European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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This is the second part of a paper on the relevance and significance of the Hippocratic Oath to modern medical ethical and moral values with the aim at answering questions on controversial issues related to the Oath. Part I argued that the general attributes and ethical values of the Oath are relevant to the modern world. Part II attempts to elucidate the interpretation of the specific injunctions of the Oath from today's perspective in relation to ethical values concerning the duties of physicians to patients and society. ⋯ Furthermore, the Oath as a code of professional identity has had a powerful impact on modem judicial opinions regarding medical ethics. In a lot of ways, it is as relevant of the values of contemporary medicine as it was for ancient medicine. These slides can be retrieved under Electronic Supplementary Material.
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Review Case Reports
Recurrent primary osseous hemangiopericytoma in the thoracic spine: a case report and literature review.
Primary osseous hemangiopericytoma (HPC) of the spine is exceedingly rare. HPC has malignant potential and has the capacity for metastasis and local recurrence. We herein present the first case of recurrent primary osseous HPC in the thoracic spine that was successfully treated by total spondylectomy at three vertebral levels and spinal reconstruction. ⋯ Total spondylectomy and spinal reconstruction with instrumentation might be useful for performing the safe and adequate excision of recurrent HPC of the spine. However, patients should be closely monitored to detect local recurrence and the malignant degeneration of the tumor after surgery.
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Quality registers give unique possibilities to achieve information from large groups of patients, but outcome must be interpreted carefully due to less stringent data collection and lower follow-up rates than in research projects. We tried to quantify any outcome differences between a national spine quality register and a prospective observational study. ⋯ Higher response rates than seen in Swespine are not needed to achieve reasonably representative data on patient-reported outcome for large cohorts. Two-year data do not seem to add additional information. These slides can be retrieved under Electronic Supplementary Material.
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To help guide treatment strategies and create insight into functional outcomes in patients with Giant herniated thoracic discs (GHTD), which are defined as occupying more than 40% of spinal canal. ⋯ Surgery for giant herniated thoracic disc has favorable outcome in majority (91%) of patients. However, significant approach-related complications are to be anticipated in patients undergoing thoracotomies, most of them being manageable. Author recommends costotransversectomy, only in paracentral discs with smaller percentage canal stenosis.
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Abstract