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The 8^th Singapore International Symposium for Protection Against Toxic Substances (SISPAT) is a technical forum that aims to share the latest knowledge and technology with regards to defence against unconventional threats amongst scientists and operations managers (military and public health) from the academia, government and other relevant industries. Asymmetrical threats posed by the use of unconventional agents transcend international boundaries and is constantly evolving to circumvent existing defence measures. Henceforth, defence measures against CBRN threats must leverage on bilateral and multi-lateral cooperation to remain effective. The theme for the 8^th SISPAT, "Staying One Step Ahead of Evolving CBRNe Threats Through International Cooperation", reinforces the importance of continuing this tradition of information sharing, scientific exchange and close-knit interactions between international communities to counter such asymmetric threats.The Symposium will be held in conjunction with the 24^th edition of NCT CBRNe Asia and the 25^th edition of NCT eXplosive Asia.

The 8^th Singapore International Symposium for Protection Against Toxic Substances (SISPAT) is a technical forum that aims to share the latest knowledge and technology with regards to defence against unconventional threats amongst scientists and operations managers (military and public health) from the academia, government and other relevant industries. Asymmetrical threats posed by the use of unconventional agents transcend international boundaries and is constantly evolving to circumvent existing defence measures. Henceforth, defence measures against CBRN threats must leverage on bilateral and multi-lateral cooperation to remain effective. The theme for the 8th SISPAT, "Staying One Step Ahead of Evolving CBRNe Threats Through International Cooperation", reinforces the importance of continuing this tradition of information sharing, scientific exchange and close-knit interactions between international communities to counter such asymmetric threats.The Symposium will be held in conjunction with the 24^th edition of NCT CBRNe Asia and the 25^th edition of NCT eXplosive Asia.

Dear Readers,this special issue of our journal, Military Medical Science Letters, is aimed at the summary of meeting abstracts presented at the 18^th Interdisciplinary Czech-Slovak Toxicology Conference - TOXCON 2013. This meeting was held in Hradec Kralove, Czech Republic, from 19^th to 21^st June 2013. This particular meeting was organized by Czech Society for Experimental and Clinical Pharmacology and Toxicology and Slovak Toxicology Society with the support of the University hospital Hradec Kralove, Faculty of Medicine, Charles University Hradec Kralove and Faculty of Military Health Sciences, University of Defence Hradec Kralove.It brought together academic, government and third sector organisations to debate key issues in toxicology. This summary presents all oral and poster contributions which were presented within this meeting. We hope that these abstracts will be useful to those who are working in this area of research.Kamil Kuca

In February 2016, the World Health Organization (WHO) declared the current Zika outbreak a Public Health Emergency of international concern. The Zika virus disease is caused by a virus (family Flaviviridae) transmitted by Aedes spp. mosquitoes. People with the Zika virus disease usually have symptoms that can include a low-grade fever, maculopapular rash, conjunctivitis, arthralgia, malaise, headache and retro-ocular headaches. Neurological and autoimmune complications have been described during the outbreaks in Polynesia and recently in Brazil. There are no licensed medical countermeasures - vaccines, therapies or preventive drugs available for the Zika virus infection and disease.

The University of Defence (UD) provides comprehensive education and training of students to get knowledge and skills which enable graduates to manage activities in the area of management and leadership. Formerly, the UD students received military and leadership skills especially within the military training outside the UD in basic training, in the Career course or the Specialized officer course at the Training Command - Military Academy (TC-MA) in Vyškov. Currently, the UD has included the Officer course into its own teaching curriculum, and thus bears a full responsibility for comprehensive preparedness of the UD graduates for their assignment to systemized positions in the Army of the Czech Republic (ACR).

The Syrian civil war is a shameful matter for the contemporary world. It is full of suffering for the civilian population and is one of the causes of the current huge migration of Syrian people in Europe. Suffering of people affected by the war is still escalating due to use of banned chemical weapons. The entire civilized world is appalled by the atrocities of the Syrian civil war.

In April 2005, an international advanced research workshop entitled, “Preparedness of Medical Systems: Guidelines for Mass-Casualty Situations” was convened in Haifa, Israel, under the auspices of NATO. Numerous specialists from various countries addressed the management of problems that arise during the hospital and pre-hospital phases of a medical response to mass-casualty situations, as well as the issue of preparedness for potential toxicological events. Methods for evaluating the quality of care provided during such situations were also discussed (1). In November 2009, the authors and their team organized the “NATO Advanced Training Course: Best Way of Training for Mass-Casualty Situations” for specialists from countries participating in the Partnership for Peace (PfP) and Mediterranean Dialogue (MD) programs; once again, the course was held in Haifa, Israel. The aim of the course was to inform its participants (all of whom were experienced protagonists in the field of emergency medical services and hospital management, or ministry of health officials, in their respective countries) about teaching and training methods for preparation for mass-casualty situations (2)...

Group of viral hemorrhagic fevers (VHF) present a range of disorders from relatively moderately serious to human life threatening entities whose mortality reaches high levels. There are classified as acute viral febrile diseases characterized by nausea, myalgia and fatigue, dominating with general alteration of vessel permeability and regulation. Symptoms of bleeding often occur, particularly in severe cases which are usually diffuse and present a symptom of general vessel injury rather than life-threatening condition.

Soldiers, particularly those involved in combat operations, are exposed to a continuous danger frequently resulting in various types of injuries, out of which the most common and serious is traumatic brain injury (TBI). Up to the second quarter of 2015, the Defense and Veterans Brain Injury Center has recorded 333,169 cases of active soldiers affected with TBI. TBI can be defined as an injury that results from external force to the head and causes an alternation of loss of consciousness. The key symptoms of TBI comprise physical problems, sensory impairments, behavioral changes, cognitive disorders, communication difficulties, and swallowing disorders. The purpose of this study is to review available studies on TBI among active military personnel with special focus on communication disorders. The methods applied for this study include a method of literature review of both clinical and review studies relevant for the researched issue in the acknowledged databases and a method of comparison and evaluation of their findings. The findings show that the research studies exploring communication disorders among the active military personnel are rare. In addition, earlier diagnosis of TBI is needed as well as a multidisciplinary team intervention approach to the treatment of TBI.

Viral hemorrhagic fevers (VHFs) represent a collection of illnesses caused by several distinct viral families. While some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses cause life-threatening diseases. In general, the term "viral hemorrhagic fever" describes a severe multisystem syndrome. Typical for this syndrome is a systemic damage of vascular system often accompanied by hemorrhages.Ebola is a type of VHF, along with Marburg, Lassa, dengue, Rift Valley, and yellow fever. VHFs are RNA viruses whose survival is dependent on animal or insect hosts. Ebola hemorrhagic fever initially makes the leap from an animal reservoir to a human, and can then be passed from human to human through direct contact.In the autumn and winter of 2014 every day professional and popular press published new information about Ebola outbreak in West Africa. It was not just data related to the number of patients, new recommendations and protocols, information about testing of potential vaccines, but also theoretical works that tried to analyze the situation and data.

A report about experiences gained during a month internship at the Queen Astrid Military Hospital Burns Centre in Brussels, Belgium, in May 2015.

The main goal of this reaserch is an evaluatin of mental stress. The level of stress was studied in a group of nurses that spent some time on the military missions, especially in Afghanistan.We used Meister questionary for evaluation of a stress level at work, in a civilian hospital in the Czech Republic and a military work place, during the mission.In conclusion, the goal of our reaserch is classification of a stress level during the nurses' deployment in foreign mission. Based on these results, some methods convenient for managing a higher level of stress were described and mechanisms of stress adaptation are discussed.

Healthcare is an industry that has a very strong position in economies and a relatively high share of GDP. It also includes the medical device industry. The aim of this paper is to analyse the potential of the market for medical devices in Europe. The starting point is the analysis of the external environment, describing the selected macroeconomic variables affecting aggregate demand and therefore the medical device industry in selected countries. The tool for strategic analysis of the European market is Porter's Five Forces model, where initial information is obtained from the analysis of economic indicators of the given industry, analysis of world databases data, analysis of documents dealing with studies of the medical device industry.The European market can be described as highly competitive, with a large number of small and medium-sized companies, stable innovative activity, which is significantly defined by the regulations by the competent authorities. Globally, this industry is predicted to grow.

Currently, Biomedicine is characterised by a growing need for processing large amounts of data in real time. This leads to new requirements for information and communication technologies (ICT). Cloud computing offers a solution to these requirements and provides a lot of advantages such as cost savings, elasticity and scalability of using ICT.The aim of this paper is to explore the concept of cloud computing. Firstly, the forms of cloud computing are described. Secondly, the potential benefits and limitations of Biomedicine technology are discussed. Finally, the current (present) situation of using this technology in Biomedicine in the Czech Republic from an economic point of view is analysed.

MAIN TOPICS: Influenza and new respiratory viral agents, Viral emerging infections, Viral congenital and neonatal infections, Viral blood born infections, Anthropozoonoses of viral origin, Viral gastroenteritis, Viruses and immunosuppressed host, Viral pathogenesis and immunity, Viral diagnosis, Viruses and oncogenesis, New antiviral agents, Strategies and progress in viral vaccines, Molecular epidemiology, Quality assurance in virology laboratory.

The Headquarters Joint Force Command (JFC) at Brunssum is an operational NATO headquarters located in that small town in the Limburg province of the Netherlands. The history of this HQ stems from 1967 when the Allied Forces Central Europe Command (AFCENT) was established there. In March 2000, HQ AFCENT stood down, and the new Regional Headquarters, Allied Forces Northern Europe (RHQ AFNORTH), assumed command of and responsibility for Northern Europe. As a result of the Prague Summit in November...

Personnel decontamination belongs to one of the crucial measurements performed to personnel's protection within hazard management after either employment of Weapons of Mass Destruction or leakage of Toxic Industrial Materials. Suitable personnel, technical and material conditions corresponding to current demands and trends are necessary to create its realization in this area. Knowledge gained within solution problems of personnel decontamination, casualty decontamination, immobile people decontamination, decontamination of personnel weapons, selected Individual Protective Equipment, personnel garments, accoutrements and other materials with the usage of modular elements are summarized in this paper. A conceptual proposal of solution of a mobile decontamination system for personnel decontamination is also stated in this paper.

On 28^th November 2012, the Social Health Academy, the Regional Emergency Medical Service, and the Department of Military Surgery at the University of Defence together held a workshop on States of Preparedness for Emergency- and Mass-Casualty Situations (MCS). The speakers were Dr. Moshe Michaelson (Director, Teaching Centre for Trauma, Emergency and Mass-Casualty Situations) and Mrs. Gila Hyams, RN (Director of Nursing and Trauma Co-ordinator) at the Rambam Hospital in Haifa, Israel. Altogether, thirty medical ...

The most complex topic is represented by operative treatment of type IV lesions of rotator cuff. Palliative arthroscopic resection of rotator cuff did not produce optimal results. We thus intend to evaluate the newly implemented surgical techniques at our department.Fifty-six patients with type IV rotator cuff lesions were treated surgically between October 2007 and December 2010. In 6 patients, combined operations had to be performed because of their pathology, and these were not included in detailed evaluation. The population selected for detailed evaluation of new surgical techniques included 50 patients (mean age: 59 years, range: 41-73 years). The patients were randomized into two subpopulations, each formed by 25 people. Both subpopulations can be considered representative and comparable.All operations were performed in the "beach-chair" position in general anesthesia or/and in interscalenic block. After type IV lesion was diagnosed, the prespecified surgical procedure followed - partial muscle transfer of subscapularis muscle tendon (Karas) or partial non-anatomic rotator cuff reconstruction (Burkhart). The results were evaluated after 6 months using the modified Constant Functional Score. The following parameters were assessed: sex, age, side of the operation, dominance of the limb, Constant Functional Score pre-operatively and post-operatively, subjective and objective evaluation, pain, activities, movement and muscle strength, Constant Score improvement, improvement in its individual items and subitems, pain pre-operatively and post-operatively.In older patients with type IV lesions, we have good experience with Karas method while in younger and more active patients, Burkhart method seems to be more useful.

On the 1^st July 2012 the Center for Transfer of Biomedical Technologies (CTBT) started its operation at the premisses of University Hospital Hradec Kralove. The center provides intellectual property protection assistance and other commercialization support to researchers of University Hospital Hradec Kralove and partner organizations - Faculty of Military Health Sciences of University of Defence, Faculty of Informatics and Management and Faculty of Science of University Hradec Kralove. CTBT links industrial partners interested in commercializing ...

A 43-year-old man, injured during a factory explosion on January 4, 2010, was transported to the nearest hospital. Volume resuscitation started, subclavian vein cannulation, chest tube, and covering of burns were performed. The intubated and ventilated patient was transferred by helicopter to our hospital. The leading diagnoses were: haemorrhagic - traumatic and burns shock, haemoperitoneum, pneumothorax, subtotal amputation of the left distal crus/feet, burns over 40 % of the body surface, right calcaneus fracture etc. Preliminary circulatory stabilisation with discontinuation of norepinephrine infusion was achieved within 10 hours, by excessive positive fluid balance, which took three days (22, 10 and 9 litres). Preliminary blood lactate 7 mmol/l was normalised within 24 hours. Blood albumin level 15 g/l was tolerated without any artificial replacement. The second hit appeared on day 10, in a form of septic shock caused by Aspergillus fumigatus infection from the lacerated left lower limb. High-volume continuous haemodiafiltration because of hyperpyrexia was used, after the exarticulation in the left knee-joint. An excessive proteolysis (urea loss more than 1000 mmol/day) persisted 1.5 months, with energy expenditure over 2600 kcal/day. The patient underwent multiple surgical interventions. Metabolic support using combined parenteral and enteral nutrition was performed during the first month, enteral nutrition combined with food were consequently given for more than 3 months. The patient was hospitalised until April 26, 2010. These types of traumas are fully comparable with military battlefield environment injuries. Principles of war surgery (life and limb saving, damage control surgery) should be applied also in civilian environment, particularly in disaster situations.

Sonography, thanks to the miniaturization, is increasingly widespread as a bedside examination technique in both hospital and prehospital emergency care. A number of protocols were set up for its effective and fast usage. The article briefly depicts this method and the requirements and ways of its application in the emergency care.

The Czech Republic, as a member of the United Nations Organization, sends Czech Army officers every year to fulfil various tasks in foreign missions in a lot of countries, especially on the African continent. In the following article, the authors deal with the disease which has become a serious topic of recent months in Liberia due to sudden death of UNMIL members of Pakistani origin. The author of the article works as an observer in UNMIL mission in Sector 1, in the town of Kakata, where she cooperates with the local C.H. Rennie Hospital.

The NATO Advanced Training Course on training for mass casualty situations was held in cooperation with Traumacenter Rambam Hospital in Haifa, Israel from November 16-18, 2009. In total, 22 participants from 8 countries of the Partnership for Peace and Mediterranean Dialogue Programmes attended the course. The participants, divided into three groups, discussed and practised scenarios of mass casualty management in the area of pre-hospital care, hospital care and use of non-conventional weapons. The international team of instructors used the following teaching methods: general lectures, guided discussions, use of advanced multimedia tools, tabletop drills, clinical simulations in a specialized center and a large-scale drill. The mass casualty drill was held at the end of the course. The trainees of the course also participated as observers and reviewers in the drill, and debriefed it together with Traumacenter medical staff. The course was made possible by the provision of a grant by the NATO Science for Peace and Security Programme.

The discipline of medical ethics is concerned with morality, moral obligations and the principles of proper professional conduct concerning the rights and duties of a physician himself, his patients and fellow practitioners, as well as his actions in the care of patients and in relation with their families. Its foundations lie in the philosophical traditions of Eastern and Western thought and have strongly shaped modern codes of conduct and conventions...

The marine microalgae producing the phycotoxins are common food for many marine animals which then themselves become toxic. In the recent years an enhanced attention has been paid to the phycotoxins because they penetrate into the fishery products through feed chains and they can cause intoxication in humans the therapy of which is very difficult. The danger concerning toxigenic microalgae is growing as a consequence of the enhanced migration of population and military missions into unstable regions of the world. These activities can cause severe health impairment of somatic and psychological character. The possibilities and importance of preventive measures and their observance are outlined particularly for military missions.

The authors provide an overview of the social significance of the deep venous thrombosis (DVT) and large funds from both patients and health insurance organisations for the treatment.
We compared the results obtained during treatment of patients with unfractionated heparin (UFH) and low molecular weight heparin (LMWH).
The presented data and results for the cost of treatment of DVT patients require considerable financing. From the economic point of view under the conditions of health insurance it is important to increase the number of patients treated in outpatient settings.

In spite of sporadic occurrence of Invasive Meningococcal Diseases (IMD), epidemics with high death rates and Seque/ae are nothing exceptional. N. Meningitidis B was replaced by a new clone of N. meningitidis C: 2a: P1.2 (P1.5). Recruits of military troops deployed in the O/omouc district have occurred among the first afflicted. The clinical outlook resulted even in few deaths. Mass immunization of all the recruits demonstrated increasing immunization coverage reaching up to 98 % in 1998. Vaccine against A+C (Pasteur Merieux) has been used. The mass immunization of all the recruits was followed by a substantial decrease of IMD incidence, which has a/most disappeared Since that time.....