Ethical principles serve as the foundation of healthcare practice, guiding medical professionals in their interactions with patients and shaping healthcare policies worldwide. However, the interpretation and application of these principles can vary significantly across different cultural and socio-political contexts. Understanding these variations is essential for enhancing cross-cultural healthcare practices. The aim of this review was to identify and show the differences and similarities in understanding and implementation of four ethical principles in Poland, Ukraine, India and Thailand. The PubMed database was searched for articles, which resulted in 16 papers about the principle of non-maleficence, 36 papers about the principle of justice, 79 on autonomy and 16 on beneficence, all of which were included in the review. The results revealed ethical dilemmas encountered in routine healthcare practice, highlighting both commonalities and distinctions across the analyzed countries. This analysis offers valuable insights into how ethical challenges are addressed within diverse healthcare systems, contributing to a deeper understanding of the needs of both patients and medical personnel.

A thoracic outlet syndrome (TOS) is the type of brachial plexus disorder most difficult to objectively assess using a clinical examination and differential diagnosis. Its symptoms can be frequently misdiagnosed, especially among others with cervical disc-root conflicts, plexopathies, and peripheral neuropathies. In this study, we aim to identify the correlations between positive Doppler ultrasonography results indicating pathological changes in the subclavian flow velocity, clinical tests, and chosen clinical neurophysiology recordings as proposed alternative or supplementary diagnostic tools for evaluating TOS patients. Sixty TOS patients with positive Doppler ultrasonography and Roos test results and sixty healthy people as a control group were bilaterally examined, and the results were compared. Pain intensity was assessed using a visual analogue scale (VAS). Sensory perceptions within C4–C8 dermatomes were assessed with Von Frey filament (FvF) tests. The activity of motor units in the proximal and distal muscles of the upper extremities was evaluated using surface electromyography (sEMG) during maximal contractions before and after a provocative raised hands test (RHT). An electroneurography (ENG) was used to evaluate the transmission of nerve impulses peripherally. Motor evoked potential (MEP) recordings, induced by the over-vertebral magnetic stimulation of the C5–C7 neuromeres, were used to examine motor transmissions from the cervical motor centres to the upper extremities muscles. The results revealed a relationship between positive Doppler test scores and pathological changes in the subclavian flow velocity through the results of the following diagnostic tools: a VAS score of 1.9 was detected on average, superficial sensory perception abnormalities were found in the innervation areas of the ulnar nerves detected by FvF tests, a decrease in the amplitudes of sEMG recordings was seen in distal rather than proximal muscles (especially following the RHT), a decrease in the motor and sensory peripheral transmissions of nerve impulses in the median, ulnar and cutaneous anterobrachial median nerves was seen, as well as MEP amplitudes recorded from the abductor pollicis brevis muscle. The provocative RHT combined with sEMG and MEP recordings can be considered accurate and objective clinical neurophysiology tools that could supplement the commonly used clinical tests. Such an approach may result in a more precise neurogenic TOS diagnostic algorithm.

Background: Occipital horn syndrome is a rare, X-linked recessive, connective tissue disorder caused by abnormal copper transporter proteins coded by the ATP7A gene. 32 cases have been reported worldwide to date. Clinically, patients typically present with inguinal hernia, exostosis, cutis laxa, and bladder diverticula. Orthopaedic problems often include exostosis of the elbows, thoracolumbar scoliosis, thoracic cavity deformities, and joint hypermobility due to joint laxity. Case presentation: An 18-year-old presented with occipital horn syndrome and was treated for flat-valgus foot and posterior dislocation of the elbow joints. Due to collagen structure abnormalities, vulnerability to joint deformation makes treating patients with occipital horn syndrome challenging as they need complex orthopaedic intervention. Conclusion: There is no effective causal therapy for this condition. Surgical procedures can help patients improve their physical condition and maintain adequate joint range of motion.

Peripheral facial nerve damage is the most common condition of all cranial nerve damage; this nerve innervates the face in motor, sensory and parasympathetic ways. Bell’s palsy prevents patients from functioning normally by disturbing the speech function, eating and facial expressions. It can also lead to severe infl ammation of the eyeball and consequently to blindness. The study focuses on the influence of appropriately selected physical procedures on the time over which facial palsy affects a patient. The use of therapeutic methods such as: electrotherapy, heat treatment, facial massage, kinesitherapy and fi llers were also presented Comprehensive rehabilitation therapy based on the cooperation of doctors, physiotherapists and cosmetologists signifi cantly improves the results of pharmacological treatment and shortens convalescence time.

Arthroscopic Bankart and Coracoid Transfer are the most common procedures. Results of Bankart technique differ depending on the surgeon’s experience (type of anchors used, qualification, long learning curve). Performing Arthroscopic Bankart may be effective when there is minimal bone loss (< 10–15%), good soft tissue (no ALPSA) and ISIS < 3. With these assumptions long term recurrence rate (RR) can be stated as 8%. Adding of remplissage improves RR to 3–6%, which is comparable to Latarjet with RR 4.4–6%. Coracoid transfer has advantage of being quicker, safer and cheaper. It must be underlined that this type of surgery is effective for patients with risk factors (probably regardless risk). Moreover, we assume that good function and satisfaction level with high return to sport (85%) is associated with this intervention. Still some issues remain like frequent complications (mostly temporary) like apprehension or residual pain. Learning curve is also not in favor of this technique. Yet it is difficult to conclude whether Arthroscopic Bankart or Coracoid Transfer are superior. Free bone block has comparable results to Latarjet, with the main problem being donor side complication in autografts. Open Bankart also do not stand out of Coracoid Transfer.