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

Quantifying chemical weathering intensity and trace element release from two contrasting basalt profiles, Deccan Traps, India

Weathering profiles developed on basalt substrate contain information relevant to climate, atmospheric composition and evolution, nutrient release into the hydrosphere, and understanding Martian regolith. In this study, the chemical compositions of two profiles developed on Deccan Trap basalt are examined. One is sub-Recent and has only progressed to a moderate degree of alteration (Chhindwara profile), whereas the other is ancient (Paleocene) and the degree of alteration is extreme (Bidar laterite). In an attempt to better quantify the chemical changes during incipient to intermediate weathering of mafic substrates, we propose a new index: the mafic index of alteration (MIA). Similar to the chemical index of alteration (CIA), the MIA quantifies the net loss of the soluble major element cations (Ca, Mg, Na, K ± Fe) relative to the insoluble major elements (Al ± Fe). The redox-dependent weathering behaviour of Fe is factored into two separate arrangements of the MIA that apply to oxidative [MIA(O)] or reduced [MIA(R)] weathering. The MIA can be visualised in a variety of ternary diagrams in the Al–Fe–Mg–Ca–Na–K system. To chemically quantify the stages of advanced to extreme weathering, at which the MIA and CIA are ineffective, the SiO2 to (Al2O3+Fe2O3) mass ratio, based on the established Si–Al–Fe (SAF) ‘laterite’ ternary diagram, is used; we propose that this ratio be referred to as the ‘index of lateritisation’ (IOL). Major element chemical variations, as expressed by weathering indices, were used to relate the extent of weathering with the behavior of trace elements (alkali, alkaline earth, rare earth, and Nb) in the profiles. During the early stages of basalt weathering, the mobile trace elements (Sr, Be, Li) are anti-correlated with the chemical weathering indices and thus released during these stages. By contrast, the monovalent elements (K, Rb, Cs, Tl), excluding Na and Li, appear to be associated with the pedogenetic clay minerals and the elements with the closest ionic radii are most closely related. Fractionation of the REE (Sm/Nd, Eu/Eu*, Ce/Ce*) is evident during weathering of the basalt. The loss of Eu is linked with Sr, Ca, and Na and thus plagioclase dissolution during the stages of incipient to intermediate weathering. The fractionation of Sm/Nd suggests that basaltic weathering products may not always preserve their parent rock ratio and, consequently, their Nd isotope composition over time. Finally, weathering in the sub-Recent profile is shown to have progressed across two lava flows, whose morphology initially controlled the extent of weathering. Certain compositional variations in the original flows (e.g., immobile element ratios) are preserved through the effects of chemical weathering and have the potential to influence mass balance calculations across the entire profile

Comparação entre as administrações tópica e sistêmica de oxitetraciclina no tratamento de vacas com dermatite digital papilomatosa Efficacy of topical and systemic treatments with oxytetracycline for papillomatous digital dermatitis in cows

Comparou-se a eficiência dos tratamentos tópico e sistêmico com oxitetraciclina em vacas com dermatite digital papilomatosa (DDP) e determinaram-se a presença de resíduos desse antimicrobiano no leite e sua concentração no líquido sinovial e no plasma. Utilizaram-se o tratamento tópico com oxitetraciclina em pó (grupo 1) e o sistêmico de longa ação (grupo 2) em 16 vacas holandesas em lactação, acometidas por DDP. Obtiveram-se amostras de plasma, líquido sinovial e leite nos momentos: M0, antes dos tratamentos; M1, seis horas após o tratamento e em intervalos de 12 horas até M23 (264 horas pós-tratamentos). Avaliaram-se o grau de claudicação, a extensão da lesão e a concentração da oxitetraciclina pela cromatografia líquida de alta eficiência. Nas vacas do grupo 1, ocorreu redução das lesões e da claudicação, quando comparadas com as do grupo 2. Nenhuma das amostras de leite, de líquido sinovial e de plasma nos animais do grupo 1 foi positiva para oxitetraciclina. As amostras de leite dos animais do grupo 2, entre M1 e M23, apresentaram valores acima do limite máximo residual permitido para esse antimicrobiano. O tratamento tópico foi eficiente no tratamento de DDP, sem produzir resíduos no leite ou concentrações no plasma e no líquido sinovial. O tratamento sistêmico foi ineficiente para DDP, resultando em resíduos no leite, durante a avaliação.<br>The efficacy of topical versus systemic treatment with oxytetracycline for papillomatous digital dermatitis (PDD) in dairy cows was compared. Antimicrobial residues in milk and their concentrations in synovial fluid and plasma were analysed. Sixteen lactating Holstein cows with PDD lesions were topically treated with oxytetracycline powder (group 1) or long-acting oxytetracycline (group 2). Plasma, synovial fluid, and milk samples were collected in the following moments: M0 (before treatments); at six hours after treatments (M1), and at 12-hour intervals until 264 hours after treatments (M23). Lameness score and lesion size were evaluated. Analysis of oxytetracycline concentration was performed by high-performance liquid chromatography (HPLC). Cows in group 1 showed reduced lesion size and lameness score when compared to cows in group 2. None of the plasma, synovial fluid, or milk samples collected from cows in group 1 were positive to oxytetracycline. However, violative antimicrobial residues were detected in milk samples collected from cows in group 2, from M1 until M23. Topical application of oxytetracycline powder was an efficient treatment for PDD with no risk of violative antimicrobial residues in milk or increases its concentration in plasma or synovial fluid. The systemic administration of oxytetracycline was inefficient to treat PDD and caused violative residues in milk