P. Bagolan - Academia.edu (original) (raw)

Papers by P. Bagolan

Ultrasound in Obstetrics & Gynecology, 2020

The aim of the study is to evaluate cardiac dimensions and function at different gestational age ... more The aim of the study is to evaluate cardiac dimensions and function at different gestational age in a single centre low-risk pregnancies population. Methods: A cohort of 84 low-risk singleton pregnancies, without congenital anomalies, was collected prospectively in women undergoing routine prenatal assessment in our centre, between 15 and 37 weeks of gestation. Cardiac dimensions such as mitral valve (MV) and tricuspid valve (TV), left (LV) and right (RV) ventricle length and area were measured. Functional assessment was performed with tissue Doppler imaging (TDI) velocities, at the basal part of the right ventricular (RV) wall, at the interventricular septum (IVS) and at the left ventricular (LV) wall. Using this technique, a first positive wave (S' for systole), two negative waves (E' for diastole and A' for atrial systole) and their ratio (E/A ratio) were obtained. Results: No significant changes were found for MV/TV ratio suggesting that LV and RV proportion remain stable during all pregnancy. Fetal cardiac dimensions significantly correlated with GA: MV and TV diameter; LV and RV length and area.

Ultrasound in Obstetrics & Gynecology, 2020

gestation, AVPD ± SD in the RV was 6.4 ± 2.6 mm, in the septum 4.3 ± 1.3 mm and in the LV 4.1 ± 2... more gestation, AVPD ± SD in the RV was 6.4 ± 2.6 mm, in the septum 4.3 ± 1.3 mm and in the LV 4.1 ± 2.4 mm. In the pilot study with 35 fetuses with a suspicion of IUGR, the mean AVPD z-scores ± SD were significantly lower in the RV wall-0.45 ± 0.87 (p = 0.020) and the septum-0.44 ± 1.05 (p = 0.018). Conclusions: AVPD increased with gestational age in normal pregnancies and it was lower in the RV wall and in the septum in fetuses with a suspicion of IUGR. This study also showed that it is possible to analyse AVPD from cTDI recordings using an automated method. VP18.04 Impact of cardiovascular hemodynamics on surgical and neurodevelopmental outcomes in fetuses with Ebstein's anomaly and tricuspid valve dysplasia

Background%3A Since mortality in cong... more Background%3A Since mortality in congenital diaphragmatic hernia (CDH) is decreasing, morbidity such as neurodevelopmental outcome is becoming increasingly important. Objectives%3A We evaluated neurodevelopmental outcome in high-risk CDH patients treated according to the CDH EURO Consortium standardized treatment protocol. Methods%3A This observational, prospective cohort study was conducted in two European centers. Neurodevelopment of 88 patients (Rotterdam n = 49; Rome n = 39) was assessed at 12 and 24 months with the Bayley Scales of Infant Development (BSID)-II-NL (Rotterdam) or BSID-III (Rome). Data of the centers were analyzed separately. Results%3A Cognition was normal in 77.8%25 of children from Rotterdam and in 94.8%25 from Rome at 12 months, and in 70.7 and 97.4%25, respectively, at 24 months. Motor function was normal in 64.3%25 from Rotterdam and in 81.6%25 from Rome at 12 months and in 45.7 and 89.8%25, respectively, at 24 months. Longer length of hospital stay (LoS) was associated with worse cognitive outcome and motor function; LoS, low socioeconomic status, and ethnicity were associated with lower cognition. Conclusions%3A At 2 years, most CDH patients have normal cognition, but are at risk for motor function delay. Due to differences in outcomes between centers, careful interpretation is needed before conclusions can be drawn for other centers. Future multicenter collaboration should not only focus on standardization of postnatal care, but also on international standardization of follow-up to identify risk factors and thereby reduce morbidity.

Diseases of the Esophagus, 2019

Background Vascular anomalies (VA) may cause severe tracheomalacia in some cases. Chronic upper a... more Background Vascular anomalies (VA) may cause severe tracheomalacia in some cases. Chronic upper airway obstruction (UAO) is the most common symptom. Increased pulmonary pressure and cardiac dysfunction have been described in patients with chronic UAO, but not in infants with VA. Aim The aim of this study was to evaluate myocardial strain in infants with VA. Method Demographics characteristics, respiratory symptoms, and the percentage of tracheal obstruction measured on CT were collected. Left and right ventricle (LV, RV) systolic function were measured with speckle tracking longitudinal strain (LS) analysis. Pulmonary artery pressure was evaluated on tricuspid regurgitation (TR) jet and quantified by end-systolic eccentricity index (EI). Conclusion Of 15 cases, 6 had tracheal obstruction 50%. LS LV and RV was significantly reduced in cases with obstruction > 50% compared to those with 50%. There are no significant data for TR and EI. Results In cases with VA with severe tracheo...

Diseases of the Esophagus, 2016

Length of fi rst hospitalization was associated with the existence of prenatal orientation, prema... more Length of fi rst hospitalization was associated with the existence of prenatal orientation, prematurity, need of nutritional support, diffi cult anastomosis, and early antirefl ux procedure surgery (p = 0.03, < 0.001, 0.002, 0.001 and 0.006 respectively). Full oral feeding at fi rst discharge was negatively correlated to duration of mechanical ventilation, genital and cardiac abnormalities, and positively with standard initial surgery (p = 0.003, 0.03, 0.01 and 0.007 respectively). Discussion: This fi rst large population based study suggests that malformations and initial intensive care unit stay infl uence survival, while morbidity is infl uenced by different independent factors.

Archives of Disease in Childhood, 2014

primary outcome variable, consideration of PA, defined as clearly-documented consideration of PA ... more primary outcome variable, consideration of PA, defined as clearly-documented consideration of PA in attending or trainee note OR skeletal survey ordered OR child-abuse team consult ordered. Co-variates examined as well. Results Characteristics of 529 patients and physicians are displayed in Table 1. For the entire cohort, consideration of PA occurred in 346 (65%), whereas consideration in infants <6 months of age occurred in 194 (78%). EMR clearlydocumented consideration of PA occurred in 288 (54%). Characteristics associated with greater odds for consideration of PA after covariate adjustment (OR and 95% CI) included younger patient age (IQR of 12.1 to 38.7 weeks: 0.53 [0.33, 0.84]), no history provided for injury (9.41 [3.88, 22.82]), softtissue injury (4.95, [1.57, 15.54]), and male attending (1.84, [1.12, 3.01]). Conclusion PED physicians frequently do not consider PA in infants with fractures. Characteristics associated with consideration for PA include patient age, no history provided to explain the injury, soft-tissue injury, and male attending gender.

Minerva pediatrica, 2010

Congenital diaphragmatic hernia (CDH) is one of the most serious and controversial congenital ano... more Congenital diaphragmatic hernia (CDH) is one of the most serious and controversial congenital anomalies. Pulmonary hypoplasia with/without pulmonary hypertension (and major associated anomalies) are reported the main causes of death in these patients. New treatment strategies for CDH have allowed an increase of survival also of more severe patients. As a consequence many attentions are now focused on long term follow up of these delicate babies. Many reports, in the last years, have highlighted associated morbidities in CDH survivors, such as pulmonary sequelae, neurodevelopmental delay, auxological deficits, gastrointestinal and orthopedic disorders. Therefore it is nowadays quite evident that this group of patient is a complex population to care during the first year of life but also throughout infancy and childhood, thus requiring a well defined follow up. Single institution data on overall survival have been frequently reported, only few of these however reported long term follo...

Transplantation proceedings, 1996

Prenatal Diagnosis, 1990

ABSTRACT

European Urology, 1992

There is no univoque opinion about the place of preoperative studies in non-palpable testes. Duri... more There is no univoque opinion about the place of preoperative studies in non-palpable testes. During a 6.5-year period, we operated on 296 impalpable testes in prepubertal boys. A combined inguinal-abdominal approach was used in all cases verifying the eventual abdominal testis and its exact vascular anatomy before any manipulation of the cord was undertaken. Forty-five testes (15.2%) were canalicular, 142 (48%) were abdominal, 5 (1.7%) dysgenetic and 104 (34.1%) absent (agenesis or vanishing testis). Of the abdominal testes, 122 underwent a standard orchidopexy in dartos pouch, 11 a staged repair, 8 a Fowler-Stephens operation and 1 orchiectomy. All means of investigation for impalpable testes are either unreliable, too expensive or too invasive for routine use, and in most cases, a surgical exploration has to be performed anyway. The primary surgical approach has the most favorable cost/benefit ratio, being diagnostic and therapeutic at one time. Provided the exploration is performed correctly, all the advantages of previous laparoscopy can be achieved with surgery alone.

Journal of Pediatric Surgery, 2003

Background/Purpose: As long as the survival rate of patients with abdominal wall defects (AWD) in... more Background/Purpose: As long as the survival rate of patients with abdominal wall defects (AWD) increases, information about long-term follow-up is becoming necessary. Even though quality of life in these patients, in absence of associated anomalies, appears to be unaffected, respiratory impairment soon after birth has been documented; therefore, participation in sports rarely is addressed. Methods: Eighteen patients, ranging in age

Journal of Clinical Ultrasound, 1993

Renal vein thrombosis and adrenal hemorrhage can both be encountered in the neonatal period and t... more Renal vein thrombosis and adrenal hemorrhage can both be encountered in the neonatal period and they may occur at the same time. Inferior vena cava thrombosis can complicate some cases. These diseases can be easily diagnosed by means of ultrasound. The authors present 4 cases in which newborns were affected by renal vein thrombosis associated with adrenal hemorrhage and caval thrombosis, evaluated by means of ultrasound. The echographic aspect of renal, adrenal and caval involvement is described. 0 1993 John Wiley & Sons, Inc. Indexing Words: Thrombosis * Renal vein thrombosis Adrenal hemorrhage * Inferior vena cava thrombosis-Newborn

European Journal of Pediatric Surgery, 2011

Congenital diaphragmatic hernia (CDH) presents with a broad spectrum of severity, depending on th... more Congenital diaphragmatic hernia (CDH) presents with a broad spectrum of severity, depending on the degree of pulmonary hypoplasia and persistent pulmonary hypertension (PPH). It is currently not clear whether pulmonary hypertension may affect late morbidity. Aim of the present study was to evaluate the influence of PPH on mid-term morbidity in high-risk CDH survivors. All high-risk (prenatal diagnosis and/or respiratory symptoms within 6 h of life) CDH survivors, treated between 2004 and 2008 in our Department were followed up in a multidisciplinary outpatient clinic as part of a longitudinal prospective study. Auxological, gastroesophageal, pulmonary and orthopedic evaluations were done at specific time-points (at 6, 12, and 24 months of age). Patients were grouped depending on the presence/absence of pulmonary hypertension (defined by expert pediatric cardiologists after echocardiography). Paired t-test and Fisher&amp;#39;s exact test were used as appropriate. P &amp;lt; 0.05 was considered significant. 70 survivors out of a total of 95 high-risk CDH infants treated in our Department attended our follow-up clinic and were prospectively evaluated. 17 patients were excluded from the present study because no clear data was available regarding the presence/absence of PPH during the perinatal period. Moreover, 9 infants were not enrolled because they did not reach at least 6 months of age. A total of 44 survivors were finally enrolled since they met the inclusion criteria. 26 infants did not present with PPH during the first hospital admission, while 18 had PPH. The 2 groups did not differ with regard to any of the outcomes considered at follow-up (p &amp;gt; 0.2). In our cohort of high-risk CDH survivors, PPH was not found to affect late sequelae at mid-term follow-up. This may indicate that postnatal pulmonary development is not (always) influenced by perinatal PPH. Nevertheless, a longer follow-up and more patients are needed to properly quantify possible late problems in high-risk CDH survivors with associated neonatal PPH.

Diseases of the Esophagus, 2013

Long-gap esophageal atresia (LGEA) is still a major surgical challenge. Options for esophageal re... more Long-gap esophageal atresia (LGEA) is still a major surgical challenge. Options for esophageal reconstruction include the use of native esophagus or esophageal replacement with stomach, colon, or small intestine. Nonetheless, there is a consensus among most pediatric surgeons that the preservation of the native esophagus is associated with better postoperative outcomes. Thus, every effort should be made to conserve the native esophagus. The present study is aimed at critically reporting our experience focused on a standardized protocol based on the preoperative assessment of the gap in all cases and reviewing the present literature because no consensus is available regarding many aspects of LGEA (from definition to treatment). All newborn infants treated since 1995 for esophageal atresia (EA), regardless of type, were included in the present study. Identification of LGEA patients (gap ≥3 vertebral bodies) was performed based on preoperative esophageal gap measurement. The selected patients were grouped based on EA type (A/B vs. C/D) and whether they were referred from an outside institution or not. Postoperative outcome was compared. Statistical analysis was performed with the Fisher&amp;#39;s exact test and Mann-Whitney test as appropriate, with P &amp;lt; 0.05 considered statistically significant. Two hundred and nineteen patients have been consecutively treated between 1995 and 2012 with the following EA subtypes: type: A 25 (11.4%); B 6 (2.7%); C 182 (83.1%); D 3 (1.4%); E 3 (1.4%). Fifty-seven patients (26%) were classified as LGEA: type A-B, 31 (54.4%); type C-D, 26 (45.6%). Twenty seven (47%) of these patients were referred after at least one failed attempt at esophageal correction: type A-B, 15 (55%); type C-D, 12 (45%). Only one patient ultimately required esophageal substitution, with an overall survival rate of 94%. A standardized perioperative protocol enhances the possibility of preserving the native esophagus in cases of LGEA. Gap measurement can be accurately defined before surgery in all patients with EA. Esophageal anastomosis (either immediate or delayed repair) is almost always feasible; esophageal substitution should only be considered after a rigorous attempt at achieving end-to-end esophageal anastomosis.

Journal of Surgical Oncology, 1981

ABSTRACT Side-effects to levamisole given as adjuvant to surgery in a consecutive series of 203 n... more ABSTRACT Side-effects to levamisole given as adjuvant to surgery in a consecutive series of 203 neoplastic patients are reported: Thirty-four patients (16.7%) suffered gastric adverse reactions; 8 (3.9%) allergic; 6 (2.9%) intestinal; 6 (2.9% neurologic; 4 (1.9%) severe hyperthermia (more than 40.5 degrees C); 3 (1.4%) flu-like illness; 1 (0.4% leucopenia; and 1 (0.4%) agranulocytosis. Withdrawal rate was 5.4% or 11 patients. Side effects appeared sex-related (39.0% in females, 17.7% in males; with seven female dropout out of 11), unrelated to other eventual adjuvant treatments, and reappearing at a new challenge with levamisole. The opportunity of very close control of patients taking levamisole for at least the first months is discussed.

Ultrasound in Obstetrics & Gynecology, 2020

Diseases of the Esophagus, 2019

Diseases of the Esophagus, 2016

Archives of Disease in Childhood, 2014

Minerva pediatrica, 2010

Transplantation proceedings, 1996

Prenatal Diagnosis, 1990

ABSTRACT

European Urology, 1992

Journal of Pediatric Surgery, 2003

Journal of Clinical Ultrasound, 1993

European Journal of Pediatric Surgery, 2011

Diseases of the Esophagus, 2013

Journal of Surgical Oncology, 1981