Removal of nuclear bomb debris, Strontium 90-Yttrium 90, and Cesium 137-Barium 137 from water with Corps of Engineers mobile water-treating equipment /

Mode of access: Internet.

Battlefield damage assessment and repair for chemical defensive materiel.

"September 1987."

Operator's manual : decontaminating kit, skin, M258A1, NSN 4230-01-101-3984 and training aid, skin decontaminating, M58A1, NSN 6910-01-101-1768.

"17 May 1985."

Direct support and general support maintenance repair parts and tools lists for decontaminating apparatus, power-driven, skid-mounted, 500-gallon, M12A1 (NSN 4230-00-926-9488).

"March 1977."

Direct and general support maintenance manual : decontaminating apparatus, power-driven, skid-mounted, multipurpose, nonintegral, 500-gallon, ABC-M12A1 (FSN 4230-926-9488).

"June 1974."

Operator's manual : decontaminating apparatus, power-driven, skid-mounted, 500-gallon, M12A1 (NSN 4230-00-926-9488).

"June 1986."

Operator's manual : decontaminating kit, skin, M291.

"October 1989."

Operator's manual : decontaminating apparatus, power-driven, skid-mounted, 500-gallon, M12A1 (NSN 4230-00-926-9488).

"June 1986."

Treatment of chemical warfare casualties /

Includes index.

Technical escort information on chemical agents and decontaminating procedures.

"January 1971."

Demilitarization procedures for FSC 4230, decontaminating and impregnating equipment; FSC 4410, industrial boilers; FSC 6810, chemicals; FSC 6850, miscellaneous.

"September 1976."

A Comparative Analysis of Two Slug Test Methods in Puget Lowland Glacio-Fluvial Sediments near Coupeville, WA

Two different slug test field methods are conducted in wells completed in a Puget Lowland aquifer and are examined for systematic error resulting from water column displacement techniques. Slug tests using the standard slug rod and the pneumatic method were repeated on the same wells and hydraulic conductivity estimates were calculated according to Bouwer & Rice and Hvorslev before using a non-parametric statistical test for analysis. Practical considerations of performing the tests in real life settings are also considered in the method comparison. Statistical analysis indicates that the slug rod method results in up to 90% larger hydraulic conductivity values than the pneumatic method, with at least a 95% certainty that the error is method related. This confirms the existence of a slug-rod bias in a real world scenario which has previously been demonstrated by others in synthetic aquifers. In addition to more accurate values, the pneumatic method requires less field labor, less decontamination, and provides the ability to control the magnitudes of the initial displacement, making it the superior slug test procedure.

The population pharmacokinetics of citalopram after deliberate self-poisoning: A Bayesian approach

Defining the pharmacokinetics of drugs in overdose is complicated. Deliberate self-poisoning is generally impulsive and associated with poor accuracy in dose history. In addition, early blood samples are rarely collected to characterize the whole plasma-concentration time profile and the effect of decontamination on the pharmacokinetics is uncertain. The aim of this study was to explore a fully Bayesian methodology for population pharmacokinetic analysis of data that arose from deliberate self-poisoning with citalopram. Prior information on the pharmacokinetic parameters was elicited from 14 published studies on citalopram when taken in therapeutic doses. The data set included concentration-time data from 53 patients studied after 63 citalopram overdose events (dose range: 20-1700 mg). Activated charcoal was administered between 0.5 and 4 h after 17 overdose events. The clinical investigator graded the veracity of the patients' dosing history on a 5-point ordinal scale. Inclusion of informative priors stabilised the pharmacokinetic model and the population mean values could be estimated well. There were no indications of non-linear clearance after excessive doses. The final model included an estimated uncertainty of the dose amount which in a simulation study was shown to not affect the model's ability to characterise the effects of activated charcoal. The effect of activated charcoal on clearance and bioavailability was pronounced and resulted in a 72% increase and 22% decrease, respectively. These findings suggest charcoal administration is potentially beneficial after citalopram overdose. The methodology explored seems promising for exploring the dose-exposure relationship in the toxicological settings.

Antibiotic resistance in the intensive care unit: A primer in bacteriology

The clinical use of potent, well-tolerated, broad-spectrum antibiotics has been paralleled by the development of resistance in bacteria, and the prevalence of highly resistant bacteria in some intensive care units is despairingly commonplace. The intensive care community faces the realistic prospect of untreatable nosocomial infections and should be searching for new approaches to diagnose and manage resistant bacteria. In this review, we discuss some of the relevant underlying biology, with a particular focus on genetic transfer vehicles and the relationship of selection pressure to their movements. It is an attempt to demystify the relevant language and concepts for the anaesthetist and intensivist, to explain some of the reasons for the emergence of resistance in bacteria, and to provide a contextual basis for discussion of management approaches such as selective decontamination and antibiotic cycling.

Protein contamination of the laryngeal mask airway and its relationship to re-use

The Laryngeal Mask Airway is a reusable device for maintaining the patency of a patient's airway during general anaesthesia. The device can be reused after it has been cleaned and sterilized. Protein contamination of medical instruments is a concern and has been found to occur despite standard sterilization techniques. The reason for the concern relates to the possibility of the transmission of prions and the risk of developing a neurodegenerative disorder such as Creutzveldt-Jacob disease. The purpose of this study was to quantify the amount of protein contamination that occurs, and to relate this to the number of times the Laryngeal Mask Airway has been used. Fifty previously used Classic Laryngeal Masks were collected after routine sterilization and packaging. The devices were immersed in protein detecting stain and then visual inspection performed to assess the degree and distribution of the staining. The researcher was blinded to the number of times the Laryngeal Mask Airway had been used. Linear regression analysis of the degrees of staining of the airway revealed that protein contamination occurs after the first use of the device and this increases with each subsequent use. This finding highlights the concern that the currently used cleaning and sterilization methods do not prevent the accumulation of proteinaceous material on Laryngeal Mask Airways. Consideration should be given to the search for more efficient cleaning and sterilization techniques or the use of disposable devices.