Breath Test Research Articles

A Cross-Sectional Study of Cardiovascular Autonomic Reactivity in Ehlers-Danlos Syndrome.

Ehlers-Danlos syndrome (EDS) may be linked to dysfunction in the autonomic nervous system, affecting collagen production and processing. These collagen abnormalities lead to a condition called dysautonomia. Findings underscore the need for further investigation into autonomic nervous system function in EDS which involves larger studies to strengthen the evidence of non-invasive screening tools like cardiovascular reflex tests. These tests might offer a valuable way to assess an individual's risk for future complications. This study aimed to assess autonomic reactivity in EDS patients using cardiovascular reflex tests. This study was conducted at the Department of Physiology, Naraina Medical College and Research Centre, Kanpur (Uttar Pradesh). The cardiovascular reflex test was used to identify 60 individuals, 30 of whom were EDS patients and 30 were healthy controls, with a common age limit of 18-25 years. Cardiovascular reflex tests, such as the delta heart rate, lying-to-standing test (LST), deep breathing test (DBT), and Valsalva maneuver, were performed and recorded for each subject. IBM SPSS Statistics for Windows, Version 21.0 (Released 2012; IBM Corp., Armonk, New York, United States) was used for the compilation and analysis of data. The expiration-to-inspiration (E:I) ratio and delta heart rate of the EDS patients both significantly decreased as compared to the healthy control group (1.10±0.02 versus 1.22±0.77 and 14.03±0.31 versus 15.52±0.32). The Valsalva ratio of the EDS patients decreased (1.28±0.01) as compared to the healthy control group (1.46±0.01), which was statistically significant. The 30:15 ratio in the EDS patients was significantly decreasedcompared to the healthy control group (1.08±0.01 versus 1.15±0.01). The handgrip test and cold pressor test results were statistically insignificant. The study suggests a connection between EDS and autonomic nervous system dysfunction, causing symptoms like tachycardia and hypotension. It recommends exploring non-invasive cardiovascular reflex tests as a tool to identify autonomic dysfunction in EDS patients and predict long-term cardiovascular complications. These tests offer valuable insights into autonomic function.

The impact of diet, exercise, and sleep on Helicobacter pylori infection with different occupations: a cross-sectional study

BackgroundAssociations between Helicobacter pylori infection and lifestyle factors vary greatly by geographic location. This study aims to evaluate the prevalence of Helicobacter pylori infection in the Hunan cohort of central China and analyze the associations between Helicobacter pylori infection and lifestyle factors in different occupations.MethodsThis was a cross-sectional study. Participants who received an annual physical examination were invited. Helicobacter pylori infection was detected by the 13 C-urea breath test. Self-reported physical examination questionnaires were used to analyze participants’ demographic information, diet, exercise status, and sleep situations.Results23254 participants finished this study. The Helicobacter pylori infection rate in the Hunan area was 25.8%, with the lowest prevalence in students (8.5%) and the highest prevalence in business managers (29.9%). The risk factors for Helicobacter pylori infection were marital status (divorced or married) (OR:1.16, 95%CI:1.090–1.234), overeating (OR:1.105, 95%CI: 1.001–1.220), and consumption of eggs (OR:1.047, 95%CI:1.004–1.092), animal viscera (OR: 1.077, 95%CI:1.014–1.144) and coffee (OR:1.074, 95%CI:1.019–1.132). Participants’ education level (OR:0.911, 95%CI:0.881-0942), consumption of midnight snack (OR:0.926, 95%CI:0.877–0.977), and vegetable (OR:0.927, 95%CI: 0.884–0.972) were protective factors against Helicobacter pylori infection. Whether participants exercised regularly or had sleep problems had no significant effect on Helicobacter pylori infection. Different professionals showed significant differences in the rates of overeating, eating three meals on time, midnight snack, and consuming coffee, eggs, animal viscera, and vegetables > 3 times/week (P values < 0.05).ConclusionsHelicobacter pylori infection showed a significant relationship with dietary factors, but not significantly with sleep and exercise factors. Different occupations showed different dietary tendencies related to Helicobacter pylori infection. The design of an occupation-based Helicobacter pylori screening and prevention program is supported.

Exhaled breath analysis for the discrimination of asthma and chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) and asthma are the most common chronic respiratory diseases. In middle-aged and elderly patients, it is difficult to distinguish between COPD and asthma based on clinical symptoms and pulmonary function examinations in clinical practice. Thus, an accurate and reliable inspection method is required. In this study, we aimed to identify breath biomarkers and evaluate the accuracy of breathomics-based methods for discriminating between COPD and asthma. In this multi-center cross-sectional study, exhaled breath samples were collected from 89 patients with COPD and 73 with asthma and detected on a high-pressure photon ionization time-of-flight mass spectrometry (HPPI-TOFMS) platform from 20 October 2022, to 20 May 2023, in four hospitals. Data analysis was performed from 15 June 2023 to 16 August 2023. The sensitivity, specificity, and accuracy were calculated to assess the overall performance of the volatile organic component (VOC)-based COPD and asthma discrimination models. Potential VOC markers related to COPD and asthma were also analyzed. The age of all participants ranged from to 18–86 years, and 54 (33.3%) were men. The age [median (minimum, maximum)] of COPD and asthma participants were 66.0 (46.0, 86.0), and 44.0 (17.0, 80.0). The male and female ratio of COPD and asthma participants were 14/75 and 40/33, respectively. Based on breathomics feature selection, ten VOCs were identified as COPD and asthma discrimination biomarkers via breath testing. The joint panel of these ten VOCs achieved an area under the curve of 0.843, sensitivity of 75.9%, specificity of 87.5%, and accuracy of 80.0% in COPD and asthma discrimination. Furthermore, the VOCs detected in the breath samples were closely related to the clinical characteristics of COPD and asthma. The VOC-based COPD and asthma discrimination model showed good accuracy, providing a new strategy for clinical diagnosis. Breathomics-based methods may play an important role in the diagnosis of COPD and asthma.

Identification potential biomarkers for diagnosis, and progress of breast cancer by using high-pressure photon ionization time-of-flight mass spectrometry

BackgroundIn this study, exhaled breath testing has been considered a promising method for the detection and monitoring of breast cancer (BC). MethodsA high-pressure photon ionization time-of-flight mass spectrometry (HPPI-TOFMS) platform was used to detect volatile organic compounds (VOCs) in breath samples. Then, machine learning (ML) models were constructed on VOCs for the diagnosis of BC and its progression monitoring. Ultimately, 1981 women with useable breath samples were included in the study, of whom 937 (47.3 %) had been diagnosed with BC. VOC panels were used for ML model construction for BC detection and progression monitoring. ResultsOn the blinded testing cohort, this VOC-based model successfully differentiated patients with and without BC with sensitivity, specificity, and area under receiver operator characteristic curve (AUC) values of 85.9 %, 90.4 %, and 0.946. The corresponding AUC values when differentiating between patients with and without lymph node metastasis (LNM) or between patients with tumor-node-metastasis (TNM) stage 0/I/II or III/IV disease were 0.840 and 0.708, respectively. While developed VOC-based models exhibited poor performance when attempting to differentiate between patients based on pathological patterns (Ductal carcinoma in situ (DCIS) vs Invasive BC (IBC)) or molecular subtypes (Luminal vs Human epidermal growth factor receptor 2 (HER2+) vs Triple-negative BC (TNBC)) of BC. ConclusionCollectively, the HPPI-TOFMS-based breathomics approaches may offer value for the detection and progression monitoring of BC. Additional research is necessary to explore the fundamental mechanisms of the identified VOCs.

Development of a Reference Installation for Metrological Support of the Delta Value Measurements of the Ratio of Carbon and Oxygen Isotopes in Exhaled Air

Breath tests in domestic and foreign medicine are recognized as an effective and safe way to identify pathogens in the gastrointestinal tract, in particular the Helicobacter Pylori bacteria. At the end of the 20th century, a urease breath test was introduced into clinical practice to diagnose diseases of the gastrointestinal tract; it was based on the use of urea labeled with a stable isotope 13C ( 13C-urease breath test). The essence was to measure the delta value of the ratio of carbon and oxygen isotopes in exhaled air.Over decades of clinical practice of using this test, a wealth of experience related to the diagnosis of diseases caused, including by the Helicobacter Pylori bacteria has been accumulated. A significant amount of knowledge has also been accumulated in terms of metrological support of the carbon and oxygen isotope delta in exhaled air.The article describes the procedure and results of developing a development of a measurement standard of carbon and oxygen isotope delta in exhaled air, implemented within the R&amp;D a/c No. «Sistema-2020-М» at the D. I. Mendeleyev Institute for Metrology (VNIIM). The authors presented the theoretical study, test methodology, their sequence and results. The article also contains a report on the international comparisons CCQM-P204 “Isotope ratios of CO2 (δ13VPDB and δ18VPDB) in pure CO2” with the application of the measurement standard developed by VNIIM. The metrological characteristics of the measurement standard obtained during the comparisons correspond to the most accurate measurements of the ratio of carbon and oxygen isotopes, which guarantees the recognition of the measurement results at the international level. Considering the high demand for breath tests in medical practice and obvious prospects of this type of diagnostics, further research will be aimed at creating a State Primary Standard for the delta value unit of the ratio of isotopes of carbon, oxygen, hydrogen based on the created measurement standard and the development of certified reference materials of the ratio of isotopes of carbon, oxygen, hydrogen in liquid, solid, and gaseous media, including for the purpose of replacing foreign-made materials.

Helicobacter pylori infection is a risk factor for constipation in patients with Parkinson's disease: A multicenter prospective cohort study

Background and aimsConstipation is one of the most common nonmotor symptoms (NMSs) of Parkinson's disease (PD). The infection rate of Helicobacter pylori (HP) is greater in PD patients. This study was a multicenter prospective cohort study in which propensity score matching (PSM) was used to determine whether HP infection was a risk factor for constipation in patients with PD. MethodsA total of 932 PD patients with 13C‐urea breath test for HP were included in the study. The PSM was estimated with the use of a nonparsimonious multivariate logistic regression model, with HP infection as the dependent variable and all the baseline characteristics as covariates. A total of 697 patients composed the study cohort, including 252 (36.2 %) patients in the HP-positive (HPP) group and 445 (63.8 %) patients in the HP-negative (HPN) group. Before PSM, there were differences in several of the baseline variables between the two groups. After PSM, 250 HPP patients were matched with 250 HPN patients and the standardized differences were less than 0.1 for all variables. ResultsThe present results demonstrate that HP infection is a risk factor for constipation in patients with PD [RR (95 % CI) 1.412 (1.155–1.727), P < 0.001]. Subgroup analyses revealed that HP infection was both a risk factor for constipation in Hoehn-Yahr scale (1,1.5) group and Hoehn-Yahr scale (2–5) group [OR (95 % CI) 1.811 (1.079–3.038), P < 0.025; OR (95 % CI) 2.041 (1.177–3.541), P < 0.011]. ConclusionsThe results of our prospective cohort study suggest that Helicobacter pylori infection is a risk factor for constipation in patients with PD. Trial registrationChiCTR2300071631.

Predicting Recidivism of Male Offenders with Driving under Influence in a Correctional Setting in Taiwan

Objectives: Alcohol consumption is a public health challenge, contributing to the global burden of diseases and about three million deaths worldwide in 2016. Drunk driving has great morbidity, mortality, and social consequences. In this study, we intended to identify predictors of recidivism among male driving under influence (DUI) offenders and to focus on the interplay between sociodemographic factors, alcohol or tobacco use, and other health risk behaviors. Methods: A cross-sectional questionnaire survey was done in male DUI offenders referred from the Tainan Detention Center, Tainan, Taiwan, between January 2014 and June 2018. We used the Alcohol Use Disorders Identification Test and the Drug-taking Confidence Questionnaire-8 for Alcohol to assess study participants’ alcohol consumption patterns and coping self-efficacy. We also did logistic regression analysis to identify predictors of drunk driving recidivism and to examine factors of sociodemographic characteristics, smoking habits, and other health risk behaviors. Results: The study included 1,435 male participants, with a recidivism rate of 10%. Factors significantly associated with recidivism included lower education levels (p &lt; 0.01), unemployment (p &lt; 0.01), and tobacco use (p &lt; 0.01). The results of logistic regression on those variables showed that tobacco use, odd ratio [OR] (95% confidence interval [CI]) = 11.07 (3.14–39.02), p &lt; 0.01, and unemployed individuals, OR (95% CI) = 6.8 (4.48–10.3), p &lt; 0.01, had significantly higher odds of recidivism. Conclusion: This study identifies key predictors of male DUI recidivism, emphasizing that individuals who are unemployed, with taboo use, and who have lower levels of education are more likely to be recidivists. The recurrence of drunk driving among individuals who also use tobacco suggests that tobacco use might influence the risk of driving under the influence of alcohol, a relationship that warrants further exploration. Recidivist offenders have specific characteristics, indicating that the therapeutic interventions are necessary for considering the circumstances of individual cases.

The Effects of Blenderized Watermelon on Gastrointestinal Comfort, Skin Health, and Breath Tests

The Effects of Blenderized Watermelon on Gastrointestinal Comfort, Skin Health, and Breath Tests

Driver Drowsiness Detection System

Among the leading causes of fatalities in traffic accidents is being sleepy while driving. Long-haul truck drivers, bus or overnight bus drivers, and drivers who operate their cars after midnight are more prone to encounter this issue. Accidents Senger’s worst Every year, car accidents involving drunk drivers result in several fatalities and serious injuries. Due to their enormous practical significance, identifying driver tiredness and its indication are therefore significant study areas. The acquisition system, processing system, and warning system are the three components or modules that make up the fundamental sleepiness detecting apparatus. The acquisition system takes a frontal facial video of the driver's and transmits it to the processing block for real-time analysis to identify weariness.

Short- and long-term reproducibility of body surface gastric mapping using the Gastric Alimetry® system.

Many diagnostic tests for gastroduodenal symptoms, such as gastric emptying scintigraphy (GES), gastric emptying breath tests (GEBT), and electrogastrography (EGG) show variable intra-individual reproducibility over time. This study investigated the short- and long-term reproducibility of body surface gastric mapping (BSGM), a non-invasive test for assessing gastric function, in controls and patients with chronic gastroduodenal disorders. Participants completed three standardized BSGM tests using Gastric Alimetry® (Alimetry, New Zealand). The test encompassed a fasting baseline (30 min), a 482 kCal standard meal, and a 4 h postprandial recording. The first two tests were >6 months apart and the last occurred ~1 week after the second test, to evaluate long and short-term reproducibility. Fourteen patients with upper gastrointestinal symptoms and 14 healthy controls were recruited. There were no significant differences in any BSGM metrics between the tests at short and long term (all p > 0.180). Lin's concordance correlation coefficients (CCC) for the primary metrics were high, ranging from 0.58 to 0.96, with intra-individual coefficients of variance (CVintra) ranging from 0.2% to 1.9%. Reproducibility was higher, and intra-individual variation lower, than in previous studies of GES (CCC = 0.54-0.83, CVintra = 3%-77%), GEBT (CVintra = 8%-11%), and EGG (CVintra = 3%-78%). BSGM spectral metrics demonstrate high reproducibility and low intra-individual variation at both short and long term, with superior results to comparable tests. The high reproducibility of Gastric Alimetry supports its role as a diagnostic aid for gastric dysfunction and a reliable tool for evaluating treatment outcomes and disease progression over time.

Reference Ranges and Comparison of Pepsinogen by Chemiluminescence Immunoassay and Enzyme-Linked Immunosorbent Assay in Chinese Population.

Serum pepsinogen (PG) is a good indicator of atrophic changes in the gastric mucosa. Gastric mucosal atrophy is a high-risk factor for gastric cancer. Serological testing for PG combined with endoscopy can help to improve gastric cancer screening. In this study, we established the reference ranges of serum PG-I, PG-II, and the PG-I/II ratio (PGR) in the Chinese population by chemiluminescence immunoassay (CLIA) and enzyme-linked immunosorbent assay (ELISA). Besides, in the real world, doctors are often confused by the results of different testing platforms. Thus, a comparison of methods CLIA and ELISA was performed. 2904 individuals were enrolled from six regions in China as part of the Chinese Adult Digestive Diseases Surveillance (2016) program. The individuals completed questionnaires and volunteered to undergo examinations, including gastroscopy, urea breath test, abdominal ultrasound examination and routine serologic tests. Serum was collected to measure PGs (including PG-I, PG-II and PGR) by CLIA and ELISA. Participants who were found obvious abnormalities or absent from the examinations were excluded. Ultimately, 747 healthy individuals were enrolled in this study. The Kolmogorov-Smirnov test was used to assess the distribution of variables. The Kruskal-Wallis H or Mann-Whitney U-tests were used to compare different sex, age, and geographical groups. The 95% reference ranges of PGs obtained by the two methods were established according to document CLSI-EP28-A3, with covariates of sex, age, and region. Spearman correlation analysis, linear regression analysis and allowable total error (ATE) zone analysis were utilized for comparing the two methods. On overall, the 95% reference ranges of PG-I, PG-II, and PGR measured by CLIA were 23.00-110.64 ng/mL, 2.50-19.13 ng/mL, and 3.87-13.30, respectively. Meanwhile, the reference ranges of PG-I, PG-II, and PGR measured by ELISA were 36.93-205.06 ng/mL, 1.65-17.96 ng/mL, and 7.50-33.60, respectively. Both PG-I and PG-II levels measured by the two platforms were found to be influenced by sex and age. PGR measured by CLIA was influenced by age but not by sex, while PGR measured by ELISA was not affected by either age or sex. Regional factors did not significantly impact the PG results, except for PG-I detected by ELISA. Ultimately, reference ranges for PGs were established based on age and sex stratification. Additionally, the Spearman correlation analysis revealed that the correlation coefficients for PG-I, PG-II, and PGR detected by the two methods were 0.899, 0.887, and 0.777, respectively, indicating a strong correlation between the two methods. The regression equation for the PG levels detected by two methods was obtained through linear regression analysis. The ATE analysis provided a visual depiction of the consistency between the two methods, clearly indicating the poor agreement between them. This study established the reference ranges of PGs by strict and intact enrollment standard. In addition, the results indicated a strong linear relationship between the two methods, yet with a clear bias, which was valuable for laboratory interpretation.

Effects of fucoidan and synbiotics supplementation during bismuth quadruple therapy of Helicobacter pylori infection on gut microbial homeostasis: an open-label, randomized clinical trial.

The eradication regimen for Helicobacter pylori (H. pylori) infection can induce gut dysbiosis. In this open-label, prospective, and randomized clinical trial, we aimed to assess the effects of fucoidan supplementation on the eradication rate and gut microbial homeostasis in the context of quadruple therapy, as well as to investigate the combined effects of fucoidan and synbiotics supplementations. Eighty patients with H. pylori infection were enrolled and randomly assigned to one of four treatment groups: the QT (a 2-week quadruple therapy alone), QF (quadruple therapy plus a 6-week fucoidan supplementation), QS (quadruple therapy plus a 6-week synbiotics supplementation), and QFS (quadruple therapy with a 6-week fucoidan and synbiotics supplementation), with 20 patients in each group. The QT regimen included rabeprazole, minocycline, amoxicillin, and bismuth potassium citrate. The synbiotics supplementation contained three strains of Bifidobacterium, three strains of Lactobacillus, along with three types of dietary fiber. All of the patients underwent 13C-urea breath test (13C-UBT) at baseline and at the end of the 6th week after the initiation of the interventions. Fresh fecal samples were collected at baseline and at the end of the 6th week for gut microbiota analysis via 16S rRNA gene sequencing. The eradication rates among the four groups showed no significant difference. In the QT group, a significant reduction in α-diversity of gut microbiota diversity and a substantial shift in microbial composition were observed, particularly an increase in Escherichia-Shigella and a decrease in the abundance of genera from the Lachnospiraceae and Ruminococcaceae families. The Simpson index was significantly higher in the QF group than in the QT group. Neither the QS nor QFS groups exhibited significant changes in α-diversity or β-diversity. The QFS group was the only one that did not show a significant increase in the relative abundance of Escherichia-Shigella, and the relative abundance of Klebsiella significantly decreased in this group. The current study provided supporting evidence for the positive role of fucoidan and synbiotics supplementation in the gut microbiota. The combined use of fucoidan and synbioticss might be a promising adjuvant regimen to mitigate gut dysbiosis during H. pylori eradication therapy.

Tetracycline Three Times Daily Versus Four Times Daily in Bismuth-Containing Quadruple Therapy as the First-Line Treatment of Helicobacter pylori Infection: A Multicenter, Noninferiority, Randomized Controlled Trial.

Current guidelines recommend bismuth-containing quadruple therapy for patients newly diagnosed with Helicobacter pylori (H. pylori) infection. We aimed to compare the efficacy and safety of tetracycline administered three times daily versus four times daily in bismuth-containing quadruple therapy for first-line treatment of H. pylori infection. This multicenter, noninferiority, randomized controlled study, conducted in China, recruited treatment-naïve adults with H. pylori infection, randomized 1:1 into two treatment groups to receive either of the following bismuth-containing quadruple therapies: esomeprazole 20 mg twice-daily; bismuth 220 mg twice-daily; amoxicillin 1000 mg twice-daily; and tetracycline 500 mg three times daily (TET-T) versus 500 mg four times daily (TET-F). At least 6 weeks post-treatment, a 13C-urea breath test was performed to evaluate H. pylori eradication. In total, 406 patients were randomly assigned to the two treatment groups. Intention-to-treat eradication rates were 91.63% (186/203; 95% confidence interval [CI] 87.82%-95.44%) versus 90.15% (183/203; 95% CI 86.05%-94.25%) (p = 0.0005) and per-protocol eradication rates were 95.34% (184/193; 95% CI 92.36%-98.31%) versus 95.72% (179/187; 95% CI 92.82%-98.62%) (p = 0.0002) for the TET-T and TET-F group, respectively. TET-T-treated patients had a lower incidence of adverse effects than TET-F-treated patients (21.61% vs. 31.63%, p = 0.024), with no significant differences in compliance to treatment between the groups. As a first-line therapy for H. pylori infection, the eradication rate of the TET-T therapy was noninferior to that of the TET-F therapy while significantly reducing the incidence of adverse reactions. ClinicalTrials.gov identifier: NCT05431075.

EFFECT OF TOBACCO AND ELECTRONIC CIGARETTES ON HEART RATE AND CARDIOVASCULAR SYSTEM IN SMOKERS

Smoking is widespread among the young working population in Russia. Moreover, e-cigarettes are very popular among smokers as an alternative to traditional ones. The purpose of the study was to establish the effect of traditional cigarettes and modern e-cigarettes on the physiological characteristics of smokers, namely young people aged 18–21. Materials and Methods. The study involved young people agd 18–21 with at least 1 year of smoking experience and non-smokers. The trial participants were organized into three groups: a control group (non-smokers) and two experimental groups (traditional cigarette smokers and e-cigarette smokers). The research methods included physical tests, such as a breathing test, pressure measurements at rest, at load and after smoking, and calculation of cardiovascular state parameters. Results. During the experiment, no changes in blood pressure were observed in e-cigarette smokers.In traditional cigarette smokers, an increase in systolic blood pressure was observed at load. However, diastolic blood pressure was normal. It indicated a decrease in the distensibility of arterial vessels. An increase in heart rate was noted in both cigarette and e-cigarette smokers at load and immediately after smoking. The predominance of the sympathetic influence on the cardiovascular system was determined in all trial subjects. The obtained data indicated a violation in cardiovascular system activity in all subjects before and after exercise, and after smoking. At the same time, cardiovascular system activity deteriorated in the experimental groups after smoking. Under normal conditions and after exercise, all trial subjects showed tension in their adaptation mechanisms. After smoking in both experimental groups cardiovascular system adaptation potential was unsatisfactory. Conclusion. An assessment of physical parameters in smokers revealed a negative impact of tobacco and e-cigarettes on the cardiovascular system, namely on heart rate, regulation of cardiovascular system activity, adaptation mechanisms, which was likely to increase with smoking history.

A positive psychology framework for understanding teenage driving behaviors: Examining the role of life purpose and mindfulness

Objective The overwhelming majority of teenage driving research in the US is framed around characteristics associated with risk, rather than factors that promote safety. In this study, we examine the role of purpose in life and mindfulness as two factors that may be associated with safer driving behaviors. Methods Using survey responses from a nationally representative sample of teenagers (aged 16–19) we used structural equation modeling to construct three latent variables – sense of purpose, mindfulness, and risky driving—and evaluate the associations between these latent variables among teenage drivers. Risky driving was based on measures of self-reported distracted driving, drunk driving, driving under the influence of marijuana and other drugs, inconsistent seatbelt use, and riding with an impaired driver. Results We found that sense of purpose and mindfulness were associated with fewer risky driving behaviors. We also identified mindfulness as a mediator between sense of purpose and risky driving. Conclusions Purpose in life and mindfulness are associated with fewer risky driving behaviors among US teenagers. Driver education and training could include components related to purpose and mindfulness, in order to promote safer driving behaviors in this population.

Real-world evidence of a novel tetravalent immunoglobulin Y effectiveness and safety in patients with the refractory Helicobacter pylori infection

BackgroundRefractory Helicobacter pylori (H. pylori) infection inevitably increase the difficulty of drug selection. Here, we described our experience with the use of a novel tetravalent IgY against H. pylori for the treatment of patients with refractory H. pylori infection.MethodsPatients were randomly assigned to receive the standard quadruple therapy (amoxicillin, clarithromycin, omeprazole and bismuth potassium citrate ) for 2 weeks or 250 mg of avian polyclonal IgY orally twice a day for 4 weeks. The binding efficacy of IgY to H. pylori antigens was detected by western blotting13. C-urea breath test was performed to evaluate the eradication therap’s efficacy. The side effects of IgY were evaluated via various routine tests. The questionnaire was used to gather clinical symptoms and adverse reactions.ResultsWestern blot analysis showed that tetravalent IgY simultaneously bind to VacA, HpaA, CagA and UreB of H. pylori. Tetravalent IgY had an eradication rate of 50.74% in patients with refractory H. pylori and an inhibition rate of 50.04% against DOB (delta over baseline) of 13C-urea. The symptom relief rate was 61.76% in thirty-four patients with clinical symptoms, and no adverse reactions were observed during tetravalent IgY treatment period.ConclusionsPolyclonal avian tetravalent IgY reduced H. pylori infection, and showed good efficacy and safety in the treatment of refractory H. pylori infection patients, which represented an effective therapeutic option of choice for patients with refractory H. pylori infection.

Single-Arm, Prospective, Interventional Study of Helicobacter pylori Eradication Rescue Therapy with Rifabutin, Metronidazole, and Vonoprazan.

Background and Objective: Rescue Helicobacter pylori eradication can be challenging. Rifabutin (RBT) demonstrates high activity against Helicobacter pylori and is incorporated into various rescue eradication regimens. This exploratory study was performed to evaluate the efficacy and safety of a rescue regimen comprising RBT, metronidazole (MNZ), and vonoprazan (VPZ). Methods: This prospective, single-center, single-arm, interventional study was performed in Japan. Eligible patients were those who underwent failed primary eradication treatment (7-day treatment with three drugs: VPZ or a proton pump inhibitor [PPI], amoxicillin [AMPC], and clarithromycin) and secondary eradication treatment (7-day treatment with three drugs: VPZ or a PPI, AMPC, and MNZ) and those who were unable to receive first- and second-line therapy because of penicillin allergy. Twenty Helicobacter pylori-positive patients were treated with RBT (150 mg twice daily), MNZ (250 mg twice daily), and VPZ (20 mg twice daily) for 10 days (RBT-MNZ-VPZ therapy). Eradication success was evaluated using the urea breath test. Drug susceptibility test results were available in 16 patients. This study is registered in the Japan Registry of Clinical Trials (jRCT031220504). Results: The intention-to-treat (ITT) and per-protocol (PP) eradication rates of RBT-MNZ-VPZ therapy were 70% (90% confidence interval [CI]: 49.2%-86.0%) and 72.2% (95% CI: 50.2%-88.4%), respectively. In the MNZ-susceptible subgroup, the ITT (n = 8) and PP (n = 7) eradication rates were 100% (90% CI: 68.8%-100%) and 100% (90% CI: 65.2%-100%). In the MNZ-resistant subgroup, the ITT (n = 8) and PP (n = 7) eradication rates were both 62.5% (90% CI: 28.9%-88.9%). All infections were RBT-susceptible. Conclusions: These findings suggest that RBT-MNZ-VPZ therapy may be a promising rescue regimen, especially in MNZ- and RBT-susceptible infections or patients with penicillin allergy.

Determinants of substance use and the impact on mental health status, risky sexual and physical health behaviors among unmarried students

ABSTRACT Objective To assess the prevalence of substance use and its association with other risky behaviors among unmarried male students. Methods This was a cross-sectional study at the University of Nigeria on the use of cigarette, alcohol and psychoactive drugs among students who resided off-campus. Questionnaires were analyzed using SPPS (Version-25). Descriptive statistics were utilized in summarizing the responses. The correlates and predictors of substances use were also determined. Results A total of 491 students participated in the study (response rate = 98.1%). The prevalence of recent use of tobacco, psychoactive drugs, and alcohol was 28.1%, 20.6%, and 46.8% respectively. Also, 13% considered committing suicide, 22.4% were victims of sexual assault, while 56.1% experienced serious injury. Alcohol use (aOR = 0.078, [0.029–0.210], p < 0.001) and driving being drunk (aOR = 0.123, [0.030–0.503], p < 0.001) influenced the current use of tobacco. Previous suicide attempt (aOR = 5.765, [1.148–28.944], p < 0.05) was a predictor of alcohol use. Recent use of psychoactive drugs was influenced by their age and been driven by a drunk driver (p < 0.05). Conclusion Unmarried male students exhibited high prevalence of substance use and other risky health behaviors. These risky substances use practices were also influenced by their age, risky sexual and physical practices induced by alcohol and mental health status.

A qualitative study of the first COVID-19 pandemic lockdown: The impact on alcohol consumption and driving behaviours

COVID-19 influenced life in a multitude of ways beyond immediate health impacts. This included driving behaviours. People drove less often during the early months of the pandemic, yet crash rates increased. There were reports of increased alcohol consumption during this same time which was considered to impact on driving behaviours such as drink driving. This study explores the thoughts and opinions of Queensland, Australian drivers (n = 798) concerning driving behaviours, alcohol consumption, and drink driving behaviours during the early phases of the pandemic (April – August 2020). Participants responded to qualitative questions in online questionnaires over three phases that prompted thoughts in these domains. Bronfenbrenner’s bioecological model was found to explain participants’ comments with the six layers seeming to impact driving, alcohol consumption, and drink driving behaviours. That is, these behaviours were influenced at an individual level (e.g., coping mechanisms), the microsystem level (e.g., reduced opportunities for socialisation), the mesosystem (e.g., work demands impacting family), the exosystem (e.g., large scale random breath testing was suspended and road police deployed to border control), the macrosystem (e.g., Australian drinking culture), and the chronosystem (the pandemic). Understanding the perspectives of individuals during a sudden shift in life caused by COVID-19 highlights the broader impact of the pandemic on people’s behaviours. In addition, this study also provides important insights into the intricacies of driving, drinking and drink driving behaviours. These understandings can inform future research and countermeasures to prevent these risky behaviours.

Antimicrobial susceptibility of clinical Helicobacter pylori isolates and its eradication by standard triple therapy: a study in west central region of Colombia.

The aim of the present study was first to isolate Helicobacter pylori from gastric biopsy specimens and to test their antibiotic susceptibility. Second, it was to evaluate the efficacy of the standard triple therapy from patients of the west central region of Colombia. H. pylori positive patients received standard triple therapy with proton pump inhibitor (PPI) (40 mg b.i.d.), clarithromycin (500 mg b.i.d.), and amoxicillin (1 g b.i.d.) for 14 days. Thereafter, antibiotic susceptibility of the isolates was assessed by E-Test. From 94 patients enrolled, 67 were positive for H. pylori by histology or culture. Overall resistance to metronidazole, levofloxacin, rifampicin, clarithromycin, and amoxicillin was 81%, 26.2%, 23.9%, 19%, and 9.5%, respectively. No resistance was found for tetracycline. A total of 54 patients received standard triple therapy, 48 attended follow-ups testing, and of them, 30 had resistance test reports. Overall eradication rate was 81.2%. Second-line treatment was given to eight patients, four of whom were followed up with a 13C urea breath test (UBT) and remained positive for H. pylori. Eradication was significantly higher in patients with clarithromycin susceptible than in resistant strains (95.6% vs 42.8% P = 0.001). The updated percentages of resistance to clarithromycin in this geographical area had increased, so this value must be considered when choosing the treatment regimen.IMPORTANCEAntibiotic resistance in Helicobacter pylori has increased worldwide, as has resistance to multiple antimicrobials (MDRs), which seriously hampers the successful eradication of the infection. The ideal success rate in eradicating H. pylori infection (≥90%) was not achieved in this study (81.2%). This is the first time that MDR is reported (14.3%) in the region; the resistance to clarithromycin increased over time (3.8%-19%), and levofloxacin (26.2%) and rifampicin (23%) resistant isolates were detected for the first time. With these results, strain susceptibility testing is increasingly important, and the selection of treatment regimen should be based on local antibiotic resistance patterns.