A review of the practice of requesting skull x-rays from the Emergency Department of St Luke’s Hospital

Background: In the Emergency Department (ED) of St. Luke's Hospital (SLH), head injuries are a common presentation. Although there are various guidelines which recommend approaches to the management of head injuries, these are not followed locally and the authors feel that a significant number of unnecessary skull x-rays (SXR) are being ordered by doctors. In this review we wished to observe the current trends in head injury investigations at the SLH ED and compare these with the NICE head injury guidelines. We also wanted to determine the impact that the NICE guidelines would have on these trends if they were to be instituted. Methods: The study is retrospective and observational. The demographics together with the rates of SXRs, CT scans and admissions were determined for patients presenting with head injury between the 1st of February and the 31st March 2006. The study also looked at the predicted rates had NICE guidelines been applied. Results: 387 patients were studied in a 2 month period. Of this total, only 2 patients (0.5%) had indications for a SXR but 312 patients (80.6 %) had this investigation. Out of this total of SXRs only 6 had positive findings (1.9%) and these went on to have a CT brain. A total of 72 patients had a CT scan of the head and of these 10 (13.9%) had positive findings. According to NICE guidelines 70 patients had indications for a CT. One hundred and twenty one patients (31.3%) were admitted, 201 were discharged (51.9%) and 65 patients (16.8%) discharged themselves against medical advice. Conclusion: The implementation of NICE guidelines would greatly reduce the rates of SXRs and hence reduce costs and radiation exposure. It also seems that the rates of CT scans will not change significantly.peer-reviewe

New records of ichneumon wasps (Hymenoptera, Ichneumonidae) from Malta with an updated checklist

Ten new records of ichneumon wasps are reported for the first time from Malta. A checklist of all 56 species of Ichneumonidae so far recorded from Malta is also included.peer-reviewe

Enantioselective synthesis and application to the allylic imidate rearrangement of amine-coordinated palladacycle catalysts of cobalt sandwich complexes

The reaction of (η5-(N,N-dimethylaminomethyl)cyclopentadien-yl)(η4-tetraphenylcyclobutadiene)cobalt with sodium tetrachloropalladate and (R)-N-acetylphenylalanine gave planar chiral palladacycle di-μ-chloridebis[(η5-(Sp)-2-(N,N-dimethylaminomethyl)cyclopentadienyl,1-C,3′-N)(η4-tetraphenylcyclobutadiene)cobalt]dipalladium [(Sp)-Me2-CAP-Cl] in 92 % ee and 64 % yield. Enantiopurity (>98 % ee) was achieved by purification of the monomeric (R)-proline adducts and conversion back to the chloride dimer. Treatment with AgOAc gave (Sp)-Me2-CAP-OAc which was applied to asymmetric transcyclopalladation (up to 78 % ee). The (R)-N-acetylphenylalanine mediated palladation methodology was applicable also to the corresponding N,N-diethyl (82 % ee, 39 % yield) and pyrrolidinyl (>98 % ee, 43 % yield) cobalt sandwich complexes. A combination of 5 mol % of the latter [(Sp)-Pyrr-CAP-Cl] and AgNO3 (3.8 equiv) is a catalyst for the allylic imidate rearrangement of an (E)-N-aryltrifluoroacetimidate (up to 83 % ee), and this catalyst system is also applicable to the rearrangement of a range of (E)-trichloroacetimidates (up to 99 % ee). This asymmetric efficiency combined with the simplicity of catalyst synthesis provides accessible solutions to the generation of non-racemic allylic amine derivatives

Locusta migratoria cinerascens Fabricius, 1781 (Orthoptera : Acrididae) in the Maltese Islands

Breeding of Locusta migratoria cinerascens in the wild is reported for the first time in the Maltese Islands. This was established following the discovery of four late-instar nymphs from Aћrax tal-Mellieћa, which were collected and reared. One individual successfully attained maturity in captivity. The presence of this species in the Maltese Islands is discussed.peer-reviewe

The introduction and establishment of Sceliphron caementarium (Drury, 1773) (Hymenoptera, Sphecidae) in Malta (Central Mediterranean)

The introduction and establishment of the North American mud-dauber wasp Sceliphron caementarium (Drury, 1773) is reported for the first time from the Maltese Islands. A check-list of the Maltese Sphecidae is provided.peer-reviewe

New records of Crabronidae (Hymenoptera : Apoidea) from the Maltese Islands with an updated checklist

Eight species of Crabronidae are recorded from the Maltese Islands for the first time: Cerceris flavilabris (Fabricius), Miscophus niger Dahlbom, Oxybelus trispinosus (Fabricius), Passaloecus brevilabris Wolf, Trypoxylon scutatum Chevrier, Prosopigastra creon (Nurse), Mimumesa unicolor (Vander Linden) and Nitela lucens Gayubo & Felton. Of these, Prosopigastra creon is recorded from Europe for the first time. A checklist of the fifty-four species of Maltese Crabronidae is also provided.peer-reviewe

The Intranidal Myrmecophiles of the Maltese Islands with notes on Messor Nests as repositories of biodiversity

The intranidal myrmecophilous arthropod fauna of the Maltese Islands is reviewed. Thirty species from nine orders are found to be obligate myrmecophiles, of which four species are recorded from the Maltese archipelago for the first time: Phrurolithus sp. (Araneae: Phrurolithidae), Pogonolaelaps canestrinii (Berlese, 1904), Gymnolaelaps messor Joharchi, Halliday, Saboori & Kamali, 2011 and G. myrmecophilus (Berlese, 1892) (Mesostigmata: Laelapidae). Phrurolithus also represents the first record of the family Phrurolithidae in Malta. Notes on the biology and local distribution of each species are provided, including ant-myrmecophile associations, of which two appear to be previously unknown: the occurrence of Smynthurodes betae Westwood, 1849 (Hemiptera: Aphididae) in the nest of Plagiolepis pygmaea (Latreille, 1798) and Phrurolithus in the nest of Pheidole pallidula (Nylander, 1849). Fourteen additional species are found to be either only occasionally myrmecophilic, accidental ant-guests or potentially myrmecophilous, the latter remaining ambiguous due to a lack of knowledge of their biology. Of these, the family Caeculidae (Arachnida: Trombidiformes) represents a new record for the Maltese Islands, on the basis of Microcaeculus sp. occurring in a nest of Camponotus barbaricus Emery, 1905. Preliminary results indicate that Messor nests may be repositories of considerable myrmecophile diversity, with the most unique symbionts.peer-reviewe

Rituximab : a novel treatment for Pemphigus in Malta

Until recently, the main treatment for pemphigus has been systemic corticosteroids, usually administered at high doses with consequent side-effects. Lately, the biological agent rituximab has been introduced as an effective treatment for this condition. This article describes seven cases of pemphigus successfully treated with rituximab in Malta and discusses the benefits and drawbacks of this novel treatment modality.peer-reviewe

A change in tune : acoustic analysis of Malta’s cicadas reveals 162-year-old misnomer

For over 160 years, the cicadas inhabiting the Maltese Islands were assigned to the widespread European species Cicada orni Linnaeus. However, analysis of their calling song reveals with certainty that the taxon known to occur in the archipelago is, in fact, the sibling species Cicada barbara Stål.peer-reviewe

A change in tune : acoustic analysis of Malta’s cicadas reveals 162-year-old misnomer

For over 160 years, the cicadas inhabiting the Maltese Islands were assigned to the widespread European species Cicada orni Linnaeus. However, analysis of their calling song reveals with certainty that the taxon known to occur in the archipelago is, in fact, the sibling species Cicada barbara Stål.peer-reviewe