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[ { "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, Aging, Bone Density, Calcaneus, Cross-Sectional Studies, Health Status, Humans, Insulin-Like Growth Factor I, Linear Models, Male, Middle Aged, Osteoporosis, Sex Hormone-Binding Globulin, Testosterone, Ultrasonography, Young Adult." }, { "role": "user", "content": "Is insulin-like growth factor-1 a mediator of age-related decline of bone health status in men? Context: The role of insulin-like growth factor-1 (IGF-1) in bone health in men is debatable. This study aimed to determine whether IGF-1 is a mediator in age-related decline of bone health status measured by calcaneal speed of sound (SOS) in Malaysian men. The study recruited 279 Chinese and Malay men. Their demographic data, weight, height, calcaneal SOS were taken and fasting blood was collected for total testosterone, sex-hormone binding globulin and IGF-1 assays. The associations between the studied variables were assessed using multiple linear regression (MLR) analysis. Mediator analysis was performed using Sobel test. There was a significant and parallel decrease of IGF-1 and SOS with age (p < 0.05). Serum IGF-1 was significantly and positively associated with SOS (p < 0.05) but after further adjustment for age, the significance was lost (p > 0.05). The strength of the association between age and SOS decreased after adjusting for IGF-1 level but it remained significant (p < 0.05). Sobel test revealed that IGF-1 was a significant partial mediator in the relationship between age and SOS (z = -4.3)." }, { "role": "assistant", "content": "Serum IGF-1 is a partial mediator in the age-related decline of bone health in men as determined by calcaneal ultrasound. A prospective study should be performed to validate this relationship. 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": "When using low-flow circle absorber techniques, the uptake of nitrous oxide must be considered. In a healthy 70 kg adult the expected uptake of nitrous oxide, with a 70% inspired concentration, after 1.5 hours would be about" }, { "role": "assistant", "content": "The correct answer is uptake of N2O (in mls/min) is equal to 1000 divided by the square root of the time elapsed (in mins) * the time elapsed is 100 minutes. * the square root of this is 10 * 1000 divided by 10 is 100 so the N2O uptake at 100 mins into the case would be about 100mls/min." } ]

[ { "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: Blood Pressure, Body Temperature, Brain, Cerebral Angiography, Humans, Injections, Intra-Arterial, Intracranial Hypertension, Middle Aged, Oxygen, Papaverine, Retrospective Studies, Subarachnoid Hemorrhage, Vasodilator Agents, Vasospasm, Intracranial." }, { "role": "user", "content": "Does intra-arterial papaverine used to treat cerebral vasospasm reduce brain oxygen? Context: Intra-arterial papaverine (IAP) is used to treat symptomatic cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH). IAP, however, can increase intracranial pressure (ICP). In this study we examined whether IAP alters brain oxygen (BtO2). Poor clinical grade (Hunt & Hess IV or V) SAH patients who underwent continuous ICP and BtO2 monitoring during IAP infusion for symptomatic cerebral vasospasm were evaluated as part of a prospective observational study. Data are available for five patients (median age 58) who received IAP for cerebral vasospasm 4 to 7 days after SAH. In each patient, angiographic vasospasm was improved on postinfusion angiogram. Mean ICP before IAP was 23.04 +/- 1.18 mmHg; it increased immediately after IAP infusion and remained elevated (29.89 +/- 1.18 mmHg; p < 0.05) during IAP and for approximately 10 minutes after IAP ended. Baseline mean arterial pressure (MAP) was 110.55 +/- 1.36 mmHg. During IAP treatment MAP remained stable (110.90 +/- 2.00 mmHg; p = 0.31). Mean BtO2 before IAP was 32.99 +/- 1.45 mmHg. There was a significant BtO2 decrease in all patients during IAP to a mean of 22.96 +/- 2.9 mmHg (p < 0.05). BtO2 returned to baseline within 10 minutes after IAP ended. There was a modest relationship between the ICP increase and BtO2 decrease (R2 = 0.526)." }, { "role": "assistant", "content": "IAP infusion to treat cerebral vasospasm following SAH can increase ICP and reduce BtO2. The IAP-induced reduction in BtO2 may help explain why IAP, although it reverses arterial narrowing, does not improve patient outcome. 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": "About management of monoamniotic pregnancy , which of the following is TRUE?" }, { "role": "assistant", "content": "The correct answer is Timing of elective delivery in twin pregnancy Uncomplicated dichorionic: 38 weeks Uncomplicated monochorionic diamniotic: between 34 to 37 weeks Monoamniotic: 32-34 weeks, To be done by LSCS only due to high risk of conjoint twins, cord entanglement No role of prophylactic tocolytics, progesterones or prophylactic cervical encirclage in twins" } ]

[ { "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": "Carnitine shuttle is involved in ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Fatty acid oxidationVery sho chain, sho chain, medium chain and long chain fatty acids get oxidized in mitochondria,Very sho chain, sho chain and medium chain fatty acids can cross inner mitochondrial membrane by passive diffusion,Long chain fatty acids cannot cross the inner mitochondrial membrane. Hence they need a carrier. The carrier is carnitine.Carnitine is p hydroxy y N trimethylaminobutyric acid. It is synthesized from lysine." } ]

[ { "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 30-year-old woman, gravida 1, para 0, at 40 weeks' gestation is admitted to the hospital in active labor. Pregnancy was complicated by iron deficiency anemia treated with iron supplements. At the beginning of the first stage of labor, there are coordinated, regular, rhythmic contractions of high intensity that occur approximately every 10 minutes. Four hours later, the cervix is 100% effaced and 10 cm dilated; the vertex is at -1 station. Over the next two hours, there is minimal change in in fetal descent; vertex is still at -1 station. Fetal birth weight is estimated at the 75th percentile. The fetal heart rate is 145/min and is reactive with no decelerations. Contractions occurs approximately every 2 minutes with adequate pressure. Epidural anesthesia was not given, as the patient is coping well with pain. Which of the following is the most appropriate next step in management?" }, { "role": "assistant", "content": "Observation for another hour" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Acute Disease, Aged, Aged, 80 and over, Brain Ischemia, Cerebral Revascularization, Collateral Circulation, Endovascular Procedures, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Radiography, Regional Blood Flow, Stroke, Thrombolytic Therapy." }, { "role": "user", "content": "Does collateral flow predict response to endovascular therapy for acute ischemic stroke? Context: Collaterals sustain the penumbra before recanalization and offset infarct growth, yet the influence of baseline collateral flow on recanalization after endovascular therapy remains relatively unexplored. We analyzed consecutive patients who received endovascular therapy for acute cerebral ischemia from 2 distinct study populations. We assessed the relationship between pretreatment collateral grade and vascular recanalization (Thrombolysis In Myocardial Ischemia [TIMI] scale). In addition, we assessed infarct growth on serial MRI. A total of 222 patients was included, 138 from the United States and 84 from South Korea. Complete revascularization occurred in 14.1% (11 of 78) patients with poor pretreatment collateral grades, whereas it was observed in 25.2% (26 of 103) patients with good collaterals and 41.5% (17 of 41) patients with excellent collaterals (P<0.001). This relationship was consistently observed in both study populations, although the mode of endovascular therapy was different between them. After adjustment for other factors, including mode of endovascular therapy, prior use of intravenous tissue plasminogen activator, and site of occlusion, pretreatment collateral grade was independently associated with recanalization. When revascularization was achieved, greater infarct growth occurred in patients with poor collaterals than in those with good collaterals (P=0.012)." }, { "role": "assistant", "content": "Our data indicate that angiographic collateral grade determines the recanalization rate after endovascular revascularization therapy. When therapeutic revascularization was achieved, beneficial effects were not observed in patients with poor collaterals. Angiographic collateral grade may therefore help guide treatment decision-making in acute cerebral ischemia. 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: Alleles, Beverages, Daucus carota, Diet, Feeding Behavior, Gene Expression, Glucosinolates, Heterozygote, Humans, Polymerase Chain Reaction, Propylthiouracil, RNA, Messenger, Receptors, G-Protein-Coupled, Taste, Taste Buds, Taste Perception." }, { "role": "user", "content": "Does human bitter perception correlate with bitter receptor messenger RNA expression in taste cells? Context: Alleles of the receptor gene TAS2R38 are responsible in part for the variation in bitter taste perception of 6-n-propylthiouracil (PROP) and structurally similar compounds (eg, glucosinolates in cruciferous vegetables). At low concentrations, people with the PAV (\"taster\" amino acid sequence) form of TAS2R38 perceive these bitter compounds, whereas most with the AVI (\"nontaster\" amino acid sequence) form do not; heterozygotes (PAV/AVI) show the widest range of bitter perception. The objectives were to examine individual differences in expression of PAV-TAS2R38 messenger RNA (mRNA) among heterozygotes, to test the hypotheses that the abundance of allele-specific gene expression accounts for the variation in human bitter taste perception, and to relate to dietary intake of bitter-tasting beverages and foods. Heterozygous individuals (n = 22) provided psychophysical evaluation of the bitterness of PROP, glucosinolate-containing broccoli juice, non-glucosinolate-containing carrot juice, and several bitter non-TAS2R38 ligands as well as dietary recalls. Fungiform taste papillae were examined for allele-specific TAS2R38 expression by using quantitative polymerase chain reaction. PAV-TAS2R38 mRNA expression was measured in 18 of 22 heterozygous subjects. Relative expression varied widely and positively correlated with ratings of bitterness intensity of PROP (P = 0.007) and broccoli juice (P = 0.004) but not of the control solutions carrot juice (P = 0.26), NaCl (P = 0.68), caffeine (P = 0.24), or urea (P = 0.47). Expression amounts were related to self-reported recent and habitual caffeine intake (P = 0.060, P = 0.005); vegetable intake was too low to analyze." }, { "role": "assistant", "content": "We provide evidence that PAV-TAS2R38 expression amount correlates with individual differences in bitter sensory perception and diet. The nature of this correlation calls for additional research on the molecular mechanisms associated with some individual differences in taste perception and food intake. The trial was registered at clinicaltrials.gov as NCT01399944. 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": "Tardive dyskinesia is least commonly associated with which of the following drugs?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., Clozapine * Clozapine is an atypical antipsychotic while others are typical traditional antipsychotic drugs; thus tardive dyskinesia is least commonly associated with clozapine, amongst the options given." } ]

[ { "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, Contrast Media, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Image Enhancement, Kidney, Male, Microvessels, Rats, Wistar, Ultrasonography." }, { "role": "user", "content": "Is contrast-enhanced ultrasonography a valid technique for the assessment of renal microvascular perfusion dysfunction in diabetic Goto-Kakizaki rats? Context: To evaluate the reliability of contrast-enhanced ultrasonography (CEUS) for the detection of renal microvascular blood perfusion in a type 2 diabetic Goto-Kakizaki (GK) rat model. Male GK and Wistar rats at the age of 4, 12 and 20 weeks (n=10, respectively) were used for the study. Real-time and haemodynamic imaging of the renal cortex was performed using CEUS with SonoVue. Outage time-intensity curves (TICs) were applied for the analysis of basic intensity, slope rates of the ascending (S1) and descending curves (S2), time to peak (TTP), half time of peak descending (HDT), peak intensity (PI), and total area under the curve (AUC). Immunohistochemical staining for endothelial cells (ECs) was performed using the CD34 monoclonal antibody for the quantification of microvessel density and distribution. Images of the renal cortex microvascular beds after injection of SonoVue in the rats were rapidly and clearly displayed, and it is easy to differentiate the enhanced and faded images of renal perfusion. The TICs of the GK rats were much wider than the controls; however, no significant changes in PI were found in all aged rats. Ultrasonographic quantitative analysis revealed a decrease in S1 and S2, and an increase in TTP, HDT and AUC in the 12- and 20-week-old GK rats compared with the controls (P<0.05). Moreover, the 20-week-old GK rats had much lower glomerular density and smaller distribution area of CD34-positive ECs, which was in parallel with more severe proteinuria, GBM thickening, glomerulosclerosis and interstitial vascular damages (P<0.05). Interestingly, negative correlations between AUC and glomerular microvessel density or distribution were detected, respectively (P<0.05)." }, { "role": "assistant", "content": "Contrast-enhanced ultrasonography is a valid technique for the real-time and dynamic assessment of renal cortex microvascular perfusion and haemodynamic characterization in GK rats. 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": "Emile Durkheim is linked with work on which of the following conditions in psychiatry?" }, { "role": "assistant", "content": "The correct answer is Emile Durkheim studied extensively the social factors associated with suicide." } ]

[ { "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: Child Welfare, Child, Preschool, Democratic Republic of the Congo, Female, Humans, Infant, Male, Malnutrition, Medical Records, Monte Carlo Method." }, { "role": "user", "content": "Malnutrition among children under the age of five in the Democratic Republic of Congo (DRC): does geographic location matter? Context: Although there are inequalities in child health and survival in the Democratic Republic of Congo (DRC), the influence of distal determinants such as geographic location on children's nutritional status is still unclear. We investigate the impact of geographic location on child nutritional status by mapping the residual net effect of malnutrition while accounting for important risk factors. We examine spatial variation in under-five malnutrition with flexible geo-additive semi-parametric mixed model while simultaneously controlling for spatial dependence and possibly nonlinear effects of covariates within a simultaneous, coherent regression framework based on Markov Chain Monte Carlo techniques. Individual data records were constructed for children. Each record represents a child and consists of nutritional status information and a list of covariates. For the 8,992 children born within the last five years before the survey, 3,663 children have information on anthropometric measures.Our novel empirical approach is able to flexibly determine to what extent the substantial spatial pattern of malnutrition is driven by detectable factors such as socioeconomic factors and can be attributable to unmeasured factors such as conflicts, political, environmental and cultural factors. Although childhood malnutrition was more pronounced in all provinces of the DRC, after accounting for the location's effects, geographic differences were significant: malnutrition was significantly higher in rural areas compared to urban centres and this difference persisted after multiple adjustments. The findings suggest that models of nutritional intervention must be carefully specified with regard to residential location." }, { "role": "assistant", "content": "Childhood malnutrition is spatially structured and rates remain very high in the provinces that rely on the mining industry and comparable to the level seen in Eastern provinces under conflicts. Even in provinces such as Bas-Congo that produce foods, childhood malnutrition is higher probably because of the economic decision to sell more than the population consumes. Improving maternal and child nutritional status is a prerequisite for achieving MDG 4, to reduce child mortality rate in the DRC." } ]

[ { "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": "Microorganism adhere to host cell with the help of -" }, { "role": "assistant", "content": "The correct answer is Some gram negative bacillli carry very fine , hair like surface appendages called fimbriae or pili. They are shoer and thinner than flagella and project from the cell surfaces as straight filaments . Fimbriae function as organ of adhesion helping the cells to adhere firmly to paicles of various kinds . This propey may serve to anchor the bacteria in nutritionally ourable microenvironments. Fimbriated bacteria form surface pellicles in liquid media Ref: Ananthanarayan & panikers textbook of microbiology 9th edition page no 20" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Anti-Bacterial Agents, Bacterial Proteins, Drug Resistance, Bacterial, Gene Expression Regulation, Bacterial, Helminth Proteins, Microbial Sensitivity Tests, Penicillin-Binding Proteins, Peptides, Sigma Factor, Staphylococcus aureus, Up-Regulation." }, { "role": "user", "content": "Is in vitro resistance to the CSalphabeta-type antimicrobial peptide ASABF-alpha conferred by overexpression of sigma factor sigB in Staphylococcus aureus? Context: ASABF (Ascaris suum antibacterial factor) is a CSalphabeta-type antimicrobial peptide isolated from nematodes. ASABF-alpha, a member of ASABF, is particularly effective against the gram-positive pathogen Staphylococcus aureus. In this study, we investigated the role of sigB expression on ASABF-resistance in S. aureus. Based on preliminary characterization of the ASABF-resistant strain, Mu50, we speculated that the alternative sigma factor sigB may regulate resistance against antimicrobial peptides. To test this hypothesis, the ASABF susceptibility was compared between NKSB (a sigB-knockout derivative of N315) and its sigB-overexpressing derivative. In addition, similar experiments were carried out for N315ex, a deletion mutant of N315 for SCCmec (Staphylococcus cassette chromosome mec) which contains essential genes for beta-lactam resistance. The sigB-overexpressing NKSB acquired an increased resistance to ASABF-alpha compared with the parent strain. The sigB-induced ASABF-alpha resistance was also observed in N315ex." }, { "role": "assistant", "content": "The overexpression of sigB confers resistance to the antimicrobial peptide, ASABF-alpha. SCCmec is not essential for this resistance. 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: Alcoholism, Apolipoproteins E, Cholelithiasis, Disease Susceptibility, Ethanol, Female, Follow-Up Studies, Humans, Lipids, Male, Middle Aged, Multivariate Analysis, Pancreatitis, Phenotype, Triglycerides." }, { "role": "user", "content": "Does lipid intolerance account for susceptibility to alcoholic and gallstone pancreatitis? Context: Hypertriglyceridemia is an established cause of pancreatitis and has been suggested as a predisposing factor in alcohol and gallstone-induced pancreatitis. The aims of this study were to determine fasting and postprandial triglyceride levels of alcoholics with pancreatitis, alcoholics without pancreatitis, patients with previous gallstone pancreatitis, patients with choledocholithiasis, and healthy controls. Oral lipid tolerance studies were performed in the above groups. No relationship was found between alcoholic pancreatitis and hypertriglyceridemia, regardless of whether subjects were studied in the fasting state, after ingestion of fat, or after ingestion of fat with ethanol. Plasma triglyceride levels of alcoholics with pancreatitis remained similar to those of alcoholics without pancreatitis, but levels in both groups varied in relation to recent alcohol intake. Plasma triglyceride levels from both groups of alcoholics were greater than those of nonalcoholic healthy subjects. In addition, the previously reported association between postprandial hypertriglyceridemia and gallstone pancreatitis was not observed." }, { "role": "assistant", "content": "Plasma triglyceride levels do not account for individual susceptibility to either alcoholic or gallstone pancreatitis. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is not a vasodilator?" }, { "role": "assistant", "content": "The correct answer is Thromboxane A2, Leukotrienes C4, D4, E4 are vasoconstrictors. PGI2, PGE1, PGE2, PGD2 and lipoxins are vasodilators.Ref: Robbins Basic Pathology, 7th Edition, Page 48." } ]

[ { "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, Antihypertensive Agents, Contrast Media, Disease Models, Animal, Endothelin Receptor Antagonists, Hypoxia, Iohexol, Kidney Diseases, Kidney Medulla, Male, Oligopeptides, Peptides, Cyclic, Piperidines, Rats, Rats, Sprague-Dawley, Receptors, Endothelin, Renal Circulation." }, { "role": "user", "content": "Does et-A receptor antagonist BQ123 prevent radiocontrast media-induced renal medullary hypoxia? Context: Renal vasoconstriction with resultant tissue hypoxia, especially in the renal medulla, has been suggested to play a role in contrast media (CM)-induced nephropathy. Endothelin (ET) is released into the blood stream following CM injection and has been proposed as a potential mediator through its vasoconstrictive properties. To investigate the possible protective influence of ET-receptor antagonists against CM-induced reduction in renal function, we studied the effects of injection of iopromide with and without pretreatment with BQ123 (ET-A antagonist) or BQ788 (ET-B antagonist) on renal superficial cortical flow (CBF), outer medullary blood flow (OMBF) and outer medullary oxygen tension (pO2) in normal rats. Administration of CM (1600 mg I/kg b.w.) did not affect CBF in any of the groups. However, a transient decrease in OMBF occurred, which was unaffected by both BQ123 and BQ788. Also a transient decrease in outer medullary pO2 was induced by CM administration. The pO2 reduction was significantly smaller after pretreatment with BQ123, than after injection of CM alone or together with BQ788, and pO2 returned more rapidly to the control level. Neither receptor antagonist had an effect on CM-mediated increases in electrolyte excretion." }, { "role": "assistant", "content": "In the normal rat, activation of ET-A receptors is partly involved in the depression of outer medullary pO2 caused by injection of iopromide. However, the decrease in OMBF after iopromide injection is not mediated by ET receptors. The beneficial effects of the ET-A receptor antagonist on CM-induced changes in outer medullary pO2 seem therefore not primarily mediated on the hemodynamic level but may rather involve tubular transport mechanisms. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Angiotensin II, Animals, Anti-Inflammatory Agents, Non-Steroidal, Blood Pressure, Body Weight, Cell Division, Creatinine, Disease Models, Animal, Fibronectins, Hypertension, Renal, Kidney, Leukocytes, Mononuclear, Lipid Peroxidation, Male, Malondialdehyde, Mycophenolic Acid, Osteopontin, Rats, Rats, Sprague-Dawley, Receptor, Angiotensin, Type 1, Receptor, Angiotensin, Type 2, Receptors, Angiotensin, Sialoglycoproteins, Superoxides, Vasoconstrictor Agents." }, { "role": "user", "content": "Does mycophenolate mofetil prevent salt-sensitive hypertension resulting from angiotensin II exposure? Context: Interstitial mononuclear cell infiltration is a feature of experimental models of salt-sensitive hypertension (SSHTN). Since several products of these cells are capable of modifying local vascular reactivity and sodium reabsorption, we investigated whether mycophenolate mofetil (MMF), a drug known to inhibit infiltration and proliferation of immune cells, would modify the SSHTN induced by angiotensin II (Ang II) infusion. Sprague-Dawley rats received Ang II for two weeks using subcutaneous minipumps. A high-sodium (4% NaCl) diet was started on the third week and was maintained until the eighth week. MMF (30 mg/kg, N = 15), an immunosuppressive drug, or vehicle (N = 15) was given daily by gastric gavage during the initial three weeks. Sham-operated rats (N = 9) were used as controls. Body weight, blood pressure (tail-cuff plethysmography), and serum creatinine were determined weekly. Urinary malondialdehyde (MDA) excretion, renal histology, and immunohistology, including the presence of Ang II and superoxide-producing cells, were analyzed at the end of Ang II infusion and at eight weeks. MMF treatment did not modify hypertension induced during exogenous Ang II infusion, but prevented the subsequent SSHTN. Tubulointerstitial injury resulting from Ang II infusion was significantly reduced by MMF treatment, as were proliferative activity, T-cell infiltration and activation (interleukin-2 receptor expression), superoxide-producing cells, and urinary MDA excretion. Ang II-producing cells were present in the renal tubulointerstitium of rats with SSHTN (60 +/- 30 Ang II-positive cells/mm(2) at 8 weeks) and were reduced by two thirds in the MMF-treated group. Forty percent of lymphocytes infiltrating the tubulointerstitium stained positive for Ang II. The expression of Ang II receptors in the kidney was unmodified." }, { "role": "assistant", "content": "SSHTN resulting from Ang II infusion is associated with infiltration and activation of immune cells that produce Ang II. MMF treatment reduces these features and prevents the development of SSHTN. 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, Colon, Diarrhea, Female, Gastrointestinal Transit, Humans, Intestinal Absorption, Intestinal Mucosa, Male, Osmosis, Polyethylene Glycols, Time Factors." }, { "role": "user", "content": "Does the distal colon provide reserve storage capacity during colonic fluid overload? Context: In addition to its absorptive function the capacity of the colon to retain fluid might be relevant in compensating for increased fluid loads and prevention of diarrhoea. The distal colon is considered to be mainly a conduit without extensive storage function. To evaluate colonic volume capacity in a model of pure osmotic diarrhoea. A non-absorbable, iso-osmotic solution (OS) containing polyethylene glycol (500 ml) was infused into the caecum of nine healthy volunteers; the control group (n = 5) received an equal amount of an easily absorbable electrolyte solution (ES). Fluids were radiolabelled with technetium-99m and gamma camera images were obtained for 48 hours. Counts in the proximal and distal colon were measured and regional and overall colonic transit and stool output were quantified. After OS, in contrast to ES, faecal output was increased significantly (p < 0.05), but colonic transit after OS was not different from transit after ES (p > 0.05). This indicates storage of OS in the colon: after OS infusion, counts in the proximal colon decreased linearly while the distal colon stored approximately 30% of radioactivity for the whole 48 hour study period. After OS, stool output correlated with distal (p < 0.01), but not with proximal (p > 0.05), colonic transit. In contrast, after ES, stool output was determined by proximal colonic transit (p < 0.05) but not by transit through the distal colon (p > 0.05)." }, { "role": "assistant", "content": "The distal colon retains non-absorbable fluid volumes extensively. In our model transit through the distal colon--but not the proximal colon--determined the time at which diarrhoea occurred. 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: Plant Shoots, Seasons, Temperature, Vitis." }, { "role": "user", "content": "Do warm spring temperatures induce persistent season-long changes in shoot development in grapevines? Context: The influence of temperature on the timing of budbreak in woody perennials is well known, but its effect on subsequent shoot growth and architecture has received little attention because it is understood that growth is determined by current temperature. Seasonal shoot development of grapevines (Vitis vinifera) was evaluated following differences in temperature near budbreak while minimizing the effects of other microclimatic variables. Dormant buds and emerging shoots of field-grown grapevines were heated above or cooled below the temperature of ambient buds from before budbreak until individual flowers were visible on inflorescences, at which stage the shoots had four to eight unfolded leaves. Multiple treatments were imposed randomly on individual plants and replicated across plants. Shoot growth and development were monitored during two growing seasons. Higher bud temperatures advanced the date of budbreak and accelerated shoot growth and leaf area development. Differences were due to higher rates of shoot elongation, leaf appearance, leaf-area expansion and axillary-bud outgrowth. Although shoots arising from heated buds grew most vigorously, apical dominance in these shoots was reduced, as their axillary buds broke earlier and gave rise to more vigorous lateral shoots. In contrast, axillary-bud outgrowth was minimal on the slow-growing shoots emerging from buds cooled below ambient. Variation in shoot development persisted or increased during the growing season, well after temperature treatments were terminated and despite an imposed soil water deficit." }, { "role": "assistant", "content": "The data indicate that bud-level differences in budbreak temperature may lead to marked differences in shoot growth, shoot architecture and leaf-area development that are maintained or amplified during the growing season. Although growth rates commonly are understood to reflect current temperatures, these results demonstrate a persistent effect of early-season temperatures, which should be considered in future growth models. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Ammonia, Bicarbonates, Creatinine, Glomerular Filtration Rate, Humans, Kidney, Middle Aged, Prospective Studies, Renal Dialysis, Renal Insufficiency, Chronic, Severity of Illness Index, Urea, Uremia, Young Adult." }, { "role": "user", "content": "Is blood ammonia influenced by kidney function? Context: We have investigated whether blood ammonia is increased with worsening CKD. Fifty eight subjects with a range of CKD were recruited for analysis of plasma ammonia and other electrolytes. The concentrations of plasma ammonia were all within the normal reference range and there was no correlation between ammonia and CKD without any effect of dialysis." }, { "role": "assistant", "content": "Blood ammonia is not elevated in or related to the severity of chronic kidney disease." } ]

[ { "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": "Three days after delivery of a male newborn, a 36-year-old gravida 1, para 1 woman has fever and pain in her left leg. Pregnancy was complicated by premature rupture of membranes; the child was delivered at 35 weeks' gestation by lower segment transverse cesarean section because of a nonreassuring fetal heart rate. The patient has smoked half a pack of cigarettes daily for 5 years and continued to smoke during her pregnancy. Her temperature is 38.9°C (102°F), pulse is 110/min, and blood pressure is 110/80 mm Hg. Examination shows an edematous, erythematous, and warm left leg. Passive dorsiflexion of the left foot elicits pain in the calf. The peripheral pulses are palpated bilaterally. The uterus is nontender and palpated at the umbilicus. Ultrasonography of the left leg shows an incompressible left popliteal vein. Which of the following is the most appropriate initial step in management?" }, { "role": "assistant", "content": "Low molecular weight heparin" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adenosine, Animals, Blotting, Northern, Blotting, Western, Cattle, Cell Hypoxia, Cells, Cultured, Cyclic AMP, Cyclic AMP-Dependent Protein Kinases, Dose-Response Relationship, Drug, Endothelial Growth Factors, Endothelium, Vascular, Enzyme Activation, Hypoxia, Lymphokines, Purinergic P1 Receptor Antagonists, RNA, Messenger, Receptors, Purinergic P1, Retinal Vessels, Vascular Endothelial Growth Factor A, Vascular Endothelial Growth Factors." }, { "role": "user", "content": "Does adenosine mediate hypoxic induction of vascular endothelial growth factor in retinal pericytes and endothelial cells? Context: To determine the mechanistic role for adenosine and adenosine receptors in the hypoxic induction of vascular endothelial growth factor (VEGF) in retinal microvascular cells. Bovine retinal capillary endothelial cells and microvascular pericytes were studied under normoxic (95% air, 5% CO2) or hypoxic conditions (0% to 2% O2, 5% CO2, 93% to 95% N2) using a variety of well-characterized adenosine and adenosine receptor agonists and antagonists. Vascular endothelial growth factor mRNA expression was evaluated by Northern blot analysis, VEGF protein levels were determined by Western blot analysis, and cyclic adenosine monophosphate (cAMP) accumulation was measured by radioimmunoassay. Inhibitors of oxidative respiration increased VEGF mRNA 5 +/- 3 times (P < 0.001) after 3 hours. Adenosine A1 receptor (A1R) agonist N6-cyclopentyl-adenosine did not increase VEGF mRNA at A1R stimulatory concentrations; however, adenosine A2 receptor (A2R) agonists DPMA, NECA, and CGS21680 increased VEGF mRNA in a dose-dependent manner with elevations of 2 +/- 0.3 (P < 0.001), 2.3 +/- 0.5 (P = 0.016), and 2 +/- 0.2 (P = 0.002) times, respectively. A2R antagonist CSC and adenosine degradation by adenosine deaminase reduced hypoxic stimulation of VEGF mRNA 68% +/- 18% (P = 0.038) and 37% +/- 6% (P = 0.025), respectively, in a dose-dependent manner. A1R antagonists DPCPX and 8-PT had no significant effect. Hypoxia and NECA increased VEGF protein secretion 4.7 times, whereas CSC inhibited hypoxia-induced VEGF protein secretion by 96%. NECA and CGS21680 increased cAMP production within 10 minutes, and cAMP stimulation increased VEGF mRNA 4.8 +/- 2.6 times (P = 0.034). CSC suppressed the hypoxic elevation of cAMP (P < 0.05). Inhibition of protein kinase A using H-89 reduced hypoxia-induced VEGF expression 61% +/- 6.3% (P = 0.043) in a dose-dependent manner." }, { "role": "assistant", "content": "These data suggest that the hypoxia-induced accumulation of adenosine stimulates VEGF gene expression through stimulation of adenosine A2a receptor and subsequent activation of the cAMP-dependent protein kinase A pathway in retinal vascular cells. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 16-year-old boy presented with asymptomatic, multiple, erythematous, annular lesions with a collarette of scales at the periphery of the lesions present on the trunk. The most likely diagnosis is:" }, { "role": "assistant", "content": "The correct answer is Lesions predominantly localized to the trunk and their erythematous nature with other features of pityriasis lead to diagnosis of pityriasis rosea. Ref: Anthony Du Vivier, Phillip H. McKee, Chapter 6, \"Pityriasis Rosea and Pityriasis Rubra Pilaris\", In the book, \"Atlas of Clinical Dermatology\", Elsivier Publication, 2002, 3rd Edition, Spain, Page 87" } ]

[ { "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": "Normal pregnancy can be continued in" }, { "role": "assistant", "content": "The correct answer is Hea disease in which Termination of pregnancy is advised Pulmonary hypeension- primary or secondary Marfans syndrome with aoa involvement Eisenmenger syndrome Any hea disease which belongs to NYHA Class 3 or 4 Ejection fraction < 40% Severe aoic stenosis or Severe mitral stenosis Previous peripaum cardiomyopathy with any residual impairment of LV function ABSOLUTE INDICATIONS FOR TERMINATION OF PREGNANCY Pulmonary HTN Eisenmenger's Syndrome Pulmonary veno-occlusive disease. Reference: William's Obstetrics; 24th edition; Chapter 49 Reference: DC.Duttas textbook of OBG,9th edition,page 259" } ]

[ { "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, Aged, 80 and over, Body Mass Index, Female, Humans, Male, Middle Aged, Obesity, Respiration, Artificial, Respiratory Insufficiency, Retrospective Studies, Risk Factors, Survival Rate, Tracheotomy, Young Adult." }, { "role": "user", "content": "Is obesity truly a risk factor for mortality after tracheotomy? Context: We sought to determine the short-term and long-term overall mortality rates in obese and non-obese patients after tracheotomy and to evaluate which factors, including the Charlson Comorbidity Index (CCI), predict mortality rates among obese patients. We performed a retrospective chart review of patients who underwent open tracheotomy in the operating room at a single hospital from 2005 to 2010. Of 200 patients reviewed, 146 were non-obese and 54 were obese. The rate of mortality was higher at 30 days (p = 0.02) and at 1 year (p = 0.04) in obese patients (35.1% and 59.2%, respectively) than in non-obese patients (19.2% and 42.5%, respectively). The need for tracheotomy due to ventilator-dependent respiratory failure (VDRF) was much higher (p<0.001) in obese patients (83.3%) than in non-obese patients (56.8%), and the rate of mortality was significantly higher (p<0.001) in those who required tracheotomy for VDRF (32.8% at 30 days and 57% at 1 year) than in those who required tracheotomy for all other indications (4.2% at 30 days and 25% at 1 year). The mortality risk increased with higher CCI scores at both 30 days (p = 0.08) and 1 year (p = 0.009)." }, { "role": "assistant", "content": "The overall mortality rate is higher in obese patients after tracheotomy than in non-obese control subjects in the short and long terms. This increased rate of mortality is due to the heightened incidence of tracheotomy for VDRF among obese patients. The mortality rates after tracheotomy correlate well with the CCI." } ]

[ { "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 FDA approved Anti-CTLA-4 immunotherapy agent for the treatment of metastatic melanoma?" }, { "role": "assistant", "content": "The correct answer is TREATMENT OPTIONS FOR METASTATIC MELANOMA - Surgery: Metastasectomy for small number of lesions Immunotherapy: - Interleukin-2 - Immune checkpoint blockade FDA approved - Anti-CTLA-4: Ipilimumab Experimental - Anti-PD-1: Nivolumab, Lambrolizumab (Monoclonal antibody to programmed cell death-1 protein (PD-1); blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2 Molecular targeted therapy: - BRAF inhibitor: Vemurafenib, Dabrafenib - MEK inhibitor: Trametinib" } ]

[ { "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 33-year-old man presents to the emergency department with a fever and fatigue. He states that he has not felt well since he returned from a hiking trip in Alabama. He is generally healthy and has no other medical conditions. His temperature is 101°F (38.3°C), blood pressure is 127/85 mmHg, pulse is 108/min, respirations are 14/min, and oxygen saturation is 99% on room air. Physical exam including a full dermatologic inspection is unremarkable. Laboratory studies are ordered as seen below.\n\nHemoglobin: 13 g/dL\nHematocrit: 39%\nLeukocyte count: 2,200/mm^3 with normal differential\nPlatelet count: 77,000/mm^3\n\nSerum:\nNa+: 139 mEq/L\nCl-: 100 mEq/L\nK+: 4.3 mEq/L\nHCO3-: 24 mEq/L\nBUN: 19 mg/dL\nGlucose: 98 mg/dL\nCreatinine: 1.3 mg/dL\nCa2+: 10.2 mg/dL\nAST: 92 U/L\nALT: 100 U/L\n\nWhich of the following is the most likely diagnosis?" }, { "role": "assistant", "content": "Ehrlichiosis" } ]

[ { "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 murmur of hypertropic obstructive cardio myopathy is decreased in which of the following-" }, { "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, RESULTS. Meshes: Anacardic Acids, Analysis of Variance, Animals, COS Cells, Calcium, Cercopithecus aethiops, Down-Regulation, HEK293 Cells, Humans, Isoenzymes, Lysine, Muscle, Smooth, Vascular, Mutation, Myocytes, Smooth Muscle, NADPH Oxidases, Neutrophils, Oxidative Stress, Phosphorylation, Protein Processing, Post-Translational, Protein Stability, RNA Interference, Reactive Oxygen Species, SUMO-1 Protein, Sumoylation, Time Factors, Transfection, Ubiquitin-Conjugating Enzymes." }, { "role": "user", "content": "Does sUMO1 negatively regulate reactive oxygen species production from NADPH oxidases? Context: Increased protein SUMOylation (small ubiquitin-related modifier [SUMO]) provides protection from cellular stress, including oxidative stress, but the mechanisms involved are incompletely understood. The NADPH oxidases (Nox) are a primary source of reactive oxygen species (ROS) and oxidative stress, and thus our goal was to determine whether SUMO regulates NADPH oxidase activity. Increased expression of SUMO1 potently inhibited the activity of Nox1 to Nox5. In contrast, inhibition of endogenous SUMOylation with small interfering RNA to SUMO1 or ubiquitin conjugating enzyme 9 or with the inhibitor anacardic acid increased ROS production from human embryonic kidney-Nox5 cells, human vascular smooth muscle cells, and neutrophils. The suppression of ROS production was unique to SUMO1, and it required a C-terminal diglycine and the SUMO-specific conjugating enzyme ubiquitin conjugating enzyme 9. SUMO1 did not modify intracellular calcium or Nox5 phosphorylation but reduced ROS output in an isolated enzyme assay, suggesting direct effects of SUMOylation on enzyme activity. However, we could not detect the presence of SUMO1 conjugation on Nox5 using a variety of approaches. Moreover, the mutation of more than 17 predicted and conserved lysine residues on Nox5 did not alter the inhibitory actions of SUMO1." }, { "role": "assistant", "content": "Together, these results suggest that SUMO is an important regulatory mechanism that indirectly represses the production of ROS to ameliorate cellular stress. 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, RESULTS. Meshes: Adolescent, Age Factors, Athletic Performance, Body Height, Body Weight, Child, Cross-Sectional Studies, Football, Geographic Information Systems, Humans, Male, Physical Fitness, Puberty, Running, Self Report, Victoria." }, { "role": "user", "content": "Does biological maturity influence running performance in junior Australian football? Context: The purpose of this study was to investigate the influence of biological maturity on measures of running fitness and running performance in both training and competition in junior Australian football. Cross sectional observational. Fifty-two male junior players from five age groups (U11-U19) participated. Biological maturity was self-assessed based on Tanner's description of five pubertal stages (P1-P5) as well as objectively estimated from anthropometric measures and expressed as years to and from peak height velocity (Y-PHV). Running speed and aerobic fitness were measured using a 20m sprint and 20m multi-stage shuttle run respectively. Running movements during training and competition were analysed (n=197) using global positioning system technology, including total distance, peak speed, high-intensity running (HIR>14.4km/h) distance and number of sprints (>23km/h). Age groups included participants from a range of pubertal stages (U11: P1-2; U13: P2-4; U15: P2-5; U17: P4-5; U19: P5). Y-PHV was significantly correlated with 20m shuttle run (r=0.647), 20m sprint time (r=-0.773) and all distance and high intensity running variables (r=0.417-0.831). Incremental improvements across pubertal stages for speed, aerobic fitness and most GPS derived running variables were observed. Within age group comparisons between less and more mature players found significant differences for standing and sitting height, peak speed in training, and total distance, HIR and peak speed in matches." }, { "role": "assistant", "content": "Functional running fitness and running performance in both training and competition environments improved with increasing biological maturity. More mature players in an age group, either chronologically, biologically or a combination of both, are at a performance advantage to those less mature. 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: Adnexal Diseases, Adult, Aged, Area Under Curve, CA-125 Antigen, Contrast Media, Female, Humans, Image Enhancement, Image Processing, Computer-Assisted, Middle Aged, Ovarian Neoplasms, Polysaccharides, ROC Curve, Ultrasonography, Doppler." }, { "role": "user", "content": "Does contrast-enhanced sonography help in discrimination of benign from malignant adnexal masses? Context: To investigate the potential efficacy of real-time contrast-enhanced power Doppler sonography in the differentiation of benign and malignant adnexal masses in a pilot study. Before surgical treatment, adnexal masses were prospectively evaluated with power Doppler sonography before and after injection of a contrast agent. Real-time postinjection sequences were computerized with time-intensity analysis software to determine an enhancement curve and contrast parameters. The intraobserver and interobserver reproducibilities of these criteria were assessed on a subsample. These contrast parameters were compared between benign and malignant tumors using logistic regression. Sensitivity and specificity were used to compare contrast parameters with sonographic and Doppler variables. Ninety-nine women were included, for a total of 101 adnexal masses. There were 23 cases of ovarian malignancies and 78 benign adnexal lesions. Our procedure had excellent intraobserver and interobserver reproducibility, with an average intraclass correlation coefficient of 0.92. The time before enhancement and intensity ratio did not reliably differentiate between the benign and malignant masses. Washout times and areas under the curves were significantly greater in ovarian malignancies than in other benign tumors (P < .001), leading to sensitivity estimates between 96% and 100% and specificity estimates between 83 and 98%. Contrast parameters had slightly higher sensitivity and slightly lower specificity when compared with transvaginal sonographic variables of the resistive index and serum cancer antigen 125 levels." }, { "role": "assistant", "content": "Contrast-enhanced power Doppler imaging may easily and precisely discriminate benign from malignant adnexal lesions. Larger studies are needed to determine the appropriate use and benefits of this new 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, RESULTS. Meshes: Animals, Brain-Derived Neurotrophic Factor, Cells, Cultured, Cholesterol, Cytokines, Fluorescent Antibody Technique, Interleukin-1beta, Microglia, Phagocytosis, Rats, Sprague-Dawley, Simvastatin, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Does statin treatment affect cytokine release and phagocytic activity in primary cultured microglia through two separable mechanisms? Context: As the primary immune cells of the central nervous system, microglia contribute to development, homeostasis, and plasticity of the central nervous system, in addition to their well characterized roles in the foreign body and inflammatory responses. Increasingly, inappropriate activation of microglia is being reported as a component of inflammation in neurodegenerative and neuropsychiatric disorders. The statin class of cholesterol-lowering drugs have been observed to have anti-inflammatory and protective effects in both neurodegenerative diseases and ischemic stroke, and are suggested to act by attenuating microglial activity. We sought to investigate the effects of simvastatin treatment on the secretory profile and phagocytic activity of primary cultured rat microglia, and to dissect the mechanism of action of simvastatin on microglial activity. Simvastatin treatment altered the release of cytokines and trophic factors from microglia, including interleukin-1-β, tumour necrosis factor-α, and brain derived neurotrophic factor in a cholesterol-dependent manner. Conversely, simvastatin inhibited phagocytosis in microglia in a cholesterol-independent manner." }, { "role": "assistant", "content": "The disparity in cholesterol dependence of cytokine release and phagocytosis suggests the two effects occur through distinct molecular mechanisms. These two pathways may provide an opportunity for further refinement of pharmacotherapies for neuroinflammatory, neurodegenerative, and neuropsychiatric disorders. 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, Bacteriuria, Cystitis, Disease Susceptibility, Female, Hydrogen-Ion Concentration, Magnesium Compounds, Mice, Mice, Mutant Strains, Phosphates, Pyelonephritis, Staphylococcus, Struvite, Urinary Bladder, Urinary Diversion, Urinary Tract, Urinary Tract Infections, Urolithiasis." }, { "role": "user", "content": "Does urine Stasis predispose to Urinary Tract Infection by an Opportunistic Uropathogen in the Megabladder ( Mgb ) Mouse? Context: Urinary stasis is a risk factor for recurrent urinary tract infection (UTI). Homozygous mutant Megabladder (Mgb-/-) mice exhibit incomplete bladder emptying as a consequence of congenital detrusor aplasia. We hypothesize that this predisposes Mgb-/- mice to spontaneous and experimental UTI. Mgb-/-, Mgb+/-, and wild-type female mice underwent serial ultrasound and urine cultures at 4, 6, and 8 weeks to detect spontaneous UTI. Urine bacterial isolates were analyzed by Gram stain and speciated. Bladder stones were analyzed by x-ray diffractometry. Bladders and kidneys were subject to histologic analysis. The pathogenicity of coagulase-negative Staphylococcus (CONS) isolated from Mgb-/- urine was tested by transurethral administration to culture-negative Mgb-/- or wild-type animals. The contribution of urinary stasis to CONS susceptibility was evaluated by cutaneous vesicostomy in Mgb-/- mice. Mgb-/- mice develop spontaneous bacteriuria (42%) and struvite bladder stones (31%) by 8 weeks, findings absent in Mgb+/- and wild-type controls. CONS was cultured as a solitary isolate from Mgb-/- bladder stones. Bladders and kidneys from mice with struvite stones exhibit mucosal injury, inflammation, and fibrosis. These pathologic features of cystitis and pyelonephritis are replicated by transurethral inoculation of CONS in culture-negative Mgb-/- females, whereas wild-type animals are less susceptible to CONS colonization and organ injury. Cutaneous vesicostomy prior to CONS inoculation significantly reduces the quantity of CONS recovered from Mgb-/- urine, bladders, and kidneys." }, { "role": "assistant", "content": "CONS is an opportunistic uropathogen in the setting of urinary stasis, leading to enhanced UTI incidence and severity in Mgb-/- mice. 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: Activities of Daily Living, Brazil, Cross-Sectional Studies, Health Status, Humans, Independent Living, Jaw, Edentulous, Partially, Mobility Limitation, Poisson Distribution, Surveys and Questionnaires." }, { "role": "user", "content": "Does how functional disability relate to dentition in community-dwelling older adults in Brazil? Context: To assess the association between dentition status and functional disabilities among community-dwelling older individuals. A total of 5012 individuals aged 65-74 were interviewed in 2013 during a nationwide community-based survey. This cross-sectional study used a questionnaire including information on dentition, locomotion impairment, difficulties in basic and instrumental activities of daily life, socio-demographic characteristics, behaviour and general health status. Poisson regression models assessed prevalence ratios (PR) and 95% confidence intervals (95% CI). About 31.3% of older people in Brazil reported having ≥21 preserved teeth, the condition for a functional dentition without prosthetic appliances. This proportion was significantly lower among individuals with locomotion impairment and difficulties in basic and instrumental activities of daily life. After adjusting for relevant covariates, functional dentition remained statistically associated with severe (PR = 0.69, 95% CI = 0.15-0.63) and total (PR = 0.69, 95% CI = 0.26-0.44) locomotion impairments, and difficulties in basic activities of daily life (PR = 0.70, 95% CI = 0.53-0.93)." }, { "role": "assistant", "content": "Having a functional dentition was significantly less prevalent among those affected by functional disabilities, and this association is unlikely to be due to insufficient control for relevant covariates. The association between dentition and functional disability is bidirectional and involves a complex interplay of one upon the other, and of factors that influence both outcomes. 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": "FEV1 / FEVC ratio is decreased in all, except" }, { "role": "assistant", "content": "The correct answer is ParameterObstructive lung diseaseRestrictive lung diseaseTotal lung capacityNormal to increaseDecreaseResidual volumeIncreaseDecreaseVital capacityDecreaseDecreaseFEV1/ FVC (FEV1%)DecreaseNormal to increaseFEF 25-75% (Forced expiratory flow rate)Decrease NormalDiffusion capacityNormal (| in emphysema)DecreasedRefer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2163-2165" } ]

[ { "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 activities cannot be formed by a 7 month old infant-" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Cruise" } ]

[ { "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": "Increased velocity of conduction in a nerve is oured by" }, { "role": "assistant", "content": "The correct answer is In unmyelinated fibers, electrical impulses (action potentials) travel as continuous waves, but, in myelinated fibers, they \"hop\" or propagate by saltatory conduction. ... Myelin decreases capacitance and increases electrical resistance across the axonal membrane (the axolemma) Ref: guyton and hall textbook of medical physiology 12 edition page number:57,58,59" } ]

[ { "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, Antihypertensive Agents, Breast Feeding, Drug Administration Schedule, Female, Humans, Hypertension, Infant, Newborn, Lactation, Maternal Exposure, Milk, Human, Pregnancy, Pregnancy Complications, Cardiovascular, Prescription Drugs, United States." }, { "role": "user", "content": "The Difficulties in Antihypertensive Drug Prescription During Lactation: Is the Information Consistent? Context: The lack of consistent official information on the use of medications during lactation is probably one of the main reasons leading to an excess of prudence, based on presumption of risk rather than on evidence. The objective of this study was to compare the level of agreement between different official sources available to doctors and women on the use of medications during lactation. Sources of information included governmental regulatory agencies (RAs) and scientific sources (SS). The package leaflets (PLs) and summaries of product characteristics (SPCs) were retrieved from online databases of the European Union and U.S. RAs. Among the SS, the latest edition of the book Medications and Mothers' Milk by Hale and Rowe and the LactMed database were selected. Information about the use of 11 antihypertensive medications during breastfeeding was analyzed. The PLs and SPCs report a higher risk profile than the one expressed by SS, and they often suggest the interruption of lactation even for compatible medications." }, { "role": "assistant", "content": "Health professionals should be supported by official, accurate, comprehensive, and consistent information about maternally ingested medication and breastfeeding management to facilitate proper decision-making." } ]

[ { "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, Blood Flow Velocity, Coronary Circulation, Fatty Liver, Female, Humans, Liver Cirrhosis, Male, Microcirculation, Middle Aged." }, { "role": "user", "content": "Is coronary flow reserve impaired in patients with nonalcoholic fatty liver disease : association with liver fibrosis? Context: Nonalcoholic fatty liver disease (NAFLD) is associated with an increased risk of cardiovascular disease. Coronary flow reserve (CFR) is widely used to examine the integrity of coronary microvascular circulation. We evaluated the prevalence of impaired CFR in patients with biopsy-proven NAFLD. We also investigated the independent clinical, biochemical, and liver histology predictors of CFR in the setting of NAFLD. Fifty-nine consecutive patients with NAFLD and 77 age- and gender-matched controls were evaluated. CFR recordings were performed by transthoracic Doppler harmonic echocardiography. CFR>or=2.0 was considered normal. CFR was significantly lower in patients with NAFLD than in controls (2.11+/-0.45 vs. 2.52+/-0.62, P<0.001). An impaired CFR (i.e. <2) was found in 25 NAFLD patients (42.4%) whereas all controls had normal CFR values (P<0.001). A stepwise linear regression analysis in NAFLD patients identified liver fibrosis scores as the only independent predictor of CFR values (beta=-0.60; t=-2.44, P=0.021)." }, { "role": "assistant", "content": "Our findings indicate that in patients with biopsy-proven NAFLD: (a) an abnormal CFR is found in approximately 42.4% of cases, and (b) liver fibrosis scores are an independent predictor of depressed CFR. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All of the following are general propeies of Viruses except -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., May contain both DNA and RNA Propeies of viruses . Viruses are obligate intracellular parasites . They lack enzymes necessary for protein and nucleic acid synthesis and are dependent for replication on the synthetic machinery of host cells -4 so, they cannot grow in cell free culture media. . They do not have cellular organization. . They are unaffected by antibacterial antibiotics. . They contain only one type of nucleic acid, either RNA or DNA, never both. . They multiply by a complex process and not by binary fission. . The extracellular infections virus paicle is called the virion. . With few exceptions, viruses are very heat labile." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All of the following structures are derived from the aponeurosis of the external oblique muscle except:" }, { "role": "assistant", "content": "The correct answer is Linea semilunaris is derived from the aponneurosis of the internal oblique muscle. Ligaments derived from the external oblique aponeurosis are pectineal ligament, inguinal ligament, and lacunar ligament. Ref: Gray's Anatomy 41st edition Pgno: 1045" } ]

[ { "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, Anti-Bacterial Agents, Cardiac Output, Disease Models, Animal, Escherichia coli Infections, Heart Rate, Hypotension, Interleukin-6, Lactic Acid, Male, Mice, Shock, Septic, Statistics as Topic, Stroke Volume, Survival Analysis, Time Factors, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Is the duration of hypotension before the initiation of antibiotic treatment a critical determinant of survival in a murine model of Escherichia coli septic shock : association with serum lactate and inflammatory cytokine levels? Context: This study was designed to examine the relationship between the timing of antibiotic treatment and both survival rates and hemodynamic/inflammatory correlates of survival in a murine model of Escherichia coli septic shock. Surgical implantation of an E. coli (O18:K1:H7)-laced, gelatin capsule-encased fibrinogen clot was used to generate a bacteremic model of murine septic shock. Survival duration, hemodynamic responses, and circulating serum tumor necrosis factor (TNF)-alpha , interleukin (IL)-6, and lactate levels were assessed in relation to increasing delays in or absence of antibiotic treatment. A critical inflection point with respect to survival occurred between 12 and 15 h after implantation. When initiated at or before 12 h, antibiotic treatment resulted in < or = 20% mortality, but, when initiated at or after 15 h, it resulted in >85% mortality. Physiologically relevant hypotension developed in untreated septic mice by 12 h after implantation. Values for heart rate differed between untreated septic mice and sham-infected control mice by 6 h after implantation, whereas values for cardiac output and stroke volume did not differ until at least 18-24 h after implantation. Antibiotic treatment initiated > or = 12 h after implantation was associated with persistence of increased circulating serum lactate, TNF- alpha , and IL-6 levels." }, { "role": "assistant", "content": "The timing of antibiotic treatment relative to hypotension is closely associated with survival in this murine model of septic shock. Delay in antibiotic treatment results in the persistence of inflammatory/stress markers even after antibiotic treatment is initiated. 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": "Recognized features of asbestosis do not include:" }, { "role": "assistant", "content": "The correct answer is Features of asbestosis include - clubbing, restrictive pulmonary function, calcification of pleura.Egg shell calcification is not seen in asbestosis. Causes of eggshell calcification in CXR: Treated lymphoma: (post-irradiation Hodgkin disease) usually 1-9 years following treatment Coal workers' pneumoconiosis (CWP) Scleroderma Amyloidosis Blastomycosis Silicosis" } ]

[ { "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": "'Towne's view' in X-ray is used for visualizing the following structure:" }, { "role": "assistant", "content": "The correct answer is Towne's view is anteroposterior view with 30o tilt from above and in front. It shows both petrous pyramids which can be compared. Structures seen are, Arcuate eminence and superior semicircular canal Mastoid antrum Internal auditory canal Tympanic cavity Cochlea External auditory canal This view is usually taken for acoustic neuroma, and apical petrositis. Ref: Diseases of Ear, Nose and Throat by PL Dhingra, 4th edition, Page 386." } ]

[ { "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 is Against the Rule astigmatism" }, { "role": "assistant", "content": "The correct answer is Astigmatism:- Definition:- When the rays are focused at different points due to unequal refraction in different meridians. With the Rule Astigmatism:- * Veical meridian is more curved than the horizontal meridian * Eg : Normal eyes (0.25 D), pterygium * 90deg axis >>>> 180deg axis (+ lens at 90deg/- lens at 180deg) Against the Rule Astigmatism:- * When the horizontal meridian is more curved than the veical meridian * 180deg>>>>90deg axis (- lens at 90deg /+ lens at 180deg) * Eg: Post op astigmatism -suture related Oblique Astigmatism :- * The two principal meridias are at right angles to each other ; but not the veical and horizontal meridian like 45deg and 135deg Bioblique Astigmatism:- * The two principal meridias are not at right angles and also not the veical and horizontal meridia.eg : 30deg & 100deg Reference :- Parson's Diseases of the eye 22nd edition; page:- 53,76" } ]

[ { "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": "Percentage of monozygotic twins with schizophrenia" }, { "role": "assistant", "content": "The correct answer is Monozygotic twin → 46-50%; and Dizygotic twin → 12%." } ]

[ { "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": "Rh isoimmunisation in which trimester" }, { "role": "assistant", "content": "The correct answer is (B) 30-32 weeks> Because of its short half-life, Rh IgG routinely is administered once at 28-32 weeks' gestation and again within 72 hours after birth to all Rh-negative pregnant females as a part of routine prenatal care." } ]

[ { "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": "Nicotinic acid and serotonin are formed from :" }, { "role": "assistant", "content": "The correct answer is Following hydroxylation of tryptophan to 5-hydroxytryptophan by liver tyrosine hydroxylase, subsequent decarboxylation forms serotonin (5-hydroxytryptamine), a potent vasoconstrictor and stimulator of smooth muscle contraction. The amino acid tryptophan can be conveed to niacin with an efficiency of 60:1 by weight. Thus, the RDA for niacin is expressed in niacin equivalents. A lower conversion of tryptophan to niacin occurs in vitamin B6 and/or riboflavin deficiencies and in the presence of isoniazid. Ref: Russell R.M., Suter P.M. (2012). Chapter 74. Vitamin and Trace Mineral Deficiency and Excess. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e." } ]

[ { "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: Adiponectin, Adipose Tissue, Animals, Apolipoproteins E, Blood Glucose, Diet, High-Fat, Fibroblast Growth Factors, Gene Expression Regulation, Gene Knockdown Techniques, Glucagon-Like Peptide 1, Glucose Tolerance Test, Insulin Resistance, Liraglutide, Liver, Male, Mice, Mice, Knockout, RNA Interference, RNA, Messenger, Receptors, Fibroblast Growth Factor." }, { "role": "user", "content": "Does liraglutide increase FGF-21 activity and insulin sensitivity in high fat diet and adiponectin knockdown induced insulin resistance? Context: Liraglutide is a glucagon-like peptide-1 analogue that stimulates insulin secretion and improves β-cell function. However, it is not clear whether liraglutide achieves its glucose lowering effect only by its known effects or whether other as yet unknown mechanisms are involved. The aim of this study was to examine the effects of liraglutide on Fibroblast growth factor-21 (FGF-21) activity in High-fat diet (HFD) fed ApoE(-/-) mice with adiponectin (Acrp30) knockdown. HFD-fed ApoE(-/-) mice were treated with adenovirus vectors expressing shAcrp30 to produce insulin resistance. Hyperinsulinemic-euglycemic clamp studies were performed to evaluate insulin sensitivity of the mouse model. QRT-PCR and Western blot were used to measure the mRNA and protein expression of the target genes. The combination of HFD, ApoE deficiency, and hypoadiponectinemia resulted in an additive effect on insulin resistance. FGF-21 mRNA expressions in both liver and adipose tissues were significantly increased while FGF-21 receptor 1 (FGFR-1) and β-Klotho mRNA levels in adipose tissue, as well as FGFR-1-3 and β-Klotho mRNA levels in liver were significantly decreased in this model. Liraglutide treatment markedly improved insulin resistance and increased FGF-21 expression in liver and FGFR-3 in adipose tissue, restored β-Klotho mRNA expression in adipose tissue as well as FGFR-1-3, β-Klotho levels and phosphorylation of FGFR1 up to the levels observed in control mice in liver. Liraglutide treatment also further increased FGF-21 proteins in liver and plasma. In addition, as shown by hyperinsulinemic-euglycemic clamp, liraglutide treatment also markedly improved glucose metabolism and insulin sensitivity in these animals." }, { "role": "assistant", "content": "These findings demonstrate an additive effect of HFD, ApoE deficiency, and adiponectin knockdown on insulin resistance and unveil that the regulation of glucose metabolism and insulin sensitivity by liraglutide may be partly mediated via increased FGF-21 and its receptors action. 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 growth alteration is an example of hyperplasia rather than metaplasia?" }, { "role": "assistant", "content": "The correct answer is Hyperplasia is an increase in cell number, whereas metaplasia is the replacement of one adult cell type by another adult cell type. Hyperplasia occurs when there is increased trophic stimulation (e.g., hormones, growth factors), increased functional demand, or persistent cell injury. Only labile and stable cells undergo hyperplasia; labile cells have stern cells that frequently divide, and stable cells have resting cells that are stimulated to enter the cell cycle. The presence of increased goblet cells in the mainstem bronchus of a smoker is an example of hyperplasia, because goblet cells are normally present in this area. However, their presence in the terminal bronchiole or gastric mucosa, where they are not normally found, is an example of metaplasia. Squamous epithelium in the bladder of a patient with Schistosoma haernatobium is an example of metaplasia, because the epithelium of a normal bladder is transitional. Irritation from the eggs of the schistosomes induces squamous metaplasia and the potential for dysplasia and squamous carcinoma. A distal esophagus with glandular epithelium intermixed with squamous epithelium is an example of Barrett esophagus. Chronic acid injury to the distal esophagus from gastroesophageal reflux stimulates the formation of mucoussecreting glandular epithelium, which is a type of glandular metaplasia and predisposes the patient to adenocarcinoma. Goblet and Paneth cells in the glands of the gastric mucosa is called intestinal metaplasia and is commonly seen in chronic atrophic gastritis of the body and fundus (type A) or pylorus and antrum (type B). It is a precursor lesion of adenocarcinoma of the stomach. Squamous epithelium in the mains tern bronchus of a smoker is squamous metaplasia, because normal epithelium is pseudostratifiecl, ciliated, and columnar. The squamous epithelium is a reaction to injury induced by cigarette smoke. It predisposes the patient to squamous dysplasia and carcinoma." } ]

[ { "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 30 year biker sustained an compound fracture of the leg following RTA. The doctor has labeled it Gustilo Anderson type IIIB. Which of the following would represent the injury:" }, { "role": "assistant", "content": "The correct answer is Ans. C. Open wound more than 10 cm and soft tissue coverage not possible.Gustilo Anderson ClassificationType IWound <=1cm, minimal contamination or muscle damageType IIWound 1-10cm, moderate soft tissue injuryType IIIAwound usually >10cm, high energy, extensive soft-tissue damage, contaminatedadequate tissue for flap coveragefarm injuries are automatically at least Gustillo IIIAType IIIBextensive periosteal stripping, wound requires soft tissue coverage (rotational or free flap)Type IIICvascular injury requiring vascular repair, regardless of degree of soft tissue injuryMost accurate way to grade open fractures is by intra-operative examination" } ]

[ { "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, Antibodies, Antiphospholipid, Antiphospholipid Syndrome, Dose-Response Relationship, Drug, Humans, Hydroxychloroquine, Immunoglobulin G, Male, Mice, Mice, Inbred Strains, Reference Values, Thrombosis." }, { "role": "user", "content": "Does hydroxychloroquine reverse thrombogenic properties of antiphospholipid antibodies in mice? Context: Previous studies have demonstrated that human monoclonal and polyclonal anticardiolipin antibodies have thrombogenic properties in vivo. Using such a model in which these antibodies have been shown to increase both the size of an induced thrombus and the duration of time in which such a clot lasts, we investigated whether hydroxychloroquine alters the dynamics of such thrombus formation. Three groups of nine mice were injected with purified immunoglobulin G (IgG) from a patient with the antiphospholipid syndrome (IgG-APS) and then fed with hydroxychloroquine at various doses (100, 6, and 3 mg/kg body wt). Three control groups of mice were also studied, including mice injected with IgG-APS and then fed with placebo, as well as two other groups injected with IgG from normal human serum and fed either hydroxychloroquine or placebo. A standardized thrombogenic injury was subsequently induced in the femoral vein of each mouse and the area (size) of thrombus measured as well as the total period of time that thrombus was present. Mice treated with hydroxychloroquine and IgG-APS showed significantly smaller thrombi that persisted for a shorter period of time compared with animals treated with IgG-APS and placebo." }, { "role": "assistant", "content": "Hydroxychloroquine significantly diminished both thrombus size and total time of thrombus formation in mice previously injected with IgG-APS. 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": "Organelle that plays a pivotal role in apoptosis:" }, { "role": "assistant", "content": "The correct answer is Mitochondrion must be recognized not only as an organelle with vital roles in intermediary metabolism and oxidative phosphorylation, but also as a central regulatory structure of apoptosis." } ]

[ { "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: Bile Duct Neoplasms, Child, Cholangiocarcinoma, Female, Hepatomegaly, Heterozygote, Humans, Liver, Liver Neoplasms, Male, Middle Aged, N-Acetylneuraminic Acid, Rare Diseases, Retrospective Studies, Risk Factors, Sialic Acid Storage Disease, Whole Exome Sequencing, Young Adult." }, { "role": "user", "content": "Does new observation of sialuria prompt detection of liver tumor in previously reported patient? Context: Sialuria, a rare inborn error of metabolism, was diagnosed in a healthy 12-year-old boy through whole exome sequencing. The patient had experienced mild delays of speech and motor development, as well as persistent hepatomegaly. Identification of the 8th individual with this disorder, prompted follow-up of the mother-son pair of patients diagnosed over 15years ago. Hepatomegaly was confirmed in the now 19-year-old son, but in the 46-year-old mother a clinically silent liver tumor was detected by ultrasound and MRI. The tumor was characterized as an intrahepatic cholangiocarcinoma (IHCC) and DNA analysis of both tumor and normal liver tissue confirmed the original GNE mutation. As the maternal grandmother in the latter family died at age 49years of a liver tumor, a retrospective study of the remaining pathology slides was conducted and confirmed it to have been an IHCC as well. The overall observation generated the hypothesis that sialuria may predispose to development of this form of liver cancer. As proof of sialuria in the grandmother could not be obtained, an alternate cause of IHCC cannot be ruled out. In a series of 102 patients with IHCC, not a single instance was found with the allosteric site mutation in the GNE gene. This confirms that sialuria is rare even in a selected group of patients, but does not invalidate the concern that sialuria may be a risk factor for IHCC." }, { "role": "assistant", "content": "Sialuria is a rare inborn error of metabolism characterized by excessive synthesis and urinary excretion of free sialic acid with only minimal clinical morbidity in early childhood, but may be a risk factor for intrahepatic cholangiocarcinoma in adulthood. 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: Case-Control Studies, Chi-Square Distribution, Child, Child, Preschool, DNA Copy Number Variations, Disease-Free Survival, Electronic Health Records, Female, Gene Dosage, Genetic Markers, Genetic Predisposition to Disease, Heart Defects, Congenital, Heart Transplantation, Humans, Infant, Kaplan-Meier Estimate, Male, Phenotype, Polymerase Chain Reaction, Predictive Value of Tests, Proportional Hazards Models, Prospective Studies, Risk Factors, Time Factors." }, { "role": "user", "content": "Is burden of potentially pathologic copy number variants higher in children with isolated congenital heart disease and significantly impairs covariate-adjusted transplant-free survival? Context: Copy number variants (CNVs) are duplications or deletions of genomic regions. Large CNVs are potentially pathogenic and are overrepresented in children with congenital heart disease (CHD). We sought to determine the frequency of large CNVs in children with isolated CHD, and to evaluate the relationship of these potentially pathogenic CNVs with transplant-free survival. These cases are derived from a prospective cohort of patients with nonsyndromic CHD (n = 422) identified before first surgery. Healthy pediatric controls (n = 500) were obtained from the electronic Medical Records and Genetic Epidemiology Network, and CNV frequency was contrasted for CHD cases and controls. CNVs were determined algorithmically; subsequently screened for >95% overlap between 2 methods, size (>300 kb), quality score, overlap with a gene, and novelty (absent from databases of known, benign CNVs); and separately validated by quantitative polymerase chain reaction. Survival likelihoods for cases were calculated using Cox proportional hazards modeling to evaluate the joint effect of CNV burden and known confounders on transplant-free survival. Children with nonsyndromic CHD had a higher burden of potentially pathogenic CNVs compared with pediatric controls (12.1% vs 5.0%; P = .00016). Presence of a CNV was associated with significantly decreased transplant-free survival after surgery (hazard ratio, 3.42; 95% confidence interval, 1.66-7.09; P = .00090) with confounder adjustment." }, { "role": "assistant", "content": "We confirm that children with isolated CHD have a greater burden of rare/large CNVs. We report a novel finding that these CNVs are associated with an adjusted 2.55-fold increased risk of death or transplant. These data suggest that CNV burden is an important modifier of survival after surgery for CHD. 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, Cohort Studies, Feasibility Studies, Female, Humans, Placenta Diseases, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, First, Pregnancy, High-Risk, Prospective Studies, Ultrasonography, Prenatal, Umbilical Cord." }, { "role": "user", "content": "Is cord insertion into the lower third of the uterus in the first trimester associated with placental and umbilical cord abnormalities? Context: To assess the feasibility of detecting the cord insertion site during the late first trimester, and to investigate the possible association between perinatal complications and a cord insertion in the lower third of the uterus in the first trimester. This was a prospective cohort study in which the positional relationship between the uterus and the cord insertion site was examined using gray-scale transvaginal sonography at 9-11 weeks of gestation. The distance between the internal os and the fundus was divided equally into three parts. Cord insertions located in the upper or middle thirds were defined as normal (controls), and those located in the lower third were defined as cases, regardless of their relationship to the chorion villosum. Third-trimester sonography and pathological examination of the placenta and cord at delivery were performed to check for placental/cord abnormalities. The univariate association between the location of the cord insertion in the first trimester and placental and umbilical cord abnormalities and perinatal complications was assessed. The cord insertion site was identified in 318/340 (93.5%) cases at 9-11 weeks of gestation and it was in the lower third of the uterus in 35 (11.0%) cases. Of these 35, the cord insertion was found at delivery to be low in nine cases (26%) and the placenta was low-lying at delivery in eight (23%). None of the 283 cases with a normal cord insertion in the first trimester was found to have a low-lying placenta at delivery (P < 0.0001). Ten (29%) of the cases with a low cord insertion and four (1.4%) with a normal cord insertion in the first trimester had a velamentous or marginal cord insertion at delivery (P < 0.0001). At delivery, five (14%) of the low cord insertion cases and four (1.4%) of the normal cord insertion cases (P < 0.0001) had some form of placental malformation, including accessory placenta and infarction of the placenta. An emergency Cesarean section was performed in four (11%) and six (2.1%) of the low and normal cord insertion cases, respectively (P = 0.003)." }, { "role": "assistant", "content": "Developmental abnormalities of the placenta and umbilical cord occur frequently in cases in which the cord insertion is in the lower third of the uterus in the first trimester. We suggest that screening for the cord insertion site at 9-11 weeks of gestation may have clinical significance for predicting abnormalities of the cord and the placenta at delivery. 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, DESCRIPTION, EVALUATION. Meshes: Clinical Competence, Faculty, Medical, Humans, Internship and Residency, Pennsylvania, Photography, Qualitative Research, Social Perception, Students, Medical." }, { "role": "user", "content": "Including resident photographs on electronic evaluations: is a picture worth a thousand words? Context: Trends toward electronic course evaluation make it possible to personalize evaluations in many ways, such as including resident photographs. The purpose of the present project was to explore the impact of adding photos to electronic evaluations of residents by faculty. T tests were used to examine faculty responses to determine if resident outcomes were affected by the inclusion/exclusion of photographs from the perspective of the resident receiving the evaluation and the faculty giving the evaluation. A qualitative analysis of comments was performed. Almost no significant differences were found on the level of resident or faculty (all but one p>.05) Qualitative analysis of the comments did reveal common themes, but no significant differences were apparent between groups with/without photographs (all ps>.05)." }, { "role": "assistant", "content": "Including or excluding photographs on evaluation forms did not impact resident outcomes. Future study should explore the effect of elapsed completion time on resident evaluation." } ]

[ { "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, Brain, Brain Waves, Brain-Computer Interfaces, Cross-Over Studies, Feedback, Sensory, Female, Humans, Imagination, Learning, Male, Neurofeedback, Random Allocation, Reinforcement (Psychology), Self-Control, Young Adult." }, { "role": "user", "content": "Does closed-loop adaptation of neurofeedback based on mental effort facilitate reinforcement learning of brain self-regulation? Context: Considering self-rated mental effort during neurofeedback may improve training of brain self-regulation. Twenty-one healthy, right-handed subjects performed kinesthetic motor imagery of opening their left hand, while threshold-based classification of beta-band desynchronization resulted in proprioceptive robotic feedback. The experiment consisted of two blocks in a cross-over design. The participants rated their perceived mental effort nine times per block. In the adaptive block, the threshold was adjusted on the basis of these ratings whereas adjustments were carried out at random in the other block. Electroencephalography was used to examine the cortical activation patterns during the training sessions. The perceived mental effort was correlated with the difficulty threshold of neurofeedback training. Adaptive threshold-setting reduced mental effort and increased the classification accuracy and positive predictive value. This was paralleled by an inter-hemispheric cortical activation pattern in low frequency bands connecting the right frontal and left parietal areas. Optimal balance of mental effort was achieved at thresholds significantly higher than maximum classification accuracy." }, { "role": "assistant", "content": "Rating of mental effort is a feasible approach for effective threshold-adaptation during neurofeedback training. 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 reference protein is ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Egg Eggs are used in nutrition studies as a \"reference protein\" as eggs proteins are considered to be the best among food proteins because of their high biological value and digestibility. So NPU is also high because it is the product of biological value and digestibility cofficient divided by 100." } ]

[ { "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: Australia, Breast Neoplasms, Decision Making, Female, Genetic Testing, Health Care Surveys, Health Services Accessibility, Humans, Licensure, Patents as Topic, Private Sector." }, { "role": "user", "content": "Do patents impede the provision of genetic tests in Australia? Context: Health policy and law reform agencies lack a sound evidence base of the impacts of patents on innovation and access to healthcare to assist them in their deliberations. This paper reports the results of a survey of managers of Australian genetic testing laboratories that asked a series of questions relating to the tests they perform, whether they pay to access patented inventions and whether they have received notifications from patent holders about patents associated with particular tests. Some diagnostics facilities are exposed to patent costs, but they are all located in the private sector. No public hospitals reported paying licence fees or royalties beyond those included in the price of commercial test kits. Some respondents reported having received enforcement notices from patent holders, but almost all related to the widely known breast cancer-associated patents. Respondents were also asked for their views on the most effective mechanisms to protect their ability to provide genetic tests now and in the future. Going to the media, paying licence fees, ignoring patent rights and relying on the government to take action were widely seen as most effective. Litigation and applications for compulsory licences were seen as some of the least effective mechanisms." }, { "role": "assistant", "content": "These results provide an evidence base for development of health policy and law reform. What is known about the topic? The impact of patents on the delivery of genetic testing services remains unclear in Australia. What does this paper add? The survey reported in this paper suggests that, aside from well-known enforcement actions relating to the breast cancer associated patents, there is little evidence that providers of genetic testing services are being exposed to aggressive patent-enforcement practices. What are the implications for practitioners? Although patent-enforcement actions may increase in the future, a range of strategies are available to providers of testing services to protect them against adverse consequences of such actions. There are ongoing law reform activities aimed at improving these strategies." } ]

[ { "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, Calcium Oxalate, Cell Survival, Dogs, Epithelial Cells, Extracellular Matrix Proteins, Flow Cytometry, Humans, Madin Darby Canine Kidney Cells." }, { "role": "user", "content": "Do kidney stone matrix proteins ameliorate calcium oxalate monohydrate induced apoptotic injury to renal epithelial cells? Context: Kidney stone formation is a highly prevalent disease, affecting 8-10% of the human population worldwide. Proteins are the major constituents of human kidney stone's organic matrix and considered to play critical role in the pathogenesis of disease but their mechanism of modulation still needs to be explicated. Therefore, in this study we investigated the effect of human kidney stone matrix proteins on the calcium oxalate monohydrate (COM) mediated cellular injury. The renal epithelial cells (MDCK) were exposed to 200μg/ml COM crystals to induce injury. The effect of proteins isolated from human kidney stone was studied on COM injured cells. The alterations in cell-crystal interactions were examined by phase contrast, polarizing, fluorescence and scanning electron microscopy. Moreover, its effect on the extent of COM induced cell injury, was quantified by flow cytometric analysis. Our study indicated the antilithiatic potential of human kidney stone proteins on COM injured MDCK cells. Flow cytometric analysis and fluorescence imaging ascertained that matrix proteins decreased the extent of apoptotic injury caused by COM crystals on MDCK cells. Moreover, the electron microscopic studies of MDCK cells revealed that matrix proteins caused significant dissolution of COM crystals, indicating cytoprotection against the impact of calcium oxalate injury." }, { "role": "assistant", "content": "The present study gives insights into the mechanism implied by urinary proteins to restrain the pathogenesis of kidney stone disease. This will provide a better understanding of the formation of kidney stones which can be useful for the proper management of the disease. 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, Albuminuria, Antihypertensive Agents, Blood Pressure, Child, Cholesterol, Diet, Female, Hospitalization, Humans, Hypertension, Renal, Hypertrophy, Left Ventricular, Kidney Failure, Chronic, Male, Nutritional Status, Peritoneal Dialysis, Phosphates, Urea." }, { "role": "user", "content": "Is peritoneal dialysis still an equal option? Context: Peritoneal dialysis (PD) or conventional hemodialysis (HD) are considered to be equally efficient dialysis methods in children and adolescents. The aim of our study was to analyze whether an intensified, nocturnal HD program (NHD) is superior to PD in an adolescent cohort. Thirteen patients were prospectively enrolled in a NHD program. We measured uremia-associated parameters, parameters for nutrition, medication and blood pressure and analyzed the data. These data were compared to those of 13 PD controls, matched for gender, age and weight at the beginning the respective dialysis program and after 6 months of treatment. Serum phosphate levels decreased significantly in the NHD group and remained unchanged in the PD group. Arterial blood pressure in the NHD was significantly lower despite the reduction of antihypertensive treatment, whereas blood pressure levels remained unchanged in the PD controls. Preexisting left ventricular hypertrophy resolved and albumin levels improved with NHD. Dietary restrictions could be lifted for those on NHD, whereas they remained in place for the patients on PD treatment. Residual diuresis remained unchanged after 6 months of either NHD or PD. NHD patients experienced fewer days of hospitalization than the PD controls." }, { "role": "assistant", "content": "Based on our results, NHD results in significantly improved parameters of uremia and nutrition. If individually and logistically possible, NHD should be the treatment modality of preference for older children and adolescents." } ]

[ { "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: Caenorhabditis elegans Proteins, Case-Control Studies, Down-Regulation, Helminth Proteins, Humans, Middle Aged, Muscle, Skeletal, Nitric Oxide Synthase, Nitric Oxide Synthase Type III, RNA, Messenger, Sepsis, Up-Regulation." }, { "role": "user", "content": "Is sepsis associated with reciprocal expressional modifications of constitutive nitric oxide synthase ( NOS ) in human skeletal muscle : down-regulation of NOS1 and up-regulation of NOS3? Context: To study the expression (mRNA and protein) and activity of the constitutive isoforms of nitric oxide synthase (NOS1 and NOS3) in a skeletal muscle of septic patients. Prospective study. An adult trauma/surgical intensive care unit in an urban teaching hospital. Sixteen septic patients and 21 controls. None. Samples of the rectus abdominis muscle were obtained during surgical procedure. NOS mRNA, protein, and activity were detected by reverse-transcriptase polymerase chain reaction, Western blot, and the conversion of [3H]L-arginine to [3H]L-citrulline, respectively. The main results of this study are as follows: a) Levels of NOS1 mRNA and protein were significantly higher than those of NOS3 in the rectus abdominis muscle of control patients; b) NOS1 expression was down-regulated in septic patients, whereas NOS3 was up-regulated; c) these modulations were associated with a reduction in constitutive NOS activity; and d) modifications of NOS1 and NOS3 protein expression were correlated significantly with the severity of sepsis, assessed by the Simplified Acute Physiology Score II." }, { "role": "assistant", "content": "Sepsis induces reciprocal expressional modifications of NOS1 and NOS3 in human skeletal muscle, which decreases muscular constitutive NOS activity. These modifications may have implications for muscle impairment in septic patients. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aorta, Thoracic, Blood Flow Velocity, Cardiac Output, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Phantoms, Imaging, Pulmonary Artery, Regression Analysis." }, { "role": "user", "content": "Does baseline correction of phase contrast images improve quantification of blood flow in the great vessels? Context: Phase-contrast Cardiovascular Magnetic Resonance Imaging (CMR) generally requires the analysis of stationary tissue adjacent to a blood vessel to serve as a baseline reference for zero velocity. However, for the heart and great vessels, there is often no stationary tissue immediately adjacent to the vessel. Consequently, uncorrected velocity offsets may introduce substantial errors in flow quantification. The purpose of this study was to assess the magnitude of these flow errors and to validate a clinically applicable method for their correction. In 10 normal volunteers, phase-contrast CMR was used to quantify blood flow in the main pulmonary artery (Qp) and the aorta (Qs). Following image acquisition, phase contrast CMR was performed on a stationary phantom using identical acquisition parameters so as to provide a baseline reference for zero velocity. Aortic and pulmonary blood flow was then corrected using the offset values from the phantom. The mean difference between pulmonary and aortic flow was 26 +/- 21 mL before correction and 7.1 +/- 6.6 mL after correction (p = 0.002). The measured Qp/Qs was 1.25 +/- 0.20 before correction and 1.05 +/- 0.07 after correction (p = 0.001)." }, { "role": "assistant", "content": "Phase-contrast CMR can have substantial errors in great vessel flow quantification if there is no correction for velocity offset errors. The proposed method of correction is clinically applicable and provides a more accurate measurement of blood flow. 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: Adult, Barium Compounds, Brachial Artery, Bradykinin, Chlorides, Cyclooxygenase Inhibitors, Dose-Response Relationship, Drug, Endothelium, Vascular, Forearm, Humans, Infusions, Intravenous, Male, Nitric Oxide, Nitric Oxide Synthase, Nitroprusside, Obesity, Ouabain, Plethysmography, Potassium, Vasodilation, Vasodilator Agents." }, { "role": "user", "content": "Is visceral obesity characterized by impaired nitric oxide-independent vasodilation? Context: Endothelial dysfunction has been described in obesity. This study examines the impact of visceral obesity on nitric oxide-independent relaxation in the human forearm. In ten viscerally obese and ten matched controls forearm blood flow (FBF) was measured by venous occlusion plethysmography during intrabrachial infusion of: (1) sodium nitroprusside; (2) bradykinin, before and after inhibition of vasoactive prostaglandins and nitric oxide; (3) potassium; (4) ouabain (Na(+)/K(+)ATPase inhibitor) alone or (5) in combination with BaCl(2)(K(IR)inhibitor). Baseline FBF and endothelium-independent vasodilatation were similar in the two groups. In obese patients, bradykinin-induced increase of FBF was significantly less than in controls (P<0.01). Irrespective of prostaglandins and nitric oxide inhibition, bradykinin response was lower in the viscerally obese. Intrabrachial potassium determined a significantly blunted response (P<0.05). Ouabain caused a similar, moderate decrease in basal FBF in the two groups; the coinfusion of BaCl(2)caused a more intense decline in FBF which was significantly relevant in obese (-24+/-5%, P<0.01)." }, { "role": "assistant", "content": "In obese patients there is a blunted nitric oxide-independent relaxation determined by a decreased response of inwardly rectifying potassium channels. 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 joint involved in Gout y ahritis is ?" }, { "role": "assistant", "content": "The correct answer is Gout: Disturbed purine metabolism leading to ecxessive accumulation of uric acid in the blood -an inherited disorder ;or impaired excretion of uric acid by kidneys.result is accumulation of sodium bicarbonte crystals in soft tissues.Tisues of predliction are cailages,tendon ,bursa. Patient ,beyond 40 years of age, presents as 1.ahritis-MP joint of big toe is ourite site,acute severe pain 2.bursitis-commonly of olecranon bursa 3.tophi formation deposit of uric acid salt in soft tissue. Treatment: NSAIDS,uricosuric drugs,uric acid inhibitors. REF:Essential Ohopaedics.Maheswari &Mhaskar.Edition 9.Pg no:293" } ]

[ { "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, Angiogenesis Inhibitors, Area Under Curve, Axitinib, Female, Humans, Imidazoles, Indazoles, Male." }, { "role": "user", "content": "Do a Phase I study to evaluate the pharmacokinetics of axitinib ( AG-13736 ) in healthy Chinese volunteers? Context: To assess axitinib plasma pharmacokinetics and safety of single oral doses of axitinib under fed conditions in healthy Chinese volunteers. This Phase I, open-label study evaluated single dosing of axitinib in 14 healthy Chinese volunteers. Axitinib was administered as 5-, 7-, and 10-mg doses under fed conditions in study periods 1, 2, and 3, respectively, followed by pharmacokinetic assessments and safety monitoring. A washout period ≥ 7 days was provided between successive axitinib doses. Blood samples were collected during each period up to 32 h post-dose for pharmacokinetic analysis. Axitinib plasma pharmacokinetic parameters were estimated using standard noncompartmental methods. Estimates (geometric mean) of axitinib AUC(inf) were 150, 251, and 321 ng × h/ml for doses of 5, 7, and 10 mg, respectively, reflecting a dose-proportional increase in AUC(inf) (increments of 1 : 1.7 : 2.1 for dose increments of 1 : 1.4 : 2, respectively). Geometric mean estimates of maximum observed plasma concentration (Cmax) were 33.5, 51.1, and 69.4 ng/ml, respectively, which also showed dose proportionality. Axitinib plasma pharmacokinetics was similar to those previously observed in healthy Caucasians, with geometric mean values (% geometric coefficient of variation) for axitinib plasma AUC(inf) 150 ng × h/ml (62%) versus 125 ng × h/ml (60%), respectively. Axitinib was well tolerated, with no serious adverse events or discontinuations; one adverse event of mild abdominal distension was observed." }, { "role": "assistant", "content": "In healthy Chinese subjects, single dosing of axitinib demonstrated dose-proportional pharmacokinetics. Axitinib pharmacokinetics in this population was similar to those previously observed in healthy Caucasians, suggesting a lack of ethnic differences. 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: Breast Feeding, Coitus, Female, Humans, Labor, Obstetric, Lacerations, Pain, Postoperative, Perineum, Postnatal Care, Pregnancy, Suture Techniques, Time Factors, Treatment Outcome, Vagina, Vulva, Wound Healing." }, { "role": "user", "content": "Is it necessary to suture all lacerations after a vaginal delivery? Context: Midwives tend to leave minor perineal lacerations to heal spontaneously, and clinical experience and studies show that women can suffer from their stitched lacerations. The study purpose was to determine any differences in the healing process and experience of minor perineal lacerations when they were sutured or not sutured. Eighty term pregnant primiparas with minor perineal lacerations of grades I-II were randomized after childbirth. The experimental group was nonsutured and the control group was sutured. A follow-up examination was performed at 2 to 3 days, 8 weeks, and 6 months after the delivery. Participants were asked about the type of discomfort, and the effect of the laceration on breastfeeding and sexual intercourse. No significant differences were found in the healing process. The type of pain differed between the groups, but the amount of discomfort was the same. The sutured group had to visit the midwife more often because of discomfort from the stitches. Sixteen percent of the women in the sutured group, but none in the nonsutured group (p = 0.0385), considered that the laceration had had a negative influence on breastfeeding." }, { "role": "assistant", "content": "Minor perineal lacerations can be left to heal spontaneously. The benefits for the woman include the possibility of having a choice, avoiding the discomfort of anesthesia and suturing, providing positive affects on breastfeeding." } ]

[ { "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": "Anti-CD25 Humanized monoclonal antibody used for immunosuppression in organ Transplant patient is:" }, { "role": "assistant", "content": "The correct answer is Basiliximab is an Anti-CD25 Antibody (IL-2 receptor antagonists used for immunosuppression in organ transplant patiennts. Monoclonal Antibodies as Immunosuppressive agents in Organ Transplantation: Anti-CD3- Muromonab-CD3 Anti-CD20-Rituximab Anti-CD25 (IL 2 receptor)- Basiliximab(Chimeric), Daclizumab(Humanized) Anti-CD52-Alemtuzumab Drug (Trade name) Target Monoclonal Antibody Type Mechanism Muromonab-CD3 (Ohoclone OKT3) Anti-CD3 Murine(Mouse) Monoclonal antibody Binds CD3 associated with the TCR, leading to initial activation and cytokine release, followed by blockade of function, lysis and T cell depletion Rituximab (Rituxan) Anti-CD20 Recombinant Chimeric Monoclonal antibody Binds to CD20 on B cells and causes depletion Basiliximab (Simulect) Anti-CD25 Recombinant Chimeric Monoclonal Antibody Binds to high-affinity chain of IL-2 Receptors (CD25) on activated T cells, causing depletion and preventing IL-2 mediated activation Daclizumab (Zenopax) Anti-CD25 Recombinant Humanized Monoclonal Antibody Similar to that of Basiliximab Alemtuzumab (Campath-1h) Anti-CD52 Recombinant Humanized Monoclonal Antibody Binds to CD52 expressed on most T and B cells, monocytes, macrophages, and NK cells, causing lysis and prolonged depletion Ref: KDT 7th edition Pgno: 878" } ]

[ { "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 oxytocin are all except -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., Causes contraction of lower segmentOxytocino Oxytocin is a nonapeptide, synthesized predominantly in the paraventricular nucleus of the hypothalamus along with its binding protein neurophysin II. Oxytocin has following physiological actions : -Uterus : - It increases the force and frequency of uterine contraction. Estrogens sensitize the uterus to oxytocin, while progestins decrease the sensitivity. The increased contractility is restricted to the fundus and body, lower segment is not contracted, may even be relaxed at term.Breast: - Oxytocin contracts myoepithelium of mammary alveoli and forces milk into bigger sinusuids - Milk ejection or milk letdown reflex.o Oxytocin secretion is inhibited by sympathetic discharge and circulating catecholamines, by pain and enkephalins, by emotional stress, especially fear, and by alcohol." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: METHODS, RESULTS. Meshes: England, Humans, Incidence, Macular Degeneration, Retrospective Studies, Vision Disorders." }, { "role": "user", "content": "Visual impairment certification secondary to ARMD in Leeds, 2005-2010: is the incidence falling? Context: In this retrospective study, the primary causes of visual impairment certification in the Leeds metropolitan area between 2005 and 2010 were reviewed. ARMD was considered to be the cause of certification when recorded as the primary factor contributing to visual impairment in one or both eyes. The incidence of visual impairment certification due to ARMD was calculated using population estimates from the Office of National Statistics. ARMD was the primary cause of visual impairment certification in all study years, accounting for 58.7 and 50.8% of certifications in 2005 and 2010, respectively. For the same period, the incidence of certification due to ARMD fell from 364 to 248 per million population per year. This was largely the result of a fall in the incidence of visual impairment certification due to neovascular ARMD from 225 to 137 per million population per year, beginning in 2008 after the introduction of a local commissioning policy on the use of intra-vitreal ranibizumab." }, { "role": "assistant", "content": "The incidence of visual impairment certification due to ARMD in the Leeds metropolitan area appears to be falling. This is largely the result of a decrease in certification secondary to neovascular ARMD. This represents a change in the previously described trend for ARMD visual impairment certification." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHOD, RESULTS. Meshes: Adolescent, Adult, Aged, Biomarkers, Cognitive Therapy, Fatigue Syndrome, Chronic, Female, Follow-Up Studies, Humans, Hydrocortisone, London, Male, Middle Aged, Predictive Value of Tests, Saliva, Treatment Outcome, Young Adult." }, { "role": "user", "content": "Does hypocortisolism predict a poor response to cognitive behavioural therapy in chronic fatigue syndrome? Context: There is evidence that patients with chronic fatigue syndrome (CFS) have mild hypocortisolism. The clinical significance of this is unclear. We aimed to determine whether hypocortisolism exerted any effect on the response of CFS to cognitive behavioural therapy (CBT). We measured 24-h urinary free cortisol (UFC) in 84 patients with Centers for Disease Control and Prevention (CDC)-defined CFS (of whom 64 were free from psychotropic medication) who then received CBT in a specialist, tertiary out-patient clinic as part of their usual clinical care. We also measured salivary cortisol output from 0800 to 2000 h in a subsample of 56 psychotropic medication-free patients. Overall, 39% of patients responded to CBT after 6 months of treatment. Lower 24-h UFC output was associated with a poorer response to CBT but only in psychotropic medication-free patients. A flattened diurnal profile of salivary cortisol was also associated with a poor response to CBT." }, { "role": "assistant", "content": "Low cortisol is of clinical relevance in CFS, as it is associated with a poorer response to CBT. Hypocortisolism could be one of several maintaining factors that interact in the persistence of CFS." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aged, Blood Pressure, Blood Viscosity, Blood Volume, Blood Volume Determination, Body Weight, Female, Hematocrit, Humans, Kidney Failure, Chronic, Male, Middle Aged, Predictive Value of Tests, Renal Dialysis, Republic of Korea, Stress, Mechanical, Time Factors, Treatment Outcome." }, { "role": "user", "content": "Do changes in whole blood viscosity at low shear rates correlate with intravascular volume changes during hemodialysis? Context: Elevated blood viscosity has been shown to be independently correlated with cardiovascular risk factors and associated with increased risk of major cardiovascular events, including death and acute myocardial infarction. The aim of the present study was to investigate changes in whole blood viscosity (WBV) at shear rates of 1, 5, and 300 s-1 before and after hemodialysis in patients with end-stage renal disease (ESRD). We also examined the relationship between the changes of WBV and intravascular blood volume. 43 patients with ESRD receiving maintenance hemodialysis were enrolled. WBV was measured using a scanning capillary tube viscometer pre- and post-dialysis to quantify dialytic viscosity surges. Body weight, blood pressure, and hematocrit were also measured before and after hemodialysis, as was the fluid removed during the session. Hemodialysis had a 3 times greater impact on the low-shear WBV at a shear rate of 1 s-1 (i.e., 44.1% change) than on the high-shear WBV at a shear rate of 300 s-1 (i.e., 15.9% change). Changes in the low-shear WBV obtained at shear rates of 1 and 5 s-1 during hemodialysis were significantly correlated with changes in hematocrit. The intravascular blood volume reduction during hemodialysis was positively correlated with the changes in both high-shear and low-shear WBVs." }, { "role": "assistant", "content": "These results suggest that the WBV parameter may hold additional information beyond hemoconcentration. Further research is needed to evaluate the relationship between low-shear WBV surges and increased morbidity in the patient population with ESRD. 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, Antioxidants, Ascorbic Acid, Chromatography, High Pressure Liquid, Glutathione, Hyperoxia, Male, Mice, Mice, Inbred C57BL, Osmolar Concentration, Severity of Illness Index, Tissue Distribution, Vitamin E." }, { "role": "user", "content": "Does moderate hyperoxia ( 40 % ) increase antioxidant levels in mouse tissue? Context: Oxygen is routinely administered to patients to improve clinical outcome. Since studies have shown that administering 100% oxygen can cause unwanted side effects, intermediate concentrations of 40% oxygen are used in clinical practice. In this study, we examined whether the breathing of 40% oxygen causes beneficial effects upon tissue levels of antioxidants such as vitamin E, vitamin C, and glutathione. Four-month-old mice were separated into two groups: control (n = 11) and experimental (n = 11). The treatment group was administered 40% oxygen for 10 days. Brain, heart, lung, liver, testes, and skeletal muscle were harvested and tissue antioxidant levels were determined by HPLC. Vitamin E concentrations were higher in brain, heart, lung, liver, and testes of the treatment group (P < 0.05). Glutathione concentrations were higher in the lung tissue only (P < 0.05). No differences were found in vitamin C levels." }, { "role": "assistant", "content": "The data suggest that mice respond to oxidative stress by increasing tissue vitamin E incorporation and cellular synthesis of glutathione in the lung when exposed to moderate levels (40%) of hyperoxia. 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 young male Kallu is brought to the hospital with severe asthma. The pharmacokinetics of theophylline include the following parameters: Vd = 35 L; CL = 48 ml/min; half life is 8 hrs. If an intravenous infusion of theophylline is started at a rate of 0.48 mg/min, how long will it take to reach 93.75% of the final steady state ?" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: ." }, { "role": "user", "content": "Does a novel ICK mutation cause ciliary disruption and lethal endocrine-cerebro-osteodysplasia syndrome? Context: Endocrine-cerebro-osteodysplasia (ECO) syndrome [MIM:612651] caused by a recessive mutation (p.R272Q) in Intestinal cell kinase (ICK) shows significant clinical overlap with ciliary disorders. Similarities are strongest between ECO syndrome, the Majewski and Mohr-Majewski short-rib thoracic dysplasia (SRTD) with polydactyly syndromes, and hydrolethalus syndrome. In this study, we present a novel homozygous ICK mutation in a fetus with ECO syndrome and compare the effect of this mutation with the previously reported ICK variant on ciliogenesis and cilium morphology. Through homozygosity mapping and whole-exome sequencing, we identified a second variant (c.358G > T; p.G120C) in ICK in a Turkish fetus presenting with ECO syndrome. In vitro studies of wild-type and mutant mRFP-ICK (p.G120C and p.R272Q) revealed that, in contrast to the wild-type protein that localizes along the ciliary axoneme and/or is present in the ciliary base, mutant proteins rather enrich in the ciliary tip. In addition, immunocytochemistry revealed a decreased number of cilia in ICK p.R272Q-affected cells." }, { "role": "assistant", "content": "Through identification of a novel ICK mutation, we confirm that disruption of ICK causes ECO syndrome, which clinically overlaps with the spectrum of ciliopathies. Expression of ICK-mutated proteins result in an abnormal ciliary localization compared to wild-type protein. Primary fibroblasts derived from an individual with ECO syndrome display ciliogenesis defects. In aggregate, our findings are consistent with recent reports that show that ICK regulates ciliary biology in vitro and in mice, confirming that ECO syndrome is a severe ciliopathy. 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: 3' Untranslated Regions, Adaptor Proteins, Signal Transducing, Carcinoma, Hepatocellular, Cell Line, Tumor, Cell Proliferation, Hep G2 Cells, Humans, Liver Neoplasms, MicroRNAs, Phosphoproteins, RNA, Messenger." }, { "role": "user", "content": "Does miR-506 suppress proliferation of hepatoma cells through targeting YAP mRNA 3'UTR? Context: MiR-506 is a miRNA involved in carcinogenesis of several kinds of cancer. In this study, we explored whether miR-506 played a critical role in hepatocellular carcinoma (HCC). Twenty HCC and adjacent normal liver tissue samples were collected. Human hepatoma cell lines HepG2 and H7402 were used for in vitro studies. The expression of miR-506 and transcriptional co-activator YAP was examined using qRT-PCR. Western blot analysis was used to measure the expression of YAP and its target genes. Luciferase reporter gene assay was used to identify YAP as a target gene of miR-506. MTT and EdU assays were carried out for functional analysis. The expression of miR-506 was significantly lower in HCC than in adjacent normal liver tissues. Bioinformatics analysis revealed that YAP mRNA might be one of the targets of miR-506, and miR-506 in HCC tissues was found to be negatively correlated with YAP (r=-0.605). In both HepG2 and H7402 cells, miR-506 dose-dependently down-regulated YAP and its target genes c-Myc and the connective tissue growth factor (CTGF). Luciferase reporter gene assays demonstrated that miR-506 targeted the wild type 3'UTR of YAP mRNA, but not a 3'UTR with a mutant seed site. Furthermore, miR-506 significantly inhibited the proliferation of HepG2 and H7402 cells, while anti-miR-506 enhanced the cell proliferation, which was blocked by YAP siRNA." }, { "role": "assistant", "content": "MiR-506 suppresses the proliferation of hepatoma cells by targeting YAP mRNA. 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": "Sensory neuropathy is caused by all except-" }, { "role": "assistant", "content": "The correct answer is Harrison's principles of internal medicine * In case of lead ( ninpharmaceutucal toxins) motor involvement and CNS involvement is greater Ref Harrison20th edition pg 2345" } ]

[ { "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, Amyotrophic Lateral Sclerosis, Caudate Nucleus, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Thalamus." }, { "role": "user", "content": "Does mRI Texture Analysis reveal Deep Gray Nuclei Damage in Amyotrophic Lateral Sclerosis? Context: Amyotrophic Lateral Sclerosis (ALS) is characterized by extensive corticospinal damage, but extrapyramidal involvement is suggested in pathological studies. Texture analysis (TA) is an image processing technique that evaluates the distribution of gray levels between pixels in a given region of interest (ROI). It provides quantitative data and has been employed in several neurodegenerative disorders. Here, we used TA to investigate possible deep gray nuclei (DGN) abnormalities in a cohort of ALS patients. Thirty-two ALS patients and 32 healthy controls underwent MRI in a 3T scanner. The T1 volumetric sequence was used for DGN segmentation and extraction of 11 texture parameters using the MaZda software. Statistical analyses were performed using the Mann-Whitney non-parametric test, with a significance level set at α = 0.025 (FDR-corrected) for TA. Patients had significantly higher values for the parameter correlation (CO) in both thalami and in the right caudate nucleus compared to healthy controls. Also, the parameter Inverse Difference Moment or Homogeneity (IDM) presented significantly smaller values in the ALS group in both thalami." }, { "role": "assistant", "content": "TA of T1 weighted images revealed DGN alterations in patients with ALS, namely in the thalami and caudate nuclei. 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: Algorithms, Computer Security, Confidentiality, Databases, Factual, Decision Trees, Europe, Humans, Outsourced Services, Statistics as Topic, United States." }, { "role": "user", "content": "Outsourcing medical data analyses: can technology overcome legal, privacy, and confidentiality issues? Context: Medical data are gold mines for deriving the knowledge that could change the course of a single patient's life or even the health of the entire population. A data analyst needs to have full access to relevant data, but full access may be denied by privacy and confidentiality of medical data legal regulations, especially when the data analyst is not affiliated with the data owner. Our first objective was to analyze the privacy and confidentiality issues and the associated regulations pertaining to medical data, and to identify technologies to properly address these issues. Our second objective was to develop a procedure to protect medical data in such a way that the outsourced analyst would be capable of doing analyses on protected data and the results would be comparable, if not the same, as if they had been done on the original data. Specifically, our hypothesis was there would not be a difference between the outsourced decision trees built on encrypted data and the ones built on original data. Using formal definitions, we developed an algorithm to protect medical data for outsourced analyses. The algorithm was applied to publicly available datasets (N=30) from the medical and life sciences fields. The analyses were performed on the original and the protected datasets and the results of the analyses were compared. Bootstrapped paired t tests for 2 dependent samples were used to test whether the mean differences in size, number of leaves, and the accuracy of the original and the encrypted decision trees were significantly different. The decision trees built on encrypted data were virtually the same as those built on original data. Out of 30 datasets, 100% of the trees had identical accuracy. The size of a tree and the number of leaves was different only once (1/30, 3%, P=.19)." }, { "role": "assistant", "content": "The proposed algorithm encrypts a file with plain text medical data into an encrypted file with the data protected in such a way that external data analyses are still possible. The results show that the results of analyses on original and on protected data are identical or comparably similar. The approach addresses the privacy and confidentiality issues that arise with medical data and is adherent to strict legal rules in the United States and Europe regarding the processing of the medical data." } ]

[ { "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 given as live oral vaccine ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Typhoid" } ]

[ { "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, Autonomic Nervous System, Autonomic Nervous System Diseases, Colonic Diseases, Functional, Constipation, Diarrhea, Female, Gastrointestinal Transit, Humans, MMPI, Male, Middle Aged, Prospective Studies." }, { "role": "user", "content": "Do predominant symptoms in irritable bowel syndrome correlate with specific autonomic nervous system abnormalities? Context: Irritable bowel syndrome may be influenced by the autonomic nervous system. Abnormalities in autonomic function, colon transit time, and psychological profiles in 21 patients were assessed. Using modified Manning criteria for irritable bowel syndrome, patients were classified as constipation-predominant or diarrhea-predominant. Autonomic function was determined by one vagal cholinergic and two sympathetic adrenergic measures. Colon transit was assessed by radiopaque markers, and psychological profiles were determined by three inventories. Autonomic function tests showed that diarrhea-predominant subgroup values for one sympathetic adrenergic measure (postural adjustment ratio) were significantly different from controls (P < 0.01). Constipation-predominant subgroup values were significantly lower for the vagal cholinergic measure R-R interval (P < 0.05). Colon transit measures differed by subgroup in left, right, rectosigmoid, and total colon transit times. Both subgroups differed significantly from controls on psychological measures; the constipation subgroup showed more psychological distress." }, { "role": "assistant", "content": "Irritable bowel syndrome specific-symptom subgroups had different patterns of autonomic functioning, colonic transit, and psychological measures. The constipation subgroup is associated with a cholinergic abnormality and the diarrhea-predominant subgroup with an adrenergic abnormality. These findings suggest specific associations between the autonomic nervous system, predominant physical symptoms, colon transit time, and psychological factors in patients with irritable bowel syndrome. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Volume of distribution is NOT affected by all EXCEPT" }, { "role": "assistant", "content": "The correct answer is (Binding to plasma protein) (31-33-KDT 6th)* The extent of distribution of drug depends on* Lipid solubility* Ionization at physiological pH (dependent on pKa)* The extent of binding to plasma and tissue proteins* Differences in regional bloodflow" } ]

[ { "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 helix is placed for:" }, { "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: Autistic Disorder, Case-Control Studies, Child, Preschool, Diet, Female, Folic Acid, Folic Acid Deficiency, Homocysteine, Humans, Male, Nutrition Assessment, Nutritional Status, Odds Ratio, Oman, Vitamin B 12, Vitamin B 12 Deficiency." }, { "role": "user", "content": "Is low folate and vitamin B12 nourishment common in Omani children with newly diagnosed autism? Context: Arab populations lack data related to nutritional assessment in children with autism spectrum disorders (ASDs), especially micronutrient deficiencies such as folate and vitamin B12. To assess the dietary and serum folate and vitamin B12 statuses, a hospital-based case-control study was conducted in 80 Omani children (40 children with ASDs versus 40 controls). The ASD cases showed significantly lower levels of folate, vitamin B12, and related parameters in dietary intake and serum levels." }, { "role": "assistant", "content": "These data showed that Omani children with ASDs exhibit significant deficiencies in folate and vitamin B12 and call for increasing efforts to ensure sufficient intakes of essential nutrients by children with ASDs to minimize or reverse any ongoing impact of nutrient deficiencies. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Carcinoma, Hepatocellular, Female, Humans, Ki-67 Antigen, Liver, Liver Neoplasms, Male, Middle Aged, Prognosis, Proliferating Cell Nuclear Antigen, Receptors, Estrogen, Receptors, Progesterone, Sex Factors, Survival Analysis." }, { "role": "user", "content": "Is better survival in women with resected hepatocellular carcinoma related to tumor proliferation or expression of hormone receptors? Context: There is a well known male predominance in hepatocellular carcinoma (HCC). Moreover, female patients with HCC have better survival and lower recurrence rates after surgical resection. We previously showed that the better prognosis in female patients is related to a higher incidence of tumor encapsulation and less invasive tumors. However, the underlying mechanism is still obscure. In this study, we examined the cell proliferative indices (expression of proliferative cell nuclear antigen (PCNA) and Ki-67 antigen using MIB1 antibody) and expression of the estrogen and progesterone receptors (ERs and PRs, respectively) in 71 patients with resected HCC. These were correlated with the pathological features of the tumors and the survival rates of patients. Female patients with HCC had significantly better actuarial and disease-free survival rates than male patients (p = 0.010 and 0.004, respectively). Tumor PCNA scores, represented by positively stained nuclei per 1000 tumor cells, were significantly higher in tumors showing venous permeation (p = 0.034), positive resection margins (p = 0.011), and absence of bile production (p = 0.008). Higher tumor MIB1 scores were seen in tumors that had poorer cellular differentiation (p = 0.002) and no tumor capsules (p = 0.042). However, both tumor PCNA and MIB1 scores did not differ significantly between female and male patients. ERs were detected in the tumor cells in 23.9% of tumors, and PRs were detected in 14.3%. Expression of both ER and PR was not influenced by gender." }, { "role": "assistant", "content": "Women with HCC had significantly better survival and lower tumor recurrence rates. However, significant differences in cellular proliferation indices and expression of ER and PR were not observed between men and women to explain the difference in survival rate. 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: Aged, Alanine Transaminase, Aspartate Aminotransferases, Bilirubin, Blood Glucose, Blood Pressure, Body Mass Index, Cholesterol, Cinnamomum aromaticum, Double-Blind Method, Female, Glucose Intolerance, Glycated Hemoglobin A, Humans, Insulin, Insulin Resistance, Liver, Male, Phytotherapy, Plant Preparations, Triglycerides, Waist-Hip Ratio." }, { "role": "user", "content": "Does cassia cinnamon change the insulin sensitivity or the liver enzymes in subjects with impaired glucose tolerance? Context: Published studies have reported conflicting results regarding the effects of cinnamon on glucose, lipids and insulin. To gain further insight into the metabolic effects of Cinnamomum cassia we performed randomized, double-blinded placebo-controlled study using euglycaemic-hyperinsulinaemic clamp. Twenty-one subjects with impaired glucose tolerance (IGT) were included in the study (10 or 11 subjects in each group). The study groups were matched for age, gender and body mass index (BMI). Waist-to-hip ratio, BMI, blood pressure, fasting blood glucose, insulin, triglycerides, total cholesterol, low-density lipoprotein, high-density lipoprotein , HbA1c, ASAT, ALAT, bilirubin, ALP, GT and PK were measured before and after the intake of capsules equivalent to 6 g cinnamon twice a day for 12 weeks. The changes in insulin resistance were measured by euglycaemic-hyperinsulinaemic clamp. The Wilcoxon signed rank sum test, the Mann-Whitney U test and Pearson's chi-squared test were used to analyse the data. Values of p < 0.05 were considered to indicate statistically significant differences. At enrolment, the groups were similar in terms of age, gender and BMI. Of the 21 randomized patients with IGT, 17 completed the study (8 controls vs. 9 treated). The ingestion of 6 g cinnamon twice a day for 12 weeks had no significant effect on insulin sensitivity, HbA1c, fasting glucose or BMI. No significant changes were seen in lipids or liver enzymes." }, { "role": "assistant", "content": "This study showed that ingestion of 6 g C. cassia twice a day for 12 weeks did not change the insulin sensitivity or liver enzymes in subjects with IGT. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Allergens, Cross Reactions, Enzyme-Linked Immunosorbent Assay, Humans, Hypersensitivity, Immediate, Immunoblotting, Plant Extracts, Poaceae, Pollen, Skin Tests." }, { "role": "user", "content": "Do purification and partial characterization ofa 67-kD cross-react ive allergen from Imperata cylindrica pollen extract? Context: Grass pollens are known to induce type I allergic reactions in a large number of genetically predisposed individuals. Earlier studies have recognized Imperata cylindrica (Ic) pollen as an important source of aeroallergen which contained 7 IgE binding proteins in the MW range of 85-16 kD. To isolate, purify and characterize a cross-reactive allergenic protein from Ic pollen extract for diagnosis and therapy of grass pollen allergy. Ic pollen extract was fractionated using DEAE Sephadex A-50, Sephadex G-200 and Mono Q column. Allergenic activity of the fractions was checked by ELISA, skin tests, ELISA inhibition and immunoblot using sera of Ic-sensitive patients. A 67-kD protein was purified to homogeneity from Ic-VIII. The allergenic determinants of this protein were identified by SDS-PAGE and immunoblot after CNBr treatment. Among Ic fractions, Ic-VIII was highly potent by ELISA, skin tests and showed cross-reactivity with 4 other tropical grasses by immunoblot and ELISA inhibition. The subfraction Ic-VIIIe1 of Ic-VIII showed a band at 67 kD on SDS-PAGE. On CNBr treatment, it gave 7 peptides, 3 of which were found to be allergenic." }, { "role": "assistant", "content": "A 67-kD protein (Ic-VIIIe1) was isolated, purified to homogeneity and partially characterized. It showed cross-reactivity with tropical grasses tested and contained at least three allergenic determinants. 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: Amino Acid Sequence, Culture Media, Fungal Proteins, Meiosis, Molecular Sequence Data, Mutation, Phosphotransferases (Alcohol Group Acceptor), Saccharomyces cerevisiae Proteins, Schizosaccharomyces, Sequence Alignment, Sex Attractants, Transcription Factors." }, { "role": "user", "content": "Is phosphatidylinositol 3-phosphate 5-kinase required for the cellular response to nutritional starvation and mating pheromone signals in Schizosaccharomyces pombe? Context: Phosphatidylinositol (3,5) bisphosphate, which is converted from phosphatidylinositol 3-phosphate by phosphatidylinositol 3-phosphate 5-kinase, is implicated in vacuolar functions and the sorting of cell surface proteins within endosomes in the endocytic pathway of budding yeast. A homologous protein, SpFab1p, has been found in the fission yeast Schizosaccharomyces pombe, but its role is not known. Here we report that SpFab1p is encoded by ste12+ known as a fertility gene in S. pombe. The ste12 mutant grew normally under stress-free conditions, but was highly vacuolated and swelled at high temperatures and under starvation conditions. In nitrogen-free medium, ste12 cells were arrested in G1 phase, but partially defective in the expression of genes responsible for mating and meiosis. The ste12 mutant was defective both in the production of, and in the response to, mating pheromones. The amount of the pheromone receptor protein Map3p, was substantially decreased in ste12 cells. Map3p was transported to the cell surface, then internalized and eventually transported to the vacuolar lumen, even in the ste12 mutant." }, { "role": "assistant", "content": "The results indicate that phosphatidylinositol(3,5)bisphosphate is essential for cellular responses to various stresses and for the mating pheromone signalling under starvation conditions. 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, Antibodies, Monoclonal, Carrier Proteins, Cohort Studies, Crohn Disease, Female, Gastrointestinal Agents, Gene Frequency, Genotype, Humans, Infliximab, Intracellular Signaling Peptides and Proteins, Male, Nod2 Signaling Adaptor Protein, Predictive Value of Tests, Reference Values, Treatment Outcome, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Does nOD2/CARD15 influence response to infliximab in Crohn 's disease? Context: NOD2/CARD15 was recently identified as the first gene underlying Crohn's disease (CD) susceptibility. Monoclonal antibodies to tumor necrosis factor (TNF)-alpha (infliximab) are a potent treatment for CD, with about 70% of patients responding. It is not clear which factors influence treatment outcome. We assessed whether variants in NOD2/CARD15 are predictive for differences in clinical response. Two hundred forty-five CD patients (86 fistulizing, 159 luminal) receiving infliximab in an expanded access program were genotyped for the 3 main associated variants of NOD2/CARD15, without knowledge of the treatment response. Short-term clinical response was assessed at 4 weeks (refractory) or 10 weeks (fistulizing) after first infliximab infusion, and the mean duration of response was calculated. In a subgroup of patients, production of TNF in response to lipopolysaccharide (LPS) in mucosal biopsy tissue was also determined by means of immunoassay, and results were related to the different NOD2/CARD15 genotypes. In total, 32.6% of patients carried mutations in NOD2/CARD15 (18.8% R702W, 8.6% G908R, and 10.2% 1007fs) compared with 15% in controls (P < 0.001). Despite observed differences in TNF production in mucosal biopsy tissue, there was no relationship between the overall presence of a mutation in NOD2/CARD15 or of any of the mutations separately and short-term infliximab response or response duration. Furthermore, multivariate analysis could not identify clinical characteristics that, in combination with NOD2/CARD15 mutations, were associated with response to infliximab." }, { "role": "assistant", "content": "In this cohort of CD patients, the frequency of NOD2/CARD15 mutations was significantly greater than that of healthy controls. However, NOD2/CARD15 was not predictive of treatment outcome with infliximab in CD. 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, RESULTS. Meshes: Animal Structures, Animals, Caenorhabditis elegans, Caenorhabditis elegans Proteins, G1 Phase, Organogenesis, Receptor, EphA1, Receptors, Cytoplasmic and Nuclear." }, { "role": "user", "content": "Does the C. elegans NR4A nuclear receptor gene nhr-6 promote cell cycle progression in the spermatheca lineage? Context: NR4A nuclear receptors are a conserved, functionally diverse group of nuclear receptors that regulate multiple cellular processes including proliferation and differentiation. The gene nhr-6 encodes the sole Caenorhabditis elegans NR4A nuclear receptor homolog with an essential role in reproduction by regulating morphogenesis of the spermatheca, a somatic gonad organ involved in ovulation and fertilization. Here, we identify the spermatheca cell lineage defects that occur in nhr-6 mutants. Utilizing cell marker analysis, we find that nhr-6 is required for cell cycle progression and that the cell proliferation phenotype is not due to premature cell cycle exit. We also show that loss of the negative cell cycle regulators fzr-1 and lin-35 suppresses the cell proliferation defects. We further demonstrate that NHR-6 activity intersects with Eph receptor signaling during spermatheca cell proliferation." }, { "role": "assistant", "content": "NHR-6 has an essential function in promoting cell cycle progression during G1 phase in a specific spermatheca cell lineage. Genetic suppression of the proliferation phenotype does not affect the differentiation phenotypes observed in nhr-6 mutants, indicating a dualistic role for nhr-6 in regulating cell proliferation and cell differentiation during spermatheca organogenesis. 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: Anuria, China, Female, Humans, Kidney Failure, Chronic, Male, Peritoneal Dialysis, Retrospective Studies, Survival Analysis, Time Factors, Vascular Diseases." }, { "role": "user", "content": "Are peritoneal dialysis patients with and without residual renal function equivalent for survival study? Context: It remains unknown whether results of survival studies in anuric patients can be extrapolated to those who still have significant urine output. It is possible that after a prolonged period on dialysis, anuric patients are qualitatively different from patients with residual renal function. We performed a retrospective review to study the cause of death of 296 peritoneal dialysis patients of our centre over a 7 year period, and compared the mortality and distribution of cause of death between patients with and without residual renal function. One hundred and forty-two cases (48.0%) died of vascular diseases, 82 cases (27.7%) died of infections and 72 cases (24.3%) died of other causes. Anuric patients had a higher overall mortality rate than non-anuric patients (14.9 vs 9.9%, P=0.0005), and the difference was almost completely attributed to the difference in mortality from vascular diseases (8.0 vs 4.1%, P<0.0001). Vascular disease was a more common cause of death in anuric patients than those with residual renal function (55.3 vs 40.8%, P=0.011). The difference was largely explained by the higher prevalence of sudden cardiac death in anuric patients (39 in 149 vs 19 in 147 cases). Patients without pre-existing cardiovascular disease more commonly died of vascular disease after they became anuric (47.4 vs 34.0%, P=0.017). The difference could not be explained by the longer duration of dialysis in anuric patients because there was no significant change in the distribution of cause of death with time on dialysis (chi-square test, P=0.341)." }, { "role": "assistant", "content": "Our observation suggests that peritoneal dialysis patients with and without residual renal function are qualitatively different. Studies on peritoneal dialysis adequacy and survival in anuric patients should only be extrapolated to the general dialysis population with caution." } ]

[ { "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: Child Health Services, Child, Preschool, Continuity of Patient Care, Directive Counseling, Female, Health Care Surveys, Hospitals, Teaching, Humans, Infant, Infant, Newborn, Internship and Residency, Logistic Models, Male, Outpatient Clinics, Hospital, Parents, Patient Preference, Patient Satisfaction, Pediatrics, Pennsylvania, Prospective Studies, Students, Medical, Surveys and Questionnaires." }, { "role": "user", "content": "Does trainee involvement affect anticipatory guidance in well-child care? Context: Studies demonstrate gaps in anticipatory guidance during well-child visits, but none consider academic teaching hospitals where physician trainees also provide counseling. We prospectively assessed parental perception of anticipatory guidance at the outpatient clinic of an academic teaching hospital. Parents of patients newborn to<60 months old completed questionnaires regarding providers seen and anticipatory guidance preferences. Of 204 parents, 40% saw the child's primary attending alone. There was no association between providers seen and the number of topics covered. Seeing the child's primary attending alone increased the odds that parents' priority topics were covered compared with another attending (odds ratio [OR] = 0.31; 95% confidence interval [CI]= 0.11-0.90) or the addition of a resident (OR = 0.35; 95% CI = 0.16-0.77) or medical student (OR = 0.33; 95% CI = 0.12-0.90)." }, { "role": "assistant", "content": "Priority anticipatory guidance is covered only one third as often when the well-child visit is not conducted by the primary attending. When involving trainees, continuity of care and parental concerns must be emphasized." } ]

[ { "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 generation of bonding system combines the primer and bonding agent into a single step?" }, { "role": "assistant", "content": "The correct answer is FIFTH GENERATION  \n\nTo decrease the number of steps PRIME AND BOND WERE COMBINED. \nETCH +   (PRIME+BOND). \nCalled self priming adhesive.  \nBond strength 17-24 MPA. \nLess number of steps less post operative sensitivity. \n\nEg: Prime and bond NT, Adper single bond, Opti bond solo.\nReference- Sturdevant 6th ed" } ]

[ { "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: Age Factors, Aged, Anemia, Biomarkers, Female, Hemoglobins, Humans, Male, Middle Aged, Neoplasm Grading, Prognosis, Proportional Hazards Models, Retrospective Studies, Sarcoma, Survival Analysis." }, { "role": "user", "content": "Is pre-treatment anemia a poor prognostic factor in soft tissue sarcoma patients? Context: Anemia refers to low hemoglobin (Hb) levels, represents a common symptom and complication in cancer patients and was reported to negatively influence survival in patients with various malignancies. In the present study, we aimed to explore the prognostic impact of pre-operative Hb levels on clinical outcome in a large cohort of soft tissue sarcoma (STS) patients after curative surgery. Retrospective data from 367 STS patients, which were operated between 1998 and 2013, were included in the study. Cut-off levels for anemia were defined as Hb<13 g/dl in males and Hb<12 g/dl in females according to the current WHO guidelines. The impact of pre-operative Hb levels on cancer-specific survival (CSS) and overall survival (OS) was assessed using Kaplan-Meier curves. Additionally, Hb levels were compared for the prognostic influence on CSS and OS applying univariate and multivariate Cox proportional models. Hb level was associated with established prognostic factors, including age, tumor grade, size and depth (p<0.05). Kaplan-Meier curves showed that low Hb levels were significantly associated with decreased CSS and OS in STS patients (p<0.001 for both endpoints, log-rank test). In multivariate analysis, we found an independent association between low Hb levels and poor CSS and OS (HR = 0.46, Cl 95% = 0.25-0.85, p = 0.012; HR = 0.34, Cl 95% = 0.23-0.51, p<0.001)." }, { "role": "assistant", "content": "The present data underline a negative prognostic impact of low pre-operative Hb levels on clinical outcome in STS patients. Thus, Hb levels may provide an additional and cost-effective tool to discriminate between STS patients that are at high risk of mortality. 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: Aged, Aged, 80 and over, Benzothiazoles, Carbon Radioisotopes, Cerebral Amyloid Angiopathy, Female, Hemorrhage, Humans, Magnetic Resonance Imaging, Male, Mental Status Schedule, Middle Aged, Positron-Emission Tomography, Prospective Studies, Retrospective Studies, Surveys and Questionnaires." }, { "role": "user", "content": "Is 11C-PIB binding increased in patients with cerebral amyloid angiopathy-related hemorrhage? Context: The in vivo diagnosis of cerebral amyloid angiopathy (CAA) is inferred from clinical and structural imaging features. (11)C-Pittsburgh compound B (PIB) is a PET ligand that binds to beta-amyloid in extracellular plaques and vessel walls. We hypothesized that patients with a clinical diagnosis of CAA-related hemorrhage (CAAH) have increased (11)C-PIB uptake and that the pattern differs from Alzheimer disease (AD). Patients with CAAH based on established clinical criteria were studied using (11)C-PIB PET and were compared with age-matched controls and patients with AD. Distribution volume ratio (DVR) parametric maps were created using the cerebellar cortex as a reference region. Twelve patients with CAAH of mean age 73.9 (range 58-93) years were compared with 22 normal controls and 13 patients with AD of mean age 71.8 (59-83) and 73.8 (56-90) years, respectively. CAAH PIB median DVR binding was higher in cortical regions (1.69, interquartile range 1.44-1.97) compared with controls (1.32, 1.21-1.44, p = 0.002) but lower than AD (2.04, 1.93-2.26, p = 0.004). The occipital-global uptake ratio was lower among patients with AD than among patients with CAAH (p = 0.008), and the frontal-global uptake ratio was higher (p = 0.012)." }, { "role": "assistant", "content": "(11)C-Pittsburgh compound B (PIB) binding is moderately increased in most patients with probable cerebral amyloid angiopathy (CAA)-related intracerebral hemorrhage. The distribution may differ from that seen in Alzheimer disease. (11)C-PIB PET may assist in the in vivo diagnosis of CAA and serve as a surrogate marker for future therapeutic studies. 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, Arginine, Cardiovascular Diseases, Child, Child, Preschool, Endothelial Cells, Endothelium-Dependent Relaxing Factors, Enzyme Inhibitors, Female, Humans, Infant, Male, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Risk Factors." }, { "role": "user", "content": "Does elevated plasma ADMA contribute to development of endothelial dysfunction in children with acute lymphoblastic leukemia? Context: Childhood acute lymphoblastic leukemia (ALL) survivors are at higher cardiovascular risk than the general population, which may result from anthracycline-related endothelial dysfunction (ED). However, a few studies indirectly show that ED may appear in ALL children before treatment begins. Hence, in this study we intended to verify the hypothesis that ED is part of the ALL phenotype. Twenty-eight ALL children and 14 healthy age-matched control children were recruited. The study group was examined at baseline, then at the 33rd and 78th day of treatment. At each step of the protocol endothelial vasodilative function was assessed by a laser Doppler flowmeter, which was followed by blood collecting for subsequent analyses. Compared to controls, the study group at baseline was characterized by significantly lower endothelial vasodilative responsiveness, accompanied by elevated asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) concentrations, which were correlated with lactate dehydrogenase (LDH) and aspartate transaminase (AST). Initial ALL treatment restored endothelial function, which followed changes in ADMA and LDH concentrations." }, { "role": "assistant", "content": "This is the first demonstration that functionally assessed ED is present in ALL children at the diagnosis and results from elevated ADMA and parallel inflammatory ED. 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: Acute Disease, Adrenergic beta-Antagonists, Animals, Bradykinin, Bradykinin Receptor Antagonists, C-Reactive Protein, Disease Models, Animal, Drug Evaluation, Preclinical, Hemodynamics, Kinins, Pancreatitis, Peptides, Phospholipases A, Phospholipases A2, Random Allocation, Receptor, Bradykinin B2, Receptors, Bradykinin, Swine, Systemic Inflammatory Response Syndrome, Time Factors." }, { "role": "user", "content": "Does bradykinin B2-receptor antagonism attenuate fatal cardiocirculatory breakdown induced by severe experimental pancreatitis? Context: To investigate the impact of the long-acting bradykinin B2 receptor antagonist HOE 140 (Icatibant) on survival time in a model of severe porcine pancreatitis. Randomized, controlled intervention trial. Thirty domestic pigs of either gender anesthetized by intravenous application of piritramide, midazolam, and pancuronium and mechanically ventilated. Pancreatitis was induced by an injection of sodium taurocholate (5%, 1 mL/kg body weight [BW]) and enterokinase (10 U/kg BW). Control animals (group 1, n = 10) underwent the spontaneous course of the disease. In two treatment groups, Icatibant was administered either in a low (100 nmol/kg BW; group 2, n = 10) or in a high dosage (5000 nmol/kg BW; group 3, n = 10). Mean survival time was significantly prolonged by Icatibant (controls, 6.6 hrs; group 2, 9.8 hrs; p = .022; group 3, 10.9 hrs; p = .007). Six hours postinduction, the decline of total peripheral resistance (52% of baseline) and cardiac index (92% of baseline) in controls was significantly improved by Icatibant, both in the low (16% and 44%; p < .05) and high (6% and 45%; p < .05) dosage. The concentrations of free, nonreceptor-bound kinin in plasma 6 hrs postinduction were significantly lower in controls than in groups 2 and 3 animals (111+/-50 vs. 208+/-40 and 237+/-52 fmol/mL, respectively). Six hours postinduction, the pretreatment with Icatibant was associated with significantly higher plasma concentrations of phospholipase A2 (controls, +1194%; group 2, +2000%; group 3, +2285% of baseline values) and interleukin-1 receptor antagonist (controls, 1900+/-800; group 2, 3100+/-800; group 3, 3600+/-800 pg/mL). In contrast, the increase of urinary trypsinogen activation peptides indicating local pancreatic damage (589+/-114 nmol/L in controls) was substantially attenuated by pretreatment with Icatibant (group 2, 467+/-102, NS; 352+/-91 nmol/L in group 3; p = .022 vs. controls). Systemic inflammatory reactions, however, as quantified by C-reactive protein and the extracellularly discharged neutrophil cytosolic inhibitor leukocyte neutral proteinase inhibitor were not influenced by the bradykinin B2-receptor antagonist." }, { "role": "assistant", "content": "Pretreatment with the bradykinin B2 receptor antagonist Icatibant resulted in prolonged survival time and in delayed impairment of major macrocirculatory and pulmonary variables. Icatibant resulted in elevated concentrations of free, circulating kinin. This was associated with increased concentrations of phospholipase A2 and interleukin-1 receptor antagonist, suggesting that circulating kinins strengthen the activation of some mediator cascades, the association of which with the kinin metabolism requires further experimental clarification. Other variables indicating a systemic inflammatory response (C-reactive protein, leukocyte neutral proteinase inhibitor) remained unaffected by Icatibant. Bradykinin antagonism distinctly ameliorated the local pancreatic damage, indicated by increased urinary concentrations of trypsinogen activation peptides. It is concluded that the kinin metabolism plays an important role in the pathophysiology of systemic complications after severe experimental pancreatitis. 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: Administration, Cutaneous, Adult, Antioxidants, Bilirubin, Cardiovascular Diseases, Counseling, Double-Blind Method, Female, Humans, Lung Neoplasms, Male, Middle Aged, Naltrexone, Nicotine, Risk Factors, Smoking, Smoking Cessation, Tobacco Use Cessation Devices, Treatment Outcome." }, { "role": "user", "content": "Is smoking cessation followed by increases in serum bilirubin , an endogenous antioxidant associated with lower risk of lung cancer and cardiovascular disease? Context: Lower concentrations of serum bilirubin, an endogenous antioxidant, have been associated with risk of many smoking-related diseases, including lung cancer and cardiovascular disease, and current smokers are reported to have lower bilirubin levels than nonsmokers and past smokers. This study evaluates the effects of smoking cessation on bilirubin levels. In a secondary analysis of a 6-week placebo-controlled trial of naltrexone for smoking cessation, indirect and total bilirubin concentrations were evaluated at baseline and following smoking cessation. Individuals who were continuously abstinent for 6 weeks (n = 155) were compared to those who were not (n = 193). Participants reported smoking ≥ 20 cigarettes daily at baseline and received smoking cessation counseling, 21 mg nicotine patch daily, and either placebo or 1 of 3 doses of naltrexone (25, 50, or 100mg) for 6 weeks. Change in indirect and total bilirubin following the quit date was measured at Weeks 1, 4, and 6 compared to baseline. Individuals who were continuously abstinent from smoking, independent of naltrexone condition, showed a significantly greater mean increase in indirect (~unconjugated) bilirubin (0.06 mg/dl, SD = 0.165) compared to those who did not (mean = 0.02, SD = 0.148, p = .015). Similar results were obtained for total bilirubin (p = .037)." }, { "role": "assistant", "content": "Smoking cessation is followed by increases in bilirubin concentration that have been associated with lower risk of lung cancer and cardiovascular disease. Final Decision: yes" } ]