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P Amato

Publications and source records attributed to P Amato.

26 records · Page 2Linked to original sources

A historical perspective and review of the safety of lipid emulsion in pregnancy.

Total parenteral nutrition for pregnant patients is essential to maintain or restore optimal nutritional status for both the mother and fetus when adequate protein and caloric intake by the oral or enteral route is not feasible. This report reviews the safety of intravenous lipid emulsions in total parenteral nutrition programs for pregnant patients. Controversy regarding the adverse effects of intravenous lipid emulsion when administered to pregnant patients is based on early reports of the use of cottonseed oil lipid emulsions. The adverse effects reported included infarction of the placenta, ketonemia, increased myometrial activity, and induction of labor. In 32 subsequent case reports in which soybean oil- or soybean/safflower oil-based emulsions were used in total parenteral nutrition programs for pregnant patients, there was no relationship apparent between onset of labor and harmful maternal or fetal effects associated with the administration of lipid emulsion. It appears that the currently available soybean and soybean/safflower lipid-based emulsions can be safely administered to pregnant patients.

Fat Emulsions, Intravenous↗

Divorce and psychological stress.

While research on adjustment to divorce has been extensive, the paucity of studies assessing stress before and after divorce has kept the relation between psychological stress and martial dissolution unclear. Conflicting findings cast some doubt on the utility of using a crisis model to study divorce. Analysis of three-wave panel data from a national sample of persons married in 1980 indicates that the crisis model is appropriate for understanding adjustment to divorce. Comparisons of divorced persons with married persons show a predivorce rise in stress which then returns to levels comparable to those reported by married individuals. No evidence was found supporting the idea that a high level of psychological stress is a general cause of divorce or that dissolution resulted in more or less permanent elevation of psychological stress. Findings support the hypothesis that predivorce resources and outlooks influence the amount of stress experienced in the two years immediately following divorce. Below median family incomes, no post-high school experience, and wife not in the labor force put divorcing individuals at a disadvantage. Individuals reporting few premarital troubles and beliefs in the immorality of divorce also appear to experience heightened stress in the two years following divorce.

Adult↗

cAMP-induced apoptosis in granulosa cells is associated with up-regulation of P53 and bax and down-regulation of clusterin.

Evidence indicates that cAMP induces apoptosis in granulosa cells of rat and human ovary. The mechanism by which cAMP induces apoptosis is not known. This study was carried out to evaluate changes in expression of cell death promoters, P53 and bax, and cell death repressor, bcl-2, in cAMP-treated granulosa cells. Treatment of granulosa cells with forskolin (FSK), or 8-bromo-cAMP induced apoptosis as evidenced by internucleosomal DNA fragmentation and chromatin condensation as revealed by gel electrophoresis and fluorescent DAPI staining, respectively. The apoptotic effect of cAMP was accompanied by an increase in the expression of P53 and bax proteins as evaluated by Western blot and immunocytochemistry. No change in bcl-2 protein level was observed in cAMP-treated granulosa cells as compared to control. These data suggest that cAMP may activate apoptosis in granulosa cells by shifting the ratio of the death promoter to death repressor genes via alteration of P53 and bax expression. cAMP was also shown to inhibit gene expression of clusterin, an apoptosis-associated protein, suggesting a role for this protein in cAMP-induced apoptosis in granulosa cells. The data of the present study provide a basis for future studies to elucidate the molecular mechanism of follicular atresia and regulation of apoptotic cell death in ovarian follicles.

8-Bromo Cyclic Adenosine Monophosphate↗

Post-stroke depression: relationships to functional impairment, coping strategies, and rehabilitation outcome.

This study examined the phenomenon of post-stroke depression and evaluated its impact on rehabilitation outcome. Sixty-four patients presenting to a rehabilitation program within weeks of first stroke were evaluated for depression through self-report measures and staff ratings. Patients also rated the particular coping strategies which they used in dealing with their illness and hospital stay. Physical and occupational therapists provided measures of functional impairment at admission and discharge. A high (47%) prevalence of depression was found in this population, with no overall differences observed between patients with right or left hemisphere lesions. Depressed patients, in comparison to non-depressed, evidenced greater functional impairment at both admission and discharge. However, both groups showed similar gains over the course of rehabilitation. Coping strategies employed by depressed patients appeared to reflect a lower level of participation in the rehabilitation process. A subgroup of patients evaluated 6 weeks after discharge revealed that depression was associated with a worsening on one measure of functional status. These findings indicate that depression is a frequent companion of stroke, that it is associated with degree of functional impairment, and that it may exert a negative impact on the rehabilitation process and outcome.

Adaptation, Psychological↗

Tolerability and efficacy of high-dose furosemide and small-volume hypertonic saline solution in refractory congestive heart failure.

Thirty patients aged 65-85 years, with refractory New York Heart Association (NYHA) class IV congestive heart failure (CHF) were treated with an intravenous infusion of furosemide (250-2000 mg/d) and small-volume hypertonic saline solution (150 mL of 1.4-4.6% NaCl) twice a day for 6 to 12 days. A daily fluid oral intake of 1000 mL and previous cardiac therapy were maintained. Clinical signs and symptoms of CHF, such as dyspnea, edema and weakness, improved, as did severity of illness as defined by NYHA class. The infusion was well tolerated. After a 12-month follow-up, 24 patients (80%) were alive and in the NYHA class assigned on discharge from the hospital. This therapeutic combination is effective and well tolerated and should represent an innovative approach to the management of refractory CHF.

Aged↗

Purified FSH as a treatment for a cervical hostility.

Abnormal cervical mucus (CM) quality and quantity is considered one of the causes of infertility which occurs in only 2 to 8 per cent of infertile couples. The periovulatory mucus with its specific properties is necessary to determine a correct Post Coital Test (PCT). Twenty patients, with infertility for over 18 months and with a baseline negative PCT (repeated at least three times) for abnormal CM, were treated with pFSH. Our results show that the pFSH improves the quality and quantity of CM in all for our patients including an improvement of penetration and motility spermatozoa in 55 per cent of our cases. Therefore we suggest the routine pFSH use in case of cervical hostility and recurrent negative PCT.

Adult↗