We conducted a retrospective study of medical records of patients admitted to HGF with the diagnosis of IBDI, evaluating the following variables: gender, age, origin, conditions of cholecystectomy, type of surgery, symptoms, exams performed, surgical findings, classification of injury, treatment, complications, total duration of hospitalization and discharge conditions. Results Results ResultsResults Results: There were 27 confirmed cases of IBDI. Two injuries occurred during laparoscopic cholecystectomy cholecystectomy. Only one patient was diagnosed intraoperatively. The most frequent sign was jaundice after cholecystectomy. Hepato-duodenal Y-en-Roux anastomosis was the most often employed surgical technique (85.2%). Most patients were discharged from hospital in good clinical condition (88.8%), however, we found high morbidity rates for this disease, exemplified by the multiple hospitalizations and longer hospital stay (mean 31 days). Conclusion Conclusion Conclusion Conclusion Conclusion: Most injuries occurred during open cholecystectomy, jaundice was the most frequent sign upon admission. There was a high hospitalization length of stay, caused by postoperative complications, which could be explained by delayed diagnosis resulting in a large delay in treatment.

Introduction For several decades, testosterone and its synthetic derivatives have been used for anabolic and androgenic purposes. Initially restricted to professional bodybuilders, these substances gradually became more popular with recreational weightlifters. Considering its increasing prevalence, the consumption of anabolic androgenic steroids (AAS) has become a matter of great concern. Although most side effects are mild and reversible, some of them can cause permanent damage or can be potentially life threatening. Objectives To review and summarize medical literature regarding misuse and abuse of testosterone and other androgens, in order to provide evidence-based information on the main topics related to this subject, such as how to identify and how to deal with these patients, and to elucidate the multiple possible adverse effects secondary to this practice. Methods Key studies were retrieved from PubMed (1989–2021) with reference searches from relevant articles. Search terms included “hypogonadism”, “anabolic androgenic steroids”, “androgens”, “misuse AND testosterone”, “abuse AND testosterone”, and “side effects AND testosterone”. Results There is a significant lack of information in the peer-reviewed literature describing demographic data, implications for different organ systems and the management of current or former AAS users; however, androgen abuse has been already linked to a wide variety of cardiovascular diseases, metabolic, endocrine, neurological, psychiatric and liver disorders. Despite all this, most physicians still feel uncomfortable and hesitate to discuss the issue with patients. Conclusions The chronic use of high doses of AAS is associated with adverse effects in several organ systems; however, there are still many gaps in our knowledge about the long-term consequences of this practice and how to deal with these patients. Healthcare professionals have a crucial role in combating this public health problem, recognizing and preventing the spread of androgen abuse.

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during voiding; however, NO decreases with age. Thus, it seems reasonable to assume that urethral relaxation during voiding also decreases in aging rats. We therefore investigated this possibility by measuring urethral relaxation before and after intravenous injection of NO synthase and an inhibitor in aging rats.METHODS: Female Sprague Dawley rats (young rats aged 3 months and old rats aged 12~15 months) were used. 1) Urethral activity was evaluated by simultaneous recordings of intravesical pressure under isovolumetric conditions and urethral perfusion pressure (UPP) under urethane anesthesia. 2) Under isovolumetric conditions, L-arginine (a substrate of NO synthase, 100 mg/kg) was administered intravenously in both groups. 3) In addition, L-NAME (an NO synthase inhibitor, 100 mg/kg) was also administered intravenously in both groups.RESULTS: 1) UPP nadir during urethral relaxation was significantly higher (34%) in aging rats than that in young rats (p<0.05), whereas baseline UPPs were not significantly different. The mean rate and amplitude of high frequency oscillation (HFO) of urethral striated muscle were also significantly lower (12% and 41%, respectively) in aging rats than those in normal rats (p<0.05). 2) Following L-arginine (i.v.), UPP nadir did not change in both groups. 3) However, UPP nadir during urethral relaxation was inhibited by L-NAME (i.v.) in both groups. The effect was greater in aging rats (i.e., a detrusor sphincter dyssynergia like change) than in young rats.CONCLUSIONS: These results indicate that aging induces dysfunction in urethral relaxation during voiding, as evidenced by a decrease in HFO activity of urethral striated muscle as well as NO mediated urethral relaxation of urethral smooth muscle. Thus, it seems likely that these urethral dysfunctions caused by accruing age may lead to inefficient voiding with increased post-void residual urine volume (DU), which is often observed in elderly populations. This novel study coupled with DU would contribute to elucidate the mechanisms in the genesis of aging bladders.

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