Interhemispheric epidermoid cyst

A 44-year-old man presented following a tonicclonic seizure. Intracranial epidermoid cysts account for approximately 1% of primary intracranial tumours. They are benign slow growing tumours derived from ectodermal inclusions during neural tube closure.peer-reviewe

The Malta experience : a retrospective study of two types of peritoneal dialysis catheters

Aim: The aim of this retrospective study was to compare the one year and two year survival rate of the double cuff coiled Tenchkoff catheter (TC) and the double cuff coiled Swan Neck (SN) catheter. The incidence of the following complications in the two groups were assessed: exit site infection (ESI), tunnel infection (TI), peritonitis (P), flow problems (FP), catheter tip migration (CTP), hernia development (H) and leakage (L). Methods: This is a retrospective comparative study of peritoneal dialysis catheters inserted between January 2003 and December 2008 by one surgical team at Mater Dei Hospital. Results: The one year catheter survival rate was TC 88.5% and SN 90%. There was no statistically significant difference in catheter survival rate between the two cohorts. The survival rate at 2 years post implantation of the TC catheters was 82.6% and 88.8% for the SN catheters. Conclusions: Equally good results were obtained with the two types of peritoneal dialysis catheters studied. There was no significant difference in 1 and 2 year survival between the two types of catheters. In our local experience the catheter survival rate and episodes of peritonitis per year at risk are in line with the recommendations of the International Society of Peritoneal Dialysis (ISPD).peer-reviewe

Primary fallopian tube carcinoma presenting with a solitary metastasis in a Spigelian hernia

Primary fallopian tube carcinoma (PFTC) is a rare gynaecological tumour. Histologically, this type of tumour resembles other tumours of the female reproductive tract, predominantly serous tumours. These cancers are often difficult to distinguish from ovarian cancers and are generally treated with the same standards of surgery and chemotherapy. Diagnosis of PFTC is rarely made preoperatively. Very often, the diagnosis is made either at the operating table or by the pathologist. In this report we present a rare case of PFTC with a solitary metastatic deposit in a right Spigelian hernia, the latter being the initial presenting complaint.peer-reviewe

Low back pain : a comparative study on the value of core training versus traditional strengthening exercises

This randomised controlled trial (RCT) employed a pre-test/post-test design to compare the effects of core training (Pilates method) and traditional back exercises on a population with low back pain (LBP). Therapeutic intervention related to the Pilates method has recently become popular, but there is little evidence to prove it works. In this study, 120 individuals with LBP were allocated to three different groups. Group A was the control group, Group B was given modified Pilates intervention and Group C received traditional back exercises. All three groups were given a posture re-education session and back-care advice. After the initial session, the control group had individual sessions on posture re-education. The other groups undertook a six-week course of either modified Pilates or general back exercise classes. The modified Pilates group was taught how to use the core muscles, incorporating stabilisation with increasing functional movements. The back exercise group did similar exercises without learning to specifically stabilise. The Oswestry Low Back Pain Disability Questionnaire (ODQ) and the Visual Analogue Scale (VAS) were used as measures for pain and functional disability. Post-test ODQ readings showed no significant difference for pain-related function whilst VAS readings revealed a significant improvement in pain levels in all three groups, with the control group showing the best scores. However, the six-month follow-up scores showed that only the modified Pilates group continued to improve. At this stage, the control group was beginning to regress and the back exercise group was almost back to baseline measures. It was therefore concluded that core stability exercises have better long-term effects than traditional back exercisespeer-reviewe

The effects of a marine fish-farm on the species richness and abundance of molluscs, decapods and echinoderms associated with a "Posidonia oceanica" meadow in Malta (Central Mediterranean)

The composition of the echinoderm, mollusc and decapod assemblages associated with a Posidonia oceanica meadow located close to a fish-farm varied with distance from the cages Three ecological zones were identified. The intermediate zone II (40-160m from the cages) had a higher species richness and abundance than either zones I (nearest the cages) and III (320m from the cages), probably due to the higher production resulting from a moderate level of nutrient enrichment at intermediate distances from the source of pollution.peer-reviewe

Structural changes in a Posidonia oceanica meadow exposed to a pollution gradient from a marine fish-farm in Malta (Central Mediterranean)

Posidonia oceanica morphological parameters where measured at increasing distance from a marine fish-farm that has been operational for 7 years. Most parameters changed significantly with increasing distance from the cages, the greatest change occurring in the first 50 m.peer-reviewe

Living deep-water Lophelia and Madrepora corals in Maltese waters (Strait of Sicily, Mediterranean Sea)

The occurrence of living deep-water corals, Lophelia pertusa and Madrepora oculata, from stations 21-42 km off the southern and south-western coast of Malta is reported. Fragments of living colonies of both species, as well as some large pieces of Lophelia frameworks were recovered from depths of 390-617 m together with the solitary coral Desmophyllum dianthus (= cristagalli). The accompanying biota included the barnacle Pachylasma giganteum, the gastropod Coralliophila richardi, the bivalves Asperarca nodulosa and Spondylus gussonii, and the polychaete Eunice norvegicus, all of which are frequently associated with deep-water corals. The occurrence of the Lophelia-Madrepora- Desmophyllum triad, the large pieces of coral frameworks consisting predominantly of live, healthy polyps, and the associated biota, suggest that coral patches may be present in at least some of the investigated localities, rather than just fragmented remains or isolated colonies.peer-reviewe

Spatio-temporal variation in the structure of a deep water Posidonia oceanica meadow assessed using non-destructive techniques

The Malta-Comino Channel (Maltese islands, central Mediterranean), supports extensive meadows of the seagrass Posidonia oceanica that in some places extend to a depth of around 43 m, which is rare for this seagrass. To assess spatial and temporal variation in the state of the deeper parts of the P. oceanica meadow with time, data on the structural characteristics of the seagrass meadow at its lower bathymetric limit were collected during the summers of 2001, 2003 and 2004 from four stations (two stations within each of two sites) located at a similar depth, over a spatial extent of 500 m. Shoot density was estimated in situ, while data on plant architecture (number of leaves, mean leaf length, and epiphyte load) were successfully obtained using an underwater photographic technique that was specifically designed to avoid destructive sampling of the seagrass. Results indicated that P. oceanica shoot density was lower than that recorded from the same meadow during a study undertaken in 1995; the observed decrease was attributed to the activities of an offshore aquaculture farm that operated during the period 1995–2000 in the vicinity of the meadow. ANOVA indicated significant spatial and temporal variations in meadow structural attributes at both sites during the 3-year study; for example, shoot density values increased overall with time at site A; a indication of potential recovery of the meadow following cessation of the aquaculture operations. Lower shoot density values recorded from site B (compared with site A) were attributed to higher epiphyte loads on the seagrass, relative to those at site A. The findings, which include new data on the structural characteristics of P. oceanica occurring at depths >40 m, are discussed with reference to the use of the nondestructive photographic technique to monitor the state of health of deep water seagrass meadows.peer-reviewe

Age, growth and reproduction of Coryphaena hippurus (Linnaeus, 1758) in Maltese waters, Central Mediterranean

Age, growth and reproduction of the dolphinfish Coryphaena hippurus Linnaeus, 1758 collected from the Central Mediterranean in the period 2004-2010 by the traditional Maltese fish aggregating devices (FAD) and surface longline fisheries were studied. The a and b parameters of the length-weight relationship for fish 11-142 cm fork length (FL) (n = 4042) were determined as a = 0.018 and 0.022 with b = 2.85 and 2.79, for males and females respectively. The counting of annual increments from dorsal spines of >65 cm FL dolphinfish at X25 magnification (n = 47) permitting an age reading resolution in years, and the counting of daily increments from sagittal otoliths of <65 cm FL dolphinfish at X400 magnification (n = 583) permitting an age reading resolution in days, were estimated; the von Bertalanffy growth model applied to these fish gave the following parameters: L∞ = 107.8 cm FL and 120.2 cm FL, and K = 1.9 yr-1 and 1.56 yr-1, for males and females respectively. The maximum age observed was 2 years. Size at 50% maturity for fish 10-131 cm FL (n = 1376) was 58.9 cm FL and 62.5 cm FL for males and females, respectively. The sex ratio for the fish sampled from the FAD fishery (10.5-131 cm FL) was 1:1.54 (M:F) and for dolphinfish sampled from the surface longline fishery (91-130 cm FL) was 1:0.76 (M:F). Back-calculated hatch dates from age-0 dolphinfish (n = 518) suggested that spawning occurs from June to September with the highest levels in June. This study is the first to use dorsal spines to determine the age of adult dolphinfishpeer-reviewe

Vaccination approaches for the prevention of urinary tract infection

Urinary tract infections (UTIs) are one of the most common infectious diseases of humans, with approximately 150 million cases estimated to occur globally every year. UTIs usually start as a bladder infection (cystitis), but can develop into acute kidney infection (pyelonephritis) and even infection of the bloodstream (urosepsis). The high frequency of UTIs in community and nosocomial settings places an enormous burden on healthcare systems worldwide. Multiple different pathogens cause UTI, with uropathogenic E. coli (UPEC) the most common etiological agent. UTIs caused by these pathogens are increasingly associated with antibiotic resistance, thus severely reducing treatment options and significantly increasing UTI-associated morbidity and mortality. In this review we present an overview of the recent advances in vaccine research targeted towards the prevention of UPEC-mediated UTI. In the context of multidrug resistance, we conclude that vaccination represents a viable approach for the prevention of chronic and recurrent UTI