Impact of impaired pulmonary function on clinical outcomes in survivors of severe COVID-19 without pre-existing respiratory disease.

OBJECTIVE: To investigate the impact of impaired pulmonary function on patient-centered outcomes after hospital discharge due to severe COVID-19 in patients without preexisting respiratory disease. METHODS: This is an ongoing prospective cohort study evaluating patients (> 18 years of age) 2-6 months after hospital discharge due to severe COVID-19. Respiratory symptoms, health-related quality of life, lung function, and the six-minute walk test were assessed. A restrictive ventilatory defect was defined as TLC below the lower limit of normal, as assessed by plethysmography. Chest CT scans performed during hospitalization were scored for the presence and extent of parenchymal abnormalities. RESULTS: At a mean follow-up of 17.2 ± 5.9 weeks after the diagnosis of COVID-19, 120 patients were assessed. Of those, 23 (19.2%) reported preexisting chronic respiratory diseases and presented with worse lung function and exertional dyspnea at the follow-up visit in comparison with their counterparts. When we excluded the 23 patients with preexisting respiratory disease plus another 2 patients without lung volume measurements, a restrictive ventilatory defect was observed in 42/95 patients (44%). This subgroup of patients (52.4% of whom were male; mean age, 53.9 ± 11.3 years) showed reduced resting gas exchange efficiency (DLCO), increased daily-life dyspnea, increased exertional dyspnea and oxygen desaturation, and reduced health-related quality of life in comparison with those without reduced TLC (50.9% of whom were male; mean age, 58.4 ± 11.3 years). Intensive care need and higher chest CT scores were associated with a subsequent restrictive ventilatory defect. CONCLUSIONS: The presence of a restrictive ventilatory defect approximately 4 months after severe COVID-19 in patients without prior respiratory comorbidities implies worse clinical outcomes.

Impact of impaired pulmonary function on clinical outcomes in survivors of severe COVID-19 without pre-existing respiratory disease / Impacto do comprometimento da função pulmonar nos desfechos clínicos em sobreviventes de COVID-19 grave sem doenças respiratórias preexistentes

ABSTRACT Objective: To investigate the impact of impaired pulmonary function on patient-centered outcomes after hospital discharge due to severe COVID-19 in patients without preexisting respiratory disease. Methods: This is an ongoing prospective cohort study evaluating patients (> 18 years of age) 2-6 months after hospital discharge due to severe COVID-19. Respiratory symptoms, health-related quality of life, lung function, and the six-minute walk test were assessed. A restrictive ventilatory defect was defined as TLC below the lower limit of normal, as assessed by plethysmography. Chest CT scans performed during hospitalization were scored for the presence and extent of parenchymal abnormalities. Results: At a mean follow-up of 17.2 ± 5.9 weeks after the diagnosis of COVID-19, 120 patients were assessed. Of those, 23 (19.2%) reported preexisting chronic respiratory diseases and presented with worse lung function and exertional dyspnea at the follow-up visit in comparison with their counterparts. When we excluded the 23 patients with preexisting respiratory disease plus another 2 patients without lung volume measurements, a restrictive ventilatory defect was observed in 42/95 patients (44%). This subgroup of patients (52.4% of whom were male; mean age, 53.9 ± 11.3 years) showed reduced resting gas exchange efficiency (DLCO), increased daily-life dyspnea, increased exertional dyspnea and oxygen desaturation, and reduced health-related quality of life in comparison with those without reduced TLC (50.9% of whom were male; mean age, 58.4 ± 11.3 years). Intensive care need and higher chest CT scores were associated with a subsequent restrictive ventilatory defect. Conclusions: The presence of a restrictive ventilatory defect approximately 4 months after severe COVID-19 in patients without prior respiratory comorbidities implies worse clinical outcomes.

RESUMO Objetivo: Investigar o impacto do comprometimento da função pulmonar nos desfechos centrados no paciente após a alta hospitalar em pacientes sem doenças respiratórias preexistentes que foram hospitalizados em virtude de COVID-19 grave. Métodos: Trata-se de um estudo prospectivo de coorte em andamento, no qual pacientes com COVID-19 grave (com idade > 18 anos) são avaliados 2-6 meses depois da alta hospitalar. Avaliamos os sintomas respiratórios, a qualidade de vida relacionada à saúde, a função pulmonar e a distância percorrida no teste de caminhada de seis minutos. A definição de distúrbio ventilatório restritivo foi CPT abaixo do limite inferior da normalidade na pletismografia. As imagens de TC de tórax realizadas durante a hospitalização foram avaliadas quanto à presença e extensão de alterações parenquimatosas. Resultados: Em média 17,2 ± 5,9 semanas depois do diagnóstico de COVID-19, foram avaliados 120 pacientes. Destes, 23 (19,2%) relataram doenças respiratórias crônicas preexistentes e apresentaram pior função pulmonar e maior dispneia aos esforços na consulta de acompanhamento quando comparados aos outros participantes. Quando excluímos os 23 pacientes com doenças respiratórias preexistentes e mais 2 pacientes (sem medidas de volumes pulmonares), observamos distúrbio ventilatório restritivo em 42/95 pacientes (44%). Esse subgrupo de pacientes (52,4% dos quais eram do sexo masculino, com média de idade de 53,9 ± 11,3 anos) apresentou menor eficiência das trocas gasosas (DLCO), maior dispneia na vida diária e dessaturação de oxigênio ao exercício e redução da qualidade de vida relacionada à saúde em comparação com aqueles sem redução da CPT (50,9% dos quais eram do sexo masculino, com média de idade de 58,4 ± 11,3 anos). A necessidade de terapia intensiva e pontuações mais altas no escore de alterações parenquimatosas na TC de tórax apresentaram relação com distúrbio ventilatório restritivo subsequente. Conclusões: A presença de distúrbio ventilatório restritivo aproximadamente 4 meses depois da COVID-19 grave em pacientes sem comorbidades respiratórias prévias implica piores desfechos clínicos.

Modelling Broiler Requirements for Lysine and Arginine.

Six assays were conducted to investigate male and female broiler responses to standardized ileal digestible (SID) lysine (Lys) and arginine (Arg). Response data were modeled to estimate the efficiency of utilization (k) of both amino acids and adjust factorial models to predict bird intake for SID Lys and SID Arg. In each assay, 1280 Cobb 500® broilers (640 male and 640 female) were randomly assigned to one of sixteen dietary treatments with four replicates of 20 birds. Dietary treatments consisted of crescent levels of SID Lys or SID Arg based on the dilution technique. The values of k determined for each phase (1- to 14-, 15- to 28-, and 29- to 42-d-old) and sex were contrasted using linear regression with groups (sex and phase). The estimated efficiencies were 0.79 for Lys and 0.62 for Arg, which were unaffected by phase or sex. Factorial models based on body weight and weight gain (M1) and on body and feather protein weight and deposition (M2) were applied to estimate the SID Lys and Arg intake for growth. The amino acid intake based on M2 had a lower error of prediction. Broiler chickens require 94.9 and 92.9 mg/d of SID Lys and SID Arg to deposit 1 g of body protein.

In-feed organic and inorganic manganese supplementation on broiler performance and physiological responses.

OBJECTIVE: A trial was conducted to investigate the effects of supplemental levels of Mn provided by organic and inorganic trace mineral supplements on growth, tissue mineralization, mineral balance, and antioxidant status of growing broiler chicks. METHODS: A total of 500 male chicks (8-d-old) were used in 10-day feeding trial, with 10 treatments and 10 replicates of 5 chicks per treatment. A 2×5 factorial design was used where supplemental Mn levels (0, 25, 50, 75, and 100 mg Mn/kg diet) were provided as MnSO4∙H2O or MnPro. When Mn was supplied as MnPro, supplements of zinc, copper, iron, and selenium were supplied as organic minerals, whereas in MnSO4∙H2O supplemented diets, inorganic salts were used as sources of other trace minerals. Performance data were fitted to a linearbroken line regression model to estimate the optimal supplemental Mn levels. RESULTS: Manganese supplementation improved body weight, average daily gain (ADG) and feed conversion ratio (FCR) compared with chicks fed diets not supplemented with Mn. Manganese in liver, breast muscle, and tibia were greatest at 50, 75, and 100 mg supplemental Mn/kg diet, respectively. Higher activities of glutathione peroxidase and superoxide dismutase (total-SOD) were found in both liver and breast muscle of chicks fed diets supplemented with inorganic minerals. In chicks fed MnSO4∙H2O, ADG, FCR, Mn balance, and concentration in liver were optimized at 59.8, 74.3, 20.6, and 43.1 mg supplemental Mn/kg diet, respectively. In MnPro fed chicks, ADG, FCR, Mn balance, and concentration in liver and breast were optimized at 20.6, 38.0, 16.6, 33.5, and 62.3 mg supplemental Mn/kg, respectively. CONCLUSION: Lower levels of organic Mn were required by growing chicks for performance optimization compared to inorganic Mn. Based on the FCR, the ideal supplemental levels of organic and inorganic Mn in chick feeds were 38.0 and 74.3 mg Mn/kg diet, respectively.

Bacillus amyloliquefaciens CECT 5940 alone or in combination with antibiotic growth promoters improves performance in broilers under enteric pathogen challenge.

A study was conducted to investigate the effects of Bacillus amyloliquefaciens CECT 5940 as a direct-fed microbial (DFM) alone or in association with bacitracin methylene disalicylate (BMD) in broilers under enteric pathogen challenge. A total of 1,530-day-old male Cobb500 chicks were randomly assigned to 5 treatments, with 9 replicate pens with 34 birds each. Treatments included positive control (PC, basal diet without additives or challenge); negative control (NC, basal diet without additive and challenged birds); NC + 0.05 g/kg BMD; NC + 1 g/kg DFM (106 CFU B. amyloliquefaciens CECT 5940/g of feed); and NC + 0.05 g/kg BMD + 1 g/kg DFM. The challenge consisted of oral gavage with Eimeria maxima and Clostridium perfringens inoculum. Body weight gain (BWG), feed intake (FI), and feed conversion ratio (FCR) were evaluated on days 21, 35, and 42. Ileal and cecal content were collected on days 21 and 28 for C. perfringens enumeration by real-time PCR assay and the intestinal health was evaluated by scores. Uniformity (UN), carcass (CY), and breast meat yields (BMY) were evaluated on day 42. After 14 and 21 d post-inoculation, birds in the challenged groups had significant lower FI and BWG compared to the PC group (P < 0.05). However, the groups receiving DFM, BMD, or its combination presented better FCR, CY, BMY, UN, and lower incidence of footpad lesion and litter quality visual scores, compared to the NC group without feed additives (P < 0.05). Mortality was not affected by treatments (P > 0.05). Broilers fed DFM, BMD, or its combination presented lower C. perfringens in ileal content at 21 and 28 d compared to NC group without additives (P < 0.05) and also maintained gut health by keeping the frequency of ballooning, abnormal content, and swollen mucosa comparable to the PC group (P > 0.05). The study indicates that Bacillus amyloliquefaciens CECT 5940 is effective as BMD to provide similar performance and gut health in challenged broilers.

Standardized ileal digestible lysine requirement of white commercial layers in peak egg production / Níveis de lisina digestível em rações para galinhas poedeiras leves no pico de produção

This study was conducted to determine the standardized ileal digestible lysine (SID Lys) requirements for white commercial layers in peak egg production phase. A total of two hundred eighty-eight 24 week-old Hy-Line W-36 layers were randomly assigned to one of six treatments groups, with eight replicates of six hens each. A basal diet, SID Lys-deficient, was graded supplemented with L-Lysine HCl (78.4%) in order to produce experimental treatments (6.0, 6.6, 7.2, 7.8, 8.4 and 9.0 g SID Lys/kg diet). Throughout the 16-week-feeding trial (24 to 40 weeks of age) hens had free access to water and mash feed. Data were analyzed as one-way ANOVA and optimum SID Lys level for each dependent variable assessed were estimated using polynomial and linear broken-line regression model. Feed intake and SID Lys intake were both linearly enhanced by graded SID Lys levels. According to linear broken-line regression model, the breakpoint for egg production, egg weight, and egg mass occurred at 8.14, 8.56 and 8.35 g SID Lys/kg diet, respectively. The breakpoint for feed conversion per egg mass (kg/kg) and per dozen of eggs (kg/dozen) occurred at 8.48 and 7.80 g SID Lys/kg diet, respectively. Eggshell weight and albumen weight were unaffected by dietary SID Lys supply. Weight gain and yolk weight reached optimum values at 8.33 and 8.03 g SID Lys/kg diet, respectively, according to linear broken-line regression model. In conclusion, SID Lys requirement for white commercial layers in peak egg production phase is 8.48 g/kg diet, which corresponds to an average daily SID Lys intake of 813 mg/hen.

Este estudo foi realizado para determinar a exigência de lisina digestível para galinhas poedeiras leves no pico de postura. Foram utilizadas 288 poedeiras Hy Line W-36 durante o período de 24 a 40 semanas de idade. As poedeiras foram distribuídas em delineamento inteiramente casualizado, com seis níveis de lisina digestível (6,0; 6,6; 7,2; 7,8; 8,4 e 9,0 g/kg de ração), oito repetições e seis aves por unidade experimental. Os níveis de lisina digestível na ração proporcionaram aumento linear do consumo de ração e de lisina digestível. O modelo Linear Response Plateau (LRP) foi o que melhor representou a distribuição dos dados para produção e peso dos ovos, ocorrendo os platôs nos níveis de lisina digestível de 8,14 e 8,56 g/kg, respectivamente. Para massa dos ovos e conversões alimentares por massa e por dúzia de ovos, os platôs ocorreram nos níveis de 8,35; 8,48 e 7,80 g/kg de lisina digestível, respectivamente. Os pesos de casca e de albúmen não foram influenciados pelos níveis de lisina da ração. O ganho de peso das aves e o peso de gema atingiram, respectivamente, os platôs nos níveis de 8,33 e 8,03 g/kg de lisina digestível. A exigência de lisina digestível para galinhas poedeiras leves no pico de postura é de 8,48 g/kg de ração, que corresponde ao consumo diário de lisina digestível de 813 mg/ave.

Digestible threonine-to-lysine ideal ratio for laying hens fed with low-protein diets from 24 to 40 weeks of age / Relação treonina: lisina digestíveis em rações com baixo nível de proteína bruta para galinhas poedeiras leves de 24 a 40 semanas de idade

ABSTRACT: This trial was performed to determine the dietary digestible threonine-to-lysine (dig. Thr-to-Lys) ideal ratio for laying hens fed with low-protein diets from 24 to 40 weeks of age. At 24 weeks of age, two hundred forty Hy Line W-36 laying hens were randomly assigned to five treatments, represented by five dig Thr-to-Lys ratios (60; 67; 74; 81 and 88%), with eight replicates each one with six hens per experimental unit. Digestible Thr-to-Lys did not affect laying hen performance and egg quality, except for digestible Threonine intake, which showed linear increase as dig. Thr-to-Lys ratios increased. Linear broken-line model was chosen to analyze data according to lack of fit. According to linear broken-linen estimates, digestible Threonine ideal levels for optimum egg production, egg mass, feed efficiency of lysine utilization for egg mass, feed conversion per egg mass and dozens of eggs and nitrogen balance were 0.610; 0.580; 0.614; 0.599; 0.599 and 0.643%, which correspond respectively to dig Thr-to-Lys ratios of 80; 75; 80; 78; 78 and 83%. The digestible threonine-to-lysine ideal ratio for laying hens from 24 to 40 weeks of age is 80%.

RESUMO: Este estudo foi realizado para determinar a relação ideal de treonina:lisina digestíveis em rações com baixo nível de proteína bruta para galinhas poedeiras leves de 24 a 40 semanas de idade. Utilizaram-se 240 poedeiras Hy Line W-36 distribuídas em delineamento inteiramente casualizado, com cinco relações treonina:lisina digestíveis (60; 67; 74; 81 e 88%), oito repetições e seis aves por unidade experimental. As relações treonina:lisina digestíveis não influenciaram o consumo de ração e de lisina; peso médio dos ovos e seus componentes; ganho de peso e peso corporal final das aves, mas houve efeito linear para o consumo de treonina. O modelo Linear Response Plateau (LRP) foi o que melhor representou a distribuição dos dados para taxa de postura; massa de ovos; eficiência de utilização da lisina por massa; conversão alimentar por massa e por dúzia de ovos; e balanço de nitrogênio. Os platôs ocorrem nos níveis de treonina de 0.61; 0.580; 0.614; 0.599; 0.599 e 0.643%, que corresponde às relações treonina:lisina digestíveis de 80; 75; 80; 78; 78 e 83%, respectivamente. A relação ideal de treonina:lisina digestíveis em rações para galinhas poedeiras leves de 24 a 40 semanas de idade é de 80%.

Metabolizable energy levels for meat quails from 15 to 35 days of age / Níveis de energia metabolizável para codornas de corte de 15 a 35 dias de idade

ABSTRACT: This trial was carried out to evaluate the effects of dietetic metabolizable energy levels on performance and carcass traits of meat quails from 15 to 35 days old. Five hundred sixty, 15-d old, meat quails were randomly assigned to five treatments (2.850; 2.950; 3.050; 3.150 e 3.250kcal of ME kg-1 of diet), with eight replicates and fourteen birds per experimental unit. Feed intake, protein and lysine intake and feed conversion decreased linearly as the metabolizable energy content of diets increased (P<0.01), whereas metabolizable energy intake, body weight, weight gain and viability were not affected (P>0.05) by the treatments. Diets did not influence (P>0.05) carcass traits as dry matter, moisture and protein content in carcass. However a quadratic effect (P<0.04) were observed on carcass fat content. Based on these results, the adequate metabolizable energy level to ensure better meat quails' growth is 3.250kcal of ME kg-1 diet, that corresponds to a metabolizable energy: crude protein ratio of 139,24.

RESUMO: Com o objetivo de avaliar o efeito dos níveis de energia metabolizável (EM) sobre o desempenho de codornas de corte de 15 a 35 dias de idade, foi conduzido um experimento com 560 aves aos 15 dias de idade, distribuídas em delineamento inteiramente casualizado com cinco tratamentos (2.850; 2.950; 3.050; 3.150 e 3.250kcal de EM kg-1 de ração), oito repetições com 14 aves por unidade experimental. Verificou-se redução linear (P<0,01) no consumo de ração, de proteína, de lisina e na conversão alimentar, com o aumento dos níveis de EM da ração. O consumo de energia metabolizável, o peso corporal, o ganho de peso, viabilidade das aves não foram influenciados (P>0,05) pelos níveis de EM utilizados. Os níveis de EM das dietas não influenciaram (P>0,05) a matéria seca, o teor de umidade e a proteína nas carcaças. Foi observado efeito quadrático (P<0,04) dos níveis de EM sobre o teor de gordura nas carcaças. Conclui-se que o nível de EM de 3.250kcal kg-1 de ração, correspondendo à relação de energia metabolizável:proteína bruta de 139,24, possibilita melhor desempenho das codornas de corte.

Exigência nutricional de lisina digestível para galinhas poedeiras leves em produção / Nutritional requirement of digestible lysine for white-egg laying hens in production

O objetivo com este trabalho foi determinar a exigência nutricional de lisina digestível para galinhas poedeiras leves em idade avançada. Foram utilizadas 288 galinhas poedeiras Hy Line W-36 com 60 semanas de idade, distribuídas em delineamento inteiramente casualizado, com seis níveis de lisina digestível (6,0; 6,6; 7,2; 7,8; 8,4 e 9,0g kg-1), oito repetições e seis aves por unidade experimental. Os níveis de lisina digestível na ração influenciaram de forma linear o consumo de lisina e a eficiência de utilização da lisina. Para a produção e massa de ovos, os platôs ocorreram a partir dos níveis de 6,57g kg-1 e de 7,10g kg-1 de lisina digestível, respectivamente. Houve efeito quadrático dos níveis de lisina sobre o peso de gema, com o nível estimado em 7,6g kg-1 de lisina digestível. A exigência de lisina digestível de galinhas poedeiras leves no período de 60 a 76 semanas de idade é de 7,10g kg-1 de ração, correspondendo ao consumo diário de 690mg ave-1 de lisina digestível.

The objective of this research was to determine the nutritional requirement of digestible lysine for white laying hens in old age. Two hundred eighty-eight Hy Line W-36 laying hens at 60 weeks of age were distributed in a completely randomized design, with six levels of digestible lysine (6.0; 6.6; 7.2; 7.8; 8.4 and 9.0g kg-1) and eight replications with six birds per experimental unit. There was linear effect of lysine levels on lysine intake and efficiency of utilization of lysine. For the production and egg mass, the levels of digestible lysine in the diet from which the plateaus occurred were of 6.57g kg-1 and 7.10g kg-1, respectively. There was quadratic effect of lysine levels on yolk weight, with the estimated level of 7.6g kg-1 of digestible lysine. The digestible lysine requirement of white laying hens from 60 to 76 weeks of age is 7.10g kg-1 in diet, corresponding to daily intake of 690mg bird-1 of digestible lysine.

Performance and meat quality traits of beef heifers fed with two levels of concentrate and ruminally undegradable protein.

The effects of two levels of concentrate and ruminally undegradable protein (RUP) on performance, intake, digestibility, carcass characteristics, meat quality traits, and commercial cuts yield were assessed. Twenty crossbred heifers (240 kg average body weight) were used. At the beginning of the trial, four animals were slaughtered as reference group and the 16 remaining animals were randomly assigned to four treatments, in a 2 × 2 factorial design: two levels of concentrate (40% and 80%, dry matter (DM) basis) and two levels of RUP (48.79% and 27.19% of CP). At the end of the trial, all the animals were slaughtered. There was no interaction (P > 0.05) between concentrate and RUP levels. Dry matter intake and nutrients digestibility was not affected (P > 0.05) by RUP level. Heifers fed the highest RUP level had greater (P < 0.05) average daily gain (ADG). Concentrate level did not affect (P > 0.05) DMI and ADG. Heifers fed diets with 80% concentrate had greater intake of TDN and EE, and lower intake of NDF (P < 0.05). The digestibilities of all nutrients, except the NDF, were greater (P < 0.05) for the 80% concentrate diets. The RUP levels did not affect (P > 0.05) the carcass characteristics and carcass gain composition. Heifers fed 80% concentrate diets had larger (P < 0.05) longissimus muscle area and lower gain of bones (P < 0.05). Concentrate level did not affect (P > 0.05) the composition of carcass gain. There was no effect (P > 0.05) of RUP and concentrate levels on meat quality traits and commercial cut yields.