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Aim: Regular increasing of health-care expense brought about the development of medical implication in prescription control and the will to give more responsibility to prescribers. Emergency departments account for a large part of hospital expenses. This study was carried out to evaluate cost awareness among French emergency physicians., Methods: A questionnaire was sent to 160 physicians (junior and senior grade) working at the emergency department of 12 hospitals in the Lyon region (France). Every participant had to estimate the true hospital costs of a selection of drugs, blood products, laboratory tests and imaging modalities., Results: One hundred and seven questionnaires (68%) were returned and analysed: 48 filled in by juniors (45%), 59 by seniors (55%). Only 26 physicians accurately estimated costs within 50% of the true cost. Response errors were underestimations averaging 4695±226euros, i.e. -59±3% of the total sum (7899euros). Drug prescriptions were significantly (P<0.001) the most underestimated (-74±3%), when compared to both imaging modalities (-23±5%) or blood products prescriptions (-37±6%). High-cost drugs (>1000euros) were the most overestimated pharmaceuticals (-82±2%). Laboratory tests were rather overestimated (+12±8%). Junior grade physicians underestimated more costs than senior physicians (P=0.04)., Discussion: Physicians had a poor understanding of prescription costs at the emergencies, especially regarding high-cost drugs. Much progress is required to integrate the cost-containment problem in daily prescriptions at the emergency department., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Even today we still do not have enough precise information either on the number of diseases which should be included in this collective concept or on the frequency of the diseases and their complications. Information is also lacking on methods for measuring these frequencies and assuring satisfactory surveillance. Various methods of gauging the frequency of these diseases are examined and evaluated and a practical surveillance programme is suggested.

An epidemic of cerebrospinal meningitis (CSM) in the Mongolian People's Republic, starting in 1969, reached its peak in 1974. In that year and in early 1975, 65 000 children in the 0-8-years age group in the main towns and in the provinces were immunized with meningococcal vaccine of serogroup A. The morbidity rates due to CSM were 12 times higher in the non-immunized than in the immunized children. This result demonstrates the value of an immunization programme to control epidemics of CSM.

The most currently used methods by laboratories for the screening of sexually transmitted diseases were reviewed by the authors and their comparative reliability and sensitiivity examined. The authors endeavoured to give guidance to physicians and bacteriologists in the choice of available techniques as regards collection sites, transport of specimens, choice of transport media, serological tests for syphilis screening and diagnostic methods for urethritis or non-gonococcal vaginitis.

From the moment WHO was established in 1948, the control of venereal diseases was felt to deserve highest priority, together with activities to control malaria and tuberculosis. International action was needed in view of the high morbidity and mortality from venereal diseases, their serious human and social consequences, and the prevalence of congenital syphilis and other sexually transmitted diseases (gonorrhoea, chancroid, venereal lymphogranulomatosis, granuloma inguinale). WHO immediately set up a global programme for the control of STDs and, with the participation of other agencies, especially UNICEF, furnished countries with assistance in the form of personnel, equipment and funds for the operation of programmes to assess the extent and impact of STDs and to plan and implement practical measure of control. The 1950s witnessed a steady and considerable decline in syphilis and gonorrhoea and many health authorities relaxed their control activities and efforts to maintain public awareness of the problem. In contrast to the prevailing optimism, WHO repeatedly stressed the possibility of a renewed upsurge of STDs. In the 1960s and 1970s, there was a sharp rise in STDs, both in the "classic" diseases (the five venereal diseases mentioned above) and also in the "second generation" STDs (chlamydial infection, genital herpes, human papillomavirus and other infections). Through its programme for the control of STDs, WHO put forward suitably designed control strategies, essentially based on information and education for health, screening for STDs, diagnosis and treatment of cases, contact tracing, and the training of health personnel. By the end of the 1970s, the bacterial, but not the viral STDs, had been contained in the industrialized countries. In many of the developing countries, STDs remained a priority public health problem, above all on account of the seriousness of their sequelae. In 1981, a new sexually transmitted disease-the acquired immunodeficiency syndrome (AIDS)-was identified. As of 1982, the WHO Programme on STDs organized meetings to define the extent of the problem, compare experience, promote and coordinate research and propose strategies for prevention. In 1987, WHO established a Global Programme on AIDS. It is clear that the control of STDs is now more than ever a priority. We have strategies for the prevention and control of STDs and the WHO Programme will continue to collaborate closely with countries in strengthening their national control programmes.(ABSTRACT TRUNCATED AT 400 WORDS)

Chlamydiae are being increasingly recognized as an important cause of human disease. The known geographical distribution of lymphogranuloma venereum and the role of chlamydiae as agents of sexually transmitted diseases are reviewed. The presence of chlamydiae in the urethra and the cervix, and their etiological relationship to genital infections, first recognized in connexion with ocular infections, have been proved in a number of studies in selected populations in a few countries. Chlamydiae appear to be the most important agent of nongonococcal urethritis, which in some cases appears now to be more frequent than gonococcal urethritis. In addition to their association with cervicitis, chlamydiae appear also to be fairly frequent in the cervix of apparently normal, asymptomatic, and sexually active women. The role of chlamydiae as agents of other human diseases still requires to be clarified. The organisms have been found in association with pelvic inflammatory disease, neonatal pneumonia, pharyngitis, and otitis. There is need for additional studies in view of the fact that effective chemotherapy is available. An outline is given of laboratory methods that may be useful for the diagnosis of chlamydial infections.