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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

[s?'vaiv?l]
Critics have been eager to point out that he is not so closely involved in new product development as his predecessor, and fails to elicit the same excitement when he takes to the stage to introduce them. But Mr Cook is aware of his shortcomings and has drawn on the worlds of fitness and fashion to assemble a new team of talents, including Angela Ahrendts, formerly of Burberry, and industrial designer Marc Newson.
学员平均年龄:费城班33岁,旧金山班36岁
《那年花开月正圆》
Effective bosses and managers tend to:
冲击奖项:自从在特莱瑞德电影节首映以来,奥德曼一直就是最佳男主角奖项的宠儿。
目前全国11个省的52所高校配备了自动售货机,出售艾滋病检测试剂以供学生自查。
Last year, the CPI increase peaked at 2.5 percent in January, and later fluctuated below 2 percent during the rest of the year.
8.《没问题先生》
Other European cities have seen increases in costs, pushing them up the rankings. London rose five points, bringing it into the top 10.

I think it’s a perfect continuation of my last post of being a football widow and I simply had to share the rules here. I LOVE rule no.6.
Unfortunately for May, the big drop in the pound since the Brexit vote means her salary has plunged in dollar terms.
从周日起,各地的观众都在叹息该剧剧终,至少从Twitter名人的帖子来看是这样的。
评审委员会(就我一人)花了几周的时间来决定王室、政界以及明星当中谁应该获得一枚令人难堪的奖章,以表彰他们过去一年严重违反礼仪或行为失态的表现。
傲人的财务业绩和令人炫目的新科技,或许已足以让这位钢铁般坚定的苹果首席执行官赢得英国《金融时报》2014年年度人物(Person of the Year)的称号。但库克阐述自己价值观的勇气,同样让他与众不同。
就这一点而言,他预计美国投资会回升,“因为投资一直太弱——除非在经济衰退期,我们通常不会看到投资增长低于消费增长”。

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.

统计局:去年房产成交面积涨幅大 企业投资房产滞后

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Whatever one's view, two further points for and against Russia's global standing are undeniable:
如果一部情景喜剧播出10年堪称流行,那么播出20年后依旧令无数人挂怀的电视剧则是经典。《老友记》1994年在美国首播,讲述了六个生活在纽约的青年男女的故事。现在,该剧已经是最著名的情景喜剧之一,在全球超过100多个国家和地区播出。

1月份,中国的进口同比减少了14.4%,降至7375亿元人民币。大于去年12月4%的降幅,也和上升1.8%的预期不符。
最不守时奖
And now for the companies that lost the most love ...
这个发型与米歇尔·法伊弗(Michelle Pfeiffer)的造型有点相似,但查斯坦让它更具锋芒。凯·乔治乌(Kay Georgiou)负责这个造型。她经常为马特·达蒙(Matt Damon)和格温妮丝·帕特洛(Gwyneth Paltrow)在电影中设计发型。
作为历史上一种非常敏感的大宗商品,原油价格走势已连续三年保持波澜不惊,其背后的一大支持因素就是美国的页岩油。
水果模子
3所在这份榜单上叱咤多年的重量级学府——哈佛商学院(HBS)、伦敦商学院(LBS)和麻省理工斯隆管理学院(MIT Sloan School of Management)的排名下滑。哈佛商学院的排名下降两个位次,今年排在第四,这是这所位于波士顿的学府9年来首次跌出前三甲。伦敦商学院下滑3个位次,排在第六,为14年来最低。麻省理工斯隆管理学院的排名下滑至第13位,为10年来首次跌出前10。
Though its campuses often steal the benefits spotlight -- with their outdoor sports facilities, free food and more -- there's a more morbid perk that should certainly be noted. If a U.S. Googler passes away while working for the tech giant, the employee's spouse or domestic partner receives 50% of the deceased's salary, no matter how long or short his tenure, every year for the next decade.
拉动你的行李箱,带上你的耐心。假日航空旅行季节即将到来,如果你想有趟轻松愉快的旅程,那么对美国人最好的建议就是选择飞往西部。
2.别迷恋哥,哥只是个传说。
Guo Jingjing's alleged romance with Kenneth Fok, the grandson of late Hong Kong tycoon Henry Fok, has captured the imagination of a country that seems to have become as interested in the private lives of its athletes as in their athletic performances.
Blue skies will not be, and should not be, a luxury.
"The average salary level of employees grew by about 6.3 percent year on year in the first three quarters of last year, while China's annual GDP growth stood at 6.7 percent in 2016, both slowing from a year earlier," Jin added.
4.英国人似乎总是喜欢道歉,但道歉的意义并不相同。在英国,“对不起”实际可能表示这几种意思:(1)我没听清你说什么;(2)我没明白你的意思;(3)我听到了你说的,也明白你的意思,可我觉得你是个白痴。