[Diagnostic efficacy of free SPA/total PSA ratio in the diagnosis of prostatic carcinoma]. / Efficacia diagnostica del rapporto PSA-free/PSA totale nella diagnosi del carcinoma prostatico.

Prostate specific antigen, specific organ and tissue marker, is a glycoprotein present in serum in different molecular forms, i.e. not protein bound and bound to proteins (PSA-ACT and PSA-AMG). The total PSA is expressed by the sum of the non protein bound value (free-PSA) and PSA-ACT. The aim of our study was to evaluate the hypothesis that measurement of free/total PSA ratio may be helpful in the differential diagnosis of prostatic pathology. Our study was conducted on 350 patients, to whom the total-PSA, free-PSA and f/t PSA had been performed; 250 patients showed a total PSA between 2.5 and 10 ng/ml and 185 of them had symptoms of bladder out-flow obstruction. In all of the 250 patients digital rectal examination, transrectal ultrasound and prostatic biopsy were performed. 100 patients were controls. The cut-off to differentiate between benign and malignant prostatic disease was 16%. The pathologic diagnosis was related to the f/t PSA ratio, and in particular those patients with a f/t PSA lower than 16% were expected to be prostatic carcinoma, while those with a f/t PSA higher than 16% were expected to be benign prostatic hypertrophy. The diagnostic accuracy of the ratio was calculated, and it was observed that it was 88.65% in the diagnosis of benign prostatic hypertrophy, while in the diagnosis of prostatic carcinoma it was 84.5%. We can therefore assume that f/t PSA can add useful information on prostatic pathology, eventually sparing unnecessary prostatic biopsies.

[Plasma cortisol levels after acute administration of baclofen]. / Cortisolemia dopo somministrazione acuta di baclofene.

Plasma cortisol levels after acute administration of Baclofen, a Gaba agonist drug, were evaluated in eight healthy volunteer subjects. After 10 mg. of such drug, cortisol levels did not change appreciably. On the contrary after 20 mg. Baclofen elicited a rise in cortisol plasma levels. Baclofen increases striatal levels of dopamine. Therefore it is possible that metabolic effects of the drug are a consequence of increased levels of dopamine.

[Glycemia and insulinemia after oral administration of Nomifensine]. / Glicemia ed insulinemia dopo carico orale di Nomifensina.

Blood glucose and immunoreactive insulin (IRI) were evaluated in 8 healthy subjects after mg 200 of Nomifensina per os. 5 subjects underwent an oral glucose challenge before and after mg 200 of Nomifensine and their glucose and IRI were evaluated in both conditions. Nomifensine inhibits basal IRI but does not inhibit IRI levels after an oral glucose challenge. It is possible that nervous dopaminergic endings are present at the level of B cells.