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

Histochemical and histological investigations on the human fallopian tube under different hormonal influences - II. Proliferative processes within endosalpingeal epithelium.

Proliferative processes of human Fallopian tube (mitotic activity, number of nuclei, epithelial height) under different hormonal influences were studied by histological methods. In the 2nd half of the cycle, during pregnancy, during antiovulatory treatment and in postmenopausal period, the endosalpingeal epithelium of pars of uterina, isthmus, ampulla and infundibulum is characterized by proliferative quiescence (i.e. lack of mitoses, a small quantity of nuclei, a simple epithelium). Under minipill treatment (0.5 mg lynestrenol daily) a simple or pseudostratified epithelium with increasing amounts of nuclei in the 1st half of the cycle without mitoses, but in the midcycle (newly formed corpus luteum) with numerous mitoses is observed. Higher doses of progesterone during midcycle lead to a predominating pseudostratified epithelium with considerable quantities of nuclei, but without mitoses. Estrogen treatment in the 1st half of the cycle, in midcycle, in postmenopausal period, during extrauterine pregnancy and during antiovulatory treatment, results in distinct endosalpingeal proliferation (domination of pseudostratification, formation of epithelial papillae); secretory processes as well as cellular extrusions are observed also. Stimulation by estrogen is especially rapid in the tubal isthmus (high amounts of nuclei). A simple dosis of estrogen produces many mitoses in the oviductal epithelium within the following 12 h; with increasing interval between estrogen application and tubectomy, the quantity of mitoses is rapidly reduced. Regeneration and proliferation of endosalpingeal epithelium are results of mitotic divisions of secretory and ciliated cells rather, than of so-called basal cells, which appear to be immigrated lymphocytes

Evolução do peso testicular de cordeiros da raça Santa Inês alimentados com diferentes níveis de energia Testicle weight evolution of Santa Inês lambs fed different energy levels

Avaliou-se a evolução do peso testicular de cordeiros Santa Inês, alimentados com diferentes níveis de energia. Foram utilizados 64 cordeiros, distribuídos em quatro tratamentos: A - 8,7%; B - 17,3%; C - 26,0% e D - 34,7% de fibra em detergente neutro (FDN), proveniente da forragem na dieta, determinando a variação no consumo de energia metabolizável. Quatro animais de cada tratamento foram abatidos nas idades pré-determinadas de 43, 83, 123 e 173 dias de idade. Os testículos foram separados dos respectivos epidídimos e pesados separadamente. Os animais que receberam as dietas A e B foram os que apresentaram maior consumo de energia metabolizável (14,11Mcal/PV0,75), os mais pesados (18,89kg e 17,09kg, respectivamente) e os de maiores pesos dos testiculos (62,54g e 27,16g, respectivamente), indicando que o desenvolvimento testicular é altamente dependente do desenvolvimento corporal e da quantidade de energia metabolizável consumida. A predição do peso dos testículos por meio da circunferência escrotal mostrou ser mais eficiente do que por meio da idade e do peso vivo dos animais.<br>The development of the testicule weight of Santa Inês lambs, fed different energy levels, was evaluated. Sixty-four lambs were distributed in four treatments: A - 8.7%; B - 17.3%; C - 26.0% and D - 34.7% of neutral detergent fiber (NDF) supplied by the diet forage, determining the variation of the metabolizable energy intake. Four animals from each treatment were slaughtered at pre-defined ages of 43 days, 83 days, 123 days and 173 days. After slaughtering, the testicles were separated from the epididimous and individually weighted. The animals fed diets A and B presented higher metabolizable energy intake (14.11Mcal/LW0.75), higher live weight (18.89kg and 17.09kg, respectively) and higher testicules weight (62.54g and 27.16g, respectively), indicating that the testicular development is highly dependent on the body development and the quantity of metabolizable energy intake. The prediction of the testicules weight by the scrotal circumference showed to be more efficient than the age or the live weight of the animals

Desenvolvimento morfológico dos ovários em embriões e fetos bovinos da raça Nelore Morphological development of the ovaries in embryos and fetuses of Nelore breed

Investigaram-se os eventos morfológicos relacionados ao desenvolvimento pré-natal de ovários de 81 embriões e fetos da raça Nelore, coletados em frigoríficos, com idades variando de 26 a 240 dias pós-fecundação. Observou-se formação da crista gonádica e presença de células germinativas em seu interior aos 29 e 34 dias, respectivamente. As oogônias e folículos primordiais, ao contrário dos folículos em crescimento, apresentaram diferenças significativas de diâmetro nos vários períodos estudados. Verificou-se correlação positiva (P<0,05) entre o diâmetro das oogônias e de seus núcleos, bem como entre o diâmetro dos folículos primordiais e em crescimento com seus oócitos e respectivos núcleos. A gônada apresentou-se completamente formada aos 40 dias. Folículos primordiais, em crescimento e antrais surgiram, aproximadamente, aos 95, 140 e 180 dias, respectivamente. Na raça Nelore, a oogênese tem início e duração semelhante à de raças taurinas, mas apresenta como peculiaridade a antecipação do surgimento da foliculogênese.<br>The morphologic events related to the prenatal development of the ovaries in 81 Nelore breed embryos and fetuses gathered in a local slaughterhouse, with age range from 26 to 240 days following fecundation were studied. The age of fetuses was estimated from measures taken in the cranium-caudal direction. The sex was identified from macroscopic observations and using Polymerase Chain Reaction (PCR) technique. For histology the gonads were fixed in Bouin’s fluid for 24 hours and 5 µm thick section’s were stained with hematoxylin-eosin. Formation of gonadal ridge and presence of germinal cells were found within it at 29 and 34 days, respectively. Oogonia and primordial follicles, unlike the growing follicles, exhibited significant differences in diameter in the various periods studied. Positive correlation (P<0.05) was found between the diameter of oogonia and their nucleus as well as between primordial and growing follicles with their oocytes and respective nuclei. The gonad was fully formed at 40 days. Primordial follicles, in the growing stage, and antral follicles first appeared, approximately at 95, 140, and 180 days, respectively. Despite the onset and duration of oogenesis being similar to that of taurine breeds, folliculogenesis initiates at an early stages in the Nelore breed