Advice on assistance and protection from the Scientific Advisory Board of the Organisation for the Prohibition of Chemical Weapons : Part 2. On preventing and treating health effects from acute, prolonged, and repeated nerve agent exposure, and the identification of medical countermeasures able to reduce or eliminate the longer term health effects of nerve agents

The Scientific Advisory Board (SAB) of the Organisation for the Prohibition of Chemical Weapons (OPCW) has provided advice in relation to the Chemical Weapons Convention on assistance and protection. We present the SAB’s response to a request from the OPCW Director-General in 2014 for information on the best practices for preventing and treating the health effects from acute, prolonged, and repeated organophosphorus nerve agent (NA) exposure. The report summarises pre- and post-exposure treatments, and developments in decontaminants and adsorbing materials, that at the time of the advice, were available for NAs. The updated information provided could assist medics and emergency responders unfamiliar with treatment and decontamination options related to exposure to NAs. The SAB recommended that developments in research on medical countermeasures and decontaminants for NAs should be monitored by the OPCW, and used in assistance and protection training courses and workshops organised through its capacity building programmes.Peer reviewe

Advice from the Scientific Advisory Board of the Organisation for the Prohibition of Chemical Weapons on riot control agents in connection to the Chemical Weapons Convention

Compounds that cause powerful sensory irritation to humans were reviewed by the Scientific Advisory Board (SAB) of the Organisation for the Prohibition of Chemical Weapons (OPCW) in response to requests in 2014 and 2017 by the OPCW Director-General to advise which riot control agents (RCAs) might be subject to declaration under the Chemical Weapons Convention (the Convention). The chemical and toxicological properties of 60 chemicals identified from a survey by the OPCW of RCAs that had been researched or were available for purchase, and additional chemicals recognised by the SAB as having potential RCA applications, were considered. Only 17 of the 60 chemicals met the definition of a RCA under the Convention. These findings were provided to the States Parties of the Convention to inform the implementation of obligations pertaining to RCAs under this international chemical disarmament and non-proliferation treaty.Peer reviewe

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

Informed Consent and Cultural Diversity

Introduction : Informed consent allows a mentally competent patient to make his/her decision of undergoinga medical procedure after adequate explanation. Individual practice of informed consent varies not onlyamong physicians but among different countries with different cultures, religious beliefs and practices. Methods : We conducted a study to determine the patient’s desire for information regarding anaesthesia andsurgery; to determine whether variables like age, sex, education, type of surgery and previous anaesthesiaexperiences have any association with the desire for information and to determine whether patients maketheir own decisions or want their family to be involved in the decision making process or give consent ontheir behalf. After written consent, patients visiting the preoperative clinic were asked to fill a questionnairesof 17 pieces of information regarding anaesthesia and surgery. Results : Majority of patients (91%) showed a desire for information. Among different variables only educationwas found to be significantly associated with the desire for information. Educated patients had a higherdesire. A large number of patients wanted to involve family in decision-making and give consent on theirbehalf. This trend was higher in females and less educated patients .Conclusions : We conclude from our study that educated people in society have more desire for informationand autonomy. Our study has also highlighted the influence of culture on the concept of patient autonomyand informed consent

Advice on assistance and protection provided by the Scientific Advisory Board of the Organisation for the Prohibition of Chemical Weapons: Part 1. On medical care and treatment of injuries from nerve agents

The Scientific Advisory Board (SAB) of the Organisation for the Prohibition of Chemical Weapons (OPCW) has provided advice on assistance and protection in relation to the Chemical Weapons Convention. In this, the first of several papers describing the SAB's work on this topic, we describe advice given in response to questions from the OPCW Director-General in 2013 and 2014 on the status of available medical countermeasures and treatments to organophosphorus nerve agents. This paper provides the evidence base for this advice which recommended to the OPCW pretreatments, emergency care, and long-term treatments that were available at the time of the request for this class of chemical warfare agent (CWA). It includes a bibliography of over 140 scientific references, which can be used as a platform for watching future medical countermeasure developments. The information provided in this paper should serve as a valuable reference for medical professionals and emergency responders who may have no knowledge of the symptoms and treatment options of exposure to nerve agents.Fil: Timperley, Christopher M.. Defence Science and Technology Laboratory; Reino UnidoFil: Forman, Jonathan E.. OPCW Scientific Advisory Board Secretary and Science Policy Adviser; Países BajosFil: Abdollahi, Mohammad. Tehran University Of Medical Sciences; IránFil: Al-Amri, Abdullah Saeed. Saudi Basic Industries Corporation; Arabia SauditaFil: Baulig, Augustin. Secrétariat Général de la Défense et de la Sécurité Nationale; FranciaFil: Benachour, Djafer. Ferhat Abbas University, Setif-1; ArgeliaFil: Borrett, Veronica. Bai Scientific; Australia. University of Melbourne; AustraliaFil: Cariño, Flerida A.. University of the Philippines; FilipinasFil: Geist, Michael. Basf Se; AlemaniaFil: Gonzalez, David. Universidad de la República Facultad de Química; Uruguay. Universidad de la República; UruguayFil: Kane, William. Monsanto Company; Estados UnidosFil: Kovarik, Zrinka. Institute for Medical Research and Occupational Health; CroaciaFil: Martínez Álvarez, Roberto. Universidad Complutense de Madrid; EspañaFil: Mourão, Nicia Maria Fusaro. ABIQUIM; BrasilFil: Neffe, Slawomir. Military University of Technology; PoloniaFil: Raza, Syed K.. Institute Of Pesticide Formulation Technology (ipft); IndiaFil: Rubaylo, Valentin. State Scientific Research Institute of Organic Chemistry and Technology; RusiaFil: Suarez, Alejandra Graciela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Química Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Química Rosario; ArgentinaFil: Takeuchi, Koji. National Institute of Advanced Industrial Science and Technology; JapónFil: Tang, Cheng. National Defence University; ChinaFil: Trifirò, Ferruccio. Universidad de Bologna; ItaliaFil: van Straten, Francois Mauritz. South African Nuclear Energy Corporation SOC Ltd; SudáfricaFil: Vanninen, Paula S.. Helsingin Yliopisto; FinlandiaFil: Vucinic, Slavica. Vojnomedicinska Akademija; SerbiaFil: Zaitsev, Volodymyr. Pontifícia Universidade Católica do Rio de Janeiro; Brasil. Taras Shevchenko National University of Kyiv, Kyiv; UcraniaFil: Zafar Uz Zaman, Muhammad. National Engineering And Scientific Commission (nescom); PakistánFil: Zina, Mongia Saïd. Université de Tunis El Manar, Faculté Des Sciences de Tunis; TúnezFil: Holen, Stian. Opcw Scientific Advisory Board Secretary; Países Bajo

Advice on assistance and protection provided by the Scientific Advisory Board of the Organisation for the Prohibition of Chemical Weapons: Part 3. On medical care and treatment of injuries from sulfur mustard

Blister agents damage the skin, eyes, mucous membranes and subcutaneous tissues. Other toxic effects may occur after absorption. The response of the Scientific Advisory Board (SAB) of the Organisation for the Prohibition of Chemical Weapons (OPCW) to a request from the OPCW Director-General in 2013 on the status of medical countermeasures and treatments to blister agents is updated through the incorporation of the latest information. The physical and toxicological properties of sulfur mustard and clinical effects and treatments are summarised. The information should assist medics and emergency responders who may be unfamiliar with the toxidrome of sulfur mustard and its treatment.Fil: Timperley, Christopher M.. Defence Science And Technology Laboratory; Reino UnidoFil: Forman, Jonathan E.. Organisation For The Prohibition Of Chemical Weapons; Países BajosFil: Abdollahi, Mohammad. Tehran University of Medical Sciences; IránFil: Al-Amri, Abdullah Saeed. Saudi Basic Industries Corporation; Arabia SauditaFil: Baulig, Augustin. Secrétariat Général de la Défense Et de la Sécurité Nationale; FranciaFil: Benachour, Djafer. Ferhat Abbas University; ArgeliaFil: Borrett, Veronica. La Trobe University; AustraliaFil: Cariño, Flerida A.. University Of The Philippines Diliman; FilipinasFil: Curty, Christophe. Spiez Laboratory; SuizaFil: Geist, Michael. Basf Se; AlemaniaFil: Gonzalez, David. Universidad de la República; UruguayFil: Kane, William. Monsanto Company; Estados UnidosFil: Kovarik, Zrinka. Institut Za Medicinska Istrazivanja I Medicinu Rada; CroaciaFil: Martínez Álvarez, Roberto. Universidad Complutense de Madrid; EspañaFil: Mourão, Nicia Maria Fusaro. Brazilian Chemical Industry; BrasilFil: Neffe, Slawomir. Wojskowa Akademia Techniczna; PoloniaFil: Raza, Syed K.. National Accreditation Board For Testing And Calibration Laboratories; IndiaFil: Rubaylo, Valentin. State Research Institute Of Organic Chemistry And Technology; RusiaFil: Suarez, Alejandra Graciela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Química Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Química Rosario; ArgentinaFil: Takeuchi, Koji. National Institute Of Advanced Industrial Science And Technology; JapónFil: Tang, Cheng. Ministry of National Defence. Office for the Disposal of Japanese Abandoned Chemical Weapons; ChinaFil: Trifirò, Ferruccio. Universidad de Bologna; ItaliaFil: Straten, Francois Mauritz van. Independent Former Opcw Sab Member; SudáfricaFil: Vanninen, Paula S.. University of Helsinki; FinlandiaFil: Vucinic, Slavica. Vojnomedicinska Akademija; SerbiaFil: Zaitsev, Volodymyr. Pontifícia Universidade Católica do Rio de Janeiro; BrasilFil: Zafar-Uz-Zaman, Muhammad. National Engineering And Scientific Commission; PakistánFil: Zina, Mongia Saïd. Université de Tunis El Manar, Faculté Des Sciences de Tunis; TúnezFil: Holen, Stian. OPCW; Países BajosFil: Alwan, Wesam S.. Monash University; AustraliaFil: Suri, Vivek. OPCW Office of Strategy and Policy; Países BajosFil: Hotchkiss, Peter J.. Organisation For The Prohibition Of Chemical Weapons; Países BajosFil: Ghanei, Mostafa. Baqiyatallah University Of Medical Sciences; Irá