The role of Pap test screening against cervical cancer: a systematic review and meta-analysis.

OBJECTIVE: The first aim of this article is to quantify the role of Pap test in cervical cancer prevention, updating the pool of available studies included in a previous meta-analysis. Potential sources of meta-analysis heterogeneity were investigated as second aim. Further evidence of cost-effectiveness has been provided about age and best time interval to perform Pap test screening. DATA SOURCES: The articles' search was conducted using four medical electronic databases: PubMed, Google Scholar, ISI Web, and Scopus. Papers published until the 30th November 2013 were included. The research on Google Scholar was limited to the first 10 pages of web for each study design. METOD OF STUDY SELECTION: A systematic review/meta-analysis was performed according to PRISMA Statement. New-Castle-Ottawa Scale and Jadad have been adopted for articles quality assessment. From 4143 screened articles, 34 met eligibility criteria and 30 case-control studies were included in meta-analysis. Meta-analysis was carried out using StatsDirect2.8.0. Heterogeneity was investigated with qualitative and quantitative approaches in sensitivity-analysis. TABULATION, INTEGRATION AND RESULTS: Despite a great heterogeneity (Cochran Q=504.466, df=29, p<0.0001; I²=94.3%; 95%CI=93.1%-95.1%), a significant protective effect of Pap test has been identified (OR=0.33; 95%CI=0.268-0.408, P <0.00011) through the meta-analysis. Sensitivity analysis did not provide significant results (R=0.358 R2=0.128 p<0.469). CONCLUSIONS: The protective role of Pap test against cervical cancer has been confirmed especially among women <40 years. Annual screening still remains the most cost-effective preventive strategy.

[Effectiveness of a protocol treatment for overweight/obese patients (SIAN - ASL RMA)]. / Efficacia di un protocollo di trattamento per i pazienti in sovrappeso/obesi negli Ambulatori di Dietetica Preventiva del SIAN RMA.

OBJECTIVES: To evaluate the efficacy of treatment protocols in patients overweight/obese, pertaining to outpatient of dietary preventive of SIAN (in English: Service of Food Hygiene and Nutrition) RMA. MATERIALS AND METHODS: We extracted data from the medical records of patients with BMI≥25 (2009-2012). It was conducted a descriptive analysis, univariate analysis (chi-square test; p≤0.05) and multivariate logistic regression analysis considering as "weight loss" the outcome measure. RESULTS: There were 762 records (76.2% female; mean age 52 years). BMI average of beginning treatment: 30.26; BMI of the end of treatment: 28.37; minimum maximum range of variation of weight after treatment: -28.9 Kg and +6.5 Kg. The 55.2% of the sample has lost up to 4.9 kg, 32.4% from 5.0 to 9.9 kg, 8.1% from 10.0 to 19.9 Kg, 0.9% from 20 to 28.9 Kg. The higher initial BMI and the longer treatment, have a lower likelihood of weight loss (B=-1.267, p<0.001; B =-0.408, p<0.001); females and those who have an older age are more likely to lose weight (B=0.030, p<0.003; B=1.260, p<0.001). CONCLUSIONS: The current study highlight the efficacy of treatment protocols in overweight/obese patients. The population that benefits from the treatment more rigidly set on the estimated caloric needs is the one that starts from lower BMI and who therefore need less time to reach a certain weight loss. Instead, those who started from higher BMI is a population supposedly "binger", more resistant to the single dietary treatment and, as recognized by the scientific community, it requires a multidisciplinary approach.

Human papillomavirus and cancerous diseases of the head and neck: a systematic review and meta-analysis.

The increasing incidence of head and neck cancer (HNSCC) highlights the need to better understand the role of human papillomavirus (HPV) in the development of these cancers. The aims of this study were to conduct a systematic review and a meta-analysis concerning observational studies on the association between HPV infection and HNSCC and to quantify this association, thereby obtaining a reliable estimation of the risk of HPV infection in the development of head and neck cancer. Literature searches were performed using PubMed and Scopus databases. StatsDirect 2.7.8 program was used for the analysis. We found 15 case-control studies, 63 prevalence studies, and no cohort studies. The pooled odds ratio (OR) for all the included case-control studies resulted in a value of 1.63 (95% CI 1.27-2.09; P < 0.0001). The highest pooled OR resulted from the analysis of all the studies that examined HPV 16 genotype in association oral cavity (OR 5.36; 95% CI 1.4-20). The strong evidence of association between HPV infection and HNSCC highlights the importance of the introduction of specific tests in the cancer prevention practices to evaluate the presence of the virus, especially in the oral cavity, and the possibility of an extension of the vaccine anti-HPV in the male population too.

Action against vaccine-preventable infectious diseases and tuberculosis in Nomad Camps: the experience of a Local Health Unit in Rome.

In Italy the highest incidence of Tuberculosis (TB) cases is in young adult migrants. In 2011, the sanitarystaff of the Local Health Unit (ASL) Roma A promoted a vaccination campaign conducting several public health interventions in Nomad Camps. After notification of a case of TB in the Camp of Via Salaria, out of 357 Mantoux skin tests performed, 93 were positive (26%); subsequently, 5 subjects with radiographic positivity were hospitalized. The vaccination campaign was carried out to prevent the spread of infectious diseases in immigrant communities at high risk of contagion and to avoid the consequent transmission in the host country. As a result, vaccinations coverage among the residents of the Camps increased: 367 vaccinated subjects (30% more than previous year) and 612 administered vaccinations.