Profile of female survivors of sexual violence in the first 6 months of the COVID-19 quarantine in the city of Campinas, Brazil: A cross-sectional retrospective study.

OBJECTIVES: Describe the characteristics and changes in the profile of women who sought care after experiencing sexual violence (SV) during the first six months of the COVID-19 pandemic in a Brazilian city. METHODS: This is a cross-sectional retrospective study. Data from emergency care and legal abortion requests of women assisted at the Women's Health Care Center Hospital (School of Medical Sciences, University of Campinas, Brazil) due to SV experienced between March 23 and August 23, 2020 (Quarantine Group, QG), were collected and compared with data from the same period of the previous biennium (Comparison Group, CG). χ2 and Fisher's exact tests were used to compare groups; the significance level was 5%. RESULTS: Data for 236 women were analyzed; 70 women were included in the QG and 166 in the CG. In the QG, there was a restriction in the area of origin of women, with a higher proportion of women who lived in Campinas (P = 0.0007) and a higher frequency of chronic SV (P = 0,035). There were no rapes associated with the use of social media or apps in the QG, but 9.8% of women in the CG experienced rape associated with the use of social media or apps. There were higher rates of domestic violence (P = 0.022) and intimidation through physical force (P = 0.011) in the first two months. CONCLUSION: The COVID-19 quarantine affected the profile of women who sought care after experiencing SV. The quarantine resulted in changes in the area of origin of patients, hindering access to health services and leading to higher rates of chronic and domestic SV, particularly in the first 2 months of the pandemic.

[Qualitative analysis of voluntary abortion in the Hospital Italiano de Buenos Aires]. / Análisis cualitativo de la interrupción voluntaria del embarazo en el Hospital Italiano de Buenos Aires.

INTRODUCTION: The Voluntary Interruption of Pregnancy (IVE) law 27.610, enacted in 2020, urges healthcare providers to guarantee this practice. Previous investigations at the Hospital Italiano de Buenos Aires (HIBA) revealed that the lack of clear institutional protocols hindered the management of abortion. The objective of this research was to explore the management of abortion before and after the enactment of law 27.610, the institutional modifications implemented in response to it, and the opportunities for improvement in care from the perspective of the healthcare staff. MATERIALS AND METHODS: Qualitative study using an interpretative phenomenological approach. Professionals from the IVE office at HIBA were selected through purposive and snowball sampling between March 2022 and May 2023. Eighteen semi-structured interviews were conducted, manually analyzed using in vivo and descriptive coding, resulting in the emergence of 3 thematic areas. RESULTS: 1) Professionals experienced four stages in management of abortion, with increasing institutional support: referral to informal networks, risk reduction, legal abortion, and the IVE office. 2) A multidisciplinary team implemented changes starting in 2021 that expanded access to IVE. 3) Improving communication between services is necessary to standardize access to different abortion methods and emergency care. DISCUSSION: The evolution of abortion management at the HIBA reflects adaptations to national legislative frameworks and underscores the importance of clear institutional protocols and hierarchical support. Access to IVE is ensured through an integrated network of providers that continually seek improvements.

Introducción: La Ley 27.610 de Interrupción Voluntaria del Embarazo (IVE), sancionada en 2020, insta a los efectores de salud de Argentina a garantizar esta práctica. Investigaciones previas en el Hospital Italiano de Buenos Aires (HIBA) revelaron que la ausencia de protocolos institucionales claros obstaculizaba el manejo del aborto. El objetivo de este trabajo fue explorar dicho manejo antes y después de la Ley 27.610, las modificaciones institucionales implementadas en respuesta a la misma y oportunidades de mejora en la atención desde las experiencias del personal de salud. Materiales y métodos: Estudio cualitativo de enfoque fenomenológico interpretativo. Mediante muestreo intencional y el uso de bola de nieve, se seleccionó a profesionales del consultorio IVE del HIBA entre 03-2022 y 05-2023. Se realizaron 18 entrevistas semiestructuradas, analizadas manualmente con codificación in vivo y descriptiva, emergiendo 3 áreas temáticas. Resultados: 1) Los profesionales experimentaron cuatro etapas de manejo del aborto, con creciente apoyo institucional: derivación a circuitos informales, reducción de riesgos, interrupción legal del embarazo y consultorio IVE. 2) Un equipo multidisciplinario implementó cambios desde 2021 que ampliaron el acceso a la IVE. 3) Se requiere mejorar la comunicación entre servicios para homogeneizar el acceso a diferentes métodos de interrupción del embarazo y a la guardia. Discusión: La evolución del manejo del aborto en el HIBA refleja adaptaciones a los marcos legislativos nacionales y subraya la importancia de protocolos institucionales claros y apoyo jerárquico. El acceso a la IVE está garantizado a través de un circuito de efectores integrados que buscan mejoras continuas.

Molecular genetic characterization of porcine reproductive and respiratory syndrome virus outbreak in Assam, India and neighbouring regions.

Porcine reproductive and respiratory syndrome (PRRS) is a significant swine disease with no effective vaccine due to high viral mutation rates. This study investigates a natural PRRS outbreak through molecular, pathological, and serological analyses. Nineteen affected pigs were clinically examined, and 10 underwent post-mortem examination. PRRS virus (PRRSV) presence was confirmed in all tissue samples by RT-PCR targeting open reading frame (ORF) 5 and ORF7 genes. Clinical signs, especially in boars and sows, included fever, appetite loss, movement reluctance, erythematous skin patches, vomiting, and abortions in sows. Post-mortem findings highlighted lung consolidation, severe lymph node enlargement, interstitial pneumonia with mononuclear cells, macrophage accumulation and necrotic cells in alveolar spaces. Multifocal myocarditis, lymphoid follicular degeneration, and follicular necrosis were observed in the tonsil, spleen, and lymph nodes. PRRSV-specific antibodies were detected in 32.75% of serum samples, confirming the outbreak. Phylogenetic analysis of the PRRSV-ORF5 and ORF7 genes revealed a close genetic relationship between the outbreak samples from Assam and recent outbreaks in Idukki, Kerala, India (2018), and neighbouring country China, indicating the circulation of Genotype 2 virus in Assam. However, the sequences showed some differences from the isolates of Mizoram, India. In conclusion, this study provides molecular and pathological evidence of a PRRSV outbreak, confirms the presence of PRRSV-specific antibodies and viral RNA, and shed light on the virus's genetic characteristics in India.

Epidemiology of Bovine Neosporosis in Relation to Socioeconomic, Demographic, and Transmissibility Factors in Dual-Purpose Production Systems in Colombia.

INTRODUCTION: Bovine neosporosis represents a significant threat to reproduction and production in livestock systems worldwide. This disease is caused by the protozoan Neospora caninum, resulting in abortions of cows and neurological signs in newborn calves. This leads to significant economic losses, decreasing meat and milk production, especially in tropical regions. The infection has an endogenous and exogenous cycle of transmission involving dogs that shed the oocysts, with the highest transmission successes in humid areas. Similarly, there is a lack of knowledge about the epidemiological risk factors and management practices involved in the transmission success in tropical humid regions. METHODS: In this sense, a cross-sectional epidemiological survey was conducted on 150 farms from 24 municipalities of the Huila area. A total of 360 cattle were sampled, and information about the production system was collected using a structured poll with 128 questions. RESULTS: In these cattle, 53% (191/360) were positive for antibodies against Neospora caninum using ELISA. The logistic regression analysis using the information collected from the poll identified the presence of flooring type, water access, production systems, and feed management as risk factors. Among the protective factors were identified the geographical area, molasses supplementation, and biosecurity practices such as animal separation and access control. DISCUSSION: This study identified for the first time the epidemiological risk factors associated mainly with the exogenous cycle of neosporosis. The present study contributes to the design of intervention strategies oriented to minimize the impact of parasitism in Colombian herds.

Female genital tract microbiome: the influence of probiotics on assisted reproduction.

Assisted reproductive technology (ART) has been evolving since 1978, with the number of techniques performed increasing over the years. Despite continued advances, some couples continue to have difficulties getting pregnant, and it has recently been considered that the microbiome of the female genital tract (FGT) may influence embryo implantation and the establishment of pregnancy. This review aims to evaluate the role of probiotics on reproductive outcomes in infertile women on ART. A search throughout medical databases was performed, and six articles met the criteria. Five studies showed improvements in pregnancy rates, with only one demonstrating statistical significance. One article showed no improvement but reported a statistically significant reduction in the miscarriage rate in the probiotic group. Further research is needed to evaluate the true potential of probiotics, namely to assess whether they effectively modulate the FGT microbiome and if these changes are maintained over time.

Shedding light on risk: Seroprevalence of Q fever among farm animals and workers in Ecuador.

Q fever, caused by the bacterium Coxiella burnetii, is a zoonotic disease that has been largely overlooked despite presenting significant risks to both animal and public health. Although well studied in some countries, in most countries in Latin America, there's a lack of information on C. burnetii infection, its prevalence, and its impact on both livestock and human populations. To address this gap, we conducted a serosurvey among farm workers, cattle, sheep, and dogs on two dairy farms in Ecuador using a commercial ELISA kit. Additionally, we conducted a case-control study in cattle to investigate the association between C. burnetii infection and abortion. The findings revealed that 18 % of farm workers, 30 % of dogs, 25 % of cattle and 2 % of sheep tested positive for Q fever antibodies. Interestingly, no significant association between C. burnetii infection and abortion was observed in cattle (p < 0.05) but a high Neospora caninum seroprevalence indicated a strong link to abortion due to this parasite infection. The results highlight the presence of Q fever in both humans and animals on the surveyed farms, with farm dogs showing the highest seroprevalence. A point of concern arises from the significant prevalence of antibodies detected among farm workers, suggesting a potential history of unconfirmed symptomatic respiratory infections caused by a C. burnetii infection. However, further investigations are necessary to better understand the infection dynamics and its potential implications for public and animal health.

Live attenuated goatpox vaccination in pregnant Murcia-Granada goats: dosage implications and outcomes.

BACKGROUND: Infectious diseases, particularly the Goatpox virus (GTPV) from the Poxviridae family, significantly impact livestock health and agricultural economies, especially in developing regions. Recent GTPV outbreaks in previously eradicated areas underscore the need for effective control measures, with vaccination being the most reliable strategy. This study investigates the effects of administering standard and double doses of live attenuated goatpox vaccine in pregnant Murcia-Granada goats, a non-native breed in Iran, to determine optimal vaccination protocols. RESULTS: In 2018, 400 healthy and pregnant Murcia Granada goats imported from Spain were divided into groups of 200 and vaccinated with either a standard dose (0.5 ml) or a double dose (single 0.9 ml injection) of live attenuated goatpox vaccine. Post-vaccination, the goats were monitored daily for clinical signs of infection, with samples collected for PCR analysis to detect the presence of GTPV strains. In group A, which received the standard vaccine dose, no abortions or vaccine-related side effects were observed, and body temperatures remained normal. In group B, administered a double dose, 37% of the goats experienced abortions, displaying signs of GTPV infection, such as skin lesions (pox lesions) and increased body temperatures. Molecular analysis confirmed the vaccine strain of GTPV as the infection source, ruling out external contamination. Statistical analysis showed no significant differences in abortion rates concerning gestational age or t he age of the pregnant goats. CONCLUSION: The study highlights the importance of adhering to standard vaccine dosages in pregnant Murcia Granada goats to prevent adverse outcomes like abortions. This study emphasizes the necessity to review and revise vaccination protocols tailored to specific breeds and varying maintenance conditions, including pregnancy and outbreak scenarios. These findings stress the necessity for cautious and tailored vaccination strategies to ensure the safety and efficacy of vaccines in different goat breeds.

Conservative political rhetoric and associated enduring threat to constitutional right to abortion-A case study from Brazil.

Abortion is a critical public issue in Brazil where over 800,000 abortions might occur each year, with approximately 250,000 admitted to emergency departments due to complications from unsafe procedures. A new bill seeks to amend the Brazilian Penal Code (Código de Processo Penal), classifying the practice as a felony for patients over 22 gestational weeks, even in cases where the practice is already legally foreseen (e.g., derived from sexual abuse, as an attempt to save pregnant individuals at high risk or due to fetuses' anencephaly). This bill undermines several Sustainable Development Goals endorsed by the United Nations, particularly those related to health (Goal 3), gender equality (Goal 5), and inequality and poverty reduction (Goal 10). Among the extensive list of potential solutions to the abortion challenge that Brazil currently faces, a feasible and plausible alternative relates to investment in education, in particular sexual education aimed at adolescents.

Aya Contigo: evaluation of a digital intervention to support self-managed medication abortion in Venezuela.

Background: Venezuela continues to face a humanitarian crisis, where healthcare is difficult to access and abortion is legally restricted. In response to a growing need for life-saving abortion and sexual and reproductive health (SRH) services, a digital application called Aya Contigo was co-developed with local partners to support self-managed medication abortion. We sought to evaluate this digital health tool among pregnant people seeking abortion in Venezuela. Methods: This is a mixed-methods pilot evaluation of Aya Contigo, a digital tool for pregnant people seeking abortion in Venezuela. From April to June of 2021, people in the first trimester of pregnancy were recruited via passive sampling. Once enrolled, participants accessed information and resources on the application and were supported by study team members over an encrypted chat. Following medication abortion, participants completed an online survey and a semi-structured interview. Descriptive statistics were used to evaluate the survey responses. Interviews were coded thematically and analyzed qualitatively with NVivo. Results: Forty participants seeking medication abortion in Venezuela were recruited to the study and given access to Aya Contigo. Seventeen completed the online survey (42.5%), with all participants identifying as women and a mean age of 28 (range 19-38; SD 5.55). Participants expressed confidence in Aya Contigo; 53% (9/17) felt "very supported" and the remaining 47% (8/17) felt "somewhat supported" by the app throughout the self-managed abortion process. The app was rated as highly usable, with an overall System Usability Scale score of 83.4/100. Thirteen respondents participated in a semi-structured phone interview, and qualitative analysis identified key themes relating to the experience of seeking abortion in Venezuela, the user experience with Aya Contigo, and the app's role in the existing ecosystem of abortion and contraceptive care in Venezuela. Discussion: This mixed-methods pilot study demonstrates that the Aya Contigo mobile application may support pregnant people seeking medication abortion and post-abortion contraceptive services in Venezuela. Participants valued the provision of evidence-based information, virtual accompaniment services, and locally-available sexual and reproductive health resources via the digital tool. Further research and interventions are needed to ensure that all pregnant people in Venezuela can access safe abortion and contraceptive resources.

Parvovirus B19 remains an underestimated pathogen among infections during gestation in Argentina: Insights through the study of symptomatic and asymptomatic pregnant patients and newborns from Córdoba.

BACKGROUND: Parvovirus B19 (B19 V) infection during pregnancy can cause adverse fetal outcomes. Our aim was to characterize both clinical and asymptomatic maternal and neonatal cases by studying virological and serological markers of B19 V infection, and to sequence the complete genome of the circulating virus in Argentina. METHODS: Symptomatic patients were included based on maternal and/or fetal-neonatal signs attributable to B19 V infection during gestation. Pregnant patients were analyzed in either the timely diagnosis group (TD, samples obtained when symptoms were present and infection was suspected) or the retrospective diagnosis group (RD, samples collected immediately postpartum), and newborns were analyzed at birth. A sample of asymptomatic individuals was also analyzed. Diagnostic tests (PCR/qPCR/serology) and sequencing were performed on archived serum samples from 2018 to 2023, and clinical data were obtained from medical records. RESULTS: We studied 328 symptomatic patients, including 185 pregnant patients (73 TD and 112 RD) and 143 newborns. Among them, we identified 27/328 (8.2 %) positive cases (B19V+): 12/73 (16.4 %) in the TD group, 6/112 (5.4 %) in the RD group, and 9/143 (6.3 %) newborns. Within the 77 mother-newborn pairs included, there were 8 (10.4 %) B19 V infections and 6 cases of vertical transmission. Additionally, B19 V infection was detected in 26/310 (8.4 %) asymptomatic patients. Phylogenetic analysis identified genotype 1a as a circulating strain in Argentina. CONCLUSIONS: Our findings highlight the need to raise awareness and enhance diagnostic approaches in Argentina to more effectively identify and manage B19 V infections during pregnancy in our region.

Trusted networks: a study of communication flow and access to abortion information in Argentina.

In December 2020, Argentina approved a new abortion law following decades of feminist and social advocacy. This paper presents qualitative findings from interviews and focus group discussions with people in local communities focusing on how individuals of reproductive age access and communicate sexual and reproductive health information, particularly regarding abortion. Sixteen in-depth interviews were conducted with key informants working in the field of SRHR and four focus group discussions took place with cisgender women and girls, transmasculine people and non-binary people of reproductive age. We found that information exchange and communication about sexual and reproductive health issues, particularly abortion, took place mainly through informal social networks engaging with activists and feminist grass-root organisations. These informal social networks were built on trust as a collective affect that enabled open communication about abortion. Information sharing through word of mouth, in person and via digital means using different social media platforms, is an important means of information sharing and communication in Argentina. Monitoring the implementation of abortion policies in this country should include investigating the impact of people accessing abortion through informal social networks in terms of abortion pathways and intersections with the formal health system.

Biochemical markers for prediction of the first half pregnancy losses: a review.

Objective: 26% of all pregnancies end in miscarriage, and up to 10% of clinically diagnosed pregnancies, and recurrent pregnancy loss is 5% among couples of childbearing ages. Although there are several known causes of pregnancy loss in the first half, including recurrent pregnancy loss, including parental chromosomal abnormalities, uterine malformations, endocrinological disorders, and immunological abnormalities, about half of the cases of pregnancy loss in its first half remain unexplained. Methods: The review includes observational controlled studies (case-control or cohort, longitudinal studies, reviews, meta-analyses), which include the study of biochemical factors for predicting pregnancy losses in the first half, in singlet pregnancy. The Newcastle-Ottawa Scale (NOS) was used to assess the research quality. Results: Finally, 27 studies were included in the review, which has 134904 examined patients. The results of the review include estimates of ß-human chorionic gonadotropin, progesterone, pregnancy-associated protein - A, angiogenic vascular factors, estradiol, α-fetoprotein, homocysteine and CA-125 as a predictors or markers of the first half pregnancy losses. Conclusion: It may be concluded that to date, research data indicate the unavailability of any reliable biochemical marker for predicting pregnancy losses in its first half and require either a combination of them or comparison with clinical evidence. A fairly new model shall be considered for the assessment of α-fetoprotein in vaginal blood, which may have great prospects in predicting spontaneous miscarriages.

COVID-19 Pandemic and Hospitalizations due to Abortion among 10- to 14-Year-Old Girls in Brazil.

Introduction: Various non-pharmacological interventions to prevent coronavirus dissemination were implemented during the COVID-19 pandemic, including school closures. The effect of these interventions on particular aspects of people's lives such as sexual and reproductive health outcomes has not been adequately discussed. The objective of the study was to compare the monthly hospital admission rates due to abortion before and during school closure. Methods: We used an interrupted time series (IES) design to estimate the hospital admission rates before and during the school closure (intervention in March 2020) period. The analysis was performed considering all girls from age groups of interest and by stratifying the age groups according to skin color (white and non-white) in which the non-white category comprised both the black and mixed ethnicity together. Coefficients and 95% confidence intervals (95% CIs) were calculated using segmented linear regression models. Results: The results showed positive and statistically significant coefficients, suggesting post-intervention trend changes both in the population as a whole (coefficient: 0.07; 95% CI: 0.02; 0.11) and the non-white population group (coefficient: 0.07; 95% CI: 0.03; 0.11), indicating that the monthly hospital admission rates increased over the post-intervention period compared to baseline pre-intervention period. The ITS analysis did not detect statistically significant trend changes (coefficient: 0.02; 95% CI: -0.01; 0.05) in abortion admission rates in the white girl population group. Conclusion: The hospitalizations in Brazil due to abortions in 10- to 14-year-old girls increased during the COVID-19 pandemic in 2020 compared to 2019, and the number of abortions was higher in the non-white population than the white population. Furthermore, recognizing that the implementation of school closure has affected the minority population differentially can help develop more effective actions to face other future similar situations.

Induced abortion incidence and associated factors in a cohort of women living with HIV in Rio De Janeiro, Brazil, 1996-2016.

BACKGROUND: Abortion is a public health problem in Latin America and is more common among women living with HIV. OBJECTIVE: to verify the incidence and factors associated with induced abortion in a cohort of women living with HIV assisted in a reference service for care for individuals with HIV/AIDS in Rio de Janeiro/Brazil. METHODS: Prospective cohort during the period 1996-2016. We estimated the incidence of induced abortions during follow-up in the cohort by calculating person-time incidence rates [per 100 persons-years (PY)] and investigated the factors associated with the outcome "induced abortion" using a generalized linear mixed model. RESULTS: 753 women and 210 pregnancies were included in the present analysis. We estimated an induced abortion incidence rate of 0.68/100 persons-years (95% confidence interval [CI]: 0.47; 0.94) in the study period, with a significant reduction after 2006. The main factors associated with an induced abortion were currently living with a partner (adjusted OR [AdjOR] 0.32 95% CI: 0.10-0.98), number of children (2 children AdjOR 0.12, 95% CI: 0.02-0.95) and the type of antiretroviral treatment used (regimen without Efavirenz: AdjOR: 0.11, 95% CI 0.02-0.70). CONCLUSIONS: We showed a significant reduction in the incidence of induced abortions in a cohort of women living with HIV in Rio de Janeiro, Brazil, probably due to a decrease in the incidence of pregnancies observed in the same period. The factors associated with a lower occurrence of induced abortion suggest a good integration between the clinical and reproductive assistance offered to those women.

Seroprevalence of bovine leukemia virus and association with bovine infectious abortion in Creole breeds from tropical grazing herds in the Colombian Caribbean.

Background and Aim: In the Caribbean region of Colombia, the concomitance of endemic infectious agents is a common problem, and coinfections are possible, increasing the complexity of cattle herds' sanitary, reproductive, and productive problems. This study aimed to estimate the seroprevalence of bovine leukemia virus and its association with bovine infectious abortion in grazing Creole breeds from tropical herds in the Colombian Caribbean. Materials and Methods: For the determination of bovine leukemia virus (BLV), bovine viral diarrhea virus (BVDV), bovine herpes virus-1 (BoHV-1), and Neospora Caninum (NC), the enzyme-linked immunosorbent assay technique was used. Matrix analysis was performed to represent multiple seroprevalence in the same cow. To explore the association between the seroprevalence of BLV and bovine infectious abortion agents, a multivariate logistic regression model was used. Results: The seroprevalence was as follows: BLV 30.78%, BVDV 33.01%, BoHV-1 12.85%, and NC 8.96%. In the multivariate logistic regression model, seroprevalence of BVDV (OR 10.8; 95% CI: 7.5-15.6) and seroprevalence of BoHV-1 (OR 1.8; 95% CI: 1.1-3.0) were associated with the seroprevalence of BLV. Conclusion: Animals infected with BLV are more susceptible to coinfections with BVDV and BoHV-1. Implementing healthy measures against these two immunosuppressive infections could enhance the hygiene of numerous cattle herds. This study was designed as a retrospective cross-sectional study, which limits the ability to confirm that BLV is the primary infection. Further studies to confirm the primary infection of BLV with an active viral coinfection are necessary and the factors associated with these phenomena.

First-trimester medication abortion via telemedicine: A retrospective cohort study.

Background: Following the decriminalization of abortion in Colombia and amidst a global health crisis due to COVID-19, Profamilia implemented a telemedicine-assisted first-trimester Medication Abortion (MAB) program. This is an opportunity to reduce inequalities in access and to promote empowerment and sexual and reproductive rights. This study aims to describe socio-demographic and clinical characteristics of users and to assess its effectiveness and safety. Study design: A retrospective cohort study. Methods: The study analyzed data from users who received Profamilia's telemedicine abortion services between August 2021 and August 2022 (n = 3073). A descriptive analysis of their sociodemographic and clinical characteristics was performed, grouping, and comparing them according to follow-up status and abortion outcome. Effectiveness was assessed by the percentage of complete abortions without surgical intervention, and safety by the incidence of complications, potential adverse events, and potentially dangerous signs. Results: Most of the users were less than 8 weeks gestation at the start of treatment (88.3 %), from low socioeconomic strata (84.8 %), affiliated to the subsidized healthcare system (87.6 %), with educational levels up to secondary school (81.6 %), between 18 and 35 years (87.4 %), from urban areas (97.8 %) and singles (90,8 %). 94.9 % of users had a complete abortion using medication, and 0.3 % of cases reported complications. Conclusions: First-trimester MAB through telemedicine in the Latin American context is an effective and safe choice. Telehealth is an important strategy to expand access to safe abortion care, especially for those with limited financial means or educational backgrounds. Rural and marginalized populations need more attention to improve access.

Telemedicine for the provision of medication abortion to pregnant people at up to twelve weeks of pregnancy: a systematic literature review and meta-analysis.

BACKGROUND: Telemedicine represents an important strategy to facilitate access to medication abortion (MAB) procedures, reduces distance barriers and expands coverage to underserved communities. The aim is evaluating the self-managed MAB (provided through telemedicine as the sole intervention or in comparison to in-person care) in pregnant people at up to 12 weeks of pregnancy. METHODS: A literature search was conducted using electronic databases: MEDLINE, Embase, Cochrane (Central Register of Controlled Trials and Database of Systematic Reviews), LILACS, SciELO, and Google Scholar. The search was based on the Population, Intervention, Comparison, Outcome, and Study Design (PICOS) framework, and was not restricted to any years of publication, and studies could be published in English or Spanish. Study screening and selection, risk of bias assessment, and data extraction were performed by peer reviewers. Risk of bias was evaluated with RoB 2.0 and ROBIS-I. A narrative and descriptive synthesis of the results was conducted. Meta-analyses with random-effects models were performed using Review Manager version 5.4 to calculate pooled risk differences, along with their individual 95% confidence intervals. The rate of evidence certainty was based on GRADE recommendations. RESULTS: 21 articles published between 2011 and 2022 met the inclusion criteria. Among them, 20 were observational studies, and 1 was a randomized clinical trial. Regarding the risk of bias, 5 studies had a serious risk, 15 had a moderate risk, and 1 had an undetermined risk. In terms of the type of intervention, 7 compared telemedicine to standard care. The meta-analysis of effectiveness revealed no statistically significant differences between the two modalities of care (RD = 0.01; 95%CI 0.00, 0.02). Our meta-analyses show that there were no significant differences in the occurrence of adverse events or in patient satisfaction when comparing the two methods of healthcare delivery. CONCLUSION: Telemedicine is an effective and viable alternative for MAB, similar to standard care. The occurrence of complications was low in both forms of healthcare delivery. Telemedicine services are an opportunity to expand access to safe abortion services.

How pollen and ovule development underlay dioecy in Chloroluma gonocarpa (Sapotaceae).

Previous studies have determined that Chloroluma gonocarpa (Sapotaceae), is a species that has cryptic dioecy. This type of sexual system is characterized by flowers that are morphologically perfect (both sexual whorls are present) but functionally pistillate or staminate (in each type of flower one of the sexual whorls is non-functional). In C. gonocarpa the pistillate flowers present well-developed stigma, functional ovules, and staminodes, while the staminate flowers present a poorly developed stigma, collapsed ovules, and pollen-producing anthers. In angiosperms, the abortion of sexual organs can occur at different stages of development (from pre-meiosis to post-meiosis), that is why we conducted an anatomical analysis of both flower types at various developmental stages. Using light microscopy, we described the processes of sporogenesis and gametogenesis to establish when the staminate flowers lose their pistillate function. To achieve this, we collected, fixed, and processed the flowers following conventional anatomical techniques for observation under a light microscope. Our findings reveal that pollen development occurs only in staminate flowers, while ovule development begins in both types of flowers but ceases in staminate flowers due to post-meiosis abortion. In contrast, normal development continues in pistillate flowers. These results suggest that dioecy in C. gonocarpa may have arisen from a gynodioecious pathway.

[Association between induced abortion and depression: A systematic review and meta-analysis]. / Asociación entre aborto inducido y depresión: una revisión sistemática y metaanálisis.

This article is a systematic review (SR) and meta-analysis (MA) whose objective was to identify the association between induced abortion and the development of depression, based on the Cochrane guidelines for SRs. A systematic search was carried out in the WoS, PubMed and Scopus databases. Retrospective and prospective cohort studies, carried out until November 2020, that evaluated a population of women in childbearing age (12 to 46 years) with at least 1 induced and/or provoked abortion, including pharma-cological and surgical abortion. Only studies with healthy women at the beginning of the research were included, i.e., with absence of psychiatric pathology prior to induced abor-tion. The quality of the included studies was measured with the Newcastle-Ottawa Scale (NOS), and for the MA random-effects models were specified using the DerSimonian & Laird method, grouping them into follow-up after abortion before and after one year. The results of the SR were measured with relative risk (RR), hazard ratio (HR), odds ratio (OR), and the chi-square test, which assessed the intensity of the statistical relationship between population and exposure. Systematic review demonstrated an OR of 1.38 (95% CI 1.14-1.68) of depression after induced abortion. Meta-analysis demonstrated a statis-tically significant association between depression and induced abortion when the as-sessment after one year was performed OR: 1.37 (95% CI 1.09-1.71). The risks, harms and mental health consequences of induced abortion, such as depression, should be in-vestigated and warned.

El presente artículo es una revisión sistemática (RS) y metaanálisis (MA) cuyo objetivo fue identificar la asociación entre el aborto inducido y el desarrollo de depresión, con base en los lineamientos Cochrane para RS. Se hizo la búsqueda sistemática en las bases de datos WoS, PubMed y Scopus. Se incluyeron estudios de cohorte retrospectivos y prospectivos, hasta noviembre de 2020, que evaluaron una población de mujeres en edad fértil (12 a 46 años) con al menos un aborto inducido o provocado, incluido el aborto farmacológico y el quirúrgico. Solo se incluyeron estudios con mujeres sanas al inicio de la investigación, es decir, con ausencia de patología psiquiátrica previa al aborto inducido. La calidad de los estudios incluidos se midió con la Newcastle-Ottawa Scale (NOS) y para el MA se especificaron modelos de efectos aleatorios con el método de DerSimonian & Laird y se agruparon en seguimiento posterior al aborto antes y después de un año. Los resultados de la RS fueron medidos con riesgo relativo (RR), hazard ratio (HR), odds ratio (OR) y la prueba de chi cuadrado, que valoraron la intensidad de la relación estadística entre la población y la exposición. La RS demostró un OR 1.38 (IC 95% 1.14-1.68) de depresión tras el aborto inducido. El MA demostró una asociación estadísticamente significativa entre la depresión y el aborto inducido cuando se hizo la evaluación posterior a un año OR: 1.37 (IC 95% 1.09-1.71). Se deberían investigar y advertir los riesgos, daños y consecuencias en la salud mental, como la depresión, tras el aborto inducido.