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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": "A child is not eating vegetables. His mother stas giving a chocolate each time he finishes vegetables in the diet. This method comes under which of the following?" }, { "role": "assistant", "content": "The correct answer is Operant Conditioning Procedures for Increasing BehaviourThe common methods for augmenting an adaptive behaviour include:i. Positive reinforcement: Here, the desired behaviour is reinforced by a reward, either material or symbolic ii. Negative reinforcement: Here, on the performance of the desirable behaviour, punishment can be avoided. iii. Modelling: The person is exposed to 'model' behaviour and is induced to copy it. This can also be used to avoid ceain behaviours. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 215" } ]

[ { "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": "Spread by mosquitoes :" }, { "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: DNA, Drug Delivery Systems, Escherichia coli, Gene Transfer Techniques, Humans, Imines, Models, Molecular, Polypropylenes, Tumor Cells, Cultured." }, { "role": "user", "content": "Are the lower-generation polypropylenimine dendrimers effective gene-transfer agents? Context: To evaluate polypropylenimine dendrimers (generations 1-5: DAB 4, DAB 8, DAB 16, DAB 32, and DAB 64) as gene delivery systems. DNA binding was evaluated by measuring the reduced fluorescence of ethidium bromide, and molecular modelling of dendrimer-DNA complexes also was performed. Cell cytotoxicity was evaluated against the A431 cell line using the MTT assay. In vitro transfection was evaluated against the A431 cell line using the beta-galactosidase reporter gene and N-[1-(2,3-dioleoyloxy)propyl]-N,N,N-trimethylammonium methylsulphate (DOTAP) served as a positive control. Molecular modeling and experimental data revealed that DNA binding increased with dendrimer generation. Cell cytotoxicity was largely generation dependent, and cytotoxicity followed the trend DAB 64 > DAB 32 > DAB 16 > DOTAP > DAB 4 > DAB 8, whereas transfection efficacy followed the trend DAB 8 = DOTAP = DAB 16 > DAB 4 > DAB 32 = DAB 64." }, { "role": "assistant", "content": "The generation 2 polypropylenimine dendrimer combines a sufficient level of DNA binding with a low level of cell cytoxicity to give it optimum in vitro gene transfer activity. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Is regional cortical thinning of the orbitofrontal cortex in medication-naïve female patients with major depressive disorder associated with MAOA-uVNTR polymorphism? Context: Orbitofrontal cortex alterations have been suggested to underlie the impaired mood regulation in depression. Thirty-one patients with major depressive disorder and 43 healthy controls were included. All participants were subjected to T1-weighted structural magnetic resonance imaging and genotyped for Patients showed a significantly thinner left orbitofrontal cortex (" }, { "role": "assistant", "content": "Our results suggest that structural alterations of the orbitofrontal cortex may be associated with the pathophysiology of major depressive disorder. Future studies with larger sample sizes are needed to detect a possible association between 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": "A 3 yrs old child is brought to the emergency room by his parents after they found him having a generalized seizure at home. The child's breath smells of garlic, and he has bloody diarrhea, vomiting, and muscle twitching. Which poison is it likely that this child has encountered?" }, { "role": "assistant", "content": "The correct answer is Acute arsenic poisoning from ingestion results in increased permeability of small blood vessels and inflammation and necrosis of the intestinal mucosa; these changes manifest as hemorrhagic gastroenteritis, fluid loss, and hypotension. Symptoms include nausea, vomiting, diarrhea, abdominal pain, delirium, coma, and seizures. A garlicky odor may be detectable on the breath. Arsenic is found in herbal and homeopathic remedies, insecticides, rodenticides, and wood preservatives, and it has a variety of other industrial applications." } ]

[ { "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": "Increase in height in first year is by –" }, { "role": "assistant", "content": "The correct answer is At birth, the average height of a child is 50 cm.\n            During first year height increases about 50% of birth height (25 cm)." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, PATIENTS, RESULTS. Meshes: Adult, Aged, Case-Control Studies, Cross Infection, Disease Outbreaks, Equipment Contamination, Female, France, Hemodialysis Units, Hospital, Hepacivirus, Hepatitis C, Humans, Infection Control, Male, Middle Aged, Renal Dialysis." }, { "role": "user", "content": "Outbreak of hepatitis C virus infection in a hemodialysis unit: potential transmission by the hemodialysis machine? Context: To identify the routes of transmission during an outbreak of infection with hepatitis C virus (HCV) genotype 2a/2c in a hemodialysis unit. A matched case-control study was conducted to identify risk factors for HCV seroconversion. Direct observation and staff interviews were conducted to assess infection control practices. Molecular methods were used in a comparison of HCV infecting isolates from the case-patients and from patients infected with the 2a/2c genotype before admission to the unit. A hemodialysis unit treating an average of 90 patients. A case-patient was defined as a patient receiving hemodialysis with a seroconversion for HCV genotype 2a/2c between January 1994 and July 1997 who had received dialysis in the unit during the 3 months before the onset of disease. For each case-patient, 3 control-patients were randomly selected among all susceptible patients treated in the unit during the presumed contamination period of the case-patient. HCV seroconversion was associated with the number of hemodialysis sessions undergone on a machine shared with (odds ratio [OR] per additional session, 1.3; 95% confidence interval [CI95], 0.9 to 1.8) or in the same room as (OR per additional session, 1.1; CI95, 1.0 to 1.2) a patient who was anti-HCV (genotype 2a/2c) positive. We observed several breaches in infection control procedures. Wetting of transducer protectors in the external pressure tubing sets with patient blood reflux was observed, leading to a potential contamination by blood of the pressure-sensing port of the machine, which is not accessible to routine disinfection. The molecular analysis of HCV infecting isolates identified among the case-patients revealed two groups of identical isolates similar to those of two patients infected before admission to the unit." }, { "role": "assistant", "content": "The results suggest patient-to-patient transmission of HCV by breaches in infection control practices and possible contamination of the machine. No additional cases have occurred since the reinforcement of infection control procedures and the use of a second transducer protector." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All are food fortification except:(1994)" }, { "role": "assistant", "content": "The correct answer is Ans: aRef: Park, 17th ed, p. 453 & 18th ed, p. 480, 481" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Cartilage, Chickens, Choroid, Coculture Techniques, DNA, Hyperopia, Myopia, Proteoglycans, Sclera, Sensory Deprivation, Vision, Ocular." }, { "role": "user", "content": "Is growth of the two layers of the chick sclera modulated reciprocally by visual conditions? Context: Although visual deprivation causes increased ocular elongation and myopia in both birds and mammals, changes in sclera appear to be in opposite directions. Because avian sclera has a cartilaginous layer as well as the fibrous layer found in mammals, we examined whether the scleral responses to various visual manipulations differ between the two layers. To produce increases in ocular elongation and myopia, monocular diffusers or negative lenses were fitted to eyes. Conversely, to produce decreases in ocular elongation, diffusers were removed (restoring normal vision) or monocular positive lenses were fitted. Scleral layers were then dissected apart, and incorporation of labeled precursors into glycosaminoglycans (GAGs), DNA, and protein was assessed. Tissue coculture experiments were used to assess humoral interactions between scleral layers and with the choroid. In the cartilaginous layers, the incorporation of label into proteoglycans and DNA was significantly higher in eyes elongating faster than normal because of wearing diffusers or negative lenses and significantly lower than normal in eyes elongating slower than normal because of removal of the diffuser or wearing positive lenses. In the fibrous layers, the reverse was the case. Coculturing cartilaginous sclera from normal eyes with fibrous sclera from myopic or recovering eyes produced the same increase or decrease in sulfate incorporation into GAGs in the cartilaginous layer as though the tissue measured was from the animal providing the conditioning tissue. Coculturing with choroid, especially from recovering eyes, also inhibited cartilaginous sclera." }, { "role": "assistant", "content": "The fibrous layer of the avian sclera shows changes in sulfate incorporation into GAGs during deprivation and recovery from deprivation in the same direction as does the mammalian sclera, whereas the cartilaginous layer changes in the opposite direction. The responses of the cartilaginous layer may be controlled by the fibrous layer, although they are influenced by the choroid as well. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Allergens, Asthma, Basophils, Child, Dermatophagoides farinae, Dermatophagoides pteronyssinus, Female, Histamine Release, Humans, Immunoglobulin E, Immunotherapy, Male, Statistics, Nonparametric, Time Factors." }, { "role": "user", "content": "Does allergen-specific conventional immunotherapy decrease immunoglobulin E-mediated basophil histamine releasability? Context: Allergen-specific immunotherapy has proven to be clinically effective in the treatment of patients with atopic asthma; however, the mechanisms are still unclear. Several noted immunological changes include an increase of the allergen-specific IgG antibody, a reduction in the allergen-specific IgE antibody subsequent to transient increase, an allergen-specific T cell shift in cytokine production from Th2 to Th1, and a decrease in quantity and activity of basophils and mast cells. To analyse the changes of basophil histamine release in response to IgE-mediated and non-IgE-mediated stimuli before and after conventional house-dust mite immunotherapy in children who suffer from atopic asthma. Fourteen Dermatophagoides farinae (Df) sensitive asthmatic children with conventional immunotherapy were examined. Basophil histamine releasability was measured 0 months (just before immunotherapy), 4 months and 9 months after immunotherapy. Basophils were stimulated with Df and goat anti-human IgE antibody as IgE-mediated stimuli; and formyl-Met-Leu-Phe (fMLP) and calcium ionophore A23187 as non-IgE-mediated stimuli. Accordingly, the asthma symptom score was used to assess clinical outcome and the skin test reactivity to Df was measured. In contrast to pre-immunotherapy activity, 4 and 9 months after immunotherapy there were significant decreases in histamine release by Df and by anti-IgE antibody. The histamine release by fMLP and by calcium ionophore showed no significant changes after immunotherapy. Histamine release by Df demonstrated significant correlation to that by anti-IgE antibody and by fMLP, yet there was no observable correlation between histamine release by Df and by calcium ionophore. The asthma symptom score decreased significantly 4 and 9 months after immunotherapy and showed significant correlation with histamine release by Df. The skin test reactivity (allergen/histamine ratio) remained constant 4 months after immunotherapy, but decreased significantly 9 months after immunotherapy." }, { "role": "assistant", "content": "Basophils have the potential to play an important role in the early clinical improvement of conventional immunotherapy in children with atopic asthma, which may be a result of the decreased IgE-mediated histamine releasability during immunotherapy. 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": "Child presents with linear verrucous plaques on the trunk with vacuolisation of keratinocytes in S.Spinosum and S.Granulosum. Diagnosis is ?" }, { "role": "assistant", "content": "The correct answer is Verrucuous epidermal nevus Linear verrucuous lesions, with characteristic histopathological feature of granular degeneration of the epidermis ours the diagnosis of verrucous epidermal nevus. Epidermal nevus Epidermal nevi are hamaomas that are characterized by hyperplasia of the epidermis and adnexal structures. These nevi may be classified into a number of distinct variants which are based on clinical morphology, extent of involvement and the predominant epidermal structure in the lesion. Variants of the epidermal nevi are ? - Verrucuous epidermal nevus - Nevus sebaceous - Nevus comedonicus - Eccrine nevus - Apocrine nevus - Becker's nevus - White sponge nevus Verrucuous epidermal nevus Verrucuous epidermal ,nevus consists of hyperplasia of the surface epidermis and typically appears as verrucuous papules that coalasce to form well demarcated, skin colored to brown, papillomatous plaque. Most lesions are present at bih and develop during infancy. They enlarge slowly during childhood and generally reach a stable size at adolescence. Lesions may be localized or diffuse. Linear configurations are common especially on the limbs and may follow skin tension lines or Blaschko's lines. The salient histological features are ? Perinuclear vacuolization of the cells in the stratum spinosum and stratum granulosum. Irregular cellular boundaries peripheral to the vacuolization and increased number of irregularly :,aped large keratohyaline granules. Compact hyperkeratosis in stratum corneum. Darner white disease Autosomal dominant disease. Males and females are equally affected. Daffier white disease is not present at bih and usually begins in the first or second decade. Characteristic sites of prediliction are the face, forehead, scalp, chest and the hack (seborrhic sites). Clinical features consists of way papules and plaques in (seborrhic sites). Histology shows suprabasal acantholysis in epidermis with dyskeratotic cells. Incontinentia pigmentii X linked disease (so only seen in females) Lesions are present along the Blaschko lines, which are initially vesicular, that later on turns into verrucuous lesions and hyperpigmented stages. Common histological features are : - Hverkeratosis - Eosinophilic spongiosis of epidermis - Basal cell degeneration - Pigment incontinenti" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adenocarcinoma, Adult, Aged, Aged, 80 and over, Carcinoma, Large Cell, Carcinoma, Non-Small-Cell Lung, Carcinoma, Squamous Cell, Cohort Studies, Female, Follow-Up Studies, Humans, Immunoenzyme Techniques, Lung Neoplasms, Male, Middle Aged, Neoplasm Staging, Prognosis, Receptors, CXCR4, Retrospective Studies, Sex Factors, Survival Rate, Tissue Array Analysis." }, { "role": "user", "content": "Is cXCR4 overexpression associated with poor outcome in females diagnosed with stage IV non-small cell lung cancer? Context: It has been proposed that the chemokine receptor, CXCR4, and its ligand, stromal cell-derived factor-1 (SDF-1), play a critical role in organ-specific tumor metastasis. High CXCR4 expression in resected non-small cell lung cancer (NSCLC) tumors is associated with poorer outcome; however, its effect on patient outcome in advanced NSCLC has not been explored. After institutional ethical approval was obtained, demographic details, clinical variables, and outcome data were collected on consecutive NSCLC patients diagnosed at the Tom Baker Cancer Centre from 2003 to 2006 (Glans-Look Lung Cancer Database). Formalin-fixed paraffin-embedded diagnostic biopsies from stage IV patients were obtained and tissue microarrays generated. CXCR4 expression within NSCLC cells was analyzed by quantitative fluorescent immunohistochemistry using the HistoRx PM-2000 platform and then correlated with clinical outcome. Of 832 patients, 170 had samples suitable for tissue microarray generation and analysis. Automated immunohistochemistry for CXCR4 was successfully completed on all 170 patients. High expressors had a significantly poorer median overall survival of 2.7 months versus 5.6 months for the low expressors (p = 0.0468). This difference is driven by high-expressing females who have a median overall survival of 1.6 months versus 6.4 months for the low expressors (p = 0.006)." }, { "role": "assistant", "content": "CXCR4 is expressed in the majority of NSCLC tumors, and overexpression is associated with significantly poorer survival in stage IV NSCLC patients. Interestingly, this poor outcome is disproportionately represented in the female population. Our results suggest a gender-dependent difference in clinical outcome based on CXCR4 overexpression in stage IV NSCLC. 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": "Epidemic dropsy is due to -" }, { "role": "assistant", "content": "The correct answer is The contamination of mustard with argemone oil results in epidemic dropsyREF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-608." } ]

[ { "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 presents with vesicles over external acoustic meatus with ipsilateral facial palsy of LMN type.The cause 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, OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Body Mass Index, Energy Intake, Female, Humans, Leptin, Postpartum Period, Pregnancy, Proteins, Skinfold Thickness, Time Factors, Weight Gain." }, { "role": "user", "content": "Does plasma leptin influence gestational weight gain and postpartum weight retention? Context: Leptin, a product of the obese (ob) gene, is released from adipocytes. At the same body mass index, women have higher concentrations than men. Thus, during pregnancy, leptin may influence gestational weight gain and retention of a portion of that gain postpartum. We examined the relation between plasma leptin at entry to prenatal care and subsequent changes in weight from entry to prenatal care (at 17 wk gestation, baseline) until 6 mo postpartum. This was an observational study of leptin, gestational weight gain, and postpartum weight retention (at 6 wk and 6 mo postpartum) in 103 low-income pregnant women from Camden, NJ, with a pregravid body mass index (in kg/m2) in the normal range (19.8-26). After potential confounding variables were controlled for, leptin at entry significantly (P < 0.05) predicted weight gain in pregnancy, including measured rate of weight gain (x +/- SEE: 0.25 +/- 0.13 kg x unit log leptin(-1) x wk(-1)), measured rate of third-trimester weight gain (0.37 +/- 0.15 kg x unit log leptin(-1) x wk(-1)), rate of weight gain from recalled pregravid weight (0.23 +/- 0.09 kg x unit log leptin(-1) x wk(-1)), and net rate of gestational weight gain (0.22 +/- 0.09 kg x unit log leptin(-1) x wk(-1)). The leptin concentration at entry also significantly predicted retained weight in the postpartum period (at 6 mo: 7.29 +/- 3.33 kg/unit log leptin at entry) and marginally predicted changes in the sum of skinfold thicknesses (at 6 mo: 14.7 +/- 7.5 mm/unit log leptin at entry)." }, { "role": "assistant", "content": "These results suggest that a high leptin concentration at entry to prenatal care may predict an increased risk of overweight and obesity in vulnerable women. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following drugs produces dissociative anaesthesia: March 2013 (g)" }, { "role": "assistant", "content": "The correct answer is Ans. A i.e. Ketamine Ketamine Is a phencyclidine, Causes dissociative anaesthesia, Causes - Hallucination, - Delusion and - Illusion Causes profound analgesia Increases all pressures: - Intracranial Tension, - Intraocular pressure, - BP C/I in: Intracerebral mass/hemorrhage etc" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 40-year-old man comes to the physician because of fatigue, increased sweating, and itching in his legs for the past 2 years. He has chronic bronchitis. He has smoked two packs of cigarettes daily for 24 years and drinks one to two beers every night. His only medication is a tiotropium bromide inhaler. His vital signs are within normal limits. He is 175 cm (5 ft 9 in) tall and weighs 116 kg (256 lb); BMI is 38 kg/m2. Physical examination shows facial flushing and bluish discoloration of the lips. Scattered expiratory wheezing and rhonchi are heard throughout both lung fields. Abdominal examination shows no abnormalities. Laboratory studies show:\nErythrocyte count 6.9 million/mm3\nHemoglobin 20 g/dL\nMean corpuscular volume 91 μm3\nLeukocyte count 13,000/mm3\nPlatelet count 540,000/mm3\nSerum\nFerritin 8 ng/mL\nIron 48 μg/dL\nIron binding capacity 402 μg/dL (N: 251 - 406 μg/dL)\nWhich of the following is the most appropriate next step in treatment?\"" }, { "role": "assistant", "content": "Phlebotomy" } ]

[ { "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 Wolffs law:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Amniocentesis is best diagnostic if done in....................weeks :" }, { "role": "assistant", "content": "The correct answer is 16-18" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Cost-Benefit Analysis, Decision Trees, Esophagoscopy, Esophagus, Gastroesophageal Reflux, Gastroscopy, Health Care Costs, Humans, Middle Aged, Multivariate Analysis, Sensitivity and Specificity, Stomach." }, { "role": "user", "content": "Screening for high-grade dysplasia in gastroesophageal reflux disease: is it cost-effective? Context: The present study aimed to assess the cost-effectiveness of endoscopic screening in patients with gastroesophageal reflux disease (GERD) to rule out high-grade dysplasia of Barrett's esophagus. Using an incremental cost-effectiveness ratio as outcome measure, the cost-effectiveness of endoscopic screening was compared to not screening in a decision tree. It was assumed that GERD patients at age 60 yr undergo a one-time endoscopy with esophageal biopsies, targeting abnormal-appearing epithelium. Positive biopsies with respect to high-grade dysplasia or early esophageal adenocarcinoma result in esophagectomy. Transition rates were estimated from U.S. cancer statistics, as well as published data of endoscopic sensitivity, specificity, and surgical outcome. Costs of screening and cancer care were estimated from Medicare reimbursement data from the perspective of a third-party-payor. Compared with no screening, screening endoscopy cost $24,700 per life-year saved. The cost-effectiveness of screening is quite sensitive to the prevalence of Barrett's esophagus, high-grade dysplasia, and adenocarcinoma, as well as the sensitivity, specificity, and cost of screening endoscopy. A small drop in the health-related quality of life associated with postsurgical states markedly reduced the effectiveness of screening. Simultaneous variations of the prevalence, specificity, and health-related quality of life can easily change screening endoscopy from a life-saving into a life-losing strategy." }, { "role": "assistant", "content": "Under favorable conditions, general screening by endoscopy of all patients with reflux symptoms to prevent death from esophageal adenocarcinoma may represent a cost-effective strategy; however, such conditions may be difficult to meet." } ]

[ { "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 serious complication of clomiphene therapy for induction of ovulation is :" }, { "role": "assistant", "content": "The correct answer is Ovarian hyperstimulation syndrome is the most dreaded complication of Clomiphene (discussed in detail in chapter 9 on infertility)." } ]

[ { "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 Universal system the primary right central incisor is coded as:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Amino Acid Sequence, Animals, Chromosomes, Artificial, Bacterial, Evolution, Molecular, Expressed Sequence Tags, Gene Duplication, Genes, MHC Class II, Genomic Instability, Macropodidae, Major Histocompatibility Complex, Male, Molecular Sequence Data, Multigene Family, Phylogeny, Physical Chromosome Mapping, Sequence Alignment, Sequence Analysis, DNA." }, { "role": "user", "content": "Does the tammar wallaby major histocompatibility complex show evidence of past genomic instability? Context: The major histocompatibility complex (MHC) is a group of genes with a variety of roles in the innate and adaptive immune responses. MHC genes form a genetically linked cluster in eutherian mammals, an organization that is thought to confer functional and evolutionary advantages to the immune system. The tammar wallaby (Macropus eugenii), an Australian marsupial, provides a unique model for understanding MHC gene evolution, as many of its antigen presenting genes are not linked to the MHC, but are scattered around the genome. Here we describe the 'core' tammar wallaby MHC region on chromosome 2q by ordering and sequencing 33 BAC clones, covering over 4.5 MB and containing 129 genes. When compared to the MHC region of the South American opossum, eutherian mammals and non-mammals, the wallaby MHC has a novel gene organization. The wallaby has undergone an expansion of MHC class II genes, which are separated into two clusters by the class III genes. The antigen processing genes have undergone duplication, resulting in two copies of TAP1 and three copies of TAP2. Notably, Kangaroo Endogenous Retroviral Elements are present within the region and may have contributed to the genomic instability." }, { "role": "assistant", "content": "The wallaby MHC has been extensively remodeled since the American and Australian marsupials last shared a common ancestor. The instability is characterized by the movement of antigen presenting genes away from the core MHC, most likely via the presence and activity of retroviral elements. We propose that the movement of class II genes away from the ancestral class II region has allowed this gene family to expand and diversify in the wallaby. The duplication of TAP genes in the wallaby MHC makes this species a unique model organism for studying the relationship between MHC gene organization and function. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Area Under Curve, Creatine Kinase, Exercise, Female, Humans, Lactic Acid, Male, Muscle Contraction, Muscle, Skeletal, Physical Education and Training, Sedentary Behavior, Time Factors, Vibration, Young Adult." }, { "role": "user", "content": "Does whole-body vibration training elevate creatine kinase levels in sedentary subjects? Context: Whole body vibration (WBV) is an increasingly popular modality of muscle training, especially in sedentary subjects. We hypothesised that the vigorous muscle contractions elicited by WBV can cause muscle damage expressed as an elevation in muscle enzymes. Twenty inactive subjects, ten male and ten female, aged 22.7 ± 2.6, BMI 22.4 ± 2.1 were included based on the absence of regular physical activity as defined by international guidelines, and no history of recent trauma, musculoskeletal pathology, implanted prosthetics, cardiovascular disease or drug intake. The intervention consisted of one bout of high intensity WBV corresponding to a typical training session, involving all the major muscle groups. Plasma levels of muscle enzymes prior to and at 24, 48 and 96 hours post exercise (creatine kinase - CK, MB fraction, troponin I, aminotransferases and lactate dehydrogenase) were measured. In addition, blood lactate was assayed immediately after exercise. Delayed onset muscle soreness (DOMS) was evaluated using a visual analogical scale. Five participants (25%) showed a significant increase in post exercise CK levels (> double of baseline). Maximal value was 3520 U/l. No change was observed in CK-MB or troponin I. Lactate increased to 10.0 ± 2.4 in men and 6.9 ± 2.4 in women. All participants had some degrees of DOMS, without correlation to enzymatic changes." }, { "role": "assistant", "content": "WBV can provoke high CK elevation in healthy, medication-free inactive subjects. Such an elevation is transient and harmless, but could be wrongly attributed to drug induced myopathy, as in patients treated with statins. Practitioners should bear this in mind before discontinuing a potential life saving drug. 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, BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Death, Sudden, Cardiac, Echocardiography, Electrocardiography, Female, Humans, Male, Middle Aged, Postoperative Complications, Retrospective Studies, Risk Factors, Survival Analysis, Tetralogy of Fallot, Ventricular Dysfunction, Left." }, { "role": "user", "content": "Is left ventricular dysfunction a risk factor for sudden cardiac death in adults late after repair of tetralogy of Fallot? Context: The purpose of this study was to determine if left ventricular (LV) systolic dysfunction was also a predictor of sudden cardiac death (SCD) in adults late after repair of tetralogy of Fallot (TOF). Previous studies looking at risk factors for SCD in adults with repair of TOF have focused on the right ventricle (RV). A retrospective chart review of patients assessed at the Toronto Congenital Cardiac Centre for Adults was performed. Twelve adult patients with repaired TOF and SCD were identified (SCD group). A total of 125 living adult patients with repaired TOF were randomly selected for comparison (control group). Patients with SCD were more likely to exhibit moderate or severe pulmonary regurgitation (92% vs. 51%, p = 0.02), have a history of sustained ventricular tachycardia (42% vs. 6%, p < 0.01), and have a QRS > or =180 ms (56% vs. 13%, p = 0.02). Moderate or severe LV systolic dysfunction was also significantly more common in patients with SCD than in the control group (42% vs. 9%, p < 0.01) with a positive predictive value of 29%. The combination of moderate or severe LV systolic dysfunction and QRS > or =180 ms had a positive and negative predictive value for SCD of 66% and 93%, respectively." }, { "role": "assistant", "content": "Moderate or severe LV systolic dysfunction is significantly more common in adult patients with repaired TOF and SCD. The combination of QRS > or =180 ms and significant LV systolic dysfunction has high positive and negative predictive value for SCD. The implication of the role of prophylactic antiarrhythmic implantable cardiac defibrillator insertion in these patients needs further elucidating. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Antigens, Neoplasm, Cancer Vaccines, Cardia, Female, Gene Expression Regulation, Neoplastic, Humans, Intestine, Small, Male, Melanoma-Specific Antigens, Metaplasia, Middle Aged, Molecular Sequence Data, Neoplasm Proteins, Polymerase Chain Reaction, Stomach Neoplasms." }, { "role": "user", "content": "Are melanoma antigen genes 1 and 2 differentially expressed in human gastric and cardial carcinomas? Context: MAGE genes encode for tumor-rejection antigens and are expressed in tumors of different histologic types but not in normal tissues, with the exception of testis and placenta. The aim of this study was to evaluate the frequency of MAGE-1 and -2 expression in gastric and in cardial carcinomas; these conditions have been described as two distinct diseases, having different etiologies, epidemiologic patterns, and gene mutations. Two groups of patients were studied: patients with distal gastric carcinoma and patients with carcinoma of the cardia. A group of patients with intestinal metaplasia in the gastric mucosa and controls were also included. All of them underwent upper GI endoscopy. Paired biopsy specimens were taken for routine histology and for RNA extraction, to study the expression of MAGE-1 and -2 genes. None of the intestinal metaplastic samples or controls expressed MAGE-1 and -2 at detectable levels. Whereas 40% of the gastric cancer patients expressed either MAGE-1 or -2, 26.6% transcribed both. In the cardial cancer group, 20% of the cases expressed at least one MAGE, and only 6.6% expressed both genes. These results might reinforce the concept that cancer of the cardia is a distinct neoplastic disease with regard to esophageal and gastric (distal) carcinomas." }, { "role": "assistant", "content": "Here we show that MAGE gene expression occurs in advanced stages of gastric and cardial cancer and therefore appears to be a late event. This might point to a reconsideration of their potential role in cancer immunotherapy. 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": "Acute pancreatitis is caused bya) Gallstonesb) Alcoholc) Starvationd) Hypercalcemiae) Hypertriglyceridemia" }, { "role": "assistant", "content": "The correct answer is Causes of Acute Pancreatitis\nCommon Causes\n\nGallstones (including microlithiasis) - most common\nAlcohol (acute and chronic alcoholism) - IInd most common\nHypertriglyceridernia\nEndoscopic retrograde cholangiopancreatography (ERCP), especially after biliary manometry\nTrauma (especially blunt abdominal trauma)\nPostoperative (abdominal and nonabdominal operations)\nDrugs (L-asparginase, thiazide diuretics, frusomide, estrogens, azathioprime, 6-mercaptopurine, methyldopa, sulfonamides, tetracyclin, valproic acid, anti-HIV medications).\nSphincter of Oddi dysfunction\n\nUncommon causes\n\nVascular causes and vasculitis (ischemic-hypoperfusion states after cardiac surgery)\nConnective tissue disorders and thrombotic thrombocytopenic purpura (TTP)\nCancer of the pancreas\nHypercalcemia\nPeriampullary diverticulum\nPancreas divisum\nHereditary pancreatitis\nCystic fibrosis\nRenal failure\n\nRare causes\nInfections (mumps, coxsackievirus, cytomegalovirus, echovirus, parasites)\nAutoimmune (e.g., Sjogren's syndrome)\nCauses to consider in patients with recurrent bouts of acute pancreatitis without an obvious etiology\n\nOccult disease of the biliary tree or pancreatic ducts, especially microlithiasis, sludge\nDrugs\nHypertriglyceridemia\nPancreas divisum\nPancreatic cancer\nSphincter of Oddi dysfunction\nCystic fibrosis\nIdiopathic" } ]

[ { "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": "Medusa head appearance is a feature of" }, { "role": "assistant", "content": "The correct answer is Bacillus anthracis:When grown on blood agar plates, the organisms produce nonhemolytic gray to white, tenacious colonies with a rough texture and a ground-glass appearance. Comma-shaped outgrowths (Medusa head, \"curled hair\") may project from the colony.Reference: Jawetz, Melnick, & Adelberg's Medical Microbiology; 27th edition; Chapter 11; Spore-Forming Gram-Positive Bacilli: Bacillus and Clostridium Species" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: RATIONALE, OBJECTIVES, METHODS, MEASUREMENTS AND MAIN RESULTS. Meshes: BCG Vaccine, Child, Child, Preschool, Europe, Female, Humans, Infant, Interferon-gamma Release Tests, Latent Tuberculosis, Male, Odds Ratio, Predictive Value of Tests, Retrospective Studies, Tuberculin Test." }, { "role": "user", "content": "Identifying predictors of interferon-γ release assay results in pediatric latent tuberculosis: a protective role of bacillus Calmette-Guerin? Context: Interferon-γ (IFN-γ) release assays are widely used to diagnose latent infection with Mycobacterium tuberculosis in adults, but their performance in children remains incompletely evaluated to date. To investigate factors influencing results of IFN-γ release assays in children using a large European data set. The Pediatric Tuberculosis Network European Trials group pooled and analyzed data from five sites across Europe comprising 1,128 children who were all investigated for latent tuberculosis infection by tuberculin skin test and at least one IFN-γ release assay. Multivariate analyses examined age, bacillus Calmette-Guérin (BCG) vaccination status, and sex as predictor variables of results. Subgroup analyses included children who were household contacts. A total of 1,093 children had a QuantiFERON-TB Gold In-Tube assay and 382 had a T-SPOT.TB IFN-γ release assay. Age was positively correlated with a positive blood result (QuantiFERON-TB Gold In-Tube: odds ratio [OR], 1.08 per year increasing age [P<0.0001]; T-SPOT.TB: OR, 1.14 per year increasing age [P<0.001]). A positive QuantiFERON-TB Gold In-Tube result was shown by 5.5% of children with a tuberculin skin test result less than 5 mm, by 14.8% if less than 10 mm, and by 20.2% if less than 15 mm. Prior BCG vaccination was associated with a negative IFN-γ release assay result (QuantiFERON-TB Gold In-Tube: OR, 0.41 [P<0.001]; T-SPOT.TB: OR, 0.41 [P<0.001]). Young age was a predictor of indeterminate IFN-γ release assay results, but indeterminate rates were low (3.6% in children<5 yr, 1% in children>5 yr)." }, { "role": "assistant", "content": "Our data show that BCG vaccination may be effective in protecting children against Mycobacterium tuberculosis infection. To restrict use of IFN-γ release assays to children with positive skin tests risks underestimating latent infection." } ]

[ { "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 15-month-old boy is brought to the pediatrician’s office by his mother due to abnormal muscle tone and an inability to walk. He was able to control his head at 5 months of age, roll at 8 months of age, sit at 11 months of age, and develop hand preference at 13 months of age. On physical exam, he is observed to asymmetrically crawl. He has a velocity-dependent increase in tone and 3+ biceps and patellar reflexes. His startle, asymmetric tonic neck, and Babinski reflexes are present. Which of the following is the most common risk factor for developing this patient’s clinical presentation?" }, { "role": "assistant", "content": "Prematurity" } ]

[ { "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 55-year-old Chinese man presents to the office with a complaint of progressive unilateral nasal obstruction for 10 months. Though he was able to tolerate his symptoms at the beginning, he can’t breathe properly through the obstructed nostril anymore. Also, a bloody nasal discharge has started recently through the occluded nostril. He also complains of double vision during the past 2 months but did not pay attention to it until now. Past medical history is insignificant except for occasional sore throats.\nHis vitals include: blood pressure of 120/88 mm Hg, respiratory rate of 14/min, pulse of 88/min, temperature 37.0°C (98.6°F).\nBlood analysis shows:\nHemoglobin 15 g/dL\nHematocrit 46%\nLeukocyte count 15000/mm3\nNeutrophils 72%\nLymphocytes 25%\nMonocytes 3%\nMean corpuscular volume 95 fL\nPlatelet count 350,000/mm3\nWhich of the following viral etiology is most likely associated with the development of this patient’s condition?" }, { "role": "assistant", "content": "Epstein-Barr virus" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Asian Continental Ancestry Group, Carcinoma, Hepatocellular, China, Female, Gene Expression Regulation, Neoplastic, Genetic Predisposition to Disease, Genotype, Humans, Liver Cirrhosis, Liver Neoplasms, Male, MicroRNAs, Middle Aged, Polymorphism, Single Nucleotide, Reverse Transcriptase Polymerase Chain Reaction." }, { "role": "user", "content": "Is a variant in microRNA-196a2 associated with susceptibility to hepatocellular carcinoma in Chinese patients with cirrhosis? Context: Cirrhosis is an important risk factor for hepatocellular carcinoma (HCC) in China, while little is known of the genetic susceptibility to hepatocarcinogenesis. Traditional approaches to identification of novel genetic predisposition genes have focused on protein encoding genes. There is evidence to suggest that microRNAs (miRNA) may play an important role in tumorigenesis. Recent studies have implicated that the rs11614913 SNP in miR-196a2 may be associated with susceptibility to lung cancer, congenital heart disease, breast cancer, as well as reduced survival in non-small cell lung cancer. This study aims to assess whether this functional polymorphism can influence susceptibility to and the progression of cirrhosis-related HCC. 532 patients with hepatic cirrhosis (310 patients with HCC and 222 patients without HCC) were enrolled. DNA was extracted from blood specimens, and miR-196a2 polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). In addition, tumour tissues of liver (n=59) were obtained from the studied HCC patients for measurement of miR-196a expression levels. The frequency of the CC genotype among HCC patients was higher than that in the control group, implying that the cirrhotic patients with the CC genotype or C allele containing genotypes (CT and CC) may have a higher risk of HCC. However, in a subsequent analysis of the association between this polymorphism and clinicopathological characteristics, there was an association between rs11614913 genotype and tumour size (p=0.046), but not with tumour number, grade, stage, invasiveness or Child-Pugh grade. In a genotype-phenotype correlation analysis using 59 tumour tissues of liver, rs11614913 CC or carrying at least one C allele was associated with significantly increased mature miR-196a expression (p=0.006 or =0.002)." }, { "role": "assistant", "content": "Our results suggest, for the first time, that miR-196a2 polymorphism may contribute to cirrhosis-related HCC susceptibility in Chinese patients through influencing mature miR-196a expression. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adenocarcinoma, Adult, Aged, Aged, 80 and over, Female, Humans, Immunoenzyme Techniques, Middle Aged, Neoplasm Proteins, Ovarian Neoplasms, Polymerase Chain Reaction, Prognosis, RNA, Messenger, RNA, Neoplasm, S-Phase Kinase-Associated Proteins, Survival Rate, Tumor Cells, Cultured." }, { "role": "user", "content": "Is skp2 overexpression a prognostic factor in patients with ovarian adenocarcinoma? Context: The purpose of this study was to examine Skp2 expression in epithelial ovarian tumors and to identify the association of Skp2 expression levels with patient survival. Skp2 protein expression was examined by immunohistochemistry in 134 epithelial ovarian tumors [20 adenomas, 23 low malignant potential (LMP) tumors, and 91 adenocarcinomas]. Results of immunostaining were correlated with clinicopathological variables and overall survival. Skp2 mRNA expression was examined by semiquantitative PCR in 32 ovarian adenocarcinomas and in 3 ovarian cancer cell lines. Skp2 expression was detected in neither ovarian adenomas nor LMP tumors. In contrast, Skp2 expression was detected in 47.3% (43 of 91) of adenocarcinomas. Positive Skp2 expression was detected significantly more often in adenocarcinomas than in LMP tumors (P < 0.0001) or in adenomas (P < 0.0001). A significantly higher detection rate of Skp2 expression was observed in advanced-stage diseases compared with early-stage diseases (P = 0.010). Log-rank testing showed that Skp2 overexpression was significantly correlated with poor patient survival (P = 0.0035). Older age (P = 0.0026), advanced clinical stage (P < 0.0001), and high histological grades of the tumors (P = 0.0018) were also significantly associated with poor prognoses. In multivariate analysis, Skp2 overexpression (P = 0.0069) and clinical stage (P < 0.0001) remained significantly associated with overall survival, whereas age and histological grade lost their significance. Considerable levels of Skp2 mRNA expression were detected in all ovarian adenocarcinomas examined by semiquantitative PCR." }, { "role": "assistant", "content": "Skp2 expression might play an important role in the development and progression of ovarian adenocarcinomas, and Skp2 overexpression is an independent prognostic marker of ovarian adenocarcinoma 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": "A patient has been diagnosed with systemic sclerosis. He has the presence of anti RNA polymerase III antibody. Which of the following is more common in this patient?" }, { "role": "assistant", "content": "The correct answer is Systemic sclerosis (commonly called scleroderma) is characterized by: Chronic inflammation thought to be the result of autoimmunity Widespread damage to small blood vessels, and progressive interstitial and perivascular fibrosis in the skin and multiple organs.The patient having anti RNA polymerase III antibody, these patients will be at high risk of development of three conditions in the body: -R - Renal crisis N - NeoplasmA - Acute onset of the disease. 1st statement is false. These patients have Increased risk of scleroderma renal crisis. 2nd statement is true -Acute onset of the disease 3rd statement is false - These patients have Increased risk of malignancy. Increased risk of pulmonary hypeension is associated with the presence of anticentromere protein antibody." } ]

[ { "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": "Acetic acid staining of cervix shows the following EXCEPT :" }, { "role": "assistant", "content": "The correct answer is Cervical polyp Ans. is c i.e. Cervical polyp Colposcopy is done in case of suspected CIN and Cervical dysplasias. Colposcope is a binocular microscope. In colposcopy after visualising the suspected area on cervix with naked eyes, acetic acid (3 - 5%) is applied for better visualization.deg Principle : Application of acetic acid to normal glycogen producing epithelium of cervix does not produce any effect and it appears pink during colposcopy. But when acetic acid is applied to dysplastic epithelium which have large nuclei with abnormally large amounts of chromatin (i.e. wtein) acetic acid coagulates the proteins of the nucleus and cytoplasm, making the proteins opaque and whitethus dysplastic cells and cancerous cells appear white (called as Aceto white) (i.e. option \"13- and \"d\"are correctleck The immature metaplaIfcells have larger nuclei and also show some effects of the acetic acid. Since, metaplastic epithelium is very thin, it does not appear while but instead appears grey and filmy (i.e. option 'a'ts correct). Cervical polyp can be diagnosed by direct visualization and does not need a colposcope to diagnose it." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, METHODS, METHODS, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Attitude to Health, Cross-Sectional Studies, Fertility Preservation, Humans, Male, Middle Aged, Prostatic Neoplasms, Semen Preservation, Socioeconomic Factors, Sperm Banks, Surveys and Questionnaires." }, { "role": "user", "content": "Is sperm banking of key importance in patients with prostate cancer? Context: To assess the need for sperm banking among patients with prostate cancer (PCa) who are candidates for radical prostatectomy (RP). Cross-sectional study. Urologic department. Cohort of 510 Caucasian-European candidates for RP. A 10-item self-administered questionnaire to assess opinions on sperm banking before RP, to which descriptive statistics and logistic regression models were applied. PCa patients' wishes for preoperative sperm banking. Data collection was completed for 495 patients (97.1%). Ninety-nine (20%) expressed a wish for preoperative sperm banking. Men who wanted to bank sperm were younger (mean 62.2 vs. 65.1 years), were more frequently childless (21.2% vs. 8.8%), and more frequently had a more intense desire for fatherhood (64.7% vs. 9.3%) than the patients not interested in banking sperm. Willingness to bank sperm was not affected by the patient's educational or relationship status. Moreover, the interest for sperm banking was maintained regardless of cost issues. Overall, 84% of the patients considered it necessary to have a dedicated service of preoperative sperm cryopreservation." }, { "role": "assistant", "content": "One out of five PCa patients would bank sperm before RP. Most patients considered it necessary to establish a dedicated service for preoperative sperm cryopreservation, regardless of their own motivation to bank sperm. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "If a region or compartment is in a steady state with respect to a particular substance, then:" }, { "role": "assistant", "content": "The correct answer is Ans. C. The amount of the substance in the compartment does not change with respect to timeIn a steady state, the amount or concentration of a substance in a compartment does not change with respect to time. Although there may be considerable movements into and out of the compartment, there is no net gain or loss. Steady states in the body often do not represent an equilibrium condition, but they are displaced from equilibrium by the constant expenditure of metabolic energy." } ]

[ { "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": "Stereotactic Radiotherapy is used in –" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Amino Acid Sequence, Animals, Chordata, Databases, Genetic, Evolution, Molecular, Genetic Drift, Genetic Variation, Histones, Likelihood Functions, Models, Genetic, Molecular Sequence Data, Mutation, Phylogeny, Selection, Genetic, Sequence Alignment, Species Specificity." }, { "role": "user", "content": "Is the evolutionary differentiation of two histone H2A.Z variants in chordates ( H2A.Z-1 and H2A.Z-2 ) mediated by a stepwise mutation process that affects three amino acid residues? Context: The histone H2A family encompasses the greatest number of core histone variants of which the replacement variant H2A.Z is currently one of the most heavily studied. No clear mechanism for the functional variability that H2A.Z imparts to chromatin has yet been proposed. While most of the past studies have referred to H2A.Z generically as a single protein, in vertebrates it is a mixture of two protein forms H2A.Z-1 (previously H2A.Z) and H2A.Z-2 (previously H2A.F/Z or H2A.V) that differ by three amino acids. We have performed an extensive study on the long-term evolution of H2A.Z across metazoans with special emphasis on the possible selective mechanisms responsible for the differentiation between H2A.Z-1 and H2A.Z-2. Our results reveal a common origin of both forms early in chordate evolution. The evolutionary process responsible for the differentiation involves refined stepwise mutation change within the codons of the three differential residues. This eventually led to differences in the intensity of the selective constraints acting upon the different H2A.Z forms in vertebrates." }, { "role": "assistant", "content": "The results presented in this work definitively reveal that the existence of H2A.Z-1 and H2A.Z-2 is not a whim of random genetic drift. Our analyses demonstrate that H2A.Z-2 is not only subject to a strong purifying selection but it is significantly more evolutionarily constrained than H2A.Z-1. Whether or not the evolutionary drift between H2A.Z-1 and H2A.Z-2 has resulted in a functional diversification of these proteins awaits further research. Nevertheless, the present work suggests that in the process of their differently constrained evolutionary pathways, these two forms may have acquired new or complementary functions. 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: Alcoholism, Amnesia, Anterograde, Atrophy, Chronic Disease, Diagnosis, Differential, Female, Hippocampus, Humans, Korsakoff Syndrome, Magnetic Resonance Imaging, Male, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Severity of Illness Index, Thalamic Nuclei." }, { "role": "user", "content": "Does brain correlate of memory dysfunction in alcoholic Korsakoff 's syndrome? Context: To investigate the relation between anterograde amnesia and atrophy of brain structures involved in memory processing in alcoholic Korsakoff's syndrome. The volume of brain structures involved in memory processing was measured with MRI from 13 subjects with Korsakoff's syndrome, 13 subjects with chronic alcoholism without Korsakoff's syndrome, and 13 control subjects. The brain structures analysed were the hippocampus, the parahippocampal gyrus, the mamillary bodies, the third ventricle, and the thalamus. Brain volumes were correlated with the delayed recall of a verbal learning test. Compared with subjects with chronic alcoholism and control subjects, subjects with Korsakoff's syndrome had a reduced volume of the hippocampus, the mamillary bodies, and the thalamus, and enlargement of the third ventricle. The impairment of delayed recall correlated with the volume of the third ventricle (r=-0.55, p=0.05) in the Korsakoff group." }, { "role": "assistant", "content": "Anterograde amnesia in alcoholic Korsakoff's syndrome is associated with atrophy of the nuclei in the midline of the thalamus, but not with atrophy of the mamillary bodies, the hippocampus, or the parahippocampal gyrus. 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 56-year-old woman is referred to your office with mammography results showing a dense, spiculated mass with clustered microcalcifications. The family history is negative for breast, endometrial, and ovarian cancers. She was formerly a flight attendant and since retirement, she has started a strict Mediterranean diet because she was \"trying to compensate for her lack of physical activity\". She is the mother of two. She breastfed each infant for 18 months, as recommended by her previous physician. Her only two surgical procedures have been a breast augmentation with implants and tubal ligation. The physical examination is unremarkable. There are no palpable masses and no nipple or breast skin abnormalities. The patient lacks a family history of breast cancer. Which of the following is the most significant risk factor for the development of breast cancer in this patient?" }, { "role": "assistant", "content": "Occupation" } ]

[ { "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": "\"L-form\" phenomenon is most likely to occur in:" }, { "role": "assistant", "content": "The correct answer is Mycoplasma" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Apoptosis, Apoptosis Regulatory Proteins, Cell Cycle, Cell Cycle Proteins, Cell Line, Tumor, Cell Proliferation, E2F1 Transcription Factor, Gene Expression Regulation, Neoplastic, Humans, Mice, Inbred BALB C, Mice, Nude, RNA, Messenger, Signal Transduction, Stomach Neoplasms, Time Factors, Transfection, Tumor Burden, Up-Regulation." }, { "role": "user", "content": "Does e2F-1 overexpression inhibit human gastric cancer MGC-803 cell growth in vivo? Context: To evaluate the influence of E2F-1 on the growth of human gastric cancer (GC) cells in vivo and the mechanism involved. E2F-1 recombinant lentiviral vectors were injected into xenograft tumors of MGC-803 cells in nude mice, and then tumor growth was investigated. Overexpression of transcription factor E2F-1 was assessed by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting analysis. Apoptosis rates were determined using a terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay. Expression levels of certain cell cycle regulators and apoptosis-related proteins, such as Bax, survivin, Bcl-2, cyclin D1, S-phase kinase-associated protein 2, and c-Myc were examined by Western blotting and RT-PCR. Xenograft tumors of MGC-803 cells in nude mice injected with E2F-1 recombinant lentiviral vectors stably overexpressed the E2F-1 gene as measured by semi-quantitative RT-PCR (relative mRNA expression: 0.10 ± 0.02 vs 0.05 ± 0.02 for control vector and 0.06 ± 0.03 for no infection; both P < 0.01) and Western blotting (relative protein expression: 1.90 ± 0.05 vs 1.10 ± 0.03 in control vector infected and 1.11 ± 0.02 for no infection; both P < 0.01). The growth-curve of tumor volumes revealed that infection with E2F-1 recombinant lentiviral vectors significantly inhibited the growth of human GC xenografts (2.81 ± 1.02 vs 6.18 ± 1.15 in control vector infected and 5.87 ± 1.23 with no infection; both P < 0.05) at 15 d after treatment. TUNEL analysis demonstrated that E2F-1 overexpression promoted tumor cell apoptosis (18.6% ± 2.3% vs 6.7% ± 1.2% in control vector infected 6.3% ± 1.2% for no infection; both P < 0.05). Furthermore, lentiviral vector-mediated E2F-1 overexpression increased the expression of Bax and suppressed survivin, Bcl-2, cyclin D1, Skp2, and c-Myc expression in tumor tissue." }, { "role": "assistant", "content": "E2F-1 inhibits growth of GC cells via regulating multiple signaling pathways, and may play an important role in targeted therapy for GC. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, RESULTS. Meshes: Adult, Aged, Atherosclerosis, Carotid Stenosis, Case-Control Studies, Coronary Stenosis, Female, Femoral Artery, Genotype, Humans, Lipoprotein(a), Male, Mendelian Randomization Analysis, Middle Aged, Venous Thrombosis." }, { "role": "user", "content": "Does genetic evidence that lipoprotein ( a ) associate with atherosclerotic stenosis rather than venous thrombosis? Context: The aim of the present study was to determine whether lipoprotein(a) [Lp(a)], considered a causal risk factor for cardiovascular disease, primarily promotes thrombosis or atherosclerosis. Using a Mendelian randomization study design, we measured plasma Lp(a) and genetically elevated Lp(a) levels through the LPA kringle IV type 2 repeat genotype in 41231 individuals. We included 2 general population studies of both venous thrombosis and combined thrombosis and atherosclerosis in coronary arteries (=myocardial infarction), and 3 -case--control studies of atherosclerotic stenosis. Neither Lp(a) tertiles nor LPA kringle IV type 2 tertiles associated with the risk of venous thrombosis in general population studies (trend: P=0.12-0.76), but did each associate with risk of coronary, carotid, and femoral atherosclerotic stenosis in -case--control studies (trend: P<0.001 to 0.04). Lp(a) and LPA kringle IV type 2 tertiles also associated with the risk of myocardial infarction in general population studies (trend: P<0.001 to 0.003). For doubling of Lp(a) levels, instrumental variable estimates of hazard/odds ratios were 1.02 (95% CI 0.90-1.15) and 1.04 (0.93-1.16) for venous thrombosis in the 2 general population studies, 1.12 (1.01-1.25), 1.17 (1.05-1.32), and 1.16 (1.01-1.35), respectively, for coronary, carotid, and femoral atherosclerotic stenosis in -case-control studies, and 1.21 (1.10-1.33) and 1.17 (1.05-1.29) for myocardial infarction in general population studies." }, { "role": "assistant", "content": "This supports that Lp(a) primarily promotes atherosclerotic stenosis rather than venous thrombosis. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, RESULTS. Meshes: Adolescent, Adult, Aged, Aged, 80 and over, Anaphylatoxins, Bacterial Infections, Complement C1, Complement C1 Inactivator Proteins, Complement C3, Complement C3a, Complement C4, Complement C4a, Complement Pathway, Classical, Female, Humans, Male, Middle Aged, Peptides, Prognosis, Respiratory Distress Syndrome, Adult, Shock, Septic." }, { "role": "user", "content": "Are elevated plasma levels of the anaphylatoxins C3a and C4a associated with a fatal outcome in sepsis? Context: Both complement and contact system of coagulation have been implicated in the pathophysiology of sepsis. We therefore measured levels of the complement activation products C1-C1-inhibitor complexes and C3a in serial plasma samples (obtained every six hours) from 48 patients with clinically suspected sepsis, and related these levels to the clinical outcome. C4a was also measured in samples obtained on admission. C3a levels were elevated in 47 patients at least once during the observation period. These levels appeared to be considerably higher in patients who died than in patients who survived. This difference was found for the levels on admission (p = 0.0003), as well as for the highest (p = 0.0010) and the lowest (p less than 0.0001) levels encountered in each patient. The mortality in patients with plasma C3a levels of 13 nmol/liter or less on admission (27 patients) was 33 percent, compared with 86 percent in patients with levels of 14 nmol/liter or more. Patients with septic shock had significantly higher C3a levels than normotensive patients (p values between 0.046 and 0.004). No significant differences in C3a were found between patients who had respiratory distress syndrome and those who did not. C4a levels in plasma samples obtained on admission were elevated in 43 patients. These levels correlated very significantly with C3a levels (p less than 0.0001), and showed similar associations with a fatal outcome. C1-C1-inhibitor complexes were elevated in 23 patients at least once during the observation period. These patients had significantly higher levels of C4a and C3a than patients with normal amounts of C1-C1-inhibitor complexes. Patients who died had higher levels of C1-C1-inhibitor complexes than patients who survived. However, this difference was not significant." }, { "role": "assistant", "content": "On the basis of our results, we propose that activation of the complement system via the classical pathway is involved in the development of fatal complications in sepsis. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Drug used for obesity: (PGI June 2008)" }, { "role": "assistant", "content": "The correct answer is Ans.: A (Orlistat) [Ref: Harrison 17th/427, KDT 6th /130-31} Anti Obesity Drugs or AnorecticSibutramine<4 serotonin and nor-epinephrine reuptake inhibitor.OrlisttX: gastic and pancreatic lipase inhibitor.Rimonabantfr. selective cannabinoid receptors antagonist.Leptin analogs: Under investigational study.Olestra9 a sucrose polyester which can be used as a cooking medium in place of fat.Other Facts Harrison 17th / 427Sibutramine,;i is the only anorexiant that is currently approved by the Food and Drug Administration (FDA) for long-term use It produces an average loss of about 5-9% of initial body weight at 12 months. Sibutramine has been demonstrated to maintain weight loss for up to 2 years. The most commonly reported adverse events of sibutramine are headache, dry mouth, insomnia, and constipationCognitive behavioral therapy is used to help change and reinforce new dietary1 and physical activity' behaviorsBariatric surgery can be considered for patients with severe obesity (BMt >40 kg/m2) or those with moderate obesity (BMI >35 kg/m2) associated with a serious medical conditionNo reference found regarding the drug Rivastat on internet" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Clinical Protocols, Clinical Trials as Topic, General Surgery, Humans, Periodicals as Topic, Quality Control, Surgical Procedures, Operative, United States, Writing." }, { "role": "user", "content": "Clinical trials in general surgical journals: are methods better reported? Context: Reports of clinical trials often lack adequate descriptions of their design and analysis. Thus readers cannot properly assess the strength of the findings and are limited in their ability to draw their own conclusions. A review of 6 surgical journals in 1984 revealed that the frequency of reporting 11 basic elements of design and analysis in clinical trials was only 59%. This study attempted to identify areas that still need improvement. Eligible studies published from July 1995 through June 1996 included all reports of comparative clinical trials on human subjects that were prospective and had at least 2 treatment arms. A total of 68 articles published in 6 general surgery journals were reviewed. The frequency that the previously identified 11 basic elements of design and analysis were reported was determined. Seventy-four percent of all items were reported accurately (a 15% increase from the previous study), 4% were reported ambiguously, and 23% were not reported; improvement was seen in every journal. The reporting of eligibility criteria and statistical power improved the most. For 3 items, reporting was still not adequate; 32% of reports provided information about statistical power, 40% about the method of randomization, and 49% about whether the person assessing outcomes was blind to the treatment assignment." }, { "role": "assistant", "content": "Improvements have been made in reporting surgical clinical trials, but in general methodologic questions poorly answered in the 1980s continue to be answered poorly in the 1990s. Editors of surgical journals are urged to provide authors with guidelines on how to report clinical trial design and analysis." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Aluminum Oxide, Analysis of Variance, Ceramics, Dental Abutments, Dental Implants, Dental Instruments, Dental Polishing, Equipment Design, Metal Ceramic Alloys, Particle Size, Surface Properties, Zirconium." }, { "role": "user", "content": "Do effects of bur abrasive particle size and abutment composition on preparation of ceramic implant abutments? Context: Amid increasing use of preparable ceramic implant abutments, there is a lack of quantitative data to show which abrasive particle size of diamond bur yields the fastest reduction and provides the smoothest surface. The research aim was to determine the effects of diamond bur abrasive particle size and abutment material composition on preparation efficiency, prepared surface roughness, and surface deterioration of diamond burs. Fifteen alumina (Cera Base) and 15 zirconia (ZiReal) implant abutments were each machined using a high-speed hand piece with a diamond bur having 1 of 3 abrasive particle sizes (150, 100, or 30 microm) (n=5). Control abutments (n=5) were analyzed without machining. Abutments were weighed before starting and between machining cycles. Three profilometry measurements (root mean square surface roughness) were made for each abutment. Scanning electron micrographs were made of each bur. Lost abrasive particles were then counted on each micrograph through a randomly placed template. Two-way analysis of variance (alpha=0.05) was used to test for significant effects. Bur abrasive particle size and ceramic type had a significant interactive effect on the amount of material removed (P<.001). Super coarse (150 microm) burs yielded the roughest surfaces for each abutment material (P<.001), and prepared alumina surfaces were rougher than zirconia surfaces (P<.001). Super coarse burs showed the highest proportion of lost particles (P<.001). Abutment composition did not significantly affect bur wear." }, { "role": "assistant", "content": "Super coarse burs yielded the most efficient material removal for alumina abutments. All abrasive particle sizes removed a similar amount of material from zirconia abutments. Fine-grained alumina abutments experienced greater material removal and rougher prepared surfaces compared with zirconia abutments. Material was removed by an intergranular fracture mechanism for alumina abutments, in contrast to transgranular fracture for zirconia abutments. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Animals, Blood, Calcium, Dietary, Cyclin-Dependent Kinase Inhibitor p21, Cyclins, Dose-Response Relationship, Drug, Ergocalciferols, Female, Hyperplasia, Parathyroid Glands, Parathyroid Hormone, Phosphorus, Dietary, Rats, Rats, Sprague-Dawley, Transforming Growth Factor alpha, Uremia, Vitamin D." }, { "role": "user", "content": "Do p21WAF1 and TGF-alpha mediate parathyroid growth arrest by vitamin D and high calcium? Context: High dietary phosphorus (P) worsens uremia-induced parathyroid (PT) hyperplasia through increases in the growth promoter transforming growth factor-alpha (TGF-alpha). In contrast, P restriction prevents PT hyperplasia by inducing the cell cycle inhibitor p21. Since 1,25(OH)2D3-antiproliferative action in various cell types involve increases in p21, we studied whether induction of p21 by 1,25(OH)2D3 or the vitamin D analog, 19-Nor-1,25(OH)2D2, could counteract the PT hyperplasia induced by high dietary P in early uremia. Normal (N) and uremic (U; 5/6 nephrectomized) female Sprague-Dawley rats were fed high P (HP), low P (LP) or high Ca (HCa) diets and administered intraperitoneally (IP) either vehicle or vitamin D metabolites for seven days, as follows: N-HP; U-HP + vehicle; U-HP + 1,25(OH)2D3 (4 ng/day); U-HP + 19-Nor-1,25(OH)2D2 (30 ng/day); U-LP; U-HCa. Serum PTH and PT gland weight assessed secondary hyperparathyroidism. Immunohistochemical quantitation of two markers of mitotic activity, Ki67 and PCNA measured PT hyperplasia. Immunohistochemical expression of PT p21 and TGF-alpha addressed potential mechanisms regulating PT cell growth. 1,25(OH)2D3 and 19-Nor-1,25(OH)2D2 were effective in suppressing both PTH secretion and PT hyperplasia induced by uremia and high dietary P independent of increases in ionized Ca. Both vitamin D compounds enhanced PT p21 expression and prevented high P-induced increases in PT TGF-alpha content. Induction of PT p21 and reduction of TGF-alpha content also occurred when uremia-induced PT hyperplasia was suppressed by high dietary Ca." }, { "role": "assistant", "content": "In early uremia, vitamin D suppression of high P-induced PT hyperplasia and high dietary Ca arrest of PT growth involve induction of PT p21 and prevention of increases in TGF-alpha. 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": "Formation of excessive amounts of granulation tissue, which protrudes above the level of the surrounding skin and blocks re-epithelialization is called:" }, { "role": "assistant", "content": "The correct answer is The accumulation of excessive amounts of collagen may result in a raised scar known as a hypertrophic scar and they tend to regress over several months.\nIf  the scar tissue grows beyond the boundaries of the original wound and does not regress, it is called a keloid.\nExuberant granulation is another deviation in wound healing characterized by the formation of excessive amounts of granulation tissue, which protrudes above the level of the surrounding skin and blocks reepithelialization, this process has been called, proud flesh.\nRarely, incisional scars or traumatic injuries may be followed by exuberant proliferation of fibroblasts and other connective tissue elements that may, in fact, recur after excision called desmoids, or aggressive fibromatoses.\n\nRobin’s Textbook of pathology 10th ed Page 93-94" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Biopsy, Body Mass Index, Cholesterol, Fatty Liver, Female, Follow-Up Studies, Genotype, Hepacivirus, Hepatitis C Antibodies, Hepatitis C, Chronic, Humans, Male, Middle Aged, Prognosis, Prospective Studies, RNA, Viral, Risk Factors, Severity of Illness Index." }, { "role": "user", "content": "Is hepatic steatosis in genotype 4 chronic hepatitis C mainly because of metabolic factors? Context: Hepatic steatosis is considered to be mostly associated with viral factors in genotype 3 and metabolic factors in genotype 1 chronic hepatitis C, while there are rather few data for genotype 4. We determined the parameters associated with steatosis in 350 chronic hepatitis C patients, focusing on genotype 4. Histological lesions were evaluated according to Ishak's classification and steatosis was semiquantitatively graded. Several patient characteristics on the biopsy day were also evaluated. Steatosis was present in 73% of patients without significant differences among genotypes. Moderate/severe steatosis was more frequent in genotype 3 than 4 (44% vs 26%, P= 0.025) and similar between genotype 4 and 1 patients. Moderate/severe steatosis was associated with body mass index (BMI) in genotype 4 (P= 0.023) and gamma-glutamyl-transpeptidase in genotype 3 patients (P= 0.044). In 150 nondiabetic patients with BMI < or =25 kg/m(2), moderate/severe steatosis was present in 15, 40, and 11% of genotype 1, 3, and 4 patients, respectively, (P= 0.005) and was independently associated only with genotype 3. In multivariate analysis, steatosis grade or moderate/severe steatosis was independently associated with higher BMI, genotype 3, and lower cholesterol." }, { "role": "assistant", "content": "Moderate or severe steatosis is significantly less frequent in genotype 4 than 3 chronic hepatitis C patients and similar between genotype 4 and 1. In nondiabetic, nonoverweight patients, moderate or severe steatosis is present in only 10-15% of genotype 4 or 1 compared with 40% of genotype 3 patients. Thus, hepatic steatosis in genotype 4 is mostly associated with metabolic factors, similar to those in genotype 1. 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": "Stryker's view is used in shoulder joint to visualise:" }, { "role": "assistant", "content": "The correct answer is Ans. Recurrent subluxation" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, RESULTS. Meshes: Adult, Antiretroviral Therapy, Highly Active, Cross-Sectional Studies, Cytokines, HIV Infections, HIV-1, Herpesvirus 2, Human, Homosexuality, Male, Humans, Male, Middle Aged, Polymerase Chain Reaction, Risk Factors, Semen, Sexual Behavior, Sexually Transmitted Diseases, Surveys and Questionnaires, Urethritis, Young Adult." }, { "role": "user", "content": "Does highly active antiretroviral therapy completely suppress HIV in semen of sexually active HIV-infected men who have sex with men? Context: Although HAART can suppress genital shedding and sexual transmission of HIV, men who have sex with men (MSM) have experienced a resurgent HIV epidemic in the HAART era. Many HIV-infected MSM continue to engage in unsafe sex, and sexually transmitted infections (STIs) or other factors may promote genital HIV shedding and transmission in this population despite HAART. In this study, we determined the prevalence of seminal HIV shedding in HIV-infected MSM on stable HAART, and its relationship with a number of clinical, behavioral and biological variables. Sexually active HIV-infected men using HAART were recruited from an MSM health clinic to provide semen and blood samples. HIV levels were assessed in paired semen and blood samples by PCR. Clinical and behavioral data were obtained from medical records and questionnaires. Herpes simplex virus 2 (HSV-2) serostatus, seminal HSV-2 DNA, and markers of genital inflammation were measured using standard laboratory methods. Overall, HIV-1 was detected in 18 of 101 (18%) blood and 30 of 101 (30%) semen samples. Of 83 men with undetectable HIV in blood plasma, 25% had HIV in semen with copy numbers ranging from 80 to 2560. Multivariate analysis identified STI/urethritis (P = 0.003), tumor necrosis factor α (P = 0.0003), and unprotected insertive anal sex with an HIV-infected partner (P = 0.007) as independent predictors of seminal HIV detection." }, { "role": "assistant", "content": "STIs and genital inflammation can partially override the suppressive effect of HAART on seminal HIV shedding in sexually active HIV-infected MSM. Low seminal HIV titers could potentially pose a transmission risk in MSM, who are highly susceptible to HIV infection. 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, Arthritis, Experimental, Capillary Permeability, Cell Movement, Dexamethasone, Eicosanoids, Indomethacin, Interleukin-1, Joints, Leukocyte Count, Leukocytes, Methotrexate, Neutrophils, Prostaglandins, Rabbits, Sodium Chloride, Synovial Fluid, Synovial Membrane." }, { "role": "user", "content": "Does low dose methotrexate decrease intraarticular prostaglandin and interleukin 1 levels in antigen induced arthritis in rabbits? Context: To investigate the effects of methotrexate (MTX) on inflammation variables of antigen induced arthritis (AIA) in rabbits, such as protein leakage to the articular cavity, synovial fluid (SF) leukocyte count, synovial membrane polymorphonuclear (PMN) cell infiltrate, and intraarticular production of eicosanoids and interleukin 1 (IL-1). Dexamethasone and indomethacin were used for comparison. NZW rabbits were treated with the following drugs: MTX (0.25 mg/kg), dexamethasone (0.15 mg/kg), indomethacin (4 mg/kg), and sterile saline (control group). All drugs were given by intramuscular route before arthritis was induced and the animals were sacrificed 4 or 24 h later. Leukocyte migration, protein leakage (Evans blue method), synovium PMN cell infiltrate, and intraarticular concentration of prostaglandin E2 (PGE2), thromboxane B2 (TXB2), leukotriene B4 (LTB4) (radioimmunoassay), and IL-1 beta (ELISA) were quantified in SF. Significant reduction of leukocyte migration and protein leakage was observed in the joint fluid of all treated animals. Decrease in the intensity of synovium PMN cell infiltrate also occurred with all treatments. Intraarticular PGE2, TXB2, and IL-1 beta were significantly reduced after 4 h of arthritis induction in animals treated with MTX and dexamethasone. Treatment with indomethacin reduced only PGE2 and TXB2 in SF. Treatments did not change SF IL-1 beta concentration 24 h after arthritis induction. Treatment with dexamethasone increased inflammatory variables and SF LTB4 concentration 24 h after the synovial cavity was challenged with antigen." }, { "role": "assistant", "content": "Our results show that MTX, like dexamethasone, reduces the intensity of leukocyte afflux, protein leakage, synovial membrane PMN cell infiltrate, as well as the intraarticular production of PGE2, TXB2, and IL-1 beta in the early phase of antigen induced arthritis in rabbits. 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": "Postmortem lividity does not occur in -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'b' i.e., Drowning in a fast flowing river o Postmortem lividity does not develop in drowning in running water (due to constantly changing position of body) and areas of contact flattening (due to collapsed capillaries)o Postmortem staining has so many synomyms, i.e. livor mortis/post mortem lividity/hypostasis/cadaveric lividity/ vibices/suggilation/darkening of death.o It refers to discoloration of skin and internal organs after death due to accumulation of fluid blood in toneless capillaries and small veins of dependent part of the body.o As dead body behaves like an inert substance, therefore there is gravitational flow of blood to the dependent parts of body, causing stagnation of blood in toneless capillaries and small veins, causing bluish purple staining of these parts.o Characteristic features of postmortem staining are:1. It does not appear elevated above the surface but has sharply defined (usually horizontal) margins.2. It is an early sign of death. It starts at about 1 hour, becomes a series of mottled patches within 1-3 hours and these pathces increase in size to coalesce in about 3-6 hours. After 6-12 hours, lividity is fully developed and fixed (unchangeable), i.e. primary lividity. It ends when purification sets in. Fixation of lividity is due to stagnation of blood in distended capillaries and venules (not due to coagulation of blood).3. If the position of body is changed, after development of lividity but before it becomes fixed, these patches will disappear and fresh ones will develop in the new dependent areas (secondary lividity), but lividity to a slight degree will remain in the original area due to staining of tissue by hemolysis (complete).4. Normally the staining is at first bluish-pink and afterwards bluish purple. In severe anemia, and death from haemorrhage, the staining is very faint. In deaths from asphyxia, where blood is deoxygenated and may not readily coagulate, the staining is intensely developed and purple in colour. In conditions where blood coagulates quickly eg. in lobar pneumonia lividity is less abvious.5. It is seen on dependent parts of the body, therefore site depends upon position of body after death:i) In supine: On posterior dependent portion of body. But not seen on back of shoulder blades, buttocks and back of calves due to contact flattening, i.e. toneless capillaries are compressed and occluded by weight and pressure of body.ii) In hanging: Dependent lower half of both lower limb and upper limb (i.e. lower half of leg with feet and lower half of forearm with hands), and external genitalia.iii) In drowning: Head and upper half of body as head being the heaviest part becomes the dependent part. It does not develop in running water due to constantly changing position of the body.6. No lividity is seen on pressure points of body, i.e. contact pallor, as pressure caused by weight of body causes compression of toneless vessels and prevent their filling with blood:i) In supine: No lividity is seen on back of shoulder blades, buttocks, occipital area and calf - contact flattening.ii) Also no lividity occurs in parts tightly tied with belt, waist band or brassiere and the area is seen as stripes or bands called vibices." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Cell Differentiation, DNA-Binding Proteins, Fluorescent Antibody Technique, Indirect, Homeodomain Proteins, Leucine Zippers, Mice, Mice, Mutant Strains, Microphthalmia-Associated Transcription Factor, Microphthalmos, Nerve Tissue Proteins, Otx Transcription Factors, Photoreceptor Cells, Vertebrate, Pigment Epithelium of Eye, Retina, Retinal Degeneration, Trans-Activators, Transcription Factors." }, { "role": "user", "content": "Does dorsal retinal pigment epithelium differentiate as neural retina in the microphthalmia ( mi/mi ) mouse? Context: Microphthalmia, a bHLH-zip transcription factor associated with the onset and maintenance of pigmentation, identifies the retinal pigment epithelial (RPE) compartment during optic vesicle and optic cup development. To determine a role for microphthalmia (mi) during eye development, the effects of an mi loss of function mutation on RPE and neural retinal were investigated in the mi/mi mouse. A series of embryonic and postnatal mi/mi and wild-type eyes were sectioned and labeled with neural retina- and RPE cell type-specific antibodies. Photoreceptor loss was quantified by counting the number of photoreceptor nuclei spanning the outer nuclear layer throughout postnatal retinal development. Early neural retinal differentiation is not affected in the mi/mi mouse. The mi/mi ventral retinal pigment epithelial layer begins to develop normally, but does not pigment or attain a differentiated cuboidal morphology. The dorsal region of mi/mi retinal pigment epithelium expands and forms an ectopic retina, which develops all major retinal cell types along a similar time course as the wild type. After birth, mi/mi photoreceptors begin to form rosettes, outer segments fail to elongate, and over an extended time period, the retina degenerates." }, { "role": "assistant", "content": "Together these results suggest that early retinal development can proceed normally in the mi/mi mutant, but later retinal histogenesis is dependent on the presence of a differentiated retinal pigment epithelium. Most importantly, loss of mi function permits a change in cell fate from RPE to retina in the dorsal eye. 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, Catechin, Diet, Diet, High-Fat, Dietary Sucrose, Feces, Female, Gastrointestinal Microbiome, Grape Seed Extract, Proanthocyanidins, Rats, Rats, Inbred WKY, Vitis." }, { "role": "user", "content": "Does a high-fat high-sucrose diet affect the long-term metabolic fate of grape proanthocyanidins in rats? Context: Polyphenol metabolites are key mediators of the biological activities of polyphenols. This study aimed to evaluate the long-term effects of a high-fat high-sucrose (HFHS) diet on the metabolism of proanthocyanidins from grape seed extract (GSE). Adult female Wistar-Kyoto rats were fed a standard (STD) or HFHS diet supplemented or not with GSE for 16 weeks. PA metabolites were determined by targeted HPLC-MS/MS analysis. A lower concentration of total microbial-derived PA metabolites was present in urine and the aqueous fraction of faeces in the HFHS + GSE group than in the STD + GSE group. In contrast, a tendency towards the formation of conjugated (epi)catechin metabolites in the HFHS + GSE group was observed." }, { "role": "assistant", "content": "These results show that a HFHS diet significantly modifies PA metabolism, probably via: (1) a shift in microbial communities not counteracted by the polyphenols themselves; and (2) an up-regulation of hepatic enzymes. 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: Action Potentials, Animals, Chromans, Cnidarian Venoms, Delayed Rectifier Potassium Channels, Dose-Response Relationship, Drug, Drug Synergism, Electrocardiography, Electrophysiology, Forecasting, Long QT Syndrome, Male, Piperidines, Potassium Channels, Voltage-Gated, Pyridines, Rabbits, Sodium Channels, Sulfonamides, Torsades de Pointes." }, { "role": "user", "content": "Is potentiation of E-4031-induced torsade de pointes by HMR1556 or ATX-II predicted by action potential short-term variability or triangulation? Context: Torsade de pointes (TdP) can be induced by a reduction in cardiac repolarizing capacity. The aim of this study was to assess whether IKs blockade or enhancement of INa could potentiate TdP induced by IKr blockade and to investigate whether short-term variability (STV) or triangulation of action potentials preceded TdP. Experiments were performed in open-chest, pentobarbital-anaesthetized, alpha 1-adrenoceptor-stimulated, male New Zealand White rabbits, which received three consecutive i.v. infusions of either the IKr blocker E-4031 (1, 3 and 10 nmol kg(-1) min(-1)), the IKs blocker HMR1556 (25, 75 and 250 nmol kg(-1) min(-1)) or E-4031 and HMR1556 combined. In a second study rabbits received either the same doses of E-4031, the INa enhancer, ATX-II (0.4, 1.2 and 4.0 nmol kg(-1)) or both of these drugs. ECGs and epicardial monophasic action potentials were recorded. HMR1556 alone did not cause TdP but increased E-4031-induced TdP from 25 to 80%. ATX-II alone caused TdP in 38% of rabbits, as did E-4031; 75% of rabbits receiving both drugs had TdP. QT intervals were prolonged by all drugs but the extent of QT prolongation was not related to the occurrence of TdP. No changes in STV were detected and triangulation was only increased after TdP occurred." }, { "role": "assistant", "content": "Giving modulators of ion channels in combination substantially increased TdP but, in this model, neither STV nor triangulation of action potentials could predict TdP. 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: Anti-HIV Agents, Drug Therapy, Combination, Female, HIV Infections, HIV-1, Humans, Male, Prospective Studies, Psychomotor Disorders." }, { "role": "user", "content": "Is hAART neuroprophylactic in HIV-1 infection? Context: To find out about the prophylactic value of antiretroviral therapy on HIV-1-associated subclinical and clinical psychomotor slowing as one marker of HIV-1-associated CNS disease. Prospective study with regular clinical and neurophysiologic examination every three months of 1482 consecutive HIV-1-seropositive and AIDS patients seen at our department till June 30, 1999. Antiretroviral therapy has a significant prophylactic value over an individual observation period of ten years with regard to the first, potentially transient manifestation of HIV-1-associated subclinical psychomotor slowing and with regard to the clinical manifestation of motor signs. However, a subgroup of patients is characterized through a second, more sustained manifestation of subclinical psychomotor slowing which cannot be prevented by any type of currently available antiretroviral therapy." }, { "role": "assistant", "content": "These findings suggest the existence of different pathomechanisms underlying HIV-1-associated brain disease which may in part be effectively prevented, but which in part also escape all antiretroviral treatment strategies in use today. 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 is the most essential fatty acid?" }, { "role": "assistant", "content": "The correct answer is Most essential fatty acid is Linoleic acid (18-C, 2 double bonds). Linoleic acid Precursor of omega-6. Synthesize : Gamma Linolenic acid Arachidonic acid. Polyunsaturated fatty acids / Essential Fatty Acids (EFA) Cannot be synthesized in body. Enzymes that can introduce double bonds beyond 9th carbonare absent in humans. 2 essential fatty acids in diet - Linoleic and a-Linolenic acid. Most Essential Fatty Acid- Linoleic acid (because it can synthesize Arachidonic acid)." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, HYPOTHESIS, STUDY DESIGN, METHODS, RESULTS. Meshes: Anterior Cruciate Ligament, Female, Femur, Humans, Knee Joint, Linear Models, Male, Middle Aged, Rotation, Sex Factors, Stress, Mechanical." }, { "role": "user", "content": "Does limited internal femoral rotation increase peak anterior cruciate ligament strain during a simulated pivot landing? Context: Many factors contributing to anterior cruciate ligament (ACL) injury risk have been investigated. Recently, some ACL-injured individuals have presented with a decreased range of hip internal rotation compared with controls. The pathomechanics of why decreased hip range of motion increases risk of ACL injury have not yet been studied. Peak relative strain of the anteromedial bundle of the ACL (AM-ACL) during a simulated single-leg pivot landing is inversely related to the available range of internal femoral rotation. Controlled laboratory study. A series of pivot landings were simulated in 10 female and 10 male human knee specimens with a testing apparatus that applied a 2-bodyweight impulsive load, inducing knee compression, flexion moment, and internal tibial torque. The range of internal femoral rotation was (1) locked at ~0°, (2) limited with a hard stop to ~7°, (3) limited with a hard stop to ~11°, or (4) free, with rotation resisted by 2 springs to simulate the resistance of the active hip rotator muscles to stretch. The AM-ACL strain was quantified with a differential variable reluctance transducer. A linear mixed model was used to determine whether a significant linear relation existed between peak AM-ACL relative strain and range of internal femoral rotation. Peak AM-ACL relative strain was inversely related to the available range of internal femoral rotation (R (2) = 0.91; P<.001), with strain increasing 1.3% for every 10° decrease in rotation; this represented a 20% increase in peak relative strain, given an average range of femoral rotation of 15° upon landing in healthy athletes." }, { "role": "assistant", "content": "Peak AM-ACL relative strain was inversely proportional to the available range of internal femoral rotation during simulated single-leg pivot landings." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: ATP Binding Cassette Transporter, Subfamily B, ATP Binding Cassette Transporter, Subfamily B, Member 1, Antigens, CD34, Child, Cohort Studies, Female, Humans, Immunophenotyping, Male, Multidrug Resistance-Associated Proteins, Precursor T-Cell Lymphoblastic Leukemia-Lymphoma, Prognosis, RNA, Messenger, RNA, Neoplasm, Retrospective Studies, Reverse Transcriptase Polymerase Chain Reaction, Survival Rate, Vault Ribonucleoprotein Particles." }, { "role": "user", "content": "Is cD34 expression associated with poor survival in pediatric T-cell acute lymphoblastic leukemia? Context: Children with T-lineage acute lymphoblastic leukemia (T-ALL) have an inferior outcome with combination chemotherapy compared to B-lineage ALL, and still about 30% of the patients relapse within the first 2 years following diagnosis. As CD34 has been related with poor outcome in ALL in general, we investigated the prognostic significance of the stem cell marker CD34, as well as the association of CD34 positivity with the expression of several multidrug resistance (MDR) genes. In this retrospective study, we investigated the prognostic significance of the expression of the early T-cell differentiation marker CD34 and the expression of MDR genes in relation to outcome in a cohort of 72 newly diagnosed pediatric T-ALL patients. CD34 expression was related to a poor 5-year disease-free-survival and a poor 5-year overall survival. Using the Cox proportional hazard model, CD34 expression predicted for increased risk for relapse and death. Expression of CD34 was associated with elevated MDR1 and MRP1 mRNA expression levels. For the entire T-ALL cohort, these expression levels of MDR1 or MRP1 did not independently predict for poor outcome." }, { "role": "assistant", "content": "We conclude that CD34-positive T-ALL has a relatively poor survival that is not explained by the mRNA expression levels of MDR1, LRP, or MRP1. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Decision Making, Emergency Medicine, Fellowships and Scholarships, Female, Humans, Length of Stay, Male, Middle Aged, Outcome and Process Assessment (Health Care), Patient Care Team, Physician's Role, Retrospective Studies, Trauma Severity Indices, Traumatology, Workforce, Wounds and Injuries." }, { "role": "user", "content": "Is emergency traumatologists as partners in trauma care : the future now? Context: Decreasing manpower available to care for trauma patients both in and out of the ICU has led to a number of proposed solutions, including increasing involvement of emergency medicine-trained physicians in the care of these patients. We performed a descriptive comparative study in an effort to define the role of fellowship-trained emergency medicine physicians as full-time traumatologists. We performed a retrospective review of concurrent and prospectively collected data comparing process of care and outcomes for the resuscitative phase of trauma patients cared for by full-time fellowship-trained trauma surgeons (TS), a fellowship-trained emergency medicine physician (ET), and a first-year fellowship-trained trauma surgeon (TS1). Patient age, Revised Trauma Score, and Injury Severity Score were similar between groups. Process of care, defined by transfusion of uncrossmatched blood, prevalence of hypotension in patients receiving uncrossmatched blood, time spent in the emergency department, frequency of ICU admission, severity of injury for ICU admission, and time between emergency department and operating room for patients requiring surgery, was equivalent between groups. Outcomes evaluated by mortality and length of stay in the hospital and ICU did not differ between groups, and provider group was not predictive of mortality in stepwise logistic regression." }, { "role": "assistant", "content": "These data suggest that emergency traumatologists can provide trauma care effectively within a defined scope of practice and may provide an effective solution to manpower issues confronting trauma centers. 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 is usually a presentation of the condition shown in the immunofluorescence study of the kidney?" }, { "role": "assistant", "content": "The correct answer is The above shown immunofluorescence study is of MGN(Membranous Glomerulonephritis) It is associated with Renal vein thrombosis, CT disorder, Malignancy, Hep B & C infection Steroid responsive selective Proteinuria is a feature of Minimal change disease Nephelometer showing | Serum free light chain is feature of Multiple Myeloma. Fibrillary immunotactoid glomerulopathy is seen in non-amyloid fibril deposition is Associated with CLL." } ]

[ { "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": "Following are the adverse effects of estrogens except" }, { "role": "assistant", "content": "The correct answer is Adverse effects of estrogen are suppression of libido, gynecomastia in males, a fusion of epiphyses, increased risk of breast and endometrial cancer, migraine, liver disorders, gall stones etc Hot flushes occur due to estrogen deficiency (Ref. Essentials of medical pharmacology TD Tripathi 7th edition page no.309)" } ]

[ { "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": "Trigmenial nerve has how many nuclei in CNS:" }, { "role": "assistant", "content": "The correct answer is B i.e. FourTrigeminal nerve has 4 nucleiQ which are main sensory nucleus (carrying sensation from face & anterior scalp)Q, motor nucleus (supplying muscles of mastication, tensor tympani /palatini, mylohyoid & digastric anterior belly), mesencephalic nucleus and spinal nucleus (extending in medulla oblongata & spinal cord upto C2 segment)Q." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Accommodation, Ocular, Adult, Aged, Aged, 80 and over, Analysis of Variance, Artificial Organs, Case-Control Studies, Cornea, Corneal Diseases, Depth Perception, Female, Humans, Lens Implantation, Intraocular, Male, Middle Aged, Prostheses and Implants, Refractive Errors, Visual Acuity." }, { "role": "user", "content": "Does the Boston keratoprosthesis provide a wide depth of focus? Context: To measure the through-focus curve for eyes implanted with a type 1 Boston keratoprosthesis (KPro) and compare it to that of pseudophakic controls with fixed pupil sizes. The results should assist in evaluating postoperative visual quality after surgery. They should also help to determine the necessary KPro inventories in terms of refractive power steps. Autorefraction and manifest refraction were performed on all eyes. The monocular through-focus acuity curve was plotted in reference to the best-corrected visual acuity by spectacle plane defocus ranging from +5.00 to -5.00 dioptres in 0.50 dioptre increments. These measurements were obtained on KPro-implanted eyes, pseudophakic eyes as controls, and on the same control eyes after fixing the pupil diameter to 3 and 2 mm using black painted iris contact lenses. Ten KPro eyes and five control eyes were included. Good agreement was noted between the subjective refractions and autorefraction in KPro eyes. The average through-focus curve for the control eyes was significantly steeper than that of the KPro curve, but became comparable after fixing the control pupil to 2 and 3 mm." }, { "role": "assistant", "content": "The KPro's wide depth-of-focus makes the visual acuity less dependent on an exact refractive correction at distance and explains the 'pseudoaccomodation' experienced by these patients. This is primarily due to the small pupil diameter of the KPro. The current manufacturing steps in 0.50 dioptre increments appears to be sufficient. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Adult, Age Distribution, Aged, Burns, Child, Child, Preschool, Emergency Service, Hospital, England, First Aid, Hospitalization, Humans, Infant, Middle Aged, Patient Acceptance of Health Care, Referral and Consultation, Retrospective Studies, Self-Injurious Behavior, Time Factors, Young Adult." }, { "role": "user", "content": "Do a 1 year study of burn injuries in a British Emergency Department? Context: To determine the number of patients attending an Emergency Department with burns and to establish the epidemiology, management and outcome of these cases. A retrospective study of all patients attending an Emergency Department with a diagnosis of \"burn\" during 2004. Seven hundred and eighty-five patients presented with a diagnosis of burns, accounting for 1% of all attendances. Fifty-three percent of patients were male and most were young adults of working age. Scalds and flame injuries were the most common causes of injury. Only 30% of patients performed adequate first aid. The majority of burns were small and did not require admission to hospital. Assessment and documentation by the Emergency Department staff was found to be generally poor and this may reflect a lack of experience in managing burns." }, { "role": "assistant", "content": "Burns remain a relatively uncommon presenting complaint in the Emergency Department, even in a hospital accepting tertiary referrals. Most injuries are minor and are managed within the department. This study suggests that there is a role for better education of less experienced staff in the management of burns. There remains a need for public education in the prevention and first aid of burns. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, METHODS, METHODS, RESULTS. Meshes: Case-Control Studies, Child, Child, Preschool, Feeding Behavior, Female, Humans, Infant, Infant Nutritional Physiological Phenomena, Male, Nepal, Risk Factors, Vitamin A Deficiency, Xerophthalmia." }, { "role": "user", "content": "Do infant feeding practices reflect antecedent risk of xerophthalmia in Nepali children? Context: To determine the relationship between infant feeding history and risk of xerophthalmia due to vitamin A deficiency (VAD) in early childhood. A case-control study of previously xerophthalmic and non-xerophthalmic children. Rural lowland region of Nepal. One hundred and fifty-six children (aged 1-6 y old), half of whom previously had xerophthalmia due to vitamin A-deficiency, the other half matched by locale, age and the presence and age of a younger sibling (n = 102). Xerophthalmia was determined by trained ophthalmic assistants on the basic of current Bitot's spots, corneal xerosis or report of night blindness. Infant feeding history was collected through a diet history method obtained from the mother of the focus child. Exploratory factor analysis was conducted to determine the presence of underlying patterns in infant feeding practices. Conditional logistic regression was used to estimate odds ratios. Mothers of control children tended to have a higher level of education (P < 0.10) and to have fewer children who had died (P < 0.10) than mothers of case children. Feeding of meat (OR = 0.09, CI = 0.01-0.70) or fish (OR = 0.41, CI = 0.17-0.99) with liver, eggs (OR = 0.11, CI = 0.01-0.88) and mango (OR = 0.28, CI = 0.13-0.60) were protective in association with xerophthalmia in early childhood. Factor analysis uncovered several distinct patterns in infant feeding, which varied by age of the infant. Only the 'animal flesh' feeding pattern (factor), practiced in the second year of life, proved significantly protective from xerophthalmia (OR = 0.43, CI = 0.20-0.94). Feeding patterns of younger children closely paralleled those of their older siblings with and without VAD." }, { "role": "assistant", "content": "The study supports the hypothesis that infant dietary practices can influence subsequent risk for VAD. Our findings emphasize the importance of introducing vitamin A-rich foods during weaning to reduce the risk of VAD-associated xerophthalmia in the later preschool years. 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": "Peripheral retinal degeneration is most common in case of –" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Arthroplasty, Replacement, Hip, Equipment Failure Analysis, Femur Head, Follow-Up Studies, Humans, Middle Aged, Polyethylene, Prosthesis Failure, Radiography, Reproducibility of Results, Software, Time Factors." }, { "role": "user", "content": "Is the final follow-up plain radiograph sufficient for clinical evaluation of polyethylene wear in total hip arthroplasty . A study of validity and reliability? Context: Radiostereometric analysis (RSA) is a highly accurate tool for assessment of polyethylene (PE) wear in total hip arthroplasty (THA); however, PE wear measurements in clinical studies are often limited to plain radiographs. We evaluated the agreement between PE wear measured with PolyWare software, which uses plain radiographs, and by model-based RSA, which uses stereo radiographs. Measurements of PE wear postoperatively and at final follow-up (after mean 6 years) on plain radiographs of 12 patients after cementless THA were evaluated with PolyWare software and the results were compared with those from RSA as the gold standard (Model-based RSA using elementary geometrical shape models; EGS-RSA). With PolyWare, we either used the final radiographic follow-up (PW1) only or both the postoperative follow-up and the final follow-up (PW2). The 2D mean wear measured (in mm) was 0.80, 1.07, and 0.60 for the PW2, PW1, and RSA method. 2D intra-method repeatability was similar for PW1 and RSA with limits of agreement (LOAs, in mm) of ± 0.22, and ± 0.23, respectively. 2D inter-method concurrent validity was best between PW1 and EGS-RSA with LOAs of ± 0.55. For 2D linear wear measurements, the PW1 method had a clinical repeatability similar to that of RSA." }, { "role": "assistant", "content": "PW1 is sufficient for retrospective determination of 2D wear from medium-term wear measurements above 0.5 mm, It alleviates the need for baseline plain radiographs, has a clinical precision similar to that of RSA, and is easy and inexpensive to use. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Does tolcapone addition improve Parkinson 's disease associated nonmotor symptoms? Context: Addition of catechol-O-methyltransferase inhibitors to a conventional levodopa/dopadecarboxylase inhibitor regimen improves motor symptoms in patients with Parkinson's disease. Optimizing dopamine substitution is also beneficial for nonmotor features. To investigate the efficacy of supplemental tolcapone intake on nonmotor symptoms. A total of 125 levodopa-treated patients additionally took tolcapone in this observational trial. Initially and following 4 weeks of tolcapone intake, the neurologist scored with Unified Parkinson's Disease Rating Scale parts I, II, IV, the nonmotor symptoms scale for Parkinson's disease and recorded the off time. The patients rated themselves with the EuroQuol, its visual analogue scale and the nonmotor screening questionnaire. Caregivers reported the daily duration of care giving. All scores improved except for Unified Parkinson's Disease Rating Scale part IV and domains 4, 5 and 8 of the nonmotor symptoms scale for Parkinson's disease." }, { "role": "assistant", "content": "This trial demonstrates that tolcapone addition may improve nonmotor features. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Kartagener's syndrome includes -" }, { "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: ." }, { "role": "user", "content": "Do testosterone and gonadotropins but not SHBG vary with CKD stages in young and middle aged men? Context: The aim of this study was to assess the effects chronic kidney disease (CKD) had on sex hormones and lipids in a subgroup of men between 18 and 50 years old with CKD 1-5 stage without diabetes and not treated with hemodialysis. Data were collected from 101 men with different CKD stages. Higher CKD stage (lower function) had a significant negative linear trend on total testosterone level (p < 0.01) and free testosterone level (p < 0.01), with a significant increase of luteinizing hormone (LH) (p < 0.01), and prolactin (p < 0.01), while SHBG remained unchanged between the CKD stages. Triglycerides but not total cholesterol, HDL -cholesterol or LDL-cholesterol increased with higher CKD stage. A negative correlation was observed between BMI, SHBG and free testosterone (p < 0.01 for both) but not with other sex hormones. Age per se was related to a significant decrease of total and free testosterone level (p < 0.01 for both) even after correction for BMI. Decreased levels of total testosterone and estimated free testosterone levels had a significant correlation with an increased level of triglyceride levels (p <0.01)." }, { "role": "assistant", "content": "Our results indicate that CKD stage per se is a factor affecting testosterone levels in combination with age in men between 18 and 50 years old with CKD 1-5 stage, not treated with hemodialysis. With increased CKD stage there was a significant increase in LH level and a pattern of hypergonadotropic hypogonadism. SHBG remained unchanged between the CKD stages. 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: AMP Deaminase, Alleles, Biopsy, DNA Mutational Analysis, Electrophysiology, Female, Gene Frequency, Genotype, Humans, Male, Muscle, Skeletal, Neuromuscular Diseases, Phenotype." }, { "role": "user", "content": "Is aMP deaminase deficiency in skeletal muscle unlikely to be of clinical relevance? Context: The homozygous c.34C>T mutation in the AMPD1 gene encoding the muscle-specific isoform of AMP deaminase (AMPD) accounts for the vast majority of inherited skeletal muscle AMPD deficiencies. It is controversial (i) whether AMPD deficiency is associated with exercise-induced complaints and (ii) whether an acquired form exists in which an underlying neuromuscular disorder additionally lowers the AMPD activity. c.34C>T mutation (homozygous- TT, heterozygous-CT,wildtype-CC) was screened in 107 healthy blood donors and 294 patients with skeletal muscle biopsy including 200 with exercise-induced complaints. Additional screening for c.468G > T and c.860A > T mutations was performed in all CT.AMPD was analysed histochemically and biochemically. The mutant allele frequency (MAF) was not different in blood donors, patients with muscle biopsy, and the subgroup with exercise-induced complaints (12.9-16.8 %). CT was found in 63 and TT in 13 patients. The c.468G>T mutation was not detected. The c.860A > T mutation was found in 2.8 % blood donors and 1.6% CT. AMPD activities showed a substantial overlap in CC and CT, but not with TT. AMPD activities in TT, CT, and CC did not differ in patients with a defined neuromuscular disorder and those with only exercise-induced complaints. In TT, CT, and CC there were no differences in the frequency of signs and symptoms, hyperCKemia, or myopathological biopsy pattern." }, { "role": "assistant", "content": "MAF did not differ in normal and diseased populations. The frequency of exertion-induced complaints was not higher in TT than CC. There was no specific phenotype of TT and no evidence for an acquired form of AMPD deficiency. 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, Asian Americans, Blood Glucose, Blood Glucose Self-Monitoring, Body Mass Index, California, Cohort Studies, Diabetes Mellitus, Type 2, Educational Status, Estrogen Replacement Therapy, Ethnic Groups, Exercise, Female, Glycated Hemoglobin A, Health Maintenance Organizations, Hispanic Americans, Humans, Medical Records, Middle Aged, Registries, Smoking." }, { "role": "user", "content": "Is hormone replacement therapy associated with better glycemic control in women with type 2 diabetes : The Northern California Kaiser Permanente Diabetes Registry? Context: In women with diabetes, the changes that accompany menopause may further diminish glycemic control. Little is known about how hormone replacement therapy (HRT) affects glucose metabolism in diabetes. The aim of this study was to examine whether HbA(1c) levels varied by current HRT among women with type 2 diabetes. In a cohort of 15,435 women with type 2 diabetes who were members of a health maintenance organization, HbA(1c) and HRT were assessed by reviewing records in the health plan's computerized laboratory and pharmacy systems. Sociodemographic and clinical information were collected by survey. The mean age was 64.7 years (SD +/- 8.7). The study cohort comprised 55% non-Hispanic whites, 14% non-Hispanic blacks, 12% Hispanics, 11% Asians, 4% \"other\" ethnic groups, and 4% with missing ethnicity data. Current HRT was observed in 25% of women. HbA(1c) levels were significantly lower in women currently using HRT than in women not using HRT (age-adjusted mean +/- SE: 7.9 +/- 0.03 vs. 8.5 +/- 0.02, respectively, P = 0.0001). No differences in HbA(1c) level were observed between women using unopposed estrogens and women using opposed estrogens. In a Generalized Estimating Equation model, which took into account patient clustering within physician and adjusted for age, ethnicity, education, obesity, hypoglycemic therapy, diabetes duration, self-monitoring of blood glucose, and exercise, HRT remained significantly and independently associated with decreased HbA(1c) levels (P = 0.0001)." }, { "role": "assistant", "content": "HRT was independently associated with decreased HbA(1c) level. Clinical trials will be necessary to understand whether HRT may improve glycemic control in women with diabetes. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "The primary function of access openings is to" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Animals, Europe, Population Surveillance, Prevalence, Scrapie, Sheep, Surveys and Questionnaires." }, { "role": "user", "content": "Is the prevalence of atypical scrapie in sheep from positive flocks higher than in the general sheep population in 11 European countries? Context: During the last decade, active surveillance for transmissible spongiform encephalopathies in small ruminants has been intensive in Europe. In many countries this has led to the detection of cases of atypical scrapie which, unlike classical scrapie, might not be contagious. EU legislation requires, that following detection of a scrapie case, control measures including further testing take place in affected flocks, including the culling of genotype susceptible to classical scrapie. This might result in the detection of additional cases. The aim of this study was to investigate the occurrence of additional cases in flocks affected by atypical scrapie using surveillance data collected in Europe in order to ascertain whether atypical scrapie, is contagious. Questionnaires were used to collect, at national level, the results of active surveillance and testing associated with flock outbreaks in 12 European countries. The mean prevalence of atypical scrapie was 5.5 (5.0-6.0) cases per ten thousand in abattoir surveillance and 8.1 (7.3-9.0) cases per ten thousand in fallen stock. By using meta-analysis, on 11 out of the 12 countries, we found that the probability of detecting additional cases of atypical scrapie in positive flocks was similar to the probability observed in animals slaughtered for human consumption (odds ratio, OR = 1.07, CI95%: 0.70-1.63) or among fallen stock (OR = 0.78, CI95%: 0.51-1.2). In contrast, when comparing the two scrapie types, the probability of detecting additional cases in classical scrapie positive flocks was significantly higher than the probability of detecting additional cases in atypical scrapie positive flocks (OR = 32.4, CI95%: 20.7-50.7)." }, { "role": "assistant", "content": "These results suggest that atypical scrapie is not contagious or has a very low transmissibility under natural conditions compared with classical scrapie. Furthermore this study stressed the importance of standardised data collection to make good use of the analyses undertaken by European countries in their efforts to control atypical and classical scrapie. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All of the following are autoimmune diseases, EXCEPT:" }, { "role": "assistant", "content": "The correct answer is Sickle cell diease is not an autoimmune disease. Sickle Cell Disease is a structural hemoglobinopathy caused by a mutation in the f3-globin gene that changes the sixth ammoacid from glutamic acid to valine (HBS a2 B2 6Glu?Val), The mode of inheritance is autosomal recessive. Ref: Harrison 16th Edition, Page 678 ; Robbins Pathologic basis of disease 6th Edition, Page 611." } ]

[ { "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 extra intestinal manifestation of amoebiasisis" }, { "role": "assistant", "content": "The correct answer is Ans. is 'a' i.e., Amoebic liver abscess * Amoebic Ever abscess is the most common extraintestinal manifestation of amebiasis. Disease begins when E. histolytica trophozoites penetrate through the colonic mucosa, travel through the portal circulation, and reach the liver.* Most individuals with amebic liver abscess do not have concurrent signs or symptoms of colitis, and most do not have E. histolytica trophozoites in their stools.* The classic presentations of amebic liver abscess are right-upper-quadrant pain, fever, and hepatic tenderness.* The most common laboratory findings are leukocytosis (without eosinophilia), an elevated alkaline phosphatase level, mild anemia, and an elevated erythrocyte sedimentation rate." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Actins, Animals, Antigens, Antigens, Differentiation, Biomarkers, Choroid, Choroidal Neovascularization, Desmin, Endothelium, Vascular, Female, Fluorescent Antibody Technique, Indirect, Green Fluorescent Proteins, Hematopoietic Stem Cell Transplantation, Hematopoietic Stem Cells, Indicators and Reagents, Laser Coagulation, Luminescent Proteins, Mice, Mice, Inbred C57BL, Muscle, Smooth, Vascular, Platelet Endothelial Cell Adhesion Molecule-1, Proteoglycans." }, { "role": "user", "content": "Do bone marrow-derived progenitor cells contribute to experimental choroidal neovascularization? Context: The pathogenesis of choroidal neovascularization (CNV) is postulated to be driven by angiogenesis, a process in which the cellular components of the new vessel complex are derived from cells resident within an adjacent preexisting capillary. Recently, an alternative paradigm, termed postnatal vasculogenesis, has been shown to contribute to some forms of neovascularization. In vasculogenesis, the cellular components of the new vessel complex are derived from circulating vascular progenitors from bone marrow. In the current study, transplantation of green fluorescent protein (GFP)-labeled bone marrow and laser-induced CNV were combined to examine the contribution of vasculogenesis to the formation of CNV. Ten adult C57BL/6 female mice were used as recipients for bone marrow transplantation. Bone marrow was obtained from three C57BL/6 female mice transgenic for the beta-actin promoter GFP. One month after bone marrow transplantation, CNV was induced in recipient mice by making four separate burns in the choroid of each eye with a red diode laser. Four weeks after CNV was induced, eyes of recipient mice were processed for immunohistochemistry to detect GFP and markers for vascular smooth muscle cells (alpha-smooth muscle actin, desmin, and NG2 chondroitin sulfate proteoglycan), endothelial cells (CD31, BS-1 lectin), or macrophages (F4/80). GFP-labeled cells represented 17% of the total cell population in the lesion. Many of the GFP-labeled cells were immunoreactive for alpha-smooth muscle actin (39%), desmin, NG2, CD31 (41%), BS-1 lectin, or F4/80. GFP-labeled cells were morphologically indistinguishable from cells normally present in CNV lesions." }, { "role": "assistant", "content": "This study is the first to demonstrate that bone marrow-derived progenitor cells are a source of endothelial and smooth musclelike cells in CNV. 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 32-year-old woman who has been on oral contraceptive pills for 5 years, developed symptoms of depression, irritability, nervousness and mental confusion. Her hemoglobin level was 8g/dl. Biochemical investigations revealed that she was excreting highly elevated concentrations of xanthurenic acid in urine. She also showed high levels of triglycerides and cholesterol in serum. All of the above are most probably related to a vitamin B6 deficiency caused by prolonged oral contraceptive use except:" }, { "role": "assistant", "content": "The correct answer is Vit B6 deficiency will not cause increased triglyceride and cholesterol levels in serum. It is best attributed to the metabolic effects of steroidal contraceptives. Pyridoxal phosphate is a coenzyme involved in the metabolism of protein, carbohydrates and fat. In protein metabolism, Vit B6 paicipates in the decarboxylation of amino acids and the conversion of tryptophan to niacin or serotonin. Ref: Harper's Biochemistry Pages 258, 491 ; Textbook of Therapeutics: Drug and Disease Management By Richard A. Helms, David J. Quan, 2006, Page 737 ; Psychology and Schizophrenia By Janet E. Pletson, 2007, Page 110" } ]

[ { "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 5 days old, full term male infant was severely cyanotic at bih. PEE was administered initially and later balloon atrial septostomy was done which showed improvement in oxygenation. Most likely diagnosis:" }, { "role": "assistant", "content": "The correct answer is Transposition of great vessels Transposition of great aeries with an intact ventricular septum is also referred to a simple TGA or isolated TGA. * Cyanosis and tachypnea are most often recognized within hours or day one of life, hypoxemia is severe but hea failure is less common. * Transposition of great aeries with VSD - cyanosis can generally recognized within the { 'l month of life, but it may remain diagnosed in some infants for several months. Treatment - Infusion of prostaglandin E2 should be initiated immediately to maintain patency of the ductus aeriosus and improve oxygenation * Infant who remain severely hypoxic or acidotic despite prostaglandin infusion should undergo Rashkind-halloon atrial septostomy Aerial switch (Jantene) procedure is the surgical treatment of choice for neonates with d-TGA and intact ventricular septum and is usually performed within the 1-2 week of life. Truncus Aeriosus (TA) a single aerial trunk :runcus aeriosus) arises from the hea and supplies the systemic pulmonary and coronary circulation. A VSD is always present Clinical picture - In the immediate newborn period, signs of hea failure are usually absent, a murmur and minimal cyanosis are the initial signs. As a conotruneal lesion, T A is often associated with a deletion of chromosome 22q 11 (DiGeorge syndrome) and associated endocrine immunologic, facial and pulmonary abnormalities Treatment - surgery is indicated usually in the 12 weeks of life Older patients -* Hea -lung transplantation is the only options." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, B7 Antigens, Blotting, Western, Brain Neoplasms, Cell Movement, Cell Proliferation, Cytotoxicity, Immunologic, Gene Expression Regulation, Neoplastic, Glioblastoma, Humans, Immunoenzyme Techniques, Killer Cells, Natural, Mice, Mice, Nude, Neoplasm Invasiveness, Phenotype, RNA, Messenger, Real-Time Polymerase Chain Reaction, Survival Rate, Tumor Cells, Cultured." }, { "role": "user", "content": "Does costimulatory protein 4IgB7H3 drive the malignant phenotype of glioblastoma by mediating immune escape and invasiveness? Context: Recent work points out a role of B7H3, a member of the B7-family of costimulatory proteins, in conveying immunosuppression and enforced invasiveness in a variety of tumor entities. Glioblastoma is armed with effective immunosuppressive properties resulting in an impaired recognition and ineffective attack of tumor cells by the immune system. In addition, extensive and diffuse invasion of tumor cells into the surrounding brain tissue limits the efficacy of local therapies. Here, 4IgB7H3 is assessed as diagnostic and therapeutic target for glioblastoma. To characterize B7H3 in glioblastoma, we conduct analyses not only in glioma cell lines and glioma-initiating cells but also in human glioma tissue specimens. B7H3 expression by tumor and endothelial cells correlates with the grade of malignancy in gliomas and with poor survival. Both soluble 4IgB7H3 in the supernatant of glioma cells and cell-bound 4IgB7H3 are functional and suppress natural killer cell-mediated tumor cell lysis. Gene silencing showed that membrane and soluble 4IgB7H3 convey a proinvasive phenotype in glioma cells and glioma-initiating cells in vitro. These proinvasive and immunosuppressive properties were confirmed in vivo by xenografted 4IgB7H3 gene silenced glioma-initiating cells, which invaded significantly less into the surrounding brain tissue in an orthotopic model and by subcutaneously injected LN-229 cells, which were more susceptible to natural killer cell-mediated cytotoxicity than unsilenced control cells." }, { "role": "assistant", "content": "Because of its immunosuppressive and proinvasive function, 4IgB7H3 may serve as a therapeutic target in the treatment of glioblastoma. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Most common site of morgagni hernia is-" }, { "role": "assistant", "content": "The correct answer is Sites of Congenital Hernia\n-        Posterolateral costo vertebral hernia - (Foramen of Bochdalek) - Most common. More common on left side.\n-        Retrosternal - (Foramen of Morgagni) - More common on right side\n-        Posterior hernia - Failure of posterior part development of diaphragm.\n-        Central hernia - Rupture of fetal membranous diaphragm - Rare. If present, more commonly seen on left side.\n-        Through esophageal opening." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Contrast Media, Esophagitis, Esophagus, Humans, Lung Neoplasms, Radiation Injuries, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Retrospective Studies, Tomography, X-Ray Computed." }, { "role": "user", "content": "Are `` Anatomically-correct '' dosimetric parameters may be better predictors for esophageal toxicity than traditional CT-based metrics? Context: Incidental esophageal irradiation during lung cancer therapy often causes morbidity. There is interest in trying to relate esophageal dosimetric parameters to the risk of injury. These parameters typically rely on CT-defined esophageal contours, and thus systematic limitations in esophageal contouring will influence these parameters. We herein assess the ability of a correction method, based on physiologic principles, to improve the predictive power of dosimetric parameters for radiation-induced esophageal injury. Esophageal contours for 236 patients treated for lung cancer were quantitatively analyzed. All patients received three-dimensional planning, and all contours were generated by the same physician on axial CT images. Traditional dose-volume histogram (DVH)-based dosimetric parameters were extracted from the three-dimensional data set. A second set of \"anatomically correct\" dosimetric parameters was derived by adjusting the contours to reflect the known shape of the esophagus. Each patient was scored for acute and late toxicity using ROTG criteria. Univariate analysis was used to assess the predictive power of corrected and uncorrected dosimetric parameters (e.g., mean dose, V(50), and V(60)) for toxicity. The p values were taken as a measure of their significance. The univariate results indicate that both corrected and uncorrected dosimetric parameters are generally predictors for toxicity. The corrected parameters are more highly correlated (lower p value) with outcomes than the uncorrected metrics." }, { "role": "assistant", "content": "The inclusion of corrections, based on anatomic realities, to DVH-based dosimetric parameters may provide dosimetric parameters that are better correlated with clinical outcomes than are traditional DVH-based metrics. 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, Carcinoma, Female, Humans, Male, Melanoma, Middle Aged, Neoplasms, Germ Cell and Embryonal, Prognosis, Reoperation, Sarcoma, Survival Rate, Thoracic Neoplasms, Thoracic Surgical Procedures." }, { "role": "user", "content": "Does sequential thoracic metastasectomy prolong survival by re-establishing local control within the chest? Context: The value of sequential thoracic metastasectomies is unknown. We evaluate repeat metastasectomy for limited recurrences within the thorax. From July 1988 to September 1998, 54 patients underwent 2 to 6 separate sequential procedures to excise metastases after recurrence isolated to the thorax. Kaplan-Meier survival and Cox modeling determined prognostic variables. Thirty-three men and 21 women, 22 to 76 years underwent 2 (100%, n = 54), 3 (50%), 4 (22%), or 5 to 6 (11%) metastasectomies. Fifty-four percent of patients had carcinoma, 35% sarcoma, 9% germ cell, and 2% melanoma. There were no operative deaths; all late deaths occurred from cancer. Median follow-up was 48 months. Cumulative 5-year survival from the second procedure was 57%. After the second, third, fourth, and fifth procedures, respectively, permanent control was achieved in 15 (27%) of 54 patients, 5 (19%) of 27, 1 (8%) of 12, and 0 of 7. Recurrence amenable to additional surgery occurred in 27 (50%) of 54, 12 (44%) of 27, 6 (50%) of 12, and 1 (17%) of 6. Mean hazard for the development of unresectable recurrence increased from 0.21 after the second procedure to 0.91 after the fifth procedure. The 5-year survival for the 27 patients undergoing only 2 metastasectomies was 60% (median not yet reached), 33% for the 15 patients undergoing only 3 metastasectomies (median 34.7 months), and 38% for the 12 patients undergoing 4 or more (median 45.6 months). From the time a recurrence was declared unresectable, patients had a 19% 2-year survival (median 8 months)." }, { "role": "assistant", "content": "Multiple attempts to re-establish intrathoracic control of metastatic disease is justified in carefully selected patients, but the magnitude of benefit decays with each subsequent attempt. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Animals, Cell Movement, Cerebral Cortex, Chemokine CXCL12, Disease Models, Animal, Female, Forkhead Transcription Factors, Interneurons, Male, Meningocele, Mice, Mice, Inbred C57BL, Mice, Transgenic, Nervous System Malformations, Primary Cell Culture." }, { "role": "user", "content": "Do meningeal defects alter the tangential migration of cortical interneurons in Foxc1hith/hith mice? Context: Tangential migration presents the primary mode of migration of cortical interneurons translocating into the cerebral cortex from subpallial domains. This migration takes place in multiple streams with the most superficial one located in the cortical marginal zone. While a number of forebrain-expressed molecules regulating this process have emerged, it remains unclear to what extent structures outside the brain, like the forebrain meninges, are involved. We studied a unique Foxc1 hypomorph mouse model (Foxc1hith/hith) with meningeal defects and impaired tangential migration of cortical interneurons. We identified a territorial correlation between meningeal defects and disruption of interneuron migration along the adjacent marginal zone in these animals, suggesting that impaired meningeal integrity might be the primary cause for the observed migration defects. Moreover, we postulate that the meningeal factor regulating tangential migration that is affected in homozygote mutants is the chemokine Cxcl12. In addition, by using chromatin immunoprecipitation analysis, we provide evidence that the Cxcl12 gene is a direct transcriptional target of Foxc1 in the meninges. Further, we observe migration defects of a lesser degree in Cajal-Retzius cells migrating within the cortical marginal zone, indicating a less important role for Cxcl12 in their migration. Finally, the developmental migration defects observed in Foxc1hith/hith mutants do not lead to obvious differences in interneuron distribution in the adult if compared to control animals." }, { "role": "assistant", "content": "Our results suggest a critical role for the forebrain meninges to promote during development the tangential migration of cortical interneurons along the cortical marginal zone and Cxcl12 as the factor responsible for this property. 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, SAMPLE, RESULTS. Meshes: Adult, African Americans, Age Factors, Analysis of Variance, Caregivers, Child, Decision Making, Dissent and Disputes, Ethnic Groups, European Continental Ancestry Group, Female, Florida, Hispanic Americans, Humans, Logistic Models, Male, Medicaid, Parents, Professional-Family Relations, Sex Factors, Terminally Ill, United States." }, { "role": "user", "content": "Does decisional conflict differ across race and ethnicity groups? Context: Children with life-threatening illnesses and their families may face a myriad of medical decisions in their lifetimes. Oftentimes these complicated medical decisions cause disagreements among patients, families, and providers about what is the best course of action. Although no evidence exists, it is possible that conflict may affect subgroups of the population differently. This study aims to investigate how decisional conflict varies among racial and ethnic subgroups. Two hundred sixty-six surveys were completed with parents whose children have a life-threatening illness. All children lived in Florida and were enrolled in the Medicaid program. The Decisional Conflict Scale, overall and broken down into its five distinct subscales, was used to assess parental decision-making. Descriptive, bivariate, and multivariate analyses were conducted. Subgroup analyses were conducted on Latino respondents. Our bivariate results suggest that minority parents report less Effective Decision Making (p<0.05) and report less Support in Decision Making (p<0.05) compared to white, non-Hispanic parents. For the subgroup analysis, we found that those who identify as Mexican American and Central/South American report having greater Uncertainty in Choosing Options (p<0.05) and less Values Clarity (p<0.05) as compared to Puerto Rican or Cuban Americans. Results from the multivariate analyses suggest that those whose primary language is not English are associated with greater Uncertainty in Choosing Options (p<0.05). Values Clarity was lower for children who were diagnosed with their life-threatening condition at birth (p<0.05) as compared to children diagnosed at a later time." }, { "role": "assistant", "content": "Our study is the first to describe racial and ethnic differences in decisional conflict of parents of children with life-threatening illnesses. Significant differences exist by race, ethnicity, language spoken, and diagnosis time across several subdomains of decisional conflict. These differences are important to address when creating clinical care plans, engaging in shared decision-making, and creating interventions to alleviate decisional conflict." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Case-Control Studies, Endoscopy, Enzyme-Linked Immunosorbent Assay, Female, Gastritis, Atrophic, Gene Expression Regulation, Neoplastic, Helicobacter Infections, Helicobacter pylori, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasm Metastasis, Odds Ratio, Pepsinogen C, Risk Factors, Stomach Neoplasms." }, { "role": "user", "content": "Is serum pepsinogen II a better diagnostic marker in gastric cancer? Context: To investigate screening makers for gastric cancer, we assessed the association between gastric cancer and serum pepsinogens (PGs). The subjects comprised 450 patients with gastric cancer, 111 individuals with gastric atrophy, and 961 healthy controls. Serum anti-Helicobacter pylori (H. pylori) immunoglobulin G (IgG), PGI and PG II were detected by enzyme-linked immunosorbent assay. Gastric atrophy and gastric cancer were diagnosed by endoscopy and histopathological examinations. Odds ratios and 95%CIs were calculated using multivariate logistic regression. Rates of H. pylori infection remained high in Northeastern China. Rates of H. pylori IgG positivity were greater in the gastric cancer and gastric atrophy groups compared to the control group (69.1% and 75.7% vs 49.7%, P < 0.001). Higher levels of PG II (15.9 μg/L and 13.9 μg/L vs 11.5 μg/L, P < 0.001) and lower PGI/PG II ratio (5.4 and 4.6 vs 8.4, P < 0.001) were found in patients with gastric cancer or gastric atrophy compared to healthy controls, whereas no correlation was found between the plasma PGI concentration and risk of gastric cancer (P = 0.537). In addition, multivariate logistic analysis indicated that H. pylori infection and atrophic gastritis were independent risk factors for gastric cancer. Lower plasma PGI/PG II ratio was associated with higher risks of atrophy and gastric cancer. Furthermore, plasma PG II level significantly correlated with H. pylori-infected gastric cancer." }, { "role": "assistant", "content": "Serum PG II concentration and PGI/PG II ratio are potential biomarkers for H. pylori-infected gastric disease. PG II is independently associated with risk of gastric cancer. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 65-year-old man is brought to the emergency department for a 1-week history of worsening shortness of breath. The symptoms occur when he climbs the stairs to his apartment on the 3rd floor and when he goes to bed. He gained 2.3 kg (5 lbs) in the past 5 days. He has a history of hypertension, hyperlipidemia, alcoholic steatosis, and osteoarthritis. He received surgical repair of a ventricular septal defect when he was 4 months old. He started taking ibuprofen for his osteoarthritis and simvastatin for his hyperlipidemia one week ago. He drinks 2–3 beers daily after work. His temperature is 37.0°C (98.6°F), his pulse is 114/min, and his blood pressure is 130/90 mmHg. Physical examination reveals jugular venous distention and 2+ pitting edema in his lower legs. On cardiac auscultation, an additional, late-diastolic heart sound is heard. Bilateral crackles are heard over the lung bases. Echocardiography shows concentric hypertrophy of the left ventricle. Which of the following is the most likely underlying cause of this patient's condition?" }, { "role": "assistant", "content": "Arterial hypertension" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Contrast Media, Energy Intake, Female, Fluoroscopy, Gastric Emptying, Humans, Male, Oxytocin, Satiation, Surveys and Questionnaires." }, { "role": "user", "content": "Does oxytocin reduce satiety scores without affecting the volume of nutrient intake or gastric emptying rate in healthy subjects? Context: Oxytocin is expressed throughout the gastrointestinal tract and is released in response to a fatty meal. Administration of an oxytocin receptor antagonist prolongs the gastric emptying rate. The aim of this study was to examine the effect of oxytocin on gastric accommodation, gastric emptying time, and satiety after food intake. Ten healthy subjects participated in a slow satiety drinking test with a liquid meal. Every 5 min the subjects scored their sensation of satiety using a visual analogue scale (VAS) until maximum satiety was reached and the amount of liquid intake was determined. Twelve subjects participated in a gastric emptying test. They were given a standardized meal containing 20 radio-opaque markers, after which fluoroscopy was performed and VAS was scored every hour. Both tests were performed four times during infusions of saline and three different oxytocin concentrations. Blood was collected for oxytocin concentration measurements. There were no differences in the volume of nutrient intake at maximum satiety between the three doses of oxytocin and saline. However, lower satiety scores at maximum satiety were seen after oxytocin infusion (P = 0.031), with 40 mU min(-1) being the most effective dosage (P = 0.013), and this was also true 30 min after finishing the meal (P = 0.032). There was no difference in gastric emptying time between saline and oxytocin. The oxytocin concentration in plasma was increased proportional to the oxytocin infusions." }, { "role": "assistant", "content": "Infusion of oxytocin reduces satiety without affecting the volume of nutrient intake or gastric emptying in healthy subjects. 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": "Test to differentiate the chromosome of normal and cancer cells:" }, { "role": "assistant", "content": "The correct answer is Ans. b. Comparative genomic hybridization (Ref: Harrison 19/e 83e-2, 83e-2, 83e-2f, 18/e p512)Comparative genomic hybridization differentiate the chromosome of normal and cancer cells.FISH comparative genomic hybridization (CGH) is a method that can be used only when DNA is available from a specimen of interestQ.The entire DNA specimen from the sample of interest is labeled in one color (e.g., green), and the normal control DNA specimen is indicated by another color (e.g., red). These are mixed in equal amounts and hybridized to normal metaphase chromosomes. The red-to-green ratio is analyzed by a computer program that determines where the DNA of interest may have gains or losses of material.Comparative genomic hybridization is used to study cryptic chromosomal imbalances in patients with mental retardation and multiple congenital anomalies, as well as in prenatal diagnosis and to detect microdeletions and microduplications in cancer and in previously unidentified genomic disordersQ.Exact location of a genetic loci is identified by Fluorescent in-situ hybridization (FISH).Fluorescent in-situ hybridization:FISH, which utilizes fluorescent rather than radioactiveiy labeled probes, is a very sensitive technique for exact location of a genetic lociQ.This often places the gene at a location on a given band or region of the chromosomeQ.Polymerase chain reaction:PCR is a cell free, test tube method used for amplifying a target sequence of DNAQ.Much faster and more sensitive than cell based cloningQPCR is used to amplify specific regions of DNA strandQ (target DNA)Chromosome painting:A technique for visualizing CHROMOSOME ABERRATIONS using fluorescently labeled DNA probes, which are hybridized to chromosomal DNA.Multiple fluorochromes may be attached to the probes.Upon hybridization, this produces a multicolored, or painted, effect with a unique color at each site of hybridizationQ.This technique may also be used to identify cross-species homology by labeling probes from one species for hybridization with chromosomes from another species.Comparative genomic hybridization:Comparative genomic hybridization differentiate the chromosome of normal and cancer cellsQ.Comparative genomic hybridization is used to study cryptic chromosomal imbalances in patients with mental retardation and multiple congenital anomalies, as well as in prenatal diagnosis and to detect microdeletions and microduplications in cancer and in previously unidentified genomic disordersQ.FISH (Fluorescent In-Situ Hybridization)The majority of FISH applications involve hybridization of one or two probes of interest as an adjunctive procedure to conventional chromosomal banding techniques.In this regard. FISH can be utilized to identify specific chromosomes, characterize de novo duplications or deletions, and clarify subtle chromosomal rearrangementsQ.Its greatest utilization in constitutional analysis, however, is in the detection of microdeletionsQ.In cancer cytogenetics, it is used extensively in the analysis of structural rearrangements.Though conventional cytogenetic studies ean detect some microdeietions, initial detection and/or confirmation with FISH is essential.In addition to metaphase FISH, cells can be analyzed at a variety of stages. Interphase analysis can be used to make a rapid diagnosis in instances when metaphase chromosome preparations are not yet available (e.g., amniotic fluid interphase analysts).One specialized type of interphase analysts involves the application of FISH to paraffin-embedded sections, thereby preserving the architecture of the tissue.The use of interphase FISH has increased recently, especially for analyses of amniocentesis samplesQ.These studies are performed on uncultured amniotic fluid, typically using DNA probes specific for the chromosomes most commonly identified in trisomies (chromosomes 13, 18, 21, and the X and Y).These studies can be performed rapidly (24-48 hours) and will ascertain about 60% of the abnormalities detected prenatally.Interphase analysts is routinely utilized is cancer cytogeneticsQ.Many site-specific translocations are associated with specific types of malignanciesQ.For example, there are probes available for both the Abelson (Abl) oncogene and breakpoint cluster region (ber) involved in chronic myelogenous leukemia (CML); these probes are labeled in red and green, respectively; the fusion of these genes in CML combines the fluorescent colors and appears as a yellow hybridization signal.Enhanced techniques for specific types of analysis:Multicolor FISH techniquesReverse paintingFiber FISHComparative genomic hybridizationSpectral karyotyping (SKY) and multicolor FISH (m-FISH) techniquesSKY and m-FISH techniques use combinatorially labeled probes that create a unique color for individual chromosomes.Useful in the identification of unknown chromosome material (such as accessory marker chromosomes containing additional material) but has been most commonly used with the complex rearrangements seen in cancer specimens.Fiber FISHFiber FISH is a technique in which chromosomes are mechanically stretched, using a variety of different methods.It provides a higher resolution of analysis than conventional FISH.FISH comparative genomic hybridization (CGH)FISH comparative genomic hybridization (CGH) is a method that can be used only when DNA is available from a specimen of interestQ.The entire DNA specimen from the sample of interest is labeled in one color (e.g.. green), and the normal control DNA specimen is indicated by another color (e.g.. red). These are mixed in equal amounts and hybridized to normal metaphase chromosomes. The red-to-green ratio is analyzed by a computer program that determines where the DNA of interest may have gains or losses of material.The major advance for examining human chromosomes is an extension of the FISH CGH technologies.Used to study cryptic chromosomal imbalances in patients with mental retardation and multiple congenital anomalies, as well as in prenatal diagnosisQ.Used to detect microdeletions and microduplications in cancer and in previously unidentified genomic disordersQ" } ]

[ { "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": "Brodie’s abscess is -" }, { "role": "assistant", "content": "The correct answer is Chronic osteomyelitis is of 3 types: \na) chronic osteomyelitis secondary to acute osteomyelitis \nb) Garre's osteomyelitis \nc) Brodie's abscess \n\nBrodies abscess is a special type of osteomyelitis in which body's defence mechanism have been able to contain infection so as to create chronic bone abscess containing pus or jelly-like granulation tissue surrounded by a zone of sclerosis. \nC/f: Common in 11-20 years Common sites upper tibia and the lower end of femur A deep boring pain is a predominant symptom. can become worse to-night. Examination reveals tenderness and thickening of bone." } ]

[ { "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 blockage of blood flow in the proximal pa of the anterior interventricular aery could deprive a large area of hea tissue of blood supply, unless a substantial retrograde flow into this aery develops an impoant anastomosis with which other aery?" }, { "role": "assistant", "content": "The correct answer is The anterior interventricular aery and posterior interventricular aery travel on the anterior and posterior surfaces of the interventricular groove. These two vessels often anastamose. If there was a very extensive anastomoses between the anterior and posterior interventricular aeries, it is possible that the posterior interventricular aery might supply the tissue usually fed by the anterior interventricular aery. The other aeries listed would not be able to anastamose with anterior interventricular aery; they supply other areas of the hea. Ref: Seward J.B., Malouf J.F., Edwards W.D., Tajik A. (2011). Chapter 4. Functional Anatomy of the Hea. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adolescent, Adult, Aged, Cardiomyopathy, Dilated, Female, Genetic Predisposition to Disease, Humans, Male, Middle Aged, Muscle Proteins, Mutation, Missense, Nuclear Proteins, Repressor Proteins, Signal Transduction, Up-Regulation." }, { "role": "user", "content": "Is aNKRD1 , the gene encoding cardiac ankyrin repeat protein , a novel dilated cardiomyopathy gene? Context: We evaluated ankyrin repeat domain 1 (ANKRD1), the gene encoding cardiac ankyrin repeat protein (CARP), as a novel candidate gene for dilated cardiomyopathy (DCM) through mutation analysis of a cohort of familial or idiopathic DCM patients, based on the hypothesis that inherited dysfunction of mechanical stretch-based signaling is present in a subset of DCM patients. CARP, a transcription coinhibitor, is a member of the titin-N2A mechanosensory complex and translocates to the nucleus in response to stretch. It is up-regulated in cardiac failure and hypertrophy and represses expression of sarcomeric proteins. Its overexpression results in contractile dysfunction. In all, 208 DCM patients were screened for mutations/variants in the coding region of ANKRD1 using polymerase chain reaction, denaturing high-performance liquid chromatography, and direct deoxyribonucleic acid sequencing. In vitro functional analyses of the mutation were performed using yeast 2-hybrid assays and investigating the effect on stretch-mediated gene expression in myoblastoid cell lines using quantitative real-time reverse transcription-polymerase chain reaction. Three missense heterozygous ANKRD1 mutations (P105S, V107L, and M184I) were identified in 4 DCM patients. The M184I mutation results in loss of CARP binding with Talin 1 and FHL2, and the P105S mutation in loss of Talin 1 binding. Intracellular localization of mutant CARP proteins is not altered. The mutations result in differential stretch-induced gene expression compared with wild-type CARP." }, { "role": "assistant", "content": "ANKRD1 is a novel DCM gene, with mutations present in 1.9% of DCM patients. The ANKRD1 mutations may cause DCM as a result of disruption of the normal cardiac stretch-based signaling. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following statement is/are true about dengue" }, { "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: Action Potentials, Adult, Aged, Case-Control Studies, Diagnosis, Differential, Electromyography, Female, Humans, Male, Middle Aged, Muscles, Nerve Degeneration, Neural Conduction, POEMS Syndrome, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating." }, { "role": "user", "content": "Do uniform demyelination and more severe axonal loss distinguish POEMS syndrome from CIDP? Context: POEMS syndrome (the acronym reflects the common features: Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein and Skin changes) is a paraneoplastic disorder with a 'demyelinating' peripheral neuropathy that is often mistaken for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). The nerve conduction study (NCS) and electromyography (EMG) attributes that might differentiate POEMS from CIDP and lead to earlier therapeutic intervention were explored. NCS/EMG of POEMS patients identified through retrospective review from 1960 to 2007 were compared with matched CIDP controls. 138 POEMS patients and 69 matched CIDP controls were compared. POEMS patients demonstrated length dependent reduction in compound muscle action potentials, low conduction velocities, prolonged distal latencies and prolonged F wave latencies. Compared with CIDP controls, POEMS patients demonstrated: (1) greater reduction of motor amplitudes, (2) greater slowing of motor and sensory conduction velocities, (3) less prolonged motor distal latencies, (4) less frequent temporal dispersion and conduction block, (5) no sural sparing, (6) greater number of fibrillation potentials in a length dependent pattern and (7) higher terminal latency indices (TLI). TLI ≥0.38 in the median nerve demonstrated a sensitivity of 70% and specificity of 77% in discriminating POEMS from CIDP." }, { "role": "assistant", "content": "NCS/EMG of POEMS syndrome suggests both axonal loss and demyelination. Compared with CIDP, there is greater axonal loss (reduction of motor amplitudes and increased fibrillation potentials), greater slowing of the intermediate nerve segments, less common temporal dispersion and conduction block, and absent sural sparing. These findings imply that the pathology of POEMS syndrome is diffusely distributed (uniform demyelination) along the nerve where the pathology of CIDP is probably predominantly proximal and distal. Median motor TLI may be useful in clinically distinguishing these disorders. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Is the hyperdense posterior cerebral artery sign in CT related to larger ischemic lesion volume? Context: Hyperdensity of the middle cerebral artery (MCA) on unenhanced CT is a recognized sign associated with brain's early ischemia. The number of studies which showed a hyperdense posterior cerebral artery (HPCA) sign in posterior circulation infarct is relatively small. We investigated the prevalence of the HPCA sign, correlations with ischemic lesion volume, and stroke risk factors. We also determined the association with prothrombotic and inflammatory markers which have not been studied before. In the group of 376 patients with a first acute stroke consecutively admitted to Emergency Department, early signs of brain infarction were visible in 221 (58%) cases. Fifty five (25%) subjects had ischemic lesions in the brain supplied by the posterior circulation. We analyzed the unenhanced CT scans, calculated the density of the posterior cerebral arteries, infarct volume, and assessed the relation of the HPCA sign to other factors. The HPCA sign appeared on CT scans of 12 (22%) patients with evidence of the posterior circulation infarct. The density (in Hounsfield units) of the affected PCA was 46.5 comparing to 20.2 of an intact vessel (p<0.0001). The stroke volume was larger when the HPCA sign was observed (medians: 17.6 vs. 4.3 cm(3), p=0.02); in multivariate analysis this association was still significant (OR=1.07; 95% CI, 0.99-1.13). The C-reactive protein and fibrinogen levels were significantly higher (p=0.02 for both factors) in patients with the HPCA sign in the univariate analysis." }, { "role": "assistant", "content": "The HPCA may be considered as an additional marker of early brain infarct, especially with large lesion volume. 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 clostridium difficile is:" }, { "role": "assistant", "content": "The correct answer is C. difficile: 1. Gram positive 2. Obligately anaerobic 3. Spore-forming bacillus (spores are found widely in nature)" } ]