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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": "Drugs used in treatment of essential tremor are all, EXCEPT:" }, { "role": "assistant", "content": "The correct answer is Many cases are mild and require no treatment other than reassurance. Occasionally, tremor can be severe and interfere with eating, writing, and activities of daily living. Primidone (25-1000 mg/d) and propranolol (20-80 mg/d) are the standard drug therapies and can be administered alone or in combination. Alprazolam, gabapentin, topiramate, clonazepam, clozapine, and nimodipine have been repoed to improve tremor in some patients. Botulinum toxin injections may be helpful for limb or voice tremor, but treatment can be associated with muscle weakness. Surgical therapies targeting the VIM nucleus of the thalamus can be very effective in severe and drug-resistant cases. Ref: Harrison's principle of internal medicine 17th edition, chapter 367." } ]

[ { "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, Antimetabolites, Antineoplastic, CA-19-9 Antigen, Deoxycytidine, Disease-Free Survival, Fluorodeoxyglucose F18, Humans, Middle Aged, Multivariate Analysis, Pancreatic Neoplasms, Positron-Emission Tomography, Radiopharmaceuticals, Radiosurgery, Radiotherapy Dosage, Retrospective Studies." }, { "role": "user", "content": "Is 18Fluorodeoxyglucose PET prognostic of progression-free and overall survival in locally advanced pancreas cancer treated with stereotactic radiotherapy? Context: This study analyzed the prognostic value of positron emission tomography (PET) for locally advanced pancreas cancer patients undergoing stereotactic body radiotherapy (SBRT). Fifty-five previously untreated, unresectable pancreas cancer patients received a single fraction of 25-Gy SBRT sequentially with gemcitabine-based chemotherapy. On the preradiation PET-CT, the tumor was contoured and the maximum standardized uptake value (SUVmax) and metabolic tumor burden (MTB) were calculated using an in-house software application. High-SUVmax and low-SUVmax subgroups were created by categorizing patients above or below the median SUVmax. The analysis was repeated to form high-MTB and low-MTB subgroups as well as clinically relevant subgroups with SUVmax values of <5, 5-10, or >10. Multivariate analysis analyzing SUVmax, MTB, age, chemotherapy cycles, and pretreatment carbohydrate antigen (CA)19-9 was performed. For the entire population, median survival was 12.7 months. Median survival was 9.8 vs.15.3 months for the high- and low- SUVmax subgroups (p <0.01). Similarly, median survival was 10.1 vs. 18.0 months for the high MTB and low MTB subgroups (p <0.01). When clinical SUVmax cutoffs were used, median survival was 6.4 months in those with SUVmax >10, 9.5 months with SUVmax 5.0-10.0, and 17.7 months in those with SUVmax <5 (p <0.01). On multivariate analysis, clinical SUVmax was an independent predictor for overall survival (p = 0.03) and progression-free survival (p = 0.03)." }, { "role": "assistant", "content": "PET scan parameters can predict for length of survival in locally advanced pancreas cancer patients. 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, Breast Neoplasms, Cell Line, Tumor, Gene Expression Regulation, Neoplastic, Humans, Interleukin-11, Mice, MicroRNAs, Microfilament Proteins, Neoplasm Metastasis, Neoplastic Stem Cells, Protein-Tyrosine Kinases, Serum Response Factor, Signal Transduction, Trans-Activators, Xenograft Model Antitumor Assays." }, { "role": "user", "content": "Does microRNA-206 inhibit stemness and metastasis of breast cancer by targeting MKL1/IL11 pathway? Context: Effective targeting of cancer stem cells is necessary and important for eradicating cancer and reducing metastasis-related mortality. Understanding of cancer stemness-related signaling pathways at the molecular level will help control cancer and stop metastasis in the clinic. By analyzing microRNA profiles and functions in cancer development, we aimed to identify regulators of breast tumor stemness and metastasis in human xenograft models in vivo and examined their effects on self-renewal and invasion of breast cancer cells in vitro. To discover the direct targets and essential signaling pathways responsible for microRNA functions in breast cancer progression, we performed microarray analysis and target gene prediction in combination with functional studies on candidate genes (overexpression rescues and pheno-copying knockdowns). In this study, we report that hsa-miR-206 suppresses breast tumor stemness and metastasis by inhibiting both self-renewal and invasion. We identified that among the candidate targets, twinfilin (TWF1) rescues the miR-206 phenotype in invasion by enhancing the actin cytoskeleton dynamics and the activity of the mesenchymal lineage transcription factors, megakaryoblastic leukemia (translocation) 1 (MKL1) and serum response factor (SRF). MKL1 and SRF were further demonstrated to promote the expression of interleukin-11 (IL-11), which is essential for miR-206's function in inhibiting both invasion and stemness of breast cancer." }, { "role": "assistant", "content": "The identification of the miR-206/TWF1/MKL1-SRF/IL-11 signaling pathway sheds lights on the understanding of breast cancer initiation and progression, unveils new therapeutic targets, and facilitates innovative drug development to control cancer and block metastasis. 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 among the following is the most impoant preventive strategy of penile cancer?" }, { "role": "assistant", "content": "The correct answer is With respect to penile cancer, neonatal circumcision and good hygiene to prevent phimosis represent the most impoant prevention strategies. HPV vaccination has a role in preventing transmission of HPV between males and females and thereby decreasing the risk of penile cancer. The efficacy for prevention of HPV-associated penile lesions is lesser. Condom use is effective in preventing the spread of sexually transmitted infections, including HPV. Less significant in developing penile cancer. There is an association between tobacco use and penile, as well as other HPV-associated anogenital cancers. The precise role of tobacco in penile carcinogenesis has not been defined. Ref: Pagliaro L.C. (2011). Chapter 35. Penile Cancer. In H.M. Kantarjian, R.A. Wolff, C.A. Koller (Eds), The MD Anderson Manual of Medical Oncology, 2e." } ]

[ { "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: Angiotensin II, Animals, Aortic Aneurysm, Abdominal, Apolipoproteins E, Arteritis, Dipeptides, Disease Models, Animal, Haploinsufficiency, Humans, Macrophages, Male, Mice, Mice, Knockout, Receptor, Notch1, Signal Transduction." }, { "role": "user", "content": "Does inhibition of Notch1 signaling reduce abdominal aortic aneurysm in mice by attenuating macrophage-mediated inflammation? Context: Activation of inflammatory pathways plays a critical role in the development of abdominal aortic aneurysms (AAA). Notch1 signaling is a significant regulator of the inflammatory response; however, its role in AAA is unknown. In an angiotensin II-induced mouse model of AAA, activation of Notch1 signaling was observed in the aortic aneurysmal tissue of Apoe(-/-) mice, and a similar activation of Notch1 was observed in aneurysms of humans undergoing AAA repair. Notch1 haploinsufficiency significantly reduced the incidence of AAA in Apoe(-/-) mice in response to angiotensin II. Reconstitution of bone marrow-derived cells from Notch1(+/-);Apoe(-/-) mice (donor) in lethally irradiated Apoe(-/-) mice (recipient) decreased the occurrence of aneurysm. Flow cytometry and immunohistochemistry demonstrated that Notch1 haploinsufficiency prevented the influx of inflammatory macrophages at the aneurysmal site by causing defects in macrophage migration and proliferation. In addition, there was an overall reduction in the inflammatory burden in the aorta of the Notch1(+/-);Apoe(-/-) mice compared with the Apoe(-/-) mice. Last, pharmacological inhibition of Notch1 signaling also prevented AAA formation and progression in Apoe(-/-) mice." }, { "role": "assistant", "content": "Our data suggest that decreased levels of Notch1 protect against the formation of AAA by preventing macrophage recruitment and attenuating the inflammatory response in the aorta. 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, Apoptosis, Blood Glucose, Deoxyguanosine, Diabetes Mellitus, Experimental, Gene Expression, Graft Rejection, Graft Survival, Injections, Intravenous, Interleukin-1beta, Islets of Langerhans, Islets of Langerhans Transplantation, Male, Mice, Mice, Transgenic, Oxidative Stress, Portal Vein, Streptozocin, Thioredoxins." }, { "role": "user", "content": "Does thioredoxin-1 attenuate early graft loss after intraportal islet transplantation in mice? Context: Recent studies suggest that decreasing oxidative stress is crucial to achieve successful islet transplantation. Thioredoxin-1 (TRX), which is a multifunctional redox-active protein, has been reported to suppress oxidative stress. Furthermore, it also has anti-inflammatory and anti-apoptotic effects. In this study, we investigated the effects of TRX on early graft loss after islet transplantation. Intraportal islet transplantation was performed for two groups of streptozotocin-induced diabetic mice: a control and a TRX group. In addition, TRX-transgenic (Tg) mice were alternately used as islet donors or recipients. The changes in blood glucose levels were significantly lower in the TRX group compared with the TRX-Tg donor and control groups (p<0.01). Glucose tolerance and the residual graft mass were considerably better in the TRX group. TRX significantly suppressed the serum levels of interleukin-1β (p<0.05), although neither anti-apoptotic nor anti-chemotactic effects were observed. Notably, no increase in the 8-hydroxy-2'-deoxyguanosine level was observed after islet infusion, irrespective of TRX administration." }, { "role": "assistant", "content": "The present study demonstrates that overexpression of TRX on the islet grafts is not sufficient to improve engraftment. In contrast, TRX administration to the recipients exerts protective effects on transplanted islet grafts by suppressing the serum levels of interleukin-1β. However, TRX alone appears to be insufficient to completely prevent early graft loss after islet transplantation. We therefore propose that a combination of TRX and other anti-inflammatory treatments represents a promising regimen for improving the efficacy of islet transplantation. 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 24-year-old man is running a marathon. Upon reaching the finish line, his serum lactate levels were measured and were significantly increased as compared to his baseline. Which of the following pathways converts the lactate produced by muscles into glucose and transports it back to the muscles?" }, { "role": "assistant", "content": "Cori cycle" } ]

[ { "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 muscle in lid is a ached to upper margin of superior tarsus?" }, { "role": "assistant", "content": "The correct answer is ." } ]

[ { "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: HYPOTHESIS, STUDY DESIGN, PATIENTS AND METHODS, RESULTS. Meshes: Adult, Diagnosis, Differential, Female, Fibromyalgia, Follow-Up Studies, Humans, Middle Aged, Neck Pain, Ossification, Heterotopic, Prospective Studies, Rheumatic Diseases, Temporal Bone, Temporomandibular Joint Dysfunction Syndrome." }, { "role": "user", "content": "Is there a relationship between Eagle Syndrome and cervicofacial painful soft tissue rheumatisms? Context: To investigate the incidence of locomotor system pathologies such as myofacial pain syndrome (MPS), fibromyalgia syndrome (FMS), and temporomandibular dysfunction in patients with Eagle Syndrome. Prospective study. Fourteen patients with Eagle Syndrome, who were treated surgically, were enrolled in the study. Etiologic factors for cervicofacial pain were assessed, pain status was compared preoperatively and postoperatively using visual analogue scale. Palpation of tonsillar fossa, neck and shoulder examination, neurologic examination, evaluation of occlusion status, trigger points, and painful zones were done. Plain anteroposterior and lateral radiographs of the cervical spine were obtained and the lengths of the transverse processes of the seventh cervical vertebrae were measured bilaterally. MPS, FMS, and temporomandibular dysfunction were diagnosed in 9 (64.3%), 3 (21.4%), and 2 (14.3%) patients, respectively. Visual analogue scale scores decreased significantly after the surgical excision of elongated styloid processes (from 6.7 +/- 2.3 to 2.1 +/- 1.8), and all the complaints except for headache had diminished (P<.05). Lengths of transverse processes of seventh cervical vertebra were found to be correlated with the length of styloid process (right; r = 0.644, P = .024, left; r = 0.616, P = .033)." }, { "role": "assistant", "content": "Cervicofacial pain is a common complaint in patients with Eagle Syndrome. It frequently coexists with rheumatic disorders resulting in chronic pain such as MPS and FMS. Even though Eagle Syndrome is a rare condition, it should be kept in mind in patients suffering from chronic cervicofacial pain that is refractory to treatment. Clinicians should be alert to diagnose and treat coexisting locomotor system disorders." } ]

[ { "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: Adenosine Triphosphatases, Age of Onset, Cation Transport Proteins, Copper-transporting ATPases, Genotype, Hepatolenticular Degeneration, Humans, Nervous System, Phenotype, Point Mutation." }, { "role": "user", "content": "Is the H1069Q mutation in ATP7B associated with late and neurologic presentation in Wilson disease : results of a meta-analysis? Context: Wilson disease is an hereditary disorder of copper metabolism, caused by mutations in the ATP7B gene, and leading to hepatic or neurologic disease. We examined whether H1069Q, the most common ATP7B mutation, is associated with a specific phenotype. Genotyping results in 70 Dutch patients were related to clinical presentation. Subsequently a meta-analysis for genotype-phenotype correlation was performed on all patients available from literature, combined with the current Dutch group, a total of 577 patients. The Dutch patients homozygous or heterozygous for the H1069Q mutation presented more frequently with neurologic disease (63% and 43% vs. 15%), and at a later age (20.9 and 15.9 vs. 12.6 years) than patients without the H1069Q mutation. In the meta-analysis the odds-ratio for neurologic presentation in homozygous or heterozygous H1069Q vs. non-H1069Q patients was 3.50 (95% CI 2.01-6.09) and 2.13 (95% CI 1.18-3.83), respectively. Age at presentation was 21.1, 19.2 and 16.5 years, respectively, corresponding to a weighted mean difference (WMD) of 4.41 (95% CI 1.56-7.26) for homozygous H1069Q vs. heterozygous patients and 6.68 (95% CI 4.33-9.38) for homozygous H1069Q vs. non-H1069Q patients." }, { "role": "assistant", "content": "Our results indicate that the H1069Q mutation is associated with a late and neurologic presentation. 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 these is FALSE about laparoscopic sterilisation??" }, { "role": "assistant", "content": "The correct answer is Laparoscopic ligation is commonly used for interval ligation Electrocoagulation is used for destruction of a segment of tube and canbe accomplished with either unipolar or bipolar electrical current. Although unipolar electrocoagulation has the lowest long-term failure rate it also has the highest serious complication rate. Can be done by rings, clips, electrocoagulation or ligatures Laparoscopy should be avoided in patients with co morbid abdominal pathologies that require exploration by laparotomy." } ]

[ { "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: Anastomosis, Surgical, Animals, Apoptosis, Bilirubin, Cell Proliferation, DNA, Disease Models, Animal, Enterocytes, Hyperbilirubinemia, Ileum, Intestinal Mucosa, Jejunum, Male, Microvilli, Organ Size, Proteins, Rats, Rats, Sprague-Dawley, Short Bowel Syndrome." }, { "role": "user", "content": "Does bilirubin impair intestinal regrowth following massive small bowel resection in a rat model? Context: The purpose of the present study was to evaluate the effects of exogenous bilirubin on structural intestinal adaptation, cell proliferation, and apoptosis in a rat model of short bowel syndrome (SBS). Male Sprague-Dawley rats were divided into 5 experimental groups: Sham rats underwent bowel transection and reanastomosis, sham multiple doses of bilirubin (MDB) rats underwent bowel transection and were treated with bilirubin, SBS rats underwent a 75% small bowel resection, SBS-SDB (single dose bilirubin) rats underwent a bowel resection and were treated with a single dose of bilirubin, and SBS-MDB underwent a bowel resection and were treated with 3 doses of bilirubin. Bilirubin was administered intraperitoneally from the 7th day through the 14th day postoperatively. Serum total bilirubin concentration over time was evaluated in 5 SBS-SDB rats following a single intraperitoneal dose. Total bilirubin, alanine aminotransferase, and aspartate aminotransferase in serum and parameters of intestinal adaptation, enterocyte proliferation, and enterocyte apoptosis were determined on day 15. SBS-SDB and SBS-MDB animals demonstrated lower ileal bowel and mucosal weights, jejunal mucosal DNA and ileal mucosal protein, and jejunal and ileal villus height and crypt depth (vs SBS animals). Bilirubin-treated rats showed a lower apoptotic index in jejunum and ileum and a trend toward an increase in cell proliferation in jejunum and ileum (vs SBS group)." }, { "role": "assistant", "content": "In a rat model of SBS, exogenous bilirubin inhibits structural intestinal adaptation. Increased cell proliferation and decreased apoptosis may be considered adaptive mechanisms that maintain cell mass. 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": "'Bull neck' in Diphtheria is due to -" }, { "role": "assistant", "content": "The correct answer is Ans. is `d' i.e., Lymphadenopathy Clinical manifestations of diphtheria A) Faucial (tonsillo pharyngeal) diphtheria o It is the commonest type of diphtherial infection. o Incubation period is 2-5 days. o Patients present with malaise, sore throat and moderate fever. o A thick adherent pseudomembrane (gray or white) is present on one or both tonsils or adjacent pharynx. o Dislodging the membrane is likely to cause bleeding. o A small percentage of patients present with massive swelling of the tonsils and uvula with cervical lymphadenopathy (bull neck) and severe toxemia --> Malignant diphtheria. Systemic toxicity (toxemia) is usually most severe when pseudomembrane extends from tonsil and pharynx (faucial diphtheria) to adjacent areas. B) Laryngeal diphtheria o Presents as hoarseness and cough. o It is the most severe form of respiratory diphtheria. Trocheostomy may be required. C) Nasal diphtheria o Presents with unilateral or bilateral nasal discharge. o Mildest form of respiratory diphtheria D)Cutaneous diphtheria Caused by nontoxigenic strains o Presents as distinct \"punched out\" ulcers. o More common in tropical areas. o Other less common type of diphtheria are con juctival, otitic, genital - (vulval, vaginal or prepucial), gastrointestinal." } ]

[ { "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": "X-ray of a person presenting with intestinal obstruction is shown below. It is taken in which view?" }, { "role": "assistant", "content": "The correct answer is Ans. (a) X-ray abdomen erect* The film shows X-ray abdomen erect -- with multiple air fluid levels showing small intestinal obstruction." } ]

[ { "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": "Naltrexone is: March 2013" }, { "role": "assistant", "content": "The correct answer is Ans. C i.e. lc antagonist Naltrexone is an opioid receptor antagonist used primarily in the management of alcohol dependence and opioid dependence." } ]

[ { "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, Asthma, Carbon Dioxide, Chronic Disease, Cross-Sectional Studies, Female, Forced Expiratory Volume, Home Care Services, Humans, Longitudinal Studies, Male, Oxygen, Oxygen Inhalation Therapy, Physical Examination, Pulmonary Disease, Chronic Obstructive, Respiratory Insufficiency, Smoking, Total Lung Capacity, Vital Capacity." }, { "role": "user", "content": "Is asthma a common cause of severe chronic respiratory failure in non-smokers : ALOT study? Context: Little is known about the long-term natural history of asthma and the long-term clinical and functional consequences in non-smoking patients. From a functional point of view, non-smoking asthmatic patients may have a significantly greater decline in forced expiratory volume in one second (FEV1) compared with non-asthmatic subjects and may develop chronic irreversible (fixed) airflow limitation. This has been related to the physiological consequences of chronic airway inflammation causing airway remodeling. However these lesions are all potentially reversible and there is little radiological evidence indicating lung destruction (pulmonary emphysema), which is potentially irreversible, in non-smoking asthmatics. Severe chronic respiratory failure is the major cause of mortality in patients with severe chronic lung diseases. Domiciliary long-term oxygen therapy (LTOT) is an accepted treatment for patients with severe chronic respiratory failure. Our reasoning, therefore, was that if asthma is a cause of severe chronic respiratory failure in non-smokers we should be able to find non-smoking asthmatics within a large population of patients on LTOT. The aim of our study (Asthma and Long-term Oxygen Therapy, \"ALOT\") was to investigate the prevalence of non-smoking asthmatics in patients on LTOT in a multi-centre, cross-sectional study. Between June and September 2003 we screened all subjects on long-term domiciliary oxygen therapy in three different hospitals in the North-East area of Italy (within the provinces of Ferrara and Bologna). Taken collectively, we have found one-hundred and eighty-four patients on LTOT. We have reviewed their clinical data (age, sex, smoking, history and physical examination, arterial blood gas analysis, pulmonary function). 114 patients (all smokers) fulfilled the diagnostic criteria for COPD. Seventy patients (all smokers) had other diseases. We were unable to find any non-smokers in our screened population of subjects on long-term domiciliary oxygen therapy. Furthermore, there was no past history of asthma and/or acute wheezing episodes in either of the patient groups." }, { "role": "assistant", "content": "This data suggests that asthma is an uncommon cause of severe chronic respiratory failure necessitating long-term domiciliary oxygen therapy in non-smokers and supports the current consensus that asthma and COPD are different diseases with differing stages of severity and the concept that long-term avoidance of active smoking is fundamental for the prevention of severe chronic respiratory failure. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: AIMS, BACKGROUND, METHODS, FINDINGS. Meshes: Benchmarking, Health Care Reform, Health Services Accessibility, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Organizational Innovation, Politics, State Medicine, United Kingdom." }, { "role": "user", "content": "Is access to a standardized neonatal intensive care possible? Context: This paper aims to determine the factors which impact on the issue of availability and access to a standard quality of neonatal intensive care provision in order to clarify strategies for change. New targets set within the NHS reforms have highlighted quality and fair access to services. Current frameworks for the provision of neonatal services may not be in place to support a standardized quality service provision. The paper examines the historical and political basis for current models of service, giving a grounding for recommendations for change in an attempt to achieve a more standardized, equitable level of care. Changes within health care policy in the late 1980s and 1990s have led to confusion within the service and a lack of the definition needed to provide universally accepted criteria on which to base a regional service provision." }, { "role": "assistant", "content": "The organization of services will need to be reviewed to include the introduction of national and regional data collection and analysis, and national definitions standardizing service criteria to be used to support variations in regional models of care. In conjunction with these recommendations independent auditing processes must exist to allow for accreditation of services." } ]

[ { "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: METHOD, RESULTS. Meshes: Adolescent, Case-Control Studies, Child, Child Behavior Disorders, Depression, Diabetes Mellitus, Type 1, Female, Humans, Male, Mass Screening, Quality of Life, Reproducibility of Results, Risk Assessment, Self-Assessment, Surveys and Questionnaires." }, { "role": "user", "content": "Can one question be a useful indicator of psychosocial problems in adolescents with diabetes mellitus? Context: One hundred and fifty-one adolescents with T1DM and 122 healthy peers between 12 and 18 years of age were asked to rate their life on a scale, varying from 0 to 10. Behaviour problems and depressive symptoms were measured with the Youth Self-Report (YSR) and the Children's Depression Inventory (CDI). Adolescents with T1DM rated their life less positive in comparison with their healthy peers (F(1,269) = 14.01, p = 0.000). Adolescents with T1DM who rated their life with a 6 or lower reported more depressive symptoms and behaviour problems (F(2,131) = 24.19, p = 0.00) compared to those with higher scores (7 or up)." }, { "role": "assistant", "content": "One question the 'rate your life scale' identified most of the adolescents at risk of internalizing behaviour problems, especially depression. The results of this first step in exploring the validity of this question as a screening tool for psychological functioning are promising." } ]

[ { "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 15 year old boy has bilateral optic atrophy, diabetes mellitus and diabetes insipidus. The diagnosis is-" }, { "role": "assistant", "content": "The correct answer is The Wolfram syndrome is a hereditary optic atrophy. It presents between the ages of 5-21 years. This is also referred to as \"DIDMOAD\" i.e. Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy and Deafness." } ]

[ { "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, Disease Models, Animal, Fibrinogen, Humans, Liver, Male, Random Allocation, Swine, Time Factors, Wounds, Nonpenetrating." }, { "role": "user", "content": "Does fibrinogen concentrate suppress endogenous fibrinogen synthesis in a 24-hour porcine trauma model? Context: Fibrinogen concentrate may reduce blood loss after trauma. However, its effect on endogenous fibrinogen synthesis is unknown. The authors investigated the effect of exogenous human fibrinogen on endogenous fibrinogen metabolism in a 24-h porcine trauma model. Coagulopathy was induced in 20 German Landrace pigs by hemodilution and blunt liver injury. Animals were randomized to receive fibrinogen concentrate (100 mg/kg; infusion beginning 20 min postinjury and lasting approximately 10 min) or saline. Fibrinogen concentration, thromboelastometry, and quantitative reverse transcriptase polymerase chain reaction of fibrinogen genes in liver tissue samples were recorded. Internal organs were examined histologically for emboli. Coagulation parameters were impaired and plasma fibrinogen concentrations were reduced before starting infusion of fibrinogen concentrate/saline. Twenty minutes after starting infusion, exogenous fibrinogen supplementation had increased plasma fibrinogen concentration versus controls (171 ± 19 vs. 63 ± 10 mg/dl [mean ± SD for Multifibren U]; 185 ± 30 vs. 41 ± 4 mg/dl [Thrombin reagent]; P < 0.05 for both comparisons). The between-group difference in plasma fibrinogen concentration diminished thereafter, with maximum concentrations in both groups observed at approximately 24 h, that is, during the acute-phase reaction after trauma. Fibrinogen supplementation did not down-regulate endogenous fibrinogen synthesis (no between-group differences in fibrinogen messenger RNA). Total postinjury blood loss was significantly lower in the fibrinogen group (1,062 ± 216 vs. 1,643 ± 244 ml; P < 0.001). No signs of thromboembolism were observed." }, { "role": "assistant", "content": "Administration of human fibrinogen concentrate did not down-regulate endogenous porcine fibrinogen synthesis. The effect on plasma fibrinogen concentration was most pronounced at 20 min but nonsignificant at approximately 24 h. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "How many parts are there in insulin receptor?" }, { "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": "Clinical scenario having scrotum with bag of worms:" }, { "role": "assistant", "content": "The correct answer is Ans. (a) VaricoceleRef: Bailey 26th Edition Page 1381* On palpation of varicocele with the patient standing the varicose plexus feels like a bag of worm." } ]

[ { "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, Breast Neoplasms, Carcinoma, Ductal, Breast, Carcinoma, Lobular, Chemotherapy, Adjuvant, Combined Modality Therapy, E2F1 Transcription Factor, E2F2 Transcription Factor, Female, Humans, Immunoenzyme Techniques, Korea, Lymphatic Metastasis, Mastectomy, Middle Aged, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Neoplasm Staging, Neoplasms, Hormone-Dependent, Receptors, Estrogen, Receptors, Progesterone, Survival Rate, Tissue Array Analysis, Treatment Outcome." }, { "role": "user", "content": "Does e2F1 expression predict outcome in Korean women who undergo surgery for breast carcinoma? Context: The transcriptional factors E2F1 and E2F2 have been reported to be associated with improved chemosensitivity in various cancers. We aimed to investigate whether E2F1 and E2F2 can be used as predictors of chemosensitivity in hormone-receptor-negative breast cancers (HRNBCs), which are common in Korean women. A total of 183 patients with primary breast cancer who had undergone surgical resection were evaluated on the basis of hormonal status, age, histological subtype and grade, tumor size, lymph node metastasis, and stage. The immunohistochemical expressions of E2F1 and E2F2 were analyzed for these histopathological data and patient survival. E2F1 expression was associated with low histological grade (grade 1) and larger tumor size (>2 cm), while E2F2 expression was correlated only with large tumor size (>2 cm). The E2F1-positive group had less tumor recurrences, lymph node metastases during follow-up, and distant metastases than the E2F1-negative group; E2F1 expression was found to be an independent predictive factor of more favorable survival among HRNBC patients on univariate and multivariate analyses, but E2F2 expression was not." }, { "role": "assistant", "content": "E2F1 may be a potential prognostic and predictive factor for clinical outcome and therapeutic results following adjuvant chemotherapy in HRNBC patients. 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: Action Potentials, Adult, Electroencephalography, Epilepsies, Partial, Feasibility Studies, Female, Humans, Magnetoencephalography, Male, Middle Aged, Rest." }, { "role": "user", "content": "Is epileptic focus localization based on resting state interictal MEG recordings feasible irrespective of the presence or absence of spikes? Context: To investigate whether epileptogenic focus localization is possible based on resting state connectivity analysis of magnetoencephalographic (MEG) data. A multivariate autoregressive (MVAR) model was constructed using the sensor space data and was projected to the source space using lead field and inverse matrix. The generalized partial directed coherence was estimated from the MVAR model in the source space. The dipole with the maximum information inflow was hypothesized to be within the epileptogenic focus. Applying the focus localization algorithm (FLA) to the interictal MEG recordings from five patients with neocortical epilepsy, who underwent presurgical evaluation for the identification of epileptogenic focus, we were able to correctly localize the focus, on the basis of maximum interictal information inflow in the presence or absence of interictal epileptic spikes in the data, with three out of five patients undergoing resective surgery and being seizure free since." }, { "role": "assistant", "content": "Our preliminary results suggest that accurate localization of the epileptogenic focus may be accomplished using noninvasive spontaneous \"resting-state\" recordings of relatively brief duration and without the need to capture definite interictal and/or ictal abnormalities. 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: Alphavirus Infections, Animals, Antigens, Differentiation, B-Lymphocyte, Apoptosis, Arthritis, Infectious, Cells, Cultured, Chemokines, Chikungunya virus, Cytokines, Disease Models, Animal, Female, Histocompatibility Antigens Class II, Humans, Male, Mice, Mice, Inbred C57BL, Mice, Knockout, Monocytes, Myositis, Receptors, Immunologic, Ross River virus, Severity of Illness Index." }, { "role": "user", "content": "Does macrophage migration inhibitory factor receptor CD74 mediate alphavirus-induced arthritis and myositis in murine models of alphavirus infection? Context: Arthrogenic alphaviruses such as Ross River virus (RRV) and chikungunya virus (CHIKV) circulate worldwide. This virus class causes debilitating illnesses that are characterized by arthritis, arthralgia, and myalgia. In previous studies, we identified macrophage migration inhibitory factor (MIF) as a critical inflammatory factor in the pathogenesis of alphaviral diseases. The present study was undertaken to characterize the role of CD74, a cell surface receptor of MIF, in both RRV- and CHIKV-induced alphavirus arthritides. Mouse models of RRV and CHIKV infection were used to investigate the immunopathogenesis of arthritic alphavirus infection. The role of CD74 was assessed using histologic analysis, real-time polymerase chain reaction, flow cytometry, and plaque assay. In comparison to wild-type mice, CD74-/- mice developed only mild clinical features and had low levels of tissue damage. Leukocyte infiltration, characterized predominantly by inflammatory monocytes and natural killer cells, was substantially reduced in the infected tissue of CD74-/- mice, but production of proinflammatory cytokines and chemokines was not decreased. CD74 deficiency was associated with increased monocyte apoptosis, but had no effect on monocyte migratory capacity. Consistent with these findings, alphaviral infection resulted in a dose-dependent up-regulation of CD74 expression in human peripheral blood mononuclear cells, and serum MIF levels were significantly elevated in patients with RRV or CHIKV infection." }, { "role": "assistant", "content": "CD74 appears to regulate immune responses to alphaviral infection through its effects on cellular recruitment and survival. These findings suggest that both MIF and CD74 play a critical role in mediating alphaviral disease, and blocking these factors with novel therapeutic agents could substantially ameliorate the pathologic manifestations. 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, DESIGN, SETTING, PARTICIPANTS, MAIN OUTCOME MEASURES, RESULTS. Meshes: Adult, Case-Control Studies, Cerebral Palsy, Child, Preschool, Female, Humans, Male, Maternal-Child Nursing, Nursing Assessment, Odds Ratio, Pregnancy, Pregnancy Complications, Prevalence, Risk Factors, Urinary Tract Infections." }, { "role": "user", "content": "Urinary tract infection during pregnancy: a risk factor for cerebral palsy? Context: To assess a possible association of urinary tract infection (UTI) during pregnancy and cerebral palsy in offspring. Secondary analysis of a case-control study using structured telephone interviews and birth certificate reviews. Cases from community-based agencies providing services to preschool children who were developmentally delayed. One hundred twelve preschool children with cerebral palsy and 153 children without cerebral palsy. Risk for cerebral palsy. The prevalence of UTI among case mothers was 17.9% compared with 5.2% among control mothers. The crude odds ratio for risk of cerebral palsy for a mother with a UTI was 3.9, whereas the adjusted odds ratio was approximately 5, indicating that the risk of having a child with cerebral palsy was 4 to 5 times greater for mothers who had a UTI during pregnancy." }, { "role": "assistant", "content": "Urinary tract infection during pregnancy was found to be a risk factor for development of cerebral palsy in offspring. Assessment for UTI should occur at the initial prenatal visit and more frequently for women with symptoms or who are at risk. Pregnant women should be educated about preventive measures for UTI. Future research is needed to assess more directly the relationship between UTI during pregnancy and cerebral palsy in offspring." } ]

[ { "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 60 year old man, who is a known case of LV Aneurysm post MI in 2017, presents with recurrent episodes of syncope. Today after having a strong coffee he developed syncope and was rushed to the hospital. What is the best way to prevent such episodes from developing again?" }, { "role": "assistant", "content": "The correct answer is The ECG shows hea rate of 300/min with broad complex tachycardia. Axis is indeterminate. This indicates a monomorphic Ventricular Tachycardia. In acute setting DC shock 200J Biphasic should be given. However recurrence of VT episodes can occur due to structural damage in form of LV aneurysm. Hence Implantable cardioveer defibrillator is the best method to prevent recurrent VT episodes Catheter ablation is done for idiopathic monomorphic VT." } ]

[ { "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: 25-Hydroxyvitamin D 2, Aged, Autonomic Nervous System Diseases, Biomarkers, Calcifediol, Cardiovascular Diseases, Cohort Studies, Denmark, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Neuropathies, Dietary Supplements, Female, Humans, Male, Middle Aged, Prevalence, Severity of Illness Index, Vitamin D, Vitamin D Deficiency." }, { "role": "user", "content": "Is high and low vitamin D level associated with cardiovascular autonomic neuropathy in people with Type 1 and Type 2 diabetes? Context: To investigate the possible association between vitamin D deficiency and cardiovascular autonomic neuropathy in people with diabetes. A total of 113 people with Type 1 or Type 2 diabetes [mean (interquartile range) diabetes duration 22.0 (12-31) years, mean (sd) age 56.2 (13.0) years, 58% men] underwent vitamin D (D2 and D3) assessment, and were screened for cardiovascular autonomic neuropathy using three cardiovascular reflex tests [heart rate response to deep breathing (E/I ratio), to standing (30/15 ratio) and to the Valsalva manoeuvre] and assessment of 5-min resting heart rate and heart rate variability indices. We found an inverse U-shaped association between serum vitamin D level and E/I ratio, 30/15 ratio and three heart rate variability indices (P < 0.05). Vitamin D level was non-linearly associated with cardiovascular autonomic neuropathy diagnosis (P < 0.05 adjusted for age and sex). Linear regression models showed that an increase in vitamin D level from 25 to 50 nmol/l was associated with an increase of 3.9% (95% CI 0.1;7.9) in E/I ratio and 4.8% (95% CI 4.7;9.3) in 30/15 ratio. Conversely, an increase from 125 to 150 nmol/l in vitamin D level was associated with a decrease of 2.6% (95% CI -5.8;0.1) and 4.1% (95% CI -5.8;-0.5) in the respective outcome measures." }, { "role": "assistant", "content": "High and low vitamin D levels were associated with cardiovascular autonomic neuropathy in people with diabetes. Future studies should explore this association and the efficacy of treating dysvitaminosis D to prevent cardiovascular autonomic neuropathy. 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: Brain, Child, Preschool, Confidence Intervals, Disability Evaluation, Female, Humans, Infant, Magnetic Resonance Imaging, Male, Movement Disorders, Nerve Fibers, Myelinated, Odds Ratio, Predictive Value of Tests, Premature Birth, Severity of Illness Index." }, { "role": "user", "content": "Does neonatal white matter abnormality predict childhood motor impairment in very preterm children? Context: Children born very preterm are at risk for impaired motor performance ranging from cerebral palsy (CP) to milder abnormalities, such as developmental coordination disorder. White matter abnormalities (WMA) at term have been associated with CP in very preterm children; however, little is known about the impact of WMA on the range of motor impairments. The aim of this study was to assess whether WMA were predictive of all levels of motor impairments in very preterm children. Two hundred and twenty-seven very preterm infants (< 30 wks gestational age or birthweight < 1250 g) had brain magnetic resonance imaging at term-equivalent age to assess for WMA, which were categorized as nil, mild, or moderate to severe. At 5 years of age children were classified as having a moderate to severe motor impairment if they were below the 5th centile or mild to severe motor impairment if their score placed them no higher than the 15th centile on the Movement Assessment Battery for Children (MABC). WMA (nil vs mild and nil vs moderate-severe) were explored as predictors of motor impairment using logistic regression. Analyses were repeated adjusting for the effects of other perinatal variables and excluding children with CP. Of the 193 very preterm children (97 males, 96 females) assessed with the MABC, 53 (27%) were classified as having a moderate to severe motor impairment and 96 (50%) a mild to severe motor impairment. WMA were predictive of motor impairment in very preterm children, with mild versus no WMA increasing the odds of moderate to severe motor impairment by over fivefold (odds ratio [OR] 5.6; 95% confidence interval [CI] 1.9-16.1; p=0.002) and mild to severe impairment by twofold (OR 2.2; 95% CI 1.1-4.2; p=0.02). Compared with no WMA, moderate to severe WMA increased the odds for moderate to severe impairment 19-fold (OR 19.4; 95% CI 5.6-66.7; p<0.001) and for mild to severe motor impairment ninefold (OR 9.4; 95% CI 3.2-28.1; p<0.001). Results remained similar after controlling for several potential confounders and after excluding 14 children who had CP at age 2 years." }, { "role": "assistant", "content": "WMA predict motor impairment at 5 years, with rates of impairment increasing with more severe WMA. Very preterm children with any WMA at term require follow-up throughout childhood. 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 neurology resident sees a stroke patient on the wards. This 57-year-old man presented to the emergency department after sudden paralysis of his right side. He was started on tissue plasminogen activator within 4 hours, as his wife noticed the symptoms and immediately called 911. When the resident asks the patient how he is doing, he replies by saying that his apartment is on Main St. He does not seem to appropriately answer the questions being asked, but rather speaks off topic. He is able to repeat the word “fan.” His consciousness is intact, and his muscle tone and reflexes are normal. Upon striking the lateral part of his sole, his big toe flexes and the other toes flare down. Which of the following is the area most likely affected in his condition?" }, { "role": "assistant", "content": "Temporal lobe" } ]

[ { "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 seen in 22q 11.2 deletion syndrome except" }, { "role": "assistant", "content": "The correct answer is (A) B cell immunodeficiency # DiGeorge syndrome or 22q11.2 deletion syndrome, which has several presentations including DiGeorge syndrome (DGS), DiGeorge anomaly, velo-cardio-facial syndrome, Shprintzen syndrome, conotruncal anomaly face syndrome, Strong syndrome, congenital thymic aplasia, and thymic hypoplasia, is a syndrome caused by the deletion of a small piece of chromosome 22.> Salient features Mnemonic CATCH-22 of DiGeorge's syndrome, with the chromosomal abnormality is found on the 22 chromosome: Cardiac Abnormality (especially tetralogy of Fallot) Abnormal facies Thymic aplasia Cleft palate Hypocalcemia/Hypoparathyroidism." } ]

[ { "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, Cell Survival, Coronary Artery Disease, Coronary Restenosis, Cyclosporine, Disease Models, Animal, Dose-Response Relationship, Drug, Graft Rejection, Graft Survival, Heart Rate, Heart Transplantation, Immunosuppressive Agents, Male, Models, Cardiovascular, Random Allocation, Rats, Rats, Inbred F344, Rats, Inbred Lew, Time Factors, Treatment Outcome, Weight Gain, Withholding Treatment." }, { "role": "user", "content": "Does cyclosporine enhance the development of accelerated coronary artery disease : experimental study in a rat cardiac transplant model? Context: Among other factors, cyclosporine (CsA) is linked with the development of accelerated coronary artery disease (ACAD) after transplantation. The objective of this study was to assess the influence of different CsA regimens on ACAD after rat heart transplantation. After heterotopic cardiac transplantation (Lewis to Fisher), animals were treated with 3 or 12 mg/kg per day of CsA, administered subcutaneously. The control group received no therapy. CsA blood levels were determined every 10 days. Twenty and 80 days after grafting, the incidence of ACAD was determined and the extent of ACAD was assessed as mean vessel occlusion (mvo). In the 12-mg group, CsA levels were nearly 10-fold higher than in the 3-mg group. Only in the 12-mg CsA group was the incidence of ACAD significantly reduced at Days 20 and 80 when compared with controls. Continuous therapy with 3 mg and 12 mg of CsA significantly reduced the mvo at Days 20 and 80 when compared with control animals (p <.05). However, comparing the two dosages, there were no significant differences. When the 20-day-limited course of CsA application was used we did not observe significant differences in mvo at Day 80 upon comparison of 3-mg and 12-mg CsA treatment versus untreated animals." }, { "role": "assistant", "content": "Despite the excessive increase in CsA blood levels we observed neither a further reduction nor an increase of ACAD in the high-dose group compared with the low-dose group. Therefore, CsA did not enhance the development of chronic rejection in this experiment. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Not true about strangulated hernia" }, { "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, STUDY DESIGN, PATIENTS AND METHODS, RESULTS. Meshes: Adult, Chi-Square Distribution, Cross-Sectional Studies, Data Collection, Delivery, Obstetric, Demography, Female, Health Services Research, Humans, Length of Stay, Obstetrics and Gynecology Department, Hospital, Ohio, Patient Acceptance of Health Care, Patient Satisfaction, Perception, Pregnancy." }, { "role": "user", "content": "Does length of hospital stay during labor and delivery influence patient satisfaction? Context: To examine the relationship between patients' satisfaction with hospital obstetric care, length of stay, and patients' perceived appropriateness of the length of stay. A cross-sectional study. We surveyed 27,789 women (a 58% response rate) discharged after labor and delivery from 18 hospitals in a large metropolitan region from 1992 through 1994. Patient satisfaction was assessed using the Patient Judgment System, a previously validated instrument. Our analysis focused on four scales evaluating specific aspects of care (physician care, nursing care, provision of information, and preparation for discharge) and two single-item indicators of satisfaction (overall quality and willingness to return to the hospital). Patients with shorter lengths of stay were more likely (P<0.001) to perceive their stays as \"too short.\" In addition, the six measures of satisfaction were lower (P<0.001) in patients who perceived their stays as too short. However, the hypothesized lower satisfaction in patients with shorter stays was not observed; differences in satisfaction according to length of stay were small and of questionable practical significance." }, { "role": "assistant", "content": "The findings suggest that patients' satisfaction with obstetric care may not depend on the absolute duration of stay but rather on whether patients perceive the length of stay to be adequate. The results are timely because of recent legislation that mandates minimum hospital stays for labor and delivery." } ]

[ { "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, MATERIALS AND METHODS, RESULTS. Meshes: Acute Disease, Adult, Contrast Media, Female, Follow-Up Studies, Gadolinium DTPA, Humans, Intervertebral Disc Displacement, Lumbar Vertebrae, Male, Organometallic Compounds, Pentetic Acid, Prognosis, Prospective Studies, Treatment Outcome." }, { "role": "user", "content": "Does postcontrast MR enhancement in lumbar disk herniation have prognostic value? Context: The aim of our study was to evaluate the prognostic value, if any, of Gd-enhanced MR in patients with lumbar disk herniation. Fifteen patients undergoing conservative treatment for acute lumbar disk herniation were included in a prospective Gd-DTPA follow-up MR study. In each patient, the size of the herniation was measured, and, according to the changes in pathology that occurred, patients were divided into four categories. In addition, on the basis of the clinical outcome patients were divided into three classes. In 11 of 15 patients, MR performed in the acute phase of the disease showed Gd-DTPA enhancement around the herniated disk; in all cases, disk herniation was markedly reduced at follow-up MRIs. The clinical outcome was good. In the remaining four cases, no enhancement was evident in the acute phase or at follow-up MRIs; no modification in the size of disk herniation was demonstrated at follow-up in two. Symptoms were unchanged in two patients and mildly improved in one." }, { "role": "assistant", "content": "Epidural enhancement, which is likely related to an inflammatory process, seems to play a role in the modification of the size of disk herniation." } ]

[ { "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": "Kupffer cells in liver are responsible for:September 2007" }, { "role": "assistant", "content": "The correct answer is Ans. D: Phagocytic functionsKupffer cells/Browicz-Kupffer cells are specialized macrophages located in the liver lining the walls of the sinusoids that form pa of the reticuloendothelial system." } ]

[ { "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 line joining ant. sup iliac spine to ischial tuberosity and passes a greater trochanter -" }, { "role": "assistant", "content": "The correct answer is Nelaton's line :\n\nWith the hip in 90 degree of flexion, a line joining the ASIS and ischial tuberosity passes through the tip of the greater trochanter on that side.\nIn cases of supratrochanteric shortening the trochanter will be proximal to this line.\n\nShoemaker's line :\n\nWith the patient lying supine, the line joining ASIS and tip of the greater trochanter is extended on the side of the abdomen on both sides.\n\n\n\nNormally these lines meet in the middle above the umblicus.\nIn case one of the greater trochanters has migrated proximally the lines will meet in the opposite side of the abdomen and below the umblicus.\n\nChiene's line :\n\nWith the patient lying supine, lines are drawn joining the two ASIS and the two greater trochanters.\nNormally these make two parallel lines. In case one of the trochanters has moved proximally the lines will converge on that side.\n\nPerkin's line :\n\nWhen the congenital Dislocation of hip is mild in nature, the perkins lines are drawn to detect it.\nA horizontal line is drawn through the triradiate cartilage and a vertical line is drawn down from the outer edge of the acetabulum on both sides.\nThe upper femoral epiphyses normally lies medial to the vertical line and below the horizontal line.\nBut in congenital dislocation of hip the epiphyses will lie on the outer aspect of the vertical line and above the horizontal line.\n\nBryants triangle :\n\nThe patient lies supine.\nThe tips of the greater trochanter and ASIS on both sides are marked.\nA perpendicular is dropped from each ASIS on to the bed. From the tip of the greater trochanter, another perpendicular is dropped on to the first one. The tips of the greater trochanter are joined to the ASIS on the respective side. This forms a triangle ABC.\nThe side BC of the triangle measures supra trochanteric shortening of the hip." } ]

[ { "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: Antineoplastic Agents, Phytogenic, Camptothecin, Carcinoma, Cell Line, Tumor, Colonic Neoplasms, Drug Evaluation, Preclinical, Gene Expression Regulation, Neoplastic, HCT116 Cells, Hep G2 Cells, Humans, Inactivation, Metabolic, Irinotecan, Pregnane X Receptor, Receptors, Cytoplasmic and Nuclear, Receptors, Steroid, Signal Transduction, Up-Regulation, Xenobiotics." }, { "role": "user", "content": "Does irinotecan induce steroid and xenobiotic receptor ( SXR ) signaling to detoxification pathway in colon cancer cells? Context: Resistance to chemotherapy remains one of the principle obstacles to the treatment of colon cancer. In order to identify the molecular mechanism of this resistance, we investigated the role of the steroid and xenobiotic receptor (SXR) in the induction of drug resistance. Indeed, this nuclear receptor plays an important role in response to xenobiotics through the upregulation of detoxification genes. Following drug treatments, SXR is activated and interacts with the retinoid X receptor (RXR) to induce expression of some genes involved in drug metabolism such as phase I enzyme (like CYP), phase II enzymes (like UGT) and transporters (e.g. MDR1). In this study, we have shown that endogenous SXR is activated in response to SN-38, the active metabolite of the anticancer drug irinotecan, in human colon cancer cell lines. We have found that endogenous SXR translocates into the nucleus and associates with RXR upon SN-38 treatment. Using ChIP, we have demonstrated that endogenous SXR, following its activation, binds to the native promoter of the CYP3A4 gene to induce its expression. RNA interference experiments confirmed SXR involvement in CYP3A4 overexpression and permitted us to identify CYP3A5 and MRP2 transporter as SXR target genes. As a consequence, cells overexpressing SXR were found to be less sensitive to irinotecan treatment." }, { "role": "assistant", "content": "Altogether, these results suggest that the SXR pathway is involved in colon cancer irinotecan resistance in colon cancer cell line via the upregulation of select detoxification genes. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: AIMS, METHODOLOGY, RESULTS. Meshes: Adult, Aged, Female, Hepatectomy, Hepatic Veins, Humans, Japan, Liver Transplantation, Living Donors, Male, Middle Aged, Treatment Outcome, Young Adult." }, { "role": "user", "content": "Is preservation of middle hepatic vein tributaries during right hemi-hepatectomy beneficial for live donor liver transplantation? Context: When right hemi-hepatectomy without middle hepatic vein (MHV) is performed in a living donor (LD), MHV tributaries such as V5 and V8 may be preserved during parenchymal transection to preserve liver function and reduce the damage of the graft. However, no study has so far investigated whether this preservation of MHV tributaries during parenchymal transection has impact on live donor operation or graft function. Of 52 hepatectomies for right lobe LD, MHV tributaries were preserved during hepatic parenchymal transection in 11 cases, while, in the remaining 41 cases MHV tributaries were sacrificed when those were encountered during hepatic parenchymal transection. There was no significant difference in blood loss, operative time, zenith liver enzyme level in a donor and rate of graft failure in a recipient." }, { "role": "assistant", "content": "It was demonstrated that there was no significant effect of outflow preservation from MHV tributaries on LD hepatectomy for right lobe donation and subsequent liver transplantation." } ]

[ { "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": "Hypercalcemia related to malignancy is seen in which of the following cancers?" }, { "role": "assistant", "content": "The correct answer is Answer- D. All the aboveMalignancy related-Solid tumor with metastasis/ paraneoplastic syndromeCarcinoma breast/ Lung/ Kidney etcHematological: Multiple myeloma/Lymphoma/LeukemiaAluminum intoxicationMilk Alkali syndrome" } ]

[ { "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": "Phelp's sign is seen in:" }, { "role": "assistant", "content": "The correct answer is Phelp's sign Phelp sign This sign is seen on CT scan In CT- in case of glomus jugulare tumor the normal crest between the carotid canal and jugulare tumor is absent whereas it is not so in case of glomus tympanicum" } ]

[ { "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, Cardiac Surgical Procedures, Catheter Ablation, Electrodes, Equipment Design, Female, Male, Myocardium, Postoperative Period, Swine, Temperature." }, { "role": "user", "content": "Does temperature-controlled radiofrequency catheter ablation with a 10-mm tip electrode create larger lesions without charring in the porcine heart? Context: Radiofrequency catheter ablation of atrial flutter, atrial fibrillation or ventricular tachycardia may be favoured by large lesions. We compared lesions created in unipolar mode using 10-mm/8 F electrodes with those of 4-mm/7 F catheters. Ablations were first performed in porcine hearts in vitro (70 degrees C, 60 s, tangential catheter tip-tissue orientation). Anaesthetized pigs were thereafter ablated with 10- or 4-mm catheters in the right atrial free wall (RAFW), inferior vena cava-tricuspid valve (IVC-TV) isthmus and left ventricle (LV). In vitro, lesion length doubled and lesion volume tripled using the 10-mm catheter. Average power supply was 69 (SD12) (10-mm tip) versus 26 (SD7) W (4-mm tip). In vivo, lesion length increased by 50% and lesion volume fivefold. Charring at the lesion surface or sudden impedance rises were not observed in vivo. Histologically, coagulation necrosis and minor haemorrhages were found. One RAFW lesion (10-mm) showed a dissection approaching the epicardium. Fibrinous platelet clots or overt thromboses covered the endocardial surface in half of all lesions. Three 10-mm electrode isthmus lesions extended to the right descending posterior artery and one LV lesion to the left anterior descending artery, but there was no damage to the arterial walls. Following six ablations with the 10-mm electrode and two with the 4-mm tip, injury to the adjacent lung tissue of 0.5 to 6.0 mm depth was found (p = 0.22)." }, { "role": "assistant", "content": "RF ablation using 10-mm/8 F electrodes created significantly larger lesions. 10-mm electrodes appeared safe in the porcine IVC-TV isthmus and LV, but not in the RAFW. 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, Adult, Aged, Aged, 80 and over, Asian Continental Ancestry Group, Carotid Arteries, Carotid Artery Diseases, Carotid Intima-Media Thickness, China, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Humans, Inpatients, Male, Microvessels, Middle Aged, Regression Analysis, Retinal Vessels, Ultrasonography, Young Adult." }, { "role": "user", "content": "Are retinal microvascular abnormalities associated with early carotid atherosclerotic lesions in hospitalized Chinese patients with type 2 diabetes mellitus? Context: Controversies concerning the association of retinal microvascular abnormalities (RMAs) with atherosclerosis in patients with diabetes exist. The objective of this study was to investigate the association between RMAs and carotid atherosclerotic lesions in Chinese inpatients with type 2 diabetes. This cross-sectional study involved 2870 type 2 diabetic patients including 1602 men aged 15-90 years and 1268 women aged 17-88 years. Both retinal arteriosclerosis (RA) and diabetic retinopathy (DR) were determined by digital fundus photography using a standardized protocol. RMAs are defined as the presence of either RA or DR. Carotid atherosclerotic lesions including carotid intima-media thickness (CIMT), carotid atherosclerotic plaque and stenosis were assessed and compared between patients with and without RMAs based on Doppler ultrasound. The association of RMAs with carotid atherosclerotic lesions was analyzed by linear and binary logistic regression analyses. The CIMT values in both male and female diabetics with RMAs were significantly greater than in those without RMAs after controlling for age (0.88±0.21 vs. 0.77±0.20 mm for men, p=0.002; and 0.84±0.19 vs. 0.76±0.21 mm for women, p=0.002). The prevalence of carotid plaque was also markedly higher in patients with RMAs than in those without RMAs after adjusting for age (54.3% vs. 23.9% for men, p<0.001; 48.4% vs. 32.0% for women, p=0.046). However, no significant difference was observed in the prevalence of carotid stenosis in either men or women with or without RMAs. After controlling for multiple confounding factors, RMAs were independently associated with increased CIMT in both men (β: 0.067, 95% CI: 0.026-0.269, p=0.018) and women (β: 0.087, 95% CI: 0.058-0.334, p=0.005) with type 2 diabetes, and they were also closely associated with the presence of carotid plaque (OR: 2.17, 95% CI: 1.54-3.05, p<0.001 for men; OR: 1.38, 95% CI: 0.91-2.08, p=0.129 for women) in men with type 2 diabetes." }, { "role": "assistant", "content": "RMAs were closely associated with early carotid atherosclerotic lesions in hospitalized Chinese patients with type 2 diabetes. Our results suggested that changes in retinal microvasculature may play a role in the pathogenesis of atherosclerosis and may be used as an indicator of early atherosclerosis in patients with type 2 diabetes. 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, Child, Exercise Test, Female, Humans, Male, Physical Fitness, Reference Values, Running." }, { "role": "user", "content": "Do international normative 20 m shuttle run values from 1 142 026 children and youth representing 50 countries? Context: To develop sex-specific and age-specific international norms for the 20 m shuttle run test (20mSRT) in children and youth (aged 9-17 years), and to estimate the prevalence meeting the FITNESSGRAM criterion-referenced standards for healthy cardiorespiratory endurance (CRE). A systematic review was undertaken to identify papers explicitly reporting descriptive 20mSRT (with 1 min stages) data on children and youth since 1981. Data were included on apparently healthy (free from known disease/injury) 9-17 years old. Following standardisation to a common metric and for protocol differences, pseudo data were generated using Monte Carlo simulation, with population-weighted sex-specific and age-specific normative centiles generated using the Lambda Mu and Sigma (LMS) method. Sex-related and age-related differences were expressed as per cent and standardised differences in means. The prevalence with healthy CRE was estimated using the sex-specific and age-specific FITNESSGRAM criterion-referenced standards for [Formula: see text]. Norms were displayed as tabulated centiles and as smoothed centile curves for the 20mSRT using 4 common metrics (speed at the last completed stage, completed stages/minutes, laps and relative [Formula: see text]). The final data set included 1 142 026 children and youth from 50 countries, extracted from 177 studies. Boys consistently outperformed girls at each age group (mean difference±95% CI: 0.86±0.28 km/h or 0.79±0.20 standardised units), with the magnitude of age-related increase larger for boys than for girls. A higher proportion of boys (mean±95% CI: 67±14%) had healthy CRE than girls (mean±95% CI: 54±17%), with the prevalence of healthy CRE decreasing systematically with age." }, { "role": "assistant", "content": "This study provides the most comprehensive and up-to-date set of international sex-specific and age-specific 20mSRT norms for children and youth, which have utility for health and fitness screening, profiling, monitoring and surveillance. 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: Body Weight, Brachytherapy, Education, Endometrial Neoplasms, Female, Humans, Middle Aged, Poland, Retrospective Studies, Risk Factors, Rural Population, Urban Population." }, { "role": "user", "content": "Does effect of demographic factors on brachytherapy treatment result in patients with endometrial cancer 1995-2010? Context: Approximately 1 in 20 female cancers in Europe is of the endometrium. Endometrial carcinoma is the most common gynaecologic cancer. Considering the fact that an upward tendency has recently been observed in morbidity due to this type of cancer, this is a serious medical problem. The presented report describes the results of the analysis of selected demographic factors and their effect on the incidence of endometrial cancer. Analysis of the results of treatment of endometrial cancer during 1995-2010 was also an objective of the study. Based on medical records obtained from the HDR Laboratory of Brachytherapy at the Gynaecological & Obstetrics Clinical Hospital, University of Medical Sciences in Poznań, the results of treatment of patients with endometrial cancer by brachytherapy were analyzed. The analysis covered a group of 400 patients. More than a half of the patients completed their education on the level of elementary or secondary school. Taking into consideration the weight of the patients, it appeared that most women had excessive body weight. Most frequently, concomitant hypertension was observed. Moreover, the age at menarche was 12 and 13." }, { "role": "assistant", "content": "Demographic factors exert a significant effect on the incidence of endometrial cancer. 1. Overweight and obesity are important risk factors of endometrial cancer. 2. A strong relationship is observed between the occurrence of hypertension or diabetes, and the development of endometrial cancer. 3. Women who come from the rural environment and continue to live in this environment are more likely to contract endometrial cancer. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Not a risk for cholangio carcinoma -" }, { "role": "assistant", "content": "The correct answer is </p> Davidson&;s principles and practice of medicine 22nd edition. *The tumour is associated with gallsgallstones,primary and secondary cholangitis,caroli&;s disease and choledochalcyst,chronic liver fluke infection (clonorchis sinensis) is the major risk factor for development for CCA.</p>" } ]

[ { "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": "There is a mid-cycle shift in the basal body temperature (BBT) after ovulation in women. This is caused by:" }, { "role": "assistant", "content": "The correct answer is Basal Body Temperature Biphasic changes in BBT are characteristic of the ovulatory cycle Mediated by alterations in progesterone levels. Secretion of progesterone following ovulation causes a temperature rise of about 0.5 to 1degF over the baseline temperature of 97degF to 98.8degF that is typically recorded during the follicular phase of the menstrual cycle. Ovulation is assumed after 3 consecutive days of raised temperatures." } ]

[ { "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: AIDS-Associated Nephropathy, Adult, African Americans, Aged, Anemia, Sickle Cell, Apolipoprotein L1, Apolipoproteins, Apolipoproteins L, Disease Progression, Female, Genetic Predisposition to Disease, Glomerulosclerosis, Focal Segmental, High-Throughput Nucleotide Sequencing, Humans, Hypertension, Renal, Kidney Failure, Chronic, Lipoproteins, HDL, Lupus Nephritis, Male, Middle Aged, Molecular Motor Proteins, Myosin Heavy Chains, Nephritis, Polymorphism, Single Nucleotide, Renal Insufficiency, Chronic, Sequence Analysis, DNA." }, { "role": "user", "content": "Does re-Sequencing of the APOL1-APOL4 and MYH9 Gene Regions in African Americans Identify Additional Risks for CKD Progression? Context: In African Americans (AAs), APOL1 G1 and G2 nephropathy risk variants are associated with non-diabetic end-stage kidney disease (ESKD) in an autosomal recessive pattern. Additional risk and protective genetic variants may be present near the APOL1 loci, since earlier age ESKD is observed in some AAs with one APOL1 renal-risk variant, and because the adjacent gene MYH9 is associated with nephropathy in populations lacking G1 and G2 variants. Re-sequencing was performed across a ∼275 kb region encompassing the APOL1-APOL4 and MYH9 genes in 154 AA cases with non-diabetic ESKD and 38 controls without nephropathy who were heterozygous for a single APOL1 G1 or G2 risk variant. Sequencing identified 3,246 non-coding single nucleotide polymorphisms (SNPs), 55 coding SNPs, and 246 insertion/deletions. No new coding variations were identified. Eleven variants, including a rare APOL3 Gln58Ter null variant (rs11089781), were genotyped in a replication panel of 1,571 AA ESKD cases and 1,334 controls. After adjusting for APOL1 G1 and G2 risk effects, these variations were not significantly associated with ESKD. In subjects with <2 APOL1 G1 and/or G2 alleles (849 cases; 1,139 controls), the APOL3 null variant was nominally associated with ESKD (recessive model, OR 1.81; p = 0.026); however, analysis in 807 AA cases and 634 controls from the Family Investigation of Nephropathy and Diabetes did not replicate this association." }, { "role": "assistant", "content": "Additional common variants in the APOL1-APOL4-MYH9 region do not contribute significantly to ESKD risk beyond the APOL1 G1 and G2 alleles. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "What is common in amalgam and ceramics?" }, { "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: Aged, Base Sequence, Carcinoma, Non-Small-Cell Lung, DNA Primers, Female, Gene Expression Regulation, Neoplastic, Humans, Lung, Lung Neoplasms, Male, Middle Aged, Neoplasm Metastasis, Neoplasm Staging, Osteonectin, Osteopontin, Prognosis, RNA, Messenger, Reverse Transcriptase Polymerase Chain Reaction, Sialoglycoproteins, Survival Analysis." }, { "role": "user", "content": "Is osteopontin but not osteonectin messenger RNA expression a prognostic marker in curatively resected non-small cell lung cancer? Context: The purpose of this study was to better define the role of osteopontin (OPN) and osteonectin [also known as secreted protein acidic and rich in cysteine (SPARC)] in lung tumorigenesis by comparing the expressions of these genes in lung tumor tissue and matched normal tissue and by determining the prognostic significance of the gene expressions. Quantitative real-time reverse transcription-PCR was used to analyze OPN and SPARC mRNA expression in normal lung tissue and matching tumor samples from 82 patients with non-small cell lung cancer. Gene expression data for each patient were matched to survival data. The overall median mRNA expression level of OPN was about 20-fold higher in tumor tissues than in matching normal lung tissues (P < 0.001), whereas SPARC gene expression was not significantly different in both tissue types. Forty of 82 patients had high (>or=4.1) intratumoral OPN expression, and 15 of 82 patients had high (>or15.5) SPARC expression. High OPN expression in the tumor tissue was associated with inferior survival (P = 0.014), whereas high SPARC expression showed a trend toward longer survival (P = 0.095). The impact of high OPN and low SPARC expression on patient survival was additive (P = 0.001)." }, { "role": "assistant", "content": "The large increase in OPN expression in tumors compared with normal tissue and its association with survival suggest a role for OPN in lung tumorigenesis. 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": "Bilateral Babinski sign is characteristic of:" }, { "role": "assistant", "content": "The correct answer is Ans. a. Pontine hemorrhage (Ref: Harrison 19/e p2583, 209, 18/e p3286-3287)Features of Pontine StrokeSudden onsetDeep coma with quadriplegia (usually occurs over few minutes)Pinpoint pupil (1 mm pupils) that react to lightLoss of reflex eye movements and corneal responsesDecerebrate rigidity/PosturingHyperpnea/HyperventilationSevere hypertensionOcular bobbingExcessive sweating/HyperhidrosisHyperpyrexiaPontine StrokesVentral pontine syndrome (Millard Gubler syndrome)Lower dorsal pontine syndrome (Foville's syndrome)Upper dorsal pontine syndrome (Raymond ceston syndrome)* Caused by paramedian infarction of pons* Caused by lesion is dorsal tegmentum of lower pons* Caused by obstruction of long circumferential branches of basilar artery" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, BACKGROUND, METHODS, RESULTS. Meshes: Abnormalities, Multiple, Cerebellum, Chromosome Mapping, Chromosomes, Human, Pair 7, Consanguinity, Epilepsy, Fatal Outcome, Genes, Recessive, Genotype, Humans, Intellectual Disability, Lod Score, Microcephaly, Musculoskeletal Diseases, Oman, Pedigree, Pons." }, { "role": "user", "content": "Does a novel form of pontocerebellar hypoplasia map to chromosome 7q11-21? Context: To describe a novel form of pontocerebellar hypoplasia (PCH) and map its genetic locus. PCH is a heterogeneous group of disorders that are characterized by abnormally small cerebellum and brainstem. Autosomal recessive inheritance has been implied in many cases, but no genetic loci have been mapped to date. The authors studied a consanguineous family from the Sultanate of Oman with three siblings with a novel form of PCH. The authors performed clinical studies and linkage analysis of this pedigree. The clinical features of the affected children include developmental delay, progressive microcephaly with brachycephaly, seizures during the first year of life, hypotonia with hyperreflexia, short stature, and optic atrophy. Imaging studies showed a small pons and cerebellum, prominent sulci and lateral ventricles, and decreased cerebral white matter volume. A lack of dyskinesias distinguishes this pedigree from PCH type 2. Genetic studies of this family revealed evidence of significant linkage to chromosome 7q11-21 (maximum multipoint lod score 3.23)." }, { "role": "assistant", "content": "This pedigree represents a novel form of autosomal recessive PCH, which the authors propose to call cerebellar atrophy with progressive microcephaly (CLAM). This disorder maps to chromosome 7q11-21, and this locus was named CLAM. This report represents the first identification of a genetic locus for PCH. 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": "Tricarboxylic acid cycle to be continuous requires the regeneration of" }, { "role": "assistant", "content": "The correct answer is Oxaloacetate may be viewed as a catalyst, which enters into the reaction, causes complete oxidation of acetyl CoA and comes out of it without any change.\nReference: Vasudevan 7th  ed, pg 249" } ]

[ { "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, Arginine, Enterocytes, Enzyme Inhibitors, Female, Intestine, Small, Laparotomy, Male, NG-Nitroarginine Methyl Ester, Nitric Oxide, Nitric Oxide Donors, Nitric Oxide Synthase, Physical Stimulation, Rats, Rats, Wistar." }, { "role": "user", "content": "Does nitric oxide protect the intestine from the damage induced by laparotomy and gut manipulation? Context: The intestine is highly susceptible to free radical-induced damage, and our earlier work has shown that surgical stress induces the generation of oxygen free radicals in enterocytes, resulting in intestinal damage along with ultrastructural changes. Since nitric oxide (NO) is an important mediator of gastrointestinal function, this study looked at the effect of NO on surgical stress-induced intestinal alterations. Control rats and rats pretreated with the NO donor l-arginine were subjected to surgical stress by opening the abdominal wall and handling the intestine as done during laparotomy. Enterocytes were isolated and homogenate prepared, and the protection offered by l-arginine against damage due to surgical stress was determined and compared with normal controls. Protection to structural as well as functional aspects of the intestine was also examined. Intestinal manipulation affected intestinal structure as assessed by electron microscopy. Functional impairment of the enterocyte was also evident, with increased xanthine oxidase activity resulting in production of superoxide anion. This impairment is more dramatic in the crypt cells. Increased protease activity was also seen following laparotomy and handling. Pretreatment with the NO synthase substrate l-arginine prevented these damaging effects. Arginine protection was abolished in the presence of the NO synthase inhibitor NG-nitro-l-arginine methyl ester, indicating the role of NO." }, { "role": "assistant", "content": "Stress in the small intestine due to any surgery can affect enterocyte structure and function. These damaging effects can be prevented by NO, an important modulator of cellular function. 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: Adolescent, Adult, Aged, Child, Fasting, Female, Folic Acid, Homocysteine, Humans, Male, Methionine, Middle Aged, Risk Factors, Venous Thrombosis, Vitamin B 12, Vitamin B 6." }, { "role": "user", "content": "Are low plasma levels of vitamin B ( 6 ) independently associated with a heightened risk of deep-vein thrombosis? Context: Elevated plasma levels of total homocysteine (tHcy) before and after an oral methionine load (PML) are associated with an elevated risk of deep-vein thrombosis (DVT). We investigated whether plasma levels of B vitamins that are involved in Hcy metabolism are associated with an elevated risk of DVT. We compared 397 cases with previous DVT with 585 matched healthy controls. The plasma levels of folate, vitamin B(12), vitamin B(6,), and fasting and PML tHcy were measured. The ORs for DVT associated with high (>95th percentile) fasting levels and PML increases of tHcy were 2.1 (95% CI, 1.2 to 3.4) and 2.4 (95% CI, 1.5 to 3.9) after adjustment for established risk factors for DVT. Fasting plasma levels and PML increases in tHcy correlated negatively with vitamin levels. The crude OR for folate levels in the lowest quartile compared with the highest was 1.5 (95% CI, 1.1 to 2.1), and that for B(6) levels in the lowest and second quartiles compared with the highest was 1.5 (95% CI, 1.0 to 2.1). However, after adjustment for established risk factors and fasting and PML tHcy, the ORs for B(6) levels in the lowest and second quartiles only remained statistically significant (lowest quartile: OR, 1.8; 95% CI, 1.2 to 2.8; second quartile, OR, 1.9; 95% CI, 1.3 to 2.9)." }, { "role": "assistant", "content": "High fasting and PML tHcy and low vitamin B(6) plasma levels are associated with an elevated risk for DVT independently of established risk factors for DVT. The association of low vitamin B(6) levels with the risk for DVT is independent of fasting and PML tHcy levels. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: AIMS, METHODS AND RESULTS. Meshes: Aged, Aged, 80 and over, Cardiac Pacing, Artificial, Cost-Benefit Analysis, Female, Follow-Up Studies, Heart Block, Humans, Male, Middle Aged, Pacemaker, Artificial." }, { "role": "user", "content": "Cost-effectiveness of dual-chamber pacemaker therapy: does single lead VDD pacing reduce treatment costs of atrioventricular block? Context: Implantation of single-lead VDD pacemakers is an established alternative to DDD pacing in patients with atrioventricular block. This study compares the long-term costs of both systems. Three hundred and sixty patients with atrioventricular block received VDD or DDD pacemakers in alternating order. Primary costs of implantation included: devices, leads and operation material, surgeons, nurses, medical technicians, and hospitalization. The mean cost of an uncomplicated DDD pacemaker implantation was defined as 1000 virtual cost-units (CU). Costs of pacemaker related complications or re-operations as well as upgrades from VDD to DDD devices were considered secondary costs and assessed during a mean follow-up period of 42+/-15 months. Pacing efficacy was assessed by event-free survival with maintained atrioventricular synchronized pacing mode. Costs of pacemaker devices were not different (639+/-26 CU in VDD vs 641+/-32 CU in DDD, ns). However, due to lower costs of lead hardware (102+/-10 CU in VDD vs 133+/-14 CU in DDD, P<0.001) and shorter implantation procedures (44.3+/-5.1 min vs 74.4+/-13.5 min, P<0.001), costs of an uncomplicated implantation were 8.9% lower in the VDD group (911+/-35 CU vs 1000+/-39 CU, P<0.001). A smaller complication rate in the VDD group led to a 16.1% reduction of secondary costs (26+/-17 CU year(-1)vs 31+/- 25 CU year(-1), P=0.024). Event-free survival did not differ between groups (83.4% in VDD vs 84.9% in DDD, ns)." }, { "role": "assistant", "content": "Use of single-lead VDD pacemakers achieves significant reduction of implantation and follow-up costs without loss of therapeutic efficacy compared to conventional DDD systems." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is the most sensitive method for detecting cervical Chlamydia trachomatis infection?" }, { "role": "assistant", "content": "The correct answer is PCR and LCR are both sensitive and specific methods for detecting cervical Chlamydia trachomatis infection in women. Nucleic acid amplification test is the most sensitive method for detecting Chlamydia trachomatis in endocervical samples (CDC2002). PCR is a method to amplify minute amounts of genetic material. The reaction can thus be used for detecting very tiny amounts of pathogen. Prerquisite is the preparation of pathogen specific DNA primer. Ref: Women's Gynecologic Health By Kerri Durnell Schuiling, Page 131 ; Microbial Pathogenesis: A Principles-Oriented Approach, 1st Edition, By Bruce A. McClane, Page 156 ; Rapid Detection of Infectious Agents By Steven Specter, Page 87 ; Infections in Obstetrics and Gynecology: Textbook and Atlas By Eiko E. Petersen, Page 35" } ]

[ { "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, Behavior, Animal, Circadian Rhythm, Drinking, Drug Administration Schedule, Eating, Feeding Behavior, Leptin, Male, Melatonin, Photoperiod, Rats, Rats, Sprague-Dawley, Time Factors." }, { "role": "user", "content": "Does daytime melatonin treatment influence food carrying ( hoarding ) behavior in rats? Context: Three experiments were performed to verify whether melatonin (MEL) may influence hoarding behavior in rats. This hypothesis was supported by the consideration that leptin treatment decreases food hoarding in hamsters and that an inverse relation exists between plasma leptin concentration and MEL treatment. Male Sprague-Dawley rats housed individually and kept on 12h:12h light-dark cycle were used. First experiment was performed to check whether a bimodal distribution of food hoarding scores exists in rats, and to select two groups of high (HH-rats) or low (LH-rats) hoarding. Second experiment was designed to verify whether MEL treatment modifies food-hoarding, while the third one was performed to investigate whether MEL treatment was able to modify the reciprocal relation between leptin and MEL plasma concentration. In rats the hoarding tendency fell into a bimodal distribution and the plasma leptin concentration was significantly higher in HH-rats than LH-rats. When MEL was injected, circulating concentration of leptin was decreased in both HH-rats and LH-rats and such MEL treatment significantly increased the number of pellets hoarded by LH-rats but not that hoarded by HH-rats." }, { "role": "assistant", "content": "MEL influences the food-hoarding in rats either directly, or indirectly by the MEL and leptin reciprocal interaction. Our results support the hypothesis that the endocrine system either directly, by the action of one or more combined hormones (MEL, leptin), or indirectly via its actions on neural substrates determines, at least in part, food-hoarding of 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: BACKGROUND, METHODS. Meshes: Animals, Computational Biology, Gene Expression Profiling, Male, MicroRNAs, Oligonucleotide Array Sequence Analysis, Reproducibility of Results, Sexual Maturation, Spermatogenesis, Swine, Testis." }, { "role": "user", "content": "Does microarray-based approach identify differentially expressed microRNAs in porcine sexually immature and mature testes? Context: MicroRNAs (miRNAs) are short non-coding RNA molecules which are proved to be involved in mammalian spermatogenesis. Their expression and function in the porcine germ cells are not fully understood. We employed a miRNA microarray containing 1260 unique miRNA probes to evaluate the miRNA expression patterns between sexually immature (60-day) and mature (180-day) pig testes. One hundred and twenty nine miRNAs representing 164 reporter miRNAs were expressed differently (p<0.1). Fifty one miRNAs were significantly up-regulated and 78 miRNAs were down-regulated in mature testes. Nine of these differentially expressed miRNAs were validated using quantitative RT-PCR assay. Totally 15,919 putative miRNA-target sites were detected by using RNA22 method to align 445 NCBI pig cDNA sequences with these 129 differentially expressed miRNAs, and seven putative target genes involved in spermatogenesis including DAZL, RNF4 gene were simply confirmed by quantitative RT-PCR." }, { "role": "assistant", "content": "Overall, the results of this study indicated specific miRNAs expression in porcine testes and suggested that miRNAs had a role in regulating spermatogenesis. 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: Animals, Cell Nucleolus, Cell Nucleus, Cell Nucleus Shape, Cell Polarity, Centromere, DNA, Ribosomal, Embryo, Mammalian, Embryonic Development, Female, Heterochromatin, In Situ Hybridization, Fluorescence, Male, Mice, Telomere, Zygote." }, { "role": "user", "content": "Does 3D-FISH analysis of embryonic nuclei in mouse highlight several abrupt changes of nuclear organization during preimplantation development? Context: Embryonic development proceeds through finely tuned reprogramming of the parental genomes to form a totipotent embryo. Cells within this embryo will then differentiate and give rise to all the tissues of a new individual. Early embryonic development thus offers a particularly interesting system in which to analyze functional nuclear organization. When the organization of higher-order chromatin structures, such as pericentromeric heterochromatin, was first analyzed in mouse embryos, specific nuclear rearrangements were observed that correlated with embryonic genome activation at the 2-cell stage. However, most existing analyses have been conducted by visual observation of fluorescent images, in two dimensions or on z-stack sections/projections, but only rarely in three dimensions (3D). In the present study, we used DNA fluorescent in situ hybridization (FISH) to localize centromeric (minor satellites), pericentromeric (major satellites), and telomeric genomic sequences throughout the preimplantation period in naturally fertilized mouse embryos (from the 1-cell to blastocyst stage). Their distribution was then analyzed in 3D on confocal image stacks, focusing on the nucleolar precursor bodies and nucleoli known to evolve rapidly throughout the first developmental stages. We used computational imaging to quantify various nuclear parameters in the 3D-FISH images, to analyze the organization of compartments of interest, and to measure physical distances between these compartments." }, { "role": "assistant", "content": "The results highlight differences in nuclear organization between the two parental inherited genomes at the 1-cell stage, i.e. just after fertilization. We also found that the reprogramming of the embryonic genome, which starts at the 2-cell stage, undergoes other remarkable changes during preimplantation development, particularly at the 4-cell stage. 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": "Aspirin is associated with-" }, { "role": "assistant", "content": "The correct answer is Reye Syndrome \n\nSecondary Mitochondrial hepatopathy.\nH/o viral injection (Influenza, varicella) & salicylate interactions higher mortality rate.\nLFT (raised enzyme with normal bilirubin).\n\nSjogren’s syndrome \n\nAutoimmune disorder.\nA/w generalised dryness (dry mouth-xerostomia, dry eye-keratoconjuncvis sicca).\nA/w other rhemac disorder like - SLF, Rheumatoid arthris, systemic sclerosis.\n\nReiter syndrome \n\nAuto immune.\nRiad of arthris of large joint, uveis, urethris (cervicis in female)." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Allergens, Animals, Asthma, Female, Hair, Humans, Immunoglobulin E, Male, Middle Aged, Nose, Rhinitis, Allergic, Seasonal, Risk Factors, Skin Tests, Surveys and Questionnaires, Young Adult." }, { "role": "user", "content": "Does nasal hair (vibrissae) density affect the risk of developing asthma in patients with seasonal rhinitis? Context: Large particles entering the nose are collected by nasal hair present in the anterior nares. Increased hair density provides an improvement in the filtering efficiency of the nose, while reduced amounts of nasal hair cause a decrease in its efficiency. The amount of nasal hair can vary between individuals, which can make a difference in the filtering efficiency of the nose. Reduced filter function of the nose leads to increased exposure of the airways to allergens. The aim of this study was to determine the effect of nasal hair density on the risk of developing asthma in seasonal rhinitis (SR) patients. A standard questionnaire was filled in, and physical examination and allergy tests were performed in 233 patients. Patients were divided into 3 groups according to the amount of nasal hair [few (few or none), moderate and many]. The association between asthma and nasal hair density was assessed. Asthma was detected in 75 patients (32.2%), and of these, 45 (60%) also had pollen asthma. The rate of asthma was 44.7, 26.2 and 16.7% in the few, moderate and many groups, respectively (p = 0.002). Few nasal hairs significantly increased the risk of developing asthma [odds ratio (95% confidence interval): few, reference; moderate, 0.41 (0.21-0.78); many, 0.19 (0.06-0.55); p = 0.002]." }, { "role": "assistant", "content": "Our findings suggest that the amount of nasal hair providing a nose filtration function has a protective effect on the risk of developing asthma in SR patients. To the best of our knowledge, this is the first report on this subject in the literature." } ]

[ { "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 minimum possible score in \"Glasgow coma scale'' is:" }, { "role": "assistant", "content": "The correct answer is Ans: C (3) Ref: Harrison 3 Principles of Internal Medicine. 18th edition. 2012. Chapter 267 (Table 267-1)Explanation:Glasgow Coma Scale for Head InjuryEye opening (E) Verbal response (V) Spontaneous4Oriented5To loud voice3Confused, disoriented4To pain2Inappropriate words3Nil1Incomprehensible sounds2 Nil1Best motor response (M) Obeys6 Localizes5 Withdraws (flexion)4 Abnormal flexion posturing3 Extension posturing2 Nil1 Note: Coma score = E + M + V,The lowest possible score = 1 + 1 + 1 =3" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 27-year-old man comes to the physician for a follow-up evaluation. Two days ago, he was involved in a physical altercation and sustained a bruise on his left arm and an injury to his left shoulder. Initially, there was a reddish-purple discoloration on his left upper arm. A photograph of the left upper arm today is shown. Which of the following enzymes is most likely responsible for the observed changes in color?" }, { "role": "assistant", "content": "Heme oxygenase" } ]

[ { "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, Antibodies, Anticardiolipin, Antibodies, Monoclonal, Antirheumatic Agents, Arthritis, Rheumatoid, Etanercept, Female, Humans, Immunoglobulin G, Immunosuppressive Agents, Infliximab, Male, Middle Aged, Receptors, Tumor Necrosis Factor, Retrospective Studies, Treatment Outcome, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Does treatment with tumour necrosis factor alpha antagonists in patients with rheumatoid arthritis induce anticardiolipin antibodies? Context: To determine the frequency and clinical impact of anticardiolipin antibodies (aCL) in patients with rheumatoid arthritis treated with infliximab and etanercept. 121 patients from the Stockholm tumour necrosis factor alpha (TNFalpha) follow up registry (STURE) treated with infliximab or etanercept were studied. At baseline 9/65 (14%) infliximab and 10/56 (18%) etanercept treated patients had positive aCL. After 3 months the frequencies of aCL positivity were 29% (p<0.05 compared with baseline) and 27%, respectively, and after 6 months 28% and 25%. Increases were seen for both IgG and IgM aCL. Increasing age, a higher number of prior DMARDs, and higher DAS28 were predictors for the development of aCL. In the infliximab treated patients, 26/30 (87%) aCL(-) but only 7/14 (50%) aCL(+) patients met the ACR20 criteria (p<0.05), and the frequency of treatment limiting infusion reactions in the aCL(+) patients was higher than expected (17%). aCL positivity in the etanercept treated patients did not show such a clinical correlate. Four patients had thromboembolic events, of whom two were aCL(+) and two aCL(-)." }, { "role": "assistant", "content": "Frequencies of both IgM and IgG aCL positivity increase in patients treated with these TNFalpha antagonists for 3 months or longer. Increasing age, a greater number of prior DMARDs and a greater disease activity at baseline are predictors for the development of aCL. The development of aCL during treatment with infliximab, but not etanercept, is associated with worse clinical results and more frequent serious infusion reactions. aCL are an important class of autoantibodies associated with TNFalpha blocking 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": "Maximum electrophoretic mobility and least lipid content -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., HDL o HDL:- Has maximum electrophoretic mobility, has maximum density, has minimum lipid content, has maximum protein (apoprotein) content, are smallest in size, has maximum phospholipid, has minimum triglycerideso Chylomicrons :- Have no electrophoretic mobility, have minimum density, have maximum lipid content, have minimum protein content, are largest in size, have minimum phospholipids, have maximum triglycerides. ChylomicronVLDLLDLHDLElectrophoresisFound at originPre-b (a2)ba (or a1)Mobility in electric fieldLeast Found in beta regionHighestAporproteinApob48Apo b-100Apo b-100Apo A-1 & IIOrigin (synthesis)Intestine (-nt in serum)Liver, intestineIn blood from degradationLiver of VLDLSize1000-10,000 A0 (maxm)300-700 A (minm)150-250 A075-100A0Density<.96 (lowest) > 1.063 (Max.)Major lipidsTG (90%)TG (50%)Cholesterol (45%)PL (30%)FunctionsTransports exogenous/dietary TG (Intestine - liver)Transport endogenous TG liver - peripheral tissueAtherogenic caused CAD coronary artery d/s; (major transporter of choresstrol in bid)Scavenging action transports cholest- rol from peripheral tissue to liver for degrada\"" } ]

[ { "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 Movement, Rabbits, Simvastatin, Subarachnoid Hemorrhage, Vasospasm, Intracranial." }, { "role": "user", "content": "Does systemic administration of simvastatin after the onset of experimental subarachnoid hemorrhage attenuate cerebral vasospasm? Context: Experimental evidence suggests that intercellular adhesion molecule-1 mediated leukocyte extravasation contributes to the pathogenesis of cerebral vasospasm. Simvastatin, an HMG-CoA reductase inhibitor, decreases intercellular adhesion molecule-1 expression and competitively inhibits leukocyte intercellular adhesion molecule-1 binding. We hypothesized that administration of simvastatin after the onset of subarachnoid hemorrhage (SAH) would attenuate perivascular granulocyte migration and ameliorate cerebral vasospasm in a rabbit model of SAH. New Zealand white rabbits (n = 15) underwent injection of autologous blood into the cisterna magna or sham surgery followed by subcutaneous injection of simvastatin (40 mg/kg) or vehicle 30 minutes, 24 hours, and 48 hours after SAH or sham surgery. Seventy-two hours later, basilar artery lumen diameter was measured by in situ perfusion/fixation and image analysis. CD-18 monoclonal antibody stained perivascular granulocytes and macrophages were counted under light microscopy. In vehicle treated rabbits, mean +/- standard deviation basilar artery diameter was reduced 3 days after SAH (n = 5) versus sham (n = 5) rabbits (0.49 +/- 0.08 mm versus 0.75 +/- 0.03 mm, P < 0.01). After SAH, mean +/- standard deviation basilar artery diameter was greater in simvastatin (n = 5) treated rabbits versus vehicle (n = 5) (0.63 +/- 0.04 mm versus 0.49 +/- 0.08 mm, P < 0.01). In vehicle treated rabbits, SAH resulted in an increase in the mean +/- standard deviation perivascular CD18 cell count (sham-vehicle, 2.8 +/- 2; SAH-vehicle 90 +/- 27; P < 0.01). Subcutaneous administration of simvastatin attenuated this increase in perivascular CD18-positive cells after SAH (SAH statin, 41.6 +/- 13; SAH vehicle, 90 +/- 27; P < 0.001)." }, { "role": "assistant", "content": "Subcutaneous administration of simvastatin after the onset of SAH attenuates perivascular granulocyte migration and ameliorates basilar artery vasospasm after experimental SAH in rabbits. 5-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, such as simvastatin, may potentially serve as agents in the prevention of cerebral vasospasm after SAH. 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: Acacia, Antioxidants, Biphenyl Compounds, Diet, Dietary Fats, Dietary Proteins, Ecotype, Fatty Acids, Omega-6, Flavonoids, Humans, Phenols, Picrates, Polyphenols, Seeds, Tunisia." }, { "role": "user", "content": "Unexploited Acacia cyanophylla seeds: potential food sources of ω6 fatty acids and antioxidants? Context: In order to investigate new sources of dietary phytochemicals, recent studies have focused on underexploited seeds. In this study the total lipid contents, fatty acid profiles and levels of soluble proteins, minerals and antioxidants in seeds from 12 Acacia cyanophylla ecotypes commonly grown in Tunisia were determined. Total lipids averaged 101.7 g kg(-1) on a dry weight basis. Linoleic (61.11-65.45% of total fatty acid content), oleic (19.67-22.85%) and palmitic (9.18-9.98%) acids were the principal fatty acids. Smaller proportions of stearic (1.49-1.82%), vaccenic (1.13-2.05%) and palmitoleic (0.34-0.58%) acids were also quantified. Proteins (by Kjeldahl assay) averaged 107.2 g kg(-1) on a dry weight basis. Total phenolics averaged 1.91 g gallic acid equivalent kg(-1) dry weight (DW) and total flavonoids averaged 0.40 g rutin equivalent kg(-1) DW. The free radical-scavenging activity determined by 2,2-diphenyl-1-picrylhydrazyl assay averaged 0.59 mmol L(-1) Trolox equivalent antioxidant capacity (TEAC), while that determined by 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) assay averaged 0.28 mmol L(-1) TEAC." }, { "role": "assistant", "content": "The findings of this study confirm the presence of ω6 fatty acids at high levels in A. cyanophylla seeds. These metabolites could be used as such and/or extracted for the formulation of supplements and/or ingredients to provide a ratio close to the ideal for the ω3/ω6 balance." } ]

[ { "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": "Insulin resistance in pregnancy is because of:" }, { "role": "assistant", "content": "The correct answer is During pregnancy, insulin levels are increased because of increased insulin secretion as well as increase in insulin resistance due to number of contra insulin factors. These are Estrogen Progesterone Human placental lactogen Coisol Prolactin The main hormone responsible for insulin resistance is HPL. Ref:Dutta Obs 9e pg 55." } ]

[ { "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": "Short metacarpal seen in?" }, { "role": "assistant", "content": "The correct answer is Ans DCauses of short metacarpal are: Basal cell nevus syndrome, Idiopathic, Chromosomal: Turner syndrome and Pseudohypo- parathyroidism/pseudopseduohypoparathyroidism, Trauma/ 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: METHODS, RESULTS. Meshes: C-Reactive Protein, Cholesterol, HDL, Cholesterol, LDL, Comorbidity, Dyslipidemias, Female, Humans, Latex Fixation Tests, Lupus Erythematosus, Systemic, Male, Triglycerides." }, { "role": "user", "content": "Is there a relationship between serum C-reactive protein level and dyslipidaemia in systemic lupus erythematosus? Context: seventy six patients fulfilled the American College of Rheumatology criteria for classification of Systemic Lupus Erythematosus (SLE) (revised in 1997) were enrolled in our study. Clinical and laboratory measures included complete history and physical examination, determination of serum CRP level by latex agglutination test and lipid profile. Statistical significance of association was analysed by X2 test. T-test were used to compare values of each lipid component between positive and negative CRP group. All analyses were performed using the SPSS 10.0 computer software. the study was done in 76 (73 female and 3 male) SLE patients. Dyslipidaemia was found in 57 patients (75.0%). Hypercholesterolemia was found in 31 patients (40.8%), hypertriglyceridemia in 33 patients (43.4%), low HDL cholesterol in 19 patients (25%) and high LDL cholesterol in 28 patients (36.8%). Patients with positive CRP (66 patients) demonstrated dyslipidaemia in 49 patients (74.2%) and patients with negative CRP (10 patients) showed dyslipidaemia in 8 patients (80.0%)(P 1.0). There was no association between CRP and abnormal values of each lipid component (cholesterol, triglyceride, HDL and LDL cholesterol)(P value 0.30, 0.74, 0.43, 0.15 respectively). There was also no association between CRP and dyslipidaemia as a whole (P 1.00). The difference between serum level of each lipid component between positive and negative CRP group was also non significant (P value 0.68, 0.90, 0.96, 0.59 respectively)." }, { "role": "assistant", "content": "there was no association between CRP and dyslipidaemia in SLE patients. In the development of dyslipidaemia in SLE, factors other than inflammation should be put into consideration." } ]

[ { "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 Stem Cells, Cell Proliferation, Endothelial Cells, Glucose, Growth Substances, Human Growth Hormone, Humans, Immunohistochemistry, In Vitro Techniques, Insulin-Like Growth Factor I." }, { "role": "user", "content": "Do growth factors enhance endothelial progenitor cell proliferation under high-glucose conditions? Context: The purpose of this study was to investigate the impact of growth regulators, including growth hormone (GH), insulin-like growth factor 1 (IGF-1), and mechano growth factor (MGF), on endothelial progenitor cell (EPC) proliferation at different glucose concentrations. EPCs were isolated and cultured from peripheral blood samples of healthy volunteers and immunocytochemically characterized after 7 days. The effects of glucose and growth regulators on EPC proliferation were determined with the Alamar Blue and Trypan Blue assays. The effect of glucose supplementation at 2.5, 11.1, and 25.0 mM was examined using cells seeded at densities of 15000, 30000, and 45000 cells/ml. For the GH-treated cells, enhancement of EPC proliferation was detected in the samples supplemented with 11.1 and 25.0 mM glucose. A slight elevation in EPC proliferation was only observed in the IGF-1-treated cells supplemented with 25.0 mM glucose. Significant enhancement of EPC proliferation was observed in MGF-treated cells supplemented with 11.1 and 25.0 mM glucose. All three growth factors demonstrated enhancement of cellular proliferation when the cells were supplemented with 25.0 mM glucose. No enhancement of EPC proliferation by the growth factors was detected in any of the cells supplemented with 2.5 mM glucose." }, { "role": "assistant", "content": "GH, IGF-1, and MGF enhance EPC proliferation under 25.0 mM glucose conditions. The presence of these growth regulators in EPC culture may contribute to protecting EPCs from high-glucose conditions. This action may be of therapeutic relevance contributing to beneficial cardiovascular effects for diabetic patient. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following types of shock will have high cardiac output" }, { "role": "assistant", "content": "The correct answer is Distributive shock describes the pattern of cardiovascular responses characterising a variety of conditions including septic shock, anaphylaxis and spinal cord injury. Inadequate organ perfusion is accompanied by vascular dilatation with hypotension, low systemic vascular resistance, inadequate afterload and a resulting abnormally high cardiac output." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, BACKGROUND, METHODS, RESULTS. Meshes: Angiotensin II, Animals, Fluorobenzenes, Graft Occlusion, Vascular, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Hyperplasia, Male, Pyrimidines, Random Allocation, Rats, Rats, Wistar, Rosuvastatin Calcium, Stents, Sulfonamides, Tunica Intima." }, { "role": "user", "content": "Does rosuvastatin attenuate angiotensin II-induced neointimal formation after stent implantation in the rat? Context: We investigated the efficacy of oral rosuvastatin treatment to reduce in-stent neointima formation, both in the absence and presence of high levels of the proproliferative substance angiotensin II (Ang II). Drawbacks of current drug-eluting stents include inhibition of reendothelialization, induction of abnormal coronary endothelial function, and, most importantly, late in-stent thrombosis. Statin treatment might be a more subtle approach, with known beneficial vascular effects. Wistar rats were allocated to four treatment groups by two consecutive randomization steps: one to allocate rosuvastatin 0.047% (wt/wt) supplemented rat chow, and one to implant an osmotic minipump releasing Ang II (200 ng/kg). Stents were implanted in the abdominal aorta in all groups. After 4 weeks, in-stent neointima formation and vascular function in the thoracic aorta were determined. In the absence of Ang II, rosuvastatin reduced neointima formation by 23% as compared with control (0.66+/-0.06 versus 0.51+/-0.02 mm2; P<0.05). The presence of Ang II enhanced neointimal area by 30%. This was inhibited to the same extent by rosuvastatin (0.88+/-0.06 versus 0.67+/-0.03 mm2; P<0.05). In parallel, rosuvastatin improved endothelial-dependent vasodilatation, both in the presence and absence of high levels of Ang II." }, { "role": "assistant", "content": "Ang II infusion increases in-stent neointima formation and decreases endothelial function. We now provide evidence that rosuvastatin effectively inhibits in-stent neointima formation and in parallel improves endothelial dilator function, both in the presence and absence of high Ang II levels. 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: ." }, { "role": "user", "content": "Does tGF-β induce fascin expression in gastric cancer via phosphorylation of smad3 linker area? Context: Fascin is an actin-bundling protein critical for tumor invasion. TGF-β could induce fascin expression in gastric cancer cells. In this study, we attempted to explore the role of p-smad3L in the expression of fascin induced by TGF-β in gastric cancer cells. Pseudopodia were evaluated by immunofluorescence. Fascin expression was detected by RT-PCR and western blot. Smad3 siRNA was used to repress the endogenous smad3. The phosphorylations of smad3 linker region at sites s204, s208 and s213 were detected by western blot. The fascin promoter reporter activity was measured by dual luciferase assay. TGF-β could increase the formation of pseudopodia and the expression of fascin in gastric cancer cells. Smad3 depletion abrogated the expression of fascin induced by TGF-β. The phosphorylation of smad3 linker region at serine 204, 208 and 213 was enhanced in gastric cancer cells after TGF-β treatment. The fascin promoter reporter activity was significantly enhanced with TGF-β treatment in both wild-type Smad3 group and Smad3EPSM group (P<0.05). Furthermore, the fascin promoter reporter activity in the wild-type Smad3 transfectant cells was significantly higher than that in Smad3EPSM cells (P<0.05)." }, { "role": "assistant", "content": "fascin expression induced by TGF-β depends on smad3, at least in part, depends on smad3 linker phosphorylation. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, CD8 Antigens, CD8-Positive T-Lymphocytes, Case-Control Studies, Chronic Disease, Female, Genetic Predisposition to Disease, Humans, Male, Membrane Transport Proteins, Middle Aged, Polymorphism, Single Nucleotide, Prospective Studies, Rhinitis, Sinusitis." }, { "role": "user", "content": "Do cD8A gene polymorphisms predict severity factors in chronic rhinosinusitis? Context: A genetic basis to chronic rhinosinusitis (CRS) is postulated, but remains elusive. We have recently identified low levels of circulating CD8 lymphocytes as a frequent finding in difficult-to-treat or refractory CRS. In major histocompatibility complex 1 class 1 (MHC1) deficiency, low circulating levels of CD8 lymphocytes secondary to mutations in the cluster of differentiation 8a (CD8A), tapasin 1 (TAP1), tapasin 2 (TAP2), or tapasin binding-protein (TAPBP) genes lead to a clinical syndrome, which is associated with severe CRS. The objective of this work was to identify whether genetic factors associated with MHC1 deficiency are present in CRS. Previous results from a genomewide association study of CRS were screened for polymorphisms in the CD8A, TAP1, TAP2, and TAPBP genes associated with MHC1 immunodeficiency syndrome. Significant polymorphisms were tested for associations with demographic factors characterizing severe CRS. Polymorphisms in the CD8A (rs3810831) and TAPBP (rs2282851) genes were significantly associated with CRS. Major allele homozygosity for CD8A (rs3810831) was associated with a higher frequency of affected relatives (p = 0.052), increased severity as characterized by age at diagnosis (p = 0.009), age at first surgery (p = 0.004), and number of surgeries (p = 0.008), whereas TAPBP (rs2282851) was associated increased risk for CRS (odds ratio [OR] = 2.48, p = 0.0076)." }, { "role": "assistant", "content": "Modified CD8A or TAPBP gene function may contribute to the development of refractory CRS via altered MHC1 function and reduction of circulating CD8 lymphocytes. Identification of markers in the CD8A or TAPBP genes via sequencing may offer a basis for genetic testing in CRS. 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 methods is used for deflouridation?" }, { "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, METHODS, METHODS, RESULTS. Meshes: Adrenal Insufficiency, Adrenocorticotropic Hormone, Adult, Aged, Asthma, Dose-Response Relationship, Drug, Female, Glucocorticoids, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Middle Aged, Pituitary-Adrenal System, Prospective Studies, ROC Curve, Sensitivity and Specificity." }, { "role": "user", "content": "Does the low-dose ACTH test provide a useful assessment of the hypothalamic-pituitary-adrenal axis in secondary adrenal insufficiency? Context: The 1 microg ACTH stimulation test has been introduced to improve the sensitivity of ACTH as a test of the integrity of hypothalamic-pituitary-adrenal axis (HPAA). This study aims to compare the sensitivity, specificity and diagnostic accuracy of the \"low-dose\" 1 microg ACTH (LDACTH) test and the \"standard dose\" 250 microg ACTH (SDACTH) test, with the overnight metyrapone test (OMT) which assesses the entire HPAA. A prospective evaluation of the performance of SDACTH and LDACTH screening tests in a diverse cohort of patients with possible adrenal insufficiency as routinely encountered in clinical practice using the OMT as the reference method. A total of 51 patients (26 with asthma on inhaled glucocorticoid, nine with hypopituitarism, three with hypothyroidism, one with hyponatraemia, one with Crohn's disease, one with encephalitis and 10 with non-specific symptoms) each underwent SDACTH, LDACTH and OMT tests in random sequence at least 1 week apart. Blood was sampled for plasma cortisol levels at 0 and 30 min after intravenous administration of 1 microg and 250 microg of ACTH. Metyrapone 30 mg/kg body weight was taken orally at midnight, and plasma samples were taken for measurement of 11-deoxycortisol and cortisol next morning between 08.00 and 09.00 h. The OMT was deemed to be abnormal when both 11-deoxycortisol and cortisol levels were less than 200 nmol/l. The sensitivity and specificity at an empirical \"normal\" plasma cortisol threshold value of 500 nmol/l were 67% and 100% for the SDACTH test, and 73% and 81% for the LDACTH test, respectively. As the plasma cortisol cut-off value was increased to 550 nmol/l and 600 nmol/l, the sensitivity of the SDACTH test was 67% and 80% and specificity was 97% and 92%, respectively. The sensitivity of the LDACTH test increased from 93% at plasma cortisol cut-off value of 550 nmol/l to 100% at plasma cortisol cut-off value of 600 nmol/l. However, the specificity of the LDACTH test fell from 72% to 56% as the plasma cortisol cut-off value was increased from 550 nmol/l to 600 nmol/l. A receiver operating characteristic curve demonstrated that the specificity of the SDACTH test was higher than the specificity of the LDACTH test at any given level of sensitivity." }, { "role": "assistant", "content": "Both the LDACTH and SDACTH tests fail to achieve acceptable levels of sensitivity and specificity to be useful as screening tests for secondary adrenal insufficiency. In this context the OMT can be safely used to assess the integrity of the entire HPAA. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, B-Lymphocytes, Central Nervous System, Encephalomyelitis, Autoimmune, Experimental, Enzyme-Linked Immunospot Assay, Female, Gastrointestinal Tract, Germinal Center, Hypersensitivity, Delayed, Immunization, Immunoglobulin G, Male, Mice, Mice, Inbred C57BL, Multiple Sclerosis, Myelin Proteolipid Protein, Peyer's Patches, Spleen, T-Lymphocytes, Th17 Cells." }, { "role": "user", "content": "Do conventional housing conditions attenuate the development of experimental autoimmune encephalomyelitis? Context: The etiology of multiple sclerosis (MS) has remained unclear, but a causative contribution of factors outside the central nervous system (CNS) is conceivable. It was recently suggested that gut bacteria trigger the activation of CNS-reactive T cells and the development of demyelinative disease. C57BL/6 (B6) mice were kept either under specific pathogen free or conventional housing conditions, immunized with the myelin basic protein (MBP)-proteolipid protein (PLP) fusion protein MP4 and the development of EAE was clinically monitored. The germinal center size of the Peyer's patches was determined by immunohistochemistry in addition to the level of total IgG secretion which was assessed by ELISPOT. ELISPOT assays were also used to measure MP4-specific T cell and B cell responses in the Peyer's patches and the spleen. Ear swelling assays were performed to determine the extent of delayed-type hypersensitivity reactions in specific pathogen free and conventionally housed mice. In B6 mice that were actively immunized with MP4 and kept under conventional housing conditions clinical disease was significantly attenuated compared to specific pathogen free mice. Conventionally housed mice displayed increased levels of IgG secretion in the Peyer's patches, while the germinal center formation in the gut and the MP4-specific TH17 response in the spleen were diminished after immunization. Accordingly, these mice displayed an attenuated delayed type hypersensitivity (DTH) reaction in ear swelling assays." }, { "role": "assistant", "content": "The data corroborate the notion that housing conditions play a substantial role in the induction of murine EAE and suggest that the presence of gut bacteria might be associated with a decreased immune response to antigens of lower affinity. This concept could be of importance for MS and calls for caution when considering the therapeutic approach to treat patients with antibiotics. 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": "Indication for surgical compament release in Compament Syndrome is an absolute pressure greater than?" }, { "role": "assistant", "content": "The correct answer is Acute compament syndrome occurs when the tissue pressure within a closed muscle compament exceeds the perfusion pressure and results in muscle and nerve ischemia. Compamental pressures higher than 30 mm Hg require surgical intervention. If such high compamental pressures are left untreated, within 6-10 hours, muscle infarction, tissue necrosis, and nerve injury occur." } ]

[ { "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": "Trotter's syndrome involves:" }, { "role": "assistant", "content": "The correct answer is Trotter's syndrome is caused by \"nasopharyngeal tumour\" and the patient will have symptoms like pain in lower jaw, tongue, and side of head with an associated middle ear deafness; The patients also exhibit asymmetry and defective mobility of soft palate. As the tumor progresses, trismus of internal pterygoid muscle may develop. The cause of pain is due to involvement of mandibular nerve in foramen ovale through which tumour invades the calvarium." } ]

[ { "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: Brain Injuries, Humans, Medical Records, Neuropsychological Tests, New South Wales, Prisoners, Substance-Related Disorders, Surveys and Questionnaires, Truth Disclosure." }, { "role": "user", "content": "Are prisoners reliable survey respondents? Context: To compare prisoners' self-reported history of TBI associated with hospital attendance with details extracted from relevant hospital medical records and to identify factors associated with the level of agreement between the two sources. From a sample of prison entrants, this study obtained a history of TBIs for which medical attention was sought at a hospital. Audit tools were developed for data extraction relevant to any possible TBI from records at a total of 23 hospitals located within New South Wales, Australia. The level of agreement between self-report and hospital records was compared in relation to demographic, psychological and criminographic characteristics. Of the 200 participants in the study, 164 (82%) reported having sustained a past TBI giving a total of 420 separate TBI incidents. Of these, 156 (37%) were alleged to have resulted in attendance at a hospital emergency department including 112 (72%) at a hospital accessible for the validation exercise. For 93/112 (83%) of reported TBIs, a corresponding hospital medical record was located of which 78/112 (70%) supported the occurrence of a TBI. Lower education and a lifetime history of more than seven TBIs were associated with less agreement between self-report and medical record data with regard to specific details of the TBI." }, { "role": "assistant", "content": "Overall, these findings suggest that prisoners' self-report of TBI is generally accurate when compared with the 'gold standard' of hospital medical record. This finding is contrary to the perception of this group as 'dishonest' and 'unreliable'." } ]

[ { "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": "Investigation of choice for High-risk breast cancer in female is" }, { "role": "assistant", "content": "The correct answer is Magnetic resonance imaging (MRI) of the breast is useful in a number of settings:To distinguish scar from recurrence in women who have had previous breast conservation therapy for cancer (although it is less accurate within 9 months of radiotherapy because of abnormal enhancement).To assess multifocality and multicentricity in lobular cancer and to assess the extent of high-grade ductal carcinoma in situ (DCIS). It is less useful in low-grade DCIS.It is the best imaging modality for the breasts of women with implants.As a screening tool for high-risk women (because of family history).Ref: Bailey and Love, 27e, page: 862" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: INTRODUCTION, METHODS, RESULTS. Meshes: Antineoplastic Combined Chemotherapy Protocols, Breast Neoplasms, Chemotherapy, Adjuvant, Cyclophosphamide, Doxorubicin, Epirubicin, Female, Follow-Up Studies, Humans, Lymph Nodes, Lymphatic Metastasis, Middle Aged, Premenopause, Receptors, Estrogen, Receptors, Progesterone, Risk Assessment, Survival Analysis, Survivors, Tamoxifen." }, { "role": "user", "content": "Is chemotherapy necessary for premenopausal women with lower-risk node-positive, endocrine responsive breast cancer? Context: International Breast Cancer Study Group (IBCSG) Trial 11-93 is the largest trial evaluating the role of the addition of chemotherapy to ovarian function suppression/ablation (OFS) and tamoxifen in premenopausal patients with endocrine-responsive early breast cancer. IBCSG Trial 11-93 is a randomized trial comparing four cycles of adjuvant chemotherapy (AC: doxorubicin or epirubicin, plus cyclophosphamide) added to OFS and 5 years of tamoxifen versus OFS and tamoxifen without chemotherapy in premenopausal patients with node-positive, endocrine-responsive early breast cancer. There were 174 patients randomized from May 1993 to November 1998. The trial was closed before the target accrual was reached due to low accrual rate. Patients randomized tended to have lower risk node-positive disease and the median age was 45. After 10 years median follow up, there remains no difference between the two randomized treatment groups for disease-free (hazard ratio=1.02 (0.57-1.83); P=0.94) or overall survival (hazard ratio=0.97 (0.44-2.16); P=0.94)." }, { "role": "assistant", "content": "This trial, although small, offers no evidence that AC chemotherapy provides additional disease control for premenopausal patients with lower-risk node-positive endocrine-responsive breast cancer who receive adequate adjuvant endocrine therapy. A large trial is needed to determine whether chemotherapy adds benefit to endocrine therapy for this population." } ]

[ { "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, DESIGN, RESULTS. Meshes: Adult, Aged, Catchment Area (Health), Depression, Educational Status, Epidemiologic Methods, Female, Geriatric Assessment, Humans, Income, Male, Marriage, Middle Aged, Prevalence, Sex Factors, United States." }, { "role": "user", "content": "Does the ECA underestimate the prevalence of late-life depression? Context: This research addresses the most frequently cited methodological criticism of the Epidemiologic Catchment Area (ECA) surveys--which might lead to significantly lower estimates of true prevalence rates for late-life depression--the inability of the Diagnostic Interview Schedule (DIS) to distinguish between somatic symptoms of depression that result from physical causes and those that result from psychiatric causes. The data for this study come from the ECA Wave Two surveys sponsored by the National Institute of Mental Health. In this analysis, symptoms of depression the respondent always attributed to physical causes are recoded to be equivalent to those having a psychiatric cause. The third edition of the Diagnostic and Statistical Manual (DSM-III) scoring algorithm for depression (i.e., dysphoria plus four of the eight Criterion B symptoms) was then applied to the recorded data set. Recording somatic symptoms of depression, originally attributed to physical or medical explanations, to psychiatric symptoms does not result in a disproportionate rise in diagnosable depression in the older age groups." }, { "role": "assistant", "content": "This analysis provides additional support for the ECA survey's prevalence estimate of late-life depression. This research failed to find evidence that the highly structured nature of the DIS makes it unsuitable for ascertaining symptoms of depression in the elderly." } ]

[ { "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, MATERIAL AND METHODS, RESULTS. Meshes: Arthritis, Infectious, Arthroplasty, Replacement, Hip, Arthroplasty, Replacement, Knee, Humans, Retrospective Studies, Risk Factors, Steroids." }, { "role": "user", "content": "Does previous intra-articular steroid injection increase the risk of joint infection following total hip arthroplasty or total knee arthroplasty? Context: Joint infection might be one of the rare but serious complications following a total knee or hip arthroplasty (TKA, THA). A previous intra-articular steroid injection was considered as a risk factor. The purpose of present study was to access the effects of ipsilateral intra-articular steroid injection followed by TKA or THA on the incidence of infections later. Clinical studies reporting infection in THA or TKA after previous injection of intra-articular steroid were identified from the online database of PubMed, Embase, the Cochrane Library, and additional manual searches until July 2013. The pooled effects were measured by risk difference (RD), together with 95% confidence intervals (CIs). A total of 11 related studies met our inclusion criteria. The final meta-analysis investigated 6 clinical studies designed as retrospectively created cohort studies with control groups, involving 1474 participants reporting 14 deep infections and 72 superficial infections. Compared with the control group, there was no significantly increased rate of infection among the participant with steroid injection prior to THA or TKA, with corresponding RD (95% CIs) of 0.01 (-0.01, 0.02) for deep infection, 0.01 (-0.02, 0.03) for superficial infection, and 0.02 (-0.02, 0.07) for total infection. The data from 3 prospective studies without control groups and 2 case-control studies were consistent with the results of our meta-analysis." }, { "role": "assistant", "content": "No increased risk of infection among patients who received steroid injections prior to the surgery was identified from the present evidence. A multicenter prospective study with more defined variables is needed further investigate this issue." } ]

[ { "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, Arthritis, Arthroscopy, Bursa, Synovial, Calcinosis, Debridement, Female, Humans, Logistic Models, Male, Middle Aged, Operative Time, Pain, Pain Measurement, Pilot Projects, Prospective Studies, Rotator Cuff, Rotator Cuff Injuries, Shoulder Joint, Tendinopathy, Ultrasonography, Interventional." }, { "role": "user", "content": "Does the intraoperative use of ultrasound facilitate significantly the arthroscopic debridement of calcific rotator cuff tendinitis? Context: During arthroscopy, the localization of calcific deposit in patients suffering from calcifying tendinitis can be demanding and time consuming, frequently using ionizing radiation. Intraoperative ultrasound has been recently promoted, facilitating deposit localization and reducing radiation dose. In this prospective, randomized, controlled and clinical observer-blinded pilot trial, 20 patients with calcific tendinitis were operated. In group I, the deposit was localized conventionally. In group II, the deposit was localized using intraoperative ultrasound. The needle punctures to detect the deposit and operation times were noted. Patients were postoperatively evaluated after 2 and 6 weeks and 9 months. In group II, the needle punctures to detect the deposit were significantly lower than in group I (p < 0.0001). Operation time to localize the deposit was also significantly less in group II (p < 0.033). In both groups, patients improved significantly with increased shoulder function (p < 0.0001) and decreased pain (p < 0.0001) 2 weeks and 9 months (p < 0.001) after surgery. The difference between the groups was not significant. Excellent radiological findings were obtained in both groups after 9 months." }, { "role": "assistant", "content": "Intraoperative US significantly facilitates the detection of calcific deposits during arthroscopic debridement by speeding up surgery and reducing the number of needle punctures. Hence, we have changed our method of detecting calcific deposits intraoperatively from fluoroscopy to ultrasound. 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: Female, France, Health Status Disparities, Health Surveys, Humans, Interviews as Topic, Male, Quality of Life, Self Report, Social Class." }, { "role": "user", "content": "SRH and HrQOL: does social position impact differently on their link with health status? Context: Self-rated Health (SRH) and health-related quality of life (HRQoL) are used to evaluate health disparities. Like all subjective measures of health, they are dependent on health expectations that are associated with socioeconomic characteristics. It is thus needed to analyse the influence played by socioeconomic position (SEP) on the relationship between these two indicators and health conditions if we aim to use them to study health disparities. Our objective is to assess the influence of SEP on the relationship between physical health status and subjective health status, measured by SRH and HRQoL using the SF-36 scale. We used data from the French National Health Survey. SEP was assessed by years of education and household annual income. Physical health status was measured by functional limitations and chronic low back pain. Regardless of their health status, people with lower SEP were more likely than their more socially advantaged counterparts to report poor SRH and poorer HRQoL, using any of the indicators of SEP. The negative impact of chronic low back pain on SRH was relatively greater in people with a high SEP than in those with a low SEP. In contrast, chronic low back pain and functional limitations had less impact on physical and mental component scores of quality of life for socially advantaged men and women." }, { "role": "assistant", "content": "Both SRH and HRQoL were lower among those reporting functional limitations or chronic low back pain. However, the change varied according SEP and the measure. In relative term, the negative impact of a given health condition seems to be greater on SRH and lower on HRQoL for people with higher SEP in comparison with people with low SEP. Using SRH could thus decrease socioeconomic differences. In contrast using HRQoL could increase these differences, suggesting being cautious when using these indicators for analyzing health disparities." } ]

[ { "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: 6-Ketoprostaglandin F1 alpha, Cordocentesis, Endothelin-1, Female, Fetal Blood, Gestational Age, Heart Rate, Fetal, Hemodynamics, Humans, Indomethacin, Pregnancy, Pulsatile Flow, Thromboxane B2, Umbilical Arteries, Umbilical Veins." }, { "role": "user", "content": "Does indomethacin modify the fetal hemodynamic response induced by percutaneous umbilical blood sampling? Context: Percutaneous umbilical blood sampling induces a marked decrease of impedance to flow in the umbilical artery. Because these changes are believed to be the result of the release of prostanoids, we conducted a study to determine whether indomethacin administration before percutaneous umbilical blood sampling affects the hemodynamic response induced by this procedure. Percutaneous umbilical blood sampling was performed in 20 singleton pregnancies that were treated for 3 days before the procedure with indomethacin (25 mg orally 6 hours apart) as tocolytic agent and in 22 untreated pregnancies. All the procedures were uncomplicated, and sampling of the umbilical vein was confirmed by blood pressure measurement at the time of the procedure. The umbilical artery pulsatility index and the fetal heart rate were measured immediately before and after the procedure. The first and last aliquots of umbilical vein plasma obtained at the beginning and closing of the procedure were assayed for endothelin-1, 6-keto-prostaglandin F1 alpha and thromboxane B2. In untreated pregnancies percutaneous umbilical blood sampling induced a decrease of the umbilical artery pulsatility index (p < 0.0001) and an increase in 6-keto-prostaglandin F1 alpha (p < 0.001) and endothelin-1 levels (p = 0.001), whereas no significant changes were present in fetal heart rate and thromboxane B2 levels. In pregnancies treated with indomethacin, 6-keto-prostaglandin F1 alpha, and thromboxane B2, concentrations at the beginning of the procedure were both significantly less (p < 0.0001) than those found in untreated pregnancies. In pregnancies treated with indomethacin percutaneous umbilical blood sampling did not affect umbilical artery pulsatility index, and 6-keto-prostaglandin F1 alpha and thromboxane B2 levels did not vary during the procedure. However, endothelin-1 (p < 0.001) and fetal heart rate (p < 0.0001) increased after the procedure." }, { "role": "assistant", "content": "Indomethacin affects the fetal hemodynamic response to percutaneous umbilical blood sampling by inhibiting the release of prostanoids and the fall in umbilical artery pulsatility index. Under this condition the fetus adapts to the procedure by increasing the heart rate. 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": "Persistent primary hyperplastic vitreous (PHPV) is associated with –" }, { "role": "assistant", "content": "The correct answer is Persistent Primary Hyperplastic Vitreous (PHPV) is seen in association with Trisomy 13 (Patau syndrome) and Trisomy 22." } ]

[ { "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: Behavior Therapy, Chi-Square Distribution, Child, Cohort Studies, Cold Temperature, Female, Follow-Up Studies, Humans, Japan, Male, Multivariate Analysis, Nocturnal Enuresis, Noise, Regression Analysis, Reminder Systems, Retrospective Studies, Risk Assessment, Seasons, Severity of Illness Index, Treatment Failure." }, { "role": "user", "content": "Is winter associated with failure in the alarm treatment of nocturnal enuresis? Context: To assess whether the winter season in Japan is associated with failure in the alarm treatment of nocturnal enuresis (NE). Consecutive patients with NE referred to our center between June 2009 and May 2010 were treated with the enuresis alarm (EA). The EA was used for 16 weeks with each child. Patients were divided into a success group and a treatment failure group. Pretreatment variables were collected, including age, sex, night-time urine volume, severity of enuresis, presence of nocturnal polyuria, presence of daytime incontinence, and treatment initiation season. These variables and initial success rates were retrospectively compared between the two groups. Chi-square, Student t tests, and multivariate regression analysis were used for statistical analysis. A total of 67 children with NE were evaluated, 37 (55%) in the success group and 30 (45%) in the failure group. None of the pretreatment variables differed significantly between groups except for season; winter season initiation was an independent risk factor for failure in multivariate regression analysis." }, { "role": "assistant", "content": "Winter was associated with failure in the EA treatment. We recommend that EA be introduced in the summer season in Japan to achieve an optimal success rate. 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": "Thurston Holland sign is seen in-" }, { "role": "assistant", "content": "The correct answer is widely used classification for physeal injury) It is a transverse fracture through the hypertrophic or calcified zone of plate , but towards the edge the fracture deviates away, from physis &split of triangular metaphyseal segment of bone i.e thurston Holland fragment." } ]

[ { "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": "Screening test for gestational diabetes is?" }, { "role": "assistant", "content": "The correct answer is Random glucose challenge REF: Dutta 6th ed p. 285 \"Screening for GDM is done by a random glucose challenge with 50 grams oral glucose irrespective of time of day\"" } ]

[ { "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, Antifungal Agents, Antipsychotic Agents, Clozapine, Cytochrome P-450 CYP3A, Cytochrome P-450 Enzyme Inhibitors, Double-Blind Method, Drug Interactions, Female, Humans, Itraconazole, Male, Mixed Function Oxygenases, Schizophrenia." }, { "role": "user", "content": "Are serum concentrations of clozapine and N-desmethylclozapine unaffected by the potent CYP3A4 inhibitor itraconazole? Context: We studied a possible pharmacokinetic interaction between clozapine and itraconazole, a potent CYP3A4 inhibitor. A double-blind randomized study design was used. Seven schizophrenic inpatients volunteered to receive, in addition to their previous drug regimen, either 200 mg itraconazole or placebo for 7 days. For the next 7 days, itraconazole was changed to placebo and vice versa. Serum concentrations of clozapine and its main metabolite desmethylclozapine were measured on days 0, 3, 7, 10 and 14. Concomitant administration of itraconazole had no significant effect on serum concentrations of clozapine or desmethylclozapine." }, { "role": "assistant", "content": "CYP3A4 seems to be of minor importance in clozapine metabolism in humans. Itraconazole, and probably also other inhibitors of CYP3A4, can be used concomitantly with clozapine. 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: Alcohol Drinking, Amygdala, Animals, Central Nervous System Depressants, Corticotropin-Releasing Hormone, Ethanol, Injections, Male, Mice, Receptors, Corticotropin-Releasing Hormone, Substance Withdrawal Syndrome." }, { "role": "user", "content": "Is increased drinking during withdrawal from intermittent ethanol exposure blocked by the CRF receptor antagonist D-Phe-CRF ( 12-41 )? Context: Studies in rodents have determined that intermittent exposure to alcohol vapor can increase subsequent ethanol self-administration, measured with operant and 2-bottle choice procedures. Two key procedural factors in demonstrating increased alcohol intake are the establishment of stable alcohol self-administration before alcohol vapor exposure and the number of bouts of intermittent vapor exposure. The present studies provide additional behavioral validation and initial pharmacological validation of this withdrawal-associated drinking procedure. Studies at 2 different sites (Portland and Scripps) examined the effect of intermittent ethanol vapor exposure (3 cycles of 16 hours of ethanol vapor+8 hours air) on 2-hour limited access ethanol preference drinking in male C57BL/6 mice. Separate studies tested 10 or 15% (v/v) ethanol concentrations, and measured intake during the circadian dark. In one study, before measuring ethanol intake after the second bout of intermittent vapor exposure, mice were tested for handling-induced convulsions (HICs) indicative of physical dependence on ethanol. In a second study, the effect of bilateral infusions of the corticotropin-releasing factor (CRF) receptor antagonist D-Phe-CRF(12-41) (0.25 microg/0.5 microL) into the central nucleus of the amygdala (CeA) on ethanol intake was compared in vapor-exposed animals and air controls. Intermittent ethanol vapor exposure significantly increased ethanol intake by 30 to 40%, and the mice had higher blood ethanol concentrations than controls. Intra-amygdala infusions of D-Phe-CRF(12-41) significantly decreased the withdrawal-associated increase in ethanol intake without altering ethanol consumption in controls. Following the second bout of intermittent vapor exposure, mice exhibited an increase in HICs, when compared with their own baseline scores or the air controls." }, { "role": "assistant", "content": "Intermittent alcohol vapor exposure significantly increased alcohol intake and produced signs of physical dependence. Initial pharmacological studies suggest that manipulation of the CRF system in the CeA can block this increased alcohol intake. 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 statement about clonidine are all except ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., Prazosin is used to antagonize side effects of clonidine Clonidine is an a-2 agonist, while prazosin blocks the a-1 receptors. o Clonidine enhances vagal tone (parasympathetic outflow) which can cause bradycardia. o The major haemodynamic effects result from stimulation of a2a receptors present mainly postjunctionally in medulla --> decrease sympathetic outflow --> fall in BP and bradycardia. o Clonidine is used in hypeension." } ]

[ { "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: Algorithms, Amino Acid Sequence, Base Sequence, Candida albicans, Codon, Codon, Initiator, Codon, Terminator, Computational Biology, Fungal Proteins, Gene Dosage, Genome, Fungal, Open Reading Frames, Phylogeny, RNA, Messenger, RNA, Transfer." }, { "role": "user", "content": "Does codon-triplet context unveil unique features of the Candida albicans protein coding genome? Context: The evolutionary forces that determine the arrangement of synonymous codons within open reading frames and fine tune mRNA translation efficiency are not yet understood. In order to tackle this question we have carried out a large scale study of codon-triplet contexts in 11 fungal species to unravel associations or relationships between codons present at the ribosome A-, P- and E-sites during each decoding cycle. Our analysis unveiled high bias within the context of codon-triplets, in particular strong preference for triplets of identical codons. We have also identified a surprisingly large number of codon-triplet combinations that vanished from fungal ORFeomes. Candida albicans exacerbated these features, showed an unbalanced tRNA population for decoding its pool of codons and used near-cognate decoding for a large set of codons, suggesting that unique evolutionary forces shaped the evolution of its ORFeome." }, { "role": "assistant", "content": "We have developed bioinformatics tools for large-scale analysis of codon-triplet contexts. These algorithms identified codon-triplets context biases, allowed for large scale comparative codon-triplet analysis, and identified rules governing codon-triplet context. They could also detect alterations to the standard genetic code. 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, Aged, 80 and over, CD56 Antigen, Carcinoembryonic Antigen, Disease Progression, Female, Humans, Interleukin-10, Killer Cells, Natural, Male, Middle Aged, Pleural Effusion, Malignant, Transforming Growth Factor beta1." }, { "role": "user", "content": "Is native soluble carcinoembryonic antigen involved in the impaired activity of CD56 natural killer cells in malignant pleural effusion? Context: Natural killer (NK) cells are lymphocytes of the innate immune system that play a crucial role in tumor immune surveillance. Accumulated data indicated that NK cells in the tumor microenvironment often display a suppressed function. However, the mechanism is not clear. In this study, the effects and relative mechanisms of malignant pleural effusion (MPE) from patients with lung cancer on NK cells were researched. MPE and peripheral blood (PB) samples were collected from patients with lung cancer. The cytotoxic activity of CD56(dim) NK cells in PB and MPE mononuclear cells was analyzed by flow cytometry. It was observed that the percentages of total NK cells and a CD56(dim) NK subset in MPE reduced accompanying impaired cytotoxic activity compared with that in paired PB. Cell-free MPE treatment reduced both the proportion and cytotoxic activity of CD56(dim) NK cells in PB from healthy donors. The suppression effects were not based on soluble carcinoembryonic antigen and the inhibitory cytokines interleukin-10 and transforming growth factor-β1, but were dependent on the factor with a molecular weight >100 kDa." }, { "role": "assistant", "content": "These results demonstrated that native soluble carcinoembryonic antigen does not suppress the activity of NK cells, and an unknown factor with a molecular weight >100 kDa plays a critical role in the impairment of CD56(dim) NK cells in MPE, which might lead to tumor progression. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Following are features of reactive ahritis except" }, { "role": "assistant", "content": "The correct answer is Reactive ahritis refers to acute nonpurulent ahritis complicating an infection elsewhere in the body.The clinical manifestations of reactive ahritis constitute a spectrum that ranges from an isolated, transient monoahritis or enthesitis to severe multisystem disease. A careful history will usually elicit evidence of an antecedent infection 1-4 weeks before onset of symptoms of the reactive disease, paicularly in postenteric reactive ahritis.The joints of the lower extremities, especially the knee, ankle, and subtalar, metatarsophalangeal, and toe interphalangeal joints, are most commonly involved.Reactive ahritis shares many features in common with psoriatic ahropathy. However, it differs in:-PSORIATIC AHRITISREACTIVE AHRITISGradual in onsetAcutePrimarily in upper extremitiesLower extremitiesLess associated periahritisPeriahritisUsually no associated mouth ulcers, urethritis or bowel symptomsUsually no associated mouth ulcers, urethritis or bowel symptoms Harrison 19e 2175" } ]

[ { "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": "Folinic acid is given for which toxicity:" }, { "role": "assistant", "content": "The correct answer is Ans. A. MethotrexateMethotrexate is drug which inhibit the dihydrofolate reductase enzyme which further blocks the conversion of dihydrofolate to tetrahydrofolate. So in case of toxicity we give tetrahydrofolate from outside in form of folinic acid or leucovorin." } ]