Transpupillary thermotherapy for malignant choroidal melanoma

Purpose: Several methods have been used for treatment of choroidal melanoma. The purpose of this preliminary paper is to evaluate the effectiveness of transpupillary thermo- therapy (TTT) as a primary treatment of small choroidal melanomas. Methods: This is a prospective nonrandomized study evaluating clinical aspects, tumor response, complications and visual outcome in patients presenting small choroidal melanomas (up to 4.0 mm thick and 12 mm base diameter) treated with TTT over 810 nm laser diode applications. Results: There were 11 patients treated with trans-pupillary thermotherapy, all of them presenting pig-mented small choroidal melanomas. Growth previous to treatment was documented in 5 patients and risk factors for growth or metastatic disease was present in all the patients. After treatment the patients were followed for 3 to 8 months (mean 5.7 months). Three laser sessions were used in 5 pa-tients and 4 sessions in 6 patients. The lesions presented at the beginning of the treatment a mean thickness of 2.7 mm, with a mean larger base diameter of 7.8 mm. All the lesions responded to treatment and presented decrease of thickness and base diameters. After transpupillary thermotherapy, the lesions' mean thickness was 1.8 mm and the mean larger base diameter was 6.7 mm. The mean reduction in thickness was 0.9 mm and the mean decrease in larger base diameter was 1.4 mm. The visual acuity remained unaffected in 5 cases and worsened after treatment in 6 cases. Nine patients presented compli- cations. A major complication occurred in a single patient who presented retinal detachment. Minor compli-cations were observed as follows: small retinal hemorrhages (7 patients), vitreous inflammation associated with tenuous vitreous membranes (1 patient) and conjunctiva and eyelid edema (1 patient). Local tumor control and conservation of the eyeball was accomplished in all the patients; they are all alive without evidence of metastatic disease in this initial follow-up period. Conclusion: This preliminary study suggests that the transpupillary thermotherapy is a promi-sing, effective and safe method for treatment of selected small choroidal melanomas. Further studies with longer follow-up period are necessary to better evaluate this treatment.Objetivo: Vários métodos vem sendo utilizados para o tratamento dos melanomas da coróide. A proposta deste trabalho preliminar é avaliar a eficácia da termoterapia transpupilar (TTT) como tratamento primário de melanomas da coróide pequenos. Métodos: Foi realizado um trabalho prospectivo e não-randomizado para avaliar os aspectos clínicos, resposta do tumor, complicações e resultados visuais de pacientes portadores de melanomas da coróide pequenos (até 4,0 mm de espessura e 12 mm de diâmetro basal) tratados por termoterapia transpupilar utilizando-se sucessivas aplicações de laser diodo contínuo de 810 nm. Resultados: Foram tratados 11 pacientes portadores de melanomas da coróide pequenos. O tumor era único e pigmentado em 100% dos casos. Crescimento documentado esteve presente em 5 pacientes (45,45%) previamente ao tratamento e fatores de risco para crescimento ou metástase estavam presentes em todos os pacientes. O tempo de seguimento destes pacientes a partir do tratamento foi em média de 5,72 meses (3 - 8 meses). Foram utilizadas 3 sessões de laser em 5 pacientes (45,45%) e 4 sessões em 6 pacientes (64,64%). As lesões apresentavam, por ocasião do diagnóstico, uma espessura média de 2,65 mm (1,85-3,86 mm), com maior diâmetro basal médio de 7,98 mm (4,2-11,33 mm). Após o tratamento, a espessura média foi de 1,83 mm (0,98-2,93 mm) e o maior diâmetro basal médio foi de 6,59 mm (3,81 mm -10,67 mm). Das lesões tratadas, 100% apresentaram diminuição da altura e do máximo diâmetro basal, tendo sido a diminuição média da espessura de 0,89 mm e do máximo diâmetro basal de 1,39 mm. A acuidade visual manteve-se inalterada em 5 casos (45,45%) e piorou após o tratamento em 6 casos (54,54%). Ocorreram complicações em 9 casos, tendo sido considerada complicação grave 1 caso de descolamento parcial da retina (9,09%); as outras complicações foram consideradas leves: pequenas hemorragias intra-retinianas em 7 pacientes (63,63%), vitreite associada a tênues membranas vítreas em 1 paciente (9,09%) e quemose associada a edema palpebral em 1 paciente (9,09%). Controle tumoral local com conservação do globo ocular foi observado durante este pequeno tempo de seguimento em 100% dos pacientes tratados. Por ocasião da última revisão, 100% dos pacientes estavam vivos e sem doença metastática. Conclusão: Este estudo preliminar sugere que a termoterapia transpupilar apresenta-se como um método efetivo e seguro para o tratamento de selecionados melanomas pequenos da coróide. Para melhor avaliação é necessário tempo de seguimento prolongado.Universidade Federal de São Paulo (UNIFESP) Departamento de Oftalmologia Setor de Ultra-somHospital A. C. CamargoUniversidade Federal de São Paulo (UNIFESP) Departamento de Oftalmologia Setor de RetinaHospital A. C. Camargo Setor de TumoresUniversidade Federal de São Paulo (UNIFESP)UNIFESP, Depto. de Oftalmologia Setor de Ultra-somUNIFESP, Depto. de Oftalmologia Setor de RetinaUNIFESPSciEL

Multifocal ERG in patients treated with low-dose tamoxifen

PURPOSE: Tamoxifen, an antiestrogen, has been used as an effective therapeutic agent in the treatment of breast cancer. The drug has been shown to cause ocular toxic effects. The purpose of this study was to determine possible central retinal toxicity by multifocal electroretinograms (mfERGs) in a cohort of patients treated with low-dose tamoxifen (20 mg/day) for breast cancer. METHODS: Multifocal electroretinograms of the central 30 degrees of the retina were obtained of 3 different groups: Experimental group - 15 females (41-59 years, mean 48.6 ± 4.5) with normal fundus, treated with low-dose tamoxifen for 1 to 55 months. Control group - 6 females (30-76 years, mean 49.9 ± 18.8) with previous breast cancer diagnosis who had not received tamoxifen as treatment until ERG testing. Normal control group - 15 normal female volunteers (30-71 years, mean 47.7 ± 12.9). The multifocal amplitude and latency for N1-P1 were measured and statistically analyzed (one-way ANOVA). RESULTS: Mean amplitudes N1-P1 (nV/deg²) were comparable for responses of different eccentricity (0 to 25 degrees). There was no statistically significant difference for implicit time of N1 and P1 (ms) in multifocal electroretinograms between the 3 groups. CONCLUSIONS: Low-dose tamoxifen showed no retinotoxic effect in this small group of women with breast cancer. Follow-up investigation could provide a better understanding of these effects.OBJETIVO: O tamoxifeno é um antiestrógeno utilizado como agente terapêutico eficaz no câncer de mama. A droga pode causar efeitos tóxicos oculares em dosagens altas. O objetivo deste estudo foi determinar possíveis efeitos retino-tóxicos centrais usando o eletrorretinograma multifocal (mfERG) em grupo de pacientes tratadas com baixa dosagem de tamoxifeno (20 mg/dia) após cirurgia do câncer de mama. MÉTODOS: O eletrorretinograma multifocal (mfERG) de 30 graus centrais da retina foi obtido em 3 diferentes grupos: Grupo experimental - 15 mulheres (41-59 anos, média 48,6 ± 4,5) com fundo de olho normal, tratadas com tamoxifeno em baixa dosagem por 1 a 55 meses. Grupo controle - 6 mulheres (30 -76 anos, média 49,9±18,8) com diagnóstico prévio de câncer de mama que não receberam tratamento com tamoxifeno até o teste do eletrorretinograma multifocal. Grupo controle normal - 15 voluntárias normais (30-71 anos, média 47,7 ± 12,9). A amplitude e a latência de eletrorretinograma multifocal para N1-P1 foram analisados estatisticamente (análise de variância de uma via). RESULTADOS: As amplitudes médias N1-P1 (nV/grau²) foram comparáveis para respostas de diferentes excentricidades (0 a 25 graus) nos três grupos. Não houve diferença estatisticamente significativa para a latência de N1 e P1 (ms) do eletrorretinograma multifocal entre os 3 grupos. CONCLUSÕES: O tratamento com baixa dosagem de tamoxifeno não mostrou efeitos retino-tóxicos em pequeno grupo de mulheres após cirurgia do câncer de mama. Investigação seriada proporcionará melhor compreensão desses efeitos.Universidade Federal de São Paulo (UNIFESP) Departamento de OftalmologiaUniversidade Federal de São Paulo (UNIFESP) Departamento de Oftalmologia Setor de Eletrofisiologia Visual ClínicaHospital do Câncer - AC. CamargoUNIFESP, Depto. de OftalmologiaUNIFESP, Depto. de Oftalmologia Setor de Eletrofisiologia Visual ClínicaSciEL

Objection of the prosecutor to the conditional release from serving the full sentence in the executive penal code

Artykuł podejmuje problem sprzeciwienia się przez prokuratora udzieleniu skazanemu w postępowaniu karnym wykonawczym warun-kowego przedterminowego zwolnienia z odbycia reszty kary (analogiczne uprawnienie przysługuje prokuratorowi w postępowaniu w przedmiocie przerwy w karze). Jest to wyjątkowe rozwiązanie w polskim postępowaniu karnym, które pozwala stronie wstrzymać natychmiastową wykonalność orzeczenia na mocy wyłącznie oświadczenia strony. W artykule krytycznie omówiono to uprawnienie strony, podnosząc także wątpliwości natury konstytucyjnej

Podstawy skargi nadzwyczajnej a postępowanie odwoławcze

Niniejszy artykuł powstał w ramach projektu badawczego pt. „Czy polski model postępowania odwoławczego w sprawach karnych jest rzetelny?” (konkurs „OPUS 8”) finansowanego przez Narodowe Centrum Nauki zgodnie z umową nr UMO-2014/15/B/HS5/02689.Uniwersytet WarszawskiBagińska Ł, Skarga kasacyjna i nadzwyczajna w postępowaniu cywilnym. Komentarz praktyczny z orzecznictwem. Wzory pism procesowych i kazus, Legalis 2018.Dziga K., Czy merytoryczne rozpoznanie skargi nadzwyczajnej w sprawach karnych jest możliwe? , CzPKiNP 5/2019.Skorupka J. (red.), Komentarz do Kodeksu postępowania karnego, Legalis 2019.Steinborn S., Prawomocność części orzeczenia w procesie karnym, Warszawa 2011.Steinborn S. (red.), Postępowanie odwoławcze w procesie karnym – u progu nowych wyzwań Warszawa 2016

Postulat nowelizacji Kodeksu postępowania karnego – krytycznie o niektórych proponowanych zmianach

The article concentrates on the proposed amendment to the Criminal procedure code. This is the another important change in the Polish criminal procedure in the last years. The amend-ments that are proposed at the moment are debatable. The aspiration to make the criminal procedure more efficient is absolutely justifiable but it can’t be made if it means the dramatic limitation of the accused rights like presence at the main trail. Some other amendments were also commented in the article

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Th e analysis of some problems associated with application of the advocates material disciplinary law within the scope of fair trial for the accused

The text is dedicated to the analysis of the function and normative status of ethical and deontological principles concerning advocates professions. It presents the normative status of the advocates ethical code and its relationships with existing law regulation. It also includes some remarks on fine penalty and the issue of guilt in disciplinary [email protected]Łukasz Chojniak – doktor nauk prawnych, adiunkt w Instytucie Profilaktyki Społecznej i Resocjalizacji (Katedra Kryminologii i Polityki Kryminalnej) Uniwersytetu Warszawskiego oraz wiceprzewodniczący Odwoławczej Komisji Dyscyplinarnej do spraw Studentów i Doktorantów na Uniwersytecie Warszawskim. Adwokat, członek Izby Adwokackiej w Warszawie i jej Rzecznik Dyscyplinarny w latach 2013-2016. Autor wielu publikacji naukowych z zakresu prawa i postępowania karnego, m.in. raportu dotyczącego przyczyn niesłusznych skazań w Polsce. Współpracował z różnymi organizacjami pozarządowymi, w tym z Forum Obywatelskiego Rozwoju w Warszawie.Łukasz Chojniak – Ph.D. in law, lecturer at the Institute for Social Prevention and Resocialisation (Chair of Criminology and Criminal Policy) at the University of Warsaw and vice-president of the Disciplinary Committee for Students and Ph.D. Students at the University of Warsaw. A practicing attorney, member of the Warsaw Bar Association and its Disciplinary Representative in the years 2013-2016. Author of many scientific publications in the field of law and criminal proceedings, among others, a report on the causes of wrongful convictions in Poland. He has worked with various non-governmental organizations, including the Civil Development Forum in Warsaw.Uniwersytet WarszawskiBodnar A., Kubaszewski P., Postępowania dyscyplinarne w wolnych zawodach prawniczych. Model ustrojowy i praktyka, Warszawa 2013.Borkowski G. (red.), Etyka zawodu radcy prawnego i adwokata. Kazusy. Objaśnienia. Orzecznictwo, Warszawa 2016.Łojko E., Dziurnowska-Stefańska E. (red.), Wartości a sukces zawodowy prawników – granice kompromisu?, Warszawa 2011.Naumann J., Zbiór Zasad Etyki Adwokackiej i Godności Zawodu. Komentarz, Warszawa 2012.Pachnik K., Odmowa sporządzania nadzwyczajnych środków zaskarżenia wymaga aktualizacji, http://www.adwokatura.pl/ogolnoprawne/odmowa-sporzadzania-nadzwyczajnych-srodkow-zaskarzenia-wymaga-aktualizacji/ (data dostępu: 29.01.2017 r.).Safjan M., Bosek L. (red.), Komentarz do Konstytucji RP, Warszawa 2016 r., Wydanie 1, Legalis (wersja elektroniczna).Świecki D., Czynności procesowe obrońcy i pełnomocnika w sprawach karnych, Warszawa 2015.Kozielewicz W., Odpowiedzialność dyscyplinarna sędziów, prokuratorów, adwokatów, radców prawnych i notariuszy, Warszawa 2012.71-8

The Analysis of Some Problems Associated with the Application of Substantive Disciplinary Law Referring to Advocates within the Scope of a Fair Trial for the Accused

Creation of the English-language versions of the articles published in the „Białostockie Studia Prawnicze” [Białystok Legal Studies] funded under the contract no. 548/P-DUN/2016 and 548/1/P-DUN/2016 from resources of the Minister of Science and Higher Education dedicated to the popularisation of science.The text is dedicated to the analysis of the function and normative status of ethical and deontological principles concerning advocates’ professions. It presents a normative status of the advocates’ ethical code and its relationships with existing law regulations. It also includes some remarks on a fine and the issue of guilt in disciplinary [email protected]Łukasz Chojniak – Ph.D. in law, lecturer at the Institute for Social Prevention and Resocialisation (Chair of Criminology and Criminal Policy) at the University of Warsaw and vice-president of the Disciplinary Committee for Students and Ph.D. Students at the University of Warsaw. A practicing attorney, member of the Warsaw Bar Association and its Disciplinary Representative in the years 2013-2016. Author of many scientific publications in the field of law and criminal proceedings, among others, a report on the causes of wrongful convictions in Poland. He has worked with various non-governmental organizations, including the Civil Development Forum in Warsaw.University of WarsawBodnar A., Kubaszewski P., Postępowania dyscyplinarne w wolnych zawodach prawniczych. Model ustrojowy i praktyka, Warszawa 2013.Borkowski G. (ed.), Etyka zawodu radcy prawnego i adwokata. Kazusy. Objaśnienia. Orzecznictwo, Warszawa 2016.Łojko E., Dziurnowska-Stefańska E. (eds.), Wartości a sukces zawodowy prawników – granice kompromisu?, Warszawa 2011.Naumann J., Zbiór Zasad Etyki Adwokackiej i Godności Zawodu. Komentarz, Warszawa 2012.Pachnik K., Odmowa sporządzania nadzwyczajnych środków zaskarżenia wymaga aktualizacji, http://www.adwokatura.pl/ogolnoprawne/odmowa-sporzadzania-nadzwyczajnych-srodkow-zaskarzenia-wymaga-aktualizacji/ (accessed on: 29 January 2017).Safjan M., Bosek L. (eds.), Komentarz do Konstytucji RP, Warszawa 2016 r., Legalis (electonic version).Świecki D., Czynności procesowe obrońcy i pełnomocnika w sprawach karnych, Warszawa 2015.Kozielewicz W., Odpowiedzialność dyscyplinarna sędziów, prokuratorów, adwokatów, radców prawnych i notariuszy, Warszawa 2012.221 en718

Duchowość jednostki a komunikacja międzykulturowa

The aim of this paper is to analyze – in the perspective of individual spirituality – the conception of intercultural communication, proposed by Young Yun Kim and Brent Ruben. In this theory intercultural communication is presented as a process of cyclic changes which enables the individuals to transcend their cultural patterns of thinking, feeling and behaving so that the increased intercultural competence and a higher level of personal development is achieved. In my opinion the type of changes which take place in the intercultural interactions, observed by the authors, is connected with psychological cathegory of spirituality.  Celem artykułu jest analiza – w kontekście duchowości indywidualnej – koncepcji komunikacji międzykulturowej zaproponowanej przez Young Yun Kim i Brenta Rubena. W ramach tej teorii komunikacja międzykulturowa jest postrzegana jako proces cyklicznych przemian, który umożliwia jednostkom transcendowanie poza kulturowe wzorce myślenia, odczuwania i zachowania w kierunku szerszych kompetencji międzykulturowych i wyższego poziomu rozwoju osobowości. Moim zdaniem typ przemian zachodzący podczas interakcji międzykulturowej, obserwowany przez autorów, jest powiązany z psychologiczną kategorią duchowości