Translation, cross-cultural adaptation and validation of the underactive bladder questionnaire to portuguese.

OBJECTIVE: The aim of the current study was to perform the translation, cross-cultural adaptation and validation of the Underactive Bladder Questionnaire (UAB-q). METHODS: The study design included the Portuguese translation, cross-cultural adaptation and validation of the UAB-q in 90 patients from a urology outpatient clinic following international methodology. The psychometric properties tested were the validity, reliability, internal consistency and stability of the instrument. RESULTS: The content validity index at the item (I-CVI) and scale level (S-CVI) were above 0.80 and did not require changes. Regarding the reliability analysis, Cronbach's alpha was 0.79. The internal consistency and the base time stability (test-retest) had excellent indexes; all were above 0.90. CONCLUSIONS: These results indicate that the UAB-q is a valid, reproducible and reliable instrument for screening underactive bladders and is a potentially useful tool to guide health actions and improve the care of underactive patients.

Predictive Factors of Male Sexual Dysfunction After Traumatic Spinal Cord Injury.

STUDY DESIGN: Observational study (Ethics Committee Number 973.648). OBJECTIVE: Evaluating the social and clinical factors associated with sexual dysfunction in men with traumatic spinal cord injury, as well as predictive factors for sexual dysfunction. SUMMARY OF BACKGROUND DATA: Besides the motor and sensory loss, sexual function changes after spinal cord injury, ranging from decreased sexual desire to erectile disorders, orgasm, and ejaculation. METHODS: Performed with 45 men, with traumatic spinal cord injury and sexually active. Sexual function was assessed by the International Index of Erectile Function and the level and degree of injury were determined following guidelines of International Standards for Neurological and Functional Examination Classification of Spinal Cord Injury. Bi and multivariate analysis was applied, with a 0.05 significance level. RESULTS: Forty-five subjects with mean injury time of 7.5 years (CI 5.2-9.9) were evaluated. Having a fixed partner is a protective factor (OR: 0.25; 95% CI: 0.07-0.92) of erectile dysfunction. Sexual desire is associated with the fixed partner (OR: 0.12; 95% CI: 0.02-0.66), masturbation (OR: 0.13; 95% CI: 0.02-0.62), and sexual intercourse in the last month (OR: 0.13; 95% IC: 0.01-0.92). Ejaculation (OR: 0.01; 95% CI: 0.00-0.15) and erectile dysfunction (OR: 15.7; 95% CI: 1.38-178.58) are associated with orgasm. Psychogenic erection (OR: 0.07; 95% CI: 0.01-0.69), monthly frequency of sexual intercourse (OR: 11.3; 95% CI: 2.0-62.8), and orgasmic dysfunction (OR: 7.1; 95% CI: 1.1-44.8) are associated with satisfaction. CONCLUSION: Fixed partner, ejaculation, masturbation are protective factors for sexual dysfunction. Erectile dysfunction, orgasmic, and infrequent sex dysfunction are predictors of sexual dysfunction. LEVEL OF EVIDENCE: 3.

The impact of bariatric surgery on urinary incontinence: a systematic review and meta-analysis.

INTRODUCTION AND HYPOTHESIS: Obesity and overweight are strongly associated with stress and urgency urinary incontinence, and weight loss has been associated with improvement in urinary incontinence. We aimed to measure pooled effect sizes for different weight loss procedures on incontinence-specific quality of life and incontinence cure rate in a systematic review and meta-analysis. METHODS: MEDLINE, Embase and the Cochrane library were searched using a pre-defined strategy for relevant cohort studies. Random effects meta-analyses were conducted for the weighted mean difference for urinary quality of life scores and weighted overall pooled estimates for proportions of women cured. We explored heterogeneity using meta-regression, testing the type of bariatric surgery and change in BMI as predictors of effect size. The studies were categorised as either low or high risk of bias using a novel instrument specifically designed for longitudinal symptom research studies. RESULTS: Twenty-three studies (n = 3,225) were included. Incontinence-specific quality of life scores were improved by 14% (weighted mean difference = -14.79; CI = -18.47 to -11.11; I2 = 87.1%); the proportion of women cured of any urinary incontinence was 59% (95% CI = 51 to 66%) and the proportion of women cured of stress urinary incontinence was 55% (95% CI = 40 to 70%). CONCLUSIONS: Bariatric surgery results in clinically meaningful improvements in incontinence-specific quality of life. Current data are limited by both short-term follow-up and unexplained heterogeneity among studies.

Transcultural translation and validation of the FIGO Assessment Scoring System (FASS) to Portuguese language.

INTRODUCTION AND HYPOTHESIS: Our aim was to validate the Brazilian Portuguese version of the International Federation of Gynecology and Obstetrics (FIGO) Assessment Scoring System (FASS) to identify and quantify signs and symptoms related to pelvic floor dysfunction. METHODS: One hundred and seventy-nine women aged 18-82 (47.68 ± 14.42) years participated in this validation study. Collected data included a sociodemographic and clinical questionnaire, application of the FASS, and physical examination using the Pelvic Prgan Prolapse Quantification (POP-Q) system. The translation and cross-cultural adaptation were performed following the international methodology. The psychometric properties tested were criterion validity, construct validity, stability, and reliability. For this purpose, the comparison with POP-Q findings and between symptomatic and asymptomatic patients, test-retest and internal consistency (Cronbach's alpha) were used, respectively. The intraclass correlation coefficient (ICC) was calculated to assess the level of agreement between evaluations (inter- and intraobservers). P < 0.05 was considered statistically significant. RESULTS: The calculated Cronbach's alpha coefficient was 0.76, indicating strong reliability for the validation sample. Symptomatic women had different scores on all FASS items as well as total score when compared with asymptomatic women (p < 0.001). Intraobserver coefficient ranged from 0.91 (urinary symptoms) to 0.98 (FASS total score), indicating excellent concordance level in all items. Interobserver coefficient ranged from 0.47 (intestinal symptoms) to 0.90 (FASS total score), indicating moderate to excellent correlation. CONCLUSIONS: The psychometric properties tested in the FASS Portuguese version proved to be a valid and reliable for evaluating signs and symptoms related to pelvic floor function in Brazilian women.

Validation of the urgency questionnaire in Portuguese: A new instrument to assess overactive bladder syndrome

ABSTRACT Purpose Overactive Bladder (OAB) is a clinical condition characterized by symptoms reported by patients. Therefore, measurement instruments based on reported information are important for understanding its impact and treatment benefits. The aim of this study was to translate, culturally adapt and validate the Urgency Questionnaire (UQ) in Portuguese. Materials and Methods Initially, the UQ was translated and culturally adapted to Portuguese. Sixty-three volunteers were enrolled in the study and were interviewed for responding the Portuguese version of the UQ and the validated Portuguese version of the Overactive Bladder Questionnaire short-form (OABq-SF), used as the gold standard measurement for the validation process. Psychometric properties such as criterion validity, stability, and reliability were tested. Results Forty-six subjects were included in the symptomatic group (presence of "urgency"), and seventeen were included in the asymptomatic group (control group). There was difference between symptomatic and asymptomatic subjects on all of the subscales (p≤0.001). The UQ subscales correlated with the OABq-SF subscales (p≤0.01), except the subscale "time to control urgency" and the item "impact" from the visual analog scales (VAS). However, these scales correlated with the OABq-SF - Symptom Bother Scale. The UQ subscales demonstrated stability over time (p<0.05), but the subscale "fear of incontinence" and the item "severity" of the VAS did not. All of the UQ subscales showed internal consistencies that were considered to be good or excellent. Conclusion The Portuguese version of the UQ proved to be a valid tool for the evaluation of OAB in individuals whose native language is Portuguese.

Validation of the urgency questionnaire in Portuguese: A new instrument to assess overactive bladder syndrome.

PURPOSE: Overactive Bladder (OAB) is a clinical condition characterized by symptoms reported by patients. Therefore, measurement instruments based on reported information are important for understanding its impact and treatment benefits. The aim of this study was to translate, culturally adapt and validate the Urgency Questionnaire (UQ) in Portuguese. MATERIALS AND METHODS: Initially, the UQ was translated and culturally adapted to Portuguese. Sixty-three volunteers were enrolled in the study and were interviewed for responding the Portuguese version of the UQ and the validated Portuguese version of the Overactive Bladder Questionnaire short-form (OABq-SF), used as the gold standard measurement for the validation process. Psychometric properties such as criterion validity, stability, and reliability were tested. RESULTS: Forty-six subjects were included in the symptomatic group (presence of "urgency"), and seventeen were included in the asymptomatic group (control group). There was difference between symptomatic and asymptomatic subjects on all of the subscales (p≤0.001). The UQ subscales correlated with the OABq-SF subscales (p≤0.01), except the subscale "time to control urgency" and the item "impact" from the visual analog scales (VAS). However, these scales correlated with the OABq-SF - Symptom Bother Scale. The UQ subscales demonstrated stability over time (p<0.05), but the subscale "fear of incontinence" and the item "severity" of the VAS did not. All of the UQ subscales showed internal consistencies that were considered to be good or excellent. CONCLUSION: The Portuguese version of the UQ proved to be a valid tool for the evaluation of OAB in individuals whose native language is Portuguese.

Immunohistochemical expression of p16, Ki-67 and p53 in cervical lesions - A systematic review.

This study evaluated the immunohistochemical (IHC) expression of p16, p53 and Ki-67 in precancerous lesions and in cervical cancer (CC). Identification and review of publications assessing IHC expression in cervical intraepithelial neoplasia (CIN) and CC until February 15, 2017. Systematic review of studies in women with and without cervical lesions in order to evaluate whether there is overexpression of these biomarkers. A total of 28 publications met the criteria which included 6005 patients. The analysis showed that there is higher IHC expression of these biomarkers associated with the more severe lesions. Nineteen out of 22 evaluated studies have shown that there is a higher p16 expression in more severe lesions (CC), while in p53 expression only 4 out of the 9 studies showed a higher expression among more severe cases. Regarding the Ki-67 expression, it was observed that 9 out of 14 studies showed higher expression in more severe lesions. A complete absence of or just minimal IHC expression was observed in the normal cervical epithelium, whilst a significant increase in the expression of these biomarkers was detected according to the severity of lesions. Results suggest that these biomarkers can be considered useful tools for discriminating between the stages of the progressive cervical disease.

Native vaginal tissue repair for genital prolapse surgical treatment: a minimum of 30 months of results.

OBJECTIVE: The aim of this study was to assess the impact of using native vaginal tissue repair as a surgical treatment for pelvic organ prolapse (POP) on quality of life using validated questionnaires. STUDY DESIGN: Fifty-one women underwent surgical POP repair. All of the women were evaluated by physical examination using the POP-Q, ICIQ-VS and P-QoL questionnaires prior to surgery as well as six and at least 30 months after surgery. RESULTS: Fifty-one patients returned for assessment at least 30 months after surgery (median 36 months, range 30-50 months). There was significant improvement in most points - Aa, Ba, C, Bp, Ap, and hg - and at the stage of prolapse. There were statistically significant improvements in bulge symptoms after surgery (p<0.001), and significant differences were also seen regarding questions related to urinary and bowel symptoms. Indeed, most quality of life questionnaire domains showed significant differences before and after surgery. CONCLUSION: Native vaginal tissue repair improved POP-related symptoms and quality of life after 30-50 months of assessment.

MC3T3-E1 Cells Behavior on Surfaces Bombarded by Argon Ions in Planar Cathode Discharge.

To evaluate the effect of topography in nanoscale, titanium surfaces were bombarded by argon ions (a chemically inert gas), in an atmosphere of plasma. The effects of surface parameters on morphology, adhesion, proliferation, and MC3T3-E1 preosteoblasts differentiation were analyzed. Nontreated (smooth) surfaces were used as a control. The levels of average roughness (Ra) observed in bombarded and smooth titanium surfaces were of 95 and 14 nm, respectively. The wettability increased on treated surfaces. The number of attached cells (30 and 60 min) was significantly higher on the bombarded surface. The cell proliferation after 3 and 7 days was also significantly higher on the ion-bombarded surface. In addition, the ALP activity and expression of osteocalcin were higher in cells grown on the treated surface. The results showed that bombardment with argon ions increased the roughness and the wettability of the Ti surface, promoting a significant increase in the adhesion, proliferation, and differentiation of preosteoblasts.

Fascial surgical repair for vaginal prolapse: effect on quality of life and related symptoms.

OBJECTIVE: The aim of this study was to evaluate the impact of surgical treatment for pelvic organ prolapse (POP) on quality of life and on bladder, vaginal and bowel symptoms using validated questionnaires such as the prolapse quality of life questionnaire (P-QoL). STUDY DESIGN: Sixty-five women underwent surgical POP repair. All were evaluated by physical examination and by the use of ICIQ-VS and P-QoL questionnaires before surgery as well as three and six months after surgery. RESULTS: The preoperative scores of all domains on the ICIQ-VS and P-QoL questionnaires and the scores obtained from quantification of the urinary, sexual and bowel symptoms were higher than those at three and six months after surgery (p<0.0001). There was no significant difference in the domain scores for the ICIQ-VS and P-QoL questionnaires at three and at six months after surgery (p>0.05). The preoperative staging was higher than that at three and six months after surgery (p<0.001), and there was no difference in staging between the two postoperative time points (p>0.05). CONCLUSIONS: Surgery with fascial repair for the treatment of pelvic organ prolapse improved health-related quality of life, as assessed by the P-QoL and ICIQ-VS, as well as urinary, vaginal and intestinal symptoms.

Analysis of HFE genes C282Y, H63D, and S65D in patients with hyperferritinemia from northeastern Brazil.

BACKGROUND: Hereditary hemochromatosis (HH) is a genetic disease caused by the high absorption and deposition of iron in several organs. This accumulation results in several clinical complications such as cirrhosis, arthritis, cardiopathies, diabetes, sexual disorders, and skin darkening. The H63D and C282Y mutations are well defined in the HH etiology. The objective of this article is identification of the H63D and C282Y mutations in the HFE protein gene and the frequency assessment of these mutations in patients with persistent increase of serum ferritin in patients from Natal City from state of Rio Grande do Norte, located in northeastern Brazil. RESULTS: Of the 299 patients studied for C282Y and H63D, 48.49% showed absence of mutation and 51.51% showed some sort of mutation: heterozygous C282Y mutation in 4.35% patients, homozygous C282Y mutation in 2.67% patients, heterozygous H63D mutation in 31.44% patients, homozygous H63D mutation in 8.03% patients, and heterozygous for the mutation in both genes (C282Y/H63D) in 5.02% patients. The S65C mutation was studied in 112 patients and heterozygous mutation (S65D/WT) in 2.67% of patients and double mutation (H63D/S65C) in 1.78% of patients were observed. CONCLUSION: Due to the high prevalence of hemochromatosis, its genetic diagnosis has become a challenge, especially in the high-risk group.

Cytokinesis-block micronucleus assay adapted for analyzing genomic instability of human mesenchymal stem cells.

Human mesenchymal stem cells (hMSCs) are multipotent cells used in cell therapy research. One of the problems involving hMSCs is the possibility of genetic instability during in vitro expansion required to obtain a suitable number of cells for clinical applications. The cytokinesis-block micronucleus (CBMN) assay measures genetic instability by analyzing the presence of micronucleus (MN), nucleoplasmic bridges (NPBs), and nuclear buds (NBUDs) in binucleated cells. The present study describes modifications in the CBMN assay methodology to analyze genetic instability in hMSCs isolated from the umbilical vein and in vitro expanded. The best protocol to achieve binucleated hMSCs with preserved cytoplasm was as follows: cytochalasin B concentration (4.0 µg/mL), use of hypotonic treatment (3 min), and the fixative solution (9 methanol:1 acetic acid). These adaptations were reproduced in three hMSC primary cell cultures and also in XP4PA and A549 cell lines. The frequency of hMSCs treated with mitomycin-C presenting MN was lower than that with other nuclear alterations, indicating that the hMSCs contain mechanisms to avoid a high level of chromosomal breaks. However, a high frequency of cells with NPBs was detected and spontaneous anaphase bridges under normal hMSC in vitro culture were observed. Considering that anaphase bridges are characteristic alterations in tumor cells, the CBMN assay is indicated as an important tool associated with other genetic analyses in order to ensure the safe clinical use of hMSCs in cell therapy.

Electrophysiological evaluation of the pudendal nerve and urethral innervation in female stress urinary incontinence.

INTRODUCTION AND HYPOTHESIS: Although still a matter of debate, stress urinary incontinence (SUI) may be accompanied by damage to urethral and pelvic floor innervations, thus promoting dysfunctions of the urethral support and sphincteric closure mechanisms. The aim of this study was to analyze the pelvic floor and urethral innervations through pelvic electrophysiological tests to identify whether neurological alterations interfere with urinary continence and urethral functional activity. METHODS: This prospective study included 52 women, 33 with clinically and urodynamically proven SUI and 19 continent volunteers matched for age, height, parity, and number of vaginal deliveries by the propensity score method. The patients were divided according to the severity of urinary loss evaluated by measuring abdominal leak point pressure (ALPP). Pudendal nerve terminal motor latency (PNTML), pudendal somatosensory evoked potential (SSEP) latencies, urethral and clitoral sensory thresholds, and urethroanal reflex latency were tested. RESULTS: SUI and control subjects did not differ in PNTML, SSEP latency, and clitoral sensory thresholds. However, reduced responsiveness to urethral electrosensitivity and prolonged urethroanal reflex latency were detected in most incontinent patients. In addition, urethral electrosensitivity was altered in suspected intrinsic sphincteric dysfunction. CONCLUSIONS: Urethral afferent pathways can be altered in women with SUI and may play an important role in evoking intrinsic sphincteric dysfunction.

Successful screening for Gaucher disease in a high-prevalence population in tabuleiro do Norte (northeastern Brazil): a cross-sectional study.

BACKGROUND: Gaucher disease (GD) is a hereditary lysosomal storage disorder characterized by the accumulation of glucosylceramide, mainly in the cells of the reticuloendothelial system, due to a deficiency of the enzyme acid ß-glucosidase (GBA). Diagnosis is usually based on measurement of GBA activity in peripheral leukocytes. The purpose of this study was to evaluate the ability of screening for GBA and chitotriosidase activity using dried blood spots on filter paper (DBS-FP) to identify individuals at high risk for GD in high-risk populations such as that of Tabuleiro do Norte, a small town in Northeastern Brazil. METHODS: Between 1 June 2007 and 31 May 2008, 740 consented residents and descendants of traditional families from Tabuleiro do Norte were submitted to screening with DBS-FP. Subjects with GBA activity < 2.19 nmol/h/mL were referred to the analysis of GBA and chitotriosidase activity in peripheral leukocytes and in plasma, respectively. Subjects at highest risk for GD (GBA activity in peripheral leukocytes < 5.6 nmol/h/mg protein) were referred to molecular analysis to confirm diagnosis. RESULTS: Screening with DBS-FP identified 135 subjects (18.2%) with GBA activity < 2.19 nmol/h/mL, 131 of whom remained in the study. In ten of these (7.6%), GBA activity in leukocytes was 2.6-5.5 nmol/h/mg protein. Subsequent molecular analysis confirmed six cases of heterozygosity and four normals for GD. CONCLUSION: DBS-FP assay was shown to be an effective initial GD-screening strategy for high-prevalence populations in developing regions. Diagnosis could not be established from GBA activity in leukocytes alone, but required confirmation with molecular analysis.

p53 flow cytometry evaluation in leukemias: correlation to factors affecting clinical outcome.

p53 is a cell cycle checkpoint control protein that assesses DNA damage and acts as a transcription factor regulating genes, which control cell growth, DNA repair, and apoptosis. p53 mutations have been found in a wide variety of different cancers including flow cytometric assessment of p53 protein expression using anti-p53 monoclonal antibodies. We studied p53 protein expression by flow cytometry (FC) assay in 223 blood and/or bone marrow samples from 72 patients with chronic myeloid leukemia (CML): 54 in chronic phase (CML-CP), 7 in accelerated phase (CML-AP), and 11 in blastic phase (CML-BP); 64 patients with chronic lymphoid leukemia (CLL): (34 at diagnosis, 21 in previously treated, and 9 with Richter's syndrome); 44 patients with acute lymphoid leukemia (ALL): 36 at diagnosis and 8 in relapse; and 43 acute myeloid leukemia (AML): 27 de novo, 7 in relapse, and 9 secondary. p53 protein expression was observed in 64 of 223 patient's samples: 14/64 (21.9%) CLL, 13/44 (29.5%) ALL, 19/43 (44.2%) AML, and 17/72 (23.6%) CML. Highest levels were detected in the advanced phases of CLL, ALL, and CML. In addition, in patients with AML, high levels of p53 expression were detected in secondary and relapse disease and also in de novo AML cases. Our results demonstrated that p53 expression levels are strongly associated with advanced disease. On the basis of these results, we concluded that FC can be a reliable approach to study p53 protein expression in leukemic patients.

Validation of the Prolapse Quality-of-Life Questionnaire (P-QoL) in Portuguese version in Brazilian women.

INTRODUCTION AND HYPOTHESIS: The aim of this study is to validate the Portuguese translated version of the Prolapse Quality-of-Life Questionnaire (P-QoL). METHODS: Ninety-eight women completed the P-QoL questionnaire translated into Portuguese at baseline and on the second visit, 2 weeks later. Clinical data and Pelvic Organ Prolapse Quantification Index (POP-Q) according to the International Continence Society were obtained. Psychometric properties of the questionnaire were assessed. RESULTS: Sixty-eight symptomatic and 30 asymptomatic women for POP symptoms were studied. Most patients presented POP-Q > 2. The P-QoL demonstrated good psychometric properties. The test-retest reliability confirmed a highly significant stability between the total scores for each domain (P < 0.0001). The construct validation distinguished differences in P-QoL questionnaire scores between symptomatic and asymptomatic women. CONCLUSION: The Portuguese version of the P-QoL questionnaire is a valid and reliable instrument to assess quality of life in Brazilian women with pelvic organ prolapse.

Pudendal somatosensory evoked potentials in normal women

OBJECTIVE: Somatosensory evoked potential (SSEP) is an electrophysiological test used to evaluate sensory innervations in peripheral and central neuropathies. Pudendal SSEP has been studied in dysfunctions related to the lower urinary tract and pelvic floor. Although some authors have already described technical details pertaining to the method, the standardization and the influence of physiological variables in normative values have not yet been established, especially for women. The aim of the study was to describe normal values of the pudendal SSEP and to compare technical details with those described by other authors. MATERIALS AND METHODS: The clitoral sensory threshold and pudendal SSEP latency was accomplished in 38 normal volunteers. The results obtained from stimulation performed on each side of the clitoris were compared to ages, body mass index (BMI) and number of pregnancies. RESULTS: The values of clitoral sensory threshold and P1 latency with clitoral left stimulation were respectively, 3.64 ± 1.01 mA and 37.68 ± 2.60 ms. Results obtained with clitoral right stimulation were 3.84 ± 1.53 mA and 37.42 ± 3.12 ms, respectively. There were no correlations between clitoral sensory threshold and P1 latency with age, BMI or height of the volunteers. A significant difference was found in P1 latency between nulliparous women and volunteers who had been previously submitted to cesarean section. CONCLUSIONS: The SSEP latency represents an accessible and reproducible method to investigate the afferent pathways from the genitourinary tract. These results could be used as normative values in studies involving genitourinary neuropathies in order to better clarify voiding and sexual dysfunctions in females.

Urethral sensory threshold and urethro-anal reflex latency in continent women.

AIMS OF STUDY: The sensory evaluation of the lower urinary tract is summarized in the bladder proprioceptive sensitivity during cystometry. Experimental studies suggest that abnormalities of the urethral innervation and micturition reflex can be related to the presence of continence disturbances. This study aimed to measure the urethral sensory threshold and the urethro-anal reflex latency in healthy volunteers, establishing reading criteria, comparing the results and technique used with the literature and verifying the effect of physiological factors. MATERIALS AND METHODS: Thirty healthy female volunteers were studied. They had an absence of genital or urinary complaints and had undergone no previous pelvic or vaginal procedures. The measurement of the urethral sensory threshold and urethro-anal reflex latency were performed as described. RESULTS: The determination of the urethral sensory threshold and urethro-anal reflex latency were obtained in 96.6% of the volunteers. The electrophysiological parameters did not correlate with age, parity or number of vaginal deliveries. There was a positive association of the urethral sensory threshold with height. Technical aspects were considered and compared with those in the literature as well as the advantages and limitations of the method. CONCLUSIONS: The measurement of the urethral sensory threshold and urethro-anal reflex latency presented consistent recordings. The urethral sensory threshold should be analyzed carefully in individuals with height above the population average. Subsequent observations are necessary to clarify their function in patients with continence disturbances and to measure the urethral function, but these values can be used as normal parameters for comparison.

Contrasting features of MDR phenotype in leukemias by using two fluorochromes: implications for clinical practice.

The expression and activity of P-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP1) were analyzed in 178 leukemia samples. Rhodamine-123 (Rho-123) and DiOC(2) were used as substrate to evaluate efflux pump activity. Chronic myeloid leukemia (CML) exhibited a higher percentage of positivity using Rho-123 than DiOC(2) (p=0.000) as compared to other types of leukemia. Moreover, Rho-123 was able to detected Pgp positive cells in a higher proportion of samples than DiOC(2) samples (p=0.004). Similarly, MRP1 positive cells were best detected by Rho-123 as opposed to DiOC(2) (p=0.003). The co-functionality of Rho-123 and DiOC(2) was observed in 26 out of 105 (24.8%) leukemic samples. Co-expression between Pgp and MRP1 was detected in 30 out of 56 (53.6%) samples. As a whole, when the same samples were analyzed, Rho-123 was able to detect Pgp positive cells in a higher proportion of samples than DiOC(2) (p=0.000). Similarly, MRP1 positive cells were best detected by Rho-123 as opposed to DiOC(2) (p=0.007). Our results support the idea that Rho-123 is the substrate of choice for leukemic cells.

Pudendal somatosensory evoked potentials in normal women.

OBJECTIVE: Somatosensory evoked potential (SSEP) is an electrophysiological test used to evaluate sensory innervations in peripheral and central neuropathies. Pudendal SSEP has been studied in dysfunctions related to the lower urinary tract and pelvic floor. Although some authors have already described technical details pertaining to the method, the standardization and the influence of physiological variables in normative values have not yet been established, especially for women. The aim of the study was to describe normal values of the pudendal SSEP and to compare technical details with those described by other authors. MATERIALS AND METHODS: The clitoral sensory threshold and pudendal SSEP latency was accomplished in 38 normal volunteers. The results obtained from stimulation performed on each side of the clitoris were compared to ages, body mass index (BMI) and number of pregnancies. RESULTS: The values of clitoral sensory threshold and P1 latency with clitoral left stimulation were respectively, 3.64 +/- 1.01 mA and 37.68 +/- 2.60 ms. Results obtained with clitoral right stimulation were 3.84 +/- 1.53 mA and 37.42 +/- 3.12 ms, respectively. There were no correlations between clitoral sensory threshold and P1 latency with age, BMI or height of the volunteers. A significant difference was found in P1 latency between nulliparous women and volunteers who had been previously submitted to cesarean section. CONCLUSIONS: The SSEP latency represents an accessible and reproducible method to investigate the afferent pathways from the genitourinary tract. These results could be used as normative values in studies involving genitourinary neuropathies in order to better clarify voiding and sexual dysfunctions in females.