Remission during pregnancy of severe Chronic Hypertension due to 11-ß Hydroxylase Deficiency

When hypertension is a result of an underlying identifiable abnormality, the latter's early discovery can lead to a timely cure of the hypertension and the prevention of its complications. We present a case of high blood pressure lowered by pregnancy, suggestive of an endocrine cause. This was confirmed following a detailed history which revealed severe hypertension intractable to therapy, yet which remitted during pregnancy. A diagnosis of 11-beta hydroxylase deficiency was made consequent upon the finding of raised serum 11-desoxycorticosterone levels. The blood pressure was finally controlled with glucocorticoid replacement therapy and spironolactone.peer-reviewe

Traitement par prothèses sur implant de l’édentement postérieur partiel : suivi à long terme d’une étude prospective

Objective: This paper reports on the long-term outcome of patients with Kennedy Class IV partial edentulism treated in the Implant Prosthodontic Unit (IPU) at the University of Toronto, Toronto, Ontario. Methods: The information for this paper was gathered from the charts of the first 30 consecutive, partially edentulous patients treated at the IPU. These patients all had Class IV edentulism and formed part of the original prospective clinical studies that were initiated in 1983. The patients’ dental history suggested maladaptive experiences with traditional removable prostheses or a reluctance to have intact or quasi-intact teeth prepared as retainers for fixed prostheses. Fifteen men and 15 women treated with 94 Brånemark dental implants, supporting 34 prostheses, were followed until June 2000 (25 patients) or until they were lost to follow-up (5 patients). The multiple missing teeth occurred in 19 maxillae and 15 mandibles. Results: The original prosthodontic treatments were intended to result in 33 fixed partial prostheses and 1 overdenture. At the time of this report, 25 patients with 86 implants supporting 31 fixed prostheses and 3 overdentures had been followed for an average of 12 years (range 7–16 years). The overall survival of implants was 92%. The difference between men (94%) and women (89%) was not statistically significant. Conclusions: This report is an interim update on an ongoing long-term prospective study. The results so far demonstratea high survival rate for Brånemark implants supporting tissue-integrated prostheses for the management of anterior partial edentulism.peer-reviewe

Priorities in the management of road traffic accidents

It has been the experience of every casualty officer in a receiving station to be faced with problems not only related to one casualty presenting with multiple injuries but to a number of casualties with varying injuries, single or multiple. It is my purpose to establish certain guidelines in selecting the patients requiring immediate treatment, and in selecting the individual injuries that take precedence over any others. The immediate mortality of road traffic accidents depends entirely on the state of circulatory or respiratory collapse. Hence one's efforts must be initially directed to the restoration of these primary bodily functions.peer-reviewe

Theory and practice of advisory work in a time of turbulences

The Maltese ministry responsible for agriculture until recently offered a free of charge extension service. In view of the need for structured advisory facilities, and the risk that farmers resort to unofficial sources of information, the same ministry has taken the initiative to regulate, monitor and support this service by the relevant legal framework and EAFRD measures in the Rural Development Programme for the period 2007-2013 (Ministry for Rural Affairs and the Environment, 2007). The newly set up private Farm Advisory Service (FAS) providers can be considered as the latest development in the provision of institutionalised advisory and extension services in Malta. Their role is crucial in empowering producers to face the challenges and exploit opportunities brought about as a result of Malta’s membership in the EU. Although Maltese rural society has a rich history and experience within the cooperative movement, the formation, and fiscal realities of producer organisations has so far been limited and problematic. The intent of this paper is to identify some of the constraints and highlight possible mitigation options that could serve as recommendations for future action.peer-reviewe

The grapsid crab Percnon gibbesi (Milne Edwards, 1853) (Crustacea, Decapoda, Brachyura) : a new addition to the marine fauna of Malta

The first records and known distribution in Maltese waters of the grapsid crab Percnon gibbesi, an alien species, are presented.peer-reviewe

The Removal of Artificially Generated Polarization in SHARP Maps

We characterize the problem of artificial polarization for the Submillimeter High Angular Resolution Polarimeter (SHARP) through the use of simulated data and observations made at the Caltech Submillimeter Observatory (CSO). These erroneous, artificial polarization signals are introduced into the data through misalignments in the bolometer sub-arrays plus pointing drifts present during the data-taking procedure. An algorithm is outlined here to address this problem and correct for it, provided that one can measure the degree of the sub-array misalignments and telescope pointing drifts. Tests involving simulated sources of Gaussian intensity profile indicate that the level of introduced artificial polarization is highly dependent upon the angular size of the source. Despite this, the correction algorithm is effective at removing up to 60% of the artificial polarization during these tests. The analysis of Jupiter data taken in January 2006 and February 2007 indicates a mean polarization of 1.44%+/-0.04% and 0.95%+/-0.09%, respectively. The application of the correction algorithm yields mean reductions in the polarization of approximately 0.15% and 0.03% for the 2006 and 2007 data sets, respectively.Comment: 19 pages, 7 figure

Charge Fluctuations on Membrane Surfaces in Water

We generalize the predictions for attractions between over-all neutral surfaces induced by charge fluctuations/correlations to non-uniform systems that include dielectric discontinuities, as is the case for mixed charged lipid membranes in an aqueous solution. We show that the induced interactions depend in a non-trivial way on the dielectric constants of membrane and water and show different scaling with distance depending on these properties. The generality of the calculations also allows us to predict under which dielectric conditions the interaction will change sign and become repulsive

Factors influencing external audit fees in Malta

The main objective of this study is to investigate factors influencing the external audit fees in Malta. This includes assessing whether client size, complexity and risk, also known as the ―traditional‖ determinants, are applicable in the case of Malta, as well as testing the issue of premium pricing amongst the Big 4 audit firms. Of particular interest is the determination of specific factors relevant to such a market. A GLM regression model is used to examine the effect of the independent factors on the amount of audit fees for a sample of audit engagements performed in the Maltese audit market. The model is further complemented by a series of semi-structured interviews with audit partners from various audit firms of different sizes. Results indicate that the amount of external fees is significantly influenced by audit client size, complexity, risk, ownership control and corporate status. Additionally a fee premium has been found to accrue to the Big 4 audit firms.peer-reviewe

The role of the A C395 IFNGR1 mutation in determining susceptibility to intracellular infection in Malta

Background: The first human mycobacterial susceptibility gene was identified amongst four children on the island of Malta in 1995. All affected children were homozygous for a nonsense mutation at position 395 of the interferon gamma receptor 1 (IFNGR1) gene, and all but one died of overwhelming mycobacterial infection. The population of Malta has high rates of infection with intracellular pathogens; leishmania, brucellosis and tuberculosis are all endemic, while leprosy, which was previously endemic, has only recently been eradicated. We hypothesised that heterozygous carriers of the IFNGR1 gene mutation, while resistant to infection with poorly pathogenic organisms, may have increased susceptibility to infection with more virulent pathogens. Methodology and Result: Screening patients with a past history of intracellular infection and healthy newborns for the presence of the IFNGR1 A->C395 mutation, using sequence specific primer PCR, did not identify any carriers of the mutation. Conclusion: These results suggest that the IFNGR1 mutation is unlikely to be of public health significance on Malta.peer-reviewe

A possible hazard of splenectomy

The first case of splenectomy in St. Luke`s Hospital of a four months old infant is described. The infant died from a fulminating septicemia just over six weeks after splenectomy. Similar case studies indicated that fulminating infection occurs after splenectomy, particularly in infancy which could result fatal. In this regard, this study recommends that splenectomy should not be performed in the preschool child. Furthermore a careful follow-up of all splenectomised patients is advisable, by also treating any infection no matter how minor it may appear to be.peer-reviewe