Monetary incentives to avoid deforestation under the Reducing emissions from deforestation and degradation (REDD)+ climate change mitigation scheme in Tanzania.

The paper estimates and compares the level of Reducing Emissions from Deforestation and Degradation (REDD+) payments required to compensate for the opportunity costs (OCs) of stopping the conversion of montane forest and miombo woodlands into cropland in two agro-ecological zones in Morogoro Region in Tanzania. Data collected from 250 households were used for OC estimation. REDD+ payment was estimated as the net present value (NPV) of agricultural rent and forest rent during land clearing, minus net returns from sustainable wood harvest, divided by the corresponding reduction in carbon stock. The median compensation required to protect the current carbon stock in the two vegetation types ranged from USD 1 tCO2e-1 for the montane forest to USD 39 tCO2e-1 for the degraded miombo woodlands, of which up to 70 % and 16 %, respectively, were for compensating OCs from forest rent during land clearing. The figures were significantly higher when the cost of farmers' own labor was not taken into account in NPV calculations. The results also highlighted that incentives in the form of sustainable harvests could offset up to 55 % of the total median OC to protect the montane forest and up to 45 % to protect the miombo woodlands, depending on the wage rates. The findings suggest that given the possible factors that can potentially affect estimates of REDD+ payments, avoiding deforestation of the montane forest would be feasible under the REDD+ scheme. However, implementation of the policy in villages around the miombo area would require very high compensation levels.

[Anterolateral thigh flap for limb reconstructive surgery: four case reports]. / Intérêt du lambeau libre antéro-latéral de la cuisse en chirurgie reconstructrice des membres.

PURPOSE OF THE STUDY: We report four cases of anterolateral thigh flap reconstructions, searching for the different advantages and disadvantages of this type of flap. MATERIAL AND METHOD: A pure skin flap was used to cover tissue loss on the plantar surface of the foot both in weight-bearing and non-weight-bearing zones as well as to cover the dorsal aspect of the first commissura of the hand. A musculocutaneous flap (fragment of the vastus lateralis) was associated with an iliac cancellous graft to treat septic nonunion of the tibia. A composite tendinocutaneous flap (fragment of the iliotibial band) was used to reconstruct extensor tendon and skin loss on the dorsal aspect of the hand. A perforating artery measuring more than 1 mm was used in all cases, but in one flap it was in the position described by Song. Side-to-side anastomosis was used in one case. For three cases, the sutured circumflex artery had the same caliber as the radial artery at the wrist level. In one case the circumflex artery had a diameter greater than the posterior tibial artery. Closure of the donor site was not possible immediately in one case. A thin skin graft was required in three cases. RESULTS: Skin healing after microsurgery was satisfactory in all cases, occurring within the usual delay. Bone healing in the patient with septic nonunion of the tibia was achieved at four months. The flap was reliable. In three cases the skin graft of the donor site only healed partially. DISCUSSION: The advantages of the antero lateral thigh flap are: surgery in the supine position, spinal anesthesia when the recipient site is on the lower limb, flap reliability, use of the flap as a bridging element, use as a composite flap. The disadvantages are: variable position of usable perforants, requirement for wide skin grafts > 6 cm to cover the donor site. CONCLUSION: The antero lateral thigh flap is a reliable flap that can be most useful when a bridging element is required and when the donor site can be closed directly.

Microsurgical replantation of a totally amputated ear without venous repair.

The authors present a case of successful replantation of a totally avulsed ear in a 37-year-old patient, using a termino-terminal arterial anastomosis on the superficial temporal artery. As no suitable vein could be identified in the amputated part, they relied on leech therapy and systemic anticoagulation for venous drainage. Despite an 18-hr ischemia, the ear survived completely.

[Y anastomosis of a free lap on peroneal artery after peroneal osteotomy. Report of a case]. / Anastomose d'un lambeau libre en Y sur l'artère péronière après ostéotomie du péroné. A propos d'un cas.

The authors report a case of an Y anastomosis of a free flap on the peroneal artery. A 30-year-old patient, the victim of a multi-traumatism after a motorcycle accident, presented open tibia and peroneal fractures and skin defect at the dorsal aspect of the foot uncovering several fractures and luxations of the foot. When general state of health allowed the achievement of a free flap, the authors noted that the two tibial arteries were destroyed with an extensive thrombosis on each side of the injury which precluded the reconstruction of a reliable artery axis. The peroneal artery insured alone a good foot vascularization. A musculocutaneous serratus anterior free flap was revascularized on the peroneal artery after segmental bone resection on each side of the peroneal fracture. The necessity to preserve the peroneal artery for the foot and the diameter of the arteries imposed flowthrough fashion anastomosis. As a result, the authors believe that anastomosis of a free flap on peroneal artery is a safe procedure, particularly interesting when a preoperative peroneal fracture achieved the osteotomy.

[The treatment of prominent ears. A technical note]. / A propos du traitement des oreilles proéminentes. Note technique.

We present a technique for ambulatory treatment of prominent ears derived from the Kaye method but which uses some procedures aimed at improving reliability and safety.

[Treatment of septicemias and skin infections in burn patient by teicoplanin. Study of its skin diffusion]. / Traitement des septicémies et infections cutanées chez le brûlé par la téicoplanine. Etude de sa diffusion cutanée.

In this study, teicoplanin was administered to burnt patients by IV and IM route in monotherapy or in association with other antibiotics. 12 cases of septicaemia and 8 severe cutaneous cocci Gram + infections were treated. Dosage varied from 5 mg/kg to 14 mg/kg. Clinical cure was observed in 89% of cases, and eradication of cocci Gram + in 83%. The MICs of Staphylococcus were between 0.25 micrograms/ml and 4 micrograms/ml, with a majority of methicillin-resistant Staphylococcus at 1. Average through serum concentrations were 7.4 micrograms/ml, and peak serum concentrations were 26 micrograms/ml (1 hour after injection). Tolerance was good in 19 of the 20 cases (95%). Skin levels of teicoplanin were found to be 1.6 times the through serum level. It was noted that in burnt patients whose UBS is superior to 100, the dose should be increased by about 50%.