Titanium versus absorbable tacks comparative study (TACS): a multicenter, non-inferiority prospective evaluation during laparoscopic repair of ventral and incisional hernia: study protocol for randomized controlled trial

BACKGROUND: Laparoscopic repair of ventral and incisional hernias has gained popularity since many studies have reported encouraging results in terms of outcomee and recurrence. Choice of mesh and fixation methods are considered crucial issues in preventing recurrences and complications. Lightweight meshes are considered the first choice due to their biomechanical properties and the ability to integrate into the abdominal wall. Titanium helicoidal tacks still represent the "gold standard" for mesh fixation, even if they have been suggested to be involved in the genesis of post-operative pain and complications. Recently, absorbable tacks have been introduced, under the hypothesis that there will be no need to maintain a permanent fixation device after mesh integration. Nevertheless, there is no evidence that absorbable tacks may guarantee the same results as titanium tacks in terms of strength of fixation and recurrence rates. The primary end point of the present trial is to test the hypothesis that absorbable tacks are non-inferior to titanium tacks in laparoscopic incisional and ventral hernia repair (LIVHR) by lightweight polypropylene mesh, in terms of recurrence rates at 3-year follow-up. Surgical complications, post-operative stay, comfort and pain are secondary end points to be assessed. METHODS/DESIGN: Two hundred and twenty patients with ventral hernia will be randomized into 2 groups: Group A (110) patients will be submitted to LIVHR by lightweight polypropylene mesh fixed by titanium tacks; Group B (110) patients will be submitted to LIVHR by lightweight polypropylene mesh fixed by absorbable tacks. DISCUSSION: A few retrospective studies have reported similar results when comparing absorbable versus non-absorbable tacks in terms of intraoperative and early post-operative outcomes. These studies have the pitfalls to be retrospective evaluation of small series of patients, and the reported results still need to be validated by larger series and prospective studies. The aim of the present trial is to investigate and test the non-inferiority of absorbable versus non-absorbable tacks in terms of hernia recurrence rates, in order to assess whether the use of absorbable tacks may achieve the same results as non-absorbable tacks in mid-term and long-term settings

Metabolic health, the metabolome and reproduction in female cattle: a review

Studies over the past 30 years have confirmed the important role of metabolic hormones and metabolic substrates in reproductive function in female cattle. The emergence of metabolomics is providing a deeper understanding of the role of specific metabolites, and clusters of metabolites, in reproduction and also health and disease. Dairy cows undergo major fluctuations in metabolic health and metabolomics is helping to better understand the changes in metabolite profiles associated with negative energy balance and ketosis. New knowledge that emerges from this work should lead to improved nutritional management of dairy cows. In reproduction, it is now possible to gain a metabolomic signature of ovarian follicular fluid and of developing embryos. This should likewise lead to improvements in both natural and assisted reproduction in cattle. Systems biology integrates genomics, transcriptomics, proteomics and metabolomics, and contributes to gaining an understanding of complex biological networks.Highlights Metabolic hormones and metabolic substrates have a major influence on reproduction in female cattle. Negative energy balance and ketosis are associated with changes in the systemic and liver metabolome in dairy cows. The metabolome of ovarian follicular fluid influences oocyte quality and embryo development. Systems biology integrates genomics, transcriptomics, proteomics and metabolomics, and provides a deeper understanding of complex biological networks

Milk somatic cell count and its relationship with milk yield and quality traits in Italian water buffaloes.

ABSTRACT In Southern Italy, buffalo (Bubalus bubalis) milk is mostly intended for the manufacture of Mozzarella di Bufala Campana Protected Denomination of Origin (PDO) cheese. Despite the economic boost of the last 2 decades, the buffalo farming system should be improved to maximize the efficiency of the dairy industry, improve yield and quality of milk and cheese, and work toward better animal welfare. Milk somatic cell count (SCC) is used worldwide as an indicator of udder health in individual milk and is useful for monitoring farm hygiene in bulk milk. Mastitis data are currently not available on a large scale in Italy; thus, SCC is essential for identifying animals with suspected udder infection and inflammation. Moreover, high milk SCC is associated with altered composition and acidity, and poor technological properties of milk. However, payment systems of the PDO area are based simply on the delivered volume of milk rather than on quality characteristics. Hence, currently there are no penalties for elevated SCC in bulk milk in the Italian buffalo dairy industry. In addition, SCC for buffalo milk is not mentioned by either the European Community regulations or the PDO protocol, evidencing a lack of rules for the maximum SCC limit. To provide a phenotypic characterization of SCC at the population level and to improve knowledge on buffalo milk quality, 876,299 test-day records of 70,156 buffaloes reared in the PDO area were analyzed. Data revealed that around 11% of herd-test-dates (≥5 animals sampled each) showed average milk SCC ≥400,000 cells/mL (i.e., above the threshold fixed by the European Community for bovine milk). This suggests that there is room to improve SCC at both the farm and individual level. Within first parity, more than 28 and 15% of lactations had average SCC ≥200,000 and ≥300,000 cells/mL, respectively. Both percentages increased with parity and were 39 and 25% in sixth parity, respectively. Supporting this, the proportion of lactations with average SCC ≥500,000 cells/mL increased from 6% in first parity to 12% in sixth parity. Milk yield and SCC were negatively correlated with each other, especially when SCC level was high. An ANOVA was carried out on test-day record milk yield and composition traits, with fixed effects of parity, lactation stage, class of somatic cell score (n = 6), month of calving, and their interactions; buffalo, herd-test-date, and residual were considered random effects. Significantly lower milk yield and lactose percentage were estimated in progressively higher classes of somatic cell score, whereas no significant differences were observed for fat and protein percentages. This is the first attempt to investigate milk SCC in a large data set of Italian dairy buffaloes. These findings may be helpful for defining reliable and effective SCC thresholds to be adopted whenever specific penalties for high SCC are included in milk payment systems. Finally, these results could be used in mastitis monitoring plans aiming to reduce SCC and udder issues at both the individual and farm levels in the Italian buffalo population

Early Prediction of Corpus Luteum Functionality Using an Imaging Software

The present study aimed to assess the applicability of luteal blood flow data acquired through the use of color Doppler ultrasonography and a post-processing analysis tool (ImageJ) for predicting pregnancy in buffaloes (Bubalus bubalis). The experiment was carried out on 59 multiparous Italian Mediterranean buffaloes that underwent synchronization of estrus and fixed-time artificial insemination (TAI). Corpus luteum features (size: CLS and blood flow: BFA) were taken from Day 5 to 10 after TAI and retrospectively measured with ImageJ. In the same period, blood samples were taken to assess progesterone (P4) concentrations. Pregnancy diagnosis was carried out on Day 45 by ultrasound and confirmed on Day 70 post-TAI. Differences in CLS, BFA, and P4 concentrations from Day 5 to 10 after TAI measured between groups were analyzed by ANOVA repeated measures as were differences within each day of measuring. Buffaloes that established a pregnancy (n = 29; 55%) had larger CLS (2.2 ± 0.1 vs. 1.9 ± 0.1 cm2; P < 0.01), higher BFA (0.6 ± 0.0 vs. 0.4 ± 0.0 cm2; P < 0.01), and higher P4 blood level (1.8 ± 0.1 vs. 1.4 ± 0.1; P < 0.01) during Day 5–10 as compared to not-pregnant buffaloes (n = 22). Throughout the entire period, the first feature that changed between groups was P4 blood concentration at Day 7 (1.7 ± 0.1 vs. 1.2 ± 0.1; P < 0.05) followed by BFA at Day 8 (0.6 ± 0.0 vs. 0.5 ± 0.0; P < 0.05), respectively, in pregnant and not-pregnant animals. The ROC analyses indicated that P4 was able to predict pregnancy since Day 5 (P < 0.05) although a more reliable result could be obtained from Day 8 (P < 0.01). At Day 10, it was possible to set a cutoff value for every parameter taken into account. The logistic regression analysis showed that pregnancy was positively influenced by P4 concentration (odds ratio 534.127; P < 0.01) and BFA (odds ratio 744.893; P < 0.01). In conclusion, the use of color Doppler ultrasonography, together with ImageJ, identified different patterns of BFA between pregnant and not-pregnant buffaloes starting from Day 8 post-TAI

Embryonic and foetal mortality in buffalo species.

The aim of this study was to verify the incidence of late embryonic mortality (between 25 and 45 days post-insemination; LEM) and foetal mortality (between 45 and 70 days postinsemination; FM) in buffaloes synchronized and mated by AI during the transitional period. The trial was performed on 288 multiparous Mediterranean Buffaloes, synchronized and inseminated by AI. Trans-rectal ultrasonography was performed 25, 45, and 70 days post-insemination to assess embryonic development. Milk samples were collected on Days 10, 20, 25, 30, and 45 post-insemination to determine progesterone concentration in whey. Pregnancy rate on Day 25 after AI was 48.6% but declined to 35.4% and to 30.6% by Day 45 and 70 respectively, representing a LEM of 27.1% and a FM of 13.7%. Progesterone concentration was higher (P<0.01) in pregnant compared to LEM buffaloes after 20 days post-insemination. Differences (P<0.05) were found between FM and LEM buffaloes on Days 25 and 30. Furthermore, progesterone concentration in pregnant buffaloes was higher (P=0.09) than that of FM buffaloes on Day 30 and 45. In conclusion, the success of application of reproductive biotechnologies in the transitional period depends from the incidence of embryonic and foetal mortality

Effect of season, late embryonic mortality and progesterone production on pregnancy rates in pluriparous buffaloes (Bubalus bubalis) after artificial insemination with sexed semen

The use of sexed semen technology in buffaloes is nowadays becoming more and more accepted by farmers, to overcome the burden of unwanted male calves with related costs and to more efficiently improve production and genetic gain. The aim of this study was to verify the coupling of some variables on the efficiency of pregnancy outcome after deposition of sexed semen through AI. Pluriparous buffaloes from two different farms (N = 152) were screened, selected, and subjected to Ovsynch protocol for AI using nonsexed and sexed semen from four tested bulls. AI was performed in two distinct periods of the year: September to October and January to February. Neither farms nor bulls had a significant effect on pregnancy rates pooled from the two periods. The process for sexing sperm cells did not affect pregnancy rates at 28 days after AI, for nonsexed and sexed semen, respectively 44/73 (60.2%) and 50/79 (63.2%), P = 0.70, and at 45 days after AI, for nonsexed and sexed semen, respectively 33/73 (45.2%) and 33/79 (49.3%), P = 0.60. Pregnancy rate at 28 days after AI during the transitional period of January to February was higher when compared with September to October, respectively 47/67 (70.1%) versus 47/85 (55.2%), P = 0.06. When the same pregnant animals were checked at Day 45 after AI, the difference disappeared between the two periods, because of a higher embryonic mortality, respectively 32/67 (47.7%) versus 40/85 (47.0%), P = 0.93. Hematic progesterone concentration at Day 10 after AI did not distinguish animals pregnant at Day 28 that would or would not maintain pregnancy until Day 45 (P = 0.21). On the contrary, when blood samples were taken at Day 20 after AI, the difference in progesterone concentration between pregnant animals that would maintain their pregnancy until Day 45 was significant for both pooled (P = 0.00) and nonsexed (P = 0.00) and sexed semen (P = 0.09). A similar trend was reported when blood samples were taken at Day 25, being highly significant for pooled, nonsexed, and sexed semen (P = 0.00). Hematic progesterone concentration between the two periods of the year was highly significant for pregnant animals at 28 days from AI when blood samples were taken at Day 20 after AI for pooled, nonsexed, and sexed semen, respectively P = 0.00, 0.00, and 0.06, and for pregnant animals at Day 45 for pooled, nonsexed, and sexed semen, respectively P = 0.00, 0.00, and 0.01. From these results, it can be stated that hematic progesterone concentration measurement since Day 20 after AI can be predictive of possible pregnancy maintenance until Day 45. Furthermore, the transitional period of January to February, although characterized by a higher pregnancy outcome when compared with September to October, suffers from a higher late embryonic mortality as evidenced by a significant different hematic progesterone concentration between the two periods at Day 20 after AI

Pregnancies following Protocols for Repetitive Synchronization of Ovulation in Primiparous Buffaloes in Different Seasons

Primiparous buffaloes were tested in two periods of the year characterized, by either low or high reproductive efficiency. They were subjected to two protocols for synchronization of ovulation: (i) Ovsynch (OV) and (ii) progesterone based (P4) treatment. After calving, the animals underwent a series of four cycles of re-synchronization protocols. The season did not affect pregnancy rates when the results of the two treatments were pooled together with regard to the first synchronization protocol, followed by AI. Pregnancy rates were similar during the low breeding season (50.3% vs. 57.4% in OV and P4, respectively), but different during the high breeding season (50.4% vs. 67.7% in OV and P4, respectively; p = 0.000). Logistic regression confirmed a significant effect of treatment and season interaction on pregnancy (p = 0.003). Following re-synchronization, a treatment by season interaction was detected during the low breeding season (odds ratio = 2.233), in favor of P4. Finally, a survival analysis showed a better response of animals subjected to P4 treatment from the second AI onward. In conclusion, the pooled data of pregnancy rates from both treatments between seasons are not different following AIs. Better results, though, were obtained from the implementation of P4 treatment, and are recorded in a season-fashioned mode when the comparison is made following first or cumulative AIs

Detection of Brucella abortus DNA and RNA in different stages of development of the sucking louse Haematopinus tuberculatus

Background: Brucellosis is considered the world’s most widespread zoonotic infection. It causes abortion and sterility in livestock leading to serious economic losses and has even more serious medical impact in humans, since it can be a trigger to more than 500,000 infections per year worldwide. The aim of this study was to evaluate the role of Haematopinus tuberculatus, a louse that can parasitize several ruminants, as a new host of brucellosis. Louse specimens were collected from seropositive and seronegative water buffaloes and divided in 3 developmental stages: adults, nymphs and nits. All samples were separately screened for Brucella spp. DNA and RNA detection by Real Time PCR. In particular, primers and probes potentially targeting the 16S rRNA and the Brucella Cell Surface 31 kDalton Protein (bcsp31) genes were used for Real Time PCR and buffalo β actin was used as a housekeeping gene to quantify host DNA in the sample. A known amount of B. abortus purified DNA was utilized for standard curve preparation and the target DNA amount was divided by the housekeeping gene amount to obtain a normalized target value. A further molecular characterization was performed for Brucella strain typing and genotyping by the Bruce-ladder, AMOS-PCR and MLVA assays. Data were statistically analysed by ANOVA. Results: Brucella abortus DNA and RNA were detected in all developmental stages of the louse, suggesting the presence of viable bacteria. Data obtained by MLVA characterization support this finding, since the strains present in animals and the relative parasites were not always identical, suggesting bacterial replication. Furthermore, the detection of Brucella DNA and RNA in nits samples demonstrate, for the first time, a trans-ovarial transmission of the bacterium into the louse. Conclusions: These findings identified H. tuberculatus as a new host of brucellosis. Further studies are needed to establish the role of this louse in the epidemiology of the disease, such as vector or reservoir

GRK2 Levels in Umbilical Arteries of Pregnancies Complicated by Gestational Hypertension and Preeclampsia

BACKGROUND G-Protein coupled receptor kinase 2 (GRK2) represents a regulator of cell function in different cardiovascular conditions, including high blood pressure. The relationship between elevated GRK2 levels and impaired vasorelaxant responses is causative of hypertension through the increase in vascular resistances. The aim of this study is to ascertain if this feature is present in the fetal placental vasculature of pregnancies complicated by hypertensive disorders. METHODS We have assessed GRK2 levels in the umbilical arteries (UA) of 21 preeclamptic or gestational hypertensive and 23 normotensive women at time of delivery. RESULTS GRK2 levels were increased in the hypertensive group (0.83 +/- 0.14 vs. 0.48 +/- 0.06 densitometry units; P < 0.05). GRK2 levels were in correlation and in linear regression with systolic, diastolic, and mean arterial pressure (P < 0.05, r(2) = 0.12, r(2) = 0.11, r(2) = 0.12). Correlations did not reach a significant value for other clinical parameters such as gestational age at birth, umbilical artery pulsatility index, maternal proteinuria, and neonatal birth weight. Out of the 21 hypertensive women, 7 who developed a preeclampsia associated with early preterm delivery (before 34 weeks) had a significantly lower GRK2 levels compared to the remaining 14 (0.51 +/- 0.12 vs. 1.08 +/- 0.20 densitometry units, P < 0.05). CONCLUSIONS We conclude that elevated GRK2 levels in the umbilical vasculature is correlated to elevated blood pressure levels, with a likely compensatory rather than causative role since the lack of protective effect of elevated GRK2 levels may negatively affect the outcome of the hypertensive state

Potential impact of functional biomolecules-enriched foods on human health: A randomized controlled clinical trial

Naturally occurring milk compounds have recently been investigated for their health-promoting properties; in fact, their anti-microbial, immuno-modulatory, antioxidant and anti-thrombotic activities, have increasingly gained interest within the scientific community. We have reported a translational, randomized, controlled clinical trial (RCT) on human subjects with a moderate to high cardiovascular risk, and a body mass index (BMI) >25.1 kg/m2, to evaluate the clinical impact of biomolecules-enriched Mediterranean Buffalo (Bubalus bubalis) milk and its derived dairy foods, produced with innovative breeding techniques. The experimental arm involved patients that followed a diet including the above-described products (treated group; n= 11); the control arm was based on a diet including cow milk and its dairy products (control group; n= 9). The results of this study have been statistically evaluated, pointing out a specific significance related to the comparative analysis of the blood pressure among the 2 arms; in fact, this value showed a significant improvement in an extremely short experimental time. Nevertheless, this study also reported not-significant results that were indicative of an interesting and promising tendency in modulating specific diet-depending haematological and biomedical values. In conclusion, this RCT has assessed that the foods derived from buffalo milk naturally enriched with biomolecules, was able to improve the overall blood glucose levels, the BMI and the body weight. These preliminary results are suitable for the design of future strategies in the prevention of cardiometabolic diseases, thus improving the overall quality of life and the policies of healthcare management