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[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 65-year-old man presents with low-grade fever and malaise for the last 4 months. He also says he has lost 9 kg (20 lb) during this period and suffers from extreme fatigue. Past medical history is significant for a mitral valve replacement 5 years ago. His temperature is 38.1°C (100.6°F), respirations are 22/min, pulse is 102/min, and blood pressure is 138/78 mm Hg. On physical examination, there is a new onset 2/6 holosystolic murmur loudest in the apical area of the precordium. Which of the following organisms is the most likely cause of this patient’s condition?" }, { "role": "assistant", "content": "Coagulase-negative Staphylococcus spp." } ]

[ { "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": "BCG is -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Live vaccine Live'attenuated' vaccinesKilled 'inactivated' vaccinesBCGPertussisOPV (Sabin - Oral polio vaccine)IPV (Salk - Inactivated polio vaccine)Measles vaccineRabies vaccineMumps vaccineCholera vaccineRubella vaccineMeningococcal vaccineYellow fever vaccineHepatitis B vaccineTyphoralTyphim - Vi vaccineHepatitis - AHepatitis - A" } ]

[ { "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 viruses causing gastroenteritis are -a) Rotavirusb) Norwalk virusc) Adenovirusd) Hepatadenoviruse) Enterovirus" }, { "role": "assistant", "content": "The correct answer is □ Viruses that are important causes of gastrointestinal infection are - rotaviruses , enteric\nadenoviruses (especially, serotype 40 & 41) Q, noroviruses, sapoviruses, astroviruses & possibly\ntoroviruses - Fields virology \n□ Viruses causing diarrhoea \nRotavirusesQ\nAstrovirusesQ\nAdenovirusesQ\nCalcivi ruses\nCoronaviruses\nNorwalk group virusesQ\nEnteroviruses\n Viral infections causing diarrhoea (Current Diagnosis & Treatment in Gastroenterology \nRotavirus & Norwalk virus are the two most common agents in viral diarrhoea in children & adults,\nrespectively\nRotavirus : The disease occur primarily in children aged 3-15 months , with infection less\ncommon after 2 years of age. Adult can develop mild infection. Typically a childe develops\nvomiting, followed by profuse, watery diarrhoea. Dehydration may develop rapidly in chidren &\ncontributes significantly to the se%rerity of the illness. Rotashieldj a live oral vaccine initially\napproved for the prevention of rotavirus infection, was withdrawm from the market because of a possible increased risk of intussusception\nNorwalk virus : The clinical spectrum of disease is varied, although all cases are mild. The duration of illness is usually 24-48 hours" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: METHODS, RESULTS. Meshes: Adolescent, Child, Child, Preschool, Endoscopy, Gastrointestinal, Esophagitis, Female, Gastroesophageal Reflux, Helicobacter Infections, Helicobacter pylori, Humans, Infant, Logistic Models, Male, Prevalence, Retrospective Studies, Turkey." }, { "role": "user", "content": "Is there a relationship between Helicobacter pylori infection and erosive reflux disease in children? Context: A total of 206 children [mean age 8.4 +/- 4.9 (0.16-18) years] who underwent diagnostic upper endoscopy were tested for H. pylori infection between 2002 and 2005 and the relationship between H. pylori infection and gastro-oesophageal reflux disease was investigated retrospectively. Endoscopic and histopathological findings were examined retrospectively. When reflux-related oesophageal damage was identified as a result of the histological examination of endoscopic biopsy samples collected from distal oesophagus, the patients were diagnosed with gastro-oesophageal reflux disease and divided into two groups: those with macroscopic erosions or ulceration constituted the erosive oesophagitis group; those without constituted the non-erosive reflux disease group. Prevalence of H. pylori infection was 31.3% in the patients with gastro-oesophageal reflux disease and 36.7% in the control group (p>0.05). Prevalence of erosive oesophagitis was found to be 23.8% in the patients with H. pylori infection and 41.3% in those without (p>0.05)." }, { "role": "assistant", "content": "No negative significant association was found between the prevalence of H. pylori infection and erosive oesophagitis. Presence of H. pylori infection did not influence the severity of oesophagitis either." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Allografts, Female, Follow-Up Studies, Hematopoietic Stem Cell Transplantation, Humans, Leukemia, Myeloid, Acute, Male, Middle Aged, Mutation, Neoplasm Staging, Prognosis, Survival Rate, Survivors, Young Adult, fms-Like Tyrosine Kinase 3." }, { "role": "user", "content": "Does FLT3 mutation impact survival after hematopoietic stem cell transplantation for acute myeloid leukemia? Context: Patients with FMS like tyrosine kinase 3 (FLT3)-mutated acute myeloid leukemia (AML) have a poor prognosis and are referred for early allogeneic hematopoietic stem cell transplantation (HCT). Data from the Center for International Blood and Marrow Transplant Research (CIBMTR) were used to evaluate 511 adult patients with de novo AML who underwent HCT during 2008 through 2011 to determine whether FLT3 mutations had an impact on HCT outcomes. In total, 158 patients (31%) had FLT3 mutations. Univariate and multivariate analyses revealed an increased risk of relapse at 3 years in the FLT3 mutated group compared with the wild-type (WT) group (38% [95% confidence interval (CI), 30%-45%] vs 28% [95% CI, 24%-33%]; P = .04; relative risk, 1.60 [95% CI, 1.15-2.22]; P = .0048). However, FLT3 mutation status was not significantly associated with nonrelapse mortality, leukemia-free survival, or overall survival. Although more patients in the FLT3 mutated group died from relapsed primary disease compared with those in the WT group (60% vs 46%), the 3-year overall survival rate was comparable for the 2 groups (mutated group: 49%; 95% CI, 40%-57%; WT group: 55%, 95% CI, 50%-60%; P = .20)." }, { "role": "assistant", "content": "The current data indicate that FLT3 mutation status did not adversely impact overall survival after HCT, and about 50% of patients with this mutation who underwent HCT were long-term survivors. Cancer 2016;122:3005-3014. © 2016 American Cancer Society." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Hemorrhagic cystitis is caused by:-" }, { "role": "assistant", "content": "The correct answer is Cyclophosphamide and Ifosfamide can cause hemorrhagic cystitis. This is due to the compound acrolein Mesna is used to prevent this adverse effect. Specific Adverse Effect of Anticancer Drugs See the diagram very carefully: Cisplatin: Ear look like C(so Cisplatin cause ototoxicity), similarly Kidney look like C (So Cisplatin cause nephrotoxicity) and mouth look like C (Cisplatin is most emetogenic) Tamoxifen: Eyes look like T (So, tamoxifen affects eye causing cataract and retinopathy) Vincristine and Vinblastine: The cap look like V (means vinca drugs release ADH from brain) and limbs look like V (means vinca drugs act in periphery causing peripheral neuropathy) Lungs look like B, So Bleomycin and Busulfan cause pulmonary fibrosis Hea look like D, So Doxorubicin like drugs cause cardiotoxicity Liver look like figure of six, so 6-mercaptopurine and 6- Thioguanine are hepatotoxic Only complete cycle in the diagram is of bladder, so Cyclophosphamide cause hemorrhagic cystitis." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Behavior, Animal, Bird Diseases, Birds, Culex, District of Columbia, Insect Vectors, Maryland, Rest, West Nile Fever, West Nile virus." }, { "role": "user", "content": "Does avian roosting behavior influence vector-host interactions for West Nile virus hosts? Context: Extensive work has shown that vectors almost never feed at random. Often, a subset of individual hosts and host species are fed on much more frequently than expected from their abundance and this can amplify pathogen transmission. However, the drivers of variation in contact patterns between vectors and their hosts are not well understood, even in relatively well-studied systems such as West Nile virus (WNV). We compared roosting height and roost aggregation size of seven avian host species of WNV with patterns of host-seeking mosquito (Culex pipiens) abundance at communal and non-communal roost sites. First, host-seeking mosquito abundance increased with height and paralleled increased mosquito feeding preferences on species roosting higher in the tree canopy. Second, there were several hundred-fold fewer mosquitoes per bird trapped at American robin (Turdus migratorius) communal roosts compared to non-communal roost sites, which could reduce transmission from and to this key amplifying host species. Third, seasonal changes in communal roost formation may partly explain observed seasonal changes in mosquito feeding patterns, including a decrease in feeding on communal roosting robins." }, { "role": "assistant", "content": "These results illustrate how variation in habitat use by hosts and vectors and social aggregation by hosts influence vector-host interactions and link the behavioral ecology of birds and the transmission of vector-borne diseases to humans. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which one of the following condition is associated with extensive pleural thickening and calcification especially involving the diaphragmatic pleura?" }, { "role": "assistant", "content": "The correct answer is Extensive pleural thickening and calcification especially involving the diaphragmatic pleura are classical features of Asbestosis. Exposure to asbestos can result in extensive pleural thickening, calcification, effusion, and malignant neoplasm of lung and pleura. Pleural fibrosis associated with asbestos fiber inhalation result in diffuse pleural thickening or focal plaque formation bilaterally, and is the most frequent manifestation of asbestos exposure. Pleural calcification occuring especially along the diaphragmatic surface of pleura is also pathognomonic of prior asbestos exposure Ref: Computed Body Tomography with MRI Correlation, Volume 1 By Joseph K. T. Lee, 4th Edition, Pages 489-90; Handbook of Medical-Surgical Nursing By Lippincott Williams and Wilkins, Page 194; Asbestos : Mixed Dust and Fela Issues, 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, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Does [ Pylorus-preserving pancreatoduodenectomy allow a better maintenance of glucose homeostasis ]? Context: Pancreatic diseases and pancreatic surgery usually cause a derangement of glucose metabolism ranging from a change in glucose tolerance test to insulin-dependent diabetes. The authors assess the changes in glycemia both in basal condition and after a challenge test in a group of patients who underwent Pylorus Preserving Pancreatoduodenectomy (PPPD) according to an original technique of reconstruction with two separate bowel loops. Ten patients who underwent PPPD either for chronic pancreatitis or ampullar carcinoma were enrolled in this study. Pre- and postoperative assessment of pancreatic endocrine function was carried out in all the patients. The evaluation included: 1) oral glucose tolerance test (OGTT), 2) intravenous glucose tolerance test (IVGTT) and 3) glucagon challenge test. Plasma glucose level in basal condition, after oral glucose tolerance test, intravenous glucose tolerance test and glucagone challenge test, shows that insulin secretion and/or its effectiveness is not impaired after PPPD. Two patients with preoperative insulin-dependent diabetes needed a lower dose of insulin in the postoperative period. One patient responded abnormally to OGTT both in the preoperative and postoperative periods. Seven patients maintained normal glucose homeostasis in the postoperative period." }, { "role": "assistant", "content": "PPPD allows a normal control of glucose metabolism. Better digestive and endocrine function noted in our patients in the postoperative period is due to the integrity of the stomach and the reconstruction technique with two bowel loops used to drain biliary and pancreatic secretion separately. 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: INTRODUCTION, MATERIALS AND METHODS. Meshes: Aged, Combined Modality Therapy, Diagnostic Techniques, Urological, Female, Follow-Up Studies, Germany, Humans, Incidence, Male, Middle Aged, Prognosis, Retrospective Studies, Survival Rate, Time Factors, Urologic Neoplasms." }, { "role": "user", "content": "Is there evidence for a multidisciplinary follow-up after urological cancer? Context: Follow-up after cancer treatment has been focussing on the detection of local recurrence or metastatic disease of the primary cancer. Subsequent independent malignancies arising during follow-up have not been considered as relevant. Our study evaluated the risk of independent cancers following the diagnosis of primary urological cancer. From 1990 to 1998 data from 4,119 patients with a minimum follow-up of 5 years were collected. A total of 1,835 patients had primary prostate cancer, 1,269 and 1,015 patients had primary bladder and renal cell cancer, respectively. The most common subsequent malignancies in males were prostate cancer followed by lung and colon cancer. Breast and colon cancer were the most frequently detected subsequent cancers in females. The age correlated comparison of diagnosed and expected cancer in men with primary prostate cancer revealed an increase in relative risk for bladder, kidney and rectal cancer of 3.75, 2.03 and 1.32-fold, respectively. In men with primary bladder cancer the relation for prostate, kidney and lung cancer was 4.05, 2.51 and 2.13-fold, respectively; for females the relation for kidney cancer was 4.55-fold. In men with primary kidney cancer subsequent rectal, prostate and bladder cancer showed a 4.38, 2.91 and 2.48-fold increase, respectively." }, { "role": "assistant", "content": "These data suggest an increase in relative risk for subsequent urologic and non-urologic cancer during follow-up. Clinicians involved in oncological follow-up need to be aware of this finding. To which degree a follow-up scheme, not solely focussing on the primary urological malignancy could improve survival needs to be evaluated in further studies." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Anions, Apoptosis, Catalase, Cell Hypoxia, Cell Line, Flow Cytometry, Humans, Hydrogen Peroxide, L-Lactate Dehydrogenase, Malondialdehyde, Membrane Potential, Mitochondrial, Mitochondria, Myocytes, Cardiac, Oxidative Stress, Oxygen, Peptides, Recombinant Fusion Proteins, Signal Transduction, Superoxides." }, { "role": "user", "content": "Does pEP-1-CAT protect hypoxia/reoxygenation-induced cardiomyocyte apoptosis through multiple sigaling pathways? Context: Catalase (CAT) breaks down H2O2 into H2O and O2 to protects cells from oxidative damage. However, its translational potential is limited because exogenous CAT cannot enter living cells automatically. This study is aimed to investigate if PEP-1-CAT fusion protein can effectively protect cardiomyocytes from oxidative stress due to hypoxia/reoxygenation (H/R)-induced injury. H9c2 cardomyocytes were pretreated with catalase (CAT) or PEP-1-CAT fusion protein followed by culturing in a hypoxia and re-oxygenation condition. Cell apoptosis were measured by Annexin V and PI double staining and Flow cytometry. Intracellular superoxide anion level was determined, and mitochondrial membrane potential was measured. Expression of apoptosis-related proteins including Bcl-2, Bax, Caspase-3, PARP, p38 and phospho-p38 was analyzed by western blotting. PEP-1-CAT protected H9c2 from H/R-induced morphological alteration and reduced the release of lactate dehydrogenase (LDH) and malondialdehyde content. Superoxide anion production was also decreased. In addition, PEP-1-CAT inhibited H9c2 apoptosis and blocked the expression of apoptosis stimulator Bax while increased the expression of Bcl-2, leading to an increased mitochondrial membrane potential. Mechanistically, PEP-1-CAT inhibited p38 MAPK while activating PI3K/Akt and Erk1/2 signaling pathways, resulting in blockade of Bcl2/Bax/mitochondrial apoptotic pathway." }, { "role": "assistant", "content": "Our study has revealed a novel mechanism by which PEP-1-CAT protects cardiomyocyte from H/R-induced injury. PEP-1-CAT blocks Bcl2/Bax/mitochondrial apoptotic pathway by inhibiting p38 MAPK while activating PI3K/Akt and Erk1/2 signaling pathways. 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": "CD8 is a marker for which of the following cell?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., T-cells Important cells with their CD marker are* Primary T cell Associated* CD1, CD3, CD4, CD5, CD8* Primary B cell associated* CD10, CD19, CD20, CD21, CD23, CD79a* Primary monocyte or macrophage associated* CD11c. CD13, CD14, CD15, CD33, CD64* Primary NK cell associated* CD16.CD56* Primary stem cell and progenitor cell associated* CD34* Activation markers* CD30* Present on all leukocytes* CD45" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Adult, Africa, CD4 Antigens, CD4-Positive T-Lymphocytes, Cell Line, Down-Regulation, Female, Genotype, HIV Infections, HIV-1, Histocompatibility Antigens Class I, Host-Pathogen Interactions, Humans, Male, North America, nef Gene Products, Human Immunodeficiency Virus." }, { "role": "user", "content": "Does ability of HIV-1 Nef to downregulate CD4 and HLA class I differ among viral subtypes? Context: The highly genetically diverse HIV-1 group M subtypes may differ in their biological properties. Nef is an important mediator of viral pathogenicity; however, to date, a comprehensive inter-subtype comparison of Nef in vitro function has not been undertaken. Here, we investigate two of Nef's most well-characterized activities, CD4 and HLA class I downregulation, for clones obtained from 360 chronic patients infected with HIV-1 subtypes A, B, C or D. Single HIV-1 plasma RNA Nef clones were obtained from N=360 antiretroviral-naïve, chronically infected patients from Africa and North America: 96 (subtype A), 93 (B), 85 (C), and 86 (D). Nef clones were expressed by transfection in an immortalized CD4+ T-cell line. CD4 and HLA class I surface levels were assessed by flow cytometry. Nef expression was verified by Western blot. Subset analyses and multivariable linear regression were used to adjust for differences in age, sex and clinical parameters between cohorts. Consensus HIV-1 subtype B and C Nef sequences were synthesized and functionally assessed. Exploratory sequence analyses were performed to identify potential genotypic correlates of Nef function. Subtype B Nef clones displayed marginally greater CD4 downregulation activity (p = 0.03) and markedly greater HLA class I downregulation activity (p < 0.0001) than clones from other subtypes. Subtype C Nefs displayed the lowest in vitro functionality. Inter-subtype differences in HLA class I downregulation remained statistically significant after controlling for differences in age, sex, and clinical parameters (p < 0.0001). The synthesized consensus subtype B Nef showed higher activities compared to consensus C Nef, which was most pronounced in cells expressing lower protein levels. Nef clones exhibited substantial inter-subtype diversity: cohort consensus residues differed at 25% of codons, while a similar proportion of codons exhibited substantial inter-subtype differences in major variant frequency. These amino acids, along with others identified in intra-subtype analyses, represent candidates for mediating inter-subtype differences in Nef function." }, { "role": "assistant", "content": "Results support a functional hierarchy of subtype B > A/D > C for Nef-mediated CD4 and HLA class I downregulation. The mechanisms underlying these differences and their relevance to HIV-1 pathogenicity merit further investigation. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which has worst prognosis in CLL?" }, { "role": "assistant", "content": "The correct answer is 13q deletion : Indolent course ; good prognosis Trisomy 12 : Intermediate prognosis 11q deletion : Poor prognosis 17p deletion : Poorest prognosis" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All the following drugs action pseudomonas infection EXCEPT" }, { "role": "assistant", "content": "The correct answer is (Azithromycin) (730-KDT 6th)Drugs which acts on Pseudomonas* Carbenicilline* Cefoperazone* Tobramycin* Acetic acid* Ticarcilline* Aztreonam* Sisomicin* Silver sulphadiazine* Azlacilline* Imipenem* Amikacin* Tetracyclines* Mezlocilline* Cefotaxime* Nitilmicin* Cefepime* Peperacilline* Ciprofloxacine* Gentamicin * Moxalactam* Norfloxacin* Polymyxin -B * Ceptazidime* Ofloxacin* Mafenide * Pefloxacin Azithromycin - It is more active than other macrolide against H. influenzae* Usefully active against a number of important gram negative organisms It is not active against erythromycin resistant bacteria" } ]

[ { "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 woman comes to the emergency department because of a 4-hour history of headaches, nausea, and vomiting. During this time, she has also had recurrent dizziness and palpitations. The symptoms started while she was at a friend's birthday party, where she had one beer. One week ago, the patient was diagnosed with a genitourinary infection and started on antimicrobial therapy. She has no history of major medical illness. Her pulse is 106/min and blood pressure is 102/73 mm Hg. Physical examination shows facial flushing and profuse sweating. The patient is most likely experiencing adverse effects caused by treatment for an infection with which of the following pathogens?" }, { "role": "assistant", "content": "Trichomonas vaginalis" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Most effective treatment for borderline personality disorders" }, { "role": "assistant", "content": "The correct answer is \"Dialectical behavioral therapy (DBT), a type of cognitive behavioral therapy (CBT), DBT was introduced by Marsha linehan DBT is a type of CBT with Mindfulness techniques it has more evidence for Borderline personality disorders and self injurious behaviour Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no. 868" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Celiac Disease, Cross-Sectional Studies, Delayed Diagnosis, Duodenum, Endoscopy, Gastrointestinal, Female, Humans, Male, Middle Aged." }, { "role": "user", "content": "Prior endoscopy in patients with newly diagnosed celiac disease: a missed opportunity? Context: Celiac disease (CD) is under-diagnosed in the United States, and factors related to the performance of endoscopy may be contributory.AIM: To identify newly diagnosed patients with CD who had undergone a prior esophagogastroduodenoscopy (EGD) and examine factors contributing to the missed diagnosis. We identified all patients age ≥ 18 years whose diagnosis of CD was made by endoscopy with biopsy at our institution (n = 316), and searched the medical record for a prior EGD. We compared those patients with a prior EGD to those with without a prior EGD with regard to age at diagnosis and gender, and enumerated the indications for EGD. Of the 316 patients diagnosed by EGD with biopsy at our center, 17 (5 %) had previously undergone EGD. During the prior non-diagnostic EGD, a duodenal biopsy was not performed in 59 % of the patients, and ≥ 4 specimens (the recommended number) were submitted in only 29 % of the patients. On the diagnostic EGD, ≥ 4 specimens were submitted in 94 %. The mean age of diagnosis of those with missed/incident CD was 53.1 years, slightly older than those diagnosed with CD on their first EGD (46.8 years, p = 0.11). Both groups were predominantly female (missed/incident CD: 65 vs. 66 %, p = 0.94)." }, { "role": "assistant", "content": "Among 17 CD patients who had previously undergone a non-diagnostic EGD, non-performance of duodenal biopsy during the prior EGD was the dominant feature. Routine performance of duodenal biopsy during EGD for the indications of dyspepsia and reflux may improve CD diagnosis rates." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Behavior, Animal, Benzodiazepines, Drug Interactions, Ethanol, GABA-A Receptor Antagonists, Ligands, Male, Motor Activity, Protein Subunits, Rats, Rats, Long-Evans, Reinforcement (Psychology)." }, { "role": "user", "content": "Does a high affinity ligand for GABAA-receptor containing alpha5 subunit antagonize ethanol 's neurobehavioral effects in Long-Evans rats? Context: Previously, we reported that the GABA(A)receptor containing alpha(5)subunit played a significant role in the reinforcing actions of EtOH in rats selectively bred to consume alcohol. However, the role of the alpha(5) receptor in regulating the neurobehavioral effects of EtOH in outbred rats is not known. In the present study, RY024, a novel benzodiazepine (BDZ) inverse agonist with high affinity (K(d) approximately 0.40 nM) and selectivity (approximately 67.3-fold) for the alpha(5)receptor, was investigated for its capacity to antagonize EtOH's reinforcing, motor impairing, and sedative effects in Long-Evans rats. Rats were trained to lever press for EtOH under a fixed-ratio 1 schedule of reinforcement. Subsequent studies evaluated EtOH's motor-impairing effects in an oscillating bar task, while EtOH's sedative effects were measured in the open field. RY024 (0.125-3.5 mg/kg; IP) markedly reduced EtOH-maintained responding with no effects on water responding, except for the highest dose. RY024 (3.0-15 mg/kg; IP) also reversed the motor impairing effects of a moderate (0.75 g/kg), and intoxicating EtOH dose (1.25 g/kg) in the absence of intrinsic effects. Finally, RY024 (7.5 mg/kg) attenuated the sedation produced by the 1.25 g/kg EtOH dose; however, it failed to attenuate the sedation induced by the 0.75 g/kg EtOH dose. Given alone, RY024 exhibited intrinsic effects in the open field." }, { "role": "assistant", "content": "The results suggest the GABA(A)receptor containing alpha(5)subtype plays an important role in regulating the reinforcing, motor-impairing, and sedative effects of alcohol in outbred rats. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is not a 4 — Aminoquinolone?" }, { "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": "Defect in Snurps causes?" }, { "role": "assistant", "content": "The correct answer is Defective splicing (defect in snurps) is the most common mutation causing thalassemia. Molecular defect in pathogensis of thalassemia:? A) b-Thalassemia Most common type of genetic abnormality in b-thalassemia is point mutation i.e., nonsense. Some may also occur due to deletion or inseion i.e., frame shift mutations. Defect may occur at different steps of b-chain synthesis: i) Splicing mutations Mutations leading to aberrant splicing are the most common cause of P-thalassemia. ii) Chain terminator mutations This cause premature termination of mRNA translation. iii) Promoter region mutations This results in transcription defect. B) a-Thalassemia The most common cause of reduced a-chain synthesis is deletion of a-globin genes. Rarely nonsense mutation may also cause a-thalassemia." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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 Adhesion, Cell Membrane, Cells, Cultured, E-Selectin, Endothelium, Vascular, Humans, Interleukin-1, NF-kappa B, Proto-Oncogene Proteins c-raf, RNA, Messenger, Recombinant Proteins, Solubility, Tumor Necrosis Factor-alpha, Up-Regulation." }, { "role": "user", "content": "Do tNF-alpha and IL-1 upregulate membrane-bound and soluble E-selectin through a common pathway? Context: Endothelial cell adhesion molecules such as E-selectin promote the capture of neutrophils (PMN) in the microcirculation and initiate the inflammatory response. In contrast, when \"shed\" into the microcirculation, soluble E-selectin can bind PMN in the blood stream, reducing the number available for adhesion to injured tissue. These experiments were designed to better characterize the molecular response to cytokines and the balance between cell surface (bound) and soluble (unbound) E-selectin. Cultured human umbilical veins, exposed to human recombinant TNF-alpha or IL-1 (10 pg/ml), were analyzed for E-selectin mRNA induction (Northern blot), E-selectin cell surface expression (flow cytometry), and sE-selectin release (ELISA). Transcriptional regulation was analyzed via Raf kinase dominant negative gene transfection. E-selectin mRNA expression was markedly increased at 2 h and sustained through 8 h. No further induction was noted at 12 h. Upregulation of cell surface E-selectin was noted (mean fluorescence) as early as 2 h for TNF-alpha (baseline, 12.28 +/- 1.32; TNF-alpha, 23.03 +/- 1.81) or 4 h for IL-1 (baseline, 12.28 +/- 1.32; IL-1, 70.00 +/- 3.04) with maximum expression at 6 h (TNF-alpha, 118.8+/-15; IL-1, 94.11 +/- 9. 34). Expression returned to baseline levels by 24 h. Soluble E-selectin (ng/ml) assays demonstrated later increases beginning at 12 h (TNF-alpha, 0.313 +/- 0.077; IL-1, 0.159 +/- 0.075) and continuing through 24 h (TNF-alpha, 0.340 +/- 0.062; IL-1, 0.157 +/- 0.030). Transfection of endothelial cells with Raf kinase 301 dominant negative gene resulted in proportionate decreases in the peak expression in both surface (bound) E-selectin (TNF-alpha, 51. 7%; IL-1, 29.6%) and sE-selectin (TNF-alpha, 49.2%; IL-1, 34.5%)." }, { "role": "assistant", "content": "The temporal sequence of late decreases in cell surface E-selectin accompanied by increases in soluble E-selectin indicates that the source of E-selectin in the microcirculation is shed receptors rather than synthesis of a different type of receptor. Enhancement of such \"shedding\" may decrease PMN adhesion to injured tissue and have therapeutic potential. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Child, Cross-Sectional Studies, Diet, Energy Intake, Female, Food Quality, Fruit, Humans, Logistic Models, Male, Mental Recall, Mexico, Nutrition Assessment, Nutrition Surveys, Nutritional Requirements, Nutritive Sweeteners, Obesity, Patient Compliance, Prevalence, Recommended Dietary Allowances, Socioeconomic Factors, Vegetables." }, { "role": "user", "content": "Does adherence to Dietary Recommendations for Food Group Intakes be Low in the Mexican Population? Context: Given the high prevalence of obesity and noncommunicable diseases in Mexico and the key role of dietary quality in these conditions, it is important to determine Mexicans' adherence to dietary recommendations. Our aim was to estimate the percentage of the Mexican population who adhere to dietary recommendations for key food groups. We analyzed 7983 participants aged ≥5 y from the nationally representative Mexican National Health and Nutrition Survey 2012. Dietary intake data were collected by using one 24-h recall and a repeated 24-h recall in 9% of the sample. We used the National Cancer Institute method for episodically consumed foods, which uses a 2-part (probability and amount) mixed regression model to estimate the usual intake distribution and its association with sociodemographic variables. For the food groups that are encouraged, only 1-4% of the population (range across sex and age groups) reached the recommended intake of legumes, 4-8% for seafood, 7-16% for fruit and vegetables, and 9-23% for dairy. For food groups that are discouraged, only 10-22% did not exceed the recommended upper limit for sugar-sweetened beverages, 14-42% for high saturated fat and/or added sugar (HSFAS) products, and 9-50% for processed meats, whereas the majority (77-93%) did not exceed the limit for red meat. A lower proportion of adolescents than children and adults adhered to recommendations for several food groups. Participants with higher socioeconomic status (SES) and living in urban areas consumed more (probability of consuming and/or amount consumed) fruit and vegetables, dairy, and HSFAS products, but they consumed fewer legumes than those of lower SES and living in rural areas." }, { "role": "assistant", "content": "These results reveal the poor dietary quality of the Mexican population and the urgent need to shift these habits. If current intakes continue, the burden of disease due to obesity and noncommunicable chronic diseases will likely remain elevated in the Mexican population. 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 35-year-old man presents with a bleeding duodenal ulcer documented by endoscopy. The patient is somewhat unstable, and bleeding does not stop despite transfusing 8 U of blood. What is the most appropriate surgical therapy?" }, { "role": "assistant", "content": "The correct answer is For the patient who is unstable and has a pyloric or duodenal ulcer, oversewing the ulcer and closing the pyloric incision as a pyloroplasty and performing a vagotomy is the procedure of choice because of its low operative mortality. However, this procedure carries a higher-recurrence rate. Major resections, such as antrectomy and subtotal gastrectomy are contraindicated in the unstable patient. At endoscopy biopsies for H. pylori should be taken and, if positive, treatment designed to eradicate H. pylori should be started. Eradication of H. pylori reduces the recurrence rate of bleeding." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Air Pollution, Cardiovascular Diseases, China, Cities, Humans, Investments." }, { "role": "user", "content": "Is large daily stock variation associated with cardiovascular mortality in two cities of Guangdong , China? Context: The current study aimed to examine the effects of daily change of the Shenzhen Stock Exchange Index on cardiovascular mortality in Guangzhou and Taishan, China. Daily mortality and stock performance data during 2006-2010 were collected to construct the time series for the two cities. A distributed lag non-linear model was utilized to examine the effect of daily stock index changes on cardiovascular mortality after controlling for potential confounding factors. We observed a delayed non-linear effect of the stock index change on cardiovascular mortality: both rising and declining of the stock index were associated with increased cardiovascular deaths. In Guangzhou, the 15-25 lag days cumulative relative risk of an 800 index drop was 2.08 (95% CI: 1.38-3.14), and 2.38 (95% CI: 1.31-4.31) for an 800 stock index increase on the cardiovascular mortality, respectively. In Taishan, the cumulative relative risk over 15-25 days lag was 1.65 (95% CI: 1.13-2.42) for an 800 index drop and 2.08 (95% CI: 1.26-3.42) for an 800 index rising, respectively." }, { "role": "assistant", "content": "Large ups and downs in daily stock index might be important predictor of cardiovascular mortality. 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 thyroid nodule is found on a 40-year-old woman on routine evaluation. She has no prior history of thyroid disease and clinically feels well. There is a 15-mm nontender nodule on the right lobe of the thyroid with no associated lymphadenopathy. Thyroid function tests are normal. Which of the following is the most appropriate next step in management?" }, { "role": "assistant", "content": "The correct answer is Needle biopsy can be used in numerous diseases, but the main rationale is to differentiate benign from malignant nodules. A thyroid scan is appropriate if the TSH is suppressed suggesting a possible \"hot\" nodule (hyperfunctioning nodules are very rarely malignant). The specimen must be read by an experienced cytologist. It is difficult to diagnose differentiated follicular carcinoma or to differentiate lymphoma from Hashimoto's thyroiditis. Papillary carcinoma is the easiest diagnosis to make by needle biopsy." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, RESULTS. Meshes: ." }, { "role": "user", "content": "Do an update on the clinical and molecular characteristics of pseudohypoparathyroidism? Context: To provide the reader with a review of contemporary literature describing the evolving understanding of the molecular pathobiology of pseudohypoparathyroidism (PHP). The features of PHP type 1 reflect imprinting of the GNAS gene, which encodes the α subunit of the heterotrimeric G protein (Gα(s)) that couples heptahelical receptors to activation of adenylyl cyclase. Transcription of Gα(s) is biallelic in most cells, but is primarily from the maternal allele in some tissues (e.g. proximal renal tubules, thyroid, pituitary somatotropes, gonads). Patients with PHP 1a have heterozygous mutations within the exons of the maternal GNAS allele that encode Gα(s), whereas patients with PHP 1b have methylation defects in the GNAS locus that reduce transcription of Gα(s) from the maternal allele. In both PHP 1a and PHP 1b, paternal imprinting of Gα(s) leads to resistance to parathyroid hormone and TSH. Although brachydactyly is characteristic of PHP 1a, it is sometimes present in patients with PHP 1b." }, { "role": "assistant", "content": "Molecular studies enable a distinction between PHP 1a and PHP 1b, with different mechanisms accounting for Gα(s) deficiency. Clinical overlap between these two forms of PHP type 1 is likely due to the variable levels of Gα(s) activity expressed in specific cell types. 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: Accidental Falls, Aged, Cross-Sectional Studies, Female, Humans, Middle Aged, Postmenopause, Risk Assessment, Risk Factors." }, { "role": "user", "content": "Does [ Evaluation of risk factors of fall in early postmenopausal women ]? Context: It was to evaluate the frequency and the risk factors of falls in early postmenopausal women. A cross-sectional study was conducted on 358 women (age: 45-65 years and amenorrhea >12 months) with time since menopause <10 years. Exclusion criteria were: neurological or musculoskeletal disorders, vestibulopathies, uncorrected visual deficit, uncontrolled hypertension and postural hypotension, or drug use (sedative and hypnotic agents). A fall was identified as an unexpected unintentional change in position which causes an individual to remain in a lower level in relation to the initial position. The history of self-reported falls during the previous 24 months, and clinical and anthropometric data (body mass index (BMI) and waist circumference (WC)) and bone densitometric measures were analyzed. For statistical analysis, c² trend test and the logistic regression method (odds ratio (OR)) were used for the comparison between groups of women with and without falls. Of the 358 women, 48.0% (172/358) had a history of falls and 17.4% (30/172) had fractures. The fall occurred indoors (at home) in 58.7% (101/172). The mean age was 53.7 ± 6.5 years, time since menopause 5.8 ± 3.5 years, BMI 28.3 ± 4.6 kg/m² and WC 89.0 ± 11.4 cm. There were differences as the occurrence of smoking and diabetes, with greater frequency among fallers vs. non-fallers, 25.6 versus 16.1% and 12.8 versus 5.9%, respectively (p<0.05). By evaluating the risk of falls in the presence of influential variables, it was observed that risk increased with current smoking status (OR 1.93; 95%CI 1.01-3.71), whereas other clinical and anthropometric variables did not influence this risk." }, { "role": "assistant", "content": "In early postmenopausal women there was higher frequency of falls. Current smoking was clinical indicators of risk for falls. With the recognition of factors for falling, preventive measures become important, as the orientation of abolishing smoking. 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, Biological Transport, Carrier Proteins, Cells, Cultured, Gene Expression, Gene Expression Regulation, Glucose, Glucose Transporter Type 4, Insulin, Insulin Receptor Substrate Proteins, Intracellular Space, Muscle Fibers, Skeletal, Myoblasts, Phosphatidylinositol 3-Kinases, Phosphorylation, Protein Transport, Proteins, Proto-Oncogene Proteins c-akt, Rats, Recombinant Proteins, Signal Transduction." }, { "role": "user", "content": "Does over-expression of NYGGF4 ( PID1 ) inhibit glucose transport in skeletal myotubes by blocking the IRS1/PI3K/AKT insulin pathway? Context: Defects in insulin-stimulated glucose uptake in muscle are the important early events in the pathogenesis of insulin resistance. NYGGF4 (also named PID1) is a recently discovered gene which is suggested to be associated with obesity-associated insulin resistance. In this study, we aimed to investigate the effects of NYGGF4 on glucose uptake and insulin signaling in rat skeletal muscle cells. Rat L6 myoblasts were transfected with either an empty vector or an NYGGF4-expressing vector and induced to differentiate into mature L6 skeletal myotubes. Glucose uptake was determined by measuring uptake of 2-deoxy-d-[(3)H] glucose. Immunoblotting was performed to detect the translocation of insulin-sensitive glucose transporter 4 (GLUT4). Immunoblotting was also used to measure phosphorylation and total protein levels of the insulin signaling proteins including insulin receptor (IR), insulin receptor substrate 1 (IRS1), Akt, extracellular signal-regulated kinase 1 and 2 (ERK1/2), p38, and c-Jun-N-terminal kinase (JNK). NYGGF4 over-expression in L6 skeletal myotubes reduced insulin-stimulated glucose uptake and impaired insulin-stimulated GLUT4 translocation. It also diminished insulin-stimulated tyrosine phosphorylation of IRS1 and serine phosphorylation of Akt without affecting the phosphorylation of IR, ERK1/2, p38, or JNK." }, { "role": "assistant", "content": "Over-expression of NYGGF4 inhibits glucose transport in skeletal myotubes by blocking the IRS1/PI3K/AKT insulin pathway. These observations highlight the potential role of NYGGF4 in glucose homeostasis and the development of insulin resistance in obesity. 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, Alleles, Analysis of Variance, Asian Continental Ancestry Group, Female, Gene Frequency, Genetic Association Studies, Genetic Predisposition to Disease, Genotype, Haplotypes, Humans, Interleukin-6, Logistic Models, Lupus Erythematosus, Systemic, Male, Middle Aged, Polymerase Chain Reaction, Polymorphism, Single Nucleotide, Promoter Regions, Genetic." }, { "role": "user", "content": "Are interleukin 6 gene polymorphisms associated with systemic lupus erythematosus in Koreans? Context: Interleukin 6 (IL-6) gene polymorphisms are known to play a role in chronic inflammatory disorders. We searched for polymorphisms in the IL-6 gene and described their pathogenic role in Korean patients with systemic lupus erythematosus (SLE). Genomic DNA was extracted from 151 patients with SLE and 151 controls, and about 1.4 kb-sized IL-6 genes located between promoter region and exon 2 region were amplified by polymerase chain reaction. The promoter activity was analyzed by luciferase reporter assay in Hep3B cells and HeLa cells. We identified 4 single-nucleotide polymorphisms (SNP; -572 C > G, -278 A > C in the promoter, and 330 T > G, and 334 A > T in exon 2) and a -373 A(n)T(n) tract polymorphism in the IL-6 gene. The genotype frequency, -373 A(10)T(11), -278 C, and 334 T allele were significantly associated with SLE (p < 0.001, p = 0.03 and p = 0.005, respectively). Patients with SLE carrying the -572 G allele had anti-dsDNA more frequently (p = 0.007). In addition, thrombocytopenia was significantly more common in patients carrying the -278 C allele (p = 0.006). In the haplotype analysis, patients with SLE had more frequently haplotype HT3 (CA(10)T(11)ATA, dominant model, p = 0.012) that was associated with arthritis, leukopenia, anti-dsDNA, and hypocomplementemia. Promoter reporter structures carrying the -278 C allele displayed significantly higher promoter activity than the -278 A allele in Hep3B cells (p < 0.001) and HeLa cells (p < 0.001)." }, { "role": "assistant", "content": "These data suggest that IL-6 gene polymorphisms are associated with disease susceptibility and phenotype of SLE. In addition, promoter polymorphisms may be involved in regulation of IL-6 expression. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Animals, Antigens, CD, Bone Marrow, Cadherins, Cell Movement, Female, Fetus, Flow Cytometry, Hematopoietic Stem Cells, Liver, Lymphocyte Function-Associated Antigen-1, Membrane Glycoproteins, Mice, Mice, Inbred C57BL, Microscopy, Confocal, Multiplex Polymerase Chain Reaction, Pregnancy, Receptors, CXCR4, Receptors, Calcium-Sensing." }, { "role": "user", "content": "Does single-cell analysis of murine long-term hematopoietic stem cells reveal distinct patterns of gene expression during fetal migration? Context: Long-term hematopoietic stem cells (LT-HSCs) migrate from the fetal liver (FL) to the fetal bone marrow (FBM) during development. Various adhesion and chemotactic receptor genes have been implicated in the migration of adult LT-HSCs. However, their role in the migration of fetal LT-HSCs is not clearly understood due, in part, to the rare number of these cells in fetal tissues, which preclude classical gene expression analysis. The aim of this study is to characterize the expression of migration related genes in fetal LT-HSC across different anatomical locations during development. We isolated fetal LT-HSC from different developmental stages, as well as different anatomical locations, and performed single-cell multiplex RT-qPCR and flow cytometry analysis of eight molecules involved in adult LT-HSC migration. Our results show that the gene expression of the chemokine receptor Cxcr4 in LT-HSC varies across developmental microenvironments and times, while the cadherin Cdh2 (Ncad) and the calcium receptor Casr show higher gene expression and variability only in FBM at 17.5 days post coitum (dpc). The cadherin Cdh5 (Vecad) maintains high expression variability only during fetal development, while the integrin subunit Itga5 (α5) increases its variability after 14.5 dpc. The integrin subunits Itga4 (α4) and Itgal (Lfa1), as well as the selectin ligand Selplg (Psgl1), did not show differences in their expression in single LT-HSCs irrespective of the developmental times or anatomical microenvironments studied." }, { "role": "assistant", "content": "Our data demonstrate that the expression pattern of phenotypically identical, single LT-HSCs fluctuates as a function of developmental stage and anatomical microenvironment. This is the first exhaustive gene expression comparison of migration-related molecules in fetal tissues across developmental times, enhancing the understanding of LT-HSC migration fate decisions during development. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Animals, Biopsy, Case-Control Studies, Cholagogues and Choleretics, Cholangitis, Sclerosing, Cyclin-Dependent Kinase Inhibitor p27, Female, Forkhead Box Protein O1, Forkhead Transcription Factors, Gene Expression Regulation, Humans, Liver Cirrhosis, Biliary, Liver Diseases, Alcoholic, Male, Mice, Mice, Knockout, Middle Aged, RNA, Messenger, Ursodeoxycholic Acid." }, { "role": "user", "content": "Does ursodeoxycholic acid influence the expression of p27kip1 but not FoxO1 in patients with non-cirrhotic primary biliary cirrhosis? Context: Enhanced expression of cell cycle inhibitor p27(kip1) suppresses cell proliferation. Ursodeoxycholic acid (UDCA) delays progression of primary biliary cirrhosis (PBC) but its effect on p27(kip1) expression is uncertain. To analyze the expression of p27(kip1) and its transcription modulator FoxO1 in patients with PBC, and to assess the impact of UDCA on this pathway. The examined human tissue included explanted livers from patients with cirrhotic PBC (n = 23), primary sclerosing cholangitis (PSC; n = 9), alcoholic liver disease (ALD; n = 9), and routine liver biopsies from patients with non-cirrhotic PBC (n = 26). Healthy liver samples served as controls (n = 19). Livers of FoxO-deficient mice were also studied. mRNA and protein expressions were analyzed by real-time PCR and Western blot. p27(kip1) expression was increased in cirrhotic and non-cirrhotic PBC. FoxO1 mRNA levels were increased in PBC (8.5-fold increase versus controls). FoxO1 protein expression in PBC was comparable to controls, but it was decreased in patients with PSC and ALD (63% and 70% reduction, respectively; both P < 0.05 versus control). UDCA-treated non-cirrhotic patients with PBC showed decreased expression of p27(kip1) mRNA." }, { "role": "assistant", "content": "PBC progression is characterized by a FoxO1-independent increase of p27(kip1) expression. In early PBC, UDCA may enhance liver regeneration via p27(kip1)-dependent mechanism. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, Ascorbic Acid, Ascorbic Acid Deficiency, Calcium-Binding Proteins, Intracellular Signaling Peptides and Proteins, Lipid Metabolism, Liver, Mice, Mice, Knockout, Microarray Analysis, Oxidation-Reduction, Transcriptome." }, { "role": "user", "content": "Does ascorbic acid deficiency affect genes for oxidation-reduction and lipid metabolism in livers from SMP30/GNL knockout mice? Context: We sought to elucidate the effect of an ascorbic acid (AA) deficiency on gene expression, because the water soluble antioxidant AA is an important bioactive substance in vivo. We performed microarray analyses of the transcriptome in the liver from senescence marker protein-30 (SMP30)/gluconolactonase (GNL) knockout (KO) mice, which are unable to synthesize AA in vivo. Our microarray analysis revealed that the AA deficiency increased gene expression related to the oxidation-reduction process, i.e., the nuclear factor, erythroid derived 2, like 2 (Nrf2) gene, which is a reactive oxygen species-sensitive transcriptional factor. Moreover, this AA deficiency increased the expression of genes for lipid metabolism including the cytochrome P450, family 7, subfamily a, polypeptide 1 (Cyp7a1), which is a late-limiting enzyme of the primary bile acid biosynthesis pathway. Although an AA deficiency increased the Cyp7a1 protein level, bile acid levels in the liver and gallbladder decreased. Since Cyp7a1 has a heme iron at the active site, AA must function as a reductant of the iron required for the continuous activation of Cyp7a1." }, { "role": "assistant", "content": "This experimental evidence strongly supports a role for AA in the physiologic oxidation-reduction process and lipid metabolism including bile acid biosynthesis. 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: PATIENTS AND METHODS, RESULTS. Meshes: Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Breast Neoplasms, Carcinoma, Ductal, Breast, Carcinoma, Lobular, Chemotherapy, Adjuvant, Combined Modality Therapy, Cyclophosphamide, Female, Follow-Up Studies, Humans, Lymphatic Metastasis, Mammaplasty, Mastectomy, Methotrexate, Middle Aged, Neoadjuvant Therapy, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Receptor, ErbB-2, Retrospective Studies, Survival Rate." }, { "role": "user", "content": "Does immediate breast reconstruction after mastectomy and neoadjuvant chemotherapy influence the outcome of patients with non-endocrine responsive breast cancer? Context: Between 1995 and 2006, 133 BC patients received NT followed by total mastectomy, 59 of whom underwent IBR. Patients receiving IBR (IBR group) were compared to patients who did not receive IBR (no-IBR group) over a prolonged median follow-up time (8.2 years). Patients receiving IBR were on average younger than patients not receiving IBR (p<0.001). The percentage of patients with positive clinical nodal status (cN) was 19% in the IBR group and 7% in no-IBR group (p=0.036), whereas patients without IBR were more frequently diagnosed as clinical T4 (59% vs. 15%, p<0.001). The 5-year cumulative incidence of locoregional recurrences were 14% in the no-IBR group and 21% in the IBR group. The hazard of locoregional events, adjusted for age, clinical T and cN, was significantly greater in the IBR group than in the no-IBR group (hazard ratio (HR)=2.77, p=0.045). The 5-year cumulative incidences of distant metastases were similar in the two groups (p=0.414)." }, { "role": "assistant", "content": "IBR following total mastectomy in patients with ER-negative disease after NT is associated with a worse rate of local relapses. More insight in mechanisms of wound healing and extent of surgery is required to further investigate this observation." } ]

[ { "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": "Sho head of Biceps is attached to" }, { "role": "assistant", "content": "The correct answer is The sho head of biceps brachii arises from the tip of the coracoid process and gets attached to the posterior rough pa of the radial tuberosity. The tendon is twisted; the anterior fibres become lateral and posterior fibres become media. The tendon is separated from the anterior pa of tuberosity by a bursa. Mnemonic Biceps brachii muscle origins: You walk shoer to a street corner .you ride longer on a superhighway. The sho head originates from the coracoid process. The long head originates from the supraglenoid tubercle. Ref- BD Chaurasia 7th edition Page no: 91 Figure:8.3 page no 89,BD chaurasia, 6th edition" } ]

[ { "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 periodontal probes has a ball at its tip?" }, { "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": "Material of choice for single-step border moulding is" }, { "role": "assistant", "content": "The correct answer is Single step or simultaneous border moulding:\nIt is a process, in which the entire periphery of the tray is refined in a single step. Polyether impression material is the material of choice because it fulfills all the requisites." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adenocarcinoma, Adenomatous Polyposis Coli, Adult, Aged, Aged, 80 and over, Apoptosis, Cell Transformation, Neoplastic, Colonic Neoplasms, Disease Progression, Female, Gene Amplification, Gene Expression Regulation, Neoplastic, Genes, myb, Genes, myc, Humans, Immunohistochemistry, Male, Middle Aged, Proto-Oncogene Proteins c-bcl-2." }, { "role": "user", "content": "Is activation of c-MYC and c-MYB proto-oncogenes associated with decreased apoptosis in tumor colon progression? Context: An increasing amount of evidence suggests that progression from normal mucosa to colorectal cancer is accompanied by morphological and genetic alterations. Genetic abnormalities affect malignant transformation via a gradual imbalance of normal tissue homeostasis involving programmed cell death (PCD) or apoptosis. Therefore, it has been hypothesized that alterations in apoptosis may contribute to carcinogenesis. The aim of the present work was to investigate the relationship between frequency of spontaneous apoptosis during transition adenoma-to-carcinoma of the colorectal tract and the incidence of activation of c-myc and c-myb proto-oncogenes, involved both in colon tumorigenesis and apoptosis. Ninety-five tissue specimens (60 polyps and 35 adenocarcinomas) were removed with autologous normal adjacent mucosa from colon cancer patients. Genomic DNA was extracted and analyzed for both apoptosis frequency (DNA fragmentation assay) and proto-oncogene activation (Southern blot analysis). On the same samples, Bcl-2 protein expression was evaluated by immunohistochemistry. Our results showed that: i) a significant relationship exists between apoptosis and genesis of colorectal cancer since, compared to adenomatous polyps and adjacent normal mucosa, cell death is markedly inhibited in tumors (p = 0.01); ii) during colon tumor progression, apoptosis and amplifications of c-myc/c-myb genes are inversely related; iii) Bcl-2 expression is retained in colon tumors even though at a significantly lower level with respect to adenomatous polyps." }, { "role": "assistant", "content": "These results indicate that failure of the normal apoptotic process together with de-regulation of c-myc and c-myb proto-oncogenes might promote the development of colorectal tumors. 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": "Fluoroscein dye study is done to detect -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Retinal vascular pathology Angiography for fundus examinationo Angiography is used for dynamic flow study of Iris, Retina or choroid. Following types of angiographies are used.Fluorescein Angiography Sodium fluorescein dye is used by injecting it into antecubital vein. It is primarily used for retinal vasculature, but iris & choroid can also be examined.Indocyanine green Angiography It is used primarily for choroidal vasculature, especially in choroidal neovascuiar membranes (CNVM). Therefore, it is used in - i) The identification and delineation of poorly defined or occult choroidal neovascularization, (ii) Retinal pigmented epithelium (RPE) detachments." } ]

[ { "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": "Cardiomyopathy is recognised finding in all except?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'None' About option 'b' o Transfusion siderosis causes hemochromtosis due to iron overload which is a cause of cardiomyopathy." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Antineoplastic Combined Chemotherapy Protocols, Apoptosis, Breast Neoplasms, Cell Division, Combined Modality Therapy, Doxorubicin, Drug Resistance, Neoplasm, Female, Fluorouracil, Glutathione S-Transferase pi, Glutathione Transferase, Humans, Isoenzymes, Mastectomy, Middle Aged, Mitomycin, Neoplasm Staging, Predictive Value of Tests, Prognosis, Prospective Studies, Treatment Outcome." }, { "role": "user", "content": "Does glutathion S transferase pi indicate chemotherapy resistance in breast cancer? Context: Breast cancer is the most common malignant disease of women. Pathologic response of breast cancer to chemotherapy has a great prognostic importance. Glutathion S Transferases (GSTs) might detoxify chemotherapeutic drugs within the cancer cells, thus contributing to chemotherapy resistance. The pi isoenzyme of GSTs seems to be of great relevance. Thus, we hypothesized that GSTpi expression in cancer biopsy can be a prognostic indicator for resistance to chemotherapy. To test this hypothesis, we evaluated before and after chemotherapy, tumor size, apoptosis of tumor cells with TUNEL assay, and proliferation of tumor cells by determining PCNA expression in biopsy samples, or in the surgically removed tumor tissue of GSTpi (-), and GSTpi (+) cases. GSTpi immunoreactivity was determined in 42 female patients with breast cancer. Patients were divided into two groups according to the expression of GSTpi in the pre-treatment biopsy specimen: (+) (n = 22) and (n = 20) samples were analyzed. Surgery was performed 2 weeks after a single intravenous injection of the chemotherapeutic drugs [5-fluorouracil, adriamycin, mitomycin (FAM protocol)]. Pre-chemotherapy values of tumor size, apoptosis, or proliferation did not differ between GSTpi (-) and (+) samples. Chemotherapy significantly inhibited tumor growth, and cell proliferation, and induced apoptosis in GSTpi (-) cases. However, these effects were significantly reduced in GSTpi (+) patients." }, { "role": "assistant", "content": "These results suggest, that the presence of GSTpi in breast cancer tissue is a bad prognostic indicator, and these tumors are largely resistant to chemotherapy. Thus, GSTpi might be important in inactivating one or more of the chemotherapeutic agents used in this treatment. 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, Biometry, Body Height, Body Weight, Child, Disease Models, Animal, Dogs, Humans, Male, Mathematics, Mice, Mice, Inbred mdx, Models, Biological, Muscle, Skeletal, Muscular Dystrophy, Duchenne, Sarcolemma, Time Factors." }, { "role": "user", "content": "Is why short stature beneficial in Duchenne muscular dystrophy? Context: Duchenne muscular dystrophy (DMD) is caused by a genetic defect resulting in absent dystrophin, yet children are able to walk when small and young but lose this ability as they grow. The mdx mouse has absent dystrophin yet does not exhibit significant disability. Allometric modeling of linearly increasing load per muscle fiber and stress on the sarcolemma with growth and exponential decline associated with loss of muscle fibers correlated with case studies and animal models of DMD. Smaller species or breeds are predictably less affected than large as follows: mdx mice < small golden retriever muscular dystrophy (GRMD) dogs < large GRMD dogs < humans. Case reports of combined growth hormone and dystrophin deficiency show a relatively benign course of disease." }, { "role": "assistant", "content": "Future therapeutic trials in DMD might include specific growth inhibitors in combination with standard of care treatments to delay the clinical onset and reduce the severity of disease and disability. 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 35-year-old woman presents to an outpatient clinic during winter for persistant rhinorrhea. She states it is persistent and seems to be worse when she goes outside. Otherwise, she states she is generally healthy and only has a history of constipation. Her temperature is 98.7°F (37.1°C), blood pressure is 144/91 mmHg, pulse is 82/min, respirations are 14/min, and oxygen saturation is 98% on room air. Nasal sputum cytology reveals eosinophilia and boggy turbinates. Which of the following is the most likely diagnosis?" }, { "role": "assistant", "content": "Environmental allergen" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Diabetes Complications, Humans, Male, Penile Induration, Penis, Risk Factors, Severity of Illness Index, Ultrasonography, Doppler, Duplex." }, { "role": "user", "content": "Is diabetes mellitus associated with severe Peyronie 's disease? Context: To evaluate the severity of penile deformity and penile blood flow variables in men with Peyronie's disease (PD) and diabetes mellitus (DM), and those with no risk factors. Men with PD and DM (59 men, group 1) and those with no risk factors (109, group 2) were compared for penile blood flow variables, severity of penile deformity, patient's age, duration of PD, the presence of pain on erection, and the degree of erectile dysfunction (ED). The men were evaluated with penile duplex Doppler ultrasonography and were categorized into specific vascular groups, using established criteria. Penile curvature was objectively measured and stratified according to the Kelâmi classification. Results were compared using Student's t-test. Men with PD and DM (group 1) were significantly older than those in group 2. The duration of disease was significantly longer in group 1 than in group 2 (median 24 vs 12 months). The mean degree of penile deformity in group 1 was significantly higher than in group 2 (45.2 degrees vs 30.2 degrees). The rate of severe penile curvature (>60 degrees ) was more frequent in group 1 (27.1% vs 5.5%). Pain on erection was significantly higher in group 2 (39.7% vs 25.5%), whereas the rate of ED was more common in group 1 (81% vs 47%). Group 1 had poorer peak-systolic velocity values and significantly higher rates of arterial insufficiency and mixed vascular disease. Nonvascular causes were twice as common in group 2 than in group 1." }, { "role": "assistant", "content": "This comparative clinical study suggests that the presence of DM as the only risk factor significantly increases the severity of PD. Furthermore, DM as a risk factor is associated with significantly worse vascular status, as shown by penile duplex Doppler ultrasonography, in men with PD. 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, Child, Cystic Fibrosis, Exocrine Pancreatic Insufficiency, Feces, Female, Humans, Lipids, Male, Predictive Value of Tests, Steatorrhea." }, { "role": "user", "content": "Is acid steatocrit determination helpful in cystic fibrosis patients without or with mild steatorrhea? Context: Most methods used for the assessment of severe steatorrhea in cystic fibrosis (CF) are sensitive. In fact, the tests show their usefulness in a borderline zone of the results. Yet, the existing data related to acid steatocrit (AS) are still contradictory. Therefore, in the present study we have aimed to assess CF patients without or with mild steatorhea (<10 g/day) and evaluate the applicability of AS in such a subset of patients. In fifty-five CF patients, AS, fecal fat concentration (FFC) and fecal fat excretion (FFE) in 1-day stool collection were assessed from one to three times (149 samples). In 50 subjects, FFC, FFE, and AS were available for 3 subsequent days. It allowed for the calculations based upon 3-day fecal fat balance study. The correlations between FFE/FFC and AS based upon 1-day stool collection, although statistically significant, were rather weak (r = 0.208, P < 0.011; r = 0.362, P < 0.000006, respectively). The correlations between FFE/FFC and AS based upon the 3-day stool collection, although stronger, did not show values a linear relationship (r = 0.394, P < 0.005; r = 0.454, P < 0.001, respectively). With no regard to the cut-off level for AS (10% and 20%), sensitivity, specificity, negative, and positive predictive values in the determination of abnormal FFC and FFE were not satisfactory. The flow charts describing the accuracy of AS to determine FFE and FC revealed a high level of uncertainty." }, { "role": "assistant", "content": "AS does not reflect in a reliable way FFE in CF patients without or mild steatorrhea. Its applicability in the assessment of FFC in such patients has therefore limited practical value. 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: OBJECTIVE, METHODS, METHODS, METHODS, RESULTS. Meshes: Adult, Brain Injuries, Case-Control Studies, Fatigue, Female, Humans, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Resilience, Psychological, Self Report, Time Factors." }, { "role": "user", "content": "Is resilience associated with fatigue after mild traumatic brain injury? Context: To examine resilience as a predictor of change in self-reported fatigue after mild traumatic brain injury (MTBI). A consecutive series of 67 patients with MTBI and 34 orthopedic controls. Prospective longitudinal study. Resilience Scale, Beck Depression Inventory-Second Edition, and Pain subscale from Ruff Neurobehavioral Inventory 1 month after injury and Barrow Neurological Institute Fatigue Scale 1 and 6 months after injury. Insomnia, pain, and depressive symptoms were significantly correlated with fatigue, but even when these variables were controlled for, resilience significantly predicted the change in fatigue from 1 to 6 months after MTBI. In patients with MTBI, the correlation between resilience and fatigue strengthened during follow-up. In controls, significant associations between resilience and fatigue were not found." }, { "role": "assistant", "content": "Resilience is a significant predictor of decrease in self-reported fatigue following MTBI. Resilience seems to be a relevant factor to consider in the management of fatigue after MTBI along with the previously established associated factors (insomnia, pain, and depressive symptoms). 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, Blotting, Western, CCAAT-Enhancer-Binding Protein-beta, Chickens, Down-Regulation, Gene Expression Regulation, Hypothalamus, Inflammation, Interleukin-1beta, Interleukin-6, Lipopolysaccharides, Liver, Male, Poultry Diseases, Promoter Regions, Genetic, Real-Time Polymerase Chain Reaction, STAT3 Transcription Factor." }, { "role": "user", "content": "Is lPS-induced inflammation in the chicken associated with CCAAT/enhancer binding protein beta-mediated fat mass and obesity associated gene down-regulation in the liver but not hypothalamus? Context: The fat mass and obesity associated gene (FTO) is widely investigated in humans regarding its important roles in obesity and type 2 diabetes. Studies in mammals demonstrate that FTO is also associated with inflammation markers. However, the association of FTO with inflammation in chickens remains unclear. In this study, male chickens on day 28 posthatching were injected intraperitoneally with lipopolysaccharide (LPS) or saline to investigate whether the FTO gene is involved in LPS-induced inflammation. We detected significant down-regulation of FTO mRNA in the liver (P < 0.01), but not in the hypothalamus, 2 and 24 h after LPS challenge. Toll-like receptor (TLR) 2 (P < 0.01) and TLR4 (P < 0.01) followed the same pattern as FTO, being suppressed significantly in liver but not in hypothalamus. IL-1β was dramatically up-regulated (P < 0.01) in both liver and hypothalamus 2 h after LPS challenge, while activation of IL-6 was observed in the liver (P < 0.01), but not in hypothalamus. The 5'-flanking sequence of the chicken FTO gene contains nine predicted binding sites for CCAAT/enhancer binding protein beta (C/EBP beta) and one for signal transducer and activator of transcription 3 (STAT3). Significant elevation of C/EBP beta was detected in the liver (P < 0.01), but not in the hypothalamus, 2 h after LPS challenge. Lipopolysaccharide challenge increased the C/EBP beta binding to FTO promoter in the liver (P < 0.01 for fragment 1, P < 0.05 for fragment 2), although the protein content of C/EBP beta was not altered. Moreover, injection of LPS resulted in enhanced phosphorylation of liver STAT3, a downstream transcription factor in IL-6 signaling. Although phosphorylated STAT3 was not detected to directly bind to FTO promoter, it was found to interact with C/EBP beta." }, { "role": "assistant", "content": "Our results reveal that FTO expression in liver, but not in hypothalamus, is affected by the i.p. injection of LPS, which may be mediated through tissue-specific FTO transcriptional regulation by C/EBP beta and STAT3 interaction. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Increased insulin secretion from beta cells is done by-" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Repaglinide o Drugs causing increased insulin secretion (by closing ATP sensitive K+ channels) :- i) Sulfonylureas: first generation (chlorpropamide, tobutamide); second generation (Glimipiride, glyburide, glipizide, gliclazide). ii) Megalitinnide/D-phenylalanine analogues: Nateglinide, Rapaglinide." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aged, Aged, 80 and over, Female, Hospital Mortality, Humans, Male, Risk Adjustment, Surgery Department, Hospital." }, { "role": "user", "content": "Are mortality rates for different operations related? Context: Except in cardiac surgery, measuring quality with procedure-specific mortality rates is unreliable because of small sample sizes at individual hospitals. Statistical power can be improved by combining mortality data from multiple operations. We sought to determine whether this approach would still be useful in understanding performance with individual procedures. We studied 11 high-risk operations performed in the national Medicare population (1996-1999). For each operation, we calculated 1) the risk-adjusted mortality rate for the procedure and 2) the mortality rate with up to 10 other operations combined (\"other\" mortality). To test for an association between these mortality rates, we calculated the correlation coefficient adjusting for random variation. We then collapsed hospitals into quintiles of other mortality and calculated procedure-specific mortality rates within each of these quintiles. Mortality with specific operations was modestly correlated with other mortality: coefficients ranged from 0.14 for pneumonectomy to 0.35 for esophagectomy. Despite small to moderate correlations, other mortality was a good predictor of procedure-specific mortality for 10 of the 11 operations. Pancreatic resection had the strongest relationship, with procedure-specific mortality rates at hospitals in the worst quintile of other mortality 3-fold higher than those in the best quintile (15.2% vs. 6.3%, P<0.001). Pneumonectomy had the weakest relationship with no significant relationship between other mortality and procedure-specific mortality." }, { "role": "assistant", "content": "Hospitals with low mortality rates for 1 operation tend to have lower mortality rates for other operations. These relationships suggest that different operations share important structures and processes of care related to performance. Future efforts aimed at predicting procedure-specific performance should consider incorporating data from other operations at that hospital." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Capillaries, Female, Humans, Male, Microcirculation, Microscopic Angioscopy, Middle Aged, Nails, Peripheral Vascular Diseases, Phenotype, Prognosis, Scleroderma, Diffuse, Scleroderma, Limited, Scleroderma, Systemic, Severity of Illness Index." }, { "role": "user", "content": "Are scleroderma patients nailfold videocapillaroscopic patterns associated with disease subset and disease severity? Context: To evaluate in a large group of scleroderma patients, the association of nailfold videocapillaroscopic patterns with both demographic and clinical features. One hundred and three Italian patients (91 women and 12 men, mean age 54.3 years, median disease duration 7 yrs, 68 with limited and 35 with diffuse subset of disease), consecutively enrolled for the study, underwent nailfold videocapillaroscopy; the microvascular alterations were classified into three different patterns, early, active and late. The nailfold videocapillaroscopic patterns were correlated with such numerous clinical features as sex, age, disease duration, disease subset, disease activity, haematochemical data, involvement of skin, heart, lung and peripheral vessels. Nailfold videocapillaroscopic patterns were significantly associated with disease subsets (P = 0.018). Severity of skin, lung, heart and peripheral vascular involvement progressively increased across nailfold videocapillaroscopic patterns, from early to late pattern (P < 0.001 for cutaneous and peripheral vascular involvement; P = 0.003 and 0.002 for lung and heart involvement, respectively) as well as homocysteine plasma levels (P = 0.02). Patients with late pattern showed an increased risk to have an active disease [OR (odds ratio) 3.50; 95% CI (confidence interval) 1.31-9.39], to present digital ulcers (OR 5.74; 95% CI 2.08-15.89) and moderate to severe skin (OR 5.28; 95% CI 1.93-14.19), heart (OR 5.75; 95% CI 2.04-16.21) and lung involvement (OR 4.41; 95% CI 1.63-11.92)." }, { "role": "assistant", "content": "Our study showed that scleroderma microangiopathy correlates with disease subset and severity of peripheral vascular, skin, heart and lung involvement; patients with late pattern showed an increased risk to have an active disease and to show a moderate/severe skin or visceral involvement compared to patients with early and active patterns. Therefore nailfold videocapillaroscopy, a simple, non-invasive and non-expensive investigation, is useful in staging scleroderma patients and also provides prognostic information. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Apoptosis, Interleukin-17, Interleukin-23, Interleukin-6, Male, Myocardial Reperfusion Injury, Myocardium, Oxidative Stress, Rats, Sprague-Dawley, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Does iL-23 promote Myocardial I/R Injury by Increasing the Inflammatory Responses and Oxidative Stress Reactions? Context: Inflammation and oxidative stress play an important role in myocardial ischemia and reperfusion (I/R) injury. We hypothesized that IL-23, a pro-inflammatory cytokine, could promote myocardial I/R injury by increasing the inflammatory response and oxidative stress. Male Sprague-Dawley rats were randomly assigned into sham operated control (SO) group, ischemia and reperfusion (I/R) group, (IL-23 + I/R) group and (anti-IL-23 + I/R) group. At 4 h after reperfusion, the serum concentration of lactate dehydrogenase (LDH), creatine kinase (CK) and the tissue MDA concentration and SOD activity were measured. The infarcte size was measured by TTC staining. Apoptosis in heart sections were measured by TUNEL staining. The expression of HMGB1 and IL-17A were detected by Western Blotting and the expression of TNF-α and IL-6 were detected by Elisa. After 4 h reperfusion, compared with the I/R group, IL-23 significantly increased the infarct size, the apoptosis of cardiomyocytes and the levels of LDH and CK (all P < 0.05). Meanwhile, IL-23 significantly increased the expression of eIL-17A, TNF-α and IL-6 and enhanced both the increase of the MDA level and the decrease of the SOD level induced by I/R (all P<0.05). IL-23 had no effect on the expression of HMGB1 (p > 0.05). All these effects were abolished by anti-IL-23 administration." }, { "role": "assistant", "content": "The present study suggested that IL-23 may promote myocardial I/R injury by increasing the inflammatory responses and oxidative stress reaction. 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, DESIGN, SETTING, PARTICIPANTS, INTERVENTION, MEASUREMENTS, RESULTS, LIMITATIONS. Meshes: Age Factors, Australia, Cardiovascular Diseases, Female, Health Behavior, Health Knowledge, Attitudes, Practice, Humans, Life Style, Male, Middle Aged, Random Allocation, Regression Analysis, Risk Assessment, Risk Factors, Surveys and Questionnaires." }, { "role": "user", "content": "Is the \"Heart Age\" Concept Helpful or Harmful Compared to Absolute Cardiovascular Disease Risk? Context: Cardiovascular disease (CVD) prevention guidelines are generally based on the absolute risk of a CVD event, but there is increasing interest in using 'heart age' to motivate lifestyle change when absolute risk is low. Previous studies have not compared heart age to 5-year absolute risk, or investigated the impact of younger heart age, graphical format, and numeracy. Compare heart age versus 5-year absolute risk on psychological and behavioral outcomes. 2 (heart age, absolute risk) × 3 (text only, bar graph, line graph) experiment. Online. 570 Australians aged 45-64 years, not taking CVD-related medication. CVD risk assessment. Intention to change lifestyle, recall, risk perception, emotional response, perceived credibility, and lifestyle behaviors after 2 weeks. Most participants had lifestyle risk factors (95%) but low 5-year absolute risk (94%). Heart age did not improve lifestyle intentions and behaviors compared to absolute risk, was more often interpreted as a higher-risk category by low-risk participants (47% vs 23%), and decreased perceived credibility and positive emotional response. Overall, correct recall dropped from 65% to 24% after 2 weeks, with heart age recalled better than absolute risk at 2 weeks (32% vs 16%). These results were found across younger and older heart age results, graphical format, and numeracy. Communicating CVD risk in a consultation rather than online may produce different results." }, { "role": "assistant", "content": "There is no evidence that heart age motivates lifestyle change more than 5-year absolute risk in individuals with low CVD risk. Five-year absolute risk may be a better way to explain CVD risk, because it is more credible, does not inflate risk perception, and is consistent with clinical guidelines that base lifestyle and medication recommendations on absolute 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": "All of the following are the reasons for sudden onset of pain in an asymptomatic case of uterine fibroid, EXCEPT:" }, { "role": "assistant", "content": "The correct answer is Mature or \"old\" leiomyomas are white but contain yellow, soft, and often gelatinous areas of hyaline change. These tumors are usually asymptomatic. Leiomyomata may cause pain when vascular compromise occurs. Thus, pain may result from degeneration associated with vascular occlusion, infection, torsion of a pedunculated tumor, or myometrial contractions to expel a subserous myoma from the uterine cavity. The pain associated with infarction from torsion or red degeneration can be excruciating and produce a clinical picture consistent with acute abdomen. Ref: Drinville J.S., Memarzadeh S. (2007). Chapter 39. Benign Disorders of the Uterine Corpus. In A.H. DeCherney, L. Nathan (Eds), CURRENT Diagnosis & Treatment Obstetrics & Gynecology, 10e." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adiponectin, Adult, African Americans, Aged, Body Mass Index, Cross-Sectional Studies, European Continental Ancestry Group, Female, Humans, Middle Aged, Obesity, Southeastern United States." }, { "role": "user", "content": "Does serum adiponectin in relation to body mass index and other correlate in black and white women? Context: Adiponectin is a promising biomarker linking obesity and disease risk; however, limited data are available regarding adiponectin in black women among whom obesity is highly prevalent. A cross-sectional analysis was conducted to assess racial differences and correlates of serum adiponectin measured in 996 black and 996 white women enrolled in the Southern Community Cohort Study through Community Health Centers in 12 southeastern states from 2002 to 2006. Black subjects had significantly lower adiponectin levels than white subjects (median 10.9 vs 14.9 μg/mL, Wilcoxon p < .0001). Among black subjects, adiponectin was lower among overweight and obese women compared with healthy weight women but showed no clear decreasing trend with increasing severity of obesity; adjusted geometric means (95% confidence interval) were 15.0 [13.8-16.4], 11.5 [10.6-12.5], 9.7 [9.0-10.6], 11.4 [10.3-12.6], and 10.9 [9.5-12.6] μg/mL for body mass index [BMI] categories of 18.5-24.9, 25-29.9, 30-34.9, 35-39.9, and 40-45, p for trend <.0001). In contrast, among whites there was a monotonic reduction in adiponectin over increasing BMI (adjusted geometric means = 19.9 [18.3-21.7], 15.1 [13.9-16.4], 14.3 [13.2-15.5], 12.5 [11.2-13.9], and 11.0 [9.7-12.5] μg/mL, p for trend <.0001). BMI, age, high-density lipoprotein cholesterol, and hypertension were important correlates of adiponectin in both groups." }, { "role": "assistant", "content": "Among women, racial differences exist in both the magnitude and form of the adiponectin-BMI association. 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: Acute Kidney Injury, Animals, Antibodies, Monoclonal, Body Weight, Creatinine, Disease Progression, Disinfectants, Epithelial Cells, Female, Flow Cytometry, Immunotherapy, Intercellular Adhesion Molecule-1, Kidney Tubules, Lymphocyte Function-Associated Antigen-1, Macrophages, Male, Mercuric Chloride, Mice, Proteinuria, Rats, Rats, Inbred Lew, Rats, Wistar." }, { "role": "user", "content": "Do antibodies to both ICAM-1 and LFA-1 protect the kidney against toxic ( HgCl2 ) injury? Context: The role of inflammatory leukocytes in acute renal failure (ARF) remains controversial and appears largely uninvestigated in toxic (in contrast to ischemic) ARF. Female Wistar rats were injected with monoclonal antibodies (mAbs) directed to both the leukocyte function-associated antigen 1 (LFA-1) and the intercellular adhesion molecule 1 (ICAM-1). Doses (6 mg/kg of each mAb) were given 24 hours prior to the induction of acute tubular necrosis (ATN) by mercuric chloride administration (2 mg/kg, subcutaneously, day 0) and subsequently every 48 hours. Control rats similarly received either control antibody (12 mg/kg) or vehicle prior to and following the induction of ATN. Renal function was also measured from male Lewis rats that were similarly treated with anti-adhesion antibodies during exposure to 30 minutes of unilateral renal ischemia. Injected antibodies were demonstrated on peripheral blood leukocytes (flow cytometrical detection of mouse anti-LFA-1) and on endothelium (immunohistochemical staining of mouse anti-ICAM-1) and were measured in serum (enzyme-linked immunosorbent assay). Macrophages and T cells were prominent in the kidney of control treatment rats after HgCl2 injection, but anti-adhesion treatment clearly had prevented their infiltration. Notwithstanding, renal tubular injury was equally pronounced in all mercuric chloride treatment groups and so was the decline in renal function (serum creatinine, proteinuria). Tubular epithelial cell proliferation seemed slightly less pronounced and delayed in anti-adhesion treated rats. Kidneys from ischemia exposed rats were, however, functionally protected by identical anti-ICAM-1/anti-LFA-1 treatment." }, { "role": "assistant", "content": "Prevention of cellular infiltration by mAbs to LFA-1 and ICAM-1 has no effect on renal morphology, function, or regeneration following mercuric chloride-induced ARF in the rat. This result contrasts with the functional protection of the rat kidney to ischemia/reperfusion injury by virtue of an identical antibody treatment protocol. Resolving that controversy should bring better insight in fundamental processes underlying different types of ARF, and will be the subject of further study. 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": "Indication of Sentinel node Biopsy in cancer breast" }, { "role": "assistant", "content": "The correct answer is Ans. (c) Breast Mass without palpable axillary node(Ref. Bailey and love 27th edition Page 877)* Sentinel node biopsy is indicated only for Node non palpable cases.* Palpable node always Cytology (FNAC) Done" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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. Meshes: Acetabulum, Aged, Aged, 80 and over, Arthroplasty, Replacement, Hip, Equipment Design, Female, Follow-Up Studies, Hip Prosthesis, Humans, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Robotics, Surgery, Computer-Assisted, Tomography, X-Ray Computed." }, { "role": "user", "content": "Does patient-specific instrumentation improve the accuracy of acetabular component placement in total hip arthroplasty? Context: Accurate placement of the acetabular component during total hip arthroplasty (THA) is an important factor in the success of the procedure. However, the reported accuracy varies greatly and is dependent upon whether free hand or navigated techniques are used. The aim of this study was to assess the accuracy of an instrument system that incorporates 3D printed, patient-specific guides designed to optimise the placement of the acetabular component. A total of 100 consecutive patients were prospectively enrolled and the accuracy of placement of the acetabular component was measured using post-operative CT scans. A total of 100 consecutive patients were prospectively enrolled and the accuracy of placement of the acetabular component was measured using post-operative CT scans." }, { "role": "assistant", "content": "Accurate placement of the acetabular component can be achieved using patient-specific guides and is superior to free hand techniques and comparable to navigated and robotic techniques. Cite this article: Bone Joint J 2016;98-B:1342-6. 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: Defibrillators, Emergency Treatment, Feasibility Studies, Humans, Rescue Work, Ships." }, { "role": "user", "content": "Do moderate sea states influence the application of an AED in rigid inflatable boats? Context: This study was to determine if the AED can be operated correctly on board rigid inflatable rescue boats (RIBs), and if downloading of data later for quality control is possible. Six AEDs were tested for their reliability, robustness and stability. Data were collected on three different types of RIBs, in a harbour and at sea. Each AED was connected to a volunteer and a manikin simulating VF. Data from the AED were continuously collected. At one of the RIBs each AED became wet; no AED had a technical problem. When connected to the volunteer, the ECGs delivered by the AEDs showed a regular sinus rhythm. When connected to a manikin in VF, each AED was able to recognise VF and to provide a shock. There were differences in the time between first analysis and the shock. The voice prompt of the Zoll AED Plus was 'understandable', while the other AEDs were 'difficult to understand'. We had a problem with the infrared connection, which means that evaluation and quality control afterwards may be difficult." }, { "role": "assistant", "content": "The use of AEDs on RIBs during patient transport over calm water is possible and effective. The AED should have a screen and better features to download data. However, AEDs are only worthwhile when they fit well in the Chain of Survival (fast arrival, immediately availability of an AED, trained provider and advanced life support). 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: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Anxiety Disorders, Arthritis, Rheumatoid, Biomarkers, Depressive Disorder, Major, Female, Humans, Male, Middle Aged, Prevalence, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Is major depression associated with serum levels of tumor necrosis factor-alpha in patients with rheumatoid arthritis? Context: This study presents the serum tumor necrosis factor-alpha (TNF-α) levels in rheumatoid arthritis (RA) patients with major depression and without any psychiatric disorder. The study sample included 61 patients with a diagnosis of RA. Major depression and other psychiatric disorders were screened with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Blood sample for the determination of serum TNF-α level was obtained before the psychiatric interview. The prevalence rates of any depressive disorder and any anxiety disorder were 40.3% (n=25) and 22.6% (n=14), respectively. Fifteen (24.2%) patients had major depression alone, whereas 27 (43.5%) patients were not diagnosed with any psychiatric disorder. We could not determine any significant differences between the patients with major depression alone and patients without any psychiatric diagnosis with regard to the serum levels of TNF-α." }, { "role": "assistant", "content": "The existence of major depression in RA patients does not seem to be associated with serum levels of TNF-α." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Anxiety, Biopsy, Fine-Needle, Cytodiagnosis, Feasibility Studies, Female, Humans, Male, Middle Aged, Reproducibility of Results, Stress, Psychological, Thyroid Nodule, Time Factors, Young Adult." }, { "role": "user", "content": "Does sAME-DAY FINE-NEEDLE ASPIRATION CYTOLOGY DIAGNOSIS FOR THYROID NODULES achieve RAPID ANXIETY DECREASE AND HIGH DIAGNOSTIC ACCURACY? Context: The time between the moment of referral for the diagnostic workup for thyroid nodules and the outcome can be worrisome for patients. In general, patients experience high levels of anxiety during the evaluation of a lesion suspicious for cancer. Therefore, the implementation of same-day fine-needle aspiration cytology (FNAC) diagnosis is becoming standard-of-care for many solid tumors. Our aim was to assess the feasibility of same-day FNAC diagnosis for thyroid nodules and to assess patient anxiety during the diagnostic process. For feasibility of same-day FNAC diagnosis, we assessed the proportion of patients receiving a diagnosis at the end of the visit. Accuracy was measured by comparing histology with the FNAC result. Patient anxiety was measured by the State Trait Anxiety Inventory at 6 moments during the diagnostic workup. Of the 131 included patients, 112 (86%) were female, and the mean age was 53 years. All patients, except those with a nondiagnostic FNAC result (n = 26; 20%), had a diagnosis at the end of the day. There were only two discordant results. Anxiety levels at the beginning of the day were high throughout the group, State Trait Anxiety Inventory (STAI) score 43.1 (SD 2.0) and decreased significantly more in patients with a benign FNAC result (STAI score 30.2), compared to patients with a malignant or indeterminate result (STAI score 39.6)." }, { "role": "assistant", "content": "Distress of patients with a thyroid nodule undergoing same-day FNAC diagnostics was high. Same-day FNAC diagnosis is feasible and accurate for the evaluation of thyroid nodules. Therefore, same-day FNAC diagnosis seems a safer, more patient-friendly approach to diagnose thyroid nodules. 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 58-year-old man comes to the physician because of a 6-month history of headaches and back pain. Examination shows mild sensorineural hearing loss. Serum concentration of alkaline phosphatase is increased. An x-ray of the skull is shown. The most appropriate pharmacotherapy for this patient is a drug that has which of the following mechanisms of action?" }, { "role": "assistant", "content": "Apoptosis of osteoclasts" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Age Factors, Cerebral Palsy, Disability Evaluation, Exercise Test, Exercise Therapy, Health Status, Humans, Male, Mobility Limitation, Postural Balance, Task Performance and Analysis, Treatment Outcome, User-Computer Interface, Walking." }, { "role": "user", "content": "Does an intensive virtual reality program improve functional balance and mobility of adolescents with cerebral palsy? Context: To examine functional balance and mobility in adolescents with cerebral palsy classified at Gross Motor Function Classification System (GMFCS) level I following an intensive short-duration virtual reality (VR) intervention. Single-subject, multiple-baseline design with 4 adolescents. Outcomes included the Community Balance and Mobility Scale (CB&M), the 6-Minute Walk Test (6MWT), the Timed Up and Down Stairs, and the Gross Motor Function Measure Dimension E. Assessments were recorded 3 to 6 times at baseline, 5 times during intervention, and 4 times at follow-up. Daily 90-minute VR intervention was completed for 5 consecutive days. Visual, statistical, and clinical significance analyses were used. Statistically significant improvements were shown in all adolescents on CB&M and 6MWT. True change was recorded in all for the CB&M and in 3 for the 6MWT." }, { "role": "assistant", "content": "Functional balance and mobility in adolescents with cerebral palsy classified at GMFCS level I improve with intense, short duration VR intervention, and changes are maintained at 1-month posttraining. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Autoimmune Diseases, Biomarkers, Diagnosis, Differential, Humans, Immunoglobulin G, Jaundice, Male, Middle Aged, Pancreatic Neoplasms, Pancreatitis." }, { "role": "user", "content": "Does differentiation of autoimmune pancreatitis with pancreatic carcinoma remain a challenge to physicians? Context: The aim of this study was to summarize the clinical features of autoimmune pancreatitis (AIP) and review the advances in the differential diagnosis with pancreatic carcinoma, thus help to make a correct diagnosis and avoid unnecessary surgery in clinical practice. Five patients diagnosed as AIP in accordance with the HISORt criteria in Zhongshan Hospital, Fudan University from 2008 to 2010 were enrolled in the study. Clinical features were analyzed and related literature was reviewed. Progressive jaundice and abdominal pain were the most frequent symptoms, as well as weight loss, together with serological changes such as elevation of alkaline phosphatase, γ-glutamyl-transpeptidase and serum bilirubin. Two of them showed high serum immunoglobulin G4 (IgG4) levels. Both focal and diffuse changes were found on computed tomography and magnetic resonance imaging. Two of our patients underwent operation because of a high suspicion of malignant tumor, and steroid therapy was administered to the other three patients diagnosed as AIP. No relapse was observed during the follow-up duration of all the patients." }, { "role": "assistant", "content": "Although some recent advances have been made to help the diagnosis of AIP, the differentiation between AIP and pancreatic carcinoma is still a challenge. Clinicians must remember to exclude AIP before making a diagnosis of pancreatic carcinoma. 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, Behavior, Animal, Calcium Channels, Capsaicin, Cisplatin, Cryopyrin-Associated Periodic Syndromes, Ganglia, Spinal, Hyperalgesia, Isothiocyanates, Male, Menthol, Mice, Mice, Inbred C57BL, Nociception, Organoplatinum Compounds, Oxaliplatin, Paclitaxel, TRPA1 Cation Channel, Transient Receptor Potential Channels." }, { "role": "user", "content": "Is acute cold hypersensitivity characteristically induced by oxaliplatin caused by the enhanced responsiveness of TRPA1 in mice? Context: Oxaliplatin, a platinum-based chemotherapeutic agent, causes an unusual acute peripheral neuropathy. Oxaliplatin-induced acute peripheral neuropathy appears in almost all patients rapidly after infusion, and is triggered or exacerbated by cold, while its mechanisms are poorly understood. In this study, the involvement of thermosensitive transient receptor potential channels (TRPA1, TRPM8 and TRPV1) in oxaliplatin-induced acute hypersensitivity was investigated in mice. A single intraperitoneal administration of oxaliplatin (1-10 mg/kg) induced cold but not mechanical hypersensitivity within 2 h in a dose-dependent manner. Infusion of the oxaliplatin metabolite, oxalate (1.7 mg/kg), also induced acute cold hypersensitivity, while another platinum-based chemotherapeutic agent, cisplatin (5 mg/kg), or the non-platinum-containing chemotherapeutic agent, paclitaxel (6 mg/kg) failed to induce mechanical or cold hypersensitivity. The oxaliplatin-induced acute cold hypersensitivity was abolished by the TRPA1 antagonist HC-030031 (100 mg/kg) and by TRPA1 deficiency. The nocifensive behaviors evoked by intraplantar injections of allyl-isothiocyanate (AITC; TRPA1 agonist) were significantly enhanced in mice treated for 2 h with oxaliplatin (1-10 mg/kg) in a dose-dependent manner, while capsaicin (TRPV1 agonist)-evoked nocifensive behaviors were not affected. Menthol (TRPM8/TRPA1 agonist)-evoked nocifensive-like behaviors were also enhanced by oxaliplatin pretreatment, which were inhibited by TRPA1 deficiency. Similarly, oxalate enhanced, but neither cisplatin nor paclitaxel affected AITC-evoked nocifensive behaviors. Pretreatment of cultured mouse dorsal root ganglia (DRG) neurons with oxaliplatin (30-300 μM) for 1, 2, or 4 h significantly increased the number of AITC-sensitive neurons in a concentration-dependent manner whereas there was no change in the number of menthol- or capsaicin-sensitive neurons." }, { "role": "assistant", "content": "Taken together, these results suggest that a brief treatment with oxaliplatin or its metabolite oxalate is sufficient to enhance the responsiveness of TRPA1 but not that of TRPM8 and TRPV1 expressed by DRG neurons, which may contribute to the characteristic acute peripheral neuropathy induced by oxaliplatin. 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 42-year-old woman comes to the physician because of progressive weakness. She has noticed increasing difficulty performing household chores and walking her dog over the past month. Sometimes she feels too fatigued to cook dinner. She has noticed that she feels better after sleeping. She does not have chest pain, shortness of breath, or a history of recent illness. She has no personal history of serious illness and takes no medications. She has smoked two packs of cigarettes daily for 25 years. She appears fatigued. Her temperature is 37°C (98.8°F), pulse is 88/min, and blood pressure is 148/80 mm Hg. Pulse oximetry shows an oxygen saturation of 98% in room air. Bilateral expiratory wheezes are heard at both lung bases. Examination shows drooping of the upper eyelids. There is diminished motor strength in her upper extremities. Her sensation and reflexes are intact. A treatment with which of the following mechanisms of action is most likely to be effective?" }, { "role": "assistant", "content": "Inhibition of acetylcholinesterase" } ]

[ { "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 48-years-old male had a road traffic accident and was brought to emergency. All of the following are done as a part of primary survey except." }, { "role": "assistant", "content": "The correct answer is Ans. A. CT abdomen for bleeder identificationExplanationThis initial assessment, also termed the primary survey, follows the mnemonic ABCDE:Airway and cervical spine protectionBreathingCirculationDisability or neurologic conditionExposure and environmental controlAlgorithm for management of a trauma victim:" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 46-year-old woman presents to your medical office complaining of ‘feeling tired’. The patient states that she has been having some trouble eating because her ‘tongue hurts’, but she has no other complaints. On examination, the patient has pale conjunctiva and skin and also appears tired. She has a smooth, red tongue that is tender to touch with a tongue depressor. The patient’s hands and feet feel cold. Fluoroscopic evaluation of the swallowing mechanism and esophagus is normal. Which of the following diagnoses is most likely?" }, { "role": "assistant", "content": "Pernicious anemia" } ]

[ { "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": "Talipes equinovarus is -" }, { "role": "assistant", "content": "The correct answer is CTEV is the commonest and most important congenital deformity of the foot.\nThe deformity consists of following elements :-\n\n\nEquinus, i.e. Plantar flexion at ankle joint (tibiotalar joint)\nInversion of foot at subtalar joint (talocalcaneal joint)\nForefoot adduction, at mid-tarsal joints, especially at talo-navicular joint.\nSometimes forefoot cavus, i.e. excessive arching of the foot at mid-tarsal joints." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, RESULTS. Meshes: Aged, Cardiopulmonary Resuscitation, Electric Countershock, Emergency Medical Services, Female, Humans, Male, Middle Aged, Netherlands, Out-of-Hospital Cardiac Arrest, Prospective Studies, Quality of Life, Registries, Surveys and Questionnaires, Text Messaging, Volunteers." }, { "role": "user", "content": "Does a text message alert system for trained volunteers improve out-of-hospital cardiac arrest survival? Context: The survival rate of sudden out-of-hospital cardiac arrests (OHCAs) increases by early notification of Emergency Medical Systems (EMS) and early application of basic life support (BLS) techniques and defibrillation. A Text Message (TM) alert system for trained volunteers in the community was implemented in the Netherlands to reduce response times. The aim of this study was to assess if this system improves survival after OHCA. From April 2012 to April 2014 data on all 1546 emergency calls for OHCA in the Dutch province of Limburg were collected according to the Utstein template. On site resuscitation attempts for presumed cardiac arrest were made in 833 cases, of which the TM-alert system was activated in 422 cases. Two cardiopulmonary resuscitation (CPR) scenarios were compared: 1. TM-alert system was activated but no responders attended (n=131), and 2. TM-alert system was activated with attendance of ≥1 responder(s) (n=291). Survival to hospital discharge was 16.0% in scenario 1 and 27.1% in scenario 2 corresponding with OR=1.95 (95% CI 1.15-3.33; P=.014). After adjustment for potential confounders the odds ratio increased (OR=2.82; 95% CI 1.52-5.24; P=.001). Of the 100 survivors, 92% were discharged from the hospital to their home with no or limited neurological sequelae." }, { "role": "assistant", "content": "The TM-alert system is effective in increasing survival to hospital discharge in OHCA victims and the degree of disability or dependence after survival is low. 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: Antibody Formation, CD4-Positive T-Lymphocytes, Graft Survival, HLA-DR Antigens, Histocompatibility Antigens Class I, Histocompatibility Testing, Humans, Immunodominant Epitopes, Kidney Transplantation, Peptides, Phenotype, Protein Binding." }, { "role": "user", "content": "Does the humoral immune response against an HLA class I allodeterminant correlate with the HLA-DR phenotype of the responder? Context: The genetic basis for control of alloantibody responses against foreign HLA histocompatibility antigens has never been delineated. The most likely postulate would be that HLA class II alloantigens of the host regulate the response through their ability to present processed HLA allopeptide fragments for the cognate interaction between CD4+ T lymphocytes and B lymphocytes that leads to IgG antibody synthesis. We have analyzed our allosensitized transplant patient population with regard to humoral responsiveness to a serologically defined public HLA class I epitope, Bw4. Peptides representing the linear sequence of the Bw4 epitope (amino acids 74-86) and the alternative Bw6 epitope were synthesized and assayed for binding to a panel of HLA homozygous lymphoblastoid B cells using a quantitative fluorescence binding assay. We found that 73% of patients who have produced a HLA-Bw4-specific alloantibody express either the HLA-DRB1*01 or HLA-DRB1*03 alloantigen; 19% of the remaining responders expressed HLA-DRB1*04. Analysis of the United Network for Organ Sharing Transplant Registry indicated that the survival of cadaver renal allografts mismatched for Bw4 was significantly compromised in sensitized DRB1*01+ or DRB1*03+ recipients (P<0.01). In vitro, the Bw4 peptide bound strongly to DRB1*01+ and DRB1*03+ lymphoblastoid B cells; no similar binding was observed with Bw6 peptide. These findings were confirmed using murine fibroblast lines transfected with HLA-DR alpha/beta genes and by solid-phase enzyme-linked immunosorbent assay using purified HLA-DR alloantigen." }, { "role": "assistant", "content": "We conclude that there are at least two human Ir genes, HLA-DRB1*01 and HLA-DRB1*03, that confer a high risk for both humoral allosensitization and renal allograft failure in situations of HLA-Bw4 incompatibility. These findings may be of future benefit in devising new antigen matching strategies for reducing the risk of humoral HLA allosensitization and chronic allograft rejection. 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": "Good syndrome is" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Thymoma with immunodeficiency Good's syndrome (thymoma with immunodeficiency) is a rare cause of combined B and T cell immunodeficiency in adults. Clinical features of Good's syndrome are :- Increased susceptibility to bacterial infections with encapsulated organisms and oppounistic viral and fungal infection. The most consistent immunological abnormalities are :- Hypogammaglobulinaemia and Reduced or absent B cells Treatment Resection of the thymoma and immunoglobulin replacement to maintain adequate through IgG values" } ]

[ { "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 ratio of c peptide: insulin in normal adults is" }, { "role": "assistant", "content": "The correct answer is C peptide and insulin are released in an equal ratio from beta cells of the pancreas. The indirect way of measurment of insulin in ones body is measuring the C peeptide . Ref:HL sharma 3rd ed.Pg 634" } ]

[ { "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 28-year-old G1 at 18 weeks has right - sided groin pain which is sharp and occuring with movement. No fever or chills. Local heat helps allete the discomfo. What is the likely etiology of this pain?" }, { "role": "assistant", "content": "The correct answer is Round ligament pain during pregnancy:- * Round ligament pain is a sharp pain often felt in the lower belly or groin area on one or both sides * It is most often felt during the second trimester * As the pregnancy advances, the round ligament stretches that makes it more likely to become strained * Sudden movements can cause the ligament to tighten quickly, like a rubber band snapping. This causes a sudden & quick jabbing feeling" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: INTRODUCTION, PATIENTS AND METHODS, RESULTS. Meshes: Adult, Alleles, Anti-Inflammatory Agents, Non-Steroidal, Area Under Curve, Aryl Hydrocarbon Hydroxylases, Cytochrome P-450 CYP2C9, Cytochrome P-450 Enzyme System, Diclofenac, Female, Genotype, Humans, Male, Middle Aged, Steroid 16-alpha-Hydroxylase, Steroid Hydroxylases, Tablets, Enteric-Coated." }, { "role": "user", "content": "Is diclofenac a valuable CYP2C9 probe in humans? Context: Besides the low therapeutic index drug tolbutamide, there is no validated in vivo probe to assess the genetically determined CYP2C9 activity in humans. The in vitro CYP2C9-specific substrate diclofenac might be a valuable, well-tolerated probe candidate. In order to validate diclofenac as an in vivo CYP2C9 probe, we planned to show that urinary 4'-hydroxydiclofenac/diclofenac metabolic ratio (MR) would correlate to the apparent partial metabolic clearance of diclofenac into 4'-hydroxydiclofenac (Clmet). Eighteen healthy volunteers received a single oral dose of 50 mg diclofenac in its enteric-coated form. Blood and urinary pharmacokinetics of diclofenac were studied over 48 h. Identification of the CYP2C9 alleles (CYP2C9*1, CYP2C9*2, and CYP2C9*3) was performed with genomic DNA sequencing. We observed a dramatic inter-individual variability in the delay of diclofenac intestinal absorption since its first detectable blood concentration ranged from 0.5 h to more than 12 h after drug intake. The Clmet of diclofenac could not be determined in two subjects who started to absorb the drug after 12 h. No correlation could be observed between Clmet of diclofenac and the different MRs calculated at 0-4 h, 0-8 h, 0-12 h, 0-24 h and 0-48 h urinary collections. The Clmet of diclofenac in heterozygous subjects tended to be lower than among wild-type homozygous subjects, but this difference did not reach statistical significance due to an insufficient number of subjects studied." }, { "role": "assistant", "content": "Diclofenac, in its enteric-coated form, is not a useful in vivo CYP2C9 probe probably because of its highly variable intestinal absorption rate. However, since we found a lower metabolic clearance of diclofenac in heterozygous CYP2C9 subjects, as observed with other CYP2C9 substrates, diclofenac, in another galenic form, might be a potential probe to quantify CYP2C9 activity in humans." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Tumor, Carcinoembryonic Antigen, Female, Flow Cytometry, Humans, Male, Meningeal Carcinomatosis, Middle Aged, Protein Isoforms, Vascular Endothelial Growth Factor A." }, { "role": "user", "content": "Is intrathecal synthesis of tumor markers a highly sensitive test in the diagnosis of leptomeningeal metastasis from solid cancers? Context: Identification of neoplastic cells in cerebrospinal fluid (CSF) by cytological analysis is the key diagnostic feature of leptomeningeal metastasis (LM). Because of the lack of sensitivity of this test, considerable efforts have been made to identify alternative diagnostic markers. Data from the literature suggest that measurement of tumor markers (TM) in CSF may be helpful for improving the diagnosis. We analyzed the concentrations of the TM carcinoembryonic antigen (CEA), CA15.3, CA125 and CA19.9 in both CSF and serum from 18 patients with neoplastic meningitis diagnosed by CSF cytology. We also performed these same measurements in 50 patients affected by other neurological diseases (OND) in order to evaluate putative intrathecal synthesis. In addition, CSF and serum concentrations of the proangiogenic factor VEGF (vascular endothelial growth factor) were evaluated. All LM patients showed intrathecal synthesis for at least one TM. In one patient, a negative CSF cytology after treatment paralleled normalization of tumor marker synthesis. None of the OND patients displayed intrathecal TM synthesis. The VEGF Index (CSF/serum VEGF relative to CSF/serum albumin ratios) was significantly higher in LM patients compared with the control group. However, significant overlap between LM patients and values seen in those with OND was observed." }, { "role": "assistant", "content": "Evaluation of intrathecal TM synthesis is a specific, sensitive, reliable, and reproducible diagnostic tool, and is useful to support diagnosis of carcinomatous meningitis. 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 55-year-old man presents to his primary care physician for a regular check-up. The patient was born in Germany in 1960 in with shortened limbs, underdeveloped digits, absent external ears, and a cleft palate. He is currently in a wheelchair. His past medical history is also notable for hypertension and allergies. He takes lisinopril daily and loratadine as needed. His mother had a complicated past medical history and took multiple medications during her pregnancy. His temperature is 98.6°F (37°C), blood pressure is 120/80 mmHg, pulse is 90/min, and respirations are 20/min. The drug that most likely caused this patient's condition is also indicated for which of the following?" }, { "role": "assistant", "content": "Multiple myeloma" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: UNLABELLED. Meshes: Adult, Burns, Duodenal Ulcer, Enteral Nutrition, Female, Glutamine, Humans, Male, Middle Aged, Stomach Ulcer, Stress, Physiological, Time Factors." }, { "role": "user", "content": "Do [ Early enteral feeding and supplement of glutamine prevent occurrence of stress ulcer following severe thermal injury ]? Context: Gastroscopic and gastric juice analysis studies were carried out on 12 patients with total body surface area over 30 percent who received early enteral feeding, supplemented with glutamine. The results indicated that early feeding was safe in major burn patients. All patients were found to have ASML on postburn days 1 to 2. Stress ulcer was not found in patients after several excision operations, and about 86 percent of ASML disappeared within about 2 weeks." }, { "role": "assistant", "content": "early feeding and supplement of glutamine can prevent the complication of stress ulcer following severe thermal 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": "All of the following are the causes of sudden increase in pain in osteochondroma, except:" }, { "role": "assistant", "content": "The correct answer is Ans. D. Degenerative changesa. Osteochondroma is usually painless. Sudden onset of pain in osteochondroma can be due to:b. Malignant transformationc. Bursitisd. Fracturee. Pressure or traction on neighboring structures (nerve/tendon/muscle)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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": "Is advancing maternal age associated with increasing risk for autism : a review and meta-analysis? Context: We conducted a meta-analysis of epidemiological studies investigating the association between maternal age and autism. Using recommended guidelines for performing meta-analyses, we systematically selected, and extracted results from, epidemiological scientific studies reported before January 2012. We calculated pooled risk estimates comparing categories of advancing maternal age with and without adjusting for possible confounding factors. We investigated the influence of gender ratio among cases, ratio of infantile autism to autism spectrum disorder (ASD), and median year of diagnosis as effect moderators in mixed-effect meta-regression. We found 16 epidemiological papers fulfilling the a priori search criteria. The meta-analysis included 25,687 ASD cases and 8,655,576 control subjects. Comparing mothers ≥ 35 years with mothers 25 to 29 years old, the crude relative risk (RR) for autism in the offspring was 1.52 (95% confidence interval [CI] = 1.12-1.92). Comparing mothers ≥ 35 with mothers 25-29, [corrected] the adjusted relative risk (RR) for autism in the offspring was 1.31 (95% CI = 1.19-1.45). [corrected] For mothers <20 compared with mothers 25 to 29 years old, there was a statistically significant decrease in risk (RR = 0.76; 95% confidence interval = 0.60-0.97). Almost all studies showed a dose-response effect of maternal age on risk of autism. The meta-regression suggested a stronger maternal age effect in the studies with more male offspring and for children diagnosed in later years." }, { "role": "assistant", "content": "The results of this meta-analysis support an association between advancing maternal age and risk of autism. The RR increased monotonically with increasing maternal age. The association persisted after the effects of paternal age and other potential confounders had been considered, supporting an independent relation between higher maternal age and autism. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Cervical Vertebrae, Dissection, Female, Humans, Male, Middle Aged, Neck Muscles, Random Allocation, Young Adult." }, { "role": "user", "content": "Do surgical Anatomy of the Longus Colli Muscle and Uncinate Process in the Cervical Spine? Context: There have been a few previous reports regarding the distances between the medial borders of the longus colli to expose the disc space. However, to our knowledge, there are no reports concerning longus colli dissection to expose the uncinate processes. This study was undertaken to assess the surgical relationship between the longus colli muscle and the uncinate process in the cervical spine. This study included 120 Korean patients randomly selected from 333 who had cervical spine MRIs and CTs from January 2003 to October 2013. They consisted of 60 males and 60 females. Each group was subdivided into six groups by age from 20 to 70 years or more. We measured three parameters on MRIs from C3 to T1: left and right longus colli distance and inter-longus colli distance. We also measured three parameters on CT: left and right uncinate distance and inter-uncinate distance. The longus colli distances, uncinate distances, and inter-uncinate distances increased from C3 to T1. The inter-longus colli distances increased from C3 to C7. There was no difference in longus colli distances and uncinate distances between males and females. There was no difference in the six parameters for the different age groups." }, { "role": "assistant", "content": "Although approximate guidelines, we recommend the longus colli be dissected approximately 5 mm at C3-5, 6 mm at C5-6, 7 mm at C6-7, and 8 mm at C7-T1 to expose the uncinate process to its lateral edge. 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: Blood Vessel Prosthesis, Female, Hemodynamics, Humans, Liver Circulation, Male, Middle Aged, Portacaval Shunt, Surgical, Portal System, Portal Vein, Vena Cava, Inferior." }, { "role": "user", "content": "Does the effect of small-diameter H-graft portacaval shunt on portal blood flow? Context: Small-diameter prosthetic H-graft portacaval shunts have been shown to promote preservation of total hepatic blood flow relative to large-diameter H-graft shunts. Nonetheless, specific changes in portal hemodynamics occurring with small-diameter H-graft shunting are unknown. This study was undertaken to evaluate changes in portal flow that occur with these shunts. Portal vein and inferior vena cava (IVC) blood flow were determined intraoperatively in 36 consecutive adults before and after prosthetic H-graft portacaval shunting using color-flow Doppler ultrasound. Postshunt measurements were made immediately cephalad and caudad to the shunt. Comparisons were undertaken using a paired Student's t-test with 95% confidence. Portal pressures decreased in all (P < 0.001), but never to normal. Postshunt portal flow cephalad and caudad to the shunt were not different from preshunt flow (P = 0.09, P = 0.28, respectively), although they were different from each other (P = 0.004). Postshunt IVC flow cephalad to the shunt was greater than caudad IVC flow (P = 0.004) and greater than preshunt IVC flow (P < 0.001), reflecting high flow through the shunt into the IVC." }, { "role": "assistant", "content": "Small-diameter prosthetic H-graft portacaval shunts divert a significant amount of blood from the portal vein and significantly decrease portal pressures. The decreases in portal pressures with shunting are significant whereas changes in portal blood flow into the liver are not. These findings help explain the low incidence of variceal rebleeding and hepatic dysfunction after these shunts. 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, Cell Division, Endothelium, Vascular, Humans, Insulin Resistance, Microcirculation, PPAR gamma, Pericytes, Retina, Retinal Vessels, Thiazolidinediones, Umbilical Veins." }, { "role": "user", "content": "Do thiazolidinediones inhibit proliferation of microvascular and macrovascular cells by a PPARgamma-independent mechanism? Context: This study evaluated the hypothesis that peroxisome proliferator-activated receptor-gamma (PPARgamma) agonists, including thiazolidinediones (TZDs) and the rexinoid LG100268 (LG), directly affect human vascular cell function (proliferation, cell cycle, protein expression, lactate release) independently of (1) their PPARgamma-activating potential and (2) the cells' vascular origin. Human umbilical vein endothelial cells (HUVECs), human adult vein endothelial cells (HAVECs), human retinal endothelial cells (HRECs) and human retinal pericytes (HRPYCs) were incubated (48 h) with 2-50 micromol/l rosiglitazone (RSG), RWJ241947 (RWJ), pioglitazone (PIO), troglitazone (TRO), 15-deoxy-Delta(12,14)-prostaglandin J2 (PGJ2) and LG. Proliferation, cell cycle distribution, protein expression, peroxisome proliferator-activated receptor responsive element (PPRE) transcriptional activity and mitochondrial effects were determined by [3H]thymidine incorporation, FACS analyses, western blots, reporter assays and lactate release respectively. In HUVECs, RSG, RWJ, PIO, TRO, PGJ2 and LG reduced (p<0.01) proliferation (due to a G0/G1 cell cycle arrest) by up to 23%, 36%, 38%, 86%, 99% and 93% respectively. The antiproliferative response was similar in HRPYCs and HAVECs, but was attenuated in HRECs. Whereas p21WAF-1/Cip1 and p27Kip were differently affected in HUVECs, all agents reduced (p<0.05) expression of cyclins (D3, A, E, B), cyclin-dependent kinase-2 and hyperphosphorylated retinoblastoma protein. The rank order of the antiproliferative effects of TZDs in HUVECs (RSG approximately PIO approximately RWJ<TRO) contrasted their PPRE transcriptional activities (TRO<PIO<RSG<RWJ), but correlated with cellular lactate release. Proliferation inhibition and lactate release were mimicked by rotenone (mitochondrial complex I inhibitor)." }, { "role": "assistant", "content": "In conclusion, this study suggests that the antiproliferative action of the TZDs in vascular cells is independent of their PPARgamma-activating and associated insulin-sensitising potential, but could relate to mitochondrial mechanisms. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Anterior Cruciate Ligament, Anterior Cruciate Ligament Injuries, Arthrometry, Articular, Arthroscopy, Bone Nails, Female, Follow-Up Studies, Humans, Joint Instability, Knee Injuries, Male, Menisci, Tibial, Middle Aged, Postoperative Complications, Prospective Studies, Range of Motion, Articular, Rupture, Tendons, Tibial Meniscus Injuries, Tissue and Organ Harvesting, Young Adult." }, { "role": "user", "content": "Do [ Single bundle anterior cruciate ligament reconstruction using quadriceps tendon autografts ]? Context: The purpose of this study was to evaluate postoperative outcome and functional scores after single bundle anterior cruciate ligament (ACL) reconstruction with the use of quadriceps tendon autografts after a 16 (12-24) month follow-up. 54 patients (9 women, 45 men, body mass index [BMI] 25.3 [18.1-36.3 kg/m (2)]) were included in this prospective series, treated between January 2004 and December 2005. Ligament stability was assessed with the Lachmann and pivot-shift tests and a KT 1000 arthrometer. Tegner index, Lysholm-Gilquist score and the International Knee Documentation Committee (IKDC) were employed to evaluate the functional outcomes. In addition, the single leg hop test was performed. Ligament arthrometry using the KT 1000 arthrometer demonstrated a mean side-to-side difference of 1.53 mm (0.2-4.1 mm). Regarding the Lachmann test, 17 patients (32%) showed 1+ laxity and no patient had an abnormal pivot-shift. The mean Tegner activity score was 4.22 (1-10), the mean Lysholm score was 80.8 (20-100) and the mean IKDC score 68.1 (29-87). Results of the single leg hop test revealed a mean decline of the treated leg to 87.7% (70-100%) of the contralateral side. The mean extension was reduced by 1.7 degrees (0-10 degrees) on the treated knee and the flexion by 2.1 degrees (0-10 degrees), compared to the contralateral knee." }, { "role": "assistant", "content": "Single bundle anterior cruciate ligament reconstruction using quadriceps tendon demonstrates highly satisfactory results. Due to a moderate donor site morbidity and preservation of the medial stabilizing structures of the knee a wider use in primary cruciate ligament reconstruction may arise in the future. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aged, Anastomosis, Surgical, Collateral Circulation, Coronary Angiography, Coronary Artery Bypass, Off-Pump, Coronary Stenosis, Coronary Vessels, Echocardiography, Transesophageal, Female, Follow-Up Studies, Graft Survival, Hemodynamics, Humans, Internal Mammary-Coronary Artery Anastomosis, Intraoperative Complications, Male, Middle Aged, Myocardial Ischemia, Risk Assessment, Severity of Illness Index, Treatment Outcome, Vascular Patency." }, { "role": "user", "content": "Does intracoronary shunt prevent ischemia in off-pump coronary artery bypass surgery? Context: The purpose of this study was to evaluate the role of intracoronary shunt during off-pump coronary artery bypass surgery. Fifty-six patients undergoing off-pump coronary artery bypass using the left internal mammary artery to bypass the left anterior descending coronary artery were randomly assigned to have the bypass performed with intracoronary shunt or by occlusive snaring. Ischemia during grafting was monitored by tissue Doppler. Hemodynamic status and indicators of ischemia were monitored, and on-table and postoperative angiography were performed. In patients with retrograde filling of the left anterior descending coronary artery, ischemia did not develop, but occlusion of antegradely perfused vessels caused ischemia in 26 of 33 patients. Ischemia was reversed in 14 of 16 shunted patients, and in 3 of 17 nonshunted cases (p = 0.004). Angiography showed a trend toward improved on-table angiographic results in shunted patients. After 3 months, graft patency was 100%, but 1 patient treated without shunt required reintervention and 15 patients had new angiographic lesions, equally distributed between shunted and nonshunted patients." }, { "role": "assistant", "content": "Intracoronary shunt prevents ischemia during grafting of the left anterior descending coronary artery and provides satisfactory immediate- and short-term graft patency. 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 9-month-old girl is brought to the emergency department because of a 3-day history of fever, irritability, and discharge from her right ear. She had an episode of ear pain and fever three weeks ago. Her parents did not seek medical advice and the symptoms improved with symptomatic treatment. There is no family history of frequent infections. She appears ill. Her temperature is 39.3°C (102.7°F). Physical examination shows erythema and tenderness in the right postauricular region, and lateral and inferior displacement of the auricle. Otoscopy shows a bulging and cloudy tympanic membrane, with pus oozing out. The remainder of the examination shows no abnormalities. Laboratory studies show:\nHemoglobin 11.5 g/dL\nLeukocyte count 15,800/mm3\nSegmented neutrophils 80%\nEosinophils 1%\nLymphocytes 17%\nMonocytes 2%\nPlatelet count 258,000/mm3\nWhich of the following is the most appropriate next step in management?\"" }, { "role": "assistant", "content": "CT scan of the temporal bone" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Action Potentials, Adipocytes, Adrenergic beta-3 Receptor Agonists, Adrenergic beta-3 Receptor Antagonists, Aged, Aniline Compounds, Benzoates, Biphenyl Compounds, Dose-Response Relationship, Drug, Drug Interactions, Electric Stimulation, Female, Ganglionic Stimulants, Humans, In Vitro Techniques, Intestines, Male, Middle Aged, Myenteric Plexus, Neurons, Nicotine, Propanolamines, Receptors, Adrenergic, beta-3, Somatostatin, Submucous Plexus." }, { "role": "user", "content": "Does the beta3-adrenoceptor agonist GW427353 ( Solabegron ) decrease excitability of human enteric neurons via release of somatostatin? Context: beta3 Adrenoceptor (beta3-AR) is expressed on adipocytes and enteric neurons. GW427353 is a human selective beta3-AR agonist with visceral analgesic effects. Some of its effects may involve release of somatostatin (SST) and actions on enteric neurons. The aim of this study was to investigate the mode of action of GW427353 in human submucous neurons. Voltage sensitive dye imaging was used to record from human submucous neurons. SST release from human primary adipocytes was measured with enzyme-linked immunoabsorbent assay. Immunohistochemistry was used to detect adiponectin, beta3-AR, SST, SST2 receptors, tyrosine hydroxylase (TH), and protein gene product 9.5. Confocal imaging showed cytoplasmic beta3-AR labeling in somata of submucous neurons and nerve varicosities. GW427353 had no direct postsynaptic actions but decreased fast synaptic input to submucous neurons. Tissue perfusion with GW427353 reduced nicotine-evoked neuronal spike frequency, an effect prevented by the beta3-AR antagonist SR-59230 and the SST2-receptor antagonist CYN154806 and mimicked by the SST2 receptor agonist octreotide. Adipocytes expressed adiponectin, beta3-AR, and SST. TH-positive fibers were in close proximity to adipocytes. Submucous neurons expressed SST2 receptors. Human primary adipocytes released SST in response to GW427353 in a concentration-dependent manner, an effect abolished by SR-59230." }, { "role": "assistant", "content": "Inhibitory action of GW427353 involves release of SST which stimulates inhibitory SST2 receptors on human submucous neurons. Adipocytes are a potential source for SST. beta3-AR activation may be a promising approach to reduce enteric neuron hyperexcitability. The action of GW427353 may be the neurophysiologic correlate of its beneficial effect in patients with irritable bowel syndrome. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Cobra head deformity is characterstic of" }, { "role": "assistant", "content": "The correct answer is B i.e. Ureterocele" } ]

[ { "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 antibody seen in drug induced SLE is" }, { "role": "assistant", "content": "The correct answer is (A) Anti histone antibody # Lupus erythematosus (LE): is an autoimmune disease that can affect the skin, joints, heart, lungs, kidneys, and brain. Drug-induced LE (DILE) is a variant of autoimmune disease that resolves within days to months after withdrawal of the culprit drug in a patient with no underlying immune system dysfunction.> Drugs such as procainamide, chlorpromazine, and quinidine cause the production of antinuclear antibodies against the histone dimer H2A-H2B.> Hydralazine forms antinuclear antibodies to H1 and the H3-H4 complex.> In persons with DILE, the antibodies also tend to attack histones (proteins typically found in cell nuclei); antihistone antibodies are indicated by a homogeneous pattern of antinuclear antibodies.> They are present in more than 75% of patients with DILE induced by hydralazine and procainamide.> One example of an antihistone antibody that is often implicated in DILE is immunoglobulin G (anti- DNA).> Antihistone antibodies are much more likely to indicate DILE; however, they can also appear in up to 50% of patients with SL.E." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Canada, Case-Control Studies, Educational Status, Female, Humans, Italy, Male, Middle Aged, Multiple Sclerosis, Norway, Protective Factors, Registries, Social Class." }, { "role": "user", "content": "Does low socioeconomic status in early life protect against multiple sclerosis? Context: The findings from existing research on the association between socioeconomic status (SES) and multiple sclerosis (MS) are inconsistent. Most previous studies are limited to one country and do not adequately adjust for other risk factors for the disease. The association between SES and MS was examined using data from the multinational Environmental Risk Factors in Multiple Sclerosis (EnvIMS) case-control study, comprising 2144 cases and 3859 controls from Norway, Canada and Italy. Multiple logistic regression was used to estimate the odds ratios and 95% confidence intervals for the association between early life SES, measured by parental educational level, and MS. Analyses were adjusted for age, sex, sunlight exposure, history of infectious mononucleosis, smoking, obesity and family size. Relative to those whose parents had primary school education or below, the adjusted odds ratio (95% confidence interval) for MS amongst individuals with university-educated parents, and the P value for trend across education levels, were 1.45 (1.03-2.05) in Canada (P for trend 0.030), 1.09 (0.85-1.39) in Norway (P for trend 0.395) and 0.65 (0.39-1.07) in Italy (P for trend 0.158)." }, { "role": "assistant", "content": "There is no consistent association between parental SES and MS risk in Norway, Canada and Italy, with a protective effect of low SES only found in Canada." } ]

[ { "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 complains of muscle weakness. It was reversed on administration of neostigmine, because:" }, { "role": "assistant", "content": "The correct answer is Ans. (D) It interferes with the action of acetyl cholinesterase(Ref: Katzung 11/e p105)Neostigmine acts by inhibiting the enzyme acetylcholinesterase. This enzyme is involved in degradation of ACh, consequently neostigmine increases the synaptic level of ACh. Muscle weakness can be improved by stimulation of NM receptors at muscle end plate due to increased ACh." } ]

[ { "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 woman died within 5 years of marriage under suspicious circumstances. Her parents complained that her in laws used to frequently demand for dowry. Under which of the following sections can be a magistrate authorize autopsy of the case?" }, { "role": "assistant", "content": "The correct answer is ref: The Essentials Forensic Medicine & Toxicology Dr.K.S. Narayana Reddy 32nd edition pg no 280 S.174 (3)Cr.P.C. Procedure in dowry (suicide,suspected murder ,request by a relative; doubt of cause of death, police consider necessary ) police has to enqire and repo.dowry death occur either by mmurder of a married woomenor she herself commiting suicide being unable to bear harassement or cruelty for not fulfiling the promises by her parents or her relatives or of those interested in her marriage. such murders are invariably commited secretely either in the house or at a place where outsiders may not witness it. the bride may killed or burnt by various methods.the usual defence in all dowry death cases is that either the women commited suicide or death occured accidently due to burns while cooking food. the doctor should make a record of the history of the injuries and the persons responsible for it,when the victim is brought to the hospital,noting the time and the name of the person who give the history.the condition of the patient should be recorded at frequent intervals. care should be taken that no person has discussion with the victim before doctors record the statement of the victim to avoid any undue influence being exeed on her. a magistrate may be called to record the dying declaration. inquest should be conducted by a magistrate or police officer not below the rank of deputy suoerintendent of police and autopsy should be carried out by two doctors in case of dowry death or if age of the wome is less than 30 years who dies in suspicious circumstances." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Activating Transcription Factor 3, Animals, Blotting, Northern, Blotting, Western, Cardiomegaly, DNA, Death, Sudden, Cardiac, Echocardiography, Electrocardiography, Electrophoretic Mobility Shift Assay, Gene Expression Regulation, Leucine Zippers, Mice, Mice, Transgenic, Myocardium, Repressor Proteins, Signal Transduction, Transcription, Genetic." }, { "role": "user", "content": "Is inhibition of basic leucine zipper transcription a major mediator of atrial dilatation? Context: Atrial fibrillation is the most prevalent clinically significant cardiac arrhythmia. Atrial dilatation, a predictor of atrial fibrillation, is thought to result from increased ventricular pressure. However, the underlying molecular mechanisms responsible for atrial dilatation are largely unknown. Here we sought to examine whether the expression of a basic leucine zipper inhibitor protein, JDP2, in the heart is sufficient for the generation of atrial dilatation. A tetracycline-regulated transgene was used to express JDP2 specifically in the mouse heart. Mice hearts were dissected and subjected to Northern and Western analysis, or analyzed by ECG recording and echocardiography. Regulation of gene expression was studied using electromobility shift assays and luciferase gene reporter analysis. Expression of JDP2 resulted in massive bi-atrial dilatation, defects in conduction, and a lethal phenotype. These effects were developmentally independent, acquired during adulthood, and were reversible upon abolishing of JDP2 expression. Connexin 40 and myosin light chain 2a expression were identified as potential target genes." }, { "role": "assistant", "content": "Expression of basic leucine zipper transcription inhibitors is sufficient to results in atrial dilatation. This dilatation is acquired postnatally and is reversible. Thus, basic leucine zipper transcription inhibitors may be a relevant therapeutic target for preventing atrial dilatation and atrial fibrillation. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, METHODS, RESULTS. Meshes: Diagnostic Techniques, Cardiovascular, Humans, Medical Overuse, Medicare, Peripheral Arterial Disease, Practice Patterns, Physicians', Prevalence, Ultrasonography, Doppler, Duplex, United States, Utilization Review." }, { "role": "user", "content": "Vascular Ultrasound and Noninvasive Physiological Testing for Peripheral Arterial Disease: Are These Tests Being Overused? Context: To examine recent trends in the use of duplex ultrasound and noninvasive physiologic tests (NPTs) for determining the presence of peripheral arterial disease (PAD). Medicare Part B databases for 2001-2013 were used. The two Current Procedural Terminology, version four codes for duplex ultrasound of lower-extremity arteries, and the three codes for NPTs of extremity arteries were selected. Procedure volumes of both types of examinations were determined, and utilization rates per 100,000 beneficiaries were calculated. Medicare specialty codes were used to determine what proportions were performed by the major specialty groups involved in these examinations: surgeons, cardiologists, radiologists, and primary care physicians (PCPs). Between 2001 and 2010 (the peak year), the total utilization rates per 100,000 of duplex ultrasound and NPTs increased by 94% and 84%, respectively. During the ensuing three years, small declines occurred in both. In 2013, utilization rates of both types of tests were far higher than they had been in 2001 (88% higher for duplex ultrasound; 63% higher for NPTs). From 2001 to 2013, use of duplex ultrasound increased 235% among cardiologists, 90% among surgeons, 76% among radiologists, and 53% among PCPs. Utilization rates of NPTs among surgeons were already high in 2001 and increased an additional 23% by 2013. The NPT utilization rates increased 180% among PCPs, 179% among cardiologists, and 61% among radiologists." }, { "role": "assistant", "content": "During a period when little growth occurred in the incidence of PAD, sharp growth occurred in testing for the disease." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Aged, Calcinosis, Cohort Studies, Coronary Disease, Female, Follow-Up Studies, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Models, Cardiovascular, Myocardial Infarction, Prognosis, Prospective Studies, ROC Curve, Risk Factors, Tomography, X-Ray Computed." }, { "role": "user", "content": "Does coronary calcium accurately predict near-term future coronary events in high-risk adults? Context: Prognostic risk models have had limited success in predicting coronary events in subjects with multiple risk factors. We and others have proposed an alternative approach using radiographically detectable coronary calcium. We evaluated and compared the predictive value of these 2 approaches for determining coronary event risk in asymptomatic adults with multiple coronary risk factors. In addition, we assessed the predictive value of a risk model that included calcium score and cardiac risk-factor data. We recruited 1196 asymptomatic high-coronary-risk subjects who then underwent risk-factor assessment and cardiac electron-beam CT (EBCT) scanning and were followed up for 41 months with a 99% success rate. We applied the Framingham model and our data-derived risk model to determine the 3-year likelihood of a coronary event. The mean age of our cohort was 66 years, and mean 3-year Framingham risk was 3.3+/-3.6%. Sixty-eight percent (818 subjects) had detectable coronary calcium. There were 17 coronary deaths (1.4%) and 29 nonfatal infarctions (2. 4%). The receiver operating characteristic (ROC) curve areas calculated from the Framingham model, our data-derived risk model, and the calcium score were 0.69+/-0.05, 0.68+/-0.05, and 0.64+/-0.05, respectively (P=NS). When calcium score was included as a variable in the data-derived model, the ROC area did not change significantly (0.68+/-0.05 to 0.71+/-0.04; P=NS)." }, { "role": "assistant", "content": "Neither risk-factor assessment nor EBCT calcium is an accurate event predictor in high-risk asymptomatic adults. EBCT calcium score does not add significant incremental information to risk factors, and its use in clinical screening is not justified at this time. 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": "True about transitional cell Ca of urinary bladder" }, { "role": "assistant", "content": "The correct answer is Answer is 'a' i.e. Smoking predisposes; 'b' i.e. Schistosoma infection predisposes; 'c' i.e. Aniline dye workers" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: China, Crime Victims, Demography, Female, Humans, Multivariate Analysis, Regression Analysis, Sex Workers, Sexual Partners, Social Support, Violence." }, { "role": "user", "content": "Intimate-Partner and Client-Initiated Violence among Female Street-Based Sex Workers in China: Does a Support Network Help? Context: Globally, female street-based sex workers are vulnerable to gender-based violence. Previous research has shown having a peer social network can reduce sex workers' risks of victimization. However, mechanisms of how social network impacts violence among female street-based sex workers are still far from clear. Our study was based on data abstracted from a paper-and-pencil survey administered among 218 female street-based sex workers in Shanghai, China. We focused on self-reported client-initiated violence and intimate-partner violence in emotional, physical, and sexual forms. Social networks were characterized by the size and sources of financial and psychosocial support (e.g. family, friends, and peers). Multi-variable logistic regression was used to estimate adjusted odds ratios (AOR) of each type of violence exposure by social network structure after the adjustment of age, education, and years in Shanghai. The street-based female sex workers in our study were primarily rural-to-urban migrants (95.7%) with an average age of 41 years old. 24.3% and 62.8% of the sex workers reported intimate-partner violence and client-initiated violence respectively. Lack of financial support, as defined by having only one individual or none in her peer support system to help financially, was significantly associated with self-reported intimate-partner violence (AOR: 2.5; 95% CI: 1.1-5.9). Respondents who reported client-initiated violence, by contrast, were more likely to report lacked psychosocial support from family (AOR: 2.2, 95% CI: 1.0-4.6) and peers (AOR: 5.1, 95% CI: 2.2-11)." }, { "role": "assistant", "content": "This study is one of the first to systematically analyze the associations between social network and gender-based violence among street-based female sex worker. We reported a high prevalence of both types of gender-based violence and their complex associations with family, friends, and peer support network. Policies with goals to reduce violence against women may apply these findings to leverage social network in the interventions against gender-based violence." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Audiology, Hearing Disorders, Hearing Tests, Humans, Internet, Telemedicine, User-Computer Interface." }, { "role": "user", "content": "Does a Browser-Server-Based Tele-audiology System That support Multiple Hearing Test Modalities? Context: Millions of global citizens suffering from hearing disorders have limited or no access to much needed hearing healthcare. Although tele-audiology presents a solution to alleviate this problem, existing remote hearing diagnosis systems support only pure-tone tests, leaving speech and other test procedures unsolved, due to the lack of software and hardware to enable communication required between audiologists and their remote patients. This article presents a comprehensive remote hearing test system that integrates the two most needed hearing test procedures: a pure-tone audiogram and a speech test. This enhanced system is composed of a Web application server, an embedded smart Internet-Bluetooth(®) (Bluetooth SIG, Kirkland, WA) gateway (or console device), and a Bluetooth-enabled audiometer. Several graphical user interfaces and a relational database are hosted on the application server. The console device has been designed to support the tests and auxiliary communication between the local site and the remote site. The study was conducted at an audiology laboratory. Pure-tone audiogram and speech test results from volunteers tested with this tele-audiology system are comparable with results from the traditional face-to-face approach." }, { "role": "assistant", "content": "This browser-server-based comprehensive tele-audiology offers a flexible platform to expand hearing services to traditionally underserved groups. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which general anaesthetic selectively inhibits excitatory NMDA receptors:" }, { "role": "assistant", "content": "The correct answer is Ketamine Intravenous inducing agent. Acts by blocking NMDA receptors. Adverse effects : Hallucinations, delirium and vivid dreams are impoant adverse effects that are seen during recovery from anaesthesia (emergence delirium). Has indirect sympathomimetic action = | blood pressure, hea rate and cardiac output Increases intraocular pressure and intracranial tension Appropriate drug for anesthetizing patients , at high risk of bronchospasm" } ]

[ { "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 enters the TCA cycle at Succinyl CoA step?" }, { "role": "assistant", "content": "The correct answer is Amino acids that enters at succinyl CoA step are :\n\nValine\nIsoleucine\nMethionine\nThreonine." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Cauda Equina, Child, Child, Preschool, Databases, Factual, Female, Humans, Infant, Laminectomy, Laminoplasty, Magnetic Resonance Imaging, Male, Peripheral Nervous System Diseases, Postoperative Complications, Retrospective Studies, Treatment Outcome." }, { "role": "user", "content": "Does use of lumbar laminoplasty vs. laminotomy for transection of the filum terminale affect early complication rates or postoperative course? Context: Various techniques are used for spinal cord untethering. The purpose of this study was to compare patient characteristics, postoperative course, and early complications after laminotomy vs. laminoplasty for transection of the filum terminale for tethered cord release. Retrospective analysis of clinical and magnetic resonance imaging data was undertaken for all patients (<18 years) who underwent tethered cord release by transection of the filum terminale at Oregon Health & Science University, Doernbecher Children's Hospital, from 2000 to 2011. Data from two hundred and forty-eight patients were analyzed. Mean age was 5.2 years (range 0.3 to 16.8 years). Access to the thecal space during surgery was achieved using laminotomy or laminoplasty in 82 (33.1 %) and 166 (66.9 %) patients, respectively. Laminoplasty patients were significantly younger than laminotomy patients (3.2 vs. 9.3 years, p<0.0001); other clinical and radiographic characteristics were similar between the groups. Nine patients (3.6 %) experienced early complications, including cerebrospinal fluid leak (n=2), suprafascial infection requiring surgical management and intravenous (IV) antibiotics (n=3) or IV antibiotics alone (n=1), a small area of peri-incisional cutaneous necrosis (n=1), perioperative seizures (n=1), and mild, transient malignant hyperthermia (n=1). There was no difference in the number of early complications between the two groups. Univariate and multivariate analyses revealed no significant risk factor for postoperative complication associated with technique. As judged by caregivers, independent of surgical technique, 97 % of patients improved after surgery." }, { "role": "assistant", "content": "There was no difference in complication risk when performing transection of the filum terminale for tethered cord release using laminotomy or laminoplasty. Final Decision: no" } ]