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- Villa, Luisa L., et al.
(författare)
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Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions
- 2007
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Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 356:19, s. 1915-1927
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Human papillomavirus types 16 (HPV-16) and 18 (HPV-18) cause approximately 70% of cervical cancers worldwide. A phase 3 trial was conducted to evaluate a quadrivalent vaccine against HPV types 6, 11, 16, and 18 (HPV-6/11/16/18) for the prevention of high-grade cervical lesions associated with HPV-16 and HPV-18. METHODS: In this randomized, double-blind trial, we assigned 12,167 women between the ages of 15 and 26 years to receive three doses of either HPV-6/11/16/18 vaccine or placebo, administered at day 1, month 2, and month 6. The primary analysis was performed for a per-protocol susceptible population that included 5305 women in the vaccine group and 5260 in the placebo group who had no virologic evidence of infection with HPV-16 or HPV-18 through 1 month after the third dose (month 7). The primary composite end point was cervical intraepithelial neoplasia grade 2 or 3, adenocarcinoma in situ, or cervical cancer related to HPV-16 or HPV-18. RESULTS: Subjects were followed for an average of 3 years after receiving the first dose of vaccine or placebo. Vaccine efficacy for the prevention of the primary composite end point was 98% (95.89% confidence interval [CI], 86 to 100) in the per-protocol susceptible population and 44% (95% CI, 26 to 58) in an intention-to-treat population of all women who had undergone randomization (those with or without previous infection). The estimated vaccine efficacy against all high-grade cervical lesions, regardless of causal HPV type, in this intention-to-treat population was 17% (95% CI, 1 to 31). CONCLUSIONS: In young women who had not been previously infected with HPV-16 or HPV-18, those in the vaccine group had a significantly lower occurrence of high-grade cervical intraepithelial neoplasia related to HPV-16 or HPV-18 than did those in the placebo group.
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| 2. |
- Koefoed-Nielsen, J, et al.
(författare)
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Maximal hysteresis : a new method to set positive end-expiratory pressure in acute lung injury?
- 2008
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 52:5, s. 641-649
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Tidskriftsartikel (refereegranskat)abstract
- Background: No methods are superior when setting positive end-expiratory pressure (PEEP) in acute lung injury (ALI). In ALI, the vertical distance (hysteresis) between the inspiratory and expiratory limbs of a static pressure–volume (PV) loop mainly indicates lung recruitment. We hypothesized that PEEP set at the pressure where hysteresis is 90% of its maximum (90%MH) would give similar oxygenation, but less cardiovascular depression than PEEP set at the pressure at lower inflection point (LIP) on the inspiratory limb or at the point of maximal curvature (PMC) on the expiratory limb in ALI. Methods: In 12 mechanically ventilated pigs, ALI was induced in a randomized fashion by lung lavage, lung lavage plus injurious ventilation, or by oleic acid. From a static PV loop obtained by an interrupted low-flow method, the pressures at LIP [25 (25, 25) cmH2O, mean and 25, 75 percentiles], at PMC [24 (20, 24) cmH2O], and at 90% MH [19 (18, 19) cmH2O] were determined and used for the PEEP-settings. We measured lung inflation (by computed tomography), end-expiratory lung volume (EELV), airway pressures, compliance of the respiratory system (Crs), blood gases, cardiac output and arterial blood pressure. Results: There were no differences between the PEEP settings in EELV or oxygenation, but the 90%MH setting gave lower end-inspiratory pause pressure (P<0.025), higher Crs (P<0.025), less hyper-aeration (P<0.025) and better maintained hemodynamics. Conclusion: In this porcine lung injury model, PEEP set at 90% MH gave better lung mechanics and hemodynamics, than PEEP set at PMC or LIP.
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| 3. |
- Lunde, J., et al.
(författare)
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Ion-dispersion and rapid electron fluctuations in the cusp : a case study
- 2008
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Ingår i: Annales Geophysicae. - 0992-7689 .- 1432-0576. ; 26:8, s. 2485-2502
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Tidskriftsartikel (refereegranskat)abstract
- We present results from co-ordinated measurements with the low altitude REIMEI satellite and the ESR (EISCAT Svalbard Radar), together with other ground-based instruments carried out in February 2006. The results mainly relate to the dayside cusp where clear signatures of so-called ion-dispersion are seen in the satellite data. The cusp ion-dispersion is important for helping to understand the temporal and spatial structure of magnetopause reconnection. Whenever a satellite crosses boundaries of flux tubes or convection cells, cusp structures such as ion-dispersion will always be encountered. In our case we observed 3 distinct steps in the ion energy, but it includes at least 2 more steps as well, which we interpret as temporal features in relation to pulsed reconnection at the magnetopause. In addition, fast variations of the electron flux and energy occurring during these events have been studied in detail. The variations of the electron population, if interpreted as structures crossed by the REIMEI satellite, would map near the magnetopause to similar features as observed previously with the Cluster satellites. These were explained as Alfven waves originating from an X-line of magnetic reconnection.
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