Rivaroxaban or Enoxaparin in Nonmajor Orthopedic Surgery

SPEEDS: A portable serological testing platform for rapid electrochemical detection of SARS-CoV-2 antibodies

The COVID-19 pandemic has resulted in a worldwide health crisis. Rapid diagnosis, new therapeutics and effective vaccines will all be required to stop the spread of COVID-19. Quantitative evaluation of serum antibody levels against the SARS-CoV-2 virus provides a means of monitoring a patient's immune response to a natural viral infection or vaccination, as well as evidence of a prior infection. In this paper, a portable and low-cost electrochemical immunosensor is developed for the rapid and accurate quantification of SARS-CoV-2 serum antibodies. The immunosensor is capable of quantifying the concentrations of immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies against the SARS-CoV-2 spike protein in human serum. For IgG and IgM, it provides measurements in the range of 10.1 ng/mL - 60 μg/mL and 1.64 ng/mL - 50 μg/mL, respectively, both with an assay time of 13 min. We also developed device stabilization and storage strategies to achieve stable performance of the immunosensor over 24-week storage at room temperature. We evaluated the performance of the immunosensor using COVID-19 patient serum samples collected at different time points after symptom onset. The rapid and sensitive detection of IgG and IgM provided by our immunosensor fulfills the need of rapid COVID-19 serological testing for both point-of-care diagnosis and population immunity screening.

The potential of COVID-19 patients' sera to cause antibody-dependent enhancement of infection and IL-6 production

Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many vaccine trials have been initiated. An important goal of vaccination is the development of neutralizing antibody (Ab) against SARS-CoV-2. However, the possible induction of antibody-dependent enhancement (ADE) of infection, which is known for other coronaviruses and dengue virus infections, is a particular concern in vaccine development. Here, we demonstrated that human iPS cell-derived, immortalized, and ACE2- and TMPRSS2-expressing myeloid cell lines are useful as host cells for SARS-CoV-2 infection. The established cell lines were cloned and screened based on their function in terms of susceptibility to SARS-CoV-2-infection or IL-6 productivity. Using the resulting K-ML2 (AT) clone 35 for SARS-CoV-2-infection or its subclone 35–40 for IL-6 productivity, it was possible to evaluate the potential of sera from severe COVID-19 patients to cause ADE and to stimulate IL-6 production upon infection with SARS-CoV-2.

A rare case of pulmonary embolus after arthroscopic meniscus surgery

Although there is consensus that thromboprophylaxis is necessary for major orthopedic surgeries such a joint replacement, there is no widespread consensus on the need for thromboprophylaxis for minor arthroscopic surgery. Here, we present a case of deep vein thrombosis (DVT) and pulmonary embolism (PE) after a common arthroscopic meniscectomy in a healthy 20-year-old female collegiate athlete. The patient had no risk factors except for prior use of combined oral contraceptive pills (COCPs). Twenty hours after an uncomplicated right knee meniscectomy, patient presented to ED with right calf pain and cramping, and DVT was confirmed using ultrasound. One week later, patient presented again to ED with dyspnea and chest pain. PE was diagnosed on CT angiography. Despite the rarity of thromboembolic complications in minor arthroscopy surgery, the broadened use of thromboprophylaxis in patients with even few risk factors could prevent thromboembolic complications from occurring.