Distribution of triglyceride-rich lipoproteins and their remnants and their contribution to cardiovascular risk in the Mexican population.

BACKGROUND AND AIMS: In recent years, scientific interest in triglyceride-rich lipoproteins (TRL) and remnant cholesterol has increased, focusing on the evidence that these lipoproteins are a causal factor for developing atherosclerotic cardiovascular disease (ASCVD). Furthermore, a high remnant concentration (>38 mg/dL) has been associated with several non-cardiovascular risks. We aimed in this study to describe the percentile distribution of remnant cholesterol. Additionally, we evaluated the association between remnant cholesterol plasma concentration and epidemiologically relevant cardio-metabolic outcomes such as hypertension, type 2 diabetes (T2D), and ASCVD. METHODS: We analyzed data from 9,591 adults from the National Survey of Health and Nutrition (ENSANUT) 2018 with fasting blood samples and complete medical history questionnaires. We built multivariate models to evaluate the association between chronic diseases and blood remnant concentration. To compare our 2018-sub-sample against a population reference, we used the NHANES (2005-2014) publicly available datasets by ethnicity. RESULTS: Remnants were independently associated with cardiovascular risk, diabetes, hypertension, obesity, and metabolic syndrome. For all outcomes, the blood remnant concentration was a stronger predictor than LDL. At all deciles, the blood remnant concentration was higher in ENSANUT-2018. CONCLUSIONS: A remnant blood concentration above 38 mg/dL was highly prevalent among Mexicans. Remnants were significantly associated with a higher risk of diabetes, hypertension, obesity, and cardiovascular risk. This association occurred independently of other lipid markers.

Effects of parity, seasonal heat stress, and colostrum collection time postpartum on colostrum quality of Holstein cattle in an arid region.

The aim of this study was to determine effects of parity (primiparous vs. multiparous), seasonal heat stress at calving (summer vs. winter), and time postpartum on some parameters associated with colostrum quality in Holstein cows reared in the Sonoran Desert ecosystem. Forty-seven cows (11 primiparous and 36 multiparous) expected to calve during summer, and 46 cows during winter (14 primiparous and 32 multiparous) were randomly selected. Management and feeding before and after parturition were similar for cows in both seasons. After parturition, colostrum from all cows was evaluated for volume, weight, temperature, density, and content of fat, protein, solids non-fat (SNF), and immunoglobulins (IGG). Data were analyzed with a model that included effects of parity status, calving season, and time postpartum, as well as all interactions. Colostrum produced in summer was warmer (P < 0.01) by almost 6 °C than winter colostrum, while colostrum from multiparous was warmer (P = 0.02) by 1.2 °C than that produced by primiparous cows. Colostrum volume and weight were not impacted by parity, calving season or time postpartum. Density, protein, and SNF content in colostrum were higher (P < 0.01) in multiparous vs. primiparous cows, as well as at parturition (0 h postpartum) than at 12 h postpartum (P < 0.01). At calving (0 h), spring colostrum had higher fat content (P < 0.01) and lower (P < 0.01) IGG concentration than that collected in summer, and no difference (P > 0.05) between seasons was observed for these components at 12 h postpartum. Multiparous cows produced colostrum with higher (P < 0.01) IGG concentrations than primiparous cows. In conclusion, only 0-h colostrum and that from multiparous cows was categorized as "Excellent," meanwhile the colostrum produced under summer heat stress was characterized as "Good" with reduced fat content. While the lacteal secretion collected at 12 post-partum still classified as colostrum, substantially lower contents of IGG, protein, fat, and SNF decreased its classification to "Poor" from the classification of "Excellent" at 0 h postpartum.

The impact of hair coat color on physiological variables, reproductive performance and milk yield of Holstein cows in a hot environment.

Vulnerable animals to heat stress have been described as ones with dark or black hides due to increasing absorption of solar radiation. The effect of coat color in pluriparous contemporary Holstein cows in a hot environment (mean annual temperature 24.6 °C), on body surface temperature (infrared thermography), physiological and hematological variables as well as milk yield and reproductive performance was assessed using 178 Holstein pluriparous cows (74 predominantly white and 104 predominantly black). Data were collected in the morning and afternoon in July (mean temperature-humidity index 82 units). Body condition score at mid-lactation (128 ±â€¯32 days in milk at the start of the experiment) was higher (P < 0.01) in predominantly white than in black cows (3.3 vs. 3.2). Respiration rate did not differ between groups (72 ±â€¯23 vs. 73 ±â€¯20 breaths/min for white and black cows, respectively, sampling time combined). In contrast, rectal temperature of black cows was 0.1 °C higher (P ≤ 0.01) than white cows, regardless of sampling time. The only significant hematologic change was a slight increase in mean corpuscular volume in black cows (54.7 fL, P < 0.01) compared to white cows (53.8 fL), but it remained within the reference range. Differences due to coat color did not alter body surface temperatures at any time of the day. Conception rates, services per conception, calving intervals and fetal losses were not associated with hair coat color, but cows with predominantly white coat produced 394 kg more (P < 0.01) fat-corrected milk in 305 days compared to cows with predominantly black coat. It was concluded that in this hot-arid environment with cows housed in facilities with extensive cooling, black hair coat moderately reduces 305-d milk yield without affecting milk composition, body surface temperature, and reproductive performance.

Effectiveness of Centruroides scorpion antivenom compared to historical controls.

BACKGROUND: Envenomation by North American scorpions of genus Centruroides is associated with a syndrome of neurotoxicity and respiratory compromise that disproportionately affects rural children. Severe scorpion envenomation is rare, which makes treatment difficult to study using conventional controlled clinical trials; and small-scale placebo-controlled trials conducted in tertiary centers are of limited generalizability to the community setting. Open label studies, although safer and easier to conduct, are of limited value unless a suitable comparator group is used. Historical controls may be appropriate when concurrent controls are not feasible or ethical. METHODS: A successful placebo-controlled, double-blind clinical trial design was adapted for community use in Arizona and Mexico. A comparator population was established by replacement of the placebo group with a retrospective cohort and preservation of criteria for inclusion, exclusion, dosing and endpoint assessment. Study endpoints were selected to demonstrate the clearest possible difference between treatment groups, while minimizing confounders. Results were summarized and endpoints were directly compared between groups and with the prior double-blind study. RESULTS: The clinical syndrome remained evident in 95.9% of the historical cohort (93/97) 4 h after admission, and their cumulative dose of midazolam given between baseline and discharge was 5.29 ± 8.68 mg/kg (range 0-62.8). Among 78 prospectively treated cases, none received midazolam and only 2 (2.8%) remained symptomatic at 4 h. Venom was detectable in the plasma of all antivenom recipients tested, and it dropped by 90% of baseline in 95% of cases studied. CONCLUSIONS: The results of this pragmatic study strongly support the findings of the double-blind, placebo controlled clinical trial of the same antivenom. Recipients of antivenom at rural sites improved at a rate similar to that in the intensive care (ICU) setting, and historical cases resolved at a rate similar to that for untreated ICU controls. Use of antivenom in the primary care setting appeared to be safe and effective and to eliminate the need for intensive care or for transport to a tertiary care center, in all subjects prospectively studied.

Pharmacokinetics in rabbits and anti-sphingomyelinase D neutralizing power of Fab, F(ab')(2), IgG and IgG(T) fragments from hyper immune equine plasma.

We describe the separation of whole IgG, IgG(T)-less IgG (called here merely IgG) and IgG(T) and the production of Fab and F(ab')(2) fragments. We studied the pharmacokinetics of these immunoglobulins and fragments in rabbits. Both, the isotypes and the whole IgG fragments were purified and/or produced from the same plasma lot from horses hyper immunized against sphingomyelinase D to produce anti-Loxosceles antivenom. The sphingomyelinase D neutralizing ability of the isotypes and their fragments was measured. Fab and F(ab')(2) PK was well described by a tri-exponential kinetics. IgG and IgG(T) PK, however, deviated from the tri-exponential kinetics 120h after injecting a bolus of the immunotherapeutics. The departure between tri-exponential PK and the experimental data, was shown to be due to a surge of anti-horse antibodies occurring after 120h, peaking at approximately 260h and decaying slowly afterward.

Construcción, validez y fiabilidad de la escala de tamizaje «FASCT» para el trastorno por déficit de atención en adultos (versión autoaplicada y del observador) / Construction, validity and realiability, of the screening scale «FASCT» for attention deficit hyperactivity disorder in adults (self-reported and observer versions)

Introducción. La fiabilidad de las escalas autoaplicadas retrospectivamente para tamizar a adultos con trastorno por déficit de atención con hiperactividad (TDAH) se ha investigado de manera limitada.Método. Se construyó un instrumento denominado «FASCT», el cual consta de dos versiones: autoaplicada y del observador. Se aplicó la primera versión a un total de 393 personas y la versión del observador a 377. Se realizó un análisis factorial exploratorio y confirmatorio para obtener las versiones finales del instrumento. Finalmente se aplicó la versión autoaplicada junto con una entrevista estructurada a 205 sujetos. La versión del observador fue aplicada a 105 de sus familiares de primer grado.Resultados. La versión autoaplicada obtuvo un alfa de Cronbach de 0,84 y la versión del observador de 0,87. El punto de corte con mejor balance entre sensibilidad y 1-especificidad fue de 23 puntos para cada versión. El coeficiente de correlación entre ambas versiones fue de 0,88. El coeficiente de correlación entre la escala de Wender-UTHA y la versión autoaplicada de la «FASCT» fue de 0,71 y para la versión del observador fue de 0,66. El grado de acuerdo entre la calificación dicotomizada de la «FASCT» con el diagnóstico de la entrevista estructurada fue de 0,82 para la versión autoaplicada y de 0,88 para la versión del observador. Asimismo se obtuvieron los siguientes índices para la versión autoaplicada: sensibilidad, 80,36; especificidad, 97,9. Los valores para la versión del observador fueron: 95,4 y 96,3, respectivamente.Conclusiones. Ambas versiones de la escala «FASCT» demostraron ser válidas y confiables para el tamizaje del TDAH en adultos

Introduction. Research about the reliability of retrospective self-report rating scales for attention deficit hyperactivity disorder (ADHD) in adults has been limited.Method. A self-report scale named «FASCT» was created with two versions: self-reported and observer. The self-reported version was applied to 393 subjects and the observer version to 377. An exploratory and confirmatory factorial analysis was made in order to obtain the final adaptation of both versions. Finally they were applied to 205 subjects and 105 of their first degree relatives.Results. Cronbach's alpha for the self-reported version was 0.84 and 0.87 for the observer version. The total score that had the best balance between sensitivity and 1-specificity was 23 points for each version of the «FASCT». Correlation between both versions was 0.88. The correlation coefficient between the Wender-UTAH scale and self-reported version was 0.71 and for the observer version was 0.66. Agreement degree between dichotomized total score and the diagnosis made by structured interview was 0.82, for the self-reported version and 0.88 for the observer version. Sensitivity and specificity for the self-reported version were 80.36 and 97.9, respectively. Sensitivity and specificity values for the observer version were 95.4 and 96.3 respectively.Conclusions. Both versions of the «FASCT» scale were shown to be valid and reliable for adult ADHD screening