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[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In a post polio case, iliotibial tract contracture is most likely to result in which of the following?" }, { "role": "assistant", "content": "The correct answer is Iliotibial tract is attached posteriorly and laterally to the axis of the knee joint, its contracture cause flexion of the knee, external rotation and posterior subluxation of tibia. Thus iliotibial contracture can cause flexion deformity of the knee, valgus of the knee, external rotation and posterior subluxation of tibia. Ref: Textbook of Ohopedics and Trauma By GS Kulkarni, Volume 1, 2nd Edition, Pages 567-8 ; Ohopaedics for The Physical Therapist Assistant By Mark Dutton, Page 520" } ]

[ { "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": "Sin of Gomorrah is another name for" }, { "role": "assistant", "content": "The correct answer is BUCCAL COITUS OR COITUS PER OS OR SIN OF GOMORRAH: The male organ is introduced into the mouth of another male or female usually children. Rarely faint teeth marks and abrasions may be present on the penis. Death may occur due to aspiration of semen, or impaction of the penis in the respiratory tract or stomach. Buccal swabs should be taken which are useful only up to 9 hours. REF: THE SYNOPSIS OF FORENSIC MEDICINE AND TOXICOLOGY 29th edition page no: 225." } ]

[ { "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: Breast Neoplasms, Databases, Factual, Disease Progression, Female, Gene Expression, Humans, Lymphatic Metastasis, Matrix Attachment Region Binding Proteins, Neoplasm Staging, Odds Ratio, Prognosis, Receptor, ErbB-2, Receptors, Estrogen, Receptors, Progesterone." }, { "role": "user", "content": "Is sATB1 Correlated with Progression and Metastasis of Breast Cancers : A Meta-Analysis? Context: Several researches have evaluated the significance of SATB1 (Special AT-rich sequence binding protein 1) expression in breast cancers (BCs), but the results have been disputed, especially in the aspects of clinicopathological features and prognosis. Therefore, our study aimed to use a meta-analysis to summarize the clinical and prognostic relevance of SATB1 gene expression in BCs. A literature search of PubMed, EMBASE, Cochrane library, Chinese Wanfang and CNKI was performed to identify eligible studies. Ten studies total, comprising 5,185 patients (1,699 SATB1-positive and 3,486 SATB1-negative), were enrolled in our study, which was performed using Revman5.3 Software and Stata11.0 Software. This meta-analysis showed that the expression of SATB1 was significantly higher in breast cancer than in normal tissues (OR = 12.28; 95%CI = 6.01-25.09), and was statistically related to several clinicopathological parameters, including lymph node metastasis (OR = 1.55, 95%CI = 1.01-2.39) and Tumor Node Metastasis(TNM) stage (OR = 0.35, 95%CI = 0.22-0.56). However, the level of SATB1 was not statistically associated with the age (OR = 1.13, 95%CI = 0.87-1.46), tumour size (OR = 0.72, 95%CI = 0.44-1.19), estrogen receptor (OR = 0.78, 95%CI = 0.55-1.09), progesterone receptor (OR = 0.64, 95%CI = 0.32-1.29), HER2 status (OR=1.98, 95%CI = 0.74-5.30), and histological type (OR = 0.49, 95%CI = 0.22-1.11)." }, { "role": "assistant", "content": "High expression of SATB1 was significantly correlated with tumourigenesis and metastasis of BCs, indicating poor prognosis for patients. SATB1 could serve as a potential marker for detection and prognosis evaluation of breast cancers. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Apoptosis, Cell Death, Female, Kidney, Male, Mice, Urinary Tract, Wolffian Ducts." }, { "role": "user", "content": "Does cell death serve as a single etiological cause of a wide spectrum of congenital urinary tract defects? Context: We genetically disrupted the wolffian duct in mice to study the affected organogenesis processes and to test the hypothesis that cell loss can be the developmental basis for a wide spectrum of congenital anomalies in the kidney and urinary tract. We used Hoxb7-Cre transgenic lines (HC1 and HC2) to induce diphtheria toxin production from a ROSA(DTA) allele, disrupting the wolffian duct and derivatives. The first set of mutants (HC1;ROSA(DTA/+)) exhibited agenesis of the kidney, ureter and reproductive tracts. The second set of mutants (HC2;ROSA(DTA/+)) exhibited diverse defects, including renal agenesis/hypoplasia, hydronephrosis, hydroureter, ureter-vas deferens fistulas in males and ureter-oviduct/uterus fistulas in females. The phenotypic differences correspond to the degree of apoptosis induced caudal truncation of the wolffian duct, which is less severe and more variable in HC2;ROSA(DTA/+) mice. Whenever the wolffian duct failed to reach the urogenital sinus, the ureter failed to separate from the wolffian duct, suggesting that ureteral migration along the common nephric duct to the cloaca and the subsequent common nephric duct degeneration constitute the only pathway for separating the ureter and wolffian duct derivatives." }, { "role": "assistant", "content": "The diverse and severe defects observed emphasize the central role of the wolffian duct in providing progenitors and signals for urogenital development. These results also indicate that the quantitative difference in cell death induced caudal truncation of the wolffian duct can lead to a wide range of qualitatively distinct defects, and that cell death can serve as a single etiological cause of a wide spectrum of congenital kidney and urinary tract defects. 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": "Post traumatic stress syndrome is due to :" }, { "role": "assistant", "content": "The correct answer is Post - traumatic stress disorder occurs after on extreme traumatic events involving the threat of personal death or injury." } ]

[ { "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: Adenosine A2 Receptor Antagonists, Animals, Apoptosis, Glaucoma, Hydrostatic Pressure, Inflammation, Lipopolysaccharides, Models, Animal, Neuroprotective Agents, Nitric Oxide, Organ Culture Techniques, Pyrimidines, Rats, Rats, Wistar, Retinal Ganglion Cells, Triazoles." }, { "role": "user", "content": "Does adenosine A2AR blockade prevent neuroinflammation-induced death of retinal ganglion cells caused by elevated pressure? Context: Elevated intraocular pressure (IOP) is a major risk factor for glaucoma, a degenerative disease characterized by the loss of retinal ganglion cells (RGCs). There is clinical and experimental evidence that neuroinflammation is involved in the pathogenesis of glaucoma. Since the blockade of adenosine A2A receptor (A2AR) confers robust neuroprotection and controls microglia reactivity in the brain, we now investigated the ability of A2AR blockade to control the reactivity of microglia and neuroinflammation as well as RGC loss in retinal organotypic cultures exposed to elevated hydrostatic pressure (EHP) or lipopolysaccharide (LPS). Retinal organotypic cultures were either incubated with LPS (3 μg/mL), to elicit a pro-inflammatory response, or exposed to EHP (+70 mmHg), to mimic increased IOP, for 4 or 24 h, in the presence or absence of the A2AR antagonist SCH 58261 (50 nM). A2AR expression, microglial reactivity and neuroinflammatory response were evaluated by immunohistochemistry, quantitative PCR (qPCR) and enzyme-linked immunosorbent assay (ELISA). RGC loss was assessed by immunohistochemistry. In order to investigate the contribution of pro-inflammatory mediators to RGC loss, the organotypic retinal cultures were incubated with rabbit anti-tumour necrosis factor (TNF) (2 μg/mL) and goat anti-interleukin-1β (IL-1β) (1 μg/mL) antibodies. We report that the A2AR antagonist (SCH 58261) prevented microglia reactivity, increase in pro-inflammatory mediators as well as RGC loss upon exposure to either LPS or EHP. Additionally, neutralization of TNF and IL-1β prevented RGC loss induced by LPS or EHP." }, { "role": "assistant", "content": "This work demonstrates that A2AR blockade confers neuroprotection to RGCs by controlling microglia-mediated retinal neuroinflammation and prompts the hypothesis that A2AR antagonists may be a novel therapeutic option to manage glaucomatous disorders. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Age Factors, Aged, Aged, 80 and over, Cohort Studies, Female, Hip Fractures, Humans, Incidence, Length of Stay, Male, Middle Aged, Recovery of Function, Retrospective Studies, Risk Factors, Trauma Centers, Treatment Outcome." }, { "role": "user", "content": "Do simultaneous bilateral hip fractures in a level I trauma center? Context: Hip fractures are a common occurrence among the population today, especially in the elderly. However, the incidence of simultaneous bilateral hip fractures is very rare, and there is a paucity of data in the current literature documenting patients with these hip fractures. A retrospective case review was performed on all patients treated for hip fractures during the past ten years at our Level I trauma center. From 1993 to 2002 there were eight patients who sustained simultaneous bilateral hip fractures. The mean age of the patients was 63 years (range, 34-88 years). The overall survival rate was 63%. In the patients of age group younger than 65, the survival rate was three out of four (75%). In the patients of age group 65 and older, the survival rate was two of four (50%). The length of hospital stay was shorter on average for the younger population, 19 days (range, 17-27 days). The average hospital duration for the older population was 29 days (range, 28-30)." }, { "role": "assistant", "content": "Bilateral hip fractures are usually the result of a high-energy trauma and are associated with other injuries. The morbidity and mortality of this injury are quite high. Patient age, associated injuries, and comorbid conditions should be examined closely because they may influence the patient's recovery. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A patient after heavy drinking of alcohol presents with too much vomiting & haematemesis. Most likely diagnosis could be: March 2012, March 2013" }, { "role": "assistant", "content": "The correct answer is Ans: A i.e. Mallory Weiss syndromeEsophagus disorders & presentationIn Mallory Weiss syndrome, vigorous vomiting produces a veical split in gastric mucosa, immediately below the squamo-columnar junction at the cardia in 90% of cases. The condition presents with haematemesisMost oesophageal neoplasms presents with mechanical symptoms, principally dysphagia, but sometimes also regurgitation, vomiting, odynophagia & weight lossAchalsia cardia presents with dysphagia, although pain (often mistaken for reflux) is common in the early stages.In Boerhaave's syndrome, vomiting occurs against a closed glottis, and pressure builds up in the oesophagus" } ]

[ { "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: Abdominal Cavity, Animals, Diet, Endometriosis, Female, Flavonoids, Humulus, Mesentery, Mice, Mice, Inbred BALB C, Neovascularization, Pathologic, Peritoneal Diseases, Phytotherapy, Propiophenones, Uterus." }, { "role": "user", "content": "Does xanthohumol inhibit growth and vascularization of developing endometriotic lesions? Context: Xanthohumol is a prenylated flavonoid isolated from hops, which is known to act as a pleiotropic cancer chemopreventive agent owing to its anti-proliferative, anti-inflammatory and anti-angiogenic properties. In the present study, we analyzed, for the first time, whether this dietary compound may also be used for the treatment of endometriosis. Peritoneal and mesenteric endometriotic lesions were surgically induced in BALB/c mice by uterine tissue transplantation into the abdominal cavity. The animals were treated daily with 100 µM xanthohumol (n= 8) or vehicle (control, n= 8) via the drinking water, starting 3 days before tissue transplantations. Lesion growth, cyst formation and vascularization were subsequently analyzed by means of high-resolution ultrasound imaging (at Day 0 and then once per week for 28 days), caliper measurements, western blotting, histology and immunohistochemistry over 4 weeks. In the treatment and control groups, uterine grafts developed typical endometriotic lesions with cyst-like dilated glands surrounded by a vascularized endometrial stroma. However, xanthohumol efficiently decreased the size of these lesions at Day 28, independent of their localization within the peritoneal cavity, compared with control (peritoneal: P =0.041; mesenteric: P =0.038). This was associated with a reduced level of phosphoinositide 3-kinase protein. Moreover, vascularization of xanthohumol-treated lesions was suppressed, as indicated by a significantly lower microvessel density at Day 28 when compared with vehicle-treated controls (peritoneal: P =0.026; mesenteric: P =0.004). Additional analyses revealed that treatment with xanthohumol did not affect the histomorphology, proliferation and vascularization of the uterine horns and ovaries." }, { "role": "assistant", "content": "Taken together, these experimental findings suggest that xanthohumol inhibits the development of endometriotic lesions in mice without inducing serious side effects in the reproductive organs. Thus, xanthohumol represents a promising dietary phytochemical that, after further testing, may be considered for the use in the selective treatment of endometriotic lesions. 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, Angiogenesis Inducing Agents, Female, Fetal Blood, Humans, Labor, Obstetric, Linear Models, Placenta, Placenta Growth Factor, Pre-Eclampsia, Pregnancy, Pregnancy Proteins, Reference Values." }, { "role": "user", "content": "Is preeclampsia associated with reduced serum levels of placenta growth factor? Context: Adequate vascular development of the placental bed is essential for normal pregnancy. We assessed serum levels of placenta growth factor, an angiogenic factor, throughout normal pregnancy and determined its association with preeclampsia. Serum samples were collected from (1) 308 healthy pregnant women throughout normal gestation, (2) at delivery from 30 each gestational age-matched patients with normal pregnancy and preeclampsia, and (3) maternal and cord blood samples from normal deliveries with and without labor (n = 37 each). Placenta growth factor levels were determined with an antigen-capture enzyme-linked immunosorbent assay. Maternal placenta growth factor levels during normal pregnancy increased from the first trimester to the late second trimester; they subsequently declined from 30 weeks' gestation to delivery. Significantly less maternal placenta growth factor (P <.0001) was found in pregnancies complicated by preeclampsia, and labor significantly lowered placenta growth factor levels in both maternal (P =.0189) and cord serum samples (P <.0001)." }, { "role": "assistant", "content": "Decreased levels of placenta growth factor during preeclampsia could influence endothelial cell and trophoblast function, thereby contributing to the pathogenesis of the 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: BACKGROUND, RESULTS. Meshes: Animals, Case-Control Studies, Child, Child, Preschool, Female, Humans, Immunity, Innate, Interleukin-13, Interleukin-5, Leukocytes, Mononuclear, Lymphocytes, Male, Schistosoma haematobium, Schistosomiasis haematobia, Th2 Cells." }, { "role": "user", "content": "Are group 2 innate lymphoid cell proportions diminished in young helminth infected children and restored by curative anti-helminthic treatment? Context: Group 2 Innate lymphoid cells (ILC2s) are innate cells that produce the TH2 cytokines IL-5 and IL-13. The importance of these cells has recently been demonstrated in experimental models of parasitic diseases but there is a paucity of data on ILC2s in the context of human parasitic infections and in particular of the blood dwelling parasite Schistosoma haematobium. In this case-control study human peripheral blood ILC2s were analysed in relation to infection with the helminth parasite Schistosoma haematobium. Peripheral blood mononuclear cells of 36 S. haematobium infected and 36 age and sex matched uninfected children were analysed for frequencies of ILC2s identified as Lin-CD45+CD127+CD294+CD161+. ILC2s were significantly lower particularly in infected children aged 6-9 years compared to healthy participants. Curative anti-helminthic treatment resulted in an increase in levels of the activating factor TSLP and restoration of ILC2 levels." }, { "role": "assistant", "content": "This study demonstrates that ILC2s are diminished in young helminth infected children and restored by removal of the parasites by treatment, indicating a previously undescribed association between a human parasitic infection and ILC2s and suggesting a role of ILC2s before the establishment of protective acquired immunity in human schistosomiasis. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In a burns ward, there is a staphylococcus infection to many patients. Where would the staphylococcus be colonized at?" }, { "role": "assistant", "content": "The correct answer is ANSWER: (B) NoseREF: Jawetz Microbiology, 24th Ed Ch. 14Staphylococci are ubiquitous human parasites. The chief sources of infection are shedding human lesions, fomites contaminated from such lesions, and the human respiratory tract and skin. Contact spread of infection has assumed added importance in hospitals, where a large proportion of the staff and patients carry antibiotic-resistant staphylococci in the nose or on the skin. Although cleanliness, hygiene, and aseptic management of lesions can control the spread of staphylococci from lesions, few methods are available to prevent the wide dissemination of staphylococci from carriers. Aerosols (eg, glycols) and ultraviolet irradiation of air have little effect.To diminish transmission within the hospital setting, high risk patients, such as those in intensive care units and patients transferred from chronic care facilities where prevalence is high, are frequently surveyed for anterior nares colonization. Patients who test positive by culture or PCR are placed upon contact precautions so as to minimize spread on the hands of health care workers. Health care workers should strictly adhere to infection control policies by wearing gloves and washing hands before and after patient contact.Rifampin coupled with a second oral antistaphylococcal drug sometimes provides long - term suppression and possibly cure of nasal carriage; this form of therapy is usually reserved for major problems of staphylococcal carriage, because staphylococci can rapidly develop resistance to rifampin." } ]

[ { "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": "What is the intubation dose of pancuronium?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., 0.1 mg/kg Dose, speed of onset and duration of neuromuscular blocking drugsDrugDose (mg/Kg)Onset time (min)Duration(min)Succinylcholine1.0-1.5< 15-10Tubocurarine0.53-530-50Atracurium0.52-320-30Cisatracurium0.12-330-40Mivacurium0.15-0.202-310-20Pancuronium0.13-540-60Vecuronium0.12-320-30Rocuronium0.61-230-40" } ]

[ { "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": "Obesity Index defined as Height (cm) - 100" }, { "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": "Most common cause of food poisoning in west" }, { "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: Aged, Aneurysm, Dissecting, Aortic Aneurysm, Case-Control Studies, Hospital Mortality, Humans, Incidence, Intraoperative Care, Middle Aged, Paraplegia, Postoperative Complications, Retrospective Studies, Risk Factors." }, { "role": "user", "content": "Paraplegia after thoracoabdominal aortic aneurysm repair: is dissection a risk factor? Context: The association between aortic dissection and paraplegia or paraparesis (P/P) after thoracoabdominal aortic aneurysm repair is not clear. Six hundred sixty patients underwent thoracoabdominal aortic aneurysm repair from 1986 through 1995 using selective atriodistal bypass, liberal reattachment of critical intercostal arteries, moderate heparinization, and permissive mild hypothermia. Dissection was present in 163 patients (24.7%) and absent in 497 (75.3%). Early mortality occurred in 7.4% overall, and did not differ between patients with nondissection, acute dissection, or chronic dissection. The incidence of P/P was 5.4% overall, 5.5% without dissection, and 5.0% with dissection. The risk of P/P for acute versus chronic dissection was 19% versus 2.9%, respectively (p = 0.011). Rupture and Crawford extent II were predictive of the development of P/P. In patients at high risk for P/P (ie, Crawford extent I or II), atriodistal bypass reduced the intercostal artery ischemic time, and reattachment of critical intercostal arteries (T8 to L1) reduced the incidence of P/P." }, { "role": "assistant", "content": "Acute dissection increases the risk of P/P after thoracoabdominal aortic aneurysm repair; using contemporary methods, however, chronic dissection does not increase the risk of postoperative P/P. Critical intercostal artery reattachment and atriodistal bypass are beneficial in patients undergoing extensive repairs." } ]

[ { "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 lady with CA ovary in follow-up with raised CA125 level nextstep;" }, { "role": "assistant", "content": "The correct answer is <p> - positron emission tomography is a functional diagnostic imaging technique, taking note of the fact that malignant cells have a greater glycolysis as ccompared to normal tissue. - it helps in staging , management and follow up of cancer growth. - it is now used in diagnosis of cancer in its early stage, detect its extent and severity. Reference : Shaw&;s textbook of gynaecology,16th edition, pg no: 120 <\\p>" } ]

[ { "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": "Vitamin B6 deficiency cause increased excretion of" }, { "role": "assistant", "content": "The correct answer is Vit B6 deficiency causes increased excretion of Xanthurenic acid.Pyridoxal phosphate is required for the synthesis of niacin from tryptophan (one vitamin is necessary for synthesis of another vitamin) (Figs17.8 and 17.9). 3-hydroxy kynurenine - 3-hydroxy anthranilic acid (Enzyme Kynureninase). Kynureninase is a PLP dependent enzyme. Hence in vitamin B6 deficiency niacin production is less. Moreover, kynurenine cannot be conveed fuher, which is metabolized to xanthurenic acid and excreted through urine. The metabolic disorders which respond to vitamin B6 therapy are xanthurenic aciduria and homocystinuria.Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 397" } ]

[ { "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, Antineoplastic Agents, Hormonal, Biological Availability, Breast Neoplasms, Case-Control Studies, Enzyme-Linked Immunosorbent Assay, Female, Humans, Insulin-Like Growth Factor Binding Protein 1, Insulin-Like Growth Factor Binding Protein 3, Insulin-Like Growth Factor I, Middle Aged, Research Design, Statistics, Nonparametric, Tamoxifen, Time Factors." }, { "role": "user", "content": "Is iGF status altered by tamoxifen in patients with breast cancer? Context: An increased concentration of insulin-like growth factor 1 (IGF-1) is an independent risk factor for premenopausal breast cancer. Tamoxifen is thought initially to reduce concentrations of IGF-1 and increase concentrations of the IGF binding proteins. The aim of this study was to compare concentrations of IGF-1, IGF binding protein 1 (IGF-BP1), and IGF-BP3 in patients with breast cancer (n = 14) with those seen in control subjects (n = 23) and to assess the effect of tamoxifen on IGF status in these patients. Non-fasting blood samples were collected from patients with breast cancer before surgery and after nine, 18, and 27 months of tamoxifen treatment. The baseline concentrations were compared with those of age and sex matched healthy control subjects. IGF-1, IGF-BP3, and IGF-BP1 concentrations were not significantly different in cases and controls. Tamoxifen treatment significantly increased IGF-BP1 after 18 and 27 months (baseline: mean, 21.6 ng/ml; SD, 16.6; 18 months: mean, 52.0 ng/ml; SD, 41.8; p = 0.019; 27 months: mean, 40.7 ng/ml; SD, 24.9; p = 0.043) and IGF-BP3 after nine, 18, and 27 months (baseline: mean, 3119 ng/ml; SD, 507; nine months: mean, 3673 ng/ml; SD, 476; p = 0.004; 18 months: mean, 3445 ng/ml; SD, 634; p = 0.034; 27 months: 3409 ng/ml; SD, 501; p = 0.043) when compared with baseline values. IGF-1 was not altered significantly from baseline at any time point. However, the IGF-1 to IGF-BP3 ratio was significantly decreased at both nine and 18 months (baseline: mean, 0.058; SD, 0.014; nine months: mean, 0.039; SD, 0.008; p = 0.033; 18 months: mean, 0.044; SD, 0.012; p = 0.01). This ratio was not significantly different from baseline at 27 months (mean, 0.054; SD, 0.01; p = 0.08)." }, { "role": "assistant", "content": "Tamoxifen increases IGF-BP3 and IGF-BP1 concentrations. It also decreases the IGF-1 to IGF-BP3 ratio but this effect may be limited after long term use. Longer follow up, with larger numbers of patients, should determine when, and for how long, tamoxifen can reduce circulating IGF-1. 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: Aggressive Periodontitis, Alleles, Brazil, Chromosome Segregation, Female, Gene Frequency, Genetic Heterogeneity, Genetic Predisposition to Disease, Genetic Variation, Genotype, Heterozygote, Humans, Likelihood Functions, Male, Models, Genetic, Pedigree, Phenotype." }, { "role": "user", "content": "Is aggressive periodontitis likely influenced by a few small effect genes? Context: To evaluate the inheritance mode of aggressive periodontitis in a collection of families with a similar geographic origin. Segregation analysis was performed in pedigree data from 74 families by the use of the SEGREG program of SAGE v.5.4.2. Homogeneous no transmission, homogeneous Mendelian transmission, homogeneous general transmission, semi-general transmission and heterogeneous general transmission models were tested assuming the prevalence of aggressive periodontitis as 1% and no deviations from Hardy-Weinberg equilibrium. The parameters of the model were estimated by the method of maximum likelihood, which provides the overall ln (likelihood), -2ln and the AIC (Akaike's score) for each model. The likelihood ratio test (LRT) was used to compare each model against a fully general model (p>0.05). The most parsimonious mode of inheritance was the semi-general transmission model that allows the heterozygote transmission probability to vary." }, { "role": "assistant", "content": "This result provides strong support for the hypothesis that genetic factors play a role in aggressive periodontitis and that a few loci, each with relatively small effects, contribute to aggressive periodontitis, with or without interaction with environmental factors. 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: Aged, Aged, 80 and over, Electrocardiography, Female, Heart Conduction System, Humans, Logistic Models, Long QT Syndrome, Male, Middle Aged, ROC Curve, Risk Factors, Sensitivity and Specificity, Torsades de Pointes." }, { "role": "user", "content": "Is fragmented QRS associated with torsades de pointes in patients with acquired long QT syndrome? Context: Acquired long QT syndrome (LQTS) is a disease due to a secondary repolarization abnormality induced by various predisposing factors. In contrast to congenital LQTS, risk factors that produce acquired LQTS include organic heart diseases that often exhibit depolarization abnormality. Although various repolarization parameters have been evaluated in acquired LQTS, the existence of depolarization abnormality in association with torsades de pointes (TdP) has not been reported. The purpose of this study was to evaluate both repolarization (QT components) and depolarization parameters (fragmented QRS [fQRS]) in acquired LQTS patients with markedly prolonged QT interval. Seventy patients with acquired severe QT prolongation (QTc ≥ 550 ms) were studied. Thirty-two patients had syncope or TdP (syncope group). Thirty-eight patients did not have any symptoms (asymptomatic group). The existence of fQRS and QT components (QT, QTc, Tpe [interval between peak and end of T wave] intervals, and U-wave voltage) was analyzed. The syncope group had more frequent fQRS (81%) than did the asymptomatic group (21%, P < .01) and the incidence of fQRS was not different before and after removal of predisposing factors. The incidence of organic heart disease was not different between the two groups. No differences in QTc interval were noted between the syncope and asymptomatic groups, although the syncope group had longer QT and Tpe intervals and higher U wave than the asymptomatic group (P < .01)." }, { "role": "assistant", "content": "Acquired predisposing factors promoted repolarization abnormality (especially prolongation of QT and Tpe intervals), and the existence of fQRS had an important role in the development of TdP in patients with acquired LQTS. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Antidepressive Agents, Second-Generation, Azabicyclo Compounds, Depressive Disorder, Major, Double-Blind Method, Eszopiclone, Female, Fluoxetine, Humans, Hypnotics and Sedatives, Male, Middle Aged, Piperazines, Psychiatric Status Rating Scales, Severity of Illness Index, Sleep Initiation and Maintenance Disorders, Suicidal Ideation, Young Adult." }, { "role": "user", "content": "Is insomnia severity an indicator of suicidal ideation during a depression clinical trial? Context: Insomnia has been linked to suicidal ideas and suicide death in cross-sectional and longitudinal population-based studies. A link between insomnia and suicide has not been previously examined in the setting of a clinical trial. Herein we describe the relationship between insomnia and suicidal thinking during the course of a clinical trial for depression with insomnia. Sixty patients aged 41.5±12.5 years (2/3 women) with major depressive episode and symptoms of insomnia received open-label fluoxetine for 9 weeks and also received blinded, randomized eszopiclone 3mg or placebo at bedtime after the first week of fluoxetine. Insomnia symptoms were assessed with the Insomnia Severity Index (ISI), and suicidal ideation was assessed with The Scale for Suicide Ideation (SSI). Depression symptoms were assessed with the depressed mood item and the anhedonia item from the Hamilton Rating Scale for Depression-24 (HRSD24), as well as a sum score for all non-sleep and non-suicide items from the HRSD (HRSD20). Measurements were taken at baseline and weeks 1, 2, 4, 6, and 8. SSI was examined by generalized linear mixed models for repeated measures as the outcome of interest for all 60 participants with ISI and various mood symptoms as independent variables, with adjustment for age, gender, treatment assignment, and baseline SSI. Higher levels of insomnia corresponded to significantly greater intensity of suicidal thinking (p<0.01). The depressed mood item of the HRSD, and the sum of the HRSD20, both corresponded to greater suicidal thinking (p<0.001). The anhedonia item did not correspond with suicidal thinking. When both ISI and the depressed mood item, or ISI and the anhedonia item, were included together in the same model, the ISI remained an independent predictor of suicidal thinking." }, { "role": "assistant", "content": "The results support the concept that insomnia may be a useful indicator for suicidal ideation and now extend this idea into clinical trials. Insomnia remains an independent indicator of suicidal ideation, even taking into account the core symptoms of depression such as depressed mood and anhedonia. The complaint of insomnia during a depression clinical trial might indicate that more direct questioning about suicide is warranted. 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: Adaptor Proteins, Signal Transducing, Cytoskeletal Proteins, DNA, Female, Follow-Up Studies, Genetic Predisposition to Disease, Genome-Wide Association Study, Genotype, Humans, In Vitro Techniques, Male, Middle Aged, Polymorphism, Genetic, Pulmonary Disease, Chronic Obstructive, Pulmonary Emphysema, Spirometry, Tomography, X-Ray Computed." }, { "role": "user", "content": "Does genome-wide association study identify BICD1 as a susceptibility gene for emphysema? Context: chronic obstructive pulmonary disease (COPD), characterized by airflow limitation, is a disorder with high phenotypic and genetic heterogeneity. Pulmonary emphysema is a major but variable component of COPD; familial data suggest that different components of COPD, such as emphysema, may be influenced by specific genetic factors. to identify genetic determinants of emphysema assessed through high-resolution chest computed tomography in individuals with COPD. we performed a genome-wide association study (GWAS) of emphysema determined from chest computed tomography scans with a total of 2,380 individuals with COPD in three independent cohorts of white individuals from (1) a cohort from Bergen, Norway, (2) the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) Study, and (3) the National Emphysema Treatment Trial (NETT). We tested single-nucleotide polymorphism associations with the presence or absence of emphysema determined by radiologist assessment in two of the three cohorts and a quantitative emphysema trait (percentage of lung voxels less than -950 Hounsfield units) in all three cohorts. we identified association of a single-nucleotide polymorphism in BICD1 with the presence or absence of emphysema (P = 5.2 × 10(-7) with at least mild emphysema vs. control subjects; P = 4.8 × 10(-8) with moderate and more severe emphysema vs. control subjects)." }, { "role": "assistant", "content": "our study suggests that genetic variants in BICD1 are associated with qualitative emphysema in COPD. Variants in BICD1 are associated with length of telomeres, which suggests that a mechanism linked to accelerated aging may be involved in the pathogenesis of emphysema. Clinical trial registered with www.clinicaltrials.gov (NCT00292552). 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": "Percentage of Halothane metabolized -" }, { "role": "assistant", "content": "The correct answer is The extent and location of inhaled anesthetic metabolism depends on multiple chemical factors. Inhaled anesthetics undergo varying degrees of biotransformation in various tissues. Methoxyflurane undergoes by far the greatest metabolism, estimated at 70%, and experiments indicate that only a small fraction of drug taken up into body tissues is exhaled. Given the remarkable lipophilicity of methoxyflurane, respiratory clearance of this drug from muscle and fat extends over a period of days. Halothane is the next most lipophilic drug and ranks second in metabolic clearance. Thus, prolonged residence in body tissues is an impoant factor in the biotransformation of inhaled anesthetics. Chemical stability is another impoant factor. Of the major organs involved in anesthetic biotransformation, the liver and kidneys are exposed to the highest metabolite concentrations and thus are most susceptible to damage from toxic metabolites. Clinically significant hepatotoxicity is primarily associated with exposure to halothane, and nephrotoxicity is associated with methoxyflurane. Ref: Miller's anesthesia 8th edition" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Age Factors, Biomarkers, Calcifediol, Child, Child, Preschool, Chronic Disease, Dietary Supplements, Eczema, Female, Humans, Immunoglobulin E, Infant, Male, Rome, Severity of Illness Index, Time Factors, Treatment Outcome." }, { "role": "user", "content": "Do serum Vitamin D levels and Vitamin D supplementation correlate with the severity of chronic eczema in children? Context: Eczema is one of the most common chronic inflammatory skin diseases, affecting about 20% of children. The pathogenic mechanisms of eczema are still not fully understood, and current treatment of moderate-severe eczema is often difficult. Recently, it has been suggested that Vitamin D plays a key role in this disease, even if mechanisms are only partially known. The purpose of our study was to assess the 25-Hydroxyvitamin D serum levels in a pediatric population suffering from chronic eczema (IgE-mediated and non-IgE-mediated), and to correlate these phenotypes with the SCORAD severity and selected clinical and biological parameters. Moreover, we aimed to evaluate whether a supplementation of Vitamin D3 could affect the same clinical and laboratory parameters. 89 children with chronic eczema were enrolled in the study. Severity of eczema was assessed with the SCORAD index. Past and present history was taken, and patients were divided into two groups according to the state of sensitization. According to a randomization schedule, the enrolled children were assigned to the following groups: supplementation group, which received a daily oral Vitamin D3 supplementation (2000 IUs) for 3 months; control group which received no supplementation. Vitamin D concentrations in patients with moderate and severe eczema were not statistically different from Vitamin D concentration detected in the serum of patients with mild eczema. Furthermore, we did not find any correlation between Vitamin D levels, total IgEs and SCORAD index, both in the Sensitized and in the Not-Sensitized group. The Vitamin D3 supplementation did not influence the SCORAD severity or the total IgEs concentration." }, { "role": "assistant", "content": "To our knowledge, our study is the first one that shows no correlation between serum levels of Vitamin D, eczema severity and IgE sensitization in a pediatric population suffering from chronic eczema. 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": "Lowest projection of ligamentum denticulatum lies at which level of spinal nerves" }, { "role": "assistant", "content": "The correct answer is First tooth of ligamentum denticulatum is at the level of foramen magnum, last between T12-L1 Ref: Gray's39e/p227" } ]

[ { "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": "SVC develops from:" }, { "role": "assistant", "content": "The correct answer is Ans. A. Right anterior cardinal veinSuperior vena cava- Developmental it consists of two parts: first and second. The first part develops from the right anterior cardinal vein caudal to the oblique transverse anastomosis. The second part develops from the right common cardinal vein.As the right common cardinal vein opens into the right horn of sinus venosus, the superior vena cava at first opens into the right horn of sinus venosus. As and when the right horn of sinus venosus is absorbed into the right atrium, the superior vena cava finally opens into the right atrium." } ]

[ { "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: Age Factors, Allergens, Animals, Australia, Child, Child, Preschool, Eczema, Female, Follow-Up Studies, Humans, Hypersensitivity, Infant, Infant, Newborn, Male, Predictive Value of Tests, Pyroglyphidae, Respiratory Sounds, Skin Tests." }, { "role": "user", "content": "Does house dust mite sensitization in toddlers predict current wheeze at age 12 years? Context: Identification of children at risk of developing asthma provides a window of opportunity for risk-reducing interventions. Allergen sensitization might identify high-risk children. We sought to determine whether skin prick tests (SPTs) to individual allergens up to age 2 years predict wheeze at age 12 years. In a birth cohort of 620 children oversampled for familial allergy, sensitization was assessed by using SPTs (monosensitized, polysensitized, or either) to 6 allergens at ages 6, 12, and 24 months. Wheeze and eczema were recorded 18 times during the first 2 years. Current wheeze was recorded at age 12 years. Adjusted associations were evaluated by multiple logistic regression. A positive SPT to house dust mite (HDM) at age 1 or 2 years predicted wheeze at age 12 years (adjusted odds ratio: 1 year, 3.31 [95% CI 1.59-6.91]; 2 years, 6.37 [95% CI, 3.48-11.66]). Among wheezy 1-year-olds, those who were HDM sensitized had a 75% (95% CI, 51% to 91%) probability of wheeze at age 12 years compared with a 36% (95% CI, 23% to 50%) probability among those not sensitized. Among eczematous 1-year-olds, those who were HDM sensitized had a 67% (95% CI, 45% to 84%) probability of wheeze at age 12 years compared with a 35% (95% CI, 25% to 45%) probability among those not sensitized. Among 1-year-old children with both eczema and wheeze, the probability of wheeze at age 12 years was 64% (95% CI, 35% to 87%) if HDM sensitized and 50% (95% CI, 26% to 74%) if not." }, { "role": "assistant", "content": "HDM sensitization at age 1 or 2 years in wheezing and eczematous children at increased familial allergy risk predicts asthma and may inform management of these high-risk groups. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Drug used for common cold that can cause stroke is?" }, { "role": "assistant", "content": "The correct answer is ANSWER: (A) PhenylpropanolamineREF: Harrison's 18th ed Chapter 370. Cerebrovascular DiseasesPhenylpropanolamine is a psychoactive drug of the phenethylamine and amphetamine chemical classes which is used as a stimulant, decongestant, and anorectic agentIt is commonly used in prescription and over-the-counter cough and cold preparations.Its used is associated hemorrhagic stroke" } ]

[ { "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: Adipose Tissue, Adult, Bone Regeneration, Cell Differentiation, Culture Media, Electromagnetic Fields, Gene Expression, Humans, Lipid Metabolism, Mesenchymal Stem Cells, Middle Aged, Neuroglia, Neurons, Osteogenesis." }, { "role": "user", "content": "Does pulsed magnetic therapy increase osteogenic differentiation of mesenchymal stem cells only if they are pre-committed? Context: Pulsed electromagnetic field (PEMF) therapy has been documented to be an effective, non-invasive, safe treatment method for a variety of clinical conditions, especially in settings of recalcitrant healing. The underlying mechanisms on the different biological components of tissue regeneration are still to be elucidated. The aim of the present study was to characterize the effects of extremely low frequency (ELF)-PEMFs on commitment of mesenchymal stem cell (MSCs) culture system, through the determination of gene expression pattern and cellular morphology. Human MSCs derived from adipose tissue (ADSCs) were cultured in presence of adipogenic, osteogenic, neural, or glial differentiative medium and basal medium, then exposed to ELF-PEMFs daily stimulation for 21days. Control cultures were performed without ELF-PEMFs stimulation for all cell populations. Effects on commitment were evaluated after 21days of cultures. The results suggested ELF-PEMFs does not influence ADSCs commitment and does not promote adipogenic, osteogenic, neural or glial differentiation. However, ELF-PEMFs treatment on ADSCs cultured in osteogenic differentiative medium markedly increased osteogenesis." }, { "role": "assistant", "content": "We concluded that PEMFs affect the osteogenic differentiation of ADSCs only if they are pre-commitment and that this therapy can be an appropriate candidate for treatment of conditions requiring an acceleration of repairing process. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Arterial Occlusive Diseases, Autonomic Nervous System, Blood Pressure, Brain Diseases, Cerebral Arterial Diseases, Cerebral Cortex, Cerebrovascular Disorders, Electrocardiography, Epinephrine, Heart, Heart Rate, Homocysteine, Hypertension, Kidney, Male, Myocardium, Norepinephrine, Rats, Rats, Inbred SHR, Rats, Wistar, Sympathetic Nervous System." }, { "role": "user", "content": "Does insular lesion evoke autonomic effects of stroke in normotensive and hypertensive rats? Context: Increases in sympathetic activity and frequency of myocardial damage occur after middle cerebral artery occlusion (MCAO) in Wistar rats, while MCAO in the spontaneously hypertensive rat (SHR) decreases sympathoadrenal activity. Autonomic changes have been suggested to result from damage to the insular cortex (IC). A lesion of the IC was made using the excitotoxin D,L-homocysteic acid (DLH; 1 mol/L), in urethane-anesthetized Wistar rats and SHRs. Mean arterial pressure (MAP), heart rate, renal sympathetic nerve discharge (SND), ECG, and plasma catecholamines were measured in 14 SHRs and 14 Wistar male rats after a 500-nL injection of DLH or phosphate-buffered saline (PBS) into the IC. Histological examination showed that DLH resulted in neuronal damage throughout the IC. DLH injection initially elevated MAP (at approximately 10 minutes after injection) in Wistar rats but not in SHRs. At 4 hours after the DLH injection, there was a secondary, longer-term increase in MAP in the Wistar rats. MAP decreased in the SHRs after IC lesion such that at 6 hours, lesioned SHRs had a MAP that was significantly lower than that of sham-lesioned SHRs. SND initially increased (at 10 minutes) after DLH injection in Wistar rats. In the SHRs, SND decreased significantly from the initial values, by 3 hours after DLH injection. Plasma catecholamine levels were not significantly changed as a result of IC lesion in the Wistar rats or the SHRs. Heart rates increased in all animals, with no differences between groups. There were no changes in the ECG or in the frequency of cardiac myocytolysis in either strain (sham or lesioned animals)." }, { "role": "assistant", "content": "IC lesion in the SHR and Wistar rat therefore appears to result in autonomic changes similar to that seen after MCAO. Unlike MCAO, however, the autonomic changes do not appear to be sufficient to produce myocardial damage. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Female, Hormone Replacement Therapy, Human Growth Hormone, Humans, Hypopituitarism, Middle Aged, Pituitary Gland, Posterior, Prospective Studies, Water Deprivation." }, { "role": "user", "content": "Are posterior pituitary functions altered after growth hormone replacement therapy in hypopituitarism due to Sheehan 's syndrome? Context: The aim of the present study was to investigate the effects of growth hormone (GH) replacement on posterior pituitary functions of GH-deficient Sheehan's syndrome (SS) patients. Ten patients with SS and 14 healthy control women were included in this prospective study. All patients were given appropriate hormone replacement therapy other than GH, according to present hormone deficiencies. Patients were euthyroid and eucortisolemic at the time of baseline evaluation. Patients and the control group were evaluated with water-deprivation and saline-infusion tests at baseline and the tests were repeated in patients with SS after 3 months of GH replacement therapy. According to the water deprivation test, 3 patients had partial central DI at baseline. Urine osmolalities of the patients were slightly lower and plasma osmolalities were significantly higher than the control group at baseline, after water deprivation and following DDAVP injection and after hypertonic saline infusion. The osmotic threshold of serum for thirst perception was found to be significantly higher in SS patients than the control group, GH replacement therapy did not influence the results of water deprivation and saline infusion tests in SS patients." }, { "role": "assistant", "content": "Patients with SS have subtle abnormalities in posterior pituitary functions and the threshold for thirst perception is increased. However GH replacement therapy does not seem to reverse or adversely affect the mildly deteriorated posterior pituitary functions of SS patients. 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: 3' Untranslated Regions, Gene Expression Regulation, Fungal, Membrane Proteins, Peptide Elongation Factors, Protein Binding, Protein Biosynthesis, Proteolipids, Proton-Translocating ATPases, RNA Processing, Post-Transcriptional, RNA, Messenger, RNA-Binding Proteins, Saccharomyces cerevisiae, Saccharomyces cerevisiae Proteins, Streptavidin." }, { "role": "user", "content": "Does the elongation factor eEF3 ( Yef3 ) interact with mRNA in a translation independent manner? Context: mRNA binding proteins (RBPs) constitute 10-15% of the eukaryotic proteome and play important part in post-transcriptional regulation of gene expression. Due to the instability of RNA and the transient nature its interaction with RBPs, identification of novel RBPs is a significant challenge. Recently, a novel methodology for RBP purification and identification (termed RaPID) was presented, which allows high affinity purification of RBPs while associated with mRNA in vivo. We performed a RaPID screen for proteins that interact with PMP1 mRNA in order to identify novel mRNA binding proteins. PMP1 mRNA was tagged in its 3' UTR with multiple MS2 loops and co-expressed with MS2-binding protein fused to streptavidin binding protein (SBP). RNA-protein complexes were cross-linked in vivo and isolated through streptavidin beads. The eluted proteins were subjected to mass spectroscopy analysis. The screen identified many proteins, about half of them were previously shown to bind RNA. We focused on eEF3 (YEF3), an essential translation elongation factor that interacts with ribosomes. Purification of TAP-tagged Yef3 with its associated RNAs confirmed that the native PMP1 transcript is associated with it. Intriguingly, high association with Yef3-TAP was observed when purification was performed in the presence of EDTA, and with PMP1 that contains stop codons immediately downstream to the initiation codon. Furthermore, high association was observed with a transcript containing only the 3' UTR of PMP1. Complementary, RaPID isolation of MS2-tagged 3' UTRs with their associated proteins revealed that Yef3 can efficiently interact with these regions." }, { "role": "assistant", "content": "This study identifies many novel proteins that interact with PMP1 mRNA. Importantly, the elongation factor Yef3 was found to interact with mRNA in non-coding regions and in a translation independent manner. These results suggest an additional, non-elongation function for this factor. 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 previously healthy 5-year-old boy is brought to the physician because of increasing weakness and a retroauricular rash that started 2 days ago. The rash spread rapidly and involves the trunk and extremities. Last week, he had a mild sore throat, pink eyes, and a headache. His family recently immigrated from Ethiopia. His immunization status is unknown. The patient appears severely ill. His temperature is 38.5°C (101.3°F). Examination shows tender postauricular and suboccipital lymphadenopathy. There is a nonconfluent, maculopapular rash over the torso and extremities. Infection with which of the following is the most likely cause of this patient's symptoms?" }, { "role": "assistant", "content": "Togavirus" } ]

[ { "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, Area Under Curve, Blood Glucose, Cooking, Glucose Intolerance, Glucose Tolerance Test, Insulin, Insulin Resistance, Linoleic Acids, Conjugated, Male, Mice, Mice, Inbred C57BL, Oxidation-Reduction, Random Allocation, Soybean Oil." }, { "role": "user", "content": "Is impairment of glucose metabolism in mice induced by dietary oxidized frying oil different from that induced by conjugated linoleic acid? Context: We previously reported that a diet high in oxidized frying oil (OFO) is less adipogenic but induces glucose intolerance in rodents, a situation somewhat is similar to that in conjugated linoleic acid (CLA)-fed mice. The present study compared the lipid and glucose metabolism effects of dietary OFO and CLA to clarify how the OFO diet compromises glucose tolerance. C57BL/6J mice were divided into four groups in which the CLA and CLA control (CC) groups received a low-fat diet supplemented with or without 1 g/100 g of CLA (1:1 mixture of cis-9, trans-11 and trans-10, cis-12), and the OFO and OFO control (CO) groups received a high-fat diet containing 20 g/100 g of OFO or fresh soybean oil, respectively. When compared with their respective controls (CLA versus CC and OFO versus CO), the OFO and CLA diets resulted in deprivation of adipose and downregulation of adipocyte marker genes, but a totally different response of lipid metabolism in the liver was observed, i.e., anabolism was enhanced by the CLA diet but catabolism was enhanced by the OFO diet. In contrast to the insulin resistance that occurred in CLA-fed mice, the glucose intolerance induced by the OFO diet was accompanied by decreases in insulin and C-peptide levels during an oral glucose tolerance test. Analysis of vitamin E and thiobarbituric acid-reactive substances in the liver showed the OFO diet, but not the CLA diet, compromised vitamin E status." }, { "role": "assistant", "content": "The impaired glucose metabolism resulting from OFO feeding is not related to CLA. In contrast to the hyperinsulinemia and insulin resistance induced by the CLA diet, the OFO diet-induced glucose intolerance is mediated by impairment of insulin secretion. 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": "Rotator cuff is formed by all, EXCEPT?" }, { "role": "assistant", "content": "The correct answer is Rotator cuff of the shoulder is a fibrous sheath formed by the flattened tendons which blend with the capsule of the shoulder joint and strengthen it. The muscle which form the cuff arise from the scapula and are inseed into the lesser or greater tubercle of the humerus. These muscle are the subscapularis, supraspinatus, infraspinatus and teres minor. Their tendon, while crossing the shoulder joint, become flattened and blends with each other on one hand, and with the capsule of the joint on the other hand, before reaching their points of inseion.Also know:The cuff gives strength to the capsule of the shoulder all around except inferiorly which explains why the dislocation of the humerus occur most commonly in downward direction." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, RESULTS. Meshes: Actinobacteria, Alphaproteobacteria, Bacteria, Bacteroidetes, Construction Materials, Corrosion, DNA Fingerprinting, DNA, Bacterial, Deltaproteobacteria, Denaturing Gradient Gel Electrophoresis, Gammaproteobacteria, Phylogeny, Polymerase Chain Reaction, RNA, Ribosomal, 16S, Steel, Utah." }, { "role": "user", "content": "Are diverse bacterial groups associated with corrosive lesions at a Granite Mountain Record Vault ( GMRV )? Context: This study applied culture-dependent and molecular approaches to examine the bacterial communities at corrosion sites at Granite Mountain Record Vault (GMRV) in Utah, USA, with the goal of understanding the role of microbes in these unexpected corrosion events. Samples from corroded steel chunks, rock particles and waters around the corrosion pits were collected for bacterial isolation and molecular analyses. Bacteria cultivated from these sites were identified as members of Alphaproteobacteria, Gammaproteobacteria, Firmicutes and Actinobacteria. In addition, molecular genetic characterization of the communities via nested-polymerase chain reaction-denaturing gradient gel electrophoresis (DGGE) indicated the presence of a broad spectrum of bacterial groups, including Alphaproteobacteria, Betaproteobacteria, Deltaproteobacteria, Actinobacteria, Firmicutes and Bacteroidetes. However, neither cultivation nor molecular approaches identified sulfate-reducing bacteria (SRB), the bacteria commonly implicated as causative organisms were found associated with corrosive lesions in a process referred to as microbially influenced corrosion (MIC). The high diversity of bacterial groups at the corrosion sites in comparison with that seen in the source waters suggested to us a role for the microbes in corrosion, perhaps being an expression of a redox-active group of microbes transferring electrons, harvesting energy and producing biomass." }, { "role": "assistant", "content": "The corrosion sites contained highly diverse microbial communities, consistent with the involvement of microbial activities along the redox gradient at corrosion interface. We hypothesize an electron transport model for MIC, involving diverse bacterial groups such as acid-producing bacteria (APB), SRB, sulfur-oxidizing bacteria (SOB), metal-reducing bacteria (MRB) and metal-oxidizing bacteria (MOB). Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All of the following are true about hemangioblastoma except?" }, { "role": "assistant", "content": "The correct answer is Hemangioblastoma - MC primary intra- axial tumor in the adult posterior fossa - Occur almost exclusively in the posterior fossa (cerebellum) - Solid or cystic with a mural nodule - May occur sporadically, and 20% of cases may be associated with von Hippel-Lindau disease (hemangioblastomas, retinal angiomas, RCC, pheochromocytoma, renal and pancreatic cysts). - It is a benign tumor - Present with Polycythemia due to increased erythropoietin production" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Is intracellular calcium a target of modulation of apoptosis in MCF-7 cells in the presence of IgA adsorbed to polyethylene glycol? Context: Clinical and epidemiological studies have indicated that breastfeeding has a protective effect on breast cancer risk. Protein-based drugs, including antibodies, are being developed to attain better forms of cancer therapy. Secretory IgA (SIgA) is the antibody class in human breast milk, and its activity can be linked to the protective effect of breastfeeding. The aim of this study was to investigate the effect of polyethylene glycol (PEG) microspheres with adsorbed SIgA on MCF-7 human breast cancer cells. The PEG microspheres were characterized by flow cytometry and fluorescence microscopy. The MCF-7 cells were obtained from American Type Culture Collection. MCF-7 cells were pre-incubated for 24 hours with or without SIgA (100 ng/mL), PEG microspheres or SIgA adsorbed in PEG microspheres (100 ng/mL). Viability, intracellular calcium release, and apoptosis in MCF-7 cells were determined by flow cytometry. Fluorescence microscopy and flow cytometry analyses revealed that SIgA was able to adsorb to the PEG microspheres. The MCF-7 cells that were incubated with PEG microspheres with adsorbed SIgA showed decreased viability. MCF-7 cells that were incubated with SIgA or PEG microspheres with adsorbed SIgA had increased intracellular Ca(2+) levels. In the presence of SIgA, an increase in the percentage of apoptotic cells was observed. The highest apoptosis index was observed when the cells were treated with PEG microspheres with adsorbed SIgA." }, { "role": "assistant", "content": "These data suggest that colostral SIgA adsorbed to PEG microspheres has antitumor effects on human MCF-7 breast cancer cells and that the presence of large amounts of this protein in secreted breast milk may provide protection against breast tumors in women who breastfed. 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: Administration, Oral, Animals, Disease Models, Animal, Drug Delivery Systems, Enterocolitis, Immunologic Factors, Inflammatory Bowel Diseases, Interleukin-10, Interleukins, Intestinal Mucosa, Lactococcus lactis, Mice, T-Lymphocytes, Transformation, Bacterial." }, { "role": "user", "content": "Does oral delivery of IL-27 recombinant bacteria attenuate immune colitis in mice? Context: Treatment of inflammatory bowel disease would benefit from specific targeting of therapeutics to the intestine. We developed a strategy for localized delivery of the immunosuppressive cytokine interleukin (IL)-27, which is synthesized actively in situ by the food-grade bacterium Lactococcus lactis (LL-IL-27), and tested its ability to reduce colitis in mice. The 2 genes encoding mouse IL-27 were synthesized with optimal codon use for L lactis and joined with a linker; a signal sequence was added to allow for product secretion. The construct was introduced into L lactis. Colitis was induced via transfer of CD4(+)CD45RB(hi) T cells into Rag(-/-) mice to induce colitis; 7.5 weeks later, LL-IL-27 was administered to mice via gavage. Intestinal tissues were collected and analyzed. LL-IL-27 administration protected mice from T-cell transfer-induced enterocolitis and death. LL-IL-27 reduced disease activity scores, pathology features of large and small bowel, and levels of inflammatory cytokines in colonic tissue. LL-IL-27 also reduced the numbers of CD4(+) and IL-17(+) T cells in gut-associated lymphoid tissue. The effects of LL-IL-27 required production of IL-10 by the transferred T cells. LL-IL-27 was more effective than either LL-IL-10 or systemic administration of recombinant IL-27 in reducing colitis in mice. LL-IL-27 also reduced colitis in mice after administration of dextran sodium sulfate." }, { "role": "assistant", "content": "LL-IL-27 reduces colitis in mice by increasing the production of IL-10. Mucosal delivery of LL-IL-27 could be a more effective and safer therapy for inflammatory bowel 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: BACKGROUND, METHODS, RESULTS. Meshes: Absenteeism, Asthma, Child, Cold Temperature, Heating, Housing, Humans, New Zealand, Schools, Single-Blind Method." }, { "role": "user", "content": "Does more effective home heating reduce school absences for children with asthma? Context: New Zealand homes are underheated by international standards, with average indoor temperatures below the WHO recommended minimum of 18 degrees C. Research has highlighted the connection between low indoor temperatures and adverse health outcomes, including social functioning and psychological well-being. Both health effects and social effects can impact on school absence rates. The aim of this study was to determine whether more effective home heating affects school absence for children with asthma. A single-blinded randomised controlled trial of heating intervention in 409 households containing an asthmatic child aged 6-12 years, where the previous heating was an open fire, plug-in electric heater or unflued gas heater. The intervention was the installation of a more effective heater of at least 6 kW before the winter of 2006 in half the houses. Demographic and health information was collected both before and after the intervention. Each child's school was contacted directly and term-by-term absence information for that child obtained for 2006 and previous years where available. Complete absence data were obtained for 269 out of 409 children. Compared with the control group, children in households receiving the intervention experienced on average 21% (p=0.02) fewer days of absence after allowing for the effects of other factors." }, { "role": "assistant", "content": "More effective, non-indoor polluting heating reduces school absence for asthmatic children. 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, Endothelial Cells, Endothelium, Vascular, Mice, Mice, Transgenic, Neovascularization, Physiologic, Receptor, TIE-2, Skin Transplantation, Stem Cells, Wound Healing, beta-Galactosidase." }, { "role": "user", "content": "Does skin graft vascularization involve precisely regulated regression and replacement of endothelial cells through both angiogenesis and vasculogenesis? Context: Long-term survival of a skin graft is dependent on eventual revascularization. The authors' aim in the present study was to determine whether skin graft vascularization occurs by (1) simple reconnection of vessels, (2) ingrowth of recipient vasculature, (3) outgrowth of donor-derived vessels, and/or (4) recruitment of bone marrow-derived endothelial progenitor cells. Full-thickness skin grafts (1 x 1 cm) were transferred between wild-type FVB/N mice (n = 20) and transgenic tie2/lacZ mice (n = 20), where lacZ expression is controlled by the endothelial specific tie2 promoter, allowing differentiation of recipient and donor endothelial cells. The contribution of endothelial progenitor cells to skin graft neovascularization was determined using a bone marrow transplant model where tie2/lacZ bone marrow was transplanted into wild-type mice (n = 20). Vascular regression in the graft was observed at the periphery starting on day 3 and moving centrally through day 21, sparing graft vessels in the absolute center of the graft. At the same time, vascular ingrowth occurred from the wound bed to replace the regressing vessels. Furthermore, bone marrow-derived endothelial progenitor cells contributed to these new vessels starting as early as day 7. Surprisingly, the contribution of bone marrow-derived vessels to the overall process was approximately 15 to 20 percent of new endothelial cells." }, { "role": "assistant", "content": "Replacement of the donor graft vasculature by endothelial and endothelial progenitor cells from the recipient along preexisting channels is the predominant mechanism for skin graft revascularization. This mechanism is likely similar for all nonvascularized free grafts and suggests novel strategies for optimizing the vascularization of tissue constructs engineered in vitro. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which one of these is NOT associated with decrease in Residual Volume?" }, { "role": "assistant", "content": "The correct answer is (A) Emphysema# RESIDUAL VOLUME is the amount of gas remaining in the lungs at the end of a maximal exhalation.> Residual Volume is important because it prevents the lungs from collapsing.> Even after we have expelled as much air as possible (expiratory reserve volume) gaseous exchange is still occurring by residual volume in the lungs. It also prevents the inner surfaces of the lungs sticking together.# In Chronic Bronchitis and Emphysema:> Increase in Residual volume> Peak Expiratory flow rate usually reduced.> VA/Q i.e., ventilation perfusion ratio is a poor indicator of the severity of the disease.TypeExamplesDescriptionFEV1/FVCRestrictiveLungDiseases Pulmonary fibrosis, Infant Respiratory Distress syndrome, Weak respiratory muscles, PneumothoraxVolumes are decreasedOften in a normal range (0.8 to 1.0)ObstructiveLungDiseases Asthma or COPD or EmphysemaVolumes are essentially normal but flow rates are impededOften low (Asthma can reduce the ratio to 0.6, Emphysema can reduce the ratio to 0.78 to 0.45)" } ]

[ { "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: Adipocytes, Angiotensin II, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Benzimidazoles, Benzoates, Blotting, Western, Endothelial Cells, Humans, Intra-Abdominal Fat, Lisinopril, Muscle, Skeletal, Nicotinamide Phosphoribosyltransferase, PPAR gamma, Receptor, IGF Type 1, Rosiglitazone, Telmisartan, Tetrazoles, Thiazolidinediones, Umbilical Veins, Valine, Valsartan." }, { "role": "user", "content": "Does angiotensin inhibition stimulate PPARgamma and the release of visfatin? Context: Angiotensin converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARB) exhibit beneficial antidiabetic effects in patients with type 2 diabetes independent of their blood pressure-lowering effects. Some antidiabetic properties of ARB and ACE-I might by exerted by activation of peroxisome proliferator-activated receptor gamma (PPARgamma). However, it is not clear whether this action is drug specific. The binding affinity of telmisartan, valsartan, lisinopril, rosiglitazone and angiotensin II to PPARgamma was assessed in a cell-free assay system. PPARgamma signalling was studied in isolated skeletal muscle cells using Western blot analysis of phosphorylated protein kinase B (pAKT) and phosphorylated insulin like growth factor-1 receptor (pILGF-1R). Further, the ability of the drugs under study to stimulate the release of the adipocytokine visfatin was investigated in isolated human adipocytes, skeletal muscle cells, and umbilical vein endothelial cells (HUVEC). The binding affinity to PPARgamma was highest for telmisartan with a half-maximal effective concentration of 463 nM, followed by lisinopril (2.9 microM) and valsartan (6.2 microM). In skeletal muscle cells phosphorylation of ILGF-1R was 2-fold increased after incubation with telmisartan or valsartan and 1.7-fold with lisinopril. pAKT expression was enhanced after incubation with telmisartan, valsartan and with lisinopril. The release of visfatin from adipocytes was 1.6-fold increased after treatment with lisinopril and about 2.0-fold increased with telmisartan and valsartan. Similar results were obtained in skeletal muscle cells and HUVEC." }, { "role": "assistant", "content": "Our data confirm agonism of telmisartan, valsartan and lisinopril on PPARgamma. Pharmacokinetic differences may explain different potencies of PPARgamma stimulation by drugs acting on the renin-angiotensin system in clinical settings. 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": "\"Multibacillarv\" is a spectrum of disease, seen in-" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e.. Leprosy ClassificationsRidley and JoplingIndianMadrido Tuberculoid (TT)o Indeterminate (I)o Indeterminateo Borderline tuberculoid (BT)o Tuberculoido Tuberculoid flat raisedo Borderline (BB)o Borderlineo Borderlineo Borderline lepromatous (BL)o Lepromatouso Lepromatouso Lepromatous (L.L)o Pure neuritic WHO classificationPauci bacillaryMultibacillaryo Bacteriological index <2o BI > 2o 5 or less skin lesionso 6 or more skin lesionso It includeso It includesB.T.B.B.T.T.B L.IndeterminateLL" } ]

[ { "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 feature is found only in the left lung?" }, { "role": "assistant", "content": "The correct answer is The cardiac notch is only found on the left lung, which makes sense since the hea is located on the left side of the mediastinum. The horizontal fissure is a deep groove that separates the middle lobe from the upper lobe of the right lung. The left lung does not have a horizontal fissure. The oblique fissure is found in both lungs. It separates the upper lobe from the lower lobe in both lungs and the middle lobe from the lower lobe in the right lung. Both lungs also have a superior lobar bronchus leading to their superior lobes. Finally, the right lung has three lobes while the left lung has two lobes." } ]

[ { "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 statement(s) out of the following is/are: a) β1 receptors in heart stimulate its contractions b) β2 receptors in heart stimulate its contractions c) β2 receptors are present in smooth muscles d) α1 receptors cause preganglionic stimulation e) α2 receptors cause postganglionic feedback inhibition" }, { "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": "A 59-year-old man presents with the persistent right-sided facial droop and slurred speech for the past 2 hours. He says he had similar symptoms 6 months ago which resolved within 1 hour. His past medical history is significant for long-standing hypertension, managed with hydrochlorothiazide. He reports a 10-pack-year smoking history but denies any alcohol or recreational drug use. The vital signs include: blood pressure 145/95 mm Hg, pulse 95/min, and respiratory rate 18/min. On physical examination, the patient has an asymmetric smile and right-sided weakness of his lower facial muscles. There is a deviation of his tongue towards the right. Dysarthria is noted. His muscle strength in the upper extremities is 4/5 on the right and 5/5 on the left. The remainder of the physical exam is unremarkable. Which of the following is the next most appropriate step in the management of this patient?" }, { "role": "assistant", "content": "CT of the head without contrast" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All are true about autism except" }, { "role": "assistant", "content": "The correct answer is About 30% of children with Autism function in the intellectually disabled range. Among them, 30% are in mild to moderate range and about 45 to 50% are in severly to profound range. Children with Autism have been observed to have a higher incidence of abnormal dermatographics (fingerprints) than those in the general population. This finding might suggest a disturbance in neuro ectodermal development. Ref: Synopsis of Psychiatry, 11e, pg 1156, 1157." } ]

[ { "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 result from accumulation of homogentisic acid?" }, { "role": "assistant", "content": "The correct answer is Ochronosis is a rare autosomal recessive disorder caused by a deficiency of homogentisic acid oxidase leading to the accumulation of homogentisic acid in connective tissue. Accumulation of homogentisic acid in the cailage, tendons and sclera leads to a darker brown to black discolouration called ochronosis. Albinism is an autosomal recessive disease with defective melanin synthesis. In this condition tyrosinase is completely absent leading to defective synthesis of melanin. Type I Tyrosinemia is an inborn error of metabolism caused by a deficiency of fumarylacetoacetase, the last enzyme involved in tyrosine degradation pathway. It results in the accumulation of fumarylacetoacetate, maleylacetoacetate and succinylacetone which inturn cause liver and kidney damage. Ref: Textbook of Biochemistry By D M Vasudevan, 3rd Edition, Page 184" } ]

[ { "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, Child, Cocaine-Related Disorders, Crack Cocaine, Female, Health Knowledge, Attitudes, Practice, Health Surveys, Humans, Incidence, Male, United States, Young Adult." }, { "role": "user", "content": "Should anyone be riding to glory on the now-descending limb of the crack-cocaine epidemic curve in the United States? Context: Many pre-clinical and clinical researchers do not appreciate the recent decline in United States (US) population-level incidence of crack-cocaine smoking. At present, no more than about 200 young people start using crack-cocaine each day. Ten years ago, the corresponding estimated daily rate was 1000. This short communication looks into these trends, surrounding evidence on this important public health topic, and checks whether duration-reducing treatment interventions might be responsible, versus selected alternatives. Via analyses of standardized computer-assisted self-interview data from the US National Surveys on Drug Use and Health (NSDUH, 2002-2011; n>500,000), we evaluated change in incidence estimates, perceived difficulty to acquire crack, risk of using cocaine, treatment entries, and persistence once crack use has started. We draw attention to a marked overall decline in year-specific incidence rates for crack-cocaine smoking from 2002 to 2011, especially 2007-2011. There is some variation in estimates of difficulty to acquire crack (p<0.001) and observed risk of using cocaine among 'at risk' susceptibles (p<0.001), but no appreciable shifts in duration of crack smoking among active users (p>0.05) or in proportion of crack users receiving treatment (p>0.05)." }, { "role": "assistant", "content": "Changing epidemiology of crack-cocaine smoking may rest largely on reductions in newly incident use with no major direct effects due to US cocaine treatment, incarceration, or interdiction. Concurrently, we see quite modest declines in survey-based estimates of cocaine-attributed perceived risk and cocaine availability. As such, we posit that no specific US agency should claim it is 'riding to glory' on the descending limb of this epidemic curve." } ]

[ { "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 AIM, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Colonic Polyps, Colonoscopy, Confidence Intervals, Female, Humans, Incidence, Male, Microsurgery, Middle Aged, Postoperative Complications, Retrospective Studies, Treatment Outcome, United Kingdom." }, { "role": "user", "content": "Cold snare polypectomy: does snare type influence outcomes? Context: Cold snare techniques are widely used for the removal of small and diminutive polyps. The influence of snare type on the effectiveness of cold snare polypectomy is unknown. Cold snare polypectomy of 3-7-mm polyps was undertaken using either a thin wire mini-snare (0.30 mm) or a thick wire mini-snare (0.47 mm). Primary outcome was endoscopic completeness of excision. Consensus regarding endoscopic assessment of completeness of excision was standardized and aided by chromoendoscopy. Secondary outcomes included: completeness of histological excision, polyp 'fly away', polyp retrieval rate, early or delayed bleeding and perforation. One hundred and fifty-seven polyps were removed ranging from 3 to 7 mm, 62% were situated in the left side of the colon and 89.4% were sessile. Endoscopic completeness of excision was significantly higher with the thin wire snare compared to the thick wire snare (90.2% vs 73.3%, P < 0.05). There was a numerical trend towards a higher complete histological excision rate with the thin wire snare, but this did not reach statistical significance (73.3% vs 65.2%, P = 0.4). There was a fair level of agreement (kappa = 0.36) between endoscopic and histological completeness of excision. Polyp 'fly away' occurred less often with the thin wire snare (14.6% vs 35.3%, P = 0.002), but there was no significant difference in polyp retrieval rate (84.3% vs 83.8%, P = 0.94). There were no complications with either snare." }, { "role": "assistant", "content": "Snare type appears to be an important determinant of completeness of excision when removing small polyps by the cold snare technique." } ]

[ { "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: Barrett Esophagus, Biomarkers, Carcinoma, Squamous Cell, Cell Transdifferentiation, Cells, Cultured, Cluster Analysis, Esophageal Neoplasms, Esophagus, Gene Expression Profiling, Homeodomain Proteins, Humans, Keratinocytes, Oligonucleotide Array Sequence Analysis, Precancerous Conditions, Proto-Oncogene Proteins c-myc." }, { "role": "user", "content": "Do cdx1 and c-Myc foster the initiation of transdifferentiation of the normal esophageal squamous epithelium toward Barrett 's esophagus? Context: Barrett's esophagus is a premalignant condition whereby the normal stratified squamous esophageal epithelium undergoes a transdifferentiation program resulting in a simple columnar epithelium reminiscent of the small intestine. These changes are typically associated with the stratified squamous epithelium chronically exposed to acid and bile salts as a result of gastroesophageal reflux disease (GERD). Despite this well-defined epidemiologic association between acid reflux and Barrett's esophagus, the genetic changes that induce this transdifferentiation process in esophageal keratinocytes have remained undefined. To begin to identify the genetic changes responsible for transdifferentiaiton in Barrett's esophagus, we performed a microarray analysis of normal esophageal, Barrett's esophagus and small intestinal biopsy specimens to identify candidate signaling pathways and transcription factors that may be involved. Through this screen we identified the Cdx1 homeodomain transcription factor and the c-myc pathway as possible candidates. Cdx1 and c-myc were then tested for their ability to induce transdifferentiation in immortalized human esophageal keratinocytes using organotypic culturing methods. Analyses of these cultures reveal that c-myc and cdx1 cooperate to induce mucin production and changes in keratin expression that are observed in the epithelium of Barrett's esophagus." }, { "role": "assistant", "content": "These data demonstrate the ability of Cdx1 and c-myc to initiate the earliest stages of transdifferentiation of esophageal keratinocytes toward a cell fate characteristic of Barrett's esophagus. 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": "Pendred's syndrome 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: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Agnosia, Analysis of Variance, Case-Control Studies, Chronic Disease, Diffuse Noxious Inhibitory Control, Female, Humans, Middle Aged, Pain Perception, Pain Threshold, Postsynaptic Potential Summation, Somatosensory Disorders, Temporomandibular Joint Disorders, Young Adult." }, { "role": "user", "content": "Are chronic temporomandibular disorders necessarily associated with a compromised endogenous analgesic system? Context: To test whether temporomandibular disorders (TMD) case-control differences in conditioned pain modulation (CPM) exist, using a mechanically evoked temporal summation (TS) model. A series of 10 repetitive, mildly noxious, mechanical stimuli were applied to the fingers of 30 women with TMD, who had a primary diagnosis of masticatory myofascial pain, and 30 age-matched healthy women. The subjects rated the pain intensity caused by the 1st, 5th, and 10th stimuli in the series. To evaluate CPM, the same series of mechanical stimulations were applied with concomitant exposure of the other hand to a painfully cold water bath. Statistical inferences were based on t tests, chi-square tests, or analysis of variance (ANOVA), as appropriate. Pain ratings increased significantly with stimulus repetition (P < .01) and CPM significantly reduced TS of pain (P < .01). Of particular note, both groups showed very similar degrees of CPM, with no significant group difference." }, { "role": "assistant", "content": "Painful TMD is not necessarily associated with a compromised ability to engage the endogenous analgesic system in an experimental setting. 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": "Discharge from Baroreceptors cause inhibition of :" }, { "role": "assistant", "content": "The correct answer is Discharge from Baroreceptor cause inhibition of Rostral Ventrolateral medulla. The baroreceptor are stimulated by distension of the structures in which they are located. Their afferent fibers pass the glossopharyngeal and vagus nerves to the medulla. These fibers release glutamate to excite neurons in the nucleus of tractus solitarius (NTS). These NTS neurons then excite neurons in the caudal ventrolateral medulla (CVLM). These CVLM neurons release the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) into the RVLM to reduce the firing rate of these. Thus, reducing the sympathetic outflow. Ref: Ganong&;s Review of Medical Physiology 26th edition Pgno: 577,578" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, RESULTS. Meshes: Biomarkers, Cholesterol, Coronary Artery Disease, Female, Humans, Male, Middle Aged, Plaque, Atherosclerotic, Prospective Studies, Psoriasis, Sex Characteristics, Tomography, X-Ray Computed, Vascular Calcification." }, { "role": "user", "content": "Is cholesterol efflux capacity in humans with psoriasis inversely related to non-calcified burden of coronary atherosclerosis? Context: Cholesterol efflux capacity (CEC) was recently shown to predict future cardiovascular (CV) events. Psoriasis both increases CV risk and impairs CEC. However, whether having poor CEC is associated with coronary plaque burden is currently unknown. We aimed to assess the cross-sectional relationship between coronary plaque burden assessed by quantitative coronary computed tomography angiography (CCTA) with CEC in a well-phenotyped psoriasis cohort. Total burden and non-calcified burden (NCB) plaque indices were assessed in 101 consecutive psoriasis patients using quantitative software. Cholesterol efflux capacity was quantified using a cell-based ex vivo assay measuring the ability of apoB-depleted plasma to mobilize cholesterol from lipid-loaded macrophages. Cholesterol efflux capacity was inversely correlated with NCB (unadjusted β-coefficient -0.33; P < 0.001), and this relationship persisted after adjustment for CV risk factors (β -0.24; P < 0.001), HDL-C levels (β -0.22; P < 0.001), and apoA1 levels (β -0.19; P < 0.001). Finally, we observed a significant gender interaction (P < 0.001) whereby women with low CEC had higher NCB compared to men with low CEC." }, { "role": "assistant", "content": "We show that CEC is inversely associated with prevalent coronary plaque burden measured by quantitative CCTA. Low CEC may therefore be an important biomarker for subclinical coronary atherosclerosis in psoriasis. 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": "Fundus examination of a patient presenting with loss of vision revealed a Cherry red spot on the macula. What is he most likely suffering from?" }, { "role": "assistant", "content": "The correct answer is Cherry red spot on the retina is seen in central retinal aery occlusion. Other retinal signs in this condition includes retinal oedema and segmentation of blood column in the retinal vein (cattle tracking sign). Patients often presents with sudden painless loss of vision. Reference: Comprehensive Ophthalmology By A K Khurana, 4th Edition, Page 255." } ]

[ { "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": "Hayman hemostatic suture is applied on:" }, { "role": "assistant", "content": "The correct answer is Hayman Suture- surgical management of PPH It is considered a uterine compression suture using two longitudinal threads and transfixing the entire uterine wall. This suture is simpler than the B-Lynch suture, sometimes being referred to as the \"simple brace.\"" } ]

[ { "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: Anti-Infective Agents, Local, Brazil, Camphor, Chlorophenols, Drug Combinations, Drug Compounding, Endodontics, Faculty, Dental, Humans, Hydrocarbons, Iodinated, Pediatric Dentistry, Prednisolone, Rifamycins, Root Canal Filling Materials, Students, Dental." }, { "role": "user", "content": "Do variability in the proportion of components of iodoform-based Guedes-Pinto paste mixed by dental students and pediatric dentists? Context: Guedes-Pinto paste (GPP) is an iodoform paste used in most dental schools in Brazil. The paste is a composite of medicines (Rifocort , camphorated paramonochlorophenol [PMCC], and iodoform) used for endodontic treatment of primary teeth. The aim of this study was to evaluate the proportion variability of GPP components when mixed by undergraduate dentistry students and pediatric dentists. The study was divided into 4 groups: G1 (15 undergraduate students), G2 (15 specialists in Pediatric Dentistry), G3 (15 professors with clinical activity), and G4 (7 professors-researchers). All volunteers prepared GPP according to the original specifications: the same visual proportion for each component. The components were weighed using an analytical balance and the percentage was calculated. After normality (Kolmogorov-Smirnov) and homogeneity tests (Levene test), the data were submitted to analysis of variance and intraclass correlation coefficient tests (P<0.05). The percentage means of each respective group were as follows: Rifocort 20.2%, 20.8%, 26.7%, 27.3%; camphorated PMCC 9.2%, 8.1%, 6.7%, 5.1%; and the iodoform 70.6%, 71.1%, 64.7%, 67.6%. There were no significant differences between groups for the component percentages. There was a high intraclass correlation coefficient (G1 0.945; G2 0.951; G3 0.921; and G4 0.870)." }, { "role": "assistant", "content": "The proportion of GPP was similar in all the groups, allowing us to conclude that ideal GPP proportion, based on the entire group mean, was 23.8% of Rifocort® ; 7.0% of camphorated PMCC; and 69.2% of iodoform. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is called balanced resuscitation?" }, { "role": "assistant", "content": "The correct answer is ANS. CComponents of damage control resuscitation:1. Permissive hypotension essential definitive surgical control2. Minimize crystalloid use3. Initial use of 5% hypertoxic saline4. Early use of blood products5. Treat coagulopathy" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is MOST impoant in separating the esophagus from the larynx, and must consequently be carefully passed behind during endoscopy?" }, { "role": "assistant", "content": "The correct answer is Endoscopists are very careful when guiding the endoscope past the epiglottis, which is a pear-shaped poion of elastic cailage that can be moved during swallowing to close the larynx, preventing swallowed material from eventually entering the lungs.The arytenoids are the site of the attachment of the vocal cords within the larynx.The cricoid cailage is in the more distal poion of the larynx.The pharynx is shared by the respiratory and gastrointestinal tracts.Also know:The thyroid cailage forms a median elevation, called the laryngeal prominence (\"Adam's apple\"), and lies inferior to the hyoid bone.The epiglottis is an elastic cailage, shaped like a spoon, that is posterior to the root of the tongue.The cricoid cailage is shaped like a signet ring, with the broad pa of the ring facing posteriorly.The arytenoid cailages are shaped like a pyramid." } ]

[ { "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": "Alkaline Nasal Douche does not contain" }, { "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, RESULTS. Meshes: Amino Acid Motifs, Amino Acid Sequence, Amino Acids, Animals, Cluster Analysis, Humans, Immunity, Innate, Mice, Protein Structure, Tertiary, Proteins, Sequence Homology, Amino Acid." }, { "role": "user", "content": "Do intrinsically disordered domains deviate significantly from random sequences in mammalian proteins? Context: In order to characterize mammalian intrinsically disordered domains (IDDs) we examined the patterns in their amino acid abundance as well as overrepresented local sequence motifs. We considered IDDs from mouse proteins associated with innate immune responses as well as a set of generic human genes. These sets were compared with artificially generated random sequences with the same overall amino acid abundance and length distributions. IDDs were then clustered by amino acid abundance, and further analyzed in terms of co-occurrence of clusters with functionally characterized Pfam domains. Overall, IDDs were very different from randomly generated sequences. The deviation from random distributions was at least as great as that for ordered domains, for which the deviation can be rationalized in terms of strong evolutionary pressure for structure and function. The co-occurrence of certain Pfam domains with specific IDD clusters was found to be significant (p-value < 0.01). Local sequence motifs that were over-represented in the innate immune set consisted mostly of low complexity fragments, primarily characterized by amino acid repeats, and could not be assigned an obvious functional role." }, { "role": "assistant", "content": "Our results suggest that IDDs are constrained within a narrow subset of possible sequences. This is most likely a result of biophysical restraints that have yet to be elucidated. More detailed examination of the functional relationship between the IDDs and associated Pfam domains is one possible avenue of investigation. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Regarding Ca gallbladder -" }, { "role": "assistant", "content": "The correct answer is Answer (b) Presents with jaundice" } ]

[ { "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: Clinical Competence, Communication, Education, Medical, Undergraduate, Goals, Humans, Interviews as Topic, New England, Physician-Patient Relations, Prospective Studies, Quality Improvement, Self-Assessment, Students, Medical, Videotape Recording." }, { "role": "user", "content": "Is self-assessment and goal-setting associated with an improvement in interviewing skills? Context: Describe the relationship between medical students' self-assessment and goal-setting (SAGS) skills and development of interviewing skills during the first-year doctoring course. 157 first-year medical students completed three two-case standardized patient (SP) interviews. After each of the first two, students viewed videotapes of their interview, completed a SAGS worksheet, and reviewed a selected tape segment in a seminar. SAGS was categorized into good and poor quality and interviewing skills were rated by trained raters. SAGS improved over time (37% good week 1 vs. 61% good week 10). Baseline SAGS and interviewing skills were not associated. Initial SAGS quality was associated with change in interviewing skills - those with poor-quality SAGS demonstrated a decrease and those with good-quality SAGS demonstrated an increase in scores by 17 weeks (ANOVA F=4.16, p=0.024). For students whose SAGS skills were good at both week 1 and 10, interviewing skills declined in weeks 1-10 and then increased significantly at week 17. For those whose SAGS remained 'poor' in weeks 1-10, interviewing skills declined in weeks 10-17." }, { "role": "assistant", "content": "In general, the quality of students' SAGS improved over time. Poor baseline SAGS skills and failure to improve were associated with a decrease in interviewing skills at 17 weeks. For students with better SAGS, interviewing skills increased at week 17. Improvement in SAGS skills was not associated with improved interviewing skills. Understanding structured self-assessment skills helps identify student characteristics that influence progressive mastery of communication skills and therefore may inform curriculum and remediation tailoring. 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, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Case-Control Studies, DNA Mutational Analysis, Female, Heterozygote, Humans, Inflammatory Bowel Diseases, Keratin-8, Keratins, Male, Middle Aged, Mutation, Missense." }, { "role": "user", "content": "Are keratin 8 Y54H and G62C mutations associated with inflammatory bowel disease? Context: Keratin 8 is a major component of intermediate filaments in single-layered epithelia of the gastrointestinal tract. Keratin 8 deficient mice display signs of colitis and diarrhoea characteristic for inflammatory bowel disease. Very recently, two keratin 8 mutations, Y54H and G62C, were identified. We investigated if these keratin 8 missense mutations were associated with inflammatory bowel disease. In total, 217 German patients with Crohn' s disease, 131 German patients with ulcerative colitis, and 560 German control subjects were enrolled in this study. Samples were analysed by PCR amplification and subsequent melting curve analysis using fluorescence resonance energy transfer probes. The G62C mutation was detected in five (2.3%) patients presenting with Crohn's disease and in three (2.3%) with ulcerative colitis. In comparison, 9 (1.6%) out of 560 controls were heterozygous for this mutation. No patient or control was homozygous for this mutation. Patients carrying one mutant allele did not show any noticeable characteristics in their corresponding phenotype. In contrast, the Y54H mutation was observed in neither any of the 348 patients with inflammatory bowel disease nor in any control subject." }, { "role": "assistant", "content": "Our data indicate that both keratin 8 mutations, G62C and Y54H, do not play a relevant pathogenic role in inflammatory bowel 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: OBJECTIVE, METHODS, RESULTS. Meshes: Action Potentials, Adolescent, Adult, Auditory Threshold, Child, Child, Preschool, Cochlear Implants, Cochlear Nerve, Electric Stimulation, Evoked Potentials, Auditory, Humans, Infant, Telemetry." }, { "role": "user", "content": "Do [ Electrically evoked auditory nerve compound action potentials in Nucleus CI24M cochlear implant users ]? Context: To study the feasibility and clinical applicability of electrically evoked auditory nerve compound action potentials (ECAP) in young patients with Nucleus CI24M cochlear implants. ECAPs have been recorded from 37 Nucleus CI24M cochlear implant users in response to monopolar electrical stimulation of the cochlea by using the neural response telemetry(NRT) software and the hardware. Behavioral thresholds and maximum comfortable levels were measured in 12 of those patients. ECAPs could be recorded in 87.6% of all patients. Good relations were observed between ECAP threshold and behavioral threshold, but poor relations between ECAP threshold and the impedance of different electrodes. We also observed growth functions and threshold variations of ECAP across subjects for a given place as well as across electrodes within a subject. These findings might be that these particular physiological measures are related to the number of living neural fibers and the excitability of the auditory nerve to electrical stimulation." }, { "role": "assistant", "content": "ECAPs were proved to be useful in adjusting the stimulation parameters of the cochlear implant speech processor in order to maximize an individual's performance with the device, especially in young children. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Child, Child, Preschool, Contrast Media, Cystoscopes, Cystoscopy, Dilatation, Pathologic, Female, Humans, Infant, Male, Predictive Value of Tests, Radionuclide Imaging, Replantation, Sampling Studies, Sensitivity and Specificity, Treatment Outcome, Ultrasonography, Doppler, Color, Ureteral Diseases, Vesico-Ureteral Reflux." }, { "role": "user", "content": "Does [ Ultrasound role in assessment of vesicoureteral reflux endoscopic treatment result ]? Context: Since the beginning of the application of the RVU treatment, the use of the ultrasound was used taking into account two main indications/symptoms: a) identification of the complications; b) assessment of the result (visualization of the implanted material and the presence of the \"uretheral jet\" by means or through/of ecodoppler-color). To determine the value of the ultrasound in the assessment of the result of the endoscopic treatment of the RVU and in the detection of its complications. From 2001-2002 we have carried out the endoscopic treatment to an overall of 261 ureteral units of all degree and etiology. 246 were assessed post-operation with an ultrasound per month and all of them were evaluated with a cistography after 3 months. In a random sample of 92 units, the result of the isotopic cistography has been compared with the visualization of the implanted material in the bladder; and in a random sample of 56 units, the result of the isotopic cistography has been compared with the presence of ureteral jet in the study with ecodoppler-color after moisturizing of the patient. In order to do, we have done two corresponding comparative charts 2 x 2 and we have calculated the Sensibility and Specificity of the tests, as well as their predictive positive and negative values, the degree of similarity of both tests with the Kappa index, and the degree of statistical relevance with Chi squared. The ultrasound did not show significant changes if compared to previous studies in 213 units (86,58 %) although in 5 patients an ectasia has been identified as attributed to the treatment. 3 of this patients have developed renoureteral pain, and in 2 pain has spontaneously disappeared as shown in later tests. The S and the E of the presence of implanted material is 94% and 10%respectively and its VPP and VPN of 80% and 10% and estadistical. The S and E of the jet visualization is 82% and 30%, with a VPP of 84% and a VPN of 27%, a level of statistical relevance of 0.836 and a degree of correlation of 0.121." }, { "role": "assistant", "content": "Ultrasound is not a useful technique in the assessment of the result of the endoscopic treatment of the RVU. The role it plays in the assessment of complications is a small one and its use is only indicated to confirm the suspicion of ectasia in those patients that present renoureteral pain. 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, Endometriosis, Female, Fertility, Gynecologic Surgical Procedures, Humans, Infertility, Female, Laparoscopy, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Young Adult." }, { "role": "user", "content": "Does laparoscopic surgery improve pregnancy outcomes in women with suspected endometriosis with or without pathological confirmation? Context: To verify whether histologic confirmation of endometriosis impacts fertility outcomes. Women with unexplained infertility (UI) underwent laparoscopic excision or ablation with CO2 laser or electrocautery of all suspected endometriotic lesions, followed by clinical treatment between January 2007 and December 2013; pregnancy (> 12 weeks) within 12 months of monitored cycles was the main outcome measured. Women with histological confirmation (n = 74) did not differ from those not confirmed (n = 29) with age, body mass index, gravidity, parity, ovulation induction protocol, and past duration of infertility. Pregnancy outcome was similar in both groups (39/74 vs. 15/29-p = 0.9--Chi-square) and there was no statistical difference in time to conceive/deliver (p = 0.7) between groups." }, { "role": "assistant", "content": "There is no difference in fertility outcomes in women with UI, whether or not suspected endometriosis is confirmed pathologically. 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 middle aged man comes to OPD with paraesthesia of hands and feet, hyperkeratosis of palms, rain drop pigmentation and transverse lines on nails. Most likely the person is having -" }, { "role": "assistant", "content": "The correct answer is The man in question has :\n\n(i) Paresthesia of hands and feet\n(ii) Raindrop pigmentation\n(iii) Hyperkeratosis of palm    \n(iv) Transverse lines on the nail (mees' line)\n\nAll are seen in arsenic poisoning." } ]

[ { "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, METHODS, METHODS, METHODS, RESULTS. Meshes: Adenocarcinoma, Aged, Barrett Esophagus, Esophageal Neoplasms, Esophagoscopy, Female, Humans, Male, Middle Aged, Mucous Membrane, Population Surveillance, Precancerous Conditions, Statistics, Nonparametric, Time Factors." }, { "role": "user", "content": "Is longer inspection time associated with increased detection of high-grade dysplasia and esophageal adenocarcinoma in Barrett 's esophagus? Context: Current guidelines recommend that endoscopic surveillance of Barrett's esophagus (BE) be performed by using a strict biopsy protocol. However, novel methods to improve BE surveillance are still needed. To evaluate the impact of Barrett's inspection time (BIT) on yield of surveillance. Post hoc analysis of data obtained from a clinical trial. Five tertiary referral centers. Patients undergoing BE surveillance. Coordinators prospectively recorded the time spent inspecting the BE mucosa with a stopwatch. Endoscopically suspicious lesions, high-grade dysplasia (HGD)/esophageal adenocarcinoma (EAC). A total of 112 patients underwent endoscopic surveillance by 11 individual endoscopists. Patients with longer BITs were more likely to have an endoscopically suspicious lesion (P < .001) and more endoscopically suspicious lesions (P = .0001) and receive a diagnosis of HGD/EAC (P = .001). There was a direct correlation between the endoscopist's mean BIT per centimeter of BE and the detection of patients with HGD/EAC (ρ = .63, P = .03). Endoscopists who had an average BIT longer than 1 minute per centimeter of BE detected more patients with endoscopically suspicious lesions (54.2% vs 13.3%, P = .04), and there was a trend toward a higher detection rate of HGD/EAC (40.2% vs 6.7%, P = .06)." }, { "role": "assistant", "content": "Post hoc analysis of an enriched study population and experienced endoscopists at tertiary referral centers. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, RESULTS. Meshes: Animals, Cell Proliferation, Cell Survival, Choroidal Neovascularization, Collagen, Drug Combinations, Endothelial Cells, Female, Glycosaminoglycans, Heparin, Heterozygote, Humans, Intercellular Signaling Peptides and Proteins, Laminin, Neovascularization, Pathologic, Penaeidae, Proteoglycans, Rats, Rats, Zucker." }, { "role": "user", "content": "Does a heparin mimetic isolated from a marine shrimp suppress neovascularization? Context:  Choroidal neovascularization (CNV) is the main cause of severe visual loss in age-related macular degeneration (AMD). Heparin/heparan sulfate are known to play important roles in neovascularization due to their abilities to bind and modulate angiogenic growth factors and cytokines. Previously, we have isolated from marine shrimp a heparin-like compound with striking anti-inflammatory action and negligible anticoagulant and hemorrhagic activities.  To investigate the role of this novel heparin-like compound in angiogenic processes.  The anti-angiogenic effect of this heparinoid in laser-induced CNV and in vitro models is reported. The compound binds to growth factors (FGF-2, EGF and VEGF), blocks endothelial cell proliferation and shows no cytotoxic effect. The decrease in proliferation is not related to cell death either by apoptosis or secondary necrosis. The results also showed that the heparinoid modified the 2-D network organization in capillary-like structures of endothelial cells in Matrigel and reduced the CNV area. The effect on CNV area correlates with decreases in the levels of VEGF and TGF-β1 in the choroidal tissue. The low content of 2-O-sulfate groups in this heparinoid may explain its potent anti-angiogenic effect." }, { "role": "assistant", "content": " The properties of the shrimp heparinoid, such as potent anti-angiogenic and anti-inflammatory activities but insignificant anticoagulant or hemorrhagic actions, point to this compound as a compelling drug candidate for treating neovascular AMD and other angioproliferative diseases. A mechanism for the anti-angiogenic effect of the heparinoid is proposed. 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: Adrenergic beta-Agonists, Air Pollutants, Albuterol, Asthma, Bronchoconstriction, Bronchodilator Agents, Child, Cohort Studies, Dose-Response Relationship, Drug, Female, Forced Expiratory Volume, Humans, Male, Mexico, Nitrogen Dioxide, Ozone, Retrospective Studies, Severity of Illness Index, Treatment Outcome." }, { "role": "user", "content": "Are increased levels of outdoor air pollutants associated with reduced bronchodilation in children with asthma? Context: Increased outdoor air pollution levels are associated with more frequent use of rescue inhalers in subjects with asthma. However, it is unknown whether this phenomenon is explained by an air pollution-mediated increase in respiratory symptom severity or whether air pollutants decrease the efficacy of short-acting beta-agonists (SABAs). We examined the relationship between the percentage change in FEV(1) after SABA use with outdoor air pollution exposure in 85 children with asthma who were 7 to 12 years of age. Outdoor air pollution exposure was determined by measuring nitrogen dioxide (NO(2)), ozone (O(3)), and fine particulate matter (ie, particulate matter with an aerodynamic diameter < 2.5 microm [PM(2.5)]) levels. These measurements were obtained from the Mexico City Automated Monitoring Network from network sites located within a 5-km radius of each child's home and school. We found that a same-day interquartile increase of 10 parts per billion (ppb) in NO(2) concentration was associated with a reduced response of FEV(1) to SABA therapy (-15%; 95% CI, -29 to -0.5). This association was also significant when considering NO(2) levels in each of the preceding 3 days. An interquartile O(3) increase (16 ppb) in the preceding fifth day was associated with a reduced response to SABA (-11%; 95% CI, -23 to -1); an interquartile PM(2.5) increase (14 microg/m(3)) was not associated with any significant reductions in the response to SABA therapy. These associations were not observed in children receiving therapy with inhaled corticosteroids." }, { "role": "assistant", "content": "Our results suggest that recent exposure to NO(2) and possibly O(3) may reduce the response to SABAs in producing bronchodilation in children with asthma. The association between NO(2) and FEV(1) response to SABA administration may have important implications in understanding how outdoor air pollution levels relate to asthma control. 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, RESULTS. Meshes: Accessory Atrioventricular Bundle, Adult, Aged, Aged, 80 and over, Arrhythmias, Cardiac, Atrial Fibrillation, Atrial Flutter, Catheter Ablation, Cohort Studies, Female, Fluoroscopy, Humans, Imaging, Three-Dimensional, Intraoperative Care, Male, Middle Aged, Operative Time, Radiation Dosage, Radiation Exposure, Retrospective Studies, Surgery, Computer-Assisted, Tachycardia, Ectopic Atrial, Tachycardia, Ventricular, Ventricular Premature Complexes." }, { "role": "user", "content": "Does fluoroscopy integrated 3D mapping significantly reduce radiation exposure during ablation for a wide spectrum of cardiac arrhythmias? Context: Despite the use of established 3D-mapping systems, invasive electrophysiological studies and catheter ablation require high radiation exposure of patients and medical staff. This study investigated whether electroanatomic catheter tracking in prerecorded X-ray images on top of an existing 3D-mapping system has any impact on radiation exposure. Two hundred and ninety-five consecutive patients were either ablated with the guidance of the traditional CARTO-3 system (c3) or with help of the CARTO-UNIVU system (cU): [typical atrial flutter (AFL) n = 58, drug refractory atrial fibrillation (AF) n = 81, ectopic atrial tachycardia (EAT) n = 37, accessory pathways (APs) n = 22, symptomatic, idiopathic premature ventricular complexes (PVCs) n = 56, ventricular tachycardias (VTs) n = 41]. The CARTO-UNIVU allowed a reduction in radiation exposure: fluoroscopy time: AFL c3: 8.6 ± 0.8 min vs. cU: 2.9 ± 0.3 min, P < 0.001; AF c3: 16.0 ± 1.3 min vs. cU: 6.4 ± 0.9 min, P < 0.001; EAT c3: 23.4 ± 3.1 min vs. cU: 9.7 ± 1.7 min, P < 0.001; AP c3: 7.1 ± 1.2 min vs. cU: 6.0 ± 1.5 min, P = 0.59; PVCs c3: 17.6 ± 2.3 min vs. cU: 15.2 ± 2.8 min, P = 0.52; VT c3: 31.4 ± 3.4 min vs. cU: 17.5 ± 2.4 min, P = 0.003. Corresponding to the fluoroscopy time the fluoroscopy dose was also reduced significantly. These advantages were not at the cost of increased procedure times, periprocedural complications, or decreased acute ablation success rates." }, { "role": "assistant", "content": "In a wide spectrum of cardiac arrhythmias, and especially in AF and VT ablation, fluoroscopy integrated 3D mapping contributed to a dramatic reduction in radiation exposure without prolonging procedure times and compromising patient's safety. That effect, however, could not be maintained in patients with APs and PVCs. 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, METHOD, RESULTS. Meshes: Denmark, Depression, Humans, Longitudinal Studies, Mood Disorders, Occupational Diseases, Seasons." }, { "role": "user", "content": "Does outdoor work during the winter season protect against depression and mood difficulties? Context: At temperate latitudes, 1-5% of the population suffer from winter depression; during winter, mood difficulties tend to increase but may be alleviated by bright light therapy. Unlike indoor workers, outdoor workers are exposed to therapeutic levels of sunlight during winter. We hypothesized that outdoor work may protect against mood difficulties and depression. We studied this hypothesis among 2910 civil servants from Århus, Denmark, who participated in a survey in January-February 2009. Mental symptoms (N=422) defined a common case category that we broke down into two parts: depression (N=66) and mood difficulties but no depression (N=356). A total of 222 controls were also sampled from the study population. All 644 participants reported the extent of outdoor work. The confounder-adjusted odds ratio (OR) of mood difficulties showed a decreasing trend by increasing hours of outdoor work of borderline statistical significance. The OR was 0.63 [95% confidence interval (95% CI) 0.34-1.18)] for those working outdoors for>2 hours a day. No such effect was suggested for depression." }, { "role": "assistant", "content": "Our study is limited by its cross-sectional design and low statistical power but nevertheless suggests that outdoor work during winter may protect against mood difficulties. If this finding holds true it may have significant impact on workers' health as well as public health in general. Therefore, further studies are recommended." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Is the survival of osteosarcoma patients 10 years old or younger worse than the survival of older patients : a retrospective analysis? Context: This study aimed to assess whether a young age at the time of diagnosis with osteosarcoma has value to predict the prognosis. Sixty-seven children with stage II osteosarcoma were stratified according to the age of 10. There were 32 preadolescents (<or=10 years) and 35 adolescents (10<age<or=15 years). The patients were analyzed for their clinical characteristics, the histologic response to preoperative chemotherapy, event-free survival (EFS) and the patterns of relapse. After a median follow-up of 54 months (range: 6 approximately 153 months), the 5-year EFS of the preadolescent and adolescent groups was 64.5+/-9.3% and 58.2+/-9.1%, respectively, and age did not have any statistical significance for survival (p=0.55). Cox regression analysis revealed that both the serum level of alkaline phosphatase and the histologic response to preoperative chemotherapy were significantly related to survival of the 67 patients. Those patients aged less than 7 years responded poorly to preoperative chemotherapy and their rate of amputation was 43%. However, their 5-year EFS was not statistically different from the older patients (57.1+/-18.7 vs 67.7+/-6.3%, respectively, p=0.58)." }, { "role": "assistant", "content": "We could not find any statistical difference in the clinical characteristics and survival from osteosarcoma for the preadolescents and adolescents, so the current approach of having the same protocol for both groups of patients seems to be reasonable. 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": "Which of the following describes grade 2 fracture neck femur?" }, { "role": "assistant", "content": "The correct answer is REF : MAHESWARI 9TH ED" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS. Meshes: Child, Cochlear Implants, Dental Enamel Hypoplasia, Dentition, Mixed, Female, Follow-Up Studies, Humans, Molar, Tooth Eruption, Ectopic, Tooth, Impacted, Usher Syndromes." }, { "role": "user", "content": "Do enamel defects and ectopic eruption in a child with Usher syndrome and a cochlear implant? Context: Usher syndrome is a genetic disorder consisting of progressive loss of vision and hearing. The paper describes an 8-year-old girl with Usher syndrome type I who presented with generalized defects of the permanent dentition and ectopic eruption of the right maxillary first permanent molar. A cochlear implant had been fitted for her hearing loss, and the report reviews the implications of this device for dental treatment. The impacted first permanent molar was encouraged to erupt into the correct position by shaving the distal surface of the second primary molar." }, { "role": "assistant", "content": "This is the first report to describe in detail an association between Usher syndrome and enamel defects. 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, Aquaporins, Blotting, Western, C-Reactive Protein, Cross-Sectional Studies, Down-Regulation, Fatty Liver, Female, Glucose Intolerance, Glycerol, Humans, Insulin Resistance, Liver, Male, Non-alcoholic Fatty Liver Disease, Permeability, Real-Time Polymerase Chain Reaction, Triglycerides." }, { "role": "user", "content": "Are reduced hepatic aquaporin-9 and glycerol permeability related to insulin resistance in non-alcoholic fatty liver disease? Context: Glycerol represents an important metabolite for the control of lipid accumulation and hepatic gluconeogenesis. We investigated whether hepatic expression and functionality of aquaporin-9 (AQP9), a channel mediating glycerol influx into hepatocytes, is impaired in non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) in the context of insulin resistance. Liver biopsies were obtained from 66 morbid obese patients undergoing bariatric surgery (66% women, mean body mass index (BMI) 46.1±1.0 kg m(-2)) with available liver echography and pathology analysis of the biopsies in this cross-sectional study. Subjects were classified according to normoglycemia (NG), impaired glucose tolerance (IGT) or type 2 diabetes (T2D). Hepatic expression of AQP9 was analyzed by real-time PCR, western blotting and immunohistochemistry, while glycerol permeability (P(gly)) was measured by stopped-flow light scattering. AQP9 was the most abundantly (P<0.0001) expressed aquaglyceroporin in human liver (AQP9>>>AQP3>AQP7>AQP10). Obese patients with T2D showed increased plasma glycerol as well as lower P(gly) and hepatic AQP9 expression. The prevalence of NAFLD and NASH in T2D patients was 100 and 65%, respectively. Interestingly, AQP9 expression was decreased in patients with NAFLD and NASH as compared with those without hepatosteatosis, in direct relation to the degree of steatosis and lobular inflammation, being further reduced in insulin-resistant individuals. The association of AQP9 with insulin sensitivity was independent of BMI and age. Consistent with these data, fasting insulin and C-reactive protein contributed independently to 33.1% of the hepatic AQP9 mRNA expression variance after controlling for the effects of age and BMI." }, { "role": "assistant", "content": "AQP9 downregulation together with the subsequent reduction in hepatic glycerol permeability in insulin-resistant states emerges as a compensatory mechanism whereby the liver counteracts further triacylglycerol accumulation within its parenchyma as well as reduces hepatic gluconeogenesis in patients with NAFLD. 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: ." }, { "role": "user", "content": "Does a resident preceptor model improve the clerkship experience on general surgery? Context: The frenetic pace of inpatient care on surgical services can create barriers to resident teaching of students. Students are often concerned that busy surgical residents will not be able to adequately evaluate their performance at the end of a clerkship. To determine whether the addition of a resident preceptor would increase the satisfaction of students rotating through the general surgery portion of the required third-year surgery clerkship. Before implementing a resident preceptor model, third-year students rotating on general surgery were administered a 24-item web-based survey regarding their experience on the general surgery portion of the surgery clerkship. General surgery residents were similarly surveyed. A resident preceptor model was then introduced. Subsequent students and residents were surveyed. Presurveys and postsurveys were compared and mean responses analyzed. The addition of a resident preceptor made students more comfortable with asking residents questions (p = 0.02), increased the time students felt was available for developing relationships with residents (p = 0.03), and improved the feeling that residents would be able to accurately evaluate the student's effectiveness as a team member (p = 0.05). The students felt resident teaching on afternoon rounds was increased with the resident preceptor model (p = 0.05). Residents reported spending more time teaching students on morning rounds (p = 0.03)." }, { "role": "assistant", "content": "Implementation of a resident preceptor model resulted in significant improvement in medical students' perceptions of resident teaching effectiveness and ability to accurately evaluate a student's performance. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, METHODS, RESULTS. Meshes: Adolescent, Adult, Attitude to Health, Clothing, Family Practice, Female, Humans, Israel, Male, Middle Aged, Nurses, Physicians." }, { "role": "user", "content": "Is our appearance important to our patients? Context: We aimed to explore patients' attitudes towards family physicians' and nurses' appearance. One hundred and sixty-eight patients from three teaching Family Medicine clinics in Beer-Sheva, Israel, were interviewed in the clinics regarding the medical staff's dress code. They were also asked to choose one picture for either a male or female physician which, in their opinion, was the most suited for their own family physician, from a selection of pictures of the same male and female doctors dressed in different attires. One hundred and twenty-six patients (75%) replied that the attire of the physician had no influence on their decision in choosing their own family doctor. Fifty-two per cent of the patients preferred the doctor in a white coat and 71 % had the same preference for the nurse. Older age was associated with increased preference for a white coat. The dressing items which scored high for male doctor were a name tag, a formal suit or a shirt with a tie and sports shoes. For a female doctor a name tag, short haircut, trousers and sports shoes ranked highly. Long hair, earrings, and sandals scored low for a male physician, while mini-dress, shorts and tight clothes scored low for a female physician." }, { "role": "assistant", "content": "About half of patients still prefer the doctor to be dressed in a white coat. Patients prefer a more formal dressing for male and female physicians in family medicine clinics. Most of the patients claimed that the attire of the physician had no influence on their choice of family physician." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: INTRODUCTION, METHODS, RESULTS. Meshes: Academic Medical Centers, Adult, Aged, Aged, 80 and over, Analysis of Variance, Body Mass Index, Cardiac Surgical Procedures, Cardiovascular Diseases, Cohort Studies, Comorbidity, Female, Hospital Mortality, Humans, Incidence, Linear Models, Male, Middle Aged, Morbidity, Multivariate Analysis, Obesity, Ontario, Patient Readmission, Postoperative Complications, Predictive Value of Tests, Probability, Prospective Studies, Reoperation, Risk Assessment, Survival Analysis, Treatment Outcome." }, { "role": "user", "content": "Is obesity a predictor of mortality, morbidity and readmission after cardiac surgery? Context: Obesity has been described as a risk factor for the development of coronary artery disease, but it has not been determined whether obesity is associated with adverse outcomes after cardiac surgery. Therefore, we analyzed a large cohort of patients who had undergone cardiac surgery to determine whether obesity is a predictor of mortality, morbidity or early readmission to hospital. At the London Health Sciences Centre, an academic tertiary care centre, we prospectively entered data from the cardiac surgical database from July 1999 to April 2002. We collected data on 1310 consecutive, unselected patients who underwent cardiac surgery during that time. We assessed the degree of obesity using the body mass index (BMI), and we prospectively documented the occurrence of 10 major complications after surgery. They included stroke, reoperation for bleeding, life-threatening cardiac arrest or arrhythmia, new renal failure requiring dialysis, septicemia, mediastinitis, sternal dehiscence, respiratory failure, postoperative myocardial infarction and low cardiac output necessitating intra-aortic balloon pump use. Univariable and multivariable analyses were conducted to determine the factors associated with and predictive of postoperative death and major complications. An increased BMI did not increase the risk of early postoperative death. Furthermore, increased BMI was not a predictor of a patient experiencing any of the major complications, except sternal dehiscence. An increased BMI was associated with a higher likelihood of readmission to hospital within 30 days of discharge." }, { "role": "assistant", "content": "Obesity was not associated with adverse outcomes after cardiac operations, aside from the increased risks of sternal dehiscence and early hospital readmission." } ]

[ { "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, METHODS, METHODS, METHODS, RESULTS. Meshes: Blood Transfusion, Electronic Health Records, Health Personnel, Humans, Medical Order Entry Systems, Physicians, Practice Guidelines as Topic, Retrospective Studies." }, { "role": "user", "content": "Do why providers transfuse blood products outside recommended guidelines in spite of integrated electronic best practice alerts? Context: Best practice alerts (BPAs) provide clinical decision support (CDS) at the point of care to reduce unnecessary blood product transfusions, yet substantial transfusions continue outside of recommended guidelines. To understand why providers order blood transfusions outside of recommended guidelines despite interruptive alerts. Retrospective review. Tertiary care hospital. Inpatient healthcare providers. Provider-BPA interaction data were collected from January 2011 to August 2012 from the hospital electronic medical record. Provider (free-text) responses to blood transfusion BPA prompts were independently reviewed and categorized by 2 licensed physicians, with agreement assessed by χ(2) analysis and kappa scoring. Rationale for overriding blood transfusion BPAs was highly diverse, acute bleeding being the most common (>34%), followed by protocolized behaviors on specialty services (up to 26%), to \"symptomatic\" anemia (11%-12%). Many providers transfused in anticipation of surgical or procedural intervention (10%-15%) or imminent hospital discharge (2%-5%). Resident physicians represented the majority (55%) of providers interacting with BPAs." }, { "role": "assistant", "content": "Providers interacting with BPAs (primarily residents and midlevel providers) often do not have the negotiating power to change ordering behavior. Protocolized behaviors, unlikely to be influenced by BPAs, are among the most commonly cited reasons for transfusing outside of guidelines. Symptomatic anemia is a common, albeit subjective, indication cited for blood transfusion. With a wide swath of individually uncommon rationales for transfusion behavior, secondary use of electronic medical record databases and integrated CDS tools are important to efficiently analyze common practice behaviors. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The natural history of disease is best established by:" }, { "role": "assistant", "content": "The correct answer is The Natural history of disease is best established by coho studies. COHO STUDY: Forward looking study Prospective study Cause to effect study Risk factor to disease study Exposure to outcome study Follow-up study Incidence study" } ]

[ { "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: Anemia, Blood Gas Monitoring, Transcutaneous, Carcinoma, Squamous Cell, Female, Head and Neck Neoplasms, Hemoglobin A, Humans, Male, Middle Aged, Muscle, Skeletal, Oxygen, Sex Factors." }, { "role": "user", "content": "Is severe anemia associated with poor tumor oxygenation in head and neck squamous cell carcinomas? Context: To investigate the relationship between tumor oxygenation and the blood hemoglobin (Hb) concentration in patients with squamous cell carcinoma of the head and neck (SCCHN). A total of 133 patients with SCCHN underwent pretreatment polarographic pO2 measurements of their tumors. In 66 patients measurements were also made in sternocleidomastoid muscles. The patients were divided into three groups according to their Hb concentration-severe anemia (Hb < 11.0 g/dl), mild anemia (female: Hb 11.0-11.9 g/dl; male: Hb 11.0-12.9 g/dl), and normal Hb concentration (female: Hb > or =12.0 g/dl; male: > or =13.0 g/dl). No significant difference in tumor oxygenation could be detected between mildly anemic patients and patients with a normal Hb level. However, the tumor oxygenation in the severely anemic group was significantly below that of each of the other two groups (p < 0.0001). There was no significant difference between the Hb groups in oxygenation of sternocleidomastoid muscles. In a multivariate analysis including Hb group, tumor volume, smoking habits, gender, T-stage, N-stage, and histologic grade a Hb level < 11 g/dl was found to be the strongest predictor for a poor tumor oxygenation. Smoking also had a marginal influence on median pO2." }, { "role": "assistant", "content": "Our data suggest that a low Hb concentration and cigarette smoking contribute to inadequate oxygenation of SCCHN and thus for increased radioresistance. Consequently, Hb correction and abstinence from smoking may significantly improve tumor oxygenation. 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, Gene Transfer Techniques, Mice, Neuroblastoma, Plasmids, Tyrosine 3-Monooxygenase, Vaccines, DNA." }, { "role": "user", "content": "Is tyrosine hydroxylase-based DNA-vaccination effective against murine neuroblastoma? Context: The disruption of self-tolerance against neuroblastoma is the ultimate goal of an effective DNA-vaccine. Here we demonstrate the induction of a protective immunity against syngeneic murine NXS2 neuroblastoma in A/J mice, following vaccination with tyrosine hydroxylase (TH) derived antigens. Oral gene delivery was accomplished using an attenuated strain of Salmonella typhimurium as a carrier harboring vectors encoding for mTH antigens. Vaccination was effective in protecting animals from a lethal challenge with wild-type NXS2 tumor cells." }, { "role": "assistant", "content": "These results provide the first evidence of the TH self antigen being recognized by T-cells and demonstrate that a TH-based DNA vaccine is a potentially useful immunotherapeutic strategy for neuroblastoma. 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": "Cholesteatoma is seen in?" }, { "role": "assistant", "content": "The correct answer is Cholesteatoma is commonly associated with the attico antral type of CSOM. Attico antral type of CSOM involves posterosuperior pa of the cleft and is associated with an attic or marginal perforation. The disease is often associated with bone eroding processes such as cholesteatoma, granulations and osteitis. Ref: PL Dhingra 7th edition of Ear, Nose and Throat; Pg no 78" } ]

[ { "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 primary tooth is generally accepted as the first to erupt, and at about what mean age?" }, { "role": "assistant", "content": "The correct answer is Eruption for the primary mandibular central incisor may be given as 6 months (Woelfel and Scheid, 2002); 6.5 months (Kraus et al., 1969); 7.5 months(Charlick et al.); or 8 (6 to 10) months (Ash and\nNelson, 2003)." } ]

[ { "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, DESIGN, METHODS, RESULTS. Meshes: Adult, Australia, Case-Control Studies, Football, Groin, Hip Injuries, Humans, Hyperalgesia, Logistic Models, Male, Odds Ratio, Pain Threshold, Prevalence, Tendon Injuries, Young Adult." }, { "role": "user", "content": "Do Australian Football players have sensitive groins? Context: This is the first study to evaluate the mechanical sensitivity, clinical classifications and prevalence of groin pain in Australian football players. Case-control. Professional (n=66) and semi-professional (n=9) Australian football players with and without current or previous groin injuries were recruited. Diagnoses were mapped to the Doha Agreement taxonomy. Point and career prevalence of groin pain was calculated. Pressure pain thresholds (PPTs) were assessed at regional and distant sites using handheld pressure algometry across four sites bilaterally (adductor longus tendon, pubic bone, rectus femoris, tibialis anterior muscle). To assess the relationship between current groin pain and fixed effects of hyperalgesia of each site and a history of groin pain, a mixed-effect logistic regression model was utilised. Receiver Operator Characteristic (ROC) curve were determined for the model. Point prevalence of groin pain in the preseason was 21.9% with a career prevalence of 44.8%. Adductor-related groin pain was the most prevalent classification in the pre-season period. Hyperalgesia was observed in the adductor longus tendon site in athletes with current groin pain (OR=16.27, 95% CI 1.86 to 142.02). The ROC area under the curve of the regression model was fair (AUC=0.76, 95% CI 0.54 to 0.83)." }, { "role": "assistant", "content": "Prevalence data indicates that groin pain is a larger issue than published incidence rates imply. Adductor-related groin pain is the most common diagnosis in pre-season in this population. This study has shown that hyperalgesia exists in Australian football players experiencing groin pain indicating the value of assessing mechanical pain sensitivity as a component of the clinical assessment." } ]

[ { "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": "Sjogren's syndrome refers to disease of -" }, { "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 nerve supply of Middle ear is from" }, { "role": "assistant", "content": "The correct answer is (B) Tympanic branch of glossopharyngeal nerve# Sensory nerve supply of middle ear cavity is provided by Glossopharyngeal nerve.> Tympanic Plexus It lies on the promontory and is formed by tympanic branch of glossopharyngeal and sympathetic fibres from the plexus round the internal carotid artery.> Tympanic plexus supplies innervation to the medial surface of the tympanic membrane, tympanic cavity, mastoid air cells and the bony eustachian tube.> It also carries secretomotor fibres for the parotid gland. Section of tympanic branch of glossopharyngeal nerve can be carried out in the middle ear in Frey syndrome.> The tympanic cavity contains the tympanic plexus and the facial nerve. Branches from the plexus and the facial nerve supply structures within the tympanic cavity but also leave the cavity to supply structures on the face. The nerves that constitute the tympanic plexus ramify on the surface of the promontory on the medial wall of the tympanic cavity They are derived from the tympanic branch of the glossopharyngeal nerve and the caroticotympanic nerves. The former arises from the inferior ganglion of the glossopharyngeal nerve, and reaches the tympanic cavity via the tympanic canaliculus for the tympanic nerve. The superior and inferior caroticotympanic nerves are postganglionic sympathetic fibres which are derived from the carotid sympathetic plexus and traverse the wall of the carotid canal to join the plexus." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, METHODS, METHODS, METHODS, RESULTS. Meshes: Adolescent, Adult, Cerebral Palsy, Child, Child, Preschool, Electromyography, Female, Gait, Humans, Linear Models, Male, Muscle Contraction, Muscle Spasticity, Range of Motion, Articular, Task Performance and Analysis." }, { "role": "user", "content": "Does spastic velocity threshold constrain functional performance in cerebral palsy? Context: To evaluate a quantitative, velocity-based assessment of spasticity in the quadriceps and hamstrings muscles of children with cerebral palsy (CP) and to show the effects of spasticity in constraining knee velocities during fast gait. A quantitative comparison of neuromuscular and biomechanical performance in patients with CP and controls without CP. Movement analysis laboratory within a university clinical referral center. A convenience sample of 18 ambulatory patients with CP and 11 control subjects without CP. Not applicable. Spastic threshold velocity recorded from electromyographic response during passive isovelocity knee movement was compared with knee angular velocity during fast walking, Gross Motor Function Measure (GMFM) scores, and Ashworth Scale score. Patients with measurable spasticity showed slower peak knee angular velocity during walking than patients without spasticity (P<.005). A significant correlation existed between spastic threshold velocity and peak knee angular velocity during fast walking (r=.85, P<.001). Spastic threshold velocity correlated significantly with GMFM (r=.58, P<.05) but not with Ashworth score." }, { "role": "assistant", "content": "The velocity dependency of spasticity can be measured by electromyograph and dynamometer to determine spastic threshold velocity. Spastic threshold velocity correlated with limitations in joint angular velocity during walking and functional performance. 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: Contraindications, Creatinine, Decision Support Systems, Clinical, Drug Therapy, Computer-Assisted, Female, Guideline Adherence, Hospitals, University, Humans, Illinois, Male, Medical Records Systems, Computerized, Medical Staff, Hospital, Medication Errors, Medication Systems, Hospital, Pharmaceutical Preparations, Reminder Systems, Renal Insufficiency, User-Computer Interface." }, { "role": "user", "content": "Does a trial of automated decision support alert for contraindicated medications using computerized physician order entry? Context: Automated clinical decision support has shown promise in reducing medication errors; however, clinicians often do not comply with alerts. Because renal insufficiency is a common source of medication errors, the authors studied a trial of alerts designed to reduce inpatient administration of medications contraindicated due to renal insufficiency. A minimum safe creatinine clearance was established for each inpatient formulary medication. Alerts recommending cancellation appeared when a medication order was initiated for a patient whose estimated creatinine clearance was less than the minimum safe creatinine clearance for the medication. Administration of medications in patients with creatinine clearances less than the medication's minimum safe clearance were studied for 14 months after, and four months before, alert implementation. In addition, the impact of patient age, gender, degree of renal dysfunction, time of day, and duration of housestaff training on the likelihood of housestaff compliance with the alerts was examined. The likelihood of a patient receiving at least one dose of contraindicated drug after the order was initiated decreased from 89% to 47% (p < 0.0001) after alert implementation. Analysis of the alerts seen by housestaff showed that alert compliance was higher in male patients (57% vs. 38%, p = 0.02), increased with the duration of housestaff training (p = 0.04), and increased in patients with worsening renal function (p = 0.007)." }, { "role": "assistant", "content": "Alerts were effective in decreasing the ordering and administration of drugs contraindicated due to renal insufficiency. Compliance with the alerts was higher in male patients, increased with the duration of housestaff training, and increased in patients with more severe renal dysfunction. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In radial nerve injures paralysis of the brachioradialis, extensor carpi radialis longus and brevis, extensor digitorum and extensor pollicis longus but sparing of the triceps places the nerve lesion at" }, { "role": "assistant", "content": "The correct answer is The level of the humeral shaft (mid) Nerve supply to the triceps is proximal to the mid shaft level" } ]

[ { "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: Diplopia, Humans, Lens Implantation, Intraocular, Lenses, Intraocular, Models, Biological, Models, Theoretical, Ophthalmoscopy, Optics and Photonics, Polymethyl Methacrylate, Prosthesis Design, Tomography, Optical Coherence." }, { "role": "user", "content": "Do occlusive IOLs for intractable diplopia demonstrate a novel near-infrared window of transmission for SLO/OCT imaging and clinical assessment? Context: Occlusive intraocular lens (IOL) implantation is an effective therapeutic option in patients with intractable diplopia, visual confusion, and unsightly leukocoria. However, their use has been restricted by concerns that inability to visualize the retina may prevent the diagnosis of important posterior pole diseases. In this study, transmission spectra of occlusive IOLs were defined as a basis for acquiring scanning laser ophthalmoscopy/optical coherence tomography (SLO/OCT) images. Fifteen IOLs of three designs were examined: black small and large PMMA and black Lotus (Morcher GmbH, Stuttgart, Germany). Each IOL was placed between a broad-spectrum white light source and a spectroradiometer, to generate transmission spectra for each lens and determine the cutoff wavelength. Transmission in the near-infrared (NIR) range was confirmed with an 850-nm LED. A model eye was implanted with occlusive IOLs, and SLO/OCT scans were acquired with seven clinical SLO/OCT imaging systems. Occlusive IOLs demonstrated high levels of transmission of NIR light. It was determined that most SLO/OCT scanners would achieve 99% to 100% transmission at their operational wavelengths of NIR light. Furthermore, all clinical SLO/OCT imaging systems were capable of imaging fine retinal features without attenuation through occlusive IOLs in a model eye." }, { "role": "assistant", "content": "In this study, a novel NIR window of high-level transmission was identified across the occlusive IOLs with applications to SLO/OCT imaging and NIR-based clinical assessment. The ability to acquire high-quality SLO/OCT scans to detect posterior pole disease may fundamentally change the current view on occlusive IOLs and encourage their use in patients with intractable diplopia. 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: Anastomosis, Surgical, Animals, Coronary Artery Bypass, Education, Medical, Continuing, Humans, Imaging, Three-Dimensional, Models, Cardiovascular, Robotics, Swine, Thoracic Surgery, Thoracoscopes." }, { "role": "user", "content": "Does 3D-visualization improve the dry-lab coronary anastomoses using the Zeus robotic system? Context: Robotic surgical instruments enable quick and precise movements and may allow complete endoscopic coronary artery bypass grafting. However, cardiac surgeons will have to become familiar with this technology and endoscopic viewing. We present our training program with special focus on 2D- and 3D-visualization. A thoracic skeleton, covered with a neoprene suit, served as model for the chest wall. Either a glove, fixed on a metal plate, or a pig heart were placed inside for training. On the glove, a suture line consisting of two lines of 16 points each, with a distance of 2 mm between each point, was stamped. On the pig heart, the LAD was prepared and incised; subsequently an anastomosis was done using the dissected right coronary artery as a graft. The time required was measured for both models. For suturing, the Zeus System (Computer Motion, Goleta, CA) was used and the third robotic arm positioned the endoscopic camera. The scopes were connected to a 3D-camera and the picture was displayed on a headset with two integrated monitors. Visualization was set to either 2D or 3D. Three surgeons were involved in the study. Each one did at least 12 anastomoses on 2D and 3D. The three surgeons involved showed a clear and rapid learning curve. The times required for the suture line decreased from 12.5 +/- 1.6 to 8.5 +/- 0.5 minutes with 2D and from 11.9 +/- 5.4 to 7.8 +/- 0.5 minutes for 3D respectively. This decrease did reach statistical significance (p = 0.03). In the pig heart model, the anastomosis times decreased from 33.2 +/- 8.4 to 15.7 +/- 0.3 minutes with 3D-visualization, and from 36.2 +/- 2.2 to 29.5 +/- 3.3 minutes with 2D. The decrease in anastomosis time did again reach significance (p = 0.025). At the end of the study, the times achieved with 2D-visualization were significantly longer than those with 3D (p = 0.01)." }, { "role": "assistant", "content": "A surgical training program is mandatory to become familiar with these new technologies. Both models showed learning curves over an acceptable time course. 3D-visualization facilitated quick and precise movements, thus resulting in shorter anastomosis times. 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, MATERIALS AND METHODS, RESULT. Meshes: Aged, Blood Flow Velocity, Echocardiography, Doppler, Color, Female, Humans, Male, Middle Aged, Renal Dialysis, Reproducibility of Results, Sensitivity and Specificity, Uremia, Ventricular Dysfunction, Left." }, { "role": "user", "content": "Color M-mode flow propagation velocity: is it really preload independent? Context: This study investigates the change in flow propagation velocity (FPV) in uremic patients who undergo regular hemodialysis (H/D). We studied 93 uremic patients (44 men and 49 women; 59 +/- 14-years-old) receiving regular hemodialysis. Patients were separated by baseline left ventricular ejection fraction (LVEF): 71 patients with LVEF>50% (group 1), 13 patients with LVEF 35-50% (group 2), 7 patients with LVEF<35% (group 3). All patients were in sinus rhythm before H/D. They received complete transthoracic echocardiographic examinations. Flow propagation velocity was measured by color M-mode echocardiography in apical four chambers view. All these parameters were obtained before and after H/D. Paired data were compared. According to different H/D amounts, we viewed the FPV response after H/D in variant baseline LVEF groups. The baseline FPV became lower in patients with low LVEF. After H/D, obvious decrement of FPV occurred in group 1, but there were no obvious changes in groups 2 and 3. In fact, a slight increment of FPV was found in group 3. In patients with baseline LVEF>50%, FPV after H/D was almost always lower, regardless of H/D amount. But there was different response in patients with baseline LVEF<50%." }, { "role": "assistant", "content": "Flow propagation velocity is preload independent in patients with LVEF<50%, but it is preload-dependent in patients with LVEF>50%." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, METHODS, RESULTS. Meshes: 4-Aminobutyrate Transaminase, Animals, Anticonvulsants, Blood Platelets, Brain, Brain Chemistry, Dose-Response Relationship, Drug, Epilepsy, Glutamate Decarboxylase, Male, Rats, Rats, Wistar, Stimulation, Chemical, Synaptic Transmission, Time Factors, Vigabatrin, gamma-Aminobutyric Acid." }, { "role": "user", "content": "Time course of the GABAergic effects of vigabatrin: is the time course of brain GABA related to platelet GABA-transaminase inhibition? Context: To analyze the time course of the effects of vigabatrin (VGB) on brain gamma-aminobutyric acid (GABA), and its relation with 4-aminobutyrate-2-ketoglutarate amino-transferase (GABA-T) in brain and platelets. Blood and brain samples were collected at 4, 24, 48, and 72 h after a single dose and after 3 and 8 days of treatment with 200 mg/kg of VGB in rats. Time courses of the GABAergic effects of VGB were different after single and multiple doses: with multiple doses, the inhibition of brain GABA-T was quicker and longer, the inhibition of platelet GABA-T was greater and longer, the increase in brain GABA was greater, and recovery began earlier. After pooling the data obtained at 4, 24, 48, and 72 h, we observed a power correlation between the increase in brain GABA in individual rats as percentage of the control and both the inhibition of brain GABA-T after a single dose of VGB (r = -0.40; p<0.05), and the inhibition of platelet GABA-T after 3 days (r = -0.48; p<0.01) and 8 days of treatment (r = -0.53; p<0.01). When all data after single and multiple doses were pooled, the increase in brain GABA correlated better with the inhibition of GABA-T in platelets (r = -0.62; p<0.001) than in brain (r = -0.38; p<0.001). Platelet GABA-T correlated with brain GABA at 4 h (r = -0.64; p<0.001) and 24 h (r = -0.66; p<0.001) but not at 48 and 72 h." }, { "role": "assistant", "content": "Platelet GABA-T reflects the time course of the increase in brain GABA better than does brain GABA-T after multiple doses of VGB in rats." } ]

[ { "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, Aged, 80 and over, Chi-Square Distribution, Critical Care, Female, Humans, Informed Consent, Intensive Care Units, Logistic Models, Male, Middle Aged, Nervous System Diseases, Patient Satisfaction, Retrospective Studies, Statistics, Nonparametric, Treatment Outcome, Young Adult." }, { "role": "user", "content": "Is retrospective agreement and consent to neurocritical care influenced by functional outcome? Context: Only limited data are available on consent and satisfaction of patients receiving specialized neurocritical care. In this study we (i) analyzed the extent of retrospective consent to neurocritical care--given by patients or their relatives--depending on functional outcome one year after hospital stay, and (ii) identified predisposing factors for retrospective agreement to neurocritical care. We investigated 704 consecutive patients admitted to a nonsurgical neurocritical care unit over a period of 2 years (2006 through 2007). Demographic and clinical parameters were analyzed, and the patients were grouped according to their diagnosis. Functional outcome, retrospective consent to neurocritical care, and satisfaction with hospital stay was obtained by mailed standardized questionnaires. Logistic regression analyses were calculated to determine independent predictors for consent. High consent and satisfaction after neurointensive care (91% and 90%, respectively) was observed by those patients who reached an independent life one year after neurointensive care unit (ICU) stay. However, only 19% of surviving patients who were functionally dependent retrospectively agreed to neurocritical care. Unfavorable functional outcome and the diagnosis of stroke were independent predictors for missing retrospective consent." }, { "role": "assistant", "content": "Retrospective agreement to neurocritical care is influenced by functional outcome. Especially in severely affected stroke patients who cannot communicate their preferences regarding life-sustaining therapy, neurocritical care physicians should balance the expected burdens and benefits of treatment to meet the patients' putative wishes. Efforts should be undertaken to identify predictors for severe disability after neurocritical care. Final Decision: yes" } ]