Sample records for breath tests

  1. Outcome of breath tests in adult patients with suspected small intestinal bacterial overgrowth

    PubMed Central

    Mattsson, Johanna; Minaya, Maria Teresa; Monegro, Milka; Lebwohl, Benjamin; Lewis, Suzanne K.; Green, Peter HR; Stenberg, Reidun

    2017-01-01

    Aim: The aim was to investigate breath test outcomes in patients with suspected SIBO and indicative symptoms of SIBO, diagnosed by breath testing. Background: Breath testing is used to detect small intestinal bacterial overgrowth (SIBO) by measuring hydrogen and methane produced by intestinal bacteria. Methods: This retrospective cross sectional study included 311 patients with gastrointestinal symptoms who underwent the breath test for evaluation of SIBO at Celiac Disease Center at Columbia University, New York, in 2014-2015. The patients were divided into two groups based on the physician’s choice: lactulose breath test group (72%) and glucose breath test group (28%). Among them, 38% had a history of celiac disease or non-celiac gluten sensitivity. Results: In total, 46% had a positive breath test: 18% were positive for methane, 24 % positive for hydrogen and 4% positive for both gases (p=0.014). Also, 50% had a positive lactulose breath result and 37% had a positive glucose breath result (p=0.036). The most common symptom for performing the breath test was bloating and the only clinical symptom that significantly showed a positive glucose breath test was increased gas (p=0.028). Conclusion: Lactulose breath test was more often positive than glucose breath test. Positivity for hydrogen was more common than methane. Bloating was the most frequently perceived symptom of the patients undergoing the breath test but the only statistically significant clinical symptom for a positive glucose breath test was increased gas. Furthermore, the results showed that there was no significant association between positive breath test result and gender, age, non-celiac gluten sensitivity or celiac disease. PMID:29118931

  2. 49 CFR 40.277 - Are alcohol tests other than saliva or breath permitted under these regulations?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Are alcohol tests other than saliva or breath... Testing § 40.277 Are alcohol tests other than saliva or breath permitted under these regulations? No.... Only saliva or breath for screening tests and breath for confirmation tests using approved devices are...

  3. 49 CFR 40.277 - Are alcohol tests other than saliva or breath permitted under these regulations?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Are alcohol tests other than saliva or breath... Testing § 40.277 Are alcohol tests other than saliva or breath permitted under these regulations? No.... Only saliva or breath for screening tests and breath for confirmation tests using approved devices are...

  4. Hydrogen breath test in schoolchildren.

    PubMed Central

    Douwes, A C; Schaap, C; van der Klei-van Moorsel, J M

    1985-01-01

    The frequency of negative hydrogen breath tests due to colonic bacterial flora which are unable to produce hydrogen was determined after oral lactulose challenge in 98 healthy Dutch schoolchildren. There was a negative result in 9.2%. The probability of a false normal lactose breath test (1:77) was calculated from these results together with those from a separate group of children with lactose malabsorption (also determined by hydrogen breath test). A study of siblings and mothers of subjects with a negative breath test did not show familial clustering of this condition. Faecal incubation tests with various sugars showed an increase in breath hydrogen greater than 100 parts per million in those with a positive breath test while subjects with a negative breath test also had a negative faecal incubation test. The frequency of a false negative hydrogen breath test was higher than previously reported, but this does not affect the superiority of this method of testing over the conventional blood glucose determination. PMID:4004310

  5. The effect of breath freshener strips on two types of breath alcohol testing instruments.

    PubMed

    Moore, Ronald L; Guillen, Jennifer

    2004-07-01

    The potential for breath freshener strips to interfere with the accuracy of a breath alcohol test was studied. Twelve varieties of breath freshener strips from five manufacturers were examined. Breath tests were conducted using the infrared based BAC DataMaster or the fuel cell based Alco-Sensor IV-XL, 30 and 150 seconds after placing a breath strip on the tongue. No effect was observed using the Alco-Sensor system. Some of the strips gave a small reading at 30 seconds (less than or equal to 0.010 g/210 L apparent alcohol) using the DataMaster. Readings on the DataMaster returned to zero by the 150 second test. A proper pre-test observation and deprivation period should prevent any interference from breath freshener strips on breath alcohol testing.

  6. 21 CFR 862.3050 - Breath-alcohol test system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breath-alcohol test system. 862.3050 Section 862....3050 Breath-alcohol test system. (a) Identification. A breath-alcohol test system is a device intened to measure alcohol in the human breath. Measurements obtained by this device are used in the...

  7. 21 CFR 862.3050 - Breath-alcohol test system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Breath-alcohol test system. 862.3050 Section 862....3050 Breath-alcohol test system. (a) Identification. A breath-alcohol test system is a device intened to measure alcohol in the human breath. Measurements obtained by this device are used in the...

  8. The glucose breath test: a diagnostic test for small bowel stricture(s) in Crohn's disease.

    PubMed

    Mishkin, Daniel; Boston, Francis M; Blank, David; Yalovsky, Morty; Mishkin, Seymour

    2002-03-01

    The aim of this study was to determine whether an indirect noninvasive indicator of proximal bacterial overgrowth, the glucose breath test, was of diagnostic value in inflammatory bowel disease. Twenty four of 71 Crohn's disease patients tested had a positive glucose breath test. No statistical conclusions could be drawn between the Crohn's disease activity index and glucose breath test status. Of patients with radiologic evidence of small bowel stricture(s), 96.0% had a positive glucose breath test, while only one of 46 negative glucose breath test patients had a stricture. The positive and negative predictive values for a positive glucose breath test as an indicator of stricture formation were 96.0% and 97.8%, respectively. This correlation was not altered in Crohn's disease patients with fistulae or status postresection of the terminal ileum. The data in ulcerative colitis were nondiagnostic. In conclusion, the glucose breath test appears to be an accurate noninvasive inexpensive diagnostic test for small bowel stricture(s) and secondary bacterial overgrowth in Crohn's disease.

  9. 13C-methacetin and 13C-galactose breath tests can assess restricted liver function even in early stages of primary biliary cirrhosis.

    PubMed

    Holtmeier, Julia; Leuschner, Maria; Schneider, Arne; Leuschner, Ulrich; Caspary, Wolfgang F; Braden, Barbara

    2006-11-01

    The 13C-methacetin breath test quantitatively evaluates cytochrome P450-dependent liver function. The 13C-galactose breath test non-invasively measures the galactose oxidation capacity of the liver. The aim of this study was to find out whether these breath tests are sensitive parameters also in non-cirrhotic patients with primary biliary cirrhosis. Nineteen patients with early-stage primary biliary cirrhosis (no cirrhotic alterations in the liver biopsy, Ludwig stage I-III) and 20 healthy controls underwent the 13C-methacetin and 13C-galactose breath tests. Patients with primary biliary cirrhosis metabolized less 13C-methacetin than controls (cumulative recovery within 30 min 7.5+/-2.4% versus 14.0+/-2.6%; p < 0.001). When a cut-off > 9.8% was used for the cumulative recovery after 30 min, the methacetin breath test reached 84.2% sensitivity and 95.0 specificity. In the 13C-galactose breath test, the percentage recovery at 60 min in patients was 3.1+/-1.3%/h, and 6.3+/-1.1%/h in controls (p < 0.001). Using a cut-off > 4.7%/h, the galactose breath test reached 89.5% sensitivity and 95.0 specificity. In non-cirrhotic, early-stage, primary biliary cirrhosis the 13C-methacetin breath test and the 13C-galactose breath test reliably indicate decreased liver function. The 13C-galactose breath test can also predict the histological score.

  10. Measurement of hepatic functional mass by means of 13C-methacetin and 13C-phenylalanine breath tests in chronic liver disease: Comparison with Child-Pugh score and serum bile acid levels

    PubMed Central

    Festi, D.; Capodicasa, S.; Sandri, L.; Colaiocco-Ferrante, L.; Staniscia, T.; Vitacolonna, E.; Vestito, A.; Simoni, P.; Mazzella, G.; Portincasa, P.; Roda, E.; Colecchia, A.

    2005-01-01

    AIM: To evaluate and compare the clinical usefulness of 13C-phenylalanine and 13C-methacetin breath tests in quantitating functional hepatic mass in patients with chronic liver disease and to further compare these results with those of conventional tests, Child-Pugh score and serum bile acid levels. METHODS: One hundred and forty patients (50 HCV- related chronic hepatitis, 90 liver cirrhosis patients) and 40 matched healthy controls were studied. Both breath test and routine liver test, serum levels of cholic and chenodeoxycholic acid conjugates were evaluated. RESULTS: Methacetin breath test, expressed as 60 min cumulative percent of oxidation, discriminated the hepatic functional capacity not only between controls and liver disease patients, but also between different categories of chronic liver disease patients. Methacetin breath test was correlated with liver function tests and serum bile acids. Furthermore, methacetin breath test, as well as serum bile acids, were highly predictive of Child-Pugh scores. The diagnostic power of phenylalanine breath test was always less than that of methacetin breath test. CONCLUSION: Methacetin breath test represents a safe and accurate diagnostic tool in the evaluation of hepatic functional mass in chronic liver disease patients. PMID:15609414

  11. 49 CFR 219.206 - FRA access to breath test results.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false FRA access to breath test results. 219.206 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.206 FRA access to breath test results. Documentation of breath test results must be made available...

  12. 49 CFR 219.206 - FRA access to breath test results.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false FRA access to breath test results. 219.206 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.206 FRA access to breath test results. Documentation of breath test results must be made available...

  13. 49 CFR 219.206 - FRA access to breath test results.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false FRA access to breath test results. 219.206 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.206 FRA access to breath test results. Documentation of breath test results must be made available...

  14. 49 CFR 219.206 - FRA access to breath test results.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false FRA access to breath test results. 219.206 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.206 FRA access to breath test results. Documentation of breath test results must be made available...

  15. 49 CFR 219.206 - FRA access to breath test results.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false FRA access to breath test results. 219.206 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.206 FRA access to breath test results. Documentation of breath test results must be made available...

  16. Results of the first semi-annual qualification testing of devices to measure breath alcohol

    DOT National Transportation Integrated Search

    1975-01-01

    Eight evidential breath testers were performance tested according to the Standard for Devices to Measure Breath Alcohol Federal Register, Vol 38, No. 212, November 5, 1973. In addition, a prototype breath tester not commercially available was tested....

  17. Fecal /sup 13/C analysis for the detection and quantitation of intestinal malabsorption

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Klein, P.D.; MacLean, W.C. Jr.; Watkins, J.B.

    Use of /sup 14/CO/sub 2/ breath tests and fecal analyses for the detection and quantitation of intestinal malabsorption has been extensively documented in adult subjects. The use of radioisotopes has extended the range of breath test applications to include pediatric and geriatric subjects. Here we report a fecal /sup 13/C analysis that can be used in conjunction with /sup 14/CO/sub 2/ breath tests. Twenty-four-hour fecal samples were collected before and after the administration of a labeled substrate. Simultaneous cholyglycine /sup 13/CO/sub 2/ breath tests and fecal assays were performed in five children. One child with bacterial overgrowth had an abnormalmore » breath test and a normal fecal test. Of three children with ileal dysfunction, only one had an abnormal breath test, whereas the fecal test was abnormal in all three. Both the breath test and fecal test were abnormal for a child who had undergone an ileal resection. Both tests were normal for a child with ulcerative colitis.« less

  18. 42 CFR 84.88 - Breathing bag test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Apparatus § 84.88 Breathing bag test. (a) Breathing bags will be tested in an air atmosphere saturated with... Institute upon request. (d) The air within the bag(s) shall not contain more than 100 parts per million of... 42 Public Health 1 2014-10-01 2014-10-01 false Breathing bag test. 84.88 Section 84.88 Public...

  19. Clinical significance of the glucose breath test in patients with inflammatory bowel disease.

    PubMed

    Lee, Ji Min; Lee, Kang-Moon; Chung, Yoon Yung; Lee, Yang Woon; Kim, Dae Bum; Sung, Hea Jung; Chung, Woo Chul; Paik, Chang-Nyol

    2015-06-01

    Small intestinal bacterial overgrowth which has recently been diagnosed with the glucose breath test is characterized by excessive colonic bacteria in the small bowel, and results in gastrointestinal symptoms that mimic symptoms of inflammatory bowel disease. This study aimed to estimate the positivity of the glucose breath test and investigate its clinical role in inflammatory bowel disease. Patients aged > 18 years with inflammatory bowel disease were enrolled. All patients completed symptom questionnaires. Fecal calprotectin level was measured to evaluate the disease activity. Thirty historical healthy controls were used to determine normal glucose breath test values. A total of 107 patients, 64 with ulcerative colitis and 43 with Crohn's disease, were included. Twenty-two patients (20.6%) were positive for the glucose breath test (30.2%, Crohn's disease; 14.1%, ulcerative colitis). Positive rate of the glucose breath test was significantly higher in patients with Crohn's disease than in healthy controls (30.2% vs 6.7%, P=0.014). Bloating, flatus, and satiety were higher in glucose breath test-positive patients than glucose breath test-negative patients (P=0.021, 0.014, and 0.049, respectively). The positivity was not correlated with the fecal calprotectin level. The positive rate of the glucose breath test was higher in patients with inflammatory bowel disease, especially Crohn's disease than in healthy controls; gastrointestinal symptoms of patients with inflammatory bowel disease were correlated with this positivity. Glucose breath test can be used to manage intestinal symptoms of patients with inflammatory bowel disease. © 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  20. Laboratory testing of two prototype in-vehicle breath test devices

    DOT National Transportation Integrated Search

    1985-08-01

    This report presents the results of laboratory testing of two recently developed prototype in-vehicle breath test devices. These devices are designed to prevent persons with alcohol on their breath from driving a car. The devices tested were the SOBE...

  1. Additional Value of CH4 Measurement in a Combined 13C/H2 Lactose Malabsorption Breath Test: A Retrospective Analysis

    PubMed Central

    Houben, Els; De Preter, Vicky; Billen, Jaak; Van Ranst, Marc; Verbeke, Kristin

    2015-01-01

    The lactose hydrogen breath test is a commonly used, non-invasive method for the detection of lactose malabsorption and is based on an abnormal increase in breath hydrogen (H2) excretion after an oral dose of lactose. We use a combined 13C/H2 lactose breath test that measures breath 13CO2 as a measure of lactose digestion in addition to H2 and that has a better sensitivity and specificity than the standard test. The present retrospective study evaluated the results of 1051 13C/H2 lactose breath tests to assess the impact on the diagnostic accuracy of measuring breath CH4 in addition to H2 and 13CO2. Based on the 13C/H2 breath test, 314 patients were diagnosed with lactase deficiency, 138 with lactose malabsorption or small bowel bacterial overgrowth (SIBO), and 599 with normal lactose digestion. Additional measurement of CH4 further improved the accuracy of the test as 16% subjects with normal lactose digestion and no H2-excretion were found to excrete CH4. These subjects should have been classified as subjects with lactose malabsorption or SIBO. In conclusion, measuring CH4-concentrations has an added value to the 13C/H2 breath test to identify methanogenic subjects with lactose malabsorption or SIBO. PMID:26371034

  2. Nondispersive infrared spectrometry for 13CO2/12CO2-measurements: a clinically feasible analyzer for stable isotope breath tests in gastroenterology.

    PubMed

    Braden, B; Caspary, W F; Lembcke, B

    1999-06-01

    13C-urea breath tests have become clinical routine for the diagnosis of Helicobacter pylori infection and other isotope breath tests have been invented e.g. for gastric emptying or quantitative liver function testing. Recently, isotope-selective nondispersive infrared spectrometers (NDIRS) have been developed for the analysis of the 13CO2/12CO2-enrichment in breath. In this study, we prospectively tested the validity of a newly developed NDIRS in comparison to isotope ratio mass spectrometry (IRMS). 142 patients with dyspeptic symptoms were tested for Helicobacter pylori infection using the 13C-urea breath test. The isotope ratio analysis of the breath samples was performed in duplicate both using IRMS and NDIRS. The results of the baseline-corrected 13CO2-exhalation values between IRMS and NDIRS were in excellent agreement. The mean difference between both methods was 0.28 +/- 1.93 delta/1000. Evaluating the qualitative urea breath test results in reference to IRMS as the reference the NDIRS had a sensitivity of 97.8% and a specificity of 98.9%. The isotope-selective nondispersive infrared spectroscopy is going to become a reliable, but low-cost and easy-to-operate alternative to expensive isotope ratio mass spectrometry in the analysis of 13C-breath tests.

  3. Pulmonary Function Testing in Children

    MedlinePlus

    ... breathing test. About 15 minutes after taking the medicine, your child will repeat the breathing test. The results from ... the first test to find out if the medicine has improved your child’s breathing. Why shouldn’t I give my child ...

  4. sup 14 C-urea breath test for the detection of Helicobacter pylori

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Veldhuyzen van Zanten, S.J.; Tytgat, K.M.; Hollingsworth, J.

    1990-04-01

    The high urease activity of Helicobacter pylori can be used to detect this bacterium by noninvasive breath tests. We have developed a {sup 14}C-urea breath test which uses 5 microCi {sup 14}C with 50 mg nonradioactive urea. Breath samples are collected at baseline and every 30 min for 2 h. Our study compared the outcome of the breath test to the results of histology and culture of endoscopically obtained gastric biopsies in 84 patients. The breath test discriminated well between the 50 positive patients and the 34 patients negative for Helicobacter pylori: the calculated sensitivity was 100%, specificity 88%, positivemore » predictive value 93%, and negative predictive value 100%. Treatment with bismuth subsalicylate and/or ampicillin resulted in lower counts of exhaled {sup 14}CO{sub 2} which correlated with histological improvement in gastritis. The {sup 14}C-urea breath test is a better gold standard for the detection of Helicobacter pylori than histology and/or culture.« less

  5. Chemical sensors for breath gas analysis: the latest developments at the Breath Analysis Summit 2013.

    PubMed

    Tisch, Ulrike; Haick, Hossam

    2014-06-01

    Profiling the body chemistry by means of volatile organic compounds (VOCs) in the breath opens exciting new avenues in medical diagnostics. Gas sensors could provide ideal platforms for realizing portable, hand-held breath testing devices in the near future. This review summarizes the latest developments and applications in the field of chemical sensors for diagnostic breath testing that were presented at the Breath Analysis Summit 2013 in Wallerfangen, Germany. Considerable progress has been made towards clinically applicable breath testing devices, especially by utilizing chemo-sensitive nanomaterials. Examples of several specialized breath testing applications are presented that are either based on stand-alone nanomaterial-based sensors being highly sensitive and specific to individual breath compounds over others, or on combinations of several highly specific sensors, or on experimental nanomaterial-based sensors arrays. Other interesting approaches include the adaption of a commercially available MOx-based sensor array to indirect breath testing applications, using a sample pre-concentration method, and the development of compact integrated GC-sensor systems. The recent trend towards device integration has led to the development of fully integrated prototypes of point-of-care devices. We describe and compare the performance of several prototypes that are based on different sensing technologies and evaluate their potential as low-cost and readily available next-generation medical devices.

  6. Sensing the effects of mouth breathing by using 3-tesla MRI

    NASA Astrophysics Data System (ADS)

    Park, Chan-A.; Kang, Chang-Ki

    2017-06-01

    We investigated the effects of mouth breathing and typical nasal breathing on brain function by using blood-oxygenation-level-dependent (BOLD) functional magnetic resonance imaging (fMRI). The study had two parts: the first test was a simple contrast between mouth and nasal breathing, and the second test involved combined breathing modes, e.g., mouth inspiration and nasal expiration. Eleven healthy participants performed the combined breathing task while undergoing 3T fMRI. In the group-level analysis, contrast images acquired by using an individual participantlevel analysis were processed using the one-sample t test. We also conducted a region-of-interest analysis comparing signal intensity changes between the breathing modes; the region was selected using an automated anatomical labeling map. The results demonstrated that the BOLD signal in the hippocampus and brainstem was significantly decreased in mouth breathing relative to nasal breathing. On the other hand, both the precentral and postcentral gyri showed activation that was more significant in mouth breathing compared to nasal breathing. This study suggests that the BOLD activity patterns between mouth and nasal breathing may be induced differently, especially in the hippocampus, which could provide clues to explain the effects on brain cognitive function due to mouth breathing.

  7. [*C]octanoic acid breath test to measure gastric emptying rate of solids.

    PubMed

    Maes, B D; Ghoos, Y F; Rutgeerts, P J; Hiele, M I; Geypens, B; Vantrappen, G

    1994-12-01

    We have developed a breath test to measure solid gastric emptying using a standardized scrambled egg test meal (250 kcal) labeled with [14C]octanoic acid or [13C]octanoic acid. In vitro incubation studies showed that octanoic acid is a reliable marker of the solid phase. The breath test was validated in 36 subjects by simultaneous radioscintigraphic and breath test measurements. Nine healthy volunteers were studied after intravenous administration of 200 mg erythromycin and peroral administration of 30 mg propantheline, respectively. Erythromycin significantly enhanced gastric emptying, while propantheline significantly reduced gastric emptying rates. We conclude that the [*C]octanoic breath test is a promising and reliable test for measuring the gastric emptying rate of solids.

  8. A novel 13C-urea breath test device for the diagnosis of Helicobacter pylori infection: continuous online measurements allow for faster test results with high accuracy.

    PubMed

    Israeli, Eran; Ilan, Yaron; Meir, Shimon Bar; Buenavida, Claudia; Goldin, Eran

    2003-08-01

    The aim of this study is to determine the accuracy of a novel laptop sized 13C-Urea breath test analyzer that continuously measures expired breath and to use its advantages to decrease testing time. One hundred and eighty-six subjects (mean age of 47.8 years) were tested simultaneously by the BreathID system (Oridion, Israel), and by the traditional IRMS. BreathID continuously measured the expired breath for a ratio of 13CO(2):12CO(2.) This value was expressed as delta over baseline (DOB) and displayed graphically on a screen in real time. One hundred and one subjects were positive and 85 were negative for H. pylori by isotope ratio mass spectrometry (IRMS). The correlation for the BreathID system at 30 minutes was 100% for positive cases and 98% for negative cases. Analysis of the continuous curves generated by the BreathID for all patients permitted definition of different DOB thresholds for a positive or negative result at shorter time intervals. Thus, after 6 minutes a conclusive test result could be obtained for 64% of subjects, and after 10 minutes for 92% of subjects. The 13C-Urea breath test utilizing the technology of molecular correlation spectrometry is an accurate method for determining infection by H. pylori. The advantage of continuous measurements can shorten testing time without compromising accuracy.

  9. News from the Breath Analysis Summit 2011.

    PubMed

    Corradi, Massimo; Mutti, Antonio

    2012-06-01

    This special section highlights some of the important work presented at the Breath Analysis Summit 2011, which was held in Parma (Italy) from 11 to 14 September 2011. The meeting, which was jointly organized by the International Association for Breath Research and the University of Parma, was attended by more than 250 delegates from 33 countries, and offered 34 invited lectures and 64 unsolicited scientific contributions. The summit was organized to provide a forum to scientists, engineers and clinicians to present their latest findings and to meet industry executives and entrepreneurs to discuss key trends, future directions and technologies available for breath analysis. A major focus was on nitric oxide, exhaled breath condensate, electronic nose, mass spectrometry and newer sensor technologies. Medical applications ranged from asthma and other respiratory diseases to gastrointestinal disease, occupational diseases, critical care and cancer. Most people identify breath tests with breathalysers used by police to estimate ethanol concentration in blood. However, breath testing has far more sophisticated applications. Breath analysis is rapidly evolving as a new frontier in medical testing for disease states in the lung and beyond. Every individual has a breath fingerprint-or 'breathprint'-that can provide useful information about his or her state of health. This breathprint comprises the many thousands of molecules that are expelled with each breath we exhale. Breath research in the past few years has uncovered the scientific and molecular basis for such clinical observations. Relying on mass spectrometry, we have been able to identify many such unique substances in exhaled breath, including gases, such as nitric oxide (NO) and carbon monoxide (CO), and a wide array of volatile organic compounds. Exhaled breath also carries aerosolized droplets that can be collected as an exhaled breath condensate that contains endogenously produced non-volatile compounds. Breath analysis is now used to diagnose and monitor asthma, check for transplant organ rejection, detect lung cancer and test for Helicobacter pyloriinfection-and the list is growing. A major milestone in the scientific study of breath was marked in the 1970s when Linus Pauling demonstrated that there is more to exhaled breath than the classic gases of nitrogen, oxygen, carbon dioxide and water vapour-a lot more. Based on the gas-liquid partition chromatography analysis, Pauling reported the presence of 250 substances in exhaled breath. We now have the technology to test for any and all of these components. The field of breath analysis has made considerable advances in the 21st century and the utility of breath analysis in health care is advancing quickly. The science is rapidly expanding, the technology is improving and several new applications have been developed or are under commercial development. Breath analysis may rely on both direct (on line) and indirect (off line) reading methods: in the on-line method, breath analysis is immediately available, whereas the use of indirect methods generally involves collecting and trapping the breath sample and subsequently transferring it to an analytical instrument for analysis. Various kinds of breath samples have been used in biological monitoring, including mixed expired air and end expired air: end exhaled air represents the alveolar air concentration and mixed exhaled air represents the gas mixture coming from the dead space of the bronchial tree and the alveolar gas-exchange space. Exhaled breath analysis is an area where the modern day advances in technology and engineering meet the ever expanding need in medicine for more sensitive, specific and non-invasive tests which makes this area a major front in the interface between medicine and engineering. A major breakthrough over the past decade has been the increase in breath-based tests approved by the US Food and Drug Administration (FDA). Devices measuring common breath gases (oxygen, nitrogen, water vapour and CO(2)) in patient respiratory monitoring have served as a platform for technological growth in clinical breath-testing applications. A few exhaled breath tests have demonstrated clinical utility and are in widespread use, and several FDA-approved devices are available. These widely used exhaled breath tests include detection of blood alcohol concentration and exhaled CO(2). Other clinical applications of exhaled breath analysis include testing for H. pylori infection, lactose intolerance, heart transplant rejection and, more recently, monitoring of airway inflammation by means of exhaled NO. Examination of exhaled breath has the potential to change the existing routine approaches in human medicine. The rapidly developing new analytical and computer technologies along with novel, unorthodox ideas are prerequisites for future advances in this field. Scientists who participated in the Breath Analysis Summit 2011 were invited to submit a full length paper to the Journal of Breath Research and this issue includes eight articles which describe the different applications of breath analysis. We thank all the authors for their valuable contribution and we trust that this collection will provide useful information and an update to this rapidly evolving field, giving an example of integration among scientists who address the same topic-breath analysis-from different and complementary perspectives, from basic to clinical research.

  10. Application of drug testing using exhaled breath for compliance monitoring of drug addicts in treatment.

    PubMed

    Carlsson, Sten; Olsson, Robert; Lindkvist, Irene; Beck, Olof

    2015-04-01

    Exhaled breath has recently been identified as a possible matrix for drug testing. This study explored the potential of this new method for compliance monitoring of patients being treated for dependence disorders. Outpatients in treatment programs were recruited for this study. Urine was collected as part of clinical routine and a breath sample was collected in parallel together with a questionnaire about their views of the testing procedure. Urine was analyzed for amphetamines, benzodiazepines, cannabis, cocaine, buprenorphine, methadone and opiates using CEDIA immunochemical screening and mass spectrometry confirmation. The exhaled breath was collected using the SensAbues device and analyzed by mass spectrometry for amphetamine, methamphetamine, diazepam, oxazepam, tetrahydrocannabinol, cocaine, benzoylecgonine, buprenorphine, methadone, morphine, codeine and 6-acetylmorphine. A total of 122 cases with parallel urine and breath samples were collected; 34 of these were negative both in urine and breath. Out of 88 cases with positive urine samples 51 (58%) were also positive in breath. Among the patients on methadone treatment, all were positive for methadone in urine and 83% were positive in breath. Among patients in treatment with buprenorphine, 92% were positive in urine and among those 80% were also positive in breath. The questionnaire response documented that in general, patients accepted drug testing well and that the breath sampling procedure was preferred. Compliance testing for the intake of prescribed and unprescribed drugs among patients in treatment for dependence disorders using the exhaled breath sampling technique is a viable method and deserves future attention.

  11. Prediction of heart transplant rejection with a breath test for markers of oxidative stress.

    PubMed

    Phillips, Michael; Boehmer, John P; Cataneo, Renee N; Cheema, Taseer; Eisen, Howard J; Fallon, John T; Fisher, Peter E; Gass, Alan; Greenberg, Joel; Kobashigawa, Jon; Mancini, Donna; Rayburn, Barry; Zucker, Mark J

    2004-12-15

    The Heart Allograft Rejection: Detection with Breath Alkanes in Low Levels study evaluated a breath test for oxidative stress in heart transplant recipients, and we report here a mathematical model predicting the probability of grade 3 rejection. The breath test divided the heart transplant recipients into 3 groups: positive for grade 3 rejection, negative for grade 3 rejection, and intermediate. The test was 100% sensitive for grade 3 heart transplant rejection when the p value was >/=0.98, and 100% specific when the p value was

  12. 46 CFR 197.450 - Breathing gas tests.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Breathing gas tests. 197.450 Section 197.450 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE OCCUPATIONAL SAFETY AND HEALTH STANDARDS GENERAL PROVISIONS Commercial Diving Operations Periodic Tests and Inspections of Diving Equipment § 197.450 Breathing gas tests. The diving...

  13. (13)C-Breath testing in animals: theory, applications, and future directions.

    PubMed

    McCue, Marshall D; Welch, Kenneth C

    2016-04-01

    The carbon isotope values in the exhaled breath of an animal mirror the carbon isotope values of the metabolic fuels being oxidized. The measurement of stable carbon isotopes in carbon dioxide is called (13)C-breath testing and offers a minimally invasive method to study substrate oxidation in vivo. (13)C-breath testing has been broadly used to study human exercise, nutrition, and pathologies since the 1970s. Owing to reduced use of radioactive isotopes and the increased convenience and affordability of (13)C-analyzers, the past decade has witnessed a sharp increase in the use of breath testing throughout comparative physiology--especially to answer questions about how and when animals oxidize particular nutrients. Here, we review the practical aspects of (13)C-breath testing and identify the strengths and weaknesses of different methodological approaches including the use of natural abundance versus artificially-enriched (13)C tracers. We critically compare the information that can be obtained using different experimental protocols such as diet-switching versus fuel-switching. We also discuss several factors that should be considered when designing breath testing experiments including extrinsic versus intrinsic (13)C-labelling and different approaches to model nutrient oxidation. We use case studies to highlight the myriad applications of (13)C-breath testing in basic and clinical human studies as well as comparative studies of fuel use, energetics, and carbon turnover in multiple vertebrate and invertebrate groups. Lastly, we call for increased and rigorous use of (13)C-breath testing to explore a variety of new research areas and potentially answer long standing questions related to thermobiology, locomotion, and nutrition.

  14. Data Mining Techniques Applied to Hydrogen Lactose Breath Test.

    PubMed

    Rubio-Escudero, Cristina; Valverde-Fernández, Justo; Nepomuceno-Chamorro, Isabel; Pontes-Balanza, Beatriz; Hernández-Mendoza, Yoedusvany; Rodríguez-Herrera, Alfonso

    2017-01-01

    Analyze a set of data of hydrogen breath tests by use of data mining tools. Identify new patterns of H2 production. Hydrogen breath tests data sets as well as k-means clustering as the data mining technique to a dataset of 2571 patients. Six different patterns have been extracted upon analysis of the hydrogen breath test data. We have also shown the relevance of each of the samples taken throughout the test. Analysis of the hydrogen breath test data sets using data mining techniques has identified new patterns of hydrogen generation upon lactose absorption. We can see the potential of application of data mining techniques to clinical data sets. These results offer promising data for future research on the relations between gut microbiota produced hydrogen and its link to clinical symptoms.

  15. Does low dose (13)C-urea breath test maintain a satisfactory accuracy in diagnosing Helicobacter pylori infection?

    PubMed

    Coelho, Luiz Gonzaga Vaz; Silva, Arilto Eleutério da; Coelho, Maria Clara de Freitas; Penna, Francisco Guilherme Cancela e; Ferreira, Rafael Otto Antunes; Santa-Cecilia, Elisa Viana

    2011-01-01

    The standard doses of (13)C-urea in (13)C-urea breath test is 75 mg. To assess the diagnostic accuracy of (13)C-urea breath test containing 25 mg of (13)C-urea comparing with the standard doses of 75 mg in the diagnosis of Helicobacter pylori infection. Two hundred seventy adult patients (96 males, 174 females, median age 41 years) performed the standard (13)C-urea breath test (75 mg (13)C-urea) and repeated the (13)C-urea breath test using only 25 mg of (13)C-urea within a 2 week interval. The test was performed using an infrared isotope analyzer. Patients were considered positive if delta over baseline was >4.0‰ at the gold standard test. One hundred sixty-one (59.6%) patients were H. pylori negative and 109 (40.4%) were positive by the gold standard test. Using receiver operating characteristic analysis we established a cut-off value of 3.4% as the best value of 25 mg (13)C-urea breath test to discriminate positive and negative patients, considering the H. pylori prevalence (95% CI: 23.9-37.3) at our setting. Therefore, we obtained to 25 mg (13)C-urea breath test a diagnostic accuracy of 92.9% (95% CI: 88.1-97.9), sensitivity 83.5% (95% CI: 75.4-89.3), specificity 99.4% (95% CI: 96.6-99.9), positive predictive value 98.3% (95% CI: 92.4-99.4), and negative predictive value 93.0% (95% CI: 88.6-96.1). Low-dose (13)C-urea breath test (25 mg (13)C-urea) does not reach accuracy sufficient to be recommended in clinical setting where a 30% prevalence of H. pylori infection is observed. Further studies should be done to determine the diagnostic accuracy of low doses of (13)C-urea in the urea breath test.

  16. A metabolic simulator for unmanned testing of breathing apparatuses in hyperbaric conditions.

    PubMed

    Frånberg, Oskar; Loncar, Mario; Larsson, Åke; Ornhagen, Hans; Gennser, Mikael

    2014-11-01

    A major part of testing of rebreather apparatuses for underwater diving focuses on the oxygen dosage system. A metabolic simulator for testing breathing apparatuses was built and evaluated. Oxygen consumption was achieved through catalytic combustion of propene. With an admixture of carbon dioxide in the propene fuel, the system allowed the respiratory exchange ratio to be set freely within human variability and also made it possible to increase test pressures above the condensation pressure of propene. The system was tested by breathing ambient air in a pressure chamber with oxygen uptake (Vo₂) ranging from 1-4 L · min(-1), tidal volume (VT) from 1-3 L, breathing frequency (f) of 20 and 25 breaths/min, and chamber pressures from 100 to 670 kPa. The measured end-tidal oxygen concentration (Fo₂) was compared to calculated end-tidal Fo₂. The largest average difference in end-tidal Fo₂during atmospheric pressure conditions was 0.63%-points with a 0.28%-point average difference during the whole test. During hyperbaric conditions with pressures ranging from 100 to 670 kPa, the largest average difference in Fo₂was 1.68%-points seen during compression from 100 kPa to 400 kPa and the average difference in Fo₂during the whole test was 0.29%-points. In combination with a breathing simulator simulating tidal breathing, the system can be used for dynamic continuous testing of breathing equipment with changes in VT, f, Vo2, and pressure.

  17. 49 CFR 40.267 - What problems always cause an alcohol test to be cancelled?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... breath tube ASD). (4) The breath tube ASD is tested with an analyzer which has not been pre-calibrated... the case of a screening test conducted on a saliva ASD or a breath tube ASD: (1) The STT or BAT reads... § 40.245(a)(8) for the saliva ASD and § 40.245(b)(8) for the breath tube ASD). (2) The saliva ASD does...

  18. 49 CFR 40.267 - What problems always cause an alcohol test to be cancelled?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... breath tube ASD). (4) The breath tube ASD is tested with an analyzer which has not been pre-calibrated... the case of a screening test conducted on a saliva ASD or a breath tube ASD: (1) The STT or BAT reads... § 40.245(a)(8) for the saliva ASD and § 40.245(b)(8) for the breath tube ASD). (2) The saliva ASD does...

  19. 49 CFR 40.267 - What problems always cause an alcohol test to be cancelled?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... breath tube ASD). (4) The breath tube ASD is tested with an analyzer which has not been pre-calibrated... the case of a screening test conducted on a saliva ASD or a breath tube ASD: (1) The STT or BAT reads... § 40.245(a)(8) for the saliva ASD and § 40.245(b)(8) for the breath tube ASD). (2) The saliva ASD does...

  20. Operation and testing of Mark 10 Mod 3 underwater breathing apparatus

    NASA Technical Reports Server (NTRS)

    Milwee, W. I., Jr.

    1972-01-01

    Performance tests on a closed circuit, mixed gas underwater breathing apparatus are reported. The equipment is designed to provide a minimum diving duration of four hours at 1500 ft below sea surface; it senses oxygen partial pressure in the breathing gas mix and controls oxygen content of the breathing gas within narrow limits about a preset value. The breathing circuit subsystem provides respirable gas to the diver and removes carbon dioxide and moisture from the expired gas. Test results indicate undesirable variations in oxygen partial pressure with oxygen addition and insufficient carbon dioxide absorption.

  1. Does smoking abstinence influence distress tolerance? An experimental study comparing the response to a breath-holding test of smokers under tobacco withdrawal and under nicotine replacement therapy.

    PubMed

    Cosci, Fiammetta; Anna Aldi, Giulia; Nardi, Antonio Egidio

    2015-09-30

    Distress tolerance has been operationalized as task persistence in stressful behavioral laboratory tasks. According to the distress tolerance perspective, how an individual responds to discomfort/distress predicts early smoking lapses. This theory seems weakly supported by experimental studies since they are limited in number, show inconsistent results, do not include control conditions. We tested the response to a stressful task in smokers under abstinence and under no abstinence to verify if tobacco abstinence reduces task persistence, thus distress tolerance. A placebo-controlled, double-blind, randomized, cross-over design was used. Twenty smokers underwent a breath holding test after the administration of nicotine on one test day and a placebo on another test day. Physiological and psychological variables were assessed at baseline and directly before and after each challenge. Abstinence induced a statistically significant shorter breath holding duration relative to the nicotine condition. No different response to the breath holding test was observed when nicotine and placebo conditions were compared. No response to the breath holding test was found when pre- and post-test values of heart rate, blood pressure, Visual Analogue Scale for fear or discomfort were compared. In brief, tobacco abstinence reduces breath holding duration but breath holding test does not influence discomfort. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. 10 CFR 26.95 - Conducting an initial test for alcohol using a breath specimen.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Conducting an initial test for alcohol using a breath specimen. 26.95 Section 26.95 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting Specimens for Testing § 26.95 Conducting an initial test for alcohol using a breath specimen. (a) The...

  3. 10 CFR 26.95 - Conducting an initial test for alcohol using a breath specimen.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Conducting an initial test for alcohol using a breath specimen. 26.95 Section 26.95 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting Specimens for Testing § 26.95 Conducting an initial test for alcohol using a breath specimen. (a) The...

  4. 10 CFR 26.95 - Conducting an initial test for alcohol using a breath specimen.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Conducting an initial test for alcohol using a breath specimen. 26.95 Section 26.95 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting Specimens for Testing § 26.95 Conducting an initial test for alcohol using a breath specimen. (a) The...

  5. 10 CFR 26.95 - Conducting an initial test for alcohol using a breath specimen.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Conducting an initial test for alcohol using a breath specimen. 26.95 Section 26.95 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting Specimens for Testing § 26.95 Conducting an initial test for alcohol using a breath specimen. (a) The...

  6. 10 CFR 26.95 - Conducting an initial test for alcohol using a breath specimen.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Conducting an initial test for alcohol using a breath specimen. 26.95 Section 26.95 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting Specimens for Testing § 26.95 Conducting an initial test for alcohol using a breath specimen. (a) The...

  7. Variability in the blood/breath alcohol ratio and implications for evidentiary purposes.

    PubMed

    Jaffe, Dena H; Siman-Tov, Maya; Gopher, Asher; Peleg, Kobi

    2013-09-01

    The breath analyzer is an indispensable tool for identifying alcohol levels among drivers. While numerous studies have shown high correlations between blood and breath alcohol concentrations, most are limited by the study design. This study seeks to assess this relationship by minimizing potential measurement bias, document time from alcohol consumption to testing, and adjusting for potential confounders. A blinded study was performed using conditions closely resembling those in the field. The Draeger 7110 MKIII IL breath analyzer was used to assess breath alcohol concentrations (BrAC). Participants were 61 healthy volunteers aged 21-37 years with body mass index ≤30 and no history of alcoholism. A total of 242 valid blood/breath tests were performed in four test sets. The study results showed a high correlation coefficient between BrAC and blood alcohol concentration (BAC) levels (r = 0.983) with high sensitivity (97%) and specificity (93%). This strong association between the breath analyzer and BAC persisted even after adjustment for various stages of alcohol absorption. These results illustrate the high diagnostic sensitivity of the breath analyzer in field-tested conditions. © 2013 American Academy of Forensic Sciences.

  8. Police custody following drink-driving: a prospective study.

    PubMed

    Lepresle, Aude; Mahindhoratep, Tiao Saysouda; Chiadmi, Fouad; Schlatter, Joël; Boraud, Cyril; Chariot, Patrick

    2012-11-01

    Drink-driving is a crime and traffic offences are a common cause of detention in police custody. Legal assessment of alcohol intoxication is based on breath or blood testing. We hypothesize that refusal of breath alcohol testing or inability to perform it can correspond to singular medical characteristics of the detainee, possibly assaulted or injured during the arrest. Our objective was to determine medical characteristics of detainees held in custody for drink-driving. Prospective monocentric study (April-October, 2010) of drink-drive arrestees. Controls were persons aged over 18 detained for other reasons than drink-driving. Data collected concerned persons' characteristics and reported assaults or observed injuries. 223 drivers were tested positive for breath alcohol level and 55 suspected drink-drivers refused or were not able to complete breath test. 2212 consecutively examined persons served as controls. Drink-drive arrestees requested medical examination more rarely (18% and 7%, vs. 43%, P<0.0001) and drivers tested positive for breath alcohol were more frequently alcohol abusers (25% vs. 14%, P<0.0001) than controls. Drivers who did not complete breath test more often reported assaults than those tested positive for breath alcohol (22% vs. 8%, P=0.007). They had more frequent traumatic injuries than those tested positive and than controls (29% vs. 11% and 17%, P=0.003 and 0.02). Only 1% of drink drivers were unfit for detention after medical examination. Physicians need to give attentive care to detained drink-drivers. Special attention should be paid to drink-drivers who refused or were not able to complete breath alcohol measurement. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. 49 CFR 219.301 - Testing for reasonable cause.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... breath or body fluid testing, or both, to determine compliance with §§ 219.101 and 219.102 or a railroad... an employee that is required when an employee is required to provide a breath or body fluid specimen... breath testing. In addition to reasonable suspicion as described in § 219.300, the following...

  10. 49 CFR 219.301 - Testing for reasonable cause.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... breath or body fluid testing, or both, to determine compliance with §§ 219.101 and 219.102 or a railroad... an employee that is required when an employee is required to provide a breath or body fluid specimen... breath testing. In addition to reasonable suspicion as described in § 219.300, the following...

  11. Application of LaserBreath-001 for breath acetone measurement in subjects with diabetes mellitus

    NASA Astrophysics Data System (ADS)

    Wang, Zhennan; Sun, Meixiu; Chen, Zhuying; Zhao, Xiaomeng; Li, Yingxin; Wang, Chuji

    2016-11-01

    Breath acetone is a promising biomarker of diabetes mellitus. With an integrated standalone, on-site cavity ringdown breath acetone analyzer, LaserBreath-001, we tested breath samples from 23 type 1 diabetic (T1D) patients, 312 type 2 diabetic (T2D) patients, 52 healthy subjects. In the cross-sectional studies, the obtained breath acetone concentrations were higher in the diabetic subjects compared with those in the control group. No correlation between breath acetone and simultaneous BG was observed in the T1D, T2D, and healthy subjects. A moderate positive correlation between the mean individual breath acetone concentrations and the mean individual BG levels was observed in the 20 T1D patients without ketoacidosis. In a longitudinal study, the breath acetone concentrations in a T1D patient with ketoacidosis decreased significantly and remained stable during the 5-day hospitalization. The results from a relatively large number of subjects tested indicate that an elevated mean breath acetone concentration exists in diabetic patients in general. Although many physiological parameters affect breath acetone concentrations, fast (<1 min) and on site breath acetone measurement can be used for diabetic screening and management under a specifically controlled condition.

  12. Can Blood Gas and Acid-Base Parameters at Maximal 200 Meters Front Crawl Swimming be Different Between Former Competitive and Recreational Swimmers?

    PubMed Central

    Kapus, Jernej; Usaj, Anton; Strumbelj, Boro; Kapus, Venceslav

    2008-01-01

    The aim of the present study was to ascertain whether maximal 200 m front crawl swimming strategies and breathing patterns influenced blood gas and acid-base parameters in a manner which gives advantage to former competitive swimmers in comparison with their recreational colleagues. Twelve former competitive male swimmers (the CS group) and nine recreational male swimmers (the RS group) performed a maximal 200 m front crawl swimming with self- selected breathing pattern. Stroke rate (SR) and breathing frequency (BF) were measured during the swimming test. Measures also included blood lactate concentration ([LA]) and parameters of blood acid-base status before and during the first minute after the swimming test. The CS group swam faster then the RS group. Both groups have similar and steady SR throughout the swimming test. This was not matched by similar BF in the CS group but matched it very well in the RS group (r = 0.89). At the beginning of swimming test the CS group had low BF, but they increased it throughout the swimming test. The BF at the RS group remained constant with only mirror variations throughout the swimming test. Such difference in velocity and breathing resulted in maintaining of blood Po2 from hypoxia and Pco2 from hypercapnia. This was similar in both groups. [LA] increased faster in the CS group than in the RS group. On the contrary, the rate of pH decrease remained similar in both groups. The former competitive swimmers showed three possible advantages in comparison to recreational swimmers during maximal 200 m front crawl swimming: a more dynamic and precise regulation of breathing, more powerful bicarbonate buffering system and better synchronization between breathing needs and breathing response during swimming. Key pointsTraining programs for competitive swimmers should promote adaptations to maximal efforts.Those adaptations should include high and maximal intensity swims with controlled breathing frequency (taking breath every fourth, fifth, sixth or eighth stroke cycle for front crawl swimming).Such training will improve breathing regulation in order to impose a better synchronization between breathing needs and breathing response during maximal swimming. PMID:24150142

  13. An acetone breath analyzer using cavity ringdown spectroscopy: an initial test with human subjects under various situations

    NASA Astrophysics Data System (ADS)

    Wang, Chuji; Surampudi, Anand B.

    2008-10-01

    We have developed a portable breath acetone analyzer using cavity ringdown spectroscopy (CRDS). The instrument was initially tested by measuring the absorbance of breath gases at a single wavelength (266 nm) from 32 human subjects under various conditions. A background subtraction method, implemented to obtain absorbance differences, from which an upper limit of breath acetone concentration was obtained, is described. The upper limits of breath acetone concentration in the four Type 1 diabetes (T1D) subjects, tested after a 14 h overnight fast, range from 0.80 to 3.97 parts per million by volume (ppmv), higher than the mean acetone concentration (0.49 ppmv) in non-diabetic healthy breath reported in the literature. The preliminary results show that the instrument can tell distinctive differences between the breath from individuals who are healthy and those with T1D. On-line monitoring of breath gases in healthy people post-exercise, post-meals and post-alcohol-consumption was also conducted. This exploratory study demonstrates the first CRDS-based acetone breath analyzer and its potential application for point-of-care, non-invasive, diabetic monitoring.

  14. When Breathing Interferes with Cognition: Experimental Inspiratory Loading Alters Timed Up-and-Go Test in Normal Humans.

    PubMed

    Nierat, Marie-Cécile; Demiri, Suela; Dupuis-Lozeron, Elise; Allali, Gilles; Morélot-Panzini, Capucine; Similowski, Thomas; Adler, Dan

    2016-01-01

    Human breathing stems from automatic brainstem neural processes. It can also be operated by cortico-subcortical networks, especially when breathing becomes uncomfortable because of external or internal inspiratory loads. How the "irruption of breathing into consciousness" interacts with cognition remains unclear, but a case report in a patient with defective automatic breathing (Ondine's curse syndrome) has shown that there was a cognitive cost of breathing when the respiratory cortical networks were engaged. In a pilot study of putative breathing-cognition interactions, the present study relied on a randomized design to test the hypothesis that experimentally loaded breathing in 28 young healthy subjects would have a negative impact on cognition as tested by "timed up-and-go" test (TUG) and its imagery version (iTUG). Progressive inspiratory threshold loading resulted in slower TUG and iTUG performance. Participants consistently imagined themselves faster than they actually were. However, progressive inspiratory loading slowed iTUG more than TUG, a finding that is unexpected with regard to the known effects of dual tasking on TUG and iTUG (slower TUG but stable iTUG). Insofar as the cortical networks engaged in response to inspiratory loading are also activated during complex locomotor tasks requiring cognitive inputs, we infer that competition for cortical resources may account for the breathing-cognition interference that is evidenced here.

  15. Clinical applications of breath testing

    PubMed Central

    Paschke, Kelly M; Mashir, Alquam

    2010-01-01

    Breath testing has the potential to benefit the medical field as a cost-effective, non-invasive diagnostic tool for diseases of the lung and beyond. With growing evidence of clinical worth, standardization of methods, and new sensor and detection technologies the stage is set for breath testing to gain considerable attention and wider application in upcoming years. PMID:21173863

  16. Breath measurement instrumentation as alcohol safety interlock systems

    DOT National Transportation Integrated Search

    1974-09-01

    This report describes the results of field tests of in-car instruments which measure alcohol on the driver's breath and prevent him from operating his vehicle if intoxicated. Two types of breath alcohol sensors were used for these tests; a fuel-cell ...

  17. Updating prognosis of cirrhosis by Cox's regression model using Child-Pugh score and aminopyrine breath test as time-dependent covariates.

    PubMed

    Merkel, C; Morabito, A; Sacerdoti, D; Bolognesi, M; Angeli, P; Gatta, A

    1998-06-01

    The determination of aminopyrine breath test on entry into the study was recently shown to improve the accuracy of prediction of death based on the Child-Pugh classification, but the possible usefulness of serial determinations of both parameters has not been assessed. In the present study, we aimed at evaluating whether serial determinations of aminopyrine breath test and Child-Pugh score improve prognostic accuracy in patients with cirrhosis, compared with determinations obtained only on admission. In 74 patients with liver cirrhosis aminopyrine breath test and Child-Pugh score were obtained upon entry into the study. Patients were followed with sequential aminopyrine breath tests and assessments of the Child-Pugh score every 4-6 months. A total number of 232 determinations were obtained. During follow-up 45 patients died, on average after 12 months of follow-up. Child-Pugh score improved in the beginning of follow-up, and then remained fairly constant; aminopyrine breath test showed no improvement in the beginning of follow-up, but rather a slowly progressive decline. In patients who died, both the Child-Pugh score and the metabolism of aminopyrine were significantly more impaired in the last year preceding death (p < 0.05). Applying Cox's regression model with time-dependent covariates, Child-Pugh score and aminopyrine breath test were independent significant predictors of survival. The model with time-dependent covariates explained the observed survival much better than the model with time-fixed covariates (chi-sq. explained by regression = 31.45 vs 11.97; d.f. = 2; p = 0.0000001 vs 0.003). These data suggest that serial determinations of Child-Pugh score and aminopyrine breath test can be used to efficiently update prognosis of cirrhosis.

  18. The effect of simulated air conditions on N95 filtering facepiece respirators performance.

    PubMed

    Ramirez, Joel A; O'Shaughnessy, Patrick T

    2016-07-01

    The objective of this study was to determine the effect of several simulated air environmental conditions on the particle penetration and the breathing resistance of two N95 filtering facepiece respirator (FFR) models. The particle penetration and breathing resistance of the respirators were evaluated in a test system developed to mimic inhalation and exhalation breathing while relative humidity and temperature were modified. Breathing resistance was measured over 120 min using a calibrated pressure transducer under four different temperature and relative humidity conditions without aerosol loading. Particle penetration was evaluated before and after the breathing resistance test at room conditions using a sodium chloride aerosol measured with a scanning mobility particle sizer. Results demonstrated that increasing relative humidity and lowering external temperature caused significant increases in breathing resistance (p < 0.001). However, these same conditions did not influence the penetration or most penetrating particle size of the tested FFRs. The increase in breathing resistance varied by FFR model suggesting that some FFR media are less influenced by high relative humidity.

  19. 42 CFR 84.88 - Breathing bag test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing bag test. 84.88 Section 84.88 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Self-Contained Breathing...

  20. 42 CFR 84.88 - Breathing bag test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Breathing bag test. 84.88 Section 84.88 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Self-Contained Breathing...

  1. 42 CFR 84.88 - Breathing bag test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Breathing bag test. 84.88 Section 84.88 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Self-Contained Breathing...

  2. 42 CFR 84.88 - Breathing bag test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Breathing bag test. 84.88 Section 84.88 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Self-Contained Breathing...

  3. Prevalence of abnormal lactose breath hydrogen tests in children with functional abdominal pain.

    PubMed

    Garg, Neha; Basu, Srikanta; Singh, Preeti; Kumar, Ruchika; Sharma, Lokesh; Kumar, Praveen

    2017-05-01

    The study was undertaken to determine the prevalence of abnormal lactose breath hydrogen test in children with non-organic chronic abdominal pain. Children with chronic abdominal pain were examined and investigated for organic causes. All children without a known organic cause underwent lactose and glucose breath hydrogen test. After a standard dose of 2 g/kg of lactose to a maximum of 50 g, hydrogen in breath was measured at 15 min intervals for 3 h. A rise of 20 ppm above baseline was considered suggestive of lactose malabsorption. Of 108 children screened, organic causes were found in 46 children. Sixty-two patients without any organic cause underwent hydrogen breath test. Lactose hydrogen breath test (HBT) was positive in 36 of 62 (58%), while 11 (17%) had positive HBT with glucose suggestive of small intestinal bacterial overgrowth (SIBO). Twenty out of 34 (59%) improved on lactose free diet while 8 out of 11 (72%) children of SIBO improved on antibiotics. Lactose malabsorption was seen in 58% of children with non-organic chronic abdominal pain.

  4. New optical analyzer for 13C-breath test

    NASA Astrophysics Data System (ADS)

    Harde, Hermann; Dressler, Matthias; Helmrich, Günther; Wolff, Marcus; Groninga, Hinrich

    2008-04-01

    Medical breath tests are well established diagnostic tools, predominantly for gastroenterological inspections, but also for many other examinations. Since the composition and concentration of exhaled volatile gases reflect the physical condition of a patient, a breath analysis allows one to recognize an infectious disease in an organ or even to identify a tumor. One of the most prominent breath tests is the 13C-urea-breath test, applied to ascertain the presence of the bacterium helicobacter pylori in the stomach wall as an indication of a gastric ulcer. In this contribution we present a new optical analyzer that is based on photoacoustic spectroscopy and uses a DFB diode laser at 2.744 μm. The concentration ratio of the CO II isotopologues is determined by measuring the absorption on a 13CO II line in comparison to a 12CO II line. In the specially selected spectral range the lines have similar strengths, although the concentrations differ by a factor of 90. Therefore, the signals are well comparable. Due to an excellent signal-noise-ratio isotope variations of less than 1% can be resolved as required for the breath test.

  5. Comparison of Accuracy Between 13C- and 14C-Urea Breath Testing: Is an Indeterminate-Results Category Still Needed?

    PubMed

    Charest, Mathieu; Bélair, Marc-André

    2017-06-01

    Helicobacter pylori infection is the leading cause of peptic ulcer disease. The purpose of this study was, first, to assess the difference in the distribution of negative versus positive results between the older 14 C-urea breath test and the newer 13 C-urea breath test and, second, to determine whether use of an indeterminate-results category is still meaningful and what type of results should trigger repeated testing. Methods: A retrospective survey was performed of all consecutive patients referred to our service for urea breath testing. We analyzed 562 patients who had undergone testing with 14 C-urea and 454 patients who had undergone testing with 13 C-urea. Results: In comparison with the wide distribution of negative 14 C results, negative 13 C results were distributed farther from the cutoff and were grouped more tightly around the mean negative value. Distribution analysis of the negative results for 13 C testing, compared with those for 14 C testing, revealed a statistically significant difference between the two. Within the 13 C group, only 1 patient could have been classified as having indeterminate results using the same indeterminate zone as was used for the 14 C group. This is significantly less frequent than what was found for the 14 C group. Discussion: Borderline-negative results do occur with 13 C-urea breath testing, although less frequently than with 14 C-urea breath testing, and we will be carefully monitoring differences falling between 3.0 and 3.5 %Δ. 13 C-urea breath testing is safe and simple for the patient and, in most cases, provides clearer positive or negative results for the clinician. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  6. Tests for H. pylori

    MedlinePlus

    Peptic ulcer disease - H. pylori ; PUD - H. pylori ... There are several methods to test for H. pylori infection. Breath Test (Carbon Isotope-urea Breath Test, or UBT) Up to 2 weeks before the test, you need to stop taking ...

  7. Breathing metabolic simulator

    NASA Technical Reports Server (NTRS)

    Bartlett, R. G.; Hendricks, C. M.; Morison, W. B.

    1972-01-01

    The development of a breathing metabolic simulator (BMS) is reported. This BMS simulates all of the breathing and metabolic parameters required for complete evaluation and test of life support and resuscitation equipment. It is also useful for calibrating and validating mechanical and gaseous pulmonary function test procedures. Breathing rate, breathing depth, breath velocity contour, oxygen uptake, and carbon dioxide release are all variable over wide ranges simulating conditions from sleep to hard work with respiratory exchange ratios covering the range from hypoventilation. In addition, all of these parameters are remotely controllable to facilitate use of the device in hostile or remote environments. The exhaled breath is also maintained at body temperature and a high humidity. The simulation is accurate to the extent of having a variable functional residual capacity independent of other parameters.

  8. [Application of the breath hydrogen test in gastroenterology].

    PubMed

    Loranskaia, I D; Panina, N A; Zheltakova, O V

    2006-01-01

    The diagnostic capacities of the breath hydrogen test in gastroenterology are discussed in the article. The authors describe the results of their own research--determination of the intestinal bacterial contamination in patients with chronic biliary pancreatitis with the help of the Micro H2 breath hydrogen analyzer.

  9. Breathing simulator of workers for respirator performance test.

    PubMed

    Yuasa, Hisashi; Kumita, Mikio; Honda, Takeshi; Kimura, Kazushi; Nozaki, Kosuke; Emi, Hitoshi; Otani, Yoshio

    2015-01-01

    Breathing machines are widely used to evaluate respirator performance but they are capable of generating only limited air flow patterns, such as, sine, triangular and square waves. In order to evaluate the respirator performance in practical use, it is desirable to test the respirator using the actual breathing patterns of wearers. However, it has been a difficult task for a breathing machine to generate such complicated flow patterns, since the human respiratory volume changes depending on the human activities and workload. In this study, we have developed an electromechanical breathing simulator and a respiration sampling device to record and reproduce worker's respiration. It is capable of generating various flow patterns by inputting breathing pattern signals recorded by a computer, as well as the fixed air flow patterns. The device is equipped with a self-control program to compensate the difference in inhalation and exhalation volume and the measurement errors on the breathing flow rate. The system was successfully applied to record the breathing patterns of workers engaging in welding and reproduced the breathing patterns.

  10. BreathDx - molecular analysis of exhaled breath as a diagnostic test for ventilator-associated pneumonia: protocol for a European multicentre observational study.

    PubMed

    van Oort, Pouline M P; Nijsen, Tamara; Weda, Hans; Knobel, Hugo; Dark, Paul; Felton, Timothy; Rattray, Nicholas J W; Lawal, Oluwasola; Ahmed, Waqar; Portsmouth, Craig; Sterk, Peter J; Schultz, Marcus J; Zakharkina, Tetyana; Artigas, Antonio; Povoa, Pedro; Martin-Loeches, Ignacio; Fowler, Stephen J; Bos, Lieuwe D J

    2017-01-03

    The diagnosis of ventilator-associated pneumonia (VAP) remains time-consuming and costly, the clinical tools lack specificity and a bedside test to exclude infection in suspected patients is unavailable. Breath contains hundreds to thousands of volatile organic compounds (VOCs) that result from host and microbial metabolism as well as the environment. The present study aims to use breath VOC analysis to develop a model that can discriminate between patients who have positive cultures and who have negative cultures with a high sensitivity. The Molecular Analysis of Exhaled Breath as Diagnostic Test for Ventilator-Associated Pneumonia (BreathDx) study is a multicentre observational study. Breath and bronchial lavage samples will be collected from 100 and 53 intubated and ventilated patients suspected of VAP. Breath will be analysed using Thermal Desorption - Gas Chromatography - Mass Spectrometry (TD-GC-MS). The primary endpoint is the accuracy of cross-validated prediction for positive respiratory cultures in patients that are suspected of VAP, with a sensitivity of at least 99% (high negative predictive value). To our knowledge, BreathDx is the first study powered to investigate whether molecular analysis of breath can be used to classify suspected VAP patients with and without positive microbiological cultures with 99% sensitivity. UKCRN ID number 19086, registered May 2015; as well as registration at www.trialregister.nl under the acronym 'BreathDx' with trial ID number NTR 6114 (retrospectively registered on 28 October 2016).

  11. Small intestinal malabsorption in chronic alcoholism: a retrospective study of alcoholic patients by the ¹⁴C-D-xylose breath test.

    PubMed

    Hope, Håvar; Skar, Viggo; Sandstad, Olav; Husebye, Einar; Medhus, Asle W

    2012-04-01

    The ¹⁴C-D-xylose breath test was used at Ullevål University Hospital in the period from 1986 TO 1995 for malabsorption testing. The objective of this retrospective study was to reveal whether patients with chronic alcoholism may have intestinal malabsorption. The consecutive ¹⁴C-D-xylose breath test database was reviewed and patients with the diagnosis of chronic alcoholism were identified. ¹⁴C-D-xylose breath test results of the alcoholic patients were compared with the results of untreated celiac patients and patient and healthy controls. In the ¹⁴C-D-xylose breath test, ¹⁴C-D-xylose was dissolved in water and given orally after overnight fast. Breath samples were taken at 30-min intervals for 210 min, and ¹⁴CO₂ : ¹²CO₂ ratios were calculated for each time point, presenting a time curve for ¹⁴C-D-xylose absorption. Urine was collected after 210 min and the fraction of the total d-xylose passed was calculated (U%). ¹⁴CO₂ in breath and ¹⁴C-D-xylose in urine were analyzed using liquid scintillation. Both breath and urine analysis revealed a pattern of malabsorption in alcoholics comparable with untreated celiac patients, with significantly reduced absorption of d-xylose compared with patient and healthy controls. Alcoholic patients have a significantly reduced ¹⁴C-D-xylose absorption, comparable with untreated celiac patients. This indicates a reduced intestinal function in chronic alcoholism.

  12. In vivo assessment of the mitochondrial response to caloric restriction in obese women by the 2-keto[1-C]isocaproate breath test.

    PubMed

    Parra, Dolores; González, Alvaro; Martínez, J Alfredo; Labayen, Idoia; Díez, Nieves

    2003-04-01

    The 2-keto[1-(13)C]isocaproate breath test has been proposed as a tool to detect mitochondrial dysfunction in alcoholic liver disease. The aim of this study was to evaluate if the 2-keto[1-(13)C]isocaproate breath test could detect in vivo dynamic changes on mitochondrial activity due to caloric restriction in obese women. Fifteen obese women (body mass index [BMI] > 30 kg/m(2)) participated in the study at baseline. Ten of these women agreed to participate on a diet program to induce body weight loss. Fifteen lean women (BMI < 25 kg/m(2)) were included as a control group. The breath test was performed by the oral administration of the tracer measuring (13)CO(2) enrichment in breath before and after ingestion using isotope ratio mass spectrometry. Body composition, resting energy expenditure, and plasma levels of insulin and leptin were measured. There were no relationships observed between the 2-keto[1-(13)C]isocaproate breath test and the plasma insulin (before diet: P =.863; after diet: P =.879), or leptin (before diet: P =.500; after diet: P =.637). In obese women before treatment, kilograms of fat free mass (P =.108), resting energy expenditure adjusted for body composition (P =.312), and the 2-keto[1-(13)C]isocaproate breath test (P =.205) were similar in comparison to lean women. However, 2-keto[1-(13)C]isocaproate oxidation tended to increase after dieting and was significantly higher than in controls (P =.015). These data suggest that the 2-keto[1-(13)C]isocaproate breath test reflected the adaptive modifications in mitochondrial oxidation in response to caloric restriction in obese women. Copyright 2003 Elsevier, Inc. All rights reserved.

  13. 49 CFR 40.245 - What is the procedure for an alcohol screening test using a saliva ASD or a breath tube ASD?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... test using a saliva ASD or a breath tube ASD? 40.245 Section 40.245 Transportation Office of the... Alcohol Screening Tests § 40.245 What is the procedure for an alcohol screening test using a saliva ASD or a breath tube ASD? (a) As the STT or BAT, you must take the following steps when using the saliva...

  14. 13C-Mixed Triglyceride Breath Test and Fecal Elastase as an Indirect Pancreatic Function Test in Cystic Fibrosis Infants.

    PubMed

    Kent, Dorothea Stark; Remer, Thomas; Blumenthal, Caron; Hunt, Sharon; Simonds, Sharon; Egert, Sarah; Gaskin, Kevin J

    2018-05-01

    The 'gold standard' test for the indirect determination of pancreatic function status in infants with cystic fibrosis (CF), the 72-hour fecal fat excretion test, is likely to become obsolete in the near future. Alternative indirect pancreatic function tests with sufficient sensitivity and specificity to determine pancreatic phenotype need further evaluation in CF infants. Evaluation of the clinical utility of both the noninvasive, nonradioactive C-mixed triglyceride (MTG) breath test and fecal elastase-1 (FE1) in comparison with the 72-hour fecal fat assessment in infants with CF. C-MTG breath test and the monoclonal and polyclonal FE1 assessment in stool was compared with the 72-hour fecal fat assessment in 24 infants with CF. Oral pancreatic enzyme substitution (PERT; if already commenced) was stopped before the tests. Sensitivity rates between 82% and 100% for CF patients with pancreatic insufficiency assessed by both the C-MTG breath test and the FE1 tests proved to be high and promising. The C-MTG breath test (31%-38%) as well as both FE1 tests assessed by the monoclonal (46%-54%) and the polyclonal (45%) ELISA kits, however, showed unacceptably low-sensitivity rates for the detection of pancreatic-sufficient CF patients in the present study. The C-MTG breath test with nondispersive infrared spectroscopy (NDIRS) technique, as well as both FE1 tests, are not alternatives to the fecal fat balance test for the evaluation of pancreatic function in CF infants during the first year of life.

  15. A comparison of standard inhalers for asthma with and without alcohol as the propellant on the measurement of alcohol in breath.

    PubMed

    Ignacio-García, José M; Ignacio-García, Juan M; Almenara-Barrios, José; Chocrón-Giraldez, María J; Hita-Iglesias, Carmen

    2005-01-01

    Because most bronchodilator inhalers contain propellant gases or a small amount of ethanol as a co-solvent, the potential for these products to generate false readings on a evidential breath alcohol instrument was evaluated in 69 volunteers with clinically stable asthma. All subjects underwent a breath test on an infrared breath alcohol analyzer (Alcotest 7110, Dräger, Lübeck, Germany) before the use of the asthma inhaler and 1 and 5 min after inhalation. The effects of antiasthmatic medications delivered by metered dose inhalers (MDIs) with alcohol as a vehicle, alcohol-free MDIs, and dry powder inhalers were assessed in homogeneous groups of four to five patients. All subjects were alcohol-free on the preliminary breath test. One minute after inhalation, negative readings were only observed in 25 (36.2%) of subjects. In 62.3% of patients, apparent alcohol results were considered interferences or unstable readings by the breath-test instrument. One subject showed a final positive breath alcohol level (0.07 mg/L). After the use of dry powder inhalers, valid results without interferences were obtained. However, 89.6% of patients in which bronchodilators were delivered by MDIs (with propellant gases in the aerosol) showed altered partial readings and labeled the final output as "invalid," but tests performed 5 min after the use of inhalers were valid and correct in all cases. MDIs with propellants as a vehicle may cause false positive breath alcohol readings in some patients. These effects are transient and may be prevented by a 5-10-min interval between the use of MDIs and breath alcohol testing.

  16. Breathing simulator of workers for respirator performance test

    PubMed Central

    YUASA, Hisashi; KUMITA, Mikio; HONDA, Takeshi; KIMURA, Kazushi; NOZAKI, Kosuke; EMI, Hitoshi; OTANI, Yoshio

    2014-01-01

    Breathing machines are widely used to evaluate respirator performance but they are capable of generating only limited air flow patterns, such as, sine, triangular and square waves. In order to evaluate the respirator performance in practical use, it is desirable to test the respirator using the actual breathing patterns of wearers. However, it has been a difficult task for a breathing machine to generate such complicated flow patterns, since the human respiratory volume changes depending on the human activities and workload. In this study, we have developed an electromechanical breathing simulator and a respiration sampling device to record and reproduce worker’s respiration. It is capable of generating various flow patterns by inputting breathing pattern signals recorded by a computer, as well as the fixed air flow patterns. The device is equipped with a self-control program to compensate the difference in inhalation and exhalation volume and the measurement errors on the breathing flow rate. The system was successfully applied to record the breathing patterns of workers engaging in welding and reproduced the breathing patterns. PMID:25382381

  17. Stability of (13) C-Urea Breath Test Samples Over Time in the Diagnosis of Helicobacter pylori.

    PubMed

    Perets, Tsachi Tsadok; Shporn, Einav; Boltin, Doron; Dickman, Ram; Niv, Yaron

    2016-05-01

    The accuracy and repeatability of breath test in the diagnosis of Helicobacter pylori infection have not been adequately investigated. Although it has been shown that storage for long periods does not affect the analysis results, no data are available on the effect of repetitive testing. In this study, our aim was to evaluate the repeatability of the analyses of breath samples at room temperature. A total of 202 positive breath samples were collected in duplicates, before and after administration of 75 mg (13) C- urea dissolved in 100 ml of orange juice. Breath test results were expressed as delta (13) CO2 . The cut-off value was 3.5 parts per thousand. Each sample was analyzed in a mass spectrometer 7, 14, 21, and 28 days after collection. The accuracy calculation was based on the comparison of the delta (13) CO2 obtained in the three consecutive weeks following the first test run to the delta (13) CO2 obtained in the first test run. Two hundred (99%), 197 (97.52%), and 196 (97%) of the 202 samples tested positive in the second, third, and fourth test runs, respectively. The accuracy of the delta (13) CO2 was 98.6%, 99.2%, and 96.7% in the three consecutive runs, respectively. Short-term storage of 1 month does not affect sample stability or the results of (13) C-urea breath tests in up to three consecutive repeats. © 2015 Wiley Periodicals, Inc.

  18. Control of gill ventilation and air-breathing in the bowfin amia calva

    PubMed

    Hedrick; Jones

    1999-01-01

    The purpose of this study was to investigate the roles of branchial and gas bladder reflex pathways in the control of gill ventilation and air-breathing in the bowfin Amia calva. We have previously determined that bowfin use two distinct air-breathing mechanisms to ventilate the gas bladder: type I air breaths are characterized by exhalation followed by inhalation, are stimulated by aquatic or aerial hypoxia and appear to regulate O2 gas exchange; type II air breaths are characterized by inhalation alone and possibly regulate gas bladder volume and buoyancy. In the present study, we test the hypotheses (1) that gill ventilation and type I air breaths are controlled by O2-sensitive chemoreceptors located in the branchial region, and (2) that type II air breaths are controlled by gas bladder mechanosensitive stretch receptors. Hypothesis 1 was tested by examining the effects of partial or complete branchial denervation of cranial nerves IX and X to the gill arches on gill ventilation frequency (fg) and the proportion of type I air breaths during normoxia and hypoxia; hypothesis II was tested by gas bladder inflation and deflation. Following complete bilateral branchial denervation, fg did not differ from that of sham-operated control fish; in addition, fg was not significantly affected by aquatic hypoxia in sham-operated or denervated fish. In sham-operated fish, aquatic hypoxia significantly increased overall air-breathing frequency (fab) and the percentage of type I breaths. In fish with complete IX-X branchial denervation, fab was also significantly increased during aquatic hypoxia, but there were equal percentages of type I and type II air breaths. Branchial denervation did not affect the frequency of type I air breaths during aquatic hypoxia. Gas bladder deflation via an indwelling catheter resulted in type II breaths almost exclusively; furthermore, fab was significantly correlated with the volume removed from the gas bladder, suggesting a volume-regulating function for type II air breaths. These results indicate that chronic (3-4 weeks) branchial denervation does not significantly affect fg or type I air-breathing responses to aquatic hypoxia. Because type I air-breathing responses to aquatic hypoxia persist after IX-X cranial nerve denervation, O2-sensitive chemoreceptors that regulate air-breathing may be carried in other afferent pathways, such as the pseudobranch. Gas bladder deflation reflexly stimulates type II breaths, suggesting that gas bladder volume-sensitive stretch receptors control this particular air-breathing mechanism. It is likely that type II air breaths function to regulate buoyancy when gas bladder volume declines during the inter-breath interval.

  19. A Ringdown Breath Analyzer for Diabetes Monitoring: Breath Acetone in Diabetic Patients.

    NASA Astrophysics Data System (ADS)

    Wang, Chuji; Mbi, Armstrong; Shepherd, Mark

    2008-03-01

    It is highly desirable for millions of diabetic patients to have a non-blood, non-invasive, point-of-care device for monitoring daily blood glucose (BG) levels and the adequacy of diabetic treatment and control. Cavity ringdown spectroscopy, due to its unique capability of high sensitivity, fast-response, and relatively low cost for instrumentation, has the potential for medical application through non-invasive analysis of breath biomarkers. We report the first ringdown acetone breath analyzer for clinic testing with diabetic outpatients. The instrument was set in a clinic center and 34 outpatients (24 T1D and 10 T2D) were tested during a four-day period. 10 T1D subjects and 15 nondiabetic persons were tested in our laboratory. Three juvenile-onset T1D subjects were selected for a 24-hr monitoring on the variations of breath acetone and simultaneous BG level. In this talk, we present our research findings including the correlations of breath acetone with BG level and A1C.

  20. [Examination of gastric emptying rate by means of 13C-octanoic acid breath test. Methods of the test for adults and results of the investigation of healthy volunteers].

    PubMed

    Bures, J; Kopácová, M; Vorísek, V; Bukac, J; Neumann, D; Rejchrt, S; Pozler, O; Douda, T; Zivný, P; Palicka, V

    2005-01-01

    13C-octanoic acid breath test (13C-OABT) is a simple, safe and non-invasive technique for measuring gastric emptying. However, the method has not been standardized yet. Aim of the study was to work up, introduce and evaluate our own method of the 13C-OABT for adults. Ten healthy volunteers entered the study (5 men, 5 women, mean age 32 years, 50 % Helicobacter pylori positive). Standard test meals (with 100 mg 13C-sodium octanoate) were used three times within 3 weeks. The same solid meal (1,178 kJ) for Tests 1 and 2 contained scrambled egg (+ 3 g oil), white bread (40 g), butter (10 g) and distilled water (200 ml). Semi-solid meal (1,020 kJ) for Test 3 contained milk pudding (200 g) and distilled water (200 ml). Duplicate breath samples were obtained before and every 15 minutes after eating the test meal during 255 minutes. Altogether 1,080 breath samples were analysed twice (isotope ratio mass spectrometry, AP2003 Analytical Precision, UK). To assess the half-life of elimination (t1/2 E), we modelled the process of elimination with the incomplete gamma-function, which has a convenient form for the empiric plotting of breath test data. Mean t1/2E was 136+/-10 minutes (Test 1), 134+/-14 (Test 2) and 123+/-16 minutes (Test 3). Clinical reproducibility of 13C-OABT in particular persons was 98.2% (18 breath samples series), 90.8 % (15 samples) and 87.1% (9 breath samples series). There was a significant correlation between Test 1 and Test 2 results (r=0.887, p<0.0001). Mean difference of duplicate breath sample analysis was 1.460 % (in 540 pairs), mean baseline one-day analysis difference was 0.0982 (99.9274% accuracy). In healthy volunteers, normal range of t1/2E is 110-160 minutes for solids and 91-155 minutes for semisolid test meal. Using our own computed mean time of intermediate metabolism of 13C-octanoic acid (76.5+/-7.5 minutes), gastric emptying half-time is 33.5-83.5 minutes for solids and 14.5-78.5 minutes for semisolid test meal in healthy volunteers. The 13C-OABT is accurate non-invasive method for gastric emptying measurement.

  1. Limited electromagnetic interference testing of evidential breath testers

    DOT National Transportation Integrated Search

    1983-05-06

    This report summarizes a limited test program conducted to determine the susceptibility of evidential breath testers (EBTs) to radio frequency interference (RFI). Several comprehensive test protocols were prepared based on procedures developed by the...

  2. A double-blind placebo-controlled randomized trial on probiotics in small bowel bacterial overgrowth in children treated with omeprazole.

    PubMed

    Hegar, Badriul; Hutapea, Esther I; Advani, Najid; Vandenplas, Yvan

    2013-01-01

    To evaluate the incidence of small bowel bacterial overgrowth (SBBO) in children treated with omeprazole, and to test whether probiotics influence the incidence. A double-blinded, placebo-controlled trial was performed in 70 children treated orally during four weeks with 20mg omeprazole per day. Lactobacillus rhamnosus R0011 (1.9×10(9) cfu) and Lactobacillus acidophilus R0052 (0.1×10(9) cfu) were simultaneously given daily to 36 subjects (probiotic group), while 34 subjects received placebo (placebo group). The diagnosis of SBBO was based on the development of suggestive symptoms, in combination with a positive glucose breath test. After one month of proton pump inhibitor (PPI) treatment, 30% (21/70) had a positive breath test suggesting SBBO; of these 62% were symptomatic. Five children developed SBBO-like symptoms, but had a negative breath test; and 44 (63%) were symptom free and had a negative breath test. There was no difference in the incidence of positive breath tests in the probiotic versus the placebo group (33% vs 26.5%; p=0.13). Since symptoms suggesting SBBO developed in 26% of PPI-treated children, and since the glucose breath test was abnormal in 72% of these, this side-effect should be more frequently considered. The probiotic tested did not decrease the risk to develop SBBO. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  3. Validation of 13C-acetic acid breath test by measuring effects of loperamide, morphine, mosapride, and itopride on gastric emptying in mice.

    PubMed

    Matsumoto, Kenjiro; Kimura, Hiroshi; Tashima, Kimihito; Uchida, Masayuki; Horie, Syunji

    2008-10-01

    Several methods are used to evaluate gastric motility in rodents, but they all have technical limitations. Recent technical developments enable a convenient method to evaluate gastric motility. The (13)C-acetic acid breath test in rodents is a non-invasive and repeatable method that can be used without physical restraints. The present study aimed to validate the (13)C-acetic acid breath test by measuring the effects of loperamide, morphine, mosapride, and itopride on gastric emptying in mice. Loperamide (1-10 mg/kg) and morphine (1.25-10 mg/kg) slowed gastric emptying and decreased the maximum concentration (C(max)) and area under the curve (AUC(90 min)) value in a dose-dependent manner. Mosapride (0.2-5 mg/kg) accelerated gastric emptying and increased C(max) value. Mosapride (20 mg/kg) did not accelerate gastric emptying on the (13)C-breath test. Itopride (30 mg/kg, per os) significantly accelerated gastric emptying compared with the vehicle group. In a comparison with the conventional phenol red test, there was a correlation between the C(max) value of breath test and gastric emptying (%) of phenol red tests in treatment with loperamide or mosapride. These results indicate that the (13)C-acetic acid breath test is an accurate, noninvasive, and simple method for monitoring gastric emptying in mice. This method is useful to assess the effect of drugs and gut function pharmacologically.

  4. Effects of breathing frequency and flow rate on the total inward leakage of an elastomeric half-mask donned on an advanced manikin headform.

    PubMed

    He, Xinjian; Grinshpun, Sergey A; Reponen, Tiina; McKay, Roy; Bergman, Michael S; Zhuang, Ziqing

    2014-03-01

    The objective of this study was to investigate the effects of breathing frequency and flow rate on the total inward leakage (TIL) of an elastomeric half-mask donned on an advanced manikin headform and challenged with combustion aerosols. An elastomeric half-mask respirator equipped with P100 filters was donned on an advanced manikin headform covered with life-like soft skin and challenged with aerosols originated by burning three materials: wood, paper, and plastic (polyethylene). TIL was determined as the ratio of aerosol concentrations inside (C in) and outside (C out) of the respirator (C in/C out) measured with a nanoparticle spectrometer operating in the particle size range of 20-200nm. The testing was performed under three cyclic breathing flows [mean inspiratory flow (MIF) of 30, 55, and 85 l/min] and five breathing frequencies (10, 15, 20, 25, and 30 breaths/min). A completely randomized factorial study design was chosen with four replicates for each combination of breathing flow rate and frequency. Particle size, MIF, and combustion material had significant (P < 0.001) effects on TIL regardless of breathing frequency. Increasing breathing flow decreased TIL. Testing with plastic aerosol produced higher mean TIL values than wood and paper aerosols. The effect of the breathing frequency was complex. When analyzed using all combustion aerosols and MIFs (pooled data), breathing frequency did not significantly (P = 0.08) affect TIL. However, once the data were stratified according to combustion aerosol and MIF, the effect of breathing frequency became significant (P < 0.05) for all MIFs challenged with wood and paper combustion aerosols, and for MIF = 30 l/min only when challenged with plastic combustion aerosol. The effect of breathing frequency on TIL is less significant than the effects of combustion aerosol and breathing flow rate for the tested elastomeric half-mask respirator. The greatest TIL occurred when challenged with plastic aerosol at 30 l/min and at a breathing frequency of 30 breaths/min.

  5. The Wagner-Nelson method can generate an accurate gastric emptying flow curve from CO2 data obtained by a 13C-labeled substrate breath test.

    PubMed

    Sanaka, Masaki; Yamamoto, Takatsugu; Ishii, Tarou; Kuyama, Yasushi

    2004-01-01

    In pharmacokinetics, the Wagner-Nelson (W-N) method can accurately estimate the rate of drug absorption from its urinary elimination rate. A stable isotope (13C) breath test attempts to estimate the rate of absorption of 13C, as an index of gastric emptying rate, from the rate of pulmonary elimination of 13CO2. The time-gastric emptying curve determined by the breath test is quite different from that determined by scintigraphy or ultrasonography. In this report, we have shown that the W-N method can adjust the difference. The W-N equation to estimate gastric emptying from breath data is as follows: the fractional cumulative amount of gastric contents emptied by time t = Abreath (t)/Abreath (infinity) + (1/0.65).d[Abreath (t)/Abreath (infinity) ]/dt, where Abreath (t) = the cumulative recovery of 13CO2 in breath by time t and Abreath ( infinity ) = the ultimate cumulative 13CO2 recovery. The emptying flow curve generated by ultrasonography was compared with that generated by the W-N method-adjusted breath test in 6 volunteers. The emptying curves by the W-N method were almost identical to those by ultrasound. The W-N method can generate an accurate emptying flow curve from 13CO2 data, and it can adjust the difference between ultrasonography and the breath test. Copyright 2004 S. Karger AG, Basel

  6. The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults.

    PubMed

    Ma, Xiao; Yue, Zi-Qi; Gong, Zhu-Qing; Zhang, Hong; Duan, Nai-Yue; Shi, Yu-Tong; Wei, Gao-Xia; Li, You-Fa

    2017-01-01

    A growing number of empirical studies have revealed that diaphragmatic breathing may trigger body relaxation responses and benefit both physical and mental health. However, the specific benefits of diaphragmatic breathing on mental health remain largely unknown. The present study aimed to investigate the effect of diaphragmatic breathing on cognition, affect, and cortisol responses to stress. Forty participants were randomly assigned to either a breathing intervention group (BIG) or a control group (CG). The BIG received intensive training for 20 sessions, implemented over 8 weeks, employing a real-time feedback device, and an average respiratory rate of 4 breaths/min, while the CG did not receive this treatment. All participants completed pre- and post-tests of sustained attention and affect. Additionally, pre-test and post-test salivary cortisol concentrations were determined in both groups. The findings suggested that the BIG showed a significant decrease in negative affect after intervention, compared to baseline. In the diaphragmatic breathing condition, there was a significant interaction effect of group by time on sustained attention, whereby the BIG showed significantly increased sustained attention after training, compared to baseline. There was a significant interaction effect of group and time in the diaphragmatic breathing condition on cortisol levels, whereby the BIG had a significantly lower cortisol level after training, while the CG showed no significant change in cortisol levels. In conclusion, diaphragmatic breathing could improve sustained attention, affect, and cortisol levels. This study provided evidence demonstrating the effect of diaphragmatic breathing, a mind-body practice, on mental function, from a health psychology approach, which has important implications for health promotion in healthy individuals.

  7. Optoacoustic 13C-breath test analyzer

    NASA Astrophysics Data System (ADS)

    Harde, Hermann; Helmrich, Günther; Wolff, Marcus

    2010-02-01

    The composition and concentration of exhaled volatile gases reflects the physical ability of a patient. Therefore, a breath analysis allows to recognize an infectious disease in an organ or even to identify a tumor. One of the most prominent breath tests is the 13C-urea-breath test, applied to ascertain the presence of the bacterium helicobacter pylori in the stomach wall as an indication of a gastric ulcer. In this contribution we present a new optical analyzer that employs a compact and simple set-up based on photoacoustic spectroscopy. It consists of two identical photoacoustic cells containing two breath samples, one taken before and one after capturing an isotope-marked substrate, where the most common isotope 12C is replaced to a large extent by 13C. The analyzer measures simultaneously the relative CO2 isotopologue concentrations in both samples by exciting the molecules on specially selected absorption lines with a semiconductor laser operating at a wavelength of 2.744 μm. For a reliable diagnosis changes of the 13CO2 concentration of 1% in the exhaled breath have to be detected at a concentration level of this isotope in the breath of about 500 ppm.

  8. Validation of a new mixing chamber system for breath-by-breath indirect calorimetry.

    PubMed

    Kim, Do-Yeon; Robergs, Robert Andrew

    2012-02-01

    Limited validation research exists for applications of breath-by-breath systems of expired gas analysis indirect calorimetry (EGAIC) during exercise. We developed improved hardware and software for breath-by-breath indirect calorimetry (NEW) and validated this system as well as a commercial system (COM) against 2 methods: (i) mechanical ventilation with known calibration gas, and (ii) human subjects testing for 5 min each at rest and cycle ergometer exercise at 100 and 175 W. Mechanical calibration consisted of medical grade and certified calibration gas ((4.95% CO(2), 12.01% O(2), balance N(2)), room air (20.95% O(2), 0.03% CO(2), balance N(2)), and 100% nitrogen), and an air flow turbine calibrated with a 3-L calibration syringe. Ventilation was mimicked manually using complete 3-L calibration syringe manouvers at a rate of 10·min(-1) from a Douglas bag reservoir of calibration gas. The testing of human subjects was completed in a counterbalanced sequence based on 5 repeated tests of all conditions for a single subject. Rest periods of 5 and 10 min followed the 100 and 175 W conditions, respectively. COM and NEW had similar accuracy when tested with known ventilation and gas fractions. However, during human subjects testing COM significantly under-measured carbon dioxide gas fractions, over-measured oxygen gas fractions and minute ventilation, and resulted in errors to each of oxygen uptake, carbon dioxide output, and respiratory exchange ratio. These discrepant findings reveal that controlled ventilation and gas fractions are insufficient to validate breath-by-breath, and perhaps even time-averaged, systems of EGAIC. The errors of the COM system reveal the need for concern over the validity of commercial systems of EGAIC.

  9. [Analysis of breath hydrogen (H2) in diagnosis of gastrointestinal function: validation of a pocket breath H2 test analyzer].

    PubMed

    Braden, B; Braden, C P; Klutz, M; Lembcke, B

    1993-04-01

    Breath hydrogen (H2) analysis, as used in gastroenterologic function tests, requires a stationary analysis system equipped with a gaschromatograph or an electrochemical sensor cell. Now a portable breath H2-analyzer has been miniaturized to pocket size (104 mm x 62 mm x 29 mm). The application of this device in clinical practice has been assessed in comparison to the standard GMI-exhaled monitor. The pocket analyzer showed a linear response to standards with H2-concentrations ranging from 0-100 ppm (n = 7), which was not different from the GMI-apparatus. The correlation of both methods during clinical application (lactose tolerance tests, mouth-to-coecum transit time determined with lactulose) was excellent (Y = 1.08 X + 0.96; r = 0.959). Using the new device, both, analysis (3 s vs. 90 s) and the reset-time (43 s vs. 140 s) were shorter whereas calibration was more feasible with the GMI-apparatus. It is concluded, that the considerably cheaper pocket-sized breath H2-analyzer is as precise and sensitive as the GMI-exhaled monitor, and thus presents a valid alternative for H2-breath tests.

  10. Variability in delivered dose and respirable delivered dose from nebulizers: are current regulatory testing guidelines sufficient to produce meaningful information?

    PubMed

    Hatley, Ross Hm; Byrne, Sarah M

    2017-01-01

    To improve convenience to patients, there have been advances in the operation of nebulizers, resulting in fast treatment times and less drug lost to the environment. However, limited attention has been paid to the effects of these developments on the delivered dose (DD) and respirable delivered dose (RDD). Published pharmacopoeia and ISO testing guidelines for adult-use testing utilize a single breathing pattern, which may not be sufficient to enable effective comparisons between the devices. The DD of 5 mg of salbutamol sulfate into adult breathing patterns with inhalation:exhalation (I:E) ratios between 1:1 and 1:4 was determined. Droplet size was determined by laser diffraction and RDD calculated. Nine different nebulizer brands with different modes of operation (conventional, venturi, breath-enhanced, mesh, and breath-activated) were tested. Between the non-breath-activated nebulizers, a 2.5-fold difference in DD (~750-1,900 µg salbutamol) was found; with RDD, there was a more than fourfold difference (~210-980 µg). With increasing time spent on exhalation, there were progressive reductions in DD and RDD, with the RDD at an I:E ratio of 1:4 being as little as 40% of the dose with the 1:1 I:E ratio. The DD and RDD from the breath-activated mesh nebulizer were independent of the I:E ratio, and for the breath-activated jet nebulizer, there was less than 20% change in RDD between the I:E ratios of 1:1 and 1:4. Comparing nebulizers using the I:E ratio recommended in the guidelines does not predict relative performance between the devices at other ratios. There was significant variance in DD or RDD between different brands of non-breath-activated nebulizer. In future, consideration should be given to revision of the test protocols included in the guidelines, to reflect more accurately the potential therapeutic dose that is delivered to a realistic spectrum of breathing patterns.

  11. A better state-of-mind: deep breathing reduces state anxiety and enhances test performance through regulating test cognitions in children.

    PubMed

    Khng, Kiat Hui

    2017-11-01

    A pre-test/post-test, intervention-versus-control experimental design was used to examine the effects, mechanisms and moderators of deep breathing on state anxiety and test performance in 122 Primary 5 students. Taking deep breaths before a timed math test significantly reduced self-reported feelings of anxiety and improved test performance. There was a statistical trend towards greater effectiveness in reducing state anxiety for boys compared to girls, and in enhancing test performance for students with higher autonomic reactivity in test-like situations. The latter moderation was significant when comparing high-versus-low autonomic reactivity groups. Mediation analyses suggest that deep breathing reduces state anxiety in test-like situations, creating a better state-of-mind by enhancing the regulation of adaptive-maladaptive thoughts during the test, allowing for better performance. The quick and simple technique can be easily learnt and effectively applied by most children to immediately alleviate some of the adverse effects of test anxiety on psychological well-being and academic performance.

  12. The rise in carboxyhemoglobin from repeated pulmonary diffusing capacity tests.

    PubMed

    Zavorsky, Gerald S

    2013-03-01

    The purpose of this study determined the rise in carboxyhemoglobin percentage (COHb) from repeated pulmonary diffusing capacity tests using 5 or 10s single breath-hold maneuvers. Five male and four female non-smokers [baseline COHb=1.2 (SD 0.5%)] performed repeated pulmonary diffusing capacity testing on two separate days. The days were randomized to either repeated 10s (0.28% CO), or 5s (0.28% CO, 55ppm NO) breath-hold maneuvers. Twenty-two 5s breath-hold maneuvers, each separated by 4min rest, raised COHb to 11.1 (1.4)% and minimally raised the methemoglobin percentage (METHb) by 0.3 (0.2)% to a value of 0.8 (0.2)%. After the 22nd test, pulmonary diffusing capacity for carbon monoxide (DLCO) was reduced by about 4mL/min/mmHg, equating to a 0.44% increase in COHb per 5s breath-hold maneuver and a concomitant 0.35mL/min/mmHg decrease in DLCO. Pulmonary diffusing capacity for nitric oxide (DLNO) was not altered after 22 tests. On another day, the 10s single breath-hold maneuver increased COHb by 0.64% per test, and reduced DLCO by 0.44mL/min/mmHg per test. In conclusion, 5s breath-hold maneuvers do not appreciably raise METHb or DLNO, and DLCO is only significantly reduced when COHb is at least 6%. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Improved workflow for quantification of left ventricular volumes and mass using free-breathing motion corrected cine imaging.

    PubMed

    Cross, Russell; Olivieri, Laura; O'Brien, Kendall; Kellman, Peter; Xue, Hui; Hansen, Michael

    2016-02-25

    Traditional cine imaging for cardiac functional assessment requires breath-holding, which can be problematic in some situations. Free-breathing techniques have relied on multiple averages or real-time imaging, producing images that can be spatially and/or temporally blurred. To overcome this, methods have been developed to acquire real-time images over multiple cardiac cycles, which are subsequently motion corrected and reformatted to yield a single image series displaying one cardiac cycle with high temporal and spatial resolution. Application of these algorithms has required significant additional reconstruction time. The use of distributed computing was recently proposed as a way to improve clinical workflow with such algorithms. In this study, we have deployed a distributed computing version of motion corrected re-binning reconstruction for free-breathing evaluation of cardiac function. Twenty five patients and 25 volunteers underwent cardiovascular magnetic resonance (CMR) for evaluation of left ventricular end-systolic volume (ESV), end-diastolic volume (EDV), and end-diastolic mass. Measurements using motion corrected re-binning were compared to those using breath-held SSFP and to free-breathing SSFP with multiple averages, and were performed by two independent observers. Pearson correlation coefficients and Bland-Altman plots tested agreement across techniques. Concordance correlation coefficient and Bland-Altman analysis tested inter-observer variability. Total scan plus reconstruction times were tested for significant differences using paired t-test. Measured volumes and mass obtained by motion corrected re-binning and by averaged free-breathing SSFP compared favorably to those obtained by breath-held SSFP (r = 0.9863/0.9813 for EDV, 0.9550/0.9685 for ESV, 0.9952/0.9771 for mass). Inter-observer variability was good with concordance correlation coefficients between observers across all acquisition types suggesting substantial agreement. Both motion corrected re-binning and averaged free-breathing SSFP acquisition and reconstruction times were shorter than breath-held SSFP techniques (p < 0.0001). On average, motion corrected re-binning required 3 min less than breath-held SSFP imaging, a 37% reduction in acquisition and reconstruction time. The motion corrected re-binning image reconstruction technique provides robust cardiac imaging that can be used for quantification that compares favorably to breath-held SSFP as well as multiple average free-breathing SSFP, but can be obtained in a fraction of the time when using cloud-based distributed computing reconstruction.

  14. Significance of hydrogen breath tests in children with suspected carbohydrate malabsorption

    PubMed Central

    2014-01-01

    Background Hydrogen breath tests are noninvasive procedures frequently applied in the diagnostic workup of functional gastrointestinal disorders. Here, we review hydrogen breath test results and the occurrence of lactose, fructose and sorbitol malabsorption in pediatric patients; and determine the significance of the findings and the outcome of patients with carbohydrate malabsorption. Methods We included 206 children (88 male, 118 female, median age 10.7 years, range 3–18 years) with a total of 449 hydrogen breath tests (lactose, n = 161; fructose, n = 142; sorbitol, n = 146) into a retrospective analysis. Apart from test results, we documented symptoms, the therapeutic consequences of the test, the outcome and the overall satisfaction of the patients and families. Results In total, 204 (46%) of all breath tests were positive. Long-term follow-up data could be collected from 118 patients. Of 79 patients (67%) who were put on a diet reduced in lactose, fructose and/or sorbitol, the majority (92%, n = 73) reported the diet to be strict and only 13% (n = 10) had no response to diet. Most families (96%, n = 113) were satisfied by the test and the therapy. There were only 21 tests (5%) with a borderline result because the criteria for a positive result were only partially met. Conclusions Hydrogen breath tests can be helpful in the evaluation of children with gastrointestinal symptoms including functional intestinal disorders. If applied for a variety of carbohydrates but only where indicated, around two-third of all children have positive results. The therapeutic consequences are successfully relieving symptoms in the vast majority of patients. PMID:24575947

  15. Relationship Between Abdominal Symptoms and Fructose Ingestion in Children with Chronic Abdominal Pain.

    PubMed

    Hammer, Veronika; Hammer, Katharina; Memaran, Nima; Huber, Wolf-Dietrich; Hammer, Karin; Hammer, Johann

    2018-05-01

    Limited valid data are available regarding the association of fructose-induced symptoms, fructose malabsorption, and clinical symptoms. To develop a questionnaire for valid symptom assessment before and during a carbohydrate breath test and to correlate symptoms with fructose breath test results in children/adolescents with functional abdominal pain. A Likert-type questionnaire assessing symptoms considered relevant for hydrogen breath test in children was developed and underwent initial validation. Fructose malabsorption was determined by increased breath hydrogen in 82 pediatric patients with functional abdominal pain disorders; fructose-induced symptoms were quantified by symptom score ≥2 and relevant symptom increase over baseline. The results were correlated with clinical symptoms. The time course of symptoms during the breath test was assessed. The questionnaire exhibited good psychometric properties in a standardized assessment of the severity of carbohydrate-related symptoms. A total of 40 % (n = 33) had malabsorption; symptoms were induced in 38 % (n = 31), but only 46 % (n = 15) with malabsorption were symptomatic. There was no significant correlation between fructose malabsorption and fructose-induced symptoms. Clinical symptoms correlated with symptoms evoked during the breath test (p < 0.001, r 2  = 0.21) but not with malabsorption (NS). Malabsorbers did not differ from non-malabsorbers in terms of symptoms during breath test. Symptomatic patients had significantly higher pain and flatulence scores over the 9-h observation period (p < 0.01) than did nonsymptomatic patients; the meteorism score was higher after 90 min. Fructose-induced symptoms but not fructose malabsorption are related to increased abdominal symptoms and have distinct timing patterns.

  16. Measurement of fatigue following 18 msw dry chamber dives breathing air or enriched air nitrox.

    PubMed

    Harris, R J D; Doolette, D J; Wilkinson, D C; Williams, D J

    2003-01-01

    Many divers report less fatigue following diving breathing oxygen rich N2-O2 mixtures compared with breathing air. In this double blinded, randomized controlled study 11 divers breathed either air or Enriched Air Nitrox 36% (oxygen 36%, nitrogen 64%) during an 18 msw (281 kPa(a)) dry chamber dive for a bottom time of 40 minutes. Two periods of exercise were performed during the dive. Divers were assessed before and after each dive using the Multidimensional Fatigue Inventory-20, a visual analogue scale, Digit Span Tests, Stroop Tests, and Divers Health Survey (DHS). Diving to 18m produced no measurable difference in fatigue, attention levels, ability to concentrate or DHS scores, following dives using either breathing gas.

  17. Breath holding spell

    MedlinePlus

    ... such as Riley-Day syndrome or Rett syndrome Iron deficiency anemia A family history of breath holding spells ( ... tests may be done to check for an iron deficiency. Other tests that may be done include: EKG ...

  18. The likelihood of acetone interference in breath alcohol measurement

    DOT National Transportation Integrated Search

    1985-09-01

    This report discusses the significance of possible interference of acetone in breath alcohol testing. The following dimensions were considered: 1) what levels of acetone concentration may appear on the breath; 2) what levels of acetone concentration ...

  19. 32 CFR 634.8 - Implied consent.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... to blood, breath, or urine tests. Persons who drive on the installation shall be deemed to have given their consent to evidential tests for alcohol or other drug content of their blood, breath, or urine...

  20. Enzyme induction in neonates after fetal exposure to antiepileptic drugs

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rating, D.; Jaeger-Roman, E.; Nau, H.

    1983-01-01

    The /sup 13/C-AP breath test is shown to be a convenient, noninvasive method to monitor velocity and capacity of P450-dependent AP N-demethylation in infancy and childhood. According to /sup 13/C-AP breath tests, neonates have a very low capacity to eliminate /sup 13/CO/sub 2/, which is only 15 to 21% of the activity in adults. During the first year of life AP N-demethylation increases to reach its maximum at about 2 years; afterwards a slight decrease occurs. In 25 neonates exposed prenatally to different antiepileptic drugs /sup 13/C-AP breath test was efficiently used to prove that cytochrome AP N-demethylation was considerablymore » stimulated. After primidone/phenobarbitone, especially in combination with phenytoin, /sup 13/C elimination reaches and even surpasses the range for older children. Valproate exposure during fetal life is not consistently followed by a significant increase in AP N-demethylation. The enzyme induction demonstrated by /sup 13/C-AP breath test was often accompanied by accelerated metabolic clearance and shortened half-life times of transplacentally acquired antiepileptic drugs. There was good agreement between /sup 13/C-AP breath tests and pharmacokinetic data for primidone/phenobarbitone but not for phenytoin. In contrast, in the case of phenytoin exposure during pregnancy the pharmacokinetic parameters and the /sup 13/C breath test data will transport very different informations about enzyme induction in these neonates.« less

  1. 49 CFR 40.243 - What is the procedure for an alcohol screening test using an EBT or non-evidential breath ASD?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false What is the procedure for an alcohol screening test using an EBT or non-evidential breath ASD? 40.243 Section 40.243 Transportation Office of the...-evidential breath ASD? As the BAT or STT, you must take the following steps: (a) Select, or allow the...

  2. 49 CFR 40.243 - What is the procedure for an alcohol screening test using an EBT or non-evidential breath ASD?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false What is the procedure for an alcohol screening test using an EBT or non-evidential breath ASD? 40.243 Section 40.243 Transportation Office of the...-evidential breath ASD? As the BAT or STT, you must take the following steps: (a) Select, or allow the...

  3. Effect of DA-9701 on gastric emptying in a mouse model: assessment by ¹³C-octanoic acid breath test.

    PubMed

    Lim, Chul-Hyun; Choi, Myung-Gyu; Park, Hyeyeon; Baeg, Myong Ki; Park, Jae Myung

    2013-07-21

    To evaluate the effects of DA-9701 on the gastric emptying of a solid meal using the ¹³C-octanoic acid breath test in a mouse model. Male C57BL/6 mice aged > 8 wk and with body weights of 20-25 g were used in this study. The solid test meal consisted of 200 mg of egg yolk labeled with 1.5 L/g ¹³C-octanoic acid. The mice were placed in a 130 mL chamber flushed with air at a flow speed of 200 mL/min. Breath samples were collected for 6 h. The half-emptying time and lag phase were calculated using a modified power exponential model. To assess the reproducibility of the ¹³C-octanoic acid breath test, the breath test was performed two times at intervals of one week in ten mice without drug treatment. To assess the gastrokinetic effects of DA-9701, the breath test was performed three times in another twelve mice, with a randomized crossover sequence of three drug treatments: DA-9701 3 mg/kg, erythromycin 6 mg/kg, or saline. Each breath test was performed at an interval of one week. Repeatedly measured half gastric emptying time of ten mice without drug treatment showed 0.856 of the intraclass correlation coefficient for the half gastric emptying time (P = 0.004). The mean cumulative excretion curve for the ¹³C-octanoic acid breath test showed accelerated gastric emptying after DA-9701 treatment compared with the saline control (P = 0.028). The median half gastric emptying time after the DA-9701 treatment was significantly shorter than after the saline treatment [122.4 min (109.0-137.9 min) vs 134.5 min (128.4-167.0 min), respectively; P = 0.028] and similar to that after the erythromycin treatment [123.3 min (112.9-138.2 min)]. The lag phase, which was defined as the period taken to empty 15% of a meal, was significantly shorter after the DA-9701 treatment than after the saline treatment [48.1 min (44.6-57.1 min) vs 52.6 min (49.45-57.4 min), respectively; P = 0.049]. The novel prokinetic agent DA-9701 accelerated gastric emptying, assessed with repeated measurements in the same mouse using the ¹³C-octanoic acid breath test. Our findings suggest that DA-9701 has therapeutic potential for the treatment of functional dyspepsia.

  4. Effects of homeopathic mother tinctures on breath alcohol testing.

    PubMed

    Boatto, Gianpiero; Trignano, Claudia; Burrai, Lucia; Spanu, Andrea; Nieddu, Maria

    2015-01-01

    In some countries, it is illegal to drive with any detectable amount of alcohol in blood; in others, the legal limit is 0.5 g/L or lower. Recently, some defendants charged with driving under the influence of alcohol and have claimed that positive breath alcohol test results were due to the ingestion of homeopathic mother tinctures. These preparations are obtained by maceration, digestion, infusion, or decoction of herbal material in hydroalcoholic solvent. A series of tests were conducted to evaluate the alcoholic content of three homeopathic mother tinctures and their ability to produce inaccurate breath alcohol results. Nine of 30 subjects gave positive results (0.11-0.82 g/L) when tests were taken within 1 min after drinking mother tincture. All tests taken at least 15 min after the mother tincture consumption and resulted in alcohol-free readings. An observation period of 15-20 min prior to breath alcohol testing eliminates the possibility of false-positive results. © 2014 American Academy of Forensic Sciences.

  5. Can handling E85 motor fuel cause positive breath alcohol test results?

    PubMed

    Ran, Ran; Mullins, Michael E

    2013-09-01

    Hand-held breath alcohol analyzers are widely used by police in traffic stops of drivers suspected of driving while intoxicated (DWI). E85 is a motor fuel consisting of 85% ethanol and 15% gasoline or other hydrocarbons, and is available at nearly 2,600 stations in the USA. We sought to determine whether handling E85 fuel could produce measurable breath alcohol results using a hand-held analyzer and to see if this would be a plausible explanation for a positive breath alcohol test. Five healthy adult subjects dispensed or transferred 8 US gallons of E85 fuel in each of four scenarios. We measured breath alcohol concentration in g/210 L of exhaled breath using the BACTrack S50 at 0, 2, 4, 6, 8, 10, 15 and 20 min after each fuel-handling scenario. Most of the subjects had no detectable breath alcohol after handling E85 motor fuel. Transient elevations (0.02-0.04 g/210 L) in breath alcohol measurement occurred up to 6 min after handling E85 in a minority of subjects. We conclude that it is unlikely that handling E85 motor fuel would result in erroneous prosecution for DWI.

  6. Determination of breath isoprene and acetone concentration with a needle-type extraction device in gas chromatography-mass spectrometry.

    PubMed

    Ueta, Ikuo; Mizuguchi, Ayako; Okamoto, Mitsuyoshi; Sakamaki, Hiroyuki; Hosoe, Masahiko; Ishiguro, Motoyuki; Saito, Yoshihiro

    2014-03-20

    Isoprene in human breath is said to be related to cholesterol metabolism, and the possibility of the correlations with some clinical parameters has been studied. However, at this stage, no clear benefit of breath isoprene has been reported for clinical diagnosis. In this work, isoprene and acetone concentrations were measured in the breath of healthy and obese subjects using a needle-type extraction device for subsequent analysis in gas chromatography-mass spectrometry (GC-MS) to investigate the possibility of these compounds as an indicator of possible diseases. After measuring intraday and interday variations of isoprene and acetone concentrations in breath samples of healthy subjects, their concentrations were also determined in 80 healthy and 17 obese subjects. In addition, correlation between these breath concentrations and the blood tests result was studied for these healthy and obese subjects. The results indicated successful determination of breath isoprene and acetone in this work, however, no clear correlation was observed between these measured values and the blood test results. Breath isoprene concentration may not be a useful indicator for obesity or hypercholesterolemia. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Can Handling E85 Motor Fuel Cause Positive Breath Alcohol Test Results?

    PubMed Central

    Ran, Ran; Mullins, Michael E.

    2013-01-01

    Hand-held breath alcohol analyzers are widely used by police in traffic stops of drivers suspected of driving while intoxicated (DWI). E85 is a motor fuel consisting of 85% ethanol and 15% gasoline or other hydrocarbons, and is available at nearly 2,600 stations in the USA. We sought to determine whether handling E85 fuel could produce measurable breath alcohol results using a hand-held analyzer and to see if this would be a plausible explanation for a positive breath alcohol test. Five healthy adult subjects dispensed or transferred 8 US gallons of E85 fuel in each of four scenarios. We measured breath alcohol concentration in g/210 L of exhaled breath using the BACTrack S50 at 0, 2, 4, 6, 8, 10, 15 and 20 min after each fuel-handling scenario. Most of the subjects had no detectable breath alcohol after handling E85 motor fuel. Transient elevations (0.02–0.04 g/210 L) in breath alcohol measurement occurred up to 6 min after handling E85 in a minority of subjects. We conclude that it is unlikely that handling E85 motor fuel would result in erroneous prosecution for DWI. PMID:23843422

  8. Rapid Point-Of-Care Breath Test for Biomarkers of Breast Cancer and Abnormal Mammograms

    PubMed Central

    Phillips, Michael; Beatty, J. David; Cataneo, Renee N.; Huston, Jan; Kaplan, Peter D.; Lalisang, Roy I.; Lambin, Philippe; Lobbes, Marc B. I.; Mundada, Mayur; Pappas, Nadine; Patel, Urvish

    2014-01-01

    Background Previous studies have reported volatile organic compounds (VOCs) in breath as biomarkers of breast cancer and abnormal mammograms, apparently resulting from increased oxidative stress and cytochrome p450 induction. We evaluated a six-minute point-of-care breath test for VOC biomarkers in women screened for breast cancer at centers in the USA and the Netherlands. Methods 244 women had a screening mammogram (93/37 normal/abnormal) or a breast biopsy (cancer/no cancer 35/79). A mobile point-of-care system collected and concentrated breath and air VOCs for analysis with gas chromatography and surface acoustic wave detection. Chromatograms were segmented into a time series of alveolar gradients (breath minus room air). Segmental alveolar gradients were ranked as candidate biomarkers by C-statistic value (area under curve [AUC] of receiver operating characteristic [ROC] curve). Multivariate predictive algorithms were constructed employing significant biomarkers identified with multiple Monte Carlo simulations and cross validated with a leave-one-out (LOO) procedure. Results Performance of breath biomarker algorithms was determined in three groups: breast cancer on biopsy versus normal screening mammograms (81.8% sensitivity, 70.0% specificity, accuracy 79% (73% on LOO) [C-statistic value], negative predictive value 99.9%); normal versus abnormal screening mammograms (86.5% sensitivity, 66.7% specificity, accuracy 83%, 62% on LOO); and cancer versus no cancer on breast biopsy (75.8% sensitivity, 74.0% specificity, accuracy 78%, 67% on LOO). Conclusions A pilot study of a six-minute point-of-care breath test for volatile biomarkers accurately identified women with breast cancer and with abnormal mammograms. Breath testing could potentially reduce the number of needless mammograms without loss of diagnostic sensitivity. PMID:24599224

  9. A comparison of blood alcohol levels as determined by breath and blood tests taken in actual field operations.

    DOT National Transportation Integrated Search

    1972-01-01

    During its 1972 session, the General Assembly of Virginia enacted Senate Bill 104, which authorizes the breath test, as well as the blood test used previously, as a proper chemical test to determine the alcoholic content of the blood. Any person arre...

  10. Positive or negative fructose breath test results do not predict response to fructose restricted diet in children with recurrent abdominal pain: results from a prospective randomized trial.

    PubMed

    Wirth, S; Klodt, C; Wintermeyer, P; Berrang, J; Hensel, K; Langer, T; Heusch, A

    2014-09-01

    To perform a prospective, blinded, randomized interventional trial in patients with recurrent abdominal pain. The primary endpoint was to determine the abdominal pain intensity after 2 weeks of fructose restricted diet. Secondary endpoints were changes of pain frequency and a secondary symptom score (SSS). 103 individuals with recurrent abdominal pain for more than 3 months were randomized. 51 patients were allocated to group A (diet) and 52 to group B (no diet). 2 weeks later the patients underwent hydrogen breath test and were assigned to the test positive or negative group to identify patients with fructose malabsorption. 2 weeks after intervention the pain score decreased significantly from a median 5.5 in group A to 4 and did not change significantly in group B (5.3 to 5). In group A both patients with positive and negative breath tests had a significant lower pain score (-2 and -1.75, respectively). Frequency of abdominal pain decreased in both groups but without significant difference, SSS improved only in group A from median 6 to 3.5. Positive breath test was no predicting factor, neither was abdominal pain during the test. Fructose restricted diet in children and adolescents with recurrent abdominal pain may be of benefit to improve both abdominal pain symptoms and other secondary symptoms. Since a negative breath test result does not exclude a positive response to fructose restriction, the hydrogen breath test does not seem to be the appropriate diagnostic mean to predict the response to the diet. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Breath tests sustainability in hospital settings: cost analysis and reimbursement in the Italian National Health System.

    PubMed

    Volpe, M; Scaldaferri, F; Ojetti, V; Poscia, A

    2013-01-01

    The high demand of Breath Tests (BT) in many gastroenterological conditions in time of limited resources for health care systems, generates increased interest in cost analysis from the point of view of the delivery of services to better understand how use the money to generate value. This study aims to measure the cost of C13 Urea and other most utilized breath tests in order to describe key aspects of costs and reimbursements looking at the economic sustainability for the hospital. A hospital based cost-analysis of the main breath tests commonly delivery in an ambulatory setting is performed. Mean salary for professional nurses and gastroenterologists, drugs/preparation used and disposable materials, purchase and depreciation of the instrument and the testing time was used to estimate the cost, while reimbursements are based on the 2013 Italian National Health System ambulatory pricelist. Variables that could influence the model are considered in the sensitivity analyses. The mean cost for C13--Urea, Lactulose and Lactose BT are, respectively, Euros 30,59; 45,20 and 30,29. National reimbursement often doesn't cover the cost of the analysis, especially considering the scenario with lower number of exam. On the contrary, in high performance scenario all the reimbursement could cover the cost, except for the C13 Urea BT that is high influenced by the drugs cost. However, consideration about the difference between Italian Regional Health System ambulatory pricelist are done. Our analysis shows that while national reimbursement rates cover the costs of H2 breath testing, they do not cover sufficiently C13 BT, particularly urea breath test. The real economic strength of these non invasive tests should be considered in the overall organization of inpatient and outpatient clinic, accounting for complete diagnostic pathway for each gastrointestinal disease.

  12. 13C-methacetin-breath test compared to also noninvasive biochemical blood tests in predicting hepatic fibrosis and cirrhosis in chronic hepatitis C.

    PubMed

    Dinesen, L; Caspary, W F; Chapman, R W; Dietrich, C F; Sarrazin, C; Braden, B

    2008-09-01

    The (13)C-methacetin-breath test and also several noninvasive blood tests comprising routine laboratory parameters have been proposed to predict fibrosis and cirrhosis in chronic hepatitis C. The aim of the study was to compare the diagnostic accuracy between these tests referring to hepatic histology as gold standard. 96 patients with chronic hepatitis C virus infection underwent percutaneous liver biopsy and the (13)C-methacetin-breath test. The Fibroindex, the aspartate aminotransferase to platelet ratio index , and the aspartate aminotransferase to alanine aminotransferase ratio were used as parameters for the staging of fibrosis. The main endpoint was the area under the characteristic curves for the diagnosis of advanced fibrosis (F3-F4) and cirrhosis (F4) according to the Batts Ludwig criteria. ROC analysis revealed a cut-off <14.6 per thousand best with 92.6% sensitivity and 84.1% specificity for the (13)C-methacetin-breath test, for the Fibroindex >1.82 70.4% sensitivity and 91.3% specificity, for the aspartate aminotransferase to platelet ratio >1.0 a 66.7% sensitivity and 75.4% specificity, and for the aspartate aminotransferase to alanine aminotransferase ratio >1.0 63.0% sensitivity and 59.4% specificity in predicting liver cirrhosis. The areas under the curve for the breath test, the Fibroindex, aspartate aminotransferase to platelet ratio and the aspartate aminotransferase to alanine aminotransferase ratio were 0.958, 0.845, 0.799, and 0.688, respectively, when predicting cirrhosis. For identifying patients with advanced fibrosis, the areas under the curve were 0.827, 0.804, 0.779, and 0.561, respectively. Discordances between Fibroindex (21%), aspartate aminotransferase to platelet ratio (29%) or aspartate aminotransferase to alanine aminotransferase ratio (37.6%) and liver biopsy were significantly more frequent than between (13)C-breath test (11.6%) and liver biopsy (P<0.05). The (13)C-methacetin-breath test is more reliable in predicting advanced fibrosis and cirrhosis than simple biochemical parameters (aspartate aminotransferase to platelet ratio; aspartate aminotransferase to alanine aminotransferase ratio).

  13. Comparison between hyperventilation and breath-holding in panic disorder: patients responsive and non-responsive to both tests.

    PubMed

    Nardi, Antonio E; Valença, Alexandre M; Mezzasalma, Marco A; Levy, Sandra P; Lopes, Fabiana L; Nascimento, Isabella; Freire, Rafael C; Veras, Andre B; Zin, Walter A

    2006-06-15

    Our aim was to compare the demographic and psychopathological features of panic disorder (PD) patients who underwent hyperventilation and breath-holding challenge tests, and to describe the features of patients who had a panic attack after both tests versus those patients who did not experience panic after either test. Eighty-five PD patients were induced to hyperventilate (30 breaths/min) for 4 min, and a week later to hold their breath for as long as possible four times with a 2-min interval in between. Anxiety scales were applied before and after the tests. Patients who responded with a panic attack to both tests (BPA, n = 25) were compared with patients who experienced spontaneous panic attacks but did not panic in response to the two tests (NPA, n = 16). The BPA group had a significantly higher presence of respiratory symptoms during a panic attack. The criteria for the respiratory PD subtype were fulfilled in 18 (72.0%) BPA patients and in 6 (37.5%) NPA patients. The BPA patients had a later onset of panic disorder and a higher familial prevalence of PD. Our data suggest that there is a distinction between PD patients who were sensitive to both hyperventilation and breath-holding tests and PD patients who were not affected by the challenge tests. The panic attack may be a final common pathway for different types of stimuli, and respiratory tests may characterize different PD subgroups.

  14. Performance of the 13C-urea breath test for the diagnosis of H. pylori infection using a substrate synthesized in Brazil: A preliminary study.

    PubMed

    Coelho, Luiz Gonzaga; Sant'Ana, Carlos Roberto; Oliveira, Ricardo Brandt de; Cezar, Raíra César E; Araujo, Aline Cordeiro Campos de; Silva, Raisa Cristina Teodoro da; Trindade, Osmar Reni; Coelho, Maria Clara; Ferrioli, Eduardo; Bendassolli, José Albertino

    2018-06-07

    The 13C-urea breath test is the main non-invasive test for the diagnosis of Helicobacter pylori infection. The availability of this test throughout the country is limited, mainly due to the difficulty in obtaining the labeled isotope from abroad. Recently, researchers from the Nuclear Energy Center in Agriculture at the University of São Paulo (CENA/USP) succeeded in synthesizing 13C-enriched urea for Helicobacter pylori diagnosis. The aim of the study was to compare the performance of the 13C-urea breath test using 13C-urea acquired abroad with that of a test using 13C-urea synthesized in Brazil. Sixty-four dyspeptic patients participated in the study (24 men and 40 women). Initially, the patients performed the 13C-urea breath test using the imported substrate (Euriso-Top, France). Seven to fourteen days later, all the patients repeated the test using the Brazilian substrate. The samples from both examinations were processed in an infrared isotope analyzer (IRIS, Wagner Analisen Technik, Germany), and all delta over baseline (DOB) [%] values above four were considered positive results. Twenty-seven patients (42%) exhibited negative results for Helicobacter pylori infection, and thirty-seven patients (58%) exhibited positive results when tested using the foreign substrate (gold standard). There was a 100% concordance regarding the presence or absence of infection when the gold standard results were compared with those obtained using the Brazilian substrate. Similar performance in the diagnosis of Helicobacter pylori infection was demonstrated when using the 13C-urea breath test with the Brazilian 13C-urea substrate and the test with the substrate produced abroad. This validation represents an important step toward increasing the availability of the 13C-urea breath test throughout the country, which will have a positive influence on the management of Helicobacter pylori infection.

  15. The Effect of Alcohol-Based Hand Sanitizer Vapors on Evidential Breath Alcohol Test Results.

    PubMed

    Strawsine, Ellen; Lutmer, Brian

    2017-11-16

    This study was undertaken to determine if the application of alcohol-based hand sanitizers (ABHSs) to the hands of a breath test operator will affect the results obtained on evidential breath alcohol instruments (EBTs). This study obtained breath samples on three different EBTs immediately after application of either gel or foam ABHS to the operator's hands. A small, but significant, number of initial analyses (13 of 130, 10%) resulted in positive breath alcohol concentrations, while 41 samples (31.5%) resulted in a status code. These status codes were caused by ethanol vapors either in the room air or their inhalation by the subject, thereby causing a mouth alcohol effect. Replicate subject samples did not yield any consecutive positive numeric results. As ABHS application can cause a transitory mouth alcohol effect via inhalation of ABHS vapors, EBT operators should forego the use of ABHS in the 15 min preceding subject testing. © 2017 American Academy of Forensic Sciences.

  16. Synthesis of ¹³C-lidocaine as a probe of breath test for the evaluation of cytochrome P450 activity.

    PubMed

    Mitome, Hidemichi; Sugiyama, Erika; Sato, Hitoshi; Akira, Kazuki

    2014-01-01

    (13)C-Labeled lidocaine, 2-di[1-(13)C]ethylamino-N-(2,6-dimethylphenyl)acetamide (1), was synthesized from [1-(13)C]acetic acid in six steps, as a probe for a breath test to evaluate in vivo cytochrome P450 activity. The measurement of (13)CO2 in breath was successfully performed following oral administration of (13)C-lidocaine 1 to mice.

  17. Effects of alcohol-based hand hygiene solutions on breath alcohol detection in the emergency department.

    PubMed

    Emerson, Beth L; Whitfill, Travis; Baum, Carl R; Garlin-Kane, Katherine; Santucci, Karen

    2016-12-01

    This study aimed to investigate the effects of alcohol-based hand hygiene solution (ABHS) use by care providers on point-of-care alcohol breath analyzer interpretation under different clinically relevant conditions. Among each test condition (foam vehicle with immediate testing, gel vehicle with immediate testing, allowing hands to dry after the use of ABHS, and donning gloves after the use of ABHS), alcohol was detected in breath at 1 minute after use of ABHS. Because the use of ABHS by individuals administering breath alcohol detection may result in false-positive detection of alcohol, staff using these devices should consider traditional hand hygiene with soap and water. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  18. Compressed air demand-type firefighter's breathing system, volume 1. [design analysis and performance tests

    NASA Technical Reports Server (NTRS)

    Sullivan, J. L.

    1975-01-01

    The commercial availability of lightweight high pressure compressed air vessels has resulted in a lightweight firefighter's breathing apparatus. The improved apparatus, and details of its design and development are described. The apparatus includes a compact harness assembly, a backplate mounted pressure reducer assembly, a lightweight bubble-type facemask with a mask mounted demand breathing regulator. Incorporated in the breathing regulator is exhalation valve, a purge valve and a whistle-type low pressure warning that sounds only during inhalation. The pressure reducer assembly includes two pressure reducers, an automatic transfer valve and a signaling device for the low pressure warning. Twenty systems were fabricated, tested, refined through an alternating development and test sequence, and extensively examined in a field evaluation program. Photographs of the apparatus are included.

  19. NASA firefighters breathing system program report

    NASA Technical Reports Server (NTRS)

    Wood, W. B.

    1977-01-01

    Because of the rising incidence of respiratory injury to firefighters, local governments expressed the need for improved breathing apparatus. A review of the NASA firefighters breathing system program, including concept definition, design, development, regulatory agency approval, in-house testing, and program conclusion is presented.

  20. 21 CFR 862.3080 - Breath nitric oxide test system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Breath nitric oxide test system. 862.3080 Section 862.3080 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test...

  1. 21 CFR 862.3050 - Breath-alcohol test system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Breath-alcohol test system. 862.3050 Section 862.3050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862...

  2. 21 CFR 862.3050 - Breath-alcohol test system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Breath-alcohol test system. 862.3050 Section 862.3050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862...

  3. 21 CFR 862.3050 - Breath-alcohol test system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Breath-alcohol test system. 862.3050 Section 862.3050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862...

  4. 21 CFR 862.3080 - Breath nitric oxide test system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Breath nitric oxide test system. 862.3080 Section 862.3080 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test...

  5. 21 CFR 862.3080 - Breath nitric oxide test system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Breath nitric oxide test system. 862.3080 Section 862.3080 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test...

  6. 21 CFR 862.3080 - Breath nitric oxide test system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Breath nitric oxide test system. 862.3080 Section 862.3080 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test...

  7. ERS technical standard on bronchial challenge testing: general considerations and performance of methacholine challenge tests.

    PubMed

    Coates, Allan L; Wanger, Jack; Cockcroft, Donald W; Culver, Bruce H; Diamant, Zuzana; Gauvreau, Gail; Hall, Graham L; Hallstrand, Teal S; Horvath, Ildiko; de Jongh, Frans H C; Joos, Guy; Kaminsky, David A; Laube, Beth L; Leuppi, Joerg D; Sterk, Peter J

    2017-05-01

    This international task force report updates general considerations for bronchial challenge testing and the performance of the methacholine challenge test. There are notable changes from prior recommendations in order to accommodate newer delivery devices. Rather than basing the test result upon a methacholine concentration (provocative concentration (PC 20 ) causing a 20% fall in forced expiratory volume in 1 s (FEV 1 )), the new recommendations base the result upon the delivered dose of methacholine causing a 20% fall in FEV 1 (provocative dose (PD 20 )). This end-point allows comparable results from different devices or protocols, thus any suitable nebuliser or dosimeter may be used, so long as the delivery characteristics are known. Inhalation may be by tidal breathing using a breath-actuated or continuous nebuliser for 1 min (or more), or by a dosimeter with a suitable breath count. Tests requiring maximal inhalations to total lung capacity are not recommended because the bronchoprotective effect of a deep breath reduces the sensitivity of the test. Copyright ©ERS 2017.

  8. Lactose (mal)digestion evaluated by the 13C-lactose digestion test.

    PubMed

    Vonk, R J; Lin, Y; Koetse, H A; Huang, C; Zeng, G; Elzinga, H; Antoine, J; Stellaard, F

    2000-02-01

    The prevalence of genetically determined lactase nonpersistence is based on the results of the lactose H2 breath test. This test, however, is an indirect test, which might lead to misinterpretation. We determined lactase activity in healthy Chinese and Dutch students using a novel 13C-lactose digestion test. The cut-off value of this test was established in a Chinese population with a homogenous genetic background of lactase nonpersistence and was compared with the results obtained in a Caucasian population. Twenty-five grams of a 13C-lactose solution was consumed by 12 known H2-positive and 5 H2-negative Chinese students and 48 Dutch students and, subsequently, 13C-glucose concentration in plasma and H2 excretion in breath were measured. A similar 13C-glucose response curve was found in all Chinese students. The mean response curve in the Dutch students was more pronounced (P < 0.01). The 1 h (peak) plasma 13C-glucose concentration was the best discriminator between lactose digesting and maldigesting subjects. The cut-off level of 2 mmol L-1 13C-glucose in plasma was defined in the H2-positive Chinese students group. Based on the 13C-glucose response the prevalence of lactose maldigestion in the Dutch subjects was 25%; based on the lactose H2 breath test 17%. Using the 13C-lactose digestion test the results demonstrate a higher prevalence of lactose maldigestion in a Caucasian population than indicated by the results of the H2 breath test. A moderate increase in the plasma 13C-glucose concentration after consumption of 13C-lactose in the young adult Chinese subjects indicates a residual lactase activity in that age group, even when a positive H2 breath test result is obtained. These results indicate that the 13C-glucose concentration in plasma more accurately reflects the small intestinal lactose digestion capacity than the lactose H2 breath test.

  9. [Detection of Helicobacter pylori by culture and the 13C-urea breath test using an automated breath 13C analyzer].

    PubMed

    Yamamoto, Y; Kouda, M; Abe, K; Sakurabayashi, S; Sezai, S; Hirano, M; Oka, H

    1995-11-01

    Up to now, the diagnosis of H. pylori infection has been made by the breath test using 13C-urea. In this study, 13C-urea breath samples were tested in 34 patients (peptic ulcer scar 17, chronic gastritis 17 cases) with an automated breath 13C analyzer (ABCA. Europa Scientific, Crewe, UK) and compared with the results of endoscopical diagnosis for H. pylori infection. Endoscopic and 13C-urea breath test (13C-UBT) were performed before eradicative medication. We described a modified protocol for the growth grade of H. pylori colonies in microbiology (H. pylori score), and for the delta 13C area under curve (AUC; permil*hr) obtained from each sample of expired breath. There was a significant correlation between delta 13C-AUC and the delta 13C level of each sample, but the correlation coefficient obtained at 10min (R2 = 0.582) was lower than that obtained at the other four time points (20min; 0.891, 30min; 0.949, 40min; 0.946, 50min; 0.946, 60min; 0.820). The delta 13C-AUC well correlated with H. pylori score (p < 0.01), none of 26 H. pylori positive patients detected by culture was 13C-UBT negative (delta 13C-AUC < 8.2 permil*hr in mean + 2SD of H. pylori negative group). In conclusion, 13C-UBT using ABCA has high sensitivity and specificity, and it provides a non-invasive method for the detection of H. pylori urease activity.

  10. Effect of Time-of-Flight Information on PET/MR Reconstruction Artifacts: Comparison of Free-breathing versus Breath-hold MR-based Attenuation Correction.

    PubMed

    Delso, Gaspar; Khalighi, Mohammed; Ter Voert, Edwin; Barbosa, Felipe; Sekine, Tetsuro; Hüllner, Martin; Veit-Haibach, Patrick

    2017-01-01

    Purpose To evaluate the magnitude and anatomic extent of the artifacts introduced on positron emission tomographic (PET)/magnetic resonance (MR) images by respiratory state mismatch in the attenuation map. Materials and Methods The method was tested on 14 patients referred for an oncologic examination who underwent PET/MR imaging. The acquisition included standard PET and MR series for each patient, and an additional attenuation correction series was acquired by using breath hold. PET data were reconstructed with and without time-of-flight (TOF) information, first by using the standard free-breathing attenuation map and then again by using the additional breath-hold map. Two-tailed paired t testing and linear regression with 0 intercept was performed on TOF versus non-TOF and free-breathing versus breath-hold data for all detected lesions. Results Fluorodeoxyglucose-avid lesions were found in eight of the 14 patients included in the study. The uptake differences (maximum standardized uptake values) between PET reconstructions with free-breathing versus breath-hold attenuation ranged, for non-TOF reconstructions, from -18% to 26%. The corresponding TOF reconstructions yielded differences from -15% to 18%. Conclusion TOF information was shown to reduce the artifacts caused at PET/MR by respiratory mismatch between emission and attenuation data. © RSNA, 2016 Online supplemental material is available for this article.

  11. Photoacoustic sensor for VOCs: first step towards a lung cancer breath test

    NASA Astrophysics Data System (ADS)

    Wolff, Marcus; Groninga, Hinrich G.; Dressler, Matthias; Harde, Hermann

    2005-08-01

    Development of new optical sensor technologies has a major impact on the progression of diagnostic methods. Specifically, the optical analysis of breath is an extraordinarily promising technique. Spectroscopic sensors for the non-invasive 13C-breath tests (the Urea Breath Test for detection of Helicobacter pylori is most prominent) are meanwhile well established. However, recent research and development go beyond gastroenterological applications. Sensitive and selective detection of certain volatile organic compounds (VOCs) in a patient's breath, could enable the diagnosis of diseases that are very difficult to diagnose with contemporary techniques. For instance, an appropriate VOC biomarker for early-stage bronchial carcinoma (lung cancer) is n-butane (C4H10). We present a new optical detection scheme for VOCs that employs an especially compact and simple set-up based on photoacoustic spectroscopy (PAS). This method makes use of the transformation of absorbed modulated radiation into a sound wave. Employing a wavelength-modulated distributed feedback (DFB) diode laser and taking advantage of acoustical resonances of the sample cell, we performed very sensitive and selective measurements on butane. A detection limit for butane in air in the ppb range was achieved. In subsequent research the sensitivity will be successively improved to match the requirements of the medical application. Upon optimization, our photoacoustic sensor has the potential to enable future breath tests for early-stage lung cancer diagnostics.

  12. Does postprandial itopride intake affect the rate of gastric emptying? A crossover study using the continuous real time 13C breath test (BreathID system).

    PubMed

    Nonaka, Takashi; Kessoku, Takaomi; Ogawa, Yuji; Yanagisawa, Shogo; Shiba, Tadahiko; Sahaguchi, Takashi; Atsukawa, Kazuhiro; Takahashi, Hisao; Sekino, Yusuke; Iida, Hiroshi; Hosono, Kunihiro; Endo, Hiroki; Sakamoto, Yasunari; Koide, Tomoko; Takahashi, Hirokazu; Tokoro, Chikako; Abe, Yasunobu; Maeda, Shin; Nakajima, Atsushi; Inamori, Masahiko

    2011-01-01

    The aim of this study was to determine whether oral Itopride hydrochloride (itopride) intake might have any effect on the rate of gastric emptying, using a novel non-invasive technique for measuring the rate of gastric emptying, namely, the continuous real time 13C breath test (BreathID system: Exalenz Bioscience Ltd., Israel). Eight healthy male volunteers participated in this randomized, two-way crossover study. The subjects fasted overnight and were randomly assigned to receive 50mg itopride following a test meal (200 kcal per 200mL, containing 100mg 13C acetate), or the test meal alone. Under both conditions, gastric emptying was monitored for 4 hours after administration of the test meal by the 13C-acetic acid breath test performed continually using the BreathID system. Using Oridion Research Software (beta version), the time required for emptying of 50% of the labeled meal (T 1/2), the analog to the scintigraphy lag time for 10% emptying of the labeled meal (T lag), the gastric emptying coefficient (GEC), and the regression-estimated constants (beta and kappa) were calculated. The parameters measured under the two conditions were compared using the Wilcoxon's signed-rank test. No significant differences in the calculated parameters, namely, the T 1/2, T lag, GEC, beta or kappa, were observed between the two test conditions, namely, administration of a test meal+itopride and administration of the test meal alone. The present study revealed that postprandial itopride intake had no significant influence on the rate of gastric emptying. Recently, several studies have shown that itopride may be effective in the treatment of patients with functional dyspepsia. Our results suggest that the efficacy of itopride in patients with functional dyspepsia may be based on its effect of improving functions other than the rate of gastric emptying, such as the activities at neuronal sites, brain-gut correlation, visceral hypersensitivity, gastric accommodation and distension-induced adaptation.

  13. Detection of flow limitation in obstructive sleep apnea with an artificial neural network.

    PubMed

    Norman, Robert G; Rapoport, David M; Ayappa, Indu

    2007-09-01

    During sleep, the development of a plateau on the inspiratory airflow/time contour provides a non-invasive indicator of airway collapsibility. Humans recognize this abnormal contour easily, and this study replicates this with an artificial neural network (ANN) using a normalized shape. Five 10 min segments were selected from each of 18 sleep records (respiratory airflow measured with a nasal cannula) with varying degrees of sleep disordered breathing. Each breath was visually scored for shape, and breaths split randomly into a training and test set. Equally spaced, peak amplitude normalized flow values (representing breath shape) formed the only input to a back propagation ANN. Following training, breath-by-breath agreement of the ANN with the manual classification was tabulated for the training and test sets separately. Agreement of the ANN was 89% in the training set and 70.6% in the test set. When the categories of 'probably normal' and 'normal', and 'probably flow limited' and 'flow limited' were combined, the agreement increased to 92.7% and 89.4% respectively, similar to the intra- and inter-rater agreements obtained by a visual classification of these breaths. On a naive dataset, the agreement of the ANN to visual classification was 57.7% overall and 82.4% when the categories were collapsed. A neural network based only on the shape of inspiratory airflow succeeded in classifying breaths as to the presence/absence of flow limitation. This approach could be used to provide a standardized, reproducible and automated means of detecting elevated upper airway resistance.

  14. Tenth anniversary special issue of the Journal of Breath Research: looking forward

    EPA Science Inventory

    The Journal of Breath Research has now reached its 10th anniversary of publication. From the general public’s perspective, breath analysis had always revolved around drinking and driving, and to some lesser extent pulmonary function testing of athletes. However, at the ince...

  15. 46 CFR 197.450 - Breathing gas tests.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... taken at the connection point to the distribution system— (1) Every 6 months; and (2) After every repair or modification. (b) Purchased supplies of breathing mixtures supplied to a diver are checked before... commencement of diving operations, at the umbilical or underwater breathing apparatus connection point for the...

  16. Breath Analysis in Disease Diagnosis: Methodological Considerations and Applications

    PubMed Central

    Lourenço, Célia; Turner, Claire

    2014-01-01

    Breath analysis is a promising field with great potential for non-invasive diagnosis of a number of disease states. Analysis of the concentrations of volatile organic compounds (VOCs) in breath with an acceptable accuracy are assessed by means of using analytical techniques with high sensitivity, accuracy, precision, low response time, and low detection limit, which are desirable characteristics for the detection of VOCs in human breath. “Breath fingerprinting”, indicative of a specific clinical status, relies on the use of multivariate statistics methods with powerful in-built algorithms. The need for standardisation of sample collection and analysis is the main issue concerning breath analysis, blocking the introduction of breath tests into clinical practice. This review describes recent scientific developments in basic research and clinical applications, namely issues concerning sampling and biochemistry, highlighting the diagnostic potential of breath analysis for disease diagnosis. Several considerations that need to be taken into account in breath analysis are documented here, including the growing need for metabolomics to deal with breath profiles. PMID:24957037

  17. Breath analysis in disease diagnosis: methodological considerations and applications.

    PubMed

    Lourenço, Célia; Turner, Claire

    2014-06-20

    Breath analysis is a promising field with great potential for non-invasive diagnosis of a number of disease states. Analysis of the concentrations of volatile organic compounds (VOCs) in breath with an acceptable accuracy are assessed by means of using analytical techniques with high sensitivity, accuracy, precision, low response time, and low detection limit, which are desirable characteristics for the detection of VOCs in human breath. "Breath fingerprinting", indicative of a specific clinical status, relies on the use of multivariate statistics methods with powerful in-built algorithms. The need for standardisation of sample collection and analysis is the main issue concerning breath analysis, blocking the introduction of breath tests into clinical practice. This review describes recent scientific developments in basic research and clinical applications, namely issues concerning sampling and biochemistry, highlighting the diagnostic potential of breath analysis for disease diagnosis. Several considerations that need to be taken into account in breath analysis are documented here, including the growing need for metabolomics to deal with breath profiles.

  18. 42 CFR 84.96 - Service time test; closed-circuit apparatus.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Service time test; closed-circuit apparatus. 84.96...-Contained Breathing Apparatus § 84.96 Service time test; closed-circuit apparatus. (a) The closed-circuit apparatus will be classified according to the length of time it supplies adequate breathing gas to the...

  19. 42 CFR 84.96 - Service time test; closed-circuit apparatus.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Service time test; closed-circuit apparatus. 84.96...-Contained Breathing Apparatus § 84.96 Service time test; closed-circuit apparatus. (a) The closed-circuit apparatus will be classified according to the length of time it supplies adequate breathing gas to the...

  20. A Portable Real-Time Ringdown Breath Acetone Analyzer: Toward Potential Diabetic Screening and Management

    PubMed Central

    Jiang, Chenyu; Sun, Meixiu; Wang, Zhennan; Chen, Zhuying; Zhao, Xiaomeng; Yuan, Yuan; Li, Yingxin; Wang, Chuji

    2016-01-01

    Breath analysis has been considered a suitable tool to evaluate diseases of the respiratory system and those that involve metabolic changes, such as diabetes. Breath acetone has long been known as a biomarker for diabetes. However, the results from published data by far have been inconclusive regarding whether breath acetone is a reliable index of diabetic screening. Large variations exist among the results of different studies because there has been no “best-practice method” for breath-acetone measurements as a result of technical problems of sampling and analysis. In this mini-review, we update the current status of our development of a laser-based breath acetone analyzer toward real-time, one-line diabetic screening and a point-of-care instrument for diabetic management. An integrated standalone breath acetone analyzer based on the cavity ringdown spectroscopy technique has been developed. The instrument was validated by using the certificated gas chromatography-mass spectrometry. The linear fittings suggest that the obtained acetone concentrations via both methods are consistent. Breath samples from each individual subject under various conditions in total, 1257 breath samples were taken from 22 Type 1 diabetic (T1D) patients, 312 Type 2 diabetic (T2D) patients, which is one of the largest numbers of T2D subjects ever used in a single study, and 52 non-diabetic healthy subjects. Simultaneous blood glucose (BG) levels were also tested using a standard diabetic management BG meter. The mean breath acetone concentrations were determined to be 4.9 ± 16 ppm (22 T1D), and 1.5 ± 1.3 ppm (312 T2D), which are about 4.5 and 1.4 times of the one in the 42 non-diabetic healthy subjects, 1.1 ± 0.5 ppm, respectively. A preliminary quantitative correlation (R = 0.56, p < 0.05) between the mean individual breath acetone concentration and the mean individual BG levels does exist in 20 T1D subjects with no ketoacidosis. No direct correlation is observed in T1D subjects, T2D subjects, and healthy subjects. The results from a relatively large number of subjects tested indicate that an elevated mean breath acetone concentration exists in diabetic patients in general. Although many physiological parameters affect breath acetone, under a specifically controlled condition fast (<1 min) and portable breath acetone measurement can be used for screening abnormal metabolic status including diabetes, for point-of-care monitoring status of ketone bodies which have the signature smell of breath acetone, and for breath acetone related clinical studies requiring a large number of tests. PMID:27483281

  1. A Portable Real-Time Ringdown Breath Acetone Analyzer: Toward Potential Diabetic Screening and Management.

    PubMed

    Jiang, Chenyu; Sun, Meixiu; Wang, Zhennan; Chen, Zhuying; Zhao, Xiaomeng; Yuan, Yuan; Li, Yingxin; Wang, Chuji

    2016-07-30

    Breath analysis has been considered a suitable tool to evaluate diseases of the respiratory system and those that involve metabolic changes, such as diabetes. Breath acetone has long been known as a biomarker for diabetes. However, the results from published data by far have been inconclusive regarding whether breath acetone is a reliable index of diabetic screening. Large variations exist among the results of different studies because there has been no "best-practice method" for breath-acetone measurements as a result of technical problems of sampling and analysis. In this mini-review, we update the current status of our development of a laser-based breath acetone analyzer toward real-time, one-line diabetic screening and a point-of-care instrument for diabetic management. An integrated standalone breath acetone analyzer based on the cavity ringdown spectroscopy technique has been developed. The instrument was validated by using the certificated gas chromatography-mass spectrometry. The linear fittings suggest that the obtained acetone concentrations via both methods are consistent. Breath samples from each individual subject under various conditions in total, 1257 breath samples were taken from 22 Type 1 diabetic (T1D) patients, 312 Type 2 diabetic (T2D) patients, which is one of the largest numbers of T2D subjects ever used in a single study, and 52 non-diabetic healthy subjects. Simultaneous blood glucose (BG) levels were also tested using a standard diabetic management BG meter. The mean breath acetone concentrations were determined to be 4.9 ± 16 ppm (22 T1D), and 1.5 ± 1.3 ppm (312 T2D), which are about 4.5 and 1.4 times of the one in the 42 non-diabetic healthy subjects, 1.1 ± 0.5 ppm, respectively. A preliminary quantitative correlation (R = 0.56, p < 0.05) between the mean individual breath acetone concentration and the mean individual BG levels does exist in 20 T1D subjects with no ketoacidosis. No direct correlation is observed in T1D subjects, T2D subjects, and healthy subjects. The results from a relatively large number of subjects tested indicate that an elevated mean breath acetone concentration exists in diabetic patients in general. Although many physiological parameters affect breath acetone, under a specifically controlled condition fast (<1 min) and portable breath acetone measurement can be used for screening abnormal metabolic status including diabetes, for point-of-care monitoring status of ketone bodies which have the signature smell of breath acetone, and for breath acetone related clinical studies requiring a large number of tests.

  2. Mathematical and statistical approaches for interpreting biomarker compounds in exhaled human breath

    EPA Science Inventory

    The various instrumental techniques, human studies, and diagnostic tests that produce data from samples of exhaled breath have one thing in common: they all need to be put into a context wherein a posed question can actually be answered. Exhaled breath contains numerous compoun...

  3. Breath Test Refusals and Their Effect on DWI Prosecution

    DOT National Transportation Integrated Search

    2012-07-01

    This report describes the design and results of a project aimed at estimating the rate that drivers : refuse to submit to a legally-requested breath alcohol concentration test, and the effect of such : refusals on the prosecution of DWI cases. The st...

  4. Performance evaluation : balloon-type breath alcohol self tester for personal use

    DOT National Transportation Integrated Search

    1984-01-01

    The accuracy of the only breath alcohol balloon-type self test device being marketed for personal use (Luckey Laboratories DM-2) was assessed in the laboratory. Data regarding this self-test device's ability to accurately classify an individual as ha...

  5. Inward contaminant leakage tests of the S-Tron Corporation emergency escape breathing device.

    DOT National Transportation Integrated Search

    1992-04-01

    At the request of S-Tron Corporation, to support their contract with the U.S. Navy, performance tests of the Emergency Escape Breathing Device (EEBD) were conducted in the Environmental Physiology Research Section contaminant leakage chamber. Sulfur ...

  6. A study of characteristics of a reliable and practical breath alcohol screening test. Part A

    DOT National Transportation Integrated Search

    1975-08-01

    The objectives of this study were (1) to investigate several commercially available breath-alcohol screening test devices of the length-of-stain type, under standardized laboratory conditions, with respect to their ability satisfactorily to detect an...

  7. Blinded Validation of Breath Biomarkers of Lung Cancer, a Potential Ancillary to Chest CT Screening

    PubMed Central

    Phillips, Michael; Bauer, Thomas L.; Cataneo, Renee N.; Lebauer, Cassie; Mundada, Mayur; Pass, Harvey I.; Ramakrishna, Naren; Rom, William N.; Vallières, Eric

    2015-01-01

    Background Breath volatile organic compounds (VOCs) have been reported as biomarkers of lung cancer, but it is not known if biomarkers identified in one group can identify disease in a separate independent cohort. Also, it is not known if combining breath biomarkers with chest CT has the potential to improve the sensitivity and specificity of lung cancer screening. Methods Model-building phase (unblinded): Breath VOCs were analyzed with gas chromatography mass spectrometry in 82 asymptomatic smokers having screening chest CT, 84 symptomatic high-risk subjects with a tissue diagnosis, 100 without a tissue diagnosis, and 35 healthy subjects. Multiple Monte Carlo simulations identified breath VOC mass ions with greater than random diagnostic accuracy for lung cancer, and these were combined in a multivariate predictive algorithm. Model-testing phase (blinded validation): We analyzed breath VOCs in an independent cohort of similar subjects (n = 70, 51, 75 and 19 respectively). The algorithm predicted discriminant function (DF) values in blinded replicate breath VOC samples analyzed independently at two laboratories (A and B). Outcome modeling: We modeled the expected effects of combining breath biomarkers with chest CT on the sensitivity and specificity of lung cancer screening. Results Unblinded model-building phase. The algorithm identified lung cancer with sensitivity 74.0%, specificity 70.7% and C-statistic 0.78. Blinded model-testing phase: The algorithm identified lung cancer at Laboratory A with sensitivity 68.0%, specificity 68.4%, C-statistic 0.71; and at Laboratory B with sensitivity 70.1%, specificity 68.0%, C-statistic 0.70, with linear correlation between replicates (r = 0.88). In a projected outcome model, breath biomarkers increased the sensitivity, specificity, and positive and negative predictive values of chest CT for lung cancer when the tests were combined in series or parallel. Conclusions Breath VOC mass ion biomarkers identified lung cancer in a separate independent cohort, in a blinded replicated study. Combining breath biomarkers with chest CT could potentially improve the sensitivity and specificity of lung cancer screening. Trial Registration ClinicalTrials.gov NCT00639067 PMID:26698306

  8. Follow-up of coeliac disease with the novel one-hour 13C-sorbitol breath test versus the H2-sorbitol breath test.

    PubMed

    Tveito, Kari; Hetta, Anne Kristine; Askedal, Mia; Brunborg, Cathrine; Sandvik, Leiv; Løberg, Else Marit; Skar, Viggo

    2011-07-01

    We recently developed a (13)C-sorbitol breath test ((13)C-SBT) as an alternative to the H(2)-sorbitol breath test (H(2)-SBT) for coeliac disease. In this study we compared the diagnostic properties of the H(2)-SBT and the (13)C-SBT in follow-up of coeliac disease. Twenty-seven coeliac patients on a gluten-free diet (GFD) performed the breath tests. All had been tested before treatment in the initial study of the (13)C-SBT, in which 39 untreated coeliac patients, 40 patient controls, and 26 healthy volunteers participated. Five gram sorbitol and 100 mg (13)C-sorbitol were dissolved in 250 ml tap water and given orally. H(2), CH(4) and (13)CO(2) were measured in end-expiratory breath samples every 30 min for 4 h. Increased H(2) concentration ≥20 ppm from basal values was used as cut-off for the H(2)-SBT. Sixty minutes values were used as diagnostic index in the (13)C-SBT. (13)CO(2) levels at 60 min increased in 20/26 treated coeliac patients (77%) after GFD, but were significantly lower than in control groups. Out of 20 patients who had a positive H(2)-SBT before GFD, 12 had a negative H(2)-SBT after GFD. Peak H(2) concentrations were not correlated with (13)C-SBT results. The study confirms the sensitivity of a one-hour (13)C-SBT for small intestinal malabsorption. The (13)C-SBT has superior diagnostic properties compared with the H(2)-SBT in follow-up of coeliac disease.

  9. 49 CFR 40.245 - What is the procedure for an alcohol screening test using a saliva ASD or a breath tube ASD?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... a breath tube ASD? (a) As the STT or BAT, you must take the following steps when using the saliva... ATF. (b) As the STT or BAT, you must take the following steps when using the breath tube ASD: (1... the manufacturer's directions. (11) You must note the fact that you used a breath tube device in Step...

  10. FEV manoeuvre induced changes in breath VOC compositions: an unconventional view on lung function tests

    NASA Astrophysics Data System (ADS)

    Sukul, Pritam; Schubert, Jochen K.; Oertel, Peter; Kamysek, Svend; Taunk, Khushman; Trefz, Phillip; Miekisch, Wolfram

    2016-06-01

    Breath volatile organic compound (VOC) analysis can open a non-invasive window onto pathological and metabolic processes in the body. Decades of clinical breath-gas analysis have revealed that changes in exhaled VOC concentrations are important rather than disease specific biomarkers. As physiological parameters, such as respiratory rate or cardiac output, have profound effects on exhaled VOCs, here we investigated VOC exhalation under respiratory manoeuvres. Breath VOCs were monitored by means of real-time mass-spectrometry during conventional FEV manoeuvres in 50 healthy humans. Simultaneously, we measured respiratory and hemodynamic parameters noninvasively. Tidal volume and minute ventilation increased by 292 and 171% during the manoeuvre. FEV manoeuvre induced substance specific changes in VOC concentrations. pET-CO2 and alveolar isoprene increased by 6 and 21% during maximum exhalation. Then they decreased by 18 and 37% at forced expiration mirroring cardiac output. Acetone concentrations rose by 4.5% despite increasing minute ventilation. Blood-borne furan and dimethyl-sulphide mimicked isoprene profile. Exogenous acetonitrile, sulphides, and most aliphatic and aromatic VOCs changed minimally. Reliable breath tests must avoid forced breathing. As isoprene exhalations mirrored FEV performances, endogenous VOCs might assure quality of lung function tests. Analysis of exhaled VOC concentrations can provide additional information on physiology of respiration and gas exchange.

  11. FEV manoeuvre induced changes in breath VOC compositions: an unconventional view on lung function tests

    PubMed Central

    Sukul, Pritam; Schubert, Jochen K.; Oertel, Peter; Kamysek, Svend; Taunk, Khushman; Trefz, Phillip; Miekisch, Wolfram

    2016-01-01

    Breath volatile organic compound (VOC) analysis can open a non-invasive window onto pathological and metabolic processes in the body. Decades of clinical breath-gas analysis have revealed that changes in exhaled VOC concentrations are important rather than disease specific biomarkers. As physiological parameters, such as respiratory rate or cardiac output, have profound effects on exhaled VOCs, here we investigated VOC exhalation under respiratory manoeuvres. Breath VOCs were monitored by means of real-time mass-spectrometry during conventional FEV manoeuvres in 50 healthy humans. Simultaneously, we measured respiratory and hemodynamic parameters noninvasively. Tidal volume and minute ventilation increased by 292 and 171% during the manoeuvre. FEV manoeuvre induced substance specific changes in VOC concentrations. pET-CO2 and alveolar isoprene increased by 6 and 21% during maximum exhalation. Then they decreased by 18 and 37% at forced expiration mirroring cardiac output. Acetone concentrations rose by 4.5% despite increasing minute ventilation. Blood-borne furan and dimethyl-sulphide mimicked isoprene profile. Exogenous acetonitrile, sulphides, and most aliphatic and aromatic VOCs changed minimally. Reliable breath tests must avoid forced breathing. As isoprene exhalations mirrored FEV performances, endogenous VOCs might assure quality of lung function tests. Analysis of exhaled VOC concentrations can provide additional information on physiology of respiration and gas exchange. PMID:27311826

  12. How to deal with morning bad breath: A randomized, crossover clinical trial.

    PubMed

    Oliveira-Neto, Jeronimo M; Sato, Sandra; Pedrazzi, Vinícius

    2013-11-01

    The absence of a protocol for the treatment of halitosis has led us to compare mouthrinses with mechanical oral hygiene procedures for treating morning breath by employing a hand-held sulfide monitor. To compare the efficacy of five modalities of treatment for controlling morning halitosis in subjects with no dental or periodontal disease. This is a five-period, randomized, crossover clinical trial. Twenty volunteers were randomly assigned to the trial. Testing involved the use of a conventional tongue scraper, a tongue scraper joined to the back of a toothbrush's head, two mouthrinses (0.05% cetylpyridinium chloride and 0.12% chlorhexidine digluconate) and a soft-bristled toothbrush and fluoride toothpaste for practicing oral hygiene. Data analysis was performed using SPSS version 17 for Windows and NCSS 2007 software (P < 0.05). The products and the periods were compared with each other using the Friedman's test. When significant differences (P < 0.05) were determined, the products and periods were compared in pairs by using the Wilcoxon's test and by adjusting the original significance level (0.05) for multiple comparisons by using the Bonferroni's method. The toothbrush's tongue scraper was able to significantly reduce bad breath for up to 2 h. Chlorhexidine reduced bad breath only at the end of the second hour, an effect that lasted for 3 h. Mechanical tongue cleaning was able to immediately reduce bad breath for a short period, whereas chlorhexidine and mechanical oral hygiene reduced bad breath for longer periods, achieving the best results against morning breath.

  13. Determination of ethanol in breath for legal purposes using a five-filter infrared analyzer: studies on response to volatile interfering substances.

    PubMed

    Jones, Alan Wayne; Andersson, Lars

    2008-06-01

    The analysis of ethanol in exhaled breath is widely accepted and used worldwide for legal purposes to gather evidence of alcohol-impaired driving. Most evidential breath-alcohol instruments incorporate infrared (IR) spectroscopy as the analytical principle focusing on C-H or C-O stretching frequencies in ethanol molecules. The instrument approved for legal purposes in Sweden is called Evidenzer and is equipped with five infrared filters of which four are used for identification and quantification of ethanol and the fifth is a reference filter. The response of Evidenzer was tested against 21 volatile organic compounds (VOCs), and the instrument was programmed to deduct any bias caused by these VOCs if present in a sample of breath. If the amount deducted exceeds a certain threshold value, the entire test is aborted. Whenever this happens, the police request a specimen of venous blood for analysis by gas chromatography. Of a total of 24 072 drunken drivers, the evidential breath-alcohol test was aborted on 27 occasions (0.11%) because an interfering substance was present above the critical threshold. The VOCs most commonly identified in blood were acetone, isopropanol and/or methyl ethyl ketone (MEK). Elevated levels of acetone and isopropanol might arise during ketogenesis in people suffering from diabetes, or in those who eat low carbohydrate diets. High concentrations of acetone and MEK are probably caused by people drinking a technical alcohol product (T-Red), which is available in Sweden and is denatured with these agents. This study confirms that relatively few apprehended drivers in Sweden have elevated concentrations of VOCs in breath other than ethanol. Even the aborted breath tests, to a large extent, contained ethanol above the legal limit for driving.

  14. Breathing efficiency during inspiratory threshold loading in patients with chronic obstructive pulmonary disease.

    PubMed

    Baarends, E M; Schols, A M; Nusmeier, C M; van der Grinten, C P; Wouters, E F

    1998-05-01

    Patients with chronic obstructive pulmonary disease (COPD) demonstrate an increased oxygen cost of breathing. It is as yet unclear whether this is related to a decreased breathing efficiency. The aim of the present study was to compare breathing efficiency in 16 patients with COPD (11 men, five women) and 16 healthy elderly subjects (seven men, nine women), and to investigate a possible relationship between breathing efficiency and resting energy expenditure (REE). REE was measured using a ventilated hood system. Breathing efficiency was assessed by measuring oxygen consumption (V'O2), mean inspiratory mouth pressure (MIP) and flow during breathing at rest and subsequently during breathing against an inspiratory threshold (40% of maximal inspiratory pressure). During loaded breathing there was a significant increase in V'O2, MIP, and external work of breathing compared with unloaded breathing in both groups. As intended, ventilation did not increase significantly during the breathing efficiency test in the patients with COPD. The breathing efficiency (median, range) of the patients with COPD was similar (3.7%, 1.4-8.7%) to that of the healthy elderly subjects (3.2%, 1.7-8.3%). Breathing efficiency was not correlated with REE in either group. In the present study, in which dynamic hyperinflation was probably prevented, no difference in breathing efficiency was found between healthy elderly subjects and COPD patients when breathing against an external inspiratory threshold. Furthermore, breathing efficiency was not related to REE in both groups.

  15. Breath test refusals and DWI prosecution : traffic tech.

    DOT National Transportation Integrated Search

    2012-08-01

    There are typically about 1.4 million DWI (driving while : impaired) arrests each year in the United States. An officers : request to a driver for a breath (or blood, or urine) test is an : important part of the arrest process. The percentage of d...

  16. 42 CFR 84.95 - Service time test; open-circuit apparatus.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... classified according to the length of time it supplies air or oxygen to the breathing machine. (c) The... 42 Public Health 1 2013-10-01 2013-10-01 false Service time test; open-circuit apparatus. 84.95...-Contained Breathing Apparatus § 84.95 Service time test; open-circuit apparatus. (a) Service time will be...

  17. 42 CFR 84.95 - Service time test; open-circuit apparatus.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... classified according to the length of time it supplies air or oxygen to the breathing machine. (c) The... 42 Public Health 1 2012-10-01 2012-10-01 false Service time test; open-circuit apparatus. 84.95...-Contained Breathing Apparatus § 84.95 Service time test; open-circuit apparatus. (a) Service time will be...

  18. 42 CFR 84.95 - Service time test; open-circuit apparatus.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... classified according to the length of time it supplies air or oxygen to the breathing machine. (c) The... 42 Public Health 1 2014-10-01 2014-10-01 false Service time test; open-circuit apparatus. 84.95...-Contained Breathing Apparatus § 84.95 Service time test; open-circuit apparatus. (a) Service time will be...

  19. 42 CFR 84.95 - Service time test; open-circuit apparatus.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Service time test; open-circuit apparatus. 84.95...-Contained Breathing Apparatus § 84.95 Service time test; open-circuit apparatus. (a) Service time will be measured with a breathing machine as described in § 84.88. (b) The open-circuit apparatus will be...

  20. 42 CFR 84.95 - Service time test; open-circuit apparatus.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Service time test; open-circuit apparatus. 84.95...-Contained Breathing Apparatus § 84.95 Service time test; open-circuit apparatus. (a) Service time will be measured with a breathing machine as described in § 84.88. (b) The open-circuit apparatus will be...

  1. Is breath acetone a biomarker of diabetes? A historical review on breath acetone measurements.

    PubMed

    Wang, Zhennan; Wang, Chuji

    2013-09-01

    Since the ancient discovery of the 'sweet odor' in human breath gas, pursuits of the breath analysis-based disease diagnostics have never stopped. Actually, the 'smell' of the breath, as one of three key disease diagnostic techniques, has been used in Eastern-Medicine for more than three thousand years. With advancement of measuring technologies in sensitivity and selectivity, more specific breath gas species have been identified and established as a biomarker of a particular disease. Acetone is one of the breath gases and its concentration in exhaled breath can now be determined with high accuracy using various techniques and methods. With the worldwide prevalence of diabetes that is typically diagnosed through blood testing, human desire to achieve non-blood based diabetic diagnostics and monitoring has never been quenched. Questions, such as is breath acetone a biomarker of diabetes and how is the breath acetone related to the blood glucose (BG) level (the golden criterion currently used in clinic for diabetes diagnostic, monitoring, and management), remain to be answered. A majority of current research efforts in breath acetone measurements and its technology developments focus on addressing the first question. The effort to tackle the second question has begun recently. The earliest breath acetone measurement in clearly defined diabetic patients was reported more than 60 years ago. For more than a half-century, as reviewed in this paper, there have been more than 41 independent studies of breath acetone using various techniques and methods, and more than 3211 human subjects, including 1581 healthy people, 242 Type 1 diabetic patients, 384 Type 2 diabetic patients, 174 unspecified diabetic patients, and 830 non-diabetic patients or healthy subjects who are under various physiological conditions, have been used in the studies. The results of the breath acetone measurements collected in this review support that many conditions might cause changes to breath acetone concentrations; however, the results from the six independent studies using clearly-defined Type 1 and Type 2 diabetic patients unanimously support that an elevated mean breath acetone concentration exists in Type 1 diabetes. Note that there is some overlap between the ranges of breath acetone concentration in individual T1D patients and healthy subjects; this reminds one to be careful when using an acetone breath test on T1D diagnostics. Comparatively, it is too early to draw a general conclusion on the relationship between a breath acetone level and a BG level from the very limited data in the literature.

  2. Analysis of Exhaled Breath for Disease Detection

    NASA Astrophysics Data System (ADS)

    Amann, Anton; Miekisch, Wolfram; Schubert, Jochen; Buszewski, Bogusław; Ligor, Tomasz; Jezierski, Tadeusz; Pleil, Joachim; Risby, Terence

    2014-06-01

    Breath analysis is a young field of research with great clinical potential. As a result of this interest, researchers have developed new analytical techniques that permit real-time analysis of exhaled breath with breath-to-breath resolution in addition to the conventional central laboratory methods using gas chromatography-mass spectrometry. Breath tests are based on endogenously produced volatiles, metabolites of ingested precursors, metabolites produced by bacteria in the gut or the airways, or volatiles appearing after environmental exposure. The composition of exhaled breath may contain valuable information for patients presenting with asthma, renal and liver diseases, lung cancer, chronic obstructive pulmonary disease, inflammatory lung disease, or metabolic disorders. In addition, oxidative stress status may be monitored via volatile products of lipid peroxidation. Measurement of enzyme activity provides phenotypic information important in personalized medicine, whereas breath measurements provide insight into perturbations of the human exposome and can be interpreted as preclinical signals of adverse outcome pathways.

  3. Gender Difference of Gastric Emptying in Healthy Volunteers and Patients with Functional Dyspepsia.

    PubMed

    Mori, Hideki; Suzuki, Hidekazu; Matsuzaki, Juntaro; Taniguchi, Kanami; Shimizu, Toshiyuki; Yamane, Tsuyoshi; Masaoka, Tatsuhiro; Kanai, Takanori

    2017-01-01

    Delayed gastric emptying is one of the reasons why functional dyspepsia (FD) occurs. The 13C-acetate breath test is widely used to evaluate gastric emptying. Nevertheless, the standard value of 13C-acetate breath test has not taken into account the gender difference of gastric emptying among healthy individuals. The main aim of this study was to readjust the standard value of 13C-acetate breath test in the light of gender differences. In addition, we clarified the prevalence and clinical characteristics of delayed gastric emptying in patients with FD using the modified standard values of 13C-acetate breath test. Fifty-two healthy individuals and 126 patients with patients with FD were enrolled. Gastric emptying was evaluated by the 13C-acetate breath test. The cut-off points of Tmax for the diagnosis of delayed gastric emptying were determined on the basis of results from healthy individuals making a distinction of genders. Gastroesophageal reflux symptoms, dyspeptic symptoms, scores of anxiety and depression, age, body mass index (BMI), smoking and alcohol consumption were compared between the delayed gastric emptying group and the non-delayed gastric emptying group. Since gastric emptying was delayed in healthy women compared with that in healthy men (Tmax, 53.6 ± 19.3 vs. 42.7 ± 16.9 min, p = 0.04), we set the cut-off points of Tmax at 60 min in men and at 75 min in women. In patients with FD, the prevalence of delayed gastric emptying was not different between men and women with the modified standard values of 13C-acetate breath test. (31.0 vs. 27.4%, p = 0.68). BMI was lower in the delayed gastric emptying group than in the non-delayed group among the male patients. Reflux symptoms were more severe in delayed gastric emptying group than in the non-delayed group among the female patients. The standard values of 13C-acetate breath test should be modified bearing the gender difference in mind. It provides us more appropriate information to understand the mechanisms of FD. © 2016 S. Karger AG, Basel.

  4. The accuracy of coin-operated breath analysers installed in licensed premises in the Perth metropolitan area.

    PubMed

    Hay, Greg; Cercarelli, L Rina

    2004-04-01

    To examine the accuracy of coin-operated breath analysers installed in licensed premises in the Perth metropolitan area. Two hundred licensed premises were contacted, which resulted in the location of 36 wall-mounted, coin-operated breath analysers. One instrument was removed prior to testing. These premises were then visited and the accuracy of the instruments was tested in situ using National Association of Testing Authorities Australia (NATA) certified 0.080% and 0.100% ethanol in nitrogen gas. The instruments were installed in the licensed premises as follows: 15 in the lounge bar, 10 in the main entrance, six in the public bar, two in the passageway to the toilets, and one in the male toilets. One licensed premise provided a handheld breath instrument. All instruments were accompanied by warning and operating instructions, but only five had any educational material. Only seven of the licensed premises had staff who had received any training in the operation of the wall-mounted instruments. Half of the licensees were unaware of the servicing requirements of the instruments. The testing found that only nine (25%) of the instruments provided acceptable results. The low level of accuracy of coin-operated breath analysers in the Perth metropolitan area is alarming and users should be informed of the potential inaccuracies. This paper, however, does not rule out that some wall-mounted breath analysing instruments may provide accurate results when properly maintained.

  5. Use of the single-breath method of estimating cardiac output during exercise-stress testing.

    NASA Technical Reports Server (NTRS)

    Buderer, M. C.; Rummel, J. A.; Sawin, C. F.; Mauldin, D. G.

    1973-01-01

    The single-breath cardiac output measurement technique of Kim et al. (1966) has been modified for use in obtaining cardiac output measurements during exercise-stress tests on Apollo astronauts. The modifications involve the use of a respiratory mass spectrometer for data acquisition and a digital computer program for data analysis. The variation of the modified method for triplicate steady-state cardiac output measurements was plus or minus 1 liter/min. The combined physiological and methodological variation seen during a set of three exercise tests on a series of subjects was 1 to 2.5 liter/min. Comparison of the modified method with the direct Fick technique showed that although the single-breath values were consistently low, the scatter of data was small and the correlation between the two methods was high. Possible reasons for the low single-breath cardiac output values are discussed.

  6. Effect of upper costal and costo-diaphragmatic breathing types on electromyographic activity of respiratory muscles.

    PubMed

    Celhay, Isabel; Cordova, Rosa; Miralles, Rodolfo; Meza, Francisco; Erices, Pia; Barrientos, Camilo; Valenzuela, Saúl

    2015-04-01

    To compare electromyographic (EMG) activity in young-adult subjects with different breathing types. This study included 50 healthy male subjects with complete natural dentition, and no history of orofacial pain or craniomandibular-cervical-spinal disorders. Subjects were classified into two groups: upper costal breathing type, and costo-diaphragmatic breathing. Bipolar surface electrodes were located on sternocleidomastoid, diaphragm, external intercostal, and latissimus dorsi muscles. Electromyographic activity was recorded during the following tasks: (1) normal quiet breathing; (2) speaking the word 'Mississippi'; (3) swallowing saliva; and (4) forced deep breathing. Sternocleidomastoid and latissimus dorsi EMG activity was not significantly different between breathing types, whereas diaphragm and external intercostal EMG activity was significantly higher in the upper costal than costo-diaphragmatic breathing type in all tasks (P<0·05; Wilcoxon signed rank-sum test). Diaphragm and external intercostal EMG activity suggests that there could be differences in motor unit recruitment strategies depending on the breathing type.

  7. Increased oxygen load in the prefrontal cortex from mouth breathing: a vector-based near-infrared spectroscopy study.

    PubMed

    Sano, Masahiro; Sano, Sayaka; Oka, Noriyuki; Yoshino, Kayoko; Kato, Toshinori

    2013-12-04

    Individuals who habitually breathe through the mouth are more likely than nasal breathers to have sleep disorders and attention deficit hyperactive disorder. We hypothesized that brain hemodynamic responses in the prefrontal cortex might be different for mouth and nasal breathing. To test this hypothesis, we measured changes in oxyhemoglobin and deoxyhemoglobin in the prefrontal cortex during mouth breathing and nasal breathing in healthy adults (n=9) using vector-based near-infrared spectroscopy. The angle k, calculated from changes in oxyhemoglobin and deoxyhemoglobin and indicating the degree of oxygen exchange, was significantly higher during mouth breathing (P<0.05), indicating an increased oxygen load. Mouth breathing also caused a significant increase in deoxyhemoglobin, but oxyhemoglobin did not increase. This difference in oxygen load in the brain arising from different breathing routes can be evaluated quantitatively using vector-based near-infrared spectroscopy. Phase responses could help to provide an earlier and more reliable diagnosis of a patient's habitual breathing route than a patient interview.

  8. Increased oxygen load in the prefrontal cortex from mouth breathing: a vector-based near-infrared spectroscopy study

    PubMed Central

    Sano, Sayaka; Oka, Noriyuki; Yoshino, Kayoko; Kato, Toshinori

    2013-01-01

    Individuals who habitually breathe through the mouth are more likely than nasal breathers to have sleep disorders and attention deficit hyperactive disorder. We hypothesized that brain hemodynamic responses in the prefrontal cortex might be different for mouth and nasal breathing. To test this hypothesis, we measured changes in oxyhemoglobin and deoxyhemoglobin in the prefrontal cortex during mouth breathing and nasal breathing in healthy adults (n=9) using vector-based near-infrared spectroscopy. The angle k, calculated from changes in oxyhemoglobin and deoxyhemoglobin and indicating the degree of oxygen exchange, was significantly higher during mouth breathing (P<0.05), indicating an increased oxygen load. Mouth breathing also caused a significant increase in deoxyhemoglobin, but oxyhemoglobin did not increase. This difference in oxygen load in the brain arising from different breathing routes can be evaluated quantitatively using vector-based near-infrared spectroscopy. Phase responses could help to provide an earlier and more reliable diagnosis of a patient’s habitual breathing route than a patient interview. PMID:24169579

  9. Automatic Recognition of Breathing Route During Sleep Using Snoring Sounds

    NASA Astrophysics Data System (ADS)

    Mikami, Tsuyoshi; Kojima, Yohichiro

    This letter classifies snoring sounds into three breathing routes (oral, nasal, and oronasal) with discriminant analysis of the power spectra and k-nearest neighbor method. It is necessary to recognize breathing route during snoring, because oral snoring is a typical symptom of sleep apnea but we cannot know our own breathing and snoring condition during sleep. As a result, about 98.8% classification rate is obtained by using leave-one-out test for performance evaluation.

  10. Air-Breathing Ramjet Electric Propulsion for Controlling Low-Orbit Spacecraft Motion to Compensate for Aerodynamic Drag

    NASA Astrophysics Data System (ADS)

    Erofeev, A. I.; Nikiforov, A. P.; Popov, G. A.; Suvorov, M. O.; Syrin, S. A.; Khartov, S. A.

    2017-12-01

    Problems on designing the air-breathing ramjet electric propulsion thruster for controlling loworbit spacecraft motion are examined in the paper. Information for choosing orbits' altitudes for reasonable application of an air-breathing ramjet electric propulsion thruster and propellant exhaust velocity is presented. Estimates of the probable increase of gas concentration in the area of air-breathing ramjet ionization are presented. The test results of the thruster are also given.

  11. Prediction of breast cancer risk with volatile biomarkers in breath.

    PubMed

    Phillips, Michael; Cataneo, Renee N; Cruz-Ramos, Jose Alfonso; Huston, Jan; Ornelas, Omar; Pappas, Nadine; Pathak, Sonali

    2018-03-23

    Human breath contains volatile organic compounds (VOCs) that are biomarkers of breast cancer. We investigated the positive and negative predictive values (PPV and NPV) of breath VOC biomarkers as indicators of breast cancer risk. We employed ultra-clean breath collection balloons to collect breath samples from 54 women with biopsy-proven breast cancer and 124 cancer-free controls. Breath VOCs were analyzed with gas chromatography (GC) combined with either mass spectrometry (GC MS) or surface acoustic wave detection (GC SAW). Chromatograms were randomly assigned to a training set or a validation set. Monte Carlo analysis identified significant breath VOC biomarkers of breast cancer in the training set, and these biomarkers were incorporated into a multivariate algorithm to predict disease in the validation set. In the unsplit dataset, the predictive algorithms generated discriminant function (DF) values that varied with sensitivity, specificity, PPV and NPV. Using GC MS, test accuracy = 90% (area under curve of receiver operating characteristic in unsplit dataset) and cross-validated accuracy = 77%. Using GC SAW, test accuracy = 86% and cross-validated accuracy = 74%. With both assays, a low DF value was associated with a low risk of breast cancer (NPV > 99.9%). A high DF value was associated with a high risk of breast cancer and PPV rising to 100%. Analysis of breath VOC samples collected with ultra-clean balloons detected biomarkers that accurately predicted risk of breast cancer.

  12. Evaluation of innovative state and community alcohol projects : breath alcohol testing program effectiveness, impact and transferability

    DOT National Transportation Integrated Search

    1987-03-01

    Breath Alcohol Testing (BAT) programs in Albuquerque and Santa Fe, New Mexico are evaluated in regard to effectiveness, impact, and transferability of the special DWI enforcement squads and their use of BAT Mobiles. Squad activity effectiveness is me...

  13. Performance of acidified 14C-urea capsule breath test during pantoprazole and ranitidine treatment.

    PubMed

    Oztürk, Emel; Yeşilova, Zeki; Ilgan, Seyfettin; Ozgüven, Mehmet; Dağalp, Kemal

    2009-07-01

    Urea breath test (UBT) results could be false negative in patients taking antisecretory drugs. This effect would be prevented by citric acid administration during UBT. We prospectively investigated whether acidified 14C-urea capsule prevents false negative UBT results in patients taking antisecretory drugs and show interference with the duration of medications. Sixty Helicobacter pylori positive patients were included. Pantoprazole (40 mg/day) was given to 27 patients for 28 days and ranitidine (300 mg. o.d.) to 33 patients for 60 days. Urea breath tests were repeated on days 14 and 28 in both groups and on day 60 in the ranitidine group. The baseline mean breath counts of two groups did not show any significant difference. Pantoprazole led to a significant decrease in mean breath counts on day 14 (P < 0.005). Six of 27 and 3 of 25 patients taking pantoprazole developed negative or equivocal UBT results on days 14 and 28, respectively. Two of 32, 2 of 32 and 3 of 21 patients taking ranitidine developed negative or equivocal UBT results on days 14, 28 and 60, respectively. The use of acidified 14C-urea capsule did not prevent false negative UBT results in patients taking pantoprazole and ranitidine, and the duration of medication does not affect the test results.

  14. Mobile selected ion flow tube mass spectrometry (SIFT-MS) devices and their use for pollution exposure monitoring in breath and ambient air-pilot study.

    PubMed

    Storer, Malina; Salmond, Jennifer; Dirks, Kim N; Kingham, Simon; Epton, Michael

    2014-09-01

    Studies of health effects of air pollution exposure are limited by inability to accurately determine dose and exposure of air pollution in field trials. We explored the feasibility of using a mobile selected ion flow tube mass spectrometry (SIFT-MS) device, housed in a van, to determine ambient air and breath levels of benzene, xylene and toluene following exercise in areas of high motor vehicle traffic. The breath toluene, xylene and benzene concentration of healthy subjects were measured before and after exercising close to a busy road. The concentration of the volatile organic compounds (VOCs), in ambient air were also analysed in real time. Exercise close to traffic pollution is associated with a two-fold increase in breath VOCs (benzene, xylene and toluene) with levels returning to baseline within 20 min. This effect is not seen when exercising away from traffic pollution sources. Situating the testing device 50 m from the road reduced any confounding due to VOCs in the inspired air prior to the breath testing manoeuvre itself. Real-time field testing for air pollution exposure is possible using a mobile SIFT-MS device. This device is suitable for exploring exposure and dose relationships in a number of large scale field test scenarios.

  15. Surgical treatment is effective in severe cases of exercise-induced laryngeal obstruction: A follow-up study.

    PubMed

    Norlander, Katarina; Johansson, Henrik; Jansson, Christer; Nordvall, Lennart; Nordang, Leif

    2015-01-01

    Surgery is an effective treatment in severe cases of supraglottic exercise-induced laryngeal obstruction (E-ILO). Conservatively treated subjects and subjects tested negative for E-ILO, who still experience breathing problems 1-3 years after diagnosis, tend to adjust their physical activity to a greater extent than surgically treated subjects. To investigate how symptoms and level of physical activity change over time in patients with E-ILO who have undergone surgery, patients with E-ILO treated conservatively and patients who tested negative for laryngeal obstruction at continuous laryngoscopy exercise-test (CLE-test). Patients referred for exercise-induced breathing difficulties answered questionnaires at diagnostic CLE-test and at follow-up. Questions regarded exercise-induced breathing problems, current physical activity level, and medical history of asthma and perennial allergy. Out of 84 invited subjects, 59 (70%) answered both questionnaires. Surgically treated subjects had less breathing problems at follow-up compared with conservatively treated subjects and subjects who tested negative (p < 0.001). None of the surgically treated subjects were less physically active or had changed sport due to exercise-induced dyspnoea, whereas 41.7% of the conservatively treated subjects had made such adjustments (p < 0.001).

  16. 10 CFR 712.3 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... special nuclear material based on a drug test, a National Agency Check, a psychological assessment, a... expressed in terms of grams of alcohol per 210 liters of breath as indicated by a breath test. Alcohol use... professional expertise in occupational medicine for the HRP. Designated Psychologist means a licensed Ph.D., or...

  17. 10 CFR 712.3 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... special nuclear material based on a drug test, a National Agency Check, a psychological assessment, a... expressed in terms of grams of alcohol per 210 liters of breath as indicated by a breath test. Alcohol use... professional expertise in occupational medicine for the HRP. Designated Psychologist means a licensed Ph.D., or...

  18. 13C-breath tests for sucrose digestion in congenital sucrase isomaltase-deficient and sacrosidase-supplemented patients

    USDA-ARS?s Scientific Manuscript database

    Congenital sucrase-isomaltase deficiency (CSID) is characterized by absence or deficiency of the mucosal sucrase-isomaltase enzyme. Specific diagnosis requires upper gastrointestinal biopsy with evidence of low to absent sucrase enzyme activity and normal histology. The hydrogen breath test (BT) is ...

  19. 77 FR 14167 - Approval Tests and Standards for Closed-Circuit Escape Respirators

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-08

    ... Dioxide 3. Oxygen 4. Peak Breathing Pressures 5. Wet-Bulb Temperature L. Section 84.304 Capacity Test... oxygen storage or chemical carbon dioxide scrubber can be altered by impact or any other effect must... inhaled carbon dioxide, average inhaled oxygen, peak breathing pressures, and wet-bulb temperature...

  20. 42 CFR 84.152 - Breathing tube test; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...: (i) Be employed on Type C supplied-air respirators of the demand and pressure-demand class; and (ii... SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Supplied-Air Respirators § 84.152 Breathing tube test; minimum requirements. (a)(1) Type A and Type B supplied-air...

  1. Evaluation of portable breath test devices for screening suspected drunken drivers by police in Hennepin County, Minnesota

    DOT National Transportation Integrated Search

    1974-06-01

    This evaluation report examines use in the field of portable breath test (PBT) devices by police in Hennepin County, Minnesota. Thirteen Brog-Warner J2 and J2A-200 "ALERT" devices were deployed by seven enforcement agencies. This report is presented ...

  2. Benzene poisoning

    MedlinePlus

    ... treated. The person may receive: Blood and urine tests. Breathing support, including a tube through the mouth into the lungs, and a breathing machine (ventilator). Chest x-ray. Endoscopy -- camera placed down ...

  3. Exhaled breath analysis for lung cancer

    PubMed Central

    Sutedja, Tom G.; Zimmerman, Paul V.

    2013-01-01

    Early diagnosis of lung cancer results in improved survival compared to diagnosis with more advanced disease. Early disease is not reliably indicated by symptoms. Because investigations such as bronchoscopy and needle biopsy have associated risks and substantial costs, they are not suitable for population screening. Hence new easily applicable tests, which can be used to screen individuals at risk, are required. Biomarker testing in exhaled breath samples is a simple, relatively inexpensive, non-invasive approach. Exhaled breath contains volatile and non-volatile organic compounds produced as end-products of metabolic processes and the composition of such compounds varies between healthy subjects and subjects with lung cancer. Many studies have analysed the patterns of these compounds in exhaled breath. In addition studies have also reported that the exhaled breath condensate (EBC) can reveal gene mutations or DNA abnormalities in patients with lung cancer. This review has summarised the scientific evidence demonstrating that lung cancer has distinct chemical profiles in exhaled breath and characteristic genetic changes in EBC. It is not yet possible to accurately identify individuals with lung cancer in at risk populations by any of these techniques. However, analysis of both volatile organic compounds in exhaled breath and of EBC have great potential to become clinically useful diagnostic and screening tools for early stage lung cancer detection. PMID:24163746

  4. A chlorate candle/lithium hydroxide personal breathing apparatus

    NASA Technical Reports Server (NTRS)

    Martin, F. E.

    1972-01-01

    A portable coal mine rescue and survival equipment is reported that consists of a chlorate candle with a lithium hydroxide carbon-dioxide absorbent for oxygen generation, a breathing bag and tubing to conduct breathing to and from the man. A plastic hood incorporating a mouth piece for communication provides also eye protection and prevents inhalation through the nose. Manned testing of a prototype system demonstrated the feasibility of this closed circuit no-maintenance breathing apparatus that provides for good voice communication.

  5. Breath tests and irritable bowel syndrome

    PubMed Central

    Rana, Satya Vati; Malik, Aastha

    2014-01-01

    Breath tests are non-invasive tests and can detect H2 and CH4 gases which are produced by bacterial fermentation of unabsorbed intestinal carbohydrate and are excreted in the breath. These tests are used in the diagnosis of carbohydrate malabsorption, small intestinal bacterial overgrowth, and for measuring the orocecal transit time. Malabsorption of carbohydrates is a key trigger of irritable bowel syndrome (IBS)-type symptoms such as diarrhea and/or constipation, bloating, excess flatulence, headaches and lack of energy. Abdominal bloating is a common nonspecific symptom which can negatively impact quality of life. It may reflect dietary imbalance, such as excess fiber intake, or may be a manifestation of IBS. However, bloating may also represent small intestinal bacterial overgrowth. Patients with persistent symptoms of abdominal bloating and distension despite dietary interventions should be referred for H2 breath testing to determine the presence or absence of bacterial overgrowth. If bacterial overgrowth is identified, patients are typically treated with antibiotics. Evaluation of IBS generally includes testing of other disorders that cause similar symptoms. Carbohydrate malabsorption (lactose, fructose, sorbitol) can cause abdominal fullness, bloating, nausea, abdominal pain, flatulence, and diarrhea, which are similar to the symptoms of IBS. However, it is unclear if these digestive disorders contribute to or cause the symptoms of IBS. Research studies show that a proper diagnosis and effective dietary intervention significantly reduces the severity and frequency of gastrointestinal symptoms in IBS. Thus, diagnosis of malabsorption of these carbohydrates in IBS using a breath test is very important to guide the clinician in the proper treatment of IBS patients. PMID:24976698

  6. Treatment of Chronic Breath-Holding in an Adult with Severe Mental Retardation: A Clinical Case Study

    ERIC Educational Resources Information Center

    Reed, Derek D.; Martens, Brian K.

    2008-01-01

    We describe a clinical case study surrounding the behavioral assessment and operant treatment of, an adult with severe mental retardation who engaged in chronic breath-holding. In this clinical case, previous neurological and medical testing had ruled out biological bases for the individual's breath-holding. A functional behavioral assessment…

  7. How to deal with morning bad breath: A randomized, crossover clinical trial

    PubMed Central

    Oliveira-Neto, Jeronimo M.; Sato, Sandra; Pedrazzi, Vinícius

    2013-01-01

    Context: The absence of a protocol for the treatment of halitosis has led us to compare mouthrinses with mechanical oral hygiene procedures for treating morning breath by employing a hand-held sulfide monitor. Aims: To compare the efficacy of five modalities of treatment for controlling morning halitosis in subjects with no dental or periodontal disease. Settings and Design: This is a five-period, randomized, crossover clinical trial. Materials and Methods: Twenty volunteers were randomly assigned to the trial. Testing involved the use of a conventional tongue scraper, a tongue scraper joined to the back of a toothbrush's head, two mouthrinses (0.05% cetylpyridinium chloride and 0.12% chlorhexidine digluconate) and a soft-bristled toothbrush and fluoride toothpaste for practicing oral hygiene. Statistical Analysis Used: Data analysis was performed using SPSS version 17 for Windows and NCSS 2007 software (P < 0.05). The products and the periods were compared with each other using the Friedman's test. When significant differences (P < 0.05) were determined, the products and periods were compared in pairs by using the Wilcoxon's test and by adjusting the original significance level (0.05) for multiple comparisons by using the Bonferroni's method. Results: The toothbrush's tongue scraper was able to significantly reduce bad breath for up to 2 h. Chlorhexidine reduced bad breath only at the end of the second hour, an effect that lasted for 3 h. Conclusions: Mechanical tongue cleaning was able to immediately reduce bad breath for a short period, whereas chlorhexidine and mechanical oral hygiene reduced bad breath for longer periods, achieving the best results against morning breath. PMID:24554886

  8. Electromyographic fatigue of orbicular oris muscles during exercises in mouth and nasal breathing children.

    PubMed

    Busanello-Stella, Angela Ruviaro; Blanco-Dutra, Ana Paula; Corrêa, Eliane Castilhos Rodrigues; Silva, Ana Maria Toniolo da

    2015-01-01

    To investigate the process of fatigue in orbicularis oris muscles by analyzing the median frequency of electromyographic signal and the referred fatigue time, according to the breathing mode and the facial pattern. The participants were 70 children, aged 6 to 12 years, who matched the established criteria. To be classified as 36 nasal-breathing and 34 mouth-breathing children, they underwent speech-language, otorhinolaryngologic, and cephalometric evaluation. For the electromyographic assessment, the children had to sustain lip dumbbells weighing 40, 60, and 100 g and a lip exerciser, until the feeling of fatigue. Median frequency was analyzed in 5, 10, 15, and 20 seconds of activity. The referred time of the feeling of fatigue was also recorded. Data were analyzed through the analysis of variance--repeated measures (post hoc Tukey's test), Kruskal-Wallis test, and Mann-Whitney U-test. A significant decrease in the median frequency from 5 seconds of activity was observed, independently from the comparison between the groups. On comparison, the muscles did not show significant decrease. The reported time for the feeling of fatigue was shorter for mouth-breathing individuals. This feeling occurred after the significant decrease in the median frequency. There were signals that indicated myoelectric fatigue for the orbicularis oris muscles, in both groups analyzed, from the first 5 seconds of activity. Myoelectric fatigue in the orbicularis oris muscles preceded the reported feeling of fatigue in all groups. The account for fatigue time was influenced by only the breathing pattern, occurring more precociously in mouth-breathing children.

  9. Asphalt cement poisoning

    MedlinePlus

    ... treated. The person may receive: Blood and urine tests. Breathing support, including a tube through the mouth into the lungs, and a breathing machine (ventilator). Bronchoscopy -- camera placed down the throat to ...

  10. Monitoring of rapid blood pH variations by CO detection in breath with tunable diode laser

    NASA Astrophysics Data System (ADS)

    Kouznetsov, Andrian I.; Stepanov, Eugene V.; Zyrianov, Pavel V.; Shulagin, Yurii A.; Diachenko, Alexander I.; Gurfinkel, Youri I.

    1997-06-01

    Detection of endogenous carbon monoxide content in breath with tunable diode lasers (TDL) was proposed for noninvasive monitoring of rapid blood pH variation. Applied approach is based on high sensitivity of the haemoglobin and myoglobin affinity for CO to blood pH value and an ability to detect rapidly small variations of CO content in expired air. Breath CO absorption in 4.7 micrometers spectral region was carefully measured using PbSSe tunable diode laser that can provide 1 ppb CO concentration sensitivity and 10 s time constant. Applied TDL gas analyzer was used to monitor expired air of studied persons in physiological tests including hyperventilation and physical load. Simultaneous blood tests were conducted to demonstrate correlation between blood and breath chemical parameters.

  11. Guidelines proposal for clinical recognition of mouth breathing children.

    PubMed

    Pacheco, Maria Christina Thomé; Casagrande, Camila Ferreira; Teixeira, Lícia Pacheco; Finck, Nathalia Silveira; de Araújo, Maria Teresa Martins

    2015-01-01

    Mouth breathing (MB) is an etiological factor for sleep-disordered breathing (SDB) during childhood. The habit of breathing through the mouth may be perpetuated even after airway clearance. Both habit and obstruction may cause facial muscle imbalance and craniofacial changes. The aim of this paper is to propose and test guidelines for clinical recognition of MB and some predisposing factors for SDB in children. Semi-structured interviews were conducted with 110 orthodontists regarding their procedures for clinical evaluation of MB and their knowledge about SDB during childhood. Thereafter, based on their answers, guidelines were developed and tested in 687 children aged between 6 and 12 years old and attending elementary schools. There was no standardization for clinical recognition of MB among orthodontists. The most common procedures performed were inefficient to recognize differences between MB by habit or obstruction. The guidelines proposed herein facilitate clinical recognition of MB, help clinicians to differentiate between habit and obstruction, suggest the most appropriate treatment for each case, and avoid maintenance of mouth breathing patterns during adulthood.

  12. eAMI: A Qualitative Quantification of Periodic Breathing Based on Amplitude of Oscillations

    PubMed Central

    Fernandez Tellez, Helio; Pattyn, Nathalie; Mairesse, Olivier; Dolenc-Groselj, Leja; Eiken, Ola; Mekjavic, Igor B.; Migeotte, P. F.; Macdonald-Nethercott, Eoin; Meeusen, Romain; Neyt, Xavier

    2015-01-01

    Study Objectives: Periodic breathing is sleep disordered breathing characterized by instability in the respiratory pattern that exhibits an oscillatory behavior. Periodic breathing is associated with increased mortality, and it is observed in a variety of situations, such as acute hypoxia, chronic heart failure, and damage to respiratory centers. The standard quantification for the diagnosis of sleep related breathing disorders is the apnea-hypopnea index (AHI), which measures the proportion of apneic/hypopneic events during polysomnography. Determining the AHI is labor-intensive and requires the simultaneous recording of airflow and oxygen saturation. In this paper, we propose an automated, simple, and novel methodology for the detection and qualification of periodic breathing: the estimated amplitude modulation index (eAMI). Patients or Participants: Antarctic cohort (3,800 meters): 13 normal individuals. Clinical cohort: 39 different patients suffering from diverse sleep-related pathologies. Measurements and Results: When tested in a population with high levels of periodic breathing (Antarctic cohort), eAMI was closely correlated with AHI (r = 0.95, P < 0.001). When tested in the clinical setting, the proposed method was able to detect portions of the signal in which subclinical periodic breathing was validated by an expert (n = 93; accuracy = 0.85). Average eAMI was also correlated with the loop gain for the combined clinical and Antarctica cohorts (r = 0.58, P < 0.001). Conclusions: In terms of quantification and temporal resolution, the eAMI is able to estimate the strength of periodic breathing and the underlying loop gain at any given time within a record. The impaired prognosis associated with periodic breathing makes its automated detection and early diagnosis of clinical relevance. Citation: Fernandez Tellez H, Pattyn N, Mairesse O, Dolenc-Groselj L, Eiken O, Mekjavic IB, Migeotte PF, Macdonald-Nethercott E, Meeusen R, Neyt X. eAMI: a qualitative quantification of periodic breathing based on amplitude of oscillations. SLEEP 2015;38(3):381–389. PMID:25581914

  13. Detection of nitric oxide in exhaled human breath: exercise and resting determinations.

    PubMed

    Mantione, Kirk J; Esch, Tobias; Stefano, George B

    2007-03-01

    Nitric oxide has become a vital indicator of health since many cells produce it constitutively. It is present in exhaled breath and can be measured. A Kiernan NO Breath analyzer (KNB) was used in the present study to determine nitric oxide (NO) levels in exhaled human breath. The KNB was calibrated via measuring NO gas in O2-free N2 obtained from Scott Specialty Gases. Human subjects aged 21 to 45 were instructed to place the KNB over their nose and mouth and to breathe normally before and after mild exercise (n=24) and relaxation (n=20). Mean exhaled NO measurements were compared before and after the protocols using paired t-tests. Regardless of the test, all subjects exhibited NO in their exhaled breath. Exhaled NO decreased significantly after exercise compared to the first reading just prior to the exercise protocol. The mean +/-SE of exhaled NO was 22.8+/-4 before and 13.0+/-2 ppb after exercise (n=24, P=0.003). In the resting experiment, exhaled NO was demonstrated to increase significantly after 10 min compared to the reading taken right after the individuals sat down. The present study demonstrates NO in exhaled human breath can vary, reflecting the activity state of the individual. Additionally, the study demonstrates that NO in exhaled human breath can be measured rapidly, with high sensitivity, and in real time via the KNB, representing an affordable means to achieve this determination.

  14. Frequency of rhinitis and orofacial disorders in patients with dental malocclusion

    PubMed Central

    Imbaud, Tamara Christine de Souza; Mallozi, Márcia Carvalho; Domingos, Vanda Beatriz Teixeira Coelho; Solé, Dirceu

    2016-01-01

    Abstract Objective: To describe the frequency and etiology of rhinitis, oral breathing, types of malocclusion and orofacial disorders in patients treated for dental malocclusion. Methods: Patients with poor dental occlusion (n=89, 8-15 years) undergoing orthodontic treatment at the Postgraduate Orthodontics Center (São Paulo, Brazil) participated in the study. Rhinitis and oral breathing were diagnosed by anamnesis, clinical assessment and allergic etiology of rhinitis through immediate hypersensitivity skin prick test with airborne allergens. The association between types of breathing (oral or nasal), rhinitis and types of dental malocclusion, bruxism and cephalometric alterations (increased Y axis of facial growth) compared to standard cephalometric tracing (Escola de Odontologia da Universidade de São Paulo) were assessed. Results: The frequency of rhinitis in patients with dental malocclusion was 76.4% (68), and, of these, 81.7% were allergic (49/60 positive skin prick test), whereas the frequency of oral breathing was 62.9%. There was a significant association between an increased Y axis of facial growth and oral breathing (p<0.001), as well as between oral breathing and rhinitis (p=0.009). There was no association between rhinitis and bruxism. Conclusions: The frequency of rhinitis in children with dental malocclusion is higher than that in the general population, which is approximately 30%. Patients with oral breathing have a tendency to a dolichofacial growth pattern (increased Y axis of facial growth). In patients with rhinitis, regardless of the presence of oral breathing, the dolichofacial growth tendency was not observed. PMID:26631324

  15. Afternoon serum-melatonin in sleep disordered breathing.

    PubMed

    Ulfberg, J; Micic, S; Strøm, J

    1998-08-01

    To study afternoon serum-melatonin values in patients with sleep disordered breathing. Melatonin has a strong circadian rhythm with high values during the night-time and low values in the afternoon. Sleep disordered breathing may change the circadian rhythm of melatonin which may have diagnostic implications. The Sleep Laboratory, The Department of Internal Medicine, Avesta Hospital, Sweden, and the Department of Anaesthesiology, Glostrup University Hospital, Copenhagen, Denmark. We examined 60 consecutive patients admitted for sleep disordered breathing and 10 healthy non snoring controls. The patients underwent a sleep apnoea screening test having a specificity of 100% for the obstructive sleep apnoea syndrome (OSAS) using a combination of static charge sensitive bed and oximetry. Obstructive sleep apnoea syndrome was found in 49 patients, eight patients had borderline sleep disordered breathing (BSDB) and three patients were excluded due to interfering disease. Patients and controls had an afternoon determination of serum-melatonin. The Epworth Sleepiness Scale was used to score day-time sleepiness. In comparison with normal controls patients suffering from OSAS had significantly higher serum-melatonin levels in the afternoon. However, as a diagnostic test for OSAS in patients with sleep disordered breathing serum-melatonin showed a low sensitivity but a high specificity. The results indicate that breathing disorders during sleep in general affect pineal function. Sleep disordered breathing seems to disturb pineal function. Determination of afternoon serum-melatonin alone or together with a scoring of daytime sleepiness does not identify OSAS-patients in a heterogeneous population of patients complaining of heavy snoring and excessive daytime sleepiness.

  16. Noise Reduction in Breath Sound Files Using Wavelet Transform Based Filter

    NASA Astrophysics Data System (ADS)

    Syahputra, M. F.; Situmeang, S. I. G.; Rahmat, R. F.; Budiarto, R.

    2017-04-01

    The development of science and technology in the field of healthcare increasingly provides convenience in diagnosing respiratory system problem. Recording the breath sounds is one example of these developments. Breath sounds are recorded using a digital stethoscope, and then stored in a file with sound format. This breath sounds will be analyzed by health practitioners to diagnose the symptoms of disease or illness. However, the breath sounds is not free from interference signals. Therefore, noise filter or signal interference reduction system is required so that breath sounds component which contains information signal can be clarified. In this study, we designed a filter called a wavelet transform based filter. The filter that is designed in this study is using Daubechies wavelet with four wavelet transform coefficients. Based on the testing of the ten types of breath sounds data, the data is obtained in the largest SNRdB bronchial for 74.3685 decibels.

  17. [Reliability study on the infrared spectrometry for measuring the delta over baseline for breath 13C].

    PubMed

    Wang, Min; Wang, Zhiling; Gou, Lingyan; Zhang, Yuhui; Yang, Xiaoguang; Sha, Lei; Li, Min

    2013-03-01

    To assess the validity and reliability of the infrared spectrometry for measuring the delta over baseline for breath 13C. Twenty-four healthy adults were selected, including twelve males and twelve females. 13C-Leucine was used as tracer in stable isotope metabolic experiments. One baseline breath was collected before the tracer protocol began. Other breath samples were collected at 60, 120, 180, 195, 210, 225, 240, 255, 270 and 300 min post-tracer challenge. The delta over baseline for breath 13C was measured by the infrared spectrometry and Heliview 13C breath analyzer. No significant differences were found between the infrared spectrometry and Heliview 13C breath analyzer in measuring the delta over baseline for breath 13C. The F value and p value of two-way ANOVA were 0.29 and 0.5874 respectively. The t and p value of consistency test were 0.48 and 0.6346 respectively. The 13C infrared spectrometry can reliably measure the delta over baseline for breath 13C.

  18. Breathing and sense of self: visuo-respiratory conflicts alter body self-consciousness.

    PubMed

    Adler, Dan; Herbelin, Bruno; Similowski, Thomas; Blanke, Olaf

    2014-11-01

    Bodily self-consciousness depends on the processing of interoceptive and exteroceptive signals. It can be disrupted by inducing signal conflicts. Breathing, at the crossroad between interoception and exteroception, should contribute to bodily self-consciousness. We induced visuo-respiratory conflicts in 17 subjects presented with a virtual body or a parallelepidedal object flashing synchronously or asynchronously with their breathing. A questionnaire detected illusory changes in bodily self-consciousness and breathing agency (the feeling of sensing one's breathing command). Changes in self-location were tested by measuring reaction time during mental ball drop (MBD). Synchronous illumination changed the perceived location of breathing (body: p=0.008 vs. asynchronous; object: p=0.013). It resulted in a significant change in breathing agency, but no changes in self-identification. This was corroborated by prolonged MBD reaction time (body: +0.045s, 95%CI [0.013; 0.08], p=0.007). We conclude that breathing modulates bodily self-consciousness. We also conclude that one can induce the irruption of unattended breathing into consciousness without modifying respiratory mechanics or gas exchange. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. 32 CFR 634.37 - Voluntary breath and bodily fluid testing based on implied consent.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.37 Voluntary breath and bodily fluid testing based on implied consent... the person was driving under the influence of alcohol or drugs. (3) A request was made to the person...

  20. 32 CFR 634.37 - Voluntary breath and bodily fluid testing based on implied consent.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.37 Voluntary breath and bodily fluid testing based on implied consent... the person was driving under the influence of alcohol or drugs. (3) A request was made to the person...

  1. Optoacoustic Determination of Carbon Dioxide Concentration in Exhaled Breath in Various Human Diseases*

    NASA Astrophysics Data System (ADS)

    Ageev, V. G.; Nikiforova, O. Yu.

    2016-11-01

    We determined the carbon dioxide concentrations in exhaled breath from healthy donors and patients with various diseases from the absorption spectra of test samples, recorded on a laser optoacoustic gas analyzer based on a CO2 laser. We observed that the carbon dioxide concentrations in exhaled breath from healthy donors is higher than in patients with various diseases.

  2. Test plan 241-C-103 natural breathing characteristics evaluation using the ultra sensitive flowmeter

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hertelendy, N.A.

    1995-02-13

    To facilitate the reduction of worker exposure to hazardous fumes and vapors, it is imperative to characterize and measure flows out of waste tanks that breathe due to atmospheric pressure changes. These measurements will lead to a better understanding of how these tanks breathe and thus will aid in better worker exposure control at lower cost.

  3. A Modified Carbon Monoxide Breath Test for Measuring Erythrocyte Lifespan in Small Animals

    PubMed Central

    Ma, Yong-Jian; Zhang, Hou-De; Ji, Yong-Qiang; Zhu, Guo-Liang; Huang, Jia-Liang; Du, Li-Tao; Cao, Ping; Zang, De-Yue; Du, Ji-Hui; Li, Rong; Wang, Lei

    2016-01-01

    This study was to develop a CO breath test for RBC lifespan estimation of small animals. The ribavirin induced hemolysis rabbit models were placed individually in a closed rebreath cage and air samples were collected for measurement of CO concentration. RBC lifespan was calculated from accumulated CO, blood volume, and hemoglobin concentration data. RBC lifespan was determined in the same animals with the standard biotin-labeling method. RBC lifespan data obtained by the CO breath test method for control (CON, 49.0 ± 5.9 d) rabbits, rabbits given 10 mg/kg·d−1 of ribavirin (RIB10, 31.0 ± 4.0 d), and rabbits given 20 mg/kg·d−1 of ribavirin (RIB20, 25.0 ± 2.9 d) were statistically similar (all p > 0.05) to and linearly correlated (r = 0.96, p < 0.01) with the RBC lifespan data obtained for the same rabbits by the standard biotin-labeling method (CON, 51.0 ± 2.7 d; RIB10, 33.0 ± 1.3 d; and RIB20, 27.0 ± 0.8 d). The CO breath test method takes less than 3 h to complete, whereas the standard method requires at least several weeks. In conclusion, the CO breath test method provides a simple and rapid means of estimating RBC lifespan and is feasible for use with small animal models. PMID:27294128

  4. Effects of exogenous lactase administration on hydrogen breath excretion and intestinal symptoms in patients presenting lactose malabsorption and intolerance.

    PubMed

    Ibba, Ivan; Gilli, Agnese; Boi, Maria Francesca; Usai, Paolo

    2014-01-01

    To establish whether supplementation with a standard oral dose of Beta-Galactosidase affects hydrogen breath excretion in patients presenting with lactose malabsorption. Ninety-six consecutive patients positive to H2 Lactose Breath Test were enrolled. Mean peak H2 levels, the time to reach the peak H2, the time to reach the cut-off value of 20 ppm, the cumulative breath H2 excretion, the areas under the curve, and a Visual Analogical 10-point Scale for symptoms were calculated. Genotyping of the C/T-13910 variant was carried out. Following the oral administration of Beta-Galactosidase, in 21.88% of the cases, H2 Lactose Breath Test became negative (Group A), while mean peak H2 levels (74.95 ppm versus 7.85), P < 0.0000, in 17.71% (Group B) were still positive, with the H2 level 20 ppm above the baseline, but the peak H2 levels were significantly lower than those observed at the baseline test (186.7 ppm versus 66.64), P < 0.0000, while in 60.41% (Group C) they were still positive with the peak H2 levels similar to those observed at the baseline test (94.43 versus 81.60 ppm). All 96 individuals tested presented the C/C-13910 genotype nonpersistence. The response to oral administration of Beta-Galactosidase in patients with symptoms of lactose malabsorption presents a significant variability.

  5. Update on diagnostic value of breath test in gastrointestinal and liver diseases

    PubMed Central

    Siddiqui, Imran; Ahmed, Sibtain; Abid, Shahab

    2016-01-01

    In the field of gastroenterology, breath tests (BTs) are used intermittently as diagnostic tools that allow indirect, non-invasive and relatively less cumbersome evaluation of several disorders by simply quantifying the appearance in exhaled breath of a metabolite of a specific substrate administered. The aim of this review is to have an insight into the principles, methods of analysis and performance parameters of various hydrogen, methane and carbon BTs which are available for diagnosing gastrointestinal disorders such as Helicobacter pylori infection, small intestinal bacterial overgrowth, and carbohydrate malabsorption. Evaluation of gastric emptying is routinely performed by scintigraphy which is however, difficult to perform and not suitable for children and pregnant women, this review has abridged the 13C-octanoic acid test in comparison to scintigraphy and has emphasized on its working protocol and challenges. A new development such as electronic nose test is also highlighted. Moreover we have also explored the limitations and constraints restraining the wide use of these BT. We conclude that breath testing has an enormous potential to be used as a diagnostic modality. In addition it offers distinct advantages over the traditional invasive methods commonly employed. PMID:27574563

  6. Evaluation of 13CO2 breath tests for the detection of fructose malabsorption.

    PubMed

    Hoekstra, J H; van den Aker, J H; Kneepkens, C M; Stellaard, F; Geypens, B; Ghoos, Y F

    1996-03-01

    Breath hydrogen (H2) studies have made clear that small intestinal absorption of fructose is limited, especially in toddlers. Malabsorption of fructose may be a cause of recurrent abdominal pain and chronic nonspecific diarrhea (toddler's diarrhea). Fructose absorption is facilitated by equimolar doses of glucose and, as we have found, amino acids (especially L-alanine); the mechanism underlying this effect remains unclear. To study fructose absorption in a more direct way, we combined breath H2 studies with breath 13CO2 studies. Gastric emptying was studied by using L-glycine-1-13C in 4 children from 12.1 to 16.0 years of age. After 25 gm of fructose and 27.5 gm of glucose, when given together, gastric emptying was significantly (p<0.05) slower than with either sugar alone. In a second series of experiments, 5 children from 12.0 to 15.9 years of age were tested with 25 gm of fructose, alone and with equimolar doses of glucose and L-alanine, and 4 younger children from 3.1 to 6.1 years of age were tested with 2 gm/kg (max 37.5 gm) fructose, alone or with an equimolar dose of L-alanine. All fructose solutions were enriched with 15 mg of D-fructose-13C-6. In all 9 children, fructose was malabsorbed as judged by breath H2 increases > or = 20 ppm, and the addition of glucose or L-alanine resulted in significantly lower breath H2 increases (p < or = 0.005 for glucose, p < or = 0.001 for alanine). In contrast, the addition of alanine or glucose did not change the pattern of breath 13CO2 excretion in the 5 older children, whereas in the 4 younger children (with relatively higher doses), L-alanine addition resulted in significantly lower increases in breath 13CO2. In the latter group, for each time point, breath H2 and 13CO2 concentrations after fructose were compared with those after fructose plus L-alanine; in 20 out of 24 points, both H2 and 13CO2 were higher after fructose. These results suggest that 13CO2 not only originated from the oxidation of absorbed substrate but also, at least in part, from colonic bacterial metabolism. For the detection of [correction of or] fructose malabsorption--as opposed to, for instance, lactose--the 13CO2 breath test seems to be of limited value.

  7. 21 CFR 862.3080 - Breath nitric oxide test system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... fractional nitric oxide concentration in expired breath aids in evaluating an asthma patient's response to anti-inflammatory therapy, as an adjunct to established clinical and laboratory assessments of asthma...

  8. Lactose Intolerance (For Parents)

    MedlinePlus

    ... Doctors usually diagnose lactose intolerance through a simple hydrogen breath test. A person blows into a tube ... there is a higher than average level of hydrogen and methane in the breath. That's because undigested ...

  9. Fructose intake at current levels in the United States may cause gastrointestinal distress in normal adults.

    PubMed

    Beyer, Peter L; Caviar, Elena M; McCallum, Richard W

    2005-10-01

    Fructose intake has increased considerably in the United States, primarily as a result of increased consumption of high-fructose corn syrup, fruits and juices, and crystalline fructose. The purpose was to determine how often fructose, in amounts commonly consumed, would result in malabsorption and/or symptoms in healthy persons. Fructose absorption was measured using 3-hour breath hydrogen tests and symptom scores were used to rate subjective responses for gas, borborygmus, abdominal pain, and loose stools. The study included 15 normal, free-living volunteers from a medical center community and was performed in a gastrointestinal specialty clinic. Subjects consumed 25- and 50-g doses of crystalline fructose with water after an overnight fast on separate test days. Mean peak breath hydrogen, time of peak, area under the curve (AUC) for breath hydrogen and gastrointestinal symptoms were measured during a 3-hour period after subjects consumed both 25- and 50-g doses of fructose. Differences in mean breath hydrogen, AUC, and symptom scores between doses were analyzed using paired t tests. Correlations among peak breath hydrogen, AUC, and symptoms were also evaluated. More than half of the 15 adults tested showed evidence of fructose malabsorption after 25 g fructose and greater than two thirds showed malabsorption after 50 g fructose. AUC, representing overall breath hydrogen response, was significantly greater after the 50-g dose. Overall symptom scores were significantly greater than baseline after each dose, but scores were only marginally greater after 50 g than 25 g. Peak hydrogen levels and AUC were highly correlated, but neither was significantly related to symptoms. Fructose, in amounts commonly consumed, may result in mild gastrointestinal distress in normal people. Additional study is warranted to evaluate the response to fructose-glucose mixtures (as in high-fructose corn syrup) and fructose taken with food in both normal people and those with gastrointestinal dysfunction. Because breath hydrogen peaks occurred at 90 to 114 minutes and were highly correlated with 180-minute breath hydrogen AUC, the use of peak hydrogen measures may be considered to shorten the duration of the exam.

  10. Photoacoustic sensor for medical diagnostics

    NASA Astrophysics Data System (ADS)

    Wolff, Marcus; Groninga, Hinrich G.; Harde, Hermann

    2004-03-01

    The development of new optical sensor technologies has a major impact on the progress of diagnostic methods. Of the permanently increasing number of non-invasive breath tests, the 13C-Urea Breath Test (UBT) for the detection of Helicobacter pylori is the most prominent. However, many recent developments, like the detection of cancer by breath test, go beyond gastroenterological applications. We present a new detection scheme for breath analysis that employs an especially compact and simple set-up. Photoacoustic Spectroscopy (PAS) represents an offset-free technique that allows for short absorption paths and small sample cells. Using a single-frequency diode laser and taking advantage of acoustical resonances of the sample cell, we performed extremely sensitive and selective measurements. The smart data processing method contributes to the extraordinary sensitivity and selectivity as well. Also, the reasonable acquisition cost and low operational cost make this detection scheme attractive for many biomedical applications. The experimental set-up and data processing method, together with exemplary isotope-selective measurements on carbon dioxide, are presented.

  11. Exercise-induced quadriceps muscle fatigue in men and women: effects of arterial oxygen content and respiratory muscle work.

    PubMed

    Dominelli, Paolo B; Molgat-Seon, Yannick; Griesdale, Donald E G; Peters, Carli M; Blouin, Jean-Sébastien; Sekhon, Mypinder; Dominelli, Giulio S; Henderson, William R; Foster, Glen E; Romer, Lee M; Koehle, Michael S; Sheel, A William

    2017-08-01

    High work of breathing and exercise-induced arterial hypoxaemia (EIAH) can decrease O 2 delivery and exacerbate exercise-induced quadriceps fatigue in healthy men. Women have a higher work of breathing during exercise, dedicate a greater fraction of whole-body V̇O2 towards their respiratory muscles and develop EIAH. Despite a greater reduction in men's work of breathing, the attenuation of quadriceps fatigue was similar between the sexes. The degree of EIAH was similar between sexes, and regardless of sex, those who developed the greatest hypoxaemia during exercise demonstrated the most attenuation of quadriceps fatigue. Based on our previous finding that women have a greater relative oxygen cost of breathing, women appear to be especially susceptible to work of breathing-related changes in quadriceps muscle fatigue. Reducing the work of breathing or eliminating exercise-induced arterial hypoxaemia (EIAH) during exercise decreases the severity of quadriceps fatigue in men. Women have a greater work of breathing during exercise, dedicate a greater fraction of whole-body V̇O2 towards their respiratory muscles, and demonstrate EIAH, suggesting women may be especially susceptible to quadriceps fatigue. Healthy subjects (8 male, 8 female) completed three constant load exercise tests over 4 days. During the first (control) test, subjects exercised at ∼85% of maximum while arterial blood gases and work of breathing were assessed. Subsequent constant load exercise tests were iso-time and iso-work rate, but with EIAH prevented by inspiring hyperoxic gas or work of breathing reduced via a proportional assist ventilator (PAV). Quadriceps fatigue was assessed by measuring force in response to femoral nerve stimulation. For both sexes, quadriceps force was equally reduced after the control trial (-27 ± 2% baseline) and was attenuated with hyperoxia and PAV (-18 ± 1 and -17 ± 2% baseline, P < 0.01, respectively), with no sex difference. EIAH was similar between the sexes, and regardless of sex, subjects with the lowest oxyhaemoglobin saturation during the control test had the greatest quadriceps fatigue attenuation with hyperoxia (r 2  = 0.79, P < 0.0001). For the PAV trial, despite reducing the work of breathing to a greater degree in men (men: 60 ± 5, women: 75 ± 6% control, P < 0.05), the attenuation of quadriceps fatigue was similar between the sexes (36 ± 4 vs. 37 ± 7%). Owing to a greater relative V̇O2 of the respiratory muscles in women, less of a change in work of breathing is needed to reduce quadriceps fatigue. © 2017 The Authors. The Journal of Physiology © 2017 The Physiological Society.

  12. A probability-based multi-cycle sorting method for 4D-MRI: A simulation study.

    PubMed

    Liang, Xiao; Yin, Fang-Fang; Liu, Yilin; Cai, Jing

    2016-12-01

    To develop a novel probability-based sorting method capable of generating multiple breathing cycles of 4D-MRI images and to evaluate performance of this new method by comparing with conventional phase-based methods in terms of image quality and tumor motion measurement. Based on previous findings that breathing motion probability density function (PDF) of a single breathing cycle is dramatically different from true stabilized PDF that resulted from many breathing cycles, it is expected that a probability-based sorting method capable of generating multiple breathing cycles of 4D images may capture breathing variation information missing from conventional single-cycle sorting methods. The overall idea is to identify a few main breathing cycles (and their corresponding weightings) that can best represent the main breathing patterns of the patient and then reconstruct a set of 4D images for each of the identified main breathing cycles. This method is implemented in three steps: (1) The breathing signal is decomposed into individual breathing cycles, characterized by amplitude, and period; (2) individual breathing cycles are grouped based on amplitude and period to determine the main breathing cycles. If a group contains more than 10% of all breathing cycles in a breathing signal, it is determined as a main breathing pattern group and is represented by the average of individual breathing cycles in the group; (3) for each main breathing cycle, a set of 4D images is reconstructed using a result-driven sorting method adapted from our previous study. The probability-based sorting method was first tested on 26 patients' breathing signals to evaluate its feasibility of improving target motion PDF. The new method was subsequently tested for a sequential image acquisition scheme on the 4D digital extended cardiac torso (XCAT) phantom. Performance of the probability-based and conventional sorting methods was evaluated in terms of target volume precision and accuracy as measured by the 4D images, and also the accuracy of average intensity projection (AIP) of 4D images. Probability-based sorting showed improved similarity of breathing motion PDF from 4D images to reference PDF compared to single cycle sorting, indicated by the significant increase in Dice similarity coefficient (DSC) (probability-based sorting, DSC = 0.89 ± 0.03, and single cycle sorting, DSC = 0.83 ± 0.05, p-value <0.001). Based on the simulation study on XCAT, the probability-based method outperforms the conventional phase-based methods in qualitative evaluation on motion artifacts and quantitative evaluation on tumor volume precision and accuracy and accuracy of AIP of the 4D images. In this paper the authors demonstrated the feasibility of a novel probability-based multicycle 4D image sorting method. The authors' preliminary results showed that the new method can improve the accuracy of tumor motion PDF and the AIP of 4D images, presenting potential advantages over the conventional phase-based sorting method for radiation therapy motion management.

  13. Breathing metabolic simulator.

    NASA Technical Reports Server (NTRS)

    Bartlett, R. G., Jr.; Hendricks, C. M.; Morison, W. B.

    1971-01-01

    Description of a device for simulation of the human breathing and metabolic parameters required for the evaluation of respiratory diagnostic, monitoring, support and resuscitation equipment. The remotely controlled device allows wide variations in breathing rate and depth, breath velocity contour, oxygen uptake and carbon dioxide release to simulate conditions from sleep to hard work, with respiration exchange ratios ranging from hypoventilation to hyperventilation. It also reduces the cost of prolonged testing when simulation chambers with human subjects require three shifts of crews and standby physicians. Several block diagrams of the device and subsystems are given.

  14. Diagnosis of acute respiratory distress syndrome by exhaled breath analysis

    PubMed Central

    2018-01-01

    The acute respiratory distress syndrome (ARDS) is a complication of critical illness that is characterized by acute onset, protein rich, pulmonary edema. There is no treatment for ARDS, other than the reduction of additional ventilator induced lung injury. Prediction or earlier recognition of ARDS could result in preventive measurements and might decrease mortality and morbidity. Exhaled breath contains volatile organic compounds (VOCs), a collection of hundreds of small molecules linked to several physiological and pathophysiological processes. Analysis of exhaled breath through gas-chromatography and mass-spectrometry (GC-MS) has resulted in an accurate diagnosis of ARDS in several studies. Most identified markers are linked to lipid peroxidation. Octane is one of the few markers that was validated as a marker of ARDS and is pathophysiologically likely to be increased in ARDS. None of the currently studied breath analysis methods is directly applicable in clinical practice. Two steps have to be taken before any breath test can be allowed into the intensive care unit. External validation in a multi-center study is a prerequisite for any of the candidate breath markers and the breath test should outperform clinical prediction scores. Second, the technology for breath analysis should be adapted so that it is available at a decentralized lab inside the intensive care unit and can be operated by trained nurses, in order to reduce the analysis time. In conclusion, exhaled analysis might be used for the early diagnosis and prediction of ARDS in the near future but several obstacles have to be taken in the coming years. Most of the candidate markers can be linked to lipid peroxidation. Only octane has been validated in a temporal external validation cohort and is, at this moment, the top-ranking breath biomarker for ARDS. PMID:29430450

  15. Imposed Work of Breathing for Flow Meters with In-Line versus Flow-Through Technique during Simulated Neonatal Breathing.

    PubMed

    Donaldsson, Snorri; Falk, Markus; Jonsson, Baldvin; Drevhammar, Thomas

    2015-01-01

    The ability to determine airflow during nasal CPAP (NCPAP) treatment without adding dead space or resistance would be useful when investigating the physiologic effects of different NCPAP systems on breathing. The aim of this study was to investigate the effect on pressure stability of different flow measuring devices at the in-line and flow-through position, using simulated neonatal breathing. Six different flow measure devices were evaluated by recording pressure changes and imposed work of breathing for breaths with 16 and 32 ml tidal volumes. The tests were performed initially with the devices in an in line position and with 5 and 10 L/min using flow through technique, without CPAP. The flow meters were then subsequently tested with an Infant Flow CPAP system at 3, 5 and 8 cm H2O pressure using flow through technique. The quality of the recorded signals was compared graphically. The resistance of the measuring devices generated pressure swings and imposed work of breathing. With bias flow, the resistance also generated CPAP pressure. Three of the devices had low resistance and generated no changes in pressure stability or CPAP pressure. The two devices intended for neonatal use had the highest measured resistance. The importance of pressure stability and increased work of breathing during non-invasive respiratory support are insufficiently studied. Clinical trials using flow-through technique have not focused on pressure stability. Our results indicate that a flow-through technique might be a way forward in obtaining a sufficiently high signal quality without the added effects of rebreathing and increased work of breathing. The results should stimulate further research and the development of equipment for dynamic flow measurements in neonates.

  16. Imposed Work of Breathing for Flow Meters with In-Line versus Flow-Through Technique during Simulated Neonatal Breathing

    PubMed Central

    2015-01-01

    Background The ability to determine airflow during nasal CPAP (NCPAP) treatment without adding dead space or resistance would be useful when investigating the physiologic effects of different NCPAP systems on breathing. The aim of this study was to investigate the effect on pressure stability of different flow measuring devices at the in-line and flow-through position, using simulated neonatal breathing. Methods Six different flow measure devices were evaluated by recording pressure changes and imposed work of breathing for breaths with 16 and 32 ml tidal volumes. The tests were performed initially with the devices in an in line position and with 5 and 10 L/min using flow through technique, without CPAP. The flow meters were then subsequently tested with an Infant Flow CPAP system at 3, 5 and 8 cm H2O pressure using flow through technique. The quality of the recorded signals was compared graphically. Results The resistance of the measuring devices generated pressure swings and imposed work of breathing. With bias flow, the resistance also generated CPAP pressure. Three of the devices had low resistance and generated no changes in pressure stability or CPAP pressure. The two devices intended for neonatal use had the highest measured resistance. Conclusion The importance of pressure stability and increased work of breathing during non-invasive respiratory support are insufficiently studied. Clinical trials using flow-through technique have not focused on pressure stability. Our results indicate that a flow-through technique might be a way forward in obtaining a sufficiently high signal quality without the added effects of rebreathing and increased work of breathing. The results should stimulate further research and the development of equipment for dynamic flow measurements in neonates. PMID:26192188

  17. DEVELOPMENT OF A SCREENING PROTOCOL TO IDENTIFY INDIVIDUALS WITH DYSFUNCTIONAL BREATHING

    PubMed Central

    Kiesel, Kyle; Rhodes, Tonya; Mueller, Jacob; Waninger, Alyssa; Butler, Robert

    2017-01-01

    Introduction Dysfunctional breathing (DB) has been linked to health conditions including low back pain and neck pain and adversely effects the musculoskeletal system. Individuals with DB often have decreased pain thresholds and impaired motor control, balance, and movement. No single test or screen identifies DB, which is multi-dimensional, and includes biochemical, biomechanical, and psychophysiological components. Several tools assess and test for DB, but no screen exists to determine whether additional testing and assessment are indicated. Purpose/Background The purpose of this study was to develop a breathing screening procedure that could be utilized by fitness and healthcare providers to screen for the presence of disordered breathing. A diagnostic test study approach was utilized to establish the diagnostic accuracy of the newly developed screen for DB. Methods A convenience sample of 51 subjects (27 females, 27.0 years, BMI 23.3) were included. To test for DB related to the biochemical dimension, end-tidal CO2 (ETCO2) was measured with a capnography unit. To test for DB related to biomechanical dimension, the Hi-Lo test was utilized. To test for DB related to the psychophysiological dimension, the Self Evaluation of Breathing Symptoms Questionnaire (SEBQ) and Nijmegen questionnaires were utilized. Potential screening items that have been shown to be related to DB in previous research and that could be performed by non-health care personnel were utilized to create the index test including activity level, breath hold time (BHT), respiration rate, and the Functional Movement Screen (FMS™). Results There were no strong correlations between the three measures of DB. Five subjects had normal breathing, 14 failed at least one measure, 20 failed at least two, and 12 failed all three. To develop screening items for each dimension, data were examined for association with failure. BHT and a four-item mini-questionnaire were identified as the most closely associated variables with failure of all three dimensions. A BHT of < 25 seconds and four questions were combined and yielded a sensitivity of 0.89 (0.85-0.93) and a specificity of 0.60 (0.18-0.92) for clinical identification of DB. Conclusion Easily obtained clinical measures of BHT and four questions can be utilized to screen for the presence of DB. If the screen is passed, there is an 89% chance that DB is not present. If the screen is failed, further assessment is recommended. Level of Evidence 2b PMID:29181255

  18. Detection of Δ9-tetrahydrocannabinol in exhaled breath collected from cannabis users.

    PubMed

    Beck, Olof; Sandqvist, Sören; Dubbelboer, Ilse; Franck, Johan

    2011-10-01

    Exhaled breath has recently been proposed as a new possible matrix for drugs of abuse testing. A key drug is cannabis, and the present study was aimed at investigating the possibility of detecting tetrahydrocannabinol and tetrahydrocannabinol carboxylic acid in exhaled breath after cannabis smoking. Exhaled breath was sampled from 10 regular cannabis users and 8 controls by directing the exhaled breath by suction through an Empore C(18) disk. The disk was extracted with hexane/ethyl acetate, and the resulting extract was evaporated to dryness and redissolved in 100 μL hexane/ethyl acetate. A 3-μL aliquot was injected onto the LC-MS-MS system and analyzed using positive electrospray ionization and selected reaction monitoring. In samples collected 1-12 h after cannabis smoking, tetrahydrocannabinol was detected in all 10 subjects. The rate of excretion was between 9.0 and 77.3 pg/min. Identification of tetrahydrocannabinol was based on correct retention time relative to tetrahydrocannabinol-d(3) and correct product ion ratio. In three samples, peaks were observed for tetrahydrocannabinol carboxylic acid, but these did not fulfill identification criteria. Neither tetrahydrocannabinol or tetrahydrocannabinol carboxylic acid was detected in the controls. These results confirm older reports that tetrahydrocannabinol is present in exhaled breath following cannabis smoking and extend the detection time from minutes to hours. The results further support the idea that exhaled breath is a promising matrix for drugs-of-abuse testing.

  19. An automated system for pulmonary function testing

    NASA Technical Reports Server (NTRS)

    Mauldin, D. G.

    1974-01-01

    An experiment to quantitate pulmonary function was accepted for the space shuttle concept verification test. The single breath maneuver and the nitrogen washout are combined to reduce the test time. Parameters are defined from the forced vital capacity maneuvers. A spirometer measures the breath volume and a magnetic section mass spectrometer provides definition of gas composition. Mass spectrometer and spirometer data are analyzed by a PDP-81 digital computer.

  20. [Breath alcohol test in construction sites in the Province of Belluno: a campaign in favour of health promotion and surveillance and against drinking].

    PubMed

    Marcolina, Daniela; De Marzo, Nicoletta; Riccio, Maria Teresa

    2011-01-01

    Health impairment due to alcohol use and abuse is well known, in terms of relationship with traffic accidents and work accidents. In Italy almost 10 per cent of accidents at work involve intoxicated people injuring themselves and innocent victims. Alcohol abuse is a factor involved in determining severe accidents in the construction industry and epidemiological studies demonstrated a relationship between an elevated alcohol use and severity of accidents. Since in the Province of Belluno alcohol consumption may be elevated also at work, the two Occupational Health Units (SPISAL) in the province organized a campaign of information and surveillance against alcohol consumption at work in the construction industry. This report shows the campaign results, mainly in terms of breath alcohol tests performed in construction workers. After an extensive information campaign we inspected 50 sites, where 105 construction companies were at work, and tested 294 workers by breath alcohol test. No-one refused the test. Only 2.7% construction workers were positive for the breath alcohol test, and the levels were not elevated. This study shows that the construction workers in Belluno Province are responsible drinkers and are well aware of the policy of prohibition of alcohol consumption at work.

  1. Physiological response of rats to delivery of helium and xenon: implications for hyperpolarized noble gas imaging

    NASA Technical Reports Server (NTRS)

    Ramirez, M. P.; Sigaloff, K. C.; Kubatina, L. V.; Donahue, M. A.; Venkatesh, A. K.; Albert, M. S.; ALbert, M. S. (Principal Investigator)

    2000-01-01

    The physiological effects of various hyperpolarized helium and xenon MRI-compatible breathing protocols were investigated in 17 Sprague-Dawley rats, by continuous monitoring of blood oxygen saturation, heart rate, EKG, temperature and endotracheal pressure. The protocols included alternating breaths of pure noble gas and oxygen, continuous breaths of pure noble gas, breath-holds of pure noble gas for varying durations, and helium breath-holds preceded by two helium rinses. Alternate-breath protocols up to 128 breaths caused a decrease in oxygen saturation level of less than 5% for either helium or xenon, whereas 16 continuous-breaths caused a 31.5% +/- 2.3% decrease in oxygen saturation for helium and a 30.7% +/- 1. 3% decrease for xenon. Breath-hold protocols up to 25 s did not cause the oxygen saturation to fall below 90% for either of the noble gases. Oxygen saturation values below 90% are considered pathological. At 30 s of breath-hold, the blood oxygen saturation dropped precipitously to 82% +/- 0.6% for helium, and to 76.5% +/- 7. 4% for xenon. Breath-holds longer than 10 s preceded by pre-rinses caused oxygen saturation to drop below 90%. These findings demonstrate the need for standardized noble gas inhalation procedures that have been carefully tested, and for continuous physiological monitoring to ensure the safety of the subject. We find short breath-hold and alternate-breath protocols to be safe procedures for use in hyperpolarized noble gas MRI experiments. Copyright 2000 John Wiley & Sons, Ltd.

  2. Experimental and modeling study of thermal exposure of a self-contained breathing apparatus (SCBA).

    PubMed

    Donnelly, Michelle K; Yang, Jiann C

    2015-08-01

    An experimental apparatus designed to study firefighter safety equipment exposed to a thermal environment was developed. The apparatus consisted of an elevated temperature flow loop with the ability to heat the air stream up to 200°C. The thermal and flow conditions at the test section were characterized using thermocouples and bi-directional probes. The safety equipment examined in this study was a self-contained breathing apparatus (SCBA), including a facepiece and an air cylinder. The SCBA facepiece was placed on a mannequin headform and coupled to a breathing simulator that was programmed with a prescribed breathing pattern. The entire SCBA assembly was placed in the test section of the flow loop for these thermal exposure experiments. Three air stream temperatures, 100°C, 150°C, and 200°C, were used with the average air speed at the test section set at 1.4m/s and thermal exposure durations up to 1200 s. Measurements were made using type-K bare-bead thermocouples located in the mannequin's mouth and on the outer surface of the SCBA cylinder. The experimental results indicated that increasing the thermal exposure severity and duration increased the breathing air temperatures supplied by the SCBA. Temperatures of breathing air from the SCBA cylinder in excess of 60°C were observed over the course of the thermal exposure conditions used in most of the experiments. A mathematical model for transient heat transfer was developed to complement the thermal exposure experimental study. The model took into consideration forced convective heat transfer, quasi-steady heat conduction through the composite layers of the SCBA cylinder wall, the breathing pattern and action of the breathing simulator, and predicted air temperatures from the thermally exposed SCBA cylinder and temperatures at the outer surface of the SCBA cylinder. Model predictions agreed reasonably well with the experimental measurements. Published by Elsevier Ltd.

  3. Breath test refusals

    DOT National Transportation Integrated Search

    2007-11-01

    The National Highway Traffic Safety Administration has found that the percentage of people who refuse to provide breath samples when arrested for Driving While Intoxicated (DWI) varies considerably across States, and this creates a concern in the cri...

  4. (13)C breath tests in personalized medicine: fiction or reality?

    PubMed

    Modak, Anil S

    2009-11-01

    The concept of personalized medicine is gathering momentum as various biomarkers are being discovered and developed to lead to genotype and phenotype diagnostic tests, which will enable physicians to individualize therapy. Noninvasive, rapid (13)C breath tests have the potential to serve as clinically significant diagnostic tools, especially for evaluating the enzyme activity of polymorphic enzymes. This would enable physicians to rapidly identify responders/nonresponders to various drugs primarily metabolized by these enzymes prior to initiation of therapy. With the information on enzyme activity, the physician can prescribe the right drug, at the right dose, at the right time, to the right individual, for the right clinical outcome. However, the promise of the era of personalized medicine, including the novel (13)C breath tests, will have to overcome several regulatory, business and financial hurdles for diagnostic tests to become part of routine mainstream clinical practice over the next decade.

  5. Quiet breathing in hindlimb casted mice.

    PubMed

    Receno, Candace N; Roffo, Katelynn E; Mickey, Marisa C; DeRuisseau, Keith C; DeRuisseau, Lara R

    2018-06-07

    The hindlimb casting model was developed to study skeletal muscle reloading following a period of unloading. It is unknown if ventilation parameters of mice are affected by the casting model. We tested the hypothesis that hindlimb casted mice have similar ventilatory patterns compared to mice with the casts removed. Male CD-1 mice underwent 14 days of hindlimb immobilization via plaster casting. Breathing parameters were obtained utilizing unrestrained barometric plethysmography (UBP). Breathing traces were analyzed with Ponemah software for breathing frequency, tidal volume (TV), and minute ventilation (MV). Frequency, TV and MV did not show any differences in quiet breathing patterns during or post-casting in mice. Thus, the hindlimb casting model does not complicate breathing during and after casting and should not interfere with the unloading and reloading of skeletal muscle. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Comparison of breath gases, including acetone, with blood glucose and blood ketones in children and adolescents with type 1 diabetes.

    PubMed

    Blaikie, Tom P J; Edge, Julie A; Hancock, Gus; Lunn, Daniel; Megson, Clare; Peverall, Rob; Richmond, Graham; Ritchie, Grant A D; Taylor, David

    2014-11-25

    Previous studies have suggested that breath gases may be related to simultaneous blood glucose and blood ketone levels in adults with type 2 and type 1 diabetes. The aims of this study were to investigate these relationships in children and young people with type 1 diabetes in order to assess the efficacy of a simple breath test as a non-invasive means of diabetes management. Gases were collected in breath bags and measurements were compared with capillary blood glucose and ketone levels taken at the same time on a single visit to a routine hospital clinic in 113 subjects (59 male, age 7 years 11 months-18 years 3 months) with type 1 diabetes. The patients were well-controlled with relatively low concentrations of the blood ketone measured (β hydroxybutyrate, 0-0.4 mmol l(-1)). Breath acetone levels were found to increase with blood β hydroxybutyrate levels and a significant relationship was found between the two (Spearman's rank correlation ρ = 0.364, p < 10(-4)). A weak positive relationship was found between blood glucose and breath acetone (ρ = 0.16, p = 0.1), but led to the conclusion that single breath measurements of acetone do not provide a good measure of blood glucose levels in this cohort. This result suggests a potential to develop breath gas analysis to provide an alternative to blood testing for ketone measurement, for example to assist with the management of type 1 diabetes.

  7. Effect of influenza vaccination on oxidative stress products in breath.

    PubMed

    Phillips, Michael; Cataneo, Renee N; Chaturvedi, Anirudh; Danaher, Patrick J; Devadiga, Anantrai; Legendre, David A; Nail, Kim L; Schmitt, Peter; Wai, James

    2010-06-01

    Viral infections cause increased oxidative stress, so a breath test for oxidative stress biomarkers (alkanes and alkane derivatives) might provide a new tool for early diagnosis. We studied 33 normal healthy human subjects receiving scheduled treatment with live attenuated influenza vaccine (LAIV). Each subject was his or her own control, since they were studied on day 0 prior to vaccination, and then on days 2, 7 and 14 following vaccination. Breath volatile organic compounds (VOCs) were collected with a breath collection apparatus, then analyzed by automated thermal desorption with gas chromatography and mass spectroscopy. A Monte Carlo simulation technique identified non-random VOC biomarkers of infection based on their C-statistic values (area under curve of receiver operating characteristic). Treatment with LAIV was followed by non-random changes in the abundance of breath VOCs. 2, 8-Dimethyl-undecane and other alkane derivatives were observed on all days. Conservative multivariate models identified vaccinated subjects on day 2 (C-statistic = 0.82, sensitivity = 63.6% and specificity = 88.5%); day 7 (C-statistic = 0.94, sensitivity = 88.5% and specificity = 92.3%); and day 14 (C-statistic = 0.95, sensitivity = 92.3% and specificity = 92.3%). The altered breath VOCs were not detected in live attenuated influenza vaccine, excluding artifactual contamination. LAIV vaccination in healthy humans elicited a prompt and sustained increase in breath biomarkers of oxidative stress. A breath test for these VOCs could potentially identify humans who are acutely infected with influenza, but who have not yet developed clinical symptoms or signs of disease.

  8. [Frequency of rhinitis and orofacial disorders in patients with dental malocclusion].

    PubMed

    Imbaud, Tamara Christine de Souza; Mallozi, Márcia Carvalho; Domingos, Vanda Beatriz Teixeira Coelho; Solé, Dirceu

    2016-06-01

    To describe the frequency and etiology of rhinitis, oral breathing, types of malocclusion and orofacial disorders in patients treated for dental malocclusion. Patients with poor dental occlusion (n=89, 8-15 years) undergoing orthodontic treatment at the Postgraduate Orthodontics Center (Sao Paulo, Brazil) participated in the study. Rhinitis and oral breathing were diagnosed by anamnesis, clinical assessment and allergic etiology of rhinitis through immediate hypersensitivity skin prick test (SPT) with airborne allergens. The association between types of breathing (oral or nasal), rhinitis and types of dental malocclusion, bruxism and cephalometric alterations (increased Y axis of facial growth) compared to standard cephalometric tracing (Escola de Odontologia da Universidade de São Paulo) were assessed. The frequency of rhinitis in patients with dental malocclusion was 76.4% (68), and, of these, 81.7% were allergic (49/60 positive skin prick test), whereas the frequency of oral breathing was 62.9%. There was a significant association between an increased Y axis of facial growth and oral breathing (p<0.001), as well as between oral breathing and rhinitis (p=0.009). There was no association between rhinitis and bruxism. The frequency of rhinitis in children with dental malocclusion is higher than that in the general population, which is approximately 30%. Patients with oral breathing have a tendency to a dolichofacial growth pattern (increased Y axis of facial growth). In patients with rhinitis, regardless of the presence of oral breathing, the dolichofacial growth tendency was not observed. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  9. Do elite breath-hold divers suffer from mild short-term memory impairments?

    PubMed

    Billaut, François; Gueit, Patrice; Faure, Sylvane; Costalat, Guillaume; Lemaître, Frédéric

    2018-03-01

    Repeated apneas are associated with severe hypoxemia that may ultimately lead to loss of consciousness in some breath-hold divers. Despite increasing number of practitioners, the relationship between apnea-induced hypoxia and neurocognitive functions is still poorly understood in the sport of free diving. To shed light onto this phenomenon, we examined the impact of long-term breath-hold diving training on attentional processing, short-term memory, and long-term mnesic and executive functions. Thirty-six men matched for age, height, and weight were separated into the following 3 groups: (i) 12 elite breath-hold divers (EBHD), mean static apnea best time 371 s, 105 months mean apnea experience; (ii) 12 novice breath-hold divers, mean best time 243 s, 8.75 months mean apnea experience; and (iii) 12 physical education students with no breath-hold diving experience; all of these participants performed varied written and computerized neuropsychological tasks. Compared with the 2 other groups, the EBHD group was slower to complete the interference card during a Stroop test (F [1,33] = 4.70, p < 0.05), and presented more errors on the interference card (F [1,33] = 2.96, p < 0.05) and a lower total interference score (F [1,33] = 5.64, p < 0.05). The time to complete the interference card test was positively correlated with maximal static apnea duration (r = 0.73, p < 0.05) and the number of years of breath-hold diving training (r = 0.79, p < 0.001). These findings suggest that breath-hold diving training over several years may cause mild, but persistent, short-term memory impairments.

  10. Getting the Facts on Food Allergy Testing

    MedlinePlus

    ... ing, vomiting or trouble breathing after eating or coming into contact with a certain food, you may ... swelling, vomiting or trouble breathing after eating or coming into contact with certain foods, it’s important to ...

  11. A dual mode breath sampler for the collection of the end-tidal and dead space fractions.

    PubMed

    Salvo, P; Ferrari, C; Persia, R; Ghimenti, S; Lomonaco, T; Bellagambi, F; Di Francesco, F

    2015-06-01

    This work presents a breath sampler prototype automatically collecting end-tidal (single and multiple breaths) or dead space air fractions (multiple breaths). This result is achieved by real time measurements of the CO2 partial pressure and airflow during the expiratory and inspiratory phases. Suitable algorithms, used to control a solenoid valve, guarantee that a Nalophan(®) bag is filled with the selected breath fraction even if the subject under test hyperventilates. The breath sampler has low pressure drop (<0.5 kPa) and uses inert or disposable components to avoid bacteriological risk for the patients and contamination of the breath samples. A fully customisable software interface allows a real time control of the hardware and software status. The performances of the breath sampler were evaluated by comparing (a) the CO2 partial pressure calculated during the sampling with the CO2 pressure measured off-line within the Nalophan(®) bag; (b) the concentrations of four selected volatile organic compounds in dead space, end-tidal and mixed breath fractions. Results showed negligible deviations between calculated and off-line CO2 pressure values and the distributions of the selected compounds into dead space, end-tidal and mixed breath fractions were in agreement with their chemical-physical properties. Copyright © 2015. Published by Elsevier Ltd.

  12. Respiratory muscle function in infants with spinal muscular atrophy type I.

    PubMed

    Finkel, Richard S; Weiner, Daniel J; Mayer, Oscar H; McDonough, Joseph M; Panitch, Howard B

    2014-12-01

    To determine the feasibility and safety of respiratory muscle function testing in weak infants with a progressive neuromuscular disorder. Respiratory insufficiency is the major cause of morbidity and mortality in infants with spinal muscular atrophy type I (SMA-I). Tests of respiratory muscle strength, endurance, and breathing patterns can be performed safely in SMA-I infants. Useful data can be collected which parallels the clinical course of pulmonary function in SMA-I. An exploratory study of respiratory muscle function testing and breathing patterns in seven infants with SMA-I seen in our neuromuscular clinic. Measurements were made at initial study visit and, where possible, longitudinally over time. We measured maximal inspiratory (MIP) and transdiaphragmatic pressures, mean transdiaphragmatic pressure, airway occlusion pressure at 100 msec of inspiration, inspiratory and total respiratory cycle time, and aspects of relative thoracoabdominal motion using respiratory inductive plethysmography (RIP). The tension time index of the diaphragm and of the respiratory muscles, phase angle (Φ), phase relation during the total breath, and labored breathing index were calculated. Age at baseline study was 54-237 (median 131) days. Reliable data were obtained safely for MIP, phase angle, labored breathing index, and the invasive and non-invasive tension time indices, even in very weak infants. Data obtained corresponded to the clinical estimate of severity and predicted the need for respiratory support. The testing employed was both safe and feasible. Measurements of MIP and RIP are easily performed tests that are well tolerated and provide clinically useful information for infants with SMA-I. © 2014 Wiley Periodicals, Inc.

  13. Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep-disordered breathing: a systematic review and meta-analysis

    PubMed Central

    El Shayeb, Mohamed; Topfer, Leigh-Ann; Stafinski, Tania; Pawluk, Lawrence; Menon, Devidas

    2014-01-01

    Background: Greater awareness of sleep-disordered breathing and rising obesity rates have fueled demand for sleep studies. Sleep testing using level 3 portable devices may expedite diagnosis and reduce the costs associated with level 1 in-laboratory polysomnography. We sought to assess the diagnostic accuracy of level 3 testing compared with level 1 testing and to identify the appropriate patient population for each test. Methods: We conducted a systematic review and meta-analysis of comparative studies of level 3 versus level 1 sleep tests in adults with suspected sleep-disordered breathing. We searched 3 research databases and grey literature sources for studies that reported on diagnostic accuracy parameters or disease management after diagnosis. Two reviewers screened the search results, selected potentially relevant studies and extracted data. We used a bivariate mixed-effects binary regression model to estimate summary diagnostic accuracy parameters. Results: We included 59 studies involving a total of 5026 evaluable patients (mostly patients suspected of having obstructive sleep apnea). Of these, 19 studies were included in the meta-analysis. The estimated area under the receiver operating characteristics curve was high, ranging between 0.85 and 0.99 across different levels of disease severity. Summary sensitivity ranged between 0.79 and 0.97, and summary specificity ranged between 0.60 and 0.93 across different apnea–hypopnea cut-offs. We saw no significant difference in the clinical management parameters between patients who underwent either test to receive their diagnosis. Interpretation: Level 3 portable devices showed good diagnostic performance compared with level 1 sleep tests in adult patients with a high pretest probability of moderate to severe obstructive sleep apnea and no unstable comorbidities. For patients suspected of having other types of sleep-disordered breathing or sleep disorders not related to breathing, level 1 testing remains the reference standard. PMID:24218531

  14. Clinical research on liver reserve function by 13C-phenylalanine breath test in aged patients with chronic liver diseases

    PubMed Central

    2010-01-01

    Background The objective of this study was to investigate whether the 13C-phenylalanine breath test could be useful for the evaluation of hepatic function in elderly volunteers and patients with chronic hepatitis B and liver cirrhosis. Methods L-[1-13C] phenylalanine was administered orally at a dose of 100 mg to 55 elderly patients with liver cirrhosis, 30 patients with chronic hepatitis B and 38 elderly healthy subjects. The breath test was performed at 8 different time points (0, 10, 20, 30, 45, 60, 90, 120 min) to obtain the values of Delta over baseline, percentage 13CO2 exhalation rate and cumulative excretion (Cum). The relationships of the cumulative excretion with the 13C-%dose/h and blood biochemical parameters were investigated. Results The 13C-%dose/h at 20 min and 30 min combined with the cumulative excretion at 60 min and 120 min correlated with hepatic function tests, serum albumin, hemoglobin, platelet and Child-Pugh score. Prothrombin time, total and direct bilirubin were significantly increased, while serum albumin, hemoglobin and platelet, the cumulative excretion at 60 min and 120 min values decreased by degrees of intensity of the disease in Child-Pugh A, B, and C patients (P < 0.01). Conclusions The 13C-phenylalanine breath test can be used as a non-invasive assay to evaluate hepatic function in elderly patients with liver cirrhosis. The 13C-%dose/h at 20 min, at 30 min and cumulative excretion at 60 min may be the key value for determination at a single time-point. 13C-phenylalanine breath test is safe and helpful in distinguishing different stages of hepatic dysfunction for elderly cirrhosis patients. PMID:20459849

  15. A probability-based multi-cycle sorting method for 4D-MRI: A simulation study

    PubMed Central

    Liang, Xiao; Yin, Fang-Fang; Liu, Yilin; Cai, Jing

    2016-01-01

    Purpose: To develop a novel probability-based sorting method capable of generating multiple breathing cycles of 4D-MRI images and to evaluate performance of this new method by comparing with conventional phase-based methods in terms of image quality and tumor motion measurement. Methods: Based on previous findings that breathing motion probability density function (PDF) of a single breathing cycle is dramatically different from true stabilized PDF that resulted from many breathing cycles, it is expected that a probability-based sorting method capable of generating multiple breathing cycles of 4D images may capture breathing variation information missing from conventional single-cycle sorting methods. The overall idea is to identify a few main breathing cycles (and their corresponding weightings) that can best represent the main breathing patterns of the patient and then reconstruct a set of 4D images for each of the identified main breathing cycles. This method is implemented in three steps: (1) The breathing signal is decomposed into individual breathing cycles, characterized by amplitude, and period; (2) individual breathing cycles are grouped based on amplitude and period to determine the main breathing cycles. If a group contains more than 10% of all breathing cycles in a breathing signal, it is determined as a main breathing pattern group and is represented by the average of individual breathing cycles in the group; (3) for each main breathing cycle, a set of 4D images is reconstructed using a result-driven sorting method adapted from our previous study. The probability-based sorting method was first tested on 26 patients’ breathing signals to evaluate its feasibility of improving target motion PDF. The new method was subsequently tested for a sequential image acquisition scheme on the 4D digital extended cardiac torso (XCAT) phantom. Performance of the probability-based and conventional sorting methods was evaluated in terms of target volume precision and accuracy as measured by the 4D images, and also the accuracy of average intensity projection (AIP) of 4D images. Results: Probability-based sorting showed improved similarity of breathing motion PDF from 4D images to reference PDF compared to single cycle sorting, indicated by the significant increase in Dice similarity coefficient (DSC) (probability-based sorting, DSC = 0.89 ± 0.03, and single cycle sorting, DSC = 0.83 ± 0.05, p-value <0.001). Based on the simulation study on XCAT, the probability-based method outperforms the conventional phase-based methods in qualitative evaluation on motion artifacts and quantitative evaluation on tumor volume precision and accuracy and accuracy of AIP of the 4D images. Conclusions: In this paper the authors demonstrated the feasibility of a novel probability-based multicycle 4D image sorting method. The authors’ preliminary results showed that the new method can improve the accuracy of tumor motion PDF and the AIP of 4D images, presenting potential advantages over the conventional phase-based sorting method for radiation therapy motion management. PMID:27908178

  16. Comparison of an increased waist circumference with a positive hydrogen breath test as a clinical predictor of lactose intolerance.

    PubMed

    Zapata-Castilleja, Carlos A; Montes-Tapia, Fernando F; Treviño-Garza, Consuelo; Martínez-Cobos, María C; García-Cantú, Jesús; Arenas-Fabbri, Vincenzo; de la O-Escamilla, Norma; de la O-Cavazos, Manuel

    2017-04-01

    Lactose intolerance is a common disease in pediatrics, and its wrong diagnosis will lead to morbidity. The primary objective of this study was to assess the usefulness of an increased waist circumference during the hydrogen breath test as a predictor of lactose intolerance. The secondary objective was to analyze the impact of body mass index, waist circumference measurement, and age on the abdominal distension of patients with lactose intolerance. A total of 138 subjects aged 3 to 15 years were included. They underwent serial measurements of the waist circumference and hydrogen levels in the breath every 30 minutes over 3 hours during the hydrogen breath test. Out of the entire sample, 35 (25.4%) patients had lactose intolerance. An increase of 0.85 cm in waist circumference compared to the baseline waist circumference results in a sensitivity of 88% and a specificity of 85% to predict lactose intolerance (odds ratio: 42.14, 95% confidence interval: 13.08-135.75, p ≤ 0.001). The body mass index and waist circumference measurement did not affect abdominal distension (p= not significant); however, age modified the time of distension. A 0.85 cm increase in waist circumference compared to the baseline waist circumference during the hydrogen breath test is a useful parameter for the diagnosis of lactose intolerance in pediatrics. Variations in relation to body mass index and waist circumference did not affect the usefulness of an increased waist circumference, unlike age.

  17. Spike-Timing of Orbitofrontal Neurons Is Synchronized With Breathing.

    PubMed

    Kőszeghy, Áron; Lasztóczi, Bálint; Forro, Thomas; Klausberger, Thomas

    2018-01-01

    The orbitofrontal cortex (OFC) has been implicated in a multiplicity of complex brain functions, including representations of expected outcome properties, post-decision confidence, momentary food-reward values, complex flavors and odors. As breathing rhythm has an influence on odor processing at primary olfactory areas, we tested the hypothesis that it may also influence neuronal activity in the OFC, a prefrontal area involved also in higher order processing of odors. We recorded spike timing of orbitofrontal neurons as well as local field potentials (LFPs) in awake, head-fixed mice, together with the breathing rhythm. We observed that a large majority of orbitofrontal neurons showed robust phase-coupling to breathing during immobility and running. The phase coupling of action potentials to breathing was significantly stronger in orbitofrontal neurons compared to cells in the medial prefrontal cortex. The characteristic synchronization of orbitofrontal neurons with breathing might provide a temporal framework for multi-variable processing of olfactory, gustatory and reward-value relationships.

  18. Study of ethane level in exhaled breath in patients with age-related macular degeneration: preliminary study.

    PubMed

    Cagini, C; Giordanelli, A; Fiore, T; Giardinieri, R; Malici, B; De Medio, G E; Pelli, M A; De Bellis, F; Capodicasa, E

    2011-01-01

    A variety of factors have been implicated in the pathogenesis of age-related macular degeneration (ARMD), and oxidative stress plays an important role in the onset and progression of the disease. Breath ethane is now considered a specific and non-invasive test for determining and monitoring the trend of lipid peroxidation and free radical-induced damage in vivo. This test provides an index of the patients' overall oxidative stress level. We evaluated the breath ethane concentration in exhaled air in patients with advanced ARMD. In this study, we enrolled 13 patients with advanced ARMD and a control group, and a breath analysis was carried out by gas chromatography. The mean ethane level in the ARMD patients was 0.82 ± 0.93 nmol/l (range: 0.01-2.7 nmol/l) and the mean ethane value in the control group was 0.12 ± 0.02 nmol/l (range: 0.08-0.16 nmol/l). The difference between the values of the 2 groups was statistically significant (p < 0.005). Receiver operating characteristic analysis showed an elevated area under the curve (0.831; 95% CI: 0.634-0.948), with a significance level of p < 0.0014 (area = 0.5). These preliminary results seem to indicate that breath ethane levels are higher in most patients with ARMD. The breath ethane test could thus be a useful method for evaluating the level of oxidative stress in patients with ARMD. To our knowledge, there are no data on this type of analysis applied to ARMD. Copyright © 2011 S. Karger AG, Basel.

  19. Breath acidification in adolescent runners exposed to atmospheric pollution: A prospective, repeated measures observational study

    PubMed Central

    Ferdinands, Jill M; Crawford, Carol A Gotway; Greenwald, Roby; Van Sickle, David; Hunter, Eric; Teague, W Gerald

    2008-01-01

    Background Vigorous outdoors exercise during an episode of air pollution might cause airway inflammation. The purpose of this study was to examine the effects of vigorous outdoor exercise during peak smog season on breath pH, a biomarker of airway inflammation, in adolescent athletes. Methods We measured breath pH both pre- and post-exercise on ten days during peak smog season in 16 high school athletes engaged in daily long-distance running in a downwind suburb of Atlanta. The association of post-exercise breath pH with ambient ozone and particulate matter concentrations was tested with linear regression. Results We collected 144 pre-exercise and 146 post-exercise breath samples from 16 runners (mean age 14.9 years, 56% male). Median pre-exercise breath pH was 7.58 (interquartile range: 6.90 to 7.86) and did not change significantly after exercise. We observed no significant association between ambient ozone or particulate matter and post-exercise breath pH. However both pre- and post-exercise breath pH were strikingly low in these athletes when compared to a control sample of 14 relatively sedentary healthy adults and to published values of breath pH in healthy subjects. Conclusion Although we did not observe an acute effect of air pollution exposure during exercise on breath pH, breath pH was surprisingly low in this sample of otherwise healthy long-distance runners. We speculate that repetitive vigorous exercise may induce airway acidification. PMID:18328105

  20. The importance of a normal breathing pattern for an effective abdominal-hollowing maneuver in healthy people: an experimental study.

    PubMed

    Ha, Sung-min; Kwon, Oh-yun; Kim, Su-jung; Choung, Sung-dae

    2014-02-01

    A normal breathing pattern while performing the abdominal-hollowing (AH) maneuver or spinal-stabilization exercise is essential for the success of rehabilitation programs and exercises. In previous studies, subjects were given standardized instructions to control the influence of respiration during the AH maneuver. However, the effect of breathing pattern on abdominal-muscle thickness during the AH maneuver has not been investigated. To compare abdominal-muscle thickness in subjects performing the AH maneuver under normal and abnormal breathing-pattern conditions and to investigate the effect of breathing pattern on the preferential contraction ratio (PCR) of the transverse abdominis. Comparative, repeated-measures experimental study. University research laboratory. 16 healthy subjects (8 male, 8 female) from a university population. A real-time ultrasound scanner was used to measure abdominal-muscle thickness during normal and abnormal breathing patterns. A paired t test was used to assess the effect of breathing pattern on abdominal-muscle thickness and PCR. Muscle thickness in the transverse abdominis and internal oblique muscles was significantly greater under the normal breathing pattern than under the abnormal pattern (P < .05). The PCR of the transverse abdominis was significantly higher under the normal breathing pattern compared with the abnormal pattern (P < .05). The results indicate that a normal breathing pattern is essential for performance of an effective AH maneuver. Thus, clinicians should ensure that patients adopt a normal breathing pattern before performing the AH maneuver and monitor transverse abdominis activation during the maneuver.

  1. A fully integrated standalone portable cavity ringdown breath acetone analyzer.

    PubMed

    Sun, Meixiu; Jiang, Chenyu; Gong, Zhiyong; Zhao, Xiaomeng; Chen, Zhuying; Wang, Zhennan; Kang, Meiling; Li, Yingxin; Wang, Chuji

    2015-09-01

    Breath analysis is a promising new technique for nonintrusive disease diagnosis and metabolic status monitoring. One challenging issue in using a breath biomarker for potential particular disease screening is to find a quantitative relationship between the concentration of the breath biomarker and clinical diagnostic parameters of the specific disease. In order to address this issue, we need a new instrument that is capable of conducting real-time, online breath analysis with high data throughput, so that a large scale of clinical test (more subjects) can be achieved in a short period of time. In this work, we report a fully integrated, standalone, portable analyzer based on the cavity ringdown spectroscopy technique for near-real time, online breath acetone measurements. The performance of the portable analyzer in measurements of breath acetone was interrogated and validated by using the certificated gas chromatography-mass spectrometry. The results show that this new analyzer is useful for reliable online (online introduction of a breath sample without pre-treatment) breath acetone analysis with high sensitivity (57 ppb) and high data throughput (one data per second). Subsequently, the validated breath analyzer was employed for acetone measurements in 119 human subjects under various situations. The instrument design, packaging, specifications, and future improvements were also described. From an optical ringdown cavity operated by the lab-set electronics reported previously to this fully integrated standalone new instrument, we have enabled a new scientific tool suited for large scales of breath acetone analysis and created an instrument platform that can even be adopted for study of other breath biomarkers by using different lasers and ringdown mirrors covering corresponding spectral fingerprints.

  2. A fully integrated standalone portable cavity ringdown breath acetone analyzer

    NASA Astrophysics Data System (ADS)

    Sun, Meixiu; Jiang, Chenyu; Gong, Zhiyong; Zhao, Xiaomeng; Chen, Zhuying; Wang, Zhennan; Kang, Meiling; Li, Yingxin; Wang, Chuji

    2015-09-01

    Breath analysis is a promising new technique for nonintrusive disease diagnosis and metabolic status monitoring. One challenging issue in using a breath biomarker for potential particular disease screening is to find a quantitative relationship between the concentration of the breath biomarker and clinical diagnostic parameters of the specific disease. In order to address this issue, we need a new instrument that is capable of conducting real-time, online breath analysis with high data throughput, so that a large scale of clinical test (more subjects) can be achieved in a short period of time. In this work, we report a fully integrated, standalone, portable analyzer based on the cavity ringdown spectroscopy technique for near-real time, online breath acetone measurements. The performance of the portable analyzer in measurements of breath acetone was interrogated and validated by using the certificated gas chromatography-mass spectrometry. The results show that this new analyzer is useful for reliable online (online introduction of a breath sample without pre-treatment) breath acetone analysis with high sensitivity (57 ppb) and high data throughput (one data per second). Subsequently, the validated breath analyzer was employed for acetone measurements in 119 human subjects under various situations. The instrument design, packaging, specifications, and future improvements were also described. From an optical ringdown cavity operated by the lab-set electronics reported previously to this fully integrated standalone new instrument, we have enabled a new scientific tool suited for large scales of breath acetone analysis and created an instrument platform that can even be adopted for study of other breath biomarkers by using different lasers and ringdown mirrors covering corresponding spectral fingerprints.

  3. Exhaled breath temperature in children: reproducibility and influencing factors.

    PubMed

    Vermeulen, S; Barreto, M; La Penna, F; Prete, A; Martella, S; Biagiarelli, F; Villa, M P

    2014-09-01

    This study will investigate the reproducibility and influencing factors of exhaled breath temperature measured with the tidal breathing technique in asthmatic patients and healthy children. Exhaled breath temperature, fractional exhaled nitric oxide, and spirometry were assessed in 124 children (63 healthy and 61 asthmatic), aged 11.2 ± 2.5 year, M/F 73/51. A modified version of the American Thoracic Society questionnaire on the child's present and past respiratory history was obtained from parents. Parents were also asked to provide detailed information on their child's medication use during the previous 4 weeks. Ear temperature, ambient temperature, and relative-ambient humidity were also recorded. Exhaled breath temperature measurements were highly reproducible; the second measurement was higher than the first measurement, consistent with a test-retest situation. In 13 subjects, between-session within-day reproducibility of exhaled breath temperature was still high. Exhaled breath temperature increased with age and relative-ambient humidity. Exhaled breath temperature was comparable in healthy and asthmatic children; when adjusted for potential confounders (i.e. ambient conditions and subject characteristics), thermal values of asthmatic patients exceeded those of the healthy children by 1.1 °C. Normalized exhaled breath temperature, by subtracting ambient temperature, was lower in asthmatic patients treated with inhaled corticosteroids than in those who were corticosteroid-naive. Measurements of exhaled breath temperature are highly reproducible, yet influenced by several factors. Corrected values, i.e. normalized exhaled breath temperature, could help us to assess the effect of therapy with inhaled corticosteroids. More studies are needed to improve the usefulness of the exhaled breath temperature measured with the tidal breathing technique in children.

  4. Impact of orocecal transit time on patient´s perception of lactose intolerance.

    PubMed

    Casellas, Francesc; Aparici, Anna; Casaus, Maite; Rodríguez, Purificación; Malagelada, Juan R

    2013-01-01

    symptoms attributed to the lactose intolerance are an important public health issue because of their prevalence and social relevance. Also because they may cause undue rejection of dairy products consume with potential health consequences. Transit time is a putative factor implied in the severity of symptoms associated with lactose. to elucidate the relation between orocecal transit time (OCTT) and lactose intolerance symptoms. observational study in patients referred to a lactose hydrogen breath test who showed an increase in breath H2 excretion higher than 25 ppm. OCTT was measured with the breath test and symptoms of lactose tolerance with a validated scale. Symptoms were measured twice: before receiving the lactose, inquiring about self perceived symptoms when patients consumed dairy products at home ("home symptoms"), and again after completing the lactose breath test ("test symptoms"). 161 patients were included. There was no correlation between OCTT and home symptoms (r = -0.1). When OCTT was faster than 60 minutes, intensity of "test symptoms" was similar to "home symptoms". However, in patients with normal or slow OCTT, the "home symptoms" were more intense than the "test symptoms" (p < 0.05). At home, symptoms were independent of OCTT but with the lactose test load the symptoms were proportionately more intense with faster OCTT. in lactose maldigesters, selfreported symptoms of lactose intolerance are more pronounced at home than after a high lactose challenge. Intolerance symptoms that patients attributed to lactose consume at home are due to factors other than fast OCTT.

  5. Comparison of the analytical capabilities of the BAC Datamaster and Datamaster DMT forensic breath testing devices.

    PubMed

    Glinn, Michele; Adatsi, Felix; Curtis, Perry

    2011-11-01

    The State of Michigan uses the Datamaster as an evidential breath testing device. The newest version, the DMT, will replace current instruments in the field as they are retired from service. The Michigan State Police conducted comparison studies to test the analytical properties of the new instrument and to evaluate its response to conditions commonly cited in court defenses. The effects of mouth alcohol, objects in the mouth, and radiofrequency interference on paired samples from drinking subjects were assessed on the DMT. The effects of sample duration and chemical interferents were assessed on both instruments, using drinking subjects and wet-bath simulators, respectively. Our testing shows that Datamaster and DMT results are essentially identical; the DMT gave accurate readings as compared with measurements made using simulators containing standard ethanol solutions and that the DMT did not give falsely elevated breath alcohol results from any of the influences tested. © 2011 American Academy of Forensic Sciences.

  6. Laboratory evaluation of two passive alcohol sensor devices

    DOT National Transportation Integrated Search

    1988-12-01

    Passive alcohol sensing devices are designed to detect the presence of alcohol in a person's normally-expelled breath; they are "passive" in that one is not required to blow into a mouthpiece as with conventional breath test devices. The National Hig...

  7. Breath biomarkers in toxicology.

    PubMed

    Pleil, Joachim D

    2016-11-01

    Exhaled breath has joined blood and urine as a valuable resource for sampling and analyzing biomarkers in human media for assessing exposure, uptake metabolism, and elimination of toxic chemicals. This article focuses current use of exhaled gas, aerosols, and vapor in human breath, the methods for collection, and ultimately the use of the resulting data. Some advantages of breath are the noninvasive and self-administered nature of collection, the essentially inexhaustible supply, and that breath sampling does not produce potentially infectious waste such as needles, wipes, bandages, and glassware. In contrast to blood and urine, breath samples can be collected on demand in rapid succession and so allow toxicokinetic observations of uptake and elimination in any time frame. Furthermore, new technologies now allow capturing condensed breath vapor directly, or just the aerosol fraction alone, to gain access to inorganic species, lung pH, proteins and protein fragments, cellular DNA, and whole microorganisms from the pulmonary microbiome. Future applications are discussed, especially the use of isotopically labeled probes, non-targeted (discovery) analysis, cellular level toxicity testing, and ultimately assessing "crowd breath" of groups of people and the relation to dose of airborne and other environmental chemicals at the population level.

  8. Breath acetone monitoring by portable Si:WO3 gas sensors

    PubMed Central

    Righettoni, Marco; Tricoli, Antonio; Gass, Samuel; Schmid, Alex; Amann, Anton; Pratsinis, Sotiris E.

    2013-01-01

    Breath analysis has the potential for early stage detection and monitoring of illnesses to drastically reduce the corresponding medical diagnostic costs and improve the quality of life of patients suffering from chronic illnesses. In particular, the detection of acetone in the human breath is promising for non-invasive diagnosis and painless monitoring of diabetes (no finger pricking). Here, a portable acetone sensor consisting of flame-deposited and in situ annealed, Si-doped epsilon-WO3 nanostructured films was developed. The chamber volume was miniaturized while reaction-limited and transport-limited gas flow rates were identified and sensing temperatures were optimized resulting in a low detection limit of acetone (~20 ppb) with short response (10–15 s) and recovery times (35–70 s). Furthermore, the sensor signal (response) was robust against variations of the exhaled breath flow rate facilitating application of these sensors at realistic relative humidities (80–90%) as in the human breath. The acetone content in the breath of test persons was monitored continuously and compared to that of state-of-the-art proton transfer reaction mass spectrometry (PTR-MS). Such portable devices can accurately track breath acetone concentration to become an alternative to more elaborate breath analysis techniques. PMID:22790702

  9. Double-blind randomized controlled trial of rifaximin for persistent symptoms in patients with celiac disease.

    PubMed

    Chang, Matthew S; Minaya, Maria T; Cheng, Jianfeng; Connor, Bradley A; Lewis, Suzanne K; Green, Peter H R

    2011-10-01

    Small intestinal bacterial overgrowth (SIBO) is one cause of a poor response to a gluten-free diet (GFD) and persistent symptoms in celiac disease. Rifaximin has been reported to improve symptoms in non-controlled trials. To determine the effect of rifaximin on gastrointestinal symptoms and lactulose-hydrogen breath tests in patients with poorly responsive celiac disease. A single-center, double-blind, randomized, controlled trial of patients with biopsy-proven celiac disease and persistent gastrointestinal symptoms despite a GFD was conducted. Patients were randomized to placebo (n = 25) or rifaximin (n = 25) 1,200 mg daily for 10 days. They completed the Gastrointestinal Symptom Rating Scale (GSRS) and underwent lactulose-hydrogen breath tests at weeks 0, 2, and 12. An abnormal breath test was defined as: (1) a rise in hydrogen of ≥20 parts per million (ppm) within 100 min, or (2) two peaks ≥20 ppm over baseline. GSRS scores were unaffected by treatment with rifaximin, regardless of baseline breath tests. In a multivariable regression model, the duration of patients' gastrointestinal symptoms significantly predicted their overall GSRS scores (estimate 0.029, p < 0.006). According to criteria 1 and 2, respectively, SIBO was present in 55 and 8% of patients at baseline, intermittently present in 28 and 20% given placebo, and 28 and 12% given rifaximin. There was no difference in the prevalence of SIBO between placebo and treatment groups at weeks 2 and 12. Rifaximin does not improve patients' reporting of gastrointestinal symptoms and hydrogen breath tests do not reliably identify who will respond to antibiotic therapy.

  10. Diagnostic accuracy of the 14C-urea breath test in Helicobacter pylori infections: a meta-analysis.

    PubMed

    Zhou, Qiaohui; Li, Ling; Ai, Yaowei; Pan, Zhihong; Guo, Mingwen; Han, Jingbo

    2017-01-01

    To summarize and appraise the available literature regarding the use of the 14 C-urea breath test in the diagnosis of Helicobacter pylori infections in adult patients with dyspepsia and to calculate pooled diagnostic accuracy measures. We systematically searched the PubMed, EMBASE, Cochrane Library, Chinese Journals Full-text (CNKI) and CBMDisc databases to identify published data regarding the sensitivity, specificity, and other measures of diagnostic accuracy of the 14 C-urea breath test in the diagnosis of Helicobacter pylori infections in adult patients with dyspeptic symptoms. Risk of bias was assessed using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies)-2 tool. Statistical analyses were performed using Meta-Disc 1.4 software and STATA. Eighteen studies met the inclusion criteria. Pooled results indicated that the  14 C-urea breath test showed a diagnostic sensitivity of 0.96 (95% CI 0.95 to 0.96) and specificity of 0.93 (95% CI 0.91 to 0.94). The positive like ratio (PLR) was 12.27 (95% CI 8.17 to 18.44), the negative like ratio (NLR) was 0.05 (95% CI 0.04 to 0.07), and the area under the curve was 0.985. The DOR was 294.95 (95% CI 178.37 to 487.70). The 14 C-urea breath test showed sufficient sensitivity and specificity for diagnosing Helicobacter pylori infection, but unexplained heterogeneity after meta-regression and several subgroup analyses remained. The UBT has high accuracy for diagnosing H. pylori infections in adult patients with dyspepsia. However, the reliability of these diagnostic meta-analytic estimates is limited by significant heterogeneity due to unknown factors.

  11. Assessment of ileal function by abdominal counting of the retention of a gamma emitting bile acid analogue.

    PubMed Central

    Thaysen, E H; Orholm, M; Arnfred, T; Carl, J; Rødbro, P

    1982-01-01

    In eight patients without gastrointestinal complaints and 30 patients with various gastrointestinal disorders ileal bile acid conservation was assessed by oral administration of 75Se 23-selena-25-homocholic acid (SeHCAT) followed by abdominal gamma counting (SeHCAT-test). The results of the test correlated fairly well with the clinical features and with the [1-14C]-cholylglycine breath test including faecal 14C measurements (breath test). Of the two bile acid absorption tests the new is perhaps the more sensitive and is the one most easily performed. PMID:7117906

  12. Effects of slow breathing rate on heart rate variability and arterial baroreflex sensitivity in essential hypertension.

    PubMed

    Li, Changjun; Chang, Qinghua; Zhang, Jia; Chai, Wenshu

    2018-05-01

    This study is to investigate the effects of slow breathing on heart rate variability (HRV) and arterial baroreflex sensitivity in essential hypertension.We studied 60 patients with essential hypertension and 60 healthy controls. All subjects underwent controlled breathing at 8 and 16 breaths per minute. Electrocardiogram, respiratory, and blood pressure signals were recorded simultaneously. We studied effects of slow breathing on heart rate, blood pressure and respiratory peak, high-frequency (HF) power, low-frequency (LF) power, and LF/HF ratio of HRV with traditional and corrected spectral analysis. Besides, we tested whether slow breathing was capable of modifying baroreflex sensitivity in hypertensive subjects.Slow breathing, compared with 16 breaths per minute, decreased the heart rate and blood pressure (all P < .05), and shifted respiratory peak toward left (P < .05). Compared to 16 breaths/minute, traditional spectral analysis showed increased LF power and LF/HF ratio, decreased HF power of HRV at 8 breaths per minute (P < .05). As breathing rate decreased, corrected spectral analysis showed increased HF power, decreased LF power, LF/HF ratio of HRV (P < .05). Compared to controls, resting baroreflex sensitivity decreased in hypertensive subjects. Slow breathing increased baroreflex sensitivity in hypertensive subjects (from 59.48 ± 6.39 to 78.93 ± 5.04 ms/mm Hg, P < .05) and controls (from 88.49 ± 6.01 to 112.91 ± 7.29 ms/mm Hg, P < .05).Slow breathing can increase HF power and decrease LF power and LF/HF ratio in essential hypertension. Besides, slow breathing increased baroreflex sensitivity in hypertensive subjects. These demonstrate slow breathing is indeed capable of shifting sympatho-vagal balance toward vagal activities and increasing baroreflex sensitivity, suggesting a safe, therapeutic approach for essential hypertension.

  13. Proportional assist ventilation system based on proportional solenoid valve control.

    PubMed

    Lua, A C; Shi, K C; Chua, L P

    2001-07-01

    A new proportional assist ventilation (PAV) method using a proportional solenoid valve (PSV) to control air supply to patients suffering from respiratory disabilities, was studied. The outlet flow and pressure from the proportional solenoid valve at various air supply pressures were tested and proven to be suitable for pressure and flow control in a PAV system. In vitro tests using a breathing simulator, which has been proven to possess the general characteristics of human respiratory system in spontaneous breathing tests, were conducted and the results demonstrated the viability of this PAV system in normalizing the breathing patterns of patients with abnormally high resistances and elastances as well as neuromuscular weaknesses. With a back-up safety mechanism incorporated in the control program, pressure "run-away" can be effectively prevented and safe operation of the system can be guaranteed.

  14. Effect of Yogic Breathing on Accommodate Braille Version of Six-letter Cancellation Test in Students with Visual Impairment.

    PubMed

    Pradhan, Balaram; Mohanty, Soubhagyalaxmi; Hankey, Alex

    2018-01-01

    Attentional processes tend to be less well developed in the visually impaired, who require special training to develop them fully. Yogic breathing which alters the patterns of respiration has been shown to enhance attention skills. Letter cancellation tests are well-established tools to measure attention and attention span. Here, a modified Braille version of the six-letter cancellation test (SLCT) was used for students with visual impairment (VI). This study aimed to assess the immediate effects of Bhramari Pranayama (BhPr) and breath awareness (BA) on students with VI. This study was a self-as-control study held on 2 consecutive days, on 19 participants (8 males, 11 females), with a mean age of 15.89 ± 1.59 years, randomized into two groups. On the 1 st day, Group 1 performed 10 min breath awareness and Group 2 performed Bhramari ; on the 2 nd day, practices were reversed. Assessments used a SLCT specially adapted for the visually impaired before and after each session. The Braille letter cancellation test was successfully taken by 19 students. Scores significantly improved after both techniques for each student following practices on both days ( P < 0.001). BhPr may have more effect on attention performance than BA as wrong scores significantly increased following BA ( P < 0.05), but the increase in the score after Bhramari was not significant. Despite the small sample size improvement in attentional processes by both yoga breathing techniques was robust. Attentional skills were definitely enhanced. Long-term practice should be studied.

  15. Effect of Yogic Breathing on Accommodate Braille Version of Six-letter Cancellation Test in Students with Visual Impairment

    PubMed Central

    Pradhan, Balaram; Mohanty, Soubhagyalaxmi; Hankey, Alex

    2018-01-01

    Context: Attentional processes tend to be less well developed in the visually impaired, who require special training to develop them fully. Yogic breathing which alters the patterns of respiration has been shown to enhance attention skills. Letter cancellation tests are well-established tools to measure attention and attention span. Here, a modified Braille version of the six-letter cancellation test (SLCT) was used for students with visual impairment (VI). Aim: This study aimed to assess the immediate effects of Bhramari Pranayama (BhPr) and breath awareness (BA) on students with VI. Methods: This study was a self-as-control study held on 2 consecutive days, on 19 participants (8 males, 11 females), with a mean age of 15.89 ± 1.59 years, randomized into two groups. On the 1st day, Group 1 performed 10 min breath awareness and Group 2 performed Bhramari; on the 2nd day, practices were reversed. Assessments used a SLCT specially adapted for the visually impaired before and after each session. Results: The Braille letter cancellation test was successfully taken by 19 students. Scores significantly improved after both techniques for each student following practices on both days (P < 0.001). BhPr may have more effect on attention performance than BA as wrong scores significantly increased following BA (P < 0.05), but the increase in the score after Bhramari was not significant. Conclusions: Despite the small sample size improvement in attentional processes by both yoga breathing techniques was robust. Attentional skills were definitely enhanced. Long-term practice should be studied. PMID:29755219

  16. Lactulose Breath Test Gas Production in Childhood IBS Is Associated With Intestinal Transit and Bowel Movement Frequency.

    PubMed

    Chumpitazi, Bruno P; Weidler, Erica M; Shulman, Robert J

    2017-04-01

    In adults with irritable bowel syndrome (IBS), bacterial gas production (colonic fermentation) is related to both symptom generation and intestinal transit. Whether gas production affects symptom generation, psychosocial distress, or intestinal transit in childhood IBS is unknown. Children (ages 7-17 years) with pediatric Rome III IBS completed validated psychosocial questionnaires and a 2-week daily diary capturing pain and stooling characteristics. Stool form determined IBS subtype. Subjects then completed a 3-hour lactulose breath test for measurement of total breath hydrogen and methane production. Carmine red was used to determine whole intestinal transit time. A total of 87 children (mean age 13 ± 2.6 [standard deviation] years) were enrolled, of whom 50 (57.5%) were girls. All children produced hydrogen and 51 (58.6%) produced methane. Hydrogen and methane production did not correlate with either abdominal pain frequency/severity or psychosocial distress. Hydrogen and methane production did not differ significantly by IBS subtype. Methane production correlated positively with whole intestinal transit time (r = 0.31, P < 0.005) and inversely with bowel movement frequency (r = -0.245, P < 0.05). Methane production (threshold 3 ppm) as a marker for identifying IBS-C had a sensitivity of 60% and specificity of 42.9%. Lactulose breath test total methane production may serve as a biomarker of whole intestinal transit time and bowel movement frequency in children with IBS. In children with IBS, lactulose breath test hydrogen and methane production did not, however, correlate with abdominal pain, IBS subtype, or psychosocial distress.

  17. The accuracy of evidential breath testers at low BACs

    DOT National Transportation Integrated Search

    1989-05-01

    This Technical Note reports on the low blood alcohol concentration (BAC) laboratory testing of seven evidential breath testers widely used by law enforcement. The findings indicated that these devices are just as accurate at low BACs in the 0.020-0.0...

  18. Use of warrants for breath test refusal : case studies

    DOT National Transportation Integrated Search

    2007-10-01

    This study investigated the use of warrants to obtain blood samples from drivers arrested for alcohol-impaired driving and who refuse to provide breath samples when requested to do so by law enforcement officers. Case studies were conducted in four S...

  19. Evaluation of the Sierra, hanging, quick-don, crew, pressure-breathing, oxygen mask.

    DOT National Transportation Integrated Search

    1966-06-01

    A new design, hanging, quick-don crew pressure breathing oxygen mask applicable to jet-transport operations was tested and evaluated in three phases, consisting of (1) exposing five masked subjects to a stepwise altitude-chamber flight profile with a...

  20. An analysis of potential breathing devices intended for use by aircraft passengers.

    DOT National Transportation Integrated Search

    1983-05-01

    This report presents the results of tests performed to examine concepts for the development of a passenger-type protective breathing device which would provide protection from toxic smoke/fumes produced during an in- flight fire and afford some prote...

  1. Lactose intolerance in Thai adults.

    PubMed

    Densupsoontorn, Narumon; Jirapinyo, Pipop; Thamonsiri, Nuchnoi; Chantaratin, Sasitorn; Wongarn, Renu

    2004-12-01

    Lactose intolerance is common in Thai adults who ingest cow's milk but its incidence has not been clearly defined The authors evaluated 45 volunteers (15 males, 35 females), aged 21-31 yrs old, who drank one 240-ml box of milk daily. A Lactose tolerance test was performed using a breath-hydrogen test (BHT) after oral intake of 25 g of lactose dissolved in 250 ml of water The presence of gastrointestinal symptoms of lactose intolerance, flatulence, abdominal pain and diarrhea, were recorded Twenty-one subjects (47%) were categorized as lactose malabsorbers and intolerant, two subjects (4%) were malabsorbers but tolerant, and 22 of 45 (49%) were absorbers and tolerant. The incidence of lactose malabsorption was, thus, 51%; symptoms of intolerance were found in 21 of the 23 malabsorbers, making the incidence of lactose intolerance 47%. In the lactose malabsorbant and intolerant group, the more breath-hydrogen (H) the more symptoms observed All subjects who had a negative breath-H2 test had no symptoms. The breath-H2 test should be used as a standard method to evaluate lactose absorption and lactose tolerance. The incidence of lactose intolerance has decreased from the past and the symptoms are not so severe that the people limit the consumption of milk since it is a major source of food containing good quality of protein and calcium.

  2. Carbon-14 urea breath test: does it work in patients with partial gastric resection?

    PubMed

    Dede, Fuat; Civen, Hüseyin; Dane, Faysal; Aliustaoglu, Mehmet; Turhal, Serdar; Turoglu, Halil Turgut; Inanir, Sabahat

    2015-11-01

    The diagnostic value of Carbon-14 urea breath test (C-14 UBT) in the detection of Helicobacter pylori (H. pylori) infection in non-operated patients has been proved. However, the efficacy of C-14 UBT in patients with partial gastric resection (PGR) has not been evaluated yet. Herein, the results of the C-14 UBT and H. pylori stool antigen test (HpSAT) in this patient group were compared with the endoscopic findings. Multi-breath samples C-14 UBT and HpSAT were performed in all patients on the same day. Histology was used as a gold standard for testing C-14 UBT and HpSAT diagnostic efficacies. 30 patients (mean age: 54.6 ± 11 year) with PGR were included. The sensitivity and specificity of standard C-14 UBT were 29 and 100 %, respectively. When breath samples were collected at 20th min, and >35 CPM was selected as radioactivity threshold, the sensitivity raised to 86 % without any loss of specificity. The specificity and sensitivity of the HpSAT were 71 and 96 %, respectively. The sensitivity of the standard C-14 UBT was very poor for patients with PGR, and results of HpSAT were superior in this population. Certain modifications are needed if C-14 UBT is to be used in PGR patients.

  3. Prevalence of alcohol-impaired driving and riding in northern Ghana.

    PubMed

    Damsere-Derry, James; Palk, Gavan; King, Mark

    2016-01-01

    The objective of this study was to determine the roadside prevalence of alcohol-impaired driving among drivers and riders in northern Ghana. The study also verifies motorists' perceptions of their own alcohol use and knowledge of the legal blood alcohol concentration (BAC) limit in Ghana. With the assistance of police, systematic random sampling was used to collect data at roadblocks using a cross-sectional study design. Breathalyzers were used to screen whether motorists had detectable alcohol in their breath and follow-up breath tests were conducted to measure the actual breath alcohol levels among positive participants. In all, 9.7% of the 789 participants had detectable alcohol, among whom 6% exceeded the legal BAC limit of 0.08%. The prevalence of alcohol-impaired driving/riding was highest among cyclists (10% of all cyclists breath-tested) followed by truck drivers (9%) and motorcyclists (7% of all motorcyclists breath-tested). The occurrence of a positive BAC among cyclists was about 8 times higher (odds ratio [OR] = 7.73; P < .001) and it was 2 times higher among motorcyclists (OR = 2.30; P = .039) compared to private car drivers. The likelihood for detecting a positive BAC among male motorists/riders was higher than that among females (OR = 1.67; P = .354). The odds for detecting a positive BAC among weekend motorists/riders was significantly higher than on weekdays (OR = 2.62; P = .001). Alcohol-impaired driving/riding in Ghana is high by international standards. In order to attenuate the harmful effects of alcohol misuse such as alcohol-impaired driving/riding, there is the need to educate road users about how much alcohol they can consume and stay below the legal limit. The police should also initiate random breath testing to instill the deterrence of detection, certainty of apprehension and punishment, and severity and celerity of punishment among drink-driving motorists and riders.

  4. Reliability of breath by breath spirometry and relative flow-time indices for pulmonary function testing in horses.

    PubMed

    Burnheim, K; Hughes, K J; Evans, D L; Raidal, S L

    2016-11-28

    Respiratory problems are common in horses, and are often diagnosed as a cause of poor athletic performance. Reliable, accurate and sensitive spirometric tests of airway function in resting horses would assist with the diagnosis of limitations to breathing and facilitate investigations of the effects of various treatments on breathing capacity. The evaluation of respiratory function in horses is challenging and suitable procedures are not widely available to equine practitioners. The determination of relative flow or flow-time measures is used in paediatric patients where compliance may limit conventional pulmonary function techniques. The aim of the current study was to characterise absolute and relative indices of respiratory function in healthy horses during eupnoea (tidal breathing) and carbon dioxide (CO 2 )-induced hyperpnoea (rebreathing) using a modified mask pneumotrachographic technique well suited to equine practice, and to evaluate the reliability of this technique over three consecutive days. Coefficients of variation, intra-class correlations, mean differences and 95% confidence intervals across all days of testing were established for each parameter. The technique provided absolute measures of respiratory function (respiratory rate, tidal volume, peak inspiratory and expiratory flows, time to peak flow) consistent with previous studies and there was no significant effect of day on any measure of respiratory function. Variability of measurements was decreased during hyperpnea caused by rebreathing CO 2 , but a number of relative flow-time variables demonstrated good agreement during eupnoeic respiration. The technique was well tolerated by horses and study findings suggest the technique is suitable for evaluation of respiratory function in horses. The use of relative flow-time variables provided reproducible (consistent) results, suggesting the technique may be of use for repeated measures studies in horses during tidal breathing or rebreathing.

  5. High-pitched breath sounds indicate airflow limitation in asymptomatic asthmatic children.

    PubMed

    Habukawa, Chizu; Nagasaka, Yukio; Murakami, Katsumi; Takemura, Tsukasa

    2009-04-01

    Asthmatic children may have airway dysfunction even when asymptomatic, indicating that their long-term treatment is less than optimal. Although airway dysfunction can be identified on lung function testing, performing these tests can be difficult in infants. We studied whether breath sounds reflect subtle airway dysfunction in asthmatic children. The highest frequency of inspiratory breaths sounds (HFI) and the highest frequency of expiratory breath sounds (HFE) were measured in 131 asthmatic children while asymptomatic and with no wheezes for more than 2 weeks. No child was being treated with inhaled corticosteroids (ICS). Breath sounds were recorded and analysed by sound spectrography and compared with spirometric parameters. After initial evaluation, cases with more than step 2 (mild persistent) asthma were treated using inhaled fluticasone (100-200 microg/day) for 1 month, and then breath sound analysis and pulmonary function testing were repeated. On initial evaluation, HFI correlated with the percentage of predicted FEF(50) (%FEF(50)), (r = -0.45, P < 0.001), the percentage of predicted FEF(75) (%FEF(75)) (r = -0.456, P < 0.001), and FEV(1) as a percentage of FVC (FEV(1)/FVC (%)) (r = -0.32, P < 0.001). HFI did not correlate with the percentage of predicted PEF (%PEF). The 69 children with lower than normal %FEF(50) were then treated with ICS. The %FEF(50) and %FEF(75) improved after ICS treatment, and increases in %FEF(50) (P < 0.005) correlated with decreases in HFI (P < 0.001). Higher HFI in asymptomatic asthmatic children may indicate small airway obstruction. Additional ICS treatment may improve the pulmonary function indices representing small airway function with simultaneous HFI decreases in such patients.

  6. Effects of forced deep breathing on blood flow velocity in the femoral vein: Developing a new physical prophylaxis for deep vein thrombosis in patients with plaster cast immobilization of the lower limb.

    PubMed

    Nakanishi, Keisuke; Takahira, Naonobu; Sakamoto, Miki; Yamaoka-Tojo, Minako; Katagiri, Masato; Kitagawa, Jun

    2018-02-01

    Patients with plaster cast immobilization of the lower limb have an estimated symptomatic venous thromboembolism rate of 5.5%. However, there is currently no practical physical prophylaxis for deep-vein thrombosis (DVT). The objective of this study was to examine the effects of forced deep breathing on peak blood velocity in the superficial femoral vein (PBVFV), which is a surrogate measure of the efficacy of thromboprophylaxis against DVT, in patients with plaster cast immobilization of the lower limb. Nine young males and 18 elderly males were recruited. We immobilized the right lower limb of each subject with a plaster splint and measured PBVFV during forced deep breathing in supine and sitting positions. In all subjects, PBVFV during forced deep breathing in both positions was significantly higher than at rest. There was no significant difference in the PBVFV change ratio for three breathing rates in the sitting position for the young subjects (15breaths/min: 415%, 5breaths/min: 475%, 3breaths/min: 483%), whereas that for the elderly subjects at 3breaths/min (449%) was significantly higher than that at 15breaths/min (284%). Forced deep breathing significantly increased PBVFV in patients with plaster cast immobilization of the lower limb in both supine and sitting positions. Testing the efficacy and adherence in clinical contexts, and following up with the incidence rate of DVT in future studies, is necessary for the development of a new physical prophylaxis for DVT. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Work of Breathing into Snow in the Presence versus Absence of an Artificial Air Pocket Affects Hypoxia and Hypercapnia of a Victim Covered with Avalanche Snow: A Randomized Double Blind Crossover Study.

    PubMed

    Roubík, Karel; Sieger, Ladislav; Sykora, Karel

    2015-01-01

    Presence of an air pocket and its size play an important role in survival of victims buried in the avalanche snow. Even small air pockets facilitate breathing. We hypothesize that the size of the air pocket significantly affects the airflow resistance and work of breathing. The aims of the study are (1) to investigate the effect of the presence of an air pocket on gas exchange and work of breathing in subjects breathing into the simulated avalanche snow and (2) to test whether it is possible to breathe with no air pocket. The prospective interventional double-blinded study involved 12 male volunteers, from which 10 completed the whole protocol. Each volunteer underwent two phases of the experiment in a random order: phase "AP"--breathing into the snow with a one-liter air pocket, and phase "NP"--breathing into the snow with no air pocket. Physiological parameters, fractions of oxygen and carbon dioxide in the airways and work of breathing expressed as pressure-time product were recorded continuously. The main finding of the study is that it is possible to breath in the avalanche snow even with no air pocket (0 L volume), but breathing under this condition is associated with significantly increased work of breathing. The significant differences were initially observed for end-tidal values of the respiratory gases (EtO2 and EtCO2) and peripheral oxygen saturation (SpO2) between AP and NP phases, whereas significant differences in inspiratory fractions occurred much later (for FIO2) or never (for FICO2). The limiting factor in no air pocket conditions is excessive increase in work of breathing that induces increase in metabolism accompanied by higher oxygen consumption and carbon dioxide production. The presence of even a small air pocket reduces significantly the work of breathing.

  8. Breathing pattern and head posture: changes in craniocervical angles.

    PubMed

    Sabatucci, A; Raffaeli, F; Mastrovincenzo, M; Luchetta, A; Giannone, A; Ciavarella, D

    2015-04-01

    The aim of this study was to observe the influence of oral breathing on head posture and to establish possible postural changes observing the variation of craniocervical angles NSL/OPT and NSL/CVT between oral breathing subjects and physiological breathing subjects. A cross-sectional study was conducted. The sample included 115 subject, 56 boys and 59 girls, 5-22-year-old. Among these, 80 were classified as oral breathers and 35 as physiological breathers. The diagnosis of oral breathing was carried out thanks to characteristic signs and symptoms evaluated on clinical examination, the analysis of characteristic X-ray images, ENT examination with active anterior rhinomanometric (AAR) test. The structural and postural analysis was carried out, calculating the craniofacial angles NSL/OPT and NSL/CVT. Both NSL/OPT and NSL/CVT appear to be significantly greater to those observed in physiological breathing patients. This means that patients who tend to breathe through the mouth rather than exclusively through the nose show a reduction of cervical lordosis and a proinclination of the head. Our study confirms that the oral breathing modifies head position. The significant increase of the craniocervical angles NSL/OPT and NSL/CVT in patients with this altered breathing pattern suggests an elevation of the head and a greater extension of the head compared with the cervical spine. So, to correct the breathing pattern early, either during childhood or during adolescence, can lead to a progressive normalization of craniofacial morphology and head posture.

  9. Development of an Exhaled Breath Monitoring System with Semiconductive Gas Sensors, a Gas Condenser Unit, and Gas Chromatograph Columns

    PubMed Central

    Itoh, Toshio; Miwa, Toshio; Tsuruta, Akihiro; Akamatsu, Takafumi; Izu, Noriya; Shin, Woosuck; Park, Jangchul; Hida, Toyoaki; Eda, Takeshi; Setoguchi, Yasuhiro

    2016-01-01

    Various volatile organic compounds (VOCs) in breath exhaled by patients with lung cancer, healthy controls, and patients with lung cancer who underwent surgery for resection of cancer were analyzed by gas condenser-equipped gas chromatography-mass spectrometry (GC/MS) for development of an exhaled breath monitoring prototype system involving metal oxide gas sensors, a gas condenser, and gas chromatography columns. The gas condenser-GC/MS analysis identified concentrations of 56 VOCs in the breath exhaled by the test population of 136 volunteers (107 patients with lung cancer and 29 controls), and selected four target VOCs, nonanal, acetoin, acetic acid, and propanoic acid, for use with the condenser, GC, and sensor-type prototype system. The prototype system analyzed exhaled breath samples from 101 volunteers (74 patients with lung cancer and 27 controls). The prototype system exhibited a level of performance similar to that of the gas condenser-GC/MS system for breath analysis. PMID:27834896

  10. The use of spirometry to evaluate pulmonary function in olive ridley sea turtles (Lepidochelys olivacea) with positive buoyancy disorders.

    PubMed

    Schmitt, Todd L; Munns, Suzanne; Adams, Lance; Hicks, James

    2013-09-01

    This study utilized computed spirometry to compare the pulmonary function of two stranded olive ridley sea turtles (Lepidochelys olivacea) presenting with a positive buoyancy disorder with two healthy captive olive ridley sea turtles held in a large public aquarium. Pulmonary function test (PFT) measurements demonstrated that the metabolic cost of breathing was much greater for animals admitted with positive buoyancy than for the normal sea turtles. Positively buoyant turtles had higher tidal volumes and significantly lower breathing-frequency patterns with significantly higher expiration rates, typical of gasp-type breathing. The resulting higher energetic cost of breathing in the diseased turtles may have a significant impact on their long-term survival. The findings represent a method for clinical respiratory function analysis for an individual animal to assist with diagnosis, therapy, and prognosis. This is the first study, to our knowledge, to evaluate objectively sea turtles presenting with positive buoyancy and respiratory disease using pulmonary function tests.

  11. Chemoresponsiveness and breath physiology in anosmia.

    PubMed

    Mazzatenta, Andrea; Pokorski, Mieczyslaw; Montinaro, Danilo; Di Giulio, Camillo

    2015-01-01

    Anosmia is a model to study the interaction among chemoreception systems. In the head injury, the traumatic irreversible anosmia caused by damage to olfactory nerve fibers and brain regions is of enviable research interest. In this study, psychophysiological tests for a comprehensive assessment of olfactory function were utilized to investigate anosmia, together with a new technique based on the breath real-time monitoring of volatile organic compounds (VOCs). We applied the breath and VOCs analysis to investigate chemoresponsiveness in the long-term irreversible post-traumatic anosmia.

  12. The relationship of normal body temperature, end-expired breath temperature, and BAC/BrAC ratio in 98 physically fit human test subjects.

    PubMed

    Cowan, J Mack; Burris, James M; Hughes, James R; Cunningham, Margaret P

    2010-06-01

    The relationship between normal body temperature, end-expired breath temperature, and blood alcohol concentration (BAC)/breath alcohol concentration (BrAC) ratio was studied in 98 subjects (84 men, 14 women). Subjects consumed alcohol sufficient to produce a BrAC of at least 0.06 g/210 L 45-75 min after drinking. Breath samples were analyzed using an Intoxilyzer 8000 specially equipped to measure breath temperature. Venous blood samples and body temperatures were then taken. The mean body temperature of the men (36.6 degrees C) was lower than the women (37.0 degrees C); however, their mean breath temperatures were virtually identical (men: 34.5 degrees C; women: 34.6 degrees C). The BAC exceeded the BrAC for every subject. BAC/BrAC ratios were calculated from the BAC and BrAC analytical results. There was no difference in the BAC/BrAC ratios for men (1:2379) and women (1:2385). The correlation between BAC and BrAC was high (r = 0.938, p < 0.0001), whereas the correlations between body temperature and end-expired breath temperature, body temperature and BAC/BrAC ratio, and breath temperature and BAC/BrAC ratio were much lower. Neither normal body temperature nor end-expired breath temperature was strongly associated with BAC/BrAC ratio.

  13. Investigation of Metabolism of Exogenous Glucose at the Early Stage and Onset of Diabetes Mellitus in Otsuka Long-Evans Tokushima Fatty Rats Using [1, 2, 3-13C]Glucose Breath Tests

    PubMed Central

    Kijima, Sho; Tanaka, Hideki

    2016-01-01

    This study aimed to evaluate changes in glucose metabolism at the early stage and onset of diabetes in Otsuka Long-Evans Tokushima Fatty (OLETF) rats. Specifically, after the oral administration of [1, 2, 3-13C]glucose, the levels of exhaled 13CO2, which most likely originated from pyruvate decarboxylation and tricarboxylic acid, were measured. Eight OLETF rats and eight control rats (Long-Evans Tokushima Otsuka [LETO]) were administered 13C-glucose. Three types of 13C-glucose breath tests were performed thrice in each period at 2-week intervals. [3-13C]glucose results in a 13C isotope at position 1 in the pyruvate molecule, which provides 13CO2. The 13C at carbons 1 and 2 of glucose is converted to 13C at carbons 2 and 1 of acetate, respectively, which produce 13CO2. Based on metabolic differences of the labeled sites, glucose metabolism was evaluated using the results of three breath tests. The increase in 13CO2 excretion in OLETF rats was delayed in all three breath tests compared to that in control rats, suggesting that OLETF rats had a lower glucose metabolism than control rats. In addition, overall glucose metabolism increased with age in both groups. The utilization of [2-13C]glucose was suppressed in OLETF rats at 6–12 weeks of age, but they showed higher [3-13C]glucose oxidation than control rats at 22–25 weeks of age. In the [1-13C]glucose breath test, no significant differences in the area under the curve until 180 minutes (AUC180) were observed between OLETF and LETO rats of any age. Glucose metabolism kinetics were different between the age groups and two groups of rats; however, these differences were not significant based on the overall AUC180 of [1-13C]glucose. We conclude that breath 13CO2 excretion is reduced in OLETF rats at the primary stage of prediabetes, indicating differences in glucose oxidation kinetics between OLETF and LETO rats. PMID:27483133

  14. Investigation of Metabolism of Exogenous Glucose at the Early Stage and Onset of Diabetes Mellitus in Otsuka Long-Evans Tokushima Fatty Rats Using [1, 2, 3-13C]Glucose Breath Tests.

    PubMed

    Kawagoe, Naoyuki; Kano, Osamu; Kijima, Sho; Tanaka, Hideki; Takayanagi, Masaaki; Urita, Yoshihisa

    2016-01-01

    This study aimed to evaluate changes in glucose metabolism at the early stage and onset of diabetes in Otsuka Long-Evans Tokushima Fatty (OLETF) rats. Specifically, after the oral administration of [1, 2, 3-13C]glucose, the levels of exhaled 13CO2, which most likely originated from pyruvate decarboxylation and tricarboxylic acid, were measured. Eight OLETF rats and eight control rats (Long-Evans Tokushima Otsuka [LETO]) were administered 13C-glucose. Three types of 13C-glucose breath tests were performed thrice in each period at 2-week intervals. [3-13C]glucose results in a 13C isotope at position 1 in the pyruvate molecule, which provides 13CO2. The 13C at carbons 1 and 2 of glucose is converted to 13C at carbons 2 and 1 of acetate, respectively, which produce 13CO2. Based on metabolic differences of the labeled sites, glucose metabolism was evaluated using the results of three breath tests. The increase in 13CO2 excretion in OLETF rats was delayed in all three breath tests compared to that in control rats, suggesting that OLETF rats had a lower glucose metabolism than control rats. In addition, overall glucose metabolism increased with age in both groups. The utilization of [2-13C]glucose was suppressed in OLETF rats at 6-12 weeks of age, but they showed higher [3-13C]glucose oxidation than control rats at 22-25 weeks of age. In the [1-13C]glucose breath test, no significant differences in the area under the curve until 180 minutes (AUC180) were observed between OLETF and LETO rats of any age. Glucose metabolism kinetics were different between the age groups and two groups of rats; however, these differences were not significant based on the overall AUC180 of [1-13C]glucose. We conclude that breath 13CO2 excretion is reduced in OLETF rats at the primary stage of prediabetes, indicating differences in glucose oxidation kinetics between OLETF and LETO rats.

  15. Isotope-selective sensor for medical diagnostics based on PAS

    NASA Astrophysics Data System (ADS)

    Wolff, M.; Groninga, H. G.; Harde, H.

    2005-06-01

    Development of new optical sensor technologies has a major impact on the progression of diagnostic methods. Of the permanently increasing number of non-invasive 13C-breath tests, the Urea Breath Test for detection of Helicobacter pylori is the most prominent. However, many recent developments go beyond gastroenterological applications. We present a new detection scheme for breath analysis that employs an especially compact and simple set-up based on Photoacoustic Spectroscopy. Using a wavelength-modulated DFB-diode laser and taking advantage of acoustical resonances of the sample cell, we performed very sensitive isotope-selective measurements on CO2. Detection limits for 13CO2 of a few ppm and for the variation of the 13CO2 concentration of approximately 1% were achieved.

  16. Breath alcohol of anesthesiologists using alcohol hand gel and the "five moments for hand hygiene" in routine practice.

    PubMed

    Lindsay, Helen A; Hannam, Jacqueline A; Bradfield, Charles N; Mitchell, Simon J

    2016-08-01

    Appropriate hand hygiene reduces hospital-acquired infections. Anesthesiologists work in environments with numerous hand hygiene opportunities (HHOs). In a prospective observational study, we investigated the potential for an anesthesiologist to return a positive alcohol breath test during routine practice when using alcohol hand gel. We observed ten volunteer anesthesiologists over four hours while they implemented the World Health Organization (WHO) "five moments for hand hygiene" using our hospital's adopted standard 70% ethanol hand gel. We measured the expired alcohol concentration at shift start and every fifteen minutes thereafter with a fuel cell breathalyzer calibrated to measure the percentage of blood alcohol concentration (BAC). Blood alcohol specimens (analyzed with gas chromatography) were collected at shift start and, when possible, immediately after a participant's first positive breathalyzer test. Of the 130 breathalyzer tests obtained, there were eight (6.2%) positive breath alcohol results from six of the ten participants, all within two minutes of a HHO. The highest value breathalyzer BAC recorded was 0.064%, with an overall mean (SD) of 0.023 (0.017)%. Five (62.5%) of the positive breathalyzer tests returned to zero in less than seven minutes. All of three blood specimens obtained immediately after a positive breathalyzer reading tested negative for alcohol. Anesthesia practitioners using alcohol hand gel in a manner that conforms with recommended hand hygiene can test positive for alcohol on a breathalyzer assay. Positive tests probably arose from inhalation of alcohol vapour into the respiratory dead space following gel application. If workplace breath testing for alcohol is implemented, it should be completed more than 15 min after applying alcohol hand gel. Positive results should be verified with a BAC test.

  17. Breath Tests in Respiratory and Critical Care Medicine: From Research to Practice in Current Perspectives

    PubMed Central

    Cheepsattayakorn, Attapon; Cheepsattayakorn, Ruangrong

    2013-01-01

    Today, exhaled nitric oxide has been studied the most, and most researches have now focusd on asthma. More than a thousand different volatile organic compounds have been observed in low concentrations in normal human breath. Alkanes and methylalkanes, the majority of breath volatile organic compounds, have been increasingly used by physicians as a novel method to diagnose many diseases without discomforts of invasive procedures. None of the individual exhaled volatile organic compound alone is specific for disease. Exhaled breath analysis techniques may be available to diagnose and monitor the diseases in home setting when their sensitivity and specificity are improved in the future. PMID:24151617

  18. Monitoring of endogenous carbon monoxide dynamics in human breath by tunable diode laser

    NASA Astrophysics Data System (ADS)

    Stepanov, Eugene V.; Daraselia, Mikhail V.; Zyrianov, Pavel V.; Shulagin, Yurii A.; Skrupskii, Vladimir A.

    1996-01-01

    High sensitive CO gas analyzer based on tunable diode laser (TDL) was used as a real time monitor of endogenous carbon monoxide in a set of breath physiology experiments. The measurements of the CO content dynamics in exhaled air with 10 ppb sensitivity were attended with detection of carbon dioxide and O2 in breath, lung ventilation parameters, heart rate and blood analysis using conventional techniques. Temporal variations of endogenous CO in human breath caused by hyperoxia, hypoxia, hyperventilation and sport loading were first studied in real time. Scattering of the CO variation time constants was observed for different tested persons. Possible reasons for this scattering related with the organisms' physiology peculiarities are discussed.

  19. Endogenous CO dynamics monitoring in breath by tunable diode laser

    NASA Astrophysics Data System (ADS)

    Kouznetsov, Andrian I.; Stepanov, Eugene V.; Shulagin, Yurii A.; Skrupskii, Vladimir A.

    1996-04-01

    High sensitive CO gas analyzer based on tunable diode laser (TDL) was used as a real time monitor of endogenous carbon monoxide in a set of breath physiology experiments. The measurements of the CO content dynamics in exhaled air with 10 ppb sensitivity were attended with detection of carbon dioxide and O2 in breath, lung ventilation parameters, heart rate and blood analysis using conventional techniques. Variations of endogenous CO in human breath caused by hyperoxia, hypoxia, hyperventilation as well as sport loading were studied in real time. Scattering of the CO variation time constants was observed for different tested persons. Possible reasons for this scattering related with the organisms' physiology peculiarities are discussed.

  20. Twice-daily cimetidine does not increase gastric bacterial flora.

    PubMed Central

    Bourne, J. T.; Mountford, R. A.; Barry, R. E.

    1984-01-01

    Thirty patients with peptic ulcer (20 duodenal, 10 gastric) underwent glucose-hydrogen (H2) breath tests before and after 6 weeks treatment with cimetidine, 400 mg twice daily. For the group as a whole, basal breath H2 and integrated H2 output over a 2.5 hr test period was unchanged by cimetidine treatment. We conclude that there was no evidence of significant gastric bacterial colonization following twice daily cimetidine treatment. PMID:6462995

  1. Results of an investigation of the performance of the Smith and Wesson Breathalyzer Model 1000 Breath Alcohol Tester

    DOT National Transportation Integrated Search

    1980-02-01

    The performance of breath alcohol test equipment used by : police is a major concern of the alcohol countermeasures effort : of the National Highway Traffic Safety Administration (NHTSA). : A Qualified Products List (QPL) has been established to ensu...

  2. Variables that Impact on the Results of Breath-Alcohol Tests

    ERIC Educational Resources Information Center

    Labianca, Dominick A.

    2004-01-01

    In a 2003 issue of the "Journal of Chemical Education," Kniesel and Bellamy describe a timely and pedagogically effective experiment involving breath-alcohol analysis using an FTIR (Fourier Transform Infrared Spectroscopy) spectrometer. The present article clarifies some of the information presented in the 2003 article.

  3. Diagnosis of Peptic Ulcer Disease

    MedlinePlus

    ... urea breath test, you will drink a special liquid that contains urea, a waste product that your body makes as it breaks down protein. If H. pylori are present, the bacteria will change this waste product into carbon dioxide—a harmless gas. Carbon dioxide normally appears in your breath when ...

  4. Correlation of Respirator Fit Measured on Human Subjects and a Static Advanced Headform

    PubMed Central

    Bergman, Michael S.; He, Xinjian; Joseph, Michael E.; Zhuang, Ziqing; Heimbuch, Brian K.; Shaffer, Ronald E.; Choe, Melanie; Wander, Joseph D.

    2015-01-01

    This study assessed the correlation of N95 filtering face-piece respirator (FFR) fit between a Static Advanced Headform (StAH) and 10 human test subjects. Quantitative fit evaluations were performed on test subjects who made three visits to the laboratory. On each visit, one fit evaluation was performed on eight different FFRs of various model/size variations. Additionally, subject breathing patterns were recorded. Each fit evaluation comprised three two-minute exercises: “Normal Breathing,” “Deep Breathing,” and again “Normal Breathing.” The overall test fit factors (FF) for human tests were recorded. The same respirator samples were later mounted on the StAH and the overall test manikin fit factors (MFF) were assessed utilizing the recorded human breathing patterns. Linear regression was performed on the mean log10-transformed FF and MFF values to assess the relationship between the values obtained from humans and the StAH. This is the first study to report a positive correlation of respirator fit between a headform and test subjects. The linear regression by respirator resulted in R2 = 0.95, indicating a strong linear correlation between FF and MFF. For all respirators the geometric mean (GM) FF values were consistently higher than those of the GM MFF. For 50% of respirators, GM FF and GM MFF values were significantly different between humans and the StAH. For data grouped by subject/respirator combinations, the linear regression resulted in R2 = 0.49. A weaker correlation (R2 = 0.11) was found using only data paired by subject/respirator combination where both the test subject and StAH had passed a real-time leak check before performing the fit evaluation. For six respirators, the difference in passing rates between the StAH and humans was < 20%, while two respirators showed a difference of 29% and 43%. For data by test subject, GM FF and GM MFF values were significantly different for 40% of the subjects. Overall, the advanced headform system has potential for assessing fit for some N95 FFR model/sizes. PMID:25265037

  5. Benefits of supplemental oxygen in exercise training in nonhypoxemic chronic obstructive pulmonary disease patients.

    PubMed

    Emtner, Margareta; Porszasz, Janos; Burns, Mary; Somfay, Attila; Casaburi, Richard

    2003-11-01

    Supplemental oxygen improves exercise tolerance of normoxemic and hypoxemic chronic obstructive pulmonary disease (COPD) patients. We determined whether nonhypoxemic COPD patients undergoing exercise training while breathing supplemental oxygen achieve higher intensity and therefore improve exercise capacity more than patients breathing air. A double-blinded trial was performed involving 29 nonhypoxemic patients (67 years, exercise SaO2 > 88%) with COPD (FEV1 = 36% predicted). All exercised on cycle ergometers for 45 minutes, 3 times per week for 7 weeks at high-intensity targets. During exercise, they received oxygen (3 L/minute) (n = 14) or compressed air (3 L/minute) (n = 15). Both groups had a higher exercise tolerance after training and when breathing oxygen. However, the oxygen-trained group increased the training work rate more rapidly than the air-trained group. The mean +/- SD work rate during the last week was 62 +/- 19 W (oxygen-trained group) and 52 +/- 22 W (air-trained group) (p < 0.01). After training, endurance in constant work rate tests increased more in the oxygen-trained group (14.5 minutes) than in the air-trained group (10.5 minutes) (p < 0.05). At isotime, the breathing rate decreased four breaths per minute in the oxygen-trained group and one breath per minute in the air-trained group (p = 0.001). We conclude that supplemental oxygen provided during high-intensity training yields higher training intensity and evidence of gains in exercise tolerance in laboratory testing.

  6. Effect of leak and breathing pattern on the accuracy of tidal volume estimation by commercial home ventilators: a bench study.

    PubMed

    Luján, Manel; Sogo, Ana; Pomares, Xavier; Monsó, Eduard; Sales, Bernat; Blanch, Lluís

    2013-05-01

    New home ventilators are able to provide clinicians data of interest through built-in software. Monitoring of tidal volume (VT) is a key point in the assessment of the efficacy of home mechanical ventilation. To assess the reliability of the VT provided by 5 ventilators in a bench test. Five commercial ventilators from 4 different manufacturers were tested in pressure support mode with the help of a breathing simulator under different conditions of mechanical respiratory pattern, inflation pressure, and intentional leakage. Values provided by the built-in software of each ventilator were compared breath to breath with the VT monitored through an external pneumotachograph. Ten breaths for each condition were compared for every tested situation. All tested ventilators underestimated VT (ranges of -21.7 mL to -83.5 mL, which corresponded to -3.6% to -14.7% of the externally measured VT). A direct relationship between leak and underestimation was found in 4 ventilators, with higher underestimations of the VT when the leakage increased, ranging between -2.27% and -5.42% for each 10 L/min increase in the leakage. A ventilator that included an algorithm that computes the pressure loss through the tube as a function of the flow exiting the ventilator had the minimal effect of leaks on the estimation of VT (0.3%). In 3 ventilators the underestimation was also influenced by mechanical pattern (lower underestimation with restrictive, and higher with obstructive). The inclusion of algorithms that calculate the pressure loss as a function of the flow exiting the ventilator in commercial models may increase the reliability of VT estimation.

  7. Predictors of response to a low-FODMAP diet in patients with functional gastrointestinal disorders and lactose or fructose intolerance.

    PubMed

    Wilder-Smith, C H; Olesen, S S; Materna, A; Drewes, A M

    2017-04-01

    Diets low in fermentable sugars (low-FODMAP diets) are increasingly adopted by patients with functional gastrointestinal disorders (FGID), but outcome predictors are unclear. To identify factors predictive of an efficacious response to a low-FODMAP diet in FGID patients with fructose or lactose intolerance thereby gaining insights into underlying mechanisms. Fructose and lactose breath tests were performed in FGID patients to determine intolerance (positive symptom score) and malabsorption (increased hydrogen or methane concentrations). Patients with fructose or lactose intolerance consumed a low-FODMAP diet and global adequate symptom relief was assessed after 6-8 weeks and correlated with pre-diet clinical symptoms and breath test results. A total of 81% of 584 patients completing the low-FODMAP diet achieved adequate relief, without significant differences between FGID subgroups or types of intolerance. Univariate analysis yielded predictive factors in fructose intolerance (chronic diarrhoea and pruritus, peak methane concentrations and fullness during breath tests) and lactose intolerance (peak hydrogen and methane concentrations and flatulence during breath tests). Using multivariate analysis, symptom relief was independently and positively predicted in fructose intolerance by chronic diarrhoea [odds ratio (95% confidence intervals): 2.62 (1.31-5.27), P = 0.007] and peak breath methane concentrations [1.53 (1.02-2.29), P = 0.042], and negatively predicted by chronic nausea [0.33 (0.16-0.67), P = 0.002]. No independent predictive factors emerged for lactose intolerance. Adequate global symptom relief was achieved with a low-FODMAP diet in a large majority of functional gastrointestinal disorders patients with fructose or lactose intolerance. Independent predictors of a satisfactory dietary outcome were only seen in fructose intolerant patients, and were indicative of changes in intestinal host or microbiome metabolism. © 2017 John Wiley & Sons Ltd.

  8. Tracking performance with two breathing oxygen concentrations after high altitude rapid decompression

    NASA Technical Reports Server (NTRS)

    Nesthus, Thomas E.; Schiflett, Samuel G.; Oakley, Carolyn J.

    1992-01-01

    Current military aircraft Liquid Oxygen (LOX) systems supply 99.5 pct. gaseous Aviator's Breathing Oxygen (ABO) to aircrew. Newer Molecular Sieve Oxygen Generation Systems (MSOGS) supply breathing gas concentration of 93 to 95 pct. O2. The margin is compared of hypoxia protection afforded by ABO and MSOGS breathing gas after a 5 psi differential rapid decompression (RD) in a hypobaric research chamber. The barometric pressures equivalent to the altitudes of 46000, 52000, 56000, and 60000 ft were achieved from respective base altitudes in 1 to 1.5 s decompressions. During each exposure, subjects remained at the simulated peak altitude breathing either 100 or 94 pct. O2 with positive pressure for 60 s, followed by a rapid descent to 40000 ft. Subjects used the Tactical Life Support System (TLSS) for high altitude protection. Subcritical tracking task performance on the Performance Evaluation Device (PED) provided psychomotor test measures. Overall tracking task performance results showed no differences between the MSOGS breathing O2 concentration of 94 pct. and ABO. Significance RMS error differences were found between the ground level and base altitude trials compared to peak altitude trials. The high positive breathing pressures occurring at the peak altitudes explained the differences.

  9. A quantitative evaluation of spurious results in the infrared spectroscopic measurement of CO2 isotope ratios

    NASA Astrophysics Data System (ADS)

    Mansfield, C. D.; Rutt, H. N.

    2002-02-01

    The possible generation of spurious results, arising from the application of infrared spectroscopic techniques to the measurement of carbon isotope ratios in breath, due to coincident absorption bands has been re-examined. An earlier investigation, which approached the problem qualitatively, fulfilled its aspirations in providing an unambiguous assurance that 13C16O2/12C16O2 ratios can be confidently measured for isotopic breath tests using instruments based on infrared absorption. Although this conclusion still stands, subsequent quantitative investigation has revealed an important exception that necessitates a strict adherence to sample collection protocol. The results show that concentrations and decay rates of the coincident breath trace compounds acetonitrile and carbon monoxide, found in the breath sample of a heavy smoker, can produce spurious results. Hence, findings from this investigation justify the concern that breath trace compounds present a risk to the accurate measurement of carbon isotope ratios in breath when using broadband, non-dispersive, ground state absorption infrared spectroscopy. It provides recommendations on the length of smoking abstention required to avoid generation of spurious results and also reaffirms, through quantitative argument, the validity of using infrared absorption spectroscopy to measure CO2 isotope ratios in breath.

  10. Aspiration tests in aqueous foam using a breathing simulator

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Archuleta, M.M.

    1995-12-01

    Non-toxic aqueous foams are being developed by Sandia National Laboratories (SNL) for the National Institute of Justice (NIJ) for use in crowd control, cell extractions, and group disturbances in the criminal justice prison systems. The potential for aspiration of aqueous foam during its use and the resulting adverse effects associated with complete immersion in aqueous foam is of major concern to the NIJ when examining the effectiveness and safety of using this technology as a Less-Than-Lethal weapon. This preliminary study was designed to evaluate the maximum quantity of foam that might be aspirated by an individual following total immersion inmore » an SNL-developed aqueous foam. A.T.W. Reed Breathing simulator equipped with a 622 Silverman cam was used to simulate the aspiration of an ammonium laureth sulfate aqueous foam developed by SNL and generated at expansion ratios in the range of 500:1 to 1000:1. Although the natural instinct of an individual immersed in foam is to cover their nose and mouth with a hand or cloth, thus breaking the bubbles and decreasing the potential for aspiration, this study was performed to examine a worst case scenario where mouth breathing only was examined, and no attempt was made to block foam entry into the breathing port. Two breathing rates were examined: one that simulated a sedentary individual with a mean breathing rate of 6.27 breaths/minute, and one that simulated an agitated or heavily breathing individual with a mean breathing rate of 23.7 breaths/minute. The results of this study indicate that, if breathing in aqueous foam without movement, an air pocket forms around the nose and mouth within one minute of immersion.« less

  11. A reservoir nasal cannula improves protection given by oxygen during muscular exercise in COPD.

    PubMed

    Arlati, S; Rolo, J; Micallef, E; Sacerdoti, C; Brambilla, I

    1988-06-01

    We verified the utility of an oxygen economizer (Pendant Oxymizer) in assuring greater protection than nasal prongs against worsening of oxyhemoglobin resting desaturation (delta SaO2) induced by muscular exercise in 16 patients (ten with chronic obstructive pulmonary disease [COPD] and six with restrictive pulmonary disease). This worsening was quantified as desaturation surface accumulated within five minutes of exercise and was expressed in arbitrary units (au). Each patient carried out the same exercise three times, in a randomized fashion (breathing air or breathing supplemental oxygen [3 L/min] delivered by either nasal prongs or by oxygen economizer). In patients with obstructive disease, delta SaO2 was reduced from 38 +/- 12.0 au when they were breathing air to 18.1 +/- 11.7 au when breathing oxygen by nasal prongs (p less than 0.001) and to 10.1 +/- 9.5 au when breathing oxygen by economizer (p less than 0.001). In patients with restrictive disease, delta SaO2 was reduced from 35.6 +/- 9.9 au when breathing air to 14.9 +/- 10.2 au breathing oxygen by nasal prongs (p less than 0.01) and to 13.7 +/- 10.3 au breathing oxygen by economizer (p less than 0.01). The difference between breathing by economizer and nasal prongs was significant (paired t-test; p less than 0.01) only in patients with COPD. One explanation could lie in the different values of the respiratory rate, which was significantly greater in patients with restrictive disease (20.7 +/- 1.2 breaths per minute at rest and 25.8 +/- 1.5 with exercise) than in patients with obstructive disease (15.3 +/- 1.2 breaths per minute at rest and 20.8 +/- 1.4 with exercise).

  12. Breath detection by transcutaneous electromyography of the diaphragm and the Graseby capsule in preterm infants.

    PubMed

    de Waal, Cornelia G; Kraaijenga, Juliette V; Hutten, Gerard J; de Jongh, Frans H; van Kaam, Anton H

    2017-12-01

    To compare triggering, breath detection and delay time of the Graseby capsule (GC) and transcutaneous electromyography of the diaphragm (dEMG) in spontaneous breathing preterm infants. In this observational study, a 30 minutes respiration measurement was conducted by respiratory inductance plethysmography (RIP), the GC, and dEMG in stable preterm infants. Triggering was investigated with an in vitro set-up using the Infant Flow ® SiPAP TM system. The possibility to optimize breath detection was tested by developing new algorithms with the abdominal RIP band (RIP AB ) as gold standard. In a subset of breaths, the delay time was calculated between the inspiratory onset in the RIP AB signal and in the GC and dEMG signal. Fifteen preterm infants with a mean gestational age of 28 ± 2 weeks and a mean birth weight of 1086 ± 317 g were included. In total, 14 773 breaths were analyzed. Based on the GC and dEMG signal, the Infant Flow ® SiPAP™ system, respectively, triggered 67.8% and 62.6% of the breaths. Breath detection was improved to 99.9% for the GC and 113.4% for dEMG in new algorithms. In 1492 stable breaths, the median delay time of inspiratory onset detection was +154 ms (IQR +118 to +164) in the GC and -50 ms (IQR -90 to -22) in the dEMG signal. Breath detection using the GC can be improved by optimizing the algorithm. Transcutaneous dEMG provides similar breath detection but with the advantage of detecting the onset of inspiration earlier than the GC. © 2017 Wiley Periodicals, Inc.

  13. Establishment of a Quick and Highly Accurate Breath Test for ALDH2 Genotyping

    PubMed Central

    Aoyama, Ikuo; Ohashi, Shinya; Amanuma, Yusuke; Hirohashi, Kenshiro; Mizumoto, Ayaka; Funakoshi, Makiko; Tsurumaki, Mihoko; Nakai, Yukie; Tanaka, Katsuyuki; Hanada, Mariko; Uesaka, Aki; Chiba, Tsutomu; Muto, Manabu

    2017-01-01

    Objectives: Acetaldehyde, the first metabolite of ethanol, is a definite carcinogen for the esophagus, head, and neck; and aldehyde dehydrogenase 2 (ALDH2) is a mitochondrial enzyme that catalyzes the metabolism of acetaldehyde. The ALDH2 genotype exists as ALDH2*1/*1 (active ALDH2), ALDH2*1/*2 (heterozygous inactive ALDH2), and ALDH2*2/*2 (homozygous inactive ALDH2). Many epidemiological studies have reported that ALDH2*2 carriers are at high risk for esophageal or head and neck squamous cell carcinomas by habitual drinking. Therefore, identification of ALDH2*2 carriers would be helpful for the prevention of those cancers, but there have been no methods suitable for mass screening to identify these individuals. Methods: One hundred and eleven healthy volunteers (ALDH2*1/*1 carriers: 53; ALDH2*1/*2 carriers: 48; and ALDH2*2/*2 carriers: 10) were recruited. Breath samples were collected after drinking 100 ml of 0.5% ethanol using specially designed gas bags, and breath ethanol and acetaldehyde levels were measured by semiconductor gas chromatography. Results: The median (range) breath acetaldehyde levels at 1 min after alcohol ingestion were 96.1 (18.1–399.0) parts per billion (p.p.b.) for the ALDH2*1/*1 genotype, 333.5 (78.4–1218.4) p.p.b. for the ALDH2*1/*2 genotype, and 537.1 (213.2–1353.8) p.p.b. for the ALDH2*2/*2 genotype. The breath acetaldehyde levels in ALDH2*2 carriers were significantly higher than for the ALDH2*1/*1 genotype. Notably, the ratio of breath acetaldehyde level-to-breath ethanol level could identify carriers of the ALDH2*2 allele very accurately (whole accuracy; 96.4%). Conclusions: Our novel breath test is a useful tool for identifying ALDH2*2 carriers, who are at high risk for esophageal and head and neck cancers. PMID:28594397

  14. Characterization of Carbon Dioxide Washout Measurement Techniques in the Mark-III Space Suit

    NASA Technical Reports Server (NTRS)

    Meginnis, Ian M.; Norcross, Jason; Bekdash, Omar; Ploutz-Snyder, Robert

    2016-01-01

    A space suit must provide adequate carbon dioxide (CO2) washout inside the helmet to prevent symptoms of hypercapnia. In the past, an oronasal mask has been used to measure the inspired air of suited subjects to determine a space suit's CO2 washout capability. While sufficient for super-ambient pressure testing of space suits, the oronasal mask fails to meet several human factors and operational criterion needed for future sub-ambient pressure testing (e.g. compatibility with a Valsalva device). This paper describes the evaluation of a nasal cannula as a device for measuring inspired air within a space suit. Eight test subjects were tasked with walking on a treadmill or operating an arm ergometer to achieve target metabolic rates of 1000, 2000, and 3000 British thermal units per hour (BTU/hr), at flow rates of 2, 4, and 6 actual cubic feet per minute (ACFM). Each test configuration was conducted twice, with subjects instructed to breathe either through their nose only, or however they felt comfortable. Test data shows that the nasal cannula provides more statistically consistent data across test subjects than the oronasal mask used in previous tests. The data also shows that inhaling/exhaling through only the nose provides a lower sample variance than a normal breathing style. Nose-only breathing reports better CO2 washout due to several possible reasons, including a decreased respiratory rate, an increased tidal volume, and because nose-only breathing directs all of the exhaled CO2 down and away from the oronasal region. The test subjects in this study provided feedback that the nasal cannula is comfortable and can be used with the Valsalva device.

  15. The Influences of Exposure Pattern and Duration on Elimination Kinetics and Exposure Assessment of Tetrachloroethylene in Humans. Yeh-Chung Chien

    EPA Pesticide Factsheets

    The current investigation was designed and conducted to examine the body kinetic behaviors by means of breath analysis under various exposure conditions to test the validity of using exhaled breath as a biological marker of exposure.

  16. Performance evaluation of the Puritan-Bennett Crew-member portable protective breathing device as prescribed by portions of FAA Action Notice A-8150.2.

    DOT National Transportation Integrated Search

    1989-05-01

    This study was undertaken, on request, to evaluate the performance of the Puritan-Bennett portable crew protective breathing device for contaminant leaks. O2, CO2 levels, inhalation/exhalation pressure, and inhalation temperature. Tests were conducte...

  17. Portable Breathing Assembly

    NASA Image and Video Library

    2017-06-12

    In the Space Station Processing Facility at NASA's Kennedy Space Center in Florida, Jacobs Test and Operations Support Contract, or TOSC, technicians fill portable breathing apparatuses, or PBAS. The PBAs are to be use on board the International Space Staton to provide astronauts with breathable air in the event of a fire or other emergency situation.

  18. Crew equipment applications - Firefighter's Breathing System.

    NASA Technical Reports Server (NTRS)

    Smith, W. L.

    1973-01-01

    The Firefighter's Breathing System (FBS) represents a significant step in applying NASA's crew equipment technologists and technologies to civilian sector problems. This paper describes the problem, the utilization of user-design committees as a forum for development of design goals, the design of the FBS, and the field test program to be conducted.

  19. Slow Breathing and Hypoxic Challenge: Cardiorespiratory Consequences and Their Central Neural Substrates

    PubMed Central

    Critchley, Hugo D.; Nicotra, Alessia; Chiesa, Patrizia A.; Nagai, Yoko; Gray, Marcus A.; Minati, Ludovico; Bernardi, Luciano

    2015-01-01

    Controlled slow breathing (at 6/min, a rate frequently adopted during yoga practice) can benefit cardiovascular function, including responses to hypoxia. We tested the neural substrates of cardiorespiratory control in humans during volitional controlled breathing and hypoxic challenge using functional magnetic resonance imaging (fMRI). Twenty healthy volunteers were scanned during paced (slow and normal rate) breathing and during spontaneous breathing of normoxic and hypoxic (13% inspired O2) air. Cardiovascular and respiratory measures were acquired concurrently, including beat-to-beat blood pressure from a subset of participants (N = 7). Slow breathing was associated with increased tidal ventilatory volume. Induced hypoxia raised heart rate and suppressed heart rate variability. Within the brain, slow breathing activated dorsal pons, periaqueductal grey matter, cerebellum, hypothalamus, thalamus and lateral and anterior insular cortices. Blocks of hypoxia activated mid pons, bilateral amygdalae, anterior insular and occipitotemporal cortices. Interaction between slow breathing and hypoxia was expressed in ventral striatal and frontal polar activity. Across conditions, within brainstem, dorsal medullary and pontine activity correlated with tidal volume and inversely with heart rate. Activity in rostroventral medulla correlated with beat-to-beat blood pressure and heart rate variability. Widespread insula and striatal activity tracked decreases in heart rate, while subregions of insular cortex correlated with momentary increases in tidal volume. Our findings define slow breathing effects on central and cardiovascular responses to hypoxic challenge. They highlight the recruitment of discrete brainstem nuclei to cardiorespiratory control, and the engagement of corticostriatal circuitry in support of physiological responses that accompany breathing regulation during hypoxic challenge. PMID:25973923

  20. Bench test evaluation of adaptive servoventilation devices for sleep apnea treatment.

    PubMed

    Zhu, Kaixian; Kharboutly, Haissam; Ma, Jianting; Bouzit, Mourad; Escourrou, Pierre

    2013-09-15

    Adaptive servoventilation devices are marketed to overcome sleep disordered breathing with apneas and hypopneas of both central and obstructive mechanisms often experienced by patients with chronic heart failure. The clinical efficacy of these devices is still questioned. This study challenged the detection and treatment capabilities of the three commercially available adaptive servoventilation devices in response to sleep disordered breathing events reproduced on an innovative bench test. The bench test consisted of a computer-controlled piston and a Starling resistor. The three devices were subjected to a flow sequence composed of central and obstructive apneas and hypopneas including Cheyne-Stokes respiration derived from a patient. The responses of the devices were separately evaluated with the maximum and the clinical settings (titrated expiratory positive airway pressure), and the detected events were compared to the bench-scored values. The three devices responded similarly to central events, by increasing pressure support to raise airflow. All central apneas were eliminated, whereas hypopneas remained. The three devices responded differently to the obstructive events with the maximum settings. These obstructive events could be normalized with clinical settings. The residual events of all the devices were scored lower than bench test values with the maximum settings, but were in agreement with the clinical settings. However, their mechanisms were misclassified. The tested devices reacted as expected to the disordered breathing events, but not sufficiently to normalize the breathing flow. The device-scored results should be used with caution to judge efficacy, as their validity depends upon the initial settings.

  1. 49 CFR 40.267 - What problems always cause an alcohol test to be cancelled?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... the case of a screening test conducted on a saliva ASD or a breath tube ASD: (1) The STT or BAT reads... § 40.245(a)(8) for the saliva ASD and § 40.245(b)(8) for the breath tube ASD). (2) The saliva ASD does... printed on the device or on its package (see § 40.245(a)(1) for the saliva ASD and § 40.245(b)(1) for the...

  2. [Breath tests in children with suspected lactose intolerance].

    PubMed

    Parra, P Ángela; Furió, C Simone; Arancibia, A Gabriel

    2015-01-01

    Up to 70% of the world population is lactose intolerance. However, there are no epidemiological studies among Chilean pediatric population affected by this condition. Clinical characterization of a series of children who underwent the lactose intolerance breath test for lactose intolerance study, establishing intolerance and malabsorption frequencies, the most frequent symptoms, and test performance depending on the origin. Patients under 18 years old who took the lactose intolerance breath test in the Gastroenterology Laboratory of the Catholic University of Chile, and who were admitted due to clinically suspected lactose intolerance. Malabsorption was considered when there was as an increase of ≥20ppm above the baseline (H2) or ≥34ppm of H2 and methane (CH4) combined. Intolerance was considered when the above was associated with a symptom intensity score ≥7 during registration. The analysis included194 patients aged 1 to17 years of age. Of these, 102 (53%) presented with malabsorption, and 53 (27%) were intolerant. The frequency of lactose intolerance varied from 7.1 to 45.4%, and it occurred more frequently at older ages. The most common reported symptoms were abdominal pain, bloating and rumbling. Lactose malabsorption and intolerance can be investigated from the first years of life using the lactose breath test plus a symptom questionnaire. An increase in the frequency of intolerance with age, and a greater number of positive tests, if they were requested by a gastroenterologist, were observed. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Measurement of breath acetone in patients referred for an oral glucose tolerance test.

    PubMed

    Andrews, Brian Terence; Denzer, Wolfgang; Hancock, Gus; Lunn, Dan; Peverall, Robert; Ritchie, Grant; Williams, Karen

    2018-04-12

    Breath acetone concentrations were measured in 141 subjects (aged 19-91 yrs, mean=59.11yrs standard deviation=12.99yrs), male and female, undergoing an oral glucose tolerance test (OGTT), having been referred to clinic on suspicion of type 2 diabetes. Breath samples were measured using an ion-molecule-reaction mass spectrometer, at the commencement of the OGTT, and after 1 and 2hrs. Subjects were asked to observe the normal routine before and during the OGTT, which includes an overnight fast and ingestion of 75g glucose at the beginning of the routine. Several groups of diagnosis were identified: type 2 Diabetes Mellitus positive (T2DM), n=22; impaired glucose intolerance (IGT), n=33; impaired fasting glucose (IFG), n=14; and reactive hypoglycaemia (RHG), n=5. The subjects with no diagnosis (i.e. normoglycaemia) were used as a control group, n=67. Distributions of breath acetone are presented for the different groups. There was no evidence of a direct relationship between blood glucose and acetone measurements at any time during the study (0hr: p=0.4482; 1hr: p=0.6854; and 2hr: p=0.1858). Nor were there significant differences between the measurements of breath acetone for the control group and the T2DM group (0hr: p=0.1759; 1hr: p=0.4521; and 2hr: p=0.7343). However, the ratio of breath acetone at 1hr to the initial breath acetone was found to be significantly different for the T2DM group compared to both the control and IGT groups (p=0.0189 and 0.011, respectively). The T2DM group was also found to be different in terms of ratio of breath acetone after 1hr to that at 2hrs during the OGTT. And was distinctive in that it showed a significant dependence upon the level of blood glucose at 2hrs (p=0.0146). We conclude that single measurements of the concentrations of breath acetone cannot be used as a potential screening diagnostic for T2DM diabetes in this cohort, but monitoring the evolution of breath acetone could open a non-invasive window to aid in the diagnosis of metabolic conditions. © 2018 IOP Publishing Ltd.

  4. Effects of respiration depth on human body radar cross section Using 2.4GHz continuous wave radar.

    PubMed

    Lee, Alexander; Xiaomeng Gao; Jia Xu; Boric-Lubecke, Olga

    2017-07-01

    In this study, it was tested whether deep and shallow breathing has an effect on the cardiopulmonary radar cross-section (RCS). Continuous wave radar with quadrature architecture at 2.4GHz was used to test 2 human subjects breathing deep and shallow for 30 seconds each while seated 2 meters away from the radar. A retro-reflective marker was placed on the sternum of each subject and measured by infrared motion capture cameras to accurately track displacement of the chest. The quadrature radar outputs were processed to find the radius of the arc on the IQ plot using a circle-fitting algorithm. Results showed that the effective RCS ratio of deep to shallow breathing for subjects 1 and 2 was 6.99 and 2.24 respectively.

  5. Carotid chemoreceptors tune breathing via multipath routing: reticular chain and loop operations supported by parallel spike train correlations.

    PubMed

    Morris, Kendall F; Nuding, Sarah C; Segers, Lauren S; Iceman, Kimberly E; O'Connor, Russell; Dean, Jay B; Ott, Mackenzie M; Alencar, Pierina A; Shuman, Dale; Horton, Kofi-Kermit; Taylor-Clark, Thomas E; Bolser, Donald C; Lindsey, Bruce G

    2018-02-01

    We tested the hypothesis that carotid chemoreceptors tune breathing through parallel circuit paths that target distinct elements of an inspiratory neuron chain in the ventral respiratory column (VRC). Microelectrode arrays were used to monitor neuronal spike trains simultaneously in the VRC, peri-nucleus tractus solitarius (p-NTS)-medial medulla, the dorsal parafacial region of the lateral tegmental field (FTL-pF), and medullary raphe nuclei together with phrenic nerve activity during selective stimulation of carotid chemoreceptors or transient hypoxia in 19 decerebrate, neuromuscularly blocked, and artificially ventilated cats. Of 994 neurons tested, 56% had a significant change in firing rate. A total of 33,422 cell pairs were evaluated for signs of functional interaction; 63% of chemoresponsive neurons were elements of at least one pair with correlational signatures indicative of paucisynaptic relationships. We detected evidence for postinspiratory neuron inhibition of rostral VRC I-Driver (pre-Bötzinger) neurons, an interaction predicted to modulate breathing frequency, and for reciprocal excitation between chemoresponsive p-NTS neurons and more downstream VRC inspiratory neurons for control of breathing depth. Chemoresponsive pericolumnar tonic expiratory neurons, proposed to amplify inspiratory drive by disinhibition, were correlationally linked to afferent and efferent "chains" of chemoresponsive neurons extending to all monitored regions. The chains included coordinated clusters of chemoresponsive FTL-pF neurons with functional links to widespread medullary sites involved in the control of breathing. The results support long-standing concepts on brain stem network architecture and a circuit model for peripheral chemoreceptor modulation of breathing with multiple circuit loops and chains tuned by tegmental field neurons with quasi-periodic discharge patterns. NEW & NOTEWORTHY We tested the long-standing hypothesis that carotid chemoreceptors tune the frequency and depth of breathing through parallel circuit operations targeting the ventral respiratory column. Responses to stimulation of the chemoreceptors and identified functional connectivity support differential tuning of inspiratory neuron burst duration and firing rate and a model of brain stem network architecture incorporating tonic expiratory "hub" neurons regulated by convergent neuronal chains and loops through rostral lateral tegmental field neurons with quasi-periodic discharge patterns.

  6. A rapid non invasive L-DOPA-¹³C breath test for optimally suppressing extracerebral AADC enzyme activity - toward individualizing carbidopa therapy in Parkinson’s disease.

    PubMed

    Modak, Anil; Durso, Raymon; Josephs, Ephraim; Rosen, David

    2012-01-01

    Peripheral carbidopa (CD) levels directly impact on central dopamine (DA) production in Parkinson disease (PD) through extracerebral inhibition of dopa decarboxylase (AADC) resulting in an increase in levodopa (LD) bioavailability. Recent data suggests that higher CD doses than those presently used in PD treatment may result in improved clinical response. Optimizing CD doses in individual patients may, therefore, result in ideal individualized treatment. A single center, randomized, double-blind study was carried out recruiting 5 Parkinson’s disease (PD) patients already on LD/CD and 1 treatment näve PD patient using stable isotope labeled LD-1-¹³C as a substrate for a noninvasive breath test to evaluate individual AADC enzyme activity. Each patient was studied five times, receiving 200 mg LD-¹³C at each visit along with one of five randomized CD doses (0, 25, 50, 100 and 200 mg). The metabolite ¹³CO₂ in breath was measured for evaluating AADC enzyme activity and plasma metabolite levels for LD-¹³C and homovanillic acid (HVA) were measured for 4 hours. HVA in plasma and ¹³CO₂ in breath are metabolic products of LD. We found a significant positive correlation of ¹³CO₂ DOB AUC0-240 with serum HVA AUC0-240 following the oral dose of LD-1-¹³C for all 5 doses of CD (r² = 0.9378). With increasing inhibition of AADC enzyme activity with CD, we observed an increase in the plasma concentration of LD.We found an inverse correlation of the 13CO2 DOB AUC with serum LD-¹³C AUC. Our studies indicate the optimal dose of CD for maximal suppression of AADC enzyme activity can be determined for each individual from ¹³CO₂ generation in breath. The LD-breath test can be a useful noninvasive diagnostic tool for evaluation of AADC enzyme activity using the biomarker ¹³CO₂ in breath, a first step in personalizing CD doses for PD patients.

  7. Breathing Maneuvers as a Vasoactive Stimulus for Detecting Inducible Myocardial Ischemia – An Experimental Cardiovascular Magnetic Resonance Study

    PubMed Central

    Fischer, Kady; Guensch, Dominik P; Shie, Nancy; Lebel, Julie; Friedrich, Matthias G

    2016-01-01

    Background Breathing maneuvers can elicit a similar vascular response as vasodilatory agents like adenosine; yet, their potential diagnostic utility in the presence of coronary artery stenosis is unknown. The objective of the study is to investigate if breathing maneuvers can non-invasively detect inducible ischemia in an experimental animal model when the myocardium is imaged with oxygenation-sensitive cardiovascular magnetic resonance (OS-CMR). Methods and Findings In 11 anesthetised swine with experimentally induced significant stenosis (fractional flow reserve <0.75) of the left anterior descending coronary artery (LAD) and 9 control animals, OS-CMR at 3T was performed during two different breathing maneuvers, a long breath-hold; and a combined maneuver of 60s of hyperventilation followed by a long breath-hold. The resulting change of myocardial oxygenation was compared to the invasive measurements of coronary blood flow, blood gases, and oxygen extraction. In control animals, all breathing maneuvers could significantly alter coronary blood flow as hyperventilation decreased coronary blood flow by 34±23%. A long breath-hold alone led to an increase of 97±88%, while the increase was 346±327% (p<0.001), when the long breath-hold was performed after hyperventilation. In stenosis animals, the coronary blood flow response was attenuated after both hyperventilation and the following breath-hold. This was matched by the observed oxygenation response as breath-holds following hyperventilation consistently yielded a significant difference in the signal of the MRI images between the perfusion territory of the stenosis LAD and remote myocardium. There was no difference between the coronary territories during the other breathing maneuvers or in the control group at any point. Conclusion In an experimental animal model, the response to a combined breathing maneuver of hyperventilation with subsequent breath-holding is blunted in myocardium subject to significant coronary artery stenosis. This maneuver may allow for detecting severe coronary artery stenosis and have a significant clinical potential as a non-pharmacological method for diagnostic testing in patients with suspected coronary artery disease. PMID:27741282

  8. A mind you can count on: validating breath counting as a behavioral measure of mindfulness.

    PubMed

    Levinson, Daniel B; Stoll, Eli L; Kindy, Sonam D; Merry, Hillary L; Davidson, Richard J

    2014-01-01

    Mindfulness practice of present moment awareness promises many benefits, but has eluded rigorous behavioral measurement. To date, research has relied on self-reported mindfulness or heterogeneous mindfulness trainings to infer skillful mindfulness practice and its effects. In four independent studies with over 400 total participants, we present the first construct validation of a behavioral measure of mindfulness, breath counting. We found it was reliable, correlated with self-reported mindfulness, differentiated long-term meditators from age-matched controls, and was distinct from sustained attention and working memory measures. In addition, we employed breath counting to test the nomological network of mindfulness. As theorized, we found skill in breath counting associated with more meta-awareness, less mind wandering, better mood, and greater non-attachment (i.e., less attentional capture by distractors formerly paired with reward). We also found in a randomized online training study that 4 weeks of breath counting training improved mindfulness and decreased mind wandering relative to working memory training and no training controls. Together, these findings provide the first evidence for breath counting as a behavioral measure of mindfulness.

  9. The relationship between self-efficacy and reductions in smoking in a contingency management procedure.

    PubMed

    Romanowich, Paul; Mintz, Jim; Lamb, R J

    2009-06-01

    Social--cognitive and behavioral theories of change disagree on what the relevant controlling variables for initiating behavior change are. Correlations between baseline smoking cessation self-efficacy and the changes in breath carbon monoxide (CO) and the reduction in breath CO and increases in smoking cessation self-efficacy from baseline were obtained from a contingency management smoking cessation procedure. A test of the difference between the cross-lag correlations suggested a nonspurious causal relationship between smoking cessation self-efficacy and changes in breath CO. Path analyses showed that decreases in breath CO (reductions in smoking) predicted later increases in smoking cessation self-efficacy. Baseline self-reports of smoking cessation self-efficacy were not significantly correlated with subsequent changes in breath CO. Rather, significant correlations were found between reductions in breath CO and later increases in smoking cessation self-efficacy. These results suggest that self-efficacy may be a cognitive response to one's own behavior, and are inconsistent with a social--cognitive view of self-efficacy's role in behavior change. Implications for the development of smoking cessation programs and health-promoting behavior changes in general are discussed.

  10. A prototype gas exchange monitor for exercise stress testing aboard NASA Space Station

    NASA Technical Reports Server (NTRS)

    Orr, Joseph A.; Westenskow, Dwayne R.; Bauer, Anne

    1989-01-01

    This paper describes an easy-to-use monitor developed to track the weightlessness deconditioning aboard the NASA Space Station, together with the results of testing of a prototype instrument. The monitor measures the O2 uptake and CO2 production, and calculates the maximum O2 uptake and anaerobic threshold during an exercise stress test. The system uses two flowmeters in series to achieve a completely automatic calibration, and uses breath-by-breath compensation for sample line-transport delay. The monitor was evaluated using two laboratory methods and was shown to be accurate. The system's block diagram and the bench test setup diagram are included.

  11. Patients' experiences of breathing retraining for asthma: a qualitative process analysis of participants in the intervention arms of the BREATHE trial.

    PubMed

    Arden-Close, Emily; Yardley, Lucy; Kirby, Sarah; Thomas, Mike; Bruton, Anne

    2017-10-05

    Poor symptom control and impaired quality of life are common in adults with asthma, and breathing retraining exercises may be an effective method of self-management. This study aimed to explore the experiences of participants in the intervention arms of the BREATHE trial, which investigated the effectiveness of breathing retraining as a mode of asthma management. Sixteen people with asthma (11 women, 8 per group) who had taken part in the intervention arms of the BREATHE trial (breathing retraining delivered by digital versatile disc (DVD) or face-to-face sessions with a respiratory physiotherapist) took part in semi-structured telephone interviews about their experiences. Interviews were analysed using thematic analysis. Breathing retraining was perceived positively as a method of asthma management. Motivations for taking part included being asked, to enhance progress in research, to feel better/reduce symptoms, and to reduce medication. Participants were positive about the physiotherapist, liked having the materials tailored, found meetings motivational, and liked the DVD and booklet. The impact of breathing retraining following regular practice included increased awareness of breathing and development of new habits. Benefits of breathing retraining included increased control over breathing, reduced need for medication, feeling more relaxed, and improved health and quality of life. Problems included finding time to practice the exercises, and difficulty mastering techniques. Breathing retraining was acceptable and valued by almost all participants, and many reported improved wellbeing. Face to face physiotherapy was well received. However, some participants in the DVD group mentioned being unable to master techniques. PATIENTS RECEPTIVE TO BREATHING RETRAINING: Patients with asthma taught how to change their unconscious breathing patterns generally like non-pharmacological interventions. Researchers in the UK, led by Mike Thomas from the University of Southampton, interviewed 16 people about their experiences in a trial that tested breathing retraining exercises delivered by DVD or face-to-face sessions with a respiratory physiotherapist. Overwhelmingly, trial participants reported that breathing retraining sessions gave them greater control over their symptoms, helped them relax, improved their quality of life and reduced the need for medications. Some participants who received DVD instruction said they had trouble mastering the techniques, and many in both groups found it hard to find time to practice the exercises. Overall, however, patients were positive about the experience. The authors conclude that breathing exercises are likely to be a well-received method of asthma management.

  12. Chemical analysis of whale breath volatiles: a case study for non-invasive field health diagnostics of marine mammals.

    PubMed

    Cumeras, Raquel; Cheung, William H K; Gulland, Frances; Goley, Dawn; Davis, Cristina E

    2014-09-12

    We explored the feasibility of collecting exhaled breath from a moribund gray whale (Eschrichtius robustus) for potential non-invasive health monitoring of marine mammals. Biogenic volatile organic compound (VOC) profiling is a relatively new field of research, in which the chemical composition of breath is used to non-invasively assess the health and physiological processes on-going within an animal or human. In this study, two telescopic sampling poles were designed and tested with the primary aim of collecting whale breath exhalations (WBEs). Once the WBEs were successfully collected, they were immediately transferred onto a stable matrix sorbent through a custom manifold system. A total of two large volume WBEs were successfully captured and pre-concentrated onto two Tenax®-TA traps (one exhalation per trap). The samples were then returned to the laboratory where they were analyzed using solid phase micro extraction (SPME) and gas chromatography/mass spectrometry (GC/MS). A total of 70 chemicals were identified (58 positively identified) in the whale breath samples. These chemicals were also matched against a database of VOCs found in humans, and 44% of chemicals found in the whale breath are also released by healthy humans. The exhaled gray whale breath showed a rich diversity of chemicals, indicating the analysis of whale breath exhalations is a promising new field of research.

  13. Enriched Air Nitrox Breathing Reduces Venous Gas Bubbles after Simulated SCUBA Diving: A Double-Blind Cross-Over Randomized Trial.

    PubMed

    Souday, Vincent; Koning, Nick J; Perez, Bruno; Grelon, Fabien; Mercat, Alain; Boer, Christa; Seegers, Valérie; Radermacher, Peter; Asfar, Pierre

    2016-01-01

    To test the hypothesis whether enriched air nitrox (EAN) breathing during simulated diving reduces decompression stress when compared to compressed air breathing as assessed by intravascular bubble formation after decompression. Human volunteers underwent a first simulated dive breathing compressed air to include subjects prone to post-decompression venous gas bubbling. Twelve subjects prone to bubbling underwent a double-blind, randomized, cross-over trial including one simulated dive breathing compressed air, and one dive breathing EAN (36% O2) in a hyperbaric chamber, with identical diving profiles (28 msw for 55 minutes). Intravascular bubble formation was assessed after decompression using pulmonary artery pulsed Doppler. Twelve subjects showing high bubble production were included for the cross-over trial, and all completed the experimental protocol. In the randomized protocol, EAN significantly reduced the bubble score at all time points (cumulative bubble scores: 1 [0-3.5] vs. 8 [4.5-10]; P < 0.001). Three decompression incidents, all presenting as cutaneous itching, occurred in the air versus zero in the EAN group (P = 0.217). Weak correlations were observed between bubble scores and age or body mass index, respectively. EAN breathing markedly reduces venous gas bubble emboli after decompression in volunteers selected for susceptibility for intravascular bubble formation. When using similar diving profiles and avoiding oxygen toxicity limits, EAN increases safety of diving as compared to compressed air breathing. ISRCTN 31681480.

  14. 78 FR 26849 - Model Specifications for Breath Alcohol Ignition Interlock Devices (BAIIDs)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-08

    ...--Acetone Test 14--Emergency Override Test 15--Radiofrequency Interference/Electromagnetic Interference Test... requirements; temperature extreme testing; radio frequency interference (RFI) or electromagnetic interference...

  15. A comparison between lactose breath test and quick test on duodenal biopsies for diagnosing lactase deficiency in patients with self-reported lactose intolerance.

    PubMed

    Furnari, Manuele; Bonfanti, Daria; Parodi, Andrea; Franzè, Jolanda; Savarino, Edoardo; Bruzzone, Luca; Moscatelli, Alessandro; Di Mario, Francesco; Dulbecco, Pietro; Savarino, Vincenzo

    2013-02-01

    A lactose breath test (LBT) is usually used to diagnose lactase deficiency, and a lactose quick test (LQT) has been proposed as a new test on duodenal biopsies to detect this disorder. We aimed to assess the diagnostic accuracy of LBT and LQT and their ability to predict the clinical response to a lactose-free diet in patients with self-reported lactose intolerance. Fifty-five patients (age 47 ± 14 y; M/F 15/36) underwent upper gastrointestinal endoscopy and 25g-LBT. Two duodenal biopsies were taken to determine lactase deficiency (normal, mild, or severe) by LQT and to rule out other causes of secondary lactose malabsorption. Patients with a positive LBT and normal LQT also underwent a glucose breath test to exclude small intestinal bacterial overgrowth as a cause of the former result. The severity of gastrointestinal symptoms was measured with a GSS questionnaire, under basal condition and 1 month after a lactose-free diet. Lactose malabsorption was detected in 31/51 patients with LBT and in 37/51 patients with LQT (P = NS). Celiac disease was found in 2 patients. Two LBT+ patients showed a positive glucose breath test for small intestinal bacterial overgrowth. Eight patients had a mild hypolactasia by LQT and a negative LBT, but they had a significant improvement of symptoms after diet. LQT and LBT were concordant in 83% of cases and predicted the response to a lactose-free diet in 98% and 81% of the cases, respectively (P = 0.03). LQT is as sensitive as LBT in detecting lactase deficiency; however, it seems to be more accurate than LBT in predicting the clinical response to a lactose-free diet.

  16. Mosapride Accelerates the Delayed Gastric Emptying of High-Viscosity Liquids: A Crossover Study Using Continuous Real-Time 13C Breath Test (BreathID System)

    PubMed Central

    Sakamoto, Yasunari; Sekino, Yusuke; Yamada, Eiji; Ohkubo, Hidenori; Higurashi, Takuma; Sakai, Eiji; Iida, Hiroshi; Hosono, Kunihiro; Endo, Hiroki; Nonaka, Takashi; Ikeda, Tamon; Fujita, Koji; Yoneda, Masato; Koide, Tomoko; Takahashi, Hirokazu; Goto, Ayumu; Abe, Yasunobu; Gotoh, Eiji; Maeda, Shin; Nakajima, Atsushi

    2011-01-01

    Background/Aims The administration of liquid nutrients to patients is often accompanied by complications such as gastroesophageal reflux. To prevent gastroesophageal reflux, high-viscosity liquid meals are used widely, however, it still remains controversial whether high-viscosity liquid meals have any effect on the rate of gastric emptying. The present study was conducted with the aim of determining whether high-viscosity liquid meals had any effect on the rate of gastric emptying and mosapride might accelerate the rate of gastric emptying of high-viscosity liquid meals. Methods Six healthy male volunteers underwent 3 tests at intervals of > 1 week. After fasting for > 8 hours, each subject received one of three test meals (liquid meal only, high-viscosity liquid meal [liquid meal plus pectin] only, or high-viscosity liquid meal 30 minutes after intake of mosapride). A 13C-acetic acid breath test was performed, which monitored the rate of gastric emptying for 4 hours. Using the Oridion Research Software (β version), breath test parameters were calculated. The study parameters were examined for all the 3 test conditions and compared using the Freidman test. Results Gastric emptying was significantly delayed following intake of a high-viscosity liquid meal alone as compared with a liquid meal alone; however, intake of mosapride prior to a high-viscosity liquid meal was associated with a significantly accelerated rate of gastric emptying as compared with a high-viscosity liquid meal alone. Conclusions This study showed that high-viscosity liquid meals delayed gastric emptying: however, mosapride recovered the delayed rate of gastric emptying by high-viscosity liquid meals. PMID:22148109

  17. PERIODIC AIR-BREATHING BEHAVIOUR IN A PRIMITIVE FISH REVEALED BY SPECTRAL ANALYSIS

    PubMed

    Hedrick; Katz; Jones

    1994-12-01

    The ventilatory patterns of air-breathing fish are commonly described as 'arrhythmic' or 'irregular' because the variable periods of breath-holding are punctuated by seemingly unpredictable air-breathing events (see Shelton et al. 1986). This apparent arrhythmicity contrasts with the perceived periodism or regularity in the gill ventilation patterns of some fish and with lung ventilation in birds and mammals. In this sense, periodism refers to behaviour that occurs with a definite, recurring interval (Bendat and Piersol, 1986). The characterisation of aerial ventilation patterns in fish as 'aperiodic' has been generally accepted on the basis of qualitative examination and it remains to be validated with rigorous testing. The bowfin, Amia calva (L.), is a primitive air-breathing fish that makes intermittent excursions to the air­water interface to gulp air, which is transferred to its well-vascularized gas bladder. Its phylogenetic position as the only extant member of the sister lineage of modern teleosts affords a unique opportunity to examine the evolution of aerial ventilation and provides a model for the examination of ventilatory patterns in primitive fishes. To establish whether Amia calva exhibit a particular pattern of air-breathing, we examined time series records of aerial ventilations from undisturbed fish over long periods (8 h). These records were the same as those used to calculate average ventilation intervals under a variety of experimental conditions (Hedrick and Jones, 1993). Their study also reported the occurrence of two distinct breath types. Type I breaths were characterised by an exhalation followed by an inhalation, whereas type II breaths were characterised by inhalation only. It was also hypothesized that the type I breaths were employed to meet oxygen demands, whereas the type II breaths were used to regulate gas bladder volume. However, they did not investigate the potential presence of a periodic ventilatory pattern. We now report the results of just such an analysis of ventilatory pattern that demonstrates a clear periodism to air-breathing in a primitive fish.

  18. Bench experiments comparing simulated inspiratory effort when breathing helium-oxygen mixtures to that during positive pressure support with air.

    PubMed

    Martin, Andrew R; Katz, Ira M; Jenöfi, Katharina; Caillibotte, Georges; Brochard, Laurent; Texereau, Joëlle

    2012-10-03

    Inhalation of helium-oxygen (He/O2) mixtures has been explored as a means to lower the work of breathing of patients with obstructive lung disease. Non-invasive ventilation (NIV) with positive pressure support is also used for this purpose. The bench experiments presented herein were conducted in order to compare simulated patient inspiratory effort breathing He/O2 with that breathing medical air, with or without pressure support, across a range of adult, obstructive disease patterns. Patient breathing was simulated using a dual-chamber mechanical test lung, with the breathing compartment connected to an ICU ventilator operated in NIV mode with medical air or He/O2 (78/22 or 65/35%). Parabolic or linear resistances were inserted at the inlet to the breathing chamber. Breathing chamber compliance was also varied. The inspiratory effort was assessed for the different gas mixtures, for three breathing patterns, with zero pressure support (simulating unassisted spontaneous breathing), and with varying levels of pressure support. Inspiratory effort increased with increasing resistance and decreasing compliance. At a fixed resistance and compliance, inspiratory effort increased with increasing minute ventilation, and decreased with increasing pressure support. For parabolic resistors, inspiratory effort was lower for He/O2 mixtures than for air, whereas little difference was measured for nominally linear resistance. Relatively small differences in inspiratory effort were measured between the two He/O2 mixtures. Used in combination, reductions in inspiratory effort provided by He/O2 and pressure support were additive. The reduction in inspiratory effort afforded by breathing He/O2 is strongly dependent on the severity and type of airway obstruction. Varying helium concentration between 78% and 65% has small impact on inspiratory effort, while combining He/O2 with pressure support provides an additive reduction in inspiratory effort. In addition, breathing He/O2 alone may provide an alternative to pressure support in circumstances where NIV is not available or poorly tolerated.

  19. Organic Gas Sensor with an Improved Lifetime for Detecting Breath Ammonia in Hemodialysis Patients.

    PubMed

    Chuang, Ming-Yen; Chen, Chang-Chiang; Zan, Hsiao-Wen; Meng, Hsin-Fei; Lu, Chia-Jung

    2017-12-22

    In this work, a TFB (poly[(9,9-dioctylfluorenyl-2,7-diyl)-co-(4,4'-(N-(4-s-butylphenyl)diphenylamine)]) sensor with a cylindrical nanopore structure exhibits a high sensitivity to ammonia in ppb-regime. The lifetime and sensitivity of the TFB sensor were studied and compared to those of P3HT (poly(3-hexylthiophene)), NPB (N,N'-di(1-naphthyl)-N,N'-diphenyl-(1,1'-biphenyl)-4,4'-diamine), and TAPC (4,4'-cyclohexylidenebis[N,N-bis(4-methylphenyl) benzenamine]) sensors with the same cylindrical nanopore structures. The TFB sensor outstands the others in sensitivity and lifetime and it shows a sensing response (current variation ratio) of 13% to 100 ppb ammonia after 64 days of storage in air. A repeated sensing periods testing and a long-term measurement have also been demonstrated for the test of robustness. The performance of the TFB sensor is stable in both tests, which reveals that the TFB sensor can be utilized in our targeting clinical trials. In the last part of this work, we study the change of ammonia concentration in the breath of hemodialysis (HD) patients before and after dialysis. An obvious drop of breath ammonia concentration can be observed after dialysis. The reduction of breath ammonia is also correlated with the reduction of blood urea nitrogen (BUN). A correlation coefficient of 0.82 is achieved. The result implies that TFB sensor may be used as a real-time and low cost breath ammonia sensor for the daily tracking of hemodialysis patients.

  20. Breath carbon stable isotope ratios identify changes in energy balance and substrate utilization in humans

    USDA-ARS?s Scientific Manuscript database

    Rapid detection of shifts in substrate utilization and energy balance would provide a compelling biofeedback tool to enable individuals to lose weight. In a pilot study, we tested whether the natural abundance of exhaled carbon stable isotope ratios (breath d13C values) reflects shifts between negat...

  1. COPD Learn More Breathe Better® | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this may be related to COPD. SUGGEST AN OFFICE VISIT A doctor or health care provider can diagnose COPD with a simple breathing test called spirometry. It's quick, painless—and worth it. ENCOURAGE YOUR LOVED ONE TO BE A GOOD "MANAGER." Once diagnosed, there are many ways that your ...

  2. Fast Responding Oxygen Sensor For Respiratorial Analysis

    NASA Astrophysics Data System (ADS)

    Karpf, Hellfried H.; Kroneis, H. W.; Marsoner, Hermann J.; Metzler, H.; Gravenstein, N.

    1990-02-01

    Breath-by-breath monitoring of the partial pressure of oxygen is the main interest for the development of a fast responding optical oxygen sensor. Monitoring the P02 finds its main interest in critical care, in artificial respiration, in breath by breath determination of respiratorial coefficients and in pulmonarial examinations. The requirements arising from these and similar applications are high precision, high long term stability, and time constants in the range of less than 0.1 sec. In order to cope with these requirements, we investigated different possibilities of fast P02-measurements by means of optical sensors based on fluorescence quenching. The experimental set up is simple: a rigid transparent layer is coated with a thin layer of an hydrophobic polymer which has a high permeability for oxygen. The oxygen sensitive indicator material is embedded into this polymer. An experimental set up showed time constants of 30 milliseconds. The lifetime is in the range of several months. Testing of our test equipment by an independent working group resulted in surprisingly good correlation with data obtained by mass spectroscopy.

  3. A simple test of one minute heart rate variability during deep breathing for evaluation of sympatovagal imbalance in hyperthyroidism.

    PubMed

    Shuvy, Mony; Arbelle, Jonathan E; Grosbard, Aviva; Katz, Amos

    2008-01-01

    Heart rate variability is a sensitive marker of cardiac sympathetic activity. To determine whether long-term hyperthyroidism induced by thyroxine suppressive therapy affects HRV. Nineteen patients treated with suppressive doses of thyroxin for thyroid cancer and 19 age-matched controls were enrolled. Thyroid function tests and 1 minute HRV were performed on all subjects and the results were compared between the groups. The 1 minute HRV was analyzed during deep breathing and defined as the difference in beats/minute between the shortest and the longest heart rate interval measured by eletrocardiographic recording during six cycles of deep breathing. One minute HRV during deep breathing was significantly lower among thyroxine-treated patients compared to healthy controls (25.6 +/- 10.5 vs. 34.3 +/- 12.6 beats/min, P < 0.05). There were no significant differences in mean, maximal and minimal heart rate between the groups. Thyroxine therapy administered for epithelial thyroid cancer resulted in subclinical hyperthyroidism and significantly decreased HRV due to autonomic dysfunction rather than basic elevated heart rate.

  4. Sleep-disordered breathing: a survey of otolaryngologic practice at military hospitals.

    PubMed

    Davidson, T M; Do, K L

    2000-11-01

    We conducted a survey of otolaryngologists at all Veterans Administration and Department of Defense hospitals in the United States to ascertain the nature and scope of their treatment of sleep-disordered breathing. Questionnaire responses indicated that head and neck surgeons in military hospitals have a strong interest in the management of patients with snoring and sleep apnea. Because of the difficulty in obtaining timely sleep test results and the low number of referrals from physicians who perform such testing, many otolaryngologists expressed a desire to be able to perform their own sleep testing.

  5. Objective vs. Subjective Evaluation of Cognitive Performance During 0.4-MPa Dives Breathing Air or Nitrox.

    PubMed

    Germonpré, Peter; Balestra, Costantino; Hemelryck, Walter; Buzzacott, Peter; Lafère, Pierre

    2017-05-01

    Divers try to limit risks associated with their sport, for instance by breathing enriched air nitrox (EANx) instead of air. This double blinded, randomized trial was designed to see if the use of EANx could effectively improve cognitive performance while diving. Eight volunteers performed two no-decompression dry dives breathing air or EANx for 20 min at 0.4 MPa. Cognitive functions were assessed with a computerized test battery, including MathProc and Ptrail. Measurements were taken before the dive, upon arrival and after 15 min at depth, upon surfacing, and at 30 min postdive. After each dive subjects were asked to identify the gas they had just breathed. Identification of the breathing gas was not possible on subjective assessment alone, while cognitive assessments showed significantly better performance while breathing EANx. Before the dives, breathing air, mean time to complete the task was 1795 ms for MathProc and 1905 ms for Ptrail. When arriving at depth MathProc took 1616 ms on air and 1523 ms on EANx, and Ptrail took 1318 ms on air and and 1356 ms on EANx, followed 15 min later by significant performance inhibition while breathing air during the ascent and the postdive phase, supporting the concept of late dive/postdive impairment. The results suggest that EANx could protect against decreased neuro-cognitive performance induced by inert gas narcosis. It was not possible for blinded divers to identify which gas they were breathing and differences in postdive fatigue between air and EANx diving deserve further investigation.Germonpré P, Balestra C, Hemelryck W, Buzzacott P, Lafère P. Objective vs. subjective evaluation of cognitive performance during 0.4-MPa dives breathing air or nitrox. Aerosp Med Hum Perform. 2017; 88(5):469-475.

  6. [Comprehensive testing system for cardiorespiratory interaction research].

    PubMed

    Zhang, Zhengbo; Wang, Buqing; Wang, Weidong; Zheng, Jiewen; Liu, Hongyun; Li, Kaiyuan; Sun, Congcong; Wang, Guojing

    2013-04-01

    To investigate the modulation effects of breathing movement on cardiovascular system and to study the physiological coupling relationship between respiration and cardiovascular system, we designed a comprehensive testing system for cardiorespiratory interaction research. This system, comprising three parts, i. e. physiological signal conditioning unit, data acquisition and USB medical isolation unit, and a PC based program, can acquire multiple physiological data such as respiratory flow, rib cage and abdomen movement, electrocardiograph, artery pulse wave, cardiac sounds, skin temperature, and electromyography simultaneously under certain experimental protocols. Furthermore this system can be used in research on short-term cardiovascular variability by paced breathing. Preliminary experiments showed that this system could accurately record rib cage and abdomen movement under very low breathing rate, using respiratory inductive plethysmography to acquire respiration signal in direct-current coupling mode. After calibration, this system can be used to estimate ventilation non-intrusively and correctly. The PC based program can generate audio and visual biofeedback signal, and guide the volunteers to perform a slow and regular breathing. An experiment on healthy volunteers showed that this system was able to guide the volunteers to do slow breathing effectively and simultaneously record multiple physiological data during the experiments. Signal processing techniques were used for off-line data analysis, such as non-invasive ventilation calibration, QRS complex wave detection, and respiratory sinus arrhythmia and pulse wave transit time calculation. The experiment result showed that the modulation effect on RR interval, respiratory sinus arrhythmia (RSA), pulse wave transit time (PWTT) by respiration would get stronger with the going of the slow and regular breathing.

  7. Screening of exhaled breath by low-resolution multicomponent FT-IR spectrometry in patients attending emergency departments.

    PubMed

    Laakso, Olli; Haapala, Matti; Kuitunen, Tapio; Himberg, Jaakko-Juhani

    2004-03-01

    Interest in noninvasive methods for disease diagnosis is increasing. In this study, we tested the utility and potential of a portable Fourier transform infrared (FT-IR) multicomponent analyzer in the emergency rooms (ERs) of two Finnish hospitals. Major detected breath volatiles in this population were ethanol, carbon monoxide, methane, and acetone, in addition to carbon dioxide and water. The analysis of breath revealed an ethanol concentration of over 25 ppm (0.1 g/L in blood) in 56 out of 589 patients (9.5%). During nightshifts the proportion was 30% for all and 63% for trauma patients. Five-hundred eighty-four patients had measurable carbon monoxide in their breath. A breath carbon monoxide of over 4 ppm (4.4 micro g/L) differentiated smokers from nonsmokers. Methane over 2 ppm (1.3 micro g/L) was detected in the breath of 32% of the participants. Methane concentration was higher among aged patients. Two-hundred ninety-eight participants had detectable acetone in their breath. Elevated exhaled acetone [10-76 ppm (23-75 micro g/L)] was detected in 10 patients. The FT-IR method proved functional in the ER setting. A major advantage over blood sampling was fast and easy analysis performed by nonlaboratory personnel.

  8. Determination of breath acetone in 149 type 2 diabetic patients using a ringdown breath-acetone analyzer.

    PubMed

    Sun, Meixiu; Chen, Zhuying; Gong, Zhiyong; Zhao, Xiaomeng; Jiang, Chenyu; Yuan, Yuan; Wang, Zhennang; Li, Yingxin; Wang, Chuji

    2015-02-01

    Over 90% of diabetic patients have Type 2 diabetes. Although an elevated mean breath acetone concentration has been found to exist in Type 1 diabetes (T1D), information on breath acetone in Type 2 diabetes (T2D) has yet to be obtained. In this study, we first used gas chromatography-mass spectrometry (GC-MS) to validate a ringdown breath-acetone analyzer based on the cavity-ringdown-spectroscopy technique, through comparing breath acetone concentrations in the range 0.5-2.5 ppm measured using both methods. The linear fitting of R = 0.99 suggests that the acetone concentrations obtained using both methods are consistent with a largest standard deviation of ±0.4 ppm in the lowest concentration of the range. Next, 620 breath samples from 149 T2D patients and 42 healthy subjects were collected and tested using the breath analyzer. Four breath samples were taken from each subject under each of four different conditions: fasting, 2 h post-breakfast, 2 h post-lunch, and 2 h post-dinner. Simultaneous blood glucose levels were also measured using a standard diabetic-management blood-glucose meter. For the 149 T2D subjects, their exhaled breath acetone concentrations ranged from 0.1 to 19.8 ppm; four different ranges of breath acetone concentration, 0.1-19.8, 0.1-7.1, 0.1-6.3, and 0.1-9.5 ppm, were obtained for the subjects under the four different conditions, respectively. For the 42 healthy subjects, their breath acetone concentration ranged from 0.1 to 2.6 ppm; four different ranges of breath acetone concentration, 0.3-2.6, 0.1-2.6, 0.1-1.7, and 0.3-1.6 ppm, were obtained for the four different conditions. The mean breath acetone concentration of the 149 T2D subjects was determined to be 1.5 ± 1.5 ppm, which was 1.5 times that of 1.0 ± 0.6 ppm for the 42 healthy subjects. No correlation was found between the breath acetone concentration and the blood glucose level of the T2D subjects and the healthy volunteers. This study using a relatively large number of subjects provides new data regarding breath acetone in diabetes (T1D and T2D) and suggests that an elevated mean breath acetone concentration also exists in T2D.

  9. Short-Term Intra-Subject Variation in Exhaled Volatile Organic Compounds (VOCs) in COPD Patients and Healthy Controls and Its Effect on Disease Classification

    PubMed Central

    Phillips, Christopher; Mac Parthaláin, Neil; Syed, Yasir; Deganello, Davide; Claypole, Timothy; Lewis, Keir

    2014-01-01

    Exhaled volatile organic compounds (VOCs) are of interest for their potential to diagnose disease non-invasively. However, most breath VOC studies have analyzed single breath samples from an individual and assumed them to be wholly consistent representative of the person. This provided the motivation for an investigation of the variability of breath profiles when three breath samples are taken over a short time period (two minute intervals between samples) for 118 stable patients with Chronic Obstructive Pulmonary Disease (COPD) and 63 healthy controls and analyzed by gas chromatography and mass spectroscopy (GC/MS). The extent of the variation in VOC levels differed between COPD and healthy subjects and the patterns of variation differed for isoprene versus the bulk of other VOCs. In addition, machine learning approaches were applied to the breath data to establish whether these samples differed in their ability to discriminate COPD from healthy states and whether aggregation of multiple samples, into single data sets, could offer improved discrimination. The three breath samples gave similar classification accuracy to one another when evaluated separately (66.5% to 68.3% subjects classified correctly depending on the breath repetition used). Combining multiple breath samples into single data sets gave better discrimination (73.4% subjects classified correctly). Although accuracy is not sufficient for COPD diagnosis in a clinical setting, enhanced sampling and analysis may improve accuracy further. Variability in samples, and short-term effects of practice or exertion, need to be considered in any breath testing program to improve reliability and optimize discrimination. PMID:24957028

  10. Short-Term Intra-Subject Variation in Exhaled Volatile Organic Compounds (VOCs) in COPD Patients and Healthy Controls and Its Effect on Disease Classification.

    PubMed

    Phillips, Christopher; Mac Parthaláin, Neil; Syed, Yasir; Deganello, Davide; Claypole, Timothy; Lewis, Keir

    2014-05-09

    Exhaled volatile organic compounds (VOCs) are of interest for their potential to diagnose disease non-invasively. However, most breath VOC studies have analyzed single breath samples from an individual and assumed them to be wholly consistent representative of the person. This provided the motivation for an investigation of the variability of breath profiles when three breath samples are taken over a short time period (two minute intervals between samples) for 118 stable patients with Chronic Obstructive Pulmonary Disease (COPD) and 63 healthy controls and analyzed by gas chromatography and mass spectroscopy (GC/MS). The extent of the variation in VOC levels differed between COPD and healthy subjects and the patterns of variation differed for isoprene versus the bulk of other VOCs. In addition, machine learning approaches were applied to the breath data to establish whether these samples differed in their ability to discriminate COPD from healthy states and whether aggregation of multiple samples, into single data sets, could offer improved discrimination. The three breath samples gave similar classification accuracy to one another when evaluated separately (66.5% to 68.3% subjects classified correctly depending on the breath repetition used). Combining multiple breath samples into single data sets gave better discrimination (73.4% subjects classified correctly). Although accuracy is not sufficient for COPD diagnosis in a clinical setting, enhanced sampling and analysis may improve accuracy further. Variability in samples, and short-term effects of practice or exertion, need to be considered in any breath testing program to improve reliability and optimize discrimination.

  11. Optimization of single shot 3D breath-hold non-enhanced MR angiography of the renal arteries.

    PubMed

    Tan, Huan; Koktzoglou, Ioannis; Glielmi, Christopher; Galizia, Mauricio; Edelman, Robert R

    2012-05-19

    Cardiac and navigator-gated, inversion-prepared non-enhanced magnetic resonance angiography techniques can accurately depict the renal arteries without the need for contrast administration. However, the scan time and effectiveness of navigator-gated techniques depend on the subject respiratory pattern, which at times results in excessively prolonged scan times or suboptimal image quality. A single-shot 3D magnetization-prepared steady-state free precession technique was implemented to allow the full extent of the renal arteries to be depicted within a single breath-hold. Technical optimization of the breath-hold technique was performed with fourteen healthy volunteers. An alternative magnetization preparation scheme was tested to maximize inflow signal. Quantitative and qualitative comparisons were made between the breath-hold technique and the clinically accepted navigator-gated technique in both volunteers and patients on a 1.5 T scanner. The breath-hold technique provided an average of seven fold reduction in imaging time, without significant loss of image quality. Comparable single-to-noise and contrast-to-noise ratios of intra- and extra-renal arteries were found between the breath-hold and the navigator-gated techniques in volunteers. Furthermore, the breath-hold technique demonstrated good image quality for diagnostic purposes in a small number of patients in a pilot study. The single-shot, breath-hold technique offers an alternative to navigator-gated methods for non-enhanced renal magnetic resonance angiography. The initial results suggest a potential supplementary clinical role for the breath-hold technique in the evaluation of suspected renal artery diseases.

  12. Sex Differences in the Prevalence and Modulators of Sleep-Disordered Breathing in Outpatients with Type 2 Diabetes

    PubMed Central

    Kroner, T.; Arzt, M.; Rheinberger, M.; Gorski, M.; Heid, I. M.; Böger, C. A.

    2018-01-01

    In patients with type 2 diabetes, sleep-disordered breathing is a widespread cause of deteriorated quality of life. However, robust prevalence estimates for sleep-disordered breathing in patients with type 2 diabetes are limited due to scarce data. We investigated sex differences in sleep-disordered breathing prevalence and its modulators in the DIACORE SDB substudy, a sample of outpatient type 2 diabetes. 721 participants were tested for sleep-disordered breathing using a two-channel sleep apnoea monitoring device. Patients were stratified according to the severity of sleep-disordered breathing, defined as an apnoea-hypopnoea index < 15, ≥15 to 29, and ≥30 events per hour as no/mild, moderate, and severe sleep-disordered breathing, respectively. In the 679 analysed patients (39% women, age 66 ± 9 years, body mass index 31.0 ± 5.4 kg/m2), the prevalence of sleep-disordered breathing was 34%. The prevalence of sleep-disordered breathing was higher in men than in women (41% versus 22%, p < 0.001) and increased with age (15%, 21%, and 30% in women and 35%, 40%, and 47% in men in those aged 18–59, 60–69, or ≥70, respectively; age trend p = 0.064 in women and p = 0.15 in men). In linear regression analysis, age, BMI, and waist-hip ratio were associated with apnoea-hypopnoea index. Modulators for higher apnoea-hypopnoea index seem to be similar in men and women. PMID:29805982

  13. Advances in chemical sensing technologies for VOCs in breath for security/threat assessment, illicit drug detection, and human trafficking activity.

    PubMed

    Giannoukos, S; Agapiou, A; Taylor, S

    2018-01-17

    On-site chemical sensing of compounds associated with security and terrorist attacks is of worldwide interest. Other related bio-monitoring topics include identification of individuals posing a threat from illicit drugs, explosive manufacturing, as well as searching for victims of human trafficking and collapsed buildings. The current status of field analytical technologies is directed towards the detection and identification of vapours and volatile organic compounds (VOCs). Some VOCs are associated with exhaled breath, where research is moving from individual breath testing (volatilome) to cell breath (microbiome) and most recently to crowd breath metabolites (exposome). In this paper, an overview of field-deployable chemical screening technologies (both stand-alone and those with portable characteristics) is given with application to early detection and monitoring of human exposome in security operations. On-site systems employed in exhaled breath analysis, i.e. mass spectrometry (MS), optical spectroscopy and chemical sensors are reviewed. Categories of VOCs of interest include (a) VOCs in human breath associated with exposure to threat compounds, and (b) VOCs characteristic of, and associated with, human body odour (e.g. breath, sweat). The latter are relevant to human trafficking scenarios. New technological approaches in miniaturised detection and screening systems are also presented (e.g. non-scanning digital light processing linear ion trap MS (DLP-LIT-MS), nanoparticles, mid-infrared photo-acoustic spectroscopy and hyphenated technologies). Finally, the outlook for rapid and precise, real-time field detection of threat traces in exhaled breath is revealed and discussed.

  14. The application of chromatographic breath analysis in the search of volatile biomarkers of chronic kidney disease and coexisting type 2 diabetes mellitus.

    PubMed

    Grabowska-Polanowska, B; Skowron, M; Miarka, P; Pietrzycka, A; Śliwka, I

    2017-08-15

    Chromatographic studies on breath composition are aimed at finding volatile markers useful for medical diagnostics or in screening investigations. Studies leading to the development of screening breath tests are especially important for the diagnostics of chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). The aim of the presented study was to confirm diagnostic usefulness of chosen volatile compounds detected in breath, which are suggested as potential biomarkers of renal dysfunction and diabetes. Breath analysis were carried out in three groups: 10 healthy volunteers, 10 patients with CKD and 10 patients with CKD and T2DM. All exhaled air samples were analyzed using gas chromatograph (Agilent 6890GC) coupled with mass spectrometer (5975MSD). Thermal desorption was applied as the enrichment method. TMA was detected only in CKD patients. Higher breath concentrations of methanethiol (MeSH) were observed in CKD patients with coexisting diabetes than in patients with renal dysfunction only or in the healthy group. There was a tendency of increasing MeSH concentration in breath with increasing total glutathione in plasma (r=0.53, p=0.0026). Also, a trend of increasing dimethylsulfide (DMS) levels detected in breath was noticed with an increase of hydrogen sulfide concentration in plasma (r=0.74; p=0.00001) as well as with aspartate aminotransferase (AST), (r=0.61; p=0.001). The presented results suggest the possibility of applying TMA, MeSH, and DMS detection in breath as diagnostic methods. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Breath stacking in children with neuromuscular disorders.

    PubMed

    Jenkins, H M; Stocki, A; Kriellaars, D; Pasterkamp, H

    2014-06-01

    Respiratory muscle weakness in neuromuscular disorders (NMD) can lead to shallow breathing and respiratory insufficiency over time. Children with NMD often cannot perform maneuvers to recruit lung volume. In adults, breath stacking with a mask and one-way valve can achieve significantly increased lung volumes. To evaluate involuntary breath stacking (IBS) in NMD, we studied 23 children of whom 15 were cognitively aware and able to communicate verbally. For IBS, a one-way valve and pneumotachograph were attached to a face mask. Tidal volumes (Vt) and minute ventilation (VE ) were calculated from airflow over 30 sec before and after 15 sec of expiratory valve closure. Six cooperative male subjects with Duchenne muscular dystrophy (DMD) participated in a subsequent comparison of IBS with voluntary breath stacking (VBS) and supported breath stacking (SBS). The average Vt in those studied with IBS was 277 ml (range 29-598 ml). The average increase in volume by stacking was 599 ml (range -140 to 2,916 ml) above Vt . The average number of stacked breaths was 4.5 (range 0-17). VE increased on average by 18% after stacking (P < 0.05, paired t-test). Oxygen saturation did not change after stacking. Four of the 23 children did not breath stack. Compared to IBS, VBS achieved similar volumes in the six subjects with DMD but SBS was more successful in those with greatest muscle weakness. IBS may achieve breath volumes of approximately three times Vt and may be particularly useful in non-cooperative subjects with milder degrees of respiratory muscle weakness. © 2013 Wiley Periodicals, Inc.

  16. Motion management within two respiratory-gating windows: feasibility study of dual quasi-breath-hold technique in gated medical procedures

    NASA Astrophysics Data System (ADS)

    Kim, Taeho; Kim, Siyong; Park, Yang-Kyun; Youn, Kaylin K.; Keall, Paul; Lee, Rena

    2014-11-01

    A dual quasi-breath-hold (DQBH) technique is proposed for respiratory motion management (a hybrid technique combining breathing-guidance with breath-hold task in the middle). The aim of this study is to test a hypothesis that the DQBH biofeedback system improves both the capability of motion management and delivery efficiency. Fifteen healthy human subjects were recruited for two respiratory motion measurements (free breathing and DQBH biofeedback breathing for 15 min). In this study, the DQBH biofeedback system utilized the abdominal position obtained using an real-time position management (RPM) system (Varian Medical Systems, Palo Alto, USA) to audio-visually guide a human subject for 4 s breath-hold at EOI and 90% EOE (EOE90%) to improve delivery efficiency. We investigated the residual respiratory motion and the delivery efficiency (duty-cycle) of abdominal displacement within the gating window. The improvement of the abdominal motion reproducibility was evaluated in terms of cycle-to-cycle displacement variability, respiratory period and baseline drift. The DQBH biofeedback system improved the abdominal motion management capability compared to that with free breathing. With a phase based gating (mean ± std: 55  ±  5%), the averaged root mean square error (RMSE) of the abdominal displacement in the dual-gating windows decreased from 2.26 mm of free breathing to 1.16 mm of DQBH biofeedback (p-value = 0.007). The averaged RMSE of abdominal displacement over the entire respiratory cycles reduced from 2.23 mm of free breathing to 1.39 mm of DQBH biofeedback breathing in the dual-gating windows (p-value = 0.028). The averaged baseline drift dropped from 0.9 mm min-1 with free breathing to 0.09 mm min-1 with DQBH biofeedback (p-value = 0.048). The averaged duty-cycle with an 1 mm width of displacement bound increased from 15% of free breathing to 26% of DQBH biofeedback (p-value = 0.003). The study demonstrated that the DQBH biofeedback system has the potential to significantly reduce the residual respiratory motion with the improved duty cycle during the respiratory gating procedure.

  17. Small Intestinal Bacterial Overgrowth May Increase the Likelihood of Lactose and Sorbitol but not Fructose Intolerance False Positive Diagnosis.

    PubMed

    Perets, Tsachi Tsadok; Hamouda, Dalal; Layfer, Olga; Ashorov, Olga; Boltin, Doron; Levy, Sigal; Niv, Yaron; Dickman, Ram

    2017-08-01

    Small intestinal bacterial overgrowth (SIBO) is defined as a bacterial count of more than 10 5 colony-forming units per milliliter in duodenal aspirate. It shares many symptoms with carbohydrate intolerance, which makes the clinical distinction of the disorders difficult. The aim of the study was to examine the relationship between a positive carbohydrate breath test and the presence of SIBO suggested by a positive lactulose hydrogen breath test. The electronic database of the gastroenterology laboratory of a tertiary medical center was searched for all patients clinically tested for SIBO in 2012-2013 for whom previous results for lactose, fructose, and/or sorbitol breath test were available. The correlation between positive findings for carbohydrate intolerance and for SIBO was statistically analyzed. The study group included 349 patients, 231 female and 118 male, of mean age 53±19 years. All had symptoms of abdominal bloating and gas. There was a statistically significant difference in rates of a positive breath test for lactose and sorbitol at ≤90 minutes between patients who were positive and negative for SIBO [χ 2 (1)=12.8, p <0.01 and χ 2 (1)=9.5, p <0.01 respectively]. Findings for fructose were not significant. There was no effect of age or gender. SIBO may represent an important reversible cause of carbohydrate intolerance. It may be especially prudent to exclude SIBO patients with an early peak (≤90 minutes) in H 2 excretion. © 2017 by the Association of Clinical Scientists, Inc.

  18. Spontaneous breathing test in the prediction of extubation failure in the pediatric population.

    PubMed

    Nascimento, Milena Siciliano; Rebello, Celso Moura; Vale, Luciana Assis Pires Andrade; Santos, Érica; Prado, Cristiane do

    2017-01-01

    To assess whether the spontaneous breathing test can predict the extubation failure in pediatric population. A prospective and observational study that evaluated data of inpatients at the Pediatric Intensive Care Unit between May 2011 and August 2013, receiving mechanical ventilation for at least 24 hours followed by extubation. The patients were classified in two groups: Test Group, with patients extubated after spontaneous breathing test, and Control Group, with patients extubated without spontaneous breathing test. A total of 95 children were enrolled in the study, 71 in the Test Group and 24 in the Control Group. A direct comparison was made between the two groups regarding sex, age, mechanical ventilation time, indication to start mechanical ventilation and respiratory parameters before extubation in the Control Group, and before the spontaneous breathing test in the Test Group. There was no difference between the parameters evaluated. According to the analysis of probability of extubation failure between the two groups, the likelihood of extubation failure in the Control Group was 1,412 higher than in the Test Group, nevertheless, this range did not reach significance (p=0.706). This model was considered well-adjusted according to the Hosmer-Lemeshow test (p=0.758). The spontaneous breathing test was not able to predict the extubation failure in pediatric population. Avaliar se o teste de respiração espontânea pode ser utilizado para predizer falha da extubação na população pediátrica. Estudo prospectivo, observacional, no qual foram avaliados todos os pacientes internados no Centro de Terapia Intensiva Pediátrica, no período de maio de 2011 a agosto de 2013, que utilizaram ventilação mecânica por mais de 24 horas e que foram extubados. Os pacientes foram classificados em dois grupos: Grupo Teste, que incluiu os pacientes extubados depois do teste de respiração espontânea; e Grupo Controle, pacientes foram sem teste de respiração espontânea. Dos 95 pacientes incluídos no estudo, 71 crianças eram do Grupo Teste e 24 eram do Grupo Controle. Os grupos foram comparados em relação a: sexo, idade, tempo de ventilação mecânica, indicação para início da ventilação mecânica e parâmetros ventilatórios pré-extubação, no Grupo Controle, e pré-realização do teste, no Grupo Teste. Não foram observadas diferenças entre os parâmetros analisados. Em relação à análise da probabilidade de falha da extubação entre os dois grupos de estudo, a chance de falha do Grupo Controle foi 1.412 maior do que a das crianças do Grupo Teste, porém este acréscimo não foi significativo (p=0,706). O modelo foi considerado bem ajustado de acordo com o teste de Hosmer-Lemeshow (p=0,758). O teste de respiração espontânea para a população pediátrica não foi capaz de prever a falha da extubação.

  19. Special report on the data collection programs for the ground based nitrogen washout experiment. Volume 1: User's guide

    NASA Technical Reports Server (NTRS)

    Bueker, P. A.

    1982-01-01

    The Nitrogen Washout System measures nitrogen elimination on a breath basis from the body tissues of a subject breathing pure oxygen. The system serves as a prototype for a Space Shuttle Life Sciences experiment and in the Environmental Physiology Laboratory. Typically, a subject washes out body nitrogen for three hours while breathing oxygen from a mask enclosed in a positive-pressure oxygen tent. A nitrogen washout requires one test operator and the test subject. A DEC LSI-11/02 computer is used to (1) control and calibrate the mass spectrometer and Skylab spirometer, (2) gather and store experimental data and (3) provide limited real time analysis and more extensive post-experiment analysis. Five programs are used to gather and store the experimental data and perform all the real time control and analysis.

  20. Physiological coherence in healthy volunteers during laboratory-induced stress and controlled breathing.

    PubMed

    Mejía-Mejía, Elisa; Torres, Robinson; Restrepo, Diana

    2018-06-01

    Physiological coherence has been related with a general sense of well-being and improvements in health and physical, social, and cognitive performance. The aim of this study was to evaluate the relationship between acute stress, controlled breathing, and physiological coherence, and the degree of body systems synchronization during a coherence-generation exercise. Thirty-four university employees were evaluated during a 20-min test consisting of four stages of 5-min duration each, during which basal measurements were obtained (Stage 1), acute stress was induced using validated mental stressors (Stroop test and mental arithmetic task, during Stage 2 and 3, respectively), and coherence states were generated using a controlled breathing technique (Stage 4). Physiological coherence and cardiorespiratory synchronization were assessed during each stage from heart rate variability, pulse transit time, and respiration. Coherence measurements derived from the three analyzed variables increased during controlled respiration. Moreover, signals synchronized during the controlled breathing stage, implying a cardiorespiratory synchronization was achieved by most participants. Hence, physiological coherence and cardiopulmonary synchronization, which could lead to improvements in health and better life quality, can be achieved using slow, controlled breathing exercises. Meanwhile, coherence measured during basal state and stressful situations did not show relevant differences using heart rate variability and pulse transit time. More studies are needed to evaluate the ability of coherence ratio to reflect acute stress. © 2017 Society for Psychophysiological Research.

  1. Detection of bronchial breathing caused by pneumonia.

    PubMed

    Gross, V; Fachinger, P; Penzel, Th; Koehler, U; von Wichert, P; Vogelmeier, C

    2002-06-01

    The classic auscultation with stethoscope is the established clinical method for the detection of lung diseases. The interpretation of the sounds depends on the experience of the investigating physician. Therefore, a new computer-based method has been developed to classify breath sounds from digital lung sound recordings. Lung sounds of 11 patients with one-sided pneumonia and bronchial breathing were recorded on both the pneumonia side and on contralateral healthy side simultaneously using two microphones. The spectral power for the 300-600 Hz frequency band was computed for four respiratory cycles and normalized. For each breath, the ratio R between the time-segments (duration = 0.1 s) with the highest inspiratory and highest expiratory flow was calculated and averaged. We found significant differences in R between the pneumonia side (R = 1.4 +/- 1.3) and the healthy side (R = 0.5 +/- 0.5; p = 0.003 Wilcoxon-test) of lung. In 218 healthy volunteers we found R = 0.3 +/- 0.2 as a reference-value. The differences of ratio R (delta R) between the pneumonia side and the healthy side (delta R = 1.0 +/- 0.9) were significantly higher compared to follow-up studies after recovery (delta R = 0.0 +/- 0.1, p = 0.005 Wilcoxon-test). The computer based detection of bronchial breathing can be considered useful as part of a quantitative monitoring of patients at risk to develop pneumonia.

  2. Prevalence and pattern of cardiac autonomic dysfunction in newly detected type 2 diabetes mellitus.

    PubMed

    Jyotsna, Viveka P; Sahoo, Abhay; Sreenivas, V; Deepak, K K

    2009-01-01

    Cardiac autonomic functions were assessed in 145 consecutive recently detected type 2 diabetics. Ninety-nine healthy persons served as controls. Criteria for normalcy were, heart rate variation during deep breathing >or=15 beats/min, deep breathing expiratory to inspiratory R-R ratio >or=1.21, Valsalva ratio >or=1.21, sustained handgrip test >or=16 mm of mercury, cold pressor test >or=10, BP response to standing or=1.04. An abnormal test was defined as the above parameters being <10 beats/min, <1.21, <1.21, or=30 mm of mercury and

  3. Bench Test Evaluation of Adaptive Servoventilation Devices for Sleep Apnea Treatment

    PubMed Central

    Zhu, Kaixian; Kharboutly, Haissam; Ma, Jianting; Bouzit, Mourad; Escourrou, Pierre

    2013-01-01

    Rationale: Adaptive servoventilation devices are marketed to overcome sleep disordered breathing with apneas and hypopneas of both central and obstructive mechanisms often experienced by patients with chronic heart failure. The clinical efficacy of these devices is still questioned. Study Objectives: This study challenged the detection and treatment capabilities of the three commercially available adaptive servoventilation devices in response to sleep disordered breathing events reproduced on an innovative bench test. Methods: The bench test consisted of a computer-controlled piston and a Starling resistor. The three devices were subjected to a flow sequence composed of central and obstructive apneas and hypopneas including Cheyne-Stokes respiration derived from a patient. The responses of the devices were separately evaluated with the maximum and the clinical settings (titrated expiratory positive airway pressure), and the detected events were compared to the bench-scored values. Results: The three devices responded similarly to central events, by increasing pressure support to raise airflow. All central apneas were eliminated, whereas hypopneas remained. The three devices responded differently to the obstructive events with the maximum settings. These obstructive events could be normalized with clinical settings. The residual events of all the devices were scored lower than bench test values with the maximum settings, but were in agreement with the clinical settings. However, their mechanisms were misclassified. Conclusion: The tested devices reacted as expected to the disordered breathing events, but not sufficiently to normalize the breathing flow. The device-scored results should be used with caution to judge efficacy, as their validity depends upon the initial settings. Citation: Zhu K; Kharboutly H; Ma J; Bouzit M; Escourrou P. Bench test evaluation of adaptive servoventilation devices for sleep apnea treatment. J Clin Sleep Med 2013;9(9):861-871. PMID:23997698

  4. Evaluation of the 13C-octanoate breath test as a surrogate marker of liver damage in animal models.

    PubMed

    Shalev, Tamar; Aeed, Hussein; Sorin, Vladimir; Shahmurov, Mark; Didkovsky, Elena; Ilan, Yaron; Avni, Yona; Shirin, Haim

    2010-06-01

    Octanoate (also known as sodium octanoate), a medium-chain fatty acid metabolized in the liver, is a potential substrate for non-invasive breath testing of hepatic mitochondrial beta-oxidation. We evaluated the 13C-octanoate breath test (OBT) for assessing injury in acute hepatitis and two rat models of liver cirrhosis, first testing octanoate absorption (per os or intraperitoneally (i.p.)) in normal rats. We then induced acute hepatitis with thioacetamide (300 mg/kg/i.p., 24-h intervals). Liver injury end points were serum aminotransferase levels and 13C-OBT (24 and 48 h following initial injection). Thioacetamide (200 mg/kg/i.p., twice per week, 12 weeks) was used to induce liver cirrhosis. OBT and liver histological assessment were performed every 4 weeks. Bile duct ligation (BDL) was used to induce cholestatic liver injury. We completed breath tests with 13C-OBT and 13C-methacetin (MBID), liver biochemistry, and liver histology in BDL and sham-operated rats (baseline, 6, 14, 20 days post-BDL). Octanoate absorbs well by either route. Peak amplitudes and cumulative percentage dose recovered at 30 and 60 min (CPDR30/60), but not peak time, correlated with acute hepatitis. Fibrosis stage 3 at week 8 significantly correlated with each OBT parameter. Cholestatic liver injury (serum bilirubin, ALP, gamma-GT, liver histology) was associated with significant suppression of the maximal peak values and CPDR30/60, respectively (P<0.05),using MBID but not 13C-octanoate. OBT is sensitive for potentially evaluating liver function in rat models of acute hepatitis and thioacetamide-induced liver cirrhosis but not in cholestatic liver injury. The MBID test may be better for evaluation of cholestatic liver disease in this model.

  5. Tidal volume single breath washout of two tracer gases--a practical and promising lung function test.

    PubMed

    Singer, Florian; Stern, Georgette; Thamrin, Cindy; Fuchs, Oliver; Riedel, Thomas; Gustafsson, Per; Frey, Urs; Latzin, Philipp

    2011-03-10

    Small airway disease frequently occurs in chronic lung diseases and may cause ventilation inhomogeneity (VI), which can be assessed by washout tests of inert tracer gas. Using two tracer gases with unequal molar mass (MM) and diffusivity increases specificity for VI in different lung zones. Currently washout tests are underutilised due to the time and effort required for measurements. The aim of this study was to develop and validate a simple technique for a new tidal single breath washout test (SBW) of sulfur hexafluoride (SF(6)) and helium (He) using an ultrasonic flowmeter (USFM). The tracer gas mixture contained 5% SF(6) and 26.3% He, had similar total MM as air, and was applied for a single tidal breath in 13 healthy adults. The USFM measured MM, which was then plotted against expired volume. USFM and mass spectrometer signals were compared in six subjects performing three SBW. Repeatability and reproducibility of SBW, i.e., area under the MM curve (AUC), were determined in seven subjects performing three SBW 24 hours apart. USFM reliably measured MM during all SBW tests (n = 60). MM from USFM reflected SF(6) and He washout patterns measured by mass spectrometer. USFM signals were highly associated with mass spectrometer signals, e.g., for MM, linear regression r-squared was 0.98. Intra-subject coefficient of variation of AUC was 6.8%, and coefficient of repeatability was 11.8%. The USFM accurately measured relative changes in SF(6) and He washout. SBW tests were repeatable and reproducible in healthy adults. We have developed a fast, reliable, and straightforward USFM based SBW method, which provides valid information on SF(6) and He washout patterns during tidal breathing.

  6. Tidal Volume Single Breath Washout of Two Tracer Gases - A Practical and Promising Lung Function Test

    PubMed Central

    Singer, Florian; Stern, Georgette; Thamrin, Cindy; Fuchs, Oliver; Riedel, Thomas; Gustafsson, Per; Frey, Urs; Latzin, Philipp

    2011-01-01

    Background Small airway disease frequently occurs in chronic lung diseases and may cause ventilation inhomogeneity (VI), which can be assessed by washout tests of inert tracer gas. Using two tracer gases with unequal molar mass (MM) and diffusivity increases specificity for VI in different lung zones. Currently washout tests are underutilised due to the time and effort required for measurements. The aim of this study was to develop and validate a simple technique for a new tidal single breath washout test (SBW) of sulfur hexafluoride (SF6) and helium (He) using an ultrasonic flowmeter (USFM). Methods The tracer gas mixture contained 5% SF6 and 26.3% He, had similar total MM as air, and was applied for a single tidal breath in 13 healthy adults. The USFM measured MM, which was then plotted against expired volume. USFM and mass spectrometer signals were compared in six subjects performing three SBW. Repeatability and reproducibility of SBW, i.e., area under the MM curve (AUC), were determined in seven subjects performing three SBW 24 hours apart. Results USFM reliably measured MM during all SBW tests (n = 60). MM from USFM reflected SF6 and He washout patterns measured by mass spectrometer. USFM signals were highly associated with mass spectrometer signals, e.g., for MM, linear regression r-squared was 0.98. Intra-subject coefficient of variation of AUC was 6.8%, and coefficient of repeatability was 11.8%. Conclusion The USFM accurately measured relative changes in SF6 and He washout. SBW tests were repeatable and reproducible in healthy adults. We have developed a fast, reliable, and straightforward USFM based SBW method, which provides valid information on SF6 and He washout patterns during tidal breathing. PMID:21423739

  7. Four-sample lactose hydrogen breath test for diagnosis of lactose malabsorption in irritable bowel syndrome patients with diarrhea

    PubMed Central

    Yang, Jian-Feng; Fox, Mark; Chu, Hua; Zheng, Xia; Long, Yan-Qin; Pohl, Daniel; Fried, Michael; Dai, Ning

    2015-01-01

    AIM: To validate 4-sample lactose hydrogen breath testing (4SLHBT) compared to standard 13-sample LHBT in the clinical setting. METHODS: Irritable bowel syndrome patients with diarrhea (IBS-D) and healthy volunteers (HVs) were enrolled and received a 10 g, 20 g, or 40 g dose lactose hydrogen breath test (LHBT) in a randomized, double-blinded, controlled trial. The lactase gene promoter region was sequenced. Breath samples and symptoms were acquired at baseline and every 15 min for 3 h (13 measurements). The detection rates of lactose malabsorption (LM) and lactose intolerance (LI) for a 4SLHBT that acquired four measurements at 0, 90, 120, and 180 min from the same data set were compared with the results of standard LHBT. RESULTS: Sixty IBS-D patients and 60 HVs were studied. The genotype in all participants was C/C-13910. LM and LI detection rates increased with lactose dose from 10 g, 20 g to 40 g in both groups (P < 0.001). 4SLHBT showed excellent diagnostic concordance with standard LHBT (97%-100%, Kappa​​ 0.815-0.942) with high sensitivity (90%-100%) and specificity (100%) at all three lactose doses in both groups. CONCLUSION: Reducing the number of measurements from 13 to 4 samples did not significantly impact on the accuracy of LHBT in health and IBS-D. 4SLHBT is a valid test for assessment of LM and LI in clinical practice. PMID:26140004

  8. Four-sample lactose hydrogen breath test for diagnosis of lactose malabsorption in irritable bowel syndrome patients with diarrhea.

    PubMed

    Yang, Jian-Feng; Fox, Mark; Chu, Hua; Zheng, Xia; Long, Yan-Qin; Pohl, Daniel; Fried, Michael; Dai, Ning

    2015-06-28

    To validate 4-sample lactose hydrogen breath testing (4SLHBT) compared to standard 13-sample LHBT in the clinical setting. Irritable bowel syndrome patients with diarrhea (IBS-D) and healthy volunteers (HVs) were enrolled and received a 10 g, 20 g, or 40 g dose lactose hydrogen breath test (LHBT) in a randomized, double-blinded, controlled trial. The lactase gene promoter region was sequenced. Breath samples and symptoms were acquired at baseline and every 15 min for 3 h (13 measurements). The detection rates of lactose malabsorption (LM) and lactose intolerance (LI) for a 4SLHBT that acquired four measurements at 0, 90, 120, and 180 min from the same data set were compared with the results of standard LHBT. Sixty IBS-D patients and 60 HVs were studied. The genotype in all participants was C/C-13910. LM and LI detection rates increased with lactose dose from 10 g, 20 g to 40 g in both groups (P < 0.001). 4SLHBT showed excellent diagnostic concordance with standard LHBT (97%-100%, Kappa​​ 0.815-0.942) with high sensitivity (90%-100%) and specificity (100%) at all three lactose doses in both groups. Reducing the number of measurements from 13 to 4 samples did not significantly impact on the accuracy of LHBT in health and IBS-D. 4SLHBT is a valid test for assessment of LM and LI in clinical practice.

  9. Rifaximin for small intestinal bacterial overgrowth in patients without irritable bowel syndrome.

    PubMed

    Boltin, Doron; Perets, Tsachi Tsadok; Shporn, Einav; Aizic, Shoshana; Levy, Sigal; Niv, Yaron; Dickman, Ram

    2014-10-17

    Rifaximin is a minimally absorbed antibiotic with high luminal activity, used to treat various gastrointestinal diseases. Although rifaximin has been proposed as first line treatment for small intestinal bacterial overgrowth (SIBO), few data are available regarding its efficacy in non-IBS subjects. We aimed to assess the ability of rifaximin to normalize lactulose-H2 breath tests in non-IBS subjects with symptoms suggestive of SIBO. Consecutive non-IBS patients presenting with bloating and flatulence were prospectively recruited and submitted to lactulose-H2 breath testing (LBT). Patients who had a positive result were offered rifaximin 1200 mg daily for 10 days. Breath testing was repeated two weeks after treatment completion in all patients in order to assess for response. A total of 19 patients with a positive result received rifaximin and repeated the breath test (7 (36.8%) males, age 56.5 ± 17.6 years). The mean peak hydrogen excretion was 13.7 ± 2.8 and 10.3 ± 7.3 ppm at baseline and following rifaximin treatment, respectively (t = 1.98, p = 0.06). LBT normalized in 8/19 (42.1%) subjects. No patients reported symptom resolution. No adverse events were reported. Strengths include the study's prospective design. Limitations include the small sample size and open label design. Rifaximin was not effective in normalizing LBT in our cohort of non-IBS subjects with symptoms suggestive of SIBO.

  10. Flavoring agents present in a dentifrice can modify volatile sulphur compounds (VSCs) formation in morning bad breath.

    PubMed

    Peruzzo, Daiane Cristina; Salvador, Sérgio Luis; Sallum, Antonio Wilson; Nogueira-Filho, Getúlio da Rocha

    2008-01-01

    This study aimed to evaluate the effects of a flavor-containing dentifrice on the formation of volatile sulphur compounds (VSCs) in morning bad breath. A two-step, blinded, crossover, randomized study was carried out in 50 dental students with a healthy periodontium divided into two experimental groups: flavor-containing dentifrice (test) and non-flavor-containing dentifrice (control). The volunteers received the designated dentifrice and a new toothbrush for a 3 X/day brushing regimen for 2 periods of 30 days. A seven-day washout interval was used between the periods. The assessed parameters were: plaque index (PI), gingival index (GI), organoleptic breath scores (ORG), VSC levels (as measured by a portable sulphide monitor) before (H1) and after (H2) cleaning of the tongue, tongue coating (TC) wet weight and BANA test from TC samples. The intra-group analysis showed a decrease in ORG, from 3 to 2, after 30 days for the test group (p < 0.05). The inter-group analysis showed lower values in ORG, H1 and H2 for the test group (p < 0.05). There was no difference between the amount of TC between groups and the presence of flavor also did not interfere in the BANA results between groups (p > 0.05). These findings suggest that a flavor-containing dentifrice seems to prevent VSCs formation in morning bad breath regardless of the amount of TC in periodontally healthy subjects.

  11. A simple, remote, video based breathing monitor.

    PubMed

    Regev, Nir; Wulich, Dov

    2017-07-01

    Breathing monitors have become the all-important cornerstone of a wide variety of commercial and personal safety applications, ranging from elderly care to baby monitoring. Many such monitors exist in the market, some, with vital signs monitoring capabilities, but none remote. This paper presents a simple, yet efficient, real time method of extracting the subject's breathing sinus rhythm. Points of interest are detected on the subject's body, and the corresponding optical flow is estimated and tracked using the well known Lucas-Kanade algorithm on a frame by frame basis. A generalized likelihood ratio test is then utilized on each of the many interest points to detect which is moving in harmonic fashion. Finally, a spectral estimation algorithm based on Pisarenko harmonic decomposition tracks the harmonic frequency in real time, and a fusion maximum likelihood algorithm optimally estimates the breathing rate using all points considered. The results show a maximal error of 1 BPM between the true breathing rate and the algorithm's calculated rate, based on experiments on two babies and three adults.

  12. Automated sleep scoring and sleep apnea detection in children

    NASA Astrophysics Data System (ADS)

    Baraglia, David P.; Berryman, Matthew J.; Coussens, Scott W.; Pamula, Yvonne; Kennedy, Declan; Martin, A. James; Abbott, Derek

    2005-12-01

    This paper investigates the automated detection of a patient's breathing rate and heart rate from their skin conductivity as well as sleep stage scoring and breathing event detection from their EEG. The software developed for these tasks is tested on data sets obtained from the sleep disorders unit at the Adelaide Women's and Children's Hospital. The sleep scoring and breathing event detection tasks used neural networks to achieve signal classification. The Fourier transform and the Higuchi fractal dimension were used to extract features for input to the neural network. The filtered skin conductivity appeared visually to bear a similarity to the breathing and heart rate signal, but a more detailed evaluation showed the relation was not consistent. Sleep stage classification was achieved with and accuracy of around 65% with some stages being accurately scored and others poorly scored. The two breathing events hypopnea and apnea were scored with varying degrees of accuracy with the highest scores being around 75% and 30%.

  13. Metabolic and ventilatory responses to submaximal and maximal exercise using different breathing assemblies.

    PubMed

    Evans, B W; Potteiger, J A

    1995-06-01

    This study compared ventilatory and metabolic responses during exercise using three breathing assemblies: mouthpiece/noseclip (BV); mouth/face mask (MM); and facemask (FM). Ten male runners completed three maximal treadmill tests with breathing assembly randomly assigned. Metabolic and ventilatory data were recorded every 15s, and heart rate (HR) and rating of perceived exertion (RPE) each min. No significant differences were found for treadmill run time, HRmax, respiratory exchange ratio (RER), and RPE, indicating similar efforts on all trials. No significant differences were found at maximal exercise for VO2 minute ventilation (VE), tidal volume (VT), and breathing frequency (f). At ventilatory threshold (TVENT), VO2, VE, and f were not significantly different. However, peak flow (PF) was significantly higher for BV than FM, and VT was significantly higher for BV than MM and FM. Results indicate alterations in ventilatory mechanics occur at TVENT, but type of breathing assembly does not significantly affect maximal values.

  14. The classification of the patients with pulmonary diseases using breath air samples spectral analysis

    NASA Astrophysics Data System (ADS)

    Kistenev, Yury V.; Borisov, Alexey V.; Kuzmin, Dmitry A.; Bulanova, Anna A.

    2016-08-01

    Technique of exhaled breath sampling is discussed. The procedure of wavelength auto-calibration is proposed and tested. Comparison of the experimental data with the model absorption spectra of 5% CO2 is conducted. The classification results of three study groups obtained by using support vector machine and principal component analysis methods are presented.

  15. Students' Learning Strategies with Multiple Representations: Explanations of the Human Breathing Mechanism

    ERIC Educational Resources Information Center

    Won, Mihye; Yoon, Heojeong; Treagust, David F.

    2014-01-01

    The purpose of this study was to understand how students utilized multiple representations to learn and explain science concepts, in this case the human breathing mechanism. The study was conducted with Grade 11 students in a human biology class. Semistructured interviews and a two-tier diagnostic test were administered to evaluate students'…

  16. [Likeness between respiratory responses on CO2 in conditions of natural breathing and voluntary-controlled mechanical ventilation].

    PubMed

    Pogodin, M A; Granstrem, M P; Dimitrienko, A I

    2007-04-01

    We did Read CO2 rebreathing tests in 8 adult males. Both at natural breathing, and at self-controlled mechanical ventilation, volunteers increased ventilation proportionally to growth end-tidal PCO2. Inside individual distinctions of responses to CO2 during controlled mechanical ventilation are result of the voluntary motor control.

  17. Evaluation of the Scott Aviation Portable Protective Breathing Device for contaminant leakage as prescribed by FAA Action Notice A-8150.2.

    DOT National Transportation Integrated Search

    1989-11-01

    Two types of crewmember protective breathing equipment (PBE) were performance tested for compliance with Action Notice A-8150.2 at ground level (- 1,300 feet) and 8,000 feet altitude. PBE 1 was a 'hood with oral-nasal mask,' which used potassium supe...

  18. Cost-effectiveness of the Carbon-13 Urea Breath Test for the Detection of Helicobacter Pylori

    PubMed Central

    Masucci, L; Blackhouse, G; Goeree, R

    2013-01-01

    Objectives This analysis aimed to evaluate the cost-effectiveness of various testing strategies for Helicobacter pylori in patients with uninvestigated dyspepsia and to calculate the budgetary impact of these tests for the province of Ontario. Data Sources Data on the sensitivity and specificity were obtained from the clinical evidence-based analysis. Resource items were obtained from expert opinion, and costs were applied on the basis of published sources as well as expert opinion. Review Methods A decision analytic model was constructed to compare the costs and outcomes (false-positive results, false-negative results, and misdiagnoses avoided) of the carbon-13 (13C) urea breath test (UBT), enzyme-linked immunosorbent assay (ELISA) serology test, and a 2-step strategy of an ELISA serology test and a confirmatory 13C UBT based on the sensitivity and specificity of the tests and prevalence estimates. Results The 2-step strategy is more costly and more effective than the ELISA serology test and results in $210 per misdiagnosis case avoided. The 13C UBT is dominated by the 2-step strategy, i.e., it is more costly and less effective. The budget impact analysis indicates that it will cost $7.9 million more to test a volume of 129,307 patients with the 13C UBT than with ELISA serology, and $4.7 million more to test these patients with the 2-step strategy. Limitations The clinical studies that were pooled varied in the technique used to perform the breath test and in reference standards used to make comparisons with the breath test. However, these parameters were varied in a sensitivity analysis. The economic model was designed to consider intermediate outcomes only (i.e., misdiagnosed cases) and was not a complete model with final patient outcomes (e.g., quality-adjusted life years). Conclusions Results indicate that the 2-step strategy could be economically attractive for the testing of H. pylori. However, testing with the 2-step strategy will cost the Ministry of Health and Long-Term Care $4.7 million more than with the ELISA serology test. PMID:24228083

  19. Clinical utility of breath ammonia for evaluation of ammonia physiology in healthy and cirrhotic adults

    PubMed Central

    Spacek, Lisa A; Mudalel, Matthew; Tittel, Frank; Risby, Terence H; Solga, Steven F

    2016-01-01

    Blood ammonia is routinely used in clinical settings to assess systemic ammonia in hepatic encephalopathy and urea cycle disorders. Despite its drawbacks, blood measurement is often used as a comparator in breath studies because it is a standard clinical test. We sought to evaluate sources of measurement error and potential clinical utility of breath ammonia compared to blood ammonia. We measured breath ammonia in real time by quartz enhanced photoacoustic spectrometry and blood ammonia in 10 healthy and 10 cirrhotic participants. Each participant contributed 5 breath samples and blood for ammonia measurement within 1 h. We calculated the coefficient of variation (CV) for 5 breath ammonia values, reported medians of healthy and cirrhotic participants, and used scatterplots to display breath and blood ammonia. For healthy participants, mean age was 22 years (±4), 70% were men, and body mass index (BMI) was 27 (±5). For cirrhotic participants, mean age was 61 years (±8), 60% were men, and BMI was 31 (±7). Median blood ammonia for healthy participants was within normal range, 10 μmol L−1 (interquartile range (IQR), 3–18) versus 46 μmol L−1 (IQR, 23–66) for cirrhotic participants. Median breath ammonia was 379 pmol mL−1 CO2 (IQR, 265–765) for healthy versus 350 pmol mL−1 CO2 (IQR, 180–1013) for cirrhotic participants. CV was 17 ± 6%. There remains an important unmet need in the evaluation of systemic ammonia, and breath measurement continues to demonstrate promise to fulfill this need. Given the many differences between breath and blood ammonia measurement, we examined biological explanations for our findings in healthy and cirrhotic participants. We conclude that based upon these preliminary data breath may offer clinically important information this is not provided by blood ammonia. PMID:26658550

  20. Reliable quantification of BOLD fMRI cerebrovascular reactivity despite poor breath-hold performance.

    PubMed

    Bright, Molly G; Murphy, Kevin

    2013-12-01

    Cerebrovascular reactivity (CVR) can be mapped using BOLD fMRI to provide a clinical insight into vascular health that can be used to diagnose cerebrovascular disease. Breath-holds are a readily accessible method for producing the required arterial CO2 increases but their implementation into clinical studies is limited by concerns that patients will demonstrate highly variable performance of breath-hold challenges. This study assesses the repeatability of CVR measurements despite poor task performance, to determine if and how robust results could be achieved with breath-holds in patients. Twelve healthy volunteers were scanned at 3 T. Six functional scans were acquired, each consisting of 6 breath-hold challenges (10, 15, or 20 s duration) interleaved with periods of paced breathing. These scans simulated the varying breath-hold consistency and ability levels that may occur in patient data. Uniform ramps, time-scaled ramps, and end-tidal CO2 data were used as regressors in a general linear model in order to measure CVR at the grey matter, regional, and voxelwise level. The intraclass correlation coefficient (ICC) quantified the repeatability of the CVR measurement for each breath-hold regressor type and scale of interest across the variable task performances. The ramp regressors did not fully account for variability in breath-hold performance and did not achieve acceptable repeatability (ICC<0.4) in several regions analysed. In contrast, the end-tidal CO2 regressors resulted in "excellent" repeatability (ICC=0.82) in the average grey matter data, and resulted in acceptable repeatability in all smaller regions tested (ICC>0.4). Further analysis of intra-subject CVR variability across the brain (ICCspatial and voxelwise correlation) supported the use of end-tidal CO2 data to extract robust whole-brain CVR maps, despite variability in breath-hold performance. We conclude that the incorporation of end-tidal CO2 monitoring into scanning enables robust, repeatable measurement of CVR that makes breath-hold challenges suitable for routine clinical practice. © 2013.

  1. Passive in-vehicle driver breath alcohol detection using advanced sensor signal acquisition and fusion.

    PubMed

    Ljungblad, Jonas; Hök, Bertil; Allalou, Amin; Pettersson, Håkan

    2017-05-29

    The research objective of the present investigation is to demonstrate the present status of passive in-vehicle driver breath alcohol detection and highlight the necessary conditions for large-scale implementation of such a system. Completely passive detection has remained a challenge mainly because of the requirements on signal resolution combined with the constraints of vehicle integration. The work is part of the Driver Alcohol Detection System for Safety (DADSS) program aiming at massive deployment of alcohol sensing systems that could potentially save thousands of American lives annually. The work reported here builds on earlier investigations, in which it has been shown that detection of alcohol vapor in the proximity of a human subject may be traced to that subject by means of simultaneous recording of carbon dioxide (CO 2 ) at the same location. Sensors based on infrared spectroscopy were developed to detect and quantify low concentrations of alcohol and CO 2 . In the present investigation, alcohol and CO 2 were recorded at various locations in a vehicle cabin while human subjects were performing normal in-step procedures and driving preparations. A video camera directed to the driver position was recording images of the driver's upper body parts, including the face, and the images were analyzed with respect to features of significance to the breathing behavior and breath detection, such as mouth opening and head direction. Improvement of the sensor system with respect to signal resolution including algorithm and software development, and fusion of the sensor and camera signals was successfully implemented and tested before starting the human study. In addition, experimental tests and simulations were performed with the purpose of connecting human subject data with repeatable experimental conditions. The results include occurrence statistics of detected breaths by signal peaks of CO 2 and alcohol. From the statistical data, the accuracy of breath alcohol estimation and timing related to initial driver routines (door opening, taking a seat, door closure, buckling up, etc.) can be estimated. The investigation confirmed the feasibility of passive driver breath alcohol detection using our present system. Trade-offs between timing and sensor signal resolution requirements will become critical. Further improvement of sensor resolution and system ruggedness is required before the results can be industrialized. It is concluded that a further important step toward completely passive detection of driver breath alcohol has been taken. If required, the sniffer function with alcohol detection capability can be combined with a subsequent highly accurate breath test to confirm the driver's legal status using the same sensor device. The study is relevant to crash avoidance, in particular driver monitoring systems and driver-vehicle interface design.

  2. Sequential simulation (SqS) of clinical pathways: a tool for public and patient engagement in point-of-care diagnostics

    PubMed Central

    Huddy, Jeremy R; Weldon, Sharon-Marie; Ralhan, Shvaita; Painter, Tim; Hanna, George B; Kneebone, Roger; Bello, Fernando

    2016-01-01

    Objectives Public and patient engagement (PPE) is fundamental to healthcare research. To facilitate effective engagement in novel point-of-care tests (POCTs), the test and downstream consequences of the result need to be considered. Sequential simulation (SqS) is a tool to represent patient journeys and the effects of intervention at each and subsequent stages. This case study presents a process evaluation of SqS as a tool for PPE in the development of a volatile organic compound-based breath test POCT for the diagnosis of oesophagogastric (OG) cancer. Setting Three 3-hour workshops in central London. Participants 38 members of public attended a workshop, 26 (68%) had no prior experience of the OG cancer diagnostic pathway. Interventions Clinical pathway SqS was developed from a storyboard of a patient, played by an actor, noticing symptoms of oesophageal cancer and following a typical diagnostic pathway. The proposed breath testing strategy was then introduced and incorporated into a second SqS to demonstrate pathway impact. Facilitated group discussions followed each SqS. Primary and secondary outcome measures Evaluation was conducted through pre-event and postevent questionnaires, field notes and analysis of audiovisual recordings. Results 38 participants attended a workshop. All participants agreed they were able to contribute to discussions and like the idea of an OG cancer breath test. Five themes emerged related to the proposed new breath test including awareness of OG cancer, barriers to testing and diagnosis, design of new test device, new clinical pathway and placement of test device. 3 themes emerged related to the use of SqS: participatory engagement, simulation and empathetic engagement, and why participants attended. Conclusions SqS facilitated a shared immersive experience for participants and researchers that led to the coconstruction of knowledge that will guide future research activities and be of value to stakeholders concerned with the invention and adoption of POCT. PMID:27625053

  3. Hypersonic propulsion flight tests as essential to air-breathing aerospace plane development

    NASA Astrophysics Data System (ADS)

    Mehta, U.

    Hypersonic air-breathing propulsion utilizing scramjets can fundamentally change transatmospheric acclerators for transportation from low Earth orbits (LEOs). The value and limitations of ground tests, of flight tests, and of computations are presented, and scramjet development requirements are discussed. Near-full-scale hypersonic propulsion flight tests are essential for developing a prototype hypersonic propulsion system and for developing computation-design technology that can be used in designing that system. In order to determine how these objectives should be achieved, some lessons learned from past programs are presented. A conceptual two-stage-to-orbit (TSTO) prototype/experimental aerospace plane is recommended as a means of providing access-to-space and for conducting flight tests. A road map for achieving these objectives is also presented.

  4. Breath carbon stable isotope ratios identify changes in energy balance and substrate utilization in humans.

    PubMed

    Whigham, L D; Butz, D E; Johnson, L K; Schoeller, D A; Abbott, D H; Porter, W P; Cook, M E

    2014-09-01

    Rapid detection of shifts in substrate utilization and energy balance would provide a compelling biofeedback tool for individuals attempting weight loss. As a proof of concept, we tested whether the natural abundance of exhaled carbon stable isotope ratios (breath δ(13)C) reflects shifts between negative and positive energy balance. Volunteers (n=5) consumed a 40% energy-restricted diet for 6 days followed by 50% excess on day 7. Breath was sampled immediately before and 1 h and 2 h after breakfast, lunch and dinner. Exhaled breath δ(13)C values were measured by cavity ring-down spectroscopy. Using repeated measures analysis of variance (ANOVA) followed by Dunnett's contrasts, pre-breakfast breath values on days 2-6 were compared with day 1, and postprandial day 7 time points were compared with pre-breakfast day 7. Energy restriction diminished pre-breakfast breath δ(13)C by day 3 (P<0.05). On day 7, increased energy intake was first detected immediately before dinner (-23.8±0.6 vs -21.9±0.7‰, P=0.002 (means±s.d.)), and breath δ(13)C remained elevated at least 2 h post dinner. In conclusion, when shifting between negative and positive energy balance, breath δ(13)C showed anticipated isotopic changes. Although additional research is needed to determine specificity and repeatability, this method may provide a biomarker for marked increases in caloric intake.

  5. Effects of online cone-beam computed tomography with active breath control in determining planning target volume during accelerated partial breast irradiation.

    PubMed

    Li, Y; Zhong, R; Wang, X; Ai, P; Henderson, F; Chen, N; Luo, F

    2017-04-01

    To test if active breath control during cone-beam computed tomography (CBCT) could improve planning target volume during accelerated partial breast radiotherapy for breast cancer. Patients who were more than 40 years old, underwent breast-conserving dissection and planned for accelerated partial breast irradiation, and with postoperative staging limited to T1-2 N0 M0, or postoperative staging T2 lesion no larger than 3cm with a negative surgical margin greater than 2mm were enrolled. Patients with lobular carcinoma or extensive ductal carcinoma in situ were excluded. CBCT images were obtained pre-correction, post-correction and post-treatment. Set-up errors were recorded at left-right, anterior-posterior and superior-inferior directions. The differences between these CBCT images, as well as calculated radiation doses, were compared between patients with active breath control or free breathing. Forty patients were enrolled, among them 25 had active breath control. A total of 836 CBCT images were obtained for analysis. CBCT significantly reduced planning target volume. However, active breath control did not show significant benefit in decreasing planning target volume margin and the doses of organ-at-risk when compared to free breathing. CBCT, but not active breath control, could reduce planning target volume during accelerated partial breast irradiation. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  6. Comparison and reproducibility of ADC measurements in breathhold, respiratory triggered, and free-breathing diffusion-weighted MR imaging of the liver.

    PubMed

    Kwee, Thomas C; Takahara, Taro; Koh, Dow-Mu; Nievelstein, Rutger A J; Luijten, Peter R

    2008-11-01

    To compare and determine the reproducibility of apparent diffusion coefficient (ADC) measurements of the normal liver parenchyma in breathhold, respiratory triggered, and free-breathing diffusion-weighted magnetic resonance imaging (DWI). Eleven healthy volunteers underwent three series of DWI. Each DWI series consisted of one breathhold, one respiratory triggered, and two free-breathing (thick and thin slice acquisition) scans of the liver, at b-values of 0 and 500 s/mm2. ADCs of the liver parenchyma were compared by using nonparametric tests. Reproducibility was assessed by the Bland-Altman method. Mean ADCs (in 10(-3) mm2/sec) in respiratory triggered DWI (2.07-2.27) were significantly higher than mean ADCs in breathhold DWI (1.57-1.62), thick slice free-breathing DWI (1.62-1.65), and thin slice free-breathing DWI (1.57-1.66) (P<0.005). Ranges of mean difference in ADC measurement+/-limits of agreement between two scans were -0.02-0.05+/-0.16-0.24 in breathhold DWI, -0.14-0.20+/-0.59-0.60 in respiratory triggered DWI, -0.03-0.03+/-0.20-0.29 in thick slice free-breathing DWI, and -0.01-0.09+/-0.21-0.29 in thin slice free-breathing DWI. ADC measurements of the normal liver parenchyma in respiratory triggered DWI are significantly higher and less reproducible than in breathhold and free-breathing DWI. Copyright (c) 2008 Wiley-Liss, Inc.

  7. On the importance of developing a new generation of breath tests for Helicobacter pylori detection.

    PubMed

    Kushch, Ievgeniia; Korenev, Nikolai; Kamarchuk, Lyudmila; Pospelov, Alexander; Kravchenko, Andrey; Bajenov, Leonid; Kabulov, Mels; Amann, Anton; Kamarchuk, Gennadii

    2015-12-15

    State-of-the-art methods for non-invasive detection of the Helicobacter pylori (H. pylori) infection have been considered. A reported global tendency towards a non-decreasing prevalence of H. pylori worldwide could be co-influenced by the functional limitations of urea breath tests (UBTs), currently preferred for the non-invasive recognition of H. pylori in a clinical setting. Namely, the UBTs can demonstrate false-positive or false-negative results. Within this context, limitations of conventional clinically exploited H. pylori tests have been discussed to justify the existing need for the development of a new generation of breath tests for the detection of H. pylori and the differentiation of pathogenic and non-pathogenic strains of the bacterium. This paper presents the results of a pilot clinical study aimed at evaluating the development and diagnostic potential of a new method based on the detection of the non-urease products of H. pylori vital activity in exhaled gas. The characteristics of breath of adolescents with H. pylori-positive and H. pylori-negative functional dyspepsia, together with a consideration of the cytotoxin-associated gene A (CagA) status of H. pylori-positive subjects, have been determined for the first time using innovative point-contact nanosensor devices based on salts of the organic conductor tetracyanoquinodimethane (TCNQ). The clinical and diagnostic relevance of the response curves of the point-contact sensors was assessed. It was found that the recovery time of the point-contact sensors has a diagnostic value for differentiation of the H. pylori-associated peptic ulcer disease. The diagnostically significant elongation of the recovery time was even more pronounced in patients infected with CagA-positive H. pylori strains compared to the CagA-negative patients. Taking into account the operation of the point-contact sensors in the real-time mode, the obtained results are essential prerequisites for the development of a fast and portable breath test for non-invasive detection of cytotoxic CagA strains of H. pylori infection. The relaxation time of the point-contact nanosensors could be selected as a diagnostic criterion for non-invasive determination of H. pylori-associated destructive lesions of the gastroduodenal area in adolescents, using the point-contact spectroscopic concept of breath analysis. This can subsequently be implemented into a 'test-and-treat' approach for the management of uninvestigated dyspepsia in populations with a high prevalence of H. pylori (according to the Maastricht III and IV Consensus recommendations).

  8. Using a respiratory navigator significantly reduces variability when quantifying left ventricular torsion with cardiovascular magnetic resonance.

    PubMed

    Hamlet, Sean M; Haggerty, Christopher M; Suever, Jonathan D; Wehner, Gregory J; Andres, Kristin N; Powell, David K; Charnigo, Richard J; Fornwalt, Brandon K

    2017-03-01

    Left ventricular (LV) torsion is an important indicator of cardiac function that is limited by high inter-test variability (50% of the mean value). We hypothesized that this high inter-test variability is partly due to inconsistent breath-hold positions during serial image acquisitions, which could be significantly improved by using a respiratory navigator for cardiovascular magnetic resonance (CMR) based quantification of LV torsion. We assessed respiratory-related variability in measured LV torsion with two distinct experimental protocols. First, 17 volunteers were recruited for CMR with cine displacement encoding with stimulated echoes (DENSE) in which a respiratory navigator was used to measure and then enforce variability in end-expiratory position between all LV basal and apical acquisitions. From these data, we quantified the inter-test variability of torsion in the absence and presence of enforced end-expiratory position variability, which established an upper bound for the expected torsion variability. For the second experiment (in 20 new, healthy volunteers), 10 pairs of cine DENSE basal and apical images were each acquired from consecutive breath-holds and consecutive navigator-gated scans (with a single acceptance position). Inter-test variability of torsion was compared between the breath-hold and navigator-gated scans to quantify the variability due to natural breath-hold variation. To demonstrate the importance of these variability reductions, we quantified the reduction in sample size required to detect a clinically meaningful change in LV torsion with the use of a respiratory navigator. The mean torsion was 3.4 ± 0.2°/cm. From the first experiment, enforced variability in end-expiratory position translated to considerable variability in measured torsion (0.56 ± 0.34°/cm), whereas inter-test variability with consistent end-expiratory position was 57% lower (0.24 ± 0.16°/cm, p < 0.001). From the second experiment, natural respiratory variability from consecutive breath-holds translated to a variability in torsion of 0.24 ± 0.10°/cm, which was significantly higher than the variability from navigator-gated scans (0.18 ± 0.06°/cm, p = 0.02). By using a respiratory navigator with DENSE, theoretical sample sizes were reduced from 66 to 16 and 26 to 15 as calculated from the two experiments. A substantial portion (22-57%) of the inter-test variability of LV torsion can be reduced by using a respiratory navigator to ensure a consistent breath-hold position between image acquisitions.

  9. [13C]Glucose Breath Testing Provides a Noninvasive Measure of Insulin Resistance: Calibration Analyses Against Clamp Studies

    PubMed Central

    Hussain, Maysa; Jangorbhani, Morteza; Schuette, Sally; Considine, Robert V.; Chisholm, Robin L.

    2014-01-01

    Abstract Background: Exhaled 13CO2 following ingestion of [13C]glucose with a standard oral glucose tolerance load correlates with blood glucose values but is determined by tissue glucose uptake. Therefore exhaled 13CO2 may also be a surrogate measure of the whole-body glucose disposal rate (GDR) measured by the gold standard hyperinsulinemic euglycemic clamp. Subjects and Methods: Subjects from across the glycemia range were studied on 2 consecutive days under fasting conditions. On Day 1, a 75-g oral glucose load spiked with [13C]glucose was administered. On Day 2, a hyperinsulinemic euglycemic clamp was performed. Correlations between breath parameters and clamp-derived GDR were evaluated, and calibration analyses were performed to evaluate the precision of breath parameter predictions of clamp measures. Results: Correlations of breath parameters with GDR and GDR per kilogram of fat-free mass (GDRffm) ranged from 0.54 to 0.61 and 0.54 to 0.66, respectively (all P<0.001). In calibration analyses the root mean square error for breath parameters predicting GDR and GDRffm ranged from 2.32 to 2.46 and from 3.23 to 3.51, respectively. Cross-validation prediction error (CVPE) estimates were 2.35–2.51 (GDR) and 3.29–3.57 (GDRffm). Prediction precision of breath enrichment at 180 min predicting GDR (CVPE=2.35) was superior to that for inverse insulin (2.68) and the Matsuda Index (2.51) but inferior to that for the log of homeostasis model assessment (2.21) and Quantitative Insulin Sensitivity Check Index (2.29) (all P<10−5). Similar patterns were seen for predictions of GDRffm. Conclusions: 13CO2 appearance in exhaled breath following a standard oral glucose load with added [13C]glucose provides a valid surrogate index of clamp-derived measures of whole-body insulin resistance, with good accuracy and precision. This noninvasive breath test-based approach can provide a useful measure of whole-body insulin resistance in physiologic and epidemiologic studies. PMID:24116833

  10. Brief ethanol exposure and stress-related factors disorganize neonatal breathing plasticity during the brain growth spurt period in the rat.

    PubMed

    Macchione, A F; Anunziata, F; Haymal, B O; Abate, P; Molina, J C

    2018-04-01

    The effects of early ethanol exposure upon neonatal respiratory plasticity have received progressive attention given a multifactorial perspective related with sudden infant death syndrome or hypoxia-associated syndromes. The present preclinical study was performed in 3-9-day-old pups, a stage in development characterized by a brain growth spurt that partially overlaps with the 3rd human gestational trimester. Breathing frequencies and apneas were examined in pups receiving vehicle or a relatively moderate ethanol dose (2.0 g/kg) utilizing a whole body plethysmograph. The experimental design also considered possible associations between drug administration stress and exteroceptive cues (plethysmographic context or an artificial odor). Ethanol exposure progressively exerted a detrimental effect upon breathing frequencies. A test conducted at PD9 when pups were under the state of sobriety confirmed ethanol's detrimental effects upon respiratory plasticity (breathing depression). Pre-exposure to the drug also resulted in a highly disorganized respiratory response following a hypoxic event, i.e., heightened apneic episodes. Associative processes involving drug administration procedures and placement in the plethysmographic context also affected respiratory plasticity. Pups that experienced intragastric administrations in close temporal contiguity with such a context showed diminished hyperventilation during hypoxia. In a 2nd test conducted at PD9 while pups were intoxicated and undergoing hypoxia, an attenuated hyperventilatory response was observed. In this test, there were also indications that prior ethanol exposure depressed breathing frequencies during hypoxia and a recovery normoxia phase. As a whole, the results demonstrated that brief ethanol experience and stress-related factors significantly disorganize respiratory patterns as well as arousal responses linked to hypoxia in neonatal rats.

  11. Simplified 13C-urea breath test with a new infrared spectrometer for diagnosis of Helicobacter pylori infection.

    PubMed

    Chen, Tseng-Shing; Chang, Full-Young; Chen, Pang-Chi; Huang, Thomas W; Ou, Jonathan T; Tsai, Ming-Hung; Wu, Ming-Shiang; Lin, Jaw-Town

    2003-11-01

    Infrared spectrometry has correlated excellently with mass spectrometry in detecting the ratio of 13CO(2) to 12CO(2) in breath samples. The present study aimed to evaluate the accuracy of the 13C-urea breath test (13C-UBT) using a new model of infrared analyzer. A total of 600 patients who were undergoing upper endoscopy without receiving eradication therapy were entered into the study. Culture, histology, and rapid urease test on biopsies from the antrum and corpus of the stomach were used for the determination of Helicobacter pylori infection. Breath samples were collected before and 20 min after drinking 100 mg 13C-urea in 100 mL water. The optimal cutoff value was determined by the receiver operating characteristic curve. Of the 586 patients who were eligible for analysis, 369 were positive for H. pylori infection, 185 were negative for H. pylori infection, and 32 were indeterminate. When the appropriate cutoff value was set at 3.5 per thousand, a sensitivity of 97.8%, a specificity of 96.8% and an accuracy of 97.5% were obtained using the 13C-UBT. The accuracy of the 13C-UBT decreased when CO(2) concentration in the breath sample was <2%, as compared with > or = 2% (93.6%vs 97.7%), mainly because of a decrease in specificity (81.8%vs 97.7%). There were 2.7% of patients with Delta13CO(2) values that fell between 3.0-4.5 per thousand, in whom the risk of error was 47%. The 13C-UBT performed with infrared spectrometry is a highly sensitive, specific, and non-invasive method for the detection of H. pylori infection. The immediate availability of the test result and technical simplicity make it particularly effective in routine clinical practice.

  12. Bench experiments comparing simulated inspiratory effort when breathing helium-oxygen mixtures to that during positive pressure support with air

    PubMed Central

    2012-01-01

    Background Inhalation of helium-oxygen (He/O2) mixtures has been explored as a means to lower the work of breathing of patients with obstructive lung disease. Non-invasive ventilation (NIV) with positive pressure support is also used for this purpose. The bench experiments presented herein were conducted in order to compare simulated patient inspiratory effort breathing He/O2 with that breathing medical air, with or without pressure support, across a range of adult, obstructive disease patterns. Methods Patient breathing was simulated using a dual-chamber mechanical test lung, with the breathing compartment connected to an ICU ventilator operated in NIV mode with medical air or He/O2 (78/22 or 65/35%). Parabolic or linear resistances were inserted at the inlet to the breathing chamber. Breathing chamber compliance was also varied. The inspiratory effort was assessed for the different gas mixtures, for three breathing patterns, with zero pressure support (simulating unassisted spontaneous breathing), and with varying levels of pressure support. Results Inspiratory effort increased with increasing resistance and decreasing compliance. At a fixed resistance and compliance, inspiratory effort increased with increasing minute ventilation, and decreased with increasing pressure support. For parabolic resistors, inspiratory effort was lower for He/O2 mixtures than for air, whereas little difference was measured for nominally linear resistance. Relatively small differences in inspiratory effort were measured between the two He/O2 mixtures. Used in combination, reductions in inspiratory effort provided by He/O2 and pressure support were additive. Conclusions The reduction in inspiratory effort afforded by breathing He/O2 is strongly dependent on the severity and type of airway obstruction. Varying helium concentration between 78% and 65% has small impact on inspiratory effort, while combining He/O2 with pressure support provides an additive reduction in inspiratory effort. In addition, breathing He/O2 alone may provide an alternative to pressure support in circumstances where NIV is not available or poorly tolerated. PMID:23031537

  13. Dyspnea on exertion in obese women: association with an increased oxygen cost of breathing.

    PubMed

    Babb, Tony G; Ranasinghe, Kamalini G; Comeau, Laurie A; Semon, Trisha L; Schwartz, Belinda

    2008-07-15

    Although exertional dyspnea in obesity is an important and prolific clinical concern, the underlying mechanism remains unclear. To investigate whether dyspnea on exertion in otherwise healthy obese women was associated with an increase in the oxygen cost of breathing or cardiovascular deconditioning. Obese women with and without dyspnea on exertion participated in two independent experiments (n = 16 and n = 14). All participants underwent pulmonary function testing, hydrostatic weighing, ratings of perceived breathlessness during cycling at 60 W, and determination of the oxygen cost of breathing during eucapnic voluntary hyperpnea at 40 and 60 L/min. Cardiovascular exercise capacity, fat distribution, and respiratory mechanics were determined in 14 women in experiment 2. Data were analyzed between groups by independent t test, and the relationship between the variables was determined by regression analysis. In both experiments, breathlessness during 60 W cycling was markedly increased in over 37% of the obese women (P < 0.01). Age, height, weight, lung function, and %body fat were not different between the groups in either experiment. In contrast, the oxygen cost of breathing was significantly (P < 0.01) and markedly (38-70%) greater in the obese women with dyspnea on exertion. The oxygen cost of breathing was significantly (P < 0.001) correlated with the rating of perceived breathlessness obtained during the 60 W exercise in experiment 1 (r(2) = 0.57) and experiment 2 (r(2) = 0.72). Peak cardiovascular exercise capacity, fat distribution, and respiratory mechanics were not different between groups in experiment 2. Dyspnea on exertion is prevalent in otherwise healthy obese women, which seems to be strongly associated with an increased oxygen cost of breathing. Exercise capacity is not reduced in obese women with dyspnea on exertion.

  14. Atropine microdialysis within or near the pre-Botzinger Complex increases breathing frequency more during wakefulness than during NREM sleep.

    PubMed

    Muere, Clarissa; Neumueller, Suzanne; Miller, Justin; Olesiak, Samantha; Hodges, Matthew R; Pan, Lawrence; Forster, Hubert V

    2013-03-01

    Normal activity of neurons within the medullary ventral respiratory column (VRC) in or near the pre-Bötzinger Complex (preBötC) is dependent on the balance of inhibitory and excitatory neuromodulators acting at their respective receptors. The role of cholinergic neuromodulation during awake and sleep states is unknown. Accordingly, our objective herein was to test the hypotheses that attenuation of cholinergic modulation of VRC/preBötC neurons in vivo with atropine would: 1) decrease breathing frequency more while awake than during non-rapid-eye-movement (NREM) sleep and 2) increase other excitatory neuromodulators. To test these hypotheses, we unilaterally dialyzed mock cerebrospinal fluid (mCSF) or 50 mM atropine in mCSF in or near the preBötC region of adult goats during the awake (n = 9) and NREM sleep (n = 7) states. Breathing was monitored, and effluent dialysate was collected for analysis of multiple neurochemicals. Compared with dialysis of mCSF alone, atropine increased (P < 0.05) breathing frequency while awake during the day [+10 breaths (br)/min] and at night (+9 br/min) and, to a lesser extent, during NREM sleep (+5 br/min). Atropine increased (P < 0.05) effluent concentrations of serotonin (5-HT), substance P (SP), and glycine during the day and at night. When atropine was dialyzed in one preBötC and mCSF in the contralateral preBötC, 5-HT and SP increased only at the site of atropine dialysis. We conclude: 1) attenuation of a single neuromodulator results in local changes in other neuromodulators that affect ventilatory control, 2) effects of perturbations of cholinergic neuromodulation on breathing are state-dependent, and 3) interpretation of perturbations in vivo requires consideration of direct and indirect effects.

  15. Hydrodynamic sensory threshold in harbour seals (Phoca vitulina) for artificial flatfish breathing currents.

    PubMed

    Niesterok, Benedikt; Dehnhardt, Guido; Hanke, Wolf

    2017-07-01

    Harbour seals have the ability to detect benthic fish such as flatfish using the water currents these fish emit through their gills (breathing currents). We investigated the sensory threshold in harbour seals for this specific hydrodynamic stimulus under conditions which are realistic for seals hunting in the wild. We used an experimental platform where an artificial breathing current was emitted through one of eight different nozzles. Two seals were trained to search for the active nozzle. Each experimental session consisted of eight test trials of a particular stimulus intensity and 16 supra-threshold trials of high stimulus intensity. Test trials were conducted with the animals blindfolded. To determine the threshold, a series of breathing currents differing in intensity was used. For each intensity, three sessions were run. The threshold in terms of maximum water velocity within the breathing current was 4.2 cm s -1 for one seal and 3.7 cm s -1 for the other. We measured background flow velocities from 1.8 to 3.4 cm s -1 Typical swimming speeds for both animals were around 0.5 m s -1 Swimming speed differed between successful and unsuccessful trials. It appears that swimming speed is restricted for the successful detection of a breathing current close to the threshold. Our study is the first to assess a sensory threshold of the vibrissal system for a moving harbour seal under near-natural conditions. Furthermore, this threshold was defined for a natural type of stimulus differing from classical dipole stimuli which have been widely used in threshold determination so far. © 2017. Published by The Company of Biologists Ltd.

  16. Gated CT imaging using a free-breathing respiration signal from flow-volume spirometry

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    D'Souza, Warren D.; Kwok, Young; Deyoung, Chad

    2005-12-15

    Respiration-induced tumor motion is known to cause artifacts on free-breathing spiral CT images used in treatment planning. This leads to inaccurate delineation of target volumes on planning CT images. Flow-volume spirometry has been used previously for breath-holds during CT scans and radiation treatments using the active breathing control (ABC) system. We have developed a prototype by extending the flow-volume spirometer device to obtain gated CT scans using a PQ 5000 single-slice CT scanner. To test our prototype, we designed motion phantoms to compare image quality obtained with and without gated CT scan acquisition. Spiral and axial (nongated and gated) CTmore » scans were obtained of phantoms with motion periods of 3-5 s and amplitudes of 0.5-2 cm. Errors observed in the volume estimate of these structures were as much as 30% with moving phantoms during CT simulation. Application of motion-gated CT with active breathing control reduced these errors to within 5%. Motion-gated CT was then implemented in patients and the results are presented for two clinical cases: lung and abdomen. In each case, gated scans were acquired at end-inhalation, end-exhalation in addition to a conventional free-breathing (nongated) scan. The gated CT scans revealed reduced artifacts compared with the conventional free-breathing scan. Differences of up to 20% in the volume of the structures were observed between gated and free-breathing scans. A comparison of the overlap of structures between the gated and free-breathing scans revealed misalignment of the structures. These results demonstrate the ability of flow-volume spirometry to reduce errors in target volumes via gating during CT imaging.« less

  17. Photoplethysmography as a single source for analysis of sleep-disordered breathing in patients with severe cardiovascular disease.

    PubMed

    Amir, Offer; Barak-Shinar, Deganit; Henry, Antonietta; Smart, Frank W

    2012-02-01

    Sleep-disordered breathing and Cheyne-Stokes breathing are often not diagnosed, especially in cardiovascular patients. An automated system based on photoplethysmographic signals might provide a convenient screening and diagnostic solution for patient evaluation at home or in an ambulatory setting. We compared event detection and classification obtained by full polysomnography (the 'gold standard') and by an automated new algorithm system in 74 subjects. Each subject underwent overnight polysomnography, 60 in a hospital cardiology department and 14 while being tested for suspected sleep-disordered breathing in a sleep laboratory. The sleep-disordered breathing and Cheyne-Stokes breathing parameters measured by a new automated algorithm system correlated very well with the corresponding results obtained by full polysomnography. The sensitivity of the Cheyne-Stokes breathing detected from the system compared to full polysomnography was 92% [95% confidence interval (CI): 78.6-98.3%] and specificity 94% (95% CI: 81.3-99.3%). Comparison of the Apnea Hyponea Index with a cutoff level of 15 shows a sensitivity of 98% (95% CI: 87.1-99.6%) and specificity of 96% (95% CI: 79.8-99.3%). The detection of respiratory events showed agreement of approximately 80%. Regression and Bland-Altman plots revealed good agreement between the two methods. Relative to gold-standard polysomnography, the simply used automated system in this study yielded an acceptable analysis of sleep- and/or cardiac-related breathing disorders. Accordingly, and given the convenience and simplicity of its application, this system can be considered as a suitable platform for home and ambulatory screening and diagnosis of sleep-disordered breathing in patients with cardiovascular disease. © 2011 European Sleep Research Society.

  18. Unloading work of breathing during high-frequency oscillatory ventilation: a bench study

    PubMed Central

    van Heerde, Marc; Roubik, Karel; Kopelent, Vitek; Plötz, Frans B; Markhorst, Dick G

    2006-01-01

    Introduction With the 3100B high-frequency oscillatory ventilator (SensorMedics, Yorba Linda, CA, USA), patients' spontaneous breathing efforts result in a high level of imposed work of breathing (WOB). Therefore, spontaneous breathing often has to be suppressed during high-frequency oscillatory ventilation (HFOV). A demand-flow system was designed to reduce imposed WOB. Methods An external gas flow controller (demand-flow system) accommodates the ventilator fresh gas flow during spontaneous breathing simulation. A control algorithm detects breathing effort and regulates the demand-flow valve. The effectiveness of this system has been evaluated in a bench test. The Campbell diagram and pressure time product (PTP) are used to quantify the imposed workload. Results Using the demand-flow system, imposed WOB is considerably reduced. The demand-flow system reduces inspiratory imposed WOB by 30% to 56% and inspiratory imposed PTP by 38% to 59% compared to continuous fresh gas flow. Expiratory imposed WOB was decreased as well by 12% to 49%. In simulations of shallow to normal breathing for an adult, imposed WOB is 0.5 J l-1 at maximum. Fluctuations in mean airway pressure on account of spontaneous breathing are markedly reduced. Conclusion The use of the demand-flow system during HFOV results in a reduction of both imposed WOB and fluctuation in mean airway pressure. The level of imposed WOB was reduced to the physiological range of WOB. Potentially, this makes maintenance of spontaneous breathing during HFOV possible and easier in a clinical setting. Early initiation of HFOV seems more possible with this system and the possibility of weaning of patients directly on a high-frequency oscillatory ventilator is not excluded either. PMID:16848915

  19. Simultaneous measurement of instantaneous heart rate and chest wall plethysmography in short-term, metronome guided heart rate variability studies: suitability for assessment of autonomic dysfunction.

    PubMed

    Perring, S; Jones, E

    2003-08-01

    Instantaneous heart rate and chest wall motion were measured using a 3-lead ECG and an air pressure chest wall plethysmography system. Chest wall plethysmography traces were found to accurately represent the breathing pattern as measured by spirometry (average correlation coefficient 0.944); though no attempt was made to calibrate plethysmography voltage output to tidal volume. Simultaneous measurements of heart rate and chest wall motion were made for short periods under metronome guided breathing at 6 breaths per minute. The average peak to trough heart rate change per breath cycle (AVEMAX) and maximum correlation between heart rate and breathing cycle (HRBRCORR) were measured. Studies of 44 normal volunteers indicated clear inverse correlation of heart rate variability parameters with age (AVEMAX R = -0.502, P < 0.001) but no significant change in HRBRCORR with age (R = -0.115). Comparison of normal volunteers with diabetics with no history of symptoms associated with autonomic failure indicated significant lower heart rate variability in diabetics (P = 0.005 for AVEMAX) and significantly worse correlation between heart rate and breathing (P < 0.001 for HRBRCORR). Simultaneous measurement of heart rate and breathing offers the possibility of more sensitive diagnosis of autonomic failure in a simple bedside test and gives further insight into the nature of cardio-ventilatory coupling.

  20. Detection of response to command using voluntary control of breathing in disorders of consciousness

    PubMed Central

    Charland-Verville, Vanessa; Lesenfants, Damien; Sela, Lee; Noirhomme, Quentin; Ziegler, Erik; Chatelle, Camille; Plotkin, Anton; Sobel, Noam; Laureys, Steven

    2014-01-01

    Background: Detecting signs of consciousness in patients in a vegetative state/unresponsive wakefulness syndrome (UWS/VS) or minimally conscious state (MCS) is known to be very challenging. Plotkin et al. (2010) recently showed the possibility of using a breathing-controlled communication device in patients with locked in syndrome. We here aim to test a breathing-based “sniff controller” that could be used as an alternative diagnostic tool to evaluate response to command in severely brain damaged patients with chronic disorders of consciousness (DOC). Methods: Twenty-five DOC patients were included. Patients’ resting breathing-amplitude was measured during a 5 min resting condition. Next, they were instructed to end the presentation of a music sequence by sniffing vigorously. An automated detection of changes in breathing amplitude (i.e., >1.5 SD of resting) ended the music and hence provided positive feedback to the patient. Results: None of the 11 UWS/VS patients showed a sniff-based response to command. One out of 14 patients with MCS was able to willfully modulate his breathing pattern to answer the command on 16/19 trials (accuracy 84%). Interestingly, this patient failed to show any other motor response to command. Discussion: We here illustrate the possible interest of using breathing-dependent response to command in the detection of residual cognition in patients with DOC after severe brain injury. PMID:25566035

  1. Detection of response to command using voluntary control of breathing in disorders of consciousness.

    PubMed

    Charland-Verville, Vanessa; Lesenfants, Damien; Sela, Lee; Noirhomme, Quentin; Ziegler, Erik; Chatelle, Camille; Plotkin, Anton; Sobel, Noam; Laureys, Steven

    2014-01-01

    Detecting signs of consciousness in patients in a vegetative state/unresponsive wakefulness syndrome (UWS/VS) or minimally conscious state (MCS) is known to be very challenging. Plotkin et al. (2010) recently showed the possibility of using a breathing-controlled communication device in patients with locked in syndrome. We here aim to test a breathing-based "sniff controller" that could be used as an alternative diagnostic tool to evaluate response to command in severely brain damaged patients with chronic disorders of consciousness (DOC). Twenty-five DOC patients were included. Patients' resting breathing-amplitude was measured during a 5 min resting condition. Next, they were instructed to end the presentation of a music sequence by sniffing vigorously. An automated detection of changes in breathing amplitude (i.e., >1.5 SD of resting) ended the music and hence provided positive feedback to the patient. None of the 11 UWS/VS patients showed a sniff-based response to command. One out of 14 patients with MCS was able to willfully modulate his breathing pattern to answer the command on 16/19 trials (accuracy 84%). Interestingly, this patient failed to show any other motor response to command. We here illustrate the possible interest of using breathing-dependent response to command in the detection of residual cognition in patients with DOC after severe brain injury.

  2. Hypoxemia, hypercapnia, and breathing pattern in patients with chronic obstructive pulmonary disease.

    PubMed

    Parot, S; Miara, B; Milic-Emili, J; Gautier, H

    1982-11-01

    The results of lung function tests (total and functional residual capacities, residual volume/total lung capacity ratio, forced expiratory volume in one second) breathing patterns and arterial PO2 and PCO2 were studied in 651 ambulatory male patients with chronic obstructive pulmonary disease, functionally and clinically stable. Function tests were only loosely correlated with gas tensions: abnormalities in mechanics and in gas exchange are not necessarily related. In patients matched for the degree of obstruction, the breathing pattern depended upon both PaO2 and PaCO2. Isolated hypoxemia was accompanied by increased respiratory frequency without any variation in tidal volume: this suggests that the chemoreceptive systems still responded to changes in PaO2. Isolated hypercapnia was accompanied by a decrease in tidal volume and an increase in respiratory frequency. Consequently, the dead space/tidal volume ratio increased, leading to a drop in alveolar ventilation and to CO2 retention.

  3. Comparison of protective breathing equipment performance at ground level and 8,000 feet altitude using parameters prescribed by portions of FAA action notice A-8150.2 : final report.

    DOT National Transportation Integrated Search

    1989-06-01

    Two types of crewmember protective breathing equipment (PBE) were performance tested for compliance with Action Notice A-8150.2 at ground level (-1,300 feet) and 8,000 feet altitude. PBE #1 was a "hood with oral-nasal mask," which used potassium supe...

  4. Meditation, Breath Work, and Focus Training for Teachers and Students--The Five Minutes a Day that Can Really Make a Difference

    ERIC Educational Resources Information Center

    Sessa, Sandra A.

    2007-01-01

    This paper is based on information researched and presented in a faculty development seminar for elementary teachers for use with students preparing for national testing to manage stress and increase attention focus. It reviews effects of stress on behavior, mood, and concentration; explains basics of breath work and meditation; provides…

  5. A European Respiratory Society technical standard: exhaled biomarkers in lung disease.

    PubMed

    Horváth, Ildiko; Barnes, Peter J; Loukides, Stelios; Sterk, Peter J; Högman, Marieann; Olin, Anna-Carin; Amann, Anton; Antus, Balazs; Baraldi, Eugenio; Bikov, Andras; Boots, Agnes W; Bos, Lieuwe D; Brinkman, Paul; Bucca, Caterina; Carpagnano, Giovanna E; Corradi, Massimo; Cristescu, Simona; de Jongste, Johan C; Dinh-Xuan, Anh-Tuan; Dompeling, Edward; Fens, Niki; Fowler, Stephen; Hohlfeld, Jens M; Holz, Olaf; Jöbsis, Quirijn; Van De Kant, Kim; Knobel, Hugo H; Kostikas, Konstantinos; Lehtimäki, Lauri; Lundberg, Jon; Montuschi, Paolo; Van Muylem, Alain; Pennazza, Giorgio; Reinhold, Petra; Ricciardolo, Fabio L M; Rosias, Philippe; Santonico, Marco; van der Schee, Marc P; van Schooten, Frederik-Jan; Spanevello, Antonio; Tonia, Thomy; Vink, Teunis J

    2017-04-01

    Breath tests cover the fraction of nitric oxide in expired gas ( F eNO ), volatile organic compounds (VOCs), variables in exhaled breath condensate (EBC) and other measurements. For EBC and for F eNO , official recommendations for standardised procedures are more than 10 years old and there is none for exhaled VOCs and particles. The aim of this document is to provide technical standards and recommendations for sample collection and analytic approaches and to highlight future research priorities in the field. For EBC and F eNO , new developments and advances in technology have been evaluated in the current document. This report is not intended to provide clinical guidance on disease diagnosis and management.Clinicians and researchers with expertise in exhaled biomarkers were invited to participate. Published studies regarding methodology of breath tests were selected, discussed and evaluated in a consensus-based manner by the Task Force members.Recommendations for standardisation of sampling, analysing and reporting of data and suggestions for research to cover gaps in the evidence have been created and summarised.Application of breath biomarker measurement in a standardised manner will provide comparable results, thereby facilitating the potential use of these biomarkers in clinical practice. Copyright ©ERS 2017.

  6. Lactitol tolerance in healthy Thai adults.

    PubMed

    Soontornchai, S; Sirichakwal, P; Puwastien, P; Tontisirin, K; Krüger, D; Grossklaus, R

    1999-10-01

    The hydrogen breath analysis test was performed in healthy Thai adults to determine lactitol tolerance. The study was conducted in 39 individuals (11 males and 28 females) aged 18-41 years. All volunteers agreed to participate in this study after the risks and benefits had been fully explained. Subjects were requested not to consume milk, milk products, or high-vegetable diets for a day and to fast from 10 p.m. of the day preceding the test day. After consumption of the test diet (12 and 20 g of lactose or lactitol, respectively, in 250 mL water), the subjects recorded the severity of symptoms for 24 hours. Breath samples were collected after fasting and after consumption of the test diet at 30 min intervals over the 7-hour study period. Breath samples were analyzed for hydrogen using gas chromatography. After consumption of 12 g lactose, the prevalence of lactose malabsorbers was established. The increment of a peak breath hydrogen level of > or = 20 ppm above the baseline level was used as an indicator of lactose malabsorption. The lactose malabsorbers were further classified as lactose tolerance or lactose intolerance according to the gastrointestinal symptoms observed. All 39 healthy Thai adults could be classified into 3 groups as follows: 9 (23%) lactose absorbers (LA), 15 (38.5%) lactose mal-absorber/tolerance (LMT), and 15 (38.5%) lactose mal-absorber/intolerance (LMI). Using the hydrogen breath test, 67% of the subjects were identified as lactitol intolerance after the consumption of 12 g lactitol. The lactitol intolerance comprised 53.8% of LMI, 34.6% of LMT, and 11.5% of LA. Among all subjects, one third of LA (33%), two thirds of LMT (60%), and 93% of LMI were lactitol intolerant. In addition, gastrointestinal symptoms such as flatulence and abdominal pain were most pronounced in LMI. Diarrhea was also a prominent manifestation after consumption of 12 g lactitol. Therefore, it was finally decided that 20 g lactose or lactitol were not given to LMI because of the risk of gastrointestinal symptoms. After high doses (20 g) of lactose and lactitol consumption, most LMT developed more symptoms than did LA and the main symptom was diarrhea. Consumption of 20 g lactose resulted in fewer symptoms than 20 g lactitol in both LA and LMT. On the basis of the hydrogen breath test, most LA tolerated 12 g lactitol without gastrointestinal symptoms except some flatulence whereas most LMT and LMI did not. Twenty g lactitol was not tolerated by both LA and LMT because there was diarrhea among the subjects, especially in LMT. Although the hydrogen breath analysis test is the best method for identification of lactose malabsorption, it is not the best method to identify lactitol intolerance. A hydrogen concentration of 15 ppm above the baseline level was found to be the best cut-off point to indicate lactitol intolerance although sensitivity was 85% and specificity only 38% in this study. It was further concluded that there is a greater susceptibility to lactitol in human lactose malabsorbers than in lactose absorbers. Our findings might be relevant for the limited use of lactitol in Thailand.

  7. Effect of pelvic irradiation of lactose absorption. [. gamma. rays or x rays were used in gynecologic malignancy therapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Stryker, J.A.; Mortel, R.; Hepner, G.W.

    1978-01-01

    Twenty-four patients undergoing pelvic irradiation for gynecologic malignancies had /sup 14/C-lactose breath tests performed in the first and fifth weeks of their treatment. The /sup 14/C-lactose breath test was performed by administering 2 ..mu..Ci of /sup 14/C-lactose by mouth along with 50 g of lactose. Breath samples were collected in ethanolic hyamine 1, 2, and 3 hr later; the radioactivity of the trapped /sup 14/CO/sub 2/ was determined by liquid scintillation spectroscopy. In the first week of treatment the percentage of administered /sup 14/C excreted as /sup 14/CO/sub 2/ at 1, 2, and 3 hr was 1.7 +- 0.8% (meanmore » +- SD), 4.5 +- 1.6%, and 5.8 +- 1.4%, respectively. In the fifth week of treatment the 1-hr, 2-hr, and 3-hr values were 1.2 +- 0.9%, 3.6 +- 2.0%, and 4.7 +- 1.9%, respectively. The difference between the first week and fifth week test results at 1, 2, and 3 hr was statistically significant (t = 2.64, p < 0.02), (t = 2.24, p < 0.05), (t = 2.95, p < 0.01). There was a negative correlation between the 1-hr /sup 14/C-lactose breath test results in the fifth week and the stool frequency at that time (r = -0.44, p < 0.05). Seven of 12 patients whose 1 hr /sup 14/C-lactose breath test results in the fifth week were below normal (<1.2%) had nausea at that time. The data suggest that in some patients, lactose malabsorption as a result of the effect of radiation on small intestinal function may be etiologically related to the symptoms of nausea and diarrhea which occur commonly in patients who are undergoing pelvic irradiation. In addition, the results suggest that lactose-containing foods should be restricted in some patients who are undergoing pelvic irradiation to prevent symptoms resulting from radiation-induced lactose intolerance.« less

  8. Air-breathing aerospace plane development essential: Hypersonic propulsion flight tests

    NASA Technical Reports Server (NTRS)

    Mehta, Unmeel B.

    1994-01-01

    Hypersonic air-breathing propulsion utilizing scramjets can fundamentally change transatmospheric accelerators for low earth-to-orbit and return transportation. The value and limitations of ground tests, of flight tests, and of computations are presented, and scramjet development requirements are discussed. It is proposed that near full-scale hypersonic propulsion flight tests are essential for developing a prototype hypersonic propulsion system and for developing computational-design technology so that it can be used for designing this system. In order to determine how these objectives should be achieved, some lessons learned from past programs are presented. A conceptual two-stage-to-orbit (TSTO) prototype/experimental aerospace plane is recommended as a means of providing access-to-space and for conducting flight tests. A road map for achieving these objectives is also presented.

  9. Breath-to-breath hypercapnic response in neonatal rats: temperature dependency of the chemoreflexes and potential implications for breathing stability.

    PubMed

    Cummings, Kevin J; Frappell, Peter B

    2009-07-01

    The breathing of newborns is destabilized by warm temperatures. We hypothesized that in unanesthetized, intact newborn rats, body temperature (T(B)) influences the peripheral chemoreflex response (PCR response) to hypercapnia. To test this, we delivered square-wave challenges of 8% CO(2) in air to postnatal day 4-5 (P4-P5) rats held at a T(B) of 30 degrees C (Cold group, n = 11), 33 degrees C (Cool group, n = 10), and 35 degrees C thermoneutral zone group [thermoneutral zone (TNZ) group, n = 11], while measuring ventilation (Ve) directly with a pneumotach and mask. Cool animals were challenged with 8% CO(2) balanced in either air or hyperoxia (n = 10) to identify the PCR response. Breath-to-breath analysis was performed on 30 room air breaths and every breath of the 1-min CO(2) challenge. As expected, warmer T(B) was associated with an unstable breathing pattern in room air: TNZ animals had a coefficient of variation in Ve (Ve CV%) that was double that of animals held at cooler T(B) (P < 0.001). Hyperoxia markedly suppressed the hypercapnic ventilatory response over the first 10 breaths (or approximately 4 s), suggesting that this domain is dominated by the PCR response. The PCR response (P = 0.03) and total response (P = 0.04) were significantly greater in TNZ animals compared with hypothermic animals. The total response had a significant, negative relationship with Vco(2) (R(2) = 0.53; P < 0.001). Breathing stability was positively related to the total response (R(2) = 0.36; P < 0.001) and to a lesser extent, the PCR response (R(2) = 0.19; P = 0.01) and was negatively related to Vco(2) (R(2) = 0.34; P < 0.001). ANCOVA confirmed a significant effect of T(B) alone on breathing stability (P < 0.01), with no independent effects of Vco(2) (P = 0.41), the PCR response (P = 0.82), or the total Ve response (P = 0.08). Our data suggest that in early postnatal life, the chemoreflex responses to CO(2) are highly influenced by T(B), and while related to breathing stability, are not predictors of stability after accounting for the independent effect of T(B).

  10. Air sampling unit for breath analyzers

    NASA Astrophysics Data System (ADS)

    Szabra, Dariusz; Prokopiuk, Artur; Mikołajczyk, Janusz; Ligor, Tomasz; Buszewski, Bogusław; Bielecki, Zbigniew

    2017-11-01

    The paper presents a portable breath sampling unit (BSU) for human breath analyzers. The developed unit can be used to probe air from the upper airway and alveolar for clinical and science studies. The BSU is able to operate as a patient interface device for most types of breath analyzers. Its main task is to separate and to collect the selected phases of the exhaled air. To monitor the so-called I, II, or III phase and to identify the airflow from the upper and lower parts of the human respiratory system, the unit performs measurements of the exhaled CO2 (ECO2) in the concentration range of 0%-20% (0-150 mm Hg). It can work in both on-line and off-line modes according to American Thoracic Society/European Respiratory Society standards. A Tedlar bag with a volume of 5 dm3 is mounted as a BSU sample container. This volume allows us to collect ca. 1-25 selected breath phases. At the user panel, each step of the unit operation is visualized by LED indicators. This helps us to regulate the natural breathing cycle of the patient. There is also an operator's panel to ensure monitoring and configuration setup of the unit parameters. The operation of the breath sampling unit was preliminarily verified using the gas chromatography/mass spectrometry (GC/MS) laboratory setup. At this setup, volatile organic compounds were extracted by solid phase microextraction. The tests were performed by the comparison of GC/MS signals from both exhaled nitric oxide and isoprene analyses for three breath phases. The functionality of the unit was proven because there was an observed increase in the signal level in the case of the III phase (approximately 40%). The described work made it possible to construct a prototype of a very efficient breath sampling unit dedicated to breath sample analyzers.

  11. Mask Ventilation during Induction of General Anesthesia: Influences of Obstructive Sleep Apnea.

    PubMed

    Sato, Shin; Hasegawa, Makoto; Okuyama, Megumi; Okazaki, Junko; Kitamura, Yuji; Sato, Yumi; Ishikawa, Teruhiko; Sato, Yasunori; Isono, Shiroh

    2017-01-01

    Depending on upper airway patency during anesthesia induction, tidal volume achieved by mask ventilation may vary. In 80 adult patients undergoing general anesthesia, the authors tested a hypothesis that tidal volume during mask ventilation is smaller in patients with sleep-disordered breathing priorly defined as apnea hypopnea index greater than 5 per hour. One-hand mask ventilation with a constant ventilator setting (pressure-controlled ventilation) was started 20 s after injection of rocuronium and maintained for 1 min during anesthesia induction. Mask ventilation efficiency was assessed by the breath number needed to initially exceed 5 ml/kg ideal body weight of expiratory tidal volume (primary outcome) and tidal volumes (secondary outcomes) during initial 15 breaths (UMIN000012494). Tidal volume progressively increased by more than 70% in 1 min and did not differ between sleep-disordered breathing (n = 42) and non-sleep-disordered breathing (n = 38) patients. In post hoc subgroup analyses, the primary outcome breath number (mean [95% CI], 5.7 [4.1 to 7.3] vs. 1.7 [0.2 to 3.2] breath; P = 0.001) and mean tidal volume (6.5 [4.6 to 8.3] vs. 9.6 [7.7 to 11.4] ml/kg ideal body weight; P = 0.032) were significantly smaller in 20 sleep-disordered breathing patients with higher apnea hypopnea index (median [25th to 75th percentile]: 21.7 [17.6 to 31] per hour) than in 20 non-sleep disordered breathing subjects with lower apnea hypopnea index (1.0 [0.3 to 1.5] per hour). Obesity and occurrence of expiratory flow limitation during one-hand mask ventilation independently explained the reduction of efficiency of mask ventilation, while the use of two hands effectively normalized inefficient mask ventilation during one-hand mask ventilation. One-hand mask ventilation is difficult in patients with obesity and severe sleep-disordered breathing particularly when expiratory flow limitation occurs during mask ventilation.

  12. A prospective gating method to acquire a diverse set of free-breathing CT images for model-based 4DCT

    NASA Astrophysics Data System (ADS)

    O'Connell, D.; Ruan, D.; Thomas, D. H.; Dou, T. H.; Lewis, J. H.; Santhanam, A.; Lee, P.; Low, D. A.

    2018-02-01

    Breathing motion modeling requires observation of tissues at sufficiently distinct respiratory states for proper 4D characterization. This work proposes a method to improve sampling of the breathing cycle with limited imaging dose. We designed and tested a prospective free-breathing acquisition protocol with a simulation using datasets from five patients imaged with a model-based 4DCT technique. Each dataset contained 25 free-breathing fast helical CT scans with simultaneous breathing surrogate measurements. Tissue displacements were measured using deformable image registration. A correspondence model related tissue displacement to the surrogate. Model residual was computed by comparing predicted displacements to image registration results. To determine a stopping criteria for the prospective protocol, i.e. when the breathing cycle had been sufficiently sampled, subsets of N scans where 5  ⩽  N  ⩽  9 were used to fit reduced models for each patient. A previously published metric was employed to describe the phase coverage, or ‘spread’, of the respiratory trajectories of each subset. Minimum phase coverage necessary to achieve mean model residual within 0.5 mm of the full 25-scan model was determined and used as the stopping criteria. Using the patient breathing traces, a prospective acquisition protocol was simulated. In all patients, phase coverage greater than the threshold necessary for model accuracy within 0.5 mm of the 25 scan model was achieved in six or fewer scans. The prospectively selected respiratory trajectories ranked in the (97.5  ±  4.2)th percentile among subsets of the originally sampled scans on average. Simulation results suggest that the proposed prospective method provides an effective means to sample the breathing cycle with limited free-breathing scans. One application of the method is to reduce the imaging dose of a previously published model-based 4DCT protocol to 25% of its original value while achieving mean model residual within 0.5 mm.

  13. Self-collected breath sampling for monitoring low-level benzene exposures among automobile mechanics.

    PubMed

    Egeghy, Peter P; Nylander-French, Leena; Gwin, Kristin K; Hertz-Picciotto, Irva; Rappaport, Stephen M

    2002-07-01

    Automobile mechanics are exposed to benzene through their contact with gasoline vapor and engine exhaust. This study investigated the benzene uptake associated with these exposures. We first evaluated the reliability of self-collected breath samples among a subset of subjects and found good agreement between these samples and those collected under expert supervision (intraclass correlation coefficient 0.79, n = 69). We then used self-monitoring together with a longitudinal sampling design (with up to three measurements per worker) to measure benzene in air and benzene in end-exhaled breath among 81 workers from 12 automobile repair garages in North Carolina. A statistically significant difference (P < 0.0001, Mann-Whitney rank sum test) was observed between non-smokers and smokers for post-exposure benzene concentration in breath (median values of 18.9 and 39.1 micro g/m(3), respectively). Comparing pre- and post-exposure breath concentrations within these two groups, the difference was significant among non-smokers (P < 0.0001) but not significant among smokers (P > 0.05). Mixed effects regression analysis using backwards elimination yielded five significant predictors of benzene concentration in breath, namely benzene exposure (P < 0.0001), pre-exposure benzene concentration in breath (P = 0.021), smoking status (P < 0.0001), fuel system work (P = 0.0043) and carburetor cleaner use (P < 0.0001). The between-person variance component comprised only 28% of the total variance in benzene levels in breath, indicating that differences among individuals related to physiological and metabolic characteristics had little influence on benzene uptake among these workers.

  14. Drug detection in breath: non-invasive assessment of illicit or pharmaceutical drugs.

    PubMed

    Trefz, Phillip; Kamysek, Svend; Fuchs, Patricia; Sukul, Pritam; Schubert, Jochen K; Miekisch, Wolfram

    2017-03-20

    Breath analysis not only holds great potential for the development of new non-invasive diagnostic methods, but also for the identification and follow up of drug levels in breath. This is of interest for both, forensic and medical science. On the one hand, the detection of drugs of abuse in exhaled breath-similar to the well-known breath alcohol tests-would be highly desirable as an alternative to blood or urine analysis in situations such as police controls for drugged driving. The non-invasive detection of drugs and their metabolites is thus of great interest in forensic science, especially since marijuana is becoming legalized in certain parts of the US and the EU. The detection and monitoring of medical drugs in exhaled breath without the need of drawing blood samples on the other hand, is of high relevance in the clinical environment. This could facilitate a more precise medication and enable therapy control without any burden to the patient. Furthermore, it could be a step towards personalized medicine. This review gives an overview of the current state of drug detection in breath, including both volatile and non-volatile substances. The review is divided into two sections. The first section deals with qualitative detection of drugs (drugs of abuse), while the second is related to quantitative drug detection (medical drugs). Chances and limitations are discussed for both aspects. The detection of the intravenous anesthetic propofol is presented as a detailed example that demonstrates the potential, requirements, pitfalls and limitations of therapeutic drug monitoring by means of breath analysis.

  15. 13CO2 breath test to measure the hydrolysis of various starch formulations in healthy subjects.

    PubMed Central

    Hiele, M; Ghoos, Y; Rutgeerts, P; Vantrappen, G; de Buyser, K

    1990-01-01

    13CO2 starch breath test was used to study the effect of physicochemical characteristics of starch digestion. As starch is hydrolysed to glucose, which is subsequently oxidised to CO2, differences in 13CO2 excretion after ingestion of different starch products must be caused by differences in hydrolysis rate. To study the effect of the degree of chain branching, waxy starch, containing 98% amylopectin, was compared with high amylose starch, containing 30% amylopectin, and normal crystalline starch, containing 74% amylopectin. The effect of the extent of gelatinisation was studied by comparing extruded starch and crystalline starch. Finally, the possible inhibitory effect of adding wheat fibre to extruded starch on the hydrolysis rate was studied. The 13CO2 excretion from two to four hours after intake of crystalline starch was significantly lower than that of extruded starch. Waxy starch was hydrolysed much faster than high amylose starch, but there was no significant difference between waxy starch and normal crystalline starch. Addition of wheat fibre did not influence the hydrolysis rate. The 13CO2 starch breath test is an attractive test for the study of factors affecting carbohydrate assimilation. PMID:2107133

  16. Does respiratory muscle training increase physical performance?

    PubMed

    Sperlich, Billy; Fricke, Hannes; de Marées, Markus; Linville, John W; Mester, Joachim

    2009-09-01

    Special force units and military personnel undergo demanding physical exercise and might benefit from high-intensity respiratory muscle training (RMT) by increasing their endurance performance. This study examined the effects of a 6-week high-intensity RMT on running performance and oxygen uptake (VO2max) in a group of German Special Force Squad members. 17 participants were randomly assigned to a training or control group. Baseline and post-testing included a ramp test, as well as an incremental test on a treadmill, performed to physical exhaustion. VO2, respiratory exchange ratio, and heart rate were measured breath by breath. Furthermore, maximum running speed (V(max)), 4 mmol x 1(-1) lactate threshold (V4) and perception of respiratory effort were determined. During pulmonary testing, sustained maximum inspiratory and expiratory pressure (PI(max) and PE(max)) were obtained. RMT was performed daily at approximately 90% PI(max) for 6 weeks with 2 x 30 breath cycles using an Ultrabreathe lung trainer. No statistical differences were detected between the groups for any parameter after RMT. High-intensity RMT did not show any benefits on VO2max and endurance performance and are unlikely to be of benefit to military or paramilitary training programs for an increase in endurance performance.

  17. Estimation of gastric pH in cynomolgus monkeys, rats, and dogs using [(13)C]-calcium carbonate breath test.

    PubMed

    Tobita, Kazuki; Inada, Makoto; Sato, Asuka; Sudoh, Kimiyoshi; Sato, Hitoshi

    2016-09-01

    The determination of gastric pH is important for the confirmation of efficacy of anti-secretory drugs. However, current methods for measurement of gastric pH provide significant stress to animals and humans. The objective of this study is to establish an easy and reliable gastric pH measurement method by determining (13)CO2 concentration in expired air of monkeys, dogs, and rats after oral administration of Ca(13)CO3. A correlation of (13)CO2 concentration determined by a Ca(13)CO3 breath test with gastric pH just before Ca(13)CO3 administration was analyzed in the 3 animal species. The equations and contribution ratios of regression line were calculated from logarithmic (13)CO2 concentrations at 15min after administration of Ca(13)CO3 using the linear regression analysis. The (13)CO2 concentration in the Ca(13)CO3 breath test was well correlated with the gastric pH just before Ca(13)CO3 administration in the 3 animal species (r=-0.977 to -0.952). The equations of regression line between the (13)CO2 concentration and the gastric pH in each animal species showed good contribution ratios (R(2)≥0.89). The Ca(13)CO3 breath test is an informative tool to estimate gastric pH in animals and will be applicable as a new noninvasive tool for patients with GERD/PPI-resistant symptoms. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  18. Determining the spatial variability of personal sampler inlet locations.

    PubMed

    Vinson, Robert; Volkwein, Jon; McWilliams, Linda

    2007-09-01

    This article examines the spatial variability of dust concentrations within a coal miner's breathing zone and the impact of sampling location at the cap lamp, nose, and lapel. Tests were conducted in the National Institute for Safety and Health Pittsburgh Research Laboratory full-scale, continuous miner gallery using three prototype personal dust monitors (PDM). The dust masses detected by the PDMs were used to calculate the percentage difference of dust mass between the cap lamp and the nose and between the lapel and the nose. The calculated percentage differences of the masses ranged from plus 12% to minus 25%. Breathing zone tests were also conducted in four underground coal mines using the torso of a mannequin to simulate a miner. Coal mine dust was sampled with multi-cyclone sampling cans mounted directly in front of the mannequin near the cap lamp, nose, and lapel. These four coal mine tests found that the spatial variability of dust levels and imprecision of the current personal sampler is a greater influence than the sampler location within the breathing zone. However, a one-sample t-test of this data did find that the overall mean value of the cap lamp/nose ratio was not significantly different than 1 (p-value = 0.21). However, when applied to the overall mean value of the lapel/nose ratio there was a significant difference from 1 (p-value < .0001). This finding is important because the lapel has always been the sampling location for coal mine dust samples. But these results suggest that the cap location is slightly more indicative of what is breathed through the nose area.

  19. 13C-Breath Tests for Sucrose Digestion in Congenital Sucrase Isomaltase Deficient and Sacrosidase Supplemented Patients

    PubMed Central

    Robayo-Torres, Claudia C.; Opekun, Antone R.; Quezada-Calvillo, Roberto; Xavier, Villa; Smith, E. O’Brian; Navarrete, Marilyn; Baker, S. Susan; Nichols, Buford L

    2008-01-01

    Congenital sucrase-isomaltase deficiency (CSID) is characterized by absence or deficiency of the mucosal sucrase-isomaltase enzyme. Specific diagnosis requires upper gastrointestinal biopsy with evidence of low to absent sucrase enzyme activity and normal histology. The hydrogen breath test (BT) is useful but is not specific for confirmation of CSID. We investigated a more specific 13C-sucrose labeled BT. Objectives were to determine if CSID can be detected with the 13C-sucrose BT without duodenal biopsy sucrase assay and if the 13C-sucrose BT can document restoration of sucrose digestion by CSID patients after oral supplementation with sacrosidase (Sucraid®). Methods Ten CSID patients were diagnosed by low biopsy sucrase activity. Ten controls were children who underwent endoscopy and biopsy because of dyspepsia or chronic diarrhea with normal mucosal enzymes activity and histology. Uniformly-labeled 13C-glucose and 13C-sucrose loads were orally administered. 13CO2 breath enrichments were assayed using an infrared spectrophotometer. In CSID patients the 13C-sucrose load was repeated adding Sucraid®. Sucrose digestion and oxidation were calculated as a mean % coefficient of glucose oxidation (% CGO) averaged between 30 and 90 minutes. Results Classification of patients by 13C-sucrose BT % CGO agreed with biopsy sucrase activity. The breath test also documented the return to normal of sucrose digestion and oxidation after supplementation of CSID patients with Sucraid®. Conclusion 13C-sucrose BT is an accurate and specific non-invasive confirmatory test for CSID and for enzyme replacement management. PMID:19330928

  20. Evaluating the Effect of Flow and Interface Type on Pressures Delivered With Bubble CPAP in a Simulated Model.

    PubMed

    Bailes, Stephanie A; Firestone, Kimberly S; Dunn, Diane K; McNinch, Neil L; Brown, Miraides F; Volsko, Teresa A

    2016-03-01

    Bubble CPAP, used for spontaneously breathing infants to avoid intubation or postextubation support, can be delivered with different interface types. This study compared the effect that interfaces had on CPAP delivery. We hypothesized that there would be no difference between set and measured levels between interface types. A validated preterm infant nasal airway model was attached to the ASL 5000 breathing simulator. The simulator was programmed to deliver active breathing of a surfactant-deficient premature infant with breathing frequency at 70 breaths/min inspiratory time of 0.30 s, resistance of 150 cm H2O/L/s, compliance of 0.5 mL/cm H2O, tidal volume of 5 mL, and esophageal pressure of -10 cm H2O. Nasal CPAP prongs, size 4030, newborn and infant RAM cannulas were connected to a nasal airway model and a bubble CPAP system. CPAP levels were set at 4, 5, 6, 7, 8, and 9 cm H2O with flows of 6, 8, and 10 L/min each. Measurements were recorded after 1 min of stabilization. The analysis was performed using SAS 9.4. The Kolmogorov-Smirnov test assessed normality of the data. The Friedman test was used to compare non-normally distributed repeated measures. The Wilcoxon signed-rank test was used to conduct post hoc analysis. All tests were 2-sided, and P values of <.05 were considered as indicating significant differences unless otherwise indicated. At lower set CPAP levels, 4-6 cm H2O, measured CPAP dropped precipitously with the nasal prongs with the highest flow setting. At higher CPAP levels, 7-9 cm H2O measured CPAP concomitantly increased as the flow setting increased. Statistically significant differences in set and measured CPAP occurred for all devices across all CPAP levels, with the measured CPAP less than set for all conditions, P < .001. Set flow had a profound effect on measured CPAP. The concomitant drop in measured pressure with high and low flows could be attributed to increased resistance to spontaneous breathing or insufficient flow to meet inspiratory demand. Clinicians should be aware of the effect that the interface and flow have on CPAP delivery. Copyright © 2016 by Daedalus Enterprises.

  1. Oxygen Uptake Efficiency Slope and Breathing Reserve, Not Anaerobic Threshold, Discriminate Between Patients With Cardiovascular Disease Over Chronic Obstructive Pulmonary Disease.

    PubMed

    Barron, Anthony; Francis, Darrel P; Mayet, Jamil; Ewert, Ralf; Obst, Anne; Mason, Mark; Elkin, Sarah; Hughes, Alun D; Wensel, Roland

    2016-04-01

    The study sought to compare the relative discrimination of various cardiopulmonary exercise testing (CPX) variables between cardiac and respiratory disease. CPX testing is used in many cardiorespiratory diseases. However, discrimination of cardiac and respiratory dysfunction can be problematic. Anaerobic threshold (AT) and oxygen-uptake to work-rate relationship (VO2/WR slope) have been proposed as diagnostic of cardiac dysfunction, but multiple variables have not been compared. A total of 73 patients with chronic obstructive pulmonary disease (COPD) (n = 25), heart failure with reduced ejection fraction (HFrEF) (n = 40), or combined COPD and HFrEF (n = 8) were recruited and underwent CPX testing on a bicycle ergometer. Following a familiarization test, each patient underwent a personalized second test aiming for maximal exercise after ∼10 min. Measurements from this test were used to calculate area under the receiver-operator characteristic curve (AUC). Peak VO2 was similar between the 2 principal groups (COPD 17.1 ± 4.6 ml/min/kg; HFrEF 16.4 ± 3.6 ml/min/kg). Breathing reserve (AUC: 0.91) and percent predicted oxygen uptake efficiency slope (OUES) (AUC: 0.87) had the greatest ability to discriminate between COPD and HFrEF. VO2/WR slope performed significantly worse (AUC: 0.68). VO2 at the AT did not discriminate (AUC for AT as percent predicted peak VO2: 0.56). OUES and breathing reserve remained strong discriminators when compared with an external cohort of healthy matched controls, and were comparable to B-type natriuretic peptide. Breathing reserve and OUES discriminate heart failure from COPD. Despite it being considered an important determinant of cardiac dysfunction, the AT could not discriminate these typical clinical populations while the VO2/WR slope showed poor to moderate discriminant ability. (Identifying an Ideal Cardiopulmonary Exercise Test Parameter [PVA]; NCT01162083). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. Oxygen Uptake Efficiency Slope and Breathing Reserve, Not Anaerobic Threshold, Discriminate Between Patients With Cardiovascular Disease Over Chronic Obstructive Pulmonary Disease

    PubMed Central

    Barron, Anthony; Francis, Darrel P.; Mayet, Jamil; Ewert, Ralf; Obst, Anne; Mason, Mark; Elkin, Sarah; Hughes, Alun D.; Wensel, Roland

    2016-01-01

    Objectives The study sought to compare the relative discrimination of various cardiopulmonary exercise testing (CPX) variables between cardiac and respiratory disease. Background CPX testing is used in many cardiorespiratory diseases. However, discrimination of cardiac and respiratory dysfunction can be problematic. Anaerobic threshold (AT) and oxygen-uptake to work-rate relationship (VO2/WR slope) have been proposed as diagnostic of cardiac dysfunction, but multiple variables have not been compared. Methods A total of 73 patients with chronic obstructive pulmonary disease (COPD) (n = 25), heart failure with reduced ejection fraction (HFrEF) (n = 40), or combined COPD and HFrEF (n = 8) were recruited and underwent CPX testing on a bicycle ergometer. Following a familiarization test, each patient underwent a personalized second test aiming for maximal exercise after ∼10 min. Measurements from this test were used to calculate area under the receiver-operator characteristic curve (AUC). Results Peak VO2 was similar between the 2 principal groups (COPD 17.1 ± 4.6 ml/min/kg; HFrEF 16.4 ± 3.6 ml/min/kg). Breathing reserve (AUC: 0.91) and percent predicted oxygen uptake efficiency slope (OUES) (AUC: 0.87) had the greatest ability to discriminate between COPD and HFrEF. VO2/WR slope performed significantly worse (AUC: 0.68). VO2 at the AT did not discriminate (AUC for AT as percent predicted peak VO2: 0.56). OUES and breathing reserve remained strong discriminators when compared with an external cohort of healthy matched controls, and were comparable to B-type natriuretic peptide. Conclusions Breathing reserve and OUES discriminate heart failure from COPD. Despite it being considered an important determinant of cardiac dysfunction, the AT could not discriminate these typical clinical populations while the VO2/WR slope showed poor to moderate discriminant ability. (Identifying an Ideal Cardiopulmonary Exercise Test Parameter [PVA]; NCT01162083) PMID:26874378

  3. Medical Diagnostic Breath Analysis by Cavity Ring Down Spectroscopy

    NASA Astrophysics Data System (ADS)

    Guss, Joseph S.; Metsälä, Markus; Halonen, Lauri

    2009-06-01

    Certain medical conditions give rise to the presence of chemicals in the bloodstream. These chemicals - known as biomarkers - may also be present in low concentrations in human breath. Cavity ring down spectroscopy possesses the requisite selectivity and sensitivity to detect such biomarkers in the congested spectrum of a breath sample. The ulcer-causing bacterium, Helicobacter pylori, is a prolific producer of the enzyme urease, which catalyses the breakdown of urea ((NH_2)_2CO) in the stomach as follows: (NH_2)_2CO + H_2O ⟶ CO_2 + 2NH_3 Currently, breath tests seeking altered carbon-isotope ratios in exhaled CO_2 after the ingestion of ^{13}C- or ^{14}C-labeled urea are used to diagnose H. pylori infection. We present recent results from an ongoing collaboration with Tampere Area University Hospital. The study involves 100 patients (both infected and uninfected) and concerns the possible correlation between the bacterial infection and breath ammonia. D. Y. Graham, P. D. Klein, D. J. Evans, Jr, D. G. Evans, L. C. Alpert, A. R. Opekun, T. W. Boutton, Lancet 1(8543), 1174-7 March 1987.

  4. THE EFFECTS OF FIXED VERSUS ESCALATING REINFORCEMENT SCHEDULES ON SMOKING ABSTINENCE

    PubMed Central

    Romanowich, Paul; Lamb, R. J.

    2015-01-01

    Studies indicate that when abstinence is initiated, escalating reinforcement schedules maintain continuous abstinence longer than fixed reinforcement schedules. However, these studies were conducted for shorter durations than most clinical trials and also resulted in larger reinforcer value for escalating participants during the 1st week of the experiment. We tested whether escalating reinforcement schedules maintained abstinence longer than fixed reinforcement schedules in a 12-week clinical trial. Smokers (146) were randomized to an escalating reinforcement schedule, a fixed reinforcement schedule, or a control condition. Escalating reinforcement participants received $5.00 for their first breath carbon monoxide (CO) sample <3 ppm, with a $0.50 increase for each consecutive sample. Fixed reinforcement participants received $19.75 for each breath CO sample <3 ppm. Control participants received payments only for delivering a breath CO sample. Similar proportions of escalating and fixed reinforcement participants met the breath CO criterion at least once. Escalating reinforcement participants maintained criterion breath CO levels longer than fixed reinforcement and control participants. Similar to previous short-term studies, escalating reinforcement schedules maintained longer durations of abstinence than fixed reinforcement schedules during a clinical trial. PMID:25640764

  5. [Evaluation of benefits of the course of positive pressure breathing training on exercise performance].

    PubMed

    Medvedev, D V; Gorbaneva, E P; Iumatova, S N; Kuznetsova, T Iu; Solopov, I N; Katuntsev, V P

    2007-01-01

    The purpose was to evaluate effects of muscle training combined with positive pressure breathing on exercise performance of 16 runners at the age of 18-20. All subjects had the first or second-class sport qualification. The 4-wk. training course for the experimental group (n=11) included 20-25% of exercises performed in an aperture mask creating an inspiration-expiration resistance of 8-10 mm H2O. The control group (n=5) worked on the same training course but w/o positive pressure breathing. The course began and ended with the PWC170 test in order to evaluate exercise performance. Indices of external respiration and gas exchange were determined on metabolograph Ergooxyscreen (Jaeger) and lung-tester Spirosift-3000 (Fukuda). Inspiration and expiration force of the breathing muscles (mm Hg) was measured isometrically with the help of a pneumomanometer. Heart rate was calculated from ECG R-R intervals. It was stated that positive pressure breathing during muscle training increases significantly sportsmen's exercise performance due to growth of the body spare capacities, and optimization of the body systems dependence structure and efficiency.

  6. A Preliminary Investigation of the Effects of Giving Testimony and Learning Yogic Breathing Techniques on Battered Women's Feelings of Depression

    ERIC Educational Resources Information Center

    Franzblau, Susan H.; Echevarria, Sonia; Smith, Michelle; Van Cantfort, Thomas E.

    2008-01-01

    Researchers have shown that mood and sense of control over one's life are significantly affected by testimony and other forms of disclosure and that learning to control breathing has positive effects on mood and anxiety. This preliminary experiment tests whether African American and European American abused women who give testimony about their…

  7. Exercise training improves breathing strategy and performance during the six-minute walk test in obese adolescents.

    PubMed

    Mendelson, Monique; Michallet, Anne-Sophie; Perrin, Claudine; Levy, Patrick; Wuyam, Bernard; Flore, Patrice

    2014-08-15

    We aimed to examine ventilatory responses during the six-minute walk test in healthy-weight and obese adolescents before and after exercise training. Twenty obese adolescents (OB) (age: 14.5±1.7 years; BMI: 34.0±4.7kg·m(-2)) and 20 age and gender-matched healthy-weight adolescents (HW) (age: 15.5±1.5 years; BMI: 19.9±1.4kg·m(-2)) completed six-minute walk test during which breath-by-breath gas analysis and expiratory flow limitation (expFL) were measured. OB participated in a 12-week exercise-training program. Comparison between HW and OB participants showed lower distance achieved during the 6MWT in OB (-111.0m, 95%CI: -160.1 to 62.0, p<0.05) and exertional breathlessness was greater (+0.78 a.u., 95%CI: 0.091-3.27, p=0.039) when compared with HW. Obese adolescents breathed at lower lung volumes, as evidenced by lower end expiratory and end inspiratory lung volumes during exercise (p<0.05). Prevalence of expFL (8 OB vs 2 HW, p=0.028) and mean expFL (14.9±21.9 vs 5.32±14.6% VT, p=0.043, in OB and HW) were greater in OB. After exercise training, mean increase in the distance achieved during the 6MWT was 64.5 meters (95%CI: 28.1-100.9, p=0.014) and mean decrease in exertional breathlessness was 1.62 (95%CI: 0.47-2.71, p=0.05). Obese adolescents breathed at higher lung volumes, as evidenced by the increase in end inspiratory lung volume from rest to 6-min exercise (9.9±13.4 vs 20.0±13.6%TLC, p<0.05). Improved performance was associated with improved change in end inspiratory lung volume from rest to 6-min exercise (r=0.65, p=0.025). Our results suggest that exercise training can improve breathing strategy during submaximal exercise in obese adolescents and that this increase is associated with greater exercise performance. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Inhibiting the Physiological Stress Effects of a Sustained Attention Task on Shoulder Muscle Activity.

    PubMed

    Wixted, Fiona; O'Riordan, Cliona; O'Sullivan, Leonard

    2018-01-11

    The objective of this study was to investigate if a breathing technique could counteract the effects of hyperventilation due to a sustained attention task on shoulder muscle activity. The trend towards higher levels of automation in industry is increasing. Consequently, manufacturing operators often monitor automated process for long periods of their work shift. Prolonged monitoring work requires sustained attention, which is a cognitive process that humans are typically poor at and find stressful. As sustained attention becomes an increasing requirement of manufacturing operators' job content, the resulting stress experienced could contribute to the onset of many health problems, including work related musculoskeletal disorders (WRMSDs). The SART attention test was completed by a group of participants before and after a breathing intervention exercise. The effects of the abdominal breathing intervention on breathing rate, upper trapezius muscle activity and end-tidal CO₂ were evaluated. The breathing intervention reduced the moderation effect of end-tidal CO₂ on upper trapezius muscle activity. Abdominal breathing could be a useful technique in reducing the effects of sustained attention work on muscular activity. This research can be applied to highly-automated manufacturing industries, where prolonged monitoring of work is widespread and could, in its role as a stressor, be a potential contributor to WRMSDs.

  9. Respiratory mechanics and breathing pattern in the neonatal foal.

    PubMed

    Koterba, A M; Kosch, P C

    1987-01-01

    Breathing pattern, respiratory muscle activation pattern, lung volumes and volume-pressure characteristics of the respiratory system of normal, term, neonatal foals on Days 2 and 7 of age were determined to test the hypothesis that the foal actively maintains end-expiratory lung volume (EEV) greater than the relaxation volume of the respiratory system (Vrx) because of a highly compliant chest wall. Breathing pattern was measured in the awake, unsedated foal during quiet breathing in lateral and standing positions. The typical neonatal foal breathing pattern was characterized by a monophasic inspiratory and expiratory flow pattern. Both inspiration and expiration were active, with onset of Edi activity preceding onset of inspiratory flow, and phasic abdominal muscle activity detectable throughout most of expiration. No evidence was found to support the hypothesis that the normal, term neonatal foal actively maintains EEV greater than Vrx. In the neonatal foal, normalized lung volume and lung compliance values were similar to those reported for neonates of other species, while normalized chest wall compliance was considerably lower. We conclude that the chest wall of the term neonatal foal is sufficiently rigid to prevent a low Vrx. This characteristic probably prevents the foal from having to use a breathing strategy which maintains an EEV greater than Vrx.

  10. Quantification of Aerosol Hydrofluoroalkane HFA‐134a Elimination in the Exhaled Human Breath Following Inhaled Corticosteroids Administration

    PubMed Central

    Barletta, Barbara; Yoonessi, Leila; Meinardi, Simone; Leu, Szu‐Yun; Radom‐Aizik, Shlomit; Randhawa, Inderpal; Nussbaum, Eliezer; Blake, Donald R.; Cooper, Dan M.

    2015-01-01

    Abstract Inhaled corticosteroids (ICS) and β2‐agonists are the primary pharmacotherapies of asthma management. However, suboptimal medication compliance is common in asthmatics and is associated with increased morbidity. We hypothesized that exhaled breath measurements of the aerosol used in the inhaled medications might prove useful as surrogate marker for asthma medication compliance. To explore this, 10 healthy controls were recruited and randomly assigned to ICS (Flovent HFA) or short acting bronchodilators (Proventil HFA). Both inhalers contain HFA‐134a as aerosol propellant. Exhaled breath sampling and pulmonary function tests were performed prior to the inhaler medication dispersion, immediately after inhalation, then at 2, 4, 6, 8, 24, and 48 hours postadministration. At baseline, mean (SD) levels of HFA‐134a in the breath were 252 (156) pptv. Immediately after inhalation, HFA‐134a breath levels increased to 300 × 106 pptv and were still well above ambient levels 24 hours postadministration. The calculated ratio of forced expiratory volume in 1 second over forced vital capacity did not change over time following inhaler administration. This study demonstrates, for the first time, that breath HFA‐134a levels can be used to assess inhaler medication compliance. It may also be used to evaluate how effectively the medicine is delivered. PMID:26155923

  11. Breathing exercises with vagal biofeedback may benefit patients with functional dyspepsia.

    PubMed

    Hjelland, Ina E; Svebak, Sven; Berstad, Arnold; Flatabø, Geir; Hausken, Trygve

    2007-09-01

    Many patients with functional dyspepsia (FD) have postprandial symptoms, impaired gastric accommodation and low vagal tone. The aim of this study was to improve vagal tone, and thereby also drinking capacity, intragastric volume and quality of life, using breathing exercises with vagal biofeedback. Forty FD patients were randomized to either a biofeedback group or a control group. The patients received similar information and care. Patients in the biofeedback group were trained in breathing exercises, 6 breaths/min, 5 min each day for 4 weeks, using specially designed software for vagal biofeedback. Effect variables included maximal drinking capacity using a drink test (Toro clear meat soup 100 ml/min), intragastric volume at maximal drinking capacity, respiratory sinus arrhythmia (RSA), skin conductance (SC) and dyspepsia-related quality of life scores. Drinking capacity and quality of life improved significantly more in the biofeedback group than in the control group (p=0.02 and p=0.01) without any significant change in baseline autonomic activity (RSA and SC) or intragastric volume. After the treatment period, RSA during breathing exercises was significantly correlated to drinking capacity (r=0.6, p=0.008). Breathing exercises with vagal biofeedback increased drinking capacity and improved quality of life in FD patients, but did not improve baseline vagal tone.

  12. An optimized 13C-urea breath test for the diagnosis of H pylori infection

    PubMed Central

    Campuzano-Maya, Germán

    2007-01-01

    AIM: To validate an optimized 13C-urea breath test (13C-UBT) protocol for the diagnosis of H pylori infection that is cost-efficient and maintains excellent diagnostic accuracy. METHODS: 70 healthy volunteers were tested with two simplified 13C-UBT protocols, with test meal (Protocol 2) and without test meal (Protocol 1). Breath samples were collected at 10, 20 and 30 min after ingestion of 50 mg 13C-urea dissolved in 10 mL of water, taken as a single swallow, followed by 200 mL of water (pH 6.0) and a circular motion around the waistline to homogenize the urea solution. Performance of both protocols was analyzed at various cut-off values. Results were validated against the European protocol. RESULTS: According to the reference protocol, 65.7% individuals were positive for H pylori infection and 34.3% were negative. There were no significant differences in the ability of both protocols to correctly identify positive and negative H pylori individuals. However, only Protocol 1 with no test meal achieved accuracy, sensitivity, specificity, positive and negative predictive values of 100%. The highest values achieved by Protocol 2 were 98.57%, 97.83%, 100%, 100% and 100%, respectively. CONCLUSION: A 10 min, 50 mg 13C-UBT with no test meal using a cut-off value of 2-2.5 is a highly accurate test for the diagnosis of H pylori infection at a reduced cost. PMID:17907288

  13. Agreement and repeatability of vascular reactivity estimates based on a breath-hold task and a resting state scan.

    PubMed

    Lipp, Ilona; Murphy, Kevin; Caseras, Xavier; Wise, Richard G

    2015-06-01

    FMRI BOLD responses to changes in neural activity are influenced by the reactivity of the vasculature. By complementing a task-related BOLD acquisition with a vascular reactivity measure obtained through breath-holding or hypercapnia, this unwanted variance can be statistically reduced in the BOLD responses of interest. Recently, it has been suggested that vascular reactivity can also be estimated using a resting state scan. This study aimed to compare three breath-hold based analysis approaches (block design, sine-cosine regressor and CO2 regressor) and a resting state approach (CO2 regressor) to measure vascular reactivity. We tested BOLD variance explained by the model and repeatability of the measures. Fifteen healthy participants underwent a breath-hold task and a resting state scan with end-tidal CO2 being recorded during both. Vascular reactivity was defined as CO2-related BOLD percent signal change/mmHg change in CO2. Maps and regional vascular reactivity estimates showed high repeatability when the breath-hold task was used. Repeatability and variance explained by the CO2 trace regressor were lower for the resting state data based approach, which resulted in highly variable measures of vascular reactivity. We conclude that breath-hold based vascular reactivity estimations are more repeatable than resting-based estimates, and that there are limitations with replacing breath-hold scans by resting state scans for vascular reactivity assessment. Copyright © 2015. Published by Elsevier Inc.

  14. Agreement and repeatability of vascular reactivity estimates based on a breath-hold task and a resting state scan

    PubMed Central

    Lipp, Ilona; Murphy, Kevin; Caseras, Xavier; Wise, Richard G.

    2015-01-01

    FMRI BOLD responses to changes in neural activity are influenced by the reactivity of the vasculature. By complementing a task-related BOLD acquisition with a vascular reactivity measure obtained through breath-holding or hypercapnia, this unwanted variance can be statistically reduced in the BOLD responses of interest. Recently, it has been suggested that vascular reactivity can also be estimated using a resting state scan. This study aimed to compare three breath-hold based analysis approaches (block design, sine–cosine regressor and CO2 regressor) and a resting state approach (CO2 regressor) to measure vascular reactivity. We tested BOLD variance explained by the model and repeatability of the measures. Fifteen healthy participants underwent a breath-hold task and a resting state scan with end-tidal CO2 being recorded during both. Vascular reactivity was defined as CO2-related BOLD percent signal change/mm Hg change in CO2. Maps and regional vascular reactivity estimates showed high repeatability when the breath-hold task was used. Repeatability and variance explained by the CO2 trace regressor were lower for the resting state data based approach, which resulted in highly variable measures of vascular reactivity. We conclude that breath-hold based vascular reactivity estimations are more repeatable than resting-based estimates, and that there are limitations with replacing breath-hold scans by resting state scans for vascular reactivity assessment. PMID:25795342

  15. Ventilatory Responses at Peak Exercise in Endurance-Trained Obese Adults

    PubMed Central

    Lorenzo, Santiago

    2013-01-01

    Background: Alterations in respiratory mechanics predispose healthy obese individuals to low lung volume breathing, which places them at risk of developing expiratory flow limitation (EFL). The high ventilatory demand in endurance-trained obese adults further increases their risk of developing EFL and increases their work of breathing. The objective of this study was to investigate the prevalence and magnitude of EFL in fit obese (FO) adults via measurements of breathing mechanics and ventilatory dynamics during exercise. Methods: Ten (seven women and three men) FO (mean ± SD, 38 ± 5 years, 38% ± 5% body fat) and 10 (seven women and three men) control obese (CO) (38 ± 5 years, 39% ± 5% body fat) subjects underwent hydrostatic weighing, pulmonary function testing, cycle exercise testing, and the determination of the oxygen cost of breathing during eucapnic voluntary hyperpnea. Results: There were no differences in functional residual capacity (43% ± 6% vs 40% ± 9% total lung capacity [TLC]), residual volume (21% ± 4% vs 21% ± 4% TLC), or FVC (111% ± 13% vs 104% ± 15% predicted) between FO and CO subjects, respectively. FO subjects had higher FEV1 (111% ± 13% vs 99% ± 11% predicted), TLC (106% ± 14% vs 94% ± 7% predicted), peak expiratory flow (123% ± 14% vs 106% ± 13% predicted), and maximal voluntary ventilation (128% ± 15% vs 106% ± 13% predicted) than did CO subjects. Peak oxygen uptake (129% ± 16% vs 86% ± 15% predicted), minute ventilation (128 ± 35 L/min vs 92 ± 25 L/min), and work rate (229 ± 54 W vs 166 ± 55 W) were higher in FO subjects. Mean inspiratory (4.65 ± 1.09 L/s vs 3.06 ± 1.21 L/s) and expiratory (4.15 ± 0.95 L/s vs 2.98 ± 0.76L/s) flows were greater in FO subjects, which yielded a greater breathing frequency (51 ± 8 breaths/min vs 41 ± 10 breaths/min) at peak exercise in FO subjects. Mechanical ventilatory constraints in FO subjects were similar to those in CO subjects despite the greater ventilatory demand in FO subjects. Conclusion: FO individuals achieve high ventilations by increasing breathing frequency, matching the elevated metabolic demand associated with high fitness. They do this without developing meaningful ventilatory constraints. Therefore, endurance-trained obese individuals with higher lung function are not limited by breathing mechanics during peak exercise, which may allow healthy obese adults to participate in vigorous exercise training. PMID:23722607

  16. Ventilatory responses at peak exercise in endurance-trained obese adults.

    PubMed

    Lorenzo, Santiago; Babb, Tony G

    2013-10-01

    Alterations in respiratory mechanics predispose healthy obese individuals to low lung volume breathing, which places them at risk of developing expiratory flow limitation (EFL). The high ventilatory demand in endurance-trained obese adults further increases their risk of developing EFL and increases their work of breathing. The objective of this study was to investigate the prevalence and magnitude of EFL in fit obese (FO) adults via measurements of breathing mechanics and ventilatory dynamics during exercise. Ten (seven women and three men) FO (mean ± SD, 38 ± 5 years, 38% ± 5% body fat) and 10 (seven women and three men) control obese (CO) (38 ± 5 years, 39% ± 5% body fat) subjects underwent hydrostatic weighing, pulmonary function testing, cycle exercise testing, and the determination of the oxygen cost of breathing during eucapnic voluntary hyperpnea. There were no differences in functional residual capacity (43% ± 6% vs 40% ± 9% total lung capacity [TLC]), residual volume (21% ± 4% vs 21% ± 4% TLC), or FVC (111% ± 13% vs 104% ± 15% predicted) between FO and CO subjects, respectively. FO subjects had higher FEV1 (111% ± 13% vs 99% ± 11% predicted), TLC (106% ± 14% vs 94% ± 7% predicted), peak expiratory flow (123% ± 14% vs 106% ± 13% predicted), and maximal voluntary ventilation (128% ± 15% vs 106% ± 13% predicted) than did CO subjects. Peak oxygen uptake (129% ± 16% vs 86% ± 15% predicted), minute ventilation (128 ± 35 L/min vs 92 ± 25 L/min), and work rate (229 ± 54 W vs 166 ± 55 W) were higher in FO subjects. Mean inspiratory (4.65 ± 1.09 L/s vs 3.06 ± 1.21 L/s) and expiratory (4.15 ± 0.95 L/s vs 2.98 ± 0.76 L/s) flows were greater in FO subjects, which yielded a greater breathing frequency (51 ± 8 breaths/min vs 41 ± 10 breaths/min) at peak exercise in FO subjects. Mechanical ventilatory constraints in FO subjects were similar to those in CO subjects despite the greater ventilatory demand in FO subjects. FO individuals achieve high ventilations by increasing breathing frequency, matching the elevated metabolic demand associated with high fitness. They do this without developing meaningful ventilatory constraints. Therefore, endurance-trained obese individuals with higher lung function are not limited by breathing mechanics during peak exercise, which may allow healthy obese adults to participate in vigorous exercise training.

  17. Development of a space activity suit

    NASA Technical Reports Server (NTRS)

    Annis, J. F.; Webb, P.

    1971-01-01

    The development of a series of prototype space activity suit (SAS) assemblies is discussed. The SAS is a new type of pressure suit designed especially for extravehicular activity. It consists of a set of carefully tailored elastic fabric garments which have been engineered to supply sufficient counterpressure to the body to permit subjects to breath O2 at pressures up to 200 mm Hg without circulatory difficulty. A closed, positive pressure breathing system (PPBS) and a full bubble helmet were also developed to complete the system. The ultimate goal of the SAS is to improve the range of activity and decrease the energy cost of work associated with wearing conventional gas filled pressure suits. Results are presented from both laboratory (1 atmosphere) and altitude chamber tests with subjects wearing various SAS assemblies. In laboratory tests lasting up to three hours, the SAS was worn while subjects breathed O2 at pressures up to 170 mm Hg without developing physiological problems. The only physiological symptoms apparent were a moderate tachycardia related to breathing pressures above 130 mm Hg, and a small collection of edema fluid in the hands. Both problems were considered to be related to areas of under-pressurization by the garments. These problems, it is suggested, can ultimately be corrected by the development of new elastic fabrics and tailoring techniques. Energy cost of activity, and mobility and dexterity of subjects in the SAS, were found to be superior to those in comparable tests on subjects in full pressure suits.

  18. Autocalibrating motion-corrected wave-encoding for highly accelerated free-breathing abdominal MRI.

    PubMed

    Chen, Feiyu; Zhang, Tao; Cheng, Joseph Y; Shi, Xinwei; Pauly, John M; Vasanawala, Shreyas S

    2017-11-01

    To develop a motion-robust wave-encoding technique for highly accelerated free-breathing abdominal MRI. A comprehensive 3D wave-encoding-based method was developed to enable fast free-breathing abdominal imaging: (a) auto-calibration for wave-encoding was designed to avoid extra scan for coil sensitivity measurement; (b) intrinsic butterfly navigators were used to track respiratory motion; (c) variable-density sampling was included to enable compressed sensing; (d) golden-angle radial-Cartesian hybrid view-ordering was incorporated to improve motion robustness; and (e) localized rigid motion correction was combined with parallel imaging compressed sensing reconstruction to reconstruct the highly accelerated wave-encoded datasets. The proposed method was tested on six subjects and image quality was compared with standard accelerated Cartesian acquisition both with and without respiratory triggering. Inverse gradient entropy and normalized gradient squared metrics were calculated, testing whether image quality was improved using paired t-tests. For respiratory-triggered scans, wave-encoding significantly reduced residual aliasing and blurring compared with standard Cartesian acquisition (metrics suggesting P < 0.05). For non-respiratory-triggered scans, the proposed method yielded significantly better motion correction compared with standard motion-corrected Cartesian acquisition (metrics suggesting P < 0.01). The proposed methods can reduce motion artifacts and improve overall image quality of highly accelerated free-breathing abdominal MRI. Magn Reson Med 78:1757-1766, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  19. Clinical comparison of a new manual toothbrush on breath volatile sulfur compounds.

    PubMed

    Williams, Malcolm I; Vazquez, Joe; Cummins, Diane

    2004-10-01

    The objective of this randomized, crossover study was to compare the effectiveness of a newly designed manual toothbrush (Colgate 360 degrees) to two commercially available manual toothbrushes (Oral-B Indicator and Oral-B CrossAction) and a battery-powered toothbrush (Crest SpinBrush PRO) for their ability to reduce overnight volatile sulfur compounds (VSC) associated with oral malodor. The study followed a four-period crossover design. Following a washout period, prospective subjects arrived at the testing facility without eating, drinking, or performing oral hygiene for baseline evaluation of breath VSC levels. For each phase of the study, subjects were given one of the test tooth-brushes and a tube of regular toothpaste to take home, and they were instructed to brush their teeth in their customary manner for 1 minute. When using the Colgate 360 degrees toothbrush, subjects were instructed to clean their tongue with the implement on the back of the brush head for 10 seconds. The following morning, subjects reported to the testing facility, again without performing oral hygiene, eating, or drinking, for the overnight evaluation. After a minimum 2-day washout period, subjects repeated the same regimen using the other toothbrushes. The levels of breath VSC were evaluated instrumentally using a gas chromatograph equipped with a flame photometric detector. Measurements were taken in duplicate and then averaged. The levels of VSC were expressed as parts per billion (ppb) in mouth air. Sixteen men and women completed the study. At baseline, the mean levels of VSC in mouth air for the 4 toothbrushes were 719.8 ppb+/-318.4 ppb, 592.8 ppb+/-264.6 ppb, 673.8 ppb+/-405.9 ppb, and 656.2 ppb+/-310.2 ppb for the Colgate 360 degrees, Oral-B Indicator, Crest SpinBrush PRO, and Oral-B CrossAction, respectively. Overnight, the mean breath VSC levels after using the four toothbrushes were lower than those observed at baseline. The respective mean levels of breath VSC were 266.5 ppb+/-269.9 ppb, 545.2 ppb+/-346.1 ppb, 567 ppb+/-335.7 ppb, and 554.6 ppb+/-398.4 ppb. Only the Colgate 360 degrees toothbrush provided a statistically significant reduction (P < .05) in breath VSC vs baseline. Additionally, the Colgate 360 degrees toothbrush was statistically significantly better (P < .05) than the three commercial toothbrushes in reducing breath VSC. Therefore, the results of this randomized, crossover clinical study indicate that a newly designed manual toothbrush with a tongue-cleaning implement on the back of the brush head was significantly more effective than three commercially available toothbrushes in reducing morning breath VSC associated with oral malodor.

  20. Sequential simulation (SqS) of clinical pathways: a tool for public and patient engagement in point-of-care diagnostics.

    PubMed

    Huddy, Jeremy R; Weldon, Sharon-Marie; Ralhan, Shvaita; Painter, Tim; Hanna, George B; Kneebone, Roger; Bello, Fernando

    2016-09-13

    Public and patient engagement (PPE) is fundamental to healthcare research. To facilitate effective engagement in novel point-of-care tests (POCTs), the test and downstream consequences of the result need to be considered. Sequential simulation (SqS) is a tool to represent patient journeys and the effects of intervention at each and subsequent stages. This case study presents a process evaluation of SqS as a tool for PPE in the development of a volatile organic compound-based breath test POCT for the diagnosis of oesophagogastric (OG) cancer. Three 3-hour workshops in central London. 38 members of public attended a workshop, 26 (68%) had no prior experience of the OG cancer diagnostic pathway. Clinical pathway SqS was developed from a storyboard of a patient, played by an actor, noticing symptoms of oesophageal cancer and following a typical diagnostic pathway. The proposed breath testing strategy was then introduced and incorporated into a second SqS to demonstrate pathway impact. Facilitated group discussions followed each SqS. Evaluation was conducted through pre-event and postevent questionnaires, field notes and analysis of audiovisual recordings. 38 participants attended a workshop. All participants agreed they were able to contribute to discussions and like the idea of an OG cancer breath test. Five themes emerged related to the proposed new breath test including awareness of OG cancer, barriers to testing and diagnosis, design of new test device, new clinical pathway and placement of test device. 3 themes emerged related to the use of SqS: participatory engagement, simulation and empathetic engagement, and why participants attended. SqS facilitated a shared immersive experience for participants and researchers that led to the coconstruction of knowledge that will guide future research activities and be of value to stakeholders concerned with the invention and adoption of POCT. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. All APAPs Are Not Equivalent for the Treatment of Sleep Disordered Breathing: A Bench Evaluation of Eleven Commercially Available Devices

    PubMed Central

    Zhu, Kaixian; Roisman, Gabriel; Aouf, Sami; Escourrou, Pierre

    2015-01-01

    Study Objectives: This study challenged on a bench-test the efficacy of auto-titrating positive airway pressure (APAP) devices for obstructive sleep disordered breathing treatment and evaluated the accuracy of the device reports. Methods: Our bench consisted of an active lung simulator and a Starling resistor. Eleven commercially available APAP devices were evaluated on their reactions to single-type SDB sequences (obstructive apnea and hypopnea, central apnea, and snoring), and to a long general breathing scenario (5.75 h) simulating various SDB during four sleep cycles and to a short scenario (95 min) simulating one sleep cycle. Results: In the single-type sequence of 30-minute repetitive obstructive apneas, only 5 devices normalized the airflow (> 70% of baseline breathing amplitude). Similarly, normalized breathing was recorded with 8 devices only for a 20-min obstructive hypopnea sequence. Five devices increased the pressure in response to snoring. Only 4 devices maintained a constant minimum pressure when subjected to repeated central apneas with an open upper airway. In the long general breathing scenario, the pressure responses and the treatment efficacy differed among devices: only 5 devices obtained a residual obstructive AHI < 5/h. During the short general breathing scenario, only 2 devices reached the same treatment efficacy (p < 0.001), and 3 devices underestimated the AHI by > 10% (p < 0.001). The long scenario led to more consistent device reports. Conclusion: Large differences between APAP devices in the treatment efficacy and the accuracy of report were evidenced in the current study. Citation: Zhu K, Roisman G, Aouf S, Escourrou P. All APAPs are not equivalent for the treatment of sleep disordered breathing: a bench evaluation of eleven commercially available devices. J Clin Sleep Med 2015;11(7):725–734. PMID:25766708

  2. Adenosine A1 Receptors in Mouse Pontine Reticular Formation Depress Breathing, Increase Anesthesia Recovery Time, and Decrease Acetylcholine Release

    PubMed Central

    Gettys, George C.; Liu, Fang; Kimlin, Ed; Baghdoyan, Helen A.; Lydic, Ralph

    2012-01-01

    Background Clinical and preclinical data demonstrate the analgesic actions of adenosine. Central administration of adenosine agonists, however, suppresses arousal and breathing by poorly understood mechanisms. This study tested the two-tailed hypothesis that adenosine A1 receptors in the pontine reticular formation (PRF) of C57BL/6J mice modulate breathing, behavioral arousal, and PRF acetylcholine release. Methods Three sets of experiments used 51 mice. First, breathing was measured by plethysmography after PRF microinjection of the adenosine A1 receptor agonist N6-sulfophenyl adenosine (SPA) or saline. Second, mice were anesthetized with isoflurane and time to recovery of righting response (RoRR) was quantified after PRF microinjection of SPA or saline. Third, acetylcholine release in the PRF was measured before and during microdialysis delivery of SPA, the adenosine A1 receptor antagonist 1,3-dipropyl-8-cyclopentylxanthine (DPCPX), or SPA and DPCPX. Results First, SPA significantly decreased respiratory rate (−18%), tidal volume (−12%) and minute ventilation (−16%). Second, SPA concentration accounted for 76% of the variance in RoRR. Third, SPA concentration accounted for a significant amount of the variance in acetylcholine release (52%), RoRR (98%), and breathing rate (86%). DPCPX alone caused a concentration-dependent increase in acetylcholine, decrease in RoRR, and decrease in breathing rate. Coadministration of SPA and DPCPX blocked the SPA-induced decrease in acetylcholine and increase in RoRR. Conclusions Endogenous adenosine acting at adenosine A1 receptors in the PRF modulates breathing, behavioral arousal, and acetylcholine release. The results support the interpretation that an adenosinergic-cholinergic interaction within the PRF comprises one neurochemical mechanism underlying the wakefulness stimulus for breathing. PMID:23263018

  3. Stable Breathing in Patients With Obstructive Sleep Apnea Is Associated With Increased Effort but Not Lowered Metabolic Rate.

    PubMed

    de Melo, Camila M; Taranto-Montemurro, Luigi; Butler, James P; White, David P; Loring, Stephen H; Azarbarzin, Ali; Marques, Melania; Berger, Philip J; Wellman, Andrew; Sands, Scott A

    2017-10-01

    In principle, if metabolic rate were to fall during sleep in a patient with obstructive sleep apnea (OSA), ventilatory requirements could be met without increased respiratory effort thereby favoring stable breathing. Indeed, most patients achieve periods of stable flow-limited breathing without respiratory events for periods during the night for reasons that are unclear. Thus, we tested the hypothesis that in patients with OSA, periods of stable breathing occur when metabolic rate (VO2) declines. Twelve OSA patients (apnea-hypopnea index >15 events/h) completed overnight polysomnography including measurements of VO2 (using ventilation and intranasal PO2) and respiratory effort (esophageal pressure). Contrary to our hypothesis, VO2 did not differ between stable and unstable breathing periods in non-REM stage 2 (208 ± 20 vs. 213 ± 18 mL/min), despite elevated respiratory effort during stable breathing (26 ± 2 versus 23 ± 2 cmH2O, p = .03). However, VO2 was lowered during deeper sleep (244 to 179 mL/min from non-REM stages 1 to 3, p = .04) in conjunction with more stable breathing. Further analysis revealed that airflow obstruction curtailed metabolism in both stable and unstable periods, since CPAP increased VO2 by 14% in both cases (p = .02, .03, respectively). Patients whose VO2 fell most during sleep avoided an increase in PCO2 and respiratory effort. OSA patients typically convert from unstable to stable breathing without lowering metabolic rate. During sleep, OSA patients labor with increased respiratory effort but fail to satisfy metabolic demand even in the absence of overt respiratory events. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  4. Individuality of breathing during volitional moderate hyperventilation.

    PubMed

    Besleaga, Tudor; Blum, Michaël; Briot, Raphaël; Vovc, Victor; Moldovanu, Ion; Calabrese, Pascale

    2016-01-01

    The aim of this study is to investigate the individuality of airflow shapes during volitional hyperventilation. Ventilation was recorded on 18 healthy subjects following two protocols: (1) spontaneous breathing (SP1) followed by a volitional hyperventilation at each subject's spontaneous (HVSP) breathing rate, (2) spontaneous breathing (SP2) followed by hyperventilation at 20/min (HV20). HVSP and HV20 were performed at the same level of hypocapnia: end tidal CO2 (FETCO2) was maintained at 1% below the spontaneous level. At each breath, the tidal volume (VT), the breath (TTOT), the inspiratory (TI) and expiratory durations, the minute ventilation, VT/TI, TI/TTOT and the airflow shape were quantified by harmonic analysis. Under different conditions of breathing, we test if the airflow profiles of the same individual are more similar than airflow profiles between individuals. Minute ventilation was not significantly different between SP1 (6.71 ± 1.64 l·min(-1)) and SP2 (6.57 ± 1.31 l·min(-1)) nor between HVSP (15.88 ± 4.92 l·min(-1)) and HV20 (15.87 ± 4.16 l·min(-1)). Similar results were obtained for FETCO2 between SP1 (5.06 ± 0.54 %) and SP2 (5.00 ± 0.51%), and HVSP (4.07 ± 0.51%) and HV20 (3.88 ± 0.42%). Only TI/TTOT remained unchanged in all four conditions. Airflow shapes were similar when comparing SP1-SP2, HVSP-HV20, and SP1-HVSP but not similar when comparing SP2-HV20. These results suggest the existence of an individuality of airflow shape during volitional hyperventilation. We conclude that volitional ventilation alike automatic breathing follows inherent properties of the ventilatory system. Registered by Pascale Calabrese on ClinicalTrials.gov, # NCT01881945.

  5. Adenosine A(1) receptors in mouse pontine reticular formation depress breathing, increase anesthesia recovery time, and decrease acetylcholine release.

    PubMed

    Gettys, George C; Liu, Fang; Kimlin, Ed; Baghdoyan, Helen A; Lydic, Ralph

    2013-02-01

    Clinical and preclinical data demonstrate the analgesic actions of adenosine. Central administration of adenosine agonists, however, suppresses arousal and breathing by poorly understood mechanisms. This study tested the two-tailed hypothesis that adenosine A1 receptors in the pontine reticular formation (PRF) of C57BL/6J mice modulate breathing, behavioral arousal, and PRF acetylcholine release. Three sets of experiments used 51 mice. First, breathing was measured by plethysmography after PRF microinjection of the adenosine A1 receptor agonist N-sulfophenyl adenosine (SPA) or saline. Second, mice were anesthetized with isoflurane and the time to recovery of righting response (RoRR) was quantified after a PRF microinjection of SPA or saline. Third, acetylcholine release in the PRF was measured before and during microdialysis delivery of SPA, the adenosine A1 receptor antagonist 1, 3-dipropyl-8-cyclopentylxanthine, or SPA and 1, 3-dipropyl-8-cyclopentylxanthine. First, SPA significantly decreased respiratory rate (-18%), tidal volume (-12%), and minute ventilation (-16%). Second, SPA concentration accounted for 76% of the variance in RoRR. Third, SPA concentration accounted for a significant amount of the variance in acetylcholine release (52%), RoRR (98%), and breathing rate (86%). 1, 3-dipropyl-8-cyclopentylxanthine alone caused a concentration-dependent increase in acetylcholine, a decrease in RoRR, and a decrease in breathing rate. Coadministration of SPA and 1, 3-dipropyl-8-cyclopentylxanthine blocked the SPA-induced decrease in acetylcholine and increase in RoRR. Endogenous adenosine acting at adenosine A1 receptors in the PRF modulates breathing, behavioral arousal, and acetylcholine release. The results support the interpretation that an adenosinergic-cholinergic interaction within the PRF comprises one neurochemical mechanism underlying the wakefulness stimulus for breathing.

  6. Comparison of 72-hour fecal fat quantification and the 13C-mixed triglyceride breath test in assessing pancreatic exocrine sufficiency in children with chronic pancreatitis.

    PubMed

    Wejnarska, Karolina; Kołodziejczyk, Elwira; Ryżko, Józef; Oracz, Grzegorz

    Chronic pancreatitis (CP) in children is still a rare, although increasingly recognized entity. Over the duration of the disease several complications can be observed, two of which are major ones: endo- and exocrine insufficiency. In the medical care of children with CP it is crucial to diagnose the decreased endo- and exocrine function of the pancreas, in order to preserve patients from malnutrition and the failure to thrive. The aim of the study was to compare the usefulness of two indirect methods of assessing the pancreas exocrine function in children with CP. Ninety one patients with CP were enrolled in the study (41 boys, 50 girls, aged 2-17.8 years). Only Patients who had had both the 72-hour fecal fat quantification and the 13C-mixed triglyceride breath test (13C -MTBT) performed were selected. We compared the results of both tests for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) in detecting exocrine pancreatic insufficiency. Out of 91 patients, 12 were diagnosed with exocrine pancreatic insufficiency (EPI). The sensitivity of the fecal fat quantification was 50%, the specificity for the test was 100%. PPV and NPV were 100% and 93%, respectively. 13C-MTBT had the sensitivity of 42% and the specificity of 99%. PPV and NPV for the breath test were of 83% and 92%, respectively. No statistically significant discrepancy between the values obtained was found. Although the 72-hour fecal fat quantification remains the gold standard in detecting EPI, both of the methods that had been investigated were shown to be comparable regarding sensitivity, specificity, PPV and NPV in assessing pancreas exocrine sufficiency in children with CP. Due to the easier execution of the breath test, both for the patient and for medical personnel, its importance may increase.

  7. Understanding the Potential of WO₃ Based Sensors for Breath Analysis.

    PubMed

    Staerz, Anna; Weimar, Udo; Barsan, Nicolae

    2016-10-29

    Tungsten trioxide is the second most commonly used semiconducting metal oxide in gas sensors. Semiconducting metal oxide (SMOX)-based sensors are small, robust, inexpensive and sensitive, making them highly attractive for handheld portable medical diagnostic detectors. WO₃ is reported to show high sensor responses to several biomarkers found in breath, e.g., acetone, ammonia, carbon monoxide, hydrogen sulfide, toluene, and nitric oxide. Modern material science allows WO₃ samples to be tailored to address certain sensing needs. Utilizing recent advances in breath sampling it will be possible in the future to test WO₃-based sensors in application conditions and to compare the sensing results to those obtained using more expensive analytical methods.

  8. Understanding the Potential of WO3 Based Sensors for Breath Analysis

    PubMed Central

    Staerz, Anna; Weimar, Udo; Barsan, Nicolae

    2016-01-01

    Tungsten trioxide is the second most commonly used semiconducting metal oxide in gas sensors. Semiconducting metal oxide (SMOX)-based sensors are small, robust, inexpensive and sensitive, making them highly attractive for handheld portable medical diagnostic detectors. WO3 is reported to show high sensor responses to several biomarkers found in breath, e.g., acetone, ammonia, carbon monoxide, hydrogen sulfide, toluene, and nitric oxide. Modern material science allows WO3 samples to be tailored to address certain sensing needs. Utilizing recent advances in breath sampling it will be possible in the future to test WO3-based sensors in application conditions and to compare the sensing results to those obtained using more expensive analytical methods. PMID:27801881

  9. Research Technology

    NASA Image and Video Library

    2004-04-15

    Pictured is an artist's concept of the Rocket Based Combined Cycle (RBCC) launch. The RBCC's overall objective is to provide a technology test bed to investigate critical technologies associated with opperational usage of these engines. The program will focus on near term technologies that can be leveraged to ultimately serve as the near term basis for Two Stage to Orbit (TSTO) air breathing propulsions systems and ultimately a Single Stage To Orbit (SSTO) air breathing propulsion system.

  10. Neuropsychological Function in Patients With Acute Tetraplegia and Sleep Disordered Breathing.

    PubMed

    Schembri, Rachel; Spong, Jo; Graco, Marnie; Berlowitz, David J

    2017-02-01

    To investigate the relationship between apnea severity and neuropsychological function in patients with acute-onset tetraplegia and sleep disordered breathing. Polysomnography and neuropsychological testing were performed on 104 participants (age M = 45.60, SD = 16.38; 10 female) across 11 international sites, 2 months postinjury (M = 60.70 days, SD = 39.48). Neuropsychological tests assessed attention, information processing, executive function, memory, learning, mood, and quality of life. More severe sleep apnea was associated with poorer attention, information processing, and immediate recall. Deficits did not extend to memory. Higher preinjury intelligence and being younger reduced the associations with sleep disordered breathing; however, these protective factors were insufficient to counter the damage to attention, immediate recall, and information processing associated with sleep disordered breathing. These data suggest that new spinal cord injury may function as a model of "acute sleep apnea" and that more widespread sleep apnea-related deficits, including memory, may only be seen with longer exposure to apnea. These findings have important implications for functioning and skill acquisition during rehabilitation and, as such, highlight the importance of sleep health following tetraplegia. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  11. A comparison of diagnostic tests for lactose malabsorption - which one is the best?

    PubMed Central

    2009-01-01

    Background Perceived milk intolerance is a common complaint, and tests for lactose malabsorption (LM) are unreliable. This study assesses the agreement between diagnostic tests for LM and describes the diagnostic properties of the tests. Methods Patients above 18 years of age with suspected LM were included. After oral intake of 25 g lactose, a combined test with measurement of serum glucose (s-glucose) and hydrogen (H2) and methane (CH4) in expired air was performed and symptoms were recorded. In patients with discrepancies between the results, the combined test was repeated and a gene test for lactose non-persistence was added. The diagnosis of LM was based on an evaluation of all tests. The following tests were compared: Increase in H2, CH4, H2+CH4 and H2+CH4x2 in expired air, increase in s-glucose, and symptoms. The agreement was calculated and the diagnostic properties described. Results Sixty patients were included, seven (12%) had LM. The agreement (kappa-values) between the methods varied from 0.25 to 0.91. The best test was the lactose breath test with measurement of the increase in H2 + CH4x2 in expired air. With a cut-off level < 18 ppm, the area under the ROC-curve was 0.967 and sensitivity was 100%. This shows that measurement of CH4 in addition to H2 improves the diagnostic properties of the breath test. Conclusion The agreement between commonly used methods for the diagnosis of LM was unsatisfactory. A lactose breath test with measurement of H2 + CH4x2 in expired air had the best diagnostic properties. PMID:19878587

  12. In Vivo Volatile Organic Compound Signatures of Mycobacterium avium subsp. paratuberculosis

    PubMed Central

    Bergmann, Andreas; Trefz, Phillip; Fischer, Sina; Klepik, Klaus; Walter, Gudrun; Steffens, Markus; Ziller, Mario; Schubert, Jochen K.; Reinhold, Petra; Köhler, Heike; Miekisch, Wolfram

    2015-01-01

    Mycobacterium avium ssp. paratuberculosis (MAP) is the causative agent of a chronic enteric disease of ruminants. Available diagnostic tests are complex and slow. In vitro, volatile organic compound (VOC) patterns emitted from MAP cultures mirrored bacterial growth and enabled distinction of different strains. This study was intended to determine VOCs in vivo in the controlled setting of an animal model. VOCs were pre-concentrated from breath and feces of 42 goats (16 controls and 26 MAP-inoculated animals) by means of needle trap microextraction (breath) and solid phase microextraction (feces) and analyzed by gas chromatography/ mass spectrometry. Analyses were performed 18, 29, 33, 41 and 48 weeks after inoculation. MAP-specific antibodies and MAP-specific interferon-γ-response were determined from blood. Identities of all marker-VOCs were confirmed through analysis of pure reference substances. Based on detection limits in the high pptV and linear ranges of two orders of magnitude more than 100 VOCs could be detected in breath and in headspace over feces. Twenty eight substances differed between inoculated and non-inoculated animals. Although patterns of most prominent substances such as furans, oxygenated substances and hydrocarbons changed in the course of infection, differences between inoculated and non-inoculated animals remained detectable at any time for 16 substances in feces and 3 VOCs in breath. Differences of VOC concentrations over feces reflected presence of MAP bacteria. Differences in VOC profiles from breath were linked to the host response in terms of interferon-γ-response. In a perspective in vivo analysis of VOCs may help to overcome limitations of established tests. PMID:25915653

  13. Urinary cotinine and breath carbon monoxide levels among bar and restaurant employees in ankara.

    PubMed

    Caman, Ozge Karadag; Erguder, Berrin I; Ozcebe, Hilal; Bilir, Nazmi

    2013-08-01

    Hospitality sector employees constitute one of the key groups with respect to their secondhand tobacco smoke exposure at work. This study aimed to detect urinary cotinine and breath carbon monoxide (CO) levels among bar and restaurant employees in Ankara, as well as the employees' opinions on the new antitobacco law, changes in smoking behavior, and subjective health status before and after the law entered into force. This before-after study was conducted in 19 premises, with the participation of 65 employees before implementation and 81 employees 3 months after implementation of the new antitobacco law in the hospitality sector. Data in both phases were collected through face-to-face surveys, breath CO measurements, and urinary cotinine analysis. Descriptive statistics were used to summarize data, whereas chi-square test, paired and unpaired t tests, and analysis of variance were used to compare groups. Most of the restaurant and bar employees were male and below 35 years old. Before-after comparison showed that health complaints of the hospitality sector employees such as watering and itching in the eyes, difficulty in breathing, and cough (p < .001), as well as breath CO (p < .001) and urinary cotinine levels (p < .001) decreased significantly 3 months after implementation of the law. Among the smoking employees, mean number of cigarettes smoked was also found to decrease (p = .012). Majority of the employees (83.8%) were found to support the smoking ban in enclosed public places. Results of this study provide solid evidence on the positive health effects of smoke-free laws and employees' support for smoke-free workplaces.

  14. Comparison of breath testing with fructose and high fructose corn syrups in health and IBS

    PubMed Central

    Skoog, S. M.; Bharucha, A. E.; Zinsmeister, A. R.

    2008-01-01

    Although incomplete fructose absorption has been implicated to cause gastrointestinal symptoms, foods containing high fructose corn syrup (HFCS) contain glucose. Glucose increases fructose absorption in healthy subjects. Our hypothesis was that fructose intolerance is less prevalent after HFCS consumption compared to fructose alone in healthy subjects and irritable bowel syndrome (IBS). Breath hydrogen levels and gastrointestinal symptoms were assessed after 40 g of fructose (12% solution) prepared either in water or as HFCS, administered in double-blind randomized order on 2 days in 20 healthy subjects and 30 patients with IBS. Gastrointestinal symptoms were recorded on 100-mm Visual Analogue Scales. Breath hydrogen excretion was more frequently abnormal (P < 0.01) after fructose (68%) than HFCS (26%) in controls and patients. Fructose intolerance (i.e. abnormal breath test and symptoms) was more prevalent after fructose than HFCS in healthy subjects (25% vs 0%, P = 0.002) and patients (40% vs 7%, P = 0.062). Scores for several symptoms (e.g. bloating r = 0.35) were correlated (P ≤ 0.01) to peak breath hydrogen excretion after fructose but not HFCS; in the fructose group, this association did not differ between healthy subjects and patients. Symptoms were not significantly different after fructose compared to HFCS. Fructose intolerance is more prevalent with fructose alone than with HFCS in health and in IBS. The prevalence of fructose intolerance is not significantly different between health and IBS. Current methods for identifying fructose intolerance should be modified to more closely reproduce fructose ingestion in daily life. PMID:18221251

  15. Comparison of breath testing with fructose and high fructose corn syrups in health and IBS.

    PubMed

    Skoog, S M; Bharucha, A E; Zinsmeister, A R

    2008-05-01

    Although incomplete fructose absorption has been implicated to cause gastrointestinal symptoms, foods containing high fructose corn syrup (HFCS) contain glucose. Glucose increases fructose absorption in healthy subjects. Our hypothesis was that fructose intolerance is less prevalent after HFCS consumption compared to fructose alone in healthy subjects and irritable bowel syndrome (IBS). Breath hydrogen levels and gastrointestinal symptoms were assessed after 40 g of fructose (12% solution) prepared either in water or as HFCS, administered in double-blind randomized order on 2 days in 20 healthy subjects and 30 patients with IBS. Gastrointestinal symptoms were recorded on 100-mm Visual Analogue Scales. Breath hydrogen excretion was more frequently abnormal (P < 0.01) after fructose (68%) than HFCS (26%) in controls and patients. Fructose intolerance (i.e. abnormal breath test and symptoms) was more prevalent after fructose than HFCS in healthy subjects (25% vs. 0%, P = 0.002) and patients (40% vs. 7%, P = 0.062). Scores for several symptoms (e.g. bloating r = 0.35) were correlated (P < or = 0.01) to peak breath hydrogen excretion after fructose but not HFCS; in the fructose group, this association did not differ between healthy subjects and patients. Symptoms were not significantly different after fructose compared to HFCS. Fructose intolerance is more prevalent with fructose alone than with HFCS in health and in IBS. The prevalence of fructose intolerance is not significantly different between health and IBS. Current methods for identifying fructose intolerance should be modified to more closely reproduce fructose ingestion in daily life.

  16. Hepatobiliary MRI: Signal intensity based assessment of liver function correlated to 13C-Methacetin breath test.

    PubMed

    Haimerl, Michael; Probst, Ute; Poelsterl, Stefanie; Beyer, Lukas; Fellner, Claudia; Selgrad, Michael; Hornung, Matthias; Stroszczynski, Christian; Wiggermann, Philipp

    2018-06-13

    Gadoxetic acid (Gd-EOB-DTPA) is a paramagnetic MRI contrast agent with raising popularity and has been used for evaluation of imaging-based liver function in recent years. In order to verify whether liver function as determined by real-time breath analysis using the intravenous administration of 13 C-methacetin can be estimated quantitatively from Gd-EOB-DTPA-enhanced MRI using signal intensity (SI) values. 110 patients underwent Gd-EOB-DTPA-enhanced 3-T MRI and, for the evaluation of liver function, a 13 C-methacetin breath test ( 13 C-MBT). SI values from before (SI pre ) and 20 min after (SI post ) contrast media injection were acquired by T1-weighted volume-interpolated breath-hold examination (VIBE) sequences with fat suppression. The relative enhancement (RE) between the plain and contrast-enhanced SI values was calculated and evaluated in a correlation analysis of 13 C-MBT values to SI post and RE to obtain a SI-based estimation of 13 C-MBT values. The simple regression model showed a log-linear correlation of 13 C-MBT values with SI post and RE (p < 0.001). Stratified by 3 different categories of 13 C-MBT readouts, there was a constant significant decrease in both SI post (p ≤ 0.002) and RE (p ≤ 0.033) with increasing liver disease progression as assessed by the 13 C-MBT. Liver function as determined using real-time 13 C-methacetin breath analysis can be estimated quantitatively from Gd-EOB-DTPA-enhanced MRI using SI-based indices.

  17. Drinking and driving in southeastern Brazil: results from a roadside survey study.

    PubMed

    Campos, Valdir Ribeiro; de Souza E Silva, Rebeca; Duailibi, Sérgio; Laranjeira, Ronaldo; Palacios, Ester Nakamura; Grube, Joel W; Pinsky, Ilana

    2013-01-01

    The objective of this study is to present data from a roadside survey study on drinking and driving and alcohol consumption in southeastern Brazil. A cross-sectional roadside survey study using a questionnaire and breathalyzer data is the method used to determine the prevalence of drinking and driving and to examine whether socio-demographic characteristics and drivers' behavior, attitude and alcohol consumption predicted positive blood alcohol content (BAC). The data were gathered from 2005 to 2007 through roadside surveys conducted on high volume public roads in four cities in southeastern Brazil. A total of 4182 randomly selected drivers took part in the research. Of these drivers, 3488 (83.4%) completed the questionnaire and agreed to take a breath test. Overall, 24.6% of drivers had a detectable blood alcohol concentration (BAC) and 15.9% had a BAC above the legal limit (0.6g/l) at the time of the study. Logistic regression controlling for locale (city), sex, age and marital status was used to predict whether each driver would present a positive breath test. Socio-demographic characteristics, driving behaviors and attitudes, and alcohol consumption patterns were included as predictors. These analyses indicated that those who believed drinking and driving was a serious offense were about two-thirds as likely to have a positive breath test, and that drivers reporting a pattern of regular alcohol use were three times as likely to have a positive breath test. These findings indicate that drinking and driving is relatively common in Brazil, and that it occurs considerably more frequently than similar surveys suggest, is the case in other countries. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Delivery of helium–oxygen mixture during spontaneous breathing: evaluation of three high-concentration face masks.

    PubMed

    Roche-Campo, Ferran; Vignaux, Laurence; Galia, Fabrice; Lyazidi, Aissam; Vargas, Frédéric; Texereau, Joëlle; Apiou-Sbirlea, Gabriela; Jolliet, Philippe; Brochard, Laurent

    2011-11-01

    To evaluate the efficacy of delivering a mixture of helium and oxygen gas (He–O2) in spontaneous ventilation. Three high oxygen flow reservoir masks were tested: the Heliox21, specifically designed for helium; the Hi-Ox80 mask, with an inspiratory and an expiratory valve; and a standard high-concentration face mask. This prospective randomized crossover study was performed in six healthy volunteers in a laboratory setting. Volunteers breathed a mixture of 78% He/22% O2 through each of the masks under two different breathing conditions (rest and hyperventilation: minute ventilation of 14.9 ± 6.1 and 26.7 ± 8.7 L min(−1), respectively) and four different He–O2 flow rates (7, 10, 12, and 15 L min(−1)). A nasopharyngeal catheter was used to estimate He pharyngeal concentration (Fp [He]) in the airways in order to determine the percentage of contamination with room air (% air cont) at end-expiration. Under all testing conditions, the Hi-Ox80 mask presented a significantly lower % air cont. During resting breathing pattern, a Fp [He] higher than 50% was achieved in 54% of the tests performed with the Hi-Ox80 mask compared to 29% for the Heliox21 mask and only 17% for the standard mask. At hyperventilation, a Fp [He] higher than 50% was achieved in 17% of the tests performed with the Hi-Ox mask compared to 4% for the other two masks. He–O2 administration via the usual high-concentration reservoir masks results in significant dilution by room air. The Hi-Ox80 mask minimized room air contamination and much more frequently achieved a pharyngeal He concentration higher than 50%.

  19. Can simple mobile phone applications provide reliable counts of respiratory rates in sick infants and children? An initial evaluation of three new applications.

    PubMed

    Black, James; Gerdtz, Marie; Nicholson, Pat; Crellin, Dianne; Browning, Laura; Simpson, Julie; Bell, Lauren; Santamaria, Nick

    2015-05-01

    Respiratory rate is an important sign that is commonly either not recorded or recorded incorrectly. Mobile phone ownership is increasing even in resource-poor settings. Phone applications may improve the accuracy and ease of counting of respiratory rates. The study assessed the reliability and initial users' impressions of four mobile phone respiratory timer approaches, compared to a 60-second count by the same participants. Three mobile applications (applying four different counting approaches plus a standard 60-second count) were created using the Java Mobile Edition and tested on Nokia C1-01 phones. Apart from the 60-second timer application, the others included a counter based on the time for ten breaths, and three based on the time interval between breaths ('Once-per-Breath', in which the user presses for each breath and the application calculates the rate after 10 or 20 breaths, or after 60s). Nursing and physiotherapy students used the applications to count respiratory rates in a set of brief video recordings of children with different respiratory illnesses. Limits of agreement (compared to the same participant's standard 60-second count), intra-class correlation coefficients and standard errors of measurement were calculated to compare the reliability of the four approaches, and a usability questionnaire was completed by the participants. There was considerable variation in the counts, with large components of the variation related to the participants and the videos, as well as the methods. None of the methods was entirely reliable, with no limits of agreement better than -10 to +9 breaths/min. Some of the methods were superior to the others, with ICCs from 0.24 to 0.92. By ICC the Once-per-Breath 60-second count and the Once-per-Breath 20-breath count were the most consistent, better even than the 60-second count by the participants. The 10-breath approaches performed least well. Users' initial impressions were positive, with little difference between the applications found. This study provides evidence that applications running on simple phones can be used to count respiratory rates in children. The Once-per-Breath methods are the most reliable, outperforming the 60-second count. For children with raised respiratory rates the 20-breath version of the Once-per-Breath method is faster, so it is a more suitable option where health workers are under time pressure. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. The effect of breathing an ambient low‐density, hyperoxic gas on the perceived effort of breathing and maximal performance of exercise in well‐trained athletes

    PubMed Central

    Ansley, L; Petersen, D; Thomas, A; Gibson, A St Clair; Robson‐Ansley, P; Noakes, T D

    2007-01-01

    Background The role of the perception of breathing effort in the regulation of performance of maximal exercise remains unclear. Aims To determine whether the perceived effort of ventilation is altered through substituting a less dense gas for normal ambient air and whether this substitution affects performance of maximal incremental exercise in trained athletes. Methods Eight highly trained cyclists (mean SD) maximal oxygen consumption (VO2max) = 69.9 (7.9) (mlO2/kg/min) performed two randomised maximal tests in a hyperbaric chamber breathing ambient air composed of either 35% O2/65% N2 (nitrox) or 35% O2/65% He (heliox). A ramp protocol was used in which power output was incremented at 0.5 W/s. The trials were separated by at least 48 h. The perceived effort of breathing was obtained via Borg Category Ratio Scales at 3‐min intervals and at fatigue. Oxygen consumption (VO2) and minute ventilation (VE) were monitored continuously. Results Breathing heliox did not change the sensation of dyspnoea: there were no differences between trials for the Borg scales at any time point. Exercise performance was not different between the nitrox and heliox trials (peak power output = 451 (58) and 453 (56) W), nor was VO2max (4.96 (0.61) and 4.88 (0.65) l/min) or maximal VE (157 (24) and 163 (22) l/min). Between‐trial variability in peak power output was less than either VO2max or maximal VE. Conclusion Breathing a less dense gas does not improve maximal performance of exercise or reduce the perception of breathing effort in highly trained athletes, although an attenuated submaximal tidal volume and VE with a concomitant reduction in VO2 suggests an improved gas exchange and reduced O2 cost of ventilation when breathing heliox. PMID:17062658

  1. 49 CFR 40.211 - Who conducts DOT alcohol tests?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Who conducts DOT alcohol tests? 40.211 Section 40... DRUG AND ALCOHOL TESTING PROGRAMS Alcohol Testing Personnel § 40.211 Who conducts DOT alcohol tests? (a) Screening test technicians (STTs) and breath alcohol technicians (BATs) meeting their respective...

  2. 49 CFR 40.211 - Who conducts DOT alcohol tests?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Who conducts DOT alcohol tests? 40.211 Section 40... DRUG AND ALCOHOL TESTING PROGRAMS Alcohol Testing Personnel § 40.211 Who conducts DOT alcohol tests? (a) Screening test technicians (STTs) and breath alcohol technicians (BATs) meeting their respective...

  3. C57BL/6J mouse apolipoprotein A2 gene is deterministic for apnea.

    PubMed

    Gillombardo, Carl B; Darrah, Rebecca; Dick, Thomas E; Moore, Michael; Kong, Nathan; Decker, Michael J; Han, Fang; Yamauchi, Motoo; Dutschmann, Mathias; Azzam, Sausan; Strohl, Kingman P

    2017-01-01

    Brainstem apolipoprotein AII (apoa2) mRNA expression correlates with apnea in breathing present in the adult C57Bl/6J (B6) sleep apnea model. To test the hypothesis that the B6 apoa2 gene contributes to the trait, we performed plethysmographic testing in apoa2 knock out (KO: -/-) mice, an in situ brainstem-spinal cord preparation comparing KO to WT (+/+) mice, and B6xDBA recombinant inbred strains (RISs). Apoa2 WT do, but KO and heterozygote (+/-) mice do not exhibit apnea during post-hypoxic breathing, measured in vivo. In the in situ model, pauses and instability in fictive phrenic bursting are substantially reduced in KO vs. WT preparations. In 24 RISs, apnea number in vivo was higher in strains with B6 apoa2 than with DBA apoa2 alleles. The B6 apoa2 polymorphism is directly involved in breath production, and its identification suggests a novel pathway influencing risk for adult sleep apnea. Published by Elsevier B.V.

  4. 42 CFR 84.99 - Man tests; testing conditions; general requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Man tests; testing conditions; general requirements...-Contained Breathing Apparatus § 84.99 Man tests; testing conditions; general requirements. (a) The man tests...) All man tests will be conducted by the Institute. (d) The apparatus will be examined before each man...

  5. 42 CFR 84.99 - Man tests; testing conditions; general requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Man tests; testing conditions; general requirements...-Contained Breathing Apparatus § 84.99 Man tests; testing conditions; general requirements. (a) The man tests...) All man tests will be conducted by the Institute. (d) The apparatus will be examined before each man...

  6. 42 CFR 84.99 - Man tests; testing conditions; general requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Man tests; testing conditions; general requirements...-Contained Breathing Apparatus § 84.99 Man tests; testing conditions; general requirements. (a) The man tests...) All man tests will be conducted by the Institute. (d) The apparatus will be examined before each man...

  7. 42 CFR 84.99 - Man tests; testing conditions; general requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Man tests; testing conditions; general requirements...-Contained Breathing Apparatus § 84.99 Man tests; testing conditions; general requirements. (a) The man tests...) All man tests will be conducted by the Institute. (d) The apparatus will be examined before each man...

  8. Effects of the medicinal plants Curcuma zedoaria and Camellia sinensis on halitosis control.

    PubMed

    Farina, Vitor Hugo; Lima, Ana Paula de; Balducci, Ivan; Brandão, Adriana Aigotti Haberbeck

    2012-01-01

    Volatile sulphur compounds (VSC) are the gases mainly responsible for halitosis (bad breath). The aim of this research was to evaluate the effects of medicinal plants on halitosis control. Two commonly used plants were tested: Curcuma zedoaria and Camellia sinensis (green tea). These plants were prepared as an aqueous solution and used as mouthwashes, compared with a standard mouthwash of 0.12% chlorhexidine gluconate and a placebo (water). The experiment was conducted with 30 volunteers from the School of Dentistry of São Jose dos Campos, Univ. Estadual Paulista - UNESP, SP, Brazil. Each volunteer tested the four mouthwashes. The Cysteine Challenge Method, modified for this study, was used for initial breath standardization. Four breath assessments were conducted after volunteers rinsed orally with acetylcysteine: one before the test mouthwash was used; the second, one minute after its use; a third 90 minutes later; and the last 180 minutes later. The results showed that chlorhexidine gluconate lowered VSC production immediately, and that this effect lasted up to 3 hours, while the tested plants had immediate inhibitory effects but no residual inhibitory effects on VSC. We concluded that Curcuma zedoaria and Camellia sinensis, prepared as infusions and used as mouthwashes, did not have a residual neutralizing effect on VSC.

  9. Validation of the Natus CO-Stat End Tidal Breath Analyzer in children and adults.

    PubMed

    Vreman, H J; Wong, R J; Harmatz, P; Fanaroff, A A; Berman, B; Stevenson, D K

    1999-12-01

    The performance of a point-of-care, noninvasive end tidal breath carbon monoxide analyzer (CO-Stat End Tidal Breath Analyzer, Natus Medical Inc.) that also reports end tidal carbon dioxide (ETCO2) and respiratory rate (RR), was compared to established, marketed (predicate) devices in children (n = 39) and adults (n = 48) who are normal or at-risk of elevated CO excretion. Concentrations of end tidal breath CO (ETCO), room air CO, ETCO corrected for inhaled CO (ETCOc), ETCO2, and RR were measured with the CO-Stat analyzer and the data compared to those obtained from the same subjects using the Vitalograph BreathCO monitor (Vitalograph, Inc.) for ETCOc and the Pryon CO2 monitor (SC210 and SC300, Pryon Corp) for ETCO2 and RR. Adults and children were studied at three medical centers. The data were analyzed by paired t-tests and linear regression. Bias and imprecision between the CO-Stat analyzer and the predicate devices was calculated by the method of Bland and Altman. Paired t-tests, performed on the three parameters measured with the CO-Stat analyzer and predicate devices showed that only the ETCOc values in the adults and the ETCO2 values in the children were significantly different (lower, p < or = 0.0001, and higher, p < or = 0.0001, respectively). The mean bias and imprecision of the CO-Stat analyzer for adult ETCOc and children ETCO2 measurements were -0.9 +/- 1.2 ppm and 0.4 +/- 0.6%, respectively. Linear regression analysis for the ETCOc results in children and adults had a high degree of correlation (r = 0.91 and 0.98, respectively). We conclude that in a clinical environment the Natus CO-Stat End Tidal Breath Analyzer performs at least as well as predicate devices for the measurements of ETCOc, ETCO2, and RR.

  10. Quantifying Aerosol Delivery in Simulated Spontaneously Breathing Patients With Tracheostomy Using Different Humidification Systems With or Without Exhaled Humidity.

    PubMed

    Ari, Arzu; Harwood, Robert; Sheard, Meryl; Alquaimi, Maher Mubarak; Alhamad, Bshayer; Fink, James B

    2016-05-01

    Aerosol and humidification therapy are used in long-term airway management of critically ill patients with a tracheostomy. The purpose of this study was to determine delivery efficiency of jet and mesh nebulizers combined with different humidification systems in a model of a spontaneously breathing tracheotomized adult with or without exhaled heated humidity. An in vitro model was constructed to simulate a spontaneously breathing adult (tidal volume, 400 mL; breathing frequency, 20 breaths/min; inspiratory-expiratory ratio, 1:2) with a tracheostomy using a teaching manikin attached to a test lung through a collecting filter (Vital Signs Respirgard II). Exhaled heat and humidity were simulated using a cascade humidifier set to deliver 37°C and >95% relative humidity. Albuterol sulfate (2.5 mg/3 mL) was administered with a jet nebulizer (AirLife Misty Max) operated at 10 L/min and a mesh nebulizer (Aeroneb Solo) using a heated pass-over humidifier, unheated large volume humidifier both at 40 L/min output and heat-and-moisture exchanger. Inhaled drug eluted from the filter was analyzed via spectrophotometry (276 nm). Delivery efficiency of the jet nebulizer was less than that of the mesh nebulizer under all conditions (P < .05). Aerosol delivery with each nebulizer was greatest on room air and lowest when heated humidifiers with higher flows were used. Exhaled humidity decreased drug delivery up to 44%. The jet nebulizer was less efficient than the mesh nebulizer in all conditions tested in this study. Aerosol deposition with each nebulizer was lowest with the heated humidifier with high flow. Exhaled humidity reduced inhaled dose of drug compared with a standard model with nonheated/nonhumidified exhalation. Further clinical research is warranted to understand the impact of exhaled humidity on aerosol drug delivery in spontaneously breathing patients with tracheostomy using different types of humidifiers. Copyright © 2016 by Daedalus Enterprises.

  11. Atropine microdialysis within or near the pre-Bötzinger Complex increases breathing frequency more during wakefulness than during NREM sleep

    PubMed Central

    Muere, Clarissa; Neumueller, Suzanne; Miller, Justin; Olesiak, Samantha; Hodges, Matthew R.; Pan, Lawrence

    2013-01-01

    Normal activity of neurons within the medullary ventral respiratory column (VRC) in or near the pre-Bötzinger Complex (preBötC) is dependent on the balance of inhibitory and excitatory neuromodulators acting at their respective receptors. The role of cholinergic neuromodulation during awake and sleep states is unknown. Accordingly, our objective herein was to test the hypotheses that attenuation of cholinergic modulation of VRC/preBötC neurons in vivo with atropine would: 1) decrease breathing frequency more while awake than during non-rapid-eye-movement (NREM) sleep and 2) increase other excitatory neuromodulators. To test these hypotheses, we unilaterally dialyzed mock cerebrospinal fluid (mCSF) or 50 mM atropine in mCSF in or near the preBötC region of adult goats during the awake (n = 9) and NREM sleep (n = 7) states. Breathing was monitored, and effluent dialysate was collected for analysis of multiple neurochemicals. Compared with dialysis of mCSF alone, atropine increased (P < 0.05) breathing frequency while awake during the day [+10 breaths (br)/min] and at night (+9 br/min) and, to a lesser extent, during NREM sleep (+5 br/min). Atropine increased (P < 0.05) effluent concentrations of serotonin (5-HT), substance P (SP), and glycine during the day and at night. When atropine was dialyzed in one preBötC and mCSF in the contralateral preBötC, 5-HT and SP increased only at the site of atropine dialysis. We conclude: 1) attenuation of a single neuromodulator results in local changes in other neuromodulators that affect ventilatory control, 2) effects of perturbations of cholinergic neuromodulation on breathing are state-dependent, and 3) interpretation of perturbations in vivo requires consideration of direct and indirect effects. PMID:23271698

  12. Evaluation of Fractional Regional Ventilation Using 4D-CT and Effects of Breathing Maneuvers on Ventilation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mistry, Nilesh N., E-mail: nmistry@som.umaryland.edu; Diwanji, Tejan; Shi, Xiutao

    2013-11-15

    Purpose: Current implementations of methods based on Hounsfield units to evaluate regional lung ventilation do not directly incorporate tissue-based mass changes that occur over the respiratory cycle. To overcome this, we developed a 4-dimensional computed tomography (4D-CT)-based technique to evaluate fractional regional ventilation (FRV) that uses an individualized ratio of tidal volume to end-expiratory lung volume for each voxel. We further evaluated the effect of different breathing maneuvers on regional ventilation. The results from this work will help elucidate the relationship between global and regional lung function. Methods and Materials: Eight patients underwent 3 sets of 4D-CT scans during 1more » session using free-breathing, audiovisual guidance, and active breathing control. FRV was estimated using a density-based algorithm with mass correction. Internal validation between global and regional ventilation was performed by use of the imaging data collected during the use of active breathing control. The impact of breathing maneuvers on FRV was evaluated comparing the tidal volume from 3 breathing methods. Results: Internal validation through comparison between the global and regional changes in ventilation revealed a strong linear correlation (slope of 1.01, R{sup 2} of 0.97) between the measured global lung volume and the regional lung volume calculated by use of the “mass corrected” FRV. A linear relationship was established between the tidal volume measured with the automated breathing control system and FRV based on 4D-CT imaging. Consistently larger breathing volumes were observed when coached breathing techniques were used. Conclusions: The technique presented improves density-based evaluation of lung ventilation and establishes a link between global and regional lung ventilation volumes. Furthermore, the results obtained are comparable with those of other techniques of functional evaluation such as spirometry and hyperpolarized-gas magnetic resonance imaging. These results were demonstrated on retrospective analysis of patient data, and further research using prospective data is under way to validate this technique against established clinical tests.« less

  13. Nasal Respiration Entrains Human Limbic Oscillations and Modulates Cognitive Function

    PubMed Central

    Jiang, Heidi; Zhou, Guangyu; Arora, Nikita; Schuele, Stephan; Rosenow, Joshua; Gottfried, Jay A.

    2016-01-01

    The need to breathe links the mammalian olfactory system inextricably to the respiratory rhythms that draw air through the nose. In rodents and other small animals, slow oscillations of local field potential activity are driven at the rate of breathing (∼2–12 Hz) in olfactory bulb and cortex, and faster oscillatory bursts are coupled to specific phases of the respiratory cycle. These dynamic rhythms are thought to regulate cortical excitability and coordinate network interactions, helping to shape olfactory coding, memory, and behavior. However, while respiratory oscillations are a ubiquitous hallmark of olfactory system function in animals, direct evidence for such patterns is lacking in humans. In this study, we acquired intracranial EEG data from rare patients (Ps) with medically refractory epilepsy, enabling us to test the hypothesis that cortical oscillatory activity would be entrained to the human respiratory cycle, albeit at the much slower rhythm of ∼0.16–0.33 Hz. Our results reveal that natural breathing synchronizes electrical activity in human piriform (olfactory) cortex, as well as in limbic-related brain areas, including amygdala and hippocampus. Notably, oscillatory power peaked during inspiration and dissipated when breathing was diverted from nose to mouth. Parallel behavioral experiments showed that breathing phase enhances fear discrimination and memory retrieval. Our findings provide a unique framework for understanding the pivotal role of nasal breathing in coordinating neuronal oscillations to support stimulus processing and behavior. SIGNIFICANCE STATEMENT Animal studies have long shown that olfactory oscillatory activity emerges in line with the natural rhythm of breathing, even in the absence of an odor stimulus. Whether the breathing cycle induces cortical oscillations in the human brain is poorly understood. In this study, we collected intracranial EEG data from rare patients with medically intractable epilepsy, and found evidence for respiratory entrainment of local field potential activity in human piriform cortex, amygdala, and hippocampus. These effects diminished when breathing was diverted to the mouth, highlighting the importance of nasal airflow for generating respiratory oscillations. Finally, behavioral data in healthy subjects suggest that breathing phase systematically influences cognitive tasks related to amygdala and hippocampal functions. PMID:27927961

  14. Nasal Respiration Entrains Human Limbic Oscillations and Modulates Cognitive Function.

    PubMed

    Zelano, Christina; Jiang, Heidi; Zhou, Guangyu; Arora, Nikita; Schuele, Stephan; Rosenow, Joshua; Gottfried, Jay A

    2016-12-07

    The need to breathe links the mammalian olfactory system inextricably to the respiratory rhythms that draw air through the nose. In rodents and other small animals, slow oscillations of local field potential activity are driven at the rate of breathing (∼2-12 Hz) in olfactory bulb and cortex, and faster oscillatory bursts are coupled to specific phases of the respiratory cycle. These dynamic rhythms are thought to regulate cortical excitability and coordinate network interactions, helping to shape olfactory coding, memory, and behavior. However, while respiratory oscillations are a ubiquitous hallmark of olfactory system function in animals, direct evidence for such patterns is lacking in humans. In this study, we acquired intracranial EEG data from rare patients (Ps) with medically refractory epilepsy, enabling us to test the hypothesis that cortical oscillatory activity would be entrained to the human respiratory cycle, albeit at the much slower rhythm of ∼0.16-0.33 Hz. Our results reveal that natural breathing synchronizes electrical activity in human piriform (olfactory) cortex, as well as in limbic-related brain areas, including amygdala and hippocampus. Notably, oscillatory power peaked during inspiration and dissipated when breathing was diverted from nose to mouth. Parallel behavioral experiments showed that breathing phase enhances fear discrimination and memory retrieval. Our findings provide a unique framework for understanding the pivotal role of nasal breathing in coordinating neuronal oscillations to support stimulus processing and behavior. Animal studies have long shown that olfactory oscillatory activity emerges in line with the natural rhythm of breathing, even in the absence of an odor stimulus. Whether the breathing cycle induces cortical oscillations in the human brain is poorly understood. In this study, we collected intracranial EEG data from rare patients with medically intractable epilepsy, and found evidence for respiratory entrainment of local field potential activity in human piriform cortex, amygdala, and hippocampus. These effects diminished when breathing was diverted to the mouth, highlighting the importance of nasal airflow for generating respiratory oscillations. Finally, behavioral data in healthy subjects suggest that breathing phase systematically influences cognitive tasks related to amygdala and hippocampal functions. Copyright © 2016 the authors 0270-6474/16/3612448-20$15.00/0.

  15. Rifaximin: The Revolutionary Antibiotic Approach for Irritable Bowel Syndrome.

    PubMed

    Triantafyllou, Konstantinos; Sioulas, Athanasios D; Giamarellos-Bourboulis, Evangelos J

    2015-01-01

    A large number of clinical studies using breath testing and a smaller number of studies using quantitative cultures of the upper small intestine established a link between irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO). A series of 12 studies both prospective and retrospective in design in a population of patients with SIBO without IBS showed that the non-absorbable antibiotic rifaximin can eradicate SIBO as proved through decrease of the exhaled hydrogen and methane in breath tests. The efficacy of rifaximin was superior over the comparator treatment in most of these studies. Based on these findings, short course rifaximin was tested in various concentrations in eight open-label trials in patients with IBS and proven SIBO by breath test. Similar efficacy of rifaximin was shown in SIBO eradication; this was accompanied by improvement of the global score for IBS symptoms. Finally, five double-blind randomized clinical trials were conducted in patients with IBS; four were placebo-controlled. The larger trials were TARGET 1 and TARGET 2 studies testing rifaximin at a regimen of 550 mg tid for 14 days. All trials showed a significant superiority of rifaximin over comparator for the improvement of global symptoms of IBS and bloating. Although the aforementioned results render rifaximin a revolutionary therapeutic approach for IBS, several concerns on induction of antimicrobial resistant flora remain.

  16. Effect of Alternate Nostril Breathing Exercise on Experimentally Induced Anxiety in Healthy Volunteers Using the Simulated Public Speaking Model: A Randomized Controlled Pilot Study.

    PubMed

    Kamath, Ashwin; Urval, Rathnakar P; Shenoy, Ashok K

    2017-01-01

    A randomized controlled pilot study was carried out to determine the effect of a 15-minute practice of ANB exercise on experimentally induced anxiety using the simulated public speaking model in yoga-naïve healthy young adults. Thirty consenting medical students were equally divided into test and control groups. The test group performed alternate nostril breathing exercise for 15 minutes, while the control group sat in a quiet room before participating in the simulated public speaking test (SPST). Visual Analog Mood Scale and Self-Statements during Public Speaking scale were used to measure the mood state at different phases of the SPST. The psychometric scores of both groups were comparable at baseline. Repeated-measures ANOVA showed a significant effect of phase ( p < 0.05), but group and gender did not have statistically significant influence on the mean anxiety scores. However, the test group showed a trend towards lower mean scores for the anxiety factor when compared with the control group. Considering the limitations of this pilot study and the trend seen towards lower anxiety in the test group, alternate nostril breathing may have potential anxiolytic effect in acute stressful situations. A study with larger sample size is therefore warranted. This trial is registered with CTRI/2014/03/004460.

  17. Effect of Alternate Nostril Breathing Exercise on Experimentally Induced Anxiety in Healthy Volunteers Using the Simulated Public Speaking Model: A Randomized Controlled Pilot Study

    PubMed Central

    Urval, Rathnakar P.; Shenoy, Ashok K.

    2017-01-01

    A randomized controlled pilot study was carried out to determine the effect of a 15-minute practice of ANB exercise on experimentally induced anxiety using the simulated public speaking model in yoga-naïve healthy young adults. Thirty consenting medical students were equally divided into test and control groups. The test group performed alternate nostril breathing exercise for 15 minutes, while the control group sat in a quiet room before participating in the simulated public speaking test (SPST). Visual Analog Mood Scale and Self-Statements during Public Speaking scale were used to measure the mood state at different phases of the SPST. The psychometric scores of both groups were comparable at baseline. Repeated-measures ANOVA showed a significant effect of phase (p < 0.05), but group and gender did not have statistically significant influence on the mean anxiety scores. However, the test group showed a trend towards lower mean scores for the anxiety factor when compared with the control group. Considering the limitations of this pilot study and the trend seen towards lower anxiety in the test group, alternate nostril breathing may have potential anxiolytic effect in acute stressful situations. A study with larger sample size is therefore warranted. This trial is registered with CTRI/2014/03/004460. PMID:29159176

  18. A Novel Approach to Prediction of Mild Obstructive Sleep Disordered Breathing in a Population-Based Sample: The Sleep Heart Health Study

    PubMed Central

    Caffo, Brian; Diener-West, Marie; Punjabi, Naresh M.; Samet, Jonathan

    2010-01-01

    This manuscript considers a data-mining approach for the prediction of mild obstructive sleep disordered breathing, defined as an elevated respiratory disturbance index (RDI), in 5,530 participants in a community-based study, the Sleep Heart Health Study. The prediction algorithm was built using modern ensemble learning algorithms, boosting in specific, which allowed for assessing potential high-dimensional interactions between predictor variables or classifiers. To evaluate the performance of the algorithm, the data were split into training and validation sets for varying thresholds for predicting the probability of a high RDI (≥ 7 events per hour in the given results). Based on a moderate classification threshold from the boosting algorithm, the estimated post-test odds of a high RDI were 2.20 times higher than the pre-test odds given a positive test, while the corresponding post-test odds were decreased by 52% given a negative test (sensitivity and specificity of 0.66 and 0.70, respectively). In rank order, the following variables had the largest impact on prediction performance: neck circumference, body mass index, age, snoring frequency, waist circumference, and snoring loudness. Citation: Caffo B; Diener-West M; Punjabi NM; Samet J. A novel approach to prediction of mild obstructive sleep disordered breathing in a population-based sample: the Sleep Heart Health Study. SLEEP 2010;33(12):1641-1648. PMID:21120126

  19. Breath alcohol analyzer mistakes methanol poisoning for alcohol intoxication.

    PubMed

    Caravati, E Martin; Anderson, Kathleen T

    2010-02-01

    Breath alcohol analyzers are used to detect ethanol in motorists and others suspected of public intoxication. One concern is their ability to detect interfering substances that may falsely increase the ethanol reading. A 47-year-old-man was found in a public park, acting intoxicated. A breath analyzer test (Intoxilyzer 5000EN) measured 0.288 g/210 L breath ethanol, without an interferent noted. In the emergency department, the patient admitted to drinking HEET Gas-Line antifreeze, which contains 99% methanol. Two to three hours after ingestion, serum and urine toxicology screen results were negative for ethanol and multiple other substances. His serum methanol concentration was 589 mg/dL, serum osmolality 503 mOsm/kg, osmolar gap 193 mOsm/kg, and anion gap 17 mmol/L. The patient was treated with intravenous ethanol, fomepizole, and hemodialysis without complication. This is a unique clinical case of a breath alcohol analyzer reporting methanol as ethanol. Intoxilyzer devices have been shown to indicate some substances (acetone) as interferents in humans but not methanol. Increased serum concentrations of methanol can be reported as ethanol by a commonly used breath alcohol analyzer, which can result in a delayed diagnosis or misdiagnosis and subsequent methanol toxicity if antidotal treatment is not administered in a timely manner. Copyright (c) 2009 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  20. Breath Methane Levels Are Increased Among Patients with Diverticulosis.

    PubMed

    Yazici, Cemal; Arslan, Deniz Cagil; Abraham, Rana; Cushing, Kelly; Keshavarzian, Ali; Mutlu, Ece A

    2016-09-01

    Diverticulosis and its complications are important healthcare problems in the USA and throughout the Western world. While mechanisms as to how diverticulosis occurs have partially been explored, few studies examined the relationship between colonic gases such as methane and diverticulosis in humans. This study aimed to demonstrate a significant relationship between methanogenic Archaea and development of diverticulosis. Subjects who consecutively underwent hydrogen breath test at Rush University Medical Center between 2003 and 2010 were identified retrospectively through a database. Medical records were reviewed for presence of a colonoscopy report. Two hundred and sixty-four subjects were identified who had both a breath methane level measurement and a colonoscopy result. Additional demographic and clinical data were obtained with chart review. Mean breath methane levels were higher in subjects with diverticulosis compared to those without diverticulosis (7.89 vs. 4.94 ppm, p = 0.04). Methane producers (defined as those with baseline fasting breath methane level >5 ppm) were more frequent among subjects with diverticulosis compared to those without diverticulosis (50.9 vs. 34 %, p = 0.0025). When adjusted for confounders, breath methane levels and age were the two independent predictors of diverticulosis on colonoscopy with logistic regression modeling. Methanogenesis is associated with the presence of diverticulosis. Further studies are needed to confirm our findings and prospectively evaluate a possible etiological role of methanogenesis and methanogenic archaea in diverticulosis.

  1. Exercise changes volatiles in exhaled breath assessed by an electronic nose.

    PubMed

    Bikov, A; Lazar, Zs; Schandl, K; Antus, B M; Losonczy, G; Horvath, Ildiko

    2011-09-01

    Exercise-caused metabolic changes can be followed by monitoring exhaled volatiles; however it has not been previously reported if a spectrum of exhaled gases is modified after physical challenge. We have hypothesized that changes in volatile molecules assessed by an electronic nose may be the reason for the alkalization of the exhaled breath condensate (EBC) fluid following physical exercise.Ten healthy young subjects performed a 6-minute running test. Exhaled breath samples pre-exercise and post-exercise (0 min, 15 min, 30 min and 60 min) were collected for volatile pattern ("smellprint") determination and pH measurements (at 5.33 kPa CO2), respectively. Exhaled breath smellprints were analyzed using principal component analysis and were related to EBC pH.Smellprints (p=0.04) and EBC pH (p=0.01) were altered during exercise challenge. Compared to pre-exercise values, smellprints and pH differed at 15 min, 30 min and 60 min following exercise (p<0.05), while no difference was found at 0 min post-exercise. In addition, a significant correlation was found between volatile pattern of exhaled breath and EBC pH (p=0.01, r=-0.34).Physical exercise changes the pattern of exhaled volatiles together with an increase in pH of breath. Changes in volatiles may be responsible for increase in EBC pH.

  2. Nocturnal snoring decreases daytime baroreceptor sensitivity.

    PubMed

    Schöbel, Christoph; Fietze, Ingo; Glos, Martin; Schary, Inett; Blau, Alexander; Baumann, Gert; Penzel, Thomas

    2014-07-01

    In patients with obstructive sleep apnea heart rate variability and baroreceptor sensitivity during night and daytime are impaired. Snoring without obstructive sleep apnea may already influence heart rate variability and baroreceptor sensitivity during daytime. Cardiovascular daytime testing was performed in 11 snorers and age, BMI, and gender matched controls. Sleep apnea and snoring were quantified by sleep recordings. Paced breathing was performed during daytime with ECG, non-invasive blood pressure, and respiration recorded. Heart rate variability and blood pressure variability were analyzed in the time and frequency domain. Baroreceptor sensitivity (alpha gain) was calculated. In snorers a significant increase in high frequency systolic blood pressure variability (SBPV-HF) compared to control group (0.37 mm Hg(2) vs. 0.11 mm Hg(2) for 12 breaths and 0.35 mm Hg(2) vs. 0.10 mm Hg(2) for 15 breaths) was demonstrated. Furthermore a lower baroreceptor sensitivity was found in snorers compared to controls (9.2 ms/mm Hg vs. 16.2 ms/mm Hg for 12 breaths and 8.5 ms/mm Hg vs. 17.4 ms/mm Hg for 15 breaths per minute) using the paced breathing protocol. Mean heart rate was elevated in snorers as well. Snorers may have a reduced parasympathetic tone during daytime rather than an increased sympathetic tone. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Preliminary investigation of human exhaled breath for tuberculosis diagnosis by multidimensional gas chromatography - Time of flight mass spectrometry and machine learning.

    PubMed

    Beccaria, Marco; Mellors, Theodore R; Petion, Jacky S; Rees, Christiaan A; Nasir, Mavra; Systrom, Hannah K; Sairistil, Jean W; Jean-Juste, Marc-Antoine; Rivera, Vanessa; Lavoile, Kerline; Severe, Patrice; Pape, Jean W; Wright, Peter F; Hill, Jane E

    2018-02-01

    Tuberculosis (TB) remains a global public health malady that claims almost 1.8 million lives annually. Diagnosis of TB represents perhaps one of the most challenging aspects of tuberculosis control. Gold standards for diagnosis of active TB (culture and nucleic acid amplification) are sputum-dependent, however, in up to a third of TB cases, an adequate biological sputum sample is not readily available. The analysis of exhaled breath, as an alternative to sputum-dependent tests, has the potential to provide a simple, fast, and non-invasive, and ready-available diagnostic service that could positively change TB detection. Human breath has been evaluated in the setting of active tuberculosis using thermal desorption-comprehensive two-dimensional gas chromatography-time of flight mass spectrometry methodology. From the entire spectrum of volatile metabolites in breath, three random forest machine learning models were applied leading to the generation of a panel of 46 breath features. The twenty-two common features within each random forest model used were selected as a set that could distinguish subjects with confirmed pulmonary M. tuberculosis infection and people with other pathologies than TB. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. A breath test for malignant mesothelioma using an electronic nose.

    PubMed

    Chapman, Eleanor A; Thomas, Paul S; Stone, Emily; Lewis, Craig; Yates, Deborah H

    2012-08-01

    Malignant mesothelioma (MM) is a rare tumour which is difficult to diagnose in its early stages. Earlier detection of MM could potentially improve survival. Exhaled breath sampling of volatile organic compounds (VOCs) using a carbon polymer array (CPA) electronic nose recognises specific breath profiles characteristic of different diseases, and can distinguish between patients with lung cancer and controls. With MM, the potential confounding effect of other asbestos-related diseases (ARDs) needs to be considered. We hypothesised that as CPA electronic nose would distinguish patients with MM, patients with benign ARDs, and controls with high sensitivity and specificity. 20 MM, 18 ARD and 42 control subjects participated in a cross-sectional, case-control study. Breath samples were analysed using the Cyranose 320 (Smiths Detection, Pasadena, CA, USA), using canonical discriminant analysis and principal component reduction. 10 MM subjects created the training set. Smell prints from 10 new MM patients were distinguished from control subjects with an accuracy of 95%. Patients with MM, ARDs and control subjects were correctly identified in 88% of cases. Exhaled breath VOC profiling can accurately distinguish between patients with MM, ARDs and controls using a CPA electronic nose. This could eventually translate into a screening tool for high-risk populations.

  5. Breathing pattern and breathlessness in idiopathic pulmonary fibrosis: An observational study.

    PubMed

    Olukogbon, Kasope L; Thomas, Paul; Colasanti, Ricardo; Hope-Gill, Ben; Williams, Edgar Mark

    2016-02-01

    Idiopathic pulmonary fibrosis (IPF) is characterized by progressive decline in lung function and increasing dyspnoea. The aim of this study was to investigate the relationship among IPF, pulmonary function, resting tidal breathing patterns and level of breathlessness. Thirty-one participants with IPF and 17 matched healthy controls underwent lung function testing, followed by a 2-min period of resting tidal breathing. The IPF cohort was stratified according to disease severity, based on their forced vital capacity and diffusion capacity for carbon monoxide. In comparison to the healthy controls, the IPF cohort showed a higher tidal volume, VT , of 0.22 L (P = 0.026) and a raised minute ventilation in the severest IPF group, while no differences in the timing of inspiration or expiration were observed. In the IPF cohort, the ratio of VT to forced vital capacity was around 15% higher. These changes corresponded with an increase in the self-reported sensation of breathlessness. Those with IPF increased their depth of breathing with worsening disease severity, with IPF-induced changes in pulmonary function and breathlessness associated with an altered tidal breathing pattern. © 2015 Asian Pacific Society of Respirology.

  6. Multifrequency high precise subTHz-THz-IR spectroscopy for exhaled breath research

    NASA Astrophysics Data System (ADS)

    Vaks, Vladimir L.; Domracheva, Elena G.; Pripolzin, Sergey I.; Chernyaeva, Mariya B.

    2016-09-01

    Nowadays the development of analytical spectroscopy with high performance, sensitivity and spectral resolution for exhaled breath research is attended. The method of two-frequency high precise THz spectroscopy and the method of high precise subTHz-THz-IR spectroscopy are presented. Development of a subTHz-THz-IR gas analyzer increases the number of gases that can be identified and the reliability of the detection by confirming the signature in both THz and MIR ranges. The testing measurements have testified this new direction of analytical spectroscopy to open widespread trends of its using for various problems of medicine and biology. First of all, there are laboratory investigations of the processes in exhaled breath and studying of their dynamics. Besides, the methods presented can be applied for detecting intermediate and short time living products of reactions in exhaled breath. The spectrometers have been employed for investigations of acetone, methanol and ethanol in the breath samples of healthy volunteers and diabetes patients. The results have demonstrated an increased concentration of acetone in breath of diabetes patients. The dynamic of changing the acetone concentration before and after taking the medicines is discovered. The potential markers of pre-cancer states and oncological diseases of gastrointestinal tract organs have been detected. The changes in the NO concentration in exhaled breath of cancer patients during radiotherapy as well as increase of the NH3 concentration at gastrointestinal diseases have been revealed. The preliminary investigations of biomarkers in three frequency ranges have demonstrated the advantages of the multifrequency high precise spectroscopy for noninvasive medical diagnostics.

  7. Breath-hold times in air compared to breath-hold times during cold water immersions.

    PubMed

    Taber, Michael J; MacKinnon, Scott N; Power, Jonathan; Walker, Robert

    2015-02-01

    Given the effects of cold water immersion on breath-hold (BH) capabilities, a practical training exercise was developed for military/paramilitary personnel completing a helicopter underwater egress training (HUET) program. The exercise was designed to provide firsth and experience of the effects of cold water exposure on BH time. After completing the required HUET, 47 subjects completed two BH testing sessions as well as a short questionnaire. The first BH was completed while standing on the pool deck. The second BH was completed while fully immersed (face down) in 2-3°C water. There were 40 of the volunteers who also breathed from an emergency breathing system (EBS) while in the cold water. Results demonstrated that BH capabilities in cold water were significantly lower than those in ambient air. A significant correlation was also found between BH in air and the difference in cold water vs. air BH capabilities, which suggests that subjects who can hold their breath the longest in air experienced the greatest decrease in BH when immersed. Results indicate that 92% of the subjects reported that the practical cold water immersion exercise had a high value. Finally, 58% of those who used the EBS reported that it was harder to breathe in cold water than while in the training pool (approximately 22°C). The BH times for this group were similar to those reported in previous cold water immersion studies. Based on the questionnaire results, it is possible, when carefully applied, to include a practical cold water immersion exercise into existing HUET programs.

  8. All APAPs Are Not Equivalent for the Treatment of Sleep Disordered Breathing: A Bench Evaluation of Eleven Commercially Available Devices.

    PubMed

    Zhu, Kaixian; Roisman, Gabriel; Aouf, Sami; Escourrou, Pierre

    2015-07-15

    This study challenged on a bench-test the efficacy of auto-titrating positive airway pressure (APAP) devices for obstructive sleep disordered breathing treatment and evaluated the accuracy of the device reports. Our bench consisted of an active lung simulator and a Starling resistor. Eleven commercially available APAP devices were evaluated on their reactions to single-type SDB sequences (obstructive apnea and hypopnea, central apnea, and snoring), and to a long general breathing scenario (5.75 h) simulating various SDB during four sleep cycles and to a short scenario (95 min) simulating one sleep cycle. In the single-type sequence of 30-minute repetitive obstructive apneas, only 5 devices normalized the airflow (> 70% of baseline breathing amplitude). Similarly, normalized breathing was recorded with 8 devices only for a 20-min obstructive hypopnea sequence. Five devices increased the pressure in response to snoring. Only 4 devices maintained a constant minimum pressure when subjected to repeated central apneas with an open upper airway. In the long general breathing scenario, the pressure responses and the treatment efficacy differed among devices: only 5 devices obtained a residual obstructive AHI < 5/h. During the short general breathing scenario, only 2 devices reached the same treatment efficacy (p < 0.001), and 3 devices underestimated the AHI by > 10% (p < 0.001). The long scenario led to more consistent device reports. Large differences between APAP devices in the treatment efficacy and the accuracy of report were evidenced in the current study. © 2015 American Academy of Sleep Medicine.

  9. Does lying in the recovery position increase the likelihood of not delivering cardiopulmonary resuscitation?

    PubMed

    Freire-Tellado, Miguel; Navarro-Patón, Rubén; Pavón-Prieto, Maria Del Pilar; Fernández-López, Marta; Mateos-Lorenzo, Javier; López-Fórneas, Ivan

    2017-06-01

    Resuscitation guidelines endorse unconscious and normally breathing out-of-hospital victims to be placed in the recovery position to secure airway patency, but recently a debate has been opened as to whether the recovery position threatens the cardiac arrest victim's safety assessment and delays the start of cardiopulmonary resuscitation. To compare the assessment of the victim's breathing arrest while placed in the recovery position versus maintaining an open airway with the continuous head tilt and chin lift technique to know whether the recovery position delays the cardiac arrest victim's assessment and the start of cardiopulmonary resuscitation. Basic life support-trained university students were randomly divided into two groups: one received a standardized cardiopulmonary resuscitation refresher course including the recovery position and the other received a modified cardiopulmonary resuscitation course using continuous head tilt and chin lift for unconscious and spontaneously breathing patients. A human simulation test to evaluate the victim's breathing assessment was performed a week later. In total, 59 participants with an average age of 21.9 years were included. Only 14 of 27 (51.85%) students in the recovery position group versus 23 of 28 (82.14%) in the head tilt and chin lift group p=0.006 (OR 6.571) detected breathing arrest within 2min. The recovery position hindered breathing assessment, delayed breathing arrest identification and the initiation of cardiac compressions, and significantly increased the likelihood of not starting cardiopulmonary resuscitation when compared to the results shown when the continuous head tilt and chin lift technique was used. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Rocket Based Combined Cycle (RBCC) Engine

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Pictured is an artist's concept of the Rocket Based Combined Cycle (RBCC) launch. The RBCC's overall objective is to provide a technology test bed to investigate critical technologies associated with opperational usage of these engines. The program will focus on near term technologies that can be leveraged to ultimately serve as the near term basis for Two Stage to Orbit (TSTO) air breathing propulsions systems and ultimately a Single Stage To Orbit (SSTO) air breathing propulsion system.

  11. Lack of effect of lactose digestion status on baseline fecal microflora

    PubMed Central

    Szilagyi, Andrew; Shrier, Ian; Chong, George; Je, Jung Sung; Park, Sunghoon; Heilpern, Debra; Lalonde, Catherine; Cote, Louis-Francois; Lee, Byong

    2009-01-01

    BACKGROUND: The genetics of intestinal lactase divide the world’s population into two phenotypes: the ability (a dominant trait) or inability (a recessive trait) to digest lactose. A prebiotic effect of lactose may impact the colonic flora of these phenotypes differently. OBJECTIVE: To detect and evaluate the effects of lactose on subjects divided according to their ability to digest lactose. METHODS: A total of 57 healthy maldigesters (n=30) and digesters (n=27) completed diet questionnaires, genetic and breath hydrogen testing, and quantitative stool analysis for species of bacteria. Log10 transformation of bacterial counts was compared with lactose intake in both groups using multiple regression analysis. RESULTS: There was a significant relationship between genetic and breath hydrogen tests. Daily lactose intake was marginally lower in lactose maldigesters (median [interquartile range] 12.2 g [31 g] versus 15 g [29.6 g], respectively). There was no relationship between lactose intake and breath hydrogen tests in either group. There were no differences in bacterial counts between the two groups, nor was there a relationship between bacterial counts and lactose intake in either group. CONCLUSION: The differential bacterial effects of lactose were not quantitatively detected in stool samples taken in the present study. PMID:19893771

  12. Effects of Ergot Alkaloids on Liver Function of Piglets as Evaluated by the 13C-Methacetin and 13C-α-Ketoisocaproic Acid Breath Test

    PubMed Central

    Dänicke, Sven; Diers, Sonja

    2013-01-01

    Ergot alkaloids (the sum of individual ergot alkaloids are termed as total alkaloids, TA) are produced by the fungus Claviceps purpurea, which infests cereal grains commonly used as feedstuffs. Ergot alkaloids potentially modulate microsomal and mitochondrial hepatic enzymes. Thus, the aim of the present experiment was to assess their effects on microsomal and mitochondrial liver function using the 13C-Methacetin (MC) and 13C-α-ketoisocaproic acid (KICA) breath test, respectively. Two ergot batches were mixed into piglet diets, resulting in 11 and 22 mg (Ergot 5-low and Ergot 5-high), 9 and 14 mg TA/kg (Ergot 15-low and Ergot 15-high) and compared to an ergot-free control group. Feed intake and live weight gain decreased significantly with the TA content (p < 0.001). Feeding the Ergot 5-high diet tended to decrease the 60-min-cumulative 13CO2 percentage of the dose recovery (cPDR60) by 26% and 28% in the MC and KICA breath test, respectively, compared to the control group (p = 0.065). Therefore, both microsomal and mitochondrial liver function was slightly affected by ergot alkaloids. PMID:23322130

  13. Effects of ergot alkaloids on liver function of piglets as evaluated by the (13)C-methacetin and (13)C-α-ketoisocaproic acid breath test.

    PubMed

    Dänicke, Sven; Diers, Sonja

    2013-01-15

    Ergot alkaloids (the sum of individual ergot alkaloids are termed as total alkaloids, TA) are produced by the fungus Claviceps purpurea, which infests cereal grains commonly used as feedstuffs. Ergot alkaloids potentially modulate microsomal and mitochondrial hepatic enzymes. Thus, the aim of the present experiment was to assess their effects on microsomal and mitochondrial liver function using the (13)C-Methacetin (MC) and (13)C-α-ketoisocaproic acid (KICA) breath test, respectively. Two ergot batches were mixed into piglet diets, resulting in 11 and 22 mg (Ergot 5-low and Ergot 5-high), 9 and 14 mg TA/kg (Ergot 15-low and Ergot 15-high) and compared to an ergot-free control group. Feed intake and live weight gain decreased significantly with the TA content (p < 0.001). Feeding the Ergot 5-high diet tended to decrease the 60-min-cumulative (13)CO(2) percentage of the dose recovery (cPDR(60)) by 26% and 28% in the MC and KICA breath test, respectively, compared to the control group (p = 0.065). Therefore, both microsomal and mitochondrial liver function was slightly affected by ergot alkaloids.

  14. Flute ``breath support'' perception and its acoustical correlates

    NASA Astrophysics Data System (ADS)

    Cossette, Isabelle A.; Sabourin, Patrick

    2004-05-01

    Music educators and performers commonly refer to ``breath support'' in flute playing, yet the term ``support'' is neither well-defined nor consistently used. Different breathing strategies used by professional flautists who were instructed to play with and without support were previously identified by the authors. In the current study, 14 musical excerpts with and without support were recorded by five professional flautists. Eleven professional flautists listened to the recordings in a random order and ranked (1 to 6) how much of the following sound qualities they judged to be in each example: support, intonation, control and musical expressiveness. Answers to the test showed that musical expressiveness was associated more closely with the supported excerpts than the answers about support itself. The ratings for each sound quality were highly intercorrelated. Acoustical parameters were analyzed (frequency and centroid variation within each note) and compared with the results of the perception test in order to better understand how the acoustical and psychological variables were related. The acoustical analysis of the central part of the notes did not show evident correlation with the answers of the perception test. [Work funded by the Social Sciences and Humanities Research Council of Canada.

  15. 13C-tryptophan breath test detects increased catabolic turnover of tryptophan along the kynurenine pathway in patients with major depressive disorder

    PubMed Central

    Teraishi, Toshiya; Hori, Hiroaki; Sasayama, Daimei; Matsuo, Junko; Ogawa, Shintaro; Ota, Miho; Hattori, Kotaro; Kajiwara, Masahiro; Higuchi, Teruhiko; Kunugi, Hiroshi

    2015-01-01

    Altered tryptophan–kynurenine (KYN) metabolism has been implicated in major depressive disorder (MDD). The l-[1-13C]tryptophan breath test (13C-TBT) is a noninvasive, stable-isotope tracer method in which exhaled 13CO2 is attributable to tryptophan catabolism via the KYN pathway. We included 18 patients with MDD (DSM-IV) and 24 age- and sex-matched controls. 13C-tryptophan (150 mg) was orally administered and the 13CO2/12CO2 ratio in the breath was monitored for 180 min. The cumulative recovery rate during the 180-min test (CRR0–180; %), area under the Δ13CO2-time curve (AUC; %*min), and the maximal Δ13CO2 (Cmax; %) were significantly higher in patients with MDD than in the controls (p = 0.004, p = 0.008, and p = 0.002, respectively). Plasma tryptophan concentrations correlated negatively with Cmax in both the patients and controls (p = 0.020 and p = 0.034, respectively). Our results suggest that the 13C-TBT could be a novel biomarker for detecting a subgroup of MDD with increased tryptophan–KYN metabolism. PMID:26524975

  16. Biofeedback-assisted relaxation training to decrease test anxiety in nursing students.

    PubMed

    Prato, Catherine A; Yucha, Carolyn B

    2013-01-01

    Nursing students experiencing debilitating test anxiety may be unable to demonstrate their knowledge and have potential for poor academic performance. A biofeedback-assisted relaxation training program was created to reduce test anxiety. Anxiety was measured using Spielberger's Test Anxiety Inventory and monitoring peripheral skin temperature, pulse, and respiration rates during the training. Participants were introduced to diaphragmatic breathing, progressive muscle relaxation, and autogenic training. Statistically significant changes occurred in respiratory rates and skin temperatures during the diaphragmatic breathing session; respiratory rates and peripheral skin temperatures during progressive muscle relaxation session; respiratory and pulse rates, and peripheral skin temperatures during the autogenic sessions. No statistically significant difference was noted between the first and second TAI. Subjective test anxiety scores of the students did not decrease by the end of training. Autogenic training session was most effective in showing a statistically significant change in decreased respiratory and pulse rates and increased peripheral skin temperature.

  17. Design and Validation of a Breathing Detection System for Scuba Divers.

    PubMed

    Altepe, Corentin; Egi, S Murat; Ozyigit, Tamer; Sinoplu, D Ruzgar; Marroni, Alessandro; Pierleoni, Paola

    2017-06-09

    Drowning is the major cause of death in self-contained underwater breathing apparatus (SCUBA) diving. This study proposes an embedded system with a live and light-weight algorithm which detects the breathing of divers through the analysis of the intermediate pressure (IP) signal of the SCUBA regulator. A system composed mainly of two pressure sensors and a low-power microcontroller was designed and programmed to record the pressure sensors signals and provide alarms in absence of breathing. An algorithm was developed to analyze the signals and identify inhalation events of the diver. A waterproof case was built to accommodate the system and was tested up to a depth of 25 m in a pressure chamber. To validate the system in the real environment, a series of dives with two different types of workload requiring different ranges of breathing frequencies were planned. Eight professional SCUBA divers volunteered to dive with the system to collect their IP data in order to participate to validation trials. The subjects underwent two dives, each of 52 min on average and a maximum depth of 7 m. The algorithm was optimized for the collected dataset and proved a sensitivity of inhalation detection of 97.5% and a total number of 275 false positives (FP) over a total recording time of 13.9 h. The detection algorithm presents a maximum delay of 5.2 s and requires only 800 bytes of random-access memory (RAM). The results were compared against the analysis of video records of the dives by two blinded observers and proved a sensitivity of 97.6% on the data set. The design includes a buzzer to provide audible alarms to accompanying dive buddies which will be triggered in case of degraded health conditions such as near drowning (absence of breathing), hyperventilation (breathing frequency too high) and skip-breathing (breathing frequency too low) measured by the improper breathing frequency. The system also measures the IP at rest before the dive and indicates with flashing light-emitting diodes and audible alarm the regulator malfunctions due to high or low IP that may cause fatal accidents during the dive by preventing natural breathing. It is also planned to relay the alarm signal to underwater and surface rescue authorities by means of acoustic communication.

  18. Nonenhanced MR angiography of the pulmonary arteries using single-shot radial quiescent-interval slice-selective (QISS): a technical feasibility study.

    PubMed

    Edelman, Robert R; Silvers, Robert I; Thakrar, Kiran H; Metzl, Mark D; Nazari, Jose; Giri, Shivraman; Koktzoglou, Ioannis

    2017-06-30

    For evaluation of the pulmonary arteries in patients suspected of pulmonary embolism, CT angiography (CTA) is the first-line imaging test with contrast-enhanced MR angiography (CEMRA) a potential alternative. Disadvantages of CTA include exposure to ionizing radiation and an iodinated contrast agent, while CEMRA is sensitive to respiratory motion and requires a gadolinium-based contrast agent. The primary goal of our technical feasibility study was to evaluate pulmonary arterial conspicuity using breath-hold and free-breathing implementations of a recently-developed nonenhanced approach, single-shot radial quiescent-interval slice-selective (QISS) MRA. Breath-hold and free-breathing, navigator-gated versions of radial QISS MRA were evaluated at 1.5 Tesla in three healthy subjects and 11 patients without pulmonary embolism or arterial occlusion by CTA. Images were scored by three readers for conspicuity of the pulmonary arteries through the level of the segmental branches. In addition, one patient with pulmonary embolism was imaged. Scan time for a 54-slice acquisition spanning the pulmonary arteries was less than 2 minutes for breath-hold QISS, and less than 3.4 min using free-breathing QISS. Pulmonary artery branches through the segmental level were conspicuous with either approach. Free-breathing scans showed only mild blurring compared with breath-hold scans. For both readers, less than 1% of pulmonary arterial segments were rated as "not seen" for breath-hold and navigator-gated QISS, respectively. In subjects with atrial fibrillation, single-shot radial QISS consistently depicted the pulmonary artery branches, whereas navigator-gated 3D balanced steady-state free precession showed motion artifacts. In one patient with pulmonary embolism, radial QISS demonstrated central pulmonary emboli comparably to CEMRA and CTA. The thrombi were highly conspicuous on radial QISS images, but appeared subtle and were not prospectively identified on scout images acquired using a single-shot bSSFP acquisition. In this technical feasibility study, both breath-hold and free-breathing single-shot radial QISS MRA enabled rapid, consistent demonstration of the pulmonary arteries through the level of the segmental branches, with only minimal artifacts from respiratory motion and cardiac arrhythmias. Based on these promising initial results, further evaluation in patients with suspected pulmonary embolism appears warranted.

  19. Modification of NASA Langley 8 foot high temperature tunnel to provide a unique national research facility for hypersonic air-breathing propulsion systems

    NASA Technical Reports Server (NTRS)

    Kelly, H. N.; Wieting, A. R.

    1984-01-01

    A planned modification of the NASA Langley 8-Foot High Temperature Tunnel to make it a unique national research facility for hypersonic air-breathing propulsion systems is described, and some of the ongoing supporting research for that modification is discussed. The modification involves: (1) the addition of an oxygen-enrichment system which will allow the methane-air combustion-heated test stream to simulate air for propulsion testing; and (2) supplemental nozzles to expand the test simulation capability from the current nominal Mach number to 7.0 include Mach numbers 3.0, 4.5, and 5.0. Detailed design of the modifications is currently underway and the modified facility is scheduled to be available for tests of large scale propulsion systems by mid 1988.

  20. Improved self-contained breathing apparatus concept. Final report Oct 80-Jun 82

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    White, L.; Walker, J.

    1982-08-01

    Past operational experiences of USAF fire fighting and rescue teams have indicated the need for an improved self-contained breathing apparatus (SCBA). In October 1980, a contract was awarded to Electronic Data Systems, Panama City, Florida, to design and develop a prototype SCBA that would meet Air Force technical requirements. A prototype was designed, developed, and tested through a subcontract with Reimers Consultants, Falls Church, Virginia. This report describes the technical requirements, a detailed technical description of the unit, and the unmanned test procedures and results. The unmanned testing demonstrate that the prototype SCBA meets all performance requirements, except for weight.more » The fully charged prototype weights 34 pounds, the maximum acceptable weight is 30 pounds. With the other performance requirements either met or exceeded, manned testing of the SCBA can proceed.« less

  1. 13C-sodium acetate breath test for evaluation of gastric emptying times in dogs with gastric dilatation-volvulus.

    PubMed

    Schmitz, S; Jansen, N; Failing, K; Neiger, R

    2013-01-01

    The aim of the study was to assess solid phase gastric emptying via non-invasive 13C-sodium acetate breath test in large breed dogs with or without gastric dilatation-volvulus (GDV). Dogs were recruited into one of the following groups: group 1 = healthy large breed dogs with no history of GDV, group 2 = dogs that underwent elective abdominal surgery for reasons unrelated to the gastrointestinal tract, and group 3 = dogs that underwent laparotomy and gastropexy to correct GDV. The dogs were fed a test meal containing 100 mg 13C-sodium acetate (for group 2 and 3, this was < 48 hours post-operatively). Breath samples were obtained at baseline and every 30 minutes for 3 hours, then every hour for a total of 7 hours. 12CO2/13CO2 ratio was measured for each breath sample via non-dispersive infrared spectroscopy and 25%, 50% and 75% gastric emptying times were calculated and compared between groups. Gastric emptying times were significantly prolonged in dogs undergoing surgery (group 2) compared to group 1 and 3. Also, gastric emptying times of dogs with GDV were significantly prolonged compared to controls, but not to the same extent as dogs in group 2. There was a significant effect of abdominal surgery on gastric emptying times. Surprisingly, dogs after GDV surgery and gastropexy had shorter gastric emptying times than dogs undergoing laparotomy for reasons other than GDV, but still prolonged compared to healthy controls. The reason for these differences requires further study.

  2. Heavy metals found in the breathing zone, toenails and lung function of welders working in an air-conditioned welding workplace.

    PubMed

    Hariri, Azian; Mohamad Noor, Noraishah; Paiman, Nuur Azreen; Ahmad Zaidi, Ahmad Mujahid; Zainal Bakri, Siti Farhana

    2017-09-22

    Welding operations are rarely conducted in an air-conditioned room. However, a company would set its welding operations in an air-conditioned room to maintain the humidity level needed to reduce hydrogen cracks in the specimen being welded. This study intended to assess the exposure to metal elements in the welders' breathing zone and toenail samples. Heavy metal concentration was analysed using inductively coupled plasma mass spectrometry. The lung function test was also conducted and analysed using statistical approaches. Chromium and manganese concentrations in the breathing zone exceeded the permissible exposure limit stipulated by Malaysian regulations. A similar trend was obtained in the concentration of heavy metals in the breathing zone air sampling and in the welders' toenails. Although there was no statistically significant decrease in the lung function of welders, it is suggested that exposure control through engineering and administrative approaches should be considered for workplace safety and health improvement.

  3. Varying efficacy of Helicobacter pylori eradication regimens: cost effectiveness study using a decision analysis model.

    PubMed

    Duggan, A E; Tolley, K; Hawkey, C J; Logan, R F

    1998-05-30

    To determine how small differences in the efficacy and cost of two antibiotic regimens to eradicate Helicobacter pylori can affect the overall cost effectiveness of H pylori eradication in duodenal ulcer disease. A decision analysis to examine the cost effectiveness of eight H pylori eradication strategies for duodenal ulcer disease with and without 13C-urea breath testing to confirm eradication. Cumulative direct treatment costs per 100 patients with duodenal ulcer disease who were positive for H pylori. In model 1 the strategy of omeprazole, clarithromycin, and metronidazole alone was the most cost effective of the four strategies assessed. The addition of the 13C-urea breath test and a second course of omeprazole, clarithromycin, and metronidazole achieved the highest eradication rate (97%) but was the most expensive (62.63 pounds per patient). The cost of each additional effective eradication was 589.00 pounds (incremental cost per case) when compared with the cost of treating once only with omeprazole, clarithromycin, and metronidazole; equivalent to the cost of a patient receiving ranitidine for duodenal ulcer relapse for more than 15 years. Eradication strategies of omeprazole, amoxycillin, and metronidazole were less cost effective than omeprazole, clarithromycin, and metronidazole alone. In model 2 the addition of the 13C-urea breath test after treatment, and maintenance treatment, increased the cost of all the strategies and reduced the cost advantage of omeprazole, clarithromycin, and metronidazole alone. Small differences in efficacy can influence the comparative cost effectiveness of strategies for eradicating H pylori. Of the strategies tested the most cost effective (omeprazole, clarithromycin, and metronidazole alone) was neither the least expensive (omeprazole, amoxycillin, and metronidazole alone) nor the most effective (omeprazole, clarithromycin, and metronidazole with further treatment for patients found positive for H pylori on 13C-urea breath testing). Cost effectiveness should be an important part of choosing an eradication strategy for H pylori.

  4. Effects of a facial nerve lesion on responses in forehead microvessels to conjunctival irritation and paced breathing.

    PubMed

    Drummond, Peter D

    2012-08-16

    To investigate parasympathetic influences on the forehead microvasculature, blood flow was monitored bilaterally in seven participants with a unilateral facial nerve lesion during conjunctival irritation with Schirmer's strips and while breathing at 0.15 Hz. Blood flow and slow-wave frequency increased on the intact side of the forehead during Schirmer's test but did not change on the denervated side. However, a 0.15 Hz vascular wave strengthened during paced breathing, particularly on the denervated side. These findings indicate that parasympathetic activity in the facial nerve increases forehead blood flow during minor conjunctival irritation, but may interfere with the 0.15 Hz vascular wave. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Nonuniformity of diffusing capacity from small alveolar gas samples is increased in smokers.

    PubMed

    Cotton, D J; Mink, J T; Graham, B L

    1998-01-01

    Although centrilobular emphysema, and small airway, interstitial and alveoli inflammation can be detected pathologically in the lungs of smokers with relatively well preserved lung function, these changes are difficult to assess using available physiological tests. Because submaximal single breath washout (SBWSM) manoeuvres improve the detection of abnormalities in ventilation inhomogeneity in the lung periphery in smokers compared with traditional vital capacity manoeuvres, SBWSM manoeuvres were used in this study to measure temporal differences in diffusing capacity using a rapid response carbon monoxide analyzer. To determine whether abnormalities in the lung periphery can be detected in smokers with normal forced expired volumes in 1 s using the three-equation diffusing capacity (DLcoSB-3EQ) among small alveolar gas samples and whether the abnormalities correlate with increases in peripheral ventilation inhomogeneity. Cross-sectional study in 21 smokers and 21 nonsmokers all with normal forced exhaled flow rates. Both smokers and nonsmokers performed SBWSM manoeuvres consisting of slow inhalation of test gas from functional residual capacity to one-half inspiratory capacity with either 0 or 10 s of breath holding and slow exhalation to residual volume (RV). They also performed conventional vital capacity single breath (SBWVC) manoeuvres consisting of slow inhalation of test gas from RV to total lung capacity and, without breath holding, slow exhalation to RV. DLcoSB-3EQ was calculated from the total alveolar gas sample. DLcoSB-3EQ was also calculated from four equal sequential, simulated aliquots of the total alveolar gas sample. DLcoSB-3EQ values from the four alveolar samples were normalized by expressing each as a percentge of DLcoSB-3EQ from the entire alveolar gas sample. An index of variation (DI) among the small-sample DLcoSB-3EQ values was correlated with the normalized phase III helium slope (Sn) and the mixing efficiency (Emix). For SBWSM, DI was increased in smokers at 0 s of breath holding compared with nonsmokers, and correlated with age, smoking pack-years and Sn. The decrease in DI with breath holding was greater in smokers and correlated with the change in Sn with breath holding. For SBWVC manoeuvres, there were no differences due to smoking in Sn or Emix, but DI was increased in smokers and correlated with age and smoking pack-years, but not with Sn. For SBWSM manoeuvres the increase in DI in smokers correlated with breath hold time-dependent increases in Sn, suggesting that the changes in DI reflected the same structural alterations that caused increases in peripheral ventilation inhomogeneity. For SBWVC manoeuvres, the increase in DI in smokers was not associated with changes in ventilation inhomogeneity, suggesting that the effect of smoking on DI during this manoeuvre was due to smoke-related changes in alveolar capillary diffusion, rather than due solely to alterations in the distribution of ventilation.

  6. Repeatability of FDG PET/CT metrics assessed in free breathing and deep inspiration breath hold in lung cancer patients.

    PubMed

    Nygård, Lotte; Aznar, Marianne C; Fischer, Barbara M; Persson, Gitte F; Christensen, Charlotte B; Andersen, Flemming L; Josipovic, Mirjana; Langer, Seppo W; Kjær, Andreas; Vogelius, Ivan R; Bentzen, Søren M

    2018-01-01

    We measured the repeatability of FDG PET/CT uptake metrics when acquiring scans in free breathing (FB) conditions compared with deep inspiration breath hold (DIBH) for locally advanced lung cancer. Twenty patients were enrolled in this prospective study. Two FDG PET/CT scans per patient were conducted few days apart and in two breathing conditions (FB and DIBH). This resulted in four scans per patient. Up to four FDG PET avid lesions per patient were contoured. The following FDG metrics were measured in all lesions and in all four scans: Standardized uptake value (SUV) peak , SUV max , SUV mean , metabolic tumor volume (MTV) and total lesion glycolysis (TLG), based on an isocontur of 50% of SUV max . FDG PET avid volumes were delineated by a nuclear medicine physician. The gross tumor volumes (GTV) were contoured on the corresponding CT scans. Nineteen patients were available for analysis. Test-retest standard deviations of FDG uptake metrics in FB and DIBH were: SUV peak FB/DIBH: 16.2%/16.5%; SUV max : 18.2%/22.1%; SUV mean : 18.3%/22.1%; TLG: 32.4%/40.5%. DIBH compared to FB resulted in higher values with mean differences in SUV max of 12.6%, SUV peak 4.4% and SUV mean 11.9%. MTV, TLG and GTV were all significantly smaller on day 1 in DIBH compared to FB. However, the differences between metrics under FB and DIBH were in all cases smaller than 1 SD of the day to day repeatability. FDG acquisition in DIBH does not have a clinically relevant impact on the uptake metrics and does not improve the test-retest repeatability of FDG uptake metrics in lung cancer patients.

  7. Exhaled gases online measurements for esophageal cancer patients and healthy people by proton transfer reaction mass spectrometry.

    PubMed

    Zou, Xue; Zhou, Wenzhao; Lu, Yan; Shen, Chengyin; Hu, Zongtao; Wang, Hongzhi; Jiang, Haihe; Chu, Yannan

    2016-11-01

    Esophageal cancer is a prevalent malignancy. There is a considerable demand for developing a fast and noninvasive method to screen out the suspect esophageal cancer patients who may undergo further clinical diagnosis. The exhaled breathes from 29 esophageal cancer patients and 57 healthy people were directly measured using our home-made proton transfer reaction mass spectrometer (PTR-MS). Mann-Whitney U test and stepwise discriminant analysis were applied to identify the ions in the breath mass spectral data which can distinguish cancer cohort from healthy group. Receiver operating characteristics (ROC) analysis was also performed. Seven kinds of ions in the breath mass spectrum, viz., m/z 136, m/z 34, m/z 63, m/z 27, m/z 95, m/z 107 and m/z 45, have been found to distinguish between the esophageal cancer patients and healthy people with a sensitivity of 86.2% and a specificity of 89.5%, respectively. Compared with that from the healthy people, the breath mass spectra from esophageal cancer patients show that the mediant intensities of five kinds of ions were decrease and the rest two kinds of ions were increase. ROC analysis gave the area under the curve (AUC) of 0.943. This pilot study shows that the ionic characteristics of exhaled VOCs detected by PTR-MS may be used to differentiate between the esophageal cancer patients and the healthy people. Although the breath tests for more patients are needed to confirm such results, the present work indicates that the PTR-MS may be a promising method in the esophageal cancer screening. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  8. Lactose intolerance and intestinal villi morphology in Thai people.

    PubMed

    Thong-Ngam, D; Suwangool, P; Prempracha, J; Tangkijvanich, P; Vivatvekin, B; Sriratanabun, A

    2001-08-01

    To study the relationship of lactose intolerance and intestinal villi morphology in Thai people. Subjects for this study were patients with functional dyspepsia who had no history of milk allergy and underwent gastroduodenoscopy. Two mucosal biopsy specimens were taken from beyond the distal end of the second part of the duodenum. The specimens were carefully orientated and were graded according to the following scheme: group I: finger shaped villi; group II: mixed finger and leaf shaped villi; group III: clubbing or blunting shaped villi. All subjects were tested for lactose malabsorption by breath hydrogen analysis after consuming 50 gram lactose. Breath hydrogen concentration was analyzed in samples collected intermittently by end-expiratory technique. A rise in breath hydrogen concentration of 20 PPM over baseline was considered evidence of lactose malabsorption. The twenty-five subjects were twenty females (80.0%) and five males (20.0%) who ranged in age from 18 to 53 years (mean 31 +/- 8.29). Sixteen subjects belonged to the finger shaped villi group (64.0%), five to the mixed finger and leaf shaped villi, group (20.0%) and four to the clubbing or blunting shaped villi group (16.0%). Results of breath hydrogen excretion test identified the prevalence of lactose intolerance in 68 per cent of the subjects: 15/16 (93.75%) of group I; 1/5 (20.0%) of group II and 1/4 (25%) of group III respectively (P<0.001). The symptom of diarrhea after lactose loading was correlated well in patients who had positive breath hydrogen analysis. As shown in this study, the lactose intolerance is not related to intestinal villi morphology. It is implied that primary lactase deficiency is more common in Thai people than secondary lactase deficiency.

  9. Research Technology (ASTP) Rocket Based Combined Cycle (RBCC) Engine

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Pictured is an artist's concept of the Rocket Based Combined Cycle (RBCC) launch. The RBCC's overall objective is to provide a technology test bed to investigate critical technologies associated with opperational usage of these engines. The program will focus on near term technologies that can be leveraged to ultimately serve as the near term basis for Two Stage to Orbit (TSTO) air breathing propulsions systems and ultimately a Single Stage To Orbit (SSTO) air breathing propulsion system.

  10. Validation of a portable nitric oxide analyzer for screening in primary ciliary dyskinesias.

    PubMed

    Harris, Amanda; Bhullar, Esther; Gove, Kerry; Joslin, Rhiannon; Pelling, Jennifer; Evans, Hazel J; Walker, Woolf T; Lucas, Jane S

    2014-02-10

    Nasal nitric oxide (nNO) levels are very low in primary ciliary dyskinesia (PCD) and it is used as a screening test. We assessed the reliability and usability of a hand-held analyser in comparison to a stationary nitric oxide (NO) analyser in 50 participants (15 healthy, 13 PCD, 22 other respiratory diseases; age 6-79 years). Nasal NO was measured using a stationary NO analyser during a breath-holding maneuver, and using a hand-held analyser during tidal breathing, sampling at 2 ml/sec or 5 ml/sec. The three methods were compared for their specificity and sensitivity as a screen for PCD, their success rate in different age groups, within subject repeatability and acceptability. Correlation between methods was assessed. Valid nNO measurements were obtained in 94% of participants using the stationary analyser, 96% using the hand-held analyser at 5 ml/sec and 76% at 2 ml/sec. The hand-held device at 5 ml/sec had excellent sensitivity and specificity as a screening test for PCD during tidal breathing (cut-off of 30 nL/min,100% sensitivity, >95% specificity). The cut-off using the stationary analyser during breath-hold was 38 nL/min (100% sensitivity, 95% specificity). The stationary and hand-held analyser (5 ml/sec) showed reasonable within-subject repeatability(% coefficient of variation = 15). The hand-held NO analyser provides a promising screening tool for PCD.

  11. Influence of different proton pump inhibitors on activity of cytochrome P450 assessed by [(13)C]-aminopyrine breath test.

    PubMed

    Kodaira, Chise; Uchida, Shinya; Yamade, Mihoko; Nishino, Masafumi; Ikuma, Mutsuhiro; Namiki, Noriyuki; Sugimoto, Mitsushige; Watanabe, Hiroshi; Hishida, Akira; Furuta, Takahisa

    2012-03-01

    Aminopyrine is metabolized by cytochrome P450 (CYP) in the liver. The investigators evaluated influences of different PPIs on CYP activity as assessed by the [(13)C]-aminopyrine breath test ([(13)C]-ABT). Subjects were 15 healthy volunteers with different CYP2C19 status (5 rapid metabolizers [RMs], 5 intermediate metabolizers [IMs], and 5 poor metabolizers [PMs]). Breath samples were collected before and every 15 to 30 minutes for 3 hours after oral ingestion of [(13)C]-aminopyrine 100 mg on day 8 of each of the following regimens: control; omeprazole 20 mg and 80 mg, lansoprazole 30 mg, and rabeprazole 20 mg. Changes in carbon isotope ratios in carbon dioxide ((13)CO(2)/(12)CO(2)) in breath samples were measured by infrared spectrometry and expressed as delta-over-baseline (DOB) ratios (‰). Mean areas under the curve of DOB from 0 to 3 h (AUC(0-3h) of DOB) were significantly decreased by omeprazole 20 mg and lansoprazole 30 mg but not by rabeprazole 20 mg. Conversely, higher PPI dose (ie, omeprazole 80 mg) seemed to further decrease AUC(0-3h) of DOB in RMs but increased it in PMs. Omeprazole and lansoprazole at the standard doses inhibit CYP activity but rabeprazole does not, whereas high-dose omeprazole seems to induce CYPs.

  12. Development of a video-delivered relaxation treatment of late-life anxiety for veterans.

    PubMed

    Gould, Christine E; Zapata, Aimee Marie L; Bruce, Janine; Bereknyei Merrell, Sylvia; Wetherell, Julie Loebach; O'Hara, Ruth; Kuhn, Eric; Goldstein, Mary K; Beaudreau, Sherry A

    2017-10-01

    Behavioral treatments reduce anxiety, yet many older adults may not have access to these efficacious treatments. To address this need, we developed and evaluated the feasibility and acceptability of a video-delivered anxiety treatment for older Veterans. This treatment program, BREATHE (Breathing, Relaxation, and Education for Anxiety Treatment in the Home Environment), combines psychoeducation, diaphragmatic breathing, and progressive muscle relaxation training with engagement in activities. A mixed methods concurrent study design was used to examine the clarity of the treatment videos. We conducted semi-structured interviews with 20 Veterans (M age = 69.5, SD = 7.3 years; 55% White, Non-Hispanic) and collected ratings of video clarity. Quantitative ratings revealed that 100% of participants generally or definitely could follow breathing and relaxation video instructions. Qualitative findings, however, demonstrated more variability in the extent to which each video segment was clear. Participants identified both immediate benefits and motivation challenges associated with a video-delivered treatment. Participants suggested that some patients may need encouragement, whereas others need face-to-face therapy. Quantitative ratings of video clarity and qualitative findings highlight the feasibility of a video-delivered treatment for older Veterans with anxiety. Our findings demonstrate the importance of ensuring patients can follow instructions provided in self-directed treatments and the role that an iterative testing process has in addressing these issues. Next steps include testing the treatment videos with older Veterans with anxiety disorders.

  13. Lack of inhibitory effect of cimetidine on caffeine metabolism in children using the caffeine breath test

    PubMed Central

    Parker, A.C.; Pritchard, P.; Preston, T.; Dalzell, A.M.; Choonara, I.

    1997-01-01

    Aims To study the potential drug interaction between cimetidine and caffeine in a group of children who received cimetidine for gastritis. Methods The caffeine breath test was carried out prior to the administration of cimetidine and after 2–3 weeks therapy. The children (n=1) received 300–800 mg cimetidine daily (11–36 mg kg−1 day−1 ). Results There was no significant change in the 2 h cumulative labelled CO2 following the administration of cimetidine (mean values 5.61% before and 4.87% during cimetidine; Student’s t-test P >0.2). Conclusions Cimetidine did not have an inhibitory effect on the metabolism of caffeine in this group of children studied. PMID:9159560

  14. 14 CFR 120.7 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... post-accident testing as required by subpart F of this part. (o) Refusal to submit to drug test means... as indicated by an evidential breath test under subpart F of this part. (d) Alcohol use means the... paragraph (i) of this section). For purposes of pre-employment testing only, the term “covered employee...

  15. 14 CFR 120.7 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... as indicated by an evidential breath test under subpart F of this part. (d) Alcohol use means the... paragraph (i) of this section). For purposes of pre-employment testing only, the term “covered employee... for random drug testing means the number of verified positive results for random drug tests conducted...

  16. 14 CFR 120.7 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... as indicated by an evidential breath test under subpart F of this part. (d) Alcohol use means the... paragraph (i) of this section). For purposes of pre-employment testing only, the term “covered employee... for random drug testing means the number of verified positive results for random drug tests conducted...

  17. 14 CFR 120.7 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... as indicated by an evidential breath test under subpart F of this part. (d) Alcohol use means the... paragraph (i) of this section). For purposes of pre-employment testing only, the term “covered employee... for random drug testing means the number of verified positive results for random drug tests conducted...

  18. 14 CFR 120.7 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... as indicated by an evidential breath test under subpart F of this part. (d) Alcohol use means the... paragraph (i) of this section). For purposes of pre-employment testing only, the term “covered employee... for random drug testing means the number of verified positive results for random drug tests conducted...

  19. Effect of tracheostomy tube on work of breathing: Comparison of pre- and post-decannulation.

    PubMed

    Villalba, Darío; Feld, Viviana; Leiva, Valeria; Scrigna, Mariana; Distéfano, Eduardo; Pratto, Romina; Rodriguez, Matías; Collins, Jesica; Rocco, Ana; Matesa, Amelia; Rossi, Damián; Areas, Laura; Virgilio, Sacha; Golfarini, Nicolás; Gil-Rosetti, Gregorio; Diaz-Ballve, Pablo; Planells, Fernando

    2016-01-01

    To describe and compare the work of breathing (WOB) during spontaneous breathing under four conditions: (1) breathing through a tracheostomy tube with an inflated cuff, (2) breathing through the upper airway (UA) with a deflated cuff and occluded tube, (3) breathing through the UA with an occluded cuffless tube, and (4) postdecannulation. Patients who tolerated an occluded cuffless tube were included. Ventilatory variables and esophageal pressure were recorded. The pressure-time product (PTP), PTP/min, and PTP/min/tidal volume (PTP/min/VT) were measured. Each condition was measured for 5 min with a 15 min time interval between evaluations. Quantitative data are expressed as mean ± standard deviation. Single-factor analysis of variance was used, and the Games-Howell test was used for post hoc analysis of comparisons between group means ( P ≤ 0.05). Eight patients were studied under each of the four conditions described above. Statistically significant differences were found for PTP, PTP/min, and PTP/min/VT. In the post hoc analysis for PTP, significant differences among all conditions were found. For PTP/min, there was no significant difference between Conditions 2 and 4 ( P = 0.138), and for PTP/min/VT, there was no significant difference between Conditions 1 and 2 ( P = 0.072) or between Conditions 2 and 3 ( P = 0.106). A trend toward a higher PTP, PTP/min, and PTP/min/VT was observed when breathing through a cuffless tracheostomy tube. The four conditions differed with respect to WOB. Cuff inflation could result in a reduced WOB because there is less dead space. Cuffless tracheostomy tubes generate increased WOB, perhaps due to the material deformity caused by body temperature.

  20. Positive-pressure ventilation during transport: a randomized crossover study of self-inflating and flow-inflating resuscitators in a simulation model.

    PubMed

    Lucy, Malcolm J; Gamble, Jonathan J; Daku, Brian L; Bryce, Rhonda D; Rana, Masud

    2014-12-01

    Positive-pressure ventilation during transport of intubated patients is generally delivered via a hand-pressurized device. Of these devices, self-inflating resuscitators (SIR) and flow-inflating resuscitators (FIR) constitute the two major types used. Selection of a particular device for transport, however, remains largely an institutional practice. To evaluate the hypothesis that transport ventilation goals of intubated pediatric patients are better achieved using an FIR compared to an SIR. This randomized crossover simulation study compared the performance of SIR and FIR among anesthesia providers in a pediatric transport scenario. Subjects hand-ventilated a test lung while simultaneously maneuvering a stretcher bed to simulate patient transport. Hand ventilation was carried out using a Jackson-Rees circuit (FIR) and a Laerdal pediatric silicone resuscitator (SIR). The primary outcome was the proportion of total breaths delivered within the predefined target PIP/PEEP range (30+/- 3, 10+/- 3 cm H2O). Secondary outcomes included proportion of total breaths delivered with operationally defined unacceptable breath variables (PIP > 35 cm H2O or PEEP < 5 cm H2O). Overall, participants were four times more likely to deliver target breaths and one-third less likely to deliver unacceptable breaths using the FIR compared to the SIR. When comparing device performance, a 44% increase in the proportions of target breaths and a 40.4% decrease in unacceptable breaths using the FIR were observed (P < 0.0001 for both). Hand ventilation during patient transport is superior using the FIR compared to the SIR to achieve target ventilatory goals and avoid unacceptable ventilatory cycles. © 2014 John Wiley & Sons Ltd.

Top