[Prevalence of pain among patients admitted to a clinical hospital]. / Prevalencia de dolor en la internación en un hospital de alta complejidad de Argentina.

BACKGROUND: Pain prevalence during hospital admission is variable, with estimates ranging from 32 to 77%. AIM: To determine pain prevalence during admission to a clinical hospital. MATERIAL AND METHODS: Patients admitted to medical and surgical wards were interrogated about the presence of pain within 48 to 72 hours after admission. Subjective pain was analyzed using a scale ranging from 0 to 10. Data was analyzed separately for medical, surgical, and obstetrical patients. RESULTS: A total of 736 patients aged 18 to 94 years (416 women) were recruited. Pain prevalence at 48 hours after admission was 56% (95% confidence intervals (CI (52.7 to 60.1). Pain prevalence in medical, surgical and obstetric patients was 37% (95% CI 31.4 to 42.1), 70% (95% CI 64.5 to 75.5) and 77% (95% CI 68.6 to 84), respectively. The median pain intensities in medical, surgical, and obstetrical patients were 7 (interquartile range (IQR) 6-8), 7 (IQR 5-8) y 7 (IQR 5-8), respectively. CONCLUSIONS: The prevalence of pain among patients admitted to the hospital is high, especially in obstetric and surgical units.

Prevalencia de dolor en la internación en un hospital de alta complejidad de Argentina / Prevalence of pain among patients admitted to a clinical hospital

Background: Pain prevalence during hospital admission is variable, with estimates ranging from 32 to 77%. Aim: To determine pain prevalence during admission to a clinical hospital. Material and Methods: Patients admitted to medical and surgical wards were interrogated about the presence of pain within 48 to 72 hours after admission. Subjective pain was analyzed using a scale ranging from 0 to 10. Data was analyzed separately for medical, surgical, and obstetrical patients. Results: A total of 736 patients aged 18 to 94 years (416 women) were recruited. Pain prevalence at 48 hours after admission was 56% (95% confidence intervals (CI (52.7 to 60.1). Pain prevalence in medical, surgical and obstetric patients was 37% (95% CI 31.4 to 42.1), 70% (95% CI 64.5 to 75.5) and 77% (95% CI 68.6 to 84), respectively. The median pain intensities in medical, surgical, and obstetrical patients were 7 (interquartile range (IQR) 6-8), 7 (IQR 5-8) y 7 (IQR 5-8), respectively. Conclusions: The prevalence of pain among patients admitted to the hospital is high, especially in obstetric and surgical units.

Effects of rumen-protected carbohydrate supplementation on performance and blood metabolites in feedlot finishing steers during heat stress.

The objective of this experiment was to evaluate the inclusion of a rumen-protected carbohydrate (RPC) on growth performance and blood metabolites of finishing steers during the summer. A 62-d feedlot study was conducted using 135 Angus crossbred steers (body weight = 287 ± 13 kg). All animals were fed a basal diet (BD), then treatments were top-dressed. The treatments were the same composition and only varied in ruminal degradability. Treatments were 1) a BD with 1 kg/d of a control supplement (0RPC), 2) the BD plus 0.5 kg/d of the control supplement and 0.5 kg/d of RPC (0.5RCP), and 3) the BD with 1 kg/d of RPC supplement (1RPC). Temperature humidity index and cattle panting scores (CPS) were measured daily during the experiment. Growth performance, back-fat over the 12th rib (BF), LM area, blood glucose and plasma insulin, urea, and nonesterified fatty acid concentrations were measured. Data were statistically analyzed (PROC Mixed, SAS) using treatment, time, and their interaction as a fixed variable and pen as a random variable. There were no differences (P > 0.10) between the three treatments on CPS, BF, and LM area on day 62. There was a trend (P = 0.06) for treatment effect for a greater body weight on the 0.5RPC, and a treatment effect for dry matter intake (P = 0.05). Treatment × day interactions were observed for average daily gain (ADG, P =0.04), suggesting a different response to treatments during the different sampling periods. There was a treatment effect for blood glucose concentration (P = 0.03), having the 0RPC the greatest concentration. Treatment × day interactions were found for plasma insulin concentration (P = 0.01). The results suggest that the response to RPC supplementation depends in part on environment. The use of 0.5 kg/d of RPC tends to improve overall body weight; however, the response to RPC on ADG and plasma insulin concentration depend on the time of sampling.

Influence of the pattern of peptide supply on microbial activity in the rumen simulating fermenter (RUSITEC).

The source and pattern of N supply was varied in the rumen simulation technique (RUSITEC) in order to determine if continuous, rather than transient, availability of peptides was required for optimum ruminal fermentation. The energy source was fibre prepared from sugar-beet pulp. N was added as NH3 continuously infused (AC) or peptides (Bacto(R) Casitone, a pancreatic hydrolysate of casein; Difco Laboratories, Detroit, MI, USA) continuously infused (PC) or added as a single dose at the time of feeding (PS). Free peptides were detected in the fermenter liquid for 4 h after feeding in the AC treatment, for 10 h in the PS treatment, and at all times with the PC treatment. Treatments had no effect on DM degradation. Approximately 40 % of the degradation occurred during the time no peptides were detected in the PS treatment. Microbial N flow tended to be higher with the peptide additions (P<0.061), with no significant difference between the two peptides treatments. The production of liquid-associated micro-organisms (LAM) was higher in the PC treatment (P<0.05) and the proportion of LAM derived from NH3 lower (P<0.05). However, LAM only accounted for 20-30 % total microbial population. Our main conclusion was that peptides had a small stimulatory effect on the fermentation, but there was no indication that synchrony of supply of energy and amino acid-N in the fermenter promoted a more efficient fermentation than non-synchronous supply. This conclusion must be qualified, however, because some N remained in the fibre and may have become available progressively as the fibre was digested by the micro-organisms.