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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

In fact, create a hard and fast rule to keep work and job searching separate. That means no sneaking out for a phone interview. No browsing job boards. No applying or networking with your work email address. "You don't watch porn at work, and you don't work on your résumé at work," Kay says. "You just don't."
由于州政府和市政府试图打击不法的旅馆经营者,明年可能会出台一项规定。而与此同时,房产租赁网站Airbnb将游说政府改变法规。“你会看到,规范这一市场的要求会变得更加迫切。”代表租户的律师塞缪尔·J·希莫尔斯泰因(Samuel J. Himmelstein)说。
approval
Total program cost: $168,000
这个位于非洲西南部的国家拥有20多家国家公园以及世界上最古老的沙漠。
The Meyerowitz Stories
我是一个封闭的人
年龄:31岁
以下10种妖魔就像无人机一样,瞄准了股市、债市和世界经济:
By 2020, annual box office sales are expected to reach 100 billion yuan, according to industry estimates.

Metals cases made up a record 46 per cent of the 233 anti-dumping actions brought worldwide in 2015, with the steel industry accounting for almost all of the metals complaints.
4.意大利威尼斯
WhatsApp had been particularly ad-averse before its sale to Facebook. CEO Jan Koum kept a note from co-founder Brian Acton taped to his desk to remind him of the company’s core values. It read: “No Ads! No Games! No Gimmicks!”
A disturbing and often bleak analysis of the automated future of work has been named 2015’s business book of the year.
两次发生在洛杉矶的反抗时间之旅。两次对女人之间时而棘手的团结的赞颂。四位演员的精彩表演,来自吉塔娜·基基·罗德里格斯(Kitana Kiki Rodriguez)、米娅·泰勒(Mya Taylor)、茱莉亚·加纳,以及了不起的莉莉·汤姆林。《与外婆同行》是制片公司资深导演的作品,《橘色》是用iPhone手机拍摄。任何哀悼电影已死的人,都应该闭上嘴巴,看看这两部影片。
A Sicilian Photographer of the Mafia and Her ‘Archive of Blood’

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.

多地推出创新举措 促进住房租赁市场健康发展

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France’s HEC Paris and Essec Business School remained second and third, respectively, for the third year running.
但这种理念不会让英国退欧或者让特朗普当选总统。

Ferreira added that while the entire Brazilian population has suffered during preparations for the World Cup, mostly because of big construction projects that have snarled traffic and extended already long commutes for the poor who live on the outskirts of cities, she feels like only the rich are reaping the benefits of the real World Cup experience.
拯救非洲癌症患者
中央纪委国际合作局局长腊翊凡表示:“在中共中央的领导下,我们将扩大与有关国家的司法合作,使腐败的外逃人员不存在“避罪天堂”。
谁都有不如意的时候,但是佳士得拍卖会上令人失望的情景已经不是第一次出现。今年7月的18世纪前绘画大师作品拍卖会仅拍得1900万英镑,而当时的最低预估价是3150万英镑。
《胡润百富榜》的编制者胡润(Rupert Hoogewerf,见文首图)表示:“姚振华代表了中国金融投资创造财富的新浪潮。”
There is a natural human tendency to idealize and whitewash days of yore, to cast them in the rosy glow of the mind’s eye.
007系列电影主题曲第十名:雪莉·巴赛--《永远的钻石》
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威廉姆斯指出,来自巴西、越南、台湾和智利的11月初数据表明,出口形势自10月以来持续改善。
After exhausting all his options, the practical kid decided to tend to his academic responsibilities, not knowing how long it would take before someone finds him.
undeniable
8. 斯特吉尔·辛普森(Sturgill Simpson),《乡村音乐的大现代之声》(Matamodern Sound in Country Music),High Top Mountain。一支极为聪敏的乐队做出复古的改革:乡村乐中曾经发生过这样的事。但在斯特吉尔·辛普森突破性的第二张专辑中,他把这一点变成了可适应环境的标志,就建立在他那动人而通透的男中音之上。
《体育画报》泳装专刊模特凯特·阿普顿位于2015全球美女榜第八。这位时尚名模去年曾是本榜单亚军。今年她也入选了《人物》杂志最性感女性榜单。
You might think that our love of lists could be pinned on the Ten Commandments, but Umberto Eco says otherwise. “The list is the origin of the culture,” he once said on a subject he knows well, having written a book titled “The Infinity of Lists.” And culture wants “to make infinity comprehensible” and “to create order — not always, but often,” hence Homer’s catalogs in “The Iliad” and the roll call of never-completed household chores on my fridge. “We like lists because we don’t want to die,” Mr. Eco also said, which is the best explanation of the listicle that I’ve yet read.