Non-invasive breath collection in murine models using a newly developed sampling device.

Volatile organic compounds (VOCs) in exhaled breath have the potential to be used as biomarkers for screening and diagnosis of diseases. Clinical studies are often complicated by both modifiable and non-modifiable factors influencing the composition of VOCs in exhaled breath. Small laboratory animal studies contribute in obtaining fundamental insight in alterations in VOC composition in exhaled breath and thereby facilitate the design and analysis of clinical research. However, long term animal experiments are often limited by invasive breath collection methods and terminal experiments. To overcome this problem, a novel device was developed for non-invasive breath collection in mice using glass nose-only restrainers thereby omitting the need of anesthetics. C57Bl/6 J mice were used to test reproducibility and different air sampling settings for air-flow (ml min-1) and time (minutes). Exhaled air was collected on desorption tubes and analysed for VOCs by gas chromatography time-of-flight mass spectrometry (GC-tof-MS). In total 27 compounds were putatively identified and used to assess the variability of the VOC measurements in the breath collections. Best reproducibility is obtained when using an air flow of 185 ml min-1and a collection time of 20 min. Due to the non-invasive nature of breath collections in murine models, this device has the potential to facilitate VOC research in relation to disturbed metabolism and or disease pathways.

Breath analysis for the detection of digestive tract malignancies: systematic review.

BACKGROUND: In recent decades there has been growing interest in the use of volatile organic compounds (VOCs) in exhaled breath as biomarkers for the diagnosis of multiple variants of cancer. This review aimed to evaluate the diagnostic accuracy and current status of VOC analysis in exhaled breath for the detection of cancer in the digestive tract. METHODS: PubMed and the Cochrane Library database were searched for VOC analysis studies, in which exhaled air was used to detect gastro-oesophageal, liver, pancreatic, and intestinal cancer in humans, Quality assessment was performed using the QUADAS-2 criteria. Data on diagnostic performance, VOCs with discriminative power, and methodological information were extracted from the included articles. RESULTS: Twenty-three articles were included (gastro-oesophageal cancer n = 14, liver cancer n = 1, pancreatic cancer n = 2, colorectal cancer n = 6). Methodological issues included different modalities of patient preparation and sampling and platform used. The sensitivity and specificity of VOC analysis ranged from 66.7 to 100 per cent and from 48.1 to 97.9 per cent respectively. Owing to heterogeneity of the studies, no pooling of the results could be performed. Of the VOCs found, 32 were identified in more than one study. Nineteen were reported as cancer type-specific, whereas 13 were found in different cancer types. Overall, decanal, nonanal, and acetone were the most frequently identified. CONCLUSION: The literature on VOC analysis has documented a lack of standardization in study designs. Heterogeneity between the studies and insufficient validation of the results make interpretation of the outcomes challenging. To reach clinical applicability, future studies on breath analysis should provide an accurate description of the methodology and validate their findings.

[Implementation of the Perioperative WHO Safety Checklist at a Maximum Care Hospital - A Retrospective Analysis]. / Implementierung der perioperativen WHO-Sicherheitscheckliste an einem Klinikum der Maximalversorgung - eine retrospektive Analyse.

BACKGROUND: In recent years there has been a significant increase of surgical procedures worldwide. Perioperative complication occurred in approximately 10 %, mortality was about 0.5 %. Half of these adverse events were considered to have been preventable. With the introduction of a perioperative checklist by the WHO in 2008, a significant reduction of morbidity and mortality could be achieved. The aim of this study was to investigate the success of the implementation process of the checklist at a maximum care hospital over a three-year period and to expose and analyse any occurring issues. PATIENTS AND METHODS: At various time points (introduction phase, five months, one year and three years after implementation) a total of 358 operations was investigated. First the presence and the handling of the checklist were investigated followed by an analysis of possible influencing factors on the processing. To examine a potential perioperative malpractice, three typical perioperative errors known from the literature on patient safety were analysed. RESULTS: The presence of the checklist improved significantly during the study. With the exception of the first column (signed by ward nurse) the checklist was processed more often among the participants (anaesthesia nurse, anaesthesia physician, surgeon) over the time. However the "sign out" column edited by the surgeon at the end of the operation fell below expectations. In addition to the duration after implementation the level of experience of the surgeon was a relevant factor for a properly completed checklist. During the study a malpractice was found in two cases, a checklist could not be detected. CONCLUSION: Within the study we could demonstrate the difficulties of introducing a surgical checklist at a maximum care hospital. Therefore involved nursing or medical staff must be aware of the usefulness of the checklist and should be motivated to use it. In addition, periodical lectures, training courses and role modelling of nursing and medical staff are required. The objective must be to establish the checklist into daily routine as it is a simple and efficient tool to reduce perioperative morbidity and mortality.

[Anterior lumbar interbody fusion as a treatment for chronic refractory lower back pain in disc degeneration and spondylolisthesis using carbon cages - stand alone]. / Die ventrale Spondylodese (ALIF) mit Carbon-Cages - stand alone - zur Behandlung therapieresistenter Kreuzschmerzen bei lumbaler Bandscheibendegeneration und Spondylolisthese.

We present a series of 22 patients who were treated between 1997 and 2000 for mono- or bisegmental disc degeneration and spondylolisthesis grade I using Brantigan I/F ALIF cages. A ventral approach was chosen and no dorsal instrumentation was performed. Special emphasis was put on the preoperative evaluation of the individual lower back pain and it's causes. At least 5 (average 17,6) months postoperatively patients were questioned regarding the amelioration of lower back pain. Out of these 18, four reported pain reduction as very good, nine as good, four as satisfactory and one patient as worse. Clinical success after 33,4 months (17-56) was defined according to an expanded Prolo scale. The five-point Likert scales for pain, function, economic status, and medication usage were added to a combined 4-20 point scale. There was an improvement observed from 8,0 points to 12,0 points postoperatively. The ascertained 21 patients were in average on regular pain medication according WHO II before surgery, and WHO I postoperatively. Radiological follow up revealed reconstruction of the preoperatively narrowed disc space and a high rate of fusion. Complications were few and will be outlined in detail. Patient acceptance of the anterior approach was high.

Design, synthesis, and structure-activity relationship studies of ATP analogues as DNA gyrase inhibitors.

We report herein the design and synthesis of ATP-analogues, namely 4-amino-pyrazolo[3,4-d]pyrimidines and 4-amino-pyrazolo[1,5-a][1,3,5]triazines, with DNA gyrase inhibitory activity. Among these series, some compounds exhibited promising antibacterial activity.