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La infección por el Helicobacter pylori, es como problema de salud ocasionado por el papel patogénico esencial en enfermedades gastroduodenales que van desde gastritis superficial y úlcera péptica hasta cáncer gástrico y linfoma MALT. El objetivo de la investigación fue, evaluar la asociación de H. Pylori y lesiones premalignas en biopsia gástrica de pacientes sometidos a endoscopía digestiva alta en el Hospital General IESS Machala. Por ende, se realizó un estudio descriptivo, no experimental, prospectivo, transversal y de campo. La población estuvo conformada por pacientes con estudio de biopsia gástrica con fines asistenciales, atendidos en los servicios de gastroenterología y laboratorio de patología del Hospital General IESS Machala. La muestra se conformó por 501 pacientes con estudio histopatológico de biopsia gástrica, de los cuales 278 (55,5%) fueron mujeres y 223 (44,5%) hombres. H. pylori se identificó en placas histológicas teñidas con hematoxilina-eosina. Se analizaron las variables de gastritis aguda, crónica, atrofia gástrica, metaplasia intestinal y displasia. Los datos obtenidos fueron procesados en el programa IBM SPSS versión 25.00. Los resultados fueron expresados como frecuencia y porcentajes, y presentados en tablas. Para determinar la asociación entre variables categóricas se empleó la prueba de chi cuadrado (X2), considerándose significativo valor de p

Human papillomavirus (HPV) is the principal risk factor for cervical cancer. Transplant recipients are at a disproportionate risk of HPV complications. We conducted a single-centre, retrospective study of adult female cystic fibrosis (CF) lung transplant recipients between 2008 and 2021. We observed 12 of 34 (35.3%) with ≥1 abnormal pap smear (median age: 26.7 years). Complications included refractory anogenital warts (n=3), vulvectomy (n=2) and cervical cancer (n=4), with two deaths from metastatic disease. None with HPV morbidity was vaccinated. Lung transplant recipients had greater odds of cervical dysplasia relative to controls (OR, 3.98; 95% CI 1.17 to 11.82). CF care providers must prioritise HPV vaccination to attenuate potential future morbidity and mortality.

Background Trends in cardiac implantable electronic device (CIED) infections have been studied previously. However, coding for administrative data is more granular in contemporary data sets and indications for CIED implantation have expanded. Objective The purpose of this study was to provide an update on the rates of CIED infection and the influence of different variables including sex, length of stay (LOS), and costs in the United States. Methods Data from the 2016 Healthcare Care and Utilization Project National Inpatient Sample database were utilized. International Classification of Diseases, Tenth Revision codes were used to track CIED infections. Demographic and clinical characteristics were collected including Elixhauser comorbidities. The univariate and multivariate logistic and linear regression models were used to assess mortality, costs, and LOS. Results Of 191,610 CIED implantations identified in the Healthcare Cost and Utilization Project National Inpatient Sample database in 2016, 8060 infections (4.2%) were identified. The in-hospital mortality rate for these patients was 4.7%. The majority of patients (68.9%) with CIED infection had ≥3 Elixhauser comorbidities. Women had decreased LOS and costs compared with men, and patients with ≥3 comorbidities had increased costs and LOS. Conclusion We identified that the majority of patients with CIED infection had ≥3 comorbidities that were associated with increased costs and LOS. The observed sex differences in health care resource utilization and in-hospital costs among patients admitted with CIED infection requires further exploration. Patients with increased numbers of comorbidities should be recognized and managed carefully peri-CIED implantation given their increased risk of infection and use of health care resources.

Rising rates of syphilis (T. pallidum; Tp) requires rapid diagnosis and treatment to manage the growing epidemic. Syphilis serology is imperfect and requires interpretation of multiple tests while molecular diagnostics allows for potential yes-no identification of highly infective, primary anogenital lesions. Accuracy of this testing modality has thus far been limited to small, highly selective studies. Therefore, we retrospectively assessed a large, adult population of patients with anogenital lesions seen at Sexually Transmitted Infection (STI) clinics in Alberta, Canada who were screened for syphilis and herpes simplex (HSV) 1/2 using PCR to evaluate Tp-PCR versus serology to diagnose primary syphilis. 114 (3.1%) of the 3,600 adult patients had at least one Tp-PCR+ anogenital lesion with 99 (2.8%) patients having newly positive syphilis serology (new INNO-LIA positive or 4-fold RPR increase). Tp-PCR had a sensitivity of 49.3% (95% CI 42.6-56.1) and specificity of 99.9% (99.7-100.0). Positive predictive values and negative predictive values in the study population or when corrected for provincial prevalence were 97.4% (92.5-99.5) or 0.4% (0.4-1.2) and 96.7% (96.1-97.3) or 100.0% (100.0-100.0), respectively. Positive and negative likelihood ratios were estimated at 555 (178-1733) and 0.5 (0.4-0.6), respectively. Review of all Tp-PCR performed with or without exclusion of HSV-positive lesions resulted in no significant change in Tp-PCR characteristics. Interestingly, 12 of the Tp-PCR+ samples had negative serology at time of lesion sampling but became positive within our 28-day testing window. Overall, this study further supports the use of Tp-PCR as an accurate assay to rapidly identify, treat, and prevent the spread of primary syphilis.

ObjectivesPaediatric congenital and acquired syphilis cases have been increasing since 2012 in the USA. Potential differences in associated hospitalisation trends and healthcare utilisation between the two syphilis entities have not yet been assessed. We sought to compare these entities and describe their clinical characteristics, distribution and impact in the USA.MethodsWe conducted a population-based cohort study using the 2016 Kids’ Inpatient Database (KID) to identify and characterise syphilis-associated hospitalisations among paediatric patients (age 0–21 years) in the USA during the year of 2016. Length of stay and hospitalisation costs for patients with congenital and acquired syphilis were compared in multivariable models.ResultsA total of 1226 hospitalisations with the diagnosis of syphilis were identified. Of these patients, 958 had congenital syphilis and 268 were acquired cases. The mean cost of care for congenital syphilis was $23 644 (SD=1727), while the treatment of a patient with acquired syphilis on average cost $10 749 (SD=1966). Mean length of stay was 8 days greater and mean total costs were $12 895 (US dollars) higher in the congenital syphilis cohort compared with the acquired syphilis cohort. In congenital syphilis, there were greater frequency of cases in the Southern and Western regions of the USA (pConclusionCongenital syphilis was associated with greater healthcare-related expenditure than acquired syphilis in paediatric patients. In addition to improving patient outcomes, congenital syphilis prevention efforts may significantly reduce healthcare utilisation burden and cost.

Vaginitis is often diagnosed by microscopy and limited to testing for bacterial vaginosis (BV), vulvovaginal candidiasis, and trichomoniasis. Approximately 10% of vaginal swabs are negative but designated “altered flora” by BV Nugent score, leaving clinicians unsure how to treat patients. Accurate and comprehensive vaginitis diagnostics are needed to direct treatment and reduce risks of recurrent or more severe infections. Vaginal swabs were collected from 93 women (mean age, 23.53 years; range, 18 to 42 years) in a cross-sectional study. Microscopy results for BV and Candida were compared to those from two molecular approaches: (i) a comprehensive quantitative PCR (qPCR) assay, including testing for aerobic vaginitis (AV), Candida, sexually transmitted infections (STI), and BV (Applied Biosystems) with an accompanying BV interpretive algorithm (Coriell Life Sciences), and (ii) microbiome profiling of the 16S rRNA gene (Illumina). Microscopy plus BV Nugent score had 76% overall agreement with the qPCR plus BV interpretive algorithm method (24 positive, 47 negative). OF the nine samples designated altered flora by Nugent, five were categorized BV positive and four were BV negative by the qPCR method. Although BV negative, 3/4 of the latter samples had positive AV targets with one also was STI positive. Microscopic identification of Candida versus that by qPCR had 94% agreement (9 positive, 78 negative). The comprehensive qPCR assay revealed alternative etiologies summarized as 38% BV, 10% AV, 5% Candida, 2% STI, 10% mixed infection (positive targets in multiple panels), and 35% negative for all targets. 16S microbiome analysis confirmed the bacterial qPCR results and identified differentiating patterns between AV, BV, and Lactobacillus-dominated vaginal microbiomes.

Background Rates of anal cancer from HPV infections are significantly higher in HIV-positive men-who-have-sex-with-men (MSM) compared to the general population. Recent estimates in the US and Europe report the incidence of anal cancer amongst HIV-positive individuals to be 75–137 cases/100 000 person-years, a rate 30–100 times higher than the general population. Despite the restoration of immune function with modern antiretroviral therapy, the incidence of anal cancers is increasing amongst HIV-positive MSM. We report the results of an anal cancer screening program in HIV-positive MSM in Calgary, AB, Canada from October 2014 to December 2018. Methods HIV-positive MSM attending the Southern Alberta Clinic and STI Clinic were offered an anal pap smear. Patients with abnormal cytology were examined with digital anorectal exam and High Resolution Anoscopy (HRA) to detect anal intraepithelial neoplasia (AIN). Dysplastic areas were biopsied and sent for histopathology. High-grade AIN II-III were treated using infrared coagulation. Results A total of 214 patients were examined with HRA. 87 patients (40.7%) had biopsy-proven AIN I, II, or III. Asymptomatic internal anal warts (AIN I) were detected in 60 patients (28%). Twenty-five patients had AIN II-III (11.7%) and 2 patients had invasive squamous cell cancer. High-risk oncogenic HPV was identified in 100% of the biopsy specimens. Conclusion High rates of anal HPV infections causing AIN I, II, and III were identified in HIV-positive MSM, supporting ongoing use of HRA for anal cancer screening programs in this population. High rates of asymptomatic internal anal warts were incidentally found. These rates of anal HPV infections support consideration of offering HPV vaccination to HIV-positive MSM on clinic intake as a preventative tool. Disclosure No significant relationships.

Background Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) caused by Chlamydia trachomatis (CT) biovars L1-3, which has been increasingly reported among men who have sex with men (MSM). Our study aimed to establish a surveillance system among MSM attending STI clinics in Alberta, Canada to determine prevalence and characteristics of cases. Methods CT NAAT (Genprobe Aptima COMBO 2® Assay) positive specimens from all anatomical sites among MSM attending three STI clinics between May to November 2018 had real-time PCR and DNA sequencing for LGV. Demographic, clinical, and sexual behaviours of cases were extracted from the provincial reporting database. Clinic-stratified analysis was performed to identify differences in sample characteristics using Chi-square or Fisher’s exact test. Results A total of 340 specimens from 299 CT cases were tested for LGV. CT cases were reported from Calgary (52.8%; n=158), Edmonton (46.2%; n=138), and Fort McMurray (1.0%; n=3). There were no significant differences in ethnicity, sexual partner type, anonymous partners, sex outside Alberta, or symptoms; however, cases from Calgary were significantly older than cases from Edmonton (median age: 34 years, IQR: 28–42 vs 29 years, IQR: 25–36, p=0.001) and more cases were co-infected with HIV (20.5% vs 10.0%; p=0.008). Anatomical site was similarly distributed between clinics with specimens from the rectum (61.2%; n=208), urine (26.2%; n=96) and pharynx (10.6%; n=36). LGV sequencing was feasible on 336 specimens. The LGV positivity rate was 1.2% (n=4; 95% CI 0.2–2.4); three rectal LGV cases (1 asymptomatic) and one asymptomatic pharyngeal LGV case were detected, of which two were HIV-positive. Conclusion LGV was rare in our MSM population; however, one pharyngeal and one asymptomatic case were found. If untreated, these cases could serve as a reservoir and play an important role in transmission. Disclosure No significant relationships.

Title. Predictors of poststroke quality of life in older Chinese adults. Aim. This paper is a report of a study to identify the changes in poststroke quality of life and other clinical issues among older Chinese adults from 1 month to 6 months after stroke and the predictors of poststroke quality of life at 6 months. Background. Stroke survivors are known to suffer from prolonged and multiple impairments leading to a compromised quality of life, but few studies report early predictors for quality of life among older Chinese adults after active rehabilitation has been undertaken during the first 6 months after stroke. Method. A total of 214 patients with first-ever ischaemic stroke were interviewed by a research nurse at 1 month and 188 patients were interviewed again 6 months after hospital admission for stroke. Assessment of quality of life was done using the Modified Rankin Scale for Quality of Life. Changes in and relationships between quality of life and variables in five domains were explored: bio-anatomical, physical, emotional, cognitive, communicative and social support. The data were collected in 2004–2005. Results. Quality of life among two-thirds of participants was unchanged or lower when scores at 1 month and 6 months after stroke were compared. Length of hospital stay after admission for stroke and other 1-month factors – level of worry over current health, cognitive and self-care deficits – were identified as having independent effects on quality of life at 6 months. Conclusion. Clinicians need to observe for early signs of mild cognitive impairments and emotional needs of stroke survivors, as well as to consider longer-term interventions to enhance poststroke quality of life.

Objective. Depression after stroke (DAS) poses a treble burden to patients, families and health care system. The purpose of this paper is to estimate the incidence of depression among first-ever ischemic stroke patients and identify the predictors of DAS. Methods. A longitudinal study design was undertaken. Of 836 patients admitted to the stroke unit of two regional hospitals in Hong Kong during the period 1 June 2004 to 31 May 2005, 295 patients fulfilled the inclusion and exclusion criteria. A total of 260 patients had given their consents and were interviewed at 1 month after stroke onset. Results. Nearly one-quarter of the first ischemic stroke patients, who were known to be free of personal and family history of psychiatric illnesses, were found to satisfy the criteria of depression using Diagnostic and Statistical Manual IV (24%, 48 out of 200 participants; 95% CI: 18.6%, 30.4%). This result was close to that assessed by the Geriatric Depression Scale (GDS) - 15 items. The psycho-emotional factor and level of dependency were found to be most significant predictors for DAS onset. Conclusion. The high incidence of DAS and low rate of accessibility to treatment indicate timely action to be undertaken.

Summary Health care professionals are the gate-keepers for elderly health information. Unfavorable attitude to the elderly posts an obstacle to health information delivery. Therefore, it is vital to identify the knowledge and attitude of nursing students toward working with the elderly. The present study aimed to examine the knowledge and working preferences toward the elderly among undergraduate nursing students in Hong Kong. Two hundred and sixty-nine students completed a questionnaire that incorporated 70 questions in the Palmore’s Aging Quiz and 10 questions reflecting the knowledge on local community resources for the elderly. The results revealed that nursing students generally have a neutral to positive working preferences toward the elderly. 83% of them gained a mean Palmore’s score of 40.90 out of 70 (SD = 5.02) and good knowledge of the community resources (mean score = 8.49, SD = 1.85). Those who disliked working with the elderly had a significantly lower mean Palmore’s score ( F = 7.73, p = 0.001). Though the level of study had a positive correlation with the knowledge of community resources, it did not increase with Palmore’s score. Further research on the study results and more detail examination of geriatric education for nursing students to refine their attitude toward the elderly are recommended.

Malonyl-CoA, a potent inhibitor of carnitine pamitoyl transferase-I (CPT-I), plays a pivotal role in fuel selection in cardiac muscle. Malonyl-CoA decarboxylase (MCD) catalyzes the degradation of malonyl-CoA, removes a potent allosteric inhibition on CPT-I and thereby increases fatty acid oxidation in the heart. Although MCD has several Ser/Thr phosphorylation sites, whether it is regulated by AMP-activated protein kinase (AMPK) has been controversial. We therefore overexpressed MCD (Ad.MCD) and constitutively active AMPK (Ad.CA-AMPK) in H9c2 cells, using an adenoviral gene delivery approach in order to examine if MCD is regulated by AMPK. Cells infected with Ad.CA-AMPK demonstrated a fourfold increase in AMPK activity as compared with control cells expressing green fluorescent protein (Ad.GFP). MCD activity increased 40- to 50-fold in Ad.MCD + Ad.GFP cells when compared with Ad.GFP control. Co-expressing AMPK with MCD further augmented MCD expression and activity in Ad.MCD + Ad.CA-AMPK cells compared with the Ad.MCD + Ad.GFP control. Subcellular fractionation further revealed that 54.7 kDa isoform of MCD expression was significantly higher in cytosolic fractions of Ad.MCD + Ad.CA-AMPK cells than of the Ad.MCD +Ad.GFP control. However, the MCD activities in cytosolic fractions were not different between the two groups. Interestingly, in the mitochondrial fractions, MCD activity significantly increased in Ad.MCD + Ad.CA-AMPK cells when compared with Ad.MCD + Ad.GFP cells. Using phosphoserine and phosphothreonine antibodies, no phosphorylation of MCD by AMPK was observed. The increase in MCD activity in mitochondria-rich fractions of Ad.MCD + Ad.CA-AMPK cells was accompanied by an increase in the level of the 50.7 kDa isoform of MCD protein in the mitochondria. This differential regulation of MCD expression and activity in the mitochondria by AMPK may potentially regulate malonyl-CoA levels at sites nearby CPT-I on the mitochondria.

Background Although the nares represent the most common carriage site for traditional hospital-associated strains of Staphylococcus aureus (SA), the predominant site of carriage of SA in the community is less certain. Methods We conducted a cross-sectional study in 285 patients attending sexually transmitted diseases and inner-city clinics to evaluate the prevalence, body site colonisation and risk factors associated with carriage of methicillin susceptible SA (MSSA). All isolates were characterized by pulsed field gel electrophoresis, staphylococcal cassette chromosome mec, staphylococcal protein A and multilocus sequence typing. Results The prevalence of colonisation with SA was 57.5% (164/285); 162 (56.8%) participants were colonized with MSSA, and 4 (1.4%) with methicillin-resistant SA (MRSA), 2 of them were co-colonised with both MRSA and MSSA. The most common sites of colonisation were the throat (73.1%), nares (65.2%) and interdigital web spaces of the hand (21.3%). Three out of 4 MRSA isolates were USA300-MRSA strains. Twelve MSSA isolates were closely related to the USA300 CA-MRSA. We identified sexual behaviours such as having more than 6 heterosexual sexual partners in the last 6 months and trimming pubic hair to be independently associated with MSSA colonisation, and more specifically practicing oral sex as a risk factor for throat colonisation. Conclusion There is a high prevalence of MSSA carriage in this population, with a low prevalence of MRSA. The throat was the most common site of carriage and sexual behaviours were found to be risk factors for MSSA colonisation. Close strain relatedness of MSSA and USA300-MRSA isolates suggests either gain or loss of the SCCmec element, respectively.

SPECIFIC AIMSMembers of the hsc70 protein family concentrate in nuclei when cells are exposed to heat stress. The effect of cell density on heat-induced hsc70 nuclear accumulation was analyzed in HeLa cell cultures. We also studied the role of protein kinases and protein phosphatases in concentrating hsc70s in nuclei of heat-treated cells.PRINCIPAL FINDINGS1. Hsc70s fail to accumulate in nuclei of confluent cellsThe density and senescence of cultured cells alter a variety of cell properties. We have stressed low and high density cultures of HeLa cells and monitored the distribution of hsc70s upon heat stress. In cells of low density cultures, we observed hsc70 nuclear accumulation whereas high density cells failed to concentrate hsc70s in nuclei. Particularly in cultures of very high density, hsc70s remained predominantly in the cytoplasm after exposure to heat (Fig. 1D⤻ ). At the margin of high density layers, where cells are less dense, some of the cells were able to concentrate hsc70s in nuclei (Fig. 1...

Because the structure, development, and functioning of a family plays an important role in health and illness, preparing nursing students to assess families in health care settings is of critical importance. A quasi-experimental design using a pre- and postcourse questionnaire was used to examine students’ perceived knowledge about family assessment and perceived difficulty applying family assessment in the clinical setting. The Calgary Family Assessment Model (CFAM) was taught in an elective nursing course, “Families in Health and Illness,” offered at the University of Hong Kong. At the completion of the course, 46 senior baccalaureate nursing students showed a significant increase in their perceived understanding of all subcategories in CFAM compared with the control group of 43 senior baccalaureate nursing students who completed an elective nursing course in women’s health. Teaching family nursing assessment in undergraduate programs may be useful in ensuring that nurses attend to families in practice.

Heat shock proteins of the hsp/hsc70 family are essential chaperones, implicated in the stress response, aging, and a growing number of human diseases. At the molecular level, hsc70s are required for the proper folding and intracellular targeting of polypeptides as well as the regulation of apoptosis. Cytoplasmic members of the hsp/hsc70 family are believed to shuttle between nuclei and cytoplasm; they are found in both compartments of unstressed cells. Our experiments demonstrate that actin filament-destabilizing drugs trigger the nuclear accumulation of hsc70s in unstressed and heat-shocked cells recovering from stress. Using human-mouse heterokaryons, we show that stress inhibits shuttling and sequesters the chaperone in nuclei. The inhibition of hsc70 shuttling upon heat shock is only transient, and transport is reestablished when cells recover from stress. Hsc70 shuttling is controlled by hsc70 retention in the nucleus, a process that is mediated by two distinct mechanisms, ATP-sensitive binding of hsc70s to chaperone substrates and, furthermore, the association with nucleoli. The nucleolar protein fibrillarin and ribosomal protein rpS6 were identified as components that show an increased association with hsc70s in the nucleus upon stress exposure. Together, our data suggest that stress abolishes the exit of hsc70s from the nucleus to the cytoplasm, thereby limiting their function to the nuclear compartment. We propose that during recovery from stress hsc70s are released from nuclear and nucleolar anchors, which is a prerequisite to restore shuttling.

In growing HeLa cells, severe stress elicited by the oxidant hydrogen peroxide inhibits classical nuclear import. Oxidant treatment collapses the nucleocytoplasmic Ran concentration gradient, thereby elevating cytoplasmic GTPase levels. The Ran gradient dissipates in response to a stress-induced depletion of RanGTP and a decreased efficiency of Ran nuclear import. In addition, oxidative stress induces a relocation of the nucleoporin Nup153 as well as the nuclear carrier importin-beta, and docking of the importin-alpha/beta/cargo complex at the nuclear envelope is reduced. Moreover, Ran, importin-beta and Nup153 undergo proteolysis upon oxidative stress. Caspases and the proteasome degrade Ran and importin-beta; however, ubiquitination of these transport factors is not observed. Inhibition of caspases in stressed cells alleviates the mislocalization of importin-beta, but does not restore the Ran concentration gradient or classical import. In summary, inhibition of classical nuclear import by hydrogen peroxide is caused by a combination of multiple mechanisms that target different components of the transport apparatus.

Background Outbreaks of syphilis have been occurring across Canada since 2001, with the province of Alberta having the 2nd highest incidence in 2007. As a result, there has been a national increase in the number of reported congenital cases. Current Canadian guidelines recommend performing syphilis serology at the 1st prenatal visit with rescreening at 28–32 weeks gestation, and at delivery in high-risk women. In our center, any positive syphilis serology is referred to the Calgary STI Clinic for staging and treatment recommendations. This is an internal audit of positive prenatal syphilis serologies from 2009 to 2010. Methods Charts from pregnant women with a positive prenatal syphilis serology, defined as a positive or indeterminate syphilis EIA, from 1 January 2009 to 31 December 2010 were retrospectively reviewed. Syphilis staging was performed by the Medical Director according to national criteria. Results 48 charts were reviewed: 9 were staged as biological false positives, 22 were previously adequately treated women with low or negative RPR titres not suggestive of reinfection, 13 were late latent (LL) treated with 7.2 μ of benzathine penicillin (PCN), and 4 were early latent (EL) treated with 2.4 μ of benzathine PCN. The mean number of days it took from receipt of a positive serology to contacting the patient were 9.8, 10.2, 2.3, and 1.8, respectively. The mean time to 1st dose of PCN was 8.8 for EL and 17.8 for LL (see Abstract P1-S6.09 table 1). There was 1 case of congenital syphilis in an infant whose mother presented in labour with no prenatal care-her RPR was 1:256. 1 woman with an RPR titre of 1:128 was treated with benzathine PCN 1 week before her estimated date of delivery. She went into preterm labour the afternoon post-injection; it is unclear whether or not the injection induced preterm labour. Her twins were treated with iv PCN with no adverse outcomes. Conclusions Routine prenatal syphilis screening has identified 14/48 women who required PCN treatment, all of whom received PCN prior to delivery with only 1 woman experiencing a possible adverse event. The only congenital case occurred in a mother with no prenatal care, suggesting a need for a strategy to identify marginalised women with syphilis early in pregnancy. Although the average time to contact these patients was short, the time to administration of 1st dose of PCN was longer, reflecting the need to educate women about the importance of prompt and complete therapy in preventing congenital syphilis.

La maternidad adolescente es un grave problema de salud pública, la presencia de una morbilidad materna extremadamente grave, genera mayores riesgos en su salud reproductiva y neonatal. Describir los resultados obstétricos y perinatales en adolescentes embarazadas con morbilidad materna extrema en el hospital obstétrico Angela Loayza de Ollague dese julio del 2019 a diciembre del 2020. Se realizó una investigación retrospectiva, descriptiva y transversal, con las historias clínicas de las pacientes de morbilidad materna extremadamente, del hospital obstétrico Angela Loayza de Ollague. Además, se realizaron consultas en Google Académico, PubMed, SciELO (Scientific Electronic Library Online), y se escogieron artículos que contribuyeran al conocimiento de la temática de estudio. La muestra fue conformada por 36 pacientes que cumplieron los criterios de inclusión para ser consideradas como morbilidad materna extrema, la mayor prevalencia es para el grupo etario comprendido entre 15 a 19 años, con el 97, 2 %. No Hubo relación estadística significativa entre las variables y cabe destacar que, el 88,9% (n=32) sobrevivieron gracias al buen accionar del personal médico de esta casa de salud. Se concluye, es vital, el oportuno diagnóstico de la mortalidad materna extremadamente grave y su admisión en las unidades decuidados intensivos, para lo cual, se deben tener presente los criterios que rigen para estas morbilidades y trabajar aunadamente con equipo interdisciplinario en la prevención de riesgos reproductivos maternos y neonatales.