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Trigeminal neuralgia (TN) causes sudden, usually unilateral, severe, brief stabbing recurrent pains in the distribution of one or more branches of the trigeminal nerve. Radiological examination is not required, however, patient interview and physical examination are necessary for diagnosis alone. When a patient is diagnosed with TN, an MRI is recommended to exclude tumor, cyst or multiple sclerosis, irrespective of the patient's age. From the etiological viewpoint, TN is classified into primary or idiopathic TN and secondary or symptomatic TN. From the symptomatic viewpoint, TN is classified into typical TN and atypical TN. Atypical TN, trigeminal neuropathy, pretrigeminal neuralgia, and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) are also described.

Aim: To analyse the performance of existing diagnosis/classification criteria for Behcet's disease (BD) in Iranian patients. There are 13 sets: Curth (1946), Hewitt (1969), Mason and Barnes (1969), Hewitt revised (1971), Japan (1972), Hubault and Hamza (1974), O'Duffy (1974), Cheng and Zhang (1980), Dilsen (1986), Japan revised (1988), International (1990), Iran (1993), Classification Tree (1993), and Dilsen revised criteria (2000). Methods: All patients from the Behcet's Disease Registry (5666) and control patients (2406) entered the study. Sensitivity, specificity and accuracy were calculated. Results: The most sensitive was Curth criteria with (99.7%), followed by Classification Tree (97.3%), Zhang (93.5%), Iran (91.4%), Japan revised (86.4%), Japan (85.3%), Dilsen (83.7%), Hubault and Hamza (81.6%), Dilsen revised (81.2%), International criteria (79.8%), Hewitt (73.8%), O'Duffy (70.7%), and Masson and Barnes (65.7%). The most specific was Masson and Barnes (99.6%), followed by the International criteria (98.3%), Dilsen revised (98.2%), O'Duffy (97.6%), Japan (97.1%), Japan revised (97%), Classification Tree (96.7%), Hewitt (95.8%), Iran (95.8%), Zhang (92.4%), Dilsen (91.4%), Hubault (90.8%), and Curth (78.6%). The most accurate criteria was Classification Tree (97.1%), followed by Curth (93.4%), Zhang (93.1%), Iran (92.7%), Japan revised (89.6%), Japan (88.8%), Dilsen revised (86.2%), Dilsen (86%), International criteria (85.3%), Hubault (84.3%), Hewitt (80.4%), O'Duffy (78.8%), and Mason and Barnes (75.8%). Discussion: Among the existing criteria, the best to classify Iranian patients is the Classification Tree. The second most accurate is Curth criteria. The difference is statistically significant. Further, Curth criteria is not optimized, having very high sensitivity and low specificity.

This column describes the work of the Nursing Diagnosis Extension and Classification (NDEC) research team, which works in a collaborative agreement with NANDA to refine and extend the diagnosis classification.

This overview discusses the chromosome changes in solid tumors and how recent advancements in techniques have yielded results which at least qualitatively are similar to those obtained in the leukemias, i.e., that consistent and recurrent chromosome changes characterize most tumors adequately examined and that tumor entities consist of cytogenetically defined and unique subsets. Thus, the findings point to a similar application of the chromosome changes in tumors in their classification, diagnosis and causation.

Two-hundred-and-sixty-three patients with cardiomyopathy were studied by M-mode echocardiography. Measurements of left ventricular cavity size, wall thickness and myo-cardial contraction were used to classify cardiomyopathy into “congestive” (272 patients) and “hypertrophic” (50 patients) groups; the “hypertrophic” group was further divided into asymmetric septal hypertrophy (37) and symmetric (concentric) mural thickening (13). Using clinical and electro-cardiographic information as well as echocardiographic data, the latter group could then be further classified into “concentric infiltrative cardiomyopathy” (9) and “concentric hypertrophic cardiomyopathy” (4). The former either presented with signs of restriction or were known to have systemic amyloidosis; the electrocardiograph showed low voltage and myocardial contraction was impaired in advanced cases. The latter had evidence of severe left ventricular hypertrophy and resembled asymmetric septal hypertrophy clinically. Problems encountered with the echocardiographic diagnosis of congestive cardiography were mainly concerned with proper clinical interpretation of the echocardiographic data whilst technical difficulties in recording the echocardiogram and in interpretation of tracings were a common problem in hypertrophic cardiomyopathy.