OAR@UM Collection:
https://www.um.edu.mt/library/oar/handle/123456789/9594
2024-03-29T06:54:28ZLaparoscopic omentoplasty and split skin graft for deep sternal wound infection and dehiscence patient
https://www.um.edu.mt/library/oar/handle/123456789/9725
Title: Laparoscopic omentoplasty and split skin graft for deep sternal wound infection and dehiscence patient
Authors: Sladden, David; Darmanin, Francis X.; Axisa, Benedict; Galea, Joseph
Abstract: Treatment of sternotomy dehiscence secondary to
infection is complex. We describe a case where
following debridement and negative pressure
therapy the greater omentum was harvested
laparoscopically, pedicled on the right
gastroepiploic artery and transposed through a
subxiphoid window and laid into the chest wound.
The omentum was covered with a split skin graft.
The omental transposition provided a healthy
vascular bed for the skin graft to be laid on top of.
This technique allows for larger defects to be closed
when due to the amount of bone loss the sternum
cannot be brought together.
Such procedures are normally performed when
all other measures have failed and myocutaneous
flaps cover the omentoplasty. Our case is novel in
that the laparoscopic harvest and the use of direct
skin grafting make this an option to be considered
earlier as a single definitive procedure.2016-01-01T00:00:00ZReferral tickets to secondary healthcare : is communication effective?
https://www.um.edu.mt/library/oar/handle/123456789/9724
Title: Referral tickets to secondary healthcare : is communication effective?
Authors: Cassar, Matthew; Mifsud, Janine; Vella Fondacaro, Daniel; Debono, Joseph
Abstract: Communication between primary and
secondary health care relies primarily on referral
tickets. They determine how patients’ details are
conveyed and hence the quality of care. The aim
of this study was to assess the quality of referral
tickets at the Surgical Outpatients at Mater Dei
Hospital in Malta and to develop
recommendations for improvement. Consecutive
referral tickets between the 7th February and 4th
March 2015 were prospectively included in the
study and analysed for completeness. The data was
entered into a proforma which was revised after
the first ten entries. A total of 351 referral tickets
were included in the study. Names and surnames
were present in all reports and identification
number in 99.42% of cases. 44.16% of referrals
were inappropriate according to clinical details.
The majority of the forms had a history of
presenting complaint (98.29%) while the past
history, drug history / allergies and examination
findings were available in 69.23%, 67.81% and
76.64% respectively. The source of referral was
not clear in 56.13%. Only 69.23% of all referral
tickets were completely legible while 30.77% were
partly legible. This study shows the need for an
overhaul in the referral system. Recommendations
include the use of electronic referrals and the
introduction of feedback letters by hospital
specialists.2016-01-01T00:00:00ZThe effect of community-based drug rehabilitation programs on recidivism in Malta
https://www.um.edu.mt/library/oar/handle/123456789/9723
Title: The effect of community-based drug rehabilitation programs on recidivism in Malta
Authors: Axiak, Claire
Abstract: Background: The argument for financing
therapeutic community-based drug rehabilitation
programs for inmates is compelling. Numerous studies
have established the positive effect of such treatment on
reducing recidivism, especially treatment based on the
therapeutic community model. Methods: This quasiexperimental
retrospective cohort study examined the
impact of therapeutic community-based drug
rehabilitation programs on recidivism amongst drug
inmates released from the national prison of Malta
between 2005 and 2008 (i.e. “the reference period”). An
experimental group consisting in all drug inmates who
participated in at least one program during the time spent
in prison for a conviction that ended during the reference
period was compared to two comparison groups of
inmates who did not attend such a program or who had
attended in the past. Chi-square tests and ANOVA were
employed in the analysis.
Results: There was no statistically significant
difference (p<0.05) between the three groups with
regard to sex, age on admission and occupation but there
was a highly significant difference with regard to the
number of previous convictions, prison-basedopioid
substitution treatment (given to all inmatesconvicted for
heroin-related offences) and prison-based psychiatric
treatment. On fitting a generalized linear model with a
logit link function to control for opioid substitution
treatment and the number of previous convictions it
emerged that the difference between groups was not
significant and thus the null hypothesis was not rejected. Conclusion: Participation of inmates in
therapeutic community-based drug rehabilitation
programs did not in itself emerge as a significant
predictor of recidivism. In this regard, possible
limitations that may have contributed to the lack of
significant results were discussed. Inmates who were not
administered any opioid substitution treatment (i.e.
corresponding to all those who were incarcerated for
drug offences other than heroin) were 74% less likely to
reoffend compared to those who were given methadone
or tramadol. Moreover, the likelihood of recidivism was
1.7 times greater for each additional prior incarceration
(p<0.001).2016-01-01T00:00:00ZTerrorist attacks and the male to female ratio at birth : the bombings of Madrid (3/2004) and London (7/2005)
https://www.um.edu.mt/library/oar/handle/123456789/9722
Title: Terrorist attacks and the male to female ratio at birth : the bombings of Madrid (3/2004) and London (7/2005)
Authors: Mamo, Julian; Grech, Victor E.
Abstract: Introduction: Males are usually in excess of
females at birth and the ratio is often expressed as
M/F (male divided by total births). Several factors
have been shown to be associated with changes in
M/F, including major terrorist attacks. These are
associated with a transient lowering of M/F for a
one month period, three to five months after such
events. This study was carried out in order to
ascertain whether the Madrid March 2004
bombings and the London July 2005 bombings
were similarly associated with changes in M/F in
their respective populations.
Methods: Monthly live births by gender for
Madrid and Spain for 2004 and for England and
Wales for 2005 were obtained from the two
countries’ National Statistics Offices.
Results: There were no significant dips in M/F
for any of the months following the March 2004
bombings in Madrid or in Spain. There were no
significant dips in M/F for any of the months
following the July 2005 London bombings. Discussion: Research to date has shown M/F
dips following catastrophic or tragic events,
including major terrorist actions with extensive
media coverage. Equivalent dips were not noted in
this study for the terrorist acts in these instances.
The reasons for this may be one or a combination of
the following. The population size was not
sufficiently large in order to detect an M/F dip.
Alternatively, the events were not felt to be
sufficiently momentous by the populace such that
an M/F dip was not produced. Yet another
possibility is that these particular populations are
somehow hardier and more resistant to such
influences. Not all terrorist events universally cause
a significant reduction in M/F.2016-01-01T00:00:00Z