Randomized comparison of total laparoscopic, laparoscopically assisted vaginal and vaginal hysterectomies for myomatous uteri

To compare the operative data and early postoperative outcomes of total laparoscopic hysterectomy (TLH), laparoscopically assisted vaginal hysterectomy (LAVH) and vaginal hysterectomy (VH). One hundred and eight women requiring hysterectomy for enlarged myomatous uterus were randomly allocated into three treatment arms: TLH (n = 36); LAVH (n = 36); VH (n = 36). Randomization procedure was based on a computer-generated list. The primary outcome was the discharge time comparison. The secondary outcomes were operating time, blood loss, paralytic ileus time, intraoperative complications, postoperative pain, and early postoperative complications. The mean discharge time was shorter after VH than after LAVH and TLH (P = 0.001). Operating time significantly influenced the discharge time, considered as a dependent variable in general linear model analysis (P = 0.006). In contrast, blood loss did not influence the discharge time (P = 0.55).The mean operating time was significantly shorter in VH than in TLH and LAVH groups (P = 0.000).The intraoperative blood loss was greater during LAVH than during TLH and VH (P = 0.000).Paralytic ileus time was shorter after VH than after TLH and LAVH (P = 0.000). No intraoperative complications or conversion to laparotomy occurred. VH was the faster operative technique with smaller blood loss and shorter discharge time compared with the others two techniques. So, VH should be considered the preferred approach in patients with enlarged myomatous uteri. When VH is not feasible or salpingo-oophorectomy is required, LAVH or TLH should be considered as valid alternatives. It is necessary to continue prospective comparative studies between the various surgical options to identify the best approach for hysterectomy in each single woman

A comparison of vaginal, laparoscopic-assisted vaginal, and minilaparotomy hysterectomies for enlarged myomatous uteri

Objective: To compare the operative data and early postoperative outcome of vaginal. hysterectomy (VH), laparoscopic-assisted vaginal hysterectomy (LAVH), and minilaparotomy hysterectomy (MiniLPT). Methods: A total of 150 women who required hysterectomy for enlarged myomatous uteri were randomly allocated into 3 treatment groups: VH (n=50), LAVH (n=50), and MiniLPT (n=50). The primary outcome was hospital discharge time. The secondary outcomes were operative time, blood toss, paralytic ileus, postoperative pain, and intraoperative and early postoperative complications. Results: Mean hospital discharge time was longest with MiniLPT, and shortest with VH (P < 0.01). VH was the fastest operating technique, was associated with less blood loss, and resulted in shortest duration of paralytic ileus (P < 0.01). No intraoperative complications occurred. Conclusion: VH should be the preferred surgical approach in patients with enlarged myomatous uteri. When VH is not feasible, LAVH should be considered an alternative to MiniLPT. Further controlled prospective studies are required to confirm these results. (c) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved

Technical note : Development of multiplex PCR assays for the molecular characterization of Streptococcus uberis strains isolated from bovine mastitis

Streptococcus uberis is an important causative agent for clinical and subclinical mastitis in dairy cattle. The aim of this study was to develop 2 multiplex PCR assays (mPCR) for the simultaneous detection of virulence factors and housekeeping genes for use when investigating the genetic variability and distribution of Strep. uberis virulence factors. The tuf, cpn60, pauA, sodA, sua, oppF, and gapC genes were grouped in assay 1 (mPCR1) and the hasA, hasB, and hasC genes were included in assay 2 (mPCR2). The detection limits were 11.8 pg and 5.9 pg of DNA for mPCR1 and mPCR2, respectively. The 2 mPCR assays were validated with 56 Strep. uberis strains isolated from mastitis milk samples collected from different bovine herds in northern Italy. Results revealed that gapC and oppF were detected in 98.2% of the strains, whereas sua and hasC genes were detected in 94.6 and 89.2% of the strains, respectively. The most common pattern was gapC+, oppF+, cpn60+, sua+, sodA+, pauA+, tuf+, hasA+, hasB+, and hasC+, which appeared in 59% of the strains analyzed. The molecular assays developed in the present study represent a powerful tool for the evaluation of virulence pattern distribution in Strep. uberis strains associated with intramammary infections

Study of bovine milk microbiota biodiversity in autoctonous italian breeds

In order to valorize the autoctonous cows milk, a better knowledge of its quality and features is requested. In the last few years a large interest on the milk microbiota composition has raised due to the impact of the microorganisms could have on the health status of the animals, on the public health and on the quality of the dairy products. Preliminary data on mammary microbiota of the ruminant species (cow, sheep and buffalo) showed that the row milk includes a complex community of microbes affected by both endogenous and esogenous factors. The present study aims to better understand the differences of the molecular mechanisms of the microbiota interaction in the Rendena\u2019s milk compared to Holstein breed. Microbial composition of the milk from 3 Rendena cows was compared to that from 3 Holstein cows from the same farm with the same management. Quarter samples were collected from each cow at different time points: dry off (T1), at calving (T2), 7-10 days after calving (T3) and 30 days after calving (T4). We analyzed somatic cell count (SCC) and bacteriological culture for each quarter. For the microbiome analysis, the bacterial DNA was extracted from each quarter using a protocol previously described (Cremonesi et al., 2005) with some modifications and the 16S rRNA gene (V3-V4 region) was analyzed by Miseq (Illumina). Bacteriological analysis showed the absence of contagious bacteria such as Staphylococcus. aureus and Streptococcus. agalactiae in both breeds. The predominant Rendena\u2019s phylum was Firmicutes (94.3%). In Holstein the milk microbiota was more complex with Firmicutes (62.6%), Proteobacteria (19.2%), Bacteriodetes (7.5%) and Actinobacteria (6.8%). The analysis of the genera showed that in Rendena cows the main microorganisms were Streptococcus (70.7%), Lactobacillus (10.4%) and Pediococcus (5.8%), whereas in the Holstein cows were Streptococci (27.1%), Staphylococci (5.5%) and Lactobacilli (4.5%). Regarding the species of the Streptococcus genus we demontrated a significant difference between the two breeds. Indeed, in the Rendena cows the 51,6% of the present Streptococci were Streptococcus thermophilus, that in the Holstein cows represent only 1.72% of the observed Steptococci. Streptococcus thermophilus is a lactic bacterium very usefull in the dairy products (fermented milks, yogourt, different cheeses). The strong presence of Streptococcus thermophilus in the Rendena milk makes it more suitable for the dairy industry. The different microbial composition of the milk from the two breeds could also have an impact on the immune response and the infections of the udder that could help to explain the high resistance to mastitis of the autoctonous Italian cow breeds. In order to better clarify this hypothesis gene expression and proteomic analysis are in progress

Studio della biodiversit&#224; del microbiota del latte bovino per la valorizzazione delle razze autoctone italiane

Una migliore conoscenza della qualit\ue0 e delle caratteristiche del latte prodotto da razze autoctone risulta necessaria ai fini della loro valorizzazione. In questi ultimi anni si \ue8 intensificato l'interesse per lo studio della composizione del microbiota del latte per l'impatto che i microrganismi presenti possono avere sia sulla salute dell'animale sia sulla qualit\ue0 e la sicurezza dei prodotti lattiero caseari (Addis et al., Molecular Biosystem, 2016). Ricerche preliminari condotte sul microbiota mammario delle principali specie di ruminanti (bovina, ovina, bufalina) hanno messo in evidenza come nel latte crudo sia presente una comunit\ue0 microbica complessa, la cui composizione \ue8 influenzata sia da fattori endogeni che esogeni (Quigley et al., FEMS Microbiol.Rev, 2013). Il presente studio mira quindi a comprendere le differenze nei meccanismi molecolari di interazione del microbiota del latte in bovine di razza Rendena rispetto alla Frisona. A tal fine \ue8 stata confrontata la composizione microbica del latte di tre bovine di razza Rendena con quella di tre bovine di razza Frisona Italiana, allevate in uno stesso allevamento e sottoposte allo stesso regime gestionale. Sono stati raccolti campioni di latte dai singoli quarti degli animali a quattro diversi tempi: alla messa in asciutta (T1), il giorno del parto (T2), 7-10 giorni dal parto (T3) e 30 giorni dal parto (T4). Per verificare lo stato di salute della ghiandola mammaria sui campioni di latte \ue8 stata eseguita la conta delle cellule somatiche e l'analisi batteriologica. Dopo aver estratto il DNA dai campioni di latte utilizzando un protocollo descritto in letteratura (Cremonesi et al., JDS, 2006), il gene 16S rRNA (regione V3-V4) \ue8 stato amplificato seguendo il protocollo standard di preparazione delle librerie Illumina e sequenziato mediante piattaforma Miseq (Illumina, San Diego, USA). L'analisi batteriologica ha mostrato l'assenza di microrganismi contagiosi nel latte di entrambe le razze analizzate. Nella razza Rendena il phylum predominante \ue8 risultato Firmicutes (94.3%), mentre nella razza Frisona Italiana il microbiota \ue8 risultato composto da Firmicutes (62.6%), Proteobacteria (19.2%), Bacteriodetes (7.5%) e Actinobacteria (6.8%). L\u2019analisi condotta a livello di genere nella Rendena ha mostrato la netta prevalenza di Streptococcus (70.7%), seguita da Lactobacillus (10.4%) e Pediococcus (5.8%), mentre nella Frisona sono stati osservati come generi prevalenti Streptococcus (27.1%), Staphylococcus (5.5%) e Lactobacillus (4.5%). Per quanto riguarda le specie del genere Streptococcus presente, \ue8 stata osservata una differenza significativa fra la razza Rendena, dove il 51.6% degli streptococchi \ue8 costituito da Streptococcus thermophilus e la razza Frisona dove lo Streptococcus thermophilus rappresenta solo l'1.72% degli streptococchi totali osservati. Streptococcus thermophilus \ue8 un batterio lattico utilizzato nella produzione di latti fermentati, yogurt e moltissimi formaggi: la sua presenza in percentuali elevate nel latte della razza Rendena rende pertanto questo latte pi\uf9 adatto alla trasformazione casearia (Quigley et al., FEMS Microbiol. Rev, 2013). Sono attualmente in corso analisi dell'espressione genica differenziale a livello della ghiandola mammaria di questi animali e lo studio delle proteine del latte mediante analisi con SDS-page e densitometria, allo scopo di acquisire maggiori conoscenze dei meccanismi molecolari, dei pathway cellulari e delle interazioni ospite-microbiota mammario. L'avvento di tecnologie high-troughput in grado di fornire un quadro completo della composizione microbica del latte consente una maggiore conoscenza delle caratteristiche di questi animali autoctoni promuovendone l\u2019allevamento e salvaguardandone cos\uec la biodiversit\ue0