ray gatt | University of Malta (original) (raw)

Papers by ray gatt

The rotator cuff consists of four muscles; the subscapularis, supraspinatus, infraspinatus, and t... more The rotator cuff consists of four muscles; the subscapularis, supraspinatus, infraspinatus, and teres minor. The long head of the biceps tendon is another important component of the complex. The subscapularis is a head depressor, and in certain positions an internal rotator. The infraspinatus and teres minor are external rotators. The conjoint tendon of these muscles, attached to the tuberosities, anatomically and functionally, works as a unit, to maintain dynamic glenohumeral stability centering the humeral head onto the glenoid articulation. The long head of the biceps attaches to the supraglenoid tubercle of the glenoid and has a stabilising and depressing action on the humeral head. The rotator cuff gives 50% of the abductor power and 80% of the external rotator power to the gleno-h umeral joint.

The Hospitaller and Military function of the Religious and Military Order of St John of Jerusalem... more The Hospitaller and Military function of the Religious and Military Order of St John of Jerusalem, later of Rhodes and later still, of Malta was its raison d’être from its very beginnings and maintained throughout its centuries of existence. This duality of purpose remained the common perception of this congregation of noble knights and it represented different aspects of Christian charity and protection. The motto of the Order Tuitio Fidei et Obsequium Pauperum explained this duality; fervour and protection for the Christian Faith and fighting with arms to achieve this goal and their love for the sick and the poor, regardless of sex, colour and creed and the physical caring of these as part of their remit. Throughout all their vicissitudes they maintained a charitable Hospitaller function with the building of hospices and hospitals at each and every domicile and arguably it was this fact that maintained their relevance throughout their existence. The Order, however, also had a military ethos par excellence. From their first garrison at Beth Gibelin and the crusader phase, through their expulsion from Palestine and onwards towards early modern times trying to stop the Ottoman invasion from taking over the navigational routes of the Mediterranean and conquer mainland Europe, their military acumen and courage on the field was unsurpassed. A multitude of archives testify to their prowess against the militant Muslim. The commandery of St John the Baptist of Ragusa in the Sicilian Kingdom was such a tiny cog in the machinations of the Order. Set up in 1626 by notarial deed of notary Petro Pippiolo, it was a commandery of jus patronatus, similar to many others that saw their beginning in the middle half of the seventeenth century. Its annual responsiones were small, but like other commanderies it also settled the intermittent impositions that the Order set up; it also rendered revenue to its commendatore so that he could live in a manner compatible with his standing. The justification in trying to resurrect this small commandery to life from long-dead archival material is to try to comprehend how this Religious Order was sustained to maintain its raison d’être for more than a millennium.

The association between hand and wrist configurations was investigated in this study. The hand an... more The association between hand and wrist configurations was investigated in this study. The hand and wrist dimensions of sixty patients with carpal tunnel syndrome and sixty healthy control subjects were measured using specific anatomical landmarks. The palm width was significantly greater in the patient group. There was no significant difference in the hand length between the two groups. Both the wrist width and wrist depth were significantly greater in the patient group. The hand ratio and the wrist ratio were significantly smaller in the patient group indicating that the latter had squarer hands and wrists than the control group respectively. This suggests that the anatomy of the hand and wrist may predispose to carpal tunnel syndrome.

Introduction: Osteoporotic hip fractures are common in elderly. There is increased risk of sustai... more Introduction: Osteoporotic hip fractures are common in elderly. There is increased risk of sustaining other fractures that incur financial burden on the health system. Prescription of bisphosphonates after osteoporotic hip fracture surgery has been shown to reduce the overall incidence of re-fractures. Methods: All osteoporotic hip fractures treated surgically in Mater Dei Hospital in the year 2011 were analysed in this observational retrospective study. The inclusion criteria were all primary osteoporotic hip fractures. The initiation, or not, of anti-osteoporotic treatment upon discharge from hospital was reviewed. The mortality and re-fracture rate of this cohort was reviewed for a period of 3 years. The cost of hospitalization for hip fracture and re-fractures was calculated based on local health services costs and compared to the benefits of providing a free bisphosphonate medication to each patient. Results: The osteoporotic hip fracture care pathway did not include initiation of anti-osteoporotic therapy after operations. A re-fracture rate of 11.7% over three years predominantly in female patients was observed. In the first year following hip fracture, an estimated direct medical health expenditure due to re-fractures was of €37,642.55-€48,835.19. Conclusion: Prescribing a bisphosphonate has been found to reduce both the re-fracture and mortality rates. In our study, a bisphosphonate prescription could have reduced the all cause mortality rate of 25.3% to 15.18% over the first year of hip fracture, as well as reduced the financial and social burden incurred due to a re-fracture.

Drafts by ray gatt

When the fires of the Order of St Anthony of Vienne were extinguished The dismantlement of the H... more When the fires of the Order of St Anthony of Vienne were extinguished

The dismantlement of the Hospitaller Order of St Anthony of Vienne occurred in the middle half of the eighteenth century with the resultant spoils carved up between two other Hospitaller Orders, the Order of St John, which was left with the lion’s share of the booty, and that of St Lazarus which had to resort to legal battles to try to obtain its rights. There were, however, other factions whose power influenced the way the spoils were to be partitioned: Rome was reconciled in favour of the Order of St John, the French king supported in the main the French Order of the Lazarites and Our Lady of Mount Carmel, whereas the French clergy saw the French benefices disappearing from their authority. The Archives of Malta vol. 1375 in the National Library are replete with memoires and three-way correspondence between ambassadors extraordinaire of both Orders, Papal delegates, and the commissioners, representatives of the French King. The interrelationship between the Orders of St John and that of St Lazarus is expounded in these memoires. From these it becomes evident that the larger Order of St John had received, directly and indirectly, most of the assets of St Anthony; however it ran into great financial difficulties because of various issues especially at the nadir of the Order’s existence. Meanwhile the smaller Order of St Lazarus had to resort to legal machinations to try to acquire their share of the booty, despite the fact that its Grandmaster was the King’s brother, Monsieur, Frère du Roi. In the end the loans engaged by the Order of St John to pay off the Lazarites for their share of the defunct Order of St Anthony were still outstanding when Grandmaster Hompesch embarked on his final voyage from Malta.

The Hospitaller and Military function of the Religious and Military Order of St John of Jerusalem... more The Hospitaller and Military function of the Religious and Military Order of St John of Jerusalem, later of Rhodes and later still, of Malta was its raison d’être from its very beginnings and maintained throughout its centuries of existence. This duality of purpose remained the common perception of this congregation of noble knights and it represented different aspects of Christian charity and protection. The motto of the Order Tuitio Fidei et Obsequium Pauperum explained this duality; fervour and protection for the Christian Faith and fighting with arms to achieve this goal and their love for the sick and the poor, regardless of sex, colour and creed and the physical caring of these as part of their remit. Throughout all their vicissitudes they maintained a charitable Hospitaller function with the building of hospices and hospitals at each and every domicile and arguably it was this fact that maintained their relevance throughout their existence.
The Order, however, also had a military ethos par excellence. From their first garrison at Beth Gibelin and the crusader phase, through their expulsion from Palestine and onwards towards early modern times trying to stop the Ottoman invasion from taking over the navigational routes of the Mediterranean and conquer mainland Europe, their military acumen and courage on the field was unsurpassed. A multitude of archives testify to their prowess against the militant Muslim.
The commandery of St John the Baptist of Ragusa in the Sicilian Kingdom was such a tiny cog in the machinations of the Order. Set up in 1626 by notarial deed of notary Petro Pippiolo, it was a commandery of jus patronatus, similar to many others that saw their beginning in the middle half of the seventeenth century. Its annual responsiones were small, but like other commanderies it also settled the intermittent impositions that the Order set up; it also rendered revenue to its commendatore so that he could live in a manner compatible with his standing. The justification in trying to resurrect this small commandery to life from long-dead archival material is to try to comprehend how this Religious Order was sustained to maintain its raison d’être for more than a millennium.

When the fires of the Order of St Anthony of Vienne were extinguished The dismantlement of the H... more When the fires of the Order of St Anthony of Vienne were extinguished

The Hospitaller and Military function of the Religious and Military Order of St John of Jerusalem... more The Hospitaller and Military function of the Religious and Military Order of St John of Jerusalem, later of Rhodes and later still, of Malta was its raison d’être from its very beginnings and maintained throughout its centuries of existence. This duality of purpose remained the common perception of this congregation of noble knights and it represented different aspects of Christian charity and protection. The motto of the Order Tuitio Fidei et Obsequium Pauperum explained this duality; fervour and protection for the Christian Faith and fighting with arms to achieve this goal and their love for the sick and the poor, regardless of sex, colour and creed and the physical caring of these as part of their remit. Throughout all their vicissitudes they maintained a charitable Hospitaller function with the building of hospices and hospitals at each and every domicile and arguably it was this fact that maintained their relevance throughout their existence.
The Order, however, also had a military ethos par excellence. From their first garrison at Beth Gibelin and the crusader phase, through their expulsion from Palestine and onwards towards early modern times trying to stop the Ottoman invasion from taking over the navigational routes of the Mediterranean and conquer mainland Europe, their military acumen and courage on the field was unsurpassed. A multitude of archives testify to their prowess against the militant Muslim.
The commandery of St John the Baptist of Ragusa in the Sicilian Kingdom was such a tiny cog in the machinations of the Order. Set up in 1626 by notarial deed of notary Petro Pippiolo, it was a commandery of jus patronatus, similar to many others that saw their beginning in the middle half of the seventeenth century. Its annual responsiones were small, but like other commanderies it also settled the intermittent impositions that the Order set up; it also rendered revenue to its commendatore so that he could live in a manner compatible with his standing. The justification in trying to resurrect this small commandery to life from long-dead archival material is to try to comprehend how this Religious Order was sustained to maintain its raison d’être for more than a millennium.