Two Grey parrots (Psittacus erithacus) were tested on various types of mirror use: mirror image stimulation, mirror-mediated object discrimination, and a simple form of mirror-mediated spatial locating. During exposure to a mirror, neither bird clearly demonstrated self-exploratory behavior but responded instead in ways similar to those of marmosets, monkeys, dolphins, extremely young children(<18 months), and to the initial responses of orangutans and young chimpanzees. The parrots' behavior was not a consequence of an inability to process mirrored information, because in subsequent tasks they used mirrors to discriminate among exemplars and to locate hidden objects; these birds are the first nonmammalian subjects to exhibit all these behavior patterns. Their behavior on all the tasks can be compared to that of humans, great apes, dolphins, monkeys, and Asian elephants.
Background
Prior research has shown that hypoglycemia is associated with worse outcomes for the elderly, in sepsis, and in children with pneumonia. The purpose of this study was to examine whether hypoglycemia (< 70 mg/dL) is associated with increased 30-day mortality, after adjusting for potential confounders, for adults hospitalized with pneumonia.
Methods
A retrospective cohort study conducted at two tertiary teaching hospitals. Eligible subjects were admitted with a diagnosis of, and had a chest x-ray consistent with, community-acquired pneumonia. Our primary analysis was a multivariable logistic regression with the dependent variable of 30-day mortality with independent variable of hypoglycemia, diabetes, severity of illness utilizing the Pneumonia Severity Index, and pneumonia-related processes of care.
Results
Data were abstracted on 787 subjects at the two hospitals. Mortality was 8.1% at 30-days. At presentation, 55% of subjects were low risk, 33% were moderate risk, and 12% were high risk. In our cohort 2.8% (n=22) had hypoglycemia at presentation. Unadjusted mortality for those who were hypoglycemic was 27.3% vs. 8.6% for those who were not (p=0.0003). In the multivariable analysis, hypoglycemia (odds ratio 4.1, 95% confidence interval 1.4–11.7) was significantly associated with 30-day mortality.
Conclusions
After adjusting for severity of illness and other potential confounders hypoglycemia is significantly associated with 30-day mortality for patients hospitalized with pneumonia. Patients with hypoglycemia should be placed in closely monitored settings even when by pneumonia specific risk systems they would normally be discharged.
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