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

Composição químico-bromatológica e degradabilidade In Situ da matéria seca, proteína bruta e fibra em detergente neutro da casca do fruto de três variedades de maracujá (Passiflora spp) Chemical composition and In situ degradability of dry matter, crude protein and neutral detergent fiber of three varieties passion fruit (Passiflora spp) shelves

O objetivo deste trabalho foi avaliar a composição químico-bromatológica e as degradabilidades potenciais e efetivas da matéria seca (MS), proteína bruta (PB) e fibra em detergente neutro (FDN) do resíduo (casca) das variedades de maracujá amarela (Passiflora edulis f. Flavicarpa Degener), roxa (Passiflora edulis Sims) e doce (Passiflora alata) e da mistura das variedades amarela e roxa. Calcularam-se, também, o consumo de MS e as concentrações de amônia, ácidos graxos voláteis e pH no líquido ruminal e a taxa de passagem das fases líquida e sólida da digesta no rúmen de bovinos. Os resíduos (casca) in natura apresentaram grande quantidade de água, enquanto a variedade roxa apresentou o maior teor de matéria seca (17,01%) e o amarelo, o menor (10,78%). O teor de proteína bruta variou de 9,82% na MS, para a variedade amarela, a 7,53%, para a doce. O teor de fósforo foi 0,13% na MS para a variedade doce, chegando a 0,09, para a roxo, e 0,08%, para a amarelo. Os teores de cálcio, FDN e FDA não diferiram entre as variedades. Às 48 horas de incubação no rúmen, a degradabilidade atingiu ponto máximo para o teor de MS, PB e FDN. Houve interação de tempo e variedade na degradabilidade de MS, PB e FDN. As degradabilidades de PB e FDN foram influenciadas pelas variedades. A DE da FDN foi maior para a mistura (45,85%) e menor para a doce (34,61%). O consumo médio de MS foi de 16,90 kg/animal, equivalente a 3,27% do peso vivo ou 156,11 g/kg0,75, quando se utilizou farelo de casca (resíduo) com 90% de MS. As concentrações de ácidos graxos voláteis mantiveram-se na faixa de 7,76 a 10,87 mmoles/100 mL. O pH do líquido ruminal variou de 6,03 a 6,75 e o N-amoniacal, de 4,93 a 9,86 mg/100 mL.<br>Chemical composition and the potential and effective degradabilities of dry matter (DM), crude protein (CP) and neutral detergent fiber (NDF) of passion fruit residue (shelves) were studied in the varieties yellow (Passiflora edulis f. Flavicarpa Degener), purple (Passiflora edulis Sims) and sweet (Passiflora alata) and in the mixture of yellow and purple varieties. DM intake, ruminal concentrations of N-ammonium, volatiles fatty acids (VFA) and pH, and rate of liquid and solid rumen digesta flows were also studied. The residues (shelves) in natura presented a high moisture content, the purple variety showed the highest DM content (17.01%) and the yellow the lowest (10.78%). The CP contents ranged from 9.82% in DM, for the yellow variety to 7.53% for the sweet, while the corresponding P contents were .13% for the sweet and 0.08% for the mixture. The contents of Ca, FDN and FDA showed no difference between varieties. Potential degradabilities of DM, CP and FDN reached the highest level after 48 hours incubation time. A significant interaction between incubation time and variety was observed for the degradability of DM, CP and FDN. The degradabilities of PB and FDN were affected by the varieties. The ED values for FDN were, respectively, 45.85 and 34.61%.The average DM intake was 16.9 kg/animal, equivalent to 3.27% of live weight or 156.11 g/kg0.75, when dried shelves (residue) with 90% of DM was fed. Rumen VFA concentrations ranged from 7.76 to 10.87 mmoles/100 mL, pH from 6.03 to 6.75 and N-ammonium from 4.93 to 9.86 mg/100 mL

Avaliação da época de nascimento sobre o desenvolvimento corporal e os rendimentos pós-abate de cordeiros da raça Texel Effect of different birth period on body development and carcass characteristics of Texel lambs

Para avaliar a viabilidade de épocas alternativas de nascimento sobre o desenvolvimento corporal e as características de carcaça de interesse comercial e dos componentes corporais em ovinos, foram utilizados 49 cordeiros machos Texel, não-castrados, nascidos em duas épocas (agosto e novembro). Os animais foram mantidos em pastagem e abatidos em dezembro para os cordeiros nascidos em agosto e abril para os nascidos em novembro, aos 129 e 164 dias de idade, respectivamente. Previamente aos abates, avaliou-se a produção forrageira do campo pelo método Botanal e verificaram-se melhores condições de forragem para os cordeiros nascidos em agosto. Esses cordeiros foram superiores quanto aos rendimentos comercial e verdadeiro, ao peso de carcaça quente e fria e quanto ao estado de engorduramento e cobertura de gordura da carcaça. O volume de vísceras verdes foi maior nos cordeiros nascidos em novembro, o que pode ser resultado da influência das condições nutricionais. A utilização de uma época alternativa de nascimentos para incrementar a oferta de cordeiros para o abate é viável em campo nativo melhorado.<br>Forty-nine intact Texel lambs were used to evaluate the effects of different birth periods (August vs. November) on body development, body measurements and carcass characteristics. Animals were maintained in pasture and slaughtered in December for those born in August and April for those born in November at 129 and 164 days of age, respectively. Prior to slaughtering forage yield was estimated by the Botanal technique, which showed that animals born in August had access to better quality pasture. These lambs had greater retail and true carcass yields, hot and cold carcass weights, and carcass fat score and covering fat than those born in November. However, green viscera yield was higher in lambs born in November probably due to the observed differences in pasture nutritional conditions. It can be concluded that birth period affected carcass characteristics in the present trial