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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

In my life, I have dreamt of seeing the great herds of wild animals, jungles and rainforests full of birds and butterfilies, but now I wonder if they will even exist for my children to see. 我一生的梦想就是能看到成群的野生动物,茂盛的丛林和大片的雨林中到处是鸟类和蝴蝶在飞舞。但是现在我想知道我们这些小孩是否还能再看到它们?
孙俪在剧中扮演女主周莹。虽然孙俪是1982年生人,但在许多观众眼中,她仍然成功塑造了一个可爱天真的少女周莹。
剩下的流行语,我们列在这里:
不久后,拉塞尔爱上了一名叫菲利普·莫里斯的狱友。莫里斯出狱后,拉塞尔通过给职员办公室打电话再次越狱,还假冒法官,大幅降低了自己的保释金。为了和莫里斯在一起,他又被捕和逃脱了两次,一度假装自己已经离世。他现在被判终身监禁,但表示看到自己的电影形象很激动。
这个领域的创新速度非常快。自从Fitbit于2008年成立以来,各家公司已经发布了五到六个完全不同的产品。三星(Samsung)则在九个月内发布了可穿戴设备Galaxy Gear的三到四个衍生产品。索尼(Sony)、Pebble、谷歌和Facebook的头戴式虚拟现实设备Oculus Rift也紧随其后。
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.
“如果贷款机构在市场繁荣时过于乐观,而在市场下行时过于悲观,这或许是当局设定保守的资本金要求的一个最好理由,”他说。“加大折幅可能会抑制最初的涨幅,但当市场转向,它们也能抑制随后的跌幅。”
I experienced this pessimism personally in Davos in January 2014. Several leading western intellectuals asked me whether war would break out between China and Japan. I was so confident that there would be no war in east Asia that I offered to take bets with ten-to-one odds against myself with eminent western journalists. Two took up my bets. And I will be collecting on these bets when I return to Davos in January.
中国官方PMI指数从10月份的50.8跌至11月份的50.3,这是3月份以来的最低读数。高于50的读数表示相关产业处于扩张之中。
为什么我如此有信心东亚不会爆发战争,无论在东中国海还是南中国海?答案很简单,因为我了解推动亚洲变化的力量。虽然许多亚洲邻国会发出愤怒的民族主义声明(他们必须这样做来应对普遍的民族主义情绪),但他们的行动是谨慎和务实的。

英国《泰晤士高等教育》专刊于上周四公布的一项调查显示,中国内地两所高校入选亚洲大学前三名。
Swyft now makes half of its money from ad campaigns like the one for Gwen Stefani. Swyft’s revenue has increased between 50% and 100% each month, Wray says. The other half comes from selling stickers—typically licensed from sports teams and entertainment brands like Shrek.
推特方面日前表示,在今年8月弗吉尼亚州夏洛特维尔爆发种族骚乱后,奥巴马发布的一条推文是今年转推量第2多的推文,转推量达170万次以上。
Belgium
在北大和清华大学之后,中国内地入选该榜单前20名的院校还有中国科学技术大学,该校位居第15位;复旦大学排名第16位,上海交通大学排名第18位,而浙江大学排名第19。
The Warriors are one of the best teams in NBA history, and you can put their championship run up against any team in NBA history for the best playoff performance ever. But there's also a legitimate question of what this means for the sport. If the best or second-best player of all time stands no chance against this team, what does it mean for the sport's competitiveness? It hasn't been a problem so far, thanks to an extremely wild offseason, but the question remains: what happens to a competitive sports league when it's not truly competitive at the highest level?

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.

家居行业转型之路 还得依靠质量把控

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Reese Witherspoon dreamt of being a non-traditionalist, reportedly wanting to transform the best actress statue she won for Walk the Line into a door knocker or a necklace (“statement” jewellery would not have cut the mustard). Neither option being practical, however, he now stands in her living room.
11. “The Black Panthers: Vanguard of the Revolution” (Stanley Nelson)

201011/117323.shtmlThe French actress will star alongside Ryan Gosling, Michael Fassbender and Natalie Portman.
而中国工商银行排在榜单的第十位,是该榜单上排名最高的中国企业。
至少希拉里今年赢得了点什么。我相信她会非常兴奋。
n. 经营方法,行为态度
In early 2005, Stone and her co-founders Elisa Camahort Page and Jory Des Jardins noticed that there were countless women blogging, but mainstream media rarely linked to their posts. The trio decided to host a grassroots conference that year and attracted sponsors like Google and Yahoo. It quickly sold out and soon after, they launched BlogHer.com. The publishing platform turned blogging into a lucrative business for many women -- it paid $25 million to 5,000 of its bloggers between 2009 and 2012 -- and now reaches an audience of 92 million.
9. 设身处地也能提高记忆力
4. We can’t go into detail on this matter.
The number of university graduates reached 7.65 million in 2016, hitting a new historic high, the Beijing News reported. Plus, the number of students graduating from secondary vocational schools hit 4.35 million, bringing the total figure to 12 million.
SplashData公司首席执行官摩根-斯莱恩说:“不幸的是,虽然最新的一部星球大战系列电影很精彩,但使用‘starwars’这个密码却很危险。”
换句话说,我们看到的只是气候变化方面的虚假黎明。
The Big Bang Theory is not short on geniuses. Not only is the show about highly intelligent scientists, but cast member Mayim Bialik has a Ph.D. in Neuroscience. So it should come as no surprise that the cast would want to show off their intelligence and attention to detail. In Sheldon and Leonard's apartment, there's a large white board. The two roommates use the board frequently for everything from actual work that Leonard or Sheldon has brought home, or to decide whether to eat before or after the new Spider-Man movie.
Meanwhile, former Fifth Harmony star Camila Cabello proved her solo career is getting off to a flying start as she picked up the Best Pop award for her debut single, Havana.Her win meant that Taylor Swift was dealt another award snub, though it was just one of many for the singer, who recently made her return to the spotlight following her one-year hiatus.
在即将卸任的中国领导层不愿做出任何有远见的决定时,中国必须沿着一条狭窄的道路审慎推进。
科学圈外的人士对论文撤稿的反应不一。