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BMC Medical Ethics (1)
The Journal of laboratory and clinical medicine (1)
Aznar, Justo (2)
Broekman, M. Johan (1)
Cosin, Juan (1)
Díez-Domingo, Javier (1)
Lago, Aida (1)
Marcus, Aaron J. (1)
Moscardó, Antonio (1)
Navarro-Illana, Pedro (1)
Piñón, Marta (1)
Sanchez, Elena (1)
Santos, M. Teresa (1)
Vallés, Juana (1)
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Ethical considerations of universal vaccination against human papilloma virus
BMC Medical Ethics
From an epidemiological perspective, the practice of universal vaccination of girls and young women in order to prevent human papilloma virus (HPV) infection and potential development of cervical cancer is widely accepted even though it may lead to the neglect of other preventive strategies against cervical cancer.
It is argued that removing the deterrent effect – the fear of developing cancer – could encourage teenage sex. This paper reflects on the ethical legitimacy of the universal vaccination of girls and young women against HPV infection, especially regarding safety issues, the need to vaccinate people who have opted to abstain from sex, the presumption of early onset of sexual relations, the commercial interests of the companies that manufacture the vaccine, and the recommendation of universal vaccination in males.
Based on the aforementioned information, we believe that the universal vaccination against HPV in young women is acceptable from an ethical point of view, given the medical advantages it presents.
Human papilloma virus; HPV; Universal vaccination; Ethical assessment
Aspirin Therapy for Inhibition of Platelet Reactivity in the Presence of Erythrocytes in Patients with Vascular Disease
Santos, M. Teresa
Broekman, M. Johan
Marcus, Aaron J.
The Journal of laboratory and clinical medicine
Inhibition of erythrocyte (RBC) promotion of platelet reactivity could improve the antiplatelet effect of aspirin (ASA). We tested different ASA regimens for optimal inhibition of platelets and the effects of RBC in patients with a history of vascular diseases. Collagen-induced platelet activation (14C-5HT, TXA2 release) and platelet recruitment (proaggregatory activity of cell-free releasates from activated platelets) were measured in PRP, platelet-RBC (Hct 40%) and whole blood (WB) in 206 patients initially on 200–300 mg ASA/day. Their regimen was modified to bi-weekly 500 mg (loading dose, L) plus daily or twice-daily low-dose ASA (50 or 100 mg). TXA2 was inhibited with all regimens. Percentage of patients with suboptimal inhibition of platelet recruitment in WB was: 200–300 ASA/day (41%), L-50/day (87%), L-100/day (58%), L-50/twice-daily (39%) and L-100/twice-daily (20%; p<0.05 vs. other regimens). 14C-5HT release was inhibited to the greatest extent with L-100/twice-daily in PRP+RBC or WB (p<0.05 vs. other regimens) due to greater inhibition of the RBC prothrombotic effect. Compared to other ASA regimens, L-100 twice-daily (equivalent to 221 mg ASA/day in the 14 day cycle), reduced by >50% the proportion of patients with suboptimal inhibition of platelet recruitment in WB and inhibited 14C-5HT release to the greatest extent.
aspirin; blood cells; platelets; erythrocytes; cardiovascular diseases; cerebrovascular disorders; thrombosis; ADP: adenosine 5′-diphosphate; ASA: acetylsalicylic acid; BID: twice-daily; 14C-5HT: 14C-serotonin; COX-1: cyclooxygenase-1; L: loading dose; OD: daily; PRP: platelet-rich plasma; RBC: erythrocyte; TXA2: thromboxane A2; WB: whole blood
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