山东强直性脊柱炎治疗费用标准(北京强直性脊柱炎 免疫机制) (今日更新中)

For the past two years, 52-year-old Kendra Jackson of Omaha, Nebraska just thought she had a bad cold."When it first started out, I just thought it was my allergies or a runny nose -- like the beginning of a fresh cold," Jackson said.The coughing, sneezing and runny nose began 2? years after Jackson was involved in a serious car accident. She remembers hitting her face against the dashboard, and she has struggled with migraine headaches ever since.In 2015, Jackson's "runny nose" began to worsen."When it didn't go away, I kept going back and forth to the doctors, and they prescribed every kind of medicine you can think of, and my nose just kept on running," she said.The doctors she saw told her that she probably had allergies. But this year, Jackson went to physicians at the University of Nebraska Medical Center and learned the real reason behind her nasal discharge: a cerebrospinal fluid (or CSF) leak caused by a small hole in her skull."She would wake up in the morning after sleeping upright in a chair, and the whole front of her shirt was wet with fluid. It was a lot of fluid," said Dr. Christie Barnes, a rhinologist at the University of Nebraska Medical Center and a lead surgeon on the case.Jackson said she was losing about half a liter of fluid per day.A physician's assistant "astutely recognized right away that this was something different than a runny nose and was consistent with a CSF leak. So we had her collect her fluids and sent it off for evaluation," Barnes said.Cerebrospinal fluid is a clear, colorless fluid that surrounds and protects the brain and spinal cord. The fluid also helps to remove waste products from the brain and distribute nutrients and other substances throughout the central nervous system, according to the Cleveland Clinic."CSF is a fluid that actually bathes the brain. Because the skull is a fixed box and the brain is a nice soft organ, it needs to be protected from moving around inside that hard box," Barnes said. "So it actually provides a cushion for the brain and the spinal cord."Cerebrospinal fluid is produced continuously in the brain and is normally absorbed into the bloodstream through protrusions in the outer membrane of the brain, called the dura mater.But in Jackson's case, a tiny hole in her cribriform plate -- a thin bone that separates her cranial and nasal cavities -- allowed the fluid to drip into her nose and mouth, resulting in her symptoms.According to Barnes, this part of the skull is "very thin, less than a potato chip. And it's one of the most common locations for this type of a CSF leak," Barnes said.Cerebrospinal fluid leaks are relatively rare, occurring in approximately five in 100,000 individuals worldwide every year. They are most commonly caused by trauma or surgery, according to the CSF Leak Association.In Jackson's case, the physicians believe that her car accident may have caused a small hole that increased in size over time."She was rear-ended and had head trauma, so it's certainly possible," Barnes said. "It may have caused a bit of a thin area there. Her symptoms actually started a little bit after (the accident), so for her, I think there's probably a combination of both the trauma and the increased pressure."Depending on the amount of fluid loss, cerebrospinal fluid leaks can be life-threatening. They also place the patient at an increased risk of infections such as meningitis, according to Barnes.In order to treat Jackson's condition, physicians at the University of Nebraska Medical Center performed a surgery that plugged the hole in her skull using tissue from her nose and abdomen, Barnes said."I used tissue from the inside of her nose to plug the leak," Barnes said. "I also borrowed some abdominal fat; it makes a great plugging agent in this location, so with just a tiny bit of fat, I was able to plug the leak."Almost a month after the surgery, Jackson is back home and reports that the mysterious drip has disappeared."I don't have the nasal drip anymore, but I still have the headaches," she said. "I actually feel pretty good, and I'm able to get a little bit of sleep."Though her condition is rare, Jackson wants people to know that cerebrospinal fluid leaks can occur, particularly after head trauma: "For people who hear my story, if they're tasting a very salty taste and something's draining in the back of your throat, it's probably something other than allergies. So get to the doctor." 4474

For the first time since July, the White House’s coronavirus task force delivered a briefing on Thursday as cases reach record levels throughout the US.President Donald Trump did not participate in Thursday's news briefing. The president has not had any public events this week. The coronavirus task force encouraged Americans to remain vigilant and practice social distancing guidelines as the virus spreads throughout the US.Dr. Anthony Fauci, the federal government’s top infectious disease expert, said that the “cavalry is coming.” He said recent developments of a pair of vaccines showing an effectiveness of 95% should give Americans confidence to get a vaccine once they become available.“The process of the speed did not compromise at all the safety nor did it compromised the scientific integrity,” Fauci said. “It was a reflection of extraordinary scientific advances in these types of vaccines which allowed us to do things in months that actually took years before but I really want to settle that concern that people have about that.”While the tone from the White House coronavirus task force was against lockdowns, states across the country have reimplemented some shutdowns of and limits to businesses. Notably, much of California will go under a curfew nightly from 10 p.m. to 5 a.m."We will be getting vaccine doses to people who are high priority at the end of December," Fauci said. "We aren't talking about shutting down the country. We are talking about locking down. We are talking about simple public health measures that we all talked about mask wearing, distancing, avoiding congregate settings, doing things to the extent that we can outdoors versus indoors and if we do that we'll be able to hold things off until the vaccine comes."Vice President Mike Pence says that the US will have 100 million doses of a vaccine ready to begin distribution as soon as an emergency use authorization is granted. General Gustave Perna, who is leading the government's distribution efforts of a vaccine said that when an emergency use authorization is given, the first doses of a vaccine will be distributed within 24 hours. Pfizer says its vaccine candidate could seek emergency use authorization from the FDA as soon as Friday.Distribution will be a challenge as the leading coronavirus vaccines have to be stored at extremely cold conditions.Perna said that the federal government is working with states on setting up places for a vaccine to be availble. The vaccines can be distributed from hospitals down to a local Walgreens or CVS. "We will distribute the vaccine accordingly," Perna said. "We want the vaccines at the places where the American people are comfortable; at our hospitals, our doctors offices, CVS, Walgreens and the health care facilities, places where people are comfortable going. That's where we started"Thursday’s briefing comes on the same day that the CDC urged Americans not to travel for the Thanksgiving holiday and asked Americans to only celebrate the holiday with those in their household.Earlier this week, task force member Dr. Scott Atlas criticized public health experts for advising Americans not to celebrate Thanksgiving with family. Atlas’ stance is an outlier among experts.On Wednesday, the number of coronavirus-related deaths since the start of the pandemic passed 250,000 in the United States. On Wednesday alone, more than 1,800 deaths were reported throughout the US, marking the most in a single day since the spring. 3488

Feel like taking a late night swim in your backyard pool? Finding a giant gator beat you to it is not want you want to see.A homeowner in Sarasota, Florida got the surprise of a lifetime when an 11-foot gator was discovered taking a late Friday night dip on the lanai.Sarasota County sheriff's deputies and a gator trapper were contacted to remove the gator.The gator didn't immediately want to go.After a short struggle, the gator gave up and was taken away quietly.  481

Former NFL quarterback Johnny Manziel is slated to take his talents north of the border, as Manziel announced on Saturday he has signed a contract with the Hamilton Tiger-Cats of the CFL. Manziel has faced challenges both on and off the football field since winning the 2012 Heisman Trophy. In 2016, Manziel was charged with domestic violence. Those charges were later dismissed. Also in 2016, Manziel was suspended for four games for violating the NFL's substance abuse policy.After an impressive collegiate stint at Texas A&M, Manziel's football career quickly flamed out. Manziel hasn't played professional football since 2015, when he was a member of the Cleveland Browns. Over two seasons, Manziel played in 15 games, and threw seven touchdowns and seven interceptions. "I don't want to wait around any more," Manziel said on Saturday. "I want to get on the field and get in the locker room and get a chance to play ball again. This is the best opportunity for me." Manziel said he is grateful for a second chance at professional football. Manziel is expected not to start at quarterback Hamilton, coach June Jones said. He will compete for the backup job behind former Oregon star Jeremiah Masoli. "Johnny is going to be a competitive player in this league," Jones said. "I feel he'll compete and competition makes everyone better."Manziel said he is ready to move forward and has learned from past missteps. "I have learned a lot from the mistakes. I feel like I wouldn't be where I am today on a personal, on a football level, going back into a locker room, if I didn't go through what I went through," Manziel said. "I am back to a point in my life where I am not taking anything for granted."One name mentioned in Manziel's press conference in Hamilton was Doug Flutie. Both Flutie and Manziel won the Heisman Trophy and went to the CFL after initial struggles in the NFL out of college. Flutie revitalized his career in Canada winning three Grey Cups. When Flutie returned to the NFL, he became a Pro Bowler. While Manziel would like another chance at the NFL, he said he will be with Hamilton for the "long haul."  2253

For many 5-year-old kids across the country, kindergarten is an exciting first introduction into the classroom. But this year, schools are grappling with growing COVID-19 cases and declining kindergarten enrollment numbers."In terms of our kinder cohort, we usually have about 23,000 students registered in Miami-Date County schools for kindergarten. Right now, as of this week, we have a total of 14,724 registered already for next year," said administrative director Berena Cabrera, with Miami-Date County Public Schools in Florida.Cabrera says the district is tackling a 40-percent decline in kindergarten enrollment, and other public schools across the country are dealing with a similar situation.At Visalia Unified School District in central California, kindergarten enrollment is down by 15 percent. At Poway Unified School District, near San Diego, they're seeing 5 percent less kindergarten students enrolling. Fulton County Schools in the Atlanta, Georgia area reports 12 percent less students are enrolled in kindergarten for the upcoming school year."Kindergarten is critical. It is the foundation of a successful student. And in Florida, it is mandatory for students to start kindergarten," said Cabrera.While kindergarten isn't mandatory in all states, educators agree it's an important beginning to a student's education. Rising coronavirus cases in communities combined with public schools having to tackle the virus head-on, has prompted some parents to turn to private kindergarten.Primrose Schools, which offers private daycare, preschool and kindergarten at more than 400 locations across the country, says they've seen a massive increase in interest, especially for those parents whose local districts are offering a virtual-only program this fall."Many of the working parents, obviously, they’ve got to have childcare. Where they would have had before and after school care now they're going to need full day. So, what we’ve seen is our schools responding rapidly by many of them opening up classrooms to kindergarten programs," Jo Kirchner, CEO of Primrose Schools, said.Kirchner says some of their locations are adding kindergarten classrooms to accommodate the increased interest. Their schools offer a 1:10 teacher to student ratio, plus heightened sanitation protocols."Even the parents who stay home with their children, who now find themselves virtual versus sending them to school, don’t really have the skill sets to provide the academic learning support the children need,” Kirchner said. “Kindergarteners have a fairly short attention span so distance learning is not the best environment for a kindergartner.”While kindergarten families across the country consider their options, Miami-Dade County Public Schools is converting a lot of their enrollment from paper to digital. Additionally, they're doing a big push on the district's website and social media."We’re hopeful that registration does pick up in the coming weeks. We are rolling out with a major marketing campaign, and we’re trying to let the parents know that there are staff in our schools that are registering," said Cabrera.Cabrera adds, whether kindergarten is in-person or remote learning this fall, she hopes parents will enroll their children for this crucial first start to their academic career. 3309

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