Recent Research Publications- February 2025

What Are Consumers Looking for With Boric Acid?

Stockdale CK, Bartolo-Costello AA, Vieira-Baptista P.

J Low Genit Tract Dis. 2025 Jan 1;29(1):93-95. doi: 10.1097/LGT.0000000000000855. PMID: 39704442.

Two separate online surveys were presented to women who were confirmed to have purchased a boric acid vaginal suppository product in the previous year for themselves March 2020 (study 1) and July 2023 (study 2) to understand consumer expectations concerning the use of vaginal boric acid. Study 1 found that repeat purchasers are more likely to buy boric acid products to prevent symptoms, especially bacterial vaginosis. Study 2 confirmed boric acid was more likely to be purchased for prevention than treatment, especially odor/bacterial vaginosis, with 83% reporting they were satisfied and 40% reporting they were extremely satisfied. While boric acid has been used for decades as an alternative treatment for vaginitis, it has recently become commercially available (for vaginal application) with high levels of satisfaction.

For a full text of the article, click here: https://oce.ovid.com/article/00128360-202501000-00016/PDF

Vulvar inspection at the time of cervical cancer screening: European Society of Gynaecological Oncology (ESGO), International Society for the Study of Vulvovaginal Disease (SSVD), European College for theStudy of Vulval Disease (ECSVD), and European Federation for Colposcopy (EFC) consensus statements.

Preti M, Lewis F, Carcopino X, Bevilacqua F, Ellis LB, Halonen P, Hemida R, Jach R, Kesic V, Kyrgiou M, Maggino T, Pedro A, Querleu D, Stockdale C, Taumberger N, Temiz BE, Bieira-Baptista P, Gultekin M.

Int J Gynaecol Obstet. 2025;35 (1). doi: 10.1016/j.ijgc.2024.100007.

Background: Vulvar squamous cell carcinoma incidence is increasing, especially among women under 60, largely attributed to human papillomavirus infections. Precursor pre-invasive vulvar lesions are frequently underdiagnosed. Routine vulvar inspection during cervical cancer screening could offer an opportunity for the detection of these lesions.

Objective: To emphasize the importance of integrating routine vulvar inspection during cervical cancer screening procedures and to raise awareness about the early detection of vulvar squamous cell carcinoma and its precursors to reduce the diagnostic delay of vulvar pathologies.

Methods: A multidisciplinary task force comprising experts from 4 international scientific societies was formed. A focused literature review was conducted, and consensus statements were developed through a structured voting process to ensure clinical relevance and comprehensiveness.

• The consensus defines key elements of normal vulvar anatomy, identifies potential pre-cancerous dermatoses, and highlights risk factors for vulvar malignancy. The consensus statements promote the integration of vulvar inspection into cervical cancer screening procedures, urging health care professionals across various levels to receive training and guidance in vulvar examinations and enhancing patient education. Health care providers are recommended to gather a brief history of vulvar symptoms, conduct comprehensive inspections of the vulvar area, and report any abnormalities. For patients with positive human papillomavirus or Pap tests, they should closely monitor vulvar findings, encourage self-examinations, and discuss risks for intra-epithelial or invasive neoplasia.

Conclusions: Establishing standardized practices in vulvar inspection during cervical cancer screening procedures along with public awareness, could significantly impact early detection and timely interventions of vulvar pathologies at cancer risk ultimately reducing the burden of vulvar cancers.

For a full text of the article, click here: https://www.sciencedirect.com/science/article/pii/S1048891X24000331?via%3Dihub

Phenotypes of Pelvic Organ Prolapse.

Sayler Z, Weston K, Johnson CM, Cunningham V, Bradley CS, Kenne KA, Wendt L, Ten Eyck P, Kowalski JT.

Urogynecology (Phila). 2025 Jan 13. doi: 10.1097/SPV.0000000000001640. Epub ahead of print. PMID: 39807787.

• The Pelvic Organ Prolapse Quantification (POP-Q) stages do not correlate with symptoms or characterize important prolapse subtypes.

Objectives: We hypothesize that clinically meaningful prolapse "phenotypes" utilizing POP-Q measurements can be defined. The primary aim was to define the phenotypes and their frequency. Secondary aims were to compare demographics, medical characteristics, and symptoms between phenotypes.

Study design: Patients who previously underwent prolapse surgery were retrospectively categorized into 1 of 8 phenotypes based on 2 principles: (1) prolapse exists when the anterior or posterior vaginal wall descend to the hymen or the apex descends half total vaginal length, and (2) prolapse may exist in anterior, posterior, and/or apical compartments. Demographics, medical characteristics, and Pelvic Floor Distress Inventory-20 (PFDI-20) responses were compared. Linear and logistic regression models were used for comparisons.

Results: The AC (anterior-predominant and apical) phenotype was most common (231 of 501 patients, 46.1%) and served as the reference for comparisons. The no prolapse, P (isolated posterior), C (isolated apical), and PC (posterior-predominant and apical) phenotypes were younger. The A (isolated anterior) phenotype was older. P, PC, and APC (anterior and posterior and apical) phenotypes had greater body mass index. The P phenotype Colorectal-Anal Distress Inventory scores were higher. Similarly, the PC phenotype had higher scores for bowel splinting and rectal prolapse. Conversely, the C phenotype total PFDI-20 scores were lower (P = 0.01). Only the APC phenotype had no significant differences in any PFDI-20 question compared with the AC phenotype.

Conclusion: These phenotypes may allow for improved understanding, communication, and counseling about prolapse and prolapse treatment.

For a full text of the article, click here: https://oce.ovid.com/article/02273501-990000000-00332/PDF

Attitudes, beliefs and preferences surrounding home-based exercise programs in endometrial cancer patients receiving treatment.

Gorzelitz J, Adeagbo M, Dungan-Seaver S, Hill EK, Kumar A, Goodheart MJ, Lutgendorf S.

Gynecol Oncol Rep. 2024 Dec 18;57:101659. doi: 10.1016/j.gore.2024.101659. PMID: 39811828; PMCID: PMC11730264.

Background: Despite recommendations, exercise participation among endometrial cancer survivors remains low. Previous interventions focused on weight loss or in-person programs with limited reach. Regular exercise, regardless of weight change, reduces mortality risk and improves functionality. Home-based programs could address participation barriers. We conducted a qualitative study with inactive survivors to identify key factors for future home-based exercise programs.

• Semi-structured interviews were conducted with ten on-treatment endometrial cancer survivors who reported low physical activity levels. Interviews, conducted via Zoom or telephone, were recorded with consent. Transcripts were coded using MAXQDA to identify attitudes, knowledge, barriers, interests, and preferences regarding home-based exercise programs.
• The interviews yielded four major themes, the first being the understanding survivors have of what exercise is and the perceived benefits of exercise. Second, participants were acutely aware of the barriers to exercise which included: health issues, treatment-related concerns, access to resources, limited strength, lack of support, and past negative experiences. The third theme focused on motivational factors to exercise including guidance, support systems, access to resources including technology, and a desire to be healthy as motivators towards changing exercise behaviors. Finally, participants expressed interest in exercise that incorporated fun with low impact and accessibility. Interestingly, all the participants preferred home-based exercise programs. The role of the provider/oncologist was often identified as central to the discussion or suggestion of exercise in our sample.

Conclusions: Understanding patient needs and preferences is crucial for creating accessible and sustainable exercise programs for endometrial cancer survivors. Our study guides the development of future home-based exercise programs for this population.

For a full text of the article, click here: https://pmc.ncbi.nlm.nih.gov/articles/PMC11730264/pdf/main.pdf

Evaluating the implementation and impact of a volunteer navigation oncology support programme: study protocol for a pragmatic, real-world hybrid type 2 study.

Rocque GB, Dent DN, Waugh C, Hill EK, Federman N, Bostock Rosenzweig I, Morris B, Kamal A.

BMJ Open. 2025 Jan 20;15(1):e088047. doi: 10.1136/bmjopen-2024-088047. PMID: 39832972.

Introduction: Patient navigation is recommended by accrediting bodies such as the Commission on Cancer and is a key element in payment reform demonstration projects, due to the established benefits in reducing barriers to healthcare, improving care coordination and reducing healthcare utilisation. However, oncology practices are often resource constrained and lack the capacity to extend navigation services at the desired intensity for their patient population. The American Cancer Society (ACS) developed the ACS Community Access to Resources, Education, and Support (CARES) programme to expand navigation capacity through the training of students from local universities as volunteers to serve as non-clinical navigators to support cancer patients. Although this approach has great potential for scalability, the best approach to early implementation and impact of volunteer navigation remains unclear.

Methods and analysis: This pragmatic single-arm pre-post study evaluates the implementation and effectiveness of volunteer navigation for patients participating in the 2023-2024 pilot. This study will use data collected during routine care for quantitative implementation and patient outcomes. The Updated Consolidated Framework for Implementation Research will guide evaluation of early programme implementation with three initial pilot sites. This pragmatic evaluation of real-world implementation of volunteer navigation in the oncology setting will support future efforts to scale-up this intervention across US health systems.

Ethics and dissemination: This study was approved by University of Morehouse School of Medicine Social and Behavioral (IRB), which served as the IRB for record for this project (IRB-2025819-2). No consent required for this study protocol. ACS CARES plans to disseminate this model and include additional sites as participants in future years.

For a full text of the article, click here: https://bmjopen.bmj.com/content/bmjopen/15/1/e088047.full.pdf

Reduced AT2R Signaling Contributes to Endothelial Dysfunction After Preeclampsia.

Schwartz KS, Sun M, Jalal DI, Santillan MK, Stanhewicz AE.

Hypertension. 2024 Dec 26. doi: 10.1161/HYPERTENSIONAHA.124.24098. Epub ahead of print. PMID: 39723536.

• Women who had preeclampsia (a history of preeclampsia) have a >4-fold risk of developing cardiovascular disease compared with women who had an uncomplicated pregnancy (history of healthy pregnancy). Despite the remission of clinical symptoms after pregnancy, vascular endothelial dysfunction persists postpartum, mediated in part by exaggerated Ang II (angiotensin II)-mediated constriction. However, the role of vasodilatory AT2Rs (Ang II type 2 receptors) in this dysfunction is unknown. We examined the functional role of AT2R in the microvasculature postpartum and whether acute activation of AT2R improves microvascular endothelial function after preeclampsia.
• Overall, 24 women (n=12/group) participated. We measured cutaneous vascular conductance responses to (1) graded infusion of compound 21 (AT2R agonist; 10-14-10-8M) alone or with NG-nitro-l-arginine methyl ester (NO synthase inhibitor; 15 mM) and (2) a standardized local heating protocol in control and 10-11M compound 21-treated sites. Expression of Ang II receptor subtypes I and II in biopsied venous endothelial cells was quantified using immunofluorescence.

Results: AT2R-mediated dilation (P<0.01) and the NO-dependent contribution (P=0.003) of this response were reduced in women with a history of preeclampsia. Endothelial AT2R expression was lower in women with a history of preeclampsia (P<0.01), but there were no differences in endothelial AT1R (Ang II type 1 receptor) expression (P>0.05). Acute activation of AT2R during local heating improved endothelium (P<0.01) and NO-dependent (P<0.01) dilation in women with a history of preeclampsia but had no effect in women with a history of healthy pregnancy (both P>0.05).

Conclusions: Reductions in AT2R-mediated dilation contribute to attenuated or impaired endothelial function in women who had a pregnancy complicated by preeclampsia. Furthermore, AT2R activation may improve endothelial function through NO-dependent mechanisms in otherwise healthy women who had preeclampsia before the onset of cardiovascular disease.

For a full text of the article, click here: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.124.24098

A Cohort Study Exploring HPV Vaccination Beliefs Among Oral Health Providers: Broadening the Scope of Education and Administration.

Brechtel L, Kilgore LC, Oyedeji O, Mastronardi AM, Carlson ER, Zite NB, Gregory S, Boone J, Kimball K, Heidel RE, Maples JM

Vaccines (Basel). 2024 Nov 27;12(12):1331. doi: 10.3390/vaccines12121331. PMID: 39771993; PMCID: PMC11680363.

Background/objectives: There is potential utility and increasing interest in engaging professionals in non-traditional vaccination settings to participate in efforts to reduce human papillomavirus (HPV)-related cancer. This study assessed the impact of a multi-disciplinary HPV educational intervention on oral health care professionals' perceived role, comfort level, and scope of practice in HPV-related cancer prevention efforts.

Methods: The virtual educational intervention was provided by a multi-disciplinary panel of experts. Seventy-three oral health care professionals attended the educational intervention and completed a questionnaire at three time points (pre-session, immediate post-session, and at the 1-month follow-up). Data were analyzed using Friedman's ANOVA and post-hoc analyses.

Results: Respondent's median belief that it is the role of an oral health professional to recommend the HPV vaccine increased from pre-session (Median = 3.0, IQR = 3.0-4.0) to immediate post-session (median = 4.5, IQR = 4.0-5.0), and this increase was maintained 1 month after the session (median = 4.0, IQR = 4.0-4.5; p < 0.001). Additionally, respondent's belief that they were up-to-date on the latest guidelines for HPV vaccination also increased from pre-session to immediate post-session (p < 0.05), and this increase was maintained 1 month after the session (pre-session median = 2.0, IQR = 2.0-3.0 vs. 1-month post-session median = 4.0, IQR = 4.0-5.0; p < 0.005).

• The multi-disciplinary HPV educational intervention was well-received by oral health professionals. Data suggest the intervention had a lasting impact on their beliefs about their role, comfort level, and scope of practice relating to HPV cancer prevention. More research needs to be conducted to better understand how obstetrician-gynecologists, other obstetric care providers, and oral health communities can support each other in promoting HPV-related cancer prevention.

For a full text of the article, click here: https://www.mdpi.com/2076-393X/12/12/1331

Reply to Letter to the Editor on "A Single Injection of Platelet-rich Plasma Injection for the Treatment of Stress Urinary Incontinence in Females: A Randomized Placebo-controlled Trial".

Johnson C, Vollstedt A.

Urology. 2024 Dec 20:S0090-4295(24)01217-2. doi: 10.1016/j.urology.2024.12.026. Epub ahead of print. PMID: 39710078.

For a full text of the article, click here: https://www.sciencedirect.com/science/article/pii/S0090429524012172?via%3Dihub

Promoting international, locally focused, and patient-oriented genetic counseling.

Weil J, Alaeddin D, Awwad R, Chanouha N, Elbassiouny B, Furqan A, Jacobs MF, Kavanaugh G, Neogi A, Rao SK, Sebastin M.

Genet Med Open. 2024 Aug 2;2(Suppl 2):101880. doi: 10.1016/j.gimo.2024.101880. PMID: 39712957; PMCID: PMC11658551.

For a full text of the article, click here: https://www.sciencedirect.com/science/article/pii/S2949774424010264?via%3Dihub