Anti-cytokine therapy in fibrosing alveolitis: where are we now?

Idiopathic pulmonary fibrosis (IPF) is a condition that has a poor prognosis, with a median survival of 4-5 years irrespective of treatment. Ziesche et al (N Engl J Med 1999, 341: 1264-1269) describe an open randomised trial of 18 patients with IPF, unresponsive to corticosteroid treatment at high dose. Nine patients were treated with continued corticosteroid and nine with prednisolone plus interferon-γ 1b (IFN-γ). Significant benefits in physiological parameters are reported in the IFN-γ-treated group. An analysis of lung tissue by reverse-transcriptase-mediated polymerase chain reaction showed corresponding decreases in the transcription of transforming growth factor-β1 and connective tissue growth factor. This is the first report of treatment showing efficacy in this disease, albeit in a very preliminary study, but the data should be viewed with caution. This study is discussed in the context of other published studies of treatment for IPF and the scientific rationale on which it was based

A possible dose–response association between distance to farmers’ markets and roadside produce stands, frequency of shopping, fruit and vegetable consumption, and body mass index among customers in the Southern United States

Background: The association between farmers’ market characteristics and consumer shopping habits remains unclear. Our objective was to examine associations among distance to farmers’ markets, amenities within farmers’ markets, frequency of farmers’ market shopping, fruit and vegetable consumption, and body mass index (BMI). We hypothesized that the relationship between frequency of farmers’ market shopping and BMI would be mediated by fruit and vegetable consumption. Methods: In 15 farmers’ markets in northeastern North Carolina, July–September 2015, we conducted a crosssectional survey among 263 farmers’ market customers (199 provided complete address data) and conducted farmers’ market audits. To participate, customers had to be over 18 years of age, and English speaking. Dependent variables included farmers’ market shopping frequency, fruit and vegetable consumption, and BMI. Analysis of variance, adjusted multinomial logistic regression, Poisson regression, and linear regression models, adjusted for age, race, sex, and education, were used to examine associations between distance to farmers’ markets, amenities within farmers’ markets, frequency of farmers’ market shopping, fruit and vegetable consumption, and BMI. Results: Those who reported shopping at farmers’ markets a few times per year or less reported consuming 4.4 (standard deviation = 1.7) daily servings of fruits and vegetables, and those who reported shopping 2 or more times per week reported consuming 5.5 (2.2) daily servings. There was no association between farmers’ market amenities, and shopping frequency or fruit and vegetable consumption. Those who shopped 2 or more times per week had a statistically significantly lower BMI than those who shopped less frequently. There was no evidence of mediation of the relationship between frequency of shopping and BMI by fruit and vegetable consumption. Conclusions: More work should be done to understand factors within farmers’ markets that encourage fruit and vegetable purchases.ECU Open Access Publishing Support Fun

A possible dose–response association between distance to farmers’ markets and roadside produce stands, frequency of shopping, fruit and vegetable consumption, and body mass index among customers in the Southern United States

Background: The association between farmers’ market characteristics and consumer shopping habits remains\r\nunclear. Our objective was to examine associations among distance to farmers’ markets, amenities within farmers’\r\nmarkets, frequency of farmers’ market shopping, fruit and vegetable consumption, and body mass index (BMI). We\r\nhypothesized that the relationship between frequency of farmers’ market shopping and BMI would be mediated by\r\nfruit and vegetable consumption.\r\nMethods: In 15 farmers’ markets in northeastern North Carolina, July–September 2015, we conducted a crosssectional\r\nsurvey among 263 farmers’ market customers (199 provided complete address data) and conducted\r\nfarmers’ market audits. To participate, customers had to be over 18 years of age, and English speaking. Dependent\r\nvariables included farmers’ market shopping frequency, fruit and vegetable consumption, and BMI. Analysis of\r\nvariance, adjusted multinomial logistic regression, Poisson regression, and linear regression models, adjusted for\r\nage, race, sex, and education, were used to examine associations between distance to farmers’ markets, amenities\r\nwithin farmers’ markets, frequency of farmers’ market shopping, fruit and vegetable consumption, and BMI.\r\nResults: Those who reported shopping at farmers’ markets a few times per year or less reported consuming 4.4\r\n(standard deviation = 1.7) daily servings of fruits and vegetables, and those who reported shopping 2 or more times\r\nper week reported consuming 5.5 (2.2) daily servings. There was no association between farmers’ market amenities,\r\nand shopping frequency or fruit and vegetable consumption. Those who shopped 2 or more times per week had a\r\nstatistically significantly lower BMI than those who shopped less frequently. There was no evidence of mediation of\r\nthe relationship between frequency of shopping and BMI by fruit and vegetable consumption.\r\nConclusions: More work should be done to understand factors within farmers’ markets that encourage fruit and\r\nvegetable purchases