Giovanni Cassata

Bovine tuberculosis (bTB) remains endemic in southern Italy, particularly in Sicily, posing challenges for disease control and eradication. This study evaluated the diagnostic agreement between the intradermal tuberculin test (IDT), interferon-gamma release assay (IFN-γ), and post-mortem lesion detection in 1801 cattle from 44 herds in the province of Palermo during 2024–2025. Diagnostic agreement between IDT and IFN-γ was substantial in 2024 (κ = 0.731; 95% CI: 0.64–0.82; n = 991) and decreased to moderate in 2025 (κ = 0.453; 95% CI: 0.33–0.57; n = 572), reflecting a higher proportion of IFN-γ positive and inconclusive animals. An increase in inconclusive results for IFN-γ was observed in 2025, but the available data did not allow investigation of the factors underlying this difference. Agreement between ante-mortem tests and post-mortem lesion detection was poor in a selected subgroup of slaughtered animals, potentially subject to verification bias, highlighting the limitations of single diagnostic tools and the need for a complementary approach combining immunological and pathological methods. These findings support the interpretation of the complementary roles of IDT and IFN-γ within herd-level bTB surveillance, highlight the need for standardized protocols to manage inconclusive IFN-γ results, and underline the complementary contribution of post-mortem inspection within integrated surveillance strategies in endemic settings. Official confirmation of bovine tuberculosis relies on an integrated evaluation combining diagnostic results, post-mortem findings, and epidemiological investigations. Given the absence of a validated gold standard applicable to all animals in this observational dataset, the study was designed as a diagnostic agreement study rather than a formal accuracy assessment.

Despite significant advancements, prosthetic hernia repair continues to face unacceptably high complication rates. These likely stem from poor biological responses, such as stiff scar tissue leading to mesh shrinkage. To overcome these issues, the Stenting and Shielding (S&S) Hernia System, a newly designed 3D dynamic device, has been developed for dissection-free laparoscopic placement to permanently obliterate hernia defects. Unlike conventional meshes, this device induces a regenerative biological response, promoting viable tissue growth rather than fibrotic plaque formation. In a porcine experimental model, the S&S device demonstrated the development of a great amount of muscle fibers, alongside nervous and vascular structures, within well-perfused connective tissue. Histological analysis of biopsy specimens excised from the experimental animals revealed progressive muscle fiber maturation from early myocyte development in the short term to fully developed muscle bundles in the long term. The enhanced biological response observed with the S&S device suggests a promising shift in hernia repair, potentially reversing the degenerative processes of hernia formation and promoting tissue regeneration. The S&S Hernia System described here can be classified not merely as a conventional hernia implant, but as part of a new category of hernia devices: the dynamic regenerative scaffold.

Background: Common bile duct (CBD) treatments are often associated with complications, limiting long-term efficacy. To overcome these issues, polymeric grafts have been suggested as promising alternatives, since they are highly customizable, biocompatible, and may reduce side effects frequency. Methods: A systematic review was conducted, interrogating MEDLINE and Cochrane Library. Next, an in vivo study involved 20 pigs, which underwent a former controlled biliary injury. To repair the defect, a α,β-Poly(N-2-hydroxyethyl)-DL-Aspartamide (PHEA)–Polylactic-acid (PLA)–Polycaprolactone (PCL) scaffold was implanted. The animals were sacrificed at one and three months for gross and histological examinations, to assess tissue integration and healing outcomes. Results: The systematic review highlighted that such scaffolds have shown promising results in CBD regeneration, both in single and joined applications. These findings were confirmed by the in vivo study, where the use of such scaffolds—particularly, the planar ones—led to safe and complete bile duct regeneration. Histological analysis revealed lymphomonocytic infiltrates and neovascularization, while microscopic examination showed progressive scaffold degradation accompanied by biliary tissue regeneration. Conclusions: Experimental results are consistent with the literature, confirming the potential of such polymeric scaffolds in aiding complete CBD regeneration and being reabsorbed shortly after. Still, further studies are needed to fully validate their translational application. PROSPERO ID: CRD420251115056.

Extensive bone loss represents a great challenge for orthopedic and reconstructive surgery. On an in vivo rabbit model, the healing of two bone defects on a long bone, tibia, was studied. A polybutylene succinate (PBS) microfibrillar scaffold was implemented with BMP-2 protein and hydroxyapatite (HA) as potential osteogenic factors. The present study was carried out on 6 male New Zealand white (4–6 months old) rabbits in vivo model. One bone defect was created in each subject on the tibia. The controls were left to heal spontaneously while the study samples were treated with the polybutylene succinate (PBS) microfibrillar scaffolds doped with BMP-2 and HA. Histological and immunohistochemical analyses were performed after euthanasia at 3 and 6 months. The bone defect treated with the BMP-2 PBS scaffold shows, from 3 months, a significantly increased presence of activated osteoblasts with mineralized bone tissue deposition. This study confirms the great potential of PBS scaffolds in the clinical treatment of bone defects.

Conventional hernia repair using static flat meshes is often associated with complications casused by extensive dissection, implant fixation, and poor biological response. The Stenting & Shielding (S&S) Hernia System offers a novel solution designed for dissection-free, fixation-free hernia repair. The S&S Hernia System has been evaluated in a porcine model, focusing on procedural simplicity, device retention and regenerative properties. The experimental study involved 10 pigs, each implanted with two S&S devices. Follow-up assessments included ultrasound, laparoscopic examinations, and histological analyses over a period ranging from 4 weeks to 8 months post-implantation. The S&S Hernia System, made from medical-grade polypropylene-based thermoplastic elastomer (TPE), features a rayed 3D scaffold and an oval shield connected by a mast. Delivered and positioned intraabdominally without dissection, the device transforms into a self-retaining scaffold to obliterate the hernia defect. Primary outcomes included ease of delivery, visceral adhesion formation, and device retention, ensuring no dislocation. Secondary outcomes evaluated histological evidence of tissue regeneration, including the development of connective tissue, muscles, vessels, and nerves within the scaffold. Immunohistochemistry was used to detect tissue growth factors promoting regeneration of the abdominal wall's typical components. All 20 implanted devices remained securely in place without dislocation. Transient adhesion bands were observed in two shields at 1 month but resolved by 3 months. No visceral adhesions were detected at the time of animal sacrifice. Histological analyses demonstrated tissue regeneration within the scaffold, while immunohistochemistry confirmed the presence of growth factors supporting regeneration. Overall, the S&S Hernia System showed promising results in a porcine model, with no dislocation and evident regenerative potential. Its rapid, dissection-free delivery and compliance with abdominal wall dynamics simplify the procedure while minimizing adhesions. These findings warrant further clinical investigation to validate its application in human patients.

The current gold standard for abdominal hernia repair involves the use of flat meshes deployed over the hernial defect via open or laparoscopic surgery. However, these conventional methods often lead to complications related to implant fixation, suboptimal biological response, and inadequate defect management. To address these challenges, a novel treatment approach has been developed using the Stenting & Shielding (S&S) Hernia System. This innovative device is laparoscopically introduced into the hernial opening without requiring tissue dissection, and it expands to permanently obliterate the defect without the need for fixation. Unlike the foreign body reaction typically observed with flat meshes, the 3D design of the S&S device exhibits dynamic responsiveness, promoting true tissue regeneration. By moving in harmony with the abdominal wall, the S&S device attracts growth factors that induce the formation and maturation of new muscular, vascular, and nervous structures, effectively restoring the integrity of the abdominal wall compromised by hernia disease. This regenerative capability was demonstrated in an experimental porcine model, where the S&S device was implanted and biopsies were taken at defined postoperative intervals ranging from 4 weeks to 8 months. Immunohistochemical analysis of these biopsies revealed the presence of specific tissue growth factors driving the regenerative processes. The results suggest that the three-dimensional design of the S&S Hernia System enables the device to respond to dynamic mechanical strains, thereby fostering progressive tissue regeneration.

Introduction: The biological response to implants used for hernia repair remains a topic of ongoing discussions. Traditional static hernia meshes often lead to poor-quality fibrotic tissue ingrowth, mesh shrinkage, and complications such as nerve entrapment. These issues are particularly problematic in groin hernia repairs, where scar tissue can impair movement and cause discomfort. To address these challenges, the dynamic Stenting & Shielding (S&S) Hernia System was developed, promoting a regenerative biological feature that induces the development of new muscles, nerves, and blood vessels. Materials and Methods: This study evaluated the quantity and quality of vascular development within the 3D scaffold of the S&S device implanted in the lower abdominal wall of pigs, with assessments made at various post-implantation stages. Results: Early-stage post-implantation revealed extensive angiogenesis within the S&S device excised from the pigs. The quantity and quality of arteries and veins progressively increased, reaching full development in the midterm after placement in the abdominal wall of the animals. Notably, no inflammatory reactions or stiff scar tissue were observed within the 3D scaffold of the S&S device even long term. Conclusion: High quality tissue development in hernia devices requires robust vascular support. The extensive network of mature arteries and veins observed in the S&S Hernia System underscores its regenerative capabilities, making it a promising solution for the cure of abdominal wall protrusions.

Despite significant advancements, prosthetic hernia repair continues to face unacceptably high complication rates, including postoperative discomfort and chronic pain. These issues often stem from poor biological responses, such as the formation of stiff scar tissue and mesh shrinkage, commonly associated with traditional static meshes and plugs. Recent studies have challenged the conventional approach of reinforcing the groin through fibrotic incorporation of meshes, particularly in light of new evidence on the degenerative origins of many types of abdominal hernias such as groin hernias. In response, the Stenting & Shielding (S&S) Hernia System, a newly designed 3D dynamic device, has been developed for dissection free laparoscopic placement to permanently obliterate hernia defects. Unlike conventional meshes, this device induces a probiotic biological response, promoting viable tissue growth rather than fibrotic plaque formation. In a porcine experimental model, the S&S device demonstrated the development of a great amount of muscle fibers, alongside nervous and vascular structures, within well-perfused connective tissue. Histological analysis of biopsy specimen excised from the experimental animals revealed progressive muscle fiber maturation from early myocyte development in the short term to fully developed muscle bundles in the long term. The enhanced biological response observed with the S&S device suggests a promising shift in hernia repair, potentially reversing the degenerative processes of hernia formation and promoting tissue regeneration. The S&S Hernia System described here can be classified not merely as a conventional hernia implant, but as part of a new category of hernia devices: the dynamic regenerative scaffold.

Vector-borne diseases represent a serious threat to human and animal health, especially where environmental conditions favor pathogen-carrying vectors. Dogs serve as natural hosts for two tick-borne pathogens: Ehrlichia canis, which causes canine monocytic ehrlichiosis, and spotted fever group (SFG) Rickettsia spp., a zoonotic threat in the Mediterranean region. Rhipicephalus sanguineus is the primary vector for these pathogens. Shelter dogs, due to increased exposure to ticks and confined living conditions, facilitate the spread of vector-borne pathogens, raising the risk of zoonotic transmission. This study conducted a serological survey of 1287 dogs from two shelters, assessing exposure to Rickettsia spp. and E. canis and examining the influence of demographic and environmental factors. Seroprevalence rates were 41.8% for Rickettsia spp. and 24.5% for E. canis, with 14% of dogs positive for both pathogens. No significant association was found with sex or breed. A higher seroprevalence was observed in dogs older than 12 months and in those from the shelter on the Mediterranean coast compared to those from the Tyrrhenian coast, likely due to climatic differences. The study highlights the role of climate in disease spread and the need for public health interventions, supporting One Health initiatives to prevent zoonotic disease transmission.

Background: Simulating the post-traumatic continuity defect of small human peripheral nerves, we compared the effectiveness of fibrin glue with neurorrhaphy for nerve gap restoration. Methods: In twenty-four male Wistar rats, a fifteen mm defect in one sciatic nerve only was made and immediately repaired with an inverted polarity autograft. According to the used technique, rats were divided into Group A (Control), using traditional neurorrhaphy, and Group B (Study), using fibrine glue sealing; in total, 50% of rats were sacrificed at 16 weeks and 50% at 21 weeks. Before sacrifice, an assessment of motor function was done through Walking Track Analysis and an electroneurophysiological evaluation. After sacrifice, selected muscle mass indexes and the histology of the regenerated nerves were assessed. All data were evaluated by Student’s t test for unpaired data. Results: No significant differences were found between the two groups, with only the exception of a relative improvement in the tibialis anterior muscle’s number of motor units in the study group. Conclusion: Despite the fact that the use of fibrin glue as a nerve sealant is not superior in terms of functional recovery, its effectiveness is comparable to that of microsurgical repair. Hence, the faster and technically easier glueing technique could deserve broader clinical application.