[Efficacy and safety of flibanserin "new female Viagra®?": Literature review]

INTRODUCTION

In August 2015, the US Food and Drug Administration (FDA) has approved Addyi^® (flibanserin) for treatment of acquired, generalized hypoactive sexual desire disorder (HSDD) in pre-menopausal women. We carried out a systematic review and meta-analysis to assess the efficacy and safety of the drug in women with HSDD.

PATIENTS AND METHODS

A systematic literature review from the PubMed database search was carried out until April 2016 using the following keywords: "HSDD", "flibanserin", "sexual desire" and "ransomised controlled trial".

RESULTS

We found four randomized double-blind control studies and two meta-analyzes and literature reviews. For the comparison of flibanserin with placebo, the results were reported in standardized mean difference (SMD). Regarding the main criterion "Satisfactory Sexual Event" (SSE), SMD was ranged from 0.49 to 1 (P<0.05); "Desire Sexual Score" SMD was ranged from 1.63 to 2.20 (P<0.05). For the Female Sexual Function Index (FSFI) desire domain score SMD was ranged from 0.03 to 0.4 (P<0.05). Adverse effects were mostly minor: dizziness and drowsiness.

CONCLUSION

Flibanserin showed a moderate benefit in terms of frequency of sex and patient satisfaction. The long-term safety of flibanserin is still poorly defined and scientific data concerning this drug are still few.

[Comparison of three models to predict non-sentinel lymph node status in breast cancer patients with metastatic sentinel lymph nodes: a retrospective study of 77 patients]

Various statistic predictive models have been developed to predict the status of the non-sentinel lymph nodes (NSLN) when the sentinel one was invaded by tumor cells in the case of breast invasive carcinoma. The objective of this study was to compare the accuracy of three of these statistic models: the MSKCC nomogram, the Tenon score and the MDA score. The study was conducted at Croix Rousse Hospital, Lyon, France.

OBJECTIVE

When sentinel lymph node is invaded by metastasis, complete lymph node dissection of the axilla can be avoided using statistic predictive models especially when talking about micrometastases and moreover about isolated tumor cells in the sentinel lymph node. Over the different existing models, we tested the three most used ones to determine the model that is most adapted to our everyday practice.

METHOD

The study population consisted of 77 women with an invasive breast cancer treated by complete axillary lymph node dissection for metastatic sentinel lymph node. Over the nine models already published, we focused on three of them due to their ease to use as well as their good preliminary results: the Memorial Sloan-Kettering Cancer Center nomogram (MSKCC), the Tenon score and the M.D Anderson score (MDA). Different criteria are used by these models, but all of them take in consideration: tumor size, multifocality, tumor type, lymphovascular invasion, hormonal receptors, number of sentinel lymph node resected, degree of sentinel lymph node invasion (i.e. macrometastasis, micrometastasis or isolated tumor cells) and histologic method used to diagnose sentinel lymph node invasion. These scores are validated depending on their false negative ratio as well as the proportion of patient selected as having a low risk of non-sentinel lymph node invasion. The major criterion for the MSKCC score is the calibration that compares the predicted likelihood of invasion and the histologically proved one.

RESULTS

The rate of non-sentinel lymph node invasion was 37.6%. The discrimination of the three models was good with an AUC of 0.74 for both MSKCC nomogram and Tenon score and of 0.72% for MDA score. MSKCC nomogram was well calibrated (P=0.23). The false negative ratio was 0 (CI 95%: 0-18.1%) for MSKCC nomogram, 16.7% (CI 95%: 8.6%-27.8%) for Tenon score and 16% (CI 95%: 6.8-31%) for MDA score. The percentage of patients considered as having a low risk of invasion of the non-sentinel lymph node was 20.5% for MSKCC nomogram, 34.7% for MDA score and 47.4% for Tenon score.

CONCLUSION

MSKCC nomogram seems to be the statistic model that is most adapted to the population we studied. To validate the Tenon and MDA score, we should have a most important population.

Current-induced two-level fluctuations in pseudo-spin-valve (Co/Cu/Co) nanostructures

Two-level fluctuations of the magnetization state of pseudo-spin-valve pillars Co(10 nm)/Cu(10 nm)/Co(30 nm) embedded in electrodeposited nanowires ( approximately 40 nm in diameter, 6000 nm in length) are triggered by spin-polarized currents of 10(7) A/cm(2) at room temperature. The statistical properties of the residence times in the parallel and antiparallel magnetization states reveal two effects with qualitatively different dependences on current intensity. The current appears to have the effect of a field determined as the bias field required to equalize these times. The bias field changes sign when the current polarity is reversed. At this field, the effect of a current density of 10(7) A/cm(2) is to lower the mean time for switching down to the microsecond range. This effect is independent of the sign of the current and is interpreted in terms of an effective temperature for the magnetization.

Echocardiography, color-coded Doppler imaging, and abdominal sonography, a non-invasive method for investigation of heart and aortic morphology and function in female gottingen minipigs: method and reference values for M-mode, B-mode, and flow parameters

OBJECTIVE

The aim of the study reported here was to set up a method for echocardiography (EC) and abdominal sonography and to obtain EC reference values for left ventricular (LV) morphology and function and sonographic abdominal aortic morphology, function, and flow values in conscious, unsedated Gottingen minipigs.

METHODS

Applying a standardized investigation procedure, the following parameters were measured by use of M-mode EC, color-coded Doppler imaging, and B-mode sonography, or were calculated, in 58 female minipigs: LV end-diastolic and end-systolic diameter, interventricular septum thickness, LV caudal wall thickness, LV end-diastolic volume and end-systolic volume, fractional shortening, ejection fraction, and percentage of thickening of interventricular septum and LV caudal wall. In addition, morphology, pulsatility, flow values, and flow patterns in the abdominal aorta were recorded or calculated during abdominal sonography and color-coded Doppler imaging.

RESULTS

Variable EC values were obtained due to individual variations of motor activity. Variation could be reduced by accustoming the animals to a standardized investigation procedure. Reference values could be obtained for EC, partially indicating clear correlation with body weight. Color-coded Doppler and Doppler spectra did not indicate flow disturbances in large arterial abdominal vessels.

CONCLUSIONS

Results indicate that handling during EC and sonography can cause discomfort in unsedated minipigs that may interfere with recording of valid reference values for functional cardiac parameters in young animals. Accustoming the animals to a standardized investigation procedure reduces stress to a satisfactory level and enables data recording. Thus the minipig is considered suitable for assessment of cardiovascular parameters in experimental or toxicologic studies.

Arginine-vasopressin in anterior pituitary cells: in situ hybridization of mRNA and ultrastructural localization of immunoreactivity

The hypothalamic nonapeptide arginine-vasopressin (AVP) exerts several distinct receptor-mediated actions on pituitary cells. Although hypothalamic AVP reaches the anterior pituitary via well-defined pathways, there is now accumulating evidence that AVP may also be produced endogenously in anterior pituitary cells. Using in situ hybridization, we demonstrate here the presence of AVP mRNA in the anterior pituitary of the rat. The observed grain density over pituitary cells was, however, greater than 10-fold lower than the one observed over AVP producing neurons present in the supraoptic and paraventricular nuclei of the hypothalamus. Immunoelectron microscopic analysis using two different AVP-specific antibodies revealed that the distribution of AVP-like immunoreactivity (AVP-LI) in the anterior pituitary is cell-specific. AVP-LI is most abundant in corticotrophs, followed by lactotrophs, gonadotrophs and thyrotrophs. On the other hand, there is complete absence of AVP-LI from somatotrophs. Interestingly, all pituitary cells in which AVP-LI is detected also represent potential target sites for AVP action. A minor fraction of AVP-LI was found to be membrane-associated and may originate, at least in part, from extrapituitary sources. This fraction likely represents receptor-bound peptide. The bulk of AVP-LI, however, was present in the cellular cytoplasm, not associated with any specific ultracellular structure. Specifically in corticotrophs, AVP-LI was excluded from secretory granules. However, our finding of AVP mRNA in anterior pituitary cells indicates that intracellular AVP-LI includes endogenously produced peptide, suggesting a paracrine and/or autocrine action.

Effects of ammoniation on the 'carry-over' of aflatoxins into bovine milk

Two experiments were performed using lactating cows fed various treated and non-treated commodities from AFB1 contaminated peanut cakes. Treatment with ammonia gas by an autoclaving process was used for detoxification. Two methods were used for AFM1 determination in every milk sample: a TLC procedure recognized by AOAC and IDF and an HPLC method with a detection limit of 0.100 and 0.010 microgram/l, respectively. In a first experiment, lactating cows were fed treated and untreated meals during periods separated by uncontaminated soya meals phases. The total excreted AFM1 was 2.6% of the total ingested AFB1 from untreated feed contaminated at 1100 micrograms/kg. During periods receiving treated meals in the diet, AFM1 contents in milk were below 0.1 microgram/l. However, by using AFM1 data obtained using the HPLC method, an AFM1/AFB1 ratio of 4.6% was found from treated feed contaminated at 40 micrograms AFB1/kg. In a second experiment, a herd of 50 lactating cows was used for a long term (16 months) feeding of mixed commodities containing 30% ammoniated peanut cakes. AFB1 residues in the treated diet were below 10 micrograms/kg, the EEC action level, and no AFM1 residue was found up to 0.1 microgram/l in collected milk throughout this experiment.