The Hospice Movement

The Hospice Movement had its beginning in the U.K. some three decades ago and has now spread to over 70 countries throughout the world. It is rooted in the Christian ethos of profound respect of the human person and of human life threatened by inexorable and progressive disease. It has given rise to the new medical specialty of Palliative Medicine which embraces the most recent advances in scientific medicine and psycho-social science in its daily practice of succour and relief of the suffering of patients and their families. The Hospice idea came to Malta ten years ago. It is now well established as a voluntary organisation providing services to sufferers from advanced cancer and motor neurone disease.peer-reviewe

Malignant lymphoma of the intestine : a report of three cases

Tumours arising in the small intestine are uncommon; those of them originating in the lymphoid tissues are said to be even less frequent than adennocarcinomas. Three cases hereby are reported, outlining the respective diagnosis and treatment. All the three cases were diagnosed histologically as Lymphosarcoma. It is interesting to note that in published series, Lymphosarcomas and Reticulum Cell Sarcomas have been about equally represented, and together accounted for the vast majority of cases. Various gross features have been reported, the commonest being polypoid, annular, ulcerative and aneurismal. An important feature of these tumours is that they have little connective tissue stroma. This, together with infiltration of the muscle coat, is said to account for the aneurismal varieties of the growth. Age incidence studies show that most cases occur in the age group 45 to 60 years, but no age group is exempt. As for signs and symptoms, it is true to say that no definite syndrome is produced by this disease. In general, it may be said that cases have presented either as surgical emergencies or insidiously. There is general consensus regarding the value of post-operative radiotherapy in unresectable growths, and in those with regional lymph node metastasis. What is uncertain is the value of radiotherapy where no evidence of lymph node spread is present.peer-reviewe

Cystic disease of lung : report of a case treated by lobectomy

A cyst or cysts of the lung may be a manifestation of disease of a widely varying nature ranging from congenital lobar emphysema to hydatid disease. An exhaustive list of pathological states in which a cystic condition of the lung may be present would also include such conditions as cavitational cancer of the lung, pulmonary tuberculosis and lung abscess. A case of a four year old girl presenting as an acute pulmonary infection and found to have cystic disease of the right lower lobe is here reported. The diagnosis was mainly based on X-ray studies. A successful result followed lobectomy. Some aspects of congenital cystic disease of the lung are discussed. The true incidence of this anomaly is difficult to determine. The case reported here presented as a severe pulmonary infection requiring parenteral antibiotic therapy and blood transfusion.peer-reviewe

Retroperitoneal tumours

Primary retro-peritoneal tumours, though uncommon, are not great rarities and should not be neglected. They merit more notice than is generally given them in the odd half page of the standard surgical text book. They pose a difficult and fascinating problem to the pathologist and to the physician. To the practicing surgeon they are a challenge that may tax his resource. Most workers agree that the diagnosis is not easy. Enlargements of the kidney, adrenal, pancreas, spleen and liver have to be excluded, as also such lesions as aortic aneurysms. The tumours may arise from anywhere from the diaphragm to the pelvic floor, and from a wide variety of tissue such as fat, areolar tissue, connective tissue, fascia, muscle, vascular tissue, nerve tissue, somatic and autonomic, lymphatic vessels and lymphatic nodes. Five cases of retroperitoneal tumours are described, focusing on the respective diagnosis, surgical treatments and therapy.peer-reviewe

Hawn jien, Ġesù...

Ġabra ta’ poeżiji u proża li tinkludi: Biex nagħarfu ngħixu ta’ G. Z. A. – Il-qalb ta’ John Sciberras – L-istedina ta’ Vic. Apap – Lill-bniedem ta’ Joseph C. Sciberras – Il-hena ta’ tfuliti ta’ George Stevens – L-ewwel ta’ Mejju ta’ Karmenu Ellul Galea – Epigrammi ta’ Pawlu Cachia – Ġibtlek bukkett ġilju ta’ Ġużè Galea – De profundis ta’ A. Agius Muscat – Did-dwejra bħal ħajja ta’ Ġużè Cardona – Ma’ dik li ġejja mill-bogħod ta’ Joe Mejlak – Hawn jien, Ġesù... ta’ Bro. Henry.peer-reviewe

First-principles calculations of the phase stability of TiO2

Published versio

Glioma Through the Looking GLASS: Molecular Evolution of Diffuse Gliomas and the Glioma Longitudinal AnalySiS Consortium

Adult diffuse gliomas are a diverse group of brain neoplasms that inflict a high emotional toll on patients and their families. The Cancer Genome Atlas (TCGA) and similar projects have provided a comprehensive understanding of the somatic alterations and molecular subtypes of glioma at diagnosis. However, gliomas undergo significant cellular and molecular evolution during disease progression. We review the current knowledge on the genomic and epigenetic abnormalities in primary tumors and after disease recurrence, highlight the gaps in the literature, and elaborate on the need for a new multi-institutional effort to bridge these knowledge gaps and how the Glioma Longitudinal AnalySiS Consortium (GLASS) aims to systemically catalog the longitudinal changes in gliomas. The GLASS initiative will provide essential insights into the evolution of glioma toward a lethal phenotype, with the potential to reveal targetable vulnerabilities, and ultimately, improved outcomes for a patient population in need

Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator.Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator