Anatomical variants of the intercostobrachial nerve and its preservation during surgery, a systematic review and meta-analysis.

BACKGROUND: The anatomic variants of the intercostobrachial nerve (ICBN) represent a potential risk of injuries during surgical procedure such as axillary lymph node dissection and sentinel lymph node biopsy in breast cancer and melanoma patients. The aim of this systematic review and meta-analysis was to investigate the different origins and branching patterns of the intercostobrachial nerve also providing an analysis of the prevalence, through the analysis of the literature available up to September 2023. MATERIALS AND METHODS: The protocol for this study was registered on PROSPERO (ID: CRD42023447932), an international prospective database for reviews. The PRISMA guideline was respected throughout the meta-analysis. A systematic literature search was performed using PubMed, Scopus and Web of Science. A search was performed in grey literature through google. RESULTS: We included a total of 23 articles (1,883 patients). The prevalence of the ICBN in the axillae was 98.94%. No significant differences in prevalence were observed during the analysis of geographic subgroups or by study type (cadaveric dissections and in intraoperative dissections). Only five studies of the 23 studies reported prevalence of less than 100%. Overall, the PPE was 99.2% with 95% Cis of 98.5% and 99.7%. As expected from the near constant variance estimates, the heterogeneity was low, I2 = 44.3% (95% CI 8.9%-65.9%), Q = 39.48, p = .012. When disaggregated by evaluation type, the difference in PPEs between evaluation types was negligible. For cadaveric dissection, the PPE was 99.7% (95% CI 99.1%-100.0%) compared to 99.0% (95% CI 98.1%-99.7%). CONCLUSIONS: The prevalence of ICBN variants was very high. The dissection of the ICBN during axillary lymph-node harvesting, increases the risk of sensory disturbance. The preservation of the ICBN does not modify the oncological radicality in axillary dissection for patients with cutaneous metastatic melanoma or breast cancer. Therefore, we recommend to operate on these patients in high volume center to reduce post-procedural pain and paresthesia associated with a lack of ICBN variants recognition.

Study of the Milkability of the Mediterranean Italian Buffalo and the Tunisian Maghrebi Camel According to Parity and Lactation Stage.

While considered as hard milkers, both buffaloes and camels are milked with equipment destined for dairy cows based on external morphological similarities with this species. This work aimed to study similarities and differences in milkability traits between Mediterranean buffaloes and Maghrebi she-camels and to evaluate the effect of parity and lactation stage. A total of 422 milk flow curves recorded with an electronic milkmeter (Lactocorder®) for both species were accessed. Milking characteristics including milk yield per milking, peak milk flow, average milk flow, duration of the main milking phase, duration of total milking, duration of various phases of milk flow, lag time and time to milk ejection, stripping yield, overmilking time and incidence of bimodal milk flow curves were evaluated for both species. Results showed that the values of milk yield per milking, duration of the main milking phase and duration of total milking were higher in buffaloes (3.98 ± 0.10 kg; 4.07 ± 0.11 min; 9.89 ± 0.21 min, respectively) compared to camels (3.51 ± 0.08 kg; 3.05 ± 0.09 min; 3.76 ± 0.09 min, respectively). However, camels had significantly higher peak and average milk flow (2.45 ± 0.07 kg/min and 1.16 ± 0.03 kg/min, respectively). Camels took significantly less time for milk ejection to occur. Only 15.49% of recorded curves were bimodal in buffaloes while 34.93% of bimodal curves were recorded for camels. Overmilking was significantly higher in buffaloes (3.64 ± 0.21 min vs. 0.29 ± 0.02 min). Parity and lactation stage had a significant effect on most studied milking traits suggesting the need for some particular practices with primiparous animals and animals at different levels of lactation for both species.

Teat morphology across five buffalo breeds: a multi-country collaborative study.

The buffalo (Bubalus bubalis) is a species of worldwide importance, raised to produce milk, meat, and hides, and often used as a working animal in rural contexts with low access to hi-tech solutions. In the present study, 100 lactating buffaloes (50 primiparous and 50 pluriparous) of five popular breeds were recruited to characterize and compare teat morphology. In particular, the focus was put on the Nili Ravi, Mediterranean, Egyptian, Bulgarian Murrah, and Azeri buffaloes raised in Pakistan, Italy, Egypt, Bulgaria, and Iran, respectively. In all countries, a longitudinal cross-section ultrasound was obtained before the milking to measure teat parameters at individual level: overall, teat canal length (TCL) averaged 24.13 mm, teat diameter (TD) 30.46 mm, cisternal diameter (CD) 17.80 mm, and teat wall (TW) 7.12 mm. The most variable trait across breeds was TCL which was positively correlated with CD and TD and negatively with TW, regardless of the teat position (front/rear or left/right). A strong negative correlation was found between TW and CD (- 0.43). The analysis of variance revealed that the fixed effect of breed significantly affected all the traits except TD. In fact, Bulgarian Murrah, Azeri, and Egyptian buffaloes presented the greatest estimate of TCL, whereas NR the smallest (14.70 mm). The TW was maximum in Nili Ravi, Egyptian, and Mediterranean buffaloes, with estimates equal to 8.19, 7.59, and 8.74 mm, respectively. Nili Ravi also showed the greatest TL (82.39 mm). In terms of CD, the lowest least square mean was that of Mediterranean buffaloes (12.14 mm). Primiparous and pluriparous buffaloes differed in terms of TD, TW, and TL, with older animals presenting the highest least square mean. In terms of position, instead, significant differences were observed for TD, CD, and TL when comparing front and rear teats, as left and right teats did not differ. Teat anatomy includes a set of heritable morphological features and is therefore breed-dependent. Differences presented in this study could be attributed to the divergent breeding objective and selective pressure across the five breeds; e.g., in some cases such as Mediterranean buffalo, selection for decades was oriented to improve milk production and milkability and achieve optimal conformation for mechanical milking. A better understanding of the mammary gland anatomical descriptors can be informative of the history of a breed and could provide useful insights to guide possible selection.

Inhibitory Effect against Listeria monocytogenes of Carbon Nanoparticles Loaded with Copper as Precursors of Food Active Packaging.

Human listeriosis is a serious foodborne disease of which outbreaks are occurring increasingly frequently in Europe. Around the world, different legal requirements exist to guarantee food safety. Nanomaterials are increasingly used in the food industry as inhibitors of pathogens, and carbon nanomaterials are among the most promising. In the present study, novel carbon nanoparticles loaded with copper (CNP-Cu) were prepared, and their antimicrobial activity against Listeria monocytogenes was assessed. CNPs of two sizes were synthesized and characterized by dynamic light scattering (DLS), electrophoretic light scattering (ELS) and electron microscopy (EM). The minimum inhibitory concentration (MIC) of CNP-Cu was determined in accordance with the available standard. To get insights into its mechanism of action, the release of copper ions into a cell media was assessed by inductively coupled plasma optical emission (ICP-OE), and the ability of loaded CNPs to generate cytotoxic reactive oxygen species (ROS) was evaluated by EPR spectroscopy. Finally, the extent of release of copper in a food simulant was assessed. The results demonstrated the antimicrobial effectiveness of CNP-Cu, with growth inhibition up to 85% and a release of copper that was more pronounced in an acidic food simulant. Overall, the results indicate CNP-Cu as a promising agent for the design of active food packaging which is able to improve food shelf-life.

A retrospective study on dioxins and dioxin-like polychlorinated biphenyls in milk and dairy products from the Latium region (Italy) over a 7-year study period (2011-2017).

This study reports the data of polychlorinated dibenzo-p-dioxins (PCDDs), -furans (PCDFs), and polychlorinated biphenyls dioxin-like (dl PCBs) measured in a total of 260 samples of the dairy supply chain collected over a period of 7 years (2011-2017) in the Latium region (Italy). Levels and average profiles of congeners were reported for each group of the analyzed dairy matrices, and any differences between different sampling strategies were considered (around likely pollutant sources or casual sampling). Of the samples, 95.4% resulted compliant with the regulated levels; only samples belonging to the "sheep bulk milk" matrix were found to be above either the action levels or the maximum levels (tot. 12 samples). Raw milk of the sheep species showed the highest averages (PCDD/F 0.248 and dl PCB 0.966 WHO TEQ pg/g of fat) compared to the milk of other species. The buffalo milk showed a content of dl PCB significantly lower (dl PCB: 0.371 WHO TEQ pg/g of fat) than the sheep milk (p<0.05). Dioxins were found to be superior to furans in almost all dairy products, except in the noncompliant samples where furans were higher. The OCDD was found to be the most abundant congener in almost all dairy products. This study provides a first list of reference values for background contamination of the dairy supply chain in the Latium region. These pre-existing values will be useful in all cases of environmental pollution to identify critical situations.

Influence of milking units and working vacuum level on the mechanical milking of goats.

The objectives of this study were to evaluate and compare the effect of working vacuum levels (35 and 44 kPa) and liners dimensions (mouthpiece lip diameter and overall length, 20-185 and 22-170 mm) on the main milking characteristics of goats. The results highlight that both the working vacuum level and the liner dimension have influenced the milk flow curve parameters. The maximum variations were found for peak flow rate, which increased significantly with liner dimensions of 20-185 mm at a working vacuum level of 44 kPa as well as average milk flow rate and for plateau phase duration. The incorrect adoption of operative parameters and unsuitable milking machine components, might affect the performance of the mechanical milking and negatively affecting animal productions and welfare.

Milk Somatic Cell Count and Polymorphonuclear Cells in Healthy Quarters of Cows That Underwent Blanket and Selective Dry Therapy: An Italian Case Study.

The incidence of mastitis increases with parity in dairy cattle and multiparous cows are often treated at drying off to limit the risk of udder health issues and support mammary gland tissues recovery. Milk somatic cells count (SCC, cells/mL) comprises different white blood cells fractions and is worldwide used to monitor and genetically improve udder health. Nevertheless, only certain SCC fractions increase when an udder inflammation occurs. Considering that antibiotic use for preventive purposes will be forbidden in 2022, we compared two different dry therapy protocols, blanket (BDCT) and selective (SDCT), on different SCC fractions in healthy quarters milk. Multiparous Holstein cows were enrolled in a randomized controlled trial and SCC, neutrophils, macrophages, lymphocytes, polymorphonuclear cells (PMN) and differential somatic cell count (DSCC) recorded after the experimental drying off were available. Significant differences were observed between the two protocols, with more favorable parameters in BDCT than SDCT cows. Results showed that moving from BDCT to SDCT is expected to significantly increase some SCC fractions, such as PMN, in healthy quarters. The baseline SCC level at the onset of lactation was greater in cows under SDCT than BDCT. Although not significant, clinical mastitis prevalence was numerically lower in BDCT (7.32%) than SDCT (8.62%). In this study we referred to a limited number of cows, but still findings will be useful to improve the knowledge on the impact of SDCT on milk SCC fractions in healthy quarters.

Effects of the Physiological Status and Diet on Blood Metabolic Parameters in Amiata Dairy Donkeys.

Body weight changes and blood metabolic parameters in jennies feeding two different diets and in three physiological statuses were investigated (maintenance vs. pregnancy; maintenance vs. lactation). The relationships between blood metabolic profile and milk quality were also evaluated. Fourteen jennies were allocated to two groups (1: pregnant/lactating; 2: non-pregnant, non-lactating). Pregnant jennies and maintenance jennies (during the first 10-week measurement period) fed a diet consisted of ad libitum grass hay (diet 1); lactating jennies and maintenance jennies (during the last 10-week measurement period) fed ad libitum grass hay plus 2 kg/head/day of concentrate (diet 2). Blood sampling was performed on the jennies of both groups; individual milk samples were also collected during the first 70 days in milk. Higher blood NEFA (p < 0.05) were found in pregnant compared to maintenance jennies (diet 1) (68 vs. 37 µmol/L). Lactating jennies showed higher (p < 0.01) average blood NEFA (268 vs. 26 µmol/L) and glucose (66 vs. 55 mg/dL) compared to the maintenance (diet 2). Blood glucose was positively correlated to milk fat (p < 0.05), while negative significant correlations between de novo milk fatty acids and NEFAs were observed. Positive correlations between plasma B-HBA and somatic cell count (p < 0.01) were also found.

The Management of Acute Colonic Diverticulitis in the COVID-19 Era: A Scoping Review.

Background and Objective: During the COVID-19 pandemic, health systems worldwide made major changes to their organization, delaying diagnosis and treatment across a broad spectrum of pathologies. Concerning surgery, there was an evident reduction in all elective and emergency activities, particularly for benign pathologies such as acute diverticulitis, for which we have identified a reduction in emergency room presentation with mild forms and an increase with more severe forms. The aim of our review was to discover new data on emergency presentation for patients with acute diverticulitis during the Covid-19 pandemic and their current management, and to define a better methodology for surgical decision-making. Method: We conducted a scoping review on 25 trials, analyzing five points: reduced hospital access for patients with diverticulitis, the preferred treatment for non-complicated diverticulitis, the role of CT scanning in primary evaluation and percutaneous drainage as a treatment, and changes in surgical decision-making and preferred treatment strategies for complicated diverticulitis. Results: We found a decrease in emergency access for patients with diverticular disease, with an increased incidence of complicated diverticulitis. The preferred treatment was conservative for non-complicated forms and in patients with COVID-related pneumonia, percutaneous drainage for abscess, or with surgery delayed or reserved for diffuse peritonitis or sepsis. Conclusion: During the COVID-19 pandemic we observed an increased number of complicated forms of diverticulitis, while the total number decreased, possibly due to delay in hospital or ambulatory presentation because of the fear of contracting COVID-19. We observed a greater tendency to treat these more severe forms by conservative means or drainage. When surgery was necessary, there was a preference for an open approach or a delayed operation.

Ilioinguinal Nerve Neurectomy is better than Preservation in Lichtenstein Hernia Repair: A Systematic Literature Review and Meta-analysis.

OBJECTIVE: This study aimed to evaluate the incidence of chronic groin pain (primary outcome) and alterations of sensitivity (secondary outcome) after Lichtenstein inguinal hernia repair, comparing neurectomy with ilioinguinal nerve preservation surgery. The exact cause of chronic groin postoperative pain after mesh inguinal hernia repair is usually unclear. Section of the ilioinguinal nerve (neurectomy) may reduce postoperative chronic pain. METHODS: We followed PRISMA guidelines to identify randomized studies reporting comparative outcomes of neurectomy versus ilioinguinal nerve preservation surgery during Lichtenstein hernia repairs. Studies were identified by searching in PubMed, Scopus, and Web of Science from April 2020. The protocol for this systematic review and meta-analysis was submitted and accepted from PROSPERO: CRD420201610. RESULTS: In this systematic review and meta-analysis, 16 RCTs were included and 1550 patients were evaluated: 756 patients underwent neurectomy (neurectomy group) vs 794 patients underwent ilioinguinal nerve preservation surgery (nerve preservation group). All included studies analyzed Lichtenstein hernia repair. The majority of the new studies and data comes from a relatively narrow geographic region; other bias of this meta-analysis is the suitability of pooling data for many of these studies. A statistically significant percentage of patients with prosthetic inguinal hernia repair had reduced groin pain at 6 months after surgery at 8.94% (38/425) in the neurectomy group versus 25.11% (113/450) in the nerve preservation group [relative risk (RR) 0.39, 95% confidence interval (CI) 0.28-0.54; Z = 5.60 (P < 0.00001)]. Neurectomy did not significantly increase the groin paresthesia 6 months after surgery at 8.5% (30/353) in the neurectomy group versus 4.5% (17/373) in the nerve preservation group [RR 1.62, 95% CI 0.94-2.80; Z = 1.74 (P = 0.08)]. At 12 months after surgery, there is no advantage of neurectomy over chronic groin pain; no significant differences were found in the 12-month postoperative groin pain rate at 9% (9/100) in the neurectomy group versus 17.85% (20/112) in the inguinal nerve preservation group [RR 0.50, 95% CI 0.24-1.05; Z = 1.83 (P = 0.07)]. One study (115 patients) reported data about paresthesia at 12 months after surgery (7.27%, 4/55 in neurectomy group vs. 5%, 3/60 in nerve preservation group) and results were not significantly different between the two groups [RR 1.45, 95% CI 0.34, 6.21;Z = 0.51 (P = 0.61)]. The subgroup analysis of the studies that identified the IIN showed a significant reduction of the 6th month evaluation of pain in both groups and confirmed the same trend in favor of neurectomy reported in the previous overall analysis: statistically significant reduction of pain 6 months after surgery at 3.79% (6/158) in the neurectomy group versus 14.6% (26/178) in the nerve preservation group [RR 0.28, 95% CI 0.13-0.63; Z = 3.10 (P = 0.002)]. CONCLUSION: Ilioinguinal nerve identification in Lichtenstein inguinal hernia repair is the fundamental step to reduce or avoid postoperative pain. Prophylactic ilioinguinal nerve neurectomy seems to offer some advantages concerning pain in the first 6th month postoperative period, although it might be possible that the small number of cases contributed to the insignificancy regarding paresthesia and hypoesthesia. Nowadays, prudent surgeons should discuss with patients and their families the uncertain benefits and the potential risks of neurectomy before performing the hernioplasty.

A rare case of polypoid primary anorectal melanoma with subsequent giant stomach metastasis: A gastrointestinal involvement of both primary and metastatic mucosal melanoma.

Melanoma can involve the gastrointestinal apparatus as both primary and metastatic lesions. Primary anorectal mucosal melanoma (ARMM) and metastatic gastric melanoma are rare entities and usually resulted in a poor prognosis. We presented a case of a 61-year-old man who after the complete excision of an ARMM developed a gastric metastasis after almost three years form the complete tumour excision. Upon esophagogastroduodenoscopy, a giant ulcered mass resulted in melanoma metastasis. The patient underwent a near-total gastrectomy. After five months of follow-up, the patient is disease-free. The incidence of ARMMs is increasing, highlighting the necessity of new prevention and treatment strategies in order to achieve a better prognosis for these patients. There are no known risk factor for ARMMs but surgery, together with the combination of anti-CTLA-4 and anti-PD-1 antibodies, are promising therapeutic options. Early and aggressive treatments are required, together with a strict multidisciplinary approach.

Dermatome Mapping Test in the analysis of anatomo-clinical correlations after inguinal hernia repair.

BACKGROUND: Nerve identification is recommended in inguinal hernia repair to reduce or avoid postoperative pain. The aim of this prospective observational study was to identify nerve prevalence and find a correlation between neuroanatomy and chronic neuropathic postoperative inguinal pain (CPIP) after 6 months. MATERIAL: A total of 115 patients, who underwent inguinal hernia mesh repair (Lichtenstein tension-free mesh repair) between July 2018 and January 2019, were included in this prospective observational study. The mean age and BMI respectively resulted 64 years and 25.8 with minimal inverse distribution of BMI with respect to age. Most of the hernias were direct (59.1%) and of medium dimension (47.8%). Furthermore, these patients were undergoing Dermatome Mapping Test in preoperatively and postoperatively 6 months evaluation. RESULTS: Identification rates of the iliohypogastric (IH), ilioinguinal (II) and genitofemoral (GF) nerves were 72.2%, 82.6% and 48.7% respectively. In the analysis of nerve prevalence according to BMI, the IH was statistically significant higher in patients with BMI < 25 than BMI ≥ 25 P (< 0.05). After inguinal hernia mesh repair, 8 patients (6.9%) had chronic postoperative neuropathic inguinal pain after 6 months. The CPIP prevailed at II/GF dermatome. The relation between the identification/neurectomy of the II nerve and chronic postoperative inguinal pain after 6 months was not significant (P = 0.542). CONCLUSION: The anatomy of inguinal nerve is very heterogeneous and for this reason an accurate knowledge of these variations is needed during the open mesh repair of inguinal hernias. The new results of our analysis is the statistically significant higher IH nerve prevalence in patients with BMI < 25; probably the identification of inguinal nerve is more complex in obese patients. In the chronic postoperative inguinal pain, the II nerve may have a predominant role in determining postoperative long-term symptoms. Dermatome Mapping Test in an easy and safe method for preoperative and postoperative 6 months evaluation of groin pain. The most important evidence of our analysis is that the prevalence of chronic pain is higher when the nerves were not identified.

The Effect of Pre-milking Stimulation on Teat Morphological Parameters and Milk Traits in the Italian Water Buffalo.

Water buffaloes (Bubalus bubalis) are very sensitive to environmental stimulus before and during milking, and this explains why disrupted milk ejections due to blood oxytocin level instability are frequent in this species. According to the literature, the manual stimulation (MS) of teats before milking promotes oxytocin release and allows milk ejection to start within 2-3 min. However, the pre-milking stimulation of teats is not always part of the milking routine in Italian buffalo farms; moreover, buffaloes with unstable milk let-down are sometimes treated with exogenous oxytocin (OX). Different types of pre-milking stimulation can impact differently on the mammary gland epithelium and structures and, therefore, on milk yield. In this study, we observed the changes in teat morphological traits before and after the application of three types of stimuli, i.e., no manual stimulation (NS), MS, and OX, in buffaloes reared in an Italian dairy farm. In particular, measurements were available for 23 and 21 buffaloes for front and rear teats, respectively. Subsequently, the effect of the pre-milking stimulation type was estimated on teat morphological characteristics and on milk traits recorded after the application of stimuli. The results showed that the teat canal length was shorter (P < 0.05) after stimulation in the case of MS and OX compared to NS. Cistern diameter was overall greater for MS and lower for OX. On the contrary, teat wall thickness was greater and lower for OX and MS, respectively. Milk yield and quality (fat, protein, and somatic cell score) were similar across the three types of pre-milking stimulation. In perspective, the impact of these types of pre-milking stimulation should be evaluated on a large scale, and the focus might be put on mammary gland epithelium integrity, mastitis incidence, and other udder health indicators in milk, e.g., electrical conductivity, differential somatic cell count, lactose content, and sodium and chloride concentration.

On the Effect of the Temperature-Humidity Index on Buffalo Bulk Milk Composition and Coagulation Traits.

Little is known about the effects of high levels of environmental temperature and humidity on milk yield and quality in buffaloes since this species is known to be more heat tolerant than cattle. However, the distribution of sweat glands and the dark skin color can negatively affect heat tolerance. Moreover, due to increased global temperatures, concerns regarding heat stress and thermoregulation in dairy animals, including buffaloes, have been extended to the northern hemisphere. In this study, the effects of both the temperature-humidity index (THI) and the maximum daily temperature-humidity index (MTHI) were estimated on bulk milk traits, namely fat, protein, lactose, urea content, pH levels, somatic cell score, coagulation properties, and bacteria count. The dataset consisted of repeated data from 99 Mediterranean water buffalo farms, and mixed models were used for the analyses. Supporting the negative correlations observed, bulk milk fat, protein, and lactose content were significantly lower when THI and MTHI were higher. Similarly, milk pH was lower when THI and MTHI were high; however, high levels of THI or MTHI seemed to not be markedly associated with the milk's coagulation ability. According to both analysis of variance and correlations, the somatic cell score was not significantly affected by the THI and MTHI. This is the first study based on a large dataset that evaluates the impact of high temperature and humidity in Italian buffalo milk and that provides correlations with traits of interest for the dairy industry, i.e., milk acidity and coagulation ability. In general, findings show that the effects of elevated THI and heat stress on bulk milk quality in buffalo is less evident than in cattle. These preliminary results intend to open debate on the issue of heat stress in dairy buffaloes that are reared in temperate regions. Further studies should focus on individual milk and performance and should investigate the relationship between high THI and buffalo fertility, behavior, and welfare.

Study of Milkability and Its Relation With Milk Yield and Somatic Cell in Mediterranean Italian Water Buffalo.

Milkability is defined as the ability of an animal to give a regular, complete, and rapid milk secretion by the mammary gland in response to a proper milking technique. The aim of the present study was to investigate the relationship of milkability pattern with milk yield and somatic cell score in buffaloes. Milk yield and milkability can be observed through the milk flow profiles recorded by an electronic milkmeter (Lactocorder). A total of 2,288 milk flow curves of Mediterranean Italian buffaloes were used for one-way analysis of variance, and eight milk emission patterns were studied. The most represented milk flow curve was type 3 (27.32%), followed by type 6 (17.79%) characterized by a very long plateau phase. The less represented curve was type 1 (4.41%) characterized by long lag time and low peak flow rate. According to analysis of variance, milk yield ranged from 2.21 to 5.22 kg per milking for types 1 and 6, respectively, whereas the peak flow rate was minimum (0.50 kg/min) and maximum (1.73 kg/min) for types 1 and 4, respectively. The total milking time was on average 11.29 ± 3.68 min; lag time and milk emission time averaged 2.19 ± 2.34 min and 4.30 ± 2.33 min, respectively. The 12.5% (n = 286) of total curves were classified as bimodal and 60 of these were found in type 4. Based on literature, type 4 curves are representative of very short teat canals and very high milk flow. Average somatic cell score was 3.63 ± 1.67 units, with maximum least-squares mean found for type 1 and minimum for type 6. Buffaloes showing curves of type 5 and 6 were characterized by the greatest milk yield at milking, lowest somatic cell score, and lowest milking time. Results of the present study evidenced that such traits could be used in the dairy buffaloes as indicators to improve udder health and milkability.

Accuracy and feasibility of SentiMag technique for localization of non-palpable breast lesions.

BACKGROUND: Non-palpable breast lesions are more frequent now than in the past due to the attention toward the mammary pathology and the screening diffusion; the marking of such lesions is very important for a successful surgery. The SentiMag System uses a magnetic marker that is inoculated transdermal in the breast through an 18-gauge needle. METHODS: Between April 1st and June 30th, 2018, 16 patients with non-palpable breast lesions were selected and subjected to surgery using the SentiMag System in our Unit. They were women with a mean age of 52 years (range 30-84 years). Seven of 16 (43.7%) had a borderline preoperative histological or cytological diagnosis (C3/B3), and nine (56.3%) a diagnosis of carcinoma (C5/B5). Six (37.5%) were marked on ultrasound guidance and 10 (62.5%) on a mammography stereotaxic guide. RESULTS: The time for the marker positioning ranged from 2 to 10 minutes. The radiological control of the surgical specimen always showed the presence of both the lesion and the marker, both centered within the specimen and intact. The pathology revealed seven benign lesions, one in-situ, and eight infiltrating carcinomas. CONCLUSIONS: The SentiMag represents a fast and safe preoperative marking system of non-palpable breast lesions, cutting the radio exposure for personnel and patients. The marker is not displaced over time and it is rapid to place and easy to locate intraoperatively, allowing a clear dissection plane around the lesion. Thus, this reduces the amount of gland removed, improving the aesthetic result mostly in small breasts.

Farms at risk from environmental pollution: a proposal for a risk ranking procedure.

OBJECTIVES: to produce a methodology for the risk ranking of farms located around proven or potential sources of contamination to prioritize the monitoring procedures in food production. DESIGN: environmental factors that can favour the risk of contamination of products of animal origin (POAO) around a pollutant source were identified. A scale of standardized scores was produced for each risk factor (RF) in order to obtain a risk-based classification. Subsequently, an algorithm was developed to obtain a relative risk assessment (RRA). SETTING AND PARTICIPANTS: in order to validate the proposed methodology, data of 80 livestock farms in a polluted area, enrolled in a previous study, were subjected to the RRA. Results of RRA were compared with contamination data. MAIN OUTCOME MEASURES: seven RFs were included in a mathematical formula used to classify each farm. RESULTS: a scoring system was produced for each RFs and an algorithm was developed to obtain RRA which is an estimate of the farm probability of having POAO contamination in comparison to other farms located in the same area potentially affected by chemical pollution based exclusively on site-specific environmental characteristics. In the case study used for validation, a significant relationship between RRA and contamination data was found. CONCLUSIONS: the proposed methodology is a useful tool to support the authorities responsible for the food safety in carrying out the monitoring of POAO in areas subject to environmental risks. It helps to rationalize resources and make controls more effective.

Reduction of postoperative lymphorrhoea in patients undergoing radical lymphadenectomy for stage III melanoma: prospective study using collagen-fibrin patches.

BACKGROUND: Radical lymph nodes dissection (RLND) is the standard procedure for regional control of disease in patients with metastatic melanoma (stage III). Because of its aggressiveness, lymphorrhoea is a constant problem in postoperative. METHODS: In this prospective nonrandomized study with a retrospective analysis of data, patients undergoing surgical treatment of axillary or iliac-inguinal RLND received standard treatment plus a collagen-fibrin sealant patch (TachoSil) (N.=50) or standard treatment alone (N.=50). The first endpoint was the comparison between the treated population and the control group, in terms of persistence of drainage and average daily volume of lymphorrhoea. The second aim was to relate patients' BMI, volume of lymphorrhoea and time of drainage in the two groups. RESULTS: In the comparison between the two groups receiving or not the treatment with collagen-fibrin patch, we found an average difference both in the volume of daily lymphorrhoea (42.91±6.61 cc) and in the persistence of drainage (9.292±1.644 days) with P value <0.0001. Besides, the collagen-fibrin patch was actually effective in reducing lymphorrhoea and time of drainage, regardless of patients' BMI. CONCLUSIONS: The results of this study confirm and support the starting thesis: TachoSil is an effective tissue sealant able to reduce lymphorrhoea and drainage removal times following a radical lymphadenectomy, independently from the BMI.

An Evaluation of the Clotting Properties of Three Plant Rennets in the Milks of Different Animal Species.

Cynara cardunculus, Carica papaya and Ficus carica extracts are proposed as milk coagulants herein. Their coagulation efficiency was measured in bovine, buffalo, goat and sheep milk incubated at different temperatures. The milk-clotting and proteolytic activities as well as the lactodynamographic parameters were determined considering animal rennet as a reference coagulant. The vegetable coagulant, extracted from C. cardunculus pistils, proved to be the most suitable milk-clotting enzyme for cheesemaking, since it possesses similar milk clotting properties to conventional calf rennet. F. carica latex, but seemed to be a promising alternative coagulant at higher temperatures. The strong proteolytic activity of papain caused poor milk coagulation in all milk samples. To conclude, this result also supports the original hypothesis of this study that the excessive proteolytic nature of plant coagulants can negatively affect the cheesemaking process. The optimization of using a plant rennet in a dairy application can be done by selecting the appropriate plant rennet with a consistent clotting efficiency. These innovative manufacturing processes may also lead to the optimization and production of new cheese varieties.