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Coronavirus|

Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

有的时候,老板挺糟糕的。但如果你觉得你的老板一直很差劲,占用了你的时间,是的,你该去找一份新的工作了。
The Death Proof star's early success was on the independent film circuit. But then she met Harvey Weinstein in a hotel room and it is there that she alleges he raped her.
It is an acoustic guitar-led anthem and instant lighters-up classic, pivoting into punk-pop with Eagles of Death Metal on "Let 'Em Talk".
星期三,2014年春晚主持名单公布,包括了朱军、董卿、毕福剑、李思思和张国立。作为电影演员和导演的张国立会首次主持央视每年举办的春晚。
在英国,今年可能是大型咨询公司正式进入法律市场的一年吗?其他的“另类业务结构”——或者说按照“乐购法”(Tesco law)成立的律所——将通过提供固定费用服务、把业务外包给松散的律师网络,或者推出法律聊天机器人提供即时而实惠的建议,而终于立足消费者市场吗?为了普通公民的利益,得有人突破这个领域。
Harvey C Mansfield, one of Harvard's most outspoken conservative professors and the author of a book called Manliness, also told the Guardian he questioned the decision. "The bounds of what is offensive have been extended and distorted, and I no longer trust the bent judgment of politically correct enforcers."
你本应该享受生活,不该时时刻刻感到压力。如果你的大部分时间都在为工作的是感到压力很大,说明你没有得到一份好的工作。
And the public chose Callabro to be crowned this year's winner, where they will take home a £250,000 cash prize and a spot at this year's Royal Variety Performance.
Apple Inc.'s Chief Executive Officer Steve Jobs is shown in this combination photo of file photographs dating (top row L to R) July 2000, November 2003, September 2005, (bottom L to R) September 2006, January 2007 and September 2008. Jobs will take a medical leave of absence until the end of June because his health problems are "more complex" than he had thought, shocking investors and sending the company's shares down as much as 10 percent on January 14, 2009.
科技:凯迪拉克将在汽车的后视镜添加高清视频功能,其视野要比传统的后视镜开扩四倍,因为它能够在最大程度上减少了车柱和乘客对视线的影响,对于上了年纪的凯迪拉克车主和颈椎不好的人来说,这的确是个福音。下一个即将被广泛采用的技术,则是让汽车在倒车时,能够发出像垃圾车那样的“滴滴声”。

节目31 京剧《迎来春色换人间》,于魁智 托马斯(孔子学院学员)
谎言2:好的,我会尽快开工的!说谎原因:如果我告诉你在做你要求的这件事之前,我还有10件事要做的话,你肯定会抓狂的。
Stryker
Rocco LaDuca, covers crime and courts at the Observer-Dispatch in Utica, New York. He says he became a reporter in part because of fond memories of reading newspapers with his grandmother.
Dershowitz said this guidance was too vague to provide students with any real understanding of the school's expectations. "When you punish a student seriously without articulating standards, I think it raises questions," he said.
根据中国海关总署(General Administration of Customs)的数据,在经历了此前一个月的同比下跌1.4%之后,11月份中国的进口同比增长6.7%,至1522亿美元,远高于同比收缩1.9%的预测中值。

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.

深圳人成惠州楼市主要购买力 成交量同比涨一倍

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[kri'eitiv]
周二,她在给客户的一封信里提出了下面几个观点,令我耳目一新:

GM is addicted to hefty sales incentives to move the cars and new CEO Ed Whitacre knows it. In 2010, he will slash incentives and end up abandoning GM's 20% U.S. market share target to find profitability. The search will prove elusive.
汤姆·佩蒂
持续推进政府职能转变。
From the beginning, social networks have been effectively walled off from the Internet. The treasure trove of content on Facebook, for instance, doesn't generally show up on Google (GOOG). But does it have to be that way? Wouldn't it be convenient to see Twitter search results automatically displayed alongside a standard Google search, for example? And why, for instance, don't the latest tweets about a restaurant pop up when you're searching Yelp (YELP)? The competing interests of different networks sends this content behind proprietary walls, but a number of tools offer creative ways to bridge the gulf. (Full disclosure: My company has developed one such tool.)
CareerCast.com, a career website owned by Adicio Inc., ranked 200 jobs from best to worst based on five criteria: physical demands, work environment, income, stress, and hiring outlook. The firm used data from the Bureau of Labor Statistics and other government agencies to determine the rankings. As in prior years, the 200 jobs were selected for their relevance in the current labor market as well as the availability of reliable data.
打造众创、众包、众扶、众筹平台
过去一年中,亚利桑那州最大的赢家是建筑和休闲/酒店行业,这两个行业共增加了超过1万个就业机会。其他快速增长的行业包括商业服务、金融活动、教育和医疗服务。
vi. 获得奖章
时间:2010-01-29 编辑:vicki
Belize's proximity to Mexico and the Caribbean ensures the street-food scene, providing an abundance of budget meal options.
[s?'k?m]
Following the devaluation in mid-August, the renminbi rallied in September and October. Devaluation resumed in November, however, and the renminbi closed at its weakest level in three months at 6.4082 to the dollar yesterday. “Since October many countries around China have experienced some capital outflow, and China has had its share,” said Xie Yaxuan, an economist at China Merchants Securities in Shenzhen. “The strengthening dollar is bound to cause some repositioning into dollar assets.”
You might want to hope that people shared these articles as a joke. I want to hope that. But we can’t: the analysis points to a recent BuzzFeed and Ipsos Public Affairs poll which found that 75 percent of Americans (84 percent of Republicans and 71 percent of Democrats) were easily tricked by fake headlines. What a fantastic year for fact-checking and rational thought and Mark Zuckerberg’s self-awareness.
On Tuesday, 17-year-old Thomas Sohmers unveiled a new super fast computer server that uses a fraction of the electricity that a normal computer does.He's showing it off at the Open Compute Project (OCP) Summit happening this week in San Francisco.This computer is the first product from Sohmers' startup, REX Computing, created with 52-year-old co-founder and CTO Kurt Keville.