Predominant Cause Research Articles

Non-classic deubiquitinase USP13 inhibits bladder cancer metastasis through destabilizing cytoplasmic KDM3A.

Bladder cancer (BLCa) metastasis is a predominant cause of death for bladder cancer patients. Histone demethylase KDM3A specifically removes the repressive mono- or di-methyl marks from H3K9 and thus contributes to the activation of gene transcription. However, the underlying mechanisms of KDM3A in bladder cancer are poorly understood. Here, we report that high levels of KDM3A are associated with bladder cancer clinical progression. KDM3A silencing inhibits bladder cancer cell growth, cell migration and invasion in vitro and in vivo. Mechanistically, we identify that non-classic deubiquitinase USP13 interacts with KDM3A to promote its degradation in cytoplasm via the proteasome-specific pathway. USP13 was significantly down-regulated in bladder cancer tissues and negatively associated with KDM3A expression. Furthermore, we show in bladder injected-liver metastasis xenograft model that USP13 inhibits bladder cancer metastasis through destabilizing cytoplasmic KDM3A. Collectively, our findings identify KDM3A is an important regulator of bladder cancer cell growth and metastasis and targeting USP13/KDM3A complex could be a valuable strategy to ameliorate bladder cancer progression and metastasis.

The Role of Clinical Pharmacists in Mitigating Drug-Induced QTc Prolongation: A Cross-Sectional Study

Background: Drug-induced QTc prolongation represents the predominant cause of acquired long QTc syndrome. Pharmacists’ intervention, through the screening of at-risk patients and the provision of recommendations to prescribers for modifying drug regimens, may mitigate the adverse outcomes associated with this condition. This cross-sectional study aimed to evaluate the role of clinical pharmacists in reducing drug-induced acquired long QTc syndrome and mitigating the risk of progression toward life-threatening arrhythmias. Methods: We included hospitalized patients who were receiving at least two concomitant QT-prolonging medications, or one QT-prolonging medication along with a diagnosis of heart failure, myocardial infarction, or sepsis in the study over three months. Using the Tisdale risk score, we provided recommendations to the prescribing physician, and acceptance rates were recorded. Additionally, the rate of QTc prolongation was assessed in the patients. Results: The study was completed with 90 patients. The concomitant use of ondansetron and methadone was identified as the most common high-risk drug combination. A total of 56 pharmacist recommendations were made, with an estimated physician acceptance rate of 89%. Additionally, normalization of the QTc interval was observed in 14 out of 22 patients (63.6%) following pharmacists’ intervention. Conclusion: Clinical pharmacists are instrumental in the prevention of drug-induced long QTc syndrome among hospitalized patients.

Collateral Circulation and Rabep2 Polymorphisms in Large Artery Occlusion: Impacts on Short- and Long-Term Prognosis.

Intracranial anterior circulation large artery occlusion (AC-LAO) is a predominant cause of ischemic stroke. Although collateral circulation plays a critical role in stroke outcomes, the genetic and environmental factors affecting collateral development are not fully understood. This study aimed to elucidate the associations between Rabep2 gene polymorphisms, collateral circulation, and both short- and long-term prognoses in patients with anterior circulation large artery occlusion. We recruited 449 patients with anterior circulation large artery occlusion with cerebral infarction. Collateral circulation was assessed using single-phase computed tomography angiography, and stroke outcomes were evaluated at 1 month and 1 year using the modified Rankin Scale. A subset of 180 patients underwent genetic analysis for Rabep2 polymorphisms. Multivariable logistic regression was employed to identify predictors of short-term and long-term outcomes. Enhanced collateral circulation (P<0.001), lower high-density lipoprotein levels (P=0.019), and the absence of complications (P<0.001) were significantly correlated with favorable short-term outcomes. In the long term, age (P=0.039) and diabetes (P=0.006) were independent predictors of poor prognosis, whereas complications demonstrated a protective effect (P=0.016). The rs11645302 polymorphism of Rabep2 was linked to poorer collateral circulation among patients with the CC genotype (odds ratio [OR], 0.498 [95% CI, 0.270-0.918], P=0.025). Collateral circulation, high-density lipoprotein levels, Rabep2 gene polymorphisms, age, and diabetes are significant predictors of outcomes in patients with anterior circulation large artery occlusion. These findings underscore the potential to integrate genetic and vascular factors into personalized risk stratification and therapeutic strategies for ischemic stroke. URL: https://www.ClinicalTrials.gov; Unique Identifier: NCT04091412.

Circulating miR-485-5p as a potential diagnostic and prognostic biomarker for HCV-related hepatocellular carcinoma

Hepatitis C virus (HCV) is the predominant viral cause of hepatocellular carcinoma (HCC). Early detection and use of reliable biological markers can improve survival for HCC patients. MiR-485-5p was identified as a tumor-suppressing microribonucleic acid (miRNA) in some human cancers and was recently found to be downregulated in HCC tissues, signifying its utility as a promising biomarker. We aimed to investigate the potential role of circulating miR-485-5p as a novel diagnostic and prognostic biomarker for HCV-related HCC. This case–control study included 50 patients with HCC associated with HCV, 50 patients with HCV-related liver cirrhosis, and 50 healthy controls. History gathering, physical examination, laboratory, and imaging assessments were performed. A quantitative real-time polymerase chain reaction was used to measure miR-485-5p levels. Serum miR-485-5p values demonstrated a stepwise decline pattern from the control group to cirrhotic patients, with the HCC group exhibiting the lowest levels (p < 0.001). HCC patients with early BCLC stages had significantly lower miR-485-5p levels than those with late stages (p = 0.004). The miR-485-5p displayed a better performance in predicting HCV-related HCC with a greater area under the ROC curve (AUC) than alpha-fetoprotein (AFP) (AUC and sensitivity 0.921 and 92.0 versus 0.704 and 64.0, respectively) (p < 0.001). Also, its performance in predicting HCC prognosis surpassed that of AFP (AUC and sensitivity 0.872 and 85.19 versus 0.695 and 62.96, respectively) (p < 0.001). Circulating miR-485-5p is a promising, accurate, and noninvasive biomarker for the early detection and prediction of prognosis in patients with HCV-linked HCC.

Thyroid peroxidase antibodies and their role in predicting outcomes in Graves' disease treatment.

Graves´ disease (GD) is the predominant cause of hyperthyroidism. Treatment options include antithyroid drugs (ATD), surgery, and radioactive iodine ablation (RI). Although thyroid peroxidase antibodies (anti-TPO) are prevalent in patients with GD, their role in driving relapse or hypothyroidism after treatment in patients with GD remains unclear. This study aimed to determine if patients with anti-TPO at GD diagnosis are more likely to relapse after ATD or RI treatment, and if patients with anti-TPO are at increased risk of developing hypothyroidism post-ATD treatment. This was an observational, non-interventional retrospective registry study, which included 712 patients treated for GD at a single center in Sweden during 2002-2018. After therapy with ATD, there was no difference in relapse rate between patients with (37.0%) or without (38.4%) anti-TPO at GD diagnosis. Age <40 years was a risk factor for relapse after ATD (p<0.0001). Presence of anti-TPO at diagnosis was associated with reduced relapse rate after RI (13.9% vs. 24.6%; p=0.049). Development of hypothyroidism after discontinuation of ATD did not correlate with anti-TPO status at diagnosis (with anti-TPO: 17.3%; without anti-TPO: 20.8%). Increased risk of hypothyroidism was seen with ATD treatment for >2 years, p<0.05. Anti-TPO positivity at diagnosis of GD did not affect the relapse rate after ATD treatment but could be associated with a better long-term effect of RI. Anti-TPO did not increase the risk of hypothyroidism post-ATD therapy. Understanding risk factors of relapse or hypothyroidism can facilitate treatment choices and help physicians individualize management and follow-up strategies for patients with GD.

Targeting Siglec-15 mediates mitochondrial retrograde regulation of cervical cancer development.

Targeting Siglec-15 mediates mitochondrial retrograde regulation of cervical cancer development.

Survival Analysis of Secondary Primary Lung Cancer After Breast Cancer Patients: Insights From a Retrospective Single-Center Study of Clinical Outcomes and Prognostic Indicators.

Breast cancer (BC) and lung cancer are the two most common malignancies among women in China. As breast cancer diagnostic and therapeutic technologies continue to advance, the lifespan of patients with breast cancer has been extended, and the number of breast cancer patients with second primary lung cancer (SPLC) has increased. Furthermore, among women with SPLC, breast cancer stands as the most prevalent initial malignancy, and SPLC remains the predominant cause of mortality within this demographic. The aim of this retrospective study was to analyze the clinical characteristics of breast cancer with SPLC patients and to investigate postoperative survival and prognostic factors. This retrospective study analyzed 150 patients diagnosed with primary lung cancer in BC at one cancer center in China from January 2000 to December 2020. We assessed demographic data, cancer characteristics, treatment modalities, and survival outcomes. Survival curves were generated using the Kaplan-Meier method, and the significance of survival differences among selected variables was verified using the log-rank test. A univariate Cox regression analysis was used for estimating hazard ratios. A multivariate Cox regression analysis with a backward elimination method was used to estimate hazard ratios and to identify independent prognostic factors. There were 29 cases (19.3%) of death. The median follow-up time for this cohort was 96.3 months. The median OS was calculated at 60.0 months, with survival rates at 1-, 3-, 5-, and 10-year marked at 89.7%, 65.5%, 44.8%, and 10.3%. The median time from BC surgical treatment to the occurrence of SPLC was observed at 4.5 months. A peak period of SPLC occurs in the first year after BC surgery. The median follow-up time from SPLC surgical treatment to death or the end of follow-up was 73.5 months. The median survival time from SPLC surgical treatment to death by any cause was 39.2 months, with survival rates at 1-, 3-, and 5-year marked at 86.2%, 51.7%, and 31.0%, and survival rates were 0% at the 9th year. The average age at BC diagnosis was 53.8 ± 10.4 years (range 25-81). 41.3% of patients had other chronic diseases. The average menarche age was 14.7 ± 1.5 years (range 11-20). 64.7% of patients had menopause. Independent prognostic factors for the BC with SPLC by multivariate analysis were the status of menopause and T-stage of SPLC. Further analysis revealed that patients who were menopausal and had a poor T stage of SPLC had a higher mortality rate. Based on these findings, future studies should focus on the menstrual status, hormone levels, and pathological stage of SPLC in BC patients.

CORRELATION OF KNEE LIGAMENTS INJURY ON MAGNETIC RESONANCE IMAGING WITH OUTER BRIDGE SYSTEM

Background: Knee ligament injuries are commonly encountered in clinical practice and are frequently evaluated using magnetic resonance imaging (MRI). MRI provides critical information not only about ligamentous damage but also about associated cartilage changes. The Outerbridge classification system is widely used to grade cartilage degeneration. Establishing a correlation between ligament injuries and Outerbridge grading can improve diagnostic precision, treatment strategies, and long-term outcomes in knee trauma patients. Objective: To assess the relationship between MRI-detected knee ligament injuries and the severity of cartilage degeneration graded by the Outerbridge classification system. Methods: This descriptive cross-sectional study included 53 patients with MRI-confirmed knee ligament injuries, conducted across three diagnostic centers in Lahore. Ligament injuries involving the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL) were recorded. Cartilage degeneration was classified into Grades 0 to IV using the Outerbridge system. Data were analyzed using SPSS version 25. Chi-square test was applied to determine statistical association, with significance set at p &lt; 0.05. Results: ACL injuries were the most common, seen in 41 patients (77.35%), followed by PCL injuries in 19 (35.84%), and one case each of MCL and LCL injuries. Outerbridge classification revealed 15 patients (28.3%) with Grade 0, 20 (37.7%) with Grade I, 17 (32.1%) with Grade II, and 8 (15.1%) with Grade III degeneration; no cases were reported in Grade IV. Road traffic accidents were the predominant cause in 27 patients (50.94%). Chi-square analysis showed no statistically significant association between ligament type and Outerbridge grade (p = 0.237). Conclusion: MRI is a valuable tool for detecting both ligament injuries and cartilage degeneration. While a trend toward increased cartilage damage with severe ligament injury was observed, the correlation was not statistically significant. Early MRI assessment remains crucial for timely diagnosis and optimized patient care.

Hyaluronan-coated gold nanoshells for enhanced synergistic effect and immunogenic cell response of chemo-photothermal therapy on lung cancer.

Hyaluronan-coated gold nanoshells for enhanced synergistic effect and immunogenic cell response of chemo-photothermal therapy on lung cancer.

Activation of the SIRT1/PGC-1α pathway by HNRNPD promotes vasculogenic mimicry in NSCLC.

Activation of the SIRT1/PGC-1α pathway by HNRNPD promotes vasculogenic mimicry in NSCLC.

The complexity of tobacco smoke-induced mutagenesis in head and neck cancer

Tobacco smoke, alone or combined with alcohol, is the predominant cause of head and neck cancer (HNC). We explore how tobacco exposure contributes to cancer development by mutational signature analysis of 265 whole-genome sequenced HNC samples from eight countries. Six tobacco-associated mutational signatures were detected, including some not previously reported. Differences in HNC incidence between countries corresponded with differences in mutation burdens of tobacco-associated signatures, consistent with the dominant role of tobacco in HNC causation. Differences were found in the burden of tobacco-associated signatures between anatomical subsites, suggesting that tissue-specific factors modulate mutagenesis. We identified an association between tobacco smoking and alcohol-related signatures, indicating a combined effect of these exposures. Tobacco smoking was associated with differences in the mutational spectra, repertoire of driver mutations in cancer genes and patterns of copy number change. Our results demonstrate the multiple pathways by which tobacco smoke can influence the evolution of cancer cell clones.

Mitral stenosis: “Persistent valvulopathy”

Mitral stenosis (MR) is essentially of rheumatic origin. AAR remains the predominant cause worldwide, representing a major public health issue in developing countries, while in industrialized countries, the prevalence of MR has decreased thanks to antibiotic prevention. Its clinical presentation has also changed, with an increase in the number of veiled forms, with valvular leaflets that are often rigid and calcified. Doppler echocardiography provides a precise and comprehensive assessment of MR. It establishes the diagnosis, assesses the severity of the stenosis and its impact on the heart chambers (left atrium and right chambers) and pulmonary circulation . Finally, the feasibility of CMP, which is currently the method of choice when the anatomy is favorable. In this article, we begin by describing the characteristic anatomical lesions of MR, then move on to methods of ultrasound assessment of its severity, anatomical criteria for accessibility to CMP, evaluation of procedural success and elements of ultrasound monitoring of a patient who has undergone CMP.

Improving postnatal social support using antenatal group-based psychoeducation: a cluster randomized controlled trial.

Inadequate social support is the predominant cause of postnatal depression, which needs to be promoted through interventions. The objective of this study was to investigate the effect of antenatal group-based psychoeducation on improving postnatal social support. The trial design was a cluster randomized controlled trial. The study was conducted on 32 non-adjusted health centers (clusters) among 550 pregnant women. Using simple randomization, health centers were randomized into 16 intervention and 16 control groups. The intervention group received both standard prenatal care and group-based psychoeducation sessions, whereas the control group received standard prenatal care alone. The study included all pregnant women who were between 12 and 20 weeks gestation and had a Patient Health Questionnaire-9 <10 level of depression. We used a functional social support questionnaire in a face-to-face interview to assess social support at 12-20 weeks of gestation and 6 weeks postpartum. An intention-to-treat analysis was done. We used relative risk and a mixed-effects multilevel logistic regression for data analysis. Out of 550 enrolled pregnant women, end-line data were collected from 511 participants, with an overall end-line response rate of 92.9%. Statistical analysis revealed that the intervention resulted in a substantial difference in all dimensions of social support between arms, although no difference was detected at baseline. As compared to that in controls, the total postnatal social support in the intervention clusters was considerably higher [190 (66.4%) vs. 88 (33.3%)], P = 0.001). Mothers who were under the intervention arms and received antenatal group-based psychoeducation were 2.04 times more likely to have postnatal social support (RR = 2.044, 95% CI: 1.684-2.481) compared to those who were under the control arms and received the usual care. Finally, mixed-effect analysis indicates that after adjusting for individual and community-level variables, the final model shows the intervention increased the total social support by 3.61 (AOR = 3.61, 95% CI: 2.14-6.09). The implementation of antenatal group-based psychoeducation intervention resulted in a statistically significant effect in improving postnatal social support. This intervention approach must therefore be implemented and promoted in maternal healthcare services. https://pactr.samrc.ac.za/, identifier (PACTR 202203616584913).

An Analysis of Bacterial Infection Distribution in the Elderly, and Their Clinical and Laboratory Profiles: Aging and Bacterial Infection.

The increasing proportion of the elderly population necessitates the development of strategies for managing infections encountered by this group. We aimed to examine the distribution of bacterial infections, their clinical presentations, treatments used, and in-hospital mortality rates among elderly patients. We examined a cohort aged 65-79 (Group 1) and aged 80 and above (Group 2) with bacterial infections. Demographic characteristics, underlying conditions, clinical/laboratory findings, and mortality rates of the cases were compared. The study included 177 patients, of which 44.6% were female, and the mean age was 76.0 ± 8.8 years. Group 2 included 36.7% of the study population with a higher incidence of sepsis and urinary system infections (p=0.038 and p=0.037, respectively). On the other hand, skin and soft tissue infections (42%) emerged as the predominant cause of hospital admissions in Group 1 (p<0.001). Fatigue and dysuria were more frequent in Group 2 (p=0.008 and p=0.044, respectively), and erythema was more common in Group 1 (p=0.012). Hypertension (58.2%) was the most frequently observed comorbidity. Neurological diseases/dementia were more common in Group 2 than in Group 1 (p=0.036). Also, a delayed procalcitonin response to antibiotics was noted in Group 2 (p=0.006). Beta-lactam/beta-lactamase inhibitors were the most frequently used antibiotics, and cephalosporin antibiotics were preferred to a greater extent in Group 2 (p=0.02). The increased rates of urinary tract infections and sepsis in individuals over 80 underscores the need for vigilant clinical oversight. Effectively managing underlying conditions can reduce the incidence of some infections in vulnerable groups.

Chlorogenic Acid Ameliorates Acetaminophen-Induced Liver Injury Through AMPK/mTOR/ULK1-Mediated Autophagy Activation.

Acetaminophen (APAP)-induced liver injury (AILI) is a universal liver disease and the predominant cause of acute liver failure in clinical practice. Autophagy is a highly conserved intracellular degradation pathway, with accumulating evidence indicating its involvement in APAP hepatotoxicity. Notably, the serine/threonine AMP-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR)/unc-51-like kinase 1 (ULK1) pathway serves as the most classical autophagy pathway and engages in autophagy activation. Thus, pharmacological activation of the AMPK/mTOR/ULK1 pathway has emerged as a critical strategy for addressing AILI. Chlorogenic acid (CGA), a main bioactive constituent isolated from Lonicera japonica Thunb., is an autophagy regulator with potential for AILI therapy. However, whether and how CGA modulates autophagy to antagonize AILI has not yet been elucidated. In the present study, we aim to explore the impact of CGA on AILI, as well as the underlying mechanisms in vitro and in vivo. The results demonstrated that CGA could protect the mice and LO2 cells from oxidative stress and liver injury induced by APAP. Regarding mechanisms, CGA activated the AMPK/mTOR/ULK1 pathway, thereby promoting autophagy. This was evidenced by the degradation of p62/SQSTM1 (hereafter referred to as p62), as well as the up-regulation of LC3B, ATG5, and Beclin1. It is worth noting that the aforementioned, CGA-provided beneficial effects were abrogated by pharmacological inhibition of AMPK with Compound C (CC, an AMPK inhibitor). These [Formula: see text] that CGA alleviates oxidative stress and liver injury induced by APAP, which is contingent upon the regulatory effect of CGA on the AMPK/mTOR/ULK1 axis.

Proteinopathies and the Neurodegenerative Aftermath of Stroke: Potential Biomarkers and Treatment Targets.

Stroke remains a predominant cause of death and long-term disability among adults worldwide. Emerging evidence suggests that proteinopathies, characterized by the aggregation and accumulation of misfolded proteins, may play a significant role in the aftermath of stroke and the progression of neurodegenerative disorders. In this review, we explore preclinical and clinical research on key proteinopathies associated with stroke, including tau, Aβ (amyloid-β), TDP-43 (TAR DNA-binding protein 43), α-synuclein, and UCH-L1 (ubiquitin C-terminal hydrolase-L1). We focus on their potential as biomarkers for recovery management and as novel treatment targets that may enhance neuronal repair and mitigate secondary neurodegeneration. The involvement of these proteinopathies in various aspects of stroke, including neuroinflammation, oxidative stress, neuronal damage, and vascular dysfunction, underscores their potential. However, further investigations are essential to validate the clinical utility of these biomarkers, elucidate the mechanisms connecting proteinopathies to poststroke neurodegeneration, and develop targeted interventions. Identifying specific protein signatures associated with stroke outcomes could facilitate the advancement of precision medicine tailored to individual patient needs, significantly enhancing the quality of life for stroke survivors.

Intestinal obstruction after surgery for congenital biliary dilatation in children: diagnosis and management.

To analyze etiologies and management of postoperative intestinal obstruction following surgery (exeision of the dilated bile duet and Roux-enY hepaticojejunostomy) for congenital biliary dilatation (CBD) in children. A single-institution retrospective review was conducted on 475 patients who underwent Roux-en-Y hepaticojejunostomy following complete excision of the dilated bile duct. Among the cohort, nine patients underwent reoperation for intestinal obstruction. The perioperative data of these cases were thoroughly analyzed. The cohort (8F:1M) developed obstruction 20 days-8.8 years postoperatively. Primary etiologies included internal hernias (Petersen's:2, transverse mesocolic:3, Brolin's:1), biliary-jejunal loop torsion (1), and adhesions (2). Three patients underwent redo biliary-enteric anastomosis secondary to Roux-en-Y loop necrosis. Cross-sectional imaging in children with internal hernia or Roux-en-Y volvulus demonstrated distended, fluid-filled biliary-jejunal loops at the porta hepatis. Surgical indications for intestinal obstruction included peritoneal signs, aggravated abdominal pain, and failure of conservative treatment. Two children with intestinal obstruction had abnormal liver function tests preoperatively. Internal hernias (particularly within the internal hernia triangle) are the predominant cause of post-CBD surgery obstruction. Cross-sectional imaging shows high diagnostic sensitivity. Given the higher likelihood of internal hernia as a cause of post-CBD surgery obstruction and its rapid progression to Roux limb necrosis, early surgical intervention should be considered.

Management of Valvular Heart Disease in Pregnancy: Challenges, Risk Stratification, and Multidisciplinary Approaches.

Advancements in medicine and surgery have led to an increasing number of women with valvular heart disease (VHD) reaching reproductive age and pursuing pregnancy. VHD, which may be congenital or acquired, accounts for a significant proportion of heart diseases in pregnant women, with rheumatic heart disease being the predominant cause globally, especially in developing countries. Pregnancy-induced hemodynamic changes can exacerbate preexisting valvular conditions, leading to complications such as heart failure, arrhythmia, and adverse fetal outcomes. Management of pregnant women with VHD requires a comprehensive, multidisciplinary approach involving preconceptional counseling, risk stratification, and careful monitoring throughout pregnancy. Risk assessment models, including CARPREG II, ZAHARA II, mWHO, and the DEVI score, help identify high-risk patients and guide management strategies. Specific challenges arise in patients with mechanical prosthetic valves due to the need for anticoagulation therapy, which must be carefully managed to minimize risks to both mother and fetus. The delivery plan should be tailored to the severity of the valvular disease, with careful consideration of the mode of delivery and the need for anticoagulation management during labor and postpartum. Preconception counseling is crucial in informing women of the potential risks and helping guide family planning decisions. This paper highlights the importance of early diagnosis, tailored treatment, and a multidisciplinary approach to reduce maternal and fetal morbidity and mortality in pregnant women with valvular heart disease.

Genomic study of Salmonella ser. Enteritidis from poultry farms in Argentina: Epidemiology and antimicrobial resistance in twenty strains.

Genomic study of Salmonella ser. Enteritidis from poultry farms in Argentina: Epidemiology and antimicrobial resistance in twenty strains.

Características de la mortalidad materna en Paraguay (2014-2021)

Introduction: maternal mortality (MM) is a critical public health indicator. In Paraguay, the progress made was impacted by the COVID-19 pandemic. This study examines the characteristics of maternal mortality in Paraguay between 2014 and 2021. Objectives: to describe the sociodemographic and clinical characteristics of maternal mortality in Paraguay during the period 2014-2021. Methodology: a retrospective cross-sectional descriptive study was conducted using data from death certificates of the General Directorate of Strategic Health Information (DIGIES) of the Ministry of Public Health and Social Welfare. We analyzed 740 cases of maternal deaths registered in the 18 Health Regions of the country, considering sociodemographic variables and variables related to causes of death. Results: there were 740 maternal deaths, with an average ratio of 83.91 per 100,000 live births. 2021 had the highest ratio (159.98). The majority occurred in young (58.65%) and adult women (66.31%), with predominant causes being diseases of Respiratory System 18.11%, toxemia 15.81%, and hemorrhaged 12.03%. Conclusion: MM presented an increase after the COVID 19 pandemic, so the study highlights the urgent need to strengthen access to quality prenatal and obstetric care, especially in public institutions, and to address the socioeconomic inequalities that affect maternal health.