The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Updated cardiovascular prevention guideline of the Brazilian Society of Cardiology: 2019

Sem informação113478788

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Análise do enxofre corrosivo em óleo mineral isolante e remoção do dibenzil dissulfeto com nanotubos de carbono baseados em matriz metálica

Unexpected failures in transformers led to the identification of copper sulphide formation, deposited on the conductors. The qualitative presence evaluation of corrosive sulfur in insulating mineral oil, led to a change in the Brazilian standards ABNT NBR 10505, which assesses the presence of corrosive sulfur in mineral oil, change in the time and test temperature to 150 °C / 48 hours. Performing the chemical speciation of organosulfur compounds (by gas chromatography coupled to mass spectrometry), were found 13 compounds in the Nynas oil and 9 compounds in the Petrobras oil. DBDS, which was found only in the Nynas oil, and it was the compound with the highest concentration. To perform the determination of the presence of DBDS in insulating mineral oil, a method by gas chromatography coupled to mass spectrometry was developed, and it was possible to quantify the amount of DBDS in insulating mineral oil samples derived from the power transformer. The passivation process by tolutriazol and benzotriazol, used as anticorrosive additives in the core of electrical equipament, was evaluated; after a while the effect of the addition of passivating agent becomes ineffective with time. The solution for the remotionl of DBDS from mineral oil was realized by using carbon nanotube reinforced by metallic matrix as agent to remove the DBDS. It was found that the adsorption agent was able to realize the complete DBDS remotion from insulating mineral oil up to a volume of 4000 mL (oil contaminated with DBD).Falhas inesperadas em transformadores levaram a identificação da formação de sulfeto de cobre, depositado sobre os condutores, avaliando-se da presença qualitativa de enxofre corrosivo resultando na alteração da norma brasileira ABNT NBR 10505, que avalia a presença de enxofre corrosivo em óleo mineral, alterando-se o tempo e a temperatura de ensaio para 150 °C por 48 horas. Realizando-se a especiação química de compostos organosulfurados via cromatografia gasosa acoplada a espectrometria de massas, onde foram encontrados 13 compostos sulfurados no óleo Nynas e 9 compostos no óleo da Petrobras, sendo o dibenzil dissulfeto (DBDS) o de maior concentração, encontrado apenas no óleo Nynas. Para realizar a determinação da presença do DBDS em óleo mineral isolante foi desenvolvido um método através de cromatografia gasosa acoplada a espectrometria de massas, e por este método foi possível quantificar o teor de DBDS em amostras de OMI oriundas de transformadores de potência. Foi avaliado o processo de passivação do cobre por benzotriazol e tolutriazol, utilizados como aditivos anticorrosivos no núcleo dos equipamentos elétricos, verificando-se que o efeito da adição agente de passivação torna-se ineficaz com o passar do tempo. A solução para a remoção de DBDS em óleo mineral foi a utilização de nanotubo de carbono baseado em matriz metálica (NTC/Al) como agente de remoção do DBDS. Verificou-se que o agente de adsorção foi capaz de efetuar a remoção total do DBDS do OMI até um volume de 4000 mL de óleo contaminado com DBDS

Production and characterization of the activated carbon from buriti stone (Mauritia flexuosa L. f.) to evaluate the adsorption's process of copper (II)

In the Amazon region some industries discharges copper into watercourse that in high concentrations is toxic to the biota. The removal of copper from industrial effluent is performed by several processes such as adsorption. This work shows the result of copper (II) adsorption on activated carbon obtained from buriti kernel, carbonized at 400 °C and activated at 900 °C. The activated carbon was characterized according to specific area, pore size, apparent and real density, porosity, scanning electron microscopy, ash content, pH, moisture, fixed carbon and surface functional groups. The study of adsorption equilibrium evaluated the influence of the coal particles diameter, contact time adsorbent/adsorbate, pH and copper (II) solution initial concentration on copper (II) remotion. The results showed a higher removal efficiency of copper (II) to the diameter D < 0.595 mm, contact time of 300 minutes, pH of 4.01 and the copper (II) initial concentrations of 50 and 80 mg L-1. The mathematical model of Langmuir was the best fit to the adsorption equilibrium data. From the contact time of 15 minutes, all the equilibrium concentrations were below the allowed maximum of 1,0 mg L-1 provided by law for discharging effluents into receiving bodies.Na região amazônica, algumas indústrias despejam cobre nos corpos receptores que, em elevadas concentrações, é tóxico para os seres vivos. A remoção de cobre de efluentes industriais é realizada por diversos processos como a adsorção. Neste trabalho mostrou-se o resultado da adsorção de cobre (II) em carvão ativado de caroço de buriti carbonizado a 400 °C e ativado a 900 °C. O carvão ativado foi caracterizado em termos de área específica, tamanho dos poros, densidades aparente e real, porosidade, microscopia eletrônica de varredura, conteúdo de cinzas, pH, umidade, carbono fixo e grupos funcionais de superfície. O estudo de equilíbrio de adsorção avaliou a influência do diâmetro das partículas do carvão, do tempo de contato adsorvente/adsorbato, do pH e da concentração inicial da solução de cobre (II) sobre a remoção de cobre (II). Com base nos resultados, concluiu-se que há uma maior eficiência de remoção de cobre (II) para diâmetro < 0,595 mm, tempo de contato de 300 minutos, pH 4,0 e concentrações iniciais de cobre (II) de 50 e 80 mg L-1. O modelo matemático de Langmuir foi o que melhor se ajustou aos dados de equilíbrio de adsorção. A partir do tempo de contato de 15 minutos todas as concentrações de equilíbrio ficaram abaixo do máximo permitido de 1,0 mg L-1 previsto pela legislação vigente para lançamento de efluentes em corpos receptores.PINTO, M. V. S.; SILVA, D. L. Universidade Federal do Par

Flow injection spectrophotometric determination of phenolic compounds in wastewaters using peroxidase of zucchini (Cucurbita pepo)

The silver diethyldithiocarbamate (SDDC) method, has been employed for the determination of arsenic in different materials. The disagreeable odor of the pyridine, the lower stability and reproducibility of the complex are justifications for many works related to the alternatives of the method. The SDDC/pyridine system was substituted for system using triethanolamine 5% v/v in chloroform with many advantages. The method was used for arsenic determination in hair samples with good recovery. Many kinds of digestions was studied.Pelo uso de técnicas mais baratas, como a do SDDC, é possível determinar níveis traços de arsênio em cabelo; entretanto esta técnica apresenta alguns inconvenientes como baixa estabilidade e o odor desagradável da piridina. A piridina foi substituída por trietanolamina/CHCl3 e as características analíticas do complexo foram estudadas. O complexo foi estável por 270 minutos, a faixa de aplicação da lei de Beer foi de 0,0 a 25,0 mg As, a repetibilidade foi de 0,028 mg As, o limite de detecção foi de 18,6 mg de As/L e a sensibilidade (e)? de 1,12 104 L.mol-1.cm-1. O método foi aplicado à amostras de cabelo. A lavagem das amostras foi feita com extran e água desionizada e seca em estufa (40-60ºC). 0,1000 g de amostra foi submetida à 11 métodos de digestão. O melhor método foi o que usou uma solução 1:1 de HNO3 e H2SO4 concentrados em temperatura de 100-110ºC com evaporação até fumos de SO3. O tempo de abertura é um inconveniente neste tipo de digestão

Toxic elements distribution in the Amazon River estuary

The non-essential elements found in the superficial waters of the Amazon River is a global worry since the local hydric resources represent the world's largest fresh water reservoir. This research aimed at studying the occurrence of As, Al, Mn and Pb in the waters of the Amazon River estuary. The 84 samples in three depths were collected in three different regions: North Channel of the Amazon River, in the state of Amapá; South Channel of the Amazon River, in the state of Pará; and Pará River, also in the state of Pará. Inductively coupled plasma atomic emission spectrometry (ICPAES) method was employed to determine the concentrations of Al, Mn and Pb in the samples while hydride generation atomic absorption spectrometry (HGAAS) method was employed in determining their As concentrations. As concentrations varied from <0.35 to 50.60 µg/L; Al concentrations varied from <1.88 to 3347.70 µg/L; Mn concentrations varied from <1.92 to 403.39 µg/L; and Pb concentrations varied from <0.18 to 51.96 µg/L. On average, the concentrations of As (samples from the South Channel), of Al (samples from the three regions), of Mn (samples from the North Channel and from the South Channel), and of Pb (samples from the North Channel) were higher than allowed by the Brazilian legislation. The origin of the elements can be anthropogenic due to mining and industrial activities as well as natural due to decomposition of igneous rocks from the drainage basin of the Amazon River which releases the element linked to the suspended particulate matter. High concentrations of toxic elements, especially of As and Pb, put the health of the populations who consume water of the Amazon River and the Pará River at risk.A presença de elementos não essenciais nas águas superficiais do rio Amazonas é uma preocupação global, o objetivo da pesquisa foi estudar a distribuição dos elementos As, Al, Mn, e Pb na água do estuário do rio Amazonas. As amostras foram coletadas em três regiões distintas: Canal Norte (AP), Canal Sul (PA) e rio Pará (PA) em três profundidades, com um total de 84 amostras. A espectrometria de emissão atômica com plasma indutivamente acoplado (ICPAES) foi utilizada para avaliar os teores de Al, Mn e Pb e a espectrofotometria de absorção atômica com geração de hidretos (HGAAS) foi usada para a análise do As. O As variou de <0,35 a 50,60 µg/L, o Al de <1,88 a 3347,70 µg/L, o Mn de 0,13 a 403,39 µg/L e Pb de <0,18 a 57,78 µg/L. Em média As (canal Sul), Al (todas as regiões), Mn (canal Norte e Sul) e Pb (canal Norte e Sul) se encontraram em valores acima do permitido pela legislação brasileira. Os elementos podem ter origem antrópica originária de atividade de mineração e industrial e origem natural proveniente de decomposição de rochas ígneas da bacia de drenagem do rio Amazonas que disponibilizam o elemento na forma ligada ao material particulado em suspensão

Arginine improves nutritional quality of sow milk and piglet performance

ABSTRACT The objective of this study was to evaluate the effect of L-arginine supplementation in lactation diets on the productive and reproductive performance of pluriparous sows and their litters. Seventy-six sows of the same genetic line were assigned to four treatments in a completely randomized design with 19 replicates. The experimental unit was the sow and its respective litter. Treatments comprised a control diet (no L-arginine supplementation) and other three diets obtained by top dressing the control diet with 0.5, 1.0, and 1.5% of L-arginine. L-arginine supplementation had no effect on any performance variables, body condition, milk production, or weaning-estrus interval. There was a quadratic effect on percentage of protein and fat in milk as well as on the daily production of these components. Protein and fat percentage declined during lactation. Adding L-arginine to the diet had a quadratic effect on piglet weight at 13 and 21 days, the optimal level of L-arginine supplementation being estimated as 0.64% and 0.71%, respectively. L-arginine supplementation had a quadratic effect on the weight gain of piglets during the first 13 days and on total period of lactation, the optimal level of L-arginine supplementation being estimated as 0.60% and 0.70%, respectively. Supplementing lactation diets with 0.70% of L-arginine, corresponding to 45 g day−1, improves the weight gain of piglets by improving the nutritional quality of sow milk