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Infection by Leptospira sp., mainly strains from the Sejroe serogroup, impairs the reproductive efficiency of ruminants leading to economic losses. Although the majority of experimental studies use the intraperitoneal route of leptospiral infection, it has been suggested that natural infection occurs frequently by sexual transmission. Thus, we assessed the genital route of infection to study genital leptospirosis in the sheep model. A strain of L. borgpetersenii serogroup Sejroe, serovar Hardjobovis was inoculated in 18 ewes, divided into three groups for inoculation: intraperitoneal (n=6; Gip), cervical superficial (genital) (n=6; Ggen) and conjunctival (n=6; Gconj). Monthly, for 90 days, blood samples were collected for serology (MAT) and PCR was performed on urine, cervical-vaginal mucus, and uterine fragments. All ewes were successfully infected, independently of the infection route. Gip and Ggen did not differ throughout the experiment, either on seroconversion or on PCR positivity on urine or genital samples. In contrast, Gconj presented fewer seroreactive animals (P<0.05) and fewer PCR-pos on genital samples than the other groups. The results obtained demonstrated that, although all groups presented both urinary and genital infections, the genital route was more efficient and did not differ from the traditional intraperitoneal. It indicates that genital via, besides being a naturally occurring transmission via, represents a promising and interesting route regarding future studies related to genital leptospirosis in ruminants, and its use should be encouraged.

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Copper (Cu) is an essential micronutrient for the correct development of eukaryotic organisms. This metal plays a key role in many cellular and physiological activities, including enzymatic activity, oxygen transport, and cell signaling. Although the redox activity of Cu is crucial for enzymatic reactions, this property also makes it potentially toxic when found at high levels. Due to this dual action of Cu, highly regulated mechanisms are necessary to prevent both the deficiency and the accumulation of this metal since its dyshomeostasis may favor the development of multiple diseases, such as Menkes' and Wilson's diseases, neurodegenerative diseases, diabetes mellitus, and cancer. As the relationship between Cu and cancer has been the most studied, we analyze how this metal can affect three fundamental processes for tumor progression: cell proliferation, angiogenesis, and metastasis. Gynecological diseases are characterized by high prevalence, morbidity, and mortality, depending on the case, and mainly include benign and malignant tumors. The cellular processes that promote their progression are affected by Cu, and the mechanisms that occur may be similar. We analyze the crosstalk between Cu deregulation and gynecological diseases, focusing on therapeutic strategies derived from this metal.

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INTRODUCTION: Breast cancer survivors (BCSs) experience more severe symptoms of genitourinary syndrome of menopause (GSM) than healthy postmenopausal women. As hormonal therapy with oestrogen should be avoided in BCSs, finding an effective and safe therapy to address vaginal symptoms and sexual dysfunction is urgently needed. Physical methods may be promising alternatives for the specificities of this group of women. This review aims to evaluate the efficacy and safety of physical methods (laser and radiofrequency) for treating GSM in BCSs. METHODS AND ANALYSIS: The PubMed, Embase, Web of Science, SciELO, LILACS, Scopus, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov databases will be searched. A search strategy was developed to retrieve clinical trials that evaluate the efficacy and safety of any physical method (laser or radiofrequency) used for GSM in BCSs. No date or language restrictions will be imposed. Two authors will independently select studies by title, abstract and full text to meet the inclusion criteria. Data will be extracted, and the risk of bias will be evaluated using the Cochrane risk-of-bias tool (RoB 2). Review Manager 5.4.1 will be used for data synthesis. The Grading of Recommendations, Assessment, Development and Evaluation will be used to assess the strength of the evidence. ETHICS AND DISSEMINATION: This study reviews the published data; thus, obtaining ethical approval is unnecessary. The findings of this systematic review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42023387680.

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OBJECTIVE: Past studies have demonstrated that women with inflammatory bowel disease (IBD) have a higher risk of gynecological conditions than do women without it. We aimed to characterize the gynecological histories of Hispanic Women living in Puerto Rico with IBD. METHODS: We identified women, aged 21 to 55 years, with a confirmed IBD diagnosis and receiving follow-up care from the University of Puerto Rico IBD clinics from 2017 through 2020. A questionnaire was administered to acquire sociodemographics, family history, past medical history, IBD diagnosis, and gynecologic aspects. RESULTS: One hundred eighty-six women were recruited. Fifty-three (28%) patients had ulcerative colitis, while 133 (72%) had Crohn's disease. Fifty-six percent of all the participants had a chronic illness in addition to than their IBD. Seventy-four out of 186 patients reported having had at least 1 late period within the last 12 months. Fifty-three (28%) described their period patterns as irregular. Thirty-nine (21%) of the patients reported having been vaccinated against human papillomavirus (HPV), and 8 (4%) had been infected by it. Nine out of 186 (5%) patients reported suffering from infertility. CONCLUSION: The results showed that our Hispanic patients (living in Puerto Rico) had a prevalence of irregular menstrual cycles that was similar to that observed in other populations. On the other hand, the presence of HPV, infertility, and cervical cancer were lower and the frequency of Papanicolaou smears performed higher than what has been seen in the continental United States, suggesting that this topic should be investigated in future studies.

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Introducción: Las enfermedades a menudo constituyen alteraciones fisiológicas que requieren acciones inminentes según su gravedad, ante ello, las mujeres andinas ponen en práctica sus conocimientos y actitudes ancestrales a fin de resolverlas, por ser el medio más inmediato. Objetivo: Interpretar las actitudes en el uso de plantas para el tratamiento de algunos eventos ginecológicos, de las mujeres andinas procedentes de la provincia de Hualgayoc, Perú. Materiales y métodos: Estudio cualitativo, exploratorio, de diseño fenomenológico ­ hermenéutico, desarrollado con 16 mujeres andinas, mediante una entrevista semiestructurada, en base a una guía de entrevista con validez de contenido óptima. Los resultados emergieron a partir de la codificación abierta, axial y selectiva y se presentan organizados en subcategorías y categorías. Resultados: Las categorías obtenidas fueron las actitudes favorables hacia la utilización de plantas y las situaciones ginecológicas para su uso, entre las subcategorías están: complacencia por los efectos alcanzados, seguridad para continuar usándolas, aptitud para aconsejar su uso, saberes sobre sus acciones terapéuticas, eventos para su utilización y formas de preparación de las plantas. Discusión: Diversos estudios internacionales convergen en actitudes similares, que se manifiestan en una mayor confianza en la medicina tradicional, conductas favorables de aceptación, convicción en sus efectos, proyección anímica de mejora y disposición para continuar con su uso. Conclusión: Las mujeres mostraron su satisfacción por los resultados obtenidos con el uso de plantas medicinales, al ser beneficiosas, oriundas de su zona y no generar gasto, su uso frecuente fue para paliar dolores durante la menstruación, infecciones de la vagina y trabajo de parto

Introduction: Diseases often represent physiological changes that require immediate action depending on the severity. Faced with these changes, Andean women put into practice their ancestral knowledge and attitudes to find a solution, as they are the most immediate means at their disposal. Objective: To interpret the attitudes of Andean women in the province of Hualgayoc, Peru, towards using plants for treating some gynecological events. Materials and Methods: A qualitative, exploratory, hermeneutic phenomenological design study was conducted with 16 Andean women through a semi-structured interview based on an interview guide with optimal content validity. The results emerged from open, axial, and selective coding and were organized into subcategories and categories. Results: The categories obtained were favorable attitudes towards using plants and gynecological situations for using plants. The subcategories include satisfaction with the results achieved, safety to continue using plants, aptitude to advise on the use of plants, knowledge of plant's therapeutic effects, events for using plants, and methods of preparing them. Discussion: Several international studies converge on similar attitudes, manifested in greater trust in traditional medicine, favorable acceptance behavior, belief in its effects, a mental projection of getting well, and willingness to continue its use. Conclusion: The women were satisfied with the results obtained from the use of medicinal plants because they were beneficial, indigenous to their region, and did not involve any expense. The frequent use of plants was to alleviate pain during menstruation, vaginal infections, and labor.

Introdução: As doenças frequentemente constituem alterações fisiológicas que requerem ações iminentes de acordo com sua gravidade, diante disso, as mulheres andinas colocam em prática seus conhecimentos e atitudes ancestrais para resolvê-las, pois este é o meio mais imediato. Objetivo: Interpretar as atitudes das mulheres andinas da província de Hualgayoc, Peru, em relação ao uso de plantas para o tratamento de alguns eventos ginecológicos. Materiais e Métodos: Estudo qualitativo, exploratório, fenomenológico-hermenêutico, desenvolvido com 16 mulheres andinas, por meio de uma entrevista semiestruturada, baseada em um guia de entrevista com validade de conteúdo ideal. Os resultados emergiram de uma codificação aberta, axial e seletiva e são apresentados organizados em subcategorias e categorias. Resultados: As categorias obtidas foram atitudes favoráveis ao uso de plantas e situações ginecológicas para seu uso, entre as subcategorias estão: satisfação com os efeitos alcançados, segurança para continuar usando-as, aptidão para aconselhar seu uso, conhecimento sobre suas ações terapêuticas, eventos para seu uso e formas de preparar as plantas. Discussão: Vários estudos internacionais convergem em atitudes semelhantes, que se manifestam em uma maior confiança na medicina tradicional, comportamentos favoráveis de aceitação, convicção em seus efeitos, projeção de melhoria do humor e disposição para continuar com seu uso. Conclusão: As mulheres ficaram satisfeitas com os resultados obtidos com o uso de plantas medicinais, pois elas são benéficas, nativas de sua área e não geram gastos; seu uso frequente foi para aliviar a dor durante a menstruação, infecções vaginais e parto.

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OBJECTIVE: The aim of this study was to describe, from a historical perspective, the relevance, resilience and outcomes of vaginal hysterectomy (VH) in gynecology in the age of technological scenario. METHODS: The authors searched records from January 2011 to January 2021 on the following databases: Medline, EMBASE, and CENTRAL (The Cochrane Library) for combinations of the terms "vaginal hysterectomy," "outcomes" AND "history"; and before that period, if the search had historical relevance. INCLUSION CRITERIA: randomized clinical trials; hysterectomy performed for benign gynecological conditions; and VH outcomes compared with Abdominal Hysterectomy (AH), Laparoscopic Hysterectomy (LH) or Robotic Hysterectomy (RH). RESULTS: The VH combines sequences of reproducible techniques which have been developed over the years to safely and effectively overcome the limitations of difficult cases of vaginal extirpation from the uterus. CONCLUSION: The authors support endoscopic surgical approaches in complex surgery for benign indications, urogynecology, and gynecologic oncology when appropriate. However, what makes the gynecological surgeon different from the general surgeon is the vaginal access. It is essential to continue to train residents in vaginal surgical skills and provide safe and cost-effective patient care. The art of technology is the resilience of keeping only the patient at the center of innovation.

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Background: Enzootic bovine leukosis (EBL) is a widespread infectious disease caused by the bovine leukemia virus (BLV), which results in immune system dysfunction. The resulting immunosuppression may lead to an increased prevalence of other diseases. Dairy cows infected have altered immune function associated with decreased milk production and shortened lifespan and decreased immune response to immunization. BLV infection, however, is often asymptomatic, so any connection between subclinical infection and common reproductive diseases remains unknown. This study aimed to describe the relationship between naturally occurring subclinical BLV and infectious reproductive diseases seroconversion in the field. Materials, Methods & Results: The diseases investigated included Bovine viral diarrhoea (BVD), Bovine alfaherpesvirus 1 (BoHV-1), Bovine gammaherpesvirus 4 (BoHV-4), Chlamydiosis, Leptospirosis, Brucellosis and Neosporosis in dairy cattle. Six hundred fifty-five sera samples from the northern and south-central regions of Uruguay, from asymptomatic female Holstein and Holstein crosses without a history of vaccination against reproductive diseases were processed using reference diagnostic methods (Seronautalization, ELISA, MAT, Rose Bengal Plate test). The seroprevalence of BLV was 20.0%. Seroprevalence of reproductive diseases BVD, BoHV-1 and BoHV-4 were 99.3%, 41.2% and 27.3% of the populations, respectively, and the total seroprevalence of Leptospirosis, bovine Neospora caninum and Chlamydiosis were 19.8%, 29.8% and 33.0% respectively. The results revealed positive associations between naturally contracted BLV and the presence of antibodies against BoHV-1 (P = 0.002), as well as between naturally contracted BLV and presence of antibodies against Leptospira spp. (P = 0.028). Discussion: BLV infection can impact innate and adaptive immune system cells and alter the proper functioning of uninfected cells. BLV infection may also induce changes in the complex balance of cytokine expression, cell proliferation, and programmed cell death in T- and B-lymphocytes, which is critical for immune competence and effective response to infectious challenges. The progression of BLV infection has a substantial effect on host defense mechanisms. Indeed, lowmagnitude serologic responses to a commercial foot-and-mouth disease vaccine and a J5 Escherichia coli vaccine have been observed. These results are supported by recent trial studies showing a reduced immune response to vaccination against BoHV-1 and Leptospira spp. in asymptomatic animals infected with BLV. These are 2 of the most prevalent infectious reproductive diseases in cattle worldwide, and our results provide evidence that a link between BLV and susceptibility to these diseases may exist. Although there is evidence of the co-occurrence of these diseases, it remains unknown whether there is a direct or indirect effect of BLV on infertility, embryonic loss, or abortion. Another possibility is that natural infection with these reproductive pathogens (BoHV-1, Leptospira, or others) promotes BLV expression, negatively affecting the farms where these pathogens are endemic. Considering the high seroprevalence of BLV in dairy herds in North and South America where the infection is endemic, it was explored BLV's role as an immunosuppressant by quantifying its co-occurrence with diseases that affect reproductive performance in breeding herds. Future work should clarify the role of BLV and the co-occurring pathogens in causing infertility or abortions.

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OBJECTIVES: To identify the frequency of clinical suspicion of sarcopenic obesity (CSSO) and probable sarcopenic obesity (PSO) and to estimate the association between them and surgical menopause. METHODS: A cross-sectional study carried out in women residing in Colombia, ages 60 to 75 years. Body mass index, the SARC-F scale, SARC-CalF < 31, and SARC-CalF <33 versions adding the calf circumference measurement in the last two were used to identify CSSO. Muscle strength measurement was added to the above measures to establish PSO. Surgical menopause was defined in women who underwent bilateral oophorectomy simultaneously with hysterectomy before natural menopause. Adjusted and unadjusted logistic regression were performed between CSSO or PSO with surgical menopause, bilateral oophorectomy after natural menopause, and abdominal hysterectomy with ovarian preservation. All participants provided informed consent. P < 0.05 was statistically significant. RESULTS: Seven hundred women 67.0 ±â€Š4.8 years old were included; 23.7% were obese, 68.1% had reduced muscle strength, and 4.2% had surgical menopause. CSSO was found in 3.0% with SARC-F and with SARC-CalF < 31; whereas 2.0% were found with SARC-CalF <33. PSO was found in 2.4%, 1.5%, and 2.2% with SARC-F, SARC-CalF <31, and SARC-CalF <33, respectively. Surgical menopause was associated with PSO but was not associated with CSSO. Bilateral oophorectomy after menopause and hysterectomy with ovarian preservation were not associated with CSSO or PSO. CONCLUSIONS: In a group of older adult women, the frequency of CSSO was up to 3.0% and PSO up to 2.4%. Surgical menopause was statistically significantly associated with PSO. On the contrary, CSSO was not associated.

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Introdução: Miomas uterinos são tumores benignos que ocorrem em 20 a 25%, e que ainda são uma importante causa de menorragia e dor pélvica crônica em mulheres, o que gera a demanda de uma abordagem menos invasiva e mais segura para o tratamento desta condição. A embolização vem sendo usada para controlar e curar doenças ginecológicas e obstétricas associadas à hemorragia. Objetivo: Avaliar os efeitos da embolização via cateterismo arterial percutâneo de artérias uterinas em mulheres portadoras de miomas sintomáticos. Método: Trata-se de um estudo prospectivo que incluiu pacientes submetidas à embolização de miomas via cateterismo arterial percutâneo no setor de Radiologia Intervencionista do Hospital do Servidor Público Municipal de São Paulo (HSPM), avaliadas antes dos procedimentos, e 15, 30, 60 e 120 dias após a embolização. Resultados: A amostra inicial deste trabalho foi composta por 14 pacientes, com média de idade de 46,8 ± 4 anos, sendo a amostra reduzida para 9 pacientes até a sexta consulta. Conclusão: A embolização de miomas por cateterismo arterial percutâneo reduziu a intensidade da cólica e a intensidade do fluxo menstrual, reduziram a incontinência urinária e a compressão retal, sem aumento significativo do volume dos ovários e do número de cistos. Palavras-chave: Mioma. Endovascular. Embolização Uterina. Metrorragia. Menorragia.

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