Macrosocial determinants of population health in the context of globalization

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55738/1/florey_globalization_2007.pd

Primary cardiac hemangiosarcoma in a horse: echocardiographic and necropsy findings

Cardiac hemangiosarcoma, especially primary, is infrequently reported in the horse and remains a diagnostic challenge because of vague clinical signs and difficulty to reach an antemortem diagnosis. A 17-year-old American Quarter Horse gelding was presented with a history of tongue swelling and secondary aspiration pneumonia. Initial assessment indicated dehydration, and thoracic ultrasound revealed an abnormal structure within the myocardium alongside the previously suspected aspiration pneumonia. A subsequent, complete echocardiogram identified a large, heterogeneous, ill-defined mass invading and replacing the normal myocardium of the right ventricular free wall. Because of lack of improvement the horse was euthanized, and postmortem examination confirmed primary cardiac hemangiosarcoma with no further masses identified in other organs. This case is an unusual presentation of primary cardiac hemangiosarcoma for which echocardiography played a significant role in identifying a cardiac mass

Evaluation of echocardiography and cardiac biomarker concentrations in dogs with gastric dilatation volvulus

Objective To assess abnormalities in concentrations of cardiac troponin I (cTnI), lactate, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in relation to arrhythmias, echocardiographic measurements, and survival in dogs with gastric dilatation volvulus (GDV). Design Prospective observational study. Setting University hospital. Animals Twenty-two dogs with naturally occurring GDV. Samples Concentrations of cTnI, plasma lactate, and NT-proBNP were recorded at presentation to the emergency room, the time closest to echocardiography, and the highest recorded concentrations during hospitalization. Interventions None. Measurements and Main Results Cardiac rhythms were categorized on a 0–4 scale (0 = no ventricular premature complexes [VPCs], 1 = single VPCs, 2 = bigeminy or trigeminy, 3 = couplets or triplets, and 4 = R-on-T phenomenon or ventricular tachycardia). Echocardiography was performed 6–18 hours postoperatively. Fifteen dogs had ventricular arrhythmias during hospitalization (Grade 1 [n = 9], Grade 4 [n = 6]). The highest recorded cTnI concentration was significantly higher in the dogs with Grade 4 (P = 0.002) or Grade 1 (P = 0.001) arrhythmias compared to dogs without arrhythmias. Plasma lactate was significantly correlated with left ventricular internal diameter in diastole (r = −0.52, P = 0.01) and systole (r = −0.57, P = 0.006), left ventricular free wall in diastole (LWDd, r = 0.59, P = 0.004), and interventricular septal thickness in diastole (IVDs, r = 0.65, P = 0.001). Dogs that did not survive to 1 week postdischarge (3/22) had a significantly thicker LVWd (P = 0.04) and IVSd (P = 0.05), and received significantly less fluids in the first 24 (P = 0.02) and 48 hours (P = 0.03) of hospitalization. Conclusions Concentrations of cTnI and NT-proBNP increased during hospitalization, but only cTnI concentrations were significantly higher in dogs with a higher arrhythmia grade. Additional research on the potential role of serial measurement of biomarkers in dogs with GDV is warranted

Flow excursion experiments with a production reactor assembly mockup

A series of power ramp and loss-of-coolant accidents were simulated with an electrically heated mockup of a Savannah River Site production reactor assembly. The one-to-one scale mockup had full multichannel annular geometry in its heated section in addition to prototypical inlet and outlet endfitting hardware. Power levels causing void generation and flow instability in the water coolant flowing through the mockup were found under different transient and quasi-steady state test conditions. A reasonably sharp boundary between initial operating powers leading to or not leading to flow instability were found: that being 0.2 MW or less on power levels of 4 to 6.3 MW. Void generation occurred before, but close to, the point of flow instability. The data were taken in support of the Savannah River reactor limits program and will be used in continuing code benchmarking efforts. 6 refs., 12 figs., 2 tabs