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[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Acoustic Stimulation, Adult, Alpha Rhythm, Attention, Auditory Cortex, Brain-Computer Interfaces, Electroencephalography, Female, Functional Laterality, Humans, Individuality, Male, Reproducibility of Results, Sensory Gating, Speech Perception, Young Adult." }, { "role": "user", "content": "Do envelope responses in single-trial EEG indicate attended speaker in a 'cocktail party '? Context: Recent studies have shown that auditory cortex better encodes the envelope of attended speech than that of unattended speech during multi-speaker ('cocktail party') situations. We investigated whether these differences were sufficiently robust within single-trial electroencephalographic (EEG) data to accurately determine where subjects attended. Additionally, we compared this measure to other established EEG markers of attention. High-resolution EEG was recorded while subjects engaged in a two-speaker 'cocktail party' task. Cortical responses to speech envelopes were extracted by cross-correlating the envelopes with each EEG channel. We also measured steady-state responses (elicited via high-frequency amplitude modulation of the speech) and alpha-band power, both of which have been sensitive to attention in previous studies. Using linear classifiers, we then examined how well each of these features could be used to predict the subjects' side of attention at various epoch lengths. We found that the attended speaker could be determined reliably from the envelope responses calculated from short periods of EEG, with accuracy improving as a function of sample length. Furthermore, envelope responses were far better indicators of attention than changes in either alpha power or steady-state responses." }, { "role": "assistant", "content": "These results suggest that envelope-related signals recorded in EEG data can be used to form robust auditory BCI's that do not require artificial manipulation (e.g., amplitude modulation) of stimuli to function. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Blood Glucose, Disease Susceptibility, Embryo, Mammalian, Embryonic Development, Female, Glucose, Hyperglycemia, Mice, Pregnancy, Pregnancy in Diabetics, Teratogens, Tretinoin." }, { "role": "user", "content": "Does hyperglycaemia potentiate the teratogenicity of retinoic acid in diabetic pregnancy in mice? Context: We recently showed in mice that maternal diabetes increases embryonic susceptibility to caudal regression induced by vitamin A metabolite retinoic acid. Here we tested whether in the maternal diabetic milieu hyperglycaemia is the critical factor responsible for mediating this increased susceptibility. Non-diabetic pregnant mice were made hyperglycaemic by subcutaneous injections of glucose at regular intervals. Conversely, diabetic pregnant mice were treated with phlorizin to induce renal glucosuria and thus reduce blood glucose concentrations. Pregnant mice were treated with retinoic acid and the extent of caudal regression in mouse embryos, measured in terms of the ratio of tail length to crown-rump length was assessed. Embryos were also examined for Wnt-3a expression and cell death. Embryos of mice treated with glucose had a greater extent of caudal regression induced by retinoic acid than saline-treated controls, with enhanced down-regulation of Wnt-3a expression and exacerbated cell death specifically at the caudal end of the embryo. Embryos of diabetic mice treated with phlorizin had a similar extent of caudal regression to embryos of non-diabetic mice after treatment with retinoic acid." }, { "role": "assistant", "content": "Hyperglycaemia increases embryonic susceptibility to caudal regression induced by retinoic acid, with the underlying cellular and molecular changes closely mimicking those that occur in maternal diabetes. Reduction of blood glucose concentrations in diabetic mice completely abolishes this increased susceptibility to retinoic acid. These results suggest that in maternal diabetes hyperglycaemia is the critical factor responsible for potentiating the teratogenic effect of retinoic acid. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Brain Abscess, Disease Models, Animal, Female, Hyperbaric Oxygenation, Random Allocation, Rats, Rats, Wistar, Staphylococcal Infections, Staphylococcus aureus, Time Factors, Treatment Outcome, Wound Healing." }, { "role": "user", "content": "Is hyperbaric oxygen effective in early stage of healing of experimental brain abscess in rats? Context: Current therapy of brain abscess (BA) includes a combined approach that involves antibiotics and minimal invasive surgery, but also hyperbaric oxygen treatment (HBOT) as a supportive measure. Optimum treatment is still a matter of significant controversy. The experiment, previously approved by a relevant ethical committee, involved 80 female Wistar rats. BA was experimentally induced by inoculation of Staphylococcus aureus. The animals were randomized into groups and treated either with antibiotics, HBOT, or with a combination of both. Beneficial effect of HBOT was evident in groups treated with HBOT or with a combination of antibiotic+HBOT. It was mainly manifested on days three and five of the experiment and was evident as statistically significant increase of a number of newly formed blood vessels, increase in mean vascular density, and smaller abscess necrotic core." }, { "role": "assistant", "content": "Although the results of the present study should be interpreted cautiously, they suggest that HBOT has an important but limited role in the treatment of BA. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Condition (s) associated with hypokalemia except -" }, { "role": "assistant", "content": "The correct answer is Type IV A is the only type characterized by a hyperkalemic, hyperchloremic acidosis. CAUSES OF HYPOKALEMIA Inadequate potassium intake Eating disorders : Anorexia, bulimia, starvation, pica, and alcoholism Dental problems: Impaired ability to chew or swallow Povey: Inadequate quantity or quality of food (eg, \"tea-and-toast\" diet of elderly individuals) Hospitalization: Potassium-poor TPN Increased potassium excretion Mineralocoicoid excess (endogenous or exogenous) Hyperreninism from renal aery stenosis Osmotic diuresis: Mannitol and hyperglycemia can cause osmotic diuresis Increased gastrointestinal losses Drugs Genetic disorders Endogenous sources of excess mineralocoicoid include the following: <a href=\" syndrome</a> Primary hyperaldosteronism, most commonly from an adrenal adenoma or bilateral adrenal hyperplasia Secondary hyperaldosteronism from volume depletion, congestive hea failure, cirrhosis, or vomiting Tumor that is producing adrenocoicotropic hormone Genetic disorders Exogenous causes of mineralocoicoid excess include the following: Steroid therapy for immunosuppression Glycyrrhizic acid - Inhibits 11-beta hydroxysteroid dehydrogenase; contained in licorice and Chinese herbal preparations Renal tubular disorders - Type I and type II renal tubular acidosis Hypomagnesemia Drugs that can cause hypokalemia include the following: Diuretics (carbonic anhydrase inhibitors, loop diuretics, thiazide diuretics): Increased collecting duct permeability or increased gradient for potassium secretion can result in losses Methylxanthines (theophylline, aminophylline, caffeine) Verapamil (with overdose) Quetiapine (paicularly in overdose) Ampicillin, carbenicillin, high-dose penicillins Bicarbonate Antifungal agents (amphotericin B, azoles, echinocandins) Gentamicin Cisplatin Ephedrine (from Ephedra; banned in the United States, but available over the Internet) Beta-agonist intoxication Genetic disorders Congenital adrenal hyperplasia (11-beta hydroxylase or 17-alpha hydroxylase deficiency) Glucocoicoid-remediable hypeension Bater syndrome Gitelman syndrome Liddle syndrome Gullner syndrome Glucocoicoid receptor deficiency Hypokalemic period paralysis Thyrotoxic periodic paralysis (TTPP) Seizures, sensorineural deafness, ataxia, mental retardation, and electrolyte imbalance (SeSAME syndrome) A shift of potassium to the intracellular space may result from any of the following: Alkalosis (metabolic or respiratory) Insulin administration or glucose administration (the latter stimulates insulin release) Intensive beta-adrenergic stimulation Hypokalemic periodic paralysis Thyrotoxic periodic paralysis Refeeding: This is observed in prolonged starvation, eating disorders, and alcoholism Hypothermia (ref : harrisons principles of internal medicine, 19E, page 305)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following condition is associated with Restless leg syndrome (RLS)?" }, { "role": "assistant", "content": "The correct answer is Chronic renal failure" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Draining abscess by cutting a window in the bone is" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHOD, RESULTS. Meshes: Adolescent, Adult, Cardiovascular Diseases, Education, Nursing, Continuing, England, Female, Health Status, Humans, Life Style, Male, Mental Disorders, Middle Aged, Physical Examination, Primary Health Care, Risk Factors, Severity of Illness Index, Young Adult." }, { "role": "user", "content": "Does training practice nurses to carry out physical health checks for people with severe mental illness increase the level of screening for cardiovascular risk? Context: Compared to the general population, people with severe mental illness (SMI) have a higher risk of developing cardiovascular disease (CVD). Authors of clinical guidelines advise annual screening for CVD risk factors with appropriate lifestyle counselling. There are seven recommended elements of this health check: blood pressure, body mass index (or waist circumference), blood glucose, serum cholesterol, diet advice, exercise recommendations and smoking cessation guidance.AIM: To establish whether training practice nurses increases the proportion of patients with SMI who are screened for CVD risk factors and given lifestyle advice in primary care. A before-and-after audit of 400 patients on the SMI registers in five primary care centres in Northampton, England. Following the training, the proportion of patients with SMI who received all elements of the health check significantly increased (pre-training: n = 33, 8%, 95% CI = 6-11; post-training: n = 60, 15%, 95% CI = 12-19; RR = 1.82, 95% CI = 1.22-2.72, p = .01)." }, { "role": "assistant", "content": "Training practice nurses about CVD prevention in people with SMI may be effective in increasing the proportion of patients in this group who receive a comprehensive health check." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adenocarcinoma, Antimetabolites, Antineoplastic, Apoptosis, Apoptosis Regulatory Proteins, Arabidopsis Proteins, Blotting, Western, Caspase 3, Caspases, Computer Systems, Deoxycytidine, Fas Ligand Protein, Fatty Acid Desaturases, Flow Cytometry, GPI-Linked Proteins, HeLa Cells, Humans, Jurkat Cells, Membrane Glycoproteins, Neoplasm Proteins, Pancreatic Neoplasms, Proto-Oncogene Proteins, Proto-Oncogene Proteins c-bcl-2, Receptors, Cell Surface, Receptors, TNF-Related Apoptosis-Inducing Ligand, Receptors, Tumor Necrosis Factor, Receptors, Tumor Necrosis Factor, Member 10c, Receptors, Tumor Necrosis Factor, Member 6b, Recombinant Proteins, Reverse Transcriptase Polymerase Chain Reaction, TNF-Related Apoptosis-Inducing Ligand, Tumor Cells, Cultured, Tumor Necrosis Factor Decoy Receptors, Tumor Necrosis Factor-alpha, bcl-2-Associated X Protein, bcl-X Protein, fas Receptor." }, { "role": "user", "content": "Do pancreatic adenocarcinoma cell lines show variable susceptibility to TRAIL-mediated cell death? Context: Programmed cell death via the Fas receptor/Fas Ligand and DR4, DR5/TRAIL plays a major role in tumor escape and elimination mechanisms. It also promises to be an effective therapy alternative for aggressive tumors, as has been recently shown for colon, breast, and lung cancer cells. We attempted to clarify the role of these molecules in aggressivity of pancreatic carcinomas and to identify possible pathways as targets for therapy. Five pancreatic cell lines were investigated for the expression of FasL/Fas, DcR3, DR4, DR5/TRAIL, DcR1, DcR2, and other death pathways related molecules such as Bax, bcl-xL, bcl-2, FADD, and caspase-3 by flow cytometry, immunoblotting, and RT/PCR, both semiquantitative and real time (TaqMan). The susceptibility of these cell lines to apoptosis mediated by recombinant TRAIL was investigated. The effect of therapeutic agents (gemcitabine) on their susceptibility to TRAIL induced apoptosis was studied as well. Pancreatic adenocarcinomas expressed high levels of apoptosis-inducing receptors and ligands. They showed differential susceptibility to cell death induced by TRAIL, despite expressing intact receptors and signaling machineries. Treatment with commonly used therapeutic agents did not augment their susceptibility to apoptosis. This could be explained by the fact that they expressed differentially high levels of decoy receptors, as well as molecules known as inhibitors of apoptosis." }, { "role": "assistant", "content": "The data suggest that pancreatic carcinoma cells have developed different mechanisms to evade the immune system. One is the expression of nonfunctional receptors, decoy receptors, and molecules that block cell death, such as bcl2 and bcl-xL. The second is the expression of apoptosis-inducing ligands, such as TRAIL, that could induce cell death of immune cells. The success in treating malignant tumors by recombinant TRAIL might apply to some but not all pancreatic tumors because of their differential resistance to TRAIL-induced cell death. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Carcinoma, Basal Cell, Carcinoma, Squamous Cell, Diagnosis, Differential, Female, Giant Cells, Humans, Hutchinson's Melanotic Freckle, Male, Melanocytes, Middle Aged, Odds Ratio, Sensitivity and Specificity, Skin, Skin Aging, Skin Neoplasms, Sunlight." }, { "role": "user", "content": "Is the starburst giant cell useful for distinguishing lentigo maligna from photodamaged skin? Context: Because lentigo maligna (LM) occurs in areas of the body that are subjected to long-term UV radiation (UVR), it may be difficult to distinguish atypical melanocytes in LM from the pleomorphic, atypical melanocytes in actinically damaged skin. The purpose of this study was to determine whether the presence of multinucleated melanocytes would help to make this distinction. A total of 89 cases of LM were reviewed for the presence or absence of multinucleated melanocytes and, if present, the maximum number of nuclei was recorded. As controls, 107 elliptical excisions of basal cell carcinoma or squamous cell carcinoma were randomly selected. The tips of the ellipses were reviewed for the presence or absence of multinucleated melanocytes. Multinucleated melanocytes with a \"starburst\" appearance, because of their prominent dendritic processes, were present in 85% of LM cases but in only 21% of sun-damaged control specimens (p < 0.00001; odds ratio [OR] = 22.6; 95% confidence interval [CI] = 10.6-47.9). The sensitivity and specificity of starburst giant cells (SGCs) in the diagnosis of LM was 85% and 78%, respectively. The maximum number of nuclei per SGC ranged from 2 to 30 in the LM cases (mean, 6.8 +/- 6.1) and from 2 to 6 in the controls (mean, 2.7 +/- 1.1) (p < 0.001). If only those SGCs with more than two nuclei are considered, 76% of cases but only 8% of controls contained SGCs (p < 0.00001; OR = 35.3; CI = 15.2-81.7). Similarly, 64% of cases and 3% of controls had SGCs with more than three nuclei (p < 0.00001; OR = 61.8; CI = 18.1-210.6)." }, { "role": "assistant", "content": "The SGC is a useful indicator for the diagnosis of LM. The diagnosis of LM is also more likely as the number of nuclei in SGC increases. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, MATERIALS AND METHODS, RESULTS. Meshes: Analysis of Variance, Bone Neoplasms, Cell Nucleus, Cell Size, Cohort Studies, Female, Giant Cell Tumors, Humans, Jaw Neoplasms, Male, Neoplasm Invasiveness, Predictive Value of Tests, Retrospective Studies, Statistics, Nonparametric, Stromal Cells." }, { "role": "user", "content": "Do histologic criteria predict biologic behavior of giant cell lesions? Context: To determine whether the clinical behavior of giant cell lesions (GCLs) or their anatomic location can be differentiated by histologic criteria alone. We performed a retrospective study of patients with GCLs treated at Massachusetts General Hospital between 1993 and 2008. Predictor variables were histologic parameters: number of giant cells (GCs) per high-power field, number of nuclei per GC, GC size, stromal cellularity, stromal type, presence of hemorrhage and reactive osteoid, and blinded pathologists' prediction of location and behavior. Outcome variables were clinical behavior (aggressive or nonaggressive) and GCL location, that is, maxillofacial (MF) or axial/appendicular (AA). Descriptive and bivariate statistics were computed with statistical significance set at P ≤ .05. The sample included 88 subjects: 41 MF GCLs (35 aggressive) and 47 AA GCLs (28 aggressive). Aggressive AA lesions had more GCs per high-power field, larger mean GC size, and increased stromal cellularity, and they more frequently had a mononuclear stroma when compared with aggressive MF lesions (P<.05). There were no significant histologic differences between aggressive and nonaggressive MF lesions or between nonaggressive MF and nonaggressive AA lesions. Aggressive AA lesions had more nuclei/GC than nonaggressive AA lesions (P = .03). Using histologic criteria only, blinded pathologists predicted clinical behavior in only 45% of cases (κ = 0.19, P = .09). They predicted a lesion's location in 82% of cases with fair agreement (κ = 0.44, P<.01)." }, { "role": "assistant", "content": "Results of this study indicate that histologic differences between aggressive and nonaggressive GCLs are insufficient for pathologists to differentiate them consistently regardless of location." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Accidental Falls, Aged, Community Health Services, Emergency Medical Services, Humans, Prospective Studies." }, { "role": "user", "content": "Does a prospective study of the costs of fall in older adults living in the community? Context: To establish the hospital cost and three-month, post-hospital community and personal costs associated with older adults discharged to the community after a fall. The timing, incidence and the determinants of these costs to the various sectors were also examined. Patients who attended the Emergency. Department of a teaching hospital in Perth, Western Australia, were asked to complete a daily diary for three months of all community and informal care they received due to their fall and any associated expenses. Unit costs were collected from various sources and used to estimate the cost of community and informal care. Hospital inpatient costs were estimated using a patient-based costing system. Seventy-nine patients participated with a total estimated falls-related cost for the three-month period of $316,155 to $333,648 (depending on assumptions used) and a mean cost per patient of between $4,291 and $4,642. The hospital cost accounted for 80%, community costs 16% and personal costs 4% of the total. Of community and personal costs, 60% was spent in the first month. Type of injury was the most significant determinant of hospital and community costs. Extrapolating these figures to the WA population provided an estimate of the total hospital and three-month, post-hospital cost of falls of $24.12 million per year, with $12.1 million funded by the Federal Government, $10.1 million by State/local government and $1.7 million in out-of pocket expenses by patients." }, { "role": "assistant", "content": "In the acute and immediate post-discharge period, hospital costs accounted for most of the cost of care for older adults discharged to the community after a fall. Community and personal costs, however, were also incurred. The cost estimates provide useful information for planners of hospital and community care for older people who have sustained a fall. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Most common type of phagus in twins?" }, { "role": "assistant", "content": "The correct answer is c. Thorachophagus(Ref: Nelson's 20/e p 820)Conjoined twins (Also called Siamese twins)Result from relatively late monovular separation; Types depending on the site of connections are: thoraco-omphalopagus (28% of conjoined twins), thoracopagus (18%), omphalopagus (10%), craniopagus (6%) & incomplete duplication (10%)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Defect in folding of the protein result in which of the following clinical disease:" }, { "role": "assistant", "content": "The correct answer is A i.e. Kuru" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In a neuron, graded electrogenesis occurs at:" }, { "role": "assistant", "content": "The correct answer is Graded electrogenesis is local potential generation of which occurs in dendrite or, soma.\nNeurons generally have some important zones: \n\nA receptor, or dendritic zone, where multiple local potential generated by synaptic connections are integrated;\nA site where propagated action potentials are generated (the initial segment in spinal motor neurons, the initial node of Ranvier in cutaneous sensory neurons)." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Brain, Child, Encephalitis, Female, Hepatitis B Vaccines, Humans, Magnetic Resonance Imaging, Male, Multiple Sclerosis." }, { "role": "user", "content": "Encephalitis after hepatitis B vaccination: recurrent disseminated encephalitis or MS? Context: To describe clinical and MRI features of patients with a disease suggestive of CNS inflammation after hepatitis B vaccination. Eight patients with confirmed CNS inflammation occurring less than 10 weeks after hepatitis B vaccination are described. They received follow-up clinically and on MRI for a mean period of 18 months. Clinical and MRI findings were compatible with acute disseminated encephalomyelitis. However, clinical follow-up, repeated MRI, or both showed the persistence of inflammatory activity, which makes this encephalitis more suggestive of MS than of acute disseminated encephalomyelitis." }, { "role": "assistant", "content": "The persistent inflammatory activity observed clinically and on MRI in these patients is comparable with that usually observed in MS. Epidemiologic studies are currently testing the hypothesis of a triggering role of hepatitis B vaccination in CNS demyelination." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Electroacupuncture, Electroretinography, Female, Glaucoma, Rats, Rats, Sprague-Dawley, Time Factors, Visual Fields." }, { "role": "user", "content": "Does electroacupuncture provide a new approach to neuroprotection in rats with induced glaucoma? Context: To investigate, using multifocal electroretinogram (mfERG), the effect of electroacupuncture (EA) on retinal function in rats with experimental glaucoma. Glaucoma was induced in the right eyes of 15 adult female Sprague-Dawley rats by laser photocoagulation for three quarters of the perilimbal and episcleral vessels. The left eye of each rat was used as the control. The animals were divided into 3 groups: no treatment (non-EA control group), 2 Hz EA group, and 100 Hz EA group. EA treatment at different frequencies can produce different levels of analgesia and hence the effect of EA with different frequencies on glaucoma treatment was investigated. Both eyes of each rat in the EA experimental groups received 3 EA treatment sessions each week for 4 weeks. The retinal function was measured using mfERG after 4 weeks of EA treatment. There was no significant difference in the amplitude (both N1 trough and P1 peak) of mfERG firstorder kernel response between the treatment and control groups. In determining the waveform characteristics by the ratio of N1 amplitude to P1 amplitude (N/P ratio), obvious differences were found in the N/P ratio between the control eyes and the glaucoma eyes in the non-EA group and the 100 Hz EA treatment group, but similar values in the N/P ratio were observed between the control eyes and the glaucoma eyes in the 2 Hz EA treatment group. The waveform from the eyes with glaucoma was deformed in both the non-EA group and the 100 Hz EA group, but the waveform from the glaucomatous eye was preserved in the 2 Hz EA group." }, { "role": "assistant", "content": "Application of EA at 2 Hz provides neuroprotection by preserving retinal function in rats with experimental glaucoma. Low frequency EA may be an alternative therapy in the treatment of glaucoma. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 55 years old male had retrosternal discomfo unrelated to physical exeion. Pain gets worse after lying down there is paial relief with antacids. The most likely diagnosis is:" }, { "role": "assistant", "content": "The correct answer is From the given question Unrelated to physical exeion - Not ischemic hea disease Paial relief with antacids - Not Ca. Esophagus Achalasia cardia - Mostly present with dysphagia to liquids . Retrosternal discomfo -->REFLUX Pain | after lying down SLIDING HIATUS HERNIA Dx - Barium Swallow Tx - Laparoscopic hiatus hernia repair(Via trans abdominal route)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Albuminuria, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Disease Progression, European Continental Ancestry Group, Fatty Liver, Female, Follow-Up Studies, Glomerular Filtration Rate, Humans, Kidney Failure, Chronic, Male, Middle Aged, Non-alcoholic Fatty Liver Disease, Prevalence, Prospective Studies, Risk Assessment, Risk Factors, Scotland." }, { "role": "user", "content": "Are hepatic steatosis and non-alcoholic fatty liver disease associated with decline in renal function in people with Type 2 diabetes? Context: We aimed to determine whether the presence of hepatic steatosis and/or non-alcoholic fatty liver disease was associated with decline in renal function or onset of microalbuminuria in a cohort of people with Type 2 diabetes, including those managed in both primary and secondary care. Nine hundred and thirty-three patients from the Edinburgh Type 2 Diabetes Study, a cohort of Scottish men and women aged 60-74 years with Type 2 diabetes, underwent assessment for hepatic steatosis by liver ultrasonography 1 year after recruitment. Non-alcoholic fatty liver disease was defined as the presence of steatosis following exclusion of secondary causes of liver disease. Patients were followed for 4 years and decline in renal function was assessed by the change in estimated glomerular filtration rate over time. Of the 933 subjects, 530 had hepatic steatosis and, of those with hepatic steatosis, 388 had non-alcoholic fatty liver disease. Neither hepatic steatosis nor non-alcoholic fatty liver disease were significantly associated with rate of decline in renal function, with the mean rate of decline in estimated glomerular filtration rate being -1.55 ml min(-1) 1.73 m(-2) per year for participants with hepatic steatosis compared with -1.84 ml min(-1) 1.73 m(-2) for those without steatosis (P = 0.19). Similar results were obtained when the analysis was restricted to participants with and without non-alcoholic fatty liver disease (-1.44 vs. -1.64 ml min(-1) 1.73 m(-2) per year, respectively; P = 0.44). Additionally, neither hepatic steatosis nor non-alcoholic fatty liver disease were associated with the onset or regression of albuminuria during follow-up (all P ≥ 0.05)." }, { "role": "assistant", "content": "The presence of hepatic steatosis/non-alcoholic fatty liver disease was not associated with decline in renal function during a 4-year follow-up in our cohort of older people with Type 2 diabetes. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Analgesics, Anesthetics, Local, Animals, Benzoxazines, Bupivacaine, Cannabinoid Receptor Agonists, Dose-Response Relationship, Drug, Drug Synergism, Formaldehyde, Humans, Injections, Spinal, Male, Morpholines, Naphthalenes, Pain Measurement, Rats, Rats, Sprague-Dawley." }, { "role": "user", "content": "Do antinociceptive synergy between the cannabinoid receptor agonist WIN 55,212-2 and bupivacaine in the rat formalin test? Context: The analgesic interaction between cannabinoids and local anesthetics has not been investigated. We sought to determine the nature of the interaction between the intrathecal cannabinoid receptor agonist (WIN 55,212-2) and bupivacaine using the formalin test. Lumbar intrathecal catheters were implanted in male Sprague-Dawley rats. After intrathecal administration of WIN 55,212-2, bupivacaine, or their combination, 50 microL of 5% formalin was injected subcutaneously into the hindpaw. Dose-response curves were established and the respective ED50 (50% effective dose) values were determined for each agent alone. Fixed-ratio combinations of WIN 55,212-2 and bupivacaine were tested for combined antinociceptive effects in the formalin test and an isobolographic analysis was performed to characterize the pharmacologic interaction of both drugs. Intrathecally administered WIN 55,212-2, bupivacaine, or their combination produced a dose-dependent decrease in the number of flinches during Phase 1 and 2 of the formalin test. Isobolographic analysis revealed a synergistic interaction between intrathecal WIN 55,212-2 and bupivacaine in both phases of the formalin test. In combination, the ED50 value was significantly smaller than the theoretical additive value (P < 0.05)." }, { "role": "assistant", "content": "These results demonstrate that intrathecally coadministered WIN 55,212-2 and bupivacaine provide synergistic antinociceptive interaction in both phases of the formalin test. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Do plasma Vitamin D Levels And Vitamin D Receptor Polymorphisms Are Associated with Survival of Non-small Cell Lung Cancer? Context: Vitamin D and its receptor (VDR) involve in multiple cellular processes and play an important role in the initiation and progression of malignancy. Thus we hypothesized that plasma vitamin D levels and single nucleotide polymorphisms (SNPs) in VDR may be of prognostic significance in non-small cell lung cancer (NSCLC). We examined plasma 25-hydroxyvitamin D [25(OH)D] levels in 87 patients diagnosed with NSCLC using enzyme-linked immunosorbent assay (ELISA) and genotyped seven potentially functional SNPs in VDR in 568 NSCLC patients on Illumina Golden Gate platform. Patients with higher plasma 25(OH)D levels had worse survival than patients with lower ones (P for trend = 0.048). The SNPs of rs1544410 and rs739837 were independently associated with NSCLC survival (adjusted HR = 1.61, 95% CIs = 1.06-2.45 for rs739837 AA vs AC/CC and adjusted HR = 1.51, 95% CIs = 1.06-2.16 for rs1544410 AG/AA vs GG). A joint effect was observed between rs1544410 and rs739837 and the risk of death elevated as the number of unfavourable genotypes patients carried increased (P for trend = 0.003). There were no significant associations between VDR polymorphisms and plasma 25(OH)D levels." }, { "role": "assistant", "content": "Our findings indicate that plasma 25(OH)D levels and genetic variants of VDR may serve as prognostic markers for NSCLC in this Chinese population. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, C-Reactive Protein, CD40 Ligand, Cohort Studies, Coronary Artery Disease, Enzyme-Linked Immunosorbent Assay, Female, Homocysteine, Humans, Male, Middle Aged, Risk Factors." }, { "role": "user", "content": "Is c-reactive protein but not soluble CD40 ligand and homocysteine associated to common atherosclerotic risk factors in a cohort of coronary artery disease patients? Context: One third to one half of the variation in vascular disease occurrence remains unexplained by traditional risk factors. Since atherosclerosis may, in part, be an inflammatory disease, circulating factors related to inflammation may be predictors of cardiovascular disease. The aim of this study was to evaluate the association between common atherosclerotic risk factors and markers of inflammation. Serum levels of soluble CD40 (sCD40L), high-sensitive C-reactive protein (hs-CRP) and homocysteine (Hcy) were measured in 251 patients selected from a series of 438 subjects affected by previous myocardial infarction, angina or other cardiovascular diseases. sCD40L levels were lower in patients with previous myocardial infarction while no association was observed between sCD40L and Hcy levels and other risk factors. Only hs-CRP levels positively correlated with increased number of risk factors." }, { "role": "assistant", "content": "In a setting of patients affected with coronary artery disease no association between sCD40L and homocysteine levels and atherosclerotic risk factors was observed; only hs-CRP showed increased levels according to the number of risk factors. Future studies using larger cohorts will be needed to validate the clinical use of markers of inflammation in the prediction of cardiovascular events. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Age Distribution, Aged, Blood Pressure, Female, Humans, Male, Metabolic Syndrome, Middle Aged." }, { "role": "user", "content": "Is increase of metabolic syndrome score an independent determinant of increasing pulse pressure? Context: The objective of this study was to determine whether the progressive increase of metabolic syndrome (MetS) score, the number of components of MetS, is correlated significantly with increasing pulse pressure (PP). 4,034 subjects were enrolled from the Cardiovascular Genome Center of Yonsei University (M:F=2344:1690, 55.2 +/- 10.5). Most of the study population were recruited from hypertension clinics, controlled with medications according to JNC7 guidelines. The Asian modified criteria of MetS were applied and MetS score was estimated. The HOMA index for insulin resistance, cholesterol profiles, and anthropometric measurements were assessed. Among 4034 participants, 1690 (41.9%) were classified as MetS. Progressive increase in PP was demonstrated for increasing components of the MetS score. Multiple linear regression analysis with PP as the dependent variable showed that age (beta = 0.311, p < 0.001), MetS score (beta = 0.226, p < 0.001), male gender (beta = -0.093, p < 0.001) and HOMA index IR (beta = 0.033, p = 0.03) are significantly associated with PP (R2 = 0.207, p < 0.001)." }, { "role": "assistant", "content": "The present results from this study demonstrate that increasing MetS score is an independent determinant of increasing PP. The results also demonstrate the independent role of MetS in increasing arterial stiffness and PP. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Cholangitis, Sclerosing, Genotype, HLA-B8 Antigen, HLA-DRB1 Chains, Humans, Inflammatory Bowel Diseases, Linkage Disequilibrium, Norway, Odds Ratio, Phenotype, Risk Factors, Sweden, United Kingdom, United States." }, { "role": "user", "content": "Is small duct primary sclerosing cholangitis without inflammatory bowel disease genetically different from large duct disease? Context: Small duct primary sclerosing cholangitis (PSC) is phenotypically a mild version of large duct PSC, but it is unknown whether these phenotypes share aetiology. We aimed to characterize their relationship by investigating genetic associations in the human leucocyte antigen (HLA) complex, which represent the strongest genetic risk factors in large duct PSC. Four classical HLA loci (HLA-A, HLA-B, HLA-C and HLA-DRB1) were genotyped in 87 small duct PSC patients, 485 large duct PSC patients and 1117 controls across three geographical regions. HLA-DRB1*13:01 (OR = 2.0, 95% CI 1.2-3.4, P = 0.01) and HLA-B*08 (OR = 1.6, 95% CI 1.1-2.4, P = 0.02) were significantly associated with small duct PSC compared with healthy controls. Based on the observed frequency of HLA-B*08 in small duct PSC, the strongest risk factor in large duct PSC, an estimated 32% (95% CI 4-65%) of this population can be hypothesized to represent early stages or mild variants of large duct PSC. This subgroup may be constituted by small duct PSC patients with inflammatory bowel disease (IBD), which greatly resembled large duct PSC in its HLA association. In contrast, small duct PSC without IBD was only associated with HLA-DRB1*13:01(P = 0.03) and was otherwise distinctly dissimilar from large duct PSC." }, { "role": "assistant", "content": "Small duct PSC with IBD resembles large duct PSC in its HLA association and may represent early stages or mild variants of large duct disease. Different HLA associations in small duct PSC without IBD could indicate that this subgroup is a different entity. HLA-DRB1*13:01 may represent a specific risk factor for inflammatory bile duct disease. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Acclimatization, Adaptation, Physiological, Animals, Autophagy, Female, Muscle Fibers, Skeletal, Muscle, Skeletal, Physical Conditioning, Animal, Rats, Sprague-Dawley, Running." }, { "role": "user", "content": "Is autophagic adaptation associated with exercise-induced fibre-type shifting in skeletal muscle? Context: Acute exercise is known to activate autophagy in skeletal muscle. However, little is known about how basal autophagy in skeletal muscle adapts to chronic exercise. In the current study we aim to, firstly, examine whether long-term habitual exercise alters the basal autophagic signalling in plantaris muscle and, secondly, examine the association between autophagy and fibre-type shifting. Adult female Sprague-Dawley rats aged 2 months were randomly assigned to control and exercise groups. Animals in exercise group were kept in cages equipped with free access running wheels to perform habitual exercise for 5 months. Animals in the control group were caged in the absence of running wheels. Animals were sacrificed after the 5-month experimental period. Plantaris muscle tissues were harvested for analysis. We showed that long-term habitual exercise enhanced basal autophagy, but without altering expressions of autophagy proteins in plantaris muscle. Interestingly, sirtuin protein, a possible regulator of autophagy, was upregulated in plantaris muscle. Furthermore, we suspected that different types of muscle fibre adapted to chronic exercise in different ways. Long-term habitual exercise resulted in fibre-type shifting from type IIX to IIA in both gastrocnemius muscle and plantaris muscle. Intriguingly, our analysis demonstrated that LC3-II protein abundance is positively correlated with the proportion of type IIA fibre whereas it was negatively correlated with the proportion of type IIX fibre in plantaris muscle. PGC-1α protein abundance was positively associated with the proportion of type IIA fibre and LC3-II in plantaris muscle." }, { "role": "assistant", "content": "These results suggest that basal autophagy is enhanced in plantaris muscle after long-term habitual exercise and associated with fibre-type shifting. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A young adults presents with night blindness and tubular vision. On examination, intraocular pressure was observed to be 18 mm and the anterior segment was unremarkable. Fundoscopy showed attenuation of aerioles and waxy pallor of the optic disc with bony corpuscles like spicules of pigmentation in mid peripheral retina. Ring scotomas were observed on perimetry. Which of the following is the most likely diagnosis:" }, { "role": "assistant", "content": "The correct answer is Ans. Pigmentary retinal dystrophy" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Apoptosis, Biomarkers, Tumor, Carcinoma, Ovarian Epithelial, Cell Line, Tumor, Cell Nucleus, Disease-Free Survival, Drug Resistance, Neoplasm, Female, Gene Expression, Humans, Kaplan-Meier Estimate, Middle Aged, Neoplasms, Glandular and Epithelial, Ovarian Neoplasms, Prognosis, RecQ Helicases, Young Adult." }, { "role": "user", "content": "Is the level of RECQL1 expression a prognostic factor for epithelial ovarian cancer? Context: The human RECQ DNA helicase family is involved in genomic stability. Gene mutations of RECQL2, RECQL3, and RECQL4 are associated with genetic disorders and induce early aging and carcinogenesis. Although previous studies have reported that the level of RECQL1 expression is correlated with the prognosis of some of malignancies, the function of RECQL1 is not yet clarified. The present study aimed to examine the relationship between prognosis and the level of RECQL1 expression in epithelial ovarian cancer (EOC), and to identify the role of RECQL1 in EOC cells. The level of RECQL1 expression was determined immunohistochemically in 111 patients with EOC who received initial treatment at Hirosaki University hospital between 2006 and 2011. Effects of RECQL1 on cell growth or apoptosis were examined in vitro using wild-type and OVCAR-3 cells (RECQL1(+) cells) and similar cells transfected with RECQL1 siRNA transfected (RECQL1(-) cells). The level of RECQL1 expression was not related to histological type, clinical stage, or retroperitoneal lymph node metastasis, but the expression level was significantly higher (P = 0.002) in patients with recurrence than those without recurrence, and progression-free survival and complete response rate to chemotherapy were also improved in patients with RECQL1-low expression (n = 39) stage III/IV EOC (P = 0.02 and P <0.05 vs RECQL1-high expression patients (n = ), respectively). A cell proliferation and colony formation assays revealed significantly less growth of RECQL1(-) cells compared to RECQL1(+) cells. A flow cytometry using annexin V -FITC and propidium iodide (PI) staining revealed a significant increase in apoptotic RECQL1(-) cells. Cell cycle analysis showed a significantly greater distribution in subG1 phase indicating apoptotic cells in RECQL1(-) cells than in RECQL1(+) cells." }, { "role": "assistant", "content": "These results suggest that RECQL1 is a prognostic factor for EOC and that RECQL1 contributes to potential malignancy by inhibiting apoptosis. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Blood Glucose, Brachial Artery, Diet, Femoral Artery, Glucose, Glucose Tolerance Test, Humans, Insulin, Male, Motor Activity, Muscle, Skeletal, Postprandial Period, Regional Blood Flow, Young Adult." }, { "role": "user", "content": "Does acute inactivity impair glycemic control but not blood flow to glucose ingestion? Context: Insulin-stimulated increases in skeletal muscle blood flow play a role in glucose disposal. Indeed, 7 d of aerobic exercise in patients with Type 2 diabetes increased blood flow responses to an oral glucose tolerance test (OGTT) and improved insulin sensitivity. More recent work suggests that reduced daily physical activity impairs glycemic control (GC) in healthy individuals. Herein, we sought to determine whether an acute reduction in daily activity (from >10,000 to <5000 steps per day) for 5 d (RA5) in healthy individuals reduced insulin-stimulated blood flow and GC in parallel and if a 1-d return to activity (RTA1) improved these outcomes. OGTT were performed as a stimulus to increase insulin in 14 healthy, recreationally active men (24 ± 1.1 yr) at baseline, RA5, and RTA1. Measures of insulin sensitivity (Matsuda index) and femoral and brachial artery blood flow were made during the OGTT. Free-living measures of GC including peak postprandial glucose (peak PPG) were also made via continuous glucose monitoring. Femoral and brachial artery blood flow increased during the OGTT but neither was significantly impacted by changes in physical activity (P > 0.05). However, insulin sensitivity was decreased by RA5 (11.3 ± 1.5 to 8.0 ± 1.0, P < 0.05). Likewise, free-living GC measures of peak PPG (113 ± 3 to 123 ± 5 mg·dL(-1), P < 0.05) was significantly increased at RA5. Interestingly, insulin sensitivity and GC as assessed by peak PPG were not restored after RTA1 (P > 0.05)." }, { "role": "assistant", "content": "Thus, acute reductions in physical activity impaired GC and insulin sensitivity; however, blood flow responses to an OGTT were not affected. Further, a 1-d return to activity was not sufficient to normalize GC after 5 d of reduced daily physical activity. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Blotting, Western, Calcineurin, Calpain, Enzyme Activation, Female, Humans, Male, Middle Aged, Myocardium, Proteolysis, Recombinant Proteins." }, { "role": "user", "content": "Does proteolysis by endogenous calpain I lead to the activation of calcineurin in human heart? Context: The calmodulin-independent pathway is thought to involve the activation of calcineurin by calpain. However, the effect of endogenous calpain on calcineurin in human heart is not well known. Proteolysis and activation of recombinant calcineurin by purified calpain isozymes I and II as well as endogenous calcineurin by calpains in the human heart were investigated by Western blot. Activation of calpain and calcineurin in the human heart was examined using zymography and a calcineurin activity assay. Calpains I and II caused limited proteolysis of full-length calcineurin in a Ca(2+)-dependent manner, and the degradation fragment(s) were constitutively active in the absence of calmodulin. Calpain I and calcineurin were expressed in ventricular myocardium from patients with heart failure, with no difference in expression levels in the left and right heart chambers. Human heart calpains I and II degraded the specific substrate casein in gels which were incubated in medium containing Ca2+, but not in Ca(2+)-free medium. Calpain inhibitor-sensitive calcineurin activity was stimulated in the human ventricular myocardium in the presence of concentrations of Ca2+ that were found to activate calpain I." }, { "role": "assistant", "content": "Proteolysis of calcineurin A by endogenous calpain I leads to the formation of constitutively active calcineurin in the human heart, which may contribute to the pathogenesis of myocardial disease. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "I-cell disease is associated with" }, { "role": "assistant", "content": "The correct answer is Mutations in proteins of the plasma membrane, with one affecting lysosomal function (I-cell disease).I-cell disease - Mutations in the gene encoding GlcNAc phosphotransferase, resulting in absence of the Man 6-P signal for lysosomal localization of ceain hydrolases" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Child, Child, Preschool, Chloride Channels, Codon, Nonsense, Computational Biology, DNA Mutational Analysis, Genetic Predisposition to Disease, Humans, Infant, Male, Models, Genetic, Mutation, Mutation, Missense, Oculocerebrorenal Syndrome, Phenotype, Phosphoric Monoester Hydrolases, Protein Isoforms, Renal Tubular Transport, Inborn Errors." }, { "role": "user", "content": "Do oCRL1 mutations in Dent 2 patients suggest a mechanism for phenotypic variability? Context: Dent disease is an X-linked renal proximal tubulopathy associated with mutations in CLCN5 (Dent 1) or OCRL1 (Dent 2). OCRL1 mutations also cause the oculocerebrorenal syndrome of Lowe. Dent patients with normal sequence for CLCN5 were sequenced for mutations in OCRL1. By analyzing these and all other OCRL1 mutations reported, a model relating OCRL1 mutations to the resulting disease (Dent 2 or Lowe's) was developed. Six boys with Dent disease had novel OCRL1 mutations: two missense (R301H, G304E) and four mutations predicted to produce premature termination codons (L56DfsX1, S149X, P161PfsX3, and M170IfsX1). These include one of the original patients reported by Dent and Friedman. Slit lamp examinations revealed early cataracts in only one boy with normal vision. None of these Dent 2 patients had metabolic acidosis; 3 had mild mental retardation. Analysis of all known OCRL1 mutations show that Dent 2 mutations fall into two classes that do not overlap with Lowe mutations. Bioinformatics analyses identified expressed OCRL1 splice variants that help explain the variability of those clinical features that distinguish Dent disease from Lowe syndrome." }, { "role": "assistant", "content": "OCRL1 mutations can cause the renal phenotype of Dent disease, without acidosis or the dramatic eye abnormalities typical of Lowe syndrome. We propose a model to explain the phenotypic variability between Dent 2 and Lowe's based on distinctly different classes of mutations in OCRL1 producing splice variants. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, Contrast Media, Electrophoresis, Capillary, Glomerular Filtration Rate, Inulin, Iothalamic Acid, Loop of Henle, Male, Nephrons, Perfusion, Rats, Rats, Sprague-Dawley, Tritium." }, { "role": "user", "content": "Is iothalamate measured by capillary electrophoresis a suitable alternative to radiolabeled inulin in renal micropuncture? Context: Inulin remains the gold standard for measurements of fluid reabsorption (Jv) and single nephron glomerular filtration rate (SNGFR) in micropuncture experiments. However, the method used to measure cold inulin in nanoliter samples is time-consuming, while the use of radiolabeled inulin is disadvantaged by possible radioactive contamination, disposal of radioactive material and cost of the isotope. It has been reported that non-radiolabeled iothalamate may be a suitable alternative for estimation of whole kidney GFR. The present study tested whether iothalamate can be used to measure Jv in microperfusion and free-flow micropuncture experiments. Superficial loops of Henle (LOH) were perfused from late proximal to early distal tubules with an end-like proximal solution. In the first set of experiments, the perfusate contained both iothalamate (1.9 mmol/L) and 3H-methoxy-inulin (50 microCi. mL(-1)). To test if iothalamate was able to detect changes in Jv, two additional sets of experiments were performed: (1) mannitol (61 mmol/L) was added to the perfusate to partially replace NaCl, a condition known to inhibit Jv; (2) LOH of remnant kidneys were perfused, which in previous experiments we showed to have a higher Jv. Lastly, free-flow micropuncture experiments were performed by infusing iothalamate IV at 18.3 mg. h(-1). Iothalamate analysis in nanoliter samples of renal tubular fluid obtained in vivo was performed by capillary electrophoresis (CE). In the first set of experiments, liquid scintillation counting of 3H-methoxy-inulin versus iothalamate analysis with CE resulted in almost identical calculated perfusion rates (20.4 +/- 0.6 vs. 20.6 +/- 0.7 nL. min(-1), N = 20) and tubular fluid/perfusate ratios (TF/P; 1.35 +/- 0.04 vs. 1.36 +/- 0.04) and thus also Jv (5.17 +/- 0.50 vs. 5.38 +/- 0.59 nL. min(-1)). In the mannitol experiments, iothalamate measurements showed that the addition of mannitol significantly reduced Jv from 4.98 +/- 0.40 (N = 19) to 0.72 +/- 0.58 nL. min(-1) (N = 33; P < 0.0001). Iothalamate determinations by CE were able to detect a significant increase in Jv in LOH of remnant rats perfused at 40 nL. min(-1)[from to 8.40 +/- 0.73 (N = 20) in sham-operated to 17.8 +/- 2.9 nL. min(-1) (N = 6) in remnant animals; P < 0.0001]. In free flow micropuncture experiments the ratio of tubular fluid to plasma iothalamate (TF/P) along the proximal tubule was 1.62 +/- 0.10 (N = 15)." }, { "role": "assistant", "content": "These data demonstrate that iothalamate can replace inulin to measure Jv in microperfusion and free-flow micropuncture experiments. Since iothalamate analysis by CE technique is a fast, easy and highly reproducible technique, it may become the gold standard method for the detection of fluid reabsorption in microperfused nephron segments. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Female, Hippocampus, Humans, Memory Disorders, Personality, Recognition (Psychology), Schizophrenic Psychology, Schizotypal Personality Disorder, Space Perception, Spatial Memory, Surveys and Questionnaires." }, { "role": "user", "content": "Do high and low schizotypal female subjects differ in spatial memory abilities in a virtual reality task? Context: Schizotypy is a psychological construct related to schizophrenia. The exact relationship between both entities is not clear. In recent years, schizophrenia has been associated with hippocampal abnormalities and spatial memory problems. The aim of this study was to determine possible links between high schizotypy (HS) and low schizotypy (LS) and spatial abilities, using virtual reality tasks. We hypothesised that the HS group would exhibit a lower performance in spatial memory tasks than the LS group. Two groups of female students were formed according to their score on the ESQUIZO-Q-A questionnaire. HS and LS subjects were tested on two different tasks: the Boxes Room task, a spatial memory task sensitive to hippocampal alterations and a spatial recognition task. Data showed that both groups mastered both tasks. Groups differed in personality features but not in spatial performance. These results provide valuable information about the schizotypy-schizophrenia connections." }, { "role": "assistant", "content": "Schizotypal subjects are not impaired on spatial cognition and, accordingly, the schizotypy-schizophrenia relationship is not straightforward. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In a patient having dense bones, penetration is best\nachieved by:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Hydroxylation of proline require the following except:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Vineyard Sprayer's lung disease is caused by?" }, { "role": "assistant", "content": "The correct answer is Copper sulphate spray (Blue vitriol) is used in the control of insects/fungi in Vineyards and chronic inhalation of which can cause granulomatous lesions in the lung, it may also be associated with liver damage. The involvement of lung in case of chronic inhalation of Copper sulphate results in Vineyard Sprayer's disease. Ref: Textbook of Forensic Medicine and Toxicology By V.V Pillay, 15th Edition, Pages 448-49" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Antibody Specificity, Child, Female, Humans, Immunoglobulin E, Male, Middle Aged, Mucous Membrane, Paranasal Sinuses, Retrospective Studies, Sinusitis, Tomography, X-Ray Computed." }, { "role": "user", "content": "Do total IgE serum levels correlate with sinus mucosal thickness on computerized tomography scans? Context: Sinusitis involves an inflammatory response with similarities to asthma. We sought to determine whether a correlation exists between total IgE and the sinus mucosal thickening as assessed by computed tomography (CT) scans. We screened the charts of 300 otolaryngology patients who had total and specific serum IgE determinations in 1994 and from this group selected all patients who had also undergone a sinus CT scan close to the time of serum evaluation (n = 86). Severity of disease on CT scan was graded by two investigators blinded to IgE levels. There was a significant positive correlation between severity of disease on CT scans and IgE (r[s] = 0.37, p = 0.0007). Furthermore, patients with a more advanced disease stage had higher IgE levels. There was also a positive correlation between severity of disease and the sum of specific IgE grades (r[s] = 0.29, p = 0.007)." }, { "role": "assistant", "content": "The data suggest that IgE levels or a linked genetic parameter may contribute to the mucosal inflammation in the paranasal sinuses. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Acetonitriles, Cell Wall, Growth Inhibitors, Indoles, Microscopy, Electron, Transmission, Paenibacillus, Signal Transduction, Spores, Bacterial." }, { "role": "user", "content": "Do indole and 3-indolylacetonitrile inhibit spore maturation in Paenibacillus alvei? Context: Bacteria use diverse signaling molecules to ensure the survival of the species in environmental niches. A variety of both gram-positive and gram-negative bacteria produce large quantities of indole that functions as an intercellular signal controlling diverse aspects of bacterial physiology. In this study, we sought a novel role of indole in a gram-positive bacteria Paenibacillus alvei that can produce extracellular indole at a concentration of up to 300 μM in the stationary phase in Luria-Bertani medium. Unlike previous studies, our data show that the production of indole in P. alvei is strictly controlled by catabolite repression since the addition of glucose and glycerol completely turns off the indole production. The addition of exogenous indole markedly inhibits the heat resistance of P. alvei without affecting cell growth. Observation of cell morphology with electron microscopy shows that indole inhibits the development of spore coats and cortex in P. alvei. As a result of the immature spore formation of P. alvei, indole also decreases P. alvei survival when exposed to antibiotics, low pH, and ethanol. Additionally, indole derivatives also influence the heat resistance; for example, a plant auxin, 3-indolylacetonitrile dramatically (2900-fold) decreased the heat resistance of P. alvei, while another auxin 3-indoleacetic acid had a less significant influence on the heat resistance of P. alvei." }, { "role": "assistant", "content": "Together, our results demonstrate that indole and plant auxin 3-indolylacetonitrile inhibit spore maturation of P. alvei and that 3-indolylacetonitrile presents an opportunity for the control of heat and antimicrobial resistant spores of gram-positive bacteria. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Absorptiometry, Photon, Adolescent, Adult, African Continental Ancestry Group, Bone Density, Calcium, Dietary, Child, Cohort Studies, Cross-Sectional Studies, Diet, Diet Records, European Continental Ancestry Group, Exercise, Female, Humans, Puberty, Retrospective Studies, Television." }, { "role": "user", "content": "Do diet in midpuberty and sedentary activity in prepuberty predict peak bone mass? Context: An average daily calcium intake of 1300 mg is recommended for North American adolescents aged 9-18 y. However, questions remain about these recommendations. We assessed whether there is a stage of puberty when dietary calcium is more strongly related to peak bone mass, as indicated by young adult bone mass (YABM); whether dietary calcium intake > 1000 mg/d in adolescence is associated with higher YABM; and whether race affects any of these associations between dietary calcium and YABM. Secondarily, we evaluated relations between sedentariness and YABM. In a retrospective cohort study, we recruited 693 black and white women aged 21-24 y who had participated in the 10-y National Heart, Lung, and Blood Institute Growth and Health Study and measured YABM with the use of dual-energy X-ray absorptiometry. Dietary calcium and sedentary activity data, gathered through 3-d food records and self-reports of television-video viewing at 8 annual examinations, were averaged over 3 pubertal stages. Complete data were available from 161 black and 180 white females. Multiple regression, controlling for race, weight, and height, was applied to assess diet and activity relations with YABM. Dietary calcium was most strongly associated with YABM in midpuberty. Calcium intake > 1000 mg/d was associated with higher YABM, but this association was not significant at all skeletal sites. Race did not affect the observed relations between calcium and YABM. Sedentary activity in prepuberty was inversely associated with YABM." }, { "role": "assistant", "content": "Interventions should focus on ensuring adequate calcium intake in midpuberty and on minimizing sedentariness in prepuberty. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Amino Acid Sequence, Animals, Bombyx, Computational Biology, Fibroins, Genetic Association Studies, Genetic Variation, High-Throughput Nucleotide Sequencing, Insect Proteins, Molecular Sequence Annotation, Molecular Sequence Data, Phylogeny, Quantitative Trait, Heritable, Sericins, Silk, Transcriptome." }, { "role": "user", "content": "Do comparative transcriptome analyses on silk glands of six silkmoths imply the genetic basis of silk structure and coloration? Context: Silk has numerous unique properties that make it a staple of textile manufacturing for several thousand years. However, wider applications of silk in modern have been stalled due to limitations of traditional silk produced by Bombyx mori. While silk is commonly produced by B. mori, several wild non-mulberry silkmoths--especially members of family Saturniidae--produce silk with superior properties that may be useful for wider applications. Further utilization of such silks is hampered by the non-domestication status or limited culturing population of wild silkworms. To date there is insufficient basic genomic or transcriptomic data on these organisms or their silk production. We sequenced and compared the transcriptomes of silk glands of six Saturniidae wild silkmoth species through next-generation sequencing technology, identifying 37758 ~ 51734 silkmoth unigenes, at least 36.3% of which are annotated with an e-value less than 10(-5). Sequence analyses of these unigenes identified a batch of genes specific to Saturniidae that are enriched in growth and development. Analyses of silk proteins including fibroin and sericin indicate intra-genus conservation and inter-genus diversification of silk protein features among the wild silkmoths, e.g., isoelectric points, hydrophilicity profile and amino acid composition in motifs of silk H-fibroin. Interestingly, we identified p25 in two of the silkmoths, which were previously predicted to be absent in Saturniidae. There are rapid evolutionary changes in sericin proteins, which might account for the highly heterogeneity of sericin in Saturniidae silkmoths. Within the six sikmoths, both colored-cocoon silkmoth specific transcripts and differentially expressed genes between the colored-cocoon and non-colored-cocoon silkmoths are significantly enriched in catalytic activity, especially transferase activity, suggesting potentially viable targets for future gene mining or genetic manipulation." }, { "role": "assistant", "content": "Our results characterize novel and potentially valuable gene resources of saturniid silkmoths that may facilitate future genetic improvement and modification of mulberry silkworms. Our results suggest that the disparate features of silk--coloration, retention, strength, etc. --are likely not only due to silk proteins, but also to the environment of silk assembly, and more specifically, that stable silk coloration exhibited by some Saturniidae silkmoths may be attributable to active catalytic progress in pigmentation. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Child, Epiphyses, Female, Humans, Knee Joint, Leg Length Inequality, Male, New Mexico, Orthopedic Procedures, Postoperative Complications, Retrospective Studies, Treatment Outcome." }, { "role": "user", "content": "Is dual 8-plate technique as effective as ablation for epiphysiodesis about the knee? Context: Lower extremity length inequality can be problematic in children and is often addressed surgically. Several techniques have traditionally been utilized for epiphysiodesis, the goal being physeal ablation. Recently, 8-plates, initially developed for hemiepiphysiodesis, have been extended to epiphysiodesis by placing the plates on both medial and lateral sides of the physis. No prior studies have compared 8-plates with physeal ablation techniques. Between January 2003 and August 2009, 27 patients underwent epiphysiodesis surgery using either physeal ablation or 8-plate technique. Sixteen patients had physeal ablation and 11 had dual 8-plates. A retrospective chart review sought demographic data, outcomes, and complications. Radiographs were reviewed to measure pretreatment and posttreatment limb lengths. The median improvement in limb length discrepancy was 15.5 mm in the physeal ablation group and 4 mm in the 8-plate group (P<0.001). This difference was maintained following linear regression factoring out the effect of time (10.78 mm for ablation vs. 5.62 mm for 8-plates; P=0.016). There was no statistically significant difference in complication rate between the groups (P=0.112)." }, { "role": "assistant", "content": "Our study demonstrated physeal ablation to be a significantly superior treatment compared with dual 8-plates for epiphysiodesis. Despite theoretical advantages of 8-plates to perform epiphysiodesis about the knee, this study does not recommend the use of medial and lateral 8-plates to effect epiphysiodesis. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND AND PURPOSE, MATERIALS AND METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Child, Fast Neutrons, Female, Heavy Ion Radiotherapy, Humans, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Grading, Salivary Gland Neoplasms." }, { "role": "user", "content": "Malignant salivary gland tumours: can fast neutron therapy results point the way to carbon ion therapy? Context: To evaluate the outcome of malignant salivary gland tumours treated with neutron therapy to assess the potential for other high linear energy transfer (LET) beams. Neutrons at iThemba LABS are produced by the reaction of 66MeV protons on a beryllium target. A median dose 20.4Gy, in 12 fractions in 4weeks or 15 fractions in 5weeks, was given to 335 patients with 176 irresectable, 104 macroscopically residual and 55 unresected tumours. Locoregional control was 60.6% at 5years and 39.1% at 10years and DSS was 66.8% and 53.7% at 5 and 10years respectively. In the univariate analysis T4,>4cm, high grade, squamous carcinoma, unresected and irresectable tumours, and positive nodes were significantly worse for LRC. In the multivariate analysis tumours>6cm, squamous carcinoma, irresectable tumours and nodes were significantly worse for LRC. Tumours>6cm, high grade, squamous carcinoma and nodes were significantly worse for DSS. Neither LRC nor DSS was influenced by age, sex, site, dose, fractionation or for initial or recurrent disease." }, { "role": "assistant", "content": "Neutron therapy appears to be the treatment of choice for macroscopically incompletely excised and irresectable salivary gland tumours with improved survival rates. Further improvement may be achieved with other high LET modalities with a superior dose profile, such as carbon ions." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "True about Nissl granulea) Involves in RNA synthesisb) Present in axonc) Present in dendrited) Involves in protein synthesise) Structurally they are endoplasmic reticulum" }, { "role": "assistant", "content": "The correct answer is Nissl granules are rough endoplasmic reticulum found in dendrites, but absent in axon or axon hillock. They help in protein synthesis." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Foramen of magendie, drains CSF from which midline structure and exits from it?" }, { "role": "assistant", "content": "The correct answer is Fouh ventricle is the last ventricle in the cerebellum, its T shaped roof has three apeures which communicates with the subarachonoid space. Foramen of magendi a median apeure is present doraslly in the roof, it communicates with the cisterna magna. Foramen of luschka is a lateral apeure which is present on right and left side. It drains into the cerebellopontine angle cistern." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Absorptiometry, Photon, Adult, Aged, Aged, 80 and over, Bone Density, Bone and Bones, Breast, Breast Diseases, Calcinosis, Female, Humans, Logistic Models, Mammography, Middle Aged, Multivariate Analysis, Osteoporosis, Peripheral Vascular Diseases, Retrospective Studies." }, { "role": "user", "content": "Is reduced bone mineral density associated with breast arterial calcification? Context: Arterial calcification, a marker of atherosclerosis, results from a complex process of biomineralization resembling bone formation. Breast arterial calcification (BAC) has been associated with angiographic and clinical cardiovascular disease. The purpose of this study was to determine the association between reduced bone mineral density (BMD) and BAC, which may share a common pathophysiology. We conducted a retrospective study of 228 women (55% Hispanic, mean age 64 +/-10 yr) who had both mammography and BMD evaluation at Columbia University Medical Center from 2001-2003. Each mammogram was reviewed for the presence of BAC using standardized methods. BMD was measured using dual-energy x-ray absorptiometry and categorized as normal, low bone density (osteopenia), or osteoporosis as defined by the World Health Organization. Univariate and multivariate logistic regression analyses were performed to evaluate the association between reduced BMD and BAC. The prevalence of BAC, low bone density (osteopenia), and osteoporosis was 39, 42, and 29%, respectively. Women with BAC were significantly more likely to be older, Hispanic, and postmenopausal and have osteoporosis as compared with women without BAC. In age-adjusted analyses, women with BAC were more likely to have reduced BMD (odds ratio 3.0, P < 0.01) as compared with women without BAC. Furthermore, osteoporosis was strongly associated with the presence of BAC (odds ratio 3.5, P < 0.01)." }, { "role": "assistant", "content": "These data suggest that osteoporosis and arterial calcification are strongly and independently correlated. Reduced BMD may identify women at risk of vascular disease. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Pulmonary Compliance is decreased in all of the following conditions, except:" }, { "role": "assistant", "content": "The correct answer is In COPD, compliance is increased and the pressure volume curve is shifted upward and to the left. In a highly compliant lung, as in emphysema, the elastic tissue has been damaged, usually due to their being overstretched by chronic overinflation. Patients with emphysema have a very high lung compliance due to the poor elastic recoil, they have no problem inflating the lungs but have extreme difficulty exhaling air. In this condition extra work is required to get air out of the lungs. Ref: Review of Medical Physiology by William ganong, 22nd edn/page 654" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Autoantibodies, Autoantigens, Dermatomyositis, Female, Humans, Male, Middle Aged, Nuclear Proteins, Transcription Factors." }, { "role": "user", "content": "Do myositis-specific anti-155/140 autoantibodies target transcription intermediary factor 1 family proteins? Context: To identify the 140-kd autoantigen recognized by anti-155/140 autoantibodies that are associated with adult cancer-associated dermatomyositis (DM) and juvenile DM and to determine the clinical relevance of anti-155/140 antibodies in a large cohort. Sera from 456 DM patients were assessed for the presence of anti-155/140 antibodies by immunoprecipitation using K562 cell extracts as substrate. Using immunoprecipitation and Western blotting, we then examined whether anti-155/140-positive sera recognized transcription intermediary factor 1α (TIF-1α), TIF-1β, and TIF-1γ. The clinical associations of antigen reactivity were also evaluated. Anti-155/140-positive sera reacted with 140-kd TIF-1α in addition to 155-kd TIF-1γ. Among sera from 456 DM patients, 52 were reactive with both TIF-1α and TIF-1γ, while another 25 were reactive with TIF-1γ alone. Additionally, 7 were reactive with TIF-1β. Malignancy was more frequently found in adult patients with both anti-TIF-1α and anti-TIF-1γ antibodies than in those with anti-TIF-1γ antibodies alone (73% versus 50%; P < 0.05). In addition to juvenile DM patients and middle-aged and older DM patients with high percentages of malignancy, 8 \"young adult\" DM patients without malignancy had these autoantibodies." }, { "role": "assistant", "content": "Anti-155/140 antibodies target TIF-1 family proteins, TIF-1α and TIF-1β, in addition to TIF-1γ. Since TIF-1 proteins have significant roles in oncogenesis, these antibodies may be produced during misdirected antitumor immunity. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Pott's puffy tumor is" }, { "role": "assistant", "content": "The correct answer is POTT'S PUFFY TUMOUR It is formation of diffuse external swelling in the scalp due to subperiosteal pus formation (abscess) and scalp oedema. x It originates commonly in frontal region and may extend into other regions. x There is acute osteomyelitis of frontal bone. Causes x Chronic frontal sinusitis which eventually suppurates and extends into subperiosteal region. x Trauma--subperiosteal haematoma. x Chronic suppurative otitis media. Features x Pain and boggy swelling in frontal region which is warm, tender. x Toxicity and drowsiness. x Pitting scalp oedema is typical. x Investigations: \u0017 Total leucocyte count--increased. ESR--raised. \u0017 X-ray skull. CT scan. x Differential diagnosis: Secondaries in the skull or brain. Complications Osteomyelitis of frontal bone. Spread of infection into intracranial cavity leads to intracranial abscess (Extradural or subdural abscess) (dumb-bell abscess). So may present with features of raised intracranial tension like headache, coning and convulsions. Pott's Puffy tumor can be associated with coical vein throm- bosis, epidural brain abscess/subdural empyema. The cause of vein thrombosis is explained by diplopic veins in frontal bone, which communicates with the dural venous plexus; septic thrombi can potentially evolve from foci within the frontal sinus and propagate through this venous system. Treatment x Antibiotics and drainage under general anaesthesia before it spreads into cranial cavity. x Once it extends into cranial cavity, it is treated accordingly by formal neurosurgical decompression (often using Dandy's brain cannula). x Osteomyelitis of skull bones requires radical removal with recon- struction of skull defect. Ref: SRB manual of surgery 5th edition Pgno: 48" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aged, Bronchoscopy, Exercise Tolerance, Female, Follow-Up Studies, Forced Expiratory Volume, Humans, Male, Middle Aged, Perfusion Imaging, Pneumonectomy, Prospective Studies, Pulmonary Emphysema, Quality of Life, Tomography, X-Ray Computed, Treatment Outcome." }, { "role": "user", "content": "Do baseline regional perfusion impacts exercise response to endobronchial valve therapy in advanced pulmonary emphysema? Context: Advanced heterogeneous emphysema with hyperinflation impacts exercise tolerance in COPD. Bronchoscopic lung volume reduction using Zephyr endobronchial valves (EBVs) has been shown to improve lung function in patients with heterogeneous emphysema. It is unclear whether the target lobe perfusion of patients receiving EBV therapy impacts exercise tolerance as measured by the 6-min walk test distance (6MWTD). We performed a retrospective analysis on the treatment group of the Endobronchial Valve for Emphysema Palliation Trial (VENT) to evaluate the impact of perfusion, measured by 99mTc-MAA-perfusion scintigraphy, on the 6-month improvement in 6MWTD. A mixed-model analysis was performed for the treatment outcome, adjusting for other variables such as age, target lobe position, fissure integrity, BMI, sex, destruction score, and lobar exclusion. Dichotomized at the median, of the 169 patients who received EBV therapy, 88 had a low target lobe regional perfusion and 81 had high target lobe regional perfusion at baseline. Patients with a low target lobe regional perfusion had a significant improvement in 6MWTD when compared with those with a high baseline target lobe regional perfusion (30.24 m vs 3.72 m, P = .03). Shifts in perfusion after EBV therapy occurred only in patients with high baseline perfusion and did not correlate with improved 6MWTD." }, { "role": "assistant", "content": "Patients having heterogeneous emphysema with a low baseline target lobe regional perfusion benefit from EBV therapy, independent of the degree of target lobe destruction. This effect is attenuated if the EBV therapy is not occlusive. Characterization of baseline perfusion may enhance clinical results of patients with emphysema undergoing EBV therapy. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aged, Atrophy, Brain, Brain Damage, Chronic, Cerebral Hemorrhage, Cerebral Small Vessel Diseases, Cognition Disorders, Female, Humans, Hypertension, Interviews as Topic, Ischemic Attack, Transient, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies, Risk, Severity of Illness Index, Stroke, Surveys and Questionnaires, Treatment Outcome." }, { "role": "user", "content": "Are cerebral microbleeds associated with long-term cognitive outcome in patients with transient ischemic attack or minor stroke? Context: Cerebral microbleeds have been related to cerebrovascular disease and dementia. They occur more frequently in patients with ischemic stroke than in the general population, but their relation to cognition in these patients is uncertain, particularly in the long run. We examined the relationship between microbleeds in patients with a transient ischemic attack (TIA) or minor ischemic stroke, and cognitive performance 4 years later. Participants were recruited from a prospective multicenter cohort of patients with a TIA or minor ischemic stroke (n=397). They underwent magnetic resonance imaging (MRI), including a T2*-weighted sequence, within 3 months after their ischemic event. Microbleeds, atrophy, lacunae and white matter hyperintensities (WMH) were rated visually. Cognitive status was examined in 94% of all patients who were still alive after a mean interval of 3.8 years by the Dutch version of the Telephone Interview for Cognitive Status (TICS; n=280) or by an Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) obtained from a close relative if a TICS could not be obtained (n=48). The relationship between presence of microbleeds and TICS or IQCODE score was assessed with linear regression analyses adjusted for age, sex, educational level and time interval between MRI and cognitive evaluation. The mean age was 65±12 years at inclusion. The vascular event at inclusion was a TIA in 170 patients (52%) and a minor ischemic stroke in 155 patients (47%). Microbleeds were present in 11.6% of the patients. Patients with microbleeds were significantly older than patients without microbleeds (70±9 vs. 64±12 years), more often had hypertension, and had more cerebral atrophy, WMH and lacunae on MRI (all p<0.05). The mean TICS score was 35.3±5.9 for patients with microbleeds (n=29) and 34.6±5.2 for patients without microbleeds (n=251); the adjusted mean difference (95% CI) was 1.69 (-0.01 to 3.38). The total IQCODE score was 66.0±10.8 for patients with microbleeds (n=9) and 63.1±12.9 for patients without microbleeds (n=39); the adjusted mean difference was 2.43 (-7.55 to 12.41). The relative risk (adjusted for age) for abnormal cognitive performance when having microbleeds was 1.19 (95% CI: 0.63-2.26). Subcortical atrophy was associated with lower TICS score [standardized regression coefficient β: -0.12 (-0.23 to 0.00); p=0.04] and with lower IQCODE score [0.51 (0.19-0.83); p=0.00]. The adjusted mean difference of IQCODE scores between patients with and those without a lacunar infarct was 0.39 (0.12-0.65; p=0.01)." }, { "role": "assistant", "content": "In this sample of patients with a recent TIA or minor ischemic stroke, microbleeds were not associated with cognitive performance 4 years later. Apparently, this association is different from other markers of small vessel disease. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Aged, 80 and over, Body Mass Index, Female, Follow-Up Studies, Humans, Inspiratory Capacity, Male, Middle Aged, Prognosis, Proportional Hazards Models, Prospective Studies, Pulmonary Disease, Chronic Obstructive, ROC Curve, Total Lung Capacity, Vital Capacity." }, { "role": "user", "content": "Does inspiratory capacity predict mortality in patients with chronic obstructive pulmonary disease? Context: Chronic obstructive pulmonary disease (COPD) severity is usually graded upon the FEV(1) reduction and FEV(1) has been considered the most important mortality predictor with age in COPD. Recent studies suggest other factors as more powerfully related to mortality than FEV(1) in COPD patients. To assess the impact of inspiratory capacity (IC) on mortality and morbidity in COPD patients during a 5-year follow-up period. We recruited 222 patients with mild-to-moderate COPD from January 1995 to December 2001 with an average follow-up period of 60 months (range 30-114 months). Among different respiratory parameters measured in stable conditions FEV(1), FEV(1)/FVC%, IC and PaO(2), PaCO(2) and BMI were chosen and their relationships with all-cause and respiratory mortality and with morbidity were assessed. All these variables were associated with mortality at the univariate analysis. However, in a multivariate regression analysis (Cox proportional hazards model) for all-cause mortality age (year), IC (%pred.) and PaO(2) (mmHg) remained the only significant, independent predictors (HR=1.056, 95%CI: 1.023-1.091; HR=0.981, 95%CI: 0.965-0.998; HR=0.948, 95%CI: 0.919-0.979, respectively). According to the same analysis, IC (%pred.) and PaO(2) (mmHg) were significant independent predictors for respiratory mortality (HR=0.967, 95%CI: 0.938-0.997; HR=0.919, 95%CI: 0.873-0.969) together with FEV(1)/FVC% and BMI (kg/m(2)) (HR=0.967, 95%CI: 0.933-1.022; HR=0.891, 95%CI: 0.807-0.985, respectively). IC (%pred.), FEV(1)/FVC%, and PaO(2) (mmHg) were also significantly related to morbidity, as independent predictors of hospital admissions because of exacerbations (OR=0.980, 95%CI: 0.974-0.992; OR=0.943, 95%CI: 0.922-0.987; OR=0.971, 95%CI: 0.954-0.996, respectively)." }, { "role": "assistant", "content": "IC (%pred.) is a powerful functional predictor of all-cause and respiratory mortality and of exacerbation-related hospital admissions in COPD patients. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A person has poor performance in front of his seniors in public place, has tachycardia when he has to deliver a lecture, avoids going to paies. The diagnosis is" }, { "role": "assistant", "content": "The correct answer is C i.e. Social phobia A social phobic is socially normal, has friends & is cheerful until he is faced with a situation where he has to perform in presence of other; whereas in avoidant P.D. the person persistently feels tension & apprehension. Social phobia is a localized pa of avoidant personality & the differences are: Social Phobia Irrational fear of performing activities in presence of other people or interacting with otherQ Avoidant Personality Disorder Persistent feeling of tension & apprehension - Excessive preoccupation with being criticized or rejected in social situation - Inferiority Complex (belief that one is socially inept personally unappealing or inferior to others) - Unwilling to be involved with people; Restriction in life style; Avoidance of social activities." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Anti-Parkinsonism drug that is a selective COMT inhibitor" }, { "role": "assistant", "content": "The correct answer is Inhibitors of COMT increase the elimination half-life of levodopa and enhance its brain availability. Combining levodopa with a COMT inhibitor reduces \"off\" time and prolongs \"on\" time in fluctuating patients while enhancing motor scores. Two COMT inhibitors have been approved, tolcapone and entacapone. Reference: Harrison's Principles of Internal Medicine; 19th edition; Chapter 449; Parkinson's Disease and Other Movement Disorders" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Henoch-Schonlein purpura is characterized by the deposition of the following immunoglobulin around the vessels" }, { "role": "assistant", "content": "The correct answer is (C) IgA # In HENOCH-SCHONLEIN PURPURA Whatever the histologic lesions, the prominent feature by fluorescence microscopy is the deposition of IgA, sometimes with IgG and C3 in the mesangial region.> IgA is the antibody class most often seen in the immune complexes and has been demonstrated in the renal biopsies." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Schiller Duval body is characteristic of" }, { "role": "assistant", "content": "The correct answer is Yolk Sac TumorThough rare, yolk sac tumor (also known as endodermal sinus tumor) still ranks as the second most common malignant tumor of germ cell origin. Similar to the normal yolk sac, the tumor cells elaborate a-fetoprotein. Its characteristic histologic feature is a glomerulus-like structure composed of a central blood vessel enveloped by tumor cells within a space that is also lined by tumor cells (Schiller-Duval body).Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 22; The Female Genital Tract; Page no: 1031" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "1st symptom to respond to IV Thiamine in Wernicke's encephalopathy is?" }, { "role": "assistant", "content": "The correct answer is Wernicke's encephalopathy * Global Confusion * Ophthalmoplegia: VI N. * Ataxia - Rx- IV Thiamine -First to respond to treatment - Ophthalmoplegia" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Acid-Base Imbalance, Critical Illness, Female, Hospital Mortality, Humans, Lactic Acid, Male, Middle Aged, Neoplasms, Predictive Value of Tests, Survival Analysis." }, { "role": "user", "content": "Are lactate and base deficit predictors of mortality in critically ill patients with cancer? Context: Cancer patients frequently require admission to intensive care unit. However, there are a few data regarding predictive factors for mortality in this group of patients. The aim of this study was to evaluate whether arterial lactate or standard base deficit on admission and after 24 hours can predict mortality for patients with cancer. We evaluated 1,129 patients with severe sepsis, septic shock, or postoperative after high-risk surgery. Lactate and standard base deficit collected at admission and after 24 hours were compared between survivors and non-survivors. We evaluated whether these perfusion markers are independent predictors of mortality. There were 854 hospital survivors (76.5%). 24 h lactate > 1.9 mmol/L and standard base deficit < -2.3 were independent predictors of intensive care unit mortality. 24 h lactate >1.9 mmol/L and 24 h standard base deficit < -2.3 mmol/Lwere independent predictors of hospital death." }, { "role": "assistant", "content": "Our findings suggest that lactate and standard base deficit measurement should be included in the routine assessment of patients with cancer admitted to the intensive care unit with sepsis, septic shock or after high-risk surgery. These markers may be useful in the adequate allocation of resources in this population. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Cerebrovascular Circulation, Excitatory Amino Acid Antagonists, Gyrus Cinguli, Humans, Ketamine, Male, Neuropsychological Tests, Perception, Spin Labels, Thinking, Young Adult." }, { "role": "user", "content": "Are phenomenologically distinct psychotomimetic effects of ketamine associated with cerebral blood flow changes in functionally relevant cerebral foci : a continuous arterial spin labelling study? Context: The N-methyl-D-aspartate (NMDA) receptor antagonist ketamine provides a pragmatic approach to address the link between glutamate-mediated changes in brain function and psychosis-like experiences. Most studies using PET or BOLD fMRI have assessed these symptoms broadly, which may limit inference about specific mechanisms. The objective of this study is to identify the cerebral blood flow (CBF) correlates of ketamine-induced psychopathology, focusing on individual psychotomimetic symptom dimensions, which may have separable neurobiological substrates. We measured validated psychotomimetic symptom factors following intravenous ketamine administration in 23 healthy male volunteers (10 given a lower dose and 13 a higher dose) and correlated ketamine-induced changes in symptoms with regional changes in CBF, measured non-invasively using arterial spin labelling (ASL). The main effect of ketamine paralleled previous studies, with increases in CBF in anterior and subgenual cingulate cortex and decreases in superior and medial temporal cortex. Subjective effects were greater in the high-dose group. For this group, ketamine-induced anhedonia inversely related to orbitofrontal cortex CBF changes and cognitive disorganisation was positively correlated with CBF changes in posterior thalamus and the left inferior and middle temporal gyrus. Perceptual distortion was correlated with different regional CBF changes in the low- and high-dose groups." }, { "role": "assistant", "content": "Here, we provide evidence for the sensitivity of ASL to the effects of ketamine and the strength of subjective experience, suggesting plausible neural mechanisms for ketamine-induced anhedonia and cognitive disorganisation. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: APACHE, Age Factors, Aged, Aged, 80 and over, Biomarkers, Case-Control Studies, Critical Care, Cross Infection, Delirium, Female, Humans, Hyperprolactinemia, Intensive Care Units, Male, Middle Aged, Odds Ratio, Prolactin, Prospective Studies, Psychometrics, Psychomotor Agitation, Risk Factors, Sepsis." }, { "role": "user", "content": "Are high prolactin levels associated with more delirium in septic patients? Context: We investigated whether high prolactin levels were associated with delirium in septic patients because neuropsychiatric disorders are frequently associated with hyperprolactinemia. Prolactin levels were measured daily for 4 days in 101 patients with sepsis. Delirium was assessed using the Richmond Agitation Sedation Scale and the Confusion Assessment Method in the ICU. Delirium developed in 79 patients (78%) and was more common in patients older than 65 years. Prolactin levels were higher in patients with delirium than in those without over the 4 days of observation (P = .032). In patients with delirium, higher prolactin levels were associated with a lower incidence of nosocomial infection (P = .006). Multivariable logistic regression showed that the Sequential Organ Failure Assessment score at intensive care unit admission (odds ratio, 1.24; 95% confidence interval, 1.04-1.48; P = .002) and the combined effect of prolactin levels with age (odds ratio, 1.018; 95% confidence interval, 1.01-1.031; P = .006) were associated with the development of delirium." }, { "role": "assistant", "content": "High prolactin levels may be a risk factor for delirium in septic patients. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Pregnancy is contraindicated in which of the following cardiovascular condition?" }, { "role": "assistant", "content": "The correct answer is World Health Organization (WHO) Risk Classification of Cardiovascular Disease and Pregnancy with Management RecommendationsWHO 1--Risk no higher than general population Uncomplicated, small, or mild: Pulmonary stenosis Ventricular septal defect Patent ductus aeriosus Mitral valve prolapse with no more than tril mitral regurgitation Successfully repaired simple lesions: Ostium Secundum atrial septal defect Ventricular septal defect Patent ductus aeriosus Total anomalous pulmonary venous drainage Isolated ventricular extrasystoles and atrial ectopic beatsWHO 2--Small increase in risk of maternal moality and morbidity If otherwise uncomplicated:Unoperated atrial septal defectRepaired Fallot tetralogyMost arrhythmiasWHO 2 or 3--Depends on individual case Mild left ventricular impairment Hyperophic cardiomyopathy Native or tissue valvular hea disease not considered WHO 4 Marfan syndrome without aoic dilation Hea transplantationWHO 3--Significantly increased risk of maternal moality or expe cardiac and obstetrical care requiredMechanical valveSystemic right ventricle--congenitally corrected transposition, simple transposition post Mustard or Senning repairPost-Fontan operationCyanotic hea diseaseOther complex congenital hea diseasesWHO 4--Very high risk of maternal moality or severe morbidity; pregnancy contraindicated and termination discussedPulmonary aerial hypeensionSevere systemic ventricular dysfunction (NYHA III-IV or LVEF <30%)Previous peripaum cardiomyopathy with any residual impairment of left ventricular functionSevere left hea obstructionMarfan syndrome with aoa dilated >40 mmReference: William's obstetrics; 25th edition; Chapter 49; Cardiovascular Disorders" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Anastomosis, Surgical, Bile Duct Neoplasms, Cholangiocarcinoma, Cholestasis, Extrahepatic, Female, Gallbladder Neoplasms, Hepatic Duct, Common, Humans, Jejunum, Male, Middle Aged, Palliative Care, Postoperative Complications, Survival Rate." }, { "role": "user", "content": "Does intrahepatic biliary enteric bypass provide effective palliation in selected patients with malignant obstruction at the hepatic duct confluence? Context: Palliating the effects of biliary obstruction is a major goal of therapy in patients with cancer at the hepatic duct confluence. This study was undertaken to evaluate the effectiveness of intrahepatic biliary-enteric bypass to either the segment III duct or the right sectoral hepatic ducts in patients with unresectable hilar cholangiocarcinoma or gallbladder carcinoma. From December 1991 to October 1996, 55 consecutive bypass procedures were prospectively evaluated in patients with unresectable hilar cholangiocarcinoma or gallbladder cancer. Patients were divided into three groups based on the primary tumor and the type of bypass performed: group 1A, cholangiocarcinoma/segment III bypass (n = 20); group 1B, cholangiocarcinoma/right sectoral hepatic duct bypass (n = 14); group 2, gallbladder cancer/segment III bypass (n = 21). Mean hospital stay (14+/-2 days) and mean blood loss (629+/-84 mL) were similar among the three groups. Perioperative death occurred in 6 patients (11%): 0 in group 1A, 3 each in groups 1B and 2. All survivors had relief of jaundice and pruritus after bypass. Complications occurred in 25 patients (45%). Preoperative transhepatic biliary drainage, performed in 14 patients prior to referral, was associated with a higher incidence of contaminated bile, greater operative blood loss, and postoperative biliary leak that was less likely to resolve spontaneously. Median survival in patients with cholangiocarcinoma (groups 1A and 1B) was 52 weeks and was unaffected by the type of bypass performed. By contrast, median survival in patients with gallbladder cancer (group 3) was 20 weeks; all but 3 died within 32 weeks of surgery. In patients with cholangiocarcinoma, the 1-year bypass patency was 80% in group 1A (segment III bypass) and 60% in group 1B (right sectoral hepatic duct bypass). Overall, there were 9 late bypass failures (18%) requiring reintervention." }, { "role": "assistant", "content": "Intrahepatic biliary-enteric bypass effectively relieves symptoms due to malignant hilar obstruction. In patients with cholangiocarcinoma, segment III bypass provides excellent palliation with relatively few late complications and can be performed with minimal morbidity and mortality. Bypass to the right sectoral hepatic ducts, on the other hand, is associated with significant procedure-related morbidity and mortality and more late complications. Patients with gallbladder cancer, because of their poor survival, are probably better palliated by percutaneous biliary stenting. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Anabolic Agents, Bone Density Conservation Agents, Cell Differentiation, Cell Proliferation, Cell Survival, Cells, Cultured, Gene Knockdown Techniques, Humans, Organometallic Compounds, Osteoblasts, Osteoclasts, Osteoprotegerin, RANK Ligand, RNA, Messenger, RNA, Small Interfering, Receptors, Calcium-Sensing, Thiophenes." }, { "role": "user", "content": "Do osteoblasts play key roles in the mechanisms of action of strontium ranelate? Context: Strontium ranelate reduces fracture risk in postmenopausal women with osteoporosis. Evidence from non-clinical studies and analyses of bone markers in phase III trials indicate that this is due to an increase in osteoblast formation and a decrease of osteoclastic resorption. The aim of this work was to investigate, in human cells, the mechanisms by which strontium ranelate is able to influence the activities of osteoblasts and osteoclasts. Human primary osteoblasts were used to examine effects of strontium ranelate on replication (thymidine incorporation), differentiation (Runx2 and alkaline phosphatase) and cell survival (cell counts and caspase activity). Osteoprotegerin (OPG) was measured by quantitative reverse transcription PCR (qRT-PCR) and elisa and receptor activator of NFkappaB ligand (RANKL) by qRT-PCR and Western blot. As strontium ranelate has been proposed as an agonist of the calcium-sensing receptor (CaSR), the involvement of CaSR in the effects of strontium ranelate on OPG and RANKL expression, and cell replication was examined using siRNA. Strontium ranelate increased mRNA and protein levels of OPG and suppressed those of RANKL. Strontium ranelate also stimulated osteoblast replication and differentiation and increased cell survival under stress. Knocking down CaSR suppressed strontium ranelate-induced stimulation of OPG mRNA, reduction of RANKL mRNA, and increase in replication, indicating the involvement of CaSR in these responses." }, { "role": "assistant", "content": "Our results demonstrate that osteoblasts play a key role in the mechanism of action of the anti-fracture agent, strontium ranelate by mediating both its anabolic and anti-resorptive actions, at least in part, via activation of CaSR. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Cytokines, Female, Humans, Inflammation, Interleukin-1beta, Interleukin-6, Interleukin-8, Leukocytes, Mononuclear, Male, Middle Aged, Psoriasis, RNA, S100 Calcium Binding Protein A7, S100 Proteins, Tumor Necrosis Factor-alpha, Ultraviolet Therapy, Young Adult." }, { "role": "user", "content": "Are leukocyte-derived koebnerisin ( S100A15 ) and psoriasin ( S100A7 ) systemic mediators of inflammation in psoriasis? Context: Psoriasis is a systemic immune-mediated chronic inflammatory disease. In the skin, the antimicrobial proteins koebnerisin (S100A15) and psoriasin (S100A7) are overexpressed in the epidermis of psoriatic lesions and mediate inflammation as chemoattractants for immune cells. Their role for systemic inflammation in circulating leukocytes is unknown. The aim of the study was to identify circulating leukocyte populations as a source of koebnerisin and psoriasin. Further, immune-stimulatory effects of these S100A proteins on circulating leukocytes were evaluated and their role as therapeutic response markers in patients with psoriasis was analyzed upon UVB treatment. The expression and production of koebnerisin and psoriasin by leukocytes were assessed by quantitative real-time PCR (qRT-PCR) and immunoblotting. The S100A protein mediated regulation of proinflammatory cytokines by peripheral blood mononuclear cells (PBMCs) was measured with qRT-PCR and cytometric bead assay. We identified circulating leukocytes as novel sources of koebnerisin (S100A15) and psoriasin (S100A7). Circulating leukocytes (PBMCs) of patients with psoriasis produced increased levels of koebnerisin and psoriasin compared to healthy individuals. Both S100A proteins further acted as 'alarmins' on PBMC to induce proinflammatory cytokines implicated in the pathogenesis of psoriasis, such as IL-1β, TNF-α, IL-6 and IL-8. Koebnerisin levels were suppressed in PBMC of psoriatic patients when effectively treated with narrow-band UVB." }, { "role": "assistant", "content": "Data suggest that koebnerisin and psoriasin are systemic pro-inflammatory mediators and koebnerisin acts as a therapeutic response marker in psoriasis. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Adult, Analysis of Variance, Aorta, Thoracic, Aortic Diseases, Aortic Valve, Blood Flow Velocity, Case-Control Studies, Chi-Square Distribution, Echocardiography, Female, Hemodynamics, Humans, Image Interpretation, Computer-Assisted, Imaging, Three-Dimensional, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Severity of Illness Index, Shear Strength, Statistics, Nonparametric." }, { "role": "user", "content": "Is bicuspid aortic valve associated with altered wall shear stress in the ascending aorta? Context: Hemodynamics may play a role contributing to the progression of bicuspid aortic valve (BAV) aortopathy. This study measured the impact of BAV on the distribution of regional aortic wall shear stress (WSS) compared with control cohorts. Local WSS distribution was measured in the thoracic aorta of 60 subjects using 4-dimensional (4D) flow-sensitive magnetic resonance imaging. WSS analysis included 15 BAV patients: 12 with fusion of the right-left coronary cusp (6 stenotic) and 3 with fusion of the right and noncoronary cusp. The right-left BAV cohort was compared with healthy subjects (n=15), age-appropriate subjects (n=15), and age-/aorta size-controlled subjects (n=15). Compared with the age-appropriate and age-/aorta size-matched controls, WSS patterns in the right-left BAV ascending aorta were significantly elevated, independent of stenosis severity (peak WSS=0.9 ± 0.3 N/m(2) compared with 0.4 ± 0.3 N/m(2) in age-/aorta size-controlled subjects; P<0.001). Time-resolved (cine) 2D images of the bicuspid valves were coregistered with 4D flow data, directly linking cusp fusion pattern to a distinct ascending aortic flow jet pattern. The observation of right-anterior ascending aorta wall/jet impingement in right-left BAV patients corresponded to regions with statistically elevated WSS. Alternative jetting patterns were observed in the right and noncoronary cusp fusion patients." }, { "role": "assistant", "content": "The results of this study demonstrate that bicuspid valves induced significantly altered ascending aorta hemodynamics compared with age- and size-matched controls with tricuspid valves. Specifically, the expression of increased and asymmetric WSS at the aorta wall was related to ascending aortic flow jet patterns, which were influenced by the BAV fusion pattern. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which is not true regarding Bernard soulier syndrome?" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The term MHC restriction refers to which of the following statements?" }, { "role": "assistant", "content": "The correct answer is MHC class I- or class II-restriction means that T cells recognize antigen peptide fragments only when they are presented in the antigen-recognition site of a class I (for CD8+ T cells) or class II MHC molecule(for CD4+ T cells), respectively." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Dose of vitamin A prophytaxis given in age group 1– 6 years –" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Balloon Occlusion, Databases, Factual, Embolization, Therapeutic, Female, Follow-Up Studies, Humans, Intracranial Aneurysm, Male, Middle Aged, Paresis, Postoperative Complications, Prospective Studies, Retreatment, Retrospective Studies, Thromboembolism, Time Factors, Treatment Outcome, Young Adult." }, { "role": "user", "content": "Is selective embolization of unruptured intracranial aneurysms associated with low retreatment rate? Context: To report long-term imaging findings of 101 patients with 129 unruptured intracranial aneurysms (UIA) treated by embolization. A retrospective review of our prospectively maintained database identified all patients with an UIA treated by embolization with coils only and with a minimal 12-month imaging follow-up. The clinical charts, procedural data, and angiographic results were reviewed. Between March 2004 and June 2009, 101 patients with 129 UIA were identified (71 women/30 men, mean age = 51.4 years). Ninety-four aneurysms (73%) were large (10-25 mm), and 35 (27%) were small (<10 mm). Aneurysms mean size was 10.7 mm (median, 9 mm; range 3-22 mm); 87 UIA (67.5%) had a small neck (<4 mm or neck/sac ratio < 0.7), and 42 (32.5%) had a wide neck (> or =4 mm or neck/sac ratio > or = 0.7). Selective coiling with bare/coated coils was performed in 125 cases and four cases, respectively. The balloon-assisted technique was used in 47 cases (36.4%). Only one patient experienced a symptomatic complication (thromboembolism) and kept a slight hemiparesis. Immediate results included 77 complete occlusions (59.7%), 45 neck remnants (34.9%), and 7 incomplete occlusions (5.4%). Mean imaging follow-up of 32 months showed 104 stable occlusions (80.6%), 12 further thrombosis (9.3%), 7 major recanalizations (5.4%), and 6 minor recanalizations (4.7%). Retreatment was required in seven wide-necked and/or large aneurysms including four treated with coated coils. No bleeding occurred during follow-up." }, { "role": "assistant", "content": "Selective embolization of UIA is associated with stable long-term anatomical results and low retreatment rate. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Hiatus semilunaris is present in" }, { "role": "assistant", "content": "The correct answer is Middle meatus: Uncinate process is a hook-like structure running in from anterosuperior to the posteroinferior direction in the middle meatus. It&;s postero superior border is sharp and runs parallel to the anterior border of bulla ethmoidalis. This gap between the two is called hiatus semilunaris .it is two-dimensional space of 1-2 mm width. (Ref: Diseases of Ear, Nose and Throat and head and neck surgery, Dhingra 7th edition, Pg no. 150)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adipocytes, Animals, Anti-Inflammatory Agents, CCAAT-Enhancer-Binding Proteins, Cell Differentiation, Cells, Cultured, Dexamethasone, Glycogen Synthase Kinase 3, Glycogen Synthase Kinase 3 beta, Intercellular Signaling Peptides and Proteins, Lithium Chloride, Phosphorylation, RNA Interference, RNA, Messenger, RNA, Small Interfering, Rats, Stem Cells, Tendons, Up-Regulation, Wnt Signaling Pathway, beta Catenin." }, { "role": "user", "content": "Does dickkopf1 Up-Regulation Induced by a High Concentration of Dexamethasone promote Rat Tendon Stem Cells to Differentiate Into Adipocytes? Context: Dexamethasone (Dex)-induced spontaneous tendon rupture and decreased self-repair capability is very common in clinical practice. The metaplasia of adipose tissue in the ruptured tendon indicates that Dex may induce tendon stem cells (TSCs) to differentiate into adipocytes, but the mechanism remains unclear. In the present study, we used in vitro methods to investigate the effects of Dex on rat TSC differentiation and the molecular mechanisms underlying this process. First, we used qPCR and Western blotting to detect the expression of the adipogenic differentiation markers aP2 and C/EBPα after treating the TSCs with Dex. Oil red staining was used to confirm that high concentration Dex promoted adipogenic differentiation of rat TSCs. Next, we used qPCR and Western blotting to detect the effect of a high concentration of dexamethasone on molecules related to the canonical WNT/β-catenin pathway in TSCs. Treating rat TSCs with Dex promoted the synthesis of the inhibitory molecule dickkopf1 (DKK1) at the mRNA and protein levels. Western blotting results further showed that Dex downregulated the cellular signaling molecule phosphorylated glycogen synthase kinase-3β (P-GSK-3 β (ser9)), upregulated P-GSK-3β (tyr216), and downregulated the pivotal signaling molecule β-catenin. Furthermore, DKK1 knockdown attenuated Dex-induced inhibition of the canonical WNT/β-catenin pathway and of the adipogenic differentiation of TSCs. Lithium chloride (LiCl, a GSK-3β inhibitor) reduced Dex-induced inhibition of the classical WNT/β-catenin pathway in TSCs and of the differentiation of TSCs to adipocytes." }, { "role": "assistant", "content": "In conclusion, by upregulating DKK1 expression, reducing the level of P-GSK-3β (ser9), and increasing the level of P-GSK-3β (tyr216), Dex causes the degradation of β-catenin, the central molecule of the classical WNT pathway, thereby inducing rat TSCs to differentiate into adipocytes. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "You have clinically diagnosed a patient as having SLE and ordered 6 tests, out of which 4 have come positive and 2 have negative. To know the probability of SLE at this point, you need to know:" }, { "role": "assistant", "content": "The correct answer is To know the probability of SLE at this point,We need to know Prior probability (Prevalence) of each test, sensitivity and specificity of each test Probability of having a Disease means PPV i.e. Positive Predictive Value and it depends upon (BAYES'THEORM) sensitivity specificity and disease Prevalence" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All the strains of A.A. Comitans are sensitive to:" }, { "role": "assistant", "content": "The correct answer is If given :Ciprofloxacin+ metronidazole is the best option." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: UNLABELLED, OBJECTIVES, PATIENTS AND METHODS, RESULTS. Meshes: Adolescent, Adult, Bayes Theorem, DNA, Ejaculation, Genotype, Humans, Male, Middle Aged, Oxytocin, Polymorphism, Single Nucleotide, Premature Ejaculation, Receptors, Vasopressin, Retrospective Studies, Young Adult." }, { "role": "user", "content": "Are single nucleotide polymorphisms in the oxytocin and vasopressin 1A/1B receptor genes likely candidates for variation in ejaculatory function? Context: What's known on the subject? and What does the study add? There is also evidence that the etiology of premature ejaculation is partially genetic. So far, all molecular genetic studies of premature ejaculation have focused on serotonergic and dopaminergic genes. Serotonergic and dopaminergic neurotransmission aside, studies on both animals and humans have shown that both oxytocin and vasopressin are also involved in ejaculatory function. The present study is, to our knowledge, the first to investigate effects of polymorphisms in oxytocin and vasopressin receptor genes on ejaculatory function. Although a large sample (1517 men) was available for the present study, we could not detect any clear-cut effects of any gene variant on ejaculatory function. We detected a heterozygote effect of one polymorphism (rs75775) in the oxytocin receptor gene. Rare variants of the vasopressin receptor 1A gene may theoretically have a stronger impact on ejaculatory function, but would need a very large sample in order to be established. Based on our results, we conclude that the oxytocin and vasopressin receptor genes are unlikely targets for successful pharmacogenetic interventions. • To investigate associations between single nucleotide polymorphisms (SNPs) linked to the oxytocin, and arginine vasopressin 1A and 1B receptor genes and ejaculatory function. • To investigate these associations in a large, population-based sample. • In all, 1517 male twins and non-twin brothers of twins aged 18-45 years (mean = 26.43; sd = 4.87) provided questionnaire data regarding ejaculatory function and relevant covariates and saliva samples for genotyping. • A Bayesian linear mixed-effects model, which appropriately controls for between-subjects dependence, was used to estimate genotype associations. • We corrected for multiple testing using a linkage disequilibrium correlation measure. • We found a heterozygote effect on one SNP in the oxytocin receptor gene (rs75775), so that individuals heterozygous for this SNP had significantly elevated risk for premature ejaculation symptoms compared with carriers of either homozygote. • Several SNPs in the arginine vasopressin receptor genes had rare or very rare genotypes. This study may be underpowered to detect potential effects of rare genotypic variants in arginine vasopressin receptor genes." }, { "role": "assistant", "content": "• Our results regarding the oxytocin receptor polymorphisms support previous studies that indicate a complex relationship between oxytocin and ejaculatory function. • Oxytocin receptor genes are, for example, unlikely suitable targets for pharmacogenetic intervention studies. • Rare variants in arginine vasopressin receptor genes may have significant effects on premature ejaculation, but would need larger sample sizes or case-control designs to be detected." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: ATP Binding Cassette Transporter, Subfamily G, Member 2, ATP-Binding Cassette Transporters, Bromodeoxyuridine, Cell Cycle Proteins, Cell Differentiation, Cell Line, Tumor, Cell Lineage, GAP-43 Protein, Homeodomain Proteins, Humans, Immunohistochemistry, N-Acetylgalactosaminyltransferases, Neoplasm Proteins, Neural Crest, Neuroblastoma, Neurofilament Proteins, Proto-Oncogene Proteins c-kit, Reverse Transcriptase Polymerase Chain Reaction, S100 Calcium Binding Protein A6, S100 Proteins, SOXE Transcription Factors, Stem Cells, Transcription Factors, Tretinoin, Vimentin." }, { "role": "user", "content": "Does comprehensive characterization of neuroblastoma cell line subtypes reveal bilineage potential similar to neural crest stem cells? Context: Neuroblastic tumors (NBT) derive from neural crest stem cells (NCSC). Histologically, NBT are composed by neuroblasts and Schwannian cells. In culture, neuroblastic (N-), substrate-adherent (S-) and intermediate phenotype (I-) cell subtypes arise spontaneously. Here, neuroblastoma (NB) cell line subtypes were characterized according to embryonic peripheral nervous system development markers (GAP43, Phox2b, Sox10, c-kit, GD2, NF68, vimentin, S100beta, calcyclin and ABCG2), morphological features, gene expression and differentiation potential. I-type cells were investigated as a bipotential (neuronal and glial) differentiation stage. Positive immunostaining of NCSC (GAP43, c-kit, NF68, vimentin and Phox2b) and undifferentiated cell (ABCG2) markers was observed in all NB subtypes. N- and I-type cells displayed cytoplasmic membrane GD2 staining, while nuclear calcyclin was restricted to S-type. N- and I-type cells showed similar phenotype and immunoreactivity pattern. Differential gene expression was associated with each cell subtype. N- and I-type cells displayed similar differentiation capacity towards neuronal and glial lineage fates. S-type cells, upon induction, did not show a neuronal-like phenotype, despite gene expression changes." }, { "role": "assistant", "content": "Results suggest that N- and I-type NB cell subtypes represent an immature bilineage stage, able to progress towards neuronal and glial fates upon induction of differentiation. S-type cells appear irreversibly committed to a glial lineage fate. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Academic Medical Centers, Cross-Sectional Studies, Emergency Service, Hospital, Humans, Mandatory Programs, Retrospective Studies, Time Factors, Triage, United States." }, { "role": "user", "content": "Does mandatory triage identify high-acuity patients within recommended time frames? Context: We determine whether mandatory formal triage of walk-in emergency department (ED) patients provides timely recognition of the most acutely ill. This retrospective cross-sectional study was conducted at a US urban academic ED, annual census 39,000, which uses Emergency Severity Index-5 triage (ESI-5) for all arriving patients. ESI-5 recommends that level 1 and 2 patients be treated by a physician immediately or within 10 minutes, respectively. For all high-acuity (ESI 1 or 2) patients presenting between January 1 and December 31, 2008, data from electronic medical records and registration and tracking systems were used to determine elapsed time from arrival to completion of triage (median, range, 95th percentile), proportion of these intervals that met ESI-5 recommendations, and whether triage throughput differed during peak arrival hours. For 3,932 high-acuity walk-in visits (ESI 1=63; ESI 2=3,869), median time from arrival to triage completion was 12.3 minutes, range 0 to 128 minutes. Twenty-seven percent (95% confidence interval [CI] 26% to 29%) of high-acuity patients were taken to rooms on arrival; 41% (95% CI 40%, 43%), including those roomed immediately, completed triage within 10 minutes. Twenty-five percent (95% CI 24% to 26%) completed triage in greater than 20 minutes and 10% (95% CI 9% to 11%) greater than 30 minutes after arrival. Between 10 am and 10 pm (peak arrival hours), triage took longer for level 2 patients, and fewer met ESI recommendations." }, { "role": "assistant", "content": "Less than half of high-acuity patients in this urban ED completed triage within time frames recommended by the ESI-5, resulting in potentially unsafe delays. Although mandatory formal triage theoretically identifies patients who should be treated most quickly, the value and safety of this process should be reassessed. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Adult, Brain, Calcitonin Gene-Related Peptide, Female, Healthy Volunteers, Hot Temperature, Humans, Magnetic Resonance Imaging, Male, Nociception, Placebos, Young Adult." }, { "role": "user", "content": "Does calcitonin Gene-Related Peptide modulate Heat Nociception in the Human Brain - An fMRI Study in Healthy Volunteers? Context: Intravenous infusion of calcitonin-gene-related-peptide (CGRP) provokes headache and migraine in humans. Mechanisms underlying CGRP-induced headache are not fully clarified and it is unknown to what extent CGRP modulates nociceptive processing in the brain. To elucidate this we recorded blood-oxygenation-level-dependent (BOLD) signals in the brain by functional MRI after infusion of CGRP in a double-blind placebo-controlled crossover study of 27 healthy volunteers. BOLD-signals were recorded in response to noxious heat stimuli in the V1-area of the trigeminal nerve. In addition, we measured BOLD-signals after injection of sumatriptan (5-HT1B/1D antagonist). Brain activation to noxious heat stimuli following CGRP infusion compared to baseline resulted in increased BOLD-signal in insula and brainstem, and decreased BOLD-signal in the caudate nuclei, thalamus and cingulate cortex. Sumatriptan injection reversed these changes." }, { "role": "assistant", "content": "The changes in BOLD-signals in the brain after CGRP infusion suggests that systemic CGRP modulates nociceptive transmission in the trigeminal pain pathways in response to noxious heat stimuli. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, UNASSIGNED, BACKGROUND, UNASSIGNED, RESULTS. Meshes: Animals, Blastocyst, DNA Methylation, Female, Fertilization in Vitro, Genomic Imprinting, Male, Mice, Mice, Inbred C57BL, Oocytes, Ovarian Follicle, Ovulation Induction, RNA, Long Noncoding." }, { "role": "user", "content": "Is the loss of imprinted DNA methylation in mouse blastocysts inflicted to a similar extent by in vitro follicle culture and ovulation induction? Context: Does in vitro follicle culture (IFC) have an effect on maintenance of imprinted DNA methylation in preimplantation mouse embryos? We report similar alterations in the methylation pattern of H19 imprinted maternally expressed transcript (H19), small nuclear ribonucleoprotein polypeptide N (Snrpn) and mesoderm specific transcript (Mest) imprinted genes in mouse blastocysts obtained after ovulation induction and IFC. Furthermore, we observed no differences in the gene expression of maternal effect proteins related with imprinting maintenance between superovulated in vivo grown or IFC oocytes. Assisted reproductive technology is associated with adverse post-natal outcomes such as increased risk of premature birth, altered birthweight, congenital anomalies and genomic imprinting syndromes in human and in animal models. Previous studies have shown that ovulation induction allowed normal imprinting establishment in mouse oocytes, but interfered with imprinting maintenance during preimplantation . Normal imprinting establishment was also observed in mouse oocytes derived from a standardized IFC from the early pre-antral follicle stage. The methylation profiles of differentially methylated regions (DMRs) of three key imprinted genes (H19, Snrpn and Mest) were compared at hatched blastocyst stage between embryos obtained from IFC or superovulated oocytes, each subjected to IVF and preimplantation in vitro culture (IVC); in non-manipulated in vivo produced late blastocyst (control) and in in vivo produced 2-cell embryos that were in vitro cultured until the hatched blastocyst stage (to assess the effect of IVC). Two different mice strains (Mus musculus C57BL/6J X CBA/Ca and Mus musculus B6 (CAST7)) were used to discriminate between maternal and paternal alleles of imprinted genes. Additionally, a limiting-dilution bisulfite-sequencing technique was carried out on individual embryos in order to avoid amplification bias. To assess whether IFC and ovulation induction differentially affect the mRNA expression of imprinting maintenance genes in the oocyte, a comparison of DNA methyltransferase 1 (Dnmt1o), methyl-CpG binding domain protein 3 (MBD3) and developmental pluripotency-associated 3 (Dppa3) was performed by qPCR between in vivo and in vitro grown oocytes at the germinal vesicle and metaphase II (MII) stage. Results showed a loss of global imprinted DNA methylation in all in vitro manipulated embryos, due to an increase in the amount of abnormal alleles (<50% methylated). Importantly, there were no differences in blastocysts obtained from IFC and ovulation induction. Moreover, similar mRNA expression levels for Dnmt1o, MBD3 and Dppa3 genes were observed in IFC and stimulated oocytes." }, { "role": "assistant", "content": "The methylation analysis was restricted to a number of well-selected imprinted genes. Future studies need to determine whether ovulation induction and IFC affect maternal effect factors at the protein level. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Secreting active thyroid follicles are lined by which type of epithelium ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., ColumnarThis question is different from the one which was asked in session- 3.Here the examiner is asking about lining of thyroid follicles, which are secreting actively.Normally, thyroid follicle is lined by low couboidal epithelium. But, when they are active, their lining is tall columnar like.\"When inactive thyroid follicular epithelial cells are simple fiat or cuboidal cells, but when actively synthesizing or secreting thyroid hormone they are tall and columnar\" Wheater's functional histology.\"Active follicular cells are columnar\" Histology at a Glance.\"A thyroid follicle that is actively secreting thyroid hormones look somewhat different from one that is inactice. An inactive follicle is large, lined by flat cells and contains abundant colloid. In contrast, an active follicle is smaller, is lined by columnar cells and contains less colloid\" Principles of medical physiology." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "About first order kinetics true statement is" }, { "role": "assistant", "content": "The correct answer is I 1st order reaction half life remains constant and clearence remains constant In zero order reaction half life decrease with decrease in concentration Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:489,490" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "SABE is most commonly due to: March 2013" }, { "role": "assistant", "content": "The correct answer is Ans:C i.e. Streptococcus viridans Subacute bacterial endocarditis/Endocarditis lenta It can be considered a form of Type III hypersensitivity. It is usually caused by a form of streptococci viridians bacteria that normally live in the mouth and throat (Streptococcus mutans, mitis, sanguis or milleri). Osler's nodes can indicate this condition. Nail clubbing is also often seen in subacute endocarditis. In cases of subacute bacterial endocarditis, the causative organism (streptococcus viridans) needs a previous hea valve disease to colonize and cause such disease. On the other hand, in cases of acute bacterial endocarditis, the organism can colonize on the healthy hea valve, causing the disease." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Latent period of muscle twitch is 10 s, contraction period is 40 s and the relaxation time is 50 s. Tetanising frequency would be:" }, { "role": "assistant", "content": "The correct answer is For tetanus to occur, stimulus must fall repeatedly in the contraction phase that will cause the accumulation of Ca++ in myoplasm leading to sustained contraction. Tetanising frequency = 1 / time of contraction phase = 1/40 = 25 Hz" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Breast Neoplasms, Female, Humans, Image Enhancement, Image Interpretation, Computer-Assisted, Mammography, Middle Aged, New South Wales, Observer Variation, Prevalence, Professional Competence, Reproducibility of Results, Sensitivity and Specificity, Ultrasonography." }, { "role": "user", "content": "Do markers of good performance in mammography depend on number of annual readings? Context: To explore relationships between reader performance and reader characteristics in mammography for specific radiologist groupings on the basis of annual number of readings. The institutional review board approved the study and waived the need for patient consent to use all images. Readers gave informed consent. One hundred sixteen radiologists independently reviewed 60 mammographic cases: 20 cases with cancer and 40 cases with normal findings. Readers located any visualized cancer, and levels of confidence were scored from 1 to 5. A jackknifing free response operating characteristic (JAFROC) method was used, and figures of merit along with sensitivity and specificity were correlated with reader characteristics by using Spearman techniques and standard multiple regressions. Reader performance was positively correlated with number of years since qualification as a radiologist (P ≤ .01), number of years reading mammograms (P ≤ .03), and number of readings per year (P ≤ .0001). The number of years since qualification as a radiologist (P ≤ .004) and number of years of reading mammograms (P ≤ .002) were negatively related to JAFROC values for radiologists with annual volumes of less than 1000 mammographic readings. For individuals with more than 5000 mammographic readings per year, JAFROC values were positively related to the number of years that the reader was qualified as a radiologist (P ≤ .01), number of years of reading mammograms (P ≤ .002), and number of hours per week of reading mammograms (P ≤ .003). Number of mammographic readings per year was positively related with JAFROC scores for readers with an annual volume between 1000 and 5000 readings (P ≤ .03). Differences in JAFROC scores appear to be more related to specificity than location sensitivity, with the former demonstrating significant relationships with four of the five characteristics analyzed, whereas no relationships were shown for the latter." }, { "role": "assistant", "content": "Radiologists' determinants of performance are associated with annual reading volumes. Ability to recognize normal images is a discriminating factor in individuals with a high volume of mammographic readings. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Catatonia is characterized by all except NOT RELATED-PSYCHIATRY" }, { "role": "assistant", "content": "The correct answer is Catatonia is characterized by marked disturbance of motor behavior presents in 3 clinical forms.a) Excited catatoniab) Stuporous catatoniac) Catatonia alternating between excitement & stupor." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, METHODS, RESULTS. Meshes: Cost-Benefit Analysis, Databases, Bibliographic, Drug Therapy, Economics, Pharmaceutical, Evidence-Based Medicine, Humans, Review Literature as Topic, State Medicine, Technology Assessment, Biomedical, United Kingdom." }, { "role": "user", "content": "Are the best available clinical effectiveness data used in economic evaluations of drug therapies? Context: Use of evidence on clinical effectiveness that is of poor quality or is biased in favour of the therapy under study is a concern in economic evaluations and may contribute to a mistrust of pharmacoeconomic studies. This study aimed to determine whether the authors of economic evaluations use the best available evidence for clinical effectiveness. One hundred economic evaluations of drug therapies (published in 2001-2003) were sampled randomly from the National Health Service Economic Evaluation Database, and the source of clinical evidence was identified. For each therapy, alternative, high quality sources of clinical effectiveness data were sought by searching the Database of Abstracts of Reviews of Effects and Health Technology Assessment databases. The magnitude and direction of the effect size in the different sources of evidence were compared. Relevant systematic reviews were found for only 32 of the 100 economic evaluations in the sample. In three cases these reviews had been identified by the authors of the economic evaluations and two of these cases were used in the evaluation. Comparisons were possible in 21 cases. The clinical effects reported in all 21 comparisons were similar in direction but differed in magnitude. Compared to the systematic reviews, the authors of economic evaluations used evidence that was more favourable in five cases, less favourable in four cases, and similar in 12 cases. Six of the economic evaluations and corresponding systematic reviews did not present measures of effectiveness in a manner that allowed comparison." }, { "role": "assistant", "content": "Authors of economic evaluations have not made sufficient use of the evidence available from systematic reviews of clinical effectiveness. The central role of economic evaluations in health policy makes it essential that improvements in economic methods are accompanied by a structured search for the highest quality information on clinical effectiveness." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Renal calculi associated with proteus infection?" }, { "role": "assistant", "content": "The correct answer is Urease producing organisms eg :- proteus ,psuedomonas , and staphylococcus , break down urea to produce ammonia and CO2.The urine becomes alkaline which promotes formation of struvite calculi ( magnesium ammonium phosphate ) which grow to become staghorn calculi.E coli never forms struvite stones. Struvite occupying pelvi-calyceal system:- TYPES:1.Complete- occupancy of > 80%of pelvi- calyceal system. 2.Incomplete:- Occupancy of atleast 2 pelvicalyceal system. ref :- Bailey and Love 27th edition .chapter 72 . pg no 1406" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which anticancer drug inhibits dihydrofolate reductase?" }, { "role": "assistant", "content": "The correct answer is Ref: K.D. Tripathi, 6th ed. pg. 823* Methotrexate is one of the oldest and highly efficacious antineoplastic drugs* MOA: It inhibits dihydrofolate reductase (DHFRase)- blocking the conversion of dihydrofolic acid (DHFA) to tetrahydrofolic acid (THFA) which is an essential coenzyme required for one carbon transfer reactions in de novo purine synthesis and amino acid interconversions.* DHFRase inhibitors are: methotrexate, Pemetrexed, Pralatrexate* Vincristine is a mitotic spindle formation inhibitor* Paclitaxel is a spindle breakdown inhibitor* Cisplatin is a platinum based compound." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Costimulatory factor for T cell include all except" }, { "role": "assistant", "content": "The correct answer is CD80 - B7-1 CD86 - B7-2 Co-stimulatory signal Helps in self-tolerance if this signal is impaired: high risk of autoimmune diseases Impoant in pathogenesis of rheumatoid ahritis. Drug - Abatacept blocks co-stimulatory signal CD 40 - CD40L interaction (T-cell) | Class switching of antibodies IgM - Ig G/A/E If CD40-CD40L interaction is impaired= Hyper IgM syndrome Anergy: Lymphocytes that recognize self-antigens may be rendered functionally unresponsive this phenomenon is called as Anergy. Activation of Ag-specific T-cells requires 2 signals. Recognition of peptide-ag in association with self MHC molecules on surface of APCs & a set of co-stimulatory signals from APCs. If Ag is presented to T-cell without adequate levels of co-stimulatory signals the cells become anergic. ." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Comorbidity, Confidence Intervals, Contraception Behavior, Contraceptive Agents, Female, Female, Humans, Linear Models, Medication Adherence, Mental Disorders, Middle Aged, Multivariate Analysis, Odds Ratio, Retrospective Studies, Risk Factors, Substance-Related Disorders, Veterans, Veterans Health, Young Adult." }, { "role": "user", "content": "Do contraceptive adherence among women Veterans with mental illness and substance use disorder? Context: Emerging data suggest that mental illness and substance use disorder (SUD) are important risk factors for inconsistent contraceptive use. We investigated whether mental illness without or with SUD is associated with contraceptive adherence and continuation of hormonal methods among women Veterans. We conducted a retrospective analysis of national Veteran's Administration data among women aged 18-45 with a hormonal contraceptive prescription (pill/patch/ring/injectable) during the first week of fiscal year 2013. We tested associations between mental illness diagnoses (depression, posttraumatic stress disorder, anxiety, bipolar disorder, schizophrenia, adjustment disorder) without or with SUD diagnoses (drug/alcohol abuse) and 12-month contraceptive adherence (number and length of gaps ≥7 days between refills and months of contraceptive coverage) using multivariable regression models. Among 9780 Veterans, 43.6% had mental illness alone, 9.4% comorbid mental illness and SUD, and 47.0% neither diagnosis. In adjusted analyses, compared to women with neither diagnosis, women with mental illness alone had a similar rate of gaps but increased odds of having gaps longer than 30 days [odds ratio (OR): 1.35, 95% confidence interval (CI): 1.10-1.52] and fewer months of contraceptive coverage (β_coefficient: -0.39, 95% CI: -0.56 to -0.23). Women with mental illness and SUD experienced more gaps (incidence rate ratio: 1.12, 95% CI: 1.03-1.21), increased odds of gaps longer than 30 days (OR: 1.46, 95% CI: 1.10-1.79), fewer months of contraceptive coverage (β_coefficient: -0.90, 95% CI: -1.20 to -0.62) and reduced odds of continuous 12-month coverage (adjusted OR: 0.76, 95% CI: 0.63-0.93)." }, { "role": "assistant", "content": "Mental illness, particularly with comorbid SUD, is associated with reduced contraceptive adherence and continuation among women Veterans. Women with these risk factors could potentially benefit from use of long-acting reversible methods. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Sickle cell anemia is due to which type of mutation?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Base substitution mutation Sickle cell anemia is a hereditary hemoglobinopathy, i.e., the type of disease characterized by production of defective hemoglobin. Sickle cell anemia results from mutation in b-globin gene. It is caused by a point mutation (Base substitution mutation) at the sixth position of the b-globin chain leading to subsitution of a valine residue for a glutamic acid residue resulting in sickle hemoglobin (HbS). Sickle cell anemia is an autosomal recessive disorder. If an individual is homozygous for the sickle cell mutation, almost all the hemoglobin in the red cell is HbS. In heterozyogotes, only about 40% of the hemoglobin is HbS, the remainder being normal hemoglobins." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which muscle of larynx is not supplied by recurrent laryngeal nerve?" }, { "role": "assistant", "content": "The correct answer is All intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve except for the cricothyroid which is supplied by the external laryngeal nerve. Ref BDC volume 3;Sixth edition pg 257" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Analysis of Variance, Chi-Square Distribution, Cohort Studies, Depression, Diet Surveys, Dietary Fats, Unsaturated, Docosahexaenoic Acids, Eicosapentaenoic Acid, Fatty Acids, Omega-3, Female, Fish Products, Humans, Longitudinal Studies, Male, Odds Ratio, Regression Analysis, Sex Characteristics, Young Adult." }, { "role": "user", "content": "Is higher dietary intake of long-chain omega-3 polyunsaturated fatty acids inversely associated with depressive symptoms in women? Context: Experimental and observational data suggest that a higher dietary intake of long-chain omega-3 polyunsaturated acids may lead to a decreased risk of depressive disorders. We assessed multivariable-adjusted associations of fish consumption and dietary intakes of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) with depressive symptoms in a population-based sample of 3317 African-American and Caucasian men and women from the Coronary Artery Risk Development in Young Adults study. Diet was assessed in year 7 (1992-1993) and depressive symptoms were measured in years 10 (1995-1996), 15 (2000-2001), and 20 (2005-2006) by the 20-item Center for Epidemiological Studies Depression Scale. Depressive symptoms were defined as a Center for Epidemiological Studies Depression Scale score > or =16 or self-reported use of antidepressant medication. In the entire cohort, the highest quintiles of intakes of EPA (> or =0.03% energy), DHA (> or =0.05% energy), and EPA + DHA (> or =0.08% energy) were associated with a lower risk of depressive symptoms at year 10 (P for trends = 0.16, 0.10, and 0.03, respectively). The observed inverse associations were more pronounced in women. For the total number of occasions with depressive symptoms, the multivariable adjusted odds ratios (95% confidence interval) in women were 0.75 (0.55-1.01) for fish intake, 0.66 (0.50-0.89) for EPA, 0.66 (0.49-0.89) for DHA, and 0.71 (0.52-0.95) for EPA + DHA when comparing the highest with the lowest quintiles. Analyses of continuous Center for Epidemiological Studies Depression Scale scores revealed inverse associations with fourth-root-transformed omega-3 variables in women." }, { "role": "assistant", "content": "Our findings suggest that dietary intakes of fish and long-chain omega-3 fatty acids may be inversely associated with chronic depressive symptoms in women. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Bacterial Infections, Body Fluids, Child, Preschool, Chronic Disease, Cytokines, Humans, Infant, Inflammation, Otitis Media, Recurrence, Virus Diseases, Viruses." }, { "role": "user", "content": "Is inflammation in the middle ear of children with recurrent or chronic otitis media associated with bacterial load? Context: Viral upper respiratory tract infections have been described as an important factor in the development of otitis media (OM), although it is unclear whether they facilitate bacterial OM or can directly cause OM. To clarify the role of viral infections in OM, we compared the relative contribution of viruses and bacteria with the induction of inflammatory cytokine responses in the middle ear of children suffering from OM. Children up to 5 years of age, with recurrent or chronic episodes of OM and scheduled for ventilation tube insertion were enrolled in a prospective study. Middle ear fluids (n = 116) were collected during surgery, and quantitative polymerase chain reaction was performed to detect bacterial and viral otopathogens, that is, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and 15 respiratory viruses. Finally, concentrations of the inflammatory mediators interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-17a and tumor necrosis factor-α were determined. Middle ear fluids were clustered into 4 groups, based on the detection of viruses (28%), bacteria (27%), both bacteria and viruses (27%) or no otopathogens (19%). Bacterial detection was associated with significantly elevated concentrations of cytokines compared with middle ear fluids without bacteria (P < 0.001 for all cytokines tested) in a bacterial load-dependent and species-dependent manner. In contrast, the presence of viruses was not associated with changes in cytokine values, and no synergistic effect between viral-bacterial coinfections was observed." }, { "role": "assistant", "content": "The presence of bacteria, but not viruses, is associated with an increased inflammatory response in the middle ear of children with recurrent or chronic OM. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Antibodies, Monoclonal, Apoptosis, BH3 Interacting Domain Death Agonist Protein, Bile Ducts, Caspase 8, Caspases, Cholestasis, Chronic Disease, Disease Models, Animal, Ligation, Liver, Mice, Phosphorylation, Signal Transduction, fas Receptor." }, { "role": "user", "content": "Is sustained phosphorylation of Bid a marker for resistance to Fas-induced apoptosis during chronic liver diseases? Context: Increased rates of apoptosis have been reported to play a role in the pathophysiology of many disorders, including liver diseases. Conversely, genetic mutations that result in impairment of programmed cell death have been associated with cancer development. However, apoptosis resistance can also be the result of nongenetic stress adaptation, as seen in the cancer-prone metabolic liver disease hereditary tyrosinemia. To clarify whether stress-induced apoptosis resistance is a general feature of chronic liver diseases, an animal model of chronic cholestasis was examined. Studies were performed with mice before and 2 weeks following bile duct ligation and with Fah-/- and Fah/p21-/- mice before and after NTBC withdrawal. Here we show that bile duct ligation induced profound resistance against Fas monoclonal antibody-mediated hepatocyte death. The apoptosis signaling pathway was blocked downstream of caspase-8 activation and proximal to mitochondrial cytochrome c release. In controls, activation of the Fas receptor resulted in rapid dephosphorylation of Bid and its subsequent cleavage, whereas Bid remained phosphorylated and uncleaved in chronic cholestasis and other models of hepatic apoptosis resistance." }, { "role": "assistant", "content": "We propose a model in which the phosphorylation status of Bid determines the apoptotic threshold of hepatocytes in vivo. Furthermore, resistance to apoptosis in chronic cholestasis may contribute to the long-term risk of cancer in this setting. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "During water analysis in a hostel, amoebic cysts were seen. The best step to manage it is –" }, { "role": "assistant", "content": "The correct answer is \"Amoebic infection is spread by ingestion of food or water contaminated with cysts. since an asymptomatic carrier may excrete upto 15 million cysts/day. Prevention of infection requires adequate sanitation and eradication of cyst carriage. In high risk areas infection can be minimized by avoidance of unpeeled fruits and the use of Bottled water.\nBecause cysts are resistant to readily attainable levels of chlorine, disinfection by iodination (Tetraglycine hyperiodide) is recommended.\" - Harrison" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, MATERIALS AND METHODS, RESULTS. Meshes: Computer-Aided Design, Imaging, Three-Dimensional, Lactic Acid, Materials Testing, Polyesters, Polymers, Sterilization, Surgical Instruments." }, { "role": "user", "content": "Three-dimensional printing surgical instruments: are we there yet? Context: The applications for rapid prototyping have expanded dramatically over the last 20 y. In recent years, additive manufacturing has been intensely investigated for surgical implants, tissue scaffolds, and organs. There is, however, scant literature to date that has investigated the viability of three-dimensional (3D) printing of surgical instruments. Using a fused deposition modeling printer, an Army/Navy surgical retractor was replicated from polylactic acid (PLA) filament. The retractor was sterilized using standard Food and Drug Administration approved glutaraldehyde protocols, tested for bacteria by polymerase chain reaction, and stressed until fracture to determine if the printed instrument could tolerate force beyond the demands of an operating room (OR). Printing required roughly 90 min. The instrument tolerated 13.6 kg of tangential force before failure, both before and after exposure to the sterilant. Freshly extruded PLA from the printer was sterile and produced no polymerase chain reaction product. Each instrument weighed 16 g and required only $0.46 of PLA." }, { "role": "assistant", "content": "Our estimates place the cost per unit of a 3D-printed retractor to be roughly 1/10th the cost of a stainless steel instrument. The PLA Army/Navy retractor is strong enough for the demands of the OR. Freshly extruded PLA in a clean environment, such as an OR, would produce a sterile ready-to-use instrument. Because of the unprecedented accessibility of 3D printing technology world wide and the cost efficiency of these instruments, there are far reaching implications for surgery in some underserved and less developed parts of the world." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Intra nuclear inclusion body is exclusively seen in:" }, { "role": "assistant", "content": "The correct answer is Ans. (d) Herpes virusRef: Microbiology by Ananthanarayan and Paniker 8th ed. /444, 453* Inclusion bodies are nuclear or cytoplasmic aggregates of stainable substances, usually proteins. They typically represent sites of viral multiplication in a bacterium or a eukaryotic cell and usually consist of viral capsid proteins.Examples of Viral Inclusion BodiesIntracytoplasmicIntranuclearIntracytoplasmic + Intranuclear* Negri bodies in Rabies* Guarnieri bodies in Small pox* Henderson- Peterson bodies in Molluscum contagiosum* Cowdrytype A in Herpes simplex virus and Varicella zoster virus and Torres bodies in Yellow fever* Cowdrytype B in Polio and adenovirus* Warthin finkeldey bodies in Measles" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, METHODS, RESULTS. Meshes: Case-Control Studies, Dehydration, Female, Hemolytic-Uremic Syndrome, Humans, Infant, Kidney, Male, Patient Admission, Recovery of Function, Retrospective Studies, Risk Factors." }, { "role": "user", "content": "Is dehydration upon admission a risk factor for incomplete recovery of renal function in children with haemolytic uremic syndrome? Context: Haemolytic uremic syndrome (HUS) is the most common cause of acute renal failure and the second leading cause of chronic renal failure in children. The factors that affect incomplete renal function recovery prior to hospital admission are poorly understood. To analyse the risk factors that determine incomplete recovery of renal function prior to hospitalisation in children with HUS. A retrospective case-control study. age, sex, duration of diarrhoea, bloody stools, vomiting, fever, dehydration, previous use of antibiotics, and incomplete recovery of renal function (proteinuria, hypertension, reduced creatinine clearance, and chronic renal failure during follow-up). Patients of both sexes under 15 years of age were included. Of 36 patients, 23 were males (65.3%; 95%CI: 45.8 to 80.9), with an average age of 2.5 ± 1.4 years. Twenty-one patients required dialysis (58%; 95% CI: 40.8 to 75.8), and 13 (36.1%; 95% CI: 19.0 to 53.1) did not recover renal function. In the bivariate model, the only significant risk factor was dehydration (defined as weight loss >5%) [(OR: 5.3; 95% CI: 1.4 to 12.3; P=.0220]. In the multivariate analysis (Cox multiple regression), only dehydration was marginally significant (HR: 95.823; 95% CI: 93.175 to 109.948; P=.085)." }, { "role": "assistant", "content": "Our data suggest that dehydration prior to admission may be a factor that increases the risk of incomplete recovery of renal function during long-term follow-up in children who develop HUS D+. Consequently, in patients with diarrhoea who are at risk of HUS, dehydration should be strongly avoided during outpatient care to preserve long-term renal function. These results must be confirmed by larger prospective studies. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Arthritis, Rheumatoid, Celecoxib, Cricetinae, Cross-Sectional Studies, Cyclooxygenase Inhibitors, Drug Monitoring, Female, Humans, Kidney, Liver, Male, Mesocricetus, Mice, Mice, Inbred C57BL, Middle Aged, Naproxen, Pyrazoles, Pyridoxal Phosphate, Sulfonamides, Vitamin B 6, Vitamin B 6 Deficiency." }, { "role": "user", "content": "Does clinical use of cyclooxygenase inhibitors impair vitamin B-6 metabolism? Context: A low circulating vitamin B-6 concentration, which is an independent risk factor for cardiovascular disease, is commonly seen in human inflammation. We investigated whether cyclooxygenase inhibitors alter vitamin B-6 metabolism. To investigate whether subjects taking a cyclooxygenase inhibitor had an altered vitamin B-6 profile, we conducted a cross-sectional study that involved 150 rheumatoid arthritis patients, with and without cyclooxygenase inhibitor treatments. C57BL/6J mice and hyperlipidemic Syrian hamsters received drug regimens that reflected clinical nonsteroidal antiinflammatory drug (NSAID) uses in treating human inflammation. The impact of long-term physiologic use of selective and nonselective cyclooxygenase inhibitors on vitamin B-6 metabolism was systematically investigated in these independent in vivo models. Patients who were taking cyclooxygenase inhibitors had lower circulating pyridoxal-5'-phosphate, especially those taking NSAIDs >6 mo. Long-term celecoxib and naproxen use reduced hepatic pyridoxal-5'-phosphate in mice. Nonselective cyclooxygenase inhibitor naproxen significantly decreased vitamin B-6 vitamers in the kidney." }, { "role": "assistant", "content": "To our knowledge, we show novel findings that long-term physiologic doses of cyclooxygenase inhibitor may impede the synthesis of the coenzymatically active form of vitamin B-6. Because the cause of vitamin B-6 depletion in inflammation remains unknown, this study provides a potential mechanism that could account for the poor vitamin B-6 status in human inflammation. Moreover, this study further raises concerns about the long-term clinical use of antiinflammatory NSAIDs in humans. Vitamin B-6 status should be carefully monitored in long-term NSAID users. Future randomized placebo-controlled studies are needed to determine the impacts of antiinflammatory cyclooxygenase inhibitor use on vitamin B-6 metabolism in humans. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Cardiac Resynchronization Therapy, Female, Heart Failure, Humans, Male, Middle Aged, Outcome Assessment (Health Care), Prognosis, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity, Treatment Outcome, Ultrasonography, Vascular Resistance, Ventricular Dysfunction, Right." }, { "role": "user", "content": "Can Pulmonary Vascular Resistance Predict Response to Cardiac Resynchronization Therapy in Patients with Heart Failure? Context: To evaluate if pulmonary vascular resistance (PVR) calculated by echocardiography can be a novel criterion to predict the response to cardiac resynchronization therapy (CRT). Forty-five patients with heart failure who underwent CRT were retrospectively analyzed. Based on CRT response, which was defined by a decrease of left ventricular end-systolic volume by at least 15% after 6 months, the patients were assigned to the responder or nonresponder groups. The peak tricuspid regurgitant velocity (TRV) and time velocity integral of the right ventricular outflow tract (TVIRVOT ) were obtained. The relation between TRV, PVR, and CRT response were analyzed using univariate and multivariate analyses. Twenty-seven patients (60%) were responders and 18 patients (40%) were nonresponders to CRT. At baseline, responders had lower PVR (3.57±1.65 vs 2.32 ± 1.28 wood; P = 0.01), or lower PVR1 (3.26 ± 1.32 vs 1.83 ± 0.79 wood; P = 0.01) compared with nonresponders. Multivariate analysis has shown that PVR and PVR1 were independent factors for CRT response. The optimal cutoff point of PVR to predict nonresponse to CRT was 2.39 wood, with a sensitivity of 0.78 and a specificity of 0.81 (95% confidence interval [CI]: 53.4-88.2). The optimal cutoff point of PVR1 calculated by the other model was 3.55 wood, determined at a sensitivity of 0.72 and a specificity of 0.82 (95%CI: 56.7-90.7). In nonresponders, patients demonstrated higher PVR, TVIA , and TVIRVOT , and decreased TRV." }, { "role": "assistant", "content": "PVR could be used to predict response to CRT after 6 months as a novel criterion, and higher PVR may indicate nonresponse." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The main cytokine, involved in erythma nodosum leprosum (ENL) reaction is -" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The clinical feature of normal pressure hydrocephalus is" }, { "role": "assistant", "content": "The correct answer is (D) Gait disturbance # Causes Of Dementia# Normal-pressure hydrocephalus (NPH) is a relatively uncommon syndrome consisting of an abnormal gait (ataxic or apractic), dementia (usually mild to moderate), and urinary incontinence.> Historically, many individuals who have been treated as having NPH have suffered from other dementias, particularly AD, multi- infarct dementia, and DLB.> Neuroimaging findings in NPH are those of a communicating hydrocephalus with a patent aqueduct of Sylvius.> In many cases periventricular edema is present.> Lumbar puncture findings include an opening pressure in the high-normal range and normal CSF protein, sugar concentrations, and cell count.> NPH is presumed to be caused by obstruction to normal flow of CSF over the cerebral convexity and delayed absorption into the venous system.> Indolent nature of the process results in enlarged lateral ventricles but relatively little increase in CSF pressure.> There is presumably stretching and distortion of white matter tracts in the corona radiata, but the exact physiologic cause of the clinical syndrome is unclear." } ]