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IntroductionA new detection model directed at the coordination and simplification of global HIV treatment is described in this paper. It provides both health workers, as well as patients worldwide, with important medical information regarding disease status in real-time, at home. We developed an innovative monitoring technology that significantly streamlines HIV treatment strategies and thus leads to more effective control of HIV infection.Material and methodsThis technology is built around an original BioNanoSensor (BNS) detection device, which utilizes piezoelectric technology to detect and track HIV infection within hours of initial exposure to the virus. The BNS device rapidly, and specifically, detects even low levels of HIV-1 p24 core protein within a small sample.ResultsBNS assays were conducted with small volume samples (10-100μl) in a 10-20mm3 detection chamber, and results were obtained within 5-15 minutes of test initiation. This assay was able to detect of 0.3-3.0 ng/ml of p24 protein, which was validated with a parallel ELISA analysis. These levels are typically observed during the early onset of infection and/or in individuals undergoing HAART therapy.ConclusionsThe BNS assay will provide a specific and personal health profile or health signature of HIV/AIDS patients. The potential applicability of the BNS for use in multiple clinical and point-of-care settings worldwide is considerable. It lowers the cost of HIV detection and treatment as well as significantly improves patients’ quality of life. Finally, this technology will provide a platform for the detection and treatment of numerous other viral infections and health conditions.

Body mass index (BMI) is an easily calculated indicator of a patient’s body mass including muscle mass and body fat percentage and is used to classify patients as underweight or obese. This study is to determine if BMI extremes are associated with increased 28-day mortality and hospital length of stay (LOS) in emergency department (ED) patients presenting with severe sepsis. We performed a retrospective chart review at an urban, level I trauma center of adults admitted with severe sepsis between 1/2005 and 10/2007, and collected socio-demographic variables, comorbidities, initial and most severe vital signs, laboratory values, and infection sources. The primary outcome variables were mortality and LOS. We performed bivariable analysis, logistic regression and restricted cubic spline regression to determine the association between BMI, mortality, and LOS. Amongst 1,191 severe sepsis patients (median age, 57 years; male, 54.7 %; median BMI, 25.1 kg/m2), 28-day mortality was 19.9 % (95 % CI 17.8–22.4) and 60-day mortality was 24.4 % (95 % CI 21.5–26.5). Obese and morbidly obese patients were younger, less severely ill, and more likely to have soft tissue infections. There was no difference in adjusted mortality for underweight patients compared to the normal weight comparator (OR 0.74; CI 0.42–1.39; p = 0.38). The obese and morbidly obese experienced decreased mortality risk, vs. normal BMI; however, after adjustment for baseline characteristics, this was no longer significant (OR 0.66; CI 0.42–1.03; p = 0.06). There was no significant difference in LOS across BMI groups. Neither LOS nor adjusted 28-day mortality was significantly increased or decreased in underweight or obese patients with severe sepsis. Morbidly obese patients may have decreased 28-day mortality, partially due to differences in initial presentation and source of infection. Larger, prospective studies are needed to validate these findings related to BMI extremes in patients with severe sepsis.

Sepsis is a major cause of hospital admissions and mortality. Nevertheless, there are significant gaps in our knowledge of the epidemiology of sepsis in obese people, who now represent more than one-third of the population in the United States. The objective of this study was to measure the association between obesity and mortality from presumed sepsis. A retrospective cohort study was used of 1,779 adult inpatients with presumed sepsis at a Tertiary Care Academic Institution from March 1, 2007 to June 30, 2011. Cases of sepsis were identified using a standardized algorithm for sepsis antibiotic treatment. Exposure (i.e., obesity) was defined as a body mass index ≥30 kg/m(2). Multivariable logistic regression was used to assess the adjusted association between obesity and mortality. Patients with presumed sepsis were of a median age of 60.9 years (interquartile range 49.7-71) and 41.1 % were women. A total of 393 patients died, resulting in a 28-day in-hospital mortality of 22.1 %. In adjusted analysis, obesity was not significantly associated with increased mortality (odds ratio 1.11, 95 % CI 0.85-1.41, P = 0.47). There was also no difference in the in-hospital length of stay (P = 0.45) or maximum percent change in serum creatinine (P = 0.32) between obese and non-obese patients. Finally, there was no difference in the proportion of initial inadequate vancomycin levels (P = 0.1) after presumed sepsis. Obesity was not associated with increased mortality in patients with presumed sepsis. Further research is needed to determine how excess adiposity modulates inflammation from sepsis.