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physiological aspects of anal sexual practices. J Homosex 1985, 12:75–96.PubMedCrossRef Competing interests The authors declare that they have no competing interests. Authors’ EPZ6438 contributions SYY: conception and design, or acquisition Selleckchem GSK2879552 of data, or analysis and interpretation of data, have given final approval of the version to be published. MK: conception and design, or acquisition of data, or analysis and interpretation of data. SA: revising it critically for important intellectual content; AC: revising it critically for important intellectual content; HTT: have made substantial contributions to conception and design. SH: have made substantial contributions to conception and design. All authors read and approved the final manuscript.”
“Introduction Ischemia-reperfusion (IR) injury
represents a fundamental common pathway of tissue damage in a wide variety of disease and surgical processes such as major trauma, acute mesenteric ischemia, septic and hypovolemic shock, abdominal aortic aneurism surgery, and cardiopulmonary bypass [1, 2]. Interruption of blood supply results in ischemic injury to all body systems and especially to high metabolically active tissues; the intestine is a prominent example Salubrinal of a sensitive tissue to IR injury which is associated with high morbidity and mortality [1]. Paradoxically, restoration of blood flow to the ischemic tissue augments cell injury by delivering toxic mediators induced in the ischemic tissue into the circulation thus affecting distant organs. This might lead to the GPX6 development of systemic inflammatory response syndrome, which can progress to multiple organ failure and death [2]. Among the toxic mediators produced in the IR injured tissue are acute-phase proteins, pro-inflammatory cytokines, oxygen free radicals, and components of the complement system [3]. Emergency surgery and trauma situations
may require abbreviated procedures during the initial phase of shock and organ ischemia. Definitive procedures including anastomosis to restore bowel continuity are undertaken 24 hours or more afterward. Two common examples of such situations are the strategy of damage control surgery in seriously injured patients, and acute mesenteric ischemia. In damage control laparotomy the goal in the emergency surgery is to stop bleeding and to control spillage from the intestine. In the second operation, which is done after the patient’s deranged physiology is corrected, bowel anastomosis may be created. In mesenteric ischemia gangrenous segments of the bowel are resected, while fluid resuscitation continues. Not infrequently, the patient condition does not allow performing primary anastomosis.