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Identification of volatile organic compounds in breath associated with liver disease and their potential applications for medical use

Fernández del Río, Raquel (2017)
Ph.D. thesis, University of Birmingham.

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Proton Transfer Reaction Mass Spectrometry (PTR-MS) was applied to determine which volatile organic compounds in breath are associated with cirrhosis and hence diagnostically useful. A two-stage biomarker procedure was used. In the first-stage, alveolar breath samples of 31 cirrhotic patients and 30 controls were analysed and compared. In the second-stage, 12 of the patients had their breath analysed after liver transplant.
The first-stage study showed that seven volatiles were elevated in patients’ breath compared to controls. Of these, limonene, methanol, 2-pentanone showed a statistically significant decrease post-transplant and hence can unequivocally be used as biomarkers for chronic liver disease. Limonene which is not produced in the body showed washout characteristics and the best diagnostic capability. These findings suggest that limonene, methanol and 2-pentanone are potential biomarkers for early-stage liver disease.
Limonene was detected in higher levels in patients with symptoms of hepatic encephalopathy (HE) in comparison to those with no symptoms. Limonene discriminates patients suffering from HE, but not methanol or 2-pentanone.
The elimination characteristics of post-operative isoflurane levels in breath of 5 patients were investigated. High concentrations of isoflurane remained in their breath for several weeks. This study raises the question about the effect of isoflurane in the neurocognitive function of patients after major surgery.

Type of Work:Ph.D. thesis.
Supervisor(s):Mayhew, Christopher
School/Faculty:Colleges (2008 onwards) > College of Engineering & Physical Sciences
Department:School of Physics and Astronomy
Additional Information:

Redacted contacts in appendix V and faces in figure 3.11

Subjects:QC Physics
RC Internal medicine
Institution:University of Birmingham
ID Code:7742
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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