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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": "Insulin causes decrease in activity of which enzyme?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Pyruvate carboxylase -Enzymes / Pathways activated by insulinGlycolysis : PFK-1, Pyruvate kinase, glucokinase, PDH.Glycogenesis : Glycogen synthase.Lipogenesis : Acetyl-Co-carboxylase, Fatty acid synthase.Cholesterol synthesis : HMG - CoA reductase.Triglyceride synthesis : Acyl - CoA glycerol-3-P transferase, glycerol kinase.Lipoprotein degradation : Lipoprotein lipase. -Enzymes /Pathways inhibited by insulin :Gluconeogenesis : Pyruvate carboxylase, PEP carboxykinase, fructose-1, 6-bisphosphatase, glucose-6 phosphataseGlycogenolysis : Glycogen phosphorylaseLipolysis : Hormone sensitive lipase." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, BACKGROUND, METHODS, RESULTS. Meshes: Animals, Apoptosis, Disease Models, Animal, Echocardiography, Growth Hormone, Heart Failure, Hemodynamics, Male, Myocardial Infarction, Myocytes, Cardiac, Random Allocation, Rats, Rats, Sprague-Dawley, Survival Rate, Ventricular Function, Left." }, { "role": "user", "content": "Does growth hormone prolong survival in experimental postinfarction heart failure? Context: We evaluated the effects of growth hormone (GH) on survival in experimental heart failure (HF). Growth hormone has been beneficial in various models of experimental HF. Whether GH also affects HF progression and survival is not known. A total of 119 rats with moderate myocardial infarction were randomized to receive either GH (3.5 mg/kg every other day) or placebo for 28 days. Treatment was initiated one month after coronary ligation; the follow-up lasted 13 months. In the surviving animals, Doppler echocardiography and closed-chest Millar left ventricular (LV) catheterization were performed. Apoptosis, collagen volume fraction, and capillary density in the LV zone remote from infarction were measured. The early effects of GH on apoptosis were also assessed in a subgroup of eight infarcted rats, treated as specified earlier and euthanized at one month. Survival rate was 68% in GH-treated rats and 48% in the placebo group (p = 0.0377). Growth hormone had no effect on myocardial architecture, systolic function, and sarcoplasmatic reticulum calcium ATPase-2 messenger ribonucleic acid. Growth hormone improved LV relaxation; this was associated with a 50% reduction in collagen volume fraction and a 27% increase in capillary density. Growth hormone reduced the apoptotic index by 50% at one month and by 33% at 13 months." }, { "role": "assistant", "content": "Growth hormone prolonged survival of rats with postinfarction HF. This effect was associated with marked attenuation of cardiomyocyte apoptosis and pathologic interstitial remodeling in the surviving myocardium and enhanced LV relaxation. 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": "K-F ring is pathognomonic of" }, { "role": "assistant", "content": "The correct answer is Ans. d (Decreased ceruloplasmin level). (Ref. Parson, Diseases of Eye, 19th ed.568)Keyser-Fleischer (KF) ring is a diagnostic feature of Wilson's Disease or hepatolenticular degeneration.TYPE OF PIGMENTDISORDERLOCATIONIronKeratoconus (Fleischer ring)Corneal epithelium Old opacity (Hudson-Stahhline)Corneal epithelium Pterygium (Stocker's line)Corneal epithelium Filtering bleb (Ferry's line)Corneal stromaCopperWilson's disease, Chalcosis (KF ring)Descemets membraneMelaninPigment dispersion syndrome (Krukenberg's spindle)Descemets membrane" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: INTRODUCTION, METHODS, RESULTS. Meshes: Duodenal Obstruction, Echocardiography, Female, Heart Defects, Congenital, Humans, Infant, Newborn, Male, Oximetry, Radiography, Thoracic, Retrospective Studies, Risk Factors, Sensitivity and Specificity." }, { "role": "user", "content": "Is routine preoperative screening echocardiogram indicated in all children with congenital duodenal obstruction? Context: Congenital duodenal obstruction (DO) is frequently associated with congenital heart disease (CHD). Operative repair of DO is often postponed until an echocardiogram is completed, which may result in unnecessary delays. We aimed to identify and characterize CHD in children with DO to determine if appropriately selected patients could forego preoperative echocardiogram. A two-center retrospective review of all infants with DO undergoing operative repair with completed echocardiograms was included (2003-2011). Demographics, co-morbid conditions, clinical exam findings, radiologic imaging, and need for cardiac surgery were recorded. 67 children were identified. 47 (70.1%) had CHD on echocardiogram of which 19 (40.5%) had significant CHD. Children without clinical findings, abnormalities on physical examination, and/or abnormal chest x-ray were unlikely to have CHD; i.e., no asymptomatic child had significant CHD. Sensitivity and specificity of clinical findings, physical exam, and/or chest x-ray for significant CHD were 100% (95% CI 0.79-1.0) and 37.5% (95% CI 0.24-0.53), respectively, for major CHD and 87.2% (0.74-0.95) and 60% (0.36-0.80) for any CHD." }, { "role": "assistant", "content": "Careful clinical assessment, evaluation with pulse oximetry, and chest x-ray may be sufficient to exclude significant CHD in children with DO. Identifying children at low risk for cardiac lesions may prevent unnecessary delays to operative intervention and may limit medical expenses." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Anesthesia, Spinal, Conscious Sedation, Consciousness, Drug Administration Schedule, Electroencephalography, Humans, Hypnotics and Sedatives, Infusions, Intravenous, Middle Aged, Motor Neurons, Physical Stimulation, Propofol, Spinal Cord." }, { "role": "user", "content": "Does level of consciousness affect the excitability of spinal motor neurones during propofol sedation in humans? Context: To investigate the relationship between the depression of spinal motor neuronal excitability and the sedative level induced by propofol infusion, we simultaneously analysed the suppressive effect of propofol on the F wave and the sedative level during propofol infusion. After spinal anaesthesia, sedation was achieved using a propofol target-controlled infusion (TCI) system to achieve a score of 4 on the Wilson sedation scale. The excitability of spinal motor neurones was determined by measuring the left median nerve F wave. F-wave persistence and the F/M ratio were recorded at pre-sedation as the control, during sedation, at arousal by mild physical stimulation and at post-sedation. Wilson sedation scores increased significantly corresponding to the increase in the target propofol concentration (Cpt), and a Cpt-producing Wilson sedation scale 4 ranged between 1.2 and 1.8 microg ml(-1). The F-wave persistence and F/M ratio before propofol infusion were 80.7 (8.6)% and 9.5 (3.9)%, respectively. At Wilson sedation scale 4, F-wave persistence and F/M ratio were 17.6 (12.8)% (0-37.5%) and 4.3 (4.1)%, and, at return of consciousness by mild physical stimulation, significantly increased to 71.3 (7.9)% and 10.0 (5.0)%, respectively." }, { "role": "assistant", "content": "We demonstrated that the excitability of spinal motor neurones was suppressed during sedation by propofol TCI, but this suppressive effect vanished at return of consciousness by mild physical stimulation even at a constant Cpt. Our data suggested that the effect of propofol on the excitability of spinal motor neurones might be affected by consciousness level rather than propofol Cpt in humans. 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 suspended animation: PGI 10" }, { "role": "assistant", "content": "The correct answer is Ans. Can be voluntary" } ]

[ { "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": "Cystoscopic findings in TB bladder are all except -" }, { "role": "assistant", "content": "The correct answer is Bladder tuberculosis is almost always secondary to renal tuberculosis\nThe disease starts at the ureteric opening, the earliest evidence being pallor of the mucosa due to submucosal edema.\nSubsequently tiny white transluscent tubercles develop all over. Gradually these tubercles enlarge and may ulcerate (but do not cause bladder perforation).\nThese tubercles lend 'cobblestone' appearance on cystoscopy.\nThere is considerable submucous fibrosis which causes diminished capacity of bladder. Scarred & fibrosed, small capacity bladder is k/a thimble bladder.\nThe fibrosis which usually starts around the ureter, contracts to cause a pull at the ureters. This either leads to a stricture or displaced, dilated and rigid wide mouthed ureter k/a golf hole ureters. this almost always leads to ureteral reflux." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Child, Female, Humans, Kidney, Laparoscopy, Male, Safety." }, { "role": "user", "content": "Is laparoscopic approach safe for ectopic pelvic kidneys? Context: To assess the feasibility and safety of a laparoscopic approach to pelvic kidneys for ablative and reconstructive surgery. Between January 2002 and February 2005, 6 patients with a left pelvic kidney; 2 with ureteropelvic junction obstruction, 2 with nonfunctioning kidney and 2 with pelvic stones were selected. These patients underwent dismembered pyeloplasty, simple nephrectomy and pyelolithotomy by laparoscopic approach. For pyeloplasty, omitting the prior retrograde stent facilitated dissection around the pelvis, which was identified first and then the ureter was traced downwards. Dismembered pyeloplasty was done by continuous sutures using 4-0 vicryl over a double-J stent placed antegradely. During nephrectomy, the ureter was identified over the iliac vessels and divided first. Subsequent dissection was carried out after lifting the kidney to identify ectopic renal vessels. Pyelolithotomy was performed for a large single pelvic stone after placing the ureteric catheter and confirming the stone's position by fluoroscopy. One patient with pyelolithotomy was converted to open surgery while the others were completed laparoscopically. Mean hospital stay was 4.16 (range 3-5) days, blood loss 115 (range 30-300) ml and mean operative time was 170 (range 140-220) min. There were no post-operative complications. After pyeloplasty there was significant improvement in renal function and drainage pattern on diuretic scan at 11 and 12 months." }, { "role": "assistant", "content": "The laparoscopic approach provides all the benefits of a minimally invasive procedure to the patients. Due to the different locations of renal vessels, it is safe to approach the ureter first when performing nephrectomy. When performing pyeloplasty, omitting the prior stent placement helps in the identification and dissection of the renal pelvis." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Animals, Carcinoma, Islet Cell, Cell Adhesion Molecule-1, Cell Adhesion Molecules, Gene Expression Regulation, Neoplastic, Genes, Tumor Suppressor, Glucagon, Humans, Immunoglobulins, Immunohistochemistry, Islets of Langerhans, Membrane Proteins, Mice, Neoplasms, Experimental, Pancreatic Neoplasms, Polymerase Chain Reaction, RNA, Neoplasm, Tumor Suppressor Proteins." }, { "role": "user", "content": "Is cell adhesion molecule 1 a novel pancreatic-islet cell adhesion molecule that mediates nerve-islet cell interactions? Context: Cell adhesion molecule 1 (CADM1), mediates nerve-mast cell attachment and communication through homophilic binding. An immunohistochemical screen showed that CADM1 is expressed in pancreatic islets. Here, we determined the cell types expressing CADM1 and examined its role in nerve-islet cell interactions. Immunohistochemistry and double-staining immunofluorescence were performed on murine and human pancreases and on islet cell tumors (ICTs). alphaTC6 cells, a murine alpha cell line, were cultured on neurite networks of superior cervical ganglia. Neurite-alphaTC6 cell attachment and communication were examined after nerves were activated specifically by scorpion venom. CADM1 was expressed on the plasma membrane in all 4 major types of islet cells, alpha, beta, D, and pancreatic polypeptide in human beings, but primarily in alpha cells in mice. In cocultures, alphaTC6 cell to neurite attachment was inhibited dose-dependently by an anti-CADM1 function-blocking antibody. In response to scorpion venom-evoked nerve activation, 36% of the alphaTC6 cells mobilized Ca(2+), and introduction of a CADM1-targeting small interfering RNA reduced the fraction of responding cells to 7%. In 21 human ICTs, CADM1 was present in the plasma membrane of 7, and the others were negative for CADM1. Six of the CADM1-expressing tumors were functional hormonally, whereas all but 2 of the CADM1-negative tumors were nonfunctional (P = .0032)." }, { "role": "assistant", "content": "CADM1 is a novel islet cell adhesion molecule mediating nerve-islet cell interactions. The strong correlation between CADM1 expression and hormonally functional phenotypes suggests that CADM1 is involved in hormone secretion from ICTs. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: UNLABELLED, OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Biomechanical Phenomena, Cross-Sectional Studies, Electromyography, Female, Femur, Humans, Knee Joint, Male, Movement, Pain, Patella, Range of Motion, Articular, Walking." }, { "role": "user", "content": "Is knee flexion during stair ambulation altered in individuals with patellofemoral pain? Context: Reduced knee flexion is a logical gait adaptation for individuals with patellofemoral pain (PFP) to lessen the patellofemoral joint reaction force and minimise pain during stair ambulation. This gait adaptation may be related to the co-ordination of individual vasti components. This study investigated the amount of stance-phase knee flexion in individuals with (n=48) and without (n=18) PFP using a cross-sectional design. The relationship between stance-phase knee flexion and onset timing of individual vasti activity was also examined. Stance-phase knee flexion was measured in 2-dimensions using a PEAK movement analysis system during stair ascent and descent. Individuals with PFP were separated into those with synchronous onset of the EMG activity of vastus medialis obliquus (VMO) and vastus lateralis (VL), and those where the onset of VMO EMG activity was delayed relative to the VL. The amount of knee flexion at heel-strike and peak was less in the individuals with PFP compared with the healthy controls. In addition, there were trends towards individuals with PFP who had a delayed EMG onset of VL having reduced knee flexion during stair descent compared with PFP individuals with simultaneous vasti onsets and the control participants." }, { "role": "assistant", "content": "These results indicate that the amount of stance-phase knee flexion is lower in individuals with PFP and that this may be related to onset timing of the vasti. 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": "Dupuytren's contracture mvolves-" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Palmar fascia o Dupuytren's contracture is characterized in the established phase by flexion contracture of one or more fingers from thickening and shortening of palmar aponeurosis.o The exact etiology is unknow; However, the condition is more commonly associated with following conditionsi) Epileptics taking phenytoiniv) Alcoholic cirrhosisii) Diabetesv) AIDSiii) Smokingvi) Pulmonary TB o Often both hands are affected (Bilateral disease), one more than the other,o The earliest sign is a small thickened nodule in the mid-palm opposite the base of ring finger,o Gradually this extends distally to involve the ring or little finger.o There is a rare, curious association with fibrosis of the corpus Cavemosum." } ]

[ { "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 person died due to bullet injury. On post-moem examination, a metallic bullet was found in his body. This bullet showed the presence of primary and markings. These markings can be used for" }, { "role": "assistant", "content": "The correct answer is Ans. a. Identification of weapon \"Primary and secondary marks on the surface of the bullet help in identification of the gun. Primary markings on the surface of the bullet tells about the 'make' or type of the gun used and the secondary marks which are due to some elevation or depression on the inner surface of the barrel of the gun will tell specifically about the paicular gun which has been used when compared with similar markings of a bullet test-fired from the suspected gun \"" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Alveolar Process, Animals, Biomechanical Phenomena, Bone Density, Bone Remodeling, Calcification, Physiologic, Estrogens, Female, Fluoresceins, Fluorescent Dyes, Image Processing, Computer-Assisted, Imaging, Three-Dimensional, Mandible, Mastication, Ovariectomy, Rats, Rats, Sprague-Dawley, Stress, Mechanical, Time Factors, X-Ray Microtomography." }, { "role": "user", "content": "Does estrogen deficiency increase variability of tissue mineral density of alveolar bone surrounding teeth? Context: Estrogen deficiency increases bone remodeling leading to increased variability of tissue mineral density (TMD). Due to the functional demands of mastication, alveolar bone around teeth is inherently a highly remodeled region of bone tissue with a highly variable distribution of TMD. This study investigated the effect of estrogen deficiency on the TMD distribution of alveolar bone. Using three-dimensional micro-computed tomography images of sham surgery (Sham) and ovariectomized (OVX) rat mandible sections, alveolar bone region (AB) and control bone region (CB) of interest were isolated. Based on histograms of gray levels equivalent to TMD values, mean (Mean), standard deviation (SD) and coefficient of variation (COV=SD/Mean) were computed. Fifth and 95th percentile gray level values were also obtained (Low(5) and High(5), respectively). Absolute value of percentage (%) differences of the gray level parameters between AB and CB regions were computed. Both SD and COV were significantly higher in AB region than those in CB region for all specimens of both Sham and OVX groups (p<0.001). The mean values of % differences for SD were moderately higher (p<0.073) and those for COV and Low(5) were significantly higher for the OVX group than for the Sham group (p<0.04)." }, { "role": "assistant", "content": "Higher variability of mineralization observed in AB of OVX group indicates that estrogen deficiency amplifies the active bone remodeling of AB already present due to the mastication. These findings provide an insight that the increased variability of TMD induced by estrogen deficiency may compromise the mechanical stability of the tooth-bearing alveolar bone. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 10-month-old girl is brought to the physician because of a 4-day history of irritability and a rash. Her temperature is 37.7°C (99.9°F). Examination of the skin shows flaccid, transparent blisters and brown crusts on her chest and upper extremities. Application of a shear force to normal skin causes sloughing. Which of the following is the most likely underlying cause of this patient's condition?" }, { "role": "assistant", "content": "Exfoliative toxin A release" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Acetamides, Adult, Ambulatory Care, Circadian Rhythm, Cross-Over Studies, Cross-Sectional Studies, Drug Tolerance, Famotidine, Helicobacter Infections, Helicobacter pylori, Histamine H2 Antagonists, Humans, Hydrogen-Ion Concentration, Male, Middle Aged, Piperidines, Pyridines." }, { "role": "user", "content": "Does helicobacter pylori infection prevent the occurrence of the tolerance phenomenon of histamine H2 receptor antagonists? Context: The attenuated anti-secretory activity of H2 receptor antagonists (H2RA) during continuous administration is referred to as the tolerance phenomenon. However, it is not clarified whether Helicobacter pylori infection affects the occurrence of tolerance to H2RA. It is also not clarified whether the tolerance phenomenon occurs to a new H2RA, lafutidine. To investigate the occurrence of the tolerance phenomenon in subjects with and without H. pylori infection during the continuous administration of lafutidine and famotidine. Subjects were 20 healthy male volunteers (seven H. pylori positive and 13 H. pylori negative cases). All subjects were examined by ambulatory intragastric pH monitoring five times without medication, on the first and 15th day of the administration of 20 mg b.d. famotidine and 10 mg b.d. lafutidine in a cross-over fashion. The tolerance phenomenon was not observed in H. pylori-positive subjects during the 15-day-long administration of both H2RAs. In contrast, the tolerance phenomenon was observed in H. pylori negative subjects, which has been previously reported." }, { "role": "assistant", "content": "This study demonstrated that H. pylori infection affects the tolerance phenomenon during continuous administration of H2RAs. 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, Bulbar Palsy, Progressive, Case-Control Studies, Child, Deglutition, Deglutition Disorders, Electromyography, Feeding Behavior, Female, Humans, Male, Outcome Assessment (Health Care), Posture, Spinal Muscular Atrophies of Childhood, Video Recording." }, { "role": "user", "content": "Dysphagia in spinal muscular atrophy type II: more than a bulbar problem? Context: In patients with spinal muscular atrophy (SMA) type II, feeding problems and dysphagia are common, but the underlying mechanisms of these problems are not well defined. This case control study was designed to determine the underlying mechanisms of dysphagia in SMA type II. Six children with SMA type II and 6 healthy matched controls between 6.4 and 13.4 years of age were investigated during swallowing liquid and solid food in 2 different postures using surface EMG (sEMG) of the submental muscle group (SMG) and a video fluoroscopic swallow study (VFSS). The VFSS showed postswallow residue of solid food in the vallecula and above the upper esophageal sphincter (UES), which can be responsible for indirect aspiration. Better results in swallowing were achieved in a more forward head position. These findings were supported by the sEMG measurements of the SMG during swallowing." }, { "role": "assistant", "content": "Dysphagia in spinal muscular atrophy type II is due to a neurologic dysfunction (lower motor neuron problems from the cranial nerves in the brainstem) influencing the muscle force and efficiency of movement of the tongue and the submental muscle group in combination with a biomechanical component (compensatory head posture). The results suggest an integrated treatment with an adapted posture during meals and the advice of drinking water after meals to prevent aspiration pneumonias." } ]

[ { "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": "According to NACO 2011, prevalence of HIV affected people?" }, { "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: Adolescent, Adult, Antibodies, Bacterial, Antibodies, Viral, Estonia, Female, Humans, Pregnancy, Pregnancy Complications, Infectious, Seroepidemiologic Studies, Sexual Behavior, Sexual Partners, Sexually Transmitted Diseases, Bacterial, Sexually Transmitted Diseases, Viral." }, { "role": "user", "content": "Is seropositivity to multiple sexually transmitted infections common? Context: Seropositivity for several sexually transmitted infections (STIs) is often used as a surrogate measure of sexual behavior. The authors assessed the concomitant seropositivity for STIs in women. To estimate the excess of concomitant seropositivity for four STIs among fertile-aged women assuming no coinfections above what would be expected at random. Antibodies to herpes simplex virus type 2, human papillomavirus type 16, HIV, Chlamydia trachomatis, and Treponema pallidum were determined from a random sample of 1110 pregnant women in Tallinn, Estonia. A total of 310 combinations of the concomitant seropositivity were observed, whereas only 193 were expected by chance. Among persons seropositive for two STIs, 78 extra combinations were observed, whereas for three STIs, 35 extra combinations were observed. For four STIs, 3.8 extra combinations were found." }, { "role": "assistant", "content": "Seropositivity to multiple STIs is not common. This fits the concept of different transmission probabilities and the spread of the STIs, and suggests that seropositivity alone should be used with caution as a surrogate to sexual behavior in women. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Earliest radiological sign of pulmonary venous hypeension in chest X-ray is -" }, { "role": "assistant", "content": "The correct answer is Upper lobe venous diversion is the 1st radiological sign of PVH. Kerley B lines , perihilar haze ,peribronchial cuffing,pulmonary ossicles,fine punctate calcification and perihilar wing pattern." } ]

[ { "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": "HMB 45 is a tumor marker for -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Malignant melanomaMarkers for melanona1. S-100 - 90% of tumors are positive2 HMB-45 - More specific but less sensitive than S-l 003. TA-90Important markersTumoro S-l00.HMB-45Melanomao TA-90Melanoma, colon & breast ca.o NMP-22Urinary bladder ca.o Neuron Specific enalase}Neuroendocrine tumors (small cell ca of lung, carcinoid tumor & neuroblastoma)o Chromogranin Ao Lipid associated Sialic acid (LASA-P)Ovarian Ca.o C A 72-4Ovarian, pancreatic & gastric Ca.o CA19-9Pancreatic & colorectal Cao CA 125Epithelial ovarian tumoro CA27.29&CA15-3Breast Cancer." } ]

[ { "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": "Auerbachs plexus is present in the" }, { "role": "assistant", "content": "The correct answer is Nerve Plexuses - The gut is richly supplied with nerves. A number of nerve plexuses are present as follows: The myenteric plexus (of Auerbach) lies between the circular and longitudinal coats of muscularis externa. The submucosal plexus (of Meissner) lies in the submucosa (near its junction with the circular muscle layer). A third plexus is present near the muscularis mucosae. The nerve fibres in these plexuses are both afferent and efferent. The efferent fibres supply smooth muscle and glands. Postganglionic neurons meant for these structures lie amongst the nerve fibres forming these plexuses. REF : Inderbir Singh's Textbook of Human Histology, SEVENTH EDITION, PG.NO., 263." } ]

[ { "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": "Narrowest pa of middle ear is:" }, { "role": "assistant", "content": "The correct answer is When seen in corona section, the cavity of the middle ear is biconcave, as the medial and lateral walls are closest to each other in the center." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Angiotensin II, Animals, Basilar Artery, Cell Line, Cell Movement, Cells, Cultured, Chloride Channels, Male, Mice, Knockout, Muscle, Smooth, Vascular, Myocytes, Smooth Muscle, Phosphorylation, Rats, Threonine, rho-Associated Kinases." }, { "role": "user", "content": "Is threonine532 phosphorylation in ClC-3 channels required for angiotensin II-induced Cl ( - ) current and migration in cultured vascular smooth muscle cells? Context: Angiotensin II (AngII) induces migration and growth of vascular smooth muscle cell (VSMC), which is responsible for vascular remodelling in some cardiovascular diseases. Ang II also activates a Cl(-) current, but the underlying mechanism is not clear. The A10 cell line and primary cultures of VSMC from control, ClC-3 channel null mice and WT mice made hypertensive with AngII infusions were used. Techniques employed included whole-cell patch clamp, co-immunoprecipitation, site-specific mutagenesis and Western blotting, In VSMC, AngII induced Cl(-) currents was carried by the chloride ion channel ClC-3. This current was absent in VSMC from ClC-3 channel null mice. The AngII-induced Cl(-) current involved interactions between ClC-3 channels and Rho-kinase 2 (ROCK2), shown by N- or C-terminal truncation of ClC-3 protein, ROCK2 siRNA and co-immunoprecipitation assays. Phosphorylation of ClC-3 channels at Thr(532) by ROCK2 was critical for AngII-induced Cl(-) current and VSMC migration. The ClC-3 T532D mutant (mutation of Thr(532) to aspartate), mimicking phosphorylated ClC-3 protein, significantly potentiated AngII-induced Cl(-) current and VSMC migration, while ClC-3 T532A (mutation of Thr(532) to alanine) had the opposite effects. AngII-induced cell migration was markedly decreased in VSMC from ClC-3 channel null mice that was insensitive to Y27632, an inhibitor of ROCK2. In addition, AngII-induced cerebrovascular remodelling was decreased in ClC-3 null mice, possibly by the ROCK2 pathway." }, { "role": "assistant", "content": "ClC-3 protein phosphorylation at Thr(532) by ROCK2 is required for AngII-induced Cl(-) current and VSMC migration that are involved in AngII-induced vascular remodelling in hypertension. 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": "Hepatic enzyme undergoes phosphorylation from the dephosphorylated state. Which of the following is true?" }, { "role": "assistant", "content": "The correct answer is Ans- B cAMP is not an activator always. It can be other kinases like serine-threonine kinases, However, in starvation, there is always phosphorylation of enzymes by glucagon or catecholamines" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Apoptosis, Biomarkers, Blotting, Western, Caveolin 1, Cell Proliferation, Cells, Cultured, Fluorescent Antibody Technique, Gene Expression Profiling, Humans, Interleukin-6, JNK Mitogen-Activated Protein Kinases, Lipopolysaccharides, Mammary Glands, Human, Oligonucleotide Array Sequence Analysis, Phosphorylation, Signal Transduction, Toll-Like Receptor 4, p38 Mitogen-Activated Protein Kinases." }, { "role": "user", "content": "Is caveolin-1 , through its ability to negatively regulate TLR4 , a crucial determinant of MAPK activation in LPS-challenged mammary epithelial cells? Context: To explore the role of caveolin-1(CAV-1) gene silencing on MAPK activation in lipopolysaccharide (LPS)-challenged human mammary epithelial cells. We established a MCF-10ACE of CAV-1 gene silencing from human mammary epithelial cell line MCF-10A by RNAi technology. DNA Microarray were used to detect the expression of inflammation-associated genes in MCF-10ACE. Western blotting was used to examine the activation of MAPK in lipopolysaccharide(LPS)-challenged MCF-10A and MCF-10ACE. Moreover, immunofluorescence and Western bloting were performed to detect the co-localization of CAV-1 and toll-like receptor 4 (TLR4) in human mammary epithelial cells. MCF-10ACE exhibited significant increases in inflammation-associated gene expression, especially IL-6 (~7-fold) and IL6R (~17-fold). In addition, LPS-induced p38 MAPK and JNK MAPK activation was significantly increased in MCF-10ACE. Furthermore, CAV-1 co- localized with TLR4 and appeared a negative correlation trend." }, { "role": "assistant", "content": "CAV-1 gene silencing promotes MAPK activation via TLR4 signaling in human mammary epithelial cells response to LPS. 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, Diagnosis, Female, Humans, Stillbirth, Western Australia." }, { "role": "user", "content": "Is aetiology of stillbirth : unexplored unexplained? Context: To describe the rate of and demographic factors associated with fetal postmortem investigation and to classify the cause of all fetal deaths that underwent postmortem investigation. To compare the proportion of deaths remaining unexplained after postmortem investigation with estimates derived from death certificates. All fetal deaths in Western Australia (WA) from 1990 to 1999 were identified. These data were used to calculate postmortem rates and describe the characteristics of women consenting to postmortems. A multidisciplinary team classified the cause of all deaths that underwent postmortem investigation using the Perinatal Society of Australia and New Zealand Perinatal Death Classification System. The proportion of deaths that were unexplained was compared with estimates based on death certificates. Of the 1,619 fetal deaths recorded for 1990 to 1999, 49% (n=789) underwent complete postmortem investigation. Based on investigations, 22% of the 789 fetal deaths were unexplained and a further 18% were identified as having fetal growth restriction. Based on death certificates, 42% were unexplained and 65% were later explained by postmortem investigation." }, { "role": "assistant", "content": "Postmortem investigation rates are low. They reveal a cause of death for the majority of cases that are unexplained clinically. Epidemiological investigations of unexplained fetal death based on cases not subject to complete postmortem investigation may lead to inaccurate conclusions. A standardised definition for unexplained fetal deaths that distinguishes between cases with detailed investigation and those with limited or no investigation is needed. 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: Animals, Calcimycin, Calcium, Endothelial Cells, Endothelins, Male, Oxidative Stress, Rats, Rats, Inbred SHR, Rats, Inbred WKY, Reactive Oxygen Species, Vasoconstriction." }, { "role": "user", "content": "Do calcium and reactive oxygen species increase in endothelial cells in response to releasers of endothelium-derived contracting factor? Context: Experiments were designed to assess whether or not the intracellular concentration of calcium and reactive oxygen species (ROS) increase in endothelial cells of the rat thoracic aorta in response to releasers of endothelium-derived contracting factor (EDCF) and if so, whether or not a difference exists between spontaneously hypertensive (SHR) and normotensive (WKY) rats. Calcium and ROS were measured by confocal microscopy, using Fura-red in combination with Fluo-4 and dichlorodihydrofluorescein diacetate, respectively. Acetylcholine caused a rapid increase in cytosolic calcium concentration in endothelial cells of both SHR and WKY, which was significantly more pronounced in aortae of the former strain. This rise of calcium was not affected by indomethacin (an inhibitor of cyclooxygenase) or Tiron plus diethyldithiocarbamate acid (DETCA) (membrane permeable antioxidants). In the presence of a nitric oxide synthase blocker, acetylcholine also caused a rapid increase in ROS in endothelial cells of SHR but not in those of WKY. The burst of ROS was prevented by indomethacin or Tiron plus DETCA." }, { "role": "assistant", "content": "These experiments show that endothelial cells of SHR are more prone to calcium and ROS overload upon stimulation with acetylcholine. The abnormal accumulation of calcium is a prerequisite to initiate the release of EDCF and can be mimicked using the calcium ionophore A23187. The sequence of events occurring during endothelium-dependent contractions firstly requires the accumulation of calcium, which then activates cyclooxygenase and produces ROS along with EDCF that in turn stimulates TP-receptors, resulting in EDCF-mediated contractions. 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: Angiogenesis Inducing Agents, Animals, Blotting, Western, Burns, Chemical, Chemokines, Cornea, Corneal Neovascularization, Corneal Opacity, Cytokines, Disease Models, Animal, Eye Burns, Fibroblasts, Humans, Immunity, Innate, Immunohistochemistry, Interleukins, Male, Polymerase Chain Reaction, RNA, Messenger, Rats, Rats, Sprague-Dawley, Ribonuclease, Pancreatic." }, { "role": "user", "content": "Does angiogenin ameliorate corneal opacity and neovascularization via regulating immune response in corneal fibroblasts? Context: Angiogenin (ANG), a component of tears, is involved in the innate immune system and is related with inflammatory disease. We investigated whether ANG has an immune modulatory function in human corneal fibroblasts (HCFs). HCFs were cultured from excised corneal tissues. The gene or protein expression levels of interleukin (IL)-1beta (β), IL-4, IL-6, IL-8, IL-10, complements, toll-like receptor (TLR)4, myeloid differentiation primary response gene (MYD)88, TANK-binding kinase (TBK)1, IkappaB kinase-epsilon (IKK-ε) and nuclear factor-kappaB (NF-κB) were analyzed with or without ANG treatment in tumor necrosis factor-alpha (TNF-α)- or lipopolysaccharide (LPS)-induced inflammatory HCFs by real-time polymerase chain reaction (PCR), Western blotting and immunocytochemistry. Inflammatory cytokine profiles with or without ANG were evaluated through immunodot blot analysis in inflammatory HCFs. Corneal neovascularization and opacity in a rat model of corneal alkali burn were evaluated after application of ANG eye drops. ANG decreased the mRNA levels of IL-1β, IL-6, IL-8, TNF-α receptor (TNFR)1, 2, TLR4, MYD88, and complement components except for C1r and C1s and elevated the mRNA expression of IL-4 and IL-10. Increased signal intensity of IL-6, IL-8 and monocyte chemotactic protein (MCP)-1 and MCP-2 induced by TNF-α or LPS was weakened by ANG treatment. ANG reduced the protein levels of IKK-ε by either TNF-α and LPS, and decreased TBK1 production induced by TNF-α, but not induced by LPS. The expression of NF-κB in the nuclei was decreased after ANG treatment. ANG application lowered corneal neovascularization and opacity in rats compared to controls." }, { "role": "assistant", "content": "These results demonstrate that ANG reduces the inflammatory response induced by TNF-α or LPS in HCFs through common suppression of IKK-ε-mediated activation of NF-κB. This may support the targeting of immune-mediated corneal inflammation by using ANG. 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": "Skin with all its appendages is known as:" }, { "role": "assistant", "content": "The correct answer is Skin with all of its appendages is known as Integumentary system. It protects the body from external damage, loss of water etc. It includes hair and nails as well.(in case of animals/birds/reptiles- includes scales, feathers, hooves as well)" } ]

[ { "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": "Gp2b3A inhibitors are all except -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., Prasugrel Glycoproteins lIb / IIIa inhibitorso The platelet glycoprotein mediates platelet aggregation via binding of adhesive proteins such as fibrinogen and Von Willebrand factor.o GP lib / Ilia inhibitors, inhibit platelet aggregation by blocking GPIIb / IlIa.o They are more complete inhibitors than either aspirin or clopidogrel / ticlopidinejj because they inhibit final pathway in platelet aggregation (whether it is mediated by ADP or TXA2), while aspirin blocks only TXA2 pathway and clopidogrel blocks only ADP pathway,o Drugs are -o In addition to inhibiting Gp lib / Ilia receptor, abciximab also inhibits ay(33 receptor (which binds vitronectin) and amb2 (a leukocyte integerin). This action is responsible for anti-inflammatory and antiproliferative properties of abciximab." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Algorithms, Belgium, Coronary Care Units, Epidemiologic Methods, Female, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Postoperative Complications, Prognosis." }, { "role": "user", "content": "Is EuroSCORE useful in the prediction of extended intensive care unit stay after cardiac surgery? Context: Risk stratification allows preoperative assessment of cardiac surgical risk faced by individual patients and permits retrospective analysis of postoperative complications in the intensive care unit (ICU). The aim of this single-center study was to investigate the prediction of extended ICU stay after cardiac surgery using both the additive and logistic model of the European System for Cardiac Operative Risk Evaluation (EuroSCORE). A retrospective observational study was conducted. We collected clinical data of 1562 consecutive patients undergoing cardiac surgery over a 2-year period at the Antwerp University Hospital, Belgium. EuroSCORE values of all patients were obtained. The outcome measure was the duration of ICU stay in days. The predictive performance of EuroSCORE was analyzed by the discriminatory power of a receiver operating characteristic (ROC) curve. Each EuroSCORE value was used as a theoretical cut-off point to predict duration of ICU stay. Three subsequent ICU stays were defined as prolonged: more than 2, 5 and 7 days. ROC curves were constructed for both the additive and logistic model. Patients had a median ICU stay of 2 days and a mean ICU stay of 5.5 days. Median additive EuroSCORE was 5 (range, 0-22) and logistic EuroSCORE was 3.94% (range, 0.00-87.00). In the additive EuroSCORE model, a predictive value of 0.76 for an ICU stay of>7 days, 0.72 for>5 days and 0.67 for>2 days was found. The logistic EuroSCORE model yielded an area under the ROC curve of 0.77, 0.75 and 0.68 for each ICU length of stay, respectively." }, { "role": "assistant", "content": "In our patient database, prolonged length of stay in the ICU correlated positively with EuroSCORE. The logistic model was more discriminatory than the additive in tracing extended ICU stay. The overall predictive performance of EuroSCORE is acceptable and most likely based on the presence of variables that are risk factors for both mortality and extended ICU stay. Hence, EuroSCORE is a useful predicting tool and provides both surgeons and intensivists with a good estimate of patient risk in terms of ICU stay." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Arthritis, Rheumatoid, Female, Humans, Immunocompromised Host, Incidence, Male, Middle Aged, Proportional Hazards Models, Retrospective Studies, Risk Factors, Tuberculosis, Pulmonary." }, { "role": "user", "content": "Does rheumatoid arthritis increase the risk of nontuberculosis mycobacterial disease and active pulmonary tuberculosis? Context: Few studies have examined the association of rheumatoid arthritis (RA) with nontuberculosis mycobacterium (NTM) disease and pulmonary tuberculosis (PTB). We identified 29 131 patients with RA from the catastrophic illness registry who were diagnosed from 1998-2008; 116 524 patients without RA from inpatient data files were randomly frequency matched according to sex, age, and index year and used as a comparison group. Both groups were followed-up until the end of 2010 to measure the incidence of NTM disease and active PTB. We analyzed the risk of NTM disease and active PTB using the Cox proportional hazards regression models, controlling for sex, age, and Charlson comorbidity index (CCI). The incidence of NTM disease was 4.22 times greater in the RA group than in the non-RA group (1.91 vs 0.45 per 10,000 person-years). The incidence of PTB was 2.99 times greater in the RA group than in the non-RA group (25.3 vs 8.46 per 10,000 person-years). After adjusting for age, sex, and CCI, the adjusted hazard ratios (HRs) of NTM disease and active PTB for the RA group were 4.17 (95% CI = 2.61-6.65) and 2.87 (95% CI = 2.55-3.23), respectively, compared with the non-RA group. In the first 2 years of follow-up, the RA group yielded corresponding adjusted HRs of 4.98 and 3.39 compared with the non-RA group. The follow-up time-specific RA group to the non-RA group HR of both the NTM disease and active PTB varied." }, { "role": "assistant", "content": "This study can serve as a reference for clinical physicians to increase awareness regarding the detection of NTM disease and active PTB in RA patients among the any stage of the clinical course even without CCI. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Animals, Gene Expression Profiling, Gene Expression Regulation, Gene Library, Nerve Growth Factor, PC12 Cells, Pheochromocytoma, RNA, Messenger, Rats, Ribosomal Proteins." }, { "role": "user", "content": "Does nerve growth factor selectively regulate expression of transcripts encoding ribosomal proteins? Context: NGF exerts a variety of actions including promotion of neuronal differentiation and survival. The PC12 rat pheochromocytoma cell line has proved valuable for studying how NGF works and has revealed that the NGF mechanism includes regulation of gene expression. Accordingly, we used SAGE (Serial Analysis of Gene Expression) to compare levels of specific transcripts in PC12 cells before and after long-term NGF exposure. Of the approximately 22,000 transcripts detected and quantified, 4% are NGF-regulated by 6-fold or more. Here, we used database information to identify transcripts in our SAGE libraries that encode ribosomal proteins and have compared the effect of NGF on their relative levels of expression. Among the transcripts detected in our SAGE analysis, 74 were identified as encoding ribosomal proteins. Ribosomal protein transcripts were among the most abundantly expressed and, for naive and NGF-treated PC12 cells, represented 5.2% and 3.5%, respectively, of total transcripts analyzed. Surprisingly, nearly half of ribosomal protein transcripts underwent statistically significant NGF-promoted alterations in relative abundance, with changes of up to 5-fold. Of the changes, approximately 2/3 represented decreases. A time course revealed that the relative abundance of transcripts encoding RPL9 increases within 1 hr of NGF treatment and is maximally elevated by 8 hr." }, { "role": "assistant", "content": "These data establish that NGF selectively changes expression of ribosomal protein transcripts. These findings raise potential roles for regulation of ribosomal protein transcripts in NGF-promoted withdrawal from the cell cycle and neuronal differentiation and indicate that regulation of individual ribosomal protein transcripts is cell- and stimulus-specific. 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, Adolescent Behavior, Advertising as Topic, Electronic Nicotine Delivery Systems, Female, Humans, Male, Mass Media, Odds Ratio, Smoking, Smoking Prevention, Students, Surveys and Questionnaires." }, { "role": "user", "content": "Does e-Cigarette Marketing Exposure be Associated With E-Cigarette Use Among US Youth? Context: E-cigarettes are currently the most commonly used tobacco product among US youth. However, unlike conventional cigarettes, e-cigarettes are not subject to marketing restrictions. This study investigates the association between exposure to e-cigarette marketing and susceptibility and use of e-cigarettes in youth. Data were obtained from the 2014 National Youth Tobacco Survey. Participants were 22,007 US middle and high school students. Multivariate logistic regression models assessed the relationship between e-cigarette marketing (internet, print, retail, and TV/movies) and current and ever use as well as susceptibility to use e-cigarettes among never e-cigarette users. Exposure to each type of e-cigarette marketing was significantly associated with increased likelihood of ever and current use of e-cigarettes among middle and high school students. Exposure was also associated with susceptibility to use of e-cigarettes among current nonusers. In multivariate models, as the number of channels of e-cigarette marketing exposure increased, the likelihood of use and susceptibility also increased." }, { "role": "assistant", "content": "Findings highlight the significant associations between e-cigarette marketing and e-cigarette use among youth and the need for longitudinal research on these relationships. 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": "Birth length is double at the age of" }, { "role": "assistant", "content": "The correct answer is D. i.e. (4 years) (4 Ghai 6th) (6 - Ghai 7th)WeightLength or heightHead circumference*birth - about =3 kg*birth50 cm*Birth34 cm5 month(Doubles)6 kg1 years75 cm1 years45 cm1 years9 kg2years85 cm2years47 cm2 years12 kg3 years95 cm 3 years14 kg4 years(doubles)100 cm3 years49 cm4 years16 kg 4 years50 cm* A useful guide for normal range is target height + 7 cm for girls and target height + 8.5 cm for boys" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Alcohol Drinking, Case-Control Studies, Female, Humans, Internet, Lupus Erythematosus, Systemic, Male, Middle Aged, Socioeconomic Factors, Temperance, United States." }, { "role": "user", "content": "Is alcohol consumption protective for systemic lupus erythematosus? Context: Several studies have suggested that alcohol drinking is protective for the development and progression of systemic lupus erythematosus (SLE). However, a protopathic bias might also explain this apparent association. Our objective was to investigate the association between alcohol consumption and incidence of SLE in a data set that has information on both current and pre-diagnostic alcohol consumption. We performed an Internet-based case-control study of SLE. Cases were diagnosed within 5 years of the study and met > or =4 American College of Rheumatology criteria for SLE. The control participants were tightly matched to cases on demographic and socio-economic characteristics using a propensity score. Participants completed an online exposure assessment. We used conditional logistic regression analyses to test the association of current and pre-diagnostic alcohol consumption with SLE. The sample comprised 114 cases with SLE and 228 matched controls. Current drinking (>2 days per week) was inversely associated with SLE (OR 0.35, 95% CI 0.13 to 0.98). Having more than two drinks per day was also inversely associated with SLE (OR 0.41, 95% CI 0.18 to 0.93). However, alcohol consumption before SLE diagnosis was not associated with the risk of SLE (p> or =0.4). Analysis of the change in drinking habits showed that people with lupus were more likely to quit drinking before (OR 2.25, 95% CI 0.96 to 5.28) or after (OR 2.38, 95% CI 0.88 to 6.49) being given the SLE diagnosis." }, { "role": "assistant", "content": "Our results show that alcohol consumption before SLE diagnosis is not associated with the risk for SLE, and that individuals who develop SLE are more likely to quit. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "True about phenylephrine is:" }, { "role": "assistant", "content": "The correct answer is Ans: c (Increases peripheral resistance) KDT, 5 ed, p. 127Phenylephrine is a selective alpha 1 agonist.It causes vasoconstriction and therefore increases BP.No cardiac action.HR decreases due to reflex bradycardia.Mydriatic with no cycloplegia. Therefore preferred in elderly.Reduces IOT by constricting ciliary body blood vessels.Use: Orally administered nasal decongestant." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Biomarkers, Tumor, Carcinoma, Ovarian Epithelial, Cystadenocarcinoma, Serous, Female, Gene Expression Regulation, Neoplastic, Humans, Kaplan-Meier Estimate, Middle Aged, Neoplasm Grading, Neoplasm Proteins, Neoplasms, Glandular and Epithelial, Ovarian Neoplasms, Prognosis, Transcription Factors, Tumor Cells, Cultured." }, { "role": "user", "content": "Does the NER-related gene GTF2H5 predict survival in high-grade serous ovarian cancer patients? Context: We aimed to evaluate the prognostic and predictive value of the nucleotide excision repair-related gene GTF2H5, which is localized at the 6q24.2-26 deletion previously reported by our group to predict longer survival of high-grade serous ovarian cancer patients. In order to test if protein levels of GTF2H5 are associated with patients' outcome, we performed GTF2H5 immunohistochemical staining in 139 high-grade serous ovarian carcinomas included in tissue microarrays. Upon stratification of cases into high- and low-GTF2H5 staining categories (> and ≤ median staining, respectively) Kaplan-Meier and log-rank test were used to estimate patients' survival and assess statistical differences. We also evaluated the association of GTF2H5 with survival at the transcriptional level by using the on-line Kaplan-Meier plotter tool, which includes gene expression and survival data of 855 high-grade serous ovarian cancer patients from 13 different datasets. Finally, we determined whether stable short hairpin RNA-mediated GTF2H5 downregulation modulates cisplatin sensitivity in the SKOV3 and COV504 cell lines by using cytotoxicity assays. Low expression of GTF2H5 was associated with longer 5-year survival of patients at the protein (hazard ratio [HR], 0.52; 95% CI, 0.29 to 0.93; p=0.024) and transcriptional level (HR, 0.80; 95% CI, 0.65 to 0.97; p=0.023) in high-grade serous ovarian cancer patients. We confirmed the association with 5-year overall survival (HR, 0.55; 95% CI, 0.38 to 0.78; p=0.0007) and also found an association with progression-free survival (HR, 0.72; 95% CI, 0.54 to 0.96; p=0.026) in a homogenous group of 388 high-stage (stages III-IV using the International Federation of Gynecology and Obstetrics staging system), optimally debulked high-grade serous ovarian cancer patients. GTF2H5-silencing induced a decrease of the half maximal inhibitory concentration upon cisplatin treatment in GTF2H5-silenced ovarian cancer cells." }, { "role": "assistant", "content": "Low levels of GTF2H5 are associated with enhanced prognosis in high-grade serous ovarian cancer patients and may contribute to cisplatin sensitization. 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, DESIGN, RESULTS. Meshes: Humans, Long-Term Care, Nursing Administration Research, Nursing Care, Nursing Homes, Qualitative Research, Spain." }, { "role": "user", "content": "Is the influence of nurse care practices and nursing home organization understood? Context: Nursing home organization, nursing practices and rules within the institution may all influence residents' daily living and their perception on the quality of care provided. A qualitative approach was conducted, using purposeful and theoretical sampling. Data were collected from nursing home residents, following unstructured and semi-structured interviews, researcher field notes and residents' personal diaries and letters. Giorgi analysis was conducted. Two main themes emerged. (1) 'Following nursing home rules'. Norms may be seen as boundaries, especially for those residents who were independent before admission. (2) 'Prioritizing nursing care in residents'. Prioritizing the nursing care may limit the autonomy of residents because it does not meet their preferences and needs." }, { "role": "assistant", "content": "Understanding the meaning of nursing home organization and nursing care practices with nursing home residents might provide deeper insight into their expectations." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Aged, 80 and over, Analysis of Variance, Body Weight, Exercise Test, Female, Humans, Male, Monitoring, Ambulatory, Motor Activity, Sex Factors, Socioeconomic Factors, Surveys and Questionnaires, Time Factors, Walking." }, { "role": "user", "content": "Is there a sex difference in accelerometer counts during walking in older adults? Context: Accelerometers have emerged as a useful tool for measuring free-living physical activity in epidemiological studies. Validity of activity estimates depends on the assumption that measurements are equivalent for males and females while performing activities of the same intensity. The primary purpose of this study was to compare accelerometer count values in males and females undergoing a standardized 6-minute walk test. The study population was older adults (78.6 ± 4.1 years) from the AGES-Reykjavik Study (N = 319). Participants performed a 6-minute walk test at a self-selected fast pace while wearing an ActiGraph GT3X at the hip. Vertical axis counts · s(-1) was the primary outcome. Covariates included walking speed, height, weight, BMI, waist circumference, femur length, and step length. On average, males walked 7.2% faster than females (1.31 vs. 1.22 m · s(-1), P<.001) and had 32.3% greater vertical axis counts · s(-1) (54.6 vs. 39.4 counts · s(-1), P<.001). Accounting for walking speed reduced the sex difference to 19.2% and accounting for step length further reduced the difference to 13.4% (P<.001)." }, { "role": "assistant", "content": "Vertical axis counts · s(-1) were disproportionally greater in males even after adjustment for walking speed. This difference could confound free-living activity estimates." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Antimetabolites, Antineoplastic, Cell Line, Cell Proliferation, Chemokine CXCL9, Disease Models, Animal, Enzyme-Linked Immunosorbent Assay, Fluorouracil, Humans, Immunohistochemistry, Intestinal Mucosa, Mice, Mucositis, Phosphorylation, RNA, Messenger, Real-Time Polymerase Chain Reaction, Receptors, CXCR3, Ribosomal Protein S6 Kinases, 70-kDa, Signal Transduction, TOR Serine-Threonine Kinases, Transforming Growth Factor beta." }, { "role": "user", "content": "Does the chemokine CXCL9 exacerbate chemotherapy-induced acute intestinal damage through inhibition of mucosal restitution? Context: Acute intestinal damage induced by chemotherapeutic agent is often a dose-limiting factor in clinical cancer therapy. The aim of this study was to investigate the effect of chemokine CXCL9 on the intestinal damage after chemotherapy and explore the therapeutic potential of anti-CXCL9 agents. In vitro cell proliferation assay was performed with a non-tumorigenic human epithelial cell line MCF10A. Multiple pathway analysis was carried out to explore the pathway that mediated the effect of CXCL9, and the corresponding downstream effector was identified with enzyme-linked immunosorbent assays. Chemotherapy-induced mouse model of intestinal mucositis was prepared by a single injection of the chemotherapeutic agent 5-fluorouracil (5-FU). In vivo expression of cxcl9 and its receptor cxcr3 in intestinal mucosa after chemotherapy was determined by quantitative real-time PCR. Therapeutic treatment with anti-CXCL9 antibodies was investigated to confirm the hypothesis that CXCL9 can contribute to the intestinal epithelium damage induced by chemotherapy. CXCL9 inhibited the proliferation of MCF10A cells by activating phosphorylation of p70 ribosomal S6 kinase (p70S6K), which further promotes the secretion of transforming growth factor beta (TGF-β) as the downstream effector. A blockade of phospho-p70S6K with inhibitor abolished the effect of CXCL9 on MCF10A cells and reduced the secretion of TGF-β. The expression levels of cxcl9 and cxcr3 were significantly up-regulated in intestinal mucosa after 5-FU injection. Neutralizing elevated CXCL9 with anti-CXCR9 antibodies successfully enhanced reconstitution of intestinal mucosa and improved the survival rate of mice that received high-dose chemotherapy." }, { "role": "assistant", "content": "CXCL9 inhibits the proliferation of epithelial cells via phosphorylation of p70S6K, resulting in the excretion of TGF-β as downstream mediator. CXCL9/CXCR3 interaction can exacerbate chemotherapeutic agent-induced intestinal damage, and anti-CXCL9 agents are potential novel therapeutic candidates for promoting mucosal restitution. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, DESIGN, SETTING, PARTICIPANTS, RESULTS. Meshes: Competitive Behavior, Humans, Internship and Residency, Orthopedics, Surgeons, United States." }, { "role": "user", "content": "Is orthopedics more competitive today than when my attending matched? Context: This study evaluated supply and demand trends for orthopedic postgraduate year 1 (PGY1) positions from 1984 to 2011 for the purpose of estimating national intercandidate competition over time. National Resident Matching Program (NRMP) data for orthopedic surgery from 1984 to 2011 were collected. Proxy variables including (total number of orthopedic applicants/number of orthopedic PGY1 positions), (number of US senior applicants to orthopedics/number of orthopedic PGY1 positions), (number of US seniors matching into orthopedics/number of US senior orthopedic applicants), (total number of matched orthopedic applicants/total number of orthopedic applicants), and (total number of US applicants who fail to match into orthopedics/total number of US senior applicants into orthopedics) as well as average United States Medical Licensing Examination Step 1 scores were used to gauge the level of competition between candidates and were compared over time. Academic medical center in the Midwestern United States. Medical professors and medical students. The NRMP data suggested that the number of positions per applicant decreased or remained stable since 1984 and that the percentage of applicants who did not match was no higher now than in the past. This finding was primarily because of the relative decrease in the ratio of applicants to available PGY1 positions, which stems from the number of positions increasing more rapidly than the number of applicants." }, { "role": "assistant", "content": "The NRMP data from 1984 to 2011 supported our hypothesis that intercandidate competition intensity for orthopedic PGY1 positions has not increased over time. The misconception that orthopedics is becoming more competitive likely arises from the increased number of applications submitted per candidate and the resulting relative importance placed on objective criteria such as United States Medical Licensing Examination Step 1 scores when programs select interview cohorts." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Drug of choice for ventricular arrhythmias due to myocardial infarction (MI) 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: Contraindications, Female, Graft Survival, Humans, Liver Transplantation, Living Donors, Logistic Models, Male, Middle Aged, Portal Vein, Prospective Studies, Risk Factors, Statistics, Nonparametric, Survival Rate, Thrombectomy, Tomography, X-Ray Computed, Treatment Outcome, Ultrasonography, Doppler, Venous Thrombosis." }, { "role": "user", "content": "Is thrombosis confined to the portal vein a contraindication for living donor liver transplantation? Context: There is a lack of agreement regarding preexisting portal vein thrombosis (PVT) in patients undergoing living donor liver transplantation (LDLT). We report the results of a single-center study to determine the impact of PVT on outcomes of adult LDLT recipients. Of 133 cases of adult LDLT performed between January 2000 and December 2004, a thrombectomy was performed on 22 patients (16.5%) with PVT during the transplant procedure. One hundred eleven patients without PVT (group 1) were compared with those with a thrombosis confined to the portal vein (group 2; n = 15) and patients with the thrombosis beyond the portal vein (group 3; n = 7). The sensitivities of Doppler ultrasound and CT in detecting PVT were 50 and 63.6%. A prior history of variceal bleeding (OR = 10.6, p = 0.002) and surgical shunt surgery (OR = 28.1, p = 0.044) were found to be an independent risk factors for PVT. The rate of postoperative PVT was significantly higher in patients with PVT than in those without (18.2 vs. 2.7%; p = 0.014). In particular, the rethrombosis rate in group 3 was 28.6%. The actuarial 3-year patient survival rate in PVT patients (73.6%) was similar to that of the non-PVT patients (85.3%; p = 0.351). However, the actuarial 3-year patient survival rate in group 3 was 38.1%, which was significantly lower than that in groups 1 and 2 (p = 0.006)." }, { "role": "assistant", "content": "A thrombosis confined to the portal vein per se should not be considered a contraindication for LDLT. 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: Analysis of Variance, Child Development, Cognition, Cognition Disorders, Female, Humans, Infant, Male, Mother-Child Relations, Multivariate Analysis, Parenting, Regression Analysis, Risk Factors, Triplets." }, { "role": "user", "content": "Does a triplet birth pose a special risk for infant development? Context: To examine whether a triplet birth per se poses a risk to the development of infants' cognitive competencies and to the mother-infant relationship. Twenty-three sets of triplets were matched with 23 sets of twins and 23 singleton infants (n = 138) with respect to gestational age, birth weight, and medical and demographic features. Infants with perinatal asphyxia, intraventricular hemorrhage of grade 3 or 4, periventricular leukomalacia, or central nervous system infection were excluded from the study. At 6, 12, and 24 months of age, mother-infant interaction was observed and infants' cognitive development was tested with the Bayley II test. Mothers of triplets displayed lower levels of sensitivity at 6, 12, and 24 months and infants were less socially involved at 6 and 24 months, compared with singletons and twins. Triplets scored lower than singletons and twins on the Bayley Mental Developmental Index at 6, 12, and 24 months. A weight discordance of>15% was found for 15 triplet sets (65.2%). The discordant triplets showed decreased cognitive skills at 12 and 24 months, compared with their siblings, and received the lowest scores for maternal sensitivity. Hierarchical multivariate regression analysis revealed that greater medical risk at birth, multiple-birth status, lower maternal sensitivity, and reduced infant social involvement in the first 2 years were each predictive of lower cognitive outcomes at 2 years (R2 = 0.33)." }, { "role": "assistant", "content": "Triplets appear to be at higher risk for cognitive delays in the first 2 years of life, and discordant infants are at especially high risk. This delay is related in part to the difficulty of providing sensitive mothering to 3 infants at the same time. The findings may assist practitioners in guiding prenatal and postpartum parental care and management." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Amantadine, Antiviral Agents, Double-Blind Method, Drug Therapy, Combination, Female, Hepacivirus, Hepatitis C, Chronic, Humans, Interferon alpha-2, Interferon-alpha, Male, Middle Aged, Prospective Studies, RNA, Viral, Recombinant Proteins, Treatment Outcome." }, { "role": "user", "content": "Does combination of interferon alfa-2a and amantadine improve the efficacy of interferon therapy in patients with chronic hepatitis C? Context: A recent pilot study suggested that 18% of patients with hepatitis C viral infection achieved a sustained response to a 6-month course of 200 mg of oral amantadine alone with disappearance of serum hepatitis C virus ribonucleic acid. We prospectively studied 30 naive patients with chronic hepatitis C viral infection for the possible role of amantadine in improving the efficiency of interferon for the treatment of chronic hepatitis C. Patients were assigned into two groups on a double-blind and randomized controlled basis. Placebo group received 4.5 MU of interferon alfa-2a thrice weekly and oral placebo daily for 24 weeks. Amantadine group received a combination of the interferon and 200 mg of oral amantadine daily for 24 weeks. Patients were observed and tested for blood chemistry every week for the initial 4 weeks and every 2 weeks thereafter during the treatment until 24 weeks. After the end of treatment, patients were followed up at 4-week intervals for an additional 12 months. At the end of treatment, 5 (33.3%) patients responded to the combination therapy, and 7 (46.7%) patients responded to interferon therapy alone. Twelve months after cessation of the treatment, 3 (21.4%) patients had a sustained complete response to the combination therapy, and 3 (20.0%) patients had a sustained complete response to interferon alone (P = 0.64)." }, { "role": "assistant", "content": "Amantadine does not increase the efficacy of interferon in the treatment of chronic hepatitis C. 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: Adult, Brain, Cognition, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Nerve Net, Neuropsychological Tests, Rest, Young Adult." }, { "role": "user", "content": "Does task-dependent recruitment of intrinsic brain networks reflect normative variance in cognition? Context: Functional neuroimaging has great potential to inform clinical decisions, whether by identifying neural biomarkers of illness progression and severity, predicting therapeutic response, or selecting suitable patients for surgical interventions. Yet a persisting barrier to functional neuroimaging's clinical translation is our incomplete understanding of how normative variance in cognition, personality, and behavior shape the brain's structural and functional organization. We propose that modeling individual differences in these brain-behavior relationships is crucial for improving the accuracy of neuroimaging biomarkers for neurologic and psychiatric disorders. We addressed this goal by initiating the Cognitive Connectome Project, which bridges neuropsychology and neuroimaging by pairing nine cognitive domains typically assessed by clinically validated neuropsychological measures with those tapped by canonical neuroimaging tasks (motor, visuospatial perception, attention, language, memory, affective processing, decision making, working memory, and executive function). To date, we have recruited a diverse sample of 53 participants (mean [SD], age = 32 [9.7] years, 31 females). As a proof of concept, we first demonstrate that our neuroimaging task battery can replicate previous findings that task performance recruits intrinsic brain networks identified during wakeful rest. We then expand upon these previous findings by showing that the extent to which these networks are recruited by task reflects individual differences in cognitive ability. Specifically, performance on the Judgment of Line Orientation task (a clinically validated measure of visuospatial perception) administered outside of the MRI scanner predicts the magnitude of task-induced activity of the dorsal visual network when performing a direct replication of this task within the MRI scanner. Other networks (such as default mode and right frontoparietal) showed task-induced changes in activity that were unrelated to task performance, suggesting these networks to not be involved in visuospatial perception." }, { "role": "assistant", "content": "These findings establish a methodological framework by which clinical neuropsychology and functional neuroimaging may mutually inform one another, thus enhancing the translation of functional neuroimaging into clinical decision making. 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 among the following is not a feature of the Unhappy triad of O' donoghue?" }, { "role": "assistant", "content": "The correct answer is The most common mechanism of ligament disruption of the knee is adduction (valgus), flexion and internal rotation of femur on tibia which usually occur in spos in which the foot is planted solidly on the ground and leg is twisted by rotating body (i.e. football, soccer, basketball, skiing)The medial structures medial (tibial) collateral ligament (MCL) and medial capsular ligament are first to fail, followed by ACL tears if the force is of sufficient magnitude. The medial meniscus may be trapped between condyles and have a peripheral tear, thus producing unhappy triad of O' Donoghue.(Refer: GS Kulkarni Textbook of Ohopedics, 3rd edition, pg no.2565)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Aged, Arthritis, Rheumatoid, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Motor Activity, Netherlands, Surveys and Questionnaires, Time Factors." }, { "role": "user", "content": "Are patients with rheumatoid arthritis less physically active than the general population? Context: Although promoting physical activity (PA) and exercise among patients with rheumatoid arthritis (RA) is highly advocated nowadays, little is known about actual PA levels of these patients. In particular, the literature investigating how these PA levels are in proportion to the levels among the general population is scarce. To compare the self-reported PA levels of patients with RA with those of the general Dutch population. A sample of 400 RA patients were sent the Short QUestionnaire to ASsess Health-Enhancing PA comprising 10 questions about PA. From these data the proportions meeting the Dutch public health recommendation for PA (i.e., moderate PA for 30 minutes on>or = 5 days/wk) and the total number of minutes of PA per week were calculated. These data were compared with similar data from a representative sample of the general Dutch population. Two hundred fifty-two patients returned the questionnaire (response 63%). The proportions of RA patients meeting the PA recommendation were similar to those of the general population (57% in categories 45-64 years; 59% in categories>or = 65 years, and 58% in the total groups). The average number of minutes of PA per week was significantly lower in the RA population compared with the general population in the category 45 to 64 years (1836 vs. 2199, respectively, P = 0.001), whereas the difference in the category>or = 65 years was not significant (1115 vs. 1218 minutes, respectively, P = 0.33)." }, { "role": "assistant", "content": "The proportion of RA patients meeting the Dutch PA recommendation was similar to the general Dutch population. However, with respect to the average number of minutes of PA per week, the RA patients were less physically active. Because patients with RA have an increased risk of chronic conditions such as osteoporosis or cardiovascular diseases along with their arthritis, it remains a matter of utmost importance for health care professionals such as rheumatologists, physical therapists, and clinical nurse specialists to promote PA in daily clinical practice and guide patients in achieving and maintaining a healthy lifestyle." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: METHODS, METHODS, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Is maternal smoking during pregnancy associated with a higher risk of non-syndromic orofacial clefts in infants? Context: Medline and Embase were searched to 2002 using the search terms \"cleft lip\", \"cleft palate\", \"smoking\", \"tobacco\", \"cigarette\", \"mother\" and \"maternal\". Reference lists from retrieved articles and a monograph on neural tube defects were also examined for more studies. Case-control and cohort studies that reported data on smoking by women during pregnancy were included. The outcomes were orofacial clefts (OFC) in infants, specifically cleft lip with or without cleft palate (CL+/-P) and cleft palate only (CP). Isolated or multiple defects were included, but syndromic cases were excluded wherever possible. Meta-analyses were carried out for CL+/-P, CP and total clefts. The analyses of CL+/-P and CP were repeated following stratification by the presence or absence of malformations in addition to the cleft, after the exclusion of studies that used malformed controls. Heterogeneity was assessed using the Q test and a random effect model was used if the P value was less than 0.1. Tests for publication bias and presence of a linear dose-response effect were also carried out when suitable data were available. The search identified 32 articles, of which 24 met the inclusion criteria (15 case-control and nine cohort studies). Statistically significant associations were found between maternal smoking and CL+/-P (relative risk, 1.34; 95% confidence interval, 1.25-1.44), and between maternal smoking and CP (relative risk, 1.22; 95% confidence interval, 1.10-1.35). There was evidence of a modest dose-response effect for CL+/-P, but the evidence was not clear for CP. No strong evidence of publication bias could be found." }, { "role": "assistant", "content": "This study showed a consistent, moderate association between maternal tobacco smoking during pregnancy and nonsyndromic OFC in infants. The effect was observed for both isolated and multiple clefts, and was stronger and more consistent for CL+/-P than for CP. 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, Anti-Bacterial Agents, Child, Drug Resistance, Haemophilus influenzae, Health Surveys, Humans, Microbial Sensitivity Tests, Norway, Respiratory Tract Infections, Streptococcus pneumoniae, Streptococcus pyogenes." }, { "role": "user", "content": "Is the prevalence of antibiotic resistance in bacterial respiratory pathogens from Norway low? Context: To determine the degree of bacterial susceptibility to the most commonly used drugs for respiratory infections in Norway, and to find if bacterial resistance is emerging. Clinical isolates of Streptococcus pneumoniae, Haemophilus influenzae and group A streptococci from respiratory tract specimens and from the eye were collected from different parts of Norway during two study periods. During the first period (1993-1994), three laboratories, covering 15% of the Norwegian population, participated. During the second study period in 1997, five laboratories, covering 27% of the population, collected respiratory isolates. In total, 494 isolates of S. pneumoniae, 696 isolates of H. influenzae and 694 isolates of group A streptococci were included in the study. The study population comprised children and adults attending hospital and general practice. Bacterial susceptibility was determined by the E test, and breakpoints were according to the National Committee for Clinical Laboratory Standards (NCCLS). The prevalence of bacterial resistance was low, and we observed no significant increase in bacterial resistance between the two study periods. In 1997, only 0.6% of pneumococci had decreased susceptibility to penicillin, 1.6% of group A streptococci were resistant to erythromycin, and 6.7% of all isolates of H. influenzae produced beta-lactamase." }, { "role": "assistant", "content": "The prevalence of antibiotic resistance in respiratory pathogens in Norway is low. 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": "Primary site of infection in Cryptococcosis is" }, { "role": "assistant", "content": "The correct answer is Infection is acquired by inhalation causing pulmonary cryptococcosis leading to mild pneumonitis. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Administration, Topical, Animals, Blood Loss, Surgical, Cardiac Surgical Procedures, Cellulose, Oxidized, Coated Materials, Biocompatible, Female, Hemostasis, Hemostatic Techniques, Hemostatics, Models, Animal, Sus scrofa, Time Factors, Vascular Surgical Procedures." }, { "role": "user", "content": "Does a Novel Hemostatic Patch That stop Bleeding in Cardiovascular and Peripheral Vascular Procedures? Context: Achieving hemostasis during surgery is a common challenge across surgical specialties and procedures, including cardiovascular and peripheral vascular procedures. Although several hemostatic agents are available, they all become less effective as bleeding becomes more vigorous. Veriset™ hemostatic patch is a topical hemostatic agent that has been approved for use on solid organs and in soft tissue. The primary aim of these studies was to assess the safety of Veriset hemostatic patch during cardiovascular and peripheral vascular procedures. Adult domestic swine were given intraoperative anticoagulation and systemic antiplatelet therapy, and then underwent a variety of cardiovascular coronary artery bypass graft (CABG anastomosis and aortotomy closure) and peripheral vascular (carotid arteriotomy with patch angioplasty) procedures. Bleeding was identified or created from each anastomotic site and was brisk in many cases. Veriset hemostatic patch, Surgicel(®) Nu-Knit(®) absorbable hemostat, or standard of care treatment was applied topically to the site of bleeding, and time to hemostasis was monitored for each animal. Animals were assessed during and after the surgical procedure to determine the effects of treatment on vessel diameter, clinical laboratory parameters, and host tissue response and/or tissue integration. Application of Veriset hemostatic patch had no effect on vessel diameter, similar to Surgicel Nu-Knit absorbable hemostat and standard of care treatment. Approximately 28 days after application, Veriset hemostatic patch and Surgicel Nu-Knit absorbable hemostat were completely absorbed, with no impact on serum chemistry profiles. Furthermore, Veriset hemostatic patch was as effective or more effective than Surgicel Nu-Knit absorbable hemostat when applied during carotid arteriotomy (30.0 ± 0.0 sec vs. 163.6 ± 86.9 sec, P < 0.001) and CABG anastomosis (91.9 ± 66.0 sec vs. 207.5 ± 159.2 sec, P = 0.053)." }, { "role": "assistant", "content": "Veriset hemostatic patch exhibits similar safety as Surgicel Nu-Knit absorbable hemostat, with effectiveness against cardiovascular and peripheral vascular bleeding. If these preclinical results are confirmed in clinical trials, this highly effective patch with a topical application requiring less than 30 seconds is likely to prove useful in many clinical settings. 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 Kidney Injury, Animals, Antineoplastic Agents, Antioxidants, Benzoquinones, Blood Urea Nitrogen, Creatinine, Cytokines, Dose-Response Relationship, Drug, Gentamicins, Male, Protein Synthesis Inhibitors, Rats, Rats, Wistar." }, { "role": "user", "content": "Does thymoquinone ameliorate Acute Renal Failure in Gentamicin-Treated Adult Male Rats? Context: Gentamicin (GEN) is considered as a main aminoglycoside antibiotic medicine. The top therapeutic side effect of GEN is nephrotoxicity. The current research was proposed to determine the protective effect of thymoquinone (TQ) on GEN-induced acute renal failure (ARF). The rats were divided into 6 groups: sham group, control group, GEN-treated group and the TQ-treated groups. At the end of the research period, the serum blood urea nitrogen (BUN) and creatinine (Cr) were measured. The kidneys were then removed for evaluating malondialdehyde (MDA), reduced glutathione (GSH), interleukins IL-6, IL-10, IL-18 and IL-1β, tumor necrosis factor α (TNF-α), superoxide dismutase (SOD) and glutathione peroxidase (GPx) levels. GEN induced a raise in the levels of serum Cr, BUN and also the levels of MDA, IL-6, IL-18, IL-1β and TNF-α with decease in GSH, SOD, GPx and IL-10 in the kidney (p < 0.05). The data illustrated that the significant elevation in the levels of serum Cr, BUN, MDA, IL-6, IL-18, IL-1β, TNF-α and also the reduction of GSH, SOD, SOD, GPx, IL-10 in the kidney were ameliorated in the TQ-treated groups versus the untreated group, in a dose-dependent manner (p < 0.05)." }, { "role": "assistant", "content": "The present investigation proposes that TQ may be ameliorated ARF through modulation of the oxidative stress and inflammatory responses. 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 man uses nasal drops continuously for long period of time. What can be the possible adverse effect?" }, { "role": "assistant", "content": "The correct answer is Rhinitis Medicamentosa (RM) The addiction to over the counter decongestant nasal sprays is referred to as \"Rhinitis Medicamentosa\" or \"RM\". As the name implies, RM refers to rhinitis (congestion) caused by medication (medicamentosa). Prolonged use of over-the-counter (OTC) decongestant nasal sprays which contain topical vasoconstrictors such as Oxmetazoline hcl, Phenylephrine hcl and Xylometazoline hcl are known to cause RM." } ]

[ { "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 Couinaud's segmental nomenclature of the liver is based on the position of which of the following structures?" }, { "role": "assistant", "content": "The correct answer is According to the nomenclature of Couinaud classification, liver is divided into 4 sectors and 8 segments. Each segment has independent aery, bile duct, tributary of hepatic vein and poal tributary. Liver is divided into 8 couinaud's segments depending on the position of 3 main hepatic vein and poal vein. Hepatic veins lie between segments. The left hepatic vein divides the left side of the liver into medial and lateral segments. Middle hepatic vein divides the liver into left and right lobes. The right hepatic vein divides the right side of the liver into anterior and posterior segments. Horizontal line through the left and right main poal vein branches divide hepatic lobes into superior and inferior segments." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: MATERIAL, METHOD, RESULTS. Meshes: Cephalometry, Child, Preschool, Combined Modality Therapy, Dental Occlusion, Facial Asymmetry, Follow-Up Studies, Humans, Mandible, Maxilla, Nose, Orbit, Orthodontic Appliance Design, Orthodontic Appliances, Functional, Osteogenesis, Distraction, Radiography, Panoramic, Treatment Outcome, Vertical Dimension." }, { "role": "user", "content": "Does functional appliance treatment truly improve stability of mandibular vertical distraction osteogenesis in hemifacial microsomia? Context: Ten children were treated by a combined orthodontic-distraction treatment, seven by distraction only. Only the vertical changes in the mandible and maxilla in the panoramic and postero-anterior cephalometric X-rays were measured. All of the patients showed a gradual return of the asymmetry with growth. Occlusal plane correction and, to a much lesser extent, mandibular vertical ramus height correction were better maintained over 5 years post-DO in the orthopaedic group." }, { "role": "assistant", "content": "Although orthopaedic treatment allows for a more stable occlusal plane and for a slower return of the mandibular vertical asymmetry, it has mainly a dento-alveolar effect. Therefore, the decision of applying an orthopaedic treatment associated with distraction, should be taken by surgeon and orthodontist together, considering both the advantages and the disadvantages of this treatment." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND AND OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Chest Tubes, Contraindications, Dyspnea, Female, Humans, Male, Platelet Aggregation Inhibitors, Pleural Effusion, Respiratory Insufficiency, Retrospective Studies, Thoracostomy, Ticlopidine, Treatment Outcome, Ultrasonography, Interventional." }, { "role": "user", "content": "Is chest tube insertion with ultrasound guidance safe in patients using clopidogrel? Context: Drainage of the pleural space is a common procedure. The safety of chest tube insertion in patients using clopidogrel has not been investigated. Ultrasound-guided chest tube insertions performed on 24 patients who were being actively treated with clopidogrel were retrospectively reviewed. No excessive bleeding occurred in any of these patients." }, { "role": "assistant", "content": "Given the known effects of clopidogrel on platelet function, these results were interpreted as indicating that clopidogrel therapy is a relative but not an absolute contraindication to chest tube insertion, if an experienced operator places a small-bore tube under ultrasound guidance." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: STUDY DESIGN, OBJECTIVE, SUMMARY OF BACKGROUND DATA, METHODS, RESULTS. Meshes: Adult, Equipment Failure, Female, Fracture Fixation, Internal, Humans, Male, Middle Aged, Outcome Assessment (Health Care), Pedicle Screws, Prognosis, Radiography, Spinal Fractures, Thoracic Vertebrae." }, { "role": "user", "content": "Correlation between pedicle size and the rate of pedicle screw misplacement in the treatment of thoracic fractures: Can we predict how difficult the task will be? Context: A retrospective study. To correlate the incidence of pedicle-screw (PS) misplacement with the dimensions of the pedicles in the treatment of thoracic spine fractures. The technical challenge of internal fixation with PS in the thoracic spine has been well documented in the literature. However, there are no publications that document the correlation between the pedicle dimensions of the thoracic vertebrae in the preoperative computed tomography scans (CT) and the rate of PS misplacement. All patients who had PSs inserted between the T1 and T12 vertebrae during a 24-month period were included in this study. PS position was assessed on high quality CT scans by two independent observers and classified in 2 categories: correct or misplaced. The transverse diameter, craniocaudal diameter and cross-sectional area of the pedicles from T1 to T12 were measured in the pre-operative CT. During the period of this study 36 patients underwent internal fixation with 218 PS. Of the 218 screws, 184 (84.5%) were correct and 34 (15.5%) were misplaced. Misplacement rate was 33% for pedicles with a transverse diameter less than 5 mm, 10.7% for those with a transverse diameter between 5 and 7 mm and 0% for those with a transverse diameter larger than 7 mm. There was a statistically significant difference in the rate of PS misplacement in pedicles with transverse diameter smaller than 5 mm compared with the others. Also, those with transverse diameter between 5.1 and 7 mm compared with those bigger than 7 mm in diameter. The rate of PS misplacement was higher between T3 and T9 (p<0.05), which in turn correlated with pedicle transverse diameter." }, { "role": "assistant", "content": "The rate of PS misplacement in the mid thoracic spine (T4-T9) is high and correlates with pedicle transverse diameter." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Amino Acid Oxidoreductases, Animals, Arginine, Colitis, Colon, Dinoprostone, Intestinal Mucosa, Iodoacetamide, Leukotriene B4, Leukotriene C4, Male, NG-Nitroarginine Methyl Ester, Nitric Oxide, Nitric Oxide Synthase, Peroxidase, Rats, Rats, Sprague-Dawley." }, { "role": "user", "content": "Is sulfhydryl blocker-induced rat colonic inflammation ameliorated by inhibition of nitric oxide synthase? Context: Sulfhydryl compounds are essential in maintaining mucosal integrity, and nitric oxide may contribute to tissue injury. The aim of this study was to characterize experimental colitis induced by a sulfhydryl blocker. Colitis was induced in rats by intracolonic administration of 0.1 mL 3% iodoacetamide with and without addition of 0.1 mg/mL NG-nitro-L-arginine methyl ester (L-NAME) to the drinking water. After death, the distal colonic segment was resected and weighed, and mucosal inflammatory mediator, myeloperoxidase, and NO synthase activities were determined. Iodoacetamide induced multifocal mucosal erosions and ulceration that were present for up to 1 week. At 3 weeks, the mucosa was almost intact. Colonic wet weight was maximal at 7 days. Myeloperoxidase activity and NO generation were increased in the first 72 hours, and NO synthase activity and prostaglandin E2 generation were increased up to 21 days. Leukotriene B4 and leukotriene C4 generation were increased up to 14 days. One week after iodoacetamide plus L-NAME treatment, lesion area was reduced by 85% and NO synthase activity by 52%." }, { "role": "assistant", "content": "Inflammatory mediators have an important contribution to the pathogenesis of colonic injury induced by a sulfhydryl alkylator. The protective effect of L-NAME indicates that NO contributes to tissue injury and that its modulation may be a novel approach to treat inflammatory bowel disease. 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": "Pulseless disease is -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Takayasu aeritisTakayasu aeritis o Takayasu aeritis is gran u lomatous vasculitis of large and medium aeries.o It is characterized principally by ocular disturbance and marked weakening of pulses in the upper extremities --> Pulseless disease.o It is also characterized by a strong predilection for aoic arch and its branches --> Aoic arch syndrome. o It is more common in Adolescent girls and young women.o Morphological changes in vessel wall are same as in giant cell aeritis.Clinical presentationSymptoms are mainly according to the involved vessel -Subclan aery :o Most commonly involved vesselo Symptoms are - Arm claudication, lower BP and weaker pulse in upper limb then in lower limb, Raynaud's phemomenon. Common carotid -+ Visual disturbances, stroke, TIA, syncope. Abdominal aoa or coeliac aery or superior mesentric aery --> Abdominal pain, nausea, vomiting Renal --> Hypeension, Renal failure Aoic root --> Aoic regurgitation, CHF Veebral Visual disturbances Iliac - Leg claudication Pulmonary --> Pulmonary hypeension, dysnea, chest pain. Coronary Angina, MI Constitutional symptoms --> As with other vasculitis malaise, fatigue, anarexia and weight loss are common. Elevated ESR and Anemia (as with other vasculitis)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Basilar Artery, Brain Stem Infarctions, Cerebral Angiography, Chi-Square Distribution, Diffusion Magnetic Resonance Imaging, Disability Evaluation, Disease Progression, Female, Humans, Logistic Models, Magnetic Resonance Angiography, Male, Middle Aged, Motor Activity, Motor Disorders, Multivariate Analysis, Odds Ratio, Plaque, Atherosclerotic, Pons, Predictive Value of Tests, Registries, Retrospective Studies, Risk Factors, Time Factors, Vertebrobasilar Insufficiency." }, { "role": "user", "content": "Does basilar plaque on high-resolution MRI predict progressive motor deficits after pontine infarction? Context: The association between progressive motor deficits (PMD) in acute pontine infarction and basilar stenosis is unclear. High resolution MRI (HRMRI) is an emerging tool for basilar artery evaluation and might provide more accurate information. We aimed to analyze the association between basilar plaque assessed by HRMRI and PMD after acute pontine infarction. We identified consecutive patients with unilateral pontine infarction within 24 h of stroke onset. All the patients underwent diffusion weighted MRI, MR angiography and HRMRI within 24 h of admission. PMD was defined as an increase in National Institutes of Health Stroke Scale score by ≥1 during hospitalization. Factors potentially associated with PMD were validated by multivariate analyses. Of a total of 87 patients, 63 (72%) had paramedian pontine infarction (PPI) and PMD was observed in 28 (32%) patients. Apparent basilar plaque assessed by HRMRI was more frequent in those with PMD than in those without PMD (52% versus 33%, p<0.001). In contrast, the frequency of basilar stenosis (>30%) assessed by MR angiography was similar regardless of PMD. In the patients with PPI, PMD was associated with hypertension and apparent plaque on HRMRI. After adjusting covariates, PMD was independently associated with apparent plaque on HRMRI (OR, 9.1; 95% CI 1.4-58.9)." }, { "role": "assistant", "content": "Our results suggest that basilar plaque assessed by HRMRI is associated with PMD in patients with acute unilateral pontine infarction. Since basilar stenosis may be underestimated by MR angiography, HRMRI may provide additional information for predicting PMD and evaluating basilar artery stenosis. 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, Antioxidants, Burns, Fluid Therapy, Hydroxyethyl Starch Derivatives, Reperfusion Injury, Resuscitation, Shock, Swine." }, { "role": "user", "content": "Do [ Effects on ischemia-reperfusion injury with different fluid resuscitation regimens during burn shock stage in swines ]? Context: To explore the effects on ischemia-reperfusion injury with different regimens of fluid resuscitation during severe burn shock stage in swines. A total of 24 Guangxi BA-MA mini-swine were numbered from 1 to 24 and randomly divided by EXCEL 2007 into 4 groups of succinylated gelatin, hydroxyethyl starch (HES 130/0.4), Parkland and allogeneic plasma (n = 6 each). Then the burn shock model was established. And fluid resuscitation therapy was applied according to the established regimens of burn shock fluid resuscitation. Blood samples were collected from the animals prior to burn injury and again at intervals of 4, 8, 24 and 48 hours post-injury. The levels of malondialdehyde, superoxide dismutase (SOD), xanthine oxidase (XOD) and total antioxidant capacity (T-AOC) were measured. And the results were analyzed statistically. Six swines within each group survived the shock stage and the outliers in detection index were eliminated. Then there were 5 swines in each group. The MDA of allogeneic plasma group at intervals of 8 hours was significantly lower than that of succinylated gelatin group, but higher than that of Parkland group [(3.46 ± 0.40) vs (4.55 ± 0.82), (2.59 ± 0.35) µmol/L, both P < 0.05]. The level of SOD had statistical difference at 48 hours between the HES 130/0.4 and allogeneic plasma groups ((72.55 ± 5.70) vs (65.42 ± 5.07) U/ml, P < 0.05). The level of XOD of the succinylated gelatin group at 4, 8 hour and they increased when compared to pre-burn ((12.00 ± 0.57), (11.28 ± 0.71) vs (9.12 ± 0.51) U/L, both P < 0.01).Statistical significance was observed at 4, 8 hours between succinylated gelatin and allogeneic plasma groups ((10.39 ± 1.24), (9.59 ± 1.17) U/L, both P < 0.01). The T-AOC of HES 130/0.4 group at 8 hours exceed the pre-burn ((2.06 ± 0.43) vs (1.30 ± 0.35) U/ml, P < 0.05). The allogeneic plasma group at 4, 8 hours showed increase when compared to pre-burn ((1.55 ± 0.37), (2.59 ± 0.60) vs (1.06 ± 0.13) U/ml, both P < 0.05). The succinylated gelatin group at 8, 48 hours decreased during the corresponding phase of allogeneic plasma group ((1.14 ± 0.26), (0.89 ± 0.20) vs (2.59 ± 0.60), (1.16 ± 0.20) U/ml, both P < 0.05). The comparison at 24, 48 hours between HES 130/0.4 and allogeneic plasma groups ((1.84 ± 0.41), (1.53 ± 0.21) vs (1.13 ± 0.35), (1.16 ± 0.20) U/ml) had statistical difference (both P < 0.01). The Parkland group at intervals of 8 hours was lower than that of allogeneic plasma group ((1.31 ± 0.19) vs (2.59 ± 0.60) U/ml, P < 0.01)." }, { "role": "assistant", "content": "HES130/0.4 and allogeneic plasma have comparable the parallel minimum damage effect on ischemia-reperfusion injury during burn shock stage are. 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": "An 18-year old college freshman presents to his university clinic because he has not been feeling well for the past two weeks. He has had a persistent headache, occasional cough, and chills without rigors. The patient’s vital signs are normal and physical exam is unremarkable. His radiograph shows patchy interstitial lung infiltrates and he is diagnosed with atypical pneumonia. The patient is prescribed azithromycin and takes his medication as instructed. Despite adherence to his drug regimen, he returns to the clinic one week later because his symptoms have not improved. The organism responsible for this infection is likely resistant to azithromycin through which mechanism?" }, { "role": "assistant", "content": "Methylation of ribosomal binding site" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A patient presents with increased serum ferritin, decreased TIBC, increased serum iron, % saturation increased. Most probable diagnosis 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, RESULTS. Meshes: Bile Duct Neoplasms, Bile Ducts, Intrahepatic, Cholangiocarcinoma, Cholangitis, Sclerosing, CpG Islands, Cyclin-Dependent Kinase Inhibitor p16, DNA Methylation, Exons, Gene Expression, Genes, Reporter, Genetic Predisposition to Disease, Humans, Luciferases, Mutagenesis, Site-Directed, Mutation, Prevalence, Promoter Regions, Genetic, Transcriptional Activation." }, { "role": "user", "content": "Are p16INK4a promoter mutations frequent in primary sclerosing cholangitis ( PSC ) and PSC-associated cholangiocarcinoma? Context: Primary sclerosing cholangitis (PSC) predisposes individuals to cholangiocarcinoma; however, the molecular mechanisms involved in the carcinogenesis process remain unclear. Because p16(INK4a) inactivation has been implicated in cholangiocarcinoma, our aims were to examine PSC cholangiocytes for p16(INK4a) gene mutations. We studied 4 patient groups: PSC patients without cholangiocarcinoma (n = 10), patients with PSC-associated cholangiocarcinoma (n = 10), non-PSC controls (n = 10), and disease controls with primary biliary cirrhosis (n = 10). Cholangiocytes and hepatocytes were isolated from tissue sections using laser capture microdissection. Genomic DNA was extracted, and the promoter region and the 3 exons for p16(INK4a) were amplified by PCR and directly sequenced. In the promoter region, 8-point mutations in 5 PSC cases and 14 mutations in 8 cholangiocarcinoma cases were observed. In exon 1, 1 PSC patient and 3 cholangiocarcinoma patients had point mutations. In contrast, no case had a mutation in exon 2 or 3. Mutations were not detected in cholangiocytes from control patients or primary biliary cirrhosis patients nor in hepatocytes from any of the groups; these data indicate that the observed base changes were disease specific and not genetic polymorphisms. Several of the promoter mutations (4 of 8) dramatically decreased promoter activity (>50% reduction in luciferase activity) in a reporter gene assay." }, { "role": "assistant", "content": "The results show that functional point mutations in the p16(INK4a) promoter region likely contribute to the initiation/progression of cholangiocarcinoma in PSC. Promoter mutations in CpG islands may function as a methylation equivalent phenomenon resulting in gene inactivation. 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": "Posterior to transverse pericardial sinus-" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., SVC Pericardial sinuseso These are parts of pericardial cavity,o The pericardial sinuses areTransverse pericardial sinusIf lies between arterial and venous sleeves of pericardial reflection and connects right and left halves of pericardial cavity with each other.It is boundedAnteriorly by A seen ding aorta and pulmonary trunk.Posteriorly by S upertor vena cava and atria.Above :- Bifurcation of pulmonary trunk.Below ;- Upper surface of left atrium.Obi iqu e pericard ial sinusIt is a large cul-de-sac lying within the venous sleeve of pericardial reflection.It lies behind the left atriumPericardium separates the oblique sinus from esophagus.An oval shaped opening, between iVC and lower left pulmonary vein, directed downwards and to the left connect oblique sinus with the rest of the pericardial cavity.# It is bounded by:i) Anteriorlyii) Posteriorlyiii) Rightiv) Leftv) Above:- Left atrium:- Parietal layer:- Right pair of pulmonary veins and IVC:- Left pair of pulmonary veins:- Upper margin of left atriun." } ]

[ { "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": "Legal responsibility of insane is/are all except:" }, { "role": "assistant", "content": "The correct answer is A i.e. Rule of Haase" } ]

[ { "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": "Both Oral and Nasal intubation are C/I" }, { "role": "assistant", "content": "The correct answer is D i.e. Acute Tracheo - Laryngo - bronchitis" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, DESIGN, SETTING, SUBJECTS, MAIN OUTCOME MEASURES, RESULTS. Meshes: Blood Pressure, Heart Rate, Humans, Male, Prospective Studies, Soccer, Stress, Psychological." }, { "role": "user", "content": "Haemodynamic response in soccer spectators: is Scottish football exciting? Context: To determine the effect of watching a game of Scottish football on heart rate and blood pressure. Prospective study. Two Scottish Premier League football grounds. 10 healthy men, each a supporter of one of two clubs. Systolic and diastolic blood pressure and heart rate at home, while walking, and during the match. Systolic blood pressure and heart rate were significantly higher when the men were watching the match than when they were at home. While they were watching the match, heart rate was maximal immediately after a goal had been scored by the supported team." }, { "role": "assistant", "content": "The emotional stress invoked by Scottish football is associated with significant increases in heart rate and systolic blood pressure." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is not a side effect of lithium?" }, { "role": "assistant", "content": "The correct answer is Ans: a (Blood dyscrasias)Ref: Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 10th ed, Pg. 1058Lithium dose and its toxicity are very favourite topics for Kerala PG Entrance Examination.Blood dyscrasias are not seen as a side effect of lithium therapy.Side effects of lithium therapy NeurologicBenign, nontoxic: Dysphoria, lack of spontaneity, slowed reaction time, memory difficulties Tremor - Postural, occasional extrapyramidal Toxic - Coarse tremor, dysarthria, ataxia, neuromuscular irritability, seizures, coma, death Miscellaneous - Peripheral neuropathy, benign intracranial hypertension, myasthenia gravis-like syndrome, altered creativity, lowered seizure thresholdEndocrineThyroid - goiter, hypothyroidism, exophthalmos, hyperthyroidism (rare)Parathyroid - hyperparathyroidism, adenomaCardiovascularBenign T-wave changes, sinus node dysfunctionRenalConcentrating defect, morphologic changes, polyuria (nephrogenic diabetes insipidus), reduced GFR, nephrotic syndrome, renal tubular acidosisDermatologicAcne, hair loss, psoriasis, rashGastrointestinalAppetite loss, nausea, vomiting, diarrhoea Miscellaneous - Altered carbohydrate metabolism, weight gain, fluid retention" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, BACKGROUND, METHODS, RESULTS. Meshes: Acute Disease, Adult, Aged, Angina Pectoris, Blood Platelets, Coronary Disease, Female, Humans, Male, Middle Aged, Multivariate Analysis, Nitric Oxide, Nitroglycerin, Nitroprusside, Platelet Aggregation, Syndrome." }, { "role": "user", "content": "Are stable angina and acute coronary syndromes associated with nitric oxide resistance in platelets? Context: The study examined possible clinical determinants of platelet resistance to nitric oxide (NO) donors in patients with stable angina pectoris (SAP) and acute coronary syndromes (ACS), relative to nonischemic patients and normal subjects. We have shown previously that platelets from patients with SAP are resistant to the antiaggregating effects of nitroglycerin (NTG) and sodium nitroprusside (SNP). Extent of adenosine diphosphate (1 micromol/liter)-induced platelet aggregation (impedance aggregometry in whole blood) and inhibition of aggregation by NTG (100 micromol/liter) and SNP (10 micromol/liter) were compared in normal subjects (n = 43), nonischemic patients (those with chest pain but no fixed coronary disease, (n = 35) and patients with SAP (n = 82) or ACS (n = 153). Association of NO resistance with coronary risk factors, coronary artery disease (CAD), intensity of angina and current medication was examined by univariate and multivariate analyses. In patients with SAP and ACS as distinct from nonischemic patients and normal subjects, platelet aggregability was increased (both p < 0.01), and inhibition of aggregation by NTG and SNP was decreased (both p < 0.01). Multivariate analysis revealed that NO resistance occurred significantly more frequently with ACS than with SAP (odds ratio [OR] 2.3:1), and was less common among patients treated with perhexiline (OR 0.3:1) or statins (OR 0.45:1). Therapy with other antianginal drugs, extent of CAD, intensity of angina and coronary risk factors were not associated with variability in platelet responsiveness to NO donor." }, { "role": "assistant", "content": "Patients with symptomatic ischemic heart disease, especially ACS, exhibit increased platelet aggregability and decreased platelet responsiveness to the antiaggregatory effects of NO donors. The extent of NO resistance in platelets is not correlated with coronary risk factors. Pharmacotherapy with perhexiline and/or statins may improve platelet responsiveness to NO. 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 causative organism for formation of Baholin cyst?" }, { "role": "assistant", "content": "The correct answer is Baholin's glands (great vestibular glands) are located at the vaginal orifice at the 4 and 8 o'clock positions. Their ducts are lined with transitional epithelium and their obstruction secondary to inflammation may lead to the development of a Baholin's cyst or abscess. Baholin's cysts range in size from 1 to 3 cm. Infections are often polymicrobial; however, sexually transmitted Neisseria gonorrhoeae and C. trachomatis are sometimes implicated. Treatment consists of incision and drainage and placement of a Word catheter, a small catheter with a balloon tip, for 2 to 3 weeks to allow for formation and epithelialization of a new duct. Ref: Cain J., ElMasri W.M., Gregory T., Kohn E.C. (2010). Chapter 41. Gynecology. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e." } ]

[ { "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": "Phase 3 clinical trial is also called as" }, { "role": "assistant", "content": "The correct answer is Phase 3 trial-done on 1000s of patients in various centers- multicentric, double-blinded after completion of phase 3, new drug will be released into the market Reference: Katzung's Pharmacology; 13th edition; Chapter 5; Development & Regulation of Drugs" } ]

[ { "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": "Presence of more than two germ cell layer in a tumor is called :" }, { "role": "assistant", "content": "The correct answer is Teratoma" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The most impoant factor for maintaining arches of the foot is" }, { "role": "assistant", "content": "The correct answer is Factors in maintaining arches of foot are1 The shape of the bones concerned.2 intersegmental ties/staples or ligaments (and muscles) that hold the different segments of the arch together.3 Tie beams or bowstrings that connect the two ends of the arch.4 Slings that keep the summit of the arch pulled up.5 Suspension\"The longitudinal arches are prevented from flattening by the plantar aponeurosis, and by the muscles of the first layer of the sole.\"Ref: Vishram Singh; Volume II; 2nd edition" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Attitude, False Positive Reactions, Female, Hearing Tests, Humans, Infant, Newborn, Mothers, Neonatal Screening, Predictive Value of Tests, Prospective Studies, Surveys and Questionnaires." }, { "role": "user", "content": "Does maternal concern about positive test result in universal newborn hearing screening? Context: A positive test result from universal newborn hearing screening (UNHS) has been suspected to cause maternal concern. However, findings so far are inconclusive. Against the background of a 2-stage UNHS protocol, we investigated the extent of maternal concern in 2 different situations: 1) mothers' immediate reactions after a positive result at the first-stage test and 2) maternal concern during a 1-month period while waiting for the infant's hearing assessment after the infant also failed the retest (ie, the screening). In addition, we checked whether mothers who are informed by an audiologist about the low predictive validity of positive test results in hearing screening are less concerned about a positive result than mothers who are not informed. A prospective study was conducted over a 1-year period, in which all mothers whose infants tested positive in the first stage or failed the screening were questioned about their level of concern attributable to the positive test result. Of 85 mothers whose infants tested positive in the first-stage test (situation 1), 34 (40%) did not know the result. Of the remaining 51 mothers, 59% were not at all concerned and 27% were only slightly concerned about the result, whereas 14% stated that they were highly concerned. In an additional sample of 43 mothers whose infants failed the screening (situation 2), 42% reported not being worried and 37% only slightly worried, whereas 21% were highly concerned about the positive screening result. No effect of information about the low predictive validity of positive test results on the extent of maternal concern could be ascertained." }, { "role": "assistant", "content": "The results of this study contradict the findings of some previous surveys that reported considerably higher levels of maternal concern after a positive test in UNHS. The failure to demonstrate the impact of information on maternal concern might be attributable to the fact that the number of uninformed mothers was too small to affect our results perceptibly. 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": "Patient of contamination phobia was asked by therapist to follow behind and touch everything he touches in patients house Therapist kept talking quietly & calmly all the time. And the patient was asked to repeat the procedure twice daily. The procedure is" }, { "role": "assistant", "content": "The correct answer is B i.e. Modelling" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, RESEARCH DESIGN AND METHODS, RESULTS. Meshes: Adult, Albuminuria, Antihypertensive Agents, Blood Pressure, Cholesterol, HDL, Creatinine, DNA Transposable Elements, Diabetes Mellitus, Type 1, Diabetic Nephropathies, Female, Genotype, Glomerular Filtration Rate, Glycated Hemoglobin A, Humans, Hypertension, Losartan, Male, Middle Aged, Peptidyl-Dipeptidase A, Potassium, Risk Factors, Sequence Deletion." }, { "role": "user", "content": "Long-term renoprotective effects of losartan in diabetic nephropathy: interaction with ACE insertion/deletion genotype? Context: Several observational follow-up studies have found that the D allele of the insertion (I)/deletion (D) polymorphism of the ACE gene (ACE/ID) is associated with an increased risk of renal function loss, even during ACE inhibition. Therefore, we investigated the long-term effect of the angiotensin II subtype-1 (AT1) receptor antagonist losartan (100 mg o.d.) on kidney function in II and DD type 1 diabetic patients with diabetic nephropathy. A total of 54 hypertensive type 1 diabetic patients with diabetic nephropathy homozygous for the insertion (n = 26) or the deletion (n = 28) allele were included in the study. After a 4-week washout, the patients received losartan (tablet, 100 mg o.d.) and were followed prospectively with a mean follow-up period of 36 months. Patients and investigators were blinded to ACE genotypes. At baseline, after 2 and 4 months and every 6 months thereafter, glomerular filtration rate (GFR), albuminuria, and 24-h blood pressure were determined. At baseline, GFR, albuminuria, and blood pressure were similar in the two genotype groups, II versus DD: mean (SD), 86 (22) vs. 88 (24) ml. min(-1). 1.73 m(-2); median (interquartile range), 1,134 (598-2,023) vs. 1,451 (893-1,766) mg/24 h; and mean (SD), 156/82 (17/9) vs. 153/80 (17/11) mmHg, respectively. GFR decreased similarly in both genotype groups, versus DD, respectively (P = 0.4): geometric mean (95% CI), 2.9 (2.0-4.2) vs. 3.4 (2.3-5.1) ml. min(-1). year(-1). Albuminuria and arterial blood pressure were significantly reduced during the study; no differences were noted between groups. During follow-up, albuminuria was decreased by 75% (95% CI 59-85) and 73% (56-83) in the II and DD groups, respectively (P<0.01 vs. baseline). Mean systolic and diastolic blood pressures were 139/74 mmHg (14/8) in both genotype groups during the study (P<0.01 vs. baseline)." }, { "role": "assistant", "content": "In contrast to previous observational studies with ACE inhibitors, long-term treatment with losartan has similar beneficial renoprotective effects on progression of diabetic nephropathy in hypertensive type 1 diabetic patients with ACE II and DD genotypes." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 35-year-old Caucasian female with a history of rheumatoid arthritis presents to your clinic with pleuritic chest pain that improves while leaning forward. Which of the following additional findings would you expect to observe in this patient?" }, { "role": "assistant", "content": "Increase in jugular venous pressure on inspiration" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Biomarkers, Cardiovascular Diseases, China, Cohort Studies, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Neuropeptide Y, Nutritional Status, Prognosis, Prospective Studies, ROC Curve, Renal Insufficiency, Chronic, Risk Factors, Sensitivity and Specificity, Severity of Illness Index, Up-Regulation." }, { "role": "user", "content": "Are neuropeptide Y levels associated with nutritional status and cardiovascular events in adults with chronic kidney disease? Context: Neuropeptide Y (NpY) is an important factor in neuropeptide signalling, and significantly change in the blood and cerebrospinal fluid (CSF) during chronic kidney disease (CKD) progression. However, the role of NpY remains unclear. We aimed to investigate the associations between NpY levels, nutritional status and cardiovascular disease (CVD) in patients with CKD. In this cohort study, we performed Pearson's correlation analysis and multiple linear regressions to assess the relationship between CSF and serum NpY levels, as well as nutritional indices. Receiver operating characteristic curves were used to evaluate the sensitivity and specificity of CSF NpY levels. As NpY affects the cardiovascular system, Kaplan-Meier analysis was used to investigate the relationship between serum NpY levels and CVD. CSF NpY levels and nutritional indices were related during CKD progression (energy intake: β=0.236, P<0.001; mid-arm muscle circumference: β=0.953, P=0.014; prealbumin: β=0.067, P<0.001), and had high specificity (79.9%). High serum NpY levels may be a risk factor associated with CVD (relative risk=1.8015, 95% confidence interval: 1.0509-3.0881)." }, { "role": "assistant", "content": "Our results suggested a relationship between CSF NpY levels and nutritional indices in CKD patients. High serum NpY concentrations may be a risk factor associated with CVD. 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 AND AIMS, METHODS, RESULTS. Meshes: Biomarkers, Feasibility Studies, Hepatitis B, Hepatitis B Surface Antigens, Hepatitis B virus, Hospitals, Teaching, Humans, Immunoenzyme Techniques, India, Neutralization Tests, Predictive Value of Tests, Reagent Kits, Diagnostic, Sensitivity and Specificity." }, { "role": "user", "content": "Do we need an 'in-house' neutralization assay for confirmation of hepatitis B surface antigen? Context: Hepatitis B surface antigen (HBsAg) is an important serological marker for diagnosis of hepatitis B virus (HBV) infection. Commercial kits for detection of HBsAg emphasize confirmation by neutralization assays. In this study, we have standardized an 'in-house' neutralization test for HBsAg confirmation. Among 6684 HBsAg-positive samples, 615 were subjected to an 'in-house' HBsAg neutralization test (NT). Of these, 91 (100%) high-reactive samples (optical density [OD] 1.000-3.000) and 286 (93%) of 289 low-reactive samples (OD<1.000) were neutralized, and 235 (100%) grey-zone reactive samples were 'in-house' NT negative. Eighty-four samples of varying reactivities that were tested by the 'in-house' NT were compared with a commercial NT (AxSYM, Abbott). The 'in-house' NT showed an excellent agreement (kappa = 0.83, P<0.001) with the commercial confirmatory assay. The sensitivity, specificity, positive and negative predictive values were 90%, 94%, 96% and 87%, respectively." }, { "role": "assistant", "content": "The enzyme immunoassay-based 'in-house' HBsAg neutralization assay is a feasible alternative to the commercial HBsAg confirmatory assay. This technique is easily adaptable, cost-effective and reliable for the confirmation of HBsAg in a low resource setting, enhancing the overall quality of HBsAg screening." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Animals, Anticipation, Psychological, Behavior, Animal, Cues, Feeding Behavior, Ghrelin, Hypothalamus, Intracellular Signaling Peptides and Proteins, Leptin, Male, Motor Activity, Neuropeptide Y, Rats, Rats, Wistar." }, { "role": "user", "content": "Do food cues and ghrelin recruit the same neuronal circuitry? Context: Cues that are associated with the availability of food are known to trigger food anticipatory activity (FAA). This activity is expressed as increased locomotor activity and enables an animal to prepare for maximal utilization of nutritional resources. Although the exact neural network that mediates FAA is still unknown, several studies have revealed that the medial hypothalamus is involved. Interestingly, this area is responsive to the anorexigenic hormone leptin and the orexigenic hormone ghrelin that have been shown to modulate FAA. However, how FAA is regulated by neuronal activity and how leptin and ghrelin modulate this activity is still poorly understood. We aimed to examine how the total neuronal population and individual neurons in the medial hypothalamus respond to cue-signaled food availability in awake, behaving rats. In addition, ghrelin and leptin were injected to investigate whether these hormones could have a modulatory role in the regulation of FAA. Using in vivo electrophysiology, neuronal activity was recorded in the medial hypothalamus in freely moving rats kept on a random feeding schedule, in which a light cue signaled upcoming food delivery. Ghrelin and leptin were administered systemically following the behavioral paradigm. The food-predictive cue induced FAA as well as a significant increase in neural activity on a population level. More importantly, a sub-population of medial hypothalamic neurons displayed highly correlated identical responses to both ghrelin and FAA, suggesting that these neurons are part of the network that regulates FAA." }, { "role": "assistant", "content": "This study reveals a role for ghrelin, but not leptin, signaling within medial hypothalamus in FAA on both a population level and in single cells, identifying a subset of neurons onto which cue information and ghrelin signaling converge, possibly to drive FAA. 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": "Last electron acceptor in electron transpo chain is" }, { "role": "assistant", "content": "The correct answer is Complex IV: Cyt-c Oxidase The system functions: * As proton pump * Catalyses transfer of electrons to molecular O2 to form H2O. This is the terminal component of ETC. It catalyzes the transfer of electrons from Cyt-c to molecular O2 Cyt-a, Cu++ ions and Cyt-a3.Ref: MN Chatterjea Textbook of Medical Biochemistry, 8th edition, page no: 142" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Aged, 80 and over, Female, Humans, Intensive Care Units, International Classification of Diseases, Male, Middle Aged, Patient Discharge, Sepsis." }, { "role": "user", "content": "Is severe sepsis in the ICU often missing in hospital discharge codes? Context: Different International Classification of Diseases (ICD)-based code abstraction strategies have been used when studying the epidemiology of severe sepsis. The aim of this study was to compare three previously used ICD code abstraction strategies to the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) consensus criteria for severe sepsis, in a setting of intensive care patients. All patients (≥ 18 years of age) with severe sepsis according to the ACCP/SCCM criteria registered in the Swedish Intensive Care Registry (2005-2009) were included in the study. Using the Swedish National Patient Register, we investigated whether these patients fulfilled an ICD code compilation for severe sepsis at hospital discharge. Overall, 9271 patients with severe sepsis were registered in the Swedish Intensive Care Registry. A majority of these patients (55.4%) were discharged from the hospital with ICD codes that did not correspond to any of the ICD code compilations. A minority of patients (10.3%) were discharged with ICD codes corresponding to all three code abstraction strategies applied. Overall, the proportion of patients discharged with ICD codes corresponding to the criteria of Angus et al. was 15.1%, to the criteria of Flaatten was 39.8%, and to the criteria of Martin et al. was 16.0%." }, { "role": "assistant", "content": "A majority of patients with severe sepsis according to the ACCP/SCCM criteria were not discharged with ICD codes corresponding to the ICD code abstraction strategies; thus, the abstraction strategies did not identify the correct patients. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Mesothelioma is caused by -" }, { "role": "assistant", "content": "The correct answer is - asbestos enters the body by inhalation and fine dust may be deposited in the alveoli. - the dust deposited in the lungs causes pulmonary fibrosis leading to respiratory insufficiency and death. - also causes mesothelioma of the pleura or peritoneum. Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no:807 <\\p>" } ]

[ { "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 21-year-old Caucasian male presents to your office with wheezing and rhinitis. Laboratory results show peripheral eosinophilia and antibodies against neutrophil myeloperoxidase. What is the most likely diagnosis?" }, { "role": "assistant", "content": "Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Most common electrolyte imbalance that causes paralytic ileus is" }, { "role": "assistant", "content": "The correct answer is In paralytic ileus uraemia and hypokalemia are the most common contributory factors. Paralytic ileus is defined as a state in which there is failure of transmission of peristaltic waves secondary to neuromuscular failure. Reference : Bailey & Love, 27th Edition, page no = 1297." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Cholangiopancreatography, Endoscopic Retrograde, Female, Humans, Male, Middle Aged, Pancreatitis, Sphincter of Oddi, Sphincterotomy, Endoscopic, Stents." }, { "role": "user", "content": "Does pancreatic stenting prevent pancreatitis after biliary sphincterotomy in patients with sphincter of Oddi dysfunction? Context: Patients with sphincter of Oddi dysfunction are at high risk of developing pancreatitis after endoscopic biliary sphincterotomy. Impaired pancreatic drainage caused by pancreatic sphincter hypertension is the likely explanation for this increased risk. A prospective, randomized controlled trial was conducted to determine if ductal drainage with pancreatic stenting protects against pancreatitis after biliary sphincterotomy in patients with pancreatic sphincter hypertension. Eligible patients with pancreatic sphincter hypertension were randomized to groups with pancreatic duct stents (n = 41) or no stents (n = 39) after biliary sphincterotomy. The primary measured outcome was pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). Pancreatic stenting significantly decreased the risk of pancreatitis from 26% to 7% (10 of 39 in the no stent group and 3 of 41 in the stent group; P = 0.03). Only 1 patient in the stent group developed pancreatitis after sphincterotomy, and 2 others developed pancreatitis at the time of stent extraction. Patients in the no stent group were 10 times more likely to develop pancreatitis immediately after sphincterotomy than those in the stent group (relative risk, 10.5; 95% confidence interval, 1.4-78.3)." }, { "role": "assistant", "content": "Pancreatic duct stenting protects significantly against post-ERCP pancreatitis in patients with pancreatic sphincter hypertension undergoing biliary sphincterotomy. Stenting of the pancreatic duct should be strongly considered after biliary sphincterotomy for sphincter of Oddi dysfunction; pancreatic sphincter of Oddi manometry identifies which high-risk patients may benefit from pancreatic stenting. 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 eye finding is not seen in which of the following diseases?" }, { "role": "assistant", "content": "The correct answer is The given picture shows bilateral cataract, can be seen in: Galactosemia Diabetes mellitus Wilson disease Peroxisomal disorders So, answer is option 3- phenylketonuria" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, DNA, Viral, Female, Hepatitis B, Hepatitis B Antibodies, Hepatitis B Core Antigens, Hepatitis C Antibodies, Humans, Male, Middle Aged, Renal Dialysis." }, { "role": "user", "content": "Is occult HBV infection in hemodialysis setting marked by presence of isolated antibodies to HBcAg and HCV? Context: Hepatitis B virus (HBV) infections are a matter of concern in hemodialysis units; occult HBV infections (serum HBsAg negative but HBV DNA positive) were demonstrated in this setting, and this involves further concerns regarding possible transmission and pathogenic consequences. This study aimed to investigate the prevalence and correlates of occult HBV infection in a group of patients with reference to a single hemodialysis unit in southeastern Italy. We analyzed HBV serology and DNA (using a qualitative nested PCR) in 128 HBsAg-negative hemodialysis patients, and correlated the results obtained, with sex, age, hemodialysis duration and HCV seropositivity. As a whole, occult HBV infection was demonstrated in 34/128 patients (26.6%); HBV DNA detection was more frequent when anti-HBcAg antibodies were detected in isolation (72%) than when associated with anti-HBsAg antibodies (31%). Among HCV-seropositive patients, occult HBV infection was observed in 66%, and among these as many as 14/15 patients (93%) who were HCV+/anti-HBcAg+ had serum HBV DNA detectable. On multivariate analysis, HCV seropositivity and the presence of anti-HBs were still respectively correlated to the presence and absence of occult HBV infection." }, { "role": "assistant", "content": "Occult HBV infection is frequent among hemodialysis patients in our geographical area, particularly correlated to the presence of isolated anti-HBcAg and anti-HCV antibodies. Thus, the presence of isolated anti-HBcAg should prompt the clinician to evaluate a possible occult HBV infection especially if anti-HCV antibodies are also detectable; this condition, in fact, seems to strongly predict the detection of HBV DNA. 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: Caspase 3, Cells, Cultured, Endostatins, Endothelial Cells, Enzyme Activation, Humans, Proto-Oncogene Proteins c-bcl-2, Recombinant Proteins, bcl-2-Associated X Protein." }, { "role": "user", "content": "Does endostar induce apoptotic effects in HUVECs through activation of caspase-3 and decrease of Bcl-2? Context: Endostar is a novel recombinant human endostatin expressed and purified in Escherichia coli with the N-terminal modified. It has been shown that endostar inhibited the proliferation of human umbilical vein endothelial cells (HUVECs) through the membrane surface receptor KDR/flt-1(VEGFR-2, vascular endothelial growth factor receptor-2) by exerting anti-angiogenesis effects. But the molecular mechanism remained unclear. The apoptotic effects induced by endostar in the serum-deprived situation were investigated by 4'-6-diaminidino-2-phenylindole (DAPI) staining and the Annexin V-fluorescein isothiocyanate (FITC) binding assay. The mechanism of action was explored by Western blotting assay. Endostar induced remarkable apoptosis in HUVECs. The expressions of apoptosis-related proteins showed that caspase-3 was activated, but caspase-8, a marker of the non-mitochondria-mediated apoptosis signal pathway, was not. Further investigation revealed that cellular Bcl-2 decreased in the endostar-treated groups, while the level of Bax was almost unchanged." }, { "role": "assistant", "content": "Endostar induces apoptotic effects in HUVECs through the activation of caspase-3 and a decrease of the Bcl-2 to Bax ratio. 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, Aged, 80 and over, Anemia, Iron-Deficiency, Cardiovascular Diseases, Cause of Death, Cohort Studies, Confidence Intervals, Female, Humans, Iron, Male, Prevalence, Risk Factors, Severity of Illness Index, Taiwan." }, { "role": "user", "content": "Is iron deficiency associated with increased risk for cardiovascular disease and all-cause mortality in the elderly living in long-term care facilities? Context: The association between serum iron status, cardiovascular disease (CVD), and all-cause mortality remains controversial in the elderly. In the present study, we aim to determine the relevance of serum iron level on the incidences of CVD and all-cause mortality in an elderly population. A baseline cohort of 336 participants, aged ≥65 y, was recruited from eight long-term care facilities between 2002 and 2003. The degree of iron deficiency was defined based on the serum iron level (mild: 40 mg/dL ≤serum iron <60 mg/dL; severe: serum iron <40 mg/dL). Cox proportional hazard regression analyses were adopted to evaluate the relative risks (RRs) of CVD and all-cause death. Taiwan's Department of Health provided the mortality data. There were 210 deaths during a 5-y follow-up period, 62 of which were due to CVD. The prevalence of iron deficiency among the subjects was 50.3%. Age, sex, body mass index, waist circumference, mean arterial pressure, performance status, lifestyle factors, blood glucose, hemoglobin, lipid, albumin, and high sensitivity C-reactive protein levels were adjusted to compare the RRs of the subjects. The RRs (95% confidence interval) of CVD and all-cause mortality among mildly iron-deficient subjects were 1.08 (0.51-2.29) and 1.63 (1.14-2.31), respectively, and 2.77 (1.28-5.99) and 1.96 (1.26-3.04), respectively, among severely iron-deficient subjects. The severity of iron deficiency was positively associated with CVD and all-cause mortality." }, { "role": "assistant", "content": "These results suggest that iron deficiency is independently associated with CVD and all-cause mortality in elderly Taiwanese living in long-term care facilities. 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": "Risk of the damage to fetus by maternal rubella is maximum if mother gets infected in:" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., 6 - 12 weeks of pregnancyIn the first trimester, 80% of the infants would be affected, and severity of the disease depends on how early the infection occurs." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Adult, Aged, Alleles, Arthritis, Disability Evaluation, Female, Genetic Predisposition to Disease, Genotype, HLA-DRB1 Chains, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide, Protein Tyrosine Phosphatase, Non-Receptor Type 22, STAT4 Transcription Factor, Severity of Illness Index." }, { "role": "user", "content": "Is the TT genotype of the STAT4 rs7574865 polymorphism associated with high disease activity and disability in patients with early arthritis? Context: The number of copies of the HLA-DRB1 shared epitope, and the minor alleles of the STAT4 rs7574865 and the PTPN22 rs2476601 polymorphisms have all been linked with an increased risk of developing rheumatoid arthritis. In the present study, we investigated the effects of these genetic variants on disease activity and disability in patients with early arthritis. We studied 640 patients with early arthritis (76% women; median age, 52 years), recording disease-related variables every 6 months during a 2-year follow-up. HLA-DRB1 alleles were determined by PCR-SSO, while rs7574865 and rs2476601 were genotyped with the Taqman 5' allelic discrimination assay. Multivariate analysis was performed using generalized estimating equations for repeated measures. After adjusting for confounding variables such as gender, age and ACPA, the TT genotype of rs7574865 in STAT4 was associated with increased disease activity (DAS28) as compared with the GG genotype (β coefficient [95% confidence interval] = 0.42 [0.01-0.83], p = 0.044). Conversely, the presence of the T allele of rs2476601 in PTPN22 was associated with diminished disease activity during follow-up in a dose-dependent manner (CT genotype = -0.27 [-0.56- -0.01], p = 0.042; TT genotype = -0.68 [-1.64- -0.27], p = 0.162). After adjustment for gender, age and disease activity, homozygosity for the T allele of rs7574865 in STAT4 was associated with greater disability as compared with the GG genotype." }, { "role": "assistant", "content": "Our data suggest that patients with early arthritis who are homozygous for the T allele of rs7574865 in STAT4 may develop a more severe form of the disease with increased disease activity and disability. 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": "An obese 37-year-old woman is brought to the emergency department 2 hours after the onset of weakness in her left arm and leg. She fell from the stairs the day prior but did not have any loss of consciousness or nausea after the fall. She travels to Asia regularly on business; her last trip was 4 days ago. She has no history of serious illness. Her only medication is an oral contraceptive. Her temperature is 37.8°C (100°F), pulse is 113/min and regular, and blood pressure is 162/90 mm Hg. Examination shows decreased muscle strength on the left side. Deep tendon reflexes are 4+ on the left. Babinski sign is present on the left. The right lower leg is swollen, erythematous, and tender to palpation. Further evaluation is most likely to show which of the following?" }, { "role": "assistant", "content": "Patent foramen ovale" } ]

[ { "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 surgeon is exploring the mediastinum found a thymic mass invading the neighboring pericardium and phrenic nerves. Frozen section is showing benign thymoma. The next intraoperative plan should be" }, { "role": "assistant", "content": "The correct answer is Answer- C. Complete resection of tumorThe treatment of choice for the patient presented in the question is as complete a resection as possible while at Ieast one phrenic nerve is preserved.Postoperatively, the patient should receive x-ray therapy, and the combination of surgery plus irradiation offers a good chance of satisfactorily controlling the neoplasm." } ]

[ { "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": "Neurotoxin is which snake -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Krait Type of poisoningSnakeVasculotoxicVipersMyotoxicSea snakesNeurotoxicElapids- cobra, Krait, coral" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Anti-Inflammatory Agents, Antidepressive Agents, Brain, Corticosterone, Cytokines, Depression, Drugs, Chinese Herbal, Female, Humans, Inflammation Mediators, Interleukin-1beta, Magnoliopsida, Ovariectomy, Phytotherapy, Random Allocation, Rats, Sprague-Dawley, Stress, Psychological." }, { "role": "user", "content": "Does soyo-san reduce depressive-like behavior and proinflammatory cytokines in ovariectomized female rats? Context: Soyo-san is a traditional oriental medicinal formula, a mixture of 9 crude drugs, and it has been clinically used for treating mild depressive disorders. The role of pro- and anti-inflammatory cytokines in psychiatric disorders has been the focus of great research attention in recent years. In the present study, we detected the antidepressant effect of soyo-san in the ovariectomized and repeated stressed female rats. This study was designed to evaluate the antidepressant-like effect of soyo-san on the forced swimming test (FST). The rats were randomly divided into the following groups: the nonoperated and nonstressed group (non-op), the nonoperated and stressed group (non-op + ST), the ovariectomized and stress group (OVX) and sham operated and stressed group (sham), the ovariectomized and stressed group (OVX + ST), the ovariectomized, stressed and soyo-san 100 mg/kg treated group (SOY100) and the ovariectomized, stressed and soyo-san 400 mg/kg treated group (SOY400). The rats were exposed to immobilization stress (IMO) for 14 day (2 h/14 day), and soyo-san (100 mg/kg and 400 mg/kg) was administrated during the same time. In the same animals, the levels of corticosterone and interleukin-1-beta (IL-1β) were examined in the serum. Also, the change of IL-1β expression in brain regions was examined after behavior test. In the FST, the lower dose (100 mg/kg) of extract was effective in reducing immobility, along with an increase in swimming time. The serum levels of corticosterone and IL-1β in the SOY groups were significantly lower than those in the control group. In the brain, the expression of IL-1β positive neurons in the control group were significantly increased in the paraventricular nucleus (PVN) and hippocampus compared to the non-op. However, soyo-san groups significantly reduced the IL-1β-ir neurons in the PVN and hippocampal regions compared to the control." }, { "role": "assistant", "content": "The present results demonstrated that soyo-san effectively reduced behavioral and patho-physiological depression-like responses. 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, Depression, Fatigue, Female, Fibromyalgia, Humans, Lupus Erythematosus, Systemic, Male, Middle Aged, Statistics as Topic." }, { "role": "user", "content": "Is fatigue in lupus correlated with disease activity? Context: The relationship between fatigue and disease activity in systemic lupus erythematosus (SLE) has been questioned. We examined whether self-reported fatigue in patients with SLE is correlated with disease activity. Consecutive patients with SLE at the University of Toronto Lupus Clinic were evaluated for disease activity using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). They were also evaluated for fibromyalgia (FM) by American College of Rheumatology criteria. One hundred patients completed the following health status questionnaires: the Fatigue Severity Score (FSS), Center for Epidemiologic Studies Depression Scale (CES-D), and Medical Outcomes Study Short Form Health Survey (SF-20). Disease activity was measured by the SLEDAI. Statistical correlations were made using the Spearman test. No significant correlation was found between FSS scores and SLEDAI (p = NS). Fatigue was found to be highly correlated with the presence of FM (p < 0.05) and depression (p < 0.01). In addition, fatigue was significantly associated with lower performance in all 6 domains of the SF-20 (p < 0.001); disease activity correlated with decreases in social function, mental health, and health perception areas of the SF-20. SLEDAI was not found to correlate with FM (p = NS)." }, { "role": "assistant", "content": "Fatigue in patients with SLE does not correlate with disease activity. However, fatigue is correlated with FM, depression, and lower overall health status in this population. Fatigue is a manifestation of these conditions, which are commonly co-expressed in SLE, and may reflect a decreased overall coping ability in these patients, rather than active disease itself. Final Decision: no" } ]