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

Avaliação do processo de gestão na implantação de processos inovadores na Faculdade de Medicina de Marília: aspectos da resiliência docente e discente Evaluation of the management process in the implementation of innovative processes in the Medical School of Marília: aspects of teacher and student resilience

Este artigo apresenta e discute os resultados de uma pesquisa avaliativa, com enfoque qualitativo, durante o processo de gestão na implantação de métodos ativos de ensino-aprendizagem. Foi verificado como se comportam gestores, docentes e discentes e a relação com a efetividade destes processos. A análise apontou como núcleos temáticos o entendimento do que é gestão participativa, resultados esperados com a implantação da gestão participativa e aprendizagens institucionais em relação à implantação da gestão participativa.<br>This essay presents and discusses the results of a qualitative evaluation of the management process during the implementation of active teaching-learning methods. The following issue was checked: the behavior of management, teachers and students and its relation to the effectiveness of the process. The analysis pointed out the following themes relative to shared management: understanding of the concept, the expected results and institutional learning in relation to its implementation