Military Medical Service is able for detection, identification and confirmation of biological agents; it is part of medical protection against CBRN weapons. We are specialized capabilities for in vitro tests, under construction, the maximum containment laboratory designed for work with Risk Group Microorganisms. An efficient primary containment system must be in place, consisting of one or a combination of the following: Class III safety cabinet laboratory, passage of two doors, suit laboratory, controlled access, controlled air system. Negative pressure in the facility, supply and exhaust air must be HEPA-filtered, decontamination of effluents, sterilization of waste and materials, airlock entry ports for specimens, materials and animals must be provided etc. Complementary is an Animal facility for in vivo tests. This is suitable for work with animals that are deliberately inoculated with microorganisms in Risk Group.
Background Left ventricular ejection fraction (LVEF), the single most important metric in cardiology, is the cornerstone on which prognosis is estimated and costly decisions such as whether to implant an ICD are based. LVEF is most often assessed by 2D echocardiography (2DE), although 3D echocardiography (3DE) has been shown repeatedly to be more accurate. Aim of the study. We set out to assess whether using 3DE would reclassify the severity of LV impairment in patients with LVEF < 35% by 2DE. Setting. Tertiary cardiac centre serving a population of one million, and performing approximately 100 ICD implants/year. Methods. Successive patients in sinus rhythm, with good endocardial border definition and LVEF<35% by 2D Simpson’s method, had scans according to the BSE protocol. 3D loops were acquired from the apical 4-chamber view and were analysed off-line using for regional wall motion abnormalities (RWMAs) and LVEF. The patients were classified in subgroups according to EF value: less than 20%, 20-25%, 25-30%, 35% and more than 35%. Moderate LV systolic was defined as LVEF between 35% and 45% and severe as LVEF ≤35%. Results. We studied 100 patients (78 M, mean age (SD) 69.94 (13.54) years). 2DE had been requested for decision-making regarding ICD implantation in 86 patients (86%) and for LVEF measurement after acute coronary syndromes in 14 patients (14%). Regional wall motion abnormalities (RWMAs) were present in half of patients (55%, 51 pts – 56% in LAD territory, 31% in RCA/CX territory and 12% multiple territories). 3D LVEF regrouped 67% of patients: 10% to a lower EF and 57% to a higher EF subgroup. Twenty nine patients (29%) were reclassified from severe LV systolic dysfunction by to 2DE to moderate LV systolic dysfunction by 3DE. Patients with RWMAs were more often reclassified than patients without RWMAs (p=0.006). The LV dimensions were lower for the reclassified patients. The image quality had no effect on reclassification. Conclusion Measuring LVEF by 3DE reclassifies the severity of LV systolic impairment in a substantial proportion of patients with 2D LVEF<35% and RWMAs, which may have important clinical and financial implications by resetting thresholds for costly interventions such as ICD implants.
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.
Nanotechnology is applied in wide-ranging fields including energy, information technology, consumables, medicine, etc. Nanomedicine includes the medical applications of nanomaterials in the fields of diagnosis and treatment. This paper focuses on the application of nanotechnology in medical diagnostics for which the main applications of nanomedicine include the detection and discovery of specific biomarkers and rapid identification of biological agents. The
Chronic inflammation and immunosuppressive treatment may play a role in the etiopathogenesis of cancer in psoriasis patients. We wanted to evaluate the Papanicolaou smear (Pap smear) results of female patients with psoriasis which were performed for cervical cancer screening before the initiation of biological agent treatment. Between April 2019 and November 2021, Pap smear results of female patients with psoriasis were reviewed retrospectively. This study included 70 female psoriasis patients with a mean age of 48.41±11.62 years. 49 (70%) patients were biologically naive, whereas 21 (30%) patients previously received biological agents. Obscuring inflammation was reported in 33 (47.1%) patients. Atrophy, intermediate cell predominance, reactive cellular changes due to inflammation, and both atrophy and reactive cellular changes were detected in 15 (21.4%), 7 (10%), 3 (4.3%) patients, and 1 (1.4%) patient, respectively. No malignancy or intraepithelial lesion was observed in 69 (98.6%) patients, whereas atypical squamous cells of undetermined significance were reported in 1 (1.4%) patient. Infections such as bacterial vaginosis, candidiasis, and actinomycosis were detected in 13 (18.6%) patients. Pap smear tests should be performed in female psoriasis patients to detect premalignant lesions of the cervix before the initiation of biological agent treatment. Moreover, psoriasis treatment guidelines should be updated accordingly.
Psoriasis has been associated with metabolic syndrome and nonalcoholic fatty liver disease. We wanted to investigate the abdominal ultrasonography results of psoriasis patients before biological agent treatment. Between April 2019 and February 2022, abdominal ultrasonography results of psoriasis patients which were performed before biological agent treatment were reviewed retrospectively. This study included 90 patients, 45 females, and 45 males with a mean age of 48.91±13.43 years. The most common ultrasonography finding was increased echogenicity of the liver parenchyma due to steatosis (58.9%) which was followed by an increase in liver size (25.6%), kidney cysts (17.8%), gallstones (8.9%) and increase in spleen size (7.8%). Hepatic steatosis was more frequent in older patients (p<0.001), patients with diabetes (p=0.007), and patients who were previously treated with biological agents (p=0.007). 70.4% of the patients with moderate or severe hepatic steatosis were female. Herein, hepatic steatosis was detected in 53 (58.9%) patients. Nonalcoholic fatty liver disease which presents as hepatic steatosis in early stages has an asymptomatic course and poor prognosis in psoriasis patients. We suggest that abdominal ultrasonography should be performed in psoriasis patients before biological agent treatment, especially in females, patients with advanced age, patients who were previously treated with biological agents, and patients with diabetes.
