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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

How could we not include the ancient Chinese theory of interior aesthetics? Where your desk is situated is the most important aspect to freeing the energy in your space. Place your desk so that you face the door— the ultimate power position. Avoid placing your desk against a wall with your back facing the door, as it will interfere with the balance of your chi.
香港房地产价格过去十年大幅上涨,但在去年9月见顶,那时中国经济引发的紧张占据了主导。
不过,多个大城市新建住宅价格增速似乎已显著放缓。
Columbus Day became a U.S. holiday in 1971. It is generally observed by banks, state government offices, the Postal Service and federal agencies. The bond markets are closed for the holiday, but many businesses and stock exchanges remain open.
Of the 200 nominated companies, 101 are privately-owned, while the rest are State-owned enterprises. The total value of these 200 listed brands has risen by 36 percent year-on-year to reach $696 billion, with the top 10 accounting for 46 percent of the total value.
中国民航大学经济管理学院教授李晓津表示,数量迅速增加的航班以及民用航空有限的空域是延误的主要原因。
confident
3、全面放开二孩政策
The film version of the popular television series "Legend of Sword and Fairy", also known as Chinese Paladin starts shooting in Zhejiang Province today.
Leatrice Eiseman, the executive director of the Pantone Color Institute, said the joining of the two colors reflected “a soothing sense of order and peace” — presumably an attractive thing to incorporate into a product at a time of insecurity and global turbulence. It also implies that there is no line between “us” and “them.”

It came as no surprise that the likes of Emily Ratajkowski, Adriana Lima, Lily Donaldson and Petra Nemcova turned out to be the red carpet rulers on day one of the 70th Cannes Film Festival.
苹果公司创始人史蒂夫乔布斯在旧金山的库比蒂诺(苹果电脑的全球总公司所在地)介绍新研发的苹果II 型机,1977,旧金山
菲律宾警察总长表示,新总统罗德里戈?杜特尔特(Rodrigo Duterte)上台后,不断升级的禁毒战争已造成近1800人死亡。
One of the two artefacts which has a metal ring attach to it was discovered in the Yizheng city in western Jiangsu.
与此同时,有一首非常有意思的歌曲来自我们的读者Libby Russell,是她为所有世界杯期间的足球寡妇所作。非常感谢Libby的分享,太棒了!
n. 飞行,航班

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.

人民时评:让居住证安定那些漂泊的心

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?The Aston Martin doesn't hurt. Not at all. Neither does dropping tons of cash at exotic casinos -- throwing money around makes men more attractive to women who are interested in flings. And, like Bond, men who gamble with women around are better at it.
Julia Hartz

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A New York City restaurant is taking a stab at creating the most decadent pizza on the market with a pie topped in gold flakes, foie gras and even truffles.
Wealthy Chinese are showing growing interest in islands in recent years.
以下是其中最值得期待的10部,我们相信这10部电影都将成为票房宠儿,值得反复欣赏。
改编自上世纪70年代真实贿赂事件的影片《美国骗局》当晚表现更加抢眼,埃米?亚当斯(Amy Adams)和珍妮弗?劳伦斯(Jennifer Lawrence)凭此片分获最佳女主角和最佳女配角奖。《为奴十二年》虽在提名数量上与《美国骗局》打平,参与了七个奖项的角逐,但当晚只摘得最佳剧情片一个奖项。
More than an hour into Apple’s annual shareholder meeting in February, Tim Cook had patiently fielded questions ranging from its plans for the television market to what he thought of Google Glass. But when one audience member tried to push Apple’s chief executive on the profitability of Apple’s various environmental initiatives, such as its solar-powered data centre, Mr Cook snapped.
UK schools account for more than a third of all graduates from the top 50 pre-experience programmes and not only attracted nearly half of all female students but also almost half of all international students. Indeed, 94 per cent of students enrolled in a UK MiF pre-experience programme in 2014 were from overseas. About 85 per cent of these students were from outside the European Economic Area, including 55 per cent of the overall number from mainland China.
尽管谷歌已经竭尽所能,那一刻却依然还未到来。许多报告都声称,可穿戴设备将在2014年成为主流。不过来自数字研究公司L2的最新报告证实了许多人正在默默为之努力的一件事:可穿戴设备仍然没有得到社会的广泛接受,要扩大销量依旧障碍重重。
Hanging on the coat tails of Ronaldo and Messi are NBA star LeBron James (pound 53 million) and tennis player Roger Federer (pound 46 million).
Top programme:Tsinghua/Insead
James Bond Themes 9. "The Man with the Golden Gun" by Lulu
The ranking is based on surveys of schools and alumni who graduated in2011. This edition gives a snapshot of alumni’s situation compared with when they started the programme.
3. Do I take time out of my day purely for myself? We all need a little “me time.” Set aside some time every day to just relax and do something that you enjoy, whether that is reading, meditating, watching TV, cooking, spending quality time with your loved ones, etc.
动词last的现在分