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

Lodo de esgoto em atributos biológicos do solo e na nodulação e produção de soja Sewage sludge effects on soil biological parameters and on soybean nodulation and yield

O objetivo deste trabalho foi avaliar os efeitos da aplicação do lodo produzido pela Companhia de Saneamento Ambiental do Distrito Federal (Caesb) na nodulação e rendimento de grãos da soja e em atributos biológicos de um Latossolo Vermelho de Cerrado. O experimento foi conduzido por dois anos consecutivos em um delineamento experimental de blocos ao acaso com três repetições e nove tratamentos - um controle, quatro doses de lodo de esgoto e quatro doses de fertilizante mineral - aplicados apenas no primeiro ano de cultivo. Foram avaliados: a nodulação e a produtividade da soja, o carbono da biomassa microbiana, o carbono prontamente mineralizável e a atividade das enzimas beta-glicosidase, fosfatase ácida e arilsulfatase no solo. Nos dois anos agrícolas, o rendimento de grãos da soja foi inferior ao do tratamento com o fertilizante mineral somente na dose de 1,5 Mg ha-1 de lodo de esgoto. A aplicação do lodo de esgoto no primeiro ano de cultivo não afetou a nodulação da soja, e a aplicação de até 6 Mg ha-1 não apresentou efeito sobre o carbono da biomassa microbiana, o carbono prontamente mineralizável e a atividade das enzimas beta-glicosidase, arilsulfatase e fosfatase ácida do solo no período de dois anos.<br>The objective of this study was to evaluate the effects of applying sewage sludge produced by the Companhia de Saneamento Ambiental do Distrito Federal (Caesb) on the nodulation and yield of soybean and on the biological parameters of a Cerrado Oxisol. The experiment was done for two consecutive years in a completely randomized block design with three replicates and nine treatments - one control, four dosages of sewage sludge and four dosages of mineral fertilizer - applied only in the first year of the experiment. Soybean nodulation, grain yield, soil microbial biomass carbon, readily mineralizable carbon and activity of the beta-glucosidase, acid phosphatase and arylsulphatase enzymes were evaluated. In both years, the grain yield was lower than that of the mineral fertilizer only at the sewage sludge dose of 1.5 Mg ha-1. The application of sewage sludge in the first year of the crop does not affect soybean nodulation, and the application of up to 6 Mg ha-1 of sewage sludge had no effect on microbial biomass carbon, readily mineralizable carbon and on the activity of the beta-glucosidase, arylsulphatase and acid phosphatase soil enzymes in the two-year period