Per un atlante dei castelli dell’Emilia Romagna: Rubiera, Salvaterra, Dinazzano e la difesa del confine orientale

Il lavoro è stato strutturato in due parti distinte. La prima riguarda il riordino delle informazioni contenute nella Banca Dati sui Castelli dell’Emilia Romagna ultimata nel 2004, arricchendo le informazioni con nuove fonti sia edite che inedite e fotografie, mettendo poi tutti i dati online sul sito Geologia Storia Turismo della Regione Emilia Romagna. La seconda parte ha riguardato invece l’analisi dell’area reggiana e, in particolare, di tre castelli: Rubiera, Salvaterra e Dinazzano che, a partire dalla fine del XII secolo, hanno costituito quella che è stata definita la Cintura sul Secchia, una vera e propria catena difensiva costruita dal comune di Reggio Emilia a protezione del suo confine orientale, quello con Modena. Nella prima parte si è predisposto l’avvio di un Atlante dei castelli esistenti e scomparsi dell’Emilia Romagna, strutturato provincia per provincia, con corredo di piante e grafici che indicano la consistenza del fenomeno nelle diverse aree della Regione; poi, per l’area reggiana, si è completata la disamina con una serie di grafici che mettono in luce la dislocazione per aree, la localizzazione sicura dei castelli in rapporto alla loro condizione attuale e la densità per aree del fenomeno. Infine si sono inserite informazioni ricavate da materiale inedito per verificare possibili sviluppi della Banca Dati. La seconda parte ha ricostruito non solo le vicende storico-costruttive dei castelli di Rubiera, Salvaterra e Dinazzano, ma ha approfondito anche la genesi e l’evoluzione di questo progetto di difesa territoriale: studiare questo progetto significa capire come il comune di Reggio Emilia, nell’arco di oltre un secolo, ha governato i propri castelli, come ne ha organizzato la difesa e la manutenzione e come ne ha progettato il popolamento.

Drosophila melanogaster as a model to study host-parasitoid interactions: the case of the polydnaviral protein TnBVANK1

Parasitic wasps attack a number of insect species on which they feed, either externally or internally. This requires very effective strategies for suppressing the immune response and a finely tuned interference with the host physiology that is co-opted for the developing parasitoid progeny. The wealth of physiological host alterations is mediated by virulence factors encoded by the wasp or, in some cases, by polydnaviruses (PDVs), unique viral symbionts injected into the host at oviposition along with the egg, venom and ovarian secretions. PDVs are among the most powerful immunosuppressors in nature, targeting insect defense barriers at different levels. During my PhD research program I have used Drosophila melanogaster as a model to expand the functional analysis of virulence factors encoded by PDV focusing on the molecular processes underlying the disruption of the host endocrine system. I focused my research on a member of the ankyrin (ank) gene family, an immunosuppressant found in bracovirus, which associates with the parasitic wasp Toxoneuron nigriceps. I found that ankyrin disrupts ecdysone biosynthesis by impairing the vesicular traffic of ecdysteroid precursors in the cells of the prothoracic gland and results in developmental arrest.

Medical Malpractice in Public Healthcare Systems: An Empirical Investigation of Scheduled Damages

In the last decades, medical malpractice has been framed as one of the most critical issues for healthcare providers and health policy, holding a central role on both the policy agenda and public debate. The Law and Economics literature has devoted much attention to medical malpractice and to the investigation of the impact of malpractice reforms. Nonetheless, some reforms have been much less empirically studied as in the case of schedules, and their effects remain highly debated. The present work seeks to contribute to the study of medical malpractice and of schedules of noneconomic damages in a civil law country with a public national health system, using Italy as case study. Besides considering schedules and exploiting a quasi-experimental setting, the novelty of our contribution consists in the inclusion of the performance of the judiciary (measured as courts’ civil backlog) in the empirical analysis. The empirical analysis is twofold. First, it investigates how limiting compensations for pain and suffering through schedules impacts on the malpractice insurance market in terms of presence of private insurers and of premiums applied. Second, it examines whether, and to what extent, healthcare providers react to the implementation of this policy in terms of both levels and composition of the medical treatments offered. Our findings show that the introduction of schedules increases the presence of insurers only in inefficient courts, while it does not produce significant effects on paid premiums. Judicial inefficiency is attractive to insurers for average values of schedules penetration of the market, with an increasing positive impact of inefficiency as the territorial coverage of schedules increases. Moreover, the implementation of schedules tends to reduce the use of defensive practices on the part of clinicians, but the magnitude of this impact is ultimately determined by the actual degree of backlog of the court implementing schedules.

Einfluss unterschiedlicher polymerer Nanopartikel auf das Differenzierungsverhalten von humanen Stammzellen

n der vorliegenden Dissertation wurde systematisch die Interaktion von rnunterschiedlichen polymeren Nanopartikeln auf die Zellfunktionalität und das rnDifferenzierungspotential zweier humaner Stammzelllinien (mesenchymale und rnhämatopoetische Stammzellen) untersucht. Als Modellsystem wurden Polystyrol-rnPartikel für bioinerte Nanopartikel und PLLA-Partikel als Modell für bioabbaubare Nanopartikel gewählt. rnDie Analyse der Partikelaufnahme und der Zytotoxizität ergab, dass alle getesteten Partikel nach einen Zeitraum von 24 h und einer Inkubation mit 300 µg/mL Partikeln in beiden Zellsorten nicht toxisch waren. Für die CTMA-Cl-stabilisierten Partikel wurde während Differenzierungsversuche mit hMSCs eine Langzeittoxizität festgestellt, so dass diese Partikel für weitere Versuche nicht verwendet werden konnten. rnAlle Partikel wurden in die Zellen aufgenommen. Die Lutensol-stabilisierten Polystyrol-Partikel zeigten sowohl in unfunktionalisierter Form als auch mit Aminogruppen auf der Oberfläche ein geringeres Aufnahmeverhalten in hMSCs und wurden deswegen nicht für weitere Versuche verwendet. Die SDS-stabilisierten Polystyrol-Partikel zeigten eine gute Aufnahme, die durch die funktionalisierung mit Carboxylgruppen um ca. das 3-fache rnverstärkt werden konnte (hMSCs). Gleiches wurde für die CTMA-Cl stabilisierten rnPolystyrol und dem dazugehörigen aminofunktionalisierten Partikel beobachtet rn(hMSCs). In hHSCs wurden nur die SDS-stabilisierten Polystyrol-Partikel (nicht rnfunktionalisiert, carboxylfunktionalisiert) getestet. Hierbei konnte kein Unterschied bezüglich der Aufnahme festgestellt werden. Die PLLA- und PLLA-Fe-Partikel wurden sowohl in hMSCs als auch in hHSCs sehr gut und besser als die Polystyrol-Partikel aufgenommen. Das in den Partikeln eingebaute Magnetit zeigt keine Auswirkungen auf die Zellaufnahme. Für weitere Versuche wurden deshalb auf Grund der Aufnahme und Toxizitätsdaten die SDS-stabilisierten Polystyrol-Partikel (PS und PS-COOH) sowie die ebenfalls SDS-stabilisierten PLLA-Partikel (PLLA und PLLA-Fe) gewählt. Somit standen 4 Partikel zur Auswahl, die sich sowohl in ihrer Größe als auch im verwendeten Tensid nicht unterscheiden und so Aussagen über den Einfluss von Oberflächenfunktionalisierung sowie Magnetit zulassen. rnDie Zellfunktionalität der hMSCs unter Partikeleinfluss wurde mit Hilfe von IL-6 und IL-8 Messungen untersucht, hierbei zeigte sich, dass nur der PLLA-Fe-Partikel zu einer signifikant erhöhten IL-8 Ausschüttung führte, die Sekretion von IL-6 blieb vollständig unverändert. Die IL-8 Sekretion der hHSCs wurde durch die Anwesenheit der Partikel nicht verändert. rnUm den Einfluss der oben beschriebenen Partikel auf das Differenzierungspotential von hMSCs und hHSCs zu untersuchen, wurden beide Zelllinien vor der Induktion der Differenzierung für 24 h mit 300 µg/mL Partikeln inkubiert. Sowohl die histochemischen Färbungen der differenzierten hMSCs als auch die CD-Marker-Färbungen der differenzierten hHSCs zeigten keinen Einfluss der Partikel auf die Differenzierungsfähigkeit. Bei den hMSCs konnte auch keine durch die Partikel hervorgerufene Differenzierung nachgewiesen werden. Die Analyse der Differenzierung auf RNA-Ebene (qPCR) ergab jedoch für beide Zelllinien, dass einzelne Partikel einzelne Differenzierungsmarker in ihrer Expression positiv oder negativ beeinflussen. Einzig der PLLA-Partikel zeigt bei allen untersuchten Differenzierungsrichtungen in beiden Zelllinien rnkeine Veränderung der Expression. Die jeweils beobachteten Expressionsveränderungen sind jedoch nicht stark genug, um die Differenzierung sichtbar zu beeinflussen, was die histologischen bzw. CD-Marker-Färbungen gezeigt haben. rnIn einem Kooperationsprojekt mit der Gruppe von Arancha del Campo (MPI für rnPolymerforschung) wurde der Einfluss unterschiedlicher BMP-2-Peptide auf die rnosteogene Differenzierung von hMSCs untersucht. Hierbei konnte gezeigt werden, dass die unterschiedlichen Peptide in keiner Konzentration und Kombination eine positive Wirkung auf die osteogene Differenzierung haben. rnIm Rahmen eines Kooperationsprojekts mit Kerstin Münnemann (MPI für rnPolymerforschung) konnte gezeigt werden, dass eine quantitative Bestimmung des rnzellulären Eisengehalts nach Inkubation mit SPIOs sowohl mit Hilfe von MRT, H1rn NMR als auch UV/VIS Messungen bis zu einem Detektionslimit von 100.000 Zellen /mL (bei einer Beladung von 10 pg Fe/Zelle) erfolgen kann.

Il consenso informato come strumento di esercizio del diritto alla salute per i pazienti stranieri?

L’elaborato propone una riflessione rispetto all’atto giuridico del consenso informato quale strumento garante dell’esercizio del diritto alla salute per i migranti. Attraverso una riflessione antropologica rispetto alla natura, alla costruzione e alla logica dei diritti universali, verranno analizzate le normative nazionali, europee ed internazionali a tutela del diritto alla salute per i migranti; l’obiettivo della ricerca è indagare l’eventuale scarto tra normative e politiche garantiste nei confronti della salute migrante e l’esistenza di barriere strutturali che impediscono un pieno esercizio del diritto alla salute. L’ipotesi di ricerca si basa sulla reale capacità performativa del consenso informato, proposto solitamente sia come strumento volto ad assicurare la piena professionalità dell’operatore sanitario nell’informare il paziente circa i rischi e i benefici di un determinato trattamento sanitario, sia come garante del principio di autonomia. La ricerca, attraverso un’analisi quanti-qualitativa, ha interrogato il proprio campo, rappresentato da un reparto di ginecologia ed ostetrica, rispetto alle modalità pratiche di porre in essere la firma nei moduli del consenso informato, con particolare attenzione alle specificità proprie delle pazienti migranti. Attraverso l’osservazione partecipante è stato quindi possibile riflettere su aspetti rilevanti, quali le dinamiche quotidiane che vengono a crearsi tra personale sanitario e pazienti, le caratteristiche e i limiti del servizio di mediazione sanitaria, le azioni pratiche della medicina difensiva. In questo senso il tema del “consenso informato”, indagato facendo interagire discipline quali l’antropologia, la bioetica, la filosofia e la sociologia, si è posto sia come lente di lettura privilegiata per comprendere le dinamiche relazionali ad oggi esistenti tra professionisti sanitari e popolazione migrante, ancora vittima di diseguaglianze strutturali, ma altresì come “innesco potenziale” di nuove modalità di intendere la relazione medico-paziente.

Modelli e strumenti di supporto alla scelta informata del paziente: un argine alla medicina difensiva

L’aumento esponenziale del contenzioso medico-legale – originatosi negli USA negli anni Sessanta in proporzioni tali da far parlare di medical liability crisis, e sviluppatosi in Italia a partire dalla metà degli anni Ottanta – ha comportato e continua a comportare, unitamente ad altre conseguenze negative, il ricorso sempre più frequente dei sanitari alle pratiche di medicina difensiva, con elevatissimi costi a carico del Servizio Sanitario Nazionale dovuti alla sovrabbondanza di trattamenti e ricoveri inutili e di procedure diagnostiche invasive non necessarie, peraltro produttive di stress emotivo nei pazienti. La causa dell’aumento della litigiosità deve essere ricercata in buona parte nella relazione medico-paziente, in particolar modo con riferimento al momento informativo che precede l’acquisizione del consenso informato al trattamento clinico. In Italia, i limiti che per lo più caratterizzano gli studi riguardanti il consenso informato derivano principalmente dal fatto che essi tendono a focalizzarsi unicamente sulla componente scritta del medesimo. Il fulcro del consenso informato, invece, deve ritenersi rappresentato da una comunicazione tra sanitario e paziente relativa ad un trattamento proposto ed alle possibili alternative, alla non sottoposizione ad alcun trattamento e ai rischi e benefici di ciascuna di queste opzioni. In un tale contesto il tema della comunicazione tra il professionista e la persona assistita sta suscitando interesse poiché ci si aspetta che esso conduca a miglioramenti degli outcome dei pazienti e alla diminuzione delle denunce da parte di questi ultimi per casi di responsabilità sanitaria. La maggiore attenzione al rapporto medico - paziente ha fatto emergere il bisogno di migliorare e potenziare le abilità comunicative dei medici, in un’ottica in cui il momento comunicativo possa essere percepito dal professionista come fulcro del rapporto medico-paziente, nella prospettiva di una elaborazione di strategie di prevenzione e contrasto ai fenomeni di medicina difensiva.

La sanità mediata: il rapporto medico-paziente dentro e fuori lo schermo televisivo

L’obiettivo di questa tesi è rilevare se e quanto i medical dramas abbiano contribuito a ridefinire conoscenze, aspettative e pratiche dei telespettatori/pazienti rispetto a questioni concernenti la salute e il loro ruolo all’interno della relazione medico-paziente. Grazie ad un lavoro di campo, fatto di questionari e interviste con utenti, operatori della sanità di Centro e Nord Italia e studenti di Medicina, sono state poi registrate le modalità di interazione che i protagonisti della scena della cura dichiarano di sperimentare quotidianamente. Ciò ha permesso di rendere conto delle trasformazioni più recenti della professione medica e di come viene elaborato oggi il sapere sulla malattia da parte dei soggetti implicati, fra tecnicismi, atteggiamenti difensivi, sfiducia e affidamento. La tesi restituisce anche alcune modalità sperimentali di interazione fra pazienti e medici, messe in atto in contesti locali, che testimoniano l’esigenza di approdare a un sapere partecipato delle relazioni di cura. Infine, raccogliendo la sfida posta dalle medical humanities, immagina un utilizzo del medical drama nella formazione degli studenti di medicina per l’apprendimento di competenze narrative necessarie ad una pratica medica più umana e efficace.

La prova penale nelle indagini difensive. Analisi comparata degli strumenti processuali concessi alla difesa nei sistemi italiano e statunitense.

L’elaborato si occupa di fare il punto in materia di indagini difensive a tre lustri dall’entrata in vigore della legge n. 397/2000, epilogo di un lungo processo evolutivo che ha visto da un lato, una gestazione faticosa e travagliata, dall’altro, un prodotto normativo accolto dagli operatori in un contesto di scetticismo generale. In un panorama normativo e giurisprudenziale in continua evoluzione, i paradigmi dettati dagli artt. 24 e 111 della Costituzione, in tema di diritto alla difesa e di formazione della prova penale secondo il principio del contraddittorio tra le parti, in condizioni di parità, richiedono che il sistema giustizia offra sia all’indagato che all’imputato sufficienti strumenti difensivi. Tenuto conto delle diversità che caratterizzano naturalmente i ruoli dell’accusa e della difesa che impongono asimmetrie genetiche inevitabili, l’obiettivo della ricerca consiste nella disamina degli strumenti idonei a garantire il diritto alla prova della difesa in ogni stato e grado del procedimento, nel tentativo di realizzare compiutamente il principio di parità accusa - difesa nel processo penale. La ricerca si dipana attraverso tre direttrici: l’analisi dello statuto sulle investigazioni difensive nella sua evoluzione storica sino ai giorni nostri, lo studio della prova penale nel sistema americano e, infine, in alcune considerazioni finali espresse in chiave comparatistica. Le suggestioni proposte sono caratterizzate da un denominatore comune, ovvero dal presupposto che per contraddire è necessario conoscere e che solo per tale via sia possibile, finalmente, riconoscere il diritto di difendersi indagando.

Paracrine factors secreted by endothelial progenitor cells prevent oxidative stress-induced apoptosis of mature endothelial cells

Endothelial progenitor cells (EPC) play a fundamental role in tissue regeneration and vascular repair. Current research suggests that EPC are more resistant to oxidative stress as compared to differentiated endothelial cells. Here we hypothesized that EPC not only possess the ability to protect themselves against oxidative stress but also confer this protection upon differentiated endothelial cells by release of paracrine factors. To test this hypothesis, HUVEC incubated with conditioned medium obtained from early EPC cultures (EPC-CM) were exposed to H2O2 to assess the accumulation of intracellular ROS, extent of apoptosis and endothelial cell functionality. Under oxidative stress conditions HUVEC treated with EPC-CM exhibited substantially lower levels of intracellular oxidative stress (0.2+/-0.02 vs. 0.4+/-0.03 relative fluorescence units, p<0.05) compared to control medium. Moreover, the incubation with EPC-CM elevated the expression level of antioxidant enzymes in HUVEC (catalase: 2.6+/-0.4; copper/zinc superoxide dismutase (Cu/ZnSOD): 1.6+/-0.1; manganese superoxide dismutase (MnSOD): 1.4+/-0.1-fold increase compared to control, all p<0.05). Furthermore, EPC-CM had the distinct potential to reverse the functional impairment of HUVEC as measured by their capability to form tubular structures in vitro. Finally, incubation of HUVEC with EPC-CM resulted in a significant reduction of apoptosis (0.34+/-0.01 vs. 1.52+/-0.12 relative fluorescence units, p<0.01) accompanied by an increased expression ratio of the anti/pro-apoptotic factors Bcl-2/Bax to 2.9+/-0.7-fold (compared to control, p<0.05). Most importantly, neutralization of selected cytokines such as VEGF, HGF, IL-8 and MMP-9 did not significantly reverse the cyto-protective effect of EPC-CM (p>0.05), suggesting that soluble factors secreted by EPC, possibly via broad synergistic actions, exert strong cyto-protective properties on differentiated endothelium through modulation of intracellular antioxidant defensive mechanisms and pro-survival signals.

A double role of sperm in scorpions: the mating plug of Euscorpius italicus (Scorpiones: Euscorpiidae) consists of sperm

Mating plugs occluding the female gonopore after mating are a widespread phenomenon. In scorpions, two main types of mating plugs are found: sclerotized mating plugs being parts of the spermatophore that break off during mating, and gel-like mating plugs being gelatinous fluids that harden in the female genital tract. In this study, the gel-like mating plug of Euscorpius italicus was investigated with respect to its composition, fine structure, and changes over time. Sperm forms the major component of the mating plug, a phenomenon previously unknown in arachnids. Three parts of the mating plug can be distinguished. The part facing the outside of the female (outer part) contains sperm packages containing inactive spermatozoa. In this state, sperm is transferred. In the median part, the sperm packages get uncoiled to single spermatozoa. In the inner part, free sperm is embedded in a large amount of secretions. Fresh mating plugs are soft gelatinous, later they harden from outside toward inside. This process is completed after 3-5 days. Sperm from artificially triggered spermatophores could be activated by immersion in insect Ringer's solution indicating that the fluid condition in the females' genital tract or females' secretions causes sperm activation. Because of the male origin of the mating plug, it has likely evolved under sperm competition or sexual conflict. As females refused to remate irrespective of the presence or absence of a mating plug, females may have changed their mating behavior in the course of evolution from polyandry to monandry.

The venom composition of the parasitic wasp Chelonus inanitus resolved by combined expressed sequence tags analysis and proteomic approach

Background Parasitic wasps constitute one of the largest group of venomous animals. Although some physiological effects of their venoms are well documented, relatively little is known at the molecular level on the protein composition of these secretions. To identify the majority of the venom proteins of the endoparasitoid wasp Chelonus inanitus (Hymenoptera: Braconidae), we have randomly sequenced 2111 expressed sequence tags (ESTs) from a cDNA library of venom gland. In parallel, proteins from pure venom were separated by gel electrophoresis and individually submitted to a nano-LC-MS/MS analysis allowing comparison of peptides and ESTs sequences. Results About 60% of sequenced ESTs encoded proteins whose presence in venom was attested by mass spectrometry. Most of the remaining ESTs corresponded to gene products likely involved in the transcriptional and translational machinery of venom gland cells. In addition, a small number of transcripts were found to encode proteins that share sequence similarity with well-known venom constituents of social hymenopteran species, such as hyaluronidase-like proteins and an Allergen-5 protein. An overall number of 29 venom proteins could be identified through the combination of ESTs sequencing and proteomic analyses. The most highly redundant set of ESTs encoded a protein that shared sequence similarity with a venom protein of unknown function potentially specific of the Chelonus lineage. Venom components specific to C. inanitus included a C-type lectin domain containing protein, a chemosensory protein-like protein, a protein related to yellow-e3 and ten new proteins which shared no significant sequence similarity with known sequences. In addition, several venom proteins potentially able to interact with chitin were also identified including a chitinase, an imaginal disc growth factor-like protein and two putative mucin-like peritrophins. Conclusions The use of the combined approaches has allowed to discriminate between cellular and truly venom proteins. The venom of C. inanitus appears as a mixture of conserved venom components and of potentially lineage-specific proteins. These new molecular data enrich our knowledge on parasitoid venoms and more generally, might contribute to a better understanding of the evolution and functional diversity of venom proteins within Hymenoptera.

Comparison of genomic and proteomic data in recurrent airway obstruction affected horses using Ingenuity Pathway Analysis(R)

BACKGROUND: Recurrent airway obstruction (RAO) is a severe chronic respiratory disease affecting horses worldwide, though mostly in the Northern hemisphere. Environmental as well as genetic factors strongly influence the course and prognosis of the disease. Research has been focused on characterization of immunologic factors contributing to inflammatory responses, on genetic linkage analysis, and, more recently, on proteomic analysis of airway secretions from affected horses. The goal of this study was to investigate the interactions between eight candidate genes previously identified in a genetic linkage study and proteins expressed in bronchoalveolar lavage fluid (BALF) collected from healthy and RAO-affected horses. The analysis was carried out with Ingenuity Pathway Analysis(R) bioinformatics software. RESULTS: The gene with the greatest number of indirect interactions with the set of proteins identified is Interleukin 4 Receptor (IL-4R), whose protein has also been detected in BALF. Interleukin 21 receptor and chemokine (C-C motif) ligand 24 also showed a large number of interactions with the group of detected proteins. Protein products of other genes like that of SOCS5, revealed direct interactions with the IL-4R protein. The interacting proteins NOD2, RPS6KA5 and FOXP3 found in several pathways are reported regulators of the NFkappaB pathway. CONCLUSIONS: The pathways generated with IL-4R highlight possible important intracellular signaling cascades implicating, for instance, NFkappaB. Furthermore, the proposed interaction between SOCS5 and IL-4R could explain how different genes can lead to identical clinical RAO phenotypes, as observed in two Swiss Warmblood half sibling families because these proteins interact upstream of an important cascade where they may act as a functional unit.

Effects of induced parturition in goats on immunoglobulin G and chitotriosidase activity in colostrum and plasma and on plasma concentrations of prolactin

The effect of induction of parturition with a PGF(2)alpha analog on plasma concentration of prolactin (PRL) and its effects on colostrum concentration of IgG and chitotriosidase (ChT) activity were studied in 16 pregnant Majorera goats. Treated goats, those in which parturition was induced, had greater concentrations of PRL than control goats 24 h before parturition (P < 0.05) and 48 h after parturition (P < 0.05). Control goats had greater concentrations of PRL than treated goats 96 h after parturition (P < 0.05). Plasma concentration of IgG did not differ between groups during the experimental period, but colostrum concentrations of IgG were greater in control goats than in treated goats at parturition (P < 0.05). Plasma ChT activity decreased during the period 72 h before parturition to 24 h after parturition in control and treated goats. Time evolution after partum affected the colostrum ChT activity, being greater at parturition than after parturition in both groups (P < 0.05). In summary, concentration of IgG in colostrum is slightly diminished if parturition is induced. Induction of parturition causes an early increase in PRL, which is most likely responsible for preterm suppression of IgG transport into mammary secretions. (C) 2011 Elsevier Inc. All rights reserved.

Management effects on colostrogenesis in small ruminants: a review

Colostrum feeding in small ruminants is crucial during the first hours after birth due to the lack of Ig transfer during pregnancy via the placenta. In addition the immature immune system of the neonate is slow to produce its own Ig during the first weeks of life. Colostrogenesis, i.e. the transfer of Ig from blood into mammary secretions, starts several weeks prepartum. In goat plasma, immunoglobulin G (IgG) concentration decreases by around 38% from the third month of gestation until partum, which coincides with the dry period. Thus, management during the dry period is crucial for the course of colostrogenesis. The colostrum synthesis is determined by the nutrition during the prepartum period, but the transfer of Ig is obviously independent of nutritional influences. The administration of conjugated linoleic acid during the dry period to dairy goats causes a less pronounced decrease of blood plasma IgG concentration (6%) but it did not change colostral IgG levels. In cattle, IgG1 is transported from blood into colostrum by an IgG1 specific receptor located on the surface of alveolar epithelial cells during colostrogenesis, and this is most likely similar in small ruminants. Via inactivation of this receptor, the Ig transfer is downregulated by increasing prolactin (PRL) during lactogenesis. It was recently observed in goats treated with PGF2 alpha, in order to induce parturition, lower colostrum IgG concentrations occurred concomitantly with an earlier increase of plasma PRL as compared to untreated animals. The effect of litter size and number of lactations on colostral IgG concentration in small ruminants has not been made fully clear until now most likely due to the different breeds used in the published studies.

Ordering CT pulmonary angiography to exclude pulmonary embolism: defense versus evidence in the emergency room

To identify reasons for ordering computed tomography pulmonary angiography (CTPA), to identify the frequency of reasons for CTPA reflecting defensive behavior and evidence-based behavior, and to identify the impact of defensive medicine and of training about diagnosing pulmonary embolism (PE) on positive results of CTPA.