Systematic comparison of methods for offline breath sampling.

Harnessing the potential of exhaled breath analysis is an emerging frontier in medical diagnostics, given breath is a rich source of volatile organic compound (VOC) biomarkers for different medical conditions. A current downfall in this field, however, is the lack of standardized and widely available methods for offline sampling of exhaled VOCs. Herein, strides are taken toward the standardization of breath sampling in Tedlar bags by exploring several factors that can impact VOC heterogeneity, including tubing material, chemical composition of collection bags, breath fractionation, exhalation volume, and transfer flow rate.

Elexacaftor/Tezacaftor/Ivacaftor Supports Treatment for CF with ΔI1023-V1024-CFTR.

Cystic Fibrosis (CF) is a common genetic disease in the United States, resulting from mutations in the gene. CFTR modulators, particularly Elexacaftor/Tezacaftor/Ivacaftor (ETI), have significantly improved clinical outcomes for patients with CF. However, many CFTR mutations are not eligible for CFTR modulator therapy due to their rarity.

2024 Year in Review: Fugitive Aerosols-Keeping the Air Clear for Patients and Staff.

Although concerns about and precautions to prevent transmission of diseases through the air have existed since Hippocrates, renewed interest in risks and prevention strategies grew significantly since the onset of the COVID-19 pandemic. This altered respiratory care practice globally owing to concerns that some respiratory care procedures may generate or disperse aerosols that could spread pathogens. A paucity of evidence, as well as a lack of general consensus, existed at the pandemic onset to determine the associated risks of these procedures and best practices for mitigating those risks.

The Role of Fractional Exhaled Nitric Oxide and Oscillometry in Pediatric Asthma.

Diagnosing pediatric asthma is challenging and requires the evaluation of symptoms, inflammation, and lung function. Spirometry, which is commonly used to evaluate lung function in asthma, is difficult to obtain from young pediatric patients and frequently not possible to obtain from patients under 5 years of age. This is also true for the fraction of exhaled nitric oxide (F) measurement, which can indicate type 2 airway inflammation in asthma, and controversy has existed regarding the appropriate use of F measurement in asthma diagnosis and monitoring.

Effectiveness of a short-term oxygen therapy training program in Liberia during and after COVID-19.

Background: Access to high-quality medical oxygen has been a long-standing challenge in Liberia due to barriers that span across the health system, which were amplified during the COVID-19 pandemic. The surge in cases requiring oxygen therapy necessitated rapid capacity-building for healthcare workers. In response, an emergency oxygen training package was adapted and implemented by the Liberia Ministry of Health and the National Incidence Management System.

Plastic bronchitis in an adult.

Plastic bronchitis is rare in adult pulmonology and has a wide range of aetiology. Cast analysis is key in narrowing down the differential diagnosis of plastic bronchitis. If suspected of having lymphocytic PB, complete imaging to evaluate thoracic lymphatics is important to find out the potential causes for PB.

2023 Year in Review: High-Flow Nasal Cannula for COVID-19.

COVID-19, caused by SARS-CoV-2 infection, led to a pandemic of acute respiratory illness that is ongoing. High-flow nasal cannula (HFNC) is a commonly used form of respiratory support during acute respiratory distress and is used to treat patients with COVID-19 in many centers. Due to the novel nature of COVID-19 at the onset of the pandemic, evidence to support the use and best practices of HFNC for treating patients with COVID-19 was lacking.

Antigen stasis and airway nitrosative stress in human primary ciliary dyskinesia.

Nasal nitric oxide (nNO) is low in most patients with primary ciliary dyskinesia (PCD). Decreased ciliary motion could lead to antigen stasis, increasing oxidant production and NO oxidation in the airways. This could both decrease gas phase NO and increase nitrosative stress.

A Concise Review of Exhaled Breath Testing for Respiratory Clinicians and Researchers.

Exhaled breath contains an extensive reservoir of biomolecules. The collection of exhaled breath is noninvasive and low risk. Therefore, its testing is an appealing strategy for the discovery of biomarkers of respiratory diseases.

Desalkylgidazepam blood concentrations in 63 forensic investigation cases.

Desalkylgidazepam, also known as bromonordiazepam, is the latest designer benzodiazepine to appear in postmortem blood samples in British Columbia. Our laboratory was first alerted to the presence of desalkylgidazepam in seized drug samples in May 2022, and the analyte was added to an in-house library shortly thereafter. Previously acquired spectra from routine death investigation cases were reprocessed using the updated library with the first presumptive identification of desalkylgidazepam occurring in a sample received in April 2022.

Defining and Promoting Pediatric Pulmonary Health: Developing Biomarkers for Pulmonary Health.

Children with inherited and/or acquired respiratory disorders often arrive in adolescence and adulthood with diminished lung function that might have been detected and prevented had better mechanisms been available to identify and to assess progression of disease. Fortunately, advances in genetic assessments, low-cost diagnostics, and minimally- invasive novel biomarkers are being developed to detect and to treat respiratory diseases before they give rise to loss of life or lung function. This paper summarizes the Developing Biomarkers for Pulmonary Health sessions of the National Heart, Lung, and Blood Institute- sponsored 2021 Defining and Promoting Pediatric Pulmonary Health workshop.

Effects of pH alteration on respiratory syncytial virus in human airway epithelial cells.

Background: Respiratory syncytial virus (RSV) is a leading cause of respiratory distress and hospitalisation in the paediatric population. Low airway surface pH impairs antimicrobial host defence and worsens airway inflammation. Inhaled Optate safely raises airway surface pH in humans and raises intracellular pH in primary human airway epithelial cells (HAECs) .

Methods to Detect Volatile Organic Compounds for Breath Biopsy Using Solid-Phase Microextraction and Gas Chromatography-Mass Spectrometry.

Volatile organic compounds (VOCs) are byproducts from metabolic pathways that can be detected in exhaled breath and have been reported as biomarkers for different diseases. The gold standard for analysis is gas chromatography-mass spectrometry (GC-MS), which can be coupled with various sampling methods. The current study aims to develop and compare different methods for sampling and preconcentrating VOCs using solid-phase microextraction (SPME).

Nocturnal High-Flow Nasal Cannula Therapy and Sinonasal Symptoms During Cystic Fibrosis Exacerbations.

Background: Both nasal obstruction and sleep disturbance are common in patients with cystic fibrosis (CF). In patients with obstructive sleep apnea (OSA), studies suggest that these conditions are related and that nasal congestion improves with CPAP therapy. We hypothesized that subjects admitted to hospital for therapy of an exacerbation of CF would have both nasal symptoms and sleep disturbance and that these would improve with the initiation of nocturnal high-flow nasal cannula therapy (HFNC).

correlation of aerosol deposition before and after metered-dose inhaler coaching in healthy children.

Although pressurized metered dose inhaler (pMDI) education is a routine part of childhood asthma management and encouraging 'optimal breathing patterns' (i.e. slowly, deeply, completely, and with a mouth seal on the mouthpiece) is an integral part of recommended pMDI education, there is currently no quantifiable way to determine if a child is inhaling their medication correctly or optimally through a valved holding chamber (VHC).

Bromazolam Blood Concentrations in Postmortem Cases-A British Columbia Perspective.

Bromazolam is a designer benzodiazepine that was first detected in British Columbia in January 2021. Postmortem cases were analyzed using a comprehensive blood drug screening procedure by liquid chromatography-high-resolution mass spectrometry before being retrospectively analyzed using an in-house novel psychoactive substances data processing method. Bromazolam was detected in 41 postmortem cases in 2021 and quantitatively confirmed by standard addition, using liquid chromatography-tandem mass spectrometry.

Volatile metabolites differentiate air-liquid interface cultures after infection with .

Early detection of lung infection is critical to clinical diagnosis, treatment, and monitoring. Measuring volatile organic compounds (VOCs) in exhaled breath has shown promise as a rapid and accurate method of evaluating disease metabolism and phenotype. However, further investigations of the role and function of VOCs in bacterial-host-stress response is required and this can only be realised through representative models.

The physics of human breathing: flow, timing, volume, and pressure parameters for normal, on-demand, and ventilator respiration.

Normal breathing for healthy humans is taken for granted; it occurs without conscious effort using ambient (1-atmosphere) pressure with 21% oxygen (O) concentration. The body automatically adjusts for stress, exercise, altitude, and mild disease by increasing the volume and frequency of breathing. Longer term adaptations for exercise and altitude include increases in red blood cell counts and higher concentrations of capillaries in muscle tissue.

Somatic cell hemoglobin modulates nitrogen oxide metabolism in the human airway epithelium.

Endothelial hemoglobin (Hb)α regulates endothelial nitric oxide synthase (eNOS) biochemistry. We hypothesized that Hb could also be expressed and biochemically active in the ciliated human airway epithelium. Primary human airway epithelial cells, cultured at air-liquid interface (ALI), were obtained by clinical airway brushings or from explanted lungs.

2020 Year in Review: Pharmacologic Treatments for COVID-19.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 infection, has led to a pandemic of acute respiratory illness. Pharmacologic treatments for COVID-19 have included treatments that target infection prevention, prevention of viral replication, reduce inflammation, and manage symptoms of respiratory failure caused by the disease. This is a review of key pharmacologic treatments for COVID-19 based on peer-reviewed articles from 2020.