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assumed that in meningitis the bacteria lowered the CSF glucose by their active metabolism, but the fact that the glucose remains at a subnormal level for 1 to 2 weeks after effective treatment of the meningitis suggests that another mechanism may be operative Theoretically at least, an inhibition of the entry of glucose into the CSF, due to an impairment of the membrane transfer system, can be implicated As a rule, viral infections of the meninges and brain do not lower the CSF glucose, although low glucose values have been reported in a small number of patients with mumps meningoencephalitis and rarely with herpes simplex and zoster infections Serologic and Virologic Tests It has become routine practice to test the CSF for cryptococcal surface antigen as a rapid method of detecting this fungal infection On occasion, a false-positive reaction is obtained in the presence of high titers of rheumatoid factor or antitreponemal antibodies, but otherwise the test is diagnostically more dependable than the conventional India ink preparation (page 621) The nontreponemal antibody tests of the blood Venereal Disease Research Laboratories (VDRL) slide occulation test and rapid plasma reagin (RPR) agglutination test can also be performed on the CSF When positive, these tests are diagnostic of neurosyphilis, but false-positive reactions may occur with collagen diseases, malaria, and yaws or with contamination of the CSF by seropositive blood Tests that depend on the use of treponemal antigens, including the Treponema pallidum immobilization test and the uorescent treponemal antibody test, are more speci c and assist in the interpretation of false-positive reactions The value of CSF examinations in the diagnosis and treatment of neurosyphilis is discussed in Chap 32, but routine testing of CSF for treponemal antibodies is no longer practiced Serologic tests for the Lyme spirochete are useful in circumstances of suspected infection of the central nervous system with this agent The utility of serum serologic tests for viruses is limited by the time required to obtain results, but they are useful in determining retrospectively the source of meningitis or encephalitis More rapid tests that utilize the polymerase chain reaction (PCR) in CSF, which ampli es viral DNA fragments, are now widely available for diagnosis, particularly for herpesviruses and cytomegalovirus These tests are most useful in the rst week of infection, when the virus is being reproduced and its genomic material is most prevalent; after this time, serologic techniques for viral infection are more sensitive Ampli cation of DNA by PCR is particularly useful in the more rapid detection of tubercle bacilli in the CSF, the conventional culture of which takes several weeks at best New tests for the detection of prion proteins in the spinal uid are available and may aid in the diagnosis of the spongiform encephalopathies, but the results have been erratic in our experience (Chap 33) Changes in Solutes and Other Components The average osmolality of the CSF (295 mosmol/L) is identical to that of plasma As the osmolality of the plasma is increased by the intravenous injection of hypertonic solutions such as mannitol or urea, there is a delay of up to several hours in the rise of osmolality of the CSF It is during this period that the hyperosmolality of the blood dehydrates the brain and decreases the volume of CSF The CSF and serum levels of sodium, potassium, calcium, and magnesium are listed in Table 2-2 Neurologic disease does not alter the CSF concentrations of these constituents in any characteristic way The low CSF concentration of chloride that occurs in. barcode font excel 2010 free download How to create barcode in Excel using barcode font - YouTube
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Tutorial in using the Barcode Fonts in Microsoft Excel 2007, 2010, 2013 or 2016. All the functions ... It is extremely easy to create and print barcodes in Excel . Glucose Normally the CSF glucose concentration is in the range of 45 to 80 mg/dL, ie, about two-thirds of that in the blood (06 to 07 of serum concentrations) Higher levels parallel the blood glucose; but with marked hyperglycemia, the ratio of CSF to blood glucose is reduced (05 to 06) With extremely low serum glucose, the ratio becomes higher, approximating 085 In general, CSF values below 35 mg/dL are abnormal After the intravenous injection of glucose, 2 to 4 h is required to reach equilibrium with the CSF; a similar delay follows the lowering of blood glucose For these reasons, samples of CSF and blood for glucose determinations should ideally be drawn simultaneously in the fasting state or the serum should be obtained a few hours before the puncture (this is often impractical) Low values of CSF glucose (hypoglycorrhachia) in the presence of pleocytosis usually indicate pyogenic, tuberculous, or fungal meningitis, although similar reductions are observed in some patients with widespread neoplastic in ltration of the meninges and occasionally with sarcoidosis and subarachnoid hemorrhage (usually in the rst week) The almost invariable rise of CSF lactate in purulent meningitis probably means that some of the glucose is undergoing anaerobic glycolysis by polymorphonuclear leukocytes and by cells of the meninges and adjacent brain tissue For a long time it was barcode excel 2007 Barcodes in Excel 2003 , XP, 2000 spreadsheets - ActiveBarcode
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