Effectiveness of the addition of Lidocaine to a hemostatic, bioresorbable putty in the treatment of iliac crest donor site pain

Background: The harvest of iliac crest bone grafts (ICBG) is associated with relevant donor site pain, but may be lowered by the application of lidocaine loaded on biodegradable, hemostatic putty for sustained local analgesic release. The goal of this double-blind controlled trial was to assess the efficacy of adding lidocaine to a hemostatic putty (Orthostat ™) to treat donor site pain following harvest of ICBG in foot and ankle procedures. Methods: After ICBG harvest during a foot and ankle procedure, the resulting bone defect was either filled with Orthostat™ (n = 7) or with the same hemostatic putty loaded with lidocaine (Orthostat-L™, n = 7). During the first 72 postoperative hours, donor site and surgical site pain were managed by patient controlled morphine delivery and a peripheral nerve block. Donor site pain was periodically quantified on a Visual Analog (VAS) and a Wong Baker FACES scale. Pain scores were plotted over time to calculate the area under the curve (AUC) to quantify the overall pain experienced in specific time intervals. Results: Orthostat-L™ significantly reduced donor site pain over the first 12 hours postoperatively as evidenced by a significant decrease of the AUC in both VAS (p = 0.0366) and Wong Baker FACES pain score plots (p = 0.0024). Cumulated morphine uses were not significantly decreased with Orthostat-L™. Conclusion: The addition of lidocaine to a hemostatic putty offers a significant ICBG donor site pain reduction over the first 12 postoperative hours. Trial registration ClinicalTrials.gov NCT01504035. Registered January 2nd 2012

Cardiomyopathy Associated With Coronary Arteriosclerosis in Free-Ranging Eurasian Lynx (Lynx lynx carpathicus).

The Eurasian lynx (subspecies Lynx lynx carpathicus) was reintroduced to Switzerland in the 1970's. Health monitoring of the reintroduced population started in the late 1980's. Since then, six lynx have been found affected by a myocardial disease. The earliest case was an animal that died after a field anesthesia. Two lynx were found dead, two were euthanized/culled because of disease signs, and one was hit by car. Two had a heart murmur at clinical examination. At necropsy, the first animal showed only lung edema but the other five had cardiomegaly associated with myocardial fibrosis. Three had multisystemic effusions. Histological examination of all six lynx showed mild to severe, multifocal, myocardial interstitial and perivascular fibrosis along with multifocal myocyte degeneration and loss, and replacement fibrosis. Moderate to severe multifocal arteriosclerosis with associated luminal stenosis of the small and medium-sized intramural coronary arteries and the presence of Anitschkow cells was also observed. The heart lesions may have led to sudden death in the first case and to a chronic right-sided heart failure in the remaining. None of the lynx showed lesions or signs suggestive of an acute or subacute infection. Given the common geographic origin of these animals and the severe loss of heterozygocity in this population, a genetic origin of the disease is hypothesized

Situations de violence et migration

La violence ne peut pas être réduite à des faits objectifs ni appréhendée « objectivement », elle relève aussi de la perception et de l’expérimentation qu’en ont et qu’en font les acteurs dans des situations et des contextes. Elle ne peut pas non plus être seulement appréhendée « subjectivement » comme un phénomène subi : dans leur rapport à ce qui est vécu comme violence, les migrants élaborent des stratégies ou des tactiques d’évitement, de protection, pour faire face aux dangers. Sans directement rendre compte des nombreux usages du concept de violence qui, même adjectivé, violence structurelle, violence institutionnelle, violence interpersonnelle, violence raciste, sexiste, classiste, violence physique, psychologique, symbolique, recouvre un large champ de significations, les auteurspubliés dans le dossier « Situations de violence et migration » questionnent l’inhospitalité et les violences qui affligent les mobilités des hommes et des femmes que ce soit par voie terrestre ou par voie maritime. On retrouvera les problématiques d’entrée en migration, les aléas des routes empruntées et les situations plus ou moins durables d’installation. On retrouvera également la question centrale du rôle de l’État et des logiques administratives et de leurs conséquences sur les populations migrantes. Violence cannot be reduced to objective facts or apprehended “objectively”; it also depends on the perception and experimentation ofvarious actors facingmany situations and contexts. Neither can it be understood “subjectively” as a phenomenonedured: in their relation to what is experienced as violence, migrants develop strategies, tactics of avoidance, and ways of protecting themselves to facedangers. Without giving a direct account of the many uses of the concept of violence which, even when adjectival, structural violence, institutional violence, interpersonal violence, racist, sexist, classist, physical, psychological and symbolic violence,covering a wide range of meanings, the authors published in theprevious dossier “Violence and Migration in Contexts”have questioned the inhospitality and violence that afflict the mobility of men and women, whether by land or by sea. We will complete the reflexion, in this file, withthe problems of migrationentries, the hazards of the routes taken and the more or less lasting situations of settlements. The central question of the role of the State and administrative logics and their consequences on migrant populations will also be studied