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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

贝莱德(BlackRock)的iShares亚太区主管陈蕙兰(Susan Chan)表示,ETF更受该地区机构投资者的欢迎。
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.
adj. 城市的,都市的
A Florida teen is causing strangers to freeze and stare because of her uncanny likeness to Queen Elsa from the Disney movie Frozen.
单词platform 联想记忆:
n. 品质,特质,才能
他赢得了名动词奖,而其姐妹奖,最佳动词名词化奖,则由另一位顾问凭借这句“全球联络”(global touch-base)摘得。
If you constantly arrive late to work, or return late from breaks, it displays an attitude of complacency and carelessness. So be prompt or even a bit early to show that you are time conscious and that you do care about your job and other people’s time, as well.
近日,新一期福布斯世界富豪排行榜揭晓,比尔·盖茨在近22年内第17次问鼎榜首。
strengthen

一座陵墓般的濒危物种仓库。
The discovery has caused huge excitement among historians, as it provides firm evidence about a monarch whose life has been shrouded in controversy since his death at the Battle of Bosworth in 1485.
iPhone 8
还记得《类人猿行动》吗.这是一部被众人忽略的2016年早些时候的电影,由杰米.多南和斯里安.墨菲担任主演,讲述了对希特勒身边的三把手、党卫队将军莱因哈德.海德里希进行的一次失败暗杀。《行动代号:猿人》也尝试讲述这一故事,杰克.莱诺和奥康奈尔将在片中饰演密谋的士兵,而罗莎曼德.派克和米娅.华希科沃斯卡是他们片中的感情对象,杰森.克拉科则饰演他们的刺杀目标。
不管使用什么样的固有动力方式,所有这些引擎都利用最新的发动机技术,从而使性能和燃料经济最大化,其范围包括从福特嘉年华(Fiesta)的小型、高效1.0升涡轮增压三缸发动机到雪佛兰科尔维特Stingray已经被证明无可替代的巨大6.2升V8引擎。我们在本文的幻灯片里列出了《沃兹汽车》十大最佳引擎。
Over at Huffington Post Mark Gongloff warns: That 'dramatic downgrade of U.S. economic growth in the first quarter revealed the economy's lingering weakness, exposed the folly of Washington's austerity obsession and slapped the Federal Reserve's newfound optimism right in the face.' And with politics deteriorating, it'll get worse.

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.

O2O将至,建材经销商如何转型做电商?

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这一新数据公布之际,杜特尔特正抵御国内外对其禁毒运动的指责,已有60万名潜在嫌疑人向当局自首。
reservation

两人的正式获奖词说的是表彰其“稳定匹配理论和市场设计实践”。
“温家宝总理强调指出,中国有效应对了全球金融危机的严重影响,经济保持稳定快速增长。因此中国成为全球第二大经济体,在五年内GDP几乎翻番。”Luis Schmidt Montes, Chilean ambassador
在第三场也是最后一场总统候选人辩论中,奥巴马就外交政策发起攻势,一再指责罗姆尼在重大国际问题上的立场不坚定,但未能给他对手迅速崛起的竞选活动一个致命打击。
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The Incredible Jessica James
单词administration 联想记忆:
Perhaps the biggest domestic threat to the 3% growth scenario would be a surprisingly swift hike in interest rates, but from all indications a dovish Federal Reserve is unlikely to take aggressive action in 2015.
13 Reasons Why
Yes. Mr Meade is the candidate of the ruling Institutional Revolutionary Party, or PRI. His main rival is the hard leftist Andrés Manuel López Obrador, a passionate orator who can work a crowd. Mr Meade has a lot to overcome: he will have to convince voters that they can trust him, after he put up petrol prices by 20 per cent overnight in January, triggering a surge in inflation. He will also have to reveal himself as his own man, not just a clone of an unpopular government that has failed spectacularly to rein in rampant corruption and crime. But backed by the formidable PRI get-out-the-vote machine, he could prove unstoppable. In Mexico’s one-round-only system, 30 per cent of the vote might be enough.
10、日本8.5级地震
Sa?d Business School achieved the biggest rise at the top of the open ranking, jumping five places to fourth. It is the first time that the school, based at the University of Oxford, is ranked in the top five. Sa?d improved its position in all 10 criteria informed by the participants’ ratings.
CareerCast.com, a career website owned by Adicio Inc., ranked 200 jobs from best to worst based on five criteria: physical demands, work environment, income, stress, and hiring outlook. The firm used data from the Bureau of Labor Statistics and other government agencies to determine the rankings. As in prior years, the 200 jobs were selected for their relevance in the current labor market as well as the availability of reliable data.
美国在2014年的新增工作岗位被设定为300万个—这是自1999年以来最大的增加量。新增工作岗位的增加预计在2015年将会对得到持续,这将确保消费者支出得到持续的动力;同时汽油价格的下降也将为家庭支出节省额外的开支用以购买其他的商品和服务。详见:汽油价格在2014年下降美国将会节省140亿美元开支。
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