Safety, tolerability, and efficacy of a widely available nusinersen program for Polish children with Spinal Muscular Atrophy

Spinal muscular atrophy (SMA) is a devastating neuromuscular disorder with limited treatment options. Nusinersen is the first disease-modifying therapy to treat children and adults with SMA. This study aimed to review the safety, tolerability, and efficacy data of a nusinersen treatment program in Polish children. A total of 298 patients aged from 0 to 18 years were included in the nusinersen treatment program in Poland between March 1 and September 20, 2019. All patients were prospectively followed for at least one year. The mean age at treatment onset was 6.9 years. SMA type 1 symptoms were reported in 127 patients (43.5%), SMA type 2 symptoms in 68 cases (23.3%), and SMA type 3 in 93 patients (31.8%). No patient met the inefficiency criteria defined in the program. One year after treatment initiation, all patients assessed by the CHOP-INTEND scale had improved or remained stable. The mean change in CHOP-INTEND score was an increase of 8.9 points between baseline and after one-year treatment (p < 0.001). Except for 2 fatal cases, not related to the treatment, no serious adverse events were reported. The results of our study indicate that treatment with nusinersen is beneficial for children with SMA regardless of their age, baseline functional status, or the number of SMN2 gene copies. Therapy with nusinersen was effective and well tolerated by patients.

Treatment of ocular squamous cell carcinomas in cattle with interleukin-2

In total, 174 bovine ocular squamous cell carcinomas of varying sizes (20 to 2800 mm(2) in area) were treated daily with peritumoural injections of solvent, or solvent containing 5000 U, 20,000 U, 200,000 U, 500,000 U, 1 million U or 2 million U interleukin-2 (IL-2) for 10 days. The tumours were measured and clinically staged before treatment and at one, three, four, nine and 20 months after treatment. After 20 months, 14 per cent of the tumours treated with the solvent had regressed completely, a significantly smaller proportion than the 55 per cent treated with 5000 U IL-2, 52 per cent treated with 20,000 U IL-2, 58 per cent treated with 200,000 U IL-2, 50 per cent treated with 500,000 U IL-2, 69 per cent of tumours treated with 1 million U IL-2, 52 per cent treated with 2 million U IL-2. The tumours on the third eyelid and limbus were the most responsive.

[The vestibular system and migraine in children]

Migraine in childhood is relatively common disease. Although clinical practice and scientific publications recognize frequent association of migraine and vestibular disorders, relationships have yet to be well defined. In present study the vestibular function was extensively tested in 20 children suffering from migraine. All the patients underwent complete neurootological examination including tonal threshold audiometry, testing of vestibulo-spinal reflexes--Romberg and Unterberger-Fukuda tests, Dix-Halpike test for BPPV, videonystagmography. On videonystagmography each patient was evaluated regarding: calibration, spontaneous nystagmus, gaze nystagmus, eye tracking test, optokinetic and positional nystagmus, and caloric testing. The same procedure have been performed regarding control group comprised of 15 healthy. All the patients with migraine presented abnormalities in vestibular testing. Analysis of the results showed that: functional state of structures forming both visuo-ocular and vestibulo-ocular structures was altered in all the migraine patients evaluated in the study, pathological findings suggest mainly central localisation of vestibular dysfunction in children suffering from migraine, the number of pathological VNG findings seems not to be correlated with the type of migraine.

[Fluorine and the dentition]

In order to estimate the influence of fluorine (in drinking-water and air) on the occlusion 372 twelve-year-old children have been examined in four different localities with differing fluorine concentrations of drinking water and air. Apart from the determination of the fluorosis frequency and of the DMFt index, the number of children who do not require any orthodontic treatment according to the WHO recommendation has been determined. The degree of malocclusion has been defined by means of the Eismann-Masztalerz's method. There was observed that the optimal fluorine concentration in drinking water (0.7-0.9 mg/l) decreases the degree of malocclusion except for the crowding of the teeth whereas its concentration above the optimum (4.0-7.0 mg/l) as well as fluorine polluted air are one of the causes of crowding.

[Frequency of indications to orthodontic treatment]

The purpose of the study was determination of the per cent of children requiring orthodontic treatment. The material analysed included 422 children from Lower Silesia aged 12 years. According to WHO criteria about 1/3 of the studied children were qualified for orthodontic treatment.

[Indications and execution of early treatment]

42% of the school children show malocclusion. Eugnathic dentitions are observed in only 26%, and there is a downward trend. For this reason, orthodontic prophylaxis is practised systematically in Poland. All the children in nurseries, nursery schools and the first three forms of the elementary schools are involved. They are subdivided into 4 groups. Children with eugnathic dentitions are in the first group; children with severe anomalies, in the fourth group. The first group needs only supervision. The second group benefits from prophylactic measures performed by a paedodontist. In the third group, a paedodontist institutes a causal therapy using simple means. Complex orthodontic treatment by an orthodontist is needed only in the fourth group.