https://www.um.edu.mt/library/oar/handle/123456789/414 2026-11-03T21:54:50Z 2026-11-03T21:54:50Z https://www.um.edu.mt/library/oar/handle/123456789/150468 2026-10-26T13:24:31Z 2023-01-01T00:00:00Z

Title: Reflections on women’s medical autonomy in the 21st century Abstract: One of the fiercest and most pragmatic of women’s battle was their right of medical autonomy vis-a- vis full information and right of acceptance/ refusal of any treatment offered. One of the most celebrated of these medico-legal battles and one which proved a page-turner was the case of Montgomery (Appellant) v Lanarkshire Health Board (Respondent) [2015] UKSC 11. It is time to take a reality check on the situation arising in this case, for it is becoming amply clear that in daily obstetric practice, women’s rights are far from being respected for one reason or another. [extract]

2023-01-01T00:00:00Z Cetin, Irene Carlson, Susan E. Burden, Christy da Fonseca, Eduardo B. Carlo di Renzo, Gian Hadjipanayis, Adamos Harris, William S. Kumar, Kishore R. Olsen, Sjurdur Frodi Mader, Silke McAuliffe, Fionnuala M. Muhlhausler, Beverly Oken, Emily Poon, Liona C. Poston, Lucilla Ramakrishnan, Usha Roehr, Charles C. Savona-Ventura, Charles Smuts, Cornelius M. Sotiriadis, Alexandro Su, Kuan-Pin Tribe, Rachel M. Vannice, Gretchen Koletzko, Berthold https://www.um.edu.mt/library/oar/handle/123456789/146395 2026-05-12T13:39:04Z 2024-01-01T00:00:00Z

Title: Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth Authors: Cetin, Irene; Carlson, Susan E.; Burden, Christy; da Fonseca, Eduardo B.; Carlo di Renzo, Gian; Hadjipanayis, Adamos; Harris, William S.; Kumar, Kishore R.; Olsen, Sjurdur Frodi; Mader, Silke; McAuliffe, Fionnuala M.; Muhlhausler, Beverly; Oken, Emily; Poon, Liona C.; Poston, Lucilla; Ramakrishnan, Usha; Roehr, Charles C.; Savona-Ventura, Charles; Smuts, Cornelius M.; Sotiriadis, Alexandro; Su, Kuan-Pin; Tribe, Rachel M.; Vannice, Gretchen; Koletzko, Berthold Abstract: This clinical practice guideline on the supply of the omega-3 docosahexaenoic acid and eicosapentaenoic acid in pregnant women for risk reduction of preterm birth and early preterm birth was developed with support from several medical-scientific organizations, and is based on a review of the available strong evidence from randomized clinical trials and a formal consensus process. We concluded the following. Women of childbearing age should obtain a supply of at least 250 mg/d of docosahexaenoic+eicosapentaenoic acid from diet or supplements, and in pregnancy an additional intake of ≥100 to 200 mg/d of docosahexaenoic acid. Pregnant women with a low docosahexaenoic acid intake and/or low docosahexaenoic acid blood levels have an increased risk of preterm birth and early preterm birth. Thus, they should receive a supply of approximately 600 to 1000 mg/d of docosahexaenoic+eicosapentaenoic acid, or docosahexaenoic acid alone, given that this dosage showed significant reduction of preterm birth and early preterm birth in randomized controlled trials. This additional supply should preferably begin in the second trimester of pregnancy (not later than approximately 20 weeks’ gestation) and continue until approximately 37 weeks’ gestation or until childbirth if before 37 weeks’ gestation. Identification of women with inadequate omega-3 supply is achievable by a set of standardized questions on intake. Docosahexaenoic acid measurement from blood is another option to identify women with low status, but further standardization of laboratory methods and appropriate cutoff values is needed. Information on how to achieve an appropriate intake of docosahexaenoic acid or docosahexaenoic+eicosapentaenoic acid for women of childbearing age and pregnant women should be provided to women and their partners.

2024-01-01T00:00:00Z Muscat Baron, Yves https://www.um.edu.mt/library/oar/handle/123456789/145424 2026-04-08T13:25:20Z 2023-01-01T00:00:00Z

Title: Could the Omicron variant be the last variant of concern of the COVID-19 pandemic? Global immunity is key Authors: Muscat Baron, Yves Abstract: The Omicron variant was designated a Variant of Concern (VoC) due to its increased transmissibility and antibody evasion. Data from several countries however suggested a milder clinical outcome for the Omicron variant compared to the previous VoCs. The clinical outcome in the coming year (2023) is however uncertain due to Omicron’s persistent evolution, developing variants with increased immune escape attributes in the presence of populations that may not possess adequate immunological defences.; The Omicron variant utilizes the endosomal route of cell entry unlike previous VoCs. This may be due to Omicron’s superior spike protein receptor binding domain (RBD)’s adhesion to the host cell’s angiotensin converting enzyme II (ACE2) receptor. Efficient cell entry may have increased Omicron’s tropism to rapidly infect the extensive surface area of the nasopharyngeal mucosa and its adjacent sinuses. The endocytic mode of cell invasion may result in a more efficient recruitment of several contemporaneous RBD-ACE2 complexes of the same virus and other viruses to the attached host cell, suggesting a correlation between viralhost cell binding and transmissibility and a negative correlation with clinical severity. The nasopharyngeal region acting as a buffer, would have gained time with the initial containment of the Omicron infection providing immunological protection, preceding significant seeding into the lungs.; The combination of previous waves of natural infection, uneven global vaccination efforts and widespread Omicron infection and its most recent sub-variants (BF7 and XXB), may elude worldwide immunity, exacerbating the pathogenic effects of future SARS-CoV-2 outbreaks. Emulating the pattern of waves of infection during the devastating 1918 Spanish influenza, the current COVID-19 Pandemic may have approached an upended immunological equilibrium, due to adverse immunological, anthropogenic and environmental factors, swaying in favour of a more virulent subvariants.

2023-01-01T00:00:00Z Muscat Baron, Yves Craus, Johann Camilleri Agius, Rodianne Brincat, Mark https://www.um.edu.mt/library/oar/handle/123456789/145423 2026-04-08T13:18:04Z 2012-01-01T00:00:00Z

Title: Synergistic effect on the treatment of menorrhagia by endometrial biopsy followed by contemporaneous insertion of the levonorgestrel intrauterine system Authors: Muscat Baron, Yves; Craus, Johann; Camilleri Agius, Rodianne; Brincat, Mark Abstract: Objective: To evaluate the efficacy of endometrial biopsy followed by intrauterine system-releasing levonorgestrel (LNG-IUS) insertion in the treatment of women with menorrhagia. Method: This was a retrospective, non-comparative study. Ninety-two patients who had menorrhagia due to non-malignant causes were sequentially recruited into the study over a 3-year period (age range 29–51 years). Patients with a uterine size more than 12 weeks were not included. A LNG-releasing intrauterine system was inserted during the mid-cycle immediately after an endometrial biopsy was taken. One year after the closure of the study period, the women recruited were then contacted by telephone or by direct questioning at the outpatient clinic as to the outcome of the above treatment. Results: The most common (15%) complaint regarding bleeding patterns at 3–6 months after insertion was spotting and intermenstrual bleeding. Following the introduction of the LNG-IUS, six women required a hysterectomy for various reasons. The remaining 86 women (93.5%) continued the use of LNG-IUS. Conclusion: LNG-IUS following an endometrial biopsy is an effective treatment for menorrhagia due to benign causes and could be an alternative to other forms of medical and surgical treatments.

2012-01-01T00:00:00Z