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1.
J Fish Dis ; 41(3): 463-468, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29064105

RESUMO

Hungary is an important carp producer with intensive trading relationships with farms in other carp-producing areas in Europe. Carp in Europe were recently found infected with carp edema virus (CEV), a poxvirus which causes the koi sleepy disease (KSD) syndrome. Moribund carp were collected from 17 fish farms and angling ponds in different regions of Hungary. Histological analysis of gills from these carp revealed a proliferation of the interlamellar epithelium and an infiltration by eosinophilic cells. In 13 of 17 of these carp, CEV DNA was detected by qPCR and in seven fish more than 1 × 104 copies of virus-specific DNA sequences per 250 ng of DNA, which could be considered as clinically relevant and a cause of disease. A phylogenetic analysis of the sequences revealed that all three genogroups of CEV were present in Hungarian common carp with genogroup I being most abundant. These results support the hypothesis of a prolonged presence of CEV in European carp populations and suggest that previous outbreaks of KSD were not recorded or misdiagnosed. Hence, a testing of carp and koi for infection with CEV should be included into disease surveillance programmes to prevent further spreading of this disease.


Assuntos
Carpas , Doenças dos Peixes/patologia , Infecções por Poxviridae/veterinária , Poxviridae/fisiologia , Animais , DNA Viral/análise , Doenças dos Peixes/virologia , Genótipo , Hungria , Filogenia , Poxviridae/genética , Infecções por Poxviridae/patologia , Infecções por Poxviridae/virologia , Análise de Sequência de DNA
2.
J Fish Dis ; 41(7): 1077-1092, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29542825

RESUMO

The effect of dietary ß-glucan on the bacterial community in the gut of common carp (Cyprinus carpio) was examined after oral application of Aeromonas hydrophila. Carp received either feed supplemented with 1% MacroGard® , a ß-1,3/1,6-glucan, or a ß-glucan-free diet. Fourteen days after feeding, half of the carp from each group were intubated with 109 colony-forming units (CFU) of a pathogenic strain of A. hydrophila. Gut samples were taken 12 hr to 7 days after application and analysed using microbiological and molecular biological techniques (NGS, RT-PCR-DGGE). The reaction of the mucosa and the microbiota to an A. hydrophila intubation differed in carp fed with ß-glucan compared to carp from the control group. In ß-glucan fed carp, the total bacterial amount was lower but the number of bacterial species was higher. Bacterial composition was different for carp from both treatment groups. The number of mucin filled goblet cells was reduced in carp fed the ß-glucan diet. Mucus was obviously released from the goblet cells and was probably washed out of the gut together with high numbers of bacteria. This might be protective against pathogenic bacteria and, therefore, feeding with ß-glucan may provide protection against infections of the gut in carp.


Assuntos
Carpas/imunologia , Carpas/microbiologia , Doenças dos Peixes/imunologia , Microbioma Gastrointestinal/efeitos dos fármacos , Glucanos/metabolismo , Mucosa Intestinal/imunologia , Aeromonas hydrophila/fisiologia , Ração Animal/análise , Animais , Carpas/metabolismo , Dieta/veterinária , Suplementos Nutricionais/análise , Glucanos/administração & dosagem , Infecções por Bactérias Gram-Negativas/imunologia
3.
Dis Aquat Organ ; 126(2): 155-166, 2017 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-29044045

RESUMO

Carp edema virus disease (CEVD), also known as koi sleepy disease, is caused by a poxvirus associated with outbreaks of clinical disease in koi and common carp Cyprinus carpio. Originally characterised in Japan in the 1970s, international trade in koi has led to the spread of CEV, although the first recognised outbreak of the disease outside of Japan was not reported until 1996 in the USA. In Europe, the disease was first recognised in 2009 and, as detection and diagnosis have improved, more EU member states have reported CEV associated with disease outbreaks. Although the structure of the CEV genome is not yet elucidated, molecular epidemiology studies have suggested distinct geographical populations of CEV infecting both koi and common carp. Detection and identification of cases of CEVD in common carp were unreliable using the original PCR primers. New primers for conventional and quantitative PCR (qPCR) have been designed that improve detection, and their sequences are provided in this paper. The qPCR primers have successfully detected CEV DNA in archive material from investigations of unexplained carp mortalities conducted >15 yr ago. Improvement in disease management and control is possible, and the principles of biosecurity, good health management and disease surveillance, applied to koi herpesvirus disease, can be equally applied to CEVD. However, further research studies are needed to fill the knowledge gaps in the disease pathogenesis and epidemiology that, currently, prevent an accurate assessment of the likely impact of CEVD on European koi and common carp aquaculture and on wild carp stocks.


Assuntos
Carpas/virologia , Doenças dos Peixes/virologia , Infecções por Poxviridae/veterinária , Poxviridae/isolamento & purificação , Animais , Europa (Continente)/epidemiologia , Doenças dos Peixes/epidemiologia , Poxviridae/genética , Infecções por Poxviridae/epidemiologia , Infecções por Poxviridae/virologia
4.
J Fish Dis ; 40(11): 1695-1706, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28452055

RESUMO

The Schlei fjord in northern Germany is the recipient water of a comprehensive eel, Anguilla anguilla (L.), stocking programme. Since 2015, stocked eels become alizarin red S marked, but to date no control mechanism is implemented in this stock enhancement measure to prevent anthropogenic spreading of diseases. Consequentially, it was possible that farmed stocking cohorts of 2015 and 2016 (in total ca. 1040 kg) were subsequently tested positive for anguillid herpesvirus 1 (AngHV 1). For this study, 100 eels [total length (TL) 24.3-72.9 cm, age ca. 1-6 years] were caught in 2016 and investigated with regard to AngHV 1 infection, parasite load (Anguillicoloides crassus) and body conditions. 68% of the eels were found to be virus positive while larger specimens were more often infected. In addition, a fitted generalized linear model (area under the curve = 0.741) demonstrated that an increase in individual TL is accompanied with an increased risk of clinically relevant virus loads. Anguillicoloides crassus turned out to be an important stressor for eels, because parasite and virus load revealed a significant positive correlation. The results of this study evidently show the urgent need of a disease containment strategy for eel stocking programmes.


Assuntos
Anguilla , Dracunculoidea/fisiologia , Doenças dos Peixes/epidemiologia , Infecções por Herpesviridae/veterinária , Herpesviridae/fisiologia , Infecções por Spirurida/veterinária , Animais , Feminino , Doenças dos Peixes/parasitologia , Doenças dos Peixes/virologia , Alemanha/epidemiologia , Infecções por Herpesviridae/epidemiologia , Infecções por Herpesviridae/virologia , Masculino , Carga Parasitária/veterinária , Prevalência , Infecções por Spirurida/epidemiologia , Infecções por Spirurida/parasitologia , Carga Viral/veterinária
5.
Water Sci Technol ; 75(5-6): 1204-1210, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28272049

RESUMO

A 'membrane-denitrification' reactor (MDR) was developed and tested in a semi-technical recirculation aquaculture system in comparison to a double - without MDR - as reference system. The MDR consisted of a reactor with an ultrafiltration membrane unit for removal of micro-particles (e.g. sludge flocs, bacteria and parasites). Specific carrier material provided surfaces for biofilm growth in a fluidized bed reactor with ethanol as carbon source for denitrification. The continuous motion of these carriers cleaned the membrane surface. With online and laboratory measurements of water parameters and operational data the feasibility of the concept was verified. An advantage is that no chemicals are needed to clean the membranes. Examinations of the fish and water analyses proved an MDR can positively influence cortisol, as a stress marker, and the microflora of the aquatic system.


Assuntos
Aquicultura/instrumentação , Aquicultura/métodos , Reatores Biológicos/microbiologia , Desnitrificação , Material Particulado/isolamento & purificação , Animais , Peixes , Membranas Artificiais , Nefelometria e Turbidimetria , Nitratos/análise , Nitritos/análise , Permeabilidade , Pressão , Esgotos/microbiologia
6.
Pol J Vet Sci ; 17(4): 733-5, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25638991

RESUMO

A Cyprinid herpesvirus 3 infection of carp induces a disease which causes substantial losses in carp culture. Here we present the use of a possible strategy for the management of the virus infection RNA interference based on small interfering RNAs. As a result of in vitro studies, we found that a mixture of short interfering RNAs specific for viral DNA enzyme synthesis and capsid proteins of the CyHV-3 can be a potential inhibitor of virus replication in fibroblastic cells. This gives the basis for the development of a combinatorial RNA interference strategy to treat CyHV-3 infections.


Assuntos
Proteínas do Capsídeo/metabolismo , Fibroblastos/virologia , Herpesviridae/fisiologia , Interferência de RNA/fisiologia , RNA Interferente Pequeno/genética , Animais , Proteínas do Capsídeo/genética , Morte Celular , Linhagem Celular , Fibroblastos/fisiologia , Peixes , Regulação Viral da Expressão Gênica , Herpesviridae/genética , Replicação Viral
7.
Am J Transplant ; 13(4): 1063-1068, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23398855

RESUMO

Natural killer (NK) cell function can be modulated by the killer cell immunoglobulin-like receptors (KIR) which interact with human leukocyte antigen (HLA) class I molecules on target cells. KIR-ligand mismatching has recently been shown by van Bergen et al. (American Journal of Transplantation 2011; 11(9): 1959-1964) to be a significant risk factor for long-term graft loss in HLA-A, -B and -DR compatible kidney transplants. To verify this potentially important finding, we performed genotyping of 608 deceased-donor kidney graft recipients and their HLA-A, -B and -DR compatible donors for KIR and HLA, using samples and clinical data provided by the Collaborative Transplant Study. Graft survival of KIR-ligand-matched and -mismatched transplants was compared. We found no impact of KIR-ligand mismatching on 10-year graft survival in HLA-A, -B, -DR compatible kidney transplants. Further analysis did not reveal a significant effect of recipient activating/inhibitory KIR or KIR genotypes on graft survival. Our data do not support the concept that KIR-HLA matching might serve as a tool to improve long-term renal allograft survival.


Assuntos
Antígenos de Histocompatibilidade Classe I/genética , Transplante de Rim/métodos , Receptores KIR/metabolismo , Insuficiência Renal/imunologia , Adolescente , Adulto , Idoso , Estudos de Coortes , Feminino , Genótipo , Sobrevivência de Enxerto , Teste de Histocompatibilidade , Humanos , Ligantes , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Insuficiência Renal/cirurgia , Fatores de Risco , Fatores de Tempo , Adulto Jovem
8.
Tissue Antigens ; 82(6): 410-5, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24134411

RESUMO

Mannose-binding lectin (MBL) is a major component of the lectin pathway of complement activation. High and low MBL levels have been associated with susceptibility and severity of a variety of infectious and autoimmune diseases. Several single-nucleotide polymorphisms (SNPs) in the promoter region and exon 1 of the MBL2 gene are responsible for variations in serum MBL levels. We developed a sequence-based typing method for allele-specific MBL2 genotyping and measured serum MBL protein levels in 24 German blood donors. We identified the common MBL2 haplotypes including five promoter polymorphisms in linkage with the Q allele and correlated serum MBL levels with the respective genotypes. The genotyping method presented here could provide a basis for confirmatory studies in larger cohorts.


Assuntos
Doenças Autoimunes/imunologia , Infecções/imunologia , Lectina de Ligação a Manose/genética , Análise de Sequência de DNA/métodos , Doenças Autoimunes/genética , Lectina de Ligação a Manose da Via do Complemento/genética , Éxons/genética , Feminino , Estudos de Associação Genética , Genótipo , Alemanha , Humanos , Infecções/genética , Desequilíbrio de Ligação , Masculino , Lectina de Ligação a Manose/sangue , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas/genética
13.
Rozhl Chir ; 88(12): 704-7, 2009 Dec.
Artigo em Tcheco | MEDLINE | ID: mdl-20662433

RESUMO

Blunt injury of the carotid artery is uncommon but serious injury with high mortality and morbidity. The symptomatology may be inconspicuous, in other case a neurological deficit is present. The cause is mainly head hyperexstension and rotation, basal scull fracture, compression, blunt stroke. The diagnosis is usually confirmed by CT scan, CT angiography, MRI. In the therapy in present prevail heparin anticoagulation and endovascular stent implantation in some cases.


Assuntos
Lesões das Artérias Carótidas/diagnóstico , Ferimentos não Penetrantes/diagnóstico , Acidentes de Trânsito , Adulto , Lesões das Artérias Carótidas/cirurgia , Artéria Carótida Interna , Feminino , Humanos , Tomografia Computadorizada por Raios X , Ferimentos não Penetrantes/cirurgia
14.
J Hazard Mater ; 160(2-3): 514-20, 2008 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-18455302

RESUMO

In this paper, the authors deal with the problem of processing various types of waste generated by leather industry, with special emphasis to chrome-tanned waste. The agent that makes this waste potentially hazardous is hexavalent chromium. Its compounds can have negative effects on human health and some CrVI salts are considered carcinogens. The authors present the risks of spontaneous oxidization of CrIII to CrVI in the open-air dumps as well as the possible risks of wearing bad quality shoes, in which the chromium content is not controlled. There are several ways of handling primary leather waste, but no satisfactory technology has been developed for the secondary waste (manipulation waste, e.g. leather scraps and used leather products). In this contribution, a new three-step hybrid technology of processing manipulation waste is presented and tested under laboratory, pilot-scale and industrial conditions. The filtrate can be used as a good quality NPK fertilizer. The solid product, titanium-chromium sludge, can serve as an inorganic pigment in glass and ceramic industry. Further, the authors propose selective collection of used leather products (e.g. old shoes), the hydrolysable parts of which can be also processed by the new hybrid technology.


Assuntos
Resíduos Industriais/efeitos adversos , Curtume , Poluentes Químicos da Água/efeitos adversos , Poluição Química da Água/efeitos adversos , Poluição Química da Água/prevenção & controle , Cromo/química , Cromo/toxicidade , Feminino , Filtração , Humanos , Neoplasias Renais/mortalidade , Projetos Piloto , Eliminação de Resíduos , Neoplasias da Bexiga Urinária/mortalidade
15.
Oncogene ; 25(24): 3365-74, 2006 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-16462769

RESUMO

Photodynamic therapy is a promising antitumor treatment modality approved for the management of both early and advanced tumors. The mechanisms of its antitumor action include generation of singlet oxygen and reactive oxygen species that directly damage tumor cells and tumor vasculature. A number of mechanisms seem to be involved in the protective responses to PDT that include activation of transcription factors, heat shock proteins, antioxidant enzymes and antiapoptotic pathways. Elucidation of these mechanisms might result in the design of more effective combination strategies to improve the antitumor efficacy of PDT. Using DNA microarray analysis to identify stress-related genes induced by Photofrin-mediated PDT in colon adenocarcinoma C-26 cells, we observed a marked induction of heme oxygenase-1 (HO-1). Induction of HO-1 with hemin or stable transfection of C-26 with a plasmid vector encoding HO-1 increased resistance of tumor cells to PDT-mediated cytotoxicity. On the other hand, zinc (II) protoporphyrin IX, an HO-1 inhibitor, markedly augmented PDT-mediated cytotoxicity towards C-26 and human ovarian carcinoma MDAH2774 cells. Neither bilirubin, biliverdin nor carbon monoxide, direct products of HO-1 catalysed heme degradation, was responsible for cytoprotection. Importantly, desferrioxamine, a potent iron chelator significantly potentiated cytotoxic effects of PDT. Altogether our results indicate that HO-1 is involved in an important protective mechanism against PDT-mediated phototoxicity and administration of HO-1 inhibitors might be an effective way to potentiate antitumor effectiveness of PDT.


Assuntos
Heme Oxigenase-1/fisiologia , Fotoquimioterapia/efeitos adversos , Animais , Monóxido de Carbono/química , Monóxido de Carbono/farmacologia , Quelantes/farmacologia , Éter de Diematoporfirina/química , Heme/química , Heme Oxigenase-1/metabolismo , Humanos , Ferro/farmacologia , Camundongos , Neoplasias/patologia , Análise de Sequência com Séries de Oligonucleotídeos , Oxigênio/metabolismo , Espécies Reativas de Oxigênio
16.
J Anim Sci ; 95(7): 3173-3183, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28727099

RESUMO

Masculinized females, named sex-reversed females (SRF), have a male phenotype but retain the female genotype (XX) and all spermatozoa produced in their testes carry the X chromosome. Masculinization of females leads to incomplete testicular development and the production of lower-quality semen. The mechanism of masculinization is unknown at present. Therefore, the aim of our study was to identify differentially abundant proteins in testicular semen of normal males and SRF using a difference in-gel electrophoresis approach. Masculinization seemed to not lead to significant changes in the testicular seminal plasma proteome, but did have an impact on the proteome of SRF and normal male sperm. We identified 26 proteins enriched ( < 0.05) in testicular male spermatozoa compared to SRF. A total of 28 proteins were also found to be differentially expressed ( < 0.05) in testicular SRF sperm in comparison to normal males. Bioinformatic analysis highlighted pathways associated with energy production for normal male spermatozoa and pathways related to protein remodeling for SRF sperm. Normal male spermatozoa seemed to be equipped with proteins participating in diverse metabolic pathways, focusing on producing the energy required for sperm movement. On the other hand, SRF spermatozoa were characterized by the enhanced expression of proteins associated with cytoskeletal structures and those related to remodeling, which could indicate that spermatogenesis and spermiogenesis are not fully accomplished. These results can be the basis for further research on the molecular mechanisms of masculinization and toward the development of a method for separating X and Y fish sperm.


Assuntos
Regulação da Expressão Gênica/fisiologia , Oncorhynchus mykiss/genética , Oncorhynchus mykiss/fisiologia , Sêmen/metabolismo , Espermatozoides/fisiologia , Animais , Feminino , Regulação da Expressão Gênica/genética , Cariótipo , Masculino , Proteoma/metabolismo , Proteômica/métodos , Análise do Sêmen , Caracteres Sexuais , Processos de Determinação Sexual , Motilidade dos Espermatozoides , Espermatogênese , Testículo/metabolismo
17.
HLA ; 90(2): 102-105, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28470865

RESUMO

FoxP3 and Vav1 are known to be involved in the development of regulatory T cells. Two polymorphic sites in the FoxP3 promoter (rs3761548 and a (GT) n -dinucleotide repeat) and 2 single nucleotide polymorphisms in intron 1 of the Vav1 gene (rs2546133 and rs2617822) have been shown to correlate with gene expression levels. We investigated a potential impact of FoxP3 and Vav1 genetic variants on kidney allograft failure using samples and data of the Collaborative Transplant Study. A cohort of 384 kidney transplant patients was tested. We found no significant association of FoxP3 promoter rs3761548 or (GT) n repeat length with presumed immunological graft failure. The genotype frequencies of Vav1 intron polymorphisms did not significantly differ between patients with graft failure and matched controls.


Assuntos
Fatores de Transcrição Forkhead/genética , Genótipo , Sobrevivência de Enxerto/genética , Transplante de Rim , Polimorfismo de Nucleotídeo Único , Proteínas Proto-Oncogênicas c-vav/genética , Adulto , Aloenxertos , Feminino , Fatores de Transcrição Forkhead/imunologia , Sobrevivência de Enxerto/imunologia , Humanos , Íntrons , Masculino , Pessoa de Meia-Idade , Regiões Promotoras Genéticas , Proteínas Proto-Oncogênicas c-vav/imunologia
18.
Photodiagnosis Photodyn Ther ; 3(2): 132-3, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25049105

RESUMO

In dermatology PDT has been proven to be effective in the treatment of actinic keratoses, basal cell carcinomas (BCC), Bowen's disease, superficial squamous cell carcinomas (SCC).

19.
J Cancer Res Clin Oncol ; 126(3): 125-38, 2000 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10741906

RESUMO

Aqueous extracts from leaves of the European mistletoe (Viscum album L.) are postulated to exert an anticancer efficacy by cytotoxic and/or immunological mechanisms of action. Although popular as an unconventional therapy modality, no controlled randomized clinical trials are available, reliably documenting a clinically beneficial antineoplastic potential of the various commercial mistletoe preparations. Since previous investigations have focused on the purified galactoside-specific lectin (Viscum album L. agglutinin, VAA) as major biological response modifier in the low-dose range, the objective of the present experimental study was to examine its effect on N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN)-induced carcinogenesis in the urinary bladder of rats, a suitable animal model for human disease. The carcinogen was fed by gavage in three fractionated low doses (150 mg/kg body weight each) to obtain low-grade and low-stage transitional cell carcinomas. From the onset of the experiment VAA was injected subcutaneously twice a week (1 ng/kg body weight) continuously for either 6 or 15 months. Following an experimental period of 6 months the incidence of bladder carcinomas was 10.2% in rats given exclusively BBN and 6.7% in those additionally treated with VAA. After an experimental time of 15 months 25.8% of the rats fed BBN only and 19.7% of the animals additionally receiving VAA had developed urothelial carcinomas. The differences of the tumor incidences did not reach the level of statistical significance, neither after an experimental duration of 6 (P = 0.88) nor of 15 months (P = 0.71). A difference was found in the size of the transitional cell carcinomas. They proved to be significantly larger (P = 0.02) in the rats additionally treated with VAA for 15 months (mean maximum diameter: 3.31 mm) than in those without lectin treatment (mean maximum diameter: 1.88 mm). Quantitative immunocytochemistry analyzing a panel of immune cells yielded no evidence for the ability of the lectin to provoke a substantial, biologically relevant local cellular immune response in the wall of tumor-free and tumor-bearing bladders. From the current experiment it is obvious that galactoside-specific mistletoe lectin failed to protect against, inhibit, delay or reduce development of chemically induced urothelial carcinomas of the urinary bladder even after long-term administration in the clinically recommended schedule. It seems highly unlikely that adjuvant treatment with mistletoe extracts or VAA might favorably influence bladder cancer in patients by immunological effector mechanisms.


Assuntos
Anticarcinógenos/uso terapêutico , Carcinoma de Células de Transição/imunologia , Carcinoma de Células de Transição/prevenção & controle , Galactosídeos/metabolismo , Preparações de Plantas , Proteínas de Plantas , Toxinas Biológicas/uso terapêutico , Neoplasias da Bexiga Urinária/imunologia , Neoplasias da Bexiga Urinária/prevenção & controle , Animais , Anticarcinógenos/administração & dosagem , Butilidroxibutilnitrosamina , Carcinoma de Células de Transição/induzido quimicamente , Modelos Animais de Doenças , Esquema de Medicação , Feminino , Imunidade Celular/efeitos dos fármacos , Imuno-Histoquímica , Incidência , Lectinas/uso terapêutico , Erva-de-Passarinho/uso terapêutico , Fitoterapia , Lectinas de Plantas , Plantas Medicinais , Ratos , Ratos Wistar , Proteínas Inativadoras de Ribossomos Tipo 2 , Organismos Livres de Patógenos Específicos , Toxinas Biológicas/administração & dosagem , Falha de Tratamento , Neoplasias da Bexiga Urinária/induzido quimicamente
20.
Am J Prev Med ; 15(1): 60-4, 1998 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-9651640

RESUMO

INTRODUCTION: Physicians have a unique role to play in the prevention of elder suicide, yet they may not be sufficiently attentive to the prominence of firearms in the rising trend in suicide by elder persons. This study sought to examine the extent to which physicians inquired about firearms with their depressed and suicidal elderly patients and further identified factors associated with physicians' likelihood of asking about firearms. METHODS: A probability sample of 300 primary care physicians in Illinois was drawn from the American Medical Association Physician Masterfile. Physicians were chosen from the specialties most likely to be involved with elderly persons: internal medicine and family practice. A mailed questionnaire yielded a 63% response rate. RESULTS: Although they were treating depressed and suicidal older patients, a sizable proportion of the respondents (42%) reported that they did not ask such patients or their family members whether they had access to a firearm. Several factors distinguished physicians who assessed for firearms from those who did not. The most salient predictors were: continuing medical education training in suicide risk assessment, expertise in geriatric mental health, confidence in diagnosing depression, having a patient mention suicide in the past year, and indicating patient reluctance as a barrier to mental health treatment. DISCUSSION: Physicians working with depressed and suicidal elderly persons need to be informed about the prevalence of elder suicide and about the likelihood of elderly persons using firearms as a method of suicide. Effective suicide prevention will require physician training that directly addresses geriatric mental health and firearm suicide, in particular, at the student, residency, and continuing education levels.


Assuntos
Armas de Fogo/estatística & dados numéricos , Serviços de Saúde para Idosos/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Prevenção do Suicídio , Idoso , Atitude do Pessoal de Saúde , Distribuição de Qui-Quadrado , Competência Clínica/estatística & dados numéricos , Intervalos de Confiança , Depressão/diagnóstico , Depressão/terapia , Educação Médica , Educação Médica Continuada/estatística & dados numéricos , Feminino , Avaliação Geriátrica/estatística & dados numéricos , Psiquiatria Geriátrica/educação , Pesquisas sobre Atenção à Saúde , Humanos , Illinois , Modelos Logísticos , Masculino , Medicina/estatística & dados numéricos , Pessoa de Meia-Idade , Razão de Chances , Aceitação pelo Paciente de Cuidados de Saúde , Medição de Risco , Estudos de Amostragem , Especialização
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