Milichiella lacteipennis (Loew, 1866) is associated with beeswax (Diptera, Milichiidae)

The Milichiidae (Diptera, Schizophora) is a family of acalypterate Diptera of worldwide distribution. Some 240 species are recognised (Brake, 2000). The most comprehensive account on the biology and breeding habits of the family may be found in Ferrar (1987) from which most of the following information is taken.peer-reviewe

New distributional data on sandflies from rubble walls in the Maltese Islands with an illustrated key to the Maltese species (Diptera: Phlebotominae)

The results of a survey which involved collecting phlebotomine sandflies in rubble walls from 20 different localities on the islands of Malta and Gozo in the period from August to October 2008 are reported. A total of 402 specimens were collected, all belonging to two species: Sergentomyia minuta and Phlebotomus perniciosus. A short diagnosis, and notes on the biology of the six species of sandflies recorded from the islands is given, together with an illustrated key to their identification.peer-reviewe

The rise of pertussis in Malta in 2011 : a case for adolescent and adult pertussis booster vaccination

Notwithstanding the high rates of pertussis infant vaccination coverage in developed countries, Bortedella pertussis infections are manifesting a changing epidemiological pattern of disease. Of notable concern is the rise of pertussis in adolescents and adults. This changing picture is largely attributable to waning immunity after natural infection or vaccination. The belief that pertussis is chiefly a childhood disease is a common misconception. A significant rise of pertussis cases in Malta in older age groups was recorded in 2011. The addition of an adolescent and/or an adult booster dose against pertussis should be strongly considered.peer-reviewe

The Drosophila phosphatidylinositol transfer protein encoded by vibrator is essential to maintain cleavage-furrow ingression in cytokinesis

Cytokinesis requires the coordination of cytoskeletal and plasma membrane dynamics. A role for phosphatidylinositol lipids has been proposed for the successful completion of cytokinesis but this is still poorly characterised. Here, we show mutants of the gene vibrator, previously found to encode the Drosophila phosphatidylinositol transfer protein, produce multinucleate cells indicative of cytokinesis failure in male meiosis. Examination of fixed preparations of mutant spermatocytes showed contractile rings of anillin and actin that were of normal appearance at early stages but were larger and less well organised at later stages of cytokinesis than in wild-type cells. Time-lapse imaging revealed sequential defects in cytokinesis of vibrator spermatocytes. In cells that fail cytokinesis, central spindle formation occurred correctly, but furrow ingression was delayed and the central spindle did not become compressed to the extent seen in wild-type cells. Cells then stalled at this point before the apparent connection between the constricted cytoskeleton and the plasma membrane was lost; the furrow then underwent elastic regression. We discuss these defects in relation to multiple functions of phosphoinositol lipids in regulating actin dynamics and membrane synthesis

Recent records of spiders (Arachnida : Araneae) from Malta

Two spider species are recorded from Malta, one for the first time (Zora sp., Family Zoridae) and one for the second time (Aphantaulax cincta, Family Gnaphosidae). Observations and other information about the species together with photographs are provided.peer-reviewe

The process of anaesthetic preoperative assessment

Preoperative assessment is an essential prerequisite to the safe conduct of anaesthesia. The work presented examines several aspects of the process of preoperative assessment and investigates some strategies to improve reliability. The conduct of preoperative assessment, and the information which needs to be acquired in the process has been studied by several authors, and is the subject of guidelines and advisories published by various prominent associations and learned bodies. This literature is reviewed to establish the desired goals of the preoperative assessment, The degree to which local practice is congruent with the various recommendations was investigated by means of a survey amongst local anaesthesia practitioners. To further understand anaesthetists expectations of the preoperative assessment, a series of semi-structured interviews were conducted and subjected to thematic analysis. A healthcare failure modes and effects analysis (HFMEA) of the workings of a preoperative assessment clinic was carried out to predict likely points of failure. The actual functioning of the clinic in practice was further studied from two aspects. A survey of patient experience with the clinic was carried out, which revealed good overall performance, but with some issues regarding excessive waiting times and inadequate provision of information to the patients. An evaluation of the technical quality of the preoperative assessment was also conducted by soliciting feedback from attending anaesthetists. Issues reported included the failure to identify significant problems and failure to effectively communicate with the perioperative team. These issues were anticipated in the earlier HFMEA. It was hypothesised that a cognitive aid to facilitate a structured approach to decision making and communication would improve the preoperative assessment process. With the input from a focus group, two body-systems based aids was constructed. These were assessed using a tabletop simulation of preoperative assessment. Improvement in reliability was observed. The effect of the aids on attending anaesthetist situation awareness, through better communication and memory formation, was also investigated using a tabletop simulation. Under these conditions no improvement could be identified. Subjectively, anaesthetists found the aids useful for both preoperative patient assessment and peroperative case management. Junior doctors with no anaesthetic training, however, found the aids confusing

Retropharyngeal abscess with atlanto-axial subluxation

We describe a case of a 4-year-old boy who presented with fever, neck pain and bilateral non-suppurative cervical lymphadenopathy. Torticollis, painful limitation of neck movements and nuchal tenderness were present. CT scan revealed a retropharyngeal abscess and rotatory subluxation of the atlanto-axial joint, consistent with Grisel’s syndrome. This is an important differential in children with fever and torticollis as if unrecognized, may potentially lead to serious neurological deficits from cervical cord compression.peer-reviewe

The process of anaesthetic preoperative assessment

Preoperative assessment is an essential prerequisite to the safe conduct of anaesthesia. The work presented examines several aspects of the process of preoperative assessment and investigates some strategies to improve reliability. The conduct of preoperative assessment, and the information which needs to be acquired in the process has been studied by several authors, and is the subject of guidelines and advisories published by various prominent associations and learned bodies. This literature is reviewed to establish the desired goals of the preoperative assessment, The degree to which local practice is congruent with the various recommendations was investigated by means of a survey amongst local anaesthesia practitioners. To further understand anaesthetists expectations of the preoperative assessment, a series of semi-structured interviews were conducted and subjected to thematic analysis. A healthcare failure modes and effects analysis (HFMEA) of the workings of a preoperative assessment clinic was carried out to predict likely points of failure. The actual functioning of the clinic in practice was further studied from two aspects. A survey of patient experience with the clinic was carried out, which revealed good overall performance, but with some issues regarding excessive waiting times and inadequate provision of information to the patients. An evaluation of the technical quality of the preoperative assessment was also conducted by soliciting feedback from attending anaesthetists. Issues reported included the failure to identify significant problems and failure to effectively communicate with the perioperative team. These issues were anticipated in the earlier HFMEA. It was hypothesised that a cognitive aid to facilitate a structured approach to decision making and communication would improve the preoperative assessment process. With the input from a focus group, two body-systems based aids was constructed. These were assessed using a tabletop simulation of preoperative assessment. Improvement in reliability was observed. The effect of the aids on attending anaesthetist situation awareness, through better communication and memory formation, was also investigated using a tabletop simulation. Under these conditions no improvement could be identified. Subjectively, anaesthetists found the aids useful for both preoperative patient assessment and peroperative case management. Junior doctors with no anaesthetic training, however, found the aids confusing

Laryngeal lymphoma : the high and low grades of rare lymphoma involvement sites

The larynx is an extremely rare site of involvement by lymphomatous disease.We present two cases of isolated laryngeal high-grade and another low-grade lymphoma, together with a literature review of laryngeal lymphoma management.peer-reviewe