Background The INBUILD trial investigated the efficacy and safety of nintedanib versus placebo in patients with progressive fibrosing interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis (IPF). We aimed to establish the effects of nintedanib in subgroups based on ILD diagnosis. Methods The INBUILD trial was a randomised, double-blind, placebo-controlled, parallel group trial done at 153 sites in 15 countries. Participants had an investigator-diagnosed fibrosing ILD other than IPF, with chest imaging features of fibrosis of more than 10% extent on high resolution CT (HRCT), forced vital capacity (FVC) of 45% or more predicted, and diffusing capacity of the lung for carbon monoxide (DLco) of at least 30% and less than 80% predicted. Participants fulfilled protocol-defined criteria for ILD progression in the 24 months before screening, despite management considered appropriate in clinical practice for the individual ILD. Participants were randomly assigned 1:1 by means of a pseudorandom number generator to receive nintedanib 150 mg twice daily or placebo for at least 52 weeks. Participants, investigators, and other personnel involved in the trial and analysis were masked to treatment assignment until after database lock. In this subgroup analysis, we assessed the rate of decline in FVC (mL/year) over 52 weeks in patients who received at least one dose of nintedanib or placebo in five prespecified subgroups based on the ILD diagnoses documented by the investigators: hypersensitivity pneumonitis, autoimmune ILDs, idiopathic non-specific interstitial pneumonia, unclassifiable idiopathic interstitial pneumonia, and other ILDs. The trial has been completed and is registered with ClinicalTrials.gov, number NCT02999178.

Sixty patients (16 children, 44 adults) participated in the study aiming at evaluating: (i) IgG levels when switching patients from intravenous IgG (IVIG) infusions in hospital to subcutaneous (SCIG) self-infusions at home using the same cumulative monthly dose, (ii) protections against infections, and (iii) safety of a new, ready-to-use 16% IgG preparation. All children and 33 adults had received IVIG therapy for >6 months at enrolment. Ten adults who had been on SCIG therapy for many years served as controls. Mean serum IgG trough levels increased in the pre-IVIG children from 7.8 to 9.2 g/L (non-inferiority: p < 0.001) and in the adults from 8.6 to 8.9 g/L (non-inferiority: p < 0.001). Totally 114 respiratory tract infections occurred, 90% of them mild. One serious bacterial infection (pneumonia) was reported for one adult. The annualized rate of serious infections was 0.04 episodes/patient. In total 2297 infusions were given and 28 (1%) systemic adverse reactions occurred, none of them severe. Local tissue reactions declined over time, this being particularly distinct after 8 to 10 weeks. In conclusion, the SCIG administration route was safe. High IgG levels were easily maintained resulting in a very good protection against infections.

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Ceftaroline fosamil demonstrated high clinical cure and microbiological response rates in hospitalized patients with CAP of PORT risk class III or IV. Ceftaroline fosamil was well tolerated, with a safety profile similar to that of ceftriaxone and consistent with the cephalosporin class. In this study, ceftaroline fosamil was an effective and well-tolerated treatment option for CAP.

Benzoxazinones are naturally occurring secondary metabolites of some Gramineae plants, responsible for their resistance to some pathogenic fungi and for their allelopathic action. Six varieties of winter wheat grown in fields under organic or conventional systems and 11 old accessions were tested for two consecutive seasons and three plant development stages for the concentration in their roots of cyclic hydroxamic acids and their degradation products. This is the first report of six benzoxazinones analyzed in plants grown in the field. An analytical technique employing LC-DAD was used for determination. It was shown that 2,4-dihydroxy-7-methoxy-1,4-benzoxazin-3-one, its degradation product 6-methoxybenzoxazolin-2-one, and the lactam 2-hydroxy-7-methoxy-1,4-benzoxazin-2-one were predominant compounds in all tested samples. Their concentrations significantly differed with plant development stage and season, but no significant differences were found between varieties and between plant cultivation systems. The concentrations of 2,4-dihydroxy-1,4-benzoxazin-3-one (DIBOA) and its degradation product benzoxazolin-2-one (BOA) were much lower, ranging from 60 to 430 mg/kg of dry matter, depending on accession, stage of development, and season. There was no significant difference found between plants grown in different cultivation systems, but there were significant differences between old and new varieties; concentrations of DIBOA and its derivatives were significantly lower in old accessions. It was concluded that the concentrations of DIBOA and BOA, which are precursors of highly fungicidal 2-aminophenol, 2-amino-3H-phenoxazin-3-one, and 2-acetylamino-3H-phenoxazin-3-one, are theoretically high enough to protect plants against some soilborne pathogens.

Wojciech J. Piotrowski et al., Diagnosis and treatment of idiopathic pulmonary fibrosis 43 www.journals.viamedica.pl

The aim of this study was to compare the effect of organic and conventional management systems on total porosity, water and ethanol sorptivity, repellency index, and tensile strength of soil aggregates. Two size fractions of soil aggregates (15-20 and 30-35 mm) were collected from the 0-10 and 10-20 cm depths. Data on water and ethanol sorptivities of the initially air-dry soil aggregate fractions were obtained from the steady state flow measurements using an infiltration device. Water repellency was identified by the ethanol/water sorptivity method. The total porosity was higher in aggregates from the conventionally than organically managed soil irrespective of soil layer or aggregate size. Infiltration and sorptivity of ethanol (60 mm3) were faster under the conventional than organic management irrespective of aggregate size and depth. Infiltration and sorptivity of water in 30-35mmaggregates were greater under organic than conventional management. The repellency index was mostly higher for the conventional management of soil and for agregates 30-35 than 15-20 mm in each management system. Aggregate crushing strength was in most cases greater under the organic than conventional management and could increase resistance to compaction and carbon sequestration under the former.