Ten Misconceptions from the History of Analysis and Their Debunking

The widespread idea that infinitesimals were "eliminated" by the "great triumvirate" of Cantor, Dedekind, and Weierstrass is refuted by an uninterrupted chain of work on infinitesimal-enriched number systems. The elimination claim is an oversimplification created by triumvirate followers, who tend to view the history of analysis as a pre-ordained march toward the radiant future of Weierstrassian epsilontics. In the present text, we document distortions of the history of analysis stemming from the triumvirate ideology of ontological minimalism, which identified the continuum with a single number system. Such anachronistic distortions characterize the received interpretation of Stevin, Leibniz, d'Alembert, Cauchy, and others.Comment: 46 pages, 4 figures; Foundations of Science (2012). arXiv admin note: text overlap with arXiv:1108.2885 and arXiv:1110.545

Непосредственные результаты расширенных и мультивисцеральных резекций при раке прямой кишки

Background. Currently, the indications for multivisceral pelvic resections have increased dramatically. However, short-and long-term outcomes after these resections for locally advanced rectal cancer remain a subject of debate.The purpose of the study was to evaluate short-term surgical and oncological outcomes after multivisceral pelvic resections in patients with locally advanced rectal cancer.Material and methods. We analyzed surgical outcomes in 32 patients (13 men and 19 women) aged 44-69 years, with locally advanced rectal cancer, who were treated between 2010 and 2016. Of the 32 patients, 28 (87.5 %) had rectal cancer with invasion into adjacent organs (posterior wall of the bladder - 13, uterus - 10, ureters - 5, prostate - 4, vagina - 3; simultaneous damage to more than 2 organs - 14, multiple primary malignant tumors: rectal cancer + bladder cancer - 2, rectal cancer + endometrial cancer - 1, rectal cancer + rectal GIST - 1.Results. Total pelvic evisceration was performed in 6 (18.8 %) cases, combined resection of the rectum and adjacent organs was performed in 26 (81.2 %). Urinary tract resection was performed in 24 (75.0 %) patients. Of these patients, 13 (40.6 %) had primary plasty of the bladder and/or ureters. Postoperative surgical complications were observed in 11 (34.4 %) patients, of whom 7 (21.8 %) patients needed re-surgery. In 1 patient (3.1 %), who died in the early postoperative period, the cause of death was thrombosis of the right iliac vessels with subsequent acute renal failure. For patients with locally advanced rectal cancer, long-term outcomes were as follows: the overall and recurrence-free 2-year survival rates were 75 % and 56.3 %, respectively. All patients with multiple primary malignant tumors were alive with no evidence of disease recurrence at a follow-up of >24 months.Conclusion. Multivisceral resection in patients with locally advanced rectal cancer is a complex surgical procedure requiring the multidisciplinary team of surgeons. Despite high operative morbidity, proper perioperative management of the patients helps to achieve satisfactory immediate treatment outcomes. Long-term outcomes allowed us to consider such resections as a method of choice for locally advanced and multiple primary rectal cancers.Введение. В настоящее время значительно расширились показания для мультивисцеральных резекций малого таза, однако непосредственная и отдаленная эффективность подобных операций при местнораспространенном раке прямой кишки остается предметом дискуссий.Цель исследования - оценить непосредственные хирургические и онкологические результаты мультивисцеральных резекций органов малого таза у больных местнораспространенным раком прямой кишки.Материал и методы. Проведен анализ результатов хирургического лечения 32 больных (мужчин - 13, женщин - 19) в возрасте 44-69 лет, с местнораспространенными и первично-множественными опухолями прямой кишки, которые получали лечение в 2010-16 гг. Из них у 28 (87,5 %) пациентов - рак прямой кишки (РПК) с инвазией в смежные органы (задняя стенка мочевого пузыря - 13, матка - 10, мочеточники - 5, простата - 4, влагалище - 3; в 14 случаях - одновременное поражение более 2 органов), у 4 (12,5 %) - первичномножественные злокачественные опухоли органов малого таза (РПК + рак мочевого пузыря - 2, РПК + рак эндометрия - 1, РПК + GIST прямой кишки - 1).Результаты. Объемы выполненных операций: в 6 (18,8 %) случаях - полная эвисцерация малого таза, в 26 (81,2%) - комбинированная резекция прямой кишки с резекцией смежных органов. Чаще всего выполнялась резекция мочевых путей - у 24 (75,0 %) больных, из них у 13 (40,6 %) - первичная пластика мочевого пузыря и/или мочеточников. Послеоперационные хирургические осложнения развились у 11 (34,4 %) пациентов, что потребовало повторных операций в 7 (21,8 %) наблюдениях. В раннем послеоперационном периоде умер 1 (3,1 %) больной, причина - тромбоз правых подвздошных сосудов с последующей острой почечной недостаточностью. Отдаленные результаты: РПК - общая и безрецидивная 2-летняя выживаемость -75 % и 56,3 % соответственно, ПМЗО - все пациенты живы без признаков рецидивов, сроки наблюдения >24 мес.Заключение. Лечение распространенных опухолей органов малого таза требует выполнения обширных операций мультидисциплинарной бригадой хирургов. Несмотря на травматичность побочных вмешательств, при адекватном обеспечении периоперационного периода непосредственные результаты можно расценивать как удовлетворительные. Отдаленные результаты позволяют рассматривать подобные операции в качестве метода выбора при местнораспространенном и первично-множественном раке прямой кишки

A systematic review of non-invasive modalities used to identify women with anal incontinence symptoms after childbirth

© 2018, The International Urogynecological Association. Introduction and hypothesis: Anal incontinence following childbirth is prevalent and has a significant impact upon quality of life (QoL). Currently, there is no standard assessment for women after childbirth to identify these symptoms. This systematic review aimed to identify non-invasive modalities used to identify women with anal incontinence following childbirth and assess response and reporting rates of anal incontinence for these modalities. Methods: Ovid Medline, Allied and Complementary Medicine Database (AMED), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Collaboration, EMBASE and Web of Science databases were searched for studies using non-invasive modalities published from January 1966 to May 2018 to identify women with anal incontinence following childbirth. Study data including type of modality, response rates and reported prevalence of anal incontinence were extracted and critically appraised. Results: One hundred and nine studies were included from 1602 screened articles. Three types of non-invasive modalities were identified: validated questionnaires/symptom scales (n = 36 studies using 15 different instruments), non-validated questionnaires (n = 50 studies) and patient interviews (n = 23 studies). Mean response rates were 92% up to 6 weeks after childbirth. Non-personalised assessment modalities (validated and non-validated questionnaires) were associated with reporting of higher rates of anal incontinence compared with patient interview at all periods of follow-up after childbirth, which was statistically significant between 6 weeks and 1 year after childbirth (p < 0.05). Conclusions: This systematic review confirms that questionnaires can be used effectively after childbirth to identify women with anal incontinence. Given the methodological limitations associated with non-validated questionnaires, assessing all women following childbirth for pelvic-floor symptomatology, including anal incontinence, using validated questionnaires should be considered

Regional transition in Russia A study of the free economic zone policy in the Kaliningrad region

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Oxygen embolism after hydrogen peroxide irrigation of a vulvar abscess

We report a case of venous oxygen embolism in a 33‐yr‐old healthy woman after irrigation of a vulvar abscess with 25 ml of 3% hydrogen peroxide. Venous oxygen embolism was diagnosed by the development of sudden hypoxia associated with a decrease in end‐tidal carbon dioxide concentration from 5.3 kPa to 3.2 kPa, and a ‘mill‐wheel' sound on cardiac auscultation soon after injection of the solution. The patient responded to corrective treatment including the Trendelenburg position and 100% oxygen. She made an uneventful recovery. We discuss the possible causative mechanism of this embolism, the different diagnostic methods, and the controversial aspects of available treatments. We emphasize that hydrogen peroxide is a dangerous and unsuitable agent for routine wound irrigation and debridement. Br J Anaesth 2002; 88: 597-