The Human Immunodeficiency Virus (HIV) and the Acquired Immunodeficiency Syndrome (AIDS) remain significant public health concerns worldwide. This review seeks to present an updated perspective on the spread, consequences, and control measures of HIV/AIDS, focusing on military personnel as a particular at-risk group. It starts by outlining general information about the transmission of the virus and summarizing recent global epidemiological trends. This review further explores the difficulties that HIV/AIDS presents in military settings, including policies regarding the management of service members living with the virus. Additionally, it examines several prevention strategies implemented by militaries around the world, such as educational programs, provision of condoms, and efforts to reduce the stigma associated with the infection.
Neurotoxic chemical agents induce complex toxicological effects with major adverse effects for those who are exposed to them. Medical countermeasures include administering atropine, a cholinesterase reactivating oxime and an anticonvulsant. The purpose of this reseach is the optimization of an antidote-based treatment in the intoxication with organophosphates through the synthesis and toxicological testing of new compounds with a pyridin-isonitrosoacetanilide structure and their comparison with obidoxime as reference. The objective of this study was the in vitro/in vivo assessment of the antidote properties and acute toxicity of synthethic oximes active in the exposure to neuroparalytic organophosphates. The CT50 value for obidoxime was estimated, through calculus, to be 3.24 mg/ml and 9.33 ×10 -6 M respectively. The CT50 value for Bis1,3[2-hydroxyimino-N-(pyridyl)acetamide]oxapropandichloride (HIN 2) was estimated to be 2.72 mg/ml and 6.29 ×10 -6 M respectively. The studied compounds showed values close to cellular viability at low and moderate equimolecular concentrations, administered in vitro to a cellular culture of fibroblasts. Bis1,3[2-hydroxyimino-N-(piridyl)acetamide]oxapropandichloride (HIN 2) showed an in vitro cellular viability value smalled than obidoxime at higher equimolecular concentrations, proving itself to be more toxic than obidoxime at high concentrations. Taking into account the close values of CT50, the newly synthethized compound, having this particular characterization from a toxicological standpoint, qualifies for further studies as an antidote.
Acute drug-related acute intoxications or suicidal ideation following overdose with anticonvulsants may cause major morbidity, in many cases requiring intensive care and prolonged periods of hospitalization. The case of a 35-year-old patient known for a history of epilepsy with phenobarbital and carbamazepine treatment is brought to the Emergency Unit by transfer from another hospital in a comatose state with insufficient respiratory performance, bilateral active mydriasis. From the family members' claims, the patient discontinued treatment with phenobarbital two weeks ago. Following interdisciplinary examination, hospitalization in the Neurology Department with the diagnosis of epileptic status is decided. Due to the progressive aggravation of acute respiratory insufficiency, the ventilator support is constituted. Since the biological samples related to probability diagnosis and cerebral imaging were not conclusive, toxicological samples were collected. The GC/MS analytical toxicology screening in urine reveals the presence of carbamazepine and phenobarbital and their plasma levels (5.92 and 92.3 mg/l) as determined by the FPIA method indicate an overdose of phenobarbital therapy. The patient is taken over by the Department of Clinical Toxicology where specific intensive care measures are applied. Clinical evolution is favorable. The psychiatric examination highlights the depressive idea, suicidal ideas, and uselessness. The suicide attempt is confirmed. It also presents a review of the main information about acute poisoning with anticonvulsants, but also about the analytical laboratory methods that bring precious information in establishing the diagnosis of certainty.
One of the great dreams of humanity has been the improvement of its behavioural, affective and emotional status. Depression represents the suffering of beings over their existential course, as a point of passage between the human condition and its destiny. The attempts of psychiatry to introduce efficient and increasingly performing antidepressants represent one of medicine’s great achievements. At the same time, antidepressant overdosing may lead to cardiotoxic manifestations presenting lethal risks as consequences [1]. We hereby present the case of a patient that was poisoned with tianeptine, ingested for suicidal purposes, who survived repetitive episodes of ventricular fibrillation, electrically converted to sinusal rhythm. The GC/MS analytical diagnosis played an essential part in detecting tianeptine in the biological samples. The rapid and very competent therapeutic intervention allowed for the patient’s survival, despite further complications. A review of main tianeptine information is also presented, as this type of intoxication may have deadly consequences.
The biological attack is the artificial spread by various means of pathogens that can cause serious infectious and contagious diseases as well as the spread of germ toxins that can be used by an aggressor as a means of fighting in order to reduce the troops’ fighting force, by causing serious disease outbreaks or by killing people, animals and/or plants. Biological agents are microorganisms and/or microbial, animal or plant toxins, used as specific ammunition for biological weapons or used by terrorists in "bio-chem" attacks. The risks of bioterrorism and biocrime attack in the contemporary world are real, and the history of the 20th century and the beginning of the 21st century confirms this. It is necessary for preventive measures to be implemented on the unlawful use of biological agents. Early medical and non- medical countermeasures must be prepared for the prophylaxis, treatment and cessation of the consequences of any biological attack.
In the current military-political context, with the Cold War having ended, we find ourselves in full anti-terror war, in which Romania is a direct participant, as a member of N.A.T.O. and the E.U., and the issue of biological warfare and bioterrorism is again highly topical but bearing other valences. There is information that there are still laboratories and plants specializing in the research and manufacture of biological weapons. Most of the results of such research are not intended to be published; however, a number of research guidelines that testify to the trends in the improvement of biological weapons and their means of use can be deduced from the data published by researchers from several research institutes. We believe that the threats posed by bioterrorism are real and that it is mandatory to be prepared at any time to prevent, combat and liquidate the consequences of "bio-chem" attacks, respectively the management of the consequences.
Benzodiazepine overdose has various clinical manifestation, mainly regarding the central nervous system (CNS), cardiac and respiratory side effects, but rarely results in significant morbidity and mortality. Acute benzodiazepine poisoning results in dizziness, ataxia, nystagmus, dysarthria, hypoxia, hypothermia, bradycardia, hypotension, apnea, pulmonary aspiration, respiratory depression, coma, cardiopulmonary arrest and death. Anyway, deep nonresponsive coma should be investigated for additional etiologies. On the other hand, human transmissible prion disease has a fatal outcome with no specific treatment.
Mass spectrometry is a chemical analytical method of determining organic substances by comparing their mass spectrum with mass spectra found in system libraries. In the case of biological products, substances of interest, like organophosphorus compounds, must be separated and identified for rapid and good medical measures (antidotism procedures) in acute intoxication case. A gas chromatograph coupled with a Varian mass spectrometer (GC-MS), was used to develop the application. The proposed objective is presenting the medical applicability in acute organophosphorus compounds intoxication management of the GC/MS method (gas chromatography coupled with mass spectrometry) as a separation and identification method for these compounds and their metabolites in urine samples.
Mushroom poisoning is rarely associated with skin involvement. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening mucocutaneous reactions, characterized by extensive necrosis. SJS/TEN overlap includes patients with skin exfoliation between 10 to 30 percent of the body surface area. We report the case of a patient that was assumed to have ingested one type of toxic mushroom within the twelve hours prior to the appearance of skin lesions typical for SJS/TEN overlap syndrome.
Object: The aim of the study is to select the most active new imidazolium-quinuclidinum- oxime, from some similar chemical compounds synthesized in our chemistry department, with sufficient efficacy to decrease the acute toxicity of neurotoxic organophosphates known as nerve agents. Method: The experimental study consist in vivo testing the antidotal efficacy of obidoxime and of selected imidazolium oximes synthesized in our chemistry department. Each oxime was included, by equimolar replacing the obidoxime, in an antidotal formula, which also contains atropine. The above mentioned formula containing atropine and obidoxime was used as reference. The protective ratio, defined as the ratio between the lethal median dose of the poisoned and treated study group and the median lethal dose (LD50) of the poisoned and untreated study groups was one of the used parameters in order to select a new active chemical structure in counteracting the neurotoxic organophosphorus compounds acute toxicity. Another studied parameter was the erythrocyte acetylcholinesterase value measured in whole blood 24 hours after exposure. Results: The protective ratio against an organophosphorus compound were the follow: obidoxime chloride: 2; 1,3- dimethyl-2-hydroxyethyl-imidazolyliodide: 1,75;3-oxime-[3-(2-hidroxyimino-methyl-1-imidazolyl-)- 2oxapropyl]quinuclidin-dichl-oride: 2,5; 1-methyl-quinuclidin-3-iodide: 1,5. The erythrocyte acetycholinesterase main values were the following: the unpoisoned and untreated study group:3,45 ±0,13mmol/dl; the poisoned and untreated study group: 0,89 ±0,09 mmol/dl; the poisoned and 3- oxime-[3-(2-hidroxyimino-methyl-1-imidazolyl-)-2oxapropyl]quinuclidindichloride study group:2,89 ±0,11 mmol/dl; the poisoned and obidoxime treated study group: 2,53±0,15 mmol/dl. Conclusions: quinuclidindichloride synthesized in our chemistry department, has shown a better protective ratio and a more prolonged surviving time than the reference (obidoxime). It has shown the best AChE reactivation of all the synthetized compounds. This compound can be a cheap and good option for replacing obidoxime in the antidotal formula active in nerve agent exposure. 3-oxime-[3-(2-hidroxyimino-methyl-1-imidazolyl-)-2oxapropyl] treated
