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SARS-CoV-2 emerged in late 2019 as a zoonotic infection of humans, and proceeded to cause a worldwide pandemic of historic magnitude. Here, we use a simple epidemiological model and consider the full range of initial estimates from published studies for infection and recovery rates, seasonality, changes in mobility, the effectiveness of masks and the fraction of people wearing them. Monte Carlo simulations are used to simulate the progression of possible pandemics and we show a match for the real progression of the pandemic during 2020 with an R 2 of 0.91. The results show that the combination of masks and changes in mobility avoided approximately 248.3 million (σ = 31.2 million) infections in the US before vaccinations became available.
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BACKGROUND: Changes in clinical variables associated with the administration of pimobendan to dogs with preclinical myxomatous mitral valve disease (MMVD) and cardiomegaly have not been described. OBJECTIVES: To investigate the effect of pimobendan on clinical variables and the relationship between a change in heart size and the time to congestive heart failure (CHF) or cardiac-related death (CRD) in dogs with MMVD and cardiomegaly. To determine whether pimobendan-treated dogs differ from dogs receiving placebo at onset of CHF. ANIMALS: Three hundred and fifty-four dogs with MMVD and cardiomegaly. MATERIALS AND METHODS: Prospective, blinded study with dogs randomized (ratio 1:1) to pimobendan (0.4-0.6 mg/kg/d) or placebo. Clinical, laboratory, and heart-size variables in both groups were measured and compared at different time points (day 35 and onset of CHF) and over the study duration. Relationships between short-term changes in echocardiographic variables and time to CHF or CRD were explored. RESULTS: At day 35, heart size had reduced in the pimobendan group: median change in (Δ) LVIDDN -0.06 (IQR: -0.15 to +0.02), P < 0.0001, and LA:Ao -0.08 (IQR: -0.23 to +0.03), P < 0.0001. Reduction in heart size was associated with increased time to CHF or CRD. Hazard ratio for a 0.1 increase in ΔLVIDDN was 1.26, P = 0.0003. Hazard ratio for a 0.1 increase in ΔLA:Ao was 1.14, P = 0.0002. At onset of CHF, groups were similar. CONCLUSIONS AND CLINICAL IMPORTANCE: Pimobendan treatment reduces heart size. Reduced heart size is associated with improved outcome. At the onset of CHF, dogs treated with pimobendan were indistinguishable from those receiving placebo.
Assuntos
Cardiotônicos/uso terapêutico , Prolapso da Valva Mitral/tratamento farmacológico , Piridazinas/uso terapêutico , Animais , Cardiomegalia/tratamento farmacológico , Cardiomegalia/veterinária , Doenças do Cão/tratamento farmacológico , Cães , Ecocardiografia/veterinária , Cardiopatias/mortalidade , Cardiopatias/veterinária , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/veterinária , Prolapso da Valva Mitral/diagnóstico por imagem , Prolapso da Valva Mitral/patologia , Estudos Prospectivos , Qualidade de VidaRESUMO
BACKGROUND: Pimobendan is effective in treatment of dogs with congestive heart failure (CHF) secondary to myxomatous mitral valve disease (MMVD). Its effect on dogs before the onset of CHF is unknown. HYPOTHESIS/OBJECTIVES: Administration of pimobendan (0.4-0.6 mg/kg/d in divided doses) to dogs with increased heart size secondary to preclinical MMVD, not receiving other cardiovascular medications, will delay the onset of signs of CHF, cardiac-related death, or euthanasia. ANIMALS: 360 client-owned dogs with MMVD with left atrial-to-aortic ratio ≥1.6, normalized left ventricular internal diameter in diastole ≥1.7, and vertebral heart sum >10.5. METHODS: Prospective, randomized, placebo-controlled, blinded, multicenter clinical trial. Primary outcome variable was time to a composite of the onset of CHF, cardiac-related death, or euthanasia. RESULTS: Median time to primary endpoint was 1228 days (95% CI: 856-NA) in the pimobendan group and 766 days (95% CI: 667-875) in the placebo group (P = .0038). Hazard ratio for the pimobendan group was 0.64 (95% CI: 0.47-0.87) compared with the placebo group. The benefit persisted after adjustment for other variables. Adverse events were not different between treatment groups. Dogs in the pimobendan group lived longer (median survival time was 1059 days (95% CI: 952-NA) in the pimobendan group and 902 days (95% CI: 747-1061) in the placebo group) (P = .012). CONCLUSIONS AND CLINICAL IMPORTANCE: Administration of pimobendan to dogs with MMVD and echocardiographic and radiographic evidence of cardiomegaly results in prolongation of preclinical period and is safe and well tolerated. Prolongation of preclinical period by approximately 15 months represents substantial clinical benefit.
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Cardiomegalia/veterinária , Cardiotônicos/uso terapêutico , Doenças do Cão/tratamento farmacológico , Insuficiência da Valva Mitral/veterinária , Piridazinas/uso terapêutico , Animais , Cardiomegalia/tratamento farmacológico , Cardiotônicos/efeitos adversos , Cães , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/veterinária , Masculino , Insuficiência da Valva Mitral/tratamento farmacológico , Insuficiência da Valva Mitral/mortalidade , Piridazinas/efeitos adversosRESUMO
BACKGROUND: Myxomatous mitral valve disease (MMVD) is an important cause of morbidity and mortality in dogs. OBJECTIVES: To compare, throughout the period of follow-up of dogs that had not yet reached the primary endpoint, the longitudinal effects of pimobendan versus benazepril hydrochloride treatment on quality-of-life (QoL) variables, concomitant congestive heart failure (CHF) treatment, and other outcome variables in dogs suffering from CHF secondary to MMVD. ANIMALS: A total of 260 dogs in CHF because of MMVD. METHODS: A prospective single-blinded study with dogs randomized to receive pimobendan (0.4-0.6 mg/kg/day) or benazepril hydrochloride (0.25-1.0 mg/kg/day). Differences in outcome variables and time to intensification of CHF treatment were compared. RESULTS: A total of 124 dogs were randomized to pimobendan and 128 to benazepril. No difference was found between groups in QoL variables during the trial. Time from inclusion to 1st intensification of CHF treatment was longer in the pimobendan group (pimobendan 98 days, IQR 30-276 days versus benazepril 59 days, IQR 11-121 days; P = .0005). Postinclusion, dogs in the pimobendan group had smaller heart size based on VHS score (P = .013) and left ventricular diastolic (P = .035) and systolic (P = .0044) dimensions, higher body temperature (P = .030), serum sodium (P = .0027), and total protein (P = .0003) concentrations, and packed cell volume (P = .030). Incidence of arrhythmias was similar in treatment groups. CONCLUSIONS AND CLINICAL IMPORTANCE: Pimobendan versus benazepril resulted in similar QoL during the study, but conferred increased time before intensification of CHF treatment. Pimobendan treatment resulted in smaller heart size, higher body temperature, and less retention of free water.
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Benzazepinas/farmacologia , Cardiotônicos/farmacologia , Doenças do Cão/fisiopatologia , Insuficiência Cardíaca/veterinária , Doenças das Valvas Cardíacas/veterinária , Valva Mitral/fisiopatologia , Piridazinas/farmacologia , Animais , Benzazepinas/uso terapêutico , Pressão Sanguínea/fisiologia , Temperatura Corporal/fisiologia , Cardiotônicos/uso terapêutico , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/tratamento farmacológico , Cães , Ecocardiografia/veterinária , Feminino , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/fisiopatologia , Frequência Cardíaca/fisiologia , Doenças das Valvas Cardíacas/diagnóstico por imagem , Doenças das Valvas Cardíacas/tratamento farmacológico , Doenças das Valvas Cardíacas/fisiopatologia , Hematócrito/veterinária , Estimativa de Kaplan-Meier , Estudos Longitudinais , Masculino , Valva Mitral/diagnóstico por imagem , Valva Mitral/efeitos dos fármacos , Estudos Prospectivos , Piridazinas/uso terapêutico , Qualidade de Vida , Método Simples-Cego , Sódio/sangueRESUMO
The curvature of a liquid vapor interface has long been known to change the equilibrium vapor pressure. It has also been shown that a capillary structure will affect the temperature at which both freezing and vaporization of a substance will occur. However, describing interfacial effects on the latent heat of a phase change has proven more difficult. Here, we present a classical thermodynamic model for how the latent heat of melting changes as the size of the particles undergoing the transition decreases. The scale dependence for the surface tension is taken into consideration using a Tolman length correction. The resulting model is tested by fitting to published experimental data for the latent heat of melting for benzene, heptane, naphthalene, and water contained in nano-porous glass. In all cases the model fits the data with a R(2) ≥ 0.94.
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Cruzamento/normas , Doenças do Cão/diagnóstico , Ecocardiografia/veterinária , Cardiopatias/veterinária , Exame Físico/veterinária , Animais , Doenças do Cão/genética , Cães , Ecocardiografia/instrumentação , Ecocardiografia/normas , Eletrocardiografia/veterinária , Cardiopatias/diagnóstico , Cardiopatias/genética , Exame Físico/normas , Registros/veterinária , Índice de Gravidade de Doença , Sociedades , Medicina VeterináriaRESUMO
Reaction-diffusion phenomena are encountered in an astonishing array of natural systems. Under the right conditions, self stabilizing reaction waves can arise that will propagate at constant velocity. Numerical studies have shown that fission waves of this type are also possible and that they exhibit soliton like properties. Here, we derive the conditions required for a solitary fission wave to propagate at constant velocity. The results place strict conditions on the shapes of the flux, diffusive, and reactive profiles that would be required for such a phenomenon to persist, and this condition would apply to other reaction diffusion phenomena as well. Numerical simulations are used to confirm the results and show that solitary fission waves fall into a bistable class of reaction diffusion phenomena.
RESUMO
The Kelvin equation relates the equilibrium vapor pressure of a fluid to the curvature of the fluid-vapor interface and predicts that vapor condensation will occur in pores or irregularities that are sufficiently small. Past analyses of capillary condensation in porous systems with fractal structure have related the phenomenon to the fractal dimension of the pore volume distribution. Recent work, however, suggests that porous systems can exhibit distinct fractal dimensions that are characteristic of both their pore volume and the surfaces of the pores themselves. We show that both fractal dimensions have an effect on the thermodynamics that governs capillary condensation and that previous analyses can be obtained as limiting cases of a more general formulation.
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BACKGROUND: Myxomatous mitral valve disease (MMVD) continues to be an important cause of morbidity and mortality in geriatric dogs despite conventional therapy. HYPOTHESIS: Pimobendan in addition to conventional therapy will extend time to sudden cardiac death, euthanasia for cardiac reasons, or treatment failure when compared with conventional therapy plus benazepril in dogs with congestive heart failure (CHF) attributable to MMVD. ANIMALS: Two hundred and sixty client-owned dogs in CHF caused by MMVD were recruited from 28 centers in Europe, Canada, and Australia. METHODS: A prospective single-blinded study with dogs randomized to PO receive pimobendan (0.4-0.6 mg/kg/d) or benazepril hydrochloride (0.25-1.0 mg/kg/d). The primary endpoint was a composite of cardiac death, euthanized for heart failure, or treatment failure. RESULTS: Eight dogs were excluded from analysis. One hundred and twenty-four dogs were randomized to pimobendan and 128 to benazepril. One hundred and ninety dogs reached the primary endpoint; the median time was 188 days (267 days for pimobendan, 140 days for benazepril hazard ratio = 0.688, 95% confidence limits [CL]=0.516-0.916, P= .0099). The benefit of pimobendan persisted after adjusting for all baseline variables. A longer time to reach the endpoint was also associated with being a Cavalier King Charles Spaniel, requiring a lower furosemide dose, and having a higher creatinine concentration. Increases in several indicators of cardiac enlargement (left atrial to aortic root ratio, vertebral heart scale, and percentage increase in left ventricular internal diameter in systole) were associated with a shorter time to endpoint, as was a worse tolerance for exercise. CONCLUSIONS AND CLINICAL IMPORTANCE: Pimobendan plus conventional therapy prolongs time to sudden death, euthanasia for cardiac reasons, or treatment failure in dogs with CHF caused by MMVD compared with benazepril plus conventional therapy.
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Benzazepinas/uso terapêutico , Doenças do Cão/tratamento farmacológico , Insuficiência Cardíaca/veterinária , Insuficiência da Valva Mitral/veterinária , Piridazinas/uso terapêutico , Animais , Benzazepinas/efeitos adversos , Cardiotônicos/efeitos adversos , Cardiotônicos/uso terapêutico , Cães , Feminino , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/mortalidade , Masculino , Insuficiência da Valva Mitral/complicações , Insuficiência da Valva Mitral/tratamento farmacológico , Análise Multivariada , Modelos de Riscos Proporcionais , Piridazinas/efeitos adversosRESUMO
The relationship between capillary pressure and saturation in a porous medium often exhibits a power-law dependence. The physical basis for this relation has been substantiated by assuming that capillary pressure is directly related to the pore radius. When the pore space of a medium exhibits fractal structure this approach results in a power-law relation with an exponent of 3-D(v), where D(v) is the pore volume fractal dimension. However, larger values of the exponent than are realistically allowed by this result have long been known to occur. Using a thermodynamic formulation for equilibrium capillary pressure we show that the standard result is a special case of the more general exponent (3-D(v))(3-D(s)) where D(s) is the surface fractal dimension of the pores. The analysis reduces to the standard result when D(s)=2, indicating a Euclidean relationship between a pore's surface area and the volume it encloses, and allows for a larger value for the exponent than the standard result when D(s)>2 .
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Defining a relation for equilibrium pressure in a porous medium has been difficult to do in terms of readily measurable parameters. We present a simplified analysis of this problem using the first law of thermodynamics combined with a fractal description of a porous system. The results show that the variation in fluid interfacial area with fluid volume, and the respective interfacial surface tensions, are dominant factors determining equilibrium capillary pressure. Departures from equilibrium are seen to occur when fluid-solid contact lines are in movement. By describing the pore space as fractal we are able to obtain an expression for the change in fluid interfacial area with respect to its volume, and the resulting model shows a strong fit to pressure data obtained from a capillary rise experiment conducted in a coarse-grained SiO2 sand.
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This paper reports on a case of hepatozoonosis of a dog imported from Italy to Germany being additionally infected with Ehrlichia canis and Babesia canis. Furthermore, a survey of the epidemiology of the Hepatozoon canis infection is presented.
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Coccidiose/veterinária , Doenças do Cão , Infecções por Protozoários/etiologia , Animais , Babesiose/complicações , Coccidiose/complicações , Cães , Ehrlichiose/complicações , Ehrlichiose/veterinária , Eucoccidiida , Alemanha/epidemiologia , Itália , Masculino , Infecções por Protozoários/diagnóstico , Infecções por Protozoários/epidemiologia , Infecções por Protozoários/terapiaRESUMO
Enteral force feeding via a feeding tube is a widely accepted, but rarely used technique in practice. Two simple methods are discussed: the nasoesophageal tube, which can be positioned quickly without the need of general anaesthesia for diseases of predictably short duration and the percutaneous gastrostomy tube, which is placed blindly under short general anaesthesia without endoscopic or surgical procedures and which is designed for month long force feeding.