Vaccination of cattle only is sufficient to stop FMDV transmission in mixed populations of sheep and cattle.

We quantified the transmission of foot-and-mouth disease virus in mixed cattle-sheep populations and the effect of different vaccination strategies. The (partial) reproduction ratios (R) in groups of non-vaccinated and vaccinated cattle and/or sheep were estimated from (published) transmission experiments. A 4 × 4 next-generation matrix (NGM) was constructed using these estimates. The dominant eigenvalue of the NGM, the R for a mixed population, was determined for populations with different proportions of cattle and sheep and for three different vaccination strategies. The higher the proportion of cattle in a mixed cattle-sheep population, the higher the R for the mixed population. Therefore the impact of vaccination of the cattle is higher. After vaccination of all animals R = 0·1 independent of population composition. In mixed cattle-sheep populations with at least 14% of cattle, vaccination of cattle only is sufficient to reduce R to < 1.

[Choledocolithiasis predictors in high-risk population subjected to endoscopic retrograde pancreatocholangiography at "Hospital Nacional Arzobispo Loayza"]. / Predictores de coledocolitiasis en población de alto riesgo sometida a pancreatocolangiografía retrógrada endoscópica en el Hospital Arzobispo Loayza.

INTRODUCTION: The choledocholithiasis is a frequent complication of gallstone disease. The endoscopic retrograde cholangiopancreatography (ERCP) is suitable for its diagnosis and treatment. That approach has both significative morbility and mortality so others methods of diagnosis have been proposed such as intraoperatorycholangiography (IOC) and magnetic resonance cholangiography (MRC), reserving ERCP only for therapy purpose. OBJECTIVES: Verify the utility of choledocholithiasis predictors described in literature MATERIAL AND METHODS: This study is a correlational observational transversal prospective approach. It was performed at the Arzobispo Loayza Hospital from August 2004 to January 2005. Many clinical, biochemical and ecographyc predictors of choledocholithiasis were analyzed in 151 patient underwent to ERCP. In all peopleunder study and analyzing separately patients underwent to cholecystectomy or not previous to ERCP, it was identified some risk factors for choledocholithiasis by means of both univariate and multivariate analysis. RESULTS: The univariate analysis showed a relationships among age, icterus, cholangytis, direct bilirrubin, amylase, lactic deshidrogenasa, ductal dilatation (>8 mm) and choledocholithiasis. In all groups, the multivariate analysis determined that ductal dilatation by ecography was the unique predictor for choledocholithiasis in the group of patients postoperated. CONCLUSIONS: None single indicator was able to predict with accuracy the choledocholithiasis. However, the parameters described in the literature are useful in our country.

Predictores de coledocolitiasis en población de alto riesgo sometida a pancreatocolangiografía retrógrada endoscópica en el Hospital Arzobispo Loayza / Predicting of choledocholithiasis in population of high risk submissive an endoscopic retrograde cholangiopancreatography in yhe Hospital Arzobispo Loayza

Introducción: La coledocolitiasis es una complicación frecuente de la litiasis vesicular. La pancreatocolangiografía retrógrada endoscópica (PCRE) es el "gold Standard" para su diagnóstico y tratamiento, sin embargo debido a su significativa morbilidad y mortalidad, otros métodos diagnósticos han sido planteados, tales como la colangiografía intraoperatoria (CIO) y la colangioresonancia (CRMN), reservado a la PCRE sólo para fines terapéuticos. Objetivo: Verificar la utilidad de los predoctores de coledocolitiasis descritos en la literatura. Material y Método: Estudio correlacional, observacional, transversal prospectivo que se realizó entre agosto del 2004 y enero del 2005 en el Hospital Arzobispo Loayza. Conocidos criterios clínicos, bioquímicos y ecográficos predictores de coledocolitiasis fueron analizados en 151 pacientes sometidos a PCRE. Usando análisis univariado y multivariado, se identificaron los factores de riesgo para coledocolitiasis, en el total de pacientes del estudio, así como en los pacientes colecistectomizados o no antes de la PCRE. Resultados: El análisis univariado en el total de pacientes encontró que la edad, ictericia, colangitis, biblirrubina directa, amilasa, deshidrogenada láctica (DHL), dilatación del colédoco (>8mm) y coledocolitiasis por ecografía, estuvieron asociados con coledocolitiasis. Cuando se evaluó por separado, el análisis multivariado en los tres grupos se encontró que sólo la dilatación del colédoco por ecografía fue el único predictor de coledocolitiasis en el grupo de pacientes post-operados. Conclusiones: Ningún indicador único es capaz de predecir, con total exactitud, la presencia de coledocolitiasis. Pero los parámetros descritos en la literatura, son de utilidad en nuestro medio.

Introducction: The choledocholithiasis is a frequent complication of gallstone disease. The endoscopic retrograde cholangiopancreatography (ERCP) is suitable for its diagnosis and treatment. That approach has both significative morbility and mortality so others methods of diagnosis have been proposed such as intraoperatorycholangiography (IOC) and magnetic resonance cholangiography (MRC), reserving ERCP only for therapy purpose.OBJETIVES: Verify the utility of choledocholithiasis predictors described in literature MATERIAL AND METHODS: This study is a correlational observational transversal prospective approach. It was performed at the Arzobispo Loayza Hospital from August 2004 to January 2005. Many clinical, biochemical and ecographyc predictorsof choledocholithiasis were analyzed in 151 patient underwent to ERCP. In all people under study and analyzing separately patients underwent to cholecystectomy or not previous to ERCP, it was identified some risk factors for choledocholithiasis by means of both univariate and multivariate analysis.RESULTS: The univariate analysis showed a relationships among age, icterus, cholangytis, direct bilirrubin, amylase, lactic deshidrogenasa, ductal dilatation (minor 8mm) and choledocholithiasis. In all groups, the multivariate analysis determined that ductal dilatation by ecography was the unique predictor for choledocholithiasisin the group of patients postoperated.CONCLUSIONS: None single indicator was able to predict with accuracy thecholedocholithiasis. However, the parameters described in the literature are useful in our country.

[Results of electric stimulation in the treatment of post-prostatectomy urinary incontinence]. / Resultados de la electroestimulación en el tratamiento de la incontinencia urinaria post-prostatectomía.

Clinical and urodynamic studies were conducted in 19 patients undergoing intrarectal electrostimulation due to post-prostatectomy urinary incontinence. It was corroborated that patients referring incontinence with isolated coughing presented better clinical outcome (80% positive results) than those who also referred urgency-incontinence (44%). Patients with stress incontinence showed positive clinical results post-stimulation in 78% cases. Patients with vesical instability, in 40% cases and patients with mixed incontinence, in 60%. In contrast, elimination of vesical instability was urodynamically proven in 60% cases, but in only 22% with stress incontinence. In mixed incontinence (instability + stress) the instability persisted only in 20% while stress incontinence persisted in 80% cases. The above data would advocate electric stimulation as a therapeutical alternative in post-prostatectomy urinary incontinence.

[Reliability of the estimate of post-voiding bladder volume with ultrasound. Comparison of 2 ultrasonography methods]. / Fiabilidad de la estimación del volumen vesical postmiccional mediante ultrasonidos. Comparación de dos métodos ecográficos.

OBJECTIVES: To determine the reliability of the postvoiding volume measurement of two US methods. METHODS: A comparative study of transabdominal and portable ultrasound (Bladderscan model) in the selected and non-selected modes was conducted in 96 patients (54 males, 42 females; mean age 59.92 yrs). RESULTS: Conventional US had the lowest failure rate (26.99%). The failure rate was 41.66% for the selected mode and 57.77% for the non-selected mode. The main failure of transabdominal ultrasound was a defect failure. The non-selected mode had a defect and excess failure. The selected mode had a defect failure. There was and inverse relationship between the residual volume and the failure rate of the non-selected mode of the Bladderscan model. The failure rate was higher for males vs females in the non-selected mode. The possible sources of failure are analyzed. CONCLUSION: Conventional transabdominal ultrasound is currently the most reliable ultrasound method.

[Retrovesical hydatid cyst]. / Quiste hidatídico retrovesical.

Hydatid disease is not an uncommon entity in endemic areas. However, the finding of an isolated cyst in the retrovesical region is less frequent. One such case is described herein. The diagnosis and therapeutic aspects are discussed.

[Distal urethral obstruction in girls: a diagnosis to keep in mind]. / Obstrucción de la uretra distal en niñas: un diagnóstico a tener en cuenta.

Although obstruction of the distal urethra is uncommon in the female, it should not be discarded if the patient is a young girl who consults for symptoms as diverse as enuresis, frequency and urgency, urinary infections, etc. Such a case is reported herein. The patient underwent internal urethrotomy which resolved the obstruction and eliminated the symptoms.