Safety and efficacy of recombinant human interleukin 10 in chronic active Crohn's disease

AbstractBackground & Aims: Interleukin (IL)-10 is a cytokine with potent anti-inflammatory properties. We investigated the safety and efficacy of different doses of human recombinant (rhu)IL-10 in patients with Crohn's disease (CD). Methods: A prospective, multicenter, double-blind, placebo-controlled study was conducted in 329 therapy-refractory patients with CD. Clinical improvement was defined by a reduction of the Crohn's Disease Activity Index (CDAI) by 100 points or more and clinical remission by a decrease of the CDAI to Results: Subcutaneous treatment with rhuIL-10 over 28 days induced a fully reversible, dose-dependent decrease in hemoglobin and thrombocyte counts but no clinically significant side effects. No differences in the induction of remission were observed between rhuIL-10 groups (1 μg, 18% [9.6–29.2]; 4 μg, 20% [11.3–32.2]; 8 μg, 20% [11.1–31.8]; 20 μg, 28% [18–40.7]; and placebo, 18% [9.6–29.6]). Clinical improvement was observed in 46% (33.7–59) in the 8-μg/kg rhuIL-10 group in comparison with 27% (17–39.6) in patients taking placebo. Responders to rhuIL-10 showed inhibition of NF-κB p65 activation in contrast to nonresponders. Conclusions: Up to 8 μg/kg of rhuIL-10 was well tolerated. A tendency toward clinical improvement but not remission was observed in the 8-μg/kg dose group. Further studies should delineate which subgroups of patients with CD benefit from rhuIL-10 therapy.GASTROENTEROLOGY 2000;119:1461-147

The Health Impacts of Ethanol Blend Petrol

A measurement program designed to evaluate health impacts or benefits of using ethanol blend petrol examined exhaust and evaporative emissions from 21 vehicles representative of the current Australian light duty petrol (gasoline) vehicle fleet using a composite urban emissions drive cycle. The fuels used were unleaded petrol (ULP), ULP blended with either 5% ethanol (E5) or 10% ethanol (E10). The resulting data were combined with inventory data for Sydney to determine the expected fleet emissions for different uptakes of ethanol blended fuel. Fleet ethanol compatibility was estimated to be 60% for 2006, and for the air quality modelling it was assumed that in 2011 over 95% of the fleet would be ethanol compatible. Secondary organic aerosol (SOA) formation from ULP, E5 and E10 emissions was studied under controlled conditions by the use of a smog chamber. This was combined with meteorological data from Sydney for February 2004 and the emission data (both measured and inventory data) to model pollutant concentrations in Sydney’s airshed for 2006 and 2011. These concentrations were combined with the population distribution to evaluate population exposure to the pollutant. There is a health benefit to the Sydney population arising from a move from ULP to ethanol blends in spark-ignition vehicles. Potential health cost savings for Urban Australia (Sydney, Melbourne, Brisbane and Perth) are estimated to be A$39 million (in 2007 dollars) for a 50$42 million per annum for a 100% take up of E10 in 2011. Over 97% of the estimated health savings are due to reduced emissions of PM2.5 and consequent reduced impacts on mortality and morbidity (e.g., asthma, cardiovascular disease). Despite more petrol-driven vehicles predicted for 2011, the quantified health impact differential between ULP and ethanol fuelled vehicles drops from 2006 to 2011. This is because modern petrol vehicles, with lower emissions than their older counterparts, will make up a higher proportion of the fleet in the future. Hence the beneficial effects of reductions in particulate matter become less significant as the fleet as a whole produces lower emissions

Culture and health

Planned and unplanned migrations, diverse social practices, and emerging disease vectors transform how health and wellbeing are understood and negotiated. Simultaneously, familiar illnesses—both communicable and non-communicable—continue to affect individual health and household, community, and state economies. Together, these forces shape medical knowledge and how it is understood, how it comes to be valued, and when and how it is adopted and applied. Perceptions of physical and psychological wellbeing differ substantially across and within societies. Although cultures often merge and change, human diversity assures that different lifestyles and beliefs will persist so that systems of value remain autonomous and distinct. In this sense, culture can be understood as not only habits and beliefs about perceived wellbeing, but also political, economic, legal, ethical, and moral practices and values