• CIN management is currently surveillance or surgical therapy. This review describes current research on medical therapies. • Imiquimod is the most studied with evidence of safety and efficacy. • 5-Fluorouracil has also shown promise with two clinical trials showing efficacy as adjuvant and primary treatment. • Antivirals therapies have produced mixed results with cidofovir showing the most potential. • The data remains weak regarding hormonal, herbal and alternative therapies rending it difficult to draw conclusions.
23 August 2021 in Cancer Epidemiology, Biomarkers & Prevention
Infrequent provider recommendations continue to be a key barrier to human papillomavirus (HPV) vaccination, including among adolescents at higher risk for future HPV cancers. To inform future interventions, we sought to characterize disparities in health care providers' HPV vaccine recommendation for U.S. adolescents. We systematically reviewed studies published in 2012–2019 that assessed provider HPV vaccine recommendations for adolescents aged 9–17. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified 52 eligible studies and used a standardized abstraction form to assess recommendation prevalence by adolescent demographic characteristics. Studies consistently found that fewer parents of boys than girls reported receiving HPV vaccine recommendations (14 studies, range of difference: −11 to −35 percentage points). Studies also found fewer recommendations for adolescents who were younger (2 studies, −3% to −12% points), non-White (3 studies, −5% to −7% points, females only), lower income (3 studies, −1% to −8% points), or uninsured (1 study, −21% points, males only). Studies identified geographic disparities in southern and rural areas. In conclusion, findings from this systematic review identify disparities in HPV vaccine recommendation that may contribute to suboptimal vaccine uptake. Efforts to improve providers’ HPV vaccine communication should focus on increasing recommendation consistency, especially for lower-income, non-White, and rural adolescents.
1 June 2022 in Research in Social and Administrative Pharmacy
Immunologic and non-immunologic loss of islet cells upon their transplantation into the liver leads to suboptimal outcomes. Anti-inflammatory agents are used during autologous and allogeneic transplantation. The aim of this qualitative systematic literature review is to evaluate their clinical use and safety. Electronic databases Embase, PubMed, Cumulative Index for Nursing and Allied Health Literature, ClinicalTrials.gov, and EU Clinical Trials Register were searched. Of the 216 unique citations, 10 with tumor necrosis factor (TNF) blockers [etanercept (ETA) or infliximab] and 3 with both TNF blockers and an interluekin-1 receptor antagonist [anakinra (ANA)]) were included. Of these, 12 were in allogeneic and one in autologous transplant. Insulin independence with decreased islet cells and number of transfusions were reported with their use. One infection was reported in a group receiving ETA. Analysis suggested that the use of ETA ± ANA have the potential to improve outcomes in islet cell transplant.