[Life-threatening differential diagnoses of vertigo and sudden hearing loss]. / Lebensbedrohliche Differenzialdiagnosen des Drehschwindels und des Hörsturzes.

Many patients call the ENT emergency department because of vertigo and sudden hearing loss. The majority of cases are due to peripheral or neurootological reasons. A serious and ongoing problem is that life-threatening ischemic, hemorrhagic and inflammatory diseases of the central nervous system may cause identical symptoms, making it difficult to differentiate between them. On the basis of our own patients with cerebellar ischemia, basilar thrombosis, dissection of the vertebral artery, cerebellar abscess, brain tumor and cholesteatoma and on the basis of expert opinions, typical sets of symptoms in patients with neurootological symptoms of a central cause are defined. To ensure early detection of these rare differential diagnoses, physicians should place particular importance on modern imaging diagnostics and neurological, interdisciplinary cooperation.

Provider-performed microscopy.

The category of provider-performed microscopy was defined in the Federal Register to provide a unique regulatory approach for bright-field and phase-contrast microscopy performed by a physician, dentist, or midlevel practitioner examining labile specimens. A CLIA certificate for this category of testing is available, which also permits the performance of waived tests. Because these provider-performed microscopy procedures do not have quality-control materials available, special challenges are encountered in establishing and monitoring such testing within a hospital. Vigilance is required to maintain a provider-performed microscopy program within a hospital.

Integrated bacterial genomics for the discovery of novel antimicrobials.

Sequencing of bacterial genomes has been progressing with breathtaking speed. Currently, the genomes of 23 bacterial species are sequenced, with approximately 40 more sequencing projects in progress. Industrial research is now facing the challenge of translating this information efficiently into drug discovery. This review will summarize the impact of bacterial genomics, bioinformatics and second-generation genomic technologies on target identification, assay development, lead optimization and compound characterization.