[The role of the pulmonologist in an armed conflict]

INTRODUCTION

Recent news points to the eventuality of an armed conflict on the national territory.

STATE OF THE ART

In this situation, pulmonologists will in all likelihood have a major role to assume in caring for the injured, especially insofar as chest damage is a major cause of patient death.

PERSPECTIVES

The main injuries that pulmonologists may be called upon to treat stem not only from explosions, but also from chemical, biological and nuclear hazards. In this article, relevant organizational and pedagogical aspects are addressed. Since exhaustiveness on this subject is unattainable, we are proposing training on specific subjects for interested practitioners.

CONCLUSION

The resilience of the French health system in a situation of armed conflict depends on the active participation of all concerned parties. With this in mind, it is of prime importance that the pneumological community be sensitized to the potential predictable severity of war-related injuries.

[The French Armed Forces Biomedical Research Institute (IRBA) and wastewater-based epidemiology: Applicability and relevance in armed forces]

The French Armed Forces Biomedical Research Institute (IRBA) deeply involved in research on SARS-COV-2, participated in the creation of the Obépine sentinel network in charge of detecting, qualifying and quantifying the virus genome in wastewater in France. During this pandemic, wastewater-based epidemiology has proven to be a first class public health tool for assessing viral dynamics in populations and environment. Obépine has also conducted research demonstrating the low infectivity of faeces and wastewater and allowed for early detection of epidemic waves linked to new variants. The IRBA has adapted this powerful tool to the monitoring of viral infections on board the aircraft carrier Charles-de-Gaulle in order to get an operational system for anticipation after the first local outbreak in 2020. The presence of this surveillance and anticipation tool has allowed a better management of SARS-CoV-2 contingent introductions on board during stopovers or crewmembers entries. The combination of a mandatory vaccination protocol and the surveillance of viral circulation in black waters has made it possible to identify and locate cases, and thus to continue the operational mission in the COVID-19 environment while limiting the spread and preserving the health of the crew. This innovative tool can easily be redirected to the search for any other pathogens in blackwater or even, in the long term, to ensure health surveillance of any military establishment, at sea or on land, in France or on overseas bases.

Sweet little Gabonese palm wine: a neglected alcohol

BACKGROUND

During the last ten years, consumption of palm wine, a popular traditional alcoholic beverage, seriously increases in Gabon. This sweet beverage seems to be the main alcohol and the most drunken in low socioeconomic population.

OBJECTIVE

To have an idea of its composition and toxicity, 21 samples of palm wine were collected in the country and analysed.

METHODS

Twenty-one palm wine samples were randomly selected from all over Gabon. Methanol and ethanol concentrations in the samples were measured by gas chromatography. Aromatic hydrocarbons were measured by selected ion monitoring mode in mass spectrometry. Delection of heavy metals was by standard techniques.

RESULTS

Gabonese palm wine contained ethanol at a mean concentration of about 60 g*L-1, i.e. 7.5 degrees (volume %), volatile components such as alcohols, aldehydes, carboxylic acids and esters and trace metals. Trace metals were present at low concentrations below internationally recognized maximal limits for alcoholic beverages with less than 2 microg*L-1 for cadmium, less than 10 microg*L-1 for arsenic and for lead 15 samples with concentrations under 10 microg*L-1 and the last six samples with concentrations between 11 and 61 microg*L-1. None of the searched aromatic or chlorinated solvents, indicative of refined fuel or industrial contamination, was detected.

CONCLUSION

For the parameters analyzed here, there seems to be no significant difference in constitution between Gabonese wine palm and others kind of palm wine produced in West Africa. This alcohol needs to be more considered by public health authorities and medical teams because of its health and economic consequences.

Modeling of hospital wastewater pollution by pharmaceuticals: first results of Mediflux study carried out in three French hospitals

A study has been carried out in three French hospitals in order to assess and model the pharmaceutical load in hospital wastewater and its impact in WWTP. This study, called Mediflux, consisted of three successive steps: first, an original prioritization procedure developed in our laboratory enabled us to select a list of relevant molecules from different Anatomical Therapeutic Chemical (ATC) classes containing pharmaceuticals for specific hospital use such as anesthetics or antineoplastic agents and pharmaceuticals dispensed in the community. Then, analytical quantification procedures were developed and validated according to 2002/657/EC European directive. Sampling campaigns were performed in three different hospitals, two located in the Paris area and one in a medium-sized city 150 km from Paris. Sampling was also carried out in wastewater treatment plants. At the same time, in order to model the pharmaceutical loads from hospitals, predicted concentrations were calculated as a first approach assuming it would be a single-box model, i.e. hospitals have no effect on drug loads and only human metabolism is taken into account to evaluate the fraction of drugs eliminated in hospital effluent. In the last step, the comparison of measured and calculated concentrations showed a satisfactory correlation for some pharmaceuticals, mainly those with short elimination half-lifes and weak human metabolism. For others, it appeared that modeling should take into account various factors such as out patient use, pharmacokinetic data and molecule stability in wastewater.

[Infrared spectrophotometry: a versatile analytical tool in hospital pharmacy]

Pharmacy services in healthcare facilities have increasing analytical needs, as frequently recalled by good practices guidelines (hospital pharmacy good practices, hospital pharmaceutical preparations good practices). Various analytical methods can be employed, from spot tests to the most recent chromatographic methods. The purpose of this paper is to demonstrate, with two concrete examples, the versatility and pertinence of one of these analytical methods: infrared spectrophotometry. We describe two current applications, used in a hospital pharmacy service: identification of pharmaceutical raw material and dose control of cytotoxic injectable preparations.