Strokes do not discriminate by age.

They hit when the factors are right – and those factors can be found as frequently in younger adults who have strokes as in an older population, according to a new study.

Stroke is most common in adults 65 and older. But the stroke rate among younger adults has steadily increased over the past two decades, even as the overall incidence of stroke has dipped.

Research being presented this week at the American Stroke Association’s International Stroke Conference in Honolulu tried to determine why. The findings suggest that addressing risk factors as early as possible could be critical in reversing the trend.

In the study, stroke survivors seen at a northern California health care system during a recent 15-year period were grouped by age, ranging from 1 month to 49 years. Researchers compared traditional risk factors for stroke – high blood pressure, diabetes, smoking, obesity and high cholesterol – among survivors and people of similar ages who did not have strokes.

They found the odds of having a stroke increased significantly as people entered their 20s – but only if they had high blood pressure or more than one risk factor.

That chance grew considerably during the next two decades of life.

Having any one risk factor significantly increased the chance for stroke among people in their 30s and 40s, the study found. The risk at that age was found to be 10 times greater if the individual had at least two risk factors.

The findings suggest doctors need to do a better job screening younger patients for stroke risk, said Dr Sharon Poisson, the study’s lead researcher and an associate professor of neurology at the University of Colorado.

“People in their 20s and 30s aren’t typically thinking that high blood pressure or diabetes are things they need to worry about, yet they really do make an impact on stroke risk,” she said.

‘I’m too young for that’

Kelly Fucheck knows this firsthand. She was 32 when she had a stroke.

The daughter of a firefighter and EMT, Fucheck thought she knew the signs of a stroke – and was aware she had several risk factors. She was a smoker and was severely overweight at the time. Still, the morning she woke up with vertigo, vision problems and neck pain, she tried to ignore the problems. She failed to seek medical attention until two days later.

“I know that sounds crazy now, but stroke never crossed my mind at all,” said Fucheck, now 40 and a wellness consultant. “I always associated stroke with the elderly, silver-haired, walking with canes. I never really thought it could happen to someone my age, even though I had health issues. I was just dumbfounded.”

Fucheck’s story is not unusual among younger adults, many of whom associate strokes with their grandparents, said Dr. Carolyn Brockington, director of the Stroke Center at Mount Sinai West and Mount Sinai St. Luke’s hospitals in New York City.

“They think, ‘I’m too young for that,’ when really, we can have a stroke at any age,” she said.

Brockington, who was not involved in the new study, said the findings should urge people to take an active role in their health, especially when they visit the doctor.

“Somebody who has elevated blood pressure shouldn’t be discounted,” she said, “even if the person is younger – and particularly if they have a family history of stroke, or a family history of hypertension.”

Brockington urges young adults to identify their personal risk factors and then work to lower that risk.

“It’s sort of like taking out an insurance policy for yourself on the rest of your life, to have a good quality of life while we’re here.”

^{Image credit: iStock}

Forget the mellow slacker image – pot smoking might actually make men more potent.

Men who’ve smoked marijuana appear to have significantly higher sperm concentrations than those who’ve never given it a try, a new study reports.

An observational study

There’s also a potential link between pot use and testosterone, said senior researcher Dr Jorge Chavarro. He’s an associate professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health in Boston.

“With increasing use of marijuana, there was a positive association with serum testosterone levels,” Chavarro said. “More marijuana, higher testosterone levels.”

Couples shouldn’t start smoking marijuana to improve their chances of conception, however.

This was an observational study, and it’s entirely possible that the link between pot and male fertility might run in the opposite direction, Chavarro said.

“We know that men with higher testosterone levels tend to engage in risk-tasking behaviours. The higher your testosterone, the more likely you are to do risky stuff,” like frequent pot smoking, Chavarro said.

Chavarro and his team set out to study the possible effects of pot smoking on male reproduction by observing 662 men enrolled at the Massachusetts General Hospital Fertility Center in Boston between 2000 and 2017.

Higher sperm concentrations

Semen samples were taken from all of the men, and 317 provided blood samples that were analysed for reproductive hormones. The men also filled out a questionnaire about their marijuana use.

Fifty-five% of the men said they’d smoked pot at some point, with 44% saying they were past smokers and 11% reporting they currently toke.

The researchers had hypothesised that marijuana use would be associated with lower semen quality, so they were surprised to learn that pot smokers had higher sperm concentrations.

Current and past marijuana users had average sperm concentrations of 62.7 million sperm per millilitre of ejaculate, while men who had never smoked marijuana had average concentrations of 45.4 million sperm per millilitre.

Only 5% of marijuana smokers had sperm concentrations below 15 million, the World Health Organization’s threshold for “normal” levels. By comparison, 12% of men who never tried marijuana had below-normal sperm levels, the findings showed.

These findings were “unexpected and surprising”, Chavarro said.

“We spent a couple of months doing analysis to figure out if we had done something wrong,” he added. “As far as we can tell, this is what the data is showing. Now the question is: What does it mean?”

Further investigation required

Animal studies have shown that cannabinoid receptors play a part in the male reproductive system, Chavarro said. It could be that marijuana complements or boosts the role played by cannabinoids that are naturally produced within the body.

Or it could just be that guys with higher testosterone levels are more likely to smoke pot, as part of an overall pattern of risk-taking, he suggested.

Dr Norbert Gleicher, medical director and chief scientist at the Center for Human Reproduction in New York City, said “it’s too preliminary” to say whether pot would help or harm a man’s fertility.

“What this study shows is pot smoking doesn’t make you automatically infertile, but there have been studies on pot smoking for many years and there are a good number of studies out there that indeed have reported adverse effects on semen in pot smokers,” Gleicher said.

A difference in fertility potential?

“It requires further investigation, and I would argue those investigations have become more urgent now because pot has become more legalised,” he added.

And pot smokers might not necessarily have a better chance of conception just because their sperm concentrations are higher, said Dr Jennifer Kawwass, medical director of the Emory Reproductive Center in Atlanta.

Although there are more sperm, their quality might be affected by marijuana use in ways that remain undetected.

“It is important to understand that the difference in sperm concentration between light smokers and never-smokers is not necessarily associated with a difference in fertility potential,” Kawwass said.

The new study was published in the journal Human Reproduction.

^{Image credit: iStock}

The rash is diagnostic and means the patient needs urgent antibiotics, new guidelines tell doctors.

The government wants young people to work in the care sector as care workers and therapists.

Expectant mothers are smoking in private because of judgement from doing so in public, a study claims.

Ethan Lindenberger took to the website to ask whether he could get vaccines without his parents .

Scott Marsden, 14 from Sheffield, died when a blow to his chest caused cardiac arrest.

Luke Henderson’s partner claims he asked for medical help eight times in the week leading up to his death.

For people with type 2 diabetes, could the days of having to jab themselves with a needle whenever they need insulin be over?

It’s now a distinct possibility, say researchers who have developed a capsule that can deliver insulin once it reaches the stomach. The new device has only been tested in animals so far, and such findings don’t always pan out in humans, but the scientists say the results look promising.

“If you try to deliver insulin orally, the acid and enzymes [in the digestive system] break up the proteins,” explained senior study author Dr Giovanni Traverso. He’s from Brigham and Women’s Hospital in Boston and the department of mechanical engineering at MIT in Cambridge, Mass.

That’s why insulin – a hormone that helps regulate blood sugar – has to be delivered by injection. But Traverso said that people with type 2 diabetes often delay beginning treatment with insulin because of the discomfort and stigma attached to insulin injections.

“People would prefer the oral route over injections,” he said.

To try to meet this challenge, the researchers developed a capsule that contains a small needle that’s made of compressed insulin. The capsule is about the size of a blueberry.

When the device reaches the stomach, the capsule reorients itself and injects the insulin into the lining of the stomach.

Lead author Alex Abramson, a Ph.D. student in the department of chemical engineering at MIT, said, “The system had to be self-orienting. The stomach is a large space and there’s no guarantee where it will land.”

Promising study

So, the researchers borrowed “technology” from the leopard tortoise, found in Africa. The animal’s shell has a high, steep dome. This allows it to right itself if it rolls onto its back.

The researchers also had to make sure the capsule had a chance to right itself before the injection occurred. To accomplish this, they loaded the insulin needle onto a compressed spring that’s held in place by a sugar disk. The sugar disk takes 5.5 minutes to dissolve, according to Abramson.

Once it dissolves, the insulin needle is injected into the stomach lining. There are no pain receptors in the stomach, so the injection shouldn’t hurt, the researchers noted.

After the capsule has delivered its contents, the remains pass harmlessly through the digestive system.

Tests in pigs have shown the device is able to successfully deliver insulin in the same quantities that people with type 2 diabetes would typically take.

The researchers also looked at the stomach tissue where the insulin was injected and saw no signs of damage or abnormalities. They also didn’t see any changes in the way the pigs ate or in their stool patterns.

Traverso said the researchers will continue the animal experiments and are hoping to test the insulin capsule in humans in approximately three years. In addition to insulin, he said that the capsule system could likely be used to deliver drugs for other diseases.

Endocrinologist Dr Minisha Sood is from Lenox Hill Hospital in New York City, and was not part of the study. “This technology is something I never imagined would be possible. Thus far, it’s only been tested in animals, but it’s a proof-of-concept study that is promising, and I’m looking forward to seeing how this pans out in human trials,” she said.

“Making oral insulin available will dramatically improve the options for people with diabetes – it would be life-changing,” Sood explained. Currently, she added, people with diabetes who need to be on insulin often have a delay of seven to 10 years before they begin insulin therapy. Having to inject insulin is one of the main reasons for this delay, she said.

The capsule system was developed by a team of researchers from MIT, Brigham and Women’s Hospital, and insulin manufacturer Novo Nordisk.

The study was published February 7 in the journal Science,