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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

Compared with an average age of 45, 52-year-old Jack Ma is the oldest among the top 10 IT tycoons.
“我才17岁——我想留在家人和朋友身边,继续上学,”他说,“在可以预见的未来里,我将留在伦敦。”
In news that should come as little surprise to global air travelers, Singapore's done it again.
3. Mathematician
英国《金融时报》EMBA项目排行榜在对商学院和2011年毕业生进行调查的基础上编制,可以让人们大致了解学员在读EMBA前后的变化。
This Noah Baumbach Netflix film is both funny and award-worthy, which means you can feel really smart while you chuckle.
今年临近尾声之际,欧洲央行在12月3日投票削减其存款利率至负0.3%,并扩大资产购买,使量化宽松计划的规模达到1.46万亿欧元。此举出炉十几天后,美联储(Federal Reserve)自2006年以来首次提高利率,突显大西洋两岸正在推行的货币政策截然不同。
8.《生活大爆炸》白板上的公式都是真的
Fair enough. Let's put the Kings in the “maybe” file. I'll drop the Nuggets in there, as well, as they are in basically the same place as a franchise, give or take some dysfunctional elements. The Wizards have to go in there, too, much as I am down on them at the moment.
高通(Qualcomm)总部所在地的农民们肯定像它的雇员一样超爱这家无线电公司。每周,高通会在其总部圣地亚哥择址两处举办农夫市集。出售的商品从传统农产品到果酱、果冻无所不包。凡是订购了“社区支持农业”素食礼盒的高通雇员,在总部的一家咖啡馆即可轻松收货。

他补充说,原本的故事情节里有个无法回避的问题,因为格洛本来的设定是个深陷对邦德的欲望而无法自拔的女同性恋。
In the United States, emissions rose 2.9 percent, after declining in recent years.
故事发生在《海底总动员》第一部结束的一年后,多莉展开了一场全新的海底冒险:寻找自己的父母。在这部史诗巨制中,多莉沿加利福尼亚海岸的冒险之旅,得到了尼莫和马林的鼎力相助。 故事中也将迎来一批全新的角色。
然而,华尔街和硅谷对库克的态度转为欣赏,不仅仅是因为苹果本季度有望卖出7000万部iPhone,或者上季度销售额达到了420亿美元。
Paul George, Chris Paul, Carmelo Anthony, Gordon Hayward Jimmy Butler, Derrick Rose, Paul Millsap, J.J. Redick, Eric Bledsoe, Dwight Howard ... the list goes on and on of players who switched uniforms since last year.
The jobs were ranked based on the following attributes, with much of the data coming from the Bureau of Labor Statistics: “income, outlook, environmental factors, stress and physical demands.”

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.

精装住宅方案出台:家装市场也将迎来新一轮的挑战

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马科斯卡瓦略是一名18岁的巴西球迷,本周早些时候,在巴西利亚国家体育馆闲逛的他表示:“我们甚至压根就没想过买票这事。门票太贵了,我们根本买不起,能做的也就是在家看看球了。我们看着去那些现场观战兴高采烈的人们,但我们自己却去不了,这真令人难过。”
我们必须牢牢抓住就业这一民生之本,让人们在劳动中创造财富,在奋斗中实现人生价值。

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11. Arctic and Antarctic sea ice volumes both fall to an all-time low
在销量方面,通用和福特的部分市场份额被克莱斯勒蚕食,后者已经把Jeep品牌成功提升到此前难以想象的高度。随后,克莱斯勒将它的光辉历史抛在身后,将总部搬到荷兰,并更名为FCA US LLC。
Regulators in other countries will draw lessons from the success or failure of the Japanese model.
SplashData的首席执行官摩根·斯兰说:“当你看到‘最差劲密码’榜单上出现‘adobe123’或者‘photoshop’,你就该意识到,在你正在使用的网站或应用上,不该用它本身的名字作为密码。”
8月首播的《秦时丽人明月心》全剧共48集,围绕着秦朝(公元前221-206年)时的争斗和爱情故事展开,剧情均为虚构。
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《拉里·威尔莫夜间秀》(The Nightly Show with Larry Wilmore),Comedy Central,1月19日播出。威尔莫的主题喜剧秀将取代《科尔伯特报告》(The Colbert Report)在夜间11:30播出,这是深夜节目多样化的最新尝试。完全没有压力!
OUTDOOR SPACE: Steps down from the patio is a walled garden with a lawn and a fountain. The property is 0.10 acre.
But retail sales growth softened to 10 per cent in October, betraying economists’ expectations it would hold steady at 10.7 per cent growth from September.
Investors have noticed Honda’s troubles. The automaker was one of the very few worldwide to avoid deep losses during the global financial crisis. Still, its common shares are down 17.2% over the past year, while the Nikkei 225 Index is up 7.4% and Toyota Motor shares are up 19.5%.
谢丽尔·布恩·艾萨克斯,学院理事会主席
This pseudo-comedic 1970s crime drama tells the story of two romantically involved con artists named Irving Rosenfeld and Sydney Prosser, who are caught by an FBI agent and forced to scam corrupt politicians. The two continue to manipulate the FBI agent, their political targets, and their own family members, ultimately cutting an immunity deal that allows them to escape the ordeal without any criminal charges.
No. This crisis hit Amsterdam in 1772, after a respected Dutch investment syndicate made a disastrous bet on shares of the British East India Company.