Efficacy and safety of leflunomide compared with placebo and sulphasalazine in active rheumatoid arthritis: a double-blind, randomised, multicentre trial. European Leflunomide Study Group

BACKGROUND: Phase II trials of leflunomide, an inhibitor of de-novo pyrimidine synthesis, have shown efficacy in rheumatoid arthritis. This double-blind randomised trial compared leflunomide with placebo and sulphasalazine in active rheumatoid arthritis. METHODS: 358 patients were randomly assigned leflunomide (100 mg daily on days 1-3, then 20 mg daily), placebo, or sulphasalazine (0.5 g daily, titrated progressively to 2.0 g daily at week 4). The primary endpoints were tender and swollen joint counts and investigator's and patient's overall assessments. Analyses were by intention to treat. FINDINGS: The mean changes in the leflunomide, placebo, and sulphasalazine groups were -9.7, -4.3, and -8.1 for tender joint count; -7.2, -3.4, and -6.2 for swollen joint count; -1.1, -0.3, and -1.0 for physician's overall assessment; and -1.1, -0.4, and -1.1 for patient's overall assessment. Leflunomide and sulphasalazine were significantly superior to placebo (p=0.0001 for joint counts; p<0.001 for assessments). Radiographic disease progression was significantly slower with leflunomide and sulphasalazine than with placebo (p<0.01). Most common adverse events with leflunomide were diarrhoea (17%), nausea (10%), alopecia (8%), and rash (10%). Transiently abnormal liver function was seen in three leflunomide-group patients and five sulphasalazine-group patients. There were two cases of reversible agranulocytosis in the sulphasalazine group. INTERPRETATION: Leflunomide was more effective than placebo in treatment of rheumatoid arthritis and showed similar efficacy to sulphasalazine. Leflunomide was well tolerated. This drug may be a useful option as a disease-modifying antirheumatic drug.     

Studies in the process optimization and characterization of low formaldehyde emission urea‐formaldehyde resin by response surface methodology

Stringent control of formaldehyde emission standards the world over has intensified research and development effort to explore several paths for reducing formaldehyde release. A new generation of low odour resins is currently being developed and some resin manufacturers are now programming formaldehyde and urea additions at two or more stages in the overall reaction. This article reports on the studies conducted on a four‐stage condensation process consisting of the first stage involving a high acid environment followed by an alkaline condensation, a condensation under a pH 6, and finally neutralization to pH 7. A programmed variation consisting of changing “the number of additions” and “the duration between additions” of urea to formaldehyde was considered as an effective method to control the molecular weight, molecular weight distribution, and the oligomeric structures. Response surface methodology was employed to optimize the above conditions to produce particle boards with minimum formaldehyde emission and maximum internal bond strength. The studies showed that sequential addition of urea [“the duration between additions” and the “number of additions”] improved the internal bond strength and reduced formaldehyde emission of the particleboards. Detailed resin characterization in terms of the number and weight average molecular weights, molecular weight distribution, polydispersity, percentages of reactive moieties, and interlinking units present in the oligomer could be stipulated. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 103: 2709–2719, 2007     

Metabolites of ebrotidine, a new H2-receptor antagonist, in human urine

The clinical application of ultrasonographic contrast agents in colour Doppler flow imaging of hepatic tumours is receiving increasing attention. Levovist is a suspension of galactose microparticles that provides reproducible concentrations of stabilized air bubbles with transpulmonary stability. Its effect on colour Doppler imaging was assessed in 26 patients with colorectal cancer and histologically proven hepatic metastases. Colour Doppler flow imaging was performed before and after intravenous injection of 10 ml Levovist 300 mg/ml. At 5-10 s after injection there was significant enhancement of the hepatic lesions with colour Doppler signals in 23 patients, lasting for a mean(s.d.) of 180(45) s. A consistent pattern of colour Doppler signal was observed, with increased enhancement predominantly around the tumour periphery and little or no central enhancement. These data suggest that Levovist may increase the sensitivity and specificity of colour Doppler flow imaging of colorectal hepatic metastases.     

Rubberwood–polymer composites based on diallyl phthalate and methyl methacrylate

Wood–polymer composites (WPC) of rubberwood (Hevea brasiliensis), were prepared by impregnating the wood with methyl methacrylate (MMA), and the combinations of MMA and diallyl phthalate (MMA/DAP). Polymerization was carried out by catalyst heat treatment. Impregnated samples showed significant improvements in compressive and impact strengths, hardness, and dimensional stability (toward water) over that the untreated rubberwood. © 1995 John Wiley & Sons, Inc.     

Asbestos in the air of public buildings: a public health risk?

The Environmental Health and Safety Council of the American Health Foundation has examined current estimates of cancer risks associated with the presence of asbestos-containing materials (ACM) in public buildings. The Council finds that even complete removal of asbestos from all of these buildings will provide no measurable benefit to public health. The removal of nonfriable ACM only can be postulated to protect the public against a small hypothetical risk that cannot be measured epidemiologically. Moreover, examination of the assumptions used in the risk assessment calculations leads to the conclusion that these small calculated risks are likely to represent overestimates. In recent surveys, the measured asbestos levels in indoor air cast some doubt on whether occupant exposure to asbestos levels are contributed to significantly by ACM even when some of the material is friable or in bad condition. Furthermore, the models used for cancer risk estimates assume no threshold level for cancer and conclude that any exposure is carcinogenic. This may be unjustified in light of information on the mechanisms for some asbestos-caused disease. Based on the best available data, it is very unlikely that cancer will result from indoor asbestos exposure, especially where ACM is well maintained.     

Qualitative and quantitative analysis and comparison of Java distributed architectures

In this article we have undertaken a qualitative and quantitative comparison of common approaches used to develop distributed solutions in Java: RMI and Web services for regular unsecured communication, RMI‐SSL and WS‐Security for secure communication and authentication, and HTTP‐to‐port and HTTP‐to‐CGI/servlet tunnelling for RMI communication through firewalls and proxies. We have performed a functional comparison that helps with the selection of the most appropriate approach. We have also carried out a detailed performance analysis with the identification of major bottlenecks, identification of design and implementation guidelines for distributed applications, and specification of optimizations for distributed middleware. This article contributes to the understanding of different approaches for developing Java distributed applications, provides detailed performance analysis, presents design and implementation guidelines, and identifies the major performance overheads. Copyright © 2006 John Wiley & Sons, Ltd.