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[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "M/C uterine malformation associated with renal anomalies:" }, { "role": "assistant", "content": "The correct answer is Ans. is b, i.e. UnicornuateRef: Leon Speroff 8th/ed, pt46\"Approximately 40% of patients with a unicornuate uterus will have a urinary tract anomaly (usually of kidney) - Ref: Leon Speroff 8th/ed, p146" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, Bile Acids and Salts, Bosentan, Endothelins, Female, Pancreatitis, Acute Necrotizing, Random Allocation, Rats, Rats, Wistar, Sulfonamides, Taurocholic Acid, Treatment Failure." }, { "role": "user", "content": "Does the endothelin antagonist bosentan improve survival in severe experimental pancreatitis in rats? Context: Severity of pancreatitis seems to be aggravated by impairment of vascular perfusion of the gland. Early mortality occurs within the first few days from the acute consequences of pancreatic injury with subsequent inflammatory response. Because vasoactive substances, including endothelin, seem to contribute to early mortality in acute pancreatitis, we tested the hypothesis that the inhibition of endothelin action could alter the outcome after severe experimental pancreatitis. In two groups of rats, pancreatitis was induced by intraductal infusion into the pancreatic duct of 1 microL/g body weight (b.w.) of either a 4% or a 5% sodium taurocholate solution. The mixed endothelin A and endothelin B receptor antagonist bosentan (20 mg/kg b.w.) or vehicle was injected intravenously in 12-h intervals for 3 d starting 1 h after induction of bile acid pancreatitis. This dose of bosentan is known to completely inhibit the effect of exogenous endothelin. The survival rate was monitored for 7 d. Thereafter, the surviving rats were sacrificed and the pancreas was prepared for histological and biochemical evaluation. Irrespective of the treatment protocol (bosentan versus saline), survival was not different in animals challenged with either 4% or 5% sodium taurocholate. The corresponding survival rates were 62% with bosentan and 77% without bosentan in the 4% sodium taurocholate group. In the 5% sodium taurocholate group, the survival rates were 20% with and 27% without bosentan. Morphological and biochemical alterations were identical in control as well as in endothelin-antagonist-treated rats." }, { "role": "assistant", "content": "Therapy with the mixed endothelin A and endothelin B receptor antagonist bosentan does not influence the outcome after severe experimental pancreatitis. Therefore, blockade of endothelin A and B receptor subtypes may not be of major importance as a therapeutic principle in this model of experimental pancreatitis. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In exhaled air, normal pCO2 pressure is:" }, { "role": "assistant", "content": "The correct answer is (Refer: Ganong’s Review of Medical Physiology, 24th edition, pg no: 635)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Feature of diabetes mellitus in pregnancy:a) Postdatismb) Hydramniosc) Neonatal hyperglycemiad) ↑congenital defecte) PPH" }, { "role": "assistant", "content": "The correct answer is As explained in the previous question maternal hyperglycaemia leads to fetal hyperglycaemia, which in turn causes polyuria and thus causes polyhydramnios.\n\n\nPolyhydramnios leads to preterm delivery and not post datism.\nExcessive uterine enlargement because of polyhydramnios and macrosomia causes increased incidence of atonic PPH.\n\n\nDiabetes leads to increased incidence of congenital defects in fetus.\nMaternal hyperglycemia → to fetal hyperglycemia → hyperinsulinemia → to neonatal hypoglycemia at birth." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 50-year-old man comes to the physician for the evaluation of recurrent palpitations and a feeling of pressure in the chest for the past 6 months. He also reports shortness of breath when walking several blocks or while going upstairs. There is no personal or family history of serious illness. He does not smoke. He has a 30-year history of drinking 7–10 beers daily. His temperature is 37°C (98.6°F), pulse is 110/min, respirations are 18/min, and blood pressure 130/80 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 92%. There are jugular venous pulsations 9 cm above the sternal angle. Crackles are heard at both lung bases. Cardiac examination shows an S3 gallop and a displaced point of maximum impulse. There is pitting edema below the knees. Which of the following is the most appropriate step in the management of the underlying cause of this patient's current condition?" }, { "role": "assistant", "content": "Abstinence from alcohol" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, STUDY DESIGN, RESULTS. Meshes: Adult, Aged, Diagnostic Tests, Routine, Electrocardiography, Female, Fever, Hemorrhagic Fever, Crimean, Humans, Male, Middle Aged, Minnesota, Myocardium, Prognosis, Retrospective Studies, Treatment Outcome, Turkey." }, { "role": "user", "content": "Does electrocardiography at admission predict outcome in Crimean -Congo hemorrhagic fever? Context: Crimean - Congo hemorrhagic fever is an acute viral hemorrhagic fever with considerable mortality. Despite increasing knowledge about hemorrhagic fever viruses, the pathogenesis of Crimean -Congo hemorrhagic fever and causes of death were not well described. We aimed to evaluate whether there were electrocardiographic parameters designating mortality among these patients. This retrospective study was performed among confirmed Crimean -Congo hemorrhagic fever cases in Turkey. Electrocardiography was available in 49 patients within 24 h of hospitalization. All electrocardiograms were evaluated by two expert cardiologists according to Minnesota coding system. Among patients with available electrocardiograms, there were 31 patients who survived, and 18 patients who died of Crimean - Congo hemorrhagic fever. Both groups were similar in terms of age, sex, body temperature, heart rate, and blood parameters. T-wave changes and bundle branch block were more frequently encountered among those who died. Presence of T-wave negativity or bundle branch block in this cohort of patients with Crimean -Congo hemorrhagic fever predicted death with a sensitivity of 72.7%, specificity of 92.6%, positive predictive value of 88.9%, negative predictive value of 80.6%." }, { "role": "assistant", "content": "We think within the light of our findings that simple electrocardiography at admission may help risk stratification among Crimean-Congo hemorrhagic fever cases." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Hoarseness of voice occurs early in -" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Kappa angle is the angle between the" }, { "role": "assistant", "content": "The correct answer is Angle kappa: It is the angle formed between the visual axis and pupillary line. Reference :- A K KHURANA; pg num:-27" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Animals, Binding Sites, Down-Regulation, Houseflies, Insect Control, Insect Proteins, Insecticides, Monoterpenes, Nicotine, Nicotinic Antagonists, Phenols, Protein Binding, Receptors, Nicotinic." }, { "role": "user", "content": "Does the phenolic monoterpenoid carvacrol inhibit the binding of nicotine to the housefly nicotinic acetylcholine receptor? Context: The phenolic monoterpenoid carvacrol, which is found in many plant essential oils (thyme, oregano and Alaska yellow cedar), is highly active against pest arthropods, but its mechanisms of action are not fully understood. Here, carvacrol is shown to bind in a membrane preparation containing insect nicotinic acetylcholine receptors (nAChRs). [(14) C]-Nicotine binding assays with Musca domestica (housefly) nAChRs were used in this study to demonstrate carvacrol's binding to nAChRs, thereby acting as a modulator of the receptors. Carvacrol showed a concentration-dependent inhibition of [(14) C]-nicotine binding in a membrane preparation of housefly heads containing nAChRs, with IC50 = 1.4 μM, in a non-competitive pattern. Binding studies with neonicotinoid insecticides revealed that imidacloprid and thiamethoxam did not inhibit the binding of [(14) C]-nicotine, while dinotefuran, from the guanidine subclass of neonicotinoids, inhibited nicotine binding like carvacrol." }, { "role": "assistant", "content": "Carvacrol binds to housefly nAChRs at a binding site distinct from nicotine and acetylcholine, and the nAChRs are a possible target of carvacrol for its insecticidal activity. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 59-year-old woman with a 10-year history of type 2 diabetes mellitus is noted by her physician to have bilateral pitting edema of the ankles and feet. No erythema is noted. On questioning, the patient also repos shoness of breath on exeion and states that she has been using 3 pillows at night in order to sleep comfoably. A chest x-ray film demonstrates pulmonary venous congestion and interstitial edema indicative of pulmonary edema. Which of the following physiologic mechanisms is most likely the immediate cause of the pulmonary edema?" }, { "role": "assistant", "content": "The correct answer is The cause of pulmonary edema in congestive hea failure is an increase in the hydrostatic pressure at the level of the capillaries of the lung. This increased pressure serves to drive fluid out of the capillaries and into the alveoli. The other reasons cited in the choices can also cause pulmonary edema, but occur in other clinical settings. Damage to endothelial cells can occur in vasculitis. Damage to the epithelial lining of the alveoli can occur in pneumonia and respiratory distress syndrome. Low serum albumin can be seen in liver and kidney disease." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Amine Oxidase (Copper-Containing), Aspartate Aminotransferases, Bile, Bilirubin, Biomarkers, Carcinoma, Hepatocellular, Cell Adhesion Molecules, Chronic Disease, Colorectal Neoplasms, Creatinine, Enzyme-Linked Immunosorbent Assay, Hepatitis, Hepatitis, Alcoholic, Humans, Liver Circulation, Liver Cirrhosis, Alcoholic, Liver Diseases, Liver Failure, Acute, Liver Neoplasms, Liver Transplantation, Monoamine Oxidase, Portal System, Reference Values, Sialoglycoproteins." }, { "role": "user", "content": "Does circulating soluble vascular adhesion protein 1 account for the increased serum monoamine oxidase activity in chronic liver disease? Context: Vascular adhesion protein 1 (VAP-1) is an endothelial glycoprotein that supports adhesion of lymphocytes to hepatic endothelium and has sequence homology with semicarbazide-sensitive amine oxidases (SSAOs). We investigated whether soluble VAP-1 (sVAP-1) displays SSAO activity and thereby accounts for increased monoamine oxidase activity in the serum of patients with liver diseases. sVAP-1 concentration and SSAO activity were measured in peripheral, hepatic, and portal blood and in bile from patients with liver disease and in peripheral blood of control subjects, using enzyme-linked immunosorbent assay and enzymatic assays. sVAP-1 concentration (mean [+/-SE], 143. 67 [34.97-92.67] ng/mL) and SSAO activity (18.8 [12.0-24.6] nmol. mL(-1). h(-1)) were significantly increased in chronic liver diseases compared with healthy controls (87.1 [53.5-127] ng/mL [P<0.001] and 10.7 [6.5-12.7] nmol. mL(-1) x h(-1) [P<0.05]) but not in massive necrosis caused by paracetamol poisoning (109 [80.3-140] ng/mL and 8.9 [5.7-12.3] nmol. mL(-1) x h(-1)). sVAP-1 correlated with serum transaminase and bilirubin but not with creatinine. In 5 paired samples, sVAP-1 concentration was higher in hepatic (median, 113 [range, 53-122]) than in portal vein (102 [42-109]; 2P<0.05), and was not detected in bile. There was a highly significant correlation between serum sVAP-1 and SSAO activity in normal subjects, patients with acute liver failure, and those with chronic liver disease (r = 0.895; P<0.001). When serum was depleted of sVAP-1 by immunoaffinity chromatography, SSAO activity was eliminated." }, { "role": "assistant", "content": "sVAP-1 levels are increased in chronic liver disease, and sVAP-1 is likely derived from the liver. Serum sVAP-1 displays SSAO activity and accounts for most of the monoamine oxidase activity in human serum. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: 15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid, Adenocarcinoma, Adenocarcinoma of Lung, Antineoplastic Agents, Apoptosis, Benzofurans, Blotting, Western, Bridged Bicyclo Compounds, Heterocyclic, Cell Cycle, Cell Line, Tumor, Cell Proliferation, Cyclooxygenase 2, Cyclooxygenase Inhibitors, Enzyme Inhibitors, Enzyme-Linked Immunosorbent Assay, Fatty Acids, Unsaturated, Flow Cytometry, Humans, Hydrazines, Immunoenzyme Techniques, Lung Neoplasms, Nitrobenzenes, Real-Time Polymerase Chain Reaction, Receptors, Thromboxane, Reverse Transcriptase Polymerase Chain Reaction, Signal Transduction, Sulfonamides, Sulfonylurea Compounds, Thromboxane A2, Thromboxane-A Synthase." }, { "role": "user", "content": "Does thromboxane A2 exert promoting effects on cell proliferation through mediating cyclooxygenase-2 signal in lung adenocarcinoma cells? Context: Lung cancer concerns a worldwide health problem and the efficacy of available treatments is unsatisfactory. Recently, thromboxane A2 (TXA2) synthase (TXAS) and receptor (TXA2R) have been documented to play a role in lung cancer development. Therefore, dual TXA2R modulator (i.e., the dual blocker of TXAS and TXA2R) may be more efficacious to kill lung tumor cells than single TXAS inhibitor or TXA2R antagonism. The close relationship between cyclooxygenase (COX)-2 and TXAS also raises whether or how TXA2 contributes to the oncogenic activity of COX-2. This study is therefore conducted to answer these questions. Various inhibitors and siRNA were used to evaluate the roles of TXA2 and COX-2 in the proliferation and apoptosis of lung adenocarcinoma cells. Cell proliferation was detected using both MTS ELISA and BrdU labeling ELISA. Cell cycle distribution and apoptosis were examined by flow cytometric analysis. TXB2 level, reflecting the biosynthesis of TXA2, was detected by peroxidase-labeled TXB2 conjugates using an enzyme immunoassay kit. Western blotting was performed to evaluate many biomarkers for cell cycles, apoptosis and proliferation. The levels of COXs were screened by reverse transcriptase and real-time quantitative PCR. We found either single TXAS inhibitor/TXA2R antagonist or the dual TXA2 modulators offered a similar inhibition on cell proliferation. Moreover, inhibition of TXA2 arrested cells at the G2/M phase and induced apoptosis. It is further demonstrated that TXA2 was able to function as a critical mediator for tumor-promoting effects of COX-2 in lung adenocarcinoma cells." }, { "role": "assistant", "content": "The present study has for the first shown that dual TXA2 modulators and the single blocker of TXAS or TXA2R offer a similar inhibitory role in lung adenocarcinoma cell proliferation and that the tumor-promoting effects of COX-2 can largely be relayed by TXA2. Thus, TXA2 should be regarded as a critical molecule in COX-2-mediated tumor growth and a valuable target against lung cancer. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: AIMS, METHODOLOGY, RESULTS. Meshes: Acute Kidney Injury, Adult, Aged, Comorbidity, Databases, Factual, Esophageal and Gastric Varices, Female, Gastrointestinal Hemorrhage, Hospitalization, Humans, Kidney Failure, Chronic, Liver Cirrhosis, Male, Middle Aged, Prognosis, Proportional Hazards Models, Retrospective Studies, Risk Assessment, Risk Factors, Taiwan, Time Factors." }, { "role": "user", "content": "Is end stage renal disease a risk factor for the mortality of cirrhotic patients with esophageal variceal bleeding? Context: End stage renal disease (ESRD) patients are prone to have bleeding due to uremic platelet dysfunction. However, it is still unknown if ESRD is a risk factor for the mortality of cirrhotic patients with esophageal variceal bleeding (EVB). The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to enroll 6740 cirrhotic patients who were hospitalized with EVB from January 1 to December 31, 2007. The patients were matched with individuals from a national mortality database to calculate their survival time. Of all, 418 patients had renal function impairment (RFI) during their hospitalization. There were 209 (50%) patients with acute renal failure (ARF), and 110 (26.3%) patients with ESRD. The adjusted hazard ratios (HR) of ARF for 6-week and 1-year mortalities of cirrhotic patients with EVB were 4.90 (P<0.001) and 4.34 (P<0.001), compared to the non-RFI group. However, the adjusted HRs of ESRD for 6-week and 1-year mortalities were 1.19 (P=0.404) and 1.50 (P<0.001), compared to the non-RFI impairment group." }, { "role": "assistant", "content": "ESRD is associated with 1-year mortality, but not a risk factor for 6-week mortality in cirrhotic patients with EVB." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Biomarkers, Brain Ischemia, Cerebral Hemorrhage, Cerebral Infarction, Female, Humans, Male, Matrix Metalloproteinase 9, Middle Aged, Prospective Studies, Risk Factors, Stroke." }, { "role": "user", "content": "Does plasma metalloproteinase-9 concentration predict hemorrhagic transformation in acute ischemic stroke? Context: Matrix metalloproteinase-9 (MMP-9) activity has been associated with hemorrhagic transformation (HT) in experimental models of cerebral ischemia. Our aim was to investigate the relationship between MMP-9 concentrations in blood within 24 hours of stroke onset and subsequent HT of cerebral infarction. We studied 250 patients with a hemispheric ischemic stroke of 7.8+/-4.5 hours' duration. Early CT signs of cerebral infarction were evaluated on admission. The HT and infarct volume were analyzed from the CT performed on days 4 through 7. MMP-9 levels were determined by enzyme-linked immunosorbent assay in blood samples obtained on admission. HT was observed in 38 patients (15.2%): 24 (63.2%) had a hemorrhagic infarction, and 14 (36.8%) had a parenchymal hematoma. A total of 108 patients (43%) received anticoagulants before the second CT scan. Systolic and diastolic blood pressures, body temperature, frequency of early CT signs of ischemia (92% versus 22%), and treatment with anticoagulants (79% versus 37%) were significantly higher in the group with HT (P<0.001). Mean infarct volume was 126+/-60 cm(3) in the HT group and 90+/-68 cm3 in the group without HT (P=0.003). Median (quartiles) plasma MMP-9 concentrations were higher in the HT group (193 [163, 213] versus 62 [40, 93] ng/mL, P<0.001), even in the 24 patients seen within 3 hours of symptom onset (P=0.014). MMP-9 levels > or =140 ng/mL had a positive and negative predictive value of HT of 61% and 97%, respectively. MMP-9 > or =140 ng/mL was associated with HT (odds ratio, 12; 95% confidence interval, 3 to 51; P<0.001) after adjustment for potential confounders and final infarct volume." }, { "role": "assistant", "content": "High plasma MMP-9 concentration in the acute phase of a cerebral infarct is an independent biochemical predictor of HT in all stroke subtypes. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "What is sade's grade when tympanic membrane is retracted touching promontory" }, { "role": "assistant", "content": "The correct answer is Retraction of Pars Tensa (Sade's classification) Grade 1: Mild retraction not touching the long process of the incus. Grade 2: Retracted drum touching the long process of the incus. Grade 3: Retracted drum touching the promontory. It is also called as middle ear atelectasis. Grade 4: Drum plastered on the promontory. It is also called as adhesive otitis media. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 79)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Administration, Inhalation, Blood Pressure, Drug Interactions, Female, Hemodynamics, Humans, Hypertension, Pulmonary, Male, Middle Aged, Nitric Oxide, Vasodilator Agents." }, { "role": "user", "content": "Is the response to inhaled nitric oxide in patients with pulmonary artery hypertension masked by baseline vasodilator use? Context: Assessment of pulmonary vasodilator responsiveness is important in determining the prognosis and management of patients with pulmonary hypertension. Many patients, however, are already on vasodilators at the time of testing. It is unclear if these agents should be temporarily discontinued to improve the sensitivity of testing. We examined the hemodynamic effects of nitric oxide (NO) inhalation in 60 patients with pulmonary arterial hypertension. Thirty-one of these patients were receiving medications with vasodilating properties. Vasodilator testing was performed with invasive measurement of pressure of the right side of the heart at baseline and during inhalation of 40 ppm NO. No significant demographic differences were seen between patients receiving and not receiving vasodilators. Similar reductions in mean pulmonary artery pressure (19 +/- 12% vs 20 +/- 12%, P = .734) and pulmonary vascular resistance (31 +/- 18 vs 32 +/- 16, P = .967) were seen in patients receiving and not receiving vasodilators. Using the definition of positive vasodilator response (> or = 20% drop in mean pulmonary artery pressure), 55% (17/31) of patients in the baseline vasodilator group had a positive response compared with 62% (18/29) of the patients not on vasodilators (P = .570)." }, { "role": "assistant", "content": "Concurrent use of oral vasodilators does not appear to mask a significant response to inhaled NO on the pulmonary vasculature. Therefore, routine discontinuation of pulmonary vasodilators is likely unnecessary before vasodilator testing in patients with pulmonary arterial hypertension. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In a nulliparous woman, the treatment of choice in ruptured ectopic pregnancy is:" }, { "role": "assistant", "content": "The correct answer is Ans. is a, i.e. Salpingectomy and end to end anastomosisRef Dutta Obs 7/e, p 185In the question the patient is presenting with ruptured ectopic pregnancy therefore surgical management is a must and we have to do laparotomy. (option \"c\" ruled out)Always remember- In ruptured ectopic, the tube is already damaged so the only surgery which has to be done is Salpingectomy, whether the patient is a young/old or whether she is nulliparous or multiparous. Their is no role of Salpingostomy (i.e. option \"d\" ruled out). As discussed in previous question in case of ectopic pregnancy salpingo oophorectomy is never done (i.e. option \"b\" ruled out)." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Brain, Cerebral Infarction, Chronic Disease, Diagnosis, Computer-Assisted, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Motor Activity, Physical Therapy Modalities, Prognosis, Recovery of Function, Retrospective Studies, Stroke, Stroke Rehabilitation, Treatment Outcome." }, { "role": "user", "content": "Is improvement after constraint-induced movement therapy independent of infarct location in chronic stroke patients? Context: Disruption of the corticospinal tract at various locations in the brain has been shown to predict worse spontaneous motor recovery after stroke. However, the anatomic specificity of previous findings was limited by the categorical classification of infarct locations. Here we used computational methods to more precisely determine the specific anatomic locations associated with impaired motor ability. More important, however, our study also used these techniques to evaluate whether infarct location could influence motor outcomes after Constraint-Induced Movement therapy (CI therapy), a specific and controlled form of physical therapy. Quantitative voxel-based analyses were used to determine whether infarct location could predict either initial motor ability or clinical improvement after CI therapy in chronic stroke patients. Although corona radiata infarcts were associated with worse in-laboratory motor ability at pretreatment, infarct location did not predict improvement in either the laboratory or the life situation after CI therapy." }, { "role": "assistant", "content": "The extent of improvement from CI therapy does not depend on the location of neurological damage, despite there being a pretreatment relationship between infarct location and in-laboratory motor ability. This dissociation could be explained by brain plasticity induced by CI therapy. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Macular involvement is common in" }, { "role": "assistant", "content": "The correct answer is Decreased visual acuity may occur as a result of macular involvement or severe vitreous inflammation. ... An active toxoplasmic retinochoroiditis is whitish and moderately exudative with ill-defined borders and involves the macula in a majority of patients. Ref khurana 6/e" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Confidence Intervals, Cross-Cultural Comparison, Demography, Female, Humans, India, Male, Multivariate Analysis, Odds Ratio, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Suicide, Attempted, United States." }, { "role": "user", "content": "Does differing correlate for suicide attempts among patients with schizophrenia or schizoaffective disorder in India and USA? Context: Suicide is one of the most common causes of death among persons with schizophrenia. Differing risk factors have been identified in published studies. The differences may have arisen because a uniform set of variables was not analyzed. Alternatively, the nature and effect of risk factors may vary in different settings. To test these possibilities, we investigated the same set of variables in two independent cross-national samples ascertained using identical protocols. Patients with schizophrenia or schizoaffective disorder (DSM IV criteria) were recruited in India (n=460) and the USA (n=424). Consistent with earlier publications, a diagnosis of schizoaffective disorder, history of depression, pattern of symptoms and educational status were significantly associated with suicide attempts in the US sample. None of these variables were significantly associated in the Indian sample." }, { "role": "assistant", "content": "The impact of known risk factors for suicide attempts among patients with schizophrenia differs across ethnic groups. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Angiotensin II, Animals, Biomechanical Phenomena, Estradiol, Estrogen Replacement Therapy, Female, Hypertension, Medroxyprogesterone Acetate, Ovariectomy, Rats, Rats, Sprague-Dawley, Saphenous Vein, Veins." }, { "role": "user", "content": "Does hormone replacement reduce elevated in vivo venous tone in hypertensive ovariectomized rats? Context: The venous system may play a role in the development and progression of postmenopausal hypertension. In the present study, we investigated the effect of chronic angiotensin II-induced hypertension on the geometric, elastic, and contractile properties of the saphenous vein in sex hormone deficient and replaced female rats. Thirty Sprague-Dawley rats were ovariectomized (n = 10), ovariectomized and angiotensin-infused (n = 10), or ovariectomized plus angiotensin-infused and hormone replaced with estradiol and medroxyprogesterone (n= 10). After 4 weeks, the saphenous veins were removed and cylindrical segments of the vessels were placed into a microangiograph and cannulated at both ends. Intraluminal pressure versus outer diameter curves were registered in Krebs-Ringer solution, in maximal norepinephrine contraction, and in full papaverine relaxation. In vivo venous tone of the saphenous vein in ovariectomized plus angiotensin-infused animals was significantly higher than in ovariectomized animals without angiotensin treatment (27.2 +/- 3.7% versus 5.3 +/- 2.1%, respectively; P <.05). Hormone replacement restored venous tone (9.6 +/- 3.4%; P <.01). In vitro pressure-induced myogenic tone was markedly reduced by chronic angiotensin infusion, which was partially reversed by hormone replacement. Passive incremental distensibility was lowered after angiotensin infusion independently of the sex hormone state." }, { "role": "assistant", "content": "Hormone replacement improved venous contractility (rapid adaptation response), which was seen as decreased in vivo venous tone, but venous distensibility (chronic adaptation) was not improved by hormone replacement in our short-term study. We demonstrate beneficial short-term effects of hormone replacement on the venous system in our model of postmenopausal hypertension. Further studies might be warranted to see whether long-term benefits can be achieved. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 79-year-old man, hospitalized for overnight monitoring after elective surgery, is found on morning rounds to be confused and disoriented. He was recovering well in the post-anesthesia care unit before being moved up to the inpatient floor unit; however, he was found to be delirious and agitated overnight. Therefore, he was given a dose of a drug that affects the opening frequency of a neuronal ion channel. During morning rounds, he is found to have weakness, tremors, uncoordinated muscle movements, blurred vision, and disorientation. Which of the following could be used to reverse the drug that was administered to this patient?" }, { "role": "assistant", "content": "Flumazenil" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Muscae volitantes are seen in" }, { "role": "assistant", "content": "The correct answer is These are physiological opacities and represent the residues of primitive hyaloid vasculature.\nPatient perceives them as fine dots and filaments, which often drift in and out of the visual field, against a bright background (e.g., clear blue sky)." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All are morphine effects EXCEPT:" }, { "role": "assistant", "content": "The correct answer is (Ref: Goodman & Gillman's 14th ed. pg. 363-6* Effect of morphine is seen mainly at m-receptor. Effect on m-receptor depends on either supraspinal or spinal m- receptor.# Supraspinal effects: Physical dependence, euphoria, analgesia, sedation. (PEAS)# Spinal effects: Constipation, analgesia and respiratory depression. (CAR)* Effect of morphine at heart: No effect at usual dose but at high dose it can cause bradycardia and hypotension.* Effect of morphine at eye: No effect if applied locally. Miosis on systemic intake. Miosis can be worsened to pinpoint pupil upon systemic morphine toxicity.Note: Morphine causes analgesia. Hyperalgesia is one of thewithdrawal symptoms." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Antigens, CD, Antineoplastic Agents, B7-1 Antigen, B7-H1 Antigen, Cells, Cultured, Dermatitis, Dermis, Extracellular Signal-Regulated MAP Kinases, Fibroblasts, Gene Deletion, Gene Expression, Genetic Complementation Test, Humans, Interferon-gamma, MAP Kinase Signaling System, Membrane Glycoproteins, NF-kappa B, Peptides, Phosphatidylinositol 3-Kinases, Promoter Regions, Genetic, RNA, Messenger." }, { "role": "user", "content": "Does iFN-gamma regulate the expression of B7-H1 in dermal fibroblast cells? Context: Programmed cell death ligand 1 (B7-H1) was recently cloned in antigen presenting cells (APCs) and represents a third member of the B7 family. Thus, B7-H1 may be a novel target for clinical intervention in human inflammatory disease. The aim of this study is to investigate the signal transduction mechanism and transcriptional regulation of B7-H1 expression in human dermal fibroblasts. We performed reverse transcription PCR (RT-PCR) for the detection of mRNA expression, luciferase reporter assays with B7-H1 promoter constructs, and Western blot analysis. From RT-PCR analysis, IFN-gamma can induce the expression of B7-H1 mRNA in dermal fibroblast. This expression is similar to the results of luciferase reporter assay with B7-H1 promoter. Western blot analysis and EMSA revealed that NF-kappaB transcription factors mediate the induction of B7-H1 expression via the transient phosphorylation of ERK1/2 and PI3K when cells are stimulated by IFN-gamma. Also, Specific destruction of the NF-kappaB binding site abolished the induction of the promoter activity by IFN-gamma." }, { "role": "assistant", "content": "Our data not only provides the first evidence to demonstrate that dermal fibroblast express the B7-H1 mRNA in the process of skin inflammation, but also suggests the involvement of NF-kappaB and MAPK and PI3K, that may play some important roles in inflammation process in human skin diseases. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Depression, Fatigue, Female, Gastrointestinal Diseases, Humans, Irritable Bowel Syndrome, Liver Cirrhosis, Biliary, Male, Mental Fatigue, Middle Aged, Psychological Tests, Quality of Life." }, { "role": "user", "content": "Is fatigue a specific symptom in patients with primary biliary cirrhosis? Context: Fatigue has been reported to be common in patients with primary biliary cirrhosis (PBC). Limited data exist on comparison with fatigue in the general population and comparison with patients with other chronic gastrointestinal disorders are lacking. We enrolled 96 patients with PBC (87 females); mean age 63 (range 34-65) who completed the Fatigue Impact Scale (FIS). In comparison we included matched controls from the general population, patients with organic (OGD) and functional GI disorders (FGD). Liver function test and the latest liver biopsy were analysed and correlated with fatigue scores. The mean duration of PBC was 7.4 years, the mean bilirubin 13 micromol/l. Twelve per cent of patients had cirrhosis, 29% were in stage I on Ludwig's histology score and 30% and 29% were in stages II and III, respectively. The PBC patients had a median FIS total score of 29 in comparison with 38 in GP controls (P<0.05). Patients with OGD and FGD had more severe fatigue (FIS total score 67 and 59 (P<0.01 compared with PBC)). Fatigue in the PBC patients did not correlate with liver tests and histology stage." }, { "role": "assistant", "content": "PBC patients had less severe fatigue measured with the FIS than controls from the GP and patients with OGD and FGD. This study also confirms results of other studies showing no correlation with fatigue in PBC and liver disease parameters. These results argues strongly against fatigue as a specific symptom in PBC. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Diagnose the condition in the given x -ray" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Monteggia fracture * This is the fracture of upper third of ulna with dislocation of the radial head. It is usually called \"tracherous lesion\" because the dislocation is often missed - monteggia fracture." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Splaying and cupping of the'metaphysis is seen in :" }, { "role": "assistant", "content": "The correct answer is A i.e. Rickets" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Fungal spores are produced" }, { "role": "assistant", "content": "The correct answer is Singly borne spore - microconidia Spores in chain - ahrospores In sporangium - sporangiospores Reference: Textbook of Microbiology; Baveja; 4th edition" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Does late tourniquet release and drain clamping reduce postoperative blood loss in total knee arthroplasty? Context: Many studies have investigated the effect of tourniquet release time and closed suction drainage in total knee arthroplasty (TKA). However, controversy remains as to the advisability of preclosure tourniquet release and the advisability of closed suction drain use following total knee arthroplasty. The aim of the study was to investigate if there is a benefit of performing tourniquet release after skin closure, along with drain clamping, for the first 6h following TKA. Ninety-six patients underwent TKA between May 2009 and April 2010. Fourteen of these were excluded because of systemic diseases and simultaneous bilateral TKA. Twenty-nine of these were excluded due to use of a patellar component and posterior cruciate ligament (PCL)-sacrificing systems. Thus, 53 patients that underwent PCL-retaining cemented TKA were reviewed retrospectively. In the control group (group C), the tourniquet was released before skin closure, an attempt at hemostasis was made, and a compressive bandage was applied. The drain was not clamped in these patients. The test group of 23 patients (group T) had tourniquet release after skin closure and after the compressive bandage was applied. The drain was clamped for the first 6h after surgery. The two groups were compared as to the amount of drained blood, postoperative change in hemoglobin, postoperative complications, and knee function. We found that drained blood and hemoglobin drop were significantly lower in group T compared with group C. There was no difference regarding postoperative complications and knee function." }, { "role": "assistant", "content": "We conclude that tourniquet release after skin closure and compressive dressing followed by 6h of drain clamping reduces postoperative blood loss in TKR surgery. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Arthritis, Rheumatoid, Bone and Bones, Cartilage, Articular, Disease Models, Animal, Disease Progression, Interleukin-17, Joints, Mice, Mice, Knockout, RANK Ligand, Receptors, IgG, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Is tNFα but not IL-17 critical in the pathogenesis of rheumatoid arthritis spontaneously occurring in a unique FcγRIIB-deficient mouse model? Context: TNFα and IL-17 have been shown to be the major inflammatory cytokines involved in the pathogenesis of rheumatoid arthritis (RA). Here, we examined the effect of these cytokines on spontaneously occurring RA in our newly established arthritis-prone FcγRIIB- deficient C57BL/6 (B6) mice, designated KO1, by introducing genetic deficiency of TNFα and IL-17 into KO1 mice. KO1.TNFα(-/-) and KO1.IL-17(-/-) mice were established by crossing KO1 with TNFα-deficient and IL-17-deficient B6 mice, respectively. The incidence and severity of RA, cartilage and bone destruction, immunological abnormalities, and transcription levels of receptor activator of NF-κB ligand (RANKL)/osteoprotegerin (OPG) and inflammatory cytokines/chemokines in ankle joints were compared among KO1, KO1.TNFα(-/-), and KO1.IL-17(-/-) mice. The development of RA was completely inhibited in KO1.TNFα(-/-) mice. In contrast, KO1.IL-17(-/-) mice unexpectedly developed severe RA comparable to KO1. Compared with those in KO1 and KO1.IL-17(-/-) mice, frequencies of peripheral monocytes, known to be containing osteoclast precursors, were significantly decreased in KO1.TNFα(-/-) mice. Intriguingly, while RANKL expression levels in ankle joints did not differ among the three strains, OPG expression levels were drastically decreased in arthritis-prone, but not arthritis-free, mice. The expression levels of inflammatory cytokines/chemokines, such as MCP-1, IL-6, and TNFα, were up-regulated in arthritis-prone mice." }, { "role": "assistant", "content": "TNFα is indispensable while IL-17 is dispensable in the pathogenesis of RA in KO1 mice. In this model, TNFα may contribute to the development of arthritis, through mediating the increase in frequencies of osteoclast precursors in circulation and their migration into the joints, and the decrease in OPG expression, leading to the up-regulated osteoclastogenesis associated with severe cartilage and bone destruction. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "SLE is which type of hypersensitivity reaction:March 2005" }, { "role": "assistant", "content": "The correct answer is Ans. C: Type III hypersensitivityType III hypersensitivity response (Immune-complex mediated response) Examples are:Some form of glomerulonephritisSerum sicknessAhus reactionSLEAntinuclear antibody (ANA) testing and anti-extractable nuclear antigen (anti-EN A) form the mainstay of serologic testing for SLE.Several techniques are used to detect ANAs. Clinically the most widely used method is indirect immunofluorescence. The pattern of fluorescence suggests the type of antibody present in the patient's serum.ANA screening yields positive results in many connective tissue disorders and other autoimmune diseases, and may occur in normal individuals.Subtypes of antinuclear antibodies include anti-Smith and anti-double stranded DNA (dsDNA) antibodies (which are linked to SLE) and anti-histone antibodies (which are linked to drug-induced lupus).Anti-dsDNA antibodies are highly specific for SLE; they are present in 70% of cases, whereas they appear in only 0.5% of people without SLE.The anti-dsDNA antibody titers also tend to reflect disease activity, although not in all cases." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, Central Nervous System Depressants, Dopamine, Ethanol, Female, Fetal Alcohol Spectrum Disorders, Male, Mesencephalon, Neurons, Pregnancy, Prenatal Exposure Delayed Effects, Rats, Rats, Long-Evans, Synaptic Transmission." }, { "role": "user", "content": "Does prenatal ethanol reduce the activity of adult midbrain dopamine neurons? Context: Prenatal ethanol exposure has been demonstrated to reduce dopamine (DA) neurotransmission in the forebrain area, which could be contributed by altered electrical activity in midbrain DA neurons. This hypothesis was tested in the present study. The effects of prenatal ethanol exposure on the spontaneous activity of DA neurons in the substantia nigra and ventral tegmental area were investigated with extracellular single-unit recording techniques in adult male rats. Pregnant rats were administered single daily doses of 0, 3, or 5 g/kg ethanol via intragastric intubation from gestation day 8 through 20. An additional control group did not receive the intubation procedure. Prenatal ethanol treatment significantly reduced the number of spontaneously active DA neurons in the substantia nigra and ventral tegmental area in 3- to 5-month-old male offspring. The firing rate and firing pattern of the remaining spontaneously active DA neurons were not altered. There were no differences in the spontaneous activity of DA neurons between the nonintubated and 0 g/kg control groups, indicating possible intubation-induced stress did not influence the activity of DA neurons in adult offspring. Similar prenatal ethanol effects were also determined from older animals (14-16 months old), suggesting that the reduction in the spontaneous activity of DA neurons is a persistent phenomenon in adulthood after prenatal ethanol exposure. Furthermore, the reduction in the number of spontaneously active DA neurons was not the result of a loss in DA neurons per se, as revealed by the results of tyrosine hydroxylase immunohistochemistry. The prenatal ethanol exposure-induced reduction in DA neuronal activity may result from depolarization inactivation, because systemically administered apomorphine (20 microg) increased the spontaneous activity of DA neurons." }, { "role": "assistant", "content": "Prenatal ethanol exposure induced a long-lasting reduction in the activity of midbrain DA neurons in adult animals. The effect was not the result of cell loss but possible changes in the electrical properties of DA neurons. The decreased electrical activity in midbrain DA neurons could contribute to the prenatal ethanol exposure-induced reduction in DA content and metabolites observed in previous studies and the attention/hyperactivity problems reported in children with fetal alcohol effects/fetal alcohol syndrome. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In a hemoglobin molecule which of the following is a homologous substitution for valine?" }, { "role": "assistant", "content": "The correct answer is Valine can be replaced by glutamic acid. At position number 67 in the amino acid sequence, three different amino acid substitutions have been found in different varient hemoglobins. Hb Sydney Valine - Alanine; Hb M Milwaukee Valine - Glu; & Hb Bristol Val - Asp. All of these are functionally normal hemoglobin types. Ref: Harper's Biochemistry, 26th Edition, Page 362 ; Color Atlas of Genetics By Eberhard Passarge, 2007, Page 348" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is a cause of peripheral arterial occlusive disease" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Bull's eye type of radiologic feature is seen in:" }, { "role": "assistant", "content": "The correct answer is Bull's eye lesions are important clinical feature of erythema multiformae." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Analysis of Variance, Animals, Biomechanical Phenomena, Blood, Cartilage, Articular, Cells, Cultured, Chondrocytes, Materials Testing, Swine, Tissue Engineering, Tissue Scaffolds." }, { "role": "user", "content": "Does blood exposure have a negative effect on engineered cartilage? Context: The aim of this study was to investigate the in vitro effect of different concentrations of blood on the morphological and biochemical properties of engineered cartilage. Previous studies have demonstrated a negative effect of blood on native cartilage; however, the effect of the contact of blood on engineered cartilage is unclear. Articular chondrocytes were isolated from swine joints, expanded in monolayer culture, and seeded onto collagen membranes. The seeded membranes were cultured for 3 days in the presence of different concentrations of peripheral blood. Some samples were retrieved at the end of the blood contact, others after 21 additional days of standard culture conditions, in order to investigate the \"long-term effect\" of the blood contact. All seeded samples showed an increase in the weight and an evident cartilage-like matrix production. A concentration-dependent reduction in the mitochondrial activity due to blood contact was shown at the earlier culture time, followed by a partial recover at the longer culture time." }, { "role": "assistant", "content": "A blood contact of 3 days affected the chondrocytes' activity and determined a delay in the maturation of the engineered cartilage. These findings have clinical relevance, as autologous chondrocytes seeded onto biological scaffolds has become an established surgical method for articular cartilage repair. Therefore, further investigation into material sciences should be encouraged for the development of scaffold protecting the reparative cells from the blood insult. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following drugs should not be given with tyramine as it may result in a dangerous reaction?" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which pattern is seen in pulmonary function tests in a patient with interstitial lung disease?" }, { "role": "assistant", "content": "The correct answer is Pulmonary function tests In PFT,Airway narrowing,lung volume and gas exchange capacity are quantified and compared with normal values adjusted for age,gender,height,etc. Most forms of ILD will show restrictive pattern on PFT. Restrictive deficit TLC(Total lung capacity) Reduced FEV1(Forced expiratory volume in 1 sec) Symmetrically reduced FVC(Forced vital capacity) Reduced DLCO(Diffusing capacity of the lung for carbon monoxide) Reduced FEV1/FVC ratio Normal or increased characteristically >0.7 Approach to pulmonary function test interpretation:" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, Antibody Specificity, Calcineurin Inhibitors, Cyclosporine, Graft Rejection, Heart Transplantation, Immunosuppressive Agents, Isoantibodies, Mice, Mice, Inbred BALB C, Mice, Inbred C3H, Mice, Inbred C57BL, Models, Animal, T-Lymphocytes, Tissue Donors, Transplantation, Homologous, Vascular Diseases." }, { "role": "user", "content": "Does cyclosporine immunosuppression prevent the production of donor-specific antibody capable of mediating allograft vasculopathy? Context: Late cardiac graft rejection, primarily mediated by allograft vasculopathy (AV), remains a major limitation to cardiac transplantation, even in the face of significant calcineurin inhibitor (CNI) immunosuppression. The role played by alloantibody in AV is unclear. Evidence that CNI immunosuppression suppresses CD4(+) T-cell function would suggest that antibody production and effector function would be severely limited in CNI-treated patients. In this study we examine the capacity of CNI-treated animals to develop effective alloantibody that can mediate AV. Wild-type (WT) B6 mice were alloimmunized using donor splenocytes or a fully major histocompatibility complex-mismatched allogeneic abdominal aortic graft in the presence of CNI immunosuppression (30 or 50 mg/kg/day cyclosporine A). Anti-serum was harvested and tested using complement-dependent in vitro cytotoxicity assays. Anti-serum was passively transferred to immunodeficient RAG1(-/-) recipients of allogeneic grafts. C4d deposition was quantified in the allografts from WT recipients. CNI immunosuppression did not prevent the development of alloantibody in response to either immunization method (p < 0.05). Passive transfer of anti-serum generated AV lesions in immunodeficient graft recipients and mediated complement-dependent destruction of donor cells (p < 0.05). C4d deposition was localized to the media of grafts of CNI treated animals." }, { "role": "assistant", "content": "CNI therapy does not prevent the production of alloantibody with the capacity to mediate AV. C4d deposition in the media suggests a role for medial smooth muscle cell loss in antibody-mediated AV lesion development in our model. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, METHODS, RESULTS. Meshes: AIDS-Related Opportunistic Infections, Adolescent, Adult, Aged, Anti-Infective Agents, Antibiotic Prophylaxis, Child, Child, Preschool, Cohort Studies, Diarrhea, Disease Transmission, Infectious, Drug Resistance, Family, Family Health, Female, HIV Infections, Humans, Infant, Infant, Newborn, Male, Middle Aged, Prospective Studies, Trimethoprim, Sulfamethoxazole Drug Combination, Uganda." }, { "role": "user", "content": "Does cotrimoxazole prophylaxis by HIV-infected persons in Uganda reduce morbidity and mortality among HIV-uninfected family members? Context: The effect of cotrimoxazole prophylaxis taken by persons with HIV on community health and antimicrobial resistance is unknown. To assess the effect of cotrimoxazole prophylaxis taken by persons with HIV on morbidity, mortality, and antimicrobial resistance of diarrheal pathogens infecting their HIV-negative family members. Prospective cohort in rural Uganda. A total of 879 persons with HIV and 2771 HIV-negative family members received weekly home-visits. After 5 months, persons with HIV received daily cotrimoxazole prophylaxis and households were followed for an average of 17 additional months. During the study, 224 participants with HIV (25%) and 29 household members (1%) died. Mortality among HIV-negative family members < 10 years old was 63% less during the cotrimoxazole period than before [hazard ratio, 0.37; 95% confidence interval (CI), 0.14-0.95; P = 0.04]. Malaria among family members was less common during cotrimoxazole treatment [incidence rate ratio (IRR), 0.62; CI, 0.53-0.74; P < 0.0001], as were diarrhea (IRR, 0.59; CI, 0.45-0.76; P = 0.0001), and hospitalizations (IRR, 0.57; CI, 0.36-0.92; P = 0.02). Death of a parent with HIV was associated with a threefold increase in mortality among HIV-negative children < 10 years old (hazard ratio, 2.9; CI, 1.1-8.1; P = 0.04). Of 134 bacterial isolates from family members before cotrimoxazole treatment, 89 (66%) were resistant to cotrimoxazole; of 75 recovered during cotrimoxazole treatment, 54 (72%) were resistant (P = 0.41)." }, { "role": "assistant", "content": "Cotrimoxazole prophylaxis taken by persons with HIV was associated with decreased morbidity and mortality among family members. Antimicrobial resistance among diarrheal pathogens infecting family members did not increase. Concerns regarding the spread of bacterial resistance should not impede implementation of cotrimoxazole programs. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Carcinoma cervix is associated with all except :" }, { "role": "assistant", "content": "The correct answer is Diabetes mellitus" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "During cataractogenesis lens stria appear at first in:" }, { "role": "assistant", "content": "The correct answer is Ans. Lower nasal quadrant" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Cell Survival, Dose-Response Relationship, Drug, Metformin, Oxidative Stress, PC12 Cells, Proto-Oncogene Proteins c-akt, Rats, TOR Serine-Threonine Kinases." }, { "role": "user", "content": "Is metformin-induced protection against oxidative stress associated with AKT/mTOR restoration in PC12 cells? Context: Reactive oxygen species have been recognized to impair cell function through suppressing Akt the well-known pro-survival molecule. Pile of concrete evidence imply metformin as an Insulin sensitizer may enhance Akt/mTOR activity however the significance of Akt/mTOR recruitment has not yet been revealed in metformin induced neuroprotection against oxidative stress. In the current study using H2O2 induced injury in PC12 cells; we first examined metformin impact on cell death by MTT assay and visual assessment. Metformin pretreated cells were then subjected to immunoblotting as well as real time PCR to find PI3K, Akt, mTOR and S6K concurrent transcriptional and post-transcriptional changes. The proportions of phosphorylated to non-phosphorylated constituents of PI3K/Akt/mTOR/S6K were determined to address their activation upon metformin treatment. According to cells morphology and MTT data metformin led to significant protection against H2O2 induced injury in 0.1 and 0.5mM concentrations. Metformin induced protection concurred with elevated PI3K/Akt/mTOR/S6K activity as well as enhanced GSH levels. These changes paralleled with a profound decline in the corresponding transcripts as determined by real time PCR." }, { "role": "assistant", "content": "Taken together our experimentation supports the hypothesis that Akt/mTOR/S6K cascade may contribute to metformin alleviating effect. The present work while highlighting metformin anti-oxidant characteristics, concludes that Akt/mTOR signaling might be central to the drug's alleviating effects. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, DESIGN, PARTICIPANTS, METHODS, MAIN OUTCOME MEASURES, RESULTS. Meshes: Adolescent, Adult, Aged, Aniridia, Blepharoptosis, Blood Glucose, Corneal Opacity, Diabetes Mellitus, Eye Abnormalities, Eye Proteins, Female, Glycated Hemoglobin A, Homeodomain Proteins, Humans, Iris, Male, Middle Aged, Mutation, PAX6 Transcription Factor, Paired Box Transcription Factors, Pedigree, Repressor Proteins, Young Adult." }, { "role": "user", "content": "PAX6 mutation in association with ptosis, cataract, iris hypoplasia, corneal opacification and diabetes: a new variant of familial aniridia? Context: We report a family with ptosis, cataract, iris hypoplasia and gradual corneal opacification occurring in association with a PAX6 mutation. Case-series. Fourteen family members - 8 affected, 6 unaffected controls. All participants underwent ophthalmological assessment, including best-corrected visual acuity, slit-lamp-examination, pachymetry, endothelial cell-count, tonometry and dilated fundoscopy. All subjects underwent anthropometry and assessment of glycaemic status. Genetic analysis of the PAX6 gene was performed. Presence of ptosis, corneal, iris and lenticular changes, gycaemic and PAX6 status. All eight affected subjects had ptosis with reduced levator function, anterior polar cataracts, and corneal changes of variable severity - two patients had undergone penetrating keratoplasties, with graft histology revealing conjunctival cells on the cornea and severe fibroinflammatory change. Five patients had iris hypoplasia. One patient had aphakic glaucoma and another had hypoplastic optic discs. Four of the six controls had no ocular features of this syndrome, and two had isolated mild ptosis. There was no difference in height or body mass index between cases and family controls (p>0.05), but Haemoglobin A1c was greater in the cases (median [interquartile range] 5.6(0.8) vs 5.1(0.3), p = 0.028). Genetic analysis confirmed a pathogenic PAX6 mutation in exon 12 (c1439delC) in all eight patients, but none of the controls." }, { "role": "assistant", "content": "This is the first report of this particular constellation of ocular signs occurring in association with a PAX6 mutation. There was no association with anthropometric features, but affected subjects had worse glycaemia than controls, which may be related to the known role of PAX6 in development of the pancreas." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "LDH isoenzyme specific for heart is -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., LDH1* Lactate Dehydrogenase converts pyruvate to lactate.* It is present in cytoplasm of cells* It is a tetramer. Two subunits H and M in various combinations make up the various isoenzymes of LDHLDH ISOENZYMESUBUNITSLOCATIONLDH 1H4Heart, RBC, BrainLDH 2H3M1Reticuloendothelial cellsLDH3H2M2LungsLDH4H1M3Kidneys, placenta, PancreasLDH 5M4Liver and skeletal muscle* In blood generally LDH 2 isoenzyme concentration is higher. In myocardial infarction, LDH1 concentration is increased. This LDH 1 being more than LDH2 is called as flipped pattern of LDH which is suggestive of myocardial infarction." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "High dose methotrexate is used for the treatment of:" }, { "role": "assistant", "content": "The correct answer is Methotrexate (Mtx) It is one of the oldest and highly efficacious antineoplastic drugs; inhibits dihydrofolate reductase (DHFRase)-blocking the conversion of dihydrofolic acid (DHFA) to tetrahydrofolic acid (THFA) which is an essential coenzyme required for one carbon transfer reactions in de novo purine synthesis and amino acid interconversions. The inhibition is pseudoirreversible because Mtx has 50,000 times higher affinity for the enzyme than the normal substrate. Methotrexate is apparently curative in choriocarcinoma.Highly effective in maintaining remission in children with acute leukaemias, but not good for inducing remission: 2.5-15 mg/day. It is also useful in other malignancies, rheumatoid ahritis, psoriasis and as immunosuppressant The use of folinic acid rescue has permitted much higher doses of Mtx and has enlarged its scope to many difficult-to-treat neoplasms ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:823" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: METHODS, RESULTS. Meshes: Adipose Tissue, Adult, Age Factors, Blood Pressure, Body Constitution, Body Mass Index, Feeding Behavior, Female, Humans, Mathematics, Memory, Short-Term, Middle Aged, Overweight, Physical Fitness, Postmenopause, Vitamin D, Vitamins, Young Adult." }, { "role": "user", "content": "Determinants of short-term memory: is there a difference between young adults and postmenopausal women? Context: Forty-five healthy overweight women were recruited through general physicians: 23 were young adults (24.63±4.17 years) and 22 were postmenopausal (53.30±2.95 years). Overweight condition was assessed according to the age-adjusted reference values. Participants were analyzed for Digit Span, blood pressure, body composition, aerobic fitness and dietary habits. Young adults and postmenopausal women did not differ either in Digit Span or in dietary habits. In postmenopausal women Digit Span was positively correlated with body weight, body mass index, body fat, waist circumference and daily intake of vitamin D. Linear regression model indicated vitamin D as the only significant predictor variable of Digit Span. In young adults Digit Span had no correlations with the others investigated variables." }, { "role": "assistant", "content": "In postmenopause, vitamin D daily intake is important not only for skeletal, but also for cognitive health. Even though young adults and post-menopausal women did not differ for health status, short-term memory in young adulthood seems to be differently linked with the investigated variables than during post-menopause." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 27-year-old man comes to the physician because of worsening abdominal pain over the last several months. He has also had recent feelings of sadness and a lack of motivation at work, where he is employed as a computer programmer. He denies suicidal thoughts. He has a history of multiple kidney stones. He has a family history of thyroid cancer in his father and uncle, who both underwent thyroidectomy before age 30. His temperature is 37°C (98°F), blood pressure is 138/86 mm Hg, and pulse is 87/min. Physical examination shows diffuse tenderness over the abdomen and obesity but is otherwise unremarkable. Serum studies show:\nNa+ 141 mEq/L\nK+ 3.6 mEq/L\nGlucose 144 mg/dL\nCa2+ 12.1 mg/dL\nAlbumin 4.1 g/dL\nPTH 226 pg/mL (normal range 12–88 pg/mL)\nResults of a RET gene test return abnormal. The physician refers him to an endocrine surgeon. Which of the following is the most appropriate next step in diagnosis?\"" }, { "role": "assistant", "content": "Urine metanephrines" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Most common cardiac manifestation of Holt Oram syndrome is ?" }, { "role": "assistant", "content": "The correct answer is Holt-Oram syndrome (also called Hea and Hand Syndrome, atrio-digital syndrome, atriodigital dysplasia, cardiac-limb syndrome, hea-hand syndrome type 1, HOS, ventriculo-radial syndrome is an autosomal dominant disorder that affects bones in the arms and hands (the upper limbs) and may also cause hea problems. The syndrome includes an absent radial bone in the arms, an atrial septal defect , and a first degree hea block Ref Davidson 23rd edition pg 467" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is the most beta-1 selective antagonist?" }, { "role": "assistant", "content": "The correct answer is Ans: D (Bisoprolol) Ref: Goodman & Gill man's The Pharmacological Basis of Therapeutics. 2011, 12th Edition, McGraw-Hill, Burton LL P 328Explanation:Bisoprolol is highly selective beta-1 selective antagonist among the given drugsHowever nehivolol has higher beta-1 selective antagonist than bisoprololBeta-1 selective antagonist includeAcebutololAtenololBetaxololBisoprololCeliprololEsmololMetoprololNebivolol" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 34-year-old woman presents to the emergency department with moderate right wrist pain after falling on her outstretched hand. She has numbness in the 3 medial digits. The patient has no known previous medical conditions. Her family history is not pertinent, and she currently takes no medications. Physical examination shows her blood pressure is 134/82 mm Hg, the respirations are 14/min, the pulse is 87/min, and the temperature is 36.7°C (98.0°F). When asked to make a fist, the patient is able to flex only the lateral 2 digits. Tapping the anterior portion of her wrist elicits tingling in the medial 3 digits. The patient is taken to get an X-ray. Which of the following is the most likely diagnosis for this patient’s injury?" }, { "role": "assistant", "content": "Lunate dislocation" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Antibodies, Antiphospholipid, Antiphospholipid Syndrome, Autoimmune Diseases of the Nervous System, Comorbidity, Epilepsies, Partial, Epilepsy, Female, Humans, Male, Middle Aged, Prospective Studies, Recurrence, Seroepidemiologic Studies, Young Adult." }, { "role": "user", "content": "Is the high prevalence of antiphospholipid antibodies in refractory focal epilepsy related to recurrent seizures? Context: Previous studies have shown the association between antiphospholipid antibodies with epilepsy but there are no studies addressing the effect of seizure frequency, duration of epilepsy, epilepsy type and aetiology on the prevalence of these antibodies in well-evaluated refractory epilepsy. Anticardiolipin, anti-beta2-glycoprotein I and antinuclear antibody levels were measured in 105 well-evaluated patients with refractory focal epilepsy. Clinical determinants included the patient history, electroclinical classification and high resolution brain magnetic resonance imaging. Patients with seizures during the month prior to sampling (recent seizures) had increased prevalence of immunoglobulin (Ig) G class anticardiolipin antibodies (29%) compared with healthy controls [13%; age-adjusted odds ratio (OR): 3.09, 95% confidence interval (CI): 1.30-7.34] and patients with no recent seizures (11%; age-adjusted OR: 4.00, CI: 0.84-19.02). The patients with recent seizures had increased prevalence of moderate positive IgG class anticardiolipin antibodies (12%) compared with the controls (4%) and the patients with no recent seizures (0%; age-adjusted OR: 4.45, CI: 1.14-17.36). The prevalence of IgG class anticardiolipin antibodies was not associated with epilepsy type, duration or aetiology." }, { "role": "assistant", "content": "The presence of antiphospholipid antibodies is associated with recurrent seizures in patients with refractory focal epilepsy. The measurement of these antibodies may be useful in evaluating the outcome of epilepsy. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Atherosclerosis, Cellular Senescence, Female, Humans, Inflammation, Interleukin-10, Kidney Failure, Chronic, Leukocytes, Mononuclear, Lipoproteins, LDL, Male, Middle Aged, Oxidative Stress, Renal Dialysis, Telomerase, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Is serum oxidized low-density lipoprotein inversely correlated to telomerase activity in peripheral blood mononuclear cells of haemodialysis patients? Context: Telomerase preserves telomeres' function and structure preventing cellular senescence. Its activity is reduced in peripheral blood mononuclear cells (PBMC) of haemodialysis (HD) patients. The purpose of this study is to investigate the potential correlation between increased oxidative stress/inflammation and telomerase activity in PBMC of HD patients. Telomerase activity was measured by PCR-ELISA in PBMC isolated from a group of 42 HD patients and 39 subjects with estimated glomerular filtration rate >or=80 mL/min (control group). Serum oxidized low-density lipoprotein (ox-LDL), tumour necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) were also measured in both groups by ELISA. Ox-LDL was negatively correlated to percentage telomerase activity in PBMC (r = -0.506, P = 0.000 in the whole group of 81 HD and normal subjects and r = -0.559, P < 0.001 in HD patients). TNF was also inversely associated with percentage telomerase activity in the whole group studied (r = -0.492, P = 0.000) while IL-10 was not. In stepwise multiple linear regression, taking into consideration the most important characteristics of the HD patients and control group, the only significant predictors for percentage telomerase activity in PBMC were ox-LDL and TNF (beta = -0.421, t = -4.083, P = 0.000 and beta = -0.381, t = -3.691, P = 0.000, respectively) while examining separately HD patients, the predictors for the same parameter were ox-LDL and HD duration (beta = -0.671, t = -4.709, P = 0.000 and beta = -0.349, t = -2.447, P = 0.023, respectively)." }, { "role": "assistant", "content": "Ox-LDL serum level is inversely correlated to telomerase activity in PBMC of HD patients. Our study proposes a new consequence of increased oxidative stress in HD patients: the premature cellular senescence potentially related to atherosclerosis through LDL oxidation. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The production of cervical mucus is stimulated by :" }, { "role": "assistant", "content": "The correct answer is Cervical mucus is a glycoprotein gel that expand and contract in response to cyclic changes in the steroid hormone environment across the menstrual cycle to facilitate or inhibit the passage of sperms. Estrogen stimulates cervical mucus production, and as levels rise during the follicular phase, mucus becomes more abundant and watery, less cellular, and more easily penetrated by sperm. Progesterone inhibits cervical mucus production and renders it opaque, viscid, and impenetrable. Ref: Clinical Gynaecologic Endocrinology and Infeility; 8th Edition, Chapter 27" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Components of comunication" }, { "role": "assistant", "content": "The correct answer is Communication has following components:Sender (source)Receiver (Audience)Message (Content)Channel (medium)Feedback (effect)Park 23e 854" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Biomarkers, Blotting, Western, Cell Movement, Cell Survival, Disease Models, Animal, Female, Gene Expression Regulation, Immunohistochemistry, Intravitreal Injections, Male, Nerve Crush, Nerve Growth Factors, Neural Stem Cells, Photoreceptor Cells, Vertebrate, Pregnancy, Rats, Rats, Sprague-Dawley, Retinal Degeneration, Retinal Ganglion Cells, Stem Cell Transplantation, Transfection, beta-Crystallin B Chain." }, { "role": "user", "content": "Do crystallin-β-b2-overexpressing NPCs support the survival of injured retinal ganglion cells and photoreceptors in rats? Context: Crystallin β-b2 (crybb2) is known to support the regeneration of retinal ganglion cell (RGC) axons in culture. We investigated whether neuronal progenitor cells (NPCs) overexpressing crybb2 (crybb2-NPC) affect secondary retinal degeneration due to optic nerve crush in vivo. NPCS were produced by dissociation and propagation of rat embryonic neural tube and eye primordial cells at embryonic days 13.5 and 15. Retinal degeneration was induced by injured optic nerve crush (BY suture, 20 seconds). Several groups were built: crybb2-NPC were injected into the vitreous body, while the Controls were comprised of recombinant crybb2-injected and PBS-injected groups. The eyes, in particular the retina, were analyzed by immunohistochemistry and Western blotting for different antigens at 2 and 4 weeks after surgery. At 2 and 4 weeks post surgery, crybb2-NPC resided within the vitreoretinal compartment, and were persistently nestin-positive throughout the experimental period. The cells stained positive for various neurotrophins and acted as \"living\" cell factories to support the survival of injured RGCs. The crybb2-NPC migrated throughout the eye structures and sometimes became integrated within the tissue. Most of the ocular cells responded to the appearance of crybb2-NPC with marked changes of certain proteins, including Iba-1 (microglia), vimentin (glial cells), and rhodopsin (photoreceptors). Photoreceptors also displayed a better survival after crybb2-NPC injection compared to control groups." }, { "role": "assistant", "content": "Crybb2-NPC exert beneficial effects on the vitreoretinal compartment, which suggests that modified crybb2-NPC could be used in a novel strategy for the treatment of degenerative vitreoretinal diseases. However, future studies must determine the safety of in vivo administration of crybb2-NPC. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Fascia of Waldeyer&;s is seen in?" }, { "role": "assistant", "content": "The correct answer is The fascia of Waldeyer is a connective tissue by which the rectum( ampulla) is attached to the sacrum and coccyx.Fascia of Denonvilliers lies between the prostate and the ampulla of the rectum.Reference: Textbook of anatomy, Abdomen and lower limb, Vishram Singh, 2nd edition, page no.281" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, RESULTS. Meshes: Animals, Aspirin, Cattle, Cell Survival, Cells, Cultured, Citrulline, Cyclic GMP, Cyclic N-Oxides, Cytoprotection, Diclofenac, Endothelium, Vascular, Enzyme Inhibitors, Guanylate Cyclase, Hydrogen Peroxide, Imidazoles, Indomethacin, Nitric Oxide Synthase, Nitric Oxide Synthase Type III, Receptors, Cytoplasmic and Nuclear, Soluble Guanylyl Cyclase, Swine, omega-N-Methylarginine." }, { "role": "user", "content": "Does aspirin protect endothelial cells from oxidant damage via the nitric oxide-cGMP pathway? Context: Aspirin is known to exert cytoprotection by presently unidentified mechanisms. This study investigates the involvement of nitric oxide (NO) in antioxidant cellular protection induced by aspirin. A 24-hour incubation with hydrogen peroxide markedly reduced viability of cultured endothelial cells. Preincubation with aspirin (3 to 30 micromol/L) protected endothelial cells from hydrogen peroxide-mediated toxicity and increased viability in a concentration-dependent fashion by up to 95% of control. This effect was specific in that other nonsteroidal anti-inflammatory drugs, such as salicylate or indomethacin, did not alter hydrogen peroxide toxicity. Aspirin-induced endothelial protection was abrogated in the presence of the NO scavenger PTIO (30 micromol/L) and the inhibitor of soluble guanylyl cyclase ODQ (1 micromol/L). Moreover, the l-arginine antagonist L-NMMA (25 micromol/L), but not its D-enantiomer, led to complete inhibition of aspirin-dependent cytoprotection. Correspondingly, aspirin enhanced NO synthase activity (citrulline formation) and intracellular cyclic GMP accumulation in endothelial cells. Protein expression of endothelial NO synthase remained unaffected in the presence of aspirin." }, { "role": "assistant", "content": "Our data suggest that endothelial NO synthase is a site of action of aspirin and that the NO/cyclic GMP system assumes a crucial function in mediating the cytoprotective action of aspirin. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is the largest protozoan?" }, { "role": "assistant", "content": "The correct answer is Balantidium coli is a unicellular protozoan parasite with a length up to 200 micrometer, making it the largest of the human intestinal protozoa. It belongs to the Ciliophora phylum and is the only protozoan ciliate to infect humans. It goes through two development phases: a cyst and a trophozoite. Balantidiasis is often asymptomatic. The trophozoites invade the mucosa and submucosa of the large intestine and destroy the host cells when multiplying. Clinical symptoms are similar to amoebiasis." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Choriocarcinoma commonly metastasize to:\na.Brain\nb. Lung\nc. Vagina\nd. Ovary\ne. Cervix" }, { "role": "assistant", "content": "The correct answer is Most common sites of metastases in choriocarcinoma are:\nLung (80%) > Vagina (30%) > Pelvis (20%) > Liver (10%) and Brain (10%)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Acute Disease, Animals, Capsid Proteins, Cell Adhesion Molecules, Coxsackievirus Infections, Disease Models, Animal, Electroporation, Genetic Therapy, HeLa Cells, Humans, Membrane Proteins, Mice, Mice, Inbred BALB C, Myocarditis, Receptors, Virus, Recombinant Fusion Proteins, Survival Analysis." }, { "role": "user", "content": "Does virus receptor trap neutralize coxsackievirus in experimental murine viral myocarditis? Context: The coxsackie and adenovirus receptor (CAR) and the decay-accelerating factor (DAF) are receptors for coxsackievirus B3 (CVB3), which is known as the major cause of human viral myocarditis. We investigated the potential for therapeutic use of soluble virus receptor fusion proteins. We designed and generated a novel virus receptor trap (hCAR-hDAF:Fc) consisting of both CVB3 receptors and the Fc portion of human IgG1 and evaluated its antiviral effects in experimental CVB3 myocarditis. Among four soluble virus receptor fusion proteins (hCAR:Fc, hDAF:Fc, hCAR-hDAF:Fc and hDAF-hCAR:Fc), hCAR:Fc and hCAR-hDAF:Fc in the supernatant of transfected cells neutralized echovirus, adenovirus, and various serotypes of CVB in a dose-dependent manner. Both soluble viral receptor proteins bound to the VP0 and VP1 capsid proteins of CVB3. The in vivo efficacy of viral receptor proteins was evaluated by intramuscular injection of plasmid (hCAR:Fc or hCAR-hDAF:Fc) followed by electroporation in a murine model of CVB3 myocarditis. Serum levels of the virus receptor proteins increased relative to baseline values from day 3 and peaked on day 14 at 12.9-fold for hCAR:Fc and 7.1-fold for hCAR-hDAF:Fc. The 3-week survival rate was significantly higher in hCAR-hDAF:Fc-treated mice (61%) than in hCAR:Fc-treated mice (29%) and in controls (15%; p<0.05). Myocardial inflammation, fibrosis, and myocardial virus titers were all significantly reduced in the hCAR:Fc and hCAR-hDAF:Fc groups compared to the controls." }, { "role": "assistant", "content": "Our soluble virus receptor trap, hCAR-hDAF:Fc, attenuated viral infection, myocardial inflammation, and fibrosis, resulting in higher survival rates in mice with coxsackieviral myocarditis. Furthermore, it consists exclusively of human components, and we demonstrated that this soluble virus receptor trap may be used as a potential candidate for a novel therapeutic agent for the treatment of acute viral myocarditis during the viremic phase. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Adult, African Continental Ancestry Group, Blood Pressure, Body Mass Index, Child, Child, Preschool, Cross-Sectional Studies, European Continental Ancestry Group, Humans, Hypertension, Linear Models, Middle Aged." }, { "role": "user", "content": "Is adult hypertension associated with blood pressure variability in childhood in blacks and whites : the bogalusa heart study? Context: Blood pressure (BP) is a variable physiological parameter in health and disease. Increased BP variability over time in adults is associated with severity of end-organ damage and a higher rate of cardiovascular events, even after adjusting for the mean levels. This study tested the hypothesis that childhood BP variability, besides the mean levels, is also predictive of adulthood hypertension. The study cohort consisted of 1,797 subjects (1,091 whites and 706 blacks; age = 21-48 years) enrolled in the Bogalusa Heart Study since childhood. BP variability was depicted as s.d. of 4-8 serial measurements in childhood. Blacks showed significantly greater childhood systolic BP (SBP) variability than whites. In multivariable logistic regression analyses, adjusting for race, sex, mean childhood age, s.d. of childhood body mass index (BMI), mean childhood BP levels, adulthood age and BMI, adult hypertension was significantly associated with s.d. of childhood SBP (odds ratio (OR) (95% confidence intervals) = 1.28 (1.09, 1.51), P = 0.002) and s.d. of childhood diastolic BP (DBP; 1.36 (1.16, 1.58), P < 0.001). When using adulthood BP levels as continuous dependent variables in linear regression models, adjusting for the same covariates, adulthood SBP and DBP levels were significantly associated with s.d. of childhood SBP (standardized regression coefficient β = 0.086, P < 0.001) and s.d. of childhood DBP (β = 0.105, P < 0.001), respectively." }, { "role": "assistant", "content": "Increases in BP variations as well as levels in early life are predictive of adult hypertension, which underscore the childhood origin of the natural history of essential hypertension. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The following feature is common to both cytotoxic T cells and NK cells?" }, { "role": "assistant", "content": "The correct answer is Common to both cytotoxic T cells and NK cells is affectivity against virus-infected cellsNK cells:1st line of defense against virus-laden cells and neoplastic cellsCytotoxicity is not MHC restricted Cytotoxic T cells:They are antigen-specific T cells whose function is to produce antigen-specific lysis of target cells by the direct cell to cell contactAre usually CD+ class I MHC restricted T cellsAre impoant in defense against virus infections of tissues (Ref: Harrison's 18/e p2688,2669)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "An alcoholic who presented with heaburn is diagnosed of having esophagitis. The MOST common cause of esophagitis is:" }, { "role": "assistant", "content": "The correct answer is Esophagitis is defined as the presence of signs of inflammation of the esophageal mucosal surfaces, both macroscopically and microscopically. Gastroesophageal reflux disease (GERD) is the most common cause of esophagitis, followed closely by medication-induced and infection-induced inflammation. Ref: Chan W.W., Burakoff R. (2012). Chapter 154. Gastroesophageal Reflux Disease and Esophagitis. In G.V. Lawry, S.C. McKean, J. Matloff, J.J. Ross, D.D. Dressler, D.J. Brotman, J.S. Ginsberg (Eds), Principles and Practice of Hospital Medicine." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Burns, Cells, Cultured, Cicatrix, Collagen, Cyclic GMP, Fibroblasts, Humans, Linear Models, Microscopy, Fluorescence, NG-Nitroarginine Methyl Ester, Nitric Oxide, Nitroprusside, Proline, Signal Transduction, Transforming Growth Factor beta, Up-Regulation." }, { "role": "user", "content": "Is up-regulation by human recombinant transforming growth factor beta-1 of collagen production in cultured dermal fibroblasts mediated by the inhibition of nitric oxide signaling? Context: Hypertrophic scarring remains the most disabling sequela for burn survivors. Little is known about its pathogenesis. Collagen accumulation, however, has been consistently observed in burn hypertrophic scars (HS). We have studied collagen production in the dermal fibroblasts derived from HS, which has developed for 9 months to 2 years. Reconstructive surgery was performed to remove HS from which the fibroblasts were cultured. Similarly, the normal cells were grown from the patient's donor site (DS), which provided autografting to the HS site. Collagen production in HS and DS fibroblasts was compared and analyzed in minimal essential amino acid medium containing 5% fetal bovine serum with inclusion of L-ascorbic acid (100 microg/mL) and beta-aminopropoinitrile (100 microg/mL) by monitoring a 20-h [3H]proline incorporation into bacterial collagenase III-digestible protein in the conditioned media. We failed to detect any significant difference in collagen production in vitro between HS and DS. Irrespective of the fibroblasts from HS or DS, collagen production was substantially stimulated by human recombinant transforming growth factor beta-1 (TGF-beta1) (20 ng/mL) by approximately 250% after a 3-day pretreatment. In contrast, sodium nitroprusside (SNP) at 100 microM exhibited significant suppression (68%), which was rescued by hemoglobin (10 microM). TGF-beta1 significantly decreased nitric oxide (NO) production by 55%. In contrast, NO level drastically increased by 350% following SNP treatment. Epidermal growth factor showed no effect on either collagen production or NO level. The linear regression analysis shows a significant inverse correlation (r = 0.72; p < 0.05) of NO level with collagen production, suggesting the involvement of NO signaling in the modulation of collagen production. Consistent with the notion, we further showed that N-nitro-L-arginine methyl ester (100 microM) caused a synergistic stimulation and an arrested inhibition of collagen production in the presence of TGFbeta-1 and SNP, respectively. 8-BrcGMP (300 microM) mimicked the NO inhibitory action, while methylene blue (50 microM) restored the collagen production which was inhibited by SNP. Moreover, 8-BrcGMP offset the stimulation of collagen production." }, { "role": "assistant", "content": "The dermal fibroblasts derived from HS were not different from normals with respect to collagen production and their responses to regulations. The inhibition of collagen production was achieved by a cGMP-dependent NO action. TGFbeta-1 inhibited NO/cGMP signaling to ensure its stimulatory effect on collagen production in the dermal fibroblasts. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Tetralogy of Fallot's present with one of the following:" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e. . Central cyanosis with clubbing. TOF is the commonest cyanotic congenital* heart disease in children above the age of 2 years.The four constituents of Tetralogy are :Ventricular septal defect*Pulmonic stenosis*Overriding of dextroposed Aorta *Right ventricular hypertrophy *Physiologically the pulmonary stenosis causes concentric right ventricular hypertrophy without cardiac enlargement. When the right ventricular pressure is as high as the left ventricular or the aortic through the VSD. Since right ventricle is effectively decompressed by V.S.D. congestive cardiac failure never occurs in TOF*Right ventricular hypertrophy in E.C.G. reflected by Right axis deviation*.The flow from the right ventricle into the pulmonary artery occurs across the pulmonary stenosis producing an ejection systolic murmur*.Clinical features of TOF :Cyanosis usually presents after neonatal period*Hypoxemic or cyanotic spells* (Tet spells)*Commonest congenital lesion with which squatting* is usedClubbing*Auscultatory findings :s1-Normals2-Single predominantly AorticMurmur-Ejection systolic* TOF patients are RARELY CYANOTIC AT BIRTH*Chest x-rayNormal heart size *Oligemic lung fields*Right aortic arch present in 25% caseECG - Right axis deviation*" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A young patient with dysphagia more for liquids than solids. He regurgitates food often at night. Radiography shows a rat tailed appearance. Likely diagnosis is :" }, { "role": "assistant", "content": "The correct answer is Answer is A (Achlasia cardia) Presence of dysphagia which is more for liquids than for solids along with a characteristic rat tail appearance on radiography in a young patient suggests the diagnosis of aehalasia. Malignancy (CA esophagus) usually presents with dysphagia which is more for solids than for liquids and is seen in the elderly. Zenker's diveiculum and esophageal spasm do not show a rat tail appearance on radiography." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Prelacteal feed given just after bih is: March 2009" }, { "role": "assistant", "content": "The correct answer is Ans. D: None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "How to differentiate between psychological and organic erectile dysfunction?" }, { "role": "assistant", "content": "The correct answer is Presence of early morning erections and erection during REM sleep (nocturnal erection) are suggestive of psychogenic erectile dysfunction as there is no anxiety. Whereas, a patient with organic erectile dysfunction (due to vascular or neurological causes) would not have erections even during sleep. Investigations, such as penile plethysmography and nocturnal penile intumescence (NPT) can be used to record nocturnal erections." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, Animals, Newborn, Antiviral Agents, Astrocytes, Computational Biology, Flavivirus, Gene Expression Regulation, Viral, Immunoglobulin G, Male, Mice, Mice, Inbred C57BL, Mice, Knockout, Neurons, Oxazines, RNA, Messenger, Receptor, Interferon alpha-beta, Xanthenes." }, { "role": "user", "content": "Does fast type I interferon response protect astrocytes from flavivirus infection and virus-induced cytopathic effects? Context: Neurotropic flaviviruses such as tick-borne encephalitis virus (TBEV), Japanese encephalitis virus (JEV), West Nile virus (WNV), and Zika virus (ZIKV) are causative agents of severe brain-related diseases including meningitis, encephalitis, and microcephaly. We have previously shown that local type I interferon response within the central nervous system (CNS) is involved in the protection of mice against tick-borne flavivirus infection. However, the cells responsible for mounting this protective response are not defined. Primary astrocytes were isolated from wild-type (WT) and interferon alpha receptor knock out (IFNAR Here, we show that astrocytes control viral replication of different TBEV strains, JEV, WNV, and ZIKV. In contrast to fibroblast, astrocytes mount a rapid interferon response and restrict viral spread. Furthermore, basal expression levels of key interferon-stimulated genes are high in astrocytes compared to mouse embryonic fibroblasts. Bioinformatic analysis of RNA-sequencing data reveals that astrocytes have established a basal antiviral state which contributes to the rapid viral recognition and upregulation of interferons. The most highly upregulated pathways in neighboring cells were linked to type I interferon response and innate immunity. The restriction in viral growth was dependent on interferon signaling, since loss of the interferon receptor, or its blockade in wild-type cells, resulted in high viral replication and virus-induced cytopathic effects. Astrocyte supernatant from TBEV-infected cells can restrict TBEV growth in astrocytes already 6 h post infection, the effect on neurons is highly reinforced, and astrocyte supernatant from 3 h post infection is already protective." }, { "role": "assistant", "content": "These findings suggest that the combination of an intrinsic constitutive antiviral response and the fast induction of type I IFN production by astrocytes play an important role in self-protection of astrocytes and suppression of flavivirus replication in the CNS. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Asian Continental Ancestry Group, Case-Control Studies, Colorectal Neoplasms, DNA Mutational Analysis, Disease Progression, Female, Genotype, Growth Differentiation Factor 15, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Mutation, Odds Ratio, Polymorphism, Single Nucleotide, Prognosis, Proportional Hazards Models, Young Adult." }, { "role": "user", "content": "Is the H6D genetic variation of GDF15 associated with genesis , progress and prognosis in colorectal cancer? Context: Growth differentiation factor 15 (GDF15) plays important roles in the carcinogenesis of many types of tumors. The aim of this study was to investigate whether H6D polymorphism is contributed to the genesis, progress and prognosis of colorectal cancer (CRC) in Chinese population. Pyrosequencing was used to determine the H6D genotypes. The relationship between the genotypes and clinical characteristics was analyzed. The frequency of CG+GG genotype in the GDF15 H6D polymorphism was significantly increased in CRC patients when compared with controls [odds ratio (OR), 1.543; 95% confidence interval (95% CI), 1.138-2.094, P=0.005]. We also found that the patients with CG+GG genotype had an increased risk of death from colon cancer than those carrying homozygote CC [hazard ratio (HR), 2.472; 95% CI, 1.172-5.214; P=0.017] and the patients with CG+GG genotype of colon cancer also have a positive correlation with distant metastasis than those carrying homozygote CC (χ(2)=4.087, P=0.043). For the first time, H6D was also identified as somatic mutation when compared the H6D genotype in tumor tissues and their matched normal tissues, and the mutation rate is 7.2%. The male CRC patients with the H6D mutation were susceptible to distant metastasis (P=0.028, χ(2)=4.820) and had a relatively poor prognosis." }, { "role": "assistant", "content": "Our results suggest that the H6D genetic variant may be considered as a biomarker of tumorgenesis, metastasis and prognosis in colorectal cancer in Chinese population. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, Cells, Cultured, Gene Expression, Humans, Insulin, Kidney Tubules, Proximal, Rats, Rats, Inbred SHR, Rats, Inbred WKY, Receptor, Insulin, Receptors, Dopamine D5, Sodium-Potassium-Exchanging ATPase, Stimulation, Chemical." }, { "role": "user", "content": "Does insulin increase D5 dopamine receptor expression and function in renal proximal tubule cells from Wistar-Kyoto rats? Context: Ion transport in the renal proximal tubule (RPT) is regulated by numerous hormones and humoral factors, including insulin and dopamine. Previous studies show an interaction between insulin and the D(1) receptor. Because both D(1) and D(5) receptors belong to the D(1)-like receptor subfamily, it is possible that an interaction between insulin and the D(5) dopamine receptor exists in RPT cells from normotensive Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHRs). D(5) receptor expression in immortalized RPT cells from WKY and SHRs was quantified by immunoblotting and D(5) receptor function by measuring Na(+)-K(+) ATPase activity. Insulin increased the expression of the D(5) receptor. Stimulation with insulin (10(-7) mol/l) for 24 h increased D(5) receptor expression in RPT cells from WKY rats. This effect of insulin on D(5) receptor expression was aberrant in RPT cells from SHRs. The stimulatory effect of insulin on D(5) receptor expression in RPT cells from WKY rats was inhibited by a protein kinase C (PKC) inhibitor (PKC inhibitor peptide 19-31, 10(-6) mol/l) or a phosphatidylinositol 3 (PI3) kinase inhibitor (wortmannin, 10(-6) mol/l), indicating that both PKC and PI3 kinase were involved in the signaling pathway. Stimulation of the D(5) receptor heterologously expressed in HEK293 cells with fenoldopam (10(-7) mol/l/15 min) inhibited Na(+)-K(+) ATPase activity, whereas pretreatment with insulin (10(-7) mol/l/24 h) increased the D(5) receptor-mediated inhibition." }, { "role": "assistant", "content": "Insulin and D(5) receptors interact to regulate renal sodium transport; an aberrant interaction between insulin and D(5) receptor may participate in the pathogenesis of hypertension. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Asian Continental Ancestry Group, CD4-CD8 Ratio, CD4-Positive T-Lymphocytes, CD8-Positive T-Lymphocytes, China, Coronary Artery Disease, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Prevalence, Risk." }, { "role": "user", "content": "Is the CD4/CD8 ratio associated with coronary artery disease ( CAD ) in elderly Chinese patients? Context: The aim of this study was to investigate the relationship between number of circulating T cells and coronary artery disease (CAD) in an elderly Chinese population. A total of 295 elderly inpatients (age≥60) were included in this cross-sectional study. Their clinical and biochemical characteristics were recorded. Patients were divided to two groups: control patients and CAD patients. The risk factors of CAD were explored by binary logistic regression analysis. Compared with control patients, the ratio of CD4 to CD8 T cells was significantly increased in CAD patients. There was no difference in the number of CD3, CD4, and CD8 T cells between the two groups. Multiple logistic regression analysis showed that CAD was independently associated with age, gender, body mass index (BMI), systolic blood pressure (SBP), chronic heart failure (CHF) and the CD4/CD8 ratio. In addition, after adjusting for different clinical parameters (including gender, age, CHF, hypertension, arrhythmia, SBP, and BMI), the risk of CAD was significantly increased in patients with a CD4/CD8 ratio>1.5." }, { "role": "assistant", "content": "There was a strong and independent association between the ratio of CD4/CD8 and CAD in elderly Chinese population. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Paraxial mesoderm develops into" }, { "role": "assistant", "content": "The correct answer is Human embryology Tenth edition Inderbier Singh Page no 62At first, the cells of paraxial mesoderm are homogeneously arranged later the mesoderm get segmented The segment are two categories somitomeres and somites" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adenocarcinoma, Adult, Aged, Aged, 80 and over, Biomarkers, Databases, Factual, Disease-Free Survival, Female, Humans, Kaplan-Meier Estimate, Lymphocyte Count, Male, Middle Aged, Neoplasm Recurrence, Local, Neutrophils, Pancreatic Neoplasms, Pancreaticoduodenectomy, Predictive Value of Tests, Preoperative Care, Prognosis, Proportional Hazards Models, Retrospective Studies, Survival Analysis, Treatment Outcome." }, { "role": "user", "content": "Is preoperative neutrophil-to-lymphocyte ratio ( NLR ) associated with reduced disease-free survival following curative resection of pancreatic adenocarcinoma? Context: Serological proinflammatory markers such as C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) have been associated with reduced survival for many different types of cancer. This study determined the prognostic value of the preoperative value of these markers in patients with resectable pancreatic adenocarcinoma. Consecutive patients who underwent pancreaticoduodenectomy for pancreatic ductal adenocarcinoma were entered into our database from 2001 to the present day. CRP, NLR, and PLR at the time of presentation were recorded as well as overall and disease-free survival. Seventy-four patients were identified. Overall median survival was 35.0 months and median disease-free survival was 27.0 months. Follow-up ranged from 1 to 125.8 months. Preoperative NLR was significantly greater in those patients who developed recurrence in the follow-up period (4.5 vs. 3.1). CRP and PLR were not found to differ significantly between the two groups. Kaplan-Meier survival analysis of patients with NLR > 5 demonstrated a disease-free survival of 12 months compared with 52 months for those patients with NLR < 5 (p < 0.001)." }, { "role": "assistant", "content": "Preoperative NLR offers important prognostic information regarding disease-free survival following curative resection of pancreatic ductal adenocarcinoma. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, BACKGROUND, METHODS, RESULTS. Meshes: Adult, Analysis of Variance, Atrial Fibrillation, Body Mass Index, Catheter Ablation, Cohort Studies, Dose-Response Relationship, Radiation, Electrocardiography, Female, Fluoroscopy, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Probability, Pulmonary Veins, Radiation Dosage, Radiography, Interventional, Risk Assessment, Severity of Illness Index, Survival Analysis, Treatment Outcome." }, { "role": "user", "content": "Is obesity a major determinant of radiation dose in patients undergoing pulmonary vein isolation for atrial fibrillation? Context: This study sought to evaluate the impact of obesity on patient radiation dose during atrial fibrillation (AF) ablation procedures under fluoroscopic guidance. Obesity is a risk factor for AF and its recurrence after ablation. It increases patient radiation dose during fluoroscopic imaging, but this effect has not been quantified for AF ablation procedures. Effective radiation dose and lifetime attributable cancer risk were calculated from dose-area product (DAP) measurements in 85 patients undergoing AF ablation guided by biplane low-frequency pulsed fluoroscopy (3 frames/s). Three dose calculation methods were used (Monte Carlo simulation, dose conversion coefficients, and depth-profile dose curves). Median DAP for all patients was 119.6 Gy x cm2 (range 13.9 to 446.3 Gy x cm2) for procedures with a median duration of 4 h and 83 +/- 26 min of fluoroscopy. Body mass index was a more important determinant of DAP than total fluoroscopy time (r = 0.74 vs. 0.37, p < 0.001), with mean DAP values per hour of fluoroscopy of 58 +/- 40 Gy x cm2, 110 +/- 43 Gy x cm2, and 184 +/- 79 Gy x cm2 in normal, overweight, and obese patients, respectively. The corresponding effective radiation doses for AF ablation procedures were 15.2 +/- 7.8 mSv, 26.7 +/- 11.6 mSv, and 39.0 +/- 15.2 mSv, respectively (Monte Carlo). Use of conversion coefficients resulted in higher effective dose estimates than other methods, particularly in obese patients. Mean attributable lifetime risk of all-cancer mortality was 0.060%, 0.100%, and 0.149%, depending on weight class." }, { "role": "assistant", "content": "Obese patients receive more than twice the effective radiation dose of normal-weight patients during AF ablation procedures. Obesity needs to be considered in the risk-benefit ratio of AF ablation and should prompt further measures to reduce radiation exposure. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: INTRODUCTION, METHODS, RESULTS. Meshes: Adult, Chronic Disease, Disability Evaluation, Female, Health Status Indicators, Humans, Low Back Pain, Male, Middle Aged, Self Efficacy, Surveys and Questionnaires, Task Performance and Analysis." }, { "role": "user", "content": "General and specific self-efficacy reports of patients with chronic low back pain: are they related to performances in a functional capacity evaluation? Context: The objective of this study was to analyze the relationship of general and specific self-efficacy (SE) beliefs with functional capacity evaluation (FCE) performances in patients with chronic non-specific low back pain (CLBP), while controlling for influence of gender, age, and self-reported pain intensity, self-esteem, disability, psychosocial distress and health status. Included were 92 patients with CLBP referred to an outpatient university based multidisciplinary pain rehabilitation program in The Netherlands. All patients underwent an FCE. General SE was measured with the ALCOS questionnaire prior to the FCE, specific SE was measured with a self-constructed standardized question during the FCE. Paired samples t-tests were used to tests differences between predicted and actual performances. Pearson and Spearman rank correlation coefficients were used to express the strength of the relationships between SE and performances. Multivariate analyses were used to test the influence of control variables on the relationships between SE (general or specific) and performances. Performances were consistently higher than patients' self-predictions. Differences between predictions and performances were significant in male lifting low, male carrying, and female carrying. With exception of the association between specific SE and lifting in males (r = 0.55, P<0.05), all other correlations between general and specific SE and FCE performances were non-significant. Multivariable regression analyses showed that the relative contribution of SE measures over gender was little or none." }, { "role": "assistant", "content": "The contribution of specific SE to the prediction of FCE performances is moderate in one instance, and insignificant in most instances (both specific and general SE). Because of the consistency of the differences between prediction (specific SE) and performances, and depending on the level of accuracy needed, future research may deliberate the use of predicted material handling capacities at group level and correct for a systematic underprediction." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: UNLABELLED, OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Carcinoma, Endometrioid, Carcinoma, Ovarian Epithelial, Cystadenocarcinoma, Mucinous, Cystadenocarcinoma, Serous, Female, Humans, Middle Aged, Neoplasm Grading, Neoplasm Staging, Neoplasms, Glandular and Epithelial, Ovarian Neoplasms, Prognosis, Receptor, ErbB-2, Receptor, IGF Type 1, Receptors, Estrogen, Receptors, Progesterone, Young Adult." }, { "role": "user", "content": "Is positive expression of insulin-like growth factor-1 receptor associated with a positive hormone receptor status in ovarian cancer? Context: Summary Ovarian cancer is the most deadly of all gynecologic malignancies, due in part to the diagnosis at an advanced stage caused by the deficiency of specific marks and symptoms, by the absence of reliable tests for screening, and by early detection. Insulin-like growth factor-I (IGF-I) is known to be involved in the development and promotion of diverse examples of solid tumors including ovarian cancer. IGF-I levels in local tissue are subject to both endocrine and paracrine/autocrine regulation. Most patients will react initially to treatment, but almost 70% of them will have a recurrence. Consequently, new therapeutic modalities are urgently required to overcome chemoresistance observed in ovarian cancer patients. IGF-1R expression was evaluated immunohistochemically in tissue microarray blocks constructed from 1,200 ovarian cancer samples collected from three medical institutions." }, { "role": "assistant", "content": "Evidence accumulates suggesting that the insulin/insulin growth factor (IGF) pathways could play a good therapeutic target in various cancers, including ovarian cancer. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following types of multiple myeloma is maximally and most commonly associated with increased risk of hyperviscosity syndrome?" }, { "role": "assistant", "content": "The correct answer is Ans. a (IgM) (Ref. H-17th/704; Robbin's 7th/680)Lymphoplasmacytic lymphoma is the tissue manifestation of Waldenstrom's macroglobulinemia. This type of lymphoma has been associated with chronic hepatitis C virus infection, and an etiologic association has been proposed. Patients typically present with lymphadenopathy, splenomegaly, bone marrow involvement, and occasionally peripheral blood involvement. The tumor cells do not express CD5. Patients often have a monoclonal IgM protein, high levels of which can dominate the clinical picture with the symptoms of hyperviscosity. Treatment of lymphoplasmacytic lymphoma can be aimed primarily at reducing the abnormal protein, if present, but will usually also involve chemotherapy. Chlorambucil, fludarabine, and cladribine have been utilized. The median 5- year survival for patients with this disorder is ~60%.HYPERVISCOSITY SYNDROME IN MULTIPLE MYELOMA (MM)# Hyperviscosity syndromes may develop in MM depending on the physical properties of the M component.# It is most common with IgM, IgG3, and IgA paraproteins.# Hyperviscosity is defined on the basis of the relative viscosity of serum as compared with water.# Normal relative serum viscosity is 1.8 (i.e., serum is normally almost twice as viscous as water).# Symptoms of hyperviscosity occur at a level of 5-6, a level usually reached at paraprotein concentrations of ~- 40 g/L (4 g/dL) for IgM,- 50 g/L (5 g/dL) for IgG3, and- 70 g/L (7 g/dL) for IgA.# Hypercalcemia may produce lethargy, weakness, depression, confusion, headache, fatigue, visual disturbances, and retinopathy.# Raynaud's phenomenon and impaired circulation may result if the M component forms cryoglobulins.# Note: Sensory neuropathy is also a side effect of thalidomide and bortezomib therapy.Additional Educational Points# Light chain disease is associated with Bence Jones proteinuria=m chain disease.# IgM type of lymphoplasmacytoid lymphoma = is most closely associated with monoclonal gammopathy.# Primary livedo reticularis with ulceration is also called atrophie blanche en plaque. The ulcers are painful and may take months to heal. Secondary livedo reticularis can occur with atheroembolism, SLE and other vasculitides, anticardiolipin antibodies, hyperviscosity, cryoglobulinemia, and Sneddon's syndrome (ischemic stroke and livedo reticularis).# Similar bihemispheral damage is produced by disorders that occlude small blood vessels throughout the brain; examples include cerebral malaria, thrombotic thrombocytopenic purpura, and hyperviscosity.# Blood viscosity increases logarithmically at hematocrits >55%.# Concern that the hemoglobin level may be abnormally high is usually triggered at 170 g/L (17 g/dL) for men and 150 g/ L (15 g/dL) for women. Hematocrit levels >50% in men or >45% in women may be abnormal. Hematocrits >60% in men and >55% in women are almost invariably associated with an increased red cell mass.# A decrease in the AG can be due to hyperviscosity and severe hyperlipidemia." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aged, Body Weights and Measures, Cross-Sectional Studies, Exercise Test, Female, Heart Rate, Humans, Insulin, Male, Metabolic Syndrome." }, { "role": "user", "content": "Is heart rate recovery more strongly associated with the metabolic syndrome , waist circumference , and insulin sensitivity in women than in men among the elderly in the general population? Context: Low heart rate recovery (HRR) at exercise test and the metabolic syndrome (MetS) are both predictors of cardiovascular morbidity and mortality. We studied in 75-year-old women and men, representative of the general population, the relationship between (1) HRR and the MetS, (2) HRR and the individual components of the MetS, and (3) HRR and insulin sensitivity. A cross-sectional study of randomly selected 75-year-olds from a general population was performed (191 women and 194 men). The MetS was defined according to the National Cholesterol Education Program criteria. Heart rate was measured as beats per minute immediately after exercise and at 4 minutes into recovery. Heart rate recovery (median and interquartile range, beat/min) was 48 (37-58) for women and 49 (38-58) for men. Thirty-seven percent of the women and 25% of the men had the MetS. Heart rate recovery was 52 (42-61) for women with the MetS and 42 (31-49) for those without. The corresponding values for men was 50 (39-61) and 47 (35-54); the difference between individuals with and without the MetS was significant for women (P < .001) but not for men (P = .084). The following significant correlation coefficients between HRR and MetS components were found: for women, waist circumference (-0.43, P < .001), high-density lipoprotein cholesterol (0.37, P < .001), insulin sensitivity (-0.37, P < .001), fasting plasma glucose (-0.30, P < .001), and triglycerides (-0.24, P = .001); for men, triglycerides (-0.20, P = .005). The sex disparity in the strength of correlation reached statistical significance for insulin sensitivity (P < .001) and waist circumference (P = .042)." }, { "role": "assistant", "content": "Among 75-year-olds, the MetS and related components are more strongly correlated to HRR in women than in men. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 48-year-old female suffering from severe menorrhagia (DUB) underwent hysterectomy. She wishes to take hormone replacement therapy. Physical examination and breast are normal but X-ray shows osteoporosis. The treatment of choice is:" }, { "role": "assistant", "content": "The correct answer is Ans. is c, i.e. EstrogenRef: Jeffcoate 7th/ed, p95 onwards; Williams Gynae 1st/ed, p495,499-500* The female underwent hysterectomy, i.e. surgical menopause at the age of 48 years and her X-ray shows osteoporosis -- hence HRT can be advised.* Both estrogen alone or estrogen + progesterone can be used for treating osteoporosis.The choice depends on whether uterus is present or not (i.e. patient is hystrectomised or not).We have already discussed the agents used for treating osteoporosis and as I have mentioned earlier bisphosphonates are the first line of treatment for osteoporosis (Ref: ]olm Hopkins Manual of Obs and Gynae 4th/ed, p513) but it is not given in the options.\"For women with a uterus, a progestin should be combined with an estrogen, to lower the risk of endometrial cancer.\" Ref: William Gynae 3rd/edf p495According to Jeffcoate (7th/ed, p96) \"all women who have intact uterus or even those who underwent hysterectomy for endometrial Cancer (Stage I), endometroid ovarian tumors or endometriosis or those with severe osteoporosis should receive combined estrogen - progesterone therapy or be considered for selective estrogen receptor modulator therapy (SERM therapy).\"In the question the patient has undergone hysterectomy therefore we can use only estrogen." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Blotting, Southern, Chloramphenicol O-Acetyltransferase, DNA Primers, Enhancer Elements, Genetic, Eye Proteins, Gene Expression, Genes, Reporter, Immunoenzyme Techniques, Mice, Mice, Inbred C57BL, Mice, Transgenic, Polymerase Chain Reaction, Promoter Regions, Genetic, Retinal Cone Photoreceptor Cells, Retinol-Binding Proteins, Tissue Distribution, Transducin." }, { "role": "user", "content": "Is a CAT reporter construct containing 277bp GNAT2 promoter and 214bp IRBP enhancer specifically expressed by cone photoreceptor cells in transgenic mice? Context: The alpha-subunit of human cone transducin plays an important role in interacting with visual pigment and activating the cGMP-dependent phosphodiesterase (cGMP-PDE). The human GNAT2 gene (cone transducin alpha-subunit) has been cloned and characterized by Fong et al. In this report, we describe the use of transgenic mice to characterize the tissue specificity of the GNAT2 promoter. A chimeric reporter gene construct which consists of a 277 bp 5'-flanking fragment of the GNAT2 gene at 5' end of the chloramphenicol acetyltransferase (CAT) gene and a 214 bp enhancer region from the human interphotoreceptor retinoid-binding protein (IRBP) gene at the 3' end of the CAT gene was used to generate transgenic mice. Transgenic mice were identified by Southern blot hybridization and polymerase chain reaction (PCR) analysis using tail DNA from experimental animals. Immunostaining was used to study the developmental expression of CAT and the endogenous GNAT2 gene. Analysis of four transgenic mouse lines revealed that three lines had low CAT activity in the retina. The CAT gene, along with the endogenous GNAT2 gene, was expressed at high levels in cone photoreceptor cells in the fourth transgenic mouse line as determined by CAT enzyme assays and immunostaining." }, { "role": "assistant", "content": "The results show that the 277 bp 5'-flanking sequence from the human GNAT2 gene coupled with the 214 bp IRBP enhancer can direct a tissue-specific expression pattern of CAT reporter gene in mouse retina, which parallels the expression pattern of endogenous GNAT2. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following statements is true regarding the relation of bile duct" }, { "role": "assistant", "content": "The correct answer is Bile duct : Anatomy It lies in front of the poal vein and to the right of the hepatic aery Common hepatic duct is 1-4cm in length and has a diameter of approx. 4mm CBD is about 7-11 cm in length and 5-10 mm in diameter A fibroareolar tissue containing scant smooth muscle surround the mucosa (a distinct muscle layer is absent) Most impoant aeries to the Supra duodenal bile duct run parallel to the duct at the 3 & 9'o clock position Approximately 60% of the blood supply to the Supra duodenal bile duct originates inferiorly from the pancreaticoduodenal and retro duodenal aeries Whereas 38% of blood supply originate superiorly from the right hepatic atmeru and cystic duct aery Ref: Sabiston 20th edition Pgno : 1482-1484" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Aneurysm, False, Cardiac Catheterization, Female, Femoral Artery, Hemostatic Techniques, Humans, Male, Middle Aged, Pressure, Retreatment, Ultrasonography." }, { "role": "user", "content": "Manual compression repair of post-catheterization femoral pseudoaneurysms: an alternative to ultrasound guided compression repair? Context: It is unknown, whether direct guidance by ultrasound is essential for the safety and efficacy of ultrasound-guided compression repair (UGCR) of pseudoaneurysms. We therefore tested, whether clinically guided manual compression repair (MCR) without continuous ultrasound control may represent an equally effective alternative. After ultrasound diagnosis of a pseudoaneurysm, direct manual compression was applied to the lesion until the characteristic clinical signs disappeared or for a maximum of 1 hour. Then a compression bandage was applied for 24 hours. If the pseudoaneurysm persisted, MCR was repeated up to a maximum of three times. Of 96 consecutive patients with pseudoaneurysms, ten patients were referred to primary surgery; one patient refused any therapy. The remaining 85 patients (89%) were treated by MCR. MCR was successful in 74 patients (87%). Of these, 74% were cured at the first attempt, while 16% resp. 10% required 2 resp. 3 compression manoeuvers for definite cure. The success rate tended to be somewhat lower in patients on anticoagulants (78%) than in those on aspirin (91%) or those without any antithrombotic medication (89%) (p = 0.14). No major complications were observed. Of the 11 patients in whom MCR was unsuccessful, five patients underwent surgical repair; in four patients the pseudoaneurysms thrombosed spontaneously within 1-3 months and 2 pseudoaneurysms persist without complications." }, { "role": "assistant", "content": "Our results with MCR are comparable to those published for UGCR. Since MCR requires less technical equipment and seems to be less painful for the patient, a prospective comparison of both methods appears warranted." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is the most commonly used site for Deep Brain Stimulation to reduce frequency of Parkinsonism symptoms" }, { "role": "assistant", "content": "The correct answer is High-frequency stimulation of the subthalamic nucleus is a neurosurgical procedure for the alletion of motor symptoms of Parkinson's disease and debilitating medication-induced dyskinesias Ref Harrison20th edition pg 2456" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Features of Alzheimer include all Except:" }, { "role": "assistant", "content": "The correct answer is Pharmacological treatments available for dementia are limited to symptomatic relief. To date, with the exception of interventions to reduce the risk of recurrent stroke in vascular dementia, there are no treatments available that can alter the disease course or produce substantial or long-lived improvements in symptomatology. Risk factors for Dementia Old age Alcohol obesity DM/HT/CAD Female Uneducated Saturated fat Screening tools MMSE, Mental test score Severity assessment clinical dementia rating scale, Functional Assessment Staging, Hachinski 's ischemic score (Vascular Dementia) Imaging SPECT, FDG-PET treatment Reference: P.1175 10.3 Dementia (Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th Edition)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Female, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Male, Middle Aged, Multiple Birth Offspring, Parents, Patient Preference, Randomized Controlled Trials as Topic, Research Design, Siblings, Young Adult." }, { "role": "user", "content": "Do multiples and parents of multiples prefer same arm randomization of siblings in neonatal trials? Context: Although common among Neonatal Intensive Care Units, multiples births are randomized inconsistently within trials, which can impact enrollment, analytical approach and trial outcomes. It is not known what randomization approach (same arm, different arm and independent randomization) is preferred by multiples and their families. Surveys distributed to parents of multiples and adult multiples addressed the preferences on randomization by eliciting the most desired method and likelihood of enrolling twins for each randomization approach. Populations included 209 parents and 321 adult multiples. Seventy-eight percent of parents and 59% of multiples prefer same arm placement of multiples over other methods (both P<0.001), which also had highest likelihood of enrollment among both the groups." }, { "role": "assistant", "content": "Parents of multiples and adult multiples prefer placement of multiples into same treatment arm in randomized trials, making such methodology a potential way to optimize consent rates while ethically approaching human subject research. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following anti-cancer drug is not antiinflammatory or immunosuppressive -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., L-Asparginase o Repeat from previous session" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: ." }, { "role": "user", "content": "Does medial prefrontal cortex serotonin 1A and 2A receptor binding interact to predict threat-related amygdala reactivity? Context: The amygdala and medial prefrontal cortex (mPFC) comprise a key corticolimbic circuit that helps shape individual differences in sensitivity to threat and the related risk for psychopathology. Although serotonin (5-HT) is known to be a key modulator of this circuit, the specific receptors mediating this modulation are unclear. The colocalization of 5-HT1A and 5-HT2A receptors on mPFC glutamatergic neurons suggests that their functional interactions may mediate 5-HT effects on this circuit through top-down regulation of amygdala reactivity. Using a multimodal neuroimaging strategy in 39 healthy volunteers, we determined whether threat-related amygdala reactivity, assessed with blood oxygen level-dependent functional magnetic resonance imaging, was significantly predicted by the interaction between mPFC 5-HT1A and 5-HT2A receptor levels, assessed by positron emission tomography. 5-HT1A binding in the mPFC significantly moderated an inverse correlation between mPFC 5-HT2A binding and threat-related amygdala reactivity. Specifically, mPFC 5-HT2A binding was significantly inversely correlated with amygdala reactivity only when mPFC 5-HT1A binding was relatively low." }, { "role": "assistant", "content": "Our findings provide evidence that 5-HT1A and 5-HT2A receptors interact to shape serotonergic modulation of a functional circuit between the amygdala and mPFC. The effect of the interaction between mPFC 5-HT1A and 5-HT2A binding and amygdala reactivity is consistent with the colocalization of these receptors on glutamatergic neurons in the mPFC. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Autophagy, Autophagy-Related Proteins, Carrier Proteins, Case-Control Studies, Cohort Studies, Colonoscopy, Crohn Disease, GTP-Binding Proteins, Genetic Predisposition to Disease, Granuloma, Humans, Inflammatory Bowel Diseases, Polymorphism, Single Nucleotide." }, { "role": "user", "content": "Is there a role for Crohn's disease-associated autophagy genes ATG16L1 and IRGM in formation of granulomas? Context: Autophagy-related 16-like 1 gene (ATG16L1) and immunity-related guanosine triphosphatase gene (IRGM) are associated with Crohn's disease susceptibility and autophagy. Elimination of invading pathogens is a function of autophagy. Formation of granulomas can be attributed to impaired recognition of bacterial components by the innate immune system. This study was undertaken to elucidate whether disease-associated variants in ATG16L1 and IRGM by affecting autophagy pathways impair pathogen clearance in the cell and thereby cause increased prevalence of granulomas in Crohn's disease patients. Genotypes of the inflammatory bowel disease patient cohort consisting of 819 inflammatory bowel disease patients and over 1700 histology reports on intestinal biopsies obtained during ileocolonoscopy stating the presence or absence of granulomas were included in this case-control study. We confirm the association of the ATG16L1 variant and IRGM variants with Crohn's disease. Comparison of the genotype frequency of the ATG16L1 SNP (rs2241880) and the presence or absence of granuloma in 179 cases showed a P value of 0.16. Both variants in IRGM (rs4958847 and rs13361189) showed P values of 0.7 after comparison with granuloma prevalence in 213 cases. A total of 169 Crohn's disease patients were genotyped for both the genes, but no evidence for gene-gene interaction between ATG16L1 and IRGM and granuloma formation was found." }, { "role": "assistant", "content": "Our Crohn's disease patient cohort showed no association of the variants in ATG16L1 or IRGM and the presence of granulomas." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Birdshot retinopathy is characterized by all except?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Unilateral Bird-shot retinochoroidopathy It is a rare, idiopathic, bilaterally symmetrical chronic multifocal chorioretinitis characterised by numerous flat creamy-yellow spots due to focal chorioretinal hypopigmentation, resembling the pattern of \"bird-sho scatter from a shotgun\". The disease, more common in females than males, typically affects middle-aged healthy persons who are positive for HLA-A29. It runs a long chronic course of several years. Treatment with coicosteroids is usually not effective" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: African Americans, Aged, Aged, 80 and over, Comorbidity, Ethnic Groups, European Continental Ancestry Group, Female, Health Expenditures, Health Services, Health Services Accessibility, Health Status, Healthcare Disparities, Hispanic Americans, Humans, Male, Minority Groups, Regression Analysis, United States." }, { "role": "user", "content": "Does impact of comorbid mental health need on racial/ethnic disparities in general medical care utilization among older adults? Context: The objective is to apply the Institute of Medicine definition of healthcare disparities in order to compare (1) racial/ethnic disparities in general medical care use among older adults with and without comorbid mental health need and (2) racial/ethnic disparities in general medical care use within the group with comorbid mental health need. Data were obtained from the Medical Expenditure Panel Survey (years 2004-2012). The sample included 21,263 participants aged 65+ years (14,973 non-Latino Caucasians, 3530 African-Americans, and 2760 Latinos). Physical illness was determined by having one of the 11 priority chronic health illnesses. Comorbid mental health need was defined as having one of the chronic illnesses plus a Kessler-6 Scale >12, or two-item Patient Health Questionnaire >2. General medical care use refers to receipt of non-mental health specialty care. Two-part generalized linear models were used to estimate and compare general medical care use and expenditures among older adults with and without a comorbid mental health need. Racial/ethnic disparities in general medical care expenditures were greater among those with comorbid mental health need compared with those without. Among those with comorbid mental health need, non-Latino Caucasians had significantly greater expenditures on prescription drug use than African-Americans and Latinos." }, { "role": "assistant", "content": "Expenditure disparities reflect differences in the amount of resources provided to African-Americans and Latinos compared with non-Latino Caucasians. This is not equivalent to disparities in quality of care. Interventions and policies are needed to ensure that racial/ethnic minority older adults receive equitable services that enable them to manage effectively their comorbid mental and physical health needs. Copyright © 2016 John Wiley & Sons, Ltd. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Endochondral ossification is seen in -" }, { "role": "assistant", "content": "The correct answer is Endochondral ossification : Bone formation within cailage (hyaline cailage) Long bones which undergo Endochondral ossification : TYPES OF OSSIFICATION: 1. Endochondral ossification - Most long bones. 2. Intramembranous ossification - Flat skull bones/Vault bones. 3. Both Endochondral and intramembranous - Clavicle & Mandible (intramembranous> Endochondral)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Alkaline Phosphatase, Animals, Bone Substitutes, Cell Culture Techniques, Cell Differentiation, Cell Survival, Cells, Cultured, In Vitro Techniques, Mesenchymal Stem Cells, Osteogenesis, Rats, Tissue Scaffolds." }, { "role": "user", "content": "Does bone substitute enhance osteogenic differentiation of mesenchymal stem cells in three-dimensional scaffolds? Context: The present study aimed to find bone substitutes to enhance osteogenic differentiation of mesenchymal stem cells in three-dimensional scaffolds in the absence of dexamethasone. Seven commercial bone substitutes were added to a three-dimensional fibrin-matrix containing rat mesenchymal stem cells in a biocompatible poly-L-lactic-acid mesh. Cell viability, cytotoxicity and alkaline phosphatase activity were followed for three weeks. Expression of bone markers was examined by qualitative evaluation of corresponding transcripts. Six out of the seven bone derivatives exhibited an osteogenic-enhancing effect." }, { "role": "assistant", "content": "The osteogenic-enhancing effect of the evaluated bone substitutes suggests their potential clinical application for preparation of autologous bone replacement material in three-dimensional carriers. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "For open pneumothorax which of the following is Min of choice -" }, { "role": "assistant", "content": "The correct answer is \"Open Pneumothorax is one in which full thickness segment of the chest wall has been destroyed and the negative intrapleural pressure sucks air directly through the chest wall defect rather than through the trachea into the alveoli. It occurs most commonly after shotgun blasts explosion with flying debris.\nThe pt. is stabilized by any mechanical covering over the open wound. As soon as convenient a watertight dressing should be placed and an intercostal catheter inserted into the pleural cavity. Early debridement and formal closure of the wound should then be performed.\"" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aerosols, Air Pollution, Indoor, Animals, Edema, Eosinophils, Epithelial Cells, Humans, Male, Metaplasia, Nasal Mucosa, Nasal Obstruction, Rats, Rats, Wistar, Time Factors, Volatile Organic Compounds." }, { "role": "user", "content": "Does usage of a room air freshener affect the nasal mucosa? Context: Effects of chemicals emitted from the room air freshener sprays (RAFSs) on nasal mucosa are still unclear. The purpose of this study was to investigate effects of RAFSs on the nasal mucosa of rats for different time intervals. Twenty-eight rats were randomly divided into four experimental groups: group 1 (n = 7) was the control group and not exposed to RAFS or other chemicals, group 2 (n = 7) was exposed to RAFS for 1 month, group 3 (n = 7) was exposed to RAFS for 2 months, and group 4 (n = 7) was exposed to RAFS for 3 months. Samples from the nasal septum were stained using hematoxylin and eosin solution, examined by a pathologist using a light microscope, and analyzed with Fisher's exact test. We observed that distinct histopathological differences in the nasal mucosa of exposed rats depends on different time intervals (p<0.05). Increased congestion was found after the 1st month of exposure (group 2). Although edema and mild inflammatory cell infiltration, including some eosinophils, was seen after the 2nd month (group 3), squamous metaplasia, numerous eosinophils, and intense inflammatory cell infiltration began after 3 months of exposure (group 4)." }, { "role": "assistant", "content": "Our results showed that continuous use of RAFS can cause inflammation and eosinophilic infiltration in rats, which begins after 2 months of exposure and may lead to metaplasia after 3 months. Because of differences in body size, geometry, and physiological responses of rats, the extrapolation of these results to humans is not straightforward. However, any such comparison should be made with caution. Finally, more performance is necessary to clarify this subject." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Congenital Hypothyroidism, Humans, Infant, Newborn, Retrospective Studies, Risk Factors, Seasons." }, { "role": "user", "content": "Is the birthdate a risk factor for congenital hypothyroidism? Context: To verify statistically the hypothesis that birthdate represents a risk factor for Congenital Hypothyroidism, as proposed by some European Authors. Moreover, to verify the existence of seasonal cyclic trends in TSH levels. For the verification of birthdate as a risk factor, we considered retrospectively a data set of all consecutives newborns of Marche Region (Italy) affected by Congenital Hypothyroidism, in the period 1981-1996 (n = 92). For the evaluation of seasonal cyclic trends in TSH, we considered the level of the hormone in all newborns of Marche Region screened in the period 1989-1996. Data were collected from Neonatal Screening Register of Marche Region. All the statistical analyses are based on circular statistics techniques (Rayleigh test, Roger test, estimation of density by kernel method, Mardia test for circular-linear correlation, Maximization of Mean Vector Length). No cyclic trend was pointed out with regard to Congenital Hypothyroidism; neither seasonal rhythms nor other cyclic patterns of TSH levels were evidenced." }, { "role": "assistant", "content": "Neither the hypothesis of birthdate as a risk factor for Congenital Hypothyroi-dism, nor the existence of seasonal variations in TSH hormone releasing were confirmed." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Arthroplasty, Replacement, Knee, Female, Femur, Humans, Male, Middle Aged, Prosthesis Design, Retrospective Studies, Tibia, Treatment Outcome." }, { "role": "user", "content": "Do the influence of the implant size on the outcome of unconstrained total knee arthroplasty? Context: The influence of implant size on the results in unconstrained total knee arthroplasty has never been investigated before. 133 patients with unconstrained total knee arthroplasty were examined (HSS Score, Knee Society Score) with consideration of the different sizes of femoral and tibial components and the thicknesses of the tibial inlays. The medium follow up was 41.2 months (8 months to 74 months). Although the different component sizes gained different results, the differences were not significant. The combination of two component sizes did not lead to a significant change of the results. The results of the Knee Society Score seemed to become worse with thinner polyethylene tibial inlays although these differences were not significant." }, { "role": "assistant", "content": "In conclusion, implant size had no significant influence on the outcome of total knee arthroplasty. The combination of two implant sizes showed no disadvantage. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Disease-Free Survival, Female, Hematopoietic Stem Cell Transplantation, Humans, Male, Middle Aged, Mutation, Myelodysplastic Syndromes, Prognosis, Transplantation Conditioning, Transplantation, Autologous, Treatment Outcome, Young Adult." }, { "role": "user", "content": "Do somatic mutations predict poor outcome in patients with myelodysplastic syndrome after hematopoietic stem-cell transplantation? Context: Recurrently mutated genes in myelodysplastic syndrome (MDS) are pathogenic drivers and powerfully associated with clinical phenotype and prognosis. Whether these types of mutations predict outcome after allogeneic hematopoietic stem-cell transplantation (HSCT) in patients with MDS is not known. We used massively parallel sequencing to examine tumor samples collected from 87 patients with MDS before HSCT for coding mutations in 40 recurrently mutated MDS genes. Mutations were identified in 92% of patients, most frequently in the ASXL1 (29%), TP53 (21%), DNMT3A (18%), and RUNX1 (16%) genes. In univariable analyses, only TP53 mutations were associated with shorter overall (OS; hazard ratio [HR], 3.74; P < .001) and progression-free survival (HR, 3.97; P < .001). After adjustment for clinical variables associated with these end points, mutations in TP53 (HR, 2.30; P = .027), TET2 (HR, 2.40; P = .033), and DNMT3A (HR, 2.08; P = .049) were associated with decreased OS. In multivariable analysis including clinical variables, complex karyotype status, and candidate genes, mutations in TP53 (HR, 4.22; P ≤ .001) and TET2 (HR, 1.68; P = .037) were each independently associated with shorter OS. Nearly one half of patients (46%) carried a mutation in TP53, DNMT3A, or TET2 and accounted for 64% of deaths. Three-year OS in patients without these mutations was 59% (95% CI, 43% to 72%), versus 19% (95% CI, 9% to 33%) in patients with these mutations." }, { "role": "assistant", "content": "Mutations in TP53, TET2, or DNMT3A identify patients with MDS with shorter OS after HSCT. Final Decision: yes" } ]