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This is observed most frequently in patients who have had some type of ventriculovenous shunting procedure for the treatment of hydrocephalus or who have an incompletely closed dural opening after surgery When the origin of the recurrence is inapparent, one should always suspect a congenital neuroectodermal sinus or a stulous connection between the nasal sinuses and the subarachnoid space The stula in these latter cases is more often traumatic than congenital in origin (eg, a previous basilar skull fracture), although the interval between injury and the initial bout of meningitis may be several years The site of trauma is in the frontal or ethmoid sinuses or the cribriform plate, and Strep pneumoniae is the usual pathogen Often it re ects the predominance of such strains in nasal carriers These cases usually have a good prognosis; mortality is much lower than in ordinary cases of pneumococcal meningitis CSF rhinorrhea is present in most cases of posttraumatic meningitis, but it may be transient and dif cult to nd Suspicion of its presence is raised by the recent onset of anosmia or by the occurrence of a watery nasal discharge that is salty to the taste and increases in volume when the head is dependent One way of con rming the presence of a CSF leak is to measure the glucose concentration of nasal secretions; ordinarily they contain little glucose, but in CSF rhinorrhea the amount of glucose approximates that obtained by lumbar puncture (two-thirds of the serum value) The site of a CSF leak can sometimes be demonstrated by injecting a dye, radioactive albumin, or water-soluble contrast material into the spinal subarachnoid space and detecting its appearance in nasal secretions or its site of exit by CT scanning This testing is best

We can demonstrate subplot by examiningMATLAB's capabilityto generate threedimensionalplots The simplest manifestation this capability is the p1or3 command of which has the syntax p1ot3 \x, y, z)

This single chapter about LINQ, a critically important new development in the NET Framework 35, is the first step in a thousand-mile journey You should be aware that more steps are available In numerous blogs and online articles available from Microsoft, you can find some excellent and not-so-excellent discussions of LINQ However, beware of some of the initial materials on LINQ and Visual Studio 2008 Many articles online, while initially accurate, are no longer so because of changes in Visual Studio 2008 or in the LINQ framework At the time of this writing, several books are available where the authors have ample room to go into all of the intense detail of LINQ After reading this chapter, if you wish to find out more about LINQ for your projects, check out some of these books that lead to the rest of the steps in the LINQ journey

Bacterial meningitis is a medical emergency The rst therapeutic measures are directed to sustaining blood pressure and treating septic shock (volume replacement, pressor therapy) A premium is then placed on choosing an antibiotic that is known both to be bactericidal for the suspected organism and is able to enter the CSF in effective amounts Treatment should begin while awaiting the results of diagnostic tests and may be altered later in accordance with the laboratory ndings Whereas penicillin formerly suf ced

wherex, y, and z arethreevectors the samelength of The resultis a line in three-dimensional space throughthe pointswhosecoordinates the elements x, y, anrJ are of z Plotting a helix providesa nice exampleto illustrateits utility First, let's grapha circle with the two-dimensional plot function using the parametric representation: sin(t) -r: - cos(r)We employ the subplot commandso we can subsequently the three-diandy add mensionalplot >> l- = 0:pi/50:10*pi; > > s u b p l o r -( 1 , 2 , I ) ; p 1 o t ( s j n ( L ) , c o s ( r ) )

Cefotaxime plus ampicillin Third-generation cephalosporin plus ampicillin (plus dexamethasone) 3 months 18 years Third-generation cephalosporin plus vancomycin ( ampicillin) 18 50 years Third-generation cephalosporin plus vancomycin ( ampicillin) 50 years Third-generation cephalosporin plus vancomycin plus ampicillin Immunocompromised Vancomycin plus ampicillin and state ceftazidime Basilar skull fracture Third-generation cephalosporin plus vancomycin Head trauma; neuro- Vancomycin plus ceftazidime surgery CSF shunt Vancomycin plus ceftazidime

In a very fundamental way LINQ was designed to improve developer productivity Because LINQ makes query statements more like standard language statements, developers are not sidetracked by incorporating a special flavor of SQL depending on the database system Likewise, built-in tools in ASPNET 35, such as the LinqDataSource control, make development easier through several properties used in LINQ queries The next section examines how to use the controls in ASPNET 35 to make queries as well as nonquery operations with LINQ

>> axis squaLe >> rirle (' (a) ') As in Fig 2la,the result is a circle Note that the circle would have been distorted if we had not used the axis souer e command

For all ages from 3 months onward, an alternative treatment is meropenem plus vancomycin (does not provide coverage for Listeria) For severe penicillin allergy, consider vancomycin and chloramphenicol (for meningococcus) and trimethoprim/sulfamethoxazole (for Listeria) A high failure rate has been reported with chloramphenicol in patients with drug-resistant pneumococcus

To see how to use the new LINQ control LinqDataSource, this example goes through a rather lengthy Visual Studio 2008 process However, once everything is done, you may be surprised at how little ASPNET code the process generates Basically, the whole operation uses only two controls: LinqDataSource and DetailsView If you are familiar with the DetailsView control from ASPNET 20, you will be happy to hear that the new 35 version of control can use the LinqDataSource control as a data source So while a lot of this will look new, the key display control is an old friend