Use of CytoSorb® hemoadsorption column during prolonged cardiopulmonary bypass in complex cardiac surgery patient

Background

Complex cardiac surgery and prolonged cardiopulmonary bypass are associated with significant activation of the systemic inflammatory response system. Pro-inflammatory cytokines, oxygen free radicals and complement activation products contribute to postoperative complications and multiorgan injury. CytoSorb® hemoadsorption therapy has been suggested to alleviate the hyperinflammatory response triggered by cardiopulmonary bypass during cardiac surgery.

Case presentation

We describe the use of CytoSorb® hemoadsorption therapy in a 61-year-old male presenting for aortic valve replacement, mitral valve replacement, tricuspid valve repair, coronary artery bypass grafting and left atrial appendage clip.

Conclusion

We were able to demonstrate that CytoSorb® use during cardiopulmonary bypass may be a safe and feasible adjunct therapy that may contribute to improved postoperative outcomes in a patient with complex cardiac disease.

Between Exploration, Pleasure, and Performance: Sexual Enhancement Medication Use among Older Gay and Heterosexual Men

Pharmaceutical marketing campaigns and biomedical discourses tend to oppose two types of sexual enhancement medication (SEM) use. While "therapeutic" use is associated with older heterosexual men in committed relationships, "recreational" use is associated with young gay men, and with the context of casual sex. However, little is known about the real objectives of older men (especially older gay men) who use SEM or the contexts in which they use such drugs. Furthermore, SEM conveys representations of masculinity and sexuality that focus on performance and youth, and the influence of these representations on SEM users remains unexplored. Based on semi-structured interviews conducted, in French, in 2015-2016, with 27 Canadian men (12 heterosexual, 15 gay) aged 65 to 84 years, we examined the context in which older men used such medication and the reasons why they used it, and we explored how older men's notions of sexuality, masculinity, and aging influenced their experiences with SEM use. Our participants' narratives focused on three themes: exploring sexual possibilities/improving one's sex life, restoring sexual capacities, and masculinity and aging. This study improves our understanding of older men's use of SEM and contributes to the deconstruction of normative models of older men's masculinity and sexuality.