Publications by authors named "Nadya Ben Fadel"

Article Synopsis
  • * A survey of 194 healthcare providers revealed that while many recognize the importance and have interest in learning POC-LU, lack of trained personnel remains a significant barrier to its adoption.
  • * The study suggests that establishing a consensus and creating training programs are essential for effective integration of POC-LU in NICUs across Canada.
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Premenstrual syndrome (PMS) is a very prevalent condition that affects premenopausal women and can result in monthly debilitating emotional and physical symptoms. The objective of this systematic review was to determine which predictive factors were associated with an increased amount of bias in non-randomized studies (NRSs) of PMS. A search of the EMBASE and Medline electronic databases was completed from January 1, 2010 to December 2021.

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Sudden unexpected clinical deterioration or cardiorespiratory instability is common in neonates and is often referred as a "crashing" neonate. The established resuscitation guidelines provide an excellent framework to stabilize and evaluate these infants, but it is primarily based upon clinical assessment only. However, clinical assessment in sick neonates is limited in identifying underlying pathophysiology.

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Children born prematurely, particularly those with bronchopulmonary dysplasia, have persisting lung abnormalities requiring longitudinal monitoring. Pulmonary ultrashort echo time magnetic resonance imaging (MRI) measurements may provide sensitive markers of persisting lung abnormalities and have not been evaluated in school-aged children born prematurely. To compare pulmonary MRI and pulmonary function test measurements in preterm-born school-aged children with and without bronchopulmonary dysplasia.

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Article Synopsis
  • Patent ductus arteriosus (PDA) is a common heart condition in preterm infants, and there's uncertainty about the best treatment, with practices varying across Canadian neonatal intensive care units (NICUs).
  • This study aims to compare the effectiveness of different medications—indomethacin, ibuprofen, and acetaminophen—in treating PDA in extremely preterm infants (born before 29 weeks gestation).
  • The main goal is to assess the failure rate of these treatments, looking at the need for additional medical or surgical intervention, along with other related clinical outcomes.
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Background: Accurate interpretations of neonatal cranial ultrasound (CUS) studies are essential skills for physicians in neonatal intensive care units (NICUs) in order to properly diagnose and manage brain injury. However, these skills are not formally taught to pediatric and neonatal-perinatal medicine (NPM) trainees in Canada. Therefore, our study describes the design, implementation, and evaluation of a new web-based learning (WBL) module that focuses on teaching these skills.

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Background: Recent clinical practice changes in neonatal care resulted in higher, narrower oxygen saturation target ranges for preterm infants. The effect of targeting higher or lower oxygen saturations on respiratory outcomes of preterm infants and duration of hospitalization has not been extensively reviewed in the context of current care, but could have significant implications.

Methods: A multicentre retrospective cohort of 145 preterm infants was conducted; 105 had lower oxygen saturation targets (88 to 92%), 40 had higher targets (90 to 95%).

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Article Synopsis
  • - This study aimed to determine how the timing of therapeutic hypothermia (TH) initiation affects brain injury and neurodevelopmental outcomes in newborns with hypoxic ischemic encephalopathy (HIE) after 18 months.
  • - A total of 91 patients were divided into two groups: those who received early TH (before 3 hours of life) and those who received late TH (between 3 to 6 hours of life), with both groups receiving TH for 72 hours.
  • - The results showed no significant difference in brain injury severity or neurodevelopmental outcomes at 18 months between the early and late TH groups, suggesting that early initiation of TH may not confer additional benefits compared to later initiation. *
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Objectives: Despite increased evidence that point-of-care ultrasound (POCUS) has the potential to improve patient care in many clinical areas, the extent of use and training in POCUS in Canadian neonatal intensive care units (NICUs) has not been described in the literature. In this study, we aimed to explore the extent to which POCUS is being used and the need for a formal curriculum with defined POCUS competencies in the field of Neonatal-Perinatal Medicine (NPM).

Methods: We sent a cross-sectional electronic survey to all NPM program directors and fellows in Canada.

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Objective: Determine whether higher targeted oxygen levels are associated with reduced incidence of pulmonary hypertension (PH) and elevated pulmonary vascular resistance (PVR) in extremely premature infants.

Study Design: Retrospective chart review of 252 extremely preterm infants (<29 weeks), who underwent echocardiogram prior to discharge. PH rates were compared during periods (June 2012-May 2015 and June 2015-April 2016) when lower (88-92%) or higher (90-95%) oxygen saturation targets were used.

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Deficient nitric oxide (NO) signaling plays a critical role in the pathogenesis of chronic neonatal pulmonary hypertension (PHT). Physiological NO signaling is regulated by S-nitrosothiols (SNOs), which act both as a reservoir for NO and as a reversible modulator of protein function. We have previously reported that therapy with inhaled NO (iNO) increased peroxynitrite-mediated nitration in the juvenile rat lung, although having minimal reversing effects on vascular remodeling.

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Neonatal herpes simplex virus (NHSV) infections are associated with significant morbidity and mortality. Numerous factors influence the transmission of HSV infection to newborns; however, immersion in water during labor has received very little attention as a possible risk factor despite the increasing popularity of water births. We report a case of disseminated NHSV type 1 infection, possibly acquired during a water birth.

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Article Synopsis
  • Delivering unexpected health news, particularly trisomy 21 diagnoses, can be emotionally challenging for pediatric trainees, highlighting the need for improved communication skills.
  • A workshop at the University of Ottawa was developed to train trainees using an evidence-based communication framework, allowing them to practice disclosing diagnoses with support from experienced facilitators.
  • Feedback from participants in the pilot workshop was very positive, suggesting that this training could enhance confidence in delivering difficult news and improve the experience for parents receiving such diagnoses.
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Background: Appropriate tools are essential to support a clinician's decision to refer very preterm infants to developmental resources. Streamlining the use of developmental assessment or screening tools to make clinical decisions offers an alternative methodology to help to choose the most effective way to assess this very high-risk population.

Objective: To examine the influence of the Ages and Stages Questionnaire-3rd edition (ASQ3) and the Bayley Scales of Infant Development-3rd edition (Bayley-III) scores within a clinically-based decision-making process.

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We present the investigation and management of a premature, hypotensive neonate born after a pregnancy complicated by anhydramnios to highlight the impact of early and informed management for rare kidney disease. Vasopressin was used to successfully treat refractory hypotension and anuria in the neonate born at 27 weeks of gestation. Next generation sequencing of a targeted panel of genes was then performed in the neonate and parents.

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Peripheral tissue injury is one of the well-described morbidities associated with stays in the neonatal intensive care unit. Despite the potential long-term disability associated with this event, the current available therapeutic options remain very limited. Topical nitroglycerin has emerged as a promising agent for the treatment of tissue injury in infants.

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