The cost-utility of Viagra® in The Netherlands

OBJECTIVE: Clinical trials suggest that sildenafil is an effective treatment for erectile dysfunction. Nevertheless, reimbursement is controversial: sildenafil is expected to be more effective than conservative therapy (papaverine/ phentolamine injections), but also more costly to society. Economic appraisal of sildenafil is of interest given the prevalence of the disorder. DESIGN: We analyzed the cost-effectiveness of a sildenafil scenario (allowing a switch to injection therapy) and the papaverine/ phentolamine scenario (conservative therapy, no switch allowed). Analyses were performed from the societal perspective. Values for health states of erectile dysfunction were collected using time trade-off. Using these values (N=169), we converted trial outcomes (Goldstein, 1998) into quality adjusted lif

Snelle meetmethoden als managementinstrument bij de teelt van ruwvoer

Quick measuring methods as management tools in the production of roughage. The most promising technique is spectroscopy, which can be applied in on-line analysis methods for measuring dry matter yield and feed value of silage and grass and which can be available for use within 5 years as a management tool in the production of roughage on dairy farms. Conceptual spectroscopy seems the best technique under the conditions mentioned for measuring feed value. The use of spectroscopy in a dotted measurement seems to be the best technique for measuring dry matter yield

Selection for scrapie resistance and simultaneous restriction of inbreeding in the rare sheep breed "Mergellander"

Scrapie is a fatal infectious neurodegenerative disease for which susceptibility is associated with polymorphisms in the ovine prion protein (PrP) gene. Scrapie-eradication programmes are based on eliminating the susceptible VRQ allele and/or breeding for the resistant ARR allele. In rare breeds or breeds with a low frequency of the ARR allele this can lead to unacceptably high inbreeding rates with associated increased risk of genetic defects and inbreeding depression. The conservation status of populations with inbreeding rates (¿F) above 1% is considered critical. In the Dutch rare sheep breed the Mergellander animals carrying ARR alleles are closely related to one another, and could reach 1.53% when only ARR/ARR animals are used as parents. Inbreeding rates can be reduced by selecting the set of parents according to their average co-ancestry. We minimised inbreeding rates by calculating the optimal contribution of each ram and selection of ewes. This resulted in inbreeding rates of ¿0.17% with exclusive use of homozygous ARR rams, and ¿0.38% if use of heterozygous rams was allowed as well. Thus sophisticated breeding programs can prevent unacceptably high inbreeding rates when breeding for scrapie resistance