Intradialytic hypotension (IDH) is considered to be a frequent complication of hemodialysis (HD) and is associated with symptom burden, increased incidence of access failure, cardiovascular events, and higher mortality. This systematic literature review aims to analyse studies that investigated the prevalence of IDH. A complicating factor herein is that many different definitions of IDH are used in literature.Methods: A systematic literature search from databases, Medline, Cinahl, EMBASE, and the Cochrane library to identify studies reporting on the actual prevalence of IDH was conducted. Studies were categorized by the type of definition used for the prevalence of IDH. A meta-analysis of the prevalence of IDH was performed.Results: In a meta-analysis comprising 4 studies including 1,694 patients and 4 studies including 13,189 patients, the prevalence of HD sessions complicated by IDH was 10.1 and 11.6% for the European Best Practice Guideline (EBPG) definition and the Nadir <90 definition, respectively. The proportion of patients with frequent IDH could not reliably be established because of the wide range in cutoff values that were used to identify patients with frequent IDH. There was a large variety in the prevalence of symptoms and interventions. Major risk factors associated with IDH across studies were diabetes, a higher interdialytic weight gain, female gender, and lower body weight.Conclusion: Our meta-analysis suggests that the prevalence of IDH is lower than 12% for both the EBPG and the Nadir <90 definition which is much lower than stated in most reviews.
LINK
Growth curve analysis of sedentary plant parasitic nematodes on different hosts and at different population densities is used to assess plant suitability including their resistance and tolerance. The estimated parameters of host suitability can be used in pest management programs for economic important species such as potato cyst nematodes.
LINK
Background: Acne vulgaris is a multifaceted skin disorder, affecting more than 85% of young individuals worldwide. Pharmacological therapy is not always desirable because of the development of antibiotic resistance or the potential risk of adverse effects. Non‐pharmacological therapies can be viable alternatives for conventional therapies. However, sufficient evidence‐based support in the efficacy and safety of non‐pharmacological therapies is lacking. Objective: To assess the efficacy and safety of several non‐pharmacological therapies in the treatment of acne vulgaris. Methods: A systematic literature review, including a best‐evidence synthesis, was performed to identify literature. Three electronic databases were accessed and searched for studies published between January 2000 and May 2017. Results: Thirty‐three eligible studies were included in our systematic review. Three main types of non‐pharmacological therapies were identified laser‐ and light‐based therapies, chemical peels and fractional microneedling radiofrequency. The majority of the included studies demonstrated a significant reduction in acne lesions. However, only seven studies had a high methodologic quality. Based on these seven trials, a best‐evidence synthesis was conducted. Strong evidence was found for glycolic acid (10–40%). Moderate evidence was found for amino fruit acid (20–60%), intense pulsed light (400–700 and 870–1200 nm) and the diode laser (1450 nm). Initially, conflicting evidence was found for pulsed dye laser (585–595 nm). The most frequently reported side‐effects for non‐pharmacological therapies included erythema, tolerable pain, purpura, oedema and a few cases of hyperpigmentation, which were in most cases mild and transient. Conclusion: Circumstantial evidence was found for non‐pharmacological therapies in the treatment of acne vulgaris. However, the lack of high methodological quality among included studies prevented us to draw clear conclusions, regarding a stepwise approach. Nevertheless, our systematic review including a best‐evidence synthesis did create order and structure in resulting outcomes in which a first step towards future research is generated.
In dit onderzoek wordt de uitvoerbaarheid van een bewegingsprogramma tijdens chemoradiatie bij patienten met hoofd-halskanker onderzocht.The feasibility of an exercise intervention during CRT in HNSCC patients will be studied to design an optimal, large-scale RCT comparing the exercise intervention during CRT to usual care (UC) with the aim of a beneficial effect on the tolerability of CRT and physical fitness, body composition, fatigue and QoL on the longer term.