Neurological disorders in the emergency department (ED) setting are diverse in presentation and diagnostic spectrum. At least 6% of all emergency department visits are for neurological problems. 1 An important issue is that of diagnostic accuracy. Previous retrospective analyses in the neurological literature have demonstrated that 5-11% of all patients given the diagnosis of stroke in the emergency department had another diagnosis altogether. [2][3][4] Similarly, 13-26% of patients referred to epilepsy ABSTRACT: Background: Previous studies describe significant rates of misdiagnosis of stroke, seizure and other neurological problems, but there are few studies examining diagnostic accuracy of all emergency referrals to a neurology service. This information could be useful in focusing the neurological education of physicians who assess and refer patients with neurological complaints in emergency departments. Methods: All neurological consultations in the emergency department at a tertiary-care teaching hospital were recorded for six months. The initial diagnosis of the requesting physician was recorded for each patient. This was compared to the initial diagnosis of the consulting neurologist and to the final diagnosis, as determined by retrospective chart review. Results: Over a six-month period, 493 neurological consultations were requested. The initial diagnosis of the requesting physician agreed with the final diagnosis in 60.4% (298/493) of cases, and disagreed or was uncertain in 35.7% of cases (19.1% and 16.6% respectively). In 3.9% of cases, the initial diagnosis of both the referring physician and the neurologist disagreed with the final diagnosis. Common misdiagnoses included neurocardiogenic syncope, peripheral vertigo, primary headache and psychogenic syndromes. Often, these were initially diagnosed as stroke or seizure. Conclusions: Our data indicate that misdiagnosis or diagnostic uncertainty occurred in over one-third of all neurological consultations in the emergency department setting. Benign neurological conditions, such as migraine, syncope and peripheral vertigo are frequently mislabeled as seizure or stroke. Educational strategies that emphasize emergent evaluation of these common conditions could improve diagnostic accuracy, and may result in better patient care. (19,1% et 16,6% respectivement). Chez 3,9% des cas, le diagnostic initial du médecin référant et du neurologue ne concordaient pas avec le diagnostic final. Les diagnostics erronés les plus fréquents étaient la syncope neurocardiogénique, le vertige d'origine périphérique, la céphalée primaire et les syndromes psychogéniques. Souvent ces cas recevaient un diagnostic initial d'un accident cérébrovasculaire ou de crise convulsive. Conclusions : Nos données révèlent qu'un diagnostic erroné ou incertain a été posé chez plus du tiers des patients vus à la salle d'urgence qui sont référés en neurologie. Des affections neurologiques bénignes comme la migraine, la syncope et le vertige d'origine périphérique sont fréquemment diagnostiqués c...

The abundant nuclear complex termed FACT affects several DNA transactions in a chromatin context, including transcription, replication, and repair. Earlier studies of yeast FACT, which indicated the apparent dispensability of conserved sequences at the N terminus of the FACT subunit Cdc68/Spt16, prompted genetic and biochemical studies reported here that suggest the domain organization for Spt16 and the other FACT subunit Pob3, the yeast homolog of the metazoan SSRP1 protein. Our findings suggest that each FACT subunit is a multidomain protein, and that FACT integrity depends on Pob3 interactions with the Spt16 Mid domain. The conserved Spt16 N-terminal domain (NTD) is shown to be without essential function during normal growth, but becomes important under conditions of replication stress. Genetic interactions suggest that some functions carried out by the Spt16 NTD may be partially redundant within FACT.

SUMMARY We investigated phylogenetic relationships among red algae of the order Bangiales by analysis of sequences of the nuclear gene encoding cytosolic small‐subunit ribosomal RNA in Bangia atropurpurea (Roth) C. Ag. and eight samples representing seven species of Porphyra. The ssu‐rDNA range from 1818 to 1845 nucleotides in length, with guanosine plus cytosine ratios between 47.0% and 48.6%. A group IC1 intron occurs in the B atropurpurea ssu‐rDNAs at the same position as in P. spiralis var. amplifolia Oliveira Filho et Coll and several other eukaryote ssu‐rDNAs. The nine sequences form a stable monophyletic group upon phylogenetic analysis. The ssu‐rDNA from B. atropurpurea nests stably within the Porphyra group and is closely related to P. amplissima (Kjellm.) Setchell et Hus in Hus, making the genus Porphyra paraphyletic. No correlation is seen between phylogenetic position and number of cell layers in the Porphyra thallus. We discuss possible taxonomic and evolutionary implications of these observations.