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Article: A Unique Presentation of Nelson Syndrome Due to Partial Adrenal Insufficiency Without Bilateral Adrenalectomy.

Desai, Priyanka D / Kargutkar, Smita / Nalla, Raveena

2023 Volume 15, Issue 8, Page(s) e43518

Abstract: Nelson syndrome is a rare disorder, characterized by clinical features arising from an adrenocorticotropic hormone (ACTH)-secreting pituitary macroadenoma after bilateral adrenalectomy. Common symptoms of Nelson syndrome include weight gain, vision ... ...

Abstract	Nelson syndrome is a rare disorder, characterized by clinical features arising from an adrenocorticotropic hormone (ACTH)-secreting pituitary macroadenoma after bilateral adrenalectomy. Common symptoms of Nelson syndrome include weight gain, vision problems, and skin hyperpigmentation, among many others. In this case report, a 58-year-old Asian female who displayed clinical features akin to Nelson syndrome despite not undergoing bilateral adrenalectomy is investigated. The patient has a past history of an ACTH-secreting pituitary macroadenoma, for which a transsphenoidal resection was performed along with radiation therapy. A year following this, she displayed severe facial and neck hyperpigmentation. According to the laboratory results obtained, the patient displayed initial high ACTH levels and low-normal AM cortisol levels, which are signs of partial adrenal insufficiency. A brain MRI was performed, which confirmed stable residual tumor tissue in the cavernous sinus. The results pointed to the adrenal glands as the cause of the hyperpigmentation, and the patient was diagnosed with primary adrenal insufficiency. To bring her ACTH levels and low-normal AM cortisol into the proper range, she was given low-dose hydrocortisone and monitored for five years. Over this time period, her hyperpigmentation improved significantly and eventually resolved entirely, and her ACTH levels were lowered, indicating that hydrocortisone was the appropriate treatment for normalizing ACTH levels. In this case, it was determined that unresponsive adrenal glands lead to high ACTH levels, which resulted in an atypical case of Nelson syndrome and the physical symptom of hyperpigmentation.
Language	English
Publishing date	2023-08-15
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.43518
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Article ; Online: Patient-Centered Clinical Decision Support-Where Are We and Where to Next?

Dullabh, Prashila / Leaphart, Desirae / Dhopeshwarkar, Rina / Heaney-Huls, Krysta / Desai, Priyanka

Studies in health technology and informatics

2024 Volume 310, Page(s) 444–448

Abstract: Patient-centered clinical decision support (PC CDS) includes digital health tools that support patients, caregivers, and care teams in healthcare decisions that incorporate patient-centered factors related to four components: knowledge, data, delivery, ... ...

Abstract	Patient-centered clinical decision support (PC CDS) includes digital health tools that support patients, caregivers, and care teams in healthcare decisions that incorporate patient-centered factors related to four components: knowledge, data, delivery, and use. This paper explores the current state of each factor and how each promotes patient-centeredness in healthcare. We conducted a literature review, reviewing 175 peer-reviewed and grey literature, and eighteen key informant interviews. Findings show a need for more research on how to incorporate patient input into the guideline selection and prioritization for PC CDS, development and implementation of PC CDS tools, technical challenges for capturing patient contributed data, and optimizing PC CDS across various settings to meet patient and caregiver needs. While progress is being made in each of the four components of PC CDS, critical gaps remain.
MeSH term(s)	Humans ; Decision Support Systems, Clinical ; Digital Health ; Expert Systems ; Health Facilities ; Patient-Centered Care
Language	English
Publishing date	2024-01-25
Publishing country	Netherlands
Document type	Review ; Journal Article
ISSN	1879-8365
ISSN (online)	1879-8365
DOI	10.3233/SHTI231004
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Article ; Online: Evaluation of Immunoexpression of AJUBA Protein in Normal Oral Mucosa and Oral Squamous Cell Carcinoma.

Desai, Priyanka / Awatiger, Manjula M / Mane, Deepa R

Applied immunohistochemistry & molecular morphology : AIMM

2022 Volume 31, Issue 1, Page(s) 1–8

Abstract: AJUBA is multifunctional scaffold protein which belongs to Zyxin family of proteins. It is known to have dual role in cancer as a tumor promoter and tumor suppressor. AJUBA has a key role in systemic malignancies like esophageal squamous cell carcinoma, ... ...

Abstract	AJUBA is multifunctional scaffold protein which belongs to Zyxin family of proteins. It is known to have dual role in cancer as a tumor promoter and tumor suppressor. AJUBA has a key role in systemic malignancies like esophageal squamous cell carcinoma, colorectal cancer, cervical, breast, prostate cancer, etc. But there is very sparse literature available regarding its expression profile in oral squamous cell carcinoma (OSCC) and moreover its expression has not been observed in normal oral mucosa (NOM). Thus, the aim of this research is to explore the expression profile of AJUBA by immunohistochemical method in NOM and OSCC. Furthermore, we also evaluated the association of AJUBA expression with clinicopathologic parameters. A total of 84 samples of formalin fixed paraffin embedded tissue blocks comprising of 42 cases each of NOM and OSCC were subjected to detect immunoexpression of AJUBA. We found enhanced intense immune-expression of AJUBA in OSCC cases than compared with NOM and found to be statistically significant. The parameters specific to histologic tumor grade and inflammatory response in OSCC also found to have statistically significant with AJUBA expression. Our study is first of its kind to reveal AJUBA expression in basal and suprabasal layer of NOM suggestive of its definitive role in differentiation and stratification process. We also observed its intense expression in peripheral cell of tumor islands of OSCC cases, which can suggest its possible role in tumor growth and progression.
MeSH term(s)	Humans ; Mouth Neoplasms ; Carcinoma, Squamous Cell ; Squamous Cell Carcinoma of Head and Neck ; Mouth Mucosa ; Esophageal Neoplasms ; Esophageal Squamous Cell Carcinoma ; Head and Neck Neoplasms ; LIM Domain Proteins
Chemical Substances	AJUBA protein, human ; LIM Domain Proteins
Language	English
Publishing date	2022-10-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	1473273-7
ISSN	1533-4058 ; 1062-3345 ; 1541-2016
ISSN (online)	1533-4058
ISSN	1062-3345 ; 1541-2016
DOI	10.1097/PAI.0000000000001077
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Article ; Online: Bedside ultrasonographic evaluation of optic nerve sheath diameter for monitoring of intracranial pressure in traumatic brain injury patients: a cross sectional study in level II trauma care center in India.

Kshirsagar, Sujit J / Pande, Anandkumar H / Naik, Sanyogita V / Yadav, Alok / Sakhala, Ruchira M / Salve, Sangharsh M / Nuhaimah, Aysath / Desai, Priyanka

Acute and critical care

2024 Volume 39, Issue 1, Page(s) 155–161

Abstract: Background: Optic nerve sheath diameter (ONSD) is an emerging non-invasive, easily accessible, and possibly useful measurement for evaluating changes in intracranial pressure (ICP). The utilization of bedside ultrasonography (USG) to measure ONSD has ... ...

Abstract	Background: Optic nerve sheath diameter (ONSD) is an emerging non-invasive, easily accessible, and possibly useful measurement for evaluating changes in intracranial pressure (ICP). The utilization of bedside ultrasonography (USG) to measure ONSD has garnered increased attention due to its portability, real-time capability, and lack of ionizing radiation. The primary aim of the study was to assess whether bedside USG-guided ONSD measurement can reliably predict increased ICP in traumatic brain injury (TBI) patients. Methods: A total of 95 patients admitted to the trauma intensive care unit was included in this cross sectional study. Patient brain computed tomography (CT) scans and Glasgow Coma Scale (GCS) scores were assessed at the time of admission. Bedside USG-guided binocular ONSD was measured and the mean ONSD was noted. Microsoft Excel was used for statistical analysis. Results: Patients with low GCS had higher mean ONSD values (6.4±1.0 mm). A highly significant association was found among the GCS, CT results, and ONSD measurements (P<0.001). Compared to CT scans, the bedside USG ONSD had 86.42% sensitivity and 64.29% specificity for detecting elevated ICP. The positive predictive value of ONSD to identify elevated ICP was 93.33%, and its negative predictive value was 45.00%. ONSD measurement accuracy was 83.16%. Conclusions: Increased ICP can be accurately predicted by bedside USG measurement of ONSD and can be a valuable adjunctive tool in the management of TBI patients.
Language	English
Publishing date	2024-02-23
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	3003021-3
ISSN	2586-6060 ; 2586-6052
ISSN (online)	2586-6060
ISSN	2586-6052
DOI	10.4266/acc.2023.01172
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Article ; Online: Addressing challenges in the evidence base for bipolar disorders: Diagnostic accuracy and attrition.

Desai, Priyanka / Urošević, Snežana / Butler, Mary

Bipolar disorders

2021 Volume 23, Issue 4, Page(s) 321–323

MeSH term(s)	Bipolar Disorder/diagnosis ; Humans
Language	English
Publishing date	2021-08-04
Publishing country	Denmark
Document type	Editorial ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	1472242-2
ISSN	1399-5618 ; 1398-5647
ISSN (online)	1399-5618
ISSN	1398-5647
DOI	10.1111/bdi.13054
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Article ; Online: Protecting healthcare workers and patients during the COVID-19 pandemic: a comparison of baseline and follow-up infection prevention and control needs in Nigerian military healthcare facilities delivering HIV services.

Lee, Elizabeth H / Rashid, Ayesha / Lawal, Ismail / Adekanye, Usman / Adamu, Yakubu / Godfrey, Catherine / Agaba, Patricia A / Okeji, Nathan / Desai, Priyanka

BMC health services research

2023 Volume 23, Issue 1, Page(s) 1254

Abstract: Background: Protecting the HIV health workforce is critical for continuity of services for people living with HIV, particularly during a pandemic. Early in the COVID-19 pandemic, the Nigerian Ministry of Defence, in partnership with the US Military HIV ... ...

Abstract	Background: Protecting the HIV health workforce is critical for continuity of services for people living with HIV, particularly during a pandemic. Early in the COVID-19 pandemic, the Nigerian Ministry of Defence, in partnership with the US Military HIV Research Program, took steps to improve infection prevention and control (IPC) practices among staff working in select PEPFAR-supported Nigerian military health facilities. Methods: We identified a set of IPC activities a priori for implementation at four Nigerian military hospitals in HIV and related departments in early 2021, including continuous medical masking, physical distancing, placement of additional hand washing stations and hand sanitizers throughout facilities, and training. We fine-tuned planned intervention activities through a baseline needs assessment conducted in December 2020 that covered eight IPC components: 'IPC program structure, funding and leadership engagement'; 'IPC policies, guidelines and standard operating procedures (SOPs)'; 'infrastructure'; 'triage and screening'; 'training, knowledge and practice'; 'personal protective equipment (PPE) materials, availability and adequacy'; 'biosafety and waste management'; and 'monitoring and remediation' prior to implementation. Baseline results were compared with those of a follow up assessment administered in August 2021, following intervention implementation. Results: IPC readiness remained high at both baseline and follow-up assessments for 'IPC guidelines, policies, and SOPs' (96.7%). The components 'infrastructure' and 'monitoring and remediation', which needed improvement at baseline, saw modest improvements at follow-up, by 2% and 7.5%, respectively. At follow-up, declines from high scoring at baseline were seen in 'IPC program structure, funding and leadership engagement', 'training, knowledge and practice', and 'biosafety and waste management'. 'PPE materials availability and adequacy' improved to 88.9% at follow-up. Although unidirectional client flow was newly implemented, the score for 'triage and screening' did not change from baseline to follow-up (73%). Conclusion: Variability in IPC component readiness and across facilities highlights the importance of building resilience and employing a quality improvement approach to IPC that includes regular monitoring, re-assessment and re-training at set intervals. Results can be used to encourage solutions-oriented dialogue between staff and leadership, determine needs and implement action plans to protect staff and people with HIV.
MeSH term(s)	United States ; Humans ; COVID-19/epidemiology ; Follow-Up Studies ; Pandemics/prevention & control ; Health Personnel ; HIV Infections/prevention & control ; Infection Control
Language	English
Publishing date	2023-11-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-10289-x
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Article ; Online: A comparison of brief versus explicit descriptors for verbal rating scales: interrupted time series design.

Vickers, Andrew J / Assel, Melissa / Hannon, Michael / Desai, Priyanka / Carlsson, Sigrid V / McCready, Taylor / Cracchiolo, Jennifer / Simon, Brett

Health and quality of life outcomes

2023 Volume 21, Issue 1, Page(s) 105

Abstract: Background: Verbal rating scales (VRS) are widely used in patient-reported outcome (PRO) measures. At our institution, patients complete an online instrument using VRSs with a five-point brief response scale to assess symptoms as part of routine follow- ... ...

Abstract	Background: Verbal rating scales (VRS) are widely used in patient-reported outcome (PRO) measures. At our institution, patients complete an online instrument using VRSs with a five-point brief response scale to assess symptoms as part of routine follow-up after ambulatory cancer surgery. We received feedback from patients that the brief VRS descriptors such as "mild" or "somewhat" were vague. We added explicit descriptors to our VRSs, for instance, "Mild: I can generally ignore my pain" for pain severity or "Somewhat: I can do some things okay, but most of my daily activities are harder because of fatigue" for fatigue interference. We then compared responses before and after this change was made. Methods: The symptoms investigated were pain, fatigue and nausea. Our hypothesis was that the explicit descriptors would reduce overall variance. We therefore compared the coefficient of variation of scores and tested the association between symptoms scores and known predictors thereof. We also compared time to completion between questionnaires with and without the additional descriptors. Results: A total of 17,500 patients undergoing 21,497 operations were assigned questionnaires in the period before the descriptors were added; allowing for a short transition period, 1,417 patients having 1436 operations were assigned questionnaires with the additional descriptors. Symptom scores were about 10% lower with the additional descriptors but the coefficient of variation was slightly higher. Moreover, the only statistically significant difference between groups for association with a known predictor favored the item without the additional language for nausea severity (p = 0.004). Total completion time was longer when the instrument included the additional descriptors, particularly the first and second time that the questionnaire was completed. Conclusions: Adding descriptors to a VRS of post-operative symptoms did not improve scale properties in patients undergoing ambulatory cancer surgery. We have removed the additional descriptors from our tool. We recommend further comparative psychometric research using data from PROs collected as part of routine clinical care.
MeSH term(s)	Humans ; Interrupted Time Series Analysis ; Quality of Life ; Fatigue/diagnosis ; Nausea ; Pain
Language	English
Publishing date	2023-09-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2098765-1
ISSN	1477-7525 ; 1477-7525
ISSN (online)	1477-7525
ISSN	1477-7525
DOI	10.1186/s12955-023-02184-0
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Article: Cabazitaxel-Loaded Nanoparticles Reduce the Invasiveness in Metastatic Prostate Cancer Cells: Beyond the Classical Taxane Function.

Lampe, Jana B / Desai, Priyanka P / Tripathi, Amit K / Sabnis, Nirupama A / Chen, Zhe / Ranjan, Amalendu P / Vishwanatha, Jamboor K

Pharmaceutics

2023 Volume 15, Issue 2

Abstract: Bone-metastatic prostate cancer symbolizes the beginning of the later stages of the disease. We designed a cabazitaxel-loaded, poly (lactic-co-glycolic acid) (PLGA) nanoparticle using an emulsion-diffusion-evaporation technique. Bis (sulfosuccinimidyl) ... ...

Abstract	Bone-metastatic prostate cancer symbolizes the beginning of the later stages of the disease. We designed a cabazitaxel-loaded, poly (lactic-co-glycolic acid) (PLGA) nanoparticle using an emulsion-diffusion-evaporation technique. Bis (sulfosuccinimidyl) suberate (BS3) was non-covalently inserted into the nanoparticle as a linker for the conjugation of a bone-targeting moiety to the outside of the nanoparticle. We hypothesized that the nanoparticles would have the ability to inhibit the epithelial-to-mesenchymal transition (EMT), invasion, and migration in prostate cancer cells. Targeted, cabazitaxel-loaded nanoparticles attenuated the EMT marker, Vimentin, and led to an increased E-cadherin expression. These changes impart epithelial characteristics and inhibit invasive properties in cancer progression. Consequently, progression to distant sites is also mitigated. We observed the reduction of phosphorylated Src at tyrosine 416, along with increased expression of phosphorylated cofilin at serine 3. These changes could affect migration and invasion pathways in cancer cells. Both increased p-120 catenin and inhibition in IL-8 expression were seen in targeted, cabazitaxel-loaded nanoparticles. Overall, our data show that the targeted, cabazitaxel-loaded nanoparticles can act as a promising treatment for metastatic prostate cancer by inhibiting EMT, invasion, and migration, in prostate cancer cells.
Language	English
Publishing date	2023-02-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527217-2
ISSN	1999-4923
ISSN	1999-4923
DOI	10.3390/pharmaceutics15020662
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Article ; Online: Short peptides based on the conserved regions of MIEN1 protein exhibit anticancer activity by targeting the MIEN1 signaling pathway.

Tripathi, Amit K / Desai, Priyanka P / Tyagi, Antariksh / Lampe, Jana B / Srivastava, Yogesh / Donkor, Michael / Jones, Harlan P / Dzyuba, Sergei V / Crossley, Eric / Williams, Noelle S / Vishwanatha, Jamboor K

The Journal of biological chemistry

2024 Volume 300, Issue 3, Page(s) 105680

Abstract: Migration and invasion enhancer 1 (MIEN1) overexpression characterizes several cancers and facilitates cancer cell migration and invasion. Leveraging conserved immunoreceptor tyrosine-based activation motif and prenylation motifs within MIEN1, we ... ...

Abstract	Migration and invasion enhancer 1 (MIEN1) overexpression characterizes several cancers and facilitates cancer cell migration and invasion. Leveraging conserved immunoreceptor tyrosine-based activation motif and prenylation motifs within MIEN1, we identified potent anticancer peptides. Among them, bioactive peptides LA3IK and RP-7 induced pronounced transcriptomic and protein expression changes at sub-IC50 concentrations. The peptides effectively inhibited genes and proteins driving cancer cell migration, invasion, and epithelial-mesenchymal transition pathways, concurrently suppressing epidermal growth factor-induced nuclear factor kappa B nuclear translocation in metastatic breast cancer cells. Specifically, peptides targeted the same signal transduction pathway initiated by MIEN1. Molecular docking and CD spectra indicated the formation of MIEN1-peptide complexes. The third-positioned isoleucine in LA3IK and CVIL motif in RP-7 were crucial for inhibiting breast cancer cell migration. This is evident from the limited migration inhibition observed when MDA-MB-231 cells were treated with scrambled peptides LA3IK SCR and RP-7 SCR. Additionally, LA3IK and RP-7 effectively suppressed tumor growth in an orthotopic breast cancer model. Notably, mice tolerated high intraperitoneal (ip) peptide doses of 90 mg/Kg well, surpassing significantly lower doses of 5 mg/Kg intravenously (iv) and 30 mg/Kg intraperitoneally (ip) used in both in vivo pharmacokinetic studies and orthotopic mouse model assays. D-isomers of LA3IK and RP-7 showed enhanced anticancer activity compared to their L-isomers. D-LA3IK remained stable in mouse plasma for 24 h with 75% remaining, exhibiting superior pharmacokinetic properties over D/L-RP-7. In summary, our findings mark the first report of short peptides based on MIEN1 protein sequence capable of inhibiting cancer signaling pathways, effectively impeding cancer progression both in vitro and in vivo.
MeSH term(s)	Animals ; Mice ; Cell Movement/genetics ; Cell Proliferation ; Epithelial-Mesenchymal Transition ; Intracellular Signaling Peptides and Proteins/metabolism ; Molecular Docking Simulation ; Neoplasm Proteins/genetics ; Neoplasm Proteins/metabolism ; Signal Transduction ; Humans ; Cell Line ; Neoplasms/genetics ; Neoplasms/metabolism ; Neoplasms/pathology
Chemical Substances	Intracellular Signaling Peptides and Proteins ; Neoplasm Proteins ; MIEN1 protein, human ; CLN3 protein, human
Language	English
Publishing date	2024-01-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2997-x
ISSN	1083-351X ; 0021-9258
ISSN (online)	1083-351X
ISSN	0021-9258
DOI	10.1016/j.jbc.2024.105680
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Article ; Online: The Technology Landscape of Patient-Centered Clinical Decision Support - Where Are We and What Is Needed?

Dullabh, Prashila / Heaney-Huls, Krysta / Hovey, Lauren / Sandberg, Shana / Lobach, David F / Boxwala, Aziz / Desai, Priyanka / Sittig, Dean F

Studies in health technology and informatics

2022 Volume 290, Page(s) 350–353

Abstract: Patient Centered Outcomes Research (PCOR) and health care delivery system transformation require investments in development of tools and techniques for rapid dissemination of clinical and operational best practices. This paper explores the current ... ...

Abstract	Patient Centered Outcomes Research (PCOR) and health care delivery system transformation require investments in development of tools and techniques for rapid dissemination of clinical and operational best practices. This paper explores the current technology landscape for patient-centered clinical decision support (PC CDS) and what is needed to make it more shareable, standards-based, and publicly available with the goal of improving patient care and clinical outcomes. The landscape assessment used three sources of information: (1) a 22-member technical expert panel; (2) a literature review of peer-reviewed and grey literature; and (3) key informant interviews with PC CDS stakeholders. We identified ten salient technical considerations that span all phases of PC CDS development; our findings suggest there has been significant progress in the development and implementation of PC CDS but challenges remain.
MeSH term(s)	Decision Support Systems, Clinical ; Delivery of Health Care ; Humans ; Patient Outcome Assessment ; Patient-Centered Care ; Technology
Language	English
Publishing date	2022-06-08
Publishing country	Netherlands
Document type	Journal Article ; Review
ISSN	1879-8365
ISSN (online)	1879-8365
DOI	10.3233/SHTI220094
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