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Article ; Online: Nodular vasculitis (erythema induratum) associated with systemic minocycline.

Farrugia, Stephanie / Cachia, Monique / Betts, Alexandra / Clark, Eileen

2023 Volume 65, Issue 2, Page(s) 167–170

Abstract: A 29-year-old Caucasian woman presented with a 3-month history of bilateral lower limb swelling with painful erythematous nodules on shins without ulceration. She had been taking minocycline for acne vulgaris for 3 years. Biochemical investigations ... ...

Abstract	A 29-year-old Caucasian woman presented with a 3-month history of bilateral lower limb swelling with painful erythematous nodules on shins without ulceration. She had been taking minocycline for acne vulgaris for 3 years. Biochemical investigations showed deranged liver function test with positive ANA and mixed antinuclear factor (ANF) pattern. A skin biopsy was in keeping with a diagnosis of nodular vasculitis. Her skin lesions and liver function test improved within 3 months of stopping the minocycline treatment. This case report raises the awareness that minocycline could be a potential cause of nodular vasculitis, patients on minocycline should be closely monitored and minocycline should ideally not be prescribed for more than 12 weeks, given the possible adverse effects.
MeSH term(s)	Female ; Humans ; Adult ; Erythema Induratum ; Minocycline/adverse effects ; Skin/pathology ; Acne Vulgaris/complications ; Vasculitis/chemically induced ; Vasculitis/drug therapy ; Vasculitis/complications
Chemical Substances	Minocycline (FYY3R43WGO)
Language	English
Publishing date	2023-12-06
Publishing country	Australia
Document type	Case Reports ; Journal Article
ZDB-ID	138052-7
ISSN	1440-0960 ; 0004-8380
ISSN (online)	1440-0960
ISSN	0004-8380
DOI	10.1111/ajd.14195
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Palmar Digital Vein Thrombosis: A Case Report and Review of 36 Cases.

Farrugia, Stephanie / Cachia, Monique / Degaetano, James / Boffa, Michael J

European journal of case reports in internal medicine

2022 Volume 9, Issue 9, Page(s) 3552

Abstract: Thrombosis of the palmar digital veins is relatively rare, typically reported in women aged 35-65 years and most commonly occurring on the fourth digit. Clinical presentation varies and the lesion can present on the fingers or the palms of the hands. ... ...

Abstract	Thrombosis of the palmar digital veins is relatively rare, typically reported in women aged 35-65 years and most commonly occurring on the fourth digit. Clinical presentation varies and the lesion can present on the fingers or the palms of the hands. Diagnosis may be suspected clinically and confirmed on histology and radiologically. The condition can be managed conservatively or surgically. A 58-year-old woman presented with a 3-month history of a tender, skin-coloured nodule on her right palm. This was surgically excised, and the histopathological diagnosis was a thrombosed varix. As no underlying medical issues were raised on further testing, it was thought that her thrombosed varix was likely secondary to repeated trivial mechanical trauma, given that she was a housewife. A literature review yielded 36 cases of thrombosed varix, including our case. Most cases (85.3%) occurred in females, and the mean age of patients was 51.67 years, with two-thirds of patients between 35 and 65 years of age. The fourth digit and the proximal interphalangeal joint were the most commonly affected sites, respectively. Although rare, doctors should consider the possibility of a thrombosed varix when presented with tender and raised nodules on the palms or fingers. Learning points: Thrombosis of the palmar digital veins is rare but can occur secondary to mechanical trauma and hypercoagulable states.Physicians should consider the possibility of a thrombosed varix when presented with a tender, raised and firm nodule on the hand or fingers, especially since some cases may be associated with hypercoagulable states which can have more serious sequelae.
Language	English
Publishing date	2022-09-21
Publishing country	Italy
Document type	Journal Article
ISSN	2284-2594
ISSN (online)	2284-2594
DOI	10.12890/2022_003552
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Sensitivity to treatment and score bands of the Infants and Toddlers Dermatology Quality of Life questionnaire.

Chernyshov, Pavel V / Marron, Servando E / Boffa, Michael J / Pustišek, Nives / Manolache, Liana / Kakourou, Talia / Cachia, Monique / Svyatenko, Tetiana / Koumaki, Dimitra / Chernyshov, Andrii V / Tomas-Aragones, Lucia

JAAD international

2022 Volume 10, Page(s) 61–67

Abstract: Background: The Infants and Toddlers Dermatology Quality of Life (InToDermQoL) questionnaire is the first dermatology-specific proxy health related QoL instrument for children from birth to 4 years. Score meaning bands and the sensitivity to successful ... ...

Abstract	Background: The Infants and Toddlers Dermatology Quality of Life (InToDermQoL) questionnaire is the first dermatology-specific proxy health related QoL instrument for children from birth to 4 years. Score meaning bands and the sensitivity to successful therapeutic intervention are important to interpret the clinical meaning of an instrument. Objective: The aim of the present study was to check the sensitivity to successful therapeutic intervention and establish score bands of the InToDermQoL questionnaire. Methods: Parents or grandparents of 424 children with skin diseases from Spain, Malta, Croatia, Romania, Greece, and Ukraine filled in national language versions of the InToDermQoL questionnaire. Disease severity of children with atopic dermatitis was assessed by SCORAD (Scoring atopic dermatitis). Cohen's d was used to assess the responsiveness of the instrument. Results: The mean total InToDermQoL scores significantly decreased after treatment. Severity grading of the SCORAD scores gave stratification of the InToDermQoL severity grades based on 95% confidence intervals. Scores below a calculated minimal important difference of 2 corresponded to no effect on patient's health related QoL. Limitations: Score banding may be slightly different across patient population and study context. Conclusion: All 3 age-specific versions of the InToDermQoL questionnaire showed sensitivity to treatment. Score bands for the InToDermQoL questionnaire have been established.
Language	English
Publishing date	2022-11-25
Publishing country	United States
Document type	Journal Article
ISSN	2666-3287
ISSN (online)	2666-3287
DOI	10.1016/j.jdin.2022.11.009
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Eosinophilic gastrointestinal disorder: is it what it seems to be?

Zammit, Stefania Chetcuti / Cachia, Monique / Sapiano, Karen / Gauci, Julia / Montefort, Stephen / Ellul, Pierre

Annals of gastroenterology

2018 Volume 31, Issue 4, Page(s) 475–479

Abstract: Background: Eosinophilic gastroenteropathy is an uncommon condition whose causes can be numerous and non-specific. The aim of the study was to characterize the presence of gastrointestinal disorders in the adult Maltese population and assess the degree ... ...

Abstract	Background: Eosinophilic gastroenteropathy is an uncommon condition whose causes can be numerous and non-specific. The aim of the study was to characterize the presence of gastrointestinal disorders in the adult Maltese population and assess the degree of association with atopic diseases. Methods: Adult patients with gastrointestinal eosinophilia in the gastrointestinal tract on histology were identified and their clinical case notes were reviewed. Patients were interviewed and asked questions regarding asthma, allergic rhinitis, and eczema. Results: Sixty-six patients (39 female) were recruited. The most common clinical symptoms were diarrhea (42.4%) and abdominal pain (33.3%). The sites involved were stomach (10.6%), colon (56.1%), small bowel (10.6%), small bowel and colon (18.2%), esophagus (1.5%), and esophagus and colon (1.5%). Forty percent had persistent lower gastrointestinal symptoms and a repeat ileocolonoscopy was performed within 12 months. These patients were diagnosed with ulcerative colitis (n=10; 47.6%), Crohn's disease (n=6; 28.6%), indeterminate colitis (n=1; 4.8%) or microscopic colitis (n=4; 19%). Allergic rhinitis was present in 39.4% of the study group, eczema in 26.1%, and asthma in 19.7%. These findings were compared with local data for atopic conditions and the study group was found to have a significantly higher prevalence of allergic rhinitis (P=0.002), but not of asthma (P=0.62) or eczema (P=0.19). Conclusions: A high proportion of patients with eosinophilic gastrointestinal infiltration were subsequently diagnosed with inflammatory bowel disease. Patients persistently symptomatic or who do not respond to treatment should be reassessed to exclude inflammatory bowel disease, given its high prevalence in this group of patients.
Language	English
Publishing date	2018-04-27
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2032850-3
ISSN	1108-7471
ISSN	1108-7471
DOI	10.20524/aog.2018.0263
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Article ; Online: Rare case of dermonecrosis caused by a recluse spider bite in Europe.

Cachia, Monique / Mercieca, Liam / Mallia Azzopardi, Charles / Boffa, Michael J

BMJ case reports

2016 Volume 2016

Abstract: Spider poisoning is rare in Europe, with very few reported cases in the literature. Recluse spider (genus Loxosceles) bites may lead to cutaneous and systemic manifestations known as loxoscelism. We report the second known case of spider bite poisoning ... ...

Abstract	Spider poisoning is rare in Europe, with very few reported cases in the literature. Recluse spider (genus Loxosceles) bites may lead to cutaneous and systemic manifestations known as loxoscelism. We report the second known case of spider bite poisoning in Malta caused by Loxosceles rufescens (Mediterranean recluse spider). A young adult female presented with localised erythema and pain on her left thigh after a witnessed spider bite. Over a few days, the area developed features of dermonecrosis together with systemic symptoms, including fever, fatigue and a generalised erythematous eruption. She was managed by a multidisciplinary team and the systemic symptoms resolved within 6 days, while the skin lesion healed with scarring within 2 months. A recluse spider bite should be considered in patients with dermonecrosis. Although spider bite poisoning is uncommon in Europe, it is important to diagnose and manage it appropriately since it could lead to potentially serious sequelae.
MeSH term(s)	Adult ; Animals ; Brown Recluse Spider ; Cicatrix/etiology ; Cicatrix/pathology ; Europe ; Female ; Humans ; Necrosis ; Skin/pathology ; Spider Bites/complications ; Spider Bites/pathology ; Young Adult
Language	English
Publishing date	2016-07-20
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2016-215832
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Systemic and venous thromboembolism: think about paradoxical embolism.

Cachia, Monique / Pace Bardon, Michael / Fsadni, Peter / Montefort, Stephen

BMJ case reports

2015 Volume 2015

Abstract: Patent foramen ovale (PFO) is one of the most important causes of paradoxical embolism; it is found in about 25-30% of the population. In most patients, it is asymptomatic and diagnosis is usually made during routine echocardiography. In a small ... ...

Abstract	Patent foramen ovale (PFO) is one of the most important causes of paradoxical embolism; it is found in about 25-30% of the population. In most patients, it is asymptomatic and diagnosis is usually made during routine echocardiography. In a small proportion of patients, PFO is diagnosed after paradoxical embolism is suspected. We present a case of a middle-aged smoker who was admitted with lower limb deep vein thrombosis and pulmonary embolism, who developed acute upper limb ischaemia during his inpatient stay. Since doctors might dismiss such cases as routine, this report highlights the importance of detailed history taking and examination in patients with venous thromboembolism. Paradoxical embolism should always be considered as a possible diagnosis when managing patients with concomitant venous and arterial embolism.
MeSH term(s)	Echocardiography ; Embolism, Paradoxical/diagnosis ; Embolism, Paradoxical/etiology ; Extremities/blood supply ; Foramen Ovale, Patent/complications ; Foramen Ovale, Patent/diagnosis ; Foramen Ovale, Patent/diagnostic imaging ; Humans ; Male ; Middle Aged ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/etiology ; Venous Thromboembolism/diagnosis ; Venous Thromboembolism/etiology ; Venous Thrombosis/complications
Language	English
Publishing date	2015-07-28
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2015-211174
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Simulation training for foundation doctors on the management of the acutely ill patient.

Cachia, Monique / Pace-Bardon, Michael / Balzan, Gabriella / Tilney, Russel / Micallef, Josef / Balzan, Martin

Advances in medical education and practice

2015 Volume 6, Page(s) 657–663

Abstract: Background: A study evaluating subjective trainee responses to simulation training organized by the Malta Foundation Program in particular whether this changed their clinical practice.: Method: Feedback using a standardized questionnaire was obtained ...

Abstract	Background: A study evaluating subjective trainee responses to simulation training organized by the Malta Foundation Program in particular whether this changed their clinical practice. Method: Feedback using a standardized questionnaire was obtained from 120 (M=55%) participants. A 0-10 Likert scale was used to evaluate responses. Results: Participants scored the simulation sessions as "useful" at 7.7 (95% confidence interval [CI] 7.4-8.0), rated "the overall experience" at 7.5 (95% CI 7.2-7.8), and thought it made a change in "daily practice" at 5.83 (95% CI 5.4-6.3). The score for the tutor "creating a satisfactory learning environment" and "quality of simulator equipment" was 7.8 (95% CI 7.6-8.1) and 7.7 (95% CI 7.4-8), respectively. Trainees rated "how close was the simulation to a real-life scenario" as 6.24 (95% CI 5.9-6.6). When asked whether the presence of colleagues hindered or helped, the majority were neutral 50 (41.7%), 36 (30%) said it hindered, while only 21 (28.3%) felt it helped. In contrast, 94 (78.33%) stated it was useful to observe colleagues while only 5 (4.2%) stated it was not. Likelihood for future participation was 7.4 (95% CI 7-7.8). Trainees recommended a median of 3 (interquartile range 2-5) simulations per year. Conclusion: Trainees rated the sessions as useful and asked for more sessions possibly at an undergraduate level. Rating for equipment and tutors was positive; however, some felt that the effect on daily practice was limited. Most were comfortable observing others and uncomfortable being observed. The value of increasing sessions to 3-4 per year, timing them before clinical attachments and audiovisual prebriefing for candidates naïve to simulation needs to be evaluated in future studies.
Language	English
Publishing date	2015-12-16
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2578539-4
ISSN	1179-7258
ISSN	1179-7258
DOI	10.2147/AMEP.S96566
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Simulation training for foundation doctors on the management of the acutely ill patient

Cachia M / Pace-Bardon M / Balzan G / Tilney R / Micallef J / Balzan M

Advances in Medical Education and Practice, Vol 2015, Iss Issue 1, Pp 657-

2015 Volume 663

Abstract: Monique Cachia,1 Michael Pace-Bardon,2 Gabriella Balzan,2 Russel Tilney,2 Josef Micallef,2 Martin ...

Abstract	Monique Cachia,1 Michael Pace-Bardon,2 Gabriella Balzan,2 Russel Tilney,2 Josef Micallef,2 Martin Balzan2 1Department of Medicine, 2Department of Respiratory Medicine, Mater Dei Hospital, Msida, Malta Background: A study evaluating subjective trainee responses to simulation training organized by the Malta Foundation Program in particular whether this changed their clinical practice. Method: Feedback using a standardized questionnaire was obtained from 120 (M=55%) participants. A 0–10 Likert scale was used to evaluate responses. Results: Participants scored the simulation sessions as “useful” at 7.7 (95% confidence interval [CI] 7.4–8.0), rated “the overall experience” at 7.5 (95% CI 7.2–7.8), and thought it made a change in “daily practice” at 5.83 (95% CI 5.4–6.3). The score for the tutor “creating a satisfactory learning environment” and “quality of simulator equipment” was 7.8 (95% CI 7.6–8.1) and 7.7 (95% CI 7.4–8), respectively. Trainees rated “how close was the simulation to a real-life scenario” as 6.24 (95% CI 5.9–6.6). When asked whether the presence of colleagues hindered or helped, the majority were neutral 50 (41.7%), 36 (30%) said it hindered, while only 21 (28.3%) felt it helped. In contrast, 94 (78.33%) stated it was useful to observe colleagues while only 5 (4.2%) stated it was not. Likelihood for future participation was 7.4 (95% CI 7–7.8). Trainees recommended a median of 3 (interquartile range 2–5) simulations per year. Conclusion: Trainees rated the sessions as useful and asked for more sessions possibly at an undergraduate level. Rating for equipment and tutors was positive; however, some felt that the effect on daily practice was limited. Most were comfortable observing others and uncomfortable being observed. The value of increasing sessions to 3–4 per year, timing them before clinical attachments and audiovisual prebriefing for candidates naïve to simulation needs to be evaluated in future studies. Keywords: simulation, foundation, training, acute, medical, mannequin
Keywords	Simulation ; Foundation ; Training ; Acute ; Medical ; Special aspects of education ; LC8-6691 ; Medicine (General) ; R5-920
Subject code	550
Language	English
Publishing date	2015-12-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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