Complications and pitfalls of lumbar interlaminar and transforaminal epidural injections

Lumbar interlaminar and transforaminal epidural injections are used in the treatment of lumbar radicular pain and other lumbar spinal pain syndromes. Complications from these procedures arise from needle placement and the administration of medication. Potential risks include infection, hematoma, intravascular injection of medication, direct nerve trauma, subdural injection of medication, air embolism, disc entry, urinary retention, radiation exposure, and hypersensitivity reactions. The objective of this article is to review the complications of lumbar interlaminar and transforaminal epidural injections and discuss the potential pitfalls related to these procedures. We performed a comprehensive literature review through a Medline search for relevant case reports, clinical trials, and review articles. Complications from lumbar epidural injections are extremely rare. Most if not all complications can be avoided by careful technique with accurate needle placement, sterile precautions, and a thorough understanding of the relevant anatomy and contrast patterns on fluoroscopic imaging

Evolution of the Southern Annular Mode during the past millennium

International audienceThe Southern Annular Mode (SAM) is the primary pattern of climate variability in the Southern Hemisphere1,2, influencing latitudinal rainfall distribution and temperatures from the subtropics to Antarctica. The positive summer trend in the SAM over recent decades is widely attributed to stratospheric ozone depletion2; however, the brevity of observational records from Antarctica1\textemdashone of the core zones that defines SAM variability\textemdashlimits our understanding of long-term SAM behaviour. Here we reconstruct annual mean changes in the SAM since AD 1000 using, for the first time, proxy records that encompass the full mid-latitude to polar domain across the Drake Passage sector. We find that the SAM has undergone a progressive shift towards its positive phase since the fifteenth century, causing cooling of the main Antarctic continent at the same time that the Antarctic Peninsula has warmed. The positive trend in the SAM since ~AD 1940 is reproduced by multimodel climate simulations forced with rising greenhouse gas levels and later ozone depletion, and the long-term average SAM index is now at its highest level for at least the past 1,000 years. Reconstructed SAM trends before the twentieth century are more prominent than those in radiative-forcing climate experiments and may be associated with a teleconnected response to tropical Pacific climate. Our findings imply that predictions of further greenhouse-driven increases in the SAM over the coming century3 also need to account for the possibility of opposing effects from tropical Pacific climate changes

Can vibrational playback improve control of an invasive stink bug?

Improved understanding of the function of insect vibrational signals has spurred development of a vibrational method for mass-trapping the brown marmorated stink bug, which is currently one of the most notorious invasive insect pests. We outline the ongoing research program, which started with the basic description of close-range sexual behaviour that is mediated by vibrational signals, and continued with testing of a promising female vibrational signal that proved to be considerably attractive to males in playback trials. On this basis, a bi-modal trap was constructed, comprising an aggregation pheromone dispenser, the vibrational signal playback and a device for electrocuting the attracted animals in a pyramid trap design. Preliminary field trial results are discussed in the context of the interplay between chemical and vibrational modalities during reproductive behaviour in stink bugs, and the potential for achieving environmentally friendlier control of this pest