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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

The magazine also notes that he gave $66 million to his presidential campaign and paid $25 million to settle a lawsuit related to Trump University.
China’s investment in Europe and the US has reached record highs, despite the slowdown in the country’s domestic economy.
安德森想让男人们脸上的毛发丰富多样,每个演员脸上装饰的胡子都不太一样。它是名符其实的时髦派风格,从一字胡、八字胡,再到杰夫·戈德布拉姆(Jeff Goldblum)的黑灰色山羊胡。
James Bond is one of the few constants that movie lovers have in this crazy world of ours. We seem to know that, no matter what, a new Bond movie is always on the way.
The Swiss school came top of the list of 90 best masters programmes worldwide in 2016, winning its sixth consecutive crown.
保罗·乔治,克里斯·保罗,卡梅罗·安东尼,戈登·海沃德,吉米·巴特勒,德里克·罗斯,保罗·米尔萨普,J·J·雷迪克,埃里克·布莱索,德怀特·霍华德……自去年以来,换了东家的球员名单还在不断增加。
另有其他四部国产电影挤入榜单前十位,排名第三的是《羞羞的铁拳》,第四名为《功夫瑜伽》,第五名为《西游伏妖篇》,第八名为《芳华》。
凯瑟琳·毕格罗和编剧马克.波尔已经为了这部电影筹备了一段时间,影片讲述的是1967年发生在底特律的警方突袭行动,这次行动引发了美国历史上规模最大的一场民众暴动。出演该片的有凯特林.德弗、约翰.卡拉辛斯基、威尔.保尔特、约翰.波耶加以及杰克.莱诺。
During Monday night’s debate Mr Rutte reiterated that he would not form a coalition government with Mr Wilders’ party, even ruling out forming a government that relied on support from the anti-immigration party. “I’m not going to work with such a party again,” said Mr Rutte, whose first minority government was propped up by PVV after the 2010 elections.
每天向大家推送短小精悍的英语学习资料.

冲击奖项:最佳电影提名应该可以肯定。参演《至暗时刻》的加里奥德曼是最佳男主角的最热人选,如果说有谁能击败他的话,那可能就是克莱门特了。
今年上榜的十亿美元级富豪为1810名,低于去年1826人的记录。上榜富豪净资产总计为64800亿美元,比去年减少了5700亿美元。
Morocco is a gateway to Africa. Major tourism cities in the North African kingdom include the capital of Rabat, Casablanca – the country's largest city - Marrakesh and Agadir.
这两部纪录片都使用标准工具——资料影像、人物采访,悉心选择的音乐资料——在目前的紧张局势中书写历史。在“黑人的命也是命”(Black Lives Matter)的时代,关于黑豹党和爵士歌手兼行动分子妮娜·西蒙妮的影片确实意义重大。尼尔逊和贾巴斯精彩地讲述了他们的故事。
塞巴斯蒂安佩恩(Sebastian Payne)
extravagant

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.

央视:不生二孩就得变相“罚款”? 一项荒唐的建议

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中国一群现代汽车经销商要求韩国现代汽车赔偿8-9亿元(1.2-1.35亿美元),称现代汽车削减了向他们出口的车型,导致经销商亏损严重。
《余秀华:从普通农妇到著名诗人》(A Chinese Poet’s Unusual Path From Isolated Farm Life to Celebrity)

美国人星期一庆祝哥伦布日。每年十月第二个星期一是纪念哥伦布到达美洲的哥伦布日,属于联邦假日。意大利探险家哥伦布受命西班牙国王,四次率领船队探索新世界,但从来没有完成他最初的目标,也就是找到一条向西通往亚洲的海上航线。哥伦布为探险者开辟了美洲大陆,使世界历史进入一个新时代。
We will explore new forms of social governance.
The dollar value of outbound shipments from China rose 12.3 per cent year on year in November, lifting from a revised pace of 6.8 per cent in October, and smashing a median forecast of 5 per cent from economists polled by Reuters.
补救办法:虽然自己当老板的想法很诱人,但并不是每个人都适合创业。创造属于自己的事业,让家人过上幸福生活,改善顾客的生活,这些听起来肯定很浪漫,但漫长的工作时间、没有闲暇时间、承担资金风险,身兼老板、职员、营销人员、会计和门卫等多个职位于一身,这些你能承受吗?如果你喜欢稳定的工作和专注于某项具体任务而不是身兼多职,又或者你不喜欢冒险,你就无法想象整天为工作忙碌的生活。如果你属于以上情况,那么创业并不适合你。
《Look What You Made Me Do》(《看看你们都让我做了什么》)这首单曲可以载入史册了,流行音乐学者们可能会世世代代地讨论它是否是一次绝妙的公关行动。
The film is shot to mark the tenth anniversary of the television series, first released in 2005.
The pipelines were building in spite of poor performance for this year’s high-profile deal from Snap, the owner of Snapchat, in the US and investor concerns that a strengthening euro may curtail the earnings recovery in Europe.
Winners: Mavericks
HOW MUCH: $2,050,000
By the end of 2015, Shanghai's population of migrant residents had decreased to 9.8 million, comprising 40.6 percent of the city's roughly 24 million permanent residents, according to statistics released by the Shanghai Municipal Statistics Bureau on Monday.
乔布斯在苹果博览会上展示iPod mini ,2004年1月6日,旧金山
1.你一夜之间成了领英平台的香饽饽。
3.The Andrea Yates Trial Inspired Desperate Housewives
No students or teachers drank the poisoned water, the report said.