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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

不会。傻子才会去预测足球比赛的结果。最好是作事后诸葛亮。目前已经举办过20届世界杯。其中,巴西(5次捧杯)和德国(4次捧杯)是决赛常客。主场优势有所帮助,东道国赢得了6次奖杯。但是明年的世界杯将在俄罗斯举行,而这位东道主在参赛队伍中排名垫底。
时间:2009-07-16 编辑:vicki
反对:在颁奖季前一年早早上映可能不利于其冲奖。
Call Me By Your Name
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普兰特?莫兰:甜食福利惹人馋
Bella is the youngest model on the list, having just turned 21 last month.

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.

全国楼市现去库存式回暖 稳中有升成下半年主旋律

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On Tuesday Saarland became the first German region to ban campaigning by foreign politicians. Several German local councils had called off planned Turkish ministers’ campaign meetings on technical grounds, such as fire safety.

时间:2009-07-16 编辑:vicki
While oil prices may rebound in 2015, they almost certainly won't return to $100 a barrel any time soon, barring a geopolitical crisis in a major petroleum-producing region. So the gift will keep giving this year and further feed an accelerating U.S. recovery.
事实证明,许多投资者站在了库克这一边。经历了动荡的2013年,苹果股价在这次股东大会后上涨了约50%,一度将苹果市值推至7000亿美元之上。
10. Mail carrier
Concerns about the vulnerability of some emerging economies and gyrations in financial markets over the past few days should not dent “cautious optimism” about the global economy this year, leading central bankers and officials said on Saturday.
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时间:2010-06-03 编辑:francie
adj. 暂时的,临时的
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It was there in Rossella Jardini’s Moschino, from the bows and bouffants of spring-summer 2009 to the Mary Quant-inspired spring 2013 collection.