Evaluacion economica de una vacunacion protectora contra el riesgo de enfermedades contagiosas del ganado

En recientes epizootias occuridas en los Paises Bajos, muchos animales sanos hubieron de ser sacrificados y se solicito a los responsables politicos impulsaran un plan de vacunacion para prevenir futuros brotes. No obstante, se tiene poca experiencia sobre la eficacia de la administracion de vacunas protectoras. Las consecuencias sobre el mercado de la venta de productos procedentes de animales vacunas protectoras. Las consecuencias sobre el mercardo de la venta de productos procedentes de animales vacunados son muy inciertas, y no estan cubiertas por ningun plan de financiacion del riesgo. En este articulo se cuantifican las consecuencias epidemiologicas y economicas de la vacunacion protectora de epizootias de fiebre aftosa en los Paises Bajos empleando un modelo de evaluacion economica. Los resultados indican que los costes veterinarios y las perdidas por interrupcion del negocio probablemente disminuyan con la vacunacion preventiva frente al sacrificio de urgencia en casi un 75 por ciento y un 95 por ciento, respectivamente. No obstante, es probable tambien que las perdidas de mercado aumenten en casi un 20 por ciento, dada la importancia de las cadenas de suministro de carne de cerdo y ternaera blanca, que se suministran en gran medida de explotaciones con animales vacunacion, las perdidas de mercado son apartentemente las mas dificiles de compartir, y podrian requerir algun tipo de contrato para compartir el riesgo entre el sector publico y el privado para poner en practica las companas de vacunacion protectora...Recent livestock epidemics in the Netherlands, during which many healthy animals were destructed, urged policy makers to opt for protective vaccination for future epidemics. However, little experience is available with regard to the effectiveness of applying emergency vaccination, and market consequences of selling products from vaccinated animals are highly uncertain and not covered by any risk financing scheme. This paper quantifies the epidemicological and economic impact of protective vaccination for foot and mouth disease epidemics in the Netherlands. Results show that veterinary costs and business interruption losses are likely to decrease in case of protective vaccination compared to stamping-out, i.e. by about 75 percent and 95 percent respectively. Market losses however are likely to increase by about 20 percent, mainly on the account of pork and white veal supply chains and with a relatively large share for vaccinated farms. From the various damage components considered, market losses seem to be most difficult to pool and some form of public-private risk-sharing agreement might be needed to actually implement protective vaccination in practice

Complicações rinossinusais após descompressão orbital em técnica externa e endonasal combinada Sinus complications after orbital decompression by combined external and endonasal technique

Muitas técnicas de descompressão orbital têm sido utilizadas no tratamento da oftalmopatia por Graves. Recentemente, introduziu-se a cirurgia endoscópica endonasal na descompressão de órbita, como técnica isolada ou combinada com as já existentes, acreditando proporcionar melhor visão da parede medial da órbita e menor incidência de infecção bacteriana quando a parede medial é acessada por endoscópio. OBJETIVO: Avaliar as complicações após a descompressão orbital por técnica combinada assistida por endoscopia na prevenção de infecção rinossinusal. FORMA DE ESTUDO: Clínico Prospectivo. MATERIAL E MÉTODO: 16 pacientes 18 órbitas foram submetidos à descompressão orbital no Setor de Órbita do Departamento de Oftalmologia da Escola Paulista de Medicina UNIFESP. RESULTADOS: Quatro pacientes, durante o acompanhamento por tomografia no pós-operatório, apresentaram velamento do seio maxilar ou frontal, sem sintomatologia. CONCLUSÃO: A descompressão orbital por via externa combinada com a via endonasal auxiliada por endoscopia mostrou-se eficaz na prevenção de sinusite clinicamente manifesta e suas complicações, embora no acompanhamento tomográfico 22% dos pacientes apresentaram velamento do seio maxilar ou frontal.<br>Many techniques of orbital decompression have been used in the treatment of Graves ophthalmopathy. Recently endonasal endoscope surgery was introduced in the orbital decompression, as an isolated technique, or combined with existing techniques hopefully to give better visualization of medial wall and a lower incidence infection when the medial wall is acessed. AIM: To evaluate orbital decompression combined with endoscope in prevention of bacterial infection, we relate three cases of assyntomatic patients with computer tomography control of facial sinus presenting opacification of maxillary or frontal sinus. STUDY DESIGN: Clinical Prospective. MATERIAL AND METHOD: 16 patients with 18 orbita procedures underwent orbital decompression, in the Ophthalmology Department at the Escola Paulista de Medicina-UNIFESP an orbital decompression was obtained by combined technique using endonasal access with an endoscope. RESULTS: Four patients during postoperative CT scan presented assymtomatic opacification of the maxillary or frontal sinuses. CONCLUSION: A combination of endoscopy in orbital decompression by external approach showed the effectiveness in prevention of sinusitis clinically manifested and its complications, although a longer time of follow-up is needed to understand better radiological findings 22% presented opacification of the sinuses and their consequences