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

Crustacea decapoda da praia rochosa da Ilha do Farol, Matinhos, Paraná: II. Distribuição espacial de densidade das populações

<abstract language="eng">Decapod crustaceans from rocky shore at Farol Isle, Matinhos, Paraná, Brazil. II. Spatial distribution of population densities. A study of the spatial distribution of the decapod populations from a rocky shore at Farol Isle, Matinhos, State of Paraná, Brazil (25º51'S, 48º32'W) was canied out. In the supralittoral the rocky surface is covered partially by a layer of litter coming from the terrestrial habitats; in the midlittoral boulders and pebbles cover the rocky basin and in the infralittoral, there is a belt of seaweeds. A total of 8 samples were taken by hand, two from each of the following levels: supralittoral (emersion time 8-12 hours), upper midlittoral (4-8), lower midlittoral (0-4) and limit between midlittoral and infralittoral, monthly, from May/1990 to April/1991. The number of species increased from supralittoral (5) to infralittoral (22) and a clear vertical zonation on density was observed according to the emersion time gradient. The supralittoral is characterized by grapsids Armases angustipes (Dana, (1852), Cyclograpsus integer H. Milne Edwards, 1837 and Metasesarma rubripes (Rathbun, 1897) which have terrestrial habits and aerial respiration as a main way in obtaining the oxygen. In the midlittoral, the decapods show three basic types of adaptation against emersion desiccation and thermal stresses: (1) by digging into wet mud among the stones such as Panopeus americanus Saussure, 1857, Panopeus occidentalis Saussure, 1857 and Eurypanopeus abbreviatus Stimpson, 1860, (2) by resting in shady and wet space between the boulders and pebbles or underside of them, like Pachygrapsus transversus (Gibbes, 1850), Petrolisthes armatus (Gibbes, 1850) and adults of Menippe nodifrons Stimpson, 1859 and (3) by clinging over the soaked filamentous algae layer on the pebbles or bouders surfaces, a strategy observed in small species such as Pilumnus dasypodus Kingsley, 1879, Podochela sp., Petrolisthes galathinus (Bosc, 1801 ), Alpheus bouvieri A. Milne Edwards, 1878 and juveniles of Menippe nodifrons. In the infralittoral, small species which are vulnerable to desiccation stresses share space by diversification of their diet and adaptation strategies such as camouflage, body color change according to the substratum, flattened body for tight adhesion on hard surface and rapid movements. The main species of this zone are Petrolisthes armatus, Petrolisthes galathinus, juveniles of Menippe nodifrons, Epialtus brasiliensis Dana, 1852, P. dasypodus, Synalpheus fritzmuelleri Coutière, 1909, Megalobrachium roseum (Rathbun, 1900) and species of Palaemonidae. The rocky shore at Farol Isle is a complex architectural environment due to the conjunction of diversified habitats such as litter over a hard surface, spaces and crevices among boulders and pebbles, muddy substratum and phytal