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Article ; Online: Sodium-not harmful?

Deschênes, Georges

2020 Volume 35, Issue 9, Page(s) 1771–1776

Abstract: Background: The temporality between the mandated reduction of salt in processed food and the decrease of death from stroke and ischemic heart disease, the association of hypertension, and cardiovascular disease led many public health organizations to ... ...

Abstract	Background: The temporality between the mandated reduction of salt in processed food and the decrease of death from stroke and ischemic heart disease, the association of hypertension, and cardiovascular disease led many public health organizations to recommend reducing dietary sodium to a maximum of 2300 mg per day. It turns out that some nuances can be brought about to this universally shared belief. Methods & results: Indeed, consideration of health outcomes instead of only blood pressure as a surrogate marker of cardiovascular disease and prognosis gave contradictory results whereas low sodium intake is associated to an excess of death and cardiovascular events. Conclusions: Accordingly, sodium intake should be adapted to individual risk factors, and evidence is still clearly lacking to support indiscriminate recommendations in healthy people. By contrast, a restricted sodium diet is certainly useful in patients with chronic kidney disease exposed to salt retention, and by reciprocity, low sodium diet must be absolutely avoided in all patients presenting renal or extra renal sodium wasting where sodium depletion is a life-threatening condition.
Language	English
Publishing date	2020-05-21
Publishing country	Germany
Document type	Journal Article
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-019-04356-x
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Article ; Online: Incidence of ophthalmologic pathology and associated risk factors in orbital fractures at a level I trauma centre.

Nassrallah, Georges / Dhillon, Jobanpreet / Gaffar, Judy / Kondoff, Matthew / Ross, Michael / Deschênes, Jean

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

2023

Abstract: Objective: To estimate the incidence of ophthalmologic pathology at presentation of patients with orbital fracture to a level I trauma centre and the most significant associated risk factors.: Methods: A total of 244 patients with 278 fractured ... ...

Abstract	Objective: To estimate the incidence of ophthalmologic pathology at presentation of patients with orbital fracture to a level I trauma centre and the most significant associated risk factors. Methods: A total of 244 patients with 278 fractured orbits over a 2-year period at a level I trauma centre were reviewed. The primary outcome was the incidence of urgent ophthalmologic pathology, defined as requiring attention without delay. Patient demographics, history, findings on radiographic imaging, and physical examination findings at initial and follow-up examinations were recorded. Odds ratios with 95% confidence intervals were calculated. Results: On initial examination and follow-up, 9.7% of orbits had ophthalmologic pathology. Only 3 patients (1.1%) had urgent pathology, including orbital compartment syndrome and globe rupture, whereas 22 patients (7.9%) had semiurgent pathology and 4 patients (1.4%) had nonurgent pathology. Subjective decreased vision (odds ratio [OR] = 3.5; p = 0.021), assault-related injuries (OR = 2.4; p = 0.036), work-related injuries (OR = 7.7; p = 0.004), afferent pupillary defect (OR = 19.2; p = 0.017), anisocoria (OR = 7.8; p = 0.001), and symmetrical extraocular movement limitation (OR = 5.2; p = 0.003) and fixed pupil (OR = 16.9; p < 0.001) had statistically significant odds ratios associated with pathology. Patient sex, eye involved, intoxication, anticoagulation, and antiplatelets, as well as previous ocular surgery, were not associated with pathology. Conclusions: Most orbital fractures do not present with ophthalmologic pathology. Subjective vision loss, history of assault or work trauma, and pupil abnormalities on examination were the greatest risk factors for pathology. Our results highlight the most important factors on patient presentation that should prompt first responders to seek urgent ophthalmologic consultation.
Language	English
Publishing date	2023-03-28
Publishing country	England
Document type	Journal Article
ZDB-ID	80091-0
ISSN	1715-3360 ; 0008-4182
ISSN (online)	1715-3360
ISSN	0008-4182
DOI	10.1016/j.jcjo.2023.03.007
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Article ; Online: Significance of subconjunctival hemorrhage in predicting ocular pathology for patients with orbital fracture.

Dhillon, Jobanpreet / Nassrallah, Georges / Nithianandan, Harrish / Gaffar, Judy / Kondoff, Matthew / Ross, Michael / Deschênes, Jean

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

2022 Volume 58, Issue 4, Page(s) 295–301

Abstract: Objective: Subconjunctival hemorrhage (SCH) is a common presentation in patients with orbital trauma and often warrants investigation of underlying ocular pathology. Our study aims to assess the significance of SCH severity, graded in a spatial 0-360° ... ...

Abstract	Objective: Subconjunctival hemorrhage (SCH) is a common presentation in patients with orbital trauma and often warrants investigation of underlying ocular pathology. Our study aims to assess the significance of SCH severity, graded in a spatial 0-360° manner, as a predictor for ocular pathology in patients with orbital fracture. Design: Retrospective chart review. Participants: Patients with fractured orbits (n = 265) presenting to a level 1 trauma centre between August 2015 and January 2018. Methods: Key elements of ophthalmic assessment, including visual acuity, SCH (0-360°), anterior- and posterior-segment examination, Hertel exophthalmometry, and ocular pathology, were recorded. Simple logistic regression assessed for association between SCH severity and ocular pathology. Odds ratios (ORs) were calculated with 95% CI. Results: Among the 265 fractured orbits, 158 (59.6%) presented with no SCH, and 107 (40.4%) had some degree of SCH. Ocular pathology was noted in 24 fractured orbits (9%). Most common pathologies included entrapment (22.2%), hyphema (16.7%), traumatic optic neuropathy (8.3%), and commotio retinae (8.3%). Simple logistic regression revealed a higher incidence of ocular pathology with increasing severity of SCH from 0-360° (OR = 1.004; 95% CI 1.001-1.007; p = 0.0085). In addition, χ Conclusions: Our findings suggest that there is some correlation between the extent of SCH and ocular pathology. However, patient care and investigations should continue to be directed by a full clinical assessment of patients with orbital trauma.
MeSH term(s)	Humans ; Orbital Fractures/complications ; Orbital Fractures/diagnosis ; Retrospective Studies ; Eye Hemorrhage/diagnosis ; Eye Hemorrhage/etiology ; Conjunctival Diseases/diagnosis ; Conjunctival Diseases/etiology ; Hyphema ; Eye Injuries/complications ; Eye Injuries/diagnosis ; Eye Injuries/epidemiology
Language	English
Publishing date	2022-03-10
Publishing country	England
Document type	Journal Article
ZDB-ID	80091-0
ISSN	1715-3360 ; 0008-4182
ISSN (online)	1715-3360
ISSN	0008-4182
DOI	10.1016/j.jcjo.2022.02.003
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Article: The Struggling Odyssey of Infantile Primary Hyperoxaluria.

Guillaume, Adrien / Chiodini, Benedetta / Adams, Brigitte / Dahan, Karin / Deschênes, Georges / Ismaili, Khalid

Frontiers in pediatrics

2021 Volume 9, Page(s) 615183

Abstract: Introduction: ...

Abstract	Introduction:
Language	English
Publishing date	2021-04-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2021.615183
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Article ; Online: Incidence and outcomes of retrobulbar hematoma diagnosed by computed tomography in cases of orbital fracture.

Kondoff, Matthew / Nassrallah, Georges / Ross, Michael / Deschênes, Jean

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

2019 Volume 54, Issue 5, Page(s) 606–610

Abstract: Objective: Retrobulbar hemorrhage (RBH) is a potentially sight-threatening complication of orbital fractures causing an orbital compartment syndrome (OCS). RBH causing OCS is regarded as a clinical diagnosis when evidence of optic nerve compression is ... ...

Abstract	Objective: Retrobulbar hemorrhage (RBH) is a potentially sight-threatening complication of orbital fractures causing an orbital compartment syndrome (OCS). RBH causing OCS is regarded as a clinical diagnosis when evidence of optic nerve compression is found. Nonetheless, many patients with facial trauma will have received imaging by computed tomography (CT) on which there is documented RBH, with or without signs of OCS. The aim of this study was to identify the incidence and describe the outcomes of these CT-diagnosed RBH. Methods: This is a retrospective chart review of patients with orbital fractures for which ophthalmology was consulted. Confirmation of orbital fracture and presence of an RBH on facial-bones CT was recorded. Patient demographics, proptosis, visual acuity, intraocular pressure and interventions received at initial visit and follow-up were recorded. Results: 292 orbits with wall fractures were identified. 94 (32.2%) were documented by CT to have RBH. Of these orbits, only one (1.1%) was diagnosed with OCS receiving canthotomy and cantholysis. 53 orbits with initial CT-diagnosed retrobulbar hematoma were seen in follow-up a week or more later, none of which had developed signs of OCS or needed medical or surgical intervention for OCS. Conclusions: RBH is a frequently reported finding on CT in cases of orbital fractures. In this study, almost all of these CT-diagnosed RBH did not develop OCS initially or by the time of follow-up. CT presence of RBH is not an accurate predictor for OCS, and the diagnosis and treatment of OCS should be directed clinically.
MeSH term(s)	Adult ; Female ; Hematoma/diagnosis ; Hematoma/epidemiology ; Hematoma/etiology ; Humans ; Incidence ; Male ; Middle Aged ; Orbit/diagnostic imaging ; Orbit/injuries ; Orbital Fractures/complications ; Orbital Fractures/diagnosis ; Quebec/epidemiology ; Retrobulbar Hemorrhage/diagnosis ; Retrobulbar Hemorrhage/epidemiology ; Retrobulbar Hemorrhage/etiology ; Retrospective Studies ; Tomography, X-Ray Computed/methods ; Visual Acuity
Language	English
Publishing date	2019-04-02
Publishing country	England
Document type	Journal Article
ZDB-ID	80091-0
ISSN	1715-3360 ; 0008-4182
ISSN (online)	1715-3360
ISSN	0008-4182
DOI	10.1016/j.jcjo.2019.01.006
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Article ; Online: How to improve response to rituximab treatment in children with steroid-dependent nephrotic syndrome: answer to Drs. Fujinaga and Nishino.

Hogan, Julien / Deschenes, Georges

Pediatric nephrology (Berlin, Germany)

2018 Volume 34, Issue 2, Page(s) 361–362

MeSH term(s)	B-Lymphocytes ; Child ; Humans ; Nephrotic Syndrome ; Recurrence ; Rituximab
Chemical Substances	Rituximab (4F4X42SYQ6)
Language	English
Publishing date	2018-11-07
Publishing country	Germany
Document type	Letter ; Comment
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-018-4133-x
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Article ; Online: Quality of life considerations in uveal melanoma patients: a systematic review.

Anchouche, Sonia / Liu, Jiaru / Zaguia, Fatma / Nassrallah, Georges / Deschênes, Jean

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

2020 Volume 55, Issue 5, Page(s) 413–423

Abstract: Objective: The aim of this study is to examine the quality of life (QOL) outcomes of patients undergoing different uveal melanoma (UM) treatments and to appraise the literature on the topic.: Design and participants: A systematic review was conducted ...

Abstract	Objective: The aim of this study is to examine the quality of life (QOL) outcomes of patients undergoing different uveal melanoma (UM) treatments and to appraise the literature on the topic. Design and participants: A systematic review was conducted to address the study objective. Patients undergoing UM treatment with or without metastasis were eligible for inclusion in this review. Methods: A literature search was performed using National Library of Medicine (PubMed), Embase, Ovid online, and Cochrane Central Register of Controlled Trials databases. We included all English, original retrospective or prospective studies published between January 1998 to September 2019 in which the primary outcome was the QOL of patients with treated UM. Results: Our search strategy yielded 101 articles. Of these, 18 articles met all our inclusion criteria. The majority of included articles (61%) are cross-sectional studies. On average, each study employed 2 different QOL assessment tools. Overall, physical functioning and mental well-being are impaired in patients with UM after treatment compared with the general population. The severity of the impairment decreases as early as 3 months post-treatment; 8 of 12 studies comparing treatment options reported no statistical difference in physical functioning between treatments; 4 of 12 studies reported better visual function with radiation therapy compared with enucleation, 2 of which described no difference between the 2 options at long-term. Anxiety is more prevalent than depression, and both decrease to less than 10% at 1-year follow-up. Conclusions: Overall, there is no significant difference in long-term QOL in patients with UM from different treatment groups past 1-year follow-up. This work underscores the need for and importance of developing a standardized, complete assessment tool tailored to the challenges inherent to the diagnosis of UM.
MeSH term(s)	Cross-Sectional Studies ; Humans ; Melanoma ; Prospective Studies ; Quality of Life ; Retrospective Studies ; United States ; Uveal Neoplasms
Language	English
Publishing date	2020-07-08
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	80091-0
ISSN	1715-3360 ; 0008-4182
ISSN (online)	1715-3360
ISSN	0008-4182
DOI	10.1016/j.jcjo.2020.05.010
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Article ; Online: Primary care assessment of orbital trauma at a level 1 trauma centre.

Gaffar, Judy / Nassrallah, Georges / Kondoff, Matthew / Ross, Michael / Deschênes, Jean

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

2020 Volume 56, Issue 2, Page(s) 118–123

Abstract: Objective: With increasing constraints on our publicly funded health care system, appropriate triage of trauma patients is becoming pivotal, making the primary care assessment (PCA) invaluable. Our study aims to compare the initial assessment of ... ...

Abstract	Objective: With increasing constraints on our publicly funded health care system, appropriate triage of trauma patients is becoming pivotal, making the primary care assessment (PCA) invaluable. Our study aims to compare the initial assessment of patients with orbital fractures with that conducted by the ophthalmology service. Design: Retrospective chart review. Participants: 243 patients with 277 fractured orbits presenting to a level 1 trauma centre seen between August 2015 and January 2018. Methods: Key elements of the PCA, including subjective vision loss, visual acuity, intraocular pressure, pupil examination, and extraocular movements, were documented and compared with the assessment by the ophthalmology service as the control. The primary outcome was inter-rater reliability as estimated by Cohen's kappa (κ) coefficient. Secondary outcomes included the sensitivity and specificity, as well as the rate of completion of examination components. Results: PCA examination findings agreed with the ophthalmology service on most components of the examination with the highest agreement with relative afferent pupillary defects and detection of hyphemas (κ = 1). Primary care physicians less often performed most aspects of the assessment. Among performed components of the examination, the average sensitivity was 60.6%, and the average specificity was 84.2%. Conclusions: Our results show good inter-rater reliability of the PCA compared with the ophthalmology examination but low rate of completion of examination components, suggesting a potential overdependence on the ophthalmology assessment. Given the limited resources of the public health care system, our study may highlight the PCA as a potential focus to improve effective and safe patient management.
MeSH term(s)	Eye Injuries/diagnosis ; Humans ; Primary Health Care ; Reproducibility of Results ; Retrospective Studies ; Trauma Centers
Language	English
Publishing date	2020-09-17
Publishing country	England
Document type	Journal Article
ZDB-ID	80091-0
ISSN	1715-3360 ; 0008-4182
ISSN (online)	1715-3360
ISSN	0008-4182
DOI	10.1016/j.jcjo.2020.08.005
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Article ; Online: Treating the idiopathic nephrotic syndrome: are steroids the answer?

Deschênes, Georges / Dossier, Claire / Hogan, Julien

Pediatric nephrology (Berlin, Germany)

2018 Volume 34, Issue 5, Page(s) 777–785

Abstract: The use of steroids in idiopathic nephrotic syndrome is the major discovery of the twentieth century in the field of pediatric nephrology. At onset of the twenty-first century, steroids remain the first line of treatment at first flare. All the protocols ...

Abstract	The use of steroids in idiopathic nephrotic syndrome is the major discovery of the twentieth century in the field of pediatric nephrology. At onset of the twenty-first century, steroids remain the first line of treatment at first flare. All the protocols to treat the first flare are similar by a common sequence including a first phase of daily prednisolone/prednisone at a dose of 60 mg/m
MeSH term(s)	Child ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drug Therapy, Combination/methods ; Glucocorticoids/administration & dosage ; Humans ; Immunosuppressive Agents/administration & dosage ; Nephrotic Syndrome/drug therapy ; Nephrotic Syndrome/immunology ; Prednisolone/administration & dosage ; Prednisone/administration & dosage ; Recurrence ; Remission Induction/methods ; Secondary Prevention/methods ; Treatment Outcome
Chemical Substances	Glucocorticoids ; Immunosuppressive Agents ; Prednisolone (9PHQ9Y1OLM) ; Prednisone (VB0R961HZT)
Language	English
Publishing date	2018-06-04
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-018-3963-x
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Article ; Online: Asymptomatic bacteriuria in pediatric kidney transplant recipients: to treat or not to treat? A retrospective study.

Bonnéric, Stéphanie / Maisin, Anne / Kwon, Theresa / Deschênes, Georges / Niel, Olivier

Pediatric nephrology (Berlin, Germany)

2019 Volume 34, Issue 6, Page(s) 1141–1145

Abstract: Background: Urinary tract infections (UTI) are common infectious complications in kidney transplant recipients (KTR); asymptomatic bacteriuria (AB) is also frequent. It is unclear whether treatment of AB reduces subsequent UTI in KTR; no guideline is ... ...

Abstract	Background: Urinary tract infections (UTI) are common infectious complications in kidney transplant recipients (KTR); asymptomatic bacteriuria (AB) is also frequent. It is unclear whether treatment of AB reduces subsequent UTI in KTR; no guideline is available in pediatric KTR. In this retrospective study, we analyzed the incidence of AB in pediatric KTR and the impact of screening and treating AB on the onset of subsequent UTI. Methods: Thirty-seven pediatric patients were included. Inclusion criteria were the occurrence of one or more episodes of AB between 2 and 24 months post-renal transplantation. Primary outcome was the cumulative incidence of acute pyelonephritis (APN) or lower urinary tract infections (LUTI) occurring between 2 and 24 months post-renal transplantation. Results: Thirty-seven patients presented 171 AB episodes. One hundred sixty-four AB episodes were untreated (95.9%); among them, 150 episodes (91.5%) were not followed by a clinical infection. Ten episodes (6.1%) led to APN, and 4 (2.4%) to LUTI. There were 53 episodes of APN: 10 (18.9%) after untreated AB and 43 (81.1%) de novo. There were 11 episodes of LUTI: 4 (36.4%) after untreated AB and 7 (63.6%) de novo. Multi-drug resistant bacteria were present in 27% of the patients and in 20% of patients with pre-existing uropathy. Conclusions: Our results are not in favor of systematic treatment of AB in pediatric KTR. Notably, limitation of antibiotic treatment is an urgent and important health issue in this population, in order to reduce multi-drug resistant bacteria emergence.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Bacteriuria/drug therapy ; Bacteriuria/epidemiology ; Bacteriuria/etiology ; Child ; Female ; Humans ; Incidence ; Kidney Transplantation/adverse effects ; Male ; Postoperative Complications/drug therapy ; Postoperative Complications/epidemiology ; Pyelonephritis/epidemiology ; Retrospective Studies ; Transplant Recipients ; Urinary Tract Infections/epidemiology
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2019-02-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-019-04204-y
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