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Military Medical Academy MEDICAL MANAGEMENT OF CHEMICAL AND BIOLOGICAL CASUALTIES MILITARY MEDICAL ACADEMY MMeeddiiccaall MMaannaaggeemmeenntt ooff CChheemmiiccaall aanndd BBiioollooggiiccaall CCaassuuaallttiieess Edited by Major-General Prof. Stoian Tonev, MD,PhD Assoc. Prof. Kamen Kanev, MD,PhD, DSc Prof. Christophor Dishovsky, MD, PhD, DSc SOFIA 2009 1 S. Tonev, K. Kanev, C. Dishovsky © Stoian Tonev, Kamen Kanev and Christophor Dishovsky, 2009 All rights reserved. No reproduction, copy or transmission of this publi- cation may be made without written permission from the authors. Authors bear full responsibility for their articles presented in this publi- cation. Authors will not receive honoraria for their contributions. First published in August 2009 by Publishing House IRITA A catalogue record of this book is available from National Library “St. St. Cyril and Methodius”, Sofia. Stoian Tonev, Kamen Kanev and Christophor Dishovsky Medical Management of Chemical and Biological Casualties Publishing House IRITA ISBN 978-954-9993-91-2 2 MEDICAL MANAGEMENT OF CHEMICAL AND BIOLOGICAL CASUALTIES Contents Preface ……………………………………………………………….. 11 Part 1 NEW APPROACHES IN ORGANISATION OF EMERGENCY RESPONSE AND COUNTERACTION TO CHEM- ICAL AND BIOLOGICAL TERRORISM……………....… 13 Chapter 1 Military Medical Academy In Emergency Response In Bulgaria …..... 15 Tonev S. Chapter 2 Specificity of the Interaction between the Bulgarian Ministry of Health with the Other Goevrnnment Agencies in the Event of Chemical Incidents…………………………………………………...... 26 Zhelev E., Gigov K. and Kolev S. Chapter 3 Medical Support in Case of Chemical and Biological Threat………….35 Kanev K. Chapter 4 Clinical Particularities and Strategic Complex Advanced Therapeutic Program Against the Toxic Chemical and Biological Traumatism and Terrorism………………………………………………………………...…… 41 Monov A. Chapter 5 Military Medical Readiness for Chemical and Biological Terrorists’ attacks…………………………………………………...…. 45 Kostadinov R., Dimitrov A. and Kanev K. 3 S. Tonev, K. Kanev, C. Dishovsky Chapter 6 Unified Strategic Doctrine Against the Contemporary Traumatism and Terrorism…………………………………....……… 53 Monov A. Chapter 7 Contemporary Trends in Computer Aided Tools Development for Enhancing Chemical Accidents Medical Support…………………..… 56 Gigov K., Dragnev V. and Galabova A. Chapter 8 Bulgarian National Legislation and Biological Weapons Proliferation………………………………………………… 60 Galev A. Chapter 9 What are the Risks of WMD by Organized Crime in Southeast Europe…………………………………………………...…. 66 Stipetic D. and Orehovec Z. Chapter 10 Preparedness Against Chemical Terrorism: Poison Information Centers Roles………………………………………………………….. 71 Soltaninejad K. Part 2 CHEMICAL AGENTS - MECHANISMS OF ACTION, DIAGNOSIS , TREATMENT OF INTOXICATIONS AND PROBLEMS OF CHEMICAL TER- RORISM………………………………………………………… 81 Chapter 11 Chemical Terrorism, History and Threat Assessment……………...…. 83 Kostadinov R., Kanev K. and Dimov D. 4 MEDICAL MANAGEMENT OF CHEMICAL AND BIOLOGICAL CASUALTIES Chapter 12 Structure, Chemical Reactivity and Toxicity of Organophosphorus Compounds……………………………………………………….…… 91 Popov I. and Popov G. Chapter 13 Biological Markers of Intoxication with Nerve Agents – Biochemical investigations in rats poisoned with tabun…………..…. 100 Dishovsky C., Samnaliev I., Ivanov T. and Petrova I. Chapter 14 Peculiarities of Treating Water Contaminated with Toxic Chemical Substances Using Cold Contact Plasma………………………………107 Pivovarov O., Kravchenko O., Tischenko G. and Kublanovsky V. Chapter 15 Difficulties in the Treatment of Poisoning by Carbamates………..… 115 Tonkolpii V. Chapter 16 Synthesis of New Reactivators of Cholinesterase………………...… 121 Petrova I., Samnaliev I. and Dishovsky C. Chapter 17 Investigation of the Efficacy of New Reactivators of Cholinesterase in Soman and Tabun Inhibited Rat Brain Acetylcholinesterase........... 127 Samnaliev I., Petrova I., Pencheva T. and Dishovsky C. Chapter 18 What is the Clinical Significance of Oxime and Sodium Bicarbonate Therapy for Acute Organophosphate Poisoning?............. 135 Vucinic S., Ercegovic G., Djordjevic D., Jovanovic M., Vukcevic-perkovic N, Potrebic O. and Zlatkovic M. Chapter 19 A Test Battery of Combined Methods to Determine Cytotoxic Effects of Sulfur Mustard and to Investigate Cytoprotective Effects of PARP Inhibitors…………………………………………………… 144 Balszuweit F., Heinrich A., Kehe K. and Thiermann H. 5 S. Tonev, K. Kanev, C. Dishovsky Chapter 20 Delayed complications of sulfur mustard poisoning in Iranian veterans………………............................................................. 155 Balali-Mood M. and Balali-Mood B. Chapter 21 Unfavourable Effects of Dioxins on Environment and Human Health…………………………………………………..……. 174 Gesheva M. and Radenkova-Saeva J. Chapter 22 Influence of the Opioid Compounds on the Immune Response……... 182 Radenkova-Saeva J. Chapter 23 Accidental and Suicidal Self-Poisoning Among Heroin Addicts….… 188 Radenkova-Saeva J. Chapter 24 Effect of Number of Cigarettes Daily Consumed on Offspring Sex Ratio……………………………………………………………... 197 Khan U.A. and Adil M.M. Chapter 25 Epidemiological Research on the Suicidal Attempts and Suicidal Adjustments Due to Intoxications in the Coming Generation…………………………………………………………… 205 Barzshka E. Chapter 26 Re-evaluation of Some Stages of the Classical Conventional Treatment of Amanita Phalloides Mushroom Poisoning ……………. 216 Trankova V. and Hubenova A. Chapter 27 Acute methanol intoxications in Varna region during the period 2000 - 2008 year – an important social problem - III announcement on this theme………………………………….… 221 Sabeva Y., Yovcheva M., Koleva M., Zlateva S. and Marinov P. 6 MEDICAL MANAGEMENT OF CHEMICAL AND BIOLOGICAL CASUALTIES Chapter 28 Use of Derivatized Reference Standards for Determination of Dialkylphosphates/Alkylphosphonates in the Coarse of Organophosphorus Agents’ Exposure Analysis………………………227 Bardarov V. Chapter 29 Organochlorine and Organophosphate Pesticides Monitoring in Non Conventional Biological Samples……………………………. 231 Tzatzarakis M. and Tzatzarakis A. Chapter 30 Possible Problems Connected to Alcohol Abstinence in Case of Mass Disasters……………………………………………………. 242 Yovcheva M., Zlateva S., Kerezova J., Borisova E. and Sabeva Y. Chapter 31 Protective Effect of Purified Saponin Mixture from Astragalus Corniculatus on Toxicity Models In Vitro………………. 249 Micheva M., Kondeva-Burdina M., Krasteva I. and Nikolov S. Chapter 32 Effects of Multiple D-amphetamine Administration on Some Hepatic Biochemical Parameters in Spontaneously Hypertensive Rats (SHR)…………………………………………………………… 262 Simeonova R., Vitcheva V. and Micheva M. Chapter 33 Protective Effect of New L-Valine Derivatives on Brain Function in Experimental Model of Aggression in Mice after Social Isolation….. 270 Tancheva L., Petkov V., Encheva E., Novoselski M. and Tsekova D. Chapter 34 In Vitro and in Vivo Studies on Toxicity and Pharmacological Activity of New L-Valine Peptidomimetics…………………………………... 277 Tancheva L., Novoselski M., Encheva E., Petkov V., Gorneva G., Tseko- va D., Chekalarova J., Gurt I., Katz E. and Pavlova E. 7 S. Tonev, K. Kanev, C. Dishovsky Chapter 35 Influence of Nifedipine on Morphine Elimination after Multiple Administration in Rats……………………………………………….. 285 Vitcheva V., Karova D. and Micheva M. Chapter 36 Learning, Memory and Biogenic Amine Levels in Rat Hippocampus after Treatment with New L-Valine Derivatives………………………………………………………….... 293 Stancheva S., Alova L., Tancheva L., Petkov V., Encheva E., Tsekova D. and Novoselski M. Chapter 37 Hepatic Interaction Between Amphetamine and Calcium Channel Blocker Nifedipine after Multiple Administrations in Rats….............. 298 Vitcheva V., Simeonova R. and Mitcheva M. Part 3 BIOLOGICAL AGENTS- PROBLEMS OF BIOLOGICAL TERRORISM ………………… 305 Chapter 38 Bioterrorism, History and Threat Assessment……………………….. 307 Kostadinov R. and Galbova A. Chapter 39 Dual-Use Goods in the Production of Biological Weapons…………. 316 Ristanovic E. and Jevtic M. Chapter 40 Transborder Cooperation on the Protection, Surveillance and Control of Endemic Diseases………………………………………… 322 Savov E., Doganov B., Kamenov G., Angelov K., Kalvachev Z., Rusev A. and Dimova J. 8 MEDICAL MANAGEMENT OF CHEMICAL AND BIOLOGICAL CASUALTIES Chapter 41 Threats and Counteractions Concerning the Use of Viruses for Biological Terrorism…………………………………………………. 326 Kalvachev Z. Chapter 42 Generation of Monoclonal Antibody for Real-time Detection of Chemical and Biological Agents by an Optical Biosensor…………... 336 Baranova E., Biketov S., Gorshkov B., Ksenevich T. and Nikitin P. Chapter 43 Congo-Crimean Hemorrhagic Fever: Spread and Prophylaxis in Bulgaria………………………………………………………………. 342 Kamarinchev B., Kovacheva T., Gergova I., Alexandrov E. and Mekushinov K. Chapter 44 Rickettsioses – imminent infections to our present…………………. 347 Alexandrova D., Kunchev A., Shindov M., Kamenova T., Kantarjiev T., Teoharova M. and Alexadnrov E. Chapter 45 Rickettsioses – Emergency Situations – Bioterrorism – Preventive Therapy………………………………………………………………. 352 Alexandrova D., Kamarinchev B., Shindov M., Kantarjiev T., Teoharova M., Macela A. and Alexadnrov E. Chapter 46 Effective Real-Time PCR SYBR Green System for Early and Rapid Detection of Coxiella Burnetii………………………….......... 358 Kunchev M., Alexandrov E., Kamarinchev B., Gergova I. and Mekushinov K. Author Index....................................................................................... 363 Subject Index....................................................................................... 369 9 S. Tonev, K. Kanev, C. Dishovsky 10
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