126 results match your criteria CBRNE – Biological Warfare Agents

'Life communication' after the 2011 Fukushima nuclear disaster: what experts need to learn from residential non-scientific rationality.

Sae Ochi

J Radiat Res 2021 May;62(Supplement_1):i88-i94

Department of Laboratory Medicine, The Jikei University School of Medicine, Katsushika-ku, Aoto 6-41-2, Tokyo, 125-0062, Japan.

After chemical, biological, radiological, nuclear or explosive (CBRNE) disasters, trepidation and infodemics about invisible hazards may cause indirect casualties in the affected society. Effective communication regarding technical issues between disaster experts and the residents is key to averting such secondary impacts. However, misconceptions about scientific issues and mistrust in experts frequently occur even with intensive and sincere communications. Read More

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Decontamination effectiveness and the necessity of innovation in a large-scale disaster simulation.

Am J Disaster Med 2021 Winter;16(1):67-73

Associate Professor, Institute of Health Sciences Education and Department of Medicine, McGill University, Montreal, Canada.

Background: Chemical, biological, radiologic, nuclear, and explosive (CBRNE) events threaten the health and integrity of human populations across the globe. Effective decontamination is a central component of CBRNE disaster response.

Objective: This paper provides an objective determination of wet decontamination effectiveness through the use of a liquid-based contaminant proxy and describes the mobilization and adaptation of easily available materials for the needs of decontamination in pediatric victims. Read More

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Formate test for bedside diagnosis of methanol poisoning.

Basic Clin Pharmacol Toxicol 2021 Jul 12;129(1):86-88. Epub 2021 May 12.

Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.

Methanol poisoning kills thousands of people every year and remains a diagnostic challenge, especially where the resources are scarce, but also in high-income countries worldwide. We are in the course of developing a bedside strip to detect formate - the toxic metabolite of methanol. We hereby present the first clinical methanol case where formate was detected bedside from a drop of blood: The patient, a 61-year-old male, was admitted with a suspect methanol poisoning and severe metabolic acidosis. Read More

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Characterization of a highly neutralizing single monoclonal antibody to botulinum neurotoxin type A.

FASEB J 2021 May;35(5):e21540

Institut Pasteur, Unité des Toxines Bactériennes, UMR CNRS 2001, Paris, France.

Compared to conventional antisera strategies, monoclonal antibodies (mAbs) represent an alternative and safer way to treat botulism, a fatal flaccid paralysis due to botulinum neurotoxins (BoNTs). In addition, mAbs offer the advantage to be produced in a reproducible manner. We previously identified a unique and potent mouse mAb (TA12) targeting BoNT/A1 with high affinity and neutralizing activity. Read More

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Rapid Denaturing Organic Digestion Method for Targeted Protein Identification and Characterization.

Anal Chem 2021 03 17;93(12):5046-5053. Epub 2021 Mar 17.

Nottingham Trent University, Clifton Campus, College Drive, Nottingham NG11 8NS, U.K.

Bottom-up mass spectrometry-based protein analysis methods employing protease digestion are routinely used to identify and characterize proteins with high specificity and sensitivity. Method performance is generally measured by sequence coverage capability and the total number of characteristic peptides identified, when compared to predicted databases. Limitations to commonly used solvent-based digestion methods currently employed include long digestion times (18-24 h or more), leading to protease autolysis, which also precludes automation, decreases sensitivity, and increases both intra- and inter-day performance variability. Read More

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Variation of drugs involved in acute drug toxicity presentations based on age and sex: an epidemiological approach based on European emergency departments.

Clin Toxicol (Phila) 2021 Mar 16:1-13. Epub 2021 Mar 16.

Emergency Department, Hospital Clínic, IDIBAPS, Barcelona, Spain.

Objective: To analyse the relative percentage of acute recreational drug toxicity emergency department (ED) presentations involving the main drug groups according to age and sex and investigate different patterns based on sex and age strata.

Methods: We analysed all patients with acute recreational drug toxicity included by the Euro-DEN Plus dataset (22 EDs in 14 European countries) between October 2013 and December 2016 (39 months). Drugs were grouped as: opioids, cocaine, cannabis, amphetamines, gamma-hydroxybutyrate (GHB), hallucinogens, new psychoactive substances (NPS), benzodiazepines and ketamine. Read More

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1ST Cavalry Division Forward's Defender Europe 2020 Plus: Lessons Learned Fighting in a Biological Contested Environment.

Med J (Ft Sam Houst Tex) 2021 Jan-Mar(PB 8-21-01/02/03):144-149

Deputy Division Surgeon/Medical OPS, 1st Cavalry Division.

The 1st Cavalry Division Forward (1CD FWD) along with Polish ally, subordinate brigades, adjacent supporting commands, and the 7th Army Training Command successfully executed large scale combat operations training in the Defender Europe 2020 Plus (DE20P) exercise in a biologically compromised environment. The coronavirus 2019 (COVID-19) presented many unique challenges and opportunities across all warfighting functions. Still, it proved that it is possible to train in a large-scale multinational exercise while effectively mitigating the contraction and contamination of COVID-19. Read More

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Evaluating the disaster preparedness of emergency medical service agencies in the world: A systematic literature review protocol.

J Educ Health Promot 2020 29;9:351. Epub 2020 Dec 29.

MD National Emergency Medical Organization, Tehran, Iran.

Introduction: Disasters occur almost everywhere in the world, and preparation is essential. Preparedness is an effective approach for disaster management, and it is crucial for the health systems, especially the Emergency Medical Service (EMS) agencies. This systematic review will be conducted to assess the preparedness levels of EMS agencies in the world for the response to disasters and explore the key dimensions and strategies to enhance it. Read More

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December 2020

Ricin Antibodies' Neutralizing Capacity against Different Ricin Isoforms and Cultivars.

Toxins (Basel) 2021 01 29;13(2). Epub 2021 Jan 29.

Paris-Saclay University, CEA, INRAE, Medicines and Healthcare Technologies Department (DMTS), SPI, 91191 Gif-sur-Yvette, France.

Ricin, a highly toxic protein from , is considered a potential biowarfare agent. Despite the many data available, no specific treatment has yet been approved. Due to their ability to provide immediate protection, antibodies (Abs) are an approach of choice. Read More

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January 2021

A survey of the antidote preparedness in Norwegian hospitals.

Eur J Hosp Pharm 2021 Jan 22. Epub 2021 Jan 22.

Norwegian National Unit for CBRNE Medicine, Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.

Objectives: Antidotes are an important part of the emergency preparedness in hospitals. In the case of a major chemical accident or a fire, large quantities of antidotes may be needed within a short period of time. For time-critical antidotes it is therefore necessary that they be immediately available. Read More

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January 2021

Life-Saving Procedures Performed While Wearing CBRNe Personal Protective Equipment: A Mannequin Randomized Trial.

Simul Healthc 2021 Jan 8;Publish Ahead of Print. Epub 2021 Jan 8.

From the Department of Medicine (DIMED) (G.M., M.P., C.A., S.S., F.F.), University of Padova, Padova; Venice Emergency Medical Service Operations Center (N.B., D.P.), Venezia; and Istituto di Anestesia e Rianimazione-Azienda Ospedaliera Universitaria di Padova (A.G., P.N.), Padova, Italy.

Introduction: Chemical-biological-radiological-nuclear-explosive (CBRNe) are complex events. Decontamination is mandatory to avoid harm and contain hazardous materials, but can delay care. Therefore, the stabilization of patients in the warm zone seems reasonable, but research is limited. Read More

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January 2021

Testing the identification effectiveness of an unknown outbreak of the Infectious Diseases Seeker (IDS) using and comparing the novel coronavirus disease (COVID-19) outbreak with the past SARS and MERS epidemics.

J Infect Public Health 2021 Jan 9;14(1):123-130. Epub 2020 Dec 9.

Department of Industrial Engineering, University of Rome "Tor Vergata", Italy.

Background: The aim of this research is to assess the predictive accuracy of the Infectious Diseases Seeker (IDS) - an innovative tool for prompt identification of the causative agent of infectious diseases during outbreaks - when field epidemiological data collected from a novel outbreak of unknown origin are analysed by the tool. For this reason, it has been taken into account the novel coronavirus disease (COVID-19) outbreak, which began in China at the end of December 2019, has rapidly spread around the globe, and it has led to a public health emergency of international concern (PHEIC), declared to the 30th of January 2020 by the World Health Organization (WHO).

Methods: The IDS takes advantage of an off-line database, built before the COVID-19 pandemic, which represents a pivotal characteristic for working without an internet connection. Read More

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January 2021

Improving Quantification of tabun, sarin, soman, cyclosarin, and sulfur mustard by focusing agents: A field portable gas chromatography-mass spectrometry study.

J Chromatogr A 2021 Jan 13;1636:461784. Epub 2020 Dec 13.

Hazardous Materials Research Center (HMRC), Battelle Columbus Laboratories, Battelle Memorial Institute, Columbus, OH, USA.

Commercial gas chromatograph-mass spectrometers, one of which being Inficon's HAPSITE® ER, have demonstrated chemical detection and identification of nerve agents (G-series) and blistering agents (mustard gas) in the field; however most analyses relies on self-contained or external calibration that inherently drifts over time. We describe an analytical approach that uses target-based thermal desorption standards, called focusing agents, to accurately calculate concentrations of chemical warfare agents that are analyzed by gas chromatograph-mass spectrometry. Here, we provide relative response factors of focusing agents (2-chloroethyl ethyl sulfide, diisopropyl fluorophosphate, diethyl methylphosphonate, diethyl malonate, methyl salicylate, and dichlorvos) that are used to quantify concentrations of tabun, sarin, soman, cyclosarin and sulfur mustard loaded on thermal desorption tubes (Tenax® TA). Read More

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January 2021

Protection Level and Reusability of a Modified Full-Face Snorkel Mask as Alternative Personal Protective Equipment for Healthcare Workers during the COVID-19 Pandemic.

Chem Res Toxicol 2021 01 17;34(1):110-118. Epub 2020 Dec 17.

Institute of Environmental Engineering, Department of Civil, Environmental and Geomatic Engineering, ETH Zurich, Zurich 8093, Switzerland.

The worldwide outbreak of COVID-19 has drastically increased pressure on medical resources and highlighted the need for rapidly available, large-scale, and low-cost personal protective equipment (PPE). In this work, an alternative full-face mask is adapted from a modified snorkel mask to be used as PPE with two medical-grade filters and a 3D-printed adapter. Since the mask covers the eyes, mouth, and nose, it acts as a full-face shield, providing additional protection to healthcare workers. Read More

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January 2021

Disaster Preparedness among Emergency Medical Service Providers: A Systematic Review Protocol.

Emerg Med Int 2020 26;2020:6102940. Epub 2020 Oct 26.

Health in Emergency and Disaster Research Center, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

. The emergency medical service (EMS) provides first-line medical care to people who require urgent medical care in emergency and disaster situations. Preparedness is the most effective approach for the management of disaster risks, and it is essential for the emergency medical service (EMS) providers, such as paramedics, emergency medical technicians (EMT), and other EMS personnel. Read More

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October 2020

Natural outbreaks and bioterrorism: How to deal with the two sides of the same coin?

J Glob Health 2020 Dec;10(2):020317

Bacteriology Unit, French Armed Forces Biomedical Research Institute (IRBA), Bretigny sur Orge, France.

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December 2020

First Prototype of the Infectious Diseases Seeker (IDS) Software for Prompt Identification of Infectious Diseases.

J Epidemiol Glob Health 2020 12 21;10(4):367-377. Epub 2020 Jul 21.

Department of Industrial Engineering, University of Rome Tor Vergata, Rome, Italy.

The rapid detection of ongoing outbreak - and the identification of causative pathogen - is pivotal for the early recognition of public health threats. The emergence and re-emergence of infectious diseases are linked to several determinants, both human factors - such as population density, travel, and trade - and ecological factors - like climate change and agricultural practices. Several technologies are available for the rapid molecular identification of pathogens [e. Read More

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December 2020

Pediatric Mass Casualty Preparedness.

Alison R Perate

Anesthesiol Clin 2020 Sep 15;38(3):509-516. Epub 2020 Jul 15.

Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address:

Disaster medicine refers to situations in which the need to care for patients outweighs the available resources. It is imperative for anesthesiologists to be involved at a leadership level in mass casualty/disaster preparedness planning. Mass casualty disaster plans should be clear, concise, and easy to follow. Read More

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September 2020

MDMA-related presentations to the emergency departments of the European Drug Emergencies Network plus (Euro-DEN Plus) over the four-year period 2014-2017.

Clin Toxicol (Phila) 2021 02 17;59(2):131-137. Epub 2020 Jul 17.

Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland.

Context: 3,4-Methylenedioxymethamphetamine (MDMA) remains one of the most commonly used recreational drugs in Europe. Monitoring of Emergency Department (ED) presentations with acute toxicity associated with MDMA is important to determine trends in MDMA use and harms.

Methods: Data were extracted from the European Drug Emergencies Network (Euro-DEN) Plus database for all ED presentations with acute toxicity involving MDMA use, alone or in combination with other substances, between 1 January 2014 and 31 December 2017. Read More

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February 2021

Shiga Toxin Uptake and Sequestration in Extracellular Vesicles Is Mediated by Its B-Subunit.

Toxins (Basel) 2020 07 10;12(7). Epub 2020 Jul 10.

Department of Pediatrics, Clinical Sciences Lund, Lund University, 22185 Lund, Sweden.

Shiga toxin (Stx)-stimulated blood cells shed extracellular vesicles (EVs) which can transfer the toxin to the kidneys and lead to hemolytic uremic syndrome. The toxin can be taken up by renal cells within EVs wherein the toxin is released, ultimately leading to cell death. The mechanism by which Stx is taken up, translocated, and sequestered in EVs was addressed in this study utilizing the B-subunit that binds to the globotriaosylceramide (Gb3) receptor. Read More

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Fentanyl and carfentanil permeation through commercial disposable gloves.

J Occup Environ Hyg 2020 09 13;17(9):398-407. Epub 2020 Jul 13.

National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory (NPPTL), Pittsburgh, Pennsylvania.

In 2018, the Centers for Disease Control and Prevention reported that opioid overdose deaths (including fentanyl and carfentanil) comprised 46,802 (69%) of the 67,367 total drug overdose deaths. The opioid overdose epidemic affects Americans not only at home but also in the workplace. First responders may be at risk of opioid exposure during incidents such as vehicle searches and responses to overdose calls. Read More

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September 2020

Double trouble: methanol outbreak in the wake of the COVID-19 pandemic in Iran-a cross-sectional assessment.

Crit Care 2020 07 9;24(1):402. Epub 2020 Jul 9.

The Norwegian CBRNE Centre of Medicine, Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.

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Acute toxicity related to misuse (nonmedical use) of tramadol: Experience of the European Drug Emergencies Network Plus.

Br J Clin Pharmacol 2021 Apr 15;87(4):1668-1675. Epub 2020 Jul 15.

Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.

Following the development of the tramadol crisis currently affecting countries in the Middle East, and Africa, there has been increasing international interest in the regulation of tramadol. This study investigates the misuse of tramadol in patients presenting to emergency departments across Europe. Data from 32 emergency departments in 21 countries were extracted from the Euro-DEN Plus database for the 4-year period from 1 January 2014 to 31 December 2017. Read More

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Antitumor, Anti-Inflammatory and Antiallergic Effects of Mushroom Extract and the Related Medicinal Basidiomycetes Mushrooms, and : A Review of Preclinical and Clinical Studies.

Nutrients 2020 May 8;12(5). Epub 2020 May 8.

Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway.

Since the 1980s, medicinal effects have been documented in scientific studies with the related mushrooms Murill (AbM), (HE) and (GF) from Brazilian and Eastern traditional medicine. Special focus has been on their antitumor effects, but the mushrooms' anti-inflammatory and antiallergic properties have also been investigated. The antitumor mechanisms were either direct tumor attack, e. Read More

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NETs analysed by novel calprotectin-based assays in blood donors and patients with multiple myeloma or rheumatoid arthritis: A pilot study.

Scand J Immunol 2020 May 4;91(5):e12870. Epub 2020 Mar 4.

Department of Immunology and Transfusion Medicine, Oslo University Hospital (OUH), Oslo, Norway.

Two novel enzyme-linked immunosorbent assays (ELISAs), designed to detect complexes containing DNA, leucocyte calprotectin and S100A12 proteins, were generated for improved specificity and rapid measurement of neutrophil extracellular traps (NETs). The assays were applied on plasma and serum samples from blood donors for establishment of reference values, and from patients with multiple myeloma (MM) or rheumatoid arthritis (RA) in order to examine putatively increased values in the two different inflammatory conditions. Although NETs were hardly detectable in healthy individuals, NET levels were as expected highly and statistically significantly increased in RA patients. Read More

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Fatal liver failure after therapeutic doses of paracetamol in a patient with Duchenne muscular dystrophy and atypical pharmacogenetic profile of drug-metabolizing enzymes.

Basic Clin Pharmacol Toxicol 2020 Jul 5;127(1):47-51. Epub 2020 Feb 5.

Norwegian National Unit for CBRNE Medicine, Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.

Paracetamol has a good safety profile, but pharmacogenetic differences in drug-metabolizing enzymes may have an impact on its risk of hepatotoxicity. We present a case of fatal acute liver failure (ALF) after therapeutic doses of paracetamol in a patient with Duchenne muscular dystrophy, where pharmacogenetic screening was conducted. This 30-year-old man was electively admitted for a tracheostomy. Read More

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Offline Next Generation Metagenomics Sequence Analysis Using MinION Detection Software (MINDS).

Genes (Basel) 2019 07 30;10(8). Epub 2019 Jul 30.

US Army, CCDC-Chemical Biological Center, Aberdeen Proving Ground, MD 21010, USA.

Field laboratories interested in using the MinION often need the internet to perform sample analysis. Thus, the lack of internet connectivity in resource-limited or remote locations renders downstream analysis problematic, resulting in a lack of sample identification in the field. Due to this dependency, field samples are generally transported back to the lab for analysis where internet availability for downstream analysis is available. Read More

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Consensus statements on the approach to patients in a methanol poisoning outbreak.

Clin Toxicol (Phila) 2019 12 22;57(12):1129-1136. Epub 2019 Jul 22.

The Norwegian CBRNE Centre of Medicine, Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.

Methanol poisoning is an important cause of mortality and morbidity worldwide. Although it often occurs as smaller sporadic events, epidemic outbreaks are not uncommon due to the illicit manufacture and sale of alcoholic beverages. We aimed to define methanol poisoning outbreak (MPO), outline an approach to triaging an MPO, and define criteria for prioritizing antidotes, extracorporeal elimination treatments (i. Read More

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December 2019

Clinical relevance of ethanol coingestion in patients with GHB/GBL intoxication.

Toxicol Lett 2019 Oct 10;314:37-42. Epub 2019 Jul 10.

Emergency Department, Hospital Clínic, Barcelona, IDIBAPS, Barcelona, Spain; Medical School, University of Barcelona, Spain.

Objective: Ethanol intake can increase the sedative effects of gamma-hydroxybutyrate/gamma-butyrolactone (GHB/GBL), although the real clinical impact is unknown. We studied the clinical impact of the co-ingestion of ethanol in patients presenting to the Emergency Department (ED) with acute toxicity related to GHB/GBL use.

Method: We performed a secondary analysis of the Euro-DEN Plus Registry (14 countries, 22 EDs) which includes 17,371 consecutive patients presenting to the ED with acute recreational drug toxicity over 39 consecutive months (October 2013 - December 2016). Read More

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October 2019