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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

现在iPhone又夺回声势,对Apple Watch的期待也在升温,库克似乎重新赢得了苹果员工的信任。分析师表示,这一点从他在今年产品发布会上的表现就可以看出来。
狗狗雨伞正流行。可爱又有趣的,也非常实用。
n. 范围,行列,射程,山脉,一系列
The only thing worse than being bad is being bad without a vision. Johnson never lacked vision as a player and he's off to a good start as an executive.
一位来自美国佛罗里达州的少女引起了世人的惊叹,因为她长得酷肖迪士尼动画电影《冰雪奇缘》中的艾丽莎女王。
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.
伦敦阿格纽艺术品交易所(Agnew’s)的主管安东尼·克赖顿-斯图尔特(Anthony Crichton-Stuart)说:“如果没有意识到我们处在非常危急的关头,那就太天真了。人们的偏好出现了重大转变。但是如果拍卖会上出现一幅18世纪前绘画大师的佳作,而且价位合理,人们还是会感到兴奋。”
vt. 安慰,使
辛塔·努里亚在印度尼西亚开展她的家庭运动。她举办不同宗教信仰者参加的活动,并建立了一个进步伊斯兰女子寄宿学校网络。
然后,事情峰回路转。库迪斯和沃斯发现,荷兰贷款机构对于Seppenwolde的倒闭做出的反应截然不同。那些曾经贷款给Seppenwolde、但一毛钱也没损失的贷款机构变得越发悲观,要求所有新借款人都提供更多的“折幅”。而那些从未贷款给Seppenwolde、因而躲过一劫的贷款机构则根本没有提高要求。事实上,这些贷款机构可能还略略降低了对借款人的“折幅”要求,至少表明他们和过去一样乐观。

US schools are rebuilding their strength in this ranking, with their number increasing to 51. This had dropped below 50 for the first time in 2016, down to 47. Six of the eight new or returning schools are from the US.
●Van Full Of Illegals Shows Up To Vote Clinton At SIX Polling Places, Still Think Voter Fraud Is A Myth?
美国各州对特斯拉大献殷勤,希望在其计划投资50亿美元兴建的大型锂电池工厂选址中胜出。这家工厂有可能解决多达6500人的就业。加利福尼亚州就正在与内华达、亚利桑那、新墨西哥和德克萨斯等州展开竞争,而吸引该厂落户的条件据说是要给予5亿美元的支持。
5Japan
New construction will provide luxury options for renters with deep pockets, mostly in the boroughs outside Manhattan. In Brooklyn, 6,527 new rental units are expected to hit the rental market next year, nearly twice the 3,802 units anticipated for Manhattan, according to Citi Habitats.
[n?t]

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.

市场蝴蝶效应初显 端午节家居卖场几成独角戏

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中国的网红经济发展到今天,经历了三个阶段:第一个阶段是文字时代,第二个阶段是图文时代,现在这一阶段是要归功于宽带的可用性的视频时代。
Earlier on Tuesday Mr Rutte had issued a call for calm in the dispute with Turkey.

David said: ‘It was wonderful, you couldn’t fault it. It was perfection.’
来自用卫星采集的独立温度测量结果没有显示2014年是记录年,但是接近记录。几位科学家说,卫星测量的数据反映的是大气层的温度,而不是地球的表面温度,所以卫星数据会与来自地面和海洋表面的测量结果略有不同,并不奇怪,而表面的温度测量显示了创记录的温暖。
statement
EMBA-Global是排在前10名的项目中唯一一个毕业学员平均薪资同比略微下滑的项目(其他9个项目的毕业学员平均薪资都出现强劲增长)。
The Cnzz.com report states that almost two-thirds of China's 338 million Web users are now online game players. The online game industry, which currently accounts for more than half of the total Internet economy, will see strong annual growth at a rate of 20% in future years, the report says.
下面这条消息,可以给人带来一线希望:市价房的租金太高了,它们明年可能涨不了多少。“好消息是,租金不会再涨了,”米勒说,“坏消息是,它们很可能也不会下降。”
汉口滨江的居民数周前就已将财产转移。
consistently
根据《每日经济新闻》报道,1980版的猴年生肖纪念邮票价格由于种种原因创下了历史新高。
尽管詹姆斯和费德勒在工资和薪水上要少一些(相比于C罗和梅西),但是这两人去年的代言费是最高的,其中17次大满贯得主费德勒去年代言收入达到了4100万英镑。
Although Chinese domestic suppliers have expanded their market share to 32.7% in 2016, the trend was reversed in 2017, as their share shrank to 26.8%, said Qu Daokui, president of China Robot Industry Alliance.
Manufacturing has held up better, with profits growing 6.5 per cent, while profits from utilities such as electricity, heat and water grew 17 per cent, boosted by lower energy prices.
支持:奥德曼塑造的战时领袖丘吉尔收获一致好评,而这对他似乎是手到擒来的。
check原是检查的意思,后来有这么一帮人喜欢突然阻止你,检查你的暂住证,所以就有了突然阻止的意思。