messages
listlengths 3
3
|
|---|
[
{
"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: Appointments and Schedules, Automation, Decision Making, Computer-Assisted, Education, Medical, Graduate, Humans, Internship and Residency, Personnel Staffing and Scheduling, Physicians, Work Schedule Tolerance, Workload."
},
{
"role": "user",
"content": "Does automation improve Schedule Quality and Increases Scheduling Efficiency for Residents? Context: Medical resident scheduling is difficult due to multiple rules, competing educational goals, and ever-evolving graduate medical education requirements. Despite this, schedules are typically created manually, consuming hours of work, producing schedules of varying quality, and yielding negative consequences for resident morale and learning. To determine whether computerized decision support can improve the construction of residency schedules, saving time and improving schedule quality. The Optimized Residency Scheduling Assistant was designed by a team from the University of Michigan Department of Industrial and Operations Engineering. It was implemented in the C.S. Mott Children's Hospital Pediatric Emergency Department in the 2012-2013 academic year. The 4 metrics of schedule quality that were compared between the 2010-2011 and 2012-2013 academic years were the incidence of challenging shift transitions, the incidence of shifts following continuity clinics, the total shift inequity, and the night shift inequity. All scheduling rules were successfully incorporated. Average schedule creation time fell from 22 to 28 hours to 4 to 6 hours per month, and 3 of 4 metrics of schedule quality significantly improved. For the implementation year, the incidence of challenging shift transitions decreased from 83 to 14 (P < .01); the incidence of postclinic shifts decreased from 72 to 32 (P < .01); and the SD of night shifts dropped by 55.6% (P < .01)."
},
{
"role": "assistant",
"content": "This automated shift scheduling system improves the current manual scheduling process, reducing time spent and improving schedule quality. Embracing such automated tools can benefit residency programs with shift-based scheduling needs. 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: UNLABELLED. Meshes: Aurora Kinase A, Axin Protein, Cell Line, Tumor, Cell Transformation, Neoplastic, Drug Resistance, Neoplasm, Gene Silencing, Glioblastoma, Glioma, Humans, Neoplasm Recurrence, Local, Neoplastic Stem Cells, Phosphorylation, Wnt Proteins, Wnt Signaling Pathway, beta Catenin."
},
{
"role": "user",
"content": "Does aURKA govern self-renewal capacity in glioma-initiating cells via stabilization/activation of β-catenin/Wnt signaling? Context: Glioma-initiating cells (GIC), which are characterized by their self-renewal capacity and tumorigenicity, were recently identified as a highly tumorigenic subpopulation of glioblastoma multiforme and are considered responsible for glioblastoma recurrence and chemo/radiation resistance. Previously, it was revealed that Wnt signaling activation is critical to the self-renewal of GICs. However, the molecular mechanism underlying the high expression of β-catenin, the key transcription factor of the Wnt signaling pathway, remains elusive. In this investigation, it was determined that aurora kinase A (AURKA) regulates the self-renewal and tumorigenicity of GICs by stabilizing β-catenin. In GICs, AURKA directly interacts with AXIN and disrupts the AXIN/GSK3β/β-catenin destruction complex and stabilizes β-catenin, thereby activating Wnt signaling to promote self-renewal. Stable knockdown of AURKA destabilizes β-catenin by increasing phosphorylated β-catenin bound to AXIN and suppresses Wnt signaling, which inhibits the ability of GICs to self-renew. This effect is rescued by expression of an AURKA kinase dead mutant, D274A, which lacks the ability to phosphorylate GSK3β, indicating that stabilization of β-catenin by AURKA in GICs is independent from phosphorylation of GSK3β. Functional experiments confirm that inhibition of AUKRA in GICs could suppress their \"stemness,\" self-renewal ability, and tumorigenicity both in vitro and in vivo, and these effects could be rescued by stabilized β-catenin mutant. These findings indicate that AURKA competes away the binding of AXIN from β-catenin, induces β-catenin stabilization, and activates Wnt signaling in GICs."
},
{
"role": "assistant",
"content": "AURKA kinase inhibition could effectively attenuate Wnt signaling, thereby inhibiting the self-renewal and tumorigenicity of GICs, and may be a novel target for glioblastoma treatment strategies. 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": "Vesicouretric reflux is demonstrated by"
},
{
"role": "assistant",
"content": "The correct answer is VUR - Tc 99 - DMSA\nGFR estimation Tc 99 - DTPA"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Anastomosis, Roux-en-Y, Female, Gastric Bypass, Humans, Laparoscopy, Male, Middle Aged, Obesity, Morbid, Postoperative Period, Reproducibility of Results, Treatment Outcome, Weight Loss."
},
{
"role": "user",
"content": "Does common Limb Length Influence Weight Loss After Standard Laparoscopic Roux-En-Y Gastric Bypass? Context: Although Roux-en-Y gastric bypass (RYGBP) has proven its reliability over time in terms of weight loss and resolution of comorbidities, there continues to be a significant controversy in terms of used limb lengths. In the classical RYGBP, most surgeons have reported an alimentary limb length (ALL) of 100 to 150 cm and a bilio-pancreatic limb length (BPLL) of 50 to 75 cm. On the other hand, the common limb length (CLL) remains unknown in all the patients. As it is theoretically related to the level of malabsorption, CLL could influence weight loss after RYGBP. We performed a laparoscopic RYGBP in 90 patients with a mean preoperative body mass index (BMI) of 44.8. ALL and BPLL were respectively fixed at 150 and 75 cm. A systematic intraoperative measurement of CLL was performed. As expected, we found a great variation of the jejuno-ileal length and also of the CLL. We created three subgroups of patients: one with the entire population, one excluding the super-obese patients (BMI > 50) and the third one excluding the revisions. There was no statistically significant correlation between CLL and excess BMI loss (EBMIL) at 1, 3, 6 and 12 months of follow-up in each group. We also found a linear correlation between the jejuno-ileal length and the height of individuals."
},
{
"role": "assistant",
"content": "With a fixed 150-cm ALL and a 75-cm BPLL, there is no evidence that the anatomical variations of CLL could influence weight loss after classical RYGBP. 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": "An 18-year-old male presented with acute onset a history of blurring of vision for the same duration on examination, the patient has quadriparesis with areflexia. Both the pupils are non-reactive.The most probable diagnosis is -"
},
{
"role": "assistant",
"content": "The correct answer is Ans. b. Botulism"
}
] |
[
{
"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 most radiosensitive cells are"
},
{
"role": "assistant",
"content": "The correct answer is The most sensitive cells are those that are undifferentiated, well nourished, dividing quickly and highly active metabolically. Amongst the body cells, the most sensitive are spermatogonia and erythroblasts, epidermal stem cells, gastrointestinal stem cells. The least sensitive are nerve cells and muscle fibres.Very sensitive cells are also oocytes and lymphocytes, although they are resting cells and do not meet the criteria described above. The reasons for their sensitivity are not clear.Reference: Eric J Hall Textbook of Radiobiology for Radiologist; 5th edition"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Activins, Adolescent, Adult, Aged, Biomarkers, Tumor, Carcinoma, Embryonal, Child, Choriocarcinoma, Dysgerminoma, Endodermal Sinus Tumor, Female, Humans, Inhibin-beta Subunits, Inhibins, Male, Middle Aged, Ovarian Neoplasms, Seminoma, Testicular Neoplasms."
},
{
"role": "user",
"content": "Do gonadal malignant germ cell tumors express immunoreactive inhibin/activin subunits? Context: Inhibin and activin are proteins produced by ovarian granulosa cells and testicular Sertoli cells and are members of the transforming growth factor-beta superfamily. Since increased circulating levels of immunoreactive inhibin were detected in women with malignant ovarian tumors, they were proposed as tumor markers for ovarian carcinoma. Immunohistochemical studies later confirmed the presence of inhibin and activin subunits in granulosa cell tumors and epithelial ovarian cancer, as well as in Sertoli and Leydig cell testicular cancer. However, there is discrepant information on the detection of inhibin and activin in malignant germ cell tumors (MGCT). The aim of the present study was to evaluate the immunohistochemical expression of the inhibin/activin alpha, betaA and betaB subunits in ovarian and testicular MGCT specimens using polyclonal antisera. The ovarian tissue samples were composed of 19 MGCT, including dysgerminoma (n=18) and yolk sac tumor (n=1). The testis specimens included classic seminomas (n=20), embryonal carcinomas (n=7), choriocarcinomas (n=2), and yolk sac tumor (n=1). Ovarian and testicular malignant germ cell tumors expressed positive staining for inhibin/activin alpha, betaA and betaB subunits, with some variations between and within individual tumors: while ovarian dysgerminomas were diffusely positive for alpha, betaA and betaB, testicular tumors expressed alpha and betaB subunits, whereas betaA staining was weak."
},
{
"role": "assistant",
"content": "The present results show positive staining for inhibin/activin subunits in ovarian and testicular MGCT, suggesting a possible role in tumorigenesis with the resultant clinical implication. 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, Aged, Aged, 80 and over, Automation, Blood Coagulation Tests, Calibration, Clinical Laboratory Techniques, Hemophilia A, Humans, Middle Aged, Plant Proteins, Reproducibility of Results, Thrombin, Thrombophilia, Thromboplastin."
},
{
"role": "user",
"content": "Does clinical measurement of thrombin generation by calibrated automated thrombography require contact factor inhibition? Context: Measurement of thrombin generation by calibrated automated thrombography (CAT) could fulfill the requirements of a global test of coagulability and is potentially applicable to routine clinical laboratory practice. The purpose of this study was to determine if corn trypsin inhibitor (CTI) could be used to abolish contact factor activation in this assay, thus allowing accurate measurement of low tissue factor (TF) concentration-triggered thrombin generation on samples taken in a routine clinical setting. The endogenous thrombin potential (ETP) was measured by CAT. The study demonstrated that addition of CTI after plasma separation is not sufficient and blood must be drawn into tubes containing CTI if in-vitro contact factor-activated thrombin generation is to be abolished. Contact factor-activated thrombin generation is completely inhibited at a CTI concentration of 18.3 microg mL(-1) whole blood. Increasing the CTI concentration above this level does not lead to suppression of the TF-triggered ETP. At a TF concentration of 2 pmol, ETPs were significantly lower in the presence of CTI (P < 0.001). The difference (no CTI minus CTI) between results ranged from - 1 to 2159 nM min(-1) (median - 754). Whilst the low concentration TF-ETP assay was not optimized to distinguish degrees of coagulability between patient samples, there was a significant difference in ETP between normal and hemophilia samples and samples from patients with a clinical prothrombotic tendency."
},
{
"role": "assistant",
"content": "CTI can be applied to ETP measurement by CAT. This permits the use of CAT in a low TF-triggered thrombin generation assay without concern for the effect of interference from in-vitro contact factor activation and the optimum reagent conditions for using CAT as a global test of coagulability in clinical practice can now be defined. 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 statement(s) is false with respect to Borderline personality disorder?"
},
{
"role": "assistant",
"content": "The correct answer is Borderline Personality Disorder: It is a cluster B disorder It is characterized by extreme emotionality and erratic behaviours Multiple and unstable relationships are common Deliberate self-harm (parasuicidal) behaviour 10% of patients commit suicide Micro-psychotic episodes Black and white thinking (all or none thinking)"
}
] |
[
{
"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 23-year-old woman presents to the emergency department with a 3-day history of fever and headache. She says that the symptoms started suddenly after she woke up 3 days ago, though she has been feeling increasingly fatigued over the last 5 months. On presentation, her temperature is 102°F (38.9°C), blood pressure is 117/74 mmHg, pulse is 106/min, and respirations are 14/min. Physical exam reveals diffuse petechiae and conjunctival pallor and selected laboratory results are shown as follows:\n\nBleeding time: 11 minutes\nPlatelet count: 68,000/mm^3\nLactate dehydrogenase: 105 U/L\n\nWhich of the following would also most likely be true for this patient?"
},
{
"role": "assistant",
"content": "Increased serum von Willebrand factor multimers"
}
] |
[
{
"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 drugs are eliminated by kidney except"
},
{
"role": "assistant",
"content": "The correct answer is B i.e. Atracurium besylate"
}
] |
[
{
"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": "Hypercalciuria is said to be present in children if daily calcium excretion in urine is more than:"
},
{
"role": "assistant",
"content": "The correct answer is Ans: d (4 mg/kg) Ref:Nelson, 17th ed, p. 1824, Table 539-1, 18th ed, p. 2184, Table 547-3Normal values of urine chemistry in childrenCalcium< 4.0 mg/kgOxalate< 0.57 mg/kgUric acid< 10.7 mg/kgCitrate> 2.0 mg/kgCysteinea) Heterozygote 1.4 - 2.8b) Homozygote >5.7Phosphate <15.0"
}
] |
[
{
"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, RESULTS. Meshes: ."
},
{
"role": "user",
"content": "Is sonothrombolysis : the story ( t ) old or just the beginning? Context: Intravenous administration of recombinant tissue plasminogen activator, fastest and widely feasible treatment in acute ischemic stroke induces arterial recanalization, a prerequisite for neurological recovery. THE THERAPEUTIC ROLE OF ULTRASOUND AND POTENTIAL MECHANISM OF SONOTHROMBOLYSIS: Augmentation of recanalization can be achieved safely in combination with diagnostic transcranial Doppler by delivering mechanical pressure waves to the thrombus and exposing more thrombus surface to circulating drug. The addition of microspheres can further improve thrombolytic effect. International multicenter CLOTBUST trial showed that acute ischemic stroke patients treated with sonothrombolysis had higher rate of arterial recanalization and dramatic clinical recovery without increasing risk of symptomatic intracranial hemorrhage. A microsphere dose-escalation study called TUCSON showed that rates of recanalization and clinical recovery tended to be higher in target groups compared with controls. META-ANALYSIS OF CLINICAL TRIALS OF SONOTHROMBOLYSIS: Cochrane Stroke Group found that sonothrombolysis was likely to reduce death or dependency. A meta-analysis of sonothrombolysis showed that patients who received any form of sonothrombolysis had more than twofold higher likelihood of achieving complete arterial recanalization. PERSPECTIVES FOR SONOTHROMBOLYSIS - OPERATOR-INDEPENDENT DEVICE FOR SONOTHROMBOLYSIS: The collaborative group of the CLOTBUST trial designed multi-transducer assembly to cover conventional windows used for transcranial Doppler examinations. Operator-independent device can be quickly mounted by medical personnel with no prior experience in ultrasound. Sonothrombolysis for acute ischemic stroke is now tested in a pivotal efficacy multi-national trial called CLOTBUSTER."
},
{
"role": "assistant",
"content": "Ultrasound is a promising tool to enhance systemic thrombolysis. 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. Meshes: Blastocyst, Embryo Implantation, Female, Humans, Peptide Hormones, Placenta, Placentation, Pregnancy, Pregnancy Trimester, First, Trophoblasts."
},
{
"role": "user",
"content": "Is intermedin/adrenomedullin 2 associated with implantation and placentation via trophoblast invasion in human pregnancy? Context: Intermedin (IMD) is a novel peptide expressed in trophoblast cells in human placenta and enhances the invasion, migration, and human leukocyte antigen class I, G (HLA-G) expression in first-trimester HTR-8SV/neo cells. We recently reported that infusion of IMD antagonist in pregnant rats is detrimental to pregnancy outcome, resulting in impaired fetoplacental growth and deformed placental vasculature. This study was undertaken to assess expression of IMD and its involvement in human implantation and early placentation and assess whether its expression is altered in spontaneous abortion."
},
{
"role": "assistant",
"content": "We demonstrate for the first time that IMD is present in day 5 embryonic secretome; villous and decidual expression of IMD is higher at 6-8 weeks after a decline as gestation advances toward the second trimester; first-trimester spontaneous abortion is associated with a lower expression of IMD in serum, villi, and decidua; IMD stimulates the invasive capacity of first-trimester primary Extravillous cytotrophoblast cells; and IMD decreases elevated levels of tumor suppressor Kangia-1 in decidual explants from first-trimester spontaneous abortion. In conclusion, this study is the first to demonstrate a potential involvement of IMD in human embryo implantation and placental development via regulation of trophoblast invasion at the maternal-fetal interface and suggests a physiological role for this novel peptide in establishment of human pregnancy. 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, Cross-Sectional Studies, Enzyme-Linked Immunosorbent Assay, Female, HIV Infections, Humans, Male, Middle Aged, alpha 1-Antitrypsin."
},
{
"role": "user",
"content": "Is hIV infection associated with reduced serum alpha-1-antitrypsin concentrations? Context: Several observations suggest the presence of HIV-suppressive factors in the fluid phase of blood. Alpha-1-antitrypsin (AAT), the most abundant serine protease inhibitor in the circulation, has potent anti-HIV activity in vitro, and may function as an endogenous HIV suppressor. Therefore, we assessed serum AAT concentrations for association with HIV infection. In this cross-sectional study, serum AAT concentrations were measured in 66 persons with HIV infection and in 45 healthy persons (Controls). In the HIV-infected group, antiretroviral therapy (ART) use was assessed and CD4+ T cell levels and plasma HIV RNA were quantified. Median AAT concentration was significantly lower in the HIV-infected group (1.64 mg/mL) in comparison with Controls (1.94 mg/mL; p=0.001). AAT reduction was most pronounced in the HIV-infected subgroup with CD4+ T cell levels > 200 cells/µL in comparison with Controls (p < 0.01). Serum AAT concentrations < 1.0 mg/mL are clinically significant, and concentrations below this level were identified in 4.5% of the HIV-infected group and in no Control subjects. No association between AAT levels and viral load or use of ART was observed in HIV-infected subjects."
},
{
"role": "assistant",
"content": "The association between reduced serum AAT concentration and HIV infection is consistent with a role for AAT as an endogenous HIV suppressor. 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 26-year-old G1P0 woman at 40 weeks estimated gestational age presents after experiencing labor pains. Pregnancy has been uncomplicated so far. Rupture of membranes occurs, and a transvaginal delivery is performed under epidural anesthesia, and the baby is delivered alive and healthy. The patient voids a few hours after the delivery and complains of mild irritation at the injection site on her back. On the second day, she complains of a severe headache over the back of her head. The headache is associated with pain and stiffness in the neck. Her headache is aggravated by sitting up or standing and relieved by lying down. The pain is relieved slightly by acetaminophen and ibuprofen. The patient is afebrile. Her vital signs include: pulse 100/min, respiratory rate 18/min, and blood pressure 128/84 mm Hg. Which of the following statements is the most accurate regarding this patient’s condition?"
},
{
"role": "assistant",
"content": "This patient’s condition can resolve on its own"
}
] |
[
{
"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": "Within 5 minutes after a bee sting, a 15-year-old girl suddenly has difficulty breathing, with marked inspiratory stridor from laryngeal edema. She experiences marked urticaria and notes swelling of the hand that was stung. Which of the following is the best pharmacologic agent to treat her signs and symptoms?"
},
{
"role": "assistant",
"content": "The correct answer is Her systemic anaphylactic reaction results from an immediate type I hypersensitivity reaction with antigen triggering mast cell-bound IgE with release of preformed mediators such as histamine. Epinephrine is the fastest acting agent to treat this life-threatening condition. Cyclosporine is used to minimize lymphocyte-mediated transplant rejection. Glucocorticoids can reduce immune inflammatory reactions, although this occurs over days to weeks, not minutes. Methotrexate is useful in the treatment of graft-versus-host disease and for some malignancies. Penicillin is an antibiotic that can induce a type I hypersensitivity reaction in sensitized persons."
}
] |
[
{
"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: Biomarkers, Body Mass Index, Cell Death, Creatinine, Female, Humans, Kidney Transplantation, Linear Models, Male, Middle Aged, Nerve Growth Factors, S100 Calcium Binding Protein beta Subunit, S100 Proteins."
},
{
"role": "user",
"content": "Are body mass index and creatinine clearance associated with steady-state serum concentrations of the cell damage marker S100B in renal transplant recipients? Context: S100B is a prominent cell damage marker which can lead to sustained pro-inflammatory signaling. The aim was to investigate cross-sectional associations of steady-state S100B concentrations, particularly with C-reactive protein (CRP), in renal transplant recipients (RTRs) and also to investigate prospectively whether S100B would predict graft failure or mortality. Outpatient RTRs with a graft functioning for >1 year were eligible for participation in this study. S100B was determined at baseline from serum. Mortality and the occurrence of graft failure were recorded until September 2007. Multivariable linear regression analyses were performed to identify potential determinants of S100B. Multivariable Cox regression analyses were performed to investigate S100B as a potential predictor of mortality or graft failure. Five hundred eighty-one RTRs participated in the study. The median S100B concentration was 0.19 (0.14-0.25) microg/l. Recipient age (beta=0.009, p=0.02), body mass index (BMI) (beta=0.021, p<0.001), and creatinine clearance (beta=-015, p<0.001) were independently associated with S100B. During follow-up, 95 RTRs (16.4%) died and 41 (7.1%) developed graft failure. S100B levels did not predict mortality or graft failure."
},
{
"role": "assistant",
"content": "BMI, creatinine clearance, and age are determinants of steady-state serum S100B concentrations in renal transplant recipients. The association of BMI with S100B suggests that S100B might be a new adipokine. 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, DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, MAIN RESULTS. Meshes: Age Factors, Antiviral Agents, CD4-Positive T-Lymphocytes, Case-Control Studies, Child, Cohort Studies, HIV Core Protein p24, HIV Infections, HIV-1, Humans, Leukocyte Count, National Institutes of Health (U.S.), Prognosis, Sex Factors, United States."
},
{
"role": "user",
"content": "CD4 status and P24 antigenemia. Are they useful predictors of survival in HIV-infected children receiving antiretroviral therapy? Context: To determine the relationship between CD4 status and the P24 antigen level and survival in children infected with the human immunodeficiency virus. Cohort, case-control. Clinical Center at the National Institutes of Health, Bethesda, Md. One hundred forty-seven children infected with the human immunodeficiency virus enrolled in antiretroviral therapy protocols at the National Cancer Institute were reviewed and the relationships between CD4 counts, P24 antigenemia, and death were analyzed. None.MEASUREMENTS/ The presence of a very low CD count, less than 21% of the lower limit of normal values for age (equivalent to 0.05 x 10(9)/L in an adult), was associated with a significantly increased risk of death within 2 years. Although the risk of death was highest for children with CD4 counts below this level and who had detectable P24 antigen levels, P24 antigenemia by itself contributed little to the prognostic value of the CD4 count alone. However, it was also notable that a group of children with low CD4 counts also experienced prolonged survival."
},
{
"role": "assistant",
"content": "The association between low CD4 counts and death suggests that the age-adjusted CD4 count should be used as a marker to guide therapeutic intervention. At the same time, the presence of a very low CD4 count alone should not be considered a reason for therapeutic nihilism."
}
] |
[
{
"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": "Increased levels of haemoglobin A2 is characteristic of"
},
{
"role": "assistant",
"content": "The correct answer is None"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response."
},
{
"role": "user",
"content": "If an otherwise well child presents with 1st episode of unprovoked seizures & continues to have seizures despite 2 doses of Lorazepam, what drug should be administered next?"
},
{
"role": "assistant",
"content": "The correct answer is - The given case scenario suggests a diagnosis of status epilepticus. - If seizures continue despite giving Lorazepam/ Midazolam, then follow this sequence: IV lorazepam or midazolam | seizure persisting Inj. Phenytoin (20 mg / kg) loading dose | seizure persisting Repeat inj. phenytoin (10 mg/kg) | seizure persisting Inj valproate /levetiracetam /phenobarbitone"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Arthritis, Bed Rest, Combined Modality Therapy, Double-Blind Method, Female, Glucocorticoids, Humans, Injections, Intra-Articular, Knee, Male, Middle Aged, Radiography, Radiosurgery, Synovectomy, Synovitis, Yttrium Radioisotopes."
},
{
"role": "user",
"content": "Is radiation synovectomy for arthritis of the knee more effective than intraarticular treatment with glucocorticoids? Context: To compare the clinical efficacy and safety of radiation synovectomy (RSO) with intraarticular (IA) yttrium-90 plus glucocorticoids (GCs) with the efficacy and safety of IA placebo yttrium plus GCs and to identify parameters that predict efficacy. The knees of 97 patients with persistent arthritis despite outpatient treatment with IA GCs (n = 113 knees), were treated with either IA (90)Y plus GCs (50%) or IA placebo yttrium plus GCs (50%), followed by 3 days of bed rest in the hospital clinic, with splinting of the treated knee. Predominant diagnoses were undifferentiated arthritis (39%) and rheumatoid arthritis (32%). The clinical effect of therapy was assessed at 6 months using a composite change index (CCI; range 0-12). The primary outcome measure was the response rate (i.e., the percentage of joints with a CCI>or =6). Knees with persistent arthritis after 6 months underwent crossover therapy (51% of the (90)Y plus GCs group versus 45% of the placebo plus GCs group). Adverse effects and radiologic damage during followup were documented. Neither the response rate (48% in both groups), the mean CCI, nor the duration of remission was significantly different between groups. No clinically relevant short-term adverse effects were observed, except for progression of radiologic damage in 34% of the (90)Y plus GCs group versus 28% of the placebo plus GCs group (knee prosthesis placement in 8% versus 1%). The functional and radiologic status at study entry predicted the clinical effect."
},
{
"role": "assistant",
"content": "Treatment with (90)Y plus GCs with bed rest and splinting is not superior to IA GCs with bed rest and splinting. Over the short term, both treatments appeared to be safe, although a negative effect of (90)Y on cartilage and bone cannot be ruled out. Thus, it appears that RSO with (90)Y should no longer be considered the treatment of first choice for persistent arthritis of the knee."
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Administration, Topical, Animals, Bone Cements, Calcium Hydroxide, Cattle, Dentin, Elastic Modulus, Tooth Fractures."
},
{
"role": "user",
"content": "Do change in elastic modulus of bovine dentine with exposure to a calcium hydroxide paste? Context: To determine the effect of calcium hydroxide [Ca(OH)(2)] paste exposure on the elastic modulus of bovine dentine. Dentine sections (4 mm x 4 mm x 1 mm) were obtained from freshly extracted bovine incisors and placed in dishes containing a 1-mm deep layer of Ca(OH)(2) paste or physiological saline as a control. An ultrasonic device was used to measure the sonic velocities of the longitudinal and shear waves, and the elastic modulus was calculated. Data were examined by analysis of variance followed by the Tukey H.S.D. test in order to compare different storage times. Exposure to Ca(OH)(2) paste significantly increased the mean elastic modulus of the dentine from 16.3 to 22.1 GPa. By contrast, the elastic modulus of the control dentine, which was exposed to physiological saline, remained constant."
},
{
"role": "assistant",
"content": "These results demonstrate that exposure to Ca(OH)(2) paste increases the elastic modulus of dentine, thereby making it more prone to fracture. 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, Bias, Catastrophization, Female, Humans, Longitudinal Studies, Male, Models, Psychological, Prospective Studies, Somatoform Disorders, Surveys and Questionnaires."
},
{
"role": "user",
"content": "Do catastrophizing misinterpretations predict somatoform-related symptoms and new onsets of somatoform disorders? Context: Somatoform disorders are characterized by multiple recurring symptoms that resemble physical illnesses but defy medical explanation. Psychological models suggest that catastrophizing misinterpretations of harmless physical symptoms play a key role. However, the question of whether such biases predict somatoform-related symptoms and the onset of somatoform disorders has not been adressed. Hence, the aim of the present study was to further advance our understanding of the role of catastrophizing misinterpretations in somatoform disorders. In the present study, we used data from the Dresden Predictor Study (N=1538), in which an epidemiologic sample of young German women was tested at two time points approximately 17 months apart. Each participant completed a diagnostic interview, an interpretation questionnaire for somatoform and hypochondriacal symptoms, and three measures of such symptomatology: somatization subscale of the Symptom Checklist-90-Revised (SCL-90-R), Whiteley Index (WI), Body Sensations Questionnaire (BSQ). At follow-up, 33 women were diagnosed with new onsets of lifetime somatoform disorder. Results showed that catastrophizing misinterpretations assessed at baseline were predictive of somatoform-related symptoms at follow-up, i.e., symptoms assessed with the WI and BSQ. Moreover, catastrophizing misinterpretations were predictive of new onsets of somatoform disorders, even after controlling for general threat-related misinterpretations and indices of somatoform symptoms (i.e., SCL-90-R and BSQ)."
},
{
"role": "assistant",
"content": "This is the first prospective, longitudinal study to demonstrate that catastrophizing misinterpretations have incremental validity as predictors of future somatoform-related symptomatology and somatoform disorders. Final Decision: yes"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Adult, Age Distribution, Aged, Angina Pectoris, Cost-Benefit Analysis, Databases, Factual, Electronic Data Processing, Family Practice, Female, Health Surveys, Humans, Italy, Male, Middle Aged, Prevalence, Sex Distribution."
},
{
"role": "user",
"content": "Do computerized general practice databases provide quick and cost-effective information on the prevalence of angina pectoris? Context: The aim of this study was to compare the prevalence of angina pectoris (AP) using self-reported information and primary care databases. A comparison between the prevalence of AP in 730,586 subjects from the Health Search Database (HSD) and 119,799 individuals from a Health Interview Survey (HIS) was performed. The age-specific prevalence was calculated by dividing the detected cases by the total number of individuals in each age group. The age-standardized prevalence was estimated by direct standardization performed using the Italian standard population. The HSD reported a higher crude prevalence of AP than the HIS, both in males (1374/100,000 vs 1006/100,000) and females (1449/100,000 vs 1007/100,000). In the HSD the age-specific prevalence was lower for patients aged <65 years, whilst higher estimates were reported for older patients. Age standardization slightly reduced the prevalence in both samples, although the HSD always reported higher estimates."
},
{
"role": "assistant",
"content": "Prescription data from general practice databases may be a valid, simple, and cost-effective method to evaluate and serially monitor the prevalence of AP. Final Decision: yes"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: ."
},
{
"role": "user",
"content": "Do comparison between performance with a pushrim-activated power-assisted wheelchair and a manual wheelchair on the Wheelchair Skills Test? Context: To test the hypothesis that people using a pushrim-activated power-assisted wheelchair (PAPAW) can accomplish a wider range of wheelchair skills than when using a manual wheelchair (MWC). We studied 30 able-bodied participants, using within-participant comparisons. Participants used a manual wheelchair equipped with both PAPAW and regular MWC rear wheels, and rear anti-tip devices (Arc-RADs) that permitted wheelie-like function. We trained participants to perform the wheelchair skills of the Wheelchair Skills Training Program (WSTP, Version 2.4). From the Wheelchair Skills Test (WST, Version 2.4), we calculated pass-fail success rates for the 50 individual skills and a total percentage WST score. The mean (+/-SD) total WST scores were 89.3 (+/-7.0)% for the PAPAW and 88.8 (+/-8.4)% for the MWC, with a mean difference of 0.6 (+/-5.6)% (p = 0.59). Qualitative observations suggested that skills requiring a higher force on the pushrim (e.g., incline ascent) were performed more easily with the PAPAW, whereas skills requiring greater control of the wheelchair (e.g., wheelie-dependent skills) were performed more easily with the MWC."
},
{
"role": "assistant",
"content": "Overall wheelchair skill performance with the PAPAW is not superior to that when using the MWC. The PAPAW may be helpful for specific skills that require more wheel torque, but the additional torque appears to be disadvantageous when performing skills that require greater control. Final Decision: yes"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Animals, Apoptosis, Caenorhabditis elegans, Caenorhabditis elegans Proteins, DNA Breaks, Double-Stranded, Female, Germ Cells, Hermaphroditic Organisms, Humans, Male, Meiosis, Recombinant Fusion Proteins."
},
{
"role": "user",
"content": "Do meiotic errors activate checkpoints that improve gamete quality without triggering apoptosis in male germ cells? Context: Meiotic checkpoints ensure the production of gametes with the correct complement and integrity of DNA; in metazoans, these pathways sense errors and transduce signals to trigger apoptosis to eliminate damaged germ cells. The extent to which checkpoints monitor and safeguard the genome differs between sexes and may contribute to the high frequency of human female meiotic errors. In the C. elegans female germline, DNA damage, chromosome asynapsis, and/or unrepaired meiotic double-strand breaks (DSBs) activate checkpoints that induce apoptosis; conversely, male germ cells do not undergo apoptosis. Here we show that the recombination checkpoint is in fact activated in male germ cells despite the lack of apoptosis. The 9-1-1 complex and the phosphatidylinositol 3-kinase-related protein kinase ATR, sensors of DNA damage, are recruited to chromatin in the presence of unrepaired meiotic DSBs in both female and male germlines. Furthermore, the checkpoint kinase CHK-1 is phosphorylated and the p53 ortholog CEP-1 induces expression of BH3-only proapoptotic proteins in germlines of both sexes under activating conditions. The core cell death machinery is expressed in female and male germlines; however, CED-3 caspase is not activated in the male germline. Although apoptosis is not triggered, checkpoint activation in males has functional consequences for gamete quality, because there is reduced viability of progeny sired by males with a checkpoint-activating defect in the absence of checkpoint function."
},
{
"role": "assistant",
"content": "We propose that the recombination checkpoint functions in male germ cells to promote repair of meiotic recombination intermediates, thereby improving the fidelity of chromosome transmission in the absence of apoptosis. 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 drug are not used in severe persistent Asthma?"
},
{
"role": "assistant",
"content": "The correct answer is Oral coicosteroids are given in very severe persistent asthma and not severe persistent asthma. Sho acting beta 2 agonists are used for emergency management of acute asthma. Regular prolonged usage of S.A.B.A /salbutamol results in tachyphylaxis and tolerance to the effects of the drug. Hence S.A.B.A should be used for symptomatic relief as and when required. L.A.B.A with inhaled high dose steroids is used for the management of severe persistent asthma."
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response."
},
{
"role": "user",
"content": "Which one of the following is NOT true regarding Noonan's syndrome -"
},
{
"role": "assistant",
"content": "The correct answer is Ans. is 'c' i.e., Chromosomal abnormality"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Animals, Aqueous Humor, Cattle, Cell Line, Transformed, Cell Movement, Cells, Cultured, Child, Child, Preschool, Dose-Response Relationship, Drug, Fibronectins, Glaucoma, Open-Angle, Humans, Middle Aged, Trabecular Meshwork."
},
{
"role": "user",
"content": "Does aqueous humor stimulate the migration of human trabecular meshwork cells in vitro? Context: Depletion of trabecular meshwork cell numbers is a feature of the outflow system in aging and in primary open-angle glaucoma. It is possible that migration stimulated by factors present in aqueous humor may contribute to the cell loss. This investigation assessed the chemoattractant potential of glaucomatous and nonglaucomatous human aqueous humor and fibronectin, one of its constituents, on a range of cultured trabecular meshwork cell lines. Migration was assessed in 48-well modified Boyden chambers. The potential migratory stimulants were soluble fibronectin and glaucomatous and nonglaucomatous aqueous humor. The glaucomatous aqueous samples were collected from patients undergoing trabeculotomy for primary open-angle glaucoma and the normal aqueous from normal bovine eyes and patients undergoing cataract surgery. The target cell types were normal human and bovine meshwork cells grown from explants and two human transformed meshwork cell lines from a normal (HTM-5) and a glaucomatous (HTM-3) source. Soluble fibronectin stimulated all the target cells to migrate with an optimal concentration ranging from 1 to 30 microg/ml, and Zigmond Hirsch checkerboard analysis indicated that both chemotaxis and chemokinesis took place. All the aqueous humor samples stimulated migration of the meshwork cell lines at an optimal concentration of 200 microl/ml. Glaucomatous aqueous humor stimulated a greater migratory response than nonglaucomatous aqueous for two of the four target cell types (P < or = 0.03). Neutralization of the fibronectin content of nonglaucomatous and glaucomatous aqueous by addition of excess anti-fibronectin antibody indicated that fibronectin could account for 35% to 80% of the migratory activity of the aqueous."
},
{
"role": "assistant",
"content": "Aqueous humor contains potentially powerful chemoattractants for trabecular meshwork cells. The activity of one of these constituents, fibronectin, has been accounted for by this study. Glaucomatous aqueous appears to be as good and in some cases a better migratory stimulant than nonglaucomatous aqueous in vitro. The migratory evidence points to a trend that may help to explain cell loss in the aging meshwork and possibly some of the extra loss in primary open-angle glaucoma. 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, Cell Movement, Cytokines, Disease Models, Animal, Male, Mice, Mice, Inbred C57BL, Myeloid Differentiation Factor 88, Myocardial Reperfusion Injury, Myocardium, NF-kappa B, Neutrophils, Pyrrolidines, Receptors, Interleukin-1, Signal Transduction, Valine, Ventricular Dysfunction, Left."
},
{
"role": "user",
"content": "Does the TIR/BB-loop mimetic AS-1 protect the myocardium from ischaemia/reperfusion injury? Context: Innate immune and inflammatory responses are involved in myocardial ischaemia/reperfusion (I/R) injury. The interleukin-1 receptor (IL-1R)-mediated, MyD88-dependent nuclear factor kappa B (NF-kappaB) activation pathway plays an important role in the induction of innate immunity and inflammation. However, the role of the IL-1R-MyD88 pathway in myocardial I/R injury has not been thoroughly investigated. We hypothesized that inhibition of the interaction of IL-1R with MyD88 will attenuate myocardial ischaemic injury through reducing inflammatory responses. Male C57BL/6 mice were subjected to myocardial ischaemia (45 min) followed by reperfusion (4 h). In the treatment group, after mice were subjected to ischaemia (45 min), the TIR/BB-loop mimetic (AS-1), which inhibits the interaction of IL-1R with MyD88, was administered immediately before reperfusion. Hearts were harvested and cellular proteins were isolated for immunoprecipitation and immunoblotting. AS-1 administration significantly decreased infarct size by 32.92% compared with the untreated I/R group. Ejection fraction and fractional shortening in AS-1-treated mice were also significantly increased by 18.0 and 25.6%, respectively, compared with the untreated I/R group. AS-1 administration significantly decreased the I/R-increased interaction between IL-1R and MyD88, attenuated the I/R-increased NF-kappaB binding activity, and reduced levels of inflammatory cytokines and adhesion molecules in the myocardium compared with the untreated I/R group. In addition, AS-1 administration significantly decreased myocardial myeloperoxidase activity by 23.6% and neutrophil infiltration in the myocardium compared with the untreated I/R group."
},
{
"role": "assistant",
"content": "The results demonstrated an important role for the IL-1R-mediated MyD88-dependent signalling pathway in myocardial I/R injury. The data suggest that modulation of the IL-1R/MyD88 interaction could be a strategy for reducing myocardial ischaemic injury. 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": "Are dietary Patterns Derived Using Exploratory and Confirmatory Factor Analysis Stable and Generalizable Across Race , Region , and Gender Subgroups in the REGARDS Study? Context: Examining diet as a whole using dietary patterns as exposures is a complementary method to using single food or nutrients in studies of diet and disease, but the generalizability of intake patterns across race, region, and gender in the United States has not been established. To employ rigorous statistical analysis to empirically derive dietary patterns in a large bi-racial, geographically diverse population and examine whether results are stable across population subgroups. The present analysis utilized data from 21,636 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who completed the Block 98 food frequency questionnaire. We employed exploratory factor analysis and confirmatory factor analyses on 56 different food groups iteratively and examined differences by race, region, and sex to determine the optimal factor solution in our sample. Five dietary patterns emerged: the \"Convenience\" pattern was characterized by mixed dishes; the \"Plant-based\" pattern by fruits, vegetables, and fish; the \"Sweets/Fats\" pattern by sweet snacks, desserts, and fats and oils; the \"Southern\" pattern by fried foods, organ meat, and sweetened beverages; and the \"Alcohol/Salads\" pattern by beer, wine, liquor, and salads. Differences were most pronounced in the Southern pattern with black participants, those residing in the Southeast, and participants not completing high school having the highest scores."
},
{
"role": "assistant",
"content": "Five meaningful dietary patterns emerged in the REGARDS study and showed strong congruence across race, sex, and region. Future research will examine associations between these patterns and health outcomes to better understand racial disparities in disease and inform prevention efforts. 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": "If you desire to study the incidence of diarrhea in a community which study method would you like to opt for"
},
{
"role": "assistant",
"content": "The correct answer is The aim of study would be to find risk factors. It is a prospective study.In the coho study, we can determine incidence rates.&;A well-designed coho study is considered the most reliable means of showing an association between a suspected risk factor and subsequent disease\"Park 23rd edition pg: 76"
}
] |
[
{
"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: Adenoviridae, Animals, Arachidonic Acid, Basilar Artery, Brain Ischemia, Brain-Derived Neurotrophic Factor, Cerebral Arteries, Cerebrospinal Fluid Proteins, Cerebrovascular Circulation, Cyclic AMP, Cyclooxygenase Inhibitors, Cytochrome P-450 Enzyme System, Disease Models, Animal, Epoprostenol, Genetic Vectors, Intramolecular Oxidoreductases, Male, Muscle, Smooth, Vascular, Rabbits, Receptor, trkB, Transfection, Up-Regulation, Vasodilation."
},
{
"role": "user",
"content": "Does brain-derived neurotrophic factor stimulate production of prostacyclin in cerebral arteries? Context: The role of brain-derived neurotrophic factor (BDNF) and its receptor, tropomyosin receptor kinase B, in control of cerebral circulation is poorly understood. The present study was designed to investigate the cerebral vascular effects of BDNF in vivo. Replication incompetent adenovirus encoding either rat BDNF (AdBDNF) or green fluorescent protein was injected intracisternally into rabbits. Forty-eight hours later, animals were euthanized. Plasma and cerebrospinal fluid levels of BDNF were measured by enzyme-linked immunosorbent assay, vasomotor function of isolated basilar arteries was studied in organ chambers, protein expression in the basilar arteries was studied by Western blotting, prostanoid levels were measured by enzyme-linked immunosorbent assay, and cyclic adenosine 3',5'-monophosphate levels were measured by radioimmunoassay. The levels of BDNF in the cerebrospinal fluid were significantly elevated in AdBDNF-treated rabbits as compared with adenovirus encoding green fluorescent protein-treated rabbits (37+/-5 ng/mL versus 0.006+/-0.003 ng/mL, respectively; P<0.05; n=14). Western blotting studies revealed that in basilar arteries, AdBDNF increased protein expression of prostacyclin synthase, whereas expression of endothelial nitric oxide synthase and phosphorylated (Ser 1177) endothelial nitric oxide synthase remained unchanged. During incubation with arachidonic acid (1 micromol/L), PGI(2) production and levels of cyclic adenosine 3',5'-monophosphate were significantly elevated only in AdBDNF-treated rabbit basilar arteries (P<0.05, n=6). Relaxations to acetylcholine (10(-9) to 10(-5) mol/L) and arachidonic acid (10(-9) to 10(-5) mol/L) were significantly potentiated in basilar arteries from rabbits injected with AdBDNF. Potentiation of relaxations to acetylcholine in AdBDNF-treated basilar arteries was inhibited by the nonselective cyclooxygenase inhibitor, indomethacin (10(-5) mol/L, P<0.05, n=6) and constitutive phospholipase A(2) inhibitor, AACOCF3 (2x10(-5) mol/L, P<0.05, n=5)."
},
{
"role": "assistant",
"content": "Our results demonstrate that in cerebral arteries, BDNF-induced activation of tropomyosin receptor kinase B receptor signaling in vivo promotes prostacyclin biosynthesis. These findings provide novel mechanistic insight into the vascular protective effect of BDNF in cerebral circulation. 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": "Best way to prevent caries is:"
},
{
"role": "assistant",
"content": "The correct answer is None"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response."
},
{
"role": "user",
"content": "The following are \"stop codons\" EXCEPT"
},
{
"role": "assistant",
"content": "The correct answer is Ans. b (UAU) (Ref. Harper, 27th/Chapter 37.; Chatterjee, 4th ed., 221)PROTEIN SYNTHESIS:-# Activation of Amino acids:-- Formation of aminoacyl tRNA by key enzyme-Aminoccyl tRNA synthatase-specific for a particular amino acid and also for tRNA- There are 20 different aminoacids (one codon for one amino acid)- Very high specificity is the most significant feature of this enzyme because once amino acid is attached to tRNA recognition of a specific codon on mRNA is due entirely to the tRNA not to the amino acid. (Fidelity = Faithfulness)# Initiation by Aug codon (methionine)# Elongation# Termination by terminator codons or stop codons or nonsense codon-UAA, UGA, UAGFidelity enzyme in protein synthesis-Aminoacyl tRNA sybnthetaseNull = indicates no functional gene product"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response."
},
{
"role": "user",
"content": "A 59-year-old Caucasian man with a history of hypertension and emphysema is brought to the hospital because of progressive lethargy and confusion. The patient has been experiencing poor appetite for the past 3 months and has unintentionally lost 9 kg (19.8 lb). He was a smoker for 35 years and smoked 1 pack daily, but he quit 5 years ago. He takes lisinopril and bisoprolol for hypertension and has no allergies. On examination, the patient appears cachectic. He responds to stimulation but is lethargic and unable to provide any significant history. His blood pressure is 138/90 mm Hg, heart rate is 100/min, and his oxygen saturation on room air is 90%. His mucous membranes are moist, heart rate is regular without murmurs or an S3/S4 gallop, and his extremities are without any edema. His pulmonary examination shows mildly diminished breath sounds in the right lower lobe with bilateral wheezing. His laboratory values are shown:\nSodium 110 mEq/L\nPotassium 4.1 mEq/L\nChloride 102 mEq/L\nCO2 41 mm Hg\nBUN 18\nCreatinine 1.3 mg/dL\nGlucose 93 mg/dL\nUrine osmolality 600 mOsm/kg H2O\nPlasma osmolality 229 mEq/L\nWBC 8,200 cells/mL\nHgb 15.5 g/dL\nArterial blood gas pH 7.36/pCO2 60/pO2 285\nChest X-ray demonstrates a mass in the right upper lobe. What is the most appropriate treatment to address the patient’s hyponatremia?"
},
{
"role": "assistant",
"content": "3% saline at 35 mL/h"
}
] |
[
{
"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": "Action of tibialis anterior ?"
},
{
"role": "assistant",
"content": "The correct answer is Ans. is 'c' i.e., Inversion of foot"
}
] |
[
{
"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: Attitude of Health Personnel, Clinical Clerkship, Data Collection, Education, Medical, General Surgery, Hospitals, Teaching, Humans, Internship and Residency, Personal Satisfaction, Program Evaluation, Specialization, Students, Medical, Victoria."
},
{
"role": "user",
"content": "A tale of two colleges: do specialist trainees receive adequate hospital-based training? Context: Both medical and surgical trainees have a dual reliance on their specialist training college and their respective teaching hospitals to maintain standards in teaching and training. Although guidelines are in place for the administration of this teaching, hospital-based teaching has been minimally regulated. A review of trainee satisfaction with current levels of hospital-based training was performed, both to reflect the thoughts of trainees themselves and to highlight specific areas requiring improvement. Sixty-four basic specialist trainees (44 surgical [BSTs] and 20 physician [BPTs]) from all of the major Melbourne metropolitan teaching hospitals completed an anonymous survey. Surgical trainees considered all areas of hospital-based training to be deficient, with overall dissatisfaction significantly greater for BSTs compared with BPTs (P=0.046). A requirement for increased hospital-based training was similarly greater for BSTs (P=0.0072)."
},
{
"role": "assistant",
"content": "The study confirms the need for a change in the regulation and administration of hospital-based teaching for surgical trainees."
}
] |
[
{
"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, Biomarkers, C-Reactive Protein, Firefighters, Fires, Forced Expiratory Volume, Humans, Inflammation, Lung, Male, Middle Aged, Occupational Exposure, Physical Fitness, Spirometry, Surveys and Questionnaires, Vital Capacity."
},
{
"role": "user",
"content": "Is high hsCRP associated with reduced lung function in structural firefighters? Context: To assess the association between markers of systemic inflammation and pulmonary function in a population of structural firefighters. We studied male career members of a large Midwestern fire department with questionnaires, spirometry, and high-sensitivity C-reactive protein (hsCRP) as a biomarker of systemic inflammation. We examined percent predicted forced expiratory volume in 1 s (FEV1 %-predicted) and forced vital capacity (FVC%-predicted). Complete data were available for 401 firefighters. Higher hsCRP levels were associated with lower lung function values, after adjusting for confounding variables. Specifically, for every twofold increase in log10-hsCRP, FEV1 %-predicted decreased by a mean 1.5% (95% CI: 0.4, 2.6%) and FVC%-predicted decreased by a mean 1.4% (95% CI: 0.4, 2.3%)."
},
{
"role": "assistant",
"content": "hsCRP as a biomarker of systemic inflammation may indicate reduced lung function in structural firefighters. 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: Apoptosis, Arginase, Arginine, Argininosuccinate Synthase, Carcinoma, Hepatocellular, Caspase 3, Cell Cycle, Cell Line, Tumor, Cell Proliferation, Cell Survival, Enzyme Induction, Humans, Ki-67 Antigen, Liver Neoplasms, Models, Biological, Pancreatic Neoplasms, Protein Engineering, Recombinant Proteins."
},
{
"role": "user",
"content": "Does bioengineered arginase I increase caspase-3 expression of hepatocellular and pancreatic carcinoma cells despite induction of argininosuccinate synthetase-1? Context: Hepatocellular and pancreatic carcinomas are often auxotrophic for L-arginine, a semi-essential amino acid. The purpose of this study was to investigate cancer cell death using a significantly more active, cobalt-substituted bioengineered arginase. Panc-1, a human pancreatic carcinoma cell line, and Hep 3B, a human hepatocellular carcinoma cell line, were exposed to L-arginase. Flow cytometry was used to measure expression of Ki-67, caspase-3, and argininosuccinate synthetase-1 (ASS-1) 4 days after treatment. An MTT assay measured proliferation. The Student t test determined statistical significance. Viability decreased by 31% +/- 2% for Panc-1 cells (P < .0001) and 34% +/- 1% (P < .0001) for Hep 3B cells after treatment. Both cell lines demonstrated a 4-fold increase activated caspase-3 expression after high dose treatment (P < .01), and 5-fold increase in ASS-1 expression (P < .002). Ki-67 expression did not vary in Hep 3B cells but decreased for Panc-1 cells (P < .015). The 50% inhibitory concentration was 8-fold higher for Panc-1 cells than for Hep 3B cells (P < .03)."
},
{
"role": "assistant",
"content": "Increased ASS-1 expression by these cells, in order to increase L-arginine concentration, is inadequate, suggesting a mechanism by which arginine depletion can be used in multimodality therapy for arginine-dependent 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": "The laboratory diagnosis of thiamine deficiency is by:"
},
{
"role": "assistant",
"content": "The correct answer is The laboratory diagnosis of thiamine deficiency usually is made by a functional enzymatic assay of transketolase activity measured before and after the addition of thiamine pyrophosphate. >25% stimulation by the addition of thiamine pyrophosphate is interpreted as abnormal. Thiamine or the phosphorylated esters of thiamine in serum or blood also can be measured by high-performance liquid chromatography to detect deficiency."
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response."
},
{
"role": "user",
"content": "Most common ovarian tumor -"
},
{
"role": "assistant",
"content": "The correct answer is Serous tumors are the most common of the ovarian epithelial tumors. About 60% are benign, 15% are of low malignant potential, and 25% are malignant. Benign lesions are usually encountered in patients between 30 and 40 years of age, and malignant serous tumors are more commonly seen between 45 and 65 years of age. Taken together, borderline and malignant serous tumors are the most common ovarian malignancies, accounting for about 60% of all ovarian cancers. ref : Robbins Basic Pathology, 9E,page-697"
}
] |
[
{
"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: Alkaline Phosphatase, Animals, Arthritis, Rheumatoid, Bone Density, Bone Diseases, Metabolic, Calcium, Disease Models, Animal, Femur, Genetic Predisposition to Disease, Humans, Interleukin-1, Mice, Mice, Transgenic, Tomography, X-Ray Computed."
},
{
"role": "user",
"content": "Does overexpression of the human interleukin 1a gene cause osteopenia in mice? Context: Osteoporosis is a major complication of chronic inflammatory diseases such as rheumatoid arthritis (RA). We describe disordered bone metabolism in transgenic mice that overexpress human interleukin 1a (hIL-1a). Bone mineral density (BMD), microcomputed tomography (microCT), histomorphometry, and blood biochemical data of hIL-1a transgenic mice and littermate wild-type mice were examined. The femoral BMD of transgenic mice was decreased by 27.7% compared with wild-type mice. microCT revealed a marked reduction in the trabecular bone, and cortical thinning with an enlarged cavity was observed in femora of transgenic mice. Histomorphometric analysis revealed inhibition of several measures of bone formation, while the serum alkaline phosphatase level was reduced in transgenic mice; however, their indices of bone resorption were not elevated."
},
{
"role": "assistant",
"content": "Overexpression of hIL-1a causes osteopenia in mice. It was suggested that the systemic osteopenia in these transgenic mice occurred primarily as a result of decreased bone formation, with a reduction of bone mineralization rather than increased osteoclastic bone resorption. This may be one aspect of bone metabolism in RA that results in disease complications. Final Decision: yes"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, MATERIAL AND METHOD, RESULTS. Meshes: Female, Humans, Lung Diseases, Male, Middle Aged, Pulmonary Embolism, Survival Analysis, Thorax, Ultrasonography, Venous Thrombosis."
},
{
"role": "user",
"content": "The asymptomatic lung embolism: should every patient with deep vein thrombosis be examined using thoracic ultrasound? Context: Examination of the prognostic importance of sonographically diagnosed pleural defects in patients with deep vein thrombosis (DVT) who are clinically asymptomatic for lung emboli (LE). n = 124 patients with a sonographically diagnosed DVT and without clinical symptoms for an LE were accepted for this retrospective study. The thorax was subsequently sonographically examined in all patients. The patients were split into two groups (group 1: with pleural defects; group 2: without pleural defects). These groups were observed for an average of 36.6 months. The endpoints death and recurrence of pulmonary embolism or thrombosis were documented. The survival time was calculated using the Kaplan-Meier analysis. Of the 124 patients, n = 50 (40.3 %) had pleural defects (group 1) and n = 74 (59.7 %) had no pleural defects (group 2) on thoracic sonography. During the time of observation, n = 9 patients experienced a recurrent event of thrombosis or pulmonary embolism. In total, n = 39 (31.5 %) patients died (group 1: n = 16, group 2: n = 23 patients). The one-year mortality rate for patients with pleural defects was 24 % in group 1 and 22 % in group 2. The differences in the survival curves were not statistically significant (p = 0,7581)."
},
{
"role": "assistant",
"content": "The sonographic diagnosis of pleural defects that are indicative for small embolism for patients with diagnosed deep vein thrombosis (DVT) and without clinical symptoms for an LE has no prognostic significance with respect to death or recurrent pulmonary embolism or thrombosis. Routine thorax sonography for such patients does not seem to be indicated."
}
] |
[
{
"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, Angioplasty, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, Carotid Stenosis, Endarterectomy, Carotid, Feasibility Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Stents, Stroke, Time Factors."
},
{
"role": "user",
"content": "Are long-term results of carotid stenting competitive with surgery? Context: The feasibility of carotid stenting (CS) is no longer questionable, although its indications remain debatable. Until the results of randomized trials are available, personal series and registries should help in the comparison of long-term results of CS with those of endarterectomy. We report here the long-term results of a large series of CS in our department with a long follow-up. This retrospective study reviews a single surgeon's 11-year experience with CS. Our results are compared with those of conventional surgery emanating from our own series and the North American Symptomatic Carotid Endarterectomy Trial (NASCET), European Carotid Surgery Trial (ECST), and Asymptomatic Carotid Atherosclerosis Study (ACAS). CS has been performed in our department in a single, semi-private institution for 12 years. Patients with high lesions, and postradiotherapy and postendarterectomy stenoses were treated with CS, as were patients at high risk for surgery. The others were operated on with conventional endarterectomy. During the study, we performed 221 CS procedures on 193 patients (150 men and 43 women). The average follow-up was 2.7 years (1 month to 9.3 years). We analyzed the late results in terms of prevention from stroke, the freedom from new neurologic events, and also patency rates of the treated carotid vessels. We also identified predictors for neurologic complication and in-stent restenosis by using univariate analysis. Life-table analyses at 10 years gave a 96% (confidence interval [CI] = 3%) rate for stroke freedom, a 98% (CI = 2%) rate for fatal stroke freedom, and a primary assisted patency rate of 95% (CI = 3%). Predictors for neurologic complication were [corrected] age >70 ( P = .041), and [corrected] potential renal insufficiency ( P = .056 [corrected] In-stent restenosis occurrence extended from 2 months to 4.5 years after the procedure. The restenosis rates at 6 months, 1, 2, and 4.5 years were, respectively, 1.4%, 2.3%, 3.7%, and 5.9% (13/221). No factors were found to be strong predictors of in-stent restenosis [corrected]"
},
{
"role": "assistant",
"content": "These long-term results show that CS is competitive with conventional surgery. A more accurate selection for CS or surgery might reduce the rate of complications after carotid stenosis repair. Final Decision: yes"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Age Factors, Body Mass Index, C-Reactive Protein, Case-Control Studies, Cholesterol, HDL, Chronic Periodontitis, Dental Plaque Index, Female, Humans, Male, Middle Aged, Periodontal Attachment Loss, Periodontal Index, Periodontal Pocket, Sex Factors, Smoking, Vitamin D, Vitamins."
},
{
"role": "user",
"content": "Is low serum level of 1,25 ( OH ) 2 D associated with chronic periodontitis? Context: Vitamin D has been studied primarily for its involvement in calcium and phosphate absorption and bone metabolism. The active form of vitamin D-1,25(OH)2 D-has also been investigated for its immune modulatory properties. We explored associations between serum levels of 25(OH)D and 1,25(OH)2 D and periodontal health. This case-control study included 55 subjects with chronic periodontitis (cases) and 30 periodontally healthy subjects (controls). Their serum levels of 25(OH)D, 1,25(OH)2 D, ultrasensitive C-reactive protein and high-density lipoprotein cholesterol were determined. Associations between vitamin D and periodontal health status were studied using logistic regression analysis. A statistically significant association was found between serum 1,25(OH)2 D level and periodontal health status; in that subjects with a low 1,25(OH)2 D were more likely to belong to the periodontitis group (OR = 0.97, 95% CI = 0.95-1.00). There was practically no association between 25(OH)D level and periodontal health status."
},
{
"role": "assistant",
"content": "In this case-control study low serum 1,25(OH)2 D level appeared to be associated with periodontitis, which was in line with the previously reported associations between serum 1,25(OH)2 D levels and other inflammatory diseases. Whether this association is causal in nature, remains to be confirmed in future studies. Final Decision: yes"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: UNLABELLED, OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Anti-Inflammatory Agents, Non-Steroidal, Aspirin, Asthma, Drug Hypersensitivity, Eosinophil Cationic Protein, Eosinophilia, Eosinophils, Female, Humans, Male, Middle Aged, Nasal Polyps, Surveys and Questionnaires."
},
{
"role": "user",
"content": "Is [ Nasal polyps a homogenous pathology ]? Context: Nasal polyposis is still a disease of unknown etiology. Looking at its clinical course it seems to be not homogenous pathology. Inflammation of the mucosa, mainly eosinophilic is probably the most important factor, which leads to the development of nasal polyps. To analyze and compare the history data and eosinophilic inflammation parameters in patients with nasal polyps. 67 patients with nasal polyposis were included into the study. They were divided into three groups: PP-primary nasal polyps (n = 33-49.2%); A-polyps and bronchial asthma without aspirin intolerance (n = 19-28.4%); ASA-polyps and aspirin-induced asthma (n = 15-22.4%). The history data were taken using patient's questionnaire. To assess the eosinophilic inflammation intensity the blood and nasal eosinophilia and serum eosinophilic cationic protein (ECP) concentration were measured. The average age of all patients was 55 +/- 1.5 (range 32-76), the age distribution was comparable in all groups. The ratio males:females--1.5:1 (PP--2.7:1; A--1.1:1; ASA--0.7:1. The females with nasal polyps much more often suffer from asthma than males (p = 0.036). The age when polyps were first seen was 45.1. The duration of nasal polyps was 10 +/- 10 years (range 0.5-30 years): PP-- 10 +/- 9; A-- 14 +/- 11; ASA-- 7 +/- 7 (A/ASA-- p = 0.045). Period of 6.6 years of rhinitis had preceded the diagnosis of nasal polyposis (PP--7.3; A--7.1; ASA--4.5). Age when asthma was developed (A+ASA groups)--45.5; the duration of asthma was 11 +/- 9 years. 58% of patients had polypectomy/ethmoidectomy (PP--45%; A--60%; ASA--80%). The number of operations per one patient: 1.3 (PP--1.0; A--1.2; ASA--2.0), the most often performed in ASA group (PP/ASA-- p = 0.01 and A/ASA-- p =0.045). The mean interval between polypectomies in all patients--9.1 years (PP--10; A--12, ASA--3.5). Blood eosinophilia: 5.6 +/- 0.4% (PP-- 4.6 +/- 0.5; A-- 6.2 +/- 0.9; ASA-- 7.2 +/- 0.9% and PP/ASA-- p = 0.019; PP/A+ASA-- p = 0.03). Nasal eosinophilia: 18.5 +/- 3% (PP-- 15.0 +/- 4; A-- 15.5 +/- 6; ASA-- 30.0 +/- 8% and PP/ASA-- p = 0.01; A/ASA-- p = 0.02). Serum ECP concentration: 24 +/- 2 microg/l."
},
{
"role": "assistant",
"content": "The patient's history and the intensity of eosinophilic inflammation are not similar in all nasal polyposis patients, that support the classification into PP, A and ASA groups. The most severe clinical picture and the highest values of eosinophilic parameters are observed in ASA group. Aspirin intolerance seems to be unfavourable prognostic factor in nasal polyposis. 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: Acidosis, Respiratory, Airway Resistance, Animals, Carbon Dioxide, Central Venous Pressure, Disease Models, Animal, Female, Hypercapnia, Male, Pulmonary Gas Exchange, Random Allocation, Respiration, Artificial, Respiratory Dead Space, Respiratory Distress Syndrome, Adult, Swine, Trachea."
},
{
"role": "user",
"content": "Does tracheal double-lumen ventilation attenuate hypercapnia and respiratory acidosis in lung injured pigs? Context: Evaluation of ventilatory and circulatory effects with coaxial double-lumen tube ventilation for dead-space reduction as compared with standard endotracheal tube ventilation. Experimental study in a pig model of lung lavage induced acute lung injury. University research laboratory. Tidal volumes of 6, 8 and 10 ml/kg body weight with a set respiratory rate of 20 breaths per minute were used in a random order with both double-lumen ventilation and standard endotracheal tube ventilation. Measurements of ventilatory and circulatory parameters were obtained after steady state at each experimental stage. With a tidal volume of 6 ml/kg, PaCO(2) was reduced from 10.9 kPa (95% CI 9.0-12.9) with a standard endotracheal tube to 8.2 kPa (95% CI 7.0-9.4) with double-lumen ventilation. This corresponds to a reduction in carbon dioxide levels by 25%. At 6 ml/kg, pH increased from 7.17 (95% CI 7.09-7.24) with a standard endotracheal tube to 7.27 (95% CI 7.21-7.32) with double-lumen ventilation. Tracheal pressure was monitored continuously and no difference between single- or double-lumen ventilation was noted at corresponding levels of ventilation. There was no formation of auto-PEEP. Partial tube obstruction due to secretions was not observed during the experiments."
},
{
"role": "assistant",
"content": "Coaxial double-lumen tube ventilation is an effective adjunct to reduce technical dead space. It attenuates hypercapnia and respiratory acidosis in a lung injury pig model. 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, Anesthetics, Intravenous, Cross-Over Studies, Dose-Response Relationship, Drug, Double-Blind Method, Female, Hand, Humans, Incidence, Injections, Intravenous, Male, Pain, Pain Measurement, Propofol, Severity of Illness Index, Time Factors."
},
{
"role": "user",
"content": "Does low-dose propofol reduce the incidence of moderate to severe local pain induced by the main dose? Context: Local pain on injection of propofol remains a considerable problem in clinical anaesthesiology. As slow infusion of a low dose of propofol induces little or no pain at the site of injection, and as propofol-induced pain fades during prolonged exposure, this randomized, double-blind, clinical cross-over study was designed to test whether pain on injection of propofol is attenuated by initial slow injection of a low dose of propofol by the same intravenous line. Seventy-seven adult surgical patients were cannulated in a dorsal vein on each hand. In each cannula, a 0.5-ml priming dose of either propofol 10 mg/ml dissolved in an emulsion of medium- and long-chain triglycerides or aqueous sodium chloride 9.0 mg/ml was injected over 30 s, and followed 120 s later by a main dose of 2.0 ml of the same propofol formula over 6 s. After each injection, the patients were asked by a blind investigator to score the maximal pain intensity on a visual analogue scale (VAS). Although the decrease in maximal pain intensity did not reach statistical significance (P= 0.070), significantly fewer patients reported moderate or severe pain intensity (corresponding to 3.0 VAS units or more) after the main dose of propofol was preceded by a priming dose of propofol than by sodium chloride (P= 0.041)."
},
{
"role": "assistant",
"content": "The incidence of moderate to severe local pain induced by intravenous propofol can be decreased by a readily applicable technique in which a low dose of propofol emulsion is slowly administered by the same intravenous route 2 min in advance. 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 38-year-old woman presents to her primary care physician for complaints of insomnia. She states that for the last 8 months, she has had difficultly falling asleep. Additionally, she awakens in the middle of the night or early morning and cannot fall back to sleep. When further questioned, she reports decreased appetite with a 12-lb. weight loss in the last 6 months. She was recently demoted at her work as a baker due to trouble focusing and coordinating orders and excess fatigue. She feels she is to blame for her families current financial status given her demotion. She is given a prescription for fluoxetine at this visit with follow-up 2 weeks later. At the follow-up visit, she reports no improvement in her symptoms despite taking her medication consistently. What is the most appropriate next step in management?"
},
{
"role": "assistant",
"content": "Continue current medication"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Colectomy, Colitis, Emergency Medical Services, Female, Humans, Intestinal Obstruction, Intestinal Perforation, Laparoscopy, Male, Middle Aged, Retrospective Studies, Young Adult."
},
{
"role": "user",
"content": "Is minimally invasive surgery safe and effective for urgent and emergent colectomy? Context: There are a limited number of studies describing the role of minimally invasive colectomy for urgent or emergent conditions of the large bowel. We hypothesize that laparoscopic colectomy in urgent and emergent setting can be performed safely in select settings. A cohort of patients treated at a single institution from 2001 to 2006 was identified from a prospective database. Patients who underwent open or minimally invasive surgery (MIS), including laparoscopic (LAP) or hand-assisted laparoscopic surgery (HALS) colectomy for urgent and emergent conditions were included. A total of 68 [open 32, MIS 36 [HALS 22, LAP 14)] patients underwent urgent or emergent colectomy on our colorectal service during the 5-year time period. Patients with toxic colitis were more often selected for MIS. Patients with colon perforation or large bowel obstruction were more often selected for open surgery. The MIS group had a lower body mass index (BMI), lower American Society of Anesthesiologists fitness grade and was more likely to have been immunosuppressed. There was no difference in patient morbidity between the open and MIS groups. The MIS group had a longer median operative time and fewer cases of prolonged hospitalization."
},
{
"role": "assistant",
"content": "We conclude that minimally invasive colectomy by experienced surgeons appears to be safe and effective for appropriately selected patients with emergent and urgent conditions of the large bowel. 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: Analysis of Variance, Blood Pressure, Cardiac Catheterization, Chi-Square Distribution, Child, Child, Preschool, Echocardiography, Fontan Procedure, Heart Valve Diseases, Humans, Infant, Stroke Volume, Ventricular Function."
},
{
"role": "user",
"content": "Does use of the Damus-Kaye-Stansel procedure prevent increased ventricular strain in Fontan candidates? Context: In Fontan candidates, we have recently been aggressively performing the Damus-Kaye-Stansel procedure (DKS) to prevent increased afterload on the systemic ventricle. The present study investigated the efficacy of the DKS procedure in terms of the ventricular function following a Fontan operation. Patients undergoing a Fontan operation were divided into three groups: DKS performed at the time of the bidirectional Glenn or Fontan operation (DKS group, n = 25); DKS not performed at any stage due to mild pulmonary stenosis (PS) (PS group, n = 23) and DKS not performed due to pulmonary atresia (PA) or severe PS (PA group, n = 24). Ventricular function, afterload on the systemic ventricle and atrioventricular valve regurgitation were compared between groups. Cardiac catheterization before a Glenn or Fontan operation and at 1-year following the Fontan revealed significantly decreased ventricular end-diastolic pressure in the DKS group. The ventricular ejection fraction was significantly deteriorated in the PS group. Effective arterial elastance, as an index of total ventricular afterload, was increased after a Fontan in all groups, with a substantial increase in the PS group. As an index of ventricular mechanical efficiency, ventriculoarterial coupling was significantly increased only in the PS group. Cardiac ultrasonography revealed atrioventricular valve regurgitation above grade 3 persisting in many patients from the PS group. Semilunar valve function after DKS operation did not progress to moderate or worse in any patients."
},
{
"role": "assistant",
"content": "The proactive performance of the DKS procedure prevents increased ventricular afterload, avoiding deterioration of cardiac function and contributing to improved long-term results following a Fontan operation. 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, Brain Neoplasms, Cell Line, Tumor, Cell Proliferation, Cell Transformation, Neoplastic, Disease Models, Animal, Gene Expression Profiling, Gene Expression Regulation, Neoplastic, Glioblastoma, Heterografts, Humans, Prognosis, Reactive Oxygen Species, gamma-Glutamyltransferase."
},
{
"role": "user",
"content": "Is γ-Glutamyl transferase 7 a novel regulator of glioblastoma growth? Context: Glioblastoma (GBM) is the most malignant primary brain tumor in adults, with a median survival time of one and a half years. Traditional treatments, including radiation, chemotherapy, and surgery, are not curative, making it imperative to find more effective treatments for this lethal disease. γ-Glutamyl transferase (GGT) is a family of enzymes that was shown to control crucial redox-sensitive functions and to regulate the balance between proliferation and apoptosis. GGT7 is a novel GGT family member that is highly expressed in brain and was previously shown to have decreased expression in gliomas. Since other members of the GGT family were found to be altered in a variety of cancers, we hypothesized that GGT7 could regulate GBM growth and formation. To determine if GGT7 is involved in GBM tumorigenesis, we modulated GGT7 expression in two GBM cell lines (U87-MG and U138) and monitored changes in tumorigenicity in vitro and in vivo. We demonstrated for the first time that GBM patients with low GGT7 expression had a worse prognosis and that 87% (7/8) of primary GBM tissue samples showed a 2-fold decrease in GGT7 expression compared to normal brain samples. Exogenous expression of GGT7 resulted in a 2- to 3-fold reduction in proliferation and anchorage-independent growth under minimal growth conditions (1% serum). Decreasing GGT7 expression using either short interfering RNA or short hairpin RNA consistently increased proliferation 1.5- to 2-fold. In addition, intracranial injections of U87-MG cells with reduced GGT7 expression increased tumor growth in mice approximately 2-fold, and decreased mouse survival. To elucidate the mechanism by which GGT7 regulates GBM growth, we analyzed reactive oxygen species (ROS) levels in GBM cells with modulated GGT7 expression. We found that enhanced GGT7 expression reduced ROS levels by 11-33%."
},
{
"role": "assistant",
"content": "Our study demonstrates that GGT7 is a novel player in GBM growth and that GGT7 can play a critical role in tumorigenesis by regulating anti-oxidative damage. Loss of GGT7 may increase the cellular ROS levels, inducing GBM occurrence and growth. Our findings suggest that GGT7 can be a promising biomarker and a potential therapeutic target for GBM. 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: Abdominal Fat, Adiposity, Adolescent, Anthropometry, Blood Pressure, Body Mass Index, Cardiovascular Diseases, Child, Cross-Sectional Studies, Female, Humans, Logistic Models, Male, Obesity, Abdominal, Physical Fitness, Risk Factors, Waist Circumference."
},
{
"role": "user",
"content": "Is the Association Between Cardiorespiratory Fitness and Cardiometabolic Risk in Children Mediated by Abdominal Adiposity : The HAPPY Study? Context: It is unclear whether cardiorespiratory fitness (CRF) is independently linked to cardiometabolic risk in children. This study investigated a) the association between CRF level and presence of cardiometabolic risk disorders using health-related cut points, and b) whether these associations were mediated by abdominal adiposity in children. This was a cross-sectional design study. Anthropometry, biochemical parameters and CRF were assessed in 147 schoolchildren (75 girls) aged 10 to 14 years. CRF was determined using a maximal cycle ergometer test. Children were classified as 'fit' or 'unfit' according to published thresholds. Logistic regression was used to investigate the odds of having individual and clustered cardiometabolic risk factors according to CRF level and whether abdominal adiposity mediated these associations. Children classified as unfit had increased odds of presenting individual and clustered cardiometabolic risk factors (P < .05), but these associations no longer remained after adjusting for abdominal adiposity (P > .05)."
},
{
"role": "assistant",
"content": "This study suggests that the association between CRF and cardiometabolic risk is mediated by abdominal adiposity in 10- to 14-year-old children and that abdominal adiposity may be a more important determinant of adverse cardiometabolic health in this age group. 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 indications of cast metal inlay are all except"
},
{
"role": "assistant",
"content": "The correct answer is Inlays\n\nAn inlay can be defined as a restoration which has been constructed out of mouth from gold, porcelain or other materials and then cemented into the prepared cavity of a tooth.\n\nIndications\n\nThe cavity's width does not exceed one-third the intercuspal distance.\nStrong, self-resistant cusps are there.\nMinimum or no occlusal facets present and if present, are confined to the occlusal surfaces only.\nThe tooth is not to be used as an abutment for a fixed or removable prosthesis.\nOcclusal or occluding surfaces are not to be changed by the restorative procedure.\n\nMDS Prep Bytes (Cast Restoration – Inlay)"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, MATERIALS AND METHODS, RESULTS. Meshes: Adult, African Americans, Aged, European Continental Ancestry Group, Female, Hispanic Americans, Humans, Male, Middle Aged, Nocturia, Prevalence, Socioeconomic Factors."
},
{
"role": "user",
"content": "Are racial/ethnic disparities in the prevalence of nocturia due to socioeconomic status? Context: Racial/ethnic disparities in nocturia prevalence have been reported previously. We estimated nocturia prevalence rates by race/ethnicity and determined the contribution of socioeconomic status to potential differences by race/ethnicity. The Boston Area Community Health Survey used a multistage stratified design to recruit a random sample of 5,501 adults, including 2,301 men and 3,200 women, who were 30 to 79 years old. Nocturia was defined as voiding more than once per night in the last week or voiding more than once per night fairly often, usually or almost always in the last month. Self-reported race/ethnicity was defined as black, Hispanic and white. Socioeconomic status was defined as a combination of education and household income. The overall prevalence of nocturia was 28.4% with a higher prevalence in black and Hispanic participants compared to white participants (38.6% and 30.7%, respectively, vs 23.2%), a trend that was consistent by gender. After adjusting for socioeconomic status the increased odds of nocturia in Hispanic men disappeared (adjusted OR 1.04, 95% CI 0.71, 1.52), while the OR in black men was attenuated but remained statistically significant (OR 1.57, 95% CI 1.12, 2.21). In women the association between race/ethnicity and nocturia was attenuated but remained statistically significant after adjusting for socioeconomic status."
},
{
"role": "assistant",
"content": "Socioeconomic status accounts for part of the racial/ethnic disparities in prevalence of nocturia. The effect of socioeconomic status was more pronounced in men and in Hispanic participants, while differences in nocturia prevalence remained significant in black men and women."
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, RESULTS. Meshes: Aging, Animals, Antioxidants, Cardiomegaly, Cells, Cultured, DNA, Mitochondrial, Energy Metabolism, Gene Expression Regulation, Enzymologic, Glucose, Homeostasis, Lipid Metabolism, Mice, Mice, Inbred C57BL, Mice, Knockout, Mitochondria, Heart, Myocytes, Cardiac, Oxidation-Reduction, Oxidative Stress, PPAR delta, Palmitic Acid, RNA, Messenger, Superoxide Dismutase, Superoxide Dismutase-1, Transcription, Genetic, Ventricular Dysfunction, Left."
},
{
"role": "user",
"content": "Is peroxisome proliferator-activated receptor { delta } an essential transcriptional regulator for mitochondrial protection and biogenesis in adult heart? Context: Peroxisome proliferator-activated receptors (PPARs) (alpha, gamma, and delta/beta) are nuclear hormone receptors and ligand-activated transcription factors that serve as key determinants of myocardial fatty acid metabolism. Long-term cardiomyocyte-restricted PPARdelta deficiency in mice leads to depressed myocardial fatty acid oxidation, bioenergetics, and premature death with lipotoxic cardiomyopathy. To explore the essential role of PPARdelta in the adult heart. We investigated the consequences of inducible short-term PPARdelta knockout in the adult mouse heart. In addition to a substantial transcriptional downregulation of lipid metabolic proteins, short-term PPARdelta knockout in the adult mouse heart attenuated cardiac expression of both Cu/Zn superoxide dismutase and manganese superoxide dismutase, leading to increased oxidative damage to the heart. Moreover, expression of key mitochondrial biogenesis determinants such as PPARgamma coactivator-1 were substantially decreased in the short-term PPARdelta deficient heart, concomitant with a decreased mitochondrial DNA copy number. Rates of palmitate and glucose oxidation were markedly depressed in cardiomyocytes of PPARdelta knockout hearts. Consequently, PPARdelta deficiency in the adult heart led to depressed cardiac performance and cardiac hypertrophy."
},
{
"role": "assistant",
"content": "PPARdelta is an essential regulator of cardiac mitochondrial protection and biogenesis and PPARdelta activation can be a potential therapeutic target for cardiac disorders. Final Decision: yes"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response."
},
{
"role": "user",
"content": "Which of the following is not a Deep Lymphoid tissue"
},
{
"role": "assistant",
"content": "The correct answer is Mucosa-associated lymphoid tissue (MALT): Small numbers of lymphocytes may be present almost anywhere in the body, but signifi cant aggregations are seen in relation to the mucosa of the respiratory, alimentary and urogenital tracts. These aggregations are referred to as MALT. Mucosa-associated lymphoid tissue in the respiratory system: In the respiratory system the aggregations are relatively small and are present in the walls of the trachea and large bronchi. The term bronchial-associated lymphoid tissue (BALT) is applied to these aggregations. Mucosa-associated lymphoid tissue in the alimentary system: This is also called gutassociated lymphoid tissue (GALT) and includes Peyer's patches of ilium, adenoids (located in the roof of pharynx), lingual tonsils in posterior 1/3rd of tongue, palatine tonsils and lymphoid nodules in vermiform appendix. REF : Inderbir Singh's Textbook of Human Histology, Seventh edition, pg.no., 127, 128."
}
] |
[
{
"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: Aged, Capillaries, Coronary Circulation, Female, Humans, Kaplan-Meier Estimate, Male, Microcirculation, Middle Aged, Multiple Organ Failure, Myocardial Infarction, Prognosis, Prospective Studies, Shock, Cardiogenic, Sublingual Gland."
},
{
"role": "user",
"content": "Does impaired microcirculation predict poor outcome of patients with acute myocardial infarction complicated by cardiogenic shock? Context: we investigated the relationship between sublingual perfused capillary density (PCD) as a measure of tissue perfusion and outcome (i.e. occurrence of organ failure and mortality) in patients with cardiogenic shock from acute myocardial infarction. we performed a prospective study in 68 patients. Using Sidestream Dark Field imaging, PCD was measured after hospital admission (T0, baseline) and 24 h later (T1). We compared patients with baseline PCD ≤ median to patients with baseline PCD > median. Sequential organ failure assessment (SOFA) scores were calculated at both time points. The Kaplan-Meier 30-day survival analyses were performed and predictors of 30-day mortality were identified. The baseline PCD was a predictor of the change in the SOFA score between T0 and T1 (ΔSOFA; ρ = -0.25, P = 0.04). Organ failure recovered more frequently in patients with PCD > median (>10.3 mm mm(-2); n = 33) than in patients with PCD ≤ median (n = 35; 52 vs. 29%, P < 0.05). Twenty-two patients (32%) died: 17 patients (49%) with PCD ≤ median vs. 5 patients (15%) with PCD > median (P = 0.004). After adjustment, the cardiac power index [odds ratio (OR): 0.48, 95% CI: 0.24-0.94) and PCD (OR: 0.65, 95% CI: 0.45-0.92) remained significant predictors of 30-day outcome. Patients with baseline sublingual PCD ≤ median that improved at T1 had a considerable better prognosis relative to patients who had a persistently low PCD."
},
{
"role": "assistant",
"content": "diminished sublingual PCD, at baseline or following treatment, is associated with development of multi-organ failure and is a predictor of poor outcome in patients with acute myocardial infarction complicated by cardiogenic shock. 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 25-year-old G1P0 at 20 weeks of gestation woman arrives at a prenatal appointment complaining of pelvic pressure. She has had an uncomplicated pregnancy thus far. She takes prenatal vitamins and eats a well-balanced diet. Her medical history is significant for major depressive disorder that has been well-controlled on citalopram. Her mother had gestational diabetes with each of her 3 pregnancies. On physical exam, the cervix is soft and closed with minimal effacement. There is white vaginal discharge within the vagina and vaginal vault without malodor. Vaginal pH is 4.3. A transvaginal ultrasound measures the length of the cervix as 20 mm. Which of the following is most likely to prevent preterm birth in this patient?"
},
{
"role": "assistant",
"content": "Vaginal progesterone"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response."
},
{
"role": "user",
"content": "Drug of choice for schizophrenic patient with poor oral absorption is?"
},
{
"role": "assistant",
"content": "The correct answer is Clozapine REF: Kaplan and sadock's synopsis in psychiatry 10th ed p. 489-490 Antipsychotics can be categorized into two main groups: the older conventional antipsychotics, which have also been called first-generation antipsychotics or dopamine receptor antagonists (DRA), and the newer drugs, which have been called second-generation antipsychotics or serotonin dopamine antagonists (SDAs) Strategies for Poor Responders of Antipsychotic: It may suggest that the patient is a rapid metabolizer of the antipsychotic or that the drug is not being adequately absorbed. Changing to another drug is preferable to changing to a high dose. If a patient has responded poorly to a conventional DRA, it is unlikely that this individual will do well on another DRA. Changing to an SDA is more likely to be helpful. Clozapine is effective for patients who respond poorly to DRAs. Double-blind studies comparing clozapine to other antipsychotics indicated that clozapine had the clearest advantage over conventional drugs in patients with the most severe psychotic symptoms, as well as in those who had previously responded poorly to other antipsychotics."
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS, RESULTS. Meshes: Aged, Cross-Sectional Studies, Female, Geriatrics, Humans, Inappropriate Prescribing, Male, Societies, Medical, Spain, Surveys and Questionnaires, United States."
},
{
"role": "user",
"content": "2012 American Geriatrics Society Beers criteria: enhanced applicability for detecting potentially inappropriate medications in European older adults? Context: To determine the prevalence of potentially inappropriate medications (PIMs) and related factors through a comparative analysis of the Screening Tool of Older Person's Potentially Inappropriate Prescriptions (STOPP), the 2003 Beers criteria, and the 2012 AGS update of the Beers criteria. Cross-sectional. Primary care. Community-dwelling persons aged 65 and older who live on the island of Lanzarote, Spain (N = 407). Sociodemographic characteristics; independence in activities of daily living; cognitive function; Geriatric Depression Scale; clinical diagnoses; and complete data on indication, dosage, and length of drug treatments. One thousand eight hundred seventh-two prescriptions were examined, and the rate of PIMs was assessed with the three criteria. The primary endpoint was the percentage of participants receiving at least one PIM. Multivariate logistic regression was used to examine the factors related to PIMs. Potentially inappropriate medications were present in 24.3%, 35.4%, and 44% of participants, according to the 2003 Beers criteria, STOPP, and 2012 Beers criteria, respectively. The profile of PIMs was also different (the most frequent being benzodiazepines in both Beers criteria lists and aspirin in the STOPP). The number of drugs was associated with risk of prescribing PIMs in all three models, as was the presence of a psychological disorder in the 2003 Beers criteria (odds ratio (OR) = 2.07, 95% confidence interval (CI) = 1.26-3.40) and the 2012 Beers criteria (OR = 2.91, 95% CI = 1.83-4.66). The kappa for degree of agreement between STOPP and the 2012 Beers criteria was 0.35 (95% CI = 0.25-0.44)."
},
{
"role": "assistant",
"content": "The 2012 Beers criteria detected the highest number of PIMs, and given the scant overlapping with the STOPP criteria, the use of both tools may be seen as complementary."
}
] |
[
{
"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": "α polypeptide of hemoglobin closely resembles which of the following?"
},
{
"role": "assistant",
"content": "The correct answer is Although it possesses seven rather than eight helical regions, the α polypeptide of hemoglobin also closely resembles myoglobin.\nRef: Harper’s illustrated biochemistry. 30th edition page no: 54"
}
] |
[
{
"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, Clinical Competence, Computer Simulation, Education, Medical, Continuing, Female, Humans, Hypnosis, Laparoscopy, Male, Middle Aged, Task Performance and Analysis."
},
{
"role": "user",
"content": "Does hypnosis-induced mental training improve performance on the Fundamentals of Laparoscopic Surgery ( FLS ) simulator? Context: Mental training (MT) is used extensively by musicians and athletes to improve their performance. Recently, it has been suggested as a training method for surgical trainees. We assessed the influence of MT, induced by hypnosis, on the performance of simulated tasks on a laparoscopic simulator, as compared to a non-specific relaxing intervention. 11 surgeons completed a proficiency-based training program on the Fundamentals of Laparoscopic Surgery (FLS) simulator, until they reached performance plateau of the peg transfer task. Thereafter, they received a single music session, as a relaxing intervention, followed by repeating of the peg transfer task. Then they went through a hypnosis session guided by an experienced psychologist, with suggestions of smooth flow of pegs from one position on the board to another, and re-performed the task. Plateau performance was 51.1 ± 6.9 s. After the music session performance improved by 6.3% to 47.9 ± 5.4 s (p = 0.86). After the MT session performance further improved by 15.3% to 40.1 ± 5.8 s (p = 0.009), which was a 21.6% improvement from baseline (p < 0.001). Subject's satisfaction from their performance, without knowledge of the task scores, was 6.0 ± 2.9 on 0-10 VAS after the music and reached as high as 8.5 ± 1.7 after the hypnotic session (p = 0.01)."
},
{
"role": "assistant",
"content": "Hypnosis-induced MT significantly improves performance on the FLS simulator, which cannot be attributed to its relaxing qualities alone. This study contributes evidence to the effectiveness of MT in surgical skills acquisition and suggests that hypnotic techniques should be used in mental preparation processes. There is a need to further study these effects on operating room performance. Final Decision: yes"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Adult Survivors of Child Abuse, Case-Control Studies, Factor Analysis, Statistical, Female, Gene-Environment Interaction, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Interview, Psychological, Male, Mental Disorders, Middle Aged, Risk Factors, Sex Factors, Siblings, Substance-Related Disorders."
},
{
"role": "user",
"content": "Is the variance shared across forms of childhood trauma strongly associated with liability for psychiatric and substance use disorders? Context: Forms of childhood trauma tend to co-occur and are associated with increased risk for psychiatric and substance use disorders. Commonly used binary measures of trauma exposure have substantial limitations. We performed multigroup confirmatory factor analysis (CFA), separately by sex, using data from the Childhood Trauma (CT) Study's sample of twins and siblings (N = 2594) to derive three first-order factors (childhood physical abuse, childhood sexual abuse, and parental partner abuse) and, as hypothesized, one higher order, childhood trauma factor (CTF) representing a measure of their common variance. CFA produced a good-fitting model in the CT Study; we replicated the model in the Comorbidity and Trauma (CAT) Study's sample (N = 1981) of opioid-dependent cases and controls. In both samples, first-order factors are moderately correlated (indicating they measure largely unique, but related constructs) and their loadings on the CTF suggest it provides a reasonable measure of their common variance. We examined the association of CTF score with risk for psychiatric and substance use disorders in these samples and the OZ-ALC GWAS sample (N = 1538) in which CT Study factor loadings were applied. We found that CTF scores are strongly associated with liability for psychiatric and substance use disorders in all three samples; estimates of risk are extremely consistent across samples."
},
{
"role": "assistant",
"content": "The CTF is a continuous, robust measure that captures the common variance across forms of childhood trauma and provides a means to estimate shared liability while avoiding multicollinearity. 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: CONTEXT, OBJECTIVE, DESIGN, MAIN OUTCOME MEASURES, RESULTS. Meshes: Peer Review, Research, Periodicals as Topic, Practice Guidelines as Topic."
},
{
"role": "user",
"content": "Are guidelines following guidelines? Context: Practice guidelines play an important role in medicine. Methodological principles have been formulated to guide their development. To determine whether practice guidelines in peer-reviewed medical literature adhered to established methodological standards for practice guidelines. Structured review of guidelines published from 1985 through June 1997 identified by a MEDLINE search. Mean number of standards met based on a 25-item instrument and frequency of adherence. We evaluated 279 guidelines, published from 1985 through June 1997, produced by 69 different developers. Mean overall adherence to standards by each guideline was 43.1% (10.77/25). Mean (SD) adherence to methodological standards on guideline development and format was 51.1% (25.3%); on identification and summary of evidence, 33.6% (29.9%); and on the formulation of recommendations, 46% (45%). Mean adherence to standards by each guideline improved from 36.9% (9.2/25) in 1985 to 50.4% (12.6/25) in 1997 (P<.001). However, there was little improvement over time in adherence to standards on identification and summary of evidence from 34.6% prior to 1990 to 36.1 % after 1995 (P = .11). There was no difference in the mean number of standards satisfied by guidelines produced by subspecialty medical societies, general medical societies, or government agencies (P = .55). Guideline length was positively correlated with adherence to methodological standards (P = .001)."
},
{
"role": "assistant",
"content": "Guidelines published in the peer-reviewed medical literature during the past decade do not adhere well to established methodological standards. While all areas of guideline development need improvement, greatest improvement is needed in the identification, evaluation, and synthesis of the scientific evidence."
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Fibula, Head, Humans, Length of Stay, Microsurgery, Middle Aged, Neck, Postoperative Complications, Predictive Value of Tests, Quality Improvement, Reconstructive Surgical Procedures, Retrospective Studies, Risk Assessment, Risk Factors, Societies, Medical, Surgical Flaps, United States."
},
{
"role": "user",
"content": "Does the American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator Accurately Predict Risk of 30-Day Complications Among Patients Undergoing Microvascular Head and Neck Reconstruction? Context: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) Surgical Risk Calculator (SRC) is a novel universal risk calculator designed to aid in risk stratification of patients undergoing various types of major surgery. The purpose of this study was to assess the validity of the ACS NSQIP SRC in predicting postoperative complications in patients undergoing microvascular head and neck reconstruction. A retrospective cohort study of patients undergoing head and neck microvascular reconstruction with fibular free flaps at a single institution was completed. The NSQIP SRC was used to compute complication risk estimates and length of stay (LOS) estimates for all patients under study. Associations between complication risk estimates generated by the SRC and actual rates of observed complications were evaluated using logistic regression models. Logistic regression models also were used to evaluate the SRC estimates for LOS duration compared with the actual observed LOS after surgery. Of 153 patients under study, 46 (30%) developed a postoperative complication corresponding to those defined by NSQIP SRC. Thirty-eight patients (25%) developed a postoperative complication categorized as severe in the parameters of the NSQIP SRC. None of the SRC complication estimates showed a statistically relevant association with the corresponding observed rates of complications. The mean LOS predicted by the SRC was 8.0 days (median, 7.5 days; interquartile range [IQR], 6.5 to 9; range, 5.0 to 18.5 days). The mean observed LOS for the study group was 9.6 days (median, 7.0 days; IQR, 6 to 9; range, 5 to 67 days). Lin's (Biometrics 45:255, 1989) concordance correlation coefficient to measure agreement between observed and predicted LOS was 0.10, indicating only slight agreement between the 2 values."
},
{
"role": "assistant",
"content": "The ACS NSQIP SRC is not a useful risk-stratifying metric for patients undergoing major head and neck reconstruction with microvascular fibular free flaps. The SRC also does not accurately predict hospital LOS for this same patient cohort. Final Decision: no"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Antigens, Human Platelet, Blood Platelets, Cell Culture Techniques, Chemokine CCL5, Female, Histocompatibility Antigens Class I, Humans, Infant, Newborn, Infant, Newborn, Diseases, Isoantibodies, Male, Purpura, Receptors, IgG, Thrombocytopenia, Transfusion Reaction."
},
{
"role": "user",
"content": "Do human platelet antigen-1a antibodies induce the release of the chemokine RANTES from human platelets? Context: Binding of human platelet antigen-1a (HPA-1a)-specific antibodies to target platelets can trigger platelet activation and mediator release. Here we tested the effect of HPA-1a antibody-containing sera on platelet release of the chemokine RANTES (regulated on activation, normal, T-cell expressed, and presumably secreted) in vitro. HPA-1a-containing sera obtained from 11 mothers delivered of an infant with neonatal alloimmune thrombocytopenia (NAIT) and from six patients with post-transfusion purpura (PTP) were incubated with HPA-1a/a target platelets. Antibody-induced release of soluble RANTES was determined by enzyme-linked immunosorbent assay (ELISA). A significant release of soluble RANTES was induced by four out of the 17 sera. Two out of the four reactive sera were obtained from mothers who were delivered of a baby with NAIT and the remaining two sera were from patients with PTP. Chemokine release was specific for binding of anti-HPA-1a to the platelet membrane, as none of the reactive sera induced the release of soluble RANTES when incubated with HPA-1b/b platelets. The blockade of platelet-expressed Fc gamma receptor type II (FcgammaRII) inhibited anti-HPA-1a-mediated RANTES release when incubated with the reactive sera of patients with NAIT, but not when platelets were incubated with sera of patients with PTP."
},
{
"role": "assistant",
"content": "Our findings suggest that anti-HPA-1a antibody-induced release of platelet-derived RANTES can play a role in adverse reactions in alloimmunized 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: BACKGROUND, METHODS, RESULTS. Meshes: Apoptosis, DNA Fragmentation, Granulocyte-Macrophage Colony-Stimulating Factor, Humans, Lipopolysaccharides, Mitogen-Activated Protein Kinases, Neutrophils, Ultraviolet Rays."
},
{
"role": "user",
"content": "Does granulocyte-macrophage colony-stimulating factor rescue human polymorphonuclear leukocytes from ultraviolet irradiation-accelerated apoptosis? Context: Bacterial lipopolysaccharide (LPS) and granulocyte-macrophage colony-stimulating factor (GM-CSF) delay PMN apoptosis during in vitro culture. The present study was undertaken to determine if LPS and GM-CSF can rescue UV-irradiated PMN from undergoing apoptosis and to determine the role of extracellular signal-regulated kinase (ERK) in this process. PMN were preincubated with LPS (20 ng/ml) and GM-CSF (100 units/ml) for 60 min before being UV-irradiated for 15 min. Additional PMN were UV-irradiated for 15 min and then treated with LPS and GM-CSF. To determine the role of ERK in protection or rescue of PMN from apoptosis, PMN were preincubated with PD098059 for 30 min. Morphologic features of apoptosis were determined 4 h after UV irradiation. DNA laddering was confirmed by agarose gel electrophoresis. LPS and GM-CSF pretreatment significantly protected PMN from UV-accelerated apoptosis, although GM-CSF was more effective than LPS. Only GM-CSF rescued PMN that had already been exposed to UV irradiation from undergoing apoptosis. Time response experiments demonstrated that GM-CSF rescued a significant percentage of PMN when added up to 90 min after UV irradiation. Inhibition of ERK with PD098059 abrogated the protective effect of LPS and GM-CSF and blocked rescue of PMN from apoptosis by GM-CSF."
},
{
"role": "assistant",
"content": "LPS and GM-CSF protect PMN, whereas only GM-CSF can rescue PMN from UV-accelerated apoptosis. The ERK-signaling pathway plays an important role in the protection and/or rescue of PMN from UV-accelerated apoptosis, but appears to be a proximal event in this process. This study provides further insight into factors that regulate PMN apoptosis and provides a novel approach for investigating signal transduction pathways involved in PMN apoptosis. 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 14-year-old girl presents to the pediatrician because she has not experienced the onset of menstruation. Her mother reports that her pubic hair developed at the age of 9 years. Her mother also informs that she has been experiencing recurrent serous otitis media since early childhood. The temperature is 36.8°C (98.4°F), pulse is 88/min, blood pressure is 128/78 mm Hg, and respiratory rate is 14/min. The physical examination shows hypoplastic nails, along with short 4th and 5th metacarpals, and cubitus valgus bilaterally. In addition, the examination of her chest shows lack of breast development with widely spaced nipples. The auscultation of the chest reveals normal heart sounds with no murmur noted. The examination of the head and neck region shows a high arched palate, dental malocclusion, and a low hairline. Which of the following signs is most likely to be present on examination of her skin?"
},
{
"role": "assistant",
"content": "Increased number of benign nevi"
}
] |
[
{
"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 mother brings in her 7-year-old son because she is worried about his behavior after his teacher called. The patient’s mother says she was told that he has not been doing his assignments and frequently tells his teachers that he forgets about them. In addition, he tends to have a difficult time sitting still in class and frequently disrupts the other children. This behavior has been going on for about 8 months, but recently it worsened prompting his teacher to bring it to his mother’s attention. The patient’s mother was surprised to hear about these issues; however, she admits that she needs to repeat herself several times when asking her son to complete his chores. He also has trouble sitting still when doing homework. Which of the following is the most likely diagnosis in this patient?"
},
{
"role": "assistant",
"content": "Attention deficit hyperactivity disorder"
}
] |
[
{
"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, METHOD, RESULTS. Meshes: Acute Disease, Adult, Aged, Aged, 80 and over, Brain, Cerebral Infarction, Contrast Media, Diffusion, Echo-Planar Imaging, Female, Gadolinium DTPA, Humans, Image Enhancement, Male, Middle Aged, Neurologic Examination, Sensitivity and Specificity."
},
{
"role": "user",
"content": "Diffusion-weighted imaging of cerebral infarctions: are higher B values better? Context: The purpose of this work is to determine whether high -value ( = 3,000 s/mm ) diffusion-weighted (DW) imaging is superior to low -value ( = 1,000 s/mm ) DW imaging for the detection of cerebral infarctions older than 6 h. Echo planar DW imaging was performed at 1.5 T in 26 consecutive patients (mean age 66 years) referred for clinical diagnosis of definite acute/subacute cerebral infarction (6 h to 14 days old). The DW imaging sequences were performed using matched parameters (TR = 10,000 ms, TE (eff)= 97 ms, FOV = 24 cm, 128 x 192 matrix, slice = 5 mm, NEX = 2) with values of 1,000 and 3,000 s/mm. Areas of infarction were compared visually by two experienced neuroradiologists. Quantitative measures of MR signal and noise levels in the infarcted areas compared with contralateral normal brain were also obtained. The median time after infarction was 2.5 days (range 10 h to 14 days). By visual inspection, all infarctions were reliably identified on both the = 1,000 and the = 3,000 images. The gross signal ratio (infarct/normal brain) was approximately 33% higher in the = 3,000 images, but the = 3,000 images were rated as noticeably \"noisier\" by both observers in every case. This visual observation was confirmed quantitatively: The signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were 70% and 51% higher in the = 1,000 than the = 3,000 images (p<0.0005 for both)."
},
{
"role": "assistant",
"content": "For the evaluation of late acute/subacute cerebral infarctions, high -value ( = 3,000 s/mm(2) ) DW imaging offers no apparent diagnostic advantages compared with = 1,000 images and is significantly inferior in terms of SNR and CNR."
}
] |
[
{
"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, Blood Glucose, Blood Pressure, Body Mass Index, C-Peptide, Cohort Studies, Fasting, Glucose Tolerance Test, Humans, Insulin, Islets of Langerhans, Male, Models, Biological, Reference Values, Risk Factors, Smoking."
},
{
"role": "user",
"content": "Does loss of beta cell function as fasting glucose increase in the non-diabetic range? Context: Our aim was to define the level of glycaemia at which pancreatic insulin secretion, particularly first-phase insulin release, begins to decline. Plasma glucose and insulin concentrations were measured during an IVGTT in 553 men with non-diabetic fasting plasma glucose concentrations. In 466 of the men C-peptide was also estimated. IVGTT insulin secretion in first and late phases was assessed by: (i) the circulating insulin response; (ii) population parameter deconvolution analysis of plasma C-peptide concentrations; and (iii) a combined model utilising both insulin and C-peptide concentrations. Measurements of insulin sensitivity and elimination were also derived by modelling analysis. As fasting plasma glucose (FPG) increased, IVGTT first-phase insulin secretion declined by 73%, 71% and 68% for the three methods respectively. The FPG values at which this decline began, determined by change point regression, were 4.97, 5.16 and 5.42 mmol/l respectively. The sensitivity of late-phase insulin secretion to glucose declined at FPG concentrations above 6.0 mmol/l. Insulin elimination, but not insulin sensitivity, varied with FPG."
},
{
"role": "assistant",
"content": "The range of FPG over which progressive loss of the first-phase response begins may be as low as 5.0 to 5.4 mmol/l, with late-phase insulin responses declining at FPG concentrations above 6.0 mmol/l. 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, MATERIALS AND METHODS, RESULTS. Meshes: Aged, Carcinoma, Non-Small-Cell Lung, Diffusion Magnetic Resonance Imaging, Female, Fluorodeoxyglucose F18, Humans, Lung Neoplasms, Male, Metabolic Clearance Rate, Multimodal Imaging, Positron-Emission Tomography, Radiopharmaceuticals, Reproducibility of Results, Sensitivity and Specificity, Tomography, X-Ray Computed."
},
{
"role": "user",
"content": "Diffusion weighted MRI and 18F-FDG PET/CT in non-small cell lung cancer (NSCLC): does the apparent diffusion coefficient (ADC) correlate with tracer uptake (SUV)? Context: To investigate the potential correlation of the apparent diffusion coefficient assessed by diffusion-weighted MRI (DWI) and glucose metabolism determined by the standardized uptake value (SUV) at 18F-FDG PET/CT in non-small cell lung cancer (NSCLC). 18F-FDG PET/CT and DWI (TR/TE, 2000/66 ms; b-values, 0 and 500 s/mm(2)) were performed in 41 consecutive patients with histologically verified NSCLC. Analysing the PET-CT data calculation of the mean (SUV(mean)) and maximum (SUV(max)) SUV was performed. By placing a region-of-interest (ROI) encovering the entire tumor mean (ADC(mean)) and minimum ADC (ADC(min)) were determined by two independent radiologists. Results of 18F-FDG PET-CT and DWI were compared on a per-patient basis. For statistical analysis Pearson's correlation coefficient, Bland-Altman and regression analysis were assessed. Data analysis revealed a significant inverse correlation of the ADC(min) and SUV(max) (r=-0.46; p=0.032). Testing the correlation of the ADC(min) and SUV(max) for each histological subtype separately revealed that the inverse correlation was good for both adenocarcinomas (r=-0.47; p=0.03) and squamouscell carcinomas (r=-0.71; p=0.002), respectively. No significant correlation was found for the comparison of ADC(min) and SUV(mean) (r=-0.29; p=0.27), ADC(mean) vs. SUV(mean) (r=-0.28; p=0.31) or ADC(mean) vs. SUV(max) (r=-0.33; p=0.23). The κ-value of 0.88 indicated a good agreement between both observers."
},
{
"role": "assistant",
"content": "This preliminary study is the first to verify the relation between the SUV and the ADC in NSCLC. The significant inverse correlation of these two quantitative imaging approaches points out the association of metabolic activity and tumor cellularity. Therefore, DWI with ADC measurement might represent a new prognostic marker in NSCLC."
}
] |
[
{
"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: Antibodies, Antinuclear, Arthritis, Rheumatoid, Autoantibodies, Humans, Interleukin-17, Mast Cells, Osteoarthritis, Synovial Membrane."
},
{
"role": "user",
"content": "Are mast cells the main interleukin 17-positive cells in anticitrullinated protein antibody-positive and -negative rheumatoid arthritis and osteoarthritis synovium? Context: Mast cells have been implicated to play a functional role in arthritis, especially in autoantibody-positive disease. Among the cytokines involved in rheumatoid arthritis (RA), IL-17 is an important inflammatory mediator. Recent data suggest that the synovial mast cell is a main producer of IL-17, although T cells have also been implicated as prominent IL-17 producers as well. We aimed to identify IL-17 expression by mast cells and T cells in synovium of arthritis patients. Synovial samples of anticitrullinated protein antibody-positive (ACPA+) and ACPA-negative (ACPA-) RA and osteoarthritis (OA) patients were stained for IL-17 in combination with CD117 (mast cells), CD3 (T cells) and CD68 (macrophages). Concentrations of IL-17 in synovial fluid were determined by ELISA. The number of IL-17+ cells in synovium was comparable in all groups. Although the vast majority of IL-17+ cells are mast cells, no difference in the percentage of IL-17+ mast cells was observed. Nonetheless, levels of IL-17 in synovial fluid were increased in ACPA+ RA patients compared to ACPA- RA and OA patients."
},
{
"role": "assistant",
"content": "The synovial mast cell is the main IL-17+ cell in all three arthritis groups analyzed. These data are relevant for studies aimed at blocking IL-17 in the treatment of 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: BACKGROUND, METHODS, RESULTS. Meshes: Aging, Animals, Behavior, Animal, Cognition Disorders, Down-Regulation, Electrodes, Gene Expression Profiling, Male, Maze Learning, Oligonucleotide Array Sequence Analysis, Parietal Lobe, Rats, Rats, Inbred F344, Sleep Stages, Telemetry, Up-Regulation."
},
{
"role": "user",
"content": "Are deep sleep and parietal cortex gene expression changes related to cognitive deficits with age? Context: Age-related cognitive deficits negatively affect quality of life and can presage serious neurodegenerative disorders. Despite sleep disruption's well-recognized negative influence on cognition, and its prevalence with age, surprisingly few studies have tested sleep's relationship to cognitive aging. We measured sleep stages in young adult and aged F344 rats during inactive (enhanced sleep) and active (enhanced wake) periods. Animals were behaviorally characterized on the Morris water maze and gene expression profiles of their parietal cortices were taken. Water maze performance was impaired, and inactive period deep sleep was decreased with age. However, increased deep sleep during the active period was most strongly correlated to maze performance. Transcriptional profiles were strongly associated with behavior and age, and were validated against prior studies. Bioinformatic analysis revealed increased translation and decreased myelin/neuronal pathways."
},
{
"role": "assistant",
"content": "The F344 rat appears to serve as a reasonable model for some common sleep architecture and cognitive changes seen with age in humans, including the cognitively disrupting influence of active period deep sleep. Microarray analysis suggests that the processes engaged by this sleep are consistent with its function. Thus, active period deep sleep appears temporally misaligned but mechanistically intact, leading to the following: first, aged brain tissue appears capable of generating the slow waves necessary for deep sleep, albeit at a weaker intensity than in young. Second, this activity, presented during the active period, seems disruptive rather than beneficial to cognition. Third, this active period deep sleep may be a cognitively pathologic attempt to recover age-related loss of inactive period deep sleep. Finally, therapeutic strategies aimed at reducing active period deep sleep (e.g., by promoting active period wakefulness and/or inactive period deep sleep) may be highly relevant to cognitive function in the aging community. 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: Adiposity, Adolescent, Anthropometry, Autonomic Nervous System Diseases, Blood Pressure, Body Composition, Child, Cross-Sectional Studies, Female, Heart Conduction System, Heart Rate, Humans, Hypertension, Logistic Models, Male, Obesity, Prehypertension, Puberty."
},
{
"role": "user",
"content": "Is impaired cardiac autonomic nervous system function associated with pediatric hypertension independent of adiposity? Context: We examined whether sympathetic nervous system activity influences hypertension status and systolic blood pressure (SBP) independent of adiposity in youth ranging from normal-weight to severe obesity. We examined the association of heart rate variability (HRV) with hypertension status and SBP among youth (6-18 y old; n = 188; 103 female). Seated SBP was measured using an automated cuff. Prehypertension (SBP percentile ≥ 90th to <95th) and hypertension (SBP percentile ≥ 95th) were defined by age-, sex-, and height-norms. Autonomic nervous system activity was measured using HRV via SphygmoCor MM3 system and analyzed for time- and frequency-domains. Total body fat was measured via dual-energy X-ray absorptiometry. Logistic regression models demonstrated lower values in each time-domain HRV measure and larger low-frequency (LF):high-frequency (HF) ratio to be significantly associated with higher odds of being prehypertensive/hypertensive (11-47% higher odds) independent of total body fat (P < 0.05). In linear regression analysis, lower time-domain, but not frequency-domain, HRV measures were significantly associated with higher SBP independent of total body fat (P < 0.05)."
},
{
"role": "assistant",
"content": "These data suggest that impaired cardiac autonomic nervous system function, at rest, is associated with higher odds of being prehypertensive/hypertensive and higher SBP which may be independent of adiposity in youth. 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: ."
},
{
"role": "user",
"content": "Does dihydrotestosterone modulate endothelial progenitor cell function via RhoA/ROCK pathway? Context: Previous findings indicate that testosterone level is negatively correlated with the incidence and mortality of cardiovascular diseases in men. Endothelial progenitor cells (EPCs) play a critical role in endothelial healing and vascular integrity. This study aimed to examine the effects of dihydrotestosterone (DHT), an active metabolite of testosterone, on human EPC function and investigate the underlying mechanism. EPCs were isolated from peripheral blood of healthy adult males and incubated with a series of concentrations (1, 10, and 100 nmol/L in dimethyl sulfoxide) of DHT for 24 h or with 10 nmol/L DHT for different periods (6, 12, 24, 36, and 48 h). EPC proliferation, migration, and adhesion were determined by MTT assay, modified Boyden chamber assay, and cell counting, respectively. Furthermore, vascular endothelial growth factor (VEGF) production was examined by ELISA, RhoA activity was determined through pull-down assay. The protein level of RhoA was quantified by Western blot analysis. DHT significantly increased the proliferative, migratory, and adhesive abilities of EPCs in a dose- and time-dependent manner and upregulated the levels of VEGF and activated RhoA. However, RhoA inhibitor C3 exoenzyme or ROCK inhibitor Y-27632 significantly inhibited DHT-induced proliferation, migration, and adhesion, as well as VEGF production. Moreover, C3 exoenzyme inhibited the activation of RhoA stimulated by DHT."
},
{
"role": "assistant",
"content": "DHT promotes EPC proliferation, migration, and adhesion activities via RhoA/ROCK pathway. 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: Cells, Cultured, Female, Gene Silencing, Genetic Therapy, Glyceraldehyde-3-Phosphate Dehydrogenases, Humans, Middle Aged, Muscle, Smooth, Vascular, Myocytes, Smooth Muscle, RNA, Small Interfering, Transfection, Vascular Diseases."
},
{
"role": "user",
"content": "Is smooth muscle cell polymeric transfection an efficient alternative to traditional methods of experimental gene therapy? Context: Gene therapy shows promise in the treatment of vascular disease. However, traditional transfection methods commonly used in the laboratory are poorly translatable to in vivo conditions, primarily due to the immune response to viral vectors, the cellular toxicity of chemical transfection, and the technical impracticality of electroporation. Biodegradable polymers have shown promise as a safe, predictable, and nontoxic alternative, relying on endocytosis of synthetic polymeric carriers, which are bioconjugated to the targeted genetic material of choice. However, to date most of the feasibility studies have been exclusively performed in stem cells. Differentiated cell types would be prime targets for therapeutic gene modulation in the prevention of various disease processes. We aim to establish polymeric transfection as a method for gene therapy in cells of vascular origin. Here we compared the efficiency of polymeric transfection with chemical transfection agents routinely used in a laboratory setting in vascular smooth muscle cells. Human aortic smooth muscle cells (HASMC) were transfected with fluorescently labeled GAPDH siRNA or negative control (NC) siRNA. Transfection methods included poly(B-amino ester) polymer (StemFECT) bioconjugates, DharmaFECT2 complexes, and Santa Cruz complexes. Conjugate endocytosis was confirmed by fluorescent microscopy, and GAPDH gene silencing was assayed by qPCR normalized to 18S. Santa Cruz reagent complexes were the least efficient, with the maximum achievable gene silencing using a 9 μL reagent : 70 pmol siRNA/mL complex (59% ± 6%; n = 3). Maximum GADPH gene silencing using DharmaFECT2 was achieved with a 1.5 μL reagent : 100 pmol siRNA/mL complex (19% ± 1% expression versus NC; n = 4). Equivalent silencing was achieved using a comparable StemFECT bioconjugate of 1.3 μL polymer : 100 pmol siRNA/mL (25% ± 3% expression versus NC; n = 4; P = NS versus DharmaFECT2). By increasing the StemFECT bioconjugate to 1.95 μL polymer : 100 pmol siRNA/mL, gene silencing was significantly increased (10% ± 1% expression versus NC; n = 6; P < 0.05 versus DharmaFECT2 and StemFECT 1.3:100)."
},
{
"role": "assistant",
"content": "HASMCs were efficiently transfected using polymeric bioconjugates in a manner comparable to and exceeding other transfection agents routinely used in vitro. This proof of concept establishes polymeric transfection as a viable method for in vitro investigation of differentiated vascular cells. Future studies will expand on this method of gene therapy for ex vivo transfection of whole vessel segments and in vivo transfection in animal models of vascular disease. Our long-term goal is to deliver molecular inhibitors of genes thought to play a role in intimal hyperplasia, restenosis, and vessel graft failure. 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 alcoholic liver failure requires general anaesthesia for surgery. The agent to be used –"
},
{
"role": "assistant",
"content": "The correct answer is Isoflurane is the volatile agent of choice in liver disease as it has the least effect on hepatic blood flow."
}
] |
[
{
"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 hepatitis viruses have significant perinatal transmission?"
},
{
"role": "assistant",
"content": "The correct answer is The hepatitis virus with significant perinatal transmission is Hepatitis - B virus. Hepatitis - C virus may also be transmitted if there are high levels of viremia. Hepatitis B is a DNA virus, it is acquired perinatally from a carrier mother, or later in life from exposure to contaminated blood through shared needles, needle sticks, skin piercing, tattoos or sexual transmission. Infants are infected with hepatitis B at the time of bih. Intrauterine transmission of this virus occur rarely. Ref: Harrisons Internal Medicine, 18th Edition, Chapter 304 ; CURRENT Diagnosis and Treatment: Pediatrics, 20th Edition, Chapter 1"
}
] |
[
{
"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 serum concentration in which of the following human IgG subclasses is maximum?"
},
{
"role": "assistant",
"content": "The correct answer is IgG 1 - 65%, IgG2- 23%. IgG3 -8% IgG4 - 4%"
}
] |
[
{
"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": "This patient presented following a high-speed motor vehicle crash. Which structure has been disrupted?"
},
{
"role": "assistant",
"content": "The correct answer is Answer B. DiaphragmThe elevated right hemidiaphragm suggests traumatic diaphragmatic rupture. The other listed structures appear to be intact. A computed tomographic scan confirmed the diaphragmatic rupture and showed that the dome of the liver had herniated into the right hemithorax."
}
] |
[
{
"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: Adenocarcinoma, Aged, Cell Line, Tumor, Cell Proliferation, Chromosomes, Human, Pair 9, CpG Islands, DNA Methylation, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Staging, Prognosis, Promoter Regions, Genetic, RNA Interference, Receptor-Like Protein Tyrosine Phosphatases, Class 2, Stomach Neoplasms."
},
{
"role": "user",
"content": "Does reduced expression of PTPRD correlate with poor prognosis in gastric adenocarcinoma? Context: PTPRD, encoding protein tyrosine phosphatases receptor type D, is located at chromosome 9p23-24.1, a loci frequently lost in many types of tumors. Recently, PTPRD has been proposed to function as a tumor suppressor gene. The current study aimed to investigate PTPRD expression and its prognostic significance in primary gastric adenocarcinoma. Quantitative real time reverse transcription PCR (qRT-PCR) and western blotting were used to examine PTPRD expression in paired gastric tumourous and paracancerous tissues. Compared with the matched normal gastric mucosa tissues, both the mRNA (P = 0.0138) and protein (P = 0.0093) expression of PTPRD in fresh surgical specimens were significantly reduced. Clinicopathological and prognostic roles of PTPRD in gastric adenocarcinoma were investigated using immunohistochemistry with 513 paraffin-embedded gastric adenocarcinoma tissue blocks. Statistical analysis revealed that reduced PTPRD expression was significantly associated with T stage (P = 0.004), TNM stage (P<0.001) and tumor size (P = 0.003). Furthermore, Kaplan-Meier survival analysis revealed that low expression of PTPRD significantly correlated with poor survival of gastric cancer patients (P<0.001). Cox regression analysis confirmed PTPRD expression as independent predictor of the overall survival of gastric cancer patients. The MTT assay determined the effects of PTPRD on cell proliferation of MGC803 and GES1 cell lines. Restoring PTPRD expression in MGC803 cells significantly inhibited their growth rate. Silencing PTPRD expression by siRNA treatment in GES1 significantly enhanced cell proliferation compared with mock siRNA treatment. Methylation analysis of PTPRD promoter CpG island in 3 primary GC samples showed one case with partial methylation."
},
{
"role": "assistant",
"content": "These results indicated that PTPRD is a candidate tumour suppressor in gastric cancer. Thus, PTPRD may play an important role in gastric tumorigenesis and serve as a valuable prognostic marker of gastric adenocarcinoma. 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, Amoxicillin, Antibiotic Prophylaxis, Clavulanic Acid, Embryo Transfer, Female, Fertilization in Vitro, Humans, Pregnancy, Pregnancy Rate, Prospective Studies."
},
{
"role": "user",
"content": "Is [ Prophylactic antibiotic therapy ( amoxicillin + clavulanic acid ) before embryo transfer for IVF useless . Results of a randomized study ]? Context: We studied the implantation rate during IVF cycles according to the prescription or not of antibiotics. During a 5-month period all the patients aged less than 38 years were randomized into two groups according to an independent personal variable. In group 1 amoxicilline + clavulanic acid 1g/125 mg were administrated from the ovum pick-up day for 6 days. In the group 2 no antibiotic treatment was administered. The two groups were identical for all the criteria (type of stimulation, IVF/ICSI report, indications, average age). The average number of collected oocytes, obtained embryos and transferred embryos was similar in the two groups. The implantation rate per transfer was similar in the two groups (36.9% versus 36.5%; p>0.95). The pregnancy loss rate (biological pregnancy, early and late miscarriages or extra uterine pregnancy) was increased in a non significant manner (p=0.15) in the group with antibiotic: 33.3% (16/48) versus 20.8% (11/53) in the group without antibiotic."
},
{
"role": "assistant",
"content": "This prospective randomised study leads us not to recommend this antibiotic prescription at the time of the embryo transfer during in vitro fertilisation attempt. 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: ."
},
{
"role": "user",
"content": "Does intensive hyperglycemia control reduce postoperative infections after open heart surgery? Context: Diabetes mellitus increases the risk of infections in patients undergoing cardiac surgery. We hypothesized that intensive perioperative hyperglycemia control by intravenous insulin infusion reduces postoperative infections in all patients undergoing open heart surgical procedures. Sixty diabetics patients who underwent CABG operation (Group 1) were compared with fifty-five patients who underwent other cardiac surgery (Group 2) between January 2004 and March 2005. A continuous infusion of insulin was used in all these patients. There were no 30-day mortalities in either group. There was no difference in the incidence of infections between the two groups: in Group 1, 3 (5%) patients were diagnosed to have postoperative infection (superficial sternal wound infections in 1 (1.66%) and lung infection in 2 (3.33%) patients); postoperative infection occurred in only 2 patients (3.63%) in Group 2, 1 superficial sternal wound infections (1.81%) and 1 lung infection (1.81%)."
},
{
"role": "assistant",
"content": "Our analysis indicates that continuous intravenous insulin infusion improves outcome and reduces postoperative infections in patients undergoing CABG as well as those undergoing other cardiac surgery 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": "Serum alkaline phosphate is not rased in -"
},
{
"role": "assistant",
"content": "The correct answer is ALKALINE PHOSPHATASE. Serum alkaline phosphataseis produced by many tissues, especially bone, liver,intestine and placenta and is excreted in the bile. Most of thenormal serum alkaline phosphatase (range 33-96 U/L) isderived from bone. Elevation in the activity of the enzyme canthus be found in diseases of the bone, liver and in pregnancy. Inthe absence of bone disease and pregnancy, an elevatedserum alkaline phosphatase levels generally reflecthepatobiliary disease. The greatest elevation (3 to 10 timesnormal) occurs in biliary tract obstruction. Slight to moderateincrease is seen in parenchymal liver diseases such as inhepatitis and cirrhosis and in metastatic liver disease. It ispossible to distinguish serum hepatic alkaline phosphatasefrom bony alkaline phosphatase by fractionation intoisoenzymes but this is not routinely done. ALP increases in multiple myeloma only when associated with fractures HARSH MOHAN Textbook of pathology 6th edition pg no 595"
}
] |
[
{
"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": "Lamina densa of the gingival basement membrane is rich in"
},
{
"role": "assistant",
"content": "The correct answer is None"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Clinical Competence, Curriculum, Diagnosis-Related Groups, Documentation, Feedback, Female, Hospitals, Teaching, Humans, Internship and Residency, Male, Medical Staff, Hospital, Quality Improvement, Risk Assessment, Severity of Illness Index."
},
{
"role": "user",
"content": "Does real-time feedback to residents with or without attendings improve medical documentation? Context: Teaching resident physicians to appropriately document patient diagnoses in the medical record is critical to ensure accuracy of publicly reported data and to enable quality improvement initiatives. We sought to determine if providing real-time feedback to resident or attending physicians would lead to improved medical documentation. We audited charts to determine if target diagnoses were present and documented. After a baseline data-gathering period, during the intervention period the first author randomly provided feedback to either residents alone or residents plus their attending physicians. Capture rates for targeted diagnoses, total diagnoses documented and coded, severity of illness (SOI), risk of mortality (ROM), and case mix index were compared pre- and postintervention. During the intervention, the proportion of target diagnoses captured increased from 30% to 54% (P<0.001), as did the median (interquartile [IQ] range) number of diagnoses captured (from 11 [IQ range, 8-13]to 12 [IQ range, 9-16], P<0.05). We also achieved significant increases in median (IQ range) SOI scores (from 2 [IQ range, 2-3] to 3 [IQ range, 2-3], P = 0.04) and complication code capture (61% vs 75%, P = 0.01). However, there was no significant increase in ROM, case mix index, or hospital billing. Notifying attending physicians in addition to residents was of no benefit."
},
{
"role": "assistant",
"content": "An educational program based on real-time feedback to resident physicians regarding documentation improved diagnostic capture and SOI scores, but not case mix index or billing at our public, safety net, teaching hospital. Even with enhanced education of resident physicians regarding documentation, other interventions are needed to further improve diagnostic capture."
}
] |
[
{
"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 39-year-old female presents with confusion. Her husband reports that she doesn't know where she is and cannot remember the date. She was recently diagnosed with small cell lung cancer. Vital signs are T 37C, HR 80, BP 120/80 mmHg, RR 14, and O2 sat 99% on room air. She is not orthostatic. Physical examination reveals moist mucous membranes and normal capillary refill. A basic metabolic profile reveals that serum sodium is 129. Regarding this patient's illness, which of the following is true?"
},
{
"role": "assistant",
"content": "Urinary osmolarity will be > 100, and this illness will not correct with saline infusion"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, DESIGN, SUBJECTS AND SETTING, RESULTS. Meshes: Anthropometry, Child Nutrition Disorders, Child, Preschool, Cross-Sectional Studies, Dietary Supplements, Female, Humans, Infant, Male, Mali, Night Blindness, Nutrition Surveys, Prevalence, Treatment Outcome, Vitamin A, Vitamin A Deficiency, Xerophthalmia."
},
{
"role": "user",
"content": "National immunisation days and vitamin A distribution in Mali: has the vitamin A status of pre-school children improved? Context: The impact on vitamin A status of the distribution of vitamin A during national immunisation days (NIDs) has not been well established despite strong promotion by international agencies and donors. Using a pre-post design, the change in prevalence of vitamin A deficiency was examined in pre-school children in Mali. Two cross-sectional surveys were conducted in Mopti region, the first in March 1997 before this strategy was adopted and the second in March 1999, four-and-a-half months after a mass distribution of vitamin A during NIDs. We compared the vitamin A status of children aged 12 to 66 months targeted in 1999 by NIDs with the status of children in the same age group in 1997. Infectious events of the previous two weeks were concurrently recorded. Within the 1999 sample, the status of recipient and non-recipient children was also compared. In 1997, the prevalence of xerophthalmia (defined by the presence of night blindness and/or Bitot spots) was 6.9% (95% confidence interval (CI) 5.1-9.2) and the modified retinol dose response (MRDR) test proved abnormal in 77.8% of 12-66-month-old children (95% CI 68.27-85.17). In 1999 this picture had improved significantly, both for xerophthalmia prevalence, 3.3% (95% CI 2.1-5.2), and abnormal MRDR test response, 63.1% (95% CI 54.25-71.23). The infectious morbidity rates between 1997 and 1999 tended to decrease. No significant improvement was found among children older than those targeted by NIDs. In 1999, children who received vitamin A had a lower risk for xerophthalmia (3.0% for recipients vs. 8.7% for non-recipients) and experienced fewer infectious events."
},
{
"role": "assistant",
"content": "The clinical and biological vitamin A status of pre-school children improved between 1997 and 1999. Mass distribution of vitamin A appears to reduce the occurrence of xerophthalmia and would seem to be associated with a decrease in other related illnesses. Vitamin A supplementation during NIDs should be given a high priority when vitamin A deficiency remains a public health problem."
}
] |
[
{
"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 43-year-old man is brought to the emergency department 25 minutes after being involved in a high-speed motor vehicle collision in which he was a restrained passenger. On arrival, he has shortness of breath and is in severe pain. His pulse is 130/min, respirations are 35/min, and blood pressure is 90/40 mm Hg. Examination shows superficial abrasions and diffuse crepitus at the left shoulder level. Cardiac examination shows tachycardia with no murmurs, rubs, or gallops. The upper part of the left chest wall moves inward during inspiration. Breath sounds are absent on the left. He is intubated and mechanically ventilated. Two large bore intravenous catheters are placed and infusion of 0.9% saline is begun. Which of the following is the most likely cause of his symptoms?"
},
{
"role": "assistant",
"content": "Flail chest"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Alleles, Case-Control Studies, Cholangitis, Sclerosing, Cohort Studies, Colitis, Ulcerative, Female, Genetic Predisposition to Disease, Haplotypes, Humans, Interleukin-2, Interleukins, Liver Cirrhosis, Biliary, Male, Middle Aged, Polymorphism, Single Nucleotide, Young Adult."
},
{
"role": "user",
"content": "Does analysis of IL2/IL21 gene variants in cholestatic liver diseases reveal an association with primary sclerosing cholangitis? Context: The chromosome 4q27 region harboring IL2 and IL21 is an established risk locus for ulcerative colitis (UC) and various other autoimmune diseases. Considering the strong coincidence of primary sclerosing cholangitis (PSC) with UC and the increased frequency of other autoimmune disorders in patients with primary biliary cirrhosis (PBC), we investigated whether genetic variation in the IL2/IL21 region may also modulate the susceptibility to these two rare cholestatic liver diseases. Four strongly UC-associated single nucleotide polymorphisms (SNPs) within the KIAA1109/TENR/IL2/IL21 linkage disequilibrium block were genotyped in 124 PBC and 41 PSC patients. Control allele frequencies from 1,487 healthy, unrelated Caucasians were available from a previous UC association study. The minor alleles of all four markers were associated with a decreased susceptibility to PSC (rs13151961: p = 0.013, odds ratio (OR) 0.34; rs13119723: p = 0.023, OR 0.40; rs6822844: p = 0.031, OR 0.41; rs6840978: p = 0.043, OR 0.46). Moreover, a haplotype consisting of the four minor alleles also had a protective effect on PSC susceptibility (p = 0.0084, OR 0.28). A haplotype of the four major alleles was independently associated with PSC when excluding the patients with concomitant inflammatory bowel disease (p = 0.033, OR 4.18)."
},
{
"role": "assistant",
"content": "The IL2/IL21 region may be one of the highly suggestive but so far rarely identified shared susceptibility loci for PSC and UC. Final Decision: yes"
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, Body Mass Index, Female, Humans, Male, Middle Aged, Patient Readmission, Prognosis, Pyelonephritis, Recurrence, Retrospective Studies, Risk Factors, Treatment Outcome, Ureteroscopes, Ureteroscopy, Urinary Calculi."
},
{
"role": "user",
"content": "Prognostic factors for severe infection after flexible ureteroscopy: Clinical interest of urine culture the day before surgery? Context: The objectives of this study have been to determine prognostic factors for acute pyelonephritis (AP) after flexible ureteroscopy (FU), to assess the frequency of readmission for AP and to study the usefulness of urinalysis the day before surgery. Between 2010 and 2013, 266 patients have had at least one ureteroscopy (n=325). All infectious complications and unplanned readmissions within the month after FU were retrospectively evaluated. Several data have been collected: age, sex, BMI, surgical indication (calculis or tumor), number of previous ureteroscopies, number of previous surgeries for calculis, stones number, size and location, bilateral interventions, operating time, preoperative ureteral stenting, postoperative stenting, hospitalization stay, urine culture the day before surgery (j-1) and prescription of antibiotic therapy the week before FU. Correlation between these variables and acute pyelonephritis (AP) the month following the USSR was tested (StatView 4.5, SAS Institute) (P<0.05 significant). We observed 24 postoperative APs (7.4%), 17 prior to hospital discharge and 7 requiring rehospitalization. In univariate analysis, the significant prognostic factors of postoperative AP have been: stone size (>14 mm) (P=0.03); operating time (70 minutes) (P<0.005); positive day - 1 urine culture (P<0.001); antibiotics treatment the week before FU (P<0.001). In multivariate analysis, antibiotics prescription during the week before USSR remained significant (P<0.002; RR 5.8 [1.9-15])."
},
{
"role": "assistant",
"content": "Acute pyelonephritis requiring unplanned admission after ureteroscopy is a rare complication (2.4%). Urinalysis one day before ureteroscopy could allow early antibiotic therapy and may reduce 63% of unplanned hospital admissions for acute pyelonephritis."
}
] |
[
{
"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": "Shoest acting local anaesthetic"
},
{
"role": "assistant",
"content": "The correct answer is ."
}
] |
[
{
"role": "system",
"content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Absenteeism, Adult, Aged, Australia, Cardiovascular Diseases, Comorbidity, Cost of Illness, Cross-Sectional Studies, Depressive Disorder, Major, Diagnostic and Statistical Manual of Mental Disorders, Disability Evaluation, Female, Health Status Indicators, Humans, Logistic Models, Male, Middle Aged, Occupational Health, Population Surveillance, Surveys and Questionnaires, Task Performance and Analysis, Workplace, World Health Organization."
},
{
"role": "user",
"content": "Is co-morbid depression associated with poor work outcomes in persons with cardiovascular disease ( CVD ) : a large , nationally representative survey in the Australian population? Context: Co-morbid major depressive disorder (MDD) and cardiovascular disease (CVD) is associated with poor clinical and psychological outcomes. However, the full extent of the burden of, and interaction between, this co-morbidity on important vocational outcomes remains less clear, particularly at the population level. We examine the association of co-morbid MDD with work outcomes in persons with and without CVD. This study utilised cross-sectional, population-based data from the 2007 Australian National Survey of Mental Health and Wellbeing (n = 8841) to compare work outcomes of individuals with diagnostically-defined MDD and CVD, MDD but not CVD, CVD but not MDD, with a reference group of \"healthy\" Australians. Workforce participation was defined as being in full- or part-time employment. Work functioning was measured using a WHO Disability Assessment Schedule item. Absenteeism was assessed using the 'days out of role' item. Of the four groups, those with co-morbid MDD and CVD were least likely to report workforce participation (adj OR:0.4, 95% CI: 0.3-0.6). Those with MDD only (adj OR:0.8, 95% CI:0.7-0.9) and CVD only (adj OR:0.8, 95% CI: 0.6-0.9) also reported significantly reduced odds of participation. Employed individuals with co-morbid MDD and CVD were 8 times as likely to experience impairments in work functioning (adj OR:8.1, 95% CI: 3.8- 17.3) compared with the reference group. MDD was associated with a four-fold increase in impaired functioning. Further, individuals with co-morbid MDD and CVD reported greatest likelihood of workplace absenteeism (adj. OR:3.0, 95% CI: 1.4-6.6). Simultaneous exposure to MDD and CVD conferred an even greater likelihood of poorer work functioning."
},
{
"role": "assistant",
"content": "Co-morbid MDD and CVD is associated with significantly poorer work outcomes. Specifically, the effects of these conditions on work functioning are synergistic. The development of specialised treatment programs for those with co-morbid MDD and CVD is required. 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, Aged, Antirheumatic Agents, Arthritis, Rheumatoid, B-Lymphocytes, Female, Humans, Male, Middle Aged, Positron Emission Tomography Computed Tomography, Radioisotopes, Rituximab, Tissue Distribution, Zirconium."
},
{
"role": "user",
"content": "Is b-cell imaging with zirconium-89 labelled rituximab PET-CT at baseline associated with therapeutic response 24 weeks after initiation of rituximab treatment in rheumatoid arthritis patients? Context: B cells are key players in the pathogenesis of rheumatoid arthritis (RA). Although successful in 50-60% of patients with RA, anti-B-cell therapy given as rituximab could be more efficient by identifying potential responders prior to treatment. Positron emission tomography (PET) using radiolabeled rituximab for B-cell imaging might provide the means to fulfil this unmet clinical need. The objective of this study was to investigate the association between biodistribution of zirconium-89 ( We included 20 patients with RA who were starting rituximab treatment. At the first intravenous (i.v.) therapeutic dose, patients were also injected with PET-positive hand joints (range 1-20) were observed in 18/20 patients. Responders had significantly higher "
},
{
"role": "assistant",
"content": "Non-invasive B-cell imaging by 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": "Least reabsorption out of the following in the Nephron is -"
},
{
"role": "assistant",
"content": "The correct answer is Renal handling of various plasma constituents in a normal adult human on an average diet."
}
] |
[
{
"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: Analysis of Variance, Animals, Animals, Newborn, Brain, Cells, Cultured, Cytokines, Enzyme-Linked Immunosorbent Assay, Gene Expression Regulation, Humans, Leukocyte Common Antigens, Mice, Mice, Inbred C57BL, Mice, Knockout, Microglia, Nucleocytoplasmic Transport Proteins, Protein Biosynthesis, Receptors, IgG, Signal Transduction, Time Factors, alpha-Synuclein."
},
{
"role": "user",
"content": "Is the gamma chain subunit of Fc receptors required for alpha-synuclein-induced pro-inflammatory signaling in microglia? Context: The protein alpha-synuclein (α-SYN), which is found in the Lewy bodies of dopamine-producing (DA) neurons in the substantia nigra (SN), has an important role in the pathogenesis of Parkinson's disease (PD). Previous studies have shown that neuroinflammation plays a key role in PD pathogenesis. In an AAV-synuclein mouse model of PD, we have found that over-abundance of α-SYN triggers the expression of NF-κB p65, and leads to microglial activation and DA neurodegeneration. We also have observed that Fcγ receptors (FcγR), proteins present on the surface of microglia that bind immunoglobulin G (IgG) and other ligands, are key modulators of α-SYN-induced neurodegeneration. In order to study the role of FcγRs in the interactions of α-SYN and microglia, we treated the primary microglial cultures from wild-type (WT) and FcγR-/- mice with aggregated human α-SYN in vitro. Using immunocytochemistry, we found that α-SYN was taken up by both WT and FcγR-/- microglia, however, their patterns of internalization were different, with aggregation in autophagosomes in WT cells and more diffuse localization in FcγR-/- microglia. In WT microglia, α-SYN induced the nuclear accumulation of NF-κB p65 protein and downstream chemokine expression while in FcγR-/- mouse microglia, α-SYN failed to trigger the enhancement of nuclear NF-κB p65, and the pro-inflammatory signaling was reduced."
},
{
"role": "assistant",
"content": "Our results suggest that α-SYN can interact directly with microglia and can be internalized and trafficked to autophagosomes. FcγRs mediate this interaction, and in the absence of the gamma chain, there is altered intracellular trafficking and attenuation of pro-inflammatory NF-κB signaling. Therefore, blocking either FcγR signaling or downstream NF-κB activation may be viable therapeutic strategies in PD. Final Decision: yes"
}
] |