https://www.um.edu.mt/library/oar/handle/123456789/32943 Fri, 10 Apr 2026 09:28:09 GMT 2026-04-10T09:28:09Z https://www.um.edu.mt/library/oar/handle/123456789/22273 Title: The prevention of fractures in adults Authors: Baldacchino, Ian; Baldacchino, Lisa Abstract: Background General practitioners (GPs) encounter patients who have suffered a fracture or are at an increased risk. Fragility fractures cost Europe 32 billion Euros per year. Recognizing this challenge and understanding its management allows GPs to engage in primary and secondary prevention of fragility fractures. Aim To illustrate lifestyle and pharmacological management options offered by a general practitioner to an adult at increased risk of fractures or low bone mineral density (BMD). The National Osteoporosis Guideline Group (NOGG, 2016), World Health Organisation (WHO), International Osteoporosis Foundation (IOF, 2012), Kidney Disease Improving Global Outcomes (KDIGO, 2009), Scottish Intercollegiate Guidelines Network (SIGN) and National Institute for Health and Care Excellence (NICE) management guidelines are discussed in this regard. Objectives • To provide key definitions in the management of osteoporosis. • To identify groups at risk of developing low BMD, vitamin D deficiency and fragility fractures. • To illustrate the current management options for an adult at increased risk of fractures or low bone mass by a general practitioner. • To discuss current methods of investigation and measurement of low BMD, fracture risk assessment and vitamin D deficiency. • To address dietary requirements of calcium and vitamin D and local formulations available. Method A literature search was conducted using Pubmed and Google search engines. Keywords included: osteoporosis; low bone mineral density; vitamin D; fragility fracture; postmenopausal. The NOGG (2016), WHO, IOF (2012), KDIGO (2009), SIGN and NICE management guidelines were included directly. Treatments ranging from fall prevention, dietary modification, anti-resorptive therapy and tailoring in subgroups were reviewed. Conclusion Guidelines can close the gap between physicians in primary and secondary care, institutions and private practice providing a multifaceted approach for the proper identification, prevention and management of fragility fractures. Tue, 01 Aug 2017 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/22273 2017-08-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/22272 Title: The role of sports and exercise medicine in the military Authors: Psaila, Matthew Abstract: Background Military training is notorious for being physically intensive interspersed by limited recovery periods, culminating in a high frequency of training-related injuries. Confusion may arise when military personnel are compared to athletes in other sporting disciplines in view of different training regimes employed by the military according to the set standard of the respective army. Hence, in line with other sporting disciplines having a designated medical team of sports and exercise professionals that is experienced in that particular field, this article discusses the importance of having such a team in the military. Objective The benefits of having a designated sports and exercise medicine set-up are discussed vis-à-vis the military. Methods A literature review of injuries related to military training comparing different armies is presented. Audit work attained from a military sports and exercise clinic is presented, listing injury type (acute or overuse) as well as the anatomical areas involved to highlight the specifics of injury outcomes in this population. Results A total of 72% of injuries listed were overuse in nature with a high propensity of injuries recorded in the lower limbs, in keeping with the methods of training employed by armies worldwide. Conclusion The availability of a designated sports and exercise clinic in a military setting can serve various purposes, not only through the provision of a service that is specific to military personnel and which therefore complements the ongoing training structures, but also through the provision of guidance in the planning of training regimes as well as in pre-training medical screening. Tue, 01 Aug 2017 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/22272 2017-08-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/22271 Title: Ten years of specialist training in family medicine in Malta 2007-17 Abstract: On the 9th July 2007, specialist training in family medicine was launched in Malta under the auspices of the government’s Primary Health Care Department, with the Malta College of Family Doctors (MCFD) responsible for ensuring the quality of academic training and assessment. This came about after Malta’s accession to the European Union in 2004, following which family medicine was accepted as a specialty and a ‘Specialist Training Programme in Family Medicine – Malta’ was drawn up by the MCFD in 2005 and approved by the Ministry of Health’s Specialist Accreditation Committee in 2006. The training programme is accredited for international membership of the UK’s Royal College of General Practitioners. Tue, 01 Aug 2017 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/22271 2017-08-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/22265 Title: Prescribing medication for athletes : guidelines for general practitioners Authors: Attard, Lucienne; Attard, David Abstract: The number of persons taking part in organized sports in our islands is increasing every year. Many of these athletes and the events that they participate in are subject to doping control tests by the National Anti-Doping Organisation (NADO) or the national federation or association of their particular sport. A small number of these tests record a prohibited substance present in the athlete’s sample, which may have serious consequences on the sporting career of the athlete. Many athletes consult their general practitioner (GP) or team doctor regularly for advice when they develop a medical condition. This article is intended to provide the GP with background information regarding drugs that may be used safely and without consequences for the athlete, the procedure to follow when the athlete needs to be treated with drugs which are prohibited to athletes, and the pitfalls of accidental doping. Tue, 01 Aug 2017 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/22265 2017-08-01T00:00:00Z