Aspectos Jurídicos do Patrimônio Cultural e Ambiental

( Jalusa Prestes Abaide ) 한국포르투갈-브라질학회 2007 포르투갈-브라질 연구 Vol.4 No.2

Le nouveau millénaire a commencé avec l’arrivée de nouvelles situations juridiques, résultat de nouveaux droits qui mènent à la discussion sur quelques concepts et théories, comme par exemple les circonstances de l’usage de l’informatique avec des imbrications qui atteignent des droits fondamentaux et/ou les droits de l’auteur; de même le développement de la génétique et de la biotechnologie qui mènent à envisager les valeurs ethniques qui incluent l’homme et la société moderne capitaliste. Le droit est le point de départ de toutes ces questions à être discuter. Le développement de la technologie de nouveaux matériaux ex vi, favorise la création et la transformation des oeuvres et des produits exigeant de nouvelles formes de prestation de services comme ceux qui dérivent des oeuvres qui exigent de grandes infrastructures capables d’affecter non seulement l’environnement physique rustique ou urbaine mais aussi l’espace cybernétique, à partir du développement des réseaux de prestation de services, ce qui peut causer, d’une certaine manière, un impact sur l’esthétique de l’environnement naturel ou artificielle. Ces nouveaux droits ou «cyber droit» qui exigent la création de «cyber lois» mènent à la formation d’un nouveau modèle d’Etat et de relations «public-privé». Ces nouveaux droits qui déterminent les «nouveaux biens juridiques» entraînent à une réflexion sur les limites du «public-privé» et à un réexamen de la théorie traditionnelle du domaine public. De cette forme, dans la liste des nouveaux droits surgit le droit de l’environnement avec ses différentes nuances. Les normes qui incluent la protection de l’environnement d’une manière pratiquement codifiée ont été étudiée comme dans un domaine d’étude individualisé. Cependant, le droit de l’environnement est nécessairement imbriqué dans d'autres domaines du droit, ce qui nous ramène à repenser et à refaire les théories juridiques traditionnelles. C’est le cas de l’environnement culturel, il est done nécessaire d’analyser la façon dont l’espace culturel naturel ou artificiel (dans les villes) sont entrain d’être interprétés quand il est alors urgent de protéger des biens qui lui sont intégrés et qui, cependant, ne s’adaptent pas au critère anthropomorphiste qui définit les oeuvres d'art créées par l’homme. Les oeuvres d'art élaborées par la nature ne sont pas considérées dans la définition traditionnelle de la culture, il y a des oeuvres de la nature qui sont des biens publics et qui se constituent comme oeuvres de valeur extra comercium, comme les paysages destinés simplement à la contemplation, d’intérêt touristique ou scientifique qui deviennent objet de culture pour sa nature ou sa valeur intrinsèque, comme le sont quelques monts qui font partie des paysages protégés. De même les cavernes et quelques minéraux comme les fossiles sont des biens qui appartiennent au patrimoine paléontologique et le patrimoine culturel, ce qui dénote le surgissement d’une nouvelle catégorie à être définie par le droit. Il existe un vrai vide juridique en rapport, par exemple, avec les compétences administratives pour diriger les fossiles trouvés lors des fouilles. S’ils ne sont pas encore des biens juridiques ils ne font pas partie du monde juridique, done qui serait le titulaire ? A observer qu’il est nécessaire d’accorder juridiquement entre des biens qui font partie du patrimoine culturel et/ou d’environnement et des biens de domaine public face aux nouvelles définitions constitutionnelles bresiliene (art. 2l6 CF/88), centralisant l’attention sur celui qui devient «constitution culturelle», «constitution économique» et «constitution d’environnement». Ainsi, dans une tentative de discuter la situation, nous avons apporté du droit comparé des nouveaux paramètres pour interpréter le patrimoine historique-culturel (en particulier une réflexion sur des biens juridiques nouveaux : les fossiles) et sa relation avec l’environnement. Pour cette fin, nous analysons quelques catégories comme celle de l’environnement,a partir de là, nous pourrions comprendre le concept juridique du patrimoine d’environnement culturel dans le contexte urbain et donnons comme exemples la doctrine juridique brésilienne et espagnole, et en passant, les aspects du droit nord-américain et italien.

Sequential chemotherapy and radiotherapy as sandwich therapy for the treatment of high risk endometrial cancer

Lisa N. Abaid,Mark A. Rettenmaier,John V. Brown III,John P. Micha,Alberto A. Mendivil,Marie A. Wabe,Bram H. Goldstein 대한부인종양학회 2012 Journal of Gynecologic Oncology Vol.23 No.1

Objective: The purpose of this retrospective study was to assess the tolerability and efficacy of sequential chemotherapy and radiotherapy for the treatment of high risk endometrial cancer. Methods: We conducted a retrospective study of previously untreated high risk endometrial cancer patients who received sequential chemotherapy and radiotherapy in accordance with the sandwich approach from June 2008 until June 2011. High risk endometrial cancer patients underwent complete surgical staging followed by adjuvant therapy encompassing sequential chemotherapy, radiation therapy and consolidation chemotherapy. Results: The study analysis comprised 32 endometrial cancer patients. All subjects were treated with carboplatin and paclitaxel chemotherapy; currently, 186 cycles have been administered and 94% of patients have completed the planned number of cycles. Grade 3 neutropenia developed in 1 (3.1%) patient; there was no incidence of grade 4 neutropenia. Moreover, we observed grade 3 anemia in four (12.5%) patients and grade 4 anemia in one (3.1%) patient. One (3.1%) patient developed grade 3 thrombocytopenia; grade 4 thrombocytopenia was not observed. Five patients exhibited progressive disease, three of whom have since expired; mean progression free survival and follow-up were 17.4 months and 18.9 months, respectively. Conclusion: The preliminary results from our study suggest that the sandwich approach to treating high risk endometrial cancer patients is feasible. Hematologic toxicity was well tolerated and non-hematologic toxicity was mild and easily managed. Further study of this novel regimen in a larger patient population with extended follow-up is necessary. Objective: The purpose of this retrospective study was to assess the tolerability and efficacy of sequential chemotherapy and radiotherapy for the treatment of high risk endometrial cancer. Methods: We conducted a retrospective study of previously untreated high risk endometrial cancer patients who received sequential chemotherapy and radiotherapy in accordance with the sandwich approach from June 2008 until June 2011. High risk endometrial cancer patients underwent complete surgical staging followed by adjuvant therapy encompassing sequential chemotherapy, radiation therapy and consolidation chemotherapy. Results: The study analysis comprised 32 endometrial cancer patients. All subjects were treated with carboplatin and paclitaxel chemotherapy; currently, 186 cycles have been administered and 94% of patients have completed the planned number of cycles. Grade 3 neutropenia developed in 1 (3.1%) patient; there was no incidence of grade 4 neutropenia. Moreover, we observed grade 3 anemia in four (12.5%) patients and grade 4 anemia in one (3.1%) patient. One (3.1%) patient developed grade 3 thrombocytopenia; grade 4 thrombocytopenia was not observed. Five patients exhibited progressive disease, three of whom have since expired; mean progression free survival and follow-up were 17.4 months and 18.9 months, respectively. Conclusion: The preliminary results from our study suggest that the sandwich approach to treating high risk endometrial cancer patients is feasible. Hematologic toxicity was well tolerated and non-hematologic toxicity was mild and easily managed. Further study of this novel regimen in a larger patient population with extended follow-up is necessary.

Chemotherapy and patient co-morbidity in ventral site hernia development

Mark A. Rettenmaier,Lisa N. Abaid,John V. Brown III,John P. Micha,Bram H. Goldstein 대한부인종양학회 2009 Journal of Gynecologic Oncology Vol.20 No.4

Objective: The risk factors associated with early ventral site hernia development following cancer surgery are ill defined and associated with an undetermined incidence. Methods: We analyzed 1,391 gynecologic cancer patient charts to identify the number of post-operative ventral site hernias over a nearly 6 year period. The following study variables were noted for evaluation: patient demographics, disease co-morbidity (hypertension, cardiovascular disease, diabetes), body mass index (BMI), treatment (e.g., chemotherapy regimen), intra-operative (e.g., bleeding) and postoperative (e.g., infection) complications, time to hernia development and length of hospital stay. Results: Twenty-six gynecologic cancer patients who developed a post-operative ventral hernia and subsequently underwent herniorrhaphy by our gynecologic oncology service were identified. The patient group’s overall time to initial hernia development was 11.23 months. Following a multiple regression analysis, we found that treatment (e.g., bevacizumab, liposomal doxorubicin or radiotherapy associated with compromised wound healing [p=0.0186] and disease co-morbidity [0.0432]) were significant prognostic indicators for an accelerated time to hernia development. Moreover, five patients underwent treatment associated with compromised wound healing and also had disease co-morbidity. In this sub-group, post-operative hernia development occurred more rapidly (3.8 months) than the overall group of patients. BMI and age did not impact time to hernia development (p>0.05). Conclusion: In the present gynecologic cancer patient series, a tendency for early post-operative hernia development appeared to coincide with treatment associated with compromised wound healing and disease co-morbidity. Gynecologic cancer surgeons should anticipate this potential complication and consider employing prophylactic intra-operative mesh to potentially prevent this condition. Objective: The risk factors associated with early ventral site hernia development following cancer surgery are ill defined and associated with an undetermined incidence. Methods: We analyzed 1,391 gynecologic cancer patient charts to identify the number of post-operative ventral site hernias over a nearly 6 year period. The following study variables were noted for evaluation: patient demographics, disease co-morbidity (hypertension, cardiovascular disease, diabetes), body mass index (BMI), treatment (e.g., chemotherapy regimen), intra-operative (e.g., bleeding) and postoperative (e.g., infection) complications, time to hernia development and length of hospital stay. Results: Twenty-six gynecologic cancer patients who developed a post-operative ventral hernia and subsequently underwent herniorrhaphy by our gynecologic oncology service were identified. The patient group’s overall time to initial hernia development was 11.23 months. Following a multiple regression analysis, we found that treatment (e.g., bevacizumab, liposomal doxorubicin or radiotherapy associated with compromised wound healing [p=0.0186] and disease co-morbidity [0.0432]) were significant prognostic indicators for an accelerated time to hernia development. Moreover, five patients underwent treatment associated with compromised wound healing and also had disease co-morbidity. In this sub-group, post-operative hernia development occurred more rapidly (3.8 months) than the overall group of patients. BMI and age did not impact time to hernia development (p>0.05). Conclusion: In the present gynecologic cancer patient series, a tendency for early post-operative hernia development appeared to coincide with treatment associated with compromised wound healing and disease co-morbidity. Gynecologic cancer surgeons should anticipate this potential complication and consider employing prophylactic intra-operative mesh to potentially prevent this condition.