Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 16 de 16
Filtrar
Mais filtros

Base de dados
País/Região como assunto
Tipo de documento
Intervalo de ano de publicação
1.
Ann Allergy Asthma Immunol ; 131(6): 752-758.e1, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37689113

RESUMO

BACKGROUND: Epinephrine is the first-line treatment for anaphylaxis but is often replaced with antihistamines or corticosteroids. Delayed epinephrine administration is a risk factor for fatal anaphylaxis. Convincing data on the role of antihistamines and corticosteroids in anaphylaxis management are sparse. OBJECTIVE: To establish the impact of prehospital treatment with epinephrine, antihistamines, and/or corticosteroids on anaphylaxis management. METHODS: Patients presenting with anaphylaxis were recruited prospectively and retrospectively in 10 Canadian and 1 Israeli emergency departments (EDs) between April 2011 and August 2022, as part of the Cross-Canada Anaphylaxis REgistry. Data on anaphylaxis cases were collected using a standardized form. Primary outcomes were uncontrolled reactions (>2 doses of epinephrine in ED), no prehospital epinephrine use, use of intravenous fluids in ED, and hospital admission. Multivariate regression was used to identify factors associated with primary outcomes. RESULTS: Among 5364 reactions recorded, median age was 8.8 years (IQR, 3.78-16.9); 54.9% of the patients were males, and 52.5% had a known food allergy. In the prehospital setting, 37.9% received epinephrine; 44.3% received antihistamines, and 3.15% received corticosteroids. Uncontrolled reactions happened in 250 reactions. Patients treated with prehospital epinephrine were less likely to have uncontrolled reactions (adjusted odds ratio [aOR], 0.955 [95% CI, 0.943-0.967]), receive intravenous fluids in ED (aOR, 0.976 [95% CI, 0.959-0.992]), and to be admitted after the reaction (aOR, 0.964 [95% CI, 0.949-0.980]). Patients treated with prehospital antihistamines were less likely to have uncontrolled reactions (aOR, 0.978 [95% CI, 0.967-0.989]) and to be admitted after the reaction (aOR, 0.963 [95% CI, 0.949-0.977]). Patients who received prehospital corticosteroids were more likely to require intravenous fluids in ED (aOR, 1.059 [95% CI, 1.013-1.107]) and be admitted (aOR, 1.232 [95% CI, 1.181-1.286]). CONCLUSION: Our findings in this predominantly pediatric population support the early use of epinephrine and suggest a beneficial effect of antihistamines. Corticosteroid use in anaphylaxis should be revisited.


Assuntos
Anafilaxia , Serviços Médicos de Emergência , Masculino , Humanos , Criança , Feminino , Anafilaxia/tratamento farmacológico , Anafilaxia/epidemiologia , Anafilaxia/etiologia , Estudos Retrospectivos , Dados de Saúde Coletados Rotineiramente , Canadá/epidemiologia , Epinefrina/uso terapêutico , Serviço Hospitalar de Emergência , Antagonistas dos Receptores Histamínicos/uso terapêutico , Corticosteroides/uso terapêutico
2.
CMAJ ; 192(48): E1612-E1619, 2020 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-33257343

RESUMO

BACKGROUND: Less than two-thirds of children with abdominal pain in the emergency department receive analgesia. We sought to determine whether hyoscine butylbromide was superior to acetaminophen for children with nonspecific colicky abdominal pain. METHODS: We randomly allocated children aged 8-17 years with nonspecific colicky abdominal pain who presented to the pediatric emergency department of London Health Sciences Centre, London, Ontario to receive hyoscine butylbromide, 10 mg given orally, or acetaminophen, 15 mg/kg given orally (maximum 975 mg). We considered the minimal clinically important difference for the primary outcome (self-reported pain at 80 min) to be 13 mm on a 100 mm visual analogue scale. Secondary outcomes included administration of rescue analgesia, adverse effects and pain score less than 30 mm at 80 minutes. RESULTS: A total of 236 participants (120 in the hyoscine butylbromide group and 116 in the acetaminophen group) were included in the trial. The mean visual analogue scale scores at 80 minutes were 29 mm (standard deviation [SD] 26 mm) and 30 mm (SD 29 mm) with hyoscine butylbromide and acetaminophen, respectively (adjusted difference 1, 95% confidence interval -7 to 7). Rescue analgesia was administered to 4 participants (3.3%) in the hyoscine butylbromide group and 1 participant (0.9%) in the acetaminophen groups (p = 0.2). We found no significant differences in rates of adverse effects between hyoscine butylbromide (32/116 [27.6%]) and acetaminophen (28/115 [24.3]) (p = 0.5); no serious adverse effects were observed. The proportion with a pain score less than 30 mm at 80 minutes was 66 (55.0%) with hyoscine butylbromide and 63 (54.3%) with acetaminophen (p = 0.9). INTERPRETATION: Hyoscine butylbromide was not superior to acetaminophen in this setting. Both agents were associated with clinically important pain reduction, and either can be considered for children presenting to the emergency department with nonspecific colicky abdominal pain. Trial registration: Clinicaltrials.gov, no. NCT02582307.


Assuntos
Acetaminofen , Escopolamina , Dor Abdominal/tratamento farmacológico , Acetaminofen/uso terapêutico , Adolescente , Criança , Humanos , Hidrocarbonetos Bromados , Ontário
3.
Acad Psychiatry ; 44(1): 59-63, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31701387

RESUMO

OBJECTIVE: Stigma against individuals with mental illness has disastrous consequences for patient outcomes. Better approaches to reducing stigma in health care professionals are required. Implicit stigma education is an emerging area of research that may inform the design and implementation of stigma reduction programs. In this "in brief report," the authors describe the evaluation of a novel implicit stigma reduction workshop for health professionals. METHODS: The authors conducted a realist evaluation using a longitudinal multiple case study approach. Once a conceptual model was established, three case studies were conducted on physicians and nurses (n = 69) at an academic health sciences center. Within each case, pre- and post-attitudinal scales and qualitative data from semi-structured interviews were used. Consistent with realist evaluation principles, context-mechanism-outcome configuration patterns were analyzed. RESULTS: An implicit stigma recognition and management workshop produced statistically significant changes in participant attitudes in two out of three contexts. The qualitative evaluation described the perceptions of sustainable changes in perspective and practice. The degree to which individual participants learned with and worked among inter-professional teams influenced outcomes. CONCLUSIONS: Implicit stigma recognition and management is a useful educational strategy for reducing stigma among health professionals. Once stigma is recognized, curricular interventions may promote behavioral change by encouraging explicit alternative behaviors that are sustained through social reinforcement within inter-professional teams.


Assuntos
Atitude do Pessoal de Saúde , Educação/métodos , Conhecimentos, Atitudes e Prática em Saúde , Enfermeiras e Enfermeiros , Médicos , Estigma Social , Adulto , Humanos , Estudos Longitudinais
4.
J Emerg Med ; 47(1): 51-8, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24680102

RESUMO

BACKGROUND: Appendicitis is a common pediatric condition requiring urgent surgical intervention to prevent complications. Pelvic ultrasound (US) as a diagnostic aid has become increasingly common. Despite its advantages, evidence suggests US can lead to delayed definitive management. OBJECTIVE: The objective was to test the hypothesis that US is associated with an increased time to appendectomy in children with acute appendicitis. METHODS: A chart review was conducted of all children aged 0-17 years who presented to the pediatric emergency department (ED) with a discharge diagnosis of appendicitis. The primary outcome variable was the interval between initial evaluation to appendectomy between patients who received an US and those who did not. RESULTS: Of 662 cases included, 424 patients (64%) underwent a pelvic US and 238 patients underwent an appendectomy without US. Median time interval from initial evaluation in the ED by a physician to appendectomy among patients who received an US was 9.7 h (interquartile range [IQR]: 6.8-15.0 h) compared with 5.5 h (IQR: 3.8-8.6 h) among patients who did not receive an US (Mann-Whitney, p < 0.001). The increased time to appendectomy in patients who received an US was dependent on the patient being female and presenting to the ED after hours (univariate analysis of variance test for interaction, p < 0.05). CONCLUSIONS: Female pediatric patients and those presenting after hours that undergo an US have a significantly increased time to appendectomy compared with those who do not undergo diagnostic imaging.


Assuntos
Apendicite/diagnóstico por imagem , Apendicite/cirurgia , Perfuração Intestinal/etiologia , Pelve/diagnóstico por imagem , Tempo para o Tratamento , Abscesso Abdominal/etiologia , Adolescente , Plantão Médico , Apendicectomia , Apendicite/complicações , Criança , Estudos Transversais , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores Sexuais , Fatores de Tempo , Ultrassonografia
5.
Swiss Med Wkly ; 154: 3421, 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38753467

RESUMO

Emergency physicians are the most at-risk medical specialist group for burnout. Given its consequences for patient care and physician health and its resulting increased attrition rates, ensuring the wellbeing of emergency physicians is vital for preserving the integrity of the safety net for the healthcare system that is emergency medicine. In an effort to understand the current state of practicing physicians, this study reviews the results of the first national e-survey on physician wellbeing and burnout in emergency medicine in Switzerland. Addressed to all emergency physicians between March and April 2023, it received 611 complete responses. More than half of respondents met at least one criterion for burnout according to the Maslach Burnout Inventory - Human Services Survey (59.2%) and the Copenhagen Burnout Inventory (54.1%). In addition, more than half reported symptoms suggestive of mild to severe depression, with close to 20% screening positively for moderate to severe depression, nearly 4 times the incidence in the general population, according to the Patient Health Questionnaire-9. We found that 10.8% of respondents reported having considered suicide at some point in their career, with nearly half having considered this in the previous 12 months. The resulting high attrition rates (40.6% of respondents had considered leaving emergency medicine because of their working conditions) call into question the sustainability of the system. Coinciding with trends observed in other international studies on burnout in emergency medicine, this study reinforces the fact that certain factors associated with wellbeing are intrinsic to emergency medicine working conditions.


Assuntos
Esgotamento Profissional , Depressão , Medicina de Emergência , Médicos , Humanos , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Suíça/epidemiologia , Médicos/psicologia , Médicos/estatística & dados numéricos , Feminino , Masculino , Inquéritos e Questionários , Depressão/epidemiologia , Depressão/psicologia , Adulto , Pessoa de Meia-Idade , Satisfação no Emprego
6.
JMIR Form Res ; 7: e37527, 2023 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-36862464

RESUMO

BACKGROUND: Physicians experience higher rates of burnout relative to the general population. Concerns of confidentiality, stigma, and professional identities as health care providers act as barriers to seeking and receiving appropriate support. In the context of the COVID-19 pandemic, factors that contribute to burnout and barriers to seeking support have been amplified, elevating the overall risks of mental distress and burnout for physicians. OBJECTIVE: This paper aimed to describe the rapid development and implementation of a peer support program within a health care organization located in London, Ontario, Canada. METHODS: A peer support program leveraging existing infrastructures within the health care organization was developed and launched in April 2020. The "Peers for Peers" program drew from the work of Shapiro and Galowitz in identifying key components within hospital settings that contributed to burnout. The program design was derived from a combination of the peer support frameworks from the Airline Pilot Assistance Program and the Canadian Patient Safety Institute. RESULTS: Data gathered over 2 waves of peer leadership training and program evaluations highlighted a diversity of topics covered through the peer support program. Further, enrollment continued to increase in size and scope over the 2 waves of program deployments into 2023. CONCLUSIONS: Findings suggest that the peer support program is acceptable to physicians and can be easily and feasibly implemented within a health care organization. The structured program development and implementation can be adopted by other organizations in support of emerging needs and challenges.

7.
J Immunol ; 182(1): 39-43, 2009 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-19109132

RESUMO

NKG2D is a receptor used by NK cells to detect virally infected and transformed cells. It recognizes ligands that are expressed constitutively on primary tumors and tumor cell lines. In this report, we have identified four microRNAs (miRNAs) that each was sufficient to reduce the expression of the NKG2D ligand MHC class I-related chain A (MICA). One of these miRNAs (miR-520b) was induced by IFN-gamma, leading to a reduction in MICA surface protein levels. Interestingly, miR-520b acted on both the MICA 3'-untranslated region and the promoter region and caused a decrease in the levels of MICA transcript. In contrast, an antisense oligonucleotide inhibitor of miR-520b increased the expression of a reporter construct containing the MICA 3'-untranslated region but not the MICA promoter region. These findings demonstrate the novel regulation of an NKG2D ligand by an endogenous microRNA that is itself induced by IFN-gamma.


Assuntos
Regulação para Baixo/genética , Regulação para Baixo/imunologia , Regulação da Expressão Gênica , Antígenos de Histocompatibilidade Classe I/metabolismo , Interferon gama/fisiologia , MicroRNAs/fisiologia , Supressão Genética , Regiões 3' não Traduzidas/antagonistas & inibidores , Linhagem Celular Tumoral , Regulação da Expressão Gênica/imunologia , Células HCT116 , Células HeLa , Antígenos de Histocompatibilidade Classe I/biossíntese , Humanos , MicroRNAs/biossíntese , MicroRNAs/genética , Regiões Promotoras Genéticas/imunologia , Supressão Genética/imunologia
8.
Nurs Health Sci ; 12(3): 369-74, 2010 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-20727089

RESUMO

Nurse researchers and educators often engage in outreach to narrowly defined populations. This article offers examples of how variations on the snowball sampling recruitment strategy can be applied in the creation of culturally appropriate, community-based information dissemination efforts related to recruitment to health education programs and research studies. Examples from the primary author's program of research are provided to demonstrate how adaptations of snowball sampling can be used effectively in the recruitment of members of traditionally underserved or vulnerable populations. The adaptation of snowball sampling techniques, as described in this article, helped the authors to gain access to each of the more-vulnerable population groups of interest. The use of culturally sensitive recruitment strategies is both appropriate and effective in enlisting the involvement of members of vulnerable populations. Adaptations of snowball sampling strategies should be considered when recruiting participants for education programs or for research studies when the recruitment of a population-based sample is not essential.


Assuntos
Pesquisa em Enfermagem , Seleção de Pacientes , Projetos de Pesquisa , Sujeitos da Pesquisa , Humanos , Estudos de Amostragem
9.
J Cancer Educ ; 24(1): 10-5, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19259859

RESUMO

BACKGROUND: Deaf women encounter barriers to accessing cancer information. In this study, we evaluated whether deaf women's knowledge could be increased by viewing a graphically enriched, American Sign Language (ASL) cervical cancer education video. METHODS: A blind, randomized trial evaluated knowledge gain and retention. Deaf women (n = 130) completed questionnaires before, after, and 2 months after viewing the video. RESULTS: With only a single viewing of the in-depth video, the experimental group gained and retained significantly more cancer knowledge than the control group. CONCLUSIONS: Giving deaf women access to the ASL cervical cancer education video (http://cancer.ucsd.edu/deafinfo) significantly increased their knowledge of cervical cancer.


Assuntos
Surdez/complicações , Educação de Pessoas com Deficiência Auditiva , Educação em Saúde , Língua de Sinais , Neoplasias do Colo do Útero , Gravação em Vídeo/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , California , Estudos Cross-Over , Competência Cultural , Avaliação Educacional , Escolaridade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , Método Simples-Cego , Inquéritos e Questionários , Neoplasias do Colo do Útero/prevenção & controle , Adulto Jovem
10.
J Allergy Clin Immunol Pract ; 7(4): 1166-1173.e1, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30476682

RESUMO

BACKGROUND: Anaphylaxis due to unknown trigger (AUT) is anaphylaxis not explained by a proved or presumptive cause or stimulus at the time of the reaction. Research describing the management and follow-up of AUT is limited. OBJECTIVE: To assess and compare the demographic and clinical characteristics and the management of adult and pediatric AUT cases across Canada. METHODS: Participants were identified between 2011 and 2018 in emergency departments at 8 centers across Canada as part of the Cross-Canada Anaphylaxis Registry. A standardized form documenting the reaction and management in children and adults was completed. Patients were contacted for follow-up to determine assessment by an allergist. RESULTS: A total of 295 AUT cases (7.5%) were recruited among 3,922 cases of anaphylaxis. In the prehospital setting, children (adjusted odds ratio [aOR], 1.20; 95% CI, 1.05-1.37) and those with a known food allergy (aOR, 1.14; 95% CI, 1.02-1.28) were more likely to receive treatment with epinephrine. Children were also more likely to be assessed by an allergist after their reaction (aOR, 1.43; 95% CI, 1.13-1.81) and were more likely to have an identified trigger for their reaction (aOR, 1.35; 95% CI, 1.07-1.70). Among patients contacted for follow-up, food was identified as the cause of reaction in 11 of 76 patients. A new food allergy was diagnosed in 4 patients (2 children and 2 adults). CONCLUSIONS: Our findings highlight important differences between management and follow-up of adult and pediatric AUT cases. It is crucial to follow up all cases of AUT and establish appropriate treatment and management guidelines.


Assuntos
Anafilaxia/terapia , Epinefrina/uso terapêutico , Hipersensibilidade Alimentar/diagnóstico , Antagonistas dos Receptores Histamínicos/uso terapêutico , Simpatomiméticos/uso terapêutico , Adolescente , Corticosteroides/uso terapêutico , Agonistas Adrenérgicos beta/uso terapêutico , Adulto , Assistência ao Convalescente , Fatores Etários , Alergia e Imunologia , Anafilaxia/epidemiologia , Anafilaxia/etiologia , Anafilaxia/metabolismo , Asma/epidemiologia , Canadá/epidemiologia , Criança , Pré-Escolar , Comorbidade , Serviços Médicos de Emergência , Serviço Hospitalar de Emergência , Feminino , Hidratação , Seguimentos , Hipersensibilidade Alimentar/complicações , Hipersensibilidade Alimentar/epidemiologia , Humanos , Lactente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Encaminhamento e Consulta , Sistema de Registros , Testes Cutâneos , Triptases/metabolismo , Adulto Jovem
12.
Ann Pharmacother ; 41(9): 1368-74, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17636113

RESUMO

BACKGROUND: Musculoskeletal (MSK) ankle injuries cause significant morbidity in ambulatory pediatric populations. No optimal pharmacotherapy is available. OBJECTIVE: To conduct a randomized, double-blind trial to compare 2 drug therapies for soft tissue injury of the ankle. METHODS: Patients (N = 77, aged 8-14 y, 61% male) with ankle injuries presenting to a regional pediatric emergency department were assigned to receive either acetaminophen (15 mg/kg 4 times a day) or naproxen (5 mg/kg 4 times a day) in a double-blind fashion on a routine basis for a 5 day period. On days 0 and 7, patients rated their degree of disability and pain on weight bearing using a 10 cm visual analog scale developed for this study. In addition, they were examined by a physician who rated pain, tenderness on palpation, and swelling using a 4 point scale. There were 3 follow-up telephone calls on days 3, 14, and 21. Adherence was evaluated by self-report and pill count. RESULTS: Both the acetaminophen and naproxen groups had significant improvement in degree of disability and pain from day 0 to day 7. There was no statistically significant difference in outcome between the 2 groups by patient self-evaluation or physician assessment. There also was no significant difference in adverse event rates between the 2 groups, and the majority of patients in both groups felt that the medication was helpful. CONCLUSIONS: No significant difference in efficacy of pain control or improvement of disability between the naproxen and acetaminophen groups suggests no preferential advantage for naproxen over acetaminophen for MSK injuries when given on a regular basis, with concurrent supportive treatment. Possible differential benefit from intermittent therapy needs to be evaluated among children with ankle injury.


Assuntos
Acetaminofen/uso terapêutico , Analgésicos não Narcóticos/uso terapêutico , Traumatismos do Tornozelo/tratamento farmacológico , Anti-Inflamatórios não Esteroides/uso terapêutico , Naproxeno/uso terapêutico , Lesões dos Tecidos Moles/tratamento farmacológico , Adolescente , Criança , Método Duplo-Cego , Feminino , Humanos , Masculino , Dor/tratamento farmacológico
13.
CJEM ; 8(4): 277-80, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17324309

RESUMO

OBJECTIVE: The aim of the study was to characterize the nature of the injuries sustained by children involved in all-terrain vehicle (ATV) crashes in Southwestern Ontario over a 5-year period. METHODS: A retrospective chart review was conducted of children who sustained ATV-related trauma and who presented to the emergency department at the Children's Hospital of Western Ontario between Sept. 1, 1998, and Aug. 31, 2003, with an Injury Severity Score (ISS) = 12. Patients were identified by the London Health Sciences Centre Trauma Program Registry. Patient charts were then retrieved and reviewed to record patient demographics, injuries, interventions and length of stay in hospital. RESULTS: Seventeen patients, 14 male and 3 female, met inclusion criteria. Ages ranged from 8-17 years, with an average age of 13.7 years. Thirteen were <16 years of age. Overall there were 7 different systems injured in these 17 patients. Fourteen patients sustained an injury to more than 1 system. The average ISS was 22.8. The average length of hospital stay was 9.7 days. Six patients sustained significant head injuries; 4 of these 6 patients were not wearing helmets. Eight patients suffered splenic injuries, and 3 required a splenectomy. Thirteen patients sustained fractures. CONCLUSION: ATV trauma is a significant threat to the children in Southwestern Ontario. These results clearly support the Canadian Paediatric Society's recommendation that children <16 years of age should be prohibited from operating or riding on ATVs.


Assuntos
Acidentes/estatística & dados numéricos , Veículos Off-Road/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Criança , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Ontário/epidemiologia , Sistema de Registros , Estudos Retrospectivos
15.
CJEM ; 18(5): 323-30, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26804807

RESUMO

OBJECTIVES: Evidence exists that analgesics are underutilized, delayed, and insufficiently dosed for emergency department (ED) patients with acute abdominal pain. For physicians practicing in a Canadian paediatric ED setting, we (1) explored theoretical practice variation in the provision of analgesia to children with acute abdominal pain; (2) identified reasons for withholding analgesia; and (3) evaluated the relationship between providing analgesia and surgical consultation. METHODS: Physician members of Paediatric Emergency Research Canada (PERC) were prospectively surveyed and presented with three scenarios of undifferentiated acute abdominal pain to assess management. A modified Dillman's Tailored Design method was used to distribute the survey from June to July 2014. RESULTS: Overall response rate was 74.5% (149/200); 51.7% of respondents were female and mean age was 44 (SD 8.4) years. The reported rates of providing analgesia for case scenarios representative of renal colic, appendicitis, and intussusception, were 100%, 92.1%, and 83.4%, respectively, while rates of providing intravenous opioids were 85.2%, 58.6%, and 12.4%, respectively. In all 60 responses where the respondent indicated they would obtain a surgical consultation, analgesia would be provided. In the 35 responses where analgesia would be withheld, 21 (60%) believed pain was not severe enough, while 5 (14.3%) indicated it would obscure a surgical condition. CONCLUSIONS: Pediatric emergency physicians self-reported rates of providing analgesia for acute abdominal pain scenarios were higher than previously reported, and appeared unrelated to request for surgical consultation. However, an unwillingness to provide opioid analgesia, belief that analgesia can obscure a surgical condition, and failure to take self-reported pain at face value remain, suggesting that the need exists for further knowledge translation efforts.


Assuntos
Dor Abdominal/tratamento farmacológico , Analgesia/métodos , Analgésicos Opioides/administração & dosagem , Atitude do Pessoal de Saúde , Serviço Hospitalar de Emergência , Medição da Dor , Dor Abdominal/diagnóstico , Dor Aguda/tratamento farmacológico , Adolescente , Canadá , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Avaliação das Necessidades , Manejo da Dor/métodos , Pediatria , Padrões de Prática Médica , Índice de Gravidade de Doença , Inquéritos e Questionários , Resultado do Tratamento
16.
PLoS One ; 9(8): e105626, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25162609

RESUMO

How animals use sensory information to weigh the risks vs. benefits of behavioral decisions remains poorly understood. Inter-male aggression is triggered when animals perceive both the presence of an appetitive resource, such as food or females, and of competing conspecific males. How such signals are detected and integrated to control the decision to fight is not clear. For instance, it is unclear whether food increases aggression directly, or as a secondary consequence of increased social interactions caused by attraction to food. Here we use the vinegar fly, Drosophila melanogaster, to investigate the manner by which food influences aggression. We show that food promotes aggression in flies, and that it does so independently of any effect on frequency of contact between males, increase in locomotor activity or general enhancement of social interactions. Importantly, the level of aggression depends on the absolute amount of food, rather than on its surface area or concentration. When food resources exceed a certain level, aggression is diminished, suggestive of reduced competition. Finally, we show that detection of sugar via Gr5a+ gustatory receptor neurons (GRNs) is necessary for food-promoted aggression. These data demonstrate that food exerts a specific effect to promote aggression in male flies, and that this effect is mediated, at least in part, by sweet-sensing GRNs.


Assuntos
Agressão/fisiologia , Proteínas de Drosophila/metabolismo , Drosophila melanogaster/genética , Receptores de Superfície Celular/metabolismo , Células Receptoras Sensoriais/metabolismo , Paladar/fisiologia , Animais , Proteínas de Drosophila/genética , Drosophila melanogaster/metabolismo , Comportamento Alimentar/fisiologia , Alimentos , Expressão Gênica , Masculino , Receptores de Superfície Celular/genética , Sacarose/química , Sacarose/metabolismo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA