Emergency surgery on mentally impaired patients: standard in consenting

Emergency surgery is often performed on the elderly and susceptible patients with significant comorbidities; as a consequence, the risk of death or severe complications are high. Consent for surgery is a fundamental part of medical practice, in line with legal obligations and ethical principles. Obtaining consent for emergency services (for surgical patients with chronic or acute mental incapacity, due to surgical pathology) is particularly challenging, and meeting the standards requires an up-to-date understanding of legislation, professional body guidelines, and ethical or cultural aspects. The guidance related to consent requires physicians and other medical staff to work with patients according to the process of ‘supported decision-making’. Despite principles and guidelines that have been exhaustively established, the system is sometimes vulnerable in actual clinical practice. The combination of an ‘emergency’ setting and a patient without mental ‘capacity’ is a challenge between patient-centered and ‘paternalistic’ approaches, involving legislation and guidelines on ‘best interests’ of the patient

Emergency surgery on mentally impaired patients: standard in consenting

Emergency surgery is often performed on the elderly and susceptible patients with significant comorbidities; as a consequence, the risk of death or severe complications are high. Consent for surgery is a fundamental part of medical practice, in line with legal obligations and ethical principles. Obtaining consent for emergency services (for surgical patients with chronic or acute mental incapacity, due to surgical pathology) is particularly challenging, and meeting the standards requires an up-to-date understanding of legislation, professional body guidelines, and ethical or cultural aspects. The guidance related to consent requires physicians and other medical staff to work with patients according to the process of ‘supported decision-making’. Despite principles and guidelines that have been exhaustively established, the system is sometimes vulnerable in actual clinical practice. The combination of an ‘emergency’ setting and a patient without mental ‘capacity’ is a challenge between patient-centered and ‘paternalistic’ approaches, involving legislation and guidelines on ‘best interests’ of the patient

Emergency surgery on mentally impaired patients: standard in consenting

Emergency surgery is often performed on the elderly and susceptible patients with significant comorbidities; as a consequence, the risk of death or severe complications are high. Consent for surgery is a fundamental part of medical practice, in line with legal obligations and ethical principles. Obtaining consent for emergency services (for surgical patients with chronic or acute mental incapacity, due to surgical pathology) is particularly challenging, and meeting the standards requires an up-to-date understanding of legislation, professional body guidelines, and ethical or cultural aspects. The guidance related to consent requires physicians and other medical staff to work with patients according to the process of ‘supported decision-making’. Despite principles and guidelines that have been exhaustively established, the system is sometimes vulnerable in actual clinical practice. The combination of an ‘emergency’ setting and a patient without mental ‘capacity’ is a challenge between patient-centered and ‘paternalistic’ approaches, involving legislation and guidelines on ‘best interests’ of the patient

Characteristics of Body Posture in the Sagittal Plane in 8–13-Year-Old Male Athletes Practicing Soccer

Background: An important part of a healthy lifestyle for children and adolescents is exercising to satisfy the natural need for physical activity. However, young athletes should take special care when they participate in intense physical training, to ensure their proper physical development. The aim of this study was to evaluate the body posture in the sagittal plane of soccer players in comparison with healthy untrained peers. Methods: A total of 245 young males aged 8–13 who participated in the study were divided into two groups: “Group F—Footballer”, elite youth soccer players comprising 132 male athletes, and “Group C—Control group”, consisting of 113 boys from primary schools. The elite, youth soccer players played and trained in the Gold Standard Certificate Academy for their age group and belonged to the top 1% of all players from their category, respectively (Polish Soccer Association (PZPN)). The control group consisted of healthy boys from primary schools in Wroclaw not practicing any sport. A photogrammetric method based on the projection moiré phenomenon was used to assess the body posture in all subjects. Results: The analysis showed statistically significant differences in body posture parameters in the sagittal plane between the trained (F) and non-trained (C) groups. In all age groups, a significantly higher value of the upper thoracic angle and a lower value of the trunk inclination angle were observed in the football players’ group. Significant differences were also observed for the thoracic spine in each age group. In the groups of 8–9 and 12–13 years, they concerned the angle of thoracic kyphosis, and in the group of 10–11-year-old, the depth of thoracic kyphosis. In the group of children with ages 8–9 and 10–11, significantly higher values of lumbosacral angle and upper thoracic angle were observed in the group of soccer players. Conclusions: The soccer training load can influence the anterior–posterior curvature of the spine. In the group of footballers in all age groups, higher angular values of thoracic kyphosis and greater tilt of the torso forward were found, compared with their untrained peers. There were also significant differences in body posture between children of different ages, both in the group of footballers and in the group of untrained children. In the group of footballers, the differences concerned mainly the size of the lumbosacral angle and the depth of both curves, which decreased with the age of the players. A similar phenomenon was observed in the group of untrained boys but only in children in the older age groups