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Purpose: The main objective of this study was to provide a description and classification of lumbosacral spine injuries based on the new AOSpine classification system. Methods: A cross-sectional study was conducted on 75 patients with lumbosacral spine trauma who were admitted to Hue University of Medicine and Pharmacy Hospital in Hue, Vietnam, between April 2021 and July 2022. All patients underwent lumbosacral computed tomography, and each injured vertebra was classified according to the AOSpine classification system. The frequency and percentage of subtypes of lumbosacral spine trauma were determined. Results: The mean age of the patients was 50.6 ± 16.1 years, and the male-to-female ratio was 1.5:1. Falls and traffic accidents were found to be the main causes of injuries. Among the patients, 78.7% did not exhibit any neurological symptoms, while 1.3% experienced complete hemiplegia and 20% had incomplete hemiplegia. The most common fracture subtype was A3, accounting for 34.6% of cases. Conclusion: This study provides valuable insights into the demographics, associated injuries, and classification of traumatic lumbosacral spine injuries based on the new AOSpine classification system. The study found that falls and motor vehicle accidents were the main causes of these injuries, with a higher proportion of male patients. The majority of injuries were classified as type A fractures, while type C fractures were the least common. Sacral fractures were relatively infrequent and often associated with pelvic ring fractures. These findings contribute to our understanding of lumbosacral spine trauma and can aid in the development of more effective treatment protocols.
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We reported a case of a 48-year-old female patient admitted to the hospital due to balance disorder which progressed rapidly within 1 week. Cerebral magnetic resonance imaging showed significant atrophy and hyperintensities at the middle cerebellar peduncles and the "hot cross bun" sign of the pons. The final diagnosis was probable multiple system atrophy, cerebellar subtype. The clinical and imaging findings will be discussed as well as a brief literature review.
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BACKGROUND: Anti-CD38 antibodies such as daratumumab (DARA) are critical therapies for multiple myeloma and other diseases. Unfortunately, anti-CD38 antibodies cause panreactivity in indirect antiglobulin tests (IATs), complicating blood compatibility testing. The anti-CD38 interference is most often mitigated by treating reagent red blood cells (RBCs) with dithiothreitol (DTT). However, when using the DTT method, not all RBC antibody specificities can be detected (e.g., anti-K), and the DTT method is impractical for some transfusion services. We evaluated the ability of a new anti-idiotype antibody to neutralize DARA in vitro and eliminate the anti-CD38 interference. STUDY DESIGN AND METHODS: A recombinant monoclonal rabbit anti-DARA idiotype antibody ("anti-DARA") was generated. The ratio of anti-DARA required to neutralize DARA in spiked samples was evaluated in IATs performed in gel. IATs performed in tube were used to demonstrate that anti-DARA allows alloantibody detection in the presence of DARA. Plasma samples from 29 patients receiving DARA were treated with a fixed quantity of anti-DARA (120 µg) before performing antibody detection tests (screens) in tube. RESULTS: Anti-DARA used at or above a 1:1 ratio with DARA eliminated the DARA interference with IATs. Anti-DARA allowed detection of both alloanti-E and alloanti-K in the presence of DARA. In 27/29 (93.1%) clinical samples, 120 µg anti-DARA was sufficient to neutralize the DARA in 100 µl patient plasma. DISCUSSION: An anti-DARA:DARA ratio as low as 1:1 is sufficient to neutralize DARA in solution. A fixed amount of anti-DARA eliminates the anti-CD38 interference in most patient samples.