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4 Right-click the App_Data folder and select Add New Item 5 Under Templates select SQL Server Database, and in the Name window change

8 4 8 12 4 6 8 12 24 6 12 8 12 8 4 4 4 8 24 8 6 12 6 12

--=-al'

Right-click the Tables folder icon, and select Add New Table as shown in Figure 14-2

Unless indicated, therapy is administered intravenously Aminoglycosides are not used as sole treatment for meningitis Peak and trough serum concentrations should be monitored c Higher dose recommended for pneumococcal meningitis d Risk of seizures with meropenem e Oral administration f Dosage based on trimethoprim component g CSF concentrations may have to be monitored in severely ill patients Newer drugs are available for methicillin-resistant staph infections but are not well studied for staphylococcal meningitis: linezolid, quinupristin-dalfopristin, and daptomycin

a, [h -

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Bacteria Haemophilus in uenzae B-lactamase-negative B-lactamase-positive Neisseria meningitidis Streptococcus pneumoniae Penicillin MIC 01 g/mL (sensitive) Penicillin MIC 01 10 g/mL (intermediate sensitivity) Penicillin MIC 20 g/mL (highly resistant) Enterobacteriaceae Pseudomonas aeruginosa Listeria monocytogenes Streptococcus agalactiae Staphylococcus aureus Methicillin-sensitive Methicillin-resistantd Staphylococcus epidermidis

Your textbooks are filled with formulas developed in the past by Bockground renowned scientistsand engineersAlthough theseare of great utility, engineersand scientheserelationships collectingand analyzingtheir own data by tists often must supplement Sometimesthis leads to a new forrnula However, prior to arriving at a final predictive equaand developingplots ln tion, we usually "play" with the data by per{ormingcalculations hiddenin the data most cases, intent is to gain insight into the pattemsand mechanisms our In this casestudy,we will illustratehow MAILAB facilitatessuch exploratorydata analysisWe will do this by estimatingthe drag coefficientof a free-falling human based on Eq (21) and the data from Table 2 1 However, beyond merely computing the drag coefficient, we will use MATLAB's graphicalcapabilitiesto discernpatternsin the data Solution can as The datafrom Table21 alongwith gravitational acceleration be entered

( continued )

Ampicillin Third-generation cephalosporina Penicillin G or ampicillin Penicillin G or ampicillin Third-generation cephalosporina Vancomycin plus third-generation cephalosporin Third-generation cephalosporina Ceftazidime or cefepimeb Ampicillin or penicillin Gb Ampicillin or penicillin Gb Nafcillin or oxacillin Vancomycinc

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a little while You will see the five fields you created Click in the first field and press TAB to move to the LastName field Begin entering records in this second field because the first field automatically enters values Add about five records to have something to work with Figure 14-4 shows an example (Whenever you make changes in a record, the ReqID changes, so some of the ReqID values are out of sequence in Figure 14-4)

Third-generation cephalosporina; chloramphenicol Chloramphenicol; cefepime Third-generation cephalosporina; chloramphenicol Third-generation cephalosporina; chloramphenicol; vancomycin plus rifampin Vancomycin; meropenem Meropenem Meropenem; uoroquinolone; trimethoprim/ sulfamethoxazole, or cefepime Meropenem; uoroquinoloneb; pipericillin Trimethoprim/sulfamethoxazole Third-generation cephalosporina; vancomycin Vancomycin Linezolid, quinupristan-dalfopristan, daptomycin Vancomycinc

Key: MIC Minimal inhibitory concentration a Cefotaxime or ceftriaxone b Addition of an aminoglycoside should be considered c Addition of rifampin should be considered d Linezolid, quinupristan-dalfopristan, and daptomycin are newer alternatives for methicillin-resistant Staphylococcus, but few cases have been studied

Classes, and in the Name window change the default name to RegClientsdbml and click Add Figure 14-5 shows the correct settings

The drag coefficientscan then be computedwith Eq (2 l) Becausewe are performing operations vectors,we must include periodsprior to the operators: on element-by-element

low for many days after other signs of infection have subsided and should occasion concern only if bacteria are present in the uid and the patient remains febrile and ill Prolongation of fever or the late appearance of drowsiness, hemiparesis, or seizures should raise the suspicion of subdural effusion, mastoiditis, sinus thrombosis, cortical vein or jugular phlebitis, or brain abscess; all require that therapy be continued for a longer period Bacteriologic relapse after treatment is discontinued requires reinstitution of therapy Corticosteroids Early controlled studies demonstrated no bene cial effects of corticosteroids in the treatment of pyogenic meningitis More recent studies have given another perspective of the therapeutic value of dexamethasone in children and adults with meningitis In children, although mortality was not affected in the main study conducted by Lebel and colleagues, fever subsided more rapidly and the incidence of sensorineural deafness and other neurologic sequelae was reduced, particularly in those with H in uenzae meningitis On these grounds, it is recommended that the treatment of childhood meningitis include dexamethasone in high doses (015 mg/kg four times daily for 4 days), instituted as soon as possible Despite con icting results from earlier studies of corticosteroids in adults, the trial by deGans and van de Beck has persuasively demonstrated a reduction in mortality and improved overall outcome if dexamethasone 10 mg is given just before the rst dose of antibiotics and every 6 h for 4 days The improvement was largely in patients who were infected with pneumococcus Seizures and coma were reduced in incidence as a result of the administration of corticosteroids, but neurologic sequlae, such as hearing loss,

14:

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