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

DECONTAMINATION OF CELLS 6 AND 7, BUILDING 3019, FOLLOWING PLUTONIUM- RELEASE INCIDENT

As a result of the evaporation explosion in the Radiochemical Processing Pilot Plant on Nov. 20, 1959, two cells were contaminated with plutonium to a transferable level of 10/sup 8/ d/m/100 sq cm. The area involved measures 40 by 20 by 27 ft high with a total surface area, including equipment, of 10,000 sq ft. The cells were decontaminated by a factor of 1000 in five months by removing loose equipment, debris, and shielding blocks and flushing with 430,600 liters of various decontaminating reagents. The remaining contamination (10/sup 4/ - 10/ sup 5/ d/-m/100 sq cm) was fixed to the surface with three coats of paint. The general beta-gamma radiation background was decreased from 2000 to 30 mr/hr and the long-lived alpha contamination in the air was reduced from 2 x 10/sup -10/ to 8 x 10/sup -13/ mu c/cc. Approximately 141 g of plutonium was flushed from the cell surfaces. The total direct effort expended was 3000 man-hr including 250 entries into the cell, 175 of which were made in plastic air suits. There were no overexposares from beta-gamma radiation and no detectable increase in the body burden of plutonium of any individual involved. (auth

Decontamination of concrete surfaces in Building 3019, Oak Ridge National Laboratory. [After Nov. 20, 1959 incident]

This building was built in 1943 to serve as a pilot plant for separating isotopes from irradiated fuels. A chemical explosion leading to widespread Pu contamination occurred on Nov. 20, 1959, and the steps taken to treat the building afterwards are discussed, in particular the floor and the cells. The experience shows how hard it is to decontaminate concrete; smooth coatings should be utilized. (DLC

Separation of uranium from process wastewaters using microbial cells as sorbents. [Mixed culture of denitrifying bacteria]

A mixed culture of denitrifying bacteria was evaluated for separating U from process wastewaters. The mixed culture was obtained as films on coal particles in an operating fluidized-bed bioreactor system. Biosorption of U by the mixed culture was rapid, reaching a saturation of approx. 0.14 g U per gram of dry cells. Two contacting devices were also evaluated. 4 figures. (DLC