[Local administration of amphotericin B by VAC instillation: Therapeutic aid in the treatment of mucormycosis]. / Application locale d'amphotéricine B par VAC instillation : aide thérapeutique dans le traitement de la mucormycose.

Mucormycosis is a rare and serious fungal infection, occurring mainly in immunocompromised, diabetic, polytrauma or burn patients. Current standard treatments include iterative carcinological surgical trimming, systemic treatment with liposomal amphotericin B and second-line Posaconazole or Isavuconazole. We report the case of a 37-year-old female patient with no previous medical history who developed a disseminated mucormycosis, with an estimated 25 % loss of skin substance and major decay of the chest wall. In addition to standard treatment, local instillations of amphotericin B using the VAC Veraflow® system were performed. We believe that local instillations of amphotericin B by VAC could improve the functional prognosis of patients with skin involvement.

Prise en charge d'une mucormycose disséminée chez un patient polytraumatisé et brûlé: intérêt des instillations locales, rapport de cas et revue de la littérature.

Mucormycosis are infrequent filamentous fungal infections, but severe and with high mortality (20 to 50%). Symptoms are very common, like necrosis, and burn/polytrauma patients have a higher risk of mucormycosis than the general population. We report here the history of a 38-year-old man, polytraumatized and burned because of a tractor incident. During the first two weeks two haemorrhagic shock episodes occurred because of necrosis of the humeral artery. Analysis of vascular fragment identified Lichteimia spp. The diagnosis of invasive infection was established after identifying Lichteimia spp. in blood cultures also. We treated the patient with intravenous liposomal amphotericin, oral posaconazole and surgical debridement according to the gold standard. The wound mucormycosis was also treated with a humeral bypass with vascular allograft and a latissimus dorsi pedicled flap. Furthermore, mucormycosis was treated with local instillations of amphotericin B in the dressings twice a day with 1% (1 mg/100mL) solution of non-liposomal amphotericin. Early diagnosis and treatment is very important for mucormycosis healing and to minimize morbimortality. With burn and polytrauma patients necrosis and bad local evolution have to be carefully screened and analyzed.

A new Tier 3 method to calculate methane emission inventory for ruminants.

Livestock is the main source of methane (CH4) emissions. It is important to accurately determine emissions from ruminants that meet standardized international guidelines for national greenhouse gas inventories. A new method to improve the accuracy of CH4 emissions that complies with IPCC rules for a Tier 3 method is described and evaluated. This method, developed by INRA (French Institute for Agricultural Research), was applied to the French inventory of CH4 emissions by ruminants and compared with the IPCC Tier 2 method. For enteric CH4, depending on the animal category, the INRA CH4 emission estimates lay between 88% and 114% of IPCC's. The INRA/IPCC ratio for enteric emission was close to unity and did not differ between methods (P = 0.43) for adult cows (i.e. most cattle). In France, feedlot manure is stored in aerobic conditions, and so the INRA/IPCC fit for manure emission was poorer (P < 0.05). The INRA/IPCC fit for enteric CH4 was very close between methods to that for total CH4 (P = 0.39), enteric CH4 representing 93% of total emissions. The main improvement is the use of a robust equation (from numerous data and diets), based on digestible organic matter intake (DOMI) corrected for the digestive interactions, to predict CH4 consistently from enteric and manure sources. It was developed for the French livestock inventory but is customizable for other countries. This new improved CH4 estimation method, based on equations from a large literature database, complies with IPCC rules for a Tier 3 method.

Generation and distribution of productivity gains in beef cattle farming: Who are the winners and losers between 1980 and 2015?

Surplus accounting is a method for evaluating trends in how a firm's productivity factors (intermediate inputs, capital, land, labour) are performing and how the productivity gains are redistributed between agents in the economy. Here the surplus accounting method was applied on a database of 164 Charolais-area suckler cattle farms running from 1980 to 2015. Over this 36-year period - with differences per sub-period - the cumulative productivity surplus (PS) increased at a low rate of +0.17%/year (i.e. cumulative volume of outputs produced increased slightly more than cumulative volume of inputs used). This timid increase in PS is linked to the constant expansion in labour productivity whereas other factor productivities have shrunk. The observable period-wide macrotrends are that commercial farm businesses struggle to protect their revenues, we also observe a slight fall in input prices, land rent and financing costs, and a huge climb in direct support-policy payments. The bulk of the cumulative economic surplus has been captured downstream - 64% downstream of the cattle value chain as a drop in prices, and 22% downstream of other value chains (chiefly cereals). It emerges that the productivity gains in beef cattle farming mostly benefit the downstream value chain (packers-processors, distributors and consumers), whereas it is mainly government money backing this drop in prices of agricultural output. Here we see the principal of the 1992 'MacSharry' reform at work, with a transfer from the taxpayer through direct support-policy payments through to the consumer via lower prices. The simple fact that farmers' incomes are stagnating is a clear indication that they are net losers in this distribution of productivity gains, despite the improvement in labour factor productivity.

Productivity and technical efficiency of suckler beef production systems: trends for the period 1990 to 2012.

Over the past 23 years (1990 to 2012), French beef cattle farms have expanded in size and increased labour productivity by over 60%, chiefly, though not exclusively, through capital intensification (labour-capital substitution) and simplifying herd feeding practices (more concentrates used). The technical efficiency of beef sector production systems, as measured by the ratio of the volume value (in constant euros) of farm output excluding aids to volume of intermediate consumption, has fallen by nearly 20% while income per worker has held stable thanks to subsidies and the labour productivity gains made. This aggregate technical efficiency of beef cattle systems is positively correlated to feed self-sufficiency, which is in turn negatively correlated to farm and herd size. While volume of farm output per hectare of agricultural area has not changed, forage feed self-sufficiency decreased by 6 percentage points. The continual increase in farm size and labour productivity has come at a cost of lower production-system efficiency - a loss of technical efficiency that 20 years of genetic, technical, technological and knowledge-driven progress has barely managed to offset.

Mixed crop-livestock farming systems: a sustainable way to produce beef? Commercial farms results, questions and perspectives.

Mixed crop-livestock (MC-L) farming has gained broad consensus as an economically and environmentally sustainable farming system. Working on a Charolais-area suckler cattle farms network, we subdivided the 66 farms of a constant sample, for 2 years (2010 and 2011), into four groups: (i) 'specialized conventional livestock farms' (100% grassland-based farms (GF), n=7); (ii) 'integrated conventional crop-livestock farms' (specialized farms that only market animal products but that grow cereal crops on-farm for animal feed, n=31); (iii) 'mixed conventional crop-livestock farms' (farms that sell beef and cereal crops to market, n=21); and (iv) organic farms (n=7). We analyse the differences in structure and in drivers of technical, economic and environmental performances. The figures for all the farms over 2 years (2010 and 2011) were pooled into a single sample for each group. The farms that sell crops alongside beef miss out on potential economies of scale. These farms are bigger than specialized beef farms (with or without on-farm feed crops) and all types of farms show comparable economic performances. The big MC-L farms make heavier and consequently less efficient use of inputs. This use of less efficient inputs also weakens their environmental performances. This subpopulation of suckler cattle farms appears unable to translate a MC-L strategy into economies of scope. Organic farms most efficiently exploit the diversity of herd feed resources, thus positioning organic agriculture as a prototype MC-L system meeting the core principles of agroecology.