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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

11月18日
Extreme heat blanketed Alaska and much of the western United States last year. Records were set across large areas of every inhabited continent. And the ocean surface was unusually warm virtually everywhere except near Antarctica, the scientists said, providing the energy that fueled damaging Pacific storms.
If the bounce is minimal and transitory it will be clear that the structural shift is under way. I hope the companies which are over invested in expensive projects and countries still overwhelmingly dependent on oil and gas revenues are ready.
我们不希望看到打贸易战,贸易战带不来贸易公平,而且双方都受损。
Scientists confirmed Monday that a skeleton found under a carpark in the English city of Leicester was that of King Richard III, in a bizarre end to a 500-year-old historical mystery.
as加强+soc社会+ion→社团;联合
赢家:雷霆
巴里摩尔的病情基于米歇尔·菲利普斯的真实生活,她的头部在在两次机动车事故中受伤,记忆只能维持24小时。桑德勒用录像带,菲利普斯则是用便利贴和手机(对她而言还真时髦)撑了23年。
[k?m'plein]
Global pharmaceutical spending will surpassthe trillion dollar threshold in 2014, with high prices for innovativehepatitis C and cancer drugs in the US, a new study says. By 2018spending is expected to increase by another 30 percent.

PwC, the accountancy firm that has been responsible for counting Oscars votes for 80 years and ensuring that the correct envelopes are handed to presenters, swiftly apologised to the films, the presenters and the audience for giving the prize announcement for the wrong category to Beatty and Dunaway.
Given that travel costs to Russia may surge in 2018 when the FIFA World Cup will take place there, visiting this year would be a smarter choice.
学员非常有经验,一位毕业生说,所有学员之间的交往和互动是这个项目的重要方面。
This is a story about six friends with precarious love lives who spend their days sitting in a cafe sipping coffee from oversized mugs. Who’d have thought this premise would go on to become one of the most influential sitcoms of all time?
A network of walking and biking trails leads to other lakeside neighborhoods and to downtown, which is about 15 minutes by bicycle and 10 by car. The Walker Art Center and other museums are nearby. Hockey and skating are popular on the lakes in winter; canoeing, swimming and fishing in the summer.
Dua Lipa, 'Dua Lipa'

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.

春节一二线楼市成交下降 业内:投资客暂时离场

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需要快速发送大到2GB的大型文件?不妨试试WeTransfer.com。你甚至不需要建立账户,我几乎每天都用它传文件。
For the first time, it’s a blend of two colors: Rose Quartz (a kind of mineral pink) and Serenity (a light blue). On the company’s website, the colors flow seamlessly into each other so that it’s impossible to tell where one begins and the other ends.

在简历中提到你的孩子和嗜好没有任何好处。永远不要说,“我的孩子上大学了,我就能安心回到工作岗位了。”
“This is not an excuse — this is the reality of the environment we operate in, ” Dervin said. Since 2012, JetBlue has been implementing a series of technology efforts to help it recover more quickly from bad weather. She said other tools are coming online that will help the airline keep to its schedules.
社交时我找不到合适的话题
换总部:随着丰田迁至德州,奔驰从新泽西搬往北卡罗来纳州或乔治亚州,斯巴鲁也要建它的新总部了。它的一个选择是搬到离其客户群更近的佛蒙特州。
Hopefully the experts come up with a better plan than one that fell flat earlier this year. The country's tourism body unveiled a 'Beautiful China' logo in February to market the country overseas, but the campaign was mocked for its contrast with the many photos of China's not-so-beautiful cities shrouded in pollution.
China’s reserves have fallen for nine of 11 months this year and stand at $3.43tn, as investors sell renminbi assets to protect themselves against depreciation and the central bank sells dollars from its reserves to curb renminbi weakness. Falling interest rates in China and expectations of an imminent rate rise by the US Federal Reserve have also fuelled outflows. Reserves rebounded mildly in October, suggesting outflows had diminished.
台湾电影无缘2012奥斯卡最佳外语片
Developer activity is also at a fever pitch. According to the contributor graph at GitHub, the total number of contributions to bitcoin’s master code in November was the highest it had been since spring 2012. Bitcoin is also the 31st “most forked repository” on GitHub—”forks” are basically proposed or in-progress alterations to core code—out of more than 900,000. In other words, for developers, bitcoin is trending. The number of open jobs currently posted at bitcoin companies also underscores developer interest: it’s at 105, which is close to the all-time high in September of 137, according to Bitcoin Pulse, which monitors such trends.
Chinese companies filed 7,150 patents with the European Patent Office (EPO) in 2016, a year-on-year increase of 24.8%, according to figures released by the EPO last Tuesday.
['sindr?um]
iPhone 8
'The market for colored diamonds is really, really high, because they are so rare,' he said.
对欧洲的新投资比2014年的180亿美元高出28%,相比之下,2014年投资额较2013年翻了一倍。对美国的投资比2014年的128亿美元高出17%。
n. 名人,名誉,社会名流