https://www.um.edu.mt/library/oar/handle/123456789/431 Tue, 16 Jun 2026 03:42:08 GMT 2026-06-16T03:42:08Z https://www.um.edu.mt/library/oar/handle/123456789/147438 Title: Mortality and recurrence following surgically treated primary lung malignancy Abstract: Primary lung malignancy comprised 10.3% of all new cancers detected in Malta in 2020. Our study examines patient outcomes and mortality rates following surgically resected primary lung malignancy.; We retrospectively analysed the electronic records of 126 patients who underwent surgical resection of their primary lung malignancy between 2016 and 2020.; Our study included 126 patients with an average age of 66.4 years and 64.3% were male (n=81). 71 .4% of patients underwent lobectomy (n=90). The median time from date of histological diagnosis to date of resection was 51 days. Adenocarcinoma was the commonest histological diagnosis (71.4%, n=90). Pre-operative radiological staging underestimated the tumour's stage in 27.0% (n=34) of cases. A majority had Stage IA disease (51.6%, n=65) according to TNM Classification 8th Edition, and these patients had the best 2-year survival at 96.9% (n=63). Overall survival was 87.3% at two years. At the time of data analysis 26.2% of patients (n=33) had died. Most commonly, death was attributed to progression of malignancy (57 .6%, n=19). Our study identified recurrent disease in 40.5% (n=51) of patients, with a progression free survival (PFS) of 34.4 months. 70.6% (n=24) of wedge resections were carried out in Stage IA disease. PFS was 49.5 months for lobectomy vs 48.9 months for wedge resections of Stage IA disease. 28.6% (n=36) of patients had a second malignancy, with the most common being colorectal (22.2%, n=8).; Our results correlate well with international data regarding survival and outcomes postlobectomy and limited resection in Stage IA disease. There is limited data regarding the incidence of other primary tumours in patients with early-stage lung cancer. Sun, 01 Jan 2023 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/147438 2023-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/147437 Title: A Maltese study in determining the presence of chronic obstructive pulmonary disease in metabolic syndrome Authors: Gauci, Jonathan; Gauci Pullicino, Stephanie; Caruana, Emma; Petroni Magri, Vanessa; Formosa, Melissa Marie; Fenech, Anthony G.; Fava, Stephen; Montefort, Stephen; Fsadni, Peter Abstract: Introduction: Both Chronic Obstructive Pulmonary Disease (COPD) and Metabolic Syndrome (MetS) are pro-inflammatory states, and while the diagnosis of MetS in COPD has been extensively studied, the diagnosis of COPD in MetS is poorly studied. The study focuses on determining the presence of COPD in persons living with diabetes and MetS in Malta, and aims to identify differences in biomarkers between MetS subjects with and without COPD.; Materials and Methods: Diabetic MetS subjects at Malta’s main general hospital were assessed through St George’s Respiratory Questionnaire for COPD (SGRQ-C), modified Medical Research Council scale (mMRC), COPD Assessment Test (CAT), Centre for Epidemiological Studies Depression scale (CES-D), Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue scale, Spirometry, Six Minute Walk Test (6MWT), BODE index (composed of Body Mass Index, Obstruction, Dyspnoea, Exercise capacity) and routine blood tests. They were divided into three groups: the main study group consisted of MetS subjects with COPD, one control group consisted of MetS subjects with a smoking history but not COPD, and the other control group consisted of diabetic MetS subjects with no smoking history.; Results: A total of 67 MetS subjects were included. Those with COPD had significantly worse outcomes in SGRQ-C scores, mMRC, CAT, spirometry, BODE, CES-D and FACIT Fatigue scale than smokers without COPD and non-smokers. 25-hydroxy-vitamin D levels were significantly lower in MetS subjects with COPD compared to smokers without COPD (p=0.030) and non-smokers (p=0.043). C-reactive protein (p=0.036), triglycerides (p=0.023) and total cholesterol (p=0.039) were significantly higher in MetS subjects with COPD compared to smokers without COPD.; Discussion: Screening for depression and fatigue in subjects with COPD and MetS is recommended. Low vitamin D, high CRP, high triglyceride and high total cholesterol levels are correlated with a COPD diagnosis within the local MetS population, and monitoring these parameters would enable timely management. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/147437 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/147436 Title: Radiological manifestations of lymphangioleiomyomatosis : a local patient cohort analysis Authors: Conti, Luca; Mercieca, Darlene; Gatt, Gianluca; Sant Fournier, Luca; Fsadni, Peter Abstract: Background: Lymphangioleiomyomatosis (LAM) is an ultra-rare neoplastic cystic disease primarily affecting females of reproductive age, characterized by the infiltration of smooth muscle cells into the lungs and the formation of cystic lesions. This study aims to compare the radiological findings in patients with sporadic LAM (s-LAM) and those with LAM associated with tuberous sclerosis complex (TSC-LAM) in the Maltese population.; Methods: A retrospective observational study was conducted at Mater Dei Hospital, Malta, involving eight patients diagnosed with LAM between 2014 and 2024. Thoracic and abdominal CT scans were reviewed, and findings were categorized based on the presence of s-LAM or TSC-LAM.; Results: The cohort included five patients with s-LAM and three with TSC-LAM, alongside 15 patients with tuberous sclerosis complex (TSC) but no LAM. All LAM patients exhibited diffuse thin-walled cysts, with sizes ranging from 7 to 72 mm. Notably, chylous pleural effusions were observed only in the s-LAM group. The TSC-LAM group demonstrated significant extra-pulmonary manifestations, including renal angiomyolipomas, with some requiring intervention.; Conclusion: This study highlights the distinct radiological features and complications associated with s-LAM and TSC-LAM. The findings underscore the necessity for vigilant screening and monitoring in TSC patients to manage potential LAM-related complications effectively. A multidisciplinary approach is essential for optimizing patient outcomes and addressing the broader implications of TSC and LAM on health. Wed, 01 Jan 2025 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/147436 2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/146373 Title: A systematic review of the interventions for management of pain in patients after spinal cord injury Authors: Koukoulithras, Ioannis; Alkhazi, Abdulaziz; Gkampenis, Athanasios; Stamouli, Alexandra; Plexousakis, Minas; Drousia, Gianna; Xanthi, Eleana; Roussos, Charis; Kolokotsios, Spyridon Abstract: Chronic pain is a very common problem in patients with spinal cord injury (SCI) as it affects 80% of these patients, which negatively affects their quality of life. Despite many advantages that exist in the management of any type of pain (neuropathic, nociceptive, mixed) in these patients, there is no cure, and the analgesic effect of some treatments is inadequate.; This study aims to conduct an evidence-based systematic review regarding the various interventions used for the management of pain after SCI. The PubMed, Physiotherapy Evidence Database (PEDro), and Cochrane Library databases were searched from 1969 to 2023. The risk of bias was assessed using the PEDro scoring system.; A total of 57 studies met the inclusion criteria and were included in this systematic review. Among the different interventions at present, 18 studies examined the role of oral medications, 11 studies examined the role of minimally invasive methods (injection and infusion), 16 studies investigated physiotherapy and alternative treatments, and 12 studies examined the role of repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and cranial electrotherapy stimulation (CES) in the management of pain in patients after SCI.; Gabapentin and pregabalin are very effective in managing chronic neuropathic pain after SCI, and pregabalin also seems to reduce anxiety and sleep disturbances in the patients. It is noteworthy that lamotrigine, valproate, and carbamazepine do not have an analgesic effect, but mirogabalin is a novel and promising drug. Antidepressants (selective serotonin reuptake inhibitors and serotonin and noradrenaline reuptake inhibitors) did not reduce the pain of the patients, although some studies showed an efficacy of amitriptyline especially in depressed patients and tramadol should be considered short-term with caution. Also, tDCS and rTMS reduced pain. Moreover, botulinum toxin type A, lidocaine, ketamine, and intrathecal baclofen significantly reduced pain intensity, although the sample of the studies was small. Physiotherapy and alternative treatments seem to relieve pain, and transcutaneous electrical nerve stimulation had the greatest reduction of pain intensity.; In conclusion, several pharmaceutical and non-pharmaceutical methods exist, which can reduce pain in patients after SCI. The type of intervention can be considered by the physician depending on the patients' preference, age, medical history, type of pain, and associated symptoms. However, more studies with greater samples and with better methodological quality should be conducted. Sun, 01 Jan 2023 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/146373 2023-01-01T00:00:00Z