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Resumen OBJETIVO: Describir, de forma retrospectiva, el comportamiento del cáncer de endometrio en pacientes diagnosticadas en el Complexo Hospitalario Universitario de Ourense MATERIALES Y MÉTODOS: Estudio descriptivo, observacional y retrospectivo efectuado en el Complexo Hospitalario Universitario de Ourense entre septiembre de 2014 y enero de 2018. Criterio de inclusión: diagnóstico, tratamiento y seguimiento en nuestro centro. Criterio de exclusión: historia incompleta y diagnóstico o tratamiento en otro centro. Variables de estudio: tipo de tumor y de tratamiento. Se realizó un análisis descriptivo. Las posibles asociaciones se comprobaron mediante χ2, Fisher, t de Student y prueba de Mann-Whitney. RESULTADOS: Se estudiaron 149 pacientes, con edad media al diagnóstico de 69.38 años ± 9.6 años. El 86.6% (n = 129) de las pacientes estaban en la posmenopausia. El 68% (n = 101) eran obesas y el 54.7% (n = 81) hipertensas. El 54.7% (n = 81) se diagnosticaron en estadio IA. El 68.4% de los tumores grado 3 tuvieron infiltración miometrial mayor al 50%, el 28.6% grado 1 (p < 0.001). De las pacientes que recibieron radioterapia o braquiterapia el 46% estaba en estadios avanzados; 76% en estadio IB, 26% en estadio IA (p < 0.001). El 91.3% de los tumores estadio I fueron tipo I, en los estadios avanzados hubo 48.6% de tumores tipo I (p < 0.001). El 87.4% de los tumores grados 1 o 2 se encontraron en estadio I, un 45.2% de los tumores grado 3 en estadio I (p < 0.001). CONCLUSIONES: La mayoría de las pacientes tenía más de 60 años y eran diabéticas, hipertensas y obesas. El cáncer de endometrio suele diagnosticarse en estadios tempranos. La braquiterapia es la coadyuvancia más indicada.
Abstract OBJECTIVE: To retrospectively describe the behavior of endometrial cancer in patients diagnosed at the Complexo Hospitalario Universitario de Ourense. MATERIALS AND METHODS: Descriptive, observational and retrospective study in the Complexo Hospitalario Universitario de Ourense between September 2014 and January 2018. Inclusion criteria: diagnosis, treatment and follow-up in our center. Exclusion criteria: incomplete history and diagnosis or management in another center. Patient, tumor and treatment variables were collected. A descriptive analysis was performed. Possible associations were tested by Chi-square, Fisher, Student's t-test and Mann-Whitney test. RESULTS: 149 patients were studied, with mean age at diagnosis of 69.38 years ± 9.6 years. 86.6% (n = 129) of the patients were postmenopausal. 68% (n = 101) were obese and 54.7% (n = 81) hypertensive. 54.7% (n = 81) were diagnosed at stage IA. 68.4% of grade 3 tumors had myometrial infiltration greater than 50%, 28.6% grade 1 (p < 0.001). Of the patients who received radiotherapy or brachytherapy 46% were advanced stage; 76% stage IB, 26% stage IA (p < 0.001). 91.3% of stage I tumors were type I, in advanced stages there were 48.6% of type I tumors (p < 0.001). 87.4% of grade 1 or 2 tumors were stage I, 45.2% of grade 3 tumors were stage I (p < 0.001). CONCLUSIONS: Most patients were older than 60 years and were diabetic, hypertensive and obese. Endometrial cancer is usually diagnosed at early stages. Brachytherapy is the most indicated adjuvant.
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Resumen: OBJETIVO: Determinar la asociación entre los márgenes afectados con la persistencia-recurrencia de neoplasia intraepitelial cervical, persistencia del virus del papiloma humano y las reintervenciones. MATERIALES Y MÉTODOS: Estudio de casos y controles anidado en una cohorte retrospectiva del Complexo Hospitalario Universitario de Ourense (enero 2010-octubre 2017). Criterio de inclusión: mujeres con al menos una revisión postintervención. Criterios de exclusión: mujeres sin evidencia de displasia de alto grado en la pieza de conización y a las que no se dio seguimiento. Variables de estudio: edad, tabaquismo, preservativo, anticonceptivos orales, vacunación contra VPH, persistencia-recurrencia de NIC y de VPH y reintervención. Se realizaron pruebas paramétricas y no paramétricas entre las variables. RESULTADOS: La cohorte se integró con 248 mujeres, de éstas 81 (32.6%) tuvieron afectación de los márgenes quirúrgicos en la conización. La inmunosupresión, el tabaquismo y la anticoncepción oral fueron las asociaciones más frecuentes en los márgenes afectados. El uso de preservativo y la vacunación contra VPH fueron significativamente más frecuentes en los márgenes libres. Los márgenes afectados reportaron mayor persistencia de VPH (50 vs 23.9%; OR 3.17 (1.90-5.26), p < 0.001), enfermedad persistente-recurrente (47.2 vs 22.5%; OR 3.07 (1.84-5.12), p < 0.001) y reintervenciones (40.2 vs 15.4%; OR 3.679 (2.094-6.463), p < 0.028). El margen más afectado fue, en orden descendente, endocervical (55.6%), exocervical (25%) y ambos (19.4%). CONCLUSIONES: El margen afectado confiere un riesgo importante en la evolución de la infección por VPH y la recurrencia de la enfermedad.
Abstract: OBJECTIVE: To determine the association between affected margins with persistence-recurrence of cervical intraepithelial neoplasia, persistence of human papillomavirus and re-interventions. MATERIALS AND METHODS: Study of cases and controls nested in a retrospective cohort of the Complexo Hospitalario Universitario de Ourense (January 2010-October 2017). Inclusion criteria: women with at least one post-intervention check-up. Exclusion criteria: women without evidence of high-grade dysplasia in the conization piece and who were not followed up. Study variables: age, smoking, condom, oral contraceptives, HPV vaccination, persistence-recurrence of CIN and HPV, and re-operation. Parametric and non-parametric tests were performed among the variables. RESULTS: The cohort consisted of 248 women, 81 of whom (32.6%) had affected surgical margins on conization. Immunosuppression, smoking and oral contraception were the most frequent associations in affected margins. Condom use and HPV vaccination were significantly more frequent in free margins. Affected margins reported greater persistence of HPV (50 vs 23.9%; OR 3.17 (1.90-5.26), p < 0.001), persistent-recurrent disease (47.2 vs 22.5%; OR 3.07 (1.84-5.12), p < 0.001), and reinterventions (40.2 vs 15.4%; OR 3.679 (2.094-6.463), p < 0.028). The most affected margin was, in descending order, endocervical (55.6%), exocervical (25%) and both (19.4%). CONCLUSIONS: The affected margin confers a significant risk in the evolution of HPV infection and disease recurrence.
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Humanos , Preescolar , Niño , Discapacidades para el Aprendizaje , Epilepsia , Neuropsicología , Trastorno Autístico , Aprendizaje , Sistema Nervioso CentralRESUMEN
BACKGROUND: Essure procedure consists in the placement of two coils in the intramural segment of Fallopian tubes by hysteroscopic causing a fibrosis reaction that unleashes a physiological obstruction. Hysterosalpingography, until today, is the gold standard checking the success of this method of sterilization. OBJECTIVE: Determining if a scan at three months postimplantation is sufficient to confirm the correct positioning of the device. MATERIAL AND METHODS: Descriptive study with 61 patients undergoing definitive hysteroscopic sterilization to validate transvaginal ultrasound as a technique to determine the effectiveness of the method. RESULTS: There were placed 120 devices, of which 117 (97'5%) were visible by ultrasound. Comparing ultrasound findings with gold standard, we obtain that in cases of proper bilateral implantation by hysterosalpingography, with ultrasound we diagnosed the 81 '13%; in cases of correct unilateral implantation we detected 75% with ultrasound, except one patient who was considered proper placement of the coil by ultrasound but hysterosalpingography reported that it was misplaced and the Fallopian tube was permeable. DISCUSSION: Transvaginal ultrasound is an appropriate method to confirm the correct position of intratubaric Essure devices, its safety, low cost and reproducibility. However, our study cannot replace the hysterosalpingography as gold standard.
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Dispositivos Anticonceptivos Femeninos , Trompas Uterinas/diagnóstico por imagen , Histeroscopía , Adulto , Femenino , Humanos , Histerosalpingografía , Factores de Tiempo , UltrasonografíaRESUMEN
El mesotelioma peritoneal maligno es un tumor de presentación infrecuente, diagnóstico difícil y comportamiento agresivo en la mayoría de los casos. Presentamos el caso de una mujer de 80 años con una formación pélvica que depende de útero con carcinomatosis peritoneal, abundante líquido ascítico e infiltración de recto y vejiga. Se decide realizar un estudio histológico de la masa para después comenzar con quimioterapia paliativa por estado avanzado de la enfermedad. Se indica una minilaparotomía y se realizan múltiples biopsias. La histología y la inmunohistoquímica de la pieza son compatibles con un mesotelioma peritoneal maligno de tipo mixto (epitelial y sarcomatoide). La paciente comienza con evolución desfavorable y se deciden medidas de soporte paliativo. Fallece a los 15 días poscirugía. En mujeres con afectación de órganos genitales es importante hacer el diagnóstico diferencial con los tumores serosos de origen ginecológico puesto que los protocolos de tratamiento quimioterápico son diferentes (AU)
Malignant mesothelioma of the peritoneum is an infrequent tumor that is difficult to diagnose and usually behaves aggressively. We present the case of an 80-year-old woman with a pelvic mass of uterine origin, peritoneal carcinomatosis and abundant ascites. Histologic study of the mass was requested and palliative chemotherapy was started because of the advanced stage of the disease. A minilaparotomy was performed and multiple biopsies were taken. Histologic and immunochemistry studies were compatible with a mixed (epithelial and sarcomatoid) malignant mesothelioma of the peritoneum. Prognosis was poor and palliative care was provided. The patient died 15 days after surgery. In women with involvement of the genital organs, it is important to make a differential diagnosis with serous tumors of gynecologic origin because the chemotherapy protocols differ (AU)
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Humanos , Femenino , Anciano de 80 o más Años , Neoplasias Peritoneales/cirugía , Neoplasias Peritoneales/complicaciones , Neoplasias Peritoneales/diagnóstico , Carcinoma/complicaciones , Carcinoma/diagnóstico , Carcinoma/cirugía , Inmunohistoquímica/métodos , Diagnóstico Diferencial , Neoplasias Peritoneales/fisiopatología , Neoplasias Peritoneales , Genitales Femeninos/patología , Genitales Femeninos/cirugía , Genitales FemeninosRESUMEN
BACKGROUND: Diagnostic hysteroscopy is an endoscopic technique that allows the evaluation of the endocervical canal and uterine cavity. OBJECTIVE: To evaluate indications, complications and referral to operative hysteroscopy. To analyze the correlation between sonographic display, hysteroscopy findings and histological diagnosis. MATERIALS AND METHODS: Retrospective and descriptive study of 904 patients who underwent diagnostic hysteroscopy between January 1, 2008 and June 30, 2012. RESULTS: The most frequent indication was sonographic detection of endometrial polyps (75% were premenopausal and 71.2% postmenopausal). The complication rate associated with the test was 11.4%. The reduction experimented in operative hysteroscopies was from 31.2% in 2008 to 12.2% between January and June 2012. When a polyp or a myoma was detected by sonography, diagnostic hysteroscopy showed them in 64.4% y 62.5% of the cases, respectively. The correlation between hysteroscopic findings and histopathologic diagnosis was 77.7% for normal endometrium, 77.9% for polyps, 17.8% for hyperplasic appearance and 100% for carcinoma suspicion. CONCLUSIONS: Diagnostic hysteroscopy is a safe technique that allows small interventions avoiding operative hysteroscopies. There is a good relation between hysteroscopic visual inspection and anatomopathologic diagnosis, but biopsy should be taken except if normal endometrium is visualized.
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Histeroscopía/estadística & datos numéricos , Enfermedades Uterinas/diagnóstico , Adenocarcinoma/diagnóstico , Adenocarcinoma/epidemiología , Atención Ambulatoria , Remoción de Dispositivos , Femenino , Hospitales Universitarios , Humanos , Hiperplasia , Infertilidad Femenina/diagnóstico , Infertilidad Femenina/epidemiología , Dispositivos Intrauterinos , Leiomioma/diagnóstico , Leiomioma/epidemiología , Menopausia , México/epidemiología , Pólipos/diagnóstico , Pólipos/epidemiología , Pólipos/patología , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/epidemiología , Prevalencia , Estudios Retrospectivos , Enfermedades Uterinas/epidemiología , Hemorragia Uterina/diagnóstico , Hemorragia Uterina/epidemiología , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/epidemiología , Útero/anomalías , Útero/patologíaRESUMEN
La gestación ovárica es una forma de presentación poco habitual del embarazo ectópico. El diagnóstico preoperatorio es difícil; algunos se diagnostican durante la intervención pero la mayoría necesita confirmación histopatológica. El tratamiento de elección es intentar la preservación de tejido ovárico para mantener la fertilidad mediante la enucleación del saco gestacional o la resección en cuña del ovario, preferiblemente por vía laparoscópica. En algunos casos el tratamiento con metotrexato intramuscular puede ser efectivo. Presentamos 2 casos de embarazo ectópico ovárico en nuestro hospital(AU)
Ovarian pregnancy is an uncommon type of ectopic pregnancy. Preoperative diagnosis is difficult. Some cases are diagnosed during surgery and most need to be confirmed by histopathological study. The treatment of choice is conservative ovarian surgery to preserve fertility such as enucleation of the gestational sac or wedge resection of the ovary, preferably by laparoscopy. In some cases intramuscular methotrexate could be effective. We report two cases of ectopic ovarian pregnancy in our hospital(AU)
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Humanos , Femenino , Embarazo , Adulto Joven , Adulto , Embarazo Ectópico/diagnóstico , Embarazo Ectópico/cirugía , Metotrexato/uso terapéutico , Dolor Abdominal/complicaciones , Dolor Abdominal/etiología , Laparotomía/métodos , Laparotomía , Ovariectomía/instrumentación , Ovariectomía/métodos , Embarazo Ectópico/fisiopatología , Embarazo Ectópico , Dolor Abdominal/fisiopatología , Ovario , /métodosRESUMEN
High-risk human papillomavirus (HPV) DNA detection provides high sensitivity but low specificity for moderate-grade cervical intraepithelial neoplasia or worse histological identification. A prospective study evaluated mRNA testing efficacy for predicting this histological diagnosis in case of HPV 16 and/or 18 DNA detection. A total of 165 endocervical samples harboring HPV 16 and/or 18 DNA were tested with NucliSENS-EasyQ® HPV E6/E7-mRNA-assay (Biomerieux, Marcy l´Etoile, France). Women with cytological alterations were referred to colposcopy (n = 111). Moderate-grade cervical intraepithelial neoplasia or worse was diagnosed in 25.8% of women presenting atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesions and in 89.8% of women with high-grade squamous intraepithelial lesions. mRNA sensitivity was 81.3% and 84.1%, respectively. Specificity was 52.2%, and 80.0%, respectively. Negative predictive value (NPV) was 88.9% in undetermined or low-grade squamous lesions. Positive predictive value (PPV) was 97.4% in high-grade squamous lesions. mRNA reduced colposcopies by 44.3% in undetermined or low-grade squamous lesions. Direct treatment of mRNA-positive cases reduced 77.5% of colposcopies in high-grade squamous lesions. Women without cytological alterations were followed for 18 months (n = 35), and moderate-grade cervical intraepithelial neoplasia or worse was diagnosed in 34.3%; mRNA sensitivity and specificity were 83.3% and 86.9%, respectively. PPV and NPV were 76.9% and 90.9%, respectively for predicting moderate-grade cervical intraepithelial neoplasia or worse in 18 months. mRNA reduced the number of visits for follow-up in 62.2%. In conclusion, NucliSENS-EasyQ® HPV E6/E7-mRNA-assay (Biomerieux) can serve as a triage test in case of HPV 16 and/or 18 DNA detection.
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Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Infecciones por Papillomavirus/diagnóstico , ARN Mensajero/genética , ARN Viral/genética , Displasia del Cuello del Útero/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Adolescente , Adulto , Anciano , Cuello del Útero/patología , Cuello del Útero/virología , Colposcopía , Pruebas Diagnósticas de Rutina , Femenino , Papillomavirus Humano 16/aislamiento & purificación , Papillomavirus Humano 18/aislamiento & purificación , Humanos , Persona de Mediana Edad , Proteínas Oncogénicas Virales/análisis , Proteínas Oncogénicas Virales/genética , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/virología , Embarazo , Estudios Prospectivos , ARN Mensajero/análisis , ARN Viral/análisis , Sensibilidad y Especificidad , Triaje , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/virología , Displasia del Cuello del Útero/patología , Displasia del Cuello del Útero/virologíaRESUMEN
El dispositivo intrauterino (DIU) de levonorgestrel (LNG) es un método anticonceptivo de solo gestágeno de larga duración. Su acción se ejerce a nivel local pero a veces se asocia a manifestaciones sistémicas por el efecto androgénico del LNG. Presentamos el caso de una paciente que desarrolló un cuadro de hidrosadenitis supurativa después de la inserción del DIU de LNG y que mejoró tras su retirada. Los dermatólogos deben preguntar acerca del uso de métodos anticonceptivos que lleven LNG en mujeres que cursan con esta enfermedad cutánea(AU)
The levonorgestrel (LNG)-releasing intrauterine device (IUD) is a long-acting, progestin-only contraceptive method. The effect of this method is mainly local but systemic side effects sometimes occur because of the androgenic activity of LNG. We report the case of a woman who developed hidrosadenitis suppurativa after insertion of an LNG-IUD, which was resolved by removal of the device. Dermatologists should inquire about the use of LNG as a contraceptive method in women with this cutaneous disease(AU)
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Humanos , Femenino , Adulto , Hidradenitis/complicaciones , Hidradenitis/diagnóstico , Dispositivos Intrauterinos/efectos adversos , Dispositivos Intrauterinos/tendencias , Dispositivos Intrauterinos , Hidradenitis/tratamiento farmacológico , Dapsona/uso terapéutico , Hidradenitis , Andrógenos/genéticaRESUMEN
El mutismo acinético es considerado como una alteración del estado motivacional de la persona, por la cual el paciente es incapaz de iniciar respuestas verbales o motoras de carácter voluntario, aún teniendo preservadas las funciones sensoriomotoras y de vigilancia. La lesión, que puede ser vascular, infecciosa, tóxica o degenerativa, incide sobre dos circuitos que podrían estar funcionalmente relacionados: el cortex frontal medial con afectación del cíngulo anterior, o el daño en regiones talámicas y mesencefálicas relacionadas con la formación reticular activadora ascendente. El diagnóstico de mutismo acinético resulta a veces difícil de establecer, y suele confundirse con algunos tipos de afasias o estados de alteración de la conciencia, que tienen un abordaje clínico y un pronóstico notablemente diferentes. Con el objetivo de llevar a cabo un buen diagnóstico diferencial proponemos un protocolo clínico con una evaluación neuropsicológica breve de las funciones que pudieran estar diferencialmente afectadas en todos esos síndromes, como atención, praxias y lenguaje. Exponemos un caso de mutismo evaluado con este protocolo para demostrar su especificidad a la hora de distinguirlo de otras afecciones o síndromes (AU)
Akinetic mutism is considered as a disturbance of a person's motivational state, therefore the patient is unable to initiate verbal or mo-tor responses, although they continue to maintain sensorimotor and vigilant functions. The lesion can be vascular or it can be caused by infections, cerebral degeneration and toxicity. Lesions can influence the functions of two cerebral circuits: the Frontal medial cortex affecting to cingulated cortex, or it can damage the thalamic and mesencephalic regions related to the ascending reticular activating system. It is difficult to diagnose Akinetic Mutism since it can be confused with some types of aphasia and altered states of consciousness, which require different interventions. In order to complete a clinical protocol we recommend a brief neuropsychological evaluation of functions such as attention, praxis and language, all of which could be affected by the syndromes previously named. We expound a case of akinetic mutism evaluated with this protocol in order to show its specificity distinguishing akinetic mustism from other syndromes (AU)
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Humanos , Masculino , Anciano , Mutismo Acinético/diagnóstico , Lóbulo Frontal/fisiopatología , Neoplasias Encefálicas/complicaciones , Diagnóstico Diferencial , Afasia/diagnóstico , Pruebas Neuropsicológicas , Meningioma/cirugía , Complicaciones PosoperatoriasRESUMEN
Objetivo: Se determinó la prevalencia de complicaciones precoces en pacientes con intervenciones quirúrgicasbariátricas en una clínica especializada de Cali- Colombia.MetodologíaSe realizó un estudio descriptivo retrospectivo, revisando 1388 registros de pacientes sometidos acirugía bariátrica entre el 2007 y el 2011 y se realizó un control de calidad de la información converificación aleatoria de 10 registros. Para la consolidación de las variables se elaboró una ficha técnicaque incluía las variables del estudio, actividad realizada directamente por el grupo investigador ypara el análisis se utilizó el programa Ep-Info, versión 2003.ResultadosLa prevalencia de complicaciones en todo el período fue de 4,8%, con tendencia a la disminución, de11,2% en el 2007 a 2,4% en el 2011. El 69,7% eran de sexo femenino con predominio de edades entre40 y 60 años.Al 56,1% de los pacientes que presentaron complicaciones, se les había realizado sleevegástrico, al 42,4% by-pass gástrico y al 1,5%retiro de banda gástrica.Las complicaciones presentadasfueron: absceso intra-abdominal (33,3%), fístula (19,7%), diarrea (16,7%), dehiscencia de sutura(13,6%), hemorragia digestiva (7,6%),desnutrición (4,5%),infección de herida quirúrgica (3,0%)e infección urinaria (1,5%). La fístula y la diarrea fueron más frecuentes en el sleeve gástrico ladehiscencia de sutura y la hemorragia digestiva lo fueron en el by-pass gástrico.ConclusionesLa baja prevalencia de complicaciones con una clara tendencia al descenso en los años analizados,expresa los esfuerzos realizados por perfeccionar la técnica y brindar la mejor calidad asistencial alpaciente intervenido.
Objective: To determine the prevalence of early complications in patients with bariatric surgery in a specializedhospital in Cali, Colombia.MethodologyA descriptive, retrospective study was conducted, by reviewing 1388 records of patients undergoingbariatric surgery between 2007 and 2011. It was performed a quality control check of the information,with the verification of 10 records at random. In order to consolidate the variables, the research groupdesigned a data sheet that included such variables of the study. An EpiInfo program, version 2003,was used for the analysis of the results.ResultsThe prevalence of complications throughout the period was 4,8%, with a tendency to decrease, from11,2% in 2007 to 2,4% in 2011. 69,7% were female, predominantly aged between 40 and 60. 56,1%of patients with complications had undergone gastric sleeve, 42,4% gastric bypass and 1,5% gastricband removal. The complications observed were: intra-abdominal abscess (33,3%), fistula (19,7%),diarrhea (16,7%), suture dehiscence (13,6%), gastrointestinal bleeding (7,6% ), malnutrition (4,5%),wound infection (3,0%) and urinary tract infection (1,5%). Fistula and diarrhea were more commonin the gastric sleeve, while suture dehiscence and gastrointestinal bleeding were more common in thegastric bypass.ConclusionsThe low prevalence of complications with a clear downward trend in the years analyzed, expresses theefforts to perfect the technique and to provide the best quality care for the surgical patient.
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Humanos , Cirugía Bariátrica , Complicaciones Posoperatorias , PrevalenciaRESUMEN
La hiperemesis gravídica se define como la forma más grave de los vómitos durante la gestación. Ya en el siglo xviii, se describió en la literatura médica como causa de muerte materna por inanición, desenlace que no fue infrecuente hasta el siglo xx. Actualmente, la defunción materna es excepcional (AU)
Hyperemesis gravidarum is seen as the most serious form of vomiting during pregnancy. It was described in the medical literature in the 18th century as a cause of maternal death due to starvation, a not uncommon event until the 20th century. Nowadays maternal death is unusual (AU)
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Humanos , Femenino , Embarazo , Adulto , Síndrome de Korsakoff/complicaciones , Hiperemesis Gravídica , Complicaciones del Embarazo , Antieméticos/uso terapéutico , Tiamina/uso terapéuticoRESUMEN
BACKGROUND: Clinical studies suggest that the second generation antipsychotics (APs) clozapine and olanzapine and to a lesser extent the typical antipsychotics may be associated with a procoagulant and proinflammatory state that promotes venous thromboembolism. We evaluated here several blood factors associated with coagulation and inflammation in AP-treated schizophrenia patients and their first-degree relatives. METHODS: Procoagulant factors (fibrinogen and plasminogen activator inhibitor [PAI-1]), the anticoagulant factor antithrombin III [AT-III], and inflammation-related factors (C-reactive protein [CRP] and leptin) were assessed in patients chronically treated with clozapine (n=29), olanzapine (n=29), typical APs (n=30) and first degree relatives of clozapine (n=23) and olanzapine subjects (n=11). RESULTS: The typical AP group had the highest CRP level (p=0.013) in spite of having the lowest body mass index (BMI). Patients as a single group had higher CRP levels than relatives (p=0.003). The typical AP group also had the highest AT-III levels (p=0.021). Fibrinogen levels did not differ between the groups (p=0.13). Olanzapine patients displayed the highest PAI-1 and leptin levels among the drug-treated subjects, but values were similar to those observed in their relatives, and were significantly correlated with the BMI. CONCLUSIONS: A homogeneous negative profile of high inflammation and procoagulant factors along with low levels of anticoagulants was not detected in any group. While preliminary, our results suggest that the observed abnormalities were not related to a direct drug effect, but to elevated BMI (high PAI-1 and leptin in olanzapine-treated patients). We speculate that the high CRP in the typical AP group might be related to poor lifestyle habits, but this must we confirmed in future studies.