https://www.um.edu.mt/library/oar/handle/123456789/188 2026-04-11T11:18:26Z https://www.um.edu.mt/library/oar/handle/123456789/860 Title: Escherichia coli O157:H7 in Malta Authors: Cuschieri, Paul Abstract: E coli O157:H7 infection causes a wide spectrum of disease ranging from asymptomatic carriage to severe disease leading to death. Typical disease includes a non-bloody diarrhoea, haemorrhagic colitis, HUS and thrombotic thrombocytopaenic purpura. While the incubation period is commonly 3-4 days, it can range from one to eight days. In this article the author describes the epidemiology, the clinical features and the microbiology of the infection, whilst giving a short view of the local situation. 1996-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/843 Title: Two judicial post-mortems that went awry 1870 & 1908 Authors: Cassar, Paul Abstract: The first instance of an exhumation of a cadaver for a judicial post-mortem took place in 1870 in connection with a murder case. Knowledge, on the part of the pathologist, of the scene of the crime and of the events leading to the murder are important as they may suggest to the pathologist what to look for in the corpse, but only a thorough autopsy may reveal the cause of death. This is possible even after exhumation of a decomposed cadaver. 1996-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/718 Title: Screening for congenital hypothyroidism in Maltese newborns using cord blood Authors: Parascandalo, Raymond; Felice, Alex; Rizzo, M.; Vassallo Agius, Paul Abstract: Routine screening for congenital hypothyroidism (CHT) has been introduced because clinical features of CHT may not be evident before the baby is a few weeks old and treatment at this stage may already be too late. Since a newborn testing programme employing liquid cord blood for other conditions had already been developed in the University of Malta and the Department of Health, we explored the possibility of implementing newborn thyroid testing using liquid cord blood. A similar programme had been implemented successfully in Finland and Philadelphia. Between September 1989 and August 1995 around 32,000 newborns were tested. This is nearly complete ascertainment. Preliminary testing was by radioimmunoassay for TSH. The sera of those with TSH levels more than 13mU/l were further tested for free T4. If the free T4 level was below 12 pmol/l, the babies were recalled for clinical evaluation and repeat testing. Other babies were recalled for technical reasons, giving a total recall rate of 3.88%. CHT was identified in seven newborns and treatment started within 3 weeks of delivery. One baby was reported normal on screening but was suspected to have CHT on clinical grounds at 3 weeks of age, confirmed biochemically. The incidence of CHT in Malta is therefore 1 in 4500. 1996-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/714 Title: A review of acute bacterial meningitis in childhood Authors: Muscat Baron, Yves; Muscat Baron, Astrid Abstract: This paper reviews the epidemiology, pathogenesis and management of acute bacterial meningitis in childhood. The epidemiology of this infection has undergone significant changes with the implementation of effective immunisation, antibiotic therapy and chemoprophylaxis. The reported incidence of bacterial meningitis in children in the Maltese Islands is low compared to other countries. A high index of suspicion is required to diagnose the onset of bacterial meningitis especially in infants. Third-generation cephalosporins are currently the antibiotics of choice for the acute disease. The timely administration of penicillin may be life saving in cases of meningococcal septicaemia. Adjuvant therapy such as dexamethasone may reduce the occurrence and the severity of sequelae, in particular sensorineural hearing loss. Chemoprophylaxis with rifampicin has played an important role in curtailing epidemics of meningococcal disease. The Haemophilus influenzae type b (Hib) vaccine has made a significant impact on the incidence of H. influenzae meningitis in children. Effective vaccines against pneumococci and meningococci (type b) do not yet exist, however ongoing research seeks to produce these vaccines in an effort to emulate the successful outcome attained by the Hib vaccine. 1996-01-01T00:00:00Z