Sanid. mil. 2018; 74 (2) 67 Sanidad Militar Revista de Sanidad de las Fuerzas Armadas de España Sanid. Mil. Volumen 74, número 2. ISSN: 1887-8571 Abril-junio 2018 CONTENTS EDITORIAL 70 Madrid Defence University College: a Step ahead in training new military doctors. García Honduvilla N. ORIGINAL ARTICLE 72 Medical site survey influence over medical treatment facility deployment in operations areas Munayco Sánchez A., Carbayo Herencia JA., Quintana Díaz M. SUMMARY: Introduction: Medical treatment facilities are deployed in international missions. Site Survey carried on by experts must be done to reach the aims. In some cases, this task does not involve the medical element. Objectives: The aim of this study has been to assess the impact of the medical site survey and its planning in order to achieve the deployment of medical resources in war, violent or austere environments when abroad. Methods: Observational study with the evaluation of 13 medical deployments resources. In 7 cases previous medical site survey and 6 during the operation itself were assessed. The operating capability was considered fully achieved when reached within a maximum known time. Proportions were compared to ji tests and exactly to Fisher tests. Results: From the 13 medical operations 7 missions with previous medical site survey, 6 reached “full capability” in a minimum time (P=0,005). However, on the 6 missions where the study was performed without a previous survey, “full capability” was never reached within this minimum time (P=0,005). Conclusion: The key to reach a successful medical operation depends on its previous planning though a medical site survey and carried out by military health corps experts. This is the way to reach the aims defined during the previous phase. KEYWORDS: Planning, ROLE, medical site survey unit, operating capability, check list. 79 Study of the NKD POD+ bottle efficacy: analysis of its safety filtering system Garavís González J., Moreno Talavera I., Pérez Alcalde B., Vírseda Chamorro IJ. SUMMARY: Background and objectives: Nowadays, the Army uses disinfectant tablets to purify water. Recently, it was hinted the possibility of including in our combatants’ equipment a special kind of bottle with a new filtering system, the NKD POD+ The main objective of this research is to analyse the efficacy of this bottle filtering system in order to assess its possible use by Spanish Army so as to allow the filtering of any type of water which, once drunk, implies no health risk. In order to do so, the Laboratorio de Análisis de Aguas (Water Analysis Lab) of the Instituto de Toxicología de la Defensa (Defence Toxicology Institute) performed chemical and microbiological tests on different water samples to assess the degree of efficacy of the filter in order to eliminate heavy metals, pesticides, nitrates and water microorganisms. Materials and method: In order to conduct the tests, different samples with distilled water and certified patron solutions of the contaminants were used. Later, these samples were filtered through the bottle. The samples were analyses prior and after the filtering process. The analysis of the nitrites was conducted with visible ultraviolet spectroscopy (UV-Vis), heavy metals through inductive coupling plasma, coupled to mass spectrometry (ICP-MS), and pesticides through coupling gas chromatography to mass spectrometry (CG/MS). Results: It was proved that the water filter had hardly eliminated heavy metals. Pesticides in concentration of 1 μg/L were properly filtered by the bottle but to a lesser extent for concentrations of 10 μg/L. Regarding nitrites, it was observed an increase with respect to the original concentration in the filtered sample. In the microbiological test, the filtering system only retained those particles bigger than 0.45 μm, being totally ineffective with the tiniest ones such as enterococcus. Conclusions: the Nkd POD+ bottle generates a false feeling of safety as it does not meet the necessary requirements and compromises the combatants’ health. KEYWORDS: Nkd POD+ bottle, Filter, Water, Water safety. 84 Optimization and validation of a real-time PCR for rapid identification of Bacillus thuringiensis, surrogate of Bacillus anthracis Bassy Álvarez O., Larigauderie G., Ortega García MªV., Granja Albarellos C., Cabria Ramos JC. SUMMARY: Introduction: Bacillus anthracis is the most employed biological warfare agent in the world. However, in biological defense laboratories, on many occasions, it is convenient to use other bacteria similar to Bacillus anthracis but less dangerous or non-pathogenic. One of the main surrogates of Bacillus anthracis is Bacillus thuringiensis, due to its high homology with B. anthracis and its null pathogenicity for humans. Objective: The objective of the present study is to develop and validate a real-time PCR for the rapid identification of Bacillus thuringiensis DNA, a biological agent very often employed in the training of the Operative Units of CBRN sampling of the Armed Forces. Methods: The identification of Bacillus thuringiensis has been performed by the amplification and detection with a hydrolysis probe of a 69 base pairs fragment of the cry1A gene, which is specific for this bacterium. After optimizing the amplification conditions by testing three different hybridization / extension temperatures, the validation of the new developed method was carried out. Results: The new developed real-time PCR showed an efficiency of 93%, as well as a high linearity (regression coefficient R2 0.9993). The limit of detection at 95% probability was 13 genome equivalents per reaction. Both the inclusiveness and the exclusivity of the method were 100%. Conclusions: The molecular method developed at the Molecular Biology Laboratory of INTA allows the rapid identification of Bacillus thuringiensis DNA, surrogate of Bacillus anthracis, with a high analytical sensitivity and specificity. KEYWORDS: Bacillus thuringiensis, real-time PCR, molecular identification, cry1A gen.
RSM 74-2
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