Bansari Patel - Academia.edu (original) (raw)
Papers by Bansari Patel
Best practice & research. Clinical obstetrics & gynaecology, Jan 14, 2018
Despite an estimated prevalence of 11% in women and plausible historical descriptions dating back... more Despite an estimated prevalence of 11% in women and plausible historical descriptions dating back to the 17th century, the etiology of endometriosis remains poorly understood. Classical theories of the histological origins of endometriosis are reviewed below. Clinical presentations are variable, and signs and symptoms do not correlate well with the extent of disease. In this summary, we have attempted to synthesize the growing evidence that hormonal and immune factors conspire to activate a local inflammatory microenvironment that encourages endometriosis to persist and elaborate mediators of its two cardinal symptoms: pain and infertility. Surprisingly, in the search for novel therapeutics for medical treatment of endometriosis, some compounds appear to have dual pharmacological functions, simultaneously modifying the endocrine and immune system facets of this complex gynecologic syndrome. We predict that these lead drugs will provide more therapeutic choices for patients in the fu...
Southern medical journal, 2017
A potential consequence of chemotherapy is the destruction of oocytes, resulting in primary ovari... more A potential consequence of chemotherapy is the destruction of oocytes, resulting in primary ovarian insufficiency (POI) in young patients; this often results in secondary amenorrhea and necessitates hormone replacement therapy. Regardless of the etiology of POI, the chance of pregnancy is low in this patient population. Given the extent to which oocyte depletion or dysfunction is variable, there is the possibility of spontaneous ovulation on hormone replacement therapy and subsequent pregnancy, however. If pregnancy is not desired, contraception always should be discussed. In most patients, the etiology of POI will not be known, but the treatment for all patients includes estrogen and progesterone therapy, which ensures the development of secondary sex characteristics, acquisition of peak bone mass, and promotion of uterine growth and maturation. Early diagnosis, patient education, and emotional support are important to mitigate long-term sequelae.
Acta obstetricia et gynecologica Scandinavica, Jan 19, 2017
Endometriosis is a common cause of pelvic pain and affects up to 10% of women of reproductive age... more Endometriosis is a common cause of pelvic pain and affects up to 10% of women of reproductive age. Aberrant progesterone signaling in the endometrium plays a significant role in impaired decidualization and establishment of ectopic endometrial implants. Eutopic endometrial cells from women with endometriosis fail to downregulate genes needed for decidualization, such as those involved in cell cycle regulation, leading to unbridled proliferation. Several causes of progesterone resistance in the endometrium have been postulated, including congenital "preconditioning", whereby the in utero environment renders infants susceptible to neonatal uterine bleeding and endometriosis. Progesterone action is crucial to decreasing inflammation in the endometrium, and deviant progesterone signaling results in a proinflammatory phenotype. Conversely, chronic inflammation can induce a progesterone resistant state. Repetitive retrograde endometrial shedding begets chronic peritoneal inflamm...
Clinical Journal of Oncology Nursing, 2016
Background: Pain is a common symptom reported by hospitalized patients with cancer. Cancer pain m... more Background: Pain is a common symptom reported by hospitalized patients with cancer. Cancer pain management requires an interdisciplinary approach for quality patient care. Although the literature suggests that most cancer pain can be managed with available treatments, many patients continue to experience pain even with opioid prescriptions. Implementation of evidence-based guidelines, such as the National Comprehensive Cancer Network's guidelines for adult cancer pain, promotes collaboration across disciplines and enhances patient care.
Endocrinology, 2016
The steroid hormone progesterone acting via the nuclear progesterone receptor (PR) isoforms, prog... more The steroid hormone progesterone acting via the nuclear progesterone receptor (PR) isoforms, progesterone receptor A (PR-A) and progesterone receptor B (PR-B), is essential for the maintenance of uterine quiescence during pregnancy. Inhibition of PR signaling augments uterine contractility and induces labor. Human parturition is thought to be triggered by modulation of PR signaling in myometrial cells to induce a functional progesterone withdrawal. One mechanism for functional progesterone withdrawal is increased abundance of PR-A, which decreases progesterone responsiveness by inhibiting the transcriptional activity of PR-B. Human parturition also involves tissue-level inflammation within the myometrium. This study examined the control of PR-A abundance and transrepressive activity in myometrial cells and the role of the inflammatory stimuli in the form of interleukin-1b (IL-1b) and lipopolysaccharide (LPS) in these processes. We found that abundance of PR-A was markedly increased by progesterone and by exposure to IL-1b and LPS via posttranslational mechanisms involving increased PR-A protein stability. In contrast, progesterone decreased abundance of PR-B by increasing its rate of degradation. Together, progesterone and proinflammatory stimuli induced a PR-A-dominant state in myometrial cells similar to that observed in term laboring myometrium. IL-1b and LPS also increased the capacity for PR-A to inhibit the transcriptional activity of PR-B. Taken together, our data suggest that proinflammatory stimuli increase the steady-state levels of PR-A and its transrepressive activity in myometrial cells and support the hypothesis that tissue-level inflammation triggers parturition by inducing PR-Amediated functional progesterone withdrawal.
Seminars in Reproductive Medicine, Nov 1, 2011
Unexplained and recurrent loss of pregnancies is a heartbreaking and frustrating condition. The r... more Unexplained and recurrent loss of pregnancies is a heartbreaking and frustrating condition. The routine diagnostic workup for pregnancy loss includes hormonal evaluation, screening for genetic or chromosomal defects, immunologic and thrombophilic testing, and evaluation of congenital or acquired Müllerian defects. In cases of idiopathic pregnancy loss, defects in endometrial receptivity are increasingly being investigated. The role of the endometrium in pregnancy loss has historical roots but remains controversial. Exciting new directions based on microRNAs, proteomics, and epigenetics promises to keep this area of investigation both interesting and complex. With each new diagnostic and therapeutic biomarker identified comes a greater potential for diagnosis and treatment of women. The clinical assessment of the endometrium remains an important part of the investigation of couples with unexplained pregnancy loss.
American Journal of Obstetrics and Gynecology, 2014
Measurement of estradiol is an important marker of ovarian function. At low levels, accurate meas... more Measurement of estradiol is an important marker of ovarian function. At low levels, accurate measurement has been difficult due to unique characteristics of immunoassay kits. We present this case to emphasize the importance of accurate estimation of estrogen activity and estradiol levels to avoid unnecessary surgical intervention.
Seminars in Reproductive Medicine, 2011
Unexplained and recurrent loss of pregnancies is a heartbreaking and frustrating condition. The r... more Unexplained and recurrent loss of pregnancies is a heartbreaking and frustrating condition. The routine diagnostic workup for pregnancy loss includes hormonal evaluation, screening for genetic or chromosomal defects, immunologic and thrombophilic testing, and evaluation of congenital or acquired Müllerian defects. In cases of idiopathic pregnancy loss, defects in endometrial receptivity are increasingly being investigated. The role of the endometrium in pregnancy loss has historical roots but remains controversial. Exciting new directions based on microRNAs, proteomics, and epigenetics promises to keep this area of investigation both interesting and complex. With each new diagnostic and therapeutic biomarker identified comes a greater potential for diagnosis and treatment of women. The clinical assessment of the endometrium remains an important part of the investigation of couples with unexplained pregnancy loss.
Journal of Palliative Medicine, 2010
... Full Text: HTML PDF for printing (44.7 KB) PDF w/ links (49.3 KB). Bansari Patel, APN a... more ... Full Text: HTML PDF for printing (44.7 KB) PDF w/ links (49.3 KB). Bansari Patel, APN and.Deon Cox-Hayley, DO. Address correspondence to: ... Wounds. 2002; 14(8S):1318. 2. Bates-Jensen B, Seaman S, Early L: Skin disorders: Tumor necrosis, fistulas, and stomas. ...
Journal of Pain and Symptom Management, 2010
Journal of Pain and Symptom Management, 2010
Journal of Pain and Symptom Management, 2010
Best practice & research. Clinical obstetrics & gynaecology, Jan 14, 2018
Despite an estimated prevalence of 11% in women and plausible historical descriptions dating back... more Despite an estimated prevalence of 11% in women and plausible historical descriptions dating back to the 17th century, the etiology of endometriosis remains poorly understood. Classical theories of the histological origins of endometriosis are reviewed below. Clinical presentations are variable, and signs and symptoms do not correlate well with the extent of disease. In this summary, we have attempted to synthesize the growing evidence that hormonal and immune factors conspire to activate a local inflammatory microenvironment that encourages endometriosis to persist and elaborate mediators of its two cardinal symptoms: pain and infertility. Surprisingly, in the search for novel therapeutics for medical treatment of endometriosis, some compounds appear to have dual pharmacological functions, simultaneously modifying the endocrine and immune system facets of this complex gynecologic syndrome. We predict that these lead drugs will provide more therapeutic choices for patients in the fu...
Southern medical journal, 2017
A potential consequence of chemotherapy is the destruction of oocytes, resulting in primary ovari... more A potential consequence of chemotherapy is the destruction of oocytes, resulting in primary ovarian insufficiency (POI) in young patients; this often results in secondary amenorrhea and necessitates hormone replacement therapy. Regardless of the etiology of POI, the chance of pregnancy is low in this patient population. Given the extent to which oocyte depletion or dysfunction is variable, there is the possibility of spontaneous ovulation on hormone replacement therapy and subsequent pregnancy, however. If pregnancy is not desired, contraception always should be discussed. In most patients, the etiology of POI will not be known, but the treatment for all patients includes estrogen and progesterone therapy, which ensures the development of secondary sex characteristics, acquisition of peak bone mass, and promotion of uterine growth and maturation. Early diagnosis, patient education, and emotional support are important to mitigate long-term sequelae.
Acta obstetricia et gynecologica Scandinavica, Jan 19, 2017
Endometriosis is a common cause of pelvic pain and affects up to 10% of women of reproductive age... more Endometriosis is a common cause of pelvic pain and affects up to 10% of women of reproductive age. Aberrant progesterone signaling in the endometrium plays a significant role in impaired decidualization and establishment of ectopic endometrial implants. Eutopic endometrial cells from women with endometriosis fail to downregulate genes needed for decidualization, such as those involved in cell cycle regulation, leading to unbridled proliferation. Several causes of progesterone resistance in the endometrium have been postulated, including congenital "preconditioning", whereby the in utero environment renders infants susceptible to neonatal uterine bleeding and endometriosis. Progesterone action is crucial to decreasing inflammation in the endometrium, and deviant progesterone signaling results in a proinflammatory phenotype. Conversely, chronic inflammation can induce a progesterone resistant state. Repetitive retrograde endometrial shedding begets chronic peritoneal inflamm...
Clinical Journal of Oncology Nursing, 2016
Background: Pain is a common symptom reported by hospitalized patients with cancer. Cancer pain m... more Background: Pain is a common symptom reported by hospitalized patients with cancer. Cancer pain management requires an interdisciplinary approach for quality patient care. Although the literature suggests that most cancer pain can be managed with available treatments, many patients continue to experience pain even with opioid prescriptions. Implementation of evidence-based guidelines, such as the National Comprehensive Cancer Network's guidelines for adult cancer pain, promotes collaboration across disciplines and enhances patient care.
Endocrinology, 2016
The steroid hormone progesterone acting via the nuclear progesterone receptor (PR) isoforms, prog... more The steroid hormone progesterone acting via the nuclear progesterone receptor (PR) isoforms, progesterone receptor A (PR-A) and progesterone receptor B (PR-B), is essential for the maintenance of uterine quiescence during pregnancy. Inhibition of PR signaling augments uterine contractility and induces labor. Human parturition is thought to be triggered by modulation of PR signaling in myometrial cells to induce a functional progesterone withdrawal. One mechanism for functional progesterone withdrawal is increased abundance of PR-A, which decreases progesterone responsiveness by inhibiting the transcriptional activity of PR-B. Human parturition also involves tissue-level inflammation within the myometrium. This study examined the control of PR-A abundance and transrepressive activity in myometrial cells and the role of the inflammatory stimuli in the form of interleukin-1b (IL-1b) and lipopolysaccharide (LPS) in these processes. We found that abundance of PR-A was markedly increased by progesterone and by exposure to IL-1b and LPS via posttranslational mechanisms involving increased PR-A protein stability. In contrast, progesterone decreased abundance of PR-B by increasing its rate of degradation. Together, progesterone and proinflammatory stimuli induced a PR-A-dominant state in myometrial cells similar to that observed in term laboring myometrium. IL-1b and LPS also increased the capacity for PR-A to inhibit the transcriptional activity of PR-B. Taken together, our data suggest that proinflammatory stimuli increase the steady-state levels of PR-A and its transrepressive activity in myometrial cells and support the hypothesis that tissue-level inflammation triggers parturition by inducing PR-Amediated functional progesterone withdrawal.
Seminars in Reproductive Medicine, Nov 1, 2011
Unexplained and recurrent loss of pregnancies is a heartbreaking and frustrating condition. The r... more Unexplained and recurrent loss of pregnancies is a heartbreaking and frustrating condition. The routine diagnostic workup for pregnancy loss includes hormonal evaluation, screening for genetic or chromosomal defects, immunologic and thrombophilic testing, and evaluation of congenital or acquired Müllerian defects. In cases of idiopathic pregnancy loss, defects in endometrial receptivity are increasingly being investigated. The role of the endometrium in pregnancy loss has historical roots but remains controversial. Exciting new directions based on microRNAs, proteomics, and epigenetics promises to keep this area of investigation both interesting and complex. With each new diagnostic and therapeutic biomarker identified comes a greater potential for diagnosis and treatment of women. The clinical assessment of the endometrium remains an important part of the investigation of couples with unexplained pregnancy loss.
American Journal of Obstetrics and Gynecology, 2014
Measurement of estradiol is an important marker of ovarian function. At low levels, accurate meas... more Measurement of estradiol is an important marker of ovarian function. At low levels, accurate measurement has been difficult due to unique characteristics of immunoassay kits. We present this case to emphasize the importance of accurate estimation of estrogen activity and estradiol levels to avoid unnecessary surgical intervention.
Seminars in Reproductive Medicine, 2011
Unexplained and recurrent loss of pregnancies is a heartbreaking and frustrating condition. The r... more Unexplained and recurrent loss of pregnancies is a heartbreaking and frustrating condition. The routine diagnostic workup for pregnancy loss includes hormonal evaluation, screening for genetic or chromosomal defects, immunologic and thrombophilic testing, and evaluation of congenital or acquired Müllerian defects. In cases of idiopathic pregnancy loss, defects in endometrial receptivity are increasingly being investigated. The role of the endometrium in pregnancy loss has historical roots but remains controversial. Exciting new directions based on microRNAs, proteomics, and epigenetics promises to keep this area of investigation both interesting and complex. With each new diagnostic and therapeutic biomarker identified comes a greater potential for diagnosis and treatment of women. The clinical assessment of the endometrium remains an important part of the investigation of couples with unexplained pregnancy loss.
Journal of Palliative Medicine, 2010
... Full Text: HTML PDF for printing (44.7 KB) PDF w/ links (49.3 KB). Bansari Patel, APN a... more ... Full Text: HTML PDF for printing (44.7 KB) PDF w/ links (49.3 KB). Bansari Patel, APN and.Deon Cox-Hayley, DO. Address correspondence to: ... Wounds. 2002; 14(8S):1318. 2. Bates-Jensen B, Seaman S, Early L: Skin disorders: Tumor necrosis, fistulas, and stomas. ...
Journal of Pain and Symptom Management, 2010
Journal of Pain and Symptom Management, 2010
Journal of Pain and Symptom Management, 2010