/library/oar/handle/123456789/39635 2025-11-11T05:13:57Z /library/oar/handle/123456789/1449 Title: Surgical excision of renal cell carcinoma with caval and intra-atrial tumour thrombus extension using deep hypothermic circulatory arrest Authors: Bugeja, Simon; Zammit, Patrick; Galea, Joseph; German, Karl Andrew Abstract: Surgery for tumour thrombus extension in Renal Cell Carcinoma may be associated with a good prognosis if no distant metastases are identified and if the thrombus can be completely excised. The surgical approach chosen will depend on the level of tumour thrombus extension. We present a case of Renal Cell Carcinoma in the right kidney with tumour thrombus extension into the right atrium. This was successfully removed by right radical nephrectomy and excision of the atrial thrombus using cardio-pulmonary bypass and deep hypothermic circulatory arrest. This is the first procedure of its kind to be undertaken in Malta. 2013-01-01T00:00:00Z /library/oar/handle/123456789/1448 Title: Audit on the use of radiological investigations in the management of rhinosinusitis Authors: Grech, Stephan; McKearney, Richard M.; Borg Xuereb, Hermann K. Abstract: Objectives: The aim of this audit is to establish the cost to the Maltese health system from the use of radiological imaging in managing rhinosinusitis and to identify areas in which these costs can be minimised by following guidelines on the management of rhinosinusitis. Methods: All plain radiographs and computed tomography scans (CT) of the paranasal sinuses requested in the Mater Dei Hospital over a one year period were analysed. Data was collected regarding: the quantity of investigations ordered, age of the patients, cost and requesting department. Results: Over one year: 205 CT scans and 113 sets of plain radiographs of the paranasal sinuses were requested, costing a total of euro103,440. The majority (73%) were elective requests made by ENT consultants. Five percent of CT scans were requested for patients less than 10 years of age. Conclusion: Rhinosinusitis is diagnosed clinically, only requiring radiological investigation in more complex cases best managed by specialists in ENT. Plain radiographs have limited use in the management of rhinosinusitis. Judicious use of imaging requests whilst following clinical guidelines is required to save money and minimise patient exposure to ionising radiation. 2013-01-01T00:00:00Z /library/oar/handle/123456789/1447 Title: Amyand’s hernia : a case report Authors: Muscat, Peter Abstract: The presence of vermiform appendix, whether normal or inflamed in the inguinal hernia, is referred to as Amyand’s hernia. This is rare occurring in about 1% of inguinal hernias in adults. This is a report of Amyand’s hernia, which presented as a component along with partially necrotic omentum with metastasis in a 75 year old male patient. Appendicectomy followed by hernia repair using synthetic mesh was performed with an uneventful recovery. 2013-01-01T00:00:00Z /library/oar/handle/123456789/1446 Title: Motor Neurone Disease (MND) among Maltese in Malta and Australia is not linked to Poliomyelitis Authors: Wyatt, Harold Vivian Abstract: To link death from motor neurone disease/amyotrophic lateral sclerosis (MND /ALS) with previous paralysis of poliomyelitis. The forebearers (parents, grand-parents, etc) of 196 Maltese with MND, who have died in Malta and Australia, were compared with records of 1072 Maltese with paralytic poliomyelitis. There is no evidence that MND was linked to previous poliomyelitis. 2013-01-01T00:00:00Z