Experimental approaches to study the nutritional value of food ingredients for dogs and cats

This review covers methods that have been applied to study the nutrient value or quality of specific ingredients fed to dogs, cats and comparable species (i.e. foxes, minks, rats, etc.). Typically, the nutritional value or utilization of a specific ingredient is measured by total tract digestibility and has been expanded through the measurement of total nutrient balance (i.e. nitrogen or energy). However, to better understand digestion it is necessary to obtain a more accurate measurement of nutrients entering and leaving the small intestine. Accurate measurement of small intestinal digestion is crucial in dogs and cats because nutrient digestion and absorption occurs primarily in the small intestine. Measuring small intestinal digestibility requires access to digesta leaving the small intestine and can be obtained by placing a cannula at the terminal ileum. This approach also necessitates the use of markers (e.g. chromic oxide) to monitor flow of digesta. Specifically, this approach has been used for the direct measurement of intestinal digestion of carbohydrates and amino acids. It also permits a separate measurement of large intestinal digestion which is particularly useful for the study of fiber fermentation. Passage of foods through the gastrointestinal tract is also an important component of utilization and these methods are reviewed

Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

Objectives: Few studies have analyzed factors associated with delirium subtypes. In this study, we investigate factors associated with subtypes of delirium only in patients with dementia to provide insights on the possible prevention and treatments. Design: This is a cross-sectional study nested in the \u201cDelirium Day\u201d study, a nationwide Italian point-prevalence study. Setting and Participants: Older patients admitted to 205 acute and 92 rehabilitation hospital wards. Measures: Delirium was evaluated with the 4-AT and the motor subtypes with the Delirium Motor Subtype Scale. Dementia was defined by the presence of a documented diagnosis in the medical records and/or prescription of acetylcholinesterase inhibitors or memantine prior to admission. Results: Of the 1057 patients with dementia, 35% had delirium, with 25.6% hyperactive, 33.1% hypoactive, 34.5% mixed, and 6.7% nonmotor subtype. There were higher odds of having venous catheters in the hypoactive (OR 1.82, 95% CI 1.18-2.81) and mixed type of delirium (OR 2.23, CI 1.43-3.46), whereas higher odds of urinary catheters in the hypoactive (OR 2.91, CI 1.92-4.39), hyperactive (OR 1.99, CI 1.23-3.21), and mixed types of delirium (OR 2.05, CI 1.36-3.07). We found higher odds of antipsychotics both in the hyperactive (OR 2.87, CI 1.81-4.54) and mixed subtype (OR 1.84, CI 1.24-2.75), whereas higher odds of antibiotics was present only in the mixed subtype (OR 1.91, CI 1.26-2.87). Conclusions and Implications: In patients with dementia, the mixed delirium subtype is the most prevalent followed by the hypoactive, hyperactive, and nonmotor subtype. Motor subtypes of delirium may be triggered by clinical factors, including the use of venous and urinary catheters, and the use of antipsychotics. Future studies are necessary to provide further insights on the possible pathophysiology of delirium in patients with dementia and to address the optimization of the management of potential risk factors