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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": "Most common cause of viral pneumonia in infant is" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., RSV RSV is the most common cause of pneumonia and bronchilis in infants. In adults, influenza is the most common cause of viral pneumonia." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All of the following are risk factors for increased lactic acidosis in patients on metformin therapy except" }, { "role": "assistant", "content": "The correct answer is Metformin can result in lactic acidosis and the risk factors includes old age,renal and liver insufficiency, alcoholics.\nSmoking is not a risk factor." } ]

[ { "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": "Cherry red colour of blood is seen in poisoning with-" }, { "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, METHODS. Meshes: Angiotensin-Converting Enzyme Inhibitors, Animals, Antihypertensive Agents, Blood Pressure, Calcium Channel Blockers, Enalaprilat, Extracellular Space, Male, Myocardium, Nicardipine, Norepinephrine, Rats, Rats, Inbred SHR, Reflex." }, { "role": "user", "content": "Does enalaprilat blunt reflexive increases in cardiac interstitial norepinephrine in conscious rats? Context: We have reported that acute administration of enalaprilat, an angiotensin converting enzyme inhibitor, induces less reflexive increase in lumbar sympathetic nerve activity in spontaneously hypertensive rats (SHRs) than nicardipine, a dihydropyridine calcium-channel blocker. The current study was conducted to determine if angiotensin converting enzyme inhibitors likewise suppress cardiac sympathetic activation. Cardiac interstitial levels of norepinephrine were measured in fully conscious SHRs before and after acute blood pressure lowering with enalaprilat or nicardipine. Microdialysis probes were inserted into the left ventricular wall of SHRs. Twenty-four to 48 hours post-implantation, myocardial interstitial fluid was collected in fully conscious rats during a 60-min baseline period. Mean arterial pressure was lowered 20 mmHg with intravenous infusion of enalaprilat or nicardipine. During continuous enalaprilat or nicardipine infusion, myocardial interstitial fluid was again collected. Norepinephrine levels were assayed in the perfusate." }, { "role": "assistant", "content": "Enalaprilat-induced reduction in mean arterial pressure did not significantly increase cardiac interstitial norepinephrine levels. In contrast, nicardipine-induced reduction in blood pressure was associated with a significant increase in interstitial norepinephrine levels. These results indicate that enalaprilat suppresses reflexive sympathetic activation of the heart during acute blood pressure lowering. These results may be clinically relevant in that reductions in end-organ sympathetic stimulation may enhance the long-term cardiovascular benefit of angiotensin converting enzyme inhibitors. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Analysis of Variance, Cardiovascular Diseases, Case-Control Studies, Cholesterol Ester Transfer Proteins, Cholesterol, HDL, Cross-Sectional Studies, Family Health, Female, Genetic Predisposition to Disease, Humans, Male, Middle Aged, Polymorphism, Genetic, Taiwan." }, { "role": "user", "content": "Is cholesteryl ester transfer protein B1B1 genotype associated with a parental history of cardiovascular diseases in Taiwanese people? Context: To investigate the association between family history of cardiovascular disease (CVD) and cholesteryl ester transfer protein (CETP) TaqIB polymorphism in Taiwanese subjects. In this cross-sectional study, 240 subjects (115 men and 125 women) were divided into two groups based on whether or not they had a parental history of CVD. Polymerase chain reaction/restriction fragment length polymorphism was used to analyze the genotype of the subjects for the TaqIB polymorphism of CETP in intron 1. The frequency of the B1B1 genotype was significantly higher in Taiwanese subjects with a family history of CVD than in those without it (31.2 vs. 18.8%, odds ratio = 1.97, 95% confidence interval = 1.084-3.579, p = 0.035). Siblings with the B1B1 genotype had lower levels of serum high-density lipoprotein cholesterol (HDL-C) than siblings with either B1B2 (46.7 +/- 11.0 vs. 52.5 +/- 11.1 mg/dl, p = 0.034) or B2B2 genotypes (46.7 +/- 11.0 vs. 55.2 +/- 9.6 mg/dl, p = 0.01)." }, { "role": "assistant", "content": "CETP TaqIB polymorphism is associated with plasma HDL-C levels. The CETP B1B1 genotype may influence the susceptibility to CVD in Taiwan. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, METHODS, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Child, China, Female, HLA Antigens, Hemochromatosis, Hemochromatosis Protein, Histocompatibility Antigens Class I, Humans, Male, Membrane Proteins, Middle Aged, Mutation, Retrospective Studies, Thalassemia." }, { "role": "user", "content": "Is the C282Y mutation of the HFE gene found in Chinese haemochromatotic patients : multicentre retrospective study? Context: To detect two novel mutations (C282Y and H63D) of the HFE gene in Chinese patients with hepatic iron overload. Multicentre retrospective study. Four public hospitals, Hong Kong. Fifty Chinese patients who presented from January 1987 through December 1999 with hepatic iron overload from various causes. The DNA from liver biopsy samples was tested for HFE mutations by restriction fragment length polymorphism analysis. The sample DNA quality was unsatisfactory for analysis of the C282Y mutation in one case and the H63D mutation in nine cases. The C282Y mutation was not detected in any of the 49 satisfactory samples. Three of the 41 samples were heterozygous for the H63D mutation and only one was homozygous, giving an allele frequency of 6.1%. Of the three H63D-heterozygotes, one had beta-thalassaemia major, one had beta-thalassaemia minor, and one had hereditary spherocytosis. None of the 12 patients who were presumed to have primary haemochromatosis were positive for either mutation." }, { "role": "assistant", "content": "The classical form of human leukocyte antigen-linked hereditary haemochromatosis appears to be absent form this locality. The H63D mutation is found in a minority (9.8%) of the patients, in whom it may act synergistically with an erythropoietic factor. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Acetylcholine, Adult, Aged, Angiogenesis Inhibitors, Animals, Carcinoma, Renal Cell, Endothelium, Vascular, Forearm, Humans, Hypertension, Indoles, Kidney Neoplasms, Male, Mesenteric Arteries, Middle Aged, NG-Nitroarginine Methyl Ester, Nitric Oxide, Nitroprusside, Pyrroles, Rats, Regional Blood Flow, Sunitinib, Vascular Endothelial Growth Factor A, Vasodilation, Vasodilator Agents." }, { "role": "user", "content": "Does impaired endothelium-dependent vasodilation initiate the development of sunitinib-associated hypertension? Context: Tyrosine kinase inhibitors targeting angiogenesis have become an important part of the treatment of patients with several types of cancer. One of the most reported side effects of vascular endothelial growth factor receptor (VEGFR)-targeted therapies is hypertension. In this study, we hypothesized that the development of hypertension in patients treated with sunitinib, a multitargeted tyrosine kinase inhibitor, is preceded by reduced endothelium-dependent vasodilation. Moreover, we hypothesized that this endothelial dysfunction is a result of impaired nitric oxide release. In a placebo-controlled experiment, we determined vascular responses in isolated mesenteric arteries of rats (n = 26) after 7 days of sunitinib treatment. Sunitinib reduced endothelium-dependent vasodilation, but not endothelium-independent vasodilation. Moreover, we observed that the difference in endothelium-dependent vasodilation between controls and sunitinib-treated animals disappeared in the presence of N-nitro-L-arginine methyl ester (L-NAME), a nitric oxide antagonist. In patients with metastatic renal cell carcinoma, before and 1 week after start of sunitinib, the endothelium-dependent vasodilator response to intra-arterial acetycholine and the endothelium-independent vasodilator response to intra-arterial sodium nitroprusside was assessed with venous occlusion plethysmography. No changes in forearm blood flow ratios were observed. Mean arterial pressure did significantly increase from 101.9 ± 3.8 to 106.1 ± 2.6 mmHg after 1 week and further to 115.8 (±4.9) mmHg after 2 weeks of treatment." }, { "role": "assistant", "content": "In animals, this study confirms that exposure to high concentrations of sunitinib reduces endothelium-dependent vasodilation by reducing endothelial release of nitric oxide. In humans, however, reduced endothelium-dependent vasodilation does not precede the development of hypertension in patients treated with sunitinib. 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": "All the following are salient features of genetic code, EXCEPT" }, { "role": "assistant", "content": "The correct answer is Salient features of genetic code : Triplet base sequence Non- overlap Non- punctuated Degenerate Unambiguous Universal NOTE: The demonstration that DNA contained the genetic information was first made in 1944 in a series of experiments by Avery, MacLeod, and McCay." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, RESULTS. Meshes: Acoustic Stimulation, Adult, Audiometry, Pure-Tone, Audiometry, Speech, Cochlear Implantation, Cochlear Implants, Comprehension, Deafness, Discrimination (Psychology), Female, Hearing, Humans, Loudness Perception, Male, Middle Aged, Persons With Hearing Impairments, Prosthesis Design, Prosthesis Fitting, Psychoacoustics, Sound Spectrography, Speech Intelligibility, Speech Perception, Surveys and Questionnaires, Treatment Outcome." }, { "role": "user", "content": "Do fitting prelingually deafened adult cochlear implant users based on electrode discrimination performance? Context: This study investigated the hypotheses that (1) prelingually deafened CI users do not have perfect electrode discrimination ability and (2) the deactivation of non-discriminable electrodes can improve auditory performance. Electrode discrimination difference limens were determined for all electrodes of the array. The subjects' basic map was subsequently compared to an experimental map, which contained only discriminable electrodes, with respect to speech understanding in quiet and in noise, listening effort, spectral ripple discrimination and subjective appreciation. Subjects were six prelingually deafened, late implanted adults using the Nucleus cochlear implant. Electrode discrimination difference limens across all subjects and electrodes ranged from 0.5 to 7.125, with significantly larger limens for basal electrodes. No significant differences were found between the basic map and the experimental map on auditory tests. Subjective appreciation was found to be significantly poorer for the experimental map." }, { "role": "assistant", "content": "Prelingually deafened CI users were unable to discriminate between all adjacent electrodes. There was no difference in auditory performance between the basic and experimental map. Potential factors contributing to the absence of improvement with the experimental map include the reduced number of maxima, incomplete adaptation to the new frequency allocation, and the mainly basal location of deactivated electrodes. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, BACKGROUND, METHODS, RESULTS. Meshes: Adenosine, Blood Flow Velocity, Coronary Stenosis, Coronary Vessels, Fractional Flow Reserve, Myocardial, Humans, Hyperemia, Models, Cardiovascular, Monte Carlo Method, Myocardial Contraction, Myocardial Revascularization, Vascular Resistance, Vasodilator Agents." }, { "role": "user", "content": "Does the instantaneous wave-free ratio approximate the fractional flow reserve? Context: This study sought to examine the clinical performance of and theoretical basis for the instantaneous wave-free ratio (iFR) approximation to the fractional flow reserve (FFR). Recent work has proposed iFR as a vasodilation-free alternative to FFR for making mechanical revascularization decisions. Its fundamental basis is the assumption that diastolic resting myocardial resistance equals mean hyperemic resistance. Pressure-only and combined pressure-flow clinical data from several centers were studied both empirically and by using pressure-flow physiology. A Monte Carlo simulation was performed by repeatedly selecting random parameters as if drawing from a cohort of hypothetical patients, using the reported ranges of these physiologic variables. We aggregated observations of 1,129 patients, including 120 with combined pressure-flow data. Separately, we performed 1,000 Monte Carlo simulations. Clinical data showed that iFR was +0.09 higher than FFR on average, with ±0.17 limits of agreement. Diastolic resting resistance was 2.5 ± 1.0 times higher than mean hyperemic resistance in patients. Without invoking wave mechanics, classic pressure-flow physiology explained clinical observations well, with a coefficient of determination of>0.9. Nearly identical scatter of iFR versus FFR was seen between simulation and patient observations, thereby supporting our model." }, { "role": "assistant", "content": "iFR provides both a biased estimate of FFR, on average, and an uncertain estimate of FFR in individual cases. Diastolic resting myocardial resistance does not equal mean hyperemic resistance, thereby contravening the most basic condition on which iFR depends. Fundamental relationships of coronary pressure and flow explain the iFR approximation without invoking wave mechanics." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which one of the following condition is associated with unconjugated hyper bilirubinemia" }, { "role": "assistant", "content": "The correct answer is Gilbe's syndrome (GS) is a mild liver disorder in which the liver does not properly process bilirubin. Many people never have symptoms. Occasionally a slight yellowish color of the skin or whites of the eyes may occur. Other possible symptoms include feeling tired, weakness, and abdominal pain. Gilbe's syndrome is due to a mutation in the UGT1A1 gene which results in decreased activity of the bilirubin uridine diphosphate glucuronosyltransferase enzyme. It is typically inherited in an autosomal recessive pattern and occasionally in an autosomal dominant pattern depending on the type of mutation. Episodes of jaundice may be triggered by stress such as exercise, menstruation, or not eating.Diagnosis is based on higher levels of unconjugated bilirubin in the blood without either signs of other liver problems or red blood cell breakdown Refer robbins 9/e" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Blotting, Western, Brain Neoplasms, Cathepsin K, Gene Expression Profiling, Gene Expression Regulation, Enzymologic, Gene Expression Regulation, Neoplastic, Genetic Association Studies, Glioblastoma, Humans, Immunohistochemistry, Protease Inhibitors, Real-Time Polymerase Chain Reaction, Reproducibility of Results, Signal Transduction, Up-Regulation." }, { "role": "user", "content": "Does expression analysis of all protease genes reveal cathepsin K to be overexpressed in glioblastoma? Context: Cancer genome and transcriptome analyses advanced our understanding of cancer biology. We performed transcriptome analysis of all known genes of peptidases also called proteases and their endogenous inhibitors in glioblastoma multiforme (GBM), which is one of the most aggressive and deadly types of brain cancers, where unbalanced proteolysis is associated with tumor progression. Comparisons were performed between the transcriptomics of primary GBM tumors and unmatched non-malignant brain tissue, and between GBM cell lines (U87-MG and U373) and a control human astrocyte cell line (NHA). Publicly-available data sets and our own datasets were integrated and normalized using bioinformatics tools to reveal protease and protease inhibitor genes with deregulated expression in both malignant versus non-malignant tissues and cells. Of the 311 protease genes identified to be differentially expressed in both GBM tissues and cells, 5 genes were highly overexpressed, 2 genes coding for non-peptidase homologues transferrin receptor (TFRC) and G protein-coupled receptor 56 (GPR56), as well as 3 genes coding for the proteases endoplasmic reticulum aminopeptidase 2 (ERAP2), glutamine-fructose-6-phosphate transaminase 2 (GFPT2) and cathepsin K (CTSK), whereas one gene, that of the serine protease carboxypeptidase E (CPE) was strongly reduced in expression. Seventy five protease inhibitor genes were differentially expressed, of which 3 genes were highly overexpressed, the genes coding for stefin B (CSTB), peptidase inhibitor 3 (PI3 also named elafin) and CD74. Seven out of 8 genes (except CSTB) were validated using RT-qPCR in GBM cell lines. CTSK overexpression was validated using RT-qPCR in GBM tissues as well. Cathepsin K immunohistochemical staining and western blotting showed that only proteolytically inactive proforms of cathepsin K were overexpressed in GBM tissues and cells." }, { "role": "assistant", "content": "The presence of high levels of inactive proforms of cathepsin K in GBM tissues and cells indicate that in GBM the proteolytic/collagenolytic role is not its primary function but it plays rather a different yet unknown role. 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: Adipose Tissue, Adult, Anthropometry, Blood Glucose, Body Mass Index, Calorimetry, Diabetes Mellitus, European Continental Ancestry Group, Female, Glucose, Glucose Clamp Technique, Glucose Tolerance Test, Humans, Infusions, Intravenous, Insulin, Liver, Magnetic Resonance Imaging, Mexican Americans, Mexico, Texas, Tritium." }, { "role": "user", "content": "Is insulin sensitivity impaired in Mexican-American women without a family history of diabetes? Context: The purpose of this research was to compare insulin sensitivity in Mexican-Americans and non-Hispanic whites without a family history of diabetes to establish whether insulin resistance is a defect intrinsically related to subjects of Mexican origin. In study A, we compared insulin sensitivity in 12 Mexican-American and 12 non-Hispanic white women with normal glucose tolerance and no family history of diabetes. In study B, we compared insulin sensitivity in two groups of normal glucose-tolerant Mexican-Americans, nine with a positive (FHD+) and nine with a negative (FHD-) family history of diabetes. In both studies, the groups were closely matched for age, total body fat content, and fat topography. Insulin sensitivity was assessed with the euglycemic insulin clamp (20 microU.min-1.m2 surface area) which was performed in combination with tritiated glucose infusion and indirect calorimetry. Total fat mass and fat-free mass (FFM) were assessed by a tritiated water dilution technique, and regional fat distribution was evaluated by anthropometry and magnetic resonance imaging. During a 4-h euglycemic insulin clamp (study A), rates (mg.min-1.kg FFM-1) of total (6.32 +/- 0.64 vs. 6.62 +/- 0.81), oxidative (3.54 +/- 0.24 vs. 3.51 +/- 0.19), and nonoxidative (2.78 +/- 0.48 vs. 3.11 +/- 0.75) glucose utilization were similar in Mexican-Americans and non-Hispanic whites; hepatic glucose production (0.33 +/- 0.13 vs. 0.35 +/- 0.13) was suppressed similarly in both groups. During a 2-h euglycemic insulin clamp (study B), Mexican-Americans with FHD+ had lower rates of insulin-mediated total (3.55 +/- 0.39 vs. 5.93 +/- 0.59, P < 0.001), oxidative (3.31 +/- 0.25 vs. 4.32 +/- 0.17, P < 0.01), and nonoxidative (0.24 +/- 0.28 vs. 1.61 +/- 0.49, P < 0.01) glucose disposal than subjects with FHD-; suppression of hepatic glucose production (0.24 +/- 0.14 vs. 0.18 +/- 0.12) was similar in both groups." }, { "role": "assistant", "content": "These results indicate that in the absence of a family history of non-insulin-dependent diabetes mellitus, Mexican-American women are not less sensitive to insulin than non-Hispanic white women. 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": "Vitamin Bi2 deficiency results in: March 2013" }, { "role": "assistant", "content": "The correct answer is Ans. D i.e. Macrocytic anemiaMacrocytic anemia Especially common causes of macrocytic anemias are the so-called megaloblastic anemias, in which cells are larger because they cannot produce DNA quickly enough to divide at the right time as they grow, and thus grow too large before division.Causes for the DNA synthetic problem range from lack of ceain vitamins needed to produce DNA (notably folate and B12), to poisons or inhibitors of DNA replication, such as some kinds of antiviral drugs and chemotherapeutic agents.Classically these megaloblastic types of anemias are associated also with more specific features, such as megaloblasts in the bone marrow, the presence of ovalocytes in the (peripheral) blood smear, and the pathognomonic presence of hypersegmented neutrophils." } ]

[ { "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": "Hypergonadotropic hypogonadism is sean in all except?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Down syndrome Hypergonadotropic hypogonadism Also K/a primary or peripheral hypogonadism. Characterised by hypogonadism due to an impaired response of the gonads to the gonadotropin, FSH and LH. In turn a lack of sex steroid production and elevated gonadotropin level. Causes : Chromosomal abnormalitis Turner's syndrome Klinefelter syndrome Swyer's syndrome Enzyme defect 17 , hydroxylase 17, 20 lyase deficiency" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Allopurinol is used in the treatment of:" }, { "role": "assistant", "content": "The correct answer is Allopurinol a xanthine oxidase inhibitor is used in the treatment of gout. By inhibiting xanthine oxidase it reduces uric acid synthesis. Ref: Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Page 191 - 2." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, METHODS, RESULTS. Meshes: Adverse Drug Reaction Reporting Systems, Aged, Aged, 80 and over, Awareness, Cross-Sectional Studies, Drug-Related Side Effects and Adverse Reactions, Female, Frail Elderly, Geriatric Assessment, Humans, Lung Diseases, Obstructive, Male, Netherlands, Patient Admission, Patient Education as Topic." }, { "role": "user", "content": "Do older hospital patients recognize adverse drug reactions? Context: To establish the relationship between subjective complaints of side effects of drugs and the objective presence of adverse drug reactions in older patients. Observational cross-sectional study. Five medical wards at the University Hospital Rotterdam Dijkzigt. Patients aged 70 and over admitted to the general medical wards over a 3-month period. Statistical comparison and Kramer's algorithm. Of 106 patients, 102 used medication, and 93 of these were able to report whether they believed they were experiencing drug side effects. Thirty-six [39% (95% confidence interval 28.8-48.6)] believed that they were experiencing side effects and the number of diagnoses per patient and the proportion of patients with chronic obstructive pulmonary disease was higher in these 36 'complainers' than in the group of the 'non-complainers'. We found a correct opinion (true positive and negative) about the objective presence or absence of mild or severe adverse drug reactions in 79% (95% confidence interval 70.2-86.8). Asking the patient about side effects of drugs had a sensitivity of 0.70 and a specificity of 0.85 patients. The severe adverse drug reactions in 21 patients were not recognized by 14 of them." }, { "role": "assistant", "content": "At hospital admission, older patients should be asked about drug side effects because they are often correct in recognizing them. However, severe adverse drug reactions are not easily recognized." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Airway Resistance, Angiopoietin-1, Animals, Asthma, Bronchial Hyperreactivity, Bronchoalveolar Lavage Fluid, Cytokines, Immunoglobulin E, Interleukin-5, Male, Mice, Mice, Inbred BALB C, NF-kappa B, Ovalbumin, Vascular Cell Adhesion Molecule-1." }, { "role": "user", "content": "Does angiopoietin-1 protect against airway inflammation and hyperreactivity in asthma? Context: The angiopoietins (Ang) comprise a family of growth factors mainly known for their role in blood vessel formation and remodeling. The best-studied member, Ang-1, exhibits antiapoptotic and antiinflammatory effects. Although the involvement of Ang-1 in angiogenesis is well recognized, little information exists about its role in respiratory physiology and disease. On the basis of its ability to inhibit vascular permeability, adhesion molecule expression, and cytokine production, we hypothesized that Ang-1 administration might exert a protective role in asthma. To determine changes in the expression of Ang and to assess the ability of Ang-1 to prevent the histologic, biochemical, and functional changes observed in an animal model of asthma. To test our hypothesis, a model of allergic airway disease that develops after ovalbumin (OVA) sensitization and challenge was used. Ang-1 expression was reduced at the mRNA and protein levels in lung tissue of mice sensitized and challenged with OVA, leading to reduced Tie2 phosphorylation. Intranasal Ang-1 treatment prevented the OVA-induced eosinophilic lung infiltration, attenuated the increase in IL-5 and IL-13, and reduced eotaxin and vascular cell adhesion molecule 1 expression. These antiinflammatory actions of Ang-1 coincided with higher levels of IkappaB and decreased nuclear factor-kappaB binding activity. More importantly, Ang-1 reversed the OVA-induced increase in tissue resistance and elastance, improving lung function." }, { "role": "assistant", "content": "We conclude that Ang-1 levels are decreased in asthma and that administration of Ang-1 might be of therapeutic value because it prevents the increased responsiveness of the airways to constrictors and ameliorates inflammation. 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: METHODS, RESULTS. Meshes: Anesthesiology, Comorbidity, Databases, Factual, Female, Health Status Indicators, Humans, Male, Middle Aged, Morbidity, Odds Ratio, Postoperative Complications, Predictive Value of Tests, Prognosis, Reproducibility of Results, Surgical Procedures, Operative, United States." }, { "role": "user", "content": "Is aSA class a reliable independent predictor of medical complications and mortality following surgery? Context: The American Society of Anesthesiologists Physical Status classification system (ASA PS) is a method of characterizing patient operative risk on a scale of 1-5, where 1 is normal health and 5 is moribund. Every anesthesiologist is trained in this measure, and it is performed before every procedure in which a patient undergoes anesthesia. We measured the independent predictive value of ASA-PS for complications and mortality in the ACS-NSQIP database by multivariate regression. We conducted analogous regressions after standardizing ASA-PS to control for interprocedural variations in risk in the overall model and sub-analyses by surgical specialty and the most common procedures. For 2,297,629 cases (2005-2012; median age 55, min = 16, max > 90 [90 and above are coded as 90+]), at increasing levels of ASA-PS (2-5), odds ratios (OR's) from 2.05 to 63.25 (complications, p < 0.001) and 5.77-2011.92 (mortality, p < 0.001) were observed, with non-overlapping 95% confidence intervals. Standardization of ASA-PS (OR = 1.426 [per standard deviation above the mean ASA-PS per procedure], p < .001) and subgroup analyses yielded similar results." }, { "role": "assistant", "content": "ASA PS was not only found to be associated with increased morbidity and mortality, but independently predictive when controlling for other comorbidities. Even after standardization based on procedure type, increases in ASA predicted significant increases in complication rates for morbidity and mortality post-operatively. 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 patient with CSOM, labrynthine fistula most commnonly involves ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Lateral SCC Labrynthine fistula is almost exclusively repoed in association with chronic otitis media and cholesteatoma. The most commonly affected canal is lateral (horizontal) semicircular canal, but involvement of the posterior and superior canals as well as other regions of labyrinth have been repoed. The incidence of labrynthine fistula in chronic otitis media is approximately 10%." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Dental wax pattern should be invested as soon as possible because of danger of:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A tall man with gynecomastia and testicular atrophy has a testicular biopsy that shows sparse, completely hyalinized seminiferous tubules with a complete absence of germ cells and only rare Seoli cells. Leydig cells are present in large clumps between the hyalinized tubules. Which of the following genetic disorders should be suspected?" }, { "role": "assistant", "content": "The correct answer is The testicular changes described are those observed in Klinefelter's syndrome, most often due to 47, XXY genetics. Testicular feminization syndrome is due to a genetically determined unresponsiveness to testosterone that produces a phenotypic female in an individual with 46, XY chromosomes. Trisomy 18 is Edwards' syndrome, characterized by facial features that are small and delicate. Trisomy 21 is Down syndrome, the most common trisomy. Characteristics include oblique palpebral fissures, epicanthal folds, endocardial cushion defects, simian creases, and high-arched palate, among other anomalies. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 6. Genetic Disorders. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds), Pathology: The Big Picture." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Animals, Capillaries, Capillary Permeability, Cells, Cultured, Cornea, Endothelial Growth Factors, Endothelium, Vascular, Female, Fibroblast Growth Factor 2, Intercellular Signaling Peptides and Proteins, Lymphokines, Male, Mice, Mice, Inbred BALB C, Mice, Inbred C57BL, Neovascularization, Physiologic, Signal Transduction, Vascular Endothelial Growth Factor A, Vascular Endothelial Growth Factors, rac GTP-Binding Proteins." }, { "role": "user", "content": "Is small GTP-binding protein Rac an essential mediator of vascular endothelial growth factor-induced endothelial fenestrations and vascular permeability? Context: Vascular endothelial growth factor/vascular permeability factor (VEGF/VPF) induces both angiogenesis and vascular permeability. Although its angiogenic activity has been well characterized, the signaling pathways of VEGF-induced permeability remain poorly understood. Using the mouse corneal micropocket assay, Miles assay, and a combination of cytochemical, electron microscopic, and biochemical assays, we demonstrate that VEGF-induced vascular leakage partly can be separated from its angiogenic activity. VEGF but not FGF-2 induced capillaries with a highly fenestrated endothelium, a feature linked with increased vascular permeability. A cell-permeable Rac antagonist (TAT-RacN17) converted VEGF-induced, leaky vascular plexuses into well-defined vascular networks. In addition, this Rac mutant blocked formation of VEGF-induced endothelial fenestrations and vascular permeability but only partially inhibited angiogenesis. Studies on endothelial cell cultures further revealed that VEGF stimulated phosphorylation of VEGF receptor-2 (VEGFR-2), leading to activation of Rac as well as increased phosphorylation of phospholipase Cgamma (PLCgamma), protein kinase B (Akt), endothelial nitric oxide synthase (eNOS), and extracellular regulated kinase (Erk1/2). We further found that phosphatidylinositol-3-OH kinase (PI3K) acted upstream of Rac and Akt-eNOS in VEGF/VEGFR-2 signaling." }, { "role": "assistant", "content": "Our findings indicate that the small GTP-binding protein Rac is a key component in mediation of VEGF-induced vascular permeability but less so in neovascularization. This may have conceptual implications for applying Rac antagonists in treatment and prevention of VEGF-induced vascular leakage and edema in connection with ischemic disorders. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Presentation, when the engaging diameter is Mentovertical, is?" }, { "role": "assistant", "content": "The correct answer is Ans-ARef.: Dutta 6th edp-393" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 62-year-old man comes to the physician because of increasing pain in his right leg for 2 months. The pain persists throughout the day and is not relieved by rest. He tried taking acetaminophen, but it provided no relief from his symptoms. There is no family history of serious illness. He does not smoke. He occasionally drinks a beer. Vital signs are within normal limits. On examination, the right tibia is bowing anteriorly; range of motion is limited by pain. An x-ray of the right leg shows a deformed tibia with multiple lesions of increased and decreased density and a thickened cortical bone. Laboratory studies show markedly elevated serum alkaline phosphatase and normal calcium and phosphate levels. This patient is most likely to develop which of the following complications?" }, { "role": "assistant", "content": "Impaired hearing" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which is the commonest malignancy of ovary?" }, { "role": "assistant", "content": "The correct answer is Serous cystadenoma and cystadenocarcinoma are amongst the most common of cystic ovarian neoplasm, accounting about 50% of all ovarian tumors, of these 60% are benign, 15% borderline and 25% are malignant. Of the all cystic tumors of the ovary 5 to 10% are dermoids. Dermoid cyst is usually unilocular, with smooth surface seldom attaining more than 15 cm in diameter. Granulosa cell tumours are fairly common and represents 10% of all solid ovarian tumours. Ref: Shaw's Textbook of Gynaecology, 13th Ed, Page 358-359." } ]

[ { "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": "'Crippling Fluorosis' is characterized by:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 25 year old man presents with 3 days history of pain in the right lower abdomen and vomitings. patient's general condition is satisfactory and clinical examination reveals a tender lump in right iliac fossa. The most appropriate management in this case would be" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Oschner Sherren regimen" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Cartilage, Articular, Cells, Cultured, Chondrocytes, Culture Media, Conditioned, Elafin, Humans, Immunoenzyme Techniques, Leukocyte Elastase, Osteoarthritis, Protein Precursors, RNA, Messenger, Reverse Transcriptase Polymerase Chain Reaction, Synovial Fluid." }, { "role": "user", "content": "Is the serine protease inhibitor trappin-2 present in cartilage and synovial fluid in osteoarthritis? Context: Trappins are small serine protease inhibitors bound to extracellular matrix (ECM) through the actions of transglutaminase (TGase) enzymes. Trappin-2 is present in many tissues and is upregulated at sites of injury. In osteoarthritis (OA), serine proteases contribute to articular cartilage destruction, and TGase activity is increased. Yet little is known about matrix-bound serine protease inhibitors or TGase substrates in articular cartilage. Our purpose was to determine if trappin-2 was present in OA cartilage and synovial fluid (SF). OA knee articular cartilage and SF were assayed for trappin-2 protein by Western blotting, ELISA, and immunohistochemistry. Trappin-2 mRNA was detected with RT-PCR. The ECM components bound to trappin-2 were identified by 2-D gel electrophoresis and peptide fingerprinting. Trappin-2 was detectable in OA articular cartilage extracts, cultured chondrocytes, conditioned media, and SF by Western blotting. OA cartilage protein extracts contained significantly higher quantities of trappin-2 than normal cartilage protein extracts (22.98 +/- 1.28 ng/mg wet weight vs 14.97 +/- 1.92 ng/mg wet weight; p < 0.01). RT-PCR confirmed the presence of trappin-2 mRNA in OA chondrocytes. Immunohistochemical studies of OA cartilage revealed trappin-2 protein in chondrocytes. Peptide mapping of trappin-2 binding partners showed that fibromodulin was bound to trappin-2 in cartilage." }, { "role": "assistant", "content": "We confirmed the presence of trappin-2 in OA cartilage and SF. Elevated levels of TGase activity in OA cartilage may increase levels of this serine protease inhibitor in response to injury. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, METHODS, RESULTS. Meshes: Ablation Techniques, Adult, Decision Making, Female, Guidelines as Topic, Humans, Iodine Radioisotopes, Male, Middle Aged, Neoplasm, Residual, Quality Assurance, Health Care, Radiopharmaceuticals, Thyroid Neoplasms." }, { "role": "user", "content": "Difficulties in deciding whether to ablate patients with putatively \"low-intermediate-risk\" differentiated thyroid carcinoma: do guidelines mainly apply in the centres that produce them? Context: We determined the reasons for radioiodine thyroid remnant ablation, and the procedure's necessity based on postsurgical remnant size, in patients with putatively \"low-intermediate-risk\" differentiated thyroid carcinoma (DTC). We identified key clinicopathological, treatment and remnant characteristics, and factors associated with remnant size in 336 patients with pT1/2, M0 DTC ablated during the period September 2010 to October 2013 at one Cypriot or one Greek referral centre. Clinicopathological/treatment characteristics were compiled from charts. Experienced nuclear medicine physicians rated the numbers/intensities of uptake foci in the thyroid bed on postablation planar scintigrams using scales of 0-4 points and 0-3 points, respectively. The product of these scores was taken as the \"remnant score\" that ranged from 0 (no remnant) to 12 (multiple remnants, intense uptake). DTC was predominantly papillary. The median [25th-75th percentile] longest primary tumour diameter was 1.0 cm [0.7-1.5 cm]. Despite favourable histotypes and primary tumour classifications, patients often had preablation characteristics suggesting elevated or uncertain risk: 31.0% of patients (104 of 336) had primary tumour multifocality, 22.0% (74) had confirmed cervical lymph node metastases, 37.2% (125) had unknown nodal status, and 38.1% (128) had antithyroglobulin antibody seropositivity. The median [25th-75th percentile] remnant score was 4 [2-6]; 39.9% of patients (134 of 336) had scores ≥6. For the entire cohort, T or N stages (r ≤ 0.174, P ≤ 0.05) correlated positively with the remnant score in a univariate Spearman analysis. The numbers of patients referred by the surgeon, cervical lymph nodes excised and metastatic nodes excised correlated negatively (r ≤ 0.243, P ≤ 0.038) with the remnant score, and the first two factors independently predicted the remnant score (P ≤ 0.037) in a multivariate analysis." }, { "role": "assistant", "content": "Patients with putatively \"low-intermediate-risk\" DTC frequently had disease characteristics denoting high or uncertain risk, suggesting that \"selective\" radioiodine ablation in such patients may seldom be applicable outside international centres of excellence. Proxies for surgeon experience and surgical completeness correlated with remnant number/uptake intensity and may aid ablation-related decision-making." } ]

[ { "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 nulliparous woman in spontaneous labor was examined by you at 2pm and was found to be 6 cm dilated, 80% effaced with absent membranes, clear liquor and fully effaced cervix and vertex at 0 station and oxytocin was started to augment the contractions. At 6pm, she is reassessed and found to have same findings, but now with a caput formation and grade 3 moulding. Her contractions were seen to have been adequate for the last 4 hrs. What is the next step?" }, { "role": "assistant", "content": "The correct answer is Ans. C. Shift her to OT for caesareana. The woman is diagnosed with arrest of active stage of laborb. ACOG has updated the definition of arrest of 1st stage of labor in woman undergoing spontaneous labor to decrease the incidence of first caesarean section.c. Arrest in dilatation in active labor is defined at more than or equal to 6cm dilatation, with membrane rupture with no cervical change and one of the following:d. 4 hours or more of adequate uterine contractions (more than 200 Montevideo Units) ORe. 6 hours or more of inadequate uterine contractions" } ]

[ { "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 child swallowed a watch battery containing alkaline content. What next -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Immediate X-ray measurements Alkaline dry cell batteries contain:* Sodium hydroxide* Potassium hydroxideLithium dioxide dry cell batteries contain:* Manganese dioxideSymptoms Of Alkaline Battery Poisoning May Include:* Severe pain in the mouth* Collapse* Inability to breathe due to the throat swelling shut* Severe pain in the throat* Severe abdominal pain* Diarrhea* Vomiting* Drooling* Rapid drop in blood pressureImmediate Management* The person will need immediate x-rays to make sure the battery is not stuck in the esophagus. Most swallowed batteries that pass through the esophagus will pass in the stool without complication. However, if a battery gets stuck in the esophagus, it can cause a hole in the esophagus very quickly.* Radiographic studies of the entire digestive system may be taken. Disk batteries have a characteristic double- density (two-layer) shadow on Xrays. Laterally, their edges are rounded, and they contain a step-off junction at the positive and negative terminal. This can help distinguish them from coins and buttons.* If a battery is located in the esophagus (food pipe), immediate removal is necessary." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Anesthesia, Epidural, Birth Weight, Cesarean Section, Delivery, Obstetric, Female, Forecasting, Humans, Labor, Induced, Pelvimetry, Predictive Value of Tests, Pregnancy, Radiographic Image Enhancement, Sensitivity and Specificity, Ultrasonography, Prenatal." }, { "role": "user", "content": "Does the fetal-pelvic index have minimal utility in predicting fetal-pelvic disproportion? Context: Our purpose was to evaluate the fetal-pelvic index in our patient population and to determine whether it would be predictive of route of delivery. One hundred seventy-six patients with a previous history or clinical findings in the current pregnancy suggestive of fetal-pelvic disproportion participated in this Human Investigation Committee-approved study. All underwent fetal ultrasonographic examinations and modified digital radiography before labor. Fetal head and abdominal circumferences and maternal inlet and midpelvic circumferences were determined, and the fetal-pelvic index was calculated. Ninety-one patients fulfilled all aspects of the study, including rigorous criteria pertaining to labor management. Thirty of these patients underwent cesarean delivery and 61 were delivered vaginally. The fetal-pelvic index value for the vaginal delivery group was -5.4 +/- 5.3, as opposed to -2.4 +/- 5.8 in the cesarean delivery group (P <.02). Notwithstanding this difference, the fetal-pelvic index had a low overall ability to predict fetal-pelvic disproportion (0.65) and had associated sensitivity and specificity of 0.27 and 0.84, respectively. Predictive thresholds other than zero were tested, but optimal predictive ability, at a fetal-pelvic index cutoff of 2, was only 70% (sensitivity 0.20, specificity 0.95)." }, { "role": "assistant", "content": "In our patient population the fetal-pelvic index was only moderately predictive of fetal-pelvic disproportion. Factors other than those assessed by the fetal-pelvic index are probably important in determining the route of delivery. Further studies are indicated. 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: Cohort Effect, Female, Humans, Incidence, Male, Mortality, Multiple Sclerosis, Risk, Sex Ratio, Switzerland." }, { "role": "user", "content": "Is the change in the sex ratio in multiple sclerosis driven by birth cohort effects? Context: Birth cohort effects have greatly shaped long-term trends in multiple sclerosis (MS). This study examined whether birth cohort effects have also determined trends in the sex ratio. Age-period-cohort analyses were applied to Swiss mortality data, 1901-2010, using logit models. Sex was introduced as an additional main effect (overall effect) and in interaction terms with A, P and C. Birth cohort effects strongly impacted the trends of MS risk in Switzerland, with a peak in cohorts born in the 1910s and 1920s. Similarly, birth cohort effects accounted for the change in the sex ratios during the 20th century. The balanced sex ratio at the beginning of the 20th century has been superseded by a ratio with a preponderance of women. Despite similarities in timing, the patterns of overall and sex-specific birth cohort estimates were not congruent." }, { "role": "assistant", "content": "The change in the sex ratio in MS is driven by birth cohort related factors. Overall and sex-specific trends indicate that the appearance of MS has changed dramatically in the 20th century. The driving force behind these trends is related to yet unknown environmental factors. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Does simethicone adjunct to polyethylene glycol improve small bowel capsule endoscopy imaging in non-Crohn 's disease patients? Context: Currently, there is no standardized protocol for bowel preparation before small bowel capsule endoscopy (SBCE). This study aimed to investigate the effect of simethicone combined with polyethylene glycol (PEG) on the visualization quality (VQ) of the SBCE in patients with or without known or suspected Crohn's disease (CD). This observational, prospective, single-center study included consecutive patients undergoing a SBCE between 2007 and 2008. Patients received either a standard bowel cleansing preparation of 2 L PEG and 80 mg simethicone orally 12 and 1 h before SBCE respectively (Group A) or only PEG (Group B). VQ, based on scores for luminal bubbles in frames taken from the small intestine, examination completeness, SBCE diagnostic yield, gastric and small bowel transit times were recorded. Of the 115 patients finally included (Group A, n=56 and Group B, n=59) the cecum was visualized in 103 (89.6%). Simethicone overall improved the VQ in the proximal [OR: 2.43 (95%CI: 1.08-5.45), P=0.032] but not in the distal bowel segment (P=0.064). Nevertheless, this effect was not observed in patients undergoing SBCE for either known or suspected CD." }, { "role": "assistant", "content": "Simethicone as an adjunct to PEG for bowel preparation in patients undergoing SBCE significantly improved the VQ in non-CD patients. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: METHODS, OBJECTIVE, BACKGROUND, METHODS, RESULTS. Meshes: Animals, Cattle, Cell Proliferation, Cells, Cultured, Chondrocytes, Culture Media, Conditioned, Dogs, Dose-Response Relationship, Drug, Intervertebral Disc, Notochord, Proteoglycans." }, { "role": "user", "content": "Do notochord cells regulate intervertebral disc chondrocyte proteoglycan production and cell proliferation? Context: Non-chondrodystrophic dog notochord cell conditioned medium was used to evaluate chondrocyte proteoglycan production and cell proliferation. To evaluate the responsiveness of bovine disc-derived chondrocytes to notochord-cell conditioned medium with respect to proteoglycan and cell proliferation. In addition, to examine phenotypic changes of notochord cells cultured in monolayered as compared to 3-dimensional culture. Non-chondrodystrophic dogs maintain their intervertebral disc notochord cells into adulthood and are protected from having degenerative disc disease develop. The chondrodystrophic breeds such as beagles do not preserve these cells and have disc disease develop much earlier in life. The role of the notochord cell within the disc nucleus is poorly understood. Canine notochord cells were cultured within alginate beads in serum-deficient conditions using Dulbecco modified Eagle medium to produce notochord cell conditioned medium (NCCM). NCCM was used to stimulate bovine disc chondrocytes from which we evaluated proteoglycan production and cell proliferation as compared to chondrocytes grown in DMEM alone. In addition, parallel cultures of notochord cells were seeded within alginate beads as well as in monolayer and cultured in order to examine for differences in phenotype between the 2 culture conditions. The morphologic aspects of the intervertebral disc between the species differed markedly. A dose- dependent relationship was seen between proteoglycan production and NCCM concentration across various concentrations of NCCM in repeated experiments. Although there was a 4-fold increase in cell proliferation under all NCCM concentrations, this increase in cell proliferation was not dose dependent in the concentrations tested. Unlike chondrocytes, notochord cells do not adhere to tissue culture plate (monolayer) until at least day 4-6, do not markedly alter their phenotype, and rapidly assume masses of cells while floating within tissue culture medium." }, { "role": "assistant", "content": "The biology of the disc-derived chondrocyte is profoundly affected by NCCM in that various concentrations of NCCM activate proteoglycan production in a dose-dependent fashion. However, in the doses tested in our study, cell proliferation was increased but in a nondose-dependent fashion. Notochord cells retain their phenotype even in monolayer and through the development of floating intimately associated masses of cells suggest the development and maintenance of cell-cell interaction. These masses of cells are retained even after 6 days in culture when they do attach to the tissue plate surface. The persistence of notochord cells in non-chondrodystrophic dog species suggests that these in vitro studies may mirror the milieu of the disc in vivo, in which the notochord cell may play a key role in disc homeostasis. 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: 2-Pyridinylmethylsulfinylbenzimidazoles, Animals, Anti-Ulcer Agents, Esophageal Neoplasms, Gastroesophageal Reflux, Male, Rabeprazole, Rats, Rats, Sprague-Dawley." }, { "role": "user", "content": "Does rabeprazole impede the development of reflux-induced esophageal cancer in a surgical rat model? Context: The role of proton pump inhibitors in Barrett's metaplasia and esophageal adenocarcinoma has been an area of controversy. We evaluated the effectiveness of the proton pump inhibitor rabeprazole as a chemoprevention agent in a surgical rat reflux model of esophageal cancer. The rat reflux model was created by performing a jejuno-esophagostomy on Sprague-Dawley rats. The surgery promoted the reflux of gastro-duodenal contents into the esophagus. Rabeprazole sodium (Eisai, Tokyo, Japan) was dissolved in 0.9% physiological saline to a desired concentration of 1.5% (W/V). Beginning 4 weeks post-surgery, all animals were administered either 0.2 ml per 100 g body weight injections of rabeprazole or equivalent injections of saline 3 days per week into the subcutaneous tissue of the back. Forty animals were killed 40 weeks after surgery and their esophagi were examined. Of these, 23 were included in the control group, while the remaining 17 were subjected to rabeprazole. While 74% (17/23) of the controls developed esophageal cancer, animals administered rabeprazole had an incidence of cancer of 29% (5/17) (p < 0.05, Fisher's exact test). Barrett's metaplasia was found on 100% (23/23) of the rats in the placebo group, but there was a protective effect in the rabeprazole group with 65% (11/17) of the rats displaying signs of Barrett's metaplasia (p < 0.05, Fisher's exact test). All of the rats developed proliferative hyperplasia." }, { "role": "assistant", "content": "Rabeprazole protected against the development of esophageal cancer in a clinically relevant surgical reflux model. Rabeprazole warrants further investigation for potential clinical use as a chemoprevention agent. 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: Accidents, Home, Adult, Ambulatory Care, Burns, Case-Control Studies, Educational Status, Female, Health Knowledge, Attitudes, Practice, Hospitalization, Humans, Male, Middle Aged, Parents, South Africa, Surveys and Questionnaires, Young Adult." }, { "role": "user", "content": "Do parent knowledge on paediatric burn prevention related to the home environment? Context: Burns amongst children in South Africa are common and usually occur in the immediate home environment. In surveys many parents have requested ongoing educational burn prevention programs. This exploratory thematic parent orientation study assessed the level of parental knowledge on burn prevention strategies in the home. Study populations included: Parent with a burned child admitted to hospital, parents of non-burnt hospital attenders and hospital naive parents unbiased by previous exposure to burns. Participants answered a burn prevention questionnaire consisting of five sections. In this, two pictures depicting the circumstances associated with paediatric burns sustained at home were used, one with 15 potential danger points and one sanitized. There was no educational intervention prior to parents viewing the pictures. There were 268 participants; 72 burnt inpatient, 97 non-burnt outpatients and 99 hospital naive participants. The inpatient population displayed the highest incidence of informal housing. A positive relationship was identified between the overall study population and burns general knowledge and prevention. Educated participants were more knowledgeable about burns and better at identifying risk factors. Knowledge about burns was higher in the outpatient population and the highest in the Naïve group when compared to the Inpatients group (p<0.01). The naïve group scored higher in prior knowledge about burns and burn prevention. Of the potential 15 danger points only four of 72 inpatients and three of 97 outpatients identified more than 80% of the potential danger points as compared to 43 of 99 of the naïve group. The dangling kettle cord, the use of a mug to pour paraffin into a lantern and the child pulling a tablecloth were the most common dangerous aspects identified. We demonstrated a positive correlation between participants' ability to identify potential dangers, identify safe practice and implementing safe practice." }, { "role": "assistant", "content": "Our findings show that people living in environments optimal for burn incidents know relatively little about burn prevention strategies. Future intervention needs to not only target the population's behavior but most importantly needs to promote better education models. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The biphasic pattern on histology is seen in which tumor-" }, { "role": "assistant", "content": "The correct answer is In synovial cell Sarcoma characteristic biphasic pattern seen i.e., Epithelial cells sharply segregated by sarcomatoid cells." } ]

[ { "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": "Frankel\tbehaviour\trating\tsystem\tdoes\tnot\tinclude\nfollowing behaviour:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Age Factors, Aged, Asian Continental Ancestry Group, Blood Glucose, Blood Pressure, Brazil, Cross-Sectional Studies, Diet, Dietary Fats, Dietary Fiber, Education, Emigrants and Immigrants, Female, Humans, Male, Middle Aged, Peripheral Vascular Diseases, Triglycerides." }, { "role": "user", "content": "Are fat and fiber consumption associated with peripheral arterial disease in a cross-sectional study of a Japanese-Brazilian population? Context: The Western diet plays a role for the epidemics of obesity and related diseases. This study examined a possible association between peripheral arterial disease (PAD) and the dietary components of Japanese immigrants living in Brazil. In this cross-sectional study, 1,267 subjects (aged > or =30 years) with complete dietary, clinical and laboratory data were studied according to a standardized protocol. Ankle-to-brachial index was used to identify subjects with PAD. The overall prevalence of PAD was 14.6%. Subjects with PAD were older, had lower education and higher mean values of blood pressure, triglycerides, and fasting and 2-h plasma glucose levels compared with those without the disease. Among the subjects with PAD, the consumption of fiber from whole grains (3.0 vs 3.4 g, p=0.001) and linoleic acids (11.0 vs 11.7 g, p=0.017) were lower and intake of total (72.8 vs 69.1 g, p=0.016) and saturated fatty acids (17.4 vs 16.3 g, p=0.012) were higher than those without PAD. Results of multiple logistic regression analysis showed a significant association between PAD with high total fat intake, low intake of fiber from fruit and oleic acid, independently of other variables." }, { "role": "assistant", "content": "Despite limitations in examining the cause - effect relationship, the data support the notion that diet could be important in reducing the occurrence of PAD. 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": "Pleural fluid having low glucose is seen in all except" }, { "role": "assistant", "content": "The correct answer is Ref Harrison 19 th ed/pg 1717 Figure 316-1 Glucose < 60 mg/dL Consider: Malignancy Bacterial infections Rheumatoid pleuritis . In tubercular effusion , pleural fluid glucose level is usually normal / mildly reduced." } ]

[ { "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": "Maastricht classification of category 3 stands for DCD donor\nstands for" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Adolescent Behavior, Adult, Alcohol Drinking, Cohort Studies, Female, Humans, Longitudinal Studies, Male, Marijuana Abuse, Psychology, Adolescent, Victoria." }, { "role": "user", "content": "Do trajectories of adolescent alcohol and cannabis use into young adulthood? Context: Both alcohol and cannabis use carry health risks. Both are commonly initiated in adolescence. To date little research has described trajectories of adolescent cannabis or alcohol use or compared their respective consequences in young adulthood. The design was a 10-year eight-wave cohort study of a state-wide community sample of 1943 Victorians initially aged 14-15 years. Moderate- and high-risk alcohol use was defined according to total weekly alcohol consumption. Moderate- and high-risk cannabis use were defined as weekly and daily use, respectively. Around 90% of young adults used either alcohol or cannabis. Although an association existed between alcohol and cannabis use, there was a tendency for heavy users to use one substance predominantly at any one time. Weekly or more frequent cannabis use in the absence of moderate-risk alcohol use in teenagers predicted a sevenfold higher rate of daily cannabis use in young adults but only a twofold increase in high-risk alcohol use. Conversely, moderate-risk adolescent alcohol use in the absence of weekly cannabis predicted an approximately threefold increased rate of both high-risk drinking and daily cannabis use in young adulthood. Selective heavy cannabis use in both adolescence and young adulthood was associated with greater illicit substance use and poorer social outcomes in young adulthood than selective alcohol use." }, { "role": "assistant", "content": "Heavier teenage cannabis users tend to continue selectively with cannabis use. Considering their poor young adult outcomes, regular adolescent cannabis users appear to be on a problematic trajectory. 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, Aged, 80 and over, Amphiregulin, Biomarkers, Tumor, Colorectal Neoplasms, EGF Family of Proteins, Female, Glycoproteins, Humans, Immunohistochemistry, Intercellular Signaling Peptides and Proteins, Liver Neoplasms, Male, Middle Aged, Prognosis." }, { "role": "user", "content": "Is amphiregulin a promising prognostic marker for liver metastases of colorectal cancer? Context: Aberrant activation of epidermal growth factor receptors (EGFR/HER1) by ligand stimulation or heterodimerization with human epidermal growth factor 2 (HER2) is considered to play an important role in the development of colorectal carcinoma. Amphiregulin (AR) is a ligand of EGFR that might be related to the development and progression of gastrointestinal tumors. The aim of this study was to determine the AR, EGFR, and HER2 protein expression levels and to evaluate their prognostic relevance to the clinical course of colorectal cancer. The AR, EGFR, and HER2 protein levels in primary tumors of colorectal cancer (n = 106) were examined using immunohistochemistry. Metastatic sites in liver specimens (n = 16) were also analyzed in the same manner. Thirteen (81.6%) metastatic lesions of the liver stained positive for AR. Among the primary lesions of colorectal cancer, 58 (54.7%) stained positive for AR, 13 (12.3%) stained positive for EGFR, and 5 (4.7%) stained positive for HER2. When the relationships between each protein expression level and the clinicopathologic factors were examined, only the AR expression level was significantly related to liver metastasis (P = 0.0296). A multivariate analysis of liver metastasis proved that AR expression was an independent prognostic factor of liver metastasis from colorectal cancer (P = 0.0217)." }, { "role": "assistant", "content": "AR expression in primary lesions of colorectal cancer is an important predictive marker of liver metastasis. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Humans, Image-Guided Biopsy, Magnetic Resonance Imaging, Male, Middle Aged, Prostatic Neoplasms, Retrospective Studies, Ultrasonography, Interventional, Watchful Waiting." }, { "role": "user", "content": "Does multiparametric magnetic resonance imaging enhance detection of significant tumor in patients on active surveillance for prostate cancer? Context: To determine whether multiparametric magnetic resonance imaging (MRI) of the prostate (mpMRI) combined with MRI fusion technology during transrectal ultrasound-guided biopsy can enhance the detection of significant disease in patients with apparent low-risk prostate cancer on active surveillance (AS). We reviewed the charts of 603 patients on AS for localized prostate cancer between January 2006 and September 2013. mpMRI before repeat transrectal ultrasound-guided biopsy was obtained in 111 patients, of whom 69 underwent subsequent fusion biopsy (39 true and 30 cognitive) in addition to standard template biopsy. The results of fusion biopsy were compared with the standard biopsy. The primary endpoint was termination of AS. mpMRI detected 118 suspicious lesions in 70 patients (63%). Of these, 42 patients (60%) had lesions with Prostate imaging, reporting, and data system (PIRADS) score 3, and 28 patients (40%) had PIRADS score 4 or 5 lesions. AS was terminated in 27 (24.3%) of the 111 patients who underwent mpMRI. Seventeen patients stopped AS based on mpMRI findings including 16 for pathologic progression in target biopsies and 1 for lesion size increase, whereas the other 10 stopped AS because of pathologic progression in the standard cores (n = 6) or other reasons (n = 4). Use of mpMRI increased the rate of AS termination (27 vs. 10; P = .002). On multivariate analysis, PIRADS score 4-5 (vs. 3) was the only significant predictor of AS termination (P = .015)." }, { "role": "assistant", "content": "These preliminary retrospective findings suggest that mpMRI with subsequent fusion biopsy enhances the identification of AS patients requiring definitive treatment. 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": "How many episodes of vulval candidiasis per year are needed for diagnosis of recurrent vulvovaginal candidiasis?" }, { "role": "assistant", "content": "The correct answer is Vulvovaginal candidiasis: *Vulvovaginal candidiasis is considered recurrent when at least four specific episodes occur in one year(or) *At least three episodes unrelated to antibiotic therapy occur within one year Ref : Ananthanarayana textbook of Microbiology 9th edition Pgno : 612" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 45-year-old man with a complaint of ear pain and difficulty hearing is diagnosed with tonsillitis. Otoscopic examination reveals fluid in the middle ear cavity. Hypertrophy of which of the following structures would be most likely to compromise the drainage of the auditory tube?" }, { "role": "assistant", "content": "The correct answer is The pharyngeal tonsil is situated in a slit-like space, the pharyngeal recess, in the nasopharynx behind the opening of the auditory (eustachian) tube, and a pharyngeal tonsil in this location can lead to blockage of the drainage of the auditory tube. The lingual tonsil is located in the posterior aspect of the tongue, whereas the palatine tonsil is contained within the tonsillar fossa between the palatoglossal and palatopharyngeal arches. An enlargement of the lingual tonsil or the palatine tonsil will not occlude the auditory tube due to their location in the oropharynx. The superior pharyngeal constrictor would not be involved in occlusion of the auditory tube because it is located more posteriorly. The uvula is drawn upward during deglutition and prevents food from entering the nasopharynx; it does not block the auditory tube." } ]

[ { "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": "Herbert's pits are seen in -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e. Trachoma Signs of Trachomao Conjunctival signs:- Congestion, conjunctival follicles (boiled sagograin like), Papillary hyperplasia, conjunctival scarring (Arifs line), concretion.o Corneal signs Superficial keratitis, Herbert follicles, Pannus, Corneal ulcer, Herbert pits, Corneal opacity." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Female, Health Status Indicators, Humans, Male, Middle Aged, Pain Measurement, Quality of Life, Sickness Impact Profile, Tinnitus, Transcutaneous Electric Nerve Stimulation." }, { "role": "user", "content": "Does treatment of tinnitus with transcutaneous electrical nerve stimulation improve patients ' quality of life? Context: Tinnitus can adversely affect patients' quality of life. Transcutaneous electrical nerve stimulation (TENS) may be effective in the management of tinnitus. No study has investigated the efficacy of TENS for the management of tinnitus by means of quality of life measures. In this study, we evaluated the efficacy of TENS for the management of tinnitus symptoms by using the visual analogue scale (VAS), tinnitus handicap inventory test, Nottingham health profile (NHP) and short form-36 (SF-36) questionnaires. Twenty-two patients were included in this study (male/female, 16/6; mean age, 48.04 +/- 15.57 years). Nine patients had unilateral and 13 patients had bilateral tinnitus. After TENS, improvement measured by VAS was only marginally significant (p = 0.059). However, after TENS, there were statistically significant improvements regarding tinnitus severity scores, tinnitus handicap inventory scores, NHP fatigue, social isolation and emotional problems scores, and many parameters measured by the SF-36 (physical functioning, general health, vitality, social functioning, role limitations due to emotional problems, and mental health)(p < 0.05)." }, { "role": "assistant", "content": "Transcutaneous electrical nerve stimulation is a useful method to improve the quality of life of patients with tinnitus. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All of the following are signs of Cerebella disease except" }, { "role": "assistant", "content": "The correct answer is guyton and hall textbook of medical physiology. *When a person who have lost cerebellum performs a voluntary act the movements tend to oscillate,especially when they approach intended mark 1st over shooting the mark then vibrating back and forth before settling on the mark -intention or action tremors" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: 3T3-L1 Cells, Adipocytes, White, Animals, Coconut Oil, CpG Islands, DNA Methylation, Dietary Fats, Epigenesis, Genetic, Gene Expression Regulation, Intra-Abdominal Fat, Linoleic Acid, Male, Mice, Oleic Acid, Olive Oil, Palmitic Acid, Plant Oils, Promoter Regions, Genetic, Random Allocation, Rats, Sprague-Dawley, Subcutaneous Fat, Abdominal, Sunflower Oil, Vascular Endothelial Growth Factor B." }, { "role": "user", "content": "Are methylation patterns of Vegfb promoter associated with gene and protein expression levels : the effects of dietary fatty acids? Context: We have investigated the epigenetic regulation by dietary fatty acids of Vegfb levels in rats' white adipose tissue and 3T3-L1 cells. A group of rats were assigned to three diets, each one with a different composition of saturated, monounsaturated and polyunsaturated fatty acids. Samples of white adipose tissues were taken for the methylation and expression studies. Additionally, 3T3-L1 cells were treated with palmitic, oleic, and linoleic fatty acids. After treatment, cells were harvested and genetic material was extracted for the analysis of Vegfb levels. We report evidence of changes in the methylation levels of the CpG island at the Vegfb promoter and in the Vegfb expression levels in vivo and in vitro by dietary fatty acid, with the main contribution of the linoleic fatty acid. Vegfb promoter methylation levels were closely related to the Vegfb gene expression." }, { "role": "assistant", "content": "According to our results, the regulation of Vegfb gene expression by dietary fatty acids may be mediated, at least in part, by epigenetic modifications on Vegfb promoter methylation. Considering the deep association between angiogenesis and tissue growth, we suggest the nutriepigenetic regulation of Vegfb as a key target in the control of the adipose tissue expansion. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Biomarkers, Bone Regeneration, Cartilage, Articular, Chondrocytes, Chronic Disease, Collagen Type II, Disease Models, Animal, Injections, Intralesional, Lower Extremity, Male, Platelet-Rich Plasma, Rats, Rats, Sprague-Dawley, Wound Healing." }, { "role": "user", "content": "Does platelet-rich plasma enhance microfracture treatment for chronic focal chondral defects? Context: The purpose of the present study was to compare the effectiveness of platelet-rich plasma (PRP) + microfracture and microfracture treatments in the healing of chronic focal chondral defects. The study included 57 adult male Sprague-Dawley rats. Forty-two rats were divided into three groups of 14 rats with a chondral defect (control, microfracture only, PRP+microfracture). The remaining 15 rats were used to produce the PRP preparation. The rats were then euthanatized at 3 and 6 weeks after treatment and examined. Histological analysis using the modified Pineda scoring system and immunohistochemical staining for Type 2 collagen were performed. At both time intervals, control group histological scores (Week 3: 8.8±1.2, Week 6: 8.5±0.7) were higher than microfracture (Week 3: 6.8±1.0, Week 6: 7.1±0.6) and PRP+microfracture (Week 3: 6.4±1.3, Week 6: 5.7±1.2) scores (p<0.05). The microfracture group score was higher at Week 6 than the PRP+microfracture group (p<0.05). The degree of Type 2 collagen staining was higher at Week 6 in the PRP+microfracture group and was unique in showing staining at the cell membrane." }, { "role": "assistant", "content": "The addition of PRP application to microfracture treatment appears to enhance cartilage healing in chronic focal chondral defects." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Cell Differentiation, Cyclooxygenase 2, Gene Expression, Humans, Male, Membrane Proteins, Middle Aged, Neoplasm Staging, Prostatic Neoplasms, Protein Transport, Receptors, Thromboxane, Thromboxane A2, Thromboxane-A Synthase." }, { "role": "user", "content": "Does activation of the thromboxane A2 pathway in human prostate cancer correlate with tumor Gleason score and pathologic stage? Context: We investigated the potential involvement of the thromboxane A(2) (TXA(2)) pathway in human prostate cancer (PCa). Expression of cyclooxygenase-2 (COX-2), TXA(2) synthase (TXS), and TXA(2) receptors (TPRs), the main actors of the TXA(2) pathway, was analyzed on serial tissue sections from 46 human PCa specimens. The expression levels of COX-2, TXS, and TPRs were significantly higher in malignant than in corresponding nontumoral prostatic epithelial cells. Increased immunoreactivity for these antigens was also observed in high-grade prostate intraepithelial neoplasia (HGPIN) glands. COX-2, TXS, and TPR proteins usually displayed a coordinated overexpression pattern in PCa lesions, as assessed in serial tissue sections. Increased levels of these proteins in the tumors were all significantly associated with higher Gleason scores and pathologic stages." }, { "role": "assistant", "content": "Proteins specifically involved in the TXA(2) pathway are up-regulated in human PCa and their level of expression is associated with tumor extraprostatic extension and loss of differentiation. Our study is the first to examine simultaneously all key proteins involved in this pathway including TXA(2) receptors and results suggest that the TXA(2) pathway may be a potential target for PCa prevention/therapy. 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": "Open fracture is treated by" }, { "role": "assistant", "content": "The correct answer is C i.e. Debridement" } ]

[ { "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 female with diabetes visits antenatal clinic at 6 weeks of amenorrhea. She has not been on any treatment. What is the first step in the management?" }, { "role": "assistant", "content": "The correct answer is Ans. is c, i.e. Perform HbA1cThe first step is to do HbA1c to check her glucose status and assess the risk of fetal congenital malformations." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Does the quality of evidence in Chinese meta-analyses need to be improved? Context: We conducted a systematic review using GRADE (Grading of Recommendations Assessment, Development and Evaluation) system to assess the quality of evidence of Chinese meta-analyses (MAs). A systematic review of MAs listed in Chinese Biomedicine Literature Database from January 2010 to December 2012. Mesh term \"meta-analysis\" was used to search the Chinese Biomedicine Literature Database from January 2010 to December 2012. Characteristics and main outcomes of each included MA were extracted, and the GRADE system was used to assess the quality of evidence for each outcome. A 10% random sample of Cochrane MAs between 2010 and 2012 was also assessed as control group. A total of 564 Chinese MAs (including 1,237 main outcomes) and 95 Cochrane MAs (including 251 main outcomes) were identified. Almost half (600, 48.5%) of the outcomes in Chinese MAs were rated as low, and the proportion of outcomes with high or moderate quality of evidence was lower in Chinese MAs than Cochrane MAs (Chinese, 406 [32.8%] vs. Cochrane MAs, 155 [61.8%], P < 0.001). Of the outcomes in Chinese MAs, 1,012 (81.8%) were downgraded for risk of bias. Other common factors for downgrading were imprecision (448, 36.2%), publication bias (418, 33.8%), inconsistency (351, 28.4%), and indirectness (1, 0.1%)." }, { "role": "assistant", "content": "Chinese MAs were of low quality of evidence. Risk of bias, inconsistency, and publication bias were the three most common downgrade factors in Chinese MAs. Efforts must be made to improve quality of evidence of Chinese MAs, and a call for more rigorous training of investigators in China is warranted. 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 child resorts to lip biting habit without primary involvement of mentalis muscle, the differential diagnosis is:" }, { "role": "assistant", "content": "The correct answer is An important consideration is the necessity for making a differential diagnosis before attempting to break the lip habits. If there is class II div 1 malocclusion or an excessive overjet problem, the abnormal lip activity may be purely compensatory or adaptive to the dentoalveolar morphology. Abnormal lip activity is almost always associated with Class II div 1 malocclusion and open bite problems, and the elimination of the malocclusion usually restores normal muscle function." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Cardiac Surgical Procedures, Comorbidity, Female, Humans, Hyponatremia, Length of Stay, Logistic Models, Male, Middle Aged, Postoperative Complications, Proportional Hazards Models, Stroke Volume, Survival Rate, Ventricular Dysfunction, Left." }, { "role": "user", "content": "Does preoperative hyponatremia potentiate the effects of left ventricular dysfunction on mortality after cardiac surgery? Context: Left ventricular dysfunction and preoperative hyponatremia are associated with adverse outcomes after cardiac surgery. However, the interactions between them are unknown. Thus, we evaluated the interaction of low left ventricular ejection fraction (<40%) and preoperative hyponatremia (Na<135 mEq/L) with morbidity and mortality after cardiac surgery. The interaction of hyponatremia and ejection fraction with hospital complications, length of stay, and mortality was analyzed using logistic and Cox regression analysis in 2247 patients who underwent cardiac surgery between 2005 and 2008 at The Ohio State University Wexner Medical Center. Of the patients, 68.5% had normal ejection fraction. Hyponatremia was present in 18% of patients with normal ejection fraction and 35% of patients with low ejection fraction. Hyponatremic patients had higher rates of New York Heart Association class III and IV, more comorbidities, and higher Society of Thoracic Surgeons score and European System for Cardiac Operative Risk Evaluation irrespectively of their ejection fraction. The correlation between preoperative sodium and ejection fraction was weak (r(2) = 0.04). Hyponatremia increased the rate of postoperative complications and hospital stay, and decreased 1- and 3-year survivals in patients with both normal and low ejection fraction. Hyponatremia was independently associated with longer hospital stay for normal ejection fraction (multiplier, 1.18; confidence interval, 1.09-1.27; P < .001) and low ejection fraction (multiplier, 1.10; confidence interval, 1.0-1.21; P = .05), increased need for dialysis for normal ejection fraction (odds ratio, 2.16; confidence interval, 1.08-4.32; P = .03), and increased risk of mortality for normal ejection fraction (hazard ratio, 1.56; confidence interval, 1.20-2.05; P = .001), but not for patients with low ejection fraction (hazard ratio, 1.21; confidence interval, 0.89-1.65; P = .21)." }, { "role": "assistant", "content": "Hyponatremia is more common in patients with low ejection fraction. Although preoperative hyponatremia is independently associated with adverse outcomes in patients with normal ejection fraction, an association with adverse outcomes in patients with low ejection fraction was not demonstrated." } ]

[ { "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 scientist is studying the characteristics of a newly discovered infectious disease in order to determine its features. He calculates the number of patients that develop the disease over several months and finds that on average 75 new patients become infected per month. Furthermore, he knows that the disease lasts on average 2 years before patients are either cured or die from the disease. If the population being studied consists of 7500 individuals, which of the following is the prevalence of the disease?" }, { "role": "assistant", "content": "0.24" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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. Meshes: Adult, Age Factors, Embryonic Development, Female, Fertilization in Vitro, Humans, Male, Pregnancy, Pregnancy Rate, Sperm Count, Spermatozoa, Telomere." }, { "role": "user", "content": "Is sperm telomere length positively associated with the quality of early embryonic development? Context: What is the relationship between telomere length in sperm and early embryonic development in in vitro fertilization (IVF)?" }, { "role": "assistant", "content": "Sperm telomere length (STL) is positively associated with embryo quality in IVF. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is not true regarding infrabulge clasp" }, { "role": "assistant", "content": "The correct answer is Some of the advantages attributed to the infrabulge clasp are,\n\nIts interproximal location, which may be used to esthetic advantage.\nIncreased retention without tipping action on the abutment.\nLess chance of accidental distortion, resulting from its proximity to the denture border." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Amino Acids, Branched-Chain, Bacterial Translocation, Female, Humans, Intestines, Male, Methylhistidines, Middle Aged, Nitrogen, Postoperative Care, Postoperative Complications, Prospective Studies." }, { "role": "user", "content": "Does a branched chain amino acid-enriched solution induce any beneficial effect on the postoperative intestinal functions? Context: This study was conducted in order to clarify the significance of using a branched chain amino acid-enriched solution on surgical patients, especially regarding the postoperative nitrogen balance as well as such intestinal functions as permeability and immunity. Eight patients were prospectively and randomly divided into 2 groups. Consisting of a control group (n = 4) who all received conventional postoperative hyperalimentation using the branched chain amino acid-enriched solution; and a high-dose group (n = 4), who received an additional amount of branched chain amino acid-enriched solution immediately after operation up until postoperative day 7. No significant differences were observed in the background variables between the two groups. The nitrogen balance in the high dose group from postoperative day 1 to day 4 was significantly better for all compared to those of the control group. The ratio of the branched-chain amino acids to aromatic amino acids at postoperative day 3 in the high dose group was significantly higher than that in the control group. The urinary 3-methylhistidine excretion in the high-dose group tended to be lower than that in the control group. However, regarding the intestinal functions, no significant differences between the two groups were observed regarding the lactulose-mannitol test, the rate of positive Candida antigen, and the serum level of secretary immunoglobulin A, or the serum activity of diamine oxidase." }, { "role": "assistant", "content": "A high dose branched chain amino acid-enriched solution can improve immediately postoperative nitrogen balance and may also lead to the prevention of a breakdown in the skeletal muscles. However, no beneficial effects were observed in the postoperative intestinal functions, which play an important role in preventing bacterial translocation. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND AND AIMS, PATIENTS AND METHODS, RESULTS. Meshes: Acute Disease, Age Factors, Aged, Aged, 80 and over, Cholecystectomy, Cholecystitis, Cholecystolithiasis, Choledocholithiasis, Female, Follow-Up Studies, Gallbladder, Humans, Male, Middle Aged, Recurrence, Retrospective Studies, Sphincterotomy, Endoscopic." }, { "role": "user", "content": "Is cholecystectomy necessary after endoscopic treatment of bile duct stones in patients older than 80 years of age? Context: Although patients with cholecystocholedocholithiasis are generally referred to cholecystectomy after endoscopic sphincterotomy (ES) and common bile duct clearance, we often have a conflict whether cholecystectomy is necessary in very elderly patients with comorbid diseases. The aim of this study is to assess whether cholecystectomy in very elderly patients is justified after ES. Patients with cholecystocholedocholithiasis who underwent ES and stone extraction and were followed-up for more than 10 years were retrospectively reviewed. We divided these patients into two groups: the elderly group (equal to or more than 80 years old) and young group (less than 80 years old) and compared late biliary complications and mortality. The 10-year cumulative incidence of overall biliary complications was significantly lower in cholecystectomized patients than in patients with gallbladder in situ in the young group (7.5 vs. 21.7%, p = 0.0037), but not different in the elderly group (8.3 vs. 7.4%, p = 0.92). When each complication was evaluated separately, the rate of recurrent common bile duct stones (CBDS) was not different, but that of acute cholecystitis was significantly lower in the elderly group than in the young group (4.1 vs. 22.6%, p = 0.011)." }, { "role": "assistant", "content": "In very elderly patients the incidence of acute cholecystitis is low even when the gallbladder is preserved after endoscopic treatment of CBDS, with a similar risk of CBDS recurrence. Thus, it may not be necessary to recommend cholecystectomy after ES for CBDS in very elderly patients." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Blood Glucose, Cohort Studies, Diabetes Mellitus, Type 2, European Continental Ancestry Group, Fasting, Female, Glucose Intolerance, Humans, Interleukin-6, Italy, Male, Middle Aged." }, { "role": "user", "content": "Are plasma interleukin-6 levels increased in subjects with impaired glucose tolerance but not in those with impaired fasting glucose in a cohort of Italian Caucasians? Context: While the relationship between impaired glucose tolerance (IGT) and circulating interleukin-6 (IL-6) is well established, there is no information whether IL-6 levels are elevated in impaired fasting glucose (IFG). To this end, we examined the relationship between plasma IL-6 concentration and different degrees of glucose homeostasis in a cohort of 470 Italian Caucasian subjects comprising 236 normal glucose tolerant (NGT), 49 IFG, 51 IGT, and 134 type 2 diabetic subjects. We observed that IL-6, CRP and fibrinogen levels were higher in subjects with IGT or type 2 diabetes as compared with NGT and IFG subjects. Univariate correlations between IL-6 concentrations and metabolic variables in the whole cohort showed that IL-6 levels were positively correlated with age, BMI, waist, systolic and diastolic blood pressure, fasting plasma glucose, triglycerides, CRP, fibrinogen, and negatively correlated with insulin sensitivity, IGF-I and HDL. In a subgroup analysis including NGT, IFG and IGT (n = 336), IL-6 levels were positively correlated with age, BMI, waist, systolic and diastolic blood pressure, triglycerides, CRP, fibrinogen, fasting insulin, 2 h post-load glucose, and negatively correlated with insulin sensitivity, IGF-I and HDL. Stepwise linear regression analysis in a model including gender, age, BMI, waist, glucose tolerance status, fasting plasma glucose, 2 h post-load glucose, triglycerides, HDL, fasting insulin, and insulin sensitivity revealed that waist was the only independent variable associated with IL-6 levels accounting for 21.0% of its variation (P < 0.0001)." }, { "role": "assistant", "content": "These data show that IGT and type 2 diabetes, but not IFG, are associated with elevated plasma IL-6 levels. 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 type of bartter's syndrome is associated with Sensorineural deafness ." }, { "role": "assistant", "content": "The correct answer is Chloride Channel accessory subunit also Expressed in inner ear, and also associated with  type 4 Bartter's." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Biomarkers, Tumor, Cadherins, Cell Movement, Chemokine CXCL12, Humans, Male, Middle Aged, Prognosis, Prostatectomy, Prostatic Neoplasms, RNA, Messenger, Receptors, CXCR4, beta Catenin." }, { "role": "user", "content": "Is cXCR4 highly expressed at the tumor front but not in the center of prostate cancers? Context: To evaluate the expression of CXCR4, its ligand SDF-1, β-catenin and E-cadherin throughout the local tumor microenvironment of prostate cancer. A total of 64 prostate cancer specimens, 24 frozen and 40 paraffin-embedded sections, were obtained from patients treated with radical prostatectomy for clinically localized cancer. Real-time RT-PCR was used for mRNA quantification of CXCR4 and SDF-1 in the tumor center (T), tumor front (F) and distant peritumoral tissue (D). Immunohistochemical analysis was used to investigate the expression patterns of CXCR4, E-cadherin and β-catenin. Clinical records of these patients were studied for follow-up data, and the prognostic value of these molecules' expression was statistically assessed. CXCR4 mRNA and protein were significantly increased at the tumor front as compared to distant tissue or tumor center. In comparison, SDF-1 mRNA level gradually increased from the tumor center to the distant peritumoral tissue. High CXCR4 at the tumor front was associated with high Gleason score. Low SDF-1 at the tumor front was associated with locally advanced cancer and disease recurrence. Moreover, high CXCR4 staining at the tumor front and increased cytosolic E-cadherin expression in the same location was associated with locally advanced disease." }, { "role": "assistant", "content": "CXCR4 seems overexpressed at the tumor front of prostate tumors, where it potentially promotes cell migration toward the SDF-1 centrifugal attracting gradient, as well as epithelial-mesenchymal transition. High CXCR4 and low SDF-1 levels at tumor front were both associated with adverse histological features. 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 10 year old boy presents with mucosal bleeding of 1 week duration. The investigation of choice that will be most useful in him is –" }, { "role": "assistant", "content": "The correct answer is Bleeding from mucosal surface suggests thrombocytopenia or defect in platelet function.\nFirst do platelet count, if there is thrombocytopenia, further investigation will be required." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Birth Weight, Breast Neoplasms, Cohort Studies, Diseases in Twins, Environment, Female, Genetic Predisposition to Disease, Humans, Pregnancy, Proportional Hazards Models, Risk Factors, Sweden." }, { "role": "user", "content": "Birth weight-breast cancer revisited: is the association confounded by familial factors? Context: The study aimed to investigate whether the association between birth weight and the risk of breast cancer can be confounded by familial factors, such as shared environment and common genes. Eligible were all female like-sexed twins of the Swedish Twin Registry, born during the period 1926-1958 and alive in 1973. Data were obtained from birth records, and the final study population with reliable birth weight data was made up of 11,923 twins. Hazard ratios (HR) for breast cancer according to birth weight were estimated through Cox regression, using robust SE to account for the dependence within twin pairs. Paired analysis was done to account for potential confounding by familial factors. In the cohort analysis, a birth weight>or=3,000 g was associated with an increased risk of breast cancer diagnosed at or before 50 years [adjusted HR, 1.57; 95% confidence interval (95% CI), 1.03-2.42] but not with breast cancer with a later onset (adjusted HR, 0.80; 95% CI, 0.57-1.12). From>or=2,500 g, a 500-g increase in birth weight conferred a HR of 1.62 (95% CI, 1.16-2.27) for breast cancer diagnosed at or before 50 years. This risk remained in analysis within twin pairs (HR, 1.57; 95% CI, 1.00-2.48)." }, { "role": "assistant", "content": "In the present study, findings indicate that the association between birth weight and breast cancer risk, seen only in women diagnosed early (<or=50 years), is not confounded by familial factors." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, STUDY DESIGN, RESULTS. Meshes: Adolescent, Adult, African Americans, African Continental Ancestry Group, Birth Weight, Blood Glucose, Blood Pressure, Body Constitution, Body Mass Index, Cardiovascular Diseases, Child, Child, Preschool, Female, Growth, Humans, Infant, Infant, Newborn, Linear Models, Lipids, Longitudinal Studies, Male, Models, Statistical, Obesity, Prospective Studies, Risk Factors, Urban Population." }, { "role": "user", "content": "Can cardiovascular risk be predicted by newborn, childhood, and adolescent body size? Context: Recent retrospective studies of older adults have demonstrated a correlation between lower birth weight and hypertension and insulin resistance. We tested this finding in our sample of urban African Americans with prospective data on growth and blood pressure and also tested other variables (in addition to birth weight) for their relationship to adult cardiovascular risk. A prospective study of birth weight, growth, and blood pressure (Philadelphia Perinatal Collaborative Project) followed a sample of 137 African Americans, with nine examinations from birth through 28.0 +/- 2.7 years. Metabolic measurements (oral glucose tolerance testing, euglycemic hyperinsulinemic clamp, and plasma lipid concentration) were performed on the subjects as adults. Bivariate correlations among parameters were computed using the Pearson r. The chi-squared statistic was used to determine associations of outcomes with birth weight. Stepwise multiple linear regressions were computed using newborn, early childhood, adolescent, and young adult parameters to predict adult outcomes. Birth weight and blood pressure at age 28 years are not correlated (Pearson r = 0.06). Birth weight is also unrelated to adult obesity. However, weight at 0.3 years and after and body mass index at 7 years and after are correlated with adult weight. Furthermore, weight at age 14 years is significantly negatively correlated with measures of insulin-stimulated glucose use, indicating that obese adolescents may be at greater risk than nonobese adolescents for development of non-insulin dependent diabetes in adulthood." }, { "role": "assistant", "content": "We found no relationship between birth weight and adult outcomes pertaining to cardiovascular risk in this sample of adult African Americans. However, we did find evidence that somatic growth (body weight and body mass index) is significantly related to obesity and attenuated insulin-stimulated glucose utilization in adulthood. These findings indicate that the origins of adult cardiovascular disease are related to somatic growth, but not intrauterine growth, and are evident during childhood." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Catheters, Indwelling, Contrast Media, Device Removal, Feasibility Studies, Humans, Male, Middle Aged, Pain, Postoperative, Postoperative Complications, Postoperative Period, Prostatectomy, Prostatic Neoplasms, Radiography, Time Factors, Urinary Bladder, Urinary Catheterization, Urinary Incontinence." }, { "role": "user", "content": "Is early removal of urinary catheter after radical retropubic prostatectomy both feasible and desirable? Context: To determine the feasibility and desirability of removing the urinary catheter 7 days after radical retropubic prostatectomy. Between February 28, 2000 and October 5, 2000, 184 men underwent radical retropubic prostatectomy by a single surgeon. Of these men, 97% underwent gravity cystography under fluoroscopic control on postoperative day (POD) 7. The indwelling urinary catheter was removed on POD 7 if no evidence of extravasation was observed on cystography. Patients completed a self-administered questionnaire at the time of catheter removal to capture the degree of bother from incisional pain and the indwelling urinary catheter during the recovery period. The level of urinary continence was determined at 3 months after radical retropubic prostatectomy. One hundred thirty-five of the cystograms (75%) had no evidence of extravasation. The indwelling catheters were removed in 130 (97%) of 135 cases. The body weight, surgical specimen weight, presence or absence of intraoperative anastomotic extravasation, volume of pelvic drainage recorded from the Hemovac drain, and creatinine level of the pelvic drainage fluids did not predict the finding of extravasation on the POD 7 cystogram. Fifteen percent of the men whose catheters were removed on POD 7 developed acute urinary retention. At 3 months, 72% of men required no or a single protective pad, and 87% indicated they experienced no or slight bother from incontinence. These continence outcomes are comparable with a historical control group by the same surgeon who underwent catheter removal on POD 14. Forty-five percent of the men reported the catheter caused moderate to severe bother, compared with only 19% of men who indicated moderate to severe bother from incisional pain. In retrospect, 95.6% of men indicated willingness to undergo cystography on POD 7 with the intent of early catheter removal." }, { "role": "assistant", "content": "The results of our study suggest that most men will have no extravasation on a cystogram performed on POD 7 and that removing the catheter at this time in these cases does not increase the risk of complications or compromise overall urinary continence. The urinary catheter is a significant bother and limits physical activity during the postoperative period. Cystography and early removal of the catheter is both feasible and desirable and should be offered to men after radical retropubic prostatectomy. 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, METHODS, RESULTS. Meshes: Anti-Bacterial Agents, Brazil, Bronchodilator Agents, Child, Child Health Services, Cross-Sectional Studies, Hospitals, Pediatric, Humans, Male, Practice Guidelines as Topic, Respiratory Sounds, Respiratory Tract Infections, Treatment Outcome, World Health Organization." }, { "role": "user", "content": "Wheezing and respiratory infections in Brazilian children: does a standard management work? Context: Wheezing associated with acute respiratory infections (ARI) is responsible for unnecessary use of antibiotics. To evaluate the response of children with ARI and wheezing managed according to the World Health Organization (WHO) protocol. Cross-sectional study of children aged 2-59 months conducted in a Brazilian pediatric public hospital. Children showing fast breathing received inhalations of bronchodilator. Those who persisted with fast breathing had chest radiographs taken. When appropriate, oral antibiotics were prescribed for pneumonia. Audible wheezing was also registered. We included 217 children: mean age 25.7 months (SD = 17.5) with 54.4% (118/217) being males. Audible wheezing was detected in 18.6% (40/217). In 87.6% (190/217) of children normal respiratory rates were reached after inhalations. In cases of pneumonia, 26% (7/27) persisted with fast breathing." }, { "role": "assistant", "content": "A good response using WHO protocol suggests its usefulness in emergency rooms, although few cases will continue to receive antibiotics unnecessarily." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which one of the following phenomena is closely associated with slow wave sleep" }, { "role": "assistant", "content": "The correct answer is Slow wave sleep events (Stage 3 & 4 NREM)\n-        Somnambulism\n-        Night terrors\n-        Nocturnal enuresis\n-        Bruxism\n-        Sleep talking" } ]

[ { "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": "Cranial Nerve 8 palsy causes all EXCEPT:" }, { "role": "assistant", "content": "The correct answer is Ans. (a) Gag reflexRef : Harrison 19th ed. / 2537-38Damage to the vestibulocochlear nerve may cause the following symptoms:* Hearing loss* Vertigo* False sense of motion* Loss of equilibrium (in dark places)* Nystagmus* Motion sickness* Gaze-evoked tinnitusThe gag reflex has the following pathway* The sensory limb is mediated predominantly by CN IX (glossopharyngeal nerve)* The motor limb by CN X (Vagus nerve).The gag reflex involves a brisk and brief elevation of the soft palate and bilateral contraction of pharyngeal muscles evoked by touching the posterior pharyngeal 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: UNLABELLED. Meshes: Aged, Biomarkers, Tumor, Carcinoma, Hepatocellular, Cell Transformation, Neoplastic, DNA Mutational Analysis, Female, Humans, Liver Cirrhosis, Liver Neoplasms, Male, Middle Aged, Mutation, Precancerous Conditions, Promoter Regions, Genetic, Telomerase." }, { "role": "user", "content": "Is telomerase reverse transcriptase promoter mutation an early somatic genetic alteration in the transformation of premalignant nodules in hepatocellular carcinoma on cirrhosis? Context: Genetic determinants of the early steps of carcinogenesis on cirrhosis are still poorly understood. We aimed to evaluate the occurrence of telomerase reverse transcriptase (TERT) promoter mutations in the transformation of cirrhotic nodules into hepatocellular carcinoma (HCC). We analyzed a series of 268 liver samples, including 96 nodules developed in 58 patients with cirrhosis and 114 additional cirrhosis. All samples were screened for TERT promoter mutations, and in 31 nodules, for 10 genes recurrently mutated in HCC. Immunohistochemistry (IHC) analyses were performed for glypican 3, glutamine synthase, and heat shock protein 70. Six liver pathologists reviewed all the samples. Among The 96 nodules, 88 were firmly diagnosed as low-grade dysplastic nodules (LGDNs; 32 cases), high-grade dysplastic nodules (HGDNs; 16 cases), early HCC (eHCC; 23 cases), or small and progressed HCC in 17 cases. The agreement between the initial diagnosis from pathological report and the final expert consensus report was moderate for the diagnosis of benign versus malignant nodules (weighted kappa = 0.530). TERT promoter mutations were highly related to the step-wise hepatocarcinogenesis because mutations were identified in 6% of LGDNs, 19% of HGDNs, 61% of eHCCs, and 42% of small and progressed HCC. TERT promoter mutation is the most frequent molecular alteration in eHCC given that the IHC criteria for diagnosis of malignancy were found in only 39% of the cases. TERT promoter mutation was also the earliest genetic alteration because mutations in 10 other genes were only identified in 28% of the small and progressed HCC." }, { "role": "assistant", "content": "Frequency of TERT promoter mutations rapidly increases during the different steps of the transformation of premalignant lesions into HCC on cirrhosis. Consequently, somatic TERT promoter mutation is a new biomarker predictive of transformation of premalignant lesions into HCC. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The conversion of C02 and H20 into carbonic acid during the formation of aqueous humor is catalysed by which one of the following enzymes" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' ie carbonic anhydrase (Ref: Parson, 19/e, p166; Kanski, 5/e, p193; Chatterjee Shinde Biochemistry. 6/e, p629).Nowhere could 1 find a direct answer. The points in favour of the above answer are --Of all the above options, carbonic anhydrase is the only enzyme which catalyzes the reversible reaction :CO2+H2O =H2 CO3Kanski writes - \"Aqueous humor is actively secreted by the non pigmented epithelium as a result of a metabolic process that depends on several enzyme systems, specially the Na+/K+ ATPase pump, which secretes Na+ ions into the posterior chamber. Water follows passively along the osmotic gradient. Carbonic anhydrase also plays a role, but the precise mechanism is uncertain.\"Parson writes - \"Carbonic anhydrase inhibitors block the action of carbonic anhydrase and reduce the production of aqueous in the eye.\"" } ]

[ { "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 fulfil all the criterias of Koch's postulates?" }, { "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": "Indications of circumcision are all except:" }, { "role": "assistant", "content": "The correct answer is Indications of Circumcision Phimosis Religion (Jews and Muslims) Paraphimosis Balanitis or balanoposthitis Recurrent UTI BXO (balanitis xerotica obliterans)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, STUDY DESIGN, RESULTS. Meshes: Adaptation, Psychological, Adolescent, Adult, Affective Symptoms, Aged, Chi-Square Distribution, Chronic Disease, Depression, Female, Headache, Humans, Male, Middle Aged, Pain, Pain Measurement, Psychological Tests, Self-Assessment, Sickness Impact Profile, Surveys and Questionnaires, Temporomandibular Joint Disorders." }, { "role": "user", "content": "A psychological comparison of temporomandibular disorder and chronic daily headache: are there targets for therapeutic interventions? Context: Temporomandibular disorder (TMD) and chronic daily headache (CDH) are chronic problems affecting the head and face. The aim of this study was to compare TMD and CDH, in terms of cognitive factors, including illness perceptions and coping strategies. A total of 102 patients, 18 to 70 years of age, classified into 2 groups, TMD or CDH, were recruited in this study from a variety of centres in London. On initial consultation patients underwent clinical examination and were asked to complete 8 questionnaires and checklists evaluating mental and psychological state. Six months later, identical questionnaires were posted to all patients; response rate was 76% and 65% for the TMD and CDH patients, respectively. The data were then analyzed to assess different targets for therapeutic interventions. At first observation, TMD patients were found to have more clinical signs: localized increased jaw sounds, limited mouth opening, arthralgia, and myalgia during palpation, however, the duration of pain was higher in the CDH group. Significant differences (P<.01) in terms of psychological distress, were identified between the 2 groups. The CDH group scored higher in 3/3 bands of the Toronto Alexithymia Scale, indicating difficulty expressing emotion; the consequence band of the Illness Perceptions Questionnaire, indicating they were less likely to expect a cure; and were more likely to catastrophize as shown by the Coping Strategies Questionnaire. The 2/4 bands of the McGill Pain Questionnaire showed that CDH group had more severe pain and more depression as measured by the Hospital Anxiety and Depression Scale. TMD patients scored higher in the control band of the Coping Strategies Questionnaire indicating greater control over pain. However, at 6-month follow-up, the only significant difference (P<.01) was in the physiological band of the Illness Perception Questionnaire, the CDH group scored higher. However, this is probably of limited clinical significance. There were no significant differences except in the depression part of the Hospital Anxiety and Depression Scale, the headache group scored higher. Temporomandibular disorder was reported to be less painful, more controllable, and possibly less responsive to reassurance." }, { "role": "assistant", "content": "This study suggests that differences in cognitive findings between the 2 groups of patients are not sustained over time. Initially, the headache patients catastrophized, were more distressed, and more depressed. However, these differences disappeared at follow-up. Significant correlations between perceived performance (\"timeline\" IPQ); disability and anxious mood; perceived consequence with disability and depressed mood; and catastrophizing (CSG) with pain, disability, and anxious mood present possible targets for therapeutic intervention." } ]

[ { "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": "One PHC covers how much population in hilly area?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., 20000" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Acromegaly, Adult, Bulgaria, Cohort Studies, Comorbidity, Dopamine Agonists, Female, Human Growth Hormone, Humans, Insulin-Like Growth Factor I, Italy, Life Expectancy, Male, Middle Aged, Receptors, Somatotropin, Retrospective Studies, Somatostatin, Treatment Outcome." }, { "role": "user", "content": "Could different treatment approaches in acromegaly influence life expectancy? Context: Mortality in acromegaly strictly depends on optimal control of GH and IGF1 levels. Modern medical therapy with somatostatin analogs (SSAs) and GH receptor antagonists (GHRAs) is not available in many countries due to funding restrictions. This retrospective, comparative, cohort study investigated the impact of different treatment modalities on disease control (GH and IGF1) and mortality in acromegaly patients. Two cohorts of patients with acromegaly from Bulgaria (n=407) and Campania, Italy (n=220), were compared, and mortality rates were evaluated during a 10-year period (1999-2008). The major difference in treatment approach between cohorts was the higher utilization of SSAs and GHRAs in Italy, leading to a decreased requirement for radiotherapy. Significantly more Italian than Bulgarian patients had achieved disease control (50.1 vs 39.1%, P=0.005) at the last follow-up. Compared with the general population, the Bulgarian cohort had a decreased life expectancy with a standardized mortality ratio (SMR) of 2.0 (95% CI 1.54-2.47) that was restored to normal in patients with disease control - SMR 1.25 (95% CI 0.68-1.81). Irradiated patients had a higher cerebrovascular mortality - SMR 7.15 (95% CI 2.92-11.37). Internal analysis revealed an independent role of age at diagnosis and last GH value on all-cause mortality and radiotherapy on cerebrovascular mortality. Normal survival rates were observed in the Italian cohort: SMR 0.66 (95% CI 0.27-1.36)." }, { "role": "assistant", "content": "Suboptimal biochemical control was associated with a higher mortality in the Bulgarian cohort. Modern treatment options that induce a strict biochemical control and reduce the necessity of radiotherapy might influence the life expectancy. Other factors, possibly management of comorbidities, could contribute to survival rates." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, RESULTS. Meshes: AMP-Activated Protein Kinases, Adult, Biopsy, Needle, Cell Culture Techniques, Glucose Transporter Type 4, Histone Deacetylases, Humans, Kinetics, Male, Multienzyme Complexes, Muscle, Skeletal, Phosphorylation, Plasmids, Polymerase Chain Reaction, Protein-Serine-Threonine Kinases, RNA, Transcription, Genetic." }, { "role": "user", "content": "Does aMP-activated protein kinase regulate GLUT4 transcription by phosphorylating histone deacetylase 5? Context: Insulin resistance associated with obesity and diabetes is ameliorated by specific overexpression of GLUT4 in skeletal muscle. The molecular mechanisms regulating skeletal muscle GLUT4 expression remain to be elucidated. The purpose of this study was to examine these mechanisms. Here, we report that AMP-activated protein kinase (AMPK) regulates GLUT4 transcription through the histone deacetylase (HDAC)5 transcriptional repressor. Overexpression of HDAC5 represses GLUT4 reporter gene expression, and HDAC inhibition in human primary myotubes increases endogenous GLUT4 gene expression. In vitro kinase assays, site-directed mutagenesis, and site-specific phospho-antibodies establish AMPK as an HDAC5 kinase that targets S259 and S498. Constitutively active but not dominant-negative AMPK and 5-aminoimidazole-4-carboxamide-1-beta-D-ribonucleoside (AICAR) treatment in human primary myotubes results in HDAC5 phosphorylation at S259 and S498, association with 14-3-3 isoforms, and H3 acetylation. This reduces HDAC5 association with the GLUT4 promoter, as assessed through chromatin immunoprecipitation assays and HDAC5 nuclear export, concomitant with increases in GLUT4 gene expression. Gene reporter assays also confirm that the HDAC5 S259 and S498 sites are required for AICAR induction of GLUT4 transcription." }, { "role": "assistant", "content": "These data reveal a signal transduction pathway linking cellular energy charge to gene transcription directed at restoring cellular and whole-body energy balance and provide new therapeutic targets for the treatment and management of insulin resistance and type 2 diabetes. 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": "Index case is the -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., First case defected by investigator [Ref: Park 22nd/e d. 92 & 21st/e p. 9/1o Primary caseo Index case--First case of communicable disease introduced into the population.First case to come to attention of the investigator.o It is not always necessary that primary case will be index case : -When the first case noticed by the investigator is also the first case of the population - Primary case and index case are the same.When the first case nociced by the investigator is not the first case of the population (primary case) - Index case and primary case are different.o Secondary cases - Cases those developing from contact with primary case." } ]

[ { "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 not an indication of this procedure:" }, { "role": "assistant", "content": "The correct answer is Ans. (C). Wife is FrigidThe image shows artificial insemination procedure.It is the procedure of artificial introduction of semen into female genital tract to induce pregnancy.Indications of artificial insemination:Husband is impotentHusband is sterileHusband is unable to deposit semen due to hypospadiasisHusband is suffering from hereditary diseaseRh incompatibility between husband & wife" } ]

[ { "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 girl is brought to the emergency room by her parents with severe shortness of breath, cough, and wheezing after playing with her friends in the garden. She has a history of bronchial asthma. Her vital signs are as follows: respiratory rate 39/min, pulse 121/min, blood pressure 129/67 mm Hg, and temperature 37.2°C (99°F). On physical exam, she looks confused and has bilateral diffuse wheezes on chest auscultation. Which of the following is the most appropriate drug to rapidly reverse her respiratory distress?" }, { "role": "assistant", "content": "Inhaled albuterol" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Calcitriol, Female, Humans, Hyperthyroidism, Male, Middle Aged, Parathyroid Hormone, Prospective Studies, Renal Dialysis, Reproducibility of Results." }, { "role": "user", "content": "Does intact PTH assay overestimate true 1-84 PTH levels after maxacalcitol therapy in dialysis patients with secondary hyperparathyroidism? Context: Although the so-called intact parathyroid hormone (iPTH) assay detects not only true 1-84 PTH (1-84PTH) but also large C-terminal PTH fragments, it remains inconclusive whether the 1-84PTH assay is more useful in clinical practice. Previous studies have shown that the results of these two PTH assays in dialysis patients are closely correlated. Chronic dialysis patients whose plasma iPTH levels were >400 pg/ml were selected for inclusion in the present study. Following a 4 week wash-out time during which all vitamin D administration was halted, maxacalcitol was intravenously injected at the end of dialysis sessions three times per week for 24 weeks, at an initial dosage of 10 micro g. Ninety-seven patients with secondary hyperparathyroidism were included in our analysis. Their serum calcium levels were elevated from the start levels while phosphate levels remained unchanged. The plasma 1-84PTH levels constantly declined throughout the 24 weeks. Although the patients' plasma 1-84PTH and iPTH levels were closely correlated with each other both at the beginning of the study and after 24 weeks of maxacalcitol therapy, the ratio of 1-84PTH/iPTH consistently decreased throughout the study period (P<0.01). The changes in the ratio were significantly correlated with changes in serum calcium levels." }, { "role": "assistant", "content": "Twenty-four weeks of intravenous maxacalcitol injection therapy significantly reduced the 1-84PTH/iPTH ratio. Estimated 1-84PTH levels from iPTH levels using a conversion formula obtained before the treatment were 21.0+/-20.4% higher than measured 1-84PTH levels after the therapy. Thus, iPTH measurement has a potential risk to overestimate 1-84PTH levels when evaluating the efficacy of maxacalcitol therapy in dialysis patients with secondary hyperparathyroidism. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which one of the following is NOT true in relation to angiotensin converting enzyme (ACE)  inhibitor?" }, { "role": "assistant", "content": "The correct answer is ACEI are used for the treatment of hypertension, CHF, evolving MI, diabetic nephropathy, diabetic retinopathy, non-diabetic renal disease and also in scleroderma crisis. These drugs reduce proteinuria in diabetic as well as non-diabetic renal disease and also prevent the manifestations of scleroderma crisis which are mediated by angiotensin II.\nMost frequent adverse effect associated with these agents is dry cough. It can be reduced by iron supplements and asprin. ACEI can also cause angioedema. Both cough and angioedema is due to elevated levels of bradykinin.\nThese can cause hyperkalemia if used along with other agents causing elevation of serum potassium (like potassium sparing diuretics).\nOther adverse effects include rashes, dysguesia (altered taste sensation), and acute renal failure (if used in bilateral renal artery stenosis). It is important to distinguish between acute renal failure and a normal predictable rise in serum creatinine secondary to ACE inhibitor therapy. An increase in serum creatinine upto 30% within 2-5 days can be expected in most patients started on ACE inhibitors. It stabilizes in 2-3 weeks and is reversible on stopping drug therapy. These drugs are contra-indicated in pregnancy (teratogenic in second half of pregnancy) and when serum creatinine is more than 3.5 mg/dl.\n\nAll patients with diabetic nephropathy, whether hypertensive or normotensive, deserve ACE inhibitor therapy.  Deterioration of retinopathy in diabetics also appears to be retarded by ACE inhibitors.\nReference: Essentials of Medical Pharmacology Eighth Edition KD  TRIPATHI page no 535" } ]

[ { "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 type of face bow is used to locate the exact hinge axis point:" }, { "role": "assistant", "content": "The correct answer is Arbitrary face bows are used to record terminal hinge axis arbitrarily. It is most commonly used in complete denture prosthodontics. It may be of facial type or eyepiece type.\nKinematic face bow is used to determine and locate the exact hinge axis point. It is attached to lower jaw. It is not used for complete denture fabrication. It is generally used for the fabrication of FPD and full mouth rehabilitation." } ]

[ { "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": "Fecal contamination of water is evaluated by" }, { "role": "assistant", "content": "The correct answer is Coliforms are E. coli (faecal) and Klebsiella (non-faecal). E. coli is the most typical faecal coliform. They are chosen as the indicators of faecal pollution of water because, They are constantly present in abundance in the human intestine. They can be easily detected by culture methods. they tend to survive longer than the pathogens. they have greater resistance to forces of natural purification than waterborne pathogens. Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 780" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adenylyl Cyclases, Adult, Amygdala, Animals, Depressive Disorder, Disease Models, Animal, Emotions, Female, Functional Neuroimaging, Gene Expression, Genetic Predisposition to Disease, Genotype, Gyrus Cinguli, Humans, Magnetic Resonance Imaging, Male, Mice, Mice, Inbred C57BL, Mice, Knockout, Polymorphism, Single Nucleotide, Serotonin Plasma Membrane Transport Proteins." }, { "role": "user", "content": "Is adenylate cyclase 7 implicated in the biology of depression and modulation of affective neural circuitry? Context: Evolutionarily conserved genes and their associated molecular pathways can serve as a translational bridge between human and mouse research, extending our understanding of biological pathways mediating individual differences in behavior and risk for psychopathology. Comparative gene array analysis in the amygdala and cingulate cortex between the serotonin transporter knockout mouse, a genetic animal model replicating features of human depression, and existing brain transcriptome data from postmortem tissue derived from clinically depressed humans was conducted to identify genes with similar changes across species (i.e., conserved) that may help explain risk of depressive-like phenotypes. Human neuroimaging analysis was then used to investigate the impact of a common single-nucleotide polymorphism (rs1064448) in a gene with identified conserved human-mouse changes, adenylate cyclase 7 (ADCY7), on threat-associated amygdala reactivity in two large independent samples. Comparative analysis identified genes with conserved transcript changes in amygdala (n = 29) and cingulate cortex (n = 19), both critically involved in the generation and regulation of emotion. Selected results were confirmed by real-time quantitative polymerase chain reaction, including upregulation in the amygdala of transcripts for ADCY7, a gene previously implicated in human depression and associated with altered emotional responsiveness in mouse models. Translating these results back to living healthy human subjects, we show that genetic variation (rs1064448) in ADCY7 biases threat-related amygdala reactivity." }, { "role": "assistant", "content": "This converging cross-species evidence implicates ADCY7 in the modulation of mood regulatory neural mechanisms and, possibly, risk for and pathophysiology of depression, together supporting a continuous dimensional approach to major depressive disorder and other affective disorders. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Lyme's disease is caused by" }, { "role": "assistant", "content": "The correct answer is Lyme disease is named after the town of Lyme, Connecticut, where clusters of cases in children were identified. Lyme disease is caused by the spirochete Borrelia burgdorferi and is transmitted to humans by the bite of a small Ixodes tick. The disease has early manifestations with a characteristic skin lesion, erythema migrans, along with flu-like symptoms, and late manifestations often with arthralgia and arthritis." } ]

[ { "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 52-year-old man is complaining of fatigue. His physical examination is normal, but his hemoglobin is low at 8.9 mg/dL. The reticulocyte count is 0.5 %, serum iron and TIBC are normal, and ferritin is elevated. A bone marrow aspirate reveals erythroid precursors that have accumulated abnormal amounts of mitochondrial iron.For the above patient with a hypochromic microcytic anemia, select the most likely diagnosis." }, { "role": "assistant", "content": "The correct answer is Erythroid precursors that have accumulated abnormal amounts of iron are called ringed sideroblasts. Sideroblastic anemia can be either inherited or acquired. Common acquired causes are ingestion of certain drugs, alcohol, or toxins such as lead or zinc. The beta-thalassemia trait is diagnosed by demonstrating an elevated HbA2, iron deficiency by iron studies and ferritin levels, and anemia of chronic disease by demonstrating a chronic disease. Sideroblastic anemia generally requires a bone marrow aspiration revealing ringed sideroblasts for diagnosis." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Drug used to perform stress ECHO -" }, { "role": "assistant", "content": "The correct answer is Stress echo has the same technique used to acces the hea function at rest with a stressor as exercise or dobutamine infusion. It can cause emergence of regions of akinesis or dyskinesis not present at rest.IT Is primarily indicated to confirm the suspicion of ischaemic hea disease and to estmate its severity. Response of gradient to dobutamine stimulation is of diagnostic and therapeutic value in pts with low systolic function of concomitant coronary hea disease. Ref : Sutton 7/e p-277" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 25 year old lady, presents with vaginal discharge. Examination of the discharge reveals the presence of Chlamydial infection. The treatment of choice is:" }, { "role": "assistant", "content": "The correct answer is If Chlamydia Trachomatis is suspected or diagnosed, both the patient and the paner should be treated. Recommended therapy includes azithromycin 1g orally in a single dose or doxycycline 100mg orally twice daily for 7 days. Ref: Harrison's Principles of Internal Medicine, 15th Edition, Page 1001 ; Current Obs and Gynae Diagnosis and Treatment, 9th Edition, Pages 652-3" } ]

[ { "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": "Mechanism of action of protease inhibitors is:" }, { "role": "assistant", "content": "The correct answer is Ans. (A) Prevents maturation of new viral particles(Ref: KDT 7/e p809)Function of protease enzyme in HIV is to break inactive polyproteins to functional components. This post-translational modification is required for maturation of new viral particles. Protease inhibitors like atazanavir inhibit this step." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Antihypertensive Agents, Drug Substitution, Enalapril, Humans, Hydrochlorothiazide, Therapeutic Equivalency." }, { "role": "user", "content": "Is meta-analysis for bioequivalence studies : interchangeability of generic drugs and similar containing Hydrochlorothiazide possible but not with Enalapril Maleate? Context: The generic drugs program provided a better population's access to medicines. To ensure interchangeability between a brand-name and generic or similar drugs is necessary that they are bioequivalent. With the growing number of generic drugs, it is common for patients to replace a generic to another or one similar. However, this exchange can not guarantee the maintenance of bioequivalence. To evaluate the safety interchangeability between different generic and similar drugs with Hydrochlorothiazide and Enalapril Maleate, a meta-analysis was carried out with several bioequivalence studies with these drugs. Data from bioequivalence of generic and similar drugs approved by the National Health Surveillance Agency (Anvisa) (drug regulatory agency in Brazil) were used. The compatibility of data from each study was analyzed and the determination of a confidence interval for the differences between the means of pharmacokinetic parameters, area under the curve (ASC0-t) and maximum plasma concentration (Cmax), was made for each study by meta-analysis. The interchangeability between the combinations of the three products with Hydrochlorothiazide was confirmed based on the obtained confidence intervals. For the drugs studied with Enalapril Maleate interchangeability has not been confirmed for 50% of the product comparisons." }, { "role": "assistant", "content": "The exchange was established between the three products with hydrochlorothiazide. However, for the Enalapril Maleate half of the products studied are not interchangeable, considering they do not match the established intervals for bioequivalence tests, so the pharmacokinetics behavior and thus the effectiveness of the product may be changed. 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, Dialysis Solutions, Erythrocytes, Female, Glucose, Humans, Male, Middle Aged, Oxidative Stress, Pentose Phosphate Pathway, Renal Dialysis." }, { "role": "user", "content": "Does glucose present in the dialysate limit oxidative stress in patients undergoing regular hemodialysis? Context: Decreased glucose concentration in the blood causes the inhibition of the hexose monophosphate (HMP) cycle in the erythrocyte. NADPH, which is the source of the reductive equivalents necessary for the reproduction of glutathione (GSH), is not regenerated. The presence of glucose in dialysate should provide the stability of its concentration in the blood of patients undergoing hemodialysis (HD). The aim of the study was to assess the influence of glucose in the dialysate on the intensity of oxidative stress in patients undergoing regular HD. The study comprised 43 patients hemodialyzed with dialysate containing (HD-g(+)) or not containing glucose (HD-g(-)). The concentrations of the products of reaction with thiobarbituric acid-reactive substance (TBARS) and GSH as well as the activity of erythrocyte superoxide dismutase were determined. Glucose concentrations in the blood before and immediately after dialysis were also measured. After flow-through dialysis the glucose concentration in the blood decreases both when dialysate does not contain glucose (4.8 vs. 1.6 mmol/l) and when dialysate contains glucose (6.6 vs. 5.8 mmol/l). HD caused changes in the TBARS concentration: in the HD-g(+) group the concentration decreased after HD, whereas in the HD-g(-) group it increased. In both groups of patients studied the GSH concentration changed after HD; in the HD-g(-) group it decreased and in the HD-g(+) group it increased. The results obtained in the groups of patients examined were confirmed by in vitro studies." }, { "role": "assistant", "content": "The presence of glucose in the dialysate guarantees the normal activity of the HMP cycle, which provides the production of reductive equivalents for the regeneration of reduced GSH - free radicals scavenger - and therefore the limitation of oxidative stress." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Animals, Biological Evolution, Female, Genitalia, Female, Genitalia, Male, Male, Muscidae, Reproduction, Selection, Genetic, Sex Characteristics, Sex Factors, Sexual Behavior, Animal, Spermatozoa." }, { "role": "user", "content": "Does sexual conflict select for male and female reproductive characters? Context: Strict genetic monogamy leads to sexual harmony because any trait that decreases the fitness of one sex also decreases the fitness of the other. Any deviation from monogamy increases the potential for sexual conflict. Conflict is further enhanced by sperm competition, and given the ubiquity of this phenomenon, sexual conflict is rife. In support of theory, experimentally enforced monogamy leads to the evolution of sexual benevolence. In contrast, with multiple mating, males evolve traits causing massive female fitness reductions when female evolution is restrained. Theory also predicts increased investment in spermatogenesis when sperm competition risk is high. While this supposition has correlational support, cause and effect has yet to be firmly established. By enforcing monogamy or polyandry in yellow-dung-fly lines, we have shown experimentally that males from polyandrous treatments evolved larger testes. Furthermore, females from this treatment evolved larger accessory sex glands. These glands produce a spermicidal secretion, so larger glands could increase female ability to influence paternity. Using molecular techniques, we have shown that, consistent with this idea, males' success as second mates is reduced in females from the polyandrous treatment. Nevertheless, males from polyandrous lines achieve higher paternity during sperm competition, and this finding further supports the testis evolution patterns." }, { "role": "assistant", "content": "These results provide direct experimental support for macroevolutionary patterns of testis size evolution. Furthermore, we have shown that sperm competition selects for traits likely to be important in sexual conflicts over paternity, a result only previously demonstrated in Drosophila melanogaster. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Drug of choice for chronic hea failure -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., AEC inhibitors o ACE inhibitors are now drug of choice for initial management of hea failure.o Loop diuretics (furosemide) are the DOC for acute hea faiure.o Though the ACE inhibitors are the DOC for chronic HE, diuretics are given to almost all the patient initially to relieve congestive symptoms." } ]

[ { "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": "HPV vaccine Cervarix is protective against subtypes" }, { "role": "assistant", "content": "The correct answer is HPV vaccines have been developed from the capsid coat of the virus. It has high immunogenicity. Bivalent vaccine is against HPV 16 & 18. Quadrivalent vaccine is against 16, 18, 6 & 11. Effective in the prevention of 90% of cervical cancer. Both vaccines have some cross-protection against strains 31, 33 & 45. Vaccines are given at an age of 12-18years, safe and well tolerated. Three doses, IM over deltoid muscle. The impact is greatest when given before women are infected with HPV. Vaccine-induced neutralizing antibodies works locally on cervix by preventing attachment of the virus to the cervical epithelium. Immune defense is type specific & is effective only when given prophylactically. Vaccines are effective for at least 7.5years. Pap smear screening should be continued as vaccines are type specific and do not protect all types of HPV. Reference: Dutta's Textbook of Gynecology" } ]