Bubble ring play of bottlenose dolphins (Tursiops truncatus): implications for cognition.

Research on the cognitive capacities of dolphins and other cetaceans (whales and porpoises) has importance for the study of comparative cognition, particularly with other large-brained social mammals, such as primates. One of the areas in which cetaceans can be compared with primates is that of object manipulation and physical causality, for which there is an abundant body of literature in primates. The authors supplemented qualitative observations with statistical methods to examine playful bouts of underwater bubble ring production and manipulation in 4 juvenile male captive bottlenose dolphins (Tursiops truncatus). The results are consistent with the hypothesis that dolphins monitor the quality of their bubble rings and anticipate their actions during bubble ring play.

The effect of age on medical decisions made by patients with chronic illness.

Patients are currently encouraged to appoint surrogates to make healthcare decisions for them in the event that they are not able to make those decisions for themselves. Many studies have suggested that in hypothetical situations, surrogates often make different decisions than the still-capacitated patients say they would make. Age difference between patient and appointed surrogate is one possible explanation because many surrogates are next-generation relatives. This study evaluated differences in end-of-life decision making between elderly and younger patients with chronic disease. Two age groups were interviewed: (1) geriatric patients aged 70 and older and; (2) acquired immunodeficiency syndrome (AIDS) patients aged 30-50. Subjects who demonstrated an understanding of cardiopulmonary resuscitation (CPR) and artificial nutrition and hydration (ANH) were asked to choose, on a five-point Likert scale, whether they would want these treatments for themselves in four hypothetical scenarios: (1) an older person in a coma after a car accident; (2) a younger person in a coma after a car accident; (3) an older person with Alzheimer's disease; (4) a younger person with AIDS dementia. One hundred seventy-six subjects were included: 84 geriatric patients and 92 AIDS patients. Differences in the two groups were significant only in the scenario of an older person in a coma after a car accident (p = 0.007), with the geriatric patients wanting more treatment. The lack of significant differences between healthcare decisions made by the two groups under the hypothetical scenarios utilized in this study may indicate that age differences will not prevent a next-generation healthcare agent from making substituted judgement that accurately reflects patient wishes.

Lipohyperplasia of ileocecal valve, causing recurrent intussusception.

Lipohyperplasia of the ileocecal valve is a fairly common entity that occasionally behaves as an intestinal tumor, causing obstruction, sometimes with intussusception, or bleeding, which may be acute or chronic. Most often occurring in middle-aged or elderly women, it may be mistaken clinically and radiologically for carcinoma or other neoplasms. Its differentiation is best made by endoscopy, confirmed if possible by biopsy. Differentiation is important, as the treatment is a limited ileal and cecal resection, instead of a blind hemicolectomy. A recent study suggests possible associations with other medical conditions. We describe the clinical and pathological findings of this entity in a patient who had recurrent bouts of intussusception over a period of seven years, causing gastrointestinal symptoms and a palpable mass, eventually requiring surgical treatment.