A Prospective Community-Based Study of Stroke in Warsaw, Poland

Background and Purpose Poland is a Country with High Morbidity and Mortality Rates from Cardiovascular Diseases. No Recent Studies Have Evaluated the Contribution of Cerebrovascular Diseases to This Morbidity and Mortality. Our Aim Was to Accurately Determine Stroke Incidence Rates in Warsaw, Poland. Methods a 2-Year Prospective and Population-Based Stroke Registry Was Maintained for Health Care Units 2 and 3 in Warsaw, Poland (Population, 182 285). Case Subjects Were Ascertained by Surveying Hospital Admissions, Outpatient Visits, and Death Certificates. Results during the 2 Years of the Study (1991 to 1992), 633 Cases of First-Event Strokes Were Registered, 462 of Which Were First Ever in a Lifetime. Computed Tomography or Necropsy Was Performed in 72% of First-Ever Stroke Cases. the Crude Annual Incidence Rate for First-Ever Stroke Was 127/100 000 (95% Confidence Intervals, 111 to 145); the Rate Standardized to the European Population Was 111 (95% Confidence Intervals, 96 to 128). Our Incidence Rates for First-Event Strokes Were Found to Be in the Middle of the Range among Other First-Event Studies. When Comparing Our First-Ever Stroke Incidence Rates with Those of Comparable Studies Performed throughout Europe, They Were Found to Be Similar for Groups Aged Younger Than 65 Years But Lower in the Older Age Groups. the Distribution of Ischemic and Hemorrhagic Stroke Subtypes Was Similar to that of Other Countries. Conclusions This First Population-Based Prospective Stroke Registry in Poland Showed that Incidence Rates Were Not High Compared with Other Studies throughout Europe and the World. These Stroke Incidence Rates Are Not a Large Contributing Factor to High Cardiovascular Morbidity Rates in Poland. © 1994 American Heart Association, Inc. All Rights Reserved

Analysis of 30-Day Stroke Mortality in a Community-Based Registry in Warsaw, Poland

Between January 1, 1991, and December 31, 1992, in the Upper Mokotow District of Warsaw, Poland (Population 182,285), 462 First-Ever-In-A-Lifetime (FEL) Strokes Were Registered, 12% (55/462) with Parenchymatous Intracerebral Hemorrhages (PICH) and 88% (407/462) with Ischemic Strokes. Confirmation by Either Computed Tomography or Autopsy Was Made in 72.3% of Cases. the overall 30-Day Case Fatality Rate (CFR) for FEL Strokes Was 40% (186/462), 60% for PICH (33/55), and 38% for Ischemic Stroke (153/407). of the 186 Patients Who Died within 30 Days of their FEL Stroke, 49% (91) Underwent Full Autopsy Examination. Fifty-Two Percent of These 91 Patients Were Found to Have Died from Direct Neurological Sequelae, 21% from Cardiac Causes, 17% from Pneumonia, 5.6% from Septicemia, 2.2% from Pulmonary Emboli, and 2.2% from Metastatic Cancer. Despite Our High 30-Day Stroke CFR Compared with Western Europe and North America, Mechanisms of Death Were Similar. © 1994, National Stroke Association. All Rights Reserved

Factors Predicting 30-Day Mortality in the Warsaw Stroke Registry

Poland Has High Mortality and Morbidity Due to Stroke. Our Prospective Population-Based Study Conducted in Warsaw in 1991–1992 Showed a Stroke Incidence Similar to Other European Countries. However, 30-Day Case Mortality Rates Were Much Higher. Our Aim Was to Explore Factors Predicting 30-Day Mortality in Warsaw. the Study Population Consisted of All Patients with First-Ever-In-A-Lifetime Strokes Admitted to the Department of Cerebrovascular Diseases during the 2-Year Prospective Population-Based Stroke Registry. Cases with Uncertain Stroke Type Were Excluded from Analysis. during the 2-Year Study Period, 633 Patients with Stroke Were Registered (462 with First-Ever-In-A-Lifetime Stroke); 351 of Them Completed Full Diagnostic Procedures, and 297 Were Diagnosed with Ischemic Stroke (IS) and 54 with Intracerebral Hemorrhage (ICH). a Logistic Regression Model for is Identified 7 Independent Variables Predicting 30-Day Mortality: Increasing Age, Decreased Consciousness at the Onset of Stroke, Extraocular Movement Disorder, Severity of Motor Weakness, Congestive Heart Failure, Kidney Diseases, and Chronic Obstructive Pulmonary Diseases (COPD). a Logistic Regression Model for ICH Identified Two Independent Predictor Variables: Extraocular Movement Disorders and Decreased Consciousness. Comparison of the Warsaw Stroke Registry with the Stroke Data Bank (SDB) Revealed Higher Prevalences of Heart Disease (Angina and Atrial Fibrillation) and COPD in the Warsaw Population. Comorbidity of Medical Diseases with Stroke Probably Contributed to Higher Mortality in the Warsaw as Opposed to U.S. Patient Sample. Disorders of Consciousness at the Onset of Stroke Were More Severe in Warsaw Than in the U.S. Sample. Stroke Type, Severity of Weakness Score, and Severity of Stroke Scale Were Similar for the SDB and Warsaw Populations. in Poland, High Levels of Medical Comorbidity Rather Than Stroke Severity Probably Account for Poor Short-Term Prognosis in Stroke. © 1995, National Stroke Association. All Rights Reserved

Cell-of-origin-specific 3D genome structure acquired during somatic cell reprogramming

Forced expression of reprogramming factors can convert somatic cells into induced pluripotent stem cells (iPSCs). Here we studied genome topology dynamics during reprogramming of different somatic cell types with highly distinct genome conformations. We find large-scale topologically associated domain (TAD) repositioning and alterations of tissue-restricted genomic neighborhoods and chromatin loops, effectively erasing the somatic-cell-specific genome structures while establishing an embryonic stem-cell-like 3D genome. Yet, early passage iPSCs carry topological hallmarks that enable recognition of their cell of origin. These hallmarks are not remnants of somatic chromosome topologies. Instead, the distinguishing topological features are acquired during reprogramming, as we also find for cell-of-origin-dependent gene expression patterns.This work was supported by an NWO/CW TOP grant (714.012.002), an NWO VICI grant 724.012.003, a NanoNextNL grant, and a European Research Council Starting Grant (209700, ‘‘4C’’) to W.d.L.; a Ministerio de Educacion y Ciencia, SAF.2012-37167, Fundació La Marató TV3 120410, AGAUR SGR 1136, and European Research Council Synergy Grant (‘‘4D-Genome) to T.G.; and an ERC Stg (637587, ‘‘HAP-PHEN’’) to E.d.