RESUMO
RATIONALE: Coronavirus disease 2019 (COVID-19) can damage the central nervous system. Although there have been reports of cerebral hemorrhage and infarction caused by COVID-19, hematomyelia due to COVID-19 has never been reported. PATIENT CONCERNS: A 40-year-old male was admitted to the hospital with positive nucleic acid detection for COVID-19 after experiencing fever for 2 weeks, urinary retention, fecal retention, and pain in both lower extremities for a week. DIAGNOSES: The patient diagnosis was established using thoracic and lumbar magnetic resonance imaging (MRI). Contrast-enhanced thoracic and lumbar MRI revealed subdural (dorsal predominant) short T1 and slightly long T2 bands in the T12-S2 infundibular canal in the scan field, and the subdural hematoma was yet to be distinguished from other diseases. Spinal cord edema was observed in the left vertebral plate and facet joint of the T11 vertebral body, indicative of inflammation. The cerebrospinal fluid (CSF) was positive for COVID-19 nucleic acid. INTERVENTIONS: Antiinfection, immunomodulation, correction of acid-base balance and electrolyte disorders, improvement of circulation, nerve nutrition, and other symptomatic supportive treatments were administered to the patient. OUTCOMES: The patient symptoms significantly improved after 4 weeks of anti-infection and immunomodulatory therapy. Repeat thoracolumbar MRI revealed absorption of the spinal cord hematoma, and the patient was discharged from the hospital. To date, COVID-19-related hematomyelia has not been reported and anti-infective and immunomodulatory therapies may be effective. LESSONS: COVID-19 not only easily leads to brain injury but can also cause spinal cord injury and even spinal cord hemorrhage. When patients with COVID-19 experience symptoms and signs of spinal cord injury, spinal cord injury and bleeding caused by COVID-19 should be considered, and MRI and lumbar puncture should be performed as soon as possible to make a clear diagnosis.
Assuntos
COVID-19 , Doenças da Medula Espinal , Traumatismos da Medula Espinal , Doenças Vasculares da Medula Espinal , Masculino , Humanos , Adulto , COVID-19/complicações , Coluna Vertebral/patologia , Hematoma/patologia , Imageamento por Ressonância MagnéticaRESUMO
RATIONALE: Recurrent herpes simplex encephalitis (HSE) can easily induce autoimmune encephalitis (AE). However, there are few reports of anti-contactin-associated protein-2 (CASPR2)-related encephalitis, especially with positive anti-aquaporin 4 (AQP4) antibodies. PATIENT CONCERNS: A 14-year-old boy was admitted to the Department of Neurology of the First Affiliated Hospital of Kunming Medical University for "headache, dizziness, and fever for four days" with positive anti-CASPR2 and anti-AQP4 antibodies in the cerebrospinal fluid. DIAGNOSES: Cranial MRI showed lesions in the right hippocampus, amygdala, and insular lobe, with local sulcus enhancement in the right insular, temporal, and frontal lobes. The fluid-attenuated inversion recovery was significantly enhanced. Human herpes virus type I was detected by cerebrospinal fluid metagenomic testing. The patient was diagnosed with AE secondary to HSE, with positive anti-CASPR2 and anti-AQP4 antibodies. INTERVENTIONS: After 2 weeks of immunoglobulin and methylprednisolone immunomodulatory therapy, acyclovir antivirus, mannitol dehydration, reducing intracranial pressure, and other symptomatic support therapy. OUTCOMES: The patient's symptoms significantly improved, with no complaints of discomfort, and he was discharged for observation. The patient was followed up a month after discharge and had no complaints of discomfort. LESSONS: CASPR2 and anti-aquaporin-4 antibody-positive AE have not been reported to be positive. This case will raise awareness of CASPR2 and anti-aquaporin-4 antibody-positive AE secondary to HSE, strengthen diagnostic capacities, and provide advice to treat it.
Assuntos
Doenças Autoimunes do Sistema Nervoso , Encefalite por Herpes Simples , Herpes Simples , Masculino , Humanos , Adolescente , Encefalite por Herpes Simples/complicações , Encefalite por Herpes Simples/diagnóstico , Encefalite por Herpes Simples/tratamento farmacológico , Aciclovir , Herpes Simples/complicações , Doenças Autoimunes do Sistema Nervoso/complicaçõesRESUMO
The occurrence of crop fungal diseases is closely related to warm environmental conditions. In order to control the release of fungicides in response to warm conditions, and enhance the efficacy, a series of thermo-responsive fungicide-loaded nanoparticles were developed. The fungicide azoxystrobin, solvent DEP, emulsifier Tween 80 and thermo-responsive component TDA were combined to create thermal-response oil phases, conditions for emulsification were then optimized. LDLS, zeta potential, FTIR, DSC, TGA, XRD, SEM and antifungal efficacy assays were carried out to investigate the characteristics and forming mechanism. The results indicated that the formula with 5 g azoxystrobin, 10 mL DEP, 6 mL Tween 80 and 2.5 g TDA constructed the proposed oil phase with the ability to transform from solid at 20 °C to softerned at 31.5 °C. Both DEP and TDA played key roles in interfering with the crystallization of azoxystrobin. The optimal T3t-c12 nanoparticles had a mean particle size of 162.1 nm, thermo-responsive morphological transformation between 20 °C and 30 °C, AZO crystal reforming after drying, the ability to attach to fungal spores and satisfied antifungal efficacy against P. nicotiana PNgz07 and A. niger A1513 at 30 °C. This report provides referable technical support for the construction of smart-release nanoparticles of other agrochemicals.