Seksuele disfunctie en relatieproblemen na prostaatkankerbehandeling: De gewenste zorg vanuit het oogpunt van patiënt en partner

Erectile dysfunction (ED) is one of the most common side effects of prostate cancer (PC) treatment and may lead to changes in a relationship. The aim of this study was to identify sexual and/or relational problems and to investigate what kind of supportive care is preferred by patients and their partners. A cross-sectional survey was performed among men diagnosed with PC enrolled in active surveillance or treated with laparoscopic radical prostatectomy, brachytherapy, intensity-modulated radiotherapy or hormonal therapy. If possible, partners were included as well. Out of 250 patients, 80,5% suffered from moderate to severe erectile complaints. Half of them (53,7%) was treated for ED and a great part was partially (30,7%) up to not satisfied (25,7%). Out of 168 partners, 50,6% found it difficult to cope with changes around sexuality. The majority of men (74,7%) preferred a standard consultation with a urologist-sexologist three months after treatment to discuss sexuality

Leflunomide in the treatment of patients with early rheumatoid arthritis—results of a prospective non-interventional study

Leflunomide is effective and well tolerated in the treatment of rheumatoid arthritis (RA), however, data on its use in early RA are scarce. This study seeks to evaluate effectiveness and safety of leflunomide in the treatment of early RA in daily practice. This prospective, open-label, non-interventional, multi-center study was carried out over 24 weeks including adults with early RA (≤1 year since diagnosis). Leflunomide treatment was according to label instructions. Three hundred thirty-four patients were included. Disease activity score in 28 joints (DAS28) response (reduction in DAS28 of >1.2 or reduction of >0.6 and a DAS28 of ≤5.1) was 71.9% at week 12 and 84.6% at week 24. 25.0% of patients achieved clinical remission (DAS28 ≤ 2.6). Most frequently reported adverse drug reactions (ADR) were diarrhea (3.0%), nausea (2.4%), hypertension (1.8%), and headache (1.5%). Serious ADR were reported in four patients (1.2%). Leflunomide showed the effectiveness which was to be expected from controlled studies without revealing any new or hitherto unknown side effects. Onset of action was quick and significant improvement of disease was seen after 12 weeks of therapy and at even higher rates after 24 weeks irrespective of the use of a loading dose. Interestingly, the DAS28-remission rate achieved was similar to the rate seen with methotrexate or biologic therapy in other studies

A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity.

BACKGROUND: In the midst of the coronavirus pandemic, the International Chiropractors Association (ICA) posted reports claiming that chiropractic care can impact the immune system. These claims clash with recommendations from the World Health Organization and World Federation of Chiropractic. We discuss the scientific validity of the claims made in these ICA reports. MAIN BODY: We reviewed the two reports posted by the ICA on their website on March 20 and March 28, 2020. We explored the method used to develop the claim that chiropractic adjustments impact the immune system and discuss the scientific merit of that claim. We provide a response to the ICA reports and explain why this claim lacks scientific credibility and is dangerous to the public. More than 150 researchers from 11 countries reviewed and endorsed our response. CONCLUSION: In their reports, the ICA provided no valid clinical scientific evidence that chiropractic care can impact the immune system. We call on regulatory authorities and professional leaders to take robust political and regulatory action against those claiming that chiropractic adjustments have a clinical impact on the immune system

Genome sequencing and analysis of the versatile cell factory Aspergillus niger CBS 513.88

The filamentous fungus Aspergillus niger is widely exploited by the fermentation industry for the production of enzymes and organic acids, particularly citric acid. We sequenced the 33.9-megabase genome of A. niger CBS 513.88, the ancestor of currently used enzyme production strains. A high level of synteny was observed with other aspergilli sequenced. Strong function predictions were made for 6,506 of the 14,165 open reading frames identified. A detailed description of the components of the protein secretion pathway was made and striking differences in the hydrolytic enzyme spectra of aspergilli were observed. A reconstructed metabolic network comprising 1,069 unique reactions illustrates the versatile metabolism of A. niger. Noteworthy is the large number of major facilitator superfamily transporters and fungal zinc binuclear cluster transcription factors, and the presence of putative gene clusters for fumonisin and ochratoxin A synthesis

Rapportage project Nitraatwijzer Fase I

Nederland moet voldoen aan de doelstellingen voor waterkwaliteit volgens de Nitraatrichtlijn. In het kader van het Zesde Actieprogramma Nitraatrichtlijn werd onderzocht hoe Nederland het risico van nitraatuitspoeling van individuele percelen en landbouwbedrijven het beste kan bepalen. Voorliggend rapport doet verslag van de eerste onderzoeksfase die indicatoren voor het nitraatuitspoelingsrisicoevalueerde op basis van literatuur en van ervaringen in Vlaanderen en Baden-Württemberg. Voor gebruik op bedrijfs- en perceelsniveau komt het nitraatresidu NR (de hoeveelheid nitraatstikstof in de bodem in de laag 0-90 cm –mv in het najaar, kg N/ha) als beste indicator naar voren. Deze is relatief eenvoudig en goedkoop te bepalen en heeft een betere voorspellende waarde dan enige andere indicator op deze twee schaalniveaus. Niettemin bedraagt de voorspelfout (onzekerheid in voorspelde nitraatconcentratie in bovenste grondwater op bedrijfs- of perceelsniveau bij bepaalde NR waarde) enkele tientallen mg/l. Verder onderzoek zal de relatie tussen NR en nitraat in het bovenste grondwater voor geselecteerde clusters (combinaties van gewas, grondsoort en grondwatertrap) kunnen preciseren, maar de voorspelfout voor een individueel perceel of bedrijf zal naar verwachting enkele tientallen mg/l blijven. De studie geeft een beoordeling van de bruikbaarheid van NR bij (i) handhaving van het mestbeleid, (ii) monitoring en rapportage over de effecten van het mestbeleid, en (iii) sturing en bewustwording over de effecten van maatregelen op het eigen bedrijf. Voor laatstgenoemde toepassing is NR bij uitstek geschikt, ondanks diverse nadelen. Gebruik van NR als handhavingsinstrument heeft in Vlaanderen en Baden-Württemberg geleid tot zeer complexe regelgeving. In het najaar van 2018 werd een pilotstudie uitgevoerd, waarin NR gemeten werd op percelen vanmelkveehouderij- en vollegrondsgroentenbedrijven in Nederland. Gevonden NR waarden waren in het algemeen hoog ten opzichte van de drempelwaarden gehanteerd in Vlaanderen, ook wanneer rekening gehouden wordt met de uitzonderlijke weersomstandigheden in groeiseizoen 2018. De pilot wordt in 2019 vervolledigd door meting van de nitraatconcentratie in grondwater onder dezelfde percelen