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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

除了印度,其他金砖国家——巴西,俄罗斯,中国和南非——也削减了对美国政府债券的持有。
Domestic action movie "Wolf Warrior II" was top on the list and became the country's highest-grossing film ever, raking in 5.68 billion yuan in ticket sales.
历史学家希望解开有关理查三世的谜团,公开证据以反驳他杀害了两个年轻侄子的说法,重点关注他在位两年期间的成就,包括建立了保释制度和法律援助制度。
adj. 有毒的
[in'k?rid?]
《蝙蝠侠大战超人:正义黎明》将于2016年3月23日横扫各大影院。
萎靡不振的不光是那些挑选个股的基金。截止12月1日,对冲基金整体回报严重落后于市场。彭博收集的数据显示,对冲基金平均同比上涨了2%,其回报率也就勉强赶上无风险10年期美国国债的票面利率。2014年将有1000多只基金倒闭,是自2009年以来破产清算最多的一年。
Barney Thompson is legal correspondent
“Climate change is perhaps the major challenge of our generation,” said Michael H. Freilich, director of earth sciences at NASA, one of the agencies that track global temperatures.
这句简练、言之有物、几乎可称之为妙语的话提醒我们,即便接下来的奖项都相当雷人,还是有人能够做到直白的。

发行于2013年的《炫富帮》是一部语带讽刺的犯罪剧情片,记录了一帮好莱坞山高中生的冒险,他们偷到了当地名人的家里。少年们进入梅根·福克斯和帕丽斯·希尔顿这样的偶像家,偷走现金、衣服、手袋和珠宝,用来模仿杂志上让他们羡慕的奢华生活。在朋友圈炫耀战利品的照片后,他们终于被抓进了监狱。
某种程度上,这种借鉴是基于这样的假设:把一种时装风格从它自身的环境中剥离出来,就能同时去除它所有潜在的负面寓意:譬如战争和王朝。它会变成一种独立存在的审美形式,不再象征任何复杂的社会和政治动荡。
奥运会是世界各国放下分歧、从事体育运动的时刻。不过这究竟能否付诸实践,还是有争议的。虽然运动员们一定会专注于比赛,不过长期存在的分歧很难会被他们的祖国遗忘,即使是暂时遗忘。
Five programmes feature in the pre-experience ranking for the first time. The highest new entrant is Lee Kong Chian School of Business at Singapore Management University. The school came second in terms of the international mobility of its graduates, and is the first school to feature in both pre-experience and post-experience rankings.
This so-called “playground for millionaires” is now open to everyone. The wallet-friendly hotels, guesthouses and self-catering apartments make tours affordable. With more than 100 divine islands scattered on the Indian ocean, many activities await, such as sunbathing, fishing, diving, sailing, and going on boat tours. The Seychelles islands are blessed with a warm tropical climate all year round, so you can go there whenever you want.
Premiered in August, the 48-episode TV series is a fictional story, with a plot centering on struggles and romance during the Qin Dynasty (221-206 BC).

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.

深圳房价暴涨卖家反悔 被判赔违约金44万元

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Democracy is at bottom a civilised form of civil war.
On Monday night, Ankara confirmed that the Dutch ambassador would not be welcome to return to Turkey.

2018年特里萨梅(Theresa May)会继续担任英国首相吗
《火线警探》,FX,1月20日。副警长瑞兰·吉文斯(Raylan Givens,蒂莫西·奥利芬特[Timothy Olyphant]饰)与他的朋友兼天敌博伊德·克劳达(Boyd Crowder,沃尔顿·戈金斯[Walton Goggins]饰)之间爱恨交织的关系贯穿了整部剧,不管怎样,这个问题将在第六季,也就是最终季中得到最终解决。
Enrollment: 511
多数天主教徒(60%)和非福音派白人新教徒(65%)表示,他们相信飓风和洪灾等自然灾害是气候变化所致。
As the fashion world mourns Lagerfeld, his beloved cat Choupette is one of a number who could be set to inherit his £150million fortune.
5.谷歌网站管理员工具
n. 监牢,监狱,拘留所
It was also the "most liked" tweet of the year, with 4.59 million likes.
“…started swearing during the interview.”
“食品批发价格显示,上月,猪肉、蔬菜和水果的价格上涨都有所放缓,”凯投宏观(Capital Economics)在CPI数据公布前表示。
China has fully complied with UN resolutions on the denuclearization of the Korean Peninsula, and is a staunch supporter of upholding the international nuclear non-proliferation regime.
adj. 最初的,首要的,最好的,典型的
When Finnish programmer Jerry Jalava had a motorcycle accident in 2008, he faced a double tragedy. First, he lost his finger, an obvious problem for anyone who types for a living. Second, he had to deal with a medical team who thought they were comedians—learning of his profession, one surgeon joked that Jalava should go out and buy a “USB finger drive.”
Hurricane Irma