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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": "Condyloma accuminata in pregnancy is treated by" }, { "role": "assistant", "content": "The correct answer is Treatment of condyloma -acuminata - (verruca-genital is) Podophyllum is effective only on the genital was Podophyllum is potentially toxic and must be avoided in during pregnancy Chemical cauterization is usually done with liquified phenol or concentrated trichloroacetic acid Ref: KD Tripathi 8th ed/" } ]

[ { "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 anterior relation of the middle ear cavity is:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, METHODS, RESULTS. Meshes: Adult, Aged, Cholesterol, Coffee, Cross-Sectional Studies, Diet Surveys, Drinking, Ethnic Groups, Feeding Behavior, Female, Humans, Male, Middle Aged, Norway, Surveys and Questionnaires." }, { "role": "user", "content": "Do the effect of coffee consumption on serum total cholesterol in the Sami and Norwegian populations? Context: To assess coffee consumption in the Sami and Norwegian populations and to investigate the impact of unfiltered boiled coffee consumption on serum cholesterol concentrations. A cross-sectional study. Information was collected by self-administrated questionnaires and total serum cholesterol was analysed. Participants were divided into three ethnic groups: Sami I (Sami used as home language in the last three generations), Sami II (at least one Sami identity marker) and Norwegian. In an area with Sami, Kven/Finnish and Norwegian populations, the SAMINOR study, 2003-2004. A total of 5647 men and 6347 women aged 36-79 years. More than 90 % of the study populations were coffee drinkers. Only 22 % were unfiltered coffee consumers. Sami I had the highest proportion of participants who consumed nine or more cups of unfiltered coffee per day, although the number of participants was limited. Total coffee consumption was associated with increased total cholesterol for men (P < 0·01) and women (P < 0·0001). For those who drank only unfiltered coffee, a significant association was found only in Norwegian men, adjusted for physical activity in leisure time, BMI and smoking habits (P < 0·001). From the lowest (less than five cups) to the highest (nine or more cups) unfiltered coffee consumption category, the mean total cholesterol levels increased by 0·29 mmol/l in Norwegian men." }, { "role": "assistant", "content": "Unfiltered coffee consumption was lower in the present study compared to previous reports. In general, total coffee consumption was positively associated with total cholesterol levels. However, for unfiltered coffee consumption, an association was found only in Norwegian men. 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, Alkalies, Allopurinol, Citrates, Female, Humans, Hydrogen-Ion Concentration, Male, Middle Aged, Potassium Citrate, Urinary Calculi, Urine." }, { "role": "user", "content": "Do urinary citrate levels correlate with urinary pH in patients with urinary stone formation? Context: Urinary excretion of citrate is dependent on glomerular filtration, tubular reabsorption, and excretion. Acid base status is thought to play a significant role in urinary citrate excretion. It has been assumed that increased urinary citrate will increase urinary pH. The aim of this study was to confirm the association of increased urinary citrate levels with increased urinary pH. The 24-hour urine collections of all patients with stones referred to our clinic in the past 4 years were reviewed. The samples were collected and analyzed for routine stone risk profiles by a commercial laboratory (Litholink, Chicago, Ill). The Student t test and analysis of variance were used to compare the mean values as applicable. Pearson's correlations were also calculated for each variable. A total of 572 patients had at least one 24-hour urine sample from the past 4 years. The mean urinary citrate was 305 mg/day. The mean urinary pH of all patients was 6.14. Statistical evaluation of all patients showed no correlation between urinary citrate and pH (r = -0.04, P = 0.36). In a subset of patients with urinary potassium greater than 100 mEq/day (n = 100), urinary citrate and urinary pH were both increased; however, there was still no correlation between the two (r = 0.011, P = 0.806)." }, { "role": "assistant", "content": "Despite the current dogma that increasing urinary citrate increases urinary pH, in a cohort of patients with urinary stone formation who provided 24-hour urine specimens, no correlation was found between urinary citrate and urinary pH levels. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Child, Preschool, Developmental Disabilities, Female, Fetal Diseases, Follow-Up Studies, France, Humans, Infant, Newborn, Perinatal Mortality, Placenta, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Prevalence, Retrospective Studies, Thrombosis, Young Adult." }, { "role": "user", "content": "Is fetal thrombotic vasculopathy associated with thromboembolic events and adverse perinatal outcome but not with neurologic complications : a retrospective cohort study of 54 cases with a 3-year follow-up of children? Context: to test the hypothesis that placental fetal thrombotic vasculopathy (FTV) is associated with obstetric complications and predisposes the child to unfavorable outcomes. 54 placentas with FTV lesions and 100 placentas without FTV lesions were collected over a 5-year period at the Croix-Rousse Pathology Department. Clinical findings including maternal, fetal, neonatal condition and pediatric outcome up to three years were collected for each case and control observation. The statistical analyses were assessed with Wald's chi-square derived from conditional logistic regression modeling. FTV was associated with a significantly higher frequency of obstetric complications: (pregnancy-induced hypertension (OR 3.620, CI 1.563-8.385), preeclampsia (OR 3.674, CI 1.500-8.998), emergency delivery procedures (OR 3.727, CI 1.477-9.403), cesarean sections (OR 2.684, CI 1.016-7.088)), poor fetal condition (intrauterine growth restriction (IUGR) (OR 5.440, CI 2.007-14.748), nonreassuring fetal heart tracing (OR 6.062, CI 2.280-16.115), difficulties in immediate ex utero adaptation (OR 3.416, CI 1.087-10.732)) and perinatal or early childhood demise (OR 3.043, CI 1.327-6.978). On pathological examination, FTV was associated with marginal cord insertion (OR 3.492, CI 1.350-9.035), cord stricture and hypercoiled cord (OR 3.936, CI 1.209-12.813). Thromboembolic events were significantly more frequent in cases with FTV (OR 2.154, CI 1.032-5.622). Neurological complications within the first 3 years of life were also more frequent in the FTV group compared to the control group, but this association was not statistically significant." }, { "role": "assistant", "content": "FTV is associated with maternal complications, pathological findings in the placenta, especially gross cord abnormalities, IUGR, and poor perinatal or early childhood outcome. It may also predispose children to somatic thromboembolic events. 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": "Duret's hemorrhages are seen in which of the following organ?" }, { "role": "assistant", "content": "The correct answer is Duret hemorrhages are seen in subjects who have suffered brain herniation for several hours before death usually at least 12 - 24 hours, and are attributed to the stretching of and tearing of midline veins as the brainstem is progressively elongated under the force of the herniating cerebrum. Duret hemorrhage is the most frequent complication of uncal herniation. It occur in the midline of the midbrain and upper pons." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Cardiac Surgical Procedures, Depressive Disorder, Electrocardiography, Emotions, Female, Heart Rate, Humans, Imagination, Male, Middle Aged, Narration, Neuropsychological Tests, Postoperative Period, Psychiatric Status Rating Scales, Rest, Self Report, Surveys and Questionnaires, Vagus Nerve." }, { "role": "user", "content": "Is depression associated with increased vagal withdrawal during unpleasant emotional imagery after cardiac surgery? Context: The aim of this study was to examine the influence of depression on heart rate and heart rate variability (HRV) during emotional imagery in patients after cardiac surgery. Based on the scores of the Center for Epidemiological Studies of Depression (CES-D) scale, 28 patients after cardiac surgery were assigned either to the group with depression (CES-D scores ≥ 16; N = 14) or the one without depression (CES-D scores<16; N = 14). Each patient completed a rest period and an emotional imagery including pleasant, neutral and unpleasant scripts. Inter-beat intervals (IBIs) and HRV were measured during the entire protocol. Compared to nondepressed patients, those with depression had greater reductions in high frequency expressed in normalized units (HF n.u.) during the imaging of the unpleasant script (p = .003, Cohen's d = 1.34). Moreover, HF n.u. were lower during the imaging of the unpleasant script than the pleasant one in depressed patients only (p = .020, Cohen's d = 0.55). CES-D scores were also inversely correlated with residualized changes in IBIs (r = -.38, p = .045) and HF n.u. (r = -.49, p = .008) from rest to the imaging of the unpleasant script." }, { "role": "assistant", "content": "The relationship between depression and increased vagal withdrawal during unpleasant emotional imagery extends to patients after cardiac surgery. The present study suggests that increased vagal withdrawal to negative emotions in patients after cardiac surgery may mediate the conferral of cardiac risk by depression. 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 cephalometric point represents the centre of ramus of mandible?" }, { "role": "assistant", "content": "The correct answer is Xi point:\nA point located at the geometric centre of the ramus. The location of the Xi point can be found geometrically by drawing a line through the porion–orbitale (FH) and perpendicularly through the PT vertical (PTV)." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, RESULTS. Meshes: Adolescent, Adult, Aged, Alleles, Carrier Proteins, Case-Control Studies, Child, Child, Preschool, Chymotrypsin, Cystic Fibrosis Transmembrane Conductance Regulator, Female, Genetic Predisposition to Disease, Genetic Variation, Genotype, Humans, Infant, Male, Middle Aged, Pancreatitis, Chronic, Polymerase Chain Reaction, Risk Factors, Sequence Analysis, DNA, Trypsin, Trypsin Inhibitor, Kazal Pancreatic." }, { "role": "user", "content": "CFTR, SPINK1, CTRC and PRSS1 variants in chronic pancreatitis: is the role of mutated CFTR overestimated? Context: In chronic pancreatitis (CP), alterations in several genes have so far been described, but only small cohorts have been extensively investigated for all predisposing genes. 660 patients with idiopathic or hereditary CP and up to 1758 controls were enrolled. PRSS1, SPINK1 and CTRC were analysed by DNA sequencing, and cystic fibrosis transmembrane conductance regulator (CFTR) by melting curve analysis. Frequencies of CFTR variants p.R75Q, p.I148T, 5T-allele and p.E528E were comparable in patients and controls. We identified 103 CFTR variants, which represents a 2.7-fold risk increase (p<0.0001). Severe cystic fibrosis (CF)-causing variants increased the risk of developing CP 2.9-fold, and mild CF-causing variants 4.5-fold (p<0.0001 for both). Combined CF-causing variants increased CP risk 3.4-fold (p<0.0001), while non-CF-causing variants displayed a 1.5-fold over-representation in patients (p=0.14). CFTR compound heterozygous status with variant classes CF-causing severe and mild represented an OR of 16.1 (p<0.0001). Notably, only 9/660 (1.4%) patients were compound heterozygotes in this category. Trans-heterozygosity increased CP risk, with an OR of 38.7, with 43/660 (6.5%) patients and 3/1667 (0.2%) controls being trans-heterozygous (p<0.0001)." }, { "role": "assistant", "content": "Accumulation of CFTR variants in CP is less pronounced than reported previously, with ORs between 2.7 and 4.5. Only CF-causing variants reached statistical significance. Compound and trans-heterozygosity is an overt risk factor for the development of CP, but the number of CFTR compound heterozygotes in particular is rather low. In summary, the study demonstrates the complexity of genetic interactions in CP and a minor influence of CFTR alterations in CP development." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Amino Acid Sequence, Cell Membrane, Cell Proliferation, Endoplasmic Reticulum, Gene Knockdown Techniques, Golgi Apparatus, HeLa Cells, Humans, Molecular Sequence Data, Protein Transport, rab GTP-Binding Proteins." }, { "role": "user", "content": "Is rab41 a novel regulator of Golgi apparatus organization that is needed for ER-to-Golgi trafficking and cell growth? Context: The 60(+) members of the mammalian Rab protein family group into subfamilies postulated to share common functionality. The Rab VI subfamily contains 5 Rab proteins, Rab6a/a', Rab6b, Rab6c and Rab41. High-level knockdown of Rab6a/a' has little effect on the tightly organized Golgi ribbon in HeLa cells as seen by fluorescence microscopy. In striking contrast, we found Rab41 was strongly required for normal Golgi ribbon organization. Treatment of HeLa cells with Rab41 siRNAs scattered the Golgi ribbon into clustered, punctate Golgi elements. Overexpression of GDP-locked Rab41, but not wild type or GTP-locked Rab41, produced a similar Golgi phenotype. By electron microscopy, Rab41 depletion produced short, isolated Golgi stacks. Golgi-associated vesicles accumulated. At low expression levels, wild type and GTP-locked Rab41 showed little concentration in the Golgi region, but puncta were observed and most were in ruffled regions at the cell periphery. There was 25% co-localization of GTP-locked Rab41 with the ER marker, Sec61p. GDP-locked Rab41, as expected, displayed an entirely diffuse cytoplasmic distribution. Depletion of Rab41 or overexpression of GDP-locked Rab41 partially inhibited ER-to-Golgi transport of VSV-G protein. However, Rab41 knockdown had little, if any, effect on endosome-to-Golgi transport of SLTB. Additionally, after a 2-day delay, treatment with Rab41 siRNA inhibited cell growth, while overexpression of GDP-locked Rab41, but not wild type or GTP-locked Rab41, produced a rapid, progressive cell loss. In double knockdown experiments with Rab6, the Golgi ribbon was fragmented, a result consistent with Rab41 and Rab6 acting in parallel." }, { "role": "assistant", "content": "We provide the first evidence for distinctive Rab41 effects on Golgi organization, ER-to-Golgi trafficking and cell growth. When combined with the evidence that Rab6a/a' and Rab6b have diverse roles in Golgi function, while Rab6c regulates mitotic function, our data indicate that Rab VI subfamily members, although related by homology and structure, share limited functional conservation. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Female, Forearm, Histamine, Humans, Hypersensitivity, Immediate, Immunoglobulin E, Male, Middle Aged, Predictive Value of Tests, Sensitivity and Specificity, Skin Tests, Urticaria, Young Adult." }, { "role": "user", "content": "Does the Lancet Weight determine Wheal Diameter in Response to Skin Prick Testing with Histamine? Context: Skin prick test (SPT) is a common test for diagnosing immunoglobulin E-mediated allergies. In clinical routine, technicalities, human errors or patient-related biases, occasionally results in suboptimal diagnosis of sensitization. Although not previously assessed qualitatively, lancet weight is hypothesized to be important when performing SPT to minimize the frequency of false positives, false negatives, and unwanted discomfort. Accurate weight-controlled SPT was performed on the volar forearms and backs of 20 healthy subjects. Four predetermined lancet weights were applied (25 g, 85 g, 135 g and 265 g) using two positive control histamine solutions (1 mg/mL and 10 mg/mL) and one negative control (saline). A total of 400 SPTs were conducted. The outcome parameters were: wheal size, neurogenic inflammation (measured by superficial blood perfusion), frequency of bleeding, and the lancet provoked pain response. The mean wheal diameter increased significantly as higher weights were applied to the SPT lancet, e.g. from 3.2 ± 0.28 mm at 25 g to 5.4 ± 1.7 mm at 265 g (p<0.01). Similarly, the frequency of bleeding, the provoked pain, and the neurogenic inflammatory response increased significantly. At 265 g saline evoked two wheal responses (/160 pricks) below 3 mm." }, { "role": "assistant", "content": "The applied weight of the lancet during the SPT-procedure is an important factor. Higher lancet weights precipitate significantly larger wheal reactions with potential diagnostic implications. This warrants additional research of the optimal lancet weight in relation to SPT-guidelines to improve the specificity and sensitivity of the procedure. 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 drugs is used in MI ?" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Do alcohol and drug use prevalence and factors associated with the experience of alcohol use in Iranian adolescents? Context: Alcohol and other drugs use is a problem among adolescents leading to numerous physical, social, and educational damages. For determining the prevalence of alcohol and other substance use as well as the factors associated with the experience of alcohol use in adolescents. This is a population-based and cross-sectional study, which was conducted in August 2010 on adolescents aged 15-18 years in Tehran. Data were collected by a Youth Risk Behavior Surveillance System (YRBSS) in 1,201 adolescents. The multistage cluster sampling method was used. Questions belonging to the domain of alcohol and other substance use were analyzed. In general, 15.1% of adolescents had experienced alcohol, which is significantly higher in boys (21.9%) compared to girls (8.4%) (P = 0.000). 3.1% of adolescents had experience using opium and marijuana. 5.6% had used ecstasy. The results of multivariate logistic regression indicated that low parental control rather than medium control [AOR: 0.09], lifetime cigarette use [AOR: 10.41], having a tobacco user friend [AOR: 4.36], and having an alcohol user friend [AOR: 5.84] are factors that are significantly related to the experience of alcohol use in female adolescents. In addition, studying in private schools rather than public schools [AOR: 3.46], lifetime cigarette use [AOR: 3.41], lifetime water pipe use [AOR: 4.43], experience of sexual activity [AOR: 8.52], having an alcohol user friend [AOR: 12.60], and having a water pipe user in family [AOR: 2.98] are factors that are significantly related to the experience of alcohol use in male adolescents." }, { "role": "assistant", "content": "We recommend interventional plans based gender aimed at improving adolescent health with regard substance abuse. 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: Alanine Transaminase, Animals, Aspartate Aminotransferases, Biomarkers, Blood Glucose, Body Mass Index, Cohort Studies, Disease Progression, Follow-Up Studies, Glucose Intolerance, Glucose Tolerance Test, Humans, Hyperglycemia, Japan, Liver, Male, Middle Aged, Prevalence, Risk Factors, gamma-Glutamyltransferase." }, { "role": "user", "content": "Are elevated liver enzymes related to progression to impaired glucose tolerance in Japanese men? Context: To investigate whether the elevation of liver enzymes is associated with the progression from normal to impaired glucose tolerance. A historical cohort study was conducted in 594 male workers at public schools, who had normal glucose tolerance at baseline. The progression to impaired glucose tolerance and impaired fasting glycaemia during a mean follow-up of 3.1 years was measured using an oral glucose tolerance test. Overall, 141 (23.7%) subjects developed impaired glucose tolerance and 68 (11.4%) subjects developed impaired fasting glycaemia, 23 of whom had combined impaired fasting glycaemia/impaired glucose tolerance. The incidence of impaired glucose tolerance increased significantly with increasing quartiles of serum aspartate aminotransferase, alanine aminotransferase and γ-glutamyltransferase (P for trend <0.01). In Cox proportional hazards regression analysis, after adjusting for comprehensive risk factors, including plasma glucose levels, BMI and homeostatic model assessment of insulin resistance, the risk of progression to impaired glucose tolerance was significantly higher in the highest quartile of alanine aminotransferase than in the lowest quartile (hazard ratio 2.5; 95% CI 1.1-5.7). A significant association between alanine aminotransferase and the progression to impaired glucose tolerance was found after further adjustments for other liver enzymes or after the sample was limited to those with BMI < 25.0 kg/m(2) or with fasting plasma glucose < 5.5 mmol/l." }, { "role": "assistant", "content": "A higher level of alanine aminotransferase was independently associated with progression from normal to impaired glucose tolerance in Japanese men. The elevation of alanine aminotransferase may be a change that occurs early in the evolution of diabetes. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHOD, RESULTS. Meshes: Adolescent, Adult, Body Mass Index, Diet, Reducing, Eating, Energy Intake, Feeding Behavior, Female, Humans, Male, Middle Aged, Obesity, Patient Compliance, Time Factors, Treatment Outcome, Weight Loss, Young Adult." }, { "role": "user", "content": "Should snacks be recommended in obesity treatment? Context: To study the effect to recommend no snacks vs three snacks per day on 1-year weight loss. The hypothesis was that it is easier to control energy intake and lose weight if snacks in between meals are omitted.SUBJECTS/ In total 140 patients (36 men, 104 women), aged 18-60 years and body mass index>30 kg/m(2) were randomized and 93 patients (27 men, 66 women) completed the study. A 1-year randomized intervention trial was conducted with two treatment arms with different eating frequencies; 3 meals/day (3M) or 3 meals and 3 snacks/day (3+3M). The patients received regular and individualized counseling by dieticians. Information on eating patterns, dietary intake, weight and metabolic variables was collected at baseline and after 1 year. Over 1 year the 3M group reported a decrease in the number of snacks whereas the 3+3M group reported an increase (-1.1 vs +0.4 snacks/day, respectively, P<0.0001). Both groups decreased energy intake and E% (energy percent) fat and increased E% protein and fiber intake but there was no differences between the groups. Both groups lost weight, but there was no significant difference in weight loss after 1 year of treatment (3M vs 3+3M=-4.1+/-6.1 vs -5.9+/-9.4 kg; P=0.31). Changes in metabolic variables did not differ between the groups, except for high-density lipoprotein that increased in the 3M group but not in 3+3M group (P<0.033 for group difference)." }, { "role": "assistant", "content": "Recommending snacks or not between meals does not influence 1-year weight loss." } ]

[ { "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": "Lady recovered from severe PPH, complains of failure of lactation and menstruation, which of the following can be seen" }, { "role": "assistant", "content": "The correct answer is Sheehan Syndrome Rare consequence of severe postpaum haemorrhage which causes anterior pituatory necrosis and leads to pituitary failure The typical picture is failure of lactation, amenorrhoea, hypothyroidism and adrenocoical insufficiency Failure of lactation is the first sign Ref: Text book of Obstetrics; Sheila balakrishnan; 2 nd edition; Page no 403" } ]

[ { "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": "Root value of intercostobrachial nerve is" }, { "role": "assistant", "content": "The correct answer is The intercostobrachial nerve is a lateral cutaneous branch of the second intercostal nerve that supplies sensation to the skin of the Axilla . It leaves the second intercostal space at the midaxillary line and subsequently pierces the serratus anterior muscle to enter the subcutaneous tissues of the axilla. The nerve may be injured during axillary surgery such as nodal clearance for breast cancer The anterior divisions of the second, third, fouh, fifth, and sixth thoracic nerves, and the small branch from the first thoracic, are confined to the walls of the thorax, and are named thoracic intercostal nerves respectively . They pass forward in the intercostal spaces below the intercostal vessels. At the back of the chest they lie between the pleura and the posterior intercostal membranes, but soon they run between the internal intercostals and the innermost intercostals then anteriorly they lie between the pleura and the internal intercostals . Ref - radiology assistant.com" } ]

[ { "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 group of scientists is studying various methods of bacterial reproduction. They find out that bacteria also exchange genetic material via these reproductive processes. They are about to study one such method known as bacterial conjugation. Which of the following occurs through bacterial conjugation?" }, { "role": "assistant", "content": "Two Pseudomonas aeruginosa bacteria with identical copies of a plasmid after sharing DNA through sex pili." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adolescent, Adult, Analysis of Variance, Case-Control Studies, Chi-Square Distribution, Confidence Intervals, Echocardiography, Three-Dimensional, Exercise Tolerance, Female, Humans, Male, Middle Aged, Regression Analysis, Sports, Sports Medicine, Statistics, Nonparametric, Stroke Volume, Systole, Time Factors, Ventricular Function, Left, Young Adult." }, { "role": "user", "content": "Is left ventricular systolic performance improved in elite athletes? Context: We sought to investigate the systolic time interval (STI) and efficiency of left ventricular (LV) contraction comparatively in elite athletes and healthy sedentary controls by means of three-dimensional echocardiography (3DE). Four hundred and twenty-nine elite athletes, involved in skill (n = 41), power (n = 63), mixed (n = 167), and endurance (n = 158) disciplines and 98 sedentary controls, matched for age, underwent 3DE. By off-line analysis, we measured the absolute and relative (normalized by the R-R interval) timing of LV systolic emptying (STI and STI%) and the systolic flow velocity (SFV = stroke volume/STI). Both STI and STI% were shorter in athletes, regardless of the sport discipline, compared with controls (respectively, 324 ± 36 vs. 345 ± 33 ms, P < 0.001; 30 ± 4 vs. 40 ± 4%; P< 0.001). Regression analysis showed that heart rate was the most important determinant of STI (R(2) = 0.38; P < 0.001), while age, body surface area, blood pressure, LV volumes, and mass had no significant association. After removing the effects of heart rate and gender, athletes showed a significant reduction (by 50.4 ms; 95% confidence interval, from 57.7 to 43.1) in STI compared with untrained subjects. Finally, higher SFV were identified in skill (256 ± 60 mL/s; P < 0.001), strength (297 ± 78 mL/s; P < 0.001), mixed (308 ± 67 mL/s; P < 0.001), and endurance (334 ± 74 mL/s; P < 0.001) athletes compared with controls (204 ± 50 mL/s)." }, { "role": "assistant", "content": "Elite athletes show a significant shortening of the systolic time duration in comparison with sedentary controls, in association with a significant increase in LV emptying velocity. This pattern characterizes the physiological LV adaptation of the athletes and may potentially be useful in differential diagnosis of the 'athlete heart'. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Analysis of Variance, Angioplasty, Balloon, Coronary, Animals, Arachidonate 12-Lipoxygenase, Carotid Artery Diseases, Cell Movement, Contrast Media, Disease Models, Animal, Fibronectins, Fluorescein, Hyperplasia, Leukocytes, Lipoxygenase Inhibitors, Male, RNA, Catalytic, RNA, Messenger, Rats, Rats, Sprague-Dawley, Transfection, Tunica Intima." }, { "role": "user", "content": "Does ribozyme-mediated inhibition of rat leukocyte-type 12-lipoxygenase prevent intimal hyperplasia in balloon-injured rat carotid arteries? Context: 12-Lipoxygenase (12-LO) products of arachidonate metabolism have growth and chemotactic effects in vascular smooth muscle cells. We have also recently demonstrated increased 12-LO mRNA and protein expression in the neointima of balloon-injured rat carotid arteries. In this study, we evaluated whether 12-LO activation plays a role in neointimal thickening in this rat model by using a specific ribozyme (Rz) directed to rat 12-LO. We designed a chimeric DNA-RNA hammerhead Rz to cleave rat leukocyte-type 12-LO mRNA. This Rz dose-dependently cleaved a 166-nucleotide target 12-LO mRNA substrate in vitro and reduced 12-LO mRNA and protein expression in rat vascular smooth muscle cells. A control mutant Rz (MRz) with a point mutation in the catalytic site was inactive. To test the in vivo efficacy of the 12-LO Rz, the left common carotid arteries of rats were injured with a balloon catheter. The distal half of the injured arteries was treated with Rz or MRz mixed with lipofectin. The proximal half received only lipofectin. Twelve days after injury, intima-to-media ratios were significantly lower in the Rz-treated sections than in untreated sections from the same rat (0.742+/-0.16 versus 1.749+/-0.12, P:<0.001). In contrast, the MRz had no significant effect." }, { "role": "assistant", "content": "These results indicate the important role of the leukocyte-type 12-LO pathway in restenosis in response to injury. 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": "Most Potent Stimulator of Naive T-cell is:" }, { "role": "assistant", "content": "The correct answer is Mature dendritic cells" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Celiac Disease, Cohort Studies, Diet, Gluten-Free, Duodenum, Female, Glutens, Humans, Intestinal Mucosa, Male, Middle Aged, Statistics as Topic, Treatment Outcome, Young Adult." }, { "role": "user", "content": "Does complete recovery of intestinal mucosa occur very rarely in adult coeliac patients despite adherence to gluten-free diet? Context: Expected benefits of gluten-free diet (GFD) in coeliac patients include healing of small intestinal mucosa, but it remains unclear to what extent this benefit is achieved in adults. To assess factors affecting histological outcome of GFD in a large cohort of adult coeliac patients. We extracted information on 465 consecutive coeliac patients studied before and during GFD. Duodenal biopsies at diagnosis were classified as Marsh I in 11, II in 25 and III in 429 cases. After a median 16 months GFD, 38 (8%) patients had histological 'normalization', 300 (65%) had 'remission' with persistent intraepithelial lymphocytosis, 121(26%) had 'no change' and 6 (1%) had 'deterioration'. Coeliac disease related serology was negative in 83% of patients with Marsh III lesion during GFD. Male gender and adherence to GFD were independently associated with histological 'normalization' and 'remission'. Persistence of intraepithelial lymphocytosis was not associated with human lymphocyte antigen gene dose or with Helicobacter pylori infection." }, { "role": "assistant", "content": "Complete normalization of duodenal lesions is exceptionally rare in adult coeliac patients despite adherence to GFD, symptoms disappearance and negative CD related serology. Control biopsies are mandatory to identify lack of response to gluten-free diet. 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": "What is the percentage of coding DNA in genome?" }, { "role": "assistant", "content": "The correct answer is REPEATED QUESTION" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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 AND SETTING, PARTICIPANTS, METHODS AND MEASURES, RESULTS. Meshes: Adult, Aged, Arousal, Attention, Case-Control Studies, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Polysomnography, Psychomotor Performance, Reaction Time, Sleep Initiation and Maintenance Disorders, Young Adult." }, { "role": "user", "content": "Does physiological hyperarousal enhance error rates among insomnia sufferers? Context: To examine the association between physiological hyperarousal and response accuracy on reaction time tasks among individuals with insomnia. This study was conducted at affiliated Veterans Administration (VA) and academic medical centers using a matched-group, cross-sectional research design. Eighty-nine individuals (48 women) with primary insomnia, PI (MAge = 49.8 ± 17.2 y) and 95 individuals (48 women) who were well-screened normal sleepers, NS (MAge = 46.9 ± 17.0 y). Participants underwent 3 nights of polysomnography followed by daytime testing with a four-trial Multiple Sleep Latency Test (MSLT). Before each MSLT nap, they rated their sleepiness and completed computer-administered reaction time tasks. The mean number of correct and error responses made by each participant across testing trials served as dependent measures. The PI and NS groups were each subdivided into alert (e.g., MSLT mean onset latency>8 min) and sleepy (e.g., MSLT mean onset latency ≤ 8 min) subgroups to allow for testing the main and interaction effects of participant type and level of alertness. Alert participants had longer MSLT latencies than sleepy participants (12.7 versus 5.4 min), yet both alert and sleepy individuals with PI reported greater sleepiness than NS. Alert participants also showed lower sleep efficiencies (83.5% versus 86.2%, P = 0.03), suggesting 24-h physiological hyperarousal particularly in the PI group. Individuals with PI had fewer correct responses on performance testing than did NS, whereas a significant group × alertness interaction (P = 0.0013) showed greater error rates among alert individuals with PI (mean = 4.5 ± 3.6 errors per trial) than among alert NS (mean = 2.6 ± 1.9 errors per trial)." }, { "role": "assistant", "content": "Physiological hyperarousal in insomnia may lead to more apparent daytime alertness yet dispose individuals with insomnia to higher error rates on tasks requiring their attention." } ]

[ { "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": "Cause of hairy leukoplakia which is characterised by severe discomfort on lateral part of the tongue" }, { "role": "assistant", "content": "The correct answer is (B) EBV # Hairy leukoplakia is a distinctive oral lesion that is seen in immunocompromised patients.> Approximately 80% of patients with hairy leukoplakia have been infected with the human immunodeficiency virus (HIV); the presence of this lesion sometimes calls attention to the existence of the infection.> Hairy leukoplakia takes the form of white, confluent patches of fluffy (\"hairy\") hyperkeratotic thickenings, almost always situated on the lateral border of the tongue.> The distinctive microscopic appearance consists of hyperparakeratosis and acanthosis with \"balloon cells\" in the upper spinous layer." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Arthrography, Carpal Bones, Cohort Studies, Female, Finger Joint, Hand, Humans, Joint Instability, Logistic Models, Male, Metacarpus, Middle Aged, Odds Ratio, Osteoarthritis, Wrist." }, { "role": "user", "content": "Is articular hypermobility a protective factor for hand osteoarthritis? Context: Very few studies have evaluated the association of articular hypermobility and radiographic osteoarthritis (OA) in humans. We assessed hypermobility and its relationship to radiographic hand OA in a family-based study. A total of 1,043 individuals were enrolled in the multicenter Genetics of Generalized Osteoarthritis study, in which families were required to have 2 siblings with radiographic OA involving >/=3 joints (distributed bilaterally) of the distal interphalangeal (DIP), proximal interphalangeal (PIP), or carpometacarpal (CMC) joint groups, and OA in at least one DIP joint. Radiographic OA was defined as a score of >/=2 on the Kellgren/Lawrence scale in one or more joints within the group. The Beighton criteria for assessment of hypermobility were recorded on a 0-9-point scale. Hypermobility was defined as a Beighton score of >/=4, a threshold generally used to establish a clinical diagnosis of joint laxity. A threshold of >/=2 was also evaluated to assess lesser degrees of hypermobility. The Beighton score for the present was calculated based on clinical examination, and that for the past was based on recall of childhood hypermobility in the first 2 decades of life. The association of hypermobility and radiographic OA of the PIP, CMC, and metacarpophalangeal joints was evaluated in all participants and in men and women separately. Multiple logistic regression was used to examine the relationship of hypermobility with radiographic OA in each joint group, after adjusting for age and sex. The association of hypermobility and DIP OA was not evaluated, because evidence of DIP OA was required for study inclusion. Using a threshold Beighton score of 4, 3.7% of individuals were classified as hypermobile based on the present examination, and 7.4% were classified as hypermobile based on the past assessment. A significant negative association between present hypermobility and age was observed. In persons with hypermobility, the odds of OA in PIP joints was lower (for present, odds ratio [OR] 0.34, 95% confidence interval [95% CI] 0.16-0.71; for past, OR 0.43, 95% CI 0.24-0.78). Similar results were obtained using a threshold Beighton score of 2. The lower odds of PIP OA with hypermobility were significant after adjusting for sex and age (for present, OR 0.44, 95% CI 0.20-0.94; for past, OR 0.48, 95% CI 0.26-0.87)." }, { "role": "assistant", "content": "This study demonstrated a joint-protective effect of hypermobility for radiographic OA of PIP joints. In contrast to previous studies showing an association of hypermobility and CMC OA, in this cohort there was no evidence for increased odds of OA in any joint group of the hand in association with articular hypermobility. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, Cerebrovascular Circulation, Hematocrit, Hemodilution, Hyperemia, Male, Oxygen, Rats, Rats, Sprague-Dawley." }, { "role": "user", "content": "Is functional cerebral hyperemia unaffected by isovolemic hemodilution? Context: The cerebral hyperemic effect of hemodilution is well known; however, its mechanism and potential modifying effect on the functional hyperemic response to neuronal activation are unclear. The authors investigated the effects of isovolemic hemodilution on vibrissal stimulation-induced changes in cerebrocortical laser Doppler flow and tissue oxygen tension in the rat. The hyperemic response to whisker stimulation was assessed in the whisker barrel cortex of 12 rats anesthetized with chloralose-urethane before and after hemodilution. Graded, isovolemic hemodilution was performed by three repeated withdrawals of 3 ml blood with replacement of equal volume of 5% serum albumin. Measured systemic hematocrit values were 39.3 +/- 1.3% (control), 29.5 +/- 1.0%, 22.3 +/- 1.5%, and 17.0 +/- 1.6% (after the three hemodilution steps). Arterial blood pressure was maintained at control levels with an infusion of methoxamine. Unilateral whisker stimulation was performed with a mechanical actuator at 8 Hz, and 10 cycles of 10 s on-30 s off periods. In six control animals, shed blood was immediately reinfused, resulting in no change in hematocrit, and whisker stimulation was performed using the same timeline as in the other animals. In six additional experiments, resting cerebral cortical oxygen tension was measured using the phosphorescence quenching technique following the same hemodilution protocol. Graded hemodilution increased baseline laser Doppler flow by 5.5 +/- 0.9%, 13 +/- 1.6%, and 23.7 +/- 2.2%. Vibrissal stimulation transiently increased laser Doppler flow by 17.0 +/- 2.0%. The hyperemic response was unchanged after hemodilution and was identical to that seen in the control group in all conditions. Tissue oxygen tension increased slightly but significantly with hemodilution at a rate of 1.4 mmHg per 10% hematocrit change (r = 0.83). Mean arterial pressure, arterial oxygen tension, carbon dioxide tension, and pH were within normal limits in each experimental group and were not different from control during hemodilution." }, { "role": "assistant", "content": "The results suggest that an increase in baseline flow during hemodilution maintains cortical oxygen supply and consequently preserves the normal functional hyperemic response. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, MATERIALS AND METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Body Weight, Female, Humans, Male, Middle Aged, Radiation Dosage, Radiography, Thoracic, Tomography, X-Ray Computed, Young Adult." }, { "role": "user", "content": "Is weight-based adjustment of automatic exposure control necessary for the reduction of chest CT radiation dose? Context: To assess the effects of radiation dose reduction in the chest CT using a weight-based adjustment of the automatic exposure control (AEC) technique. With Institutional Review Board Approval, 60 patients (mean age, 59.1 years; M:F = 35:25) and 57 weight-matched patients (mean age, 52.3 years, M:F = 25:32) were scanned using a weight-adjusted AEC and non-weight-adjusted AEC, respectively on a 64-slice multidetector CT with a 0.984:1 pitch, 0.5 second rotation time, 40 mm table feed/rotation, and 2.5 mm section thickness. Patients were categorized into 3 weight categories;<60 kg (n = 17), 60-90 kg (n = 52), and>90 kg (n = 48). Patient weights, scanning parameters, CT dose index volumes (CTDIvol) and dose length product (DLP) were recorded, while effective dose (ED) was estimated. Image noise was measured in the descending thoracic aorta. Data were analyzed using a standard statistical package (SAS/STAT) (Version 9.1, SAS institute Inc, Cary, NC). Compared to the non-weight-adjusted AEC, the weight-adjusted AEC technique resulted in an average decrease of 29% in CTDIvol and a 27% effective dose reduction (p<0.0001). With weight-adjusted AEC, the CTDIvol decreased to 15.8, 15.9, and 27.3 mGy for the<60, 60-90 and>91 kg weight groups, respectively, compared to 20.3, 27.9 and 32.8 mGy, with non-weight-adjusted AEC. No significant difference was observed for objective image noise between the chest CT acquired with the non-weight-adjusted (15.0 +/- 3.1) and weight-adjusted (16.1 +/- 5.6) AEC techniques (p>0.05)." }, { "role": "assistant", "content": "The results of this study suggest that AEC should be tailored according to patient weight. Without weight-based adjustment of AEC, patients are exposed to a 17 - 43% higher radiation-dose from a chest CT." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Biopsy, Needle, Breast Neoplasms, Carcinoma in Situ, Carcinoma, Ductal, Breast, Chi-Square Distribution, Female, Humans, Mammography, Middle Aged, Neoplasm Grading, Neoplasm Invasiveness, Retrospective Studies, Ultrasonography, Interventional." }, { "role": "user", "content": "Is ductal carcinoma in situ with \"possible invasion\" more predictive of invasive carcinoma than pure ductal carcinoma in situ? Context: To compare the underestimation of ductal carcinoma in situ (DCIS) vs DCIS with \"possible invasion\" at breast biopsy and to determine if any factors related to clinical indication, imaging abnormality, biopsy, or DCIS-grade affected the likelihood of underestimation. Of 3836 consecutive lesions that were biopsied by using a 14-gauge needle, 117 lesions revealed DCIS. Surgical pathology results of invasive carcinoma were compared with needle biopsy results of DCIS or DCIS with possible invasion. Clinical indication, imaging abnormality, biopsy guidance modality, sample number, and histologic grade were recorded. Yates corrected χ(2) and Fisher exact tests were used to determine differences between groups. A total of 101 lesions were DCIS and 16 were DCIS with possible invasion at biopsy. Thirty-six of 117 lesions (31%) revealed invasive carcinoma at resection pathology. Invasive carcinoma was present more often when DCIS with possible invasion was diagnosed compared with pure DCIS (7/16 [44%] vs 29/101 [29%], P = .36). No factor, including clinical indication, imaging abnormality, biopsy guidance method, sample number, or grade, was found to significantly affect the likelihood of underestimation for lesions diagnosed as DCIS vs DCIS with \"possible invasion.\" The likelihood of pure DCIS underestimation significantly increased when lesions were high grade compared with either intermediate or low grade (18/44 [41%] vs 9/44 [21%]vs 2/10 [20%], P = .03)." }, { "role": "assistant", "content": "For lesions biopsied by using a 14-gauge needle, there is a trend towards underestimation of the presence of invasive carcinoma when pathology reveals DCIS with possible invasion compared with pure DCIS. High-grade DCIS was significantly more likely to be underestimated." } ]

[ { "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": "You are called to a hemodialysis suite. The patient is a 61-year-old man with a history of hypertension, hypercholesterolemia, and type-2 diabetes mellitus-induced end-stage renal disease who has required hemodialysis for the past year. His current hemodialysis session is nearing the end when the nurse notices that his blood pressure has dropped to 88/60 mm Hg from his normal of 142/90 mm Hg. The patient denies any shortness of breath or chest pain. He took his daily bisoprolol, metformin, and insulin this morning before coming to the hospital. On examination, the patient’s blood pressure is 92/60 mm Hg, and his heart rate is 119/min. Chest auscultation is unremarkable. What is the most appropriate next management step?" }, { "role": "assistant", "content": "Stop ultrafiltration and decrease blood flow into the machine" } ]

[ { "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": "Poal Acinus means" }, { "role": "assistant", "content": "The correct answer is The hepatic or poal acinus is the functional unit of the liver.The acinus consists of an irregular shaped, roughly ellipsoidal mass of hepatocytes aligned around the hepatic aerioles and poal venules just as they anastomose into sinusoids.The acinus is roughly divided into zones that correspond to distance from the aerial blood supply - those hepatocytes closest to the aerioles (zone 1 below) are the best oxygenated, while those fahest from the aerioles have the poorest supply of oxygen. This arrangement also means that cells in the center of the acinus (again, zone 1) are the first to \"see\" and potentially absorb blood-borne toxins absorbed into the poal blood from the small intestine.Reference: Krishna Garg Histology; 5th edition; Page no: 171" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, Blood Bactericidal Activity, Disease Models, Animal, Endotoxemia, Hemodynamics, Immunoglobulin M, Immunoglobulins, Intravenous, Neutrophils, Phagocytosis, Pharmaceutical Solutions, Rabbits, Respiratory Burst." }, { "role": "user", "content": "Does igM-enriched solution BT086 improve host defense capacity and energy store preservation in a rabbit model of endotoxemia? Context: The therapeutic value of intravenous immunoglobulin (IVIG) as an adjuvant therapy in sepsis remains debatable. We hypothesized that intravenous administration of BT086, a predominantly IgM IVIG solution, would improve host defense in an established rabbit model of endotoxemia and systemic sepsis. New Zealand white rabbits were randomized into the following four groups: (1) the negative control group without lipopolysaccharide (LPS, control), (2) the positive control group with LPS infusion (LPS group), (3) the albumin-treated LPS group (ALB+LPS group), and (4) the BT086-treated LPS group (BT086 + LPS group). A standardized amount of E. coli was intravenously injected into all of the animals. The vital parameters, the concentration of E. coli in the blood and other organs, the residual granulocyte phagocytosis activity, and the levels of the inflammatory mediators were measured. Histological changes in the lung and liver tissue were examined following autopsy. The elimination of E. coli from the bloodstream was expedited in the BT086-treated group compared with the LPS- and albumin-treated groups. The BT086 + LPS group exhibited higher phagocytic activity of polymorphonuclear neutrophils (PMNs) than the control and ALB+LPS groups. The liver energy stores were higher in the BT086 + LPS group than in the other groups." }, { "role": "assistant", "content": "Our data suggest that the IgM-enriched IVIG has the potential to improve host defense in a rabbit model of endotoxemia. Studies using different animal models and dosages are necessary to further explore the potential benefits of IgM-enriched IVIG solutions. 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 with increased Ca++ & hyperphosphatemia is seen in" }, { "role": "assistant", "content": "The correct answer is Ans. c (Renal osteodystrophy). (Ref. Harrison Medicine, 18th/Ch.44, 279, Nelson, Paediatrics, 17th/223)# The principal clinical consequences of hyperphosphatemia are hypocalcemia and systemic calcification.# Ectopic calcification occurs in untreated, chronic renal failure with severe hypercalcemia and in vitamin D intoxication.# Tumor calcinosis is rare inherited disorder in which hyperphosphatemia is associated with ectopic calcification.# Vitamin D intoxication causes excessive gastrointestinal absorption of both Ca++ and Ph++ and suppression of PTH by hypercalcemia causes decrease in renal phosphorous excretion.# Hyperphosphatemia in hyperthyroidism or acromegaly is also associated with hypercalcemia." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Acute Kidney Injury, Adult, Aged, Alprostadil, Contrast Media, Creatinine, Diabetes Complications, Double-Blind Method, Drug Tolerance, Female, Humans, Infusions, Intravenous, Kidney, Male, Middle Aged, Risk Factors." }, { "role": "user", "content": "Prostaglandin E1: a new agent for the prevention of renal dysfunction in high risk patients caused by radiocontrast media? Context: Acute renal failure following the administration of radiocontrast media (RCM) is a complication found especially in patients with impaired renal function. Within the limits of a pilot study, the objective was to (a) show the effectiveness and compatibility of prostaglandin E(1) (PGE(1)=Alprostadil) in preventing acute renal failure in patients with elevated levels of serum creatinine and (b) to identify the most appropriate PGE(1)-dose. 130 patients with renal impairment (serum creatinine>/=1.5 mg/dl) were included in the study prior to intravascular RCM injection. The patients received one of three different doses of PGE(1) (10, 20, or 40 ng/kg bodyweight/min) or placebo (physiologic sodium chloride solution) intravenously over a time period of 6 h (beginning 1 h prior to RCM application). Serum creatinine was measured 12, 24, and 48 h post RCM-application and creatinine clearance was determined with two 12 h collection periods, as well as one 24 h collection within 48 h post RCM administration. Adverse events during PGE(1) administration were recorded. In the placebo group, the mean elevation of serum creatinine was markedly higher (0.72 mg/dl) 48 h after RCM administration compared with the three PGE(1) groups (0.3 mg/dl in the 10 ng/kg/min group, 0. 12 mg in the 20 ng/kg/min group, and 0.29 mg/dl in the 40 ng/kg/min group). No clinically relevant changes were seen regarding the creatinine clearance in the four groups examined." }, { "role": "assistant", "content": "Results from this pilot-study suggest that intravenous PGE(1) may be used efficaciously and safely to prevent RCM-induced renal dysfunction in patients with pre-existing impaired renal 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: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adjuvants, Immunologic, Allergens, Animals, Female, Gestational Age, Hypersensitivity, Immunity, Maternally-Acquired, Immunization, Immunization Schedule, Immunoglobulin E, Immunoglobulin G, Mice, Mice, Inbred Strains, Models, Animal, Ovalbumin, Pregnancy." }, { "role": "user", "content": "Does maternal allergen immunization during pregnancy in a mouse model reduce adult allergy-related antibody responses in the offspring? Context: The immune status and allergen exposure of the mother may influence the immune response in the offspring after birth. This relationship may be important both for allergen avoidance strategies and, alternatively, for allergy prophylaxis by allergen exposure of the mother. The aim of the present study was to investigate the effect of allergen immunization of the mother during pregnancy and postpartum, in relation to the allergy-related immune response (IgE) and the non-allergy-related (IgG2a) response in the offspring. Pregnant NIH/OlaHsd females were immunized three times during pregnancy and one time postpartum with ovalbumin and the adjuvant Al(OH)3, and the offspring's ovalbumin-specific IgE, IgG1 and IgG2a responses were measured after challenge with the same allergen as young adults. Ovalbumin-specific IgE, IgG1 and IgG2a responses were also analysed in offspring of NIH/OlaHsd females immunized once at different times during pregnancy: about 3 days into pregnancy, mid-pregnancy (10 days into pregnancy) and about 4 days before giving birth (17 days into pregnancy). Allergen immunization of mother during pregnancy and postpartum significantly reduced the IgE response in the progenies, whereas the IgG2a response to the same allergen was increased. Allergen immunization of the mother 3 days into pregnancy resulted in a significantly lower IgE response in offspring compared with the response in offspring of non-immunized mothers and in offspring of mothers immunized 17 days into pregnancy." }, { "role": "assistant", "content": "Maternal allergen immunization might favour selection for an allergen-specific Th1-dependent antibody response in the offspring. Our results indicate that IgE suppression is stronger after maternal allergen exposure during early pregnancy than after exposure in late pregnancy. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, Bone and Bones, Cell Count, Dental Pulp, Flow Cytometry, Gene Deletion, Inflammation, Interleukin-1 Receptor-Like 1 Protein, Interleukin-33, Lymph Nodes, Mice, Mice, Inbred BALB C, Mice, Knockout, Osteoclasts, Periapical Tissue, Tartrate-Resistant Acid Phosphatase, Th1 Cells, Th17 Cells." }, { "role": "user", "content": "Does sT2 deletion increase inflammatory bone destruction in experimentally induced periapical lesions in mice? Context: ST2 is a member of the interleukin (IL)-1 receptor family, and IL-33 is its natural ligand. ST2 signaling promotes Th2 immune response in allergy, autoimmunity, and chronic inflammatory disorders, but its role in the pathogenesis of periapical lesions is unknown. The purpose of this study was to investigate whether ST2 gene deletion affects the development of experimentally induced periapical lesions in mice. Pulps of mandibular molars from wild-type (WT) and ST2 knockout (ST2(-)/(-)) BALB/c mice were exposed and left open to the oral environment. After death, hemi-mandibles were isolated and prepared for histologic, immunohistochemical, and flow cytometric analysis. The expression of IL-33 and its receptor ST2 was higher in periapical lesions in WT mice compared with normal root apices (both P < .05). The increased periapical bone loss observed in ST2(-)/(-) mice was associated with enhanced influx of neutrophils, CD3+ CXCR3+ Th1 cells, and CD3+ CCR6+ Th17 cells and increased number of tartrate-resistant acid phosphatase+ osteoclasts (all P < .05). Furthermore, periapical lesions in ST2(-)/(-) mice contained increased percentages of T cells expressing interferon-γ, IL-17, tumor necrosis factor-α, and IL-6 (all P < .05). In comparison with WT mice, CD3+ receptor activator of nuclear factor kappa B ligand+ T cells were increased, whereas CD3+ osteoprotegerin+ T cells were decreased in the lesions of ST2(-)/(-) mice (both P < .05)." }, { "role": "assistant", "content": "ST2 deletion increases inflammatory bone loss in experimental periapical lesions in mice, which is associated with enhanced Th1/Th17 cell mediated periapical immune responses and increased osteoclastogenesis. 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 boy age 8 years came to your dental clinic with no crowding in both arches. Lateral cephalogram reveals SNA angle of 78 and SNB angle of 82 the line of treatment is" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 71-year-old woman comes to the physician because of progressive shortness of breath and swollen legs for 4 weeks. She has tried sleeping in a raised position using 2 pillows but still wakes up occasionally from a choking sensation. She returned from a safari tour in Tanzania 3 months ago. She has type 2 diabetes mellitus, arterial hypertension, and gastroesophageal reflux disease. Her sister has polymyalgia rheumatica. Her current medications include insulin, enalapril, and omeprazole. She has smoked one half-pack of cigarettes daily for 45 years. Her temperature is 37°C (98.6°F), pulse is 112/min, respirations are 22/min, and blood pressure is 119/76 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 90%. Examination shows pitting edema below the knees and jugular venous distention. Crackles are heard at both lung bases. A photograph of her tongue is shown. Her hemoglobin concentration is 10.0 g/dL, leukocyte count is 6,100/mm3, and erythrocyte sedimentation rate is 62 mm/h. ECG shows sinus rhythm and low-voltage QRS complexes. Echocardiography shows symmetrical left ventricular hypertrophy, reduced diastolic filling, and an ejection fraction of 55%. Which of the following is the most likely cause of this patient's symptoms?" }, { "role": "assistant", "content": "Multiple myeloma" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: 3-Phosphoinositide-Dependent Protein Kinases, Cell Line, Humans, Intercellular Signaling Peptides and Proteins, Membrane Proteins, Protein-Serine-Threonine Kinases, Signal Transduction, Ubiquitin Thiolesterase, Ubiquitin-Specific Proteases, Ubiquitination." }, { "role": "user", "content": "Does ubiquitin-specific protease 4 inhibit mono-ubiquitination of the master growth factor signaling kinase PDK1? Context: Phosphorylation by the phospho-inositide-dependent kinase 1 (PDK1) is essential for many growth factor-activated kinases and thus plays a critical role in various processes such as cell proliferation and metabolism. However, the mechanisms that control PDK1 have not been fully explored and this is of great importance as interfering with PDK1 signaling may be useful to treat diseases, including cancer and diabetes. In human cells, few mono-ubiquitinated proteins have been described but in all cases this post-translational modification has a key regulatory function. Unexpectedly, we find that PDK1 is mono-ubiquitinated in a variety of human cell lines, indicating that PDK1 ubiquitination is a common and regulated process. Ubiquitination occurs in the kinase domain of PDK1 yet is independent of its kinase activity. By screening a library of ubiquitin proteases, we further identify the Ubiquitin-Specific Protease 4 (USP4) as an enzyme that removes ubiquitin from PDK1 in vivo and in vitro and co-localizes with PDK1 at the plasma membrane when the two proteins are overexpressed, indicating direct deubiquitination." }, { "role": "assistant", "content": "The regulated mono-ubiquitination of PDK1 provides an unanticipated layer of complexity in this central signaling network and offers potential novel avenues for drug discovery. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: UNLABELLED, OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Diet, Diet, High-Fat, Intestine, Small, Methanobrevibacter, Rats, Rats, Sprague-Dawley, Weight Gain." }, { "role": "user", "content": "Is intestinal Methanobrevibacter smithii but not total bacteria related to diet-induced weight gain in rats? Context: It is increasingly understood that gastrointestinal (GI) methanogens, including Methanobrevibacter smithii, influence host metabolism. Therefore, we compared M. smithii colonization and weight gain in a rat model under different dietary conditions. Sprague-Dawley rats were inoculated with M. smithii or vehicle (N = 10/group), fed normal chow until day 112 postinoculation, high-fat chow until day 182, then normal chow until day 253. Thereafter, five rats from each group were fed high-fat and normal chow until euthanasia. Both groups exhibited M. smithii colonization, which increased following inoculation only for the first 9 days. Change to high-fat chow correlated with significant increases in weight (P < 0.00001) and stool M. smithii (P < 0.01) in all rats, with stool M. smithi decreasing on return to normal chow. Rats switched back to high-fat on day 253 further increased weight (P < 0.001) and stool M. smithii (P = 0.039). Euthanasia revealed all animals had higher M. smithii, but not total bacteria, in the small intestine than in the colon. Rats switched back to high-fat chow had higher M. smithii levels in the duodenum, ileum, and cecum than those fed normal chow; total bacteria did not differ in any bowel segment. Rats which gained more weight had more bowel segments colonized, and the lowest weight recorded was in a rat on high-fat chow which had minimal M. smithii colonization." }, { "role": "assistant", "content": "We conclude that M. smithii colonization occurs in the small bowel as well as in the colon, and that the level and extent of M. smithii colonization is predictive of degree of weight gain in this animal model. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Denmark, Education, Medical, Continuing, Female, Health Status Indicators, Humans, Male, Medication Errors, Outcome Assessment (Health Care), Patients, Physicians, Family, Polypharmacy, Practice Patterns, Physicians', Primary Health Care, Program Evaluation, Time Factors." }, { "role": "user", "content": "Does combined intervention programme reduce inappropriate prescribing in elderly patients exposed to polypharmacy in primary care? Context: To evaluate the effect of a combined or a single educational intervention on the prescribing behaviour of general practitioners (GPs). The primary endpoint was effect on inappropriate prescribing according to the Medication Appropriateness Index (MAI). General practitioners were randomised to either (1) a combined intervention consisting of an interactive educational meeting plus feedback on participating patients' medication, (2) a single intervention with an interactive educational meeting or (3) a control group (no intervention). Elderly (>65 years) patients exposed to polypharmacy (>or=5 medications) were identified and approached for inclusion. Data on medications prescribed over a 3-month period were collected, and the GPs provided detailed information on their patients before and after the intervention. A pre- and post-MAI were scored for all medications. Of the 277 GPs invited to participate; 41 (14.8%) volunteered. Data were obtained from 166 patients before and after the intervention. Medication appropriateness improved in the combined intervention group but not in the single intervention group. The mean change in MAI and number of medications was -5 [95% confidence interval (CI) -7.3 to -2.6] and -1.03 (95% CI -1.7 to -0.30) in the combined intervention group compared with the group with the educational meeting only and the no intervention group." }, { "role": "assistant", "content": "A combined intervention consisting of an interactive educational meeting plus recommendations given by clinical pharmacologists/pharmacists concerning specific patients can improve the appropriateness of prescribing among elderly patients exposed to polypharmacy. This study adds to the limited number of well-controlled, randomised studies on overall medication appropriateness among elderly patients in primary care. Important limitations to the study include variability in data provided by participating GPs and a low number of GPs volunteering for the study. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A patient in regular rhythm presents with absent P waves on ECG. Leads II, III and AVF reveal a Saw-Tooth Pattern. Which of the following is the most likely diagnosis:" }, { "role": "assistant", "content": "The correct answer is Answer is C (Atrial Flutter with Fixed Block) The absence of any discernible P waves on ECG, together with the presence of Saw Tooth Flutter waves in inferior leads (Leads II, III and AVF) strongly suggests a diagnosis of Atrial Flutter. The presence of a regular rhyti,,o suggests a Fixed Block . Findings/Features Diagnosis Irregular Rhythm with no discernible P wave (Chaotic base line with fibrillary f waves) Atrial Fibrillation Irregular rhythm with no discernible P wave (Saw tooth ,Ilutter waves especially in inferior leads and VI) Atrial Flutter with variable block Regular rhythm with no discernible P waves (Saw tooth flutter waves especially in inferior leads and V1) Atrial Flutter with fixed block Irregular Rhythm with multiple P wave morphologies (P waves Discernible) and Varying PR intervals Multifocal Atrial Tachycardia" } ]

[ { "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": "Atria mois other name for ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Gateways of death Atria Mois Also called gateways of death/ deaths poal of entry. It is believed that death enters the body due to stoppage of one of the three organs i. e. hea, lungs, brain; and thus each of these organs is called atria mois." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Alleles, Female, Gene Frequency, Genotype, Humans, Logistic Models, Male, Middle Aged, Myocardial Infarction, Platelet Membrane Glycoproteins, Polymorphism, Genetic, Randomized Controlled Trials as Topic, Risk Factors." }, { "role": "user", "content": "Is platelet glycoprotein GP VI 13254C allele an independent risk factor of premature myocardial infarction? Context: The purpose of this study was to asses the impact of haemostatic and platelet receptor gene polymorphisms as an inherited risk factor for premature onset of myocardial infarction (MI). Polymorphisms of platelet receptors - GP Ia (807C>T, rs1126643), GP VI (13254T>C, rs1613662), GP IIIa (HPA-1, rs5918), PAR -1 (IVS -14A>T; rs168753), P2Y(12) (34C>T, rs6785930 and H1/H2 haplotype, rs2046934), and genetic variations of the gene coding for cyclooxygenase-1 (COX-1) ( -842A>G, rs10306114 and 50C>T, rs3842787) were investigated. Mutations in the genes coding for coagulation factor V (Q506R (Leiden) mutation, rs6025) and factor II (prothrombin G20210A, rs1799963) were also determined. The prevalence of gene polymorphisms was investigated in 105 consecutive patients with premature MI. This was compared with the same gene polymorphism prevalence in a group of 132 patients in which coronary artery disease had been excluded. Genotyping was done using PCR, followed by melting curve analysis with specific fluorescent hybridization probes. A significant association between GP VI 13254C allele carriers and premature MI was found (p=0.025). No other differences in prevalence of the investigated polymorphisms between the compared patient populations reached statistical significance. In a logistic regression, which took other cardiovascular risk factors into account, the significance of the GP VI 13254C allele and vascular risk was suggested (OR 1.888, 95% C.I. 1.029 to 3.464, p=0.040). In a binary logistic regression the positive relationship between the GP VI genotype and female gender was observed (0R 3.676; 95% C.I. 1.159 to 11.628; p=0.027). The frequencies of GP VI and GP Ia gene polymorphisms were independent of one another (p=0.836)." }, { "role": "assistant", "content": "The presence of the GP VI 13254C allele is an independent predictor of premature MI. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Adult, Asthma, Child, Child, Preschool, DNA Primers, England, Female, Gene Frequency, Genetic Predisposition to Disease, Genotype, Humans, Hypersensitivity, Immunoglobulin E, Male, Membrane Proteins, Polymorphism, Genetic, Receptors, Leukotriene, Sequence Analysis, DNA." }, { "role": "user", "content": "Is the cysteinyl-leukotriene type 1 receptor polymorphism 927T/C associated with atopy severity but not with asthma? Context: The cysteinyl-leukotriene receptor type 1 (CysLT1) mediates the bronchoconstrictor and pro-inflammatory actions of cysteinyl-leukotrienes (LTC4, LTD4, LTE4) in asthma and is the molecular target of the lukast class of oral anti-leukotriene drugs. We screened the CYSLTR1 gene on chromosome Xq13-21 for coding region polymorphisms, and investigated their associations with allergy and asthma. Solid-phase chemical cleavage was used to screen polymorphisms in the coding region of CYSLTR1. A TaqMan allelic discrimination assay was used to genotype a 927T/C SNP and oligonucleotide ligation assays were used to genotype the previously reported 617T/C and 898G/A SNPs of CYSLTR1 in 341 asthmatic families from the UK. Associations with asthma diagnosis, atopic status, serum-specific IgE and severity of allergy and asthma were examined. Family-based association tests showed that the 927 T allele was associated with atopy severity, especially in female subjects, but not with asthma diagnosis or severity, atopic status, bronchial hyper-responsiveness to methacholine or forced expiratory volume in 1 s." }, { "role": "assistant", "content": "Mutation screening identified only one polymorphism, 927T/C, in the coding region of the CysLT1 receptor. This polymorphsim is predictive of atopy severity, but not associated with asthma. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Analgesics, Opioid, Consensus, Cultural Characteristics, Data Collection, Female, Humans, Male, Models, Theoretical, Opioid-Related Disorders, Prescription Drugs, Risk, United States, Young Adult." }, { "role": "user", "content": "'m `` I afraid of those ones just 'cause they 've been prescribed '' : perceptions of risk among illicit users of pharmaceutical opioids? Context: There has been a rise in the illicit use of pharmaceutical opioids (\"pain pills\") in the United States. Conducted with young adult non-medical users of pharmaceutical opioids, this study uses qualitative methods and cultural consensus analysis to describe risk perceptions associated with pharmaceutical opioids and to determine patterns of cultural sharing and intra-cultural variation of these views. The qualitative sub-sample (n=47) was selected from a larger sample of 396 young adults (18-23 years old), who were participating in a natural history study of illicit pharmaceutical opioid use. Qualitative life history interviews, drug ranking task, and cultural consensus analysis were used to elicit participant views about risks and harms associated with pain pills and other drugs, as well as alcohol and tobacco. Cultural consensus analysis revealed that the participants shared a single cultural model of drug risks, but the level of agreement decreased with the increasing range of drugs ever used. Further, those with more extensive drug use histories differed from less \"experienced\" users in their views about OxyContin and some other drugs. Overall, pain pills were viewed as addicting and potentially deadly substances, but these properties were linked to the patterns and methods of use, as well as characteristics of an individual user. Further, risks associated with pharmaceutical opioids were further curtailed because they \"came from the doctor,\" and thus had a legitimate aspect to their use." }, { "role": "assistant", "content": "This study highlights potential problems with universal approaches to substance use prevention and intervention among young people since such approaches ignore the fact that substance use education messages may be experienced differently depending on an individual's drug use history and his/her perceptions of drug risks. Findings reported here may be useful in the development of prevention and intervention programs aimed at reducing the harm associated with illicit use of pain pills. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Animals, Cadherins, Cell Line, Epithelial-Mesenchymal Transition, Fetal Proteins, Fibrosis, Humans, Kidney Tubules, Male, Rats, Sprague-Dawley, Snail Family Transcription Factors, T-Box Domain Proteins, Transcription Factors, Transforming Growth Factor beta." }, { "role": "user", "content": "Does the T-box transcription factor Brachyury promote renal interstitial fibrosis by repressing E-cadherin expression? Context: Epithelial-to-mesenchymal transition (EMT) induced by TGF-β1 is one of well-recognized factors contributing to renal fibrosis. However, the underlying molecular mechanisms of EMT are not fully understood. Brachyury, an evolutionarily conserved transcription factor, was recently identified as an important factor promoting EMT in human carcinoma cell lines. There is no evidence that Brachyury is involved in renal tubular EMT. Our results demonstrated that Brachyury was prominently induced in TGF-β1-treated human proximal tubular epithelial (HK-2) cells and that this induction was accompanied by changes characteristic of EMT. Blockage of Brachyury expression by short interfering RNA (siRNA) in HK-2 cells effectively reversed the TGF-β1-induced EMT phenotype. Brachyury induction repressed E-cadherin transcription; the E-cadherin promoter contains a Brachyury binding site, and decreased expression of E-cadherin occurred in Brachyury-overexpressing cells when they were transfected with reporter constructs using the promoter. This effect was partially mediated by Slug and Snail, as knockdown of Snail and Slug by siRNA effectively reversed Brachyury-mediated EMT and partially restored E-cadherin expression. The expression of Brachyury also presented in a rat model of obstructive nephropathy and in tubulointerstitial fibrosis tissues of IgA nephropathy, suggesting that it may have a role in EMT and renal fibrosis in vivo." }, { "role": "assistant", "content": "Our results demonstrate for the first time that Brachyury plays an important role in regulating TGF-β1-mediated renal EMT and could be an attractive target for progression of renal disease therapies. 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 operating temperature in an ethylene oxide sterilization during a warm cycle is:" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e, 49-63(Ref: Ananthanarayan, 9th/e, p. 35, 36; Baveja, 4th/e, p. 38)EO sterilization cycles - Cold cycle at 37+-5 and Warm cycle 54+-5." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, Burn Units, Burns, Child, Child, Preschool, Drug Resistance, Multiple, Bacterial, Female, Gram-Negative Bacteria, Gram-Positive Bacteria, Humans, Infant, Male, Microbial Sensitivity Tests, Middle Aged, Retrospective Studies." }, { "role": "user", "content": "Do [ Bacteriological surveillance in a burn intensive care unit and the analysis of bacterial resistance to antibiotics ]? Context: To investigate the dynamic changes of the bacterial flora in our burn intensive care unit (ICU) in the past 6 years, and to analyze resistance of bacteria to various antibiotics. A retrospective analysis of bacterial culture and drug-sensitivity results from 209 patients in our burn intensive care unit during a period of 1998 to 2003 was carried out. Eight hundred and forty-five strains of bacteria were isolated from 209 specimens, among which 486 strains were gram negative (G(-)) (57.51%), and 339 were gram positive (G(+)) (40.12%). Among all the G(+) bacteria, Enterococcus faecalis accounted for 34.51%, Staphylococcus aureus accounted for 31.27%, and 72.64% of Staphylococcus aureus strains were MRSA. Pseudomonas aeruginosa was predominant among all G(-) bacteria, and it accounted for 66.26% of the latter. All the bacteria isolated showed multiple resistance to antibiotics." }, { "role": "assistant", "content": "G(-) bacilli were still predominant in our burn intensive care unit. The isolated bacteria exhibited multiple resistance to antibiotics. The results imply that antibiotics should be administered rationally in the burn wards guided by the bacterial resistance test. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All are true about Right ventricular infarct EXCEPT:" }, { "role": "assistant", "content": "The correct answer is ANSWER: (B) Normal JVPREF: Robbins 7th ed p. 563Right sided MI will lead to right ventricular dysfunction with features of right ventricular failureBackward failure of the right ventricle leads to congestion of systemic capillaries. This generates excess fluid accumulation in the body.This causes swelling under the skin (termed peripheral edema or anasarca) and usually affects the dependent parts of the body first (causing foot and ankle swelling in people who are standing up, and sacral edema in people who are predominantly lying down).Nocturia (frequent nighttime urination) may occur when fluid from the legs is returned to the bloodstream while lying down at night.In progressively severe cases, ascites (fluid accumulation in the abdominal cavity causing swelling) hepatomegaly (enlargement of the liver) may develop.Significant liver congestion may result in impaired liver function, and jaundice and even coagulopathy (problems of decreased blood clotting) may occur.Pleural effusion, Raised JVP, positive hepatojuglar reflex, parasternal heave." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Area Under Curve, Biomarkers, Tumor, Carcinoma, Squamous Cell, Confidence Intervals, Extracellular Matrix, Female, Galectin 1, Humans, Kaplan-Meier Estimate, Neoplasm Recurrence, Local, Prognosis, Proportional Hazards Models, ROC Curve, Radiation Tolerance, Retrospective Studies, Survival Rate, Uterine Cervical Neoplasms." }, { "role": "user", "content": "Is galectin-1 an independent prognostic factor for local recurrence and survival after definitive radiation therapy for patients with squamous cell carcinoma of the uterine cervix? Context: To investigate the role of galectin-1 in patients with cervical cancer after definitive radiation therapy. We reviewed 154 patients with International Federation of Gynecology and Obstetrics stage I-II squamous cell carcinoma. Patients underwent curative-intent radiation therapy. Paraffin-embedded tissues were analyzed using immunohistochemistry staining for galectin-1. The rates of cancer-specific survival (CSS), local recurrence (LR), and distant metastasis were compared among patient tissue samples with no, weak, and strong galectin-1 expression. The Kaplan-Meier method and the Cox proportional hazard model with hazard ratios and 95% confidence intervals (CIs) were used for univariate and multivariate analyses, respectively. The areas under the curve for the intracellular expression scores of galectin-1 for both LR and CSS were significantly higher than those for stromal expression. There were no significant differences in the demographic data, such as stage and serum tumor markers, between patients with and without intracellular expression of galectin-1 in cancer tissue samples. Using multivariate analyses, the hazard ratios of LR and CSS were 2.60 (95% CI 1.50-4.52) (P=.001) and 1.94 (95% CI 1.18-3.19) (P=.010), respectively." }, { "role": "assistant", "content": "Galectin-1 is an independent prognostic factor associated with LR and CSS in stage I-II cervical cancer patients undergoing definitive radiation therapy. Further studies targeting galectin-1 may improve the local control of cervical cancer. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All are risk factors of preeclampsia except" }, { "role": "assistant", "content": "The correct answer is Primiparous is at a higher risk than multiparous lady H.mole due to abnormal trophoblastic proliferation and uterine distension is at higher risk. Infact h.mole is associated with early onset preeclampsia. Previous h/o preeclampsia also increases risk." } ]

[ { "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 aggressive type of Basal cell carcinoma:" }, { "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": "Shoest diameter of true pelvis amongst the following is: September 2008" }, { "role": "assistant", "content": "The correct answer is Ans. C: Interspinous Diameter True conjugate-between the midpoint of the sacral promontory to the inner margin of the upper border of symphysis pubis-11 cm Diagonal conjugate-between the lower border of symphysis pubis to the midpoint on the sacral promontory-12 cm Interspinous (Bispinous) diameter-between the tip of two ischial spines-10.5 cm lnteuberous diameter-between inner borders of ischial tuberosities-11 cm" } ]

[ { "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": "Duration of maternal benefit under ESI acts is -" }, { "role": "assistant", "content": "The correct answer is - the ESI act passed in 1948 is an impoant measure of social security and health insurance in the country. - it provides for ceain cash and medical benefits to industrial employees in case of sickness, maternity and employment injury. - maternity benefit is payable cash to an insured woman for confinement/ miscarriage or sicknesses arising out of confinement. -the duration of benefit for confinement is 12 weeks or 84 days. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no: 815,817 <\\p>" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Analgesics, Opioid, Chromatography, High Pressure Liquid, Excitatory Amino Acids, Female, Humans, Injections, Spinal, Male, Middle Aged, Morphine, Neoplasms, Pain Measurement, Pain, Intractable, Spectrometry, Fluorescence." }, { "role": "user", "content": "Is loss of intrathecal morphine analgesia in terminal cancer patients associated with high levels of excitatory amino acids in the CSF? Context: To examine excitatory amino acid (EAA) levels in the cerebrospinal fluid (CSF) of patients on long-term morphine treatment for terminal cancer pain relief and to correlate these with morphine's analgesic effect. Fourteen terminal cancer patients suffering severe pain and requiring long-term opioid treatment for pain relief were included. An intrathecal (IT) catheter was implanted at the L(3-4)/L(4-5) level and advanced 10 cm in a cephalad direction. IT morphine injection was started at 100 microgram q 12 hr with a daily incremental dose of 50 microgram until the effective dose was reached. The CSF was sampled (2 mL) as follows: 1) before the first IT morphine injection, 2) when the effective dose of morphine was reached, 3) when loss of morphine's analgesic effect at the effective dose (pain visual analogue scale > 5), and 4) after consecutive increases of the morphine dose (50 microgram, IT, daily) for satisfactory pain relief and up to double the effective dose. The concentrations of glutamate and aspartate in the CSF were determined. CSF levels of glutamate and aspartate at the effective dose of morphine were lower than the baseline levels and increased when pain intensity increased and when morphine's analgesic effect was lost." }, { "role": "assistant", "content": "Long-term IT morphine administration was accompanied by an increase of EAA level in the CSF that was associated with a loss of morphine's analgesic effect. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Anticoagulants, Cerebral Hemorrhage, Child, Drainage, Female, Heparin, Humans, Male, Middle Aged, Retrospective Studies, Risk, Severity of Illness Index, Time Factors, Treatment Outcome, Venous Thromboembolism, Young Adult." }, { "role": "user", "content": "Does risks for hemorrhagic complications after placement of external ventricular drain with early chemical prophylaxis against venous thromboembolisms? Context: Patients undergoing placement of an external ventricular drain (EVD) are at increased risk for development of venous thromboembolisms (VTEs). Early chemical prophylaxis has been shown to decrease rates of embolism formation, but the risks for bleeding and the optimal time to initiate prophylaxis have not been clearly defined for this patient population. The authors evaluated the safety and risks for bleeding when chemical prophylaxis for VTEs was started within 24 hours of EVD placement. To compare rates of hemorrhage among patients who received prophylaxis within 24 hours and those who received it later than 24 hours after admission, the authors conducted an institutional review board-approved retrospective review. Patients were those who had had an EVD placed and postprocedural imaging conducted at Bellevue Hospital, New York, from January 2009 through April 2012. Data collected included demographics, diagnosis, coagulation panel results, time to VTE prophylaxis and imaging, and occurrence of VTEs. The EVD-associated hemorrhages were classified as Grade 0, no hemorrhage; Grade 1, petechial hyperdensity near the drain; Grade 2, hematoma of 1-15 ml; Grade 3, epidural or subdural hematoma greater than 15 ml; or Grade 4, intraventricular hemorrhage or hematoma requiring surgical intervention. Among 99 patients, 111 EVDs had been placed. Low-dose unfractionated heparin had been given within 24 hours of admission (early prophylaxis) to 56 patients and later than 24 hours after admission (delayed prophylaxis) to 55 patients. There were no statistical differences across all grades (0-4) among those who received early prophylaxis (n = 45, 5, 5, 1, and 0, respectively) and those who received delayed prophylaxis (n = 46, 4, 1, 1, and 3, respectively) (p = 0.731). In the early prophylaxis group, 3 VTEs were discovered among 32 of 56 patients screened for clinically suspected VTEs. In the delayed prophylaxis group, 5 VTEs were discovered among 33 of 55 patients screened for clinically suspected VTEs (p = 0.71)." }, { "role": "assistant", "content": "Hemorrhagic complications did not increase when chemical prophylaxis was started within 24 hours of admission. Also, the incidence of VTEs did not differ between patients in the early and delayed prophylaxis groups. Larger randomized controlled trials are probably needed to assess decreases in VTEs with earlier prophylaxis. 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": "Adding glucose to stored blood causes?" }, { "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: Biomarkers, Biomarkers, Tumor, Cell Proliferation, Disease Progression, Gastric Mucosa, Gene Expression Regulation, Neoplastic, Helicobacter pylori, Humans, Immunohistochemistry, Intestinal Mucosa, Intestines, Metaplasia, Proliferating Cell Nuclear Antigen, SOX9 Transcription Factor, Stomach Neoplasms." }, { "role": "user", "content": "Is sOX9 expressed in normal stomach , intestinal metaplasia , and gastric carcinoma in humans? Context: SOX9 is a marker for stem cells in the intestine and overexpression of SOX9 is found in some types of cancer. However, the expression of SOX9 in normal stomach, precancerous intestinal metaplasia, and gastric carcinoma has not yet been clarified. This study aimed to investigate SOX9 expression in the corpus and pyloric regions of the normal human stomach, premalignant intestinal metaplasia, and gastric carcinoma by using immunohistochemistry. We evaluated SOX9 expression in 46 clinical samples (early gastric well-differentiated adenocarcinoma including surrounding intestinal metaplasia) resected under esophagogastroduodenoscopy. A small amount of SOX9 was expressed in the neck/isthmus of the corpus region and SOX9 expression was predominantly restricted to the neck/isthmus of the pyloric region in normal human stomach. In the intestinal metaplastic mucosa, SOX9- and PCNA-positive cells were located at the base of the intestinal metaplastic mucosa. Almost all of the gastric carcinoma cells expressed SOX9." }, { "role": "assistant", "content": "SOX9 is expressed in intestinal metaplasia and gastric carcinoma in humans. 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: Acute Disease, Adolescent, Adult, Child, Child, Preschool, Cytokines, Female, Genotype, Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Humans, Male, Middle Aged, Polymorphism, Genetic, T-Lymphocytes, Transplantation Chimera, fas Receptor." }, { "role": "user", "content": "Do serum levels of cytokines correlate to donor chimerism and acute graft-vs.-host disease after haematopoietic stem cell transplantation? Context: Some patients become full donor chimeras (DC) early after stem-cell transplantation (SCT), while others remain mixed chimeras for a longer time. Little is known about the mechanism behind these phenomena. Serum cytokine levels during conditioning and during the first month after SCT were analysed in 30 patients. Of the 21 patients who became full T-cell DC from the first analysed sample, 12 developed grade II-IV acute graft-vs.-host disease (GVHD) and the other nine, mild or no acute GVHD. Another nine patients were T-cell mixed chimeras (MC). All MC patients had no or mild acute GVHD. During the pretransplant conditioning, DC patients had higher levels of tumour necrosis factor (TNF)-alpha and lower levels of transforming growth factor (TGF)-beta and interleukin (IL)-10, compared with MC patients. During the first week after SCT, lower levels of TGF-beta and IL-10 and higher levels of soluble Fas (sFas) were found in DC patients compared with MC patients. During the second and third weeks after SCT, increased levels of TNF-alpha, interferon (IFN)-gamma and sFas were found among DC patients compared with MC patients. Patients who developed moderate-to-severe acute GVHD had higher levels of TNF-alpha, IFN-gamma, IL-10 and sFas at 2 weeks post-SCT than in those with less GVHD. Patients homozygous for the TNFd microsatellite alleles 3 or 4 had significantly higher TNF-alpha levels during conditioning and more often developed acute GVHD grades II-IV." }, { "role": "assistant", "content": "These results indicate that an imbalance between pro-inflammatory and immune- modulating cytokines are involved in the development of chimerism and acute GVHD after allo-SCT. The Fas/FasL pathway is probably involved in the elimination of recipient cells leading to full donor chimerism. 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, Case-Control Studies, Dog Diseases, Dogs, Inflammatory Bowel Diseases, Lipase, Logistic Models, London, Pancreas, Prognosis, Ultrasonography." }, { "role": "user", "content": "Is elevated canine pancreatic lipase immunoreactivity concentration in dogs with inflammatory bowel disease associated with a negative outcome? Context: To investigate whether elevated canine pancreatic lipase immunoreactivity (CPLI) concentrations in dogs with inflammatory bowel disease (IBD) is associated with a worse clinical outcome. Serum CPLI assays were performed on serum stored from cases diagnosed with IBD. Thirty-two dogs with CPLI results within the reference range were designated as the control group and 15 dogs had CPLI above the reference range. Clinical signs, age, serum lipase and amylase activities, serum albumin and cobalamin concentrations, abdominal ultrasound examination, histopathology on small intestinal biopsies, management of IBD and outcome were compared between the two groups. No significant differences were found in clinical activity score (P=0.54), number of antibiotic-responsive disease cases (P=0.480), number of steroid-responsive disease cases (P=0.491), serum amylase activity (P=0.058), serum cobalamin concentration (P=0.61), serum albumin concentration (P=0.052), abdominal ultrasound score (P=0.23) and histopathology scores for IBD (P=0.74) between the two groups. Dogs with increased CPLI concentration were significantly older and had a higher serum lipase activity than dogs with a CPLI concentration within the normal reference range (P=0.001, P=0.001, respectively). Moreover, dogs with increased CPLI concentration responded poorly to steroid treatment (P=0.01) and were significantly more likely to be euthanased at follow-up (P=0.02)." }, { "role": "assistant", "content": "CPLI should be measured in cases of canine IBD as elevated CPLI was associated with a worse outcome. 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 60 year old man admitted with a pathological fracture on examination he was found to be anemic, laboratory examination showed ESR: 100mm/hr, X-ray - multiple lytic lesions. Peripheral smear showed increased rouleaux formation of the red cells and thrombocytopenia. Bone marrow examination confirmed the diagnosis" }, { "role": "assistant", "content": "The correct answer is Above clinical features are charateristic of multiple mycloma." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Albuminuria, Animals, Blood Glucose, Blotting, Northern, Creatinine, Diabetes Mellitus, Type 1, Diabetic Nephropathies, Female, Growth Hormone, Hypertrophy, Insulin, Insulin-Like Growth Factor Binding Protein 1, Insulin-Like Growth Factor I, Kidney Glomerulus, Mice, Mice, Inbred NOD, Organ Size, RNA, Messenger, Somatostatin." }, { "role": "user", "content": "Does a novel somatostatin analogue prevent early renal complications in the nonobese diabetic mouse? Context: PTR-3173 (S) is a novel somatostatin analogue that has been found to exert a prolonged inhibitory action on the growth hormone (GH)-insulin-like growth factor (IGF)-I axis, but not on insulin secretion. We investigated the potential effect of this agent on the development of markers of diabetic nephropathy in the nonobese diabetic (NOD) mouse model of insulin-dependent diabetes. Female diabetic NOD mice treated with PTR-3173 (DS group) or saline (D) and their control groups of nonhyperglycemic age-matched littermates (C) and C mice treated with PTR-3173 (CS) were sacrificed three weeks after onset of diabetes. Serum GH was elevated in the D group, decreased in the DS group, and unchanged in the CS group. Serum IGF-I was significantly decreased in both the D and DS groups. Kidney weight, glomerular volume, albuminuria, and creatinine clearance were increased in the D animals and showed a trend toward normalization in the DS animals. Renal extractable IGF-I protein and IGFBP1 mRNA were increased in the D group and normalized in the DS group." }, { "role": "assistant", "content": "GH antagonism by PTR-3173 has a blunting effect on renal/glomerular hypertrophy, albuminuria, and glomerular filtration rate (GFR) in diabetic NOD mice. This phenomenon is apparently associated with the prevention of renal IGF-I accumulation. Thus, modulation of GH effects may have beneficial therapeutic implications in diabetic nephropathy. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Birth Weight, Diabetes, Gestational, Female, Fetal Macrosomia, Gestational Age, Glycated Hemoglobin A, Humans, Infant, Infant, Newborn, Middle Aged, Overweight, Pregnancy, Pregnancy Complications, Prevalence, Risk Factors, Young Adult." }, { "role": "user", "content": "Is high maternal HbA1c associated with overweight in neonates? Context: The aims of this study were to determine the prevalence of women with gestational diabetes mellitus (GDM) not obtaining HbA1c within the normal range (≤ 5.6%) before delivery and to examine whether elevated HbA1c values are associated with an increased risk of large for gestational age (LGA) infants. A population of 148 women with singleton pregnancies who had been diagnosed with GDM < 34 weeks, and who had a minimum of two HbA1c tests with a ≥ 3 week interval. They were divided into those obtaining a HbA1c ≤ 5.6%, and those who did not before delivery and further stratified according to baseline HbA1c ≤ or > 5.6%. The primary outcome was LGA infants. A total of 51 (34%) women did not obtain a HbA1c ≤ 5.6% before delivery. The median HbA1c before delivery was 5.9% versus 5.3% in the two groups. At baseline, body mass index and HbA1c were higher in the women not obtaining the goal (30.9 versus 27.8 kg/m², 5.9% versus 5.1%, both p < 0.01). Women with an elevated HbA1c before delivery had a higher prevalence of LGA infants (adjusted odds ratio (OR) 3.1 (95% confidence interval (CI) 1.3-7.6) and neonatal hypoglycaemia (adjusted OR 6.2 (95% CI 1.3-29.0). Other pregnancy outcomes were similar in the two groups. Stratification according to baseline HbA1c did not seem to change the result." }, { "role": "assistant", "content": "Women with GDM not obtaining HbA1c within the normal range before delivery had a threefold increased risk of having an LGA infant and a sixfold increased risk of neonatal hypoglycaemia. 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": "Topical mitomycin-C is used in: (REPEAT)" }, { "role": "assistant", "content": "The correct answer is Mitomycin-C is an antineoplastic antibiotic that acts as an alkylating agent by inhibiting DNA and protein synthesis. It can inhibit cell division, protein synthesis, and fibroblast proliferation. Topical application of mitomycin-C (0.4 mg/mL) was used as an adjuvant treatment in the endoscopic laser management of laryngeal and tracheal stenosis. REFERENCE: www.ncbi.nlm.nih.gov" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Biopsy, Child, Child, Preschool, Fibrosis, Graft Survival, Humans, Kidney, Kidney Diseases, Kidney Transplantation, Middle Aged, Time Factors, Transplantation, Homologous." }, { "role": "user", "content": "Does fibrous intimal thickening at implantation adversely affect long-term kidney allograft function? Context: Kidneys from marginal and older donors are increasingly used to respond to the increasing demand for kidney transplants. This study evaluated the predictive value of intimal hyperplasia, as a marker of vasculopathy, in the renal allograft at the time of transplantation (transplantation) on the subsequent graft function (7 years). The intima/media ratio of the arterial walls (I/M) was morphometrically determined by the sectorial elliptic method, in 51 implantation biopsies. Two study groups were determined. Group 1, with I/M less than or equal to 0.47, was considered as the group with minimal vascular damage at transplantation. Group 2, with I/M more than 0.47, was considered as having vasculopathy at transplantation. During the first 15 months, the estimated glomerular filtration rate improved in group 1 from 53+/-17 to 61+/-17 mL/min/1.73 m2, whereas it decreased from 51+/-21 to 46+/-14 mL/min/1.73 m2 in group 2. From 1 year posttransplantation, the estimated glomerular filtration rate (eGFR) was significantly higher in group 1 at all time points (6 month evaluation). The difference in graft function between the two groups (mean, 11 mL/min/1.73 m2) remained unchanged between 1 and 7 years posttransplantation. Among several clinical parameters investigated, blood pressure of the recipient significantly modulates the impact of preexisting vasculopathy on graft function." }, { "role": "assistant", "content": "Our data provide evidence that donor-related vasculopathy, at the time of transplantation, has a persistent significant impact on the subsequent graft function. This effect becomes only apparent at 1 year posttransplantation and is increased in recipients with inadequately controlled blood pressure. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Argentina, Computer Simulation, Coronary Disease, Diabetes Complications, Female, Health Policy, Health Surveys, Humans, Male, Middle Aged, Risk Factors, Smoking, Stroke, United States." }, { "role": "user", "content": "Is coronary heart disease and stroke attributable to major risk factors similar in Argentina and the United States : the Coronary Heart Disease Policy Model? Context: Cardiovascular disease is the leading cause of death in Argentina and the U.S. Argentina is 92% urban, with cardiovascular disease risk factor levels approximating the U.S. The Coronary Heart Disease (CHD) Policy Model is a national-scale computer model of CHD and stroke. Risk factor data were obtained from the Cardiovascular Risk Factor Multiple Evaluation in Latin America Study (2003-04), Argentina National Risk Factor Survey (2005) and U.S. national surveys. Proportions of cardiovascular events over 2005-2015 attributable to risk factors were simulated by setting risk factors to optimal exposure levels [systolic blood pressure (SBP) 115 mm Hg, low-density lipoprotein cholesterol (LDL) 2.00 mmol/l (78 mg/dl), high-density lipoprotein cholesterol (HDL) 1.03 mmol/l (60 mg/dl), absence of diabetes, and smoking]. Cardiovascular disease attributable to body mass index (BMI) >21 kg/m² was assumed mediated through SBP, LDL, HDL, and diabetes. Cardiovascular disease attributable to major risk factors was similar between Argentina and the U.S., except for elevated SBP in men (CHD 8% points higher in Argentine men, 6% higher for stroke). CHD attributable to BMI >21 kg/m² was substantially higher in the U.S. (men 10-11% points higher; women CHD 13-14% higher)." }, { "role": "assistant", "content": "Projected cardiovascular disease attributable to major risk factors appeared similar in Argentina and the U.S., though elevated BMI may be responsible for more of U.S. cardiovascular disease. A highly urbanized middle-income nation can have cardiovascular disease rates and risk factor levels comparable to a high income nation, but fewer resources for fighting the epidemic. 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, Cells, Cultured, Cyclic AMP, Enteroendocrine Cells, Female, Galanin, Gastric Inhibitory Polypeptide, Glucagon-Like Peptide 1, Guanine Nucleotide Exchange Factors, Male, Mice, Inbred C57BL, Mice, Transgenic, RNA, Messenger, Receptor, Galanin, Type 1." }, { "role": "user", "content": "Does galanin inhibit GLP-1 and GIP secretion via the GAL1 receptor in enteroendocrine L and K cells? Context: Galanin is a widely expressed neuropeptide, which in the gut is thought to modulate gastrointestinal motility and secretion. We aimed to elucidate the poorly characterised mechanisms underlying the inhibitory effect of galanin and the potential involvement of G-protein coupled inwardly rectifying potassium, Kir 3, (GIRK) channels in glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) secretion. Purified murine L and K cells were analysed for expression of galanin receptors and GIRK subunits. Hormone secretion was measured from primary murine intestinal cultures. Intracellular cAMP was monitored in primary L cells derived from mice expressing the Epac2camps sensor under the control of the proglucagon promoter. Galanin receptor 1 (GAL1, Galr1) and GIRK channel 1 (Kir 3.1, Kcnj3) and 4 (Kir 3.4, Kcnj5) mRNA expression was highly enriched in K and L cells. Galanin and a selective GAL1 receptor agonist (M617) potently inhibited GLP-1 and GIP secretion from primary small intestinal cultures. In L cells, galanin significantly inhibited the forskolin-induced cAMP response. The GIRK1/4 activator ML297 significantly reduced glucose-stimulated and IBMX-stimulated GLP-1 secretion but had no effect on GIP. The GIRK blocker tertiapin-Q did not impair galanin-mediated GLP-1 inhibition." }, { "role": "assistant", "content": "Galanin, acting via the GAL1 receptor and Gi -coupled signalling in L and K cells, is a potent inhibitor of GLP-1 and GIP secretion. Although GIRK1/4 channels are expressed in these cells, their activation does not appear to play a major role in galanin-mediated inhibition of incretin secretion. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Are higher levels of cardiovascular fitness associated with better executive function and prefrontal oxygenation in younger and older women? Context: Many studies have suggested that physical exercise training improves cognition and more selectively executive functions. There is a growing interest to clarify the neurophysiological mechanisms that underlie this effect. The aim of the current study was to evaluate the neurophysiological changes in cerebral oxygenation associated with physical fitness level and executive functions. In this study, 22 younger and 36 older women underwent a maximal graded continuous test (i.e., [Formula: see text]O2max ) in order to classify them into a fitness group (higher vs. lower fit). All participants completed neuropsychological paper and pencil testing and a computerized Stroop task (which contained executive and non-executive conditions) in which the change in prefrontal cortex oxygenation was evaluated with near infrared spectroscopy (NIRS). Our findings revealed a Fitness × Condition interaction (p < 0.05) such that higher fit women scored better on measures of executive functions than lower fit women. In comparison to lower fit women, higher fit women had faster reaction times in the Executive condition of the computerized Stroop task. No significant effect was observed in the non-executive condition of the test and no interactions were found with age. In measures of cerebral oxygenation (ΔHbT and ΔHbO2), we found a main effect of fitness on cerebral oxygenation during the Stroop task such that only high fit women demonstrated a significant increase in the right inferior frontal gyrus." }, { "role": "assistant", "content": "Higher fit individuals who demonstrate better cardiorespiratory functions (as measured by [Formula: see text]O2max ) show faster reaction times and greater cerebral oxygenation in the right inferior frontal gyrus than women with lower fitness levels. The lack of interaction with age, suggests that good cardiorespiratory functions can have a positive impact on cognition, regardless of age. 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 following is used for exocytosis" }, { "role": "assistant", "content": "The correct answer is Calcium plays an impoant role in exocytosis Exocytosis is an active vesicular transpo system" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adaptation, Psychological, Adult, Aged, Child, Preschool, Cochlear Implantation, Cochlear Implants, Deafness, Denial (Psychology), Female, Humans, Language, Male, Middle Aged, Sex Factors, Surveys and Questionnaires, Treatment Outcome." }, { "role": "user", "content": "Do [ Coping strategies in postlingually deafened adult cochlear implant users in comparison to the hearing population ]? Context: The research question was: what coping strategies are used by the postlingually deafened adult cochlear implant (CI) users, in comparison to the hearing population, taking into account their gender and CI experience. In the assessment of the coping strategies we used the C.S. Carver's Brief COPE questionnaire in Polish adaptation. The questionnaire and information form have been sent to the adult patients implanted in the Institute of Physiology and Pathology of Hearing in the years 2005 and 2009. The response ratio was 59.5% (n = 78). The control group (n = 77) comprised hearing persons selected at random, allowing for age. The stress coping strategies are different in the postlingually deafened adults and hearing ones. The postlingually deaf more seldom use the effective strategies, such as the active coping, planning and humour, and more often the denial. Also, they significantly more seldom turn to the self-blame and the substance use. People with longer CI experience significantly more often use the denial, more seldom they adopt the substance use and the self-distraction compared with those with shorter CI experience. Female postlingually deafened CI users are significantly less active in coping with stress and more seldom turn to the substance use, but more often, compared with the hearing women in the same age-group, use the denial. Male postlingually deafened CI users differ significantly from the hearing men only in more seldom turning to the self-blame and the substance use." }, { "role": "assistant", "content": "Postlingually deafened CI patients more often use the ineffective coping strategies. This tendency becomes stronger with the time lapse from the cochlear implantation and is more frequent in women, which corresponds with the data on both the considerably worse mental health of the postlingually deafened people compared to the general population and the deterioration of the mental, social and physical functioning with the lapse of time from the implantation. The standing availability of the psychological support for these patients is essential, as well as the awareness of their problems. 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: 17-alpha-Hydroxyprogesterone, Adolescent, Adrenal Hyperplasia, Congenital, Adult, Androsterone, Carotid Intima-Media Thickness, Cholesterol, HDL, Female, Humans, Male, Obesity, Sex Characteristics, Young Adult." }, { "role": "user", "content": "Does carotid Intima-Media Thickness be Associated with Increased Androgens in Adolescents and Young Adults with Classical Congenital Adrenal Hyperplasia? Context: Youth with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency develop cardiovascular disease (CVD) risk factors of obesity and hypertension. Carotid intima-media thickness (CIMT), a marker of CVD risk, is increased in CAH young adults. We examined CIMT and its relationship with androgens and obesity in adolescents/young adults with CAH. Twenty CAH subjects (age 16 ± 3.3 years, 50% female) and 20 matched controls were studied cross-sectionally. Eight additional obese patients with CAH were included in within-group comparisons. CIMT by high-resolution ultrasound, androgens, anthropometry, bone age (BA), and metabolic/inflammatory markers were assessed. Within the CAH group, CIMT correlated with 17-hydroxyprogesterone (r = 0.48, p < 0.05) and androstenedione (r = 0.46, p < 0.05), and was greater in obese subjects. CIMT was greater in CAH males than females, but similar among CAH females with advanced BA, CAH males with normal BA, and control males. There was no difference in CIMT between CAH and controls, although high-density lipoprotein was inversely correlated with CIMT in both groups." }, { "role": "assistant", "content": "CIMT is associated with increased androgens in CAH adolescents and young adults, with loss of sex differences in CAH females with excess androgen exposure. Our findings highlight the importance of hormonal control for CVD prevention in CAH. 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 beta lactam antibiotic can be safely used in a patient with a history of allergy to Pencillin" }, { "role": "assistant", "content": "The correct answer is Refer KDT 6/e p708 Aztreonan is the only beta lactam anti6 that can be used in patients having severe allergy to Pencillin or cephalosporin" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Acute Disease, Animals, Apoptosis, Eye Diseases, Female, In Situ Nick-End Labeling, Male, Neutrophils, Nitric Oxide Synthase, Nitric Oxide Synthase Type II, Rats, Rats, Inbred F344, Uveitis, Anterior." }, { "role": "user", "content": "Is apoptosis a prominent feature of acute anterior uveitis in the Fischer 344 rat? Context: To examine the hypothesis that apoptosis of infiltrating cells contributes to spontaneous resolution of uveitis in clinically relevant rodent models. Experimental melanin induced uveitis (EMIU) was induced in Fischer 344 rats by immunisation with 250 microg bovine ocular melanin. Endotoxin induced uveitis (EIU) was induced by injection of 200 microg Escherichia coli lipopolysaccharide. Formalin fixed, paraffin embedded ocular cross sections were stained by terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate biotin nick end labelling (TUNEL) to identify apoptotic cells. Indirect immunoperoxidase staining of paraformaldehyde lysine periodate fixed tissue cross sections was used to demonstrate expression of inducible nitric oxide synthase (iNOS). TUNEL positive mononuclear cells were observed in the anterior uvea during both EMIU and EIU at all selected time points. However, whereas the majority of mononuclear cells appeared apoptotic from the outset of disease, neutrophils were notably TUNEL negative at all time points examined. Many infiltrating neutrophils expressed iNOS." }, { "role": "assistant", "content": "Apoptosis occurs early in the course of rat EMIU and EIU, and may contribute to resolution of these diseases. In general, infiltrating mononuclear cells die rapidly, while neutrophils survive, producing inducible nitric oxide synthase which may contribute to disease pathogenesis. 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": "True about Secretin includes all of the following EXCEPT" }, { "role": "assistant", "content": "The correct answer is The principal function of secretin is to maintain the alkaline pH of the duodenal environment. It increases bicarbonate content of the pancreatic and biliary secretion. Thus, statement A is incorrect, hence the answer. It decreases gastric acid secretion and gastric emptying, thereby preventing the entry of acidic chyme into the duodenum. The stimulus for secretin release is the entry of acidic chyme into the duodenum. Production of bile is increased by secretin. It increases the water and bicarbonate content of the bile. This will increase the bulk of the bile, increasing its flow." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Breast Neoplasms, Chromosome Mapping, Cluster Analysis, Endpoint Determination, Female, Gene Expression Profiling, Gene Expression Regulation, Neoplastic, Genes, Neoplasm, Humans, Kaplan-Meier Estimate, Models, Genetic, Multivariate Analysis, Principal Component Analysis, Prognosis, Proportional Hazards Models, Risk Factors." }, { "role": "user", "content": "Does combining gene signatures improve prediction of breast cancer survival? Context: Several gene sets for prediction of breast cancer survival have been derived from whole-genome mRNA expression profiles. Here, we develop a statistical framework to explore whether combination of the information from such sets may improve prediction of recurrence and breast cancer specific death in early-stage breast cancers. Microarray data from two clinically similar cohorts of breast cancer patients are used as training (n = 123) and test set (n = 81), respectively. Gene sets from eleven previously published gene signatures are included in the study. To investigate the relationship between breast cancer survival and gene expression on a particular gene set, a Cox proportional hazards model is applied using partial likelihood regression with an L2 penalty to avoid overfitting and using cross-validation to determine the penalty weight. The fitted models are applied to an independent test set to obtain a predicted risk for each individual and each gene set. Hierarchical clustering of the test individuals on the basis of the vector of predicted risks results in two clusters with distinct clinical characteristics in terms of the distribution of molecular subtypes, ER, PR status, TP53 mutation status and histological grade category, and associated with significantly different survival probabilities (recurrence: p = 0.005; breast cancer death: p = 0.014). Finally, principal components analysis of the gene signatures is used to derive combined predictors used to fit a new Cox model. This model classifies test individuals into two risk groups with distinct survival characteristics (recurrence: p = 0.003; breast cancer death: p = 0.001). The latter classifier outperforms all the individual gene signatures, as well as Cox models based on traditional clinical parameters and the Adjuvant! Online for survival prediction." }, { "role": "assistant", "content": "Combining the predictive strength of multiple gene signatures improves prediction of breast cancer survival. The presented methodology is broadly applicable to breast cancer risk assessment using any new identified gene set. 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 36-year-old man comes to the physician for a follow-up examination. Two weeks ago, he was diagnosed with an ischemic stroke of the right middle cerebral artery. He was treated with thrombolytics and does not have any residual symptoms. His pulse is 82/min and regular. Cardiovascular examination shows no abnormalities. Echocardiography shows a reproducible, transient, low-volume, right-to-left shunt through the atrial septum during coughing. Which of the following conditions is caused by failure of an embryologic process similar to that responsible for this patient's heart condition?" }, { "role": "assistant", "content": "Hypospadias" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: AIMS, METHODOLOGY, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Female, Gastrectomy, Humans, Male, Middle Aged, Postoperative Complications, Pylorus, Stomach Neoplasms, Vagus Nerve." }, { "role": "user", "content": "Is preservation of the celiac branch of the vagal nerve effective in preventing stasis following pylorus-preserving gastrectomy? Context: Although pylorus-preserving gastrectomy (PPG) is performed as a function preserving surgery, patients sometimes suffer from postoperative stasis of the gastric contents after the procedure. Preservation of blood flow and both celiac and pyloric branches of the vagal nerve may decrease the incidence of the stasis. Patients who underwent PPG at the Cancer Institute Hospital between April 2005 and December 2007 were included in the study. Early surgical results and the incidence of stasis were investigated and compared between patients in whom the celiac branch had been preserved (PPG-CBP group) and those in whom it had not (PPG-nCBP group). Patients in the PPG-nCBP group had a higher body mass index than patients in the PPG-CBP group (23.9 vs. 22.3 kg/m2; p=0.004), as well as a longer operation time (249.3 vs. 227.0 min; p=0.010). There was no significant difference in the incidence of stasis between the groups (13% vs. 8%; p=0.523)." }, { "role": "assistant", "content": "There was no correlation between preservation of the celiac branch and the incidence of stasis in the first 30 days after PPG. A large randomized control trial investigating both short- and long-term outcomes after PPG is required to elucidate the primary cause of postoperative stasis." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Combined Modality Therapy, Female, Glucocorticoids, Humans, Intraocular Pressure, Male, Middle Aged, Postoperative Complications, Reoperation, Retinal Diseases, Triamcinolone Acetonide, Visual Acuity, Vitrectomy." }, { "role": "user", "content": "Do possible benefits of triamcinolone-assisted pars plana vitrectomy for retinal diseases? Context: To study the advantages and complications of triamcinolone acetonide (TA)-assisted pars plana vitrectomy (PPV) for various retinal diseases. This report is an interventional case series and nonrandomized study. One hundred seventy-seven eyes from 158 patients underwent PPV with or without TA. Group TA(+) consisted of 94 eyes and group TA(-) consisted of 83 eyes. The improvement in vision and postoperative complications were prospectively studied. Sixty-two percent of the eyes in group TA(+) and 49% of the eyes in group TA(-) had improved vision after surgery (P = 0.34). Twelve eyes in group TA(+) and 12 eyes in group TA(-) had an intraocular pressure higher than 21 mmHg after the operation, with no statistically significant difference (P = 0.63). Four eyes with proliferative diabetic retinopathy in group TA(+) and five eyes with proliferative diabetic retinopathy in group TA(-) needed an additional filtering surgery. Group TA(+) (five eyes) had a lower incidence (P = 0.041) of reoperation caused by preretinal fibrous membrane formation than group TA(-) (13 eyes). No apparent corneal disorder or infectious signs were found in any eyes." }, { "role": "assistant", "content": "Triamcinolone acetonide-assisted PPV appears to be potentially useful to reduce the incidence of reoperation owing to preretinal fibrosis with no serious complications. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aged, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Hepatocellular, Case-Control Studies, Chemoembolization, Therapeutic, Chemotherapy, Adjuvant, Combined Modality Therapy, Epirubicin, Ethiodized Oil, Female, Follow-Up Studies, Hepatectomy, Humans, Liver Neoplasms, Male, Middle Aged, Mitomycin, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Retrospective Studies." }, { "role": "user", "content": "Does adjuvant chemolipiodolization reduce early recurrence derived from intrahepatic metastasis of hepatocellular carcinoma after hepatectomy? Context: The recurrence of hepatocellular carcinoma is still high even after surgery. Two general recurrence patterns occur: intrahepatic metastasis (IM) and multicentric carcinogenesis (MC). The aim of this study was to investigate the effectiveness of adjuvant chemolipiodolization for reducing IM or MC recurrences after surgery. A retrospective case-control study was carried out. From April 2005, adjuvant chemolipiodolization was performed in 63 initial hepatocellular carcinoma patients 3 months after surgery. Sixty-four patients who underwent surgery between April 2001 and March 2005 were analyzed as the control group. Recurrence-free and overall survival as well as prognostic factors were analyzed univariately and multivariately. The 2-year recurrence-free survival was 57% in the chemolipiodolization group and 37% in the control group (P = 0.02). However, there was no significant difference at 5 years after surgery (P = 0.09). The 5-year overall survival rates in the chemolipiodolization and the control groups were 82.4 and 55.7%, respectively (P = 0.04). Cox proportional multivariate analysis revealed that adjuvant chemolipiodolization was an independent favorable prognostic factor for 2-year recurrence-free survival, and the odds ratio [95% confidential interval] was 0.55 [0.34-0.90] (P = 0.02). However, adjuvant chemolipiodolization was not an independent favorable prognostic factor for 5-year overall survival." }, { "role": "assistant", "content": "Adjuvant chemolipiodolization can reduce the risk of early recurrences, which would be mainly IM derived. However, chemolipiodolization did not reduce late phase recurrences after surgery, which would be mainly MC derived. To prevent late phase recurrences, another novel strategy would be needed. 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": "Aboion stick used in criminal aboion causes aboion by the mechanism of -" }, { "role": "assistant", "content": "The correct answer is Ref: Synopsis of forensic medicine and toxicology (K.S.Narayan Reddy) 28th edition, page no. 214 Aboion Stick: This is a thin wood or bamboo stick, from 12 to 13 cm long. This stick is wrapped round at one end or for a greater poion of its length with cotton-wool or a piece of cloth, and socked with juice of marking nut, calotropis, abrus precatorius, asafoetida or paste made of arsenious oxide, arsenic sulphate, red lead etc. It is introduced into the vagina or is of uterus by untrained midwives, and retained there till uterine contraction begin. The uterus contract, cervix dilate and foetus gets out." } ]

[ { "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": "Bacitracin sensitive streptococci:" }, { "role": "assistant", "content": "The correct answer is Ans. (b) Streptococcus pyogenes Ref Ananthanarayan 8/e, p 207, 9/e, p 210 \"Sensitivity to hacitracin is employed as a convenient method for differentiating Str. pyogenes from other hemolytic streptococci.\" For details see answer no 20 of chapter 8." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Amphetamines, Area Under Curve, Aryl Hydrocarbon Hydroxylases, Cytochrome P-450 CYP2C19, Cytochrome P-450 Enzyme System, Female, Half-Life, Humans, Male, Metabolic Clearance Rate, Mixed Function Oxygenases, Monoamine Oxidase Inhibitors, Phenotype, Polymorphism, Genetic, Selegiline." }, { "role": "user", "content": "Is cYP2C19 polymorphism important for the in vivo metabolism of selegiline? Context: To address the relevance of cytochrome P-450 (CYP) 2C19 polymorphism for the pharmacokinetics and dynamics of selegiline and its two known primary metabolites, desmethylselegiline and l-methamphetamine. Six extensive (mephenytoin S/R ratio < 0.3; EM) and six poor (mephenytoin S/R ratio > 0.8; PM) hydroxylators of S-mephenytoin ingested a single 10-mg oral dose of selegiline hydrochloride. Serum concentrations of selegiline, desmethylselegiline and l-methamphetamine were measured by gas chromatography--mass spectrometry for up to 48 h. In addition, the platelet monoamine oxidase type B (MAO-B) activity was measured for 14 days to describe possible differences in the pharmacodynamics of selegiline and its metabolites between EM and PM. The CYP2C19 phenotype had no significant effects on the pharmacokinetic variables of selegiline. PM of S-mephenytoin had 68% higher mean AUC of desmethylselegiline (P = 0.0017) than EM, but no significant differences were observed in other pharmacokinetic parameters of desmethylselegiline. Contrary to desmethylselegiline, the serum l-methamphetamine concentrations were slightly lower in PM, but no statistically significant differences were observed in l-methamphetamine pharmacokinetics between the two CYP2C19 phenotypes. Accordingly, the magnitude of MAO-B inhibition showed no significant differences between the study groups." }, { "role": "assistant", "content": "CYP2C19 polymorphism does not seem to be crucial for the metabolism or clinical effects of selegiline. 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: Biomarkers, Exercise, Female, Humans, Male, Middle Aged, Myocardial Infarction, Radiography, Troponin I, Troponin T." }, { "role": "user", "content": "Release of cardiac troponin using a high sensitivity assay after exercise: Type 2 acute myocardial infarction? Context: Cardiac troponin is used as a marker for all types of myocardial infarction. Assays for high-sensitivity troponin T and I were performed before, immediately and 24h after a 40 km bicycle ride in two middle aged individuals. There was a significant increase in cardiac troponin immediately after exercise in both individuals. This was accompanied by a return to baseline levels within 24h. A CT angiogram was normal in one while the other had a significant occlusion in the mid-right coronary artery. After a stent placement, in this latter individual, there was no major increase in troponin after a second bicycle ride." }, { "role": "assistant", "content": "Using high sensitivity assays, at least one of these two subjects may have suffered a type 2 myocardial infarction had the increases in hs-cTnI were accompanied by other acceptable evidence of myocardial ischemia (symptoms, ECG, etc.)." } ]

[ { "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 percentage of copper in high copper alloy is:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Case-Control Studies, Celiac Disease, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Lost to Follow-Up, Male, Multivariate Analysis, Patient Compliance, Regression Analysis, Young Adult." }, { "role": "user", "content": "Are pediatric celiac disease patients who lost to follow-up have a poorly controlled disease? Context: Follow-up of celiac disease (CD) patients is recommended for gluten-free diet (GFD) adherence monitoring and complication detection. We recently showed that 35% of children with CD were lost to follow-up (LTFU). We aimed to characterize LTFU population, and thus identify compliance barriers to GFD and follow-up. 50 LTFU patients were investigated using a telephone questionnaire, regarding frequency of follow-up, serology testing, and adherence to GFD (using the validated Biagi score). Fifty two regular follow-up patients served as controls. LTFU patients had poor adherence to GFD (average Biagi score of 2.0 ± 1.4) compared to controls (3.0 ± 1.0, p < 0.001). Only 22% of LTFU performed periodic celiac serology testing compared to 82% of controls (p < 0.001). LTFU had higher prevalence of positive celiac serology tests (50% compared to 25% of controls, p = 0.01). Fewer LTFU were National Celiac Association members (24%) compared with controls (44%, p = 0.05). Regression analysis showed positive relationships between LTFU and poor adherence to GFD (R(2) = 0.26737, p = 0.001), older age at diagnosis (R(2) = 0.30046, p = 0.03), and non-membership in a celiac association (R(2) = 0.18591, p = 0.0001)." }, { "role": "assistant", "content": "LTFU is associated with non-adherence to GFD and positive serology. Risk factors for LFTU should be identified and addressed in order to improve patient care. 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, Fasting, Female, Germany, Glucose Intolerance, Humans, Male, Middle Aged, Prediabetic State, Retinol-Binding Proteins, Plasma." }, { "role": "user", "content": "Is retinol-binding protein 4 associated with prediabetes in adults from the general population : the Cooperative Health Research in the Region of Augsburg ( KORA ) F4 Study? Context: We examined the association between retinol-binding protein 4 (RBP4), a novel adipokine, and prediabetes (isolated impaired fasting glucose [i-IFG], isolated impaired glucose tolerance [i-IGT], and combined IFG and IGT) in men and women aged 32-81 years. The analysis was based on 2,614 participants without previously diagnosed diabetes and those with newly diagnosed diabetes of the Cooperative Health Research in the Region of Augsburg (KORA) F4 Study, conducted from 2006 to 2008 in southern Germany. Plasma RBP4 was analyzed by immunonephelometry. In logistic regression analysis, RBP4 levels in the fourth quartile versus the first quartile were significantly associated with prediabetes (i-IGT, i-IFG, and IFG/IGT; reference normal glucose tolerance) independent of known metabolic risk factors and lifestyle variables (odds ratio 1.63 [95% CI 1.17-2.27] after multivariable adjustment). Stratification by sex showed generally similar results." }, { "role": "assistant", "content": "RBP4 levels were associated with prediabetes in individuals from the general population. Prospective studies investigating the impact of RBP4 on the development of glucose intolerance are needed. 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": "Cafe - coronary is" }, { "role": "assistant", "content": "The correct answer is Cafe - coronary is accidental choking due to food bolus, usually appens when person is intoxicated." } ]

[ { "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": "Ganglion of tendons is an example of-" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., Myxomatous degeneration Ganglion o A ganglion is a small cyst located near a joint capsule or tendon sheath. A common location is around the joints of the wrist where it appears as a firm, fluctuant, pea sized, translucent nodule. It arises as a result of cystic or myxoid degeneration of connective tissue; hence the cyst wall lacks a true cell lining. The fluid in the cyst is similar to synol fluid; However, there is no communication with the joint space." } ]

[ { "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 lactating woman has Sputum positive TB. The neonate is 3 months old. What is the recommended chemoprophylaxis?" }, { "role": "assistant", "content": "The correct answer is Chemoprophylaxis Asymptomatic children under 6 years of age, exposed to an adult with infectious (smear-positive) tuberculosis from the same household, will be given 6 months of isoniazid (5 mg per kg daily)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Antidepressive Agents, Depression, Female, Humans, Male, Middle Aged, Risk Assessment, Scotland, Social Identification, Surveys and Questionnaires, Young Adult." }, { "role": "user", "content": "Is greater number of group identifications associated with lower odds of being depressed : evidence from a Scottish community sample? Context: Group identification has been shown to be associated with reduced risk of depression, but this research has important limitations. Our aim was to establish a robust link between group identification and depression whilst overcoming previous studies' shortcomings. 1824 participants, recruited from General Practice throughout Scotland, completed a questionnaire measuring their identification with three groups (family, community, and a group of their choice), as well as their intensity of contact with each group. They also completed a self-rated depression measure and provided demographic information. Their medical records were also accessed to determine if they had been prescribed antidepressants in the previous 6 months. The number of group identifications was associated with both lower self-rated depression and lower odds of having received a prescription for antidepressants, even after controlling for the number of contact-intensive groups, level of education, gender, age, and relationship status." }, { "role": "assistant", "content": "Identifying with multiple groups may help to protect individuals against depression. This highlights the potential importance of social prescriptions, where health professionals encourage a depressed patient to become a member of one or more groups with which the patient believes he/she would be likely to identify. 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: Depressive Disorder, Major, Double-Blind Method, Female, Humans, Hydrocortisone, Male, Middle Aged, Phototherapy, Predictive Value of Tests, Psychometrics, Saliva, Serotonin Uptake Inhibitors, Sertraline, Treatment Failure, Wakefulness." }, { "role": "user", "content": "Is high cortisol awakening response associated with an impairment of the effect of bright light therapy? Context: We investigated the predictive validity of the cortisol awakening response (CAR) in patients with non-seasonal major depression. Patients were treated with sertraline in combination with bright or dim light therapy for a 5-week period. Saliva cortisol levels were measured in 63 patients, as an awakening profile, before medication and light therapy started. The CAR was calculated by using three time-points: awakening and 20 and 60 min after awakening. Patients with low CAR had a very substantial effect of bright light therapy compared with dim light therapy, whereas patients with a high CAR had no effect of bright light therapy compared with dim light therapy." }, { "role": "assistant", "content": "High CAR was associated with an impairment of the effect of bright light therapy. This result raises the question of whether bright light acts through a mechanism different from that of antidepressants. 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: APACHE, Attitude to Death, Ethics, Medical, Female, Funeral Rites, Hospital Mortality, Humans, Intensive Care Units, Male, Medical Staff, Hospital, Middle Aged, Patient Care Planning, Quality of Health Care, Treatment Outcome." }, { "role": "user", "content": "Is intensivists ' base specialty of training associated with variations in mortality and practice patterns? Context: Current evidence regarding whether the staffing of intensive care units (ICUs) with a trained Intensivist benefits patient outcomes is discordant. We sought to determine whether, among certified Intensivists, base specialty of training could contribute to variation in practice patterns and patient outcomes in ICUs. The records of all patients who were admitted to one of three closed multi-system ICUs within tertiary care centers in the Calgary Health Region, Alberta, Canada, during a five year period were retrospectively reviewed. Outcomes for patients admitted by Intensivists with base training in General Internal Medicine, Pulmonary Medicine, or other eligible base specialties (Anesthesia, General Surgery, and Emergency Medicine combined) were compared. ICU mortality in the entire cohort (n = 9,808) was 17.2% and in-hospital mortality was 32.0%. After controlling for potential confounders, ICU mortality (odds ratio (OR): 0.69; 95% confidence interval (CI): 0.52 to 0.94) was significantly lower for patients admitted by Intensivists with Pulmonary Medicine as a base specialty of training, but not ICU length of stay (LOS) (coefficient: 0.11; -0.20 to 0.42) or hospital mortality (OR: 0.88; 0.68 to 1.13). There was no difference in ICU or hospital mortality or length of stay between the three base specialty groups for patients who were admitted and managed by a single Intensivist for their entire ICU admission (n = 4,612). However, we identified significant variation in practice patterns between the three specialty groups for the number of invasive procedures performed and decisions to limit life-sustaining therapies." }, { "role": "assistant", "content": "Intensivists' base specialty of training is associated with practice pattern variations. This may contribute to differences in processes and outcomes of patient care. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Blood Flow Velocity, Female, Humans, Kidney, Kidney Transplantation, Male, Middle Aged, Patient Positioning, Predictive Value of Tests, Regional Blood Flow, Renal Artery, Renal Artery Obstruction, Renal Circulation, Transplantation, Homologous, Treatment Outcome, Ultrasonography, Doppler, Ultrasonography, Doppler, Color, Ultrasonography, Doppler, Pulsed." }, { "role": "user", "content": "Do doppler-ultrasound measurements in renal allografts depend on the patient 's body position? Context: Due to anatomical reasons a position-dependent renal allograft artery stenosis is being discussed (e.g. only in patient's upright position). The tortuous course of the allograft artery complicates the direct, angle-dependent measurement of maximum systolic flow velocities (vmax). So indirect signs such as intraparenchymal vmax and resistance index might be helpful, but it is unknown how these values change physiologically when patient's body position changes. We examined renal allografts of 60 patients (38 male, 22 female) with stable graft function using B-Mode-, colour-coded duplex-sonography and pulsed-wave-Doppler. We measured vmax and RI-values of three interlobar arteries in the cortex and allograft artery in the hilus in patients standing upright and in horizontal position. Corresponding values were analyzed for significant differences. Intraparenchymal RI-values and vmax were significantly reduced in patients upright compared to the horizontal position (16 %, MW=0.59 vs. MW=0.70, p < 0.001 resp. 6 %, MW=30.18 cm/s vs. MW=32.17 cm/s, p = 0.045). Similar results could be detected in the renal hilus." }, { "role": "assistant", "content": "Patients with stable graft-function show significant, position-dependent differences of the intraparenchymal and hilar RI-values and maximal systolic flow velocities. These changes of Doppler parameters has to be kept in mind for the correct diagnosis of a position dependent allograft artery stenosis. 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 40-year-old woman presents with bilateral conductive hearing loss, palpable purpura on the legs and hemoptysis. CT scan of the chest shows few thin-walled lung cavities bilaterally. Fuher investigations reveal total leukocyte count 12,000/mm3, red cell casts in the urine and, serum creatinine 2.3 mg/dL. What is the most probable diagnosis?" }, { "role": "assistant", "content": "The correct answer is Wegener's granulomatosis: Granulomatosis with polyangiitis (GPA), previously known asWegener granulomatosis, is a multisystem necrotizing non-caseating granulomatous c-ANCA positive vasculitis affecting small to medium-sized aeries, capillaries, and veins, with a predilection for the respiratory system and kidneys. Figure: Multiple thick walled cavitating lesions in both lungs. On CT, a feeding vessel leading to nodules and air bronchogram on it may be seen. Linear bands, spiculations and pleural tags may also be seen in the relation. Cavitation is characteristic of it. Consolidation and groundglass opacities are also recognized features." } ]

[ { "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 multipara with 34 weeks pregnancy tachycardia, fever, hepatospleenomegaly, pallor has :" }, { "role": "assistant", "content": "The correct answer is Malaria" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Aged, Anesthesia, Anesthesia, General, Antifibrinolytic Agents, Biomarkers, Blood Glucose, Blood Pressure, Coronary Artery Bypass, Echocardiography, Transesophageal, Female, Glucose Clamp Technique, Heart Rate, Hemodynamics, Humans, Hypoglycemic Agents, Infusions, Intravenous, Insulin, Male, Middle Aged, Postoperative Care, Sample Size, Ventricular Function, Left." }, { "role": "user", "content": "Does high-dose insulin administration improve left ventricular function after coronary artery bypass graft surgery? Context: To test the hypothesis that the intravenous administration of high doses of insulin while maintaining normoglycemia (GIN therapy) improves myocardial function after coronary artery bypass graft (CABG) surgery. A prospective, randomized clinical trial. A university hospital. Forty patients undergoing elective CABG surgery. Patients were randomized to the GIN or control group. Applying the principles of the hyperinsulinemic-normoglycemic clamp technique in the GIN group, insulin was administered at 5 mU/kg/min during surgery. Glucose 20% was infused at a rate adjusted to maintain blood glucose (BG) between 4.0 and 6.0 mmol/L. Patients in the control group received insulin on a sliding scale, also aiming at normoglycemia. Systemic hemodynamic parameters included heart rate, mean arterial pressure, pulmonary artery wedge pressure, vascular resistance index, and cardiac index (CI). Left ventricular function was assessed by transesophageal echocardiography using the myocardial performance index (MPI) as a parameter of global left ventricular function, the fractional area change (FAC) for systolic function, and flow propagation velocity for diastolic function before and after surgery. All patients receiving GIN therapy were hyperinsulinemic (3,474 ± 1,204 pmol/L) and normoglycemic, showing a lower mean BG concentration (4.9 ± 0.5 mmol/L) than patients in the control group (8.2 ± 2.0 mmol/L). Patients receiving GIN therapy had an increased CI after surgery compared with the control group (p = 0.005). The GIN therapy was associated with improved MPI and FAC values when compared with standard care. Also, there was no difference in the parameters indicating left ventricular diastolic function." }, { "role": "assistant", "content": "Intraoperative GIN therapy improves global and systolic left ventricular function after CABG surgery. 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, Carcinoma, Non-Small-Cell Lung, Cell Nucleus, Cytoplasm, Disease-Free Survival, Female, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Lung Neoplasms, Male, Middle Aged, Neoplasm Recurrence, Local, Parathyroid Hormone-Related Protein, Prognosis, Retrospective Studies." }, { "role": "user", "content": "Are cytoplasmic and nuclear parathyroid hormone-related proteins opposing prognostic factors in patients with non-small-cell lung cancer who have undergone curative resection? Context: Parathyroid hormone-like related protein was a prognostic factor for non-small-cell lung cancer, but the results were conflicting. The present study was to examine the role of cytoplasmic and nuclear parathyroid hormone-like related protein in patients with non-small-cell lung cancer who have undergone surgical therapy. The expression of parathyroid hormone-like related protein was examined by immunohistochemical staining in 56 patients with resectable non-small-cell lung cancer. The impact of parathyroid hormone-like related protein expression on cancer recurrence and survival was assessed in combination with clinicopathologic features. Patients with a high expression of cytoplasmic parathyroid hormone-like related protein had a significantly unfavorable prognosis in both disease-free survival (median 16.7 vs. 58.0 months, P = 0.029) and overall survival (median 31.6 months vs. not reached, P = 0.046). In contrast, the patients with high expression of nuclear parathyroid hormone-like related protein had favorable disease-free survival (median 35.1 vs. 19.9 months, P = 0.069) and a significantly better overall survival (median not reached vs. 36.9 months, P = 0.033). There was no correlation between the expression of cytoplasmic and nuclear parathyroid hormone-like related protein (P = 1.00). Furthermore, multivariate analysis using a Cox regression model confirmed that high expression of cytoplasmic parathyroid hormone-like related protein (disease-free survival, hazard ratio: 1.973, P = 0.079; overall survival, hazard ratio: 2.461, P = 0.067) and nuclear parathyroid hormone-like related protein (disease-free survival, hazard ratio: 0.436, P = 0.029; overall survival, hazard ratio: 0.375, P = 0.018) were independently prognostic factors for disease-free survival and overall survival." }, { "role": "assistant", "content": "Cytoplasmic and nuclear parathyroid hormone-like related protein play opposing prognostic roles for the disease-free survival and overall survival of patients with early non-small-cell lung cancer who have undergone curative resection. 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 the most common cause of meningoencephalitis in children -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., Enterovirus \"Enteroviruses are the most common cause of meningoencephalitis\"" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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": "Is tNFRSF10C copy number variation associated with metastatic colorectal cancer? Context: Genetic markers for distant metastatic disease in patients with colorectal cancer (CRC) are not well defined. Identification of genetic alterations associated with metastatic CRC could help to guide systemic and local treatment strategies. We evaluated the association of tumor necrosis factor receptor superfamily member 10C (TNFRSF10C) copy number variation (CNV) with distant metastatic disease in patients with CRC using The Cancer Genome Atlas (TCGA). Genetic sequencing data and clinical characteristics were obtained from TCGA for all available patients with CRC. There were 515 CRC patient samples with CNV and clinical outcome data, including a subset of 144 rectal adenocarcinoma patient samples. Using the TCGA CRC dataset, CNV of TNFRSF10C was evaluated for association with distant metastatic disease (M1 vs. M0). Multivariate logistic regression analysis with odds ratio (OR) using a 95% confidence interval (CI) was performed adjusting for age, T stage, N stage, adjuvant chemotherapy, gender, microsatellite instability (MSI), location, and surgical margin status. TNFRSF10C CNV in patients with CRC was associated with distant metastatic disease [OR 4.81 (95% CI, 2.13-10.85) P<0.001] and positive lymph nodes [OR 18.83 (95% CI, 8.42-42.09)]; P<0.001) but not MSI (OR P=0.799). On multivariate analysis, after adjusting for pathologic T stage, N stage, adjuvant chemotherapy, gender, and MSI, TNFRSF10C CNV remained significantly associated with distant metastatic disease (OR P=0.018). Subset analysis revealed that TNFRSF10C CNV was also significantly associated with distant metastatic disease in patients with rectal adenocarcinoma (OR P=0.016)." }, { "role": "assistant", "content": "TNFRSF10C CNV in patients with CRC is associated with distant metastatic disease. With further validation, such genetic profiles could be used clinically to support optimal systemic treatment strategies versus more aggressive local therapies in patients with CRC, including radiation therapy for rectal adenocarcinoma. Final Decision: yes" } ]