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Traffic Injury Prevention 2013Progress in reducing alcohol-impaired driving crash fatalities in the United States has stagnated over the last 15 years. This article reviews 2 current U.S.... (Review)
Review
OBJECTIVE
Progress in reducing alcohol-impaired driving crash fatalities in the United States has stagnated over the last 15 years. This article reviews 2 current U.S. driving-while-intoxicated (DWI) laws and their enforcement with an aim toward generating opportunities to improve their enforcement approaches.
METHODS
Impaired-driving enforcement methods in Europe and Australia are compared with those in the United States, and the legal basis for current DWI criminal procedures is examined.
RESULTS
An examination of relevant U.S. Supreme Court decisions and current legal practices indicates that the requirements for use of breath test technology to determine blood alcohol concentrations of drivers on public roads are not entirely clear. Several potential methods for using field breath test technology to improve the detection of impaired drivers are suggested. These include (a) breath testing all drivers stopped for certain violations that have a high probability of involving an impaired driver, (b) breath testing all drivers at sobriety checkpoints, and (c) breath testing all drivers involved in fatal and serious injury crashes.
CONCLUSIONS
Breath test technology has enabled other countries around the world to adopt and implement enforcement strategies that serve as both general and specific deterrents to alcohol-impaired driving. Many of these enforcement strategies have been shown to be effective. If any one of these strategies can be adopted in the United States, further progress in reducing impaired driving is probable. It may be necessary to provide the U.S. Supreme Court with a test case of breath testing all drivers at a sobriety checkpoint, depending upon whether or not a police agency is willing to use that strategy.
Topics: Alcohol Drinking; Automobile Driving; Breath Tests; Ethanol; Humans; Law Enforcement; Supreme Court Decisions; United States
PubMed: 23944649
DOI: 10.1080/15389588.2012.754095 -
Chest Mar 2022Diagnosing sarcoidosis can be challenging, and a noninvasive diagnostic method is lacking. The electronic nose (eNose) technology profiles volatile organic compounds in...
BACKGROUND
Diagnosing sarcoidosis can be challenging, and a noninvasive diagnostic method is lacking. The electronic nose (eNose) technology profiles volatile organic compounds in exhaled breath and has potential as a point-of-care diagnostic tool.
RESEARCH QUESTION
Can eNose technology be used to distinguish accurately between sarcoidosis, interstitial lung disease (ILD), and healthy control subjects, and between sarcoidosis subgroups?
STUDY DESIGN AND METHODS
In this cross-sectional study, exhaled breath of patients with sarcoidosis and ILD and healthy control subjects was analyzed by using an eNose (SpiroNose). Clinical characteristics were collected from medical files. Partial least squares discriminant and receiver-operating characteristic analyses were applied to a training and independent validation cohort.
RESULTS
The study included 252 patients with sarcoidosis, 317 with ILD, and 48 healthy control subjects. In the validation cohorts, eNose distinguished sarcoidosis from control subjects with an area under the curve (AUC) of 1.00 and pulmonary sarcoidosis from other ILD (AUC, 0.87; 95% CI, 0.82-0.93) and hypersensitivity pneumonitis (AUC, 0.88; 95% CI, 0.75-1.00). Exhaled breath of sarcoidosis patients with and without pulmonary involvement, pulmonary fibrosis, multiple organ involvement, pathology-supported diagnosis, and immunosuppressive treatment revealed no distinctive differences. Breath profiles differed between patients with a slightly and highly elevated soluble IL-2 receptor level (median cutoff, 772.0 U/mL; AUC, 0.78; 95% CI, 0.64-0.92).
INTERPRETATION
Patients with sarcoidosis can be distinguished from ILD and healthy control subjects by using eNose technology, indicating that this method may facilitate accurate diagnosis in the future. Further research is warranted to understand the value of eNose in monitoring sarcoidosis activity.
Topics: Breath Tests; Cross-Sectional Studies; Electronic Nose; Exhalation; Humans; Sarcoidosis, Pulmonary; Technology; Volatile Organic Compounds
PubMed: 34756945
DOI: 10.1016/j.chest.2021.10.025 -
Journal of Thoracic Oncology : Official... Jul 2018The electronic nose (e-nose) is a promising technology as a useful addition to the currently available modalities to achieve lung cancer diagnosis. The e-nose can assess... (Review)
Review
The electronic nose (e-nose) is a promising technology as a useful addition to the currently available modalities to achieve lung cancer diagnosis. The e-nose can assess the volatile organic compounds detected in the breath and derived from the cellular metabolism. Volatile organic compounds can be analyzed to identify the individual chemical elements as well as their pattern of expression to reproduce a sensorial combination similar to a fingerprint (breathprint). The e-nose can be used alone, mimicking the combinatorial selectivity of the human olfactory system, or as part of a multisensorial platform. This review analyzes the progress made by investigators interested in this technology as well as the perspectives for its future utilization.
Topics: Breath Tests; Early Detection of Cancer; Electronic Nose; Humans; Lung Neoplasms; Volatile Organic Compounds
PubMed: 29526822
DOI: 10.1016/j.jtho.2018.02.026 -
American Journal of Hematology Oct 2021The red blood cell (RBC) lifespan is an important physiological indicator of clear significance in clinical research, used for the differential diagnosis of various... (Comparative Study)
Comparative Study
The red blood cell (RBC) lifespan is an important physiological indicator of clear significance in clinical research, used for the differential diagnosis of various diseases such as anemia, compensatory phase hemolysis, and polycythemia. The N-glycine labeling technique is the gold standard method for determining RBC lifespans. However, the usefulness of this technique in clinical settings is seriously hindered by the several weeks required to complete the analyses. Levitt's CO breath test is another reliable technique for determining RBC lifespans, with a simpler protocol giving much faster results, making it more useful in clinical applications. We compared the CO breath test and N-glycine labeling technique for measuring the human RBC lifespan. We investigated human RBC lifespans where each subject undertook both the N-glycine labeling technique and the CO breath test. The correlation between the results from these two methods was analyzed. Eight of the ten subjects successfully completed the study. The RBC lifespan values obtained by Levitt's CO breath test were lower than those obtained by the N-glycine labeling technique. The RBC lifespan values determined from the N-glycine labeling technique and the CO breath test were significantly correlated, with a Pearson correlation coefficient of R = 0.98 (p < 0.05), while the R of the linear regression equation was 0.96. The CO breath test exhibits as good performance as the N-glycine labelling technique in distinguishing healthy subjects from subjects with hemolysis. The result suggests that the CO breath test is a reliable method for quickly determining human RBC lifespans in clinical applications.
Topics: Adult; Breath Tests; Carbon Monoxide; Cell Survival; Erythrocytes; Female; Glycine; Hemolysis; Humans; Male; Middle Aged; Nitrogen Isotopes
PubMed: 34265098
DOI: 10.1002/ajh.26290 -
Experimental Biology and Medicine... Jul 2022Lung cancer is one of the leading causes of cancer incidence and cancer-related deaths in the world. Early diagnosis of pulmonary tumors results in improved survival... (Review)
Review
Lung cancer is one of the leading causes of cancer incidence and cancer-related deaths in the world. Early diagnosis of pulmonary tumors results in improved survival compared to diagnosis with more advanced disease, yet early disease is not reliably indicated by symptoms. Despite of the improved testing and monitoring techniques for lung cancer in the past decades, most diagnostic tests, such as sputum cytology or tissue biopsies, are invasive and risky, rendering them unfeasible for large population screening. The non-invasive analysis of exhaled breath has gained attentions as an innovative screening method to measure chemical alterations within the human volatilome profile as a result of oncogenesis. More importantly, volatile organic compounds (VOCs) have been correlated to the pathophysiology of disease since the source of volatile compounds relies mostly on endogenous metabolic processes that are altered as a result of disease onset. Therefore, studying VOCs emitted from human breath may assist lung cancer diagnosis, treatment monitoring, and other surveillance of this devastating disease. In this mini review, we evaluated recent human studies that have attempted to identify lung cancer-derived volatiles in exhaled breath of patients. We also examined reported volatiles in cell cultures of lung cancer to better understand the origins of cancer-associated VOCs. We highlight the metabolic processes of lung cancer that could be responsible for the endogenous synthesis of these VOCs and pinpoint the protein-encoding genes involved in these pathways. Finally, we highlight the potential value of a breath test in lung cancer and propose prominent areas for future research required for the incorporation of VOCs-based testing into clinical settings.
Topics: Breath Tests; Exhalation; Humans; Lung; Lung Neoplasms; Volatile Organic Compounds
PubMed: 35410512
DOI: 10.1177/15353702221082634 -
BMJ Open Gastroenterology Jun 2021A high quality end-expiratory breath sample is required for a reliable gastrointestinal breath test result. Oxygen (O) concentration in the breath sample can be used as...
OBJECTIVE
A high quality end-expiratory breath sample is required for a reliable gastrointestinal breath test result. Oxygen (O) concentration in the breath sample can be used as a quality marker. This study investigated the characteristics of O concentration in the breath sample and the impact of using a correction factor in real-time breath measurement.
DESIGN
This study includes two separate groups of patient data. Part 1 of the study analysed the patient's ability to deliver end-expiratory breath samples over a 2-year period (n=564). Part 2 of the study analysed a separate group of patients (n=47) with additional data to investigate the O characteristics and the role of correction factor in breath test.
RESULTS
The results indicated 95.4% of 564 patients were able to achieve an O concentration below 14% in their end-expiratory breath. Part 2 of the study revealed that the distribution of O concentration was between 9.5% and 16.2%. Applying a correction factor to predict the end-expiratory H and CH values led to an average measurement error of -36.4% and -12.8%, respectively.
CONCLUSION
The majority of patients are able to deliver a high quality end-expiratory breath sample, regardless of age or gender. The correction factor algorithm is unreliable when predicting the end-expiratory result at 15% O and it would have resulted in false negative result for 50% of the positive cases in this study. It has also indicated that the continuous O measurement is essential to ensure breath sample quality by preventing secondary breathing during real-time breath collection.
Topics: Breath Tests; Humans; Hydrogen; Oxygen; Respiration
PubMed: 34168044
DOI: 10.1136/bmjgast-2021-000640 -
Respiratory Research Nov 2023Interstitial lung disease (ILD) may be difficult to distinguish from other respiratory diseases due to overlapping clinical presentation. Recognition of ILD is often...
INTRODUCTION
Interstitial lung disease (ILD) may be difficult to distinguish from other respiratory diseases due to overlapping clinical presentation. Recognition of ILD is often late, causing delay which has been associated with worse clinical outcome. Electronic nose (eNose) sensor technology profiles volatile organic compounds in exhaled breath and has potential to detect ILD non-invasively. We assessed the accuracy of differentiating breath profiles of patients with ILD from patients with asthma, chronic obstructive pulmonary disease (COPD), and lung cancer using eNose technology.
METHODS
Patients with ILD, asthma, COPD, and lung cancer, regardless of stage or treatment, were included in a cross-sectional study in two hospitals. Exhaled breath was analysed using an eNose (SpiroNose) and clinical data were collected. Datasets were split in training and test sets for independent validation of the model. Data were analyzed with partial least squares discriminant and receiver operating characteristic analyses.
RESULTS
161 patients with ILD and 161 patients with asthma (n = 65), COPD (n = 50) or lung cancer (n = 46) were included. Breath profiles of patients with ILD differed from all other diseases with an area under the curve (AUC) of 0.99 (95% CI 0.97-1.00) in the test set. Moreover, breath profiles of patients with ILD could be accurately distinguished from the individual diseases with an AUC of 1.00 (95% CI 1.00-1.00) for asthma, AUC of 0.96 (95% CI 0.90-1.00) for COPD, and AUC of 0.98 (95% CI 0.94-1.00) for lung cancer in test sets. Results were similar after excluding patients who never smoked.
CONCLUSIONS
Exhaled breath of patients with ILD can be distinguished accurately from patients with other respiratory diseases using eNose technology. eNose has high potential as an easily accessible point-of-care medical test for identification of ILD amongst patients with respiratory symptoms, and could possibly facilitate earlier referral and diagnosis of patients suspected of ILD.
Topics: Humans; Electronic Nose; Cross-Sectional Studies; Pulmonary Disease, Chronic Obstructive; Asthma; Respiration Disorders; Lung Neoplasms; Lung Diseases, Interstitial; Breath Tests; Volatile Organic Compounds; Exhalation
PubMed: 37932795
DOI: 10.1186/s12931-023-02575-3 -
Scientific Reports Jan 2021Breast cancer causes metabolic alteration, and volatile metabolites in the breath of patients may be used to diagnose breast cancer. The objective of this study was to... (Clinical Trial)
Clinical Trial
Breast cancer causes metabolic alteration, and volatile metabolites in the breath of patients may be used to diagnose breast cancer. The objective of this study was to develop a new breath test for breast cancer by analyzing volatile metabolites in the exhaled breath. We collected alveolar air from breast cancer patients and non-cancer controls and analyzed the volatile metabolites with an electronic nose composed of 32 carbon nanotubes sensors. We used machine learning techniques to build prediction models for breast cancer and its molecular phenotyping. Between July 2016 and June 2018, we enrolled a total of 899 subjects. Using the random forest model, the prediction accuracy of breast cancer in the test set was 91% (95% CI: 0.85-0.95), sensitivity was 86%, specificity was 97%, positive predictive value was 97%, negative predictive value was 97%, the area under the receiver operating curve was 0.99 (95% CI: 0.99-1.00), and the kappa value was 0.83. The leave-one-out cross-validated discrimination accuracy and reliability of molecular phenotyping of breast cancer were 88.5 ± 12.1% and 0.77 ± 0.23, respectively. Breath tests with electronic noses can be applied intraoperatively to discriminate breast cancer and molecular subtype and support the medical staff to choose the best therapeutic decision.
Topics: Adult; Aged; Biopsy; Breast Neoplasms; Breath Tests; Case-Control Studies; Electronic Nose; Humans; Machine Learning; Middle Aged; Nanotubes, Carbon; Volatile Organic Compounds
PubMed: 33420275
DOI: 10.1038/s41598-020-80570-0 -
BMJ (Clinical Research Ed.) Jan 2005
Topics: Antigens, Bacterial; Breath Tests; Dyspepsia; Feces; Helicobacter Infections; Helicobacter pylori; Humans; Urea
PubMed: 15649907
DOI: 10.1136/bmj.330.7483.105 -
BMJ Open Feb 2022Pancreatic cancer (PC) is the fifth leading cause of cancer-related death in the UK. The incidence of PC is increasing, with little or no improvement in overall survival...
DEPEND study protocol: early detection of patients with pancreatic cancer - a pilot study to evaluate the utility of faecal elastase-1 and C-mixed triglyceride breath test as screening tools in high-risk individuals.
INTRODUCTION
Pancreatic cancer (PC) is the fifth leading cause of cancer-related death in the UK. The incidence of PC is increasing, with little or no improvement in overall survival and the best chance for long-term survival in patients with PC relies on early detection and surgical resection. In this study, we propose the use of a diagnostic algorithm that combines tests of pancreatic exocrine function (faecal elastase-1 (FE-1) test and the C-mixed triglyceride (C-MTG) breath test) to identify patients with PC that urgently needs imaging studies.
METHODS AND ANALYSIS
This prospective pilot (proof of concept) study will be carried out on 25 patients with resectable PC, 10 patients with chronic pancreatitis and 25 healthy volunteers. This study will construct a predictive algorithm for PC, using two tests of pancreatic exocrine function, FE-1 test and the C-MTG breath test. Continuous flow isotope ratio mass spectrometry in the C-MTG breath test will be used to analyse enriched CO in exhaled breath samples. The additional predictive benefit of other potential biomarkers of PC will also be considered. Potential biomarkers of PC showing abilities to discriminate between patients with PC from healthy subjects or patients with chronic pancreatitis will be selected by metabolomic analysis.
ETHICS AND DISSEMINATION
The study was approved by the North of Scotland Research and Ethics Committee on 1 October 2020 (reference: 20/NS/0105, favourable opinion granted). The results will be disseminated in presentations at academic national/international conferences and publication in peer-review journals.
Topics: Biomarkers; Breath Tests; Early Detection of Cancer; Exocrine Pancreatic Insufficiency; Humans; Pancreatic Elastase; Pancreatic Neoplasms; Pancreatitis, Chronic; Pilot Projects; Prospective Studies; Triglycerides
PubMed: 35217541
DOI: 10.1136/bmjopen-2021-057271