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BACKGROUND AND OBJECTIVES: The 9-valent human papillomavirus (9vHPV) vaccine Phase III immunogenicity study in 9- to 15-year-old boys and girls was extended to assess immunogenicity and effectiveness through 10 years after the last vaccine dose (NCT00943722). METHODS: Boys (n = 301) and girls (n = 971) who received three 9vHPV vaccine doses in the base study (day 1, months 2 and 6) enrolled in the extension. Serum was collected through month 126 for antibody assessments by competitive Luminex immunoassay and immunoglobulin G-Luminex immunoassay. For effectiveness analysis starting at age 16 years, genital swabs were collected (to assess HPV DNA by polymerase chain reaction) and external genital examinations conducted every 6 months. Primary analyses were conducted in per-protocol populations. RESULTS: Geometric mean antibody titers peaked around month 7, decreased sharply between months 7 and 12, then gradually through month 126. Seropositivity rates remained ≥81% by competitive Luminex immunoassay and ≥95% by immunoglobin G-Luminex immunoassay at month 126 for each 9vHPV vaccine type. After up to 11.0 (median 10.0) years of follow-up postdose 3, there were no cases of HPV6/11/16/18/31/33/45/52/58-related high-grade intraepithelial neoplasia or condyloma in males or females. Incidence rates of HPV6/11/16/18/31/33/45/52/58-related 6-month persistent infection in males and females were low (54.6 and 52.4 per 10000 person-years, respectively) and within ranges expected in vaccinated cohorts, based on previous human papillomavirus vaccine efficacy trials. CONCLUSIONS: The 9vHPV vaccine demonstrated sustained immunogenicity and effectiveness through ∼10 years post 3 doses of 9vHPV vaccination of boys and girls aged 9 to 15 years.

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OBJECTIVE: Body fat distribution may be a stronger predictor of metabolic risk than BMI. Yet, few studies have investigated secular changes in body fat distribution in middle-income countries or how those changes vary by socioeconomic status (SES). This study evaluated changes in body fat distribution by SES in Colombia, a middle-income country where BMI is increasing rapidly. DESIGN: We applied factor analysis to previously published data to assess secular changes in adiposity and body fat distribution in cross-sectional samples of urban Colombian women. Anthropometry was used to assess weight, height and skinfolds (biceps, triceps, subscapular, suprailiac, thigh, calf). SETTING: Cali, Colombia. PARTICIPANTS: Women (18-44 years) in 1988-1989 (n 1533) and 2007-2009 (n 577) from three SES groups. RESULTS: We identified an overall adiposity factor, which increased between 1988-1989 and 2007-2008 in all SES groups, particularly in the middle SES group. We also identified arm, leg and trunk adiposity factors. In all SES groups, leg adiposity decreased, while trunk and arm adiposity increased. CONCLUSIONS: Factor analysis highlighted three trends that were not readily visible in BMI data and variable-by-variable analysis of skinfolds: (i) overall adiposity increased between time periods in all SES groups; (ii) the adiposity increase was driven by a shift from lower body to upper body; (iii) the adiposity increase was greatest in the middle SES group. Factor analysis provided novel insights into secular changes and socioeconomic variation in body fat distribution during a period of rapid economic development in a middle-income country.

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OBJECTIVES: We conducted stable isotope and dietary analyses of women from higher and lower socioeconomic status (SES) groups in Cali, Colombia. The objectives were to test between-group differences in stable isotope, dietary, and anthropometric characteristics, and to evaluate relationships between diet and stable isotope values. METHODS: Hair samples from 38 women (mean age 33.4) from higher and lower SES groups were analyzed for δ(13) C, δ(15) N, and δ(34) S values. Dietary intake was assessed via 24-h recalls. Anthropometric variables measured were body mass index, five body circumferences, and six skinfold thicknesses. RESULTS: Mean δ(13) C and δ(15) N values of the higher SES group (-16.4 and 10.3‰) were significantly greater than those of the lower SES group (-17.2 and 9.6‰; P < 0.01), but mean δ(34) S values did not differ significantly between groups (higher SES: 4.6‰; lower SES: 5.1‰). The higher SES group consumed a greater percentage of protein than the lower SES group (14% vs. 12% of energy; P = 0.03), but the groups did not differ in other dietary characteristics or in anthropometric characteristics. δ(13) C, δ(15) N, and δ(34) S values were not correlated with intake of the dietary items predicted (sugars, animal-source protein, and marine foods, respectively). The lower SES group was more variable in all three stable isotope values (P < 0.05), mirroring a trend toward greater dietary variability in this group. CONCLUSIONS: Stable isotope values revealed a difference between SES groups that was not explained by the dietary data. The relationship between diet and stable isotope composition is complex.

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OBJECTIVES: To quantify changes in the diets of low-income women in Cali, Colombia between 1990-1995 and 2008, a period of increases in body size, and to situate these changes within national-level trends in food availability, as well as to compare these changes with those expected in countries undergoing a nutrition transition. METHODS: Individual dietary intake was assessed via 24-hour recalls in both 1990-1995 (n = 85) and 2008 (n = 88). Dietary data were analyzed for intake of energy, macronutrients, and specific food items. National-level trends in food availability were evaluated using data from the Food and Agriculture Organization. RESULTS: Total energy and protein intake did not change over time, but in 2008 women consumed proportionally more fat (23.0 vs. 19.1% of calories; P = 0.002) and less carbohydrate (66.5 vs. 71.0% of calories; P < 0.001) than in 1990-1995. The increased fat consumption is attributable to vegetable oils. This increase in vegetable oil consumption, and a decrease in starchy vegetable consumption, fit with both national-level trends in food supply, and the expectations of a nutrition transition. On the other hand, the increased consumption of non-starchy vegetables, and the stability in consumption of added sugars and animal-source proteins was contrary to the expectations of a nutrition transition. CONCLUSIONS: The changes in diet among low-income women in Cali, Colombia between 1990-1995 and 2008 partially match national-level trends in food supply and the theoretical expectations of a nutrition transition, but are nonetheless a localized phenomenon. They do not help explain concurrent changes in body size.

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Adult stature variation is commonly attributed to differential stress-levels during development. However, due to selective mortality and heterogeneous frailty, a population's tall stature may be more indicative of high selective pressures than of positive life conditions. This article examines stature in a biocultural context and draws parallels between bioarchaeological and living populations to explore the multidimensionality of stature variation in the past. This study investigates: 1) stature differences between archaeological populations exposed to low or high stress (inferred from skeletal indicators); 2) similarities in growth retardation patterns between archaeological and living groups; and 3) the apportionment of variance in growth outcomes at the regional level in archaeological and living populations. Anatomical stature estimates were examined in relation to skeletal stress indicators (cribra orbitalia, porotic hyperostosis, linear enamel hypoplasia) in two medieval bioarchaeological populations. Stature and biocultural information were gathered for comparative living samples from South America. Results indicate 1) significant (P < 0.01) differences in stature between groups exposed to different levels of skeletal stress; 2) greater prevalence of stunting among living groups, with similar patterns in socially stratified archaeological and modern groups; and 3) a degree of regional variance in growth outcomes consistent with that observed for highly selected traits. The relationship between early stress and growth is confounded by several factors-including catch-up growth, cultural buffering, and social inequality. The interpretations of early life conditions based on the relationship between stress and stature should be advanced with caution.

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OBJECTIVE: Describe factors associated with aggressive forms of recurrent respiratory papillomatosis (RRP). MATERIALS AND METHODS: One hundred eighty-nine RRP cases diagnosed between 1985 and 2009 were identified in pathological records. HPV was detected by the SPF-10 method with broad spectrum primers, (version 1). RESULTS: 113 patients had only one surgery (less aggressive) and 76, two or more interventions (more aggressive). The likelihood of aggressive lesions decreased with increasing age at diagnosis and HPV-11 was associated with no significant increase in the risk of aggressiveness. CONCLUSIONS: The age at diagnosis was the main determinant of RRP aggressiveness.

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Objective. Describe factors associated with aggressive forms of recurrent respiratory papillomatosis (RRP). Materials and methods. One hundred eighty-nine RRP cases diagnosed between 1985 and 2009 were identified in pathological records. HPV was detected by the SPF-10 method with broad spectrum primers, (version 1). Results. 113 patients had only one surgery (less aggressive) and 76, two or more interventions (more aggressive). The likelihood of aggressive lesions decreased with increasing age at diagnosis and HPV-11 was associated with no significant increase in the risk of aggressiveness. Conclusions. The age at diagnosis was the main determinant of RRP aggressiveness.

Objetivo. Describir factores asociados con formas agresivas de papilomatosis respiratoria recurrente (PRR). Material y métodos. Se identificaron 189 casos de PRR diagnosticados entre 1985-2009 en registros patológicos. VPH fue detectado por el método SPF-10 con cebadores de amplio espectro, (versión 1). Resultados. 113 casos presentaron una intervención quirúrgica (menos agresivas) y 76, dos o más intervenciones (más agresivas). La probabilidad de lesiones agresivas disminuyó con el aumento de la edad al momento del diagnóstico y el VPH-11 se asoció con aumento no significativo del riesgo de agresividad. Conclusiones. La edad al momento del diagnóstico fue el principal determinante de la agresividad de PRR.

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OBJECTIVES: Ongoing social and economic changes in developing countries are associated with increases in body size, and most notably increases in the prevalence of obesity. The social patterning of these changes in terms of socioeconomic status (SES) is not well documented. The aim of this study was to assess the changes in stature, body mass index (BMI) and fatness in adult women in urban Cali, Colombia between 1988-1989 and 2007-2008. METHODS: We compared the results of anthropometric surveys completed in 1988-1989 and 2007-2008 of nonpregnant, nonlactating women, 18-44 years of age. Samples in both studies were stratified by SES. We calculated age-standardized prevalence rates to assess time trends in obesity. Body fatness was assessed by skinfold thicknesses. RESULTS: Stature increased in all SES groups and remained positively associated with SES. BMI increased only in the lower SES group, from 24.4 to 25.9 kg/m(2) and remained negatively associated with SES. The age-standardized prevalence of obesity increased from 7.9 to 17.0% in the lower SES group, but only from 4.5 to 8.2% in the middle SES group, and was unchanged in the upper SES group. Body fatness increased in all SES groups, but only in the upper body. CONCLUSION: The increased stature in all SES groups is indicative of general improvements in socioeconomic conditions. The increased prevalence of obesity in the lower SES groups is in keeping with the findings in other middle-income developing countries.

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