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

Liver allografts from donors with peritoneal contamination: report of two cases

Organs from deceased donors with traumatic abdominal injury, peritoneal contamination and open abdomen are usually discarded due to risks of transmission of severe infections to the recipient. There are no specific recommendations regarding organ utilization from these donors, but they might be an unexplored source able to attenuate organ shortage. Herein, the first successful report of a case involving liver transplantation using a liver allograft procured from a deceased donor with an open abdomen is outlined. This donor was a young trauma patient in which peritoneal contamination had occurred following a gunshot wound. Also included in this the report is liver transplant from a donor, who also was a trauma victim with an enteric perforation. The decision-making process to accept liver allografts from donors with a greater risk of peritoneal infection involved the absence of uncontrolled sepsis or visible contamination of the cavity. Appropriate donor-recipient matching and adequate anti-infectious management might have contributed to a favorable outcome, which suggest that these donors can be used as alternatives to reduce organ shortage

Identificação de Paspalum notatum fluegge e Axonopus affinis chase através da análise de fragmentos foliares Identification of Paspalum notatum fluegge and Axonopus affinis chase through leaf fragments analysis

Este trabalho teve como objetivo a caracterização e identificação de fragmentos foliares de Paspalum notatum Fluegge e Axonopus affinis Chase, como forma de subsidiar projetos de avaliação da dieta de animais fistulados. Para a caracterização das espécies, foram feitas várias coletas de folhas em áreas de pastagem natural do Campus da Universidade Federal de Santa Maria (RS), de maio de 1992 a junho de 1993. A diferenciação das espécies foi baseada no padrão de nervação, presença de pêlos e características do ápice e bordo foliar, observadas com auxílio de estereomicroscópio. A habilidade de um observador em identificar fragmentos das duas espécies numa mistura e a eficácia dos descritores foliares mencionados foram testadas através de análise estatística. Desta forma, foi constatado que o padrão de nervação é o melhor critério de diferenciação e que A. affinis difere de P. notatum, basicamente, pelo ápice foliar obtuso e pela presença de nervuras quaternárias. A análise estatística confirmou a capacidade do observador em reconhecer fragmentos das duas espécies.<br>This research aimed at the characterization and identification of leaves, fragments of Paspalum notatum Fluegge and Axonopus affinis Chase, for future studies of diet evaluation of fistuleted animals. For the species characterization, several collections of leaves were made in native pasture areas at the UFSM Campus (Santa Maria, RS) from May, 1992 to June, 1993. The differentiation of the species was based on the leave’s venation pattern, hair presence, leaf border and apex features, observed with a stereomicroscope. The obverver’s ability to identify the two species of leaves in a misture were tested with statistical analysis. It was observed that the venation pattern is the best characterization criteria and that A. affinis differs from P. notatum mainly by the obtuse leaf apex and by the quaternary vein presence. The statistical analysis confirmed the observer’s ability in recognizing leaves fragments of the two species

Levantamento fitossociológico de um campo limpo da Estação Experimental Agronômica, UFRGS, Guaíba, RS: 1ª etapa Phytossociological survey of an open grassland of the Agronomic Experimental Station of the UFRGS, Guaíba, RS: 1º stage

Foi realizado um estudo fitossociológico numa área de campo limpo, sob pastejo, durante os meses de outubro e novembro de 1984. No levantamento qualitativo de 16 amostras identificaram-se 28 famílias, 76 gêneros e 112 espécies, destacando-se as famílias Gramineae (27 espécies), Compositae (25 espécies), Rubiaceae (9 espécies), Cyperaceae (8 espécies), Leguminosae (7 espécies) e Umbelliferae (5 espécies). Para o estudo quantitativo das comunidades botânicas foram avaliadas: presença, freqüência absoluta, freqüência relativa, cobertura relativa e importância relativa.<br>A phytosociological survey was undertaken during October-November 1984, on a "open grassland" area under grazing. The qualitative survey of 16 quadrats has yelded 28 botanical families, 76 genera and 112 species with relevance to the Gramineae (27 species), Compositae (25 species), Rubiaceae (9 species), Cyperaceae (8 species), Leguminosae (7 species) and Umbelliferae (5 species). For the quantitative survey, presence, absolute frequency, relative frequency, relative coverage and relative importance were evaluated

Espécies forrageiras para produção de leite em solos de várzea Forage species for milk production in lowland soil

Objetivou-se com este trabalho avaliar a disponibilidade de forragem, a composição morfológica e química do pasto, a capacidade de suporte do pasto e a produção de leite de vacas em três gramíneas forrageiras sob lotação contínua e taxa variável em solo de várzea. O delineamento experimental foi inteiramente casualizado com três tratamentos e três repetições. Os tratamentos constituíram-se das gramíneas Paspalum atratum cv. Pojuca, Brachiaria humidicola cv. Llanero e capim-tangola, híbrido natural de Brachiaria arrecta e Brachiaria mutica. A taxa de lotação foi ajustada para manter a forragem disponível entre 2.000 e 3.000 kg de massa seca por hectare. O período avaliado foi de novembro de 2003 a maio 2004. Não houve diferença significativa entre as espécies quanto à disponibilidade de massa seca de forragem verde, com valor médio de 2.902 kg/ha. O capim-pojuca apresentou 62% de lâminas foliares e 38% de colmo + bainha na massa seca de forragem verde, seguido pelo capim-humidícola com 49 e 51% e o capim-tangola com 18 e 82%, respectivamente. O capim-tangola apresentou teor mais alto de proteína bruta na lâmina foliar (15,41%) que os capins humidícola (9,98%) e pojuca (8,74%) e menores de fibra (FDN e FDA). A produção individual das vacas refletiu o melhor valor alimentício do capim-tangola, cuja média diária (10,27 kg/vaca) foi maior que no capim-pojuca (7,80 kg/vaca) e semelhante ao obtido com capim-humidícola (9,16 kg/vaca). A produção de leite por área não foi afetada pela gramínea forrageira, com média de 27,8 kg/ha × dia-1, uma vez que a taxa de lotação um pouco mais alta no capim-pojuca, apesar de não apresentar diferença significativa, compensou a menor produção individual das vacas.<br>The objective of this study was to evaluate the forage availability, pasture morphological and chemical composition, pasture carrying capacity and the milk production of cows on three forage grasses under continues stocking and the variable rate on lowland soil. The experimental design was completely randomized with three treatments and three replicates. The treatments were the Paspalum atratum cv Pojuca grass, Brachiaria humidicola cv Llanero grass and tangola grass (natural hybrid of Brachiaria arrecta and Brachiaria mutica). The stocking rate was adjusted to maintain the forage available between 2.000 and 3.000 kg dry matter per hectare. The period evaluated was from November 2003 to May 2004. There was no significant difference between the species when the dry matter availability of green forage was evaluated, with mean value of 2.902 kg/ha. The pojuca grass had 62% of leaf blade and 38% of stem + sheath in green forage dry mass, followed by humidícola grass with 49 and 51% and tangola grass with 18 and 22%, respectively. The tangola grass showed higher level of crude protein on the leaf blade (15.41%) than humidícola (9.98%) and pojuca (8.74%) grasses and lower levels of fiber (NDF and ADF). The individual production of cows was affected by the better nutritional value of the tangola grass. The average daily production of this grass was higher (10.27 kg/cow) than the pojuca grass (7.8 kg/cow) and had similar value to humidícola grass (9.16 kg/cow). The milk production per area, with had mean of 27.8 kg/ha × day-1, was not affected by the forage grasses because the more high stocking rate of pojuca grass, although not significant, compensated the lower individual production

Análise comparativa de fragmentos identificáveis de forrageiras, pela técnica micro-histológica Comparative analysis of identifiable fragments of forages, by the microhistological technique

Objetivou-se, com este trabalho, verificar, pela técnica micro-histológica, diferenças entre espécies forrageiras quanto ao percentual de fragmentos identificáveis, em função do processo digestivo e da época do ano. Lâminas foliares frescas recém-expandidas, correspondentes à última e à penúltima posição no perfilho, das espécies Melinis minutiflora Pal. de Beauv (capim-gordura), Hyparrhenia rufa (Nees) Stapf. (capim-jaraguá), Brachiaria decumbens Stapf. (capim-braquiária), Imperata brasiliensis Trin. (capim-sapé), de Medicago sativa L. (alfafa) e de Schinus terebenthifolius Raddi (aroeira), amostradas nos períodos chuvoso e seco, foram digeridas in vitro e preparadas de acordo com a técnica micro-histológica. Observou-se que as espécies apresentaram diferenças marcantes na porcentagem de fragmentos identificáveis e que a digestão alterou estas porcentagens em torno de 10 %; que o período de amos&shy;tragem não influenciou a porcentagem de fragmentos identificáveis para a maioria das espécies; que a presença de pigmentos e a adesão da epiderme às células dos tecidos internos da folha prejudicaram a identificação dos fragmentos; e que a digestão melhorou a visualização dos fragmentos dos capins sapé e jaraguá e da aroeira, mas prejudicou a do capim-braquiária e, principalmente, a da alfafa.<br>The objetive of this study was to verify differences among forages species in relation to the percentage of identifiable fragment as affected by the digestion process and season. Fresh last expanded leaf lamina samples of the species Melinis minutiflora Pal. de Beauv (Molassesgrass), Hyparrhenia rufa (Nees) Stapf. (Jaraguagrass), Brachiaria decumbens Stapf. (Signalgrass), Imperata brasilienses Trin. (Sapegrass), and foliar laminas of Medicago sativa L. (Alfalfa) and Schinus terebenthifolius Raddi (Aroeira), sampled in the rainy and dry seasons, were digested in vitro and prepared according to the microhistological technique. The digestion process caused change of 19 units in the percentage of identifiable fragments whose values varied among forage species. The season did not influence the percentage of identifiable fragments for most species; the presence of pigments and adherence of epidermis to internal tissues of the leaf hindered the identification of fragments. The digestion improved the identification of sapegrass fragments, jaraguagrass and Schinus terebenthifolius Raddi, but hindered identification of signalgrass fragments and mainly those of alfalfa