Biomedical subjects

Eyal Robenshtok

Publications and source records attributed to Eyal Robenshtok.

11 recordsLinked to original sources

PubMed2003

[Using thalidomide against pathological neovascularization].

Thalidomide was first used during the 50's-60's, especially for morning sickness in pregnant women. It was found to be a powerful teratogen only years later and was banned from use. At the same time it was found to have anti-inflammatory and anti-angiogenic properties and was approved as treatment for leprosy. As such, thalidomide might be used against pathological neovascularization, as seen in mustard gas exposure. From past experience we know that the eyes are the most vulnerable organ to mustard gas exposure. In some of the casualties there is a late sequella including pathological corneal neovascularization. So far there is no specific effective treatment against this neovascularization. The purpose of this review is to examine current research about the potential use of thalidomide as an anti-angiogenic agent, including potential role in treating mustard gas eye injury.

Angiogenesis Inhibitors↗

PubMed2003

[Medical aspects of the lacrimator CS].

Since the 1960's, CS has become the main riot control agent in use by police and army forces throughout the world. The first post-exposure symptom is a burning sensation in the eyes, nose and throat. At a later stage, lacrimation, rhinorrhea, conjunctivitis, sore throat and salivation appear. These symptoms are followed by chest pain and dry cough, and if the substance is swallowed, it may cause nausea and vomiting. This article reviews the physical properties of CS, the main dispersing techniques, the clinical signs and symptoms of exposure, including information on mutagenicity, carcinogenesis, pregnancy safety, and will introduce guidelines for treatment after exposure.

Chest Pain↗

PubMed2002

Preparedness of the Israeli health system for a biologic warfare event.

The threat of a disease outbreak resulting from biologic warfare has been of concern for the Israeli health system for many years. In order to be prepared for such an event the health system has formulated doctrines for various biologic agents and defined the logistic elements for the procurement of drugs. During the last 4 years, and especially after the West Nile fever epidemic in 2000, efforts to prepare the healthcare system and the relevant organizations were accelerated. The Director-General of the Ministry of Health nominated a Supreme Steering Committee to fill in the gaps and upgrade the preparedness of the health system for an unusual disease outbreak. This committee and its seven subcommittees established appropriate guidelines, communication routes among different organizations, and training programs for medical personnel. The anthrax outbreak in the United States found the healthcare system in the hub of the preparation process, and all modes of action were intensified. Further work by hospitals, primary care clinics and all other institutes should be increased to maintain a state of proper preparedness.

Biological Warfare↗

PubMed2002

Adverse reaction to atropine and the treatment of organophosphate intoxication.

Atropine is the drug of choice for treatment of organophosphate nerve agent and insecticide intoxication and has been used for this indication for several decades. Adverse reactions to atropine may occur, and are of two types: toxic and allergic. Toxic reaction, the most common form, results from the anti-muscarinic effects of the drug. Since it is most probably related to interpersonal variation in sensitivity to atropine, toxic effects may appear at the usual therapeutic doses. The second type, allergic reaction, includes local manifestations, usually after the administration of eyedrops, and systemic reaction in the form of anaphylaxis. Since most patients manifest only a mild reaction, allergy testing is not performed and the prevalence of allergy to atropine is therefore not known. Severe allergic reaction to atropine is rare, as evidenced by the small number of case reports in the literature despite the drug's extensive use. Alternative anti-muscarinic drugs recommended for OP poisoning include glycopyrrolate and scopolamine. Glycopyrrolate is a peripheral anti-muscarinic drug that has been studied in comparison to atropine for many clinical indications, while scopolamine is an anti-muscarinic drug with both peripheral and central effects. An acceptable alternative regimen for patients with proven allergy to atropine is a combination of glycopyrrolate with centrally active drugs such as benzodiazepines or scopolamine.

Atropine↗

PubMed2002

Training Israeli medical personnel to treat casualties of nuclear, biologic and chemical warfare.

Recent events have significantly increased concern about the use of biologic and chemical weapons by terrorists and other countries. Since weapons of mass destruction could result in a huge number of casualties, optimizing our diagnostic and therapeutic skills may help to minimize the morbidity and mortality. The national demands for training in medical aspects of nuclear, biologic and chemical warfare have increased dramatically. While Israeli medical preparedness for non-conventional warfare has improved substantially in recent years especially due to extensive training programs, a standardized course and course materials were not available until recently. We have developed a core curriculum and teaching materials for a 1 or 2 day modular course, including printed materials.

Biological Warfare↗

PubMed2002

[The spectrum of symptoms associated with biological warfare].

BACKGROUND: There are hundreds of potential agents that could be used in biological warfare or bioterrorism: bacteria, viruses and toxins. There are no similarities between clinical presentations of organisms or toxins belonging to specific microbial families. Therefore, it is important for the physician, required to cope with an unusual disease or outbreak among his patients, to become familiar with the various symptoms that victims of biological warfare or bioterrorism may present. METHODS: To describe the six most common groups of symptoms expected in the above setting. The most common symptoms will be described as they appear in nature, because of a fortunate lack of experience with the majority of these agents in biological warfare. Hence, variations of these presentations may be possible. RESULTS: The six most common presentations reviewed are: 1) respiratory tract symptoms; 2) hemorrhagic fevers; 3) meningitis and encephalitis; 4) flaccid paralyses; 5) fever syndromes with rash; and 6) diarrheal syndromes. Additional presentations may be possible due to alterations made in these organisms or development of new agents and mixtures. A list is provided of features that may alert a physician of the possibility of biological warfare or bioterrorism. CONCLUSION: Knowledge of the principal clinical presentations of victims of biological warfare or bioterrorism is essential to all physicians. This knowledge may contribute to the early recognition of a cluster of patients, an epidemic, an unusual disease, or biological warfare; quick referral to the emergency department, leading to early microbiological diagnosis; and rapid notification of the Ministry of Health. All these, and the institution of appropriate measures, will ultimately contribute to the survival of individual patients and at-risk populations.

Biological Warfare↗

PubMed2002

[Viral encephalitis caused by biowarfare agents].

Many viruses may cause encephalitis. Three such viruses of the Alpha genus (Venezuelan equine encephalitis (VEE), Western equine encephalitis (WEE) and Eastern equine encephalitis (EEE)) may be used as biological warfare agents. The clinical course of the diseases caused by these viruses is not specific, and resembles a broad range of bacterial and viral diseases. Several attenuated and inactivated vaccines were developed, but their efficacy in the biological warfare scenario is questionable. There is no effective drug therapy for the treatment of these diseases, and treatment is mainly supportive. Several VEE outbreaks were reported in humans and horses in South America and southern United States. This virus usually causes a febrile illness, which might be complicated with encephalitis, mainly in the cases of children and elderly patients. The EEE virus causes the most severe form of disease, with severe encephalitis and high proportion of sequel. It is prevalent mainly in the eastern parts of Northern America. The WEE virus, which is hybridization between the Sindbis virus and the EEE virus, causes encephalitis mainly in children. The severity of the disease caused by WEE and the sequel rate is much lower than that of EEE.

Biological Warfare↗

PubMed2002

[Biological warfare: disease prevention and post exposure medical treatment].

The use of biological warfare agents has become a reality in recent years, emphasizing the need for local and national preparedness programs. In the event of a biological attack, the use of medical measures for prophylaxis and treatment can greatly reduce its impact. Antibiotics, active and passive immunizations, and antiviral agents can all be used for this purpose. Since diseases resulting from biological warfare agents have an incubation period of days, there is a short time period in which proper post exposure prophylaxis may be given. This paper provides a therapeutic approach to patients exposed to biological warfare agents, in comparison to the management of naturally occurring diseases.

Biological Warfare↗

PubMed2002

[The history of biological warfare].

Selected events in the history of biological weapons are highlighted to increase the physician's awareness of this crucial threat. The deliberate use of biological substances originated in antiquity and has pervaded the history of human wars throughout time until the 21th century. The history of biological warfare is difficult to assess because of a number of confounding factors. These include the difficulty in verification of allegation, the use of the threat of this weapon for propaganda purposes, the lack of microbiological or epidemiological data, and the incidence of natural occurring endemic or epidemic diseases during hostilities. Although it may be problematic to verify at times, the use of such weapons has not been limited to national armies or militia. Frustrated civilians, terrorists and even physicians have used biological substances to promote their interests. Today, the biological threat has become more serious. It's potency, cost-effectiveness, and the ability to manufacture and deploy it with little sophistication, or under the semblance of legitimate commercial endeavors, will ensure that biological weapons remain a constant threat to human health.

Biological Warfare↗

PubMed2002

[Plague].

Plague has been known to mankind for hundreds of years, and it has caused some of the most devastating epidemics in history. This review covers epidemiological, clinical and therapeutic aspects of the disease, and is intended to serve as a tool for the physician for treating plague patients.

Biological Warfare↗

PubMed2002

[Viral hemorrhagic fever as a biological weapon].

The viruses that cause hemorrhagic fever belong to four virus families: the Arenaviridae, Bunyaviridae, Filoviridae and Flaviviridae. These viruses are candidates for biological warfare agents because they are stable when aerosolized and cause severe debilitating disease. Research and development regarding the use of these viruses as warfare agents has been performed in the former Soviet Union and other countries. The introduction of these agents into non endemic countries poses a major public health threat to that country. Israel is not endemic for these agents, and therefore, local infection can occur from a traveller (human or animal) from an endemic country or due to intentional dissemination. Major clinical manifestations of hemorrhagic fevers are that of fever, rash, malaise and hemorrhagic signs. Due to the similarity between syndromes, any person with a history of persistent fever and any sign of hemorrhage should be considered as having viral hemorrhagic fever, and appropriate care instituted. Definitive diagnosis requires laboratory testing and is important to identify a possible biological warfare attack and to prepare for appropriate defense. This paper reviews the viruses that cause hemorrhagic fever, and their role as possible warfare agents.

Biological Warfare↗