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

Tratamento de águas residuárias de suinocultura em reator anaeróbio operado em batelada sequencial Treatment of swine wastewater in anaerobic sequencing batch reactor

Neste estudo avaliou-se o desempenho de um reator anaeróbio operado em batelada sequencial, em escala piloto, com volume total de 280 L, no tratamento de águas residuárias de suinocultura. As cargas orgânicas volumétricas aplicadas no reator foram de 4,42; 5,27; 9,33 e 11,79 g DQOtotal (L d)-1. As eficiências médias de remoção de DQOtotal, sólidos suspensos totais (SST) e sólidos suspensos voláteis (SSV) variaram de 56 a 87%. O nitrogênio total Kjedahl (NTK), fósforo total (P-total) e magnésio (Mg) foram removidos com eficiências médias de 26 a 39%. As produções volumétricas de metano variaram de 0,50 a 0,64 L CH4 (L reator d)-1 e não foram observadas diferenças significativas. As relações sólidos voláteis/sólidos totais (SV/ST) do lodo de tal reator variaram de 0,74 a 0,58. As maiores concentrações médias de nutrientes no lodo do reator foram para o nitrogênio, fósforo, ferro e cálcio, com valores de 30.610 a 64.400, 1.590 a 9.870, 6.180 a 8.700 e 1.180 a 6.760 mg kg-1 base seca, respectivamente.<br>In the present study, we evaluated an anaerobic sequencing batch reactor, in pilot scale and with a total volume of 280 L, for the treatment of swine wastewater. The organic loading rates applied in such reactor were 4.42; 5.27; 9.33 and 11.79 g CODtotal (L d)-1. The average efficiencies of removal of CODtotal total solids suspension (TSS) and volatile suspension solids (VSS) varied from 56 to 87%. The nutrients total Kjedahl nitrogen (TKN), total phosphorus (total P) and Mg were removed with average efficiencies from 26 to 39%. The volumetric methane productions varied from 0.50 to 0.64 L CH4 (L reactor d)-1 and did not present significant differences. The VS/TS relations of the aforementioned reactor's sludge varied from 0.74 to 0.58. The highest mean concentrations of nutrients in the reactor sludge were those of nitrogen, phosphorus, iron and calcium, with values from 30.610 to 64.400, 1.590 to 9.870, 6.180 to 8.700 and 1.180 to 6.760 mg kg-1 base dry, respectively