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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

1999年中国航空工业第一、第二集团公司(之后两者合并为中国航空工业集团公司)的成立标志着中国开始进军商业航天领域,显示了中国迈向这一行业的绝心与意志。但实现这一雄心的脚步并不那么平坦。20年之后毫无疑问中国已经成为了大型商用航天领域的成熟玩家,将其他几国远远甩在身后,并有望打破空客和波音的长期垄断。
adj. 可能的,潜在的
Prince Miteb, who headed the powerful National Guard until early November, was released on November 28th, the official said. At least three other suspects have also finalized settlement deals.
这个由财新赞助的系列指数,是基于对民营企业的调查得出的,样本数目也比官方PMI指数少得多,往往波动性更大。相比之下,官方PMI指数则主要关注规模更大的国有企业。
There’s no arguing with that one. From bathroom signs to fashion runways, the gender lines have been blurring at an ever-faster pace. It’s about time we ended ye olde pink/blue, girl/boy stereotype divide.
Only asset management firms saw profits rise, up 16.7 per cent year-on-year to Rmb3.7bn.
平板电脑的病毒出现。
该版猴票为我国发行的首套生肖邮票,因此颇受追捧。据悉,一枚邮票的价格已经从当时的发行价8分涨至1.2万元,整版价格更是达到150万元。
新建的房产将给那些财大气粗的租房者提供奢华的居住选择,它们大多位于曼哈顿以外的行政区。根据花旗居屋的数据,在布鲁克林,预计有6527个新的出租单元,将于明年(2015年——译注)投放租赁市场,比曼哈顿3802个单元多出近一倍。
年度最佳艺人:卢克·布莱恩

"A total of 297 projects will be carried out in Tongzhou, such as building new subway lines and expressways, and improving ecologies," Lu Yan, director of the Beijing Municipal Commission of Development and Reform, said at a news conference on Wednesday.
Two-thirds of this year’s deals are trading above their issue price. On average, 2017’s class of US IPOs have risen in value by about double the S&P 500, at 20 per cent, according to Renaissance Capital, which runs IPO-focused exchange traded funds.
支持:美国国家评论协会将最佳电影、最佳男主角和最佳女主角奖颁给了这部电影。
2015年最差职业
噢,卡梅隆,真希望你还有高中时的风采,因为那时的你是史诗般的存在。
The film pulls heavily from the life of Arthur Bremer, who shot presidential candidate and segregationist George Wallace in 1972. Similarly to his film counterpart, Bremer shot Wallace shortly after being rebuffed by a young girl. Overall, though, his life was much less exciting than that of De Niro's character, with the biggest commonality between the two being that neither actually succeeds in killing a politician.

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.

智能家居或成为中国家庭的最后一道保护屏障

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Adapted from an online novel Queen of No.11 Agent, the TV series is about the adventure of a female slave Chu Qiao and her romance with a prince Yan Xun.
[grɑ:nt]

中国政府鼓励向中小规模的借款人放贷,其中很多贷款者没有信用纪录。分析师预计,在金融上表现活跃但没有信贷渠道的中国消费者有5亿之多。
冲击奖项:在最佳女主角的最热人选弗兰西斯麦克多蒙德面前,莎莉霍金斯的获奖几率很小。
但舒尔茨没有停留在担心这一步。美国政府停摆期间,星巴克还在一些日子里为给他人买咖啡的顾客免单。舒尔茨希望此举能帮助人们“在期待民选官员为了国家利益团结起来的同时,彼此也能团结起来。”
《经济学人》的数据显示,在2010年,亚洲的整形手术总量超过了580万例,而在美国这个数字仅为450万多一点。
The decaying feet, some dating back to 1967, were being 'cleaned up', plumped up and whitened at the 'foul-smelling' plant using bleach and other chemicals, before being prepared for sale.
2. Organize
圣加伦大学校友的薪资排名第三,为114449美元(按购买力平价调整后),排在艾哈迈达巴德的印度管理学院(Indian Institute of Management)和印度管理学院班加罗尔分校(IIM Bangalore)之后,这两所商学院校友的平均薪资分别为116476美元和116094美元。圣加伦大学还在职业服务质量方面排名第一。
During the summers, Good Humor ice cream trucks visit the company's campuses every other Friday during lunchtime. In the fall, cider and doughnuts are served twice a month, mid-morning.
But pop's wider world also offered a lot of pleasures from artists all over the spectrum, such as the 20th century legends like Blondie and Tori Amos, and upstarts like Dua Lipa and Girl Ray.
这种增长为中国电影业未来的发展奠定了坚实的基础。
与此同时,大学毕业生选择继续深造的意向也降低了,这让今年选择就业的人数比例达到了75.6%,而去年这一数据为71.2%。
arrogant
Meanwhile the services PMI reading for the month was 51.2. It had been 52 in October. The manufacturing PMI, reported earlier this week, came in at 48.6 in November, versus expectations of 48.3. It had been 48.3 in October
Also featured in the 2013 top 10 were Singapore, Zurich, Paris, the Venezuelan capital of Caracas and Geneva.