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[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "During a clinical study examining the diffusion of gas between the alveolar compartment and the pulmonary capillary blood, men between the ages of 20 and 50 years are evaluated while they hold a sitting position. After inhaling a water-soluble gas that rapidly combines with hemoglobin, the concentration of the gas in the participant's exhaled air is measured and the diffusion capacity is calculated. Assuming that the concentration of the inhaled gas remains the same, which of the following is most likely to increase the flow of the gas across the alveolar membrane?" }, { "role": "assistant", "content": "Treadmill exercise" } ]

[ { "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": "Pain in absolute glaucoma is best relieved by: March 2004" }, { "role": "assistant", "content": "The correct answer is Ans. A i.e. Retrobulbar injection of steroid" } ]

[ { "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: Disease Progression, Head and Neck Neoplasms, Hemochromatosis, Humans, Iron, Up-Regulation." }, { "role": "user", "content": "Does hemochromatosis enhance tumor progression via upregulation of intracellular iron in head and neck cancer? Context: Despite improvements in treatment strategies for head and neck squamous cell carcinoma (HNSCC), outcomes have not significantly improved; highlighting the importance of identifying novel therapeutic approaches to target this disease. To address this challenge, we proceeded to evaluate the role of iron in HNSCC. Expression levels of iron-related genes were evaluated in HNSCC cell lines using quantitative RT-PCR. Cellular phenotypic effects were assessed using viability (MTS), clonogenic survival, BrdU, and tumor formation assays. The prognostic significance of iron-related proteins was determined using immunohistochemistry. In a panel of HNSCC cell lines, hemochromatosis (HFE) was one of the most overexpressed genes involved in iron regulation. In vitro knockdown of HFE in HNSCC cell lines significantly decreased hepcidin (HAMP) expression and intracellular iron level. This in turn, resulted in a significant decrease in HNSCC cell viability, clonogenicity, DNA synthesis, and Wnt signalling. These cellular changes were reversed by re-introducing iron back into HNSCC cells after HFE knockdown, indicating that iron was mediating this phenotype. Concordantly, treating HNSCC cells with an iron chelator, ciclopirox olamine (CPX), significantly reduced viability and clonogenic survival. Finally, patients with high HFE expression experienced a reduced survival compared to patients with low HFE expression." }, { "role": "assistant", "content": "Our data identify HFE as potentially novel prognostic marker in HNSCC that promotes tumour progression via HAMP and elevated intracellular iron levels, leading to increased cellular proliferation and tumour formation. Hence, these findings suggest that iron chelators might have a therapeutic role in HNSCC management. 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": "Left homonymous hemianopia is seen in which right sided lesion?" }, { "role": "assistant", "content": "The correct answer is Contralateral homonymous hemianopia occurs in retrochiasmal lesions which includes lesions of optic tract, lateral geniculate nucleus,optic radiations. Lesions of the visual pathways at the level of: 1. Optic nerve; 2. Proximal pa of optic nerve; 3. Central chiasma; 4. Lateral chiasma (both sides); 5. Optic tract; 6. Geniculate body; 7. Pa of optic radiations in temporal lobe; 8. Pa of optic radiations in parietal lobe; 9. Optic radiations; 10. Visual coex sparing the macula; 11. visual coex, only macula" } ]

[ { "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, Aged, Analysis of Variance, Bone Density, Estradiol, Humans, Male, Middle Aged, Polymorphism, Genetic, Receptors, Estrogen, Testosterone." }, { "role": "user", "content": "Are serum oestradiol and oestrogen-receptor gene polymorphism associated with bone mineral density independently of serum testosterone in normal males? Context: The physiological effects of oestrogens on bone in men were largely unanticipated until recently, when oestrogen deficiency in males with aromatase deficiency and oestrogen resistance was found to cause osteoporosis and delayed fusion of epiphyses despite sufficient serum testosterone. This raises the possibility that in normal men oestrogens rather than androgens are of physiological importance in bone maturation. In the present study, we examined the association of serum oestradiol (E2) compared to that of free testosterone (FT) with bone mineral density (BMD) in normal men. The effect of oestrogen receptor (ER) gene polymorphism on BMD in men was also addressed. Eighty-one Thai men aged 20-79 years. All were healthy and did not take medication which may affect calcium and bone metabolism. BMD was assessed by DEXA. Dietary calcium was assessed by a 3-day dietary record. Serum E2 and FT concentrations were measured by radioimmunoassay. Polymorphism at intron 1 of the alpha isoform of ER gene was determined by PCR-RFLP. Small p represents the presence of the restriction site while capital P indicates the absence of the restriction site. Serum FT decreased with increasing age (r = -0.58, P < 0.0001) while E2 did not. However, there was a positive association between E2 and FT (r = 0.28, P < 0.05). Serum FT was related to BMD at femoral neck (r = 0.26, P < 0.05) and Ward's triangle (r = 0.30, P < 0.01) while E2 was related to BMD at anteroposterior (AP) lumbar spine (r = 0.29, P < 0.05), femoral neck (r = 0.23, P < 0.05) and femoral trochanter (r = 0.27, P < 0.05). Besides FT and E2, age, body weight, fat mass and fat-free mass were also correlated to BMD at various skeletal sites. Using stepwise multiple linear regression to control for the confounding effects among these factors, fat-free mass was found to be strongly associated with BMD at most skeletal sites. Serum E2 was related to BMD independently of other factors including FT at AP lumbar spine (r = 0.22, P < 0.05), femoral neck (r = 0.26, P < 0.01), femoral trochanter (r = 0.22, P < 0.05) and Ward's triangle (r = 0.26, P < 0.01) while serum FT was not associated with BMD at any site after controlling for E2 and other related factors. Concerning ER alpha gene polymorphism, 27 (33.3%) of the subjects had pp genotype, while 42 (51.9%) and 12 (14.8%) Pp and PP genotypes, respectively. After controlling for age, body weight, fat mass, fat-free mass, calcium intake, FT and E2, the presence of P allele was associated with higher BMD at AP L2-L4 (P < 0.05)." }, { "role": "assistant", "content": "Serum oestradiol is more related to bone mass than free testosterone in normal men. Oestrogen-receptor gene polymorphism is also associated with bone mass in men independently of oestradiol levels. Serum oestradiol together with oestrogen-receptor genotype may partly determine bone mass in males. 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": "Meckel&;s diveiculum is remnant of" }, { "role": "assistant", "content": "The correct answer is It is a congenital diveiculum arising from the terminal ileum and is pa of the unobliterated proximal poion of the vitello intestinal duct..Intestinal endof the vitelline duct may remain patent forming Meckel's diveiculum, which may be attached to umbilicus with a fibrous band. Meckel's diveiculum itself can cause diveiculitis, obstruction. ref:SRB&;S manual of surgery,ed 3,pg no 798" } ]

[ { "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 a non operating dental auxillary:" }, { "role": "assistant", "content": "The correct answer is Classification of dental auxiliaries\n1) Non-operating \n\nDental assistant\nReceptionist\nDental laboratory technician or denturist\nDental health educator\n\n2) Operating\n\nDental nurse\nDental therapist\nDental hygienist" } ]

[ { "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 9 year old female patient has come for a routine dental examination. She is unable to articulate her words properly. General examination reveals muscle weakness and stiffness, irregular gait, uncoordinated and involuntary movements, chewing and swallowing difficulties as well as speech problems. Which of the following reflexes may be absent in this patient?" }, { "role": "assistant", "content": "The correct answer is In many patients with cerebral palsy, certain neonatal reflexes may persist long after the age at which they normally disappear. These primitive reflexes are usually modified or are progressively replaced as the subcortical dominance of the infant’s behavior is suppressed by higher centers of the maturing central nervous system. Three of the most common reactions, which a dentist should recognize, are the following:\n1. Asymmetric tonic neck reflex. If the patient’s head is suddenly turned to one side, the arm and leg on the side to which the face is turned extend and stiffen. The limbs on the opposite side flex.\n2. Tonic labyrinthine reflex. If the patient’s head suddenly falls backward while the patient is supine, the back may assume the position known as postural extension; the legs and arms straighten out, and the neck and back arch.\n3. Startle reflex. This reflex, which is frequently observed in persons with cerebral palsy, consists of sudden, involuntary, often forceful bodily movements.  This reaction is produced when the patient is surprised by stimuli, such as sudden noises or unexpected movements by other people. \nNote: \nParachute reflex appears at 6-9 months and persists throughout life.\nClinical importance: it is either absent or abnormal in spastic form of cerebral palsy." } ]

[ { "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, Antibodies, Antinuclear, Biomarkers, Biopsy, Chi-Square Distribution, Child, Female, Humans, Immunosuppressive Agents, Kidney, Logistic Models, Lupus Nephritis, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Young Adult, snRNP Core Proteins." }, { "role": "user", "content": "Is anti-Sm associated with the early poor outcome of lupus nephritis? Context: We investigated whether anti-Smith (Sm) is associated with the outcome of kidney biopsy-proven lupus nephritis. We retrospectively analyzed clinical, laboratory and histological results in 90 patients with kidney biopsy-proven lupus nephritis. We defined persistent administration of immunosuppressants for more than 3 months after the kidney biopsy as early poor outcome of lupus nephritis. We compared baseline variables and delta values of lupus nephritis-related variables between patients with and without anti-Sm. The independent predictive values for early poor outcome were analyzed using logistic regression analysis. The median age was 32.0 years old, and 77 patients (85.5%) were women. Anti-Sm was found in 44 of 90 patients (48.8%). When we analyzed the differences in delta values of variables reflecting the kidney function or the early poor outcome between patients with and without anti-Sm, we found significant difference in the early poor outcome between the two groups (80.0% of patients having anti-Sm vs. 56.5% of those not having anti-Sm, P = 0.022). In multivariate logistic regression analysis, along with age and Systemic Lupus Erythematosus Disease Activity Index, the presence of anti-Sm increased the potential of the early poor outcome of lupus nephritis (odds ratio 2.870, 95% confidence interval, 1.033, 7.976, P = 0.043)." }, { "role": "assistant", "content": "Our data suggest that anti-Sm identified at kidney biopsy might have a predictive value for the early poor outcome of biopsy-proven lupus nephritis during the follow-up period. 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, METHODS, RESULTS. Meshes: Cancer Care Facilities, Health Services Accessibility, Humans, Neoplasms, Ontario, Regional Medical Programs." }, { "role": "user", "content": "Does a centralized radiotherapy system provide adequate access to care? Context: In the Canadian province of Ontario, all radiotherapy is provided by a centrally managed provincial network of nine cancer centers. The primary goal of this study was to determine whether this highly centralized radiotherapy system provides adequate and equitable access to care for the province's dispersed population. The Ontario Cancer Registry (OCR) was used to identify 295,386 cases of invasive cancer, excluding nonmelanoma skin cancer, which were diagnosed in Ontario between 1984 and 1991. Electronic radiotherapy records from each of the province's radiotherapy centers were linked to the registry at the level of the individual case. The proportion of incident cases treated with radiotherapy was 18.8% at 4 months after diagnosis, 23.7% at 1 year, 25.8% at 2 years, 28.2% at 5 years, and 29.1% at 8 years. These rates of radiotherapy use are much lower than the accepted national and international targets, and lower than rates reported from other jurisdictions. The rate of radiotherapy use at 1 year varied significantly from county to county across Ontario (range, 18.6% to 32.4%; P<10(-6)), and the highest rates were recorded in communities close to radiotherapy centers. There was a common geographic pattern of rate variations among several disease groups, including breast cancer, lung cancer, the genitourinary malignancies, and the gastrointestinal malignancies." }, { "role": "assistant", "content": "The low and uneven rates of radiotherapy use across the province indicate that Ontario's centralized radiotherapy system does not, at present, provide adequate or equitable access to care." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Angioplasty, Balloon, Female, Follow-Up Studies, Humans, Hypertension, Pulmonary, Male, Middle Aged, Pulmonary Artery, Pulmonary Embolism, Regional Blood Flow, Vascular Resistance, Ventricular Dysfunction." }, { "role": "user", "content": "Does balloon Pulmonary Angioplasty improve Biventricular Functions and Pulmonary Flow in Chronic Thromboembolic Pulmonary Hypertension? Context: It remains to be determined whether balloon pulmonary angioplasty (BPA) improves biventricular cardiac functions and pulmonary flow in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We enrolled 30 consecutive patients with inoperable CTEPH who underwent BPA, and carried out serial cardiac magnetic resonance imaging (CMR; M/F, 9/21; median age, 65.2 years). No patient died during the treatment or follow-up period. BPA significantly improved WHO functional class (III/IV, 83.0 to 4.0%), 6-min walking distance (330.2±168.7 to 467.3±114.4 m), mean pulmonary artery pressure (40.8±10.7 to 23.2±4.94 mmHg), pulmonary vascular resistance (9.26±4.19 to 3.35±1.40 WU) and cardiac index (2.19±0.64 to 2.50±0.57 L·min·m(2); all P<0.01). CMR also showed improvement of right ventricular (RV) ejection fraction (EF; 41.3±12.4 to 50.7±8.64%), left ventricular (LV) end-diastolic volume index (72.1±14.0 to 81.6±18.6 ml/m(2)) and LV stroke volume index (41.0±9.25 to 47.8±12.3 ml/m(2); all P<0.01). There was a significant correlation between change in RVEF and LVEF (Pearson's r=0.45, P=0.01). Average velocity in the main pulmonary artery was also significantly improved (7.50±2.43 to 9.79±2.92 cm/s, P<0.01)." }, { "role": "assistant", "content": "BPA improves biventricular functions and pulmonary flow in patients with inoperable CTEPH. (Circ J 2016; 80: 1470-1477). 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": "Neonatal conjunctivitis is caused by all except-" }, { "role": "assistant", "content": "The correct answer is Gonococcus,Chlamydia & Pseudomonas are the common organisms causing Neonatal conjunctivitis Gonococcal infection was considered a serious disease in the past, as it used to be responsible for 50 per cent of blindness in children. Neonatal inclusion conjunctivitis caused by serotypes D to K of Chlamydia trachomatis is the commonest cause of ophthalmia neonatorum in developed countries. Ref: A K KHURANA COMPREHENSIVE OPHTALMOLOGY,E4,page-72 ref img" } ]

[ { "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, Bicycling, Energy Metabolism, Exercise Test, Fatigue, Heart Rate, Humans, Male, Muscle Fatigue, Oxygen Consumption, Physical Endurance, Running, Swimming, Time Factors." }, { "role": "user", "content": "Does cadence selection affect metabolic responses during cycling and subsequent running time to fatigue? Context: To investigate the effect of cadence selection during the final minutes of cycling on metabolic responses, stride pattern, and subsequent running time to fatigue. Eight triathletes performed, in a laboratory setting, two incremental tests (running and cycling) to determine peak oxygen uptake (VO2PEAK) and the lactate threshold (LT), and three cycle-run combinations. During the cycle-run sessions, subjects completed a 30 minute cycling bout (90% of LT) at (a) the freely chosen cadence (FCC, 94 (5) rpm), (b) the FCC during the first 20 minutes and FCC-20% during the last 10 minutes (FCC-20%, 74 (3) rpm), or (c) the FCC during the first 20 minutes and FCC+20% during the last 10 minutes (FCC+20%, 109 (5) rpm). After each cycling bout, running time to fatigue (Tmax) was determined at 85% of maximal velocity. A significant increase in Tmax was found after FCC-20% (894 (199) seconds) compared with FCC and FCC+20% (651 (212) and 624 (214) seconds respectively). VO2, ventilation, heart rate, and blood lactate concentrations were significantly reduced after 30 minutes of cycling at FCC-20% compared with FCC+20%. A significant increase in VO2 was reported between the 3rd and 10th minute of all Tmax sessions, without any significant differences between sessions. Stride pattern and metabolic variables were not significantly different between Tmax sessions." }, { "role": "assistant", "content": "The increase in Tmax after FCC-20% may be associated with the lower metabolic load during the final minutes of cycling compared with the other sessions. However, the lack of significant differences in metabolic responses and stride pattern between the run sessions suggests that other mechanisms, such as changes in muscular activity, probably contribute to the effects of cadence variation on Tmax 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": "Does exercise training improve aerobic endurance and musculoskeletal fitness in female cardiac transplant recipients? Context: Female cardiac transplant recipients' aerobic capacity is 60% lower than sex and age-predicted values. The effect of exercise training on restoring the impaired aerobic endurance and muscle strength in female cardiac transplant recipients is not known. This study examined the effect that aerobic and strength training have on improving aerobic endurance and muscle strength in female cardiac transplant recipients. 20 female cardiac transplant recipients (51 +/- 11 years) participated in this investigation. The subjects performed a baseline six-minute walk test and a leg-press strength test when they were discharged following cardiac transplantation. The subjects then participated in a 12-week exercise program consisting of aerobic and lower extremity strength training. Baseline assessments were repeated following completion of the exercise intervention. At baseline, the cardiac transplant recipients' aerobic endurance was 50% lower than age-matched predicted values. The training program resulted in a significant increase in aerobic endurance (pre-training: 322 +/- 104 m vs. post-training: 501 +/- 99 m, p < 0.05) and leg-press strength (pre-training: 48 +/- 16 kg. vs. post-training: 78 +/- 27 kg, p < 0.05)." }, { "role": "assistant", "content": "Aerobic and strength training are effective interventions that can partially restore the impaired aerobic endurance and strength found in female cardiac transplant recipients. 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: Axilla, Drainage, Exudates and Transudates, Fibrin Tissue Adhesive, Humans, Intraoperative Period, Lymph, Lymph Node Excision, Lymphatic Metastasis, Melanoma, Postoperative Complications, Seroma, Single-Blind Method, Skin Neoplasms, Tissue Adhesives." }, { "role": "user", "content": "Does intraoperative application of fibrin sealant reduce the duration of closed suction drainage following radical axillary lymph node dissection in melanoma patients : a prospective randomized trial in 58 patients? Context: Patients suffering from malignant melanoma often require radical lymph node dissection of the axillary nodal basin. The effects of intraoperative application of fibrin sealant following radical axillary lymph node dissection (RALND) on the incidence of postoperative lymphatic secretion are discussed. To study the effect of intraoperatively applied fibrin sealant following RALND a randomized patient-blinded trial was carried out. Fifty-eight patients with axillary lymph node metastases of malignant melanoma underwent therapeutic RALND and were randomized into two groups: 29 patients received 2 cc of fibrin glue intraoperatively and 29 patients were only irrigated with 0.9% saline. The amount of drainage was recorded every 24 h. The main outcome criterion was the duration of drain placement in the wound. Minor criteria were the total amount of fluid and the length of hospital stay. Statistical analysis was performed using Spearman's log-rank correlation and paired t-test. There was no significant difference between the nonfibrin group 5 days (range = 3.6-5.7 days) and the fibrin group 5 days (range = 4.1-8.5 days) (p = 0.701). The total amount of fluid for the nonfibrin group (410 cc, range = 362-727 cc) and that for the fibrin group (503 cc, range = 369-1098 cc) (p = 0.605) and the length of postoperative hospital stay of 6 days (range = 5.4-7) vs. 7 days (range = 5.9-10.7), respectively, were not different between both groups (p = 0.387)." }, { "role": "assistant", "content": "Considering our study results, we cannot recommend the use of 2 cc of fibrin glue intraoperatively in the prevention of lymphatic secretion in patients undergoing RALND for metastatic melanoma. 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": "The fungus with septate hyphae and dichotomous branching is -" }, { "role": "assistant", "content": "The correct answer is Septate hyphae with dichotomous branching into two equal divisions at a regular angle of 45° are typical of Aspergillus.\nMucor and Rhizopus are non-septate (aseptate) and Penicillium has no hyphae (It is yeast like a fungus)." } ]

[ { "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": "Bile acid pool size is?" }, { "role": "assistant", "content": "The correct answer is Bile acids are not present in our diet but are synthesized in the liver by a series of enzymatic steps that represent catabolism of cholesterol. The rate limiting enzyme is 7-alpha-hydroxylase. Bile acids are reabsorbed in the ileum, jejunum and colon. The total size of bile acid pool is 4g. In case of disease of the terminal ileum, the bile acids are not absorbed and lead to active chloride secretions in the colon. This leads to secretory bile acid diarrhea. Cholic acid, chenodeoxycholic acid, and deoxycholic acid constitute more than 95% of biliary bile acids, and viually all biliary bile acids are in the conjugated form. Fecal bile acids are almost entirely unconjugated as a result of bacterial deconjugating enzymes in the colon and consist primarily of the dehydroxylated bile acids, deoxycholic acid, and lithocholic acid" } ]

[ { "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": "Surgical ciliated cyst is often associated with surgeries of the" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Alanine Transaminase, Analysis of Variance, Animals, Aspartate Aminotransferases, Blood Urea Nitrogen, Cholesterol, Creatine Kinase, Creatinine, Enzyme-Linked Immunosorbent Assay, Fatty Acids, Monounsaturated, Fluvastatin, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Indoles, Injections, Intravenous, Interleukin-10, L-Lactate Dehydrogenase, Lipopolysaccharides, Male, Multiple Organ Failure, Nitric Oxide, Rats, Rats, Wistar, Triglycerides, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Does fluvastatin ameliorate endotoxin induced multiple organ failure in conscious rats? Context: Sepsis is a severe inflammatory disorder that may lead to multiple organ failure. Lipopolysaccharide (LPS) is associated with Gram-negative sepsis and can activate monocytes and macrophages to release pro-inflammatory mediators such as tumor necrosis factor-alpha (TNF-alpha), nitric oxide (NO) and anti-inflammatory mediator such as interleukin-10 (IL-10). In this present study, we used fluvastatin, a HMG-CoA reductase inhibitor, to study its effects upon LPS-induced endotoxic shock in conscious rats. The experiments were designed that rats received an intravenous injection of 1mg/kg fluvastatin followed 10min later, by an intravenous injection of 10mg/kg Klebsiella pneumoniae LPS, the latter inducing endotoxic shock amongst conscious rats. Subsequently, the levels of certain biochemical variables and cytokines in serum were then measured during the ensuing 48-h period following sepsis. These included total cholesterol (TCH), triglyceride (TG), blood urea nitrogen (BUN), creatinine (Cre), creatine phosphokinase (CPK), lactic dehydrogenase (LDH), aspartate transferase (GOT), alanine transferase (GPT), tumor necrosis factor-alpha, interleukin-10 and nitric oxide. LPS significantly increased blood TG, BUN, Cre, LDH, CPK, GOT, GPT, TNF-alpha, IL-10 and NO levels but decreased the blood TCH level. Pretreatment of test rats with fluvastatin decreased blood levels of certain markers of organ injury, suppressed the release of TNF-alpha and increased IL-10, and NO levels following LPS treatment. Fluvastatin did not affect the blood TCH and TG level subsequent to the development of sepsis." }, { "role": "assistant", "content": "Pre-treatment with fluvastatin suppresses the release of plasma TNF-alpha, increases plasma IL-10, and NO production, and decreases the levels of markers of organ injury associated with endotoxic shock, so ameliorating LPS-induced organ damage amongst conscious rats. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aged, Coronary Artery Bypass, Female, Heart Arrest, Induced, Heart Injuries, Humans, Male, Middle Aged, ROC Curve, Retrospective Studies, Treatment Outcome." }, { "role": "user", "content": "A retrospective analysis of myocardial preservation techniques during coronary artery bypass graft surgery: are we protecting the heart? Context: Retrograde perfusion into coronary sinus during coronary artery bypass graft (CABG) surgery reduces the need for cardioplegic interruptions and ensures the distribution of cardioplegia to stenosed vessel territories, therefore enhancing the delivery of cardioplegia to the subendocardium. Peri-operative myocardial injury (PMI), as measured by the rise of serum level of cardiac biomarkers, has been associated with short and long-term clinical outcomes. We conducted a retrospective analysis to investigate whether the combination of antegrade and retrograde techniques of cardioplegia delivery is associated with a reduced PMI than that observed with the traditional methods of myocardial preservation. Fifty-four consecutive patients underwent CABG surgery using either antegrade cold blood cardioplegia (group 1, n = 28) or cross-clamp fibrillation (group 2, n = 16) or antegrade retrograde warm blood cardioplegia (group 3, n = 10). The study primary end-point was PMI, evaluated with total area under the curve (AUC) of high-sensitivity Troponin-T (hsTnT), measured pre-operatively and at 6, 12, 24, 48 and 72 hours post-surgery. Secondary endpoints were acute kidney injury (AKI) and inotrope scores, length of intensive care unit (ICU) and hospital stay, new onset atrial fibrillation (AF) and clinical outcomes at 6 weeks (death, non-fatal myocardial infarction, coronary artery revascularization, stroke). There was evidence that mean total AUC of hsTnT was different among the three groups (P = 0.050). In particular mean total AUC of hsTnT was significantly lower in group 3 compared to both group 1 (-16.55; 95% CI: -30.08, -3.01; P = 0.018) with slightly weaker evidence of a lower mean hsTnT in group 3 when compared to group 2 (-15.13; 95% CI -29.87, -0.39; P = 0.044). There was no evidence of a difference when comparing group 2 to group 1 (-1.42,; 95% CI: -12.95, 10.12, P = 0.806)." }, { "role": "assistant", "content": "Our retrospective analysis suggests that, compared to traditional methods of myocardial preservation, antegrade retrograde cardioplegia may reduce PMI in patients undergoing first time CABG surgery." } ]

[ { "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": "Does epstein-Barr virus Latent Membrane Protein LMP1 reduce p53 protein levels independent of the PI3K-Akt pathway? Context: Nasopharyngeal carcinoma (NPC) is an epithelial malignancy, which commonly occurs in Southern China, Taiwan, North Africa and Southeast Asia. Nasopharyngeal carcinoma is strongly associated with Epstein-Barr virus infection. The p53 tumour suppressor protein is rarely mutated in NPC suggesting that the inactivation of p53 pathway in NPC could be due to the presence of EBV proteins. The aim of this work was to determine the effects of EBV proteins namely LMP1 and LMP2A on the expression levels of p53 protein. In this work we found that LMP1, but not LMP2A, decreased p53 protein levels. Overexpression of LMP1 resulted in increased ubiquitination of p53 suggesting that the decreased p53 protein levels by LMP1 was due to increased degradation of the protein. The reduction of p53 protein levels was independent of the PI3K-Akt pathway." }, { "role": "assistant", "content": "LMP1, but not LMP2A, reduced p53 protein levels through the increase in the polyubiquitination of p53 protein and was independent of the PI3K-Akt pathway. 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": "False regarding Endrin" }, { "role": "assistant", "content": "The correct answer is ENDRIN: MOST toxic organochlorine Also known as plant penicillin Has kerosene like smell Resists putrefaction" } ]

[ { "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": "Normal liver histology is seen in -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Gilbe's syndrome; 'b' i.e, Rotor syndrome; 'c' i.e, Crigler Najor syndrome" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, STUDY DESIGN, METHODS, RESULTS. Meshes: Adult, Cohort Studies, Cranial Nerve Neoplasms, Diagnosis, Differential, Facial Nerve Diseases, Female, Hearing Loss, Sensorineural, Humans, Male, Middle Aged, Neurilemmoma, Neuroma, Acoustic, Retrospective Studies, Statistics as Topic." }, { "role": "user", "content": "Is the cause of sensorineural hearing loss in patients with facial schwannomas multifactorial? Context: Facial nerve schwannomas (FNSs) and vestibular nerve schwannomas (VNSs) may occupy similar locations in the internal auditory canal (IAC). Risk factors for hearing loss in patients with FNS are unknown. Similar to VNSs, we hypothesize that the size and location of FNSs do not correlate with hearing loss. Retrospective cohort study and otopathology case review. A single institution retrospective review of all patients diagnosed with FNS was performed. Demographic data, tumor size and location, severity and type of hearing loss, and facial nerve function were analyzed. Otopathologic review of a case of FNS was also performed. Thirty-three patients with FNS were identified. Mean age was 44 years, and 61% (n = 21) were female. Nine patients had tumors involving the IAC facial nerve, whereas 24 had distal tumors without IAC involvement. Eleven patients (33%) had hearing loss, and 55% of patients with sensorineural hearing loss (SNHL) had tympanic segment tumors without IAC involvement. The presence of SNHL was not associated with IAC tumor location (P = 0.21). Maximal dimensions of FNSs were 3 mm to 42 mm, without correlation between size and SNHL severity (r = -0.017, P = 0.926). Otopathologic review of an untreated 5-mm IAC FNS demonstrated disproportionate spiral ganglion and hair cell loss within the ipsilateral cochlea compared to the contralateral ear." }, { "role": "assistant", "content": "Tympanic segment FNS without IAC involvement may result in SNHL. Tumor size is not associated with the presence or severity of SNHL. Otopathologic review suggests degenerative cochlear changes in FNS. Mechanisms for SNHL in schwannomas are likely multifactorial and may be unrelated to cochlear nerve compression." } ]

[ { "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 is one of the mixed dentition analysis" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adenosine Triphosphate, Animals, Antineoplastic Agents, Benzamides, Benzenesulfonates, Binding, Competitive, Cell Proliferation, Humans, Imatinib Mesylate, Inhibitory Concentration 50, Interleukin-3, Mice, Mutation, Niacinamide, Phenylurea Compounds, Piperazines, Proto-Oncogene Proteins c-kit, Proto-Oncogene Proteins c-sis, Pyridines, Pyrimidines, Sorafenib." }, { "role": "user", "content": "Does sorafenib inhibit imatinib-resistant KIT and platelet-derived growth factor receptor beta gatekeeper mutants? Context: Targeting of KIT and platelet-derived growth factor receptor (PDGFR) tyrosine kinases by imatinib is an effective anticancer strategy. However, mutations of the gatekeeper residue (T670 in KIT and T681 in PDGFRbeta) render the two kinases resistant to imatinib. The aim of this study was to evaluate whether sorafenib (BAY 43-9006), a multitargeted ATP-competitive inhibitor of KIT and PDGFR, was active against imatinib-resistant KIT and PDGFRbeta kinases. We used in vitro kinase assays and immunoblot with phosphospecific antibodies to determine the activity of sorafenib on KIT and PDGFRbeta kinases. We also exploited reporter luciferase assays to measure the effects of sorafenib on KIT and PDGFRbeta downstream signaling events. The activity of sorafenib on interleukin-3-independent proliferation of Ba/F3 cells expressing oncogenic KIT or its imatinib-resistant T670I mutant was also tested. Sorafenib efficiently inhibited gatekeeper mutants of KIT and PDGFRbeta (IC(50) for KIT T670I, 60 nmol/L; IC(50) for PDGFRbeta T681I, 110 nmol/L). Instead, it was less active against activation loop mutants of the two receptors (IC(50) for KIT D816V, 3.8 micromol/L; IC(50) for PDGFRbeta D850V, 1.17 micromol/L) that are also imatinib-resistant. Sorafenib blocked receptor autophosphorylation and signaling of KIT and PDGFRbeta gatekeeper mutants in intact cells as well as activation of AP1-responsive and cyclin D1 gene promoters, respectively. Finally, the compound inhibited KIT-dependent proliferation of Ba/F3 cells expressing the oncogenic KIT mutant carrying the T670I mutation." }, { "role": "assistant", "content": "Sorafenib might be a promising anticancer agent for patients carrying KIT and PDGFRbeta gatekeeper mutations. 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": "Colour change in pyrogallol test for air embolism is" }, { "role": "assistant", "content": "The correct answer is Pyrogallol test : - To detect antemoem air embolism - Gas from the hea on addition to pyrogallol solution will change from colourless to brown in presence of free oxygen" } ]

[ { "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: Adenoviridae, Animals, Antibodies, Calcium, Calcium-Binding Proteins, Chickens, Cricetinae, Echocardiography, Genetic Therapy, Genetic Vectors, Heart Failure, Immunization, Passive, Male, Myocardial Contraction, Myocardium, Transduction, Genetic." }, { "role": "user", "content": "Does gene transfer of a phospholamban-targeted antibody improve calcium handling and cardiac function in heart failure? Context: Abnormalities of intracellular calcium handling are widely recognized as a common hallmark of heart failure in animal models and humans. Modifying the interaction of phospholamban (PLB) with the sarcoplasmic reticulum ATPase (SERCA) by PLB mutants improves cardiac function but may also lead to heart failure. In this study we describe the in vivo effects of a new approach to modify the PLB-SERCA interaction using a recombinant, intracellularly expressed chicken-antibody derived protein (PLADP) targeting the cytoplasmic domain of PLB in the cardiomyopathic BIO 14.6 hamster. In vivo gene transfer was performed in 12-14-week-old BIO 14.6 cardiomyopathic hamsters using intracoronary delivery of adenovirus containing the PLADP or the beta-galactosidase (LacZ) gene (8 x 10(9) PFU per animal). A third group was injected with saline (Sham). Echocardiography was performed before and, together with hemodynamic measurements, repeated 4-5 days after gene transfer. Indo-1 calcium transients and myocyte contractility were measured in isolated cardiomyocytes from the BIO 14.6 hamster transfected with the PLADP. Gene expression (LacZ) was found in 54+/-15% of cells throughout the heart without any signs of myocardial inflammation. Echocardiographic and hemodynamic indices of left ventricular function were significantly increased after gene transfer with the PLADP, compared to controls. Measurements of myocyte contractility and calcium transients in isolated cardiac myocytes from BIO 14.6 hamsters revealed improved intracellular calcium handling and contractility." }, { "role": "assistant", "content": "In vivo adenoviral gene transfer with the PLADP resulted in short-term intracellular expression of a PLADP, improving LV function and enhancing myocardial contractility in the failing cardiomyopathic hamster heart. The PLADP enhanced contractility and cardiac function by improving intracellular calcium handling. Expression of antibody-derived protein represents a new approach to modify protein-protein interactions at the cellular level. 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: Alkaloids, Antioxidants, Catharanthus, Oxidative Stress, Phenols, Plant Growth Regulators, Plant Leaves, Plant Roots, Salicylic Acid, Salinity, Salt Tolerance, Sodium Chloride." }, { "role": "user", "content": "Does salicylic acid alter antioxidant and phenolics metabolism in Catharanthus roseus grown under salinity stress? Context: Salicylic acid (SA) acts as a potential non-enzymatic antioxidant and a plant growth regulator, which plays a major role in regulating various plant physiological mechanisms. The effects of salicylic acid (SA; 0.05 mM) on physiological parameters, antioxidative capacity and phenolic metabolism, lignin, alkaloid accumulation in salt stressed Catharanthus roseus were investigated. Catharanthus roseus seeds were grown for two months in a glass house at 27-30°C in sunlight, and then divided into four different groups and transplanted with each group with the following solutions for one month: group I (non-saline control), group II, 100 mM NaCl, group III, 0.05 mM SA, group IV, 100 mM NaCl+0.05 mM SA and to determine the physiological parameters (DW, FW, WC), chlorophyll contents, carotenoid contents, lipid peroxidation, phenolics, lignin, alkaloid and enzymatic assays in each leaf pairs and roots. SA exhibited growth-promoting property, which correlated with the increase of dry weight, water content, photosynthetic pigments and soluble proteins. SA has additive effect on the significant increase in phenylalanine ammonia-lyase (PAL) activity, which is followed by an increase in total soluble phenolics and lignin contents in all leaf pairs and root of C. roseus. SA enhances malondialdehyde content in all leaf pairs and root. The antioxidant enzymes (catalase, glutathione reductase, glutathione-S-tranferase, superoxide dismutase, peroxidase) as well as alkaloid accumulation increased in all treatments over that of non-saline control but the magnitude of increase was found more in root. Further, the magnitude of increase of alkaloid accumulation was significantly higher in 100 mM NaCl, but highly significant was found in presence of 0.05 mM SA and intermediate in presence of both 0.05 mM SA+100 mM NaCl." }, { "role": "assistant", "content": "We concluded that applied SA to salt stress, antioxidant and phenolic metabolism, and alkaloid accumulation were significantly altered and the extent of alteration varied between the SA and salt stress. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "During retinoscopy of a 30 years old male, which cycloplegic is used routinely -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., None of the above o There is no need for cycloplegia as a routine in adults (20-40 years).Cycloplegic in retinoscopyo Cycloplegics are drugs which cause paralysis of ciliary muscles (accommodation) and dilatation ofpupil. The use of cycloplegics is useful in refraction and there are certain situations where they are indicated,o Because of their strong accommodative reserve, very young people (< 16 years) should always be refracted after the use of cyclopleagics : -<5 years of age: - Atropine 1 % ointment is the drug of choice.15 - 20years: - Homatropine (2% drop), cyclopentolate (1% drop) or tropicamide (5%, 10% drop) are used. Atropine must be used if the patient has a convergent squint or has high hypermetropia.o There is no need for cycloplegia as a routine in adults (20-40 years). However cycloplegics are indicated in following situations: -Accommodation is abnormally active (e.g., spasm of accommodation).Objective findings by retinoscopy do not agree with the patient's subjective requirement.Symptoms of accommodative asthenopia are present.If the pupil is small.o If the patient is above 40 years, cycloplegia is rarely necessary. Only mydriatic (10% phenylephrine) may be needed when the pupil is narrow or media is slightly hazy." } ]

[ { "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, Extracellular Fluid, Female, Humans, Kidney Failure, Chronic, Male, Middle Aged, Natriuretic Peptide, Brain, Peptide Fragments, Peritoneal Dialysis, Peritoneal Dialysis, Continuous Ambulatory, Predictive Value of Tests, Prognosis, Prospective Studies, Renal Dialysis." }, { "role": "user", "content": "Are nT-proBNP , fluid volume overload and dialysis modality independent predictors of mortality in ESRD patients? Context: N-terminal fragment of B-type natriuretic peptide (NT-proBNP) is a marker of both fluid volume overload and myocardial damage, and it has been useful as a predictor of mortality in patients with end-stage renal disease (ESRD). It has been suggested that continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and haemodialysis (HD) may have different effects on fluid volume and blood pressure control; however, whether the independent predictive value of NT-proBNP for mortality is preserved when analysed in conjunction with fluid overload and dialysis modality is not clear. A prospective multicentre cohort of 753 prevalent adult patients on CAPD, APD and HD was followed up for 16 months. Plasmatic levels of NT-proBNP, extracellular fluid volume/total body water ratio (ECFv/TBW) and traditional clinical and biochemical markers for cardiovascular damage risk were measured, and their role as predictors of all-cause and cardiovascular mortality was analysed. NT-proBNP level, ECFv/TBW and other cardiovascular damage risk factors were not evenly distributed among the different dialysis modalities. NT-proBNP levels and ECFv/TBW were correlated with several inflammation, malnutrition and myocardial damage markers. Multivariate analysis showed that NT-proBNP levels and ECFv/TBW were predictors of both all-cause and cardiovascular mortality, independently of dialysis modality and the presence of other known clinical and biochemical risk factors." }, { "role": "assistant", "content": "NT-proBNP is a reliable predictor of death risk independently of the effect of dialysis modality on fluid volume control, and the presence of other clinical and biochemical markers recognized as risk factors for all-cause and cardiovascular mortality. NT-pro-BNP is a good predictor of mortality independently of fluid volume overload and dialysis modality. 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 malignancy shows least lymph node involvement:" }, { "role": "assistant", "content": "The correct answer is Ans: c (Glottic cancer) Ref: Dhingra, 3rd ed, p. 372; 4th ed, p. 286No lymphatics in vocal cords so nodal metastasis are practically never seen in cord lesions unless the disease spreads beyond the membraneous cord. SupraglottisGlottisSubglottisSiteEpiglottisAryepiglottic foldArytenoidVentricular bandsVentricles & sacculeTrue vocal cordsAnt.commissurePost.commissureWall of subglottis upto lower border of cricoid cartilageFrequencyLess frequent than glotticMost commonLeast commonNodal metsNodal mets earlyNo lymph node metsNodal mets as common as in supraglottic varietySymptomsOften silent, hoarseness lateHoarsenessStridor" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Child, Child Behavior, Child Rearing, Child, Preschool, Counseling, Domestic Violence, Family, Female, Firearms, Humans, Male, Mass Media, Pediatrics, Physician's Role." }, { "role": "user", "content": "Is office-based counseling about media use, timeouts, and firearm storage effective? Context: The objective of this study was to determine whether patients' families' violence-prevention behaviors would be affected by their primary care practitioner's use of a violence-prevention clinical intervention during the routine well-child examination. In this cluster-randomized, controlled trial (2002-2006), 137 Pediatric Research in Office Settings practices were randomly assigned and initiated patient recruitment for either an office-based violence-prevention intervention or a control group (educational handout on literacy promotion provided). Primary caregivers of children who were aged 2 to 11 years and presented for a well-child visit were surveyed at baseline and 1 and 6 months. Practitioners were trained to (1) review a parent previsit summary regarding patient-family behavior and parental concern about media use, discipline strategies, and children's exposure to firearms, (2) counsel using brief principles of motivational interviewing, (3) identify and provide local agency resources for anger and behavior management when indicated, and (4) instruct patient-families on use of tangible tools (minute timers to monitor media time/timeouts and firearm cable locks to store firearms more safely where children live or play). Main outcomes were change over time in self-reported media use<120 minutes per day, use of timeouts, and use of firearm cable locks. Generalized estimating equation analysis revealed a significant effect at 6 months for decreased media use and safer firearm storage. The intervention group compared with the control group showed an increase in limiting media use to<120 minutes per day. There was no significant effect for timeout use. There was a substantial increase in storing firearms with cable locks for the intervention group versus a decrease for the control group." }, { "role": "assistant", "content": "This randomized, controlled trial demonstrated decreased media exposure and increased safe firearm storage as a result of a brief office-based violence-prevention approach." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "At what level of b-hCG is it that normal pregnancy can be earliest detected by TVS (transvaginal USG)?" }, { "role": "assistant", "content": "The correct answer is Ans. is b, i.e. 1000IU/MLRef Dutta Obs. 7/e, p 642Critical titre of hCG:b-hCG level (mIU/ml)Structure visibleTVS/TAS* 1000-1200Gestational sacTVS* 6000Gestational SacTAS" } ]

[ { "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 related with 'Thanatology' in forensic medicine?" }, { "role": "assistant", "content": "The correct answer is Thanatology deals with death in all its aspects. The word \"death\" denotes the death of a human being. S.46, I.P.C.: Death denotes death of a human being unless the contrary appears from the context. Ref: The Essentials of Forensic Medicine and Toxicology by Dr. K. S. Narayan Reddy, 27th edition, Page 119." } ]

[ { "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": "Japanese Encephalitis is caused by" }, { "role": "assistant", "content": "The correct answer is Transmitted by Culex mosquitoes" } ]

[ { "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, Blood Glucose, DNA Primers, Enzyme Induction, Graft Survival, Heme Oxygenase-1, Humans, Metalloporphyrins, Pancreas Transplantation, Pancreatitis, Postoperative Complications, Rats, Rats, Inbred Lew, Reverse Transcriptase Polymerase Chain Reaction, Transplantation, Homologous, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Does induction of heme oxygenase-1 improve the survival of pancreas grafts by prevention of pancreatitis after transplantation? Context: Ischemia/reperfusion (I/R) injury after pancreas transplantation might result in graft pancreatitis. The role of heme oxygenase-1 (HO-1) in pancreas transplantation and prevention of graft pancreatitis is unknown. We studied the impact of HO-1 induction with cobalt protoporphyrin (CoPP) in experimental pancreas transplantation with moderate (6 hr) and prolonged (20 hr) cold ischemic time (CIT). Donor animals received CoPP 5 mg/kg intraperitoneal at 48 hr or intraperitoneal saline injections in the corresponding control groups before procurement. Harvested grafts were perfused with HTK solution and stored at 4 degrees C. After prolonged CIT, graft survival was 100% with CoPP pretreatment in contrast to only 37.5% without pretreatment. CoPP-pretreated grafts demonstrated an unimpaired endocrine graft function at moderate and prolonged CIT. Serum lipase activity as a sign of exocrine preservation was significantly lower. In addition, morphological architecture was well preserved. CoPP pretreatment markedly increased HO-1 gene expression in donor pancreas (130-fold increase) by means of quantitative reverse transcriptase -polymerase chain reaction. Immunohistochemical examinations showed that the increase of HO-1 on the protein level was related to HO-1-positive donor macrophages in the pancreas grafts. HO-1 overexpression was accompanied by significant decrease of proinflammatory cytokines such as tumor necrosis factor-alpha, interleukin (IL)-2, IL-6, interferon-y, and by significant increase of the anti-inflammatory cytokine IL-10 and less expression of adhesion molecules such as e- and p-selectins." }, { "role": "assistant", "content": "HO-1 is highly inducible in the allograft rat pancreas and associated with a survival benefit and good graft function after transplantation. This study contributes to the beneficial potentials of HO-1 for the prevention of graft pancreatitis. 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, Chronic Disease, Female, Humans, Kidney Diseases, Male, Middle Aged, Multivariate Analysis, Nephrology, New York, Odds Ratio, Outcome and Process Assessment (Health Care), Primary Health Care, Referral and Consultation, Regression Analysis, Retrospective Studies, Time Factors." }, { "role": "user", "content": "Referral to nephrologists for chronic kidney disease care: is non-diabetic kidney disease ignored? Context: Late referral to nephrologists is common and associated with increased morbidity and mortality. We aimed to analyze the prevalence rates, predictors and consequences of late referral to nephrologists by primary care physicians for chronic kidney disease (CKD) care. A retrospective analysis of 204 patients started on dialysis for CKD in two community hospitals between March 2003 and March 2005 was conducted. Relevant clinical and laboratory data were obtained from the patient records of the nephrology clinics and dialysis units. Patients referred in CKD stage 5 (estimated glomerular filtration rate<15 ml/min) were defined as late referral and patients in CKD stage 1-4 (estimated glomerular filtration rate>15 ml/min) as early referral. Forty-five (22%) of the 204 patients were referred late. In the multivariate analysis, non-diabetic kidney disease (odds ratio = 2.46, p = 0.02) and Charlson comorbidity index (odds ratio = 1.17, p = 0.009) were significantly associated with late referral. The late referral group had lower hematocrit and serum calcium levels, and higher serum phosphorus and parathyroid hormone levels than the early referral group (p<or =0.05) at the time of referral. Late referral resulted in less permanent vascular access for initiation of dialysis (p = 0.03). Even though there was twice the number of deaths in the late referral group in 1 year (18 vs. 9%), this was not statistically significant (p = 0.07)." }, { "role": "assistant", "content": "Referring physicians should pay special attention to patients with non-diabetic kidney disease and patients with multiple comorbidities since delayed referral to nephrologists may result in poorer patient-related outcomes. Larger and long-term prospective studies analyzing the long-term consequences of late referral to nephrologists are needed." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, METHODS, METHODS, RESULTS. Meshes: Colonoscopy, Colorectal Neoplasms, Female, Humans, Male, Neoplasm Invasiveness, Predictive Value of Tests, Retrospective Studies." }, { "role": "user", "content": "Does narrow-band imaging magnification predict the histology and invasion depth of colorectal tumors? Context: There are several reports concerning the differential diagnosis of non-neoplastic and neoplastic colorectal lesions by narrow-band imaging (NBI). However, there are only a few NBI articles that assessed invasion depth. To determine the clinical usefulness of NBI magnification for evaluating microvessel architecture in relation to pit appearances and in the qualitative diagnosis of colorectal tumors. A retrospective study. Department of Endoscopy, Hiroshima University, Hiroshima, Japan. A total of 289 colorectal lesions were analyzed: 12 hyperplasias (HP), 165 tubular adenomas (TA), 65 carcinomas with intramucosal to scanty submucosal invasion (M-SM-s), and 47 carcinomas with massive submucosal invasion (SM-m). Lesions were observed by NBI magnifying endoscopy and were classified according to microvessel features and pit appearances: type A, type B, and type C. Type C was divided into 3 subtypes (C1, C2, and C3), according to the detailed NBI magnifying findings of pit visibility, vessel diameter, irregularity, and distribution. These were compared with histologic findings. Histologic findings of HP and TA were seen in 80.0% and 20.0%, respectively, of type A lesions. TA and M-SM-s were found in 79.7% and 20.3%, respectively, of type B lesions. TA, M-SM-s, and SM-m were found in 21.6%, 29.9%, and 48.5, respectively, of type C lesions. HPs were observed significantly more often than TAs in type A lesions, TAs were observed significantly more often than carcinomas in type B lesions, carcinomas were observed significantly more often than TAs in type C (P < .01). TA, M-SM-s, and SM-m were found in 46.7%, 42.2%, and 11.1% of type C1 lesions, respectively. M-SM-s and SM-m were found in 45.5% and 54.5%, respectively, of type C2 lesions. SM-m was found in 100% of type C3 lesions. TAs and M-SM-s were observed significantly more often than SM-m in type C1 lesions, and SM-m were observed significantly more often than TAs and M-SM-s in type C3 lesions (P < .01)." }, { "role": "assistant", "content": "NBI magnification findings of colorectal lesions were associated with histologic grade and invasion depth. 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 hepatotoxic anti TB drug 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": "This finding is seen in" }, { "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: OBJECTIVE, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Does long-term spatial memory and morphological changes in hippocampus of Wistar rats exposed to smoke from Carica papaya leave? Context: To investigate the effects of smoking of dried leaves of Carica papaya (pawpaw) based on ethnopharmacological information which indicated that smoking of papaya leaves could influence motor performance and learning. Twenty-four rats were used for the study, and were grouped into four groups. Groups 1 served as the control (not exposed to papaya leaves smoke), while Groups 2, 3 and 4 were exposed to smoke from 6.25 g, 12.50 g and 18.75 g of dry pawpaw leaves respectively in a smoking chamber twice daily for 21 d with each exposure lasting for 3 min. Lastly, hippocampus was harvested in each group for histological study. The results showed that there were significant (P<0.05) increases in mean of recall latencies of long-term spatial memory in the animal administered the high dose while the other groups had significantly (P<0.05) lower frequencies. Histological investigation showed signs of mild neural degeneration in high dose group and hypochromic appearance of the Nissl substance in all treated groups." }, { "role": "assistant", "content": "In conclusion, the findings from this study has demonstrated that smoking of papaya leaves has the ability to maintain an intact long-term spatial memory at all doses but retrieving such memory is faster with the low and medium dosages. 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: Alkaline Phosphatase, Analysis of Variance, Animals, Bone Marrow Cells, Calcification, Physiologic, Cell Differentiation, Cells, Cultured, Collagen, Female, Mesenchymal Stem Cells, Models, Animal, Osteogenesis, Phenotype, Rats, Rats, Wistar, Tetrazolium Salts, Thiazoles, Triiodothyronine." }, { "role": "user", "content": "Does [ Triiodothyronine increase osteogenic differentiation reduced by age in bone marrow mesenchymal stem cells of female rats ]? Context: To examine if triiodothyronine (T3) increases osteogenic differentiation in bone marrow mesenchymal stem cells (BMMSCs) of adult rats compared with young rats. BMMSCs were cultured in osteogenic medium and distributed into six groups: 1) BMMSCs of young rats; 2) BMMSCs of adult rats; 3, 4, 5 and 6) BMMSCs of adult rats with T3 (0.01, 1, 100 to 1000 nM). We analyzed alkaline phosphatase activity, dimethylthiazol (MTT) conversion, and collagen synthesis at 7, 14, and 21 days, and percentage of cells per field and number of mineralized nodules at 21 days of differentiation. T3 reduced MTT conversion, alkaline phosphatase activity, collagen synthesis, and the synthesis of mineralizalized nodules in at least one of the doses and periods studied (p < 0.05). Values were lower when compared with young and adult rats BMMSCs (p < 0.05) without T3." }, { "role": "assistant", "content": "T3 has a negative effect on the factors involved in osteogenic differentiation of BMMSC from adult rats. 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": "Substrate level phosphorylation is catalysed by" }, { "role": "assistant", "content": "The correct answer is In glycolysis, The enzyme pyruvate kinase transfers a P from phosphoenolpyruvate (PEP) to ADP to form pyruvic acid and ATP Result in step 10. Details: The final step of glycolysis conves phosphoenolpyruvate into pyruvate with the help of the enzyme pyruvate kinase. As the enzyme's name suggests, this reaction involves the transfer of a phosphate group. The phosphate group attached to the 2' carbon of the PEP is transferred to a molecule of ADP, yielding ATP. Again, since there are two molecules of PEP, here we actually generate 2 ATP molecules.Ref: DM Vasudevan, 7th edition, page no: 111" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Most common cause of UTI in a neonate is" }, { "role": "assistant", "content": "The correct answer is Causative agents of UTI:Uncomplicated UTIComplicated UTI*E.coli *Klebsiella*Proteus species*Enterobacter*Staphylococcus saprophyticus*Enterococci *Chlamydia , Neisseria *Ureaplasma, Mycoplasma . Adenovirus *E.coli *Klebsiella*Proteus species*Serratia marcescens*Pseudomonas *Enterococci Staphylococci Ref:Harrison's infectious disease 2nd edition, p296" } ]

[ { "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: Adrenal Glands, Adrenocorticotropic Hormone, Animals, Colitis, Colon, Corticosterone, Dextrans, Glucocorticoids, Intestinal Absorption, Intestinal Mucosa, Male, Peroxidase, Prodrugs, Rats, Rats, Sprague-Dawley." }, { "role": "user", "content": "Does a glucocorticoid prodrug facilitate normal mucosal function in rat colitis without adrenal suppression? Context: Glucocorticoids remain the foundation of therapy for acute ulcerative colitis despite systemic side effects that limit their use. Prodrugs that selectively deliver glucocorticoids to the colon may lower the required dose and side effects. The aim of this study was to assess the efficacy of a newly synthesized glucocorticoid-dextran prodrug. Novel glucocorticoid-dextran prodrug conjugates in which dexamethasone and methylprednisolone were attached to dextran were synthesized using the dicarboxylic acid linkers, succinate and glutarate. The efficacy of the dextran prodrug conjugates and their free glucocorticoids was tested in an acetic acid-induced model of colitis. Repair of the colitis and mucosal function was assessed by measuring net intestinal fluid absorption, macroscopic ulceration, and myeloperoxidase activity. Glucocorticoid toxicity was evaluated by measuring plasma adrenocorticotropic hormone and serum corticosterone levels. The prodrug dexamethasone-succinate-dextran was nine times more potent and dexamethasone-glutarate-dextran three times more potent than free dexamethasone in accelerating mucosal repair. Similarly, methylprednisolone-succinate-dextran was four times more potent than free methylprednisolone. The dextran prodrug conjugates affected adrenocorticotropic hormone and corticosterone levels only at the highest doses in contrast to free dexamethasone and methylprednisolone, which caused marked adrenal suppression at all doses." }, { "role": "assistant", "content": "The results show that recently synthesized glucocorticoid-dextran prodrug conjugates can be administered orally to facilitate mucosal repair in rat colitis without adrenosuppression. 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": "Walls of CT scan rooms are coated with-" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Lead * Lead is the most common agent used in modern constructions (Room design) to offer radiation shielding.* Computed tomography is a special type of x-ray procedure. A1 the precautions are same as X-rays." } ]

[ { "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 33-year-old man visits his psychiatrist with feelings of sadness on most days of the week for the past 4 weeks. He says that he is unable to participate in his daily activities and finds it hard to get out of bed on most days. If he has nothing scheduled for the day, he sometimes sleeps for 10–12 hours at a stretch. He has also noticed that on certain days, his legs feel heavy and he finds it difficult to walk, as though there are bricks tied to his feet. However, he is still able to attend social events and also enjoys playing with his children when he comes home from work. Other than these simple pleasures, he has lost interest in most of the activities he previously enjoyed. Another troubling fact is that he had gained weight over the past month, mainly because he eats so much when overcome by these feelings of depression. His is prescribed a medication to treat his symptoms. Which of the following is the mechanism of action of the drug he was most likely prescribed?" }, { "role": "assistant", "content": "Non-selectively inhibits monoamine oxidase A and B" } ]

[ { "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, Arteriosclerosis, Biopsy, Needle, Cardiovascular Diseases, Cholesterol, Cricetinae, Disease Models, Animal, Female, Flax, Hypercholesterolemia, Immunohistochemistry, Mesocricetus, Ovariectomy, Phytotherapy, Reference Values, Seeds, Sensitivity and Specificity." }, { "role": "user", "content": "Does flaxseed reduce plasma cholesterol and atherosclerotic lesion formation in ovariectomized Golden Syrian hamsters? Context: Dietary modification contributes significantly in reducing cardiovascular disease (CVD) risk factors including lowering cholesterol and atherosclerosis. The purpose of this study was to investigate the effects of flaxseed, a rich source of lignans, alpha-linolenic acid and soluble fiber mucilage, on the prevention of ovariectomy-induced rise in total cholesterol and atherosclerotic lesions. Seventy-two 6-month-old female Golden Syrian hamsters were either ovariectomized (ovx) or sham-operated (sham) and randomly assigned to six groups (n = 12): sham, ovx, or ovx plus either 17beta-estradiol (E(2), 10 microg/kg body weight) or semi-purified diet adjusted for macronutrients and fiber to contain one of the three doses of flaxseed (7.5, 15, or 22.5%) for 120 days. Ovariectomy significantly elevated plasma total-, HDL-, and free-cholesterol concentrations. Similar to estrogen, all doses of flaxseed were effective in preventing the ovx-induced rise in plasma total cholesterol. Triglyceride concentrations were significantly higher in the flax-fed hamsters. There were no significant differences in plasma non-HDL- and esterified-cholesterol among the treatment groups. Ovariectomy also increased the number of hamsters with lesions and the aortic fatty streak area. All three doses of flaxseed reduced the fatty streak area and the incidence of lesions to levels similar to the sham group." }, { "role": "assistant", "content": "The findings of this study show that flaxseed is beneficial in reducing plasma cholesterol and plaque formation induced by ovarian hormone deficiency. 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": "Chromosomal non - disjunction responsible for all except-" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Neurofibromatosis type 1 Nondisjunctiono Nondisjunction is the failure of homologous chromosomes or sister chromatids to separate properly during cell division.o There are three forms of nondisiunction:Failure of a pair of homologous chromosomes to separate in meiosis I.Failure of sister chromatids to separate during meiosis II, andFailure of sister chromatids to separate during mitosis.o Nondisjunction results in daughter cells with abnormal chromosome numbers (aneuploidy).NondisjunctionMonosomyAutosomal trisomySex chromosome aneuploidyUniparental disomyMosiacism# Tumer syndrome (45XO)# Downs syndrome - Trisomy 21# Edwards syndrome - Trisomy 18# Patau syndrome - Trisomy 13# Kleinfelter syndrome# XYY male# Pradderwilli and angleman syndrome# Pallisterkillian syndrome# Hypomelanosis of ito" } ]

[ { "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": "Enlows 'V' principle of growth is found in" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Features of carcinoma penis are all EXCEPT: March 2013" }, { "role": "assistant", "content": "The correct answer is Ans. B i.e. Pagets disease is not a premalignant disease" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Characteristic features of meningioma are all except –" }, { "role": "assistant", "content": "The correct answer is Meningioma is an extra-axial tumor (not intra-axial)." } ]

[ { "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, OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Aphasia, Broca, Female, Humans, Male, Prefrontal Cortex, Speech, Tomography, Emission-Computed, Single-Photon, Transcranial Magnetic Stimulation." }, { "role": "user", "content": "Does prefrontal cortex rTMS enhance action naming in progressive non-fluent aphasia? Context: Progressive non-fluent aphasia (PNFA) is a neurodegenerative disorder that is characterized by non-fluent speech with naming impairment and grammatical errors. It has been recently demonstrated that repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) improves action naming in healthy subjects and in subjects with Alzheimer's disease. To investigate whether the modulation of DLPFC circuits by rTMS modifies naming performance in patients with PNFA. Ten patients with a diagnosis of PNFA were enrolled. High-frequency rTMS was applied to the left and right DLPFC and the sham (i.e. placebo) condition during object and action naming. A subgroup of patients with semantic dementia was enrolled as a comparison group. A repeated-measure anova with stimulus site (sham, left and right rTMS) showed significant effects. Action-naming performances during stimulation of both the left and right DLPFC were better than during placebo stimulation. No facilitating effect of rTMS to the DLPFC on object naming was observed. In patients with a diagnosis of semantic dementia, no effect of stimulation was reported." }, { "role": "assistant", "content": "Our study demonstrated that rTMS improved action naming in subjects with PNFA, possibly due to the modulation of DLPFC pathways and a facilitation effect on lexical retrieval processes. Future studies on the potential of a rehabilitative protocol using rTMS applied to the DLPFC in this orphan disorder are required. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In a male after laparoscopic cholecystectomy, specimen is sent for histopathology which shows carcinoma gallbladder stage Tla. Appropriate management is:" }, { "role": "assistant", "content": "The correct answer is Excision of all po sites Repeat from May 2011" } ]

[ { "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: Brain Diseases, Child, Child, Preschool, Female, Genetic Predisposition to Disease, Humans, Infant, Male, Mutation, Missense, NAV1.1 Voltage-Gated Sodium Channel, NAV1.2 Voltage-Gated Sodium Channel, Seizures, Febrile." }, { "role": "user", "content": "Do missense mutations in sodium channel SCN1A and SCN2A predispose children to encephalopathy with severe febrile seizures? Context: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a childhood encephalopathy following severe febrile seizures. The pathogenesis of AESD is considered to be fever-induced seizure susceptibility and excitotoxicity, which may be caused by sodium channel dysfunction in some cases. Here we studied whether mutations in genes encoding sodium channels, SCN1A and SCN2A, predispose children to AESD. We recruited 92 AESD patients in a nationwide survey of acute encephalopathy in Japan from 2008 to 2011. We collected their genomic DNA samples, and sequenced the entire coding region of SCN1A and SCN2A. Five out of 92 patients (5.4%) had missense mutations either in SCN1A or SCN2A. After a preceding infection with fever, all the patients showed status epilepticus at the onset. Hemiconvulsion-hemiplegia was recognized in three patients during the acute/subacute phase. One patient had taken theophylline for the treatment of bronchial asthma just before the onset of AESD. Familial history was not remarkable except one patient with a SCN1A mutation (G1647S) whose mother had a similar episode of AESD in her childhood. A different substitution (G1674R) at the same amino acid position, as well as two other SCN1A mutations found in this study, had previously been reported in Dravet syndrome. Another SCN1A mutation (R1575C) had been detected in other types of acute encephahlitis/encephalopathy. One patient had SCN2A mutation, F328V, which had previously been reported in Dravet syndrome. Another SCN2A mutation, I172V, was novel. None of the patients were diagnosed with Dravet syndrome or genetic (generalized) epilepsy with febrile seizure plus in the following-up period." }, { "role": "assistant", "content": "Mutations in SCN1A and SCN2A are a predisposing factor of AESD. Altered channel activity caused by these mutations may provoke seizures and excitotoxic brain damage. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVES, PARTICIPANTS AND SETTING, METHODS, RESULTS. Meshes: Adult, Child Behavior, Child, Preschool, Feasibility Studies, Humans, Immunization, Observer Variation, Pain, Parent-Child Relations." }, { "role": "user", "content": "Can behaviour during immunisation be used to identify attachment patterns? Context: Infant attachment is a strong predictor of mental health, and current measures involve placing children into a stressful situation in order to observe how the child uses their primary caregiver to assuage their distress. This study aimed to explore observational correlates of attachment patterns during immunisation. 18 parent-child pairs were included in the study. They were all recruited through a single general medical practice. Infant immunisation videos were observed and coded for parenting behaviours as well as pain promoting and pain reducing strategies. Results were compared between different attachment groups, as measured with the Manchester Child Attachment Story Task. Parents of securely attached children scored higher on positive Mellow Parenting Observational System behaviours, but not at a statistically significant level. Parents of securely attached children were also significantly more likely to engage in pain reducing behaviours (p<0.01) than parents of insecurely attached children." }, { "role": "assistant", "content": "Robust composite measures for attachment informative behaviours in the immunisation situation should be developed and tested in a fully powered study." } ]

[ { "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": "Two months after giving birth to a boy, a 27-year-old woman comes to the physician with her infant for a well-child examination. She was not seen by a physician during her pregnancy. Physical examination of the mother and the boy shows no abnormalities. Laboratory studies show elevated titers of hepatitis B surface antigen in both the mother and the boy. Which of the following statements regarding the infant's condition is most accurate?" }, { "role": "assistant", "content": "Significant elevation of transaminases is not expected" } ]

[ { "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 32-year-old man comes to the physician because of low-grade fever, dry cough, and shortness of breath. His symptoms began 6 days ago while he was on vacation in Thailand where he went to an urgent care clinic and was started on cefuroxime. His temperature is 38.2°C (100.8°F). Physical examination shows decreased breath sounds at bilateral lung bases. An x-ray of the chest shows diffuse patchy infiltrates. Sputum analysis shows numerous neutrophils but no organisms. Giemsa stain shows epithelial cells with cytoplasmic inclusion bodies. This patient's condition did not improve after the initial treatment because of which of the following properties of the most likely causal pathogen?" }, { "role": "assistant", "content": "Lack of peptidoglycan in cell wall" } ]

[ { "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, Autonomic Nervous System, Electrocardiography, Endoscopy, Gastrointestinal, Esophageal pH Monitoring, Esophagitis, Peptic, Female, Follow-Up Studies, Gastroesophageal Reflux, Heart Conduction System, Heart Rate, Humans, Male." }, { "role": "user", "content": "Does cardiac autonomic regulation differentiate reflux disease with and without erosive esophagitis? Context: Impaired autonomic function has been observed in patients with gastroesophageal reflex disease (GERD), but little is known about autonomic function in patients with non-erosive reflux disease (NERD). The objective of this study was to investigate potential differences in autonomic function by means of heart rate variability in GERD patients with and without erosive esophagitis. Thirty-five GERD patients and 20 healthy controls participated in the study. Seventeen subjects with NERD and 18 patients with erosive reflux disease (ERD) were identified based on typical reflux symptoms, endoscopic findings, and 24-h esophageal pH. Spectral analysis of heart rate variability was performed to calculate the low-frequency (LF) band, the high-frequency (HF) band, and the LF/HF ratio. No significant differences were found in age, gender, body mass index, or current tobacco use among the reflux patients and controls. The Helicobacter pylori status and severity of reflux symptoms were similar between the two groups. The HF band power was significantly lower in patients with ERD than in NERD patients (p < 0.01) and controls (p < 0.05). LF band power (%) and LF/HF ratio were significantly lower in the NERD patients compared with ERD patients (p < 0.05) and controls (p < 0.05). There was no statistically significant correlation between any heart rate variability parameter and symptom severity score in either the ERD or NERD group." }, { "role": "assistant", "content": "Patients with ERD and NERD display a similar degree of symptom severity, but the pattern of autonomic function appears to differ between NERD and ERD. 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: Colitis, Ulcerative, Humans, Immunologic Factors, Probiotics, Prognosis, Severity of Illness Index." }, { "role": "user", "content": "Is probiotic mix VSL # 3 effective adjunctive therapy for mild to moderately active ulcerative colitis : a meta-analysis? Context: VSL#3 is a probiotic mix preparation reported to be effective in the treatment of mild to moderately active ulcerative colitis. We aimed to perform a systematic review of the literature and a meta-analysis of studies on its efficacy. The searched databases included PubMed, Scopus, and ScienceDirect. The Mantel-Haenszel method was used to pool the effect- ize across studies, and the odds ratios (ORs) and 95% confidence intervals (CIs) of experiencing a specific outcome were calculated. Five studies with 441 patients were identified. The pooled remission rate was 49.4% (95% CI, 42.7-56.1). Only 3 low risk of bias studies with 319 patients met the inclusion criteria for further analysis. A total of 162 patients received 3.6 × 10 CFU/d VSL#3, and 157 patients received placebo. A total of 95% of patients received concomitant therapies with 5-ASA and/or immunomodulators. The Ulcerative Colitis Disease Activity Index was used to define response and remission. A >50% decrease in the Ulcerative Colitis Disease Activity Index was achieved in 44.6% of the VSL#3-treated patients versus 25.1% of the patients given placebo (P = 0008; OR, 2.793; 95% CI, 1.375-5.676; number needed to treat = 4-5). The response rate was 53.4% in VSL#3-treated patients versus 29.3% in patients given placebo (P < 0001; OR, 3.03; 95% CI, 1.89-4.83; number needed to treat = 3-4). The remission rate was 43.8% in VSL#3-treated patients versus 24.8% in patients given placebo (P = 0007; OR, 2.4; 95% CI, 1.48-3.88; number needed to treat = 4-5). No serious side effects were reported." }, { "role": "assistant", "content": "VSL#3, when added to conventional therapy at a daily dose of 3.6 × 10 CFU/d, is safe and more effective than conventional therapy alone in achieving higher response and remission rates in mild to moderately active ulcerative colitis. 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, SUBJECTS, MAIN OUTCOME MEASURES, RESULTS. Meshes: Adolescent, Body Composition, Body Mass Index, Child, Child, Preschool, Cohort Studies, Dietary Carbohydrates, Dietary Fats, Energy Intake, Female, Humans, Longitudinal Studies, Male, Obesity, Parents, Prospective Studies." }, { "role": "user", "content": "Does fat intake predict adiposity in healthy children and adolescents aged 2--15 y? Context: To investigate the relationship between food energy and macronutrient intake and body fatness assessed up to seven times between 2 and 15 y of age. Prospective, observational study. Generalised linear estimating equations were used to evaluate the longitudinal relationship between body fatness and macronutrient intake. Regression analysis was used to assess whether body fatness at a particular age was predicted by intake at any of the previous ages. Community-based project in Adelaide, South Australia. In all 143--243 subjects from a representative birth cohort of healthy children recruited in 1975 and followed over 15 y. The dependent variables were body mass index (BMI), triceps (TC) and subscapular (SS) skinfolds, expressed as standard deviation (s.d.) scores at each age. The predictor variables were energy-adjusted macronutrient intake and total energy intake, estimated from a 3--4 day diet diary, the previous corresponding measure of body fatness, sex and parental BMI, TC or SS. Across 2--15 y energy-adjusted fat and carbohydrate intakes were respectively directly and inversely related to SS skinfold measures but not to either BMI or TC skinfold. The best predictor of fatness was previous adiposity, with the effect strengthening as the age interval shortened. Parental BMI, maternal SS and paternal TC contributed to the variance of the corresponding measure in children at some but not all ages." }, { "role": "assistant", "content": "The current level of body fatness of the child and parental adiposity are more important predictors than dietary intake variables of risk of children becoming or remaining overweight as they grow." } ]

[ { "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 common risk factor for coronary heart disease except ?" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Cells, Cultured, Enzyme-Linked Immunosorbent Assay, Female, Humans, Interleukin-1, Leukocytes, Mononuclear, Male, Middle Aged, Sjogren's Syndrome, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Are interleukin 1beta and tumour necrosis factor alpha secreting cells increased in the peripheral blood of patients with primary Sjögren 's syndrome? Context: To study systemic alterations of cytokine secreting peripheral blood mononuclear cells (PBMC) in primary Sjögren's syndrome (pSS) and their relation to common clinical and immunological manifestations of this disease. PBMC spontaneously secreting tumour necrosis factor alpha (TNFalpha), interleukin 1beta (IL1beta), and interleukin 6 (IL6) were assessed by enzyme linked immunospot (ELISPOT) analysis in a cohort of 31 patients with pSS fulfilling the modified European classification criteria. Nineteen healthy volunteers served as controls. ELISPOT results were correlated with glandular and extraglandular manifestations and autoantibody titres-that is, rheumatoid factor (RF) isotypes, anti-Ro/SS-A, anti-La/SS-B as determined by an enzyme linked immunosorbent assay (ELISA) technique. The number of TNFalpha and IL1beta secreting cells was significantly higher in patients with pSS than in controls. No differences were detected in the number of IL6 secreting PBMC. Patients with recurrent parotid swelling (RPS) had a significantly increased number of IL1beta secreting PBMC. Moreover, the number of IL1beta secreting PBMC correlated with the disease duration (r(s)=0.479; p<0.01) and with the concentration of IgM RF (r(s)=0.63; p<0.01) and IgG RF (r(s)=0.42; p<0.05). Other autoantibodies did not correlate with cytokine secreting PBMC." }, { "role": "assistant", "content": "The increased systemic secretion of IL1beta and TNFalpha in patients with pSS points to a pathogenic impact of these cytokines in this autoimmune disease. In particular the correlation of IL1beta secreting PBMC with RPS and RF production indicates that IL1beta is a crucial regulator in the development of local and systemic disease manifestations. 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: Bacterial Adhesion, Binding Sites, Lectins, Models, Molecular, Molecular Structure, Neuraminidase, Protein Conformation, Structure-Activity Relationship, Vibrio cholerae, X-Ray Diffraction." }, { "role": "user", "content": "Does crystal structure of Vibrio cholerae neuraminidase reveal dual lectin-like domains in addition to the catalytic domain? Context: Vibrio cholerae neuraminidase is part of a mucinase complex which may function in pathogenesis by degrading the mucin layer of the gastrointestinal tract. The neuraminidase, which has been the target of extensive inhibitor studies, plays a subtle role in the pathology of the bacterium, by processing higher order gangliosides to GM1, the receptor for cholera toxin. We report here the X-ray crystal structure of V. cholerae neuraminidase at 2.3 A resolution. The 83 kDa enzyme folds into three distinct domains. The central catalytic domain has the canonical neuraminidase beta-propeller fold, and is flanked by two domains which possess identical legume lectin-like topologies but without the usual metal-binding loops. The active site has many features in common with other viral and bacterial neuraminidases but, uniquely, has an essential Ca2+ ion which plays a crucial structural role." }, { "role": "assistant", "content": "The environment of the small intestine requires V. cholerae to secrete several adhesins, and it is known that its neuraminidase can bind to cell surfaces, and remain active. The unexpected lectin-like domains possibly mediate this attachment. These bacterial lectin folds represent additional members of a growing lectin superfamily. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Adult, Aged, Atrial Fibrillation, Cardiomyopathy, Hypertrophic, Catheter Ablation, Electrocardiography, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Recurrence, Tachycardia." }, { "role": "user", "content": "Does qTc Interval Prolongation predict Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy? Context: In hypertrophic cardiomyopathy (HCM) patients complicated with atrial fibrillation (AF), catheter ablation has been recommended as a treatment option. Meanwhile, prolongation of QTc interval has been linked to an increased AF incidence in the general population and to poor outcomes in HCM patients. However, whether QTc prolongation predicts arrhythmia recurrence after AF ablation in the HCM population remains unknown. Thirty-nine HCM patients undergoing primary AF ablation were enrolled. The ablation strategy included bilateral pulmonary vein isolation (PVI) for paroxysmal AF (n=27) and PVI plus left atrial roof, mitral isthmus and tricuspid isthmus linear ablations for persistent AF (n=12). Pre-procedural QTc was corrected by using the Bazett's formula. At a 14.8-month follow up, 23 patients experienced atrial tachyarrhythmia recurrence. Recurrent patients had longer QTc than non-recurrent patients (461.0±28.8 ms vs. 434.3±18.2 ms, P=0.002). QTc and left atrial diameter (LAD) were independent predictors of recurrence. The cut-off value of QTc 448 ms predicted arrhythmia recurrence with a sensitivity of 73.9% and a specificity of 81.2%. A combination of LAD and QTc (global chi-squared=13.209) was better than LAD alone (global chi-squared=6.888) or QTc alone (global chi-squared=8.977) in predicting arrhythmia recurrence after AF ablation in HCM patients." }, { "role": "assistant", "content": "QTc prolongation is an independent predictor of arrhythmia recurrence in HCM patients undergoing AF ablation, and might be useful for identifying those patients likely to have a better outcome following the procedure. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Antibodies, Monoclonal, Antilymphocyte Serum, Cross Reactions, Female, Flow Cytometry, Graft Rejection, HLA Antigens, Histocompatibility Testing, Humans, Immunoglobulins, Intravenous, Incidence, Isoantibodies, Kidney Transplantation, Male, Middle Aged, Plasmapheresis, Time Factors, Treatment Outcome." }, { "role": "user", "content": "Does addition of plasmapheresis decrease the incidence of acute antibody-mediated rejection in sensitized patients with strong donor-specific antibodies? Context: The objective of this study was to investigate the effects of desensitization protocols using intravenous Ig with or without plasmapheresis in patients with donor-specific anti-HLA antibodies on prevention of antibody-mediated rejection and downregulation of donor-specific antibodies. Thirty-five complement-dependent cytotoxicity T cell cross-match-negative but complement-dependent cytotoxicity B cell and/or flow cytometry cross-match-positive kidney transplant recipients were treated with high-dosage intravenous Ig plus Thymoglobulin induction treatment. Donor-specific antibody strength was stratified as strong, medium, or weak by Luminex flow beads. Group 1 patients had weak/moderate and group 2 strong donor-specific antibodies Whereas no group 1 patients had acute rejection, 66% of group 2 had acute rejection (44% antibody-mediated rejection, 22% cellular rejection). The protocol was then changed to the addition of peritransplantation plasmapheresis to patients with strong donor-specific antibodies (group 3). This change resulted in a dramatic decrease in the acute rejection rate to 7%. During a median 18 mo of follow-up, patient survival was 100, 100, and 93% and graft survival was 100, 78, and 86% in groups 1, 2, and 3, respectively. During follow-up, 17 (52%) patients lost donor-specific antibodies completely, and 10 (30%) lost some of donor-specific antibodies and/or decreased the strength of existing donor-specific antibodies." }, { "role": "assistant", "content": "These results indicated that in patients with strong donor-specific antibodies, the addition of plasmapheresis to high-dosage intravenous Ig decreases the incidence of acute rejection. The majority of the patients, whether they received intravenous Ig alone or with plasmapheresis, lost their donor-specific antibodies during follow-up. 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": "MicroWick and Microcatheter sustained release devices are used in:" }, { "role": "assistant", "content": "The correct answer is Ans is 'd' i.e. Delivering drug to the round membrane Repeat from Nov 08Micro Wick and Microcatheter are methods of delivery of medications directly to the inner ear.Intratympanic direct therapy for inner ear diseases has several advantages over the conventional systemic and indirect therapy:Increased therapeutic concentrations in the inner ear Reduced side-effectsCan be used when systemic therapy is contraindicatedCan be used when systemic therapy failsIn direct therapy to the inner ear, the drug is delivered at the Round window membrane. Round window membrane separates the middle ear from the inner ear. A large range of substances are able to cross the RWM, including antimicrobials, corticosteroids, anesthetics etc.Delivery methods: Typical intratympanic injection- Drug is administered directly around RWM using injection after a myringotomy. There are several drawbacks of intratympanic injection method i.e. the injected medication may leak down the Eustachian tube, escape out of the external auditory canal, or be sequestered in the middle ear. In order to address these problems, several sustained release vehicles have been developed.Gelfoam method- A dry gelfoam pad can be placed directly in the round window niche. The medication is directly injected over the gelfoam pad.Mechanical sustained release devices- there are 2 devices that are presently used for sustained release of the medication:The Silverstein Micro Wick- It is made of polyvinyl acetate. It's a wick measuring 1x9 mm small enough to fit through a tympanostomy tube. The wick absorbs medication which can be instilled into the external auditory canal by the patient at home and delivers it to the RWM.The Intra Ear Microcatheter- consists of an electronic pump connected to a catheter tip that is placed directly on the RWM. Implantation of the Microcatheter is more invasive and requires the elevation of a tympanomeatal flap.Fully implantable micro pump system- This device is made from pure titanium, polyethylene, and silicone and is designed for life-long implantation in humans. To place the device, a cavity is drilled in the mastoid bone to house the pump and the reservoir system, a procedure that is similar to the one used to place cochlear implants or implantable hearing devices. This device can deliver drugs which require chronic and continuous application." } ]

[ { "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 reciprocal inhibition of antagonistic muscle upon lateral gaze is explained by:" }, { "role": "assistant", "content": "The correct answer is Synergistic & Antagonistic Muscles (Sherrington's Law) Synergistic muscles are those that have the same field of action. Thus, for veical gaze, the superior rectus and inferior oblique muscles are synergists in moving the eye upward. Muscles synergistic for one function may be antagonistic for another. For example, the superior rectus and inferior oblique muscles are antagonists for torsion, the superior rectus causing intorsion and the inferior oblique extorsion. The extraocular muscles, like skeletal muscles, show reciprocal innervation of antagonistic muscles (Sherrington's law). Thus, in dextroversion (right gaze), the right medial and left lateral rectus muscles are inhibited while the right lateral and left medial rectus muscles are stimulated. What is reciprocal innervation? When a stretch reflex occurs, the muscles that antagonize the action of the muscle involved (antagonists) relax. This phenomenon is said to be due to reciprocal innervation. Impulses in the Ia fibers from the muscle spindles of the protagonist muscle cause postsynaptic inhibition of the motor neurons to the antagonists. The pathway mediating this effect is bisynaptic. A collateral from each Ia fiber passes in the spinal cord to an inhibitory interneuron that synapses on a motor neuron supplying the antagonist muscles. Ref: Motley W., Asbury T. (2011). Chapter 12. Strabismus. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e." } ]

[ { "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 presents with right hypochondrium pain. Which of the following investigations should be done:" }, { "role": "assistant", "content": "The correct answer is Ans. (c) USGRef: Bailey 26th ed. H100" } ]

[ { "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, Blood Sedimentation, Carcinoma, Renal Cell, Female, Humans, Japan, Kidney Neoplasms, Male, Middle Aged, Preoperative Care, Prognosis." }, { "role": "user", "content": "Is preoperative erythrocyte sedimentation rate an independent prognostic factor in Japanese patients with localized clear cell renal cell carcinoma? Context: Few studies have examined the prognostic significance of common laboratory variables in Japanese patients with localized clear cell renal cell carcinoma (CCRCC). We evaluate the prognostic significance of preoperative laboratory variables in Japanese patients with localized CCRCC. The study included 110 Japanese patients who were pathologically confirmed as nonmetastatic CCRCC (pT1-3 N0M0) after radical nephrectomy at our institution. We assessed the clinical (including laboratory measurements) and pathological findings, with the survival rates after surgery. Tumor stage and erythrocyte sedimentation rate (ESR) were identified as significant independent prognostic factors of progression-free survival in multivariate analysis. As for the prognostic factors for disease-specific survival, tumor stage and ESR had prognostic significance both in univariate and multivariate analyses. When the analysis was limited to pT1, multivariate analysis showed that only ESR was an independent prognostic factor for disease-specific survival." }, { "role": "assistant", "content": "Preoperative ESR is an independent prognostic factor in Japanese patients with localized CCRCC, especially in patients with pT1. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, MATERIALS AND METHODS, RESULTS. Meshes: Animals, Bone Density, Bone Screws, Female, Mandible, Orthopedic Procedures, Osteogenesis, Osteotomy, Sheep." }, { "role": "user", "content": "Is it possible to shorten the jaws using contraction osteogenesis? Context: This study investigated whether shortening of osteotomized jaws is possible. Nine sheep were used (2 as controls and 7 as experimental subjects). Distraction devices that had previously been activated to 10 mm were fixed to the mandibles of all animals bilaterally and used in reverse as a contraction device. Control and experimental animals were sacrificed at 1 month and 3 months. Bone in the area of contraction was evaluated using radiodensitometry and microscopy. The mandibles were shortened an average of 5.5 mm. Exaggerated bone formation was seen around the osteotomized cortical bone. When histologic slices from experimental animals were examined 1 month after the contraction period, fibrous pseudoarthrosis formation was seen centrally, with hyaline cartilage around it, whereas normal bone formation was seen in the outer part. The hyaline cartilage had turned into normal bone 3 months after the end of contraction." }, { "role": "assistant", "content": "It is possible to shorten bones using contraction osteogenesis." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In a toddler few drops of blood was noticed per rectally. What can be the most probable diagnosis among the conditions given below?" }, { "role": "assistant", "content": "The correct answer is This child is most likely suffering from juvenile polyp. Adenomatous polyposis coli, rectal ulcer and piles are diseases of the adults. Juvenile polyp is a benign, pedunculated and solitary lesion occuring mainly in the rectosigmoid colon. t is usually seen in children between 3 to 5 years of age, and is rare before 1 year. It ususally autoamputates by 15 years. Passage of small amount of bright red blood on a normal or constipated stool is the most common manifestation." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All are true about secretin except" }, { "role": "assistant", "content": "The correct answer is Actions of secretin: Increases bicarbonate-rich pancreatic secretion. Stimulates bile secretion. Potentiates effect of CCK on pancreas. It causes contraction of pyloric sphincter delaying gastric emptying. Ref: Medical physiology, Indu Khurana" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, METHODS, RESULTS. Meshes: Cadaver, Female, Humans, Imaging, Three-Dimensional, Magnetic Resonance Imaging, Male, Mouth Mucosa, Muscle, Skeletal, Neoplasm Staging, Sensitivity and Specificity, Tomography, X-Ray Computed, Tongue, Tongue Neoplasms." }, { "role": "user", "content": "A detailed anatomical assessment of the lateral tongue extrinsic musculature, and proximity to the tongue mucosal surface. Does this confirm the current TNM T4a muscular subclassification? Context: The current T4a subclassification of the TNM staging system for oral malignancies has been criticised as based almost exclusively on anatomical data. The aim of this study was to provide anatomical confirmation of the muscular constraints of T4a classification of oral tongue tumours. A detailed anatomical study describing and measuring the adjacency of the named extrinsic tongue muscles to the lateral tongue surface was completed on the Visible Human Female (VHF). The distance of styloglossus and hyoglossus to the over lying mucosa were determined. The appearance, position, orientation and anatomical relationships of the lateral tongue extrinsic muscles, with comparison to their classical descriptions are described. The right VHF styloglossus was 1.3 mm (0.33-1.48) and left 2.91 mm (0.66-7.68) from the mucosal surface in the axial plane. The right VHF hyoglossus was 2.93 mm (1.48-4.96) and left 4.33 (1.68-8.71) from the mucosal surface in the axial line." }, { "role": "assistant", "content": "In the lateral tongue, styloglossus and hyoglossus are very superficial. The inclusion criteria of hyoglossus and styloglossus in the T4a staging does not appear justified based upon their anatomical position." } ]

[ { "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": "Does meta-analysis reveal an association of STAT4 polymorphism with hepatocellular carcinoma risk? Context: Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related mortality worldwide. Signal transducers and activators of transcription (STAT) proteins play a multitude of important functions in liver pathophysiology. Recent studies have indicated associations of rs7574865 single nucleotide polymorphism (SNP) in the STAT4 gene with various autoimmune diseases. The association between STAT4 polymorphism and the risk of HCC has been analyzed in several studies, but results remain inconsistent. This study used a meta-analysis approach to comprehensively investigate the correlation between STAT4 polymorphism and HCC risk based on previously published literatures. Studies were searched from the database of PubMed, EMBase, Web of Science, and the Chinese National Knowledge Infrastructure up to 31 December 2015. The meta-analysis was conducted based on statement of preferred reporting items for systematic reviews and meta-analyses (PRISMA). Eight published studies, consisting of 7,503 HCC patients (case) and 13,831 without HCC individuals (control), were included in the present study. Meta-analysis of the included studies revealed that STAT4 rs7574865 polymorphism contributed to the risk of HCC under all four genetic models, consisting of the allelic model (G vs T:OR = 1.25; 95%CI = 1.19-1.30), the dominant effect model (GG + GT vs TT: OR = 1.52; 95%CI = 1.26-1.84), the recessive effect model (GG vs GT + TT: OR = 1.35; 95%CI = 1.21-1.50), and the co-dominant effect model (GG vs TT: OR = 1.72; 95%CI = 1.42-2.10) comparisons. No publication bias was indicated from both visualization of the funnel plot and Egger's test." }, { "role": "assistant", "content": "A significantly increased risk of HCC associated with the rs7574865 G was found. The rs7574865 polymorphism might be used as one risk factor for HCC. 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: Age Distribution, Aged, Aged, 80 and over, Cross-Sectional Studies, Databases, Factual, Drug Prescriptions, Female, Humans, Italy, Male, Polypharmacy, Terminal Care." }, { "role": "user", "content": "Advanced Age and Medication Prescription: More Years, Less Medications? Context: In older adults co-occurrence of multiple diseases often leads to use of multiple medications (polypharmacy). The aim of the present study is to describe how prescription of medications varies across age groups, with specific focus on the oldest old. We performed a cross-sectional study using 2013 data from the OsMed Health-DB database (mean number of medicines and defined daily doses prescribed in 15,931,642 individuals). There were 3,378,725 individuals age 65 years or older (21.2% of the study sample). The mean number of prescribed medications progressively rose from 1.9 in the age group<65 years to 7.4 in the age group 80-84 years and then declined, with a more marked reduction in the age group 95 years or older with a mean number of 2.8 medications. A similar pattern was observed for the mean number of defined daily doses. Among participants age ≥65 years, proton pump inhibitors were the most commonly prescribed medication (40.9% of individuals ≥65 years), followed by platelet aggregation inhibitors (32.8%) and hydroxy-methylglutaryl-coenzyme A reductase inhibitors (26.1%). A decline in prescription was observed among individuals age 90 years or older, but this reduction was less consistent for medications used to treat acute conditions (ie, antibiotics and glucocorticoids) rather than preventive medicines commonly used to treat chronic diseases (ie, antihypertensive medications and hydroxy-methylglutaryl-coenzyme A reductase inhibitors)." }, { "role": "assistant", "content": "The burden of medication treatment progressively increases till age 85 and substantially declines after age of 90 years. Patterns of medication prescription widely vary across age groups." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, RESULTS. Meshes: Animals, Autoimmune Diseases, Blood Pressure, Clarithromycin, Heart Rate, Immunohistochemistry, Male, Matrix Metalloproteinase Inhibitors, Myocardial Contraction, Myocarditis, Protein Synthesis Inhibitors, Rats, Rats, Inbred Lew." }, { "role": "user", "content": "Does early treatment with clarithromycin attenuate rat autoimmune myocarditis via inhibition of matrix metalloproteinase activity? Context: Matrix metalloproteinase (MMP) activity is upregulated in the hearts with myocarditis, and its activation contributes to the changes in left ventricular function. A major macrolide antibiotic, clarithromycin (CAM), has many biological functions including MMP regulation. However, little is known about the effect of CAM in myocarditis via MMPs. To clarify the role of MMPs regulated by CAM in the progression of myocarditis. Design CAM was given to experimental rats with autoimmune myocarditis (EAM) from day -7 to day 21 (early treated group, n=6) or from day 1 to day 21 (late treated group, n=6) twice a day. Although the non-treated rats showed blood pressure decline and impaired cardiac function, early CAM treatment prevented this progression. Pathologically, severe myocardial cell infiltration (30.5+/-4.2%) and fibrosis (32.2+/-1.1%) were detected in the non-treated group, while early CAM treatment significantly suppressed these changes (infiltration 6.5+/-0.2%, fibrosis 5.9+/-3.9%). Zymography showed that non-treated EAM resulted in enhanced ventricular activities of MMP-9, while early CAM treatment reduced the alteration. However, late CAM treatment was less effective than the early treatment." }, { "role": "assistant", "content": "Early CAM treatment is effective to attenuate myocarditis by suppressing MMP-9. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In Peck and Peck index, mesiodistal and buccolingual measurements of which of the following tooth is taken:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Drug Administration Routes, Female, Humans, Male, Propiophenones, Psychiatric Status Rating Scales, Regression Analysis, Self Report, Substance-Related Disorders, Young Adult." }, { "role": "user", "content": "Is there any difference in patterns of use and psychiatric symptom status between injectors and non-injectors of mephedrone? Context: In recent years, increasing intravenous mephedrone use was reported in several countries. The aim of this study was to describe the characteristics of such a form of mephedrone use, while identifying the differences between injectors and non-injectors in patterns of mephedrone use and psychiatric symptom status. One hundred and forty-five mephedrone users were surveyed on patterns of mephedrone use using a structured questionnaire as well as the Brief Symptom Inventory. Majority of users received mephedrone from acquaintances and used it in discos/parties settings regarding both first and current mephedrone use. Intranasal use was the most typical route of administration (84.4%). Injectors (11%) used the drug more frequently and in higher dosages. This group included a greater proportion of opiate users (37.5%) and showed more diffuse psychiatric symptoms. Regarding the predictors of being an injector, heroin use showed the highest odds ratio." }, { "role": "assistant", "content": "Intravenous mephedrone use is associated with a higher risk of harmful drug use, elevated psychiatric symptom profile and increased possibility of mephedrone being considered as an addictive substance. These findings might be important in efficient treatment planning." } ]

[ { "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: APACHE, Adult, Aged, Critical Care, Electroencephalography, Female, Hospital Mortality, Humans, Intensive Care Units, Length of Stay, Male, Medicine, Middle Aged, Monitoring, Physiologic, Outcome and Process Assessment (Health Care), Retrospective Studies, Risk Factors, Status Epilepticus." }, { "role": "user", "content": "Management of status epilepticus in neurological versus medical intensive care unit: does it matter? Context: Admission of patients with status epilepticus (SE) to the neurosciences intensive care unit (NICU) may improve management and outcomes compared to general ICUs. We reviewed all patients with SE admitted to the NICU versus the Medical ICU in our institution between 2005 and 2008. We included only patients with definite or probable SE based on pre-defined criteria. We collected demographic and clinical data, including severity of admission scores and adjusted short-term outcomes for admission and management in the two ICUs. There were 168 visits in 151 patients for definite or probable SE, 46 (27 %) of which were in the NICU and 122 (73 %) in the MICU. APACHE II scores were significant higher in the MICU group (17.5 vs 13.4, p = 0.003) and age in the NICU (58.3 vs 51.5 years, p = 0.041). More continuous EEGs were ordered in the NICU (85 vs 30 %, p<0.001), where fewer patients were intubated, but more eventually tracheostomized. The NICU had a higher rate of complex partial SE and more alert or somnolent patients, whereas the MICU had a higher rate of generalized SE and more stuporous or comatose patients. Admission diagnoses also differed, with the NICU having higher rate of strokes and the MICU higher rate of toxometabolic etiologies (39 vs 12 % and 11 vs 21 %, p = 0.002). After adjustment, no difference was found in mortality, the ICU or hospital length of stay and modified Rankin score at discharge." }, { "role": "assistant", "content": "SE treatment revealed increased use of continuous EEG in NICU-admitted patients, but without concomitant reduction in LOS or discharge outcomes compared to the MICU." } ]

[ { "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: Adenocarcinoma, Follicular, Antineoplastic Agents, Carcinoma, Papillary, Cell Line, Tumor, Drug Resistance, Neoplasm, Extracellular Signal-Regulated MAP Kinases, Humans, Indoles, MAP Kinase Signaling System, Oncogene Proteins, Fusion, Protein-Tyrosine Kinases, Proto-Oncogene Proteins, Proto-Oncogene Proteins B-raf, Proto-Oncogene Proteins c-ret, Proto-Oncogene Proteins p21(ras), Pyrroles, Sunitinib, Thyroid Neoplasms, ras Proteins." }, { "role": "user", "content": "Does activation of the RAS/RAF/ERK signaling pathway contribute to resistance to sunitinib in thyroid carcinoma cell lines? Context: Sunitinib is currently being evaluated in advanced human thyroid carcinomas, based on the rationale that the vascular endothelial growth factor and platelet-derived growth factor receptors and the RET/PTC rearrangement are valuable targets for the treatment of this malignancy. However, criteria for selecting thyroid tumors that may benefit from sunitinib are lacking. The effect of activating somatic mutations in the KRAS and BRAF genes on the responsiveness to sunitinib was evaluated in a panel of thyroid cancer cell lines harboring wild-type KRAS and BRAF genes, the RET/PTC1 rearrangement, the G12R KRAS, or the V600E BRAF mutation. Sunitinib was found to selectively inhibit cell proliferation, induce cell accumulation in the G0-G1 phase, and inhibit the phosphorylation of ERK1/2 in both KRAS/BRAF wild-type thyroid cancer cells and in tumor cells harboring the RET/PTC rearrangement, whereas it was completely ineffective in KRAS- or BRAF-mutated thyroid carcinoma cells. This differential antitumor activity of sunitinib did not correlate with the expression profile of the vascular endothelial growth factor receptors 1, 2, and 3, platelet-derived growth factor receptor-α and cKIT genes. Of note, the constitutive activation of RAS/RAF/ERK signaling in KRAS/BRAF wild-type cells by transfection of the R12 HRAS or V600E BRAF mutants or stimulation with epithelial growth factor resulted in the loss of responsiveness to sunitinib, whereas pharmacological inhibition of MAPK kinase activity resulted in the resensitization of KRAS- or BRAF-mutated cells to the multikinase inhibitor." }, { "role": "assistant", "content": "The constitutive activation of the RAS/RAF/ERK pathway may favor resistance to sunitinib in thyroid carcinoma cells. 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: Adrenal Cortex Hormones, Adult, Aged, Aged, 80 and over, Anti-Asthmatic Agents, Asthma, Bronchodilator Agents, Female, Forced Expiratory Volume, Fungi, Humans, Immunoglobulin E, Macrophages, Male, Middle Aged, Phagocytosis, Sputum, Young Adult." }, { "role": "user", "content": "Is isolation of filamentous fungi from sputum in asthma associated with reduced post-bronchodilator FEV1? Context: Fungal sensitization is common in severe asthma, but the clinical relevance of this and the relationship with airway colonization by fungi remain unclear. The range of fungi that may colonize the airways in asthma is unknown. To provide a comprehensive analysis on the range of filamentous fungi isolated in sputum from people with asthma and report the relationship with their clinico-immunological features of their disease. We recruited 126 subjects with a diagnosis of asthma, 94% with moderate-severe disease, and 18 healthy volunteers. At a single stable visit, subjects underwent spirometry; sputum fungal culture and a sputum cell differential count; skin prick testing to both common aeroallergens and an extended fungal panel; specific IgE to Aspergillus fumigatus. Fungi were identified by morphology and species identity was confirmed by sequencing. Four patients had allergic bronchopulmonary aspergillosis. Forty-eight percent of asthma subjects were IgE-sensitized to one fungal allergen and 22% to ≥ 2. Twenty-seven different taxa of filamentous fungi were isolated from 54% of their sputa, more than one species being detected in 17%. This compared with 3 (17%) healthy controls culturing any fungus (P < 0.01). Aspergillus species were most frequently cultured in isolation followed by Penicillium species. Post-bronchodilator FEV (1) (% predicted) in the subjects with asthma was 71(± 25) in those with a positive fungal culture vs. 83 (± 25) in those culture-negative, (P < 0.01)." }, { "role": "assistant", "content": "Numerous thermotolerant fungi other than A. fumigatus can be cultured from sputum of people with moderate-to-severe asthma; a positive culture is associated with an impaired post-bronchodilator FEV (1) , which might be partly responsible for the development of fixed airflow obstruction in asthma. Sensitization to these fungi is also common. 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: Adenosine Diphosphate, Adult, Arginine, Collagen, Female, Gestational Age, Humans, Nitric Oxide, Nitroprusside, Platelet Aggregation, Pregnancy." }, { "role": "user", "content": "Does the L-arginine-nitric oxide system regulate platelet aggregation in pregnancy? Context: To investigate the ex vivo platelet aggregation in response to a substrate (L-arginine [L-Arg]) and a donor (sodium nitroprusside [SN]) of nitric oxide (NO) in nonpregnant women and in normotensive pregnancies. Platelet aggregation was studied with a dual-channel aggregometer and expressed as a percentage of light transmission. Measurements were done at baseline and after preincubation with scalar doses of L-Arg and SN. The intraplatelet L-citrulline (L-Cit) levels were measured by high-performance liquid chromatography (HPLC). In both groups, the baseline aggregation values were similar for adenosine diphosphate (ADP) and collagen stimuli. Wilcoxon rank-sum testing demonstrated that in both groups the addition of L-Arg had a significant effect on aggregation: Doses of 50 to 5000 mumol decreased ADP-induced aggregation. Conversely, collagen-induced aggregation was affected only by the highest dose of L-Arg. Sodium nitroprusside administered in doses of 2.5 to 250.0 nmol decreased ADP- and collagen-induced platelet aggregation equally. ADP-induced aggregation values obtained after (SN) incubation were positively correlated with gestational age. Intraplatelet L-Cit levels showed a significant rise after the incubation with L-Arg, and this effect was negatively correlated with gestational age." }, { "role": "assistant", "content": "The L-Arg-NO system regulates platelet aggregation during pregnancy. Moreover, a physiologic reduction of platelet sensitivity to the antithrombotic effect of NO occurs. 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: Adenocarcinoma, Clear Cell, Animals, Antineoplastic Agents, Cell Line, Tumor, Cisplatin, Drug Resistance, Neoplasm, Everolimus, Female, Humans, Immunosuppressive Agents, Mice, Mice, Nude, Ovarian Neoplasms, Protein Kinases, Proto-Oncogene Proteins c-akt, Sirolimus, TOR Serine-Threonine Kinases, Tissue Array Analysis, Xenograft Model Antitumor Assays." }, { "role": "user", "content": "Is mTOR a promising therapeutic target both in cisplatin-sensitive and cisplatin-resistant clear cell carcinoma of the ovary? Context: Mammalian target of rapamycin (mTOR) plays a central role in cell proliferation and is regarded as a promising target in cancer therapy, including for ovarian cancer. This study aimed to examine the role of mTOR as a therapeutic target in clear cell carcinoma of the ovary, which is regarded as an aggressive, chemoresistant histologic subtype. Using tissue microarrays of 98 primary ovarian cancers (52 clear cell carcinomas and 46 serous adenocarcinomas), the expression of phospho-mTOR was assessed by immunohistochemistry. Then, the growth-inhibitory effect of mTOR inhibition by RAD001 (everolimus) was examined using two pairs of cisplatin-sensitive parental (RMG1 and KOC7C) and cisplatin-resistant human clear cell carcinoma cell lines (RMG1-CR and KOC7C-CR) both in vitro and in vivo. Immunohistochemical analysis showed that mTOR was more frequently activated in clear cell carcinomas than in serous adenocarcinomas (86.6% versus 50%). Treatment with RAD001 markedly inhibited the growth of both RMG1 and KOC7C cells both in vitro and in vivo. Increased expression of phospho-mTOR was observed in cisplatin-resistant RMG1-CR and KOC7C-CR cells, compared with the respective parental cells. This increased expression of phospho-mTOR in cisplatin-resistant cells was associated with increased activation of AKT. RMG1-CR and KOC7C-CR cells showed greater sensitivity to RAD001 than did parental RMG1 and KOC7C cells, respectively, in vitro and in vivo." }, { "role": "assistant", "content": "mTOR is frequently activated in clear cell carcinoma and can be a promising therapeutic target in the management of clear cell carcinoma. Moreover, mTOR inhibition by RAD001 may be efficacious as a second-line treatment of recurrent disease in patients previously treated with cisplatin. 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, Child, Child, Preschool, Diet, Diet Records, Diet, Vegetarian, Female, Folic Acid, Homocysteine, Humans, Male, Nutritional Status, Vitamin B 12." }, { "role": "user", "content": "Is vitamin B-12 status associated with plasma homocysteine in parents and their preschool children : lacto-ovo , lacto , and ovo vegetarians and omnivores? Context: Vegetarians may be at risk of certain nutrient deficiencies, particularly vitamin B-12. Vitamin B-12 deficiency may increase plasma homocysteine concentration and thus may potentially increase the risk of cardiovascular disease in vegetarians. The purpose of this study was to assess and compare plasma homocysteine and vitamin B-12 status in vegetarian and omnivorous preschool children and their parents. In addition, the association between parents' and children's homocysteine and vitamin B-12 concentration was also examined. Fifty-six omnivores (28 preschool children and one of their parents), 34 lacto-ovo vegetarians (16 parents and 18 children), 5 ovo vegetarians (2 parents and 3 children), 1 lacto vegetarian parent, and 2 vegan parents were enrolled in this study. The mean age of preschool children was 5.1 +/- 1.3 years and that of their parent was 35.4 +/- 4.2 years. Nutrient intakes were recorded using 3-day dietary records. Fasting venous blood samples were obtained to measure serum creatinine, high-sensitivity C-reactive protein, hematological parameters, plasma homocysteine, serum folate, and vitamin B-12 concentrations. There was no significant difference in dietary folate intake between vegetarian and omnivores within parent and child groups. The mean plasma homocysteine level of vegetarian parents and their children was in the physiological range, and they had slightly but not significantly higher plasma homocysteine levels than omnivores. Omnivorous parents and their children had significantly higher vitamin B-12 intake than vegetarian participants but similar serum vitamin B-12 concentrations. Plasma homocysteine concentration was significantly and negatively associated with only serum folate levels (beta = -0.15) and dietary vitamin B-12 intake (beta = -0.05) in the omnivorous parents after adjusting for age, gender, body mass index, and serum creatinine." }, { "role": "assistant", "content": "Vegetarian parents and their preschool children had a lower vitamin B-12 intake than omnivorous parents and their preschool children but similar plasma vitamin B-12 and homocysteine concentrations. Plasma homocysteine was not associated with serum vitamin B-12 levels in the parent, child, or pooled group. 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": "Fluroide ions act by inhibiting -" }, { "role": "assistant", "content": "The correct answer is A i.e. Enolase" } ]

[ { "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, Anti-Bacterial Agents, Biomarkers, Case-Control Studies, Female, Follow-Up Studies, Gastric Mucosa, Helicobacter Infections, Helicobacter pylori, Humans, Male, Middle Aged, Pepsinogens, Peptides, Prospective Studies, Risk Factors, Stomach Neoplasms, Stomach Ulcer, Trefoil Factor-1, Trefoil Factor-2, Trefoil Factor-3, Tumor Suppressor Proteins." }, { "role": "user", "content": "Is influence of Helicobacter pylori status and eradication on the serum levels of trefoil factors and pepsinogen test : serum trefoil factor 3 a stable biomarker? Context: Emerging data indicate that serum trefoil factors (TFFs), especially TFF3, could be potential biomarkers for gastric cancer risk. We aimed to evaluate the influence of Helicobacter pylori (H. pylori) status and eradication on serum TFFs and the pepsinogen test. Healthy individuals who underwent a thorough medical checkup were enrolled in study 1, and gastric ulcer patients who undertook H. pylori eradication therapy were enrolled in studies 2 and 3. Serum levels of the TFFs (TFF1, TFF2 and TFF3), H. pylori antibody and pepsinogen test were examined in all studies. In study 3, TFF expressions in biopsy samples of the gastric mucosa were additionally examined before and 2 months after eradication. In 1,260 healthy individuals enrolled in study 1, serum TFF1 and TFF2 levels were markedly different between H. pylori antibody-positive and -negative participants (P < 0.0001). Differences in serum TFF3 levels between H. pylori antibody-positive (5.85 ± 3.93 ng/ml) and -negative subjects (5.27 ± 2.38 ng/ml) were statistically significant (P = 0.002) but small in absolute value. In 178 gastric ulcer patients enrolled in study 2, serum TFF1, TFF2 and positive rates of the pepsinogen test significantly decreased 2 months after H. pylori eradication therapy (P < 0.001). In contrast, serum TFF3 levels and positive rates of high TFF3 levels (≥7 ng/ml) did not significantly change with H. pylori-eradication until 5 years after eradication. In 18 gastric ulcer patients (study 3), TFF1 and TFF2 were mainly expressed in the foveolar epithelium, and TFF2 was additionally expressed in the pyloric glands. These expressions significantly decreased with H. pylori eradication. TFF3s were scarcely expressed in the gastric mucosa except in goblet cells of intestinal metaplasia, which did not change with H. pylori eradication." }, { "role": "assistant", "content": "In serum TFFs and pepsinogen tests, only serum TFF3s were not significantly affected by H. pylori eradication, suggesting that serum TFF3 could be a stable biomarker of gastric cancer risk even after H.pylori eradication in contrast with the pepsinogen test. 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 27-year-old woman visits her family physician complaining of the recent onset of an unpleasant fish-like vaginal odor that has started to affect her sexual life. She was recently treated for traveler’s diarrhea after a trip to Thailand. External genitalia appear normal on pelvic examination, speculoscopy shows a gray, thin, homogenous, and malodorous vaginal discharge. Cervical mobilization is painless and no adnexal masses are identified. A sample of the vaginal discharge is taken for saline wet mount examination. Which of the following characteristics is most likely to be present in the microscopic evaluation of the sample?" }, { "role": "assistant", "content": "Clue cells on saline smear" } ]

[ { "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: 4-Butyrolactone, Animals, Base Sequence, Cell Line, Gene Expression Regulation, Genetic Engineering, Humans, Mice, Molecular Sequence Data, Oligonucleotides, Protein Biosynthesis, RNA, Small Interfering, Streptomyces, Transcription, Genetic, Transgenes." }, { "role": "user", "content": "Do engineered Streptomyces quorum-sensing components enable inducible siRNA-mediated translation control in mammalian cells and adjustable transcription control in mice? Context: Recent advances in functional genomics, gene therapy, tissue engineering, drug discovery and biopharmaceuticals production have been fostered by precise small-molecule-mediated fine-tuning of desired transgenes. Capitalizing on well-evolved quorum-sensing regulatory networks in Streptomyces coelicolor we have designed a mammalian regulation system inducible by the non-toxic butyrolactone SCB1. Fusion of the S. coelicolor SCB1 quorum-sensing receptor ScbR to the human Kox-1-derived transsilencing domain reconstituted a mammalian transsilencer (SCS) able to repress transcription from SCS-specific operator-containing promoters in a reverse SCB1-adjustable manner. This quorum-sensing-derived mammalian transgene control system (Q-ON) enabled precise SCB1-specific fine-tuning of (i) desired transgene transcription in a variety of mammalian/human cell lines and human primary cells, (ii) small interfering RNA-mediated posttranscriptional knockdown (siRNA) in mammalian cells, and (iii) dosing of a human glycoprotein in mice." }, { "role": "assistant", "content": "As exemplified by Q-ON technology, bacterial quorum-sensing regulons may represent a near-infinite source for the design of mammalian gene control systems compatible with molecular interventions relevant to future gene therapy and tissue engineering scenarios. 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: Activities of Daily Living, Chronic Disease, Cohort Studies, Confounding Factors (Epidemiology), Depression, Fatigue, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Movement Disorders, Netherlands, Prospective Studies, Quality of Life, Regression Analysis, Severity of Illness Index, Stroke, Stroke Rehabilitation, Time Factors, Treatment Outcome." }, { "role": "user", "content": "Is fatigue an independent factor associated with activities of daily living, instrumental activities of daily living and health-related quality of life in chronic stroke? Context: To determine the longitudinal association of poststroke fatigue with activities of daily living (ADL), instrumental ADL (IADL) and perceived health-related quality of life (HRQoL) and to establish whether this relationship is confounded by other determinants. A prospective cohort study of stroke patients consecutively admitted for inpatient rehabilitation was conducted. ADL, IADL and HRQoL were assessed in 223 patients at 6, 12 and 36 months after stroke. Fatigue was determined by the Fatigue Severity Scale. Random coefficient analysis was used to analyze the impact of fatigue on ADL, IADL and HRQoL. The association between fatigue and outcome was corrected for potential confounders, i.e. age, gender, comorbidity, executive function, severity of paresis and depression. The covariate was considered to be a confounder if the regression coefficient of fatigue on outcome changed by>15%. Fatigue was significantly related to IADL and HRQoL but not to ADL. The relation between fatigue and IADL was confounded by depression and motor impairment. Depression biased the relation between fatigue and HRQoL, but fatigue remained independently related to HRQoL." }, { "role": "assistant", "content": "Fatigue is longitudinally spuriously associated with IADL and independently with HRQoL. These findings suggest that in examining the impact of poststroke fatigue on outcome, one should control for confounders such as depression." } ]

[ { "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": "Le Fo classification involves fracture of" }, { "role": "assistant", "content": "The correct answer is Le Fo classification involves the fractures of maxilla which includes transverse fracture, pyramidal fracture and craniofacial dysfunction. Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 207" } ]

[ { "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: Aortic Stenosis, Subvalvular, Cardiac Surgical Procedures, Child, Child, Preschool, Female, Follow-Up Studies, Heart Septal Defects, Humans, Infant, Length of Stay, Male, Reoperation, Retrospective Studies, Treatment Outcome." }, { "role": "user", "content": "Modified single patch: are we still worried about subaortic stenosis? Context: When the modified single-patch technique for atrioventricular septal defect (AVSD) repair was introduced by Dr Benson Wilcox, there was concern that these patients might be at risk for late subaortic stenosis and left ventricular outflow tract obstruction (LVOTO). This review evaluated our modified single-patch population for LVOTO in the postoperative period. Between January 2000 and 2013, 77 infants underwent AVSD repair with a modified single-patch technique. Median age was 4.2 months, and median weight was 5 kg. Eight patients had a prior repair of coarctation of the aorta via left thoracotomy in the newborn period. The median hospital stay was 10 days. No patient required a pacemaker. The mean and median follow-up times were 4.6 and 3.7 years, respectively. Only 2 patients (2.5%) required reoperation for LVOTO; both had prior repair of coarctation of the aorta (2 of 8 vs 0 of 69, p = 0.01). A discrete fibrous subaortic membrane developed in the first patient that required resection at 3 and 7 years after repair. The other patient had LVOTO from accessory chordae of the left atrioventricular valve and required mitral valve replacement 5 months after repair. One early death occurred at 4 months postoperatively due to liver failure related to hyperalimentation." }, { "role": "assistant", "content": "At intermediate term follow-up, LVOTO does not appear to be a significant postoperative issue after modified single-patch repair of AVSD. Coarctation of the aorta was the most significant predictor of late LVOTO after repair of AVSD with the modified single-patch technique." } ]

[ { "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 10-year-old child presents with history of chronic sinusitis and multiple nasal polypi. He also suffers from recurrent chest infections and malabsorption syndrome. Which one of the following tests would be useful for diagnosis?" }, { "role": "assistant", "content": "The correct answer is Presence of chronic sinusitis, multiple nasal polypi and malabsorption point towards cystic fibrosis and therefore sweat chloride test would be useful." } ]

[ { "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 seen in Parkinsonism: March 2013" }, { "role": "assistant", "content": "The correct answer is Ans. A i.e. Preserved postural reflexes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, METHODS, RESULTS. Meshes: Animals, Blood Pressure, Cardiovascular Diseases, Disease Models, Animal, Electrocardiography, Heart Rate, Male, Rats, Rats, Wistar, Reproducibility of Results, Risk Factors, Sleep Deprivation." }, { "role": "user", "content": "Does experimental paradoxical sleep deprivation (EPSD) is an appropriate model for evaluation of cardiovascular complications of obstructive sleep apnea? Context: Some of the previous studies have used animal model of paradoxical sleep deprivation for investigation of sleep loss complications. The present study is designed to examine the effectiveness and reliability of this model for investigation and assessment of some cardiovascular complications of obstructive sleep apnea syndrome. The Wistar rat groups were divided into the control group, the Test48 and Test72 groups, who experienced paradoxical sleep deprivation for 48 and 72 h, and the Sham48 and Sham72 groups, who were exposed to environmental conditions same to test groups but without sleep deprivation, respectively. At the end of the experiment, blood pressure and heart rate variability were assessed. The results showed that 72 h rapid eye movements sleep deprivation significantly increased the systolic blood pressure compared to the control (p < 0.01), Sham48 and Test48 groups (p < 0.05). The comparison of the heart rate and heart rate variability parameters such as time domain indices (RR interval, SDNN, RMSSD, SD1, SD2, and SD1/SD2) as well as frequency-domain variables (total power, LF and HF power, and LF/HF) had no significant difference among animal groups." }, { "role": "assistant", "content": "These findings suggest that rat paradoxical sleep deprivation may be a suitable model for induction and investigation of hemodynamic alterations which occurs in obstructive sleep apnea syndrome; however, it cannot be an alternative model to induce heart rate variability alterations similar to those reported in patient with obstructive sleep apnea." } ]

[ { "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 drug that inhibits mRNA synthesis has the well-documented side effect of red-orange body fluids. For which of the following is this drug used as monotherapy?" }, { "role": "assistant", "content": "Neisseria meningitidis prophylaxis" } ]

[ { "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": "Stocker&;s line is seen in" }, { "role": "assistant", "content": "The correct answer is Pterygium It presents as a triangular fold of conjunctiva encroaching the cornea in the area of the palpebral apeure, usually on the nasal side, but may also occur on the temporal side. Deposition of iron seen sometimes in corneal epithelium anterior to advancing head of the pterygium called as stocker's line. Pas. A fully developed pterygium consists of three pas: i. Head (apical pa present on the cornea), ii. Neck (limbal pa), and iii. Body (scleral pa) extending between limbus and the canthus. Stocker's line in pterygium. Pterygium is a fibrovascular proliferative disorder in which conjunctival tissue grows medially to cover the clear cornea. On slit-lamp examination showed marked pterygium that extend from the nasal side of bulbar conjunctiva onto the cornea in the left eye Ref: Khurana; 4th ed; Pg 80" } ]

[ { "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: Arabidopsis, Crosses, Genetic, Ecotype, Germination, Glucans, Hybridization, Genetic, Inheritance Patterns, Lycopersicon esculentum, Pollen Tube, Time Factors." }, { "role": "user", "content": "Do callose plug deposition patterns vary in pollen tubes of Arabidopsis thaliana ecotypes and tomato species? Context: The pollen grain contains the male gametophyte that extends a pollen tube that grows through female tissues in order to deliver sperm to the embryo sac for double fertilization. Growing pollen tubes form periodic callose plugs that are thought to block off the older parts of the tube and maintain the cytoplasm near the growing tip. The morphology of callose plugs and the patterns of their deposition were previously shown to vary among species, but variation within a species had not been examined. We therefore systematically examined callose plug deposition in Arabidopsis thaliana ecotypes, tested for heritability using reciprocal crosses between ecotypes that had differing deposition patterns, and investigated the relationship between callose plugs and pollen tube growth rate. We also surveyed callose plug deposition patterns in different species of tomato. We used in vitro grown pollen tubes of 14 different A. thaliana ecotypes and measured the distance from the pollen grain pore to the first callose plug (termed first interval). This distance varied among Arabidopsis ecotypes and in some cases even within an ecotype. Pollen tubes without a callose plug were shorter than those with a callose plug, and tubes with a callose plug near the grain were, on average, longer than those with the first callose plug farther from the grain. Variations in the first callose plug position were also observed between different species of tomato." }, { "role": "assistant", "content": "We showed that the position of the first callose plug varied among Arabidopsis ecotypes and in tomato species, and that callose plug deposition patterns were heritable. These findings lay a foundation for mapping genes that regulate callose plug deposition or that determine pollen tube length or growth rate. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 20-year-old girl presents to a physician following unprotected coitus with her boyfriend about 10 hours ago. She tells the doctor that although they usually use a barrier method of contraception, this time they forgot. She does not want to become pregnant. She also mentions that she has major depression and does not want to take an estrogen-containing pill. After necessary counseling, the physician prescribes an enteric-coated pill containing 1.5 mg of levonorgestrel. Which of the following is the primary mechanism of action of this drug?" }, { "role": "assistant", "content": "Delayed ovulation through inhibition of follicular development" } ]