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Background: Impacts of delivery modes on the subsequent risk of coronary heart disease (CHD) in pregnant women have not been elucidated. Materials and Methods: Data of women who had undergone cesarean delivery (CD cohort) or vaginal delivery (VD cohort) between January 2000 and December 2012 from Taiwan Health Insurance Database were analyzed. All subjects were tracked until December 31, 2013. For women with multiple deliveries, only the first delivery data were included. Study end point was the diagnosis of new-onset CHD after delivery. Results: In total, 51,765 subjects (CD cohort: n = 17,839; VD cohort: n = 33,926) were included. During 1–14 years of follow-up, the incidence rate of new-onset CHD in the CD cohort was significantly higher than in the VD cohort (1.3% [231/17,839] vs. 0.8% [257/33,926], p < 0.001; effect size: 0.30). Analysis revealed that the subsequent risk of CHD in the CD cohort was significantly higher than in the VD cohort (adjusted hazard ratio [HR] = 1.28, 95% confidence intervals [CI]: 1.06–1.55, p = 0.012). We performed sensitivity tests by excluding subjects who had undergone CD due to nonmedical reasons from the CD cohort. The remaining subjects were named as the *CD cohort. Analysis also revealed a higher subsequent risk of CHD in the *CD cohort than in the VD cohort (adjusted HR = 1.32, 95% CI: 1.08–1.60, p = 0.006). Conclusions: Women who had undergone primary CD, especially those who had undergone CD due to medical reasons, were associated with an ∼30% higher risk of CHD than those who had undergone VD. [ABSTRACT FROM AUTHOR]

Abstract: Characteristic signs of malignant hyperthermia (MH) include unexplained tachycardia, increased end-tidal carbon dioxide (Etco 2 ) concentration, metabolic and respiratory acidosis, and an increase in body temperature above 38.8°C. We present the case of a patient with highly probable MH. In addition to sinus tachycardia and metabolic and respiratory acidosis, this patient also had a negative arterial to Etco 2 gradient and an increased requirement for minute ventilation to maintain a normal Etco 2 concentration, with signs of increased CO2 production. Despite these signs of MH, the patient's rectal temperature monitoring equipment did not show an increase in temperature, although the temperature measured in the mouth was increased. This case illustrates the unreliability of measuring rectal temperature as a means of reflecting body temperature during MH and the usefulness of increased CO2 production signs in helping to diagnose MH. [Copyright &y& Elsevier]