OAR@UM Collection:

Life expectancy, mortality and elections : their association during elections in Malta

2019-10-14T09:08:31Z

Title: Life expectancy, mortality and elections : their association during elections in Malta Authors: Lautier, Elaine Claire; England, Kathleen; Azzopardi Muscat, Natasha; Calleja, Neville; Gauci, Dorothy Abstract: Introduction: While life expectancy has increased over the past thirty years, such increases have not been constant around election times in Malta. This study seeks to explore the relationship between the time of elections in Malta and specific mortality rates. Aim: To determine if there is an association between mortality and elections in Malta. Method: Yearly age specific death rates for all-cause mortality, mortality from ischaemic heart disease, cerebrovascular disease, other heart diseases and all circulatory diseases as well as suicides were calculated from the Malta National Mortality Register for the period between 1985 and 2013. Years when elections and referenda were held between 1985 and 2013 were obtained from the Electoral Commission.1 The years 1985 – 2013 were coded using dummy variables to categorise them into pre-election, post-election, election year or any other year. Data was analysed using Poisson’s regression technique in STATA with Mortality Rate Ratio (MRR) presented as the outcome measure. Results: A significant increase in overall mortality during election years resulted for circulatory disease MRR 1.058 (p<0.001; 95% CI 1.029-1.087), cerebrovascular disease MRR 1.09 (p=0.002; 95% CI 1.032-1.155) and other heart diseases MRR 1.36 (p<0.001; 95% CI 1.276-1.449). A significant increase was also noted during pre- election years in circulatory disease MRR 1.046 (p=0.002; 95% CI 1.017-1.075) and other heart diseases MRR 1.33 (p<0.001; 95% CI 1.248-1.422) and post-election years for cerebrovascular disease MRR 1.08 (p=0.009; 95% CI 1.020-1.150) and other heart diseases MRR 1.19 (p<0.001; 95% CI 1.108-1.273)) relative to the other years. Conclusion: This ecological study provides an indication that mortality patterns may be associated with the electoral cycle in Malta. Further research on individual physical and psychological responses to political events, particularly around election time is warranted.

Zika virus : the 21st century traveller

2018-04-12T17:14:56Z

Title: Zika virus : the 21st century traveller Abstract: Zika virus (ZIKV) has emerged from the shadows to become one of the hottest topics of public discussion amongst health practitioners and lay people alike, surpassing most of its viral relatives in notoriety. At first, ZIKV infection was a geographically distant problem but has this issue, now, migrated much closer to home?

Ruptured abdominal aortic aneurysm with a horseshoe kidney : an uncommon but potentially troublesome coexistence

2019-10-14T09:09:10Z

Title: Ruptured abdominal aortic aneurysm with a horseshoe kidney : an uncommon but potentially troublesome coexistence Authors: Petrovic, Nebojsa; Micallef Eynaud, Stephen; Pejkic, Sinisa Abstract: We report a case of an elderly patient with a ruptured abdominal aortic aneurysm (AAA) associated with a horseshoe kidney (HSK) treated by an emergency open repair and discuss the anatomical features and surgical challenges attendant to this rare combined pathology.

Optimal gestational age for delivery in uncomplicated dichorionic twin pregnancies : a population-based study

2019-10-14T09:09:36Z

Title: Optimal gestational age for delivery in uncomplicated dichorionic twin pregnancies : a population-based study Authors: Brincat, Mark R.; Sant, Mark; Calleja, Neville Abstract: Objectives: To identify the optimal gestational age for delivery in uncomplicated dichorionic twin pregnancies. Study Design: A retrospective analysis of gestational age-specific neonatal morbidity and mortality data was performed for 254 uncomplicated dichorionic twin pregnancies. Outcome measures included 1st and 5th minute Apgar scores, NICU admission, RDS, TTN, sepsis, seizure, hyperbilirubinemia, hypoglycaemia, neonatal length of hospital stay, birthweight and overall outcome. After correcting for confounding variables by regression analysis, adverse variable trends were assessed in each of the gestational-age- at-birth groups. Results: A significant drop in the incidence of LBW, RDS, TTN and hypoglycaemia, accompanied with the lowest NICU admission rate and neonatal length of hospital stay occurred concordantly at 38 completed weeks of gestation. The incidence of severe hyperbilirubinemia requiring phototherapy decreased significantly by 36 weeks. No correlation was found between advancing gestation and foetal, perinatal or neonatal mortality. Conclusion: Elective delivery in uncomplicated dichorionic twin pregnancies should be delayed until at least 38 completed weeks of gestation as this significantly reduces neonatal morbidity with no impact on mortality.