Rivaroxaban for Venous Thromboembolism Prophylaxis in Abdominoplasty: A Multicenter Experience

BACKGROUND: Abdominoplasty, a commonly performed aesthetic procedure, is considered to have an increased risk of venous thromboembolism (VTE) events. At present, routine VTE chemoprophylaxis following abdominoplasty remains controversial. OBJECTIVES: This study evaluates the authors' experience with rivaroxaban, an oral Factor Xa inhibitor, for VTE prophylaxis in abdominoplasty patients. METHODS: A retrospective case series was conducted. All patients who underwent abdominoplasty and received rivaroxaban were included. The prophylactic dose was 10 mg daily for 7 days, beginning 12 hours postoperatively. Patient demographics, comorbidities, and type of surgery were recorded. The primary outcome measured was hematologic complication, including VTE, hematoma requiring operative evacuation, and need for blood transfusion. RESULTS: From September 2012 until July 2014, 132 patients (122 women and 10 men) underwent abdominoplasty surgery and received rivaroxaban postoperatively. Mean patient age was 43.7 years, and mean body mass index was 27.1. One hundred twenty-five patients also underwent abdominal muscle plication. Eleven patients underwent a fleur de lis vertical skin resection component. One hundred patients underwent concomitant abdominal liposuction, while 79 patients also had back liposuction. Only 1 patient had a symptomatic VTE event. Three patients had a hematoma requiring operative evacuation, and all went on to heal without sequelae. Two patients received a blood transfusion for anemia during their course of rivaroxaban. CONCLUSIONS: Oral rivaroxaban administration for chemoprophylaxis in abdominoplasty patients is safe, with low rates of symptomatic VTE and hematoma formation. The authors continue routine use of the medication for patients at increased risk for VTE events. LEVEL OF EVIDENCE 4: Risk

Ribosomal frameshifting and transcriptional slippage: From genetic steganography and cryptography to adventitious use.

Genetic decoding is not 'frozen' as was earlier thought, but dynamic. One facet of this is frameshifting that often results in synthesis of a C-terminal region encoded by a new frame. Ribosomal frameshifting is utilized for the synthesis of additional products, for regulatory purposes and for translational 'correction' of problem or 'savior' indels. Utilization for synthesis of additional products occurs prominently in the decoding of mobile chromosomal element and viral genomes. One class of regulatory frameshifting of stable chromosomal genes governs cellular polyamine levels from yeasts to humans. In many cases of productively utilized frameshifting, the proportion of ribosomes that frameshift at a shift-prone site is enhanced by specific nascent peptide or mRNA context features. Such mRNA signals, which can be 5' or 3' of the shift site or both, can act by pairing with ribosomal RNA or as stem loops or pseudoknots even with one component being 4 kb 3' from the shift site. Transcriptional realignment at slippage-prone sequences also generates productively utilized products encoded trans-frame with respect to the genomic sequence. This too can be enhanced by nucleic acid structure. Together with dynamic codon redefinition, frameshifting is one of the forms of recoding that enriches gene expression.This work was supported by grants from Science Foundation Ireland [12/IP/1492 and 13/1A/1853 to J.F.A; 12/IA/1335 to P.V.B.], US. National Institutes of Health [RO3 MH098688 to J.F.A.], the Wellcome Trust [106207 to A.E.F and 094423 to P.V.B.] and the European Research Council (ERC) grant No. 646891 to A.E.F.]This is the final version of the article. It first appeared from Oxford University Press via https://doi.org/10.1093/nar/gkw53

An Association Between Acute Retinal Necrosis Syndrome and HLA-DQw7 and Phenotype Bw62,DR4

Human leukocyte antigen (HLA) typing was performed on 27 white patients with acute retinal necrosis syndrome. Antigens for the HLA-A, -B, -C, -DR and -DQ loci were determined, and frequencies were compared with racially matched controls. There was a statistically significant increase in the frequency of HLA-DQw7 (11 of 20 [55%] of patients vs 294 of 1546 [19%] of controls, P = .0004, relative risk 5.20) that remained significant at the P = .05 level when the P value was multiplied by the number of antigens tested. The HLA phenotype Bw62,DR4 is also more frequent than in normal control populations (4 of 25 [16%] of patients vs 26 of 1023 [2.6%] of controls, relative risk 7.49). These results support an association between the acute retinal necrosis syndrome and certain HLA specificities and suggest a possible immunogenetic predisposition to the syndrome in some patients

Search for physics beyond the standard model using multilepton signatures in pp collisions at s =\sqrt{s}\ = 7 TeV

A search for physics beyond the standard model in events with at least three leptons and any number of jets is presented. The data sample corresponds to 35 inverse picobarns of integrated luminosity in pp collisions at sqrt(s) = 7 TeV collected by the CMS experiment at the LHC. A number of exclusive multileptonic channels are investigated and standard model backgrounds are suppressed by requiring sufficient missing transverse energy, invariant mass inconsistent with that of the Z boson, or high jet activity. Control samples in data are used to ascertain the robustness of background evaluation techniques and to minimise the reliance on simulation. The observations are consistent with background expectations. These results constrain previously unexplored regions of supersymmetric parameter space