Serum IL-6: a candidate biomarker for intracranial pressure elevation following isolated traumatic brain injury

<p>Abstract</p> <p>Background</p> <p>Increased intracranial pressure (ICP) is a serious, life-threatening, secondary event following traumatic brain injury (TBI). In many cases, ICP rises in a delayed fashion, reaching a maximal level 48-96 hours after the initial insult. While pressure catheters can be implanted to monitor ICP, there is no clinically proven method for determining a patient's risk for developing this pathology.</p> <p>Methods</p> <p>In the present study, we employed antibody array and Luminex-based screening methods to interrogate the levels of inflammatory cytokines in the serum of healthy volunteers and in severe TBI patients (GCS≤8) with or without incidence of elevated intracranial pressure (ICP). De-identified samples and ELISAs were used to confirm the sensitivity and specificity of IL-6 as a prognostic marker of elevated ICP in both isolated TBI patients, and polytrauma patients with TBI.</p> <p>Results</p> <p>Consistent with previous reports, we observed sustained increases in IL-6 levels in TBI patients irrespective of their ICP status. However, the group of patients who subsequently experienced ICP ≥ 25 mm Hg had significantly higher IL-6 levels within the first 17 hours of injury as compared to the patients whose ICP remained ≤20 mm Hg. When blinded samples (n = 22) were assessed, a serum IL-6 cut-off of <5 pg/ml correctly identified 100% of all the healthy volunteers, a cut-off of >128 pg/ml correctly identified 85% of isolated TBI patients who subsequently developed elevated ICP, and values between these cut-off values correctly identified 75% of all patients whose ICP remained ≤20 mm Hg throughout the study period. In contrast, the marker had no prognostic value in predicting elevated ICP in polytrauma patients with TBI. When the levels of serum IL-6 were assessed in patients with orthopedic injury (n = 7) in the absence of TBI, a significant increase was found in these patients compared to healthy volunteers, albeit lower than that observed in TBI patients.</p> <p>Conclusions</p> <p>Our results suggest that serum IL-6 can be used for the differential diagnosis of elevated ICP in isolated TBI.</p

Put It in Your Shoe It Will Make You Limp: British Men’s Online Responses to a Male Pill

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.This article analyzes online interactions between British men and other online readers’ comments in response to two news articles focused on a male contraceptive pill. The aim of the study was to explore how British men’s online accounts construct a male pill as a potential contraceptive option for family planning. The two online articles reported the scientific innovations, as well as the production and marketing, of a nonhormonal, plant-based pill for men. Discourse analysis was used to analyze the online comments, from which two discourses emerged: (a) “Men as responsible health consumers” and (b) “‘Killing sperm’ and other side effects on semen.” When provided with the opportunity to take future responsibility for family planning, male readers were found to be unlikely to use a contraceptive pill. The men expressed the need for new options of contraception but, overall, felt a male pill was not the solution

Assessing the acceptability, service delivery requirements, and use-effectiveness of the diaphragm in Colombia, Philippines, and Turkey

The diaphragm is not available in many countries, despite the recommendations of numerous authors that it has important advantages as a woman-controlled method that offers some protection against sexually transmitted diseases, and one that is safe and free of side effects. An interagency tram collaborated to introduce the diaphragm in Colombia, the Philippines, and Turkey, using the same protocol to assess the acceptability, service delivery requirements and use-effectiveness of the method. Eighteen public and private sector service delivery sites were involved and a total of 550 women were enrolled in the study. Provider training aimed to improve the quality of care with which all methods were delivered and included counseling about sexuality and reproductive health risks. The cumulative 12-month pregnancy rare of 10.1 (SE 1.7) per 100 woman-years is on the low End of previous studies of the diaphragm, and the 12-month continuation rate (57.2 [SE 2.4] per 101) compares favorably with that for oral contraceptives and the intrauterine device. Focus group discussions conducted with clients and providers indicated that the method was an important alternative for some women, particularly those who had experienced health problems with other methods or were unable to negotiate condom use with their partners. Provider biases diminished as they observed the strategic niche that the diaphragm filled for their clients. While providing the diaphragm requires training and good client-provider interaction, the requirements are consistent with those called for in the Programme of Action of the international Conference on Population and Development (ICPD, 1994). With proper attention to quality of care, the diaphragm can be successfully offered in resource-poor settings. (C) 2001 Elsevier Science Inc. All rights reserved

Liv og død i Hierapolis Norske utgravninger i en hellenistisk–romersk–bysantinsk by i Lilleasia

Life and Death at Hierapolis. Norwegian excavations in a Hellenistic–Roman–Byzantine town in Asia Minor From 2007 to 2015 the University of Oslo, invited by The Italian Archaeological Mission at Hierapolis in Phrygia, conducted archaeological research in the North-East Necropolis at Hierapolis. The aim of the project was to document all visible tombs and sarcophagi of the necropolis and excavate selected tomb areas and tombs. The research, including osteological, DNA- and isotope-analyses, investigated the life of the inhabitants over a long period of time (ca. 100–1300 A.C.) with reference to tomb architecture, landscape perception, organization, entrepreneurship, ritual practices, genetic relations and origins, demography, health, sickness, diets, and individual movement patterns. Many of the aims are answered in the article, here shall only be mentioned two important discoveries: cremation has been documented as late as the 5th/6th centuries A.C., in periods of crisis perhaps used to signal pagan opposition to imposed Christian practices; the life conditions in the Roman/Early Byzantine period were much better than in that of the Middle Byzantine period.