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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

迅速崛起的“色情短信”服务商Snapchat与早期的社交媒体巨头Facebook具有令人不可思议的相似性。我们现在都知道扎克伯格早早就投下的赌注获得了多大的成功(更不必说他还彻底击败了卑劣的文克莱沃斯孪生兄弟)。那么,Snapchat能否拥有同样光明的未来?
But Michael DeFranco, chair of Baker & McKenzie’s M&A practice, hailed the Chinese group’s investment in developed economies.
Build the armed forces through political work and reform, and run them by law
“我想,在21世纪,人们绝对会质疑这件事。”
adj. 有限的,被限制的
With Westbrook playing such a hands-on, high-usage role and Victor Oladipo already locked in on a high-dollar extension, Payne needed to prove he could be an off-ball threat or a lead guard on the second unit.
Sweden, one of the most generous countries in terms of contributing funds to humanitarian aid, ranks No. 6 overall. The country is No. 2 in Citizenship and No. 1 in Best Countries for Green Living.
Marvel created superhero Blue Ear, who wears a hearing aid, after a little boy refused to wear one because "superheroes don’t wear hearing aids".
公司:垃圾处理公司Nation Waste
特朗普几乎是教科书式的煽动家。

n. 飞机,水平
国际消费类电子产品展
This 1977 file photo shows Apple co-founder Steve Jobs as he introduces the new Apple II in Cupertino, Calif.
小贝现身纽约时装周 为凯特选嫁衣?
You will ignore others when you are together.
历史会这样回首2012年:这一年,中国“第五代”领导层亮相,同时中国经济转向较低速增长的轨道。这种转变发生的背景,将是一系列令人畏惧的国内挑战——不断增加的社会不安定,不断扩大的收入差距,以及生态和人为的灾难——加上不断升级的外部紧张,这源于美国重新转向亚洲,同时亚太邻国对中国的经济崛起越来越感到忧虑。

In 2010, a 14-month-old child accidentally fell on a chopstick he had playfully placed into his nose. It did, indeed, puncture the roof of his nose and lodge into his brain. Neurosurgeons did successfully remove the chopstick, with little internal damage long term.

The nasal, or nasopharyngeal, swab for Covid-19 is a PCR (polymerase chain reaction) test looking for active infection, and remains the most accurate to date to assess for acutely infected individuals. This in contrast to the antigen, or rapid test, also performed as a nasopharyngeal swab, which is much less accurate, especially if the test result is negative (it has a very high false-negative rate). The antibody test, which is a blood test, is performed to detect evidence of prior infection, not active illness.

A 40-year-old woman in Iowa underwent a nasopharyngeal Covid-19 swab test as part of her preoperative clearance for an elective hernia repair. Soon after, she developed headache, nausea, vomiting, and clear watery drainage from the side of her nose where the swab had been placed. This was not the type of drainage one would get from allergies, a cold, or even a sinus infection. Picture your kitchen sink trickling out water if it’s not fully turned off. That’s what a spinal fluid leak can look like, which is what she had. In addition, the fact that a runny nose is just on one side is often a tip-off of something unusual. As published in the October issue of JAMA Otolaryngology, it turned out that she had had prior nasal polyp surgery two decades ago, as well as a history of disorder called intracranial hypertension, or increased pressure of the fluid surrounding the brain. The combination of these two entities led to a small defect in the bone between the roof of the nose and the brain, and she had developed a pocket of the brain’s lining prolapsing into the nose, known as an encephalocele. The sack of the encephalocele got nicked by the Covid-19 swab.

Radiologic imaging of her brain and sinuses demonstrated a one-inch area where there was no bony roof of her nose. Instead, there was an out-pouching of the brain’s lining, known as an encephalocele, filled with spinal fluid. The pouch got pierced by the swab, and just like piercing a water balloon that’s attached to a faucet, it immediately started leaking clear cerebrospinal fluid. Once this was identified, she underwent surgical repair of the defect in the bone, and the spinal fluid leak was controlled and repaired.

According to Dr. Jarrett Walsh, Assistant Professor of Otolaryngology-Head and Neck Surgery at the University of Iowa, and senior author of this report, “If the swab is introduced at an angle toward the skull base, then any defect in the skull base is potentially put at risk. Correct technique, following the floor of the nose, is exceptionally safe and will not cause skull base trauma.” When asked if he would recommend avoiding nasopharyngeal testing swabs in general, he thinks not: “Nasopharynx swabs, performed correctly, are safe...I think the group of patients that needs to exercise caution in testing are those who have had anterior (nasal) skull base surgery – specifically those who have had reconstruction of the anterior skull base. With missing bone between the nose and the brain, an errant swab could have significant consequences. This is the group that I would encourage considering an alternative testing technique, if it is available.”

When it comes to Covid-19 diagnostic testing, nasopharyngeal swab approach has been shown to be more accurate than oropharyngeal (oral) swab. However, in some cases, especially where a patient has had prior surgeries in the area between the nose and the brain, or prior injuries in that region, physicians will accept oropharyngeal testing for pre-procedure screening.

东莞:上半年全市建设工程质量安全检查情况公布

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1. You became a LinkedIn superstar overnight。
当你听说今年3月份,一个17岁的学生把自己设计的一款软件以3,000万美元卖给雅虎公司(Yahoo! Inc., YHOO)的时候。对于这孩子的形貌,你脑海里或许已勾画出一个搞笑的形象了吧:不用说,肯定是个极客。一个除了一行一行写代码之外对什么也不感兴趣的学霸。一个不敢正眼瞧人还老小声儿嘀咕着什么的神经质。

这栋房屋坐落在街道上的一处小山丘上。房屋的入口处是一个大玻璃门廊,有砖砌的地面和对着湖的玻璃窗墙。翻修工程保留了花格镶板的天花板和原建筑部分大量运用的木材。其布局规划是开敞式设计,几乎每个房间都可以从观景窗看见湖景。
这段深入11岁女孩心灵与情感的旅程可能是皮克斯迄今最疯狂的冒险。这是一部非常有趣的工作场合情景喜剧,艾米·波勒(Amy Poehler)、菲利丝·史密斯(Phyllis Smith)和敏迪·卡灵(Mindy Kaling)等人带来了精彩感人的演出,这是一则关于心理发展的精巧语言,也是对于悲伤在我们的生活中所扮演的角色的一种感人而诚恳的辩护。
《为奴十二年》导演史蒂夫?麦奎因(Steve McQueen)在登台领奖时说:我有点吓到了。然后他微微耸肩,引用片中福音歌曲的歌词,说了句“翻涌吧,约旦河,翻涌吧”("Roll, Jordan, roll")。
去年12月,中国工业利润降幅达到创纪录的8%,显示中国有针对性的刺激计划未能抑制工业放缓,而工业是中国经济的主要推动力。
Paramore, 'After Laughter'
豆瓣网友“Jiuyuehuashang”称:“剧中,爱情就是女主唯一的追求。她生命的意义似乎就是找一个真命天子谈情说爱。不对,不是一个,是三四个。”
According to the 2016 Hurun IT Rich List released last Tuesday, the average wealth of the top 50 Chinese IT tycoons hit a record, surging 13% year-on-year to 26.9 billion yuan.
badminton;basketball;fencing;Judo;Ping Pang;taekwondo;Tennis;weightlifting;Wrestling;Volleyball;Boxing;Hocky.
单词surrogate 联想记忆:
中国的网红经济发展到今天,经历了三个阶段:第一个阶段是文字时代,第二个阶段是图文时代,现在这一阶段是要归功于宽带的可用性的视频时代。
Because of her success, she no longer lives anything resembling a normal life.
Australia is the No. 8 Best Country overall. The Land Down Under – No. 4 in Quality of Life and No. 9 in Adventure – also ranks in the top 10 in terms of education.
超过了9月份11.2%的上涨幅度。
但关于是否会诞生另一个火爆产品,来打破关于后乔布斯时代苹果前途的质疑,库克许久以前就学会了耐心和相信自己的直觉,正如他在1998年加入正处在困境中的苹果时对质疑者置之不理一样。