Microbiological survey of raw and ready-to-eat leafy green vegetables marketed in Italy.

The presence of foodborne pathogens (Salmonella spp., Listeria monocytogenes, Escherichia coli O157:H7, thermotolerant Campylobacter, Yersinia enterocolitica and norovirus) in fresh leafy (FL) and ready-to-eat (RTE) vegetable products, sampled at random on the Italian market, was investigated to evaluate the level of risk to consumers. Nine regional laboratories, representing 18 of the 20 regions of Italy and in which 97.7% of the country's population resides, were involved in this study. All laboratories used the same sampling procedures and analytical methods. The vegetable samples were screened using validated real-time PCR (RT-PCR) methods and standardized reference ISO culturing methods. The results show that 3.7% of 1372 fresh leafy vegetable products and 1.8% of 1160 "fresh-cut" or "ready-to-eat" (RTE) vegetable retailed in supermarkets or farm markets, were contaminated with one or more foodborne pathogens harmful to human health.

[Benign uterine pathology in premenopause and transvaginal sonohysterography: personal experience]. / Patologia uterina benigna in premenopausa e isterosonografia transvaginale: Nostra esperienza.

BACKGROUND: In this study we report our experience about hysterosonography and its use for the diagnosis of benign uterine pathology in premenopausal women referred to our Hospital. METHODS: From May to October 2000, 58 patients underwent transvaginal sonohysterography. They referred to our Ultrasonography Center because of sterility, intermenstrual bleedings, menometrorrhagias or anomalous endometrial echopatterns which had been found by basal transvaginal ultrasound examination. All patients were in fertile age and were examined during the follicular phase of the ovarian cycle. The hysterosonographic examination consisted in introducing 20 cc of a physiological solution by catheter with inflating balloon for hysterosalpingography and assessment of the uterine cavity was possible thanks to the acoustic window created by the fluid which gradually distended the cavity itself. We considered as failures of the techniques those cases in which the profile of endometrial cavity was not clearly visualized. RESULTS: Sonohysterography was performable in 52 of the 58 patients. The failure of examination in 3 cases was due to inadequate distention of the uterine cavity, in 2 cases to cervical stenosis and in 1 case to the reflux of the contrast medium. Diagnosis effected with sonohysterography revealed 3 uterus bicornis, 16 endometrial polyps and 9 submucosal myomas. No ultrasound anomalies were found in 23 patients. All the women underwent a subsequent hysteroscopy which confirmed our ultrasound diagnosis. CONCLUSIONS: Our study shows that sonohysterography allows to obtain a precise diagnosis of benign uterine pathology, which generally basal transvaginal ultrasonography can only suspect. The applicability of positive and negative predictive values, of the sensitivity and specificity is limited by the small number of cases included in the study. The role of sonohysterography is more difficult to define when compared to hysteroscopy. The conclusion is drawn that this new method offers an important aid for gynecological diagnosis of benign pathology.

Endometriosis arises from implant of endometriotic cells outside the uterus: a report of active vesicouterine centrifugal fistula.

Vesicouterine fistula is rare, accounting for nearly 4% of all urogenital fistulas. Lower segment cesarean delivery is the main predisposing event but in the last few years other possible predisposing factors have been pointed out. Clinically, it can show itself in different forms and the diagnosis is often delayed although it is not difficult. We report our experience about a case of postcesarean vesicouterine fistula arising on a focus of vesical endometriosis and we discuss an eventual hypothetical pathogenetic correlation between bladder endometriosis and uterovesical fistula.

[Vesicouterine fistula and bladder endometriosis. A case report]. / Fistola vescicouterina ed endometriosi vesicale.

Vesicouterine fistula is rare, accounting nearly 4% of all urogenital fistulas. Cesarean delivery through uterine lower segment is the main predisposing event but in the last years other possible predisposing factors have been pointed out. Clinically, it can occur in different forms and the diagnosis is often delayed although it is not difficult. In this study personal experience in a case of postcesarean vesicouterine fistula arisen on a focus of bladder endometriosis is reported and an eventual hypothetical pathogenetic correlation between bladder endometriosis and vesicouterine fistula is discussed.

[Guaranteeing fetal well-being in water childbirth: is it possible?]. / Garantire il benessere fetale durante il parto in acqua: è possibile?

The criteria, which a modern obstetric department is based on, are to deliver serenely and naturally according to the mother's personal exigencies and preserving the child's right to his/her own safety. The attempt to offer the woman a natural place with respect for these principles has improved the knowledge about the physiologic changes of the female organism during labour and water birth. Our experience about water birth began on 1st of July 2000, the day of the inauguration of the new birth room of the maternal-infantile department of the hospital of Lavagna. We nursed 15 women during labour and water birth, 11 were multiparas, 4 were primiparas, the average age was 31-year-old. We used the existing criteria of maternal and fetal selection for the care of physiologic water birth with a low risk. Particularly, the fetal heart rate was monitored at least for 30 minutes before the immersion into water and then at scheduled intervals during labour. To this purpose we used a cardiotocograph provided with an ultrasound probe (with high density of crystals) and with a toco (with high sensitivity), both waterproof and wireless. In our sample the episiotomy was not performed and 3rd degree lacerations did not happen. The neonatal average weight was 3100 gr for the primiparas and 3040 gr for the multiparas, respectively. The Apgar measurement was never lower than 8. The average time of labour was 6 hours for the group of the primiparas and 4.25 hours for the multiparas, respectively. In conclusion the monitoring of fetal welfare during water labour does not substantially differ from the monitoring of traditional labour, but it requires specific equipments.