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[PMID]: 28817714 [Au] Autor: Tripp L; Sawchuk LA [Ad] Endereço: Department of Anthropology, University of Toronto at Scarborough, Toronto, Ontario, Canada. [Ti] Título: Insights into secular trends of respiratory tuberculosis: The 20th century Maltese experience. [So] Source: PLoS One;12(8):e0183296, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Over half a century ago, McKeown and colleagues proposed that economics was a major contributor to the decline of infectious diseases, including respiratory tuberculosis, during the 19th and 20th centuries. Since then, there is no consensus among researchers as to the factors responsible for the mortality decline. Using the case study of the islands of Malta and Gozo, we examine the relationship of economics, in particular, the cost of living (Fisher index) and its relationship to the secular trends of tuberculosis mortality. Notwithstanding the criticism that has been directed at McKeown, we present results that improvement in economics is the most parsimonious explanation for the decline of tuberculosis mortality. We reaffirmed that the reproductively aged individuals were most at risk of dying of tuberculosis, seeing that 70 to 90% of all deaths due to tuberculosis occurred between the ages of 15 and 45. There was a clear sex differential in deaths in that, prior to 1930, rates in females were generally higher than males. During times of extreme hardship, the sex differential was exacerbated. Over the course of World War I, the sex gap in tuberculosis rates increased until peaking in 1918 when there was also the influenza pandemic. The heightened differential was most likely a result of gendered roles as opposed to biological differences since female tuberculosis rates again surpassed male rates in 1945 during World War II. Respiratory tuberculosis in both urban and rural settlements (in Malta proper) was significantly influenced by the Fisher index, which explains approximately 61% of the variation in TB death rates (R = 0.78; p<0.0001). In Gozo, there was no significant impact on respiratory tuberculosis (R = 0.23; p = 0.25), most likely a consequence of the island's isolation, a self-sufficient economy and limited exposure to tuberculosis. [Mh] Termos MeSH primário: Tuberculose Pulmonar/epidemiologia [Mh] Termos MeSH secundário: Feminino História do Século XX Seres Humanos Masculino Malta/epidemiologia Fatores Sexuais Tuberculose Pulmonar/história Tuberculose Pulmonar/mortalidade [Pt] Tipo de publicação: HISTORICAL ARTICLE; JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171016 [Lr] Data última revisão: 171016 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170818 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0183296

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[PMID]: 28614909 [Au] Autor: Luo G; Zhang Y; Guo P; Wang L; Huang Y; Li K [Ad] Endereço: Department of Public Health, Shantou University Medical College, Shantou, Guangdong, 515041, China. [Ti] Título: Global patterns and trends in stomach cancer incidence: Age, period and birth cohort analysis. [So] Source: Int J Cancer;141(7):1333-1344, 2017 Oct 01. [Is] ISSN: 1097-0215 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: The cases of stomach cancer (SC) incidence are increasing per year and the SC burden has remained very high in some countries. We aimed to evaluate the global geographical variation in SC incidence and temporal trends from 1978 to 2007, with an emphasis on the effect of birth cohort. Joinpoint regression and age-period-cohort model were applied. From 2003 to 2007, male rate were 1.5- to 3-fold higher than female in all countries. Rates were highest in Eastern Asian and South American countries. Except for Uganda, all countries showed favorable trends. Pronounced cohort-specific increases in risk for recent birth cohorts were seen in Brazil, Colombia, Iceland, New Zealand, Norway, Uganda and US white people for males and in Australia, Brazil, Colombia, Costa Rica, Czech Republic, Ecuador, Iceland, India, Malta, New Zealand, Norway, Switzerland, United Kingdom, Uganda, US black and white people for females. The cohort-specific ratio for male significantly decreased in Japan, Malta and Spain for cohorts born since 1950 and in Austria, China, Croatia, Ecuador, Russia, Switzerland and Thailand for cohorts born since 1960 and for female in Japan for cohorts born since 1950 and in Canada, China, Croatia, Latvia, Russia and Thailand for cohorts born since 1960. Disparities in incidence and carcinogenic risk persist worldwide. The favorable trends may be due to changes in environmental exposure and lifestyle, including decreased Helicobacter pylori prevalence, increased intake of fresh fruits and vegetables, the availability of refrigeration and decreased intake of salted and preserved food and smoking prevalence. [Mh] Termos MeSH primário: Saúde Global/estatística & dados numéricos Neoplasias Gástricas/epidemiologia [Mh] Termos MeSH secundário: Adulto Grupo com Ancestrais do Continente Africano/estatística & dados numéricos Distribuição por Idade Fatores Etários Idoso Idoso de 80 Anos ou mais Ásia/epidemiologia Canadá/epidemiologia Estudos de Coortes Europa (Continente)/epidemiologia Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos Feminino Seres Humanos Incidência Masculino Malta/epidemiologia Meia-Idade Oceania/epidemiologia Distribuição por Sexo América do Sul/epidemiologia Fatores de Tempo Estados Unidos/epidemiologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170927 [Lr] Data última revisão: 170927 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170615 [St] Status: MEDLINE [do] DOI: 10.1002/ijc.30835

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[PMID]: 28580660 [Au] Autor: Caruana M; Grech V [Ad] Endereço: Department of Cardiology, Mater Dei Hospital, Msida, Malta. [Ti] Título: Long-term outcomes after aortic coarctation repair in Maltese patients: A population-based study. [So] Source: Congenit Heart Dis;12(5):588-595, 2017 Sep. [Is] ISSN: 1747-0803 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVES: To investigate survival and freedom from reintervention after aortic coarctation repair in Maltese patients and to compare cardiovascular mortality in coarctation repair survivors with that in the general population. DESIGN: All 72 aortic coarctation patients with any type of repair, born by end-1997 and logged in the local database were included. Trends in timing and type of repair were determined by comparing patients born before and after 1985. Kaplan-Meier analyses of survival and reintervention-free survival were performed on the 59 repair survivors with complete follow-up data (mean follow-up 26.13 ± 9.62 (range 1.05-44.55 years). Cardiovascular mortality in repair survivors was compared with that in 438 age- and sex-matched general Maltese controls. RESULTS: Patients born after 1985 underwent repair at a younger age (median age 0.18 vs 13.96 years; P < .001), with less patch aortoplasties in favor of end-to-end anastomosis or transcatheter stenting. Among the 59 long-term follow-up patients, there were 7 cardiovascular deaths and 10 patients needed reintervention. Estimated mean survival was 40.33 years (95% CI 37.71, 42.95) with a survival rate of 67.5% at 40 years from repair. Estimated mean reintervention-free survival was 38.13 years (95% CI 34.52, 41.75) with freedom from reintervention rate of 77% at 30 years. Patients repaired aged <10 years required earlier reintervention (estimated mean reintervention-free survival 35.12 years (95% CI 29.54, 40.71) vs 40.80 years (95% CI 37.16, 44.37); P = .04). There was an excess of cardiovascular deaths among repaired coarctation subjects compared to the general population (11.9% vs 1.4%; P < .001) and survival in coarctation patients was significantly lower (67.90 years (95% CI 60.28, 75.52) vs 85.78 years (95% CI 83.12, 88.44); P < .001). CONCLUSIONS: Despite earlier diagnosis and repair, contemporary coarctation repair survivors remain at increased risk of cardiovascular death. An important proportion require repair site reintervention. Specialist follow-up and aggressive cardiovascular risk factor management are mandatory to improve long-term outcomes. [Mh] Termos MeSH primário: Aorta Torácica/cirurgia Coartação Aórtica/cirurgia Previsões Vigilância da População Medição de Risco/métodos Stents Procedimentos Cirúrgicos Vasculares/métodos [Mh] Termos MeSH secundário: Adolescente Adulto Coartação Aórtica/mortalidade Criança Pré-Escolar Feminino Seguimentos Seres Humanos Masculino Malta/epidemiologia Período Pós-Operatório Prognóstico Estudos Retrospectivos Fatores de Risco Taxa de Sobrevida/tendências Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171102 [Lr] Data última revisão: 171102 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170606 [St] Status: MEDLINE [do] DOI: 10.1111/chd.12488

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[PMID]: 28485715 [Au] Autor: Azzopardi-Muscat N; Buttigieg S; Calleja N; Merkur S [Ad] Endereço: Department of Health Services Management, Faculty of Health Science, University of Malta; Directorate for Health Information and Research, Ministry for Health, Malta. [Ti] Título: Malta: Health System Review. [So] Source: Health Syst Transit;19(1):1-137, 2017 Jan. [Is] ISSN: 1817-6127 [Cp] País de publicação: Denmark [La] Idioma: eng [Ab] Resumo: Maltese life expectancy is high, and Maltese people spend on average close to 90% of their lifespan in good health, longer than in any other EU country. Malta has recently increased the proportion of GDP spent on health to above the EU average, though the private part of that remains higher than in many EU countries. The total number of doctors and GPs per capita is at the EU average, but the number of specialists remains relatively low; education and training are being further strengthened in order to retain more specialist skills in Malta. The health care system offers universal coverage to a comprehensive set of services that are free at the point of use for people entitled to statutory provision. The historical pattern of integrated financing and provision is shifting towards a more pluralist approach; people already often choose to visit private primary care providers, and in 2016 a new public-private partnership contract for three existing hospitals was agreed. Important priorities for the coming years include further strengthening of the primary and mental health sectors, as well as strengthening the health information system in order to support improved monitoring and evaluation. The priorities of Malta during its Presidency of the Council of the EU in 2017 include childhood obesity, and Structured Cooperation to enhance access to highly specialized and innovative services, medicines and technologies. Overall, the Maltese health system has made remarkable progress, with improvements in avoidable mortality and low levels of unmet need. The main outstanding challenges include: adapting the health system to an increasingly diverse population; increasing capacity to cope with a growing population; redistributing resources and activity from hospitals to primary care; ensuring access to expensive new medicines whilst still making efficiency improvements; and addressing medium-term financial sustainability challenges from demographic ageing. [Mh] Termos MeSH primário: Assistência à Saúde/organização & administração [Mh] Termos MeSH secundário: Assistência à Saúde/economia Assistência à Saúde/métodos Reforma dos Serviços de Saúde/economia Reforma dos Serviços de Saúde/métodos Reforma dos Serviços de Saúde/organização & administração Gastos em Saúde Serviços de Saúde/economia Financiamento da Assistência à Saúde Seres Humanos Malta Atenção Primária à Saúde/organização & administração Qualidade da Assistência à Saúde/economia Qualidade da Assistência à Saúde/organização & administração Cobertura Universal [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171113 [Lr] Data última revisão: 171113 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170510 [St] Status: MEDLINE

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[PMID]: 28482828 [Au] Autor: Marmarà D; Marmarà V; Hubbard G [Ad] Endereço: Faculty of Health Sciences, University of Stirling, Room E9, Pathfoot, Stirling, FK9 4LA, Scotland, UK. attard.danika@gmail.com. [Ti] Título: Health beliefs, illness perceptions and determinants of breast screening uptake in Malta: a cross-sectional survey. [So] Source: BMC Public Health;17(1):416, 2017 May 08. [Is] ISSN: 1471-2458 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Women's beliefs and representations of breast cancer (BC) and breast screening (BS) are salient predictors for BS practices. This study utilized the health belief model (HBM) and common-sense model (CSM) of illness self-regulation to explore factors associated with BS uptake in Malta and subsequently, to identify the most important predictors to first screening uptake. METHODS: This cross-sectional survey enrolled Maltese women (n = 404) ages 50 to 60 at the time of their first screening invitation, invited to the National Breast Screening Programme by stratified random sampling, with no personal history of BC. Participants responded to a 121-item questionnaire by telephone between June-September 2015. Data were analyzed using descriptive statistics, chi-square tests and logistic regression. RESULTS: There is high awareness of BC signs and symptoms among Maltese women (>80% agreement for 7 out of 8 signs), but wide variation about causation (e.g., germ or virus: 38.6% 'agree', 30.7% 'disagree'). 'Fear' was the key reason for non-attendance to first invitation (41%, n = 66) and was statistically significant across all subscale items (p < 0.05). Most items within HBM constructs (perceived barriers; cues to action; self-efficacy) were significantly associated with first invitation to the National Breast Screening Programme, such as fear of result (χ2 = 12.0, p = 0.017) and life problems were considered greater than getting mammography (χ2 = 38.8, p = 0.000). Items within CSM constructs of Illness Representation (BC causes; cyclical cancer timeline; consequences) were also significantly associated, such as BC was considered to be life-changing (χ2 = 18.0, p = 0.000) with serious financial consequences (χ2 = 13.3, p = 0.004). There were no significant associations for socio-demographic or health status variables with uptake, except for family income (χ2 = 9.7, p = 0.047). Logistic regression analyses showed that HBM constructs, in particular perceived barriers, were the strongest predictors of non-attendance to first invitation throughout the analyses (p < 0.05). However, the inclusion of illness representation dimensions improved the model accuracy to predict non-attendance when compared to HBM alone (65% vs 38.8%). CONCLUSIONS: Interventions should be based on theory including HBM and CSM constructs, and should target first BS uptake and specific barriers to reduce disparities and increase BS uptake in Malta. [Mh] Termos MeSH primário: Neoplasias da Mama/diagnóstico Neoplasias da Mama/psicologia Conhecimentos, Atitudes e Prática em Saúde Percepção [Mh] Termos MeSH secundário: Conscientização Estudos Transversais Feminino Seres Humanos Modelos Logísticos Malta Mamografia Meia-Idade Exame Físico Autoeficácia Inquéritos e Questionários [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171011 [Lr] Data última revisão: 171011 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170510 [St] Status: MEDLINE [do] DOI: 10.1186/s12889-017-4324-6

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[PMID]: 28383003 [Ti] Título: Europe must find a new home for its drug regulator - and a way to keep using English. [So] Source: Nature;544(7648):6, 2017 04 03. [Is] ISSN: 1476-4687 [Cp] País de publicação: England [La] Idioma: eng [Mh] Termos MeSH primário: Aprovação de Drogas/organização & administração União Europeia/organização & administração Linguagem [Mh] Termos MeSH secundário: Aprovação de Drogas/economia Irlanda Londres Malta [Pt] Tipo de publicação: EDITORIAL [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170626 [Lr] Data última revisão: 170626 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170407 [St] Status: MEDLINE [do] DOI: 10.1038/nature.2017.21762

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[PMID]: 28341902 [Au] Autor: Caruana M; Apers S; Kovacs AH; Luyckx K; Thomet C; Budts W; Sluman M; Eriksen K; Dellborg M; Berghammer M; Johansson B; Soufi A; Callus E; Moons P; Grech V; APPROACH-IS consortium and the International Society for Adult Congenital Heart Disease (ISACHD) [Ad] Endereço: Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Msida, MSD 2090, Malta. caruana.maryanne@gmail.com. [Ti] Título: 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. [So] Source: Pediatr Cardiol;38(5):965-973, 2017 Jun. [Is] ISSN: 1432-1971 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Studies in recent years have explored lifestyle habits and health-risk behaviours in adult congenital heart disease (ACHD) patients when compared to controls. The aim of this study was to investigate differences in lifestyle habits between Maltese and other European ACHD patients. Data on alcohol consumption, cigarette smoking, substance misuse, dental care and physical activity collected in 2013-2015 during "Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease-International Study" (APPROACH-IS) were analysed. Responses from 119 Maltese participants were compared to those of 1616 participants from Belgium, France, Italy, Norway, Sweden, Switzerland and the Netherlands. Significantly fewer Maltese patients with simple (Maltese 84.1% vs. European 97.5%, p < 0.001) and moderately complex CHD (Maltese 83.6% vs. European 97.4%, p < 0.001) brushed their teeth daily. Only 67.2% of Maltese with moderately complex disease had dental reviews in the previous year compared to 80.3% of Europeans (p = 0.02). Maltese patients with simple (Maltese 31.8% vs. European 56.1%, p = 0.002) and moderately complex lesions (Maltese 30.0% vs. European 59.2%, p < 0.001) performed less regular sport activities. Comparison by country showed Maltese patients to have significantly poorer tooth brushing and sports participation than patients from any other participating country. Alcohol consumption, cigarette smoking and substance misuse were not significantly different. This study highlights lifestyle aspects that Maltese ACHD patients need to improve on, which might not be evident upon comparing patients to non-CHD controls. These findings should also caution researchers against considering behaviours among patients in one country as necessarily representative of patients on the larger scale. [Mh] Termos MeSH primário: Assistência Odontológica/estatística & dados numéricos Cardiopatias Congênitas/epidemiologia Esportes/estatística & dados numéricos [Mh] Termos MeSH secundário: Adulto Consumo de Bebidas Alcoólicas/epidemiologia Europa (Continente)/epidemiologia Exercício Feminino Comportamentos Relacionados com a Saúde Seres Humanos Estilo de Vida Masculino Malta/epidemiologia Meia-Idade Fumar/epidemiologia Transtornos Relacionados ao Uso de Substâncias/epidemiologia Inquéritos e Questionários Adulto Jovem [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171005 [Lr] Data última revisão: 171005 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170326 [St] Status: MEDLINE [do] DOI: 10.1007/s00246-017-1604-y

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[PMID]: 28245825 [Au] Autor: Bartolo K; Balzan M; Schembri EL; Asciak R; Mercieca Balbi D; Pace Bardon M; Montefort S [Ad] Endereço: Mater Dei Hospital, Dun Karm Street, Msida, Malta. kyrabartolo@gmail.com. [Ti] Título: Predictors of correct technique in patients using pressurized metered dose inhalers. [So] Source: BMC Pulm Med;17(1):47, 2017 Feb 28. [Is] ISSN: 1471-2466 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Corret inhaler technique is recommended by guidelines for optimum asthma care. The objective of the study is to determine real life predictors of correct pressurized metered dose inhaler (pMDI) technique in Asthma and COPD patients. METHODS: Two hundred eight adult patients aged 18+ from respiratory outpatients (69.2%) and the community on regular pMDI for a diagnosis of Asthma (78.9%) or COPD, were recruited. A questionnaire containing 31 possible predictors was administered and pMDI technique with or without spacer was observed by trained researchers on 12 point steps, of which 4 were considered critical. RESULTS: 23.1% of patients had no errors in inhaler technique and 32.2% had no critical errors. Patients had a median of 10 correct steps (IQR9-11), and 3(IQR2-4) correct critical steps. Using binary logistic regression the predictors of 10 correct steps were, other healthcare professional (pharmacist, nurse, physiotherapist) explained OR 3.73(1.63-8.54, p = 0.001), male gender 2.70(1.35-5.39, p = 0.004), self-score 1-10 1.21(1.05-1.39, p = 0.007), spacer use 0.38(0.19-0.79, p = 0.007), inhaled steroid 3.71(1.34-10.25, p = 0.01), heart disease 0.31(0.13-0.77, p = 0.01), pneumococcal vaccine 2.48(1.0-6.15, p = 0.043), education level 1-4 1.44(1.00-2.06, p = 0.05) and respiratory physician explained 0-7 times, 1.11(0.99-1.26, p = 0.08). Using ordinal logistic regression, predictors for correct critical steps 0-4, were: technique self-score 1-10 1.2(1.05-1.42, p = 0.006), inhaled corticosteroid use 2.78(1.1-7.31, p = 0.03) and education level 1-4 1.41(1.02-1.95, p = 0.03 Times respiratory physician explained inhaler technique 0-7 1.1(0.98-1.24, p = 0.1), married status 1.55(0.85-2.82, p = 0.15), hypercholesterolaemia 0.52(0.25-1.01, p = 0.054) and male gender 1.76(0.97-3.18, p = 0.06). CONCLUSIONS: Known predictors of correct pMDI use, such as gender and education level were confirmed, while age and concomitant use of dry powder inhaler were not. Pneumococcal vaccination and awareness of steroid side effects were possible novel positive predictors, while the use of a spacer and co-morbidity with heart disease were found to be negative predictors. Patients' self-assessment correlated well with actual performance. This information may be useful in defining approaches to optimize inhaler techniques which are so susceptible to human error. [Mh] Termos MeSH primário: Corticosteroides/administração & dosagem Asma/tratamento farmacológico Broncodilatadores/administração & dosagem Inaladores Dosimetrados Cooperação do Paciente/estatística & dados numéricos Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico [Mh] Termos MeSH secundário: Administração por Inalação Adulto Idoso Lista de Checagem Feminino Seres Humanos Modelos Logísticos Masculino Malta Meia-Idade Inquéritos e Questionários [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Adrenal Cortex Hormones); 0 (Bronchodilator Agents) [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171102 [Lr] Data última revisão: 171102 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170302 [St] Status: MEDLINE [do] DOI: 10.1186/s12890-017-0386-6

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[PMID]: 28143697 [Au] Autor: Licari E; Takács N; Solymosi N; Farkas R [Ad] Endereço: The Veterinary Clinic' Triq Frangisk Xerri, Birkirkara, BKR1020, 27692277, Malta. Electronic address: petlovencare@gmail.com. [Ti] Título: First detection of tick-borne pathogens of dogs from Malta. [So] Source: Ticks Tick Borne Dis;8(3):396-399, 2017 Mar. [Is] ISSN: 1877-9603 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: The knowledge about the vector-borne infections in domestic dogs has been increasing worldwide. However no studies have been done on hard tick infestation and tick-borne pathogens (TBPs) of dogs present in Malta. Therefore, a total of 99 dogs was selected and inspected between March and July 2013 in 18 urban and 17 rural areas on the islands of Malta and Gozo. All ticks were removed from the dogs and identified. Blood samples were taken and tested for protozoa (Babesia spp. and Hepatozoon spp.) and bacteria (Anaplasma spp., Ehrlichia spp., Rickettsia spp.) by conventional PCR. All of the ticks collected from 34 (34.3%; 95% CI: 26-44) dogs belong to the species Rhipicephalus sanguineus sensu lato. Tick infestation on the farm dogs was significantly higher than that of dogs kept outdoors as pets (OR: 15.19, 95% CI: 2.72-118.92, p<0.001) or in a sanctuary (OR: 35.11, 95% CI: 3.20-1986.67, p<0.001). Altogether 22 animals were infected with one or two TBPs, most of them with Hepatozoon canis (16/22; 72.7%). Anaplasma platys and Babesia vogeli were detected in 5 and 4 dogs, respectively. Three dogs had co-infections caused by H. canis and A. platys. To the best of our knowledge, this is the first report on tick infestation and TBPs of dogs in Malta. [Mh] Termos MeSH primário: Anaplasma/isolamento & purificação Babesia/isolamento & purificação Coccídios/isolamento & purificação Doenças do Cão/epidemiologia Rhipicephalus sanguineus/microbiologia Infestações por Carrapato/veterinária Doenças Transmitidas por Carrapatos/veterinária [Mh] Termos MeSH secundário: Anaplasma/genética Anaplasma/patogenicidade Anaplasmose/epidemiologia Anaplasmose/microbiologia Animais Babesia/genética Babesia/patogenicidade Babesiose/epidemiologia Babesiose/parasitologia Coccídios/genética Coccídios/patogenicidade Coccidiose/epidemiologia Coccidiose/parasitologia Coccidiose/veterinária Coinfecção/epidemiologia Coinfecção/microbiologia Coinfecção/parasitologia Coinfecção/veterinária Doenças do Cão/microbiologia Doenças do Cão/parasitologia Cães Malta/epidemiologia Reação em Cadeia da Polimerase Infestações por Carrapato/epidemiologia Infestações por Carrapato/microbiologia Infestações por Carrapato/parasitologia Doenças Transmitidas por Carrapatos/epidemiologia Doenças Transmitidas por Carrapatos/microbiologia Doenças Transmitidas por Carrapatos/parasitologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171031 [Lr] Data última revisão: 171031 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170202 [St] Status: MEDLINE

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[PMID]: 28038317 [Au] Autor: Psaila M; Ranson C [Ad] Endereço: Armed Forces of Malta, Medical Centre, Luqa Barracks, Malta. Electronic address: mjpsaila@yahoo.co.uk. [Ti] Título: Risk factors for lower leg, ankle and foot injuries during basic military training in the Maltese Armed Forces. [So] Source: Phys Ther Sport;24:7-12, 2017 Mar. [Is] ISSN: 1873-1600 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: OBJECTIVES: Basic military training is physically and psychologically demanding placing recruits at high risk of injury and premature discharge. This study aimed to identify risk factors for lower leg, ankle and foot injury in Maltese military recruits during basic training. DESIGN: This was a prospective cohort study. SETTING: An armed forces barracks. PARTICIPANTS: 127 recruits commencing one basic military training course agreed to participate in the study. The cohort comprised 114 males and 13 females with a mean age of 21.7 ± 2.4 years. MAIN OUTCOME MEASURES: All injuries to the lower leg, ankle and foot were recorded using the Orchard Sports Injury Classification System. Injuries were analysed for associations with fitness scores, smoking status, body mass index and foot type. RESULTS: A total of 34 (26.2%) recruits sustained at least one injury, with 10 recruits (7.9%) terminating their training prematurely (three due to musculoskeletal injury). Smoking history, body mass index and foot type were not associated with injury risk. Lower fitness levels at the commencement of basic military training compared with fitness levels measured six months prior, were associated with higher injury risk. CONCLUSIONS: Lower fitness at the commencement of basic training was associated with higher injury risk in army recruits. Thus, conditioning programmes aimed at improving recruit fitness should be considered within an injury prevention strategy. [Mh] Termos MeSH primário: Traumatismos do Tornozelo/etiologia Traumatismos do Pé/etiologia Traumatismos da Perna/etiologia Militares [Mh] Termos MeSH secundário: Traumatismos do Tornozelo/classificação Índice de Massa Corporal Feminino Traumatismos do Pé/classificação Seres Humanos Traumatismos da Perna/classificação Masculino Malta Aptidão Física Estudos Prospectivos Fatores de Risco Fumar/efeitos adversos Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170308 [Lr] Data última revisão: 170308 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161231 [St] Status: MEDLINE

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