Prince County Hospital

The global demand for sterile medical devices is increasing due to technological advancements and growing health care needs. Although Electron beam (EB) and X-ray have existed for a long time, they have been less utilized compared to other sterilization methods such as ethylene oxide and Gamma irradiation. Currently, their application is developing, offering new possibilities in response to a rapidly expanding sterilization market. This study assesses the impact of these irradiation techniques on polypropylene (PP) materials used in medical devices, focusing on their mechanical properties, structural changes, and color stability. PP is known for its sensitivity to irradiation, which makes the evaluation of its properties under different irradiation conditions particularly relevant. Three different PP grades, with varying radiotolerance claims, were exposed to controlled irradiation doses (30, 45, and 85 kGy). Analyses including electron spin resonance (ESR), rheology, tensile testing and colorimetry were carried out. They were also employed in conjunction with principal component analysis (PCA). The results allowed to evaluate irradiation-induced modification. Results indicate that Gamma irradiation induces the most significant degradation due to its low dose rate, leading to increased chain scission and oxidation effects. E-beam irradiation has the least impact, while X-ray effects are generally lower to Gamma irradiation at equivalent doses. The study highlights the importance of selecting appropriate PP formulations to ensure optimal post-irradiation performance, particularly in the context of transitioning from traditional sterilization methods to E-beam or emerging X-ray technology.

Abstract Introduction: Stress fractures, resulting from repetitive stress, are common amongst athletes and high-impact activity participants. Although Vitamin D deficiency has been linked to higher stress fracture risk, recent studies show inconsistent results. In addition, intercondylar distance (ICD), the space between medial femoral condyles when standing with malleoli approximated, has not been examined for its role in stress fractures. This study evaluates the relationships between ICD, Vitamin D levels and stress fracture incidence in young male recruits. Methods: Population: 200 male recruits, aged 18–25 years, from a military training facility in Eastern India. Inclusion: Recruits with bony pain in the lower limbs diagnosed with stress fractures. Exclusion: Knock knees (medial malleoli distance >5 cm). Assessments: X-rays for suspected fractures. Vitamin D measured by the enzyme-linked immunosorbent assay, classified into deficient (<20 ng/mL), insufficient (20–40 ng/mL) or normal (>40 ng/mL). ICD measured and categorised as normal (≤4 cm) or abnormal (>4 cm). Statistical analysis: Chi-square test and Cramér’s V coefficient assessed associations. Results: Amongst participants, 52% had normal Vitamin D levels, 77% had abnormal ICD and 16% experienced stress fractures. Vitamin D deficiency (<20 ng/ml) was linked to a 71% probability of fracture and abnormal ICD increased fracture probability to 36% even with normal Vitamin D levels. Conclusion: This study highlights Vitamin D deficiency and ICD malalignment as associated fracture risk factors. It supports implementing Vitamin D screening and supplementation, along with biomechanical assessment, to prevent stress fractures in military recruits, supporting comprehensive assessment to prevent stress fractures in active populations.

Abstract Autoimmune pancreatitis (AIP) is a rare fibro inflammatory form of chronic pancreatitis. Owing to its typically non-specific presentation, its diagnosis requires a high degree of clinical suspicion. It is diagnosed by a combination of imaging studies, such as a computed tomography scan and pancreatography, laboratory analyses that include immunoglobulin G (IgG) 4 and/or autoantibodies, histopathological evaluations and positive response to corticosteroid therapy. This case report presents a unique instance of AIP in a 28-year-old male who presented with significant weight loss, limb weakness and features suggestive of systemic illness. Imaging revealed a diffusely enlarged pancreas with focal thickening of the pancreatic head. Elevated serum IgG4 levels confirmed the diagnosis of AIP. The patient responded dramatically to corticosteroid therapy. This case highlights the importance of keeping AIP as a differential in patients presenting with unexplained pancreatic abnormalities and systemic symptoms, particularly when radiologic findings are suggestive and IgG4 levels are elevated. Early steroid therapy can significantly improve the outcomes.

BACKGROUND:Fetal alcohol spectrum disorder (FASD) is a leading preventable cause of neurodevelopmental disability in North America. The stigma associated with alcohol use and abuse during pregnancy makes it difficult to obtain information on prenatal alcohol use through self-reporting. We assessed the incidence of prenatal alcohol exposure in Prince Edward Island to facilitate future public health initiatives addressing FASD.METHODS:Prenatal alcohol exposure was examined via population-based collection of meconium and analysis of fatty acid ethyl esters (FAEEs). Fatty acid ethyl esters are nonoxidative metabolites of ethanol that are produced in the fetus. Meconium FAEE concentrations of 2.0 nmol/g or greater are indicative of frequent prenatal alcohol exposure during the last 2 trimesters of pregnancy. Samples were collected from 1307 neonates between Nov. 8, 2010, and Nov. 8, 2011, in hospitals in PEI, or from those born to mothers who resided in PEI but gave birth in Halifax, Nova Scotia. Samples were frozen and shipped for analysis. Fatty acid ethyl esters were analyzed by gas chromatography-mass spectrometry and quantified by means of deuterated internal standards.RESULTS:Of the 1307 samples collected, 1271 samples were successfully analyzed. Positive results for FAEEs were obtained in 3.1% (n = 39) of samples collected within the first 24 hours after birth.INTERPRETATION:Not all neonates exposed to heavy prenatal alcohol in utero will exhibit FASD; based on current estimates of predictive value for disease by exposure, our findings suggest that 1.3% of neonates born in PEI during this 1-year period will have FASD. In its application to an entire provincial birth cohort, this study successfully implemented a public health-centred approach for evaluating population-based risk of FASD, with implications for practice across Canada.