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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

“An employee bragged to all his colleagues that it was his last day, but failed to let his boss or the HR manager know.”
The Veterans Day holiday, which pays tribute to all men and women who have served in the U.S. military, dates back to 1919, when President Woodrow Wilson proclaimed November 11 as Armistice Day to celebrate the end of fighting exactly one year earlier in World War One - "the war to end all wars" - between Germany and the allied nations of Britain, France and the United States. The armistice famously went into effect at "the eleventh hour of the eleventh day of the eleventh month."
[r?'m?ntik]
While the debate was supposed to be solely about foreign policy, domestic concerns were never far from the surface and the candidates took every opportunity to pivot to their stump speech attacks over the economy and tax. The same was true in the spin room afterwards where both campaign teams dispensed quickly with debate comments and moved instead to analysis of the state of the race in swing states.
债券大王比尔?格罗斯(Bill Gross)承认:“QE必须结束。”数万亿的低成本资金“扭曲了激励机制,将资产价格推高至人为水平”。但现在格罗斯说“美联储的计划可能过于仓促了”。
Show must go on
对投资者来说,这一切都是坏消息。而现在恰好是美国30年债券牛市行情即将终结的时候。
台湾电影无缘2012奥斯卡最佳外语片
哈佛大学位居榜首,紧随其后的是麻省理工学院和斯坦福大学。
An American actress, author, fashion designer, dancer, producer, and singer Jennifer Lopez hold the second place in the list of 10 most beautiful women of 2015. Lopez's personal relationships have attracted worldwide media attention; she has been married three times. Beside entertainment world, J. Lo enjoyed a highly successful business career, consisting of various clothing lines, accessories, fragrances, a production company, television shows and a charitable foundation among other business interests.

However, others argued that doctors' hands may be forced by an unfair system. "As a patient, I'm more concerned about whether they can cure my illness rather than how many papers they've published," another netizen said.
如今,蓬勃发展的互联网经济在支撑我国信息技术(IT)行业财富增长方面正发挥着越来越重要的作用。
外套。来一套贝达弗的大衣和蓝围巾。一套价值1350英镑的大衣,随时准备迎接人生的精彩时刻。
Ever since the 1994 World Cup, the average scoring has been on a steady downward slope. In 2010 it bottomed out at 2.27, the second lowest average in World Cup history (1990 averaged just 2.20).
研究显示,美国已经取代印度成为反倾销和其他贸易保护案件的最大发起国,而中国及其钢铁行业正是美国的最大目标。
The United States saw its real GDP increase at an annual rate of 3.9 per cent in the three months ended September,according to official data released last month.

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.

北新建材:业绩增长稳健 股价回调显估值优势

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影片评价极高,演技也大获好评,尤其是故事的主人公——那些孩子们,以及汽车旅馆经理的扮演者威廉?达福。
Only Kobe Bryant had played in more games by age 32, and did so with fewer minutes, and that's just including regular-season games.

“理查三世研究小组”的成员菲利帕?朗丽说,她希望能重塑理查三世的形象,都铎王朝的继任者塑造出来的片面形象将不复存在。她负责协调研究工作以及筹款。
雷军表示:“这是一个使我震惊的消息。作为一名围棋的忠实爱好者,我从来没有想到人工智能在当前阶段可以击败一个人类冠军,因为这是一项非常复杂的棋类运动。”
It shifts your kid's weight to your shoulders and core instead of your back.
Don't mistake the lack of a late flurry for an uneventful deadline:
The dollar value of China’s exports fell markedly more than expected last month and import growth more than halved, while revisions to November data erased what had appeared to be a long-hoped-for return to growth for outbound shipments.
一名校友表示:我们被迫远离了安逸,但获得了独特的体验。
Ujiri's well-timed and thoughtful moves should help reverse the Raptors' backsliding.
announced
摩根士丹利首席执行长戈尔曼(James Gorman)将给该行所谓“降低风险”的策略来个大掉头。
adj. 吓人的
订婚买钻石真是太没新意了
“Selling out!” “Pandering to the Americans!” The cries went up immediately when the official selection was announced. The list of directors crossing over to make films in English was a long one including the Italians Matteo Garrone and Paolo Sorrentino, Yorgos Lanthimos of Greece, Norway's Joachim Trier and even Guillaume Nicloux of France, a country whose cultural establishment is highly sensitive to the creeping Anglophone menace. The argument goes that Cannes is supposed to be a haven for world cinema; for English, there is Hollywood. But does it really matter? Films at Cannes in languages other than French or English play with subtitles in both languages – and that's a lot of text to deal with.
北京、上海等城市都存在严重的空气污染问题。北京1月份爆发了近期最为严重的雾霾,而去年12月上海空气污染指数一度爆表。严重的空气污染问题显然无助于吸引更多外国游客前来旅游。
?The Aston Martin doesn't hurt. Not at all. Neither does dropping tons of cash at exotic casinos -- throwing money around makes men more attractive to women who are interested in flings. And, like Bond, men who gamble with women around are better at it.