BackgroundIntracerebral hemorrhage (ICH) is a disease with high mortality and a substantial risk of recurrence. However, the recurrence risk is poorly documented and the knowledge of potential predictors for recurrence among co-morbidities and medicine with antithrombotic effect is limited.Objectives1) To estimate the short- and long-term cumulative risks of recurrent intracerebral hemorrhage (ICH). 2) To investigate associations between typical comorbid diseases, surgical treatment, use of medicine with antithrombotic effects, including antithrombotic treatment (ATT), selective serotonin reuptake inhibitors (SSRI’s), and nonsteroidal anti-inflammatory drugs (NSAID’s) with recurrent ICH.MethodsThe cohort consisted of all individuals diagnosed with a primary ICH in Denmark 1996–2011. Information on comorbidities, surgical treatment for the primary ICH, and the use of ATT, SSRI’s and NSAID’s was retrieved from the Danish national health registers. The cumulative recurrence risk of ICH was estimated using the Aalen-Johansen estimator, thus taking into account the competing risk of death. Associations with potential predictors of recurrent ICH were estimated as rate ratios (RR’s) using Poisson regression. Propensity score matching was used for the analyses of medicine with antithrombotic effects.ResultsAmong 15,270 individuals diagnosed with a primary ICH, 2,053 recurrences were recorded, resulting in cumulative recurrence risk of 8.9% after one year and 13.7% after five years. Surgical treatment and renal insufficiency were associated with increased recurrence risks (RR 1.64, 95% CI 1.39–1.93 and RR 1.72, 95% CI 1.34–2.17, respectively), whereas anti-hypertensive treatment was associated with a reduced risk (RR 0.82, 95% CI 0.74–0.91). We observed non-significant associations between the use of any of the investigated medicines with antithrombotic effect (ATT, SSRI’s, NSAID’s) and recurrent ICH.ConclusionsThe substantial short-and long-term recurrence risks warrant aggressive management of hypertension following a primary ICH, particularly in patients treated surgically for the primary ICH, and patients with renal insufficiency.

Approximately 9% of gastric carcinomas worldwide are associated with Epstein‐Barr virus (EBV), making it the most frequent EBV‐associated malignancy. Pernicious anemia, a condition with chronic gastritis and achlorhydria, is strongly associated with gastric carcinoma. Both chronic inflammation and the lack of stomach acid may influence the likelihood of EBV infection of the neoplastic gastric epithelium, but the prevalence of EBV‐associated gastric carcinoma among patients with pernicious anemia is unknown. Therefore, we conducted a Danish nationwide case–control study comparing gastric carcinoma patients with pernicious anemia (PA‐GC) with those without pernicious anemia (nonPA‐GC), frequency matched 1:2. Tumor tissues were reclassified by expert histopathologists blinded to pernicious anemia and EBV status. In total, 186 samples (55 PA‐GC and 131 nonPA‐GC) were identified. EBV‐associated gastric carcinoma (EBV‐GC) was more common among PA‐GC compared with nonPA‐GC, adjusted odds ratio (OR) = 2.53 (CI: 0.88; 7.14), p = 0.08, with further adjustment for lymphocytic infiltrate OR = 2.94 (0.99–8.67), p = 0.05. Gastric carcinomas with signet‐ring cell morphology were significantly less common in patients with PA‐GC compared with nonPA‐GC (OR = 0.05, CI 0.01; 0.24). Although these conditions are rare, we found suggestive evidence that EBV‐associated gastric carcinomas are more common among gastric carcinoma patients with pernicious anemia compared with those without.

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CYP27B1 gene encodes 1alpha-hydroxylase, responsible for conversion of the vitamin D 3 precursor into its most active metabolite, involved in the immune function. Its promoter C(-1260) A polymorphism might affect 1alpha-hydroxylase expression and therefore contribute to autoimmunity. PDCD1 gene encodes an inhibitory cell-surface receptor, expressed on activated lymphocytes, which plays a role in maintaining immune tolerance. PDCD1 G7146A variant with putative regulatory function, has previously been associated with various autoimmune disorders. Autoimmune destruction of glandular cells is the main reason of type 1 diabetes (T1D). The aim of this study was to investigate the associations of the CYP27B1 C(-1260)A and PDCD1 G7146A polymorphisms with T1D in Polish children. The study comprised 215 T1D patients with mean age 8.3 (±4.3) years compared to 251 healthy controls. Genotyping was performed by PCR-RFLP method, using TfiI and PstI restriction enzymes, respectively. No association with CYP27B1 polymorphism was found for T1D (p=0.594 and p=0.989 for alleles and genotypes, respectively). The frequencies of alleles and genotypes at the PDCD1 G7146A polymorphism did not present significant differences between affected subjects and controls (p>0.05). In conclusion, this study presents no association of the CYP27B1 C(-1260)A and PDCD1 G7146A polymorphism with T1D risk in Polish children.