TASK DEFINITION: Given a passage with a context and an answer, construct a question on the basis of the information present in the passage. Construct the question in such a way that (i) it is unambiguous, (ii) it is answerable from the passage, (iii) its answer is unique (iv) it answer uses text phrases from the passage. Avoid creating questions that (i) can't be answered correctly without actually understanding the passage and (ii) uses the same words or phrases given in the passage.
PROBLEM: Context: Almost all the past CSWT studies show the beneficial effects on CAD patients in a maximum duration of 1-year follow-up. The aim of this study was to evaluate the actual CSWT effects in 6 years follow-up period.', 'The subjects were selected exclusively on the basis of inclusion criteria. The total number of patients was 52, out of which control group (n = 11) and the shock wave group (SW group, n = 41) was selected.', 'The wall motion, MPI, nitrate dosage, NYHA classification, SAQ scores, CCS grading, 6 MWT were markedly improved in the long-term (6 years) follow-up for SW group than the control group.
Answer: Following 6 years of follow-up, the CSWT provided agreeable results that improved myocardial function and quality of life in comparing to the month 0 and the control group. These outcomes advise that on a long-term (72 months) CSWT shows better parameters than the control group. These findings highlight that CSWT can improve clinical symptoms, morphology, functions of the heart and quality of life in patients with CHD than the patients just on drug therapy for a long-term.

SOLUTION: Does cardiac shock wave therapy show better outcomes in the coronary artery disease patients in a long term?

PROBLEM: Context: The necessity for general anesthesia represents an impediment to using a laparoscopic approach for some procedures that are otherwise performed with the patient under local anesthesia using a conventional open technique. Heating and humidifying the insufflation gas reportedly reduces perioperative pain associated with a CO2 pneumoperitoneum, thus enabling awake laparoscopy.', 'Two cases are reported herein of laparoscopy performed with the patient under local anesthesia using heated, humidified CO2 gas for the pneumoperitoneum.', 'Both patients experienced pain with insufflation of heated, humidified CO2 gas of sufficient magnitude that the procedure could not be performed. The CO2 gas was washed out and replaced with helium gas insufflation with complete resolution of pain. The laparoscopic procedures were accomplished without further discomfort with local anesthesia and using a helium gas pneumoperitoneum.
Answer: Heated, humidified CO2 gas insufflation does not reduce pain sufficiently to permit satisfactory performance of laparoscopy with local anesthesia, especially when full volume insufflation is required. Cold, dry helium gas produces no pain. The theory that cold, dry insufflation gas is a source of peritoneal pain during laparoscopy needs to be reassessed.

SOLUTION: Is heated , humidified CO2 gas unsatisfactory for awake laparoscopy?

PROBLEM: Context: Cardiopulmonary exercise stress testing (CPET) is used to grade the severity of heart failure and to assess its prognosis. However it is unknown whether CPET may improve diagnostic accuracy of standard ECG stress testing to identify or exclude obstructive coronary artery disease (O-CAD) in patients with chest pain.', 'We prospectively studied 1265 consecutive subjects (55 8 years, 156 women) who were evaluated with ECG stress testing (ET) for chest pain. No one had a documented O-CAD. All patients performed an incremental CPET with ECG recordings on an electronically braked cycle ergometer.', 'Of 1265 patients, 73 had a positive CPET and 1192 had a negative CPET. Seventy-three patients with a positive CPET and 71 patients with a negative CPET agreed to undergo nuclear SPECT imaging and coronary angiography. Follow-up lasted 48 7 months. As compared with ET, sensitivity, specificity, PPV and NPV were all improved significantly (ET: 48%, 55%, 33%, 95%; CPET: 88%, 98%, 73%, 99%, respectively, P<0.001). Patients with both peak VO2>91% of predicted VO2 max and absence of VO2-related signs of myocardial ischemia had no evidence of O-CAD in 100% of cases. Cardiac events occurred in 32 patients with a positive CPET and 8 patients with a negative CPET (log rank 18.2, P<0.0001).
Answer: In patients with chest pain, CPET showed a better diagnostic and predictive accuracy than traditional ET to detect/exclude myocardial ischemia. Its use should be encouraged among physicians as a first line diagnostic tool in clinical practice.

SOLUTION:
Is cardiopulmonary exercise testing more accurate than ECG-stress testing in diagnosing myocardial ischemia in subjects with chest pain?