Experts’ recommendations for the management of cardiogenic shock in children

International audienceCardiogenic shock which corresponds to an acute state of circulatory failure due to impairment of myocardial contractility is a very rare disease in children, even more than in adults. To date, no international recommendations regarding its management in critically ill children are available. An experts' recommendations in adult population have recently been made (Levy et al. Ann Intensive Care 5(1):52, 2015; Levy et al. Ann Intensive Care 5(1):26, 2015). We present herein recommendations for the management of cardiogenic shock in children, developed with the grading of recommendations' assessment, development, and evaluation system by an expert group of the Groupe Francophone de Réanimation et Urgences Pédiatriques (French Group for Pediatric Intensive Care and Emergencies). The recommendations cover four major fields of application such as: recognition of early signs of shock and the patient pathway, management principles and therapeutic goals, monitoring hemodynamic and biological variables, and circulatory support (indications, techniques, organization, and transfer criteria). Major principle care for children with cardiogenic shock is primarily based on clinical and echocardiographic assessment. There are few drugs reported as effective in childhood in the medical literature. The use of circulatory support should be facilitated in terms of organization and reflected in the centers that support these children. Children with cardiogenic shock are vulnerable and should be followed regularly by intensivist cardiologists and pediatricians. The experts emphasize the multidisciplinary nature of management of children with cardiogenic shock and the importance of effective communication between emergency medical assistance teams (SAMU), mobile pediatric emergency units (SMUR), pediatric emergency departments, pediatric cardiology and cardiac surgery departments, and pediatric intensive care units

The role of diffusion MRI in neuroscience

preprint déposé dans bioRxivDiffusion weighted imaging has further pushed the boundaries of neuroscience by allowing us to peer farther into the white matter microstructure of the living human brain. By doing so, it has provided answers to fundamental neuroscientific questions, launching a new field of research that had been largely inaccessible. We will briefly summarise key questions, that have historically been raised in neuroscience, concerning the brain's white matter. We will then expand on the benefits of diffusion weighted imaging and its contribution to the fields of brain anatomy, functional models and plasticity. In doing so, this review will highlight the invaluable contribution of diffusion weighted imaging in neuroscience, present its limitations and put forth new challenges for the future generations who may wish to exploit this powerful technology to gain novel insights

Polysaccharide Containing Gels for Pharmaceutical Applications

WOS: 000456875000007Bio-derived polymers are falling into the needs of pharmaceutical formulations for topical applications due to their gelling ability. Generally, in topical delivery, as an alternative way for local and systemic application of active substances, formulations in gelling form are preferred as they have multiple advantages, e.g., minimize systemic side effects, avoid gastrointestinal irritation, prevent the metabolism of the active substance in liver, etc. The present chapter reviews bio-based polymers with special reference to polysaccharides-based hydrogels with respect to their pharmaceutical applications