Abrupt climate shift in the Western Mediterranean Sea.

One century of oceanographic measurements has evidenced gradual increases in temperature and salinity of western Mediterranean water masses, even though the vertical stratification has basically remained unchanged. Starting in 2005, the basic structure of the intermediate and deep layers abruptly changed. We report here evidence of reinforced thermohaline variability in the deep western basin with significant dense water formation events producing large amounts of warmer, saltier and denser water masses than ever before. We provide a detailed chronological order to these changes, giving an overview of the new water masses and following their route from the central basin interior to the east (toward the Tyrrhenian) and toward the Atlantic Ocean. As a consequence of this climate shift, new deep waters outflowing through Gibraltar will impact the North Atlantic in terms of salt and heat input. In addition, modifications in the Mediterranean abyssal ecosystems and biogeochemical cycles are to be expected.

[Local haemostasis with an adhesive cyanoacrylate-coated membrane following tooth extraction in patients under anticoagulant or anti-platelet therapy]. / Hémostase locale par membrane enduite de cyanoacrylate, après avulsions dentaires sous anticoagulants ou anti-agrégants.

OBJECTIVE: Assessment of a local hemostasis with a compressive, extemporaneous gutter glued to the alveolar crest after tooth avulsion in patients under anticoagulant and/or platelet aggregation inhibitors, and economical impact of this technique. MATERIAL AND METHOD: Ninety-seven tooth extractions were performed in patients under AVK and/or anti-platelet drugs. The interventions were consecutive and concerned 251 teeth (138 different alveolar sites). The extraction alveolus was protected by an absorbable oxycellulose membrane coated with sterilized cyanoacrylate adhesive for medical use. This procedure was used with all patients, whatever the hemorrhagic risk (the only inclusion criterion was INR less than 4 for patients under AVK). All procedures were performed under local anesthesia. RESULTS: There was one hemorrhagic complication (0.72%) due to mechanical gutter destruction by an antagonist tooth. The adhesive did not run, there was no tissue necrosis, and no wound infection requiring gutter removal. DISCUSSION: This local hemostasis procedure is reliable. It may be an alternative to substitution of heparin, without or with hospitalization. This procedure, requiring modification of treatment, greatly decreases healthcare costs. Contra-indications include the presence of an antagonist tooth harmful for the gutter, and patients with impaired consciousness or tongue dyspraxia.

[Bilateral brown tumor of the jaw. Apropos of a case]. / Tumeur brune bilatérale des maxillaires. A propos d'un cas.

A 42 years old woman was seen October 1987 because of tumor on the left maxilla. Removal of the lesion and histologic examination conclude at myeloplaxe tumor. A second giant cell lesion appears in the right maxilla 2 years later. The diagnosis of brown tumor was confirmed by the discovery of a parathyroid adenoma. We discuss about this case diagnosis difficulty of brown tumor from the others giant cell lesions of the jaws.