Presentation to the Research Advisory Committee on Gulf War Veterans Illnesses June 11 2019 By James N Woody MD PhD CAPT MC USN RET Former Commanding Officer of NAMRU3 Cairo Egypt 19851989 ID: 933027
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Some thoughts on the Gulf War, Gulf War Illness, and potential for therapies
Presentation to theResearch Advisory Committee on Gulf War Veterans IllnessesJune 11, 2019ByJames N. Woody MD, PhDCAPT MC USN ( RET) Former Commanding Officerof NAMRU-3, Cairo, Egypt (1985-1989)and former Commanding Officer of the US Navy Medical Research and Development CommandBethesda MD 20184 (1989-1991)
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Slide2NAMRU-3 Cairo Egypt 1947- ? 2018US NAVY BL-3/4 FACILITY
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Cairo
Slide3WORKED WITH EGYPTIAN MOH
PUBLISHED OVER 40 PAPERS WITH COUNTRIES MOH OR HELTHCARE WORKERSINFECTIOUS DISEASE SURVEILLANCE:HIV, HEPATITIS, FLU, DENGUE, MALARIA, SHIGELLA, P-ECOLI, SALMONELLA, CHOLERA, PARASITES, SHISTOSOMIASIS, LEISHMANIASIS, ETC.
EBOLA, CONGO CRIMEAN, RIFT, MARBURG, LASSA, CHIKUGUNYA, WEST NILE, SANDFLY FEVER ,
NAMRU-3 CAIRO EGYPT DISEASE SURVEILLANCE MISSION FOR AREA
Some Accomplishments:
Designated WHO HIV Reference
Center for Eastern Med Region
ALAC Certified
BL-3 facility brought on line
Set up HIV/ other screening in 7 countries
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Slide5NAMRU-3 AND NPMU No 7 PERSONELL PROVIDED COMPREHENSIVE INFECTIOUS DISEASE AND BIOWARFARE AGENT DETECTION TECHNOLOGY ON THE FRONT LINES FOR DESERT SHIELD /DESERT STORM 1990-1991
NMR&DC awarded Marine Corps Meritorious Service Medal
Hyams
, Bourgeois,
Escamilia
, Burans,
Exceptional
Navy
Medical Officers
.
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Slide6Navy Forward Lab
6In TheatreReported to US Naval Forces Command (NAVCENT)
NAMRU-3 and US Navy Environmental and
Preventative Medicine Unit No 7 ( Naples Italy)
Provided Personnel and Equipment.
Support from out of theater:
Naval Medical Research Institute (NMRI)
Armed Forces Research Institute of Medical Sciences (AFRI)US Army Medical Research Institute of
Infectious Diseases
Walter Reed Army Institute of Research ( WRAIR)
NIH
Naval Research Laboratory
Chemical Biologic Defense Establishment ,
Porton Down UK
*Complete Infectious Disease Identification and Microscopy
*Immunologic based assays for detecting bacterial or viral
antigens and antibodies including BW agents
*Molecular Techniques like Polymerase Chain Reactions (PCR)
Slide7SOME FINDINGS for the Navy Forward Lab
MOP GEAR STRESSORSHORRIFIC EVENTS
ENVIRONMENTAL TOXIN EXPOSURES
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Slide8Gulf War Illness (GWI)
High frequency of unexplained health problems, across multiple biologic systems, as well as overall poor health amongst Gulf War VeteransExposures:Multiple VaccinationsPyridostigimineSarin/ CycloSarin gasDepleted uraniumSmoke from burning oil wellsInsecticidesHorrific Events
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Slide9Articles on Gulf War Syndrome and PTSD
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Slide10Available Information
1996
Vol 1 , 2000 to Volume 10 , 2016
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Slide11Progress
Congress Approves
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7 Academic Centers
Slide12Therapy Guidelines and more Progress 2017
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Slide13Best Information for my use
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Slide14Where are we:
1316 Trials for PTSD in Progress Approximately 250for various drug therapies., others psychosocial14
Slide15Research Progress : VA Brain Bank Enormous Asset
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Slide16Ketamine
Glutamate is the major excitatory transmitter for Brain functionKetamine blocks the NMDA receptor channel for glutamateAnalog of PCP… “ Special K”Clinical Trials in Major Depressive Disorder (MDD) and PTSD encouraging
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Slide17Ketamine as a Therapeutic
IntravenousIntramuscularOralIntranasal : J&J/ Janssen received FDA approval for eskatamine (Spravato) March 2019 Only available at “ Approved Centers” Must have failed two antidepressants Administered with a third antidepressant Patients stay in office, device does not leave office.
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Slide18Summary of GWI
GWI is a high frequency of unexplained health problems, across multiple biologic systems, as well as overall poor health amongst Gulf War VeteransExhaustive studies have not identified a unifying etiologyEpidemiology is well studiedNew insights are being gained into the psychological issuesVA PTSD Brain Bank- enormous resourceRna/Dna/ Proteomics analysis provide therapeutic targets to testNovel Brain receptor diagnostic probes provide insightsWorldwide Issues of CNS Depressive and Cognitive diseases are ChallengingMajor Depressive Disorder ( MDD)PTSDAlzheimer'sParkinson'sAutism
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