The international classification of headache disorders

The international classification of headache disorders

tion of povidone-iodine preparation to the skin and conjunctiva is the only proven endophthalmitis prophylaxis. Endophthalmitis may be chronic and may...

38KB Sizes 4 Downloads 188 Views

tion of povidone-iodine preparation to the skin and conjunctiva is the only proven endophthalmitis prophylaxis. Endophthalmitis may be chronic and may follow glaucoma surgery and intravitreal injection of gas and drugs. The EVS did study these issues, although they are associated with specific features that may require alterations in patient management.—Hans E. Grossniklaus *2021 Santa Monica Blvd 720E, Santa Monica, CA 90404; email: [email protected]



Prognostic value of cell-cycle markers in ocular adnexal lymphoma: an assessment of 230 cases. Coupland SE,* Hellmich M, Au-Haedrich C, Lee WR, Stein H. Graefes Arch Clin Exp Ophthalmol 2004;242:130 –145.

T

WO HUNDRED SIXTY-ONE CASES OF OCULAR ADNEXAL

lymphoproliferative lesions were subdivided into reactive lymphoid hyperplasia (RLH), atypical lymphoid hyperplasia (ALH) and ocular adnexal lymphoma (OAL). The latter were sub-typed according to the new WHO Lymphoma Classification. All lesions were investigated applying standard immunohistochemical methods with antibodies specific for pRB, p53, p16, p21, BCL-6 and for multiple myeloma oncogene-1-protein (MUM1, also known as IRF4). The association of prognostic variables with endpoints was assessed by multiple logistic and Cox regression models, respectively. The ocular adnexal lymphoproliferative lesions were categorized as OAL (n ⫽ 230; 88%), RLG (n ⫽ 29; 11%), and ALH (n ⫽ 2; 1%). The major lymphoma subtypes included 136 extranodal marginal zone B-cell lymphoma (EMZL), 31 diffuse large cell B-cell lymphomas, 27 follicular lymphomas, 9 plasmacytomas, 9 lymphoplasmacytic lymphoma/immunocytomas and 8 mantle cell lymphomas. The median follow-up was 44.5 months. Most OAL patients had Stage IE and were treated with radiotherapy. Thirty-seven (25%) Stage IE patients had tumor relapses that were significantly associated with an increased BCL6 blast percentage. Sixty-two (42%) Stage IE patients developed systemic disease, had non-EMZL with large growth fractions and increased blast percentages for BCL6. Fifty-seven (25%) OAL patients died because of their lymphoma. Lymphoma-related death was significantly associated on multi-variable analysis with advanced clinical stage, and age ⬎60 years and large tumor growth fractions. Subtyping OAL according to the new WHO Lymphoma Classification, the stage of disease and tumor cell growth fraction aided in prediction of tumor relapse, development of systemic disease and lymphoma related death.—Hans E. Grossniklaus *Department of Pathology, University Hospital Benjamin Frankly of the Free University, Hindenburgdamm 30, 1200 Berlin, Germany; email: [email protected]

VOL. 138, NO. 1

● Career satisfaction and surgical practice patterns among female ophthalmologists. Jinapriya D, Cockerill R, Trope GE*. Can J Ophthalmol 2003;38:373–378.

I

N ORDER TO IDENTIFY GENDER DIFFERENCES IN CAREER

satisfaction and practice patterns, survey was mailed to all Ontario female ophthalmologists (n ⫽ 65) and a random sample of male ophthalmologists (n ⫽ 72). Men reported performing more operations per months (P ⫽ 0.039) and more operations in the last typical year (P ⫽ 0.003). More men than women were doing laser refractive surgery (P ⫽ 0.004). There were no gender differences in the proportion performing eye surgery or in the hours worked per week or weeks worked per year. Women reported being primarily responsible for their children for significantly more hors per week than men (P ⫽ 0.0003). There were no gender differences in any of the parameters of career satisfaction evaluated: number of hours worked, number of hours in the operating room (OR), balance with personal life, flexibility of work schedules, ability to structure work, relationship with colleagues and relationship with OR staff. Despite spending significantly more hours as the primary care-giver of their children, female ophthalmologists maintained the same work week as their male colleagues and reported equal career satisfaction.—Hans E. Grossniklaus *The University Health Network, Toronto Western Hospital, 7-044 Edith Cavil Wing, 399 Bathurst St, Toronto ON M5T 2S8, Canada

● The International Classification of Headache Disorders. 2nd ed. Headache Classification Subcommittee of the International Headache Society. Cephalalgia 2004; 24(Suppl 1): 9 –160.

T

HE REVISED CLASSIFICATION OF HEADACHE DISORDERS

is out! In 1988, the first classification of headache disorders was published under the auspices of the International Headache Society. It has proved to be an enormous advance, transforming studies of the epidemiology of headache and also clarifying the recruitment of patients for experimental and therapeutic studies. The revised classification is much more developed than the first classification and includes information on genetics and pathophysiology. It is still based on the clinical features of each condition and provides a collection of very useful diagnostic criteria for a number of headaches, facial and ocular pain syndromes commonly encountered by the ophthalmologist. It is designed to be used as a reference for studies, but also can be used on a daily basis to diagnose patients with various pain syndromes. This classification provides detailed descriptions of migraine with visual aura, so-called retinal migraine, and challenges the concept of ophthalmoplegic migraine. Various facial pain syndromes such as cluster headache, SUNCT syndrome, and hemicrania continua are clarified.—Vale´ rie Biousse.

ABSTRACTS

179