Cases Of Endometritis Research Articles

Human leukocyte antigen, isotype DR (HLA-DR) expression in the normal endometrium and in endometrial pathology

BACKGROUND: Human leukocyte antigen, isotype DR (HLA-DR) expression is associated with inflammatory and autoimmune diseases. It is also found on the surface of tumor cells. The role of HLA-DR in endometrial pathology has not been sufficiently studied. AIM: The aim of this study was to determine HLA-DR expression features in the endometrium under normal and pathological conditions. MATERIALS AND METHODS: We performed immunohistochemical examination of endometrial biopsy specimens, namely, 18 cases of endometrioid carcinomas, 139 cases of chronic endometritis, and 37 cases of endometrial polyps. The control group included 50 cases of the endometrium without pathology. Positive HLA-DR expression was detected as brown staining of varying intensity of immune cells of the cytogenic stroma, as well as the cytoplasm and membranes of endometrial epithelial cells. The average number of positively stained stromal cells in ten visual fields was counted. HLA-DR expression in the cytoplasm and on the membrane of endometrial epithelial cells was assessed semi-quantitatively as weak (low) (with staining up to 50% of the glands) or pronounced (high) (with staining more than 50% of the glands). RESULTS: HLA-DRim expression was detected on immune cells of the cytogenic stroma of the endometrium in all of the study groups. HLA-DR expression in the endometrial epithelium was characterized by two main immunophenotypes — negative and positive. Negative HLA-DR expression was found in 55.6% of endometrial cancer cases, in 25.2% of chronic endometritis cases, in 27.7% of endometrial polyp cases, and in all cases of the normal endometrium. The positive HLA-DR (high) immunophenotype was found in 21.6% of chronic endometritis cases, in 28.6% of endometrial polyp cases, and in 16.7% of endometrial cancer cases. Pronounced HLA-DR expression in the epithelium was associated with a high HLA-DR level in the cytogenic stroma and a significantly frequent detection of HLA-DR+ lymphoid follicles in endometrial cancer. The positive HLA-DR (low) immunophenotype was established in 51.8% of chronic endometritis cases and in 27.8% of endometrial polyp cases, and in 27.7% of endometrial cancer cases, and was associated with low HLA-DR levels in the stroma. CONCLUSIONS: The revealed heterogeneity of HLA-DR expression in chronic inflammation and endometrial cancer allows for distinguishing two main immunophenotypes of endometrial cancer, namely, with negative and positive HLA-DR expression. HLA-DR may be an early predictor of adverse background endometrium and endometrial cancer. The positive HLA-DR immunophenotype of endometrial cancer probably indicates a specific mechanism of carcinogenesis associated with chronic inflammation and requires further comprehensive clinical, morphological and molecular genetic research.

An economic evaluation of sensor-assisted health monitoring in dairy farming using the example of a rumen bolus.

The study investigates the economics of sensor-assisted dairy health management and indicates a certain economic potential in the use of a commercial rumen bolus capable of tracking activity and core body temperature. The economic evaluation was performed applying a stochastic model with the net return (NR) of investment of the sensor system as the target variable. The calculated NR considers the gross margin (GM) for both sensor-assisted and visual health monitoring, time savings through sensor-assisted monitoring, additional time spent addressing false positive messages from the sensor system, labor costs, and all costs associated with the investment in the sensor system. The analysis relies on a data set acquired from a dairy research and demonstration farm on which 65 dairy cows were equipped with the sensor system. A comparison of health-related messages issued by the rumen bolus with disease diagnoses shows that the sensor system issued a message in 7 of 11 cases of retained placenta (sensitivity = 64%), in 19 of 31 cases of clinical hypocalcemia (sensitivity = 61%), in 30 of 70 cases of mastitis (sensitivity = 43%), in 6 of 24 cases of metritis (sensitivity = 25%), and in 2 of 42 cases of diseases of the locomotor system (sensitivity = 5%) in a defined observation period, in many cases several days before the visual diagnosis. SimHerd (A/S Viborg, Denmark) was applied to determine the GM as a function of incidence, somatic cell count, risk of a mild case of disease, and days of milk withdrawal. In a workshop, veterinarians (n = 9) used the data set to assess the impact of using the sensor system on these parameters. The empirical distributions given by the veterinarians' individual assessments were used to model the parameters considered in the calculation of the "sensor-assisted" GM. For the modeled Holstein herds with a milk yield of 9,000 kg, simulation results show that average NR of investment ranges from +€23 to +€119 per cow per year for a herd of poor health, from -€12 to +€84 per cow per year for a herd of average health, and from -€33 to +€63 per cow per year for a herd of good health, depending on the scenario. The assumptions made regarding changes in labor had a strong influence on the calculated NR of investment. For a full economic evaluation of the sensor system, other functions (estrus detection, calving detection) and functional extensions (e.g., monitoring rumination) have to be considered.

Monitoring of subclinical endomeritis in cows

The article presents the results of research on the spread of various forms of endometritis in cows. Subclinical endometritis was most often recorded in cows of various farms. This form of endometritis was found in 35.0% of cows in JSC "PZ Meliorator", 33.93% in UNPO "Mummovskoye" and 26.35% in LLC "Stepnoye" of the Saratov region. Endometritis was noticeably more common in red-mottled cows. Clinical and laboratory studies have shown a clearly pronounced seasonal pattern of subclinical endometritis in cows. If in January – February this form of endometritis was registered in 15.91 – 24.56% of females, then in March - May it was 1.21-2.00 times more often. At a later date (September-December), a significant decrease in the number of cases of endometritis was observed - from 9.09 to 12.28%. Regardless of the breed, endometritis most often occurred at the age of 3-4 years (34.09 – 42.11%). At an older age (5-6 years), there is a decrease in cases of endometritis by 10.71; 7.02 and 9.09%, respectively. As the age of the animals increases further, there is an increase in the number of cases of subclinical endometritis in cows of all breeds.

Comparative Efficacy of Single-Dose versus Multiple-Dose Antibiotic Prophylaxis in Reducing Postoperative Infections in Elective Cesarean Deliveries

Cesarean Sections (CS) were common surgeries that may lead to complications like endometritis and Surgical Site Infections (SSIs). While prophylactic antibiotics reduce these risks, the ideal dosing regimen remains debated. Objective: To evaluates whether a single or multiple-dose antibiotic regimen offers better protection against infections in patients undergoing planned cesarean sections. Methods: A six-month quasi-experimental study was conducted from October 1, 2020, to March 30, 2021, at Lady Reading Hospital in Peshawar. Eighty-two women scheduled for elective CS were assigned into two groups: one received a single 1g dose of intravenous cefazolin before surgery, and the other received the same initial dose followed by two additional doses every eight hours. Primary outcomes assessed were the incidence of endometritis and SSIs within 30 days post-surgery. Results: Postpartum infections were significantly lower in the multiple-dose group (4.9%) compared to the single-dose group (19.5%, p = 0.039). The multiple-dose group also had fewer SSIs (4.9% vs. 14.6%, p = 0.140) and no cases of endometritis (0% vs. 4.9%, p = 0.154), though these differences were not statistically significant. There were no significant differences in adverse drug reactions, hospital stay duration, or antibiotic resistance development between the groups. Conclusions: Multiple-dose antibiotic regimens may reduce infection rates in planned CS without increasing adverse effects or antibiotic resistance. Further studies were needed to confirm these findings and optimize prophylactic strategies.

Histopathologic patterns of female genital tuberculosis with clinical correlation: a 10-year (2013–2022) retrospective cross-sectional study

ObjectiveUnderdiagnosis of female genital tuberculosis (FGTB) often leads to infertility. In this study, we aimed to determine the site and histopathologic patterns of FGTB and its correlation with clinical presentation and acid-fast bacilli (AFB) status.MethodsA retrospective cross-sectional study was conducted on 122 patients with a histopathological diagnosis of FGTB at the Department of Pathology, College of Health Sciences (CHS), Tikur Anbessa Specialized Hospital (TASH), Addis Ababa University (AAU), from January 1, 2013, to August 30, 2022.ResultsFemale genital tuberculosis was found in 0.94% of the gynecology specimens examined. The most common presentations were menstrual disturbance, abdominopelvic pain, and infertility. Among patients with FGTB, 4.6% exhibited misleading clinical and radiologic findings, leading to suspicion of malignancy and subsequent aggressive surgical management. The endometrium was the most frequently affected organ, followed by the fallopian tube, ovary, cervix, and vulva. In the majority of tuberculous endometritis cases (53.3%), histopathology revealed early-stage granulomas. Acid-fast bacilli were found in a significant proportion (42.6%) of FGTB tissues with TB histopathology. The ovary had the highest rate of AFB detection, followed by the fallopian tube, endometrium, and cervix.ConclusionFemale genital tuberculosis should be considered in reproductive-age women presenting with menstrual irregularities, abdominopelvic pain, infertility, or an abdominopelvic mass. The endometrium is commonly affected, displaying early granulomas with low AFB positivity.

Comparison between intrauterine application of an antibiotic and an herbal product to treat clinical endometritis in dairy cattle – A randomized multicentre field study

Uterine diseases are main indications for antibiotic use in dairy cows. To test a non-antibiotic treatment option, we compared the effect of an intrauterine cephapirin (Metricure®; cefapirin benzathin 500 mg per dosis; CEPH) with an intrauterine applied herbal product (25 ml of EucaComp® PlantaVet containing alcoholic extracts of Calendula officinalis L., Mellissa officinalis L., Origanum majorana L. and Eucalyptus globulus Labill. (EUC)) on the clinical cure of endometritis.Examinations of 816 cows between 21 and 35 days after calving were performed and cases of clinical endometritis (n = 169) were included. Diagnosis based on a scoring system for vaginal discharge. Study animals were randomly assigned to one of two treatment groups and treated immediately. After excluding animals with incomplete datasets, 136 cows (EUC: n = 61; CEPH: n = 75) remained for the final analysis.In total, 64% (EUC: 61%, CEPH: 67%) of analysed endometritis cases were considered as clinically cured 14 ± 2 days after the first treatment, 15% stayed uncured after the application of a maximum of two consecutive treatments, leading to an overall clinical cure rate of 85% (EUC: 82%, CEPH: 88%). No statistically difference in clinical cure rates could be observed between both treatment groups nor 14 ± 2 days after the first treatment (p = 0.956) neither regarding the overall cure rate (p = 0.923).In conclusion, the clinical cure of dairy cows' endometritis after the intrauterine application of the herbal product was non-inferior to the intrauterine application of the antibiotic cephapirin. These results could contribute to reduce the antimicrobial use in the daily veterinary routine treatment of endometritis.

Udder, Claw, and Reproductive Health in Genomic Selection of the Czech Holstein.

The aim of this study was to construct an enhanced selection index using the genomic and economic parameters of new health disorders and current production and functional traits. Genomic evaluation for the incidence of clinical mastitis (CM), three claw disease traits, retained placenta (RET), metritis (MET), and cystic ovaries (CYS) was performed using linear animal models based on producer-recorded data. Good correlations among the health disorders were found, and their heritability estimates did not exceed 7%. Economic weights (EWs) for the health disorders were EUR -132.10 for CM, EUR -128.87 for overall claw diseases, EUR -52.10 for RET, EUR -80.48 for MET, and EUR -16.16 for CYS. These EWs indicate changes in the present value of the annual profit per cow when increasing the incidence of the traits by one case per cow year. Selection using the enhanced index resulted in favourable responses for most of the new health disorders (e.g., -0.001 and -0.006 cases of RET and MET per cow year, respectively), and also in the current breeding objective traits (+49 kg of milk, -0.02% of calf losses). An index contribution of 7% for the new health disorders was assessed as acceptable for the breeders.

Success of different therapies for bacterial endometritis in stud farm practice

Bacterial endometritis is a major problem in equine reproduction usually treated with antibiotics, however reports of success rates are scarce. This study collected data from mares diagnosed with intrauterine bacterial growth and compared the outcome of different therapies for bacterial endometritis in German stud farm practice. Data on mares with positive uterine culture results were collected retrospectively in veterinary practices (n = 5; 2018-2022). Information relating to 30 factors (mare, diagnostics, therapy, pregnancy rate) of bacterial endometritis cases (n = 772) were recorded and analyzed. Possible effects on treatment success (positive pregnancy result in the first cycle after treatment) were tested by binomial logistic regression. In most cases β-hemolytic streptococci were detected (n = 707). Treatments for the endometritis included trimethoprim-sulfonamides (n = 409), procaine-penicillin (n = 227), marbofloxacin (n = 53) or no antibiotics (n = 59) and most antibiotics were administered systemically (n = 711) rather than locally (n = 23). Uterine lavage was reported in 49 % of mares. Uterotonic drugs were administered in 42.2 % of mares. Breeding programs included artificial insemination (AI) with chilled semen (n = 667), AI with frozen semen (n = 169), transfer of fresh (n = 112) or cryopreserved (n = 27) embryos and natural cover (n = 27). In the first cycle after treatment, the pregnancy rate was 47 % and it rose to 69 % by end of the season. Treatment success was affected by duration of antibiotic treatment, veterinary practice, and presence of clinical signs. In conclusion, reported treatment practices in German stud farm practice resulted in acceptable pregnancy results and the multiple binomial logistic regression approach identified factors affecting the pregnancy outcome in this dataset.

Isolation, Identification and Antibiogram Pattern of Bacteria Associated with Postpartum Metritis in Dairy Cattle

Microbial agents were isolated from forty-three clinical cases of postpartum metritis in dairy cattle from Bikaner, Rajasthan, India and their antibiogram pattern was recorded. Staphylococcus species were the most prevalent and Klebsiella species were the least prevalent. Maximum percent of uterine isolates were sensitive to Ceftiofur sodium, Ceftriaxone, Cephapirin, Cefoperazone and were resistant to Ampicillin and Amoxycillin. This analysis may help in understanding and tracking the types of microorganisms involved and the development of antimicrobial sensitivity and resistance patterns for different categories and generations of antibiotics frequently used in given geographical area related to clinical cases of metritis in dairy cattle.

Isolation of lactic acid bacteria from the reproductive tract of mares as potentially beneficial strains to prevent equine endometritis.

Endometritis, the inflammation of the endometrium, is the leading cause of subfertility in mares, and therefore responsible for major economic losses in the horse industry worldwide. It is generally treated with uterine lavages combined with ecbolic agents and local or systemic antibiotics. However, since antibiotic overuse has been associated with antimicrobial resistance in mares with persistent endometritis, new prevention and treatment alternatives are needed. One such alternative could be the use of probiotic lactic acid bacteria (LAB) isolated from the host. Thanks to their species specificity, resident microbiota may restore ecological equilibrium within the host, and therefore, help prevent infections and improve physiological functions. In the present study, 257 bacterial strains were isolated from 77 healthy mares, and 88.76% (n = 228) of them were phenotypically classified as LAB. Within this group, 65.79% were able to inhibit at least one strain from each of the genera that most commonly cause equine endometritis (Streptococcus equi subsp. zooepidemicus, Escherichia coli, and Staphylococcus spp.). Five strains (RCE11, RCE20, RCE91, RCE99, and RCE167) were selected on the basis of their beneficial properties: ability to autoaggregate and adhere to equine epithelial cells, high inhibition of and co-aggregation with all the bacteria isolated from clinical cases of endometritis evaluated, and negative co-inhibition between one another. All five were finally identified as Enterococcus spp., namely E. faecium (two strains), E. hirae (two strains), and E. gallinarum (one strain). Further studies will assess their safety and biotechnological potential for the design of a multi-strain probiotic formula to prevent equine endometritis.

Characterization of E. coli and Staph. aureus Bacteria Associated with Dystocia and Normal Birth in Dairy Cows

Dystocia or birth difficulties may make the animals more prone to develop a case of metritis or endometritis due to uterine trauma and introduction of many bacterial strains into uterus. The objective of this study was to identify and characterize the main bacteria which would present in uterine samples of dairy cows during the first three weeks after parturition in dairy cows suffering from dystocia and those with normal birth. The obtained findings showed that E. coli was the most prevalent isolates throughout the three weeks, Staph.aureus was not reported in the first and second week but became more prominent in the third week. In addition, the combination of E. coli with Staph. aureus, and E.coli with streptococci is consistently observed throughout the three weeks. Other bacterial isolates, such as Trueperella pyogenes were detected in the first and third weeks, additionally, Micrococcus and Pseudomonas were detected in third week only. Regarding isolated bacteria, and based on antibiotics sensitivity test, Staphylococcus aureus was more sensitive to streptomycin and ciprofloxacin. On the other hand, E. coli show 100% sensitivity for imipenem, sulfamethoxazole and trimethoprim. Interestingly, both isolates showed 100% resistance to amoxiclav. Serodiagnosis of E. coli and presence of enterotoxins genes of Staph. aureus would confirm enterogenic origin of both of bacteria which indicate low hygienic measures. In conclusion, the prevalence of the isolated bacteria and bacterial combination besides persistence of theses bacteria till third week after parturition was more in cases suffered from dystocia than animals with normal birth. Antibiotic sensitivity test should be applied before administration of any antibiotics to the animals suffering from any uterine infection after parturition

On-farm epidemiology and phylogenetic evaluation of methicillin and beta-lactam-resistant Staphylococcus aureus isolated from dairy cattle and buffaloes with endometritis.

Staphylococcus aureus is a potential emerging and prevailing multidrug-resistant (MDR) pathogen involved in bovine endometritis. Present research evaluated the prevalence and molecular characterization of methicillin-resistant S. aureus (MRSA) and beta-lactam resistant S. aureus (BRSA) and also analyzed the associated risk factors with endometritis along with antibiotic resistance patterns. A total of 384 uterine and vaginal fluid samples were collected from the adult dairy cattle and buffaloes showing the clinical signs of endometritis including foul-smelling vaginal discharge, fever, enlarged and thickened uterine horns on rectal palpation, and confirmation by ultrasonography findings. The collected samples were subjected to standard microbiological methods for the detection of S. aureus. The confirmed isolates were further subjected to the Kirby-Bauer disc diffusion test and the detection of the mecA and blaZ genes for the confirmation of MRSA and BRSA. Study found an overall prevalence of 17.96% for S. aureus from bovine endometritis cases. Among S. aureus isolates, 50.72% and 37.68% isolates were confirmed MRSA while BRSA was found as 36.23% and 18.84%, based on phenotypic and genotypic methods, respectively. Phylogenetic analysis indicated the possibility of pathogen transmission within and between livestock animals. Risk factor analysis showed that the breed of animal, visible discharge from vagina, lactation number, insemination procedure, and calving place showed significant (P<0.05) association with S. aureus-associated endometritis. Antimicrobial susceptibility testing of study isolates showed the resistance to various commonly used antibiotics. The study concluded that S. aureus is found in 17.96% of bovines affected with endometritis and require further intensive research to elucidate the farm economic losses.

Endometritis after hysteroscopic procedures in Ukraine: results a multicenter study

Aim: To determine the current prevalence of endometritis after hysteroscopic procedures and antimicrobial resistance of responsible pathogens in Ukraine. Materials and Methods: Multicenter prospective cohort study was conducted from January 2020 to December 2022 in fifteen hospitals from twelve regions of Ukraine. Definitions of endometritis were adapted from the Centers for Disease Control and Prevention’s National Healthcare Safety Network. Antibiotic susceptibility was done by the disc diffusion test as recommended by EUCAST. Results: Among 13,872 patients with hysteroscopic procedures, 1027 (7.4%) endometritis were observed. Of these cases, 0.4% were detected after diagnostic hysteroscopy, and 7.0% were detected after operative hysteroscopy. Of all endometritis cases, 64.2% were detected after hospital discharge. The most commonly reported bacterial species were Escherichia coli (24.3%), followed by Enterobacter spp. (12.7%), Enterococcus spp. (8.3%), Pseudomonas aeruginosa (8.1%), Serratia marcescens (6.8%), Staphylococcus aureus (5.9%), Proteus mirabilis (5.8%), Klebsiella oxytoca (5.1%), Stenotrophomonas maltophilia (4.5%), Klebsiella pneumoniae (4.1%). A significant proportion of patients were affected by endometritis caused by bacteria developed resistance to several antimicrobials, varying widely depending on the bacterial species, antimicrobial group, and geographical region of Ukraine. Conclusions: Our data suggest a high prevalence of endometritis after hysteroscopic procedures. Risk for endometritis was higher after operative hysteroscopy compared with diagnostic hysteroscopy. Many most of patients were affected by endometritis caused by bacteria developed resistance to several antimicrobials. These data underscore the importance of tracking antimicrobial resistance of responsible pathogens of HAIs in hospitals.

Epidemiology of healthcare-associated endometritis after surgical abortion in Ukraine: results a multicenter study.

Aim: To determine the current prevalence of healthcare-associated endometritis after surgical abortion and antimicrobial resistance of responsible pathogens in Ukraine. Materials and Methods: We performed a prospective, multicentre cohort study was based on surveillance data of healthcare-associated endometritis after legal induced surgical abortion. Women who underwent induced surgical abortion at gynecological departments of 16 regional hospitals between 2020 and 2022 are included in the study. Definitions of endometritis were adapted from the CDC/NHSN. Antibiotic susceptibility was done by the disc diffusion test as recommended by EUCAST. Results: Among 18,328 women who underwent surgical abortion, 5,023 (27.4%) endometritis were observed. Of all post-abortion endometritis cases, 95.3% were detected after hospital discharge. The prevalence of endometritis in different types surgical abortion was: after vacuum aspiration at < 14 weeks, 23.8%, and after dilatation and evacuation at ≥ 14 weeks, 32%. The most responsible pathogens of post-abortion endometritis are Escherichia coli (24.1%), Enterococcus spp. (14.3%), Enterobacter spp. (12,8%), Pseudomonas aeruginosa (8.3%), Proteus mirabilis (6.6%), Serratia marcescens (6.2%), Staphylococcus aureus (5.9%), and Stenotrophomonas maltophilia (5.7%). A significant proportion these pathogens developed resistance to several antimicrobials, varying widely depending on the bacterial species, antimicrobial group. Conclusions: Results this study suggest a high prevalence of endometritis after surgical abortion in Ukraine. A significant proportion of women were affected by endometritis caused by bacteria developed resistance to several antimicrobials. Optimizing the antibiotic prophylaxis may reduce the burden of endometritis after surgical abortion, but prevention is the key element.

Maternal and obstetric outcomes after Ex-Utero Intrapartum Treatment (EXIT): a single center experience

BackgroundThe Ex-utero Intrapartum Treatment (EXIT) is a procedure developed to manage a range of fetal conditions, aiming to ensure the maintenance of neonatal airway and preserving the feto-placental circulation. Its goal is to enhance the neonatal ability to successfully transition and adapt to postnatal life, thereby reducing perinatal morbidity and mortality. However, EXIT has been associated with a high risk of maternal complications. This paper provides an overview of the indications and characteristics of the EXIT procedure, as well as the obstetric outcomes and maternal complications.MethodsA retrospective analysis was conducted on a cohort of patients undergoing EXIT at our center between January 2007 and December 2022. Maternal outcomes, including demographic information, data related to the surgical procedure, surgical complications, and postoperative complications were analyzed. To assess the severity of the surgical complications, a modified Clavien-Dindo classification was used. Comparative analysis was performed by randomly selecting a sample from elective cesarean deliveries performed at our center.ResultsA total of 34 EXIT procedures were performed. According to the modified Clavien-Dindo classification, we observed no major complications, while minor maternal complications were present in 2.94% of cases. Compared to elective cesarean deliveries (n = 350), there were no significant differences in terms of maternal complications, highlighting the similarity observed in the mean decrease in postoperative hemoglobin (1.15 g/dL in EXIT vs. 1.2 g/dL in elective cesarean deliveries, p = 0.94). In EXIT group, there was a higher rate of polyhydramnios (26.47% vs 6.59%, p < 0.001), as well as the need for amnioreduction (14.71% vs 0%, p = 0.001) and preterm delivery (32.35% vs 6.02%, p = 0.001). There were no cases of endometritis, post-procedural fever, or abruptio placentae following EXIT.ConclusionsEXIT can be considered a safe procedure when performed under adequate conditions, including appropriate uterine access and proper anesthetic management. In our series, EXIT procedure was not associated with a higher incidence of maternal complications when compared to elective cesarean delivery.Trial registrationRetrospectively registered.

COMPARATIVE ANALYSIS OF THE EFFICIENCY OF CLASSICAL AND MODIFIED HYSTEROSCOPIC METROPLASTY IN WOMEN WITH RPL SYNDROME

Intrauterine membranes (IMM) are one of the most common Müllerian anomalies. Their frequency in women with a history of miscarriages and infertility varies widely and is 5.5-24.5%&#x0D; Purpose. To conduct a comparative analysis of intraoperative, immediate and distant results of the classical and modified technique of the surgical intervention.&#x0D; Materials and Methods. 84 patients with a diagnosis of primary miscarriage (RPL-syndrome) and/or premature birth took part in the study. The main group (I clinical) consisted of 44 patients in whom hysteroscopic metroplasty was performed according to the proposed modified technique. The comparative group (II clinical) consisted of 40 patients who were operated according to the classical method of GM.&#x0D; Results. A comparative analysis of the effectiveness of the modified technique in comparison with the classic GM in women with RPL syndrome demonstrates a reduction in the duration of the operation by 15 minutes (р&lt;0,05), a decrease of the frequency of endometritis cases by almost 3 times (р&lt;0,05), a reduction in the length of stay of women in a day hospital by 6 hours (р&lt;0,05), and a reduction in the formation of postoperative intrauterine synechiae by about 10%.&#x0D; Conclusions. However, these results are preliminary and require further, more in-depth research on large data samples, but already at this stage of the research, the modified method of hysteroscopic metroplasty has shown positive results.

Molecular detection of bovine alphaherpesvirus-1 in cases of reproductive disorders among cattle and buffaloes in Gujarat.

Bovine alphaherpesvirus-1 (BoAHV-1) is an important viral pathogen that causes significant economic losses to the dairy industry. The present study aimed to determine the prevalence of BoAHV-1 in cases of bovine reproductive disorder. Clinical samples were collected from various villages in Gujarat using specialized FTA® cards and were tested using real-time PCR assay targeting the gB gene of BoAHV-1. Out of 401 animals, 18.20% (95% CI: 14.74-22.28%) tested positive for BoAHV-1 DNA. The percentage positivity of BoAHV-1 was 20.37% in abortion cases and 19.55% in retention of fetal membrane cases, while only one out of nine metritis cases screened in the study was positive for BoAHV-1 DNA. A higher percentage positivity in buffaloes (22.14%) compared to cattle (16.30%) was recorded, but this difference was not statistically significant (p = 0.169). The frequency of BoAHV-1 detection was higher among crossbreeds (16.76%) and exotics (19.61%) than among indigenous cattle (8.82%), although this difference was not statistically significant (p = 0.400). There was also no significant difference in frequency distribution among animals of varying parity, ranging from 15.20 to 33.33% (p = 0.540). This study confirms the widespread circulation of BoAHV-1 and highlights the need for its control and prevention.

Phenotypic and Genotypic Characteristics of Staphylococcus aureus Recovered from Mastitis and Endometritis Cases in Sheep and Goats

Phenotypic and Genotypic Characteristics of Staphylococcus aureus Recovered from Mastitis and Endometritis Cases in Sheep and Goats

P-625 Artificial intelligence-enabled analysis of endometrial CD138 positive plasma cells in infertility-associated conditions; Polycystic ovary syndrome (PCOS) and recurrent implantation failure (RIF)

Abstract Study question Can artificial intelligence (AI) algorithm identify CD138+ cells in the endometrial stroma, and is the expression altered in PCOS and RIF? Summary answer CD138+ cell detection by AI shows high accuracy. The cell count in controls was comparable to that in PCOS cases but differed in RIF patients. What is known already Immunohistochemical (IHC) staining for CD138+ plasma cells has been applied to detect endometrial inflammation; however, due to a lack of cost-effective and reliable tools, there is no golden standard for CD138+ analysis. PCOS is a common endocrine disorder characterized by irregular menstrual cycles and hyperandrogenism. The women are also affected by systemic low-grade inflammation, and the PCOS endometrium shows dysregulated immune profile. RIF is one of the main causes of a low IVF success rate, and chronic endometrial inflammation has been detected in women with RIF. To date, AI technology has been applied in the diagnostics of various clinical conditions. Study design, size, duration In this study, AI analysis was done for CD138+ cells in a total of 193 endometrial biopsy samples: 73 were obtained from healthy and fertile controls, 91 from women with PCOS (ovulatory samples; n = 78, anovulatory samples; n = 13, Rotterdam criteria), and 29 samples from RIF patients on day five after the initiation of P4 administration. Participants/materials, setting, methods The biopsy samples were collected by suction curette (Pipelle), and endometrial receptivity was assessed by gene expression profiling (beREADY test). The tissues were stained with CD138 antibody, and the AI algorithm, AITAH, was trained with 150 whole slide images (WSIs) to segment epithelium and stroma and segregate CD138- and CD138+ cells in the stroma. AITAH was validated by three external pathologists. The cell counts were compared according to cycle phases, ovulatory status, and endometrial receptivity. Main results and the role of chance The performance of AITHA was excellent, as the final training error for CD138+ cells was 3.23%, and the decisions for the cells between pathologists and AITAH were in complete agreement. The CD138+ cell percentages were higher in the proliferative phase (PE) endometrial tissue than in the ones obtained in the secretory phase (PCOS, p &amp;lt;0.001 or control, p &amp;lt;0.001), regardless of PCOS diagnosis. Similar CD138+ cell percentages were observed between PE endometrium and anovulatory endometrium in PCOS cases (p &amp;lt;0.001). The count of CD138+ plasma cells was negatively correlated with the endometrial thickness (PCOS, p =0.001 or control, p =0.009) and P4 (PCOS, p =0.001 or control, p =0.003), and positive correlations between the cell counts and gonadotropin levels were observed in ovulatory PCOS samples (FSH, p =0.001 and LH, p =0.031). More CD138+ cells were seen in RIF patients compared to the controls at the receptive stage (p = 0.046); however, there was no difference between RIF samples of three different receptivity statuses (p =0.426). Limitations, reasons for caution Further validation for AITAH using confirmed chronic endometritis cases as positive controls is required. And further analysis using control samples obtained during the hormone replacement treatment is required. The small number of anovulatory PCOS subjects may explain the absence of correlations between the CD138+ plasma cell counts and clinical characteristics. Wider implications of the findings AI-enabled analysis tools could improve histological examination of endometrial immune cells by analyzing high amounts of whole tissue slides within a short time with a high pixel resolution, thus overcoming many current impediments in manual microscopic evaluation. Trial registration number NA

Association of time to metritis diagnosis with circulating concentration of metabolites, minerals, and haptoglobin in Jersey cows

Our objective was to investigate the association of early metritis [EMET, diagnosed at <5 d in milk (DIM)] and late metritis (LMET, diagnosed at ≥5 DIM) with circulating concentrations of energy metabolites, minerals, and haptoglobin (Hp) throughout the first 14 d postpartum. A total of 379 purebred Jersey cows were enrolled in a prospective cohort study from a single herd in west Texas. Cows were examined for metritis using the Metricheck device (Simcro Ltd.) at 4, 7, and 10 DIM. Cows identified by farm employees as possible metritis cases were also evaluated for metritis. Blood samples were collected for analysis of concentrations of Ca, Mg, and glucose at DIM 1 through 5, 7, 10, and 14. Albumin, urea, fructosamine, free fatty acids (FFA), creatinine, and β-hydroxybutyrate (BHB) were analyzed at DIM 3, 5, 7, 10, and 14, and Hp at DIM 1 through 5 and 7. Data were analyzed using the MIXED and PHREG procedures of SAS (SAS Institute Inc.). A series of mixed general linear models accounting for repeated measures were fitted to the data. The independent variables metritis [no metritis (NMET), EMET, and LMET], DIM of analyte assessment, and parity were forced in all models. Multivariable Cox proportional hazard models were built to assess the risk of pregnancy and culling within 150 DIM. The overall metritis incidence was 26.9% (EMET = 49; LMET = 53; NMET = 277). Average concentrations of glucose, Mg, and urea were not associated with metritis. The associations of Ca, creatinine, BHB, and fructosamine with metritis were dependent on the DIM of analyte assessment. Cows categorized as EMET and LMET had, on average, lower albumin and fructosamine compared with NMET cows. Both EMET and LMET cows had, on average, greater BHB than NMET cows. A greater FFA concentration was only observed in cows diagnosed with EMET compared with NMET cows (EMET = 0.58, LMET = 0.52, NMET = 0.48 mmol/L). Additionally, circulating Hp concentration was greater for LMET and EMET compared with NMET cows, and EMET cows had greater Hp compared with LMET cows (EMET = 1.15; LMET = 1.00; NMET = 0.84). In conclusion, several blood biomarkers were temporally associated with early versus late metritis diagnosis in postpartum Jersey cows. No meaningful differences were observed in production, reproduction, or culling between EMET and LMET cows. These results suggest that cows with EMET undergo a more severe degree of inflammation and negative energy balance compared with NMET cows.