Strategic National Stockpile Program: Implications for Military Medicine

Need, James T.; Mothershead, Jerry L.

doi:10.7205/milmed.171.8.698

Cited by 9 publications

(13 citation statements)

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“…The accident occurred when an insecurely stored, unlicensed 60 Co radiation source (425 Ci) was recovered by scrap metal collectors who, together with other workers, dismantled the container, unknowingly exposing themselves and others nearby to ionizing radiation. Over the following weeks, those exposed developed symptoms of radiation sickness and eventually sought medical attention.…”

Section: Teletherapy Radiation Accident Samut Prakan Thailand 2000mentioning

confidence: 98%

“…On days 24, 26, and 32 after exposure, each victim received rhGM-CSF Table 3 List of known radiological accidents where victims received G-CSF and/or GM-CSF treatments. Three GM-CSF (240 lg/m 2 /day, iv), neutrophil counts improved after 9 or 10 days after treatment initiation, victim with highest dose of exposure ($8 Gy) died, other two with 2.92 and 3.77 Gy exposure doses survived [106,107] 1990 Soreq, Israel 60 Co Acute 10-20 Gy One GM-CSF (250 lg/m 2 /day) from day 1 to 18, also IL-3 from day 5-18, blood cell count improved, given BMT and died on day 36 due to graft vs host disease [108] 1992 Nesvizh, Belarus 60 Co Acute 11 Gy One GM-CSF (11.4 lg/kg/day, 1-6 days, 6 lg/kg/day, 16-39 days) and IL-3 (10 lg/kg/day, day 6-31), marrow and blood cell recovered, victim died on day 108 due to pneumonia and acute respiratory failure [109] 1996 Gilan, Iran [124][125][126][127] It should be noted that published information reporting treatment of Delhi, India accident victims was later retracted by the authors. Limited details are available for all accidents (additional details for various victims are not available).…”

Section: San Salvador El Salvador Radiation Accident 1989mentioning

confidence: 99%

“…These Push Packages are positioned in strategically located, secure warehouses ready for immediate deployment to a designated site within 12 h of the federal decision to deploy SNS assets. The SNS program ensures that the medical material stock is rotated and kept within potency shelf-life limits [22,60,61]. The HHS Office of the Assistant Secretary for Preparedness and Response Biomedical Advanced Research and Development Authority, Project BioShield is the chief mechanism through which the US government supports the advanced development and procurement of new medical countermeasures-drugs, vaccines, diagnostics, and medical supplies-to protect the health of US citizens against chemical, biological, radiological and nuclear threats.…”

Section: Stockpile Of G-csf To Treat Arsmentioning

confidence: 99%

“…In this study, female C3H/ HeN mice were administered amifostine (200 mg/kg, ip, 30 min before 60 Co irradiation) to protect hematopoietic stem cells and G-CSF (125 lg/kg/day, subcutaneously (sc), from day 1 to 16 after irradiation) to stimulate proliferation and reconstitution of the hematopoietic system. This study again reinforces that concept that classic radioprotectants and recombinant hematopoietic growth factors can be used in combination to reduce risks associated with myelosuppression induced by radiation or by radiomimetic drugs.…”

Section: Additive or Synergistic Effects Of Combining G-csf With Othementioning

confidence: 99%

“…A radiological accident occurred when two packages used to transport 60 Co teletherapy sources were sold as scrap metal [111]. The persons who purchased these packages broke open the shielded containers, exposing them and several others to radiation in December 1998 and again in January 1999.…”

Section: Teletherapy Source Accident Istanbul Turkey 1998mentioning

confidence: 99%

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Colony-stimulating factors for the treatment of the hematopoietic component of the acute radiation syndrome (H-ARS): A review

Singh

Newman²,

Seed³

2015

Cytokine

108

123

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One of the greatest national security threats to the United States is the detonation of an improvised nuclear device or a radiological dispersal device in a heavily populated area. As such, this type of security threat is considered to be of relatively low risk, but one that would have an extraordinary high impact on health and well-being of the US citizenry. Psychological counseling and medical assessments would be necessary for all those significantly impacted by the nuclear/radiological event. Direct medical interventions would be necessary for all those individuals who had received substantial radiation exposures (e.g., >1 Gy). Although no drugs or products have yet been specifically approved by the United States Food and Drug Administration (US FDA) to treat the effects of acute radiation syndrome (ARS), granulocyte colony-stimulating factor (G-CSF), granulocyte macrophage colony-stimulating factor (GM-CSF), and pegylated G-CSF have been used off label for treating radiation accident victims. Recent threats of terrorist attacks using nuclear or radiologic devices makes it imperative that the medical community have up-to-date information and a clear understanding of treatment protocols using therapeutically effective recombinant growth factors and cytokines such as G-CSF and GM-CSF for patients exposed to injurious doses of ionizing radiation. Based on limited human studies with underlying biology, we see that the recombinants, G-CSF and GM-CSF appear to have modest, but significant medicinal value in treating radiation accident victims. In the near future, the US FDA may approve G-CSF and GM-CSF as ‘Emergency Use Authorization’ (EUA) for managing radiation-induced aplasia, an ARS-related pathology. In this article, we review the status of growth factors for the treatment of radiological/nuclear accident victims.

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Section: Teletherapy Radiation Accident Samut Prakan Thailand 2000mentioning

confidence: 98%

Section: San Salvador El Salvador Radiation Accident 1989mentioning

confidence: 99%

Section: Stockpile Of G-csf To Treat Arsmentioning

confidence: 99%

Section: Additive or Synergistic Effects Of Combining G-csf With Othementioning

confidence: 99%

Section: Teletherapy Source Accident Istanbul Turkey 1998mentioning

confidence: 99%

See 3 more Smart Citations

Colony-stimulating factors for the treatment of the hematopoietic component of the acute radiation syndrome (H-ARS): A review

Singh

Newman²,

Seed³

2015

Cytokine

108

123

View full text Add to dashboard Cite

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A Spatial Modeling Framework for Siting Critical Supply Infrastructures

Maliszewski

Horner

2010

The Professional Geographer

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Since the launch of the U.S. Department of Homeland Security in 2002, research needs have been established in the areas of disaster preparedness and critical infrastructure protection. Disaster preparedness seeks to lessen the adverse effects of catastrophes by planning in advance and instituting a proper response. Critical infrastructures are those entities deemed necessary for society to function correctly and thus require protection. Recent studies have used location models to aid in the management of many of these crucial establishments, but few efforts have modeled where to geographically site a future critical supply facility. Furthermore, no research has explored a multihazards approach for siting critical supply facilities and the explicitly spatial factors that make a potential target vulnerable to attack. In this article, we propose a strategic multiobjective modeling framework for siting critical supply facilities that incorporates explicitly spatial disaster preparedness directives and critical infrastructure protection demands. We detail the spatial data requirements and modeling assumptions and present results from an application involving the placement of critical vaccine stores in Orlando, Florida. Key Words: critical infrastructure protection, critical supplies, disaster preparedness, facility location, vulnerability.Desde el lanzamiento del Departamento de Seguridad Nacional de los EE.UU. en 2002, se han establecido las necesidades de investigación en los campos de la preparación para desastres y protección de la infraestructura crítica. Con la preparación para desastres se busca aminorar los efectos adversos de las catástrofes, planeando con anticipación y determinando las respuestas apropiadas. Las infraestructuras críticas son aquellas entidades que se consideran necesarias para que la sociedad funcione correctamente y que por ello mismo requieren protección. En estudios recientes se han aplicado modelos locacionales para ayudar a manejar muchos de estas instalaciones cruciales, aunque pocos han sido los esfuerzos hechos para modelar la ubicación geográfica de una futura instalación crítica de abastecimiento. Además, hasta ahora en ninguna investigación se exploró un enfoque de multi-riesgo para ubicar ese tipo de instalaciones críticas, ni se estudiaron los factores explícitamente * The authors thank the editor and anonymous reviewers for comments that helped to improve the article. espaciales que puedan hacer vulnerable al ataque un objetivo potencial. En este artículo proponemos un marco de modelado estratégico multi-objetivos para situar instalaciones críticas de abastecimiento, en el cual se incorporan directivas explícitamente espaciales para la preparación contra desastres, lo mismo que demandas críticas para la protección de infraestructura. En el artículo detallamos los datos espaciales requeridos y los supuestos para la construcción del modelo, y presentamos los resultados logrados en una aplicación relacionada con el emplazamiento de tiendas de vacunas críticas en Orlando, Florida....

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Medical countermeasures for unwanted CBRN exposures: part II radiological and nuclear threats with review of recent countermeasure patents

Singh

Romaine

Newman

et al. 2016

Expert Opinion on Therapeutic Patents

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Introduction: The global threat of a chemical, biological, radiological, or nuclear (CBRN) disaster is an important priority for all government agencies involved in domestic security and public health preparedness. Radiological/nuclear (RN) attacks or accidents have become a larger focus of the United States Food and Drug administration (US FDA) over time because of their increased likeliness. Clinical signs and symptoms of a developing acute radiation syndrome (ARS) are grouped into three sub-syndromes named for the dominant organ system affected, namely the hematopoietic (H-ARS), gastrointestinal (GI-ARS), and neurovascular systems. The availability of safe and effective countermeasures against radiological/nuclear threats currently represents a significant unmet medical need. Areas covered: This article reviews the development of RN threat medical countermeasures and highlights those specific countermeasures that have been recently patented and approved following the FDA Animal Rule. Patents for such agents from 2015 have been presented. Expert opinion: Two granulocyte colony-stimulating factor (G-CSF)-based radiation countermeasures (Neupogen® (Amgen, Thousand Oaks, CA) and Neulasta® (Amgen, Thousand Oaks, CA)) have recently been approved by the FDA for treatment of H-ARS and both these agents are radiomitigators, used after radiation exposure. To date, there are no FDA-approved radioprotectors for ARS.

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Strategic National Stockpile Program: Implications for Military Medicine

Cited by 9 publications

References 0 publications

Colony-stimulating factors for the treatment of the hematopoietic component of the acute radiation syndrome (H-ARS): A review

Colony-stimulating factors for the treatment of the hematopoietic component of the acute radiation syndrome (H-ARS): A review

A Spatial Modeling Framework for Siting Critical Supply Infrastructures

Medical countermeasures for unwanted CBRN exposures: part II radiological and nuclear threats with review of recent countermeasure patents

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