19 research outputs found

    Reduction of the use of polyethylene bags: Ecological management alternative in San Lorenzo, Paraguay. 2015

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    The present research analyzes the problem of the harmful effect of the use of polyethylene bags in the environment, with the aim of proposing an alternative of ecological management that contributes to the reduction of the use of polyethylene bags in the area of influence of a Supermarket X in the city of San Lorenzo in 2015. Therefore, the realization of this study responds to the need to present alternatives for the use of polyethylene bags in smaller quantities through the generation of incentives and greater education. For this research we opted for a qualitative and quantitative approach of descriptive cross-sectional level. For the collection of data it was used to conduct interviews and surveys both to managers of the supermarket and customers of the same. It was found in this investigation that the costs incurred for the acquisition and sale of polyethylene bags by a supermarket branch amount, on average, to Gs. 46,000,000 per month. Also, the predisposition of the consumer to reduce their consumption of polyethylene bags can be summarized as favorable. Therefore, the present paper proposes alternatives for the use of polyethylene bags that favor merchants, customers, society and the environment

    Reducción de utilización de bolsas de polietileno: Alternativa ecológica de gestión en San Lorenzo, Paraguay. 2015

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    La presente investigación analiza la problemática del efecto nocivo que genera en el medioambiente la utilización de bolsas de polietileno, con el objetivo de proponer alternativa de gestión ecológica que contribuya a la reducción de la utilización de bolsas de polietileno en la zona de influencia de un supermercado X en la ciudad de San Lorenzo en el 2015. Por ello, la realización de este estudio responde a la necesidad de presentación de alternativas de uso de bolsas de polietileno en menores cantidades mediante la generación de incentivos y mayor educación. Para esta investigación se optó por un enfoque cualitativo y cuantitativo de nivel descriptivo de corte transversal. Para la recolección de datos se recurrió a realizar entrevistas y encuestas tanto a directivos del supermercado como a clientes del mismo. Pudo constatarse en esta investigación que los costos incurridos para la adquisición y expendio de bolsas de polietileno por una sucursal de supermercado ascienden en promedio a Gs. 46.000.000 por mes. Asimismo, la predisposición delconsumidor a reducir su consumo de bolsas de polietileno puede resumirse como favorable. Por ello el presente trabajo propone alternativas para el uso de bolsas de polietileno que favorezcan a los comerciantes, los clientes, la sociedad y el medio ambiente

    Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

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    Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

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

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    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

    Reducción de utilización de bolsas de polietileno: Alternativa ecológica de gestión en San Lorenzo, Paraguay. 2015

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    La presente investigación analiza la problemática del efecto nocivo que genera en el medioambiente la utilización de bolsas de polietileno, con el objetivo de proponer alternativa de gestión ecológica que contribuya a la reducción de la utilización de bolsas de polietileno en la zona de influencia de un supermercado X en la ciudad de San Lorenzo en el 2015. Por ello, la realización de este estudio responde a la necesidad de presentación de alternativas de uso de bolsas de polietileno en menores cantidades mediante la generación de incentivos y mayor educación. Para esta investigación se optó por un enfoque cualitativo y cuantitativo de nivel descriptivo de corte transversal. Para la recolección de datos se recurrió a realizar entrevistas y encuestas tanto a directivos del supermercado como a clientes del mismo. Pudo constatarse en esta investigación que los costos incurridos para la adquisición y expendio de bolsas de polietileno por una sucursal de supermercado ascienden en promedio a Gs. 46.000.000 por mes. Asimismo, la predisposición delconsumidor a reducir su consumo de bolsas de polietileno puede resumirse como favorable. Por ello el presente trabajo propone alternativas para el uso de bolsas de polietileno que favorezcan a los comerciantes, los clientes, la sociedad y el medio ambiente

    X Chromosome Contribution to the Genetic Architecture of Primary Biliary Cholangitis.

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    BACKGROUND & AIMS: Genome-wide association studies in primary biliary cholangitis (PBC) have failed to find X chromosome (chrX) variants associated with the disease. Here, we specifically explore the chrX contribution to PBC, a sexually dimorphic complex autoimmune disease. METHODS: We performed a chrX-wide association study, including genotype data from 5 genome-wide association studies (from Italy, United Kingdom, Canada, China, and Japan; 5244 case patients and 11,875 control individuals). RESULTS: Single-marker association analyses found approximately 100 loci displaying P < 5 × 10(-4), with the most significant being a signal within the OTUD5 gene (rs3027490; P = 4.80 × 10(-6); odds ratio [OR], 1.39; 95% confidence interval [CI], 1.028-1.88; Japanese cohort). Although the transethnic meta-analysis evidenced only a suggestive signal (rs2239452, mapping within the PIM2 gene; OR, 1.17; 95% CI, 1.09-1.26; P = 9.93 × 10(-8)), the population-specific meta-analysis showed a genome-wide significant locus in East Asian individuals pointing to the same region (rs7059064, mapping within the GRIPAP1 gene; P = 6.2 × 10(-9); OR, 1.33; 95% CI, 1.21-1.46). Indeed, rs7059064 tags a unique linkage disequilibrium block including 7 genes: TIMM17B, PQBP1, PIM2, SLC35A2, OTUD5, KCND1, and GRIPAP1, as well as a superenhancer (GH0XJ048933 within OTUD5) targeting all these genes. GH0XJ048933 is also predicted to target FOXP3, the main T-regulatory cell lineage specification factor. Consistently, OTUD5 and FOXP3 RNA levels were up-regulated in PBC case patients (1.75- and 1.64-fold, respectively). CONCLUSIONS: This work represents the first comprehensive study, to our knowledge, of the chrX contribution to the genetics of an autoimmune liver disease and shows a novel PBC-related genome-wide significant locus.The article is available via Open Access. Click on the 'Additional link' above to access the full-text.Published version, accepted versio

    Risk factors for death, stroke, and bleeding in 28,628 patients from the GARFIELD-AF registry: Rationale for comprehensive management of atrial fibrillation

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    Backgroun

    Risk Profile and 1-Year Outcome of Newly Diagnosed Atrial Fibrillation in Japan - Insights From GARFIELD-AF -

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    Background: Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective non-interventional study of stroke prevention in patients with newly diagnosed non-valvular AF (NAVF) that is being conducted in 35 countries

    International trends in clinical characteristics and oral anticoagulation treatment for patients with atrial fibrillation: Results from the GARFIELD-AF, ORBIT-AF I, and ORBIT-AF II registries

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    Background Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. We aimed to provide comprehensive data on international patterns of AF stroke prevention treatment
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