OAR@UM Community:

International child adoptions

2025-12-03T13:11:05Z

Title: International child adoptions Abstract: The adoption of children, whilst being an altruistic gesture, allows for individuals to bring up children and, in some cases, to add to their own family. The process has been and remains fraught with obstacles for prospective adoptive parent(s) including satisfying a suitability assessment, persevering through the arduous adoption process itself, as well as significant monetary outlay. The availability of ‘suitable’ prospective adoptees is a limiting factor and, in Malta, few ‘indigenous’ children are put up for adoption and more than 75% of adoptions are sourced from overseas.

Retrospective study on the prognostic significance of lymph node data post colorectal cancer resection

2025-12-03T11:18:17Z

Title: Retrospective study on the prognostic significance of lymph node data post colorectal cancer resection Authors: Callus, Leonard; Callus, Adrian; Sciortino, Philip Abstract: BACKGROUND: Lymph node data regarding the number of lymph nodes resected and studied have been found in previous studies to have prognostic value in patients diagnosed with colorectal cancer (CRC). CRC patients who underwent colorectal resections at Malta’s main hospital, Mater Dei Hospital (MDH), between 2008 and 2011 were selected to assess the prognostic value of such data.; METHODS: The Surgery Department compiled patients who underwent colorectal resections at Mater Dei. Histopathology reports were obtained from MDH’s intranet through iSoft’s iClinical Manager (iCM) and physical files. Microsoft Excel and IBM SPSS statistics were used to compile and analyse the data.; RESULTS: The number of lymph nodes resected showed a mildly significant correlation with overall survival with the Area Under the Receiver Operating Characteristic curve (AUROC) of 0.629 (CI – 95%, p = 0.008) in Stage II CRC patients. 13 lymph nodes were found to be the best cutoff below which there are risks of under-staging of Stage II patients and decreased survival. LNR and number of positive lymph nodes showed more significant correlation with overall survival with AUROC 0.739 (C.I. 95%; p = <0.0001) and 0.726 (C.I. 95%; p = <0.0001) respectively. Both LNR and number of positive lymph nodes correlated significantly with rates of new metastasis with AUROC 0.735 (C.I. = 95%; p = <0.0001) and 0.733 (C.I. = 95%; p = <0.0001), respectively. The best cutoff point for LNR was 8% in both cases.; CONCLUSION: Adequate lymph node exploration and removal are encouraged to avoid under-staging of disease that can potentially occur in Stage II patients with less than 12 lymph nodes resected. Lymph Node Ratio (LNR) provides a better overall picture of lymph node infiltration than N stage and the number of positive lymph nodes.

Obstetric admissions to the intensive care unit in Malta over a six year period (2016-2021)

2025-12-02T14:29:26Z

Title: Obstetric admissions to the intensive care unit in Malta over a six year period (2016-2021) Authors: Duca, Kristina; Attard, Nicole; Attard Cortis, Petramay; Abela, Glenn Paul Abstract: BACKGROUND: This is a retrospective evaluation of obstetric admissions to Mater Dei Hospital’s (MDH) ICU between 2016 and 2021. MDH accounts for over 90% of Malta’s deliveries. Comparison to data from a similar study covering 2012-2015 gives information over a 10-year period.; METHODS: Patients were recruited using ICU admissions records. Obstetric patients in any trimester, and up to 30 days postpartum, were included. Data was collected from patient medical records, there was no patient contact. Collected data included demographics, diagnosis, parameters, duration of ICU stay, interventions, and hospital stay. Surgical interventions, maternal and foetal outcomes were noted. MSExcel was used for data analysis.; RESULTS: 55 obstetric patients were admitted to ICU over the six year period; 51 were included in the study. 0.19% of obstetric deliveries needed ICU admission and obstetric admissions accounted for 0.68% of all ICU admissions. The commonest admission diagnosis was haemorrhage followed by hypertensive disorders of pregnancy and sepsis. In patients admitted with haemorrhage, mean blood loss was 2.16L. The mean systolic blood pressure in pre-eclamptic patients was 179mmHg. All patients had an arterial line inserted. 54.9% required overnight stay. 45 patients required surgical intervention, the commonest being an emergency Caesarean section. No maternal deaths were reported. In one case, CPR was performed.; CONCLUSIONS: Malta's rate of obstetric ICU admissions falls within the lower range when compared to international reports. The most common obstetric ICU admission diagnosis is still haemorrhage, in contrast to other international studies where hypertensive disorders of pregnancy prevail.

Updated prevalence and future projections of persons with dementia in the Maltese Islands with a focus on regionality, citizenship and costs

2025-12-02T14:26:58Z

Title: Updated prevalence and future projections of persons with dementia in the Maltese Islands with a focus on regionality, citizenship and costs Authors: Scerri, Anthony; Scerri, Charles Abstract: BACKGROUND: The global dementia prevalence is expected to double every twenty years. Previous local estimates of persons with dementia were based upon projections that did not account for the current population growth. Moreover, the prevalence of such individuals who are non-Maltese citizens, as well as the economic cost were never estimated. The main objective of this study was to provide updated figures on local prevalence rates of persons with dementia living in the Maltese Islands.; METHODS: To estimate the dementia prevalence rates, the World Health Organisation’s prevalence figures for the European region based on sex and age were used to determine the Maltese adult dementia population for each age/sex group according to data obtained from the 2021 Census. The same method was adopted to calculate the prevalence of persons with dementia who are non-Maltese citizens and for each local district. The estimates for the years 2025 to 2060 were calculated using the Eurostat population projections database.; RESULTS: The number of persons with dementia in Malta for the year 2021 was found to be 7,988 (1.54% of the total Maltese population), with 5.3% being non-Maltese citizens and 29 per cent living in the Northern Harbour district. This figure is expected to increase to 21,523 persons by the year 2060. The cost of dementia in the Maltese Islands in 2021 was estimated to range between €220-€260 million.; CONCLUSION: The projected increase in dementia prevalence in the Maltese Islands is being driven by population ageing and population growth with the latter becoming a significantly important contributor. Local policy makers need to increase capacity of high-quality health and social care provision and reduce the incidence of dementia by targeting modifiable risk factors.