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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

成功的创业者需要付出努力和毅力,因为非常不幸的是,世上并没有创业小精灵,能够神奇般地将成功赐予小公司和他们的老板。
The report shows that compared with that in 2015, the percentage of graduates to start up business are significantly decreased from 6.3% to 3.1% in 2016.
这位官员表示,相比其他职位来说,那些对教育背景或工作经历没有特殊要求的职位更受欢迎,近些年报名人数达到数千人的基本上都是这种职位。
The judging committee (of one) has spent weeks deciding which members of the Royal family, politicians and celebrities deserve one of these most galling of gongs to mark a grievous breach of protocol or lapse in mannerly judgement over the past year.
Mr Cahan said that the vision and technology behind Summly’s machine-learning and natural language processing abilities were “equally impressive”.
土耳其部长们近来一直在欧洲各地的土耳其社区举行集会,以争取海外土耳其人对埃尔多安发起的宪法改革的支持——土耳其将于下个月就修宪举行公投。
Frankly, this is unlikely to be ready in time for next year, but we'll include it just in case. The second film from Laszlo Nemes, who won the foreign language Oscar earlier this year for Son of Saul, is a coming-of-age drama set in Budapest just before the first world war.
It is the first time that news came up first since the technology company began publishing its yearly review a decade ago.Vera Chan, the company's senior editor and web trend analyst, said the BP oil spill was the most searched topic for term for a variety of reasons.
Mila Kunis just keeps on raking in those sexy titles.
States are falling all over themselves to be chosen as the site for Tesla’s proposed $5 billion Gigafactoryto produce lithium ion batteries. California is competing with Nevada, Arizona, New Mexico, and Texas, and the bidding for the factory, which could employ up to 6,500 people, is said to be up to $500 million.

《人物》评选的电影史上35位美人(1)
4. New reserves of helium discovered
China’s forex reserves — the world’s largest — have long been seen as the ultimate guarantor of financial stability, since they can be used to hedge against capital flight or to bail out domestic financial institutions struggling with a rise in bad debts.
在数年的停滞之后薪酬将会加速提升
When asked if the central bank would do more, Dario Perkins, chief European economist at Lombard Street Research, said: “I don’t think so, unless something goes wrong in the wider global economy.”
节目4 小品《我要上春晚》,周炜 刘大成 石头 张尧等

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.

“黑名单”制度下的陶瓷业,将何去何从?

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达成一个全球性气候协议的下一次大尝试,将是在来自世界各地的谈判代表今年12月聚集巴黎的时候。气候变化问题的政治活动人士上周五不失时机地引用2014年的温度记录为证,表明采取强有力行动的必要性。
For now, occasional high-ticket deals such as the Dah Sing Financial Centre and the purchase of a HK$2.1bn luxury house on the affluent Peak, come amid wider pessimism about the sector. The office sector showed the most activity in the first quarter this year, but this still translated into only eight deals in total, according to CBRE.

The Journey of Flower
中国(大陆及香港)在排行榜上新添了25个成员,增长数量超过其他任何国家,共计207家。三个国家今年首次在排行榜上亮相了:毛里求斯、斯洛伐克以及多哥。
According to the search engine, Euro 2012 beat Olympics tickets as the top internet search of the year in the UK, the Sun reported.
10.Shakira
日前,美国民主党候选人希拉里·克林顿承诺,如果她在总统竞选中获胜,那么她的内阁将有半数成员是女性。
As stars such as Kevin Spacey and Morgan Freeman were alleged to have assaulted or harassed performers, activists began using the hashtag to share their ordeals online.
这封信件在十天以前神奇般的被寄到了加利福尼亚大学的宾夕法尼亚州分校,这所大学位于宾州的东北部。寄给Moore先生的这封信是1958年2月20日的信件,上面还写着“永远爱你的Vonnie”。
您只需轻轻一挥将它们放飞,泡沫气球就会自己飘向空中。
有些模子对人体危险?
Meanwhile, figures such as Wang Jianlin, China’s richest man, have raised concerns about Chinese state-owned enterprises’ investments in Europe, arguing that they lack international management standards.
当你和他/她在一起的时候,你看不见周围的所有人,你的眼中只有他/她
He said game and live-broadcast apps currently hosted by Tencent don't require real-name registration, but the company is considering establishing a platform for parents to monitor their children's behavior.
The auction house says seven records in all were set at the Geneva auction including the highest amount ever paid for a yellow diamond - $16.3 million for the 100.09-carat Graff Vivid Yellow diamond ring.
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