Circulating tumor cells (CTCs) offer tremendous potential for the detection and characterization of cancer. A key challenge for their isolation and subsequent analysis is the extreme rarity of these cells in circulation. Here, a novel label-free method is described to enrich viable CTCs directly from whole blood based on their distinct deformability relative to hematological cells. This mechanism leverages the deformation of single cells through tapered micrometer scale constrictions using oscillatory flow in order to generate a ratcheting effect that produces distinct flow paths for CTCs, leukocytes, and erythrocytes. A label-free separation of circulating tumor cells from whole blood is demonstrated, where target cells can be separated from background cells based on deformability despite their nearly identical size. In doping experiments, this microfluidic device is able to capture >90% of cancer cells from unprocessed whole blood to achieve 10(4) -fold enrichment of target cells relative to leukocytes. In patients with metastatic castration-resistant prostate cancer, where CTCs are not significantly larger than leukocytes, CTCs can be captured based on deformability at 25× greater yield than with the conventional CellSearch system. Finally, the CTCs separated using this approach are collected in suspension and are available for downstream molecular characterization.

Purpose: To investigate the literature on the presence of COVID-19 virus in urine of infected patients and evaluate the attributes and clinical significance of COVID-19 in urine including probability of infection transmission through urine. Data sources: A systematic review of literature from December 2019 to 6 th May 2020 was conducted on Pubmed, google scholar, ovid, scopus and ISI web of science. Study eligibility criteria: Studies which investigated urinary viral shedding of COVID-19 in infected patients were included. Study appraisal and synthesis methods: Two reviewers selected relative studies and performed quality assessment of individual studies. Meta-analysis was performed the pooled case reports and case series. Fixed-effects model was used for analysis as no significant heterogeneity was observed between studies. Results: Thirty three studies were finally included in the systematic review including 12 case reports, 20 case series, and one cohort. Urinary samples from 430 patients were investigated. Ten studies reported the presence of COVID-19 in urinary samples from 16 patients. The rate of COVID-19 presence in urinary samples was 3.7%. Urinary viral load was low in most reports. The presence of virus in urine was not related to the disease course of the illness. Urinary COVID-19 was mostly detected from patients with moderate to severe disease (13 pts) but was also isolated from two children (one neonate and one 7 year-old girl) and one adult with mild disease. The pathogenicity of virus isolated from urine has been demonstrated in cell culture media in one study. Conclusions: This review highlights the low frequency of COVID-19 presence in urine of infected individuals and the potential of isolated virus for cytopathic effects. Therefore the probability of infection transmission through urine can be suggested. Caution must be exerted when dealing with urine of patients infected with COVID-19 including medical interventions like endoscopy and urethral catheterization. : medRxiv preprint ABSTRACT Purpose: To investigate the literature on the presence of COVID-19 virus in urine of infected patients and evaluate the attributes and clinical significance of COVID-19 in urine including probability of infection transmission through urine. Data sources: A systematic review of literature from December 2019 to 6 th May 2020 was conducted on Pubmed, google scholar, ovid, scopus and ISI web of science. Study eligibility criteria: Studies which investigated urinary viral shedding of COVID-19 in infected patients were included. Study appraisal and synthesis methods: Two reviewers selected relative studies and performed quality assessment of individual studies. Meta-analysis was performed the pooled case reports and case series. Fixed-effects model was used for analysis as no significant heterogeneity was observed between studies.Results: Thirty three studies were finally included in the systematic review including 12 case reports, 20 case series, and one cohort. Urinary samples from 430 patients were investigated...

No abstract

Thromboembolic events are common in patients with muscle invasive bladder cancer who undergo neoadjuvant chemotherapy before and after radical cystectomy. Our results suggest that a prospective trial of thromboembolic event prophylaxis during neoadjuvant chemotherapy is warranted.

No abstract