Datasets:

proserve

/

FedML_PubMedQA_instruction_stf_dataset

like 0

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Hand disinfection should be performed on the occasion of 5 separate moments during patient care, but some occasions are skipped. Can using hand antiseptics with residual effect reduce the problem of infection spread? We evaluated a 30-minute residual effect by different antiseptic products on endogenous and acquired microbiota. The products tested were 2% and 5% chlorhexidine, 1% and 10% iodine povidone, 60° n-propanol, 0.2% mecetronium + isopropanol, and 0.6% chlorhexidine + isopropanol + 0.1% benzalconium chloride. The microorganisms identified were 3 ATCC and 9 multiresistant strains isolated from intensive care unit patients (used as acquired microbiota). Logarithmic (log10) reductions of the colony forming units obtained with each antiseptic product and for each microorganism were calculated via in vivo (6 volunteers) and in vitro tests. The better in vivo and in vitro products with a residual effect>2 log10 after 30 minutes on hands were 2%-5% chlorhexidine and 0.6% chlorhexidine + isopropanol + 0.1% benzalconium chloride. This reduction was significantly different (P < .01) from the other 4 antiseptics. This residual effect (>2 log10) can be considered a self-disinfecting hand status in daily practice. Question: Lasting hand self-disinfection: A backup for hospital hand hygiene? <|endoftext|> <|assistant|> Hand antiseptics used in hospitals must pass tests of residual efficacy (after 30 minutes on acquired microbiota) showing a reduction>2 log10 in vivo and in vitro. A good product can be the mixture of chlorhexidine + alcohol + benzalconium chloride.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: There is preliminary evidence to suggest an impact of stress on chances of achieving a pregnancy with in-vitro fertilization (IVF). The majority of the available research has focused on stress related to infertility and going through IVF-treatment, and it is still unclear whether non-fertility-related, naturally occurring stressors may influence IVF pregnancy chances. Our aim was to explore the association between IVF-outcome and negative, i.e. stressful, life-events during the previous 12 months. Prior to IVF, 809 women (mean age: 31.2 years) completed the List of Recent Events (LRE) and questionnaires measuring perceived stress and depressive symptoms. Women who became pregnant reported fewer non-fertility-related negative life-events prior to IVF (Mean: 2.5; SD: 2.5) than women who did not obtain a pregnancy (Mean: 3.0; SD: 3.0) (t(465.28) = 2.390, P = 0.017). Logistic regression analyses revealed that the number of negative life-events remained a significant predictor of pregnancy (OR: 0.889; P = 0.02), when controlling for age, total number of life-events, perceived stress within the previous month, depressive symptoms, and relevant medical factors related to the patient or treatment procedure, including duration of infertility, number of oocytes retrieved and infertility etiology. Mediation analyses indicated that the association between negative life events and IVF pregnancy was partly mediated by the number of oocytes harvested during oocyte retrieval. Question: Are stressful life events associated with a poor in-vitro fertilization ( IVF ) outcome : a prospective study? <|endoftext|> <|assistant|> A large number of life-events perceived as having a negative impact on quality of life may indicate chronic stress, and the results of our study indicate that stress may reduce the chances of a successful outcome following IVF, possibly through psychobiological mechanisms affecting medical end-points such as oocyte retrieval outcome.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Behavioral variant frontotemporal dementia (bvFTD) patients show prefrontal cortex dysfunction and atrophy. We investigated whether executive function in conjunction with prefrontal cortex atrophy discriminates bvFTD and Alzheimer's disease (AD) patients efficiently at presentation. AD and bvFTD patients were distinguishable by 89.5% on their performance of 3 executive tasks: the Hayling Test of Inhibitory Control, Digit Span Backward and Letter Fluency. Similarly, scan ratings showed that orbitofrontal cortex (OFC) and dorsolateral prefrontal cortex regions distinguish both patient groups. More importantly, employing the Hayling error score in conjunction with the OFC atrophy rating showed that 92% of patients can be correctly classified into bvFTD and AD. Question: Does orbitofrontal dysfunction discriminate behavioral variant frontotemporal dementia from Alzheimer 's disease? <|endoftext|> <|assistant|> A combination of OFC and disinhibition measures appears to be a powerful diagnostic tool in differentiating bvFTD from AD patients in this preliminary study.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The aim of this prospective study was to define the role of an initial contrast-enhanced computed tomography (CT) obtained within 72 h after admission to hospital for determining the prognosis of acute pancreatitis and to investigate whether CT scans can be replaced by conventional prognostic parameters. The study involves 231 patients admitted to the Lüneburg clinic with a first attack of acute pancreatitis from 1988 to 1995. In all of them, a contrast-enhanced CT was performed within 72 h of admission and scored according to Balthazar. The results were compared with the Ranson and Imrie laboratory prognostic scores and with parameters of the severity of the disease: the initial organ failure according to the Atlanta classification; days spent on intensive care unit or altogether in hospital; indication for artificial ventilation, dialysis and surgical intervention (necrosectomy); development of pancreatic pseudocysts; and mortality. Although there was a good statistical correlation between Ranson, Imrie, and Balthazar scores with the severity of the disease (P<0.001 to P = 0.03), low and moderately raised Ranson (0-2, 0-5 points) and Imrie scores (0-1.0-3 points) failed to identify all patients with pancreatic necrosis with sufficient sensitivity rates (31.7; 78.0 and 39.0; 78.0%), positive (32.6; 25.3 and 75.0; 45.0%) and negative (91.0; 87.9 and 85.4; 84.8%) predictive values. Question: Do we need a computed tomography examination in all patients with acute pancreatitis within 72 h after admission to hospital for the detection of pancreatic necrosis? <|endoftext|> <|assistant|> A contrast-enhanced CT on admission correlates significantly with the severity of the disease and cannot be replaced by conventional laboratory prognostic scores. The decision to use a CT cannot depend on the results of the Ranson/Imrie scores.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Mammography screening reduces breast cancer mortality by up to 32%. However, some recent studies have questioned the impact of non-palpable breast cancer detection on mortality reduction. The aim of this study was to analyse the clinicopathological and long-term follow-up data of early stage screened and symptomatic breast cancer patients. The institutional prospectively led database was systematically analysed for breast cancer cases diagnosed via the mammography screening program from 2002 to 2009. As a control group, symptomatic early stage breast cancer patients were collected randomly from the same database and matched for age and follow-up period. All medical records were reviewed retrospectively. Data from 298 breast cancer patients were collected from 47,718 mammography screenings. In addition, 331 symptomatic breast cancer patients were randomly selected. The screened group presented a significantly lower median tumour size (P < 0.00001). The incidence of negative regional lymph nodes was significantly higher in the screened group (P < 0.0006). The incidence of chemotherapy was 17% higher in the symptomatic group (P = 4*10-5). At the median follow-up of 65 and 80 months, the screened group did not exhibit better overall (P = 0.717) or disease-free survival (P = 0.081) compared to the symptomatic group. Question: Does breast screening offer a survival benefit? <|endoftext|> <|assistant|> Our results do not suggest that mammography screening does not reduce breast cancer mortality but the mammography screening did not bring any significant improvement in patient overall or disease-free survival for the early stage breast cancer patients compared to the symptomatic group. The drawback of symptomatic early stage tumours compared to non-palpable tumours could be equalized by modern multimodality oncology treatments.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The grading of pulmonary regurgitation (PR) severity by two-dimensional (2D) and Doppler echocardiography is not standardized. Cardiovascular magnetic resonance imaging is the clinical gold standard for PR quantification. The purpose of this study was to determine the best 2D and Doppler echocardiographic predictors of severe PR. Thirty-six patients with tetralogy of Fallot or pulmonary valve stenosis with prior pulmonary valvuloplasty or transannular or subannular patch repair underwent 2D and Doppler echocardiography and cardiovascular magnetic resonance. Two-dimensional and Doppler echocardiographic measurements used to predict severe PR included diastolic flow reversal in the main or branch pulmonary arteries, PR jet width > or = 50% of the pulmonary annulus, PR pressure half-time < 100 ms, and PR index < 0.77. With the exception of PR index, all indices were significant independent predictors of severe PR. The best univariate predictor of severe PR was branch pulmonary artery diastolic flow reversal. Question: Do two-dimensional and Doppler echocardiography reliably predict severe pulmonary regurgitation as quantified by cardiac magnetic resonance? <|endoftext|> <|assistant|> Two-dimensional and Doppler echocardiography reliably identified severe PR in this cohort.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The purpose of the present study was to explore the association between cognitive function and fear of falling in frail/non-frail older adults in a community setting. We recruited 483 community-dwelling older adults aged 65 years and older (mean age 73.3 ± 5.1 years, 68.3% women). Fear of falling was assessed using a yes/no question, "Are you afraid of falling?" Cognitive function was measured using the Mini-Mental State Examination. The five subscores of the examination were also recorded. We used the frailty criteria developed by the Cardiovascular Health Study, and divided the participants into non-frail and frail groups according to the number of affected domains. The statistical analyses were carried out separately for these two groups. A multiple logistic regression analysis showed that, in frail older adults, cognitive impairment was significantly associated with the absence of fear of falling (OR 0.04, 95% CI 0.00-0.50, P = 0.012). In addition, a stepwise multivariate logistic regression analysis showed that the score on the attention and calculation subsection of the Mini-Mental State Examination was positively associated with the presence of fear of falling in frail older adults (OR 1.83, 95% CI 1.08-3.12, P = 0.026). In contrast, cognitive impairment was not associated with fear of falling in non-frail older adults. Question: Is cognitive impairment associated with the absence of fear of falling in community-dwelling frail older adults? <|endoftext|> <|assistant|> The results suggest that cognitive impairment, especially that in executive function, is associated with the absence of fear of falling in community-dwelling frail older adults. Geriatr Gerontol Int 2016; ●●: ●●-●●.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To estimate the association between periodontitis (PD) and preterm low birth weight (LBW). Observational study in a University clinical setting on a population of 120 pregnant women. One specialist in periodontics examined all the patients. Two thresholds for definition of PD were used, which detected respectively 29 women (24%) and 4 (3%) as affected by the pathology. Six patients were lost to follow-up. Out of the remaining 114, 1 had an abortion, while 20 (17%) delivered pre-term. Eleven per cent of all women delivered low-weight babies. Ten women (9%) delivered preterm LBW babies. No association was detected between any of the two definitions of PD and any of the adverse pregnancy outcomes. Question: Is there any association between periodontitis and preterm low birth weight? <|endoftext|> <|assistant|> This study was unable to provide evidence of association between PD and preterm LBW.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Growing evidence suggests that focal seizures are preceded by haemodynamic changes. Specifically, changes in cerebral blood flow, blood oxygen level-dependent magnetic resonance imaging, and near-infrared spectroscopy measurements of haemoglobin have been observed in the seizure focus and other brain regions many minutes prior to the onset of spontaneous seizures. The purpose of this study was to detect preictal haemodynamic changes using near-infrared spectroscopy, a portable and non-invasive optical technique that measures changes in cerebral haemoglobin. Five subjects with temporal lobe seizures were studied using near-infrared spectroscopy until a seizure was observed, as confirmed by electroencephalography or clinical symptoms. Relative changes in oxy- and deoxyhaemoglobin, total haemoglobin, and blood oxygen saturation were assessed in the anterior frontal lobes between 15 minutes and one minute prior to seizure onset. In all subjects, a decrease in oxyhaemoglobin, total haemoglobin, and oxygen saturation was observed in the frontal lobe, ipsilateral to the presumed seizure focus. On the contralateral side, all subjects showed a decrease in relative oxyhaemoglobin content. No consistent change in deoxyhaemoglobin was seen on either side. Question: Does near-infrared spectroscopy show preictal haemodynamic changes in temporal lobe epilepsy? <|endoftext|> <|assistant|> Preictal haemodynamic changes can be detected in the frontal lobes using near-infrared spectroscopy. Our results suggest that a decrease in metabolic rate, and thus neuronal activity, occurs in the ipsilateral frontal lobe prior to the onset of temporal lobe seizures. Extratemporal haemodynamic changes may therefore be an important marker for seizure anticipation.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Nonunited fracture shaft femur after plate fixation is a common problem in third world countries because of economic reasons. Management of such a problem is still controversial and is associated with many surgical details, due not only to the nonunited fracture itself, but also to the broken implant which is not easy to remove. This study is a randomized prospective study presenting 40 patients with aseptic nonunited fracture shaft femur associated with failed plating managed by the removal of hardware, and intramedullary fixation using an interlocking nail with or without autogenous iliac bone graft. There was no statistically significant difference between patients with and without iliac autogenous bone graft regarding the demographic data, the preoperative condition, and the postoperative course including time needed for bone union and return to work. The statistically significant difference was in the intraoperative blood loss and the duration of surgery with less blood loss and shorter duration of surgery occurring in the group treated by reamed intramedullary nail without iliac bone graft. Question: Intramedullary fixation of failed plated femoral diaphyseal fractures: are bone grafts necessary? <|endoftext|> <|assistant|> In cases with aseptic nonunited fracture shaft femur after failed plating, intramedullary reamed nailing without autogenous bone graft produced similar results as with bone graft, but with less operating time and blood loss.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To examine the ability of activity of daily living (ADL)-impaired older adults to successfully rise, and, when successful, the time taken to rise, from a bed and chair under varying rise task demands. Seven congregate housing facilities Congregate housing residents (n = 116, mean age 82) who admitted to requiring assistance (such as from a person, equipment, or device) in performing at least one of the following mobility-related ADLs: transferring, walking, bathing, and toileting. Subjects performed a series of bed and chair rise tasks where the rise task demand varied according to the head of bed (HOB) height, chair seat height, and use of hands. Bed rise tasks included supine to sit-to-edge, sit up in bed with hand use, and sit up in bed without hands, all performed from a bed where the HOB was adjusted to 0, 30, and 45 degrees elevations; roll to side-lying then rise (HOB 0 degrees); and supine to stand (HOB 0 degrees). Chair seat heights were adjusted according to the percent of the distance between the floor and the knee (% FK), and included rises (1) with hands and then without hands at 140, 120, 100, and 80% FK; (2) from a reclining (105 degrees at chair back) and tilting (seat tilted 10 degrees posteriorly) chair (100% FK); and (3) from a 80% FK seat height with a 4-inch cushion added, with and then without hands. Logistic regression for repeated measures was used to test for differences between tasks in the ability to rise. After log transformation of rise time, a linear effects model was used to compare rise time between tasks. The median total number of tasks successfully completed was 18 (range, 3-21). Nearly all subjects were able to rise from positions where the starting surface was elevated as long as hand use was unlimited. With the HOB at 30 or 45 degrees essentially all subjects could complete supine to sit-to-edge and sit up with hands. Essentially all subjects could rise from a seat height at 140, 120, and 100% FK as long as hand use was allowed. A small group (8-10%) of subjects was dependent upon hand use to perform the least challenging tasks, such as 140% FK without hands chair rise and 45 degrees sit up without hands. This dependency upon hand use increased significantly as the demand of the task increased, that is, as the HOB or seat height was lowered. Approximately three-quarters of the sample could not rise from a flat (0 degrees HOB elevation) bed or low (80% FK) chair when hand use was not allowed. Similar trends were seen in rise performance time, that is, performance times tended to increase as the HOB or chair seat elevation declined and as hand use was limited. Total self-reported ADL disability, compared to the single ADL transferring item, was a stronger predictor of rise ability and timed rise performance, particularly for chair rise tasks. Question: Do chair and bed rise performance in ADL-impaired congregate housing residents? <|endoftext|> <|assistant|> Lowering HOB height and seat height increased bed and chair rise task difficulty, particularly when hand use was restricted. Restricting hand use in low HOB height or lowered seat height conditions may help to identify older adults with declining rise ability. Yet, many of those who could not rise under "without hands" conditions could rise under "with hands" conditions, suggesting that dependency on hand use may be a marker of progressive rise impairment but may not predict day-to-day natural milieu rise performance. Intertask differences in performance time may be statistically significant but are clinically small. Given the relationship between self-reported ADL disability and rise performance, impaired rise performance may be considered a marker for ADL disability. These bed and chair rise tasks can serve as outcomes for an intervention to improve bed and chair rise ability and might also be used in future studies to quantify improvements or declines in function over time, to refine physical therapy protocols, and to examine the effect of bed and chair design modifications on bed and chai

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To investigate the relationship between magnetic resonance imaging (MRI) measures and uterus and leiomyoma size reductions after uterine artery embolization (UAE). Fifty-two women with leiomyomas underwent selective UAEs. Uterine and dominant leiomyoma sizes were measured with preinterventional MRI and a 6-month follow-up MRI. Four MRI measures of the dominant leiomyoma were recorded: T1 time; T2 time; leiomyoma-to-skeletal muscle T2 SI-ratio; and percentage of contrast enhancement. To evaluate the predictive value of MRI measures we used Spearman rank correlation, area under the receiver operating characteristic (ROC) curve (A(z)), and values for diagnostic performance. Uterus and dominant leiomyoma size reductions were highly variable. Leiomyoma size reductions of >or=75% were accurately predicted with leiomyoma-to-skeletal muscle T2 SI-ratio (ROC curve A(z) = 0.930; 95% confidence interval [CI]: 0.853, 1.000). Leiomyoma size reductions >or=75% were predicted by leiomyoma-to-skeletal muscle T2 SI-ratio >or=3.5 and T1-time >or=750 msec with 100% and 86% sensitivities and 67% and 72% specificities, respectively. Uterus size reduction >or=50% were identified by dominant leiomyoma-to-skeletal muscle T2 SI-ratio >or=2.5. Question: Does preinterventional quantitative magnetic resonance imaging predict uterus and leiomyoma size reduction after uterine artery embolization? <|endoftext|> <|assistant|> Uterus and dominant leiomyoma size reductions after UAE were predicted with preoperative MRI measures of the dominant leiomyoma.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To assess the effects of the natural progesterone on the endometriosis in a rat model. Endometriosis was surgically induced in 20 rats by transplanting an autologous fragment of endometrial tissue onto the inner surface of the abdominal wall. Rats in control group had no medication but 2.5 mg/kg/weekly natural progesterone was administered to rats in study group for four weeks. After that, all rats were sacrificed and dimensions of endometriosis were measured and they were evaluated morphologically and histologically. Scoring systems were used to evaluate preservation of epithelia. Two rats in the study group and one rat in the control group died of complications related to surgery. At the end of the treatment, there was a reduction in the size of the endometriotic lesions in the study group (p<0.01). According to histological evaluation, the study group had lower score than control goup which was statistically significant (p = 0.014). Question: Effects of natural progesterone on endometriosis in an experimental rat model: is it effective? <|endoftext|> <|assistant|> Natural progesterone is effective against endometriosis in rat model.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Human cytomegalovirus (HCMV) can cause congenital infection with risk of neurological disability. Maternal-fetal transmission is associated with placental inflammation. 5-lipoxygenase (5-LO) is the key enzyme in the biosynthesis of Leukotrienes (LTs), which are proinflammatory mediators. This study investigated the effect of HCMV infection on 5-LO expression and Leukotriene-B4 (LTB4) induction in human placentae and umbilical vein endothelial cells (HUVEC). Seven placentae from fetuses with congenital HCMV infection and brain damage and six controls were stained with HCMV-immediate-early-antigen (HCMV-IEA) and 5-LO by immunohistochemistry. 5-hydroxyeicosatetraenoic acid (5-HETE) and LTB4 were measured in culture supernatant from ex vivo HCMV-infected placental histocultures by liquid chromatography. In vitro, HCMV infected HUVEC cells were analyzed for 5-LO mRNA and protein expression by real time PCR and immunofluorescence staining. HCMV-IEA was abundant in all HCMV infected placentae but absent in control placentae. 5-LO expression was higher in endothelial and smooth muscle cells of HCMV-infected placentae, compared to control placentae. HCMV infection induced an up-regulation of LTB4 in ex vivo placental explants with higher levels of LTB4 at 72 h compared to controls (p = 0.002). In vitro, 5-LO transcript and protein expression were significantly induced in HCMV-infected HUVEC, compared to the control cultures (p = 0.036). Question: Does human cytomegalovirus infection induce leukotriene B4 and 5-lipoxygenase expression in human placentae and umbilical vein endothelial cells? <|endoftext|> <|assistant|> The presence of HCMV coincided with high 5-LO expression in cells of in vivo HCMV infected placentae. HCMV induced up-regulation of 5-LO in both ex vivo HCMV-infected placental explants and HUVEC. HCMV induced LT-biosynthesis in congenitally infected placentae may have a role in pathogenesis of congenital HCMV disease.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Surgical site infection after spinal surgery is frequently seen. It occurs between 0.7% and 12% of patients, leading to higher morbidity, mortality, and health-care costs. Osteotomy procedures are known to have increased blood losses and surgical times when compared with other spinal surgeries. Both of these factors have previously been identified as significant risk factors for SSI. We performed a cohort study of this high-risk population to identify risk factors and rates of SSI after spinal osteotomy surgery and identify difference in risk between different types of osteotomies. The objective of the study was to assess the incidence and identify significant risk factors for surgical site infection (SSI) after spinal osteotomy. Retrospective review of all adult patients who underwent spinal osteotomy surgery for deformity by an orthopedic surgeon in our university. All electronic records of adult orthopedic patients whom underwent a spinal osteotomy procedure at our department between January 1998 and December 2005 (n=363) were abstracted. During surgery, a pedicle subtraction osteotomy (transpedicular wedge resection), anterior spine osteotomy (resection of anterior and middle columns), posterior Smith-Petersen osteotomy (resection of a portion of the superior and inferior lamina, ligamentum flavum, and the inferior and superior articular processed), or a combined anterior and posterior osteotomy (vertebral column resection [VCR]) (circumferential resection of the vertebrae via either a combined anterior/posterior or posterior-only approach) was performed. Primary outcome measurement was SSI. Subanalysis to deep and superficial SSI was performed. Twenty patients (5.5%) were found to have an SSI, with nine (2.5%) having deep SSI. Analysis showed that patients undergoing VCR (p=.042) had a significant increased risk for deep SSI (11.1%). Obese patients had a significant increased risk (p=.045) for superficial SSI. Question: Surgical site infection after osteotomy of the adult spine: does type of osteotomy matter? <|endoftext|> <|assistant|> Vertebral column resection has a significant increased risk for SSI (11.1%) compared with other types of osteotomies (4.1%). When possible, osteotomy techniques that involve less extensive exposures and soft-tissue dissection should be chosen to minimize deep SSI risk. Obese patients should be counseled on weight loss to try minimizing superficial SSI risk.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Icariin, a principal flavonoid glycoside of Epimedium brevicornu Maxim, has been widely proved to possess antiosteoporotic activity with promoting bone formation and decreasing bone resorption. However, the involving mechanisms remain unclear. To clear a global insight of signal pathways involved in anti-osteoporotic mechanism of icariin at proteins and metabolites level by integrating the proteomics and NMR metabonomics, in a systems biology approach. Mice were divided into sham, OVX model and icariin-treated OVX group, after 90 days treatment, difference gel electrophoresis combined with MALDI-TOF/TOF proteomics analysis on bone femur and serum metabolomics were carried out for monitor intracellular processes and elucidate anti-osteoporotic mechanism of icariin. Osteoblast and osteoclast were applied to evaluate the potential signal pathways. Twenty three proteins in bone femur, and 8 metabolites in serum, were significantly altered and identified, involving in bone remodeling, energy metabolism, cytoskeleton, lipid metabolism, MAPK signaling, Ca Question: Do comparative proteomic and metabolomic analysis reveal the antiosteoporotic molecular mechanism of icariin from Epimedium brevicornu maxim? <|endoftext|> <|assistant|> we consider icariin as multi-targeting compounds for treating with osteoporosis, involve initiating osteoblastogenesis, inhibiting adipogenesis, and preventing osteoclast differentiation.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Previous studies have shown that populations differ with respect to interarch tooth-size relationships, and differences in tooth sizes are not systematic. The aims of this study were to determine the Bolton ratios in Spanish subjects. We used a digital method and measured the casts to the nearest 0.05 mm. The sample consisted of 100 pairs of dental casts of Spanish subjects. The Kolmogorov-Smirnov test, t test, and 95% confidence intervals were used. Anterior tooth-width ratios were 78.31% +/- 2.59% for women and 78.34% +/- 2.16% for men (P = .955). Total tooth-width ratios were 91.91% +/- 2.04% for women and 92.10% +/- 1.73% for men (P = .668). No significant differences were found in tooth-width ratios according to sex, so the sexes were pooled and new ratios calculated: 78.32% +/- 2.45%, CI 95% (77.83%-78.81%), for the anterior tooth-width ratio and 91.97% +/- 1.95%, CI 95% (91.58%-92.35%), for the total tooth-width ratio. Question: Do Bolton's ratios apply to a Spanish population? <|endoftext|> <|assistant|> Twenty-one percent of the subjects had a significant anterior discrepancy (greater than 2 SD from Bolton's), and 5% had a total discrepancy. Differences between Spanish values and Bolton's were significant, and specific standards for Spanish people might be needed.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To evaluate the body composition and inflammatory status in patients on hemodialysis (HD) according to the cutoff of 23 kg/m² for the body mass index (BMI). Forty-seven patients (30 men, 11 diabetics, 53.8 ± 12.2 y of age, 58.2 ± 50.9 mo on HD) were studied. Anthropometric data and handgrip strength were evaluated. C-reactive protein, tumor necrosis factor-α, leptin, and interleukin-6 were measured. Mortality was assessed after 24 mo of follow-up. Nineteen patients (40.4%) presented BMI values lower than 23 kg/m² and leptin levels, midarm muscle area, and free-fat mass were significantly lower in these patients. The prevalence of functional muscle loss according to handgrip strength was not different between the BMI groups. The sum of skinfold thicknesses, the percentage of body fat, fat mass, the fat mass/free-fat mass ratio, and waist circumference were significantly lower in patients with a BMI lower than 23 kg/m², but the mean values did not indicate energy wasting. Patients with a BMI higher than 23 kg/m² presented a higher prevalence of inflammation and higher waist circumference and body fat values. The adiposity parameters were correlated with C-reactive protein and leptin. A Cox multivariate regression analysis demonstrated that C-reactive protein, tumor necrosis factor-α, and interleukin-6 predict cardiovascular mortality. Question: Is a body mass index of 23 kg/m² a reliable marker of protein-energy wasting in hemodialysis patients? <|endoftext|> <|assistant|> Patients on HD with a BMI lower than 23 kg/m² did not present signs of energy wasting, whereas those with a BMI higher than 23 kg/m² had more inflammation, probably because of a greater adiposity. Thus, the BMI value of 23 kg/m² does not seem to be a reliable marker of protein-energy wasting in patients on HD.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To examine whether depression and apathy are independently associated with longitudinal trajectories of cortical atrophy in the entorhinal cortex compared with frontal subregions previously implicated in late-life mood disturbance. Data from 334 participants classified as having mild cognitive impairment in the Alzheimer's Disease Neuroimaging Initiative (ADNI) were analyzed by using multilevel models for change adjusted for age, global cognitive status, and total intracranial volume at enrollment. Participants in ADNI were recruited from>50 clinical research sites in the United States and Canada. Depression and apathy were identified by informants using the Neuropsychiatric Inventory Questionnaire. Serial magnetic resonance imaging was performed on 1.5-Tesla scanners according to the standardized ADNI-1 protocol on an average of 5 occasions over an average of 30.5 months. Regional cortical thickness values were derived from longitudinal data processing in FreeSurfer version 4.4. Depression was associated with reduced cortical thickness in the entorhinal cortex at baseline and accelerated atrophy in the anterior cingulate cortex. Similar relationships between depression and the orbitofrontal cortex and between apathy and the anterior cingulate cortex were not significant. Question: Are apathy and depression independently associated with longitudinal trajectories of cortical atrophy in mild cognitive impairment? <|endoftext|> <|assistant|> In mild cognitive impairment, depression signs are a better marker of longitudinal cortical atrophy than apathy. Results are consistent with hypotheses that depression is an early sign of a more aggressive neurodegenerative process or that depression lowers brain reserve capacity, allowing for more rapid progression of Alzheimer disease neuropathology.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To determine the ability to visualize the origin of the right inferior phrenic artery (RIPA) and the left inferior phrenic artery (LIPA) by multidetector row computed tomography (MDCT) in a population without disease of the liver. The origin of the RIPAs and the LIPAs were evaluated using arterial-phase MDCT images in 200 patients. The RIPA origin was detected in all cases, while LIPA origin was detected in 193 (96.5%) cases. RIPA and LIPA originate as a common trunk from the aorta (16%) and celiac trunk (20%). RIPAs originated separately from the aorta (29%), celiac artery (19.5%), right renal artery (10.5%), left gastric artery (3%), and proper hepatic artery (0.5%). LIPAs originated separately from the celiac artery (38.5%), aorta (16%), left renal artery (0.5%), left gastric artery (2.5%). Question: Can multidetector row CT visualize the right and left inferior phrenic artery in a population without disease of the liver? <|endoftext|> <|assistant|> Arterial-phase images of MDCT could demonstrate the origin of the non-dilated IPAs in a population without the disease of the liver.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Tissue-specific RNA plasticity broadly impacts the development, tissue identity and adaptability of all organisms, but changes in composition, expression levels and its impact on gene regulation in different somatic tissues are largely unknown. Here we developed a new method, polyA-tagging and sequencing (PAT-Seq) to isolate high-quality tissue-specific mRNA from Caenorhabditis elegans intestine, pharynx and body muscle tissues and study changes in their tissue-specific transcriptomes and 3'UTRomes. We have identified thousands of novel genes and isoforms differentially expressed between these three tissues. The intestine transcriptome is expansive, expressing over 30% of C. elegans mRNAs, while muscle transcriptomes are smaller but contain characteristic unique gene signatures. Active promoter regions in all three tissues reveal both known and novel enriched tissue-specific elements, along with putative transcription factors, suggesting novel tissue-specific modes of transcription initiation. We have precisely mapped approximately 20,000 tissue-specific polyadenylation sites and discovered that about 30% of transcripts in somatic cells use alternative polyadenylation in a tissue-specific manner, with their 3'UTR isoforms significantly enriched with microRNA targets. Question: Does comparative RNA-Seq analysis reveal pervasive tissue-specific alternative polyadenylation in Caenorhabditis elegans intestine and muscles? <|endoftext|> <|assistant|> For the first time, PAT-Seq allowed us to directly study tissue specific gene expression changes in an in vivo setting and compare these changes between three somatic tissues from the same organism at single-base resolution within the same experiment. We pinpoint precise tissue-specific transcriptome rearrangements and for the first time link tissue-specific alternative polyadenylation to miRNA regulation, suggesting novel and unexplored tissue-specific post-transcriptional regulatory networks in somatic cells.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: In the event of trauma, emergency reversal of anticoagulation therapy may be required. However, no specific reversal agents are routinely available for the direct oral anticoagulants such as dabigatran. The authors investigated four-factor prothrombin complex concentrate (PCC) for treating dabigatran-induced anticoagulation in a porcine polytrauma model. Dabigatran etexilate was given orally for 3 days and intravenously on day 4 to 32 pigs. Animals were randomized 1:1:1:1 to PCC (25, 50, or 100 U/kg) or saline. Study medication was administered 12 min after bilateral femur fractures and blunt liver injury. The primary endpoint was blood loss at 300 min. The mean plasma concentration of dabigatran was 487 ± 161 ng/ml after intravenous administration. Blood loss was 3,855 ± 258 ml in controls and 3,588 ± 241 ml in the PCC25 group. In the PCC50 and PCC100 groups, blood loss was significantly lower: 1,749 ± 47 ml and 1,692 ± 97 ml, respectively. PCC50 and PCC100 effectively reduced dabigatran's effects on coagulation parameters, whereas control and (to a lesser extent) PCC25 animals developed severe coagulopathy. Sustained increases in endogenous thrombin potential occurred with PCC50 and PCC100. Question: Does prothrombin Complex Concentrate be Effective in Treating the Anticoagulant Effects of Dabigatran in a Porcine Polytrauma Model? <|endoftext|> <|assistant|> Four-factor PCC (50 or 100 U/kg) is effective in reducing blood loss in dabigatran-anticoagulated pigs, but higher doses may induce a procoagulant state.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To investigate whether changes in diethylenetriamine pentaacetic acid (DTPA) aerosol clearance lung scans predict the development of radiation pneumonitis. Thirty-three patients with advanced non-small-cell lung cancer were treated with palliative radiation therapy to thorax. All patients were subjected to pretreatment and post-treatment DTPA aerosol clearance lung scans. The clearance t1/2 values were compared using the paired t test. Changes in percentage aerosol deposition were also compared. The patients were serially assessed clinically and radiologically for development of radiation pneumonitis. For the whole group, the mean DTPA clearance t1/2 for the diseased lung fell from 36.33 to 28.85 min (p = 0.17). Twelve patients developed radiation pneumonitis, 8 Grade 1, 2 Grade 2, 1 Grade 3, and 1 Grade 4. In patients who developed radiation pneumonitis, the clearance t1/2 for the diseased lung decreased from 37.50 min to 29.00 min after treatment (p = 0.50). Other subgroups analyzed, including smokers, nonsmokers, those with and without endobronchial disease, as well as those free from radiation pneumonitis, also showed no significant change in the clearance of the aerosol. The difference between the percentage aerosol deposition of the diseased lung (37.92%) and that of the opposite lung (62.08%) for the entire sample was significantly different both before and after treatment (p<0.01). Delivery of radiation did not significantly change the aerosol deposition in either lung. Question: Can 99mTc-DTPA aerosol scanning predict radiation pneumonitis? <|endoftext|> <|assistant|> We conclude that, in patients with advanced non-small-cell lung cancer, significant change in the pulmonary clearance of 99mTc-DTPA aerosol could not be demonstrated after radiation therapy. In such patients, clearance of the aerosol does not predict the development of radiation pneumonitis.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Retrospective ECG-gated multidetector-row computed tomography (MDCT) is increasingly used for the assessment of prosthetic heart valve (PHV) dysfunction, but is also hampered by PHV-related artefacts/cardiac arrhythmias. Furthermore, it is performed without nitroglycerine or heart rate correction. The purpose was to determine whether MDCT performed before potential redo-PHV surgery is feasible for concomitant coronary artery stenosis assessment and can replace invasive coronary angiography (CAG). PHV patients with CAG and MDCT were identified. Based on medical history, two groups were created: (I) patients with no known coronary artery disease (CAD), (II) patients with known CAD. All images were scored for the presence of significant (>50 %) stenosis. CAG was the reference test. Fifty-one patients were included. In group I (n = 38), MDCT accurately ruled out significant stenosis in 19/38 (50 %) patients, but could not replace CAG in the remaining 19/38 (50 %) patients due to non-diagnostic image quality (n = 16) or significant stenosis (n = 3) detection. In group II (n = 13), MDCT correctly found no patients without significant stenosis, requiring CAG imaging in all. MDCT assessed patency in 16/19 (84 %) grafts and detected a hostile anatomy in two. Question: Multidetector-row computed tomography for prosthetic heart valve dysfunction: is concomitant non-invasive coronary angiography possible before redo-surgery? <|endoftext|> <|assistant|> MDCT performed for PHV dysfunction assessment can replace CAG (100 % accurate) in approximately half of patients without previously known CAD.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To evaluate the role of initial cystectomy in the management of high-grade T1 bladder cancer. A selected review of the literature was performed to evaluate outcomes with intravesical therapy vs. initial cystectomy in this patient population, with a focus on identifying risk factors for failure of conservative therapy. Many studies in the literature fail to include central pathologic review and re-TUR clinical staging, and there are no randomized studies comparing outcomes with these two initial approaches. Retrospective studies of patients with high-grade T1 tumors treated with initial intravesical therapy suggest that approximately 30% of patients will ultimately require cystectomy, and 30% will die of their disease with or without cystectomy. The risk of progression continues for the life of the patient, and late recurrence and progression is common. Initial clinical and pathologic factors can be identified that predict a high risk of progression and are reasonable indicators for initial cystectomy. Question: Is the best treatment for high-grade T1 bladder cancer cystectomy? <|endoftext|> <|assistant|> Radical cystectomy can provide a very high cure rate for these patients and should be considered early in the treatment plan.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The aim of the present work was to know the incidence of HIV infection in the sanitary area of León, and its tendency, throughout the period 1983-1997. A register of cases with the patients attended in the area hospitals, those detected in the Penitentiary Centre of León and notifications of cases of AIDS at a national level have been used. Only the patients residing in a municipality belonging to the area at the time of detection of the infection have been included. Age, sex, risk group, year of detection of the infection, development to AIDS and mortality were analysed. The Spearman coefficient correlation range has been used for the study of tendency. 509 cases of HIV infection (374 males and 134 females) were detected in the area from 1983 to 1997. The accumulated incidence throughout the period of study was 1,368/million inhabitants. The annual incidence shows and upward phase until 1990, followed by another of plateau (1990-1993). In 1994-1995 there was a decrease, interrupted in 1996-1997. The curve as a whole doesn't reveal a descending tendency (p > 0.05). The annual incidence in the IDU follow a similar pattern to that of the complete group while the group of heterosexual transmission shows a tendency to increase (p < 0.025). 223 patients (43.8%) developed AIDS, 195 of whom we know the evolution. Of these, 139 have died and 56 are still alive. Question: Are [ HIV infection in the health care of Leon . Incidence from 1983-1997 ]? <|endoftext|> <|assistant|> There is no evidence that the incidence of HIV infection tends to decrease in the sanitary area of León at present. This is probably related to the behaviour of the two main risk groups: a tendency to stability in the case of IDU and to increase in heterosexual transmission. It is important to insist on the prevention campaigns, especially those directed towards avoiding heterosexual transmission.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: It is not known whether the higher restenosis rates reported after balloon angioplasty of occluded as opposed to non-occluded coronary arteries are still found after placement of coronary stents in lesions matched for factors known to affect late angiographic outcome. In a retrospective analysis of 1276 patients who had undergone coronary stent placement and in whom 6-month angiographic follow-up was available, we identified 144 patients with a total coronary occlusion which matched a non-occluded coronary lesion in another 144 patients. Matching lesion pairs were of the same type (de novo or restenotic), were supplied with the same type of stent, had reference vessel diameters identical within 0.3 mm and stented vessel segment lengths identical within 8 mm, and were located in corresponding target vessels. After stenting, statistically identical minimal lumen diameters had been achieved in both groups (occluded: 2.74+/-0.35 mm, non-occluded: 2. 77+/-0.32 mm, P = 0.45). At follow-up, minimal lumen diameters were not different (occluded: 1.65+/-0.77 mm, non-occluded: 1.76+/-0.76 mm, P = 0.24), reflecting an identical late lumen loss for occlusions (1.09+/-0.76 mm) and non-occluded lesions (1.01+/-0.70 mm, P = 0.38). Because of the significantly larger acute gain, the loss index was significantly lower for occluded vessels (0.40+/-0.27 vs 0. 51+/-0.35, P = 0.003). Corresponding restenosis rates were 33% (occluded) and 28% (non-occluded;P = 0.44). For stented vessel segment lengths>18 mm, restenosis rates were markedly higher (occluded: 42%, non-occluded: 36%) than for stented vessel segment lengths</=18 mm (occluded: 25%, non-occluded: 22%). Question: Restenosis after stenting of matched occluded and non-occluded coronary arteries. Should there be a difference? <|endoftext|> <|assistant|> In occluded and non-occluded coronary lesions matched for factors known to affect the angiographic outcome, no difference between the respective restenosis rates was observed within 6 months of coronary stenting. Thus, either type of coronary lesion appears to exhibit the same propensity for neointimal hyperplasia.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Sites of chronic inflammation are often associated with the establishment and growth of various malignancies including breast cancer. A common inflammatory condition in humans is autoimmune arthritis (AA) that causes inflammation and deformity of the joints. Other systemic effects associated with arthritis include increased cellular infiltration and inflammation of the lungs. Several studies have reported statistically significant risk ratios between AA and breast cancer. Despite this knowledge, available for a decade, it has never been questioned if the site of chronic inflammation linked to AA creates a milieu that attracts tumor cells to home and grow in the inflamed bones and lungs which are frequent sites of breast cancer metastasis. To determine if chronic inflammation induced by autoimmune arthritis contributes to increased breast cancer-associated metastasis, we generated mammary gland tumors in SKG mice that were genetically prone to develop AA. Two breast cancer cell lines, one highly metastatic (4T1) and the other non-metastatic (TUBO) were used to generate the tumors in the mammary fat pad. Lung and bone metastasis and the associated inflammatory milieu were evaluated in the arthritic versus the non-arthritic mice. We report a three-fold increase in lung metastasis and a significant increase in the incidence of bone metastasis in the pro-arthritic and arthritic mice compared to non-arthritic control mice. We also report that the metastatic breast cancer cells augment the severity of arthritis resulting in a vicious cycle that increases both bone destruction and metastasis. Enhanced neutrophilic and granulocytic infiltration in lungs and bone of the pro-arthritic and arthritic mice and subsequent increase in circulating levels of proinflammatory cytokines, such as macrophage colony stimulating factor (M-CSF), interleukin-17 (IL-17), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), and tumor necrosis factor-alpha (TNF-alpha) may contribute to the increased metastasis. Treatment with anti-IL17 + celecoxib, an anti-inflammatory drug completely abrogated the development of metastasis and significantly reduced the primary tumor burden. Question: Is breast-cancer-associated metastasis significantly increased in a model of autoimmune arthritis? <|endoftext|> <|assistant|> The data clearly has important clinical implications for patients diagnosed with metastatic breast cancer, especially with regards to the prognosis and treatment options.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Exogenous glucocorticoids suppress short-term lower leg growth in children as assessed by knemometry. The knemometric measurements, however, may be confounded by reductions in the thickness of the cutis and subcutis over the knee. To assess whether inhaled glucocorticoid-induced suppression of short-term growth is accompanied by changes in the thickness of the cutis and subcutis. The study was a randomized, controlled, crossover trial with 1 wk treatment, run-in and washout periods. Active treatment was inhaled budesonide 200 microg twice daily. Short-term growth was assessed by knemometry, and the thickness of the cutis and subcutis over the knee, on the volar forearm and abdomen was measured by 20 MHz B-mode ultrasound. Nineteen children with asthma aged 7 to 13 y. Lower leg growth was significantly reduced during budesonide treatment (0.27 mm/wk) compared to the treatment-free period (0.54 mm/wk) (p = 0.02, 95%: -0.50 to -0.05). Variations in the thickness of the cutis were seen during budesonide treatment (mean +/- SEM): -0.01 +/- 0.03 mm over the knee, -0.02 +/- 0.02 mm on the forearm and 0.01 +/- 0.02 mm on the abdomen. The variations in the total thickness of the cutis and subcutis were -0.05 +/- 0.12 mm, 0.06 +/- 0.12 mm and -0.06 +/- 0.10 mm during budesonide treatment. The variations in thickness of the cutis or subcutis were not statistically different during budesonide treatment and the treatment free period in any anatomical location. Question: Is lower leg growth suppression caused by inhaled glucocorticoids accompanied by reduced thickness of the cutis or subcutis? <|endoftext|> <|assistant|> Short-term lower leg growth suppression induced by inhaled glucocorticoids is not confounded by variations in thickness of cutis or subcutis. The present observations further establishes knemometry as a reliable tool for assessment of the risk of growth suppression of inhaled glucocorticoids in children with asthma.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Two recent literature-based meta-analyses revealed that restrictive filling pattern (RFP) was associated with a 4-fold increase in the risk of death in patients with heart failure (HF) and postacute myocardial infarction (AMI). This similar but unique analysis evaluated the link between RFP and morbidity. Prospective echocardiographic studies of patients post-AMI and with HF that reported HF morbidity were identified. Events (post-AMI: development of HF; HF: HF readmission) were compared between patients with and without RFP in both patient groups. Review Manager version 4.2.7 software was used for the analysis. Twelve post-AMI studies (1286 patients, 271 events) and 5 HF studies (647 patients, 176 events) were identified. RFP was associated with HF readmission in the HF patients (OR 2.96 [2.02-4.33] and development of HF post-AMI (OR 10.10 [7.02-14.51]). The event rate in the RFP group was the same regardless of disease category (49% post-AMI, 42% HF); however, RFP was less prevalent in the post-AMI group (22% versus 39%). Question: Is restrictive filling pattern a powerful predictor of heart failure events postacute myocardial infarction and in established heart failure : a literature-based meta-analysis? <|endoftext|> <|assistant|> This literature-based meta-analysis confirms that RFP is a powerful predictor of HF hospitalization in patients with HF and especially the development of HF post-AMI. This is an important prognostic sign and should be incorporated into routine clinical practice.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Dyspepsia is a common symptom in residents of Leh, a high-altitude region in Ladakh, India. Helicobacter pylori related gastritis is a common cause of such symptoms. However data regarding this association at high altitudes is sparse. To investigate the demographic, endoscopic and histopathology findings in patients presenting with dyspeptic symptoms in the high-altitude region of Leh. Methods: A cross-sectional study was done in 84 patients with dyspeptic symptoms, attending the outpatient department of local government hospital in Leh. Demographic details, endoscopy, histopathology of upper gastrointestinal biopsies and microbiology culture of gastric/duodenal aspirates were studied. The mean age was 38.4 years with 42% being males. Indigenous foods with high-salt content were consumed by 75% of patients. Epigastric pain was the most frequent symptom (in 96%) and pain radiating to the back was another peculiar symptom seen in 49% of patients. The predominant finding on endoscopy was antral gastritis in 71% of patients. Nodular gastritis was seen in 18% of patients. H. pylori was documented in 93% and histopathology revealed mild-to-moderate inflammation in 93% and mild-to-moderate atrophy in 90% of patients. Colonization with Gram-negative bacilli was observed in gastric/duodenal aspirate cultures. Question: Is atrophic gastritis with high prevalence of Helicobacter pylori a predominant feature in patients with dyspepsia in a high altitude area? <|endoftext|> <|assistant|> Dyspepsia at high-altitude commonly presents as pain radiating to the back with a very high (90%) prevalence of H. pylori, endoscopic findings of antral gastritis and nodular gastritis, and atrophic gastritis in biopsies. Further investigations are needed to determine whether these observations are related to the high-altitude or the high-salt content in their diet and also whether these further translate to carcinogenesis.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: This was a retrospective analysis of prospectively collected data from patients who underwent elective resection for colon cancer with anastomosis at a specialized colorectal unit from January 1993 to December 2010. Anastomotic leaks were diagnosed according to standardized criteria. Patient and tumour characteristics, surgical procedure and operating surgeons were analysed. A logistic regression model was used to discriminate statistical variation and identify risk factors for anastomotic leakage. A total of 1045 patients underwent elective colon cancer resection with primary anastomosis. Anastomotic leakage occurred in 6.4% of patients. Ileocolic anastomosis had an anastomotic leakage rate of 7.2%, colo-colonic/colorectal anastomosis 5.2% and ileorectal anastomosis 12.7%, with intersurgeon variability. The independent risk factors associated with anastomotic leakage were the use of perioperative blood transfusion (OR 2.83, CI 1.59-5.06, P < 0.0001) and the individual surgeon performing the procedure (OR up to 8.44, P < 0.0001). Question: Anastomotic leakage after colon cancer resection: does the individual surgeon matter? <|endoftext|> <|assistant|> In addition to perioperative blood transfusion, the individual surgeon was identified as an important risk factor for anastomotic leakage. Efforts should be made to reduce performance variability amongst surgeons.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: An injury to the forelimb sensorimotor cortex results in the impairment of motor function in animals. Recent research has suggested that intranasal administration of nerve growth factor (NGF), a protein naturally found in the brain, and placement into enriched environments (EE) improves motor and cognitive function after traumatic brain injury (TBI). The purpose of this study was to determine whether NGF, EE, or the combination of both was beneficial in the recovery of motor function following TBI. Uninjured animals had fewer foot faults than injured animals, displaying a lesion effect. Injured animals housed in EE were shown to have fewer foot faults whether or not they received NGF. Injured animals also displayed an increased reliance on the non-impaired limb further validating a lesion effect. Question: Does environmental enrichment aides in functional recovery following unilateral controlled cortical impact of the forelimb sensorimotor area however intranasal administration of nerve growth factor? <|endoftext|> <|assistant|> EE is an effective treatment on the recovery of motor function after a TBI. Intranasal administration of NGF was found to not be an effective treatment for functional motor recovery after a TBI.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Unilateral spinal anesthesia is performed to provide restriction of sensory and motor block. The aim of this study was to compare unilateral and bilateral spinal anesthesia, with regard to limiting the nerve block exclusively to the area of surgery. This was a prospective, randomised, double-blind study, conducted in 40 consecutive outpatients scheduled for unilateral inguinal regional surgery. Patients in both groups received 0.5% hyperbaric bupivacaine 15 mg + morphine 0.1 mg. Patients in the unilateral group (Group U) were placed in the lateral decubitus position for 10 minutes (min) on their side to be operated, while patients in the bilateral group (Group B) were placed in the supine position. The pin-prick test was used to assess the times to reach L1, T12 and T10 sensory blocks and the times to reach motor block. In addition, the sensory and motor block recovery times were recorded using a modified Bromage scale. Furthermore, the duration of the operation and the times to first analgesic requirement were noted. There were significant differences between Group U and Group B in the times to reach L1, T12 and T10 dermatome levels of sensory block, and the times to reach motor block using the modified Bromage scale on three levels. However, there was no difference in the time to ambulation, the time to complete sensory regression and the time to first analgesic requirement. Question: Is unilateral spinal anesthesia superior to bilateral spinal anesthesia in unilateral inguinal regional surgery? <|endoftext|> <|assistant|> The time to reach sensory and motor blocks for unilateral spinal anesthesia could provide an advantage over bilateral spinal anesthesia in inguinal region operations.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Plain water (PW) should be the main beverage consumed by the population. However, consumption of caloric beverages (CB) has increased considerably worldwide. The purpose of this paper is to analyze the association between CB and PW intake in Mexican adults with a low socioeconomic status (SES). In a cross-sectional design, beverage consumption was evaluated with a 24-h beverages recall using the five-step multiple-pass method recommended by the U.S. Department of Agriculture. Physical activity, anthropometric and sociodemographic information were obtained. CB was defined as those beverages that provide energy, with the exception of low-fat milk and beverages with noncaloric sweeteners. Participants were classified into five groups according to their PW consumption (nondrinkers and four quartiles). Differences between groups were evaluated with ANOVA and Bonferroni tests for multiple comparisons among quartiles. A two-stage Heckman regression model was designed with robust standard errors, adjusting for potential confounders. A total of 1108 adults between 21 and 59 years of age were evaluated. A negative association was noted between PW intake and CB consumption (p <0.001) with the exception of natural juice, which was positive (p <0.01) and sodas that no differences were found between quartiles. Specifically, for every milliliter of PW, the intake of CB was 3.4, 1.3, 0.68 and 0.38 mL in each quartile, respectively (p <0.001). In Heckman's model, PW consumers were 0.5 times less likely to consume CB (p = 0.029). This probability increased to 0.9 for low-fat milk, skim milk and beverages without added sugar (LFM-BWAS) consumers (p <0.001). Also, for every 100 mL of PW consumption, CB intake diminished by 20 mL (p <0.001). In turn, for every 100 mL of LFM-BWAS consumption, a reduction of 47 mL in CB was observed (p <0.001). Question: Is plain water consumption associated with lower intake of caloric beverage : cross-sectional study in Mexican adults with low socioeconomic status? <|endoftext|> <|assistant|> Higher PW consumption was associated with lower CB consumption. This association suggests that future studies are warranted to determine if increasing PW intake in a low SES Mexican population can reduce intake of CB.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: In patients with a transient ischemic attack (TIA) or ischemic stroke, the combination of focal and nonfocal symptoms has been associated with a higher risk of cardiovascular events. We hypothesized that nonfocal symptoms are more frequent in patients with symptomatic stenosis of a vertebral artery (VA) than of a carotid artery (CA). Therefore, we assessed the prevalence of nonfocal symptoms in patients with a recent TIA or nondisabling ischemic stroke and studied their relation with symptomatic CA or VA stenosis. We administered a standardized questionnaire on the occurrence of focal and nonfocal symptoms during the qualifying TIA or nondisabling ischemic stroke and in the preceding 6 months. We included 50 consecutive patients with a recently symptomatic CA stenosis ≥50%, 50 consecutive patients with a recently symptomatic VA stenosis ≥50%, 25 consecutive patients with an anterior circulation event without an ipsilateral CA stenosis ≥50%, and 25 consecutive patients with a posterior circulation event without a relevant VA stenosis ≥50%. Relative risks for the presence of nonfocal symptoms in relation to the presence of a symptomatic stenosis were calculated with univariate and multivariate Poisson regression. Adjustments were made for age, sex, stroke as the qualifying event, and cardiovascular risk factors. A subgroup analysis was performed for patients in whom the vascular territory of the event was confirmed on imaging. During the qualifying ischemic event, focal symptoms were accompanied by nonfocal symptoms in 80 (53%) patients. Nonfocal symptoms occurred more frequently in patients with a VA stenosis (72%) than in patients with a CA stenosis [26%; adjusted relative risk (aRR), 2.9; 95% confidence interval (CI), 1.8-4.6]. A higher prevalence of nonfocal symptoms was found in patients with posterior circulation TIAs and strokes (73%) than in patients with anterior circulation TIAs and strokes (33%; aRR, 2.2; 95% CI, 1.6-3.1). During the preceding 6 months, 45% of patients with and 20% of patients without a symptomatic stenosis had had nonfocal symptoms (aRR, 2.4; 95% CI, 1.3-4.3). Subgroup analysis for the 89 (59%) patients with ischemia visible on imaging gave essentially the same results. Question: Are nonfocal symptoms more frequent in patients with vertebral artery than carotid artery stenosis? <|endoftext|> <|assistant|> More than half of the TIAs or nondisabling ischemic strokes were associated with nonfocal neurological symptoms. Nonfocal symptoms occurred more frequently in patients with a symptomatic VA stenosis than CA stenosis.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The laryngopharyngeal form of gastroesophageal reflux disease (LF GERD) is a frequent manifestation of supraesophageal GERD. Diagnosis of LF GERD is difficult: most of the common diagnostic methods of GERD have insufficient accuracy in establishing LF GERD. The purpose of this study was to evaluate the role of endoscopic and laryngologic examination in the diagnosis of LF GERD and to create a laryngoscopic reflux index (LRI). A total of 108 LF GERD patients and 90 controls were investigated. The criteria for LF GERD were: complaints, reflux-laryngitis, and esophagitis (endoscopically or histologically proven). Lesions in four laryngeal regions were evaluated: arytenoids (A), intraarytenoid notch (IAN), vestibular folds (VF), and vocal cords (VC). Three types of mucosal lesions were evaluated on a points basis: alterations of the epithelium, erythema, and edema. Total LRI was calculated by summing-up the indices in the separate laryngeal areas. The LRI mean value (11.48+/-3.78 points) of LF GERD patients was statistically significantly greater than that (1.64+/-1.93 points) of the controls. The most significant laryngoscopic changes of LF GERD were: mucosal lesions of IAN, mucosal lesions of VC, and edema of VC. A combination of these three findings reliably distinguishes the LF GERD patients from controls in 95.9% of cases. The mucosal lesions of IAN have the greatest importance in diagnosing LF GERD: the odds ratio to LF GERD - 21.32, p<0.001. Endoscopic esophagitis was established in 36 (33.3%) cases. The severity of esophagitis did not correlate with the severity of the laryngeal findings. Question: Is laryngeal examination superior to endoscopy in the diagnosis of the laryngopharyngeal form of gastroesophageal reflux disease? <|endoftext|> <|assistant|> Laryngoscopy is superior to endoscopy in diagnosing LF GERD. Endoscopy has limited value in the diagnosis of LF GERD. Establishing the LRI could be helpful in the differential diagnosis of the disease in the everyday clinical practice.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Infection with cytotoxin-associated gene A (cagA) Helicobacter pylori is associated with severe gastric diseases. Previous studies in humans have reported a decreased gastric hydrophobicity with H pylori infection. The aim of the present study was to differentiate between the effect of cagA+ and cagA- strains on gastric mucus hydrophobicity. One hundred patients without peptic ulcers and not on medication were randomly recruited from endoscopy clinics; each patient had six biopsies. Contact angle measurements were performed using a goniometer assisted by computer software. H pylori status was assessed by histology, Campylobacter-like organism test and culture, and cagA+ status was determined by polymerase chain reaction. In age- and sex-matched patients, there was no significant difference (P=0.27) in contact angle between H pylori-positive (61+/-2.8 degrees ) and H pylori-negative patients (65.5+/-3.0 degrees ). There was also no significant difference (P=0.36) in contact angle among H pylori-negative, cagA- and cagA+ patients (65.5+/-3.0 degrees , 58.6+/-3.6 degrees and 63.4+/-4.9 degrees , respectively). However, a trend of increased mean contact angles in cagA+ compared with cagA- and H pylori-negative patients was observed in patients 50 years and younger (68.3+/-8.3 degrees , 61.1+/-6.1 degrees and 63.6+/-2.2 degrees , respectively; P=0.70) and in patients without atrophy (71.1+/-8 degrees , 59.6+/-4 degrees and 66+/-2 degrees , respectively; P=0.30). In addition, there was no significant correlation between contact angles and patient age (r=0.104, P=0.306). Question: Does human gastric mucosal hydrophobicity decrease with Helicobacter pylori infection or chronological age? <|endoftext|> <|assistant|> The present study shows that H pylori infection and the chronological age have no effect on the gastric mucus hydrophobicity, but it highlights a trend of increased mucus hydrophobicity with cagA+ infection that needs to be supported by future studies.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The primary purpose of this study was to determine whether the endotracheal intubation (ETI) success rate is different among paramedic students trained on a human patient simulator versus on human subjects in the operating room (OR). Paramedic students (n = 36) with no prior ETI training received identical didactic and mannequin teaching. After randomization, students were trained for ten hours on a patient simulator (SIM) or with 15 intubations on human subjects in the OR. All students then underwent a formalized test of 15 intubations in the OR. The primary outcome was the rate of successful intubation. Secondary outcomes were the success rate at first attempt and the complication rate. The study was powered to detect a 10% difference for the overall success rate (alpha = 0.05, beta = 0.20). The overall intubation success rate was 87.8% in the SIM group and 84.8% in the OR group (difference of 3.0% [95% confidence interval {CI} = -4.2% to 10.1%; p = 0.42]). The success rate on the first attempt was 84.4% in the SIM group and 80.0% in the OR group (difference of 4.4% [95% CI = -3.4% to 12.3%; p = 0.27]). The complication rate was 6.3% in the SIM group and 4.4% in the OR group (difference of 1.9% [95% CI = -2.9% to 6.6%; p = 0.44]). Question: Is human patient simulation effective for teaching paramedic students endotracheal intubation? <|endoftext|> <|assistant|> When tested in the OR, paramedic students who were trained in ETI on a simulator are as effective as students who trained on human subjects. The results support using simulators to teach ETI.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The administration of memantine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has clinically improved the cognitive function of patients with Alzheimer's disease (AD), indicating that a disturbance in glutamatergic transmission might be involved in a predisposition to developing the disease. The potential association of polymorphisms in NMDA receptor subunits NR3A and NR3B, encoded by the GRIN3A and GRIN3B genes, with AD was investigated. We performed a case-control study. Two single nucleotide polymorphisms, 3104 G/A (rs10989563) and 3723 G/A (rs3739722), in the GRIN3A gene and 2 GRIN3B gene polymorphisms, 1210 C/T (rs4807399) and 1730 C/T (rs2240158), were studied. Upon genotyping of the exonic polymorphism in the GRIN3A gene, the G allele was present at a higher rate than the A allele at position 3723 in AD patients compared with normal groups (p < 0.05). Three haplotypes (designated Ht1-3) were identified from these 2 polymorphisms (3104 G/A and 3723 G/A), and the distribution of Ht2 (AG) differed between AD patients and controls (p < 0.05). Additionally, from the 2 GRIN3B gene variants 1210 C/T and 1730 C/T analyzed, no strong association with AD was observed. Question: Does genetic variation in N-methyl-D-aspartate receptor subunit NR3A but not NR3B influence susceptibility to Alzheimer 's disease? <|endoftext|> <|assistant|> These observations suggest that the genetic variation of the NR3A, but not NR3B, subunit of the NMDA receptor may be a risk factor for AD pathogenesis among the Taiwanese population.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: It is generally recognized that the subchondral bone plate (SBP) is involved in development of osteoarthritis (OA). However, the pathophysiological significance is not yet clear. The goal of this study is to investigate the extent of the changes that occur in SBP of the tibial plateau in the early stages of experimental OA. Forty-three female rabbits were assigned to 5 experimental (n = 8 each group) and one sham group (n = 3). OA was induced by medial meniscectomy in the right knee, the left knee served as control. 2, 4, 8, 12, and 24 weeks after meniscectomy, cartilage damage was evaluated, and bone mineral density (BMD) and mineralization distribution of the SBP was measured by computed tomography osteoabsorptiometry (CT-OAM). Cartilage damage started 2 weeks after meniscectomy with surface roughening. Cartilage defects increased over time. 24 weeks postoperatively, subchondral bone was exposed. As early as 2 weeks after meniscectomy, BMD in the medial tibial plateau decreased significantly. BMD increased again and reached the values of the non-operated knee 12 weeks postoperatively. In addition, already 4 weeks after meniscectomy a significant shift of the density maximum on the medial tibial plateau, which is normally centrally located toward the margin was observed. Question: Does meniscectomy lead to early changes in the mineralization distribution of subchondral bone plate? <|endoftext|> <|assistant|> In conclusion, the results of this study contribute to the concept of early involvement of the SBP in the development of OA. The hypothesis that changes in the SBP occur simultaneously to cartilage damage was confirmed.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Human basophils secrete leukotriene C4 (LTC4) in response to various stimuli, and a short treatment with IL-3 enhances LTC4 release, although IL-3 alone does not induce LTC4 release. However, the mechanism of this priming effect of IL-3 for LTC4 generation remains unknown in human basophils. This study was designed to explore the mechanisms by which short treatments with IL-3 enhance stimulated secretion of LTC4, with a focus on the activation of cytosolic phospholipase A2 (cPLA2). The phosphorylation state of cPLA2 in human basophils was examined by its shift in electrophoretic mobility as detected by Western blotting. Free arachidonic acid (AA) and LTC4 were measured by gas chromatography-negative ion chemical ionization mass spectrometry and LTC4-specific RIA, respectively. Human basophils expressed cPLA2. IL-3, as well as the protein kinase C (PKC) activator phorbol 12-myristate 13-acetate, caused a shift in the electrophoretic mobility of cPLA2, which indicated phosphorylation of cPLA2 and therefore its activation. Ionomycin at a concentration of 0.1 microg/mL was used to induce a modest elevation of cytosolic calcium response ([Ca2+]I), no apparent cPLA2 phosphorylation, and little free AA and LTC4 generation. Pretreatment with IL-3 (1 to 10 ng/mL) markedly enhanced ionomycin (0.1 microg/mL)-mediated AA and LTC4 generation. The concentration dependence of cPLA2 phosphorylation by IL-3 and its effects on free AA and LTC4 generation were similar. The selective PKC inhibitors, bis-indolylmaleimide II and Ro-31-8220 inhibited the phorbol 12-myristate 13-acetate-mediated cPLA2 electrophoretic mobility shift, but not the IL-3-mediated shift, suggesting that the IL-3 effect is PKC independent. Both the anaphylatoxin split product of the C component C5 (C5a) and f-Met-Leu-Phe induced PKC-independent cPLA2 phosphorylation with a similar time course most notable for the absence of observable changes in cPLA2 phosphorylation before 30 seconds. These results suggested an explanation for the absence of free AA generation by C5a. When [Ca2+]I was elevated in response to C5a, there was no phosphorylation of cPLA2, and by the time cPLA2 became phosphorylated, [Ca2+]I had returned to resting levels. Treatment with IL-3 preconditioned the cPLA2 by causing its phosphorylation so that the transient [Ca2+]I response, which followed stimulation by C5a, could induce the generation of free AA and LTC4. Question: Is phosphorylation of cytosolic phospholipase A2 by IL-3 associated with increased free arachidonic acid generation and leukotriene C4 release in human basophils? <|endoftext|> <|assistant|> Taken together, these results suggest that the effect of IL-3 for free AA generation and LTC4 release might be due to induction of cPLA2 phosphorylation. The studies demonstrated a need for synchronous cPLA2 phosphorylation and elevations in [Ca2+]I.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Past studies of the human intestinal microbiota are potentially confounded by the common practice of using bowel-cleansing preparations. We examined if colonic lavage changes the natural state of enteric mucosal-adherent microbes in healthy human subjects. Twelve healthy individuals were divided into three groups; experimental group, control group one, and control group two. Subjects in the experimental group underwent an un-prepped flexible sigmoidoscopy with biopsies. Within two weeks, subjects were given a standard polyethylene glycol-based bowel cleansing preparation followed by a second flexible sigmoidoscopy. Subjects in control group one underwent two un-prepped flexible sigmoidoscopies within one week. Subjects in the second control group underwent an un-prepped flexible sigmoidoscopy followed by a second flexible sigmoidoscopy after a 24-hour clear liquid diet within one week. The mucosa-associated microbial communities from the two procedures in each subject were compared using 16S rRNA gene based terminal restriction fragment length polymorphism (T-RFLP), and library cloning and sequencing. Clone library sequencing analysis showed that there were changes in the composition of the mucosa-associated microbiota in subjects after colonic lavage. These changes were not observed in our control groups. Standard bowel preparation altered the diversity of mucosa-associated microbiota. Taxonomic classification did not reveal significant changes at the phylum level, but there were differences observed at the genus level. Question: Does standard colonic lavage alter the natural state of mucosal-associated microbiota in the human colon? <|endoftext|> <|assistant|> Standard bowel cleansing preparation altered the mucosal-adherent microbiota in all of our subjects, although the degree of change was variable. These findings underscore the importance of considering the confounding effects of bowel preparation when designing experiments exploring the gut microbiota.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Tricuspid valve replacement (TVR) has a high postoperative mortality, despite recent advances in perioperative care. We report the results of our experience in TVR with an emphasis on early mortality and morbidity and long-term follow-up. Between October 1994 and August 2007, 80 consecutive TVRs were performed in 78 patients. The mean age was 48+/-14 (range: 20-70) years. The underlying disease of the patients was classified as rheumatic (n=54), congenital (n=12), endocarditis (n=10) or degenerative (n=4). Previous cardiac surgery had been performed in 40 patients (50%). Isolated TVR was performed in 24 patients (30%). Hospital mortality occurred in one patient (1.4%). Postoperative morbidities included intra-aortic balloon pump (n=5), bleeding re-operation (n=4), delayed sternal closure (n=3), acute renal failure (n=3), subdural haematoma (n=3), extracorporeal membrane oxygenation (n=1), mediastinitis (n=1) and pacemaker insertion (n=4). In 42 patients, ventilator support was needed for more than 72 h. Based on multivariate analysis, age (p<0.001) and the cardiopulmonary time (p=0.004) were the identified risk factors. Follow-up was completed in all patients with a mean duration of 56+/-37 (range: 0-158) months. During the follow-up period, there were seven deaths (8.8%), including five cardiac deaths. The 5- and 8-year survival rates were 95+/-3% and 79+/-9% and event-free survival rates were 76+/-6% and 61+/-9%, respectively. Based on multivariate analysis, the only identified predictors of late deaths was a postoperative low cardiac output (p=0.024). Question: Is tricuspid valve replacement a catastrophic operation? <|endoftext|> <|assistant|> TVR can be performed and low operative mortality can be achieved thorough optimal perioperative management in the current era.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The composition of the extracellular matrix (ECM) as well as insulinlike growth factor I (IGF-I) receptor density vary along the crypt-villus axis. We determined whether components of the ECM influence IGF-I receptor expression in IEC-18 rat small intestine crypt cells. IEC-18 cells were cultured on plastic, collagen type IV, Matrigel, and laminin at the plateau and proliferative growth phases. Receptor affinity (Kd) and number (Bmax) were determined by competitive binding of 125I-IGF-I in the presence of increasing concentrations of unlabeled IGF-I. Receptor isolation was performed by affinity cross linking. Messenger RNA (mRNA) for IGF-I receptor was quantified by Northern analysis. Specific binding of IGF-I > IGF-II > insulin was observed. A 130,000-molecular weight protein was identified by cross-linking, consistent with the alpha subunit of the IGF-I receptor. Scatchard analysis revealed no effect of ECM on IGF-I binding affinity. In contrast, the Bmax was 18% lower for plateau-phase cells cultured on Matrigel vs. plastic and was 42% lower for cells cultured on laminin vs. collagen type IV. The Bmax for proliferative growth phase cells was decreased when cultured on Matrigel vs. plastic and was 10-fold less than for cells cultured at the plateau growth phase. Northern analysis revealed that IEC-18 cells cultured on Matrigel had less mRNA for IGF-I receptor than cells cultured on plastic. Question: Does extracellular matrix composition influence insulinlike growth factor I receptor expression in rat IEC-18 cells? <|endoftext|> <|assistant|> The rate of cell proliferation and the composition of the ECM influence IGF-I receptor expression in IEC-18 cells.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To evaluate the association between mood and anxiety disorders in Hashimoto disease and Euthyroid Goitre in a case control study. Cases included 19 subjects with Hashimoto disease in euthyroid phase, 19 subjects with euthyroid goitre, 2 control groups each of 76 subjects matched (4/1) according to age and sex drawn from the data base of a community based sample. Psychiatric diagnoses were formulated using the International Composite Diagnostic Interview Simplified, according to DSM-IV criteria. All subjects underwent a complete thyroid evaluation including physical examination, thyroid echography and measure of serum free T4 (FT4), free T3 (FT3), thyroid-stimulating hormone (TSH) and anti-thyroid peroxidase autoantibodies (anti-TPO). Subjects with Hashimoto disease showed higher frequencies of lifetime Depressive Episode (OR = 6.6, C.L. 95% 1.2-25.7), Generalized Anxiety Disorders (OR = 4,9 Cl 95% 1.5-25.4) and Social Phobia (OR = 20.0, CL 95% 2.3-153.3) whilst no differences were found between subjects with goitre and controls. Question: Are a case control study on psychiatric disorders in Hashimoto disease and Euthyroid Goitre : not only depressive but also anxiety disorders associated with thyroid autoimmunity? <|endoftext|> <|assistant|> The study seems to confirm that risk for depressive disorders in subjects with thyroiditis is independent of the thyroid function detected by routine tests and indicates that not only mood but also anxiety disorders may be associated with Hashimoto disease.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Treatment of high-grade osteosarcoma remains a challenge. The prognostic significance of the pre-treatment serum lactate dehydrogenase (LDH) level is currently controversial. We reviewed records from all patients diagnosed with conventional high-grade osteosarcoma at our institution over a 25-year period and analysed the prognostic significance of LDH in high-grade localised extremity osteosarcomas treated with chemotherapy. Between June 1977 and March 2003, 66 patients for whom follow-up was available were diagnosed with localised high-grade extremity osteosarcoma and treated with chemotherapy. The median age was 15 years, with only 3% older than 40 years, and the median follow-up was 100 months. The median progression-free survival (PFS) was 67 months and the median overall survival (OS) was 113 months. The absence of a response to chemotherapy was correlated with a trend toward lower PFS and OS. High serum pre-treatment LDH level was associated in multivariate analyses with a poorer prognosis for both PFS (HR=8.623, 95%CI: 1.71-43.37; p=0.009) and for OS (HR=9.38; 95%CI: 1.73-50.74; p=0.009). Question: Is pre-treatment serum lactate dehydrogenase level an important prognostic factor in high-grade extremity osteosarcoma? <|endoftext|> <|assistant|> In this series, the pre-treatment serum LDH level had an independent prognostic value for both PFS and OS in patients with high-grade localised extremity osteosarcoma. This measurement should be included in a large prospective prognostic series.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) play a role in the processes of extracellular matrix degradation. Changes in their expression levels have been observed in various tumor types, including lung carcinoma. However, their clinical significance and their prognostic importance in the progression of nonsmall cell lung carcinoma (NSCLC) remain to be specified. In this study, mRNA expression levels of MMP-1, MMP-9, TIMP-1, and TIMP-2 were evaluated in patients with resected NSCLC, and their associations with disease progression and prognosis were determined. Between June 1996 and December 1999, 116 patients underwent resection for NSCLC. Expression levels of MMPs and TIMPs were evaluated using Northern blot analysis in these NSCLC tissue samples and in 39 matched samples of normal lung tissue. MMP-1, MMP-9, and TIMP-1 expression levels were increased in tumor samples compared with matched, corresponding normal tissues. In contrast, TIMP-2 expression was decreased in tumor samples. MMP-1 tumor expression was correlated significantly with the evolution of lymph node status and tumor-lymph node-metastasis (TNM) stage. In contrast, MMP-9 tumor expression was correlated significantly with increased T stage. TIMP-1 overexpression was an independent predictor of worse survival in patients with NSCLC that was not associated with other prognosis factors, such as TNM stage. Question: Is tissue inhibitor of metalloproteinase 1 an independent predictor of prognosis in patients with nonsmall cell lung carcinoma who undergo resection with curative intent? <|endoftext|> <|assistant|> The overexpression of TIMP-1 was an independent prognostic marker in patients with NSCLC, and evaluating TIMP-1 may be important for identifying patients who are at greater risk of disease recurrence.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Unlike normal cells, ataxia telangiectasia (A-T) cells do not exhibit enhanced double-strand-break (dsb)-repair fidelity after ionizing radiation (IR) exposure. DNA-repair induction and other responses to IR are mediated by signalling pathways that are defective in A-T cells. Ataxia telangiectasia mutated (ATM) protein, the mutated protein in A-T cells, is homologous to members of the P13-kinase, including the rapamycin target FRAP. Rapamycin kills normal cells more readily in normal than in A-T cells, and inhibits the FRAP target p70 S6 kinase (p70S6K) more readily in normal than in A-T cells. Also, PHAS-1, another FRAP target, may also be a substrate for ATM. Because ATM plays a role in the response of mammalian cells to rapamycin, the effect of rapamycin on IR enhancement of dsb repair was investigated. Double-strand-break repair by normal and A-T lymphoblasts, either untreated or treated with rapamycin and y-irradiated, was analysed using shuttle pZ189 containing a dsb. Double-strand-break-rejoining fidelity in linear plasmids (linDNA) processed in either untreated or rapamycin-treated normal cells increased about twofold if transfection occurred immediately after host irradiation. In contrast, radiation did not increase or decrease the repair fidelity by untreated A-T host cells. But, like normal hosts, dsb-repair fidelity improved twofold in A-T hosts treated with rapamycin. Treatment with the P13-kinase inhibitor LY294002 did not alter dsb-rejoining fidelity in normal or in A-T hosts. Question: Does ionizing radiation enhance double-strand-break repair in rapamycin-treated ataxia telangiectasia lymphoblasts? <|endoftext|> <|assistant|> These findings demonstrate that rapamycin does not affect IR enhancement of dsb-repair fidelity in normal cells but restores this phenomenon in A-T lymphoblasts, and suggests the involvement of a rapamycin-sensitive pathway in radiation-enhanced dsb repair.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Physical disability and dependency are serious, and frequent, adverse health outcomes associated with aging and resulting from chronic disease. Reasoning has suggested that there might be a preclinical, intermediate phase of disablement which might develop in parallel with progression of underlying disease and precede and predict disability. Definition of this stage could provide a basis for screening and early intervention to prevent disability. The objective of this study was to determine preclinical functional predictors of incident mobility difficulty and provide evidence for a preclinical stage of disability. A prospective, population-based cohort study was carried out in Baltimore, Maryland, with two evaluations 18 months apart. The participants were 436 community-dwelling women, 70-80 years of age at baseline, not cognitively impaired, and reporting difficulty in no areas, or only one area, of physical function (primarily mobility), who were participating in the Women's Health and Aging Study II. Participants were recruited from a population-based, age-stratified random sample. Incident mobility disability was studied in the subset without such disability at baseline. The main outcome measure was self-reported incident difficulty walking 1/2 mile or climbing up 10 steps. At baseline, 69.3% of the cohort reported no difficulty with mobility. After 18 months, 16.0 and 11.7% of this group reported incident difficulty walking 1/2 mile or climbing up 10 steps, respectively. Those reporting baseline task modification due to underlying health problems, our measure of preclinical disability, were at three- to fourfold higher odds of progressing to difficulty than were those without such modification. In multivariate logistic regression analyses, this self-report measure, task modification without difficulty, and objective measures of performance were independently and jointly predictive of incident mobility difficulty. Specifically, for incident difficulty walking 1/2 mile, self-reported task modification odds ratio (OR) = 3.67, walking speed (.5 m/s difference) OR = 2.16; for incident difficulty climbing up 10 stairs, OR for task modification = 3.84, for stair climb speed (1/3 step/s difference) = 2.08 (95% CI did not include 1 for any). Covariates, age, living alone, number of chronic diseases, depression score, knee strength, and balance by functional reach, were not significant predictors in either model. Question: Does preclinical mobility disability predict incident mobility disability in older women? <|endoftext|> <|assistant|> Two indicators of functional changes in older women without mobility difficulty, self-report of modification of method of doing a task in the absence of difficulty and performance measures, are independent and strong predictors of risk of incident mobility disability. The self-report measure provides substantial strength in predicting risk of incident disability across the full range of performance, and may identify a vulnerable point at which other risk factors act to cause transitions to disability. Together, the preclinical indicators identify a subset of high-functioning older women who are at high risk of mobility disability, and provide a potential basis for screening for disability risk and targeting interventions to prevent mobility disability.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Surgeons have traditionally treated recurrent shoulder dislocation by open methods. With the advent of arthroscopic repair techniques some surgeons reported higher recurrence rates than with open methods but some of those reports included patients with a variety of problems, including bone loss and those continuing in contact sports. It is unclear whether recurrence rates would be higher in patients without bone loss and those willing to forego contact sports.QUESTIONS/ We therefore determined recurrence rates and functional scores after arthroscopic revision shoulder stabilization in patients without bone loss and those not subsequently participating in contact sports. We retrospectively reviewed 16 patients who underwent a revision arthroscopic Bankart repair using suture anchors. An arthroscopic approach was selected in patients with a unilateral traumatic injury and mild to moderate bone loss. Arthroscopic stabilization was contraindicated in patients with (1) multidirectional shoulder instability; (2) greater than 25% glenoid bone loss; (3) a Hill Sachs lesion involving more than one-third of the articular surface of the humeral head; and (4) patients electing to continue pursuing contact sports. At followup, physical examination of both shoulders was conducted. Several functional scores (Rowe, UCLA, and Constant&Murley) were compiled. The minimum followup was 24 months (mean, 31 months; range, 24-46 months). The UCLA score (22-31), Constant&Murley score (69-80), and Rowe score (33-80) all improved. Shoulder instability recurred in three of the 16 patients, two sustaining dislocations and one a subluxation. One recurrence was the result of new trauma and this patient underwent an open Latarjet procedure; the other two patients refused further surgery. Question: Is selective arthroscopic revision beneficial for treating recurrent anterior shoulder instability? <|endoftext|> <|assistant|> Revision arthroscopic Bankart repair using suture anchors was associated with a low recurrence rate and restoration of acceptable function in patients without bone loss and not participating in contact sports.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The goal of this study was to evaluate urinary N-terminal fragment of B-type natriuretic peptide concentrations, normalized to creatinine (UNBCR), to predict morbidities at discharge in preterm infants. UNBCR were determined in urine collected on day of life (DOL) 2, 7, 14, and 28 in 136 preterm infants <1500 g birth weight, 22 of whom developed bronchopulmonary dysplasia (BPD), defined as oxygen supplementation at 36 weeks' gestational age) and 11 infants developed severe retinopathy (ROP), defined as stage 3 or stage ≥ 2 requiring surgery). UNBCR on DOL 7, 14, and 28 was elevated in infants who developed BPD or ROP compared with controls (P ≤ .001). On multiple regression analysis including birth weight and gestational age, ROP but not BPD remained independently associated with UNBCR on DOL 14 and 28. Areas under receiver operating characteristic curves for UNBCR on DOL 14 and 28 to predict ROP were 0.938 (0.027) and 0.954 (0.021), respectively. UNBCR DOL 14 and 28 thresholds exceeded by all infants with severe ROP (100% sensitivity, 100% negative predictive value) had a specificity of 66% and 85%, respectively. Question: Does urinary N-terminal B-type natriuretic peptide predict severe retinopathy of prematurity? <|endoftext|> <|assistant|> UNBCR might hold promise to reduce unnecessary eye examinations by timely and accurate identification of infants at risk of severe ROP.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To determine the frequency of power injectable peripherally inserted central venous catheter (PIPICC) displacement after contrast injection for computed tomography. We included all patients who had a computed tomographic examination with contrast administration via PIPICC over a 4-month period. Several variables including catheter location before and after the injection were documented. Descriptive statistics were used for continuous variables. The χ² test was used to compare groups. Continuous variables were analyzed using the Student t test. Among 78 injections in 67 patients (34 men and 33 women; median age, 49 years), there were 12 catheter displacements (15.4%): 5 (62.5%) of 8 catheters initially located proximal to the tracheobronquial angle (TBA) and 7 (10.14%) of 69 catheters initially located distal to the TBA. The initial catheter position before the injection correlated with the frequency of displacement significantly (P < 0.006). Contrast injection rate and amount of contrast were no risk factors for position change. There were no complications. Question: Do power injectable peripherally inserted central venous catheter lines frequently flip after power injection of contrast? <|endoftext|> <|assistant|> Catheter displacement occurred in 62.5%, with PIPICCS cephalad to the TBA. A preliminary scout view should be checked before the contrast injection. In addition, a postinjection scan scout view is recommended to verify catheter position.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Trophoblast differentiation is a critical process for successful implantation and establishment of the human placenta. The aim of this study was to characterize the effect of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) on the expression of markers of trophoblast function and differentiation. Human cytotrophoblasts were stimulated with 1 and 10 ng/mL recombinant TNF-alpha or IL-6. Cell viability was determined and conditioned culture media was analyzed by gelatin zymography to assess protease secretion and by enzyme-linked immunosorbent assays to measure production of beta-human chorionic gonadotropin and oncofetal fibronectin. TNF-alpha increased secretion of urokinase-type plasminogen activator up to 3-fold of basal unstimulated production. Stimulation of cytotrophoblasts with this cytokine also inhibited beta-human chorionic gonadotropin secretion up to 75%. TNF-alpha did not modify the secretion of matrix metalloproteinase-9 and oncofetal fibronectin. IL-6 had no effect on these trophoblast differentiation markers. Question: Modulation of trophoblast function by tumor necrosis factor-alpha: a role in pregnancy establishment and maintenance? <|endoftext|> <|assistant|> These results show that TNF-alpha stimulated cytotrophoblasts modulate the expression of differentiation markers, down-regulating the autocrine signals that promote syncytialization, and increasing their invasive capacity through up-regulation of proteases. We suggest that this regulatory mechanism of trophoblast function could play an important role during trophoblast implantation, in pregnancy failure and in the normal and pathologic rupture of fetal membranes.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The association between unexplained falls and cardiovascular causes is increasingly recognized. Neurally mediated cardiovascular disorders and hypotensive syndromes are found in almost 20 percent of the patients with unexplained falls. However, the approach to these patients remains unclear. Gait assessment might be an interesting approach to these patients as clinical observations suggests that those with cardiovascular or hypotensive causes may not manifest obvious gait alterations. Our primary objective is to analyze the association between gait disorders and a non-cardiovascular cause of falls in patients with unexplained falls. A second objective is to test the sensitivity and specificity of a gait assessment approach for detecting non-cardiovascular causes when compared with intrinsic-extrinsic classification. Cross-sectional study performed in a falls clinic at a university hospital in 41 ambulatory elderly participants with unexplained falls. Neurally mediated cardiovascular conditions, neurological diseases, gait and balance problems were assessed. Gait disorder was defined as a gait velocity < 0.8 m/s or Tinetti Gait Score < 9. An attributable etiology of the fall was determined in each participant. Comparisons between the gait assessment approach and the attributable etiology regarding a neurally mediated cardiovascular cause were performed. Fisher exact test was used to test the association hypothesis. Sensitivity and specificity of gait assessment approach and intrinsic-extrinsic classification to detect a non-cardiovascular mediated fall was calculated with 95% confidence intervals (CI95%). A cardiovascular etiology (orthostatic and postprandial hypotension, vasovagal syndrome and carotid sinus hypersensitivity) was identified in 14% of participants (6/41). Of 35 patients with a gait disorder, 34 had a non-cardiovascular etiology of fall; whereas in 5 out of 6 patients without a gait disorder, a cardiovascular diagnosis was identified (p < 0.001). Sensitivity and specificity of the presence of gait disorder for identifying a non-cardiovascular mediated cause was 97.1% (CI95% = 85-99) and 83% (CI95% = 36-99), respectively. Question: Are gait disorders associated with non-cardiovascular falls in elderly people : a preliminary study? <|endoftext|> <|assistant|> In community dwelling older persons with unexplained falls, gait disorders were associated with non-cardiovascular diagnosis of falls. Gait assessment was a useful approach for the detection of a non-cardiovascular mediated cause of falls, providing additional value to this assessment.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The arteriole-to-venule ratio (AVR) is widely used for investigating subclinical cerebral microangiopathy. The possible occurrence of retinal vascular caliber changes was investigated in a population of hyperhomocysteinaemic (plasma total homocysteine (tHcy)>13 micromol/l) adult epileptic patients. Retinal photographs of cases and controls were evaluated for generalized narrowing of the retinal arterioles, measured as AVR, by graders masked to case-control status using standardized protocols. Plasma total homocysteine (tHcy) levels were assayed by HPLC. Sixty-seven patients (36M/31F, 36.4+/-7.5 years of age; mean level of tHcy 22.8+/-11.4 micromol/l), and 75 control subjects (42M/33F, 35.4+/-8.5 years of age; mean level of tHcy 7.8+/-2.3 micromol/l) were enroled. No retinal caliber changes were detected in any patient and healthy subject. The analysis of retinal photographs failed to identify any difference in the venular diameters, arteriolar diameters, and AVR measurements between the two groups (P=0.98). Question: Is retinal assessment useful in epileptic patients with hyperhomocysteinemia? <|endoftext|> <|assistant|> We showed that adult hyperhomocysteinaemic epileptic patients do not show any changes in retinal vascular caliber assessed by the measurement of AVR.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The respiratory variation in the pre-ejection period (Delta PEP) has been used to predict fluid responsiveness in mechanically ventilated patients. Recently, we modified this parameter (PEPV) and showed that it was a reliable predictor for post-cardiac surgery, mainly paced, patients when moderately low tidal volumes were used. One of the modifications involved tidal volume indexation, which had not been proposed before for dynamic parameters. The aim of the present animal study was to investigate whether indexation to tidal volume should be part of a new definition of dynamic parameters such as the case for our newly proposed PEPV. Eight prone, anesthetized piglets (23-27 kg) were subjected to a sequence of 25% hypovolemia, normovolemia, and 25% and 50% hypervolemia. At each volemic level, tidal volumes were varied in three steps: 6, 9, and 12 ml/kg. PEP variations (ms) and pulse-pressure variation (PPV) were measured during the three tidal volume steps at each volemic level. PEP variations increased significantly with increasing tidal volume at all volemic levels but 50% hypervolemia and were proportionally related to the tidal volume at normovolemia. PPV increased significantly with increasing tidal volume at all volemic levels and was roughly proportional to the tidal volume at all volemic levels but hypovolemia. Question: Should dynamic parameters for prediction of fluid responsiveness be indexed to the tidal volume? <|endoftext|> <|assistant|> Our study indicates that dynamic parameters are improved by indexing to tidal volume.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To provide a meta-analyisis on whether obesity could be a prognostic indicator on the severity, development of complications and mortality of acute pancreatitis (AP). Eligible articles were retrieved using electronic databases. Clinical studies evaluating the association between obesity and disease course of patients with AP were included. Weighted mean difference (WMD) and 95% confidence interval (CI) were estimated and pooled using RevMan 4.2.8. In all, 12 clinical studies with a total of 1483 patients were included in the analysis. Obese patients had a significantly increased risk of severe acute pancreatitis (SAP; RR=2.20, 95% CI 1.82-2.66, P<0.05), local complication (RR=2.68, 95% CI 2.09-3.43, P<0.05), systemic complication (RR=2.14, 95% CI 1.42-3.21, P<0.05) and in-hospital mortality (RR=2.59, 95% CI 1.66-4.03, P<0.05) compared with non-obese patients. Question: Is obesity an indicator of complications and mortality in acute pancreatitis? <|endoftext|> <|assistant|> Obesity is a definite risk factor of morbidity and in-hospital mortality for AP and may serve as a prognostic indicator.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Cholesterol homeostasis is important for formation and maintenance of myelin and axonal membranes in the central nervous system (CNS). The concentrations of the brain specific cholesterol metabolite 24S-hydroxycholesterol (24OHC) and cholesterol precursors have been shown to be altered in multiple sclerosis (MS). However, how changes in sterol levels relate to the pathological processes in MS is not clear. In this study, we compared serum and cerebrospinal fluid (CSF) sterol levels between 105 MS (51 relapsing-remitting (RR); 39 secondary progressive (SP) and 15 primary progressive (PP)) and 49 control patients. Sterol levels were correlated to magnetic resonance imaging (MRI) markers of disease activity. We found decreased serum 24OHC and 27-hydroxycholesterol (27OHC) and increased CSF lathosterol in MS patients compared to control patients (p=0.018, p=0.002 and p=0.002, respectively). Subgroup analysis showed that serum 24OHC levels were negatively correlated to normalized brain volume measurements in relapse-onset MS patients (r= -0.326, p=0.004). Question: Do oxysterols and cholesterol precursors correlate to magnetic resonance imaging measures of neurodegeneration in multiple sclerosis? <|endoftext|> <|assistant|> These results confirm that cholesterol homeostasis is disturbed in MS and suggest that changes in cholesterol synthesis are related to neurodegenerative pathological processes as seen on the MRI. The data seem to be in line with the recently reported observation that high dose statins may have a positive effect on clinical disability in secondary progressive MS.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Dickkopf-1, a newly recognized antagonist for canonical Wnt signaling, is secreted in the early stage of human adipose-derived stem cells (ASCs) adipogenic differentiation. This study was aimed to investigate whether human recombinant DKK-1 (rhDKK-1) could affect the differentiation and metabolism as well as adipocytokines secretion in primary cultured human ASCs. Human ASCs were isolated from omental adipose tissue and induced to adipogenic differentiation in the absence or presence of Wnt signaling antagonist rhDKK-1 and agonist SB216763, respectively. mRNA and protein expression profiles of adipogenic factors during the differentiation process were analyzed using quantitative RT-PCR and Western blotting. Adipocytokines secretion levels in the culture medium were measured by ELISA method. Our results showed that DKK-1 was already expressed during the early stage of adipogenesis and reached the peak on the 9th day. Exogenous rhDKK-1 exposure accelerated the differentiation by up-regulating PPAR-γ and C/EBP-α, down-regulating Wnt3a, Wnt10b and β-catenin, without affecting non-canonical Wnt signaling marker (Wnt5a). In addition, rhDKK-1 treatment increased the secretion of leptin, RBP4, TNF-α and adiponectin during differentiation. rhDKK-1 treatment also significantly increased the intracellular accumulation of lipids and lipolysis. Thus, Wnt signal pathway agonist SB216763 down-regulated DKK-1 transcriptional and secretion levels during adipogenic process. Question: Does dickkopf-1 promote the differentiation and adipocytokines secretion via canonical Wnt signaling pathway in primary cultured human preadipocytes? <|endoftext|> <|assistant|> Our results suggest that rhDKK-1 could promote ASCs differentiation and increase adipocytokines secretion via canonical Wnt signaling pathway.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Because of a concern about the ability to tolerate beating heart grafting, patients with left main coronary artery stenosis have been excluded from off-pump bypass. We reviewed our experience with off-pump coronary artery bypass grafting for patients with left main coronary artery disease. Eight hundred twenty-three patients underwent bypass grafting for left main coronary artery disease from January 1998 to October 1999. One hundred patients were revascularized without the use of cardiopulmonary bypass and compared with a contemporaneous cohort of 723 patients who underwent grafting with the aid of cardiopulmonary bypass. All patients had multivessel grafting performed through a sternotomy. There was one death (1%) in the group undergoing off-pump grafting as compared with a 30-day mortality of 4.7% (p = 0.059) in the on-pump group. Univariate analysis established that patients revascularized without cardiopulmonary bypass were significantly less likely to require postoperative inotropic support (23% versus 62%, p < 0.001) and transfusion (35% versus 67%, p < 0.001). Logistic regression analysis revealed that cardiopulmonary bypass was an independent risk factor for mortality (odds ratio, 7.3; 95% confidence interval, 1.34 to 138.4). Question: Is off-pump bypass grafting safe in patients with left main coronary disease? <|endoftext|> <|assistant|> Coronary artery bypass grafting using off-pump techniques are safe and effective in left main coronary artery disease.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: In classic studies on the genetic background of antibody production, the major histocompatibility complex (MHC) has been shown to act as the most prominent immune response gene that controls the magnitude and the specificity of antibody production. The strongest genetic risk factor for rheumatoid arthritis (RA), the human MHC HLA-DRB1 shared epitope (SE) alleles, predisposes for antibodies against citrullinated proteins (ACPAs). ACPA levels are higher in SE-positive patients with RA than in SE-negative patients with RA. The aim of the present study was to determine whether SE influences not only the magnitude but also the specificity of the ACPA response. In 2 cohorts of anti-citrullinated peptide 2-positive patients with RA, one from a study of recent-onset arthritis (n = 206) and the other from a treatment strategy study (n = 141), serum antibodies against a citrullinated peptide derived from vimentin (cVim) and antibodies against a citrullinated fibrinogen peptide (cFibr) were determined by enzyme-linked immunosorbent assay. HLA-DRB1 genotyping was performed. In the first cohort, SE alleles were significantly associated with the presence of antibodies against cVim (odds ratio [OR] 4.95, 95% confidence interval [95% CI] 1.87-15.3) and were not significantly associated with the presence of antibodies against cFibr (OR 1.71, 95% CI 0.70-4.14). These results were replicated in the second cohort (OR 5.05, 95% CI 1.92-13.6 and OR 1.19, 95% CI 0.30-3.97, respectively). Question: Is fine specificity of the anti-citrullinated protein antibody response influenced by the shared epitope alleles? <|endoftext|> <|assistant|> In 2 cohorts of ACPA-positive patients with RA, SE alleles predisposed for the development of antibodies against cVim but not for the development of antibodies against cFibr. These data indicate that SE alleles act as "classic" immune response genes in the ACPA response, because they influence both the magnitude and the specificity of this RA-specific antibody response.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Pharmacological concentrations of arsenic trioxide (ATO) and organic arsenic melarsoprol induce apoptosis in malignant plasma cells. In an attempt to further document the interest of the arsenic in vivo, we treated severe combined immunodeficient (SCID) mice transplanted with human myeloma cells by ATO or melarsoprol. Fifty-two SCID mice were irradiated before intraperitoneal (i.p.) injection of plasma cells from five myeloma patients. Engraftment was assessed by serial measurement of the human monoclonal immunoglobulin G (HuMIgG) concentration in mouse serum. Treatment with ATO (10 microg/g i.p. 5 d a week), melarsoprol (30 microg/g i.p. 5 d a week) or phosphate buffer saline was started when a sustained growth of the tumor cells was demonstrated. Seventeen mice developed the human tumor. A significant decrease in HuMIgG amounts was observed in three of five mice of the ATO group, including two that achieved an apparent complete remission persisting up to 5 months after ATO discontinuation. In these mice, no human plasma cells were detected in tissue samples collected postmortem. Soluble human interleukin-6 receptor amount, measured in mice sera as a surrogate marker of the plasma cell proliferation, varied in parallel with HuMIgG concentration. A significant difference in survival was observed between control and ATO treated mice (113 and 158 d, respectively; P = 0.01) whereas no difference could be evidenced in control and melarsoprol groups. Question: Is arsenic trioxide effective in the treatment of multiple myeloma in SCID mice? <|endoftext|> <|assistant|> Present study confirms in vivo the in vitro effects of ATO on myeloma cells. Delayed relapses were observed suggesting that prolonged or maintenance therapy has to be considered in future clinical trials. Whether or not this will translate into clinically relevant effect of the drug in myeloma patients deserves further consideration.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The significance of periodic EEG patterns in patients with impaired consciousness is controversial. We aimed to determine if treating these patterns influences clinical outcome. We studied all patients who had periodic discharges on their EEG recordings from January 2007 to December 2009. Patients with clinical seizures within the preceding 24h, or with unequivocal electrographical seizure activity were excluded. Logistic regression was performed to analyze for factors associated with (a) mortality (b) functional status (c) resolution of EEG pattern. Of the 4246 patients who had EEG, 111 (2.6%) had periodic EEG patterns. 64 met inclusion criteria. In adjusted analysis, higher mortality was associated with acute symptomatic etiology (OR 17.74, 95% CI 1.61-196.07, p=0.019), and presence of clinical seizures (OR 4.73, 95% CI 1.10-20.34, p=0.037). For each unit decrement of GCS, the odds of inpatient mortality and a poorer functional state on discharge increased by 23% (95% CI 7-37%, p=0.009) and 33% (95% CI 9-51%, p=0.011) respectively. Administration of abortive therapy was an independent risk factor for poorer functional status on discharge (adjusted OR 41.39, 95% CI 2.88-594.42, p=0.006), while patients with history of pre-existing cerebral disease appeared more likely to return to baseline functional status on discharge (unadjusted OR 5.00, 95% CI 1.40-17.86, p=0.013). Question: Should we treat patients with impaired consciousness and periodic patterns on EEG? <|endoftext|> <|assistant|> Treatment of periodic EEG patterns does not independently improve clinical outcome of patients with impaired conscious levels. Occurrence of seizures remote to the time of EEG and lower GCS scores independently predict poor prognoses.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Effective integration of visual information is necessary to utilize abstract thinking, but patients with schizophrenia have slow eye movement and usually explore limited visual information. This study examines the relationship between abstract thinking ability and the pattern of eye gaze in patients with schizophrenia using a novel theme identification task. Twenty patients with schizophrenia and 22 healthy controls completed the theme identification task, in which subjects selected which word, out of a set of provided words, best described the theme of a picture. Eye gaze while performing the task was recorded by the eye tracker. Patients exhibited a significantly lower correct rate for theme identification and lesser fixation and saccade counts than controls. The correct rate was significantly correlated with the fixation count in patients, but not in controls. Question: Do relationship between abstract thinking and eye gaze pattern in patients with schizophrenia? <|endoftext|> <|assistant|> Patients with schizophrenia showed impaired abstract thinking and decreased quality of gaze, which were positively associated with each other. Theme identification and eye gaze appear to be useful as tools for the objective measurement of abstract thinking in patients with schizophrenia.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Apoptosis of endothelial cells is a key event in the pathogenesis of systemic sclerosis (SSc). The aim of the present study was to analyze in vitro the mechanism causing endothelial cell apoptosis in SSc. Human dermal microvascular endothelial cells (HDMEC) or human umbilical vein endothelial cells (HUVEC) were cultured with native or heat-inactivated serum from SSc patients or controls with or without interleukin-2-activated natural killer (NK) cells or peripheral blood mononuclear cells. SSc and control sera were tested for the presence or absence, respectively, of anti-endothelial cell antibodies (AECA) by indirect immunofluorescence. Apoptosis was detected by the TUNEL technique. Native sera alone had no effect. Apoptosis induction was observed on HDMEC, but not on HUVEC, in the presence of AECA-positive SSc sera and activated NK cells, and could be inhibited by an anti-Fas ligand antibody. Inhibition of the perforin/granzyme pathway with concanamycin A had no effect on apoptosis induction in this in vitro model. Immunofluorescence analysis of cryosections from SSc skin showed Fas (CD95) expression by endothelial cells, supporting the in vitro findings. Question: Is endothelial cell apoptosis in systemic sclerosis induced by antibody-dependent cell-mediated cytotoxicity via CD95? <|endoftext|> <|assistant|> The results suggest that endothelial cell apoptosis in SSc is induced by antibody-dependent cell-mediated cytotoxicity via the Fas pathway. These data not only provide insight into the pathogenesis of SSc, but also may open new ways to rational therapy for this disease.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The specialty of a patient's usual provider of care is associated with use of mammography and stage of breast cancer diagnosis. It is unknown if specialty of usual provider of care affects time from discovery of a breast screening abnormality to diagnostic resolution. Retrospective chart review study of 546 women who had breast biopsies at an urban public university hospital from 2001 to 2005. Time from abnormal mammogram or clinical breast examination to pathology report was compared by specialty of usual provider of care, sociodemographic, and clinical factors. Multivariate logistic regression was conducted to assess predictors of having diagnostic interval greater than 60 days. The median diagnostic interval was 36 days (interquartile range 21 to 63). After controlling for age, race, insurance, specialty of usual provider of care, employment status, and palpable lump, decreased odds of having diagnostic delay (over 60 days) included having a family physician (odds ratio (OR) 0.242; 95% confidence interval (CI), 0.09 to 0.69), private health insurance (OR 0.360; 95% CI, 0.15 to 0.89), and cancer diagnosis (OR 0.324; 95% CI, 0.17 to 0.61). Question: Do family physicians expedite diagnosis of breast disease in urban minority women? <|endoftext|> <|assistant|> To improve timely follow-up of minority urban women with breast abnormalities, promoting development of a relationship with a family physician may be an important public health intervention.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The ability of lipopolysaccharide (LPS) pre-treatment to induce cardioprotection following ischaemia/reperfusion (I/R) has been well documented; however, the mechanisms have not been fully elucidated. LPS is a Toll-like receptor 4 (TLR4) ligand. Recent evidence indicates that there is cross-talk between the TLR and phosphoinositide 3-kinase/Akt (PI3K/Akt) signalling pathways. We hypothesized that activation of PI3K/Akt signalling plays a critical role in LPS-induced cardioprotection. To evaluate this hypothesis, we pre-treated mice with LPS 24 h before the hearts were subjected to ischaemia (45 min) and reperfusion (4 h). We examined activation of the PI3K/Akt/GSK-3beta signalling pathway. The effect of PI3K/Akt inhibition on LPS-induced cardioprotection was also evaluated. LPS pre-treatment significantly reduced infarct size (71.25%) compared with the untreated group (9.3+/-1.58 vs. 32.3+/-2.92%, P<0.01). Cardiac myocyte apoptosis and caspase-3 activity in LPS-pre-treated mice were significantly reduced following I/R. LPS pre-treatment significantly increased the levels of phospho-Akt, phospho-GSK-3beta, and heat shock protein 27 in the myocardium. Pharmacological inhibition of PI3K by LY294002 or genetic modulation employing kinase-defective Akt transgenic mice abolished the cardioprotection induced by LPS. Question: Is lipopolysaccharide-induced myocardial protection against ischaemia/reperfusion injury mediated through a PI3K/Akt-dependent mechanism? <|endoftext|> <|assistant|> These results indicate that LPS-induced cardioprotection in I/R injury is mediated through a PI3K/Akt-dependent mechanism.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To evaluate anal sphincter anatomy using three-dimensional ultrasonography (3-DAUS) in incontinent women with vaginal delivery, correlate anatomical findings with symptoms of fecal incontinence and determine the effect of vaginal delivery on anal canal anatomy and function. Female with fecal incontinence and vaginal delivery were assessed with Wexner's score, manometry, and 3DAUS. A control group comprising asymptomatic nulliparous was included. Anal pressure, the angle of the defect and length of the external anal sphincter (EAS), the anterior and posterior internal anal sphincter (IAS), the EAS + puborectal and the gap were measured and correlated with score. Of the 62, 49 had fecal incontinence and 13 were asymptomatic. Twenty five had EAS defects, 8 had combined EAS+IAS defects, 16 had intact sphincters and continence scores were similar. Subjects with sphincter defects had a shorter anterior EAS, IAS and longer gap than women without defects. Those with a vaginal delivery and intact sphincters had a shorter anterior EAS and longer gap than nulliparous. We found correlations between resting pressure and anterior EAS and IAS length in patients with defects. Question: Do changes in anal sphincter anatomy correlate with anal function in women with a history of vaginal delivery? <|endoftext|> <|assistant|> Fecal incontinence symptoms did not correlate with anal pressures and anal sphincter anatomy changes, but women with sphincter defects have shorter anterior EAS and IAS and a longer gap.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Declining gait speed is common in the elderly population and is associated with age-related conditions. Because telomere length is a reflection of aging and known to affect degenerative changes in organ systems, gait speed may be associated with telomere length. We therefore investigated the relationship between gait speed and leukocyte telomere length in elderly Korean women. Cross-sectional study. A total of 117 Korean elderly women participated. Metabolic variables were assessed along with gait speed calculated as walking distance (6m) divided by time. Leukocyte telomere length was measured by real-time quantitative polymerase chain reaction. Gait speed correlated with telomere length (r=0.38, p<0.01), fasting insulin (r=-0.19, p=0.04), homeostasis model assessment of insulin resistance index (HOMA-IR; r=-0.22, p=0.02), triglyceride (r=-0.20, p=0.03), and Korean Mini-Mental State Examination (K-MMSE; r=0.20, p=0.03) after adjusting for age. On step-wise multiple regression analysis, telomere length (β=0.35, p<0.01), K-MMSE (β=0.16, p=0.02), age (β=-0.23, p=0.01), and HOMA-IR (β=-0.19, p=0.03) were identified as independent variables associated with gait speed. Question: Is leukocyte telomere length independently associated with gait speed in elderly women? <|endoftext|> <|assistant|> This study suggested that telomere length may have a role in maintaining overall health status as well as preserving gait speed in the elderly population. Further studies are required to better understand the significance of our findings.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Elevated free fatty acids (FFAs) are thought to play an important role in the development of insulin resistance. Adiponectin is an adipose tissue-secreted protein known for its effects on the stimulation of fatty acid oxidation. The aim of this study was to investigate the association of adiponectin receptor 2 gene variations with FFAs levels in subjects with normal fasting glucose levels in Chinese Han population. Four common single nucleotide polymorphisms of ADIPOR2 were genotyped using the TaqMan method to perform association studies with metabolic parameters in 1819 subjects among Chinese Han population. All the subjects were divided into two groups: normal FFAs group (FFAs ≤0.88 mmol/L) and high FFAs group (FFAs >0.88 mmol/L). There was a significant association of rs2370055 with higher FFA levels in major T-allele carriers (P = 0.000). There was a significant difference in the distribution of genotypes of polymorphism rs2370055 between normal and high FFA groups. The frequencies of TT and CT genotypes are significantly higher in subjects with high FFA level than those in the normal FFAs group (P = 0.013 and P = 0.004, respectively). After adjustment for age, sex, body mass index, triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoproteincholesterol, the TT and CT genotypes are both independent risk factors for high FFAs level. Question: Does a Variant in ADIPOR2 be Associated with Increased Free Fatty Acid Levels in Chinese Population? <|endoftext|> <|assistant|> Our findings suggest that variants of ADIPOR2 could be a determinant for higher FFA levels, and among Chinese Han population, carriers of the CT and TT genotypes for rs2370055 even with normal glucose levels may have significantly higher insulin resistance susceptibility.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Radiofrequency ablation at the posterior papillary muscle (PM) significantly reduced ventricular fibrillation (VF) inducibility in rabbits and dogs, suggesting that PM may be involved in the generation of VF. However, the effect of ablation at the PM on VF inducibility remains unknown in normal intact swine hearts because in this species radiofrequency energy delivered at PM provoked incessant VF. Twelve anesthetized swine underwent median sternotomy. Under the ultrasonographic guidance, chemical ablation was performed via injection of dehydrated alcohol into the base of the posterior PM (group PM, n = 6) or anterior wall (control group, n = 6) in the left ventricle. Ventricular fibrillation inducibility and mitral valve function were measured pre- and post-ablation. Hearts were explanted and the ablated myocardium was stained with haematoxylin and eosin. Ventricular fibrillation inducibility was significantly decreased from 100 ± 0% pre-ablation to 11.9 ± 7.8% post-ablation in group PM (P = 0.001), whereas it was not statistically different in the control group (100 ± 0 vs. 92.9 ± 7.1%, pre-ablation vs. post-ablation). Haemorrhage and cellular necrosis was observed in the centre of ablated myocardium and no significant mitral regurgitation was observed following ablation at the posterior PM. Question: Does alcohol ablation at the posterior papillary muscle prevent ventricular fibrillation in swine without affecting mitral valve function? <|endoftext|> <|assistant|> Alcohol ablation of the left posterior PM reduced VF inducibility in normal intact swine hearts, with no significant mitral regurgitation. This suggests that the posterior PM may be involved in the generation of VF, and the recurrence of VF may be prevented by chemical ablation at the posterior PM.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Chronic ethanol abuse is associated with disrupted circadian rhythms and sleep. Ethanol administration impairs circadian clock phase-resetting, suggesting a mode for the disruptive effect of alcohol abuse on circadian timing. Here, we extend previous studies to explore the effects of chronic forced ethanol on photic phase-resetting, photic entrainment, and daily locomotor activity patterns in C57BL/6J mice. First, microdialysis was used to characterize the circadian patterns of ethanol uptake in the suprachiasmatic (SCN) circadian clock and correlate this with systemic ethanol levels and episodic drinking of 10 or 15% ethanol. Second, the effects of chronic forced ethanol drinking and withdrawal on photic phase-delays of the circadian activity rhythm were assessed. Third, the effects of chronic ethanol drinking on entrainment to a weak photic zeitgeber (1 minute of 25 lux intensity light per day) were assessed. This method was used to minimize any masking actions of light that could mask ethanol effects on clock entrainment. Peak ethanol levels in the SCN and periphery occurred during the dark phase and coincided with the time when light normally induces phase-delays in mice. These delays were dose-dependently inhibited by chronic ethanol and its withdrawal. Chronic ethanol did not impede re-entrainment to a shifted light cycle but affected entrainment under the weak photic zeitgeber and disrupted the daily pattern of locomotor activity. Question: Does chronic ethanol disrupt circadian photic entrainment and daily locomotor activity in the mouse? <|endoftext|> <|assistant|> These results confirm that chronic ethanol consumption and withdrawal markedly impair circadian clock photic phase-resetting. Ethanol also disturbs the temporal structure of nighttime locomotor activity and photic entrainment. Collectively, these results suggest a direct action of ethanol on the SCN clock.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Secondary hyperparathyroidism (sHPT) is associated with elevated levels of FGF-23, which in turn are connected to adverse outcomes in ESRD patients. The relationship between FGF-23 and bone metabolism in patients with sHPT treated with cinacalcet has not been studied. Thirty-four stable chronically hemodialyzed patients with sHPT were prospectively followed during the treatment with cinacalcet without any changes in concurrent vitamin D or phosphate binder dose. Blood samples were collected at the start and after 6 months of study. Levels of osteocalcin (OC), cross-linked C-telopeptide of type I collagen (CTX), and FGF-23 were measured. Eighteen patients finished the study. Levels of calcium, phosphate, and iPTH decreased during 6 months of treatment with cinacalcet. Serum level of FGF-23 decreased significantly (log FGF-23 from 7.58 ± 1.7 to 6.61 ± 1.7 pg/ml) (P < 0.001). Cinacalcet lowered the concentration of CTX from 3.1 ± 0.6 ng/ml to 2.6 ± 0.9 ng/ml (P < 0.05) and OC from 91.8 (41.5-558.6) to 70.3 (11.3-419.7) ng/ml (P < 0.05). The magnitude of change in FGF-23 concentration before and after treatment correlated significantly with suppression of osteoblasts' function assessed by ΔOC (r = 0.5, P < 0.05) but not with changes in bone resorption marker ΔCTX. Question: Does cinacalcet lower FGF-23 level together with bone metabolism in hemodialyzed patients with secondary hyperparathyroidism? <|endoftext|> <|assistant|> Cinacalcet treatment of sHPT results in reduction of FGF-23 levels, probably due to the suppression of osteoblasts function.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The aim of this study is to determine whether inclusion of caspase inhibitor can improve the efficacy of cryopreservation of ovarian tissue. Mice were randomly assigned to the Group A (fresh control group) Group B (inclusion of caspase inhibitor) and Group C (non-inclusion of caspase inhibitor). Ovarian tissue in Group B and Group C was vitrified-thawed. TUNEL assay and Bax protein detection were measured after cryopreservation. The mice in all groups received autotransplantation. The number of days before the resumption of estrous cycles was measured daily from the 5th day after surgery, and the percentage of cells expressing PCNA in grafts was measured one month following transplantation. The incidence of TUNEL positive follicles in Group B was significantly higher than that in Group C. Similarly, the percentage of follicles expressing Bax protein in Group B was significantly higher than that in Group C. The number of days before the resumption of estrous cycles in Group B was significantly less than that in Group C. In addition, the percentage of follicular and stromal cells expressing PCNA of grafts in Group B was significantly higher than that in Group C. Question: Is caspase inhibition a valid therapeutic strategy in cryopreservation of ovarian tissue? <|endoftext|> <|assistant|> The global caspase inhibitor Z-VAD-FMK decreases the incidence of apoptosis of ovarian tissue induced by cryopreservation, and inclusion of caspase inhibitor improves the efficacy of cryopreservation of ovarian tissue.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Renal damage from ethylene glycol and primary hyperoxaluria is linked to accumulation of calcium oxalate monohydrate (COM) crystals in the renal proximal tubule (PT). In vitro studies have shown that aluminum citrate (AC), uniquely among citrate salts, blocks COM cytotoxicity to tubular cells. These studies were designed to evaluate the interaction of COM with membrane phospholipids and the ability of AC to reduce COM toxicity by interfering with this interaction. Interaction of COM with phospholipids was assessed using differential scanning calorimetric analysis of structural changes in specific liposomes. Interaction of COM with cell membranes was studied by measuring binding of radiolabeled crystals by human PT (HPT) cells. Analysis of liposomes prepared from phosphatidylserine (PS) or phosphatidylcholine (PC) showed that COM interfered with the gel-liquid transition of PS liposomes, but not that of PC liposomes. AC reversed the COM-induced changes in liposomal structure. AC inhibited the binding of [(14)C]-COM by HPT cells in a concentration-dependent manner. AC blocked COM binding by interacting with the crystal surface and not the cell membrane. Question: Does aluminum citrate block toxicity of calcium oxalate crystals by preventing binding with cell membrane phospholipids? <|endoftext|> <|assistant|> These results indicate that AC blocks the binding of COM by PT cells, and consequently its cytotoxicity, by attaching to the surface of the crystal. Thus, AC, or a related compound that works by the same mechanism, could be a useful adjunct therapy to reduce the renal damage produced by severe hyperoxaluria.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Adiponectin receptors (AdipoRs) are located on neurons of the hypothalamus involved in metabolic regulation - including arcuate proopiomelanocortin (Pomc) and Neuropeptide Y/Agouti-related peptide (NPY/AgRP) neurons. AdipoRs play a critical role in regulating glucose and fatty acid metabolism by initiating several signaling cascades overlapping with Leptin receptors (LepRs). However, the mechanism by which adiponectin regulates cellular activity in the brain remains undefined. In order to resolve this issue, we utilized neuron-specific transgenic mouse models to identify Pomc and NPY/AgRP neurons which express LepRs for patch-clamp electrophysiology experiments. We found that leptin and adiponectin synergistically activated melanocortin neurons in the arcuate nucleus. Conversely, NPY/AgRP neurons were inhibited in response to adiponectin. The adiponectin-induced depolarization of arcuate Pomc neurons occurred via activation of Phosphoinositide-3-kinase (PI3K) signaling, independent of 5' AMP-activated protein kinase (AMPK) activity. Adiponectin also activated melanocortin neurons at various physiological glucose levels. Question: Does adiponectin potentiate the acute effects of leptin in arcuate Pomc neurons? <|endoftext|> <|assistant|> Our results demonstrate a requirement for PI3K signaling in the acute adiponectin-induced effects on the cellular activity of arcuate melanocortin neurons. Moreover, these data provide evidence for PI3K as a substrate for both leptin and adiponectin to regulate energy balance and glucose metabolism via melanocortin activity.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Increasing evidence suggests that inflammatory mechanisms are involved in the intracerebral hemorrhage-induced brain injury. We evaluated the prognostic role of the peripheral leukocyte counts and neutrophil-to-lymphocyte ratio (NLR) in patients with intracerebral hemorrhage. Patients with acute spontaneous intracerebral hemorrhage were retrospectively identified. Total white blood cells, absolute neutrophil count, and absolute lymphocyte count were obtained and the NLR computed from the admission blood work. The study end point was the occurrence of death or major disability at 3 months. One hundred seventy-seven subjects were enrolled. Ninety-four (53.1%) had unfavorable outcome. The absolute neutrophil count, absolute lymphocyte count, and NLR were independently associated with the 3-month status. The NLR resulted the best discriminating variable and the best predictive cut-off value was 4.58. Question: Does neutrophil-to-Lymphocyte Ratio predict the Outcome of Acute Intracerebral Hemorrhage? <|endoftext|> <|assistant|> In patients with acute intracerebral hemorrhage, higher neutrophils, lower lymphocytes, and higher NLRs predicted worse 3-month outcome.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Which factors predict recurrence in patients with Crohn's disease in the era of immunosuppressive medications is still under debate. The current study was conducted to assess long-term outcome after ileocolic resection for Crohn's disease and to define predictive factors for surgical relapse. This is a retrospective study. The study was conducted in a tertiary referral center. A consecutive cohort of patients (n = 203) with Crohn's disease who underwent ileocolic resection between 1997 and 2006 were analyzed. The mean follow-up time was 8.4 (±2.4) years. The cumulative probability for repeated intestinal resection for recurrent Crohn's disease was described by Kaplan-Meier curves. Predictors of surgical recurrence were analyzed by univariate tests. One hundred five patients (51.7%) were exposed to azathioprine/6-mercaptopurine, and 28 patients (13.8%) were exposed to tumor necrosis factor-α blockers after operation. During the follow-up period, 32 patients (15.8%) were reoperated on for disease recurrence. At 5 and 10 years after index surgery, 95.5% and 81.3% of the patients had reoperation-free survival. Previous resections for Crohn's disease (HR, 2.981; 95% CI, 1.411-6.29; p = 0.003) and urgent indication for surgery (HR, 2.729; 95% CI, 1.047-7.116; p = 0.03) were significant risk factors for reoperation. In addition, patients with postoperative complications following ileocolonic resection were more likely to require reoperation (HR, 1.712; 95% CI, 041-2.817; p = 0.03). In a multiple Cox regression model, previous intestinal resection for Crohn's disease remained significant (p = 0.0114) with a HR of 2.654 (95% CI, 1.246-5.654). Question: Do repeat intestinal resections increase the risk of recurrence of Crohn 's disease? <|endoftext|> <|assistant|> The limitation is the retrospective design of the study, with its potential selection bias.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Lymph node metastasis is the major clinicopathologic feature associated with poor prognosis in patients with head and neck squamous cell carcinoma (HNSCC). Here, web-based bioinformatics meta-analysis was performed to elucidate the molecular mechanism of lymph node metastasis of human HNSCC. Preferential upregulation of Myosin 1b (MYO1B) transcript in HNSCC datasets was identified. Myo1b mRNA was highly expressed in human HNSCC cells and patient tissue specimens compared with their normal counterparts as shown by quantitative PCR (qPCR) analyses. Immunohistochemistry (IHC)-detected Myo1b expression was significantly correlated with lymph node metastases in patients with oral cancer of the tongue. HNSCC with high expression of Myo1b and chemokine receptor 4 (CCR4), another metastasis-associated molecule, was strongly associated with lymph node metastasis. RNA interference (RNAi) of Myo1b in HNSCC cells, SAS and HSC4, significantly inhibited migratory and invasive abilities through decreased large protrusion formation of cell membranes. Finally, Myo1b knockdown in SAS cells significantly inhibited in vivo cervical lymph node metastases in a cervical lymph node metastatic mouse model system. Question: Does aberrant Myosin 1b Expression promote Cell Migration and Lymph Node Metastasis of HNSCC? <|endoftext|> <|assistant|> Myo1b is functionally involved in lymph node metastasis of human HNSCC through enhanced cancer cell motility and is an attractive target for new diagnostic and therapeutic strategies for patients with HNSCC.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The main aim of this study was to evaluate the relationship between obesity and renal involvement in children with Henoch-Schönlein purpura (HSP). A retrospective study of 141 pediatric patients with HSP was conducted in our hospital. The clinical data of all patients were collected from the electronic medical record management system from January 2010 to June 2014. The possible risk factors of renal involvement, especially obesity, were analyzed using univariate and multivariate analyses. Renal involvement occurred in 45/141 of the patients. A univariate analysis showed that an age more than 7 years at onset, persistent purpura, obesity, time from symptoms onset to diagnosis more than 14 days, and decreased C3 all increased the risk of renal involvement in HSP. The forward stepwise logistic regression analysis indicated obesity (odds ratio (OR) 4.43, 95 % confidence interval (CI) 1.896 to 10.358), age more than 7 years at onset (OR 2.81, 95 % CI 1.142 to 6.907), and persistent purpura (OR 2.57, 95 % CI 1.119 to 5.909) were independent risk factors for renal involvement. Question: Does obesity increase the risk of renal involvement in children with Henoch-Schönlein purpura? <|endoftext|> <|assistant|> Our results show that obesity can increase the hazard of renal involvement in children with HSP and reconfirm that older age at onset and persistent purpura are the independent risk factors for renal involvement.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: One hundred and eighty-nine patients were examined from June 2004 to June 2007; they were divided into two groups: Group A included all the patients affected by PTC without CLT and Group B all the patients affected by PTC with CLT association. The surgical treatment was in all the patients the total thyroidectomy (TT). For the study age, sex, tumour features (dimensions, angioinvasion, capsular infiltration, multifocality and lymphnode metastases) were taken into consideration. The analysis was carried on with Student t test and chi squared analysis (statistically significant P<0.05). Group A included 117 patients; Group B 72 patients. No statistical difference in sex (P=0.989), age (P=0.480); tumour dimension (P=0.832). The capsular infiltration was present in 23 cases in Group A and 19 in Group B (P=0.368). The difference in average diameter was found to be 1.161+/-0.5812 and 1.485+/-1.082 cm in Group A and in Group B (P=0.290), respectively. The angioinvasion was found in 9 cases of Group A and in 3 cases in Group B (P=0.510). Multifocality was found in 35 patients in Group A and in 26 in Group B (P=0.469). Question: The association between papillary carcinoma and chronic lymphocytic thyroiditis: does it modify the prognosis of cancer? <|endoftext|> <|assistant|> The CLT may have only a minimum impact in the development of the tumour. In this study the association does not modify the aggressiveness.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To investigate the effects of raloxifene on the insulin sensitivity and lipid profile in insulin-sensitive and insulin-resistant postmenopausal women. This placebo-controlled, double-blind, randomized study involved 64 postmenopausal women aged between 45 and 55 years. All subjects were screened with the insulin resistance homeostasis model assessment (IR-HOMA) and those patients in the lowest quartile (n = 16) were assigned as insulin sensitive and those in the highest quartile as insulin resistant (n = 16). Patients in both groups received either raloxifene hydrochloride (60 mg/day) or a placebo for a period of 12 weeks. Insulin sensitivity, the serum lipid profile and anthropometric measurements were established before and after therapy. Women with the highest IR-HOMA scores were associated with a significantly higher weight, body mass index, waist and waist-to-hip ratio (p < 0.05). Raloxifene significantly reduced the IR-HOMA scores from 5.76 ± 2.91 to 1.93 ± 0.96 (p = 0.02) and modified the lipid profile in insulin-resistant patients when compared with the placebo group and those patients receiving raloxifene in the insulin-sensitive group. Question: Does raloxifene modify the insulin sensitivity and lipid profile of postmenopausal insulin resistant women? <|endoftext|> <|assistant|> Raloxifene reduced insulin resistance and modified the lipid profile in insulin-resistant postmenopausal women.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: The NPS1/STH1 gene of Saccharomyces cerevisiae is essential for mitotic growth, especially for the progression through the G2/M phase. It encodes a major component of the chromatin-remodelling complex, RSC, of unknown function. We attempted to address the function of NPS1 in meiosis. The homozygote of the temperature sensitive nps1 mutant, nps1-105, showed reduced and delayed levels of sporulation, accompanied with a notable decrease and delay of the expression of several early meiotic genes (IME2, SPO11 and SPO13). Deletion analysis of the IME2 promoter revealed that the defect in the gene expression occurred through the URS1 site. The sporulation defect of nps1-105 was alleviated by the over-expression of either IME1 or IME2. However, over-expression of IME1 did not permit the full expression of IME2, SPO11 and SPO13 in nps1-105. In addition, the expression of NPS1 itself increased transiently upon initiation of meiosis, before the appearance of the IME2 message but after that of IME1. The impaired increase in NPS1 transcription led to inefficient sporulation. Question: Is nps1/Sth1p , a component of an essential chromatin-remodeling complex of Saccharomyces cerevisiae , required for the maximal expression of early meiotic genes? <|endoftext|> <|assistant|> The results suggest that Nps1p/RSC is required for the activation of gene expression at the initiation of meiosis.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Complete revascularization (CR) has been suggested to provide benefits to both early and long-term outcomes, but the magnitude of the benefit and frequency of incomplete revascularization (IR) after coronary artery bypass graft operations is rarely explored and is the subject of the present study. All patients who underwent isolated bypass operations (March 1995 to September 2007) at the Queen Elizabeth II Health Sciences Center (Halifax, NS, Canada) were identified. Revascularization was considered complete if each significantly diseased territory received at least 1 graft. Clinical characteristics of the CR and IR groups were examined to determine barriers of CR. A nonparsimonious Cox proportion model and survival curves were constructed to examine the association of CR and death after adjusting for clinically relevant covariates. A total of 8,570 patients underwent isolated nonredo bypass operations. IR, based on our strict definition, occurred in 19% of the patients. The territories most commonly affected were the right coronary and circumflex coronary territories. After adjustment for relevant clinical differences, IR was a significant independent predictor of long-term mortality (hazard ratio, 1.2; 95% confidence interval, 1.1 to 1.3). IR was also a significant independent predictor of hospital readmission for cardiac reasons after discharge (hazard ratio, 1.2; 95% confidence interval, 1.0 to 1.3). Question: Is incomplete revascularization after coronary artery bypass graft operations independently associated with worse long-term survival? <|endoftext|> <|assistant|> Despite advances in surgical revascularization, IR can occur in up to 19% of patients. IR significantly affects long-term death and readmission to hospital for cardiac reasons, and avoiding IR should therefore be a priority for surgeons during preoperative planning.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: It has not been definitively established which factors affect insulin resistance (IR) and whether dialysis decreases IR. The aim of this study was to investigate factors that may have an influence on homeostasis model assessment (HOMA-IR) in hemodialyzed patients (HDpts) and to compare IR between HDpts and healthy subjects. We examined 33 HDpts and paired 33 subjects of the control group, matched for sex, age, and BMI. We analyzed concentrations of insulin, glucose, leptin, resistin, and total and high-molecular-weight adiponectin (HMWad) in serum. Using computed tomography in HDpts, we evaluated visceral adipose tissue (VAT), concentrations of visfatin, CRP, and IL-6. HOMA-IR (median, 1.3 vs. 1.4, P=0.19), insulin (median 6.8 vs. 6.0 µIU/mL, P=0.7), glucose (79 mg/dL vs. 93 mg/dL, P=0.001). IR in HDpts is dependent on VAT (r=0.36, P=0.04) and this relationship is stronger than the relationship of BMI and IR (r=0.3, P=0.1). In HDpts we found higher concentrations of leptin (P=0.001) and resistin (P<0.001), with no relation to IR. HMWad and its percentage in relation to total adiponectin are higher in HDpts (P=0.03 and P<0.001, respectively). Question: Is visceral adipose tissue associated with insulin resistance in hemodialyzed patients? <|endoftext|> <|assistant|> HOMA-IR in HDpts does not differ from the control group. In HDpts it depends on the quantity of VAT and this relationship is stronger than with BMI. In HDpts leptin and resistin do not influence IR. HMWad and its percentage in total adiponectin are significantly higher in HDpts.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: We analyzed the preventive effect of immunoglobulins for intravenous use (IVIgs) in endotoxin-induced uveitis (EIU), a disease related to tumor necrosis factor alpha (TNF-alpha) production. EIU was the experimental model in Lewis rats, injecting a systemic dose of 150 microg of lipopolysaccharide (LPS) into the rat's footpad. Half of them were treated with 5 serial intravenous doses of 100 mg of IVIg during the 5 days prior to LPS injection. Eyes were repeatedly examined with a slitlamp, rats were killed and their eyes enucleated for histopathologic study at the 2nd, 16th and 24th hours. TNF-alpha serum levels were measured in aqueous humor at several time intervals by a bioassay using L-929 mouse fibroblasts. Aqueous humor proteins were detected by the Bradford method. IVIg treatment prevented EIU development, treated animals showing a lower grade of ocular inflammation beyond the 2nd hour (Fisher test, p > 0.05). Inflammatory cell infiltration was significantly reduced in the iris, ciliary body and anterior chamber at a 24-hour interval (Wilcoxon test, p < 0.05). This protection was associated with lower levels of TNF-alpha in serum at all time intervals and in aqueous humor at 16 h (Student's t test, p < 0.05), while differences were not significant between the samples of aqueous humor collected at 2 h. Protein exudate was not reduced in the treated group. Question: Do human immunoglobulin preparations for intravenous use prevent endotoxin-induced uveitis in rats? <|endoftext|> <|assistant|> Repeated IVIg injections could be useful in the preventive treatment of EIU probably mediated by a decrease in TNF-alpha release.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: In multiple sclerosis (MS), even in the absence of a clinical episode of optic neuritis (ON), the optic nerve and retinal nerve fiber layer (RNFL) may be damaged leading to dyschromatopsia. Subclinical dyschromatopsia has been described in MS associated with lower motor and cognitive performances. To set the prevalence of dyschromatopsia in eyes of MS patients without a history of ON, to compare its prevalence in patients with and without ON history, and to explore the association between dyschromatopsia and disease duration, average peripapillary RNFL thickness, macular volume, and cognitive and motor performances. An observational cross-sectional study was conducted at multiple medical centers. Data were collected after single neurological and ophthalmological evaluations. Dyschromatopsia was defined by the presence of at least 1 error using Hardy-Rand-Rittler plates. In our population of 125 patients, 79 patients (63.2%) never had ON and 35 (28.8%) had unilateral ON. The prevalence of dyschromatopsia in eyes of patients without ON was 25.7%. Patients with dyschromatopsia had a statistically significant lower RNFL thickness (P = 0.004 and P = 0.040, right and left eyes, respectively) and worse performance in symbol digit modalities test (P = 0.012). No differences were found in macular volume or motor function tasks. Question: Dyschromatopsia in Multiple Sclerosis Patients: A Marker of Subclinical Involvement? <|endoftext|> <|assistant|> Dyschromatopsia occurs frequently in MS patients. It may be associated with a worse disease status and possibly serve as a marker for the detection of subclinical disease progression since it was detected even in the absence of ON. It correlated with thinner peripapillary RNFL thickness and inferior cognitive performance.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Routine tuberculosis control services in Burundi. To determine whether systematic restaining of sputum smears for acid-fast bacilli (AFB) prior to rechecking quality assessment is necessary. Blinded rechecking of peripheral routine smears, including a second control of discordants, before and after restaining. Without restaining, 10/825 (1.2%) negative, and 59/189 (31.2%) positive results were declared false. After restaining, there were 34 (4.1%) false negatives and 13 (6.9%) false positives, both highly significant changes. Before restaining, quantification of positive smears was usually considered too high, while after restaining 41 out of 42 positives were found to have too low readings. Question: Is systematic restaining of sputum smears for quality control useful in Burundi? <|endoftext|> <|assistant|> Despite mild climatic conditions in Burundi, restaining all slides before rechecking revealed an unrecognised, widespread problem of false negatives, rather than false positives. This indicated the need for critical re-appraisal of the standard procedure using cold staining, rather than re-training, as would have been inferred from results without restaining. Systematic restaining of all slides prior to rechecking may be more widely needed in National Tuberculosis Programmes to cover all possible serious causes of error. Cold staining should be avoided in field programmes since its performance is easily affected by frequently encountered adverse factors.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: In many cases, the prognosis of an adrenocortical tumor cannot be determined from pathologic findings alone. We investigated cyclin E levels as a potential marker. We studied 57 tumors by immunohistochemical staining with an anticyclin E antibody. We also evaluated clinical and pathologic factors (McFarlane staging and Weiss score) and previously validated genetic markers (17p13 loss of heterozygosity, 11p15 uniparental disomy, and overexpression of the IGF-II gene) for these tumors. Disease-free survival was estimated in 49 patients who underwent curative surgery. Cyclin E overproduction (> or =5%) was associated with the malignant phenotype and was strongly correlated with tumor size (P<0.0001), Weiss score (P<0.0001) and the presence of genetic abnormalities in tumors (P<0.001) (nonparametric Wilcoxon test and Fisher's exact test). Within a median follow-up of 44.1 months, seven patients exhibited a recurrence and two patients died from other causes. Cyclin E overproduction was significantly associated with shorter disease-free survival in univariate analysis (P=0.016; RR: 7.6), as were histologic grade (Weiss score > or =4; P=0.0006; RR: 18), 17p13 LOH (P=0.014, RR: 14.9), 11p15 UPD (P=0.003, RR: 11.8) and overexpression of the IGF-II gene (P=0.015, RR: 13.8). Question: Does cyclin E correlate with malignancy and adverse prognosis in adrenocortical tumors? <|endoftext|> <|assistant|> This study shows that cyclin E overproduction is of adverse prognostic significance in adrenocortical tumors.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: A considerable gap exists in health and social emotional well-being between Indigenous people and non-Indigenous Australians. Recent research in stress neurobiology highlights biological pathways that link early adversity and traumas as well as life stresses to ill health. We argue that the neurobiological stress response and its maladaptive changes, termed allostatic load, provide a useful framework to understand how adversity leads to physical and mental illness in Indigenous people. In this paper we review the biology of allostatic load and make links between stress-induced systemic hormonal, metabolic and immunological changes and physical and mental illnesses. Question: Does allostatic load mediate the impact of stress and trauma on physical and mental health in Indigenous Australians? <|endoftext|> <|assistant|> Exposure to chronic stress throughout life results in an increased allostatic load that may contribute to a number of metabolic, cardiovascular and mental disorders that shorten life expectancy in Indigenous Australians.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: This paper describes a simple technique of axillary and breast massage which improves the successful identification of blue sentinel nodes using patent blue dye alone. Patent blue dye was injected in the subdermal part of the retroaroelar area in 167 patients having surgical treatment for invasive breast cancer. Three stage axillary lymphatic massage was performed prior to making the axillary incision for sentinel lymph node biopsy. All patients had completion axillary sampling or clearance. A blue lymphatic duct leading to lymph nodes of the first drainage was identified in 163 (97%) of the patients. Results are compared with 168 patients who had sentinel lymph node biopsy using blue dye without axillary massage. Allergic reactions were observed in four patients (1.2%). Question: Does three stage axillary lymphatic massage optimize sentinel lymph node localisation using blue dye? <|endoftext|> <|assistant|> Three stage axillary lymphatic massage improves the successful identification of a blue sentinel lymph node in breast cancer patients.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: To compare different classification systems in a cohort of stillbirths undergoing a comprehensive workup; to establish whether a particular classification system is most suitable and useful in determining cause of death, purporting the lowest percentage of unexplained death. Cases of stillbirth at gestational age 22-41 weeks occurring at the Department of Gynecology and Obstetrics of Foggia University during a 4 year period were collected. The World Health Organization (WHO) diagnosis of stillbirth was used. All the data collection was based on the recommendations of an Italian diagnostic workup for stillbirth. Two expert obstetricians reviewed all cases and classified causes according to five classification systems. Relevant Condition at Death (ReCoDe) and Causes Of Death and Associated Conditions (CODAC) classification systems performed best in retaining information. The ReCoDe system provided the lowest rate of unexplained stillbirth (14%) compared to de Galan-Roosen (16%), CODAC (16%), Tulip (18%), Wigglesworth (62%). Question: Is classification of stillbirths an ongoing dilemma? <|endoftext|> <|assistant|> Classification of stillbirth is influenced by the multiplicity of possible causes and factors related to fetal death. Fetal autopsy, placental histology and cytogenetic analysis are strongly recommended to have a complete diagnostic evaluation. Commonly employed classification systems performed differently in our experience, the most satisfactory being the ReCoDe. Given the rate of "unexplained" cases, none can be considered optimal and further efforts are necessary to work out a clinically useful system.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Adolescence through emerging adulthood is a developmental stage made more challenging when the person has type 1 diabetes. Little research has investigated if individuals with high and low levels of metabolic control in this age group perceive their disease differently. Qualitative descriptive. In this study, 14 participants, ages 11-22 years were interviewed in 2008 about their perceptions of living with type 1 diabetes. Through a process of induction, major themes were identified.RESULTS/ Participants with high and low metabolic control levels reported similar themes related to reactions of others, knowledge about type 1 diabetes, and believed healthcare providers used authoritarian interactions. However, high metabolic control level participants believed type 1 diabetes would be cured; had negative initial responses to being diagnosed; rarely received parental support in managing their diabetes; and were negligent in self-care activities. Participants with low metabolic control levels did not believe a cure was imminent or have negative responses to being diagnosed; received parental support in managing diabetes; and were diligent in self-care activities. Question: A qualitative study of young people's perspectives of living with type 1 diabetes: do perceptions vary by levels of metabolic control? <|endoftext|> <|assistant|> Nurses should give information to young people with type 1 diabetes beyond initial diagnosis and help and support this age group learn appropriate ways to manage their disease, develop positive relationships with healthcare professionals, and participate in interactions with others their age successfully managing type 1 diabetes.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Metabolic disturbances are common features of polycystic ovary syndrome (PCOS), which possibly enhance the risk of diabetes and cardiovascular disease. Lipid accumulation product (LAP) is an emerging cardiovascular risk factor. The aim of this study was to explore the ability of LAP to identify metabolic syndrome (MS) in PCOS women. In a cross-sectional study, anthropometric, biochemical and clinical parameters were measured in 105 PCOS women. Receiver operating characteristic (ROC) analysis was used to find out the cut-off points of LAP to predict MS. MS was categorized according to International Diabetes Federation (IDF) criteria. The prevalence of MS was 43.8% in this study. PCOS women with MS had significantly higher LAP levels compared to those without MS. LAP was highly correlated with components of MS. ROC analysis showed that LAP was a significant discriminator for MS in PCOS women, and the optimal cutoff point of LAP to predict MS was 54.2 (93.3% sensitivity, 96.7% specificity). Question: Is lipid accumulation product related to metabolic syndrome in women with polycystic ovary syndrome? <|endoftext|> <|assistant|> LAP seems to be associated with MS and has a strong and reliable diagnostic accuracy for MS in PCOS women.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Some authors of Cochrane overviews have also (co-)authored one or more of the underlying reviews. We examined the extent of dual (co-)authorship in Cochrane overviews, how it is dealt with, and whether the issue is raised in protocols. The Cochrane Library was searched for overviews and protocols for overviews in September 2015. Data on dual (co-)authorship were extracted for each review into standard spreadsheets by one author and checked for accuracy by a second. Twenty overviews and 25 protocols were identified. The overviews included a median of 10 reviews (interquartile range [IQR]: 6-18.5). In 18/20 overviews (90%), at least one of the included reviews was affected by dual (co-)authorship. A median of 5 (IQR, 2.5-7) reviews per overview was affected by dual (co-)authorship. In 8/18 (44%) overviews with dual (co-)authorship, quality assessment was conducted independently. In 7/25 (28%) protocols, dual (co-)authorship was mentioned. Question: Does most overviews of Cochrane review neglected potential biases from dual authorship? <|endoftext|> <|assistant|> Potential biases arising from dual (co-)authorship are often neglected in Cochrane overviews. We argue that authors of Cochrane overviews and Review Groups should pay more attention to the issue, to avoid bias and preserve the good reputation that Cochrane overviews will typically deserve.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: High fructose consumption is considered to be related to the increasing prevalence of hyperuricemia (HUA). Glucose transporters (GLUT) 2 and 5 are crucial for fructose absorption and transporter. Effects of anti-HUA drugs, allopurinol (API) and benzbromarone (BBR), on expressions of GLUT5 and GLUT2 are not evaluated. Wistar rats were given 10% fructose in drinking water for 60 days to induce HUA, and 5mg/kg API and 10mg/kg BBR were intragastricly treated for 30 days. Serum level of uric acid and xanthine oxidase (XOD) activity in liver were determined. Expressions of GLUT2 and GLUT5 in intestine were analyzed by immunohistochemistry staining assay and Western blot assay. Treatment with API or BBR significantly decreased the serum level of uric acid in HUA rats induced by fructose. Meanwhile, API treatment significantly reduced the XOD activity in liver and GLUT5 expression in intestine. However, BBR treatment did not show inhibitory effects on hepatic XOD activity and intestinal GLUT5 expression. In addition, treatment with API or BBR did not show any effect on GLUT2 expression in intestine. Question: Does allopurinol decrease serum uric acid level and intestinal glucose transporter-5 expression in rats with fructose-induced hyperuricemia? <|endoftext|> <|assistant|> API decreases serum level of uric acid in fructose-induced HUA rats. The mechanisms are associated with suppressing XOD activity in liver to reduce uric acid production, and inhibiting GLUT5 expression in intestine to reduce fructose absorption.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: Factors determining sodium level during sodium-profiling hemodialysis rarely have been studied. We hypothesized that the time-averaged concentration of dialysate sodium (TAC(Na)) is related to intradialytic sodium load and interdialytic complications. Eleven patients underwent 6-week periods of (1) conventional hemodialysis with a dialysate sodium concentration of 138 mmol/L (TAC(138)) and (2) sodium-profiling hemodialysis with a dialysate sodium concentration of 150 to 138 mmol/L (TAC(Na), 140 mmol/L [TAC(140)]) and (3) 155 to 130 mmol/L (TAC(Na), 147 mmol/L [TAC(147)]). Serum sodium level, weight gain, 24-hour blood pressure, and intradialytic and interdialytic discomfort were compared. Serum sodium levels increased during the TAC(140) and TAC(147) periods (P < 0.05 compared with predialysis serum sodium). Intradialytic change in sodium level correlated positively with TAC(Na) (r = 0.945; P < 0.001). Regression analysis indicates that positive sodium load occurred with TAC(Na) more than 137.8 mmol/L. Interdialytic weight gain increased in proportion to TAC(Na) (P < 0.05 compared with each other period), with a positive correlation (r = 0.823; P < 0.001). TAC(Na) causing interdialytic weight gain less than 3 kg was estimated to be less than 143.5 mmol/L. Intradialytic hypotension decreased, but interdialytic discomforts increased during the TAC(147) period (P < 0.05 compared with TAC(138) and TAC(140)). Mean 24-hour blood pressures and pressure loads increased during the TAC(147) period (P < 0.05 compared with TAC(138) and TAC(140)). Mean diastolic blood pressure correlated positively with TAC(Na) (r = 0.354; P < 0.05). Question: Does time-averaged concentration of dialysate sodium relate with sodium load and interdialytic weight gain during sodium-profiling hemodialysis? <|endoftext|> <|assistant|> TAC(Na) is a factor determining sodium load and interdialytic complications during sodium-profiling hemodialysis. Defining the optimal TAC(Na) for individual centers based on their protocols will be helpful to avoid sodium load and excessive weight gain.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: We developed a novel curriculum teaching 20 open surgical skills in 5 general domains (instrument handling, knot tying, simple wound closure, advanced wound closure, and hemostasis). The curriculum includes online didactics, skills practice, and defined performance metrics, but is entirely self-guided with no expert oversight or teaching. Subjects included first- and second-year medical students (n = 9). Subjects first viewed a demonstration video depicting proper technique. The pretest was video-recorded performance of each skill. Subjects then completed the self-guided skills curriculum at their own pace, returning for posttesting once they met defined self-assessment criteria. Performance was evaluated through both self-assessment and blinded video review by 2 expert reviewers using previously validated scales. After completion of the curriculum, performance improved significantly by both self-assessment (3,754 ± 1,742 to 6,496 ± 1,337; P < .01, Wilcoxon signed ranks) and expert assessment (10.1 ± 2.6 to 14.6 ± 2.7; P = .015). When analyzed by the 5 general domains, performance was significantly better for all domains by self-assessment (P < .05 for all domains) and in 4 domains by expert assessment (P < .04 for all domains other than instrument handling). Question: Does a structured self-directed basic skills curriculum result in improved technical performance in the absence of expert faculty teaching? <|endoftext|> <|assistant|> Completion of a self-guided basic surgical skills curriculum allows novice learners to significantly improve performance in basic open surgical skills, without traditional expert teaching. This curriculum is useful for medical students and incoming junior residents.

<|system|> You are an biomedical AI assistant that follows instruction extremely well, Your task is to answer biomedical questions precisely and truthfully using the given abstract <|endoftext|> <|prompter|> Abstract: In patients with heart failure (HF), serum erythropoietin (EPO) levels are elevated and associated with disease severity and outcome. Whether endogenous EPO levels are prospectively associated with the development of HF or cardiovascular events in the general population is unknown. Serum EPO levels were measured at baseline in 6686 subjects enrolled in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) study. Mean age (±SD) was 53 ± 12 years, 49.8% were male, and the median (interquartile range) EPO level was 7.7 (5.9-10.2) IU/L. During a median follow-up of 8.3 (7.7-8.8) years, 209 (3.1%) subjects were newly diagnosed with HF, 97 (1.5%) died of a cardiovascular cause, and 386 (6.0%) subjects had a non-fatal cardiovascular event (277 cardiac events and 93 strokes). Each doubling of EPO level was multivariably associated with new-onset HF [hazard ratio (HR) 1.32, 95% confidence interval (CI) 1.03-1.69, P = 0.031]. EPO levels showed interaction with urinary albumin excretion (P = 0.006) and were only associated with HF in subjects with albuminuria (HR 1.51, 95% CI 1.13-2.03, P = 0.005). There was an independent association of EPO levels with stroke in women (HR 1.82, 95% CI 1.24-2.65, P = 0.002), but not in men. No association was observed for EPO levels with other cardiovascular events or cardiovascular mortality. Question: Are high serum erythropoietin levels related to heart failure development in subjects from the general population with albuminuria : data from PREVEND? <|endoftext|> <|assistant|> High serum EPO levels are independently associated with an increased risk of new-onset HF in subjects with albuminuria. More research into the pathophysiological mechanisms linking EPO levels to HF is needed to understand this association.