In response to this threat, the medical community must be prepared to respond to a suspected or confirmed bioterrorism event quickly, efficiently, and in a safe manner, providing protection for healthcare personnel, patients, and those individuals who are not certain of their exposure but seek medical care because of panic and the need to receive prophylactic therapy, if available. These isolates also have a matted appearance, look fairly flat, are markedly tacky, and are white or grayish-white in color (77). Fax 502-852-1771; e-mail, Ellenhorn’s medical toxicology: diagnosis and treatment of human poisoning, 2nd ed, In: Ellenhorn’s medical toxicology: diagnosis and treatment of human poisoning, 2nd ed, Disposition of toxic drugs and chemicals in man, 4th ed, NATO handbook on the medical aspects of NBC defensive operations. ��"奈pڈ�� m5S굲�oA�$-\F{�`��Ip�p̈́��Q��i��*�ER��V�T�a��g�O;�M����t��h���-��#�F3�\4��@�}'l-�6hY#~p�=�s����j���I1���������a�ĆP3=&�P���2h�]' Sciuto AM. Complicating the role of the laboratory is the challenge that confronts laboratory personnel in suspecting and recognizing the current targeted agents. Other classifications of diabetes exist, such as gestational diabetes. Turnbull PC. The Germans introduced nerve agents in 1943 and used them to kill millions of people incarcerated in concentration camps. Laboratory Medicine: Advancing Quality in Patient Care, CDC. Dina Greene: The racial groups implied within this question have a disproportionate amount of people living in poverty. According to Troup and Ballantyne (61), determination of cyanide concentrations in blood is useful for biochemical confirmation and after antidotal treatment and other therapeutic measures. These key tests are routinely repeated throughout the patient’s life to determine the effectiveness of treatment [22]. Additionally, adults of childbearing age may seek genetic testing to determine their risk of passing inherited disorders or diseases to their children. We will review selected agents that have previously been considered or used in chemical and biological warfare, discuss the mechanisms by which these agents act, and outline the techniques used for their identification. Analysis of 1,1′-sulphonylbis[2-(methylsulphinyl)ethane] and 1-methylsulphinyl-2-[2-(methylthio)ethylsulphonyl] ethane, metabolites of sulfur mustard, in urine using gas chromatography-mass spectrometry. We will review representative agents from each class of these chemicals (Table 1 ). In addition to testing performed to diagnose specific conditions and monitor treatment, lifelong health screenings are a cost-effective preventative measure that can detect risk early, leading to better prognoses and more favorable outcomes. Gabrielle Winston-McPherson: I think improving health disparities requires 3 actions: (a) identification and characterization of the disparity, (b) root cause analysis to determine the underlying reason, and finally (c) evidence-based intervention. Table 2 lists the various bacteria and viruses that should be considered as possible agents in a bioterrorism attack. Friedman HM. Sulfur mustard is considered a vesicant because of its blistering properties, which affect the skin, eyes, and respiratory tract (29). Dina Greene: HIV-prevention policies focused on access to antiretroviral therapies and preexposure prophylactic have been instrumental in decreasing viral transmission and increasing the longevity of those infected with HIV. Smears of cells from vesicles contain large eosinophilic cytoplasmic inclusion bodies, the detection of which can provide a simple test for smallpox (82). Flingner CL, Luthi R, Linkaityte-Weiss E, Raisys VA. Paper strip screening method for detection of cyanide in blood using CYANTESMO test paper. Exposure to chlorine gas can be measured by automated portable sensors, which are based on electrochemical conversion of the gas molecule to two Cl− ions. This contribution by clinical laboratory professionals is the benchmark essence of personalized/precision medicine, revolutionized with novel diagnostic and treatment procedures. Parce JW, Owicki JC, Kercso KM, Sigal GB, Wada HG, Muir VC, et al. In the case of chemical warfare, rapid identification of the specific agents involved can be important in designing treatment strategies. This was attributed to the production of hydrochloric acid on the moist surface of his clothing, which was comparable to the surface of litmus pH paper indicating acid formation (47). Similarly in lung cancer, testing of EGFR mutations and ALK rearrangements is recommended in all patients with advanced stage adenocarcinoma to guide treatment with epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) inhibitors [39]. <<8a6688e1004e2840acd1ed832689d923>]>> Regardless of the type of agent used in an attack (i.e., chemical or biological), it is important to provide sufficient protection for laboratory personnel who will analyze suspicious environmental materials, air samples, and specimens collected from humans. It currently has extensive use in various industries, e.g., in the production of dyes, plastics, polyurethanes, pesticides, and pharmaceuticals (50).
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