромом Коудена.Вывод: Применение полногеномного секвенирования позволяет выявлять наследственные опухолевые синдромы, клиническим проявлением которых могут быть злокачественные новообразования молочной железы