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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

The media are annoying, we get that, Your Royal Highness, but there may have been more dignified ways for you (and the establishment you represent) to air your concerns.
以人民币计算,12月份出口环比成功增长0.6%,超过了收缩0.1%的预期,不过仍大大低于11月份5.9%的增幅。以人民币计的进口增长10.8%,是预期4.8%的增幅的两倍以上,不过仍比上个月低2.2个百分点。
intel在…中间+lig选择,收集+ence→从中选出好的→智力;聪明
单词criminal 联想记忆:
英国《金融时报》EMBA项目排行榜在对商学院和2011年毕业生进行调查的基础上编制,可以让人们大致了解学员在读EMBA前后的变化。
他说,这出乎我意料,但对腾讯走出国门来说这是一个好兆头,特别是因为微信同时结合了WhatsApp和Instagram的特点,所以是一个独特的产品,对于新兴市场消费者来说可能是一个相当不错的东西。
Hillary stays on: Clinton’s CV is chock full of firsts: The only first lady to become a U.S. senator turned viable presidential candidate turned secretary of state. Now a private citizen, she continues to be one of the most watched and listened-to women on the planet. All bets on that she will be the 2016 Democratic presidential candidate and the free world’s presumptive next leader. She’s done little to quiet the chatter, including hitting the speaking circuit last month at an estimated $200,000 fee per event and inking a reported $14 million book deal.
Apple will this week test its customers’ loyalty, buying power and enthusiasm for innovation when it unveils the first iPhone to cost as much as $1,000.
loan
“有个人给老板发了个短信,说他要离职了。”

intentionally
She created a whole world around the device -- one populated by humans, a whale in a top hat and dragons.
Losers: Kings
《国土安全》(Homeland):第三季末布洛迪(Brody,戴米恩·路易斯[Damian Lewis]饰)最终被杀后,映时频道(Showtime)的这部间谍惊悚剧似乎走到了尽头。目前看来,第四季没了他却变得充满活力,令人喜爱。卡莉(Carrie,克莱尔·丹尼斯[Claire Danes]饰)这次的对手是美貌、狡猾的巴基斯坦情报官塔斯尼姆(Tasneem,尼姆拉特·考尔[Nimrat Kaur]饰)。
STEP 1: GET THE LOOK
supervision

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.

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n. 高兴;快活
我们一定要让企业和群众更多感受到“放管服”改革成效,着力打通“最后一公里”,坚决除烦苛之弊、施公平之策、开便利之门。

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.
多措并举降成本。
在动画电影行业执迷于翻拍让观众有共鸣的老故事时,皮克斯却总能尝试新事物,把观众带到从未踏足的新领域。《寻梦环游记》由《玩具总动员3》导演李?昂克里奇执导,该片的视觉效果基于墨西哥的亡灵节。故事讲述了一个名叫米格尔的小男孩崇拜传奇吉他手欧内斯托?德?拉?克鲁兹,想学习如何能弹奏得和他一样好。于是他就像奥德赛一样踏上了改造性的自我发现之旅,进入死亡之地寻找那位已去世多年的偶像,还受到了一些关于创造力本质的教导。《寻梦环游记》是否能达到皮克斯2015年杰作《头脑特工队》的高度尚未可知,但这部电影绝对是一场视觉盛宴。该片将于11月15日在法国上映,11月22日在美国、克罗地亚和菲律宾上映,11月30日在以色列上映。(资料来源:迪士尼/皮克斯)
国务院总理李克强在上周五由人力资源和社会保障部组织的一次会议上表示,要优先促进就业。
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我们要求FlightAware对航班抵达延误情况进行统计,而不是航班出发延误情况,因为有时候,航空公司可以让飞机在空中飞行期间追回地面上失去的时间。
追踪制造业、服务业和建筑业商务活动的官方指标显示,10月份这几个驱动中国经济的关键行业的增长有所放缓。
中欧之间存在贸易摩擦,我们有经验去妥善解决。
时间:2009-07-16 编辑:vicki
有些人仍坚持一种可称为“资源稀缺”的理论。该理论的核心是,资源开发遵循线性模式,低成本的资源最先被开发,也就是说,未来大部分乃至全部开发活动的成本一定会更高。遗憾的是,行业发展历史并不支持这一观点。过去几十年的经验表明,情况正相反。
这款智能产品的使用可以追溯到1800年,但在2016年它才变得“智能”。 Meet Peggy,这种洗衣挂钩能够“帮助你减轻负担”,它会在洗衣机洗好衣服的时候提醒你,并告诉你天气是否适宜晾晒衣服。该装置连接到您的手机,它会在天气变化或是需要转移晾衣服的地方时发消息提醒你。
The emotions were far more visceral and less attractive.
在进行融资时,约40%的创业者并未寻求任何外部帮助。他们中的半数完全依靠自己的积蓄及(或者)家人和朋友的资助,相比之下,只有40%的创业者向学校或校友网络寻求帮助。