Implementation of a graft surveillance programme for infrainuginal vascular bypass surgery

Aim: Patients undergoing bypass graft placement in the lower limb are often entered into a graft surveillance programme using duplex scanning. The aim of this programme is to identify stenoses in vein grafts before they become symptomatic and treat these by angioplasty or surgery, thus prolonging the patency of the graft. This paper aims at reporting on the progress and viability of this programme at Mater Dei Hospital, Malta. Method: Infrainguinal bypass grafts carried out between July 2007 and May 2009 were enrolled. Scanning starts during the patient’s in-hospital stay at one week post-operation. It is then scheduled at 6 weeks, 3 months, 6 months, 12 months, 18 months, 24 months, and yearly afterwards. When a significant stenosis is encountered, the patient is referred for angioplasty. Surgery would be considered in cases when angioplasty is not an option. Results: During this period 56 patients were recruited. At one week post-op the patency rate was 100%. At 6 months the primary unassisted patency was 77.5% while the primary assisted patency was 87.5%. At 12 months the primary unassisted patency was 50% while the primary assisted patency was 77%. Secondary patency rates at 6 and 12 months were 95% and 82% respectively. Conclusion: The graft surveillance programme ensures that any problem detected in the post-operative period is dealt with as soon as possible. The study shows that this programme is being effective in that assisted rates (i.e. after angioplasty or surgery) are better than unassisted rates.peer-reviewe

Appreciating fortified cities : an educational perspective

One element in the heritage around us is constituted by the numerous sites which evoke life from long ago. One such heritage site is the fortified city. In the Maltese Islands, although not so numerous, such fortified cities do exist, and these offer much opportunity for the young and not so young to learn about a particular type of past. In modern times these heritage sites still offer snapshots of days gone and, though contemporary elements have now become an integral part of their historical texture, they are still important centres for the transmission of historical, social, architectural, and cultural education to both students and tourists who visit them.peer-reviewe

How to save a limb

The diabetic foot : how to save a limb : part I by Cassar, Kevin - URI: https://www.um.edu.mt/library/oar//handle/123456789/12576The age standardized incidence rate of lower limb amputations in diabetics is 13.1 times (95% Cl 9-17.2) greater than for the general population. The incidence of diabetes related lower limb amputations is 475 per 100,000 patients years or 10.2 per 100,000 patients per year. Extrapolating this to our own population, we would expect to have no more than 50 major amputations per year. If we take into account the higher prevalence of diabetes in our country we should not have more than 80 major amputations per year. As can be seen in this article, the number of major amputations per year in our country has been static at around 120 per year. Figure 2 in this article shows that there is also a considerable number of minor amputations carried out per year, the numbers of which have again remained relatively stable in the past five years. Clearly the numbers performed locally are far in excess of those recorder in other countries. This bags the question of why our amputation rates are so high and what can we do to try to reduce this avoidable tragedy?peer-reviewe

Malta's prehistoric temples : conservation issues

Malta's prehistoric megalithic temples, which are World Heritage sites, are currently suffering from problems associated with the deterioration of materials as well as structural problems. These problems have been studied for many years. A Scientific Committee set up by the Government of Malta in 2000, identified those elements in the surrounding environment causing deterioration of the site. It was recommended that the sites should be protected by temporary shelters, which would provide additional time for research into the long-term preservation of these sites. The sheltering project should kick off late in 2007. In preparation, Heritage Malta has been since 2005, and is still currently, intensively studying the temples as well as conditions in and around the site. Much of this information has already been fed into the final detailing of the shelters. The data obtained from the environmental monitoring in particular will also constitute important baseline information which will then be used to compare with the altered conditions under the shelters.peer-reviewe

The concept and range of charitable institutions up to World War I

The so-called Charitable Institutions of Malta and Gozo were organizations devoted to relieving the poor financially; providing them with food and shelter; nursing and treating them when sick either in their own homes or in hospitals; providing care for the aged and the mentally ill and assisting the helpless in any other way such as protecting unwanted babies and orphans and ransoming slaves. In practice all these activities took the form of three services: 1. Hospital Services 2. District Medical Service 3. Social Welfare.peer-reviewe

The burning of ships as a sanitary measure two hundred years ago in Malta

Woven throughout Maltese medical history is the constant struggle against the possibility of an invasion of the Maltese Islands by pestilence introduced by plague-infected ships. This is an account of the case histories of three plague-infected ships that came to Malta in the late eighteenth century and were destroyed by burning to eradicate the "contagion" on board.peer-reviewe

Diplazon laetatorius (Fabricius, 1781) - new record of an Ichneumonidae from Malta (Hymenoptera)

Mifsud (2012) provided a check-list of 29 recorded species of Ichneumonidae from the Maltese Islands. A recently collected ichneumonid wasp proved to be a new record for Maltapeer-reviewe

License to sell aromatic drugs granted to a shopkeeper in 1764

A document of 1764 held in a manuscript at the National Library of Malta shows the role of the Collegio di Sanita in issuing licences and setting down regulations regarding the sale of medicines when Malta was under the rule of the Order of St. John. This, and other documents carrying an earlier date prove the existence of regulatory bodies controlling the practice of pharmacy in Malta even as far back as the 17th Century.peer-reviewe

Rhagonycha fulva (Scopoli), a new record of soldier beetle (Coleoptera, Cantharidae) from Malta

Beetles of the family Cantharidae, commonly known as soldier beetles, are represented by 2,298 species and subspecies in the Palaearctic Region. Švihla & Mifsud provided a check-list of six species of Cantharidae inhabiting the Maltese Islands, of which one species of Malthodes was not identified to species levelpeer-reviewe