Datasets:

Medint

/

Multi-Med-conversational

like 1

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Antibodies, Monoclonal, Female, Genes, MHC Class I, HLA Antigens, HLA-C Antigens, HLA-G Antigens, Histocompatibility Antigens Class I, Humans, Immunohistochemistry, Pregnancy, Pregnancy Trimester, First, Trophoblasts." }, { "role": "user", "content": "Do first trimester human endovascular trophoblast cells express both HLA-C and HLA-G? Context: In human pregnancies, trophoblasts, in contrast to placental connective tissue and the fetus itself, come into direct contact with the maternal allorecognizing system at special sites. Villous syncytiotrophoblasts washed around by maternal blood lack HLA class I proteins, whereas extravillous trophoblasts, which deeply invade maternal uterine tissues, express high amounts of HLA-G and also HLA-C, the latter to a lesser degree, however. A subpopulation of extravillous trophoblasts, the endovascular trophoblast, enters maternal spiral artery lumen and, like syncytiotrophoblast, comes into direct contact with maternal blood. Less is known about HLA class I distribution on this endovascular trophoblast subpopulation. A comparative immununohistochemical analysis was done on decidual cryo-sections containing trophoblast-invaded spiral arteries using different anti-HLA class I monoclonal antibodies (mAbs) and a peroxidase-labeled streptavidinbiotin detection system. MAbs W6/32 (anti-HLA-A, -B, -C, -G), HCA2 (anti-HLA-A, -G) G233 and 87G (both anti-HLA-G) resulted in strong positivity on endovascular trophoblasts. L31 (anti-HLA-C) and HC10 (anti-HLA-B, -C) revealed clear positivity, whereas TU149 (anti-HLA-B, -C, some -A) produced a heterogeneous staining pattern, faintly positive on some endovascular trophoblastic cells and negative on others. MAb LA45 (anti-HLA-A, -B) did not bind to any endovascular trophoblast, neither did BFL.1 (anti-HLA-G) nor 16G1 (anti-HLA-G, soluble)." }, { "role": "assistant", "content": "This study shows that trophoblastic cells belonging to the endovascular subpopulation express considerable amounts of HLA-G and slightly less HLA-C. 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 25yr old women with myoclonic seizures is well controlled on valproate. she indicates that she is intrested in conceiving in next year. With respect to her antiepileptic medication, wof should be considered" }, { "role": "assistant", "content": "The correct answer is Lamotrigine Mech of action:- Lamotrigine is a broad-spectrum antiepileptic. It modifies maximal electric shock and decreases electrically evoked as well as photic after-discharge duration. Prolongation of Na+ channel inactivation and suppression of high frequency firing has been demonstrated. In addition, it may directly block voltage sensitive Na+ channels, thus stabilizing the presynaptic membrane and preventing release of excitatory neurotransmitters, mainly glutamate and aspaate. This may account for its broader-spectrum of antiseizure efficacy. uses:- Absence and myoclonic or akinetic epi-lepsy cases have also been successfully treated. Reduction in seizure frequency or complete control is obtained as frequently as with carbamazepine. Pharmacokinetics:- Lamotrigine is well absorbed orally and metabolized completely in liver. Its t 1/2 is 24 hr, but is reduced to ~16 hr in patients receiving phenytoin, carbamazepine or phenobarbitone. On the contrary valproate inhibits glucuronidation of lamotrigine and doubles its blood level, but valproate levels are lowered by lamotrigine. Reduce the dose of lamotrigine to half in patients taking valproate. However, metabolism of other anticonvulsants and oral contraceptives is not altered. Ref:- kd tripathi;pg num:-419" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Aged, 80 and over, Biomarkers, Blood Sedimentation, C-Reactive Protein, Complement C3, Female, Humans, Insulin Resistance, Intra-Abdominal Fat, Leukocyte Count, Male, Metabolic Syndrome, Obesity, Predictive Value of Tests." }, { "role": "user", "content": "Is serum C3 a stronger inflammatory marker of insulin resistance than C-reactive protein , leukocyte count , and erythrocyte sedimentation rate : comparison study in an elderly population? Context: This study was performed to ascertain the relative relevance of some inflammatory markers in insulin resistance. Four inflammatory markers (leukocyte count, erythrocyte sedimentation rate [ESR], high-sensitivity C-reactive protein [CRP], and C3 complement) were assessed as possible determinants of the homeostasis model assessment (HOMA) index, together with the five elements of the metabolic syndrome (National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults [Adult Treatment Panel III] definition), total cholesterol, physical activity, and four indicators of adiposity (BMI, waist circumference, percent body fat, and hepatic steatosis) in an unselected population of 990 subjects aged 65-91 years (the Pianoro Study). In univariable analysis, C3, CRP, and leukocyte count, but not ESR, were significantly correlated with HOMA index. In multivariable analysis, C3 remained associated with insulin resistance with the highest partial R(2) value (0.049), independently of all other covariates. The other most significant (P < 0.0001) determinants of HOMA index were total cholesterol (inverse association, R(2) = 0.026), waist circumference (R(2) = 0.023), triglycerides (R(2) = 0.022), and hepatic steatosis (R(2) = 0.021) (R(2) = 0.450 for the whole model). The adjusted relative risks of having the metabolic syndrome for the subjects with inflammatory markers in the high tertile, with respect to those with lower values, were (prevalence ratio [95% CI]): 1.77 (1.41-2.22) for C3, 1.38 (1.12-1.70) for leukocyte count, 1.17 (0.94-1.46) for CRP, and 1.13 (0.91-1.40) for ESR." }, { "role": "assistant", "content": "Of the four inflammatory markers simultaneously assessed in our elderly population, only C3 was strongly associated with insulin resistance, independently of the components of the metabolic syndrome and the main indexes of abdominal and general obesity. 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 20 year old young female had history of recurrent acne on the face treated with many antibiotics like clindamycin, tetracycline, erythromycin and others. Now she complained of multiple hyperpigmented spots at the site of old acne lesions. Which of the following drug might have been responsible for this –" }, { "role": "assistant", "content": "The correct answer is Minocyclin can cause blue black discoloration in healing acne lesions." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Biomarkers, Carotid Artery Diseases, Carotid Intima-Media Thickness, Coronary Angiography, Coronary Artery Disease, Cross-Sectional Studies, Enzyme-Linked Immunosorbent Assay, Female, Humans, Kidney Failure, Chronic, Male, Middle Aged, Multidetector Computed Tomography, Pulmonary Surfactant-Associated Protein D, Renal Dialysis, Vascular Calcification." }, { "role": "user", "content": "Is serum Surfactant Protein D Associated with Atherosclerosis of the Carotid Artery in Patients on Maintenance Hemodialysis? Context: Surfactant protein-D (SP-D) is an inflammatory modulator that has been associated with cardiovascular disease-related mortality, estimated glomerular filtration rate, and major adverse cardiac events in patients with chronic kidney disease. The aim of this study was to investigate the link between SP-D level and atherosclerosis in patients on hemodialysis. A total of 116 patients undergoing maintenance hemodialysis were recruited to this cross-sectional study. As a marker of atherosclerosis, the carotid artery intima-media thickness (CA-IMT) was measured by high-resolution ultrasonography, and the coronary artery calcification (CAC) score was determined by multislice computed tomography. Serum SP-D levels were measured by a commercial enzyme-linked immunosorbent assay kit. In patients on long-term hemodialysis, the mean serum SP-D level was 192.9 +/- 89.6 pg/mL (range: 89-537 pg/mL). The serum SP-D level exhibited positive correlations with CA-IMT (r = 0.497, p < 0.0001) and severe CAC (r = 0.352, p = 0.02), which persisted after multivariate adjustment." }, { "role": "assistant", "content": "The SP-D level showed positive correlations with carotid CA-IMT and CAC in patients on long-term hemodialysis. Therefore, SP-D may be a novel marker of atherosclerosis in patients with hemodialysis. 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": "Pituitary tumour causes:" }, { "role": "assistant", "content": "The correct answer is Ans. Bitemporal hemianopia" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, RESULTS. Meshes: Adult, Aged, Animals, Arrhythmias, Cardiac, Calcium Channels, L-Type, Cells, Cultured, Female, Heart Failure, Humans, Male, Membrane Microdomains, Middle Aged, Myocytes, Cardiac, Rats, Rats, Sprague-Dawley." }, { "role": "user", "content": "Does microdomain-Specific Modulation of L-Type Calcium Channels lead to Triggered Ventricular Arrhythmia in Heart Failure? Context: Disruption in subcellular targeting of Ca(2+) signaling complexes secondary to changes in cardiac myocyte structure may contribute to the pathophysiology of a variety of cardiac diseases, including heart failure (HF) and certain arrhythmias. To explore microdomain-targeted remodeling of ventricular L-type Ca(2+) channels (LTCCs) in HF. Super-resolution scanning patch-clamp, confocal and fluorescence microscopy were used to explore the distribution of single LTCCs in different membrane microdomains of nonfailing and failing human and rat ventricular myocytes. Disruption of membrane structure in both species led to the redistribution of functional LTCCs from their canonical location in transversal tubules (T-tubules) to the non-native crest of the sarcolemma, where their open probability was dramatically increased (0.034±0.011 versus 0.154±0.027, P<0.001). High open probability was linked to enhance calcium-calmodulin kinase II-mediated phosphorylation in non-native microdomains and resulted in an elevated ICa,L window current, which contributed to the development of early afterdepolarizations. A novel model of LTCC function in HF was developed; after its validation with experimental data, the model was used to ascertain how HF-induced T-tubule loss led to altered LTCC function and early afterdepolarizations. The HF myocyte model was then implemented in a 3-dimensional left ventricle model, demonstrating that such early afterdepolarizations can propagate and initiate reentrant arrhythmias." }, { "role": "assistant", "content": "Microdomain-targeted remodeling of LTCC properties is an important event in pathways that may contribute to ventricular arrhythmogenesis in the settings of HF-associated remodeling. This extends beyond the classical concept of electric remodeling in HF and adds a new dimension to cardiovascular disease. 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": "Black gun powder composition ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Charcoal 15% + Potassium nitrate 75% + sulphur 10% The classical gun powder is known as black powder, consists of charcol (15%), Sulphur (10%), and potassium nitrate (75%). Depending on fineness, the black gun powder is designated as FG, FFG, FFFG. etc. (F = fineness). Pyrodex is another gun powder with same components, but with different ratios. Black gun powder produces smoke, i.e. It is smoke producing powder. Smokeless powder, in addition to black powder, has nitrocellulose (single base), or nitrocellulose plus nitroglycerine (double base), or nitrocellulose plus nitroglycerine plus nitroguanidine (triple base). Semi smokeless powder has 80% black powder and 20% smokeless powder (nitrocellulose)." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adenosine, Adenosine Triphosphate, Animals, Enzyme Activation, Heart, Heart Arrest, Induced, Immunoblotting, Male, Myocardial Contraction, Protein Kinase C, Rabbits." }, { "role": "user", "content": "Does adenosine prevent protein kinase C activation during hypothermic ischemia? Context: The cardioprotective properties of exogenous and endogenously produced adenosine during ischemia have been shown previously. The models used to demonstrate the efficacy and mechanism of effect have been primarily of normothermic ischemia where adenosine was given pre-ischemia in an effort to mimic the preconditioning phenomena. The proposed mechanisms responsible for the protective effects of adenosine include A2-receptor mediated vasodilation, A1-receptor mediated improvement of glycolysis during ischemia and early reperfusion, and interaction with protein kinase C (PKC) pre-ischemia. This study was designed to assess the dose-dependent effects of adenosine on myocardial recovery after prolonged hypothermic ischemia. Using an isolated Langendorff perfused rabbit heart model, we subjected hearts to 8 hours of hypothermic ischemia with crystalloid cardioplegia containing adenosine 0, 0.01, 0.25, or 5 mmol/L followed by reperfusion. Pre- and postischemic (30 minutes of reperfusion) diastolic and developed pressure were compared among the groups. Translocation of PKC from cytosol to membrane, tissue levels of ATP, and total lactate production during ischemia were also determined. ATP levels at end-ischemia were higher in all adenosine-treated hearts, along with significantly enhanced anaerobic glycolysis as measured by total lactate production. Recovery of left ventricular diastolic pressure and developed pressure, however, were improved significantly only in hearts exposed to higher adenosine concentrations (0.25 and 5 mmol/L). The higher dose adenosine cardioplegia also prevented translocation of PKC from cytosol to membrane during ischemia." }, { "role": "assistant", "content": "We conclude that adenosine provides significant protection of the ischemic myocardium during prolonged hypothermic ischemia and that 0.25 mmol/L adenosine was equally as protective as 5 mmol/L. The mechanism of protection is most likely not related to ATP preservation or enhanced glycolysis but may be caused by prevention of PKC translocation during ischemia. 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": "Soft friable extradural hematoma with honeycomb appearance seen in autopsy in cases of death due to?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Thermal injury When the head is exposed to intense heat, sufficient to cause charring of the skull, heat hematomas occur. They have the appearance like extradural hemorrhage, but signs of injury blunt force do not accompany it. It consists of soft friable clot of light chocklate colour and may be pink, if blood contains CO. The clot has honeycombed appearance due to bubbles of steam produced by heat. Thickness - 11/2 to 15 mm and volume 120 ml. Thus the findings described in the question have typical appearance secondary to excess heat as seen in thermal injuries due to burns." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Attitude of Health Personnel, Female, General Practice, Hospitals, Humans, Male, Practice Patterns, Physicians', Quality of Health Care, Referral and Consultation, Specialization, Surveys and Questionnaires." }, { "role": "user", "content": "Does comparative performance information play no role in the referral behaviour of GPs? Context: Comparative performance information (CPI) about the quality of hospital care is information used to identify high-quality hospitals and providers. As the gatekeeper to secondary care, the general practitioner (GP) can use CPI to reflect on the pros and cons of the available options with the patient and choose a provider best fitted to the patient's needs. We investigated how GPs view their role in using CPI to choose providers and support patients. We used a mixed-method, sequential, exploratory design to conduct explorative interviews with 15 GPs about their referral routines, methods of referral consideration, patient involvement, and the role of CPI. Then we quantified the qualitative results by sending a survey questionnaire to 81 GPs affiliated with a representative national research network. Seventy GPs (86% response rate) filled out the questionnaire. Most GPs did not know where to find CPI (87%) and had never searched for it (94%). The GPs reported that they were not motivated to use CPI due to doubts about its role as support information, uncertainty about the effect of using CPI, lack of faith in better outcomes, and uncertainty about CPI content and validity. Nonetheless, most GPs believed that patients would like to be informed about quality-of-care differences (62%), and about half the GPs discussed quality-of-care differences with their patients (46%), though these discussions were not based on CPI." }, { "role": "assistant", "content": "Decisions about referrals to hospital care are not based on CPI exchanges during GP consultations. As a gatekeeper, the GP is in a good position to guide patients through the enormous amount of quality information that is available. Nevertheless, it is unclear how and whether the GP's role in using information about quality of care in the referral process can grow, as patients hardly ever initiate a discussion based on CPI, though they seem to be increasingly more critical about differences in quality of care. Future research should address the conditions needed to support GPs' ability and willingness to use CPI to guide their patients in the referral process. 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, Age Factors, Aged, Analysis of Variance, Cardiopulmonary Bypass, Echocardiography, Electrocardiography, Female, Follow-Up Studies, Heart Septal Defects, Atrial, Hemodynamics, Humans, Length of Stay, Male, Middle Aged, Patient Satisfaction, Postoperative Complications, Pulmonary Embolism, Treatment Outcome." }, { "role": "user", "content": "Should atrial septal defects in adults be closed? Context: By assessing current surgical outcome and symptomatic relief, this study attempts to answer whether atrial septal defects in adults should be closed. Thirty-nine adult patients aged 35.2 +/- 13.6 years underwent operation for an atrial septal defect between June 1988 and June 1994. Indications for closure were symptoms (33 patients) or a significant left-to-right atrial shunt (6 patients). Data were obtained from hospital records, and the latest status of the patients was determined by a written questionnaire. There were no deaths. Pulmonary embolism in 1 patient was the only complication observed. The QRS duration on the surface electrocardiogram decreased immediately (p<0.001), and the cardiothoracic ratio on chest radiographs was significantly lower 3 to 6 months after operation (p<0.001), both findings reflecting improved hemodynamics. No residual shunts were seen on follow-up (mean follow-up, 3.3 +/- 2.2 years). Twenty-seven (81.8%) of the 33 symptomatic patients improved clinically in terms of exercise performance, atrial arrhythmias, or both. Three (50%) of the 6 previously asymptomatic patients reported improved functional capacity post-operatively." }, { "role": "assistant", "content": "Today, operation for atrial septal defects in adults can be performed with no mortality and low morbidity and results in symptomatic improvement in the majority of patients. Clinical improvement was seen even in patients who considered themselves asymptomatic preoperatively. We advocate closure of atrial septal defects in adult patients with symptoms or significant atrial shunts." } ]

[ { "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": "Parkinsonism differ from atypical parkinsonism by the absence of" }, { "role": "assistant", "content": "The correct answer is Atypical Parkinsonisms Characterised by Progressive supranuclear palsy Coicobasal ganglionic degeneration Frontotemporal dementia Multiple-system atrophy a)Cerebellar type (MSA-c) b)Parkinson type (MSA-p) Poor response to dopamine early loss of balance prominent intellectual changes rapid onset of progression conspicuous postural hypotension urinary & bowel incontinence Little or no tremor Reference: Chapter 372. Parkinson's Disease and Other Movement Disorders Harrison's Principles of Internal Medicine 18th edition" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, PATIENTS AND METHODS, RESULTS. Meshes: 1-Alkyl-2-acetylglycerophosphocholine Esterase, Acute Coronary Syndrome, Aged, Biomarkers, Colorimetry, Coronary Angiography, Coronary Artery Disease, Coronary Vessels, Disease Progression, Female, Fibrosis, Humans, Longitudinal Studies, Male, Middle Aged, Phospholipases A2, Plaque, Atherosclerotic, Time Factors, Tomography, Optical Coherence, Ultrasonography, Interventional." }, { "role": "user", "content": "Is lipoprotein-associated phospholipase A2 activity correlated with fibrous-cap thickness and plaque volume in patients with acute coronary syndrome? Context: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a specific biomarker specific for vascular inflammation. Inflammation has a significant association with plaque progression. The fibrous-cap thickness (FCT) is one of the major determinants of plaque vulnerability in atherosclerotic plaques. However, data on the relationship between Lp-PLA2 activity and FCT in lipid plaque are limited. This study aimed to evaluate the in-vivo association between changes in Lp-PLA2 activity and FCT and plaque volume in patients with acute coronary syndrome (ACS). Twenty-four consecutive patients with ACS were enrolled between May 2010 and May 2012. The plaque volume and FCT of nonculprit lipid-rich plaques were assessed by intravascular ultrasound and optical coherence tomography, respectively, at baseline and after 12 months. Lp-PLA2 activity was determined using the colorimetric assay kit. During the 12 months of observation, FCT increased significantly from baseline to follow-up, with a mean percent change of 74.4±46.8%. A significant correlation was observed between changes in Lp-PLA2 activity and changes in FCT (r=-0.56, P=0.006). Changes in plaque volume were also correlated significantly with changes in Lp-PLA2 activity during the study period (r=0.52, P=0.01)." }, { "role": "assistant", "content": "Significant associations between serial changes in Lp-PLA2 activity and changes in FCT and plaque volume were observed in patients with ACS." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Elective Surgical Procedures, Female, Homes for the Aged, Hospitalization, Humans, Male, Middle Aged, Nursing Homes, Postoperative Complications, Risk Assessment, Risk Factors, Surgical Procedures, Operative, United States, Young Adult." }, { "role": "user", "content": "Is nursing home status an independent risk factor for adverse 30-day postoperative outcomes after common , nonemergent inpatient procedures? Context: Nursing home residents undergoing surgery have a higher rate of postoperative adverse outcomes than nonnursing home patients. This study seeks to determine what contribution nursing home status makes to theses occurrences, independent of comorbid conditions. Using the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database, the 30-day postoperative outcomes of the 5 commonest nonemergent inpatient procedures performed on nursing home residents were compared with those in nonnursing home residents using logistic regression analysis. Nursing home status was found to be an independent risk factor for septic complications in all procedures, for blood transfusion requirement after lower leg amputation, for pneumonia and stroke/cerebrovascular accident after thromboendarterectomy, and for mortality after partial colectomy with primary anastomosis." }, { "role": "assistant", "content": "These data suggest that, in addition to serving as a surrogate indicator of health status and current morbidity, residence in a nursing home makes an independent contribution to adverse postoperative outcomes. 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: Chemotherapy, Adjuvant, Colonic Neoplasms, Ethnic Groups, Female, Health Services, Indigenous, Healthcare Disparities, Humans, Lymph Node Excision, Male, Middle Aged, New Zealand, Quality of Health Care." }, { "role": "user", "content": "Ethnicity and management of colon cancer in New Zealand: do indigenous patients get a worse deal? Context: Racial and ethnic inequalities in colon cancer treatment have been reported in the United States but not elsewhere. The authors of this report compared cancer treatment in a nationally representative cohort of Maori (indigenous) and non-Maori New Zealanders with colon cancer. On the basis of cancer registry data, 301 Maori patients and 329 randomly selected non-Maori patients were identified who were diagnosed with colon cancer between 1996 and 2003. Medical notes were reviewed, and surgical and oncology treatments were compared by indigenous status. Maori and non-Maori patients had similar rates of surgical resection, although Maori patients were less likely to undergo extensive lymph node clearance and were more likely to die during the postoperative period. Maori patients were significantly less likely to receive chemotherapy for stage III disease (relative risk [RR], 0.69; 95% confidence interval [CI], 0.53-0.91) and were more likely to experience a delay of at least 8 weeks before starting chemotherapy (RR, 1.98; 95%CI, 1.23-3.16). Treatment disparities were not explained by differences in tumor characteristics or patient comorbidity." }, { "role": "assistant", "content": "Maori New Zealanders with colon cancer were less likely to receive adjuvant chemotherapy and experienced a lower quality of care compared with non-Maori patients. The authors concluded that attention to health system factors is needed to ensure equal access and quality of cancer treatment for indigenous and ethnic minority populations." } ]

[ { "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 23-year-old woman presents to her gynecologist for painful menses. Her menses are regular, occurring every 28 days and lasting approximately 4 days. Menarche was at age 12. Over the past 6 months, she has started to develop aching pelvic pain during the first 2 days of her menstrual period. Ibuprofen provides moderate relief of her symptoms. She denies nausea, vomiting, dyschezia, dyspareunia, irregular menses, or menses that are heavier than usual. Her past medical history is notable for chlamydia 4 years ago that was treated appropriately. She currently takes no medications. She works as a copywriter and does not smoke or drink. She has been in a monogamous relationship with her boyfriend for the past 3 years. They use condoms intermittently. Her temperature is 98.6°F (37°C), blood pressure is 111/69 mmHg, pulse is 92/min, and respirations are 18/min. Pelvic examination demonstrates a normal appearing vagina with no adnexal or cervical motion tenderness. The uterus is flexible and anteverted. Which of the following is the underlying cause of this patient's pain?" }, { "role": "assistant", "content": "Prostaglandin-induced myometrial contraction" } ]

[ { "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": "Cancer cachexia is due to?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., TNF-a \"Factors that have been most strongly associated driving skeletal muscle catabolism in cancer patients include tumor necrosis factor (TNF-a) and Proteolysis-inducing factor (P1F).\"Factors associated with cancer cachexiaa) Tumor Factors (produced by tumor cells)i) Proteolysis-inducing factor (PIF)ii) Lipid-mobilising factors (LMF).iii) Parathyroid hormone-related peptide (PTHrP)b) Host factors (produced by host cells)i) TNF-a (also k/a fcachexin? or 'cachectin')ii) IFN-giii) IL-1 and IL-6.iv) CRPv) Ghrelin" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Bone Marrow, Cells, Cultured, Coculture Techniques, Dendritic Cells, Female, Hematopoiesis, Extramedullary, Mice, Myeloid Progenitor Cells, Organ Specificity, Spleen, Stromal Cells, Thymus Gland." }, { "role": "user", "content": "Do splenic stromal niches support hematopoiesis of dendritic-like cells from precursors in bone marrow and spleen? Context: The aims of this study are to test the ability of stromal cells from murine spleen to support hematopoiesis, to define the tissue source of precursors that seed these hematopoietic niches, and to determine the type of cells produced. Cloned isolates of murine spleen stroma have been developed that support hematopoiesis. Analysis has been investigated in terms of tissue source of progenitors. Type and number of cells produced were analyzed by flow cytometry. Hematopoietic precursors that seed cocultures exist in spleen and bone marrow (BM), but not thymus. Cell production is highest if overlay cells are enriched for hematopoietic precursors. BM contains more precursors than spleen, but the cell types produced are different. Cocultures established from spleen maintain a high proportion of a distinct class of dendritic-like cells produced in only low numbers in BM cocultures. These reflect the immature myeloid dendritic cell (DC) produced continuously in long-term spleen cultures established previously in this laboratory. Stroma-conditioned medium alone does not support DC development, but does support early outgrowth of myelomonocytic cells from precursors in both spleen and BM." }, { "role": "assistant", "content": "The outcome has been development of a coculture system that supports hematopoiesis of immature myeloid dendritic-like cells in vitro. Although production of monocytes can occur in the presence of stroma-conditioned medium alone, production of DC is dependent on stromal cell interaction. Results presented here raise questions about the role of spleen as a site for DC hematopoiesis from endogenous precursors. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: AIMS, METHODOLOGY, RESULTS. Meshes: Female, Humans, Male, Middle Aged, Neoplasm Staging, Palliative Care, Postoperative Complications, Prognosis, Stomach Neoplasms, Stress, Physiological, Survival Rate, Time Factors." }, { "role": "user", "content": "Does the surgical stress associated with palliative resection for patients with incurable gastric cancer with distant metastasis shorten their survival? Context: In cases of incurable stage IV gastric cancer with distant metastases, surgical treatment has usually consisted merely of palliation. The effect of palliative resection in these highly advanced cases remains controversial. Palliative resection may be prohibited by the potential disadvantages of surgical stress. Over the past 23 years, 382 stage IV incurable gastric cancer patients with distant metastases were classified into a resection group (group R) whose subjects underwent a palliative resection of the primary tumor and the non-resection group (group N) who were treated without resection of primary tumor. In order to exclude patients with very poor prognosis due to irresectability even if trying to resect, we restricted the subjects to patients who survived more than 30 and 60 days and some months and estimated the mean survival. Cumulative survival rates were calculated by using the Kaplan-Meier method, and the mean survivals of groups R and N were compared. A significantly longer mean survival was observed in group R than in group N (381 vs. 181 days, P<0.0001). Restricting the subjects to patients who survived more than 30 and 60 days, there is also a significant difference between the mean survival of group R and that of group N. However, restricting the subjects to patients who survived more than 300 days, no significant difference was seen between the two groups. The rate of hospital death was higher in group N than in group R (15.9% vs. 3.4%)" }, { "role": "assistant", "content": "Palliative resection of the primary tumor in stage IV gastric cancer is meaningful in view of hospital stay, long-term survival, and satisfaction with the treatment. We should resect the primary tumor in cases in which it is resectable." } ]

[ { "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 alpha-glucosidase inhibitor is?" }, { "role": "assistant", "content": "The correct answer is Ans. b (Maglitol) (Ref. Harrison medicine 17th ed. Table 383-11; KD Tripathi, Pharmacology, 5th ed., 252)ORAL HYPOGLYCEMICS# Sulfonylureas : Tolbutamide, chlorpropamide, glibenclamide, glipizide, gliclazide, glimepiride# Biguanides : Phenformin and metformin.# Meglitinide analogues : Repaglinide, nateglinide# Thiazolidinediones : Rosiglitazone, pioglitazone.# Alpha-glucosidase inhibitor : maglitol, acarbose.GLUCOSE-LOWERING THERAPIES FOR TYPE 2 DIABETESClass of anti-diabetic and ExamplesMechanism of ActionAgent-Specific AdvantagesAgent-Specific DisadvantagesContraindications/ Relative ContraindicationsORALBiguanidesMetforminHepatic glucose production, weight loss, glucose, utilization, insulin resistanceWeight lossLactic acidosis, diarrhea, nauseaSerum creatinine >1.5 mg/dL (men) >1.4 mg/dL (women), CHF, radiographic contrast studies, seriously ill patients, acidosisalpha-Glucosidase inhibitorsAcarbose, Maglitol|Glucose absorptionReduce postprandial glycemiaGl flatulence, liver function testsRenal/liver diseaseDipeptidyl peptidase IV inhibitorsSitagliptinProlong endogenous GLP-1 actionDoes not cause hypoglycemia Reduce dose with renal diseaseInsulin secretagogues-- Sulfonylurea-first generation: Chlorpropamide, Tolazamide, Tolbutamide Sulfonylurea--second generation: Glimepiride, Glipizide, Glipizide (extended release), Glyburide, Glyburide (micronized)|Insulin secretionLower fasting blood glucoseHypoglycemia, weight gainRenal/ liver diseaseInsulin secretagogues-- nonsulfonylureasRepaglinideNateglinide| Insulin secretionShort onset of action, lowers postprandial glucoseHypoglycemiaRenal/ liver diseaseThiazolidinedionesRosiglitazone,Pioglitazone| Insulin resistance,| glucose utilizationLower insulin requirementsPeripheral edema, CHF, weight gain, fractures, macular edema; rosiglitazon may increase risk of MlCongestive heart failure, liver diseasePARENTERALInsulinShort-acting,subcutaneousLispro, AspartGlulisine, Regular| Glucose utilization and other anabolic actionsKnown safety profileInjection, weight gain, hypoglycemia Short-acting, inhaledInhaled regular insulinLong-actingNPH, Detemir,Glargine GLP-1 agonistExenatide| Insulin,| Glucagon, slow gastric emptyingWeight lossInjection, nausea, | risk of hypoglycemia with insulin secretagoguesRenal disease, agents that also slow GI motilityAmylin agonistPramlintideSlow gastric emptying, |GlucagonReduce postprandial glycemia, weight lossinjection, nausea, ?risk of hypogly- cemia with insulinAgents that also slow GI motilityMedical nutrition therapy and physical activityLow-calorie, low-fat diet, exercise| Insulin, resistance,| insulin secretionOther health benefitsCompliance difficult, long-term success low" } ]

[ { "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": "Simple random sampling -" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is part of ear is derived from all three germ layers -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Tymparic membrane ComponentDevelops fromI External ear PinnaFusion of 6 auricular hillocks around dorsal part of 1 st pharyngeal ectodermal cleft.Tragus1st archRest of auricle & muscles2nd archExternal auditory meatusDorsal part of l st pharyngeal ectodermal cleft.Tympanic membraneApposition of first pharyngeal cleft (ectoderm) with tubotympanic recess (endoderm) with mesoderm in between.II Internal ear Membranous labyrinthSpecial sensory' end organs of hearing and euilibrium (cristae of semicircular canals, maculae of utricle and saccule, and organ of corti of cochlea)Bony labyrinthEctoderm overlying hindbrain forming the otic placode and then the olic vesicle.Differentiation of localized areas of epithelium of membranous labyrinth.Mesenchyme around the membranous labyrinth w'hich is condensed to form otic capsule." } ]

[ { "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": "Morphine should not be used in:" }, { "role": "assistant", "content": "The correct answer is Ans. B. Biliary colicOpioids have potent analgesic effect via mu, kappa receptor. They are known to increase the intrabilliary pressure by constricting the smooth muscle. Therefore, they are contraindicated in biliary colic." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 22-year-old lady died. The postmortem appearance that will indicate that she has had delivered a child are all, except -" }, { "role": "assistant", "content": "The correct answer is Signs of remote delivery in a dead lady.\n\n\nLarge, thicker and heavier uterus.\nWalls of the uterus are concave from inside.\nThe body of the uterus is twice the length of the cervix (of the same length in virgin).\nTop of the fundus is convex and at a higher level than that of the broad ligament.\nThe cervix is irregular in form, shortened and its edges show cicatrices.\nExternal os is enlarged and internal os is not so well defined.\nMucosal folds are present in the canal of the cervix." } ]

[ { "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": "Mechanism involved in the absorption of glucose from small intestine is which of the following:March 2005" }, { "role": "assistant", "content": "The correct answer is Ans. A: Active co-transpo with sodium" } ]

[ { "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": "Largest opening in the Right atrium" }, { "role": "assistant", "content": "The correct answer is Right Atrioventricular Orifice Blood passes out of the right atrium through the right atrioventricular or tricuspid orifice and goes to the right ventricle. The tricuspid orifice is guarded by the tricuspid valve which maintains unidirectional flow of bloodReference: Vishram Singh Anatomy; 2nd edition; Page no: 265" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Cohort Studies, Emergency Service, Hospital, Female, Genital Neoplasms, Female, Health Services, Humans, Linear Models, Logistic Models, Middle Aged, Multivariate Analysis, Odds Ratio, Patient Readmission, Postoperative Complications, Preoperative Period, Prospective Studies, Quality of Life, Surveys and Questionnaires, Young Adult." }, { "role": "user", "content": "Preoperative quality of life and surgical outcomes in gynecologic oncology patients: a new predictor of operative risk? Context: Quality of life (QoL) for women with gynecologic malignancies is predictive of chemotherapy related toxicity and overall survival but has not been studied in relation to surgical outcomes and hospital readmissions. Our goal was to evaluate the association between baseline, pre-operative QoL measures and 30-day post-operative morbidity and health resource utilization by gynecologic oncology patients. We analyzed prospectively collected survey data from an institution-wide cohort study. Patients were enrolled from 8/2012 to 6/2013 and medical record data was abstracted (demographics, comorbid conditions, and operative outcomes). Responses from several validated health-related QoL instruments were collected. Bivariate tests and multivariable linear and logistic regression models were used to evaluate factors associated with QoL scores. Of 182 women with suspected gynecologic malignancies, 152 (84%) were surveyed pre-operatively and 148 (81%) underwent surgery. Uterine (94; 63.5%), ovarian (26; 17.5%), cervical (15; 10%), vulvar/vaginal (8; 5.4%), and other (5; 3.4%) cancers were represented. There were 37 (25%) cases of postoperative morbidity (PM), 18 (12%) unplanned ER visits, 9(6%) unplanned clinic visits, and 17 (11.5%) hospital readmissions (HR) within 30days of surgery. On adjusted analysis, lower functional well-being scores resulted in increased odds of PM (OR 1.07, 95%CI 1.01-.1.21) and HR (OR 1.11, 95%CI 1.03-1.19). A subjective global assessment score was also strongly associated with HR (OR 1.89, 95%CI 1.14, 3.16)." }, { "role": "assistant", "content": "Lower pre-operative QoL scores are significantly associated with post-operative morbidity and hospital readmission in gynecologic cancer patients. This relationship may be a novel indicator of operative risk." } ]

[ { "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": "Beer - claw appearance on CECT abdomen is seen in" }, { "role": "assistant", "content": "The correct answer is Beer-claw laceration : Multiple linear laceration of liver on CECT abdomen Ref: Sabiston 20th edition Pgno : 437-439" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Fibrin Tissue Adhesive, Interleukin-8, Pleura, Pleurodesis, Pneumothorax, Postoperative Period, Rabbits, Recurrence, Thoracic Surgery, Video-Assisted, Tissue Adhesives." }, { "role": "user", "content": "Does abrasion Plus Local Fibrin Sealant Instillation produce Pleurodesis Similar to Pleurectomy in Rabbits? Context: Pleurodesis performed either by pleurectomy or pleural abrasion is recommended in the approach to primary spontaneous pneumothorax to avoid recurrence. However, the efficacy of parietal pleural abrasion in producing pleurodesis is questioned. This study aims to determine the efficacy of apical abrasion alone, abrasion plus fibrin sealant application, and pleurectomy in producing pleurodesis in rabbits. Rabbits were subjected to video-assisted thoracic surgery alone (control) or to video-assisted thoracic surgery with apical gauze abrasion, abrasion plus fibrin sealant instillation, or apical pleurectomy. Blood samples were collected preoperatively and 48 h and 28 days postoperatively to measure total leukocytes (white blood cell count), neutrophil counts, and serum interleukin (IL)-8 levels. After 28 days the animals were sacrificed for macroscopic evaluation of the degree of apical pleurodesis and microscopic evaluation of local pleural fibrosis and collagen deposition. White blood cell and neutrophil counts were similar in all groups, whereas the serum IL-8 level peaked at 48 h in all groups and decreased after 28 days, except in the pleurectomy group. After 28 days the abrasion plus fibrin sealant and pleurectomy groups had significantly more pleural adhesions, pleural fibrosis, and collagen deposition than the abrasion alone group, mainly due to thick mature fibers." }, { "role": "assistant", "content": "Abrasion with local fibrin sealant instillation is as effective as pleurectomy in producing pleurodesis in rabbits. Apical pleurectomy elicits a more persistent elevation of serum IL-8 levels than apical abrasion alone or abrasion plus fibrin adhesive instillation. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In nephrotic syndrome the essential feature is :" }, { "role": "assistant", "content": "The correct answer is All the given options occur in nephrotic syndrome, but proteinuria is the most characteristic, which is the basic defect.\nThe underlying abnormality in nephrotic syndrome is an increase in permeability of the glomerular capillary wall, which leads to massive proteinuria and hypoalbuminemia." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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 AND MATERIALS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Area Under Curve, Carcinoma, Transitional Cell, Cohort Studies, Cystectomy, Disease-Free Survival, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Grading, Neoplasm Staging, Nomograms, Postoperative Period, Prognosis, ROC Curve, Retrospective Studies, Urinary Bladder Neoplasms." }, { "role": "user", "content": "Postoperative nomogram for invasive bladder cancer: does it really work? Context: Nomograms are statistical models designed to maximize predictive accuracy. We have tested the statistical correlation between the predictions of International Bladder Cancer Nomogram Consortium and the clinical outcomes in a multicenter Italian cohort of patients treated with radical cystectomy (RC) and pelvic lymph-nodes dissection. Two hundred four patients who underwent RC were selected for multiple variable and then enrolled in the study. Patients were tested by the \"online tool\" based on the nomogram, then stratified and risk grouped for 5-year predicted disease-free survival (pDFS): low risk (67%-100%), intermediate risk (34%-66%), and high risk group (0%-33%). Receiving operating characteristic curve (ROC) quantified the area under curve (AUC) as predictive accuracy. Actual overall survival (aOS) and actual disease-free survival (aDFS) were calculated with Kaplan-Meyer analysis. Median of pDFS was compared with 5-year aDFS. AUC was 0.69 (P<0.001). The aOS is 50% (95% confidence interval (95% CI, -7.68/+8.23) at 5-years after RC, the aDFS is 65.5% (95% CI, -7.56/+8.98). The 5-year aDFS is 75.3% (-8.82/+12.53) in low risk group; 67.3% (-12/+16.4) in intermediate risk group; 28.3% (-20/+17.2) in high risk group. The 5-year aDFS was well calculated by the nomogram but in all groups the nomogram slightly underestimated the prediction. In intermediate risk group, 5-year aDFS overscored both the nomogram pDFS and the pDFS range of this group (34%-66%). In all patients investigated, the pDFS was 65%, a value close to the 5-year aDFS found (65.6%)." }, { "role": "assistant", "content": "Statistical correlation between postoperative nomogram prediction and the clinical reality was observed." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Anastomosis, Surgical, Animals, Esophageal Atresia, Esophageal Stenosis, Esophagectomy, Esophagus, Male, Rabbits." }, { "role": "user", "content": "Does an oblique anastomosis have more linear length than a transverse anastomosis of a tubular structure in oesophageal anastomosis? Context: Oesophageal stricture continues to be a challenging paediatric surgical problem. This study aimed to compare the results of oblique and transverse anastomosis to prevent anastomotic stricture that occurred following oesophageal repairs. Twelve New Zealand rabbits were divided equally into two groups: oblique (O) and transverse (T). A 1-cm-long tract of the cervical oesophagus was resected through a cervical incision in both groups. Anastomosis was performed in both groups. Oesophagographic analysis was carried out on postoperative day 7 and the animals were fed orally on the same day on the condition that there was no oesophageal leakage. The rabbits were killed to measure diameters of the oesophageal lumen and bursting pressure (BP) in the anastomosis region 8 weeks later. The diameters of the oesophageal anastomosis lines (3.9 +/- 0.10 mm) in the O group were significantly greater than those (1.9 +/- 0.09 mm) in the T group (P < 0.05). The values of BP (189 +/- 10 mmHg) in the O group were also significantly higher than those (116 +/- 4 mmHg) in the T group (P < 0.05)." }, { "role": "assistant", "content": "Our results suggested that oblique anastomosis is a better surgical procedure for preventing oesophageal stricture, as shown by the increased diameters of oesophageal anastomosis lines and BP. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, RESULTS. Meshes: Animals, Aorta, Atherosclerosis, Atorvastatin, Biomarkers, Cilostazol, Drug Therapy, Combination, Hypercholesterolemia, Inflammation, Lipids, Male, Oxidation-Reduction, Oxidative Stress, Probucol, Rabbits, Tetrazoles." }, { "role": "user", "content": "Does combined use of probucol and cilostazol with atorvastatin attenuate atherosclerosis in moderately hypercholesterolemic rabbits? Context: Atherosclerotic cardiovascular disease is one of the major diseases that seriously impacts human health. Combined drug therapy may be efficacious in delaying the occurrence of cardiovascular events. The current study was designed to investigate whether combined use of probucol (an anti-oxidant agent) with cilostazol (a platelet aggregation inhibitor) would increase the inhibitory effect of statins (a lipid-lowering agent) on atherosclerosis in moderately hypercholesterolemic rabbits. Thirty Japanese white rabbits were fed with a high cholesterol diet for 12 weeks, which was supplemented with either 0.005% atorvastatin alone or 0.005% atorvastatin plus 0.3% probucol and 0.3% cilostazol. Except for high-density lipoprotein cholesterol, no difference was found in plasma lipids among vehicle, statin, and the combined treatment group. However, atherosclerotic lesions were significantly reduced by statin treatment compared with vehicle. Moreover, we found that the anti-atherogenic effect of statin was further enhanced by the combined treatment, which was due to increased anti-inflammatory and anti-oxidant properties." }, { "role": "assistant", "content": "These data demonstrated that combined drug treatment exhibits potent athero-protective effects via pleiotropic functions, such as anti-inflammatory and anti-oxidative stress, which is independent of the lipid-lowering effect. 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: OBJECTIVES, METHODS, RESULTS. Meshes: Adrenergic beta-Agonists, Adult, Electromyography, Female, Humans, Ischemia, Male, Muscle, Skeletal, Posture, Potassium, Terbutaline, Tremor." }, { "role": "user", "content": "Is postural tremor size controlled by interstitial potassium concentration in muscle? Context: To determine whether factors associated with postural tremor operate by altering muscle interstitial K(+). An experimental approach was used to investigate the effects of procedures designed to increase or decrease interstitial K(+). Postural physiological tremor was measured by conventional means. Brief periods of ischaemic muscle activity were used to increase muscle interstitial K(+). Infusion of the beta(2) agonist terbutaline was used to decrease plasma (and interstitial) K(+). Blood samples were taken for the determination of plasma K(+). Ischaemia rapidly reduced tremor size, but only when the muscle was active. The beta(2) agonist produced a slow and progressive rise in tremor size that was almost exactly mirrored by a slow and progressive decrease in plasma K(+)." }, { "role": "assistant", "content": "Ischaemic reduction of postural tremor has been attributed to effects on muscle spindles or an unexplained effect on muscle. This study showed that ischaemia did not reduce tremor size unless there was accompanying muscular activity. An accumulation of K(+) in the interstitium of the ischaemic active muscle may blunt the response of the muscle and reduce its fusion frequency, so that the force output becomes less pulsatile and tremor size decreases. When a beta(2) agonist is infused, the rise in tremor mirrors the resultant decrease in plasma K(+). Decreased plasma K(+) reduces interstitial K(+) concentration and may produce greater muscular force fluctuation (more tremor). Many other factors that affect postural tremor size may exert their effect by altering plasma K(+) concentration, thereby changing the concentration of K(+) in the interstitial fluid." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adenocarcinoma, Aged, Aged, 80 and over, Cell Line, Tumor, Colectomy, Colonic Neoplasms, Female, Humans, Insulin-Like Growth Factor Binding Protein 3, Interleukin-6, Laparoscopy, Male, Middle Aged, Tumor Suppressor Proteins." }, { "role": "user", "content": "Is depletion of circulating insulin-like growth factor binding protein 3 after open surgery associated with high interleukin-6 levels? Context: We have previously shown that plasma from open, but not laparoscopic-assisted, surgery patients has increased mitogenic activity for colon cancer cells. Decreased insulin-like growth factor binding protein 3 levels, most likely the result of an open surgery-induced proteolytic activity, may account for this finding. Plasma proteases are activated by interleukin-6. This study was designed to investigate plasma insulin-like growth factor binding protein 3 and interleukin-6 levels after major open or laparoscopic-assisted surgery. EDTA plasma was obtained from 24 patients undergoing resection for colonic adenocarcinoma. Insulin-like growth factor binding protein 3 was detected by Western blot analysis and enzyme-linked immunosorbent assay. Interleukin-6 levels were determined by enzyme-linked immunosorbent assay. The effect of insulin-like growth factor binding protein 3 on tumor growth was tested using HCT116 cells. In patients undergoing open surgery, enzyme-linked immunosorbent assay revealed a significant decrease in total insulin-like growth factor binding protein 3 levels on postoperative Day 1 (915.6 +/- 378.5 ng/ml) compared with preoperative levels (1267.5 +/- 407.9 ng/ml; P < 0.001). Western blots revealed a decrease in the levels of intact insulin-like growth factor binding protein 3. In patients undergoing laparoscopic-assisted surgery, levels of total and intact insulin-like growth factor binding protein 3 before surgery (1088.9 +/- 232.5 ng/ml) and on postoperative Day 1 (1,202.3 +/- 285.6 ng/ml) were comparable with no significant changes in Western blot analysis. Interleukin-6 levels were undetectable preoperatively. On postoperative Day 1, interleukin-6 concentration was higher in open surgery group (434.8 +/- 506.6 pg/ml) compared with laparoscopic-assisted surgery group (100.9 +/- 60.2 pg/ml; P < 0.0001), and correlated significantly with a decrease in plasma insulin-like growth factor binding protein 3 after open surgery (r = 0.81; P < 0.0001)." }, { "role": "assistant", "content": "A significant decrease in both total and free insulin-like growth factor binding protein 3 occurs after open but not laparoscopic colectomy. There is an associated increase in the levels of interleukin-6. It remains to be proven that the interleukin-6 elevations are responsible for the low insulin-like growth factor binding protein 3 level seen after open surgery. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Disability Evaluation, Female, Humans, Male, Middle Aged, Osteoarthritis, Knee, Pain, Predictive Value of Tests, Radiography, Regression Analysis, Surveys and Questionnaires." }, { "role": "user", "content": "Do knee pain and radiographic osteoarthritis interact in the prediction of levels of self-reported disability? Context: To determine predictors of disability depending on whether joint deformity and pain reporting exist independently or concurrently. Subjects were 154 volunteers for an osteoarthritis screening examination. Eligible subjects completed questionnaires for physical function, pain, and depressive symptoms; underwent evoked pain testing for tenderness assessment; and had anteroposterior and lateral radiographs taken of both knees. Two blinded rheumatologists scored the images using Kellgren-Lawrence criteria to determine presence of deformity. Subjects were divided into 3 subgroups based on radiographic evidence of deformity and self-reported pain. Disability was greatest when pain and deformity occurred together (F[2,151] = 18.8, P < 0.0001). Self-reported disability in the absence of deformity was predicted by body mass index, pain threshold, and anxiety symptoms; disability was predicted by the number of osteophytes and depressive symptoms when pain and deformity occurred together." }, { "role": "assistant", "content": "Self-reported disability in osteoarthritis of the knee is greatest with concurrent pain and joint deformity. When pain and deformity do not cooccur, disability appears to be related to separate factors, including anxiety and pain threshold (e.g., tenderness). 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, Cyclooxygenase 1, Cyclooxygenase 2, Cyclooxygenase 2 Inhibitors, Cyclooxygenase Inhibitors, Dinoprostone, Enzyme Induction, Isoenzymes, Membrane Proteins, Mouth Mucosa, Nitric Oxide Synthase, Nitric Oxide Synthase Type II, Oral Ulcer, Prostaglandin-Endoperoxide Synthases, Rats, Rats, Sprague-Dawley, Receptors, Cytoplasmic and Nuclear, Transcription Factors, Wound Healing." }, { "role": "user", "content": "Does activation of peroxisome proliferator-activated receptor gamma suppress inducible cyclooxygenase and nitric oxide synthase during oral mucosal ulcer healing? Context: Peroxisome proliferator-activated receptor-gamma (PPARgamma) is a ligand-dependent transcription factor, belonging to the steroid hormone receptor family, known to play a pivotal role in the resolution of inflammation. In this study, we investigated the effect of a specific PPARgamma ligand, ciglitazone, on the course of buccal mucosal ulcer healing by analyzing mucosal activity of inducible nitric oxide synthase (NOS-2) and the expression cyclooxygenases (COX-1 and COX-2) responsible for prostaglandin (PG) generation. Groups of rats with experimentally induced buccal mucosal ulcers were administered twice daily for up to 10 days with ciglitazone at 5, 10, and 15 mg/kg or the vehicle, and their mucosal tissue subjected to assessment of ulcer healing rate and biochemical measurements. The ulcer onset, characterized by up-regulation of NOS-2 and COX-2 protein expression, was reflected in a marked increase in the mucosal PGE2 generation and NOS-2 activity, whereas healing was accompanied by a drop in PGE2 and NOS-2 activity, and a decrease in COX-2 and NOS-2 protein expression. The mucosal expression of COX-1 protein, however, remained unchanged. Administration of ciglitazone led to a significant dose-dependent acceleration in the mucosal reduction of PGE2 generation and NOS-2 activity, and produced a marked decline in COX-2 and NOS-2 protein expression, but the rate of ulcer healing and the expression of COX-1 protein remained unaffected." }, { "role": "assistant", "content": "Our findings thus suggest that the products of induced NOS-2 and COX-2 enzymes, associated with mucosal inflammatory responses to injury, do not play a significant role in oral mucosal ulcer healing. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: AIMS, CONTEXT, METHOD, RESULTS. Meshes: Analysis of Variance, Education, Medical, Graduate, Health Personnel, Interprofessional Relations, Learning, Patient-Centered Care, Pilot Projects, Surveys and Questionnaires, Teaching, United Kingdom." }, { "role": "user", "content": "Validating the Readiness for Interprofessional Learning Scale (RIPLS) in the postgraduate context: are health care professionals ready for IPL? Context: This paper describes the process of validating the Readiness for Interprofessional Learning Scale (RIPLS) for use with postgraduate health care professionals. The RIPLS questionnaire has proved useful in the undergraduate context, enabling tutors to assess the readiness of students to engage in interprofessional learning (IPL). With the drive in the National Health Service (NHS) to deliver health care in interprofessional teams, it seems logical to ask whether postgraduate education should, or could, be delivered successfully in interprofessional contexts. As a preliminary to undertaking an extended IPL project, the researchers tested the validity of the RIPLS tool in the postgraduate health care context. A modified version of the RIPLS questionnaire was administered to all general practitioners, nurses, pharmacists and allied health professionals in the Dundee Local Health Care Cooperative (LHCC) (n = 799). A total of 546 staff responded (68%). Three factors, comprising 23 statements, emerged from the statistical analysis of the survey data, namely, teamwork and collaboration, sense of professional identity and patient-centredness. The internal consistency measure was 0.76. Analysis of variance suggested some key differences between the different professions in respect of the factors." }, { "role": "assistant", "content": "The RIPLS questionnaire was validated for use in the postgraduate context, thus providing researchers with a tool for assessing health professionals' attitudes towards interprofessional learning at practice level, community health partnership level or at a national level of education and training. Significant differences between professional groups should be taken into account in designing any interprofessional learning programme." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Alcohol Drinking, Animals, Conditioning, Operant, Ethanol, Female, Hybridization, Genetic, Male, Mice, Mice, Inbred C57BL, Mice, Inbred Strains, Models, Genetic, Self Administration, Sex Factors, Species Specificity." }, { "role": "user", "content": "Do hybrid C57BL/6J x FVB/NJ mice drink more alcohol than do C57BL/6J mice? Context: From several recent strain surveys (28 strains: Bachmanov et al., personal communication; 22 strains: Finn et al., unpublished), and from data in >100 other published studies of 24-hr two-bottle ethanol preference, it is known that male C57BL/6 (B6) mice self-administer about 10-14 g/kg/day and that female B6 mice self-administer about 12-18 g/kg/day. No strain has been found to consume more ethanol than B6. In one of our laboratories (Texas), we noted a markedly greater intake of ethanol in an F1 hybrid of B6 and FVB/NJ (FVB) mice. To confirm and extend this finding, we repeated the study at another site (Portland) using concentrations up to 30% ethanol and also tested B6xFVB F1 mice in restricted access drinking procedures that produce high levels of alcohol intake. At both sites, we found that B6xFVB F1 mice self-administered high levels of ethanol during two-bottle preference tests (females averaging from 20 to 35 g/kg/day, males 7-25 g/kg/day, depending on concentration). F1 hybrids of both sexes drank significantly more 20% ethanol than both the B6 and FVB strains. Female F1 hybrids also drank more 30% ethanol. In the restricted access tests, ethanol consumption in the F1 hybrids was equivalent to that in B6 mice." }, { "role": "assistant", "content": "These data show that this new genetic model has some significant advantages when compared to existing inbred strains, and could be used to explore the genetic basis of high ethanol drinking in 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: BACKGROUND, METHODS, RESULTS. Meshes: Cell Line, Tumor, Cell Proliferation, Gene Expression Regulation, Neoplastic, Hodgkin Disease, Humans, Inhibitor of Differentiation Protein 2, Lymphoma, Large-Cell, Anaplastic, Lymphoma, Non-Hodgkin, Lymphoma, T-Cell, Lymphomatoid Papulosis, Proto-Oncogene Proteins c-myc, RNA, Messenger, Skin Neoplasms, Up-Regulation." }, { "role": "user", "content": "Is the helix-loop-helix protein Id2 expressed differentially and induced by myc in T-cell lymphomas? Context: Inhibitor of DNA binding 2 (Id2), a helix-loop-helix protein of the inhibitor of differentiation (ID) family, is involved in hematopoiesis, mainly through interaction with the E-family of transcription factors. Recent studies have shown that Id2 is overexpressed in some types of B-cell lymphoma, including classical Hodgkin lymphoma. The authors of the current study hypothesized that Id2 also is overexpressed in T-cell lymphomas. By using reverse-transcriptase polymerase chain reaction (RT-PCR) and Western blot analyses, high Id2 messenger RNA (mRNA) and protein levels, respectively, were detected in all 4 T-cell anaplastic large cell lymphoma (ALCL) cell lines that were tested. Immunohistochemistry results indicated that Id2 was expressed strongly in 21 of 27 (78%) ALCL tumors (79% anaplastic lymphoma kinase [ALK]-negative and 75% ALK-positive), in 5 of 10 (50%) extranodal natural killer/T (NK/T)-cell lymphomas of the nasal type, in 2 of 8 (25%) cutaneous ALCLs, in 2 of 9 (22%) enteropathy type T-cell lymphomas, in 1 of 5 (20%) peripheral T-cell lymphomas not otherwise specified, and in 1 of 8 (13%) T-cell prolymphocytic leukemias. Other types of T-cell lymphoma were negative for Id2. Because it is known that myc is expressed in ALCL, myc was inhibited selectively in 2 ALCL cell lines, resulting in a concentration-dependent decrease in Id2 mRNA and protein levels. Conversely, forced expression of myc in HEK 293T cells using an myc/green fluorescent protein adenoviral vector resulted in Id2 up-regulation." }, { "role": "assistant", "content": "Taken together, the current data suggest that Id2 commonly is overexpressed in highly proliferative T-cell lymphomas, and its expression may result from transcriptional activation of myc in these tumors. 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, Blood Glucose, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Insulin, Insulin Resistance, Kidney Failure, Chronic, Male, Middle Aged, Peritoneal Dialysis, Skin Pigmentation, Treatment Outcome." }, { "role": "user", "content": "Is skin color associated with insulin resistance in nondiabetic peritoneal dialysis patients? Context: Changes in skin color are common among dialysis patients. They are associated with urochrome pigments, hemoglobin, and changes in cutaneous vasculature. Insulin resistance (IR) is strongly linked to cutaneous vascular dysfunction and is prevalent in dialysis patients. We postulated skin color may be associated with IR in dialysis patients because of the alternation in cutaneous vasculature. 50 nondiabetic peritoneal dialysis (PD) patients were recruited for measurements of skin color by the Commission Internationale de I'Eclairage (CIE; International Commission on Illumination) system (\"L\" \"a\" \"b\" system). The \"L\" values represent skin brightness, \"a\" redness, and \"b\" yellowness. Correlation analysis between skin color, homeostatic model assessment (HOMA(IR)), high-density lipoprotein cholesterol (HDL-C), and adiponectin was performed. We divided patients (age 45 +/- 13 years, 31 women) into 3 groups according to tertiles of HOMA(IR). Patients with higher HOMA(IR) had a trend to have poor skin color (lower \"a\" and \"b\" values; p = 0.038 and 0.064). HOMA(IR), adiponectin, and HDL-C levels were correlated with \"a\" and \"b\" values in logarithm (all p < 0.05). After adjustments for age, hemoglobin level, duration of PD, and residual renal glomerular filtration rate, only HOMA(IR) was associated with \"a\" values (p = 0.038) and HDL-C was associated with \"b\" values (p = 0.048) in logarithm." }, { "role": "assistant", "content": "Skin color, measured noninvasively, is associated with HOMA(IR) and HDL-C. Nondiabetic PD patients that had more severe IR had worse skin color. 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, Biomarkers, Cartilage, Cohort Studies, Disease Progression, Female, Humans, Linear Models, Longitudinal Studies, Male, Matrix Metalloproteinase 3, Middle Aged, Osteoclasts, Predictive Value of Tests, Prospective Studies, Radiography, Severity of Illness Index, Spine, Spondylitis, Ankylosing." }, { "role": "user", "content": "Is serum matrix metalloproteinase 3 an independent predictor of structural damage progression in patients with ankylosing spondylitis? Context: In prospective studies, only baseline radiographic damage has been identified as an independent predictor of radiographic progression in ankylosing spondylitis (AS). Several biomarkers have been identified as independent predictors of radiographic progression in rheumatoid arthritis, however, and these may be of use in AS. This study was undertaken to analyze serologic biomarkers as predictors of radiographic progression in AS. We measured a panel of biomarkers reflecting cartilage turnover and osteoclasis. These biomarkers were cartilage oligomeric matrix protein, human cartilage gp-39 (YKL-40), type II collagen epitopes detected by the C2C and C1,2C degradation assays and the CPII synthesis assay, aggrecan 846 epitope, osteoprotegerin, and matrix metalloproteinase 3 (MMP-3). The analysis was performed in a cohort of AS patients from the Netherlands, Belgium, and France enrolled in a longitudinal study, the Outcome Assessments in Ankylosing Spondylitis International Study. We examined 2-year radiographic progression data scored using the modified Stoke AS Spine Score (mSASSS). Complete data were available on 97 patients. Only the biomarkers YKL-40 and MMP-3 showed weak to moderate univariate correlation with 2-year progression. After adjustment for sex, age, disease duration, C-reactive protein level, and baseline mSASSS, only MMP-3 was significantly associated with 2-year progression (beta = 0.29, P = 0.004). Logistic regression analysis revealed MMP-3 (cutoff 68 ng/ml; odds ratio 9.4 [95% confidence interval 1.6-56]) and baseline mSASSS (cutoff 10 mSASSS units; odds ratio 18.6 [95% confidence interval 2.5-138]) as the only independent predictors of 2-year progression (cutoff 3 mSASSS units; model R(2) = 50%). MMP-3 was primarily contributory in patients who already had substantial baseline damage (>10 mSASSS units)." }, { "role": "assistant", "content": "These results indicate that MMP-3 is a significant independent predictor of radiographic progression in patients with AS, particularly in those with preexisting radiographic damage. 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, Atherosclerosis, Blood Glucose, Cardiovascular Diseases, Child, Cross-Sectional Studies, Female, Homocysteine, Humans, Lipid Metabolism, Male, Nitric Oxide, Nitric Oxide Synthase, Oxidative Stress, Phenylalanine, Phenylketonurias." }, { "role": "user", "content": "Is free asymmetric dimethylarginine ( ADMA ) low in children and adolescents with classical phenylketonuria ( PKU )? Context: Free asymmetric dimethylarginine (ADMA) is a competitive inhibitor of the nitric oxide synthases (NOS). Suppression of nitric oxide (NO) synthesis increases the risk of atherosclerosis. Nevertheless, in the condition of oxidative stress, NOS blockade by ADMA may exert protective effects. Protein metabolism is altered in patients with phenylketonuria (PKU) on dietary treatment and as shown recently, oxidative stress is high in PKU. Since free ADMA concentrations are determined by both protein metabolism and oxidative stress we hypothesized, that free ADMA levels may be elevated in PKU patients. Sixteen patientswith PKU on dietary treatment (mean age 10.1 ± 5.2 yrs), and 91 healthy children (mean age 11.6 ± 3.7 yrs) participated in a cross sectional study. ADMA, total homocysteine (tHcy) and blood glucose were lower and the L-arginine/ADMA ratio was higher in PKU patients compared to controls. No significant correlation was present between phenylalanine (Phe) concentrations, protein intake, and lipid profile, history of cardiovascular disease or ADMA." }, { "role": "assistant", "content": "In contrast to our hypothesis, ADMAwas lower and the L-arginine/ADMA ratio was higher in PKU patients. Therefore, in PKU patients, the regulating function of ADMA on NO synthesis is altered and may thus contribute to oxidative 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: BACKGROUND, RESULTS. Meshes: Animals, CD8-Positive T-Lymphocytes, Cytotoxicity, Immunologic, Enzyme-Linked Immunosorbent Assay, Female, Flow Cytometry, Humans, Immunoenzyme Techniques, Intercellular Adhesion Molecule-1, Lymphocyte Depletion, Lymphocytes, Tumor-Infiltrating, Mammary Neoplasms, Experimental, Mice, Transfection, Tumor Cells, Cultured, Tumor Necrosis Factor-alpha, Up-Regulation." }, { "role": "user", "content": "Is treatment of established tumor associated with ICAM-1 upregulation and reversed by CD8 depletion in a tumor necrosis factor-alpha gene transfected mouse mammary tumor? Context: We have performed TNF-alpha gene transfection in a mouse mammary cancer line and found significant antitumor effects. We hypothesize that the antitumor effects observed in this model are mediated by ICAM-1 and by the recruitment of CD4+ and CD8+ T cells. In vivo (Balb/c mice) tumor growth inhibition, treatment of established tumor and the effects of ICAM-1 and CD4+ and CD8+ T cells were evaluated. Gene transfection with highly efficient vectors resulted in secretion of large amounts of TNF-alpha (ELISA). In vivo antitumor effects were tested. The number of cells required to generate palpable tumor 7-10 days after subcutaneous injection was determined (1 x 10(6)). The same number of transfected cells were injected subcutaneously and compared to nontransfected controls. Tumors were measured blindly and size was analyzed on day 30 by the Wilcoxon rank sum test. Mean tumor size after injection of transfected cells is compared to that of controls. Control tumors reached the maximum allowable size by day 30 (4 cm(2)). On day 30 EMT6-TNF-alpha tumors were 0.48 cm(2) (p < 0.05). The effect of repeat injection (challenge was also tested. Animals were injected with transfected cells or wild-type control on day -6 and challenged with the same number of wild-type tumor cells on day 0. Significant immune protection against subsequent challenge was seen after first time injection with EMT6-TNF-alpha but not after first time EMT6 wild-type injection (1.62 vs. 4 cm(2)). Treatment of 6-day-old tumor was also evaluated. On day 30, mean tumor size in animals treated with EMT6-TNF-alpha was 0.9 cm(2) compared to 4 cm(2) for controls. In all experiments, CD8+ T cell depletion and CD4+ T cell depletion caused a reversal of TNF-alpha-induced inhibitory effects. In addition, in vivo antibody blocking of ICAM-1 in tumor growth experiments reversed antitumor effects (control 4 cm(2), TNF-alpha 0.2 cm(2) and ICAM-1 blocking 3.14 cm(2)). Using flow cytometry, MHC class I and II and ICAM-1 adhesion molecule expression of transfected tumor was tested. ICAM-I expression was significantly upregulated. MHC class II antigen expression was also increased. TNF-alpha-transfected human breast cancer was also evaluated. Three cell lines and fresh tumor were transfected to express TNF-alpha. In vitro analysis revealed ICAM-1 upregulation following transfection. Histologic analysis and immunohistochemical staining revealed TNF-alpha and ICAM-1 in transfected tumors and not in wild-type tumors." }, { "role": "assistant", "content": "Highly significant in vivo tumor growth inhibition and immune protection after injection with TNF-alpha-transfected tumors appears to be mediated predominantly by CD8+ T cells and ICAM-1 upregulation. These findings suggest that TNF-alpha increases recruitment and adhesion of effector T 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": "Drug used in glaucoma is:" }, { "role": "assistant", "content": "The correct answer is C i.e.Timolol" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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 AND RESULTS. Meshes: Caenorhabditis elegans Proteins, Cell Proliferation, Cells, Cultured, Gene Knockdown Techniques, Humans, Muscle, Smooth, Vascular, Myocytes, Smooth Muscle, RNA, Long Noncoding, Saphenous Vein." }, { "role": "user", "content": "Does smooth Muscle Enriched Long Noncoding RNA ( SMILR ) regulate Cell Proliferation? Context: Phenotypic switching of vascular smooth muscle cells from a contractile to a synthetic state is implicated in diverse vascular pathologies, including atherogenesis, plaque stabilization, and neointimal hyperplasia. However, very little is known about the role of long noncoding RNA (lncRNA) during this process. Here, we investigated a role for lncRNAs in vascular smooth muscle cell biology and pathology. Using RNA sequencing, we identified >300 lncRNAs whose expression was altered in human saphenous vein vascular smooth muscle cells following stimulation with interleukin-1α and platelet-derived growth factor. We focused on a novel lncRNA (Ensembl: RP11-94A24.1), which we termed smooth muscle-induced lncRNA enhances replication (SMILR). Following stimulation, SMILR expression was increased in both the nucleus and cytoplasm, and was detected in conditioned media. Furthermore, knockdown of SMILR markedly reduced cell proliferation. Mechanistically, we noted that expression of genes proximal to SMILR was also altered by interleukin-1α/platelet-derived growth factor treatment, and HAS2 expression was reduced by SMILR knockdown. In human samples, we observed increased expression of SMILR in unstable atherosclerotic plaques and detected increased levels in plasma from patients with high plasma C-reactive protein." }, { "role": "assistant", "content": "These results identify SMILR as a driver of vascular smooth muscle cell proliferation and suggest that modulation of SMILR may be a novel therapeutic strategy to reduce vascular pathologies. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, MATERIALS AND METHODS, RESULTS. Meshes: Adult, Aged, Chemoradiotherapy, Adjuvant, Diffusion Magnetic Resonance Imaging, Female, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Prognosis, Prospective Studies, Rectal Neoplasms, Reproducibility of Results, Signal Processing, Computer-Assisted, Treatment Outcome." }, { "role": "user", "content": "Can diffusion-weighted MRI determine complete responders after neoadjuvant chemoradiation for locally advanced rectal cancer? Context: We aimed to prospectively determine if analyzing pre- and post-chemoradiotheraphy (CRT) changes in the signal intensity (SI) and apperent diffusion coefficient (ADC) values from diffusion-weighted magnetic resonance imaging (DW-MRI) can accurately predict complete responders for locally advanced rectal cancer. Thirty patients (mean age, 54.3 years) with locally advanced rectal cancer who underwent neoadjuvant CRT and subsequent surgery were included in this study. All patients were evaluated pre- and post-CRT by standardized turbo spin echo and DW-MRI. Pre- and post-CRT tumor and normal rectal wall SI (which were gradually scored as very high, high, intermediate, low, and no signal) and ADC values were recorded. Tumor SIs were decreased in all of the patients that had a therapy response. However, complete tumor SI loss was only seen in two (22.2%) of nine patients with a pathological complete response, while it regressed to low and/or intermediate SI levels in the remaining seven patients (77.8%). Post-CRT ADC values of rectal tumors were significantly higher from the preCRT ADC values (P<0.0001; Z=-9.39). However, post-CRT ADC values from the complete and partial/no response patient groups were not significantly different (P = 0.071; Z=-1.99)." }, { "role": "assistant", "content": "In re-staging of rectal tumors by DW-MRI, an increase in ADC values and decrease in SIs can predict therapy response but cannot unequivocally determine a complete response." } ]

[ { "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 forms the boundaries of the quadrangular space which is present under the deltoid muscle in the shoulder region, from the posterior side, EXCEPT:" }, { "role": "assistant", "content": "The correct answer is Structures forming the boundaries of the quadrangular space from the posterior side are:Superiorly by teres minorInferiorly by teres majorLaterally by surgical neck of humerusMedially by long head of triceps brachiiContents of the quadrangular space are:Axillary nervePosterior circumflex humeral vesselsSagging pa of shoulder joint capsuleRef: Clinical Anatomy: (a Problem Solving Approach) By Kulkarni page 110." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND AND PURPOSE, METHODS, RESULTS. Meshes: Adult, Athletic Injuries, Atrophy, Boxing, Brain, Brain Injury, Chronic, Diffusion Magnetic Resonance Imaging, Dominance, Cerebral, Humans, Male, Middle Aged, Reference Values." }, { "role": "user", "content": "Increased diffusion in the brain of professional boxers: a preclinical sign of traumatic brain injury? Context: Professional boxing is associated with chronic, repetitive head blows that may cause brain injuries. Diffusion-weighted imaging is sensitive to microscopic changes and may be a useful tool to quantify the microstructural integrity of the brain. In this study, we sought to quantify microscopic alterations associated with chronic traumatic brain injury in professional boxers. MR and diffusion-weighted imaging were performed in 24 boxers and in 14 age- and sex-matched control subjects with no history of head trauma. Using distribution analysis, the average diffusion constant of the entire brain (BD(av)) and diffusion distribution width (sigma) were calculated for each subject; findings in professional boxers were compared with those of control subjects. In the boxer group, correlations between diffusion changes and boxing history and diffusion changes and MR imaging findings were assessed. The measured diffusion values in the boxer group were significantly higher than those measured in the control group (BD(av), P<.0001; sigma, P<.01). In the boxer group, a robust correlation was found between increased BD(av) and frequency of hospitalization for boxing injuries (r = 0.654, P<.05). The most common MR finding in the boxer group was volume loss inappropriate to age followed by cavum septum pellucidum, subcortical white matter disease, and periventricular white matter disease." }, { "role": "assistant", "content": "Boxers had higher diffusion constants than those in control subjects. Our data suggest that microstructural damage of the brain associated with chronic traumatic brain injury may elevate whole-brain diffusion. This global elevation can exist even when routine MR findings are normal." } ]

[ { "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": "Segmented genome is found in -" }, { "role": "assistant", "content": "The correct answer is Rotavirus has a characteristics appearance on electron microscopy resembling little wheel with sho spokes REF:ANANTHANARYANAN TEXT BOOKS OF MICROBIOLOGY 9EDITION PGNO.560" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Female, Fundoplication, Gastroesophageal Reflux, Humans, Laparoscopy, Male, Middle Aged, Prospective Studies." }, { "role": "user", "content": "Laparoendoscopic single site (LESS) vs. conventional laparoscopic fundoplication for GERD: is there a difference? Context: This report details our experience with laparoendoscopic single site (LESS) fundoplication for GERD and provides a comparison to earlier contiguous patients undergoing conventional laparoscopic fundoplication. With institutional review board approval, symptoms before and after LESS fundoplications and conventional laparoscopic fundoplications were scored by patients. Outcomes after 130 consecutive LESS fundoplications were compared to 130 contiguous consecutive outcomes after conventional laparoscopic fundoplications. Patients undergoing conventional laparoscopic vs. LESS fundoplication were very similar. There were no conversions to \"open\" operations and no notable complications with LESS fundoplication. Symptom reduction was broad and dramatic for patients undergoing LESS or conventional laparoscopic fundoplication; 96 % of patients who underwent LESS fundoplication scored their incision as ≥8 (1 = revolting to 10 = beautiful)." }, { "role": "assistant", "content": "Relative to conventional laparoscopy, LESS surgery provides excellent resolution of symptoms without an apparent scar. In comparison to conventional laparoscopy, LESS fundoplication is as safe with similar symptom improvement and superior cosmesis." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Administration, Intravesical, Animals, Cystitis, Disease Models, Animal, Female, Hyaluronic Acid, Hydrochloric Acid, Rats, Rats, Sprague-Dawley, Urinary Bladder, Urination, Urocanic Acid." }, { "role": "user", "content": "Does intravesical treatment with cis-urocanic acid improve bladder function in rat model of acute bladder inflammation? Context: The aim was to study the effect of intravesically instilled cis-urocanic acid (cis-UCA) on bladder function in an experimental rat model of acute bladder inflammation. Hyaluronic acid (HA) was used as a comparator compound. Bladder irritation was induced in female rats by intravesical hydrochloric acid (HCl) infusion. Vehicle, 0.5% HA, or 2% cis-UCA solutions were infused intravesically twice a day for three consequent days. On the fourth day, urodynamical measurements were performed, the animals were sacrificed, and the bladders were removed for histopathological assessment. HCl treatment caused significant impairment of bladder function indicated by decreased micturition intervals and voided urine volumes and induced severe voiding dysfunction observed as occurrence of overflow incontinence. These functional changes were accompanied by increased bladder weight, hemorrhage, and infiltration of inflammatory cells into the urothelium. Intravesical cis-UCA treatment recovered bladder function by significantly prolonging the micturition interval, increasing the voided volume, and reducing the occurrence of overflow incontinence. All these changes were comparable to the effects of HA." }, { "role": "assistant", "content": "Intravesical administration of cis-UCA was able to partially recover bladder function impaired by chemical irritation. Cis-UCA may offer a novel intravesical treatment option in some inflammatory conditions of the bladder. Neurourol. Urodynam. 35:786-791, 2016. © 2015 Wiley Periodicals, Inc. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 52-year-old woman comes to the physician because of a 3-month history of worsening chest pain and breathlessness during exercise. She has no history of serious illness and takes no medications. Vital signs are within normal limits. Auscultation of the chest shows a murmur in the 2nd right intercostal space. A phonocardiogram of the murmur is shown. Which of the following is the most likely underlying cause of this patient's symptoms?" }, { "role": "assistant", "content": "Congenital leaflet fusion" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Body Mass Index, Female, Fiber Optic Technology, Gastric Bypass, Humans, Intubation, Intratracheal, Laparoscopy, Male, Middle Aged, Obesity, Morbid, Preoperative Care, Prospective Studies, Retrospective Studies." }, { "role": "user", "content": "Predictors of a difficult intubation in the bariatric patient: does preoperative body mass index matter? Context: The incidence of difficult intubations in morbidly obese patients has been reported to be 12-20%; however, no well-established predictors of a difficult intubation exist for this patient population. Our objective was to evaluate the factors associated with a difficult intubation in morbidly obese patients undergoing laparoscopic Roux-en-Y gastric bypass at an integrated multispecialty health system with a 325-bed community teaching hospital serving 19 counties. The anesthetic records of patients undergoing LRYGB from 2001 to 2010 were reviewed. Difficult intubations were defined as direct laryngoscopy graded ≥1 on a 0-2 difficulty scale and unplanned fiberoptic intubations. Statistical analysis included chi-square, univariate, and multivariate logistic regression. A total of 915 consecutive patients underwent LRYGB during the study period. Of these, 3 patients were excluded because of incomplete data. Of the 912 included patients, 25 (2.7%) underwent planned fiberoptic intubation, 830 (91%) had an uneventful intubation, and 57 (6.3%) had a difficult intubation. Difficult intubations were more common in men than in women (11% versus 6%, P = .027). Difficult intubations were not associated with an increasing preoperative body mass index (P = .073), the presence of obstructive sleep apnea (P = .784), or the presence of gastroesophageal reflux disease (P = .335). Multivariate predictors of a difficult intubation were Mallampati class 4 (odds ratio [OR] 2.76, P = .035), abnormal thyromental distance (OR 4.39, P = .001), restricted jaw mobility (OR 3.26, P = .018), and a history of a difficult intubation (OR 4.17, P = .002)." }, { "role": "assistant", "content": "An increased Mallampati class, abnormal thyromental distance, restricted jaw mobility, and a history of difficult intubations were independent predictors of a difficult intubation. An increasing body mass index did not predict for a difficult intubation." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is a less useful diagnostic procedure in a case of acute haematemesis?" }, { "role": "assistant", "content": "The correct answer is Ans. Barium meal" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adult, Cross-Sectional Studies, Female, Humans, Humerus, Male, Muscle Strength, Muscle, Skeletal, Range of Motion, Articular, Rotation, Rotator Cuff, Scapula, Shoulder, Shoulder Joint, Torque, Young Adult." }, { "role": "user", "content": "Does humeral elevation reduce the dynamic control ratio of the shoulder muscles during internal rotation? Context: To determine the differences in the dynamic control ratio of the glenohumeral joint rotators, during internal rotation at 20° and 60° of humeral elevation in the scapular plan. Dynamic control ratio (DCR) is defined as the ratio between eccentric action of the lateral rotators and the concentric action of the medial rotators. A cross-sectional laboratory study. Thirty asymptomatic participants (men n=14, women n=16, mean age=29.4±8.9years, BMI: 24.1±5.4) were tested. Peak torque generated by the concentric action of the MR and the eccentric action of the LR of the shoulder joint and the DCR were evaluated on the dominant arm using an isokinetic dynamometer at 20° and 60° of humeral elevation at a speed of 20°/s. There was a significant decrease in the DCR at 60° humeral elevation when compared to 20° humeral elevation (p<0.05). This decrease was due to the significant decrease in eccentric peak torques at 60° humeral elevation when compared to 20° (p<0.05). However, there was no significant difference in the concentric peak torques between 20° and 60° (p>0.05)." }, { "role": "assistant", "content": "The significant decrease in the DCR as a consequence of a decrease in the eccentric peak torque of the LR when the humerus is in a more elevated position suggests that the introduction of humeral elevation can be used as a progression for improving the eccentric action of the shoulder LR and subsequently the dynamic control of the shoulder. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Age Distribution, Australia, Chlamydia, Chlamydia Infections, Community Health Services, Female, Health Services, Indigenous, Humans, Male, Mass Screening, Oceanic Ancestry Group, Retrospective Studies, Sentinel Surveillance, Sex Distribution, Young Adult." }, { "role": "user", "content": "Does chlamydia sentinel surveillance in Aboriginal Community Controlled Health Services found higher testing and positivity rates among younger people? Context: To measure chlamydia testing and positivity rates among 16-39 year olds attending Aboriginal Community Controlled Health Services (ACCHSs). Retrospective non-identifiable computerised records containing consultation and chlamydia testing data were collected for patients (16-39 years) attending eight ACCHSs during 2008-09 in urban, regional and remote settings for the Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) system. Annual chlamydia testing and positivity rates were estimated. Over two years, 13,809 patients aged 16-39 years (57.8% female, 82.3% Aboriginal or Torres Strait Islander) attended. The annual overall chlamydia testing rate was 13.0% (2008) and 16.0% (2009). Testing rates were higher among females (p<0.001) and among patients aged 16-29 than 30-39 years (males: p=0.01; females: p<0.001). Chlamydia positivity was 8.5% overall; similar in females (8.7%) and males (7.8%) (p=0.46); highest among 16-19 years (females: 17.4%; males: 13.0%), declining to 1.5% among females 35-39 years (p<0.001) and 4.8% among males 30-34 years (p<0.001)." }, { "role": "assistant", "content": "Chlamydia testing at these ACCHSs approached recommended levels among some patient groups, however, it should increase. High positivity among younger people highlights they should be targeted. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS. Meshes: Adenocarcinoma, Mucinous, Adenocarcinoma, Papillary, Blotting, Western, Humans, Immunohistochemistry, Immunoprecipitation, Pancreatic Cyst, Pancreatic Neoplasms, Plectin, Sensitivity and Specificity." }, { "role": "user", "content": "Is plectin-1 a biomarker of malignant pancreatic intraductal papillary mucinous neoplasms? Context: Pancreatic intraductal papillary mucinous neoplasms (IPMN) are now identified with increasing frequency. The detection of carcinoma in IPMN is difficult and suffers from high false-positive and false-negative rates, often resulting in inappropriate treatment decisions. Improved detection of malignancy using novel biomarkers may therefore improve diagnostic accuracy. One such promising novel biomarker is Plectin-1 (Plec-1). Using immunohistochemistry, Plec-1 expression was assayed in benign (low and moderate dysplasia, n = 6) as well as malignant IPMN (high-grade dysplasia and invasive carcinoma, n = 31) and lymph node metastases from carcinoma arising in IPMN (n = 12). Furthermore, cyst fluids from benign (n = 3) and malignant IPMN (n = 4) were evaluated for Plec-1 expression." }, { "role": "assistant", "content": "Twenty-six of 31 malignant IPMN and all 12 lymph node metastases were Plec-1 positive. In contrast, only one of six benign IPMN expressed Plec-1. The specificity of Plec-1 in distinguishing malignant IPMN from benign IPMN was 83% and its sensitivity 84%. Furthermore, all (four out of four) cyst fluids from malignant IPMN, but none of the three benign IPMN, were Plec-1 positive. These data support Plec-1 as an excellent biomarker for the early detection of carcinoma arising in IPMN. 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, METHOD, RESULTS. Meshes: Adult, Female, Follow-Up Studies, Gastroplasty, Humans, Male, Middle Aged, Obesity, Morbid, Patient Satisfaction, Silicones, Treatment Outcome, Weight Loss." }, { "role": "user", "content": "Adjustable silicone gastric banding: can We continue the original technique of Kuzmak? Context: Kuzmak developed a horizontal gastroplasty for morbid obesity using his adjustable silicone gastric banding (ASGB). The aim of this study was to evaluate the efficiency at weight loss, early and late morbidity and mortality. The records of 44 patients (mean age 36 years) were reviewed. The indication for ASGB was a BMI>40 (group A = 37 patients) or a BMI between 35 and 40 with obesity-related morbidity (group B = 7 patients). The mean preoperative BMI was 44 (+/-5). The paired t test was used to evaluate the BMI. Early complications occurred in 5 patients: splenic injury (n = 1), aspiration pneumonia (n = 1), wound infection (n = 1), gastric perforation (n = 2); mortality was 2%. Late complications occurred in 19 patients: 17 patients (39%) had a functional stenosis with pouch dilatation (FSPD) and 6 patients had an injection port leakage (14%). At the 1-year follow-up, the mean BMI (of the 39 patients available) was 30 (+/-5) and remained stable. At 36 months, 54% of group A and 100% of group B had a BMI<30." }, { "role": "assistant", "content": "The original technique of Kuzmak is effective to lose weight. However the technique must be adjusted in order to decrease the unacceptable high incidence of FSPD." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adipocytes, Adipose Tissue, Adult, Body Mass Index, Cell Differentiation, Cells, Cultured, Cross-Sectional Studies, Enzyme-Linked Immunosorbent Assay, Eye Proteins, Female, Hep G2 Cells, Humans, Insulin Resistance, Liver, Longitudinal Studies, Male, Nerve Growth Factors, Obesity, Morbid, Real-Time Polymerase Chain Reaction, Serpins, Spain." }, { "role": "user", "content": "Is liver , but not adipose tissue PEDF gene expression associated with insulin resistance? Context: Recent studies linked circulating pigment epithelium-derived factor (PEDF) to obesity-associated insulin resistance, but the main source of circulating PEDF is unknown. We aimed to investigate liver and adipose tissue PEDF gene expression in association with obesity and insulin resistance. Three (two cross-sectional and one longitudinal) independent cohorts have been studied, for adipose tissue (n=80 and n=30) and liver gene expression (n=32 and n=14). Effects of high glucose and cytokines on HepG2 cell line were also investigated. PEDF gene expression and circulating PEDF were analyzed using real-time PCR and ELISA, respectively. In a first cohort of subjects, PEDF relative gene expression was higher in subcutaneous (SC) than in omental (OM) adipose tissue (P<0.0001) being also higher in mature adipocytes compared with stromo-vascular cells (P<0.0001). However, OM PEDF relative gene expression was decreased in morbidly obese subjects (P=0.01). Both OM PEDF and OM PEDF receptor (PEDFR) correlated positively with lipogenic and lipolytic genes, and with genes implicated in the lipid vacuole formation. Circulating PEDF levels were not associated with fat PEDF gene expression. In the second cohort, SC PEDF was decreased in subjects with type 2 diabetes and did not change significantly after weight loss. We next explored circulating PEDF in association with markers of liver-related insulin resistance injury (alanine aminotransferase, r=0.59, P=0.001). Interestingly, liver PEDF gene expression increased with obesity and insulin resistance in men, being significantly associated with fasting glucose and glycated hemoglobin in two independent cohorts. In fact, high glucose led to increased PEDF in HepG2 cells, while inflammatory stimuli present in the adipose tissue environment downregulated PEDF." }, { "role": "assistant", "content": "Liver, but not adipose tissue, might be the source of increased circulating PEDF linked to insulin resistance. 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": "Naegler's reaction is due to -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Lecithinase o Two important characteristic feature of Cl. perfringens are:-1) Target hemolysis (double zone hemolysis) on blood agar. It is a narrow zone of complete hemolysis by theta toxin which is surrounded by a wider incomplete hemolysis by alpha-toxin.2) Naegler's reaction detects alpha toxin (phospholipase or lecithinase C). When Cl. perfringens is grown on a medium with the antitoxin spread on one half of the plate, colonies on the other half without the antitoxin will be surrounded by a zone of opacity. There will be no opacity around the colonies on the half of the plate with the antitoxin, due to the specific neutralisation of the alpha-toxin." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Bacterial Proteins, Cluster Analysis, DNA-Directed RNA Polymerases, Environmental Microbiology, Evolution, Molecular, Gene Transfer, Horizontal, Genome, Bacterial, Genomic Islands, Genomics, Humans, Molecular Sequence Data, Open Reading Frames, Phylogeny, Sequence Analysis, DNA, Sequence Homology, Amino Acid, Sequence Homology, Nucleic Acid, Synteny, Vibrio, Virulence Factors." }, { "role": "user", "content": "Does comparative genomic analysis reveal evidence of two novel Vibrio species closely related to V. cholerae? Context: In recent years genome sequencing has been used to characterize new bacterial species, a method of analysis available as a result of improved methodology and reduced cost. Included in a constantly expanding list of Vibrio species are several that have been reclassified as novel members of the Vibrionaceae. The description of two putative new Vibrio species, Vibrio sp. RC341 and Vibrio sp. RC586 for which we propose the names V. metecus and V. parilis, respectively, previously characterized as non-toxigenic environmental variants of V. cholerae is presented in this study. Based on results of whole-genome average nucleotide identity (ANI), average amino acid identity (AAI), rpoB similarity, MLSA, and phylogenetic analysis, the new species are concluded to be phylogenetically closely related to V. cholerae and V. mimicus. Vibrio sp. RC341 and Vibrio sp. RC586 demonstrate features characteristic of V. cholerae and V. mimicus, respectively, on differential and selective media, but their genomes show a 12 to 15% divergence (88 to 85% ANI and 92 to 91% AAI) compared to the sequences of V. cholerae and V. mimicus genomes (ANI <95% and AAI <96% indicative of separate species). Vibrio sp. RC341 and Vibrio sp. RC586 share 2104 ORFs (59%) and 2058 ORFs (56%) with the published core genome of V. cholerae and 2956 (82%) and 3048 ORFs (84%) with V. mimicus MB-451, respectively. The novel species share 2926 ORFs with each other (81% Vibrio sp. RC341 and 81% Vibrio sp. RC586). Virulence-associated factors and genomic islands of V. cholerae and V. mimicus, including VSP-I and II, were found in these environmental Vibrio spp." }, { "role": "assistant", "content": "Results of this analysis demonstrate these two environmental vibrios, previously characterized as variant V. cholerae strains, are new species which have evolved from ancestral lineages of the V. cholerae and V. mimicus clade. The presence of conserved integration loci for genomic islands as well as evidence of horizontal gene transfer between these two new species, V. cholerae, and V. mimicus suggests genomic islands and virulence factors are transferred between these species. 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, Cadherins, Cell Line, Tumor, Colorectal Neoplasms, Epithelial Cells, Female, Humans, LIM-Homeodomain Proteins, Male, Middle Aged, Muscle Proteins, Myofibroblasts, Neoplasm Metastasis, Prognosis, RNA Interference, RNA, Small Interfering, Survival Rate, Transcription Factors, beta Catenin." }, { "role": "user", "content": "Is epithelial expression of FHL2 negatively associated with metastasis-free and overall survival in colorectal cancer? Context: Four-and-a-half LIM domains protein 2 (FHL2) is a component of the focal adhesion structures and has been suggested to have a role in cancer progression. It has been shown to be overexpressed in the colorectal cancer (CRC). Here, we examined a possible prognostic value of FHL2 in CRC. Immunohistochemistry for FHL2 was performed on 296 CRCs without distant metastases at the time of surgery. Staining in the epithelial compartment was quantitatively evaluated using image analysis, and results were related to clinical variables. Antibody specificity was tested using small-interfering RNA transfection in hTERT-immortalised myofibroblasts. Varying degrees of cytoplasmic FHL2 expression by neoplastic epithelial cells were detectable in all cases. Higher FHL2 expression in the epithelial compartment was an independent adverse prognostic factor. Multivariate Cox analysis shows that expression in the tumour invasion front (P<0.001) as well as in the centre of the tumour (P<0.001) was associated with metachronous metastases independently of the clinicopathological variables; expression in the tumour invasion front was also associated with overall survival independently of the clinicopathological variables (P<0.01)." }, { "role": "assistant", "content": "Higher FHL2 expression is involved in CRC progression and correlates with the development of metachronous metastases and overall survival, suggesting that FHL2 is an independent adverse prognostic indicator for CRC. 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: Actin Cytoskeleton, Alismatales, Anthocyanins, Autophagy, Cell Membrane, Cell Nucleus, Cell Wall, Chloroplasts, DNA Fragmentation, Membrane Potential, Mitochondrial, Microscopy, Electron, Transmission, Mitochondria, Plant Cells, Plant Leaves, Vacuoles." }, { "role": "user", "content": "Does the pathway of cell dismantling during programmed cell death in lace plant ( Aponogeton madagascariensis ) leave? Context: Developmentally regulated programmed cell death (PCD) is the controlled death of cells that occurs throughout the life cycle of both plants and animals. The lace plant (Aponogeton madagascariensis) forms perforations between longitudinal and transverse veins in spaces known as areoles, via developmental PCD; cell death begins in the center of these areoles and develops towards the margin, creating a gradient of PCD. This gradient was examined using both long- and short-term live cell imaging, in addition to histochemical staining, in order to establish the order of cellular events that occur during PCD. The first visible change observed was the reduction in anthocyanin pigmentation, followed by initial chloroplast changes and the bundling of actin microfilaments. At this stage, an increased number of transvacuolar strands (TVS) was evident. Perhaps concurrently with this, increased numbers of vesicles, small mitochondrial aggregates, and perinuclear accumulation of both chloroplasts and mitochondria were observed. The invagination of the tonoplast membrane and the presence of vesicles, both containing organelle materials, suggested evidence for both micro- and macro-autophagy, respectively. Mitochondrial aggregates, as well as individual chloroplasts were subsequently seen undergoing Brownian motion in the vacuole. Following these changes, fragmentation of nuclear DNA, breakdown of actin microfilaments and early cell wall changes were detected. The vacuole then swelled, causing nuclear displacement towards the plasma membrane (PM) and tonoplast rupture followed closely, indicating mega-autophagy. Subsequent to tonoplast rupture, cessation of Brownian motion occurred, as well as the loss of mitochondrial membrane potential (ΔΨm), nuclear shrinkage and PM collapse. Timing from tonoplast rupture to PM collapse was approximately 20 minutes. The entire process from initial chlorophyll reduction to PM collapse took approximately 48 hours. Approximately six hours following PM collapse, cell wall disappearance began and was nearly complete within 24 hours." }, { "role": "assistant", "content": "Results showed that a consistent sequence of events occurred during the remodelling of lace plant leaves, which provides an excellent system to study developmental PCD in vivo. These findings can be used to compare and contrast with other developmental PCD examples in plants. 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, Aorta, Aortic Valve, Blood Vessel Prosthesis Implantation, Female, Follow-Up Studies, Heart Arrest, Induced, Heart Valve Prosthesis Implantation, Hospital Mortality, Humans, Male, Middle Aged, Postoperative Complications, Quality of Life, Treatment Outcome." }, { "role": "user", "content": "Does aortic root replacement affect outcome and quality of life? Context: Different studies have analyzed the potential impact of the underlying pathologic process and the use of deep hypothermic circulatory arrest on outcome and quality of life after surgery on the thoracic aorta. The aim of this study is to analyze the impact of different surgical procedures on outcome and quality of life. Between June 2001 and December 2003, 244 patients underwent surgery for various diseases of the ascending aorta with or without involvement of the aortic valve or root. They were divided according to the operative procedure: 76 patients (31.2%) underwent isolated replacement of the ascending aorta, 42 patients (17.2%) received separate aortic valve replacement and supracoronary replacement of the ascending aorta, 86 patients (35.2%) received a mechanical composite graft, and 40 patients (16.4%) received a biologic composite graft. All in-hospital data were assessed, and a follow-up was performed in all survivors after 26.6 +/- 8.8 months, focusing on outcome and quality of life (SF-36). Overall in-hospital mortality was 6.1%, and late mortality was 5.7%, with no significant difference between groups. Independent of the surgical technique and the extent of surgery, there was no difference in quality of life between the surgical collective and an age-matched and sex-matched standard population." }, { "role": "assistant", "content": "Operations of the ascending aorta and aortic valve are very safe, with low in-hospital mortality and favorable midterm outcome regarding late mortality and morbidity. Quality of life after operations of the ascending aorta and aortic valve is equal to a standard population and is not affected by the surgical procedure. Liberal use of aortic root replacement is therefore justified to radically treat the diseased aortic segment. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Alcoholism, Biomarkers, CD13 Antigens, Humans, Middle Aged, Statistics, Nonparametric, Temperance." }, { "role": "user", "content": "Alanine aminopeptidase activity in urine: a new marker of chronic alcohol abuse? Context: The purpose of this study was to evaluate the activity of urinary alanine aminopeptidase (AAP), the enzyme released from the brush border membranes of renal proximal tubules, as a new biological marker of chronic alcohol abuse. The AAP activity was assayed and compared between a group of 76 alcoholics undergoing detoxification and a group of 37 alcoholics abstaining from alcohol for at least 6 weeks. In all patients, the enzyme activity was measured both in untreated urine (uAAP) and after removal of endogenous AAP inhibitors by molecular filtration on Sephadex (eAAP). There was a correlation between the uAAP and eAAP activities in both groups of patients (r = 0.61 and r = 0.81 in abstinent alcoholics and in alcoholics undergoing detoxification, respectively), and both the uAAP activity and the eAAP activity were significantly and markedly higher in alcoholics being detoxified than in their abstinent counterparts. As revealed by receiver operating characteristic analysis, the discriminative power of the eAAP activity assay was higher than that of the uAAP activity assay. The area under the corresponding receiver operating characteristic curves was 0.84 +/- 0.04 and 0.78 +/- 0.05 (mean +/- SE), respectively." }, { "role": "assistant", "content": "The results of this study demonstrate that the assays of urinary AAP activity, which relate to the nephrotoxic effects of alcohol abuse, could be a valuable complement to the other presently used markers of chronic alcohol abuse that are generally based on ethanol hepatotoxicity. Compared with the uAAP activity test, the eAAP activity test is of clear diagnostic advantage." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Analysis of Variance, Angiotensin-Converting Enzyme Inhibitors, Animals, Capillaries, Hindlimb, Hypertension, Ischemia, Male, Models, Animal, Muscle, Skeletal, Peptidyl-Dipeptidase A, Perindopril, Rats, Rats, Inbred SHR, Rats, Inbred WKY, Regional Blood Flow." }, { "role": "user", "content": "Does angiotensin-converting enzyme inhibition improve defective angiogenesis in the ischemic limb of spontaneously hypertensive rats? Context: Natural angiogenesis has been shown to be impaired in spontaneously hypertensive rats (SHR). The purpose of this study was to determine whether pathological angiogenesis in the setting of tissue ischemia is also impaired in SHR, and to what extent it is modified by angiotensin-converting enzyme (ACE) inhibition. Ischemia was induced in the hindlimb of SHR by excision of the femoral artery, after which the animals were randomly assigned to receive low-dose perindopril (sub-antihypertensive, 0.2 mg/kg/day), high-dose perindopril (antihypertensive, 2.0 mg/kg/day), or vehicle for 3 weeks. Wistar-Kyoto rats (WKY) with femoral artery excision served as a control group. Tissue ACE activity in SHR was significantly increased compared to WKY (49.4+/-6.2 vs. 34.0+/-14.2 IU/mg, P<0.01). Administration of perindopril significantly reduced ACE activity in SHR (low dose: 12.4+/-2.3; high dose: 11.0+/-2.1 IU/mg, P<0.005). Angiogenesis of the ischemic limb muscles was significantly impaired at 4 weeks in SHR versus WKY as indicated by the lower capillary density in the former (364.5+/-43.0 vs. 463.8+/-63.0/mm(2), P<0.05) as well as the reduced hindlimb perfusion assessed by laser Doppler imaging (0.86+/-0.08 vs. 1.03+/-0.09, P<0.05). Administration of perindopril significantly augmented both the capillary density (low dose: 494.3+/-69.8; high dose: 543.9+/-76.9/mm(2), P<0.005) and the limb perfusion (low dose: 1.06+/-0.15; high dose: 1.05+/-0.12, P<0.05) of the ischemic limb in SHR." }, { "role": "assistant", "content": "These findings indicate that pathological angiogenesis in the setting of tissue ischemia is impaired in SHR compared with WKY, and that this impairment can be reversed by ACE inhibition. The angiogenic properties of an ACE inhibitor may benefit patients with essential hypertension presenting with lower limb vascular insufficiency. 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: OBJECTIVES, METHODS, RESULTS. Meshes: Acute Disease, Child, Preschool, Female, Head, Humans, Inflammation, Male, Neck, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity, Tomography, X-Ray Computed, Ultrasonography." }, { "role": "user", "content": "Does CT have an additional diagnostic value over ultrasound in the evaluation of acute inflammatory neck masses in children? Context: We assessed the additional value of contrast-enhanced CT versus US for evaluation of acute cervical inflammatory masses and choosing treatment strategy. We retrospectively reviewed 210 files of paediatric patients admitted with an acute inflammatory neck mass from 2005 to 2008 (M:F = 108:102, mean age 4.5 years). All patients underwent diagnostic ultrasound and Doppler of the neck; CT was performed in 25 patients within 2-72 h. Clinical and radiological findings were correlated, and imaging impact on patient management was assessed. In the 210 patients, US provided sufficient information in 184 of 185 (99.5%) patients undergoing only US. In one patient with no sonographic evidence of collection, an abscess was drained surgically on the point of fluctuation. Fluid collections were drained in 17 patients based on US findings; inflammatory processes were managed conservatively in 164. CT provided additional information in 4 of 25 patients (16.0%), revealing airways compromise in 2 and collections in 2." }, { "role": "assistant", "content": "US provided sufficient information about the nature, location, and extent of the inflammatory mass in 97.6% of our patients, suggesting it should be the main, and generally single, imaging technique in these patients. CT should be reserved for patients with an aggravating clinical course and suspicion of deep neck infection or airways compromise." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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 Donors, Enzyme Inhibitors, Factor VIII, Filtration, Freeze Drying, Genotype, Hot Temperature, Kinetics, Nanostructures, Parvovirus B19, Human, Virus Inactivation, Volatilization." }, { "role": "user", "content": "Does inactivation of parvovirus B19 during STIM-4 vapor heat treatment of three coagulation factor concentrate? Context: To enhance the viral safety margins, nanofiltration has been widely integrated into the manufacturing process of plasma-derived medicinal products. Removal of smaller agents such as parvovirus B19 (B19V) by filtration, however, is typically less efficient. Because recent investigations have demonstrated that B19V may be more heat sensitive than animal parvoviruses, the potential B19V inactivation by a proprietary vapor heating procedure (STIM-4) as incorporated into the manufacturing processes of several nanofiltered coagulation factor concentrates was investigated. An infectivity assay based on quantitative reverse transcription-polymerase chain reaction (TaqMan, Applied Biosystems) detection of B19V mRNA after inoculation of a permissive cell line (UT7 Epo S1 cells) was used to investigate the virus inactivation capacity of the STIM-4 vapor heat treatment as used during the manufacture of nanofiltered second-generation Factor VIII inhibitor-bypassing activity (FEIBA), F IX complex, and FVII products. In contrast to animal parvoviruses, both B19V genotypes investigated, that is, 1 and 2, were shown to be surprisingly effectively inactivated by the STIM-4 vapor heat treatment process, with mean log reduction factors of 3.5 to 4.8, irrespective of the product intermediate tested." }, { "role": "assistant", "content": "The newly demonstrated effective inactivation of B19V by vapor heating, in contrast to the earlier used animal parvoviruses, results in significant B19V safety margins for STIM-4-treated coagulation factor concentrates. 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 treatment of choice for a mucocele of gallbladder is:" }, { "role": "assistant", "content": "The correct answer is Ans. (b) CholecystectomyRef: Bailey 26/e p 1107-1108* Early Cholecystectomy is advised for Mucocele as it may get converted to Empyema, Perforation, Gangrene." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, HEK293 Cells, Humans, Hyperalgesia, Leucine, Male, Mice, Inbred C57BL, Morpholines, Oligopeptides, Pain, Protein Kinase Inhibitors, Pyrimidines, Pyrroles, Receptor, PAR-2, Sulfonamides, TRPV Cation Channels, Trypsin." }, { "role": "user", "content": "Does the tyrosine kinase inhibitor bafetinib inhibit PAR2-induced activation of TRPV4 channels in vitro and pain in vivo? Context: Protease-activated receptor 2 (PAR2) is expressed on nociceptive neurons, and can sensitize transient receptor potential (TRP) ion channels to amplify neurogenic inflammation and pain. The mechanisms by which this occurs are not fully understood. PAR2 causes receptor-operated activation of TRPV4 channels and TRPV4 null mice have attenuated PAR2-stimulated neurogenic inflammation and mechanical hyperalgesia. Here we investigate the intracellular signalling mechanisms underlying PAR2-induced TRPV4 channel activation and pain. Responses of non-transfected and TRPV4-transfected HEK293 cells to agonists of PAR2 (trypsin and SLIGRL) and TRPV4 channels (GSK1016790A) were determined using calcium imaging. Inhibitors of TRPV4 channels (HC067047), sarcoendoplasmic reticulum calcium transport ATPase (thapsigargin), Gαq (UBO-QIC), tyrosine kinases (bafetinib and dasatinib) or PI3 kinases (wortmannin and LY294002) were used to investigate signalling mechanisms. In vivo effects of tyrosine kinase inhibitors on PAR2 -induced mechanical hyperalgesia were assessed in mice. In non-transfected HEK293 cells, PAR2 activation transiently increased intracellular calcium ([Ca(2+) ]i ). Functional expression of TRPV4 channels caused a sustained increase of [Ca(2+) ]i , inhibited by HC067047, bafetinib and wortmannin; but not by thapsigargin, UBO-QIC, dasatinib or LY294002. Bafetinib but not dasatinib inhibited PAR2-induced mechanical hyperalgesia in vivo." }, { "role": "assistant", "content": "This study supports a role for tyrosine kinases in PAR2-mediated receptor-operated gating of TRPV4 channels, independent of Gαq stimulation. The ability of a tyrosine kinase inhibitor to diminish PAR2-induced activation of TRPV4 channels and consequent mechanical hyperalgesia identifies bafetinib (which is in development in oncology) as a potential novel analgesic therapy. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, MATERIALS AND METHODS, RESULTS. Meshes: Adult, Amniotic Fluid, Cystatin C, Female, Fetal Diseases, Humans, Predictive Value of Tests, Pregnancy, Prognosis, Ultrasonography, Prenatal, Urinary Bladder Neck Obstruction, Young Adult." }, { "role": "user", "content": "Is cystatin C a promising parameter to determine postnatal outcome of prenatally diagnosed infravesical obstruction? Context: We investigated the prognostic power of cystatin C to determine renal functional outcome in patients with prenatally diagnosed infravesical obstruction. A total of 14 fetuses with ultrasound findings of bladder outlet obstruction were enrolled in the study. Amniotic fluid and fetal urine samples were obtained. Controls consisted of 25 fetuses undergoing amniocentesis for obstetrical reasons. Three consecutive bladder punctures were performed to obtain fetal urine samples. In addition to standard prognostic parameters, cystatin C was measured in urine and amniotic fluid samples. Among the study group 6 pregnancies with poor prognostic parameters were terminated and 5 fetuses died postnatally. Two of 3 fetuses with favorable urinary indices by standard prognostic parameters and relatively low cystatin C levels survived postnatally. Mean serum creatinine was 0.2 mg/dl at 1-year followup after valve ablation. Mean +/- SD fetal urine levels of cystatin C were 1.44 +/- 1.53 mg/l (range 0.05 to 5.62), 1.35 +/- 1.43 mg/l (0.05 to 5.74) and 1.63 +/- 1.46 mg/l (0.05 to 5.89) in consecutive punctures. Mean +/- SD amniotic fluid cystatin C levels were 1.91 +/- 0.46 mg/l (range 1.1 to 2.8) in the study group and 1.12 +/- 0.20 mg/l (0.71 to 1.69) in controls (p = 0.0001). Amniotic fluid cystatin C levels were significantly higher in fetuses with suspected infravesical obstruction (study group and poor prognostic subgroup) compared to controls. There was a significant correlation between fetal urine (second and third punctures) and amniotic fluid in terms of cystatin C level (p = 0.038 and p = 0.04, respectively)." }, { "role": "assistant", "content": "In fetuses with prenatal ultrasound signs consistent with infravesical obstruction urinary levels of cystatin C progressively increase in consecutive samples. Amniotic fluid may represent fetal urine sample in suspected prenatal infravesical obstruction in terms of cystatin C level. Amniotic fluid cystatin C level was significantly increased in obstructed fetuses compared to normal controls. Cystatin C level in amniotic fluid sample may be sufficient to provide prognostic information in prenatally diagnosed infravesical obstruction." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND AND STUDY AIMS, PATIENT AND METHODS, RESULTS. Meshes: Adult, Aged, Esophageal Diseases, Esophageal Stenosis, Esophagoscopy, Female, Foreign-Body Migration, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Retrospective Studies, Self Expandable Metallic Stents, Suture Techniques, Sutures." }, { "role": "user", "content": "Esophageal Stenting With Sutures: Time to Redefine Our Standards? Context: Migration is the most common complication of the fully covered metallic self-expanding esophageal stent (FCSEMS). Recent studies have demonstrated migration rates between 30% and 60%. The aim of this study was to determine the effect of fixation of the FCSEMS by endoscopic suturing on migration rate. Patients who underwent stent placement for esophageal strictures and leaks over the last year were captured and reviewed retrospectively. Group A, cases, were patients who underwent suture placement and group B, controls, were patients who had stents without sutures. Basic demographics, indications, and adverse events (AEs) were collected. Kaplan-Meier analysis and Cox regression modeling were conducted to determine estimates and predictors of stent migration in patients with and without suture placement. Thirty-seven patients (18 males, 48.65%), mean age 57.2 years (±16.3 y), were treated with esophageal FCSEMS. A total of 17 patients received sutures (group A) and 20 patients received stents without sutures (group B). Stent migration was noted in a total of 13 of the 37 patients (35%) [2 (11%) in group A and 11 (55%) in group B]. Using Kaplan-Meier analysis and log-rank analysis, fixation of the stent with suturing reduced the risk of migration (P=0.04). There were no AEs directly related to suture placement." }, { "role": "assistant", "content": "Anchoring of the upper flare of the FCSEMS with endoscopic sutures is technically feasible and significantly reduces stent migration rate when compared with no suturing, and is a safe procedure with very low AEs rates." } ]

[ { "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": "Longest cranial nerve is" }, { "role": "assistant", "content": "The correct answer is The word \"vagus\" means wandering in Latin. This is a very appropriate name, as the vagus nerve is the longest cranial nerve. It runs all the way from the brain stem to pa of the colon. Ref - medscape.com" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All are true about anemia of chronic diseases, except" }, { "role": "assistant", "content": "The correct answer is Ref Harrison 19 th ed pg 628 AI is normo- cytic and normochromic. The iron values usually make the differential diagnosis clear, as the ferritin level is normal or increased and the percent transferrin saturation and TIBC are typically below normal." } ]

[ { "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": "Example of type-I respiratory failure is: March 2010" }, { "role": "assistant", "content": "The correct answer is Ans. D: ARDS" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: AIMS, PATIENTS AND METHODS, RESULTS. Meshes: Adolescent, Bone Lengthening, Bone Substitutes, Bone Transplantation, Calcaneus, Child, Child, Preschool, Female, Flatfoot, Humans, Hydroxyapatites, Ilium, Male, Osteotomy, Pain, Postoperative, Radiostereometric Analysis, Treatment Outcome." }, { "role": "user", "content": "Is structural hydroxyapatite tricalcium-phosphate graft or tricortical iliac crest autograft better for calcaneal lengthening osteotomy in childhood? Context: To compare the structural durability of hydroxyapatite-tricalcium phosphate (HATCP) to autologous iliac crest bone graft in calcaneal lengthening osteotomy (CLO) for pes planovalgus in childhood. We present the interim results of ten patients (HATCP, n = 6 and autograft, n = 5) with a mean age of 11.5 years (8.2 to 14.2) from a randomised controlled non-inferiority trial with six months follow-up. The primary outcome was the stability of the osteotomy as measured by radiostereometric analysis. A non-inferiority margin of ≤ 2 mm osteotomy compression was set. At six months the data showed that the osteotomy had been compressed by a mean 1.97 mm (99.8% confidence interval -1.65 to 5.60) more in the HATCP group than in the autograft group. Migration of the CLO grafted with HATCP stabilised at six months rather than at six weeks with autograft." }, { "role": "assistant", "content": "This is the first randomised trial to compare the efficacy of HATCP graft with autograft in terms of stability of CLO in children. Because of problems with the HATCP the trial was stopped. We do not recommend HATCP graft in its current structure for use in unfixed CLOs. Cite this article: Bone Joint J 2016;98-B:1554-62." } ]

[ { "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 \"Utilization rates\" except:-" }, { "role": "assistant", "content": "The correct answer is Health care delivery indicators Health care utilization indicators Doctor-population ratio Doctor-nurse ratio Population - bed ratio Population per health centre Population per bih attendant % fully immunised infants % pregnant women received ANC % population using contraceptives Bed occupancy rate Average length of stay Bed turnover ratio - Hence, option-1 is answer, as it comes under health care delivery indicators not utilization indicators." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Cholesterol, HDL, Cohort Studies, Female, Humans, Insulin Resistance, Japan, Logistic Models, Male, Middle Aged, Non-alcoholic Fatty Liver Disease, Odds Ratio, ROC Curve, Triglycerides, Ultrasonography." }, { "role": "user", "content": "Is triglycerides to high-density lipoprotein cholesterol ratio an independent predictor of incident fatty liver ; a population-based cohort study? Context: Triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C) has been recommended for surrogates of insulin resistance. However, it remains to be elucidated the association between TG/HDL-C and incident fatty liver. To investigate the association between TG/HDL-C and incident fatty liver. We performed population-based historical cohort study consisted with 4518 healthy Japanese who received yearly health-checkup programmes over decade. Fatty liver was diagnosed using ultrasonography. During the observation periods, 38.8% (case/N = 1023/2637) of men and 17.2% (case/N = 324/1881) of women developed fatty liver. Adjusting odds ratio of TG/HDL-C for incident fatty liver were 1.59 (95% confidence interval (CI) 1.42-1.79, P < 0.0001) in men and 2.50 (95% CI 1.80-3.51, P < 0.0001) in women. In addition, adjusting odds ratio of TG/HDL-C for incident non-alcoholic fatty liver disease were 1.55 (95% CI 1.35-1.77, P < 0.0001) in men and 2.72 (95% CI 1.88-3.95, P < 0.0001) in women. According to the receiver operator characteristic (ROC) analysis, the optimal cut-off point of TG/HDL-C for incident fatty liver was 0.88 (area under the ROC curve (AUC) 0.67 [95% CI 0.65-0.69], sensitivity = 0.64, specificity = 0.60, P < 0.0001) in men and 0.64 (AUC 0.69 [95% CI 0.66-0.72], sensitivity = 0.50, specificity = 0.78, P < 0.0001) in women." }, { "role": "assistant", "content": "The TG/HDL-C could predict the incident fatty liver. Thus, it is important to check TG/HDL-C and lifestyles modification is needed for preventing future fatty liver disease in patients with high TG/HDL-C. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Does low level bacterial endotoxin activate two distinct signaling pathways in human peripheral blood mononuclear cells? Context: Bacterial endotoxin, long recognized as a potent pro-inflammatory mediator in acute infectious processes, has more recently been identified as a risk factor for atherosclerosis and other cardiovascular diseases. When endotoxin enters the bloodstream, one of the first cells activated is the circulating monocyte, which exhibits a wide range of pro-inflammatory responses. We studied the effect of low doses of E. coli LPS on IL-8 release and superoxide formation by freshly isolated human peripheral blood mononuclear cells (PBMC). IL-8 release was consistently detectable at 10 pg/ml of endotoxin, reaching a maximum at 1 ng/ml, and was exclusively produced by monocytes; the lymphocytes neither produced IL-8, nor affected monocyte IL-8 release. Superoxide production was detectable at 30 pg/ml of endotoxin, reaching a maximum at 3 ng/ml. Peak respiratory burst activity was seen at 15-20 min, and superoxide levels returned to baseline by 1 h. IL-8 release was dependent on both membrane-associated CD14 (mCD14) and Toll-like receptor 4 (TLR4. Superoxide production was dependent on the presence of LBP, but was not significantly affected by a blocking antibody to TLR4. Moreover, treatment with lovastatin inhibited LPS-dependent IL-8 release and superoxide production." }, { "role": "assistant", "content": "These findings suggest that IL-8 release and the respiratory burst are regulated by distinct endotoxin-dependent signaling pathways in PBMC in low level of endotoxin exposure. Selectively modulating these pathways could lead to new approaches to treat chronic inflammatory diseases, such as atherosclerosis, while preserving the capacity of monocytes to respond to acute bacterial infections. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "An 81-year-old man with a history of congestive heart failure presents to his cardiologist because he has been feeling increasingly short of breath while lying down. Specifically, he says that he is now no longer able to sleep flat on the bed and instead has to be propped up on multiple pillows. In addition, he has been experiencing increased swelling in his legs. Finally, he reports that he has been experiencing muscle cramping and weakness. He reports that he has been taking a diuretic as prescribed and adhering to a low-salt diet. Physical exam reveals crackles on lung auscultation bilaterally and 2+ pitting edema in his legs bilaterally. Left ventricular ejection fraction (LVEF) is measured by echocardiogram and found to be 36%. This is decreased from his last measurement of 41%. He is put on a second diuretic that is a channel blocker with an additional effect that corrects an electrolyte imbalance in this patient. Which of the following medications is consistent with this description?" }, { "role": "assistant", "content": "Amiloride" } ]

[ { "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": "Commonly used FNAC needle gauge ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., 22-26" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, 80 and over, Analysis of Variance, Chi-Square Distribution, Cholecystectomy, Cholecystitis, Cholecystitis, Acute, Chronic Disease, Elective Surgical Procedures, Female, Gallstones, Humans, Length of Stay, Male, Patient Selection, Retrospective Studies, Risk Factors, Therapeutics, Time Factors." }, { "role": "user", "content": "Surgical management of gallbladder disease in the very elderly: are we operating them at the right time? Context: As life expectancy rises worldwide and the prevalence of gallstones increases with age, the number of very elderly patients requiring treatment for gallstone diseases is increasing. The aim of this study was to compare the results of cholecystectomy in patients 80 years or older according to different clinical presentations. This is a retrospective study of 81 patients 80 years or older. Indications for surgery were stratified into three groups: outpatients (symptomatic chronic cholecystitis), inpatients (complicated gallstone diseases), and urgent patients (acute cholecystitis). Data analysis included age, sex, the American Society of Anesthesiologists score, indication for surgery, length of hospital stay, morbidity, and mortality. The mean age of the patients was 83.9 (range 80-94 years); there were 34 (42%) men. Thirty patients were operated on for acute cholecystitis. Patients in the urgency group significantly required the ICU more often, required a longer hospital stay, and had more complications, with 32% mortality. No differences were found between inpatients and outpatients, with both groups presenting low morbidity, no mortality, and the same postoperative length of stay." }, { "role": "assistant", "content": "More than 80% of the patients were operated on because of complicated gallstone disease. Although the outcomes of patients undergoing semielective cholecystectomy were similar to those of patients treated as outpatients, patients operated with acute cholecystitis presented extremely high morbidity and mortality rates. Thus, we can only recommend that early elective cholecystectomy be performed in elderly patients as soon as they are found to have symptomatic gallstones. Also, further trials are required to elucidate the optimal management of acute cholecystitis in elderly patients." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Biomarkers, Tumor, Carcinoma, Squamous Cell, CpG Islands, DNA Methylation, Disease-Free Survival, Epigenomics, Female, Gene Expression Regulation, Neoplastic, Humans, Intercellular Signaling Peptides and Proteins, Kaplan-Meier Estimate, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local, Predictive Value of Tests, Prognosis, Proportional Hazards Models, Republic of Korea, Sequence Analysis, DNA, Uterine Cervical Neoplasms." }, { "role": "user", "content": "Does clinico-epigenetic combination including quantitative methylation value of DKK3 augment survival prediction of the patient with cervical cancer? Context: DKK3 is a target of methylation in various cancers and has been studied by a non-quantitative method. We assessed the quantitative methylation levels of DKK3 in cervical carcinoma, determined the potential clinical correlations, and tested whether the combination of clinical and epigenetic factors augmented the prediction power of prognosis. Sixty-two patients with cervical squamous cell carcinoma were included in this study. Quantitative methylation levels were evaluated by pyrosequencing. Clinical and pathologic findings were obtained from medical records. Survival data were analyzed using Kaplan-Meier estimates and compared with the log-rank test. The best clinico-epigenetic combinations were found using the Cox proportional hazard model. Four of five CpG positions of DKK3 were strongly methylated in cervical carcinoma compared to normal controls (p = 0.0048). The methylation in positions 1 and/or 2 were stronger in patients with higher serum levels of the SCC tumor marker and/or larger tumors (p = 0.01). The patients with a methylation level ≥26.3 % at position 1 had a lower survival rate than the patients with methylation levels at position 1 that were <26.3 % (p = 0.03). The combination of methylation level of position 1, position 3, age, parametrial invasion, and lymphovascular space invasion (LVSI) have a significant correlation with survival (p = 0.0006). Recurrence was significantly related to the combination of methylation level of position 2, position 3, age, parametrium, and LVSI (p = 0.0041)." }, { "role": "assistant", "content": "DKK3 methylation is unfavorable to prognosis. This study defined a threshold level of methylation associated with recurrence-free survival and, furthermore, identified novel clinico-epigenetic combinations predicting disease survival or recurrence. 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 research group designs a study to investigate the epidemiology of syphilis in the United States. After a review of medical records, the investigators identify patients who are active cocaine users but did not have a history of syphilis as of one year ago. Another group of similar patients with no history of cocaine use or syphilis infection is also identified. The investigators examine the medical charts to determine whether the group of patients who are actively using cocaine was more likely to have developed syphilis over a 6-month period. The investigators ultimately found that the rate of syphilis was 30% higher in patients with active cocaine use compared to patients without cocaine use. This study is best described as which of the following?" }, { "role": "assistant", "content": "Retrospective cohort study" } ]

[ { "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": "Dose of Chloroquine when used for Chemoprohylaxis of Malaria is" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Case-Control Studies, Chi-Square Distribution, Coronary Disease, Death, Sudden, Cardiac, Echocardiography, Electrocardiography, Female, Humans, Incidence, Logistic Models, Male, Oregon, Predictive Value of Tests, Prospective Studies, Risk Assessment, Risk Factors, Ventricular Dysfunction, Left." }, { "role": "user", "content": "Is prolonged QRS duration on the resting ECG associated with sudden death risk in coronary disease , independent of prolonged ventricular repolarization? Context: Abnormalities of ventricular repolarization as well as depolarization have been associated with increased risk of ventricular arrhythmias. To evaluate the relative contribution of these predictors to risk of sudden cardiac death (SCD) in patients with coronary artery disease (CAD). In the ongoing Oregon Sudden Unexpected Death Study, adult residents from the Portland, Oregon, metropolitan area (population ~1 million) who suffered SCD were identified prospectively (2002-2007). Of these, we analyzed the subgroup of SCDs that had a resting 12-lead ECG prior to SCD and also had associated CAD. Comparisons were conducted with a control group of subjects with known CAD but no history of SCD from the same geographic region. Corrected QT interval (QTc), JT interval (JTc), QRS duration (QRSd), and other parameters were measured from ECG prior and unrelated to SCD. Analysis of left ventricular function was limited to those subjects who had undergone echocardiography prior to and remote from SCD. A total of 642 SCD cases (71 ± 13 years, 62% male) were compared to 450 controls (66 ± 12 years, 64% male). SCD cases had significantly longer QRSd (102 ± 25 ms vs 97 ± 20 ms, P = .0008) as well as JTc (348 ± 44 ms vs 339 ± 34 ms, P = .0006) vs controls. In cases with prolonged QRSd, 38% had severe left ventricular systolic dysfunction and 62% had normal, mild, or moderately decreased left ventricular systolic function. In a multivariable model, QRSd, JTc, age, and severe left ventricular systolic dysfunction were independent predictors. There was minimal overlap between prolonged QRSd and JTc in both case and control groups (3% and 4%, respectively)." }, { "role": "assistant", "content": "Prolonged QRSd, JTc, and severe left ventricular systolic dysfunction had independent contributions to risk of SCD in coronary disease, in this community-based setting. 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": "Koplik spots is a feature of -" }, { "role": "assistant", "content": "The correct answer is Presence of Koplik&;s spot is pathognomic of measles. They are like table salt crystals appear on buccal mucosa opposite the first and second lower molars. Ref: PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition pg 147" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adaptation, Psychological, Adolescent, Adult, Cognition, Emotions, Female, Health Status, Humans, Irritable Bowel Syndrome, Male, Middle Aged, Perception, Quality of Life, Severity of Illness Index, Surveys and Questionnaires, Young Adult." }, { "role": "user", "content": "Do illness perceptions mediate the relationship between bowel symptom severity and health-related quality of life in IBS patients? Context: Irritable bowel syndrome (IBS) is a functional bowel disorder with a large negative impact on HRQOL. The present study examines whether severity of bowel symptoms is directly related to HRQOL, and/or indirectly, mediated by the patients' illness perceptions. Patients were recruited from an IBS support group (N = 123), and data were collected online. HRQOL was measured with the Quality of Life Measure for Persons with IBS and illness perceptions with the brief Illness Perception Questionnaire. Mediation models were tested using the bootstrapping procedure developed by Hayes. Irritable bowel syndrome symptom severity is directly related to total HRQOL and its subscales; after entering the mediator variables (i.e. the patients' illness perceptions) into the model, this direct association remained only significant for total HRQOL. The relationship between bowel symptom severity and total HRQOL was partially mediated by illness perceptions, and its relationship with each of the HRQOL subscales was fully mediated by the patients' illness perceptions. Perceived consequences were a mediator of the relationship between bowel symptom severity, total HRQOL as well as its subscales, with the exception of Sexuality." }, { "role": "assistant", "content": "Bowel symptom severity not only has a direct relationship with HRQOL, but also an indirect relationship via the patients' cognitive and emotional representations of their illness. In order to better understand this relationship, future research should not only include illness perceptions but also assess cognitive and behavioural coping responses. Clinicians wanting to improve patients' HRQOL should not only focus on the patients' symptoms, but also on their illness beliefs and coping responses. 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 Patient presents with recurrent episodes of sharp pain over his right cheek that is precipitated on chewing. Between attacks patient is otherwise normal. The most probable diagnosis is?" }, { "role": "assistant", "content": "The correct answer is Answer is B (Trigeminal Neuralgia): Recurrent attacks of sharp pain over the cheek precipitated .from trigger areas or trigger factors such as chewing with the patient being normal in the interval period strongly suggests a diagnosis of Trigeminal Neuralgia. Trigeminal Neuralgia is typically characterized by Paroxysmal attacks of brief electric shock-like pains, abrupt in onset and termination, limited to the distribution of one or more divisions of the trigeminal nerve lasting for a brief period from a fraction of a second to 2 minutes. The most common division of the trigeminal nerve involved in trigeminal neuralgia is the Maxillary division (V2) followed by the mandibular division (V3). The ophthalmic Division (VI) is rarely involved The pain often evokes spasm of the muscle of the face on the affected side. The clinical association between Trigeminal Neuralgia and hemifacial spasm is called Tic Douloureux. Typical Features of Trigeminal Neuralgia (Prosopalgia, Fothergill's disease) Sudden/ Abrupt onset and termination Sharp superficial, stabbing or burning in quality Severe in intensity Brief in duration (lasting for a brief period from a fraction of a second to 2 minutes) Intermittent (Between paroxysms the patient is usually asymptomatic. Following a painful paroxysm there is usually a refractory period during which pain cannot be triggered) Unilateral (The pain never crosses to the opposite side but it may rarely occur bilaterally in which case a central cause such as multiple sclerosis must be considered) Precipitated from trigger areas or by trigger factors in the trigeminal area such as eating or chewing, washing the face, shaving, smoking, talking or brushing the teeth There is no clinically evident neurological deficit Note : Trigeminal Neuralgia is More common with advancing age Trigeminal Neuralgia is More common in women Trigeminal Neuralgia is More common on right side Trigeminal Neuralgia attacks are most frequent during the day (but may awaken the patient at night) Trigeminal Neuralgia most frequently arises from the maxillary division of Trigeminal nerve (V2)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 24-year-old patient complains of diarrhea, vomiting and abdominal pain that was aggravated on ingestion of food since 1 week. The stool microscopy reveals the following. The appropriate treatment for this condition would be" }, { "role": "assistant", "content": "The correct answer is The given clinical picture and the stool microscopy image showing the rhabditiform larva are suggestive of Strongyloidiasis. The most appropriate treatment for this condition would be Ivermectin. Strongyloidiasis is caused by Strongyloides stercoralis. The clinical disease may have cutaneous, pulmonary and intestinal manifestations. Reference: Paniker&;s Textbook of Medical Parasitology 8th edition" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Contrast Sensitivity, Female, Humans, Lens Implantation, Intraocular, Lenses, Intraocular, Male, Middle Aged, Phacoemulsification, Pupil, Treatment Outcome, Visual Field Tests, Visual Fields." }, { "role": "user", "content": "Does the apodized diffractive intraocular lens Acrysof ReSTOR Natural interfere with FDT Matrix perimetry results? Context: To compare the effect of an apodized diffractive intraocular lens (IOL) (Acrysof ReSTOR Natural) and its yellow counterpart (Natural IQ) on frequency doubling technology (FDT) perimetry results. This study included 37 eyes from 22 patients at the 'Centro Oftalmológico Tranjan' who had undergone uncomplicated phacoemulsification and intraocular lens implantation (17 Acrysof ReSTOR Natural, 20 Natural IQ) performed by the same surgeon, at least three months prior to the study. Patients were subject to frequency doubling technology Matrix Perimeter testing. The patients were between 41 to 79 years old (mean, 70.78 +/- 9.83) in the Natural IQ and 49 to 81 years old (mean, 67.11+/- 11.48) in the Acrysof ReSTOR Natural group, and the mean IOP was 13.64 +/- 2.02 mmHg in the Natural IQ 12.94 +/- 1.39 mmHg in the Acrysof ReSTOR Natural group. The mean pupillary diameter under scotopic conditions was 6.63 +/- 1.16 mm in the Natural IQ group and 7.20 +/- 1.8 mm in the Acrysof ReSTOR Natural group (p=0.20). The mean deviation was -1.83 +/- 3.46 dB in the Natural IQ group and -1.77 +/- 3.94 dB in the Acrysof ReSTOR Natural group (p=0.28). The pattern standard deviation was 3.49 +/- 0.79 dB in the Natural IQ group and 3.20 +/- 0.86 dB in the Acrysof ReSTOR Natural group (p=0.27)." }, { "role": "assistant", "content": "There was no difference in the results of FDT Matrix perimetry in eyes that received apodized diffractive IOLs implant or eyes that received monofocal intraocular lens implant." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Bipolar Disorder, Case-Control Studies, Depressive Disorder, Major, Female, Humans, Male, Middle Aged, Psychotherapy, Sucrose, Taste, Young Adult." }, { "role": "user", "content": "Does unipolar depression moderate responses to the Sweet Taste Test? Context: The Sweet Taste Test (STT) measures hedonic responses to sweet tastes and has been linked to both alcoholism and to a family history of alcoholism. However, STT response profiles in unipolar major depressive disorder (MDD), a disorder characterized by anhedonia, have been minimally investigated. Twelve adults with and 15 adults without MDD participated in two identical STT assessments separated by approximately 12 weeks. Between assessments, MDD outpatients received Behavioral Activation Therapy for Depression, a psychotherapy modality designed to increase engagement with rewarding stimuli and reduce avoidance behaviors. Primary-dependent measures included sensitivity to sucrose, hedonic response to sucrose, and designation as a Sweet-Liker or Sweet-Disliker. A total of 75% of adults with MDD were treatment responders. There were no significant differences in STT response profiles between groups overall or at either timepoint. Furthermore, STT profiles of MDD participants did not differ after psychotherapy, relative to baseline." }, { "role": "assistant", "content": "Findings suggest that although anhedonia is a symptom of MDD, the disorder is not characterized by altered responses to sweet tastes. Implications and future directions are discussed. 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": "Indicator used in Horrock's apparatus produces which color in the presence of residual chlaine" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Amyl nitrate is most commonly administered" }, { "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: ." }, { "role": "user", "content": "Do an update on the role of glutamate in the pathophysiology of depression? Context: To review the literature on the involvement of glutamate (Glu), including its interactions with other neurochemical systems, in the pathophysiology of depression. A MEDLINE search using the terms glutamate, depression and major depressive disorder, was performed. Alterations in proteins involved in glutamatergic signalling are implicated in variations in behaviour in animal models of depression. Drugs acting at Glu receptors appear to have antidepressant-like effects in these models, and traditional antidepressant pharmacotherapies act on the glutamatergic system. Recent evidence from genetic studies and in vivo spectroscopy also correlate glutamatergic dysfunction with depression. Trials of N-methyl-d-aspartate receptor antagonists in humans have provided mixed results." }, { "role": "assistant", "content": "A growing body of evidence indicates that the glutamatergic system is involved in the pathophysiology of depression, and may represent a target for intervention. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Cell Count, Corneal Opacity, Corneal Transplantation, Endothelial Cells, Female, Graft Rejection, Kinetics, Rats, Rats, Inbred Lew, Regeneration, Transplantation, Homologous, Wound Healing." }, { "role": "user", "content": "Does corneal allograft endothelial cell replacement represent a reparative response to transplant injury? Context: To elucidate the injury of corneal allograft endothelial cells (ECs) upon rejection and the subsequent replacement process of the cells. The corneal transplantation model in an major histocompatibility complex (MHC) class I/II disparate Dark Agouti (DA)-Lewis combination was used. The rejection kinetics was observed in 16 cases in which the corneal opacity grade was recorded after grafting and after the onset of rejection. Four normal corneas and four allografts were subjected to EC staining to investigate the EC integrity in cases of rejection. Furthermore, a series of rejected allografts were examined and the EC integrity compared at one week, three weeks, three months, and six months after the onset of rejection. All corneal allografts were rejected, resulting in EC integrity loss. However, the allografts recovered transparency around 18 days after the onset of rejection with repaired endothelium by regenerative ECs. Moreover, although the whole endothelium would be fully recovered after rejection, the ratio of regenerative EC density reached only half of normal levels as long as six months after the transplant." }, { "role": "assistant", "content": "Corneal allograft EC replacement represents a reparative response to transplant-related injury. 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": "UJJAWALA scheme was launched by Ministry of Women and Child development to combat:" }, { "role": "assistant", "content": "The correct answer is Ujjawala is a scheme launched by Ministry of Women and Child development in 2007 to combat child trafficking and is being implemented through NGOs. Ref: Park 21st edition, page 542." } ]

[ { "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 is brought to the emergency department 20 minutes after he fell from the roof of his house. On arrival, he is unresponsive to verbal and painful stimuli. His pulse is 72/min and blood pressure is 132/86 mm Hg. A CT scan of the head shows a fracture in the anterior cranial fossa and a 1-cm laceration in the left anterior orbital gyrus. If the patient survives, which of the following would ultimately be the most common cell type at the injured region of the frontal lobe?" }, { "role": "assistant", "content": "Astrocytes" } ]