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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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- Viana, M., et al.
(författare)
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Source apportionment of ambient PM2.5 at five Spanish centres of the European Community Respiratory Health Survey (ECRHS II)
- 2007
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Ingår i: Atmospheric Environment. - : Elsevier BV. - 1352-2310 .- 1873-2844. ; 41:7, s. 1395-1406
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Tidskriftsartikel (refereegranskat)abstract
- Fine particulate matter (PM2.5) was sampled at 5 Spanish locations during the European Community Respiratory Health Survey II (ECRHS II). In an attempt to identify and quantify PM2.5 sources, source contribution analysis by principal component analysis (PCA) was performed on five datasets containing elemental composition of PM2.5 analysed by ED-XRF. A total of 4-5 factors were identified at each site, three of them being common to all sites (interpreted as traffic. mineral and secondary aerosols) whereas industrial sources were site-specific. Sea-salt was identified as independent source at all coastal locations except for Barcelona (where it was clustered with secondary aerosols). Despite their typically dominant coarse grain-size distribution, mineral and marine aerosols were clearly observed in PM2.5. Multi-linear regression analysis (MLRA) was applied to the data, showing that traffic was the main source of PM2.5 at the five sites (39-53% of PM2.5, 5.1-12.0 mu g m(-3)), while regional-scale secondary aerosols accounted for 14-34% of PM2.5 (2.6-4.5 mu g m(-3)), mineral matter for 13-31% (2.4-4.6 mu g m(-3)) and sea-salt made up 3-7% of the PM2.5 mass (0.4-1.3 mu g m(-3)). Consequently, despite regional and climatic variability throughout Spain, the same four main PM2.5 emission sources were identified at all the study sites and the differences between the relative contributions of each of these sources varied at most 20%. This would corroborate PM2.5 as a useful parameter for health studies and environmental policy-making, owing to the fact that it is not as subject to the influence of micro-sitting as other parameters such as PM10. African dust inputs were observed in the mineral source, adding on average 4-11 mu g m(-3) to the PM2.5 daily mean during dust outbreaks. On average, levels of Al, Si, Ti and Fe during African episodes were higher by a factor of 2-8 with respect to non-African days, whereas levels of local pollutants (absorption coefficient, S, Pb, Cl) showed smaller variations (factor of 0.5-2).
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| 5. |
- Jacquemin, B, et al.
(författare)
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Association between modelled traffic related air pollution (NO2) and asthma score in ECHRS.
- 2009
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Ingår i: European Respiratory Journal. - : The European Respiratory Society. - 0903-1936 .- 1399-3003. ; 34:4, s. 834-842
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this analysis is to study the association between air pollution and asthma among adults. For this goal, a previously developed "asthma score" was used.Persons aged 25-44 years were randomly selected (1991-1993) and followed up (2000-2002) within the European Community Respiratory Health Survey (ECRHS-I and II). The asthma score was defined from 0 to 5, based on positive answers to symptoms reported for the last 12 months: wheeze/breathlessness, chest tightness, dyspnoea at rest, dyspnoea after exercise, and woken by dyspnoea. Participants' home addresses were linked to outdoor modelled NO2 estimates for 2001. Negative binomial regression was used to model the asthma score.The score from ECRHS-II was positively associated with NO2 (Ratio of the Mean asthma Score (RMS) 1.23, 95% Confidence Intervals (CI): 1.09-1.38 for an increase of 10 microg.m(-3)). After excluding participants with asthma and symptoms at baseline, the association remained (RMS 1.25, 95%CI: 1.05-1.51) and was particularly high among those reporting a high score in ECRHS-II. The latter probably reflects incident cases of asthma.Our results suggest that traffic-related pollution causes asthma symptoms and possibly asthma incidence in adults. The asthma score offers an alternative to investigate the course and aetiology of asthma in adults.
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| 6. |
- Jones, A Wayne, 1945-, et al.
(författare)
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Does consumption of ethanol distort measurements of exhaled nitric oxide?
- 2005
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 99:2, s. 196-199
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Tidskriftsartikel (refereegranskat)abstract
- Background: Measuring FENO is a novel and non-invasive way to monitor airway inflammation (e.g. asthma). This clinical study was designed to investigate whether drinking ethanol might distort FENO measurements. Methods: Twenty healthy subjects drank 0.40 g ethanol/kg body weight in 15 min. Measurement of FENO started ∼ 30 min before drinking and at various times afterwards for 4 h post-dosing. Ethanol concentrations were determined in venous blood by gas chromatography and in end-exhaled breath by infra-red spectrometry. Results: The within subject standard deviation for determination of FENO was 1.3 ppb, corresponding to a CV of 7.7%. The mean change in FENO from pre-drinking levels during the 4 h testing was statistically significant (P
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