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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

乔布斯正在展示 iPad 2。2011年3月,旧金山
IE’s alumni have the second-highest average salary increase following graduation, at 39 per cent. The school is ranked first for aims achieved and for international mobility. It is third for career progress. “There is a definite ‘before and after’ for career progression,” says one former student. “Post-MBA I felt I had more of a sense of direction not only of where I wanted to be, but also why, and how to make it happen.”
201312/270511.shtml重点单词
横跨全美的大日食
Quite a few students were disillusioned by UK visa regulations. “A lot of people saw the programme as a gateway to employment in Europe,” says one. “If this was the objective, then a lot of them would have gone away unfulfilled.”
进口价值的增长是在强势美元推高进口商成本的情况下实现的。11月份以人民币计算的进口增长幅度则为同比增长13%,反映了人民币的相对弱势。
vi. 谈话,讲述
But Huy Vo, a senior specialist in public relations at Hawaiian, said the short flights, which make up half the airline’s routes, aren’t all that easy to operate. “Our geographic location certainly does give us an advantage, as well as our short-haul routes, ” Vo said. “However, the short-haul routes are the hardest to keep punctual, because the hops are very short, with brief ground time between flights, so any delay is difficult to make up.
该机构在2014年的一项调查显示,在完成两年教学的受访者当中,86%表示他们通过自己的工作为改变教育不平等采取了行动,65%表示在工作以外采取了行动。
英国独立党(UKIP)前领袖杰尔.法拉奇(Nigel Farage)略逊一畴,就是因为事实证明攻破英国基于党派的制度比美国总统选举更难。

The Iranian dissident filmmaker, posing as a (barely competent) Tehran cabdriver, stages a sly, pseudo-documentary inquiry into the paradoxes of cinema and the contradictions of everyday life under authoritarian rule.
大病
adj. 易坏的,脆弱的,浅薄的 n. 复写纸,薄纸副本
re回+spond承诺→承诺回去;respond的名词→回答;答应
Caleb Rogers is one of two people facing legal action from gaming studio Epic Games for using cheat software to play the game Fortnite.
“You can choose to spend the time however you like,” he wrote, suggesting people “go travelling, pursue a philanthropic project, spend quality time with family or simply take time out to recharge and refocus”.

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.

马骏:500亿美元贸易战对中国经济影响有限 已基本被市场消化

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安娜的工资也就是巴西的最低月薪,仅330美元。因此门票对普通老百姓来说实在过于昂贵。
根据荷兰经济政策研究局(Netherlands Bureau for Economic Policy Analysis)发布的《世界贸易监测》(World Trade Monitor)报告,以美元计算,去年跨越国际边境的商品总价值下降了13.8%,是自2009年以来的首次萎缩。这一暴跌很大程度上源于中国和其他新兴经济体的放缓。

“…called the interviewer by the wrong name.”
Then there were these cautionary tales, where a candidate
3. Learn from others.
Last year saw a series of disastrous floods hit countries worldwide, including the UK, which in December experienced its wettest month since records began in 1910.
1.It wasn’t me! – Because some things just aren’t worth taking credit for。
我的核心价值观是什么?作为一个人,对你来说什么是重要的?家庭、健康、信仰、工作还是其他?确保在你的生活中,你追寻了自己最在乎的东西。
慈善组织DoSomething.org本周发布了最慈善明星前20的名单,这位23岁的乡村歌手因给美国国家名人堂博物馆捐款400万美元被授予此称号。
据国际足联秘书长杰罗姆·瓦尔克说,贝老爷子的1950年版门票将在苏黎世的一家博物馆展出,展览定于2015年开放。他还说:“这版球票很稀有,我们希望博物馆能够珍藏。”
他做了几次化妆试验,希望能极大改变卡瑞尔的外貌。“我们实际上在创造一个新人,”科森说。
同样的,中国官方最初已批准了凯蒂·派瑞去上海参加维密秀的签证申请,但很快又取消了她的签证。据称,这是因为这位歌手2015年在台湾举办演唱会的时候曾举着一面台湾旗帜并穿着一件印着向日葵的连衣裙。
While the debate was supposed to be solely about foreign policy, domestic concerns were never far from the surface and the candidates took every opportunity to pivot to their stump speech attacks over the economy and tax. The same was true in the spin room afterwards where both campaign teams dispensed quickly with debate comments and moved instead to analysis of the state of the race in swing states.
Last week, Clinton campaign chairman John Podesta said that the former first lady's shortlist of potential running mates will include women, quickly leading to speculation that Clinton will consider Massachusetts Sen. Elizabeth Warren, a popular progressive, for an all-female ticket.
把职工安置好还是我们推进供给侧结构性改革,推动化解和淘汰过剩产能中最关键的问题。
She said: 'Bobbi's like a little Beyonce, a little madam really.'