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

Frequências do fornecimento da dieta sobre as características da carcaça bovina em confinamento

Objetivou-se avaliar a influência de diferentes freqüências do fornecimento do volumoso e con- centrado sobre as características da carcaça nas categorias vaca e novilha, terminadas em confinamento. Foram utilizadas 16 novilhas e 16 vacas, com idade média de 20 e 66 meses e peso médio inicial de 338 e 432 kg, respectivamente, provenientes de gerações avançadas do cruzamento rotativo contínuo entre as raças Charolês e Nelore. Os tratamentos representados pelas freqüências do fornecimento do volumoso (V) e do concentrado (C), foram: 2 V/C (V e C duas vezes ao dia); 1 V/C (V e C uma vez ao dia); 1 V/ 2 C (V uma vez e o C duas vezes ao dia); 1 V/3 C (V uma vez e o C três vezes ao dia). Cada fornecimento alimentar foi ofertado às categorias vaca e novilha. A dieta fornecida foi composta de 60 % de silagem de milho e 40 % de concentrado com base na matéria seca. O abate foi realizado em frigorífico comercial, seguindo as normas do estabelecimento. O delineamento experimental utilizado foi inteiramente casualizado em arranjo fatorial 4 x 2 (fornecimento x categoria). Os dados foram submetidos à análise de variância e as médias comparadas pelo teste t. Não houve interação significativa entre freqüência de fornecimento e categoria animal. A freqüência de fornecimento não promoveu alterações nas ca- racterísticas da carcaça avaliadas (p>0,05). As vacas apresentaram maior peso de abate e de carcaça quente e fria em relação às novilhas (525,5; 291,0; 281,7 kg vs. 424,7; 236,1; 227,5 kg, respectivamente). Entretanto, as carcaças das novilhas apresentaram maior porcentagem de traseiro do que as vacas.The influence of different frequencies of supply of roughage and supplement on carcass characteristics of feedlot cows and heifers was studied. Sixteen heifers and sixteen cows, with average age of 20 and 66 months and initial weight of 338 and 432 kg, respectively, from advanced generations of Charolais and Nellore continuous rotational crossbreeding were used. The treatments, representing the frequencies of the supply of roughage (V) and concentrate (C), were: 2 V/C (V and C twice a day); 1 V/C (V and C once a day); 1 V/2 C (V once a day and C twice a day); 1 V/3 C (V once a day and C three times a day). Each treatment was offered to cows and heifers. The supplied diet was composed by 60 % of corn silage and 40 % of concentrate, on dry matter basis. The slaughter was carried out in commercial refrigerated slaugher house, following the rules of the establishment. The complete randomized experimental design was used, with a factorial arrangement of 4 x 2 (frequency of supply x category). Data were submitted to a variance analysis and the means were compared by t test. No significant interaction was observed between frequency of supply and animal category. The frequency of supply did not change the eva- luated carcass characteristics (p>0.05). The cows presented higher slaughter weight and hot and cold carcass weights when compared to heifers (525.5, 291.0, 281.7 kg vs. 424.7, 236.1, 227.5 kg, respectively). However, the carcasses of heifers showeda higher percentage of rear cows

Qualidade e valor nutritivo de silagens de capim-marandu (B. brizantha cv. Marandu) produzidas com aditivos ou forragem emurchecida Quality and nutritive value of marandugrass (Brachiaria brizanthia, cv. Marandu) silage prepared with additive or wilting

Avaliaram-se a qualidade e o valor nutritivo de silagens de capim-marandu produzidas com polpa cítrica (PC) peletizada, com aditivo enzimático-bacteriano (ABE) ou com forragem emuchercida (E): T1 - forragem sem tratamento (controle); T2 - 10% de polpa cítrica peletizada (PC); T3 - aditivo enzimático bacteriano (AEB - SIL-ALL-C4 da Alltech), à base de 5 g/L de água/t de forragem; T4 - forragem picada grosseiramente emurchecida por 4 horas ao sol. O capim foi colhido aos 60 dias de rebrota (24% MS). Para avaliar o consumo e a digestibilidade das silagens, foram utilizados 16 novilhos mestiços com 200 kg de PV, que receberam, além das silagens, 1,0 kg de concentrado/animal/dia. O AEB não afetou a composição da silagem, mas a PC e o E aumentaram o teor de MS de 24% para 31 e 48%, respectivamente, e reduziram o pH e os teores de N-NH3 das silagens, que foram, respectivamente, de 4,17 e 4,58 e 6,78 e 7,99% NT. A PC diminuiu os teores de FDN e FDA em 12 e 4 unidades percentuais. O consumo de MS da silagem produzida com capim emurchecido foi superior (111,8 g MS/PV0,75) ao das silagens controle ou com AEB, mas não diferiu do obtido para a silagem com PC, que também não diferiu das demais. Os tratamentos não afetaram a digestibilidade, cujas médias para MS, PB, CT, FDN, FDA e NDT foram 67,0; 65,4; 68,8; 63,0; 62,5; e 65,6%, respectivamente. A PC e o E reduziram a proteólise e estimularam o consumo. A PC, o E e o AEB não melhoraram o valor nutritivo da silagem de capim-marandu colhido com 24% MS.<br>The objective of this experiment was to evaluate the quality and nutritive value of marandugrass silages. It was evaluated the followings treatments: T1- forage without treatment (control); T2 - 10% of pelleted citric pulp (CiP); T3 - enzymatic bacterial additive (EBA) (SIL-ALL-C4 of Alltech) applied at 5 g/L of water/t of forage; T4 - Coarse chopped forage wilted for 4 hours under the sun. The grass was harvested with 60 days of regrowth (24% DM). The intake and digestibility evaluations were realized in 16 crossbred steers with 200 kg of BW, which received silage plus 1.0 kg of concentrate/animal/day. The EBA did not affect silage composition, but CiP addition and wilting increased the DM silage concentration from 24% (control) to 31 and 48%, respectively. The CiP decreased the NDF and ADF concentration in 12.0 and 4.0 percentage units, respectively. The CiP and wilting decreased the pH values (4.17 and 4.58) and N-NH3 concentration (6.78 and 7.99% TN) of the silages, respectively. Wilting resulted in higher animal intake (111.8 g/DM/LW0,75) compared to control or EBA treatments. Addition of CiP resulted in similar DM intake compared to other silages. The treatments did not affect nutrient digestibility, and the mean digestibility values for DM, CP, TCHO, NDF, ADF and TDN were 67.0, 65.4, 68.8, 63.0, 62.5, and 65.6%, respectively. Proteolysis was not reduced by EBA while CiP or wilting decreased this process, stimulating intake. Addition of CiP, wilting and EBA did not improve the nutritive value of marandugrass silage harvested with 24% DM

Development and evaluation of a tropical feed library for the Cornell Net Carbohydrate and Rrotein System model Desenvolvimento e avaliação de uma biblioteca de alimentos tropicais para o modelo "Sistema de Carboidrato e Proteína Líquidos" da Universidade de Cornell

The Cornell Net Carbohydrate and Protein System (CNCPS) model has been increasingly used in tropical regions for dairy and beef production. However, the lack of appropriate characterization of the feeds has restricted its application. The objective of this study was to develop and evaluate a feed library containing feeds commonly used in tropical regions with characteristics needed as inputs for the CNCPS. Feed composition data collected from laboratory databases and from experiments published in scientific journals were used to develop this tropical feed library. The total digestible nutrients (TDN) predicted at 1x intake of maintenance requirement with the CNCPS model agreed with those predicted by the Weiss et al. (1992) equation (r² of 92.7%, MSE of 13, and bias of 0.8%) over all feeds. However, the regression r² of the tabular TDN values and the TDN predicted by the CNCPS model or with the Weiss equation were much lower (58.1 and 67.5%, respectively). A thorough comparison between observed and predicted TDN was not possible because of insufficient data to characterize the feeds as required by our models. When we used the mean chemical composition values from the literature data, the TDN predicted by our models did not agree with the measured values. We conclude using the TDN values calculated using the Weiss equation and the CNCPS model that are based on the actual chemical composition of the feeds result in energy values that more accurately represent the feeds being used in specific production situations than do the tabular values. Few papers published in Latin America journals that were used in this study reported information need by models such as the CNCPS.<br>O uso do Sistema de Carboidrato e Proteina Líquidos da Universidade de Cornell (CNCPS) tanto para produção de leite como carne tem aumentado durante o últimos anos nas regiões tropicais. Entretanto, a falta de uma caracterização adequada de alimentos tem restringido o seu uso corretamente. Esse trabalho teve como objetivo principal o desenvolvimento e a avaliação de uma tabela de composição de alimentos utilizados nas condições tropicais. Os dados da composição desses alimentos foram baseados nas informações necessárias para o uso do modelo CNCPS desenvolvido pela Universidade de Cornell, USA. A composição desses alimentos foi obtida através de análises realizadas em laboratórios e de experimentos publicados em revistas científicas. Os nutrientes digestíveis totais (NDT) estimados através da composição de carboidratos e proteina dos alimentos pela equação de Weiss et al. (1992) e pelo modelo CNCPS foram comparados com os valores da tabela. O NDT estimado ao nível de mantença (1x) com o modelo CNCPS obteve valores próximos aos estimados pela equação de Weiss et al. (1992) (r² = 92.7% e bias = 0.8%). Entretanto, o r² da regressão entre os valores de NDT da tabela e o estimado pelo CNCPS e por Weiss foram menores (58.1 e 67.5%, respectivamente). Uma comparação completa entre os valores observados e preditos não foi possível devido a falta de caracterização dos alimentos conforme necessário pelos modelos testados. Quando os valores médios de literatura foram utilizados, a correlação entre o NDT estimado e o observado foi muito baixa. Concluímos que os valores de NDT estimados por Weiss e modelo CNCPS fornecem melhores estimativas de NDT do que os valores de tabela. A maioria dos trabalhos publicados que foram avaliados nesse estudo raramente incluíam informações necessárias para modelos como o CNCPS