The increased circulating prostate-specific antigen concentrations in women with hirsutism do not respond to acute changes in adrenal or ovarian function.

Serum prostate-specific antigen (PSA) is produced in several female tissues and appears to be up-regulated by androgens. We have studied serum PSA concentrations in women with different forms of hyperandrogenism, focusing on the influence of changes in ovarian and adrenal function on these concentrations. Thirty-seven hirsute women were studied in the follicular phase of the menstrual cycle. Basal and ACTH-stimulated plasma samples were obtained, and sampling was repeated 1 (gonadal stimulation) and 21 (gonadal suppression) days after receiving a single im 3.75-mg dose of triptorelin. Eleven nonhyperandrogenic women served as controls. Hirsute women had increased PSA levels compared to controls. When considering the source of the hyperandrogenism, ovarian patients (those with increased serum androgen levels that normalized during gonadal suppression) and adrenal patients (those with increased androgen levels that remained elevated during gonadal suppression) presented increased PSA values, whereas hirsute patients without hyperandrogenemia had normal PSA levels. PSA levels did not change during ovarian or adrenal stimulation or during gonadal suppression with respect to initial values. Basal PSA levels showed significant correlations with basal total testosterone (r = 0.59; P < 0.001), free androgen index (r = 0.68; P < 0.001), sex hormone-binding globulin (r = -0.58; P < 0.001), dehydroepiandrosterone sulfate (r = 0.39; P < 0.01), 17-hydroxyprogesterone (r = 0.32; P < 0.05), and age (r = -0.33; P < 0.05) when patients and controls were considered as a whole. In conclusion, basal PSA levels are increased in hirsute patients and correlate with the degree of hyperandrogenism when patients and controls are considered as a whole. The adrenal and the ovary do not appear to be the source of PSA, suggesting that hyperandrogenism induces PSA secretion in tissues other than the adrenal and the ovary.

[Epidemiology of urinary lithiasis in our Unit. Clinical course in time and predictive factors]. / Epidemiología de la litiasis urinaria en nuestra Unidad. Evolución en el tiempo y factores predictivos.

OBJECTIVES: To analyze the incidence of lithiasis and stone composition in our setting. The trend is compared with the results of the majority of studies on urinary calculi reported in the literature based on the number and composition of stones. METHODS: The study comprised patients referred to the Urolithiasis Unit of our hospital over the last 21 years. Stone composition was analyzed by infra-red spectroscopy. The study period was divided into 4 time intervals: 1977-1979, 1977-1980, 1977-1987 and 1977-1998 in order to determine the trends of the incidence of lithiasis in our setting. RESULTS: A total of 5516 patients were reviewed; of these, 766 had recurrence. The distribution was 385, 995, 3378 and 5516, respectively. Calcium oxalate calculi showed an incidence of 61.3%, calcium phosphate 18.5%, uric acid 11.2%, infectious calculi (ammonium urate and ammonium magnesium phosphate) 6.6%, and finally the incidence of cysteine calculi was 0.77%. Concerning the distribution according to sex, 62% of the males had calcium oxalate stones, 68% uric acid, 42.5% phosphate and 45% infectious lithiasis. The trends for uric acid, infectious, oxalate and phosphate calculi changed over time. CONCLUSIONS: There is a clear trend of calculi prevalence in the male, particularly oxalate and uric acid calculi. There is a trend for cysteine calculi to remain the same, calcium phosphate and oxalate calculi to increase, and uric and infectious calculi to decrease. The changes observed may be due to dietary changes and improvement in the quality of life.