https://www.um.edu.mt/library/oar/handle/123456789/27486 2026-04-15T20:31:13Z https://www.um.edu.mt/library/oar/handle/123456789/8255 Title: Depicting the analyses of the first National Maltese Childhood BMI study Authors: Grech, Victor E.; Aquilina, S.; Camilleri, E. Abstract: Introduction Obesity is a chronic disease that often commences in childhood. Several publications have shown that a quarter to a third of Maltese children are overweight or obese. Malta will be the first country to measure height and weight (and hence Body Mass Index) for all school children in order to quantify the extent of the problem. Methods This study would include 46,000 children in 150 schools. This would be the first time that any country measured its entire childhood cohort, as opposed to sampling. Hence, it was decided to attempt to facilitate data collection and analysis with the use of bespoke spreadsheets. Results This paper will demonstrate how standard Microsoft Excel was used to accomplish this, greatly speeding up the data analysis process. Conclusion Software should be prepared in advance in anticipation of large amounts of data that need to be analysed and summarised. Particular care must be taken in order to prepare the requisite graphs and tables in advance so as to process the data once and present it in a suitable format for consumption and evaluation. 2015-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/8254 Title: Free left ventricular wall rupter in a newborn Authors: Hutter, Damian; Kreiter, Bianca; Riedel, T.; Wagner, B.; Kadner, Alexander; Pfammatter, Jean-Pierre Abstract: Free left ventricular wall rupture is very rare but mostly fatal complication of acute myocardial infarction in the elderly. Without the presence of congenital heart disease, preceding cardiac surgery or an isolated ventricular diverticulum, spontaneous rupture of the free left ventricular wall in neonates has not been described to date. We present a newborn baby who was brought to the Pediatric Intensive Care Unit (PICU) of the University Children’s Hospital in Bern, Switzerland in hemodynamic shock. Clinical assessment revealed bi-ocular cataract and a severe form of hypertrophic obstructive cardiomyopathy, both highly suspicious findings for an underlying mitochondrial myopathy. The newborn underwent extensive metabolic and genetic screening and was discharged from the PICU to the regular ward. 2015-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/8253 Title: Right ventricular outflow tract stenting : effective palliation for Fallot’s tetralogy Authors: Bugeja, Justine; Grech, Victor E.; DeGiovanni, Joseph V. Abstract: Traditionally, the management of infants with Fallot’s tetralogy (TOF) with excessively reduced pulmonary flow and cyanosis has been palliation until or unless complete repair is feasible. Palliation involves a procedure that augments pulmonary flow. Most series recognise two subgroups of patients at high risk even in the current era: the cyanotic neonate/infant with small pulmonary arteries and those with complex anatomical variants of tetralogy and/or significant comorbidities such as additional congenital heart lesions (e.g associated Atrio Ventricular Septal Defect) or other congenital anomalies. There is an argument for palliation of these high-risk groups to allow for future potentially more effective elective repair 2015-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/8252 Title: “Bendy” stents help negotiate hairpin intracardiac curves Authors: Bugeja, Justine; Grech, Victor E.; DeGiovanni, Joseph V. Abstract: Simple transposition of the great arteries (TGA) occurs in 0.2 per 1000 live births. The condition is surgically repaired in the neonatal period by the arterial switch procedure (ASO) sometimes preceded by an atrial septostomy. The ASO involves transecting the great arteries and relocating them to the appropriate ventriculo-arterial (VA) connection with attachment of the disconnected coronary arteries to the aorta. In the process, the attachment of the pulmonary artery to the right ventricle involves the Le Compte manoeuvre and to achieve this the pulmonary arteries must be fully mobilised and sometimes the main pulmonary artery may require patch augmentation as well. Nevertheless, pulmonary artery stenosis (PAS) is one of the potential problems with the ASO. However, with improved surgical techniques, this has dropped from around 15% in the 1980s to less than 3%. Apart from surgical revision when PAS occurs, there are interventional options which include angioplasty and/or stent insertion. The latter is preferred in small children and works well in around 60% but may require repeat procedures. In older patients or when angioplasty fails, stent insertion can be considered. These procedures may involve negotiating tight bends in order to reach the site of stenosis. The passage of non-premounted stents may be problematic in such situations, especially with longer stents and tighter bends as they tend to slip off balloon. We describe several techniques that may facilitate such interventions, and these were utilised in an adolescent patient who had had ASO for TGA in the neonatal period. These included manually giving the mounted stent a slight bend in order to help the balloon-stent assembly negotiate hairpin bends. 2015-01-01T00:00:00Z