This paper seeks to identify those areas that proved socially vulnerable to the earthquake that struck central Italy on 24 August 2016. The study involved four key steps. First, six relevant social vulnerability indicators were selected, based on previous conclusions in the literature. Second, the indicators were mapped using the inverse distance weighted interpolation method. Third, social vulnerability was assessed according to a spatial combination of the indicators. Fourth, in order to build a heterogeneity map, another approach was employed to represent the spatial variability of social vulnerability and to provide additional information on the synergistic contributions of the indicators. The results indicate that age and accessibility indicators affect the entire region under review, with highly vulnerable zones being close to small historical centres. These findings will be useful to governments, policymakers, and stakeholders with regard to implementing vulnerability mitigation strategies in Italian territories that are highly susceptible to earthquake hazards.
Recent studies have shown that ABGG2 protein overexpression in acute myeloid leukemia (AML) may be associated with poor response to therapy and increased relapse risk. Few data are available in patients with AML undergoing allogeneic stem cell transplantation (SCT), particularly when in complete remission (CR). We analyzed 105 patients with AML who underwent allogeneic SCT in CR evaluating the role of ABCG2 and other pretransplantation features on subsequent transplantation outcomes. Factors negatively associated with leukemia-free survival (LFS) were unfavorable cytogenetics (3-year LFS 48% versus 80%, P = .0035) and ABCG2 positivity (65% versus 80%, P = .045). Three-year cumulative incidence of relapse (CIR) in the whole population was 20%; a higher incidence of relapse was associated with adverse cytogenetics (41% versus 16%, P = .018), ABCG2 overexpression (29% versus 15%, P = .04), and, marginally, age > 50 years (30% versus 14%, P = .06). We grouped patients according to the combination of these 3 risk factors: no patient relapsed within 3 years from SCT in the group without risk factors, whereas the 3-year CIR was 12% (95% confidence interval [CI], 2% to 25%) in the group with 1 risk factor and 47% (95% CI, 31% to 70%) in patients with 2 or 3 risk factors (P = .00005). In conclusion, allogeneic SCT does not seem to abrogate the negative prognosis associated with ABCG2 overexpression at diagnosis, specifically in terms of a higher relapse risk. ABCG2, age, and cytogenetics can predict AML relapse after SCT in patients who undergo transplantation while in CR.
Anemia is highgly prevalent among elderly and few previous studies have focused on hospitalized medical patients aged ≥ 75 years. During a four-months period of this single center prospective cohort study, 508 patients were admitted and studied with a standardized set of blood tests. Anemia, defined as by WHO, was present in 277 (54.5%) and in the majority of cases was mild (71.8%), normocytic (82.8%), hypoproliferative (90.5%). Most frequent diagnosis was multifactorial anemia (47.7%); anemia of chronic disease was the most frequent single cause (28.5%) and the most frequent etiologic co-factor among multifactorial anemia. Iron deficiency was found in 22.7% of cases; vitamin B12 and folate deficiency were found in 7.5% and 26.1% respectively; chronic kidney disease in 16.2%; overt bleeding anemias in 4.8% and clonal hemopathies in 3.2%. Unexplained anemia was diagnosed only in 5.1% of cases. The finding of a very high frequency of anemia of chronic disease and multifactorial anemia has implications on both the diagnostic and therapeutic grounds.
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