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PubMedDate not supplied

[Arthur Keith and the first settlement of human being in Malta. Two subversive teeth].

The paper aims to give historical example of errors to which the examination of two fragmentary - and probably pathological - fossil remains can lead in the field of human palaeontology. In 1917, two very special human molars with a wide extension of their pulp cavity and fused fang were found in Neolothic excavations in Malta. As he had observed such a dental morphology of Neanderthal man in Jersey Arthur Keith (1866-1955) called that taurodontism and claimed it was a characteristic between Malta and the Italian coast he asserted that Neanderthat Man had lived in Malta. The theory has never been corroborated and taurodontism is not so characteristic as supposed by Keith. Furthermore it might be an individual pathological feature. Up to now there is no proof of human beings in Malta before about 5,000 BC.

History, 19th Century↗
PubMed1977

Detection and quantitation of the fetal hemoglobin variant Hb F-Malta-I in adults.

A variant of fetal hemoglobin (Hb F-Malta-I) has been detected and quantitated in adult blood with a sensitive radioimmunoassay employing monospecific antisera. The concentration of Hb-F-Malta-I was 0.002-0.05%, with an average value of 0.011%. The ratio of Hb F-Malta-I/Hb F in adults was about 4.8%, compared to a ratio of about 27% in the newborn. Since the F-Malta-I variant is a product of a mutated Ggamma locus, which is one of the nonallelic structural genes directing the gamma chain synthesis, its presence in blood of adults shows that the synthesis of this gene is not completely suppressed after birth, as was previously suggested.

Adult↗
PubMed1991

The linkage of Hb Valletta [alpha 2 beta 287(f3)Thr----Pro] and Hb F-Malta-I [alpha 2G gamma 2117(G19)His----Arg] in the Maltese population.

We have identified a new stable abnormal hemoglobin called Hb Valletta, which is characterized by a Thr----Pro substitution at position 87 of the beta chain. This mutation was found to be linked to that of the gamma chain variant Hb F-Malta-I with a His----Arg mutation at position 117 of the G gamma chain. Both variants were detected in the blood samples of 34 Maltese and two Italian newborn babies with isoelectrofocusing and reversed phase high performance liquid chromatography. Similar analyses of cord blood from 388 additional Maltese newborns failed to identify either one of these two variants. Additional analyses of 353 Maltese adults (including 39 beta-thalassemia heterozygotes) resulted in the detection of two adult Hb Valletta heterozygotes. Dot-blot hybridization analyses of amplified DNA with a probe specific for the G gamma-F-Malta-I variant showed that both also carried that mutation. These results show close linkage of the mutant forms of the G gamma- and beta-globin genes, 27-28 kb apart, and a failure to identify chromosomes with either the Hb F-Malta-I mutation alone or with the Hb Valletta mutation alone, indicating a low recombination frequency.

Adult↗
PubMed1993

Haemostatic abnormalities in African swine fever a comparison of two virus strains of different virulence (Dominican Republic '78 and Malta '78).

African swine fever (ASF) virus strains cause haemorrhage by producing a variety of defects, which vary in severity from strain to strain. To distinguish the main haemostatic defects leading to haemorrhage, two groups of pigs were infected with moderately virulent (Dominican Republic '78) and less virulent (Malta '78) ASF virus strains. Mortality rate and severity of clinical observations were greater in pigs infected with DR '78 virus compared with pigs infected with Malta '78 virus. The animals became febrile from day 3 to 4 onwards at a time when the viraemia was high (10(7) to 10(8) HAD50/ml). No difference was found during the period observed in their pattern of viraemia or pyrexia. Thrombocytopenia developed in both groups but with different kinetics, suggesting two different mechanisms of sequestration of platelets. When coagulation tests were performed, significant abnormalities were found, including evidence for disseminated intravascular coagulation. These abnormalities were much less pronounced in the group infected with Malta '78. Antithrombin III activity did not change significantly in either group. Decreased plasminogen activity was found in the early phase of disease in DR '78 infected pigs. These results indicate that when haemorrhage does occur in DR '78 infected pigs, it is a consequence of more pronounced degrees of haemostatic impairment probably due to a marked endothelial injury and/or generation of procoagulant activity.

African Swine Fever↗
PubMed2006

Characterisation of rickettsial diseases in a hospital-based population in Malta.

OBJECTIVE: The aim of the study was to characterise the causative agents of rickettsial disease in Malta. A secondary objective was to study the epidemiology of cases of rickettsial disease. METHODS: Cases admitted to St Luke's Hospital between June 2002 and May 2003 presenting with complaints of fever, headache, rash and/or an eschar were considered possible cases of rickettsial disease. A patient interview was conducted within 24h of admission. Paired sera were taken for serology and blood samples sent for rickettsial PCR and culture. Whenever an eschar was present, biopsies were taken for culture and immunohistochemical analysis. RESULTS: Thirty-three cases of possible rickettsial disease were identified. Although serological tests showed cross reactivities between different species of rickettsiae, one was diagnostic for Rickettsia conorii. None of the sera showed any cross-reactivity with Rickettsia typhi. There was one positive biopsy for R. conorii when tested by PCR and another was positive for spotted fever group Rickettsia by immunohistochemistry. CONCLUSION: Spotted fever rickettsiosis is endemic in Malta. Contrary to previous belief, none of the cases were due to murine typhus. The predominant causative agent of rickettsial disease in Malta is likely to be R. conorii, although the animal reservoir has still not been definitely identified.

Adolescent↗
PubMed1991

Alcohol and alcohol problems research. 17. Malta.

This article is an enquiry into the current status of alcohol in Maltese culture. The responses of society to alcoholism depend on the way members of the community perceive the problems incurred by the use and abuse of a dependence producing substance like alcohol. These perceptions and subsequent responses are very much influenced by prevailing attitudes and beliefs. Malta is a melting point of cultures. This factor, together with a high density population and Malta's geopolitical strategic position, combine to make Malta a tolerant society. There is a laissez-faire response to alcoholism, at least partly due to the present inability to identify the need to take appropriate measures. The police force, medical profession and politicians still do not feel the responsibility or the need to provide effective laws and regulations, specialized treatment services or educative programmes on alcohol-related issues. A systematic enquiry is needed urgently to determine the severity and degree of the problems posed by alcohol abuse among the Maltese. Such an enquiry should be followed by a well planned national policy which includes local approaches and interventions. Finally, these interventions must be evaluated frequently and developed to achieve better results in the future.

Alcohol Drinking↗
PubMed2006

A profile of invasive cutaneous malignant melanoma in Malta: 1993-2002.

BACKGROUND: The incidence of malignant melanoma of the skin has risen in every part of the world where reliable cancer registration data are found. OBJECTIVE: Our study aims to describe the changing incidence of and survival from invasive cutaneous malignant melanoma in Malta, by analysing the data from the 211 cases that were registered at the Malta National Cancer Registry between 1993 and 2002. RESULTS: The age standardized incidence rates for invasive cutaneous malignant melanoma rose from 3.7 per 100,000 population per year for males and 5.1 for females in the first 5-year period, to 8.0 per 100,000 population per year for males and 5.9 for females in the second 5-year period. In both sexes, numbers of thin (< or = 1.0 mm) invasive melanomas increased significantly between 1993 and 2002; males also registered a significant increase in intermediate-thickness (1.01-4.0 mm) melanomas. The increase in numbers of thin and intermediate-thickness melanomas between the two 5-year periods was greatest in patients aged 60 years and over. The overall absolute 5-year survival rate for the first period was 74% and for the second period 92%. CONCLUSION: Numbers of reported cases of invasive cutaneous malignant melanoma in Malta have more than doubled during the 10-year study period. This is mostly due to a marked rise in the diagnosis of thin melanomas in both sexes, occurring mainly in patients aged 60 years and over. As thin melanomas are of low metastasizing potential, this has resulted in an increase in survival between the two 5-year study periods.

Female↗
PubMed1979

Multiple sclerosis in southern Europe. II: Prevalence in Malta in 1978.

After an intensive survey only 14 patients have been found with a diagnosis of probable multiple sclerosis (MS) in the islands of Malta. This is a low prevalence of 4.2 per 100 000. The low prevalence of MS is confirmed by the small number of deaths certified as due to MS--six in 11 years--and by the absence of Maltese MS patients resident in England among the MS patients admitted to hospital in Greater London and the West Midlands (1960-72). The low prevalence of MS found in Malta can be contrasted with the high prevalence found in Enna city in central Sicily. The genetic and environmental reasons for this difference in MS prevalence between the neighbouring islands of Sicily and Malta require further study.

England↗
PubMed1998

An excess of tetralogy of Fallot in Malta.

STUDY OBJECTIVE: To estimate birth prevalence of tetralogy of Fallot (TF) in Malta. DESIGN: Retrospective data collection and analysis, and comparison with earlier epidemiological studies dealing with congenital heart disease. SETTING: Regional hospital providing exclusive diagnostic and follow up services for the entire country of Malta. PATIENTS: All Maltese live births diagnosed as having TF. MAIN RESULTS: The birth prevalence of TF in Malta for the period 1980-1994 was 0.64/1000 live births (95% confidence intervals 0.48, 0.85/1000 live births). This was significantly higher than previously reported in the medical literature. CONCLUSIONS: The Maltese gene pool seems to have a genetic predisposition towards live births with TF. Population genetic studies with emphasis on the prevalence of 22q11 microdeletion may yield clues regarding the cause of the high rate of this condition.

Causality↗
PubMed1994

The economics of imperialism and health: Malta's experience.

The thesis of this article is that the prevalence of disease and premature death depends more on national, class, and gender relationships than on medical and biological factors. The political and economic realities of life in the British Colony of Malta revealed here clearly determined the severity of both infant mortality rates and the attacks of brucellosis. A brief history sets the background for an in-depth study of the interaction between socioeconomic conditions and disease in the first half of the 20th century. Britain's adherence to imperialist "free" trade policies and refusal to consider Malta's economy beyond its use as a military base had resulted in the "underdevelopment" of Malta's traditional cotton agroindustry and the erosion of household economic stability. Persistently high infant mortality rates and the absence of preventive disease measures were a clear manifestation of continuing exploitative imperialist policies. In this scenario, the devastation of the Second World War became a catalyst for change.

Brucellosis↗
PubMed1988

Trends in mortality from major non-communicable diseases in the middle-aged population of Malta.

Trends in life expectancy and mortality from major non-communicable diseases in Malta were analyzed from the national vital statistics available. Most of the increased life expectancy during the 20th century in Malta took place between 1930 and 1960 and since then only a minor increase was observed. The peak in age standardized total mortality in men and women aged 40-69 years was during 1974-76. Total mortality in men was about 40% higher than that of women. The proportion of deaths from major non-communicable diseases (cardiovascular diseases, cancer and diabetes) of all deaths increased during 1968-82. In 1983-84 in the age group 45-64 cardiovascular diseases accounted for 54% of deaths in men and 43% in women, cancer 27% and 34%, and diabetes 3% and 11% in men and women, respectively. The international comparison of mortality data showed that mortality from both cardiovascular diseases, cancer and diabetes was clearly higher than in other European Mediterranean countries ranking among the highest in the whole Europe. Public health intervention programmes have initiated in Malta to reduce these high death rates in the future.

Cardiovascular Diseases↗
PubMed1987

HLA associations with multiple sclerosis in Sicily and Malta.

The islands of Sicily and Malta have very different prevalence rates for multiple sclerosis (MS): at least 44 per 100,000 in Sicily and only 4 per 100,000 in Malta. In Northern Europe, MS is associated with HLA-DR2/Dw2. The other components of the commonest DR2-containing haplotype of this region, HLA-A3-B7-DR2-Dw2, also tend to be present at higher frequency in MS patients. HLA Class I and II antigen frequencies and associations in controls and MS patients from Sicily and Malta were studied to discover whether they might account for the difference in MS prevalence. In Sicilian MS patients, DR2 is increased in frequency compared with controls and four out of five DR2-positive patients also type as Dw2. In the Maltese population, DR2 is present at high frequency but approximately half of the DR2 positive individuals do not type as Dw2 so that DR2 is probably most commonly present as part of Class II haplotypes other than those commonly associated with MS. Additional differences in HLA profile of the Sicilian and Maltese populations were found when HLA-A, -B, and B-DR antigen associations were examined. Therefore, some of the difference in MS prevalence might be explained by genetic factors.

Cross-Sectional Studies↗
PubMed1998

British retirees in Malta: components of the cross-national relationship.

"The paper focuses on three aspects of the retirement of British citizens to Malta and Gozo: the evolution of the British settlement, four pathways to the islands, and the formation of the current demographic and household characteristics.... The immigration of British retirees to Malta has fluctuated in volume and character over the last 35 years, partly in response to changes in Maltese fiscal and residence policies, and partly reflecting the changing demand for overseas retirement settlement in the UK. The substantial contribution of intercommunal married couples to the British retired resident population and the buoyancy of both tourist visits and new arrivals suggests that its size will at least be stable or will grow slowly for many decades to come."

Adult↗
PubMed2000

Latent class analysis of human herpesvirus 8 assay performance and infection prevalence in sub-saharan Africa and Malta.

Human herpesvirus 8 (HHV-8) is thought to be highly prevalent in Mediterranean countries and sub-Saharan Africa, where it causes Kaposi's sarcoma in a small proportion of infected immunocompetent persons. However, the lack of serological tests with established accuracy has hindered our understanding of the prevalence, risk factors and natural history of HHV-8 infection. We tested 837 subjects from Congo, Botswana (mostly young adults) and Malta (elderly adults), using an immunofluorescence assay and 2 enzyme immunoassays (EIAs, to viral proteins K8.1 and orf65). Each assay found HHV-8 seroprevalence to be high (49-87%) in the African populations and generally lower (9-54%) in Malta. However, there was only modest agreement among tests regarding which subjects were seropositive (3-way kappa, 0.05-0.34). We used latent class analysis to model this lack of agreement, estimating each test's sensitivity and specificity and each population's HHV-8 prevalence. Using this approach, the K8.1 EIA had consistently high sensitivity (91-100%) and specificity (92-100%) across populations, suggesting that it might be useful for epidemiological studies. Compared with the K8.1 EIA, both the immunofluorescence assay and the orf65 EIA had more variable sensitivity (80-100% and 58-87%, respectively) and more variable specificity (57-100% and 48-85%, respectively). HHV-8 prevalence was 7% among elderly Maltese adults. Prevalence was much higher (82%) in Congo, consistent with very high Kaposi's sarcoma incidence there. Prevalence was also high in Botswana (87% in Sans, an indigenous group, and 76% in Bantus), though Kaposi's sarcoma is not common, suggesting that additional co-factors besides HHV-8 are needed for development of Kaposi's sarcoma.

Adolescent↗
PubMed1999

Incidence and outcome of Kawasaki disease in Malta.

Kawasaki disease (KD) is an acute febrile illness of childhood of unknown origin which causes an arteritis of small and medium sized arteries. The arteritis may involve any organ, including the coronary arteries, causing diffuse dilatation, aneurysm formation, stenosis, infarction and death. This paper determines the incidence of KD in Malta and compares the incidence and morbidity of KD in Malta with that in other countries. The Maltese incidence is 3.2/100,000 population < 5 years of age, similar to that reported in non-Asiatic communities, and significantly less than that reported in Asiatic communities. None of the Maltese patients had coronary arteritis or other complications. A significant decline in delay to diagnosis was found, which is attributed to increased awareness of the disease in the medical community.

Arteritis↗
PubMed1990

Health and social inequities in Malta.

This paper focuses on the sources that are thought to lead to the genesis of health and social inequity in a small island community. It is largely a descriptive exposition, the main aim of which is to introduce the topic in Malta. Small size is the key geographical factor. This fact is dwelt upon to stress that although there are differences, say, between the two inhabitable islands, such differences are very small. Social homogeneity and an almost indiscernible urban-rural difference are strong factors that reduce any tendency for regional inequities. Socio-cultural factors in Malta are largely determined by family life and its relation with the established church. The traditional Catholic way of life is depicted as gradually giving way to a more secular lifestyle. Politics is represented as the prime factor for causing division within the this society. This is not without reason since this factor has taken over the other cause of division, namely parochialism. Political factors determine the distribution of resources including health resources. The important economic factors are that there are no great differences between the high income and the low income groups. However, due importance must always be given to the subterranean economy. The health profile is that of a developed country with low infant mortality and a long life expectancy. Infectious diseases have been on the decline and their persistence is usually linked to areas that have remained underdeveloped. The disadvantaged groups identified are the chronically unemployed, single mothers, possibly a section of the migrant population and the elderly.

Cause of Death↗
PubMed2005

Comparison between Sardinia and Malta: the Mediterranean diet revisited.

The Mediterranean diet is often characterized in terms of food items only. In this paper, the comparison of meals, in-between meals snack consumption and total daily food intake is presented between Sardinia and Malta in terms of structure, social environment and hours, together with their changes. Data were collected in 2001 in Sardinia and 2002 in Malta. A structured qualitative questionnaire, articulated around four main themes: food supply, transformation, preparation and consumption habits, was administered by face-to-face interviews with the help of a local person. Inquiries were carried out over two generations with 30 'mother-daughter' couples in each island. We highlighted some Mediterranean characteristics in Sardinia by showing striking contrasts between Sardinian and Maltese food habits such as meal preparation times, both breakfast and main meal structures, total daily food intake profiles, mealtimes and commensality in the mothers' generation. Some of these characteristics were also maintained in the daughters' generation. This investigation has presented evidence that beyond foods, meal pattern, structure and commensal rituals appeared as fundamental aspects of Sardo-Mediterranean food habits, which are important to consider when trying to maintain or implement the Mediterranean dietary model.

Adult↗
PubMed1979

Four bills of health issued from Malta by the Order of St John.

The specimens here described enlarge our knowledge of the bills of health of the Order of St John issued from Malta, an aspect of public health that had hitherto remained unexplored. These lone survivors from a vanished by-way of Maltese medical history formed, in their age, an integral part of the daily social, commercial and sanitary pattern of life in Malta. The earliest met so far, and described in the present series, dates from 1713; two belong to 1766 and another dates from 1794. A further bill, issued in 1782, has been published elsewhere. The chance preservation of these documents in unlikely places, as here indicated, makes it probable that additional ones may eventually come to light.

History, 18th Century↗