Adrenocortical cancer: late diagnosis of the disease on the example of a clinical case. Case report

Adrenocortical carcinoma (ACC) is a rare malignant tumor originating in the adrenal cortex and characterized by poor 5-year survival. It occurs with a frequency of 2–4 cases per 2 million in the population. Women are more frequently affected than men and it is mostly detected in the fourth and fifth decades. In the most of cases, the cancerogenesis occurs sporadically because of gene driver mutations in somatic adrenocortical cells, in other cases it can be found as part of a genetically determined syndrome such as Li–Fraumeni syndrome or Wermer's syndrome (multiple endocrine adenomatosis type I). ACC most frequently happens occurs without symptoms in the initial stages leading to poor diagnoses. Because of this lack of early detection, the tumor is not considered malignant reducing the benefits of further treatment. Sometimes the fact that the resected tumor is indeed adrenocortical carcinoma becomes clear only after recurrence, or after the appearance of metastases. We present a case of adrenocortical carcinoma in a 46-year-old woman who went to the doctor in 1.5 year after symptoms were manfested. This clinical case illustrates the consequences of late diagnosis of a malignant tumor. We would like to emphasize the importance of timely detection of a neoplasm, using all of the potential of laboratory-instrumental and genomic analysis. Due to low oncological awareness, our patient was slow to seek medical help, which in turn led not only to metastases, but also to complications in the cardiovascular system

PERSONALIZATION OF PROFESSIONAL DEVELOPMENT OF UNIVERSITY PEDAGOGICAL STAFF

Abstract. With the rapid updating of knowledge and technologies, a shift is necessary from shortBterm courses of improvement of university teaching staff qualification to a system of continuous professional development, combining a system of practiceBoriented courses of formal (academic) refresher training and informal methodological support of teaching staff as the developers of discipline content, training tools and methods of interaction. Personal professional development routes are implemented within modular programmes of further education, after peer to peer evaluation, taking into account the individual needs of the Faculty and the University’s programme of innovation development priorities. Personal educational results achieved in the professional development system are evaluated by means of educational products created in the course of additional educational program selected

The Issue of Obedience in the Anglican Confessional Thought in the mid 1629s

Тема послушания стала актуальна для англиканской конфессио- нальной мысли после Реформации. Эта проблематика вновь начала обсуждаться в 1620-х годах, когда королевская власть попыталась собрать не легитимный, по мнению многих подданных, принудительный заем. В 1627 г. изрядное количество дворян отказалось раскошеливаться и угодило в тюрьму. Следствием стало из- вестное дело «пяти рыцарей», дебаты в парламенте 1628 г. и принятая палатами знаменитая «Петиция о праве». В конце сентября 1626 г. Карл I отправил письмо епископам, призывая их обратиться с церковных кафедр к прихожанам с просьбой «помочь и поддержать» личными средствами «защиту королевства». Набирающий политический вес, лидер арминианского крыла в церкви епископ Бата и Уэльса Уильям Лод адресовал духовенству инструкцию, призывающую «напомнить под- данным о долге послушания». В статье разбираются четыре проповеди: первая именовалась «Апостольское послушание» и была произнесена 22 февраля 1627 г. в Нортгемптоне Робертом Сибторпом, вторая, названная в печати просто «Про- поведь», принадлежит капеллану короля, настоятелю Кентерберийского собора Исааку Баргрейву и была произнесена в присутствии монарха 27 марта 1627 г., еще две под общим названием «Религия и верность» прозвучали 4 июля 1627 г. перед Карлом I в королевском дворце в Отланде, графство Сари, и 29 июля в Олдертоне, графство Сэффолк из уст другого королевского капеллана Роджера Мэнверинга. Все проповеди для большего эффекта были по повелению короля опубликованы. Англиканский клир интересовался проблемой послушания и продвигал ее среди прихожан в интерпретации, угодной королевской власти, а именно: как важнейший духовный принцип, на котором держится установленный порядок. Англиканское духовенство считало монарха божьим наместником на земле, а неповиновение королю склонно было расценивать как сопротивление самому Господу, как по- пытку разрушить устроенное им иерархическое системное единство. Проповеди показывают, что англиканские клирики были близки к тому, чтобы поставить повиновение монарху выше повиновения закону и традиции. Некоторые из них полагали, что миссия поддерживать порядок дает королю право по своему усмо- трению назначать и собирать денежные субсидии с подданных. Однако были и те, кто расценивал такие заявления, как недопустимую попытку расширить границы королевской прерогативы и как покушения на исконные вольности . The idea of obedience emerged full blown for the Anglican confessional thought after the Reformation. This problem came under discussion again in 1620s, when the royal power tried to collect non-legitimate in the eyes of many subjects forced loans. In 1627 a number of noblemen refused to dip into their purse and were imprisoned. It resulted in famous Five Knights’ case, parliament debates in 1628, which contributed to the enactment of the Petition of Right. In late September 1626 Charles I sent a letter to his bishops, demanding to appeal from their cathedrae to the parish with a request to “help and support protection of the royalty” by their personal means. Coming into political force leader of the Arminian church wing bishop of Bath and Wells William Laud addressed an instruction to the clergy, which demanded to “remind subjects about their debt of obedience”. The present paper studies four sermons: the first was called Apostolic Obedience and was delivered by Robert Sibthorpe on the 22nd of February, 1627 in Northampton, the second, simply called in press The Sermon belonged to the king’s chaplain, Dean of Canterbury Isaac Bargrave and was delivered before the king’ majesty on the 27th of March, 1627. Two sermons under common name “Religion and Allegiance” were preached before Charles I by the king’s chaplain Roger Maynwaring the one on the 4th of July 1627 at the king’s palace at Oatlands Surrey, the other on the 29th of July at Alderton Suffolk. To heighten an effect all sermons were published by order of his majesty. The Anglican clergy was interested in the problem of obedience and promoted it among the parish in interpretation acceptable before the royal power, namely as the most impotent religious principle, lying in the ground of the stated order. The Anglican Church considered the king to be the vicar of God on earth, thus disobedience to the king was judged as rebellion to Christ Himself, i.e. an attempt to destroy a hierarchically systemized community settled by Him. The sermons show that the Anglican clergy was close to place obedience to the monarch higher than obedience to law or tradition. Some of them believed that a mission to support the order gave the king a right to set and collect monetary contributions from his subjects to his own discretion. Nonetheless, the others regarded such claims as an intolerable attempt to broaden the limits of royal prerogative and as aggression upon ancient liberties of subjects