{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:53:46Z","timestamp":1792122826173,"version":"4.4.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"5-6","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,18]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Nerve agents have emerged as a global threat since their discovery in the 1930s, posing severe risks due to their inhibition of acetylcholinesterase and the subsequent accumulation of acetylcholine in nerve synapses. Despite the enforcement of the Chemical Weapon Convention to control chemical weapons, including nerve agents, recent events, such as the Novichok attacks on Sergei Skripal and Alexei Navalny, have highlighted the persistent threat. Novichok, a distinct class of nerve agents, raises specific concerns regarding its management due to limited understanding. This article aims to comprehensively analyze existing literature.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>A scoping review was employed to comprehensively assess the current state of knowledge on managing patients poisoned with Novichok. Following the PRISMA-ScR guidelines, relevant literature was identified in peer-reviewed journals covering symptoms, diagnosis, treatment, decontamination, and long-term effects. Searches were conducted on February 1, 2023, across four electronic databases (PubMed, EMBASE, MEDLINE, and Web of Science) using \u201cNovichok\u201d as a keyword. No restrictions were applied, and additional studies were sought from the references of identified papers. Eligible papers included discussions on Novichok or its specific properties impacting management, regardless of study type, language, or publication date, while those unrelated to the study\u2019s conceptual framework were excluded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 170 records were identified from the initial database search, with 86 studies screened after removing duplicates. Among these, 28 publications met the eligibility criteria and were included in the analysis. An additional relevant study was identified from the citation lists of included studies, bringing the total to 29. The review encompasses studies published from 2018 onwards, indicating the growing interest in this topic. While most studies are reviews on Novichok or nerve agents in general, several theoretical and experimental investigations were also found.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This review highlights the significant uncertainties and knowledge gaps surrounding the management of patients poisoned with Novichok. While some aspects align with other nerve agents, limited research likely due to safety and ethical challenges leads to assumptions and uncertainties in patient care. The review identifies areas with ongoing research, such as decontamination and biomarker recognition, while other aspects remain understudied. The possible inefficacy of current treatment options and the need for further research on oximes, bioscavengers, and long-term effects emphasize the necessity for increased research to optimize patient outcomes. More studies are essential to clarify the actual threat and toxicity of Novichok. Moreover, raising awareness among medical staff is crucial for early diagnosis, prompt treatment, and safety. This review offers valuable insights into managing Novichok-poisoned patients and calls for increased research and awareness in this critical area.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usad464","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T01:51:34Z","timestamp":1701395494000},"page":"e1381-e1389","source":"Crossref","is-referenced-by-count":4,"title":["Current Perspectives on\u00a0the Management of\u00a0Patients Poisoned With Novichok: A Scoping Review"],"prefix":"10.1093","volume":"189","author":[{"given":"Tess L","family":"Blom","sequence":"first","affiliation":[{"name":"Diving and Submarine Medical Center, Royal Netherlands Navy , Den Helder, CA 1780,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7740-7392","authenticated-orcid":false,"given":"Thijs T","family":"Wingelaar","sequence":"additional","affiliation":[{"name":"Diving and Submarine Medical Center, Royal Netherlands Navy , Den Helder, CA 1780,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"issue":"1","key":"2025012315134505000_R1","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1136\/jramc-2019-001380","article-title":"Nerve agents: emergency preparedness","volume":"166","author":"Weir","year":"2020","journal-title":"BMJ Mil Health"},{"issue":"2","key":"2025012315134505000_R2","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.mpmed.2015.11.004","article-title":"Chemical terrorism and\u00a0nerve agents","volume":"44","author":"Vale","year":"2016","journal-title":"Medicine"},{"key":"2025012315134505000_R3","article-title":"Evolution of\u00a0the status of\u00a0participation in\u00a0the convention","author":"OPCW"},{"key":"2025012315134505000_R4","doi-asserted-by":"crossref","DOI":"10.1038\/d41586-019-03686-y","article-title":"Novichok nerve agents banned by chemical-weapons treaty","volume-title":"Nature (London)","author":"Castelvecchi"},{"key":"2025012315134505000_R5","article-title":"All category 1 chemicals declared by Syria now destroyed","author":"OPCW"},{"key":"2025012315134505000_R6","article-title":"Director-General commends major milestone as Russia completes destruction of\u00a0chemical weapons stockpile under OPCW verification","author":"OPCW"},{"key":"2025012315134505000_R7","article-title":"Initial U.S. assessment suggests nerve agent used in\u00a0Syria attack: sources","volume-title":"Reuters","author":"Hosenball"},{"key":"2025012315134505000_R8","article-title":"Sarin used in\u00a0April Syria attack, chemical weapons watchdog confirms","volume-title":"The Guardian","author":"Chulov"},{"key":"2025012315134505000_R9","article-title":"Kim Jong-nam killed by VX nerve agent, say Malaysian police","volume-title":"The Guardian","author":"Holmes"},{"key":"2025012315134505000_R10","article-title":"Murder at the airport: the brazen attack on\u00a0Kim Jong Nam. 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