Clearance by the hepatic portal circulation of the products of digestion and metabolism in the ruminant gut

Fib-4 Predicts Early Hematological Adverse Events Induced by Interferon-Based Triple Therapy in Chronic Hepatitis C Virus Patients

Interferon-alpha (IFN-α)-based therapy is associated with several hematological adverse events in hepatitis C virus (HCV)-infected patients with advanced fibrosis. We performed this study to evaluate the association between Fibrosis-4 (Fib-4) index and hematological adverse events in patients with chronic HCV infection, undergoing IFN-α-based triple therapy. We included 120 HCV-infected patients, receiving triple therapy: weekly PegIFN-α, daily ribavirin (1,000-1,200 mg), and daily sofosbuvir (400 mg) for 12 weeks. We compared Fib-4 scores for patients who developed hematological adverse events at weeks 4 (w4) and w12 of treatment and w12 post-treatment versus those who did not. Treatment with the aforementioned triple regimen was associated with a sustained virological response (SVR)-12 rate of 93.9%. We found no significant associations (P > 0.05) between SVR12 rate and the degree of fibrosis or the risk of hematological adverse events. The Fib-4 score could predict patients who developed hematological adverse events (anemia, leukopenia, and neutropenia) in the first month of treatment, but not in later stages. A Fib-4 cutoff value of 3.59 had high specificity for anemia, leukopenia, and neutropenia (85.1%, 87.2%, and 88.2%, respectively), but had low sensitivity for detecting the 3 events. In conclusion, the Fib-4 score may predict early hematological adverse effects in HCV-infected patients on IFN-based triple therapy.

Protein-energy interrelationships in dairy cows

In dairy cows two distinct and important aspects of the interrelationship between protein and energy-yielding nutrients can be identified. First, a change of protein input can influence performance by changing overall plane of nutrition. To a large extent this results from changes of digestibility and associated intake of ration ingredients. Within this context it appears that at high levels of feeding rumen microbial demand for nitrogen per unit fermentable organic matter is high; initial failure to meet this need for nitrogen probably accounts for many responses to protein supplementation in practice through stimulation of ruminal digestion. Second is that changing "protein" supply to tissues can alter the pattern and efficiency of absorbed nutrient use. In early lactation protein supplementation favors partition of available nutrients toward mammary secretion. There are effects on glucose and fatty acid metabolism, all interacting with the endocrine system within a metabolic framework that tends to conserve those nutrients (amino acids, glucose) that are in shortest supply relative to demand. Response to increased input of amino acids depends both on physiological state of the cow and balance of all nutrients absorbed from the gastrointestinal tract.

The influence of food intake on portal blood flow and heat production in the digestive tract of sheep

1. Measurements were made of portal blood flow, heat production and oxygen consumption in the digestive tract of sheep either fasted or given the following diets: chopped, dried grass, pelleted, dried grass; chopped, dried lucerne; pelleted, dried lucerne, or a pelleted barley diet. 2. For sheep that had been fasted for 48 h, portal blood flow was 1.84 l/min, total visceral heat production was 62.3 kJ/kg body-weight 0.75 per 24 h and aerobic heat production, estimated from oxygen consumption, was 62.1 kJ/kg body-weight 0.75 per 24 h. 3. Portal blood flow was markedly influenced by food intake, increasing from 1.8 l/min for starved sheep to 2.4 and 4 l/min for sheep feed at maintenance and 2.5 times maintenance levels of intake respectively. Variations in the quality and physical form of the diets had no apparent effect on portal blood flow. 4. There was a curvilinear relationship between total heat production in the gut and metabolizable energy (ME) intake. The increase obtained for levels of intake below maintenance was greatest with lucerne diets, and least with pelleted, dried grass or pelleted barley diets. Above maintenance levels of intake the rate of increase in heat production, with all diets, was about 150 kJ/MJ ME intake. 5. The heat of fermentation, estimated from the difference between total visceral metabolism and the aerobic metabolism of the tissues of the gut wall, was 76, 60 and 22 kJ/MJ digestible energy intake for the dried grass, lucerne and barley diets respectively. 6. The contribution of fermentation heat and the aerobic metabolism of the gut to the total heat increment of feeding in sheep was assessed. It was concluded that about half the heat increment must be derived from tissues outside the digestive tract.