https://www.um.edu.mt/library/oar/handle/123456789/1079 2026-04-04T21:25:42Z 2026-04-04T21:25:42Z Azzopardi, Neville https://www.um.edu.mt/library/oar/handle/123456789/1653 2021-03-25T07:51:59Z 2014-01-01T00:00:00Z

Title: Cystic Lesions of the Pancreas Authors: Azzopardi, Neville Abstract: With the increasing use of abdominal imaging, cystic lesions of the pancreas are being more frequently detected. These lesions may carry a significant premalignant potential. Current guidelines recommend that mucinous cystic neoplasms, solid pseudopapillary neoplasms, main duct-intraductal papillary mucinous neoplasms and branch duct-intraductal papillary mucinous neoplasms (DB-IPMN) with "high-risk stigmata" for malignancy should be resected while asymptomatic BD-IPMN without mural nodules, no main duct involvement, and a size less than 30 mm can be followed up. Serous cystadenomas carry a very small malignant risk and are usually resected only if they cause symptoms. This review article highlights the common characteristics and recommended management of these cystic lesions of the pancreas.

2014-01-01T00:00:00Z Cuschieri, Sarah Grech, Stephan Borg, Joe https://www.um.edu.mt/library/oar/handle/123456789/1652 2023-01-25T06:41:00Z 2014-01-01T00:00:00Z

Title: Outcome of low back pain patients referred to orthopeadic outpatient clinic Authors: Cuschieri, Sarah; Grech, Stephan; Borg, Joe Abstract: Background: Musculoskeletal complaints are the commonest encounters in primary care. Low back pain management is commonly initiated by the family practitioner. Guidelines are limited as to when patients should be referred for specialist treatment by the orthopaedic department. Objectives: Evaluate the justification of low back pain referrals to Orthopedic outpatients (OOP), Mater Dei Hospital, Malta and assess whether these merited specialist consultation. Method: Anonymous data was collected over a 3- month period, where 100 low back pain new case referrals were evaluated during OOP. Data collection was based on routine questions normally brought forward during a consultation and a management plan which was documented in a spreadsheet. Data was analyzed using the same software. Results: Out of the total number of patients reviewed, 57 had been referred for the first time to OOP. Out of these, only 10 required an MRI with a scheduled follow up appointment. The remainder were referred for physiotherapy or pain clinic and discharged to follow-up in the community by the primary care physician. Out of 43 patients who had had previous OOP appointments complaining of lower back pain, 5 patients required an MRI and follow up appointment, remainder were discharged with physiotherapy or pain clinic appointments. Conclusion: The majority of patients seen at OOP could have been managed in primary care. It reflects the importance of developing local management guidelines for low back pain, which would assist general practitioners. It is indicative that referral to OOP should only be triggered when all treatment options available in the primary care are exhausted. This would lead to patients achieving targeted treatment timely within the community, resulting in shorter waiting time for outpatient visits.

2014-01-01T00:00:00Z Sladden, David Casha, Aaron Manche, Alexander https://www.um.edu.mt/library/oar/handle/123456789/1645 2020-06-05T12:13:45Z 2014-01-01T00:00:00Z

Title: Chest wall reconstruction following a speedboat propeller injury Authors: Sladden, David; Casha, Aaron; Manche, Alexander Abstract: Propeller blade injuries to the chest are uncommon but can result in devastating injuries. We describe a case of a 44 year-old male scuba diver who was dragged by sea currents into the propeller of a speedboat. He suffered extensive chest wall trauma but narrowly escaped damage to major organs and vessels. He was admitted directly to the operating theatre. There was significant loss of bone from the manubrium, costal cartilages, overlying skin and muscle which were stripped off in 3 horizontal bands. During reconstruction the bony fragments were anchored to the nearest stable sternal or costal cartilage entities using steel wires, to achieve stability. The overlying muscle and skin were sutured directly to its opposite edge in layers and in an interdigitating fashion following the shape of the propeller blade lacerations. The patient remained intubated for 3 days in ITU and was transported back to his home country. He required a small skin graft to one area of necrosis but eventually made a full recovery with only his scars as a reminder of his accident. There have been other cases of propeller injuries in Malta but this is unique in being a severe injury to the chest, in which the patient made a full recovery. This report highlights the importance of legislation in preventing propeller injuries by restricting swimmer zones and introducing propeller guards or jet drive systems.

2014-01-01T00:00:00Z Galea, Gabriel Abela, Rodianne Deguara, Catriona Cuschieri, Paul Brincat, Mark P. https://www.um.edu.mt/library/oar/handle/123456789/1644 2021-03-16T15:37:49Z 2014-01-01T00:00:00Z

Title: Puerperal Streptococcus pneumoniae endometritis : a case report and literature review Authors: Galea, Gabriel; Abela, Rodianne; Deguara, Catriona; Cuschieri, Paul; Brincat, Mark P. Abstract: Streptococcus pneumoniae endometritis is an exceedingly rare clinical occurrence in the immunocompetent individual. This case report describes such an occurrence in an otherwise healthy woman 39 days post-normal vaginal delivery. The patient responded to prompt broad-spectrum intravenous antibiotics and made a full recovery. The clinical relevance of such a scenario, the likely pathogenesis of the event as well as a brief review of relevant clinical literature are discussed. Streptococcus pneumoniae genital infection was a well-documented clinical entity in the pre-antibiotic era with a high mortality rate – 26% for localised infection and 74% for peritonitis and sepsis. More recently, however, there have been only isolated reports of Streptococcus pneumoniae genital infection, with even less frequent accounts of this happening in immunocompetent individuals. In this report, we document a case of Streptococcus pneumoniae endometritis in a young, previously healthy female 39 days post-partum.

2014-01-01T00:00:00Z