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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": "Which of the following cements is contraindicated in mouth breathers:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "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: PURPOSE, METHODS, RESULTS. Meshes: Aged, Aged, 80 and over, Confidence Intervals, Delivery of Health Care, Integrated, Emergency Service, Hospital, Female, Humans, Logistic Models, Male, Middle Aged, Models, Organizational, Multivariate Analysis, Neoplasms, Nova Scotia, Odds Ratio, Palliative Care, Quality of Health Care, Retrospective Studies, Time Factors." }, { "role": "user", "content": "Can the introduction of an integrated service model to an existing comprehensive palliative care service impact emergency department visits among enrolled patients? Context: Fewer emergency department (ED) visits may be a potential indicator of quality of care during the end of life. Receipt of palliative care, such as that offered by the adult Palliative Care Service (PCS) in Halifax, Nova Scotia, is associated with reduced ED visits. In June 2004, an integrated service model was introduced into the Halifax PCS with the objective of improving outcomes and enhancing care provider coordination and communication. The purpose of this study was to explore temporal trends in ED visits among PCS patients before and after integrated service model implementation. PCS and ED visit data were utilized in this secondary data analysis. Subjects included all adult patients enrolled in the Halifax PCS between January 1, 1999 and December 31, 2005, who had died during this period (N = 3221). Temporal trends in ED utilization were evaluated dichotomously as preintegration or postintegration of the new service model and across 6-month time blocks. Adjustments for patient characteristics were performed using multivariate logistic regression. Fewer patients (29%) made at least one ED visit postintegration compared to the preintegration time period (36%, p<0.001). Following adjustments, PCS patients enrolled postintegration were 20% less likely to have made at least one ED visit than those enrolled preintegration (adjusted OR 0.8; 95% confidence interval 0.6-1.0)." }, { "role": "assistant", "content": "There is some evidence to suggest the introduction of the integrated service model has resulted in a decline in ED visits among PCS patients. Further research is needed to evaluate whether the observed reduction persists." } ]

[ { "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": "Hormonal therapy used in breast cancer are: a) Danazol b) Cyproterone acetate c) Tamoxifen d) LHRH analogue e) Methotrexate" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "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, Blood Pressure, Carbon Dioxide, Cardiac Surgical Procedures, Female, Humans, Lung Compliance, Lung Volume Measurements, Male, Middle Aged, Oxygen, Positive-Pressure Respiration, Radiography, Thoracic." }, { "role": "user", "content": "Are both lung recruitment maneuver and PEEP needed to increase oxygenation and lung volume after cardiac surgery? Context: Patients ventilated after cardiac surgery commonly have impaired oxygenation, mainly due to lung collapse. We have previously found that PaO2 and end-expiratory lung volume (EELV) were increased by a lung recruitment maneuver (LRM) followed by positive end-expiratory pressure (PEEP). The aim of this study was to evaluate whether only PEEP or only a LRM could give similar effects. Thirty circulatory stable patients (aged 55-79 years) mechanically ventilated after cardiac surgery were randomized to receive LRM (four 10-s insufflations to an airway pressure of 45 cmH2O) and zero end-expiratory pressure (LRM-group), PEEP 12 cmH2O (PEEP-group) or LRM in combination with PEEP 12 cmH2O (LRM + PEEP-group). The set end-expiratory pressure was kept for 75 min. Before, during and after the intervention, EELV (SF6 washout technique) and blood gases were measured. Initial EELV and PaO2 were similar in all groups. In the LRM-group, PaO2 and EELV increased transiently (P < 0.0001), but returned at 5 min to the initial values. In the PEEP-group, PaO2 did not change but EELV increased to 155 +/- 27% of the initial value (P < 0.0001). In the LRM+PEEP-group, PaO2 and EELV increased to 212 +/- 66% and 178 +/- 31% of the initial values (P < 0.0001), respectively, and were maintained during PEEP application." }, { "role": "assistant", "content": "In patients ventilated after cardiac surgery: (1) PEEP increased lung volume but not PaO2, (2) a lung recruitment maneuver without subsequent PEEP had no sustained effect, and (3) both a lung recruitment maneuver and PEEP were needed to increase and maintain the increased lung volume and PaO2. 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": "Positive Kehrs sign is -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Haemoperitoneum" } ]

[ { "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 diagnostic criteria is least reliable in the assessment of the pulpal status of the primary dentition?" }, { "role": "assistant", "content": "The correct answer is Electric pulp test. The relatively late appearance of A fibers in the pulp may help to explain why the electric pulp test tends to be unreliable in young teeth, since A fibers are more easily electrically stimulated than C fibers. Accuracy of pulp testing also depends on the patient’s ability to describe how the tooth reacts to stimuli. Clinicians must rely on experience, radiographs, clinical signs or symptoms, and their knowledge of the healing process to assess pulp vitality of young patients." } ]

[ { "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: Adolescent, Adult, Biomarkers, Female, Hepatitis B, Hepatitis B Antibodies, Hepatitis B Core Antigens, Hepatitis B Surface Antigens, Hepatitis B Vaccines, Humans, Immunization, Secondary, Male." }, { "role": "user", "content": "Can HB vaccine yield a booster effect on individuals with positive serum anti-HBs and anti-HBc markers? Context: Sera were collected from 1399 newly enrolled university students aged between 18-20 years at the entrance medical examination in 2001. Forty-four students (28 males and 16 females) with positive serum anti-HBs and anti-HBc markers served as an observation group and another 44 students (24 males and 20 females) without any HBV markers as the control. HB vaccination was given to all the students without positive serum HBsAg according to 0, 1, 6 month regimen and the peripheral venous blood was sampled from those of both observation and control groups for anti-HBs detection one month after the second and third doses. Anti-HBs levels were measured by ELISA. The seroconversion rate of anti-HBs in the control group was 100% after the second dose, but the geometric mean titers (GMTs) were low. The tendency of serum anti-HBs changes after the 3rd dose was completely different between the two groups. Although more than half of those with positive anti-HBs and anti-HBc showed a mild increase of anti-HBs levels after the 2nd boosting dose (mean anti-HBs level was 320:198 mIU), but the increase of serum anti-HBs titer was much smaller than that in the control group. The averages of their initial serum anti-HBs levels and the levels after the 2nd and 3rd doses were 198, 320 and 275 mIU respectively. All the subjects from the control group had an obvious increase in their serum anti-HBs levels which was nearly 4 times the baseline level (302:78 mIU)." }, { "role": "assistant", "content": "HB vaccination can not enhance anti-HBs levels in those with positive serum anti-HBs and anti-HBc markers." } ]

[ { "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, Child, Child, Preschool, Diagnostic Imaging, Female, Health Care Costs, Health Resources, Humans, Infant, Infant, Newborn, Male, United States, Urolithiasis." }, { "role": "user", "content": "Is the Economic Impact and Utilization of Imaging Studies for Pediatric Urolithiasis Across the United States Increasing? Context: To identify longitudinal trends of economic impact and resource utilization for management of pediatric urolithiasis using national databases. We analyzed the 2006-2012 Nationwide Emergency Department Sample and Nationwide Inpatient Sample. We used ICD-9 (International Classification of Diseases) codes to identify patients (≤18 years) diagnosed with urolithiasis. Diagnostic imaging and surgeries were identified using ICD-9 and Current Procedural Technology codes. We abstracted demographic, imaging, procedure, and charge data. Weighted descriptive statistics were calculated to describe the population's demographics and economic expenditures by clinical setting and year. In total, 45,333 inpatient admissions (68% females) and 234,559 emergency department encounters (63% females) were identified. Most patients (84%) were teenagers and the southern region of the United States was the most common geographic region for all encounters (44%). There was no significant trend in number of urolithiasis encounters over the period studied. Utilization of all imaging techniques increased; in particular, computed tomography was used in 23% of encounters in 2006 and 40% in 2012 (P < .0001). The mean charge per emergency department visit increased by 60% from $3645 in 2006 to $5827 in 2012 (P < .0001). The mean charge increased for inpatient admissions by 102%, from $16,399 in 2006 to $33,205 in 2012 (P < .0001). Total charges increased 72% over the study period from $230 million in 2006 to $395 million in 2012 (P < .0001), outpacing medical inflation over the same period." }, { "role": "assistant", "content": "Charges for pediatric urolithiasis management increased by 65% from 2006 to 2012 despite stable frequency of patient encounters. The utilization of computerized tomography in pediatric urolithiasis increased as well." } ]

[ { "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, Apoptosis, Brain Death, CREB-Binding Protein, Cell Line, Cell Survival, Cyclic AMP Response Element Modulator, DNA Fragmentation, Diabetes Mellitus, Experimental, Glucose, Humans, Insulin, Insulin-Secreting Cells, Islets of Langerhans, Proteasome Endopeptidase Complex, Rats, Rats, Wistar, Reverse Transcriptase Polymerase Chain Reaction, Ubiquitin." }, { "role": "user", "content": "Does degradation of cAMP-responsive element-binding protein by the ubiquitin-proteasome pathway contribute to glucotoxicity in beta-cells and human pancreatic islets? Context: In type 2 diabetes, chronic hyperglycemia is detrimental to beta-cells, causing apoptosis and impaired insulin secretion. The transcription factor cAMP-responsive element-binding protein (CREB) is crucial for beta-cell survival and function. We investigated whether prolonged exposure of beta-cells to high glucose affects the functional integrity of CREB. INS-1E cells and rat and human islets were used. Gene expression was analyzed by RT-PCR and Western blotting. Apoptosis was detected by cleaved caspase-3 emergence, DNA fragmentation, and electron microscopy. Chronic exposure of INS-1E cells and rat and human islets to high glucose resulted in decreased CREB protein expression, phosphorylation, and transcriptional activity associated with apoptosis and impaired beta-cell function. High-glucose treatment increased CREB polyubiquitination, while treatment of INS-1E cells with the proteasome inhibitor MG-132 prevented the decrease in CREB content. The emergence of apoptosis in INS-1E cells with decreased CREB protein expression knocked down by small interfering RNA suggested that loss of CREB protein content induced by high glucose contributes to beta-cell apoptosis. Loading INS-1E cells or human islets with a cell-permeable peptide mimicking the proteasomal targeting sequence of CREB blocked CREB degradation and protected INS-1E cells and human islets from apoptosis induced by high glucose. The insulin secretion in response to glucose and the insulin content were preserved in human islets exposed to high glucose and loaded with the peptide." }, { "role": "assistant", "content": "These studies demonstrate that the CREB degradation by the ubiquitin-proteasome pathway contributes to beta-cell dysfunction and death upon glucotoxicity and provide new insight into the cellular mechanisms of glucotoxicity. 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, Biomechanical Phenomena, Cornea, Elasticity, Female, Glaucoma, Open-Angle, Humans, Intraocular Pressure, Lasers, Solid-State, Male, Tonometry, Ocular, Trabeculectomy, Treatment Outcome." }, { "role": "user", "content": "Do corneal biomechanics predict the outcome of selective laser trabeculoplasty in medically uncontrolled glaucoma? Context: To evaluate the predictive value of clinical parameters, including biomechanical properties on the outcome of selective laser trabeculoplasty (SLT) in medically uncontrolled open angle glaucoma (OAG). Sixty-eight eyes from 68 patients with OAG and IOP insufficiently regulated by topical medications were enrolled. Patients' follow-up occurred 6 and 12 months after the procedure. The recorded parameters intraocular pressure (IOP), angle characteristics, central corneal thickness (CCT) and biomechanical properties of the eyes, including corneal hysteresis CH and corneal resistance factor CRF measured with the Ocular Responses Analyzer (ORA, Reichert Ophthalmic Instruments) were tested on their predictive value of SLT-induced IOP lowering effect using correlation analyses and regression models. Mean IOP reduction 12 months after SLT was 4.2 ± 5.7 mmHg (23.2%, from baseline 18.1 ± 5.2 mmHg). The preoperative IOP correlated significantly with IOP reduction (maximum Spearman's correlation r = 0.75, p < 0.001). In linear regression analysis, the corneal biomechanical properties (CH and CRF) together with the baseline IOP revealed good modelling for the IOP lowering effect of SLT (R(2) = 0.64, respectively)." }, { "role": "assistant", "content": "In addition to the baseline IOP biomechanical properties (CH and CRF) are significant predictors of SLT induced IOP lowering effect in medically uncontrolled OAG. 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: Adolescent, Alcohol Drinking, Female, Health Surveys, Humans, Life Change Events, Longitudinal Studies, Male, Stress Disorders, Post-Traumatic, Students, Substance-Related Disorders, Universities, Young Adult." }, { "role": "user", "content": "Do trauma and posttraumatic stress symptoms predict alcohol and other drug consequence trajectories in the first year of college? Context: College matriculation begins a period of transition into adulthood, one that is marked by new freedoms and responsibilities. This transition also is marked by an escalation in heavy drinking and other drug use as well as a variety of use-related negative consequences. Trauma and symptoms of posttraumatic stress disorder (PTSD) may affect alcohol and drug problems and, thus, may be a point of intervention. Yet, no studies have examined trauma, PTSD, and alcohol and drug problem associations during this developmental period. The present study provides such an examination. Matriculating college students (N = 997) completed surveys in September (Time 1) and at 5 subsequent time points (Time 2-Time 6) over their 1st year of college. With latent growth analysis, trajectories of alcohol- and drug-related consequences were modeled to examine how trauma (No Criterion A Trauma, Criterion A Only, No PTSD Symptoms) and PTSD (partial or full) symptom status predicted these trajectories. Results showed substantial risk for alcohol- and other drug-related negative consequences that is conferred by the presence of PTSD at matriculation. Those with both partial and full PTSD started the year with more alcohol and drug consequences. These individuals showed a steeper decrease in consequences in the 1st semester, which leveled off as the year progressed. Both alcohol and drug consequences remained higher for those in the PTSD group throughout the academic year. Hyperarousal symptoms showed unique effects on substance consequence trajectories. Risk patterns were consistent for both partial and full PTSD symptom presentations. Trajectories did not vary by gender." }, { "role": "assistant", "content": "Interventions that offer support and resources to students entering college with PTSD may help to ameliorate problem substance use and may ultimately facilitate a stronger transition into college and beyond. 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, Carcinoma, Case-Control Studies, DNA, DNA Damage, Disease-Free Survival, Female, Humans, Leptin, Middle Aged, Nasopharyngeal Neoplasms, Prognosis, Reverse Transcriptase Polymerase Chain Reaction, Time Factors, Treatment Outcome." }, { "role": "user", "content": "Are persistent aberrations in circulating DNA integrity after radiotherapy associated with poor prognosis in nasopharyngeal carcinoma patients? Context: Aberrations of circulating nucleic acid integrity have been observed in cancer patients. However, the clinical significance of such changes has not been completely elucidated. In this study, we investigated the plasma DNA integrity in nasopharyngeal carcinoma (NPC) patients and its association with patients' survival after radiotherapy. Plasma DNA integrity was analyzed for 105 NPC patients before and after curative-intent radiotherapy and for 40 healthy controls. The plasma DNA concentration of each sample was measured by two real-time PCRs targeting the leptin gene. The amplicon sizes of the two assays were 105 and 201 bp. The integrity index was calculated as the ratio of the two concentrations (201 bp/105 bp). More intact circulating DNA would give a higher integrity index. The plasma DNA integrity index of the NPC patients was significantly higher than that of the healthy controls (median, 0.356 versus 0.238; P < 0.001). After radiotherapy, a reduction in plasma DNA integrity index was observed in 70% NPC patients. Patients with persistent aberrations of plasma DNA integrity had significantly poorer survival probability than those with reduced DNA integrity after treatment (P < 0.001, Kaplan-Meier)." }, { "role": "assistant", "content": "NPC is associated with disturbances in the integrity of circulating cell-free DNA. The persistence of DNA integrity aberrations after radiotherapy is associated with reduced probability of disease-free survival. Therefore, the measurement of plasma DNA integrity may serve as a useful marker for the detection and monitoring of malignant diseases. 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 neonate passes black colored meconium after 12 hrs of bih. True statement is:" }, { "role": "assistant", "content": "The correct answer is Meconium stooling is seen in 90 percent of newborns within the first 24 hours, and most of the rest within 36 hours. The passage of meconium and urine indicates patency of the gastrointestinal and urinary tracts. Failure of the newborn to stool or urinate after these times suggests a congenital defect, such as imperforate anus or a urethral valve. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 28. The Newborn Infant. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e." } ]

[ { "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": "Triple assessment for carcinoma breast includes: September 2012" }, { "role": "assistant", "content": "The correct answer is Ans. D i.e. Clinical examination, Mammogram & FNAC" } ]

[ { "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, METHODS, RESULTS. Meshes: Alleles, CD8-Positive T-Lymphocytes, Cells, Cultured, Epitopes, T-Lymphocyte, Female, Gene Products, gag, HIV Infections, HIV-1, HLA Antigens, Humans, Immunohistochemistry, Peptides, RNA, Viral." }, { "role": "user", "content": "Do multiple T-cell epitopes overlap positively-selected residues in the p1 spacer protein of HIV-1 gag? Context: The p1 region of HIV-1 gag contains the frameshift stem-loop, gag-pol transframe and a protease cleavage site that are crucial for viral assembly, replication and infectivity. Identifying and characterizing CD8+ epitopes that are under host immune selection in this region will help in designing effective vaccines for HIV-1. An approach combining bioinformatical analysis and interferon gamma enzyme-linked immunosorbent spot (ELISPOT) assays is used to identify and characterize the epitopes. Potential human leukocyte antigen (HLA)-restricted epitopes were identified by correlating the positively-selected mutations with host HLA alleles. ELISPOT analysis with overlapping peptides was used to confirm and characterize the epitopes. Four positively-selected residues were significantly associated with HLA class I alleles, including HLA B*1302 (K4R, P = 0.0008 and I5L, P = 0.0108), A*7401 (S9N, P = 0.0002) and A*30 genotypes (P7S, P = 0.009), suggesting epitopes restricted by these alleles are present in this region. ELISPOT analysis with patient peripheral blood mononuclear cells (PBMCs) identified seven novel epitopes restricted by the 3 alleles. Two types of epitopes were observed in this region based on the ELISPOT responses, Type I: the positively-selected variation does not affect CD8+ T-cell responses; and Type II: the CD8+ T-cell responses are determined by the epitope variants." }, { "role": "assistant", "content": "We identified and characterized seven novel CD8+ epitopes in the p1 spacer protein region. Classifying the effects of positively-selected variants on CD8+ T-cell responses will help in designing effective vaccines for HIV-1. 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": "An investigator is studying membranous transport proteins in striated muscle fibers of an experimental animal. An electrode is inserted into the gluteus maximus muscle and a low voltage current is applied. In response to this, calcium is released from the sarcoplasmic reticulum of the muscle fibers and binds to troponin C, which results in a conformational change of tropomyosin and unblocking of the myosin-binding site. The membranous transport mechanism underlying the release of calcium into the cytosol most resembles which of the following processes?" }, { "role": "assistant", "content": "Uptake of fructose by small intestinal enterocytes" } ]

[ { "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: ." }, { "role": "user", "content": "Do regression of macular drusen after pars plana vitrectomy in a patient with age-related macular degeneration? Context: To report a case of marked regression of drusen and a pigment epithelial detachment (PED) with visual improvements after pars plana vitrectomy (PPV). A 67-year-old man noticed gradual visual deterioration to 20/80 due to macular soft drusen and a PED. A posterior vitreous detachment (PVD) was not present in the affected eye. PPV was performed to create a PVD, and there was marked regression of drusen and a PED with visual improvement to 20/30. Vision was maintained at the final examination 30 months after surgery." }, { "role": "assistant", "content": "Vitrectomy may be considered for treatment of macular drusen and prevention of choroidal neovascularization. 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, METHOD, RESULTS. Meshes: Adult, Aged, Biocompatible Materials, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Humans, Hyaluronic Acid, Injections, Intra-Articular, Male, Middle Aged, Osteoarthritis, Hip, Prospective Studies, Radiography, Severity of Illness Index, Synovial Fluid, Treatment Outcome, Ultrasonography." }, { "role": "user", "content": "Does joint effusion influence the clinical response to a single Hylan GF-20 injection for hip osteoarthritis? Context: To evaluate the influence of a joint effusion on the clinical response to a single injection of Hylan GF-20 for hip osteoarthritis. We prospectively included patients scheduled for intraarticular Hylan GF-20 injection to treat hip osteoarthritis. Disease severity was assessed based on the Kellgren-Lawrence radiological grade. Ultrasonography was performed to look for a joint effusion. The pain score on a visual analog scale, Lequesne algofunctional index, and WOMAC scores were recorded at baseline and 1, 3, and 6 months postinjection. The proportions of patients who met OARSI response criteria and who achieved Patient Acceptable Symptom State (PASS) thresholds were determined in the overall population and in the groups with and without a joint effusion at baseline. Of 55 included patients, 24 (44%) had an effusion at baseline. The baseline Lequesne index was significantly higher in the group with an effusion (11.9+/-3.6 versus 8.4+/-4.5) (p=0.003). The proportions of OARSI responders in the overall population were 31.8%, 39.4%, and 14.8% after 1, 3, and 6 months, respectively. The proportions of patients who achieved the PASS for pain and function were 52.4% and 50.0% after 1 month, 67.7% and 54.5% after 3 months, and 60.0% and 50.0% after 6 months, respectively. Presence of an effusion at baseline had no effect on any of the clinical response parameters." }, { "role": "assistant", "content": "Presence of a joint effusion is associated with worse pain and functional impairment at baseline but has no influence on the clinical response to Hylan GF-20 in patients with hip osteoarthritis." } ]

[ { "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, Aged, 80 and over, Australia, Data Interpretation, Statistical, Female, Humans, Linear Models, Longitudinal Studies, Models, Statistical, Mortality, Patient Dropouts, Research Design." }, { "role": "user", "content": "Does analytical result in longitudinal studies depended on target of inference and assumed mechanism of attrition? Context: To compare methods for analysis of longitudinal studies with missing data due to participant dropout and follow-up truncated by death. We analyzed physical functioning in an Australian longitudinal study of elderly women where the missing data mechanism could either be missing at random (MAR) or missing not at random (MNAR). We assumed either an immortal cohort where deceased participants are implicitly included after death or a mortal cohort where the target of inference is surviving participants at each survey wave. To illustrate the methods a covariate was included. Simulation was used to assess the effect of the assumptions. Ignoring attrition or restricting analysis to participants with complete follow up led to biased estimates. Linear mixed model was appropriate for an immortal cohort under MAR but not MNAR. Linear increment model and joint modeling of longitudinal outcome and time to death were the most robust to MNAR. For a mortal cohort, inverse probability weighting and multiple imputation could be used, but care is needed in specifying dropout and imputation models, respectively." }, { "role": "assistant", "content": "Appropriate analysis methodology to deal with attrition in longitudinal studies depends on the target of inference and the missing data mechanism. 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: Angiotensin II, Animals, Cell Movement, Cells, Cultured, Glomerular Mesangium, Insulin-Like Growth Factor Binding Protein 5, Insulin-Like Growth Factor I, Iodine Radioisotopes, Lipid Metabolism, Rats, Vasoconstrictor Agents, cdc42 GTP-Binding Protein." }, { "role": "user", "content": "Does iGF-1-induced lipid accumulation impair mesangial cell migration and contractile function? Context: Chronic treatment of mesangial cells with insulin-like growth factor-1 (IGF-1) results in intracellular lipid accumulation. These mesangial cells resemble foam cells. To determine whether this phenotype affects cell function, lipid-laden mesangial cells were tested for their ability to migrate in response to IGF-binding protein-5 (IGFBP-5) and to contract in response to angiotensin II (Ang II). IGFBP-5 binding and subsequent activation of the signal transduction cascade for migration were examined. To confirm that lipid accumulation was responsible for impaired contractility, lipid was removed from lipid-laden mesangial cells and the cells were re-tested for contractile response to Ang II. In comparison to control mesangial cells, lipid-laden cells failed to migrate in response to IGFBP-5. Although cellular binding of IGFBP-5 was not altered by lipid accumulation, IGFBP-5 failed to activate cdc42, a Rho GTPase required for IGFBP-5-mediated mesangial cell migration. These data indicate that lipid accumulation within the mesangial cell interferes with the signal transduction response to IGFBP-5. In addition, mesangial cells treated with IGF-1 had reduced contraction to Ang II. When lipid accumulation was exaggerated by adding cholesteryl esters to the culture medium, mesangial cells failed to contract in response to Ang II. Following removal of excess lipid from these mesangial cells, the contractile response to Ang II was restored." }, { "role": "assistant", "content": "IGF-1 induces lipid accumulation in mesangial cells, which impairs their ability to respond to specific migratory and contractile stimuli. These observations are relevant to understanding functional abnormalities in diseases where mesangial foam cells occur, such as focal and segmental glomerulosclerosis and diabetic nephropathy. 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": "Isometric contraction is seen in?" }, { "role": "assistant", "content": "The correct answer is Ans. is'd'i.e., Antigravity musclesIsotonic contraction means contraction in which there is change of length at constant tension.The tension is equal to the weight lifted during contraction of the muscle.Isometric contraction means contraction in which there is no change in length of the muscle (constant length) but there is an increase in tension.So, isometric contraction generate more force of contraction (tension).Best example of isometric contraction is the contraction of antigravity muscles to maintain tension in erect posture, without changing length." } ]

[ { "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: Adaptation, Physiological, Analysis of Variance, Animals, Blotting, Western, Cell Division, Epidermal Growth Factor, ErbB Receptors, Ileum, Intestinal Mucosa, Male, Mice, Mice, Inbred ICR, Polymerase Chain Reaction, RNA, Messenger, Up-Regulation." }, { "role": "user", "content": "Is intestinal adaptation enhanced by epidermal growth factor independent of increased ileal epidermal growth factor receptor expression? Context: Intestinal adaptation after massive small bowel resection (SBR) is augmented by epidermal growth factor (EGF) via an unknown mechanism. We recently have observed that EGF increases the expression of EGF receptor mRNA and protein content in the remnant ileum after SBR. The purpose of this study was to determine whether the magnitude of EGF-induced receptor expression correlates with intestinal adaptation. A 50% proximal SBR or sham operation (bowel transection with reanastomosis) was performed on male ICR mice. Animals from each group were then selected randomly to receive either human recombinant EGF (150 microg/kg/d) or saline by twice daily intraperitoneal injections. The remnant ileum was harvested at 1 week, and parameters of adaptation measured as changes in protein content. Ileal EGF receptor mRNA was quantitated using a ribonuclease protection assay. Changes in the expression ileal EGF receptor protein were determined by Western blot after immunoprecipitation. Comparisons of mean values between groups was performed using analysis of variance (ANOVA) and a P value of less than .05 was considered significant. Values are presented as mean +/- SEM. EGF was mitogenic to the ileum after sham operation as monitored by increases in ileal protein content (2.21 +/- 0.002 mg/cm Sham v 2.97 +/- 0.25 mg/cm Sham +/- EGF; P < .05). After SBR, adaptation resulted in increased ileal protein content (4.45 +/- 0.27 mg/cm), which was substantially boosted by EGF (5.98 +/- 0.39 mg/cm; P < .05). No differences were detected in ileal EGF receptor mRNA or protein expression between Sham or SBR groups that did not receive EGF. However, EGF significantly enhanced the expression of ileal EGF receptor mRNA to an equal extent after both sham and SBR (approximately threefold). The magnitude of this increase in EGF receptor protein (four- to sixfold) was similar in both EGF groups as shown by Western blotting." }, { "role": "assistant", "content": "Changes in ileal EGF receptor expression are not mandatory for adaptation to occur. EGF upregulates the expression of mRNA and protein for its own intestinal receptor in vivo. Because EGF-induced receptor expression was comparable after both SBR and Sham operation, the beneficial effect of EGF during adaptation is likely caused by other factors in addition to increased receptor expression. 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, METHODS, METHODS, METHODS, RESULTS. Meshes: Adolescent, Adult, Body Image, Breast Feeding, Female, Humans, Postpartum Period, Pregnancy, Prospective Studies, Surveys and Questionnaires, Time Factors, Weight Gain." }, { "role": "user", "content": "Are body image concerns during pregnancy associated with a shorter breast feeding duration? Context: breast feeding is affected by numerous psycho-social factors. Antenatal concerns such as embarrassment regarding public feeding and the impact of breast feeding upon breast shape are known to lead to artificial milk use. However, although work has explored the relationship between maternal weight and infant feeding, wider body image concerns have not been examined. The aim of the current study was to explore the association between maternal body image concerns during pregnancy upon intended and actual breast feeding duration. a two stage self report questionnaire completed during pregnancy and at six months post partum. mothers were recruited from local mother and infant groups, nurseries and online mother and infant forums. 128 pregnant women completed both stages. phase one: completion of a questionnaire exploring body image during pregnancy (concerns about stretch marks, weight gain and appearance) and planned breast feeding duration during the second/third trimester of pregnancy (body image, weight, intended duration) followed by a second questionnaire measuring actual breast feeding duration and breast feeding experiences. factor analysis revealed three primary body image concerns: pregnancy body image, prospective postnatal body image and dieting during pregnancy. Higher concerns on all three factors were associated with both intended and actual shorter breast feeding duration. Amongst mothers who stopped breast feeding before six months, those with higher body image concerns were more likely to report stopping due to embarrassment or the perceived impact upon their breast shape. The relationship was not explained by maternal weight, although a higher residual weight gain at six months was associated with a shorter breast feeding duration." }, { "role": "assistant", "content": "mothers who are affected negatively by changes to their body during pregnancy may be less likely to plan to or initiate breast feeding potentially due to underlying issues such as embarrassment or perceived impact of feeding upon their appearance. The findings are important to those working with women during pregnancy and the postpartum period in understanding the impact of body image upon intention and ability to initiate and continue breast feeding. 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 45-year-old woman underwent a modified radical mastectomy 4 years ago. She was treated for multiple bone metastases with cyclophosphamide, doxorubicin, and fluorouracil for 6 months. She is complaining of exeion on exercise, swelling of the legs, and swelling around eyes in the morning. On examination, she has bilateral rales in the lungs, Sl, S2 audible, S3, S4 gallop present. Her BP is 149/117 mm Hg, PR is 80/min, and RR is 18/min. What is the most likely cause for her cardiac condition?" }, { "role": "assistant", "content": "The correct answer is Answer is B (Drug induced cardiac toxicity) Features of cardiac failure in a patient on doxorubicin suggests the possibility of Anthracycline induced cardiac toxity.Risk of Anthracyclinc induced cardiac toxicity is increased with concomitent radiation and cyclophosphamide. cardiac failure after 6 months of chemotherapy with doxorubicin (anthracycline) and cyclophosphamide, is consistent with a diagnosis of drug induced cardiac toxity which is the single best answer of choice." } ]

[ { "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": "Who introduced patient hygiene performance index (PHP Index)" }, { "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": "The most common presentation of double aoic arch in infants is ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Tracheal compression symtoms Double aoic arch o Congenital abnormalities of the aoic arch and its major branches result in the formation of vascular rings around the trachea and esophagus with varying degrees of compression. o The most common cause is a double aoic arch. o Double aoic arch results when right dorsal aoa persists distal to the origin of the right 7th cervical intersegmental aery. o Clinical manifestations of double aoic arch are :? The age and type of presentation depend on the tightness of the ring. About 75% with a double aoic arch, 55% with a right aoic arch & abberant left subclan aery and 95% with compression by an abberant innominate aery present in infancy with repiratory symptoms, including stridor, persistent cough and frequent respiratory illnesses. If the vascular ring produces compression of the trachea and esophagus, symptoms are frequently present during infancy. Chronic wheezing is exacerbated by crying, feeding, and flexion of the neck. Extension of the neck tends to relieve the noisy respiration. Vomiting may also be a component. Affected infants may have a brassy cough, pneumonia, or sudden death from aspiration. Others can present in later childhood or even as teenagers or young adults with a history of respiratory symptoms that mimic asthma or exercise-induced asthma. Some are diagnosed later in life after being asymptomatic during entire childhood. The later the presentation, the more chances of gastrointestinal symptoms being the presenting symptoms. Symptoms like dysphagia, choking vomiting may be seen." } ]

[ { "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": "Drug of choice for acute adrenal insufficiency is ?" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "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, METHODS, RESULTS. Meshes: Depressive Disorder, Drug Monitoring, Education, Medical, Continuing, Health Maintenance Organizations, Humans, Logistic Models, Middle Aged, Outcome and Process Assessment (Health Care), Patient Education as Topic, Patient Satisfaction, Physicians, Family, Practice Guidelines as Topic, Primary Health Care, Program Evaluation, Washington." }, { "role": "user", "content": "Achieving guidelines for the treatment of depression in primary care: is physician education enough? Context: The authors examine whether physician education has enduring effects on treatment of depression. Depressed primary care patients initiating antidepressant treatment from primary care clinics of a staff-model health maintenance organization were studied. Quasi-experimental and before-and-after comparisons of physician practices, supplemented with patient surveys, were used to compare the process of care and depression outcomes. Intervention consisted of extensive physician education that spanned a 12-month period. This included case-by-case consultations, didactics, academic detailing (eg, clearly stating the educational and behavioral objectives to individual physicians), and role-play of optimal treatment. Main outcome measures were divided into two groups. Quasi-experimental samples included: (1) antidepressant medication selection and (2) adequacy (dosage and duration) of pharmacotherapy. Survey samples included: (3) intensity of follow-up; (4) physician delivered educational messages regarding depression treatment; (5) patient satisfaction; and (6) depression outcomes. No lasting educational effect was observed consistently in any of the outcomes measured." }, { "role": "assistant", "content": "There was no enduring improvement in the treatment of depression for primary care patients. Depression treatment guidelines were achieved contemporaneously, however, for intervention patients enrolled in a multifaceted program of collaborative care during the training period. These results suggest that continuing programs of reorganized service delivery to support the role of a primary care physician (eg, on-site mental health personnel, close monitoring of patient progress and adherence), in addition to physician training, are essential for the success of guideline implementation." } ]

[ { "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": "According to Herrington classification the decerebrate rigidity is characterised by all EXCEPT" }, { "role": "assistant", "content": "The correct answer is (Rigidity occurs in all muscles of the body) (210-11 Ganong 22nd) (692- Guyton 11th) (247- Ganong 23rd)DECEREBRATE - RIGIDITY -* When the brain stem of an animal is sectioned below the mid level of the mesencephalon. But the pontine and medullary reticular system as well as the vestibular system are left intact, the animal develops a condition called decerebrate rigidity* This rigidity does not occur in all muscles of the body but does occur in the antigravity muscles - the muscles of the neck and trunk and the extensors of the leg.* The cause of decerebrate rigidity is blockage of normally strong input to the medullary reticular nuclei from the cerebral cortex, the red nucleus and the basal ganglia. Lacking this input, the medullary reticular inhibitor system become non functional; Full overactivity of the pontine excitatory system occurs, and rigidity develops.* Decerebrate rigidity is found to be spasticity due to diffuse facilitation of stretch reflexes* The facilitation is due to two factors: increased general excitability of the motor neuron pool and increased in the rate of discharge in the y' efferent neuron* Decerebration produces no phenomenon akin to spinal shock. And the rigidity develops as soon as the brain stem is transected" } ]

[ { "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. Meshes: Acetyltransferases, Animals, Carcinoma, Hepatocellular, Cell Line, Tumor, Drug Interactions, Drug Synergism, Humans, Liver Neoplasms, Lung Neoplasms, Male, Mice, Mice, Inbred BALB C, Mice, Nude, Neoplasm Invasiveness, Neoplasm Metastasis, Osteopontin, Proto-Oncogene Protein c-ets-1, Transcription Factors, Transcription, Genetic, Transcriptional Activation." }, { "role": "user", "content": "Does thirty-kilodalton Tat-interacting protein suppress tumor metastasis by inhibition of osteopontin transcription in human hepatocellular carcinoma? Context: It has been previously demonstrated that the 30-kDa Tat-interacting protein (TIP30) plays an important role in the suppression of hepatocarcinogenesis by acting as a tumor suppressor. Here we report that TIP30 suppresses metastasis of hepatocellular carcinoma (HCC) through inhibiting the transcription of osteopontin (OPN), a key molecule in the development of tumor metastasis. The expression of TIP30 messenger RNA was reverse to that of OPN messenger RNA in HCC cell lines. Ectopic expression of TIP30 greatly suppressed OPN expression, inhibited invasion of HCC cells through extracellular matrix (ECM) and adhesion with fibronectin in vitro, whereas down-regulation of TIP30 by RNA-mediated interference enhanced OPN expression and promoted metastatic abilities of HCC cells in vitro. Moreover, overexpression of TIP30 significantly inhibited the growth and lung metastases of HCC cells in nude mice. In contrast, down-regulation of TIP30 greatly promoted tumor cell growth and metastases in vivo. TIP30 repressed OPN transcription through interaction with Ets-1 and suppressed the transcriptional activity of Ets-1 and synergistic actions of Ets-1 and alkaline phosphatase-1. Thus, TIP30 may act as an Ets-1 modulator and inhibit tumor metastasis through abrogating Ets-1-dependent transcription. Moreover, expression of TIP30 was inversely associated with OPN expression in HCC tissue samples as detected by immunohistochemistry assay." }, { "role": "assistant", "content": "Our results reveal a novel pathway by which OPN and possibly other Ets-1 target genes involved in tumor metastasis are regulated by TIP30 and elucidate a mechanism for metastasis promoted by TIP30 deficiency. 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, RESULTS. Meshes: Acetylcysteine, Adult, Antioxidants, Case-Control Studies, Cell Proliferation, Cells, Cultured, Cellular Senescence, Coronary Vessels, Cyclin-Dependent Kinase Inhibitor p21, Drug Therapy, Combination, Endothelial Cells, Farnesyltranstransferase, HIV Infections, HIV Protease Inhibitors, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Lamin Type A, Lopinavir, Metalloporphyrins, Methionine, Middle Aged, Nuclear Proteins, Oxidative Stress, Paris, Pravastatin, Protein Precursors, Pyrimidinones, Ritonavir, Time Factors, Tumor Suppressor Protein p53." }, { "role": "user", "content": "Is premature senescence of vascular cells induced by HIV protease inhibitors : implication of prelamin A and reversion by statin? Context: To determine whether and how protease inhibitors (PIs) could affect vascular aging. HIV therapy with PIs is associated with an increased risk of premature cardiovascular disease. The effect of ritonavir and a combination of lopinavir and ritonavir (for 30 days) on senescence, oxidative stress, and inflammation was evaluated in human coronary artery endothelial cells (HCAECs). These HCAECs were either cotreated or not cotreated with pravastatin or farnesyl transferase inhibitor (FTI)-277 or with 2 antioxidants (manganese [III] tetrakis [4-benzoic acid] porphyrin [MnTBAP] and N-acetyl cysteine). Senescence markers were evaluated in peripheral blood mononuclear cells (PBMCs) from HIV-infected patients under PI treatment. PIs induced senescence markers, prelamin A accumulation, oxidative stress, and inflammation in HCAECs. Senescence markers and prelamin A were also observed in PBMCs from HIV-infected patients under ritonavir-boosted PIs. Pravastatin, FTI-277, and antioxidants improved PI adverse effects in HCAECs. Senescence markers were lower in PBMCs from PI-treated patients cotreated with statins." }, { "role": "assistant", "content": "PIs triggered premature senescence in endothelial cells by a mechanism involving prelamin A accumulation. Accordingly, circulating cells from HIV-infected patients receiving PI therapy expressed senescence markers and prelamin A. Statin was associated with improved senescence in endothelial cells and patient PBMCs. Thus, PIs might promote vascular senescence in HIV-infected patients; and statins might exert beneficial effects in these patients. 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 6-month-old male infant is brought to a pediatrician by his guardian for scheduled immunizations. The boy was born at 39 weeks gestation via spontaneous vaginal delivery. He is up to date on all vaccines and is meeting all developmental milestones. The infant is generally healthy; however, the guardian is concerned about multiple patches of bluish discolorations on the skin overlying the lower back and sacrum. A review of medical records indicates that these patches have been present since birth. On further review the child was placed into protective services due to neglect and abuse by his biological family. On physical examination, his vital signs are normal. The pediatrician notes the presence of multiple blue-brown patches over the lumbosacral region, buttocks, and back. These patches are soft and nontender on palpation. Which of the following is the best next step in management of the infant?" }, { "role": "assistant", "content": "Reassurance" } ]

[ { "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, Antirheumatic Agents, Arthritis, Rheumatoid, Disease Models, Animal, Female, GABA-A Receptor Agonists, Isoquinolines, Ligands, Male, Mice, Mice, Inbred MRL lpr." }, { "role": "user", "content": "Does the peripheral benzodiazepine receptor ligand PK 11195 inhibit arthritis in the MRL-lpr mouse model? Context: Mice of the MRL-lpr strain develop a severe autoimmune arthritic condition when primed with complete Freund's adjuvant. The pathology is similar to that seen in human rheumatoid arthritis. We investigated whether PK 11195, a powerful ligand for peripheral benzodiazepine receptors, would have preventative or therapeutic effects in this model. MRL-lpr mice were primed with complete Freund's adjuvant at 13-14 weeks of age. Daily PK 11195 injections were started on the same day as priming to test for preventative effects. Daily PK 11195 injections were started 10 days after priming to test therapeutic effects. PK 11195 showed both preventative and therapeutic effects. At 1 mg/kg/day, it inhibited disease onset. At 3 mg/kg/day, it inhibited established disease progression." }, { "role": "assistant", "content": "The evidence suggests that PK 11195 may be the prototype of a new class of anti-inflammatory agents. 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 46-year-old woman comes to the physician for a 6-month history of worsening bronchial asthma control. Before this issue began, she only used her salbutamol inhaler once a day. Now, she has to use it multiple times daily and also reports frequent nighttime awakening. Seven months ago, she moved to an apartment that is damp and has mold on some of the walls. The physician injects 0.1 mL of Candida albicans extract on the mid-volar surface of the right arm intradermally. After 48 hours there is a palpable induration of 17 mm. This reaction is most likely a result of release of which of the following substances?" }, { "role": "assistant", "content": "Interferon-γ" } ]

[ { "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 AND OBJECTIVES, METHODS, RESULTS. Meshes: Adult, Career Choice, Cohort Studies, Education, Medical, Undergraduate, Family Practice, Humans, Internship and Residency, Retrospective Studies, Teaching." }, { "role": "user", "content": "Does teaching by family physicians in the second year of medical school increase student selection of family practice residencies? Context: Most educators feel that early instruction by family physician teachers increases the probability of students selecting family practice residencies. To examine this hypothesis, a retrospective cohort study was performed to evaluate residency selection of students who received their second-year Introduction to Clinical Medicine (ICM) teaching either from family physicians or other specialists (most commonly, internists). For the 971 students who could be followed to residency, 13.6% of those having family physicians as instructors and 15.7% of those having other specialists as instructors chose family practice residencies. The difference is not significant." }, { "role": "assistant", "content": "It is probable that the effect of having a family physician as a second-year ICM instructor is not significant enough to be detected by a study of this size and is simply \"washed out\" by other factors. It is also possible that no positive effect of second-year teaching by family physicians on residency selection exists." } ]

[ { "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": "True about Acetazolamide is ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Decreased GFR o Acetazolamide decreases GFR. o Carbonic anhydrase inhibitors increase delivery of solutes to the macula densa by inhibiting proximal reabsorption. o This results in activation of TGF (tubulo-glomerular feedback mechanism), causing increased afferent aeriolar resistance and reduces renal blood flow (RBF) and glomerular filtration rate (GFR). About option 'b' o Dont get confused with option b, with answer of previous question. o Acetazolamide has structural resemblance to sulfonamide, but mechanism of action is different. Acetazolamide acts as diuretic by inhibiting carbonic anhydrase, whereas sulfonamides are primarily antimicrobials and act by inhibiting bacterial folate synthesis." } ]

[ { "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, METHODS, RESULTS. Meshes: Adaptation, Psychological, Adolescent, Adult, Aged, Caregivers, Comorbidity, Cost of Illness, Female, Humans, Male, Mental Disorders, Middle Aged, Quality of Life, Self Report, Socioeconomic Factors, Stress, Psychological, Young Adult." }, { "role": "user", "content": "Do informal caregivers in mental illness feel more burdened? Context: This study investigates a possible added subjective burden among informal caregivers to care recipients with a mental illness or a combination of mental and somatic illnesses compared with caregivers to care recipients with a somatic illness. The study also investigates the subjective caregiver burden by caregivers' characteristics and objective burden. The association between subjective caregiver burden and socio-demographic factors, objective burden, and health-related quality of life was analyzed in a population of 865 Dutch informal caregivers, using multiple linear regression analysis. Controlling for other factors in the analysis, we found that caring for a recipient with mental illness or a combination of mental and somatic illness was associated with an extra subjective caregiver burden (measured by Caregiver Strain Index). Objective burden, in terms of more than 50 hours of care provision per week, less than three years of caregiving, or living together with the care recipients was associated with higher subjective caregiver burden. Other factors associated with higher subjective caregiver burden were being partners or a child of care recipient, having a paid job, a low health-related quality of life (EQ-5D), or having an illness." }, { "role": "assistant", "content": "This study suggests that caregivers to care recipients with a mental and especially a combination of mental and somatic illnesses have a higher subjective caregiver burden compared with caregivers to care recipients with a somatic illness. Because the study is not representative of all caregivers, more research focusing on identifying and contacting informal caregivers is needed to confirm the result." } ]

[ { "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, METHOD, RESULTS. Meshes: Adult, Antidepressive Agents, Depressive Disorder, Female, Finland, Follow-Up Studies, Humans, Life Change Events, Life Style, Logistic Models, Male, Middle Aged, Risk Factors, Smoking, Suicide, Surveys and Questionnaires." }, { "role": "user", "content": "Are factors associated with suicidal ideation true risk factors? Context: Adverse life events or the commencement of adverse lifestyles associate with suicidal ideation, but most associations only have been identified in cross-sectional studies. More information is needed about whether they are true risk factors and independently predict the development of suicidal ideation. A sample of the general population from Eastern Finland (n = 1,339) was followed-up for three-years with baseline and two follow-up assessments using postal questionnaires. The main adverse life events and changes in lifestyles were screened at baseline and on one- and three-year follow-up. The Beck Depression Inventory was used to assess the level of depression and the presence of suicidal ideation. Suicidal ideation was common in the sample (annual incidence 4.3%). At baseline it associated with a cluster of adverse life events and lifestyles, as well as depression. Nevertheless, only the Beck Depression Inventory score on 3-year follow-up (OR 1.33, 95% CI 1.22-1.45) and the onset of daily smoking during the follow-up period (OR 5.38, 95% CI 1.41-20.62) independently predicted the presence of suicidal ideation on 3-year follow-up among those who had been non-suicidal at baseline and on 1-year follow-up." }, { "role": "assistant", "content": "Depressive mood appears to be a necessary precondition for the occurrence of suicidal ideation even after adverse life events." } ]

[ { "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, Aged, Animals, Biomarkers, Blotting, Western, Case-Control Studies, Colitis, Colon, Crohn Disease, Female, Humans, Immunohistochemistry, Male, Mice, Mice, Inbred BALB C, MicroRNAs, Middle Aged, NF-KappaB Inhibitor alpha, NF-kappa B, Oligonucleotide Array Sequence Analysis, Reverse Transcriptase Polymerase Chain Reaction, Trinitrobenzenesulfonic Acid, Ubiquitin-Protein Ligases, Up-Regulation, Young Adult." }, { "role": "user", "content": "Does e3 Ubiquitin ligase RNF183 be a Novel Regulator in Inflammatory Bowel Disease? Context: Specific members of the RING finger [RNF] protein family serve as E3 ubiquitin ligases and play important roles in the regulation of inflammation. However, their roles in the pathogenesis of inflammatory bowel disease [IBD] have not been explored. Genomic microarray of inflamed colon samples from Crohn's disease [CD] patients was performed to identify potential up-regulated genes. Expression of the identified highly up-regulated RNF183 gene was subsequently examined by quantitative reverse transcription polymerase chain reaction [qRT-PCR], western blotting and immunohistochemistry of the intestinal tissues of IBD patients and the colons of trinitrobenzene sulphonic acid [TNBS]-induced colitic mice. RNF183-mediated interaction with the NF-κB pathway and ubiquitination of IκBα were examined by siRNA, plasmid transfection, and immunoprecipitation. The miRNA predicted to target RNF183 was explored and its role in the RNF183/ NF-κB pathway was investigated. RNF183 was up-regulated in intestinal epithelial cells in IBD patients and in colitic mice. RNF183 promoted intestinal inflammation via the activation of the NF-κB pathway by increasing the ubiquitination and degradation of IκBα. Computational analysis identified putative binding of miR-7 to RNF183. Transfection of intestinal cells with a miR-7 mimic or inhibitor confirmed its negative regulatory effect on RNF183 expression and ubiquitination of IκBα. miR-7 was down-regulated in inflamed colon tissues of IBD patients and colitic mice." }, { "role": "assistant", "content": "RNF183, which is negatively regulated by miR-7, is a novel regulator promoting intestinal inflammation by increasing the ubiquitination and degradation of IκBα, thereby inducing NF-κB activation. The interaction between RNF183-mediated ubiquitination and miRNA may be an important novel epigenetic mechanism in the pathogenesis of IBD. 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: ." }, { "role": "user", "content": "Does interferon-alpha-2b induce autophagy in hepatocellular carcinoma cells through Beclin1 pathway? Context: To determine whether Interferon-alpha-2b (IFN-α2b) can modulate the autophagic response in hepatocellular carcinoma cells. Hepatocellular carcinoma cells were treated with IFN-α2b. Autophagy was assessed by acridine orange staining, GFP-LC3 dotted assay, transmission electron microscopy and immunoblotting. Acridine orange staining showed that IFN-α2b triggered the accumulation of acidic vesicular and autolysosomes in HepG2 cells. The acridine orange HepG2 cell ratios were (4.3±1.0)%, (6.9±1.4)%, and (13.1±2.3)%, respectively, after treatment with 100, 1,000, and 10,000 IU/mL IFN-α2b for 48 h. A markedly punctate pattern was observed in HepG2 cells treated with 10,000 IU/mL IFN-α2b for 48 h, but only diffuse and weakly fluorescent GFP-LC3 puncta was observed in control cells. HepG2 cells treated with 10,000 IU/mL IFN-α2b for 48 h developed autophagosome-like characteristics, including single- or double-membrane vacuoles containing intact and degraded cellular debris. The Beclin1 and LC3-II protein expression was up-regulated by IFN-α2b treatment." }, { "role": "assistant", "content": "Autophagy can be induced in a dose-dependent manner by treatment with IFN-α2b in HepG2 cells, and the Beclin1 signaling pathway was stimulated by IFN-α2b. 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, Cell Proliferation, Down-Regulation, Female, Gene Expression Regulation, Neoplastic, Humans, Hyaluronan Receptors, MCF-7 Cells, Mice, Mice, Nude, Neoplasm Transplantation, Neoplastic Stem Cells, Octamer Transcription Factor-3, RNA, Small Interfering, Receptors, G-Protein-Coupled, Smoothened Receptor, Transcription Factors, Transfection, Tumor Burden, Zinc Finger Protein GLI1." }, { "role": "user", "content": "Does [ Down-regulation of Smoothened gene expression inhibit proliferation of breast cancer stem cells ]? Context: To investigate the influence of down-regulating Smoothened (SMO) gene expression through short hairpin RNA (shRNA) on the proliferation of breast cancer stem cells. Human SMO shRNA was designed, synthesized chemically, and transfected into MCF-7 cells to down-regulate SMO gene. By using G418, stable cells with down-regulated SMO were selected. In vitro proliferation of these cells was measured by CCK8 assay. The proportion of CD44(+)/CD24(-) cells was detected by flow cytometry and the mammospheres formation was determined by suspension sphere culture. The expression of SMO, GLI1 and Oct4 was detected by Western blot. In vivo, the volume of tumor was measured every 3 days and the expression of SMO, GLI1 and Oct4 detected by Western blot. In vitro, the cells were transfected with SMO-shRNA and selected by G418 after 21 days. SMO-shRNA effectively down-regulated the expression of SMO gene and protein, and inhibited the proliferation of MCF-7 and markedly reduced the proportion of CD44(+)/CD24(-) cells and mammospheres. In vivo, SMO-shRNA treatment of MCF-7 significantly inhibited the volume of tumor. The positive rate of SMO in negative control and SMO-shRNA group was 5/5 and 2/5, respectively. The expression of SMO, GLI1 and Oct4 in different groups were 0.72 ± 0.17 and 0.21 ± 0.09, 1.21 ± 0.21 and 0.47 ± 0.12, 0.83 ± 0.13 and 0.25 ± 0.07. SMO, GLI1 and Oct4 down-regulation significantly suppressed at protein levels (P < 0.05)." }, { "role": "assistant", "content": "The shRNA by chemical synthesis can effectively down-regulate SMO gene expression and inhibit the proliferation of breast cancer stem cells. 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": "Botulinum toxin type B is used in which disease -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Cervical dystonia o Botulinum toxin type A is used for strabismus, cervical dystonia, blepherospasm, and glabellar lines. o Botulinum toxin type B is used for cervical dystonia. o Abobotulinum toxin A : An acetylcholine release inhibitor and a neuromuscular blocking agent for the treatment of cervical dystonia in adults to reduce the severity of abnormal head position and neck pain, and for the temporary improvement in the appearance of moderate to severe glabellar lines." } ]

[ { "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, Apoptosis, Biomarkers, Tumor, Carcinoma, Hepatocellular, Case-Control Studies, Cell Proliferation, Disease Progression, Disease-Free Survival, Female, Humans, Immunohistochemistry, In Situ Nick-End Labeling, Kaplan-Meier Estimate, Liver, Liver Neoplasms, Male, Middle Aged, NM23 Nucleoside Diphosphate Kinases, Neoplasm Metastasis, Proliferating Cell Nuclear Antigen." }, { "role": "user", "content": "Are expressions of nucleoside diphosphate kinase ( nm23 ) in tumor tissues related with metastasis and length of survival of patients with hepatocellular carcinoma? Context: To evaluate the relationship of expressions of nucleoside diphosphate kinase (nm23) and proliferating cell nuclear antigen (PCNA), as well as apoptosis, with the prognosis of HCC patients by analyzing their pathological and clinical data. The expressions of nm23 and PCNA were analyzed by immunohistochemistry and the apoptotic phenomena were detected by TUNEL technique in the liver samples from 43 HCC tissues, 39 para-neoplastic tissues, and 10 normal tissues. The mean apoptosis index (AI) and proliferative index (PI) in individual sample were calculated. As shown by the detection, 32.6% of carcinomas had negative nm23 signal in tumor tissues, whereas all para-neoplastic and normal tissues had positive nm23. The AI in nm23 positive HCC was significantly higher than that in nm23 negative one, with statistical difference (P<0.05). Furthermore, the expressions of nm23, and the values of AI and PI were contrastively analyzed with some main pathological and clinical data of HCC. It revealed that HCC with extrahepatic metastasis showed remarkable correlation with the negative nm23 (P=0.013) and higher PI values of HCC (P=0.015). The disease-free survival in HCC patients with negative nm23 expression was significantly poorer than that in patients with positive nm23 expression." }, { "role": "assistant", "content": "These data suggest that expressions of nm23 protein in tumor tissues are correlated with occurrences of metastasis and length of survival of the HCC patients, which may be an indicator for their prognosis. 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 %age of burn in which burn surface area is equal to palmar surface?" }, { "role": "assistant", "content": "The correct answer is The overall survivability of burn injury is contingent not only on type of burn, but on how much of the skin surface is involved. The rule of nine was developed to assist EMS in relying to the receiving facility how much of the body % is involved in the burn injury. There are eleven body areas. Each of which contain approximately nine percent of body's overall area. They are: Head and neck 9% Chest 9% Abdomen 9% Front of each leg 9*2 = 18% Back of each leg 9*2=18% Arms 9*2=18% Upper back 9% Lower back 9% These body area add up to 99%; the genitalia comprises the remaining 1%. The outstretched palm and fingers approximates to 1% of the body surface area. If the burned area is small, assess how many times your hand cover the burned area and that will give you the total %age of the burned body suface area. Ref: Kaplan's Basic- Exam, 3/e, Page 122 ; The Clinical Use Of Blood ; In Medicine, Obstetric and Pediatric surgery & anaesthesia , trauma and burns; By jean C. Emmanuel, section 14.2" } ]

[ { "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, METHODS, METHODS, METHODS, METHODS, RESULTS. Meshes: Adolescent, Adult, Cohort Studies, Female, Gravidity, Humans, Infant, Newborn, Israel, Live Birth, Male, Maternal Age, Middle Aged, Parity, Paternal Age, Pregnancy, Reference Values, Retrospective Studies, Sex Ratio, Young Adult." }, { "role": "user", "content": "Is sex ratio remarkably constant? Context: To study whether the sex of the offspring is related to increasing parental age, gravidity, and parity, hypothesizing an altered male-to-female sex ratio with the advancing parental age. A large retrospective cohort study. The study analyzed birth records of Hadassah Hebrew University Medical Center in Jerusalem from June 2003 to December 2006. 35,837 birth records were analyzed including 941 multifetal deliveries, excluding foreign inhabitants (n = 744), missing data for the main study outcome (n = 2) and parturients over 50 years to control for egg donation (n = 26). None. Male-to-female sex ratio. The male-to-female sex ratio of all the newborns was 1.05. This ratio did not change significantly with either maternal or paternal age. Neither gravidity nor parity affected the male-to-female ratio. The only factor that affected the regression of sex ratio was the length of gestation." }, { "role": "assistant", "content": "Sex ratio at birth is remarkably constant. No association was found between parental age or birth order and neonatal sex ratio. 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, Apoptosis, Gene Expression Regulation, Viral, Mice, Mice, Inbred C57BL, Mice, Knockout, Microglia, Signal Transduction, Simplexvirus, Toll-Like Receptor 2." }, { "role": "user", "content": "Is toll-like receptor 2 signaling a mediator of apoptosis in herpes simplex virus-infected microglia? Context: Information regarding the response of brain cells to infection with herpes simplex virus (HSV)-1 is needed for a complete understanding of viral neuropathogenesis. We have recently demonstrated that microglial cells respond to HSV infection by producing a number of proinflammatory cytokines and chemokines through a mechanism involving Toll-like receptor 2 (TLR2). Following this cytokine burst, microglial cells rapidly undergo cell death by apoptosis. We hypothesized that TLR2 signaling might mediate the cell death process as well. To test this hypothesis, we investigated HSV-induced cell death of microglia obtained from both wild-type and TLR2-/- mice. Cell death was studied by oligonucleosomal ELISA and TUNEL staining, and the mechanisms of apoptosis were further analyzed using murine apoptosis-specific microarrays. The data obtained from microarray analysis were then validated using quantitative real-time PCR assays. HSV infection induced apoptotic cell death in microglial cells from wild-type as well as TLR2 cells. However, the cell death at 24 h p.i. was markedly lower in knockout cells. Furthermore, microarray analyses clearly showed that the expression of pro-apoptotic genes was down-regulated at the time when wild-type cells were actively undergoing apoptosis, indicating a differential response to HSV in cells with or without TLR2." }, { "role": "assistant", "content": "We demonstrate here that HSV induces an apoptotic response in microglial cells which is mediated through TLR2 signaling. 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 non ionizing radiations used in thermography?" }, { "role": "assistant", "content": "The correct answer is Infrared thermography is the process of using a thermal imager to detect infrared radiation (heat) that is emitted by an object. Thermography detects the radiant heat of the body by using infrared rays. Breast cancers have higher blood flow to the mitotically active tumor cells and hence will have a difference in temperature than surrounding normal breast which can be detected using thermography." } ]

[ { "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 number of new cases of a specific disease occurring in a defined population during a specified period of time is known as" }, { "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": "Perioral pigmentation and Dennie-Morgan sign are seen in the following condition:" }, { "role": "assistant", "content": "The correct answer is Skin lesions in chronic atopic Dermatitis: Lichenification (thickening of the skin with accentuation of skin markings): results from repeated rubbing or scratching Follicular lichenification (especially in brown and black persons) Fissures: painful, especially in flexures, on palms, fingers, and soles Alopecia: lateral one-third of the eyebrows as a result of rubbing Periorbital pigmentation: also as a result of compulsive rubbing Characteristic infraorbital fold below eyelids (Dennie-Morgan sign) Ref: Suurmond D. (2009). Section 2. Eczema/Dermatitis. In D. Suurmond (Ed), Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, 6e." } ]

[ { "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": "Last organ to putrefy after death is :" }, { "role": "assistant", "content": "The correct answer is Ans-BRef: The Essentials of Forensic Medicine and Toxicology by KS A'arayan Reddy. 29th edition. 20/0. Rage 152Note- Order of Putrefaction- earliest to last- larynx, trachea a Stomach, intestine, liver, spleen a Brain, Lungs a Heart, Kidney a Bladder, Uterus/Prostrate a Skin, muscles, tendon a lastly, bones.Explanation:As a general rule, the organs show putrefactive changes in the following order:Putrefaction:It is a type of decomposition.It is the final stage following death, in which destruction of the soft tissues of the body is caused mainly by the action of bacterial enzymes, mostly anaerobic organisms derived from intestines.The chief destructive bacterial agent is Clostridium welchii, which causes markedhemolysis, liquefaction of the postmortem clots, disintegration of tissues and gas formation in blood vessels and tissues.Lecithinase produced by Cl. welchiii is mainly responsible." } ]

[ { "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, Cataract, Chromosomes, Human, Pair 11, Computational Biology, Consanguinity, DNA Mutational Analysis, Disease Models, Animal, Evolution, Molecular, Exons, Female, Gene Expression, Genes, Recessive, Genetic Linkage, Haplotypes, Humans, Lod Score, Male, Mice, Microsatellite Repeats, Mutation, Missense, Pedigree, Slit Lamp, alpha-Crystallin B Chain." }, { "role": "user", "content": "Do missense Mutations in CRYAB Are Liable for Recessive Congenital Cataracts? Context: This study was initiated to identify causal mutations responsible for autosomal recessive congenital cataracts in consanguineous familial cases. Affected individuals underwent a detailed ophthalmological and clinical examination, and slit-lamp photographs were ascertained for affected individuals who have not yet been operated for the removal of the cataractous lens. Blood samples were obtained, and genomic DNA was extracted from white blood cells. A genome-wide scan was completed with short tandem repeat (STR) markers, and the logarithm of odds (LOD) scores were calculated. Protein coding exons of CRYAB were sequenced, bi-directionally. Evolutionary conservation was investigated by aligning CRYAB orthologues, and the expression of Cryab in embryonic and postnatal mice lens was investigated with TaqMan probe. The clinical and ophthalmological examinations suggested that all affected individuals had nuclear cataracts. Genome-wide linkage analysis suggested a potential region on chromosome 11q23 harboring CRYAB. DNA sequencing identified a missense variation: c.34C>T (p.R12C) in CRYAB that segregated with the disease phenotype in the family. Subsequent interrogation of our entire cohort of familial cases identified a second familial case localized to chromosome 11q23 harboring a c.31C>T (p.R11C) mutation. In silico analyses suggested that the mutations identified in familial cases, p.R11C and p.R12C will not be tolerated by the three-dimensional structure of CRYAB. Real-time PCR analysis identified the expression of Cryab in mouse lens as early as embryonic day 15 (E15) that increased significantly until postnatal day 6 (P6) with steady level of expression thereafter." }, { "role": "assistant", "content": "Here, we report two novel missense mutations, p.R11C and p.R12C, in CRYAB associated with autosomal recessive congenital nuclear cataracts. 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: Adenocarcinoma, Aged, Biopsy, Esophageal Neoplasms, False Positive Reactions, Fluorodeoxyglucose F18, Humans, Lymph Nodes, Lymphatic Metastasis, Male, Multimodal Imaging, Neoplasm Staging, Positron-Emission Tomography, Predictive Value of Tests, Radiopharmaceuticals, Retrospective Studies, Tomography, X-Ray Computed, Unnecessary Procedures." }, { "role": "user", "content": "Clinical staging of patients with early esophageal adenocarcinoma: does FDG-PET/CT have a role? Context: Esophageal carcinoma is a significant worldwide health problem and the incidence is increasing faster than that of any other malignancy. 18F-2-deoxy-D-glucose (FDG)-positron emission tomography/computed tomography (PET/CT) is important in the management of patients with potentially resectable esophageal cancer and is useful in initial staging of locally advanced cancer and after neoadjuvant therapy. The purpose of this study is to determine the utility of FDG-PET/CT in the clinical staging of early-stage esophageal cancer. Subjects in this retrospective study were 79 consecutive patients with cTisN0 (high-grade dysplasia) and cT1N0 primary esophageal adenocarcinoma diagnosed by endoscopy and endoscopic ultrasound biopsy that were evaluated with preoperative FDG-PET/CT and had not received neoadjuvant therapy. Seventh edition American Joint Committee on Cancer cTNM and FDG-PET/CT were compared with postoperative pTNM staging. pT1 was subdivided into intramucosal cancers with lamina propria or muscularis mucosa invasion (pT1a) and submucosal cancers (pT1b). In pT staging, the frequency of FDG uptake increased with increasing pT, from pT1a 21 of 39 (53.8%) to pT1b 19 of 22 (55.8%). pTis was three of five (60.0%). Similarly, the maximum standardized uptake value of FDG-avid lesions increased with increasing pT, with median values of 3.7 for pTis, 3.8 for pT1a and 4.2 for T1b. In cN staging, FDG-PET/CT was negative in 76 patients and positive in three patients. All three patients with FDG-avid nodes on FDG-PET/CT were negative for metastatic disease on biopsy. In 12 patients with pN1 and in one patient with N2, FDG-PET/CT was falsely negative. Sensitivity and positive predictive value for pN disease were 0% and accuracy was 82%. There were no distant metastases. In cM staging, FDG-PET/CT was falsely positive in five patients (FDG avid nodules n = 3, distant nodal metastasis n = 2) and resulted in unwarranted biopsy in four patients." }, { "role": "assistant", "content": "FDG-PET/CT is not useful in the TNM staging of primary adenocarcinoma of the esophagus when endoscopy and biopsy indicate cTis and cT1. In fact, FDGPET/CT can be detrimental to patient management. Because regional nodal metastases are uncommon and distant metastases rare, and as FDG-PET/CT can result in inappropriate clinical care, FDG-PET/CT should not be performed in the evaluation of early-stage esophageal cancer." } ]

[ { "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, Tumor, Carcinoma, Pancreatic Ductal, Cell Line, Tumor, Claudin-4, Enterotoxins, Female, Gene Expression Regulation, Neoplastic, Humans, Ligands, Liver Neoplasms, Mice, Mice, Transgenic, Neoplasm Proteins, Neoplasm Transplantation, Optical Imaging, Pancreatic Neoplasms, Precancerous Conditions, Tomography, Optical, Transplantation, Heterologous, Up-Regulation." }, { "role": "user", "content": "Does claudin-4-targeted optical imaging detect pancreatic cancer and its precursor lesions? Context: Novel imaging methods based on specific molecular targets to detect both established neoplasms and their precursor lesions are highly desirable in cancer medicine. Previously, we identified claudin-4, an integral constituent of tight junctions, as highly expressed in various gastrointestinal tumours including pancreatic cancer. Here, we investigate the potential of targeting claudin-4 with a naturally occurring ligand to visualise pancreatic cancer and its precursor lesions in vitro and in vivo by near-infrared imaging approaches. A non-toxic C-terminal fragment of the claudin-4 ligand Clostridium perfringens enterotoxin (C-CPE) was labelled with a cyanine dye (Cy5.5). Binding of the optical tracer was analysed on claudin-4 positive and negative cells in vitro, and tumour xenografts in vivo. In addition, two genetically engineered mouse models for pancreatic intraepithelial neoplasia (PanIN) and pancreatic cancer were used for in vivo validation. Optical imaging studies were conducted using 2D planar fluorescence reflectance imaging (FRI) technology and 3D fluorescence-mediated tomography (FMT). In vitro, the peptide-dye conjugate showed high binding affinity to claudin-4 positive CAPAN1 cells, while claudin-4 negative HT1080 cells revealed little or no fluorescence. In vivo, claudin-4 positive tumour xenografts, endogenous pancreatic tumours, hepatic metastases, as well as preinvasive PanIN lesions, were visualised by FRI and FMT up to 48 h after injection showing a significantly higher average of fluorochrome concentration as compared with claudin-4 negative xenografts and normal pancreatic tissue." }, { "role": "assistant", "content": "C-CPE-Cy5.5 combined with novel optical imaging methods enables non-invasive visualisation of claudin-4 positive murine pancreatic tumours and their precursor lesions, representing a promising modality for early diagnostic imaging. 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, OBJECTIVE, RESULTS. Meshes: Antithrombins, Binding Sites, Binding, Competitive, Electrophoretic Mobility Shift Assay, Heparin, Hirudins, Humans, Hydrophobic and Hydrophilic Interactions, Kinetics, Models, Molecular, Mutagenesis, Site-Directed, Mutation, Osmolar Concentration, Peptide Fragments, Polyphosphates, Protein Binding, Protein Conformation, Prothrombin, Sodium Chloride, Surface Plasmon Resonance, Thrombin." }, { "role": "user", "content": "Does polyphosphate bound with high affinity to exosite II of thrombin? Context: Polyphosphate (a linear polymer of inorganic phosphate) is secreted from platelet dense granules, and we recently showed that it accelerates factor V activation by thrombin. To examine the interaction of polyphosphate with thrombin. Thrombin, but not prothrombin, altered the electrophoretic migration of polyphosphate in gel mobility assays. Thrombin binding to polyphosphate was influenced by ionic strength, and was evident even in plasma. Two positively charged exosites on thrombin mediate its interactions with other proteins and accessory molecules: exosite I (mainly with thrombin substrates), and exosite II (mainly with certain anionic polymers). Free thrombin, thrombin in complex with hirudin's C-terminal dodecapeptide and gamma-thrombin all bound polyphosphate similarly, excluding exosite I involvement. Mutations within exosite II, but not within exosite I, the Na(+)-binding site or hydrophobic pocket, weakened thrombin binding to polyphosphate as revealed by NaCl dependence. Surface plasmon resonance demonstrated tight interaction of polyphosphate with thrombin (K(d) approximately 5 nm) but reduced interaction with a thrombin exosite II mutant. Certain glycosaminoglycans, including heparin, only partially competed with polyphosphate for binding to thrombin, and polyphosphate did not reduce heparin-catalyzed inactivation of thrombin by antithrombin." }, { "role": "assistant", "content": "Polyphosphate interacts with thrombin's exosite II at a site that partially overlaps with, but is not identical to, the heparin-binding site. Polyphosphate interactions with thrombin may be physiologically relevant, as the polyphosphate concentrations achievable following platelet activation are far above the approximately 5 nM K(d) for the polyphosphate-thrombin interaction. 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": "Minimum thickness for type I zinc phosphate cement should be" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "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, Apoptosis, Blotting, Western, Carbazoles, Cell Line, Tumor, Core Binding Factor Alpha 1 Subunit, Cytoprotection, Enzyme Activation, Enzyme Activators, Histone Deacetylase Inhibitors, Inflammation Mediators, Mice, NF-kappa B, Nitric Oxide, Osteoblasts, Osteocalcin, Polymerase Chain Reaction, RNA, Messenger, Resveratrol, Signal Transduction, Sirtuin 1, Stilbenes, Transfection, Tumor Necrosis Factor-alpha, Up-Regulation." }, { "role": "user", "content": "Does sirt1 overexpression protect murine osteoblasts against TNF-α-induced injury in vitro by suppressing the NF-κB signaling pathway? Context: Sirtuin 1 (Sirt1) is the class III histone/protein deacetylase that interferes with the NF-κB signaling pathway, thereby has anti-inflammatory function. This study was undertaken to investigate whether Sirt1 could protect osteoblasts against TNF-α-induced injury in vitro. Murine osteoblastic cell line, MC3T3-E1, was used. Overexpress of Sirt1 protein in MC3T3-E1 cells was made by transfection the cells with Sirt1-overexpressing adenovirus. The levels of mRNAs and proteins were determined with qRT-PCR and Western blotting, respectively. The activity of NF-κB was examined using NF-κB luciferase assay. The NO concentration was measured using the Griess method. Treatment of MC3T3-E1 cells with TNF-α (2.5-10 ng/mL) suppressed Sirt1 protein expression in a concentration-dependent manner. TNF-α (5 ng/mL) resulted in an increase in apoptosis and a reduction in ALP activity in the cells. Overexpression of Sirt1 in the cells significantly attenuated TNF-α-induced injury through suppressing apoptosis, increasing ALP activity, and increasing the expression of Runx2 and osteocalcin mRNAs. Furthermore, overexpression of Sirt1 in the cells significantly suppressed TNF-α-induced NF-κB activation, followed by reducing the expression of iNOS and NO formation. Sirt1 activator resveratrol (10 μmol/L) mimicked the protection of the cells by Sirt1 overexpression against TNF-α-induced injury, which was reversed by the Sirt1 inhibitor EX-527 (5 μmol/L)." }, { "role": "assistant", "content": "Overexpression of Sirt1 protects MC3T3-E1 osteoblasts aganst TNF-α-induced cell injury in vitro, at least in part, via suppressing NF-κB signaling. Sirt1 may be a novel therapeutic target for treating rheumatoid arthritis-related bone loss. 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, RESULTS. Meshes: CD4 Antigens, CD8 Antigens, Cell Line, Down-Regulation, Gene Expression, Gene Products, env, Gene Products, nef, Genes, nef, HIV Infections, HIV-1, Humans, Transfection, Virus Replication, nef Gene Products, Human Immunodeficiency Virus, src Homology Domains." }, { "role": "user", "content": "Is inhibition of HIV-1 progeny virion release by cell-surface CD4 relieved by expression of the viral Nef protein? Context: The human immunodeficiency virus type 1 (HIV-1) Nef protein is required for efficient virus replication in vivo and displays a number of distinct and apparently unrelated biological activities in vitro. Of these, one of the most readily demonstrated is the efficient internalization and degradation of cell-surface CD4, the receptor for the HIV-1 envelope protein. The biological purpose of this internalization has, however, remained unclear. Using human 293T cells expressing high levels of cell-surface CD4 or CD8, we demonstrate that CD4, but not CD8, can dramatically reduce the release of infectious virions bearing the HIV-1 envelope protein and induce a concomitant increase in the accumulation of cell-associated HIV-1 structural proteins. In contrast, CD4 had no effect on the release of HIV-1 bearing a heterologous envelope protein unable to bind CD4. Nef expression totally reversed CD4-mediated inhibition but only if the CD4 used remained susceptible to Nef-induced internalization." }, { "role": "assistant", "content": "These results support the hypothesis that cell-surface CD4 can interact with the envelope protein present on budding HIV-1 virions to inhibit their release. The internalization and degradation of cell-surface CD4 induced by the viral Nef protein can fully reverse this inhibition and is, therefore, likely to facilitate the spread of virus in vivo. 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, Anisotropy, Brain, Cerebral Small Vessel Diseases, Cognition, Cognition Disorders, Cross-Sectional Studies, Diffusion Tensor Imaging, Executive Function, Female, Humans, Leukoaraiosis, Magnetic Resonance Imaging, Male, Nerve Fibers, Myelinated, Neural Pathways, Neuropsychological Tests, Regression Analysis, Severity of Illness Index, Time Factors." }, { "role": "user", "content": "Is structural network efficiency associated with cognitive impairment in small-vessel disease? Context: To characterize brain network connectivity impairment in cerebral small-vessel disease (SVD) and its relationship with MRI disease markers and cognitive impairment. A cross-sectional design applied graph-based efficiency analysis to deterministic diffusion tensor tractography data from 115 patients with lacunar infarction and leukoaraiosis and 50 healthy individuals. Structural connectivity was estimated between 90 cortical and subcortical brain regions and efficiency measures of resulting graphs were analyzed. Networks were compared between SVD and control groups, and associations between efficiency measures, conventional MRI disease markers, and cognitive function were tested. Brain diffusion tensor tractography network connectivity was significantly reduced in SVD: networks were less dense, connection weights were lower, and measures of network efficiency were significantly disrupted. The degree of brain network disruption was associated with MRI measures of disease severity and cognitive function. In multiple regression models controlling for confounding variables, associations with cognition were stronger for network measures than other MRI measures including conventional diffusion tensor imaging measures. A total mediation effect was observed for the association between fractional anisotropy and mean diffusivity measures and executive function and processing speed." }, { "role": "assistant", "content": "Brain network connectivity in SVD is disturbed, this disturbance is related to disease severity, and within a mediation framework fully or partly explains previously observed associations between MRI measures and SVD-related cognitive dysfunction. These cross-sectional results highlight the importance of network disruption in SVD and provide support for network measures as a disease marker in treatment studies. 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": "Pulmonary eosinophilia is seen in the following parasitic infections except -" }, { "role": "assistant", "content": "The correct answer is pulmonary eosinophilia is caused by Strongyloidiasis: Paragonimiasis: Toxocariasis:" } ]

[ { "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, Atrial Fibrillation, Cardiac Surgical Procedures, Causality, Comorbidity, Early Diagnosis, Echocardiography, Elasticity Imaging Techniques, Female, Humans, Incidence, Male, Postoperative Complications, Prognosis, Reproducibility of Results, Risk Factors, Sensitivity and Specificity, Spain, Survival Rate, Treatment Outcome, Ventricular Dysfunction, Left." }, { "role": "user", "content": "Does early Transthoracic Echocardiography after Cardiac Surgery predict Postoperative Atrial Fibrillation? Context: Postoperative atrial fibrillation (POAF) is frequent after cardiac surgery. We aimed to establish a predictive model of POAF based on postoperative transthoracic echocardiography (TTE) findings. This study included 147 patients (aged 67 ± 11 years; 109 men) undergoing coronary artery bypass grafting and/or aortic valve replacement. TTE and Doppler tissue imaging were performed on intensive care unit arrival after surgery. All patients were continuously monitored during hospitalization. The end point was the appearance of POAF. POAF appeared in 37 patients (25.2%). These patients were older (69 ± 16 vs. 65 ± 12 years; P < 0.001) and had increased long axis of the left atrium (LA) dimension (5.4 ± 1 vs. 4.8 ± 0.9 cm, P = 0.02), lower early diastolic velocity of the mitral annulus (e') (6.9 ± 2.1 vs. 8 ± 1.8 cm/sec; P < 0.01), and higher early diastolic pulsed Doppler mitral ratio (E)/e' (E/e') (17.4 ± 6.8 vs. 13.8 ± 6; P = 0.01). Left ventricle diastolic dysfunction grade (DFG) of 2 or 3 relative to grade 0 was significant: odds ratio (OR) 22.5, 95% confidence interval (CI) 4.52-57.2; P < 0.001, and OR: 23.6, 95% CI: 3.57-60.1; P = 0.001), respectively. On multivariate analysis, the independent predictors of POAF were age (OR: 1.10, 95% CI: 1.01-1.18; P < 0.05), long-axis LA dimension (OR: 6.24, 95% CI: 1.97-8.23; P = 0.0017), DFG-2 (OR: 4.1, 95% CI: 1.57-15.81; P < 0.001), and DFG-3 (OR: 8.3, 95% CI: 4.11-25.37; P < 0.001)." }, { "role": "assistant", "content": "Apart from age, the simple determination by postoperative TTE of long-axis LA dimension and DFG after cardiac surgery proved to be powerful independent predictors of POAF and may be useful for risk stratification of these patients. 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": "True about atrioventricular groove are all except ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Contains left anterior descending coronary aeryGrooves (sulci) of heaA) Atrioventricular grooveAtria are separated by ventricles by atrioventricular Sulcus (atrioventricular groove, also called coronary sulcus).It is divided into anterior and posterior pas. The right half of anterior pa is large and lodges right coronary aery. Left half of anterior pa is small and lodges circumflex branch of left coronary aery.B) Interventricular groovesRight and left ventricles are separated by interventricular grooves.Anterior interventricular groove is nearer to left margin of hea and contains anterior interventricular aery (also called left anterior descending aery).Posterior interventricular groove is situated on diaphragmatic (inferior) surface. It contains posterior interventricular aery (continuation of RCA)." } ]

[ { "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, African Americans, Asian Americans, Breast Feeding, Choice Behavior, Ethnic Groups, European Continental Ancestry Group, Feeding Behavior, Female, Hispanic Americans, Humans, Infant Formula, Infant, Newborn, Intention, Mothers, Parity, Pregnancy, Self Efficacy, Young Adult." }, { "role": "user", "content": "Does comfort with the idea of formula feeding help explain ethnic disparity in breastfeeding intentions among expectant first-time mothers? Context: Little is known regarding modifiable factors that may explain sociodemographic disparities in breastfeeding rates among women in the United States. Using a mediation model approach, we examined the relative contributions of breastfeeding and formula feeding psychosocial factors in explaining disparities in breastfeeding intentions. We interviewed 532 expectant first-time mothers regarding exposure to breastfeeding by others (breastfeeding exposure), comfort with ideas of breastfeeding (breastfeeding comfort) and formula feeding (formula feeding comfort), and breastfeeding self-efficacy. We used logistic regression to evaluate the independent and mediating effects of these variables on strength of intention to fully breastfeed for 6 months (breastfeeding intention). The ethnic distribution of the sample was 41% white, non-Hispanic; 27% Hispanic; 14% African-American; 12% Asian; and 6% mixed or other ethnicity. In the overall sample, formula feeding comfort, breastfeeding comfort, and breastfeeding self-efficacy all independently predicted breastfeeding intention (p < 0.0001), but formula feeding comfort had the largest effect: adjusted odds of stronger breastfeeding intention increased threefold for each 1-level decrease (among four levels) in formula feeding comfort. The unadjusted odds (95% confidence interval) of stronger breastfeeding intention were 0.37 (0.24-0.58) for African-American versus non-African-American women; African-American women had higher formula feeding comfort (2.08 [1.32-3.29]) but similar breastfeeding comfort, breastfeeding self-efficacy, and breastfeeding exposure. Formula feeding comfort mediated 37% of the disparity in breastfeeding intentions between African-American and non-African-American women." }, { "role": "assistant", "content": "Formula feeding comfort strongly predicted and substantially mediated ethnic disparity in breastfeeding intention. These results suggest that research and public health efforts aimed at increasing exclusive breastfeeding rates should include consideration of formula feeding attitudes. 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: ." }, { "role": "user", "content": "Does mild hypothermia reduce expression of Fas/FasL and MMP-3 after cerebral ischemia-reperfusion in rats? Context: To investigate the effects of local mild hypothermia on the expression of Fas, FasL and MMP-3 after cerebral ischemia-reperfusion in rats. Male Wistar rats were divided into sham-operated group (Sham), normothermia group (NT), and hypothermia group (HT). MCAO/R model was established by Longa's method, and reperfusion was allowed after 2 hr occlusion. Mild hypothermia (33±0.5°C) for 6 hr was initiated at the start of reperfusion. Immunohistochemistry was performed to determine expression Fas, FasL, and MMP-3. Infarct volume was reduced in the hypothermia group (18.43±4.23%) compared with the normothermia group (24.76±5.76%) (P<0.05). In mild hypothermia group, numbers of Fas-positive and MMP-3 positive cells were significantly less than those of normothermia group (P<0.05). Neurological functional scores of mild hypothermia were significantly improved (P<0.05)." }, { "role": "assistant", "content": "Mild hypothermia decreases infarct volume after cerebral ischemia-reperfusion, reduces Fas and MMP-3 expression, but increases FasL in cerebral ischemia-reperfusion rats. 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: Anesthesia, Animals, Atrial Natriuretic Factor, Diaphragm, Ganglia, Sympathetic, Heart, Hemodynamics, Male, Muscle Tonus, Physical Stimulation, Rats, Rats, Wistar, Signal Transduction, Stomach, Vagotomy." }, { "role": "user", "content": "Does atrial stretch increase the gastric tonus of anesthetized rats? Context: We assessed the effects of right atrial stretch on gastric tone and neuro-humoral pathways involved in this phenomenon. Anesthetized male rats were submitted for monitoring of the mean arterial pressure (MAP) and central venous pressure (CVP). A balloon catheter positioned into the stomach monitored by plethysmography the gastric volume (GV). All rats were monitored for 55-min. After the first 20-min of monitoring (basal period), rats were either submitted to a 5-min interval of atrial stretch (AS) or maintained as controls. An intra-atrial balloon catheter was distended with 30, 50, or 70 microL of saline. GV and hemodynamic data were also monitored for a further 30-min. Another set of rats, either previously submitted to subdiaphragmatic vagotomy or splanchnicectomy plus celiac ganglionectomy or maintained as controls (sham), were also submitted to AS. Each subset consisted of six rats. The plasma level of the atrial natriuretic peptide (ANP) was measured in another group of rats. Data were compared by ANOVA followed by Bonferroni's test. In control rats, the GV, MAP, and CVP remained at stable levels throughout the studies. In addition to increase the CVP, AS also decreased (P<0.05) the GV by 14%, 11.5%, and 16.5% in the 30, 50, and 70 microL groups, respectively. Vagotomy prevented the GV decrease. In contrast, the AS decreased (P<0.05) the GV by 21.3% in splanchnicectomized rats." }, { "role": "assistant", "content": "AS decreased the GV of rats in a volume-dependent manner, a phenomenon prevented by vagotomy but enhanced by celiac ganglionectomy. 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: Adenine, Animals, Antibodies, Monoclonal, Antigen-Antibody Reactions, Antiviral Agents, CHO Cells, Cricetinae, Cricetulus, Drug Resistance, Multiple, Viral, Enzyme-Linked Immunosorbent Assay, Epitope Mapping, Gene Expression Regulation, Enzymologic, Gene Expression Regulation, Viral, Gene Products, pol, Guanine, Hepatitis B Antibodies, Hepatitis B Surface Antigens, Hepatitis B virus, Humans, Immunodominant Epitopes, Lamivudine, Mutagenesis, Site-Directed, Mutation, Organophosphonates, Transfection." }, { "role": "user", "content": "Do antiviral resistance mutations potentiate hepatitis B virus immune evasion through disruption of its surface antigen a determinant? Context: The hepatitis B virus (HBV) pol gene overlaps the S gene encoding surface antigen (HBsAg). It has been reported previously that drug-induced changes in HBsAg alter its binding to sera from humans immunized against HBV. We investigate here the changes to specific epitopes in the a determinant (the major target of neutralizing antibody) caused by a number of drug-resistant mutations. Recombinant HBsAgs, produced by transfection of Chinese hamster ovary cells with S gene plasmids into which lamivudine, adefovir and entecavir resistance and common antibody-escape mutations had been introduced, were probed with monoclonal antibodies to epitopes in the first and second loops of the a determinant. The mutations rtF166L/sF158Y (lamivudine-associated, compensatory) and rtl169T/sF161L (entecavir-associated, primary) acting alone, and the mutations rtV173L/sE164D (lamivudine-associated, compensatory) and rtSilent/sD144E (antibody escape-associated) each when combined with rtM204V/sl195M (lamivudine-associated, primary) led to decreases in antibody reactivity to epitopes in the first or second loop, or in both loops. The rtM204V/sl195M + rtV173L/sE164D mutations yielded an epitope-antibody profile similar to the rtR153Q/sG145R vaccine escape mutant. The rtM204V/sl195M mutation combined with the rtF166L/sF158Y or rtR153Q/sG145R mutation restored reactivity to second-loop epitopes previously abrogated by single mutations." }, { "role": "assistant", "content": "Mutations associated with resistance to nucleos(t)ide analogue therapy, singly or in combination with each other or antibody escape-associated mutations, alter HBsAg immunoreactivity through concomitant amino acid substitutions at codons within and downstream of the a determinant. The findings have implications for understanding the native structure of HBsAg, optimizing treatment of chronic hepatitis B and evaluating the success of immunization programmes. 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, RESULTS. Meshes: ." }, { "role": "user", "content": "Do an update on the role of bariatric surgery in diabetes management? Context: To review the current state of knowledge on the effects of weight loss (bariatric) surgical procedures in individuals with type 2 diabetes. Observational and randomized studies provide robust data on the efficacy of bariatric surgery for weight loss and improvement in hyperglycemia. Follow-up information up to 20 years is now available. Surgery offers similar benefits in individuals with BMI 30-35, compared with those with higher BMI. There is a better understanding of the role of gut hormones and nonhormonal factors on weight loss and glucose metabolism. Preoperative factors that predict favorable surgical outcomes have been identified." }, { "role": "assistant", "content": "Of commonly performed procedures, adjustable gastric banding has the lowest efficacy for weight loss and diabetes remission and a higher complication rate. Roux-en-Y gastric bypass and sleeve gastrectomy are comparable in terms of efficacy and complications. Remission rates for diabetes range between 40 and 80%; randomized trials show slightly lower remission rates compared with observational studies. At 20 years, approximately 50% of remitters have relapse of diabetes. Complex gut hormonal changes, caloric restriction, and other intestinal factors form the basis for metabolic effects of surgery. Better preoperative β-cell function is the strongest predictor for remission. Long-term follow-up data is still sparse. 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": "Maximum amount of incisor retraction achieved is:" }, { "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": "Paogram helps in detecting" }, { "role": "assistant", "content": "The correct answer is Obstructed labour" } ]

[ { "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 one of the following is the most characteristic arrythmia with digitalis toxicity" }, { "role": "assistant", "content": "The correct answer is The classic features of digoxin toxicity are nausea, vomiting, abdominal pain, headache, dizziness, confusion, delirium, vision disturbance (blurred or yellow vision). It is also associated with cardiac disturbances including irregular heabeat, ventricular tachycardia, ventricular fibrillation, sinoatrial block and AV block Refer kDT 6/e p498" } ]

[ { "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: Animals, Blotting, Western, Cell Degranulation, Cells, Cultured, Glucuronidase, Heparin, Homeostasis, Mast Cells, Mice, Mice, Knockout, Mice, Transgenic, Polymerase Chain Reaction, Secretory Vesicles." }, { "role": "user", "content": "Does heparanase affect secretory granule homeostasis of murine mast cells through degrading heparin? Context: Heparanase degradation of heparan sulfate plays important roles in a number of pathological processes, including inflammation. In vitro experiments show that heparanase is capable of degrading heparin, a polysaccharide present in mast cells (MCs), in which it has a key role in promoting the storage of secretory granule compounds. We sought to investigate the functions of heparanase in MCs. Primarily cultured fetal skin-derived mast cells (FSMCs) isolated from embryos and adult peritoneal MCs were analyzed for storage and release of granule molecules in response to MC activation. FSMCs from heparanase-overexpressing mice contained substantially shorter heparin chains and significantly less proteases than control cells. Conversely, FSMCs lacking heparanase contained heparin of larger size and more proteases than control cells. Correspondingly, heparanase-overexpressing adult MCs exhibited reduced release of heparin-bound proteases, a finding that could be attributed to spontaneous release of granular compounds. Heparanase was found to be upregulated in MCs on activation." }, { "role": "assistant", "content": "These findings reveal a novel function of heparanase in maintaining MC homeostasis through controlled degradation of heparin present in the MC secretory granules. 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": "Patent formen ovale is due to failure of fusion of-" }, { "role": "assistant", "content": "The correct answer is Cessation of placental blood flow and the beginning of respiration leads to changes in the vascular system at bihStructure/Vessel Remnant (In Adults) Timing of Closure Ductus aeriosus Ligamentum aeriosumQ Almost immediately after bih, by bradykirdn (released during inital inflation of lung) mediated contraction of muscular wall. Actual obliteration takes 1-3monthsUmbilical aeries - Distal pa form medial umbilical ligaments - Proximal poion remains open as superior vesical aeriesFew minutes after bih (d/t thermal, mechanical & 02 tension change), athough actual fibrous obliteration may take 2-3 monthsUmbilical vein (left) Ductus venosus Ligamentum teres hepatis Ligament venosum Occurs sholy after that of umbilical aeriesSeptum prinum Septum secundum (lower free edge)Fossa ovalis Annulus ova us The first breath causes increased left atrial pressure pressing the septum primum against septum secundum Vt closure of ovalforamen. During 1st day its reversible and complete fusion takes about 1 year" } ]

[ { "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": "Involvement of the joints of hand is relatively uncommon in which of the following arthritis?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Ankylosing spondylitis Joints involved in ankylosing spondylitiso Ankylosing spondylitis primarily affects axial skeleton.o The disease usually begins in the sacro-iliac joints and usually extends upwards to involve the lumbar, thoracic, and often cervical spine.o In the worst cases the hips or shouldersare also affected. Hip joint is the most commonly affected peripheral joint.o Rarely knee and ankle are also involved." } ]

[ { "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: Brain Diseases, Central Nervous System Diseases, Cerebral Ventricles, Female, Fetal Diseases, Gestational Age, Humans, Magnetic Resonance Imaging, Pregnancy, Retrospective Studies." }, { "role": "user", "content": "In utero magnetic resonance of non-isolated ventriculomegaly: Does ventricular size or morphology reflect pathology? Context: Retrospective analysis of 40 in utero magnetic resonance (MR) examinations was undertaken. Ventricular size was measured on axial sections by two observers, and morphology was agreed by consensus. Results were analysed according to gestational age at referral, degree of Vm (mild 10-15 mm, moderate/severe>15 mm) and morphology. Nine cases had no Vm (mean gestational age 23.6 weeks, range 19-33), 17 had mild Vm (mean age 23.9 weeks, range 20-31), and 14 had moderate/severe Vm (mean age 25.9 weeks, range 20-35). All groups had a mix of morphology and pathology. Eighteen suspected cases of spina bifida were referred and 17 confirmed (mean age 22.6 weeks, range 19-30) using MR. The morphology was mixed, five cases (27.8%) had an angular appearance (this morphology was only seen in cases with spina bifida). Fourteen cases (77.8%) had Vm (eight mild, six severe). Of the thirteen cases of agenesis of the corpus callosum (ACC) suspected on ultrasound, seven were confirmed using MR (mean age 26.5 weeks, range 20-35). Of those seven cases with ACC confirmed on MR, and three additional cases only detected by in utero MR, five had colpocephaly, seven had Vm (four mild, three severe)." }, { "role": "assistant", "content": "Severity of Vm did not reflect the type, or presence, of underlying pathology. Morphology appears an indicator of pathology. Angular ventricles should initiate a search for spinal defects. Colpocephaly may indicate ACC." } ]

[ { "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, Dominance, Cerebral, Electric Stimulation, Humans, Memory, Middle Aged, Prefrontal Cortex, Transcranial Magnetic Stimulation." }, { "role": "user", "content": "Does transcranial magnetic stimulation of left prefrontal cortex impair working memory? Context: Several lines of evidence suggest that the prefrontal cortex is involved in working memory. Our goal was to determine whether transient functional disruption of the dorsolateral prefrontal cortex (DLPFC) would impair performance in a sequential-letter working memory task. Subjects were shown sequences of letters and asked to state whether the letter just displayed was the same as the one presented 3-back. Single-pulse transcranial magnetic stimulation (TMS) was applied over the DLPFC between letter presentations. TMS applied over the left DLPFC resulted in increased errors relative to no TMS controls. TMS over the right DLPFC did not alter working memory performance." }, { "role": "assistant", "content": "Our results indicate that the left prefrontal cortex has a crucial role in at least one type of working memory. 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": "All are TRUE about Goodpasture's syndrome, EXCEPT:" }, { "role": "assistant", "content": "The correct answer is Goodpasture's syndrome appears in young men in their late 20s and in men and women in their 60-70s. Hemoptysis is largely confined to smokers. The patients present with lung hemorrhage as a group do better than older populations who have prolonged, asymptomatic renal injury. The performance of an urgent kidney biopsy is impoant in suspected cases of Goodpasture's syndrome. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 2342" } ]

[ { "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, MATERIAL AND METHODS, RESULTS, DISCUSSION. Meshes: Adolescent, Adult, Aged, Athletic Injuries, Child, Child, Preschool, Denmark, Facility Design and Construction, Humans, Middle Aged, Protective Devices, Skating, Surveys and Questionnaires." }, { "role": "user", "content": "Are ice-skating ramps dangerous? Context: Before the new temporary ice rink in Esbjerg was built, opponents feared that it would disproportionately increase the number of traumas needing medical care at the hospital. The reason for this concern was that it was built with ramps. During the winter of 2004 an estimated 30,000 people visited the two ice rinks in Esbjerg. The temporary rink had ramps, whereas the permanent rink had no ramps. A total of 104 persons were injured and needed treatment at the emergency room of orthopaedic surgery. They all received a questionnaire in order to obtain information about a) whether the accident took place on one or the other ice rink, and b) how frequently safety equipment was used. The answers from the questionnaire were used along with information obtained from the emergency room journals. We wanted to establish if accidents on the temporary ice rink were more serious or if the proportion of injuries was higher compared to accidents on the permanent ice rink. There was no significant difference in the number of injuries or in the severity of the traumas resulting from skating on the temporary ice rink compared with the permanent rink. Only 4% used safety equipment." }, { "role": "assistant", "content": "Having ramps on the ice rink produced no significant increase in the proportion of injuries, nor did it produce more severe traumas. Safety equipment protecting hand and wrist would probably decrease the number of soft tissue injuries presented at hospital." } ]

[ { "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. Meshes: Adolescent, Adult, Algorithms, Alkanesulfonic Acids, Androgens, Blood Proteins, Caprylates, Cross-Sectional Studies, Denmark, Endocrine Disruptors, Environmental Exposure, Environmental Pollution, Fluorocarbons, Humans, Luteinizing Hormone, Male, Reproducibility of Results, Semen, Semen Analysis, Testosterone, Young Adult." }, { "role": "user", "content": "Is pFOS ( perfluorooctanesulfonate ) in serum negatively associated with testosterone levels , but not with semen quality , in healthy men? Context: Is exposure to perfluorinated compounds (PFCs) associated with testicular function (reproductive hormone levels and semen quality) in healthy men?" }, { "role": "assistant", "content": "PFOS levels were significantly negatively associated with serum testosterone (total and calculated free), but not with any other reproductive hormones or semen quality. 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, OBJECTIVE, METHODS, RESULTS. Meshes: Adenocarcinoma, Adult, Aged, Aged, 80 and over, Female, Gastrectomy, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Retrospective Studies, Risk Factors, Stomach Neoplasms, Survival Analysis." }, { "role": "user", "content": "Do conventional clinical and pathological features fail to accurately predict recurrence in patients with gastric cancer staged N0? Context: Despite the medical-surgical advances, even after R0 gastric resections, some patients without apparent metastatic disease develop cancer recurrence and eventually die. We aimed to define recurrence in patients with node-negative gastric adenocarcinoma and to determine whether any clinicopathological features are predictive for recurrence. This was a retrospective cohort study on patients with gastric adenocarcinoma, consecutively diagnosed at our institution, staged as N0M0 between January 2000 and December 2008. We recruited 129 patients; 53% were men and 56% were older than 60 years. A total of 22% of the patients developed recurrence, with a mortality rate of 93%. Overall, 71% of the patients, N0, with recurrence presented lymphatic permeation. In univariate analysis, on comparing recurrent patients with those with no recurrence, age, size, T status, lymphatic, and venous permeation were factors that were associated significantly with recurrence, but in multivariate analysis, only age (odds ratio:19.5; 95% confidence interval: 2.3-168; P=0.008) and venous permeation (odds ratio: 6.34; 95% confidence interval: 1.8-22.8; P=0.005) were associated with recurrence. On the basis of only these two factors, the proportion of missed recurrent patients by age and venous permeation was 13 and 39%, respectively." }, { "role": "assistant", "content": "A total of 22% of patients, N0, developed recurrence of their disease. Age and venous permeation were independent risk factors for recurrence, but on the basis of these factors, up to 40% of patients may be missed for recurrence. New methods to predict recurrence are needed. 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, OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Antineoplastic Agents, Cell Line, Tumor, Chemokines, Female, Humans, Interferon alpha-2, Interferon-alpha, Interferon-gamma, Macrophages, Male, Matrix Metalloproteinases, Middle Aged, Mycosis Fungoides, Phenotype, Polyethylene Glycols, Recombinant Proteins, Skin Neoplasms, Tumor Microenvironment." }, { "role": "user", "content": "Do tumor-associated M2 macrophages in mycosis fungoides acquire immunomodulatory function by interferon alpha and interferon gamma? Context: Tumor-associated M2 macrophages (TAMs) produce chemokines that affect the formation of cutaneous T-cell lymphoma (CTCL) by stromal factors. Since IFNs are an effective treatment for advanced-stage mycosis fungoides (MF), we hypothesized that IFNs might modulate M2 macrophages. To prove our hypothesis, we stimulated monocyte-derived M2 macrophages with IFN-α2a or IFN-γ and examined the mRNA expression of chemokines. By using a microarray, we selected a series of chemokines and MMPs that were strongly connected with the IL-4 stimulation. Then, we investigated the effects of IFN-α2a and IFN-γ on these chemokines. IFN-α2a and IFN-γ decreased the expression and production of CCL17 and CCL18 and increased those of CXCL10 and CXCL11. Moreover, the subcutaneous administration of IFN-α2a increased the CXCL11-producing cells in the lesional skin of patients with advanced MF." }, { "role": "assistant", "content": "Our data suggest one possible mechanism of the therapeutic effects of IFNs through TAMs for the treatment of advanced-stage MF. 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: Biomarkers, Tumor, Cell Nucleus, DNA-Binding Proteins, Humans, Immunohistochemistry, Infant, Microarray Analysis, Neoplasm Staging, Neuroblastoma, Nuclear Proteins, Risk Factors, Y-Box-Binding Protein 1." }, { "role": "user", "content": "Is y-box-binding protein-1 a potential novel tumour marker for neuroblastoma? Context: The Y-box-binding protein-1 (YB-1) is a member of a family of DNA-binding proteins and an oncogenic transcription factor that is highly expressed in cancers of the breast, lung and prostate. To date, no data are available on its role in neuroblastoma. The aim of the present study was to evaluate the YB-1 expression in neuroblastoma. A tumour tissue microarray (TMA) was constructed from 36 neuroblastoma samples which were analysed by immunohistochemistry for YB-1 expression. Expression of YB-1 was detected in 35 of 37 (94.6%) neuroblastoma cases examined. Nevertheless, no correlation of YB-1 expression with survival, risk factors or stage of the disease was observed." }, { "role": "assistant", "content": "As the majority of neuroblastomas express YB-1, this protein may play an important role in tumour pathogenesis. The results of this study suggest that YB-1 may serve as a novel immune marker for neuroblastoma and may be potentially useful as a therapeutic target. 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, OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Aged, 80 and over, Animals, Bacterial Toxins, Bronchitis, Cohort Studies, Disease Models, Animal, Female, Hemolysin Proteins, Humans, Male, Methicillin-Resistant Staphylococcus aureus, Mice, Middle Aged, Pneumonia, Ventilator-Associated, Risk Factors, Staphylococcal Infections, Staphylococcus aureus, Virulence Factors." }, { "role": "user", "content": "Does α-Hemolysin activity of methicillin-susceptible Staphylococcus aureus predict ventilator-associated pneumonia? Context: Colonization of lower airways by Staphylococcus aureus is a risk factor for the development of ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia (VAP). However, little is known about the virulence factors of methicillin-sensitive and -resistant S. aureus (MSSA and MRSA) that may influence host colonization and progression to VAT and VAP. We evaluated MRSA and MSSA endotracheal aspirates (ETA) for genotype and α-hemolysin activity in relation to the development of VAT and VAP. Serial S. aureus ETA isolates from ventilated patients were analyzed for methicillin resistance, molecular type by Multi-Locus Sequence Typing and spa-typing, and α-hemolysin activity by semiquantitative analysis of hemolysis on sheep blood agar and quantitative measurement of cytolysis of human lung epithelial cells. The virulence of selected strains was assessed in mice by intranasal challenge. We detected S. aureus from ETA samples in a quarter of the 231 ventilated patients analyzed; one-third of them developed VAP. VAP patients (n = 15) were mainly infected by MSSA strains (87%), whereas colonized individuals (n = 18) not progressing to disease mainly carried MRSA strains (68%). MSSA isolates from colonized or VAT patients exhibited significantly lower α-hemolysin activity than those from VAP cases; however, no such relationship was found with MRSA strains. α-Hemolysin activity of S. aureus isolates was predictive for virulence in mouse pneumonia model." }, { "role": "assistant", "content": "MSSA strains with strong blood agar hemolysis and high α-hemolysin activity are markers for VAP, but not VAT, and might be considered in differential diagnosis and initiation of 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": "An adult old man gets burn injury to his hands .over few weeks .the burner skin heals without the need for skin grafting . The most impoant critical factor responsible for rapid healing in this case is" }, { "role": "assistant", "content": "The correct answer is ref baley and love 23/e p189 Burn wounds of the skin result in a rupture of the cutaneous barrier that can have serious consequences such as loss of proteins and body fluids, infection, and death (Figure 65.1). Moreover, chronic wounds or improper scarring and the development of skin cancers (Owens and Watt, 2003; Perez-Losada and Balmain, 2003). A first-degree burn wound affects only the epidermis and heals spontaneously without scarring; the reconstitution of epidermal integrity results from the migration and the proliferation of <a style=\"box-sizing: border-box; margin: 0px; padding: 0px; background-color: transparent; overflow-x: auto; color: ; transition: color 0.3s ease 0s, border-bottom-color 0.3s ease 0s; text-decoration-line: none;\" title=\"Learn more about Keratinocyte from ScienceDirect's AI-generated Topic Pages\" href=\" from the nearby epidermis or appendages</span>" } ]

[ { "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, Breast Neoplasms, Female, Humans, Lymph Nodes, Lymphatic Metastasis, Middle Aged, Radionuclide Imaging, Radiopharmaceuticals, Retrospective Studies, Sentinel Lymph Node Biopsy, Technetium Tc 99m Sulfur Colloid." }, { "role": "user", "content": "Does use of radiotracer for sentinel lymph node mapping in breast cancer optimize staging independent of site of administration? Context: In an effort to optimize sentinel lymph node (SLN) mapping for breast cancer, sites of mapping agent administration and types of mapping agents used continue to be evaluated. This study compares SLN mapping using peritumoral (PT) or subareolar (SA) injection of radiolabeled colloid and examines the relative contributions of radiotracer and blue dye to SLN identification. A retrospective review was performed of 456 patients with breast cancer and clinically negative axillae who underwent SLN mapping. Sequential groups of patients were injected with filtered Tc-99m SC, 326 peritumorally (group 1) and 130 subareolarly (group 2). All patients had intraoperative SA injection of 1% isosulfan blue dye. The SLN identification and isotope success rates were 97% and 96% in group 1 and 98% and 98% in group 2, respectively. Eighty-one patients (25%) in group 1 and 44 patients (34%) in group 2 had positive SLNs. Of these patients, 15% from group 1 and 14% from group 2 had only positive nodes detected by radiotracer, and 9 of these patients (6 from group 1 and 3 from group 2) had other nodes identified by both radiotracer and blue dye that were negative for metastases. Six percent of patients with positive SLNs were upstaged because of use of radiotracer." }, { "role": "assistant", "content": "PT and SA injection of radiotracer have comparable success rates for axillary SLN identification. Given that 15% of patients in group 1 and 14% in group 2 had only positive SLNs detected by radiotracer, independent of site of administration, radiotracer remains essential for optimizing breast SLN mapping. 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 case of glomerulonephritis (GN) , C3 is normal in all the following except?" }, { "role": "assistant", "content": "The correct answer is Low C3 nephritis is observed in: Post-infectious GN, MPGN(Membranoproliferative GN) SLE Subacute bacterial endocarditis Cryoglobulinemia, shunt nephritis" } ]

[ { "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": "Excessive eating of non-nutritive substances is known as?" }, { "role": "assistant", "content": "The correct answer is Ans. a (PICA). (Ref. O.P Ghai, 6th/pg.p 58)PICA# PICA is a disorder involving repeated or chronic ingestion of non-nutritive substances including plaster, charcoal, clay, wood, ashes and earth.# PICA after 2nd year of life needs to be investigated.# MR, lack of parental nurturing, autism, and behavior disorders like Kleine-Terin syndrome, family disorganization, low socioecomy.# Geophagia (earth eating) is seen with pregnancy.# Here patient develops craving for substance such as- Starch (amylophagia),- Ice (pagophagia) &- Clay (geophagia) these symptoms are peculiar i.e. Characteristic of iron deficiency.# Some of these materials such as starch & clay bind iron in the gastrointestinal tract, worsening the deficiency.# The basis of this bizarre behavior is unknown.# A particularly invidious consequence of iron deficiency, is increased by intestinal absorption of lead.# Children from impoverished families who often have both iron deficiency & pica are at greatest risk of developing lead poisoning.# The toxicity of lead is at least in part due to a disruption of hemesynthesis in neural tissue, a process abetted by iron deficiency.# Thus, these children are at increased risk of lead poisoning, iron deficiency anemia and parasitic infection." } ]

[ { "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, Glycated Hemoglobin A, Humans, Intra-Abdominal Fat, Longitudinal Studies, Male, Middle Aged, Smoking, Triglycerides." }, { "role": "user", "content": "Do the Associations Between Smoking Habits and Serum Triglyceride or Hemoglobin A1c Levels Differ According to Visceral Fat Accumulation? Context: Whether smokers and former smokers have worse lipid profiles or glucose levels than non-smokers remains unclear. The subjects were 1152 Japanese males aged 42 to 81 years. The subjects were divided according to their smoking habits (nonsmokers, former smokers, and current smokers) and their visceral fat area (VFA) (<100 cm(2) and ≥100 cm(2)). The serum triglyceride (TG) levels of 835 males were assessed. In the VFA ≥100 cm(2) group, a significantly greater proportion of current smokers (47.3%) exhibited TG levels of ≥150 mg/dL compared with former smokers (36.4%) and non-smokers (18.8%). The difference in TG level distribution between former smokers and non-smokers was also significant. However, among the subjects with VFA of <100 cm(2), the TG levels of the three smoking habit groups did not differ. The serum hemoglobin A1c (HbA1c) levels of 877 males were also assessed. In the VFA <100 cm(2) group, significantly higher proportions of current smokers (17.9%) and former smokers (14.9%) demonstrated HbA1c levels of ≥5.6% compared with non-smokers (6.3%). In contrast, in the VFA ≥100 cm(2) group, significantly fewer former smokers displayed HbA1c levels of ≥5.6% compared with non-smokers and current smokers. Furthermore, the interaction between smoking habits and VFA was associated with the subjects' TG and HbA1c concentrations, and the associations of TG and HbA1c concentrations and smoking habits varied according to VFA." }, { "role": "assistant", "content": "Both smoking habits and VFA exhibited associations with TG and HbA1c concentrations. The associations between smoking habits and these parameters differed according to VFA. 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, Anti-Allergic Agents, Cell Line, Tumor, Cyclooxygenase 2, Dinitrophenols, Dose-Response Relationship, Drug, Enzyme Activation, Histamine Release, Hypersensitivity, Immediate, Lignans, Mast Cells, Phosphorylation, Prostaglandin D2, Protein Kinase C beta, Protein Kinase C-alpha, Rats, Serum Albumin, Signal Transduction, Time Factors, Tumor Necrosis Factor-alpha, p38 Mitogen-Activated Protein Kinases." }, { "role": "user", "content": "Is licarin A a candidate compound for the treatment of immediate hypersensitivity via inhibition of rat mast cell line RBL-2H3 cells? Context: We previously demonstrated that some phenylpropanoids are capable of inhibiting activated mast cells. This study evaluated the anti-allergic effects of licarin A, a neolignan isolated from various plants, on antigen-stimulated rat mast cell line. The inhibitory effects of licarin A on histamine release, tumour necrosis factor-α (TNF-α) and prostaglandin D2 (PGD2) production, and cyclooxygenase-2 (COX-2) expression in dinitrophenyl-human serum albumin (DNP-HSA) rat basophilic leukemia cells (DNP-HSA-stimulated RBL-2H3 cells), were investigated by spectrofluorometry, ELISA and immunoblotting. Licarin A significantly and dose-dependently reduced TNF-α production (IC50 12.6 ± 0.3 μm) in DNP-HSA-stimulated RBL-2H3 cells. Furthermore, the levels of PGD2 secretion in DNP-HSA-stimulated cells pretreated with licarin A were lower than those stimulated with DNP-HSA alone (positive control). Treatment with licarin A at 20 μm produced slight suppression of DNP-HSA-induced increases in COX-2 mRNA and protein levels. We identified several signalling pathways that mediated these pharmacological effects. Licarin A treatment tended to reduce phosphorylated protein kinase C alpha/beta II (PKCα/βII) and p38 mitogen-activated protein kinase (MAPK) protein levels." }, { "role": "assistant", "content": "Our results demonstrate that licarin A reduces TNF-α and PGD2 secretion via the inhibition of PKCα/βII and p38 MAPK pathways; this compound may be useful for attenuating immediate hypersensitivity. 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": "Neurofibromatosis presents as all of the following except -" }, { "role": "assistant", "content": "The correct answer is • Elephantiasis neuromatosa is the most impressive manifestation of NF-1." } ]

[ { "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, Adrenergic beta-Agonists, Adult, Albuterol, Asthma, Exercise-Induced, Bronchoconstriction, Bronchodilator Agents, Drug Tolerance, Female, Humans, Hydrocarbons, Fluorinated, Male." }, { "role": "user", "content": "Does proventil HFA provide protection from exercise-induced bronchoconstriction comparable to proventil and ventolin? Context: During the 1970s, scientists suggested that the growing use of chlorofluorocarbons (CFCs) was contributing to depletion of the stratospheric ozone layer with potentially harmful results. A committee on the ozone layer organized the preparation of the Montreal Protocol. This protocol mandated the cessation of production and use of CFCs by January 1, 1996. The primary exemption to this ban is for the use of CFCs as propellants in metered dose inhalers (MDIs) for the treatment of asthma. Suitable replacement hydrofluoroalkane (HFA) propellants, such as HFA-134a, for use in MDIs have been identified. Albuterol, a selective beta-adrenergic agonist, currently widely available for inhalation asthma therapy, has been reformulated in HFA-134a (Proventil HFA). OBJECTIVE; To compare the efficacy of Proventil HFA to Ventolin, Proventil, and placebo (HFA-134a) MDI in protecting asthmatic patients from exercise-induced bronchoconstriction. This was a randomized, single-blind, placebo-controlled, 4-period crossover study of asthmatic patients with documented exercise-induced broncho-constriction. Twenty patients self administered two puffs of either Proventil HFA, Ventolin, Proventil or placebo, from an MDI, 30 minutes prior to performing a standardized exercise challenge at the study site. Spirometry was performed predose and 5, 10, 15, 30, 45, 60, 75, and 90 minutes after completion of the exercise challenge. Heart rate and blood pressure were measured just prior to spirometry and a 12-lead ECG was performed 15 minutes after completion of the exercise challenge for measurement of the QT corrected interval. The primary efficacy variable was the smallest percent change from the predose FEV1 following exercise. The smallest percent change from predose FEV1 for Proventil HFA was 2.0 +/- 9.9 SD, similar to the 2.0 +/- 11.4 SD for Ventolin, and the 3.6 +/- 10.2 SD for Proventil. The smallest percent change from predose FEV1 for each of the active treatments was significantly different from placebo, -23.7 +/- 14.5. Twelve of the patients had a > or = 20% fall in FEV1 post-exercise with placebo pretreatment, but only 1, 1, and 0 had > or = 20% FEV1 falls after treatment with Proventil HFA, Ventolin, and Proventil respectively. Changes in heart rate, blood pressure and QT corrected interval were similar for the three active treatments following exercise." }, { "role": "assistant", "content": "Proventil HFA provides protection against exercise-induced bronchoconstriction comparable to Ventolin and Proventil and protection superior to placebo. Proventil HFA has a safety profile similar to Ventolin when used to prevent exercise-induced bronchoconstriction. 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, RESULTS. Meshes: Angiotensin II, Angiotensin II Type 1 Receptor Blockers, Angiotensin II Type 2 Receptor Blockers, Angiotensin Receptor Antagonists, Animals, Antihypertensive Agents, Atrial Fibrillation, Atrial Function, Benzimidazoles, Captopril, Dogs, Female, Heart Conduction System, Male, Myocardium, Pacemaker, Artificial, Receptor, Angiotensin, Type 1, Receptor, Angiotensin, Type 2, Receptors, Angiotensin, Sinoatrial Node, Tetrazoles, Time Factors." }, { "role": "user", "content": "Does angiotensin II antagonist prevent electrical remodeling in atrial fibrillation? Context: The blockade of angiotensin II (Ang II) formation has protective effects on cardiovascular tissue; however, the role of Ang II in atrial electrical remodeling is unknown. The purpose of this study was to investigate the effects of candesartan and captopril on atrial electrical remodeling. In 24 dogs, the atrial effective refractory period (AERP) was measured before, during, and after rapid atrial pacing. Rapid atrial pacing at 800 bpm was maintained for 180 minutes. The infusion of saline (n=8), candesartan (n=5), captopril (n=6), or Ang II (n=5) was initiated 30 minutes before rapid pacing and continued throughout the study. In the saline group, AERP was significantly shortened during rapid atrial pacing (from 149+/-11 to 132+/-16 ms, P<0.01). There was no significant difference in AERP shortening between the saline group and the Ang II group. However, in the candesartan and captopril groups, shortening of the AERP after rapid pacing was completely inhibited (from 142+/-9 to 147+/-12 ms with candesartan, from 153+/-15 to 153+/-14 ms with captopril, P=NS). Although rate adaptation of the AERP was lost in the saline group, this phenomenon was preserved in the candesartan and captopril groups." }, { "role": "assistant", "content": "The inhibition of endogenous Ang II prevented AERP shortening during rapid atrial pacing. These results indicate for the first time that Ang II may be involved in the mechanism of atrial electrical remodeling and that the blockade of Ang II may lead to the better therapeutic management of human atrial fibrillation. 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: PURPOSE, METHODS, RESULTS. Meshes: Child, Child Care, Health Policy, Humans, Nutritional Status, Oral Health, United States." }, { "role": "user", "content": "Are state child care regulations meeting national oral health and nutritional standards? Context: The purpose of this study was to review of US state child care center regulations on oral health and nutrition as related to early childhood caries (ECC). Child care center regulations for the 50 states and the District of Columbia, as of April 2010, were audited for their inclusion of 8 oral health and 11 nutrition topics related to the development of or care for ECC. The topics are based on selected recommended standards from Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Out-of-Home Child Care Programs. On average, states had 2.6 (±1.7 SD; range=0-6) of the oral health standards and 5.9 (±2.5; range=1-11) of the nutritional standards included in their regulations. States varied greatly on the content covered. Seven states did not include any of the reviewed oral health topics. The 2 least covered regulations for oral health were \"toothbrush maintenance\" (4 states) and \"oral health screening\" (5 states)." }, { "role": "assistant", "content": "The weakness of coverage in child care center regulations for early childhood caries prevention calls to strengthen these policies for their potential to improve the oral health and obesity status of US children." } ]

[ { "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, Feasibility Studies, Female, Humans, Hysterectomy, Lymph Node Excision, Lymph Nodes, Lymphatic Metastasis, Middle Aged, Phytic Acid, Radionuclide Imaging, Technetium, Uterine Cervical Neoplasms." }, { "role": "user", "content": "Is sentinel node detection with ( 99m ) Tc phytate alone satisfactory for cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy? Context: If the sentinel-lymph-node (SLN) concept is valid in cervical cancer, most patients could avoid pelvic lymphadenectomy when absence of metastasis is intraoperatively confirmed in the SLN. We assessed feasibility and accuracy of SLN detection using (99m)Tc phytate in patients with cervical cancer. Eighty-two women with stage Ia-IIb cervical cancer enrolled in this study. All underwent hysterectomy or trachelectomy with accompanying total pelvic lymphadenectomy. On the day before surgery, we injected fluid containing (99m)Tc-labeled phytate subepithelially into four cervical quadrants outside the tumor. Intraoperatively, SLNs were identified as radioactive \"hot nodes\" by gamma probe. Systematic bilateral pelvic lymphadenectomy was performed after the hot node sampling to evaluate the predictive ability of hot nodes. A total of 157 lymph nodes were detected as SLNs in 72 of 82 patients. SLN detection rate was 88%. Detection rate was 95% for the subgroups of patients with stage Ia-Ib1 disease and smaller tumor size (<or=3 cm in maximal diameter). Lymph node metastasis was found in 15 patients. In 3 of them, no SLNs were detected. In the remaining 12 patients, each ipsilateral SLN contained metastasis when the pelvic lymph nodes contained metastases. Sensitivity was 100%, the false negative rate was 0%, and the negative predictive value of SLN was 100%." }, { "role": "assistant", "content": "We conclude SLN detection using (99m)Tc-labeled phytate is satisfactory to assess pelvic nodes in patients with early cervical cancer; if validated with other research, it should be incorporated into clinical practice. 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": "All of the following are impoant mechanisms of gene transfer in bacteria, except ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Veical gene transfer Gene transfer Gene transfer refers to the process of genetic material (e.g. DNA) being sent and received among two organisms-* Donor sends and recipient receives the genetic material. There are two processes of gene transfer :? 1. Horizontal gene transfer (HGT) or lateral gene transfer Horizontal gene transfer is the process by which genetic material is passed between two different organism,i.e. organism of different species. The recipient is not the offspring of donor. The most impoant example is gene transfer between the bacteria. The processes of horizontal gene transfer in bacteria are :- Transduction Transformation Conjugation 2. Veical gene transfer Veical gene transfer is the process of transferring genetic material to organism of same species, i.e. donor recieves genetic material from its ancestor, e.g. its parent or a species from which it evolved. Therefore, the donor will have the same general makeup as the parents. Veical gene transfer is \"a mix of two parents\", i.e. when two organisms mate, their genes are veically transfered to their spawn. This process is not impoant in bacteria." } ]

[ { "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, PATIENTS AND METHODS, RESULTS. Meshes: Adolescent, Adult, Follow-Up Studies, Humans, Hypospadias, Male, Patient Satisfaction, Surgery, Plastic, Urination." }, { "role": "user", "content": "Is only meatoplasty a legitimate surgical solution for extreme distal hypospadias? Context: To review the long-term outcome of glanular hypospadias repair for extreme distal hypospadias based on simple dorsal Browne meatoplasty and circumcision, with particular attention to patient satisfaction. A review of medical records identified 124 patients who underwent surgery for hypospadias between 1970 and 1979. Their age at operation ranged from 3 months to 13 years. The operation, performed as a day-case, included dorsal Browne meatoplasty for meatal advancement, based upon the Heineke-Mikulicz principle, using three absorbable sutures and often circumcision. There were no immediate complications. A questionnaire was sent to 111 patients whose present address was available. Two patients had died since the operation and of the 109 remaining patients, 43 (39%) replied. The patients were aged 16-31 years at the time of assessment, giving a follow-up of 18 (13-23) years. Seven of the 43 patients were married. Seven patients had complained of some difficulties with urination, four reporting a poor urinary flow. The stream was directed forward in 32 patients and to some degree downwards in 11, still enabling all the patients to urinate while standing with a single stream. Thirty-two patients had had sexual experience, with no functional problems. Twenty-three defined their penile appearance as normal and 20 as abnormal. Overall, 24 (56%) reported complete satisfaction, 11 (25%) partial satisfaction and eight (19%) were dissatisfied with the surgical result." }, { "role": "assistant", "content": "As there are few published reports about the long-term outcome and patient satisfaction after hypospadias repair, it is difficult to draw clear conclusions. However, this simple procedure is a legitimate surgical option for extremely distal glanular hypospadias." } ]

[ { "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, Apoptosis, Blotting, Western, Cell Cycle, Cell Proliferation, Chromatin Immunoprecipitation, Glioblastoma, Humans, Mice, Mice, Inbred NOD, Mice, SCID, MicroRNAs, Neurotensin, Proto-Oncogene Proteins c-myc, RNA, Messenger, RNA, Small Interfering, Real-Time Polymerase Chain Reaction, Receptors, Neurotensin, Reverse Transcriptase Polymerase Chain Reaction, Tumor Cells, Cultured, Xenograft Model Antitumor Assays." }, { "role": "user", "content": "Does neurotensin signaling stimulate glioblastoma cell proliferation by upregulating c-Myc and inhibiting miR-29b-1 and miR-129-3p? Context: Neurotensin (NTS) and its primary receptor NTSR1 are implicated in cancer progression. Aberrant expression of NTS/NTSR1 contributes to the proliferation of glioblastoma cells; however, the mechanism is not fully understood. Microarray and real-time PCR were performed to identify the NTS-regulated micro (mi)RNAs. The targets of the miRNAs were identified by luciferase assays and immunoblot analysis. The c-Myc binding sites in the miR-29b-1 and cyclin-dependent kinase (CDK)4 promoters were identified through chromatin immunoprecipitation assay. Cell proliferation was evaluated by Cell Counting Kit-8 assay and flow cytometry analysis. An orthotopic xenograft model demonstrated the role of NTS/NTSR1 and miRNAs in glioblastoma growth in vivo. Pharmacological inhibition or small interfering NTSR1 treatment blocked glioblastoma cell cycle progression in the G1 phase with a concomitantly decreased expression of CDK6, CDK4, and c-Myc. Knockdown of NTSR1 increased the expression of miR-29b-1 and miR-129-3p, which were responsible for the decreased CDK6 expression. NTS/NTSR1 signaling activated the transcription factor c-Myc in U87 cells, leading to increased CDK4 expression and repressed miR-29b-1 expression. Knockdown of NTSR1 decreased the glioblastoma growth in vivo and significantly prolonged the survival time of the tumor-bearing mice, an effect that can be largely reversed by antagomir." }, { "role": "assistant", "content": "Our study showed a novel regulatory mechanism of NTS/NTSR1, an upstream signaling of miRNAs and c-Myc, in glioblastoma progression. The inhibition of the NTSR1 function or the upregulation of miR-29b-1 and miR-129-3p expression impaired glioma cell proliferation. These results suggested that the NTS/NTSR1/c-Myc/miRNA axis may be a potential therapeutic target for glioblastoma 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": "In acute inflammation due to the retraction of endothelial cell cytoskeleton, which of the following results -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Delayed prolonged increase in permeability" } ]

[ { "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 35-year-old female presents with recurrent renal stone. What is not advised?" }, { "role": "assistant", "content": "The correct answer is Low-calcium diets increase the risk of the incident stone formation. Low-calcium diets lead to the stone formation by reducing the amount of calcium to bind oxalate in the intestine- | urine oxalate levels." } ]

[ { "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 true regarding symmetric IUGR except" }, { "role": "assistant", "content": "The correct answer is IUGR: Evidence of wasting +\n\n\n\n \nSymmetric IUGR\nAsymmetric IUGR\n\n\nTiming of problem\nProblem in first and\n\t\t\tearly second trimester\nProblem in last second and\n\t\t\tthird trimester\n\n\nCause \nTORCH infection\n\t\t\tChromosomal anamoly\nMaternal problems:\n\t\t\tMaternal hypertension\n\t\t\tPlacental insufficiency\n\n\n \nHead to foot are\n\t\t\tequally affected\nBrain growth (head\n\t\t\tcircumference) spared\n\n\n\nPonderal index (PI)\n\t\t\tPI = Weight (gm) X 100\n\t\t\t       Length (cm3)\n\n>2\n<2" } ]

[ { "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 22-year-old woman at 30 weeks gestation presents to the obstetrician with the sudden onset of fever, headache, anorexia, fatigue, and malaise. She mentioned that she had eaten ice cream 3 days ago. Blood cultures show gram-positive rods that are catalase-positive and display distinctive tumbling motility in liquid medium. What is the most likely diagnosis?" }, { "role": "assistant", "content": "Listeriosis" } ]

[ { "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": "Epimer combination(s) is/are" }, { "role": "assistant", "content": "The correct answer is Repeated question" } ]