Orations relating to the conferment of Doctor of Science honoris causa to Professor William Bannister

We are gathered here today to recognise a distinguished international scientist and alumnus of this University and it is indeed my honour and privilege to present Professor William Bannister for the award of the degree of Doctor of Science honoris causa. His career spans almost six decades and during this time he has helped shape numerous individual careers, whole Departments and our understanding of several branches of Physiology.peer-reviewe

A message from the Dean

It is perhaps with a certain degree of pride that I am writing this letter in what can be considered as the first 100 days in my position as Dean. I say this because a number of important changes are about to take place in the light of recent events. We may now be in a position to redraw our medical education starting from the undergraduate education right through to postgraduate studies.peer-reviewe

Hepatic metastases from colorectal carcinoma

Colorectal carcinoma is one of the increasing afflictions and is the 2nd commonest cause of death from cancer in the Western world. It accounts from 14% of cancer deaths in men and 16% of deaths in women. The best prognostic indicator for survival in colorectal disease has been based on the extent and spread of the disease. In this article the author mentions chemotherapy and surgery as the possible treatment options.peer-reviewe

Choledocholithiasis : whither surgery?

Choledocholithiasis is a common condition. It has been estimated that as many as 24% of patients with cholelithiasis have stones in the common bile duct. Until the last decade, the ’gold standard’ for treatment has been surgery. Because of the reported high incidence of morbidity and mortality associated with surgical exploration of the bile duct clinicians have turned their attention to other modalities of treatment. These recent advances for the management of choledocholithiasis are reviewed.peer-reviewe

Splenic Trauma: should we treat differently?

A 36 year old male was admitted to Accident and Emergency Department following a motor vehicle accident. Clinical examination revealed a haemodynamically stable patient. Abdominal examination showed tenderness in right upper quadrant. Ultrasonography of the abdomen was normal. Haemoglobin on admission was 13 gm/dl. A repeated haemoglobin six hours later revealed a Hb of 10 gm/dl. Computerized tomography(CT) of the abdomen showed a ruptured spleen. As the patient was haemodynamically stable, it was decided to treat the patient in the HDU setting. His condition remained stable and he was fit to be discharged home on the fifth post-operative day.peer-reviewe

Ileostomy Adenocarcinoma : a case report

Proctocolectomy is the standard treatment for patients suffering from ulcerative colitis which is long-standing, refractory to pharmacotherapy or otherwise associated with complications. An ileal pouch with pouch-anal anastomosis is fashioned in the majority of cases; however, in some instances terminal ileostomy is preferable. Ileostomy cancer is rare but a number of cases have been reported over the past twenty years suggesting a rising incidence. We report a case that developed thirty years post-operatively.peer-reviewe

The diversity of occupational therapy services for older persons in Malta

Occupational Therapy has become part of the multidisciplinary rehabilitation team, however, a number of professionals still do not understand the work carried out by the therapist especially in a long-term setting. This article highlights the services which are presently being offered by occupational therapists working at St Vincent de Paul Residence. Still, one should also keep in mind that other services are offered by occupational therapists working with older persons who receive acute care at St Luke's Hospital, subacute rehabilitation at Zammit CIapp Hospital, psychiatric care at Mount Carmel Hospital and also in Gozo.peer-reviewe

Some Aspects of Gastrointestinal Adaptation to Obstruction of the Small Intestine: Modulating Role of Diet

The "well being" of the gastrointestinal tract is maintained by the interplay of several -factors, notably diet, pancreatic and biliary secretions and gastrointestinal hormones. These same factors may be responsible for enabling the organ to adapt to chanqing circumstances. To date, most of what is known about gastrointestinal adaptation has been derived from animal experimentation and the progress in this field has, to some extent, been limited by the suitability of the animal models. One such example is the adaptive response of the gastrointestinal tract to small intestinal obstruction. Whereas a wealth of information exists regarding adaptation to acute obstruction, knowledge of the changes to the chronic event is limited. The first aim of the thesis was therefore to further develop and modify a reproducible model of chronic small bowel obstruction in the rat. The study was then extended to investigate the changes in both the proximal (i.e. oesophagus, stomach and proximal small intestine) as well as the distal (i.e. distal small intestine) bowel to obstruction. In addition, the presence and absence of food bulk on these changes was also investigated. The gastrointestinal hormone profiles under each experimental condition were also identified. It was found that: 1. An increase in oesophageal weight occurred following a high small bowel obstruction. Other levels of small bowel obstruction had no noticeable effect on the oesophagus. 2. The response of the stomach to obstruction varied with the site of the small bowel obstruction. A high obstruction produced a marked dilatation of the stomach. A mid small intestinal obstruction generated marked gastric muscle hypertrophy. 3. The jejunum and the ileum behaved in a similar fashion in that both showed an increase in weight and and in luminal circumference in response to obstruction. However the magnitude of the ileal response was far greater. 4. The administration of a low residue diet did not result, during the time period of the experiment, in a reduction of the mucosal weight of the gastrointestinal tract. However a reduction in both the DNA and protein concentration was observed. When this low residue diet was administered to rats subjected to a small bowel obstruction, the hypertrophic response noted in chow-fed obstructed animals was abolished. 5. Disuse atrophy of the mucosa was seen in the ileum of rats with a mid small bowel obstruction fed on chow. Although some degree of atrophy did occur in similarly obstructed rats fed on a low residue diet, the degree of atrophy was significantly less than that in chow fed obstructed animals. 6. Hormonal assays showed that: a. Serum gastrin was raised following a high obstruction and following the administration of a low residue diet. b. Serum N-glucagon levels showed significant increases following mid and distal small bowel obstruction. c. Vasoactive intestinal peptide levels were increased following a distal obstruction

Treatment of Alzheimer's Disease with Anti-Homocysteic acid Antibody

Homocysteic acid (HA) may play an important role in Alzhiemer disease (AD) as we previously reported that HA induced accumulation of intraneuronal A[beta]42. In this study, we first analyzed HA levels in a mouse model of AD. 4-month old pre-pathologic 3xTg-AD mice exhibited higher levels of HA in the hippocampus as compared to age-matched nontransgenic, suggesting that HA accumulation may precede both A[beta] and tau pathologies. To further determine the pathogenic role of HA in AD, we treated young 3xTg-AD mice with vitamin B6-deficient food for 3 weeks to induce the production of HA in the brain. Concominantly, mice received either saline or anti-HA antibody intraventricularly using a guide cannula every 3 days. Mice received anti-HA antibody significantly rescued cognitive impairment induced by vitamin B6 deficiency. Pathologically, 3-week treatment with vitamin B-6 deficient food resulted in strong neurodegeneration in the hippocampal CA1 zone and decreased hippocampal volume. In contrast, anti-HA antibody treatment attenuated these pathological changes. Taken together, we conclude that increased brain HA triggers memory impairment whose condition was deteriorated by amyloid and subsequent neurodegeneration and reduction of neurogenesis. Our results indicate a pathogenic role of HA in AD

Treatment of Alzheimer's Disease with Anti-Homocysteic acid Antibody

Homocysteic acid (HA) may play an important role in Alzhiemer disease (AD) as we previously reported that HA induced accumulation of intraneuronal A[beta]42. In this study, we first analyzed HA levels in a mouse model of AD. 4-month old pre-pathologic 3xTg-AD mice exhibited higher levels of HA in the hippocampus as compared to age-matched nontransgenic, suggesting that HA accumulation may precede both A[beta] and tau pathologies. To further determine the pathogenic role of HA in AD, we treated young 3xTg-AD mice with vitamin B6-deficient food for 3 weeks to induce the production of HA in the brain. Concominantly, mice received either saline or anti-HA antibody intraventricularly using a guide cannula every 3 days. Mice received anti-HA antibody significantly rescued cognitive impairment induced by vitamin B6 deficiency. Pathologically, 3-week treatment with vitamin B-6 deficient food resulted in strong neurodegeneration in the hippocampal CA1 zone and decreased hippocampal volume. In contrast, anti-HA antibody treatment attenuated these pathological changes. Taken together, we conclude that increased brain HA triggers memory impairment whose condition was deteriorated by amyloid and subsequent neurodegeneration and reduction of neurogenesis. Our results indicate a pathogenic role of HA in AD