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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

Last year was the hottest on earth since record-keeping began in 1880, scientists reported on Friday, underscoring warnings about the risks of runaway greenhouse gas emissions and undermining claims by climate change contrarians that global warming had somehow stopped.
该排名的编辑菲尔·巴蒂称:“在近几年取得重大进展之后,中国在全球排名榜上的持续增长似乎已经停滞。这些新数据显示,新兴力量要打入传统的全球名校阶层是多么困难。”
Stand: Facebook CEO Mark Zuckerberg took a stand for immigration reform
“有个人离职时给全体员工群发了一封邮件。”
Developer: Frontier, Microsoft Studios
上证综指下跌6.85%,以科技版块为重点的深证综指下跌8.22%。
Sun said he tried to pry open the elevator door, but dismissed the idea and instead leaned against the wall concerned there could be a malfunction that would send the elevator in a free fall.
The web portal, which has put mobile technology at the heart of a plan to turn around its struggling fortunes, has turned to British teenager Nick D’Aloisio and Summly, which automatically summarises news stories for the small screen.
鲜菜价格同比上涨13%,助推食品价格同比上涨3.7%,涨幅比上月扩大0.5个百分点。
But nearly two-thirds (65 percent) of white evangelical Protestants say they think the storms are evidence of the "end times" as predicted by the Bible.

单词polish 联想记忆:
每个伟大的侦探都需要专属于自己的经典故事。对于福尔摩斯而言,这个故事是《巴斯克维尔的猎犬》。对于阿加莎?克里斯蒂笔下龟毛的比利时侦探赫克尔?波洛而言,这个故事是《东方快车谋杀案》——故事讲述了一个嗜血的恶棍在驶向巴尔干半岛的列车上杀死了一个有钱的商人。真相果真是如此吗?西德尼?吕美特曾在1974年将该故事拍成了一部备受喜爱的电影,强大的演员阵容包括肖恩?康纳利、英格丽?褒曼和阿尔伯特?芬尼(饰演侦探波洛)。如今肯尼思?布拉纳自己戴上了侦探波洛的大胡子,披挂上阵,同时又担当幕后导演。这部新版电影的演员有约翰尼?德普、黛西?雷德利、米歇尔?菲佛、佩内洛佩?克鲁斯和朱迪?丹奇。这个故事还能挖掘出什么新内容呢?也许会有。不过,即使没有,阿婆的粉丝也肯定会去看。这部电影将于11月3日在英国上映,11月10日在美国、中国和土耳其上映,11月30日在中国香港和新加坡上映。(资料来源:二十世纪福克斯电影公司)
他仅面临这几个障碍:他的手下、国会里的共和党人以及总统行政权的限度。而这几个障碍都非常有分量。他竞选时声称要对中国货物征收45%关税的承诺,已经变成对中国知识产权做法展开调查。
Yet that's finally about to change. With hiring up and unemployment falling, businesses will have to go the extra mile for employees or risk losing sales to competitors because they lack enough staff to boost production.
“It’s fundamentally about ‘who are we?’” said Eric Kaufmann, a professor of politics at Birkbeck College, University of London. “What does it mean to be part of this nation? Is it not ‘our’ nation anymore, ‘our’ meaning the ethnic majority?
单词reflection 联想记忆:

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.

市场低迷迫使差异化经营 家居业现逆市升级风

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将学习放在最重要的位置
On the a monthly basis prices fell by an average 0.5 per cent.

No.4: The 1st Useful Mechanical Pet
单词consciousness 联想记忆:
Spider-Man: Homecoming
The new numbers, reported by a tracking initiative called the Global Carbon Project and published in the journal Nature Geoscience, came on the eve of a United Nations summit meeting meant to harness fresh political ambition in tackling climate change. Scientists said the figures showed that vastly greater efforts would be needed to get long-term global warming within tolerable limits.
12岁女孩发现古埃及护符
而至于他自己的教育问题:他在考虑是留在英国,还是为了离硅谷更近而去读美国的大学。再或者,他也许会放弃学业,全然专注于他的事业。他说,我非常想再创办一家公司,连续创业家们都是对创新上瘾的人。我希望能保有热情。如果我不能尝试新的事物,我会感觉很糟。
The London school’s MBA is ranked first in Europe, its EMBA programme, delivered jointly with Columbia Business School in the US, is ranked third and its MiM programme is in the top 10 on its first participation. The MiM ranking was the last missing piece for LBS to come first in Europe.
Taylor Swift and Katy Perry opted for bedazzled5 dresses in very different styles. Taylor went for a more old Hollywood, glamorous Grecian style that exposed her back and statuesque6 figure, while Katy rocked a shorter, spunkier look that exposed a little of everything.
每个人都喜欢饼干,但是买一个智能烤箱似乎可以多烤一点。这个烤箱承诺在短短10分钟内就烤好饼干,但不考虑时间的因素,使用老式的烤箱似乎更容易做更多饼干。
[fleim]
[kru:]
叙利亚五年内战使国家分裂,造成20多万人死亡,数百万人流离失所。叙利亚难民就占了报告清点人数的一半,接下来难民人数最多的是同样为战争所困扰的国家阿富汗和伊拉克。
Mr Mallaby accepted the award at a dinner in London on November 22, where the guest speaker was Dido Harding, chief executive of TalkTalk, the UK telecoms group.
1. Battle of the Sexes