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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

当你在工作的时候,你的效率应该是很高的。不然的话,那就是在浪费你自己的时间和公司的财富。如果你很厌倦,一天当中大多数时间是在浏览网页,你可能是想要寻找其他的能够激励你的工作机会了。
We will promote a steady increase in consumer spending.
在该论坛上,科技创业者们也分享了他们对虚拟现实的看法。他们纷纷表示,在未来5至10年,虚拟现实将是最重要的计算平台。
This year so far, Stephen Chow’s The Mermaid has made $526 million since its release in early February during Lunar New Year.
The number of candidates for the 2016 national civil service exam has surpassed last year's numbers, with more than 132,000 applicants on Tuesday-the most in a single day-deemed qualified for the exam.
For now, most of the activity around bitcoin is monetary in nature, so it makes sense that its critics point to volatility. Though the value of one bitcoin in U.S. dollars has fallen 67% in the past year, its value over the past two years is up 1,879%, according to the market price chart at blockchain.info. So whether it’s a good investment or a bad one is a matter of perspective.
facilitate
2年前中国股市突破6000点,而2010年股市能否重拾失地呢?当初中国股市行情十分被看好,但今天,如果你问同样的问题,有的人会拿全球经济说事儿——因为全球经济仍旧步履艰难。
斯德哥尔摩经济学院(Stockholm School of Economics)是今年排行榜上的大赢家,该学校的排名攀升16个位次,排在第28位,不仅排名晋升速度为年度最快,而且扭转了去年排名下滑11位的局面。
Banks just cannot afford to keep up. At Goldman Sachs, for example, net revenues have dropped about a third since 2009, beaten down by structural shifts in trading and new rules crimping risk-taking. The bank tries to keep its pay ratio stable, so that means smaller total packages for the typical employee.

As he scanned the Internet for knowledge, D'Aloisio decided that what he really needed was a better way to determine, at a glance, what was worth reading. He envisioned a summarization tool that used language theory to give a meaningful synopsis in fewer than 400 characters.
[i'fektiv]
这是最好的时代,这是最坏的时代……
Iese商学院的优势之一是其学风严谨。这所位于巴塞罗那的商学院在定制课程的所有指标上一贯表现优异。该校在15项指标中的11项上都跻身前五之列,并在国际客户和师资多样性两项指标上排名第一。
电视剧版《三生三世十里桃花》于1月30日首播,由人气女演员杨幂和迪丽热巴主演。该剧讲述了一个小仙女和一位神仙的三世情缘。
25 July

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.

楼市涨声一片中虚实不一 一些涨价只是营销行为

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捷蓝航空公司发言人珍妮·德文(Jenny Dervin)说,“我们75%的航班在东北部起降,无论是纽约还是波士顿,早上航班的延误都可能会影响这架飞机的整条航线。”美国东北部特别容易受到冬季暴风雪的影响,导致航班延误。
格温妮丝·帕特罗(Gwyneth Paltrow)曾出演《莎翁情史》(Shakespeare in Love)获最佳女主角奖,并成为好莱坞明星。为了避免在发表获奖感言时出现混乱,她却把小金人藏了起来,因为“这东西吓坏我了”。

outrage
Last year, Islamic State militants seized 49 Turkish hostages from Turkey's consulate in Mosul and held them for more than three months before releasing the group. Those hostages included diplomats, soldiers and children.
It seems safe to predict lots more noise and very little progress for the rest of 2017. And that will continue to be a damaging combination for business and the UK economy.
地区
为什么我如此有信心东亚不会爆发战争,无论在东中国海还是南中国海?答案很简单,因为我了解推动亚洲变化的力量。虽然许多亚洲邻国会发出愤怒的民族主义声明(他们必须这样做来应对普遍的民族主义情绪),但他们的行动是谨慎和务实的。
A total of 13.14 million new urban jobs were 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。
The movies were selected from more than 2,000 titles from 100 countries and will be screened in 30 cinemas and colleges around Beijing from April 8 to April 23, Zhang Xiaoguang, deputy head of China Film Archive, said last Thursday.
其他入围者分别是:《失去信号:黑莓离奇崛起与惊人陨落背后不为人知的故事》(Losing the Signal: The Untold Story Behind the Extraordinary Rise and Spectacular Fall of Blackberry),作者杰基麦克尼什(Jacquie Mcnish)和肖恩缠尔科夫(Sean Silcoff)回顾了黑莓是怎样偏离了航向;《数字黄金:比特币背后不为人知的故事》(Digital Gold: The Untold Story of Bitcoin),作者纳塔涅尔波佩尔(Nathaniel Popper)审视了虚拟货币比特币的崛起;《音乐如何变免费:一整代人犯下同样罪行的后果》(How Music Got Free: What Happens When an Entire Generation Commits the Same Crime?),作者斯蒂芬威特(Stephen Witt)介绍了盗版和对等网络共享(P2P)扰乱唱片业的历史;《做不完的事:女人、男人、工作、家庭》(Un滻椀猀栀攀搀 Business: Women Men Work Family),作者安妮-玛丽斯劳特(Anne-Marie Slaughter)在书中讨论了实现性别平衡面临的挑战,以及《行为不端:解读行为经济学》(Misbehaving: The Making of Behavioural Economics),作者理查德泰勒(Richard Thaler)追踪了行为经济学的发展。
“在ETF壮大的地区(美国和欧洲),有一个庞大的理财顾问生态系统,”他表示,“你需要一个更加依靠顾问的模式。但在你看到人们为建议付费(而不是支付佣金)之前,很难设想它何时起飞。”
Interestingly, a survey found Beijing was thought to be the most congested city in China, among 31.8 percent of respondents, followed by Zhengzhou at 8.8 percent.
The top SUV maker and MPV maker last month are familiar to all: Great Wall Motor and SAIC General Motor Wuling stayed on their segment thrones. SAIC Volkswagen also maintained its crown in the sedans and hatchbacks segment.
采光。在工作中,光线是很重要的,不要用上大学时候的那个小台灯了,用个更别致更有创意的灯吧。
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