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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

12-year-old girl finds ancient Egyptian amulet
瑞典
In dollar terms, imports plunged 18.8 per cent last month to $114.19, from a 7.6 per cent drop in January and versus an expected drop of 3.6 per cent.
自2008年北京奥运会后,北京入境游客数量持续增加。然而2012年这一数字下降了3.8%,并在去年进一步下滑。
汉达·阿亚里(Henda Ayari)
A spokeswoman for Harvard University declined to comment on the report. "We do not comment publicly on the admissions status of individual applicants," Rachael Dane wrote in an email.
但多数白人常把民族和种族身份混为一谈。对很多白人来说,这种身份感觉像是支撑他们的世界最重要的支柱之一,而现在,它似乎受到了威胁。
在经历了艰辛的法律诉讼之后,凯莎发表的一切都会给人一种胜利的假象。但这张回归专辑用艺术反映了一位勇士的呐喊,并带来了比所有人期望中更为强大的影响力。
Critics have been eager to point out that he is not so closely involved in new product development as his predecessor, and fails to elicit the same excitement when he takes to the stage to introduce them. But Mr Cook is aware of his shortcomings and has drawn on the worlds of fitness and fashion to assemble a new team of talents, including Angela Ahrendts, formerly of Burberry, and industrial designer Marc Newson.
supreme

时间:2011-06-02 编辑:beck
中国上海——上海这座大都市是中国人口最多的城市,在那里,有着深厚历史底蕴的城市核心区与当代全球金融枢纽融为一体。
译者:清远
n. [计]定序;排序;订购 v. 命令;指挥;订购(o
The joint programme delivered by Tsinghua and Insead University (Tiemba) moved up two places to lead the 2015 global executive MBA ranking, dethroning Trium, which drops back to third place after only one year at the top.
Ronaldo and Messi are the only football players in the top 20, which also features no women.

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.

智能家居:技术俱备只欠市场?

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2010财年,这家超级零售商可抱怨的地方不多。利润增加,而且由于销售额增长,该公司再次攀升至《财富》500强的冠军。今年沃尔玛的单店销售额和去年几乎持平,但同塔吉特百货销售额下降2.5%相比,持平已算不错。最值得注意的是沃尔玛重塑形象。前任首席执行官李?斯科特扩大了对员工医疗保险的覆盖,更关注环境,经常在公共场合露面,这些都起到了积极作用。当然,总会有人批评,而且沃尔玛第一季度的表现也不是最好的。但无可否认,斯科特给新任首席执行官麦克?杜克留下的是一个斗志昂扬的公司。
6.You Spend Time Looking For Other Jobs

Track field;hand ball;cycling;track racin;racing cycle;mountain bike race;Bicycle Motocross;horsemanship;football;Beach Volleyball.
9.忠诚待人
你如何知道你需要喝水了?这有一系列的诱因:嘴唇发干、头晕、头痛、尿量低和口渴。然而,这种智能瓶能在你的身体意识到缺水前就提醒你。
If you thought that getting sector over- and under-weights correct at the outset proved difficult, switching between them throughout the year was nearly impossible. A quantitative analyst from Nomura Securities explained to Barron’s in November that “industry leadership has been reversing from month-to-month at a rate unseen in decades of stock-market history. ‘Even if you’re picking the right stocks in a sector,’ he says, ‘things are moving around so much that your performance doesn’t persist.’”
音乐界收入最高的女明星,她一直以来的赚钱方式是靠大量的世界巡回演唱会,持续不断的热门单曲和一系列主流公司的代言,而且很少露骨地讽刺她的主要竞争对手。
这栋房屋坐落在街道上的一处小山丘上。房屋的入口处是一个大玻璃门廊,有砖砌的地面和对着湖的玻璃窗墙。翻修工程保留了花格镶板的天花板和原建筑部分大量运用的木材。其布局规划是开敞式设计,几乎每个房间都可以从观景窗看见湖景。
“It’s na瘀攀 not to recognize we’re at a pretty serious moment,” said Anthony Crichton-Stuart, director of the London dealer Agnew’s. “There has been a massive taste shift. But when a good old master does come up at auction and it is priced correctly, you do get some excitement.”
It is estimated that over 89m enterprise retirees and more than 17m institution retirees will benefit from the adjustment.
2018年,将会有更多商业领袖利用数字化、代际变动和多元化不断提高的强大结合,来精简企业层级结构,分配责任,转变他们所在的组织。
大多数企业家(78%)利用储蓄或依赖朋友和家人来筹集全部或部分启动资金。四分之三的企业家也使用天使融资来作为资金来源。
adj. 流行的,大众的,通俗的,受欢迎的
双语介绍《喜羊羊与灰太狼》
n. 基金;资金,现金(fund的复数) v. 提供资金
The amulet has been dated to 3,200 years ago and bears the name of Pharaoh Thutmose III, a prominent figure from the Eighteenth Dynasty who reigned from 1479 BCE to 1425 BCE.