142 results match your criteria CBRNE - Lung-Damaging Agents Phosgene


A cross-sectional multicenter linkage study of hospital admissions and mortality due to methanol poisoning in Iranian adults during the COVID-19 pandemic.

Sci Rep 2022 Jun 13;12(1):9741. Epub 2022 Jun 13.

Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

A methanol poisoning outbreak occurred in Iran during the initial months of coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the epidemiology of the outbreak in terms of hospitalizations and deaths. A cross-sectional linkage study was conducted based on the hospitalization data collected from thirteen referral toxicology centers throughout Iran as well as mortality data obtained from the Iranian Legal Medicine Organization (LMO). Read More

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Peppermint protocol: first results for gas chromatography-ion mobility spectrometry.

J Breath Res 2022 May 26;16(3). Epub 2022 May 26.

Centre for Analytical Science, Department of Chemistry, Loughborough University, Loughborough, United Kingdom.

Theseeks to inform the standardisation of breath analysis methods. Fivewith gas chromatography-ion mobility spectrometry (GC-IMS), operating in the positive mode with a tritiumH 5.68 keV, 370 MBq ionisation source, were undertaken to provide benchmarkdata for this technique, to support its use in breath-testing, analysis, and research. Read More

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Clinical effect of ethanol co-use in patients with acute drug toxicity involving the use of central nervous system depressant recreational drugs.

Eur J Emerg Med 2022 Apr 8. Epub 2022 Apr 8.

Division of Clinical Toxicology and Poison Control Centre Munich, Department of Internal Medicine II, TUM School of Medicine, Technical University of Munich, Germany.

Background And Importance: Patients who use recreational drugs frequently co-ingest ethanol, which is considered a central nervous system (CNS) depressant. The clinical relevance of this in acute toxicity involving other CNS depressants is not well described.

Objective: To assess the clinical impact of ethanol co-use in patients presenting to the emergency department (ED) with acute toxicity involving the use of CNS depressant drugs. Read More

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Differences in clinical features associated with cannabis intoxication in presentations to European emergency departments according to patient age and sex.

Clin Toxicol (Phila) 2022 Apr 11:1-8. Epub 2022 Apr 11.

Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.

Objective: To investigate if clinical features associated with acute cannabis intoxication in patients presenting to Emergency Departments for medical assistance differ according to patient age and sex.

Methods: We analysed presentations in the Euro-DEN Plus dataset from 2014 to 2019 in which cannabis was the only drug involved (except for alcohol), and age, sex and alcohol co-ingestion had been recorded. Age was considered as categorical (five groups; <20, 20-29, 30-39, 40-49 and ≥50 years), and sex as binary variable (male/female). Read More

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Preparing railway stakeholders against CBRNe threats through better cooperation with security practitioners.

Appl Ergon 2022 Jul 5;102:103752. Epub 2022 Apr 5.

Deutsche Hochschule der Polizei (DHPol), Germany.

This paper presents partial results from the Horizon2020 PROACTIVE project, following a set of literature reviews and surveys conducted with first responder organisations and rail security experts. Qualitative and quantitative data from two surveys are being presented. The results provide an overview of the CBRNe (Chemical, Biological, Radiological, Nuclear and explosive) preparedness and response capabilities of railway stakeholders and how these relate to a wider context represented by CBRNe first responders. Read More

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Chemical Agent Use in Terrorist Events: A Gathering Storm Requiring Enhanced Civilian Preparedness.

Prehosp Disaster Med 2022 Jun 8;37(3):327-332. Epub 2022 Apr 8.

Director, BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center; Associate Professor, Harvard Medical School, Boston, Massachusetts, USA.

Background: The use of chemical weapons in terrorist attacks, though rare, remains a significant challenge and concern due to their ability to inflict mass casualties. Chemical attacks remain a topic of interest for Disaster Medicine (DM) and Counter-Terrorism Medicine (CTM) specialists and are clearly an area in need of enhanced preparedness. This study aims to provide an epidemiological description of all terrorism-related attacks using chemical agents as a primary weapon, sustained from 1970 - 2019. Read More

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The serum glycolate concentration: its prognostic value and its correlation to surrogate markers in ethylene glycol exposures.

Clin Toxicol (Phila) 2022 Mar 24:1-10. Epub 2022 Mar 24.

Research Center, CIUSSS du Nord-de-l'île-de-Montréal, University of Montreal, Montreal, QC, Canada.

Context: Ethylene glycol poisoning manifests as metabolic acidemia, acute kidney injury and death. The diagnosis and treatment depend on history and biochemical tests. Glycolate is a key toxic metabolite that impacts prognosis, but assay results are not widely available in a clinically useful timeframe. Read More

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Treating ethylene glycol poisoning with alcohol dehydrogenase inhibition, but without extracorporeal treatments: a systematic review.

Clin Toxicol (Phila) 2022 Mar 21:1-14. Epub 2022 Mar 21.

Research Center, CIUSSS du Nord-de-l'île-de-Montréal, University of Montreal, Montreal, QC, Canada.

Context: Ethylene glycol is metabolized to toxic metabolites that cause acute kidney injury, metabolic acidemia, and death. The treatment of patients with ethylene glycol poisoning includes competitively inhibiting alcohol dehydrogenase with ethanol or fomepizole to prevent the formation of toxic metabolites, and extracorporeal treatments such as hemodialysis to remove ethylene glycol and its metabolites. In the absence of significant metabolic acidemia or kidney injury, it is hypothesized that extracorporeal treatments may be obviated without adverse outcomes to the patient if alcohol dehydrogenase inhibitors are used. Read More

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Gaps in Prehospital Care for Patients Exposed to a Chemical Attack - A Systematic Review.

Prehosp Disaster Med 2022 Mar 11:1-10. Epub 2022 Mar 11.

Retired - Royal Canadian Medical Service.

Introduction: The survivability of mass casualties exposed to a chemical attack is dependent on clinical knowledge, evidence-based practice, as well as protection and decontamination capabilities. The aim of this systematic review was to identify the knowledge gaps that relate to an efficient extraction and care of mass casualties caused by exposure to chemicals.

Methods: This systematic review was conducted from November 2018 through September 2020 in compliance with Cochrane guidelines. Read More

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Dispersion of SARS-CoV-2 in air surrounding COVID-19-infected individuals with mild symptoms.

Indoor Air 2022 02;32(2):e13001

Norwegian Defence Research Establishment, Kjeller, Norway.

Since the beginning of the pandemic, the transmission modes of SARS-CoV-2-particularly the role of aerosol transmission-have been much debated. Accumulating evidence suggests that SARS-CoV-2 can be transmitted by aerosols, and not only via larger respiratory droplets. In this study, we quantified SARS-CoV-2 in air surrounding 14 test subjects in a controlled setting. Read More

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February 2022

Effectiveness of a UVC air disinfection system for the HVAC of an ICU.

Eur Phys J Plus 2022 18;137(1):37. Epub 2021 Dec 18.

Departamento de Física, Universidade Federal de Sergipe, São Cristóvão, SE 49100-000 Brazil.

Ultraviolet germicidal irradiation (UVGI) uses short-wave ultraviolet (UVC) light to inactivate organisms like viruses, bacteria, and fungi. UVC inactivates a wide range of microorganisms by damaging the structure of nucleic acids and proteins at the molecular level, so they become unable to replicate and cause disease. Thus, UVC can improve indoor air quality by controlling bioaerosols and can be used as an engineering device to interrupt the transmission of pathogenic organisms and potential bioterrorism agents. Read More

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December 2021

Complement ratios C3bc/C3 and sC5b-9/C5 do not increase the sensitivity of detecting acute complement activation systemically.

Mol Immunol 2022 01 11;141:273-279. Epub 2021 Dec 11.

Department of Immunology, Oslo University Hospital and University of Oslo, Norway; Division of Emergencies and Critical Care, Oslo University Hospital, Norway. Electronic address:

Background: Complement activation plays an important pathogenic role in numerous diseases. The ratio between an activation product and its parent protein is suggested to be more sensitive to detect complement activation than the activation product itself. In the present study we explored whether the ratio between the activation product and the parent protein for C3 (C3bc/C3) and for C5 (sC5b-9/C5) increased the sensitivity to detect complement activation in acute clinical settings compared to the activation product alone. Read More

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January 2022

Cardiac Arrest in a Patient With Arrhythmic Mitral Valve Prolapse Syndrome: Multiple Possible Etiologies.

JACC Case Rep 2021 Nov 17;3(16):1769-1773. Epub 2021 Nov 17.

ProCardio Centre for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Arrhythmic mitral valve prolapse syndrome is associated with a high risk of death. A 60-year-old man with arrhythmic mitral valve prolapse syndrome was monitored with an implantable loop recorder. Nine months later dyspnea developed, followed by cardiac arrest. Read More

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November 2021

Osmolal and anion gaps after acute self-poisoning with agricultural formulations of the organophosphorus insecticides profenofos and diazinon: A pilot study.

Basic Clin Pharmacol Toxicol 2022 Feb 3;130(2):320-327. Epub 2021 Dec 3.

South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.

Self-poisoning with organophosphorus (OP) insecticides is an important means of global self-harm. The insecticides are formulated with solvents that may also contribute to toxicity. We set up a study to detect changes in osmolal and anion gaps following ingestion of OP insecticides. Read More

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February 2022

Survey about Intention to Engage in Specific Disaster Activities among Disaster Medical Assistance Team Members.

Prehosp Disaster Med 2021 Dec 18;36(6):684-690. Epub 2021 Oct 18.

Department of Radiation Disaster Medicine, Fukushima Medical University, Fukushima, Japan.

Introduction: Different disaster activities should be performed smoothly. In relation to this, human resources for disaster activities must be secured. To achieve a stable supply of human resources, it is essential to improve the intentions of individuals responding to each type of disaster. Read More

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December 2021

Fomepizole dosing during continuous renal replacement therapy - an observational study.

Clin Toxicol (Phila) 2022 Apr 29;60(4):451-457. Epub 2021 Sep 29.

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

Background: Fomepizole is the preferred antidote for treatment of methanol and ethylene glycol poisoning, acting by inhibiting the formation of the toxic metabolites. Although very effective, the price is high and the availability is limited. Its availability is further challenged in situations with mass poisonings. Read More

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Half-a-Century of Terrorist Attacks: Weapons Selection, Casualty Outcomes, and Implications for Counter-Terrorism Medicine.

Prehosp Disaster Med 2021 Oct 16;36(5):526-530. Epub 2021 Aug 16.

Director, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Beth Israel Deaconess Medical Center; Associate Professor, Harvard Medical School, Boston, MassachusettsUSA.

Background: High profile terrorist attacks in major capital cities have seemingly become a regular occurrence and the resultant mass-casualty events continue to challenge health care systems. Counter-Terrorism Medicine (CTM) addresses unique terrorism-related issues relating to the mitigation, preparedness, and response measures to asymmetric, multi-modality terrorist attacks. This study is an epidemiological examination of all terrorism-related events sustained from 1970-2019, analyzing historical weapon types used and the resulting fatal injuries (FI) and non-fatal injuries (NFI) sustained. Read More

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October 2021

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

Authors:
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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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 Oct 16;59(10):896-904. 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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October 2021

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 Dec;16(6):e200-e205

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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December 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