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Biomedical subjects

M G Kortepeter

Publications and source records attributed to M G Kortepeter.

10 recordsLinked to original sources
PubMed2001

Tuberculosis infection after humanitarian assistance, Guantanamo Bay, 1995.

Upon redeployment to Fort Lewis, Washington, from Operation Sea Signal in Guantanamo Bay, Cuba, 5% of a military police unit was identified as positive for purified protein derivative (PPD). A case-control study was conducted to document the number of converters and to identify risk factors among the soldiers for PPD conversion while in Cuba. Forty-six of the soldiers (3.7% of the unit) met the criteria for PPD conversion as a result of deployment. Forty-four converters and 84 controls completed surveys. Logistic regression showed that statistically significant independent risk factors for PPD conversion included working around coughing migrants (odds ratio [OR] = 6.73, 95% confidence interval [CI] = 2.2-20.4) and birthplace outside the United States (OR = 4.89, CI = 1.3-18.5). Contact in the psychiatric hospital (OR = 0.22, CI = 0.05-0.90) and contact with migrants with known tuberculosis (OR = 0.16, CI = 0.05-0.54) appeared to be protective factors, possibly because known tuberculosis patients and hospitalized patients most likely would be on treatment and rendered noninfectious. With the U.S. military's involvement in humanitarian and refugee operations in countries highly endemic for tuberculosis, service members are at increased risk of acquiring tuberculosis infection. Detection of tuberculosis infection and appropriate treatment should become a higher priority within the U.S. military.

Case-Control Studies↗
PubMed2001

Recent challenges in infectious diseases. Biological pathogens as weapons and emerging endemic threats.

This article reviews emerging and re-emerging infectious diseases and provides insights regarding the evolution of our understanding of natural diseases and how that knowledge impacts the development of plans and methods for defending against the deliberate use of biological agents. Also discussed are forensic and legal issues for the pathologist concerning agents of biological terrorism and biological warfare, the concept of chain of custody, transport, storage, and biosafety levels. It defines the importance of the pathologist in managing the threat posed by biological weapons.

Biological Warfare↗
PubMed2000

Immunization against potential biological warfare agents.

The intentional release of biological agents by belligerents or terrorists is a possibility that has recently attracted increased attention. Law enforcement agencies, military planners, public health officials, and clinicians are gaining an increasing awareness of this potential threat. From a military perspective, an important component of the protective pre-exposure armamentarium against this threat is immunization. In addition, certain vaccines are an accepted component of postexposure prophylaxis against potential bioterrorist threat agents. These vaccines might, therefore, be used to respond to a terrorist attack against civilians. We review the development of vaccines against 10 of the most credible biological threats.

Bacterial Infections↗
PubMed2000

A field-expedient algorithmic approach to the clinical management of chemical and biological casualties.

Warriors on the modern battlefield face considerable danger from possible attack with chemical and biological weapons. Aggravating this danger is the fact that medical resources at the lowest echelons of care, already likely to be strained to capacity during modern conventional combat, are at present inadequate to handle large numbers of chemical or biological casualties. Complicating this problem further is the austere nature of diagnostic modalities available at lower echelons. With this in mind, and given the urgency required to adequately manage chemical and biological casualties, it is likely that such casualties will initially require significant empiric care in the absence of a definitive diagnosis. Such care under field conditions, often rendered by relatively inexperienced medical personnel, might best be provided using an algorithmic approach. We have developed such an algorithm.

Algorithms↗
PubMed1998

Disease and nonbattle injury among United States soldiers deployed in Bosnia-Herzegovina during 1997: summary primary care statistics for Operation Joint Guard.

Systematic surveillance of outpatient (primary care) encounters with the health care system has been performed for North Atlantic Treaty Organization coalition forces during peace-keeping operations in Bosnia-Herzegovina since 1995. The present study presents an analysis of disease and nonbattle injury (DNBI) surveillance findings for U.S. forces participating in Operation Joint Guard during 1997. The mean DNBI rate for this 1-year period was 8.1/100/week (range, 5.7-11.1/100/week). Most frequently cited causes for soldier visits to medical treatment facilities were injuries and orthopedic conditions (27%), respiratory disease (26%), miscellaneous "other" medical conditions (13%), dermatologic disorders (12%), and dental disease (10%). Gastroenteritis was infrequently seen (2% of visits). Our findings extend previous observations that indicate that the Bosnia peacekeeping mission is relatively safe and healthy for U.S. forces.

Ambulatory Care↗
PubMedDate not supplied

Bioterrorism.

Although biological agents have been used in warfare for centuries, several events in the past decade have raised concerns that they could be used for terrorism. Revelations about the sophisticated biological-weapons programs of the former Soviet Union and Iraq have heightened concern that countries with offensive-research programs, including those that sponsor international terrorism, might assist in the proliferation of agents, culturing capability, and dissemination techniques, and might benefit in these undertakings from the availability of skilled laboratory technicians. Release of sarin nerve agent in the Tokyo subway system in 1995 by the Aum Shinrikyo cult demonstrated that in the future terrorists might select unconventional weapons. Certain properties of biological pathogens may make them the ideal terrorist weapon, including 1) ease of procurement, 2) simplicity of production in large quantities at minimal expense, 3) ease of dissemination with low technology, and 4) potential to overwhelm the medical system with large numbers of casualties. Dissemination of a biological agent would be silent, and the incubation period allows a perpetrator to escape to great distances from the area of release before the first ill persons seek medical care. Countermeasures include intelligence gathering, physical protection, and detection systems. Medical countermeasures include laboratory diagnostics, vaccines, and medications for prophylaxis and treatment. Public health, medical, and environmental health personnel need to have a heightened awareness, through education, about the threat from biological agents.

Bioterrorism↗