Development of neutralizing antibodies in patients with relapsing-remitting multiple sclerosis treated with IFN-beta1a.

Sixty-eight patients with relapsing-remitting multiple sclerosis (RRMS) were treated with 3 million or 9 million i.u. of recombinant interferon-beta1a (recIFN-beta1a) s.c. three times a week for 2 years. Their sera were tested for antibodies neutralizing the IFN (NAb) in a bioassay. Sera with titers > or = 1:20 were considered positive. We detected NAb in 3.2%, 13.8%, and 15.9% of the patients in sera obtained at 3, 6, and 24 months, respectively. The incidence was not related to the IFN dose. Interestingly, during the 6 month baseline period before the start of the study, relapse rates, baseline disability, and the volume of lesions on T2-weighted images were significantly higher in patients who developed NAb during treatment. Because of interpatient variability, no definitive relationship was observed between NAb formation and loss of clinical or magnetic resonance imaging (MRI) response.

Epidemiology and sequelae of head injury in San Marino Republic.

A study of head injuried patients was carried out in the smallest nation in the world (Republic of San Marino) from January 1981 to December 1982. The results show an epidemiological incidence of 468 cases/10(5) population/year in regards to Hospital admissions, whereas the cases are 694/10(5) population/year when taking into account also patients seen only by Accident and Emergency Department. The consequences of the head injury (Post Traumatic Syndrome, PTS) were studied in 187 patients having comparable features on admission and discharge, and being all residents of the Republic of San Marino. Factors significant in determining a PTS seem to be a history of previous head injuries, the presence of previous neuropsychiatric disturbances and an abnormal E.E.G. on admission. The time of onset of the syndrome, associated with the above mentioned factors, can be important in determining whether the PTS is of neurotic or organic origin.