3

Acute organophosphate (OP) intoxication is associated with many symptoms and clinical signs, including potentially life-threatening seizures and status epilepticus. Instead of being linked to the direct cholinergic toxidrome, OP-related seizures are more probably linked to the interaction of OPs with acetylcholineindependent neuromodulation pathways, such as GABA and NMDA. The importance of preventing, or recognizing and treating OP-related seizures lies in that, the central nervous system (CNS) damage from OP poisoning is thought to be due to the excitotoxicity of the seizure activity itself rather than a direct toxic effect. Muscular weakness and paralysis occurring 1-4 days after the resolution of an acute cholinergic toxidrome, the intermediate syndrome is usually not diagnosed until significant respiratory insufficiency has occurred; it is nevertheless a major cause of OP-induced morbidity and mortality and requires aggressive supportive treatment. The condition usually resolves spontaneously in 1-2 weeks.Treatment of OP intoxication relies on prompt diagnosis, and specific and immediate treatment of the lifethreatening symptoms. Since patients suffering from OP poisoning can secondarily expose care providers via contaminated skin, clothing, hair, or body fluids. EMS and hospital caregivers should be prepared to protect themselves with appropriate protective equipment, isolate such patients, and decontaminate them. After prompt decontamination, the initial priority of patient management is an immediate ABCDE (A : airway, B : breathing, C : circulation, D : dysfunction or disability of the central nervous system, and E : exposure) resuscitation approach, including aggressive respiratory support, since respiratory failure is the usual ultimate cause of death. The subsequent priority is initiating atropine therapy to oppose the muscarinic symptoms and diazepam to prevent or control seizures, with oximes added to enhance acetylcholinesterase (AChE) activity recovery. Large doses of atropine and oximes may be necessary for poisoning due to suicidal ingestions of OP pesticides.

Interconnection among academic journal platforms: Multilateral versus bilateral interconnection

Electronic academic journal websites provide new services of text and/or datamining and linking, indispensable for e¢ cient allocation of attention among abun-dant sources of scienti?c information. Fully realizing the bene?t of these servicesrequires interconnection among websites. Motivated by CrossRef, a multilateralcitation linking backbone, this paper performs a comparison between multilateralinterconnection through an open platform and bilateral interconnection, and ?ndsthat publishers are fully interconnected in the former regime while they can be par-tially interconnected in the latter regime for exclusion or di¤erentiation motives.Surprisingly, if partial interconnection arises for di¤erentiation motive, exclusion ofsmall publisher(s) occurs more often under multilateral interconnection. We also?nd that in the case of multilateral interconnection, a for-pro?t platform inducesless exclusion than an open platform. Various other extensions are analyzed.

Anàlisi de les revistes indexades al Journal of Citation Reports del Social Science Citation Index. Període 1997-2005

En aquest estat de la qüestió, s’hi presenten els resultats d’una anàlisi sobre l’evolució i les característiques principals de les revistes de geografia incloses al Journal of Citation Reports dins de la versió del Social Science Citation Index i, per tant, amb factor d’impacte. El període d’estudi escollit ha estat el que va de 1997 a 2005, és a dir, al llarg dels darrers nou anys amb dades disponibles. En total, hi han aparegut incloses trenta-nou revistes, una bona part de les quals ha romàs a la llista durant tot el temps estudiat. Hi ha hagut deu publicacions que han estat situades entre les cinc amb més factor d’impacte de cada any, i cap no ha estat la primera més de dos anys seguits. S’han trobat divuit temàtiques diferents en el conjunt de les revistes, en destaquen les de caire generalista i les de geografia econòmica i regional. Una gran majoria dels volums està publicada per editorials, Blackwell Publishing n’és la més destacada. L’origen de les revistes és clarament anglosaxó, només n’hi trobem dues d’escrites en una altra llengua. La segona part de l’article descriu totes les publicacions contemplades en els nou anys estudiats, amb una petita ressenya de cadascuna

Endoscopic Approach and Management of Parasellar Lesions

The parasellar region is the location of a wide variety of inflammatory and benign or malignant lesions. A pathological diagnostic strategy may be difficult to establish relying solely on imaging data. Percutaneous biopsy through the foramen ovale using the Hartel technique has been developed for decision-making process. It is an accurate diagnostic tool allowing pathological diagnosis to determine the best treatment strategy. However, in some cases, this procedure may fail or may be inappropriate particularly for anterior parasellar lesions. Over these past decades, endoscopy has been widely developed and promoted in many indications. It represents an interesting alternative approach to parasellar lesions with low morbidity when compared to the classic microscopic sub-temporal extradural approach with or without orbito-zygomatic removal. In this chapter, we describe our experience with the endoscopic approach to parasellar lesions. We propose a complete overview of surgical anatomy and describe methods and results of the technique. We also suggest a model of a decision-making tree for the diagnosis and treatment of parasellar lesions.