The impact of obesity on ventilator-associated pneumonia, a US nationwide study.

BACKGROUND: Ventilator-associated pneumonia (VAP) is one of the leading causes of mortality in patients with critical care illness. Since obesity is highly prevalent, we wanted to study its impact on the outcomes of patients who develop VAP. METHODS: Using the National Inpatient Sample (NIS) database from 2017 to 2020, we conducted a retrospective study of adult patients with a principal diagnosis of VAP with a secondary diagnosis with or without obesity according to 10th revision of the International Statistical Classification of Diseases (ICD-10) codes. Several demographics, including age, race, and gender, were analyzed. The primary endpoint was mortality, while the secondary endpoints included tracheostomy, length of stay in days, and patient charge in dollars. Multivariate logistic regression model analysis was used to adjust for confounders, with a p-value less than 0.05 considered statistically significant. RESULTS: The study included 3832 patients with VAP, 395 of whom had obesity. The mean age in both groups was around 58 years, and 68% of the group with obesity were females compared to 40% in females in the group without obesity. Statistically significant comorbidities in the obesity group included a Charlson Comorbidity Index score of three and above, diabetes mellitus, hypertension, chronic kidney disease, and sleep apnea. Rates and odds of mortality were not significantly higher in the collective obesity group 39 (10%) vs. 336 (8.5%), p-value 0.62, adjusted odds ratio 1.2, p-value 0.61). The rates and odds of tracheostomy were higher in the obesity group but not statistically significant. Obese patients were also found to have a longer hospitalization. Upon subanalysis of the data, no evidence of racial disparities was found in the care of VAP for both the obese and control groups. CONCLUSIONS: Obesity was not found to be an independent risk factor for worse outcomes in patients who develop VAP in the intensive care unit.

A Molecular Imprinted PEDOT CMOS Chip-Based Biosensor for Carbamazepine Detection.

A miniaturized biosensor for carbamazepine (CBZ) detection and quantification was designed, implemented and fabricated. The 1×1 mm2 CMOS chip was packaged and coupled with a 3-electrode electrochemical cell. A complete characterization of the sensor was conducted via two steps: 1) Molecular imprinting of PEDOT polymer sites by cyclic voltammetry (CV) on glassy carbon electrode (GCE) surfaces; and 2) Quantification of CBZ solutions through both CV, and a current peak detection circuitry. The proposed biosensor offered high-selectivity and high-sensitivity to CBZ molecules. Scanning electron microscopy (SEM) was utilized to validate the synthesis of the PEDOT chains. CBZ removal from the imprinted polymer was conducted through soaking the modified GCEs in acetonitrile (ACN). Extraction was then confirmed by ultraviolet-visible (UV-vis) spectroscopy and CV analyzing data from pre- and post-template extraction. Furthermore, in order to characterize the electrodes' response to CBZ levels in phosphate buffered solution (PBS) with [Fe(CN)6]3-/4- as a redox pair/mediator, CV and peak detection was conducted resulting in redox peak currents vs. CBZ concentration graphs. The limits of detection (LOD) and quantification (LOQ) were calculated to be 2.04 and 6.2 µg/mL respectively. Finally, selectivity towards CBZ was validated by studying the effect of valproic acid (VPA) and phenytoin (PHT) on the biosensor's performance. The proposed biosensor is highly sensitive and selective to CBZ molecules, simple to construct and easy to operate.

Towards an implantable bio-sensor platform for continuous real-time monitoring of anti-epileptic drugs.

The need of continuous real-time monitoring device for in-vivo drug level detection has been widely articulated lately. Such monitoring could guide drug posology and timing of intake, detect low or high drug levels, in order to take adequate measures, and give clinicians a valuable window into patients' health and their response to therapeutics. This paper presents a novel implantable bio-sensor based on impedance measurement capable of continuously monitoring various antiepileptic drug levels. This portable point-of-care microsystem replaces large and stationary conventional macrosystems, and is a one of a kind system designed with an array of electrodes to monitor various anti-epileptic drugs rather than one drug. The micro-system consists of (i) the front-end circuit including an inductive coil to receive energy from an external base station, and to exchange data with the latter; (ii) the power management block; (iii) the readout and control block; and (iv) the biosensor array. The electrical circuitry was designed using the 0.18-um CMOS process technology intended to be miniature and consume ultra-low power.