https://www.um.edu.mt/library/oar/handle/123456789/144761 Sun, 05 Apr 2026 03:15:33 GMT 2026-04-05T03:15:33Z https://www.um.edu.mt/library/oar/handle/123456789/144847 Title: The Synapse : the Medical Professionals' Network : volume 23 : issue 3 Authors: Friggieri, Jesmond; Ellul, Ian C. Abstract: Table of contents:; 1/ ELLUL, I. C. - Personal ponderations; 2/ MUSCAT, J. - Breast MRI : no time like the present; 3/ ZERAFA SIMLER, M. A., & MIFSUD, S. - Neuraxial anaesthesia in the parturient with multiple sclerosis; 4/ MIFSUD, A., & AQUILINA, M. - Towards sustainable ophthalmology: an analysis of custom packs used in cataract surgery to reduce waste and CO2 emissions; 5/ BRINCAT, M., & AGIUS, M. P. - Fertility preservation strategies in early-stage cervical cancer Mon, 01 Jan 2024 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/144847 2024-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/144785 Title: Personal ponderations Abstract: It was a dry and sunny September morning when, in 2005, I paid a visit to Dr Wilfred Galea at his Dingli office. I remember that we discussed many topics that inevitably gravitated around my involvement with The Synapse medical magazine. This was followed, a few days later, by a second meeting at a corner bar in St Luke’s square to discuss the metamorphosis of the monotone 8-pager, with the primary goal being the dissemination of relevant medical information to the busy healthcare professional. I thus became the Managing Editor of the magazine. There is no need to explain the evolution of the publication. All of you are witness to its cathartic evolution. [excerpt] Mon, 01 Jan 2024 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/144785 2024-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/144783 Title: Breast MRI : no time like the present Authors: Muscat, Jessica Abstract: Breast imaging – as a radiological subspecialty – is perhaps the epitome of how the practice of radiology has changed through the decades. Imaging of the breast is an exciting and challenging combination of multimodality image acquisition, interpretation, biopsy procedures, clinical, radiological and radiopathological correlation. The breast radiologist is an integral part of the multidisciplinary team guiding patients on this most personal journey from diagnosis to an end-goal of survivorship and quality-adjusted life-years gained. Breast magnetic resonance imaging (MRI) was introduced to the breast imaging community in the 1990s and has since then become a validated tool for the diagnostic evaluation of the breast. Compared to conventional imaging modalities, namely mammography and ultrasound, MRI has been proven to have a very high cancer detection sensitivity ranging between 93-100% albeit with a low specificity ranging between 37-97%. In simplest terms, the physiological explanation for the high sensitivity of MRI for cancer detection is that contrast-enhanced MRI is extremely sensitive for tumour angiogenesis. The vessels formed by tumour angiogenesis are abnormal and more ‘leaky’ than native vessels. The increased enhancement of cancers relative to normal breast tissue may result from both an increased supply of contrast agent (gadolinium) through this proliferation of blood vessels and their increased permeability. Hence, breast MRI utilizes the dynamic (with time) contrast-enhancement (DCE) characteristics of lesions. Several sets of imaging are acquired at different time points. The increased leakiness of the abnormal vasculature results in earlier wash-out of contrast from malignant lesions when compared to normal breast parenchyma. The varying cyclical vascularity of the premenopausal breast actually determines the opportune timing (day 10 – 16 of menstrual cycle) of imaging examination. Features such as restricted diffusivity and corresponding apparent diffusion coefficients of lesions can further differentiate benign from more suspicious findings. [excerpt] Mon, 01 Jan 2024 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/144783 2024-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/144781 Title: Neuraxial anaesthesia in the parturient with multiple sclerosis Authors: Zerafa Simler, Marie Adrienne; Mifsud, Stephanie Abstract: Multiple Sclerosis (MS) is one of the most commonly acquired neurological diseases in young adults. Due to its pathological process, anaesthetic considerations in parturient women can be difficult and must include the safety of both the mother and foetus. This case report describes the management of pain relief during labour and subsequently a Category 2 caesarean section of a 30-year-old woman (pregnant for the first time or G1P0) with MS, with epidural anaesthesia. A multidisciplinary team approach, and early planning was essential for the success of this case. This case report indicates that epidural anaesthesia is safe in the parturient with MS during labour and that there is no association between epidural anaesthesia and relapse rates of MS in these individuals. Mon, 01 Jan 2024 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/144781 2024-01-01T00:00:00Z