Evaluation of the relationship between end-tidal carbon dioxide level and heart failure classification.

OBJECTIVE: Heart failure is a disease with cardiac dysfunction, and its morbidity and mortality are associated with the degree of dysfunction. The New York Heart Association classifies the heart failure stages based on the severity of symptoms and physical activity. End-tidal carbon dioxide refers to the level of carbon dioxide that a person exhales with each breath. End-tidal carbon dioxide levels can be used in many clinical conditions such as heart failure, asthma, and chronic obstructive pulmonary disease. The aim of the study was to reveal the relationship between end-tidal carbon dioxide levels and the New York Heart Association classification of heart failure stages. METHODS: This study was conducted at Kahramanmaras Sütçü Imam University Faculty of Medicine Adult Emergency Department between 01/03/2019 and 01/09/2019. A total of 80 patients who presented to the emergency department with a history of heart failure or were diagnosed with heart failure during admission were grouped according to the New York Heart Association classification of heart failure stages. The laboratory parameters, ejection fraction values, and end-tidal carbon dioxide levels of the patients were measured and recorded in the study forms. RESULTS: End-tidal carbon dioxide levels and ejection fraction values were found to be significantly lower in the stage 4 group compared to the other groups. Furthermore, pro-B-type natriuretic peptide (BNP) values were found to be significantly higher in stage 4 group compared to the other groups. CONCLUSION: It was concluded that end-tidal carbon dioxide levels could be used together with pro-BNP and ejection fraction values in determining the severity of heart failure.

Diagnostic Methods for Helicobacter pylori.

Helicobacter pylori infection is a significant global health concern. It cannot be diagnosed based solely on the patient's medical history and symptoms, and laboratory and imaging tests are often required to confirm the diagnosis. Both noninvasive and invasive methods are available for diagnosing H. pylori infection, including conventional and advanced detection techniques. It is not uncommon for patients to present with false-negative results due to the use of inadequate investigation methodologies, which prevents the adoption of appropriate clinical management. Thus, an analysis of the literature regarding the methods of diagnosis of H. pylori, with its advantages and disadvantages, is necessary. Publications in specialized scientific journals will undoubtedly contribute to facilitating access by professionals interested in the topic providing greater knowledge and potentially clinically useful guidance. In this review, the authors have sought to analyze and summarize the invasive and noninvasive methods, their applications, limitations, and the conditions that affect the sensitivity of the tests used for diagnosing H. pylori, an essential step for the successful treatment of this infection. It is essential to treat all patients infected with H. pylori. This represents a significant change in the approach, as the treatment was recommended previously only for patients showing symptoms of infection. Therefore, it is crucial to understand the limitations of traditional diagnostic methods and help raise awareness among healthcare professionals about the latest advances in diagnosing this important bacterium.

Urea breath test for Helicobacter pylori infection in adult dyspeptic patients: A meta-analysis of diagnostic test accuracy.

BACKGROUND: Helicobacter pylori (H. pylori) infection has been well-established as a significant risk factor for several gastrointestinal disorders. The urea breath test (UBT) has emerged as a leading non-invasive method for detecting H. pylori. Despite numerous studies confirming its substantial accuracy, the reliability of UBT results is often compromised by inherent limitations. These findings underscore the need for a rigorous statistical synthesis to clarify and reconcile the diagnostic accuracy of the UBT for the diagnosis of H. pylori infection. AIM: To determine and compare the diagnostic accuracy of 13C-UBT and 14C-UBT for H. pylori infection in adult patients with dyspepsia. METHODS: We conducted an independent search of the PubMed/MEDLINE, EMBASE, and Cochrane Central databases until April 2022. Our search included diagnostic accuracy studies that evaluated at least one of the index tests (13C-UBT or 14C-UBT) against a reference standard. We used the QUADAS-2 tool to assess the methodological quality of the studies. We utilized the bivariate random-effects model to calculate sensitivity, specificity, positive and negative test likelihood ratios (LR+ and LR-), as well as the diagnostic odds ratio (DOR), and their 95% confidence intervals. We conducted subgroup analyses based on urea dosing, time after urea administration, and assessment technique. To investigate a possible threshold effect, we conducted Spearman correlation analysis, and we generated summary receiver operating characteristic (SROC) curves to assess heterogeneity. Finally, we visually inspected a funnel plot and used Egger's test to evaluate publication bias. RESULTS: The titles and abstracts of 4621 studies were screened; 79 articles were retrieved and selected for full-text reading. Finally, 60 studies were included in the diagnostic test accuracy meta-analysis. Our analysis demonstrates superior diagnostic accuracy of 13C-UBT over 14C-UBT, indicated by higher sensitivity (96.60% vs 96.15%), specificity (96.93% vs 89.84%), likelihood ratios (LR+ 22.00 vs 10.10; LR- 0.05 vs 0.06), and area under the curve (AUC; 0.979 vs 0.968). Notably, 13C-UBT's DOR (586.47) significantly outperforms 14C-UBT (DOR 226.50), making it the preferred diagnostic tool for dyspeptic individuals with H. pylori infection. Correlation analysis revealed no threshold effect (13C-UBT: r = 0.48; 14C-UBT: r = -0.01), and SROC curves showed consistent accuracy. Both 13C-UBT and 14C-UBT showed high AUC values (13C-UBT 0.979; 14C-UBT 0.968) near 1.00, reinforcing their excellent accuracy and endorsing both as reliable diagnostic tools in clinical practice. CONCLUSION: In summary, our study has demonstrated that 13C-UBT has been found to outperform the 14C-UBT, making it the preferred diagnostic approach. Additionally, our results emphasize the significance of carefully considering urea dosage, assessment timing, and measurement techniques for both tests to enhance diagnostic precision. Nevertheless, it is crucial for researchers and clinicians to evaluate the strengths and limitations of our findings before implementing them in practice.

Noninvasive Diabetes Detection through Human Breath Using TinyML-Powered E-Nose.

Volatile organic compounds (VOCs) in exhaled human breath serve as pivotal biomarkers for disease identification and medical diagnostics. In the context of diabetes mellitus, the noninvasive detection of acetone, a primary biomarker using electronic noses (e-noses), has gained significant attention. However, employing e-noses requires pre-trained algorithms for precise diabetes detection, often requiring a computer with a programming environment to classify newly acquired data. This study focuses on the development of an embedded system integrating Tiny Machine Learning (TinyML) and an e-nose equipped with Metal Oxide Semiconductor (MOS) sensors for real-time diabetes detection. The study encompassed 44 individuals, comprising 22 healthy individuals and 22 diagnosed with various types of diabetes mellitus. Test results highlight the XGBoost Machine Learning algorithm's achievement of 95% detection accuracy. Additionally, the integration of deep learning algorithms, particularly deep neural networks (DNNs) and one-dimensional convolutional neural network (1D-CNN), yielded a detection efficacy of 94.44%. These outcomes underscore the potency of combining e-noses with TinyML in embedded systems, offering a noninvasive approach for diabetes mellitus detection.

Exhaled breath condensate analysis in horses: A scoping review.

Exhaled breath condensate (EBC) collection is a non-invasive sampling method that provides valuable information regarding the health status of the respiratory system by measuring inflammatory mediators, such as pH, hydrogen peroxide, and leukotriene B4. This scoping review aimed to provide an update on the collection and analysis of EBC in horses. A systematic search of three electronic databases, PubMed, Google Scholar, Science Direct, identified 40,978 articles, of which 1590 duplicates were excluded. Moreover, 39,388 articles were excluded because of irrelevance to this review, such as studies on other species, studies on respiratory exhalation, reviews, and theses. Finally, we evaluated 14 articles in this review. Our review revealed significant differences in the collection, storage, and processing of EBC samples, emphasizing the need for standardizing the technique and using specific equipment to improve the interpretation of the results.

Serum interleukin-33 combined with FEF75% z-score and FeNO improves the diagnostic accuracy of asthma in children.

OBJECTIVE: To investigate the diagnostic efficacy of serum IL-33 single indicator and combined indicators for asthma in children. METHODS: 132 children were initially diagnosed with asthma during acute exacerbation and 100 healthy children were included. Serum IL-33 concentration differences were compared between asthmatic and normal children. Correlations between IL-33 with pulmonary function parameters, FeNO, peripheral blood EOS counts and serum total IgE were analyzed in asthmatic children. ROC curves were used to assess IL-33 diagnostic efficacy and its combined indicators. To prevent overfitting of the predictive model, the hold-out cross-validation method was used. RESULTS: (1) Serum IL-33 concentrations were significantly higher in children with asthma than in normal children (p < 0.001). (2) IL-33 concentration was negatively correlated with FVC z-score, FEV1 z-score and FEF75% z-score in asthmatic children (p < 0.05). (3) The area under the ROC curve of IL-33 was 0.821, which was higher than those of FeNO, FVC z-score, and FEV1 z-score. (4) Cross-validation of the combined indicators showed that IL-33 significantly improved asthma diagnostic efficacy. The combination of IL-33, FEF75% z-score, and FeNO showed the highest diagnostic efficacy, with the AUC, sensitivity, and specificity of the combined indicator being 0.954, 90.1%, and 89. 0%, respectively, and good extrapolation of the predictive model. CONCLUSION: Serum IL-33 is higher in children with asthma and increases with the severity of pulmonary ventilation obstruction. A single indicator of serum IL-33 demonstrates moderate diagnostic accuracy, and its combination with FEF75% z-score and FeNO significantly improves the diagnostic accuracy in childhood asthma.

The accuracy of an electronic nose to diagnose tuberculosis in patients referred to an expert centre.

INTRODUCTION: An electronic nose (eNose) device has shown a high specificity and sensitivity to diagnose or rule out tuberculosis (TB) in the past. The aim of this study was to evaluate its performance in patients referred to INERAM. METHODS: Patients aged ≥15 years were included. A history, physical examination, chest radiography (CRX) and microbiological evaluation of a sputum sample were performed in all participants, as well as a 5-minute breath test with the eNose. TB diagnosis was preferably established by the gold standard and compared to the eNose predictions. Univariate and multivariate logistic regression analyses were performed to assess potential risk factors for erroneous classification results by the eNose. RESULTS: 107 participants with signs and symptoms of TB were enrolled of which 91 (85.0%) were diagnosed with TB. The blind eNose predictions resulted in an accuracy of 50%; a sensitivity of 52.3% (CI 95%: 39.6-64.7%) and a specificity of 36.4% (CI 95%: 12.4-68.4%). Risk factors for erroneous classifications by the eNose were older age (multivariate analysis: OR 1.55, 95% CI 1.10-2.18, p = 0.012) and antibiotic use (multivariate analysis: OR 3.19, 95% CI 1.06-9.66, p = 0.040). CONCLUSION: In this study, the accuracy of the eNose to diagnose TB in a tertiary referral hospital was only 50%. The use of antibiotics and older age represent important factors negatively influencing the diagnostic accuracy of the eNose. Therefore, its use should probably be restricted to screening in high-risk communities in less complex healthcare settings.

Determination of global chemical patterns in exhaled breath for the discrimination of lung damage in postCOVID patients using olfactory technology.

The objective of this work was to evaluate the use of an electronic nose and chemometric analysis to discriminate global patterns of volatile organic compounds (VOCs) in breath of postCOVID syndrome patients with pulmonary sequelae. A cross-sectional study was performed in two groups, the group 1 were subjects recovered from COVID-19 without lung damage and the group 2 were subjects recovered from COVID-19 with impaired lung function. The VOCs analysis was executed using a Cyranose 320 electronic nose with 32 sensors, applying principal component analysis (PCA), Partial Least Square-Discriminant Analysis, random forest, canonical discriminant analysis (CAP) and the diagnostic power of the test was evaluated using the ROC (Receiver Operating Characteristic) curve. A total of 228 participants were obtained, for the postCOVID group there are 157 and 71 for the control group, the chemometric analysis results indicate in the PCA an 84% explanation of the variability between the groups, the PLS-DA indicates an observable separation between the groups and 10 sensors related to this separation, by random forest, a classification error was obtained for the control group of 0.090 and for the postCOVID group of 0.088 correct classification. The CAP model showed 83.8% of correct classification and the external validation of the model showed 80.1% of correct classification. Sensitivity and specificity reached 88.9% (73.9%-96.9%) and 96.9% (83.7%-99.9%) respectively. It is considered that this technology can be used to establish the starting point in the evaluation of lung damage in postCOVID patients with pulmonary sequelae.

Aplicación de modelos metabolómicos para la identificación de EPOC en poblaciones expuestas a humo de leña en una comunidad indígena de México / Application of metabolomic models for the identificaron of coPD in populations exposed to wood smoke in an indigenous community in Mexico

Resumen Propósito: Para la evaluación metabólica de la fisiopatología pulmonar se utiliza principalmente el aliento exhalado, el cual ha tomado una gran relevancia como método de diagnóstico no invasivo, de bajo costo, rápido y seguro. El objetivo del presente estudio fue aplicar modelos metabolómicos para la identificación de la Enfermedad Pulmonar Obstructiva Crónica (EPOC) en población vulnerable expuesta a la quema de biomasa en una comunidad indígena de México. Métodos: El estudio se conformó por 142 participantes, 44 pacientes con EPOC asociado a la quema de biomasa, 60 controles y 38 población indígena expuesta a la quema de biomasa (PIE). Las muestras de aliento exhalado se analizaron mediante una nariz electrónica (HERACLES II, Alpha MOS). Con los datos obtenidos se realizó un Análisis Canónico de Coordenadas principales (CAP), que fue utilizado para la predicción de EPOC de la PIE y se determinó la concentración de 1-hidroxipireno (1-OHP) en muestras de orina. Resultados: Se logró identificar un total 59 COVs en las muestras de aliento exhalado de los grupos de estudio, los cuales se utilizaron para establecer un modelo de discriminación entre la huella química del grupo de pacientes con EPOC y el grupo control. El modelo CAP indicó una separación entre las huellas químicas de los pacientes con EPOC y sujetos sanos, con una correcta predicción de 91,34%, con una sensibilidad y especificidad de 93,2 y 96,7% respectivamente. Se encontraron 10 participantes de la PIE con patrón obstructivo y una alta concentración de 1-OHP, determinando que existe una concentración del 1,31 ± 0,67gg/mol de creatinina. Esta concentración se encuentra más de 5 veces arriba de los valores de referencia establecidos en el 2001, que es de 0,24 gg/mol de creatinina. Al comparar los resultados de la huella química de la PIE se posicionó en el grupo de EPOC. Conclusión: Se logró obtener un diagnóstico oportuno en población vulnerable mediante el uso de la metabolómica y se demostró la exposición y los efectos pulmonares en población indígena de San Luis Potosí.

Abstract Purpose: to evaluate metabolic disorders of the pathophysiology of the lung, the exhaled breath is mainly used, this has become highly relevant as a non-invasive, low-cost, fast and safe diagnostic method. The objective of this study is to apply metabolomic models for the identification of Chronic Obstructive Pulmonary Disease (COPD) in a vulnerable population exposed to biomass burning in an indigenous community in Mexico. Methods: The study consisted of 142 participants, 44 patients with COPD associated with biomass burning, 60 controls and 38 indigenous population exposed to biomass burning (PIE). Exhaled breath samples were analyzed using an electronic nose (HERACLES II, Alpha MOS). With the data obtained, a Canonical Analy-sis of Principal Coordinates (CAP) was performed, which was used for the prediction of COPD of IEP and the concentration of 1-hydroxypyrene (1-OHP) in urine samples was determined. Results: A total of 59 VOCs were identified in the exhaled breath samples of the study groups, which were used to establish a discrimination model between the chemical fingerprint of the COPD patient group and the control group. The CAP model indicated a separation between the chemical fingerprints of COPD patients and healthy subjects, with a correct prediction of 91,34%, with a sensitivity and specificity of 93,2 and 96,7%, respectively. 10 IEP participants with an obstructive pattern and a high concentration of 1-OHP were found, determining that there is a concentration of 1,31 ± 0,67gg/mol of creatinine. This concentration is more than 5 times above the reference values established in 2001, which is 0,24 -jg/mol of creatinine. When comparing the results of the Chemical fingerprint of the PIE, it was positioned in the COPD group. Conclusion: It was possible to obtain an opportune diagnosis in a vulnerable population using metabolomics and exposure and pulmonary effects were demonstrated in the indigenous population of San Luis Potosí.

[Evaluation of a carbon 13 breath test for the diagnosis of Helicobacter pylori]. / Evaluación de un test del aliento con carbono 13 para el diagnóstico de Helicobacter pylori.

OBJECTIVE: To evaluate a Chinese-made carbon-13 breath test as a non-invasive diagnostic method for Hp infection in the Peruvian population through the determination of sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, and diagnostic utility. MATERIALS AND METHODS: A cross-sectional and descriptive study was carried out on a secondary database of the Gastroenterology Service of the Cayetano Heredia Hospital and Cayetano Heredia Clinic from November 2017 to August 2018. Patients over 18 years of age who underwent endoscopy were included upper digestive. RESULTS: A sensitivity of 90.3% (95% CI 0.81-0.96), a specificity of 82.5% (95% CI 0.67-0.93), a positive predictive value was found and negative of 90.3% and 82.5%, and positive and negative likelihood ratio of 5.16 and 0.12, respectively. The area under the ROC curve was 0.88 (95% CI: 0.80-0.96). CONCLUSIONS: The carbon 13 breath test is a non-invasive and simple test that provides results quickly. However, it is not possible to recommend the routine use of this test due to the discrepancy between the international and local results obtained. Studies with larger sample sizes, standardized protocols and different manufacturers are suggested to evaluate their performance and characteristics.

Analysis of the Budget Impact of Fractional Exhaled Nitric Oxide Monitoring in the Management of Childhood Asthma: The Colombian National Health System Perspective.

BACKGROUND: Fractional exhaled nitric oxide (FeNO) testing is a simple, noninvasive approach to assessing airway inflammation with minimal discomfort that provides results within a few minutes. For policy makers, the economic impact of this technology is the main concern, especially in developing countries. We evaluated the budget impact of asthma management using FeNO monitoring in patients aged between 4 and 18 years in Colombia. METHODS: A budget impact analysis was performed to evaluate the potential cost of FeNO monitoring. The analysis was based on a 5-year time horizon and performed from the perspective of the Colombian National Health System. The incremental budget impact was calculated by subtracting the cost of the new treatment, in which FeNO is reimbursed, from the cost of conventional treatment without FeNO (management based on clinical symptoms [with or without spirometry/peak flow] or asthma guidelines [or both] for asthma-related cases). Univariate 1-way sensitivity analyses were performed. RESULTS: In the base case analysis the 5-year costs associated with FeNO and non-FeNO were estimated to be €469 904 130 and €480 485 149, respectively, indicating savings for the Colombian National Health System of €10 581 019 if FeNO is adopted for the routine management of patients with persistent asthma. This result proved to be robust in the univariate 1-way sensitivity analysis. CONCLUSION: FeNO monitoring generated cost savings in emergency settings for infants with persistent asthma. This evidence can be used by decision makers in Colombia to improve clinical practice guidelines and should be replicated to validate the results in other middle-income countries.

Photoacoustic detection of ammonia exhaled by individuals with chronic kidney disease.

Ammonia (NH3) has been reported as a breath biomarker for chronic kidney disease (CKD) usually detected at concentrations greater than 0.25 parts per million by volume (ppmV). NH3 was detected in breath of individuals with CKD through gaseous photoacoustic spectroscopy (PAS). The efficiency of hemodialysis (HD) was demonstrated. Eight volunteers aged between 20 and 60 years and without previous respiratory disease were eligible, among which six were control volunteers (CV) and two volunteers with advanced CKD, named CKDV1 and CKDV2. The presence of CKD was confirmed by the calculation of creatinine clearance (CC) according to the Cockcroft-Gault equation. Before HD, the mean NH3 concentration exhaled by CKDV1 was 0.9 ± 0.1 ppmV and after HD was 0.20 ± 0.03 ppmV, which demonstrated an efficiency of 76% NH3 reduction in breath. The CKDV2 exhaled 1.27 ± 0.03 ppmV of NH3 pre-HD and 0.42 ± 0.08 ppmV post-HD, which resulted in efficiency of about 67%. It was not possible to quantify NH3 from CV, what led us to infer that all of them exhaled amounts below the detection limit, i.e., 0.20 ppmV. This assumption is underpinned by CC, whose values hovered at 90 ≤ CC ≤ 120 mL/ min, confirming normal renal function.

Accuracy of a portable breath meter test for the detection of halitosis in children and adolescents.

OBJECTIVES: This study aimed to determine the accuracy of the Breath-Alert™ portable breath meter (BA) for the detection of halitosis in children and adolescents, considering the organoleptic test (OT) as the gold standard in this assessment. METHODS: A cross-sectional study was conducted on 150 children (aged 6-12 years). OT was performed by three independent examiners on a single occasion, obtaining three scores of 0-5 points on the Rosenberg's organoleptic scale. The median of the three evaluations for each child was used for analysis. BA was used according to the manufacturer's instructions, with breath odor scored from 0-5 points. Scores ≥2 on both tests were considered indicative of halitosis. RESULTS: A total of 26 (17.3%) and 23 (15.3%) children were detected with halitosis on the OT and BA tests, respectively. The sensitivity and specificity of the BA scores for the detection of halitosis were 80.76% and 98.38%, respectively. The positive and negative predictive values for BA were 91.3% and 96.06%, respectively. CONCLUSION: In the present study involving children, who require fast, practical examinations, BA proved to be an auxiliary tool to OT for the detection of halitosis in the practice of pediatric dentistry, demonstrating high sensitivity and specificity.

Identification of profiles of volatile organic compounds in exhaled breath by means of an electronic nose as a proposal for a screening method for breast cancer: a case-control study.

The objective of the present study was to identify volatile prints from exhaled breath, termed breath-print, from breast cancer (BC) patients and healthy women by means of an electronic nose and to evaluate its potential use as a screening method. A cross-sectional study was performed on 443 exhaled breath samples from women, of whom 262 had been diagnosed with BC by biopsy and 181 were healthy women (control group). Breath-print analysis was performed utilizing the Cyranose 320 electronic nose. Group data were evaluated by principal component analysis (PCA), canonical discriminant analysis (CDA), and support vector machine (SVM), and the test's diagnostic power was evaluated by means of receiver operating characteristic (ROC) curves. The results obtained using the model generated from the CDA, which best describes the behavior of the assessed groups, indicated that the breath-print of BC patients was different from that of healthy women and that they presented with a variability of up to 98.8% and a correct classification of 98%. The sensitivity, specificity, negative predictive value, and positive predictive value reached 100% according to the ROC curve. The present study demonstrates the capability of the electronic nose to separate between healthy subjects and BC patients. This research could have a beneficial impact on clinical practice as we consider that this test could probably be used at the first point before the application of established gold tests (mammography, ultrasound, and biopsy) and substantially improve screening tests in the general population.

Identification of breath-prints for the COPD detection associated with smoking and household air pollution by electronic nose.

PURPOSE: The analysis of breath-print, has been proposed as an attractive alternative to investigate possible biomarkers of Chronic Obstructive Pulmonary Disease (COPD). The aim of the present study was to discriminate between healthy subjects, patients with COPD associated with smoking (COPD-S) and patients with COPD associated with household air pollution (COPD-HAP). METHODS: A cross-sectional study of 294 participants was conducted, 88 with smoking associated COPD, 28 associated with HAP and 178 healthy subjects. Breath-print analysis was performed by using the Cyranose 320 electronic nose. Group data were evaluated by Principal Component Analysis (PCA), Canonical Discriminant Analysis (CDA) and Support Vector Machine (SVM) and the test's diagnostic power by means of ROC (Receiver Operating Characteristic) curves. RESULTS: The results indicated that the breath-print of patients with COPD is different from the one of healthy subjects explaining a variability of 93.8% with a correct prediction of 97.8% and correct classification of 100%,also positive and negative predictive value of 96.5 and 100% respectively. Furthermore, the breath-print of exhaled breath from patients with COPD-S and COPD-HAP does not present any difference. CONCLUSIONS: The breath-print of exhaled breath from patients with COPD-S and COPD-HAP does not present any difference, which demonstrates that the breath-print is related to the disease and not to causality. With these results, the analysis of the breath-print of COPD is proposed as an alternative for a screening method in future clinical applications.

THE IMPACT OF SMALL INTESTINAL BACTERIAL OVERGROWTH ON THE GROWTH OF CHILDREN AND ADOLESCENTS.

OBJECTIVE: To evaluate the association between small intestinal bacterial overgrowth (SIBO) and weight and height impairment in children and adolescents with gastroenterology diseases. METHODS: Observational and retrospective study. All 162 patients aged less than 19 years old who underwent breath test in search of SIBO between 2011 and 2016 were studied. Breath test was collected after the intake of 10 grams of lactulose. The concentration of hydrogen and methane was measured for 180 minutes after the beginning of the test by 12i QuinTronMicroLyzer device. RESULTS: SIBO was identified in 51 (31.5%) patients. There was no difference between the age of those with (mean=8.7y.o; 25th and 75th percentile: 4.6 and 11.3) and without (mean=7.9y.o 25th and 75th percentile: 4.8 and 12.2) SIBO (p=0.910). There was no association between gender and SIBO (male 26.3% vs. female 36.3%, p=1.00). A lower median of height-for-age Z score (mean=-1.32; 25th and 75th percentile: -2.12 and -0.08 vs. mean=-0.59; 25th and 75th percentile: -1.57 and 0.22; p=0.04) was demonstrated in children with SIBO when compared with children without it. There was no difference between the BMI-for-age Z score of patients with (mean=-0.48) and without SIBO (mean=-0.06) (p=0.106). The BMI of patients with SIBO (median=15.39) was lower than of those without it (median=16.06); however, the statistical analysis was not significant (p=0.052). The weight-for-age Z score was lower in patients with SIBO (mean=-0.96) than in those without SIBO (mean=-0.22) (p=0.02). CONCLUSIONS: Children and adolescents with SBIO associated with diseases of the gastrointestinal tract have lower weight and height values.

Accuracy of a portable breath meter test for the detection of halitosis in children and adolescents

OBJECTIVES: This study aimed to determine the accuracy of the Breath-Alert™ portable breath meter (BA) for the detection of halitosis in children and adolescents, considering the organoleptic test (OT) as the gold standard in this assessment. METHODS: A cross-sectional study was conducted on 150 children (aged 6-12 years). OT was performed by three independent examiners on a single occasion, obtaining three scores of 0-5 points on the Rosenberg's organoleptic scale. The median of the three evaluations for each child was used for analysis. BA was used according to the manufacturer's instructions, with breath odor scored from 0-5 points. Scores ≥2 on both tests were considered indicative of halitosis. RESULTS: A total of 26 (17.3%) and 23 (15.3%) children were detected with halitosis on the OT and BA tests, respectively. The sensitivity and specificity of the BA scores for the detection of halitosis were 80.76% and 98.38%, respectively. The positive and negative predictive values for BA were 91.3% and 96.06%, respectively. CONCLUSION: In the present study involving children, who require fast, practical examinations, BA proved to be an auxiliary tool to OT for the detection of halitosis in the practice of pediatric dentistry, demonstrating high sensitivity and specificity.