Overall survival of prostate cancer from Sangrur and Mansa cancer registries of Punjab state, India.

Introduction: There is a scarcity of population-based prostate cancer survival data in India. We assessed the population-based, overall survival of patients with prostate cancer from the Sangrur and Mansa cancer registries of the Punjab state, India. Methods: In the year 2013-2016, a total of 171 prostate cancer cases were registered in these two registries. Based on these registries, survival analysis was performed using the date of diagnosis as the starting date and the last follow-up date being December 31, 2021 or the date of death. Survival was calculated using STATA software. Relative survival was calculated using the Pohar Perme method. Results: Follow up was available for all the registered cases. Of the 171 cases, 41 (24%) were alive and 130 (76.0%) were dead. Of the prescribed treatments, 106 (62.7%) cases completed the treatment and 63 (37.3%) cases did not complete the treatment. Overall, 5-year age-standardized prostate cancer relative survival was 30.3%. Patients who completed the treatment had a 7.8 times higher 5-year relative survival (45.5%) compared to those who did not (5.8%). The difference between the two groups is statistically significant (hazard ratio 0.16, 95% confidence interval [0.10-0.27]). Conclusion: To improve survival, we need to raise awareness in the community and among primary physicians so that prostate cancer cases can reach the hospital early and should be treated effectively. The cancer center should develop the systems in their hospital so that there will be no hurdles to the patients in treatment completion. We found a low overall relative survival among patients of prostate cancer in these two registries. Patients who received treatment had a significantly higher survival.

The requirement of hemodialysis in patients with acute gastroenteritis-induced acute kidney injury.

Acute gastroenteritis is an important cause of preventable acute kidney injury (AKI). Inadequate or delayed restoration of diarrheal losses results in a very high incidence of AKI. Diarrheal illness is a major reason for hospitalization, but data on consequent acute kidney injury are sparse. The objective of the study is to determine the incidence of AKI in infectious and noninfectious diarrheal illness requiring hospitalization and to identify correlates and outcomes of diarrhea-associated AKI. None of the patients had any organism isolated in stool, probably due to prompt initiation of antibiotics/inadequate culture growth. Three out of our 6 cases did not require hemodialysis (HD) and AKI resolved on conservative management alone (fluids, electrolyte management, and antibiotics). Three out of 6 cases had nonresolving AKI and were dependent on renal replacement therapy (RRT) even at 1 month after discharge as they remained oliguric. One recent paper has reported the recovery of renal function after a period of dialysis. Frequent electrolyte abnormalities, risk of (catheter-related/bloodstream) infections, and severity of the primary disease are the chief reasons for the persistently high morbidity. Although, there was no mortality in our study.

Innervation of the supinator muscle and its relationship to two-incision distal biceps tendon repair: an anatomic study.

Reinsertion of the ruptured distal biceps tendon has been performed using either a single-anterior incision or a two-incision approach. A systematic review of these two repair methods has identified a higher incidence of supination weakness following the two-incision approach. The objective of this study was to describe the innervation of the supinator muscle and its implications regarding a two-incision distal biceps repair. Twelve fresh upper extremity specimens from 12 males were dissected with the forearm in full pronation. The number of branches of the posterior interosseous nerve (PIN) to the supinator, their site of exit from the PIN trunk, and their distance from a variety of known anatomic landmarks were recorded. Specimens were characterized as high (<5 mm), moderate (6-10 mm), or low (>10 mm) risk of nerve branch injury depending on the proximity of nerve branches to the bicipital tuberosity. In general, we found the innervation of the supinator to be highly variable. There were from two to nine branches of the PIN which supplied the supinator, with 0-3 arising from the ulnar side of the nerve. Four specimens were at low, five at moderate, and three at high risk of nerve branch injury during dorsal exposure of the bicipital tuberosity. We conclude that there is a substantial amount of variability in the innervation of the supinator, with certain patterns being at higher risk of nerve branch injury if dissection of the supinator is carried out over the bicipital tuberosity.

AMPA glutamate receptor subunits 1 and 2 regulate dendrite complexity and spine motility in neurons of the developing neocortex.

Within neurons of several regions of the CNS, mature dendrite architecture is attained via extensive reorganization of arbor during the developmental period. Since dendrite morphology determines the firing patterns of the neuron, morphological refinement of dendritic arbor may have important implications for mature network activity. In the neocortex, a region of brain that is sensitive to activity-dependent structural rearrangement of dendritic arbor, the proportion of AMPA receptors increases over the developmental period. However, it is unclear whether changes in AMPA receptor expression contribute to maturation of dendritic architecture. To determine the effects of increasing AMPA receptor expression on dendrite morphology and connectivity within the neocortex, and to determine whether these effects are dependent on specific AMPA receptor subunits, we overexpressed the AMPA glutamate receptor subunit 1 (GluR1) and glutamate receptor subunit 2 (GluR2) in cultured rat neocortical neurons at the time that AMPA receptors would normally be incorporated into synapses. Following expression of GluR1 or GluR2 we observed increases in the length and complexity of dendritic arbor of cortical neurons, and a concurrent reduction in motility of spines. In addition, expression of either subunit was associated with an increased density of excitatory postsynaptic puncta. These results suggest that AMPA receptor expression is an important determinant of dendrite morphology and connectivity in neocortical neurons, and further, that contrary to other regions of the CNS, the effects of AMPA receptors on dendrite morphology are not subunit-specific.

Repair of the ruptured distal biceps tendon: a systematic review.

BACKGROUND: Reinsertion of the acutely ruptured distal biceps is the preferred method of treatment for most patients and is designed to restore flexion and supination strength. It is not clear which, if any, method of fixation is superior or whether a 2-incision or single-incision approach is associated with fewer complications or better outcomes. HYPOTHESES: (1) There is no difference in biomechanical performance between currently used fixation methods, (2) there is no difference in incidence of complications between the 2-incision and single-incision approach, and (3) there is no difference in clinical outcomes between the 2-incision and single-incision approach. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: The authors performed a systematic review of the literature studying treatment of the ruptured distal biceps tendon to determine optimal fixation method as well as surgical approach with lowest incidence of complications and highest proportion of satisfactory results. RESULTS: The review identified 8 articles that had relevant biomechanical data, 23 with relevant complication data, and 19 with relevant clinical results data. EndoButton fixation performed best in comparative biomechanical studies. There was no difference in overall incidence of complications between 2-incision approaches (16%) and single-incision approaches (18%), but there were significantly more instances of significant loss of forearm rotation with the 2-incision approach. There were significantly more unsatisfactory clinical results in the 2-incision repair group (31% vs 6%; odds ratio, 7.6; 95% confidence interval, 3.2-17.7), with the majority of unsatisfactory results in the 2-incision group due to loss of forearm rotation or rotational strength. CONCLUSION: EndoButton fixation has the highest load and stiffness of currently available fixation methods. Two-incision repairs have a significantly greater proportion of unsatisfactory results than do single-incision repairs.

Expression of the N-methyl-D-aspartate receptor subunit NR3B regulates dendrite morphogenesis in spinal motor neurons.

During postnatal development, the dendrites of spinal motor neurons are refined in an activity-dependent manner that can be influenced by blocking activation of N-methyl-D-aspartate (NMDA) receptors. In late postnatal life, dendritic refinement ceases, and dendrite architecture is unaffected by NMDA antagonists; however the molecular substrate for limiting dendritic plasticity is not understood. During late postnatal development, expression of the NR3B NMDA receptor subunit, a putative dominant-negative subunit that reduces glutamate-induced ionic currents, is upregulated within motor neurons. To investigate whether increasing NR3B expression may contribute to the loss in late development of activity-dependent dendritic reorganization in the spinal cord, we over-expressed NR3B in cultured rat spinal motor neurons, and compared its effects on dendrite morphology with the effects of pharmacological blockade of NMDA receptors. We found that over-expression of the NR3B receptor subunit increased the length and complexity of dendritic arbor, and increased numbers of dendritic filopodia, suggesting that NR3B promotes the addition of branch segments in developing motor neurons. In contrast, blockade of NMDA receptor activity by the NMDA antagonist DL-2-amino-5-phosphonovalerate (AP5) had little effect on the overall length or complexity of dendritic arbor. Instead, treatment with AP5 resulted in significant reorganization of dendritic arbor in a manner that favored addition of dendritic segments of high branch orders, at the expense of those closer to the cell body. These results suggest that expression of the NR3B subunit may participate in activity-dependent reorganization of dendritic architecture, but via a mechanism that may be inconsistent with loss of NMDA receptor activity.