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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

《老友记》播出之时,正值来自小城镇的美国年轻人向大城市转移的时代,而初到大城市的年轻人既不够成熟,也缺乏独自生存的能力。在此之前,情景喜剧都以展现家庭百态为主,父母是剧中的主要人物。但是,当年轻人独自在大城市生活时,他们不得不依靠彼此,一起度过迷茫的青春。
2. 《头脑特工队》,导演:彼得·道格特(Pete Docter)。
epic
“还有大批人没有统计进来,”胡润对英国《金融时报》表示,“两周前我在北京拜访了这家投资公司。一下午的时间,我就发掘出了30个登上今年富豪榜的人。他们去年还不在我们的视线内。”
每平方英尺单价:310美元(每平方米约合人民币2.1万元)
SAN JUAN, Puerto Rico (AP) — Puerto Rico’s new governor was sworn in Monday as the U.S. territory prepares for what many believe will be new austerity measures and a renewed push for statehood to haul the island out of a deep economic crisis.
7. “Out 1: Noli Me Tangere”(Jacques Rivette)
At the start of the year, the ruling Communist party set a target of 6 per cent growth in trade for this year but total trade has now fallen by just over 8 per cent in the first ten months of 2015 compared with the same period a year earlier.
'It's a crazy resemblance,' Carlson said. 'Every time I watch [the movie], it's weird because it's like I'm watching myself. It's kind of creepy.'
你可能希望分享这些文章的人是出于开玩笑,我也是这么想的。但是我们不能:这个分析指出,通过一个近期的BuzzFeed和Ipsos的公众事务民调显示,75%的美国人(84%的共和党人以及71%的民主党人)很容易就被假新闻的标题所欺骗。这是关于真实性调查、理性思维、扎克伯格的自我意识的梦幻一年。

巴尼汤普森(Barney Thompson)是法律记者
这一品牌的排名主要是基于财务业绩报告、对客户的影响、溢价能力或推动公司销售的能力。
它们大多来自50个不同的行业,包括食品和饮料、汽车和汽车零部件、媒体、零售、能源和互联网。
坐在前排
The June announcement of collaboration between Google and fashion designer Diane von Furstenberg to create a new line of Google Glass underscored Silicon Valley’s current strategy to enlist the fashion elite to sanction wearables as de rigueur.
stressful

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.

专家称若效果不明显 未来或将连续出现几次降息

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玛蒂?齐格勒和妈妈梅丽莎以及妹妹麦肯齐(Mackenzie)在好莱坞大道(Hollywood Boulevard)上(图)
针对那些对比较世界各地的学校有兴趣的学生,《美国新闻与世界报道》近日发布了第四版全球最佳大学年度排行榜。

But 'averages' are old data, not future facts. Happy talk won't restart a bull. And more warnings won't puncture an old bubble. Cycles have lives of their own, move up and down when they damn well feel like it. That's nature.
Manal al-Sharif is best known for challenging laws and mores that keep women down in her native country.
● “一艾滋病女子故意传播艾滋病给586名男子,计划在2017年之前传染2000人以上”
“我非常激动,皮草被禁止参加伦敦时装周是个巨大的进步!” 费斯回应道。
戛纳电影节素以质问与嘲笑著名。在本届电影节上,《青木原树海》(Sea of Trees)成为第一部遭遇观众挑剔的电影。该片由格斯?范?桑特Gus Van Sant指导。在媒体放映场,《青木原树海》遭遇嘲弄的风暴,陷入了嘘声之海。由于这些发生在首映红毯前,恶评迅速传播,使得盛典蒙上阴影。娜奥米?沃茨(Naomi Watts )和 马修?麦康纳(Matthew McConaughey)走上红毯时,《每日电讯报》(Daily Telegraph)形容此场景为“极其糟糕却又引人瞩目的羞辱之途”。但是在随后的新闻发布会上,马修?麦康纳,这位来自德克萨斯的演员表情坦然,“每个人都有权倒喝彩,正如他们有权喝彩一样,”他说道。我相信我们都知道他的意思。
除了这些理论之外,还有传统经济学家用来误导美国的坏的统计数据:最恶劣的是GDP,它在衡量美国长期增长的时候是一个狭窄的、误导人的指标。其次,我们对短期数据(每日收盘情况、季度业绩、年度回报等)的执迷正在阻碍美国的长远增长。
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《雷神3:诸神黄昏》的搞笑程度远远超出你的想象。这都要感谢杰夫?戈德布卢姆与塔伊加?维迪提两位天才的合作。维迪提不仅是本片导演,他还在电影中饰演了一个极其真诚的石头人战士Korg。
中国股市的跌势仍在继续,现在“红线”已触,一切都提早结束了。
"China is Australia's most valuable tourism market, with the potential to be worth more than $13 billion by 2020."
讽刺的是,就在该榜单公布的同一天,特朗普会见了已经连续第四年蝉联富豪榜榜首的比尔·盖茨。
Tesla:In an effort to blunt criticism about slow refueling times for battery-powered cars, Tesla TSLA -1.54% starts to roll out of a network of battery-swap stations. CEO Elon Musk must hope he can outdo Shai Agassi’s Better Place, which tried to build a whole company around battery-swaps before going bankrupt in 2013.
中国和越南的关系因中国南海领土问题而变得日益紧张。两国媒体都对这一事件进行了报道,指责各自政府将非法食品投放本国市场。
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