https://www.um.edu.mt/library/oar/handle/123456789/324 Tue, 27 Oct 2026 05:44:29 GMT 2026-10-27T05:44:29Z https://www.um.edu.mt/library/oar/handle/123456789/150483 Title: Magnetic resonance imaging evaluation of incidental cardiac irradiation during left breast cancer radiotherapy : a systematic review Authors: Nuruddeen, Mohammad Gunda; Karim, Noor Khairiah A.; Mad Naser, Mohamad Nazrulhisham; Garba, Idris Abstract: Breast cancer is one of the most common malignant tumours among women. Radiotherapy plays a key role in the management of breast cancer patients. However, radiotherapy results in incidental exposure of the heart. This work systematically reviewed articles on magnetic resonance imaging (MRI) evaluation of cardiac changes due to incidental cardiac irradiation during left breast radiotherapy and also to identify the MRI sequences used during evaluation. A systematic literature search was conducted in the following three selected databases: PubMed, ScienceDirect and Scopus using carefully defined search terms related to the left breast, MRI and cardiac irradiation. The quality of the included papers was determined using the critical appraisal skills programme for qualitative studies. The review had a total of six articles that were screened and graded for quality. Articles graded as high and moderate in terms of quality assessment were included and characterised based on the sample size, type of cancer treated, treatment methods employed, and period MRI was performed after radiotherapy. The review showed that breast cancer patients who had radiotherapy also developed radiation-induced heart disease (RIHD) few months post treatment. The review noted that breast cancer patients receiving radiation treatment are at high risk of RIHD which may affect their quality of life after completion of treatment. Cardiac MRI facilitates early detection of RIHD, hence better patient management. Sun, 01 Jan 2023 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/150483 2023-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/149462 Title: In-vitro fertilization outcomes in females of advanced maternal age with polycystic ovarian syndrome Authors: Falzon, Sharona; Sant, Mark; Portelli, Jonathan L.; Spiteri, Lorella; Falzon, Chanice Abstract: This study aimed to evaluate in vitro fertilization (IVF) outcomes in women of advanced maternal age (≥35 years) diagnosed with polycystic ovarian syndrome (PCOS), compared with age-matched women without PCOS. Given that advancing age is associated with declining ovarian reserve and fertility potential, this research sought to determine whether the hormonal and ovarian characteristics of PCOS confer any advantage in IVF outcomes within this population.; A retrospective quantitative analysis was conducted using data from 174 IVF cycles performed at an Assisted Reproductive Technology (ART) Clinic at the main public hospital in Malta between January 2021 and 2024. Key outcome measures included oocyte yield, number of embryos generated, clinical pregnancy rates, and viable pregnancy rates at 12 weeks of gestation.; Women with PCOS demonstrated significantly higher serum anti-Mullerian hormone (AMH) levels and oocyte yields, alongside increased embryo numbers and clinical pregnancy rates, compared with non-PCOS counterparts. However, viable pregnancy rates at 12 weeks did not differ significantly.; While further research can improve practice, it is evident that clinicians should provide individualised fertility counselling and design tailored ovarian stimulation protocols for women with PCOS of advanced maternal age to optimize treatment outcomes while mitigating the risk of early pregnancy loss. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/149462 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/149337 Title: Small moments, big impact : advancing excellence in paediatric imaging and radiotherapy Authors: Portelli, Jonathan L.; McGee, Allison Abstract: Introduction : A specialised commitment to our youngest patients; As medical imaging and radiation sciences continue to evolve, the care of paediatric populations remains one of our most delicate and rewarding challenges. It is estimated that approximately 350 million diagnostic examinations are performed on children under the age of 15 each year worldwide. Longitudinal data from O’Connor & Grassick (2025) confirm that while plain radiography and ultrasound remain the primary mainstays of paediatric diagnostic imaging, there is a documented increase in paediatric CT utilisation across healthcare systems. This trajectory underscores that active dose optimisation and clinical justification are not historical milestones, but ongoing operational imperatives. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/149337 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/149323 Title: Radiographers’ role and practice in suspected cases of child physical abuse in Malta Authors: Buttigieg, Emma; Portelli, Jonathan L. Abstract: Introduction: While many injuries in infants are accidental, some may indicate physical abuse, necessitating vigilance from healthcare professionals. Radiographers play a critical role in the detection of Suspected Child Physical Abuse (SCPA), facilitating timely intervention and mitigating long-term morbidity and potential mortality. The purpose of this study was to investigate the role of Maltese radiographers and their current clinical practice in the detection of SCPA.; Methods: A prospective, cross-sectional study design was implemented, with data collected via a self-designed online questionnaire distributed to 44 radiographers working in the Accident and Emergency (A&E) department of a public general hospital or Primary Health Care (PHC) Centres in Malta.; Results: Thirty-six of 44 invited radiographers completed the questionnaire, yielding a response rate of 81.8%. Most radiographers (66.7%) encountered SCPA in clinical practice, with 47.2% reporting occasional cases. All participants demonstrated an understanding of how to determine SCPA, frequently mentioning physical indica- tors, behavioural signs in children and accompanying adult(s). Notably, 61.1% recognised the detection and reporting of SCPA as part of their professional responsibilities. However, 83.4% reported limited familiarity with radiological signs of SCPA, reflecting gaps in specialised training. This was further evident in the image-based section of the questionnaire, where discrepancies in image interpretation noted variability in knowledge and diagnostic accuracy.; Discussion: The study revealed that radiographers employ a variety of evaluative approaches to identify or raise concerns related to SCPA. While most local radiographers recognised their role and demonstrated an understanding of SCPA, this study revealed gaps in knowledge, awareness,and inconsistent radiographic interpretation. Similar to previously published concerns, these inconsistencies may impede timely and effective intervention, indicating the need for enhanced education, training and clearer clinical protocols.; Conclusion: This study highlights the need to improve radiographers’ accuracy in detecting SCPA to ensure effective management. Continuous professional development, specialised training, and clear procedural guidelines are imperative to support radiographers’ safeguarding responsibilities towards children suspected of experiencing abuse.; Plain language summary: Some injuries in infants may be a sign of physical abuse, and healthcare professionals play an important role in recognising these concerns early. This study investigated the safeguarding responsibilities of radiographers practising in Malta in relation to the identification of suspected physical abuse in children. This study found that most radiographers understood their safeguarding role and had encountered possible cases, but many reported limited knowledge of imaging signs and showed differences in image interpretation. This matters because better training and clearer guidance could help radiographers identify concerns more accurately and support timely protection for children.; Introduction: Si de nombreuses blessures chez les nourrissons sont accidentelles, certaines peuvent être le signe de maltraitance physique, ce qui exige une vigilance de la part des professionnels de santé. Les radiographes jouent un rôle essentiel dans la détection des cas suspects de maltraitance physique infantile (SCPA), en facilitant une intervention rapide et en limitant la morbidité et la mortalité à long terme. L’objectif de cette étude était d’examiner le rôle des radiographes maltais et leurs pratiques cliniques actuelles dans la détection des cas suspects de maltraitance physique infantile (SCPA).; Méthodologie: Une étude prospective et transversale a été menée, Les données ont été recueillies à l’aide d’un questionnaire en ligne conçu par nos soins et distribué à 44 radiologues travaillant dans des services d’urgence ou des centres de soins de santé primaires à Malte.; Résultats: Trente-six des 44 radiographes ont répondu au questionnaire, ce qui correspond à un taux de réponse de 81,8 %. La plupart des radiographes (66,7 %) ont été confrontés à des cas de SCPA dans leur pratique clinique, 47,2 % d’entre eux signalant des cas occasionnels. Tous les participants ont démontré qu’ils savaient comment identifier la SCPA, mentionnant fréquemment des indicateurs physiques ainsi que des signes comportementaux chez les enfants et les adultes qui les accompagnent. Il convient de noter que 61,1 % d’entre eux considéraient que la détection et le signalement de la SCPA faisaient partie de leurs responsabilités professionnelles. Cependant, 83,4 % ont déclaré ne pas bien connaître les signes radiologiques de la SCPA, ce qui reflète des lacunes dans leur formation spécialisée. Cela est apparu encore plus clairement dans la partie du questionnaire consacrée aux images, où les divergences dans l’interprétation des images ont mis en évidence une variabilité des connaissances et de la précision diagnostique.; Discussion: L’étude a révélé que les radiographes utilisent diverses approches d’évaluation pour identifier ou signaler des problèmes liés à la SCPA. Bien que la plupart des radiographes locaux aient reconnu leur rôle et démontré une bonne compréhension de la SCPA, cette étude a mis en évidence des lacunes en matière de connaissances et de sensibilisation, ainsi qu’une interprétation radiographique incohérente. À l’instar des préoccupations déjà exprimées dans des publications antérieures, ces incohérences peuvent entraver une intervention rapide et efficace, ce qui souligne la nécessité d’améliorer l’éducation, la formation et de clarifier les protocoles cliniques.; Conclusion: Cette étude souligne la nécessité d’améliorer la précision des radiographes dans la détection de la maltraitance physique des enfants afin de garantir une prise en charge efficace. Le perfectionnement professionnel continu, une formation spécialisée et des directives procédurales claires sont indispensables pour soutenir les radiographes dans leurs responsabilités en matière de protection de l’enfance.; Résumé en langage simple: Certaines blessures chez les nourrissons peuvent être le signe d’une maltraitance physique, et les professionnels de la santé jouent un rôle important dans la détection précoce de ces situations préoccupantes. Cette étude a interrogé des radiographes à Malte sur leurs expériences et leurs responsabilités dans l’identification des cas suspects de maltraitance physique chez l’enfant. Elle a révélé que la plupart des radiographes comprenaient leur rôle en matière de protection de l’enfance et avaient déjà été confrontés à des cas potentiels, mais que beaucoup d’entre eux ont fait état de connaissances limitées concernant les signes visibles à l’imagerie et ont montré des divergences dans l’interprétation des images. Cela est important car une meilleure formation et des directives plus claires pourraient aider les radiographes à identifier les situations préoccupantes avec plus de précision et à contribuer à la protection rapide des enfants. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/149323 2026-01-01T00:00:00Z