Seasonality of stroke in Finland

<p><b>Introduction:</b> The burden of stroke is increasing globally. Reports on seasonal variations in stroke occurrence are conflicting and long-term data are absent.</p> <p><b>Methods:</b> A retrospective cohort study using discharge registry data of all acute stroke admissions in Finland during 2004–2014 for patients ≥18 years age. A total of 97,018 admissions for ischemic stroke (IS) were included, 18,252 admissions for intracerebral hemorrhage (ICH) and 11,271 admissions for subarachnoid hemorrhage (SAH).</p> <p><b>Results:</b> The rate of IS admissions increased (p = 0.025) while SAH admission rate decreased (p < 0.0001), and ICH admission rate remained stable during the study period. The lowest seasonal admission rates were detected in summer and the highest in autumn for all stroke subtypes. Seasonal variation of IS was more pronounced in men (p = 0.020), while no sex difference was detected in ICH or SAH. The seasonal patterns of in-hospital mortality and length of stay (LOS) differed markedly by stroke subtype. Diagnoses of hypertension, atrial fibrillation, or diabetes showed no seasonality.</p> <p><b>Conclusions:</b> All major stroke subtypes occurred most commonly in autumn and most infrequently in summer. Seasonality of in-hospital mortality and length of hospital stay appears to vary by stroke subtype. The seasonal pattern of ischemic stroke occurrence appears to have changed during the past decades.Key messages</p><p>All major stroke subtypes (ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage) occurred most frequently in autumn and least frequently in summer.</p><p>Seasonal patterns of in-hospital mortality and length of stay differed markedly by stroke subtype.</p><p>The seasonal pattern of ischemic stroke occurrence in Finland seems to have changed compared to 1982–1992.</p><p></p> <p>All major stroke subtypes (ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage) occurred most frequently in autumn and least frequently in summer.</p> <p>Seasonal patterns of in-hospital mortality and length of stay differed markedly by stroke subtype.</p> <p>The seasonal pattern of ischemic stroke occurrence in Finland seems to have changed compared to 1982–1992.</p

Additional file 2: of Cerebrospinal fluid cytokines in Lyme neuroborreliosis

CSF cytokine concentrations in LNB, non-LNB, TBE, and MS patients. The median concentrations and ranges of each measured cytokine in the CSF of different patient groups are presented. Also the p values of statistical analyses (independent samples t test with Boferroni’s correction) of each studied cytokine are shown. (DOCX 22 kb

Kaplan-Meier estimates for OS in the RC population.

<p>The effect of CD68⁺ macrophages, MAC387⁺ macrophages, and CLEVER-1/Stabilin-1⁺ macrophages/vessels on the OS in the radical cystectomy population (a-d). The association between OS and the expression of two macrophage markers (e-f).</p

Group differences between pT category and tumor grade and CD68, MAC387, and CLEVER-1 expression.

<p>The Mann-Whitney U test was used for pair-wise comparisons in analyses of tumor grade and Kruskal-Wallis rank-sum testing (KW) was used for comparison across the four pT categories. The bottom and top edges of the box indicate the intra-quartile range (IQR), the line inside the box indicates the median value, the whiskers that extend from each box indicate the range of values that are outside of the intra-quartile range but closer than or equal to 1.5 times the IQR, and any points that are at a distance of more than 1.5 times the IQR from the box are considered to be outliers [circles indicate the mild outliers (more than 1.5 times the IQR), and asterisks extreme outliers (more than 3 times the IQR)].</p

Baseline clinicopathological characteristics (n = 184).

<p>¹ TUR-BT; Transurethral resection of bladder tumor</p><p>² RC; Radical cystectomy.</p><p>Baseline clinicopathological characteristics (n = 184).</p

Immunohistological detection of macrophages in bladder cancer.

<p>TUR-BT specimens stained with a negative control antibody (a); intratumoral CD68⁺ macrophages (b), MAC387⁺ macrophages (c), and CLEVER-1/Stabilin-1⁺ macrophages and vessels (d). Filled arrows indicate positively stained macrophages, and unfilled arrows indicate CLEVER-1/Stabilin-1⁺ vessels. Magnification 40×, scale bar 100 μm.</p

Univariate and multivariate Cox proportional hazards regression analysis of factors affecting OS in the RC population.

<p>* Significant p-value</p><p>^a Marker expression in a multivariate analyses adjusted for grade, pT category, and age. Each marker was analyzed in a separate multivariate analysis.</p><p>Univariate and multivariate Cox proportional hazards regression analysis of factors affecting OS in the RC population.</p