OBJETIVODeterminar si existe relación entre la edad materna avanzada y la morbilidad neonatal en el Hospital Nacional Arzobispo Loayza.MATERIAL Y MÉTODOEstudio tipo cohorte, comparativo, analítico, retrospectivo. Se utilizó una muestra de 2771 recién nacidos entre Enero y Octubre del 2012, de los cuales fueron 460 de madres mayores de 35 años y 2311 de madres entre 20 y 34 años. El análisis estadístico utilizó SPSS 21.0 y se incluyó la prueba de chi cuadrado, siendo un valor de p < 0.05 considerado para la significancia estadística.RESULTADOSEl 1.3% de los recién nacidos de madres añosas presentaron trisomía 21, en comparación con un 0.13% en las madres de 20 a 34 años (p < 0.001; RR: 10.16 IC 95%: 2.5 - 40.8). El parto por cesárea representó el 51.52% en el grupo de mayores de 35 y 37.78% en el grupo control (p< 0.001; RR: 1.75 , IC 95%: 1.43 - 2.14). No se h...

Background Takotsubo syndrome (TTS) is characterized by acute, transient systolic dysfunction of the left ventricle not attributed to coronary artery disease (CAD). Hypothesis There are differences in hospital outcomes in patients admitted with TTS based on their gender. Methods The National Inpatient Sample database was searched for patients admitted with a principal diagnosis of TTS from 2006 to 2014 using the ICD9‐CM code 429.83. Using Pearson's χ 2 and Student's t test analyses, the P ‐value was calculated for differences among baseline characteristics of patients. Multivariate regression models were then created to adjust for potential confounders. Results A total of 39 662 admissions with TTS were identified, 91.7% female and 8.3% male with mean age of 66.5 and 61.6 years, respectively. The incidence of TTS increased progressively from 2006 to 2014. Female patients were more l...

We read with great interest the Letter to the Editor titled “Racial and Gender Disparities among Patients with Takotsubo Syndrome” by Khalid et al regarding our recent publication. Their excellent comments and detailed assessment highlights the low prevalence of diabetes mellitus in patients with Takotsubo syndrome (TTS) compared to general population. This is in contrast with relatively high prevalence of many other cardiovascular risk factors in TTS patients. This so called “diabetes paradox” has been previously explained in TTS patients and is the target of many active investigations. As highlighted in the Letter to the Editor, the prevalence of diabetes mellitus in our patient population is very close to the results of prior meta‐analyses of multiple small studies of patients with TTS.

Background The pulmonary artery catheter (PAC) has been used in a wide range of critically ill patients. It is not indicated for routine care of heart failure (HF), but its role in cardiogenic shock (CS) has not been clarified. Methods and Results We conducted a retrospective cohort study with the use of the National Inpatient Sample and identified a total of 9,431,944 adult patients admitted from 2004 to 2014 with the primary diagnosis of HF (n = 8,516,528) or who developed CS (n = 915,416) during the index hospitalization. Overall, patients with PAC had increased hospital costs, length of stay, and mechanical circulatory support use. In patients with HF, PAC use was associated with higher mortality (9.9% vs 3.3%, OR 3.96; P < .001) but the excess of mortality declined over time. In those with CS, PAC was associated with lower mortality (35.1% vs 39.2%, OR 0.91; P < .001) and in...