Escaping the Slippery Slope: Freedom of Expression and Cyberspace Regulation after the Delfi Case

In June 2015, the European Court of Human Rights delivered the final judgment in the Delfi case, where it upheld the decision of an Estonian court to fine a news portal for hosting anonymous defamatory comments. This controversial judgment has a chilling effect on freedom of expression in cyberspace and paves the way for a slippery slope leading to online censorship. The key policy issue is striking a balance between freedom of expression and other protected interests, including privacy, reputation and national security. This paper argues that holding Internet Service Providers (ISPs) liable for third-party content places a disproportionate burden on them and destabilises the architecture of Web 2.0 to the detriment of human rights. To this end, we argue that a new regulatory approach is necessary to address the rights of ISPs in the attempt to balance freedom of expression with new developments in the need for protection of personal data

Chronic Osteomyelitis With Proliferative Periostitis of the Mandible in a Child Report of a Case Managed by Immunosuppressive Treatment:Report of a Case Managed by Immunosuppressive Treatment

Background: Osteomyelitis with proliferative periostitis is a relatively uncommon inflammatory condition of the jaws, mainly characterized by periosteal formation of reactive bone. It primarily affects children and adolescences, also referred to as Garre's osteomyelitis, more frequently involving the molar region of the mandible. Cases lacking an obvious source of infection may have an immunologically mediated etiopathogenesis, falling under the spectrum of primary chronic osteomyelitis or chronic recurrent multifocal osteomyelitis (CRMO). Case report: Herein, we present a case of chronic osteomyelitis in a 6.5-year-old girl, who suffered from recurrent painful episodes of swelling of the mandible for the last 2 years, previously requiring hospitalization and administration of intravenous (IV) antibiotics and NSAIDs with limited responsiveness. The biopsy showed features consistent with osteomyelitis with proliferative periostitis. The patient was initially managed with an IV combination antibiotic regimen with only partial improvement. The possibility of an autoimmune mechanism in the context of primary chronic osteomyelitis or CRMO was considered, and immunosuppressive therapy (TNF inhibitor etanercept along with corticosteroids and methotrexate) was administered, resulting in clinical resolution. Conclusions: Osteomyelitis and its childhood variants are relatively rare and their management presents several challenges. Although typically treated with administration of antibiotics, possibly along with surgical intervention, other treatment modalities may be necessary for resilient and persistent cases. In a subset of cases, especially in the absence of local infectious factors, immunologically mediated mechanisms may play an important role and appropriate immunosuppressive therapy may be effective

The interrelation of EU law with inter se international agreements of the EU member states

This thesis examines how EU law interrelates with international agreements concluded between EU Member States inter se when a conflict between their norms can be identified. Chapter One starts by distinguishing between the different types of international agreements that may co-exist with EU law and argues that conflicts between EU law and inter se agreements need to be approached as conflicts of treaty norms on the international plane, using the conflict avoidance techniques and conflict resolution rules of international law. Against this background, Chapter Two examines and discards the premise that EU law constitutes a ‘new legal order’, highlighting the nature of EU law as international law. Chapter Three then examines the position of EU law within international law, identifying EU law as an autonomous sub-system within public international law, in the sense of a broadly conceived ‘self-contained regime’. Chapter Four moves on to define the notion of ‘conflict’ between EU law and inter se agreements and provides the conceptual framework, within which it is to be grasped. Chapter Five explores the available conflict avoidance techniques, identifying two interrelated, yet distinct interpretative methods applicable to the context of this thesis: first, the principle of systemic integration, enshrined in Article 31(3)(c) of the Vienna Convention on the Law of Treaties (VCLT); and second, the principle of a consistent-with-EU-law interpretation of inter se agreements, as a special application of the principle of harmonious interpretation applied in international law. Finally, Chapter Six identifies the rules governing conflict resolution in the interrelation of EU law with inter se agreements: first, Article 59 VCLT on the implicit abrogation of an earlier agreement by the conclusion of a later one between the same contracting parties; second, Article 30 VCLT, to the extent that it codifies the pacta tertiis principle of public international law; and third, the principle of primacy of EU law, which operates as a lex specialis, carving out the lex posterior conflict rule enshrined in Articles 30(3) and 30(4)(a) VCLT

The Impact of Achmea on Investor-State Arbitration under Intra-EU BITs: A Treaty Law Perspective

This article examines the consequences of the Court of Justice of the European Union’s (CJEU) ruling in Achmea concerning Investor-State Arbitration (ISA) under intra-EU Bilateral Investment Treaties (BITs) from a treaty law perspective. It begins by briefly setting out the arguments of Advocate General Wathelet and the CJEU supporting their different positions on whether intra-EU BITs ISA clauses are compatible with EU law. The article then proceeds to analyse Achmea’s implications for intra-EU BIT ISA. It concludes that, as a result of the CJEU’s ruling, arbitral tribunals are deprived of their jurisdiction to entertain investors’ claims brought under intra-EU BIT ISA clauses. Finally, the article argues that Achmea’s applicability to cases brought under intra-EU BIT ISA clauses is limited, using the application of EU law as a relevant qualification. In order for an arbitral tribunal to be deprived of its jurisdictional competence as a result of Achmea, it must be entitled to interpret and apply EU law directly or indirectly in determining its jurisdiction

Chronic Osteomyelitis With Proliferative Periostitis of the Mandible in a Child Report of a Case Managed by Immunosuppressive Treatment

Background: Osteomyelitis with proliferative periostitis is a relatively uncommon inflammatory condition of the jaws, mainly characterized by periosteal formation of reactive bone. It primarily affects children and adolescences, also referred to as Garre's osteomyelitis, more frequently involving the molar region of the mandible. Cases lacking an obvious source of infection may have an immunologically mediated etiopathogenesis, falling under the spectrum of primary chronic osteomyelitis or chronic recurrent multifocal osteomyelitis (CRMO). Case report: Herein, we present a case of chronic osteomyelitis in a 6.5-year-old girl, who suffered from recurrent painful episodes of swelling of the mandible for the last 2 years, previously requiring hospitalization and administration of intravenous (IV) antibiotics and NSAIDs with limited responsiveness. The biopsy showed features consistent with osteomyelitis with proliferative periostitis. The patient was initially managed with an IV combination antibiotic regimen with only partial improvement. The possibility of an autoimmune mechanism in the context of primary chronic osteomyelitis or CRMO was considered, and immunosuppressive therapy (TNF inhibitor etanercept along with corticosteroids and methotrexate) was administered, resulting in clinical resolution. Conclusions: Osteomyelitis and its childhood variants are relatively rare and their management presents several challenges. Although typically treated with administration of antibiotics, possibly along with surgical intervention, other treatment modalities may be necessary for resilient and persistent cases. In a subset of cases, especially in the absence of local infectious factors, immunologically mediated mechanisms may play an important role and appropriate immunosuppressive therapy may be effective

Diagnostic challenges in a diffuse large B-cell lymphoma of the maxilla presenting as exposed necrotic bone

Lymphoma is the second most common malignancy in the head and neck area, affecting both nodal and extranodal sites, including oral soft and hard tissues, usually in the form of non-Hodgkin’s lymphoma (NHL). However, lymphomas of the jaws, including diffuse large B-cell lymphoma (DLBCL), the most common type of NHL, are very rare and may cause significant diagnostic challenges resembling common jaw pathologies, such as periapical lesions, osteomyelitis and osteonecrosis. The aim of this paper is to present a rare case of DLBCL in an 84-years-old diabetic male patient on methylprednisolone treatment for autoimmune hemolytic anemia. The lesion appeared clinically as exposed necrotic bone of the maxilla with surrounding soft tissue ulceration and radiographically as an extensive osteolytic lesion with ill-defined borders. Despite the resemblance of the lesion with osteonecrosis or osteomyelitis that could be theoretically related to diabetes and/or systemic use of corticosteroids, histopathologic examination, necessitating a repeat biopsy in order to acquire sufficient tissue, revealed the final diagnosis of lymphoma. The need for increased clinical awareness and vigilance of this possible diagnostic conundrum is emphasized. Key words:Diffuse large B-cell lymphoma, exposed bone, oral, malignancy, maxilla, jaw osteonecrosis, differential diagnosis

Three-Dimensional Analysis of Posterior Mandibular Displacement in Rats

Mandibular protrusion and its treatment is challenging for the orthodontist. The aim of the present research was to identify macroscopic changes in the mandible, based on three-dimensional Cone Beam Computed Tomography analysis. Seventy-two male Wistar rats were divided into two equal groups, experimental (group A) and control (group B). Each consisted of three equal subgroups of 12 rats (A1, A2, A3, B1, B2, B3). Full-cast orthodontic intraoral devices were attached to the maxillary incisors of the experimental animals, and effected functional posterior mandibular displacement. Throughout the experimental period, all animals were fed with mashed food. Animals were sacrificed at 30 days (A1, B1), 60 days (A2, B2) and 90 days (A3, B3). At the 60th day of the experiment, the orthodontic devices were removed from the remaining experimental subgroup A3. Measurements revealed significant differences in the anteroposterior dimensions between experimental and control subgroups. However, the observed changes in the vertical dimensions, Condylion/Go’–Menton and the Intercondylar distance proved insignificant. Posterior mandibular displacement of the mandible in growing rats affects the morphology of the mandible and culminates in the development of a smaller mandible at a grown age