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Diagnostics and treatment of nerve agent poisoning-current status and future developments
Annals of the New York Academy of Sciences ( IF 4.1 ) Pub Date : 2020-03-21 , DOI: 10.1111/nyas.14336 Niko Amend 1 , Karin V. Niessen 1 , Thomas Seeger 1 , Timo Wille 1 , Franz Worek 1 , Horst Thiermann 1
Annals of the New York Academy of Sciences ( IF 4.1 ) Pub Date : 2020-03-21 , DOI: 10.1111/nyas.14336 Niko Amend 1 , Karin V. Niessen 1 , Thomas Seeger 1 , Timo Wille 1 , Franz Worek 1 , Horst Thiermann 1
Affiliation
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Although 193 states have committed to the Chemical Weapons Convention and 98% of the declared chemical weapons stockpiles have been destroyed so far, nerve agent poisoning remains a lingering threat. The recent dissemination of sarin in Syria, the assassination of Kim Jong‐Nam in Malaysia, and the assault on Sergei Skripal in the United Kingdom underline the need for effective treatment. The current therapeutic options of a muscarinic receptor antagonist, an oxime, and an anticonvulsant have been unchanged for decades. Therefore, new therapeutic strategies, for example, bioscavengers and receptor‐active substances, are promising concepts that have to be examined for their benefits and limitations. In order to facilitate rapid diagnosis in challenging clinical situations, point‐of‐care diagnostics and detection are of importance. Therapeutic guidance concerning the duration and success of the current oxime therapy via determination of the cholinesterase status can contribute to an optimal use of resources. In summary, the challenges of current and future therapies for nerve agent poisoning and key diagnostic devices will be discussed.
中文翻译：
神经毒剂中毒的诊治——现状与未来发展
尽管迄今为止已有 193 个国家承诺加入《化学武器公约》，并且 98% 的已申报化学武器库存已被销毁，但神经毒剂中毒仍然是一个挥之不去的威胁。最近沙林在叙利亚的传播、金正男在马来西亚被暗杀以及在英国对谢尔盖斯克里帕尔的袭击都强调了有效治疗的必要性。毒蕈碱受体拮抗剂、肟和抗惊厥药的当前治疗选择几十年来一直没有改变。因此，新的治疗策略，例如生物清除剂和受体活性物质，是很有前景的概念，必须对其益处和局限性进行研究。为了在具有挑战性的临床情况下促进快速诊断，即时诊断和检测非常重要。通过确定胆碱酯酶状态，关于当前肟治疗的持续时间和成功的治疗指导有助于资源的最佳利用。总之，将讨论当前和未来神经毒剂中毒疗法和关键诊断设备的挑战。
更新日期：2020-03-21
中文翻译：
神经毒剂中毒的诊治——现状与未来发展
尽管迄今为止已有 193 个国家承诺加入《化学武器公约》，并且 98% 的已申报化学武器库存已被销毁，但神经毒剂中毒仍然是一个挥之不去的威胁。最近沙林在叙利亚的传播、金正男在马来西亚被暗杀以及在英国对谢尔盖斯克里帕尔的袭击都强调了有效治疗的必要性。毒蕈碱受体拮抗剂、肟和抗惊厥药的当前治疗选择几十年来一直没有改变。因此，新的治疗策略，例如生物清除剂和受体活性物质，是很有前景的概念，必须对其益处和局限性进行研究。为了在具有挑战性的临床情况下促进快速诊断，即时诊断和检测非常重要。通过确定胆碱酯酶状态，关于当前肟治疗的持续时间和成功的治疗指导有助于资源的最佳利用。总之，将讨论当前和未来神经毒剂中毒疗法和关键诊断设备的挑战。
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