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Evaluation of the 2-mm punch biopsy in dermatological diagnosis
rhage associated with age-related macular degenera tion have poor prognoses, the visual acuity of other eyes did not deteriorate. These findings underscore the importance of evaluating the role of therapeutic interventions such as surgery to remove subretinal hemorrhage in randomized clinical trials.—Authors' abstract
*Ninth Floor, 550 N Broadway, Baltimore, MD 21205-2010.
• Office probing for congenital nasolacrimal duct obstruction: a study of parental satisfaction. Goldblum TA, Summers CG*, Egbert JE, Letson RD. J Pediatr Ophthalmol Strabismus 1996;33:244-247.
T
HE PURPOSE OF THIS STUDY WAS TO DETERMINE
parental satisfaction with nasolacrimal probings for congenital dacryostenosis performed without se dation in a medical office. The caretakers of 67 of 81 children less than 4 years of age who underwent probings in this setting were interviewed by tele phone. Questions related to parental satisfaction, probing effectiveness, procedural complications, and recommendations for future care. Fifty-seven caretak ers (86%) were satisfied with the procedure, and 54 (81%) preferred that nasolacrimal probing be per formed in the office rather than in a setting using general anesthesia. Satisfaction rates were similar between different age groups but were slightly lower in cases requiring bilateral probing and in those cases that were unsuccessful. The overall success rate was 73% (60 of 82 probings). Procedural side effects included minimal epistaxis in five children (8%) and excessive irritability in two patients (3%). Caretakers of children who underwent both an office procedure and a subsequent procedure under general anesthesia tended to prefer probing in the office.—George B. Bartley
*Box 493, UMHC, 420 Delaware St SE, Minneapolis, MN 55455.
764
• Evaluation of the 2-mm punch biopsy in dermatological diagnosis. Todd P*, Garioch JJ, Humphreys S, Seywright M, Thomson J, du Vivier AWP. Clin Exp Dermatol 1996;21:11-3.
T
HIS PROSPECTIVE STUDY WAS UNDERTAKEN TO DE-
termine whether the 2-mm punch biopsy tech nique yields specimens of sufficient size and quality to allow a reliable histological diagnosis to be made. A histopathological comparison was made between tis sue obtained from a 2-mm punch biopsy and a standard ellipse biopsy taken from a wide range of dermatoses and benign and malignant skin tumours. In 79 of the 84 cases studied, the same histopatholog ical diagnosis was reached with the 2-mm punch biopsy and the standard ellipse. Use of the 2-mm punch biopsy technique produces specimens which allow an accurate histological diagnosis to be made in a wide range of dermatological conditions.-— Authors' abstract * Dermatology Department, St Bartholomew's Hospital West Smithfield, London EC1, UK.
• The Physicians' Desk Reference. Problems and possible improvements. Cohen JS, Insel PA*. Arch Intern Med 1996;156:1375-1380.
E
ACH YEAR, APPROXIMATELY 500,000 COPIES OF THE
Physicians' Desk Reference (PDR) are distributed free of charge to physicians, and an equal number are sold to other professionals and to the general public. Although the PDR is the most widely used reference source for drug information, the book has several shortcomings: ( 1 ) dosage information and guidelines are inadequate and do not always account for varia tion among individual patients; (2) dosage schedules frequently are based on clinical studies that are skewed toward accelerated and higher dosing; (3) clinically relevant low-dose information, when pres ent, is inconspicuous; (4) many dosing regimens are not adjusted for elderly patients; (5) specific dosages for specific diagnoses sometimes are omitted; (6) data
AMERICAN JOURNAL OF OPHTHALMOLOGY
NOVEMBER 1996
*Ninth Floor, 550 N Broadway, Baltimore, MD 21205-2010.
• Office probing for congenital nasolacrimal duct obstruction: a study of parental satisfaction. Goldblum TA, Summers CG*, Egbert JE, Letson RD. J Pediatr Ophthalmol Strabismus 1996;33:244-247.
T
HE PURPOSE OF THIS STUDY WAS TO DETERMINE
parental satisfaction with nasolacrimal probings for congenital dacryostenosis performed without se dation in a medical office. The caretakers of 67 of 81 children less than 4 years of age who underwent probings in this setting were interviewed by tele phone. Questions related to parental satisfaction, probing effectiveness, procedural complications, and recommendations for future care. Fifty-seven caretak ers (86%) were satisfied with the procedure, and 54 (81%) preferred that nasolacrimal probing be per formed in the office rather than in a setting using general anesthesia. Satisfaction rates were similar between different age groups but were slightly lower in cases requiring bilateral probing and in those cases that were unsuccessful. The overall success rate was 73% (60 of 82 probings). Procedural side effects included minimal epistaxis in five children (8%) and excessive irritability in two patients (3%). Caretakers of children who underwent both an office procedure and a subsequent procedure under general anesthesia tended to prefer probing in the office.—George B. Bartley
*Box 493, UMHC, 420 Delaware St SE, Minneapolis, MN 55455.
764
• Evaluation of the 2-mm punch biopsy in dermatological diagnosis. Todd P*, Garioch JJ, Humphreys S, Seywright M, Thomson J, du Vivier AWP. Clin Exp Dermatol 1996;21:11-3.
T
HIS PROSPECTIVE STUDY WAS UNDERTAKEN TO DE-
termine whether the 2-mm punch biopsy tech nique yields specimens of sufficient size and quality to allow a reliable histological diagnosis to be made. A histopathological comparison was made between tis sue obtained from a 2-mm punch biopsy and a standard ellipse biopsy taken from a wide range of dermatoses and benign and malignant skin tumours. In 79 of the 84 cases studied, the same histopatholog ical diagnosis was reached with the 2-mm punch biopsy and the standard ellipse. Use of the 2-mm punch biopsy technique produces specimens which allow an accurate histological diagnosis to be made in a wide range of dermatological conditions.-— Authors' abstract * Dermatology Department, St Bartholomew's Hospital West Smithfield, London EC1, UK.
• The Physicians' Desk Reference. Problems and possible improvements. Cohen JS, Insel PA*. Arch Intern Med 1996;156:1375-1380.
E
ACH YEAR, APPROXIMATELY 500,000 COPIES OF THE
Physicians' Desk Reference (PDR) are distributed free of charge to physicians, and an equal number are sold to other professionals and to the general public. Although the PDR is the most widely used reference source for drug information, the book has several shortcomings: ( 1 ) dosage information and guidelines are inadequate and do not always account for varia tion among individual patients; (2) dosage schedules frequently are based on clinical studies that are skewed toward accelerated and higher dosing; (3) clinically relevant low-dose information, when pres ent, is inconspicuous; (4) many dosing regimens are not adjusted for elderly patients; (5) specific dosages for specific diagnoses sometimes are omitted; (6) data
AMERICAN JOURNAL OF OPHTHALMOLOGY
NOVEMBER 1996