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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

vt. 挖去果核
While French and Spanish institutions dominate the top of the pre-experience ranking, UK business schools are the real powerhouses in this category accounting for 17 schools out of 50, ahead of the US (eight) and France (six). Two UK institutions, LBS and Judge Business School at the University of Cambridge, top the post-experience ranking.
Those in third-tier cities are under relatively low financial stress and human relations stress, and enjoy better social and natural environments, and infrastructure.
北京一家旅行社向英国《金融时报》展示了一份疑似由中国国家旅游局发出的书面指示。该文件要求旅行社取消预订在3月15日之后成行的组团游,并表示不遵守该指示的企业会被罚款或吊销执照。中国国家旅游局未能马上置评此事。
adj. 准确的,精确的
是的,州市层级的退休金妨碍了复苏。公司养老金也是一个大问题,它加剧了美国的贫富分化:药品公司麦克森(McKesson)的CEO才当14年的老大,但退休时将有1.59亿美元的退休金,而美国一般打工族的收入已经30年止步不前。
Allianz
时间:2010-03-14 编辑:alex
Ten years ago, Steele was a successful investment advisor speaking at ITU World, a United Nations conference on technology for government. That same week, California experienced its first-ever gubernatorial election recall. Steele couldn't believe these kinds of hiccups were happening during such important races (the infamous Florida presidential election recall was only three years prior), so she decided to solve the problem herself. To date,169 countries, including Bosnia-Herzegovina, used Everyone Counts' electronic voting platform, as did the Academy Awards committee.
本文为与《时代》杂志的合作内容。

Celebrities throughout Hollywood have been doing just that over the last few weeks, especially when it comes to picking up some pumpkins at the local pumpkin patch.
Take solid and effective steps to cut overcapacity
谁都有不如意的时候,但是佳士得拍卖会上令人失望的情景已经不是第一次出现。今年7月的18世纪前绘画大师作品拍卖会仅拍得1900万英镑,而当时的最低预估价是3150万英镑。
Given the Raptors' existing personnel, the Ibaka/Tucker additions qualify as massive defensive upgrades, giving coach Dwane Casey the tools he will need to grind out postseason wins if Lowry and DeMar DeRozan see their scoring efficiency dip as it has in years past.
This year, China will further enhance international cooperation in fighting corruption, said a statement adopted at the second plenary session of the 19th CPC Central Commission for Discipline Inspection.
埃米?珀勒(Amy Poehler)狂吻博诺(Bono),蒂娜?费(Tina Fey)吐槽乔治?克鲁尼(George Clooney)只爱年轻女人,而诡异的是马特?戴蒙(Matt Damon)当晚数次“中枪”。

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.

统计局:上半年国民经济总体平稳、稳中向好

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Bubloons are a hybrid between bubbles and balloons.
But none of these doomed NBA squads seem all that interested in setting themselves up for it. Should they be? Do we need more tanking this year, for these teams' own sake?

These documentaries use the standard tools — archival footage, talking-head interviews, carefully selected musical cues — to write history in the present tense. In the era of Black Lives Matter, the stories of the Black Panthers and the jazz singer and activist Nina Simone could hardly be more relevant. Mr. Nelson and Ms. Garbus tell them beautifully.
随着性骚扰丑闻迫使投资者反思他们支持大多由年轻白人男性所创项目的习惯,新的一年硅谷的女性创始人将筹集更多资金。被不光彩传言缠身的一些男性创始人,其初创企业将无法再拿到融资,即使它们是很好的投资项目。
圣文森特(St. Vincent),《数码证人》(Digital Witness), Loma Vista/Republic
McDonald's (MCD, Fortune 500), the all-American fast food Mecca, announced it would put $20 billion towards share repurchases and dividends Thursday, jumping on board the buyback trend that has boomed over the past 18 months.
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。
A master class in old-school, super-linear action filmmaking, full of nasty, punk-rock, dystopian Australian humor. Also the best recent eco-feminist-socialist allegory that isn’t a novel by Margaret Atwood. (Read the review)
First, the companies that gained the most consumer love ...
1.无论在什么情况下都不要问出租车司机,对于今年夏天伦敦的奥运会有多么激动。不是说他会勉强或尴尬地发表个人意见,而是你根本就不该问这个问题。
对于像费城、凤凰城和布鲁克林这样的烂队而言,另一个问题在于他们很难笼络到好的球队拼图。
He added that “almost every major Korean company, including Hyundai Motor and AmorePacific, relies heavily on Chinese sales”.
万圣节距离现在没几天了。这意味着,如果你还没有挑选好你的万圣节服装或者装饰,那你应该立刻开始准备了。
7.摩洛哥
优化区域发展格局。
For a few years, Namibia's dollar has been depreciating against many currencies, providing affordable opportunities for travel. The best-priced flights generally avoid South African and European school-holiday times, especially late December and January.