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.
Making medical countermeasures requires documentation to assess vulnerabilities, threats and operational risks and bioterrorism through the collection and processing of specific multidisciplinary data in human medicine, veterinary, phytosanitary, the environment, defense and national security, etc. Based on retrospective data and late information (medical intelligence), we can estimate the prospective risk to public health, respectively for troops and civilian population in a given area, the area of operations. The biological military or bioterrorist attack, whether overtly or masqueraded as human or animal epidemics can cause a major biological crisis for troops and the civilian population, for domestic and wild animals, for crops or wild plants or for the environment, which remains contaminated. Therefore, it is important to constantly monitor the situation of infectious diseases in the area of responsibility (national territory, operations theaters) to assess vulnerability, threat and bioterrorist risk but also for making medical anti-bioterrorist countermeasures, which can only be effective by genuine cooperation between all specialized structures of the Ministry of Defense, other departments and the civil society.
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.
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.
