Optimization of Nonambulant Mass Casualty Decontamination Protocols as Part of an Initial or Specialist Operational Response to Chemical Incidents

Objective: The UK's Initial Operational Response (IOR) is a new process for improving the survival of multiple casualties following a chemical, biological, radiological or nuclear incident. Whilst the introduction of IOR represents a patient-focused response for ambulant casualties, there is currently no provision for disrobe and dry decontamination of nonambulant casualties. Moreover, the current specialist operational response (SOR) protocol for nonambulant casualty decontamination (also referred to as “clinical decontamination”) has not been subject to rigorous evaluation or development. Therefore, the aim of this study was to confirm the effectiveness of putatively optimized dry (IOR) and wet (SOR) protocols for nonambulant decontamination in human volunteers. Methods: Dry and wet decontamination protocols were objectively evaluated using human volunteers. Decontamination effectiveness was quantified by liquid chromatography–mass spectrometry analysis of the recovery of a chemical warfare agent simulant (methylsalicylate) from skin and hair of volunteers, with whole-body fluorescence imaging to quantify the skin distribution of residual simulant. Results: Both the dry and wet decontamination processes were rapid (3 and 4 min, respectively) and were effective in removing simulant from the hair and skin of volunteers, with no observable adverse effects related to skin surface spreading of contaminant. Conclusions: Further studies are required to assess the combined effectiveness of dry and wet decontamination under more realistic conditions and to develop appropriate operational procedures that ensure the safety of first responders.     

Comprendre le cancer du sein: guide d’information SOR SAVOIR PATIENT à destination des patientes et de leurs proches

In response to the evolution of the information-seeking behaviour of patients and concerns fromhealth professionals regarding cancer patient information, the French National Federation of Comprehensive Cancer Centres (FNCLCC) introduced, in 1998, an information and education program dedicated to patients and relatives, the SOR SAVOIR PATIENT program (SSP). The methodology of this program adheres to established quality criteria regarding the elaboration of patient information. Cancer patient information, developed in this program, is based on clinical practice guidelines produced by the FNCLCC and the twenty French cancer centres, the National League against Cancer, The National Cancer Institute, the French Hospital Federation, the National Oncology Federation of Regional and University Hospitals, the French Oncology Federation of General Hospitals, many learned societies, as well as an active participation of patients, former patients and caregivers. The SOR SAVOIR PATIENT information booklet “Comprendre le cancer du sein. (Understand breast cancer) is updated from the original edition published in 2000, first revised in 2002. The 2007 update includes the latest scientific data, especially in the areas of chemotherapy, hormonal therapy and monoclonal antibodies. The current guideline is aimed at helping patients with breast cancer and answering any questions they may have regarding the development and the diagnosis of breast cancer, the treatments available and current follow-up methods. The document also provides healthcare professionals with a valuable, concise source of validated information on breast cancer, thus facilitating communication between carers and patients. Information provided in the present article has been selected from the information handbook SOR SAVOIR PATIENT Comprendre le cancer du sein. It is based on the latest scientific data available on the treatment of primary breast cancers, especially chemotherapy, hormonal therapy and monoclonal antibodies.     

基于刺激-机体-反应理论的江苏省居民基层首诊意愿及其影响因素分析

目的 了解江苏省居民的基层首诊的意愿,探索其影响因素,为完善基层首诊制度、引导居民形成科学合理的就医秩序提供合理建议。方法 采用整群随机抽样的方法,于2019年7月至8月向江苏省的1086名居民进行问卷调查,基于SOR模型,将刺激因素(S)分为需方(居民健康管理状况)和供方(医疗单位树立的形象);居民基本信息状况为机体因素(O);居民基层首诊意愿为反应因素(R),采用分层回归分析验证模型,求解影响因素的解释力度。 结果 供方因素中,设施环境好(β=0.236,P<0.01)、费用便宜(β=0.161,P<0.01)、能满足就医需求(β=0.133,P<0.05)、等候时间短(β=0.118,P<0.05),依次正向显著影响基层诊疗次数。需方因素中,居民健康管理状况方面,建立健康档案(β=0.513,P<0.01)、患有慢性病(β=0.332,P<0.01)依次对基层诊疗次数产生显著的正向影响关系。结论 江苏省有关部门可从供需双方采取措施,提升基层医疗机构的服务水平的同时,重点关注慢性病人群,推进居民健康档案的建立,以此提升居民基层首诊意愿,贯彻落实分级诊疗下的基层首诊制度。     

Salacia oblonga ameliorates hypertriglyceridemia and excessive ectopic fat accumulation in laying hens

Ethnopharmacological relevance

Salacia oblonga root (SOR) is an Ayurvedic medicine for obesity and diabetes, those are associated with glucose and lipid metabolism.

Aim of the study

SOR has been demonstrated previously to improve glucose and lipid metabolism in animal models of obesity and diabetes and to be a peroxisome proliferator-activated receptor-alpha activator. However, the anti-obesogenic and anti-diabetic mechanisms of SOR are still not largely understood. Here, we investigated the effects of SOR on lipid metabolism using laying hen, a unique animal model with a very high rate of triglyceride synthesis in the liver.

Materials and methods

Laying hens and preadolescent pullets were treated with the layer ration containing 0%, 0.5%, or 1% SOR water extract for 4 weeks. Biochemical variables were determined enzymatically.

Results

Laying hens showed much higher fasted triglyceride concentrations (increased by 5–13 folds) in plasma, liver, skeletal muscle and heart than pullets. 1% SOR extract treatment inhibited body weight increase without affecting food intake. Importantly, this treatment substantially attenuated hypertriglyceridemia and inhibited increases in triglyceride contents in the non-adipose tissues. However, SOR extract did not induce change in plasma glucose concentration. Moreover, SOR extract did not alter all variables in pullets.

Conclusions

These results demonstrate that SOR ameliorates hypertriglyceridemia and excessive ectopic fat accumulation in laying hens. These findings suggest that the triglyceride-lowering property is one of the primary effects of SOR, possibly via hepatic mechanisms.     

以皮下反射光观测微循环方法及实用仪器

本文介绍了一种新的光学容积脉波自动测定分析方法及实用仪器。在对光学容积描记图以皮下反射光测定采集、保存、复现和分析方法上，运用微机控制整套操作，自动分析图形得出二十余项生理参数。应用该方法进行了临床观察，并同时以甲皱微循环观测作对比观察，发现该方法基本能反映微循环状态，其主要测量参数与甲皱微循环总积分密切相关。对部分患者同时测定心功能状态的观察还表明，随心功能异常程度的增加。光学容积描记图主要参数趋于劣化。可见以皮下反射光方法观测微循环状态，为临床提供了一种简便易行、准确可靠的检测手段。     

Constipation: A cause of enuresis, urinary tract infection and vesicoureteral reflux in children

The observation that constipation alone may induce uninhibited bladder contractions in children and is associated with recurrent urinary tract infection in childhood suggests an etiologic association. Rectal distension due to faecal retention in chronic functional constipation causes bladder distortion and may cause stimulation of detrusor stretch receptors resulting in detrusor peroneal dyssynergism. Distortion of the trigonal area may result in failure of ureteral valve competence and allow for vesico-ureteric reflux.     

Modulation of hepatic sterol regulatory element-binding protein-1c-mediated gene expression contributes to Salacia oblonga root-elicited improvement of fructose-induced fatty liver in rats

Ethnopharmacological relevance

Salacia oblonga root (SOR) is a traditionally herbal medicine for obesity and diabetes, which are closely associated with fatty liver. To investigate the molecular mechanisms of SOR in the treatment of dietary-induced fatty liver.

Materials and methods

Male rats were co-administered with fructose in drinking water and vehicle or the aqueous-ethanolic extract of SOR (by gavage, once daily) for 10 weeks. Biochemical variables were determined enzymatically or by ELISA. Gene expression was analyzed by Real-Time PCR and/or Western blot.

Results

SOR treatment (20 mg/kg) diminished fructose-induced fatty liver indicated by decreases in excess triglyceride accumulation and the increased vacuolization and Oil Red O staining area in the livers of rats. Importantly, Hepatic gene expression profile revealed that SOR suppressed fructose-stimulated overexpression of sterol regulatory element-binding protein (SREBP)-1/1c mRNA and nuclear protein. In accord, overexpression of SREBP-1c-responsive genes, such as fatty acid synthase, acetyl-CoA carboxylase-1 and stearoyl-CoA desaturase-1, was also downregulated. In contrast, overexpressed nuclear protein of carbohydrate response element binding protein and mRNA of its target gene liver pyruvate kinase were not altered. Additionally, SOR also did not affect expression of peroxisome proliferator-activated receptor-gamma- and -alpha, as well as their target genes, such as carnitine palmitoyltransferase-1a, acyl-CoA oxidase and CD36.

Conclusions

These results suggest that modulation of hepatic sterol regulatory element-binding protein-1c-mediated gene expression contributes to SOR-elicited improvement of fructose-induced fatty liver in rats. Our findings provide a better understanding of SOR in the treatment of obesity and diabetes.