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6. Quality of life in Maltese adults with congenital heart disease: a second look

Author

Caruana, Maryanne, primary, Moons, Philip, additional, Kovacs, Adrienne H., additional, Luyckx, Koen, additional, Thomet, Corina, additional, Budts, Werner, additional, Sluman, Maayke, additional, Eriksen, Katrine, additional, Dellborg, Mikael, additional, Berghammer, Malin, additional, Johansson, Bengt, additional, Soufi, Alexandra, additional, Callus, Edward, additional, Grech, Victor, additional, and Apers, Silke, additional

Published
2024
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20. Inconsistency in the Application of Glasgow Coma Scale in Pediatric Patients.

Author

Caruana, Maria, Hackenbruch, Sophie Noelle, Grech, Victor, and Farrugia, Ruth

Subjects
GLASGOW Coma Scale, CHILD patients, CRONBACH'S alpha, NEUROLOGIC examination, MEDICAL audit, PEDIATRIC nurses
Abstract

Objective: The Glasgow Coma Scale (GCS) is widely used to objectively describe the extent of patients' impaired consciousness. However, there are known variations in scoring GCS both in adults and children which may impact patient management. The aim of this audit was to assess the application of GCS by medical and nursing staff in pediatric medical patients. Subject and Methods: An online questionnaire was distributed amongst doctors and nurses working in the Department of Child and Adolescent Health at Mater Dei Hospital in Malta. The participants assigned GCS for 8 case scenarios involving children of different ages with varying levels of consciousness. Results were analyzed by calculating percentage agreement and by Cronbach's alpha. Results: Sixty-six participants were studied, with a response rate of 52%. Performance was poor overall, with Cronbach alpha 0.53. Correlation was better at the upper and lower ends of the scale and the worst performance was for verbal response. Only respondents with 5–10 years of experience achieved acceptable consistency in the application of the GCS (Cronbach alpha 0.78). Conclusion: There is considerable variation in application of GCS in pediatric patients, highlighting the need for education and training to improve consistency for this commonly used neurological assessment tool. [ABSTRACT FROM AUTHOR]

Published
2024
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27. Red Flags for Maltese Adults with Congenital Heart Disease: Poorer Dental Care and Less Sports Participation Compared to Other European Patients—An APPROACH-IS Substudy

Author

Caruana, Maryanne, Apers, Silke, Kovacs, Adrienne H., Luyckx, Koen, Thomet, Corina, Budts, Werner, Sluman, Maayke, Eriksen, Katrine, Dellborg, Mikael, Berghammer, Malin, Johansson, Bengt, Soufi, Alexandra, Callus, Edward, Moons, Philip, Grech, Victor, Alday, Luis, Maisuls, Héctor, Vega, Betina, Menahem, Samuel, Eaton, Sarah, Larion, Ruth, Wang, Qi Feng, Budts, Werner, Van Deyk, Kristien, Apers, Silke, Goossens, Eva, Rassart, Jessica, Luyckx, Koen, Moons, Philip, Rempel, Gwen, Mackie, Andrew, Ballantyne, Ross, Rankin, Kathryn, Norris, Colleen, Taylor, Dylan, Vondermuhll, Isabelle, Windram, Jonathan, Heggie, Pamela, Lasiuk, Gerri, Khairy, Paul, Proietti, Anna, Dore, Annie, Mercier, Lise-Andrée, Mongeon, François-Pierre, Marcotte, François, Ibrahim, Reda, Mondésert, Blandine, Côté, Marie-Claude, Kovacs, Adrienne, Oechslin, Erwin, Bandyopadhyay, Mimi, Soufi, Alexandra, Filippo, Sylvie Di, Sassolas, François, Bozio, André, Chidambarathanu, Shanthi, Farzana, Farida, Lakshmi, Nitya, Callus, Edward, Quadri, Emilia, Chessa, Massimo, Campioni, Giovanna, Giamberti, Alessandro, Enomoto, Junko, Mizuno, Yoshiko, Caruana, Maryanne, Grech, Victor, Vella, Sheena, Mifsud, Anabel, Borg, Neville, Chircop, Daniel, Mercieca Balbi, Matthew, Vella Critien, Rachel, Farrugia, James, Gatt, Yanika, Muscat, Darlene, Eriksen, Katrine, Estensen, Mette-Elise, Dellborg, Mikael, Berghammer, Malin, Mattson, Eva, Strandberg, Anita, Karlström-Hallberg, Pia, Johansson, Bengt, Kronhamn, Anna-Karin, Schwerzmann, Markus, Thomet, Corina, Huber, Margrit, Wang, Jou-Kou, Lu, Chun-Wei, Yang, Hsiao-Ling, Hua, Yu Chuan, Mulder, Barbara, Sluman, Maayke, Post, Marco, Pieper, Els, Peels, Kathinka, Waskowsky, Marc, Veldtman, Gruschen, Faust, Michelle, Lozier, Colin, Reed, Christy, Hilfer, Jamie, Daniels, Curt, Jackson, Jamie, Kutty, Shelby, Chamberlain, Carolyn, Cook, Stephen, Hindes, Morgan, Cedars, Ari, White, Kamila, Rompfh, Anitra, Fernandes, Susan, MacMillen, Kirstie, and On behalf of the APPROACH-IS consortium and the International Society for Adult Congenital Heart Disease (ISACHD)

Published
2017
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36. Congenital heart disease in Malta

Author

Grech, Victor E.

Subjects
610, Epidemiology, Paediatrics, CHD
Abstract

Introduction: Congenital malformations are important causes of morbidity and mortality. Congenital heart disease (CHD) is a label for a heterogeneous group of lesions which comprise the commonest group of malformations. Treatment of CHD has only been available for the past half-century, making paediatric cardiology and cardiac surgery relatively new subspecialities. Malta provides an ideal location for historical and epidemiological studies dealing with congenital malformations due to its relatively closed population and lack of antenatal screening programs due to unavailability of termination of pregnancy. Epidemiology: Analysis of the epidemiology of CHD in Malta over 1990–94 showed a significant excess of minor ventricular septal defects, which is attributed to high-quality clinical services which diagnose these defects prior to spontaneous closure. A significant excess of lesions causing right ventricular outflow tract obstruction, particularly Fallot's tetralogy, and a relative scarcity of lesions causing left ventricular outflow tract obstruction were also found. A genetic predisposition to right ventricular outflow tract obstruction may be inherent in the Maltese population. A significant seasonal variation in lesions requiring intervention was found with a peak in the third quarter of the year. These deliveries are conceived in the last half of the year with the first trimester occurring in the peak of the coldest weather. Environmental factors may be influencing predisposed fetuses, precipitating CHD. A significant North-South variation in the overall birth prevalence of CHD was also found, with a higher prevalence in the Southern part of the Island. The demographic trends suggest that environmental factors, rather than genetic factors, may be causing a higher rate of CHD in the South. Historical trends: This study has also shown that diagnosis and intervention in all types of CHD has occurred progressively earlier in childhood, with an ever decreasing delay in the application of new techniques to Maltese patients with CHD. These trends were significant and were associated with a significant declining mortality from CHD, both perioperatively and as a crude specific population mortality rate. Conclusion: Treatment of CHD has been very successful with a substantial decrease in mortality, increasing the pool of survivors and hence the need for health services. Further work regarding possible environmental conditions which may precipitate CHD could isolate avoidable predisposing factors, allowing a reduction in live births with CHD.

Published
1998

37. Point of care cardiac ultrasonography in three paediatric arrests

Author

Azzopardi, Eugenio, Grech, Elizabeth, and Grech, Victor E.

Subjects
Point-of-care testing, Echocardiography, Pediatric emergencies, Cardiac resuscitation, Diagnostic ultrasonic imaging
Abstract

INTRODUCTION: Point-of-Care Ultrasound (POCUS) refers to bedside ultrasonography in the clinical setting at the site of initial presentation. Few studies have reported the use of POCUS for emergency paediatric echocardiography., METHODS: This paper outlines the utility of POCUS echocardiography in three cases in Malta., RESULTS: Cardiac POCUS was used with utility and value on three children in the acute resuscitation setting., DISCUSSION: Echocardiography in children during resuscitation is feasible and it is possible to eyeball contractility and cardiac filling and assess the size of any pericardial effusions. Although the images obtained are inferior to those obtained in an echocardiography laboratory, useful information in real time can be obtained., peer-reviewed

Published
2023

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