In the 5 months since initial reports of COVID-19 came to light, the death toll due to SARS-CoV-2 has rapidly increased. The morbidity and mortality of the infection varies based upon patient age, comorbid conditions, viral load, and the availability of effective treatments. Findings from limited autopsies, clinical observations, and laboratory data suggest that high cytokine levels and a procoagulant state can precipitate acute respiratory distress syndrome and multi-organ dysfunction syndrome in critically ill patients. To complicate matters, comorbidities may affect the response to medical treatments currently in use, all of which are still in trial phase. Therapeutic plasma exchange (TPE) merits consideration in the treatment of critically ill COVID-19 patients and is an avenue for clinical trials to pursue. If efficacious, faster recovery of patients may lead to shorter intensive care unit stays and less time on mechanical ventilation. Herein, we briefly discuss some of the various approaches currently being investigated for the treatment of SARS-CoV-2 with a focus on potential benefits of TPE for selected critically ill patients.

This work explores the interface between 3D-printing, material sciences, and microfluidics with electrochemical detection in an undergraduate laboratory. This work includes a module for the characterization and electrochemical analysis of microelectrodes that spans 4 weeks (3 h per week). Laboratory exercises include the fabrication of a 3D-printed device, examination of 3D-printing techniques, scanning electron microscopy (SEM), and electrochemistry. This interdisciplinary curricula exposed students to the process of designing a functioning microfluidic device. Students began by designing the microfluidic chip with AutoDesk Inventor. To gain a better understanding of the microelectrodes utilized in a microfluidic system, students explored the surfaces of various microelectrodes with SEM. On the basis of the visualization of the microelectrodes with SEM, students formed a hypothesis on the impact of electrode surface area on the sensitivity and limit of detection. Cyclic voltammetry in a classical three-electrode system was used to experimentally examine the relationship between electrode surface area and sensitivity. The module concluded with the use of the fabricated 3D-printed chip and amperometry to develop a calibration curve and determination of an unknown concentration of analyte. This work highlights the integration of 3D-printing, SEM, microfluidics, and electrochemistry into the upper-level undergraduate curriculum.

The subsequent yearly decrease in concurrent dispensing prevalence was more than twice as large among young adults (12.83; 95% CI, prescriptions per 1000 enrollees per year) compared with adolescents (5.57; 95% CI, 2.81-8.32 prescriptions per 1000 enrollees per year). For adolescents, prevalence of concomitant benzodiazepine and opioid prescribing was 77.48 (95% CI, 63.39-91.57) prescriptions per 1000 adolescents in 2019.Discussion | The prevalence of dispensed benzodiazepines has been steadily decreasing for adolescents and young adults in a large commercially insured population since 2015 and 2013, respectively. Prevalence of concurrent benzodiazepine and opioid prescriptions has also decreased. These findings are consistent with reports showing declining use of benzodiazepines and opioids among adults. 5,6 We analyzed data from a single insurance provider, which may limit the generalizability of our findings to other patient populations, such as those covered by government insurance plans.Despite recent decreases in the prevalence of dispensed benzodiazepines, dispensing prevalence remained higher in 2019 than in 2008 in both age groups, and, in 2019, 8% of adolescents with a dispensed benzodiazepine prescription also filled an opioid prescription. Furthermore, among adolescents, only approximately one-quarter had a diagnosis corresponding with an approved indication, raising concern for frequent use of benzodiazepines for indications with limited clinical evidence of efficacy. Given the known risks associated with benzodiazepine use, additional efforts are needed to ensure judicious and evidence-based prescribing of benzodiazepines in adolescents and young adults.

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