Antioxidant effect of the guava byproduct in the diet of broilers in the starter phase

ABSTRACT This work aimed to investigate the antioxidant capacity of the guava agroindustrial waste as a functional additive in broiler feed to improve the performance and meat quality of boilers. The experiment was conducted in a completely randomized design, consisting of four treatments and six replicates with 12 birds. Treatments included different levels of guava byproduct in the feed: 0, 0.5, 1.0, and 1.5%. We evaluated the performance of broilers at 7 and 21 days old. At 21 days old, two birds from each experimental unit were euthanized for intestine histologic evaluation (duodenum, jejunum, and ileum) and breast and deboned thigh samples were collected for analyzes of pH, colorimetry (L*, a*, and b*), and thiobarbituric reactive substances (TBARS). The use of guava byproduct in the diet at 7 days old did not affect feed intake and feed conversion of the birds. However, the body weight and weight gain increased linearly with the inclusion of the byproduct. At 21 days old, the guava byproduct did not depress the performance of birds. There was no effect of treatments on villus height, crypt depth, and villus:crypt ratio of the duodenum and jejunum of the birds. The inclusion of guava byproduct resulted in lower crypt depth and linear increase in villus:crypt ratio of the ileum. There was no significant difference in pH and colorimetry of the breast and thigh. With increasing inclusion of byproduct, TBARS value was reduced to 0.72%, indicating greater lipid stability in thigh meat in this inclusion amount. Guava byproduct can be used as an alternative antioxidant additive in broiler feed because it does not depress the productive performance and improves thigh meat quality of boilers

Development and validation of the MMCD score to predict kidney replacement therapy in COVID-19 patients

Abstract Background Acute kidney injury (AKI) is frequently associated with COVID-19, and the need for kidney replacement therapy (KRT) is considered an indicator of disease severity. This study aimed to develop a prognostic score for predicting the need for KRT in hospitalised COVID-19 patients, and to assess the incidence of AKI and KRT requirement. Methods This study is part of a multicentre cohort, the Brazilian COVID-19 Registry. A total of 5212 adult COVID-19 patients were included between March/2020 and September/2020. Variable selection was performed using generalised additive models (GAM), and least absolute shrinkage and selection operator (LASSO) regression was used for score derivation. Accuracy was assessed using the area under the receiver operating characteristic curve (AUC-ROC). Results The median age of the model-derivation cohort was 59 (IQR 47–70) years, 54.5% were men, 34.3% required ICU admission, 20.9% evolved with AKI, 9.3% required KRT, and 15.1% died during hospitalisation. The temporal validation cohort had similar age, sex, ICU admission, AKI, required KRT distribution and in-hospital mortality. The geographic validation cohort had similar age and sex; however, this cohort had higher rates of ICU admission, AKI, need for KRT and in-hospital mortality. Four predictors of the need for KRT were identified using GAM: need for mechanical ventilation, male sex, higher creatinine at hospital presentation and diabetes. The MMCD score had excellent discrimination in derivation (AUROC 0.929, 95% CI 0.918–0.939) and validation (temporal AUROC 0.927, 95% CI 0.911–0.941; geographic AUROC 0.819, 95% CI 0.792–0.845) cohorts and good overall performance (Brier score: 0.057, 0.056 and 0.122, respectively). The score is implemented in a freely available online risk calculator ( https://www.mmcdscore.com/ ). Conclusions The use of the MMCD score to predict the need for KRT may assist healthcare workers in identifying hospitalised COVID-19 patients who may require more intensive monitoring, and can be useful for resource allocation

Clinical characteristics and outcomes of hospital-manifested COVID-19 among Brazilians

ABSTRACT: Objectives: To analyze the clinical characteristics and outcomes of admitted patients with the hospital- versus community-manifested COVID-19 and to evaluate the risk factors related to mortality in the first population. Methods: This retrospective cohort included consecutive adult patients with COVID-19, hospitalized between March and September 2020. The demographic data, clinical characteristics, and outcomes were extracted from medical records. Patients with hospital-manifested COVID-19 (study group) and those with community-manifested COVID-19 (control group) were matched by the propensity score model. Logistic regression models were used to verify the risk factors for mortality in the study group. Results: Among 7,710 hospitalized patients who had COVID-19, 7.2% developed symptoms while admitted for other reasons. Patients with hospital-manifested COVID-19 had a higher prevalence of cancer (19.2% vs 10.8%) and alcoholism (8.8% vs 2.8%) than patients with community-manifested COVID-19 and also had a higher rate of intensive care unit requirement (45.1% vs 35.2%), sepsis (23.8% vs 14.5%), and death (35.8% vs 22.5%) (P <0.05 for all). The factors independently associated with increased mortality in the study group were increasing age, male sex, number of comorbidities, and cancer. Conclusion: Hospital-manifested COVID-19 was associated with increased mortality. Increasing age, male sex, number of comorbidities, and cancer were independent predictors of mortality among those with hospital-manifested COVID-19 disease