Datasets:

Medint

/

Multi-Med-conversational

like 0

[ { "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, Blood Sedimentation, C-Reactive Protein, Female, Follow-Up Studies, Humans, Knee Joint, Logistic Models, Male, Middle Aged, Multivariate Analysis, Muscle Strength, Netherlands, Osteoarthritis, Knee, Quadriceps Muscle, Time Factors." }, { "role": "user", "content": "Is elevated C-reactive protein associated with lower increase in knee muscle strength in patients with knee osteoarthritis : a 2-year follow-up study in the Amsterdam Osteoarthritis ( AMS-OA ) cohort? Context: The aim of this study was to examine the associations of elevated serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) with change in muscle strength in patients with established knee osteoarthritis (OA), at 2 years. Data from 186 patients with knee OA were gathered at baseline and at 2-year follow-up. CRP (in milligrams per liter) and ESR (in millimeters per hour) were measured in serum from patients' blood. Strength of quadriceps and hamstrings muscles was assessed by using an isokinetic dynamometer. The association of inflammatory markers with change in knee muscle strength was analyzed by using uni- and multi-variate linear regression models. Patients with elevated CRP values at both baseline and 2-year follow-up exhibited a lower increase in knee muscle strength for a period of 2 years (β = -0.22; P = 0.01) compared with the group with non-elevated levels at both times of assessment. The association persisted after adjustment for relevant confounders. Elevated ESR values at both times of assessment were not significantly associated with change in knee muscle strength (β = -0.05; P = 0.49)." }, { "role": "assistant", "content": "Our results indicate that elevated CRP values are related to a lower gain in muscle strength over time in patients with established knee OA. Although the mechanism to explain this relationship is not fully elucidated, these results suggest inflammation as a relevant factor influencing muscle strength in this group of patients. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A fundamental technique used in psychoanalysis is :" }, { "role": "assistant", "content": "The correct answer is D. i.e. Free association" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Allergens, Environmental Exposure, Female, Humans, Male, Middle Aged, Pollen, Rhinitis, Allergic, Seasonal, Seasons, Skin Tests, Trees." }, { "role": "user", "content": "Is it important to perform pollen skin prick tests in the season? Context: Seasonal exposure to pollens causes the characteristic symptoms of respiratory allergy as well as an increase in specific IgE levels and inflammatory mediator release. However, little is known about the effect of natural allergen exposure on the skin test reactivity of patients with seasonal allergy. The aim of this study was to investigate the monthly variation in skin test reactions with pollen allergens during pollen season and its relation to pollen counts. Fifteen subjects with seasonal allergic rhinitis and/or asthma (4 male, 11 female) between the ages of 13 and 52 (mean 33.9 +/- 2.9) who lived in Ankara, Turkey were selected for this study. Patients were monitored from the beginning of March to the end of September 1997, and skin prick tests were performed using 5 grass, 12 tree, and 5 weed pollen allergen extracts every month. Atmospheric pollen grains were counted in the Ankara area between January and December, 1997. There were small but statistically significant increases in tree pollen-induced wheal sizes in May when compared with other months (P<0.05). Skin test reactivity was correlated with tree pollen counts (r = 0.978, P<0.05). There was not a significant difference in skin test reactivity to grass and weed pollens between months." }, { "role": "assistant", "content": "Although skin test reactivity may be slightly greater to tree pollen during the tree pollen season, the timing of skin testing is not a critical determinant in patients with pollen allergy." } ]

[ { "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: Allergens, Animals, Asthma, Bronchial Hyperreactivity, Bronchoalveolar Lavage Fluid, Chelating Agents, Cytokines, Disease Models, Animal, Eosinophilia, Ethylenediamines, Goblet Cells, Hyperplasia, Immunoglobulin E, Inflammation, Interleukin-13, Male, Mice, Mice, Inbred BALB C, Mice, Inbred C57BL, Ovalbumin, Respiratory System, Zinc." }, { "role": "user", "content": "Does a zinc chelator TPEN attenuate airway hyperresponsiveness and airway inflammation in mice in vivo? Context: Zinc is an essential element required for the cell metabolism, including gene transcription, signal transduction, immunity, and apoptosis. The pathophysiological role of zinc in asthma, however, is not entirely clear. Mast cells have been implicated in atopic asthma, and zinc deprivation has been reported to reduce mast cell activation. Here, we investigate the effects of a zinc chelator, N,N,N',N'-tetrakis (2-pyridyl-methyl) ethylenediamine (TPEN), on asthmatic responses in mouse models of ovalbumin (OVA)-induced airway hyperresponsiveness and allergic airway inflammation. Mice were sensitized with OVA with or without the adjuvant aluminum hydroxide (alum) and subjected to OVA exposure with or without treatment of TPEN. Cell profiles and cytokine levels in bronchoalveolar lavage (BAL) fluids, airway responsiveness to inhaled acetylcholine, and goblet cell hyperplasia after allergen exposure were assessed. In mice sensitized to OVA without alum, TPEN significantly suppressed airway hyperresponsiveness and eosinophilia in BAL fluids. TPEN also attenuated the upregulation of TNFα, IL-13 and IL-4 in BAL fluids and goblet cell hyperplasia after OVA exposure. By contrast, in mice sensitized to OVA with alum, TPEN suppressed eosinophilia in BAL fluids but not airway hyperresponsiveness and goblet cell hyperplasia." }, { "role": "assistant", "content": "In pulmonary allergic inflammation induced in mice immunized with antigen without alum, zinc chelator inhibits airway inflammation and hyperresponsiveness. These findings suggest that zinc may be a therapeutic target of allergic asthma. 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 with congestive heart failure was started on digoxin and diuretics. He later presents with bradycardia and GIT upset and visual disturbances. His K+ was found to be 2.5 The reason for these feature is" }, { "role": "assistant", "content": "The correct answer is (B) Digoxin toxicity > Digitalis is effective in patients with systolic HF complicated by atrial flutter and fibrillation and a rapid ventricular rate, who benefit both from slowing of the ventricular rate and from the positive inotropic effect.> Although digitalis does not improve survival in patients with systolic HF and sinus rhythm, it reduces symptoms of HF and the need for hospitalization.> Digitalis is of little or no value in patients with HF, sinus rhythm, and the following conditions: hypertrophic cardiomyopathy, myocarditis, mitral stenosis, chronic constrictive pericarditis, and any form of diastolic HF.> Digoxin, which has a half-life of 1.6 days, is filtered n the glomeruli and secreted by the renal tubules. Significant reductions of the glomerular filtration rate reduce the elimination of digoxin and, therefore, may prolong digoxin's effect, allowing it to accumulate to toxic levels, unless the dose is reduced.> DIGITALIS INTOXICATION: This is a serious and potentially fatal complication. Advanced age, hypokalemia, hypomagnesemia, hypoxemia, renal insufficiency, hypercalcemia, and acute myocardial infarction all may reduce tolerance to digitalis. Chronic digitalis intoxication may be insidious in onset and is characterized by anorexia, nausea, and vomiting, exacerbations of HF, weight loss, cachexia, neuralgias, gynecomastia, yellow vision, and delirium. The most frequent disturbances of cardiac rhythm are ventricular premature beats, bigeminy, ventricular tachycardia, and, rarely, ventricular fibrillation. Atrioventricular block and nonparoxysmal atrial tachycardia with variable atrioventricular block are characteristic of digitalis intoxication; withdrawal of the drug and treatment with li-adrenocepior blocker or lidocaine are indicated. If hypokalemia is present, potassium should be administered cautiously by the oral route. Fab fragments of purified, intact digitalis antibodies are a potentially lifesaving approach to the treatment of severe intoxication.> The administration of quinidine, verapamil, amiodarone, and propafenone to patients receiving digoxin raises the serum concentration of the latter, increasing the propensity to digitalis intoxication.> The dose of digitalis should be reduced by half in patients receiving these drugs." } ]

[ { "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 copper deficiency myelopathy produce a clinical picture like subacute combined degeneration? Context: Copper deficiency in ruminants is known to cause an ataxic myelopathy. Copper deficiency as a cause of progressive myelopathy in adults is underrecognized. To describe the clinical, biochemical, electrophysiologic, and imaging characteristics in 13 patients with myelopathy associated with copper deficiency. The records of patients with a copper deficiency-associated myelopathy were reviewed. Clinical characteristics, laboratory investigations, and responses to therapeutic intervention were summarized. Thirteen such patients were found, 11 of them in a 15-month period. All patients presented with prominent gait difficulty, reflecting a sensory ataxia due to dorsal column dysfunction and lower limb spasticity. All patients had polyneuropathy. A high or high-normal serum zinc level was seen in 7 of the 11 patients for whom this information was available. Somatosensory evoked potential studies done in eight patients showed impaired conduction in central proprioceptive pathways. Dorsal column signal change on spine MRI was present in three patients. An initial clue to the diagnosis was a very low ceruloplasmin level; further tests of copper metabolism excluded Wilson disease. The cause remained unexplained in most patients. Oral copper supplementation restored normal or near-normal copper levels in 7 of the 12 patients in whom adequate follow-up data were available; parenteral supplementation restored normal level in 3 further patients. Copper supplementation prevented further neurologic deterioration, but the degree of actual improvement was variable." }, { "role": "assistant", "content": "Unrecognized copper deficiency appears to be a common cause of idiopathic myelopathy in adults. The clinical picture bears striking similarities to the syndrome of subacute combined degeneration associated with vitamin B12 deficiency. Early recognition and copper supplementation may prevent neurologic deterioration. 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: ATP Binding Cassette Transporter, Subfamily B, Member 1, Adenosine Triphosphate, Animals, Biological Transport, Cell Survival, Cholesterol, Cholesterol Esters, Cyclosporine, Dose-Response Relationship, Drug, Female, In Vitro Techniques, Kidney Tubules, Proximal, L-Lactate Dehydrogenase, Mice, Progesterone, Trifluoperazine." }, { "role": "user", "content": "Does p glycoprotein-mediated cholesterol cycling determine proximal tubular cell viability? Context: MDR P glycoproteins may help transport plasma membrane free cholesterol (FC) to the endoplasmic reticulum (ER), where it undergoes acylation, forming cholesterol esters (CE). This study assessed whether P glycoprotein inhibitors alter renal tubular FC/CE expression, thereby altering cell integrity. Mouse proximal tubule segments (PTS) were exposed to chemically dissimilar P glycoprotein inhibitors [progesterone (prog), trifluoperazine (TFP), or cyclosporine A (CsA)]. Their effects on FC/CE and adenosine 5'-triphosphate (ATP) levels, phospholipid expression, lipid peroxidation, and cell viability (lactate dehydrogenase release; LDH) were assessed. P glycoprotein inhibitor effects on cultured proximal tubular (HK-2) cell viability and susceptibility to Fe-induced oxidant stress were also addressed. When applied to PTS, prog, TFP, and, to lesser extent, CsA induced dose-dependent ATP reductions (< or =90%), CE decrements (approximately 40%), and LDH release (< or =60%). No concomitant changes in lipid peroxidation or phospholipid profiles were observed. Ouabain did not preserve tubular ATP, suggesting that decreased ATP production, rather than increased consumption, was operative. Mechanisms leading to cell lysis were not identical, as glycine and arachidonic acid blocked prog- but not TFP-mediated cell death. When prog-driven CE reductions were attenuated in PTS with a procycling agent (cholesterol oxidase), decreased cell death resulted. P glycoprotein inhibitors also caused dose-dependent HK-2 cell death. Blocking Fe-mediated CE formation ( approximately x10) with sublethal CsA doses led to a marked increase in Fe-mediated cell death." }, { "role": "assistant", "content": "P glycoproteins may be critical to tubule cholesterol transport. If blocked with pharmacologic agents, decreased ATP production, overt cell lysis, and/or a marked propensity to superimposed tubular cell injury can result. 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": "Laparascopy is indicated in all of the following except: March 2011" }, { "role": "assistant", "content": "The correct answer is Ans. A: Acute pelvic infection Acute pelvic infection can spread during laparoscopy so it a contraindication to laparoscop" } ]

[ { "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, Base Sequence, Case-Control Studies, Eye Proteins, Female, Gene Frequency, Genetic Markers, Genetic Predisposition to Disease, Genotype, Homeodomain Proteins, Humans, Male, Myopia, PAX6 Transcription Factor, Paired Box Transcription Factors, Polymorphism, Restriction Fragment Length, Polymorphism, Single Nucleotide, Repressor Proteins." }, { "role": "user", "content": "Is a PAX6 gene polymorphism associated with genetic predisposition to extreme myopia? Context: The PAX6 gene is a homeobox gene involved in oculogenesis, ocular growth, and form-deprivation myopia. Our aim was to determine whether PAX6polymorphism at position -12 of intron 9 (IVS9-12C to T, rs667773) is associated with high myopia in Chinese Taiwanese. This case-control study compared a study group (n=188) with high myopia whose spherical equivalent was greater than -6.0 D with a control group (n=85) whose spherical equivalent was less than -0.5 D. Genotyping of IVS9-12C to T was conducted by restriction fragment length polymorphism analysis, and results were compared for the two groups. No significant difference in genotype and allelic frequency at this position between the study and control groups was detected. However, there was a significantly higher frequency of the CC genotype in extremely myopic (greater than -10 D) patients (P<0.001, odds ratio (OR=5.265), confidence interval (CI=2.0342-13.626)). Furthermore, there was a higher frequency of the C allele in the extreme myopia group than in the control group (P=0.002, OR=3.73, CI=1.57-8.81)." }, { "role": "assistant", "content": "The elevated frequency of the CC genotype within the extreme myopia group indicated that the CC genotype could act as a genetic marker, identifying patients predisposed to develop extreme myopia. Varied expression of this genotype may contribute to the genetic predisposition to high myopia in Chinese Taiwanese. 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: Anesthesia, Epidural, Animals, Apnea, Blood Pressure, Catecholamines, Heart Rate, Rabbits." }, { "role": "user", "content": "Does thoracic epidural block attenuate cardiovascular response to apnea in rabbits? Context: Apnea is one of the potential complications during anaesthesia. If sympathetic nerve activity is blocked by epidural anaesthesia, circulatory responses to apnea might change. Our objective was to assess the potential modifying effects of epidural anaesthesia on the cardiovascular responses to apnea in the animals. Twenty rabbits anaesthetised with pentobarbital (25 mg.kg-1 i.v., 8 mg.kg-1.hr-1) and pacuronium bromide (0.2 mg.kg-1.hr-1 i.v.) were randomly assigned to one of two groups: control (n = 10) and epidural (n = 10). In the control group, 0.6 ml saline, and in the epidural group, 0.6 ml lidocaine 1% was injected into the epidural space respectively. After mechanical ventilation with FIO2 0.4, apnea was induced by disconnecting the anaesthetic circuit from the endotracheal tube, and mean arterial pressure (MAP), heart rate (HR), and time to cardiac arrest were measured. Before apnea MAP was lower in the epidural than in the control group (73 +/- 10 vs 91 +/- 10 mmHg, P < 0.05). Heart rate was not different between groups (264 +/- 36 vs 266 +/- 24 bpm). Mean arterial pressure increased in the control group after apnea, but not in the epidural group. The time to cardiac arrest was less in the epidural group than in the control group (420 +/- 67 vs 520 +/- 61 sec, P < 0.05). Heart rate decreased markedly after apnea in the control group whereas it decreased gradually in the epidural group." }, { "role": "assistant", "content": "Thoracic epidural anaesthesia attenuated cardiovascular response to apnea and reduced the time to cardiac arrest. 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: Animals, Arginase, Arginine, Cell Count, Citrulline, Cytokines, Endotoxemia, Integrases, Jejunum, Lipopolysaccharides, Macrophages, Mice, Mice, Inbred C57BL, Mice, Transgenic, Microcirculation, Nitric Oxide, Nitric Oxide Synthase Type II, Nitric Oxide Synthase Type III, Nitrites, Organ Specificity, Ornithine, Perfusion, Peroxidase, RNA, Messenger, Receptor, TIE-2." }, { "role": "user", "content": "Does arginase-1 deficiency regulate arginine concentrations and NOS2-mediated NO production during endotoxemia? Context: Arginase-1 is an important component of the intricate mechanism regulating arginine availability during immune responses and nitric oxide synthase (NOS) activity. In this study Arg1(fl/fl)/Tie2-Cre(tg/-) mice were developed to investigate the effect of arginase-1 related arginine depletion on NOS2- and NOS3-dependent NO production and jejunal microcirculation under resting and endotoxemic conditions, in mice lacking arginase-1 in endothelial and hematopoietic cells. Arginase-1-deficient mice as compared with control mice exhibited higher plasma arginine concentration concomitant with enhanced NO production in endothelial cells and jejunal tissue during endotoxemia. In parallel, impaired jejunal microcirculation was observed in endotoxemic conditions. Cultured bone-marrow-derived macrophages of arginase-1 deficient animals also presented a higher inflammatory response to endotoxin than control littermates. Since NOS2 competes with arginase for their common substrate arginine during endotoxemia, Nos2 deficient mice were also studied under endotoxemic conditions. As Nos2(-/-) macrophages showed an impaired inflammatory response to endotoxin compared to wild-type macrophages, NOS2 is potentially involved. A strongly reduced NO production in Arg1(fl/fl)/Tie2-Cre(tg/-) mice following infusion of the NOS2 inhibitor 1400W further implicated NOS2 in the enhanced capacity to produce NO production Arg1(fl/fl)/Tie2-Cre(tg/-) mice." }, { "role": "assistant", "content": "Reduced arginase-1 activity in Arg1(fl/fl)/Tie2-Cre(tg/-) mice resulted in increased inflammatory response and NO production by NOS2, accompanied by a depressed microcirculatory flow during endotoxemia. Thus, arginase-1 deficiency facilitates a NOS2-mediated pro-inflammatory activity at the expense of NOS3-mediated endothelial relaxation. 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, Body Mass Index, C-Reactive Protein, Cardiovascular Diseases, Cross-Sectional Studies, Female, Glomerular Filtration Rate, Humans, Kidney, Kidney Diseases, Male, Middle Aged, Multivariate Analysis, Reference Values, Risk Factors." }, { "role": "user", "content": "Is c-reactive protein associated with renal function abnormalities in a non-diabetic population? Context: C-reactive protein (CRP) has recently been introduced in cardiovascular medicine as a predictor of myocardial infarction, stroke and peripheral artery disease in different populations. We hypothesized that elevated CRP levels are associated with renal function abnormalities. To test this hypothesis, we studied the relationship between CRP levels and renal function loss measured as diminished creatinine clearance in a large non-diabetic population (7317 subjects). In addition, the associations and confounding effects of established renal risk factors that could explain the association between CRP and diminished renal filtration were studied. Also, the association of CRP with early alterations in renal function, such as those evidenced by a relatively high glomerular filtration (\"hyperfiltration\"), was examined. CRP levels were divided in quartiles. Subjects with CRP levels within the first quartile were defined as the reference group. Diminished renal filtration and hyperfiltration were defined as a creatinine clearance below or exceeding two times the prediction interval of the age- and sex-related reference group. Elevated CRP levels were positively associated with cardiovascular and renal risk factors: age, body mass index, blood pressure, serum cholesterol level, smoking, plasma glucose level and elevated urinary albumin excretion. Elevated CRP was positively associated with diminished filtration (OR 1.8; 95% CI 1.2 to 2.6). In multivariate analyses, CRP was independently associated with a diminished filtration (OR 1.9; 95% CI 1.3 to 2.9). Interestingly, CRP also was associated with hyperfiltration (highest quartile, OR 1.7; 95% CI 1.2 to 2.5). However, body mass index accounted for most of the relationship between CRP and hyperfiltration." }, { "role": "assistant", "content": "As in cardiovascular disease, CRP appears to be a risk marker for renal function loss. The mechanism of this relationship remains to be clarified. However, the association between CRP, body weight, and a relatively elevated creatinine clearance is a hypothesis-generating finding, suggesting that early inflammatory processes related to high body fat may predispose the kidney to glomerular hyperfiltration-related renal function loss. 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": "Commotio retinae affects which pa of retina-" }, { "role": "assistant", "content": "The correct answer is *Berlin's oedema, also called commotio retinae, occurs in blunt trauma to eye. *It manifests as milky white cloudiness involving a considerable area of the posterior pole with a 'cherry-red' spot in the foveal region. *It May disappear after some days or may be followed by pigmentary changes. Ref: Khurana 7th/e p.448" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: UNLABELLED. Meshes: Carbohydrate Metabolism, Carbohydrates, Dekkera, Ethanol, Fermentation, Industrial Microbiology, Oxidative Phosphorylation, Oxygen, Saccharomyces cerevisiae, Trehalase, Trehalose." }, { "role": "user", "content": "Does high intracellular trehalase activity prevent the storage of trehalose in the yeast Dekkera bruxellensis? Context: Dekkera bruxellensis hit the spotlight in the past decade mostly due to its rather high ability to adapt to several different fermentation processes. This yeast relies on different genetic and physiological aspects to achieve and preserve its high industrial fitness and some of these traits are shared with Saccharomyces cerevisiae. We have previously described that D. bruxellensis is unable to make use of accumulating trehalose as a strategy for cell adaptation and survival in the industrial scenario, as opposed to S. cerevisiae. Since trehalose is often involved in mechanisms related to cell protection, we aimed to investigate both cause and effect of the absence of this metabolite in the cell adaptive capacity in the industrial environment. Our results indicate that the major cause for the nonaccumulation of trehalose is the high constitutive activity of neutral trehalase. Therefore, the rate of trehalose degradation could be higher than its rate of synthesis, preventing accumulation. Altogether, our data elucidate the mechanisms involved in the lack of trehalose accumulation in D. bruxellensis as well as evaluates the implications of this feature." }, { "role": "assistant", "content": "Dekkera bruxellensis can successfully take advantage of its peculiar physiological and genetic traits in order to adapt and survive in fermentation processes. So far, tolerance to stress has been credited to trehalose synthesis. The data presented in this work provided information on the underlying mechanism that prevents trehalose accumulation and corroborated the recent information that trehalose itself is not implicated in yeast stress tolerance. Second, it showed that D. bruxellensis responds differently to Saccharomyces cerevisiae to excess of sugar, which may explain its preference for respiration (oxidative metabolism) over fermentation (reductive metabolism) even at limited oxygen supply. These findings help to understand the drop on ethanol production in processes overtaken by this yeast. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Area Under Curve, Citalopram, Cross-Over Studies, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Hydrocortisone, Male, Middle Aged, Saliva, Serotonin Uptake Inhibitors." }, { "role": "user", "content": "Does acute citalopram administration produce correlated increases in plasma and salivary cortisol? Context: Intravenous administration of the selective serotonin (5-HT) re-uptake inhibitor, citalopram, increases plasma cortisol. This would be expected to produce a parallel increase in salivary cortisol concentration. To find out whether IV citalopram produces correlated increases in plasma and salivary cortisol levels. Twelve healthy volunteers were tested on two occasions receiving either citalopram (10 mg IV) or saline in a double-blind, randomised, cross-over design. Plasma and salivary cortisol levels were measured before and for 150 min after each infusion. Relative to placebo, citalopram significantly increased cortisol levels in both plasma and saliva. The size of the increases in plasma and saliva cortisol correlated significantly with each other." }, { "role": "assistant", "content": "Monitoring changes in salivary cortisol might be a valid and acceptable means of measuring 5-HT-mediated cortisol release. 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, Antigen-Antibody Complex, Arthritis, Rheumatoid, CD55 Antigens, Cells, Cultured, Collagen, Mice, Mice, Inbred C57BL, Mice, Knockout, Synovial Membrane." }, { "role": "user", "content": "Does cD55 deposited on synovial collagen fibers protect from immune complex-mediated arthritis? Context: CD55, a glycosylphosphatidylinositol-anchored, complement-regulating protein (decay-accelerating factor), is expressed by fibroblast-like synoviocytes (FLS) with high local abundance in the intimal lining layer. We here explored the basis and consequences of this uncommon presence. Synovial tissue, primary FLS cultures, and three-dimensional FLS micromasses were analyzed. CD55 expression was assessed by quantitative polymerase chain reaction (PCR), in situ hybridization, flow cytometry, and immunohistochemistry. Reticular fibers were visualized by Gomori staining and colocalization of CD55 with extracellular matrix (ECM) proteins by confocal microscopy. Membrane-bound CD55 was released from synovial tissue with phospholipase C. Functional consequences of CD55 expression were studied in the K/BxN serum transfer model of arthritis using mice that in addition to CD55 also lack FcγRIIB (CD32), increasing susceptibility for immune complex-mediated pathology. Abundant CD55 expression seen in FLS of the intimal lining layer was associated with linearly oriented reticular fibers and was resistant to phospholipase C treatment. Expression of CD55 colocalized with collagen type I and III as well as with complement C3. A comparable distribution of CD55 was established in three-dimensional micromasses after ≥3 weeks of culture together with the ECM. CD55 deficiency did not enhance K/BxN serum-induced arthritis, but further exaggerated disease activity in Fcgr2b (-/-) mice." }, { "role": "assistant", "content": "CD55 is produced by FLS and deposited on the local collagen fiber meshwork, where it protects the synovial tissue against immune complex-mediated arthritis. 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, METHODS, METHODS, RESULTS. Meshes: Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Catheterization, Swan-Ganz, Databases as Topic, Humans, Middle Aged, Odds Ratio, Retrospective Studies, Survival Rate, Trauma Severity Indices, United States, Wounds and Injuries." }, { "role": "user", "content": "Is pulmonary artery catheter use associated with reduced mortality in severely injured patients : a National Trauma Data Bank analysis of 53,312 patients? Context: To evaluate the association between pulmonary artery catheter (PAC) use and mortality in a large cohort of injured patients. We hypothesized that PAC use is associated with improved survival in critically injured trauma patients. Retrospective database analysis. A total of 268 level 1 trauma centers from across the United States. A total of 53,312 patients admitted to the intensive care units of the trauma centers participating in the National Trauma Data Bank maintained by the American College of Surgeons. The National Trauma Data Bank was queried to identify patients aged 16-90 yrs with complete data on base deficit, and Injury Severity Score (n=53,312). Patients were initially divided into two groups: those managed with a PAC (n=1,933) and those managed without a PAC (n=51,379). Chi-square and Student's t-test analysis were utilized to explore group differences in mortality. In a second analysis, groups were stratified by base deficit, Injury Severity Score, and age to further explore the influence of injury severity on PAC use and mortality. In addition, a logistic regression model was developed to assess the relationship between PAC use and mortality after adjusting for differences in age, mechanism, injury severity, injury pattern, and co-morbidities. Overall, patients managed with a PAC were older (45.8+/-21.3 yrs), had higher Injury Severity Score (28.4+/-13.5), worse base deficit (-5.2+/-6.5), and increased mortality (PAC, 29.7%; no PAC, 9.8%; p<.001). However, after stratification for injury severity, PAC use was associated with a survival benefit in four subgroups of patients. Each of these groups had advanced age or increased injury severity. Specifically, patients aged 61-90 yrs, with arrival base deficit worse than -11 and Injury Severity Score of 25-75, had a decrease in the risk of death with PAC use (odds ratio, 0.33; 95% confidence interval, 0.17-0.62). Three additional groups had a similar decrease in the risk of death with PAC use: odds ratio, 0.60 (95% confidence interval, 0.43-0.83), 0.82 (95% confidence interval, 0.44-1.52), and 0.63 (95% confidence interval, 0.40-0.98). Logistic regression analysis demonstrated a decreased mortality when a PAC was used in the management of patients with the following severe injury characteristics: Injury Severity Score of 25-75, base deficit of less than -11, or age of 61-90 yrs (odds ratio, 0.593; 95% confidence interval, 0.437-0.805)." }, { "role": "assistant", "content": "Trauma patients managed with a PAC are more severely injured and have a higher mortality. However, severely injured patients (Injury Severity Score, 25-75) who arrive in severe shock, and older patients, have an associated survival benefit when managed with a PAC. This is the first study to demonstrate a benefit of PAC use in trauma patients. 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: ." }, { "role": "user", "content": "Do management of vascular malformations and hemangiomas of the head and neck -- an update? Context: We are witnesses of improved therapeutic strategies and intensified multidisciplinary and international exchange in the field of vascular anomalies of the head and neck region. This review summarizes today's 'state of the art' in treatment and points out recent developments in clinical management of hemangiomas and vascular malformations of the head and neck. Despite the general acceptance of the 'Hamburg classification', inappropriate use of the term 'hemangioma' is still found in scientific correspondences. The majority of problematic infantile hemangiomas are nowadays successfully treated with propranolol. Topical use of β blockers is the most recent development for hemangiomas. The understanding of the condition called 'localized intravascular coagulopathy' has significantly improved the clinical management of venous malformations apart from the introduction of sophisticated ethanol-based embolization agents. No significant improvement in the management of lymphatic or capillary malformations of the head and neck has been observed within recent years. The liquid embolization agent Onyx has become popular in the treatment of extracranial arteriovenous malformations (AVM), but can be associated with severe perivascular inflammation." }, { "role": "assistant", "content": "β Blockers are the first-line modality for infantile hemangiomas, which require active treatment. Reports on pharmacotherapy of lymphatic malformations with sildenafil are subject to critical evaluation regarding drug safety. Pulsed dye laser treatment is still the 'gold standard' for capillary malformations. Surgical excision combined with intravascular embolization is treatment of choice for AVM with the knowledge that extensive AVM are still not curable. 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: Angiogenesis Inhibitors, Animals, Antibodies, Carcinoma, Pancreatic Ductal, Cell Proliferation, Colforsin, Contrast Media, Ferrosoferric Oxide, Hedgehog Proteins, Humans, Injections, Intravenous, Magnetic Resonance Imaging, Mice, Mice, Nude, Nanoparticles, Neovascularization, Pathologic, Pancreatic Neoplasms, Signal Transduction, Veratrum Alkaloids, Xenograft Model Antitumor Assays." }, { "role": "user", "content": "Does magnetic resonance imaging monitor physiological changes with antihedgehog therapy in pancreatic adenocarcinoma xenograft model? Context: The sonic hedgehog (Shh) pathway has an established role in pancreatic cancer (pancreatic adenocarcinoma [PDAC]). We tested whether magnetic resonance imaging measures of vascular volume fraction (VVF) using magnetic iron oxide nanoparticles are sensitive to the antiangiogenic effect of targeted Shh therapies in a PDAC xenograft model. Pancreatic adenocarcinoma xenograft lines were subcutaneously implanted into nude mice (n = 19 samples within 4 groups). Therapies were targeted to 3 loci of the Shh signaling pathway (anti-Shh antibody, cyclopamine, or forskolin). Magnetic resonance imaging (4.7-T Bruker Pharmascan) was performed (after 1 week of intraperitoneal therapy) before and after intravenous injection of MION-47. Vascular volume fraction was quantified as DeltaR2 (from multicontrast T2 sequences) and normalized to an assumed VVF in muscle of 3%. Linear regression compared VVF to histological indices including microvessel density (MVD), viable gland density (VGD), and proliferative index (PI). In response to anti-Hh treatment, tumors showed a decrease in VGD, PI, MVD, and VVF compared with controls (P < 0.001). Vascular volume fraction was compared with histological indicators of response: PI (R2 = 0.88; P < 0.05), VGD (R2 = 0.87; P< 0.05), and MVD (R2 = 0.85; P < 0.05)." }, { "role": "assistant", "content": "Magnetic resonance imaging VVF using magnetic iron oxide nanoparticles may serve as a noninvasive measure of biological response to Shh PDAC therapy with easy translation to the clinic. 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 47-year-old woman presents to the emergency department with ongoing dyspnea and confusion for 2 hours. She has a history of psychosis and alcohol abuse. She has smoked 1 pack per day for 25 years. She is agitated and confused. Her blood pressure is 165/95 mm Hg; pulse 110/min; respirations 35/min; and temperature, 36.7°C (98.1°F). The pulmonary examination shows tachypnea and mild generalized wheezing. Auscultation of the heart shows no abnormal sounds. The remainder of the physical examination shows no abnormalities. Laboratory studies show:\nSerum\nNa+ 138 mEq/L\nCI- 100 mEq/L\nArterial blood gas analysis on room air\npH 7.37\npCO2 21 mm Hg\npO2 88 mm Hg\nHCO3- 12 mEq/L\nWhich of the following best explains these findings?" }, { "role": "assistant", "content": "Salicylate intoxication" } ]

[ { "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": "Bleomycin toxicity is characterized by destruction of:" }, { "role": "assistant", "content": "The correct answer is Ans. b. Type I pneumocytes Bleomycin toxicity is characterized by destruction of Type I pneumocytes.Histopathotogy of Lung in Bleomycin Toxicity* Endothelial cell edema and blebbing* Necrosis of type 1 pneumocytes* Proliferation of fibroblast and fibrosis* Hyperplasia and metaplasia of type II pneumocytes* Inflammatory infiltrate with PMNBleomycin* Bleomycin is well known to cause pulmonary toxicity.* Incidence of bleomycin induced pulmonary toxicity is 5% for a total cumulative dose of 450 units and 15% for higher dosages.* Bleomycin is concentrated preferentially in the lung and is inactivated by hydrolase enzyme. This enzyme is relatively deficient in lung tissue. This may explain relative sensitivity of bleomycin to lung tissue.Type I pneumocytes are more vulnerable to bleomycin toxicity' and are destroyed by bleomycinPathological Features of Bleomycin Toxicity* Early endothelial cell damage* Destruction uf type 1 pneumocytes* Migration of type II pneumocytes into alveolar spaces inducing interstitial changesFollowing destruction of type I pneumocytes repair is characterized by hyperplasia and dysplasia of type II pneumocytes. Fibro- blast proliferation with subsequent pulmonary fibrosis is probably the basis for irreversible changes induced by Bleomycin." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 35-year-old male patient presented with history of jaundice for 15 days. The onset was preceded by a prodromal illness. His serum tested positive for HbsAg. A clinical diagnosis of acute hepatitis B was made. What should be the next best confirmatory investigation?" }, { "role": "assistant", "content": "The correct answer is Since IgM anti-HBcAg is not given in the choices, HBeAg, appears concurrently with or sholy after HBsAg. Its appearance coincides with high levels of virus replication & reflects presence of circulating intact virions and detectable HBV DNA In self-limited HBV infections, HBeAg becomes undetectable sholy after peak elevations in aminotransferase activity, before the disappearance of HBsAg, and anti-HBe then becomes detectable, coinciding with a period of relatively lower infectivity. Its principal clinical usefulness is as an indicator of relative infectivity." } ]

[ { "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, Angiodysplasia, Capsule Endoscopy, Female, Gastrointestinal Hemorrhage, Humans, Italy, Logistic Models, Male, Middle Aged, Retrospective Studies, Treatment Outcome." }, { "role": "user", "content": "Is capsule endoscopy appropriate for elderly patients? Context: Few data are available on the use of capsule endoscopy in the elderly. We performed a retrospective study on 1008 consecutive patients referred to our centre between December 1, 2002 and January 30, 2014 who underwent capsule endoscopy for various indications. Patients were enrolled and divided into 3 sub-groups according to their age (Group A:<50 years; Group B: 50-69 years; Group C:>70 years). The Pillcam diagnostic yield, clinically significant findings and post-treatment outcomes were compared between groups. Diagnostic yield was significantly higher in Group C vs. Groups A and B (65.2% vs. 42.3% and 47.5%, respectively; p<0.05). The most common diagnosis in the elderly was angiodysplasia (42.5%). In 84.5% of elderly patients (Group C) capsule endoscopy results modified patient management." }, { "role": "assistant", "content": "Capsule endoscopy has a high diagnostic yield and positive impact on management in patients aged>70 years." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is not an effect of cholinergic muscarinic receptor stimulation:" }, { "role": "assistant", "content": "The correct answer is Stimulation of muscarinic receptors decreases BP." } ]

[ { "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, MAIN OUTCOME, RESULTS. Meshes: Child, Esophagoscopy, Esophagus, Female, Foreign Bodies, Fundoplication, Humans, Infant, Male." }, { "role": "user", "content": "Distal esophageal foreign bodies: is it a common occurrence post-fundoplication requiring immediate intervention? Context: Dysphagia secondary to \"tight\" distal esophageal wraps are a well-known complication of Nissen fundoplication (NF). However, the literature makes no mention of distal esophageal foreign bodies (DEFB) appearing after NF. This study was undertaken to determine the occurrence of asymptomatic DEFB in children post-fundoplication. A retrospective review and case series of radiographic images of children who underwent NF between 2001 and 2004. Images reviewed include chest and abdominal radiographs, esophagrams, and oropharyngeal motility studies. DEFB on radiology report and image. Two hundred and thirty-three children (135 males and 98 females) underwent NF at the ages of 15 days to 19.5 years. Two thousand and seven radiographs were reviewed. Five FBs (2.15%) were noted. Four of the five FBs (80%, overall incidence 1.72%) were present in the distal esophagus. Three required rigid esophagoscopy (one marble and one with multiple foreign bodies (FBs) for removal. One who had a distal FB seen on barium swallow 'spontaneously passed' during esophagoscopy." }, { "role": "assistant", "content": "DEFB in children status post-NF is unusual with an incidence 1.72% of our patients. Our review might be underestimating the incidence as translucent foreign bodies may have been missed. DEFB are surprising due to the fact that most of these children are neurologically impaired and gastrostomy-tube fed. The children's NPO status may also result in these DEFB remaining asymptomatic until being 'incidentally' found on radiographic imaging. Thus, NF may predispose to obstruction when a foreign body (FB) is ingested; but because of the population involved, this remains a fairly unusual entity. However, the presence of a DEFB in this population may necessitate prompt endoscopic retrieval as the likelihood of spontaneous passage is less." } ]

[ { "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": "35 years old man presenting with acute pancreatitis. Ideal fluid of choice" }, { "role": "assistant", "content": "The correct answer is Ref. API Textbook of Medicine. Pg. 813\n \nMost imp consideration in the management of acute pancreatitis is conservative approach\n\nFluids >Pain >Nutrition >Inflammation\nIdeal fluid of choice is Isotonic crystalloids\n1st line management : NPO , IV Fluids ,IV antibiotics, IV anti inflammatory  + Blood investigations (Amylase and lipase)" } ]

[ { "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. Meshes: Adult, Aged, Aged, 80 and over, Anti-Inflammatory Agents, Non-Steroidal, Cross-Over Studies, Double-Blind Method, Elective Surgical Procedures, Female, Humans, Injections, Intravenous, Ketoprofen, Male, Middle Aged, Pain, Pain Measurement, Stereoisomerism, Tromethamine, Young Adult." }, { "role": "user", "content": "Does intravenous dexketoprofen induce less injection pain than racemic ketoprofen? Context: Ketoprofen has high analgesic efficacy against inflammatory and nociceptive pain. Additionally, when ketoprofen is administered in conjunction with an opioid during pain management, it prevents the development of opioid-induced hyperalgesia. The main limitation for racemic ketoprofen IV administration is venous irritation. Dexketoprofen is the active enantiomer of racemic ketoprofen and has a similar analgesic efficacy in a dose proportion of 1 : 2, but it causes fewer adverse effects than racemic ketoprofen. It has been claimed that dexketoprofen may cause less frequent and less severe injection pain than racemic ketoprofen. In this study, we compared the injection pain of IV administered racemic ketoprofen and dexketoprofen in elective surgical patients. The ethics committee of our institution approved this randomized, double-blinded, two-treatment, two-period, crossover clinical comparison of ketoprofen and dexketoprofen. A total of 221 ASA I-III adult patients, aged 20-75 years, were initially IV administered either 0·5 mg/kg racemic ketoprofen followed 2 h later with 0·25 mg/kg dexketoprofen (group 1) or vice versa (group 2). Both compounds were diluted in 20 mL of normal saline and were injected over 6 min. Patients reported injection pain on an 11-point numerical rating scale (NRS) (0 = no pain, 10 = most pain)." }, { "role": "assistant", "content": "Significantly less injection pain was reported after dexketoprofen administration. A total of 201 of 209 patients reported pain during racemic ketoprofen injection, and 157 of 210 patients reported pain during dexketoprofen injection, respectively. Moderate or severe pain was reported by 90 (41%) patients during racemic ketoprofen administration and by 43 (20%) during dexketoprofen injection (P = 0·001). The mean of injection pain during racemic ketoprofen injection was 4·2 (SD 2·5) and was 2·5 (2·4) during dexketoprofen injection (P = 0·001). No serious or unexpected adverse events were reported. 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: Aged, Cardiac Surgical Procedures, Chi-Square Distribution, Female, Humans, Linear Models, Male, Middle Aged, Mitral Valve, Mitral Valve Insufficiency, Multidetector Computed Tomography, Multivariate Analysis, Papillary Muscles, Predictive Value of Tests, Reproducibility of Results, Retrospective Studies, Risk Factors, Severity of Illness Index, Stroke Volume, Systole, Treatment Outcome, Ultrasonography, Ventricular Dysfunction, Left, Ventricular Function, Left." }, { "role": "user", "content": "Does interpapillary muscle distance independently affect severity of functional mitral regurgitation in patients with systolic left ventricular dysfunction? Context: Surgical papillary muscle (PM) imbrication has been reported to be effective to relieve leaflet tethering in patients with functional mitral regurgitation (FMR). However, the mechanism that contributes to improvement of FMR by shortening the interpapillary muscle distance (IPMD) has not been well investigated. The purpose of the present study was to investigate whether IPMD can affect MR severity independently of PM tethering distance in patients with left ventricular dysfunction (LVD) using multislice computed tomography. We analyzed volumetric multislice computed tomography images of mitral apparatus in 83 patients with LVD (ejection fraction <50%): 37 patients with FMR and 46 patients without FMR. By using the original software, we assessed the 3-dimensional geometry of mitral apparatus including IPMD, tethering distances, and mitral tenting volume at end-systole. The severity of FMR was assessed using vena contracta (VC) width by 2-dimensional echocardiography. Posterior and anterior tethering distance and IPMD were increased significantly in patients with FMR than in those without FMR. Patients with IPMD in the highest tertile had a significantly higher degrees of MR (mean ± standard error VC width, 4.5 ± 0.3 mm) compared with patients in the lowest and the middle tertiles, adjusting for PM tethering distance (mean ± standard error VC width, 3.0 ± 0.4 and 2.9 ± 0.3 mm; P < .001, respectively). Multivariate analysis showed that anteroposterior annular diameter and IPMD were the strongest determinants of FMR severity and mitral tenting volume." }, { "role": "assistant", "content": "IPMD, which affects leaflet tethering independently of PM tethering distance, was the major determinant of mitral tenting volume and FMR severity in patients with LVD. 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 are true about incidence, except-" }, { "role": "assistant", "content": "The correct answer is .<p>incidence rate is defin ed as the number of new case occurring in a defined population during a specified period of time.it will be seen from the above definition that incidence rate refers only to new cases,and during a given period usually assumed as one year.it also refers in a specified population or \";population at risk\"unless other denominators are chosen.</p><p>ref:park&;s textbook of preventive and social medicine,22 nd edition,pg no 58</p>" } ]

[ { "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, Burning Mouth Syndrome, Candidiasis, Oral, Chi-Square Distribution, China, Female, Health Status, Humans, Lichen Planus, Oral, Male, Middle Aged, Mouth Diseases, Mouth Mucosa, Quality of Life, Sickness Impact Profile, Statistics, Nonparametric, Stomatitis, Aphthous, Surveys and Questionnaires, Young Adult." }, { "role": "user", "content": "Is generic and oral quality of life affected by oral mucosal diseases? Context: The generic and oral health-related quality of life (QoL) has provided opportunity for investigation of the interrelations among generic health, oral health, and related outcomes. The purpose of this study was to identify the generic and oral QoL in the patients with oral mucosal disease (OMD). Five hundred and thirty-eight OMDs were recruited in this study. The instruments applied were Chinese version of the 36-item short form health survey (SF-36) and the short-form of Oral Health Impact Profile (OHIP-14). The mean score of sum OHIP-14 was significantly higher in the patients with OMD (10.81 ± 9.01) compared with those in the healthy subjects (HS) (6.55 ± 6.73) (p < 0.001, Mann-Whitney U test). 56.51% of the OMD patients and 12.94% of the HS reported at least one oral negative impact (p < 0.001, Chi-square test). The overall mean score of SF-36 was significantly lower in the patients with OMD (74.54 ± 12.77) compared with those in the HS (77.97 ± 12.39) (p = 0.021, t-test)." }, { "role": "assistant", "content": "Administration of specific and generic questionnaires of QoL can provide us a detailed picture of the impact of OMDs on patients, and both generic and oral QoL were impaired in the patients with OMD. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Biomarkers, Tumor, Female, Gene Expression Regulation, Neoplastic, Granulosa Cell Tumor, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Ovarian Neoplasms, Polymerase Chain Reaction, Predictive Value of Tests, Prognosis, RNA, Messenger, Vascular Endothelial Growth Factor A, Vascular Endothelial Growth Factor Receptor-1, Vascular Endothelial Growth Factor Receptor-2." }, { "role": "user", "content": "Are vascular endothelial growth factor ( VEGF ) and its receptor VEGFR-2 highly expressed in ovarian granulosa cell tumors? Context: Ovarian granulosa cell tumors (GCTs) are hormonally active sex cord stromal tumors accounting for 3-5% of all ovarian cancers. These tumors are generally diagnosed at an early stage but there is a high risk of recurrence, associated with high mortality. Treatment of recurrent GCTs is difficult, and biologically targeted treatment modalities are lacking. GCTs are highly vascularized, and angiogenic factors most probably play a role in their pathology. Vascular endothelial growth factor (VEGF) is a key regulator of tumor angiogenesis, but in GCTs, the role of VEGF and its receptors VEGFR-1 (FLT1) and VEGFR-2 (KDR) remains largely unknown. Our objective is to study the expression of VEGF and its receptors in human GCTs. We analyzed GCTs from 106 patients for the expressions of VEGF and its receptors utilizing tumor tissue microarray, tumor mRNA, and patient serum samples. We found that VEGF and its main biologically active receptor VEGFR-2 were highly expressed in primary and recurrent GCTs, when compared with normal granulosa-lutein cells. The expression of VEGF correlated positively to tumor microvessel density and to VEGFR-2 expression at the protein (P<0.05) and mRNA (P<0.05) levels. In contrast to VEGFR-2, the expression of VEGFR-1 was weak. Tumor VEGF protein expression was not prognostic for recurrence, however, we found high levels of circulating VEGF in the serum of patients with primary GCT." }, { "role": "assistant", "content": "The results suggest an important role of VEGF and VEGFR-2 in GCT pathology and support the possibility of applying novel VEGF- or VEGFR-2-targeted treatments to patients with GCT. 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 valve is present at opening of nasolacrimal duct?" }, { "role": "assistant", "content": "The correct answer is Nasolacrimal duct opens into inferior meatus and is closed by a mucosal flap called Hasner's valve.Heister valve (spiral valve) is present in cyctic duct." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Blood Vessels, Carcinoid Tumor, CpG Islands, Digestive System Neoplasms, Female, Gene Silencing, Humans, Ki-67 Antigen, Male, Methylation, Middle Aged, Mitotic Index, Neoplasm Invasiveness, Neoplasm Metastasis, Promoter Regions, Genetic, Risk Factors, Sensitivity and Specificity, Ubiquitin Thiolesterase." }, { "role": "user", "content": "Is silencing of UCHL1 by CpG promoter hyper-methylation associated with metastatic gastroenteropancreatic well-differentiated neuroendocrine ( carcinoid ) tumors? Context: Well-differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare tumors with varying metastatic potential. The underlying molecular basis for metastasis by GEP-NETs remains undefined. Quantitative PCR and immunohistochemistry (IHC) staining for ubiquitin carboxyl-terminal esterase L1 (UCHL1) gene and protein expression was performed on a group of localized and metastatic well-differentiated GEP-NET samples acquired from a prospectively maintained tissue bank. The ability of extent of UCHL1 IHC staining to differentiate localized and metastatic tumors was compared with Ki-67 index. Among 46 total samples, UCHL1 expression at both the gene and protein level was significantly greater among localized GEP-NETs compared with metastatic tumors and metastases (p < 0.001). Hypermethylation of the UCHL1 promoter was commonly observed among metastatic primary tumors and metastases (those with the lowest UCHL1 expression) but not among localized tumors (p < 0.001). Poor staining (<50 %) for UCHL1 was observed in 27 % of localized tumors compared with 87 % of metastatic tumors (p = 0.001). The presence of <50 % staining for UCHL1 was 88 % sensitive and 73 % specific for identifying metastatic disease. In contrast, there was no association between Ki-67 index and metastatic disease. In multivariable analysis, only UCHL1 staining <50 % [odds ratio (OR) 24.5, p = 0.035] and vascular invasion (OR 38.4, p = 0.03) were independent risk factors for metastatic disease at the time of initial surgery." }, { "role": "assistant", "content": "Loss of UCHL1 expression by CpG promoter hypermethylation is associated with metastatic GEP-NETs. Extent of UCHL1 staining should be explored as a potentially clinically useful adjunct to Ki-67 index in evaluating GEP-NETs for aggressive features. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: INTRODUCTION, METHOD, FINDINGS. Meshes: Adult, Ethnic Groups, Family Practice, Female, Humans, Interviews as Topic, Male, Middle Aged, New Zealand, Nurse's Role, Nurses, Surveys and Questionnaires." }, { "role": "user", "content": "Seeing patients first: creating an opportunity for practice nurse care? Context: Practice nurses see patients in both a planned (i.e., scheduled appointment) and an unplanned (i.e., opportunistic) manner. This study aimed to investigate how often and why New Zealand practice nurses see patients prior to the general practitioner and whether they organise their care to support unplanned, opportunistic activity. National postal survey from a random sample of 500 general practices, requesting a response from one nurse per practice. Semi-structured telephone interviews with a purposeful sample of respondents. Responses came from 225 nurses (51% of practices confirmed to be eligible). Nearly all (92%) said their work role was the same as that of others in their practice. Only 13% of nurses routinely saw patients prior to the doctor, while 24% would choose to do so it they could, and 65% thought it important. Positive and negative aspects of seeing patients first are presented. Constraints included time, their role assisting practice workflow and perceptions of patient expectations. Few organised their work to create opportunities for lifestyle interventions." }, { "role": "assistant", "content": "The current working environment of practice nurses in New Zealand does not readily support them routinely seeing patients before the general practitioner. We suggest this is a lost opportunity for patient-centred preventive care." } ]

[ { "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": "Characteristic feature of acute inflammation is:" }, { "role": "assistant", "content": "The correct answer is . Vasodilatation and increased vascular permeability" } ]

[ { "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, METHODS, METHODS, RESULTS. Meshes: Administration, Inhalation, Adrenal Cortex Hormones, Adult, Androstadienes, Anti-Asthmatic Agents, Anti-Inflammatory Agents, Asthma, Bone Density, Bone Remodeling, Budesonide, Cross-Sectional Studies, Female, Fluticasone, Growth Hormone-Releasing Hormone, Human Growth Hormone, Humans, Insulin-Like Growth Factor I, Long-Term Care, Male, Middle Aged, Osteocalcin, Statistics as Topic." }, { "role": "user", "content": "Is growth hormone response to growth hormone-releasing hormone reduced in adult asthmatic patients receiving long-term inhaled corticosteroid treatment? Context: Some studies have demonstrated that the function of the growth hormone (GH)-insulin-like growth factor (IGF)-1 axis is significantly impaired in patients with oral corticosteroid (CS)-induced osteoporosis. The aim of study was to investigate the effects of long-term therapy with inhaled CSs (ICSs) on the hypothalamic-pituitary-GH axis by the GH response to GH-releasing hormone (GHRH), as well as bone turnover, in adult asthmatic patients. Cross-sectional study. Twenty-seven adult subjects with mild-to-moderate persistent asthma (long-term ICS therapy [ie, > 1 year], 20 patients; naive to ICS treatment, 7 patients) and 10 control subjects. Each subject underwent testing with an IV bolus (1 mug/kg) injection of human GHRH, and samples of GH were taken 15 min before the GHRH injection, at 0 min (ie, at the time of GHRH injection), and at 15, 30, 45, 60, and 90 min after injection to obtain values for peak GH and DeltaGH. At baseline, samples of serum IGF-1 and blood-urine were collected for bone turnover markers. The GH response to GHRH was significantly reduced in asthmatic patients receiving ICSs (peak GH, p < 0.05; and DeltaGH, p < 0.01) in comparison with control subjects and asthmatic patients who were naive to ICS therapy (peak GH and DeltaGH, p < 0.01). Baseline IGF-1 levels were similar in the three groups. Serum osteocalcin, a marker of bone formation, was significantly reduced (p < 0.01) and correlated with GH peak (r(2) = 0.34; p = 0.007) in asthmatic patients who were treated with ICSs." }, { "role": "assistant", "content": "We conclude that GH secretion in response to GHRH is significantly reduced in adult asthmatic patients receiving therapy with ICS and that such inhibition could play a negative role in bone metabolism. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Blood Component Removal, Erythrocyte Transfusion, Fever, Humans, Hypersensitivity, Incidence, Leukocytes, Retrospective Studies." }, { "role": "user", "content": "Does prestorage universal WBC reduction of RBC units affect the incidence of transfusion reactions? Context: Febrile nonhemolytic transfusion reaction (FNHTR) has been identified as a pivotal reason for prestorage universal WBC reduction. A regional blood center implemented universal prestorage WBC reduction for RBCs on January 1, 2000. Whether prestorage universal WBC reduction of RBC units will affect FNHTR is not known. All reports of RBC transfusion reactions at Barnes-Jewish Hospital submitted for evaluation to the blood bank, before and after the implementation of WBC reduction of RBCs, were retrospectively evaluated. For the 36,303 allogeneic RBC transfusions administered in 1999, 85 reactions (0.23%) were reported. These reactions were classified as FNHTR in 43 cases, allergic in 13, delayed hemolytic in 19, and miscellaneous in 10. For the 31,543 non-WBC-reduced RBC transfusions performed in 1999, 78 reactions (0.25%) were reported. These reactions were classified as FNHTR in 39 cases, allergic in 13, delayed hemolytic in 19, and miscellaneous in 7. In the first half of 2000, 32 reactions (0.20%) were reported for 16,093 prestorage WBC-reduced RBC transfusions (p = 0.41). There were 13 FNHTRs and 10 allergic, 7 delayed hemolytic, and 2 miscellaneous reactions. The use of prestorage WBC-reduced RBCs did not significantly affect the rate of reactions classified as allergic (0.04% in 1999; 0.06% in 2000; p = 0.43) or as FNHTR (0.12% in 1999; 0.08% in 2000; p = 0.33). For all patients, universal WBC reduction in 2000 did not reduce the rate of FNHTR from the rate seen with selective bedside WBC reduction, the practice used in 1999 (0.12% in 1999; 0.08% in 2000; p = 0.36)." }, { "role": "assistant", "content": "No significant difference was found in the incidence of transfusion reactions in patients receiving prestorage WBC-reduced RBCs and non-WBC-reduced RBCs. In addition, no difference was found in transfusion reaction rates when periods of prestorage universal WBC reduction were compared to those of selective WBC reduction. 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, OBJECTIVES, RESULTS. Meshes: Animals, Dose-Response Relationship, Drug, Drug Interactions, Environmental Exposure, Environmental Pollutants, Humans, No-Observed-Adverse-Effect Level, Risk Assessment." }, { "role": "user", "content": "Low-level exposure to multiple chemicals: reason for human health concerns? Context: A key question in the risk assessment of exposures to multiple chemicals is whether mixture effects may occur when chemicals are combined at low doses which individually do not induce observable effects. However, a systematic evaluation of experimental studies addressing this issue is missing. With this contribution, we wish to bridge this gap by providing a systematic assessment of published studies against well-defined quality criteria. On reviewing the low-dose mixture literature, we found good evidence demonstrating significant mixture effects with combinations of chemicals well below their individual no observable adverse effect levels (NOAELs), both with mixtures composed of similarly and dissimilarly acting agents." }, { "role": "assistant", "content": "The widely held view that mixtures of dissimilarly acting chemicals are \"safe\" at levels below NOAELs is not supported by empirical evidence. We show that this view is also based on the erroneous assumption that NOAELs can be equated with zero-effect levels. Thus, on the basis of published evidence, it is difficult to rule out the possibility of mixture effects from low-dose multiple exposures." } ]

[ { "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: Abciximab, Animals, Antibodies, Monoclonal, Anticoagulants, Cattle, Enoxaparin, Enzyme-Linked Immunosorbent Assay, Heparin, Humans, Immunoglobulin Fab Fragments, Platelet Aggregation, Platelet Aggregation Inhibitors, Platelet Glycoprotein GPIIb-IIIa Complex, Swine." }, { "role": "user", "content": "Does the glycoprotein IIb/IIIa antagonist c7E3 inhibit platelet aggregation in the presence of heparin-associated antibodies? Context: Heparin-associated antibodies (HAAb), in the presence of heparin, can cause platelet activation and aggregation. The purpose of this study was to assess whether a platelet glycoprotein (GP) IIb/IIIa receptor antagonist, c7E3, would inhibit platelet aggregation in the presence of HAAb. If aggregation is inhibited by c7E3, enzyme-linked immunosorbent assays (ELISA) would be done to determine whether c7E3 interfered with the binding of heparin and the HAAb. HAAb-positive plasmas from 21 patients (determined by platelet aggregation assays) were studied. Normal donor platelet-rich plasmas (PRP) were incubated (1 minute) with either saline solution or 3 microg/ml of c7E3. Platelet-poor plasma from patients with HAAb and one of three sources of heparin (25 microl, 10 U/ml; porcine heparin, bovine heparin, and low molecular weight heparin [enoxaparin]) were added to the PRP mixture. Aggregation was determined using a platelet aggregometer by measuring time to aggregation, the slope of the aggregation curve, and the percent change in optical density. Platelet aggregation occured in 100%, 100%, and 95% of the saline solution incubations exposed to porcine heparin, bovine heparin, and enoxaparin, respectively. Incubation with c7E3 caused 100% inhibition of platelet aggregation in plasma exposed to porcine heparin, bovine heparin, and enoxaparin. The optical density curves obtained from the ELISA, which were dependent on the binding of HAAb to heparin, were not significantly different when c7E3 was compared to buffer alone." }, { "role": "assistant", "content": "The GP IIb/IIIa receptor antagonist, c7E3, inhibits HAAb-induced platelet aggregation via a mechanism that does not appear to interfere with the binding between heparin and HAAb. Clinical trials are warranted to assess whether GP IIb/IIIa antagonists may allow patients with HAAb to safely receive heparin. 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 29-year-old woman, gravida 2, para 1, at 17 weeks' gestation comes to the physician for a routine prenatal examination. A prenatal ultrasound at 10 weeks' gestation showed no abnormalities. Serum studies at 16 weeks' gestation showed an abnormally elevated α-fetoprotein level and normal beta human chorionic gonadotropin and estriol levels. After genetic counseling, the patient decides to continue with the pregnancy without any diagnostic testing. The remainder of her pregnancy is uncomplicated and she delivers a boy at 38 weeks' gestation. Analysis of the infant's leukocytes shows a 46, XY karyotype. Which of the following is the most likely cause for the abnormal second-trimester test results?" }, { "role": "assistant", "content": "Underestimation of gestational age" } ]

[ { "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, PATIENTS AND METHODS, RESULTS. Meshes: Age Factors, Aged, Analysis of Variance, End Stage Liver Disease, Humans, Life Expectancy, Liver Transplantation, Primary Graft Dysfunction, Proportional Hazards Models, Statistics, Nonparametric, Survival Analysis, Tissue Donors, Treatment Outcome." }, { "role": "user", "content": "Liver transplantation with donors over the expected lifespan in the model for end-staged liver disease era: is Mother Nature punishing us? Context: The lack of sufficient donors to satisfy the waiting list requirements has prompted many to expand the acceptance criteria. The purpose of this study was to evaluate our liver transplantation (LT) experience with donors beyond the average lifespan. From January 2008 to December 2009, we received 75 liver offers involving donors ≥ 75 years of age. Donor and recipient data were analysed by both uni- and multivariate Cox proportional hazard model analyses. We performed 32 adult liver transplants (43%). Half of the patients received organs through rescue allocations. Seven recipients (22%) developed initial poor function. Two had primary graft non-function (PNF). Four recipients were re-transplanted (two PNF and two ischaemic-type bile lesions). One- and 3-year cumulative survival was 62 and 51% respectively. PNF, lab model for end-staged liver disease (MELD), post-LT haemodialysis, post-LT re-operations and post-LT sepsis were significant predictors by univariate analysis. Only PNF reached multivariate significance (P = 0.0307). Rescue offer allocation reached significance as a predictor of PNF by general linear model forward analysis. One- and 3-year 'MELD based allocation' (n = 16) vs 'rescue allocation' (n = 16) survival rates were 44 and 29% vs 82 and 76% respectively (P = 0.0197)." }, { "role": "assistant", "content": "Although grafts from donors ≥ 75 years allow for an expansion of the donor pool, long-term recipient survival is inferior to that encountered with younger donors. Acceptable results could be obtained by identifying 'preferred' recipients for rescue allocations." } ]

[ { "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, Clinical Competence, Colorectal Neoplasms, Female, Humans, Laparoscopy, Learning Curve, Male, Mentors, Treatment Outcome." }, { "role": "user", "content": "Do trainee surgeons cause more conversions in laparoscopic colorectal surgery if they are well supervised? Context: This study was designed to look at the conversion rates and morbidity associated with laparoscopic operations performed by trainee surgeons ascending the learning curve when they are well supervised by staff surgeons. A review of 204 consecutive cases was performed. We defined experienced staff surgeons as those who have performed more than 300 laparoscopic resection cases. The trainee surgeons had less than 50 cases of experience during the study period. All operations were performed by the experienced staff surgeon or by the trainee surgeon with the staff surgeon as the first assistant and supervisor. A total of 204 laparoscopic resections for colorectal cancer were studied. The dissection was D3 in 73% (n = 149) of cases with a mean lymph node harvest of 19.4 nodes (range 1-56). The staff surgeons performed 90 cases and trainees performed 114 cases. Twenty-one cases (10.3%) required conversion. The overall morbidity rate was 17.6% and perioperative mortality rate was 1.5%. On bivariate analysis, trainee surgeons were not found to be significantly associated with a higher conversion risk. Multivariate analysis revealed that only the factor of T3 and above was an independent predictor of conversion (odds ratio (OR) 4.1; 95% confidence interval (CI) 1.09-15.48). Multivariate analysis of risk factors for morbidity revealed that it was not conversion (OR 2.37; 95% CI, 0.86-6.76) but rectal surgery (OR 4.09; 95% CI 2.04-9.9) that was the independent risk factor of morbidity." }, { "role": "assistant", "content": "Inexperienced surgeons do not cause more conversions or postoperative morbidity in laparoscopic colorectal surgery if they are well supervised. Conversion is not independently associated with increased postoperative morbidity. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, RESULTS. Meshes: Autoantibodies, Biopsy, Fine-Needle, Body Mass Index, Child, Cohort Studies, Cross-Sectional Studies, Female, Hashimoto Disease, Humans, Male, Obesity, Overweight, Thyroid Function Tests, Thyroid Gland, Thyroiditis, Autoimmune, Thyrotropin, Thyroxine, Triiodothyronine, Ultrasonography." }, { "role": "user", "content": "Are thyroid function and structure affected in childhood obesity? Context: Alterations in thyroid function are reported in obesity, although no relevant data exist on the thyroid structure of these patients and the frequency of autoimmunity. The aim of our study was to evaluate the involvement of the thyroid gland in a large group of obese children. This was a cross-sectional study. The study was conducted between March 2004 and December 2007 in 186 overweight and obese children. In all subjects, serum free T(3), free T(4), TSH, antithyroid antibodies, and a thyroid ultrasound were assessed. A total ot 40 healthy children matched for age and of normal weight for height served as controls. A total of 23 children (12.4%) showed antithyroid antibodies and an ultrasound pattern suggestive of Hashimoto's thyroiditis (group A). Of them, 20 (10.8%) showed antithyroid antibodies and normal ultrasound (group B). A total of 70 subjects (37.6%) showed absent antithyroid antibodies and an ultrasound pattern suggestive of Hashimoto's thyroiditis (group C), and 73 children (39.2%) showed no thyroid antibodies with normal ultrasound (group D). TSH was higher in groups A and C compared with groups B and C, and controls (P < 0.05). Mean free T(4) was lower in group B (P < 0.05) than in controls, whereas free T(3) was higher in group C than in controls (P < 0.05). TSH and body mass index sd scores were significantly correlated in group C (P < 0.001), and TSH was also significantly associated with the degree of thyroid structure alterations (P < 0.05)." }, { "role": "assistant", "content": "Obese children frequently show alterations of thyroid structure and function that are not completely explained by the presence of an autoimmune involvement. 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": "At PHC level vaccine storage is by?" }, { "role": "assistant", "content": "The correct answer is .ice lined refrigerators(ILR)are mkept at the PHC level.the cabinet temperature is maintained at 2 to 8 degree celsius.at the PHC level,ILR s are used to store all UIP vaccines.they are lined with tubes or ice packs filled with water which freezes and keeps the internal temperature at a safe level.</p><p>ref:park&;s textbook of preventive and social medicine,22 nd edition ,pg no 104</p>" } ]

[ { "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, PATIENTS AND METHODS, RESULTS. Meshes: Adolescent, Adult, Antineoplastic Combined Chemotherapy Protocols, Bleomycin, Case-Control Studies, Chi-Square Distribution, Cyclophosphamide, Disease-Free Survival, Doxorubicin, Female, Follow-Up Studies, Humans, L-Lactate Dehydrogenase, Lymphoma, Non-Hodgkin, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Prednisone, Prognosis, Recurrence, Remission Induction, Retrospective Studies, Risk Factors, Survival Rate, Vindesine." }, { "role": "user", "content": "Is the small non-cleaved-cell lymphoma histologic subtype a poor prognostic factor in adult patients? Context: To study the prognostic significance of the small non-cleaved-cell lymphoma (SNCCL) histologic subtype, we compared the outcome of adult patients with SNCCL with that of patients with aggressive lymphoma other than SNCCL by means of two case-controlled studies. We analyzed the results of the doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone (ACVBP) regimen used as a reference scheme in our cooperative study group (Groupe d'Etude des Lymphomes de l'Adult [GELA]) in 52 adult SNCCL patients with no bone marrow (BM) or CNS involvement. Forty-five SNCCL patients younger than 60 years could be compared with two separate case-matched groups of patients with aggressive lymphoma other than SNCCL undergoing the same therapeutic regimen. In the first case-controlled study, matching ensured identity of each risk factor of the age-adjusted International Index(ie, Ann Arbor stage, performance status, and lactate dehydrogenase [LDH] level); in the second study, matching was performed according to the number of presenting risk factors (zero, one, two, or three), regardless of their nature. The 5-year overall survival rates were not significantly different between SNCCL and control patients in both case-controlled studies: 48% versus 51% in the first study, and 48% versus 55% in the second study." }, { "role": "assistant", "content": "These results support the thesis that in patients with no bone marrow or CNS involvement, the SNCCL histologic subtype does not confer a prognosis worse than that of other aggressive lymphoma." } ]

[ { "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: Apoptosis, Caspase 9, Cell Cycle, Cell Cycle Proteins, Cell Growth Processes, Cell Line, Tumor, Cyclin B, Cyclin B1, Dose-Response Relationship, Drug, Endometrial Neoplasms, Female, Flow Cytometry, Humans, Membrane Potential, Mitochondrial, Ovarian Neoplasms, Phosphorylcholine, Protein-Serine-Threonine Kinases, Proto-Oncogene Proteins, Proto-Oncogene Proteins c-bcl-2." }, { "role": "user", "content": "Does erucylphosphocholine show a strong anti-growth activity in human endometrial and ovarian cancer cells? Context: A membrane-targeted, lipophilic ether lipid of synthetic phospholipid analog, erucylphosphocholine (ErPC) induces apoptosis in some lines of human tumor cells. We investigated the effect of ErPC on three endometrial cancer cell lines, two ovarian cancer cell lines, and normal human endometrial epithelial cells. Endometrial and ovarian cancer cells were treated with various concentrations of ErPC, and its effect on cell growth, cell cycle, apoptosis, and related measurements was investigated. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay showed that all endometrial and ovarian cancer cell lines were sensitive to the growth-inhibitory effect of ErPC, although normal endometrial epithelial cells were viable after treatment with the same doses of ErPC that induced growth inhibition in endometrial and ovarian cancer cells. Cell cycle analysis indicated that their exposure to ErPC decreased the proportion of cells in the S-phase and increased the proportion in the G2/M phases of the cell cycle. Induction of apoptosis was confirmed by annexin V staining of externalized phosphatidylserine and loss of the transmembrane potential of mitochondria. This induction occurred in concert with altered expression of genes related to cell growth, malignant phenotype, and apoptosis." }, { "role": "assistant", "content": "These results suggest that the anticancer activity of ErPC may occur with higher sensitivity of cancer cells compared with normal healthy cells, when using low concentration, rising hopes that ErPC may become a useful adjuvant therapy for endometrial and ovarian cancers. 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": "Dohle bodies can be seen in which of the following?" }, { "role": "assistant", "content": "The correct answer is In sepsis or severe inflammatory disorders (e.g., Kawasaki disease), leukocytosis is often accompanied by morphologic changes in neutrophils, such as toxic granulations, Dohle bodies, and cytoplasmic vacuoles Toxic granules are coarser and darker than normal neutrophilic granules, represent abnormal azurophilic (primary) granules Dohle bodies are patches of dilated endoplasmic reticulum that appear as sky-blue cytoplasmic \"puddles.\"" } ]

[ { "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: Adult, Cost of Illness, Cost-Benefit Analysis, Glaucoma, Humans, Incidence, Markov Chains, Mass Screening, Middle Aged, Prevalence, Quality-Adjusted Life Years, Randomized Controlled Trials as Topic, United Kingdom." }, { "role": "user", "content": "Is it worthwhile to conduct a randomized controlled trial of glaucoma screening in the United Kingdom? Context: To assess the value of conducting a glaucoma screening randomized controlled trial in the UK. Decision model based economic evaluation and value of information analysis. Model derived from a previous health technology assessment. Model updated in terms of structure and parameter estimates with data from surveys, interviews with members of the public and health care providers and routine sources. On average, across a range of ages of initiating screening (40-60 years), glaucoma prevalence (1-5%), screening uptake (30-100%), and the performance of current case finding, screening was not cost-effective at a £30,000 threshold per quality adjusted life year (QALY) from the perspective of the National Health Service (NHS). The societal value of removing all uncertainty around glaucoma screening is £107 million at a threshold of £20,000 per QALY. For informing policy decisions on glaucoma screening, reducing uncertainty surrounding the NHS and personal social care cost of sight impairment (£74 million) was of most value, followed by reducing uncertainty in test performance (£14 million) and uptake of either screening or current eye care (£8 million each)." }, { "role": "assistant", "content": "A glaucoma screening trial in the UK is unlikely to be the best use of research resources. Further research to quantify the costs of sight impairment falling on the NHS and personal social services is a priority. Further development of glaucoma tests and research into strategies to promote the uptake of screening or current eye care such as through the use of a behavioural intervention would be worthwhile." } ]

[ { "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, Atherosclerosis, Atorvastatin, Heptanoic Acids, Male, Pyrroles, Rabbits, Subcutaneous Fat, Thromboplastin." }, { "role": "user", "content": "Does atorvastatin reduce tissue factor expression in adipose tissue of atherosclerotic rabbits? Context: We have recently demonstrated that tissue factor (TF) expression increases in adipose tissues/adipocytes of cholesterol-fed rabbit, which is associated with a hypercoagulable state that contributes to thrombosis. In this study, we evaluated the ability of atorvastatin to modulate TF expression in cholesterol-fed rabbit and the regulatory mechanism. Male rabbits were randomly fed with normal diet and high-cholesterol diet for 8 weeks, following 4 weeks, those fed high-cholesterol diet were randomly assigned to atorvastatin or starch. At the end of 12 weeks, subcutaneous adipose was collected, and culture adipocyte. TF mRNA was detected by reverse transcription-polymerase chain reaction (RT-PCR). TF concentrations were determined with ELISA. The in vitro effect of atorvastatin and mevalonate (MVA) on TF production in adipocytes was observed. Atorvastatin reduced serum TC and LDL-C levels (P<0.05), and decreased plasma TF concentration and expression in adipose tissues/adipocytes from cholesterol-fed rabbits. In vitro, atorvastatin dose-dependently suppressed TF expression and protein secretion in adipocytes. MVA reversed the inhibitory effect of atorvastatin on TF expression in concentration-dependent manner." }, { "role": "assistant", "content": "Results provide further support for the antithrombotic effect of atorvastatin. It also indicated that mevalonate pathway may play an important role in TF expression in adipocyte. 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, PATIENTS AND METHODS, RESULTS. Meshes: Acetabulum, Adult, Aged, Female, Fracture Fixation, Internal, Humans, Male, Middle Aged, Prospective Studies, Treatment Outcome, Young Adult." }, { "role": "user", "content": "Operative treatment of transverse acetabular fractures: is it really necessary to fix both columns? Context: we prospectively evaluated clinical and radiographic outcomes in patients with displaced combined transverse-posterior wall acetabular fractures managed at our Institution over a period of seven years by posterolateral single approach, direct posterior wall and posterior column reduction and plating, and indirect reduction of anterior column controlled by fluoroscopic images with or without lag-screw fixation. The aim was to identify if the obtained immediate postoperative Matta radiographic roof-arc angles after fracture reduction and fixation alters in the postoperative period when comparing posterior plating alone versus posterior plate and anterior column lag-screw fixation. 35 skeletally mature patients (31 male and four female, with mean age of 39.9 years old [range, 23.3 to 66.7 y/o]) with combined transverse-posterior wall acetabular fractures surgically treated by a posterolateral single approach were enrolled in this prospective investigation. Nineteen patients had associated orthopaedic injuries. The first part of the acetabular fracture management was similar to all patients and consisted in anatomical reduction and fixation of the transverse posterior component followed by anatomical reduction and fixation of the posterior wall component. The transverse anterior component reduction was controlled by fluoroscopic images (anteroposterior (AP), iliac oblique, and obturator oblique views) and digital palpation through the greater sciatic notch. Fifteen of the 35 patients had an additional lag-screw fixation from the posterior to the anterior columns with an extra-long small-fragment cortical screw. AP and Judet oblique radiographic views were taken at the end of the procedure and roof-arc angles were measured. Clinical results were assigned according to the grading system of Merle D'Aubigne and Postel as modified by Matta et al. Radiographic roof-arc angles were checked and compared between the two groups of patients to the same data collected both at the time of the surgical procedure and at three months postoperatively. Statistical analysis was done by either using chi-square (clinical outcome) and Mann-Whitney (roentgenographic outcome) tests, with a level of significance of alpha = 5%. at final follow-up examination 18 to 84 months postoperatively (mean, 46.8 months), the clinical results were considered satisfactory in 31 (88.6%) patients (excellent in nine (25.7%) and good in 22 (62.9%) patients). There was no difference between patients with (n = 15) and without (n = 20) fixation of the transverse anterior component of the acetabular fracture (p = 0.67). Radiographic roof-arc angles measured at discharge, at three months postoperatively and at the last follow-up consultation didn't changed significantly (p>0.05). There was no statistically significant difference between patients treated with (n = 15) and without (n = 20) fixation of the anterior component of the transverse acetabular fracture in terms of medial displacement of the femoral head." }, { "role": "assistant", "content": "the authors suggest that associated transverse-posterior wall acetabular fractures can be managed by a single posterior approach. Direct reduction and fixation of the posterior wall and column components is an adequate option for these injuries. If there is adequate indirect reduction of the anterior column, as checked by digital palpation and fluoroscopy, we feel that it is not necessary to fix the anterior column component of the transverse acetabular fracture." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Cell Line, Cell Membrane Permeability, Epithelial Cells, Glutamine, Horseradish Peroxidase, Humans, Intestines, Phorbol 12,13-Dibutyrate, Protein Kinase C." }, { "role": "user", "content": "Does glutamine reduce phorbol-12,13-dibutyrate-induced macromolecular hyperpermeability in HT-29Cl.19A intestinal cells? Context: Loss of mucosal integrity is associated with intestinal hyperpermeability, which may be inhibited by glutamine. The nature of this effect is unknown. The effect of glutamine on protein kinase C (PKC)-mediated hyperpermeability in HT-29Cl.19A intestinal cells was studied. Confluent monolayers of HT-29C1.19A cells were cultured on permeable filters and mounted in Ussing chambers for permeability studies. Apical to basolateral transepithelial permeability for intact horseradish peroxidase (HRP) was determined. Phorbol-12,13-dibutyrate (PDB) was used to activate PKC-mediated hyperpermeability, and the effect of glutamine (0.6 mmol/L) was studied. Two hours of PDB stimulation increased the HRP flux, reaching five times control values after 4 hours. Bilateral exposure to glutamine for 4 hours reduced PDB-induced hyperpermeability (37%). Preincubation with glutamine 2 hours before PDB stimulation showed an earlier and greater effect (3 hours, 43%; 4 hours, 50%). This bilateral effect of glutamine was mimicked by separate apical exposure. Basolateral exposure alone had no effect." }, { "role": "assistant", "content": "Glutamine rapidly reduced the PKC-mediated hyperpermeability for HRP in HT-29Cl.19A intestinal cells. The dependency on apical exposure suggests that glutamine may be more effective when delivered by the enteral route. 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": "Ulnar paradox is due to:" }, { "role": "assistant", "content": "The correct answer is Ulnar paradox The higher the lesion of the median and ulnar nerve injury , the less prominent is the deformity and vice versa, because in higher lesions the long finger flexors are also paralysed (which were causing interphalangeal flexion/clawing). The loss of finger flexion makes the deformity look less obvious/ less clawing In low ulnar nerve palsy forearm muscles are spared but the clawing is more ( as compared to high ulnar nerve palsy) because in low ulnar nerve palsy finger flexors are spared which adds on to the deformity by flexing IP joints." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adipocytes, Adult, Carrier Proteins, Diabetes Mellitus, Type 2, Diet, Reducing, Female, Gastric Bypass, Gastrointestinal Hormones, Humans, Intestinal Mucosa, Intra-Abdominal Fat, Lipolysis, Natriuretic Peptides, Obesity, Satiation, Signal Transduction, Sterol Esterase, Weight Loss." }, { "role": "user", "content": "Do guanylin and uroguanylin stimulate lipolysis in human visceral adipocytes? Context: Uroguanylin and guanylin are secreted by intestinal epithelial cells as prohormones postprandially and act on the hypothalamus to induce satiety. The impact of obesity and obesity-associated type 2 diabetes (T2D) on proguanylin and prouroguanylin expression/secretion as well as the potential role of guanylin and uroguanylin in the control of lipolysis in humans was evaluated. Circulating and gastrointestinal expression of proguanylin (GUCA2A) and prouroguanylin (GUCA2B) were measured in 134 subjects. In addition, plasma proguanylin and prouroguanylin were measured before and after weight loss achieved either by Roux-en-Y gastric bypass (RYGB) (n=24) or after a conventional diet (n=15). The effect of guanylin and uroguanylin (1-100 nmol l(-1)) on lipolysis was determined in vitro in omental adipocytes. Circulating concentrations of prouroguanylin, but not proguanylin, were decreased in obesity in relation to adiposity. Weight loss achieved by RYGB increased plasma proguanylin and prouroguanylin. Obese T2D individuals showed higher expression of intestinal GUCA2A as well as of the receptors of the guanylin system, GUCY2C and GUCY2D, in omental adipocytes. The incubation with guanylin and uroguanylin significantly stimulated lipolysis in differentiated omental adipocytes, as evidenced by hormone-sensitive lipase phosphorylation at Ser563, an increase in fatty acids and glycerol release together with an upregulation of several lipolysis-related genes, including AQP3, AQP7, FATP1 or CD36." }, { "role": "assistant", "content": "Both guanylin and uroguanylin trigger lipolysis in human visceral adipocytes. Given the lipolytic action of the guanylin system on visceral adipocytes, the herein reported decrease of circulating prouroguanylin concentrations in obese patients may have a role in excessive fat accumulation in obesity. 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 54-year-old man comes to the emergency department because of severe pain in his right leg that began suddenly 3 hours ago. He has had repeated cramping in his right calf while walking for the past 4 months, but it has never been this severe. He has type 2 diabetes mellitus, hypercholesterolemia, and hypertension. Current medications include insulin, enalapril, aspirin, and simvastatin. He has smoked one pack of cigarettes daily for 33 years. He does not drink alcohol. His pulse is 103/min and blood pressure is 136/84 mm Hg. Femoral pulses are palpable bilaterally. The popliteal and pedal pulses are absent on the right. Laboratory studies show:\nHemoglobin 16.1 g/dL\nSerum\nUrea nitrogen 14 mg/dL\nGlucose 166 mg/dL\nCreatinine 1.5 mg/dL\nA CT angiogram of the right lower extremity is ordered. Which of the following is the most appropriate next step in management?\"" }, { "role": "assistant", "content": "Administer normal saline" } ]

[ { "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: Acute Disease, Blood Flow Velocity, Case-Control Studies, Child, Preschool, Dinoprost, Echocardiography, Doppler, Female, Heart Diseases, Humans, Infant, Male, Mucocutaneous Lymph Node Syndrome, Natriuretic Peptide, Brain, Oxidative Stress, Systole." }, { "role": "user", "content": "Are abnormal tissue doppler images associated with elevated plasma brain natriuretic peptide and increased oxidative stress in acute Kawasaki disease? Context: The aims of this study were to evaluate myocardial mechanics using pulsed tissue Doppler imaging (TDI), and to determine the relationship between abnormal myocardial performance and plasma brain natriuretic peptide (BNP) levels and oxidative stress in acute Kawasaki disease (KD). Consecutive TDI parameters, including peak systolic velocity (Sw) and early (Ew) and late diastolic excursion of the mitral annuli were obtained in 42 patients with KD (mean age: 2.4+/-0.4 years) in weeks 1, 2, and 3, and during convalescence. Plasma BNP level and urinary 8-isoprostane were also examined during the acute phase. These data were then compared with TDI profiles from 62 healthy children, plasma BNP levels in 38 controls with other febrile illnesses, and urinary 8-isoprostane levels in 13 healthy children. Ew in week 1 was significantly lower than in controls, subsequently normalizing in the convalescent stage. Plasma BNP level in acute KD patients was significantly higher (65+/-9 pg/ml) than in controls (13+/-2 pg/ml). Urinary 8-isoprostane level in acute KD patients was significantly higher as compared with control (596 +/-37 vs 379+/-26 pg/ml Cr, p<0.05). There was a significant negative correlation between week 1 Sw and plasma BNP level (r=-0.55, p=0.0001). Change in Sw velocity in the BNP >/=51 group was significantly greater than in the BNP <51 group. There was a significant negative correlation between week 1 Sw and urinary 8-isoprostane level (r=-0.48, p=0.001)." }, { "role": "assistant", "content": "Latent abnormal tissue Doppler profiles, possibly reflecting long-axis systolic and diastolic dysfunction have been noted in KD patients. Abnormal myocardial mechanics may contribute to the increased plasma BNP level and enhanced oxidative stress may contribute to cardiac dysfunction in KD. 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 does not have a viral etiology?" }, { "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, OBJECTIVE, METHODS, METHODS, RESULTS. Meshes: Adolescent, Adult, Blood Transfusion, Child, Child, Preschool, Consanguinity, Culture, Deferoxamine, Egypt, Female, Humans, Islam, Male, Thalassemia." }, { "role": "user", "content": "Do cultural preferences and limited public resources influence the spectrum of thalassemia in Egypt? Context: Cultural beliefs of Egyptians with respect to the origin of thalassemia and its prevention, as well as national resources available for care, often differ from those of Western countries. To assess the impact of cultural attitudes and the effect of limited medical and financial resources that could affect the management of Egyptian thalassemic patients. A cross sectional study included 205 Egyptians β-thalassemia major (β-TM) patients, with a mean age of 149±87.90 months and a male to female ratio of 94:111. Demographic data stressing on order of birth, consanguineous marriage, and family history of β-TM, transfusion, and chelation therapy, were reported. HCV-Ab, HBV-Ag, and complete blood count were recorded with calculation of mean pretransfusional hemoglobin. The age distribution was relatively nonhomogenous, with 39% of patients between 10 and 20 years of age and 16% were younger than 5. There were high family birth rates and 35% of patients were third or more in order of birth and a marked cultural preference for consanguineous marriage, representing 61% of all the parents' marriages, as well as a high rate (59.5%) of a positive family history of β-TM. Patients transfused on low pretransfusion hemoglobin levels around 8 g/dL, and those receiving blood transfusion before the establishment of National Blood Transfusion Services showed a statistically significant higher rate of positive hepatitis B and C viral infections. Chelation therapy tended to start at late age, mean age was around 4 years. Before 2000, subcutaneous deferoxamine was the most widely used chelation, and since then a considerable number of patients (50%) had started to use oral iron chelators." }, { "role": "assistant", "content": "The strong cultural preferences for consanguineous marriage and limited preventive programmes and resources have had a negative impact on the management of Egyptians thalassemic patients. 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: Bauhinia, Costa Rica, Germination, Reproduction, Seeds." }, { "role": "user", "content": "Does selective seed abortion affect the performance of the offspring in Bauhinia ungulata? Context: Under the microgametophytic competition hypothesis, a non-random pattern of seed abortion is expected, in which only the most vigorous seeds reach maturity. In a previous study, it was found that Bauhinia ungulata (Fabaceae) exhibits a pattern of seed abortion dependent on the position of the ovule within the ovary; ovules located in the stylar half of the fruit, close to the point of entry of pollen tubes to the ovary, have a low probability of seed abortion, whereas ovules in the basal half of the fruit are aborted with a high probability. A series of experimental fruits was generated, in which ovules from either the stylar (treatments 1 and 2) or the basal (treatments 3 and 4) half of fruits were destroyed, to evaluate whether these patterns of selective seed abortion have an effect on the vigour of the offspring in B. ungulata. Only 53 % of the seed from control fruits germinated. Seed set in fruits from treatments 1 and 2 showed a significantly lower (33-43 %) percentage of germination; the germination of seeds from fruits in treatments 3 and 4 (49-51 %) did not differ from control seeds. In addition, it was found that the differences in vigour of the offspring are not random with respect to the position of the ovule in the pod." }, { "role": "assistant", "content": "The overall performance of the seeds correlated with their likelihood of maturation. Seeds located at the basal half of the treatment fruits showed lower values of vigour than seeds located on the stylar half. The differences were more marked for early measures of fitness. 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, METHODS, RESULTS. Meshes: Adult, Attitude, Body Mass Index, Child Rearing, Child, Preschool, Cohort Studies, Female, Humans, Life Style, Male, Mothers, Social Class, Sports, Television, Time Factors, United Kingdom." }, { "role": "user", "content": "Does television viewing in early childhood predict adult body mass index? Context: To examine the effects of duration, timing and type of television (TV) viewing at age 5 years on body mass index (BMI) in adult life. 1970 British Birth Cohort, followed up at 5 (N=13,135), 10 (N=14,875), and 30 years (N=11,261). Weekday and weekend TV viewing at 5 years, type of programs, and maternal attitudes toward TV at age 5 years. BMI z-score at 10 and 30 years. Mean daily hours of TV viewed at weekends predicted higher BMI z-score at 30 years (coefficient=0.03, 95% CI: 0.01, 0.05, P=.01) when adjusted for TV viewing and activity level at 10 years, sex, socioeconomic status, parental BMIs, and birth weight. Each additional hour of TV watched on weekends at 5 years increased risk of adult obesity (BMI > or =30 kg/m2) by 7% (OR=1.07, 95% CI 1.01, 1.13, P=.02). Weekday viewing, type of program and maternal attitudes to TV at 5 years were not independently associated with adult BMI z-score." }, { "role": "assistant", "content": "Weekend TV viewing in early childhood continues to influence BMI in adulthood. Interventions to influence obesity by reducing sedentary behaviors must begin in early childhood. Interventions focusing on weekend TV viewing may be particularly effective. 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: 4-Butyrolactone, Amphetamine, Animals, Codependency (Psychology), Discrimination (Psychology), Dizocilpine Maleate, Dose-Response Relationship, Drug, Female, Macaca mulatta, Male, Midazolam, Morphine, Reinforcement (Psychology), Substance-Related Disorders, Time Factors." }, { "role": "user", "content": "Are the discriminative stimulus effects of midazolam resistant to modulation by morphine , amphetamine , dizocilpine , and γ-butyrolactone in rhesus monkeys? Context: Although abuse of benzodiazepines alone is uncommon, it is high in polydrug abusers, including those who primarily use opioids or stimulants. This study investigated whether drugs that are abused (e.g., amphetamine) or drugs that have mechanisms of action similar to abused drugs (e.g., morphine) alter the discriminative stimulus effects of the benzodiazepine midazolam. Three rhesus monkeys discriminated 0.56 mg/kg of midazolam while responding under a fixed-ratio 10 schedule of food presentation. Dose-effect curves were determined for midazolam alone and in the presence of morphine (opioid receptor agonist), amphetamine (dopamine receptor indirect agonist), dizocilpine (N-methyl-D: -aspartic acid receptor antagonist), or γ-butyrolactone (prodrug of γ-hydroxybutyrate, which acts primarily at GABA(B) receptors). Doses of midazolam larger than 0.32 mg/kg produced ≥80% midazolam-lever responding. When administered alone, morphine, amphetamine, dizocilpine, and γ-butyrolactone did not produce midazolam-lever responding, although large doses of each drug eliminated responding; when administered in combination with midazolam, they did not alter the discriminative stimulus effects of midazolam up to doses that markedly decreased response rates." }, { "role": "assistant", "content": "The current study demonstrates a lack of modulation of the discriminative stimulus effects of midazolam by morphine, amphetamine, dizocilpine, and γ-butyrolactone. Other effects of benzodiazepines, such as their reinforcing effects, might be altered by these other drugs, or benzodiazepines might modulate the discriminative stimulus or reinforcing effects of the other drugs, which might contribute to the relatively high incidence of benzodiazepine abuse among polydrug abusers. 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 which of the following a nonfunctional cusp is present:" }, { "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": "Which pox wont grow in egg, animal cells -" }, { "role": "assistant", "content": "The correct answer is Molluscum cannot be grown in eggs, tissue cultures or animals. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:465" } ]

[ { "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": "For ASOM, myringotomy is done in which quadrant-" }, { "role": "assistant", "content": "The correct answer is Myringotomy for grommet insertion (in SOM) → Antero-inferior\nMyringotomy in ASOM → Postero-inferior" } ]

[ { "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": "Glutathione requires which vitamin to act as antioxidant" }, { "role": "assistant", "content": "The correct answer is Glutathione peroxidase: It detoxifies H2O2 to H2O, while reduced glutathione (G SH) is conveed to oxidized glutathione (GS SG). The reduced glutathione can be regenerated by the enzyme glutathione reductase utilizing NADPH The hexose monophosphate shunt is the major source of NADPH. ref Satyanarayana 4th ed page 659" } ]

[ { "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": "Mucocutaneous Leishmaniasis is caused by" }, { "role": "assistant", "content": "The correct answer is L. Brasiliensis causes Espundia (Mucocutaneous Leishmaniasis)." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Acoustic Stimulation, Adolescent, Adult, Analysis of Variance, Cataract, Face, Female, Humans, Light, Male, Middle Aged, Orientation, Photic Stimulation, Reaction Time, Recognition (Psychology), Sensory Deprivation, Speech Perception, Visual Perception, Young Adult." }, { "role": "user", "content": "Does early visual deprivation affect the development of face recognition and of audio-visual speech perception? Context: The investigation of patients treated for bilateral congenital cataracts allows to study the development of visual and multisensory functions after a period of visual deprivation in early infancy. In the present study, cataract patients were tested for their capability to recognize faces and to integrate auditory and visual speech information. In Experiment 1, 12 cataract patients were tested with the Benton Facial Recognition Test. In Experiment 2, a McGurk paradigm was used that investigated audio-visual interaction and lip-reading capabilities. Here, fifteen cataract patients participated and were compared to normally sighted controls and to visually impaired controls. In the Benton Facial Recognition Test, cataract patients' performance was unimpaired when target and test face were identical. By contrast, they performed worse than a normally sighted control group when head orientation and/or lighting conditions of the test faces were changed. In the McGurk paradigm, cataract patients displayed impaired lip-reading abilities and a reduced audio-visual interaction compared to normally sighted controls. The latter deficit prevailed even in a sub-group matched for lip-reading capacities with a normally sighted control sub-group." }, { "role": "assistant", "content": "These results suggest that visual input in early infancy is a prerequisite for a normal development of visual and multisensory functions. 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: Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Follow-Up Studies, Heart Diseases, Humans, Male, Middle Aged, Myocardial Infarction, Nitrates, Prognosis, Retrospective Studies, Survival Rate, Time Factors, Treatment Outcome." }, { "role": "user", "content": "Does long-term nitrate therapy after acute myocardial infarction improve or aggravate prognosis? Context: There is conflicting information about whether nitrate treatment aggravates long-term prognosis, so the present retrospective study was designed to determine the effects of long-term nitrate therapy on major adverse events after acute myocardial infarction (AMI) in the coronary interventional era. Using the Japanese Acute Coronary Syndrome Study database, 1,236 consecutive patients who were hospitalized within 48 h of onset of symptoms of AMI from January to December 2003 were evaluated. All-cause mortality, cardiac events and cardiovascular events were lower in patients treated with nitrates than in the untreated controls. However, these crude comparisons included several confounding factors on nitrate prescription. To minimize the effect of selection bias on outcomes, the technique of propensity score matching for clinical characteristics was used and distortion of effective nitrate treatment was excluded as much as possible. The results of propensity score matching showed that nitrate therapy had no impact on all-cause mortality, cardiac events and cardiovascular events at 30, 60 or 90 days, 6 months, 1 year, and 2 years follow-up." }, { "role": "assistant", "content": "Long-term nitrate therapy after AMI neither improves nor aggravates prognosis. Prospective randomized clinical trials are warranted to determine the effects of long-term nitrate therapy for secondary prevention of AMI. 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": "Chalcosis is seen with-" }, { "role": "assistant", "content": "The correct answer is *Chalcosis refers to the specific changes produced by the alloy of copper in the eye. Ref: Khurana 7th/e p.452" } ]

[ { "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 Finnish type of congenital nephritic syndrome occurs due to gene mutations the following protein:" }, { "role": "assistant", "content": "The correct answer is \"A mutation in the Nephrin gene causes a hereditary form of congenital Nephrotic syndrome (Finnish type) with minimal change glomerular morphology\". Ref: Robbin's Illustrated Pathology, 7th Edition, Pages 981, 983, 984" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Acute Coronary Syndrome, Aged, Angioplasty, Balloon, Coronary, Anticholesteremic Agents, Female, Heart, Humans, Male, Middle Aged, Myocardium, Simvastatin, Treatment Outcome." }, { "role": "user", "content": "Does intensive cholesterol lowering with statin improve the outcomes of percutaneous coronary intervention in patients with acute coronary syndrome? Context: The incidence of no reflow phenomenon limits the clinical outcomes of percutaneous coronary intervention (PCI). This randomized controlled study was designed to evaluate the immediate protective effects of intensive statin pretreatment on myocardial perfusion and myocardial ischemic injury during PCI. Altogether 228 patients with acute coronary syndrome (ACS) were randomly assigned to standard statin group (SS group, n = 115) and intensive statin group (IS group, n = 113). Patients in the SS group received 20 mg simvastatin and patients in the IS group received 80 mg simvastatin for 7 days before PCI. Thrombolysis in myocardial infarction (TIMI) flow grade (TFG), corrected TIMI frame count (CTFC) and TIMI myocardial perfusion grade (TMPG) of the intervened vessel were recorded before and after stent deployment. Creatine kinase (CK) isoenzyme MB, troponin I and plasma level of high sensitive-C reactive protein (hs-CRP), P-selectin and intercellular adhesion molecule (ICAM) were measured before and 24 hours after the procedure. The TFG after stent deployment was significantly improved with less TIMI 0-1 and more TIMI 3 blood flow in the IS group than in the SS group (all P < 0.05). Patients with no reflow phenomenon were less in the IS group (P < 0.001). The CTFC was lower in the IS group than in the SS group (P < 0.001). TMPG was also improved in the IS group than in the SS group (P = 0.001). Although PCI caused a significant increase in CK-MB 24 hours after the procedure, the elevated CK-MB value was lower in the IS group than in the SS group (18.74 +/- 8.41 vs 21.78 +/- 10.64, P = 0.018). Similar changes were also found in troponin I (0.99 +/- 1.07 in the IS group vs 1.47 +/- 1.54 in the SS group, P = 0.006). CK-MB elevation occurred in 27.8% (32/115) of the patients in the SS group vs 15.9% (18/113) in the IS group (P = 0.030). Myocardial necrosis was detected in 4.4% (5/115) of the patients in the SS group, whereas 0.9% (1/113) in the IS group (P = 0.341). But no myocardial infarction was found. Similarly, the patients with increased level of troponin I were much more in the SS group (36.5%, 42/115) than in the IS group (19.5%, 22/113) (P = 0.04). Among them, myocardial necrosis was detected in 13.0% (15/115) of the patients in the SS group, while 4.4% (5/113) in the IS group (P = 0.021). Myocardial infarction was found in 4.4% (5/115) of the patients in the SS group and 0.9% (1/113) in the IS group (P = 0.213)." }, { "role": "assistant", "content": "Intensive statin pretreatment for 7 days before PCI can further improve myocardial blood perfusion, protect the myocardium from ischemic injury. These effects are associated with the lowered levels of hs-CRP, P-selectin and ICAM. 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": "Pulp tissue contains all except:" }, { "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: Aged, Anticoagulants, Case-Control Studies, Cohort Studies, Craniocerebral Trauma, Female, Humans, Injury Severity Score, Length of Stay, Male, Patient Discharge, Pennsylvania, Prospective Studies, Registries, Retrospective Studies, Trauma Centers, Warfarin, Wounds and Injuries." }, { "role": "user", "content": "Does preinjury warfarin impact outcome in trauma patients? Context: The objective of this study was to determine whether the preinjury condition of anticoagulation had an adverse impact on patients sustaining injury. A retrospective analysis was performed for prospectively collected registry data from 1995-2000 from all accredited trauma centers in Pennsylvania. The registry was queried for all trauma patients who had anticoagulation therapy as a preinjury condition (PIC). This group served as our experimental cohort. A control cohort (not having warfarin therapy as a PIC) was developed using case-matching techniques for age, sex, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), A Severity Characterization of Trauma (ASCOT) score, and in the head injured patients, International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnoses. Head and non-head injured patients were evaluated separately. The cohorts were examined for 28-day mortality, intensive care unit length of stay (ICU-LOS), hospital length of stay (HOS-LOS), PICs, occurrences, discharge destinations, and functional status at discharge. Chi2 and Student's t test were used to evaluate the data; p values < 0.05 were considered significant. Two thousand nine hundred forty-two patients were available for analysis. The prevalence of PICs was significantly greater in the warfarin group for both the head and non-head injured populations (p < 0.003 and p < 0.0001, respectively). The incidence of occurrences in the non-head injured population was statistically higher for the warfarin patients (p < 0.001), but showed no difference in the head injured group regardless of warfarin use (p = 0.15). Functional status at discharge demonstrated no clinically significant difference between the warfarin and non-warfarin groups in both head and non-head injured populations. There was no difference in discharge destination in the head injured population; however, in the non-head injured population a greater percentage of non-warfarin patients was discharged to home when compared with the warfarin patients." }, { "role": "assistant", "content": "Our data suggest that the PIC of anticoagulation with warfarin does not adversely impact mortality or LOS outcomes in both head and non-head injured patients. In non-head injured patients, however, the occurrence rates and discharge destination were different. More research needs to be done to determine whether this is related to anticoagulation or other reasons (i.e., number of PICs). These data should be used when weighing risk/benefit ratios of prescribing chronic anticoagulation. 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": "Bull's eye lesion seen with: (PGI Nov 2009)" }, { "role": "assistant", "content": "The correct answer is Ans: A (Chloroquine) akobiec 2nd / 2240.2248 }Causes of Bull's Eye MaculopathyChloroquine1?Toxicity of phenothiazine D Bardet-Biedl SyndromeInverse retinitis pigmentosaDystrophies:benign concentric annular macular dystrophyfenestrated sheem dystrophycone dystrophyStargardt disease Bulls eye maculopathy causes loss ofcentrai vision as well as constriction of peripheral fields.The two main S/E of Chloroquine are - corneal deposits & maculopathyQRetinal Toxicity of Systemic Drugs# Chloroquine/Hydroxy chloroquine : Bull's eye maculopa thyQ.Thioridazine : pigmentary retinopathyChloropromazine : Pigment clumping of retinaNiacin: bilateral maculopathy that mimics cystoids macular edema.Tamoxifen : fine refractive intraretinal crystals as well as granular deposits at the level of the pigment epithelium.Deferoxamine : macular pigmentary irregularities" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Does miRNA-125b inhibit proliferation and migration by targeting SphK1 in bladder cancer? Context: MicroRNAs (miRNAs) are small, non-coding RNAs (18-25 nucleotides) that post-transcriptionally modulate gene expression by negatively regulating the stability or translational efficiency of their target mRNAs.The purpose of this study was to investigate the expression levels of miR-125b in human bladder cancer and its potential role in disease pathogenesis. The expression level of miR-125b was measured in 40 bladder cancer specimens and adjacent normal breast tissues by quantitative polymerase chain reaction (qPCR). MTT and colony formation assays, transwell, cell cycle assays were conducted to explore the potential function of miR-125b in human T24 bladder cancer cells. Luciferase reporter assays were performed to analyze the regulation of putative target of miR-125b. The effects of modulating miR-125b on endogenous levels of this target were subsequently confirmed via qRT-PCR and Western blot. The expression of miR-125b in bladder cancer specimens was lower than adjacent normal tissues (P < 0.05). Overexpression of miR-125b inhibited cellular growth, suppressed cellular migration and caused an accumulation of cells in the G1 phase of the cell cycle, Luciferase assays revealed that miR-125b directly targeted the 3'UTR of SphK1. Overexpression of miR-125b led to the downregulation of SphK1 and protein level as assessed by qRT-PCR and Western blot. Targeted knockdown of SphK1 by siRNA significantly inhibited the proliferation of T24 bladder cancer cells." }, { "role": "assistant", "content": "These findings suggest that miR-125b may act as a tumor suppressor gene in bladder cancer and that, in the future, targeting of this miRNA may provide a novel strategy for the diagnosis and treatment of patients with this lethal 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, Endogenous Retroviruses, Evolution, Molecular, Genetic Fitness, Humans, Pan troglodytes, Primates, Repetitive Sequences, Nucleic Acid, Terminal Repeat Sequences." }, { "role": "user", "content": "Do orthologous endogenous retroviruses exhibit directional selection since the chimp-human split? Context: Endogenous retroviruses (ERVs) are often viewed as selfish DNA that do not contribute to host phenotype. Yet ERVs have also been co-opted to play important roles in the maintenance of stem cell identity and placentation, amongst other things. This has led to debate over whether the typical ERV confers a cost or benefit upon the host. We studied the divergence of orthologous ERVs since the chimp-human split with the aim of assessing whether ERVs exert detectable fitness effects. ERVs have evolved faster than other selfish DNA in human and chimpanzee. The divergence of ERVs relative to neighbouring selfish DNA is positively correlated with the length of the long terminal repeat of an ERV and with the percentage of neighbouring DNA that is not selfish. ERVs from the HERV-H family have diverged particularly quickly and in a manner that correlates with their level of transcription in human stem cells. A substitution into a highly transcribed HERV-H has a selective coefficient of the order of 10(-4). This is large enough to suggest these substitutions are not dominated by drift." }, { "role": "assistant", "content": "ERVs differ from other selfish DNA in the extent to which they diverge and appear to have measurable effects on hosts, even after fixation. The effects are strongest for HERV-H and suggest that the HERV-H transcriptome has recently evolved under the influence of directional selection. As there are many HERV-H loci distributed across the ape lineage, our results suggest that in future this family can be used to model the evolutionary consequences of ERV exaptation in primates and other mammals. 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 hardness test is a micro hardness test?" }, { "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": "Miliary mottling of lung is seen in all except" }, { "role": "assistant", "content": "The correct answer is <img src=\" />" } ]

[ { "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, Female, Follow-Up Studies, Gingiva, Humans, Male, Masseter Muscle, Orthodontic Wires, Pain Measurement, Pain Threshold, Periodontal Ligament, Periodontium, Physical Stimulation, Pressure, Sensory Thresholds, Tooth, Touch, Young Adult." }, { "role": "user", "content": "Does transient Pain Following Orthodontic Fixed Appliances induce Sensitization of Gingival and Periodontal Tissues? Context: To evaluate the transient effects of orthodontic treatment on the mechanical detection threshold (MDT) and mechanical pain threshold (MPT) of the buccal attached gingiva and the pressure pain threshold (PPT) of the buccal attached gingiva and of the teeth in two directions (perpendicular and parallel). A total of 20 patients (15 females and 5 males) aged 18 to 30 years participated in the study. Perceived pain on a 0- to 10-cm visual analog scale (VAS) and MDT, MPT, and PPT scores were evaluated at two time points at the masseter muscle, gingiva, teeth, and hand (control) prior to orthodontic treatment (T₀) and 24 hours after the first archwire placement (T₁). Mean values and SEMs were calculated for all continuous variables. The differences between T₀ and T₁ of MDT, MPT, and PPT were analyzed by means of a paired Student t test. The pain intensity as assessed on the VAS was 4.2 ± 1.8 cm. No significant changes in MDT or MPT were found at the hand and buccal attached gingiva (P > .06). The PPTs at the buccal attached gingiva of teeth 21, 23, 24, and 34, at teeth 21, 23, 24, and 34 (perpendicular) and at teeth 21 and 23 (parallel) were lower (ie, more sensitive) at T₁ compared with T₀ (P < .04)." }, { "role": "assistant", "content": "This study indicates for the first time that pain following insertion of an archwire causes sensitization to blunt-pressure stimuli both in the attached gingiva and in the periodontal ligament. Quantitative assessment of mechanical sensitivity may provide more insights into procedural pain and allow for better monitoring and evaluation of the effects of orthodontic treatment in the future. 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": "Courvoisier's law is related to -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Jaundice Courvoisier's law states that in the presence of an enlarged gall bladder which is nontender and accompanied with jaundice the cause is unlikely to be gallstones. This is because gall stones are formed over a longer period of time, and this result in a shrunken, fibrotic gall bladder which does not distend easily. In contrast, the gall bladder is more often enlarged in pathologies that cause obstruction of the biliary tree over a shoer period of time such as malignancy of bile duct, pancreas, leading to passive distention from backpressure." } ]

[ { "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, RESEARCH DESIGN AND METHODS, RESULTS. Meshes: Acylation, Adult, Blood Glucose, Down-Regulation, Female, Ghrelin, Glucose Clamp Technique, Humans, Male, Meals, Middle Aged, Obesity." }, { "role": "user", "content": "Does des-acyl ghrelin improve glycemic control in obese diabetic subjects by decreasing acylated ghrelin levels? Context: The objective of this study was to assess the effects of a continuous overnight infusion of des-acyl ghrelin (DAG) on acylated ghrelin (AG) levels and glucose and insulin responses to a standard breakfast meal (SBM) in eight overweight patients with type 2 diabetes. Furthermore, in the same patients and two additional subjects, the effects of DAG infusion on AG concentrations and insulin sensitivity during a hyperinsulinemic-euglycemic clamp (HEC) were assessed. A double-blind, placebo-controlled cross-over study design was implemented, using overnight continuous infusions of 3 and 10  μg DAG/kg per h and placebo to study the effects on a SBM. During a HEC, we studied the insulin sensitivity. We observed that, compared with placebo, overnight DAG administration significantly decreased postprandial glucose levels, both during continuous glucose monitoring and at peak serum glucose levels. The degree of improvement in glycemia was correlated with baseline plasma AG concentrations. Concurrently, DAG infusion significantly decreased fasting and postprandial AG levels. During the HEC, 2.5  h of DAG infusion markedly decreased AG levels, and the M-index, a measure of insulin sensitivity, was significantly improved in the six subjects in whom we were able to attain steady-state euglycemia. DAG administration was not accompanied by many side effects when compared with placebo." }, { "role": "assistant", "content": "DAG administration improves glycemic control in obese subjects with type 2 diabetes through the suppression of AG levels. DAG is a good candidate for the development of compounds in the treatment of metabolic disorders or other conditions with a disturbed AG:DAG ratio, such as type 2 diabetes mellitus or Prader-Willi syndrome." } ]

[ { "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: Genetic Vectors, Hep G2 Cells, Hepatitis B virus, Host-Pathogen Interactions, Humans, Interleukins, NF-kappa B p50 Subunit, Transcription Factor RelA, Transfection." }, { "role": "user", "content": "Is [ Interleukin-32 expression induced by hepatitis B virus ]? Context: To investigate whether hepatitis B virus (HBV) can induce the expression of the host-encoded cytokine interleukin-32 (IL-32) and its effects on host signaling mechanisms related to HBV pathogenesis. A eukaryotic expression vector harboring an enhanced green fluorescent protein was constructed with HBV genomic sequences (pIRES2-HBV-EGFP) and transfected into HepG2 cells. In addition, the nuclear factor-kappa B (NF-kB) subunits, p50 and p65, were transfected respectively into HepG2 cells. In both cases, 48 hrs after transfection, IL-32 expression was determined at the mRNA and protein levels using real-time PCR and ELISA and western blot, respectively. The HepG2 cells transfected with pIRES2-HBV-EGFP were also treated with the NF-kB inhibitor SN50 at various concentrations, and the effects on IL-32 protein expression 48 hrs later were evaluated by western blot. Significance of between-group differences was assessed by the Student's t-test. Transfection with pIRES2-HBV-EGFP led to significantly higher IL-23 expression than transfection with empty vector (mRNA: 2.8-fold higher and protein: 4.5-fold higher; both P less than 0.05). Transfection of p50 and p65 proteins led to significantly higher IL-32 expression (both P less than 0.05), and NF-kB activation was found to be required for HBV-induced IL-32 expression." }, { "role": "assistant", "content": "IL-32 expression is induced by HBV in HepG2 cells. This host-encoded cytokine, and its downstream activation of NF-kB, may be involved in the pathogenesis of HBV, especially in the subsequent liver inflammation that accompanies HBV infection. 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 usefulness of previous methicillin-resistant Staphylococcus aureus screening result in guiding empirical therapy for S aureus bacteremia? Context: Staphylococcus aureus bacteremia (SAB) is an important infection. Methicillin-resistant S aureus (MRSA) screening is performed on hospitalized patients for infection control purposes. To assess the usefulness of past MRSA screening for guiding empirical antibiotic therapy for SAB. A retrospective cohort study examined consecutive patients with confirmed SAB and previous MRSA screening swab from six academic and community hospitals between 2007 and 2010. Diagnostic test properties were calculated for MRSA screening swab for predicting methicillin resistance of SAB. A total of 799 patients underwent MRSA screening swabs before SAB. Of the 799 patients, 95 (12%) had a positive and 704 (88%) had a negative previous MRSA screening swab. There were 150 (19%) patients with MRSA bacteremia. Overall, previous MRSA screening swabs had a positive likelihood ratio of 33 (95% CI 18 to 60) and a negative likelihood ratio of 0.45 (95% CI 0.37 to 0.54). Diagnostic accuracy differed depending on mode of acquisition (ie, community-acquired, nosocomial or health care-associated infection) (P<0.0001) and hospital (P=0.0002). At best, for health care-associated infection, prior MRSA screening swab had a positive likelihood ratio of 16 (95% CI 9 to 28) and a negative likelihood ratio of 0.27 (95% CI 0.17 to 0.41)." }, { "role": "assistant", "content": "A negative prior MRSA screening swab cannot reliably rule out MRSA bacteremia and should not be used to guide empirical antibiotic therapy for SAB. A positive prior MRSA screening swab greatly increases likelihood of MRSA, necessitating MRSA coverage in empirical antibiotic therapy for SAB. 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": "Renal artery stenosis may occur in all of the following except -" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All of the followings are seen GDM; except:" }, { "role": "assistant", "content": "The correct answer is Ans. (a) MalformationsRef: Williams Obstetrics 25th Ed; Page No-1111* Malformations are seen in overt DM or Pre-gestational DM.* Past history of macrosomia is also high risk group for GDM screening.Maternal and Fetal Effects* Neonatal Hypoglycemia* Fetal Macrosomia* Maternal Obesity" } ]

[ { "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 seen in oliguric phase of Acute Tubular necrosis, Except:" }, { "role": "assistant", "content": "The correct answer is Answer is A (Aminoglycoside toxicity): Non-Oliguric Renal Failure is typically associated with Aminoglycoside toxicity. 'Aminoglycoside nephrotoxicity typically is associated with non-oliguric renal failure' - Management of Acute Kidney Problems 'Non-Oliguric renal failure is a common expression of aminoglycoside nephrotoxity and may reflect a direct inhibitory effect on solute transpo along the thick ascending loop of Hence or possibly tubulointerstitial cell injury. - Diseases of Kidney and Urinary Tract 81h/1035 'Non-Oliguric Acute Kidney Injury accompanies 10-30% of courses of aminoglvcosides even when plasm levels are in therapeutic range'- Harrison 18th/2298 'The Acute Kidney Injury of Aminoglycoside toxicity is characteristically non-oliguric and reversible with a low moality' - 'Renal and Electrolyte Disorders' by Sh -icy (Lippincott Williams) 2010/357-358 Non-Oliguric renal failure may also be associated with contrast induced nephropathy, however it is most typical /characteristic of Aminoglycoside toxity." } ]

[ { "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: Ambroxol, Animals, Antioxidants, Apoptosis, Biomarkers, Caspase 3, Disease Models, Animal, JNK Mitogen-Activated Protein Kinases, Liver, Liver Diseases, Male, Oxidative Stress, Phosphorylation, Proto-Oncogene Proteins c-bcl-2, Rats, Rats, Wistar, Reperfusion Injury, Signal Transduction, bcl-2-Associated X Protein." }, { "role": "user", "content": "Does ambroxol alleviate hepatic ischemia reperfusion injury by antioxidant and antiapoptotic pathways? Context: Hepatic ischemia/reperfusion (HI/R) injury is a common pathologic process caused by many clinical settings, such as liver resection, liver transplantation, hypovolemic shock, and trauma. The use of ambroxol, which acts as a mucolytic agent, provides antioxidant and anti-inflammatory effects. A rat model of HI/R was induced by clamping the hepatic artery, the hepatoportal vein, and the bile duct with a vascular clamp for 30 minutes followed by reperfusion for 6 hours under anesthesia. The sham group underwent laparotomy without hepatic ischemia. The ambroxol group was injected into the tail vein in the ambroxol group 5 minutes before HI/R at one dose of 20 mg/kg, 80 mg/kg, or 140 mg/kg. The control group underwent the same procedure as the ambroxol group but with administration of physiological saline. Liver injury was evaluated by biochemical and histopathological examinations. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were assayed in serum samples. Superoxide dismutase (SOD), catalase (CAT), malondiadehyde (MDA), and glutathione (GSH) were spectrophotometrically measured. Furthermore, caspase-3, Bcl-2 and Bax expression as well as the level of c-Jun N-terminal kinases (JNK) we estimated activation. Wistar rats that received 20, 80 mg or 140 mg of ambroxol displayed reduced HI/R injury compared with controls. Use of ambroxol reduced the histologic injury and significantly decreased serum ALT and AST levels. In addition, ambroxol enhanced the activity of hepatic tissue SOD and CAT, increasing GSH but decreasing MDA tissue contents. In the ambroxol group, Bcl-2 expression was increased and Bax and caspase-3 decreased compared with the controls. Furthermore, ambroxol reduced levels of phosphorylated JNK (P < .05)." }, { "role": "assistant", "content": "These results indicated that ambroxol attenuated rat HI/R through upregulation of intracellular antioxidant and anti-apoptotic signaling pathways. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Gold standard IOC for female infeility is:September 2011" }, { "role": "assistant", "content": "The correct answer is Ans. D: Laparoscopy and hysteroscopyLaparoscopy is combined with hysteroscopy as a comprehensive one-stop infeility work-up, to detect cause of infeility and treat the cause in one go" } ]

[ { "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, Contrast Media, Gadolinium, Gold, Half-Life, Metal Nanoparticles, Mice, Tomography, X-Ray Computed." }, { "role": "user", "content": "Do gold nanoparticles provide bright long-lasting vascular contrast for CT imaging? Context: Iodinated contrast agent for CT has a short half-life in the vasculature. As the field of interventional procedures expands, a more durable contrast agent would be highly useful. Our study investigated whether gold nanoparticles are feasible as a long-lasting vascular contrast agent for CT. Gold nanoparticles were synthesized by a modified Turkevich method, coated with methoxy-polyethylene glycol-thiol chains, and compared with an iodine-based contrast agent used in mice. Contrast agents were imaged in tubes by CT at 40, 60, and 140 kVp and then were tested in vivo by tail vein injection. Nine mice received gold nanoparticles, two received iodine-based contrast agent, and one received saline. CT of mice was performed at 60 kVp immediately, 6 hours, and 24 hours after injection. In an isolated form in tubes, gold nanoparticles had greater radiographic density than did iodine-based contrast agent at 40 kVp and were comparable at the other CT voltages. In mice, gold nanoparticles provided bright contrast enhancement that enabled clear visualization of the abdominal aorta and renal arteries, which could not be distinguished without contrast agent. This persisted up to 24 hours, which was the last time point assessed. Contrast enhancement of the vasculature by iodine-based contrast agent was present immediately after injection but had disappeared by 6 hours." }, { "role": "assistant", "content": "Gold nanoparticles can provide clear and durable contrast enhancement of the vasculature even at 24 hours. These findings merit further study of gold nanoparticles for their potential as a contrast agent in CT and CT-guided interventional procedures. 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": "Under the Indira Gandhi National Old Age Pensions Scheme, eligibility age is:" }, { "role": "assistant", "content": "The correct answer is Under the Indira Gandhi National Old Age Pensions Scheme, the eligibility age has been reduced to 60 years since 1st April 2011 and the rate of pension is increased to Rs. 500 for beneficiaries aged 80 years or more. Ref: Health policies and programmes in India, D.K. Taneja 11th edition page: 393" } ]

[ { "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": "T helper cells recognises -" }, { "role": "assistant", "content": "The correct answer is CD4+ T cells have TCRs with an affinity for Class II MHC Ref: Ananthanarayanan & Panikers textbook of microbiology 9th edition pg: 135" } ]

[ { "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": "Cleft like space in atheromatous plaque contains" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Cholesterol crystals" } ]

[ { "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: Adenoma, Pleomorphic, Adult, Aged, Aged, 80 and over, Antibodies, Cell Transformation, Neoplastic, Cyclooxygenase 2, Female, Humans, Immunohistochemistry, Ki-67 Antigen, Male, Middle Aged, Parotid Neoplasms, Salivary Gland Neoplasms." }, { "role": "user", "content": "Are increased expression of cyclooxygenase-2 and Ki-67 associated with malignant transformation of pleomorphic adenoma? Context: In the present study, we attempted to identify cyclooxygenase-2 (COX-2) expression and Ki-67 index in carcinoma ex-pleomorphic adenoma (Ca ex-PA) using quantitative immunohistochemical analysis and to compare the benign component of the neoplasia. We also aimed to relate the overexpression of COX-2 with the pathways of malignant transformation of Ca ex-PA as evidenced by distinct morphological features. Forty Ca ex-PA from patients treated at Department of Otolaryngology, Yokohama City University Medical Center, Yokohama, Japan, from 1999 to 2005, were selected. All Ca ex-PA showed only one malignant histological component: adenocarcinoma (23 cases), adenoid-cystic carcinoma (10), epithelial-myoepithelial carcinoma (7). The tissues were stained with monoclonal antibodies to COX-2 and Ki-67. The results were analyzed using quantitative immunohistochemical analysis. We also analyzed the association of the histological classification of the carcinomatous component. In the immunohistochemical analysis of COX-2 and Ki-67 index, significant increase was observed in Ca ex-PA, especially with adenocarcinoma, compared to pleomorphic adenoma and sialadenitis. Quantitative assessment is more sensitive as a measure of cellular protein content as compared to standard optical density measurement." }, { "role": "assistant", "content": "The data support the hypothesis that increased COX-2 expression is associated with early events in malignant transformation of pleomorphic adenoma. 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 17-year-old girl presents to an urgent care clinic after waking up in the morning with a left-sided facial droop and an inability to fully close her left eye. Of note, she is currently on oral contraceptives and escitalopram and smokes half a pack of cigarettes per day. Her temperature is 98.2°F (36.8°C), blood pressure is 110/68 mmHg, pulse is 82/min, and respirations are 12/min. On exam, she has generalized, unilateral left-sided drooping of her upper and lower face, and an inability to move the left side of her mouth or close her left eye. Her extraocular movements and swallow are intact. She has no other neurologic deficits. Which of the following interventions would most likely address the most likely cause of this patient's symptoms?" }, { "role": "assistant", "content": "Prednisone alone" } ]

[ { "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 45-year-old was given steroids after renal transplant. After 2 years he had difficulty in walking and pain in both hips. Which one of the following is most likely cause?" }, { "role": "assistant", "content": "The correct answer is Ans. B. Avascular necrosisMnemonic for causes of avascular necrosis other than fracture - SCLERAa. S-Steroidsb. C-Caisson's diseasec. LE - Lupus Erythematosusd. R-Radiatione. A-Alcohol" } ]

[ { "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 following are the branches of the anterior division of internal iliac aery except" }, { "role": "assistant", "content": "The correct answer is It arises at the bifurcation of the common iliac aery, opposite the lumbosacral aiculation, and, passing downward to the upper margin of the greater sciatic foramen, divides into two large trunks, an anterior and a posterior.The following are relations of the aery at various points: it is posterior to the ureter, anterior to the internal iliac vein, the lumbosacral trunk, and the piriformis muscle; near its origin, it is medial to the external iliac vein, which lies between it and the psoas major muscle; it is above the obturator nerve. Ref - researchgate.net" } ]

[ { "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: Coronary Stenosis, Female, Humans, Male, Middle Aged, Myocardial Infarction, Prospective Studies, Sensitivity and Specificity, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed." }, { "role": "user", "content": "Does dual-phase multi-detector computed tomography assess jeopardised and infarcted myocardium subtending infarct-related artery early after acute myocardial infarction? Context: To investigate dual-phase multi-detector computed tomography (MDCT) for assessing extent and severity of jeopardised and infarcted myocardium subtended by infarct-related artery (IRA), and its indication for revascularisation after acute myocardial infarction (AMI). Designs, setting and Prospective, single-centre study included 107 patients with uncomplicated post-AMI 3-7 days, who met criteria and underwent dual-phase 64-slice MDCT. IRA, culprit lesion and extent of jeopardised/infarcted myocardium were assessed by three-dimensional (3D) volume-rendered images with myocardium maps and computed tomography angiography (CTA), compared with stress-redistribution thallium-201 single-photon emission computed tomography (SPECT) plus conventional coronary angiography (CCA). MDCT-jeopardised score (severity of jeopardised myocardium) was defined as extent of jeopardised myocardium multiplied by the weighted factor dependent on culprit lesion severity compared with SPECT-SRS (summation of segmental reversible score). The IRA indication for revascularisation was evaluated by MDCT-jeopardised score plus CTA. SPECT-SRS > or =2 plus CCA-culprit lesion > or =50% was the standard reference. The presence of MDCT-delayed enhancement was found in 101 (94.4%) patients. The IRA and culprit lesion were identified in 99 (92.5%) patients by MDCT-myocardium maps plus CTA. The concordance between MDCT and SPECT for detecting infarcted myocardium was good (kappa = 0.702). The correlation between MDCT-jeopardised score and SPECT-SRS was 0.741. The correlation between CTA and CCA for culprit lesion severity was 0.85. The sensitivity, specificity, negative and positive predictive values of MDCT-jeopardised score > or =2.5 plus CTA for indicating revascularisation were 90.2%, 80.4%, 86.0% and 85.9%, respectively." }, { "role": "assistant", "content": "Dual-phase MDCT has good accuracy for identifying IRA, and assessing infarcted and jeopardised myocardium for clinical relevance. It provides an alternative for triage and therapeutic planning in post-AMI. 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 youngest lens fibres are present in:" }, { "role": "assistant", "content": "The correct answer is Ans. Superficial layer of the coex" } ]

[ { "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": "Stratum granulosum is not present in:" }, { "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": "Apex at of the lung lies at what level?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Above the clavicle * Apex lies in the inlet of thorax, 2.5 cm above the clavicle. It is related anteriorly to subclavian artery and vein. Posteriorly it is separated from neck of first rib by (from medial to lateral) sympathetic trunk, fist posterior intercostal vein, superior intercostal artery, and ascending branch of ventral ramus of 1st thoracic nerve." } ]

[ { "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": "Dark brown post mortem lividity is seen in-" }, { "role": "assistant", "content": "The correct answer is Phosphorus poisoning causes dark brown or yellow postmortem staining." } ]