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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

6) I find it hard to start a conversation 0 1 2 3 4
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我们的外汇储备是充裕的,是足以支付进口和满足短期偿债需要的。
报告提供了对除北京和上海之外的28个国内商业和行政中心城市进行的深入考察。
11月中国房地产价格继续下跌,因投资者把更多注意力从房地产市场转向股市。
Perhaps just as important, stable or falling prices will boost the inflation-adjusted pay of U.S. workers and gives them more bang for their buck. "It's an unambiguous positive for household demand," said Neil Dutta, head of economics at Renaissance Macro Research. "People will have more money to spend."
Good health, good luck and much happiness throughout the year.
一个由BuzzFeed News(译者注:类似今日头条的新闻搜集网站)所做的分析揭示了本年度Facebook上流传最广的50条假新闻。他们加起来大约有2150万次的点赞、评论及分享。在这些新闻里,23条和美国政治相关,2条关于女人用她们的阴道作为谋杀用的凶器,还有1条关于一个小丑娃娃其实一直都是个真人。
重点单词
The December budget deal was hardly the kind of confidence-boosting agreement Washington has been debating for years. But at least it hit the pause button on the serial brinkmanship that threatened to derail the recovery each of the past three years.

The truth is, to shut our door to the outside world would not help China do its own things well, so China will continue to open to the outside world, with this opening-up being a gradual process.
其中,在
The upcoming launch will mark the five-year anniversary of the sinking of a South Korean warship in 2010, with the loss of 46 sailors. The South pinned the blame on the North and effectively froze all inter-Korean trade and investment ties.
n. 元素,成分,组成部分,(复数)恶劣天气
Performances by Kelly Clarkson, Tim McGraw, Taylor Swift, Carrie Underwood and Miranda Lambert rocked the house at the MGM Grand Garden Arena.
Platforms will be created for crowd innovation, crowd support, crowdsourcing, and crowdfunding

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.

两会前夕调查:56.1%受访者期待住房议题 仅次于教育和就业

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The Killing of a Sacred Deer
It’s sometimes one of the scariest words in the English language, but it’s a word you should be prepared to say when opportunities arise in your career: Yes.

People with Type A personalities are often high-achieving "workaholics". They push themselves with deadlines, and hate both delays and ambivalence. People with Type A personalities experience more job-related stress and less job satisfaction.
[k?n'gr?tju.leit]
Ben McLannahan is US banking editor
"Well, I believe I am a feminist because I believe that women deserve the same rights as men in every aspect of our economy and our society, here at home and around the world," Clinton said to applause. "You know, I've devoted a lot of my public life to advocating for women's rights being human rights, and making the case that we have to do everything we can, through laws, regulations, culture, to change the still-existing stereotypes that hold women back."
贴一些小便条来激励自己。一个美好的办公环境,还需要一些能够让自己提神的小纸条。
'Gangnam Style' beat 'Call Me Maybe' as the most trending pop song and 'Skyfall' topped 'Prometheus' as the most enquired about film.
Her subjects felt like they were waiting in a long line to reach the top of a hill where the American dream was waiting for them. But the line’s uphill progress had slowed, even stopped. And immigrants, black people and other “outsiders” seemed to be cutting the line.
每一次我们詹姆斯已经达到了顶点,詹姆斯就会拿出更好的表现超过那个顶点。他那无所不包的各项技巧,是詹姆斯辛苦训练的证明。你可以嘲笑他所提发布的所有Instagram录像,但这些都是他仍然能够做到这一点的真正原因;詹姆斯从来不轻视他的每一场比赛,一次都没有。结果便是晚上一次又一次无可比拟的表演。
10.Be Dedicated and balanced
在成为德国最大贸易伙伴之前,中国是德国在亚洲的最大贸易市场。在过去两年里,德国一直是中国在欧洲最大的贸易伙伴。
adj. 泰然自若的,镇定的;摆好姿势不动的,静止的;平
Trium跃升3名,击败由凯洛格管理学院(Kellogg School of Management)与香港科技大学(HKUST)联合推出的课程,后者多年来一直高居排行榜榜首。这是Trium首次登上排行榜榜首,也是14年来第四个登上榜首的课程。
Much of the boost in exports came from shipments to the US, which grew for the first time since March at an annualised rate of 6.9 per cent to $36.8bn. Among other destinations that swung back to growth last month was the the EU, shipments to which rose 5.1 per cent to $29.9bn, as did those to Japan, by 3.2 per cent to $12.2bn.
The 62 universities account for 12.4% of the list. The only country with a larger number of universities listed is the US, which accounts for 27.8%.