Human papillomavirus 9-valent vaccine for cancer prevention: a systematic review of the available evidence.

In 2014, the Food and Drug Administration approved a new human papillomavirus 9-valent vaccine (9vHPV), targeting nine HPV types: HPV types 6, 11, 16, and 18, which are also targeted by the quadrivalent HPV vaccine (qHPV), plus five additional high cancer risk HPV types (HPV types 31, 33, 45, 52, and 58). The aim of the current study was to systematically retrieve, qualitatively and quantitatively pool, as well as critically appraise all available evidence on 9vHPV from randomized controlled trials (RCTs). We conducted a systematic review of the literature on 9vHPV efficacy, immunogenicity and safety, as well as a systematic search of registered, completed, and ongoing RCTs. We retrieved and screened 227 records for eligibility. A total of 10 publications reported on RCTs' results on 9vHPV and were included in the review. Sixteen RCTs on 9vHPV have been registered on RCT registries. There is evidence that 9vHPV generated a response to HPV types 6, 11, 16 and 18 that was non-inferior to qHPV. Vaccine efficacy against five additional HPV type-related diseases was directly assessed on females aged 16-26 years (risk reduction against high-grade cervical, vulvar or vaginal disease = 96·7%, 95% CI 80·9%-99·8%). Bridging efficacy was demonstrated for males and females aged 9-15 years and males aged 16-26 years (the lower bound of the 95% CIs of both the geometric mean titer ratio and difference in seroconversion rates meeting the criteria for non-inferiority for all HPV types). Overall, 9vHPV has been proved to be safe and well tolerated. Other RCTs addressed: 9vHPV co-administration with other vaccines, 9vHPV administration in subjects that previously received qHPV and 9vHPV efficacy in regimens containing fewer than three doses. The inclusion of additional HPV types in 9vHPV offers great potential to expand protection against HPV infection. However, the impact of 9vHPV on reducing the global burden of HPV-related disease will greatly depend on vaccine uptake, coverage, availability, and affordability.

The Lorenzini Foundation in a changing scenario of patient management.

The loss of life, disability, and economic burden attributed to cardiovascular disease (CVD) in Europe has created an urgent need for all stakeholders in CVD prevention to partner together to address the barriers in local health policy and produce effective programs in individual and population risk reduction and rational use of health services. Countries have a legal and moral obligation to achieve the highest standard of CV health care for citizens and to improve national health care systems accordingly. As part of a vision for future potential opportunities in CVD prevention, the Lorenzini Foundation would like to raise awareness of several key areas among the European authorities: Integration of interventions aimed at several risk factors within an individual country's health care system; implementation of a comprehensive approach combining policy development, capacity building, partnership and information support at all levels; promotion of transversal health policies, including coordinated action outside of the health sector to address major determinants of ill health; a combination of health policy and high-risk strategies to link health promotion, public health services, primary care, and hospital care; and, finally, reduction in ethnic, cultural, socioeconomic, and gender inequalities to multiple risk factor management among and within countries through use of cost-effective medications and medical technologies.

Accuracy of body weight prediction in Alpine ibex (Capra ibex, L. 1758) using morphometry.

The relationship between weight and body measurements of 227 Alpine ibex Capra ibex (162 males and 65 females, age range: 2-16 years) were analysed by linear and multiple regression. The animals were live-captured across all seasons of the year, in the Western Italian Alps, 1986-1994. The relationship between weight and body measurements changed with sex and season. In male ibex, the best annual estimation of the body weight was obtained using as predictor variables the squared value of the chest girth and age. In females, the best predictive variables were age, total body length and withers height. Age was always selected as a predictor variable, when considered in the prediction models. The use of chest girth and the squared value of the chest girth as predictive variables in the regression equation, being the most highly correlated linear measurements with total weight, did not result in an accurate prediction of ibex body weight. The best prediction was obtained using age and different linear measurements in stepwise multiple regression, nevertheless the standard error of the estimate and the magnitude of the 95% prediction interval were great. The use of linear measurements cannot be considered accurate nor precise predictors of body weight in Alpine ibex.

An integrated system for the automation of the clinical chemistry laboratory.

A user programmable microcomputer-based integrated system for automatic analysis in the clinical chemistry laboratory is presented. Friendly user-instrument interaction helps the operator when defining tests and analytical conditions or entering sample data and test requests. Quality control data are retained for the automatic production of various statistical lists and graphs. Routine operator intervention is limited to reagent preparation, sample loading onto the autosampler plate, definition of the tests to be performed on each of the samples and data validation before the generation of reports. Finally, connection with an existing laboratory management system is provided by means of a standard serial interface.

Multivariate statistical analysis of quantitative serum protein data in populations of Rwanda.

Data on serum protein levels of four populations from Rwanda were analyzed by multivariate statistical methods to assess their utility as an anthropological tool. These populations consisted of two ethnic groups in two different environments. Seven proteins were considered in the analysis. The total concentration of proteins is intermediate between Italian levels and those of the Binga pygmies of the Republic of Central Africa (RCA). Discrimination between the populations was possible with a 25% misclassification. The major principal components can be interpreted from a medical viewpoint, and show significant differences between the populations.

Development and improvement of a commercial uric acid enzymatic determination kit on a centrifugal fast analyzer.

The performance of a uric acid determination kit has been evaluated for five months, under routine conditions, in a General Hospital Biochemical Laboratory. An anomalous increment in fresh serum blanks was noted in the kit when first introduced. This interference, probably due to alcohol dehydrogenase contamination, was corrected by addition of 50 mmol/l (NH4)2SO4 to the reagent. Results obtained with this modified reagent correlate perfectly with those obtained with modified kits by Smith Kline Instruments (SKI), and with many other determination methods. Correlations are discussed and explanations for differences in statistical data are offered. Within run and between run precision data are presented. The kit fits perfectly with the needs of centrifugal fast analyzers and discrete micro analyzers, on account of its speed, reliability and precision.

Parasite-reactive serum IgE antibodies in African populations. Relation to intestinal parasite load.

Serum IgE levels and IgE antibodies against four intestinal parasites, and the presence and abundance of parasites in stool samples were investigated in 161 Rwanda natives. Most of the IgE turn out to be helminth-reacting antibodies. The stimulation and production of these antibodies are much different from those of anti-amoeba antibodies in their relation to the specific intestinal parasite load; helminth infestations seem to play a major role in the development of anti-amoeba antibodies as well.

Relationship between serum IgE levels and intestinal parasite load in African populations.

Serum IgE determinations and coproparasitological analyses were carried out on 161 individuals from two distinct ethnic groups (Hutus and Twas) from two regions in Rwanda (North and South). The cumulative parasitosis index (calculated for each individual as the sum of the scores for the four most frequent intestinal parasites) show a linear relation with IgE levels up to a plateau, with no clear pattern of correlation between the score for any given parasite and the IgE level. Such a direct quantitative (but not qualitative) relation reproposes the question on the role of IgE immunoglobulins in intestinal parasitoses.

Serum protein levels as anthropological markers: a statistical analysis in Binga Pygmies and Italians.

Data on serum protein levels in Binga Pygmies are presented, and these are compared with the levels in healthy Italians and in Italians suffering from liver diseases. Principal Component Analysis carried out on the three groups points out similarities in protein levels between the Pygmies and the Italian Hepatopaths on one hand and between healthy and liver diseased Italians on the other. Discriminant Analyses reveal the important differences between the populations. It is suggested that such analyses of protein levels could serve as tools in population biology.

[Critical observations on changes in gamma-glutamyl-transpepdidase in hepatopathies]. / Osservazioni critiche sulle modificazioni della gamma-glutamil transpeptidasi nelle epatopatie

The behaviour of gamma-glutamyl transpeptidase was compared with other serum enzyme activities and functional parameters in a carefully selected and relatively extensive series of patients with liver disease, including alcoholics, in an investigation of the underlying pathogenesis and its clinical expression. Reference. to the literature and to personal data showed that increased gamma-glutamyl transpeptidase levels could be attributed to enzyme induction (caused by drugs or alcohol), liver damage in the broad sense, and intra- or extrahepatic cholestasis. These causes were individually predominant, or nearly so, on occasions, though their concomitance was more common. High levels, however, were not pathognomonic for a given disease. In alcoholism, they were highly indicative, especially if accompanied by GLD changes. They were a virtually constant, early, and typical finding in intra- and extra-hepatic cholestasis, and tended to persist for a time after the resolution of icterus. Lastly, they were an aid in the early diagnosis of aggressive hepatitis and liver cancer.