/library/oar/handle/123456789/39633 2025-11-12T12:45:38Z /library/oar/handle/123456789/1612 Title: The management of patients positive to hepatitis C virus antibody in Malta Authors: Brincat, Anthea; Azzopardi, Neville; Deguara, Maria; Mifsud Taliana, Kelly; Rogers, Marilyn; Pocock, James Abstract: Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease and hepatocellular carcinoma worldwide and is an important public health concern. A retrospective analysis of the demographics and management of patients who had a positive anti-HCV detected by enzyme immunoassay test done at Mater Dei Hospital was carried out to analyse the epidemiology of HCV infection in Malta and assess our management when compared to the European Association for the Study of the Liver (EASL) guidelines. 72% of patients were male. The majority of patients were aged 21-50 years. The main mode of infection was via intravenous drugs use, accounting for 68% of cases. Only 56% of patients found to be HCV Ab positive had a scheduled appointment with an infectious diseases specialist or gastroenterologist documented on the MDH online appointment system. 58% of patients had HCV RNA testing done and 45% had genotype testing. 7.3% with HCV infection were given treatment, of which 43% had a Sustained Virological Response (SVR). 2013-01-01T00:00:00Z /library/oar/handle/123456789/1611 Title: Leadership, clinical freedom and costcontainment: lessons from recent history Authors: Manche, Alexander Abstract: Public Health provision, free at the point of contact, is espoused in many countries within the European Union. The method of funding, whether by direct taxation, or via insurance companies, is not so much a problem as the ever increasing cost of medical advances and are. Clearly structures need to be in place to manage this service, and the modern doctor is called upon to play an ever- increasing role. The British National Health Service has served as a template for our local health service, albeit with various divergences along the way. This article highlights the central role of the doctor, as leader and manager, in effecting constant change within the service. 2013-01-01T00:00:00Z /library/oar/handle/123456789/1610 Title: Audit on follow-up of patients with primary Osteoporosis Authors: Asciak, Rachelle; Attard, Carol; Casha, Ramon; Barbara, Patrick; Coleiro, Bernard Abstract: Aim: To document the frequency of Dual-energy X- ray absorptiometry (DEXA) scanning and Rheumatology clinic follow-up visits of patients with primary osteoporosis, and compare these with recommended guidelines. Method: Medical notes of all primary osteoporotic patients attending a hospital Rheumatology clinic were reviewed over a period of four months. Data was collected on age, gender, frequency of follow up visits, frequency of DEXA scanning, osteoporosis treatment, any changes in such treatment during the last visit, and comparison of the last two DEXA scan results. Frequency of follow up DEXA scans was compared to Group Health Osteoporosis Screening Diagnosis and Treatment guidelines.1 Results: Eighty-two patients were included, 6 males (7.3%) and 76 females (92.7%). The age range was 35-87 years (mean age was 68.6 years). In total, 42.7% of all the patients were on combined calcium and vitamin D, with added Bisphosphonates, Strontium ranelate, or Denosumab. During their last clinic visit, 61% showed improvement in T score since their previous result, and 64.6% of patients had no change in treatment. In this audit, 29.3% were being followed up on a 13 monthly basis, and 72% had annual bone mineral density scans or more frequently Conclusion: According to the guidelines, none of the patients included in this audit should have had a repeat DEXA scan within less than two years. Patients attending the clinic have too frequent DEXA scans and therefore, too frequent follow up appointments. 2013-01-01T00:00:00Z /library/oar/handle/123456789/1609 Title: Arterial access site in the catheterisation lab : Is radial the way to go? Authors: Cassar, Mark Philip Abstract: Aim: With radial access increasing in popularity in the United States and the United Kingdom, this literature review explores whether radial access in coronary angiography and percutaneous coronary intervention is superior to femoral access, focusing on access site complications and mortality. Methodology: Articles were acquired using: Pubmed. The keywords used were: bleeding, complications, femoral access, radial access, radial artery catheterization, angiography, radial versus femoral, access site, and mortality. The European Society of Cardiology (ESC) website The National Library of Medicine A retrospective audit, comparing radial access utilisation in Malta for the years 2011 and 2013 (1/1/2013 – 23/8/2013) was carried out using data from the cardiac catheterisation suite in Mater Dei Hospital. Results: Radial access was associated with fewer access site complications, decreased mortality, and quicker patient mobilisation post-procedure. The success of radial access was associated with a learning curve, and heavily operator dependent. Radial access utilisation in Malta for the years 2011 and 2013 (1/1/2013 – 23/8/2013) increased over three fold. Conclusion: The routine use of the radial approach in patients undergoing coronary intervention should be encouraged. 2013-01-01T00:00:00Z