744 results on '"Bagolan, P."'
Search Results
202. 60 Birthweight and Mcgoon Index Predict Outcome in Newborn Infants with Congenital Diaphragmatic Hernia (CDH).
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Capolupo, I, primary, Casaccia, G, additional, Crescenzi, F, additional, Dotta, A, additional, Braguglia, A, additional, Campi, F, additional, Rechichi, J, additional, Pasquini, L, additional, Bagolan, P, additional, Corchia, C, additional, and Orzalesi, M, additional
- Published
- 2005
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203. 204 Maturation of Lung Function During The First Two Years of Life in Infants with Congenital Diaphragmatic Hernia (CDH) Treated with a Gentle Ventilation and Delayed Surgery Strategy
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Dotta, A, primary, Palamides, S, additional, Cicchetti, R, additional, Capolupo, I, additional, Casaccia, G, additional, Bagolan, P, additional, Corchia, C, additional, and Orzalesi, M, additional
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- 2004
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204. Position Paper of INoEA Working Group on Long-Gap Esophageal Atresia: For Better Care
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van der Zee, David C., Bagolan, Pietro, Faure, Christophe, Gottrand, Frederic, Jennings, Russell, Laberge, Jean-Martin, Martinez Ferro, Marcela Hernan, Parmentier, Benoît, Sfeir, Rony, and Teague, Warwick
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Perspective ,long-gap esophageal atresia ,definition ,diagnosis ,management ,centers of expertise - Abstract
INoEA is the International Network of Esophageal Atresia and consists of a broad spectrum of pediatric specialties and patient societies. The working group on long-gap esophageal atresia (LGEA) set out to develop guidelines regarding the definition of LGEA, the best diagnostic and treatment strategies, and highlight the necessity of experience and communication in the management of these challenging patients. Review of the literature and expert discussion concluded that LGEA should be defined as any esophageal atresia (EA) that has no intra-abdominal air, realizing that this defines EA with no distal tracheoesophageal fistula (TEF). LGEA is considerably more complex than EA with distal TEFs and should be referred to a center of expertise. The first choice is to preserve the native esophagus and pursue primary repair, delayed primary anastomosis, or traction/growth techniques to achieve anastomosis. A cervical esophagostomy should be avoided if possible. Only if primary anastomosis is not possible, replacement techniques should be used. Jejunal interposition is proposed as the best option among the major EA centers. In light of the infrequent occurrence of LGEA and the technically demanding techniques involved to achieve esophageal continuity, it is strongly advised to develop regional or national centers of expertise for the management and follow-up of these very complex patients.
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- 2017
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205. Bipedicled skin flaps for reconstruction of the abdominal wall in newborn omphalocele
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Zaccara, A., primary, Zama, M., additional, Trucchi, A., additional, Nahom, A., additional, De Stefano, F., additional, and Bagolan, P., additional
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- 2003
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206. Multidisciplinary Management of Fetal Surgical Anomalies: The Impact on Maternal Anxiety
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Aite, L., primary, Trucchi, A., additional, Nahom, A., additional, Spina, V., additional, Bilancioni, E., additional, and Bagolan, P., additional
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- 2002
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207. Severe Congenital Diaphragmatic Hernia (CDH): A Critical Analysis of Eight Years' Experience
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Bagolan, P., primary, Casaccia, G., additional, Nahom, A., additional, Trucchi, A., additional, Zangari, A., additional, Laviani, R., additional, Pirozzi, N., additional, Di Liso, G., additional, and Orzalesi, M., additional
- Published
- 2002
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208. OC12.07: Fetal brain development in congenital diaphragmatic hernia.
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Fabietti, I., Savelli, S., Romiti, A., Viggiano, M., Vicario, R., Grassini, G., Nicastri, E., Valfrè, L., Giliberti, P., Capolupo, I., Morini, F., Bagolan, P., and Caforio, L.
- Abstract
It is reported that many infants with CDH have evidence of brain injury on postnatal brain magnetic resonance imaging (MRI). Results HT
ht CF were measured and corrected by biparietal diameter (BPD), obtaining a ratio (CF/BPD) for each fissure measurement to perform the statistical analysis. [Extracted from the article]CDH Controls p Transverse cerebellar diameter (mm) 39 (24-51) 41 (30-49) 0.1533 Anteroposterior vermis length (mm) 13 (9-17) 13 (9-16) 0.3214 Craniocaudal vermis length (mm) 18 (13-25) 19 (13-23) 0.7155 Parietoccipital fissure depth/BPD 0.09 (0.07-0.13) 0.09 (0.05-0.15) 0.6492 Lateral fissure depth/BPD 0.16 (0.13-0.21) 0.16 (0.12-0.19) 0.5901 Cingular fissure depth/BPD 0.06 (0.03-0.10) 0.04 (0.03-0.09) 0.0001 Insular depth/BPD 0.27 (0.24-0.33) 0.28 (0.23-0.33) 0.0149 - Published
- 2022
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209. OC03.04: Management of fetal ovarian cysts based on ultrasound morphology: a new proposal.
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Moro, F., Romiti, A., Ricci, L., Codecà, C., Pozzati, F., Viggiano, M., Vicario, R., Fabietti, I., Biscione, A., Valfrè, L., Scambia, G., Bagolan, P., Testa, A.C., and Caforio, L.
- Abstract
To describe ultrasound features of fetal ovarian cysts as reported by the original ultrasound examiner and according to IOTA terminology. Ovarian cysts with low level content could be managed expectantly, whereas ovarian cysts with other cyst content should be managed with postnatal surgery, due to the high risk of necrosis at final histology. [Extracted from the article]
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- 2022
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210. Prenatal diagnosis of a bronchogenic cyst in an unusual site
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Bagolan, P., primary, Bilancioni, E., additional, Nahom, A., additional, Trucchi, A., additional, Inserra, A., additional, Neri, M., additional, Spina, V., additional, and Giorlandino, C., additional
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- 2000
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211. Difficult esophageal atresia: Trick and treat.
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Conforti, Andrea, Morini, Francesco, and Bagolan, Pietro
- Abstract
Although most patients with esophageal atresia (EA) and tracheo-esophageal fistula (TEF) may benefit from “standard” management, which is deferred emergency surgery, some may present unexpected elements that change this paradigm. Birth weight, associated anomalies, and long gap can influence the therapeutic schedule of the patients with EA/TEF and can make their treatment tricky. As a consequence, detailed information on these aspects gives the power to develop a decision-making process as correct as possible. In this article, we will review the most important factors influencing the treatment of patients with EA/TEF and will share our experience on the diagnostic and therapeutic tips that may provide pivotal help in the management of such patients. [ABSTRACT FROM AUTHOR]
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- 2014
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212. Near infrared spectroscopy: Experience on esophageal atresia infants.
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Conforti, Andrea, Giliberti, Paola, Mondi, Vito, Valfré, Laura, Sgro, Stefania, Picardo, Sergio, Bagolan, Pietro, and Dotta, Andrea
- Abstract
Abstract: Objective: Near infrared spectroscopy (NIRS) gradually became the gold standard to guide anesthetic conduction during cardiac surgery, and nowadays, it is commonly utilized to monitor cerebral oxygenation during invasive procedures. Preterm babies also benefit from this non-invasive monitoring to prevent neurological sequelae. However, few data are available on NIRS perioperative changes in newborn operated on for major non-cardiac malformations. Aim of the present study is to evaluate the usefulness of NIRS assessment during and after esophageal atresia (EA) correction and its correlation with clinical behavior. Patients and Methods: All patients treated for EA from May 2011 were prospectively enrolled in the study. All infants underwent “open” correction of EA and cerebral and splanchnic NIRS was applied up to 48h after surgery. Body temperature, blood pressure, pH, paSO2, paCO2, and urine output, were recorded during NIRS registration. Mann–Whitney test and 1-way ANOVA (Kruskal–Wallis and Dunn’s multiple comparison tests) were used as appropriate. Results: Seventeen patients were enrolled into the study and 13 were available for the analysis. Four patients were excluded because of poor NIRS registration. Cerebral and renal NIRS values significantly decreased at 24h post-operatively (p<0.05). Interestingly, all parameters studied as possible confounders in NIRS remained stable during the study period. Urine output significantly decreased. Conclusion: Our data confirmed that perioperative monitoring of tissue oxygenation during neonatal esophageal surgery is feasible. Cerebral and renal NIRS evaluation, as for cardiac patients, may guide anesthetic conduction and postoperative care. Out data suggest a newly observed hemodynamic reorganization during esophageal surgery involving renal and, probably, splanchnic blood flow redistribution, demonstrated by the observed subsequent significant post-operative transitory decrease in urinary output. Reducing the decrement in cerebral and renal NIRS values may improve, and ideally eliminate, the well-known late sequelae linked to hemodynamic changes during surgery. More studies are needed to better understand the causes of the NIRS described hemodynamic changes and, therefore, correct them. [Copyright &y& Elsevier]
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- 2014
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213. Fetal tachycardia and chylous ascites
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Bagolan, P., primary, Bilancioni, E., additional, Spina, V., additional, Nahom, A., additional, Trucchi, A., additional, Gambuzza, G., additional, Drago, F., additional, and Giorlandino, C., additional
- Published
- 1999
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214. Sperm Parameters After Early Left Varicocele Treatment
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Lenzi, A., primary, Gandini, L., additional, Bagolan, P., additional, Nahum, A., additional, and Dondero, F., additional
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- 1998
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215. Long-term parenteral nutrition in the management of extremely short bowel syndrome
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Gambarara, M., primary, Goulet, O., additional, Bagolan, P., additional, Ferretti, F., additional, Papadatou, P., additional, Capuano, L., additional, Lucidi, V., additional, Diamanti, A., additional, and Castro, M., additional
- Published
- 1998
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216. LUNG MECHANICS IN NEWBORN INFANTS WITH SEVERE CONGENITAL DIAPHRAGMATIC HERNIA (CDH) BEFORE AND AFTER SURGICAL REPAIR
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Dotta, A, primary, Savignoni, F, additional, Bagolan, P, additional, Nahom, A, additional, Trucchi, A, additional, Crescenzi, F, additional, Guadagni, A M, additional, Palamides, S, additional, and Orzalesi, M, additional
- Published
- 1998
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217. Intestinal adaptation in short bowel syndrome
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Gambarara, M., primary, Ferretti, F., additional, Papadatou, B., additional, Lucidi, V., additional, Diamanti, A., additional, Bagolan, P., additional, Bella, S., additional, and Castro, M., additional
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- 1997
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218. Clinical heterogeneity of chronic intestinal pseudo-obstruction
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Papadatou, B., primary, Ferretti, F., additional, Gambarara, M., additional, Diamanti, A., additional, De Peppo, F., additional, Bagolan, P., additional, Rivosecchi, M., additional, and Castro, M., additional
- Published
- 1997
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219. The randomized Tracheal Occlusion To Accelerate Lung growth (TOTAL)-trials on fetal surgery for congenital diaphragmatic hernia: reanalysis using pooled data.
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Van Calster, Ben, Benachi, Alexandra, Nicolaides, Kypros H., Gratacos, Eduard, Berg, Christoph, Persico, Nicola, Gardener, Glenn J., Belfort, Michael, Ville, Yves, Ryan, Greg, Johnson, Anthony, Sago, Haruhiko, Kosiński, Przemysław, Bagolan, Pietro, Van Mieghem, Tim, DeKoninck, Philip L.J., Russo, Francesca M., Hooper, Stuart B., and Deprest, Jan A.
- Subjects
DIAPHRAGMATIC hernia ,NEONATAL intensive care units ,FETAL surgery ,PREMATURE rupture of fetal membranes ,PREMATURE labor ,LUNGS ,TRACHEAL surgery ,FETOSCOPY ,RESEARCH ,RESEARCH methodology ,GENETIC disorders ,EVALUATION research ,COMPARATIVE studies ,RANDOMIZED controlled trials ,RESEARCH funding ,CATHETERIZATION - Abstract
Background: Two randomized controlled trials compared the neonatal and infant outcomes after fetoscopic endoluminal tracheal occlusion with expectant prenatal management in fetuses with severe and moderate isolated congenital diaphragmatic hernia, respectively. Fetoscopic endoluminal tracheal occlusion was carried out at 27+0 to 29+6 weeks' gestation (referred to as "early") for severe and at 30+0 to 31+6 weeks ("late") for moderate hypoplasia. The reported absolute increase in the survival to discharge was 13% (95% confidence interval, -1 to 28; P=.059) and 25% (95% confidence interval, 6-46; P=.0091) for moderate and severe hypoplasia.Objective: Data from the 2 trials were pooled to study the heterogeneity of the treatment effect by observed over expected lung-to-head ratio and explore the effect of gestational age at balloon insertion.Study Design: Individual participant data from the 2 trials were reanalyzed. Women were assessed between 2008 and 2020 at 14 experienced fetoscopic endoluminal tracheal occlusion centers and were randomized in a 1:1 ratio to either expectant management or fetoscopic endoluminal tracheal occlusion. All received standardized postnatal management. The combined data involved 287 patients (196 with moderate hypoplasia and 91 with severe hypoplasia). The primary endpoint was survival to discharge from the neonatal intensive care unit. The secondary endpoints were survival to 6 months of age, survival to 6 months without oxygen supplementation, and gestational age at live birth. Penalized regression was used with the following covariates: intervention (fetoscopic endoluminal tracheal occlusion vs expectant), early balloon insertion (yes vs no), observed over expected lung-to-head ratio, liver herniation (yes vs no), and trial (severe vs moderate). The interaction between intervention and the observed over expected lung-to-head ratio was evaluated to study treatment effect heterogeneity.Results: For survival to discharge, the adjusted odds ratio of fetoscopic endoluminal tracheal occlusion was 1.78 (95% confidence interval, 1.05-3.01; P=.031). The additional effect of early balloon insertion was highly uncertain (adjusted odds ratio, 1.53; 95% confidence interval, 0.60-3.91; P=.370). When combining these 2 effects, the adjusted odds ratio of fetoscopic endoluminal tracheal occlusion with early balloon insertion was 2.73 (95% confidence interval, 1.15-6.49). The results for survival to 6 months and survival to 6 months without oxygen dependence were comparable. The gestational age at delivery was on average 1.7 weeks earlier (95% confidence interval, 1.1-2.3) following fetoscopic endoluminal tracheal occlusion with late insertion and 3.2 weeks earlier (95% confidence interval, 2.3-4.1) following fetoscopic endoluminal tracheal occlusion with early insertion compared with expectant management. There was no evidence that the effect of fetoscopic endoluminal tracheal occlusion depended on the observed over expected lung-to-head ratio for any of the endpoints.Conclusion: This analysis suggests that fetoscopic endoluminal tracheal occlusion increases survival for both moderate and severe lung hypoplasia. The difference between the results for the Tracheal Occlusion To Accelerate Lung growth trials, when considered apart, may be because of the difference in the time point of balloon insertion. However, the effect of the time point of balloon insertion could not be robustly assessed because of a small sample size and the confounding effect of disease severity. Fetoscopic endoluminal tracheal occlusion with early balloon insertion in particular strongly increases the risk for preterm delivery. [ABSTRACT FROM AUTHOR]- Published
- 2022
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220. Neonatal Intestinal Obstruction: Reducing Short-Term Complications by Surgical Refinements
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Bagolan, P., primary, Nappo, S., additional, Trucchi, A., additional, Ferro, F., additional, and Alessandri, A., additional
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- 1996
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221. Maximal oxygen consumption and stress performance in children operated on for congenital diaphragmatic hernia
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Zaccara, A., primary, Turchetta, A., additional, Calzolari, A., additional, Iacobelli, B., additional, Nahom, A., additional, Lucchetti, M.C., additional, Bagolan, P., additional, Rivosecchi, M., additional, and Coran, A.G., additional
- Published
- 1996
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222. Antenatal ultrasonographic diagnosis and management of fetal ovarian cysts
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Giorlandino, C., primary, Bilancioni, E., additional, Bagolan, P., additional, Muzii, L., additional, Rivosecchi, M., additional, and Nahom, A., additional
- Published
- 1994
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223. Standardized reporting for congenital diaphragmatic hernia – An international consensus.
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Lally, Kevin P., Lasky, Robert E., Lally, Pamela A, Bagolan, Pietro, Davis, Carl F., Frenckner, Bjorn P., Hirschl, Ronald M., Langham, Max R., Buchmiller, Terry L., Usui, Noriaki, Tibboel, Dick, and Wilson, Jay M.
- Abstract
Abstract: Background/purpose: Congenital diaphragmatic hernia (CDH) remains a significant cause of neonatal death. A wide spectrum of disease severity and treatment strategies makes comparisons challenging. The objective of this study was to create a standardized reporting system for CDH. Methods: Data were prospectively collected on all live born infants with CDH from 51 centers in 9 countries. Patients who underwent surgical correction had the diaphragmatic defect size graded (A–D) using a standardized system. Other data known to affect outcome were combined to create a usable staging system. The primary outcome was death or hospital discharge. Results: A total of 1,975 infants were evaluated. A total of 326 infants were not repaired, and all died. Of the remaining 1,649, the defect was scored in 1,638 patients. A small defect (A) had a high survival, while a large defect was much worse. Cardiac defects significantly worsened outcome. We grouped patients into 6 categories based on defect size with an isolated A defect as stage I. A major cardiac anomaly (+) placed the patient in the next higher stage. Applying this, patient survival is 99% for stage I, 96% stage II, 78% stage III, 58% stage IV, 39% stage V, and 0% for non-repair. Conclusions: The size of the diaphragmatic defect and a severe cardiac anomaly are strongly associated with outcome. Standardizing reporting is imperative in determining optimal outcomes and effective therapies for CDH and could serve as a benchmark for prospective trials. [Copyright &y& Elsevier]
- Published
- 2013
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224. Functional residual capacity (FRC) and lung clearance index (LCI) in mechanically ventilated infants: Application in the newborn with congenital diaphragmatic hernia (CDH).
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Landolfo, Francesca, Savignoni, Ferdinando, Capolupo, Irma, Columbo, Claudia, Calzolari, Flaminia, Giliberti, Paola, Chukhlantseva, Natalia, Bagolan, Pietro, and Dotta, Andrea
- Abstract
Abstract: Introduction: Functional residual capacity (FRC) and lung clearance index (LCI) are sensitive parameters for early detection of airway disease in infancy. The closed helium dilution method has been applied to assess lung volume and ventilation inhomogeneity (VI) in spontaneously breathing infants. Aims: The aims of this study were as follows: (1) to assess applicability of the helium gas dilution technique in mechanically ventilated infants with high-risk congenital diaphragmatic hernia (CDH) and to evaluate changes in breathing patterns, lung volume, and VI during the first days of life before and after surgery, and (2) to analyze the possible correlation between changes in lung volume, cerebral hemodynamics, and oxygenation before and after surgical correction of CDH through near-infrared spectroscopy (NIRS) monitoring. Methods: Lung function tests were performed by multibreath washout traces with an ultrasonic flowmeter and helium gas dilution technique. For all babies, three acceptable FRC and LCI measurements were collected for each test (mean and SD of three measurements were calculated) before surgery (T
0 ), 24h after surgery (T1 ) during mechanical ventilation, and within 24h after extubation in spontaneous breathing (T2 ). Cerebral and splanchnic hemodynamics were continuously monitored by NIRS during mechanical ventilation to evaluate relationships between changes in lung volume and capillary–venous oxyhemoglobin saturation in tissues. Fraction of inspired oxygen delivered was adjusted to keep oxygen saturation between 90% and 95%. Results: Thirteen CDH infants were studied; median GA=38weeks (range 35–41) and median BW=3000g (range 1850–3670). FRC and LCI significantly improved after extubation when compared with pre-surgical values. No differences were found in tidal volume (Vt) and NIRS monitoring before and after surgery and after extubation. Neither LCI nor FRC was correlated with NIRS values. Conclusions: Helium gas dilution technique is an applicable and reliable technique to measure lung volumes and ventilation inhomogeneity also in ventilated infants. NIRS is a non-invasive technique to monitor tissue oxygenation during surgery and mechanical ventilation. In CDH newborns these preliminary data show an improvement in both FRC and LCI after extubation. [Copyright &y& Elsevier]- Published
- 2013
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225. Renal vein thrombosis and adrenal hemorrhage in the newborn: Ultrasound evaluation of 4 cases
- Author
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Orazi, C., primary, Fariello, G., additional, Malena, S., additional, Schingo, P., additional, Ferro, F., additional, and Bagolan, P., additional
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- 1993
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226. Prenatal diagnosis and clinical outcome of ovarian cysts
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Bagolan, P., primary, Rivosecchi, M., additional, Giorlandino, C., additional, Bilancioni, E., additional, Nahom, A., additional, Zaccara, A., additional, Trucchi, A., additional, and Ferro, F., additional
- Published
- 1992
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227. Congenital Askin tumor with favorable outcome: case report and review of the literature.
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Crocoli, Alessandro, Bagolan, Pietro, Boldrini, Renata, Natali, Gian Luigi, De Ioris, Maria Antonietta, and Morini, Francesco
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TUMORS in infants ,NEONATAL diseases ,LITERATURE reviews ,TUMOR diagnosis ,HEALTH counseling - Abstract
Abstract: Several disorders may present as cystic complex lesions of the fetal thorax, both with benign and malignant behavior. As a consequence, their detection may pose diagnostic, therapeutic, and parental counseling dilemmas. We describe a neonate with a congenital Askin tumor, diagnosed at the 37th week of gestation and treated after birth. Counseling and treatment challenges are discussed. [Copyright &y& Elsevier]
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- 2012
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228. Symptomatic Vocal Cord Paresis/Paralysis in Infants Operated on for Esophageal Atresia and/or Tracheo-Esophageal Fistula.
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Morini, Francesco, Iacobelli, Barbara D., Crocoli, Alessandro, Bottero, Sergio, Trozzi, Marilena, Conforti, Andrea, and Bagolan, Pietro
- Abstract
Objectives: To describe the prevalence and pathogenesis of symptomatic vocal cord paresis/paralysis (VCP) in patients treated for esophageal atresia (EA), tracheo-esophageal fistula (TEF) or both. Study design: Retrospective study of all patients treated for EA/TEF in our center (1995 to 2009). Patients with and without symptomatic VCP were compared for gestational age, birth weight, associated anomalies, referrals, long-gap EA (>3cm or 3 vertebral bodies), cervical esophagostomy, anastomotic leakage, length of ventilation, and major cardiac surgery. Prevalence or median (IQR) is reported. Results: Of 174 patients, 7 (4%) had symptomatic VCP. Prevalence of referrals (5/7 versus 21/167; P = .0009), long gap (5/7 versus 41/167; P = .0146), previous cervical esophagostomy (5/7 versus 7/167; P < .0001), and anastomotic leakage (3/7 versus 10/167; P = .0097) was higher, and ventilation longer (8.5 days [7.0 to 15.5] versus 6.0 days (5.0 to 7.0); P = .0072) in patients with VCP. Conclusions: In infants treated for EA/TEF, VCP should be ruled out in case of persistent respiratory morbidity or, when present, cautiously monitored. Surgical risk factors should be actively controlled. Further studies are needed to define the prevalence of acquired and congenital VCP in patients with EA/TEF. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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229. Preoperative administration of Sudan III and successful treatment of persistent chylous ascites in a neonate.
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Spagnol, Lorna, Conforti, Andrea, Valfrè, Laura, Morini, Francesco, and Bagolan, Pietro
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ASCITES ,NEONATAL diseases ,LYMPHATIC abnormalities ,CAUTERY ,FIBRIN ,PEDIATRIC surgery ,PREOPERATIVE care ,THERAPEUTICS - Abstract
Abstract: Congenital chylous ascites is a rare entity, and surgical treatment is confined to selected intractable cases. We report 2 cases of refractory congenital chylous ascites successfully treated with preoperative administration of lipophilic dye (Sudan III) followed by abdominal systematic surgical exploration, cauterization, and fibrin glue application. [Copyright &y& Elsevier]
- Published
- 2011
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230. Long term follow-up in high-risk congenital diaphragmatic hernia survivors: patching the diaphragm affects the outcome.
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Valfrè, Laura, Braguglia, Annabella, Conforti, Andrea, Morini, Francesco, Trucchi, Alessandro, Iacobelli, Barbara Daniela, Nahom, Antonella, Chukhlantseva, Natalia, Dotta, Andrea, Corchia, Carlo, and Bagolan, Pietro
- Subjects
DIAPHRAGMATIC hernia ,INFANT disease treatment ,HEALTH outcome assessment ,FOLLOW-up studies (Medicine) ,GASTROESOPHAGEAL reflux ,LONGITUDINAL method ,CHEST abnormalities - Abstract
Abstract: Background/Purpose: The increased survival rate reached in infants with congenital diaphragmatic hernia (CDH) has shown a concomitant increase in late morbidity. A recent report from CDH Study Group showed that dimension of diaphragmatic defect is the only independent risk factor of mortality. However, the influence of defect size on late morbidity is still controversial. The aim of the study was to evaluate the influence of patch repair (proxy of diaphragmatic defects size) on midterm morbidity. Methods: All high-risk (prenatal diagnosis and/or respiratory symptoms within 6 hours of life) CDH survivors treated at our institution from 2004 to 2008 were followed up in a multidisciplinary outpatient clinic as part of a longitudinal prospective study. Auxological, gastroesophageal, pulmonary, and orthopedic evaluations were performed at 6, 12, and 24 months of age. Patient outcomes were compared with respect to +/− patch repair. Results: Of 70 survivors, 61 (87%) were enrolled and prospectively evaluated in follow-up. Poorer auxological outcome, increased rate of gastroesophageal reflux, and altered pulmonary function test were observed during follow-up. Conclusions: Patch repair correlates with higher pulmonary, auxological, and gastroesophageal morbidity without increasing chest wall deformities at long-term follow-up. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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231. Asymptomatic congenital cystic adenomatoid malformation of the lung: Is it time to operate?
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Conforti, Andrea, Aloi, Ivan, Trucchi, Alessandro, Morini, Francesco, Nahom, Antonella, Inserra, Alessandro, and Bagolan, Pietro
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LUNG abnormalities ,LUNG diseases ,GENETIC disorders in children ,SURGICAL therapeutics ,DIAGNOSTIC ultrasonic imaging ,HEALTH outcome assessment ,SURGICAL complications ,PATIENTS - Abstract
Objective: The optimal management of congenital adenomatoid malformation of the lung remains controversial. Prenatal ultrasonographic analysis has increasingly discovered asymptomatic lesions, raising questions about the need for and timing of surgical treatment for asymptomatic congenital adenomatoid malformation. The aim of our study was to analyze the short-term postoperative outcome of symptomatic congenital adenomatoid malformations compared with asymptomatic malformations. Methods: All the data of patients presenting with congenital adenomatoid malformations histologically diagnosed and operated on between 1998 and 2005 at our institution were retrospectively reviewed. Patients were divided into 2 groups: group A comprised asymptomatic infants, and group B comprised symptomatic infants. Major outcomes considered were the length of ventilation, pleural drainage, and hospital stay. Postoperative morbidity and mortality were also evaluated. Asymptomatic patients were further stratified for age at the time of the operation to evaluate whether age at surgical intervention affects the outcome. The Fisher''s exact and Mann–Whitney tests were used as appropriate. Results: Fifty-seven patients were consecutively treated. Thirty-five patients were given diagnoses of asymptomatic lesions and were enrolled into group A, whereas 22 patients presenting with symptoms were entered into group B. The lengths of ventilation, pleural drainage, and hospital stay were significantly longer in patients with symptomatic congenital adenomatoid malformations. Moreover, symptomatic patients presented with a higher postoperative complication rate. The age-based stratification of asymptomatic children did not show any difference on either postoperative mortality or major outcome considered. Conclusion: Children with congenital adenomatoid malformations operated on when asymptomatic present a better short-term outcome than symptomatic children. In addition, age at the time of the operation does not negatively affect the outcome. Our findings support early surgical treatment for asymptomatic congenital adenomatoid malformation. [Copyright &y& Elsevier]
- Published
- 2009
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232. Hearing impairment in congenital diaphragmatic hernia: the inaudible and noiseless foot of time.
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Morini, Francesco, Capolupo, Irma, Masi, Roberto, Ronchetti, Maria Paola, Locatelli, Mattia, Corchia, Carlo, and Bagolan, Pietro
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PEDIATRIC surgery ,PEDIATRICS ,GESTATIONAL age ,REGRESSION analysis - Abstract
Abstract: Aim of the Study: Infants with congenital diaphragmatic hernia (CDH) are at high risk of sensorineural hearing loss (SNHL). Extracorporeal membrane oxygenation is known to increase this risk, but little is known about other potential causes. We evaluated the impact of several risk factors on SNHL development in CDH survivors not treated with extracorporeal membrane oxygenation. Methods: All high-risk CDH survivors consecutively treated between 1999 and 2005 were included. SNHL was diagnosed based on formal assessment with standard audiologic tests. Patients with and without SNHL were compared for patient-related and treatment-related risk factors. Subsequently, a logistic regression analysis was performed to identify independent risk factors associated with SNHL development. Main Results: Out of 87 CDH survivors, 82 had a formal audiologic evaluation and 40 (49%) had SNHL. Patients with SNHL had significantly lower gestational age (P = .045); higher prevalence of sepsis (P < .001); older age at audiologic examination (P < .001); more episodes of hypocapnia (P = .045); higher prevalence of inhaled nitric oxide use (P = .005); longer mechanical ventilation (P = .009); and longer aminoglycosides (P = .006), furosemide (P = .004), and pancuronium bromide (P = .001) treatments. On logistic regression analysis, the only variable independently associated with the development of SNHL was patient''s age at audiologic follow-up (P = .012). Conclusions: Several risk factors were associated with SNHL development at univariate analysis. After logistic regression, only age at evaluation remained independently associated with SNHL. Routine audiologic follow-up is advocated in all CDH patients. Further studies are needed to define if other (genetic) factors may be involved in the pathogenesis of SNHL in patients with CDH. [Copyright &y& Elsevier]
- Published
- 2008
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233. Long-term follow up of infants with congenital diaphragmatic hernia.
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Bagolan, Pietro and Morini, Francesco
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DIAPHRAGMATIC hernia ,HUMAN abnormalities ,GASTROESOPHAGEAL reflux ,NEWBORN infants - Abstract
With improving treatment strategies for congenital diaphragmatic hernia (CDH) infants, an increase in survival of more severely affected patients can be expected. Consequently, more attention is now focused on long-term follow up of these patients. Many reports have emphasized associated morbidity, including pulmonary sequelae, neurodevelopmental deficits, gastrointestinal disorders, and other abnormalities. Therefore, survivors of CDH remain a complex patient population to care for throughout infancy and childhood, thus requiring long-term follow up. Much information has been provided from many centers regarding individual institutional improvements in overall survival. Few of these, however, have reported long-term follow up. The aim of this review is to describe the long-term outcome of survivors with CDH and to suggest a possible follow-up protocol for these patients. [Copyright &y& Elsevier]
- Published
- 2007
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234. Preoperative tracheobronchoscopy in newborns with esophageal atresia: does it matter?
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Atzori, Pietro, Iacobelli, Barbara D., Bottero, Sergio, Spirydakis, Joannis, Laviani, Raoul, Trucchi, Alessandro, Braguglia, Annabella, and Bagolan, Pietro
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ESOPHAGEAL atresia ,DIAGNOSIS ,BRONCHOSCOPY ,NEONATAL diseases - Abstract
Abstract: Background/Purpose: Despite surgical refinements, perioperative use of tracheobronchoscopy (TBS) as part of surgical approach to esophageal atresia (EA) is still controversial. The purpose of this study was to evaluate the influence of preoperative TBS in newborns with EA in preventing complications and improving diagnosis and surgical treatment. Methods: In the period ranging from 1997 to 2003, 62 patients with EA underwent preoperative TBS. The procedure was carried out with flexible bronchoscope maintaining spontaneous breathing. When a wide carinal fistula was found, this was mechanically occluded by Fogarty catheter and cannulated with rigid bronchoscopy. Type of EA, surgical procedure variations caused by TBS, and associated anomalies not easily detectable were recorded. Results: Before TBS, the Gross classification of the 62 patients was as follows: type A, 9 patients; type B, none; type C, 51 patients. At TBS, however, 3 of 9 type A patients had an unsuspected proximal fistula (type B). These 3 patients, plus the 2 with H-type fistula, were repaired through a cervical approach. In 4 patients, previously undetected malformations of the respiratory tree (2 aberrant right upper bronchus and 2 hypoplastic bronchi) were found at TBS. Carinal fistulas in 14 type C patients were occluded by Fogarty catheter to improve ventilation during repair. No complications were observed. Overall, TBS was clinically useful in 28 (45.2%) of 62 patients, including 15 (24.2%) of 62 infants in whom it was crucial in modifying the surgical approach. Conclusion: Tracheobronchoscopy is a useful and safe procedure and should be recommended in tertiary centers for babies with EA before surgical repair. [Copyright &y& Elsevier]
- Published
- 2006
- Full Text
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235. False-positive rate in prenatal diagnosis of surgical anomalies.
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Borsellino, Alessandro, Zaccara, Antonio, Nahom, Antonella, Trucchi, Alessandro, Aite, Lucia, Giorlandino, Claudio, and Bagolan, Pietro
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PRENATAL diagnosis ,OBSTETRICAL diagnosis ,MEDICAL imaging systems ,HUMAN abnormalities - Abstract
Abstract: Background/Purpose: Technical refinements and increasingly sophisticated equipment have led to higher sensitivity in prenatal diagnosis of congenital malformations; however, such progress may be accompanied by decreased specificity. The aim of this study is to evaluate evolution of prenatal diagnosis from the first sonographic suspicion of fetal anomaly until after delivery (diagnosis confirmed, resolution before birth, healthy baby, or affected with different disorder) to document rate of false-positive (FP) results. Methods: Retrospective review of prenatal ultrasound examinations performed at our institution between 2000 and 2002 was conducted. The series includes pregnancies referred to our department after detection of thoracic and abdominal anomalies at routine obstetrical sonography and with a follow-up comprising at least the first 6 months of life. Urologic malformations were excluded. Those fetuses who proved healthy at birth were considered FP results. Results: One hundred fifty-seven fetuses/neonates underwent complete follow-up. Prenatal diagnosis of esophageal atresia resulted in 3 (27%) of 11 FPs. Finding of dilated bowel, isolated or associated with hyperechogenicity or ascites, was not predictive of small bowel obstruction in 7 (41%) of 17 fetuses. No FPs were found with regard to abdominal wall defects (8 gastroschisis and 26 omphaloceles, all confirmed at birth). Concerning thoracic malformations, no FPs were seen among the 28 cases of congenital diaphragmatic hernia, whereas diagnosis of lung malformation presented a specificity of 97% (1/28 FP). Ovarian cysts accounted for an FP rate of 17% (4/23 FPs). Overall, a percentage of FP of 12% (6/50) was seen in 2000, of 11% (5/44) in 2001, and 9% (6/63) in 2002, with no statistically significant difference. Conclusions: Because of the high FP rate regarding some particular anomalies, unnecessary psychological burden to prospective parents may ensue. This issue should be dealt with in future prospective studies. [Copyright &y& Elsevier]
- Published
- 2006
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236. Congenital intestinal anomalies, neonatal short bowel syndrome, and prenatal/neonatal counseling.
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Casaccia, Germana, Trucchi, Alessandro, Spirydakis, Ioannis, Giorlandino, Claudio, Aite, Lucia, Capolupo, Irma, Catalano, Onofrio Antonio, and Bagolan, Pietro
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PRENATAL diagnosis ,BOWEL obstructions ,MEDICAL imaging systems ,NEWBORN infants - Abstract
Abstract: Background: Short bowel syndrome (SBS) is a severe malabsorption caused by bowel loss. Congenital intestinal anomalies (CIA) detectable by prenatal ultrasound as jejunoileal atresia, meconium peritonitis, complicated meconium ileus, and fetal volvulus can be responsible for SBS. Aims: This study aims to investigate either frequency of SBS or the morbidity in CIA population during the first admission. Material and methods: Records of CIA treated from 1997 to 2003 were reviewed. The prenatal ultrasound findings were correlated with SBS. Student''s t and χ
2 tests were performed to analyze epidemiological data, growth at discharge, sepsis, liver disease, catheter-related complications, motor developmental delay, and hospital stay in CIA with and without SBS. Results: Forty-four CIA: SBS developed in 43%, ranging from 83% in volvulus to 0% in complicated meconium ileus. Thirty-six prenatal diagnoses: a strong correlation with SBS was observed in isolated dilated bowel (58%). In SBS neonates, birth weight, gestational age, and growth at discharge were statistically lower, whereas sepsis, motor delay, and hospital stay were statistically higher. Conclusions: Many neonates with CIA detectable by prenatal ultrasound develop SBS. Short bowel syndrome presents a significant higher morbidity. The counseling should stress the frequent association between CIA and SBS as well as the significant morbidity in SBS. [Copyright &y& Elsevier]- Published
- 2006
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237. Corticosteroids for fetuses with congenital diaphragmatic hernia: can we show benefit?
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Lally, Kevin P., Bagolan, Pietro, Hosie, Stuart, Lally, Pamela A., Stewart, Michael, Cotten, C. Michael, Van Meurs, Krisa P., and Alexander, Gregor
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HYPERTENSION ,BLOOD circulation disorders ,CARDIOVASCULAR diseases ,OXYGEN - Abstract
Abstract: Background and Purpose: Prenatal corticosteroids have been used in fetuses with congenital diaphragmatic hernia (CDH). We tested the utility of steroids by 2 methods. Methods: Mothers carrying fetuses with CDH were randomized to 3 weekly doses of betamethasone or placebo starting at 34 weeks. Patients were followed until death or discharge. In a separate cohort study, the CDH Registry was used to compare infants who received prenatal steroids to those who had not. Results: Thirty-four patients were enrolled at 7 centers, with 32 completing the trial. There were 15 placebo and 17 steroid patients. There was no difference in survival, length of stay, duration of ventilation, or oxygen use at 30 days. For the cohort study, we looked at infants older than 34 weeks who were born after October 2000 when data on prenatal steroids were collected. There were 1093 patients; 390 were evaluable, with 56 receiving steroids. There was no difference in survival, length of stay, ventilator days, or oxygen use at 30 days. Conclusion: Neither the trial nor the CDH Registry suggest that late prenatal corticosteroids benefit fetuses with CDH. More than 1700 mothers and fetuses would need to be enrolled in a trial to show a 10% improvement in survival. It is unlikely that late steroids offer benefit to most fetuses with CDH. [Copyright &y& Elsevier]
- Published
- 2006
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238. Birth weight and McGoon Index predict mortality in newborn infants with congenital diaphragmatic hernia.
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Casaccia, Germana, Crescenzi, Francesco, Dotta, Andrea, Capolupo, Irma, Braguglia, Annabella, Danhaive, Olivier, Pasquini, L., Bevilacqua, Maurizio, Bagolan, Pietro, Corchia, Carlo, and Orzalesi, Marcello
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GESTATIONAL age ,MEDICAL informatics ,MEDICAL records ,EMBRYOLOGY - Abstract
Abstract: Background: Despite improvements in clinical management, mortality of congenital diaphragmatic hernia (CDH) remains high. Early prediction of mortality risk helps in comparing strategies and/or performances of different centers. Birth weight (BW), Apgar Score at 5 minutes, and modified McGoon Index (MGI) calculated by the ratio between the diameters of pulmonary arteries and the descending aorta have been used to determine mortality of CDH. Aim: The purpose of this study is to evaluate the relationship between early detectable variables and survival in newborns with CDH intubated at birth, managed with “gentle” ventilation and delayed surgery. Methods: All medical records of patients affected by high-risk CDH and treated with a standardized protocol at Bambino Gesù Children''s Hospital, Rome, Italy, between January 2002 and September 2004 were reviewed. Prenatal diagnosis, gestational age, BW, sex, side of hernia, and MGI were recorded on admission. The relationship with mortality of each variable was evaluated by univariate analysis. Subsequently, a predictive model of mortality was developed using a logistic regression: the explanatory variables, BW, and MGI were dichotomized in high (HBW and HMGI) and low (LBW and LMGI) according to the best cutoff found with receiver-operating characteristic curves. Results: Thirty-four newborns with CDH, treated with a standardized protocol, were studied. The main characteristics of the 34 patients were BW, 2886 g (1500-3620 g); gestational age, 37.7 weeks (32-42 weeks); male/female, 22/12; right/left, 8/26; prenatal diagnosis, 29; MGI, 1.31 (0.9-1.85). Only BW and MGI were significantly (P < .05) associated with mortality at the univariate analysis. The best cutoff values were 2755 g for BW (sensitivity, 70%; specificity, 74%) and 1.25 for MGI (sensitivity, 73%; specificity, 78%). Using these limits, BW and MGI resulted independently associated with mortality in the multivariate analysis. Using the 4 possible combinations, the LBW associated with the LMGI presented the highest prediction of mortality (80%). Conclusions: Birth weight and MGI, variously combined, were predictive of mortality. Because they are not influenced by subsequent modalities of care, they can be considered as valid early severity scores in CDH and used for comparing strategies and/or performances of different centers. [Copyright &y& Elsevier]
- Published
- 2006
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239. Successful intrauterine therapy of a large fetal ovarian cyst
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Giorlandino, C., primary, Rivosecchi, M., additional, Bilancioni, E., additional, Bagolan, P., additional, Zaccara, A., additional, Taramanni, C., additional, and Vizzone, A., additional
- Published
- 1990
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240. Effects of surgical repair of congenital diaphragmatic hernia on cerebral hemodynamics evaluated by near-infrared spectroscopy.
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Dotta, Andrea, Rechichi, Jole, Campi, Francesca, Braguglia, Annabella, Palamides, Sabrina, Capolupo, Irma, Lozzi, Simona, Trucchi, Alessandro, Corchia, Carlo, Bagolan, Pietro, and Orzalesi, Marcello
- Subjects
HERNIA ,BLOOD circulation ,HEMODYNAMICS ,NEWBORN infants - Abstract
Abstract: Background: Cardiorespiratory stabilization is recommended before surgical repair of congenital diaphragmatic hernia (CDH) because surgery may induce a transitory deterioration of chest compliance and gas exchange. It is not known if surgical intervention can affect cerebral circulation and oxygenation. Aim: The aim of the study was to assess noninvasively, by near-infrared spectroscopy, the possible changes in cerebral hemodynamics and oxygenation associated with surgical repair of CDH. Subjects: Twenty-five newborns with severe CDH (birth weight, 3057 ± 354 g; gestational age, 37.8 ± 1.8 weeks; male/female newborns, 15/10; left/right CDH, 19/6) were sedated, paralyzed, and mechanically ventilated by conventional gentle ventilation and surgically corrected at a median age of 2.7 days (min-max, 2-14 days) after cardiorespiratory stabilization. Methods: Heart rate (HR [beats per minute]), preductal transcutaneous oxygen saturation (tcSao
2 [%]), carbon dioxide tension (tcPco2 [Torr]), and mean arterial blood pressure (mm Hg) were continuously monitored. Inspired fractional oxygen concentration (Fio2 ) was adjusted to maintain and preductal tcSao2 of greater than 80%, whereas the ventilator''s settings were kept unchanged throughout the surgical procedure. Cerebral hemodynamics was assessed by near-infrared spectroscopy (NIRO 300, Hamamatsu Photonics, Japan), recording continuously and noninvasively the relative changes in concentration of oxygenated (ΔO2 Hb [μmol/L]), deoxygenated (ΔHHb [μmol/L]), and total (ΔtHb [μmol/L]) hemoglobin; the tissue oxygenation index (TOI [%]) was also calculated (TOI = O2 Hb/O2 Hb + HHb). Total hemoglobin concentration is considered to be representative of cerebral blood volume. Arterial blood gases were also measured at the beginning (T1 ) and at the end of surgery (T2 ). For all measurements, results at T1 and at T2 , as well as the differences between T1 and T2 , have been expressed as means or medians and SDs or 95% confidence intervals or ranges. The differences between T1 and T2 were considered statistically significant for a P value of less than .05 by the Student t test for paired values. Results: At T1 , mean tcSao2 % was 94.1 % (SD, 4.6) with a Fio2 of 0.25 (SD, 0.1); at T2 , to obtain similar values of tcSao2 (93.4%; SD, 4.4), it was necessary to increase the Fio2 to 0.37 (SD, 0.14; P < .001). Mean HR at T1 was 149.5 beats per minute (SD, 9.1) and increased significantly (P < .05) at T2 (165.2 beats per minute; SD, 14.2). Mean arterial blood pressure was 54.7 mm Hg (SD, 7.7) at T1 and did not change appreciably at T2 (55.6 mm Hg; SD, 8.1). Moreover, tcPco2 did not change significantly during the procedure (mean tcPco2 = 49.9 Torr [SD, 12.8] at T1 and 57.3 mm Hg [SD, 17.9] at T2 ). O2 Hb and tHb decreased (P < .001 and <.005) and HHb increased (P < .05) significantly during the surgical procedure (mean Δ [SD]: ΔO2 Hb= −10.9 μmol/L [9.7], ΔtHb = −7.5 μmol/L [11.7], and ΔHHb = −3.5 μmol/L [6.8]). Mean TOI was 70% at T1 (normal values >60%) and decreased significantly at T2 (mean ΔTOI = −6.1% [SD, 10.6]). In all infants, the greatest changes occurred when the viscera were positioned into the abdomen. Conclusions: Notwithstanding the initial cardiorespiratory stabilization, surgical repair of CDH was associated with a rise in HR and oxygen requirement and a drop in cerebral tHb and O2 Hb, suggesting a reduction in cerebral blood volume and oxygenation. These events were probably due to the combined effects of an increase in right to left shunting (as indicated by the increased oxygen requirement) and a decrease in venous return (possibly due to compression of the inferior vena cava by the viscera positioned into the abdomen). These preliminary results reinforce the importance of achieving a good cardiorespiratory stability before undertaking surgical correction of CDH to minimize the possible interference of the procedure with cerebral circulation and oxygenation. [Copyright &y& Elsevier]- Published
- 2005
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241. Long-Term Outcome of Home Parenteral Nutrition in Patients With Ultra-Short Bowel Syndrome
- Author
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Diamanti, Antonella, Conforti, Andrea, Panetta, Fabio, Torre, Giuliano, Candusso, Manila, Bagolan, Pietro, Papa, Raffaele Edo, Grimaldi, Chiara, Fusaro, Fabio, Capriati, Teresa, Elia, Domenica, and Goyet, Jean De Ville de
- Abstract
The patients with ultra-short bowel syndrome (U-SBS) have been considered potential candidates for a preemptiverehabilitative intestinal transplantation owing to the high risk of death from the underlying disease. We hypothesized that children with U-SBS, in the absence of intestinal failure-associated liver disease (IFALD), could also have a good rate of survival on home parenteral nutrition (HPN).
- Published
- 2014
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242. Reshaping neonatal intensive care units (NICUs) to avoid the spread of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to high-risk infants
- Author
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De Rose, Domenico Umberto, Auriti, Cinzia, Landolfo, Francesca, Capolupo, Irma, Salvatori, Guglielmo, Ranno, Stefania, Concato, Carlo, Braguglia, Annabella, Bagolan, Pietro, and Dotta, Andrea
- Published
- 2021
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243. Ultra-Short-Bowel Syndrome is Not an Absolute Indication to Small-Bowel Transplantation in Childhood.
- Author
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Gambarara, Manuela, Ferretti, F., Bagolan, P., Papadatou, B., Rivosecchi, M., Lucchetti, M. C., Nahom, A., and Castro, M.
- Published
- 1999
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244. Distal 4p microdeletion in a case of Wolf‐Hirschhorn syndrome with congenital diaphragmatic hernia
- Author
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Casaccia, Germana, Mobili, Luisa, Braguglia, Annabella, Santoro, Francesco, and Bagolan, Pietro
- Abstract
Wolf‐Hirschhorn syndrome (WHS) is a well‐known genetic condition characterized by typical facial anomalies, midline defects, skeletal anomalies, prenatal and postnatal growth retardation, hypotonia, mental retardation, and seizures. Affected patients with a microdeletion on distal 4p present a milder phenotype that lacks congenital malformations. WHS is rarely associated with congenital diaphragmatic hernia (CDH), and only 8 cases are reported in the literature. In almost all cases of CDH and WHS a large deletion of the short arm of chromosome 4 is present.A microdeletion of 2.6 Mb on distal 4p associated with CDH and multiple congenital malformations (i.e., cleft palate) is reported for the first time.Such a microdeletion should prompt a molecular study for WHS when in a fetus/newborn with CDH the association with cleft lip/palate and typical facial appearance (flat facial profile, hypertelorism) is found. Birth Defects Research (Part A), 2006. © 2006 Wiley‐Liss, Inc.
- Published
- 2006
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245. You are never too small to make the difference A message for everyone and a push for pediatric surgeons in training.
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Bagolan, Pietro and Morini, Francesco
- Abstract
Surgery, and training in surgery, is complex as it requires to master and to transmit both technical and non-technical skills. This is particularly true when the patient is a child with its family. Academies are called to ensure that the skills needed to guarantee the optimal care to the ill child, and to its parents, are conveyed to the new generations. In this paper, after shortly reviewing the history of academic pediatric surgery and the structure of pediatric surgery training in Italy, we will give a personal view on some of the most important non-technical challenges a young pediatric surgeon will face during his/her career, that make this discipline one of the hardest and the most rewarding at the same time. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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246. Postpartum complications in a patient with a previous proctocolectomy and ileo-pouch-anal anastomosis (IPAA) for ulcerative colitis.
- Author
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Spina, Vincenzo, Giovannini, Massimo, Fabiani, Cristina, Vetrano, Giuseppe, Bagolan, Pietro, Colizza, Sergio, and Aleandri, Vincenzo
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PUERPERAL disorders ,CESAREAN section complications ,RESTORATIVE proctocolectomy ,ILEOSTOMY complications ,ULCERATIVE colitis ,COLITIS treatment - Abstract
This case report regards pregnancy and delivery of a patient who had undergone proctocolectomy and ileo-pouch-anal-anastomosis (IPAA) for ulcerative colitis. The patient delivered through cesarean section and experienced serious complications postpartum. Such complications have been described in association with Chron's disease and have never been described after proctocolectomy and IPAA for ulcerative colitis. This case report suggests that the limit between these two diseases is not sharp. [ABSTRACT FROM AUTHOR]
- Published
- 2012
247. Prenatal rectal perforation: an unsuspected cause of isolated ascites.
- Author
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Casaccia, G., Giorlandino, C., Catalano, O. A., and Bagolan, P.
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BOWEL obstructions ,NEONATAL surgery ,ASCITES ,ILEUM diseases ,RECTAL diseases ,PRENATAL diagnosis - Abstract
In fetal intestinal perforation, inflammation leads to production of ascites. Small bowel is usually involved by perforation with the distal ileum the most frequent site. We report the first case of prenatal perforation of the intraperitoneal part of the rectum, which presented as severe ascites at a 37 weeks’ gestation antenatal ultrasonography. As none of the reported causes of intestinal perforation were identified in our case, its etiology remained idiopathic.Journal of Perinatology (2006) 26, 717–719. doi:10.1038/sj.jp.7211602 [ABSTRACT FROM AUTHOR]
- Published
- 2006
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248. Early neurologic complications of pulmonary arteriovenous malformation in a newborn: an indication for surgical resection.
- Author
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Borsellino, Alessandro, Giorlandino, Claudio, Malena, Saverio, Trucchi, Alessandro, Cilio, Roberta, and Bagolan, Piero
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PRENATAL diagnosis ,SURGICAL excision ,OBSTETRICAL diagnosis ,FAMILY history (Sociology) - Abstract
Abstract: A case report of a neonate with pulmonary arteriovenous malformation is described. The anomaly was prenatally diagnosed, and family history was positive for Rendu-Osler-Weber syndrome. Because neurologic symptoms developed during the second week of life, surgical resection was deemed the best curative option to avoid further embolic events and reoccurrence of the lesion. Previous reports detailing coil embolization therapy for pulmonary arteriovenous malformation are discussed. [Copyright &y& Elsevier]
- Published
- 2006
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249. Antenatal Diagnosis of Surgically Correctable Anomalies: Effects of Repeated Consultations on Parental Anxiety.
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Aite, L., Trucchi, A., Nahom, A., Zaccara, A., La Sala, E., and Bagolan, P.
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PRENATAL diagnosis ,ANXIETY ,PARENTS ,MEDICAL consultation ,COUNSELING ,PEDIATRICS ,SURGEONS ,OBSTETRICIANS - Abstract
OBJECTIVE:: To assess whether or not a correlation exists between antenatal consultations and parental anxiety. STUDY DESIGN:: In total, 31 couples undergoing prenatal consultation after a diagnosis of a surgically correctable anomaly were asked to fill in a questionnaire (Spielberger State-Trait Anxiety Inventory) measuring anxiety levels (AL) both after the first consultation and at birth. Prenatal counselling was done by a perinatal team including paediatric surgeon, obstetrician, and psychologist. RESULTS:: Malformations were: eight diaphragmatic hernias, 10 intestinal atresias, four abdominal masses, nine abdominal wall defects. Each fetus was subsequently followed up at regular intervals from diagnosis to birth. AL at birth were then compared with the number of antenatal consultations. A negative correlation (r=-0.688, p<0.001) was found between the number of consultations and the level of anxiety at birth. Patients having at least two consultations had significantly lower anxiety levels at birth. CONCLUSION:: Irrespective of the type of malformation, there is evidence that having more than one antenatal consultation may significantly reduce AL at birth. Therefore, early antenatal diagnosis should be encouraged in order to increase as much as possible chances of repeated consultations for the prospective parents.Journal of Perinatology (2003) 23, 652-654. doi:10.1038/sj.jp.7210992 [ABSTRACT FROM AUTHOR]
- Published
- 2003
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250. A ten-year experience of Brescia-Cimino arteriovenous fistula in children: Technical evolution and refinements
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Bagolan, Pietro, Spagnoli, Antonio, Ciprandi, Guido, Picca, Stefano, Leozappa, Giovanna, Nahom, Antonella, Trucchi, Alessandro, Rizzoni, Gianfranco, and Fabbrini, Giorgio
- Abstract
Purpose:The arteriovenous fistula (AVF) of Brescia-Cimino fulfills nearly all of the criteria for an optimal access for chronic hemodialysis, such as long-term patency rate, low complication rate, and respect of vascular morphologic features. Alternative dialytic methods (i.e., external shunts and vascular grafts) cannot easily be applied to pediatric patients, and in addition, these methods are responsible for higher complication rates. Methods:From January 1985 to December 1994, 112 Brescia-Cimino AVFs were performed in 90 children (average age, 5.5 years; range, 5 months to 18 years). The average weight of the children was 28 kg (range, 6.5 to 54 kg); 16% of AVFs were performed in children who were less than 5 years old, and 18% in children who were less than 15 kg in body weight. Results:Chronic renal failure was caused by a nephropathy in 53 cases (14 with a nephrotic syndrome), and 37 cases had a uropathy. In all cases a phlebography was performed before the microsurgical treatment. Since 1994 an inflatable tourniquet has been placed on the selected upper arm because of an optimal exsanguination of the operating field. The primary patency rate was obtained in all but six of the children; 35% of AVFs had either immediate or late complications. Thrombosis was the most frequent complication that we observed. In comparison with 79% of late thrombosis, 60% of early thrombosis was cured. Of the 80 AVFs, 63.5% with a 4-year follow-up are still patent. Conclusion:We emphasize the following two conclusions: first, microsurgery is essential to create AVFs with good results in children as well as in adult patients; and second, the results improved after the adoption of an upper-arm exsanguination and ischemia (pressure range, 400 mm Hg to 600 mm Hg) that avoided spasm of the vessels with a final 35% reduction in surgical time. (J Vasc Surg 1998;27:640-4.)
- Published
- 1998
- Full Text
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