Qatar Medical Journal - Volume 2011, Issue 2

Kaposi's Sarcoma (KS) is a rare multifocal spindle cell tumor with four epidemiologic variants: classic KS, African endemic KS, AIDS related KS, and immunosuppressant therapy related KS. Classic KS remains a rare but challenging disease because of its protracted, indolent course. The authors describe a case recently observed in our clinic, emphasizing the clinical management of the disease.

This case report illustrates an acute presentation of hemoptysis in a 21-year-old man from a TB endemic region. Further clinical evaluation resulted in extensive hypercoagulability complications of nephritic syndrome due to idiopathic membranous glomerulonephritis (MGN.) This emphasizes that proteinuria seen at a subnephrotic level, or on urine dipstick in a setting where glomerular disease might not be initially apparent, may warrant a keener look.

Pyrexia is an elevation of body temperature above the normal range due to an increase in the hypothalamic thermoregulatory set point. Hyperpyrexia is an extreme elevation of body temperature equal to or greater than 41.5°C (106.7°F). (1) Malignant hyperpyrexia is a rare and idiopathic extreme elevation of core body temperature above 42°C characterized by the acute onset of hyperthermia, coagulopathy and shock. (2) It is potentially life-threatening and can rapidly progress to severe liver and renal impairment, acidosis and encephalopathy. Reported here is a case of malignant hyperpyrexia in a patient with injury of the cervical spine.

A 54-year-old man was referred to our hospital because of a false aneurysm in his right groin following Aortobifemoral and femoropopliteal bypass surgery. He underwent false aneurysm repair and infrainguinal arterial reconstruction. He then developed MRSA sepsis in the right groin. The patient underwent a number of operations to remove the infected grafts and distal revascularization to allow limb salvage. His last operation was an iliofemoral bypass via extra-anatomical route, from just below the iliac crest into the popliteal artery using an 8 mm-ringed polyester gelatin polypropylene tube graft, with complete debridement of a groin infection. Postoperative duplex scan and 3-dimentional CT angiography revealed a patent prosthetic graft and the patient made uneventful postoperative recovery. We conclude that this extra-anatomical bypass is a safe technique and a good option for patients with an infected vascular prosthetic graft in the groin after previous revascularization.

Context Heart failure (HF) is the most common complication of infective endocarditis. However, clinical characteristics of HF in patients with infective endocarditis, use of surgical therapy, and their associations with patient outcome are not well described.

Objectives: To determine the clinical, echocardiography, and microbiological variables associated with HF in patients with definite infective endocarditis and to examine variables independently associated with in-hospital and 1 -year mortality for patients with infective endocarditis and HF, including the use and association of surgery with outcome.

Design, Setting, and Patients: The International Collaboration on Endocarditis-Prospective Cohort Study, a prospective, multicenter study enrolling 4166 patients with definite nativeor prosthetic-valve infective endocarditis from 61 centers in 28 countries between June 2000 and December 2006. Main Outcome Measures In-hospital and 1 -year mortality.

The utilization of coronary angiography and percutaneous coronary intervention in the routine care for patients with acute coronary syndromes (ACS) has resulted in significant improvement in their prognosis. Consequently, recommendations on the use of these management strategies are reflected in the ACC/AHA guidelines for the management of patients with unstable angina and myocardial infarction. However, among other causes, the 'phobia' of nephrotoxicity of iodinated contrast media (ICM) in chronic kidney disease (CKD) patients and its claimed adverse effect on shortterm and longterm survival has led to a worryingly low use of ICM-based diagnostic and therapeutic interventions in patients with CKD. We argue that the fear of iodinated contrast media-induced acute kidney injury (ICI-AKI) is not a valid reason to avoid ICMbased investigations/interventions in CKD patients with ACS; the risks of myocardial infarction and death greatly outweigh the risk of ICI-AKI in most of these patients and hence they should always be considered for myocardial revascularization.

Hamad Medical Corporation (HMC) and Cerner® have signed a landmark agreement to digitize the entire public health system of Qatar, including all HMC hospitals and Primary Health Care Centers (PHCs). Acting as a prime contractor and CIS integrator, Cerner will deliver cutting edge health IT solutions from Cerner and third party suppliers that will bring the HMC Hospital Information Management into the 21st century. This is Cerner's first project in the region to digitize an entire country's public health system on a single computing platform.