Cost-effectiveness of management strategies for acute urethritis in the developing world.

OBJECTIVE: To recommend a cost-effective approach for the management of acute male urethritis in the developing world, based on the findings of a theoretical study. METHODS: A model was developed to assess the cost-effectiveness of three urethritis management strategies in a theoretical cohort of 1000 men with urethral syndrome. (1) All patients were treated with cefixime and doxycycline for gonococcal urethritis (GU) and nongonococcal urethritis (NGU), respectively, as recommended by WHO. (2) All patients were treated with doxycycline for NGU; treatment with cefixime was based on the result of direct microscopy of a urethral smear. (3) All patients were treated with cotrimoxazole or kanamycin for GU and doxycycline for NGU. Cefixime was kept for patients not responding to the first GU treatment. Strategy costs included consultations, laboratory diagnosis (where applicable) and drugs. The outcome was the rate of patients cured of urethritis. Cost-effectiveness was measured in terms of cost per cured urethritis. RESULTS: Strategy costs in our model depended largely on drug costs. The first strategy was confirmed as the most effective but also the most expensive approach. Cefixime should cost no more than US$1.5 for the strategy to be the most cost-effective. The second strategy saved money and drugs but proved a valuable alternative only when laboratory performance was optimal. The third strategy with cotrimoxazole was the least expensive but a low follow-up visit rate, poor treatment compliance or lower drug efficacy limited effectiveness. Maximizing compliance by replacing cotrimoxazole with single-dose kanamycin had the single greatest impact on the effectiveness of the third strategy. CONCLUSION: Our model suggested that a cost-effective approach would be to treat gonorrhoea with a single-dose antibiotic selected from locally available products that cost no more than US$ 1.5

Mercury concentrations in plaice, flounder and dab from Belgian continental shelf waters (1971-1990)

Results obtained during a survey of 20 years on plaice (Pleuronectes platessa) and 15 years on flounder (Platichthys flesus) and dab (Limanda limanda) are reported. With flounder, two periods could be distinguished. In 1975-1981, higher mercury concentrations (0.38 mg/kg on average) with rather large variations were noted. From 1982 on, concentrations fluctuated around the same mean value (0.23 mg/kg). A gradual decrease of mercury levels in plaice was observed during the twenty years' monitoring period. The mean concentration in 1990 (0.06 mg/kg) was only one third of that of 1971 (0.18 mg/kg). In contrast with flounder and plaice, mercury concentrations in dab remained practically at the same level (0.09-0.13 mg/kg)

Bio-material polylactic acid/poly(butylene adipate-co-terephthalate) blend developed for extrusion- based additive manufacturing

Bio-material polylactic acid and poly(butylene adipate-co-terephthalate) were blended to achieve increased ductility of the blend. Cloisite was added to improve the stiffness of the blend. The blends were made into filament suitable for extrusion-based additive manufacturing. Melt flow index of the filament and mechanical properties of the printed bars were tested. Preliminary results showed that the melt flow index increases significantly with cloisite and the modulus of polylactic acid/poly(butylene adipate-co-terephthalate) improved slightly. The notched impact strength of the blend increased with increasing content of cloisite, and it increased significantly after annealing, especially for blends without cloisite