For an indeterministic ethics. The emptiness of the rule in dubio pro vita and life cessation decisions

It is generally claimed that there exist exceptional circumstances when taking human life may be approved and when such actions may be justified on moral grounds. Precise guidelines in the medical field for making such decisions concerning patients who are terminally ill or have irreparable injuries incompatible with a bearable life, are difficult to establish. Recommendations that take the particular logical form of a rule, such as "in dubio pro vita", "when in doubt favour life") have been suggested and in some countries incorporated into legal texts (Germany). We claim here that such a rule is of no value since it is open-ended and always allows for doubt, and a decision to employ measures that would support human life could always be argued to be a valid choice. Preservation of this rule could be encouraged, but giving it the force of law may put physicians at risk, as they may be challenged for choosing to terminate life in otherwise ethically and medically uncontroversial circumstances

IMPORTANCE OF CARDIORESPIRATORY ENDURANCE IN MALE HANDBALL PLAYERS

Abstract Team handball is a complex game which requires a series of different abilities while the fact that different players’ positions in the field require different characteristics and abilities hinders the defining of the morphofunctional model of ideal handball player. Unlike the anthropomorphological profile, the functional model of handball player is not even close to be clearly defined. The basis for assessing the optimal level of cardiorespiratory endurance in handball players is to define the duration of certain levels of load during a handball match and also a physiological requirements that the player needs to fulfill. The level of cardiorespiratory (aerobic) endurance plays an important role in inducing and controlling the desirable physiological adaptations during a training process. Previous scientific results indicate that the cardiorespiratory endurance does not represent a limiting factor for high performance of handball players during the competition. However, a good aerobic preparation allows efficient process of recovery during the period between high intensity activities. Knowing the individual cardiorespiratory endurance of handball players is the foundation for enhancing their abilities and competition results by means of sports training.   Keywords: team handball, cardiorespiratory endurance, adaptation, training

VARIATIONS OF MUSCULAR STRENGTH AND POWER IN MALE HANDBALL PLAYERS DURING AN ENTIRE SEASON

Competition performance in handball depends on various individual skills and interaction with teammates. Technical and tactical efficiency are probably the most influential factors, while physical characteristics represent the prerequisite to attaining high level of competition performance. The purpose of the study was to determine the variations of muscular strength and power in male handball players during an entire season. The study was carried out on a sample of14 male handball players, members of the handball club, the participant of the Serbian male handball league during the 2014/2015 season. Measurements were taken four times during the period between the 6th and the 18th round of the handball league. The investigation protocol consisted of anthropometric measurements, determinations of the one-repetition maximum and assessments of muscular power. The obtained data indicate that no significant variations of muscular strength and power in male handball players occur during a competitive season. Besides, this study showed that players who compete in the Serbian male handball league have similar anthropometric characteristics, but significantly lower values of muscular strength and power when compared to top level European male handball players, and that it is necessary to pay much more attention to resistance training during the preparation period. Low values of the first measurement, which was the closest to the preparation period, are the probable reason for the non-existence of major variations during the competitive season

MORPHOLOGICAL CHARACTERISTICS AND MOTOR SKILLS AS PREDICTORS OF PHYSICAL ACTIVITY OF STUDENTS IN A PHYSICAL EDUCATION CLASS

The aim of this research was to determine the influence of certain morphological characteristics and motor skills on the volume and intensity of activities in physical education (PE) classes. A total of 208 (107 boys and 101 girls) primary school children aged 10±1.4 years old participated in this study. Physical activity was estimated by a pedometer and pulse meter. The physical fitness of the children was estimated by 7 motor skills tests and morphological characteristic by bioelectrical impedance and an anthropometer. A multiple regression analysis indicates that both predictor models had a significant influence on physical activity during classes (p<0.01). For the group of boys, physical fitness had a greater prediction value while in for the girls it was the morphological characteristics. At the level of individual morphological variables, body weight and muscle mass as components have the greatest predictive power in both sexes. Explosive strength of the lower extremities, flexibility and the speed had the greatest prediction in the boys, as well as flexibility in the girls. Findings from the present study indicate that PE teachers could provide more activities which will result in significant improvements of physical fitness components and a healthy lifestyle in children

Auricular Acupuncture for Pain Relief after Ambulatory Knee Arthroscopy—A Pilot Study

Auricular acupuncture (AA) is effective in treating various pain conditions, but there have been no analyses of AA for the treatment of pain after ambulatory knee surgery. We assessed the range of analgesic requirements under AA after ambulatory knee arthroscopy. Twenty patients randomly received a true AA procedure (Lung, Shenmen and Knee points) or sham procedure (three non-acupuncture points on the auricular helix) before ambulatory knee arthroscopy. Permanent press AA needles were retained in situ for one day after surgery. Post-operative pain was treated with non-steroidal anti-inflammatory ibuprofen, and weak oral opioid tramadol was used for rescue analgesic medication. The quantity of post-operative analgesics and pain intensity were used to assess the effect of AA. The incidence of analgesia-related side effects, time to discharge from the anesthesia recovery room, heart rate and blood pressure were also recorded. Ibuprofen consumption after surgery in the AA group was lower than in the control group: median 500 versus 800 mg, P = 0.043. Pain intensity on a 100 mm visual analogue scale for pain measurement and other parameters were similar in both groups. Thus AA might be useful in reducing the post-operative analgesic requirement after ambulatory knee arthroscopy

Activated protein C improves intestinal microcirculation in experimental endotoxaemia in the rat

INTRODUCTION: Successful treatment of severe sepsis and septic shock remains a major challenge in critical care medicine. The recently introduced recombinant human activated protein C (APC) remarkably improved the outcome of septic patients. The influence of APC on intestinal circulation is still poorly understood. Therefore, the present study aimed to investigate the effects of APC on intestinal microcirculation during experimental endotoxaemia in rats by using intravital microscopy. METHODS: A total of 44 male Lewis rats were randomly assigned to receive intravenous injections of 15 mg/kg lipopolysaccharide alone (LPS) (n = 11) or LPS followed by subsequent injection of 2 mg/kg recombinant human APC (LPS + APC) (n = 11), whereas control animals received either APC (n = 11) or saline (n = 11). Animals underwent observations of functional capillary density and leucocyte adherence on venular endothelium in the microcirculation of the intestinal wall by means of intravital fluorescence microscopy. Indicators of macrocirculation as well as plasma levels of tumour necrosis factor-α, interleukin (IL)-1β, IL-6, and IL-10 were measured. RESULTS: Although APC administration of both LPS-treated and control rats did not change macrocirculation or release of inflammatory cytokines, it increased mucosal and muscular functional capillary density (p < 0.001 and p < 0.05, respectively) and reduced the number of firmly adhering leucocytes in intestinal submucosal V1 and V3 venules (p < 0.01) in LPS + APC-treated compared with LPS-treated animals, which did not receive APC. No remarkable differences that could be attributed to APC treatment were observed between the two control groups. CONCLUSION: APC administration during experimental endotoxaemia improved intestinal microcirculation by protecting functional capillary density as a measure of microvascular perfusion and exerted anti-inflammatory effects by reducing leucocyte adherence to the endothelium in submucosal venules. Therefore, beneficial effects of APC in septic patients might be due, in part, to improved intestinal microcirculation

THE EFFECTS OF AN ERGONOMIC EXERCISE PROGRAM WITH A PILATES BALL ON REDUCING THE RISK OF THE INCIDENCE OF MUSCULOSKELETAL DISORDERS

Introduction: Very few scientists have studied the influence of rehabilitation exercises on lowering the risks of muscular-skeletal disorder incidence (MSD). Therefore, it is necessary to study the influence of these exercise programmes on the prevention of and decrease in the risk of MSD development among schoolchildren. A special programme is based on the education of schoolchildren on ergonomic risks and their prevention by means of specific exercises with a Pilates ball for each recognized MSD, with the assumption that its sixteen-week application will significantly influence the risk of MSD incidence. Methods: The overall sample consisted of 55 students whose chronological age was 11, of both sexes, which was divided into two sub-samples: the experimental group (EG) of 28 students and the control group (CG) of 27 students. The Spinal Mouse with the appropriate programme support was used for the evaluation of muscular-skeletal disorders of the spine in the sagittal and frontal parts (kyphosis, lordosis, thoracic scoliosis). Results and Discussion: The results, following the experimental programme, have shown significantly lowered values of the kyphotic and thoracic scoliotic curve in the experimental group (EG), whereas the condition of the control group (CG) deteriorated, however not with the statistical significance. As for lordosis, there were no significant changes in either group during the experimental treatment. A variance analysis showed that exercises with a Pilates ball programme had statistically significant effects on decreasing MSD with kyphotic and thoracic scoliotic curves but with no significant effects on lordosis as compared to the school exercise programme. Conclusion: The conclusion drawn from the analysis of the effects of the specially defined ergonomic programme, in the form of specific exercises with a Pilates ball, is that it leads to the decreased risk of MSD incidence among fourth-grade primary school students. Applied experimental actions had a positive influence on lowering the spine MSD in the case of the experimental group, but that there were no significant changes in the case of the control group