/library/oar/handle/123456789/39507 Wed, 12 Nov 2025 22:09:40 GMT 2025-11-12T22:09:40Z /library/oar/handle/123456789/915 Title: Acute Bronchitis Authors: Buhagiar, Bjorn Abstract: Acute bronchitis is a common respiratory tract infection usually caused by viruses and encountered often by family doctors. Diagnosis is usually made on clinical symptoms, as findings on physical examination are usually limited and investigations give non-specific results. Numerous studies have shown that antimicrobial agents are useless in acute bronchitis, and have a negligible effect on symptoms. The use of other medications such as & #946;2-agonists and cough suppressants has also been questioned and these medications are usually reserved for patients suffering from chronic lung conditions. Delayed prescription has been considered as a means of reducing antibiotic overprescribing in respiratory tract infections, however, the effect of such measures on antibiotic use and resolution of symptoms is questionable, as are studies on the patients’ satisfaction with delayed prescribing. Patients’ knowledge on respiratory tract infections and their treatment must also be considered, as it has been shown that family practitioners should be aware of the patients’ expectations when they attend with a respiratory tract infection. Thu, 01 Jan 2009 00:00:00 GMT /library/oar/handle/123456789/915 2009-01-01T00:00:00Z /library/oar/handle/123456789/914 Title: A second vestigial umbilical vein : a case report Authors: Attard Montalto, Simon; Mifsud, Nathalie; Zrinzo, Salvina; DeGaetano, James; Camilleri, Astrid Abstract: A healthy female infant was found to have two umbilical arteries and two umbilical veins at the cut surface of the cord at birth. Detailed inspection of the cord showed the second vein to represent a short segment vestigial vessel that, moreover, was not associated with any other congenital anomaly as is often found in infants with umbilical vein anomalies. Thu, 01 Jan 2009 00:00:00 GMT /library/oar/handle/123456789/914 2009-01-01T00:00:00Z /library/oar/handle/123456789/913 Title: Glycosylated haemoglobin (HbA1c) and cortisol levels on admission to intensive care as predictors of outcome Authors: Farrugia, Daniel P.; Sciberras, Stephen C.; Sant, Federika; Abela, Carmel J.; Zarb Adami, Joseph; LaFerla, Godfrey Abstract: Objective: To evaluate the predictive value of glycosylated haemoglobin and cortisol on admission, in critical care patients. Design: Prospective, observational, single centre study. Setting: 14 bedded Intensive care unit of a tertiary-level university hospital. Patients: 124 consecutive emergency medical and surgical patients. Methods: Data collected on admission included patient demographics, medical history, medication, diagnosis, type of nutrition, TISS28 score, serum blood glucose, Glycosylated haemoglobin (HbA1c), cortisol, mean arterial blood pressure, and the use of inotropes in the first 24hrs. Daily baseline tests included complete blood count, urea and electrolytes, creatinine, twice weekly liver function tests. The primary outcome measure was intensive care unit mortality. Secondary outcome measures were ITU stay, days of ventilation, peak urea, peak creatinine, lowest platelet count, peak bilirubin, lowest Pa/FiO2, and the number of transfusions. Measurements and results: 124 patients (mean age 56.2 years SD 23.2) were included. Regression analysis was used to identify any potential predictors of outcome: HbA1c levels on admission were not found to be significantly associated with mortality (p=0.51), or any other secondary endpoints listed above. However, subgroup analysis revealed a predictive role of HbA1c with regards to length of ITU stay (p= 0.01) and number of days of ventilation (p=0.007) in those patients with a history of diabetes. Glucose level on admission emerged as an independent marker of mortality (p=0.009). Conclusions: This study suggests that HbA1c may not be a predictor of outcome in the general ITU population but may be of predictive value in diabetic ITU patients. On the other hand, blood glucose levels on admission emerged as a predictor of mortality, whilst no association was found between HbA1c and cortisol levels on admission. Thu, 01 Jan 2009 00:00:00 GMT /library/oar/handle/123456789/913 2009-01-01T00:00:00Z /library/oar/handle/123456789/912 Title: Problems associated with the diagnosis and the prescribing of anti-psychotic medication in children and adolescents for psychiatric conditions, by non-psychiatric specialists Authors: Camilleri, Nigel; Cassar Parnis, Abigail; Cassar, Joseph R. Abstract: Aim: The objective of this study is to assess the accuracy of the diagnosis and appropriateness of antipsychotic medication prescribed to children and adolescents referred to child guidance clinic, and how many of these remained on the said medication after consultant psychiatrist and multidisciplinary team review. Method: A retrospective case notes review of all the children referred to a child guidance clinic in the period June 2005 to July 2006 were analysed, looking specifically at the referral tickets, the treatment on first interview with a member of the multidisciplinary team at the clinic, the working diagnosis of the team, and the management plan after at least six months of follow up at child guidance clinic. There was very good interrater reliability between the two observers looking at the case notes. Results: One hundred and fifty four (63.1%) out of a total of 244 children who were referred carried an admission diagnosis, which differed from the working diagnosis after 6 months. A total of 66 children (27%) were started on various types of psychiatric treatment prior to referral. Thirty (45.5%) of these were prescribed sulpiride, an atypical neuroleptic. Following review by the multi-disciplinary team, the medication of 25 (83.3%) of these children was terminated or altered. Conclusion: This report highlights the need of consultation liaison with general practitioners and also Continued Medical Education courses for general practice management in child and adolescent psychiatry. It is advisable that non psychiatric specialists limit the use of antipsychotic medication to children and adolescents without expert advice and in addition, should refer all such children with urgency. Thu, 01 Jan 2009 00:00:00 GMT /library/oar/handle/123456789/912 2009-01-01T00:00:00Z