Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Desempenho e qualidade dos ovos de poedeiras comerciais alimentadas com rações contendo farelo de coco tratado ou não com antioxidante Performance and egg quality of laying hens fed diets containing coconut meal treated with and without antioxidant

Este experimento foi conduzido para avaliar a estabilidade oxidativa do farelo de coco (FC) tratado ou não com butil-hidroxitolueno (BHT) e armazenado por 35 dias e estudar o efeito de rações contendo esse ingrediente sobre o desempenho e a qualidade do ovo de poedeiras. Um lote de 200 kg de farelo de coco foi dividido em cinco partes: uma foi armazenada sem a adição de antioxidante e as demais tratadas com 500 ppm de BHT nos dias 0, 7, 14 e 21. A estabilidade oxidativa do farelo de coco foi acompanhada por meio dos índices de acidez e de peróxidos, determinados semanalmente. Após 35 dias de armazenamento, 10% de farelo de coco tratado e não tratado com BHT nos diferentes tempos de armazenamento foi usado na formulação de rações isonutrientes para poedeiras comerciais. Foram utilizadas 180 poedeiras da linhagem Hisex White, distribuídas ao acaso em 5 tratamentos e 6 repetições de 6 aves cada. Os índices de acidez e de peróxidos do farelo de coco armazenado com ou sem BHT aumentaram com o tempo de armazenamento. Contudo, os tratamentos não afetaram o desempenho nem a qualidade dos ovos das aves. O farelo de coco armazenado por 35 dias sem antioxidante, embora sofra oxidação, pode ser usado em níveis de até 10% na ração para poedeiras comerciais.<br>This experiment was conducted to evaluate the oxidative stability of coconut meal treated with or without butylated hydroxytoluene (BHT) at different storage times and the effect of diets containing this ingredient on laying hens' performance and egg quality. A 200-kg batch of freshly produced coconut meal was divided into five equal portions. One portion was stored without BHT and the others were treated with BHT at zero, 7, 14 and 21 days. The oxidative stability of coconut meal was measured by the acidity index and peroxide index determined weekly. At the end of the 35-day storage time, this ingredient was used in the formulation of diets for laying hen. One hundred and eighty Hisex White laying hens were randomly distributed among five treatments with six repetitions of six birds each. The acidity index and peroxide index of coconut meal treated with or without BHT at different periods of time increased with storage time. Nevertheless, treatments did not affect laying hens' performance or egg quality. Coconut meal stored for 35 days, although showing lipid peroxidation, can be included at 10% level in the diet for commercial poultry

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically