https://www.um.edu.mt/library/oar/handle/123456789/40066 2026-04-11T07:25:46Z https://www.um.edu.mt/library/oar/handle/123456789/40073 Title: All that glitters... Abstract: The full human genome sequence (via the Human Genome Project) was mapped and published 15 years ago, a 10 year project that cost circa $30bn. Since then technological advances and cheap computing power have markedly accelerated genomic sequencing at a reduced cost, to under $500. For example, the company Oxford Nanopore has taken sequencing to point-of-care status by developing a hand-held reader that can sequence genetic material in minutes. The applications will not be just for healthcare but also, for example, to establish the provenance of foodstuffs, the presence of dangerous microbes and crime scene DNA analysis. 2018-07-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/40072 Title: Doctors during the 1837 Cholera epidemic in Malta : unearthing the truth Authors: Galea, Joseph Abstract: Epidemic cholera devastated Europe throughout the 19th century. The first cholera epidemic reached Malta in the summer of 1837 finding a poor and destitute population. Maltese doctors under the influence of the Italian school believed cholera to be contagious while British doctors alongside with the French and German medical institutions were convinced that the disease was non-contagious. When it hit the islands in June 1837, the Government and the doctors were unprepared. Recruiting medical personnel was difficult because there was fear of contagion and knowledge was lacking. Maltese doctors ran the cholera hospitals erected in different locations in Malta and Gozo and all the British doctors stationed in Malta with the army and navy although few in numbers joined in to help the sick and dying. Although a number of doctors failed in their responsibility towards the patients, many others performed their duties correctly. Some doctors who attended cholera patients lost their life to the disease. 2018-07-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/40071 Title: A review of amputation and revascularisation rates in a small European state Authors: Grima, Matthew Joe; Said, Ian; Duncan, John; Cassar, Kevin Abstract: Background: Until 2007 vascular services in Malta were provided by general surgeons with a vascular interest. In late 2007 a vascular specialist was recruited to contribute to the service. This catered for a gradual transfer of services to a pure vascular specialist service in 2014. The aim was to assess the impact of the introduction of vascular specialist services on lower limb major and minor amputation rates and open revascularisation procedures in Malta. Methodsː This is a retrospective analysis of prospectively collected data. Data from the Hospital annual surgical operation reports and the Vascular Database was analysed between 2002 and 2014. Data was analysed by time period (Period 1: 2002-2007 – no vascular specialist service; Period 2: 2008-2013 - partial vascular specialist service; Period 3 – January to December 2014 complete vascular specialist service). Resultsː There was a significant drop in the average rate of major amputations/year between Period 1 and Period 2 (120 vs 96; p=0.008) and between Period 1 and Period 3 (120 vs 64; p<0.001). A significant increase in minor amputations/year between period 1 and period 2 (102 vs 242; p<0.001) and between period 1 and period 3 (102 vs 449; p<0.001) was noted. There was significant increase in open revascularisation rates between period 1 and period 2 (21.5 vs 73.2; p<0.001) and between period 1 and period 3 (21.5 vs 144; p<0.001). Conclusionː The employment of vascular specialists can lead to a significant increase in lower limb open revascularisation rates and a concomitant significant reduction in lower limb major amputation rates. 2018-07-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/40070 Title: Can the inevitable be prevented? : an analysis of loss to follow-up among grown-ups with congenital heart disease in Malta Authors: Caruana, Maryanne; Aquilina, Oscar; Grech, Victor E. Abstract: Aims: To investigate the prevalence of loss to follow-up, factors predisposing to loss to follow-up and the outcome of recall into specialist care among grown-ups with congenital heart disease (GUCH) of moderate or severe complexity prior to the introduction of formal transition in Malta. Methods: Medical documentation for all live patients with tetralogy of Fallot, aortic coarctation/interrupted aortic arch, partial and complete atrioventricular septal defect, Fontan-type circulation and transposition of the great arteries in our institutional database aged ≥16 years was analysed to determine follow-up status. Patients lost to follow-up were recalled through a postal appointment. Ordinal logistic regression was used to analyse the effect of gender, CHD complexity, consistency of paediatric cardiology follow-up during childhood, number of cardiac surgical/interventional procedures and use of long-term cardiac medications on loss to follow-up. Results: Forty-one of 187 patients (21.9%) (27 males; 34 with moderate disease) had been lost to follow-up. Limited paediatric cardiology input (OR, 5.08; 95% CI, 1.77-14.63) (p=0.003), £1 surgical/interventional procedures (OR, 3.34; 95% CI, 1.09-10.26) (p=0.035) and no long-term cardiac medications (OR 7.34; 95% CI, 1.74-31.02) (p=0.007) were associated with higher risk of loss to follow-up. A positive response to recall was obtained from 33/41 (80.5%) patients. Significant cardiac morbidity was found in 5/33 (15.2%) patients upon reassessment. Conclusions: Loss to specialist follow-up occurs even in health systems with little perceived barriers to medical care. Consistent specialist input during all stages and patient and family education through formal transition can help ensure a smoother transfer to GUCH care. 2018-07-01T00:00:00Z