Pain catastrophizing can predict postoperative pain intensity in cardiac surgery patients, independently of the presence of anxiety, depression, or preoperative level of pain. Future studies should aim to establish the role of pain catastrophizing in longer-term outcomes in cardiac surgery.

No abstract

The aim of the study was to assess the effect of exposed surface area of diethylhexylphthalate plasticized polyvinylchloride (PVC) on the expression of the adhesion molecule CD11b(mac-1) on neutrophils and to determine whether there is any apparent advantage in the current trend in reducing circuit surface area in terms of neutrophil activation. The study was carried out using a parallel plate rodent recirculation biomaterial testing model on 4 groups of 10 adult male Sprague Dawley rats weighing between 350 and 450 g. One group comprised the control group in which there was no biomaterial exposure. In the remaining 3 groups, the animals were subjected to either high (48 cm2), intermediate (24 cm2), or low (12 cm2) biomaterial surface area exposure. The parallel plate test cell was connected to the right femoral circulation and recirculation initiated at a flow rate of 1.5 ml/min for a period of 60 min. Blood samples were taken at 0, 30, and 60 min for the assessment of CD11b expression. Cd11b was assessed using flow cytometric analysis on neutrophils. The results demonstrated that there was a surface area related effect in the upregulation of CD11b. The difference at the terminal sample point between the highest surface area group (293.95 +/- 18.57%) and the low surface area group (133.80 +/- 49.31%) was highly statistically significant (p < 0.001). These results demonstrate that there may be some gain in terms of reduced inflammatory response from reducing the exposed surface area of PVC in extracorporeal perfusion circuits.

No abstract

Our objective was to assess whether using a methanol wash to reduce the level of plasticizer present on the surface of medical-grade polyvinyl chloride (PVC) has a moderating effect on the expression of CD11b (mac-1) on neutrophils in rats undergoing recirculation. The study was carried out on 3 groups of 10 adult male Sprague-Dawley rats weighing between 350 and 450 g. In the 2 test groups, the animals were exposed to 48 cm(2) of di-(2-ethyl-hexyl)-phthalate (DEHP)-plasticized PVC in a parallel plate recirculating test cell through which blood was recirculated at 1.5 ml/min. In the first test group, the PVC was untreated; in the second test group, the PVC was washed in methanol to reduce the level of plasticizer on the surface. The test cell was connected to the right femoral circulation, and recirculation was established for a period of 60 min. Blood samples were taken at 0, 30, and 60 min for assessment of CD11b expression on neutrophils using flow cytometric analysis. In a third group of 10 control experiments, rats underwent the entire surgical procedure, but without recirculation through the test cell. There was statistically significant (p < 0.001) lower Cd11b expression on neutrophils in the blood of rats perfused through the cell containing methanol-washed PVC after 30 min and at 60 min. CD11b expression was significantly (p < 0.001) lower in the control group than in both test groups at both the 30 and 60 min time points and at the 60 min time point on comparison with the group where blood was perfused through methanol-washed PVC. These results demonstrate that the biomaterial-contact-mediated upregulation of CD11b may be significantly reduced by employing a methanol-washing technique on the plasticized PVC. Although this technique does not entirely eliminate the expression of CD11b on neutrophils, the difference is significant and suggests the role of the plasticizer in the development of this inappropriate inflammatory response.

We report the presentation, investigation and management of a 22-year-old male who developed a right malignant middle cerebral artery infarct following a cardiac stab wound. This case exemplifies that early identification and timely decompression of young patients with embolic infarcts as a result of penetrating trauma can lead to a favourable clinical outcome.

Purulent pericarditis involves the whole pericardium and usually presents as an acute illness with high mortality without prompt diagnosis and treatment. Presentation as a mediastinal mass causing compression of the right ventricle (RV) and symptoms of heart failure in patients without previous cardiac surgery is very rare and only three cases have been reported up to now (English language medical literature). Clinicians should be aware of this unusual condition for prompt diagnosis and treatment to be instituted.