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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

Comic skit “You’ve Got Trouble”(Sun Tao, Qin Hailu etc)
The announcement comes from the British Fashion Council (BFC), who surveyed designers ahead of the shows and found none of the 80 designers in the September line-up would be using fur.
其他机构有宝钢集团(Shanghai Baosteel Group)旗下为钢材交易商提供融资的欧冶云商(Ouyeel)、中国第六大银行招商银行(China Merchants Bank)旗下专注财富管理领域的小企业e家(Small Entrepreneur)等。
据哈佛大学校报报道,至少10名学生因在脸书私聊小组中发布“猥琐表情”而失去哈佛大学的入学资格。
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Alumni from Edhec have the 11th highest average salary, at $105,000, behind the alumni from Sloan at $143,600. They also enjoyed theseventh-highest salary increase, at 79 per cent.
The maker of Post-it notes and Scotch tape authorized a $12 billion stock repurchase program in February, replacing its current $7.5 buyback program. 3M's (MMM, Fortune 500) move followed its announcement late last year that it intends to spend $10 billion on acquisitions and repurchase up to $22 billion of shares over the next four years.

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5. Fred Hersch Trio “Floating” (Palmetto) The articulate grace of Fred Hersch’s current piano trio, with the bassist John Hébert and the drummer Eric McPherson, finds potent expression on an album structured like a nightclub set, with a few retooled standards mixed in with sturdy, emotionally transparent original songs.
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5. Repeats & highlights are as good as the main match, so am gonna watch them.
HEC Paris and London Business School have tightened their grip on the top of the Financial Times rankings of pre-experience and post-experience Masters in Finance programmes respectively, having dominated the finance rankings since they were first published in 2011.
连平说道:“在2017年的低基准上,今年CPI可能会以一个更快的速度上涨,但在需求稳定、货币环境紧张的背景下,不会出现明显的通胀压力。”

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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除了你的华生,他会觉得这样的你性感极了!
著名美国谐星梅丽莎?麦卡西收入为3300万美元,比去年增加了1000万美元。

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