RESUMOObjetivo: a proposta deste estudo foi traduzir e validar o King´s Health Questionnaire (KHQ) para mulheres brasileiras com incontinência urinária. Métodos: 134 pacientes com incontinência urinária, confirmada pelo estudo urodinâmico, foram recrutadas em ambulatório de Uroginecologia. Inicialmente, traduzimos o questionário KHQ para a língua portuguesa (do Brasil) de acordo com critérios internacionais. Devido às diferenças da língua, fizemos a adaptação cultural, estrutural, conceitual e semântica do KHQ, para que as pacientes compreendessem as questões. Todas as pacientes responderam duas vezes o KHQ, no mesmo dia, com dois entrevistadores distintos, com intervalo de 30 minutos de uma entrevista para a outra. Depois de 7 a 14 dias, a aplicação do questionário foi repetida numa segunda visita. Foram testadas a confiabilidade (consistência interna intra e inter-observador) e validade do constructo e discriminativa. Resultados: foram necessárias várias adaptações culturais até obtermos a versão final. A consistência interna intra-observador (alfa de Cronbach) das diversas dimensões oscilou de moderada a alta (0,77-0,90) e a consistência interna inter-observador oscilou de 0,66 a 0,94. Na validação do constructo, obtivemos correlação de moderada a forte entre os domínios específicos para incontinência urinária e manifestações clínicas que, sabidamente, afetam a qualidade de vida dessas pacientes. Conclusão: o KHQ foi adaptado ao idioma português e para a cultura brasileira, mostrando grande confiabilidade e validade, devendo ser incluído e utilizado em qualquer estudo brasileiro de incontinência urinária. PALAVRAS-CHAVE: Incontinência urinária; Qualidade de vida; Questionários; Saúde da mulher; ValidadeABSTRACT Purpose: the proposal of the present study was to translate and to validate King´s Health Questionnaire (KHQ) for Brazilian women with urinary incontinence. Methods: a hundred and thirty-four patients with urinary incontinence, confirmed by urodynamic study, were enrolled from the outpatient clinic of Uroginecology. Initially, we translated the KHQ into the Brazilian Portuguese language in agreement with international criteria. Due to language and cultural differences we performed a cultural, structural, conceptual, and semantic adaptation of the KHQ, in order to make sure that patients were able to fully understand the questions. All patients answered the KHQ twice on the same day, within an interval of 30 min, applied by two different interviewers. After 7 to 14 days, on a second visit, the questionnaire was applied again. Reliability (intra-and interobserver internal consistency), construct and discriminative validity were tested. Results: several cultural adaptations were necessary until we reached the final version. The intra-observer internal consistency (alpha of Cronbach) of the several dimensions varied from moderate to high (0.77-0.90), and the interobserver internal consistency varied from 0.66 to 0.94. Moderate to strong correlation was detected among the specific KHQ urinary incontinence do...

Chromosome segregation errors during meiosis result in the formation of aneuploid gametes and are the leading cause of pregnancy loss and birth defects in humans. Proper chromosome segregation requires pairwise associations of maternal and paternal homologous chromosomes. Chiasmata, which are the cytological manifestations of crossovers (COs), provide a physical link that holds the homologs together as a pair, facilitating their orientation on the spindle at meiosis I. Although CO-promoting activities ensure a balanced number and position of COs, their identity and mechanism of action in mammals remain understudied. Previous work in yeast and Arabidopsis has shown that Zip2 and Shoc1 are ortholog proteins with an important role in promoting the formation of COs. Our work is the first study in mammals showing the in vivo and in vitro function of mouse and human SHOC1. We show that purified recombinant human SHOC1, an XPF/MUS81 family member, preferentially binds branched DNA molecules but apparently lacks in vitro endonuclease activity, despite its conserved ERCC4-(HhH)2 core structure. Cytological observations suggest that initial steps of recombination are normal in a majority of spermatocytes from SHOC1 hypomorphic mice. However, late stages of recombination appear abnormal, as chromosomal localization of MLH1 is reduced. In agreement, chiasma formation is reduced, and cells arrest at metaphase I with a few lagging chromosomes and subsequent apoptosis. This analysis of SHOC1-deficient mice and the selective localization of SHOC1 to a subset of recombination sites show that SHOC1 acts at key mid-stage steps of the CO formation process. The formation of chromosome axial elements and homologous pairing are apparently normal, but synapsis is altered with SYCP1 frequently failing to extend the full length of the chromosome axes. Finally, we describe that SHOC1 interacts with TEX11, another protein important for the formation of COs, connecting SHOC1 to chromosome axis and structure.

Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trialEficácia do treinamento da musculatura do assoalho pélvico e de exercícios hipopressivos para o tratamento do prolapso de órgãos pélvicos em mulheres: ensaio clínico randomizado. METHODS: Fifty-eight women with stage II pelvic organ prolapse were divided into three groups for physiotherapy: a pelvic floor muscle training group (GI); a hypopressive exercise group (GII); and a control group (GIII). The patients underwent transperineal ultrasonographic evaluation using a transducer of frequency 4-9 MHz. The (CSA) of the levator ani muscle was measured before physiotherapy and after 12 weeks of treatment. RESULTS:The groups were homogeneous regarding age, number of pregnancies, number of vaginal deliveries, body mass index and hormonal status. Statistically significant differences in CSA were found in GI and GII from before to after the treatment (P < 0.001), but not in relation to GIII (P = 0.816). CONCLUSIONS:The CSA of the levator ani muscle increased significantly with physiotherapy among the women with pelvic organ prolapse. Pelvic floor muscle training and hypopressive exercises produced similar improvements in the CSA of the levator ani muscle. CLINICAL TRIAL REGISTRATION NUMBER: NCT01196598reSUMO CONTEXTO E OBJETIVO: Estudos anteriores mostraram que mulheres com disfunção do assoalho pélvico possuem diminuição da área de secção transversal (AST) do músculo levantador do ânus. Uma forma de avaliar os efeitos de um programa de treinamento é mensurar a AST do músculo por ultrassonografia. O objetivo foi avaliar a eficácia do treinamento da musculatura do assoalho pélvico e de exercícios hipopressivos no aumento da AST do músculo levantador do ânus em mulheres com prolapso de órgãos pélvicos. TIPO DE ESTUDO E LOCAL: Estudo prospectivo, randomizado e controlado realizado no Ambulatório de Uroginecologia da Universidade Federal de São Paulo. MÉTODOS: Cinquenta e oito mulheres com prolapso de órgãos pélvicos estádio II foram divididas em três grupos para tratamento fisioterapêutico: (GI) grupo de treinamento dos músculos do assoalho pélvico, (GII) grupo de exercícios hipopressivos e (GIII) grupo controle. As pacientes se submeteram a avaliação ultrassonográfica transperineal com transdutor de frequência 4-9 MHz. Foi mensurada a AST do músculo levantador do ânus antes e após 12 semanas de tratamento fisioterapêutico. RESULTADOS: Os grupos foram homogêneos no que se refere a idade, número de gestações, número de partos vaginais, índice de massa corpórea e estado hormonal. Diferença significante foi observada na AST de GI e GII antes e após o tratamento (P < 0,001) e isso não ocorreu com o GIII (P = 0,816). CONCLUSÕES: A AST do músculo levantador do ânus aumentou significativamente com tratamento fisioterapêutico em mulheres com prolapso de órgãos pélvicos. Treinamento dos músculos do assoalho pélvico e exercícios hipopressivos são semelhantes no que se refere ao aumento da AST do...

rails to Paul Erdds ~ he notion of Erdds number has floated around the mathematical research community for more than thirty years, as a way to quantify the common knowledge that mathematical and scientific research has become a very collaborative process in the twentieth century, not an activity engaged in solely by isolated individuals. In thispaper we explore some (fairly short) collaboration paths that one can follow from Paul Erd6s to researchers inside and outside of mathematics.

We performed a systematic review and meta-analysis of randomized controlled trials that studied the conservative management of stress urinary incontinence (SUI). There were 1058 results after the initial searches, from which 37 studies were eligible according to previously determined inclusion criteria. For the primary outcomes, pelvic floor muscle training (PFMT) was more efficacious than no treatment in improving incontinence-specific quality of life (QoL) scales (SMD ¼ À1.24SDs; CI 95% ¼ À1.77 to À0.71SDs). However, its effect on pad tests was imprecise. Combining biofeedback with PFMT had an uncertain effect on QoL (MD ¼ À4.4 points; CI 95% ¼ À16.69 to 7.89 points), but better results on the pad test, although with elevated heterogeneity (MD ¼ 0.9g; 95%CI ¼ 0.71 to 1,10g); group PFMT was not less efficacious than individual treatment, and home PFMT was not consistently worse than supervised PFMT. Both intravaginal and superficial electrical stimulation (IES and SES) were better than no treatment for QoL and pad test. Vaginal cones had mixed results. The association of IES with PFMT may improve the efficacy of the latter for QoL and pad test, but the results of individual studies were not consistent. Thus, there is evidence of the use of PFMT on the treatment of SUI, with and without biofeedback.