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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": "Which of the following present as acute abdomen" }, { "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": "Which is not a function of PHC-" }, { "role": "assistant", "content": "The correct answer is Functions of PHC includes ; - medical care - MCH - Safe water and sanitation - health education - referral services - training of health guide, health workers - basic laboratory services Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no;905 <\\p>" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All of the following are indications of classical cesarean section except:" }, { "role": "assistant", "content": "The correct answer is Ans. is d, i.e. Cancer endometriumRef. Williams Obs. 25/e, p 578-579As discussed in text(i) Large baby with transverse lie necessitates classical cesarean(ii) In small fetus with breech, the poorly developed lower uterine segment provides inadequate space for manipulation needed for breech delivery.(iii) Fibroid is lower uterine segment are all indications of classical cesarean section. Cancer cervix but not cancer endometrium is an indication classical cesarean." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Age Factors, Aged, Antidepressive Agents, Anxiety Disorders, Austria, Benzodiazepines, Comorbidity, Depressive Disorder, Female, Humans, Male, Marital Status, Prospective Studies, Psychiatric Status Rating Scales, Sex Distribution." }, { "role": "user", "content": "Benzodiazepine use in the elderly: an indicator for inappropriately treated geriatric depression? Context: To measure the prevalence of benzodiazepine (BZD) use and to explore associated demographic and clinical variables of BZD use within a cohort of 75-year- old inhabitants of an urban district of Vienna. This is a prospective, interdisciplinary cohort study on aging. Our investigation is based on the first consecutive 500 subjects that completed the study protocol. Demographic and clinical characteristics, benzodiazepine and antidepressant use were documented using a standardized questionnaire. Affective status was assessed using the Hamilton Depression Rating Scale (HAMD), the Geriatric Depression Scale (GDS), and the Spielberger State-and Trait Anxiety Inventory subscales (STAI). Prevalence of BZD use was 13.8%. Compared to non-users, BZD users had significantly higher mean scores at the HAMD (p = 0.001), the GDS (p = 0.026), and the Spielberger State-and Trait Anxiety Inventory subscales (p = 0.003; p = 0.001). Depression was found in 12.0% (HAMD) and 17.8% when using a self-rating instrument (GDS). Less than one-third of depressed subjects were receiving antidepressants. Statistically equal numbers were using benzodiazepines." }, { "role": "assistant", "content": "Inappropriate prescription of BZD is frequent in old age, probably indicating untreated depression in many cases. The implications of maltreated geriatric depression and the risks associated with benzodiazepine use highlight the medical and socioeconomic consequences of inappropriate BZD prescription." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Hepatocellular, Female, Hepatitis, Viral, Human, Humans, Hyperplasia, Incidence, Liver, Liver Diseases, Liver Neoplasms, Male, Middle Aged, Retrospective Studies, Risk Factors." }, { "role": "user", "content": "Do hyperplastic foci reflect the risk of multicentric development of human hepatocellular carcinoma? Context: Identification of the risk factors of multicentric hepatocarcinogenesis is important for the clinical management of hepatocellular carcinoma. We investigated hyperplastic foci in non-cancerous liver parenchyma, and clarified their pathological features and clinical significance. Hyperplastic foci were defined as hypercellular areas, which architecturally and cytologically resembled early hepatocellular carcinoma or adenomatous hyperplasia but did not form macroscopically detectable nodules. Surgically resected livers from 155 patients with hepatocellular carcinoma were examined histopathologically and immunohistochemically. Hyperplastic foci were found in 26 of 155 patients (16.8%). All the patients with hyperplastic foci had chronic liver diseases, and the incidence did not differ between those with chronic hepatitis and those with liver cirrhosis. Six of 92 (6.5%) patients with single primary hepatocellular carcinoma nodules, 8 of 42 (19.0%) with two nodules, and 12 of 21 (57.0%) with more than three nodules had hyperplastic foci. The incidence of hyperplastic foci showed a significant positive correlation with the multiplicity of hepatocellular carcinoma nodules. Immunohistochemically, hyperplastic foci were masses of proliferative hepatocytes similar to adenomatous hyperplasia and early hepatocellular carcinoma." }, { "role": "assistant", "content": "Hyperplastic foci reflect the risk of multicentric hepatocarcinogenesis. Our results suggest strongly that hyperplastic foci are precursors of adenomatous hyperplasia or hepatocellular carcinoma. 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: Animals, Atherosclerosis, Blood Platelets, Blotting, Western, Carotid Arteries, Cells, Cultured, Coronary Vessels, Disease Models, Animal, Endothelium, Vascular, Gene Expression Regulation, Humans, Intercellular Signaling Peptides and Proteins, Mice, Mice, Inbred C57BL, Prognosis." }, { "role": "user", "content": "Does dickkopf-1 enhance inflammatory interaction between platelets and endothelial cells and shows increased expression in atherosclerosis? Context: Based on the emerging importance of the wingless (Wnt) pathways in inflammation and vascular biology, we hypothesized a role for Dickkopf-1 (DKK-1), a major modulator of Wnt signaling, in atherogenesis and plaque destabilization. We report increased levels of DKK-1 in experimental (ApoE(-/-) mice) and clinical (patients with coronary artery disease [n=80] and patients with carotid plaque [n=47]) atherosclerosis, both systemically (serum) and within the lesion, with particularly high levels in advanced and unstable disease. We identified platelets as an important cellular source of DKK-1 as shown by in vitro experiments and by immunostaining of thrombus material obtained at the site of plaque rupture in patients with acute ST-elevation myocardial infarction, with strong immunoreactivity in platelet aggregates. Our in vitro experiments identified a role for platelet- and endothelial-derived DKK-1 in platelet-dependent endothelial activation, promoting enhanced release of inflammatory cytokines. These inflammatory effects of DKK-1 involved inhibition of the Wnt/beta-catenin pathway and activation of nuclear factor kappaB." }, { "role": "assistant", "content": "Our findings identify DKK-1 as a novel mediator in platelet-mediated endothelial cell activation. The demonstration of enhanced DKK-1 expression within advanced carotid plaques may suggest that this DKK-1-driven inflammatory loop could be operating within the atherosclerotic lesion. 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, Caenorhabditis elegans, Chromatography, High Pressure Liquid, Fatty Acids, Gas Chromatography-Mass Spectrometry, Gene Knockout Techniques, Lipids, Magnetic Resonance Spectroscopy, Mass Spectrometry, Metabolome, Stearoyl-CoA Desaturase." }, { "role": "user", "content": "Does a metabolomic strategy define the regulation of lipid content and global metabolism by Δ9 desaturases in Caenorhabditis elegans? Context: Caenorhabditis elegans provides a genetically tractable model organism to investigate the network of genes involved in fat metabolism and how regulation is perturbed to produce the complex phenotype of obesity. C. elegans possess the full range of desaturases, including the Δ9 desaturases expressed by fat-5, fat-6 and fat-7. They regulate the biosynthesis of monounsaturated fatty acids, used for the synthesis of lipids including phospholipids, triglycerides and cholesteryl esters. Liquid chromatography mass spectrometry (LC-MS), gas chromatography mass spectrometry (GC-MS) and nuclear magnetic resonance (NMR) spectroscopy were used to define the metabolome of all the possible knock-outs for the Δ9 desaturases, including for the first time intact lipids. Despite the genes having similar enzymatic roles, excellent discrimination was achievable for all single and viable double mutants highlighting the distinctive roles of fat-6 and fat-7, both expressing steroyl-CoA desaturases. The metabolomic changes extend to aqueous metabolites demonstrating the influence Δ9 desaturases have on regulating global metabolism and highlighting how comprehensive metabolomics is more discriminatory than classically used dyes for fat staining." }, { "role": "assistant", "content": "The propagation of metabolic changes across the network of metabolism demonstrates that modification of the Δ9 desaturases places C.elegans into a catabolic state compared with wildtype controls. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, DESIGN, METHODS, RESULTS. Meshes: Aged, Aged, 80 and over, Epiretinal Membrane, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retina, Retinal Perforations, Retrospective Studies, Tomography, Optical Coherence, Visual Acuity." }, { "role": "user", "content": "Lamellar Macular Hole: Two Distinct Clinical Entities? Context: To investigate whether lamellar macular holes can be divided into different subgroups. Retrospective observational case series. In this institutional study, clinical charts and spectral-domain optical coherence tomography (OCT) images of 102 eyes of 90 consecutive patients diagnosed with lamellar macular hole were reviewed. In OCT imaging, the presence of lamellar macular hole was defined according to the following findings: presence of irregular foveal contour, separation of the layers of the neurosensory retina, and the absence of full-thickness macular defect. Mean outcome was the morphologic and functional characterization of different subtypes of macular hole. Two different subtypes of lamellar macular hole were identified: tractional and degenerative. The first type, tractional, was diagnosed in 43 eyes, and was characterized by the schitic separation of neurosensory retina between outer plexiform and outer nuclear layers. It often presented with an intact ellipsoid layer and was associated with tractional epiretinal membranes and/or vitreomacular traction. The second type, degenerative, was diagnosed in 48 eyes, and its distinctive traits included the presence of intraretinal cavitation that could affect all retinal layers. It was often associated with nontractional epiretinal proliferation and a retinal \"bump.\" Moreover, it often presented with early ellipsoidal zone defect and its pathogenesis, although chronic and progressive, remains poorly understood. Eleven eyes shared common features with both tractional and degenerative lamellar macular holes and were classified as mixed lesions." }, { "role": "assistant", "content": "Degenerative and tractional lamellar macular holes may be 2 distinct clinical entities. A revision of the current concept of lamellar macular holes is needed." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: UNLABELLED, MATERIAL AND METHODS, RESULTS AND DISCUSSION. Meshes: Adipose Tissue, Adult, Aged, Decompression, Surgical, Diplopia, Female, Graves Disease, Humans, Incidence, Male, Middle Aged, Orbit, Postoperative Complications, Prognosis, Retrospective Studies." }, { "role": "user", "content": "Is incidence of diplopia after Fat Removal Orbital Decompression a predictive factor of choice of surgical technique for Graves' ophthalmopathy? Context: Dysthroid orbitopathy or Graves ophthalmopathy is a frequent pathologic condition five times more frequent in females than males. The main symptoms are: proptosis, motility disorders related to eye muscles fibrosis, eyelid retraction, lagophthalmos, and finally the more severe ones: compressive optic neuropathy at the apex of the orbit, and corneal exposure. In order to reduce proptosis the classic approach is Bone Removal Orbital Decompression (BROD) either through eyelid skin, coronal, conjunctival, or endonasal approaches. Recently a new technique has been described by Olivari: Fat Removal Orbital Decompression (FROD). The purpose is to evaluate the incidence of diplopia after FROD and improve surgical indications for Graves' ophthalmopathy. 35 patients were included in this retrospective study (58 orbits). FROD (OLIVARI technique) was performed in all cases (23 bilateral surgery, 12 unilateral; 12 men, 23 women). All patients with optic neuropathy (severe Graves'ophthalmopathy) were eliminated because bone decompression was always performed. The ocular motility was examined before and after surgery by orthoptic screening. The average follow up was 18 months. Before FROD, 7 patients complained of moderate or severe diplopia: all remained with diplopia after FROD. After FROD 32% developed a new diplopia: only one patient remained with diplopia after strabismus surgery or adaptation by prisms glasses. Diplopia after BROD in moderate Graves' ophthalmopathy (with indications identical to our study) is reported from 23 to 34% in previous studies." }, { "role": "assistant", "content": "Diplopia after FROD is a real risk whose incidence is identical after FROD and BROD and must be explained to each patient before surgical decision." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In the presence of a drug that blocks all effects of norepinephrine and epinephrine on the hea, the autonomic nervous system can" }, { "role": "assistant", "content": "The correct answer is ." } ]

[ { "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 radiosensitive tumor among the following is:" }, { "role": "assistant", "content": "The correct answer is Ans. Dysgerminoma" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Deafness, Ethnic Groups, Exome, Female, Heterozygote, Humans, Membrane Proteins, Mutation, Pedigree, Siblings, Tibet." }, { "role": "user", "content": "Is autosomal recessive non-syndromic hearing loss caused by novel compound heterozygous mutations in TMC1 from a Tibetan Chinese family? Context: Hearing loss is the most common sensory disorder worldwide. Biallelic mutations in 42 different genes have been identified as associated with autosomal recessive non-syndromic hearing loss (ARNSHL). One of the common genes responsible for ARNSHL is TMC1. TMC1 mutations have been reported to cause non-syndromic hearing loss in a variety of populations. The current study is designed to investigate mutations prevalent among Chinese ethnic groups with ARNSHL. Targeted exome sequencing (TES) was employed to study the genetic causes of two siblings with ARNSHL in a Tibetan Chinese family. Variants identified by TES were further confirmed by Sanger sequencing. We identified two distinct variants in the TMC1 gene in two deaf siblings of one Tibetan Chinese family using TES. Both siblings inherited a paternal allele containing a deletion of c.1396_1398AAC (p.Asn466del) and a maternal allele containing an insertion of c.2210_2211insCT (p.Glu737HisfsX2). The former disrupts a highly conserved residue in the large intracellular loop domain adjacent to the fourth transmembrane domain, and the latter causes a truncation of a portion of the C-terminal domain. These variants were compound heterzygous and segregated with the hearing impairment in this family." }, { "role": "assistant", "content": "The novel compound heterozygous mutant alleles of TMC1 identified in this study were responsible for the ARNSHL in this Tibetan Chinese family. Although compound heterozygous mutations in TMC1 occurring in different TMC1 domains have been previously described in Han Chinese; this result suggests that the TMC1 variants contributing to hereditary deafness in Chinese populations may be more complex than initially assumed and that sequence-based diagnostics will be required for a comprehensive evaluation of ARNSHL. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, METHODS, RESULTS. Meshes: Adult, Child Development, Developmental Disabilities, Female, Humans, Infant, Infant, Low Birth Weight, Infant, Newborn, Infant, Newborn, Diseases, Intensive Care Units, Neonatal, Leukomalacia, Periventricular, Logistic Models, Male, Parents, Patient Care Team, Patient Discharge, Pediatrics, Physical Therapy Modalities, Physicians, Psychology, Risk Factors, Sensitivity and Specificity." }, { "role": "user", "content": "Do parents and professionals agree on the developmental status of high-risk infants? Context: To examine the degree of agreement between parental reporting of the development of high-risk infants and professional assessment by a multidisciplinary team. The developmental status of 196 infants discharged from neonatal intensive care units (NICUs) was assessed by their parents using the Infant Monitoring Questionnaire (IMQ) at 4, 8, or 12 months' corrected age. On the same day, a clinical assessment was done by a multidisciplinary team consisting of a developmental pediatrician, physical therapist, and psychologist. The kappa statistic was used to measure agreement between the assessments. Logistic regression was used to investigate factors that might influence agreement. Both the IMQ and the multidisciplinary team classified infants as developing normally (\"normal\"), being at risk for abnormal development (\"suspect\"), or developing abnormally (\"abnormal\"). Although the same proportion of children fell into the three categories by both assessments, parents and the multidisciplinary team showed poor agreement with respect to the classification of individual infants (kappa = 0.276). No infant or family characteristic was found to have an influence on agreement." }, { "role": "assistant", "content": "For a group of high-risk infants discharged from NICUs, the agreement between parental assessment of developmental status using the IMQ and the professional assessment by a multidisciplinary team is poor in the first year of life. We do not recommend the use of this questionnaire as a substitute for clinical assessment of biologically at-risk infants discharged from NICUs. However, it may be useful for those groups of infants for whom no other information is available or as an adjunct to clinical assessment when infants are not behaving typically because of an unfamiliar setting or concurrent illness." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is/are true about medullary carcinoma of thyroid? 1. Arises from parafollicular cells 2. Amyloid stroma is present on histology 3. 10-25% cases are familial 4. Diarrhoea occurs 5. Total thyroidectomy is performed" }, { "role": "assistant", "content": "The correct answer is MCT accounts for 5-10% of thyroid cancers, 80% of tumours are sporadic, and 25% occur as a pa of an autosomal dominant hereditary syndrome ( MEN 2A or 2B). Sporadic MTC often presents in the fifth decade as a unilateral solitary nodule. Patients with familial MTC more commonly present in the fouh decade with multifocal nodules in the upper poles or both thyroid lobes, where there is the greatest concentration of the cells. The malignancies involves the parafollicular cells, or C cells, derived from the neural crests. MCT is associated with the secretion of a biologic marker, calcitonin. Excess secretion of calcitonin has been demonstrated to be an effective marker for the presence of MCT. Calcitonin excess is not associated with hypocalcemia. Histologically, MCT is an ill-defined, nonencapsulated, invasive mass composed of spindle shaped or rounded cells separated by fibrous septa and amyloid deposits. Positive immunohistochemical staining for calcitonin, carcinoembryonic antigen, and amyloid aids in the diagnosis of MTC. A patients with a sporadic medullary carcinoma may have either of two manifestations: a palpable mass for which a diagnosis can be made with FNAC or the finding of an elevated calcitonin level. family members of patient with MEN-2 ideally screened for RET proto-oncogenes. The surgical approach to sporadic medullary medullary carcinoma involves at least total thyroidectomy with or without central lymph node dissection. Total thyroidectomy allows complete removal removal of the gland and a search for multicentricity. In sporadic MTC, the lesion is generally contained within one lobe, whereas in MEN 2, the malignancy involves the upper halves of both lobes. Age > 50 years at diagnosis, metastasis at the time of diagnosis, and association with MEN 2B are associated with poor prognosis. 70% of the patients with MEN 2B have metastasis at the time of diagnosis of medullary carcinoma thyroid out of which approximately less than 50% survive up to 5 years. Quotes from Love and Bailey (Ref: Given Below) \"some cases are familial, possibly accounting for 10-20% of all cases\". \"diarrhea is a feature in 30% of cases and this may be due to 5- hydroxytryptamine or prostaglandins produced by tumour\". Ref: L & B 25/e, Page 798 ; Sabiston 18/e, Page 941-42 ; CSDT 11/e, Page 306" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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 purse-string approximation superior to primary skin closure following stoma reversal : a systematic review and meta-analysis? Context: The incidence of surgical site infection (SSI) following stoma reversal can reach 40 %. A recent variation on primary linear closure (PLC) is purse-string approximation (PSA), where the skin is approximated via a purse-string suture but not closed. The optimal technique remains to be determined. The objective of this review was to compare outcomes with PLC versus PSA for skin closure following stoma reversal. A literature search of Embase and Medline was performed to identify studies comparing PLC with PSA published between 1966 and 2012. Reviews of each study were conducted and data extracted. Random-effects methods were used to combine data, and between-study heterogeneity was assessed. Six out of 47 identified studies met the inclusion criteria: 2 randomized controlled trials and 4 case controlled series. For the primary outcome of SSI rate, 233 patients in the PLC and 170 patients in the PSA group were available for comparison. PSA resulted in a reduced rate of SSI (2.4 % PSA vs. 29.6 % PLC; OR 0.083, 95 % CI = 0.03-0.21, p < 0.001). No differences were noted in length of hospital stay. Three studies assessed self-reported cosmetic results at a minimum of 7 months post-operatively. Patients who underwent PSA reported greater satisfaction with the cosmetic outcome (Standard mean difference = 0.47 on ten-point scale, 95 % CI 0.15-0.79, p = 0.005)." }, { "role": "assistant", "content": "Purse-string approximation of stoma wounds is associated with an 80 % reduction in SSI with no negative effect on length of hospital stay or long-term cosmetic outcome. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "PQLI dues not include: (Repeat)" }, { "role": "assistant", "content": "The correct answer is Ans: B (Gross national Product) Ref: Textbook of Preventive and Social Medicine. K Park, 22nd edition, Pg: 16Explanation:Physical Quality of life index (PQLI)Consolidates three indicators* Infant mortality* Life expectancy at age one* Literacy* Range - 0 to 100 Human developmental index (HDI)Consolidates three indicators* Life expectancy at birth (Longevity)* Adult literacy rate and mean year of schooling (Knowledge)* Real GDP per capita (Income)Notes:1. Extra indicator as compare to PQLI is income2. Infant mortality and life expectancy at age one is conceptually clubbed in HDI as life expectancy at birthRange - 0 to 1" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Arthroplasty, Replacement, Knee, Female, Femur, Humans, Joint Diseases, Knee Joint, Knee Prosthesis, Male, Middle Aged, Posture, Prospective Studies, Rotation, Surgery, Computer-Assisted, Tibia, Tomography, X-Ray Computed." }, { "role": "user", "content": "Does computer-assisted surgery improve rotational positioning of the femoral component but not the tibial component in total knee arthroplasty? Context: Computer-assisted surgery (CAS) may facilitate better positioning of total knee arthroplasty (TKA) along the coronal and lateral axes; however, there are doubts as to its usefulness in the rotational plane. This is a prospective study of 95 TKAs comparing two groups: the CAS group and the standard equipment group. The series comprises 95 cases. A radiography of the lower limb and computer tomographies (CTs) of the femoral condylar region, the proximal end of the tibia and the ankle were performed to measure rotational angulation. A month after TKA surgery, the radiography and the CTs were repeated to analyze the position of the prosthetic components in the rotational plane. In the coronal axis, both CAS and mechanical technique improved femoro-tibial alignment, but when there are preexisting deformities ≥4°, CAS obtains better results. A strong correlation (R = 0.94, p = 0.001) was observed between the mean rotational axis measured with CT in the tibial plateau and that measured from the axis of the ankle. The mean initial femoral rotation of the complete series was 6.7° and 2.7° at 1-month follow-up (p < 0.001). In the standard instrumentation group, the femoral rotation went from 6.8° to 2.3°, whereas in the CAS group the femoral rotation went from 6.5° to 3.1° (p = 0.039), which is very close to the ideal 3° angle of external rotation. Tibial rotation changed by 5.28° for the entire patient population, but no differences were found when comparing CAS and standard instrumentation." }, { "role": "assistant", "content": "CAS improves frontal alignment in TKA, especially in the presence of preoperative deformities. In the femoral component, navigation most closely replicated the ideal 3° external rotation of the femoral component, but tibial rotation did not differ when comparing CAS to standard instrumentation. 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, METHODOLOGY, RESULTS. Meshes: Algorithms, Antitubercular Agents, Follow-Up Studies, Humans, India, Registries, Sputum, Time Factors, Treatment Failure, Treatment Outcome, Tuberculosis." }, { "role": "user", "content": "Sputum smear microscopy at two months into continuation-phase: should it be done in all patients with sputum smear-positive tuberculosis? Context: The Revised National Tuberculosis Control Program (RNTCP) of India recommends follow-up sputum smear examination at two months into the continuation phase of treatment. The main intent of this (mid-CP) follow-up is to detect patients not responding to treatment around two-three months earlier than at the end of the treatment. However, the utility of mid-CP follow-up under programmatic conditions has been questioned. We undertook a multi-district study to determine if mid-CP follow-up is able to detect cases of treatment failures early among all types of patients with sputum smear-positive TB. We reviewed existing records of patients with sputum smear-positive TB registered under the RNTCP in 43 districts across three states of India during a three month period in 2009. We estimated proportions of patients that could be detected as a case of treatment failure early, and assessed the impact of various policy options on laboratory workload and number needed to test to detect one case of treatment failure early. Of 10055 cases, mid-CP follow-up was done in 6944 (69%) cases. Mid-CP follow-up could benefit 117/8015 (1.5%) new and 206/2040 (10%) previously-treated sputum smear-positive cases by detecting their treatment failure early. Under the current policy, 31 patients had to be tested to detect one case of treatment failure early. All cases of treatment failure would still be detected early if mid-CP follow-up were discontinued for new sputum smear-positive cases who become sputum smear-negative after the intensive-phase of treatment. This would reduce the related laboratory workload by 69% and only 10 patients would need to be tested to detect one case of treatment failure early." }, { "role": "assistant", "content": "Discontinuation of mid-CP follow-up among new sputum smear-positive cases who become sputum smear-negative after completing the intensive-phase of treatment will reduce the laboratory workload without impacting overall early detection of cases of treatment failure." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: Adult, Animals, Antineoplastic Agents, Carcinoma, Squamous Cell, Cell Death, Cell Differentiation, Cell Line, Tumor, Down-Regulation, Esophageal Neoplasms, Female, Humans, Hyaluronan Receptors, Male, Mice, Middle Aged, Neoplastic Stem Cells." }, { "role": "user", "content": "Do tumor initiating cells in esophageal squamous cell carcinomas express high levels of CD44? Context: Esophageal Squamous Cell Carcinoma (ESCC) is a major subtype of esophageal cancer causing significant morbility and mortality in Asia. Mechanism of initiation and progression of this disease is unclear. Tumor initiating cells (TICs) are the subpopulation of cells which have the ability to self-renew, as well as, to drive initiation and progression of cancer. Increasing evidence has shown that TICs exist in a variety of tumors. However, the identification and characterization of TICs in esophageal carcinoma has remained elusive. to identify TICs in ESCC, ESCC cell lines including two primary cells were used for screening suitable surface marker. Then colony formation assay, drug resistant assay and tumorigenicity assay in immune deficient mice were used to characterize TICs in ESCC. We found that just the CD44 expression correlated with tumorigenicity in ESCC cell lines. And then induced differentiation of ESCC cells by all-trans retinoic acid treatment led to decreased expression of CD44. The FACS isolated cell subpopulations with high CD44 expression showed increased colony formation and drug resistance in vitro, as well as significantly enhanced tumorigenicity in NOD/SICD mice, as compared to the low expressing CD44 ESCC cells." }, { "role": "assistant", "content": "our study has discovered a novel TIC surface marker, CD44, which can be utilized to enrich efficiently the TICs in ESCC. These findings will be useful for further studies of these cells and exploring therapeutic approaches. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aged, Aged, 80 and over, Arthroplasty, Replacement, Hip, Blood Loss, Surgical, Blood Transfusion, Female, Hip, Humans, Intraoperative Complications, Male, Multivariate Analysis, Retrospective Studies, Risk Factors, Serotonin Uptake Inhibitors." }, { "role": "user", "content": "Do sSRIs increase risk of blood transfusion in patients admitted for hip surgery? Context: Recent studies have shown that an increased bleeding tendency can be caused by Selective Serotonin Reuptake Inhibitors (SSRI) use. We aimed to investigate the occurrence and risk of blood transfusion in SSRI users compared to non-SSRI users in a cohort of patients admitted for hip-surgery. We conducted a retrospective cohort study of patients who underwent planned or emergency hip surgery from 1996 to 2011 in the Academic Medical Center in Amsterdam. Primary outcome measure was risk of blood transfusion. Secondary outcome measures were pre- and postoperative hemoglobin level. Multivariate logistic regression was used to adjust for potential confounders. One-hundred and fourteen SSRI users were compared to 1773 non-SSRI users. Risk of blood transfusion during admission was increased for SSRI users in multivariate analyses (OR 1.7 [95% CI 1.1-2.5]). Also, pre-operative hemoglobin levels were lower in SSRI users (7.8 ± 1.0 mmol/L) compared to non-SSRI users (8.0 ± 1.0 mmol/L) (p  =  0.042)), as were postoperative hemoglobin levels (6.2 ± 1.0 mmol/L vs. 6.4 ± 1.0 mmol/L respectively) (p  =  0.017))." }, { "role": "assistant", "content": "SSRI users undergoing hip surgery have an increased risk for blood transfusion during admission, potentially explained by a lower hemoglobin level before surgery. SSRI use should be considered as a potential risk indicator for increased blood loss in patients admitted for hip surgery. These results need to be confirmed in a prospective study. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "True about apoptosis:" }, { "role": "assistant", "content": "The correct answer is Ans.: B (Activation of caspase 3 execution phase)] \"The fundamental event In apoptosis is the activation of enzymes called Caspases which are cystein proteases involved in apoptosis by initiating apoptotk signals(via intrinsic or extrinsic pathway) & executing apoptoticprogram(via execution phase)\" Apoptosis Intrinsic pathway/ Phase (Mitochondrial pathway) Cytochrome C,Apaf- l, AIF, Caspase9 Extrinsic pathway/ Phase (Death receptor initiated pathway) TNF-Receptor-1, Fas(CD 95), Caspase 8 Execution phase Caspases 3,6,7 THE EXTRINSIC (DEATH RECEPTOR-INITIATED) PATHWAY This pathway is initiated by engagement of cell surface death receptors on a variety of cells.Deatb receptors are members of the tumor necrosis factor receptor family that contain a cytoplasmic domain involved in protein-protein interactions that is called the death domain because it is essential for delivering apoptotic signals. (Some TNF receptor family members do not contain cytoplasmic death domains; their role in triggering apoptosis is much less established). The best-known death receptors are the type 1 TNF receptor (TNFR1) and a related protein called Fas (CD95), but several others have been described. The mechanism of apoptosis induced by these death receptors is well illustrated by Fas The most well characterized ligands of these receptors to dateane FasL, TNF-atpha, Apo3L, and ApoZL. Corresponding receptors are FasR, TN FR1, DR3, and DR4/ D R5, respectively When Fas is cross-1 inked by its ligand, membrane-bound Fas ligand (FasL), three or more molecules of Fas come together, and their cytoplasmic death domains form a binding site for an adapter protein that also contains a death domain and is called FADD (Fas-associated death domain). FADD that is attached to the death receptors in turn binds an inactive form of caspase-8 (and, in humans, caspase-10), again via a death domain. THE INTRINSIC PATHWAY FOR PROGRAMMED CELL DEATH The intrinsic signaling pathway for programmed cell death involves non-receptor-mediated intracellular signals, inducing activities in the mitochondria that initiate apoptosis. Pro-apoptotic proteins activate caspases that mediate the destruction of the cell through many pathways. These proteins also translocate into the cellular nucleus, inducing DNA fragmentation, a hallmark of apoptosis. The regulation of pro-apoptotic events in the mitochondria occurs through activity of members of the Bcl-2 family of proteins and the tumor suppressor protein p53. Members of the Bcl-2 family of proteins may be pro- oranti-apoptotic. The anti-apoptotic proteins are Bcl-2, Bcl-x, Bcl-xL, Bcl-XS, Bcl-w, and BAG. Some of these proteins are currently under investigation as potential targets for anti cancer therapy. Fig: The extrinsic (death receptor-initiated) pathway of apoptosis, illustrated by the events following Fas engagement" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adaptor Proteins, Signal Transducing, Amino Acid Sequence, Carcinoma, Hepatocellular, Cell Division, Cell Line, Consensus Sequence, Dishevelled Proteins, Gene Expression Regulation, Neoplastic, Humans, Kidney, LIM Domain Proteins, Liver Neoplasms, Molecular Sequence Data, Phosphoproteins, Signal Transduction, Tumor Suppressor Proteins, Ubiquitin, Wnt Proteins, beta Catenin." }, { "role": "user", "content": "Does prickle-1 negatively regulate Wnt/beta-catenin pathway by promoting Dishevelled ubiquitination/degradation in liver cancer? Context: Aberrant activation of Wnt signaling due to accumulation of beta-catenin has been linked to tumorigenesis. Mutations of beta-catenin, APC, and axins are important but not frequent enough to be accountable for the accumulation of beta-catenin in human hepatocellular carcinoma (HCC). In this study, we characterized the roles of Prickle-1, a Dishevelled (Dvl)-associated protein, in regulation of Wnt/beta-catenin activity in HCC. The expression levels of human Prickle-1 and Dvl3 were examined in HCC cell lines and human HCC samples. The interaction and effects of Prickle-1 on Dvl3, the Wnt/beta-catenin pathway, and cell growth were assessed in HCC cell lines. We showed that Prickle-1 bound with Dvl3 and facilitated Dvl3 ubiquitination/degradation, and this was through its destruction box (D-box) motifs. Enforced expression of Prickle-1 significantly reduced the Wnt/beta-catenin activity and tumorigenic properties of HCC cells. Clinicopathologic analysis showed that underexpression of Prickle-1 was significantly associated with overexpression of Dvl3, beta-catenin accumulation (P = .023), and larger tumor size (P = .030)." }, { "role": "assistant", "content": "Our results have elucidated a novel mechanistic relationship between Prickle-1 and Dvl3 in the Wnt/beta-catenin pathway. The facilitation of Prickle-1 on Dvl3 degradation and the suppression of beta-catenin activity and cell growth suggest that Prickle-1 is a negative regulator of the Wnt/beta-catenin signaling pathway and is a putative tumor suppressor in human HCCs. 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: Cross Infection, Enterococcus faecium, Feces, Genome, Bacterial, Gram-Positive Bacterial Infections, Humans, Long-Term Care, Longitudinal Studies, Phylogeny, Polymorphism, Single Nucleotide, Prospective Studies, Sequence Analysis, DNA, Vancomycin-Resistant Enterococci." }, { "role": "user", "content": "Does whole-genome sequencing reveal transmission of vancomycin-resistant Enterococcus faecium in a healthcare network? Context: Bacterial whole-genome sequencing (WGS) has the potential to identify reservoirs of multidrug-resistant organisms and transmission of these pathogens across healthcare networks. We used WGS to define transmission of vancomycin-resistant enterococci (VRE) within a long-term care facility (LTCF), and between this and an acute hospital in the United Kingdom (UK). A longitudinal prospective observational study of faecal VRE carriage was conducted in a LTCF in Cambridge, UK. Stool samples were collected at recruitment, and then repeatedly until the end of the study period, discharge or death. Selective culture media were used to isolate VRE, which were subsequently sequenced and analysed. We also analysed the genomes of 45 Enterococcus faecium bloodstream isolates collected at Cambridge University Hospitals NHS Foundation Trust (CUH). Forty-five residents were recruited during a 6-month period in 2014, and 693 stools were collected at a frequency of at least 1 week apart. Fifty-one stool samples from 3/45 participants (7 %) were positive for vancomycin-resistant E. faecium. Two residents carried multiple VRE lineages, and one carried a single VRE lineage. Genome analyses based on single nucleotide polymorphisms (SNPs) in the core genome indicated that VRE carried by each of the three residents were unrelated. Participants had extensive contact with the local healthcare network. We found that VRE genomes from LTCF residents and hospital-associated bloodstream infection were interspersed throughout the phylogenetic tree, with several instances of closely related VRE strains from the two settings." }, { "role": "assistant", "content": "A proportion of LTCF residents are long-term carriers of VRE. Evidence for genetic relatedness between these and VRE associated with bloodstream infection in a nearby acute NHS Trust indicate a shared bacterial population. 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: Aortic Arch Syndromes, Aortic Coarctation, Body Weight, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Male, Recurrence, Regression Analysis, Reoperation, Retrospective Studies, Risk Factors, Thoracotomy, Time Factors." }, { "role": "user", "content": "Recurrent arch obstruction after repair of isolated coarctation of the aorta in neonates and young infants: is low weight a risk factor? Context: Repair of aortic coarctation is often delayed in small infants because of the belief that such patients are at risk of recurrent arch obstruction and that growth will decrease this risk. To determine whether low weight was a risk factor for recurrent arch obstruction, we reviewed our experience with coarctation repair via left thoracotomy in infants less than 3 months of age. From 1990 to 1999, 103 patients less than 3 months of age underwent repair of aortic coarctation through a left thoracotomy. Median age was 18 days (1-90 days), with 45 patients less than 2 weeks. Median weight was 3.3 kg (1.0-6.4 kg) and 14 patients were less than 2 kg. The method of repair was resection and end-to-end anastomosis in 64 patients, subclavian flap angioplasty in 34, and patch augmentation of the arch in 5. Demographic, echocardiographic, and operative variables were analyzed for correlation with recurrent arch obstruction. One early and 1 late death occurred, both in patients who had complications but no evidence of recoarctation. At median follow-up of 24 months, reinterventions for recurrent arch obstruction were performed in 15 patients. The median time to reintervention was 5 months and was less than 1 year in 12 patients. Kaplan-Meier freedom from arch reintervention was 88% at 1 year (95% confidence intervals: 82%-94%) and 82% at 5 years (95% confidence intervals: 72%-92%). Factors associated with shorter duration to arch reintervention by univariable Cox regression included younger age (continuous, P =.01;<2 weeks, P =.005), smaller transverse arch (absolute diameter, P<.001; indexed to weight, P =.03; indexed to ascending aortic diameter, P =.02), and smaller ascending aorta (absolute diameter, P =.02). Smaller absolute transverse arch diameter and younger age were the only independent predictors of shorter time to arch reintervention by multivariable Cox regression analysis. Weight and type of repair did not correlate with risk of recoarctation." }, { "role": "assistant", "content": "Low weight is not a risk factor for recurrent obstruction after repair of coarctation of the aorta in infants less than 3 months of age. Rather, risk of recoarctation is more a function of the anatomy of the arch. Thus, it is not indicated to delay repair in low weight infants with the goal of achieving growth." } ]

[ { "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": "Main action of superior rectus -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'c' i.e., Elevation There are six extraocular muscles in each eye.MusclePrimary ActionSecondary ActionSuperior rectusElevationAdduction and intorsionInferior rectusDepressionAdduction and extorsionMedial rectusAdduction Lateral rectusAbduction Superior obliqueIntorsionAbduction and depressionInferior obliqueExtorsionAbduction and elevationo All the extra ocular muscles are supplied by the occulomotor nerve except for the superior oblique which is supplied by the trochlear nerve and the lateral rectus which is supplied by the abducens nerve.o The occulomotor nerve also supplies the levator palpebrae superioris, sphincter papillae and the ciliary muscle." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Absorptiometry, Photon, Adolescent, Ambulatory Care, Body Composition, Burns, Child, Exercise Test, Exercise Therapy, Female, Humans, Male, Muscle Strength, Muscle Strength Dynamometer, Muscle, Skeletal, Organ Size, Oxygen Consumption, Recovery of Function, Time Factors, Torque." }, { "role": "user", "content": "Do early rehabilitative exercise training in the recovery from pediatric burn? Context: The purpose of this study was to determine the effects of early outpatient exercise on muscle mass, function, and fractional synthetic rate in severely burned children. Forty-seven children with ≥40% total body surface area burn performed a 12-wk standard of care rehabilitation (SOC, n = 23) or rehabilitative exercise training (RET, n = 24) immediately after hospital discharge. Dual-energy x-ray absorptiometry was used to assess lean body mass (LBM) at discharge, posttreatment, and 12 months post-burn. Muscle function was evaluated with a Biodex Isokinetic Dynamometer, and peak aerobic fitness (V˙O2peak) was measured using a modified Bruce treadmill protocol posttreatment. Stable isotope infusion studies were performed in a subset of patients (SOC, n = 13; RET, n = 11) at discharge and posttreatment to determine mixed-muscle fractional synthetic rate. Relative peak torque (RET, 138 ± 9 N·m·kg, vs SOC, 106 ± 9 N·m·kg) and V˙O2peak (RET, 32 ± 1 mL·kg·min, vs SOC, 28 ± 1 mL·kg·min) were greater at posttreatment with RET compared with those with SOC. In addition, RET increased whole-body (9% ± 2%) and leg (17% ± 3%) LBM compared with SOC. Furthermore, the percentage change in whole-body (18% ± 3%) and leg (31% ± 4%) LBM from discharge to 12 months post-burn was greater with RET compared to SOC. Muscle fractional synthetic rate decreased from discharge to posttreatment in both groups (6.9% ± 1.1% per day vs 3.4 ± 0.4% per day); however, no differences were observed between treatment groups at each time point." }, { "role": "assistant", "content": "Early outpatient exercise training implemented at hospital discharge represents an effective intervention to improve muscle mass and function after severe burn injury. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Anesthetics, Local, Arm, Axilla, Brachial Plexus, Humans, Mepivacaine, Nerve Block, Posture, Sodium Bicarbonate." }, { "role": "user", "content": "Does [ Arm adduction increase block extension in anesthesia of the brachial plexus by the axillary approach ]? Context: Arm abduction of 90 degrees during injection of local anesthetic followed by adduction of the arm has been recommended traditionally to favor proximal distribution of local anesthetic and extension of the blockade in the brachial plexus by the axillary route. A recent study demonstrated that there are no clinical or radiological differences between axillary blockades performed with abduction or adduction. To compare the extension of sensory blockade in axillary anesthesia performed with adduction or abduction. Forty patients were randomly distributed in two groups, 20 in the adduction group and 20 in the abduction group. The axillary catheter was inserted 3 cm in the proximal direction and a mixture of 40 ml of 1.5% mepivacaine without adrenaline and 4 ml of 8.4% bicarbonate soda was injected into each patient. No statistically significant differences in extension of sensory blockade, including circumflex, musculocutaneous and radial nerve blockade, were observed." }, { "role": "assistant", "content": "Axillary rotation of the arm is not a determining factor in sensory blockade in brachial plexus anesthesia by the axillary route. 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": "Most common malignancy of Ovary is:" }, { "role": "assistant", "content": "The correct answer is Ovarian tumors Epithelial cell tumor Germ cell tumor Sex cord tumor M/C tumor (90%) 5-8% 3% Types: Serous (75-80%) (M/C) Endometrial (8-10%) Mucinous (5%) Clear cell Brenner tumors Teratoma Yolk sac tumor Endodermal Sinus tumor Choriocarcinoma Dysgerminoma Dermoid cyst A. Estrogen Secreting tumors Granulosa cell Fibroma Thecoma B. Androgen secreting Tumor Seoli cell tumor Leydig cell Hilus cell tumor" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aged, Aged, 80 and over, Aneurysm, Ruptured, Aortic Aneurysm, Abdominal, Biomarkers, Female, Humans, Male, Matrix Metalloproteinase 1, Matrix Metalloproteinase 9, Middle Aged, Tissue Inhibitor of Metalloproteinase-1." }, { "role": "user", "content": "Are elevated plasma MMP1 and MMP9 associated with abdominal aortic aneurysm rupture? Context: The role of matrix metalloproteinases (MMPs) in abdominal aortic aneurysm (AAA) formation is well established. However the changes in plasma MMP levels with AAA rupture have not been reported. The aim of this study was to determine circulating levels of MMPs in non-ruptured and ruptured AAA immediately prior to open repair. Concentrations of MMPs and their endogenous tissue inhibitors (TIMPs) were quantified using ELISA in pre-operative plasma samples from non-ruptured and ruptured AAA. MMP1 and MMP9 were elevated in the plasma of ruptured AAA versus non-ruptured AAA. A four-fold elevation in pre-operative plasma MMP9 was associated with non-survival at 30 days from rupture surgery compared with those surviving for greater than 30 days." }, { "role": "assistant", "content": "In conclusion, these findings support the role of MMPs in AAA pathogenesis. Elevation of MMP9 was associated with ruptured aneurysm related 30-day mortality and may represent a survival indicator in this group. 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, Base Sequence, Cell Line, Endoplasmic Reticulum, Follow-Up Studies, Golgi Apparatus, Green Fluorescent Proteins, Hepacivirus, Hepatitis C Antigens, Lipid Metabolism, Microscopy, Fluorescence, Molecular Sequence Data, Protein Structure, Tertiary, Rats, Recombinant Fusion Proteins, Reproducibility of Results, Stress, Physiological, Triglycerides, Viral Core Proteins." }, { "role": "user", "content": "Is domain 3 of hepatitis C virus core protein sufficient for intracellular lipid accumulation? Context: Hepatitis C virus (HCV) is a major cause of liver disease worldwide, with steatosis, or \"fatty liver,\" being a frequent histologic finding. In previous work, we identified sequence polymorphisms within domain 3 (d3) of genotype 3 HCV core protein that correlated with steatosis and in vitro lipid accumulation. In this study, we investigated the sufficiency of d3 to promote lipid accumulation, the role of HCV genotype in d3 lipid accumulation, and the subcellular distribution of d3. Stable cell lines expressing green fluorescent protein (GFP) fusions with isolates of HCV genotype 3 core steatosis-associated d3 (d3S), non-steatosis-associated d3 (d3NS), and genotype 1 d3 (d3G1) were analyzed by means of immunofluorescence, oil red O (ORO) staining, and triglyceride quantitation. Cells that expressed d3S had statistically significantly more ORO than did cells expressing d3NS or d3G1 (P=.02 and <.001, respectively), as well as higher triglyceride levels P =.03 and .003, respectively). Immunofluorescence analysis showed that d3 does not colocalize to lipid droplets but partially colocalizes to the Golgi apparatus." }, { "role": "assistant", "content": "Our results suggest that HCV core d3 is sufficient to mediate the accumulation of lipid by means of a mechanism that is independent of domains 1 and 2. Our results also suggest that altered lipid trafficking may be involved. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: UNLABELLED, OBJECTIVE, METHODS, RESULTS. Meshes: Adaptation, Psychological, Adult, Aged, Breast Neoplasms, Depressive Disorder, Female, Humans, Immunophenotyping, Intraoperative Period, Lymphocyte Count, Lymphocyte Subsets, Middle Aged, Multivariate Analysis, Postoperative Period, Predictive Value of Tests, Preoperative Care, Psychiatric Status Rating Scales, Psychoneuroimmunology, Stress, Psychological." }, { "role": "user", "content": "Do pre-operative [ correction of Properative ] psychological variables predict immunological status in patients with operable breast cancer? Context: In a prospective study of psychobiological responses in patients with operable breast cancer, psychological data were collected one day before surgery and immunological data one day before and seven days after surgery. Explore psychoimmunological correlates related to primary surgical treatment of women with operable breast cancer. Distress was assessed with Impact of Event Scale (IES), depression with Montgomery-Aasberg Depression Rating Scale (MADRS), coping with Mental Adjustment to Cancer (MAC) scale, emotional suppression with Courtauld Emotional Control scale (CECS) and neuroticism with EPQ-N. Number of lymphocytes and subsets of lymphocytes were analyzed using a flow-cytometric method. Intrusive anxiety and anxious preoccupation were statistically significant inversely correlated to number of lymphocytes, B, T total and T4 lymphocytes and depression to B and T4 lymphocytes using Bonferroni's correction for multiple testing. Multivariate analyses including menopausal status, type of surgery and health behaviour variables demonstrated an independent, inverse effect of depression on total number of lymphocytes, T total and T4 lymphocytes 7 days after surgery. Pre-post immune changes were influenced reversely by depression (decreased) and intrusion (increased)." }, { "role": "assistant", "content": "Psychological parameters have a statistically significant impact on the number of lymphocytes and subsets of lymphocytes. 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": "Joint erosions are not a feature of :" }, { "role": "assistant", "content": "The correct answer is Answer is D (Systemic Lupus Erythematosus): SLE is characterised typically by a non-erosive Ahritis (erosions are rare). All other options mentioned in the question may have an erosive picture." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, METHODS, METHODS, METHODS, RESULTS. Meshes: Acute Disease, Adolescent, Adult, Fear, Female, Humans, Low Back Pain, Male, Middle Aged, Movement, Postural Balance, Proprioception, Psychomotor Performance, Torso, Young Adult." }, { "role": "user", "content": "Are trunk motor control deficits in acute and subacute low back pain associated with pain or fear of movement? Context: A subgroup of patients with acute to subacute low back pain (LBP) presenting with trunk movement control deficits, pain provocation with segmental testing, and segmental hypermobility have been clinically identified as having movement coordination impairments (MCIs) of the trunk. It is hypothesized that these patients have proprioceptive, postural, and movement control impairments of the trunk associated with LBP. Although trunk control impairments have been identified in patients with chronic LBP, they have not been investigated in this subgroup or closer to symptom onset. The purpose of the study was to identify trunk motor control (postural control and movement precision) impairments in a subgroup of patients with acute to subacute LBP who have been clinically identified to have MCIs and determine association of these impairments with pain and fear of movement. The study design includes observational design, university biomechanics laboratory, and clinical practice. Thirty-three patients with acute to subacute LBP presenting with trunk MCIs and 33 healthy controls matched with gender, age, and body mass index were identified. Self-report measures included Numeric Pain Rating Scale, Oswestry Disability Index Questionnaire, and Fear-Avoidance Beliefs Questionnaire and physiologic measures included postural control and movement precision. Center-of-pressure movement was measured while subjects attempted to volitionally control trunk posture and movement while sitting on a platform with a hemisphere mounted underneath. This created an unstable surface that required coordinated trunk control to maintain an upright seated posture. Postural control was tested using eyes-open and -closed balance protocols. Movement precision was tested with a dynamic control test requiring movement of the center of pressure along a discrete path. Group trunk motor control performance was compared with analysis of variance and t test. Performance association with pain and fear of movement were assessed with Pearson correlations. Patients' postural control in the eyes-closed condition (p=.02) and movement precision (p=.04) were significantly impaired compared with healthy controls, with moderate-to-large group difference effect sizes. These trunk motor control impairments were not significantly associated with the patients self-reported pain characteristics and fear of movement." }, { "role": "assistant", "content": "Patients with clinical identification of trunk MCIs demonstrated decreased trunk motor control, suggesting that impairments in proprioception, motor output, or central processing occur early in the back pain episode. This information may help to guide interventions to address these specific limitations, improving delivery of care. 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, OBJECTIVE, METHODS, RESULTS. Meshes: Administration, Inhalation, Adolescent, Asthma, Child, Drug Delivery Systems, Drug Therapy, Combination, Female, Humans, Male, Metered Dose Inhalers, Nebulizers and Vaporizers, Powders." }, { "role": "user", "content": "Does concurrent use of metered-dose and dry powder inhalers by children with persistent asthma adversely affect spacer/inhaler technique? Context: Studies conducted in adults have suggested that patients who use a metered-dose inhaler/holding chamber spacer (MDI/S) and dry powder inhaler (DPI) concurrently will have poorer MDI/S technique than that of patients who use MDI/S exclusively. To our knowledge, as of August 31, 2006, no studies have been performed in pediatric patients. To compare MDI/S technique scores of children using only MDI/S with scores of those using both MDI/S and DPIs. The MDI/S technique of children aged 6-17 years, with persistent asthma, recruited from a general pediatric practice population for an asthma intervention study project was scored using a standardized checklist. MDI/S scores of children who were being treated with maintenance and rescue medication delivered only by MDI/S were compared with those treated with both MDI/S (rescue) and DPI (maintenance). Scores lower than 70% were considered to be inadequate. A total of 117 patients (73 male, 44 female), aged 9.70 +/- 3.1 years (mean +/- SD), with persistent asthma, participated in the study. There were 83 children (54 male, 29 female, age 9.4 +/- 3.2 y) in the MDI/S only group and 34 (19 male, 15 female, age 10.3 +/- 2.9 y) in the MDI/S + DPI group. In the MDI/S + DPI group, Diskus was the DPI used for 32 patients, and Turbuhaler was used by 2 children. Sixteen patients had severe persistent asthma, 80 had moderate persistent asthma, and 21 had mild persistent asthma as classified by National Heart Lung and Blood Institute guidelines. No difference in sex and age demographics existed; however, there was a difference in the distribution of asthma severity between groups (ie, no patients with mild persistent asthma in the MDI/S + DPI group; p < or = 0.01). Mean score for the MDI/S only group was 86 +/- 17% and, for the MDI/S + DPI group, 90.1 +/- 12% (p = 0.15). More patients in the MDI/S group had inadequate scores (18%) compared with those in the MDI/S + DPI group (3%; p < 0.05)." }, { "role": "assistant", "content": "While DPI and MDI/S techniques are markedly different in several significant ways, concurrent use of these inhalers did not adversely affect MDI/S technique scores of pediatric patients with persistent asthma, compared with those using MDI/S alone. Patients in the MDI/S only group had an inadequate MDI/S score (<70%) more often than did patients in the MDI/S + DPI group. 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, RESULTS. Meshes: Adult, Biomarkers, Female, Heart Defects, Congenital, Humans, Natriuretic Peptide, Brain, Peptide Fragments, Pregnancy, Pregnancy Complications, Cardiovascular, Prenatal Care, Prenatal Diagnosis, Prospective Studies." }, { "role": "user", "content": "Does n-terminal pro-B-type natriuretic peptide predict cardiovascular complications in pregnant women with congenital heart disease? Context: In women with congenital heart disease (CHD), cardiovascular complications during pregnancy are common, but the risk assessment of these patients remains difficult. This study sought to determine the independent role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in addition to other parameters in predicting adverse cardiovascular events during pregnancy in women with CHD. We conducted a national, prospective multicentre cohort study. Follow-up with clinical evaluation and echocardiography and NT-proBNP measurement was performed at 20-week gestation. Adverse cardiovascular events occurred in 10.3% of 213 pregnancies. N-terminal pro-B-type natriuretic peptide levels >128 pg/mL at 20-week gestation, the presence of a mechanical valve, and subpulmonary ventricular dysfunction before conception were independently associated with events [odds ratio (OR) 10.6 (P = 0.039), OR 12.0 (P = 0.016), and OR 4.2 (P = 0.041), respectively]. The negative predictive value of NT-proBNP levels <128 pg/mL was 96.9%. N-terminal pro-B-type natriuretic peptide levels >128 pg/mL at 20 weeks of gestation had an additional value in predicting the occurrence of adverse cardiovascular events on the top of the other identified predictors (area under the curve 0.90 vs. 0.78, P = 0.035)." }, { "role": "assistant", "content": "Increased NT-proBNP levels at 20 weeks of gestation are an independent risk predictor of cardiovascular events during pregnancy in women with CHD. 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": "Dose of levonorgestrel used for emergency contraception:-" }, { "role": "assistant", "content": "The correct answer is Levonorgestrel is Doc for emergency contraception 0.75 mg tablets ( 2 tablets) 12 hrs apa. 1.5 mg tablet ( 1 tablet ) within 72 hrs. This is the only method of emergency contraception approved for use by Drug Controller of India Note:- IUCD - used up to 5th day after intercourse." } ]

[ { "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 features of Verrill's sign except:" }, { "role": "assistant", "content": "The correct answer is The three features of Verrill’s sign are:\n\nPartial ptosis (50%).\nBlurring vision\nSlurring speech that indicate the correct level after Diazepam sedation" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Animals, Genetically Modified, Circadian Rhythm, Cocaine, Cocaine-Related Disorders, Embryo, Nonmammalian, Female, Fetal Death, Genes, Reporter, Green Fluorescent Proteins, Humans, Melatonin, Models, Animal, Pregnancy, Prenatal Exposure Delayed Effects, Synaptic Transmission, Zebrafish." }, { "role": "user", "content": "Is the circadian system a target and modulator of prenatal cocaine effects? Context: Prenatal exposure to cocaine can be deleterious to embryonic brain development, but the results in humans remain controversial, the mechanisms involved are not well understood and effective therapies are yet to be designed. We hypothesize that some of the prenatal effects of cocaine might be related to dysregulation of physiological rhythms due to alterations in the integrating circadian clock function. Here we introduce a new high-throughput genetically well-characterized diurnal vertebrate model for studying the mechanisms of prenatal cocaine effects by demonstrating reduced viability and alterations in the pattern of neuronal development following repeated cocaine exposure in zebrafish embryos. This effect is associated with acute cocaine-induced changes in the expression of genes affecting growth (growth hormone, zGH) and neurotransmission (dopamine transporter, zDAT). Analysis of circadian gene expression, using quantitative real-time RT-PCR (QPCR), demonstrates that cocaine acutely and dose-dependently changes the expression of the circadian genes (zPer-3, zBmal-1) and genes encoding melatonin receptors (zMelR) that mediate the circadian message to the entire organism. Moreover, the effects of prenatal cocaine depend on the time of treatment, being more robust during the day, independent of whether the embryos are raised under the light-dark cycle or in constant light. The latter suggests involvement of the inherited circadian factors. The principal circadian hormone, melatonin, counteracts the effects of cocaine on neuronal development and gene expression, acting via specific melatonin receptors." }, { "role": "assistant", "content": "These findings demonstrate that, in a diurnal vertebrate, prenatal cocaine can acutely dysregulate the expression of circadian genes and those affecting melatonin signaling, growth and neurotransmission, while repeated cocaine exposure can alter neuronal development. Daily variation in these effects of cocaine and their attenuation by melatonin suggest a potential prophylactic or therapeutic role for circadian factors in prenatal cocaine exposure. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All of the following are positive acute phase reactants except________." }, { "role": "assistant", "content": "The correct answer is Acute-phase proteins are plasma proteins, mostly synthesized in the liver, whose plasma concentrations may increase several hundred-fold as part of the response to inflammatory stimuli.\nThree of the best-known of these proteins are:\n\nC-reactive protein (CRP).\nFibrinogen. \nSerum amyloid A (SAA) protein. \n\nAcute-phase proteins have beneficial effects during acute inflammation, but prolonged production of these proteins (especially SAA) in states of chronic inflammation can, in some cases, cause secondary amyloidosis.\nChronically elevated plasma concentrations of hepcidin reduce the availability of iron and are responsible for the anemia associated with chronic inflammation.\nAlbumin is a negative acute-phase protein, which is decreased in plasma concentration during acute phase response.\nReference-Robbins BASIC PATHOLOGY 10th edition pg-87" } ]

[ { "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": "Cerebellar toxicity is seen with" }, { "role": "assistant", "content": "The correct answer is Refer Katzung 11/e p945 Cytarabine causes cerebellar ataxia" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adult, Aged, Dermoscopy, Early Detection of Cancer, Female, Humans, Male, Melanoma, Middle Aged, Neoplasm Staging, New Zealand, Photography, Primary Health Care, Registries, Skin Neoplasms, Time Factors, Whole Body Imaging, Young Adult." }, { "role": "user", "content": "Does digital monitoring by whole body photography and sequential digital dermoscopy detect thinner melanomas? Context: Population screening for melanoma remains controversial. There are no studies demonstrating that population screening increases survival. As prognosis of melanoma is directly related to Breslow thickness, a surrogate marker of survival is thickness of melanoma. The development of several self-referred, whole-body photography and sequential digital dermoscopy imaging services reflects the public's concern regarding melanoma. To assess the ability of one of these services to detect melanoma at an early, thin stage. Demographic and histological details from 100 melanomas diagnosed through self-referred whole-body photography and sequential digital dermoscopy imaging service compared to those diagnosed through traditional methods from data held by the New Zealand Cancer Registry. There were 52 invasive and 48 in-situ melanomas: 90% superficial spreading type, 6% lentigo-maligna type and 4% nodular on histology. Forty-eight were diagnosed on first visit; the remainder by serial digital dermoscopy. Thirty-five percent of patients reported having had previous primary melanoma. In 60%, patients had been concerned by the lesion, the rest (40%) detected solely by screening. Patients diagnosed by whole-body photography and sequential digital dermoscopy screening had thinner melanomas compared to the Registry data: 69% <0.75 mm Breslow thickness compared to 52% (p=0.0216); only 1.9% thicker than 3 mm compared to 10.8% (p=0.067)." }, { "role": "assistant", "content": "Melanomas detected by self-referred, whole-body photography with sequential digital dermoscopy service are thinner than melanomas detected by traditional diagnostic methods. It remains to be determined whether earlier diagnosis results in improved survival. 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: Anti-Bacterial Agents, Endophytes, Fungal Proteins, Fungi, Mycobacterium tuberculosis, Plant Leaves, Polyketide Synthases, Tradescantia." }, { "role": "user", "content": "Does combined genetic and bioactivity-based prioritization lead to the isolation of an endophyte-derived antimycobacterial compound? Context: To initiate a genetic and bioactivity-based screening programme of culturable endophytes to identify micro-organisms capable of producing bioactive polyketides and peptides. Fungal endophytes were isolated from flowers, leaves and roots of Rhoeo spathacea, revealing a community consisting of Colletotrichum sp., Fusarium sp., Guignardia sp., Phomopsis sp., Phoma sp. and Microdochium sp. Genetic screening showed that all isolates had polyketide synthase (PKS) genes and most had nonribosomal peptide synthetase (NRPS) genes. Ethyl acetate extracts of the fungal isolates exhibited antiproliferative activity against at least one of the seven bacterial and mycobacterial test strains. Nuclear Magnetic Resonance -guided fractionation of the crude extract from a Fusarium sp. strain which exhibited strong antiproliferative activity against Mycobacterium tuberculosis resulted in the isolation of the polyketide javanicin. This compound was active against Myco. tuberculosis (MIC = 25 μg ml(-1)) and Mycobacterium phlei (MIC = 50 μg ml(-1))." }, { "role": "assistant", "content": "The medicinal plant R. spathacea hosts a variety of fungal endophytes capable of producing antibacterial and antimycobacterial compounds. There is a positive correlation between the presence of PKS and/or NRPS encoding genes in endophytes and the bioactivity of their respective organic extracts. Final Decision: yes" } ]

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

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Cohort Studies, Diabetes Mellitus, Type 2, Follow-Up Studies, Humans, Hypoglycemic Agents, Metformin, Middle Aged, Organic Cation Transport Proteins, Organic Cation Transporter 2, Polymorphism, Single Nucleotide, Prospective Studies, Time Factors, Treatment Outcome." }, { "role": "user", "content": "Are single nucleotide polymorphisms in the intergenic region between metformin transporter OCT2 and OCT3 coding genes associated with short-term response to metformin monotherapy in type 2 diabetes mellitus patients? Context: High variability in clinical response to metformin is often observed in type 2 diabetes (T2D) patients, and it highlights the need for identification of genetic components affecting the efficiency of metformin therapy. Aim of this observational study is to evaluate the role of tagSNPs (tagging single nucleotide polymorphisms) from genomic regions coding for six metformin transporter genes with respect to the short-term efficiency. 102 tagSNPs in 6 genes coding for metformin transporters were genotyped in the group of 102 T2D patients treated with metformin for 3 months. Most significant hits were analyzed in the group of 131 T2D patients from Slovakia. Pharmacokinetic study in 25 healthy nondiabetic volunteers was conducted to investigate the effects of identified polymorphisms. In the discovery group of 102 patients, minor alleles of rs3119309, rs7757336 and rs2481030 were significantly nominally associated with metformin inefficiency (P = 1.9 × 10" }, { "role": "assistant", "content": "For the first time, we have identified an association between the lack of metformin response and SNPs rs3119309 and rs7757336 located in the 5' flanking region of the genes coding for Organic cation transporter 2 and rs2481030 located in the 5' flanking region of Organic cation transporter 3 that was supported by the results of a pharmacokinetic study on 25 healthy volunteers. 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: Dental Models, Female, Humans, Middle Aged, Photogrammetry, Replica Techniques, Surface Properties, Tooth Abrasion, Tooth Cervix." }, { "role": "user", "content": "Does mapping a non-carious cervical lesion using stereoimagery and dental cast incorporating optical texture? Context: Recent advances in digital photogrammetry have enabled a new approach to high resolution mapping of tooth surfaces. The aim of this study was to assess the accuracy and the precision of a new system using automatic digital stereo-photogrammetry combined with an experimental casting material and to measure tooth surface loss in a non-carious cervical lesion. A test object and tooth replicas incorporating optical texture obtained at baseline, one and 2 years were imaged with a pre-calibrated stereocamera. The stereoimagery was then processed with digital photogrammetric software to automatically generate digital surface models. Test object models were analysed for accuracy and precision and tooth surface models were aligned with point cloud analysis software and tooth surface loss determined. Replicas were mapped to an accuracy of (6+/-13)microm. The sensitivity of change detection on tooth replicas was 40 microm with change ranging from 40 to 70 microm per annum in a discrete part of the lesion." }, { "role": "assistant", "content": "In the case examined, the change detection data were of sufficient accuracy and resolution to draw meaningful conclusions about the spatial distribution and quantum of tooth hard tissue loss. The results of this investigation suggest that annual change detection studies will provide a clearer picture of the pattern of tooth surface loss and, in combination with other analytical techniques, a more detailed explanation of the natural history of these lesions. 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, Blastomeres, Brefeldin A, Caenorhabditis elegans, Cell Cycle, Cell Membrane, Embryo, Nonmammalian, Spindle Apparatus." }, { "role": "user", "content": "Does completion of cytokinesis in C. elegans require a brefeldin A-sensitive membrane accumulation at the cleavage furrow apex? Context: The terminal phase of cytokinesis in eukaryotic cells involves breakage of the intercellular canal containing the spindle midzone and resealing of the daughter cells. Recent observations suggest that the spindle midzone is required for this process. In this study, we investigated the possibility that targeted secretion in the vicinity of the spindle midzone is required for the execution of the terminal phase of cytokinesis. We inhibited secretion in early C. elegans embryos by treatment with brefeldin A (BFA). Using 4D recordings of dividing cells, we showed that BFA induced stereotyped failures in the terminal phase of cytokinesis; although the furrow ingressed normally, after a few minutes the furrow completely regressed, even though spindle midzone and midbody microtubules appeared normal. In addition, using an FM1-43 membrane probe, we found that membrane accumulated locally at the apices of the late cleavage furrows that form the persisting intercellular canals between daughter cells. However, in BFA-treated embryos this membrane accumulation did not occur, which possibly accounts for the observed cleavage failures." }, { "role": "assistant", "content": "We have shown that BFA disrupts the terminal phase of cytokinesis in the embryonic blastomeres of C. elegans. We observed that membrane accumulates at the apices of the late cleavage furrow by means of a BFA-sensitive mechanism. We suggest that this local membrane accumulation is necessary for the completion of cytokinesis and speculate that the spindle midzone region of animal cells is functionally equivalent to the phragmoplast of plants and acts to target secretion to the equatorial plane of a cleaving cell. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All of the following statements are true for metaphysis of bone, EXCEPT:" }, { "role": "assistant", "content": "The correct answer is Metaphysis is the pa of the diaphysis, towards the epiphysis, from where the ossification spreads rapidly. In this area, the vessels form hair-pin-bends, so the circulation becomes sluggish. This stasis of blood resulting from the hair-pin-bend arrangement is responsible for bacteria to settle and thus the common site for osteomyelitis. It is the area of active bone formation and is therefore richly supplied by the blood." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Biopsy, Blastomeres, Chromosome Aberrations, Embryo Transfer, Embryonic Development, Female, Fertilization in Vitro, Humans, In Situ Hybridization, Fluorescence, Male, Pregnancy, Prenatal Diagnosis, Prospective Studies, Zona Pellucida." }, { "role": "user", "content": "Is the simplified two-pipette technique more efficient than the conventional three-pipette method for blastomere biopsy in human embryos? Context: To evaluate the efficiency and efficacy of a simplified two-pipette technique in comparison to the conventional three-pipette method; in the two-pipette method, a single, larger drilling/biopsy pipette is used to perform zona pellucida (ZP) drilling and blastomere aspiration for embryo biopsy. A preclinical, prospective, randomized, in vitro experiment. The reproductive unit of a university teaching hospital. Ninety-five excess embryos at the two- to four-cell stage were obtained from 35 patients undergoing IVF. At the six- to eight-cell stage, 88 embryos were allocated randomly to three groups: group I for the conventional method (n = 29), group II for the simplified technique (n = 30), and group III for controls (n = 29). The embryos then were cultured in vitro. The retrieved blastomeres were fixed and examined with fluorescence in situ hybridization using X and Y probes simultaneously. Biopsy time, successful retrieval of a blastomere, fixation of the cell, signals developed from fluorescence in situ hybridization, and growth potential and hatching capacity of the biopsied embryos were evaluated. The mean time (+/- SD) for biopsy of each embryo in group I (435 +/- 137 seconds) was significantly longer than that in group II (126 +/- 32 seconds). The success rates for obtaining an intact blastomere were not different between group I (93%) and group II (97%). The growth capacity to the blastocyst stage was similar among the three groups (34%, 37%, and 38%, respectively). However, the ZP-drilled and biopsied embryos of groups I and II had higher percentages of hatching (34% and 37%, respectively) and complete hatching (17% and 20%, respectively) than did those of group III (10% and 0, respectively). The blastomeres obtained by biopsy in groups I and II were equally fixed (90% vs. 90%, respectively) and shown in fluorescence in situ hybridization (79% vs. 80%, respectively)." }, { "role": "assistant", "content": "Compared with the conventional method, the simplified technique is more efficient and equally efficacious for blastomere biopsy in preimplantation genetic diagnosis. 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, Creatinine, Drug Administration Schedule, Female, Follow-Up Studies, Glomerular Filtration Rate, Glucocorticoids, Graft Rejection, Humans, Kidney Failure, Chronic, Kidney Transplantation, Living Donors, Male, Middle Aged, Mycophenolic Acid, Safety, Tacrolimus, Time Factors." }, { "role": "user", "content": "Is late steroid withdrawal for renal transplant recipients on tacrolimus and MMF safe? Context: We conducted a study to assess the safety of staged, late steroid withdrawal in kidney or kidney/pancreas transplant recipients on steroids, tacrolimus, and mycophenolate mofetil (MMF). We studied 50 patients including 33 recipients of cadaveric kidneys, eight living donor kidneys, and nine kidney-pancreas transplants. The mean time posttransplantation was 5.1 years (range 2.1 to 7.9 years). All patients were induced on prednisolone, tacrolimus, and MMF; steroids were withdrawn over 5 to 6 months. The rate of steroid reduction was altered in the face of typical steroid withdrawal symptoms (limb-girdle arthralgia/myalgia). No rejection episodes occurred during steroid withdrawal. No patient required transplant biopsy for graft dysfunction. Six patients failed steroid withdrawal: five due to arthralgia/myalgia and one due to recurrent pulmonary sarcoidosis. The unexplained rise in serum creatinine following steroid withdrawal described in several other steroid withdrawal studies was not observed in this patient cohort. The mean serum creatinine was 137 micromol/L with deltacreatinine -6.8 micromol/y per year prior to steroid cessation versus 132 micromol/L with deltacreatinine -5.9 micromol/y in the year post-steroid cessation. There were 14 patients with posttransplant diabetes mellitus in this cohort: eight on gliclazide and six on insulin. We observed a reduction in their daily insulin/gliclazide requirements from 52 units to 41 units, and 73 mg to 65 mg, respectively. Two patients became gliclazide-independent at the time of steroid cessation." }, { "role": "assistant", "content": "Careful steroid withdrawal from a platform of tacrolimus and MMF is safe and not associated with a significant risk of rejection or graft dysfunction. 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, Blood Glucose, Dexamethasone, Female, Glucocorticoids, Glucose Intolerance, Glucose Tolerance Test, Humans, Incretins, Insulin Resistance, Male, Young Adult." }, { "role": "user", "content": "Are steroid-induced insulin resistance and impaired glucose tolerance both associated with a progressive decline of incretin effect in first-degree relatives of patients with type 2 diabetes? Context: The aim of this study was to evaluate the separate impact of insulin resistance and impaired glucose tolerance (IGT) on the incretin effect. Twenty-one healthy glucose-tolerant first-degree relatives of patients with type 2 diabetes underwent a 75 g OGTT, an isoglycaemic i.v. glucose test and a mixed meal to evaluate the incretin effect before and after treatment with dexamethasone to increase insulin resistance. Beta cell glucose sensitivity, beta cell index and fasting proinsulin were measured as indices of beta cell function. After dexamethasone, ten individuals had increased insulin resistance but normal glucose tolerance (NGT), while 11 individuals with an equal increase in insulin resistance developed IGT. In the NGT and IGT groups, the incretin effects were 71 ± 3.2% and 67 ± 4.6% (p = 0.4) before treatment, but decreased significantly in both groups to 58 ± 5.2% and 32 ± 8.8% (p < 0.05 between groups) after treatment. Dexamethasone increased total glucagon-like peptide-1 and glucose-dependent insulinotropic peptide responses to the OGTT. The impaired incretin effect in NGT was observed in the absence of reductions in beta cell glucose sensitivity and beta cell index during i.v. glucose, corrected for insulin resistance, but in parallel with increased proinsulin/C-peptide ratio." }, { "role": "assistant", "content": "Insulin resistance and IGT, representing two stages in the path towards diabetes, are associated with differential reductions in the incretin effect seen before the development of IGT and overt type 2 diabetes. The reduction is unrelated to secretion of incretin hormones, but is related to insulin resistance and subtle beta cell defects, and is further aggravated on development of IGT. 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": "Each of the following is a feature of papillary hyperplasia except one. Which one is not true?" }, { "role": "assistant", "content": "The correct answer is Paget’s disease of bone is a bone disease characterized by bone resorption followed by attempts at bone repair involving proliferation leading to bone deformities. Its etiology is unknown and it occasionally involves the maxilla and mandible. Papillary hyperplasia is characterized by multiple papillary projections of the epithelium caused by local irritation, poor-fitting denture, poor oral hygiene, and leaving dentures in all day and night." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Age Factors, Aged, Aged, 80 and over, Bayes Theorem, Croatia, False Negative Reactions, Female, Hemagglutination Tests, Humans, Male, Mass Screening, Medical Records, Middle Aged, Public Health, Retrospective Studies, Sensitivity and Specificity, Syphilis, Syphilis Serodiagnosis, Treponema pallidum." }, { "role": "user", "content": "Do bayes ' theorem-based assessment of VDRL syphilis screening miss rates? Context: Interlaboratory differences (and conflicting practices) in syphilis screening strategies (serial versus parallel test combinations) prompted us to determine an estimate of the diagnostic miss rate in the detection of (1) infected persons and (2) infected but untreated persons potentially affected by late active syphilis. We set out to establish the most efficient syphilis screening strategy for two routine tests (VDRL and Treponema pallidum hemagglutination assay [TPHA]) with regard to our tested public health population (average VDRL+ TPHA+ and VDRL- TPHA+ reactor ages being 59.9 years and 50.5 years, respectively. Retrospective analysis covered the results of a routine parallel VDRL and TPHA testing on 24,863 persons done in four public health laboratories. Nosologic sensitivity of the VDRL test (18.32%) was determined using the TPHA test as reference. The percentage of VDRL nonreactors among infected persons (TPHA reactors) was considered as the VDRL false negative rate (81.68%). We estimated the proportion of persons infected but untreated with potential late active syphilis using our own Bayes theorem-based procedure. The Bayes theorem-based estimate showed a significantly higher value for persons at risk of active late syphilis than the number of suspected cases obtained using the classical approach (25.1% versus 18.32%, or 83 persons versus 61 of the 330 infected)." }, { "role": "assistant", "content": "In screening an older population, the VDRL test alone (or as the first of a series with TPHA as a confirmation test) may produce a diagnostic miss rate higher than the syphilis detection rate. Another miss in such a population is detected by the Bayes theorem-based method. 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": "BNP is regarded by" }, { "role": "assistant", "content": "The correct answer is Inhibition of the neutral endopeptidase (NEPinh) had been investigated as a potential novel therapeutic approach because of its ability to increase the plasma concentrations of the natriuretic peptides (NPs). Indeed, the NPs have potent natriuretic and vasodilator propeies, inhibit the activity of the renin-angiotensin-aldosterone system, lower sympathetic drive, and have antiproliferative and antihyperophic effects Refer katzung 11e p303" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Anti-Inflammatory Agents, Non-Steroidal, Cytokines, Diclofenac, Fibrinolysis, Inflammation Mediators, Pleura, Pleurodesis, Swine, Thoracic Surgery, Video-Assisted." }, { "role": "user", "content": "Does perioperative diclofenac application during video-assisted thoracic surgery pleurodesis modulate early inflammatory and fibrinolytic processes in an experimental model? Context: It has been substantiated that the quality of pleurodesis is reduced when non-steroidal anti-inflammatory drugs (NSAIDs) are used perioperatively. The effects of NSAID administration on the early inflammatory and fibrinolytic processes after mechanical pleurodesis were investigated in an established pig model. Left-sided mechanical pleural abrasion was performed on 24 pigs assigned to either an NSAID or a control group. Pleural fluid and blood samples were analysed over a 24-hour period. Histological evaluation of neutrophil influx at the site of pleural abrasion was performed. The volume of pleural effusion was significantly decreased in the diclofenac group at 10 and 24 h, and the protein content was significantly lower. The diclofenac group at 24 h had a diminished total number of white blood cells and a reduced content of transforming growth factor-β. Moreover, the diclofenac group had a reduced percentage of neutrophils at 6 h. Significantly increased levels of D-dimers and tissue plasminogen activator were measured at 6 h and of interleukin-10 at 24 h. Neutrophils at the site of pleural abrasion were significantly reduced." }, { "role": "assistant", "content": "Systemic application of diclofenac led to a local enhancement of fibrinolysis and attenuation of pro-inflammatory and fibrotic processes necessary for adhesion formation in our model. 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": "Lewy's body is seen in ?" }, { "role": "assistant", "content": "The correct answer is Ans. (c) ParkinsonismRef: Robbin's pathology 9th ed. /1294-95Lewy body is an eosinophilic cytoplasmic inclusion consisting of a dense core surrounded by a halo of 10-nm- wide radiating fibrils, the primary structural component of which is alpha-synuclein. It is seen in Parkinsonism,Dementia with Lewy bodies, shy dragger syndrome.* Alzheimer diseaseHirona bodies/ neurofibrillary tangles* RabiesNegri bodies* Parkinsonism, dementia with Lewy bodiesLewy bodies* Pick bodiesPick disease" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Antineoplastic Agents, Apoptosis, Biomarkers, Tumor, Breast Neoplasms, Clinical Trials, Phase II as Topic, Docetaxel, Doxorubicin, Electrophoretic Mobility Shift Assay, Enzyme Activation, ErbB Receptors, Female, Humans, Image Processing, Computer-Assisted, Immunohistochemistry, In Situ Nick-End Labeling, Inhibitor of Apoptosis Proteins, Ki-67 Antigen, Microtubule-Associated Proteins, Neoadjuvant Therapy, Neoplasm Proteins, Proto-Oncogene Proteins c-bcl-2, Receptor, ErbB-2, Receptors, Estrogen, Risk Factors, STAT3 Transcription Factor, Survivin, Taxoids, bcl-X Protein, src-Family Kinases." }, { "role": "user", "content": "Is activation of stat3 in primary tumors from high-risk breast cancer patients associated with elevated levels of activated SRC and survivin expression? Context: Constitutive activation of signal transducer and activator of transcription 3 (Stat3) protein has been observed in a wide variety of tumors, including breast cancer, and contributes to oncogenesis at least in part by prevention of apoptosis. In a study of 45 patients with high-risk breast cancer enrolled in a phase II neoadjuvant chemotherapy trial with docetaxel and doxorubicin, we evaluated the levels of Stat3 activation and potentially associated molecular biomarkers in invasive breast carcinoma compared with matched nonneoplastic tissues. Using immunohistochemistry and image analysis, we quantified the levels of phospho-Stat3 (pY-Stat3), phospho-Src (pY-Src), epidermal growth factor receptor, HER2/neu, Ki-67, estrogen receptor, Bcl-2, Bcl-xL, Survivin, and apoptosis in formalin-fixed, paraffin-embedded sections from invasive carcinomas and their paired nonneoplastic parenchyma. The levels of molecular biomarkers in nonneoplastic and tumor tissues were analyzed as continuous variables for statistically significant correlations. Levels of activated pY-Stat3 and pY-Src measured by immunohistochemistry were significantly higher in invasive carcinoma than in nonneoplastic tissue (P < 0.001). In tumors, elevated levels of pY-Stat3 correlated with those of pY-Src and Survivin. Levels of pY-Stat3 were higher in partial pathologic responders than in complete pathologic responders. In partial pathologic responders, pY-Stat3 levels correlated with Survivin expression." }, { "role": "assistant", "content": "Our findings suggest important roles for elevated activities of Stat3 and Src, as well as Survivin expression, in malignant progression of breast cancer. Furthermore, elevated Stat3 activity correlates inversely with complete pathologic response. These findings suggest that specific Stat3 or Src inhibitors could offer clinical benefits to patients with breast cancer. 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: INTRODUCTION, METHODS, RESULTS. Meshes: Aged, Arthroplasty, Replacement, Knee, Female, Follow-Up Studies, Humans, Knee Joint, Knee Prosthesis, Male, Middle Aged, Osteoarthritis, Knee, Range of Motion, Articular, Recovery of Function, Retrospective Studies, Treatment Outcome." }, { "role": "user", "content": "Lower limb alignment control: is it more challenging in lateral compared to medial unicondylar knee arthroplasty? Context: Limb alignment after unicondylar knee arthroplasty (UKA) has a significant impact on outcomes. The literature lacks lateral UKA alignment studies, making our understanding of this issue based on medial UKA. We evaluated limb alignment in 241 patients who underwent medial (229 knees) or lateral (37 knees) UKA. Alignment was measured pre and postoperatively in radiographs and intra-operatively using a navigation system. We compared the percentage of over-correction and the difference between post-operative alignment and navigation measurement. Percentage of overcorrection was significantly higher in the lateral UKAs (11%) compared to the medial UKAs (4%). In medial UKAs, the mean difference between the intraoperative alignment and the post-operative was 1.33°. This was significantly lower than the mean 1.86° difference in the lateral UKAs." }, { "role": "assistant", "content": "Our data demonstrated an increased risk of \"overcorrection,\" and greater difficulty in predicting postoperative alignment using computer navigation, when performing lateral UKAs compared to medial UKAs." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Asthma, Child, Guideline Adherence, Health Care Surveys, Health Services Accessibility, Health Services Needs and Demand, Humans, Monitoring, Physiologic, Needs Assessment, Patient Care Planning, Pennsylvania, Rural Population, School Health Services, Schools, Urban Population." }, { "role": "user", "content": "Rural and urban children with asthma: are school health services meeting their needs? Context: Children with asthma spend a large portion of their day in school, and the extent to which public schools are prepared to meet their health needs is an important issue. The objective of this study was to identify asthma policies and practices in rural and urban school settings and to compare them with current National Heart, Lung, and Blood Institute recommendations. A stratified random sample of school nurses who represented each of the 500 active Pennsylvania school districts were surveyed in 2004 concerning nurse staffing patterns, availability of asthma monitoring and treatment-related equipment, emergency preparedness, availability of asthma-related support and case management services, school-specific procedures including identification of children with asthma and accessibility of inhaler medication during school hours, presence and content of written asthma management plans, and perceived obstacles to asthma management in the school setting. Sampling weights were incorporated into the analyses to take the survey design into account. The overall response rate was 76%, with a total of 757 surveys analyzed. In more than half of secondary schools and three quarters of elementary schools, nurses were present<40 hours per week. Nearly 1 in 5 schools reported that staff who know what to do for a severe asthma attack were not always available. In 72% of rural schools, children were allowed to self-carry rescue inhalers, as compared with 47% of urban schools. Asthma management plans were on file for only 1 quarter of children with asthma, and important information often was omitted. Approximately half of the schools were equipped with peak flow meters and nebulizers, and spacers were available in 1 third of schools." }, { "role": "assistant", "content": "Improvements are needed to bring schools into compliance with current recommendations, including more consistent availability of knowledgeable staff, improved access to asthma monitoring and treatment-related equipment, more universal use of asthma management plans, and greater access to inhalers while at school, including increasing the proportion of children who are allowed to carry and self-administer inhaler medication." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All are True about endometrial carcinoma in clinical stage III except" }, { "role": "assistant", "content": "The correct answer is Endometrial cancer stage III:\nStage IIIA: Involvement of uterine serosa and/ or adnexa\nStage IIIB: Involvement of vagina and/or parametrium\nStage IIIC:\n\nIIIC1: Positive Pelvic nodes\nIIIC2: Positive Paraaortic nodes with or without positive pelvic nodes" } ]

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

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following pontic designs doesn’t have mucosal contact:" }, { "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: INTRODUCTION AND HYPOTHESIS, METHODS, RESULTS. Meshes: Adolescent, Adult, Body Mass Index, Delivery, Obstetric, Female, Gravidity, Gynecological Examination, Humans, Labor Stage, Second, Middle Aged, Parturition, Postpartum Period, Pregnancy, Pregnancy Complications, Prenatal Diagnosis, Rectocele, Rectum, Time Factors, Ultrasonography, Valsalva Maneuver, Young Adult." }, { "role": "user", "content": "Does childbirth play a role in the etiology of rectocele? Context: Rectoceles are common among parous women and they are believed to be due to disruption or distension of the rectovaginal septum as a result of childbirth. However, the etiology of rectocele is likely to be more complex since posterior compartment prolapse does occur in nulliparous women. This study was designed to determine the role of childbearing as an etiological factor in true radiological rectocele. This was a secondary analysis of the data from 657 primiparous women recruited as part of a previously reported study and another ongoing prospective study. Women were invited for antenatal and postnatal appointments comprising an interview, clinical examination and translabial ultrasonography. The presence and depth of any rectocele were determined on maximum Valsalva maneuver, as was descent of the rectal ampulla. Potential demographic and obstetric factors as predictors of rectocele development were evaluated using either multiple regression or logistic regression analysis as appropriate. A true rectocele was identified in 4% of women antenatally and in 16% after childbirth (P<0.001). Mean rectocele depth was 13.5 mm (10 - 23.2 mm). The mean antepartum position of the rectal ampulla on Valsalva maneuver was 4.39 mm above and it was 1.64 mm below the symphysis pubis postpartum (P<0.0001). De novo appearance of true rectocele was significantly associated with a history of previous<20 weeks pregnancy and fetal birth weight. Body mass index and length of the second stage were associated with rectocele depth increase." }, { "role": "assistant", "content": "Childbirth seems to play a distinct role in the pathogenesis of rectocele. Both maternal and fetal factors seem to contribute." } ]

[ { "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 infective form of toxoplasma gondii is-a) Oocystb) Bradycystc) Tachyzoited) All of the above" }, { "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: ADAM10 Protein, Amyloid Precursor Protein Secretases, Astrocytes, Cells, Cultured, Chemokine CX3CL1, Culture Media, Serum-Free, Cytokines, Dose-Response Relationship, Drug, Enzyme Inhibitors, Humans, Matrix Metalloproteinases, Membrane Proteins, RNA, Messenger, Time Factors, p38 Mitogen-Activated Protein Kinases." }, { "role": "user", "content": "Is fractalkine shedding mediated by p38 and the ADAM10 protease under pro-inflammatory conditions in human astrocytes? Context: The fractalkine (CX3CR1) ligand is expressed in astrocytes and reported to be neuroprotective. When cleaved from the membrane, soluble fractalkine (sCX3CL1) activates the receptor CX3CR1. Although somewhat controversial, CX3CR1 is reported to be expressed in neurons and microglia. The membrane-bound form of CX3CL1 additionally acts as an adhesion molecule for microglia and infiltrating white blood cells. Much research has been done on the role of fractalkine in neuronal cells; however, little is known about the regulation of the CX3CL1 ligand in astrocytes. The mechanisms involved in the up-regulation and cleavage of CX3CL1 from human astrocytes were investigated using immunocytochemistry, Q-PCR and ELISA. All statistical analysis was performed using GraphPad Prism 5. A combination of ADAM17 (TACE) and ADAM10 protease inhibitors was found to attenuate IL-1β-, TNF-α- and IFN-γ-induced sCX3CL1 levels in astrocytes. A specific ADAM10 (but not ADAM17) inhibitor also attenuated these effects, suggesting ADAM10 proteases induce release of sCX3CL1 from stimulated human astrocytes. A p38 MAPK inhibitor also attenuated the levels of sCX3CL1 upon treatment with IL-1β, TNF-α or IFN-γ. In addition, an IKKβ inhibitor significantly reduced the levels of sCX3CL1 induced by IL-1β or TNF-α in a concentration-dependent manner, suggesting a role for the NF-kB pathway." }, { "role": "assistant", "content": "In conclusion, this study shows that the release of soluble astrocytic fractalkine is regulated by ADAM10 proteases with p38 MAPK also playing a role in the fractalkine shedding event. These findings are important for understanding the role of CX3CL1 in healthy and stimulated astrocytes and may benefit our understanding of this pathway in neuro-inflammatory and neurodegenerative diseases. 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: Age Factors, Aged, 80 and over, Aging, China, Cross-Sectional Studies, Female, Humans, Male, Self Concept." }, { "role": "user", "content": "Does the cross-domain correlate of subjective age in Chinese oldest-old? Context: This study examined subjective age and its cross-domain correlates in Chinese oldest-old. We conducted a secondary data analysis using cross-sectional data drawn from the 2006 Sample Survey on the Aged Population in Urban/Rural China, which consisted of a sample of 860 community-dwelling Chinese older adults aged 85 years and above. A small percentage (8%) of the oldest-old participants reported that they did not feel old. Binary logistic regression analyses revealed that urban living, better physical and self-reported cognitive functioning and mental health were all related to not feeling old, whereas chronological age was found to have no association with subjective age when controlling for indicators of physical and self-reported cognitive functioning." }, { "role": "assistant", "content": "The findings revealed the key roles of functional limitations and mental health in the construction of subjective age in Chinese oldest-old. The possible cross-cultural similarity in the links of subjective age to mental health and physical functioning in later life suggests that maintaining a youthful subjective age may have adaptive value for the oldest-old and contribute to their successful aging. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All may be clinical feature of malignant hypehermia except-" }, { "role": "assistant", "content": "The correct answer is Hypercalcemia does not occur, hypocalcemia occurs. Hypeension may be rapidly followed by hypotension. Clinical Manifestations of Malignant Hypehermia: Early Signs: Elevated end-tidal carbon dioxide Tachypnea and/or tachycardia Masseter spasm, if succinylcholine has been used Generalized muscle rigidity Mixed metabolic and respiratory acidosis Profuse sweating Mottling of skin Cardiac arrhythmias Unstable blood pressure Late Signs Hyperkalemia Rapid increase of core body temperature- body temperature rises by 10C every 5 minutes Elevated creatine phosphokinase levels Gross myoglobinemia and myoglobinuria Cardiac arrest Disseminated intravascular coagulation" } ]

[ { "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": "Iron is stored in-" }, { "role": "assistant", "content": "The correct answer is Free iron is highly toxic and it is therefore impoant that storage iron be sequestered. This is achieved by binding of iron in the storage pool to either ferritin or hemosiderin.Ferritin is ubiquitous protein iron complex that is found at highest level in liver,spleen ,bonemarrow and skeletal muscles. In the liver ferritin is stored within the parenchymal cells and in other tissues such as spleen and the bonemarrow it ix found mainly in the macrophages. Ref: Robbins and Cotran Pathologic basis of disease.South Asia Edition -9;volume 1.page no . 420" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: 3' Untranslated Regions, 5' Untranslated Regions, Animals, Antibodies, Viral, Cell Line, Tumor, Chlamydomonas reinhardtii, Chloroplasts, Female, Human papillomavirus 16, Humans, Mice, Mice, Inbred C57BL, Papillomavirus E7 Proteins, Papillomavirus Infections, Papillomavirus Vaccines, Recombinant Fusion Proteins, Survival Analysis, Uterine Cervical Neoplasms, Vaccines, Subunit." }, { "role": "user", "content": "Does a Chlamydomonas-derived Human Papillomavirus 16 E7 vaccine induce specific tumor protection? Context: The E7 protein of the Human Papillomavirus (HPV) type 16, being involved in malignant cellular transformation, represents a key antigen for developing therapeutic vaccines against HPV-related lesions and cancers. Recombinant production of this vaccine antigen in an active form and in compliance with good manufacturing practices (GMP) plays a crucial role for developing effective vaccines. E7-based therapeutic vaccines produced in plants have been shown to be active in tumor regression and protection in pre-clinical models. However, some drawbacks of in whole-plant vaccine production encouraged us to explore the production of the E7-based therapeutic vaccine in Chlamydomonas reinhardtii, an organism easy to grow and transform and fully amenable to GMP guidelines. An expression cassette encoding E7GGG, a mutated, attenuated form of the E7 oncoprotein, alone or as a fusion with affinity tags (His6 or FLAG), under the control of the C. reinhardtii chloroplast psbD 5' UTR and the psbA 3' UTR, was introduced into the C. reinhardtii chloroplast genome by homologous recombination. The protein was mostly soluble and reached 0.12% of total soluble proteins. Affinity purification was optimized and performed for both tagged forms. Induction of specific anti-E7 IgGs and E7-specific T-cell proliferation were detected in C57BL/6 mice vaccinated with total Chlamydomonas extract and with affinity-purified protein. High levels of tumor protection were achieved after challenge with a tumor cell line expressing the E7 protein." }, { "role": "assistant", "content": "The C. reinhardtii chloroplast is a suitable expression system for the production of the E7GGG protein, in a soluble, immunogenic form. The production in contained and sterile conditions highlights the potential of microalgae as alternative platforms for the production of vaccines for human uses. 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: Buddleja, Cell Nucleus, Gene Dosage, Genes, Plant, Geography, Haplotypes, Hybridization, Genetic, Inbreeding, Pollen, Pollination, Sequence Analysis, DNA, Species Specificity." }, { "role": "user", "content": "Do natural hybridization and asymmetric introgression at the distribution margin of two Buddleja species with a large overlap? Context: Natural hybridization in plants is universal and plays an important role in evolution. Based on morphology it has been presumed that hybridization occurred in the genus Buddleja, though genetic studies confirming this assumption have not been conducted to date. The two species B. crispa and B. officinalis overlap in their distributions over a wide range in South-West China, and we aimed to provide genetic evidence for ongoing hybridization in this study. We investigated the occurrence of hybrids between the two species at the southern-most edge of the distribution of B. crispa using five nuclear loci and pollination experiments. The genetic data suggest substantial differentiation between the two species as species-specific alleles are separated by at least 7-28 mutations. The natural hybrids found were nearly all F1s (21 of 23), but backcrosses were detected, and some individuals, morphologically indistinguishable from the parental species, showed introgression. Pollen viability test shows that the percentage of viable pollen grains was 50 ± 4% for B. crispa, and 81 ± 2% for B. officinalis. This difference is highly significant (t = 7.382, p < 0.0001). Hand cross-pollination experiments showed that B. crispa is not successful as pollen-parent, but B. officinalis is able to pollinate B. crispa to produce viable hybrid seed. Inter-specific seed-set is low (8 seeds per fruit, as opposed to about 65 for intra-specific pollinations), suggesting post-zygotic reproductive barriers. In addition, one of the reference populations also suggests a history of introgression at other localities." }, { "role": "assistant", "content": "The occurrence of morphologically intermediate individuals between B. crispa and B. officinalis at Xishan Mountain is unequivocally linked to hybridization and almost all examined individuals of the putative hybrids were likely F1s. Despite pollination experiments indicating higher chances for introgression into B. officinalis (hybrids only produced viable seed when crossed with B. officinalis), observed introgression was asymmetrical into B. crispa. This could be due to seeds produced by hybrids not contributing to seedlings, or other factors favoring the establishment of backcrosses towards B. crispa. However, further research will be needed to confirm these observations, as the small number of plants used for the pollination experiments could have introduced an artifact, for example if used individuals were more or less compatible than the species average, and also the small number of loci used could convey a picture of introgression that is not representative for the whole genome. 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: Adenosine Diphosphate, Animals, Blood Platelets, Calcium, Disease Models, Animal, Humans, Intracellular Fluid, Mice, Platelet Aggregation, Platelet Count, Protein Kinase C-epsilon, Signal Transduction, Thrombosis, Thromboxanes." }, { "role": "user", "content": "Does protein kinase C isoform ε negatively regulate ADP-induced calcium mobilization and thromboxane generation in platelets? Context: Members of the protein kinase C (PKC) family are shown to positively and negatively regulate platelet activation. Although positive regulatory roles are extensively studied, negative regulatory roles of PKCs are poorly understood. We investigated the mechanism and specific isoforms involved in PKC-mediated negative regulation of ADP-induced functional responses. A pan-PKC inhibitor, GF109203X, potentiated ADP-induced cPLA(2) phosphorylation and thromboxane generation as well as ERK activation and intracellular calcium (Ca(2+)(i)) mobilization, 2 signaling molecules, upstream of cPLA(2) activation. Thus, PKCs inhibit cPLA(2) activation by inhibiting ERK and Ca(2+)(i) mobilization. Because the inhibitor of classic PKC isoforms, GO-6976, did not affect ADP-mediated thromboxane generation, we investigated the role of novel class of PKC isoforms. ADP-induced thromboxane generation, calcium mobilization, and ERK phosphorylation were potentiated in PKCε null murine platelets compared with platelets from wild-type littermates. Interestingly, when thromboxane release is blocked, ADP-induced aggregation in PKCε knockout and wild-type was similar, suggesting that PKCε does not affect ADP-induced aggregation directly. PKCε knockout mice exhibited shorter times to occlusion in an FeCl(3)-induced arterial injury model and shorter bleeding times in tail-bleeding experiments." }, { "role": "assistant", "content": "We conclude that PKCε negatively regulates ADP-induced thromboxane generation in platelets and offers protection against thrombosis. 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 cerebrospinal fluid" }, { "role": "assistant", "content": "The correct answer is The cerebrospinal fluid is a modified tissue fluid. It is contained in the ventricular system of the brain and in the subarachnoid space around the brain and spinal cord. The bulk of cerebrospinal fluid is formed by the choroid plexuses of the lateral ventricles and lesser amounts by the choroid plexuses of third and fouh ventricles Ref BDC volume3,6th edition pg 331" } ]

[ { "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": "Bacterial species seen in skin ?" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., Propionobacterium" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adult, Birth Weight, Cause of Death, Child, Cohort Studies, Communicable Disease Control, Dietary Supplements, Female, Gambia, Health Status, Humans, Immune System, Longitudinal Studies, Male, Maternal Welfare, Nutritional Status, Pregnancy, Prenatal Exposure Delayed Effects, Rural Health, Seasons, Vaccines." }, { "role": "user", "content": "Is immune function in rural Gambian children related to season of birth , birth size , or maternal supplementation status? Context: We previously showed that mortality from infectious diseases among young adults in rural Gambia is strongly correlated with the season of their birth. This suggests that early life insults that involve fetal malnutrition, exposure to natural toxins, or highly seasonal infections affecting the infant or pregnant mother cause permanent damage to the immune system. Excess mortality begins after puberty and has a maximal odds ratio of >10 for deaths between ages 25 and 50 y. We investigated the immune function of children according to birth weight, season of birth, and exposure to maternal dietary supplementation during pregnancy. Immune function was measured in 472 prepubertal children aged 6.5-9.5 y from 28 villages in rural Gambia. The mothers of these children had been randomly assigned to a high-energy prenatal supplementation program, which significantly increased birth weight. This permitted supplementation status, birth weight, and season of birth to be investigated as exposure variables. The outcome variables tested were naive responses to rabies and pneumococcus vaccines, delayed-type hypersensitivity skin reactions, and mucosal defense (secretory immunoglobulin A and dual-sugar permeability). Immune responses were strongly related to current age and sex, suggesting a high level of sensitivity, but were not consistently related to birth weight, season of birth, or maternal supplementation (control compared with intervention)." }, { "role": "assistant", "content": "Events in early life did not predict a measurable defect in immune response within this cohort of rural Gambian children. It is possible that the early programming of immune function may be mediated through a defect in immunologic memory or early senescence rather than through impairment of early responses. 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": "Compounds with a large amount of carbohydrate & small amount of protein -" }, { "role": "assistant", "content": "The correct answer is A large amount of carbohydrate small amount of protein → Proteoglycans.\nA large amount of protein small amount of carbohydrate → Glycoproteins." } ]

[ { "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": "Pyruvate is converted to which substance to start gluconeogenesis?" }, { "role": "assistant", "content": "The correct answer is Ans. (a) OxaloacetateRef Harper's Biochemistry 28/e, chapter 20" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Cells, Cultured, Cytokines, HSP72 Heat-Shock Proteins, Humans, Neutrophil Activation, Respiratory Mucosa, Respiratory Syncytial Viruses, Toll-Like Receptors." }, { "role": "user", "content": "Is extracellular Hsp72 , an endogenous DAMP , released by virally infected airway epithelial cells and activates neutrophils via Toll-like receptor ( TLR ) -4? Context: Neutrophils play an important role in the pathophysiology of RSV, though RSV does not appear to directly activate neutrophils in the lower airways. Therefore locally produced cytokines or other molecules released by virally-infected airway epithelial cells are likely responsible for recruiting and activating neutrophils. Heat shock proteins (HSPs) are generally regarded as intracellular proteins acting as molecular chaperones; however, HSP72 can also be released from cells, and the implications of this release are not fully understood. Human bronchial epithelial cells (16HBE14o-) were infected with RSV and Hsp72 levels were measured by Western blot and ELISA. Tracheal aspirates were obtained from critically ill children infected with RSV and analyzed for Hsp72 levels by ELISA. Primary human neutrophils and differentiated HL-60 cells were cultured with Hsp72 and supernatants analyzed for cytokine production. In some cases, cells were pretreated with polymyxin B prior to treatment with Hsp72. IkappaBalpha was assessed by Western blot and EMSA's were performed to determine NF-kappaB activation. HL-60 cells were pretreated with neutralizing antibody against TLR4 prior to Hsp72 treatment. Neutrophils were harvested from the bone marrow of wild type or TLR4-deficient mice prior to treatment with Hsp72. Infection of 16HBE14o- with RSV showed an induction of intracellular Hsp72 levels as well as extracellular release of Hsp72. Primary human neutrophils from normal donors and differentiated HL-60 cells treated with increasing concentrations of Hsp72 resulted in increased cytokine (IL-8 and TNFalpha) production. This effect was independent of the low levels of endotoxin in the Hsp72 preparation. Hsp72 mediated cytokine production via activation of NF-kappaB translocation and DNA binding. Using bone marrow-derived neutrophils from wild type and TLR4-mutant mice, we showed that Hsp72 directly activates neutrophil-derived cytokine production via the activation of TLR4." }, { "role": "assistant", "content": "Collectively these data suggest that extracellular Hsp72 is released from virally infected airway epithelial cells resulting in the recruitment and activation of neutrophils. 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, Arousal, Conditioning, Classical, Cross-Over Studies, Diazepam, Eszopiclone, GABA Agents, Hypnotics and Sedatives, Macaca mulatta, Male, Orexin Receptor Antagonists, Orexins, Piperidines, Polysomnography, Signal Transduction, Sleep, Sleep Stages, Triazoles, Wakefulness." }, { "role": "user", "content": "Does inhibition of Orexin Signaling promote Sleep Yet Preserves Salient Arousability in Monkeys? Context: In addition to enhancing sleep onset and maintenance, a desirable insomnia therapeutic agent would preserve healthy sleep's ability to wake and respond to salient situations while maintaining sleep during irrelevant noise. Dual orexin receptor antagonists (DORAs) promote sleep by selectively inhibiting wake-promoting neuropeptide signaling, unlike global inhibition of central nervous system excitation by gamma-aminobutyric acid (GABA)-A receptor (GABAaR) modulators. We evaluated the effect of DORA versus GABAaR modulators on underlying sleep architecture, ability to waken to emotionally relevant stimuli versus neutral auditory cues, and performance on a sleepiness-sensitive cognitive task upon awakening. DORA-22 and GABAaR modulators (eszopiclone, diazepam) were evaluated in adult male rhesus monkeys (n = 34) with continuous polysomnography recordings in crossover studies of sleep architecture, arousability to a classically conditioned salient versus neutral acoustical stimulus, and psychomotor vigilance task (PVT) performance if awakened. All compounds decreased wakefulness, but only DORA-22 sleep resembled unmedicated sleep in terms of underlying sleep architecture, preserved ability to awaken to salient-conditioned acoustic stimuli while maintaining sleep during neutral acoustic stimuli, and no congnitive impairment in PVT performance. Although GABAaR modulators induced lighter sleep, monkeys rarely woke to salient stimuli and PVT performance was impaired if monkeys were awakened." }, { "role": "assistant", "content": "In nonhuman primates, DORAs' targeted mechanism for promoting sleep protects the ability to selectively arouse to salient stimuli and perform attentional tasks unimpaired, suggesting meaningful differentiation between a hypnotic agent that works through antagonizing orexin wake signaling versus the sedative hypnotic effects of the GABAaR modulator mechanism of action. 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": "Kallu, a 30 years old man, presented with subcutaneous itchy nodules over the left iliac crest. On examination they are firm, non-tender and mobile. Skin scrapping contains microfilaria and adult worms of:" }, { "role": "assistant", "content": "The correct answer is Ans. (b)O. volvulus-causes onchocerciasis in man. The worms develop in the subcutaneous tissue often encapsulated in dense fibrous nodules. The nodules occur over anatomic sites where the bone is superficial such as knees, hips, iliac crests, elbow, ribs, scalp etc. The nodules are movable. The microfilariae live in the superficial layers of the skin causing itching and in heavy chronic infections, gross thickening of the skin.Loa loa--causes loiasis. The adult worms live in subcutaneous connective tissues and wander round the body causing, usually painless, oedematous swellings known as fugitive or calabar swellings.B. malayi causes lymphangitis and elephantiasis. It is characterized by absence of chyluria and rarity of scrotal swelling.Mansonella persfans-live adults appear to produce little or no host reaction, however, eosinophilia is common. Pruritis, abdominal pain, urticaria and calabar like swellings occur." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Anti-Bacterial Agents, Cross Infection, Drug Resistance, Multiple, Bacterial, Hospitals, University, Humans, Methicillin Resistance, Methicillin-Resistant Staphylococcus aureus, Microbial Sensitivity Tests, Paris, Retrospective Studies, Staphylococcal Infections, Staphylococcus aureus." }, { "role": "user", "content": "Trends in Staphylococcus aureus antimicrobials susceptibilities: is methicillin still a relevant multiresistance marker? Context: Recent change was noted in S. aureus epidemiology, especially for none multiresistant methicillinresistant S. aureus (MRSA) and for multiresistant methicillin-susceptible S. aureus (MSSA). So, a six-year retrospective study was conducted to follow trends in antimicrobials resistance and to determine if methicillin remained a relevant multiresistant marker. All S. aureus isolates (duplicates excluded) isolated between 2001 and 2006 in a French 800-beds-teaching-hospital were included in the study. Four thousand four hundred and fifty-five isolates providing from 3602 patients were identified between 2001 and 2006. MRSA rate and incidence for 1000 hospitalization-days significantly decreased from 34.7 to 22.6% and 1.3 to 0.6% respectively (p<0.001). Significant decrease was observed for multiresistant MRSA (72.9 to 46.3%, p<0.001), while no change was observed for multiresistant MSSA (2.9 to 3.4%). Among the 186 different antibiotic patterns isolated, four MRSA-phenotypes significantly decreased whereas two MSSA-phenotypes significantly increased. The main MRSA phenotype, resistant to kanamycin, tobramycin, macrolides-lincosamides-streptograminesB, and fluoroquinolones, significantly decreased from 11.9 to 5.9% (p<0.001). Glycopeptide Intermediate S. aureus (GISA) phenotypes disappeared." }, { "role": "assistant", "content": "At this date, methicillin remains in our institution a relevant marker of multiresistance but trend is changing." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Animals, Blood Gas Analysis, Blood-Brain Barrier, Blotting, Western, Boronic Acids, Bortezomib, Brain Edema, Brain Injuries, Dexamethasone, Disease Models, Animal, Immunohistochemistry, Male, Mice, Mice, Inbred C57BL, Multivariate Analysis, Proteasome Endopeptidase Complex, Pyrazines, RNA, Messenger, Random Allocation, Real-Time Polymerase Chain Reaction, Receptors, Glucocorticoid, Reference Values, Sensitivity and Specificity, Statistics, Nonparametric." }, { "role": "user", "content": "Does inhibition of proteasomal glucocorticoid receptor degradation restore dexamethasone-mediated stabilization of the blood-brain barrier after traumatic brain injury? Context: To establish the molecular background for glucocorticoid insensitivity, that is, failure to reduce edema formation and to protect blood-brain barrier integrity after acute traumatic brain injury. Controlled animal study. University research laboratory. Male C57Bl/6N mice. Mechanical brain lesion by controlled cortical impact. Our study demonstrates that 1) proteasomal glucocorticoid receptor degradation is established in brain endothelial cells after traumatic brain injury as a form of posttranslational glucocorticoid receptor modification; 2) inhibition of the proteasomal degradation pathway with bortezomib (0.2 mg/kg) in combination with the glucocorticoid dexamethasone (10 mg/kg) by subcutaneous injection 30 minutes postinjury restores levels of barrier sealing glucocorticoid receptor target occludin in brain endothelial cells, improves blood-brain barrier integrity, reduces edema formation, and limits neuronal damage after brain trauma." }, { "role": "assistant", "content": "The results indicate that the stabilizing effect of glucocorticoids on the blood-brain barrier is hampered after cerebral lesions by proteasomal glucocorticoid receptor degradation in brain endothelial cells and restored by inhibition of proteasomal degradation pathways. The results provide underlying mechanisms for the clinically observed inefficacy of glucocorticoids. The novel combined treatment strategy might help to attenuate trauma-induced brain edema formation and neuronal damage as secondary effects of brain trauma. 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: ." }, { "role": "user", "content": "Do hemodynamic changes during a deep inspiration maneuver predict fluid responsiveness in spontaneously breathing patients? Context: We hypothesized that the hemodynamic response to a deep inspiration maneuver (DIM) indicates fluid responsiveness in spontaneously breathing (SB) patients. Prospective study. ICU of a general hospital. Consecutive nonintubated patients without mechanical ventilation, considered for volume expansion (VE). We assessed hemodynamic status at baseline and after VE. We measured radial pulse pressure (PP) using an arterial catheter and peak velocity of femoral artery flow (VF) using continuous Doppler. Changes in PP and VF induced by a DIM (ΔPPdim and ΔVFdim) were calculated in 23 patients. ΔPPdim and ΔVFdim ≥12% predicted responders to VE with sensitivity of 90% and specificity of 100%." }, { "role": "assistant", "content": "In a restricted population of SB patients with severe sepsis or acute pancreatitis, ΔPPdim and ΔVFdim are accurate indices for predicting fluid responsiveness. These results should be confirmed in a larger population before validating their use in current practice. 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": "45 year old alcoholic male came for deaddiction treatment. He has alcohol induced hepatitis with other blood parameters within normal limits. The drug that should not be chosen for relapse prevention is" }, { "role": "assistant", "content": "The correct answer is NALTREXONE is an OPIOID ANTAGONIST given at a dosage of 50-150mg, should not be used in LIVER DYSFUNCTION ACAMPROSATE is an GABA AGONIST given at a dosage of 666MG TDS, should not be used in KIDNEY DYSFUNCTION Ref.Kaplon and Sadock, synopsis of psychiatry, 11 th edition, pg no.626" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Athletes, Athletic Performance, Bicycling, Body Temperature, Body Temperature Regulation, Cross-Over Studies, Drinking, Humans, Male, Temperature, Young Adult." }, { "role": "user", "content": "Does the temperature of water ingested ad libitum influence performance during a 40-km self-paced cycling trial in the heat? Context: The aim of the present study was to evaluate the effects of the temperature of ingested water on performance during a 40-km self-paced cycling trial in the heat (35º C and 60% relative humidity). The study was randomized, counterbalanced, crossover and single-blinded. Ten well-trained male cycling athletes (cyclists, mountain bikers or triathletes) who were non-acclimatized to heat were subjected to four experimental situations divided into two sets. In the first set, the participants performed two trials, during which they were given either cold (10º C) or warm water (37º C) ad libitum. In these situations, the volume and timing of the water ingestion (when each bolus was ingested) were recorded and replicated in the second set, but the water temperature was reversed. The performance times were unaffected by the water intake volume (P=0.425), but the water at a temperature of 37º C tended to induce lower performance times (P=0.078) during the trials (AL10=93.0±3.5 min; AL37=94.4±4.1 min; SC10=93.4±4.0; SC37=97.4±4.3 min). The water intake was greater when the water was cold (P<0.05), but the temperature did not affect the heat storage rate, rectal temperature, mean skin temperature, heart rate, blood glucose level, sweat loss, sweat rate, perceived exertion rate or plasma volume changes. However, a significant reduction in the plasma volume change from pre- to postexercise was observed (P<0.01)." }, { "role": "assistant", "content": "The performance, thermoregulatory, cardiovascular and metabolic responses during a 40-km self-paced cycling trial in the heat were unaffected by different water temperatures. 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, MATERIALS AND METHODS, RESULTS. Meshes: Cardiopulmonary Resuscitation, Female, Follow-Up Studies, Heart Arrest, Hospital Charges, Humans, Male, Middle Aged, Neoplasms, Prognosis, Retrospective Studies, Survival Rate, Treatment Outcome." }, { "role": "user", "content": "Should a cancer patient be resuscitated following an in-hospital cardiac arrest? Context: Previous reports from general hospitals and cancer centers have identified the presence of malignancy as a poor prognostic indicator for successful cardiopulmonary resuscitation (CPR) for an in-hospital cardiac arrest. The purpose of this study was to evaluate the initial success of CPR as determined by return of spontaneous circulation (ROSC), patient survival to hospital discharge, and 1-year survival of this group as compared to previous studies in non-oncological centers. In addition, the charges incurred in caring for these patients were analyzed. All cardiac arrests occurring between 1 January 1993 and 31 December 1994 were identified from a centralized morbidity and mortality database and reviewed retrospectively. Cardiac arrest was defined as the absence of a palpable pulse and initiation of CPR. Patients suffering pure respiratory arrest or shock without loss of pulse were excluded. Age, gender, primary site of malignancy, initial and ultimate outcome, including Zubrod's functional status (ZFS), and total hospital charges following cardiac arrest were recorded. Computerized billing records were used to tabulate total charges. 83 cardiac arrests occurred during the study period (42 women, 41 men). Mean age was 56.2 years. Forty-two percent of the patients had hematologic malignancies, 19% lung, 15% gastrointestinal, 5% head and neck cancers and 19% other malignancies. Sixty-six percent of the patients had ROSC. Only eight (9.6%) patients survived to hospital discharge: three died within 6 weeks under hospice care, two died within 6 months of discharge and only three (3.6%) patients survived to 1 year. Functional status follow-up of these three patients revealed two with ZFS 1 and one with ZFS 2. Total hospital charges for these 83 patients were US$ 2,959,740." }, { "role": "assistant", "content": "Although ROSC after cardiac arrest in our patients was better than that reported for most series in general hospitals, their ultimate survival and hospital discharge was extremely poor." } ]

[ { "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 threshold of hemoglobin A1c for Diagnosis of Ove diabetes in Pregnancy?" }, { "role": "assistant", "content": "The correct answer is Diagnosis of Ove Diabetes in PregnancyMeasure of GlycemiaThresholdFasting plasma glucoseAt least 126mg/dlHemoglobin A1cAt least 6.5%Random plasma glucoseAt least 200mg/dl plus confirmationRef: William&;s Obstetrics; 24th edition; Chapter 57" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "False + ve VDRL, is seen in all except:" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., Pregnancy(Ref: Harrison, 18th/e, p. 1385; Harrison, 19th/e, p. 1132; Ananthanarayan, 9th/e, p. 370)Since the test employs a non-treponemal antigen, there are many chances of false positive results. False positivity (other than technical) may be due to physiological of pathological conditions. These are called biological false positives (BFP).If they remain positive for less than 6 months it is considered acute and they remain positive for longer than 6 months it is called chronic BFP.The physiological reasons for BFP include pregnancy (Rarely), menstruation, repeated blood loss, vaccination, severe trauma etc., while the reasons for pathological BFP include malaria, infectious mononucleosis, hepatitis, relapsing fever, tropical eosinophilia, lepromatous leprosy, SLE, rheumatoid arthritis, who have recently been immunized etc.A reactive VDRL test does not necessarily imply that the person is syphilitic. The diagnosis must be made in conjunction with clinical findings. Any reactive VDRL test must be confirmed with a specific or treponemal test such as TPHA, FTA-ABS test." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A person laughs to a joke, and then suddenly loses tone of all his muscles. Most probable diagnosis of this condition is?" }, { "role": "assistant", "content": "The correct answer is ANSWER: (A) CataplexyREF: Kaplan & Sadock's Synopsis of Psychiatry 10th Edition Page 274, 760 Cataplexy:Temporary sudden loss of muscle tone, causing weakness and immobilization; can be precipitated by a variety of emotional states and is often followed by sleep. Commonly seen in narcolepsy.Catalepsy:Condition in which persons maintain the body position into which they are placed; observed in severe cases of catatonic schizophrenia. Also called waxy flexibility and cerea flexibilitas. See also command automatism.Cathexis:In psychoanalysis, a conscious or unconscious investment of psychic energy in an idea, concept, object, or person" } ]

[ { "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": "Triad of Miller Fischer syndrome includes all except" }, { "role": "assistant", "content": "The correct answer is Aphasia is not part of triad of Miller Fischer syndrome, which is a variant of Gullaine Barre syndrome." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is most esthetic pontic" }, { "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: Adenocarcinoma, Adult, Apoptosis, Cell Survival, Endometrial Neoplasms, Endometrium, Estradiol, Female, Humans, Inhibitor of Apoptosis Proteins, Middle Aged, Phosphatidylinositol 3-Kinases, Progesterone, Proto-Oncogene Proteins c-akt, Signal Transduction, Stromal Cells, Survivin." }, { "role": "user", "content": "Do normal endometrial stromal cells regulate survival and apoptosis signaling through PI3K/AKt/Survivin pathway in endometrial adenocarcinoma cells in vitro? Context: Stroma-tumor communication plays an important role in the genesis of neoplasia. In the current study, we investigated the effect of normal stromal cells on the survival and apoptosis signaling of endometrial cancer cells and further explored the possible mechanism implied in this communication. Using primarily cultured normal endometrial stromal cells and an endometrial adenocarcinoma cell line, Ishikawa cells, we established a 2D-coculture system to observe the stromal cell-tumor cell crosstalk in endometrial carcinomas. Using methyl thiazolyl tetrazolium (MTT) assays, cell counting and colony formation assays, we analyzed the effect of stomal cells on the growth and proliferation of Ishikawa cells under different conditions. Using western blot analysis, we determined the effect of stromal cells on the activity of PI3K/AKt/Survivin signaling in Ishikawa cells under different conditions. Using immunohistochemistry analysis, we determined the expression of Survivin in normal endometria and endometrial adenocarcinomas. We found that the paracrine factors from normal endometrial stromal cells grown on Matrigel repeatedly and significantly decreased hormone-stimulated activity of PI3K/AKt/Survivin signaling in Ishikawa cells, which were proved to be increased in endometrial adenocarcinoma and essential in hormone-induced cell growth in Ishikawa cells." }, { "role": "assistant", "content": "Paracrine factors from normal endometrial stromal cells can inhibit hormone-stimulated cell proliferation in Ishikawa cells by regulating cell survival and apoptosis through PI3K/AKt/Survivin signaling. 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: Adenoviridae, Alanine Transaminase, Animals, Apoptosis, Gene Transfer Techniques, Genes, bcl-2, Genetic Vectors, Humans, Liver, Liver Transplantation, Male, Mice, Mice, Inbred C57BL, Organ Preservation." }, { "role": "user", "content": "Does genetic modification of liver grafts with an adenoviral vector encoding the Bcl-2 gene improve organ preservation? Context: Liver function after transplantation is determined by the quality of the donor organ and the influences of preservation, flush, and reperfusion injury. In this regard, cell death (apoptosis) plays an important role in organ preservation and rejection. Therefore, we examined the possibility of genetic modification of the liver graft with a recombinant adenovirus vector encoding the Bcl-2 gene to reduce apoptosis during the preservation time. Liver grafts from C57B1/6 mice were procured and preserved using standard techniques. A replication defective adenovirus vector (deltaE1) containing the human Bcl-2 gene (AdCMVhBcl-2) was developed in our laboratory. An adenovirus vector encoding an irrelevant gene (Escherichia coli beta-galactosidase) was used as a control. Each mouse received 1 x 10(9) plaque forming units administered i.v. 48 hr before the liver procurement. Analyses of liver enzyme activities were determined in the preservation solution. Apoptosis in liver biopsies was determined by DNA fragmentation with an in situ histochemical assay. Immunohistochemical analysis and RT-PCR confirmed the expression of hBcl-2 in the grafts. Grafts from livers expressing hBcl-2 showed significant reduction of the aspartame amino transferase (AST) and lactate dehydrogenase (LDH) release compared with grafts from the control groups. After rewarming, significant cytoprotection was also observed in grafts from animals treated with AdCMVhBcl-2. Histological analysis correlated with the hepatocellular injury determined with transaminases and LDH in the preservation solution. Significant reduction in the number of apoptotic cells was observed in grafts expressing hBcl-2." }, { "role": "assistant", "content": "We have demonstrated a novel approach to reducing the preservation injury to liver grafts with the human Bcl-2 gene. This approach may allow a longer preservation time, potentially reduce the incidence of primary nonfunction, decrease the immunogenicity of the cold injured organ, and increase the safer use of \"marginal\" liver grafts. 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, RESULTS. Meshes: Acquired Immunodeficiency Syndrome, CD4-Positive T-Lymphocytes, HIV Antibodies, HIV Infections, HIV-1, Humans, Kinetics, Leukocyte Count, Neutralization Tests, Polymerase Chain Reaction, Viremia, Virus Replication." }, { "role": "user", "content": "Is lack of isolate-specific neutralizing activity correlated with an increased viral burden in rapidly progressing HIV-1-infected patients? Context: To delineate the interaction between in vivo HIV replication and host antiviral immunity during disease progression in order to elucidate the pathogenesis of AIDS. In a cohort of HIV-seropositive patients, the serum concentration of viral particles, the blood concentration of mononuclear cells harbouring infectious virus and the serum titre of isolate-specific neutralizing antibodies were correlated with the rates of CD4+ T-cell depletion and disease progression. Using a quantitative reverse-transcriptase linked polymerase chain reaction assay, the concentration of viral particles was measured in blood samples from 103 initially symptom-free subjects who were followed up for > or = 24 months. The concentration of infectious virus and the neutralizing antibodies to autologous HIV isolates were assessed in 37 out of the 103 subjects. The rate of decrease in CD4 cells over the 24 months was calculated for each subject. Rapidly progressing patients (rate of decrease in CD4 cells > or = 60%) had a high concentration of viral particles and a high concentration of infectious virus associated with an undetectable serum titre of isolate-specific neutralizing antibodies. Stable patients (rate of decrease in CD4 cells < 30%) had a low concentration of infectious virus and either a low concentration of viral particles with the absence of isolate-specific neutralizing antibodies or a high concentration of viral particles with the presence of isolate-specific neutralizing antibodies. Slowly progressing patients (rate of decrease in CD4 cells > or = 30 and < 60%) showed an intermediate profile." }, { "role": "assistant", "content": "Progression to AIDS is associated with a shift in the balance between viral replication and host immunity that increases the concentration of infected cells and destroys the CD4+ T-lymphocyte population. 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, RESULTS. Meshes: Cells, Cultured, Decidua, Endothelium, Female, Humans, Pre-Eclampsia, Pregnancy, Thromboxane B2." }, { "role": "user", "content": "Is in vitro human decidual endothelial cell thromboxane secretion in preeclampsia abnormal? Context: The aims of this study were to describe levels of thromboxane secretion by decidual endothelial cells from normal pregnancies and to determine whether decidual endothelial cell secretion of thromboxane, implicated in the causation of the hypertension and vasoconstriction of preeclampsia, is increased in this disorder. We measured thromboxane generation by cultured decidual endothelial cells from 13 normal pregnancies (NDEC) and 13 pregnancies complicated by preeclampsia (PEDEC), compared with a control population of 6 normal human umbilical vein endothelial cells (HUVEC). Responses to stimulation by bacterial lipopolysaccharide (LPS), tumor necrosis factor-alpha (TNF-alpha), and interleukin-1 beta (IL-1 beta) were examined. Thromboxane B2 levels in supernatants of cultured endothelial cells. The level of secretion over 24 h in culture by NDEC [14 (7-26) pg/10(6) cells] was approximately 25% that of HUVEC [63 (49-70) pg/10(6) cells]. Levels achieved in response to all stimuli examined were consistently lower in NDEC than in HUVEC (p < 0.01). Proportional stimulation by LPS and TNF-alpha was comparable in HUVEC and NDEC, whereas NDEC displayed a greater increase (25-fold) than HUVEC (10-fold) in response to IL-1 beta (p < 0.01). There were no significant differences between decidual endothelial cells from normotensive and preeclamptic women in basal secretion of thromboxane or in responses to the stimuli examined." }, { "role": "assistant", "content": "In vitro thromboxane secretion by decidual endothelial cells is lower than that of HUVEC, and responsiveness to specific stimuli may be quantitatively different. These findings emphasize the importance of examining endothelial cells from the involved maternal vascular bed if intrauterine vascular pathophysiological events are to be clarified. No significant differences were noted in decidual endothelial cell thromboxane secretion between normal and preeclamptic subjects. 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: PURPOSE, METHODS, RESULTS. Meshes: Adult, Age of Onset, Brain Mapping, Brain Neoplasms, Cerebral Cortex, Epilepsy, Temporal Lobe, Female, Frontal Lobe, Functional Laterality, Hippocampus, Humans, Image Processing, Computer-Assisted, Language, Magnetic Resonance Imaging, Male, Sclerosis." }, { "role": "user", "content": "Is language lateralization in temporal lobe epilepsy patients related to the nature of the epileptogenic lesion? Context: Early acquired lesions are considered to be a risk factor for atypical language lateralization in epilepsy, whereas developmental lesions are not. Hippocampal sclerosis (HS) can be understood as an early, acquired lesion, whereas developmental tumors (DT) are thought to originate in utero. We assessed whether language lateralization differs between these groups of temporal lobe epilepsy patients. We used 3-Tesla functional MRI (fMRI) to assess 41 patients (16 DT, 25 HS) and 50 controls, performing a noun-verb-generation task. fMRI data were processed by using SPM2. A laterality index (LI) was calculated based on the number of activated voxels in left- and right-sided frontal lobe language areas. Atypical lateralization was considered if the index was<or = 0.2. Patients had a lower LI (0.42 +/- 0.5) than controls (0.6 +/- 0.3; p<or = 0.05), but the LI was not different between DT (0.44 +/- 0.5) and HS patients (0.43 +/- 0.4; p = 0.9). The frequency of atypical lateralization was increased in patients (27%) compared with controls (8%) but was similar in both patient groups (DT, 31%; HS, 24%). HS patients had an earlier onset and longer duration of epilepsy and a higher frequency of significant antecedent events (p<or = 0.05)." }, { "role": "assistant", "content": "Patients with TLE demonstrate a deviation toward atypical language lateralization. However, language lateralization was not different between patients with presumably acquired lesions compared with patients with developmental pathology. This suggests that the nature of the temporal lobe lesion does not influence overall language lateralization." } ]

[ { "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 Plummer-Vinson syndrome" }, { "role": "assistant", "content": "The correct answer is PLUMMER-VINSON SYNDROME:- In Plummer-Vinson syndrome patients present with dysphagia due to web in the postcricoid region and due to incoordinated swallowing secondary to esophageal spasm. Text book of ENT Mohan Bansal; pg num:- 461" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVES, METHODS, RESULTS. Meshes: Cost-Benefit Analysis, Decision Making, Diagnostic Tests, Routine, Fibrin Fibrinogen Degradation Products, Financing, Personal, Humans, Models, Theoretical, Venous Thrombosis." }, { "role": "user", "content": "Evaluating the cost-effectiveness of diagnostic tests in combination: is it important to allow for performance dependency? Context: To investigate the importance of accounting for potential performance dependency when evaluating the cost-effectiveness of two diagnostic tests used in combination. Two meta-analysis models were fitted to estimate the diagnostic accuracy of Wells score and Ddimer in combination. The first model assumes that the two tests perform independently of one another; thus, two separate meta-analyses were fitted to the Ddimer and Wells score data and then combined. The second model allows for any performance dependency of the two tests by incorporating published data on the accuracy of Ddimer stratified by Wells score, as well as studies of Ddimer alone and Wells score alone. The results from the two meta-analysis models were input into a decision model to assess the impact that assumptions regarding performance dependency have on the overall cost-effectiveness of the tests. The results highlight the importance of accounting for potential performance dependency when evaluating the cost-effectiveness of diagnostic tests used in combination. In our example, assuming the diagnostic performance of the two tests to be independent resulted in the strategy \"Wells score moderate/high risk treated for DVT and Wells score low risk tested further with Ddimer\" being identified as the most cost-effective at the £20,000 willingness-to-pay threshold (probability cost-effective 0.8). However, when performance dependency is modeled, the most cost-effective strategies were \"Ddimer alone\" and \"Wells score low/moderate risk discharged and Wells score high risk further tested with Ddimer\" (probability cost-effective 0.4)." }, { "role": "assistant", "content": "When evaluating the effectiveness and cost-effectiveness of diagnostic tests used in combination, failure to account for diagnostic performance dependency may lead to erroneous results and nonoptimal decision making." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is not an RNA Virus:" }, { "role": "assistant", "content": "The correct answer is Simian virus 40" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHOD, RESULTS. Meshes: Adolescent, Age Factors, Amygdala, Bipolar Disorder, Brain, Child, Dominance, Cerebral, Emotions, Female, Genetic Predisposition to Disease, Hippocampus, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Parahippocampal Gyrus, Prefrontal Cortex, Puberty, Reference Values." }, { "role": "user", "content": "Subcortical gray matter volume abnormalities in healthy bipolar offspring: potential neuroanatomical risk marker for bipolar disorder? Context: A growing number of structural neuroimaging studies have shown that bipolar disorder (BD) is associated with gray matter (GM) volume abnormalities in brain regions known to support affect regulation. The goal of this study was to examine whole-brain regional GM volume in healthy bipolar offspring (HBO) relative to age-matched controls to identify possible structural abnormalities that may be associated with risk for BD. Participants were 20 youths (8-17 years old) with at least one parent diagnosed with BD, and 22 age-matched healthy individuals. All of them were free of Axis I diagnoses. High-resolution magnetic resonance imaging structural images were acquired using a 3-T Siemens scanner. Voxel-based morphometric analyses were conducted using SPM5. Relative to controls, HBO had significantly increased GM volume in left parahippocampal/hippocampal gyrus (p<.05 corrected), following whole-brain analyses. This increase was correlated with puberty but not age in HBO. Region-of-interest analyses on the amygdala and orbitomedial prefrontal cortex did not yield any significant group differences after conducting small volume correction." }, { "role": "assistant", "content": "The pattern of increased GM volume in parahippocampal/hippocampal gyrus in HBO suggests a potential marker for risk for BD. It can also be considered as a potential neuroprotective marker for the disorder because HBO were free of current psychopathology. Prospective studies examining the relationship between changes in GM volume in these regions and subsequent development of BD in HBO will allow us to elucidate further the role of this region in either conferring risk for or protecting against the development of BD." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: African Americans, Aged, Aging, Attitude to Health, Behavior Therapy, Exercise Therapy, Humans, Middle Aged, Osteoarthritis, Program Evaluation, Self Care, Treatment Outcome, Walking." }, { "role": "user", "content": "Do impact of the Arthritis Foundation 's Walk With Ease Program on arthritis symptoms in African Americans? Context: Inadequate program design and lack of access to evidence-based programs are major barriers to the management of chronic diseases such as arthritis, particularly for African Americans. This study evaluates the effectiveness of the Arthritis Foundation's Walk With Ease Program (WWE) in a subsample of African Americans who were part of a larger study that established evidence of the program's efficacy. Participants were African Americans (N = 117) with self-reported arthritis who chose to participate in either a self-directed (n = 68) or group (n = 49) 6-week WWE program. Arthritis-related symptoms (ie, pain, fatigue, stiffness; measured using visual analog scales) were assessed at baseline, 6 weeks, and 1 year. Independent samples t tests were conducted to examine group differences (ie, self-directed vs group) in arthritis-related symptoms at baseline, and paired sample t tests were conducted to examine differences over time (ie, baseline to 6 weeks and baseline to 1 year) in symptoms. Satisfaction was examined by descriptive statistics. Younger, more educated individuals chose the self-directed format (P < .001, P = .008; respectively). After the 6-week intervention, participants reported a decrease in pain (P < .001), fatigue (P = .002), and stiffness (P < .001). At 1 year, the decrease in pain (P = .04) and stiffness (P = .002) remained constant. Overall, participants were satisfied with both program formats." }, { "role": "assistant", "content": "The individualized and group formats of the WWE program improved arthritis-related pain, fatigue, and stiffness in African Americans. Culturally appealing arthritis interventions ultimately may increase the use of existing arthritis interventions. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is the exact mechanism of action of NO" }, { "role": "assistant", "content": "The correct answer is Nitric oxide is produced by nearly every type of cell in the human body and one of the most impoant molecules for blood vessel health. It's a vasodilator, meaning it relaxes the inner muscles of your blood vessels, causing the vessels to widen. In this way, nitric oxide increases blood flow and lowers blood pressure" } ]