ABSTRACT
BACKGROUND: Delirium is characterized by fluctuating attention or arousal, with high prevalence in the orthopaedic ward. Our aim was to: 1) establish the prevalence of delirium on an orthopaedic ward, and 2) compare delirium prevalence using a single geriatrician assessment vs. multiple 3D-CAM (3-Minute Diagnostic Interview for Confusion Assessment Method) assessments during the day. We hypothesized that multiple assessments would increase the detection rate due to the fluctuating nature of delirium. METHODS: Comparative study conducted at an academic hospital in Hamilton, Ontario. Participants included patients 65 years and older admitted to the orthopaedic ward (n=55). After a geriatrician made the first assessment of delirium by 3D-CAM on each patient, teams with specialized geriatrics training re-assessed participants up to four times. Delirium rates based on first assessment were compared to cumulative end-of-day rates to determine if detection increased with multiple assessments. RESULTS: The prevalence of delirium was 30.9% (17 participants) using multiple assessments. Of these cases, 13 (76.4%) were detected in the initial geriatrician assessment. In patients with hip fractures, 70.6% (12 of 17) were identified as delirious by multiple assessments. CONCLUSION: As symptoms fluctuate, multiple daily CAM assessments may increase the identification of delirium in orthopaedic inpatients.
ABSTRACT
Avaliou-se o desempenho de codornas-japonesas em postura alimentadas com níveis crescentes de milheto-gräo na raçäo. Duzentas codornas com 70 dias de idade submetidas a um delineamento inteiramente ao acaso, com cinco tratamentos e quatro repetiçöes de 10 aves, receberam níveis de milheto de 0, 25, 50, 75 e 100 por cento em substituiçäo ao milho em raçöes na fase de postura. Foram medidos a produçäo e o peso dos ovos, o consumo de raçäo, a mortalidade, a coloraçäo da gema pelo leque colorímetrico, e calculada a conversäo alimentar em termos de massa e de dúzia de ovos. Os índices de produtividade das codornas näo foram afetados pelos diferentes níveis de substituiçäo estudados e o milheto-gräo se constitui em uma fonte de substituiçäo do milho para codornas-japonesas, devendo-se, porém, incluir na raçäo uma fonte de pigmentaçäo para a gema dos ovos
Subject(s)
Animal Feed , CoturnixABSTRACT
We report a prospective trial of in vitro sperm-mucus penetration test performed in hormonally controlled environment. To enhance the quality of the cervical mucus (CM), prevent spontaneous ovulation and to eliminate the possibility that results may be biased solely because of CM inadequacy, we conceived a 28-day physiological hormonal replacement regimen. For this women received oral estradiol valerate (E2-V) (4 mg/day) from cycle 1 to 28. CM was collected on days 13 (n = 17), 14 (n = 38) or 15 (n = 16), according to patients' individual preferences. The in vitro sperm-mucus penetration test was performed approximately 30 minutes later. On the same day, measurements of P and E2 levels were done to eliminate the possibility of spontaneous ovulation. Plasma E2 on the day of testing were 220 +/- 100 pg/ml (mean +/- SD). In all patients, except 4, P levels were low (< 1 ng/ml) on the day of the test. Our results indicate that a hormonal preparation with E2/P can be clinically useful for preventing spontaneous ovulation and reliably assuring CM quality when sperm/mucus penetration tests are performed.
