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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

10月份,中国居民消费价格总水平(CPI)同比涨幅降至1.3%,为今年5月以来的最低涨幅;环比下降0.3%,为今年5月以来的首次环比下降。
'If you read Trigger Mortis, you’ll see actually there is a little twist to the tale in that particular story which I think sort of pays him off for his slightly patronising attitude.'
源于:Turkey土耳其,火鸡原产于土耳其地区。
Maria Rios
曼谷重回首位,而付出代价的是伦敦。伦敦在连续两年占据榜首后,与其亚洲对手城市交换了位置。
都柏林大学学院(UCD)迈克尔?斯墨菲特商业研究生院(Michael Smurfit Graduate School of Business)的总体进步最大,排名攀升21位至第48名。北京大学(Peking University)光华管理学院(Guanghua School of Management)重回排行榜第38名,去年该院因学员调查反馈率低而未上榜。
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.
又到了一年盘点的时候了,扬子晚报上传了一段名叫今年中国网络九条最热流行语的视频,盘点了如下几条流行语。
A disturbing and often bleak analysis of the automated future of work has been named 2015’s business book of the year.
Meme-sharing Facebook groups have become a new college tradition, Mic reported last week, with students across the country trading inside jokes and fighting battles with rival universities via screenshot and caption.

All three factors, says Mr Koepke, were at work in the Mexican currency crisis of 1994-95, when the Fed embarked on a tightening cycle in jumps of 25, 50 and crucially, in November 1994, of 75 basis points.
从“高跟鞋门”到“金棕榈狗狗奖”(Palm Dog),再到迅速走红的“老爹身材(Dad bod)”,戛纳电影展的这12天,真是令人眼花缭乱。随着电影节进入尾声,英国广播公司回顾了本届戛纳影展上的九桩事。
On the sales front, General Motors and Ford F -0.13% lost market share to Chrysler, which leveraged its Jeep brand to previously unimagined heights – and then, metaphorically left its heritage behind when it established legal domicile in the Netherlands and changed its name to FCA US LLC.
The U.S. Congress and the media will go berserk when Goldman announces the size of its 2009 bonus pool. But the outrage will be brief and of little lasting consequence. The 'hate Goldman Sachs' story has been running just too long.
Don't Make Yourself Too Comfortable
Another exceptional new field is that of nanotechnology.

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.

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英国商学院在2015年英国《金融时报》欧洲商学院排行榜上大放异彩。不仅伦敦商学院(LBS)再次摘得欧洲最佳商学院的桂冠,还有其他3所英国商学院的排名取得了自去年以来的最大幅度上升。
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对欧洲的新投资比2014年的180亿美元高出28%,相比之下,2014年投资额较2013年翻了一倍。对美国的投资比2014年的128亿美元高出17%。
猪肉和蔬菜价格均同比下降了逾8%。
18. 最有趣的道歉(并列)。11月18日,《好莱坞报道者》发表了一份1200多字的道歉,因为它的“奥斯卡女星圆桌会议”没有邀请非白人演员出席。很快,导演亚历克斯·普罗亚斯(Alex Proyas)和狮门公司就为新片《埃及众神战》(Gods of Egypt)中的演员缺乏多样性而道歉。
The Glory of Tang Dynasty
根据QS的这一排名,使得中国成为入选全球400强学校第二多的国家,仅次于有164所大学的学科入选全球400强的美国。英国排名第3,有78所大学进入榜单。
US billionaires hold 540 spots on the list, more than any other country in the world. In second is China with 251 and German with 120.
Song “The China Style”(Jiuyue Qiji)
“在三个月里,我在我的三个女儿身上总共花费了5000英镑。有一件裙子花了我两百美元,她只穿过两次,就长高了、不合身了。——不过我不打算节制开支。”
愿你一切称心如意,快乐无比。
单词appearance 联想记忆:
在360000个网红账号中,女性达到74%。而87.8%的网红年龄都在17-33岁之间,89%的网红接受过高等教育。
据二十一世纪教育研究院副院长熊丙奇表示,公费留学生都签署了一项协议,如果完成学业后不回国的话,必须偿还政府的资助款项。
Plastic surgery has long been big business in the US, but now the trend is sweeping across Asia.
3. Not starting your own business