Several studies have shown a relationship between low socioeconomic status, age and stroke mortality. However, there is lack of similar studies in relation to stroke incidence. All cases of first-ever stroke occurring in a population aged 35–85 years from the city of Umeå were collected from hospital-based registers during a 2-year study period (2000–2002), from death certificates and also from nursing homes during a 6-month period. The WHO definition of stroke was used. Register data served to analyze educational level. A total of 457 first-ever strokes (244 women and 213 men) were registered, corresponding to an overall annual incidence rate of first-ever stroke of 413.4 per 100,000. The incidence of first-ever stroke was significantly higher among low-educated compared to high-educated men and women. The highest stroke incidence was found among low-educated women aged 75–85 years. The educational-related differences in stroke incidence persisted in the oldest age group (75–85 years), also after controlling for sex and age. This is one of the first studies that analyzes first-ever stroke incidence also among elderly men and women (75–85 years) in relation to socioeconomic status. More community-based studies are needed in order to confirm the results.

Using immunohistochemistry, endothelial nitric oxide synthase (NOS), and neuronal NOS were localized in the endothelium of rat testicular arteries and in Leydig cells, respectively. NADPH-diaphorase activity, indicating NOS activity, however, was present only in endothelial cells. In order to examine the role of nitric oxide (NO) in the regulation of rat testicular vasculature, intact and hCG-pretreated (50-100 IU hCG given s.c. 6 h earlier) animals were given injections of the NOS inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME), 10 mg/kg i.v.). In all rats this resulted in a major increase in blood pressure. In intact, unstimulated animals, testicular vascular resistance was unaffected, and testicular blood flow consequently increased. In hCG-treated animals, in contrast, vascular resistance increased in an hCG dose-related way. L-NAME treatment also increased the hCG-induced accumulation of polymorphonuclear leukocytes in testicular venules. Treatment with N(G)-nitro-D-arginine methyl ester (D-NAME, 10 mg/kg i.v.), an inactive isomer of L-NAME, had no effect on the testicular vasculature. The study suggests that NO plays only a limited role in the regulation of testicular blood flow under basal conditions. After hCG treatment, however, NOS activity appears to be increased (increased endothelial NADPH-diaphorase staining), suggesting that NO in this situation is of importance to increase blood flow and to inhibit leukocyte accumulation.

A stroke can affect a person's whole being and make him or her feel helpless and insecure. In this study, the authors aimed to analyze from a gender perspective how elderly women and men responded to treatment and care after stroke in the acute care setting. They used a strategic selection procedure in this qualitative follow-up interview study, in which 7 women and 5 men aged 75 to 83 participated. Personal interviews were performed, tape-recorded, transcribed verbatim, and analyzed in accordance with grounded theory. In the hierarchic medical context, the participants used four kinds of negotiations. These negotiations were either resistant (striving for autonomy and criticizing the care) or adjustive (following the rules and building alliances) to the hierarchic structure. The authors discuss how the concepts of power from above versus power from below can be applied in the hierarchic medical context.

Background and Purpose: There is strong evidence for the existence of a socioeconomic gradient in stroke incidence and mortality, but there seem to be contradictory findings concerning an association between socioeconomic status and case fatality after stroke. Moreover, there is still a lack of studies that include men and women as well as people over 75 years. Our aim was to investigate whether there were education-related differences in 28-day case fatality after stroke in different age groups. Methods: All patients who were diagnosed with a cerebral infarction at the Umeå University Hospital during a 2-year period were included in this study. Results: In total, 610 stroke patients (331 men, 279 women) aged 20–85 were hospitalized, of whom 77% were first-ever strokes. Overall, there were few education-related differences between the patients in different age groups (20–74 and 75–85 years). The 28-day case fatality after stroke was shown to be associated with a low educational level in patients above 75 years, also after controlling for sex, risk factors and acute stroke care measures. Conclusion: In this population-based study on patients with cerebral infarction, we found an education-related difference in 28-day case fatality in patients aged 75–85 years. The socioeconomic gradient persisted when we adjusted for risk factors and acute care variables. There is a need for more community-based stroke studies including all ages, with good case ascertainment.