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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": "Biological marker for antisocial behavior in boys:-" }, { "role": "assistant", "content": "The correct answer is Low hea rate have association with antisocial behavior" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, METHODS, METHODS, RESULTS. Meshes: Adult, Base Sequence, Bupropion, Cytochrome P-450 CYP2A6, Dopamine Uptake Inhibitors, Female, Humans, Male, Middle Aged, Molecular Sequence Data, Nerve Tissue Proteins, Nicotine, Proportional Hazards Models, Receptors, Nicotinic, Recurrence, Smoking, Smoking Cessation, Tobacco Use Cessation Devices, Treatment Outcome." }, { "role": "user", "content": "Do pharmacotherapy effects on smoking cessation vary with nicotine metabolism gene ( CYP2A6 )? Context: Evidence suggests that both the nicotinic receptor α5 subunit (CHRNA5) and Cytochrome P450 2A6 (CYP2A6) genotypes influence smoking cessation success and response to pharmacotherapy. We examine the effect of CYP2A6 genotype on smoking cessation success and response to cessation pharmacotherapy, and combine these effects with those of CHRNA5 genotypes. Placebo-controlled randomized smoking cessation trial. Ambulatory care facility in Wisconsin, USA. Smokers (n = 709) of European ancestry were randomized to placebo, bupropion, nicotine replacement therapy or combined bupropion and nicotine replacement therapy. Survival analysis was used to model time to relapse using nicotine metabolism derived from CYP2A6 genotype-based estimates. Slow metabolism is defined as the lowest quartile of estimated metabolic function. CYP2A6-defined nicotine metabolic function moderated the effect of smoking cessation pharmacotherapy on smoking relapse over 90 days [hazard ratio (HR) = 2.81, 95% confidence interval (CI) = 1.32-5.99, P = 0.0075], with pharmacotherapy significantly slowing relapse in fast (HR = 0.39, 95% CI = 0.28-0.55, P = 1.97 × 10(-8)), but not slow metabolizers (HR = 1.09, 95% CI = 0.55-2.17, P = 0.80). Further, only the effect of nicotine replacement, and not bupropion, varies with CYP2A6-defined metabolic function. The effect of nicotine replacement on continuous abstinence is moderated by the combined genetic risks from CYP2A6 and CHRNA5 (Wald = 7.44, d.f. = 1, P = 0.0064)." }, { "role": "assistant", "content": "Nicotine replacement therapy is effective among individuals with fast, but not slow, CYP2A6-defined nicotine metabolism. The effect of bupropion on relapse likelihood is unlikely to be affected by nicotine metabolism as estimated from CYP2A6 genotype. The variation in treatment responses among smokers with genes may guide future personalized smoking cessation interventions. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, Blood Pressure, Brain Death, Chronic Disease, Cytokines, Graft Rejection, Inflammation Mediators, Lung, Lung Transplantation, Male, RNA, Messenger, Rats, Rats, Inbred F344, Rats, Inbred WKY, Tissue Donors." }, { "role": "user", "content": "Does donor brain death aggravate chronic rejection after lung transplantation in rats? Context: Many recipients of lung transplants from brain-dead donors develop bronchiolitis obliterans, a manifestation of chronic rejection. It has been shown that brain death increases inflammatory mediators and accelerates acute rejection in kidney, liver, and heart transplants. In this study, the authors investigated the hypothesis that brain death increases inflammatory mediators in the donor lung and subsequently aggravates chronic rejection of the lungs after transplantation in rats. Brain death was induced in F344 rats by inflation of a subdurally placed balloon catheter. After 6 hr, donor lungs were assessed for influx of leukocytes, expression of cell adhesion molecules, and cytokine mRNA expression. For assessment of the lung after transplantation, lungs from brain-dead F344 rats were transplanted into WKY rats. Lung function after transplantation was monitored by chest radiographs during an observation period of 100 days. At the end of this period, the lungs were histologically examined; also, cytokine mRNA expression was measured. Lungs from ventilated living donors and living donors served as controls. After 6 hr of brain death, influx of polymorphonuclear cells and macrophages and expression of vascular cell adhesion molecule-1 in the donor lungs was increased. After transplantation at postoperative day 100, the lung function was significantly decreased compared with allografts from living donors. In the lung allografts from brain-dead donors, histologic symptoms of chronic rejection were obvious, including severe intimal hyperplasia but without bronchiolitis obliterans. Interleukin-2 mRNA was significantly increased in allografts from brain-dead donors compared with living donors." }, { "role": "assistant", "content": "This study shows that brain death induces an inflammatory response in the donor lung and subsequently aggravates chronic rejection after transplantation. This may explain the clinical difference in long-term function between lungs from cadaveric donors and living donors. 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": "Tissue suturing glue contains:" }, { "role": "assistant", "content": "The correct answer is Most tissue adhesives or glue are cyanoacrylate polymers, such as n-butyl-2-cyanoacrylate (eg, Histoacryl®, PeriAcryl®) or 2-octyl cyanoacrylate (eg, Dermabond®, Surgiseal).\nCyanoacrylate tissue adhesives are liquid monomers that undergo an exothermic reaction on exposure to moisture (eg, on the skin surface), changing to polymers that form a strong tissue bond. When applied to a laceration, the polymer binds the wound edges together to allow normal healing of the underlying tissue.\nCompared with wounds closed with sutures, the tensile strength of wounds closed by tissue adhesives is less at the time of initial application, but equalizes by one week post-repair.\nAdvantages:\n\nLess painful application, and sometimes no need for local anesthetic injection\nMore rapid application and repair time\nCosmetically similar results at 12 months post-repair\n\tWaterproof barrier\nAntimicrobial properties\nBetter acceptance by patients\nNo need for suture removal or follow-up\n\nIndications and contraindications:\n\n\nFor use of tissue adhesives the wound needs to be clean, dry with near perfect hemostasis and under no tension.\nComplex stellate lesions or crush injuries should not be closed with tissue adhesives since good wound approximation is difficult to achieve.\nTissue adhesives are not recommended for lacerations of the hands, feet, or joints, since repetitive movements could cause the adhesive bond to break before sufficient tensile strength is achieved.\nTissue adhesives are not recommended for the oral mucosa or other mucosal surfaces or areas of high moisture such as the axillae and perineum.\nLacerations involving the hairline or vermilion border require more precision, and should be repaired with traditional sutures." } ]

[ { "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, Child, Female, Humans, Male, Observer Variation, Radiographic Image Interpretation, Computer-Assisted, Reproducibility of Results, Scoliosis, Sensitivity and Specificity, Spine, Young Adult." }, { "role": "user", "content": "Risser sign inter-rater and intra-rater agreement: is the Risser sign reliable? Context: Studies directly evaluating the reliability of the Risser sign are few in number, possess small sample sizes, and offer conflicting results. This study establishes the reliability of the Risser sign on a large sample size in an effort to provide clarification on the subject. Two years' worth of AP pelvis radiographs from patients age 8-20 were downloaded from our institution's digital imaging system. One hundred of these images were selected for inclusion by an independent reviewer whose goal was to capture a spread of radiographs that included all Risser stages. Risser grading occurred in two rounds. In each round, three examiners randomly reviewed the 100 radiographs on three different occasions. The full AP pelvis radiograph was graded in Round 1 while only the iliac apophysis was visible in Round 2. Kappa coefficients and their confidence bounds are reported to indicate intra- and inter-observer reliability. The contrast between the rates of agreement about Risser stages in Rounds 1 versus 2 was assessed by McNemar's test. The signed-rank test was used to evaluate differences in intra-observer values between rounds. Round 1 inter-observer kappa was 0.76. Round 2 inter-observer kappa was 0.51. In Round 1, 63 radiographs showed perfect agreement within the same Risser stage for all observations compared to 44 radiographs with perfect agreement within the same Risser stage in Round 2 (p = 0.004). Round 1 intra-observer kappa values were 0.92, 0.86, and 0.88. Round 2 intra-observer kappa values were 0.91, 0.77, and 0.88. Intra-observer value differences between rounds were not significant for two observers (p = 0.074, 0.061) but was significant for the third observer (p = 0.002)." }, { "role": "assistant", "content": "The reliability of the Risser sign is acceptable and can be further improved when other markers of skeletal maturity on the pelvis radiograph are used to assist in grading." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, MATERIALS AND METHODS, RESULTS. Meshes: Adult, Aged, Barrett Esophagus, Body Mass Index, Endoscopy, Digestive System, Esophagitis, Peptic, Esophagogastric Junction, Female, Gastroesophageal Reflux, Hernia, Hiatal, Humans, Male, Middle Aged, Retrospective Studies." }, { "role": "user", "content": "Does Sedation Affect Examination of Esophagogastric Junction during Upper Endoscopy? Context: During sedated esophagogastroduodenoscopy (EGD), patients may not be able to perform inspiration, which is necessary to examine the esophagogastric junction. Therefore sedation may affect diagnosis of gastroesophageal reflux-related findings. The aim of our study was to investigate the effect of sedation on diagnosis of gastroesophageal reflux-related findings during EGD. This retrospective study evaluated 28914 patients older than 20 years who underwent EGD at our institution between January 2011 and December 2011. Ultimately, 1546 patients indicated for EGD for health check-up and symptom evaluation were included. There were 18546 patients who had diagnostic EGD: 10471 patients (56%) by non-sedated EGD and 8075 patients (43%) by sedated EGD. After statistical adjustment for age, sex, and body mass index, minimal change esophagitis, and hiatal hernia were significantly less frequently observed in the sedated EGD group [odds ratio (OR), 0.651; 95% confidence interval (CI), 0.586 to 0.722 and OR, 0.699; 95% CI, 0.564 to 0.866]. Nevertheless, there was no significant difference in other findings at the gastroesophageal junction, such as reflux esophagitis with Los Angeles classification A, B, C, and D or Barrett's esophagus, between the two groups. Similarly, there were no differences in early gastric cancer, advanced gastric cancer, and gastric ulcer occurrence." }, { "role": "assistant", "content": "Sedation can impede the detection of minimal change esophagitis and hiatal hernia, but does not influence detection of reflux esophagitis of definite severity and Barrett's esophagus." } ]

[ { "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: Activating Transcription Factor 4, Antineoplastic Agents, Apoptosis, Benzopyrans, Butyrates, Carcinoma, Non-Small-Cell Lung, Cell Line, Cell Line, Tumor, Cell Survival, Drug Synergism, Endoplasmic Reticulum Stress, Humans, Lung Neoplasms, Oxidative Stress, Receptors, TNF-Related Apoptosis-Inducing Ligand, Signal Transduction, TNF-Related Apoptosis-Inducing Ligand, eIF-2 Kinase." }, { "role": "user", "content": "Does decursin enhance TRAIL-induced apoptosis through oxidative stress mediated- endoplasmic reticulum stress signalling in non-small cell lung cancers? Context: The TNF-related apoptosis-inducing ligand (TRAIL) is a promising anticancer agent due to its remarkable ability to selectively kill tumour cells. However, because most tumours exhibit resistance to TRAIL-induced apoptosis, the development of combination therapies to overcome resistance to TRAIL is required for effective cancer therapy. Cell viability and possible synergy between the plant pyranocoumarin decursin and TRAIL was measured by MTT assay and calcusyn software. Reactive oxygen species (ROS) and apoptosis were measured using dichlorodihydrofluorescein and annexin/propidium iodide in cell flow cytometry. Changes in protein levels were assessed with Western blotting. Combining decursin and TRAIL markedly decreased cell viability and increased apoptosis in TRAIL-resistant non-small-cell lung cancer (NSCLC) cell lines. Decursin induced expression of the death receptor 5 (DR5). Inhibition of DR5 attenuated apoptotic cell death in decursin + TRAIL treated NSCLC cell lines. Interestingly, induction of DR5 and CCAAT/enhancer-binding protein homologues protein by decursin was mediated through selective induction of the pancreatic endoplasmic reticulum kinase (PERK)/activating transcription factor 4 (ATF4) branch of the endoplasmic reticulum stress response pathway. Furthermore, enhancement of PERK/ATF4 signalling by decursin was mediated by ROS generation in NSCLC cell lines, but not in normal human lung cells. Decursin also markedly down-regulated expression of survivin and Bcl-xL in TRAIL-resistant NSCLC cells." }, { "role": "assistant", "content": "ROS generation by decursin selectively activated the PERK/ATF4 axis of the endoplasmic reticulum stress signalling pathway, leading to enhanced TRAIL sensitivity in TRAIL-resistant NSCLC cell lines, partly via up-regulation of DR5. 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, CASE PRESENTATION, CASE MANAGEMENT AND OUTCOMES. Meshes: Bandages, Female, Humans, Male, Middle Aged, Negative-Pressure Wound Therapy, Neoplasms, Odorants, Pain, Palliative Care, Quality of Life, Wound Healing, Wounds and Injuries." }, { "role": "user", "content": "Is the use of negative pressure wound therapy for a malignant wound legitimate in a palliative context? Context: The management of malignant wounds remains particularly difficult. They are often malodorous, highly exuding, and painful. In this context, the use of negative pressure wound therapy is usually not recommended. It is, however, an effective procedure for maintaining a good quality of life in certain palliative situations. Five patients underwent negative pressure wound therapy for a malignant wound in our unit. Three had sarcomas, one patient had a parietal recurrence of breast carcinoma, and one patient had melanoma. They were in a metastatic palliative situation and were no longer receiving specific treatment. The patients reported a decrease in odor and exudates with negative pressure wound therapy, compared with conventional dressings. No patients complained of pain associated with the suction system itself. Fewer dressing changes reduced the pain and encouraged the resumption of social interactions. The average duration of negative pressure wound therapy before the death of the patients was 49 days. No complications or bleeding were observed. The duration of the patients' stay was shortened by implementing negative pressure wound therapy at home." }, { "role": "assistant", "content": "We report on our experiences with five patients for whom manufacturers and health authorities contraindicated the use of negative pressure wound therapy because of its potential to encourage tumor growth, although it was considered to be beneficial for all of these patients. This procedure may offer an alternative to conventional wound dressings at the end of life and improve the quality of life of patients by controlling the three most disabling elements: the odor, exudate, and pain associated with changing the dressings. Miniaturization and lower costs could promote the systematic use of negative pressure wound therapy." } ]

[ { "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: Alveolar Bone Loss, Animals, Corticosterone, Disease Models, Animal, Disease Susceptibility, Escherichia coli, Injections, Intraperitoneal, Injections, Subcutaneous, Interleukin-10, Lipopolysaccharides, Male, Mecamylamine, Nicotine, Nicotinic Antagonists, Periodontitis, Rats, Rats, Inbred F344, Receptors, Nicotinic, Sodium Chloride, Transforming Growth Factor beta1, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Does nicotinic acetylcholine receptor activation mediate nicotine-induced enhancement of experimental periodontitis? Context: Smokers have an increased risk of developing periodontitis as well as showing more rapid progression and resistance to treatment of the disease, but the biological mechanisms are poorly understood. Our objective was to investigate putative biological mechanisms by which nicotine may enhance the susceptibility and thus the course of periodontitis in an animal model. Ligature-induced periodontitis was applied in periodontitis-susceptible Fischer 344 rats. The animals were given daily intraperiotonal (i.p.) injections of the nicotinic acetylcholine receptor (nAChR) antagonist mecamylamine (1 mg/kg) 45 min before subcutaneous (s.c.) injections in the neck skin with nicotine (0.8 mg/kg), or treated with the same amount of saline i.p. and nicotine s.c., or with mecamylamine and saline. Control rats received i.p. and s.c. injections of saline only. Periodontal bone loss was assessed when the ligatures had been in place for 3 weeks. Two hours before decapitation, all rats received lipopolysaccharide (LPS; 100 microg/kg, i.p.) to induce a robust immune and stress response. Compared with saline/saline-treated control rats, saline/nicotine-treated rats developed significantly more periodontal bone loss, and LPS provoked a significantly smaller increase in circulating levels of the cytokines tumour necrosis factor alpha (TNF-alpha), transforming growth factor 1beta (TGF-1beta) and interleukin-10 (IL-10). Mecamylamine pretreatment of nicotine-treated rats abrogated the increased periodontal bone loss and the LPS-induced TNF-alpha decrease, but had no significant effects on the levels of TGF-1beta and IL-10, or the stress hormone corticosterone." }, { "role": "assistant", "content": "The results indicate that nicotine enhances susceptibility to periodontitis via nAChRs, which may act via suppressing protective immune responses through the cholinergic anti-inflammatory pathway. 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: Base Sequence, Biotransformation, Cell Movement, Databases, Protein, Down-Regulation, Gene Expression Regulation, Bacterial, Glycosides, High-Throughput Nucleotide Sequencing, Metabolic Networks and Pathways, Quercetin, Rhodopseudomonas, Sequence Analysis, DNA, Transcriptome, Up-Regulation." }, { "role": "user", "content": "Does high-throughput transcriptome sequencing analysis provide preliminary insights into the biotransformation mechanism of Rhodopseudomonas palustris treated with alpha-rhamnetin-3-rhamnoside? Context: The purple photosynthetic bacterium Rhodopseudomonas palustris has been widely applied to enhance the therapeutic effects of traditional Chinese medicine using novel biotransformation technology. However, comprehensive studies of the R. palustris biotransformation mechanism are rare. Therefore, investigation of the expression patterns of genes involved in metabolic pathways that are active during the biotransformation process is essential to elucidate this complicated mechanism. To promote further study of the biotransformation of R. palustris, we assembled all R. palustris transcripts using Trinity software and performed differential expression analysis of the resulting unigenes. A total of 9725, 7341 and 10,963 unigenes were obtained by assembling the alpha-rhamnetin-3-rhamnoside-treated R. palustris (RPB) reads, control R. palustris (RPS) reads and combined RPB&RPS reads, respectively. A total of 9971 unigenes assembled from the RPB&RPS reads were mapped to the nr, nt, Swiss-Prot, Gene Ontology (GO), Clusters of Orthologous Groups (COGs) and Kyoto Encyclopedia of Genes and Genomes (KEGG) (E-value <0.00001) databases using BLAST software. A total of 3360 unique differentially expressed genes (DEGs) in RPB versus RPS were identified, among which 922 unigenes were up-regulated and 2438 were down-regulated. The unigenes were mapped to the KEGG database, resulting in the identification of 7676 pathways among all annotated unigenes and 2586 pathways among the DEGs. Some sets of functional unigenes annotated to important metabolic pathways and environmental information processing were differentially expressed between the RPS and RPB samples, including those involved in energy metabolism (18.4% of total DEGs), carbohydrate metabolism (36.0% of total DEGs), ABC transport (6.0% of total DEGs), the two-component system (8.6% of total DEGs), cell motility (4.3% of total DEGs) and the cell cycle (1.5% of total DEGs). We also identified 19 transcripts annotated as hydrolytic enzymes and other enzymes involved in ARR catabolism in R. palustris." }, { "role": "assistant", "content": "We present the first comparative transcriptome profiles of RPB and RPS samples to facilitate elucidation of the molecular mechanism of biotransformation in R. palustris. Furthermore, we propose two putative ARR biotransformation mechanisms in R. palustris. These analytical results represent a useful genomic resource for in-depth research into the molecular basis of biotransformation and genetic modification in R. palustris. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The commonest cause of lung abscess-" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' aspirated oropharyngeal secretion Harrison writes - 'Risk factors for lung abscess include conditions associated with impaired cough reflex and/or aspiration, such as alcoholism, anaesthesia, drug abuse, epilepsy, and stroke. Dental caries, bronchiectasis, *bronchial carcinoma and pulmonary infarction are also risk factors.Most aspiration - associated lung abscesses are due to a combination of aerobic and anaerobic bacteria, with an average of six or seven bacterial species identified in an individual case.The implicated anaerobic bacteria include the Bacteroides fragilis group. Bacteroides gracilis, Prevotella intermedia, Prevotella denticola, Prevotella melaninogenicus, Prevotella oralis, Fusobacterium nucleatum, Peptostreptococcus micros, Peptostreptococcus anaerobius, and Peptostreptococcus magnus.Streptococcus milleri is one of the principal aerobic pathogens; S. aureus, S. pneumoniae, H. influenzae, P. aeruginosa, E. coli, and Klebsiella pneumoniae are also isolated frequently. Rarely S. pneumoniae alone (usually capsular type 111) can cause lung abscess.In HIV-infected patients, lung abscess can be due to Pneumocystis, Rhodococcus equi. and cryptococcus neoformans as well as the bacteria noted above. \"" } ]

[ { "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, Aorta, Aortic Diseases, Apolipoproteins E, Atherosclerosis, Chemotaxis, Cytokine Receptor gp130, Diet, High-Fat, Disease Models, Animal, Female, Macrophages, Male, Mice, Inbred C57BL, Mice, Knockout, Mutation, Plaque, Atherosclerotic, STAT3 Transcription Factor, Serum Amyloid A Protein, Signal Transduction, Triglycerides." }, { "role": "user", "content": "Does imbalanced gp130 signalling in ApoE-deficient mice protect against atherosclerosis? Context: Interleukin (IL)-6 is a key modulator of the acute phase response (APR), and while both are implicated in atherosclerosis, the pathological role of specific IL-6 signalling cascades is ill-defined. Since IL-6 employs the cytokine receptor gp130 to primarily activate the STAT3 pathway, here we evaluate whether gp130-dependent STAT3 activation modulates atherosclerosis. High-fat diet-induced atherosclerosis was established in ApoE(-/-) mice crossed with gp130(F/F) knock-in mice displaying elevated gp130-dependent STAT3 activation and production of the APR protein, serum amyloid A (SAA). Also generated were gp130(F/F):Stat3(-/+):ApoE(-/-) mice displaying genetically-normalised STAT3 activation and SAA levels, and bone marrow chimeras involving ApoE(-/-) and gp130(F/F):ApoE(-/-) mice. At 10 weeks post high-fat diet, aortic atherosclerotic lesions, including the presence of CD68(+) macrophages, and plasma lipid and SAA profiles, were assessed. Aortic plaque development and plasma triglyceride levels in gp130(F/F):ApoE(-/-) mice were significantly reduced (3-fold, P < 0.001) compared to ApoE(-/-) littermates. By contrast, in gp130(F/F):ApoE(-/-) mice, atherosclerotic plaques contained augmented CD68(+) macrophage infiltrates, and plasma SAA levels were elevated, compared to ApoE(-/-) mice. Atherosclerotic lesion development and plasma triglyceride levels in gp130(F/F):ApoE(-/-) and gp130(F/F):Stat3(-/+):ApoE(-/-) mice were comparable, despite a significant (P < 0.05) reduction in macrophage numbers in lesions, and also plasma SAA levels, in gp130(F/F):Stat3(-/+):ApoE(-/-) mice. Aortic plaque development and plasma triglyceride levels were comparable in ApoE(-/-) mice reconstituted with gp130(F/F):ApoE(-/-) (ApoE(F/F:ApoE)) or ApoE(-/-) (ApoE(ApoE)) bone marrow cells." }, { "role": "assistant", "content": "Deregulation of gp130/STAT3 signalling augments the APR and macrophage infiltration during atherosclerosis without impacting on the development of aortic plaques. 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: Acamprosate, Alcohol Deterrents, Animals, Behavior, Addictive, Cocaine, Cocaine-Related Disorders, Conditioning, Operant, Cues, Dose-Response Relationship, Drug, Extinction, Psychological, Male, Motor Activity, Rats, Rats, Sprague-Dawley, Recurrence, Self Administration, Taurine." }, { "role": "user", "content": "Does acamprosate attenuate cocaine- and cue-induced reinstatement of cocaine-seeking behavior in rats? Context: Acamprosate (calcium acetylhomotaurinate) is a glutamatergic neuromodulator used for the treatment of alcoholism, but its potential efficacy in the treatment of psychostimulant addiction has not been explored. The purpose of this study was to assess the effects of acamprosate on cocaine-stimulated locomotor activity, cocaine self-administration, and cue- and cocaine-induced reinstatement of cocaine-seeking behavior. All experiments utilized once-daily treatment for 5 consecutive days. First, the effects of saline or acamprosate (100, 300, or 500 mg/kg intraperitoneally) on body weight were examined. On the last day of treatment, locomotor activity was assessed before and after drug treatment, after which all animals received an acute challenge of cocaine (10 mg/kg). Next, a separate group of rats were trained to intravenously (IV) self-administer cocaine (0.6 mg/kg per infusion), subjected to extinction procedures, and then tested for effects of acamprosate on cue- or cocaine-induced reinstatement. A third group of rats was trained to self-administer cocaine as described above and were treated with saline or acamprosate before daily IV self-administration sessions. Repeated administration of 500 mg/kg acamprosate but not lower doses produced reductions in both body weight and spontaneous locomotor activity, and thus this dose was not tested further. Acamprosate at 300 mg/kg but not 100 mg/kg attenuated both cocaine- and cue-induced reinstatement without altering baseline patterns of cocaine self-administration or cocaine-stimulated hyperlocomotion." }, { "role": "assistant", "content": "Acamprosate attenuates both drug- and cue-induced reinstatement of cocaine-seeking behavior, suggesting that this compound may serve as a potential treatment for preventing relapse in cocaine-addicted humans. 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: ." }, { "role": "user", "content": "Are microRNAs differentially expressed in Behçet disease involved in interleukin-6 production? Context: Behcet's disease (BD) is characterized by systemic recurrent inflammation with increased production of tumor necrosis factor (TNF)-α and interleukin (IL)-6 by peripheral blood mononuclear cells (PBMCs). To gain insight into the underlying mechanisms of this disease, the expression levels of distinct microRNAs in PBMCs of BD patients were determined and their association with TNF-α and IL-6 production was evaluated. The expression levels of microRNAs, miR-638 and miR-4488, were reduced in patients with stable BD in comparison with healthy controls. In addition, the expression of miR-3591-3p was increased in patients with active BD when compared to patients with stable BD. Transfection of miR-638 and miR-4488 inhibitors, together with miR-3591-3p mimics, increased IL-6 mRNA levels in THP-1 cells in response to LPS stimulation." }, { "role": "assistant", "content": "We observed differential expression of microRNAs associated with increased production of IL-6 in BD patients. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "True regarding Philadelphia chromosome are all of the following except: March2008" }, { "role": "assistant", "content": "The correct answer is Ans. C: Specific for CMLPhiladelphia translocation is a specific chromosomal abnormality that is associated with chronic myelogenous leukemia (CML).It is the result of a reciprocal translocation between chromosome 9 and 22, and is specifically designated t(9;22)(q34;q11). The presence of this translocation is a highly sensitive test for CML, since 95% of people with CML have this abnormality (the remainders have either a cryptic translocation that is invisible on G-banded chromosome preparations, or a variant translocation involving another chromosome or chromosomes as well as the long arm of chromosomes 9 and 22).However, the presence of the Philadelphia (Ph) chromosome is not sufficiently specific to diagnose CML, since it is also found in acute lymphoblastic leukemia (ALL, 25-30% in adult and 2-10% in pediatric cases) and occasionally in acute myelogenous leukemia (AML)." } ]

[ { "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, Blood Glucose, Diabetes Mellitus, Type 2, Diabetic Retinopathy, Female, Glycated Hemoglobin A, Humans, Incidence, Logistic Models, Male, Middle Aged, Severity of Illness Index, Sweden, Time Factors." }, { "role": "user", "content": "Are the frequency and severity of retinopathy related to HbA1c values after , but not at , the diagnosis of NIDDM? Context: To examine the relationship between previous glycaemic exposure and prevalence of retinopathy 8 years after diagnosis of diabetes in 58 islet cell antibodies (ICA)-negative noninsulin-dependent diabetes mellitus (NIDDM) patients and in a group of 14 ICA-positive 'NIDDM' and insulin-dependent diabetes mellitus (IDDM) patients. The Wisconsin retinopathy scale was used to assess the retinopathy which was graded into mild, moderate and severe nonproliferative diabetic retinopathy (NPDR), or proliferative retinopathy (PDR). The frequency and severity of retinopathy was related to HbA1c levels at diagnosis, and 3 and 5 years later. Thirty of the 58 ICA-negative NIDDM patients (52%) but only 2 of the 14 ICA-positive 'NIDDM' or IDDM patients (14%) had mild-moderate-severe NPDR 8 years after diagnosis (P = 0.02). None had PDR. Retinopathy 8 years after diagnosis in NIDDM (= 58 ICA-negative patients) was correlated with the degree of glycaemic control (HbA1c levels) at 3 and 5 years after diagnosis, but not to HbA1c levels at diagnosis. The relative risk for a higher average HbA1c (per percentage) at 3 and 5 years was 1.56 for any retinopathy vs. no retinopathy (95% confidence interval 1.1-2.2; P = 0.01) and 1.68 for moderate to severe NPDR in comparison with no DR and mild NPDR (95% confidence interval 1.0-2.8; P = 0.04)." }, { "role": "assistant", "content": "Retinopathy after 8 years of diabetes in NIDDM patients was associated with impaired glycaemic control during previous years but not with glycaemic control at baseline. Good glycaemic control may prevent retinopathy in patients with NIDDM. 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 female presented with pain during urination. Gram stain of the uncentrifuged urine revealed the presence of gram-negative rods. What virulence factor is essential for the survival of these uropathogenic bacteria in the urinary tract?" }, { "role": "assistant", "content": "The correct answer is Pili (a) or fimbriae are hair like structures that are found on the surface of many bacteria. They are composed of repeated subunits of the pilin protein. They promote bacterial adherence to each other and bacterial adherence to different host tissues. Uropathogenic E. coli colonize the urinary tract and resist the washing action of urine through their pili. The tip of the pilus contains a specific protein that recognizes a receptor on the host cell. The other choices are not involved in E. coli uropathogenesis. Capsules (e) are loose polysaccharide or protein layers that surround the gram-negative or gram-positive bacteria. Capsules are antiphagocytic, protect the bacteria from hydrophobic molecules, and promote adhere of certain bacteria such as Streptococcus mutans to host tissues. Flagella (d), which are anchored on the bacterial surface, are essential for bacterial motility. The heat-labile (c) and heat-stabile toxins are enterotoxins secreted by the enterotoxigenic E. coli. These toxins produce watery diarrhea by stimulating hypersecretion of fluids. LPS (b) composes the outer leaflet of the outer membrane in gram-negative bacteria and is an endotoxin, which stimulates innate immune responses." } ]

[ { "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": "Treatment of choice in ventricular fibrillation is" }, { "role": "assistant", "content": "The correct answer is Refer kDT 7/e 538 A class of medications called beta blockers is commonly used in people at risk of ventricular fibrillation or sudden cardiac arrest. Implantable cardioveer-defibrillator (ICD). After your condition stabilizes, your doctor is likely to recommend implantation of an ICD. ... The ICD constantly monitors your hea rhythm" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The most common site of Myocardial infarction is:" }, { "role": "assistant", "content": "The correct answer is Answer is A (Anterior wall) Repeat The most common site. of myocardial infarction is the anterior wall of left ventricle." } ]

[ { "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, Animals, Child, Cross-Sectional Studies, Female, Fisheries, Helminthiasis, Helminths, Humans, Hypersensitivity, Immediate, Immunoglobulin E, Male, Odds Ratio, Outcome Assessment (Health Care), Population Surveillance, Respiratory Sounds, Risk Factors, Uganda, Young Adult." }, { "role": "user", "content": "Are helminths positively associated with atopy and wheeze in Ugandan fishing communities : results from a cross-sectional survey? Context: Parasitic helminths are potent immunomodulators and chronic infections may protect against allergy-related disease and atopy. We conducted a cross-sectional survey to test the hypothesis that in heavily helminth-exposed fishing villages on Lake Victoria, Uganda, helminth infections would be inversely associated with allergy-related conditions. A household survey was conducted as baseline to an anthelminthic intervention trial. Outcomes were reported wheeze in last year, atopy assessed both by skin prick test (SPT) and by the measurement of allergen-specific IgE to dust mites and cockroach in plasma. Helminth infections were ascertained by stool, urine and haemoparasitology. Associations were examined using multivariable regression. Two thousand three hundred and sixteen individuals were surveyed. Prevalence of reported wheeze was 2% in under-fives and 5% in participants ≥5 years; 19% had a positive SPT; median Dermatophagoides-specific IgE and cockroach-specific IgE were 1440 and 220 ng/ml, respectively. S. mansoni, N. americanus, S. stercoralis, T. trichiura, M. perstans and A. lumbricoides prevalence was estimated as 51%, 22%, 12%, 10%, 2% and 1%, respectively. S. mansoni was positively associated with Dermatophagoides-specific IgE [adjusted geometric mean ratio (aGMR) (95% confidence interval) 1.64 (1.23, 2.18)]; T. trichiura with SPT [adjusted odds ratio (aOR) 2.08 (1.38, 3.15)]; M. perstans with cockroach-specific IgE [aGMR 2.37 (1.39, 4.06)], A. lumbricoides with wheeze in participants ≥5 years [aOR 6.36 (1.10, 36.63)] and with Dermatophagoides-specific IgE [aGMR 2.34 (1.11, 4.95)]. No inverse associations were observed." }, { "role": "assistant", "content": "Contrary to our hypothesis, we found little evidence of an inverse relationship between helminths and allergy-related outcomes, but strong evidence that individuals with certain helminths were more prone to atopy in this setting. 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, Antirheumatic Agents, Arthritis, Rheumatoid, Clinical Trials as Topic, Cohort Studies, Cross-Sectional Studies, Disease Progression, Female, Humans, Male, Methotrexate, Middle Aged, Prognosis, Radiography, Retrospective Studies, Rheumatoid Factor." }, { "role": "user", "content": "Does rheumatoid factor determine structural progression of rheumatoid arthritis dependent and independent of disease activity? Context: Rheumatoid factor (RF) is prototypic for rheumatoid arthritis (RA) and serves diagnostic and prognostic purposes. RF is associated with joint destruction, but the role of disease activity as a potential mediator of these effects has not been clearly elucidated yet. To investigate if higher radiographic progression (Sharp score, ΔTSS) in RF+ patients is dependent or independent of disease activity. The authors performed a cross-sectional multivariate analysis at baseline and a matched cohort study in patients from five RA clinical trials. The authors pooled methotrexate treatment arms and compared ΔTSS in RF+ and RF- patients before and after matching for other associated variables. Among 686 patients, 124 were RF- and 562 RF+, 343 having high (>160 U/ml) RF. ΔTSS was 1.03±5.83, 3.23±8.10 and 3.58±8.18 (p<0.0001), respectively, and similarly for erosions and joint space narrowing (JSN). After matching for other prognostically important variables, ΔTSS still was lower among 61 RF- versus 61 RF high+ patients (0.52±2.47 vs 3.09±8.28; p=0.028), mainly related to differences in erosion score (0.31±1.88 vs 2.07±5.62; p=0.035), but not JSN (0.21±1.26 vs 1.02±3.31; p=0.162)." }, { "role": "assistant", "content": "The data reveal that damage progression in seropositive RA patients is related to higher levels of disease activity and to independent effects of RF, particularly on bone damage. This calls for consideration of RF status irrespective of disease activity. 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, Antigens, Bacterial, Bacterial Outer Membrane Proteins, Bacterial Typing Techniques, Borrelia, Europe, Genetic Loci, Genetic Variation, Genotype, Geography, Humans, Ixodes, Lyme Disease, North America, Polymerase Chain Reaction, Spectrometry, Mass, Electrospray Ionization." }, { "role": "user", "content": "Does genotypic variation and mixtures of Lyme Borrelia in Ixodes tick from North America and Europe? Context: Lyme disease, caused by various species of Borrelia, is transmitted by Ixodes ticks in North America and Europe. Studies have shown the genotype of Borrelia burgdorferi sensu stricto (s.s.) or the species of B. burgdorferi sensu lato (s.l.) affects the ability of the bacteria to cause local or disseminated infection in humans. We used a multilocus PCR electrospray mass spectrometry assay to determine the species and genotype Borrelia from ticks collected in New York, Connecticut, Indiana, Southern Germany, and California and characterized isolates from parts of the United States and Europe. These analyses identified 53 distinct genotypes of B. burgdorferi sensu stricto with higher resolution than ospC typing. Genotypes of other members of the B. burgdorferi sensu lato complex were also identified and genotyped including B. afzelii, B. garinii, B. lusitaniae, B. spielmanii, and B. valaisiana. While each site in North America had genotypes unique to that location, we found genotypes shared between individual regions and two genotypes found across the United States. Significant B. burgdorferi s.s. genotypic diversity was observed between North America and Europe: only 6.6% of US genotypes (3 of 45) were found in Europe and 27% of the European genotypes (3 of 11) were observed in the US. Interestingly, 39% of adult Ixodes scapularis ticks from North America were infected with more than one genotype of B. burgdorferi s.s. and 22.2% of Ixodes ricinus ticks from Germany were infected with more than one genotype of B. burgdorferi s.l." }, { "role": "assistant", "content": "The presence of multiple Borrelia genotypes in ticks increases the probability that a person will be infected with more than one genotype of B. burgdorferi, potentially increasing the risks of disseminated Lyme disease. Our study indicates that the genotypic diversity of Borrelia in ticks in both North America and Europe is higher then previously reported and can have potential clinical consequences. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Adult, Cultural Characteristics, Female, HIV Infections, Health Policy, Humans, Interviews as Topic, Islam, Malaysia, Male, Middle Aged, Sexual Behavior, Young Adult." }, { "role": "user", "content": "Navigating HIV prevention policy and Islam in Malaysia: contention, compatibility or reconciliation? Context: Malaysia is a multicultural society, predominantly composed of a Muslim majority population, where Islam is influential. Malaysia has a concentrated HIV epidemic amongst high risk groups, such as, Intravenous Drug Users (IVDU), sex workers, transgender women and Men who have sex with Men (MSM). The objective of this study is to understand how Islam shapes HIV prevention strategies in Malaysia by interviewing the three key stakeholder groups identified as being influential, namely the Ministry of Health, Religious leaders and People living with HIV. Thirty-Five in depth semi structured interviews were undertaken with religious leaders, Ministry of Health and People living with HIV in the last half of 2013 using purposive sampling. Interviews adhered to a topic guide, were audiotaped, and transcribed verbatim and analyzed using a framework analysis. Themes including the importance of Islam to health, stakeholder relationships and opinions on HIV prevention emerged. Islam was seen to play a pivotal role in shaping strategies relating to HIV prevention in Malaysia both directly and indirectly. Stakeholders often held different approaches to HIV prevention, which had to be sensitively considered, with some favouring promotion of Islamic principles, whilst others steering towards a more public health centred approach." }, { "role": "assistant", "content": "The study suggests that Islam indeed plays an important role in shaping health policies and strategies related to HIV prevention in Malaysia. Certainly, stakeholders do hold differing viewpoints, such as stances of what constitutes the right approach to HIV prevention. However there are also areas of broad consensus, such as the importance in Islamic tradition to prevent harm and disease, which can be crafted into existing and future HIV prevention strategies in Malaysia, as well as the wider Muslim world." } ]

[ { "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": "Name of the parotid duct: March 2007" }, { "role": "assistant", "content": "The correct answer is Stensons duct" } ]

[ { "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": "Discharging sinus is seen in -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., Mycetoma . Mycetoma are chronic, slowly progressive infections of the subcutaneous tissue usually of the foot caused by a number of Actinomycetes and filamentous fungi. . The disease usually begins as a small subcutaneous swelling of the foot, which enlarges, burrowing into deeper tissues and tracking to the surface as multiple sinuses discharging viscid, seropurulent fluid containing granules." } ]

[ { "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, Alanine Transaminase, Aspartate Aminotransferases, Case-Control Studies, Female, Genetic Predisposition to Disease, Genome-Wide Association Study, Genotype, Humans, Linear Models, Lipase, Liver, Male, Membrane Proteins, Middle Aged, Obesity, gamma-Glutamyltransferase." }, { "role": "user", "content": "Does a common variant in the adiponutrin gene influence liver enzyme values? Context: Two recent genome-wide association studies identified the liver expressed transmembrane protein adiponutrin to be associated with liver related phenotypes such as non-alcoholic fatty liver disease and liver function enzymes. These associations were not uniformly reported for various ethnicities. The aim of this study was to investigate a common non-synonymous variant within adiponutrin (rs738409, exon 3) with parameters of liver function in three independent West Eurasian study populations including a total of 4290 participants. The study was performed in (1) the population based Bruneck Study (n=783), (2) the Salzburg Atherosclerosis Prevention Program in Subjects at High Individual Risk Study from Austria based on a healthy working population (n=1705), and the Utah Obesity Case-Control Study including a group of 1019 severely obese individuals (average body mass index 46.0 kg/m(2)) and 783 controls from the same geographical region of Utah. Liver enzymes measured were alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT). A strong recessive association of this polymorphism was found with age and gender adjusted ALT and AST concentrations: being homozygous for the minor allele resulted in a highly significant increase of ALT concentration of 3.53 U/l (p=1.86 x 10(-9)) and of AST concentration of 2.07 U/l (p=9.58 x 10(-6)), respectively. The associations were consistently found in all three study populations." }, { "role": "assistant", "content": "The highly significant associations of this transversion polymorphism within the adiponutrin gene with increased ALT and AST concentrations support a role for adiponutrin as a susceptibility gene for hepatic dysfunction. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, METHODS, RESULTS. Meshes: Age Factors, Aged, Aging, Attitude to Health, Diet, Diet Surveys, Dietary Supplements, Female, Geriatric Assessment, Humans, Logistic Models, Male, Middle Aged, Minerals, Nutrition Policy, Nutritional Physiological Phenomena, Nutritional Requirements, Predictive Value of Tests, Sex Factors, Statistics, Nonparametric, Vitamins." }, { "role": "user", "content": "Do older adults who use vitamin/mineral supplements differ from nonusers in nutrient intake adequacy and dietary attitudes? Context: To measure nutrient intake adequacy of vitamin/mineral supplement users and nonusers aged 51 years and older, determine the efficacy of supplement practices in compensating for dietary deficits, and identify predictors of supplement use. Analyses of two 24-hour recalls, demographic variables, and attitude questions collected during the Continuing Survey of Food Intakes by Individuals and Diet and Health Knowledge Survey in 1994 to 1996. Data were weighted to be representative of older Americans. Four thousand three hundred eighty-four adults aged 51 years and older (1,777 daily supplement users, 428 infrequent users, and 2,179 nonusers) residing in households in the United States. Usual nutrient intake distributions were estimated using the Iowa State University method. The Estimated Average Requirement (EAR) cutpoint method was applied to determine the proportion of older adults not meeting requirements before and after accounting for nutrient intake from supplements. Student t tests were used to assess differences between users and nonusers. Logistic regression was used to determine sociodemographic and attitudinal predictors of supplement use. For one or more of the sex-age groups studied, a significantly smaller proportion of supplement users than nonusers had intakes from food alone below the EAR for vitamins A, B-6, and C; folate; zinc; and magnesium. Even so, less than 50% of both users and nonusers met the EAR for folate, vitamin E, and magnesium from food sources alone. Overall, supplements improved the nutrient intake of older adults. After accounting for the contribution of supplements, 80% or more of users met the EAR for vitamins A, B-6, B-12, C, and E; folate; iron; and zinc, but not magnesium. However, some supplement users, particularly men, exceeded Tolerable Upper Intake Levels for iron and zinc and a small percentage of women exceeded the Tolerable Upper Intake Level for vitamin A. Significant sociodemographic factors related to supplement use for older men were age group, metropolitan area, and educational status. Race, region, smoking status, and vegetarian status were significant factors for women. Attitude about the importance of following a healthful diet was a consistent predictor of supplement use for both men and women." }, { "role": "assistant", "content": "A large proportion of older adults do not consume sufficient amounts of many nutrients from foods alone. Supplements compensate to some extent, but only an estimated half of this population uses them daily. These widespread inadequacies should be considered when developing recommendations for supplement use for clients in this age group. Modifying dietary attitudes may result in a higher rate of supplement use in this at-risk population. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Bone Neoplasms, Bone and Bones, Cell Division, Cell Line, Tumor, Cell Movement, Cell Survival, DNA, Mitochondrial, Disease Models, Animal, Fibroblast Growth Factor 1, Focal Adhesion Protein-Tyrosine Kinases, Gene Expression Regulation, Neoplastic, Humans, Male, Mice, Mice, Nude, Mutation, Neoplasm Transplantation, Oligonucleotide Array Sequence Analysis, Prostatic Neoplasms, Stromal Cells, Transplantation, Heterologous." }, { "role": "user", "content": "Does mitochondrial DNA mutation stimulate prostate cancer growth in bone stromal environment? Context: Mitochondrial DNA (mtDNA) mutations, inherited and somatically acquired, are common in clinical prostate cancer. We have developed model systems designed to study specific mtDNA mutations in controlled experiments. Because prostate cancer frequently metastasizes to bone we tested the hypothesis that mtDNA mutations enhance prostate cancer growth and survival in the bone microenvironment. The pathogenic nucleotide position (np) 8993 mDNA mutation was introduced into PC3 prostate cancer cells by cybrid formation. Wild-type and mutant cybrids were grown as nude mouse subcutaneous xenografts with or without bone stromal cell co-inoculation. Cybrids were also grown in the intratibial space. Tumor growth was assayed by direct tumor measurement and luciferase chemiluminescence. Gene expression was assayed using cDNA microarrays confirmed by real time PCR, western blot analysis and immunohistochemistry. Cybrids with the 8,993 mtDNA mutation grew faster than wild-type cybrids. Further growth acceleration was demonstrated in the bone microenvironment. A 37 gene molecular signature characterized the growth advantage conferred by the mtDNA mutation and bone microenvironment. Two genes of known importance in clinical prostate cancer, FGF1 and FAK, were found to be substantially upregulated only when both mtDNA mutation and bone stromal cell were present." }, { "role": "assistant", "content": "The ATP6 np 8,993 mtDNA mutation confers a growth advantage to human prostate cancer that is most fully manifest in the bone microenvironment. The identification of specific molecular alterations associated with mtDNA mutation and growth in bone may allow new understanding of prostate cancer bone 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": "Composition of Varnish is:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Tuberculous pleural effusion is characterized by all, except -" }, { "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": "Androgen receptor antagonists include:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which one of the following drugs is most likely to block K+ channels in the heart responsible for the delayed rectifier current?" }, { "role": "assistant", "content": "The correct answer is Amiodarone is a highly effective antiarrhythmic drug, in part because of its multiple actions, which include Na channel block, beta adrenoceptor block, K channel block, and Ca channel block. Drugs that block K channels (which include class IA and class III antiarrhythmics) prolong APD and ERP and predispose toward torsades de pointes ventricular arrhythmias. Encainide is a class IC drug, lidocaine and phenytoin are class IB, and verapamil is class IV, none of which inhibits the delayed rectifier K current responsible for membrane repolarization during the cardiac action potential." } ]

[ { "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, Blood Coagulation, Carboxypeptidase B2, Chromatography, High Pressure Liquid, Female, Fibrinolysis, Humans, Hyperhomocysteinemia, Male, Middle Aged, Multivariate Analysis, Thromboembolism." }, { "role": "user", "content": "Is mild hyperhomocysteinemia associated with increased TAFI levels and reduced plasma fibrinolytic potential? Context: Mild hyperhomocysteinemia (HHcy) has been shown to be associated with impaired fibrinolysis, but some aspects of this association are unclear. Using an in vitro model of physiological relevance, we investigated whether and how HHcy influences plasma fibrinolytic potential. We studied 176 patients with previous venous thromboembolism, 58 with HHcy, 118 with normal total homocysteine (tHcy) levels (NHcy), at least 3 months after withdrawal of anticoagulant therapy. Plasma fibrinolytic potential was measured as the fibrinolysis time of tissue factor (TF)-induced clots exposed to 15 ng mL(-1) t-PA. Fibrinolysis time was longer in HHcy than in NHcy patients, but this difference disappeared when the assay was performed in the presence of the TAFIa inhibitor, PTCI. Plasma levels of thrombin activatable fibrinolysis inhibitor (TAFI) and factor VIII (FVIII) were higher in HHcy than NHcy, whereas PAI-1, fibrinogen and endogenous thrombin potential were similar. Using multivariate analysis, plasma tHcy was identified as an independent predictor of fibrinolysis time. Experiments in which native fibrinogen was replaced by purified fibrinogen suggested that alterations of fibrinogen structure did not contribute appreciably to the hypofibrinolysis of HHcy plasma samples. The acute increase of tHcy either in vivo (after an oral methionine load) or in vitro (after incubation of normal plasma with 0.5 mm DL-Hcy) had no effects on fibrinolysis or TAFI levels." }, { "role": "assistant", "content": "We describe an enhanced TAFI-related antifibrinolytic activity in mild HHcy, which might account for the reported heightened thrombosis risk; however, it is unknown whether HHcy is causally related to hypofibrinolysis or an associated bystander. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is the drug of choice in treating suicidal overdose of digitoxin ?" }, { "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": "Drug used in renal osteodystrophy:" }, { "role": "assistant", "content": "The correct answer is Ans. (d) All of the aboveRef. Katzung 9th ed. /1028* Vitamin D has been used in treating renal osteodystrophy* In mild forms of malabsorption, vitamin D should suffice to raise serum levels of 25(OH) D into the normal range. Many patients with severe disease do not respond to vitamin D.* Calcitriol and Calcifediol have been used successfully in treatment of renal osteodystrophy and intestinal osteodystrophy." } ]

[ { "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 2-year-old child with severe dehydration has sudden-onset Gross Hematuria with a unilateral flank mass. The most likely diagnosis is" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Irreversible cell injury is indicated by" }, { "role": "assistant", "content": "The correct answer is The hallmark of irreversible cell injury is a loss of integrity of cell membrane and lysosomal membranes Myelin figures are phospholipid deposits formed as a result of cell membrane integrity loss; Seen in the very late phase of reversible injury and irreversible injury. Necrosis Necrosis is the type of cell death that is associated with loss of membrane integrity and leakage of cellular contents cul- minating in dissolution of cells, largely resulting from the degradative action of enzymes on lethally injured cells. The leaked cellular contents often elicit a local host reaction, called inflammation, that attempts to eliminate the dead cells and sta the subsequent repair process (Chapter 2). The enzymes responsible for digestion of the cell may be derived from the lysosomes of the dying cells themselves and from the lysosomes of leukocytes that are recruited as pa of the inflammatory reaction to the dead cells. MORPHOLOGY Necrosis is characterized by changes in the cytoplasm and nuclei of the injured cells (Figs. 1-6, left, and 1-8, C). * Cytoplasmic changes. Necrotic cells show increased eosinophilia (i.e., pink staining from the eosin dye--the E in the hematoxylin and eosin stain), attributable in pa to increased binding of eosin to denatured cyto- plasmic proteins and in pa to loss of the basophilia that is normally impaed by the ribonucleic acid (RNA) in the cytoplasm (basophilia is the blue staining from the hema- toxylin dye--the H in \"H&E\"). Compared with ble cells, the cell may have a more glassy, homogeneous appear- ance, mostly because of the loss of glycogen paicles. Myelin figures are more prominent in necrotic cells than during reversible injury. When enzymes have digested cytoplasmic organelles, the cytoplasm becomes vacuo- lated and appears \"moth-eaten.\" By electron microscopy, necrotic cells are characterized by discontinuities in plasma and organelle membranes, marked dilation of mitochon- dria with the appearance of large amorphous densities, disruption of lysosomes, and intracytoplasmic myelin figures. * Nuclear changes. Nuclear changes assume one of three patterns, all due to breakdown of DNA and chromatin. The basophilia of the chromatin may fade (karyolysis), presumably secondary to deoxyribonuclease (DNase) activity. A second pattern is pyknosis, characterized by nuclear shrinkage and increased basophilia; the DNA con- denses into a solid shrunken mass. In the third pattern, karyorrhexis, the pyknotic nucleus undergoes fragmen- tation. In 1 to 2 days, the nucleus in a dead cell may completely disappear. Electron microscopy reveals pro- found nuclear changes culminating in nuclear dissolution. * Fates of necrotic cells. Necrotic cells may persist for some time or may be digested by enzymes and disappear. Dead cells may be replaced by myelin figures, which are either phagocytosed by other cells or fuher degraded into fatty acids. These fatty acids bind calcium salts, which may result in the dead cells ultimately becoming calcified. Refer robbins 9/e p834" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: UNLABELLED. Meshes: Animals, Antineoplastic Combined Chemotherapy Protocols, Benzamides, Bone Neoplasms, Cell Line, Tumor, Circular Dichroism, Colorectal Neoplasms, DNA Breaks, Double-Stranded, DNA Repair, Drug Synergism, Etoposide, Glioma, High-Throughput Screening Assays, Humans, Intercalating Agents, Mice, Mice, Nude, Molecular Structure, Neoplasms, Osteosarcoma, Poly(ADP-ribose) Polymerase Inhibitors, Radiation-Sensitizing Agents, Small Molecule Libraries, Sulfonamides, Xenograft Model Antitumor Assays." }, { "role": "user", "content": "Does yU238259 be a Novel Inhibitor of Homology-Dependent DNA Repair That Exhibits Synthetic Lethality and Radiosensitization in Repair-Deficient Tumors? Context: Radiotherapy and DNA-damaging chemotherapy are frequently utilized in the treatment of solid tumors. Innate or acquired resistance to these therapies remains a major clinical challenge in oncology. The development of small molecules that sensitize cancers to established therapies represents an attractive approach to extending survival and quality of life in patients. Here, we demonstrate that YU238259, a member of a novel class of DNA double-strand break repair inhibitors, exhibits potent synthetic lethality in the setting of DNA damage response and DNA repair defects. YU238259 specifically inhibits homology-dependent DNA repair, but not non-homologous end-joining, in cell-based GFP reporter assays. Treatment with YU238259 is not only synergistic with ionizing radiation, etoposide, and PARP inhibition, but this synergism is heightened by BRCA2 deficiency. Further, growth of BRCA2-deficient human tumor xenografts in nude mice is significantly delayed by YU238259 treatment even in the absence of concomitant DNA-damaging therapy. The cytotoxicity of these small molecules in repair-deficient cells results from an accumulation of unresolved DNA double-strand breaks. These findings suggest that YU238259 or related small molecules may have clinical benefit to patients with advanced BRCA2-negative tumors, either as a monotherapy or as an adjuvant to radiotherapy and certain chemotherapies." }, { "role": "assistant", "content": "We have identified a novel series of compounds that demonstrate synthetic lethality in DNA repair-deficient cell and animal models and have strong potential for clinical translation. 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": "Drug with both antidepressant and antipsychotic propeies is?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Amoxapine o Amoxapine is the only antidepressant which blocks D2 receptors along with inhibition of NA reuptake --> has mixed antidepressant + neurolepic propey." } ]

[ { "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, PATIENTS AND METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Biopsy, Colon, Colonic Polyps, Colonoscopy, Female, Humans, Male, Middle Aged, Prospective Studies, Surgical Instruments." }, { "role": "user", "content": "Do forceps biopsies truthfully reflect the nature of endoscopically uncovered polypoid lesions of the colon? Context: Total excision of colonic polyps is not always attainable and in some patients it is clinically contraindicated. Also, a resected polyp may be lost at any step between its endoscopic removal and its embedding in paraffin. The aim of this study was to compare the histological features of colonic polyps as analysed by the study of biopsy-forceps obtained samples with those assessed on scrutinizing the totally resected growths. This prospective study included a cohort of 59 patients in whom, in the course of an elective colonoscopy, a total excision of a 6 mm-sized or larger polyp was called for. Sizeable biopsies were obtained by means of an Olympus Multibyte forceps prior to the total polypectomy. Subsequent to the study of the polypectomy specimens, the forceps biopsy samples were submitted for histological examination. The pathologists were blinded as to the source of the tissue they were studying. The diagnoses rendered by evaluating the biopsy samples and polypectomy specimens of each patient were contrasted with each other. Major discrepancies between the histological features of the fragments captured by the biopsy-forceps and the factual nature of the totally removed polyps were uncovered in 11 (18.6%) of 59 cases. Intriguingly, the grade of the tumours was underrated in all the 11 cases, as judged by contrasting the tentative diagnoses of the forceps-biopsies with the decisive diagnoses of the polypectomies. Importantly, 2 adenocarcinomas would have been missed by just looking at the forceps-retrieved sample." }, { "role": "assistant", "content": "In our experience, a discordance of 18.6% is to be expected between the diagnoses rendered after examining forceps-biopsies of and totally excised colonic polyps. Nevertheless, it is advisable to procure biopsies prior to the excision of the growths, because on those occasions in which patients' growths cannot be removed or have not been retrieved for one reason or another, a small forceps-captured tissue sample correctly reflects the characteristics of the polyp in 81.4% of the cases. Finally, the biopsies may be discarded in the event that total removal was successful." } ]

[ { "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, Female, HIV Infections, Humans, Interviews as Topic, Middle Aged, Risk Factors, Sex Work, Substance Abuse, Intravenous, Surveys and Questionnaires, Ukraine, Young Adult." }, { "role": "user", "content": "Does engagement in sex work increase HIV risk for women who inject drugs in Ukraine? Context: We studied the association between sex in exchange for money, drugs or goods and HIV for women who inject drugs (WWID) in Ukraine, as previous data on this association from the post-USSR region are contradictory. Data come from the Integrated Bio-Behavioral Survey of Ukrainian people who inject drugs collected in 2011 using respondent-driven sampling. Participants were interviewed and tested with rapid HIV tests. The sample included 2465 WWID (24% HIV positive); 214 (8.7%) of which reported having had exchange sex during the last 90 days. Crude analysis showed no association between exchange sex and HIV (OR = 0.644; 95% CI 0.385-1.077). No confounders were found to alter this result in a multivariable analysis. Further modeling showed that exchange sex modifies association between HIV and alcohol use: no association between HIV and daily alcohol use was found for those women who exchanged sex (OR = 1.699, 95% CI 0.737-3.956); while not engaging in sex work and daily using alcohol reduced odds to be HIV infected (OR = 0.586, 95% CI 0.389-0.885)." }, { "role": "assistant", "content": "Exchange sex may have less impact on the HIV status of WWID who are exposed to injecting risks. The finding that daily alcohol use appears protective against HIV among WWID who do not exchange sex requires more research. 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": "A 9 year-old has multiple itchy erythematous wheals all over the body for 2 days. There is no respiratory difficulty. Which is the best treatment?" }, { "role": "assistant", "content": "The correct answer is C i.e. Antihistamines" } ]

[ { "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 the following vessels end directly in the right atrium except" }, { "role": "assistant", "content": "The correct answer is Superior vene cava, inferior vene cava,coronary sinus, anterior cardiac veins ,vene cordis minimi. these are the veins that directly open to right atrium. BD CHAURASIA'S HUMAN ANATOMY.VOLUME 1.6 TH EDITION.PAGE NO 255" } ]

[ { "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, Biomarkers, Calcitonin, Calcitonin Gene-Related Peptide, Female, Necrosis, Pancreas, Pancreatic Diseases, Protein Precursors, Rats, Rats, Wistar, Reproducibility of Results." }, { "role": "user", "content": "Is procalcitonin a reliable marker for the diagnosis of infected pancreatic necrosis? Context: Infected necrosis in acute pancreatitis is the main factor in determining the prognosis of the disease. Early and accurate diagnosis of infected pancreatic necrosis might decrease mortality. The aim of the present study is to identify a reliable marker for the onset infection in three different experimentally induced pancreatitis models. Ninety female Wistar albino rats were randomly divided into nine groups. In three different experimental models, including cerulein induced acute oedematous pancreatitis (AEP), sterile pancreatic necrosis due to taurocholate-induced acute pancreatitis (SPN) and infected pancreatic necrosis taurocholate-induced acute pancreatitis (IPN). Serum levels of procalcitonin (PCT), C-reactive protein (CRP), tumour necrosis factor a (TNF-alpha), interleukin 6 (IL-6) and interleukin 8 (IL-8), amylase were measured. The degree of pancreatic damage also evaluated pathologically. Procalcitonin levels were increased significantly in AEP, SPN and IPN compared to control groups (P<0.05). PCT and IL-6 level were the highest in the IPN group (P<0.05). Serum amylase, CRP, TNF-alpha, IL-2, and IL-8 levels were similar between IPN and SPN groups (P>0.05), but higher than in other groups. The results of histological evaluation also correlated with the advent of the disease." }, { "role": "assistant", "content": "Procalcitonin and IL-6 acts as reliable acute phase reactant in an experimental model of AEP, SPN and IPN in the rat. PCT and IL-6 combination might be surrogate marker of infected pancreatic necrosis and should be preferred to other markers assay especially in severe pancreatitis." } ]

[ { "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 parts of the body is not affected by leprosy -" }, { "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": "Button hole sign is seen in:" }, { "role": "assistant", "content": "The correct answer is Due to defect in dermis, pressure on a neurofibroma gives a feeling of hole in dermis, which is called as Button hole sign." } ]

[ { "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": "Ductility Represents" }, { "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: Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung, Female, Fluorodeoxyglucose F18, Humans, Lung Neoplasms, Lymphatic Metastasis, Male, Mediastinoscopy, Middle Aged, Neoplasm Staging, Positron-Emission Tomography, Retrospective Studies, Sensitivity and Specificity, Tomography, X-Ray Computed." }, { "role": "user", "content": "Is mediastinal lymph node staging by means of positron emission tomography less sensitive in elderly patients with non-small-cell lung cancer? Context: We sought to identify the impact of age on the sensitivity and specificity of integrated positron emission tomography/computed tomography (PET-CT; CT) on mediastinal lymph node staging of patients with non-small-cell lung cancer (NSCLC). We conducted a retrospective review of 206 consecutive patients with histologically proven NSCLC who underwent resection and/or mediastinoscopy in our center between September 2004 and January 2007. All of these patients had preoperative staging with integrated PET-CT as an adjunct to chest CT before resection and/or mediastinoscopy. Diabetic patients and patients who received neoadjuvant chemotherapy were excluded. The pathologic results of all of these cases were reviewed and correlated with those on CT and integrated PET-CT. The sensitivity and positive predictive values (PPV) of PET-CT in mediastinal nodal staging were significantly lower in elderly patients (age>or=65 years; sensitivity, 42%; PPV, 66%) than in younger patients (age<65 years; sensitivity, 52%; PPV, 74%). Specificity and negative predictive values were similar in both groups." }, { "role": "assistant", "content": "PET-CT staging of the mediastinum is less sensitive in elderly patients with NSCLC who have a lower PPV. Positive mediastinal uptake on PET-CT should be verified by mediastinoscopy, irrespective of age. Elderly patients with positive mediastinal uptake should not be refuted a curative intent surgical resection on the basis of positive mediastinal uptake alone. 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": "Most common site for veebral cancer is" }, { "role": "assistant", "content": "The correct answer is All the veebral cancer pathologies tend to involve mainly the thoracic and the lumbar areas commonly (thoracic >>> lumber) and hence the most common site for veebral cancers in thoracolumbar(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 501)" } ]

[ { "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": "Hemorrhagic cystitis is caused by -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Cyclophosphamide Hemorrhagic cystitis is commonly associated with CyclophosphamideCyclophocphamide is the most common cause of hemorrhagic cystitis.The drug Cyclophosphamide itself is not toxic,The drug toxicity is due to its hepatic conversion to the metabolite \"acrolein\" which is excreted in the urine and causes damage to the bladder mucosaIt is believed that urothelial damage occurs due to direct contact of the bladder wall with acrolein which causes edema, ulceration, neovascularization, hemorrhage and necrosisThus patients receiving cyclophosphamide should always receive good hydration and a foley's catheter is often placed to ensure immediate drainage of the bladder.The hemorrhagic cystitis caused by cyclophosphamide can be reduced in intensity or prevented by intravenous administration of\"MESNA\" MESNA is a thiol compound. The free (Thiol) groups of MESNA combine directly with double bond of acrolein ot form a stable nontoxic compound. MESNA is given orallyQ.Cyclophosphamide induced hemorrhagic cystitis appear to be dose related and is most prevalent in patients who are dehydrated and those receiving intravenous cyclophosphamide." } ]

[ { "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": "Smallest DNA virus is?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e. Parvovirus Smallest virus (also smallest DNA virus) --> Parvovirus. Largest virus (also largest DNA virus) --> Pox virus. . Smallest RNA virus Picornavirus . Largest RNA virus Paramyxoviridae." } ]

[ { "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: Amphiregulin, Antineoplastic Agents, Biomarkers, Tumor, Carcinoma, Squamous Cell, Cell Line, Tumor, Cell Proliferation, Cetuximab, Down-Regulation, Drug Resistance, Neoplasm, Epidermal Growth Factor, Epiregulin, ErbB Receptors, Head and Neck Neoplasms, Humans, Immunohistochemistry, Ligands, Molecular Targeted Therapy, Squamous Cell Carcinoma of Head and Neck, Tongue Neoplasms." }, { "role": "user", "content": "Is epidermal growth factor a potential biomarker for poor cetuximab response in tongue cancer cells? Context: Head and neck squamous cell carcinoma is frequently associated with aberrant epidermal growth factor receptor (EGFR) signaling, which contributes to tumor growth. Here, the functional importance of EGFR ligands in relation to proliferation and sensitivity to the EGFR-targeted therapy cetuximab was investigated in three tongue cancer cell lines. The influence of epidermal growth factor (EGF), amphiregulin (AR), and epiregulin (EPR) on tumor cell proliferation and cetuximab response was evaluated by the addition of recombinant human (rh) proteins or by siRNA-mediated downregulation of the endogenous ligand production. The expression, activation and cellular distribution of EGFR were assessed by Western blot analysis and immunocytochemistry. EGF downregulation suppressed the proliferation of all investigated tumor cell lines, whereas the response to an increased level of EGF differed between EGFR-overexpressing and EGFR-non-overexpressing cell lines. Furthermore, tumor cells consistently displayed increased cetuximab resistance upon the addition of rhEGF, whereas EGF silencing was associated with an improved cetuximab response. The data regarding AR and EPR were inconclusive." }, { "role": "assistant", "content": "Our data suggest that the amount of EGF is a determinant of the tumor cell proliferation rate and the response to cetuximab treatment in tongue cancer. Thus, EGF is a potential predictive biomarker of poor cetuximab response and a possible treatment target. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Case-Control Studies, Cross-Sectional Studies, Female, Humans, Male, Postural Balance, Posture, Statistics, Nonparametric, Temporomandibular Joint Disorders." }, { "role": "user", "content": "Do temporomandibular disorders correlate with detectable alterations in body posture? Context: This study aimed to determine if temporomandibular disorders (TMD) correlate with alterations in body posture detectable through posturography. Thirty-five asymptomatic subjects and 35 TMD patients (34 males and 36 females; mean age, 27.7+/-8.6 years) constituted the matched control and TMD groups, respectively. Posturography was performed under four different experimental conditions: (a) eyes open with mandibular rest position (Eyes Open RP); (b) eyes open with dental occlusion (Eyes Open DO); (c) eyes closed with mandibular rest position (Eyes Closed RP); and (d) eyes closed with dental occlusion (Eyes Closed DO). The X, Y, and absolute centre of pressure displacements from the projection of a theoretical barycentre and the sway area, sway length, and sway velocity were recorded as static and dynamic posturographic parameters, respectively. Generally, no differences were found in any of these parameters between the groups and between the RP and DO within either Eyes Open/Closed conditions. The only differences were found under Eyes Closed as compared to Eyes Open, irrespective of the RP/DO conditions for dynamic and not for static posturographic parameters." }, { "role": "assistant", "content": "This study failed to show detectable alterations in body posture in TMD patients. 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: Adult, Aged, Biomarkers, Critical Illness, Female, Hemodynamics, Humans, Hypoxia, Intensive Care Units, Lactates, Lactic Acid, Male, Middle Aged, Multiple Organ Failure, Postoperative Complications, Predictive Value of Tests, Prognosis, Reperfusion, Resuscitation, Shock, Septic, Survival Analysis." }, { "role": "user", "content": "Is occult hypoperfusion associated with increased mortality in hemodynamically stable , high-risk , surgical patients? Context: Our aim was to examine whether serial blood lactate levels could be used as predictors of outcome. We prospectively studied 44 high-risk, hemodynamically stable, surgical patients. Blood lactate values, mean arterial pressure, heart rate and urine output were obtained at patient admission to the study, at 12, 24 and 48 hours. The nonsurvivors (n = 7) had similar blood lactate levels initially (3.1 +/- 2.3 mmol/l versus 2.2 +/- 1.0 mmol/l, P = not significant [NS]), but had higher levels after 12 hours (2.9 +/- 1.7 mmol/l versus 1.6 +/- 0.9 mmol/l, P = 0.012), after 24 hours (2.1 +/- 0.6 mmol/l versus 1.5 +/- 0.7 mmol/l, P = NS) and after 48 hours (2.7 +/- 1.8 mmol/l versus 1.9 +/- 1.4 mmol/l, P = NS) as compared with the survivors (n = 37). Arterial bicarbonate concentrations increased significantly in survivors and were higher than in nonsurvivors after 24 hours (22.9 +/- 5.2 mEq/l versus 16.7 +/- 3.9 mEq/l, P = 0.01) and after 48 hours (23.1 +/- 4.1 mEq/l versus 17.6 +/- 7.1 mEq/l, P = NS). The PaO2/FiO2 ratio was higher in survivors initially (334 +/- 121 mmHg versus 241 +/- 133 mmHg, P = 0.03) and remained elevated for 48 hours. There were no significant differences in mean arterial pressure, heart rate, and arterial blood oxygenation at any time between survivors and nonsurvivors. The intensive care unit stay (40 +/- 42 hours versus 142 +/- 143 hours, P < 0.001) and the hospital stay (12 +/- 11 days versus 24 +/- 17 days, P = 0.022) were longer for nonsurvivors than for survivors. The Simplified Acute Physiology Score II score was higher for nonsurvivors than for survivors (34 +/- 9 versus 25 +/- 14, P = NS). The urine output was slightly lower in the nonsurvivor group (P = NS). The areas under the receiving operating characteristic curves were larger for initial values of Simplified Acute Physiology Score II and blood lactate for predicting death." }, { "role": "assistant", "content": "Elevated blood lactate levels are associated with a higher mortality rate and postoperative complications in hemodynamically stable surgical patients. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following polyps is not premalignant -" }, { "role": "assistant", "content": "The correct answer is Ans. 'c' i.e. Ulcerative colitis" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Does antimicrobial Susceptibility Pattern of Invasive Pneumococcal isolate in North West Nigeria? Context: An alarming increase in infections due to penicillin non-susceptible pneumococci (PNSP) has been documented in nearly all countries. Increasingly, PNSP are also resistant to other antibiotics, and a growing number of clinical failures following the use of these agents have been reported. To determine the resistance pattern of pneumococcal isolates from patients with invasive pneumococcal infection in North West Nigeria. In a cross-sectional study clinical specimens were obtained from patients with community acquired pneumonia (CAP), meningitis and bacteraemia over a 2 year period. Pneumococcus strains were identified. Isolates were tested against a panel of antibiotics using E-test strips, and interpreted according to the CLSI criteria. 0.06 μg/ml was used as break point for penicillin. Analysis was carried out using descriptive statistics; relationships determined using chi-squared or Fisher's exact tests, with P < 0.05 regarded as significant. Total number of isolates was 132. Twenty-two (16.7%) of the isolates were fully sensitive to penicillin while 73 (55.3%) and 37 (28.0%) were intermediately and fully resistant, respectively. One hundred and twenty-seven (96.2%) of the isolates were fully resistant to trimethoprim-sulphamethoxazole. Eleven (8.5%) were fully resistant to amoxicillin and 104 (78.8%) and 17 (12.9%) were intermediately resistant and fully susceptible. One hundred and six (80.3%) of the isolates were fully susceptible to chloramphenicol. Resistance to penicillin was shown to infer resistance to other antibiotics." }, { "role": "assistant", "content": "Pneumococcal resistance is common in North West Nigeria. Ceftriaxone retains excellent activity against most of the invasive isolate, while trimethoprim-sulphamethoxazole is almost uniformly resistant. 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": "Is sleep-disordered breathing associated with depletion of circulating endothelial progenitor cells and elevation in pulmonary arterial pressure in patients with decompensated systolic heart failure? Context: Sleep-disordered breathing (SDB) is known to occur frequently in and may predict worsening progression of patients with congestive heart failure (CHF). SDB is also known to play an important role in the development of idiopathic pulmonary arterial hypertension (PAH) via inducing endothelial dysfunction and vascular remodeling, a pathological process that can be significantly influenced by factors such as osteoprotegerin (OPG) and endothelial progenitor cells (EPCs). The objective of this study is to determine if CHF with SDB is associated with changes in OPG, EPCs, and PAH. EPCs were isolated, cultured, and quantified from CHF patients with SDB (n = 52), or without SDB (n = 68). OPG and N-terminal pro-brain natriuretic peptide (NT-proBNP) from each group was analyzed and correlated with EPCs and the mean pulmonary artery pressure (mPAP) measured by right heart catheterization. A significant decrease in circulating EPCs (29.30 ± 9.01 vs. 45.17 ± 10.51 EPCs/× 200 field; P < 0.05) was found in CHF patients with SDB compared to those without SDB. Both OPG (789.83 ± 89.38 vs. 551.29 ± 42.12 pg/mL; P < 0.05) and NT-proBNP (5946.50 ± 1434.50 vs. 3028.60 ± 811.90 ng/mL; P < 0.05) were also significantly elevated in SDB CHF patients who also had significantly elevated mPAP (50.2 ± 9.5 vs. 36.4 ± 4.1 mm Hg; P < 0.05). EPC numbers correlated inversely with the episodes of apnea and hypopnea per hour (RDI, r = -0.45, P = 0.037) and blood level of OPG (r = -0.53, P = 0.011). Although NT-proBNP was also increased significantly in patients with SDB, it had no correlation with either EPCs or RDI." }, { "role": "assistant", "content": "SDB due to hypoxemia from decompensated CHF is associated with (1) OPG elevation, (2) EPC depletion, and (3) mPAP elevation. The inverse relationship of circulating OPG with EPCs suggests a likely mechanism for hypoxemia and OPG in the development of pulmonary vascular dysfunction via depleting EPCs, thus worsening prognosis of CHF. 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": "Dementia in a patient with chronic renal failure with chronic hemodialysis is due to?" }, { "role": "assistant", "content": "The correct answer is Patients undergoing long-term dialysis acquire dialysis dementia. Dialysis dementia -leading cause is A-Beta 2 amyloid deposition. But it is not given in choices. A-Beta amyloid deposition is seen with Alzheimer's disease and hence is ruled out. Aluminium toxicity either from aluminum in the dialysate or consumption of aluminium containing drugs is linked to the pathogenesis of dialysis dementia. Dialysis dementia is a unique neurologic complication of renal failure associated with chronic dialysis. While many questions remain about the pathophysiology of the disease, aluminum toxicity is probably the major factor in the pathogenesis of the dementia. Reducing dialysate aluminum levels and minimizing oral aluminum intake has markedly decreased the incidence of the disease. Deferoxamine, a chelating agent, is effective if it is given early; however, chronic use may lead to serious complications, although they are rare." } ]

[ { "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 3-year-old boy is brought to his pediatrician by his mother when he developed redness, burning, itching, and exquisite pain all over his arms, lower legs, neck, and face. The mother states that she just recently began taking him to the local playground in the afternoons. She reports that she applied liberal amounts of sunscreen before and during the time outside. She states that they were at the playground for 30 minutes to 1 hour each day for the last 3 days. The patient has experienced prior episodes of redness and pain after being outdoors, but they were relatively minor and resolved within 12 hours. She says his current presentation is much more severe with more exquisite pain than in the past. The patient's vital signs are as follows: T 37.2 C, HR 98, BP 110/62, RR 16, and SpO2 99%. Physical examination reveals edema, erythema, and petechiae over the patient's face, neck, arms, and lower legs. No blistering or scarring of the skin is noted. Which of the following is the best treatment option for this patient's condition?" }, { "role": "assistant", "content": "Initiate oral beta carotene" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "True about endometriosis:" }, { "role": "assistant", "content": "The correct answer is Endometriosis Presence of endometrial tissue at ectopic location Etiology : Retrograde menstruation Proposed by Sampsons ( Sampsons Implantation theory) 70-80% of all women have retrograde menses Among them 5-10% have poor immunity and | estrogenecity and develops Endometriosis NOTE: Option A, C, D, are related to Adenomyosis" } ]

[ { "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": "Are histological findings in infants with Gastrointestinal food allergy associated with specific gastrointestinal symptoms ; retrospective review from a tertiary centre? Context: Gastrointestinal food allergy (GIFA) occurs in 2 to 4 % of children, the majority of whom are infants (<1 year of age). Although endoscopy is considered the gold standard for diagnosing GIFA, it is invasive and requires general anaesthesia. Therefore, we aimed to investigate whether in infants with GIFA, gastrointestinal symptoms predict histological findings in order to help optimise the care pathway for such patients. All infants <1 year of age over a 20 year period who underwent an endoscopic procedure gastroscopy or colonoscopy for GIFA were evaluated for the study. Symptoms at presentation were reviewed and compared with mucosal biopsy histological findings, which were initially broadly classified for study purposes as \"Normal\" or \"Abnormal\" (defined as the presence of any mucosal inflammation by the reporting pathologist at the time of biopsy). Of a total of 1319 cases, 544 fitted the inclusion criteria. 62 % of mucosal biopsy series in this group were reported as abnormal. Infants presenting with diarrhoea, rectal (PR) bleeding, irritability and urticaria in any combination had a probability >85 % (OR > 5.67) of having abnormal histological findings compared to those without. Those with isolated PR bleeding or diarrhoea were associated with 74 % and 68 % probability (OR: 2.85 and 2.13) of an abnormal biopsy, respectively. Conversely, children presenting with faltering growth or reflux/vomiting showed any abnormal mucosal histology in only 50.8 % and 45.3 % (OR: 1.04 and 0.82) respectively." }, { "role": "assistant", "content": "Food allergy may occur in very young children and is difficult to diagnose. Since endoscopy in infants has significant risks, stratification of decision-making may be aided by symptoms. At least one mucosal biopsy demonstrated an abnormal finding in around half of cases in this selected population. Infants presenting with diarrhoea, PR bleeding, urticaria and irritability are most likely to demonstrate abnormal histological findings. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Age Factors, Aged, Alkylating Agents, Base Sequence, DNA Modification Methylases, DNA Primers, DNA Repair, DNA Repair Enzymes, Female, Genotype, Humans, Hypoxanthine Phosphoribosyltransferase, Lymphocytes, Male, Middle Aged, Mutation, Pharmacogenetics, Polymorphism, Single Nucleotide, Smoking, Tumor Suppressor Proteins." }, { "role": "user", "content": "Is the L84F polymorphism in the O6-Methylguanine-DNA-Methyltransferase ( MGMT ) gene associated with increased hypoxanthine phosphoribosyltransferase ( HPRT ) mutant frequency in lymphocytes of tobacco smokers? Context: O-methylguanine-DNA-methyltransferase (MGMT) is a crucial DNA repair protein that removes DNA adducts formed by alkylating mutagens. Several coding single nucleotide polymorphisms (cSNPs) in the MGMT gene have been reported. Their biological significance, however, is not known. We used a newly modified cloning HPRT mutant lymphocyte assay to test the hypothesis that inheritance of the L84F and I143V coding single nucleotide polymorphism in the MGMT gene is associated with increases in HPRT mutant frequency in lymphocytes of individuals exposed to alkylating agents. In addition, we expanded and sequenced 109 mutant clones to test the hypothesis that the mutation spectrum would shift to a larger percentage of base substitutions and G-->A transition mutations in cells with L84F and I143 V coding single nucleotide polymorphisms. We observed no significant effect for the I143 V coding single nucleotide polymorphism on mutant frequency. In contrast, we observed a significant increase in mutant frequency (P<0.01) in lymphocytes from smokers with the 84F coding single nucleotide polymorphism compared with smokers homozygous for the referent L84 wild-type allele. A multiple regression analysis indicated that the mutant frequency increased significantly as a function of the 84F coding single nucleotide polymorphism and smoking, according to the model; mutant frequency (x10)=0.90+0.618 (84F polymorphism)+0.46 (smoking) with R=0.22. Mutation spectra analysis revealed an apparent increase, which was short of statistical significance (P=0.08), in base substitutions in cells with the 84F polymorphism." }, { "role": "assistant", "content": "These new data suggest that the 84F coding single nucleotide polymorphism may alter the phenotype of the MGMT protein, resulting in suboptimal repair of O-methylguanine lesions after exposure to alkylating agents. 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: Acid Phosphatase, Animals, Biomarkers, Body Weight, Bone Density, Bone Marrow, Bone Matrix, Cartilage, Connective Tissue, Diaphyses, Disease Models, Animal, External Fixators, Female, Femur, Isoenzymes, Osteoclasts, Osteogenesis, Osteogenesis, Distraction, Osteoporosis, Ovariectomy, Rats, Rats, Wistar, Tartrate-Resistant Acid Phosphatase, Time Factors, Wound Healing, X-Ray Microtomography." }, { "role": "user", "content": "Does osteoporosis influence the early period of the healing after distraction osteogenesis in a rat osteoporotic model? Context: Despite the clinical adoption of distraction osteogenesis (DO), studies examining the bone healing process at the distraction gap in osteoporotic bone are limited. We examined the effect of osteoporosis in the ovariectomized rat on DO. Mid-diaphyseal osteotomies were performed on the femurs of ovariectomized (OVX) rats. External distractors were placed on these rats and also on sham-ovariectomized rats. After a 7-day latency period, distraction was carried out at a rate of 0.5mm/day for 10 days. The bone volume (BV) of the distraction gap was measured by Micro-focused X-ray computed tomography (micro-CT) at 0, 2, and 4 weeks after completion of the distraction, and the distraction gap was examined histologically. The BV of the distraction gap in the OVX group was significantly lower than that in the sham group at 2 and 4 weeks after completion of distraction (p<0.01). On histological examination, the distraction gap in the OVX group was filled with scattered smaller bone trabeculae than those seen in the sham group at 4 weeks after completion of distraction. Osteoclast numbers at the distraction gap in the OVX group were significantly increased when compared to the sham group (p<0.01)." }, { "role": "assistant", "content": "Bone turnover with osteoclast predominance in ovariectomized rats is likely to be the cause of a reduction in new bone formation at the distraction gap. 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 statements about DNA structure:" }, { "role": "assistant", "content": "The correct answer is A i.e. All nucleotides are involved in linkage; B i.e. Antiparallel; C i.e. Bases perpendicular to DNA" } ]

[ { "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, Age Factors, Aged, Female, France, Humans, Male, Middle Aged, Poverty Areas, Risk Factors, Sex Factors, Smoking, Socioeconomic Factors, Tobacco Use Disorder." }, { "role": "user", "content": "A multilevel analysis of tobacco use and tobacco consumption levels in France: are there any combination risk groups? Context: Both the predictors for tobacco use and the determinants of the amounts of tobacco consumed by smokers should be taken into account when designing prevention programmes. Using a sample of 12,948 individuals representative of the French population in 1999, multilevel models were used to carry out a comparative investigation for the predictors of tobacco use and the determinants of the amount of tobacco consumed by smokers. At the individual level, a combination of risks (higher risk of smoking and larger amounts of tobacco consumed by smokers) was found for males, for individuals with a low level of education and for divorcees. At the level of the area of residence, both the risk of smoking (odds ratio 1.07, 95% confidence interval: 1.01-1.12 for an increase by one standard deviation) and the amount of tobacco consumed among smokers (percentage variation +4%, 95% confidence interval: 0% - +8%) increased with the gross domestic product per capita." }, { "role": "assistant", "content": "This study justifies the combined use, in such analyses, of consumption levels for smokers in addition to the risk of smoking, in order to identify the profiles with the highest risk. It was possible to identify various groups with both a high risk of tobacco use and a high level of consumption among smokers, on the basis of individual (male, divorced or less educated) and environmental (living in a high GDP area) factors. The prevention efforts should thus be focused on such groups." } ]

[ { "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": "Ropy discharge from the eye is seen in –" }, { "role": "assistant", "content": "The correct answer is Ropy (stringy) discharge is seen in vernal keratoconjunctivitis." } ]

[ { "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": "Vascular involvement and thrombosis is seen in -a) Coccidioidomycosisb) Aspergillosisc) Mucormycosisd) Histoplasmosis" }, { "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": "Liver biopsy is normal in -a) Dubin johnson syndrome b) Gilbert syndromec) Hemochromatosisd) Wilson's diseasee) Rotor's syndrome" }, { "role": "assistant", "content": "The correct answer is Liver pathology is normal in Gilbert, Crigler Najjar, Rotor Syndrome.\nIn Dubin Johson syndrome liver is darkly pigmented. Liver biopsy is not normal in wilson's disease, Hemochromatosis." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Drug of choice for Zollinger-Ellison syndrome -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Proton pump inhibitors \"Proton pump inhibitors are the drug of choice for Zollinger Ellison syndrome; they have decreased the need for total gastrectomy\"." } ]

[ { "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: 3' Untranslated Regions, Cell Communication, Cell Hypoxia, Female, Gene Expression Regulation, HLA-G Antigens, Humans, MicroRNAs, Placenta, Placentation, Pregnancy, Trophoblasts." }, { "role": "user", "content": "Is hLA-G expression regulated by miR-365 in trophoblasts under hypoxic conditions? Context: Hypoxia occurs in the first trimester of placental development and is implicated in the regulation of trophoblast differentiation. Prolonged hypoxic conditions in the placenta are related to the development of preeclampsia. MicroRNAs (miRNAs) are noncoding, single-stranded RNAs that modulate gene expression by targeting messenger RNA. We hypothesized that, under hypoxic conditions, trophoblasts may have a unique miRNA profile that may play a critical role in placental development. Total RNA was extracted from human trophoblast, HChEpC1b, exposed to normoxia (20% O2) or hypoxia (2% O2) for 24 h, and the miRNA expression profiles were investigated using a microRNA array. Several differential miRNAs were selected and validated using real-time reverse transcription PCR. We identified potential targets of these miRNAs using in silico analysis. We confirmed a potential target protein by western blot analysis and luciferase assays. The expression of miR-365 was significantly upregulated under hypoxic conditions. In silico analysis showed that miR-365 targeted human leukocyte antigen (HLA)-G. Both hypoxic conditions and overexpression of miR-365 inhibited the expression of HLA-G proteins. The overexpression of miR-365 also decreased the activity of the luciferase reporter containing the 3'-untranslated region (UTR) of HLA-G with the predicted miR-365-binding site." }, { "role": "assistant", "content": "HLA-G is a non-classical HLA class-Ib molecule that is expressed mainly in extravillous trophoblasts and which plays a key role in maintaining immune tolerance at the maternal-fetal interface. Our results indicate that miR-365 targets the HLA-G 3' UTR to repress its expression. The expression of miR-365 may play an important role in human placental development and in immunoprotection of the semiallogenic embryo. 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, LIMITATIONS. Meshes: Adrenocorticotropic Hormone, Adult, Aged, Antidepressive Agents, Depressive Disorder, Major, Electroconvulsive Therapy, Female, Humans, Male, Middle Aged." }, { "role": "user", "content": "Is serotonergic function associated with the antidepressant effects of modified-electroconvulsive therapy? Context: The effect of modified-electroconvulsive therapy (m-ECT) on central serotonergic function has not been sufficiently investigated. The aim of the present study is to investigate this effect via the neuroendocrine challenge test. Sixteen inpatients (9 men and 7 women) with major depressive disorder who were receiving m-ECT at our university hospital were recruited. A neuroendocrine challenge test to estimate central serotonergic function was performed both before and after m-ECT treatment. On the whole, depressive symptoms significantly improved, but the improvement was not associated with changes in serotonergic function. The study was open-labeled and performed with a small number of subjects and no control group." }, { "role": "assistant", "content": "Serotonergic function may not be associated with the antidepressant effects of ECT." } ]

[ { "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, Emergency Medical Services, Emergency Treatment, Female, Humans, Injury Severity Score, Intensive Care Units, Intubation, Intratracheal, Length of Stay, Male, Pneumonia, Bacterial, Retrospective Studies, Sepsis, Trauma Centers, Treatment Outcome." }, { "role": "user", "content": "Urgent airway intervention: does outcome change with personnel performing the procedure? Context: Recent studies indicate that prehospital endotracheal intubation (PHEI) is associated with increased septic morbidity. Because the decision to intubate in the field is considered a life-sustaining mandate we analyzed our experience to validate these reports and to compare field intubation to that done in more controlled circumstances on patient arrival at the trauma center. The registry of our Level l trauma center was queried from January 2002 through December 2003 for patients who required emergent EI and had a hospital stay>2 days. Patients were stratified by site of EI into PHEI and trauma center intubation (TCEI). Demographic data (age, gender, Glasgow Comma Scale, Injury Severity Score) as well as outcome measures (incidence of pneumonia [PNA], Intensive Care Unit length of stay [ICU LOS], hospital length of stay [hospital LOS], and mortality) were compared between groups. Results were subjected to chi2 or unpaired t test, accepting p<0.05 as significant. The 628 patients requiring EI consisted of 27l in PHEI and 357 in TCEL. When comparing these groups, PHEI were more severely injured (lower Glasgow Comma Scale score and higher Injury Severity Score), but had no other differences in demographics or in measured outcome variables. Within these groups, patients who developed PNA were comparable. They demonstrated similar time of onset of PNA after injury and had similar incidence of resistant organisms (46%)." }, { "role": "assistant", "content": "These data demonstrate no increased risk of PNA for urgent prehospital intubation. Moreover, the onset of PNA and the similar bacteriology is reflective of injury severity and not of additional infectious risk posed by these prehospital lifesaving maneuvers." } ]

[ { "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: Aged, Anemia, Hypochromic, Angioplasty, Balloon, Coronary, Confounding Factors (Epidemiology), Female, Heart Failure, Hemoglobins, Humans, Male, Middle Aged, Myocardial Infarction, Odds Ratio, Predictive Value of Tests, Retrospective Studies, Risk Assessment, Risk Factors, Survival Analysis." }, { "role": "user", "content": "Is anemia an independent predictor of mortality after percutaneous coronary intervention? Context: The aim of the present study was to assess whether anemia is a marker of increased risk during interventional procedure and poor midterm survival after percutaneous coronary intervention (PCI). Anemia is associated with increased risk of mortality in patients with heart failure and myocardial infarction (MI). We examined the outcomes of 6,116 consecutive PCI patients based on the hemoglobin (Hb) value before the interventional procedure. Patients were divided into three groups based on the baseline Hb level (g/l): Hb <10 = severe anemia; Hb 10 to 12 = mild anemia; Hb >12 = no anemia. The presence of anemia is associated with higher 30-day major adverse cardiac events, post-PCI peak troponin and creatine kinase-MB fraction, and a longer length of stay. After controlling for multiple covariates, significant difference in one-year survival was noted in the anemic groups compared with no anemia group (adjusted hazard ratio for Hb 10 to 12: 1.5 [95% confidence interval 1.3 to 1.8]; for Hb <10: 1.8 [95% confidence interval 1.3 to 2.3]; p = 0.004.) This adverse effect of anemia on survival was noted in all three presenting clinical syndromes (stable angina, unstable angina, and MI)." }, { "role": "assistant", "content": "Anemia is an independent predictor of mortality after PCI and is associated with higher short-term adverse procedural events. 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": "Stage of analgesia in anaesthesia is ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Stage-1" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: INTRODUCTION, MATERIALS AND METHODS, RESULTS. Meshes: Adult, Deglutition Disorders, Female, Humans, Male, Middle Aged, Organ Size, Prospective Studies, Sensation, Severity of Illness Index, Thyroid Diseases, Thyroid Gland, Thyroidectomy, Thyroiditis, Treatment Outcome." }, { "role": "user", "content": "Thyroid pathology and the globus symptom: are they related? Context: The globus sensation is a constant feeling of a lump in the throat and may be associated with thyroid enlargement. A two year prospective study was set up to ascertain the relationship between thyroid pathology and globus symptoms. All patients undergoing thyroid surgery over a two year period were included. Patients were questioned pre- and post-operatively. Globus symptom scores were recorded using a visual analogue scale. The size, weight and histological features of the removed specimens were correlated and statistical analysis performed. Two hundred patients were included in the study; 58 were symptomatic for globus pharyngeus pre-operatively, and 80 per cent of these patients' symptoms resolved post-operatively (p<or = 0.0001). Patients with histological features of inflammation showed the greatest improvement (p<or = 0.0001)." }, { "role": "assistant", "content": "As many as one-third of patients with a thyroid mass will complain of a globus-like symptom. Patients undergoing thyroid surgery, who are symptomatic for globus pharyngeus, can expect that their symptoms will improve following surgery." } ]

[ { "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: Angioplasty, Balloon, Coronary, Biomarkers, Coronary Angiography, Female, Hemodynamics, Humans, Linear Models, Male, Middle Aged, Multivariate Analysis, Myocardial Infarction, Myocardium, Necrosis, Prognosis, Prospective Studies, Severity of Illness Index, Statistics as Topic, Stroke Volume, Systole, Time Factors, Tissue Survival, Treatment Outcome, Ventricular Function, Left." }, { "role": "user", "content": "Is postsystolic shortening a strong predictor of recovery of systolic function in patients with non-ST-elevation myocardial infarction? Context: Differentiation between necrotic and viable myocardium is difficult in the setting of acute myocardial infarction (MI). Post-systolic shortening (PSS) has been proposed as a marker of recovery after revascularization, but has not previously been assessed in patients with NSTEMI prior to revascularization. In this study, we aimed to examine the relation between PSS and improvement of contractile function after successful revascularization. Thirty-five patients with non-segment elevation MI and regional systolic dysfunction were examined immediately prior to revascularization, and at follow-up 9 ± 3 months after successful revascularization. Regional systolic function was assessed by speckle tracking echocardiography as regional strain, expressed as mean peak negative longitudinal strain in segments supplied by the culprit artery. Recovery of systolic function was assessed as the difference between regional strain at follow-up and baseline (ΔStrain). Post-systolic shortening was defined as shortening in diastole beyond minimum systolic length. By multivariate regression analysis, several other variables that may affect viability were also assessed. Post-systolic shortening was observed in 32 patients (91%), mean -1.9 ± 1.4%. Mean ΔStrain was -3.3 ± 2.9%. After adjustment for baseline systolic function, PSS (β = 0.77, P= 0.022), and angiographic severity were independent predictors of viability by multiple regression analysis. Interestingly, troponin T was not a significant predictor." }, { "role": "assistant", "content": "Post-systolic shortening is associated with improved myocardial function after revascularization in patients with acute MI. It predicts long-term systolic function, and provides information on the potential benefit of the procedure. 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 ghrelin inhibit oligodendrocyte cell death by attenuating microglial activation? Context: Recently, we reported the antiapoptotic effect of ghrelin in spinal cord injury-induced apoptotic cell death of oligodendrocytes. However, how ghrelin inhibits oligodendrocytes apoptosis, is still unknown. Therefore, in the present study, we examined whether ghrelin inhibits microglia activation and thereby inhibits oligodendrocyte apoptosis. Using total cell extracts prepared from BV-2 cells activated by lipopolysaccharide (LPS) with or without ghrelin, the levels of p-p38 phosphor-p38 mitogen-activated protein kinase (p-p38MAPK), phospho-c-Jun N-terminal kinase (pJNK), p-c-Jun, and pro-nerve growth factor (proNGF) were examined by Western blot analysis. Reactive oxygen species (ROS) production was investigated by using dichlorodihydrofluorescein diacetate. To examine the effect of ghrelin on oligodendrocyte cell death, oligodendrocytes were cocultured in transwell chambers of 24-well plates with LPS-stimulated BV-2 cells. After 48 hours incubation, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and terminal deoxynucleotidyl transferase 2'-deoxyuridine, 5'-triphosphate nick end labeling staining were assessed. Ghrelin treatment significantly decreased levels of p-p38MAPK, p-JNK, p-c-Jun, and proNGF in LPS-stimulated BV-2 cells. ROS production increased in LPS-stimulated BV-2 cells was also significantly inhibited by ghrelin treatment. In addition, ghrelin significantly inhibited oligodendrocyte cell death when cocultured with LPS-stimulated BV-2 cells." }, { "role": "assistant", "content": "Ghrelin inhibits oligodendrocyte cell death by decreasing proNGF and ROS production as well as p38MAPK and JNK activation in activated microglia as an anti-inflammatory hormone. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In RNTCP, One tubercular unit covers how much population ?" }, { "role": "assistant", "content": "The correct answer is Ans. b. 500000" } ]

[ { "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 should be the value of BMI for it to be classified as obesity?" }, { "role": "assistant", "content": "The correct answer is BMI stands for the Body Mass Index which is used to predict weight for the respective height. It is defined as the weight in kilograms divided by the square of height in metres and is expressed as kg/m2. A value of BMI > 30 is classified as obesity and a BMI of > 40 is classified under class III obesity. A BMI > 20 up to 30 will include those who are pre-obese and the overweight. Ref: Park's Textbook of Preventive and Social Medicine 19th Edition; Pages 332 - 335; 515." } ]

[ { "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": "Palpatory thud, audible slap is seen in -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Tracheal foreign body o A foreign body in trachea may move up and down the trachea between the carina andd the undersurface of the vocal cords causing \"audible slap\" and \"palpatory thud\". o Symptoms and signs of foreign bodies at different levels :# Larynx# Trachea" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, METHODS, METHODS, METHODS, METHODS, RESULTS. Meshes: Acylation, Adult, Aged, Appetite, Area Under Curve, Cross-Over Studies, Dietary Carbohydrates, Dietary Fats, Dietary Proteins, Female, Ghrelin, Humans, Insulin, Leptin, Male, Middle Aged, Time Factors." }, { "role": "user", "content": "Are acyl and total ghrelin suppressed strongly by ingested proteins , weakly by lipids , and biphasically by carbohydrates? Context: Ghrelin is an orexigenic hormone that can increase body weight. Its circulating levels increase before meals and are suppressed after food ingestion. Understanding the effects of specific types of ingested macronutrients on ghrelin regulation could facilitate the design of weight-reducing diets. We sought to understand how ingestion of carbohydrates, proteins, or lipids affect acyl (bioactive) and total ghrelin levels among human subjects, hypothesizing that lipids might suppress ghrelin levels less effectively than do either carbohydrates or proteins. This was a randomized, within-subjects cross-over study. The study was conducted at a University Clinical Research Center. There were 16 healthy human subjects included in the study. Isocaloric, isovolemic beverages composed primarily of carbohydrates, proteins, or lipids were provided. The magnitude of postprandial suppression of total and acyl ghrelin levels (measured with a novel acyl-selective, two-site ELISA) was determined. All beverages suppressed plasma acyl and total ghrelin levels. A significant effect of macronutrient class on decremental area under the curve for both acyl and total ghrelin was observed; the rank order for magnitude of suppression was protein more than carbohydrate more than lipid. Total ghrelin nadir levels were significantly lower after both carbohydrate and protein, compared with lipid beverages. In the first 3 postprandial hours, the rank order for acyl and total ghrelin suppression was carbohydrate more than protein more than lipid. In the subsequent 3 h, there was a marked rebound above preprandial values of acyl and total ghrelin after carbohydrate ingestion alone." }, { "role": "assistant", "content": "These findings suggest possible mechanisms contributing to the effects of high-protein/low-carbohydrate diets to promote weight loss, and high-fat diets to promote weight gain. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, RESULTS. Meshes: Breast, Breast Neoplasms, Carcinoma in Situ, Cell Division, Diagnosis, Differential, Female, Humans, Hyperplasia, Immunohistochemistry, Keratins, Neoplasm Invasiveness." }, { "role": "user", "content": "Does cytokeratin 5/6 immunohistochemistry assist the differential diagnosis of atypical proliferations of the breast? Context: This study was performed to determine the diagnostic value of keratin 5/6 (CK 5/6) immunophenotyping on routinely processed breast tissues. Six hundred and ninety-nine breast lesions, including normal tissues as well as benign and malignant lesions in 321 formalin-fixed, paraffin-embedded samples from 158 different patients were investigated immunohistochemically, following wet autoclave pre-treatment for antigen retrieval. In normal breast tissues, both myoepithelial and luminal epithelial cells expressed CK 5/6 in varying amounts. While myoepithelial immunoreactivity was most pronounced in the duct system, luminal epithelial immunoreactivity was strongest in the terminal duct lobular units. In ductal hyperplasias (DH), luminal epithelial cells predominantly revealed CK 5/6 immunoreaction. In contrast, neoplastic epithelial cells in atypical ductal and lobular hyperplasias (ADH and ALH) lacked such an expression, whereas in ductal in-situ carcinomas (DCIS) and in infiltrating ductal carcinomas 3.7% and 7.7%, of the cases respectively, showed positive immunostaining for CK 5/6." }, { "role": "assistant", "content": "Immunophenotyping of keratin 5/6 expression can be helpful in the diagnosis of atypical hyperplasias and in-situ carcinomas of the breast. It is particularly valuable in the differential diagnosis between benign and atypical proliferative lesions. 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": "Most common cause of death in EBV?" }, { "role": "assistant", "content": "The correct answer is Most cases of Infectious Mononucleosis are self-limited. Deaths are very rare and most often are due to central nervous system (CNS) complications, splenic rupture, upper airway obstruction, or bacterial superinfection." } ]

[ { "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: Air Pollution, Indoor, Health Policy, Humans, Organizational Policy, Schools, Surveys and Questionnaires." }, { "role": "user", "content": "Do school policies and practices that improve indoor air quality? Context: To determine whether schools with a formal indoor air quality management program were more likely than schools without a formal program to have policies and practices that promote superior indoor air quality. This study analyzed school-level data from the 2006 School Health Policies and Programs Study, a national study of school health programs and policies at the state, district, and school levels. Using chi-square analyses, the rates of policies and practices that promote indoor air quality were compared between schools with and schools without a formal indoor air quality program. The findings of this study show that 51.4% of schools had a formal indoor air quality management program, and that those schools were significantly more likely than were schools without a program to have policies and use strategies to promote superior indoor air quality." }, { "role": "assistant", "content": "These findings suggest that schools with a formal indoor air quality program are more likely support policies and engage in practices that promote superior indoor air quality. 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": "Source of norepinephrine is?" }, { "role": "assistant", "content": "The correct answer is Tyrosine REF: Lehninger Principles of Biochemistry 4th Edition page 440, 678, and 859 \"Tyrosine gives rise to a family of catecholamines that includes dopamine, norepinephrine, and epinephrine\" \"Norepinephrine is synthesized by a series of enzymatic steps in the adrenal medulla and postganglionic neurons of the sympathetic nervous system from the amino acid tyrosine\"" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Analysis of Variance, Diskectomy, Electromyography, Female, Humans, Intraoperative Care, Lumbar Vertebrae, Male, Middle Aged, Pain, Postoperative, Predictive Value of Tests." }, { "role": "user", "content": "Does intraoperative electromyographic monitoring in lumbar microdiscectomy correlate with postoperative pain? Context: Our objective was to correlate the findings of intraoperative electromyographic (EMG) monitoring with immediate postoperative pain in patients undergoing lumbar microdiscectomy. A total of 112 patients undergoing de novo lumbar microdiscectomy were prospectively randomized into a control group (n = 45) and a study group (n = 67) in which intraoperative EMG monitoring was used. Postoperative pain and postoperative narcotic consumption were recorded for each patient. The presence or absence of EMG monitoring did not influence the level of reported pain in any anatomic area. In the monitored group, the degree of recorded nerve root irritation did not correlate with reported pain or postoperative narcotic consumption. The level of back pain was found to be significantly higher than the level of hip and calf pain (P<0.0001)." }, { "role": "assistant", "content": "In our study no correlation was found between intraoperative EMG findings and immediate postoperative pain." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The following statements regarding benzodiazepines are true except -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Binds to both GABAA and GABAB receptors o Benzodiazepines act at GABAA receptors and not at GABAB receptors." } ]

[ { "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 female presents with primary amen-orrhea. Her breasts are Tanner 4 but she has no ax-illary or pubic hair. The most likely diagnosis is:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Acute silicosis clinical manifestation is –" }, { "role": "assistant", "content": "The correct answer is Silicosis\n\nSilicosis is a lung disease caused by inhalation of crystalline silicon dioxide (silica).\nCurrently, it is the most prevalent occupational disease in the world.\nThere are three types of silicosis -\n\ni) Acute silicosis\n\nResults from short-term exposure to a very large amounts of silica.\nA subset of acute silicosis is silicoproteinosis the chest radiographic appearance of which mimic pulmonary alveolar proteinosis.\nA miliary picture with very small round opacities may also occur in lower lung fields.\n\nii) Accelerated silicosis\n\nOccurs after exposure to large amounts of silica over a shorter period of time (4-8 years).\nInflammation, scarring and symptoms progress faster than chronic silicosis.\n\niii) Chronic silicosis\n\nResults from long term exposure (more than 20 years) of low amounts of silica dust.\nNodules in upper zones of lung.\nFibrotic lesions in hilar lymph node & pleura\n\t Progressive massive fibrosis\nIncreased susceptibility of TB → silicotuberculosis" } ]

[ { "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, Cystic Fibrosis, Female, Humans, Lung, Male, Phenotype, Pseudomonas Infections, Pseudomonas aeruginosa, Sputum, Young Adult." }, { "role": "user", "content": "Is extensive diversification a common feature of Pseudomonas aeruginosa populations during respiratory infections in cystic fibrosis? Context: Populations of the Liverpool Epidemic Strain (LES) of Pseudomonas aeruginosa undergo extensive diversification in the cystic fibrosis (CF) lung during long-term chronic infections. We analyzed sets of 40 isolates from the sputa of five CF patients, each chronically infected with a different non-LES strain of P. aeruginosa. For each sample (two per patient), diversity was assessed by characterizing nine phenotypic traits. All P. aeruginosa populations were highly diverse, with the majority of phenotypic variation being due to within-sample diversity." }, { "role": "assistant", "content": "Maintenance of diverse populations in the CF lung is a common feature of P. aeruginosa infections. 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 32-year-old man comes to the physician because of a 2 month history of difficulty sleeping and worsening fatigue. During this time, he has also had difficulty concentrating and remembering tasks at work as well as diminished interest in his hobbies. He has no suicidal or homicidal ideation. He does not have auditory or visual hallucinations. Vital signs are normal. Physical examination shows no abnormalities. Mental status examination shows a depressed mood and flat affect with slowed thinking and speech. The physician prescribes sertraline. Three weeks later, the patient comes to the physician again with only minor improvements in his symptoms. Which of the following is the most appropriate next step in management?" }, { "role": "assistant", "content": "Continue sertraline for 3 more weeks\n\"" } ]

[ { "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 alpha blocker is useful in BPH?" }, { "role": "assistant", "content": "The correct answer is BPH is treated with the alpha-blocker terazosin, prazosin, or doxazosin to relax the prostate, and finasteride or dutasteride to decrease the mass of the prostate. Must know: Prazosin is a peripheral acting alpha-adrenergic blocker used primarily to treat hypeension. Phentolamine is an a-adrenergic blocker used for controlled hypotension, treatment of perioperative hypeensive crisis that may accompany pheochromocytoma removal, prevention or treatment of dermal necrosis or sloughing after intravenous administration or extravasation of barbiturate or sympathomimetic. Tolazoline is a competitive a1 and a2 adrenergic blocking agent. It also relaxes vascular smooth muscles, producing a peripheral vasodilatation. Phenoxybenzamine is an irreversible, non-competitive a1 and a2 adrenergic receptor antagonist which decreases vascular resistance and lowers both the supine and the standing blood pressure. Ref: Essentials of Pharmacology for Health Occupations By Ruth Woodrow, Bruce J. Colbe, David M. Smith, 2010, Page 474; Advanced Therapy of Prostate Disease By Main I. Resnick, Ian Murchie Thompson, 2000, Page 533; Goodman and Gillman's, 11th edition, Page 172,173,183." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Colic, Female, Humans, Kidney Diseases, Male, Middle Aged, Radionuclide Imaging, Tomography, X-Ray Computed, Urinary Calculi." }, { "role": "user", "content": "Non contrast computerized tomography and dynamic renal scintigraphy in the evaluation of patients with renal colic: are both necessary? Context: To determine the value of the combined use of non contrast computerized tomography (NCCT) and dynamic renal scintigraphy (DRS) in the evaluation of patients with renal colic. Forty-nine consecutive patients with renal colic were evaluated with abdominal plain films (KUB), NCCT and DRS with Tc-99m DTPA or MAG-3. NCCT results showed size and location of the urolithiasis, as well as secondary signs of obstruction. DRS was used to determine the degree of obstruction in the affected renal unit. Patients were submitted to urologic intervention or followed, decision made on the basis of clinical symptoms, degree of obstruction, size, and location of the stone. Three patients had other etiologies than stone for their symptoms and were excluded from the study. Of the remaining 46 patients, KUB detected stones in 24 (52.2%), while NCCT in all. NCCT showed secondary signs of obstruction in 35 patients (76%). Seven patients in this group (15%) had severe hydronephrosis on NCCT and complete obstruction on DRS. Twenty-eight patients (61%) showed moderate hydronephrosis and/or peri-renal and peri-ureteral stranding on the NCCT. In this latter group, DRS diagnosed complete obstruction in 5 (18%) patients, partial obstruction in 16 (57%) and no signs of obstruction in 7 (25%) patients. Overall 34% (12/35) of the patients with secondary signs of obstruction on NCCT had complete obstruction on DRS. NCCT revealed no secondary signs of obstruction in 11 patients (24%) with partial obstruction diagnosed by DRS in one of them (9%). All 12 patients with complete obstruction on the DRS underwent early intervention. Of the 16 patients with partial obstruction of the DRS, two patients (12.5%) necessitated ureteric stent insertion. Three patients with no obstruction on the RNS underwent elective extracorporal shock wave lithotripsy (ESWL) while the rest of the patients were followed and passed their stones spontaneously." }, { "role": "assistant", "content": "The combination of non-enhanced helical CT and DRS assesses both anatomy and function. When NCCT shows no secondary signs of obstruction, NCCT as the sole imaging study performed may be adequate. If there are secondary signs of obstruction on NCCT, DRS can distinguish patients with different degrees of obstruction and together with the clinical course, size, and location of the lithiasis may help in selecting patients who need earlier intervention from those who may be safely observed." } ]

[ { "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: Chromatography, Liquid, Iridoid Glycosides, Methylation, Plant Extracts, Spectrometry, Mass, Electrospray Ionization, Teucrium." }, { "role": "user", "content": "Does iridoid glycoside permethylation enhance chromatographic separation and chemical ionization? Context: While natural products isolated from medicinal plants can serve as a rich source of biologically active metabolites, mixtures of structurally related compounds of a polar nature are often difficult to chemically resolve by traditional separation techniques. Chemical derivatization to reduce metabolite polarity combined with liquid chromatography (LC) is the strategy presented here to resolve a mixture of structurally related natural product glycosides solvent extracted from the medicinal herb Teucrium polium for mass spectrometric characterization. The partially purified plant extract was subjected to chemical derivatization and electrospray ionization mass spectrometry (ESI-MS) fragmentation pattern analysis allowed for structural characterization of iridoid and secoiridoid glycosides. Selected ions were subjected to tandem mass spectrometric (MS/MS) analysis with a relatively higher-energy collision dissociation to assist in structural elucidation. Permethylation replaced all protons from free hydroxyl and amino groups with methyls and resulted in increases in both hydrophobicity, for facilitated chromatographic separation, and proton affinity, for enhanced chemical ionization. Protonated and/or sodiated adducts were observed for the six compounds detected in positive-ion mode ESI-MS with a mass accuracy of less than 2 ppm." }, { "role": "assistant", "content": "Permethylation combined with LC/MS analysis is shown here to be an effective chemical practice for separating and characterizing iridoid glucosinolates and is expected to be well suited for the chemical characterization of other polar natural-product mixtures of closely related compounds. Copyright © 2016 John Wiley & Sons, Ltd. 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: Cardiomyopathy, Hypertrophic, DNA Methylation, Gene Expression, Humans, Leukocytes, Myocardium, Myosin Heavy Chains, Polymerase Chain Reaction, RNA, Messenger, Regulatory Sequences, Nucleic Acid, Transcription, Genetic." }, { "role": "user", "content": "Is human beta-myosin heavy chain mRNA prevalence inversely related to the degree of methylation of regulatory elements? Context: Methylation of cytosine in CG dinucleotides within regulatory elements is believed to silence gene expression. These dinucleotides occur in certain important regulatory elements in the promoter region of the human beta-myosin heavy chain (beta-MHC) gene. We therefore investigated whether methylation of these elements correlates with beta-MHC gene transcription in human 'expressing' (right atrial) and 'non-expressing' (peripheral blood leucocytes) cells. We employed 2 techniques to assess promoter methylation: (i) analysis of the susceptibility to digestion of a particular CCGG restriction site in the promoter region when genomic DNA is cleaved with the restriction endonucleases MspI (methylation-insensitive) and HpaII (methylation-sensitive), and (ii) the bisulphite-PCR method to examine in detail the methylation patterns of 3 important regulatory elements that contain CG dinucleotides. beta-MHC mRNA expression in right atrium and leucocytes was assessed using reverse-transcription-PCR with specific primers that do not detect alpha-MHC cDNA. The digestion pattern observed with MspI or HpaII indicated that the CCGG site was almost completely methylated in leucocytes, but relatively unmethylated in atrial myocardium from the same patients. When methylation was examined with the bisulphite-PCR method we found a reciprocal relationship between the level of beta-MHC mRNA expression in leucocytes and atrial myocardium and the degree of methylation of CG dinucleotides in the 5' regulatory elements of the gene." }, { "role": "assistant", "content": "Tissue-specific methylation of the human beta-MHC gene promoter may play a role in determining the pattern of expression of this gene. Furthermore, alteration of the level of methylation may underlie the changes in transcription of this gene that occur, for example, when atrial or ventricular myocardium hypertrophies. 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 52-year-old man presents to his primary care physician to discuss laboratory results that were obtained during his annual checkup. He has no symptoms or concerns and denies changes in eating or urination patterns. Specifically, the physician ordered a panel of metabolic laboratory tests to look for signs of diabetes, hyperlipidemia, or other chronic disorders. A spot glucose check from a random blood sample showed a glucose level of 211 mg/dL. A hemoglobin A1c level was obtained at the same time that showed a level of 6.3%. A fasting blood glucose was obtained that showed a blood glucose level of 125 mg/dL. Finally, a 2-hour glucose level was obtained after an oral glucose tolerance test that showed a glucose level of 201 mg/dL. Which of the following statements is most accurate for this patient?" }, { "role": "assistant", "content": "This patient has type 2 diabetes as diagnosed by his oral tolerance blood glucose" } ]

[ { "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 finding is not suggestive of intrinsic hepatic fibrosis:" }, { "role": "assistant", "content": "The correct answer is In caput medusa the blood flows away from the umbilicus and is suggestive of poal hypeension. The increased flow results in a venous hum. The abdominal distention due to ascites explains flank fullness and eveed umbilicus." } ]

[ { "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, Alcohol Drinking, Anemia, Birth Weight, Fathers, Female, Finland, Health Status Indicators, Hospitals, University, Humans, Infant, Newborn, Logistic Models, Male, Marital Status, Maternal Health Services, Mothers, Multivariate Analysis, Odds Ratio, Pregnancy, Pregnancy Outcome, Pregnancy in Adolescence, Risk Assessment, Risk Factors, Smoking, Surveys and Questionnaires, Unemployment, Universal Coverage." }, { "role": "user", "content": "Does unemployment in family affect pregnancy outcome in conditions of high quality maternity care? Context: The influence of unemployment in the family on pregnancy outcome is controversial. Only a few studies have involved investigation of the effect of unemployment of the father on pregnancy. The objective of this study was to assess the effects of unemployment of one or both parents on obstetric outcome in conditions of free antenatal care attended by the entire pregnant population. The data of 24,939 pregnancies included maternal risk factors, pregnancy characteristics and outcome, and was based on a self administered questionnaire at 20 weeks of pregnancy and on clinical records. Unemployment was associated with adolescent maternal age, unmarried status and overweight, anemia, smoking, alcohol consumption and prior pregnancy terminations. Multivariate logistic regression analysis indicated that after controlling for these maternal risk factors small differences only were found in pregnancy outcomes between unemployed and employed families. Unemployed women had significantly more often small-for-gestational-age (SGA) infants, at an OR of 1.26 (95% CI: 1.12-1.42) whereas, in families where both parents were unemployed, the risk of SGA was even higher at an OR of 1.43 (95% CI: 1.18-1.73). Otherwise, pregnancy outcome was comparable in the groups studied." }, { "role": "assistant", "content": "Free antenatal care was unable to fully overcome the adverse pregnancy outcomes associated with unemployment, SGA risk being highest when both parents are unemployed." } ]

[ { "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, Animals, Epithelial Cells, Female, Gram-Positive Bacteria, Humans, Interleukin-6, Interleukin-8, Macrophages, Alveolar, Swine, Tumor Cells, Cultured." }, { "role": "user", "content": "Do gram positive bacteria induce IL-6 and IL-8 production in human alveolar macrophages and epithelial cells? Context: Inhalation of dust from swine confinement buildings results in an acute inflammatory reaction in the respiratory tract. The dust has a high microbial content, dominated by Gram positive bacteria. The aim of the present study was to evaluate the significance of bacteria in the induction of IL-6 and IL-8 release from respiratory epithelial cells and alveolar macrophages. The results would give an indication to what extent the bacteria contribute to the toxic inflammation following exposure to swine dust. Epithelial cells from a human lung carcinoma cell line (A549) and human alveolar macrophages obtained from healthy subjects by bronchoalveolar lavage, were stimulated with swine dust, LPS, one Gram negative and four Gram positive bacteria strains. The dose-response release of IL-6 and IL-8 were studied. In addition, a bacteria-free supernatant was prepared from each strain and used for stimulation. With a few exceptions, a dose-dependent IL-6 and IL-8 release was demonstrated from both cell types after stimulation with bacteria. In epithelial cells, Escherichia coli was the most potent bacteria at the highest concentration of 400 bacteria/cell regarding secretion of both IL-6 and IL-8 (P < 0.001), followed by Staphylococcus hominis and Staphylococcus lentus. In alveolar macrophages, S. lentus was the most potent strain (P < 0.001) in inducing cytokine release (P < 0.001), followed by S. hominis and E. coli concerning IL-6 secretion or Micrococcus luteus and E. coli with respect to IL-8 secretion (P < 0.001). Differences in potency between the various bacteria could be demonstrated, both within the two cell types as well as between the epithelial cells and macrophages. Bacteria-free supernatants were also able to induce cytokine release in both cell types. In macrophages the supernatants were even more potent stimuli than whole bacteria." }, { "role": "assistant", "content": "The results indicate that bacteria or bacterial products could be an important contributing factor to the inflammatory reaction following exposure to swine dust. 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: Follow-Up Studies, Fundoplication, Gastroesophageal Reflux, Humans, Hydrogen-Ion Concentration, Laparoscopy, Manometry, Monitoring, Physiologic, Peristalsis, Surveys and Questionnaires, Treatment Outcome." }, { "role": "user", "content": "Is total fundoplication the operation of choice for patients with gastroesophageal reflux and defective peristalsis? Context: Partial fundoplication has traditionally been indicated for patients with gastroesophageal reflux disease (GERD) who have defective peristalsis (DP). Because partial fundoplication had been reported to be a less effective means of controlling acid reflux than total fundoplication, in 1997 we stopped performing partial fundoplication for patients with DP and switched to a floppy total fundoplication. This study analyzes the results of our new strategy and compares it to our former approach. We performed a partial fundoplication in 39 patients with DP (distal amplitude >40% of swallows) between 1994 and 1997 and a total fundoplication in 57 patients between 1997 and 2000. Symptoms scores derived from a standard questionnaire with a scale of 0-4 manometry, and 24-h pH monitoring were completed preoperatively in 86 patients and postoperatively in 40 patients. Heartburn scores improved in both groups (preoperative, 2.8; postoperative, 0.65; p<0.05). Dysphagia was 1.1 preoperatively and 0.62 postoperatively (p=NS) in the partial fundoplication group and 1.2 preoperatively and 0.3 postoperatively (p<0.05) in the total fundoplication group. Furthermore, none of the patients in the total fundoplication group developed new dysphagia and none required dilatation. Distal esophageal acid exposure normalized in both groups after operative treatment (median DeMeester score:72.3 vs 11.3, p<0.05, For partial fundoplication; 57.1 vs 6.3, p<0.05, For total fundoplication). Distal esophageal amplitudes averaged 27.8 mmHg preoperatively and 35.6 mmHg (p = NS) in the partial fundoplication group, they averaged 28.2 mmHg preoperatively vs 49.0 mmHg postoperatively (p<0.005) in the total fundoplication group. Two patients with a previous partial fundoplication required a conversion to a total fundoplication. No postoperative dilation was required in either group." }, { "role": "assistant", "content": "Our study shows that both a partial and a total fundoplication are effective in controlling the symptoms of GERD in patients with defective peristalsis. Dysphagia improves significantly after total fundoplication but not after partial fundoplication. Although both operations brought acid reflux to within normal limits, the effect was more pronounced with total fundoplication. Total, but not partial, fundoplication produced a significant increase in amplitude of esophageal peristalsis, which may explain the subjective improvement during deglutition. Therefore, fundoplication should be the treatment of choice in patients with GERD and defective peristalsis. Final Decision: yes" } ]