Epidemiol Prev
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medical cannabis refers to the use of cannabis or cannabinoids as medical therapy to treat disease or alleviate symptoms. In the United States, 23 states and Washington DC (May 2015) have introduced laws to permit the medical use of cannabis. Within the European Union, medicinal cannabis laws and praxis vary wildly between Countries. ⋯ there is incomplete evidence of the efficacy and safety of medical use of cannabis in the clinical contexts considered in this review. Furthermore, for many of the outcomes considered, the confidence in the estimate of the effect was again low or very low. To give conclusive answers to the efficacy and safety of cannabis used for medical purposes in the clinical contexts considered, further studies are needed, with higher quality, larger sample sizes, and possibly using the same diagnostic tools for evaluating outcomes of interest.
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BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». ⋯ In such conditions, the rationalization of the organization of health services based on the volume of care may make resources available to improve the effectiveness of interventions. The identification and certification of services and providers with high volume of activity can help to reduce differences in the access to non-effective procedures. To produce additional evidence to guide the reorganization of the national healthcare system, it will be necessary to design further primary studies to evaluate the effectiveness and safety of policies aimed at concentrating interventions in structures with high volumes of activity.
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Chronic infections and infestations represent major causes of cancer. Overall, Helicobacter pylori, HPV, HBV, and HCV are estimated to account for 15% of all human cancers. We have estimated that cancers associated with 6 pathogens in Italy account for 31,000 yearly cases, 42.0%of which is attributable to H. pylori, 34.7%to HBV and HCV, 19.8%to HPV, 2.9%to KSHV, and 0.2% to EBV. ⋯ Secondary prevention is based on screening programs that include Pap smear cytology and/or HPV test. To reduce the burden of HIV-associated cancers, prevention programs include primary prevention of HIV infection, early diagnosis and treatment, restoration of immune function, reduction in the prevalence of associated infections and risk factors, and secondary prevention. To date, anti-HBV and anti-HPV vaccinations, eradication of H. pylori infection, treatment of HCV and HIV carriers with antivirals, and HPV-related cancer screening prove to be the most effective strategies for the prevention of infection-associated cancers.