Human Papilloma Virus Vaccine

Human Papilloma Virus Vaccine human papilloma virus vaccine Abstract Identifying human papilloma viruses related to the pathogenesis of cancer cervix and producing vaccines against them offered hopes for primary prevention of cancer cervix. Understanding the virus and the natural history of HPV infection recommends the use of the vaccine. However; debates on the compulsory use of the vaccine for young age females delays the legislations needed. The aim of this essay is to review, briefly, HPV vaccination and spotlight the debate about how important it is as a preventive measure against cancer cervix. Introduction In 1842, Rigoni Stern presented his observation that nuns never get cervical cancer to the 4th Congress of Italian Scientists. This pointed out the possibility that sexually transmitted infection may be the cause of cervical cancer (Harper, 2004). Since then, many types of human papilloma virus (HPV) were identified to cause certain human diseases. The most serious health problem with HPV is that it is an important causative agent for cancer cervix (types 6, 11, 16, 18) (Bishop and others, 2007). Virus transmission occurs through sexual contact and infection may give no symptoms (silent infection). HPV infection is the commonest sexually transmitted infection in the US, by the age of 50, 80% of women in the US have had the chance to catch infection (National Cancer Institute 2006). I support giving HPV vaccine to females between the ages of 9 to 26 because of the possible serious outcome of HPV infection; as recommended by the Advisory Committee on Immunization Practices (ACIP) on Ju ne 2006 (ACIP 2006). Therefore; my essay is directed to parents and young sexually active females to spotlight how serious the consequences of human papilloma virus infection can be and how important is their support to HPV vaccination. Background Papilloma virus is a double strand circular DNA virus. The epithelial cells in certain tissues as the skin and the ano-genital tract are the target cells of infection are. Papilloma virus capsids (outside capsule like envelop around the virus DNA) contain two characteristic proteins (virally encoded proteins) called L1 and L2. These virally encoded proteins develop late in the infection cycle. These capsids are made of protein with L1 proteins having the intrinsic ability of self-assembly forming virus like particles (VLP) which are, in fact, empty capsids. The use of VLPs as a vaccine is because they are similar, immunologically, to the infecting virus (Bishop and others 2007). The question now is what happens when HPV infection occurs? The natural course (sequence of events) of infection takes three forms (Harper 2004). The first form is episomal infection (virus-latency or latent period of HPV infection). The virions (small virus particles) transmitted from one epithelial surface (superficial cells) become attached to another epithelial surface. Virions, then, find its way to the deeper (basal) cells. Characteristic to this stage is the association with low virus copy numbers and that is the reason for missing HPV in routine histo-pathological scrapping examination. The second form is when the virus genome (DNA) copies itself faster than the host cell DNA. In this stage, the epithelium may show some metaplasia (cell character or order change). The third form occurs when high risk virus genome incorporates with basal cell DNA with the release of precancerous substances (CIN) (Harper 2004). Cervical cancer is the third cancer that affects the female genital tract in the US (after cancer ovary and carcinoma of the uterine endometrium). It is the eighth cancer if we look to all body organs. The incidence of cervical cancer shows ethnic variations, in American white females, the incidence is 8.6 each 100.000. In African-American females, it incidence is 13 each 100.000. In Asian-American females, it is 9.3 by 100.000, while in Hispanic (Latino) females; the ratio is 14.7 each 100.000. The main reasons which predispose to cancer cervix are; practicing sexual activity at an early age, multiple sexual partners, persistent infection with papilloma virus and cigarette smoking. The major factor affecting prognosis is early detection since the 5 years survival rate is 48% when discovered in late stages. The 5 years survival rate of preinvasive (early) cases is near 100% (Benedet and others 2001). A quadrivalent HPV vaccine (types 6, 11, 16, 18) developed, recently, and approved by the FDA (Food and Drug Administration) in June 2006. According to FDA report in 2006, it is a significant step forward to prevent female HPV infection which is an important reason for developing cancer cervix (FDA News 2006). The vaccine is prepared from virus like particles (VLP) which lack DNA and therefore non infective combined with an adjuvant. The dose of vaccine is three intramuscular 0.5 ml doses with intervals of two months after the first dose and six months after the second (Cutts and others 2007). The vaccine is recommended for females nine to 26 years old. Females of young age are vaccinated because it is important to give them the vaccine before sexual activity. Parent should be acknowledged that the vaccine is only prophylactic and will not prevent the disease caused by any type of HPV if infection with that type has already occurred. Pregnant females are discouraged of taking the vac cine as its impact on the unborn fetus needs further studies. Any female who is mildly ill can still get the vaccine, but those who are moderately or severely ill should postpone the dose till they recover. Finally, those with known history of allergy to yeast (adjuvant) or to a previous dose of the vaccine should get the vaccine or following doses (ACIP 2006). Discussion Cons: The debate against HPV vaccine is on four main issues. First, knowing that health care authorities encourage HPV; should legislations be made to make the vaccine a school mandate? HPV is not a causal or droplet infection such as measles or pertussis. It needs practices that are not usual at schools at such a young age. Therefore; there is no immediate need to give the vaccine as a preschool requirement. The right of parents to refuse vaccinating their daughters is the second issue. Third, is cost-effectiveness, as the price of the three doses is 360 US$, this raises the question of funding compulsory schoolgirls vaccination. Finally, as there is no vaccine that is safe or effective, should not we wait for further confirming studies (Weber 2007)? HPV vaccine side effects range from mild to severe. Mild side effects include: pain at the site of injection (80%), redness or swelling at the site of injection (25%), mild fever (10%) and itching at the injection site (3.3%). Moderate fever i.e. 102 F occurs in 1 female vaccinated by 65. Severe risk may develop because of severe allergic reactions (ACIP 2006). However; HPV vaccine does not have a therapeutic effect on a female that have the virus nor can it prevent the disease caused by that virus (ACIP 2006). The routine screening using Papinicolaou (pap) test to detect cervical precancer lesions succeeded in reducing the overall decrease in cervical cancer incidence by 70% over the last 50 years (Guido 2004). Dungan, 2007, argues that it is better to educate women on safe sex and abstinence. Yearly pap test should not be discouraged. It might be better to improve these two lines than to provide a vaccine without being aware its long-term effects or for how long does it provide protection against the virus. Pros: Epidemiological studies show that nearly 20 million men and women are infected with HPV in the US. Additionally about 6.2 million get infected each year, and 50% of sexually active men and women are HPV infected. Although HPV infection may cause no symptoms, yet infection is important for developing cancer cervix. Cancer cervix affect 10000 women in the US every year of them 3700 die of it (ACIP 2006). HPV vaccine is effective against two viruses blamed for about 70% of cases showing malignant transformation of cells (type 16, 18) and two more viruses that cause about 90% of benign genital warts (CIAP 2006). The vaccine is made of VLPs devoid of DNA and thus is not capable of producing a disease. The vaccine does not cause serious or life threatening side effects (CIAP 2006). In addition, the vaccine is expected to give long term immunity (good immune memory) and therefore, it is likely to provide long-term protection (Stanley 2007). The vaccine is expensive, yet the cost of treatment of cancer cervix is much higher. Studies showed that if the vaccine is effective against HPV type 16, 18 only, being immune saves 15.000 to 25000 US$. In addition, the US Health Department provides vaccination at minimum or no charge for those who cannot afford it (ACIP 2006). The prospects of HPV vaccination are notable. FDA approved the vaccine (FDA 2006) and both the Advisory Committee on Immunization Practices (ACIP 2006) and the National Cancer Institute (2006) advise giving it to females between 9 to 26 years old. For a successful introduction of the vaccine, nationwide, there is the need for support of policy decision makers, healthcare professionals and the public specially parents and sexually active females. Therefore; essential communication strategies are essential for a successful HPV vaccine program. Conclusion Human papilloma virus vaccine contributes to improving the incidence of cervical cancer. Sex education and regular screening have proved relatively effective in preventing cancer cervix. However, complying of all sexually active females to these measures is questionable. A decision of approving HPV vaccine is a decision of saving lives. For better efficacy, the vaccine has to be given before the age of sexual activity. Therefore; filling the communication gap with parents is important. Making it mandatory needs state legislations which in turn need discussion with healthcare workers to solve the issues delaying legislations making the vaccine affordable to anyone irrespective of their social or economic status. References Harper, D.M (2004). Why am I scared of HPV (Editorial). CA Cancer J Clin, 54, 245-247. Bishop, B, Dasgupta, J, Klein, M, Garcea, R.L et al (2007). Crystal Structures of four types of human papilloma virus L1 capsid proteins. J. Biol. Chem., 43, 31803-31811. National Cancer Institute (2006). HPV- Vaccine: Question and answers for the public. Retrieved 02/07/2008, from Advisory Committee on Immunization Practices (ACIP) (2006).HPV (human papilloma virus) vaccine: What you need to know. Retrieved 02/07/2008, from Howe, H.L, Wu, X., Ries, L.A et al (2006). Annual report to the nation on the status of cancer 1975-2003 featuring cancer among US Hispanic/Latino populations. Cancer, 107, 1643-1658. Benedet, J.L, Odicino, F, Maisonneuve, P et al (2001). Carcinoma of the cervix uteri. J Epidemiol Biostat, 6 (1), 7-43. FDA News (June 8, 2006). FDA Licenses New Vaccine for Prevention of Cervical Cancer and Other Diseases in females caused by human papilloma virus. US Food and Drug Administration, News. Retrieved 02/07/2008, from . Cutts, F.T, Franceschi, S, Goldie, X et al (2007). Human papilloma virus and HPV vaccines: a review. Bulletin of the World Health Organization, 85, 719-726. Weber, C.J (2007). Update on vaccination against human papilloma virus (HPV). Urologic Nursing, 27 (4), 320-321. Guido, R (2004). Guidelines for screening and treatment of cervical disease in the adolescent. J pediatr Adolesc Gynaecol, 17, 303-311. Dungan, D (2007). Pros and cons of HPV vaccine debate: Gardasil remains controversial despite FDA approval. Idaho Mountain Express. Retrieved 02/07/2008 from Stanley, M (2007). Prophylactic HPV vaccines. Journal of Clinical Pathology, 60, 961-965.

General course on philosophy Essay

The world is comprised of various types of personalities and my personal experience can attest to that. My class is composed of young male and female adults of varying shapes, sizes, heights and colors. During class, I could also imagine that our instructor would perceive us as a sea of hues, all blending together within the space of the classroom. If our instructor did not focus of each one of our faces, it would be impossible for him to differentiate each one of us because we get along well enough to proceed and complete each classroom meeting. Despite the nature of viscosity of our identities, there are also times when certain members of our class would go to opposite directions, especially when philosophical concepts are being discussed. When our instructor would present a controversial topic such as euthanasia, there would be at least three distinct responses from our class. In general, there would be the group that would approve of the concept and the other group would extend an outright disapproval of the topic. The third yet silent group would be that of the neutral ones, who are always known to be nonreactive amidst all the outbursts around them. One should understand that the variations in the responses of the members of our class are not simply comprised of three general reactions. Our instructor is aware that each broad group can be further differentiated according to the principles and beliefs of each individual. For example, if euthanasia were approved in the entire country, the members of the group that is against euthanasia would aggressively react to this. The implementation of euthanasia could be equivalent to the crumbling of their world, as they would envision deaths that are at the mercy of physicians and other healthcare personnel. Looking closer into the reasons behind the disapproval of these individuals to euthanasia may be different for each individual. It is possible that one student disapproves of euthanasia because he is a strong believer of the Catholic religion, which raises the bar in terms of the value of life. Another student may not be in support of the concept of euthanasia because he has lost a loved one through such medical-ethical approach. It is also possible that another student disapproves the topic of euthanasia because his estranged father is a physician who actively participates in such technique, and thus his disagreement is not really about the topic but against his former role model. In order to shed more detail into the finer variations behind the reactions, the instructor should thus know each one of the members of the class. The class is big, as it is mainly a general course on philosophy and thus there are around 200 students in the room. When the instructor walks over to the podium and starts his lecture for the day, our eyes may seem to be tiny lights that would flicker at the very point when he utters a serious topic that needs to be discussed for an hour. He may or may not push some buttons in some of us, resulting in our reactions of support and condemnation. As for the other explosive topics, it may not be a simple button pushing for a number of students, but more of shoving a concept to our faces and asking us to express of thoughts and ideas. The course may be considered as general subject for undergraduate students, yet little do we know that we are unconsciously learning skills on how to analyze concepts. More importantly, these classroom discussions could pave the way to a clear journey for all of us, as we start our movement through an endless tunnel. It may be dark inside this tunnel of the unknown, yet after this long walk, there would be light at the end of the tunnel, leading us to a place that would cushion our identities and provide us slumber. PART II A metaphor can affect a person’s emotions because it allows the writer to symbolize his ideas using things, as well as adjectives, in order that the reader may have a better feel of the narration. A metaphor therefore facilitates in the cognition of an idea, thing or event that the writer wants to describe. This form of language can increase the impact of a narration because it can fully describe thoughts, as well as actions, by the use of transference (Hovecses, 2010). This approach allows the writer to define a certain topic through the use of comparison of two concepts that are generally considered as fully dissimilar yet may be the same in some aspect, viewpoint or perception. A metaphor can affect a person’s emotions because it assists in describing a topic through the use of descriptors of another matter (Wormeli, 2009). It should be understood that the other matter could be something else that is totally different from the topic in mind, yet the application of the descriptors of this matter can increase the weight and impact of the topic in focus. It is probably human nature to employ certain descriptors of one thing in order to provide information on another topic. The use of metaphor allows the narrator to transfer certain features that are unique to one item onto the topic of interest, resulting in a better understanding of the idea that needs to be conveyed. A simple example of a metaphor that could stimulate the emotions of a reader is to use items that are important to the reader, such as the words life, love and world. When a small item means so much to a certain person, the writer could signify this importance by claiming that this small item is equivalent to the life of that person. Once the reader sees this description, he will then feel that the item being presented is indeed so important, thus influencing his emotions to go with the narration. Language can empower or limit the expression of our thoughts because it allows the writer to use analogy in describing a certain topic (Kennedy & Gioia, 2009). The writer is therefore given the freedom to choose which words to employ for his narration. If the writer chooses to use strong words, his ideas are then delivered with great impact, influencing the reader to perceive the same emotions that the writer feels about the topic. On the other hand, a writer may employ subtle words when he feels that there is no need to purposely impart strong emotions regarding a specific matter. Language is therefore a strong tool because it could sway the reader into any direction that the writer wants provide. Every writer has a large reservoir of words that he could employ when describing or explaining a particular topic. In narration, language can be forceful if there is a need to emphasize a certain emotion. Language is empowered through the use of metaphors and other forms of speech because it allows the writer to represent certain topics by analogy (Applebee et al. , 2005). It focuses on describing a certain topic by tapping on the perceptions of the reader through the use of symbolism and analogy. The choice of words that generate a sentence may impact a reader because the writer has the capacity of employ analogy in presenting his ideas. He is capable of identifying one topic by describing features of a separate item, using the latter’s features to emphasize certain points of the former topic. Language is thus a powerful tool that could affect the perceptions and emotions of readers and this is mainly based on the writer’s capacity to apply certain form of speech such as metaphors and similes. Language can take the reader to a place where the writer has been, without physically going to that place. This successful and complete narration of a certain place mainly depends on the capacity of the writer to select words that would fully convey how he feels and sees in the place of interest. It is possible to perceive all the information that we create if we use the correct words that would impart the same effect on the reader. If we would like an audience to feel what we are actually feeling, we can use two general approaches. One approach would be to describe that condition in a straightforward manner, expressing the actual emotion. Another approach would be to employ metaphors, which assist in describing certain topics through the use of analogy. We can therefore present features that are inherent in other matters yet when applied as a descriptor for our topic, it purposefully imparts a sensation in the reader. Metaphors employed as form of speech are thus very helpful in describing and imparting certain emotions that the reader may be directly feel, yet when presented through the use of transference and analogy, could be equivalent to what the writer actually feels. In order to deliver a complete description of a certain topic, we should initially describe the general environment of the topic. For example, if we are describing a person, then the general physical features from a farther point of view should first be presented. These features may include the adjectives such as tall or short in height, lean or heavy in body size and so on. Once this has been provided, finer details of the individual can then be presented, such as wide eyes, or puckered lips or unkempt hair. The organization of the presentation of details of a certain topic is essential in conveying a message to the reader or the audience. This organization of information could significantly influence the reader’s understanding and perception of the topic being presented. If the writer or narrator does not employ this approach, the reader may not fully comprehend the scenario or the topic that is being presented. A disorganized delivery of information to the audience may therefore result in a different understand, emotion and perception of the topic and it may be totally different from what the writer intended to convey. REFERENCES Applebee, A. N. , Bermudez, A. B. & Blau, S. (2005). The language of literature. San Francisco: Holt MacDougal, 1548 pages. Hovecses, Z. (2010). Metaphor: A practical introduction, 2nd ed. London: Oxford University Press, 400 pages. Kennedy, X. J. & Gioia, D. (2009). Literature: An introduction to fiction, poetry, drama and writing. Los Angeles: Longman Publishers, 2256 pages. Wormeli, R. (2009). Metaphors and analogies: Power tools for teaching any subject. New York: Stenhouse Publishers, 264 pages.

Ecology Paper Review Essay

It is necessary to note that information provided on both sites is rather interesting and important, because it reflects the latest events and trends in ecological issues. Both sites are devoted to ecological problems discussing climatic changes, global warming, birds’ migrations, etc. for example, it is interesting to know that, according to the National Climatic Data Centre, the year of 2006 is considered the warmest year in the United States, though in the global context 2006 takes only the sixth place. It is mentioned that the previous warmest years in the UA was ranked 1998 caused by El Nino exacerbated warming. El Nino appeared this year and caused the effect of global warming leading meteorological offices to predict that â€Å"worldwide average tempts would hit a new high in 2007†. (Warming Trends 2007) According to statistics the hottest ten years noted in records have been logged since 2004: â€Å"The past nine years have all been among the 25 warmest years on record for the contiguous U.S., a streak which is unprecedented in the historical record†. According to reporter from New York Times, global warming becomes a fundamental factor affecting annual climate reports meaning that global warming is one of the serious problems not only in the USA, but in the rest of the world. (Warming Trends 2007) It is necessary to underline the article â€Å"Poverty & the Environment† providing discussion of economic and environmental injustice. For example, the author thinks that poverty and environmental degradation are combined factors characterizing the USA. Certainly, the lower income the family has, the higher the chances to be exposed to toxins either at home or at work. Apparently, low-income families have greater risk to develop asthma or cancer caused by environmental factors. Not all families are able to afford healthy food and safe outdoor spaces. Furthermore, such families are more vulnerable to human-made tragedies and natural disasters. The author says that â€Å"the worst consequences of environmental degradation are visited on the homes, workplaces, families, and bodies of the poor†. Nowadays more than 12% of the US population is behind the poverty line. (Poverty & the Environment 2006) References â€Å"Poverty & the Environment†. (2006, February 13). Retrieved January 11, 2007, from http://www.grist.org/news/maindish/2006/02/13/pate/index.html â€Å"Warming Trends†. (2007). Retrieved January 11, 2007, from http://www.sierraclub.org/compass/   

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