Apparent and standardised ileal digestibility of amino acids in wheat, triticale and barley for broiler chickens at two different ages.

1. The influence of the age of broiler chickens on ileal amino acid (AA) digestibilities in three cereals was examined. The digestibility estimates, including both apparent (AID) and standardised (SID) coefficients, for wheat, triticale and barley samples were determined using 14 and 28 d old broilers of mixed sex, fed diets containing the test grains as the only source of protein.2. Each assay diet was offered to five replicate cages of 14 and eight birds respectively, for the 14 and 28 day samplings. On both sampling days, the contents from the lower half of the ileum were collected for determination of the AID coefficients. The SID coefficients were calculated using ileal endogenous amino acid (EAA) losses previously determined from birds fed an N-free diet.3. The average AID for essential AA (EAA) in triticale and barley were significantly higher at 28 day compared to those at 14 days. In contrast, the magnitude of AID coefficients of AA in wheat was found to be in larger in the younger chickens.4. Correction of AID for EAA losses increased the values of digestibility coefficients by an average of about 7%. The SID values of AA in wheat was not influenced by the age of broilers. The SID of most AA in triticale, and of all the AA in barley, were higher in 28-day-old chickens compared with their 14-day-old counterparts. The results suggested that the SID coefficients of EAA in wheat determined at day 28 could be applied to feed formulations for 14-day-old broilers, but in the case of triticale and barley, the values obtained in older chickens were not applicable in younger birds and vice versa.

Red Blood Cell Distribution Width in End-Stage Heart Failure Patients Is Independently Associated With All-Cause Mortality After Orthotopic Heart Transplantation.

BACKGROUND: Red blood cell markers (RBCM) have been found to be predictors of mortality in various populations. However, there is no information regarding the association between the values of RBCM and long-term outcomes after orthotopic heart transplantation (OHT). The aim of this study was to assess whether the values of inflammatory markers and RBCM obtained directly before OHT are associated with mortality in patients diagnosed as having end-stage heart failure undergoing OHT. METHODS: We retrospectively analyzed data of 173 nonanemic adult patients diagnosed as having end-stage heart failure undergoing primary OHT between 2007 and 2014. Clinical and laboratory data were obtained at the time of admission for the OHT. RBCM were analyzed using an automated blood counter (Sysmex XS-1000i and XE-2100, Sysmex Corporation, Kobe, Japan). RESULTS: Mean age of the patients was 54 (41-59) and 72% of them were male. During the observation period, the mortality rate was 32%. Multivariable analysis of Cox proportional hazard confirmed that elevated pretransplantation red blood cell distribution width value (hazard ratio [HR], 1.38 [1.25-1.48], P < .001) was the sole independent predictor of death during long-term follow-up. Other red blood cell distribution width such as mean corpuscular volume, mean corpuscular hemoglobin concentration, and mean corpuscular hemoglobin (HR, 0.88 [0.84-0.91]; P < .001; HR, 0.75 [0.53-1.05]; P < .05; HR, 0.78 [0.64-0.96]; P < .05, respectively) had predictive value in univariable analysis. CONCLUSIONS: In summary, we have demonstrated that elevated red blood cell distribution width immediately before OHT is an independent predictor of all-cause mortality in heart transplant recipients. Other factors associated with posttransplantation mortality include lower values of mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration.

Predictive Value of the Model for End-Stage Liver Disease Score Excluding International Normalized Ratio One Year After Orthotopic Heart Transplantation.

BACKGROUND: The Model for End-Stage Liver Disease (MELD) scoring system incorporating a combination of hepatic and renal laboratory parameters does not adequately reflect the degree of multi-organ dysfunction in patients with heart failure, who need oral anticoagulation. In order to exclude the impact of oral anticoagulation on the international normalized ratio (INR), we used the MELD excluding INR (MELD-XI) score. The aims of the study were to calculate the individual preoperative MELD-XI score and its ability to predict 1-year mortality after heart transplantation and to identify other preoperative laboratory prognostic parameters. METHODS: We retrospectively analysed data of 87 consecutive adults undergoing heart transplantation between 2011 and 2014. Clinical data and laboratory parameters for the calculation of the MELD-XI score were obtained at the time of admission for the heart transplantation. RESULTS: The average age of the patients was 48.8 ± 13.3 years and 68.9% of them were male. During the observation period, the mortality rate was 18.4%. Multivariate analysis of Cox proportional hazard confirmed that the pretransplantation MELD-XI score (hazard ratio [HR] = 1.625 [1.286-2.053]; P < .001), sodium serum concentration (HR = 0.824 [0.677-1.001]; P < .05) and highly sensitive C-reactive protein (hs-CRP) serum concentration (HR = 1.045 [1.008-1.083]; P < .02) were independent predictors of death during the first year after heart transplantation. Area under the receiver operating characteristic (ROC) curve (AUC) indicated a good discriminatory power of MELD-XI (AUC 0.997; P < .04) and plasma sodium concentration (AUC 0.901; P < .01) in death prediction. CONCLUSIONS: Our study confirms that the pretransplantation MELD-XI score, as well as serum sodium and hsCRP concentrations, may be used to estimate postoperative risk in heart transplant recipients during a 1-year follow-up.

Perioperative Risk Factors of Cardiac Allograft Vasculopathy in the Long-Term Follow-up.

BACKGROUND: Cardiac allograft vasculopathy (CAV) still remains to be one of the most important limiting factors for heart transplant recipients' long-term survival. The aim of our study was to identify the perioperative risk factors impacting the occurrence of CAV during the long-term follow-up. METHODS: We retrospectively analysed the data from 198 consecutive adult patients, who underwent heart transplantation between 2007 and 2012, in whom at least one routine coronarography (CAG) was performed. CAV onset was defined as any lesion seen at least at one routine CAG. RESULTS: The average follow-up was 63.6 ± 14.7 months. The frequency of CAV in the analysed population was 36 (18.1%). Multivariate stepwise logistic regression analysis confirmed that NT-proBNP plasma concentration directly before heart transplant [logNT-proBNP OR = 16.455 (4.587-31.036), P < .0001], fibrinogen plasma concentration a month after heart transplant [OR = 1.022 (1.009-1.035), P < .001] and occurrence of diabetes [OR = 12.355 (1.417-35.750), P < .001], were independent predictors of CAV. Area under the ROC curves (AUC) indicated a well discriminatory power of plasma fibrinogen [AUC 0.9278, P < .001] and plasma NTproBNP concentration [AUC 0.9514, P < .001] in CAV prediction. The optimal cut-off value of fibrinogen was 509 mg/dL, and of NT-proBNP was 10080 pg/mL. CONCLUSIONS: Our data show that NT-proBNP and fibrinogen plasma concentrations as well as occurence of diabetes, both preexisting and new onset after heart transplant can be used to identify patients at risk of developing CAV.

Predictive Value of Hepatic and Renal Dysfunction Based on the Models for End-Stage Liver Disease in Patients With Heart Failure Evaluated for Heart Transplant.

BACKGROUND: The evaluation of prognosis and determination of a long-term treatment strategy is an important element of management in patients with heart failure (HF). METHODS: The aim of the study was to determine the prognostic value of the Model for End-Stage Liver Disease (MELD) and its modifications, MELD and serum sodium (MELD-Na) and MELD excluding the international normalized ratio (MELD-XI), as well as other independent risk factors for death during a 4-year follow-up. We analyzed retrospectively 143 patients with advanced HF, evaluated for heart transplant between 2009 and 2011. Patients using warfarin were excluded from the study. The long-term follow-up data were obtained during follow-up visits and/or phone contact with the patients or their families. RESULTS: The age of the patients was 54 (48-59) years and 88.1% of patients were male. Mortality rate during the follow-up period was 49%. The MELD scores (hazard ratio [HR], 1.12; P < .001), as well as serum high-sensitivity C-reactive protein (hs-CRP; HR, 1.01; P < .01) and N-terminal pro-brain natriuretic peptide (NT-proBNP; HR, 1.01; P < .05) levels, were independent risk factors for death. Receiver operator characteristic analysis indicated that a MELD cutoff of 10 (area under the curve [AUC], 0.756; P < .0001], MELD-XI cutoff of 13.0 (AUC, 0.720; P < .0001), MELD-Na cutoff of 13.0 (AUC, 0.813; P < .0001), hs-CRP cutoff of 4.02 (AUC, 0.686; P < .001), and NT-proBNP cutoff of 1055 (AUC, 0.722; P < .001) were the best predictive values as predictors of death. CONCLUSIONS: MELD, MELD-Na, and MELD-XI scores are prognostic factors for death during a 4-year follow-up. A high MELD score is an independent prognostic factor for death. NT-proBNP and hs-CRP serum concentrations are other independent factors influencing death.

Effects of conjugated linoleic acid on growth performance, feed conversion efficiency, and subsequent carcass quality in broiler chickens.

The effect of dietary conjugated linoleic acid isomers (CLA) on growth performance, carcass composition, fatty acid composition of adipose and muscle tissues, and serum lipoproteins was investigated in broiler chickens. A total of 160 (eighty male and eighty female) chickens were allocated to four dietary treatments (0.0, 0.5, 1.0, and 1.5 % CLA) and fed a standard starter diet from 8 to 21 d, and a grower-finisher diet from 22-42 d. When determined for the total period 8-42 d, feed intake and body weight gains of broiler chickens were significantly reduced (from 3.31 to 3.12 kg and from 1615 to 1435 g respectively; P < 0.05), particularly at the 1.5 % dietary CLA level. Feed conversion efficiency and carcass yield values showed no significant effects of dietary CLA. Abdominal fat deposition was significantly reduced (from 2.68 to 1.78 %; P < 0.05), the relative proportion of breast muscles was unaffected, and that of leg muscles significantly increased (from 19.0 to 20.6 %; P < 0.05). The concentration of CLA isomers (% of total methyl esters of fatty acids) increased linearly in tissue samples from broilers fed 0.5, 1.0, and 1.5 % dietary CLA. The relative proportions of saturated fatty acids (16:0, 18:0) were significantly (P < 0.01) increased, and those of monounsaturated (16:1, 18:1) and polyunsaturated fatty acids (18:2, 20:4 in muscle tissues) significantly (P < 0.05) reduced. Total serum cholesterol concentrations reached a maximum in broilers fed 1.0 % CLA and then decreased slightly (from 141.73 to 136.47 mg/dl; P < 0.01). The same was true also for HDL-cholesterol (from 113.58 to 109.97 mg/dl; The HDL cholesterol:total cholesterol ratio and serum triacylglycerol concentration was unaffected. In conclusion, feeding CLA to broiler chickens resulted in substantial incorporation of CLA isomers into their tissue lipids, thus providing a potential CLA-rich source for human consumption.