Suicide and deliberate self-harm in Oxford University students over a 30-year period

Purpose  

To determine whether rates of suicide and self-harm in university students differ from those in other young people.     

Membrane‐based therapeutic plasma exchange (mTPE): Technical and clinical experience

Therapeutic plasma exchange (TPE) has long been utilized to manage a variety of immune‐mediated diseases. The basic principle relies on removal of circulating pathogenic substances from the bloodstream. Methods of plasma separation include centrifuge (cTPE) and membrane (mTPE). Although mTPE has existed for a few decades, recent advances in developing highly permeable filters that are compatible with currently existing dialysis machines has opened a new frontier. Published data in the area of technical and clinical experience with mTPE is lacking. We report our single center experience of 998 inpatient mTPE treatments performed in 237 patients at a large tertiary care academic center. The most common treatment indication was neurologic. We found a very low incidence of patient‐reported complications. Filter clotting without the use of anticoagulation occurred in 7.7% of treatments. Laboratory parameters that significantly changed during the course of therapy included serum potassium, platelet count, and partial thromboplastin time. We found that mTPE can be safely and efficiently performed as an alternative to cTPE, and suggest an individualized approach when prescribing this therapy.     

Poverty status of worker compensation claimants with permanent impairments

Poverty levels have proven to be pernicious in Canada, with particular groups at heightened risk of poverty. Given that people with disabilities are consistently identified as among those ‘at risk’, we seek to determine the extent to which injured workers/worker compensation claimants who had sustained bodily impairments live in poverty. Employing two poverty indicators, we describe the poverty levels of Ontario injured workers with permanent impairments at an average of 52 months post-injury. For one indicator, we describe proximity to/depth of poverty; and in bivariate and multivariate analyses, we examine the factors associated with poverty in the post-injury period. Estimated poverty rates for the injured worker sample – ranging from 17 to 26% – compare unfavourably to published estimates of poverty in the general population of working-aged Canadians/Ontarians and equate to those of Canadians/Ontarians with disabilities. Pre-injury employment characteristics and income status only partly account for post-injury poverty, pre-injury health does not. Sample members in post-injury poverty were more likely to report having sustained multiple injuries at the workplace, were less likely to have returned to employment or to have recovered pre-injury earnings, and yet contributed significantly more to post-injury household incomes than those not in post-injury poverty. We discuss the implications of the findings for worker compensation boards that adjudicate and have final authority on worker claims for compensation for harms sustained in the workplace.     

In vitro and in vivo evaluation of polymer hydrogels for hemorrhage control

In vitro and in vivo experimentation of various synthetic polymer hydrogels was conducted to establish some of the integral material properties that influence hemostasis. In vitro swelling experiments suggested that positive electrostatic charge was a key determinant of the ability of a polymer hydrogel to absorb physiological fluids, e.g. human plasma and blood. In vitro testing using unadulterated sheep blood suggested positive electrostatic charge and crosslink density were key determinants of the ability of a material to induce or enhance clot formation. Hydrogel formulations composed of higher amounts of positive electrostatic charge and lower crosslink density were able to effectively induce and enhance clot formation in the presence of a coagulation cascade activator. In vivo experimentation confirmed that hydrogels containing higher electrostatic charge and low crosslink density are more effective at fostering the formation of a robust hemostatic plug to control blood loss.     

A case of external auditory canal chondroma

The differential diagnosis for an external auditory canal mass is relatively broad, with exostosis, osteoma, fibroma, keratoma, and congenital cholesteatoma among the more common diagnoses. However, an additional diagnosis, external auditory canal chondroma, should also be considered in the differential. These rare lesions are most often found in individuals of Asian ancestry. However, this is not always the case as demonstrated by this case report of an external auditory canal chondroma in a Caucasian teenager.